It sounds like those who did NOT take ADHD drugs had better heart conditions, regardless of whatever caffeine, cigarettes or whatever else they use. It is apparent that the effect is due to stimulant drugs, not other lifestyle issues of non-stimulant users, as these ought to push the needle in the other direction than what they found.
I would also remind you that “people who have ADHD” is not a scientifically definable variable. If you mean people DIAGNOSED with ADHD, it might be a good habit to clarify that. Folks are diagnosed for all kinds of reasons, and again, there is no scientific way to differentiate them from each other as “having” or “not having” ADHD or any of the other DSM “diagnoses.” It is difficult to really evaluate the scientific studies without keeping this important fact in mind. We are not working with a well-defined homogeneous group here, and the only clear variable is drug usage.
I recall some interviews done with working class folks about why they did not relate to therapy. A lot of them said that they’d feel a lot less depressed if they could pay their bills every month and didn’t have to worry about getting food on the table. Talking about how they felt about being poor didn’t really help much!
Are you suggesting that long-term use of psych drugs can cause dependence and that withdrawal can be dangerous as the client’s brain is adapted to having the drug and has a very hard time adjusting to a withdrawal period? I’ve heard from many folks that very slow withdrawal is essential for them as individuals, and also known of a few who really could not get off because the withdrawals were so bad. It’s another great argument to avoid long-term use of these drugs if at all possible, as Whitaker’s research suggests.
I remember reading that the vast majority of doctors don’t believe they are affected by drug company advertising, while the reality is the vast majority are strongly influenced. Believing that one is NOT susceptible to manipulation makes one much MORE susceptible to manipulation!
There is no delete function. Reporting a comment should bring it to my attention, though it doesn’t always work for some reason. If you want to not have a comment published, the thing to do is to contact me via email and let me know the date, time and beginning content of the post, and I will simply not approve it for publication.
First off, I am the last to deny there is real SUFFERING out there. That is not in question. The question comes down to how one views and deals with this kind of “mental” suffering.
ALL of the labels in the DSM are voted on. They are not scientifically verifiable entities, they are the results of clinicians “agreeing” on a particular set of “criteria,” which is generally a very subjective list of behaviors or thoughts or emotions that have no necessary connection to one another or any kind of “illness.” So they have no more legitimacy than “Seriously Emotionally Disturbed,” which basically means the person (usually child) says or does things that we find upsetting, confusing or inconvenient as adults. Take “ADHD” for example – one of the criteria is “acts as if driven by a motor.” Another is “Incapable of staying seated in class.” Another is “squirms when seated or fidgets with hands/feet.” Another one is “Sidetracked by external or unimportant stimuli.” Can you see that these are all simply judgments passed by an adult on a kid’s behavior? How many kids squirm or fidget? Who gets to decide what are unimportant stimuli?
But kids get this label and they are looked down upon, told they have dysfunctional brains, told they CAN’T pay attention, given controlled substances (essentially speed-like drugs) to “control their impulses,” etc. Note that there is NO attempt to ascertain WHY the child might fidgit – bored, uncomfortable chairs, dealing with trauma at home (foster kids get labeled at a MUCH higher rate), simply not a good fit with the teacher’s style? NO, it is all blamed on the kid for being inconvenient.
A similar analysis can be done for any of the labels. Scientific studies show that attributing “mental health problems” to disorders of the brain increases “stigma” (a euphemistic way of saying bias and prejudice and discrimination) and that teachers and other adults treat these kids differently once they know they “have a disorder.” Consider alone the shame of being asked in public by a teacher or parent, “Did you take your meds today?” There is a lot of shaming involved in the process, and since it has no scientific basis, I consider this kind of label just as irrelevant and damaging as saying a person is “Seriously Emotionally Disturbed.” It’s a pejorative disguised as a “diagnosis”. Look at some of the writing about “Borderline Personality Disorder” to see just how bad the discrimination can get.
Again, not saying that these behaviors and emotions don’t exist, or that people don’t need help dealing with difficulties. But the DSM labels are pseudoscientific crap voted on in committees, totally lacking in any scientific validity. Even the one-time head of the NIMH admitted this was true.
Sure, “Bipolar disorder,” “ADHD,” “Major Depressive Disorder,” “Borderline Personality Disorder,” pretty much anything in the DSM is simply a made-up label for a condition that psychiatrists and others don’t actually have the slightest understanding of. These “diagnoses” are arrived at through subjective behavioral checklists that bear no scientific relationship to any bodily process, but are simply behaviors that we find annoying, unpleasant, or difficult to deal with. Not saying that a person labeled “schizophrenic” has nothing wrong with them or doesn’t need our help, but calling them “schizophrenic” provides no additional useful information and makes it easier to dismiss them as having no value or rights to autonomy.
There are several “diagnoses” where two people can have ZERO “symptoms” in common and yet both qualify for the label! The whole thing is a scam in my mind, and is far worse than the dangerous medications these labels are used to justify forcing on an unsuspecting public.
I always find it fascinating how they claim that brain chemistry faults cause “depression,” but when they want to induce depression in rats or other animals, they always put them under stress and fear for their lives! It’s almost as if traumatic experiences cause the animals to be depressed…
Honestly, I agree with you, but “EDP” is in the end no worse than many of the other labels that are considered more “politically correct.” Labeling other people as a means of “understanding” them is always offensive.
I totally get this. It irks me no end when someone who has had PLENTY of the “best psychiatric care” has some disastrous outcome, and they call for more funding for psychiatric care. Robing Williams is a great example. If it worked so well, why did the person choose to end their life? Either it didn’t work, or it CAUSED the damage! More “mental health care” seems the last thing that is indicated!
So sorry you had to go through all that. I hope you’re doing better!
Maybe. Or “Scientism” is one of my favorites – the belief that anything “sciency” must be true, regardless of the facts. If there are a few brain scans in an article, people are apparently more likely to believe it, even if the scans have no connection to the article!
I just want to add that “bad science” is NOT actually science at all. It’s pretending to use science to explain why a person’s viewpoint is true even when the actual science says otherwise. In other words, it’s fraud!
I think “Biological Psychiatry” is much more than that. It is the ASSUMPTION that ALL “psychiatric disorders” as defined by the DSM are CAUSED by biological malfunctions and can only be “treated” biologically. An example is the insistence that “major depression” is caused by a “chemical imbalance” despite decades of evidence to the contrary, an insistence broken only very recently and now replaced with some concept of “circuitry” which again is not actually supported by science. It is the insistence that “broken brains” are the reason for all “disorders,” regardless of social conditions or traumatic history. And yes, there are plenty of psychiatrists who practice exactly in this manner.
I am afraid I have never been in that situation. Maybe some of our other experienced folks can contribute some ideas? I just know it’s often a lose-lose situation without getting some kind of outside advocacy. I have no idea if such advocacy is available to you, though.
I suppose getting an independent doctor who disagrees with the prescriptions or supports your autonomy might also be helpful, but again, I don’t know how possible that is.
Nobody asks if their cancer diagnosis is “beneficial.” It is what it is and is objectively diagnosed and you can’t decide you like or don’t like your diagnosis. (Well, you can, but it doesn’t change it!) The concept that “receiving a diagnosis may be beneficial” shows how far these folks are from an objective understanding of what is going on. But yeah, you often need a “diagnosis” to get help. It’s a very strange phenomenon to me.
But as long as AI is fed “data” from corrupt sources, it will turn out corrupt answers. It will never be in a position to say, “Wait, this asshole is lying to me for his own profit!”
The problem I see is the idea that “peers” should “be included” by… well, by those with the power in the system to decide to include them or not. Peers should not be “included” – the “peer perspective” should be the CENTRAL one that drives what we do. Doctors’ or professionals’ views can be “included” if merited, but only if the clients believe they have value. The basic institutional change we need is to stop giving doctors and other “professionals” the right and the power to decide if the “peer perspective” is worth their time. Peers don’t need to be RECOGNIZED, they need to be EMPOWERED and there needs to be no discussion of whether to “involve them” in decision making. Clients need to BE the decision-makers, or we will continue to have the power-hungry and arrogant “opinion leaders” assuring us with little pats on the head that they’ve “included the peer perspective” while they continue to do whatever they want, however misguided, damaging or corrupt.
I felt I was doing good things. When the bad outweighed the good, I had to stop. But I really respect those who are in the trenches or behind “enemy lines” because people need help NOW and it’s the only way I know those in the system can get support.
I am talking from experience here. I was inside the system with a totally different philosophy than those who were running the show. I was not confused particularly, but I was certainly disheartened by the kind of pressure and discrimination I experienced when I failed to “get with the program.” A lot of it was simply isolation – folks were “He’s an anti-med guy” and ignored many of my comments and observations. I was able to fight for clients in specific situations and provide something that others did not, but it was pretty exhausting. At a certain point, I realized I was supporting an oppressive system by even participating, even if I was doing some effective damage control, and decided I had to get out of there. But I would not say I was confused. Just annoyed, disheartened and infuriated!
I don’t agree. I think the system is organized to create confusion, and a lot of folks are simply confused. There are a small but powerful number who DO enjoy creating confusion – otherwise known as “narcissists” in their own parlance. These folks are in charge of the big decisions (opinion leaders) and support and create the system as it is. They are the ones who put out the propaganda and attack those who dare to challenge the “status quo.” Such people do absolutely exist at the lower levels of organization (the system itself attracts such people), but there are plenty who want to do the right thing and are simply confused by the propaganda and peer pressure within these organizations. There are also rebels “behind enemy lines” who do really good work and deserve credit for doing so despite the pressures and discrimination they face.
It is simplistic to assume ALL “mental health” workers have anything in common. It is absolutely not supportable to assume that creating confusion is a goal of all or even most “mental health” workers. I think most of them are more confused than we are!
The best solutions make things feel simpler, not more complex. One of the sure signs that the DSM is off base is the ever-increasing complexity of the system over time. Not to mention the ever-increasing numbers of “mentally ill” according to this system.
Just to be clear, there is no evidence that anyone’s depression is caused by a “serotonin deficit.” Why SSRIs work as antidepressants for some people is not scientifically understood, but it’s not because of a “chemical deficit” in the brain, that much has become clear.
It is an attack to pretend someone is proposing something they are not and criticize them for it. Strawman argument. Study logic sometime. And read the damned book!
It is childish at best to respond to the question, “Why did people with worse prognoses do better on less APs than those with worse prognoses on more APs” with “Longitudinal studies aren’t worth much.” That is an emotional argument not a logical one, which is why I’ve decided there’s no point in trying to have a rational conversation on this subject with you. As a wise man once said, “The first barrier to learning is thinking you know all about the subject.”
See how you attack anyone and anything that you don’t agree with, and use emotional arguments? Did I say to take everyone off their antipsychotics? Why raise these pointless straw man arguments if your case is so strong? Why not just present your evidence?
Of course it’s longitudinal, how else do you look at long term outcomes?????
The facts are there. You don’t care to learn. That’s your choice, but don’t claim I said things I did not.
You clearly didn’t really read Harrow. Whitaker has a fantastic analysis which sinks your argument fully, though clearly the psychiatric establishment grasped at that straw, and I’m guessing that’s what you are responding with rather than your own analysis.
Harrow identified 4 groups: bad prognosis on aps, bad prognosis off aps, better prognosis on aps, and better prognosis off aps. The outcomes sorted this way: better prognosis off aps, bad prognosis OFF aps, better prognosis ON aps, worse prognosis on aps.
If the worse prognosis clients off aps do BETTER than the better prognosis ON aps, that’s the opposite of selection bias.
But I doubt you will bother to revise your statement. So far, you only take positions that support your narrative. If we can’t have a rational exchange about this, I’m done with this conversation. Your position has been thoroughly undermined for anyone who actually cares about science.
They still SOMETIMES work for SOME PEOPLE. And it kind of depends what you mean by “work.” Read up on long-term studies, the folks who manage to avoid antipsychotics or use them sparingly do significantly better in the long run. This is shown in more than one long-term study. Again, your tendency to generalize make a lot of what you say of lesser value than it would be. It’s not so black and white as you want to believe.
I had a client in foster care (we were her CASA advocates) who was diagnosed with diabetes. Here CASA volunteer got them to discontinue her Seroquel (antipsychotic). Next visit, her diabetes was gone. Thank God for the CASA!
In contrast, studies on instances of suicidal behavior from weeks 1 to 10 found no significant difference in efficacy between SSRIs, non-SSRIs, and placebo. These results indicate that SSRIs MAY offer short-term protection against suicidal ideation. However, their long-term effectiveness in mitigating suicidal ideation and preventing suicidal behaviors is limited.
So this is one meta-analysis claiming no INCREASE in suicidal effects on children or young adults. It certainly doesn’t suggest that SSRIs reduce suicide attempts or thinking. Of course, there are other meta-analyses that show that there IS an increase in suicidal thinking, or there never would have been a Black Box Warning in the first place. So your one meta-analysis is evidence, but not much, and certainly does not address your initial claim of decreased suicide attempts/thoughts resulting from SSRI use overall.
“Everyone here” is an all-or-nothing blanket statement, Corey, so it seems you are displaying a bit of hypocrisy yourself here. Plenty of folks, including the Author, Robert Whitaker, (and me) take a much more nuanced approach. Read some of the articles by Johanna Moncrief, for instance.
“Fact SSRIs lower suicidal thoughts reducing suicides.” You believe this, but it is NOT a fact. Look at the work of Irving Kirsh and others. Prozac was initially not approved for sale in Germany due to increases in suicidal and violent thoughts/actions in some people. I am aware of no literature review that concludes “SSRIs lower suicidal thoughts reducing suicides.” (In fact, the best reviews I have seen suggest that only about 30% of users benefit significantly from taking antidepressants.) There is a black box warning about increased suicidal thinking in youth and young adults, hardly evidence of reduced suicides.
Do you have something to share along those lines to prove your claim? Or is that just what you believe to be the case? Have you ever read Whitaker’s work? Maybe you should have a good read before you draw unwarranted conclusions!
It sounds like you are making a lot of assumptions yourself. Why do you feel such an urge to defend these drugs? Why not read and listen for a while and maybe learn that the situation is more complicated than you want to believe it to be?
THAT feels creepy to me! Thanks for sharing your story. If she doesn’t want to take notes, she should use a Dictaphone like doctors always have. AI is NOT appropriate for this!!!!
That one should have to SUGGEST “shared decision making” as if the PRACTITIONER gets to decide whether or not to “share” their power says a hell of a lot about the “diagnostic” and “treatment” process!
The problem with “recovered memories” is when the THERAPIST tells the person they have such memories but doesn’t remember them. People come across incomplete fragments of real memory all the time that can be fleshed out by good listening in the right venue. I had this happen to me – I was hit in the head by a teacher in second grade. I always remembered the incident vaguely until right before the hitting part (including her tossing a book across the room), then blanked out until I was in the hallway. I shared this with another student in the class at my 30th reunion, and she remembered the whole incident, including my being hit by the teacher! After hearing this, I recalled the kid who was tossed in the hallway with me, I recalled being sent to the nurse by the secretary, I recalled being outside the principal’s office hearing him and the secretary chatting, with Freddy sitting next to me. I have no doubt these are real memories I recovered because someone validated MY story. But no one told me they happened, I had to recall them myself.
No one should evaluate someone else’s experience or tell them memories exist that they don’t recall. But it is very much possible to recover memories of things that a person has forgotten. It happens all the time.
You are talking about prejudice. That’s why I hate the word “stigma,” it minimizes the intent and the damage done to people.
You should know that viewing “mental illness” as a biological condition has been shown in multiple studies to INCREASE prejudice and decrease empathy for the “mentally ill” persons.
The problem, Renate, is that not everyone experiences antidepressants the way you do. As I said before, everyone should do what works for them. But because it works for you does NOT mean it works for others, and you should be careful not to state or imply that. If “Depression” were a clear-cut, identifiable disease state, we’d be able to predict who would and would not respond to antidepressants in a positive manner. But we can’t, because “Depression” is a vague and subjective concept that does not describe a group of people who necessarily have ANYTHING in common besides how they are feeling. Just to clarify – you were seriously depressed starting at a young age and have not identified any trigger or event that changed that for better or worse. Do you think that is the same as a kid in foster care being seriously depressed because his mother abandoned him at a young age, or an aging adult who is depressed about his/her life deteriorating and losing abilities, or someone who is in chronic, unresolvable pain and does not want to get out of bed every day because their life seems so hopeless? I’ve seen kids in foster care who are far WORSE after taking antidepressants, including being aggressive, suicidal or psychotic. I’ve seen doctors not listen to them or their advocates because they believed that antidepressants are “the answer” for all forms of “Depression,” regardless of the cause.
You seem an intelligent and rational person. Surely, you can see that “Depression” is far to vague to be viewed as a single entity, and that there can be many reasons for being severely depressed, and as many possible solutions as there are people suffering?
I would never want to take away something that works for you. I just want you to see that other people don’t have the same experience and for good reasons are very suspicious about antidepressants as a solution for ALL cases of “Depression.”
I sort of agree, but I think the process is more one of removing inhibitions based on talking to lots of ‘users.’ I remember one in particular who took Zoloft for migraine headaches, not depressed at all, saying that she’d run into situations and be going over possible solutions and would think, “I could kill myself!” She was shocked at herself for even thinking such a thing, and totally attributed it to the Zoloft.
So if a person is feeling inhibited, as in I can’t stand up to my mom or I feel I have to act a certain way to keep others happy, taking SSRIs might seem like a relief – who cares what mom thinks, those others can shove it! But what if the person is inhibiting wanting to kill themselves, but is staying together by saying, “I can’t do that to my kids” or “I don’t want to leave a mess for others to sort out, it would be selfish?” Removing those inhibitions could result in, “Ah my kids are better off without me” or “It won’t be my problem, I’ll be dead” or similar justifications. And Lord help us in the rare cases where the person is inhibiting the thought of hurting or killing others by thinking it would be too horrible a result. That kind of inhibition, we WANT people to keep!
That’s how I see it working for some people but being a total disaster for others. It depends if removing inhibitions works in your favor or against you. And I have personally seen both happen.
When working with foster youth, I saw a large number of cases where prescribing stimulants led to aggressive behavior. I saw one VERY clear example of psychosis being induced by stimulants. A study I’m familiar with showed 6% or so of kids who were prescribed stimulants had psychotic behavior or thoughts recorded in their files. This is a very real phenomenon.
The conclusion is not that all psychiatric drugs are bad for you, it’s that “information” coming from drug companies regarding their drugs can not be trusted based on long experience. Benefits are overplayed, adverse effects are buried or minimized, and outright propaganda is put out as if it were fact. Everyone has to make their own decision about a particular treatment, and drugs are not “good” or “bad” in the absolute sense of those words. They work or don’t work for a particular person. There is no special way to “diagnose” people and thereby determine who will “benefit” – it is simply a matter of trial and error, and we’d all be better off if doctors were honest about this instead of pitching drug company propaganda (such as the “chemical imbalance” concept) as if it were factual.
You make the simplistic mistake of assuming that all “psych patients” are “mentally disturbed” and do “insane disturbing things.” This is rank bigotry, Andy. The vast majority of “psych patients,” in particular depressed individuals, do NOT engage in doing “insane, disturbing things.” Most in my experience AND in statistical studies are actually quite safe, and are much more likely to be victims than perpetrators of violent incidents. This is particularly true for female patients. School shooters tend to be young and male. There isn’t a lot more that they have in common with each other statistically.
As for SSRIs and violence, this is not new information. SSRIs were initially banned in Germany for inducing violence and aggressive behavior back in the late 80s, in people who did NOT have that kind of problem to start with. I don’t think it’s appropriate to ever pin a particular crime on SSRIs, but the correlation is not made up. It’s a very small number, but it does happen. Look at the Germanwings plane crash for a good example.
I am not a fan of RFK, Jr, but again, “explaining” things by blaming the patients is an immature and cowardly approach to the problem. I think we’d do better to do some honest research and to add appropriate warnings if need be.
Doctors can prescribe any FDA approved drug for any indication they can find. The only way to “take away” a drug is to have the FDA withdraw their approval for that particular drug. Since drug companies contribute to both sides of the aisle heavily, it is very unlikely that any such drugs will be withdrawn from the market. Think how hard it was to even get a well-researched warning put on antidepressants. Banning them? Nothing to worry about, IMHO.
Your premise sounds more like “being male contributes to violence,” not “depression. If young women are equally depressed but NOT committing school shootings, than “depression” per se is not a variable. Being young and male most definitely is.
For the record, #1 is a completely false premise. But I tend to agree with you overall. I’d say that SSRIs play a role in a very small number of cases, and many other factors are involved even if SSRIs do contribute in some way. It’s certainly no argument for banning ADs, but it may be one for adding some informed consent. See the Germanwings plane crash for a fairly clear case of probable SSRI contribution to a disaster.
1) The observed differences are AVERAGES, they are essentially correlations. There are plenty of people diagnosed with “ADHD” who do NOT have the expected differences, and there are people who have the differences who do not display “ADHD” behaviors.
2) These studies rarely if ever take prior medication use into account, which is a confounding factor in a huge percentage of anyone in the diagnosed group. Stimulants have been associated with changes in brain volume and functioning, which have often been attributed to “ADHD.”
3) Many fMRI studies are measuring brain ACTIVITY, not structure. Variations in activity in certain areas may be an artifact of environment and not differences in the brain at all.
Additionally, the fact that some genes may code for more active and less sedentary personality styles does not automatically make such genes “malfunctioning.” Having raised two kids (out of three) who would qualify easily as “ADHD,” I can say with confidence that both have great strengths which the non-“ADHD” population lacks in general. Both ended up being successful in school by using alternative classrooms that allowed a lot more exploration and movement. Both graduated with honors from high school, the youngest graduated with honors from Evergreen State College!
I ran across a VERY interesting study a while back. They set up groups of three kids (elementary age) with one kid diagnosed with “ADHD” in each. Control groups had three kids, too, but no “ADHD” kids. They gave them three problems to solve in a given time. They measured on-task time and successful completion. The control groups scored significantly higher on “on-task” percentage – they kept their figurative noses to the grindstone and worked hard. But none of them solved any of the three problems. Whereas ALL of the study (“ADHD”-including) groups completed at least one problem, and at least one completed all three, even though these groups goofed off a lot more than the control groups!
Of course, if the groups had three “ADHD” kids each in them, they’d have probably got nothing done at all on the problems! But I think the study showed what I believe to be true – we need these active, creative, fun-loving, goof-off moments to have healthy groups of people, and there is nothing wrong with someone who tends to play that role in society. After all, if 10% of people have a particular trait, it must have some survival value, mustn’t it?
None of which argues against your using stimulants, or anyone else, if they feel it is helpful. I think it’s just important to know that there is more than one way to look at this set of traits than to view it as an aberration or disease state.
I hope that was at least an interesting read for you.
It does not. But saying “Correlation is not causation” does not mean the correlated events are NOT causally related, merely that you have not proved it. In my world, it’s the job of the drug manufacturer and the prescribing doctor to ENSURE the drug is safe. If it is not, or is even SUSPECTED not to be, it becomes a matter for informed consent immediately. Something as simple as, “A very small number of people don’t seem to react well to this drug. If you find yourself suddenly thinking about hurting yourself or someone else, please call IMMEDIATELY and we will address it.”
Then, of course, when you DO get that call (like the Germanwings pilot), you have to not pretend “it’s part of the disease” and DO something about it. “Wow, it sounds like you are finding this drug is not working for you! Let’s come up with another plan!”
It’s really not that hard. But it starts with being honest.
I agree 100%. “Wellness camps” sound bad enough if you went voluntarily!
I am opposed to involuntary “treatment” in any circumstance, as I don’t regard it as “treatment” if the client is not a willing participant. I realize that sometimes people have to be prevented from harming others or endangering society (wandering into traffic, etc.) but that does not justify forcing drugs or “wellness camps” on people who are unwilling or uninterested in such “treatment.”
There is nothing wrong with taking pills. MIA’s mission includes scientifically-supported use of medications. Of course, individuals are entitled to express whatever opinions they see fit, including plenty reporting positive results of taking medications. MIA is intended to be judgment free in that regard.
I said nothing of the sort. I said that you can’t extrapolate from your own experience to that of others (which clearly you can not), and I said that no one is coming to take your ADs away from you (which clearly no one is). These are statements of fact. I certainly have no thought that sending you to a “camp” of some sort being advisable, in fact, if you are satisfied with what is happening with your current treatment, why would they want to send you anywhere? They are sounding like the ones with the issues. I fully support you in doing whatever works for you. I just can’t agree to blame violence likely caused or exacerbated in rare cases by antidepressants on those unknowingly taking pills with such adverse effects.
Look into the Germanwings plane crash if you want a really solid example. The pilot TOLD his psychiatrist he didn’t feel right taking these drugs, but the psychiatrist ignored him, didn’t change his regime and continued to allow him to fly. The results were devastating.
That’s what happens when we pretend an adverse effect doesn’t happen when the evidence says it does. It has nothing to do with individual experiences or banning of drugs. It’s just about being honest about the data.
Or, people with ACEs may be more likely to react adversely to SSRI antidepressants and other drugs. I will repeat that the experience of “depression” in particular is RARELY associated with violence of any sort. It is usually associated with withdrawal and passivity. There is absolutely no reason to expect a rash of mass murders from depressed people. SSRIs appear to be a strong variable. They clearly don’t affect the majority this way, but as I noted earlier, Prozac was initially banned in Germany due to causing violent episodes. This is not being made up, and let’s not let SSRIs off the hook for their role in creating a more violent world! Blaming it on the victim once again is not an acceptable explanation.
Just because you love them doesn’t mean others aren’t adversely affected. The percentage who become violent is apparently small but does exist. Prozac was initially banned in Germany because of data suggesting a small but significant number of people who became quite deranged taking them.
Besides which, depression has NEVER been highly associated with aggression and violence. Depressed people tend to be withdrawn and more passive than the average human. You can’t blame “depression” for this result, even if it makes you really uncomfortable.
And BTW, no one is coming to take your SSRIs. So let’s relax and look at the data instead of our emotions!
I agree with you. A reduction in suicide compared to other methods (and how has he measured this? I don’t think he says…) might just as easily mean that fewer people are driven to suicide by this method vs. the standard. No “treatment” could very well still be superior. Since most people spontaneously recover from depressive episodes, our baseline ought to always be “untreated.” But hey, who can make money by NOT treating people? Maybe we should make it like farm subsidies – you get paid for NOT treating patients and leaving them alone!
That’s what is so great about Rat Park! Instead of seeing how they act when abused or neglected, they look at how rats act when treated well in a super supportive, rat-friendly environment!
All pending comments I see of yours have been approved. If I am missing something, please contact me by email NOT via a comment like this one, with date, time and partial text so I can identify the post in question. Asking here why it’s not been approved is a violation of our posting guidelines. Please stop doing this!
Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
I’m not sure the system is “broken” so much as that it doesn’t really have the same objectives as it claims to have. Keeping folks under control is a big part of the agenda, and “healing” is something they gave up on a long time ago, if they ever really had that as a goal at all. Someone who thinks electrocuting people into having a grand mal seizure is good “treatment” for anything is not really interested in helping you get better!
The duty to inform is very often disregarded, especially in the “mental health” fields.
When did I advise a person who is depressed to study holy scriptures? I’m afraid you have literally no idea what I’m talking about. I understand you are a “physicalist” as you put it, and I believe that blinds you to the ability to understand that the CAUSES of any “mental disorder” are actually unknown, no matter how many scans you want to do. You are ASSUMING the cause is in the brain, and therefor the consequence is diddling with the brain. The results of such reasoning have so far been fairly disastrous, if you believe the literature (including Anatomy of an Epidemic). A true “duty of disclosure” would mean admitting “we are treating an entity we don’t really understand.” I doubt very much anyone hears this from their doctor.
You are, of course, welcome to express your own philosophy, however, scientific proof of such ideas remains a long way off, if we go by the literature on success rates and damage rates and even diagnostic consistency and so on. (If these scans are so great, why aren’t they being used for “diagnosis?”) You’re not going to convince me by repeating your beliefs over and over again without bothering to try and understand where I am coming from. Probably not worth further discussion, as you seem quite certain of your ‘rightness’ and I doubt will hear me, and I am certainly not going to be convinced by your kind of arguments.
You again conflate function with structure here: “This doesn’t change the fact that a depression is not a mental state you can invoke within a blink of an eye but structural or functional deficits of your brain and such malfunctioning parts of your brain can be exposed by imaging methods.” The fact that SPECT images of “depressed” brains are similar in some respects does not imply structural differences, nor does it imply malfunction. I certainly never would suggest that depression can be overcome by thinking of different events, but that’s not what I said. Depression is a very complicated condition. The brain is clearly involved but to imagine people only get depressed because of “bad brains” is not consistent with observation, otherwise, why would it be so much more common in people with abuse histories?
And you are right, avoiding psychiatry seems like the smart path to me. I don’t think being a “physicalist” is necessarily a more rational position, though you seem to imply those who aren’t are being foolish. Being a “physicalist” is a belief system or philosophy. You are welcome to your own philosophy, of course, but that doesn’t make it any less a belief system than any other philosophy. I would prefer working with people who recognize my agency as a human being rather than seeing me as some sort of chemical machine.
It sounds like we generally agree on all that. My only objection is that I don’t believe that “mental illness” as currently understood (or misunderstood and labeled) generally requires “treatment” of the brain per se. A person who is suffering can have a perfectly sound and functioning brain. Spiritual/emotional pain is something that I believe extends well beyond the brain, and “treating the brain” to handle most of it is like replacing memory chips to fix a computer programming error. Until we get away from seeing the brain as the problem, and start looking at social conditions, we aren’t going to get far with even the best technology, because I think we’re barking up the wrong tree!
Brain ACTIVITY is not the same as brain STRUCTURE. A brain may be DOING certain things while depressed and those ACTIONS may be reflected in measurements of activity (PET and SPECT scans, for instance). However, a) these scans say ABSOLUTELY NOTHING about the reason the brain is behaving in a certain way, only that it is and b) it has been shown that changing what one is thinking can change the PET scan, hence, thinking of a depressing topic creates a certain pattern, while the same person thinking of something cheerful changes the pattern instantly to something else.
All that being said, there is NO CONSISTENT PATTERN that is associated with all cases of depression, or even most. Same with ADHD or other “disorders.” This is why these are never used in diagnosis, except by charlatans who take advantage of people’s vulnerability. They simply fail completely in being able to understand or predict the CAUSE of any psychiatric “condition,” and this will not change, as they measure ACTIVITY alone.
Of course, these “disorders” are defined by social expectations and judgments in the first place, not scientific criteria, so why anyone would expect any brain measurement to “diagnose” them is puzzling. Clearly, we have the cart before the horse here – we are supposed to find the proximal cause of a condition before assuming we can “diagnose” it concretely. For all we know, there could be 25 different reasons people become depressed, all of which result in similar brain scans. As long as that’s the case, the idea of diagnosing by scans will remain a pipe dream, IMHO.
Please try to keep the condescension out of any response, it is not appropriate.
You are assuming that all “depression” comes from some biological failure of the brain. There is, of course, absolutely no evidence to show that claim to have any validity.
I’m going to let one more post stand on this topic. Larry, if you have any validated links or literature to share that Mark can read, please help us out and do so. If not, it sounds like you’ve answered Mark’s questions and I’d like to leave off with one more post. The discussion is really quite far off the original topic.
Any therapist who thinks it his/her job to “keep the conversation going” is an idiot. Silence is really important in a good, supportive conversation. It allows important things to surface!
Does knowledge of the brain even have a primary place in this discussion? Are we really talking about “illnesses” if these “illnesses” are socially defined?
They seem to mean that they expect people to get better but they get worse instead. A paradox only if there is a rational expectation that the initial “treatment” should work. That seems to be a large part of the “trick” of selling psych drugs. Make an open claim that they “work” and then call failures “resistance” or “paradoxical” instead of just admitting they were wrong!
Walter, if you read carefully, you will see I am not generalizing, merely pointing out that the Deaf community IN MY EXPERIENCE is not monolithic in its views on “normalcy.” I am advocating for listening TO the Deaf community and its individual members to understand, rather than using “ableist assumptions” (including assuming that a member does or does not view him/herself as disabled) to characterize its members. Some do and some don’t view themselves as disabled. I’m not even disagreeing with the prior poster. This is true whether or not the prior poster identifies as part of the Deaf community.
How can the author state there have been “advances in treatment options” when it is clear that the “treatment options” are not resolving the problem? Wouldn’t an “advance” in treatment mean a DECREASE in the number of sufferers??? I think the authors miss the point. As Robert’s research demonstrates, the ADs tend to be COUNTERPRODUCTIVE, a form of ANTI-TREATMENT for many people. When the best estimates of “success” show rates of 30%, and even then with very small improvements that may not even be clinically significant, it’s hardly appropriate to call “treatment failures” a “paradox.” They are evidence that the treatment doesn’t work!
It’s not a “paradox” unless there is reason to expect the “treatments” to be effective. In this case, it’s simply evidence of either treatment failure, or a hidden agenda to create more customers!
Please email me at [email protected] and let me know the details. A delay of one day is normal, as there is only one of me and I don’t always get to this more than once a day. If I said something was duplication, it means you made another comment saying something the same or very similar. If that’s not the case, I can fix it, but I need to know the thread, preferably the date, and the first sentence or so, so I can make sure I identify the correct comments.
Unfortunately for your theory, it appears that these drugs “sculpt” the brain in most unfortunate ways that are not always repairable. We also know from experiment that activities we engage in, such as meditation, do literally alter the structure of the brain, possibly in just the ways needed. Buddhist monks, for instance, have been shown to have certain parts of the brain associated with calmness and focus are more active than the average person.
Neuroplasticity has been shown throughout the brain, namely that brains are altered by experience, both in the negative AND in the positive. And as I recall, the most healing thing for a child damaged by abuse/neglect is not a drug, but a healthy relationship with caring adults. It literally heals the brain.
So the idea that those damaged in their brain region by abuse/neglect are not capable of healing and need drugs to survive is not supported by science. Whitaker’s work demonstrates that in the long run, psych drug use does more damage than good. Have you read Anatomy of an Epidemic?
I have worked with foster kids, and many of them are remarkably calm in a crisis. I think it’s something you learn if you live in a chaotic environment as a survival technique. But of course, not everyone has that skill. It amazes me how clinical people with experience still believe you can predict someone’s behavior reliably based solely on their “diagnosis.” There are LOTS of differing reaction to stressful events, and no one should get to tell another person, “Your event isn’t stressful enough to be called a trauma.” The client is the one who knows what is bothering him/her and ultimately holds any solutions to problems that exist.
BTW, I was also a social worker, very calm in a crisis, but I sort of thrive when crisis comes compared to regular life. Used to manage a crisis line – go figure!
After reading over the article in full, my sense is that the author puts a lot of time into “differential diagnosis” despite recognizing that it is objectively not possible with the subjective DSM criteria. For me, the key to success is adapting therapy to the person in front of me, and “diagnosis” per se had very little to do with that. If someone works well with a CBT (change your thinking to change your emotions and behavior) kind of approach, I’d use that approach, whether they had a “PTSD” or “BPD” or “ADHD” or no diagnosis at all. If it didn’t work, I’d use something else. I certainly wouldn’t waste my time convincing my client we needed a new “diagnosis.” I’d simply say, “Let’s try something different. Sometimes practicing skills can be more effective than going over past events. Are you OK giving that a try?” Or, God help us, I might ask the client what they’ve found to be helpful or not. After all, they are the ones who are defining “helpful” for us! If we think we’re helping and they don’t, we’re not.
So maybe the cultural references have some validity, though I see little to no scientific data to indicate that one way or the other, just anecdotes, really. But when it comes to providing therapy to a specific client, I think we do well not to call their recollections into question (particularly by asking their parents right in front of them!) but instead to apply the widest range of skills based on what actually works for the client, regardless of their ‘diagnosis.’ After all, even if CBT worked on 90% of depressed clients, there are still 10% who will fail unless you do something different. Forget “differential diagnosis” and do what works.
Milton Erickson reportedly said we have to re-invent therapy for every client. I think he got it right!
I can’t imagine a more incompetent attempt to verify developmental trauma than asking the parents! They OF COURSE will almost always deny or minimize any harm done, and are happy to blame the child if they HAVE done some damage, as it lets them off the hook. Moreover, parents can be perfectly well intended and still do a lot of harm, of which they will not be consciously aware. They are the last people in the world to ask, “Was your child traumatized in your care?” Very often, the parents have contributed or facilitated the trauma themselves.
Beyond this, “Borderline Personality” diagnosis is HIGHLY associated with developmental trauma. I don’t think I ever encountered a person diagnosed with “BPD”(which I consider to be a diagnosis of little use except as a means of distancing oneself as a clinician from his/her client) who did NOT experience significant trauma as a child, especially when intermittent EMOTIONAL abuse is included. To diagnose BPD as an EXCLUSION for people whose parents deny they were traumatized is truly a bizarre choice, even within the confines of accepted psychiatric “differential diagnosis.”
Very odd thinking behind this kind of analysis, IMHO.
I agree 100%. Techniques are secondary, handy “tricks” that can help smooth the path sometimes. But what is really healing is having someone care enough to be open to hearing and listening deeply to what is happening for another person. It requires courage, empathy, and an ability to hold others’ pain without reaction or withdrawing or advising. These things can be learned but not “trained” in the sense of classroom instruction. And a person can spend decades “studying” human psychology and yet be completely clueless as a therapist.
I used to work managing a volunteer crisis line. Some of my best counselors were computer programmers. Some of the worst had doctorates in psychology. I can find literally no correlation between “training” and competence as a therapist.
I recall reading a study of kids in a residential program. Over 80% reported overt trauma. Less than 20% had it noted in their charts. So either the clinicians didn’t bother asking about trauma, or they didn’t consider it important enough to write down! This in a residential program for teens with behavior problems. How they can be sooo off base is beyond my comprehension.
It’s hard for me to imagine how they can see case after case, like yours, where the person remains “ill” despite or even because of their “treatments,” never really gets “better” or actually gets worse, and yet somehow continue to believe their approach works! It is somehow always the patient/client’s fault when THEIR “treatment” fails, always their own doing if they get better somehow despite their “treatment.” How can they believe this themselves, let alone perpetrate it on their victims aka “patients?”
As I suspected, your references are only talking about probabilities and associations. There is no inkling of a biological CAUSE that would apply to all situations. Valuable information, to be sure, but nothing to do with validating “depression” as a legitimate diagnosis with a unitary cause. So for sure, Vitamin D and folate should be considered viable interventions for people experiencing mood problems, but this certainly allows for a HUGE range of possible causes, and also doesn’t eliminate the possibility of low folate or low Vitamin D cases NOT being depressed or suicidal, which would also kill off any fantasies about a causal role for any one biological condition in depression or suicidality.
I have no specific objection to therapy at a distance. I used to be very successful with phone counseling at a crisis line many years back. There are some advantages to NOT being able to see one’s client – visual biases are virtually eliminated, for instance – I have no idea if I’m counseling a fat person or a black person or an old or young person.
The real question is, of course, effectiveness. I’m betting that has a lot more to do with WHO is the counselor and HOW they relate to their clients than it does with WHERE the counselor or client are during the process. In-person therapy certainly hasn’t got a fantastic record to beat!
I’m not sure we can talk about “misdiagnosis” when there is no actual way to determine objectively who does or doesn’t have a given “diagnosis.” How would anyone know they were “misdiagnosed?” More proper to say you were misunderstood and mistreated!
What exactly does that mean – a “neurometabolic condition?” Sounds like something he CONCLUDED rather than proved scientifically. I’d be willing to bet that he is talking about averages rather than finding a cause of all or most “depression.” He no doubt found that changes in neurons and metabolism are involved when people are depressed, and that certain changes are more common. Not a big revelation. But I’m willing to be enlightened. What does he imagine CAUSES most or all cases of depression, regardless of experience? What do all or most “depressed” people have in common that almost no one not “depressed” experiences? I am interested in this research. Let me know what you’ve got.
Labels certainly meet a lot of societal needs, especially related to avoidance of discomfort. Of course, those who are “loyal” to parents despite abuse are presenting a competent therapist with the very thing they need to start working on, rather than promoting avoiding it by blaming one’s brain. Additionally, while the CLIENT may initially “feel better” because they’ve been blaming themselves, the studies I referred to show that OTHERS actually are more likely to stigmatize the client, including their own therapists and “mental health professionals.” Finally, it’s not the job of a diagnosis to make the person feel better, it’s to get them on the road to healing. What if we didn’t tell people they have cancer or heart disease because it made them uncomfortable? This is what happens when “diagnoses” are tossed about without regard to scientific validity. No one should be told they have a “brain dysfunction” unless the doctor KNOWS they have one, regardless of how it “feels” to get diagnosed. It is this kind of shady “reasoning” that proves psychiatry to be based on a fraudulent premise. For REAL diseases, no one gets to pick out the diagnosis that makes them feel best!
Perhaps surprisingly, research has shown that people judge others MORE HARSHLY when their problems are attributed to “brain chemistry.” Talking about trauma and life difficulties creates empathy. If someone’s brain is blamed, it appears it’s easier for others to distance themselves, to say, “Oh, he’s ‘mentally ill,’ he’s got a brain problem, he’s not like me!”
“Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.”
I guess my sense is that anyone who was genuinely focused on making their clients’ lives better would notice if their interventions made them worse. Sure they WANT their clients to “get better,” but most seem to not deeply believe that is possible, and view “better” as meaning “less” x or y or z. Reducing one’s depressed feelings is not the same to me as improving quality or life, and even less the same as actually improving their sense of control of their lives. And if evidence came in that my approach didn’t work or was based on false premises, I would chance my approach rather than blaming my clients or insisting I was right regardless of the evidence.
But incompetent or ill-intended, it doesn’t much matter to the clients. There needs to be a real intent to find the best path. Some exceptional practitioners do have that, and get results. But I find them very much in the minority, especially in the psychiatric industry. The proof is in the pudding. And some really crappy pudding is being handed out!
Wow, that person hasn’t got a clue if he thinks his job in therapy is to come up with things to talk about! Shocking that any insurance company would pay good money for such crappy treatment!
Excellent summary about what therapists do to protect themselves at their clients’ expense. C) is particularly damaging – to state or imply that you should NOT feel depressed/anxious/etc. and that YOU are the one with the problem for feeling that way. And I agree, therapists being uncomfortable with their clients’ feelings and experiences provide the OPPOSITE of therapy, and are very hurtful!
So you are not engaged in the practice of medical science, you’re involved in the practice of perpetuating your and your colleagues’ psychiatric belief system. That’s my point. Psychiatry depends heavily on the belief systems of the mental health professionals involved, and what kind of treatment one receives is very dependent on their “philosophy.”
Of course, most people have no clue that is what is going on. They don’t think psychiatry (or alternative medicine or whatever) is something you BELIEVE IN, they think it’s some kind of scientific study that can specifically identify what is “wrong” with their brains and fix it with drugs. This despite recent reviews showing that serotonin deficits are not associated with depression, nor is excess dopamine a causal agent in “schizophrenia.” You should also keep in mind that some “clients” of psychiatry have no choice about it, whether they believe in it or not.
To compare Whitaker’s well-researched reporting to Samuel Butler or Shostakovich is an extremely weak analogy to say the least. But you don’t appear to be interested in expanding your viewpoint based on such research, so there is probably no point.
However, that still does not excuse blaming your patients for responding in predictable ways to the propaganda they’ve been exposed to. They are patients. If you don’t want to treat them, I’d say you need to get yourself a new profession. I don’t believe “psychiatrists are brainwashed,” and of course, I never said any such thing, so such strawman arguments are merely distractions. I’m not hostile toward psychiatrists, I simply don’t respect professionals who blame their clients for annoying them. They’re clients. They’re not there to make you feel good or to validate your belief systems. They are looking for help. If they don’t find your “help” helpful, it’s not their fault. You’re the professional and it’s your job to care for them. Why would you take on clients if they annoy you so much? I’ve worked with plenty of psychiatrists whom I respect, even when we disagreed about how to approach most of our clientele. I only ask for basic respect for and compassion for the client. That is what seems absent in your case. And that’s an observation, not an attack.
Why not do what one psychiatrist I respected greatly did: Say, “I know you are hearing voices that you are not happy about. I have a drug that can help you not hear them as much. They don’t work for everyone, and they can have really intense side effects, but many of my clients find it’s well worth the exchange. If the first effort doesn’t work for you, we have several options available to try. Does this sound like something you would like to try?” Or words to that effect. Of course, he did get some interesting responses. One Native American guy said, “You white folk are all the same. You hear voices, you try to make them go away. We hear voices, we go someplace quiet and listen and see if they have anything interesting to say!”
I’m sure you’d have found that client quite annoying. I find him amusingly insightful.
Do you want us to feel sorry for you that you have to deal with actual patients? You do understand that these “diagnoses” are all “clinical opinions,” that there is no way to say for sure that someone “has schizophrenia” in the same sense that they “Have a broken leg?” Is it any surprise given the sketchy marketing techniques out there (selling “disorders” rather than treatments) that people self-diagnose in massive numbers? How do you let the pharmaceutical industry and the psychiatric industry itself off the hook for convincing people they “have” diagnoses that don’t have any concrete or objective definitions?
Have you ever read “Anatomy of an Epidemic?” I very much doubt you have. If you did, you’d have a much better understanding why people behave the way they do regarding “diagnoses.” I will simply end by saying its hard to respect someone who bears such hostility and disrespect for his own clients. You are laying in a bed that your profession has made for you, and blaming the patient is not a mature reaction, IMHO. The phenomenon is the natural outgrowth of the basic (IMHO faulty) assumptions of your system combined with an essential disrespect for the experiences of your clients, which your comments very much demonstrate to me.
How and why would psychiatrists do any of the recommended things in the essay? There is no financial or professional incentives to do any of them, and in fact involves massive incentives to maintain the status quo, which meets most of the needs of most of the psychiatric workers with no change whatsoever. Those who DO challenge the status quo are generally attacked and humiliated and threatened with loss of status or income or both if they continue their sacrilegious ways.
Psychiatry will continue to oppose any sane efforts at reform. I don’t believe it is reformable, as it is at its core based on faulty assumptions that are self-serving and self-perpetuating, and no one will be able to change its basic purpose, which is NOT to help its clients have better lives!
Remember that these “diagnoses” are almost entirely invented and mean next to nothing. They are mostly just descriptions of annoying behavior and difficult emotion that tend to occur together. Saying he “has bipolar disorder” is not a scientific fact – it’s just someone’s “clinical impression,” AKA someone’s opinion based on their own biases and social values. There is no science to it whatsoever. So don’t let them convince you they know what they are talking about. Do what makes sense and what seems to work, even if they don’t agree with you. Your husband and you know far better what is going on than any psychiatrist!
Stimulants can also induce OCD behavior. It often leads to other diagnoses when folks have adverse reactions to stimulants. Especially Bipolar Disorder. It can be dead obvious what happened, but try to get them to quit giving the kid Ritalin and they freak out. Once had a kid I advocated for who had an eating disorder diagnosis. They gave her stimulants, and lo and behold, her appetite was reduced! They of course attributed it to a “relapse” in her “eating disorder” rather than realizing that stimulants were a bad idea for someone with that condition!
Actually, Irving Kirsch’s work fully supports Peter’s statements. There is more, and I do agree he would do well to include such proof.
But that doesn’t change what I said. The manufacturers can’t claim that ADs reduce suicide rates unless they have evidence that they do. No one has to “disprove” an unsupported claim. The “null hypothesis” is assumed to be true unless proven otherwise!
Just for the record, it is the job of those claiming an effect to prove it. No one has to “disprove” that ADs decrease suicide. If that claim is not supported by evidence, it is considered FALSE regardless of counter-evidence. In other words, I don’t have to prove that something doesn’t happen just because someone claims it does. The burden of proof is on the person claiming it works.
Yes, but we also have to consider that the response of the clients is the only valid measure of success. But remember, it is the quality of the relationship with the therapist/counselor which appears to be the most important variable. How can we measure that, other than by how they are perceived by the client?
While DBT has some useful skills that can be learned by anyone who wants to use them, to suggest it is a “treatment for BPD” is problematic, as there is absolutely no objective way to say who “has BPD” or “doesn’t have BPD.” As such, all we can really say is that some people find it useful and some do not, just like any other set of “therapy skills.” Until it is possible to actually define these “disorders” objectively, there is no way that “clinical research” can prove anything relating to a “disorder” that is defined by social biases rather than scientific measures.
I can’t really agree with you here. It seems to me that providing therapy is more of an art, though it should be informed by science. There is no way to train someone reliably to be a “good therapist,” and I have seen many competent counselors who have little to no formal training. There is an element of having “Done one’s own work” to be emotionally available to a client which is simply not a factor of hours of training or scientific findings. The proof is in the pudding, and many therapists with advanced degrees are mediocre to poor therapists, and many of the best therapists have come to it via alternative routes (I had an undergrad in Chemistry and a MS in Education, as an example). It is not such a black and white “scientific” question!
Thank you for taking such time giving me feedback and sharing your perception of my comments. All I can say is that you’ve given me a lot to think about. Or FEEL about?
You may be taking my comments re: euthanasia a bit too far, though. I was really just trying to get an agreed-upon definition. Whether it SEEMS like suicide or not must certainly be an individual decision!
You may be missing the point here. If there IS science to be debated, it ought to be respected. Using name calling (like “climate change deniers”) does not mean that’s true, but is a great way to distract from the fact they are avoiding talking about the real issues. The fact that antidepressants do NOT decrease suicide attempts or thinking is very well established by mainstream scientific studies. There is no evidence that any drug decreases suicide attempts except for a very thin support for Lithium which has been called into doubt. If the reviewers can’t provide any science demonstrating a reduction in suicidal thinking or attempts, it is they who have more in common with “climate change deniers.”
Yup! You can always get some tramadol paid for, but a massage comes out of your own pocket! How much in Tramadol sales could be saved by prescribing a lot more massages?
I found the idea of intentionally inducing anxiety, depression, etc. to be somewhat disturbing. Is there no sense of possible long-term damage from this process? Doesn’t life already teach us that difficult situations bring on difficult feelings? Why does that need to be “proven” by potentially harming people?
That being said, I agree completely that normalizing anxiety, depression, even delusions and hallucinations is the best path forward, along with some REAL medical care for real, objectively observable conditions (like drug adverse effects). There is no benefit to lying to people to stop them from blaming themselves. In fact, normalizing blaming yourself may be the very first step to moving beyond it!
This is a HUGE problem, for psychologists/therapists as well as psychiatrists and psych nurses. They may often feel uncomfortable and want their own discomfort to go away, so they project it onto the client and either try to drug the feelings into submission or talk the person out of it, sometimes resulting in involuntary holds (aka incarceration) in hospital wards. I can’t tell you how many times I saw foster kids or others sent to the hospital for cutting on themselves (not suicidal) or for talking about suicide. One person said she called the suicide hotline because it was not safe to talk to her therapist when she felt like cutting, because she would always send her to the hospital. The are many smaller cases where the therapist wants the client to do something in order to reduce their own discomfort.
One of my basic principles of “therapy” such as I did was that when I felt uncomfortable, I assumed the client was probably getting to something really important, and the most important thing for me was to sit with that discomfort as they had to and see what was behind it. It requires a lot of courage and willingness to experience the pain of others to be of any use to another person in distress. You have to have “done your own work,” and the vast majority of “mental health professionals” have not done that, and are therefore useless or dangerous to their own clients, IMHO. It really isn’t something you can train for – it’s an attitude one has to adopt, and most don’t even realize they need to let alone have the capability of sitting with another’s pain.
There are also plenty of untrained “amateurs” who DO have that skill, as I found out running a volunteer crisis line shift. You are often better off with a well-supervised computer programmer than a trained “mental health professional!”
Ah, but they rarely do fund this sort of study! The heavily moneyed biopsych advocates have a lot of sayso about what is studied, and protest when their pet drugs and companies get short shrift. Besides which, most studies theses days are funded by drug companies, not government entities. There’s little chance non-drug interventions will ever establish a sufficient “evidence base” to match those the drug companies can muster up!
And of course the “evidence base” depends on what gets researched, and drug company money determines what gets researched. So there is never an “evidence base” for anything but drugs!!
I read Pies and Ruffalo’s response. It is as nonsensical as I expected. They compare “schizophrenia” causing hallucinations to a volcano destroying Pompeii. Well hey, guys, a volcano is obviously THERE and concrete and erupts lava that can level a town. How is that in any way like “schizophrenia,” which cannot be seen, felt, or otherwise observed except by its purported effects? The analogy would be more like Pompeii was destroyed by a “City destroyer.” The proof is that the city was destroyed.
That trained academics engage in such childish arguments to defend an indefensible concept is beyond my comprehension!
Here is the Mirriam-Webster dictionary definition of “euthanasia:”
“the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy”
I’d say that whether it constitutes murder or not depends on the desires of the subject and the intentions of the one helping them die. To put it another way, is the person truly helping the subject accomplish his/her goals or simply helping themselves at the subject’s expense. In the latter case, I’d call it murder.
There is, of course, no possible way to objectively establish “the truth” in “mental health” diagnoses, as there is no way to determine ANY diagnosis beyond simply describing it. If there is ever even ONE test to determine ANY “mental health” diagnosis, I will be shocked.
“Reduce the core symptoms” is code for “doesn’t make any difference in long-term outcomes.” In “ADHD”, “reducing the core symptoms” simply means making the person less fidgety and more willing to sit through dull or unmotivating exercises. Stimulants, of course, will do this for anyone who takes them. While this might be viewed as helpful for some who take the stimulants, the idea that this is somehow a “treatment” for a “disorder” is delusional.
There is some evidence that accidents may be reduced, but crime involvement is not reduced by stimulants according to my research. They CERTAINLY do not die 5 years earlier on the average!!!
I will no longer be approving any comments on this article. The topic has been well aired and the comments are repetitive and not moving forward as a conversation. Please don’t add any further comments to this thread!
I’m not sure where you got the idea I disagree with you. I used to be a therapist myself, and 99% of what I did was to have people describe their experiences and what those experiences mean to them. I’m simply disagreeing with you on the definition of “taking responsibility”. I don’t think you are understanding it the same way I am. The more we know about ourselves and our emotional history, the more we understand the REASONS for our “irrational behavior” (as others choose to see it, or as we choose to see it), the more we can take responsibility for deciding whether or not we are going to continue to react/respond in the same way we did before or try something new. Mostly we develop habits of thought and behavior based on what happened to us, and I saw counseling as primarily the opportunity to question whether or not those habits continued to serve us, and if not, find out what needs they are serving and find another, better way to meet those needs. So there is no blaming oneself for what happened – only responsibility for deciding how to act NOW and in the future.
That’s MY lived experience, both as a client and as a therapist. I don’t think I’m really disagreeing with you about much here. Let me know if that raises more questions/issues.
And no, I did not read the blog. I did read your comments. I’m speaking from my own direct experiences.
I’m with Bill on this one – taking responsibility means recognizing that one’s own behavior is a choice despite past traumatic events. It’s not the same as taking the blame, which is very damaging. One can take responsibility AND be aware of and process emotion, in fact, one almost HAS to be aware to really take full responsibility.
There are also group cultural insults that are traumatic, such as the generation of Jews whose parents were in concentration camps. There are also lots of ways that parents and other adults can hurt their kids without realizing they are doing so. School was a great example for me – daily torture, but no one seemed to notice or care, I kept having to go back every day for 13 years. There are lots of ways people get hurt and traumatized as children.
We know at least that the AI does not dislike or judge us for our name, gender, sex, race, beliefs, etc. AI doesn’t have a subconscious, as far as I can tell!
I remember a study where they let students log into an AI program, this was decades ago, and it was programmed to listen and ask pertinent open-ended questions. Students reported feeling better after talking to the AI!
I think it goes back to “male privilege,” the broad teaching that men deserve more than women and that women’s job is to keep men happy. We are taught this all the time in our media and other parts of society. It seems it’s women’s job to make sure everything works out for men, and when it doesn’t, women are to blame!
Sorry, I wasn’t suggesting YOU believe those things, I was just pointing out the failure of those arguments you alluded to made by others. I understand you are NOT a supporter of the DSM or the Medical Model. Sorry if there was some confusion there!
I mean this idea that telling people “it’s a chemical imbalance” is somehow good for clients, which you refer to in your comment. Many say, “people like their diagnoses” or “the biological explanation reduces stigma.” Very tiring arguments, indeed!
I agree. Blaming women for being unwilling to be your partner is childish and unproductive. Blaming feminism for women being unwilling to be your partner is childish, unproductive AND bigoted!
There are scientific studies showing that blaming a “chemical imbalance” or brain problem leads to LESS empathy for the “mentally ill.” People relate better and are more compassionate when their issues are framed as a result of trauma or difficult life circumstances. This is science, not my opinion. I’d also suggest that lying to patients for some social reason is not the doctor’s job. You should not try and alter attitudes by lying about the science behind a “disorder.”
I think the author would be wise to avoid the word “incel.” It has taken on some other connotations than an inability to engage in sexual activities, and is associated with misogyny and violence.
I’m amazed anyone gets away with making that argument. They systematically RULE OUT suicidal people before doing these studies. Anyone who is suicidal during the study period became that way AFTER starting the study. If more on antidepressants are suicidal, it’s caused by antidepressants. That’s what double blind studies are for!
Which suggests we should be looking at nutritional/macronutritional solutions, which should help SOME people, but certainly not ALL people. Depression is a VERY complicated experience that is generally more than just physiology, at least in many, many cases.
No, I didn’t miss that part. I’m pointing out that if 55% of females have lipid abnormalities, it means 45% of them do not and are yet still depressed. Depression has multiple causes, and to try and establish ONE cause, biological or otherwise, is a fool’s errands. It’s like trying to say, “What causes a rash?” A LOT of things can cause a rash, and they require different responses. Treating all rashes with one treatment will never work. Same with depression. There will never be one “treatment” because there is never one cause. If addressing lipid abnormalities helps a good percentage, that’s wonderful, but don’t expect it to work for everyone.
1) What do you mean “a real illness like any other?” How do you define “illness?”
2) If you are “ill” both on and off “meds,” and experienced “no success,” why are you so sure that “without meds patients are worse off?”
3) Is it possible in your mind for some people to be better “on meds” and others to be better “off meds?”
You hit the nail on the head. Unfortunately, there is ABSOLUTELY NO WAY to distinguish “real ADHD” from any of these other conditions or no condition at all, and the DSM itself admits this quite bluntly in its introduction. That you feel you BENEFITTED from stimulants is not a reflection that you have “real ADHD,” it’s a reflection that stimulants work for YOU personally. While I never want to take this away from you, it’s a very large leap from saying that “stimulants makes it so I can complete tasks, etc.” and “I have a diagnosable neurological condition that is objectively distinguishable from normal or other such conditions in me and any other person.” Unless you can reflect an objective way to do that, all you’re really saying is that stimulants have worked well for you. And more power to you for that. Just don’t assume others who act or feel similarly will have the same results, because experience and science says that most kids who take stimulants do no better in the long run than those that don’t.
“They work for me” is about all we can say for sure.
Remember when tey say that these receptors were “chronically decreased,” they are talking about AVERAGES. I am sure you will find many who are suicidal that do not have this condition, and many who have it who never become suicidal. If there were a way to isolate this SUBGROUP of people who happen to have this issue AND are “depressed”, by all means, we should do so, but to suggest that ALL cases of suicidal ideation or action are attributable to this is not even vaguely supported by the data presented.
A) Szaz was not a Scientologist. He just worked with them.
B) If he is, why does that matter to you, Marcus? Why not judge a person by their evidence rather than bringing in irrelevant points like religion? A person’s argument for or against abortion, for instance, should be considered independently of whether they are Catholic, don’t you think?
With all due respect, there is not one single “mental disorder” that has a recognized “underlying brain pathology.” You should read Anatomy of an Epidemic so you will better understand why people feel they have been fooled. And people are STILL deemed “abnormal” for any negative or strong emotion they may experience. I don’t see the current system as any improvement from the viewpoint of pathologization. They are still calling you “crazy” but now have broken it down into brands of “crazy.”
There is also now evidence that making the BRAIN the focus of the “disorder” actually increases stigma and decreases empathy for the so-called “mentally ill.” Especially when you consider that the DSM “disorders” are all entirely invented in committees and have no scientific basis in brain pathology, they can keep their labels and stuff them someplace dark and stinky!
It is true that antipsychotics can be useful in the short run to help people get under control. I’m just saying that calling it a “treatment” is a lot like saying morphine is a “treatment” for a broken bone. Might make you feel better and be helpful, but it’s not going to help to simply prescribe morphine without finding out what’s really going on.
I can’t consider electrocuting someone into a seizure a “treatment,” last resort or not. And who gave the doctors the right to “see fit” when electrocuting someone is “therapeutic?”
Actually, that’s NOT the question, with all due respect. It makes the assumption that A. these drugs are “medicines” for “diseases,” and B. that it’s always better to do something than nothing. If doing something wastes money and has no positive benefit, we are better off doing nothing than pretending we are “treating” a “disease” that we clearly do not understand!
You are so right! The “Depression” can’t “resist treatment.” It just means their treatment didn’t work or made things worse. No other profession gets this kind of latitude! What if your mechanic said that you had “repair-resistant fuel injectors?” Would you bring your car back for another “treatment?” No, you’d know it did not work and your car was better off in the care of someone who knows what the f*&k they’re doing!
“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
Mark, you have not contacted me by email or responded to my emails. I’m not sure you even received them at this point. I will no longer be able to post your comments until you contact me and we can have a conversation. Again, my email is [email protected] or [email protected]. It’s also listed in the “About” section of your home screen. Meanwhile, all of your posts will simply stay as “pending” until I hear from you. I’m not sure what else to do to get a response from you.
So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
POSTING AS MODERATOR: I honestly don’t have any idea how to unsubscribe you. Perhaps one of our tech staff can help? You can find them in the “About” section under “Staff.”
Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
The use of the term “resistance” these days doesn’t mean the same as Freud’s concept. It just means “didn’t get better with our ‘treatment.'” It’s basically a way to blame the client for the failure of the “treatment.” That’s how I read it.
Electrocuting someone into a grand mal seizure sounds like malpractice to me. How can you “do it incorrectly?” What the heck is the correct way to induce a seizure that might potentially cause brain damage?
Whether or not someone receives treatment is not an “outcome.” An outcome is a result of the treatment approach. The study does not state or claim or suggest or imply that no one has a good outcome using antipsychotic drugs. It suggests that ON THE AVERAGE, those who receive light or no intervention are more likely to have a better outcome at two years onward. A better outcome ON THE AVERAGE. There can be plenty who got a better outcome with drugs or a worse one with drugs as well. Your story is one story of millions. Yours can be 100% true and yet the average person can still be worse off in the long run on antipsychotics. You are one data point. A scientific study is made up of hundreds or thousands of data points. It’s not the same.
Most of these people have HAD ECT themselves or know someone who does. Many also know the ECT research literature better than the average clinician.
It’s insulting to suggest that anyone here is making up their minds on fictional accounts. I’m glad you had a positive experience to report, but don’t assume others experienced the same or similar things!
Traumatizing experiences are also normalized and kids are expected to not complain about it. How many kids say things like, “Oh, that’s not abuse, I totally had it coming!”
Gotta love it. THEIR “treatment” doesn’t work, but it’s because YOU are resistant. Or your “schizophrenia” is. Apparently resists without consulting you. Insanity!!!!
Please explain how any one DSM “diagnosis” is derived from scientific observation and research. Specifically, please describe how exactly one can distinguish who “has” the “disorder” from who does not ‘have it.’
This is not to say that people don’t like or benefit from biological interventions. But that’s nothing new – folks have taken substances to alter their mental/spiritual reality since the beginning of human history. That’s very, very different from claiming that something as vague and amorphous and subjective as “major depressive disorder” or “adjustment disorder” or “ADHD” is derived from the scientific method. In fact, the DSM admits they are not in its introduction, in no uncertain terms. You ought to read it some time.
The fact that you feel you can “diagnose” that based on an internet comment proves how completely subjective and unscientific these “diagnoses” really are.
Your comments reflect not having read the many testimonies of people here who were diagnosed with “major depression” or “bipolar disorder” or even “schizophrenia” and were treated with drugs for years or decades with really poor outcomes, including a significant number who did far better after they came off the drugs and did other things.
There are most definitely big medication success stories. There are also disaster stories. Same drugs, same “diagnoses,” very different outcomes. If you really want to understand a site like this, that has to be your starting point. You can’t decide people are ignorant simply because they had different experiences than you. Maybe you should stop and read some of the stories before you assume that no one here has suffered any “mental illnesses” just because they had very different outcomes than you expected to hear?
Confirmation bias is generally rooted in anecdotal evidence, aka testimonies of those helped/not helped by an intervention. Citing testimonies as proof of confirmation bias seems a bit ironic.
Here are the references I quoted. Barkley and Cunningham 1978. Swanson et al 2003. Oregon Medication Effectiveness Study 2002. Montreal ADHD Study. Raine study from Australia. Finnish comparison study to USA cohort. Not to mention Whitaker himself, who summarizes the extant literature.
How are these not citations of clinical studies? Barkley in particular is a super pro-ADHD researcher. It seems you didn’t read my earlier posts yourself. My comments are firmly rooted in years of long-term research, which you’d know if you’d bothered to read Whitaker’s work before deciding you already know all about the subject. It’s not too late to educate yourself, but I get tired of repeating the same lessons for folks who don’t seem interested in seeing another viewpoint.
And the author mentioned his “clinical experience” including a specific case, as I recall, which is 100% anecdotal. I am very clear what anecdotal evidence looks like.
I think it would be nice if you would learn to respond without putting down the person you are disagreeing with.
Is it an illness if the responses are reasonable and understandable to the conditions bringing them about? Why aren’t the people COMMITTING the traumatic acts against their loved ones or employees or patients considered the ones who have an “illness?”
ADHD being “more recognized” would in no way make it more likely that people taking stimulants being more likely to develop heart problems. It’s not a new suggestion. Probably not a common event but it sounds like more common if you take stimulants. Knowing what we know about stimulants, the increased risk of heart disease associated with them should not be surprising.
None of the studies I referred to were funded by pharmaceutical companies. Government studies, especially when longitudinal, are generally more reliable.
The average “seriously mentally ill” person, most of whom have received years of drug “treatment”, die 15-20 years younger than the general population. There are, of course, multiple reasons, but psychiatric drugs and ECT are high on the list.
The antipsychotics are known to induce diabetes and other metabolic issues, and to increase heart disease. If you think inducing diabetes doesn’t kill people, you are confused.
Anecdotes are not scientific evidence except in the crudest sense. I’m not saying the drugs have no effects or that “ADHD” is trivial or that people so diagnosed don’t do worse than the general population in a number of significant ways. I’m saying that, for instance, the claim that “untreated ADHD leads to delinquency” is false, because “treated” ADHD kid aren’t less likely to become delinquent. BOTH groups are more likely to commit criminal acts, though interestingly, I recall reading a study where those identified early on as non-aggressive “ADHD” types did not commit more criminal acts later. But it makes sense, impulsive people are more likely to do impulsive things, and committing crimes is often impulsive. The point is, IN THE COLLECTIVE, we do not reduce the delinquency rates by “medicating” the subjects. This does not mean a particular individual wouldn’t, say, feel better about school, improve their grades, or even say, “This stuff saved my life!” But those are anecdotes. Scientifically, we have to look at the overall effect, and overall, the effect of widespread stimulant use on the population is not large, if we look at the data rather than stories.
I would submit to you that there are plenty of people whom you don’t know whose situations might have gotten worse to the same degree your client base got better. I don’t know what kind of selection bias you have in your population, but I worked with foster youth and saw plenty whose lives deteriorated after starting stimulants, particularly due to aggression toward others. Many ended up with more drugs and worse “diagnoses,” one ended up psychotic until she herself stopped the drugs and went back to her old “normal.” So anecdotes can tell many stories. Collective data is more reliable.
Multiple long-term studies show no significant advantages to those taking stimulants vs. those who don’t when diagnosed with “ADHD” in childhood, other than the accidents you mention, and I believe clearly overstate in your comments. Delinquency rates, HS graduation, college enrollment, social skills, not even self-esteem scores were better for those taking stimulants. This has been confirmed since Barkley and Cunningham’s first review in 1978, confirmed by Swanson’s “Review of Reviews” in 1993, and in the OSU medication effectiveness study back in 2002 or so. Also confirmed by the Raine study in Australia, the Quebec study, a comparison study between Finnish and US kids who had very different medication rates but similar outcomes, and more.
Read Whitaker’s works if you want to fully understand what’s going on at MIA. Not everything is the way the professionals have told you it is.
It’s not really a legitimate approach to say, “What else should they have done?” It assumes that doing SOMETHING is essential and that NOT doing what they propose is foolish unless you have something “better” to replace it. It is possible that antidepressants were destructive AND there was not a “better treatment” available. We should not assume “antidepressants” as some sort of minimum standard of treatment that is the default unless we have something “better” to propose. Sometimes nothing is better than doing things that are destructive.
If it were so safe, they would not have to do toxicity tests every two weeks. Lithium can do serious kidney damage among other things. It’s therapeutic dose is as close to the toxic dose as almost any other drug you can name.
I think you are missing the larger point, Donna. You say our “knowledge” of these things is in its infancy. But the “diagnoses” themselves are not explanatory of anything, regardless of the education and experience of the person involved. How is saying, “Joe feels really hopeless and sees no point in his life” any different than saying “Joe has major depression?” Is there some way to distinguish Joe’s “Major Depression” from Mary’s “Anxiety disorder with depressive features?” They are simply descriptions of what is observed, and clinicians will make a lot of noise about “clinical depression” vs. “reactive depression” but look in the DSM, there is simply NOTHING there to make a distinction. You meet 5 out of 8 criteria, you “have major depression.” Only meet 4, you don’t. Nothing about cause, nothing about ongoing stressors, nothing about culture – just a description. That’s not a “knowledge in its infancy.” That’s just making stuff up, plain and simple. There is no way any “knowledge” can advance from that kind of basis. The DSM is not knowledge. It’s a fantasy that makes people believe “knowledge” is behind it.
Not sure what the answer is, but calling people names based on arbitrary checklists isn’t it.
I really don’t want to get into debating COVID or the WHO response. It is off topic (not about the article or about the “mental health” system) and has become highly divisive. We’ve now heard both sides well expounded. Let’s get back to our mission!
Science is not created by consensus, and does not have any consideration for a “middle ground.” Are we going to start saying that gravity is inconvenient for some people, so we’re entertaining some small modifications to help people adapt?????
The hummingbird house was a new experiment at the time with an open environment rather than cages. It felt like they were pretty good with the environment or it would not have felt good to be there. I felt like I was in their world.
I used to go to the hummingbird house at the Philadelphia Zoo during the week when nobody was there. I would sit for 10 minutes making no noise, and soon I was surrounded by birds doing their thing. It was very soothing, and I didn’t need someone to tell me it “worked!”
We know this. He can’t answer my challenge and will probably ignore my response. Otherwise, he’ll say it’s “well known” and present no evidence or else attack my credibility. That’s how it seems to be done.
Easy to say that. Please provide us with the definitive proof of shared biological pathology for all forms of “schizophrenia.” Not correlations, not candidate genes – let’s hear the exact “pathology”(to use your own words) that distinguishes these conditions. I will assume failure to answer means you have no answer.
I know, it’s like when they “discover” that hiking in the woods makes people feel calmer, and instead of saying, “hey, try hiking!” they decide to call it “Nature Therapy!”
For the record, I can’t find any moderated posts from you. Next time, I’d ask that you email me and check before publishing the assumption you’ve been moderated. I almost always leave a note.
Superstition comes into play in all forms of medical treatment. Placebo effect is acknowledged to deliver half the benefits of any treatment. Drugs become less effective the longer they’re around because people start to hear issues and concerns that were not talked about before. What people believe has a lot to do with what works.
You sound very committed to the idea that “there is only one reality” that is unaffected by any of our personal narratives. Can you submit some scientific studies that prove your contention to be true? Or is it simply a matter of faith, based on… your personal narrative?
I think the real lesson is: Kids are not all nails, even if you only have a hammer. Use the hammer when the job calls for it, otherwise, quit hammering our kids!
The fact that you worked through it yourself and found out what worked and did not work for you has to be a big plus for you. Additionally, I hope you learned that not everyone responds to the same things and that a therapist has to be creative and responsive to the individual needs of their client. It’s been proven again and again that these therapist characteristics are far more important than the modality used, in fact, in many studies the modality was not a contributing factor to positive outcomes.
Bottom line, it seems you learned empathy for your clients and haven’t forgotten that lesson.
Yeah, it’s sort of rude when patients don’t comply with the doctors’ preexisting biases and expectations, isn’t it? Maybe the doctors just need to work on robots, then you get almost total predictability!
Individuals don’t need to prove the effectiveness of anything they sense is working for them. It is those claiming someone ELSE will benefit from an intervention they are offering/forcing on that person who need to show the proof.
I think it showed that administering group DBT training doesn’t lead to improved outcomes. If I’m a school administrator, that should be enough for me to think, “Well, we’ve got only so much time in the day, why waste time on something that doesn’t have a significantly positive effect?” An intervention doesn’t have to be proven harmful to be avoided. It just needs to be shown not to be significantly helpful.
These “differences” are AVERAGES – They can never be used to determine if person A “has schizophrenia” or person B does not. There are tons of “schizophrenic”-diagnosed people who do NOT have frontal cortex atrophy. It’s also well known that frontal cortex atrophy and other brain shrinkage can be caused by the antipsychotics themselves. PET and f-MRI studies are absolutely useless in “diagnosis.” And of course, this must be the case, because there is no reason to believe any 5 people with the same “diagnosis” have the same kind of problem or need the same kind of help.
I would add that psych ward staff also need to learn and practice these things. Some do this well, but some don’t. The real problem is POWER. The people with power are telling the kids how to “manage their emotions” and whatnot, but they are still free to be as abusive, neglectful, and thoughtless as they wish and suffer no consequences. Whether its parents, teachers, staff, doctors, pastoral leaders, or even just adults who are comfortable exercising power over those they feel are beneath them, as long as the person in the one-up power position is unwilling to step down, no amount of “emotional management” will make things any better.
I would add that the teachers need to learn and practice any skills they want the kids to have.
I had a neighbor kid who was in middle school. He explained to me they spent a one-hour assembly working on Carl Rogers’ reflective listening skills, including “I statements.”
He was sitting on the stage after the session and a teacher came up and said, “You, get off the stage!” in a very loud and aggressive manner. He said, “I don’t like it when you yell at me. I’d prefer we speak in calmer tones.”
He got sent to the Principal’s office immediately. What was the real lesson here?
I would add that being told over and over that their emotional struggles are a “mental disorder” has contributed to younger peoples’ lack of ability to cope. Used to be parents, teachers, and the kids themselves got the message, “Hey, you’re good at x, but not so great at y. Let’s work on your Y skills.” No excuses, you just were how you were and everyone dealt with it, admittedly poorly much of the time, but at least the message was, “Don’t feel sorry for yourself – you can figure this out.
I also remember the crazed maniacs who sometimes passed for school teachers back in my day. I’d hardly say the school environment has gotten more stressful!
When I was a counselor and sometimes had to do these “diagnoses,” I viewed them the same way, and told my clients as much. I said they’re just descriptions of behavior/emotion/thoughts that are used to bill insurance companies. I told them I’d select the one most likely to get them the kind of help they needed. I always favored PTSD or Adjustment Disorder because they would incline toward talking solutions rather than drugs.
Unfortunately, there are an unfortunately large number of terrible or mediocre counselors. I don’t think they “need to keep you sick” as much as not really understand what “better” means to the client and how to get there.
Are you saying anything is better than telling someone they have an incurable brain disease and there’s nothing they can do about it except hope that the doctors have a magic pill that never seems to develop?
A sensitive 8 year old can do better than a standard psychiatric intervention. On the average, listening to someone is going to help, but who needs to be a therapist to listen? And what guarantee is there that a therapist can and will listen anyway?
It is also possible that some are NOT there to make you feel better.
On the other hand, the bartender and the heroin peddle are there to make you feel better, too.
Making someone “feel better” is generally only effective as a short-term objective. People who set their long-term goals at “making myself feel better” generally don’t have very livable lives.
That does seem to be the message. At least from the incompetents. Just “think different thoughts” and your emotions will change! A bit of magical thinking, there. I mean, in the LONG RUN, it’s probably true, but to make out that a person can just “change thoughts” on command, especially after years of trauma or living in current danger, chronic or acute, is patently ridiculous. There’s a lot of trust building and examining patterns and detecting the purpose of certain behavior/thinking from the client’s viewpoint and a lot of “what ifs” and “Let’s imagines” before anyone gets around to saying something as monumental as “I’ve changed my viewpoint. I don’t need my mother’s constant involvement to survive.” People believe what they believe for a reason. It doesn’t work for a therapist to say, “That’s a bad belief, you need to change it!”
Hard to argue with you there. There are probably a few rare exceptions here and there, most of whom will probably quit early or be driven out by their colleagues.
Nobody is saying the medications are not valid. We’re saying PSYCHIATRY is not valid! The idea of taking a substance to make yourself feel better is as ancient as human history, maybe even older. It’s not an amazing 21st century discovery of the psychiatric profession. The biggest problem is these damned DIAGNOSES, which have no scientific reality but are used to promote certain products and discourage people from exploring their own solutions.
If the drugs work for you, more power to you! This website is not about that. It’s about bringing some kind of sanity back to the world of “mental health treatment,” including stopping psychiatrists from involuntarily forcing people to take these drugs when they do NOT work for the recipient!
CBT as practiced by many often does encourage clients to ignore or minimize or intellectualize social causes of distress. I find it useful in certain contexts, but see it as a tool, not a therapeutic school. It works fantastic for some people in some situations (I use it all the time myself), but there are times when “empowering oneself” has to take a back seat to taking an honest look at what’s going on or has happened in the past. For instance, a domestic abuse victim might learn to “think different thoughts” so they find their abuser’s comments less upsetting. This might be a useful skill, but it does not BEGIN to address the needs of the client. If all we gave our DV victims was CBT, we’d be doing them a gross disservice. Same with folks with big tramua histories. Telling them to “think different thoughts” is a short step from “get over it, you wimp!” And lest you think I’m exaggerating or making this up, several people have reported on MIA that they are told by their therapists that they should “not think of the past” and that processing historical emotions is a waste of time and they need to “Be mindful” and “focus on the present.”
A good therapist can use CBT to get good results when it is appropriate. A bad therapist can use CBT to create an emotionally unsafe environment for their clients and effectively make their “mental health” status worse.
I certainly have no intention of attacking psychiatrists. But you are saying things that are said by psychiatrists but not scientifically accurate. Antipsychotic drugs HAVE been shown to do brain damage, including reduction in grey matter volume, altering the size of the Corpus Collosum, and inducing neurological problems like Parkinsonism and Tardive Dyskinesia. No psychiatrist worth talking to will deny these things are known facts. There are now ads on TV to fight off TD, which is directly stated in the ads to be caused by their “mental health meds.” The idea that antipsychotics offer some protection from brain damage caused by schizophrenia or other “mental illnesses” is a nice concept, but again, I know of no evidence that this is actually true. Can you attach a link to a study or two to show where you’re getting this information?
It is hard sometimes for people who have used the MH system and feel they have benefitted from it to hear from others who feel it has harmed them. I don’t think anyone here wants to upset you about this stuff, but they’re mostly just telling their stories, and I believe they have a right to do that, even if these stories don’t jibe with what you’ve read or heard or been told. And if it causes others to be a little more careful how they engage with the system, I think that’s all to the good. An informed patient has the best outcomes, but our practitioners mostly have conflicts of interest that prevent them from giving out the honest information that everyone needs. A lot of that information is available here, albeit often in anecdotal form, but still, don’t you think folks have a right to tell their stories? If you came on and told YOUR story and someone told you it was “wrong” or was damaging people, how do you think you would feel about it?
It’s worse than that, Molly. They don’t know what they should be aiming at. The drugs hit parts of the brain they ARE intended to hit as well, and THOSE parts of the brain get broken down and stop working properly, too. They’re not quite shooting at random, but the targeted parts of the brain do not heal under their attack. And destroying them isn’t good for the brain, either. It is a poor solution.
I don’t consider this obvious. A person may need PROTECTION, yes, and others may need protection from THEM, but why does “treatment” in the form of enforced drugging necessarily emerge from feeling angry or confused or despairing? How about giving folks a safe place to calm down and some sane people to talk with if they want, plus some food and sleep and the like? Why start with forced drugging as the only “answer,” especially when we see how poor the outcomes are for those experiencing such “treatment” in the long term?
I learned early on that “intellectualization” is just one more coping measure, having its value and its drawbacks, just like every other coping measure. We all need coping measures, including denial, splitting, minimization, and intellectualization, in order to survive. There is nothing wrong with using any of them if they are working for you. The times we have problems is when we learn these measures early in life and come to believe they are our only options in certain situations. Becoming aware of the coping measures we choose and getting a broader range of options in any given situation is a valuable set of lessons. A lot of times, using intellectualization to “block childhood trauma” is the smartest thing to do. There are also times it can get in the way of moving forward. Just like any other coping measure. It is not good or bad in itself, it’s about how/when these coping measures are used that matters. And who is really in a position to judge that other than the person deciding how to “cope?”
The answer is simpler and more grim – they prescribe it to keep them quiet. “Antipsychotics” reduce aggression, so any sign of violence or aggression from an “autistic” kid and out comes the Risperdal or Abilify prescription. Also often used to calm down aggression that’s actually CAUSED by stimulants for “ADHD”. Doesn’t even require a “psychosis diagnosis.” If they’re annoying enough and have a label, they are fair game for antipsychotics.
Not to mention the possible damage to the fetus of continuing SSRIs. There are fairly consistent correlations with birth defects, as well as with “ADHD” behavior later in life, if I remember my research correctly.
Exactly. You see it all the time – an article proves that antidepressants are completely useless for kids and meanwhile increase the suicide rates, but the conclusion is, “We should be careful to make sure that antidepressants are only prescribed when indicated in children.” And they get away with it, because they’re saying what those in power want to hear!
Labeling terms is a very human practice. People come up with words to describe what they observe, and I have no problem with that. It’s the fetishizing of these words into “diagnoses” and “disorders” that upsets me, when the “diagnoses” have no more meaning or validity that saying someone who picks his nose has “excessive digital-nasal insertion disorder.”
I think the interesting question that never gets asked is, why do the “standard mental health” programs continue to get funded despite mountains of evidence that they not only don’t work in the long run, but in many cases cause damage? Kind of a double standard, isn’t there?
There is a difference between using a term to describe something (My husband is an ABUSER) and being DIAGNOSED with something (My husband beats me up because he has “Bipolar Disorder”). One is simply a linguistic means of describing people who have certain traits in common, the other implies some kind of deeper “causal” relationship between these people such that some sort of “treatment” will generally be helpful to all of them. Psychiatry blurs these lines badly, and I believe intentionally, such that people are confused between a description (These children all have trouble paying attention in school and get into trouble) and a diagnosis (all children who have trouble paying attention are suffering from a ‘disorder’ called ‘ADHD’ and there is a ‘treatment’ for this condition). Of course, this sells a lot of drugs, but the confusion does a great deal of damage to our society, as it prevents any real attempts to identify the actual causes in individuals, as well as taking perfectly normal behavior (being distracted when bored to death by the school curriculum or process) and making it into a disease state. But when we get as silly as calling something “Oppositional Defiant Disorder” because a person is oppositional and defiant, it should be obvious to any rational person that these “disorders” are absolute irrational nonsense! Might as well say someone picks their nose because they have “Nose Picking Disorder.” It wouldn’t be any less ridiculous.
What they mean by “stigma” is “any comment suggesting people shouldn’t take all the drugs they are prescribed without question.” The industry creates and exacerbates stigma as a marketing tool. The furthest thing from their minds is to “reduce stigma!”
As long as the peer respite concept is dependent on the larger “mental health system” for approval and monitoring, we will see power being used by those uncomfortable with the idea of peer empowerment to undermine this kind of effort or kill it off. I wish I knew the answer.
It also always seems hypocritical when they expect someone ELSE to prove their drugs cause dependency, assuming safety, while normally we expect drug trials to assume non-safety until proven otherwise. How many drugs have we been told are “not habit forming” and yet later turned out to have horrible addiction profiles? Benzedrine, Valium, Xanax, Oxy, Ativan, SSRIs… the list is pretty long at this point. Why aren’t we making the drug companies prove their drugs are NOT addictive/dependence-forming before they’re allowed to market?
It did seem odd to me that after dismissing the claim that science understands the mind, the IFS approach still “diagnoses” people with “conditions” based on their “understanding” of the mind. Better to just admit it’s a mystery and work with the person in front of us and stop trying to “understand” them separately from their own conceptualization of their own situation.
I would not just say that “patient voices” should be reported on, they should be CENTRAL to any analysis, while doctors’ opinions should be considered secondary. As long as “patient experiences” are of secondary concern, we will continue to have a system that oppresses those it’s supposed to help!
A really fun exercise is to pick a diagnosis and see how many different ways you can “diagnose” someone with the same “disorder” despite having no “symptoms” in common with each other. It’s not very hard, but it’s kind of amusing. Except when you realize people take this nonsense seriously!
From what I understand of recent studies, the scientific consensus is about 30% of people taking antidepressants express finding improvement. When you take the placebo effect into account, that number drops even lower, and if you talk about an ACTIVE placebo, Kirsch puts the effectiveness rating near zero, at least in terms of any kind of significant clinical benefit.
The drugs do DO something (mostly a stimulation effect, with a dampening of emotional reactivity), and some people find that SOMETHING positive for them. And more power to them. But we should remember that some people find marijuana or controlled doses of alcohol or taking DSMO or St. John’s Wort helpful, too. The problem isn’t that some people don’t report benefitting, it’s selling the idea that there are NO harms and that EVERYONE who is feeling depressed needs some, and even worse, that people who have adverse reactions or simply don’t improve are “treatment resistant” or are being dishonest!!!! Just because a person or persons report they like this and it helps them feel better is no reason to create a false narrative and make people who don’t feel such a benefit into some kind of monsters for “preventing effective treatment”!
I’ll just remind everyone here that “bad science” isn’t really science at all. It is mostly attempts to use a scientific veneer to justify things that REAL science doesn’t support. The way to tell the difference is what happens when real science comes out with data that contradict the “opinion leaders.” If they attack the data or those who promote or share it, they’re not involved with “bad science.” They’re involved in marketing!
But you ARE right, we do have to engage with anyone who is a real ally and not expect total agreement, except on the point that psychiatry as currently imagined needs to GO!
To be clear, I as moderator am not in the business of deciding what content or claims are accurate or inaccurate, thank the Lord! All I do is make sure that the comments fit the Posting Guidelines. There is no censorship on any kind of content-based grounds, and people are welcome to say more or less whatever they want, with very few exceptions regarding taking over the site with off-topic conversations that don’t advance the purpose of the website. It is the job of the Community at large to add their feedback and “correct” anything that seems exaggerated or unproven, just as you are attempting to do.
MIA needs to be judged on the articles. No website anywhere I know of is judged by the comments people make on the articles. I assume “professional” people understand this and act accordingly.
While I agree with your sentiments, having been “behind enemy lines” for a number of years, the problem is that the workers, while some struggle with the ethics of their situation, also have the power to easily pass on their frustrations and “moral injuries” to the very people they’re supposed to be caring for. The “consumers” or recipients or victims of their care have no such luxury. It is imperative that those working in the system who DO recognize what’s happening fight to change it, even if it means losing their jobs. Saying, “I had to harm them, I would have lost my job otherwise” is very similar to saying “I was only following orders.” Not a valid ethical “out” for someone who really understands the harm being done.
I always found “Behavioral Health” to be a bizarre term. How does behavior have “health?” Though I guess it provides a somewhat more honest glimpse into where these industries are really coming from. If we were healing “brain disorders,” wouldn’t it be “brain health?” No, it’s about controlling BEHAVIOR based on what Those In Charge think is “appropriate!” Not much science involved, but a lot of force and lies and manipulation!
Absolutely. No kid would voluntarily agree to do what is expected of kids in school. Or very few. It is absolutely bizarre to expect them to do so. The ones who act out just have more courage than I did!
Makes perfect sense, actually. Want objectivity? Talk to a robot! Healing comes from real interactions with real humans who are being honest and straight and care about each other.
I think he’s saying that the people RUNNING the system exhibit “psychopathic” tendencies, which include lack of empathy, willingness to commit crimes to accomplish desired goals, willingness to lie, cheat or steal to get what they want, sometimes even a certain perverse enjoyment in watching others suffer. Overall, it speaks to a massive need to control others’ lives at their expense, and a lack of any concern for the welfare of anyone but themselves. This is a very rough and incomplete description, but such people are only rarely ever “diagnosed” with any kind of “Mental illness,” but rather tend to skate through life making trouble for others and getting others blamed for things they themselves have arranged. Those who are “caught” are more likely to be in jail than the “mental health” system, but plenty such people get into positions of power in businesses or government agencies where they have enough control to harm people while being protected from any kind of consequences. Of course, the world of psychiatry provides many such opportunities, and it would hardly be surprising if that field attracted a disproportionate number of psychopathic individuals, some of whom may be actually directing the course of the organization/profession.
I was agonizingly bored in school! Wanted to poke my eyes out with a fork! I understand why kids act out, just to have SOMETHING interesting going on! Unfortunately, I was too scared to take those risks, but I sure thought about it!
I agree. The only therapists of any value are the ones who recognize that there is no such thing as “professional objectivity.” In order to be truly helpful, we have to understand that everything we do is at all times influenced by our own desires and motivations, and that we are only aware of a small percentage of them. It requires “constant vigilance,” not some fantasy belief that professional training somehow cancels out subjectivity!
I think you hit on something EXTREMELY important! It is those wounded by the abusers in society who are “diagnosed” and sent to “therapy,” while the perpetrators walk around harming others. Therapy at its best is about helping those harmed cope with the damage and the horrible awareness that abusers are running the show. I was fortunate to have a caring and competent therapist, so it’s very hard for me to even imagine what would happen to me if my therapist had joined forces with those authority figures responsible for the damage!!!!
Quite so. Trust is earned, it is given entirely at the discretion of the “truster.” Expecting someone to trust you because of your position is pretty massive authoritarianism.
I will suggest here that per the scientific method, we assume something is NOT effective until it is proven to be effective. The “null hypothesis” in this case is that antidepressants do not reduce suicidal thoughts or behavior. If such controversy and conflicting studies continue to exist 30-40 years after ADs were introduced, I think we can conclude at this point that they DO NOT reduce suicidal thoughts and behavior.
Of course, in the “antidepressants cause suicidal thoughts and behaviors,” the “null hypothesis is that they don’t. However, the fact there is a Black Box warning on all drugs impacting serotonin suggests there is enough evidence to concern people about their safety, especially in the young. Since there is almost zero evidence of any AD effectiveness in youth, and literally none in young children, even a chance of increasing suicide rates ought to be enough to eliminate these completely from the psychiatrist’s toolbox, at least for children.
At a minimum, the evidence to date is more than sufficient to conclude that antidepressants do not decrease the suicide rate for any subgroup of identified “depressed” people. The fact that certain “researchers” and “thought leaders” choose to cherrypick the studies they like should not divert us from this conclusion. Any decent review of the literature shows no positive effect, and many show possible increases in suicide rates, even in studies involving people who were screened for suicidality before starting. It’s not really that much in dispute, except for people who want to believe otherwise.
It has always infuriated me when therapists expect their clients to automatically trust them! Don’t they get that this is Step One of any decent helping process? I used to work with foster kids, and I’d often say to them, “I suspect you don’t trust me. That’s pretty smart. I wouldn’t trust me, either – you have no idea who I am or what my agenda is! And I don’t automatically trust you, either. I’m hoping as we get to know each other, we could develop some trust.” Or words to that effect. Oddly enough, I managed to earn the trust of many of them. I wonder why?
I agree with you for the most part. I would never have gotten where I am from psychotherapy. I did have a very good therapist and it was important in getting me started in seeing the limitations of my upbringing. But without Buddhism, meditation, exercise, a job that challenged me to overcome some of my anxieties, the support of important people (including my wife), an exploration of a wide range of spiritual practices, self-help books, and some good old fashioned hard work, I’d have never gotten anywhere. And from what I understand, the training for therapists these days has deteriorated, and they spend time studying the DSM diagnoses but don’t bother with little things like unconscious motivations or the long-term impact of trauma or domestic abuse dynamics. So I don’t want to deny that psychotherapy can play a role for some folks, but it needs to be one who really GETS what s/he is doing, and is empowering of the client to pursue his/her goals. My therapist told me her goal was for ME to become my own therapist and not need her any more. Not every therapist has such goals!
Anyway, I think you’re right, the best even the best therapist can offer (and as I see it, most of them aren’t very good!) is to help you set your feet on a different path. Where you end up going is TOTALLY up to you, and there are as many ways to find the path as there are humans on the Earth!
Forget about “borderline personality disorder” or any other of their anti-scientific labels. What does she really need? What behavior or issues does SHE think are creating problems for her? What does SHE want to be different? What does SHE think would be a good approach?
Usually, people who get branded with the “Borderline” label are those who have difficulty trusting others in relationships. See if you can talk to her about trust. Most are also people who have had traumatic experiences early in their lives. What kind of historical trauma is she still dealing with?
She needs support and understanding, not more labels. Psychotherapy CAN be helpful but only if you find the right person who can create a safe place for her to explore her life and what she wants to do with it. Another person bullying her around and telling her “what’s wrong with you” and what she needs to do will not be helpful. I don’t know what the best way to go about it is, but it starts with NOT accepting the labeling process and find some other people, professionals or not, who agree with you and are willing to help.
Nah. Psychiatry is a religion of greed selectively cherrypicking science to further its own economic ends. Science doesn’t enter into it, except as a red herring to distract from what’s actually happening. Proof is, any science contradicting their narrative is attacked and/or buried. There’s exactly nothing scientific about psychiatry.
Sorry, but psychiatry does NOT rely on “common sense.” Common sense dictates that people who have been emotionally distraught need to talk to someone. Anyone who has witnessed a car accident or experienced an upsetting incident has an immediate urge to tell their story to another human being, who helps best by listening. There is nothing common sensical about the idea that “mental disorders are caused by faulty brains.” That is a very non-intuitive idea that has been sold and sold HARD to the public through massive PR campaigns and through TV and movies and other media methods.
Common sense says that psychiatry is BS. It is only the pretense of “science” coming from the mouths of pseudo-“doctors” claiming “special knowledge” that allows people to actually invalidate their common sense and believe this unscientific and intuitively offensive nonsense!
I would also say that the training for “talk therapy” has deteriorated massively while classes on “diagnosing” with the DSM are hugely on the rise. I often wonder from talking to them whether today’s clinicians have ever even been introduced to the idea of subconscious motivation? They get trained that PTSD exists but to they get any kind of training on what to DO that might be helpful to a traumatized person (or what NOT to do?) Once one’s had “therapy” with a person who doesn’t know what they’re doing and makes things worse, the idea that “therapy” could work is canceled pretty much forever. Which leaves people with very few options!
Quite so. When the experimenters have no objective means to separate those “in” the group from those “not in” the group, the experiment is DOA. Which applies to pretty much all “mental health” studies, except perhaps those measuring adverse effects of the “treatments!”
You are confusing an observable problem and a workable solution.
Of course, no one here denies that people live on the street and talk to themselves. Believe it or not, A LOT of those people are “taking their meds” and still doing that, or have tried the “psychiatric treatment” path and it has failed miserably for them. Did you realize that the likelihood of recovering from “schizophrenia” is now a LOT WORSE than it was in the 1950s, before the “drug era” began? Did you realize that the likelihood of recovering is MUCH HIGHER in countries like Nigeria, Columbia, and other “developing countries” where “medication” is used far less frequently? Were you aware of the fact that a lot of people having first episode psychosis don’t have another, but that the likelihood of spontaneous improvement has REDUCED since psychiatric drugs are in regular use? Have you learned yet that the average “seriously mentally ill” person dies an average of 20-25 years YOUNGER than the rest of the population, and that the drugs used to “treat” these “illnesses” are largely responsible for many of these early deaths?
The social myth is that there are magic drugs that make everyone all better, and if only the “homeless” and the “mentally ill” would follow their doctors’ instructions, they’d be “normal” people working jobs and going to college and raising families, just like on the ads on TV or the movies and TV shows where someone goes “off their meds” and crashes and burns, but as soon as they’re back “on their meds,” they’re totally fine again. The industries have worked hard to create this impression, but if you can put this myth aside for a moment and actually READ some of the stories presented below, you might start to realize that it’s not such a pretty picture.
Psych drugs do seem to be helpful to a certain percentage of the population without serious damage to their quality of life, and more power to them. But the idea that doctors have some great “treatments” that make MOST people “normal” again if only they do as they’re told is completely false. The bulk of “seriously mentally ill” people who are in “compliance” with their treatment plans are poor, unemployed (on disability), and living lives that most of us would consider extremely low in quality. Those who do better often do so despite their “treatment plans” and “providers” rather than because of them, or at least have little to no support for improving their life quality from those supposedly “treating” them besides the drugs they are prescribed. Considering the massive adverse effects most experience, ranging from involuntary movements to severely blunted emotions and motivation to loss of sexual function to enormous weight gain to diabetes and heart disease, it might seem that living on the streets is hardly any worse to some recipients. And that’s not even mentioning the tremendous loss of autonomy most experience, being constantly monitored and told what to do and threatened with incarceration, framed as “hospitalization,” if they step out of line or their “symptoms” increase.
It is very easy to judge if you’re not someone who has had these experiences yourself. Why don’t you suspend the judgment for a while and try reading some of the many stories here about what has happened to people here who “complied” with their “treatment plans” and ended up devastated? There’s a LOT more to the story than you seem to have heard to this point!
The key question would be whether one could distinguish in some objective way between “biological” and “situational depression.” Of course, no one has come close to doing that, and they don’t even bother trying any longer. It’s just “let’s try these drugs out and see what happens.” No pretension in reality of any kind of scientific diagnostic process. But as long as the big money keeps coming in, no one has an incentive to look deeper.
You are assuming that treatment plans mandated by “healthcare professionals” are going to be helpful. Read some of the stories below and you may begin to question that assumption. Saying something “must be dealt with one way or another” does not mean that the one way currently being used is the best approach.
It’s hard to see why anyone needs to do a study to “prove” this. Shouldn’t it be the job of those claiming this “disorder” has validity to prove it does, rather than the other way around???
Maybe just start with the person where they are at, and stop worrying about whether they “fit” the PTSD “diagnosis,” and instead start asking questions and getting to know them on a real level and finding out where they’re at and what they really need?
But many Deaf people in my observation also DON’T view themselves as disabled. In my experience, there is a wide range of ways people view their Deafness, and it would be wise for those not a part of that community not to speak for “them.”
Where can you have come up with such statistics? As far as I know, there is no objective description or measurement of a “neurotypical” brain that is possible. So a “neurodivergent” brain, while I think can be a legitimate identity to choose, is not a scientifically observable phenomenon, and as a result, its frequency of occurrence is not something we can claim to know.
I personally find the term “neurotypical” to be to some extent demeaning, as it seems to imply that I have somehow gotten a “normal” brain and that therefore any struggles I may have are of less significance than the “neurodiverse” brain. I can tell you with absolute certainty there is nothing “typical” about how I have experienced life and I had plenty of struggles in school and elsewhere, even though my particular “brain” (if that is indeed the variable in question) allowed me to be quite successful in the educational environment and to scrape by socially, “it” has provided plenty of challenges in non-academic arenas. Of course, you could now decide (or I could) that I really am NOT neurotypical, that I’m “neurodiverse,” but again, that would be a decision of identity that I (or someone else) made, and not one that can be verified in any scientific manner.
I don’t believe there are “neurotypical” brains out there – my observation is that everyone’s brain is different and everyone has certain things in common, and our society is highly intolerant of certain personality characteristics or behavior, which leads to bigotry and discrimination against certain people who don’t BEHAVIORALLY fit what is expected, whether because of their brains or some other reason. Does neurology factor into that? No doubt. But until there is a means of drawing some kind of objective line between the “neurotypical” and the “neurodiverse,” I’m afraid these terms remain social constructs without any objective meanings. Like I said, everyone should feel free to identify themselves as they wish, but I’d appreciate you and others not choosing MY identity for me!
Quite so. It is never the fault of the practitioners – the client or the “disorder” is resisting! So how is success ever to be defined, if you can’t fail except as a result of something they have no control over!
There are most likely some in Turkey who know the truth. But it may be hard to find each other. Most countries are dominated by people who are “true believers” in psychiatry and tend to attack and humiliate those who don’t agree with them.
It may be that you are the one who will have to educate others about what you’ve learned. We are all in the minority!
My point is that having a goal over which you have no direct control is a setup for failure, in my experience. Empathy in particular is VERY difficult to teach, especially to an adult. Not saying it could not happen, but I’d be more likely to look at something more along the lines of not engaging when negative stuff is coming from her, drilling how to convey the necessary message most effectively, and how to set good boundaries when she becomes abusive. All things the person himself can control. I’ve seen way too many people spend way too much time trying to “get their viewpoint across” or “help him see how he’s hurting me,” etc., with absolutely no success and enormous frustration. I recommend setting goals that a person can accomplish, regardless of whether someone else chooses to “understand” or not!
That DOES make a lot of sense. My only caution is that “depression” is not caused by any one thing. But testing for THIS particular thing could save a LOT of trouble and suffering for a certain identifiable subset of the population!
A goal of making one’s WIFE more compassionate is a pretty inappropriate therapy goal! You can’t make other people compassionate! That seems like his first problem!
I believe the link goes both ways – psychological trauma is associated with increasing inflammation and immune response. Autoimmune diseases are more common with people who have been abused, in a dose-dependent manner, as I recall.
The question is, how can anyone POSSIBLY determine where such a “line” lies, or if it even exists? And if we DON’T objectively define what it is, then we get arbitrary and subjective rules, leading to “diagnostic drift” toward whatever makes more money for the providers and less trouble for those in control of society’s institutions.
And why do we need to define such a line anyway? Why can’t we simply say that “those who suffer need and deserve support” and provide it without pretending there is something physiological going on? Now, if there IS something physical that is off, like low thyroid, anemia, sleep problems leading to depression or hyperactivity, or whatever, then THAT is what should be treated, not “depression” or “anxiety.”
I’d really be interested in knowing why you think such a line can be and/or needs to be drawn to be able to provide full support to those who are suffering?
Somebody decided to go after Kratom and started making it into a “story.” That’s how a lot of news happens, someone with a lot of money and/or power decides to make it a “story” and then tells the papers what to write!
I hope that you found people with this label were a lot more different than they were similar to each other. That was my experience. The main thing they mostly had in common is that their early lives were shitty. Other than that, I saw a huge range of human interests, abilities, and personalities carelessly lumped together simply because traumatization had made it more challenging for the poor professionals to figure out what was going on.
I actually have no patience for this “diagnosis.” Why not just say, “Mary was abused as a kid and has trouble trusting people” or whatever else is going on? Why talk about this group as if they had anything in common besides being labeled and discriminated against by the “system” personnel?
Well, there are no profits to be made from fixing society! Far better to blame and drug the patient and protect the status quo, which provides so many “customers!”
Actually, the “comorbidity” is, in my view, not because these “conditions” share things, but because they are not actual medical “conditions” at all. What should be diagnosed is neuroinflammation, histamine intolerance, vitamin D deficiency, etc, rather than wasting time on these meaningless DSM “diagnoses” that don’t tell us anything about the actual problem at hand.
That’s one of the most insidious dangers of the “label and drug” approach. It gives the impression that your environment is harmless and YOU have the problem. If only your brain worked better, you wouldn’t MIND being worked 60 hours a week at a mindless job that challenges your personal ethics on a daily basis! It’s all about Bad Brains, never about fixing the environment and expectations that lead to burnout!
There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
I don’t believe that is completely true. They can apparently test for people who are “slow metabolizers” of different drugs and so perhaps avoid creating homicidal/suicidal ideation by SOME people taking SSRIs, but these tests appear to be far from foolproof, and just as importantly, almost no physicians regularly use such testing in their practice, despite your assertion that “ANY WISE PHYSICIAN” will do so. I’d be happy to be proven wrong about this, but that’s my understanding of the current situation. I have yet to meet a person currently engaged in the MH system who was offered such testing by their doctor, though I’ve heard of a few who demanded it themselves. Do you have any links to recent studies showing anything more promising than what I’ve identified above?
Unfortunately, a great deal of what passes for “psychotherapy” these days does not incorporate any of the important philosophical underpinnings you mention above. A lot seems to now be focused on “neurobiology,” on DSM “diagnoses,” and on compliance with “medication” and other “treatment plans” like DBT or CBT. I did therapy for a number of years in various settings, some formal and some informal, and saw and heard what others were exposed to by their “therapists,” who in my view did not deserve the name. I’m not sure they are even taught about unconscious motivations or ideas of consciousness or striving or attachment or awareness of one’s own process, let alone touching on the existential issues of the bizarre expectations and abuses of modern society. The focus seems to be on making “symptoms” go away, as if “depression” or “anxiety” were the problem rather than the observable manifestation of the actual issues causing distress. This is the inevitable result of “DSM” thinking – reducing the complexity and spiritual richness of human experience to “desirable” and “undesirable” emotions or behavior, which the therapist and/or psychiatrist is tasked to change, by force or manipulation if needed. It is small wonder that folks faith in psychotherapy as you describe it is very low – very few people seem to ever experience it these days!
I’m glad Ketamine therapy works so well for you! But I do want to remind you that this doesn’t mean it works for everyone. The idea that all people who are depressed have the same problem or need the same solution is not scientifically valid. I rejoice that people find Ketamine or any other approach workable for them. I just want to be cautious about using anecdotal data to extrapolate for others who may have very different circumstances and very different results than you had.
Clearly, the most fundamental fallacy with the entire psychiatric edifice is the assumption that all people who “have depression” or whatever “mental illness” is under discussion are all ILL and have the SAME PROBLEM and need the SAME INTERVENTION. The DSM itself invalidates this assumption in its introduction, but this apparently has no impact on people’s viewing these “diagnoses” as some kind of valid scientific entity that can somehow be “researched” as such, even though the people in the study group often have little to nothing in common with each other. In fact, it’s been shown that multiple people can “qualify” for the same “diagnosis” and have not a single “symptom” in common! How it’s not obvious to anyone of a slightly scientific bent that this whole system is a house of cards built on nothing but opinion and bias is beyond my comprehension.
Which once again reinforces the idea that the person one is interacting with, their maturity, skills, openness to experience, ability to create a safe environment, ability to help a client focus on their own goals and purposes, is what really matters in any kind of “therapy” or healing practice. I find calling MDMA “medicine” in itself to be an absurdity. It is not a “medical” process you are describing, it is a spiritual/emotional/intellectual journey that is very personal to each individual, and there is no way to create a repetitive “treatment” that can obtain any kind of consistent and predictable results for all people. The key is who is helping “guide” you and what kind of “guidance” they tend to provide (empowering vs authoritarian) rather than the particular drug or other method used. This is not to say that MDMA or any other drug may not be able to contribute to increased spiritual awareness or skills in life, but it’s not “medicine,” any more than alcohol or marijuana are “medicine” because they have certain effects that a person may or may not desire or benefit from.
I do think it is of great concern that the number of contacts appears to have a direct relationship to the number of detentions. This would imply that the increase in contacts would have the same demographic distribution of seriousness as the ones already contacting crisis lines previously. Unless this is simply a redistribution of people who would have contacted another crisis line if 988 did not exist (which of course means there is NOT really an increase in contacts at all), one would expect that the new callers would have a LESS serious distribution of issues, because we should be courting new contacts who otherwise might not have called (the purpose of the 988 easier access).
So there are two likely conclusions: first, that these callers are the same people who already used local crisis lines, and we have spent millions and millions of dollars to accomplish essentially nothing at all, or second, that calling a crisis line gives a particular probability of having the police dispatched, regardless of the average severity of the call. Neither one is a happy conclusion!
We shouldn’t have to prove they are dangerous. The standard is that the doctors/pharma need to prove they are safe. I think the biggest problem is we have hired a lot of foxes guarding the henhouse of drug safety. If we had a REAL set of standards with honest, non-corrupt people applying them, we’d all be a lot safer and it would be a lot easier to get complaints heard and acted upon!
Why is it sad? Science is about facts, not feelings. It is GOOD that Ketamine’s rah-rah propaganda has been served a well-deserved challenge. We need to know the truth.
It is easy to confuse “These categories are not scientifically valid diagnoses” with “debilitating anxiety doesn’t exist.” They are VERY different statements. I doubt anyone here would state that debilitating social fear and apprehension don’t exist or are not painful and difficult. The argument would be that just because you feel anxious in social situations, no matter how severe, it doesn’t mean you are “ill” in a medical sense.
I say this as a person who suffered debilitating anxiety and depression in my youth, and now at 65 rarely experience anything similar. I did get therapy for a while and do a lot of self-help stuff but never was “diagnosed” with anything at all by my therapist. It is not necessary to validate these “diagnoses” in order to agree that someone needs help and support and to assist them in getting to a better place. I’m also not invalidating the potential usefulness of psychiatric drugs, just saying that the “diagnoses” themselves are not valid medical/scientific entities, and that saying so doesn’t invalidate ANYONE’S suffering!
I wouldn’t call it easy, but it’s definitely do-able. I have a little preamble I give to any new doctor I see about how I’m going to be the one making the final decisions, and if that’s a problem for them, let me know now so I can find another provider. And I have had to do that on occasion, but it almost always puts them in their place.
That is exactly my point. How is “standardization” even possible when there are no objective standards possible regarding what diagnosis to give, how to do a danger assessment, optimum “treatment,” what “good outcomes” are, how to measure them, etc.? It’s all so completely arbitrary! How can “imminent risk” ever be anything but haphazard and varied?
I am sure this is an accurate summary of what is happening today. One of the main reasons I left the crisis line was the “professionalization,” which meant more fear of lawsuits, more rules and expectations and rigidity, and a greater likelihood of sending the police out on calls that did not really pose any danger at all. And the lack of any kind of objective standards for police dispatching or diagnosing or anything at all in the “mental health” world makes “quality control” almost impossible.
But it does encourage me to know that crisis lines do still exist where dispatching is not an option, and I wanted to make sure I shared that fact. Of course, it’s a volunteer crisis line, not a “professional” one!
My experience (and I have a lot) is that crisis lines I’ve worked at or volunteered at had a wide range of different views on what to do about suicidal callers. I was a supervisor for a volunteer crisis line in Portland, OR, and we tried only to talk unless a person had a specific plan and intent to carry it out. The line contract was taken over by a “professional” service and the likelihood of a dispatch went up quite significantly, though they did eventually develop a “crisis team” who would see some of the people without police being involved. I later volunteered at a crisis line that never traced or dispatched under any circumstances. So it’s not legitimate to overgeneralize – different crisis lines have different philosophies, and it may also depend very much on whom you reach when you call. I can see people being VERY cautious about sharing that they are suicidal with such a crisis line, without knowing what their general philosophy about such calls is and how frequently they tend to dispatch the police!
I’m not sure I’d say the act of a stimulant improving concentration temporarily represents “healing” per se. Smoking marijuana or drinking alcohol reduces anxiety for many, but I’d not suggest they are “healed” by the process. There are no doubt some healing processes that are mediated by drugs, but I consider this to be more or less incidental to psychiatry’s intent. For instance, I know of a guy who took stimulants for a little while and said he discovered a mental state he could get to that way, then he STOPPED taking the stimulants and found other ways to achieve that same kind of mental state. I’d call that a kind of healing, and the stimulants were a part of it, but no psychiatrist would recommend or approve of the real healing part of that action.
Anyway, that’s just my personal view on it. Some people find psychiatric drugs beneficial for whatever reason, and more power to them, but I don’t think it’s a form of “healing” to take a drug that makes you feel better temporarily. It might be the first step in healing, but psychiatry as a rule discourages any attempt at any further “steps,” in my experience. Healing tends to happen despite their interventions, not because of them.
“Pre-dying!” I love it! It’s a condition we can ALL claim!
The same happened with cholesterol, BTW. At one point, you had to be 160 or so before anyone got worried. Then for no real reason, they changed it to 120. Actually, there was a reason – to sell more cholesterol-lowering drugs!
It is not “demonizing medications” to observe what the research really shows and to share people’s individual experiences. It’s called sharing reality. If “medications” need to be protected from the actual facts about them, it says a lot about who is demonizing whom.
And is in fact contrary to research showing that long-term use of antipsychotics REDUCES the average lifespan of the recipient! The odds are that she’d have lived longer if she’s avoided psychiatry altogether!
It does feel more than a little ironic to hear that she was attacked for questioning the efficacy of antidepressants, and yet failure to take antidepressants is assumed to be the cause of her suicide. As I said earlier, wherever you come down on the “cause” of her suicide, which of course, we will never really know, it is VERY clear to me that psychiatry did NOT get her to a place where she achieved “good mental health.” She clearly eventually gave up on psychiatry because it failed her. It is more than a little disingenuous to imply that her abandoning a practice that never really worked for her is somehow responsible for her despair.
My reality is that therapists who can create a kind and secure environment for a client to share and to some extent be challenged to seek new perspectives have success, regardless of the model they use. “DBT” will work well in the hands of a highly competent therapist, and will be a disaster in the hands of an incompetent one. CBT will similarly be successful to the degree the therapist can create a safe and connected environment where a person can share their fears and explore new options without feeling judged or threatened by the therapist. Whereas an insensitive or self-involved or “rote” therapist will have no success with CBT or any other approach.
There is no way any person can become a “good therapist” by studying a manual and following instructions without truly understanding the nature of the delicate and emotionally sensitive interactions they need to become a part of. There is solid research supporting this viewpoint. I don’t think DBT is good or bad in and of itself, I just think it’s a bunch of possible tools that a competent therapist can use to build up their client’s feelings of success and control, or a bunch of possible tools an incompetent therapist can use to make their clients feel worse and then blame the clients for the therapists’ own failure.
Considering there is absolutely NO evidence that any of the DSM “mental disorders” are fully or primarily caused by biological problems or issues, it’s mystifying why “anti-stigma” campaigns focus so much on convincing people that “mental disorders” are “illnesses like any other.” Unless the intent is not, in fact, to fight stigma, but to fight resistance to accepting drug therapy as the first line intervention for these ostensible “disorders.” Then and only then does this focus make any kind of sense. But then calling these “anti-stigma campaigns” isn’t very honest, is it?
A wise person once said, “All that is not love, is fear!” Fearing our emotions prevents us from feeling the love and connection that for most of us makes life feel like it’s worth living.
They also screen out suicidal people from the vast majority of these clinical trials, so these are not “suicidal people getting the energy to do it.” These are people who, for the most part, were not suicidal until they took the drugs. They most definitely can and do cause suicidal thinking. Hence, the black box warning. That warning ought to be enough for anyone to acknowledge the possibility.
My favorite analogy is “You have pain in your knee because you suffer from knee pain disorder. You know you have knee pain disorder when your knees hurt, but knee pain disorder also CAUSES your knees to hurt.” Very informative!
As extreme and simplistic as the idea that “schizophrenia” is in all cases caused by genetic or biological malfunctions which no one has ever been able to detect but we KNOW must be there?
I’m always the enemy of extreme and simplistic. I just want to make sure that everyone is fully aware of the extreme simplistic basis for these ridiculous psychiatric “diagnoses” and the insistence on “treatments” being determined by such laughably unscientific claims. The proper attitude toward any case of “schizophrenia” is that we have a NAME but very little knowledge of what is going on IN THIS CASE and need to explore what’s happening IN THIS CASE and what might work IN THIS CASE. Trying to generalize based on these laughable “syndromes” where two people can both be “diagnosed” and literally have no symptoms in common (try it some time, it’s quite possible in at least schizophrenia and major depression by my direct observation) is almost as far away from scientific as one can get.
I don’t know about the “subscription” button. I’ll look into that for you.
Dismissing trauma as a causal factor in “mental illness” displays either ignorance or a willful attempt to redirect people away from exploring this very real issue.
I always find it odd that defenders of the current psychiatric paradigm so frequently conflate criticisms of that paradigm with ‘stigma concerning mental health.’ The two have literally nothing to do with each other. There is, in fact, HUGE “stigma” for people suffering emotional pain who DON’T use psychiatric drugs as part of their treatment, and those who choose to discontinue such treatment are often attacked relentlessly by the very people who are supposed to be helping them.
There is certainly general discrimination in the public sphere against people who qualify for or identify with a “mental health diagnosis.” On that point, I’m sure you will find no disagreement on this site whatsoever. However, it is actually shown by scientific research that teaching people to view “mental illness” as a brain disorder of some sort INCREASES “stigma” and discrimination by making it easier for people to emotionally distance themselves from those who are suffering, while a “trauma-based” framing increases empathy and DECREASES stigma.
So please don’t blame “stigma” on those who question the accepted psychiatric paradigm. It is the accepted paradigm itself which is responsible for most of the stigma, according to their own research. There is nothing wrong with questioning the scientific validity of psychiatry’s unproven assumptions, nor does questioning those assumptions mean or imply that those finding psychiatric drugs helpful are wrong or need to be forbidden from using them. Again, the two issues have literally not a thing in common.
It is not at all far fetched to suppose that childhood abuse can contribute to the eventual development of psychotic states. There is also strong correlation with being an immigrant and living in an urban environment.
As in all of the so-called “mental disorders,” the situation is FAR more complex than the “mental health” world would like us to believe. There is “no proof” (to use your words) that ANY “mental illness” as defined by the DSM is caused by any measurable biological/genetic factor either. I’d agree that current drug use and current trauma are often overlooked as contributing factors in psychosis. Maybe the problem is regarding “psychosis” as if it must always be caused by the same things or “treated” in the same fashion. Maybe there are many “causes” that work differently in many different people, and we ought to scrap the idea that “schizophrenia” is a “thing” that has a specific cause.
Additionally, a very significant percentage of studies use a “placebo washout” design, where they screen people who DO respond to the placebo out of the trials! This is obviously designed to minimize the placebo response and make it more likely that the drug will meet “statistical significance” vs. placebo. So far from using active placeboes, most studies actually try to weed out those who will respond to an INACTIVE placebo in order to bias the study in the direction of their drug. And somehow, this is not considered a violation of the scientific method!
Here is a published article in a solid, scientific journal for the original poster to read. It goes over why the author concludes that more than half of all published scientific studies can’t be replicated, and hence are not valid. It ought to make him/her more cautious in assuming that anything published in a scientific journal is de facto proven truth!
One article in an online publication has “done society a disservice!” Why refer back to Freud or Szasz to try and discredit the arguments of the author through the reverse “argument by authority” approach? Don’t you have your own arguments to make?
It would appear to me you might want to re-read Szasz again, as he never claimed that the phenomena describes as “mental illness” did not exist, but that the idea that these were discrete and identifiable “disease states” of the body was mythological, as this concept is not supported by scientific facts.
There is nothing “unqualified” about the argument that traumatic events alter people’s concept of who they are and how the world operates and what relationships are about. In fact, the entire movement toward “trauma informed care” is based on scientific proof that not only their behavior, but that people’s actual brain structures and activities can be dramatically altered both by early life trauma AND improved by healthy relationships later on in life. It is pretty regressive at this point for anyone to claim that traumatic events do NOT impact all of the so-called “mental illnesses” as defined by the DSM, however fuzzy and arbitrary those definitions may be. Even the most medicalized psychiatric supporters at this point know that the idea of a “chemical imbalance” or other purely physiological problem creating any “mental illness” being detectable by tests and repairable by drugs is completely unsupportable by scientific studies.
Ironically, there is far MORE support for the remnants of Freud’s “trauma theory” through the “trauma informed care” movement than for the idea that any discrete “mental illness” described by the DSM is a scientifically valid description of reality. Even more ironically, the DSM itself admits these things in its introduction, where it says that:
“In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi).”
And even more tellingly: “There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.” (APA, 2000, p. xxxi).”
So not only can the DSM criteria NOT distinguish between having one “disorder” or another “disorder,” or between having a “disorder” or having “no disorder.” Worse, two people who both CLEARLY QUALIFY for a given disorder may not have the same problems, needs, or possible solutions! What is the point of having “diagnoses” where the people who are so diagnosed are NOT “alike in all important ways?” Isn’t the point of a “diagnosis” to group together people who have similar needs and issues and distinguish people who have similar presentations but different underlying causes? These two clauses admit outright that these “diagnoses” are scientifically and practically meaningless!
So before you go about accusing others of “unqualified arguments,” it might be wise to spend some time to qualify your own arguments. No one arguing in favor of the DSM “diagnoses” being taken seriously in any scientific manner is in a position to criticize anyone else for being “unscientific!”
It is easy to move from “she wasn’t taking her meds” or “she engaged in recreational drug use” to “she killed herself because she stopped her meds” and/or “she killed herself because she’s an addict.” Neither of those premises has any more evidence backing them up than the “psychiatry killed her” idea. Any of those are possible, none are provable. But one thing we DO know for sure – this person had the best of available psychiatric care for decades, did not “resist” or “rebel” but in fact embraced the system for most of that time, and all of that “help” did not prevent her eventual suicide. It is certainly NOT valid to suggest that everything was going just fine before she “quit her meds!” It sounds from her blogs like she struggled the entire time she was “in treatment” and went another direction for whatever reason she chose. It would be EXTREMELY naïve to look at her situation and say, “if only she’d stayed on her meds…” Whether her suicide was caused by her engagement or disengagement with “the system” is not something we can determine, but I think it is more than fair to say that psychiatry failed her in many ways, and it’s never appropriate in my mind to blame the client for quitting services when the services have not been successful. If psychiatry were the answer for her, 20 or more years of committed engagement with the psychiatric system would have led to a different outcome. I think it’s more than fair to suggest that psychiatry AT BEST did not help the situation, despite her being fully committed to following their instructions for many years. Let’s not blame “not taking her meds” so easily, since we’re hearing we’re not supposed to be so “black and white” in our thinking as the author supposedly is.
It is true that we don’t ever know what prompted a particular person’s suicide. What we DO know in this case is that decades of psychiatric treatment did not prevent it. Whether it contributed substantially to the event or not will always be speculative, but it’s equally speculative to say, “Antidepressants save lives,” when we don’t know how people would have acted under differing circumstances.
It sounds like you might need some help getting away from an abusive partner! Are there any domestic abuse hotlines or programs in your area? There is hope, but you will have to figure out a way of putting at least some emotional distance between you and your husband. No one should be forced to live with someone who hates them so much they intentionally make an addict out of her!
I would add that the presence of psychiatric drugs not only can do damage itself, but it also diverts young people (and older people) from other approaches that have been successful over time, both formally and informally. It may be the lack of developing support networks as much as drug side effects that are helping cause the deterioration of youth “mental health” today.
Please recall that there is also a POWERFUL stigma AGAINST those who choose NOT to accept the standard “treatment” offered by psychiatry, even when it is demonstrably doing serious harm.
There are actually plenty of hard scientific studies showing that psychotropic medications IN GENERAL tend to create worse clinical outcomes. Harrow et al for instance showed that people with poorer prognoses that took antipsychotics only briefly or not at all did BETTER than those who had better prognoses and took antipsychotics long term. So on the average, they were worse off taking psychotropic drugs.
Studies on antidepressants and “ADHD” also show no average benefit or worse outcomes for those taking drugs over the long term.
Multiple studies show an increase in suicidal thinking and acts in those taking antidepressants, especially when younger.
Many studies show the “severely mentally ill” have shorter life spans than the average person, much of it due to heart and metabolic problems that are known to be caused by antipsychotic drugs (clearly, there are other contributing factors as well, but treatment is associated with reduced life span).
Your analogies are completely inappropriate. Taking diabetic treatment does not INCREASE the number of amputations, it decreases them. The same can’t be said for psychosis and antipsychotics or suicide and antidepressants. Not to mention, diabetes is known to be caused by a lack of insulin in all cases. No one suffers from psychosis for a lack of antipsychotics.
Perhaps a more open mind and some honest research will help you see that the situation is not as black and white as you currently believe. You might start by reading Whitaker’s book, “Anatomy of an Epidemic.” It could be quite enlightening.
MIA is mostly interested in looking at alternatives to the “medical model.” It is unlikely we will want to promote any “antipsychotic” drugs given the history of failure and worsening of “symptoms” and in fact the shortening of lives resulting from the “antipsychotics” currently in use. It seems very unlikely that the “new” drugs will be doing anything beyond trying to suppress dopamine and maybe suppress the uptake of Serotonin like Risperdal and Seroquel and the other current drugs.
It is truly a problem to be unable to continue. I’m betting no one warned you this could be an outcome of taking them in the first place! Have you talked to anyone who specializes in getting off drugs? There are such people around, but most psychiatrists either don’t know or actively try to prevent any effort for people to get off.
The use of the term “inclusion” already marginalizes the peer support workers. Who gets to decide if they are “included” or not? Obviously the REAL workers, who are by definition more important than the “peer workers” because they can “include” them or not at their whim.
Reminds me of the concept of “shared decision making,” where clinicians are “encouraged” to “take the views of their clients into account” before making decisions. Obviously, the people being asked to “allow” their clients to have a “voice” are already trampling the rights of clients to true informed consent, and asking them nicely to please ask my opinion before you decide what to do to me is hardly a viable solution.
It is very odd that in most cases, we assume that the device provider is responsible for proving the safety of its products, but in this case, it appears that the “clients” (including forced, involuntary victims) have to prove that it’s NOT safe!
To be clear, I am not against systematic interventions to help people who are struggling, as you seem to suggest. I just want to focus on things that actually work FROM THE POINT OF VIEW OF THE CLIENT. There are some people I know who have used the drugs as a means to help themselves, and have suffered minimal adverse effects. I’ve also known others whose lives were destroyed following that path. I used to be a counselor/therapist and I believe helped lots of people find their way to a new path or direction for their lives. My approach helped a lot of folks, but I know it didn’t help everyone I came in contact with. I had a philosophy that allowed me to connect more directly with people about what their concerns and needs were, and I’ve taken people who had all kinds of different labels and been successful when they experienced failure in “the system.” I could share some pretty impressive stories of monumental changes in people who the “Mental health professionals” had decided were intractable.
Others needed things I couldn’t provide. I tried to help them find some other pathway. I have never had or expressed the viewpoint that there is no such thing as suffering that requires some sort of advanced intervention. I am not sure where you ever got that idea, but I would appreciate it if you drop that as it applies to me. As you are against “bullying” as you so aptly put it, I’d really appreciate you not deciding for me what I believe and drawing conclusions on the basis of those assumptions.
I don’t think mapping the brain will create an understanding of “mental health.” But I do think that real brain research shows and will continue to show that the idea of “mental illness” is a “brain disease” is, scientifically speaking, complete nonsense.
The problem is not that people don’t fully use the criteria (even though they almost never do), it’s that the criteria themselves are subjective, speculative, and completely unscientific in nature. You can’t judge “overdiagnosis” if there is no objective way to tell who “has” or “does not have” a particular “disorder.” The DSM itself admits in its introduction that 1) you can’t really tell who has which “disorder,” or where the line between “disorder” and “no disorder” can be drawn, and 2) any two people who COMPLETELY FIT the criteria at a given moment may not have the same problem or need the same kind of help. Of course, almost no one ever READS the introduction, and it’s couched in very squirmy language that requires interpretation, but it’s a pretty damning admission, don’t you think? We have no way of objectively determining which diagnosis you have, and even if you and another person are right in the center of the target, your diagnosis means nothing about the cause or your needs or what treatment to recommend. What is the value of such a “diagnosis?”
When I did clinical work in the past, I simply talked to the client about his/her own conception of the problem and what they thought might have helped. While of course I asked good questions and made observations and brainstormed options with the client, in the end, the client was responsible for defining the problem and whether or not a particular intervention was “working.” It is arrogant in the extreme in my view for a clinician to enforce his/her views on what is “wrong” or what “should be done” on a client, as the main reason people suffer from “mental health issues” in the first place, ESPECIALLY when we’re talking about depression and/or anxiety, is because OTHER PEOPLE have taken over their lives and told them what to think, say or do and what was “right” in opposition to allowing the to follow their own personal “voice.” I consider it more abuse for a “professional” to boss a client around and disempower them the way they were disempowered by others in their pasts. Empowerment is the answer, not more powerful people exerting their control over the clients’ lives.
Which is how research ought to be done! The actual data should be reported and acted upon, even if the knee surgeons might lose some money in the process!
Exactly. If the current model were working, people who USED TO BE disabled would now be OFF disability and working again! If someone’s disabled with, say, a bad knee, and gets knee surgery, we would expect that the corhort of such people would be LESS disabled than before the surgery! There may be a few for whom it did not work and they didn’t get better or got worse, but overall, the average disability level would have to go DOWN for this intervention to be considered effective! If people are MORE likely to be unable to work and participate in society AFTER receiving psychiatric “treatment” than before – well, there isn’t a much better definition of “ineffective” or indeed “counterproductive” available than having a “treatment” actually INCREASE the disability rate of its recipients!
Again, I think you are confusing efforts to help with effectiveness. Stating things like “ECT is effective and safe” is just as dangerous or moreso than saying, “ECT can have serious adverse effects which should be considered before undertaking such a course of action.” Are you seriously claiming that there are NO or MINIMAL adverse reactions to “ECT” despite all of the hard and soft data showing that the results for some people are devastating? You do realize that “ECT” is the intentional induction of a convulsive seizure (hence the name) and that under normal circumstances, such seizures are considered dangerous and people take drugs to avoid them because of potential brain damage? Why would an intentionally induced seizure NOT be likely to produce brain damage when a spontaneous one IS likely to produce such damage?
My beef with psychiatry is mostly the blithe dismissal of very real concerns that exist, as you demonstrate in your comment. It is not HATEFUL toward psychiatry to report on actual events and studies that challenge the conventional wisdom. “Trust me” is a dangerous comment for ANY physician to make, but more particularly those working in psychiatry, where knowledge is scarce and speculative on the ground and no one really understands the exact cause of ANY “disorder,” or even if such a “disorder” syndrome is a legitimate entity for study rather than a broad collection of phenomena which have been cast together into a syndrome because we don’t understand them, purporting to “know all about it” is just a blatant deception.
Psychiatry would be a lot better off as a medical specialty if it took a big dose of humility and started to understand that these bad results are very often NOT random or made up or the result of “lifestyle issues,” but are very real and potentially dangerous side effects of the “treatments” they are handing out. That way, at least some measure of “informed consent” can be practiced, rather than providing bland and scientifically empty reassurances such as “ECT is safe and effective.”
I worked for 20 years in the foster care system and the stories are all too familiar. I helped get a law passed to require such evaluations of kids before they were ever put on psych drugs, and with the help of a state-level nurse, we also managed to implement a triggered review of any case involving certain polypharmacy criteria. The drugging rate HAS dropped since then in Oregon, but it’s still way too high. It is the inevitable result of inventing “diseases” that can’t be objectively determined and giving people drugs for them. There will always be “diagnostic creep” if there is no hard line to decide when intervention is needed, as is the case with essentially every psychiatric “disorder.”
Another interesting fact was that those kids cared for by relatives had a MUCH lower rate of psych drugging than those being fostered by strangers. I have the greatest respect for the many excellent foster parents out there, but think it really helps to have someone in the room with the doctor who feels a familial obligation to care for the child’s needs. It’s way too easy in the current system to believe we are acting in the child’s interests when we’re actually acting to make the adults’ lives easier. That won’t change until we get rid of these bullshit subjective “diagnoses” as excuses to drug kids into compliance or docility.
It depends on how frequent the adverse effects are and how seriously they damage people. There are plenty of banned therapies for various physiological problems that are considered too risky, even if they work for some people. I agree some people seem to report positive results, and I don’t particularly want to take that away from them, but it’s a cost/benefit analysis that transcends the needs of individuals.
I also think we should remember that Vioxx, for instance, did provide pain relief for a lot of people. It also killed a certain small percentage of them, far from a majority, actually a very small minority. It was taken off the market. Because it killed people. But some people found it very helpful. The FDA decided it wasn’t OK to risk people dying, even a small percentage, in exchange for pain relief.
It isn’t always OK to allow a potentially unsafe intervention even if some people do fine on it, especially when you have no way to determine a head of time whom you might accidentally kill or whose life you may accidentally ruin.
Can you please provide evidence for your claims? It’s easy to say things without providing the actual backup. I’ve heard and read statistics that are WILDLY different from what you are claiming, so I need to see where you’re getting this info to put it into any kind of perspective.
Saying that these folks need help does NOT translate into we should assume and accept that what the psychiatric profession has to offer is the kind of “help” that they need. It is absolutely wrong to postulate that needing attention means needing the kind of abusive and destructive behavior that is often accepted and even encouraged in the name of “psychiatric care.”
Those “helped” by psychiatry with psychotic disorders die on the average 20-25 years YOUNGER than those who don’t receive such treatment. While it’s obvious that there are many variables involved, I challenge you to name another profession where receiving treatment REDUCES average lifespan. Something is not right here. The problem is not that these individuals need attention, it’s that the kind of attention they receive is not the kind of attention then need in a large proportion of cases.
I’m so sorry you had to go through all of this. It sounds like a total nightmare. How people get PAID to do this kind of damage is beyond comprehension.
They never want to admit the significance of the placebo effect. BELIEF can be more powerful than actual physical phenomena in the body! How much MORE causative can belief be over mental phenomena?
You’re right, they can’t really study it honestly. They can’t afford to let the results get out!
Sadly, I can validate all of your observations in the people I’ve seen have to go through the system. Professionals who are prepared to be vulnerable and really care are rare and are themselves often attacked for doing so. I apparently had “bad boundaries,” according to those who wanted me to toe the line and stop giving my time and energy to actually trying to help people get OUT of the system and manage their own affairs. Eventually, I had to give it up because it was clear that the intention of “the system” was VERY different than my intention!
The idea of the “paradoxical effect” was disproven in about 1978 by Judith Rappoport, et. al. They gave stimulants to non-ADHD teens after doing a baseline behavior check. They found the same effects – better focus, less easily distracted, less movement of extremities. Rappoport said that the idea this was different for “ADHD” kids was because people were looking for that change and therefore found it, while the “Normal” kids weren’t particularly hyperactive so no one would notice if their activity levels dropped. She called it an “artifact of observation.”
“In the 1990’s, it was thought that stimulants worked “paradoxically” in those with ADHD. That is, in people without ADHD, stimulants would cause agitation and over stimulation but in those with ADHD, they would act paradoxically and calm them down. In fact, it was considered by some to be a kind of diagnostic test- if the medication helped, then by default the person must have ADHD.
This is actually not the case.
We know today that stimulants stimulate the whole brain- in everybody. Those that have ADHD and those that don’t respond in kind. Stimulants can help everyone to focus, regardless of meeting criteria for a diagnosis of ADHD or not.”
My understanding is that it’s far worse than most who haven’t experienced can imagine. I went through a VERY brief period after taking too much caffiene and being up all night. I couldn’t stand up, sit down, lay down, close my eyes, walk around – it didn’t matter what I did, it felt wrong. I’m sure this is a tiny fraction of what it would be like to have full-on akathesia, all day, every day, especially if your doctors didn’t warn you of it, or deny or minimize the effects on you. It sounds perfectly horrible!
Or to sum it up more succinctly, they have no idea how to separate “delusions” from people’s “normal” beliefs, but that doesn’t stop them from pretending they can tell the difference and charge insurance companies for the service.
Uncontrolled sense of restlessness and discomfort in remaining in one place, induced by many different psychiatric drugs. The name literally means “Can’t stay still.” It is mostly a subjective internal experience that most folks would not notice unless they asked about it. It is reportedly very uncomfortable! I’d love it if someone who’s had this experience can add some to this description, as it seems very clinical to me and I don’t think conveys how awful it is to have to put up with.
It sucks that they invalidated you like that! Seems like one of the worst things that happens as a result of the labelling process – soon nothing you say can be believed, they can dismiss anything you say as “symptoms.” It’s dehumanizing!
“Some promise” is pretty high praise from a profession whose main intervention for psychosis causes neurological damage that can be permanent and cuts the average lifespan of the “patient” by 20 years or more!
I find a balance of both to be optimum. I consult my emotions directly, and then use my reasoning to figure out where they’re coming from and what they’re telling me to do. I try not to act on emotion alone, but I also find that acting on intellect without consulting emotion can lead me to bad decisions!
“I’ve met no clinician dedicated to the care of those with neurobehavioral disorders whose repertoire of treatment possibilities didn’t span the entire biopsychosocial spectrum.”
Well, I have. Plenty of them. Not all of them, but I’d say 50-50 would be optimistic in the psychiatry world.
This sentence also subscribes to a certain viewpoint, calling people “those with neurobehavioral disorders,” and assuming that “treatment possibilities” are the answer. This lens in and of itself can blind you and others who see people this way to the many options available for approaching people who are finding the world difficult to sort out at a particular moment. You are assuming you can identify these “disorders” and can assign them to people, which is in and of itself a dehumanizing process. Additionally, seeing these issues as “neurobehavioral disorders” has been shown to DECREASE empathy and INCREASE bias and “stigma” against them. So it is possible that you and many others who see things this way may fully believe you are being open minded and humble, yet still believe you can “know” what is “wrong” with another person and can “tell them” what “treatment” they need. This disconnect can prevent trust from your clients, and can allow you to unconsciously judge people who don’t meet with your expectations.
This is not casting aspersions – this is a simple truth that has been supported by scientific investigation. NONE of the DSM “disorders” have a consistent and testable biological basis, and so none of them are objectively “diagnosable.” Why not simply talk to each person about what THEY think is needed and what they want to change about their lives, and help them based on their framing of reality rather than forcing a “neurobehavioral” frame on what is often simply normal reactions to difficult circumstances?
It sounds like we’re getting into different interpretations of the same statements here. My read of the comment was that the commenter was criticizing the labels as not being helpful in general, not saying that the poster/blogger for choosing that label for him/herself. It’s a very touchy area, and I can understand Lisa taking it the other way. I think I understand both viewpoints, and I think both have legitimacy, and I’m hoping we can respect that there are differences of viewpoint expressed at MIA and that they are generally not aimed at a person just because they disagree with that person. I’m glad both of you got to say what you needed to say, but I’m hoping we can move on from this discussion soon, as I don’t see any way to really resolve such a value-based disagreement. I leave it to you to decide if another comment or two is needed to come to some sort of closure.
Well, EVERYONE’S brain is different! Having a “different brain” is not detectable, because there is no “normal brain” to compare it to. The entire concept has no real scientific underpinnings at all.
Psychiatry has certainly NOT been standardized – they don’t even have a legitimate definition of what “success” looks like, let alone a standardized way of detecting their “disorders,” nor a standardized form of “treatment” that is even marginally effective in the broadest possible sense.
It is odd that he says no one’s heard of it but they all think it’s garbage! How can “they” think such things if “they” never heard of it?
Sure sign that someone’s afraid to be found out when they start coming up with irrational attacks! Of course, a lot of his friends probably DO think it’s garbage, but I think the same thing about their “model!” Depends who you hang with, I guess!
Very well put. The biggest difference in psychiatry is that psychiatrists can seriously make things up out of whole cloth and use “reference to authority” to “prove” they are right, since there are no actual criteria for success. As much as it may not be proven that reducing cholesterol levels has any positive effect on frequency or heart attacks or life expectancy, at least the “treatments” DO have to reduce cholesterol numbers. There’s no such measurement in psychiatry, so they can REALLY go wild with their claims, as soon as anyone believes their bogus “diagnoses” are real.
For a REAL scientist, failure to prove efficacy leads to the conclusion of “no efficacy.” The “null hypothesis” is assumed true until proven false. So Atfab is talking through his hat, but it seems that’s the only way to justify continuing to prescribe these “treatments” to innocent patients who don’t know any better.
We’d probably be better off with robots prescribing. At least they can be programmed not to be prejudiced and give the same crappy care to everyone. Less prone to power struggles, too. And that’s not an advertisement for prescription robots, either. It shows how far below the robot standards the current professions really are.
It shouldn’t be the patients’ job to act on outcomes, it should be the doctors’ jobs. It is clear they have totally abdicated that responsibility, and that they insist on using the same “treatments” despite actual WORSENING outcomes for the clients.
Though as someone else pointed out, if the desired “outcome” is to make money for the practitioners, they’re doing a fine job of it.
Of course, no real analysis has been done on causes, because they’re afraid to find out the truth because they suspect it’s their wonderful drugs.
Of course, life survival strategies and poverty and other stresses would contribute to this, but some of those strategies are actually a result of “treatment” in many cases. For instance, smoking is incredibly common in the “chronically mentally ill” and is often blamed for these dramatic statistics. But it is well known that cigarettes increase dopamine, and a discussion with the “patients” shows that many of them smoke to reduce the adverse effects of their “medications” that dramatically reduce their dopamine levels. And of course, being a “mental patient” almost ensures that poverty will result from long-term “treatment.” Drug abuse is also common among the “CMI” population, but I’d still maintain that this is another failure of the “mental heath” system, as an effective system would make people less likely rather than more likely to use street drugs.
It’s all fine and good to blame the patients, but the hard reality is, more treatment leads to shorter lives, and there is no “explanation” that absolves the “doctors” from this horrible statistical result. No other “treatment” modality for any other disease state would allow this kind of statistic stand.
There MIGHT be subgroups whose lives are extended by psychiatric intervention, but I have seen no study that has even looked at this question. If there were such findings, I’m pretty sure we’d see huge headlines saying “Psychiatric treatments increase longevity!” even if it applied to only 3% of the population!
Or it takes away extra time to live. The average “Seriously Mentally Ill” American still dies 20-25 years earlier than the average American. Psychiatry is the only “medical” specialty where treatment has been proven to SHORTEN the patients’ lives!
Just for the record, I’ve never studied psychology in any depth. My specialty is actually education, in which I have an MS. I sort of snuck into the “mental health” field through the back door, which may be part of why I never really bought into the “DSM worldview” or the psychiatric dogma. I agree with you 100% that the DSM is a complete scientific fraud.
The placebo effect is intentionally minimized in “randomized” trials. Kirsch’s findings indicate that the huge majority of “positive” impact from “antidepressants” is, in fact, due to the placebo effect.
Actually, if they’d even really rely on data, the DSM and the label-and-drug model would be long since dead. There is no “data” that suggests this approach is anything but destructive in the general analysis, regardless of some individuals possibly benefiting in their own views.
In fact, they will tell us over and over again that there IS no cure and taking their drugs will be our only hope of “managing the illness.” The choice of “Insulin for diabetes” was not one made by chance. That’s the reality they have always wanted to create, because it justifies endless drug prescriptions and the denial of other approaches meant to actually eliminate the problems they need to sell their products.
I have to say, putting the testicles on the OUTSIDE in a little skin sack is pretty good proof that “intelligent design” is nonsense! I mean, it could be “designed” that way, but is it really “intelligent?”
I do believe in penis envy. It happens when a man and a woman are outside and it’s cold and rainy and there is no bathroom available and both of them have to take a leak!
I appreciate you sharing your experience, and I agree that lived experience should include everyone who has such experience, regardless of what that experience is.
I do wonder, however, where you get the idea that if alternative approaches were identified, they would have been identified by psychiatry and adopted. I just finished posting on the article about Martin Harrow, who was apparently castigated and attacked for publishing research that did not agree with the psychiatric mainstream position that all “schizophrenic” diagnosed people must be maintained on antipsychotics for the rest of their lives. Harrow was no radical, he was a mainstream researcher who simply reported his findings of a very well-designed study. They attacked him simply because he challenged the status quo belief system and threatened the hierarchy’s control of the narrative. It seems very likely that the very best evidence of any alternative approach would be attacked and buried, rather than identified and accepted. That’s my view of it anyway, and I think that’s what the evidence tells us. Mainstream psychiatry is not particularly interested in alternative viewpoints.
It says a lot that Harrow, who before his research was very much a mainstream researcher, was vilified for simply presenting the results of his research. It goes to show the lack of integrity pervading the psychiatric industry, and the lengths to which their leaders will go to stifle any attempt to undermine their cash flow, regardless of the truth of the data presented.
“Relapse” is not even an appropriate term to employ. It originally came from the substance abuse world, and reflected a decision to start using again, “falling off the wagon,” as it were.
“The lower the levels of ferritin — a protein found inside cells that store iron — the more severe the symptoms. A small study, published in Pediatric Neurology, showed that symptoms improved when iron-deficient children with ADHD took an iron supplement.”
Not to mention the degree to which psychiatric “treatment” leads to an INABILITY to move one’s body in a normal fashion, tardive dyskinesia, EPS, akathisia, etc.
“Well, but, you see, it’s because the people in areas with high commitment rates are SICKER, that’s WHY they have higher commitment rates, I mean obviously, it’s not OUR fault, and it CERTAINLY doesn’t mean that commitment isn’t REALLY IMPORTANT as a tool in… oh, fuck, let’s just pretend we didn’t read that…”
POSTING AS MODERATOR: I just want to be clear in approving the above comment that I am assuming the author means the abusive families of those “Mad people” who HAVE abusive families, as there are plenty of “Mad people’ who don’t have abusive families, though there are also plenty who do.
That’s exactly my reaction! If you have two options, one of which is completely safe and without notable adverse effects, while the other has all sorts of possible damage AND stops working as soon as you stop it, and both are “equally effective,” clearly, the first is FAR preferable! But the researchers never seem to say this. Maybe they’re not “allowed” to!
You hit him where he lives, dogworld! There is no way to tell who is and is not “ill” or “disordered,” so the whole thing breaks down, and on some level, they all know this. You pointed out the emptiness of their philosophy, and of course, were attacked for doing so!
My point is that “mad” and “crazy” have both been used historically as more or less synonymous. There is nothing about “mad” that implies “mentally ill” in the modern sense. In fact, it is also synonymous for kind of wildly creative and spontaneous. There is also the usage of “mad skills,” meaning incredibly fantastic. And of course, “mad” also has the meaning of “angry,” which makes the choice of the word “mad” kind of interesting for a website like “Mad in America” – it can reflect any of the above meanings, including having difficulty with the weird expectations of modern society AND pissed off that we are expected to “be OK” with all that AND angry at the “system” for driving us all “mad!”
So I think it’s a very rich word with a lot of nuances, very, very different from the extremely specific word, “Mentally ill,” which was created for the very purpose of “othering” folks by the “professionals” or “experts” claiming they have some authority to determine who is or is not “normal.”
Anyway, that’s my take on it. And I’m not making comments as moderator here, just me as a person expressing my views on the point. I see no reason not to have “Mad Camp” as long as the more empowered uses of the term “mad” are intended and understood. The problem to me is not the word, it’s the intention behind the word, and I don’t see “mad” as necessarily having the the intent to disempower or other a person, especially if that person chooses to identify with “madness” as a means of empowering him/herself.
As I think I’ve said before, we’ve kind of aired this out pretty thoroughly. There are people who want to “reclaim” the word “mad” from the psychiatric profession, and those who consider it unredeemably contaminated. I think everyone is entitled to their own view on that point. “Peer” is a different issue to me, as I believe it’s fair to say the term was invented BY the psychiatric profession for the purpose of “defanging” the antipsychiatry movement, and has some associations that are hard to shake. But the term “mad” (like the word “crazy”) has a long and varied history of use over centuries. In fact, I have seldom if ever heard psychiatrists or psychologists using the term “mad” at all. They usually eschew it for terms like “mentally ill” or “mentally disordered” or even “consumers.”
But in any case, I think “mad” is going to remain an interesting and ambiguous term, and I can’t see these ambiguities being resolved in the MIA comments section any time soon!
Once again, the authors bypass the obvious conclusion that using “ECT” as a “treatment” for severely depressed people should be discontinued, as it does not work and can potentially do tremendous harm to the “patients” exposed to it.
I agree. The drive to define things as “psychiatric” is as far from scientific as it could be. It’s a big-time marketing scheme, as the inventors of the DSM III have admitted out loud. And it of course is an effort to protect the status quo social dominance system from criticism by attacking anyone who isn’t “loving it” or at least keeping quiet about their objections as being “ill” rather than “damaged” or “oppressed” or simply “dissatisfied” with the current state of affairs. As in any “dysfunctional family,” those with the power are protected and those without power are blamed. The last thing anyone suffering from emotional stress and difficulties needs is to be blamed by those in power for their own distress!
I agree absolutely. The framing of these problems as “disorders” and the semi-arbitrary division of such issues as being some sort of unitary problems is in itself hugely problematic, and accepting that framing means we’ve lost 3/4 of the battle already. The DSM is the key to psychiatry’s claims of legitimacy, and I don’t think we can undermine psychiatry’s hegemony until we challenge the legitimacy of their bogus “nomenclature” and pretense of knowledge about things they have no real understanding of.
I will once again point out that fearing retaliation from one’s peers or superiors for reporting abuse is not STIGMA. It is DISCRIMINATION, plain and simple. The person is not ashamed of reporting, s/he is AFRAID of the consequences of reporting the event, and for very concrete and real reasons. They are being treated in a violent and threatening manner for seeking justice. VERY different from the concept of “stigma,” if it ever actually does apply to any kind of violent victimization such as rape or sexual assault.
Yup. You can’t diagnose a “disorder” from averages. Just because something is more common in a particular population doesn’t make it a causal factor, as many in the non-identified population still have the same “something,” just in somewhat smaller numbers. This is the big problem with both brain scans and “genomic” studies – they rely heavily on correlations, but as any beginning scientist knows, “Correlation is not causation.”
I do get that. But most of that is in the context of “diagnosis.” I’ve heard lots of arguments about whether someone qualifies for a “PTSD diagnosis” based on whether or not their experience could really be called “traumatic.” I think this is very damaging. Traumatic experiences are at the discretion of the person feeling traumatized. Minimization is another act of discrimination that is unfortunately encouraged by the whole idea of dividing people into the “mentally ill” and the “sane,” which as we both know is not a scientifically valid distinction.
That’s my take on it anyway. Everyone on Earth has experienced trauma of one sort or another. Who is to say that being abandoned temporarily by one’s parents at the age of 6 is more or less of a trauma than being sexually molested by the babysitter or being told day after day that you’re too stupid to succeed? Something is as traumatic as the effect it has on the person being affected. No one else is really in a position to judge.
Or to put it another way: Society as a whole has become less tolerant of abusive behavior towards children, and is redefining these concepts in the favor of protecting children from abuse.
Psychiatric drugs and demon dispossession have some common roots back there historically. Both identify a vague and unidentifiable “something” that has “taken over” the victim and needs to be “driven out” by physical and or psychological means, even when the ‘exorcists’ have no actual comprehension of what the entity that has “taken over” actually might be. On the whole, I’d be more in favor of demon dispossession, though – fewer ill effects on the body in general!
I would add that kids are almost always the targets for bullying interventions in schools, but teachers and administrators most definitely engage in bullying behavior, often without consequence. I see kids referred for “behavioral problems” that originate with objecting to being mistreated by their teachers!
I would agree, attachment in the Buddhist sense is a much more ineffable quality than a sense of “attachment” to one’s caretakers. The latter has less to do with managing one’s desires and expectations and more to do with needing someone to keep us safe and feeling cared for when we are vulnerable and incapable of caring for our own bodies.
The use and meaning of the word “Mad” has been a constant controversy here for years. I totally understand the conflict from both sides. I hope we can all accept and understand that others’ use of the word is for their intended meaning, even if it means something else to us as individuals. I find “all or nothing” statements about this unproductive, and hope we can own our own beliefs and meanings without having to accuse everyone who doesn’t agree with us of some sort of misbehavior. As the prior poster says, “language is a tricky beast,” and I think we are best served by discussing how we find the word “mad” affects us or how we might seeing it affect others without the assumption that everyone has to see it the same way.
Hope that makes sense. I don’t think we’re going to come up with a black and white answer to this nuanced question!
P.S. I just came across this from Laura O posting earlier on this same thread. I hope she doesn’t mind my using it as a model. It is a perfect example of how to critique the use of this word without attacking others who see it differently:
“I, too, would never label myself or others as “Mad”. For me, it’s a condescending, disparaging word that minimizes the very real suffering survivors experience in their lives.”
The biggest problem with Freud is that he chickened out. He had it right at first, that many young women were being sexually abused by their relatives or others, and that their “Mental health issues” were largely caused by this. But his colleagues attacked him and he backed down, deciding that these recollections were “fantasies” in order to protect the men of the day from scrutiny. It took another hundred years before we finally came back to the point, and there is still a TON of resistance to the idea to this day. A large part of the effort to blame “mental illness” on the victim’s brain is that it deflects attention from the real causes, which are generally abuse/neglect, poverty and social dysfunction.
I agree 100%. I had a dog who was neglected in her early life – she was constantly anxious and needed to be petted all the time to keep from freaking out. She also used to compulsively run away, much like abused/neglected teens in foster care often do. My friend also had a parrot who behaved quite “normally” most of the time, but whenever a wooden stick or rod was brought near him, he totally freaked out, going back and forth between attacking the stick and trying to hide from it. Sounds a lot like “PTSD” to me! (I mean the parrot, not my friend!)
To yinyang: I have revised this comment slightly so it will pass our Posting Guidelines. I was unable to send you an email to discuss it, not sure exactly why, . If you want to be informed of or have feedback into moderation decisions, I’ll need a functioning email address from you. Thanks!
Great to hear from you again! I’m glad you have a plan going forward. Sometimes there are no easy answers, but I think taking as much control and responsibility as you can is most likely to give the best results!
I agree completely. It’s easy to forget why those laws were put on the books. It was because of serious and repetitive and unapologetic abuse. It is always very dangerous to afford one person power over another, especially with the façade of “helping” the person we have the power to control.
Wow, great to hear from Alice Miller again! Her wisdom never grows old. And now we have “neurological findings” to support what we’ve all known to be true all along!
It has always been my belief from observation that the main action of “antidepressants” was a general blunting of emotion. That result is described by many who take the SSRIs in particular, and fits with both the “positive” and “negative” reported effects. If one is very anxious all the time, a blunting of emotions can be associated with reduces anxiety, which might seem positive. If one is being held back from doing impulsive things (including killing oneself or harming others) by fear of the consequences, blunting may result in manic episodes, increase in suicidality, or increase in impulsive violence, including those occasional murderous acts we all have heard about. Loss of sexual function is also consistent with blunting of physiological sensations and with impairment of the motivational system to rewards (rewards are less rewarding, hence not as much worth pursuing, or sometimes not even physiologically feasible). There isn’t much that the SSRIs do that isn’t explained by emotional blunting. I think that is their main mechanism of action. And I think it is well worth recognizing that these are not “antidepressants” but “antiemotion” pills, and to ask whether this is really something that society as a whole really wants to be promoting as a benefit.
That is exactly how I used to work. I always used the client’s exact words or as close as I could get in framing the problem. The only purpose for DSM “diagnoses” was to obtain reimbursement, and if the topic of “diagnosis” ever came up in discussion (and it usually did not), I would tell them exactly that. I’d say I gave them the best “diagnosis” I could to get them the kind of help they were needing/asking for, and that the “diagnosis” meant nothing else but that. I always told folks that they were the only ones who knew what, if anything, was “wrong” and what would work. I was just helping them to sort that out for themselves.
Or perhaps they should admit that the “mental illnesses” they are studying are actually in most cases the effect of chronic stress and stop pretending they are studying genetics of behavior at all.
You are not taking responsibility for the impact of your invalidation of others. You have not demystified anything that I can see, it comes across that you have simply told another poster they were too stupid to figure out how to get EMDR paid for. It came across as condescending and had a hurtful effect. I would hope that you as a professional carer would want to know that so as to avoid doing similar harm in the future. At a minimum, you could own your own experience (“I personally haven’t had that problem” or “It’s my understanding that most insurance will pay for EMDR”) without telling the other person they were wrong for saying otherwise. You don’t know enough about their situation to presume to tell them what can and can’t be covered in their context, and I think you’d be well served to remember that next time you comment on another person’s experience.
Rachel, I’m baffled how many times you seem to have taken the exact opposite from my words that I am intending to communicate! I am a HUGE believer in the impact of environment and family upbringing as the MAJOR CAUSE of most of the DSM “diagnoses,” and science backs me up on this point. Where on earth did you get the idea I thought otherwise? I need to figure out what I’m saying that is not getting across to you. It’s really confusing to me how you are mistaking my meaning so frequently, even though I sense that you are doing your best to make sense of it!
I do not. Nor was I saying he was saying that, in fact, I was lauding him for saying it was not an either/or thing. I’ve known WAY too many in the psychiatric world who DO insist it is an either/or thing and have had many a frustrating conversation about it with “professionals” who ought to know better.
Touche! It is fascinating that the psychiatric mainstream claims that these “mental illnesses” are all or mostly genetic, yet they have to use torture of animals to create similar circumstances. Wasn’t the “wire monkey” set of experiments sufficient to establish that early childhood mistreatment/neglect leads to a host of “mental illnesses” for adults? How many times do we have to do the same experiments and still fail to see the real results?
Quite so. But you and I are in no position to judge how easy or difficult it may be to find a provider willing to support/justify the treatment the client wants. I’m saying it’s important that folks with professional backgrounds, like you and I, learn to step down from our one-up power positions and listen to the people actually in the trenches seeking services. If someone says, “I can’t get a therapist who will provide EMDR because I have a BPD diagnosis,” it is our job to listen to and believe them, because we are not in their position. A more respectful approach would be to ask some questions, like, “What state are you in? What have the therapists said to you when you asked? Is it the therapist refusing to ask or the insurance company refusing to cover it? What kind of “reasons” are you getting from the insurance company?” Then maybe we can help that person find a path toward getting it covered. Just saying, “No, you’re wrong, it’s covered by your insurance” comes across as both condescending and invalidative of the very real experience of the poster. It is, for lack of a better word, a rather unprofessional approach, IMHO.
As I have always maintained, people act a certain way because on some level it seems necessary or wise for their own survival. To think that folks can simply “think away” their own history and the reasons for their fears and their insistence on or avoidance of certain situations is actually quite invalidative of their experience. And suggests simplistic answers, such as “Just think the right thoughts and you’ll feel better soon!” which are hardly realistic for people struggling with past and often current abuse, often by the very system that’s claiming to help them. And it provides cover for blaming the victim for “failing to think the right thoughts” or “failing to take the program seriously” when it doesn’t work for them.
I’ve been told by several people that DBT practitioners sometimes FORCE people to engage in “mindfulness” activities. Nothing could show more ignorance of how mindfulness really works than thinking you can force someone to do it and expect any kind of results. These manualized “therapy programs” are of very little use in most cases, as what the person really needs is someone to LISTEN and UNDERSTAND them, and help THEM make their own minds up about what they want to be different and whether or not a certain approach is working for them.
And your last comment is most important. There is no way to completely set one’s issues aside as a therapist. The best one can do is to be aware that you DO have issues and you WILL bring them to the session, and to be aware enough of them to distinguish between your own needs and the client’s needs. The number of people who can actually do this is incredibly small!
Not saying that at all. I’m saying to do legitimate scientific research, you need a legitimate research group of people who have something that makes them the same. Murderers don’t qualify as such a group, as they are selected by a specific kind of behavior AND by the fact that they got convicted. It could be an interesting subject that might LEAD to some scientific hypotheses, which could then be tested, but simply comparing brains of convicted murderers smacks of “phrenology,” where the head shapes of criminals were compared to conclude what commonalities criminals shared in order to predict criminality. It was, of course, a complete bust, but it all sounded very “scientific.” So far, brain scan research has been used to “explain” a lot of things that it doesn’t explain at all. I’m very skeptical based on the sketchy history of brain scan research as well as the obvious heterogeneity of the group of “convicted murderers” and would have to see the basis for the research to judge.
It’s one thing to say it is “covered” as in “it is reimbursable.” Whether a person can actually GET coverage is much more complicated, as they require the insurance company to decide the treatment is “medically necessary,” which is hardly a black and white decision, and biases and financial conflicts of interest often enter into the equation.
It’s always interesting to listen to these ideas, but they are mostly very unscientific, relying on the assumption that correlation = causation. The fact that there may be some similarities between brain scans of two people who happen to be murderers proves absolutely nothing at all. Until we can see that most or all murderers have the same brain activity/structures and that no one or almost no one who doesn’t murder doesn’t have them, we have nothing of use scientifically. Murder, like all human behavior, is extremely complex, and there is no reason to believe that it is “caused” by a particular physiological state.
I just wanted to clarify where I was coming from. My main point is that you can’t vote diseases in and out of existence. There needs to be some sort of objective means of distinguishing between who does and does not “have” a particular “diagnosis,” and such means simply do not exist for ANY “DSM diagnosis.”
I think you are speaking in technical terms of what is theoretically possible, while the other posters are speaking in terms of what ACTUALLY HAPPENS in the real world. It’s probably neither possible nor appropriate for those of us who haven’t been in the position of seeking “treatment.” I defer to those who have been on that side of the table.
That being said, I really do appreciate your efforts to destigmatize the BPD “diagnosis.” I think your framing of these “diagnoses” is about as sane as anyone working within the system can make it. But I do think it’s important to remember that you (and I) are/were outliers and that most clients of the “mental health system” are not treated with anything close to the degree of respect for their context than what you are describing.
I refer to it only as a way that some people identify themselves. Of course, I don’t see psychiatry as a “product” in the same sense as a tube of toothpaste. First off, toothpaste doesn’t pretend to be more than it is. Second, no one can legally force you to accept their “toothpaste” as a “product” that they can force down your throat! I suppose the person is a “consumer” in the sense that they are forced to “consume” the drugs that are selected for them, but the social meaning of “consumer” suggests a person who can use their buying power to influence what products are available. That certainly does not apply to the bulk of psychiatric “participants,” willing or not.
It is extremely easy to describe a behavior without a label. Some examples: “I feel worried every time I go out of the house. I’m not afraid of anything specific, just have this big surge of anxiety.”
“When Mary visits her mother, she sees things in the house that remind her of her sexual abuse as a child by her father, and she often experiences flashbacks of the event.”
“Monique has never left her children with another caregiver in 5 years. She states that she is afraid that her children will be sexually abused. When asked, she relates that she was also sexually abused as a child.”
These describe what is happening far more accurately than “I have agoraphobia” or “She suffers from PTSD” or “She’s got an adjustment disorder.” And they invite an exploration of why these things are happening, and what might be done about them. In the latter case, a very short intervention inviting her to find someone she knew would NOT sexually abuse her child and make a plan to get a break led to a COMPLETE TURNAROUND in her life, from suicidal to passionately pursuing a sexual abuse recovery program. I met her two weeks later and she was virtually unrecognizable, she was so pumped. So why did she need a “diagnosis?” She did not. She needed someone to be interested in her situation and to drill down as to her motivations and to help her take some sort of effective ACTION to challenge her unproductive but understandable fears.
Some doctors THINK “mental illness” is a ‘misfiring of the brain,’ but no one really knows what that really means, even though they say that. There is no evidence of “proper firing” or “misfiring” that they can point to, no measurement of correct “chemical balances” that they can perform, no “normal brain” they can compare yours to and show some sort of abnormality. I find (and science supports me in this) that this kind of explanation leads many folks to feeling hopeless and disempowered, and deflects attention from the causes and possible interventions that might let the person herself take more control of her life.
I am certain that different people have variations in their genetic makeup, and I don’t exclude the possibility that in SOME cases, this may create some kind of vulnerability. But that does NOT make the genetic differences a “disease” marker. First off, there is absolutely no reliable evidence that any “mental disorder” associates with any “genetic abnormality” in the brain. The best correlations are in the single digits for large groups of genes considered together, but none is even close to being able to predict ANY “mental disorder” in the entire manual. Whereas most “mental disorders” correlate at over 80% levels with childhood adversity and mistreatment. Since genes are the one thing in the entire equation we can NOT change, it seems pretty silly to spend billions researching genetic causes when we know that childhood adversity is a very ADDRESSABLE reason for these “disorders” occurring.
In your case, you yourself identify that others with similar genetics have some similar behavioral tendencies, but your case became more severe because of the abuse you suffered. It seems if you need a “diagnosis” it ought to be “Victim of childhood violence,” which is at least observably true. Saying someone “has OCD” and trying to blame it on your brain is very typical psychiatric narrative, but it is pure speculation on their part, they know NOTHING about the actual causes of these behaviors and emotions.
If their approach works for you, more power to you. I would never want to take that away from you. But your personally benefiting from what they did with you does not legitimize the DSM, which the head of the NIMH himself said “lacked validity” a few years back. The NIMH even stopped using the DSM diagnoses for research after that time. It is VERY legitimate to question the DSM categories scientifically, and it has nothing to do with believing or not believing that people in distress need assistance. I think everyone should do what works for them, but I am opposed to lying to people about what is known just so they’ll be more comfortable accepting whatever treatment is offered.
I am not calling you “brainwashed,” and I have never suggested eliminating all treatment, and I don’t know how you would draw that conclusion from what I wrote. My comments clearly criticize not TREATMENT but the idea that the DSM can “diagnose” people accurately of some kind of medical problem using checklists of problematic behaviors, thoughts, and emotions.
Perhaps you are thinking that DSM “diagnoses” are the same as treatment? I understand that people benefit from getting outside help, and professional assistance CAN be quite useful to some folks if you have the right professional and the right approach.
But pretending that somehow professionals can distinguish between “obsessive thoughts” and “intrusive thoughts” and normal thoughts is not scientific, and the DSM itself says it is unable to do that. I’ve helped lots of people over the years improve the condition of their lives, and never once did a “diagnosis” play any role in helping bring it about.
Most psych survivors were psych consumers at one time. I’d say it depends on the “consumer.” Those who are invested in promoting the current system need to be left alone, but there are many “consumers” who are confused, angry, frustrated, and beginning to doubt the veracity of the psychiatric narrative. Such people need to hear from survivors rather than those other promotors of the status quo referred to above.
I consider it bigoted to assume that all “consumers” are the same.
I understand that you believe these “disorders” have some real scientific meaning. I do not. Being very familiar with the DSM, these “disorders” are very simply descriptions of behavior or thoughts or emotions a person might have which tend for whatever reason to occur together.
Intrusive thoughts are VERY common with people recovering from traumatic experiences, and seem to actually be part of the DSM description for PTSD. So how can you tell if you have “covert OCD” or “PTSD” or simply have thoughts you don’t want to have that seem to come from the outside? I’m not against DESCRIBING things I just think putting a name on something one observes is not the same as “diagnosing.” A diagnosis ought to be aimed at establishing cause, distinguishing between seemingly similar presentations based on cause, and distinguishing between effective treatments/interventions for the situation. As a former counselor/therapist, I found little to no value in labeling a person’s experience based on the DSM. I simply went directly to “What are you experiencing?” and then looked for the underlying reasons the person may be experiencing these things. “Intrusive thoughts” can have many different origins, and I’d start by asking what the thoughts were and when they arose and go from there. No “diagnosis” is needed – all I needed to know was that the client was willing to share their experiences with me and help me understand what was happening to them. The only reason I ever gave a DSM diagnosis was for insurance reimbursement, and that’s about all they are good for, IMHO.
I’m sorry if that clashes with your beliefs, and I don’t expect you to agree with me or think less of you if you don’t. But my opinion is based on decades of experience and I’m not likely to change it, as I feel I have a very good handle on exactly what these “diagnoses” really represent.
I don’t care how the DSM 5 “organizes” their fictional definitions of “disorders.” As I noted, the DSM itself admits it can’t clearly distinguish between someone who has Disorder A or Disorder B or Disorder A and nothing at all wrong with them. It goes on further to say that “There is also no assumption that two people with the same disorder are alike in all important ways.” In other words, two people with the same “disorder” may have very different needs and very different causes and very different approaches may be needed to help them, even though they have the same “diagnosis.”
What is the point of “diagnosing” people with something that they may or may not have, when even those who fit the same “diagnosis” may have totally different problems requiring totally different solutions? It makes the concept of “comorbidity” more than a bit of a joke. Do I have “excessive digital-nasal insertion disorder” or do I have “itchy nasal passage disorder?” Maybe it’s comorbid, because my nose itches AND I pick my nose to relieve it? Or is the latter simply a consequence of the former diagnosis?
The real question is, why should anyone care what label you put on my behavior? Why not just let me pick my nose, or help me with the itchiness or find something useful to do besides “diagnosing” something you have absolutely no understanding of?
It is so obvious how biased they are toward the evidence by how they talk about it. For abuse to have CAUSED “schizophrenia,” apparently we need proof beyond a reasonable doubt that EVERY case of “schizophrenia” is caused by abuse, despite there being no reason to assume all cases of “schizophrenia” are caused by any one thing, it being a behavioral syndrome that could have many causes. But for biological causation, a tiny correlation of hundreds of genes associated with less than a tenth of cases is evidence that “schizophrenia has a biological cause,” even though correlations with childhood abuse are ten or a hundred times stronger. How is it that the world of science and medicine is still willing to entertain and publish such obviously biased nonsense?
The very concept of “Comorbid disorders” presumes that the DSM is able to distinguish between one “disorder” and another, while the DSM itself asserts its own inability to do so.
“In DSM, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no disorder.”
In other words, there is no clear line between “disorders,” so the concept of “comorbid disorders” is totally invalid.
I would also ask why we would assume that the woman would NOT have lay down on the bridge just because she was “medicated.” And the term “leaving [her] unmedicated” reflects a very paternalistic attitude, as if we have a right to “leave” or “not leave” her in a particular degree of “medicatedness.” As if she herself has no particular rights to decide her own course of action.
Do they also vote on a ‘consensus definition’ of recovery from the flu, or a heart attack, or a broken leg? What kind of a medical “disorder” requires people to VOTE on whether or not you’re recovered?
I think any medical diagnosis needs to be able to differentiate between a “normal” and a “diseased” state, objectively and consistently. Medicine is to treat the BODY. “Psychiatry” and “Psychology” are supposed to deal with the “psyche,” aka the Human Spirit. Attempts to treat spiritual issues with drugs and surgery and electric-shock-induced seizures are doomed for failure. So I think the “treatment” of any spiritual/emotional condition does not belong in the realm of medicine, and therefore the idea of “diagnosis” in the medical sense is irrelevant, and likely unavoidably destructive.
I much prefer the use of descriptive language. “Mary hears voices speaking to her that others can’t hear. She is feeling very anxious and worried that the voices are going to tell her to kill herself, as they have done in the past. She feels safest at her sister’s house, who is good at calming her down.” That sort of thing is a LOT more helpful than saying, “She’s got schizophrenia!”
I never have agreed with almost anything Dr. Pies has said. He’s a marketing agent for psychiatry.
What he’s saying in the article is technically true, but he is not taking into account HOW the DSM is used. The fact that someone has a “medical diagnosis” opens the door to stigmatization, which has been proven over and over again to be greater the more medically the causes of these “diagnoses” are viewed. A lot of the text he includes are from the introduction and clinical guidelines, which I’m sorry to say most clinicians don’t bother to read, or if they do, fail to put into practice. Pies also fails to give any reason, and in facts argues AGAINST it, for putting people into these “fuzzy categories” in the first place. Any reasoning he uses is more sociology/anthropology than medical in nature. By admitting there is no clear boundary between one “disorder” and another, and between having a “disorder” and having “no disorder,” he acknowledges that the whole house of cards blows down with the slightest puff of air.
Here is an example in his own words: “When a patient presents with the complaint, “I hear threatening voices in my head,” we simply must diagnose—a word whose etymology means, “knowing the difference between.” For example, we must know the difference between “threatening voices” stemming from combat-related trauma, on the one hand, versus schizophrenia or anti-NMDA receptor encephalitis15 on the other. Otherwise, our treatment is likely to be misguided.”
Note he gives NO real reason why he “MUST DIAGNOSE,” and defines diagnosis as “knowing the difference between.” But he just admitted above that the DSM itself asserts no ability to “know the difference” between being disordered or not, or between having one diagnosis or another! So giving a DSM diagnosis does NOT provide “the difference between,” it actually confuses such efforts by lumping people with widely differing problems into the same “diagnosis!”
Notice also in his example that he is NOT talking about differentiating between “mental disorders,” but between causes (Combat trauma, encephalitis, or the mysterious and undefined “schizophrenia,” which is such a vague “diagnosis” that the Japanese are not even using it any longer.)
In short, Pies and company talk a good game, but when you look at what he’s REALLY saying, it’s simply more marketing of ideas that don’t have any scientific basis at all.
Again, this would not be a “cause” of “ADHD,” as the large majority of those so diagnosed do NOT have this mutation, and there are apparently lots of people who have the mutation who DON’T get diagnosed with “ADHD.” There may be a VERY small subset of those diagnosed who have this problem, and I have no objection to folks testing for this anomaly and doing some sort of research on the tiny subgroup. But at that point, they are no longer diagnosed with “ADHD,” they are diagnosed with CDH2 mutation, which has to be made very clear in order to get any useful outcome.
As to stimulant “treatment,” as I indicated earlier, there is little to no evidence that using stimulants in the long term improves overall outcomes for the “ADHD” cohort, and there are notable adverse effects, including growth retardation, loss of appetite, and psychotic symptoms in up to 10% or more of users at “therapeutic” dosages. But one would have to look at the CDH2 subgroup and look at them separately to really answer that question. In my book, if there are risks and no real long-term benefits, I don’t care if there IS a biological cause, there is nothing to recommend assuming the risk of drugging kids without a clear and substantial benefit.
The other problem is who gets to define what is beneficial? If the teachers are telling the story, they might decide that being relatively inert and sitting quietly in a chair all day is a beneficial outcome. But what about from the kid’s point of view? Nobody bothers to ask what THEY find helpful in most cases. It’s an intervention for the benefit of the adults. As I said, why is there no “hypoactivity disorder?”
I agree, to be scientific, one must be skeptical and always open to new data that disconfirms your hypothesis. To the exact contrary, the psychiatric/psychological industries have a marketing approach, searching for and emphasizing every tiny snippet of data that supports their contentions, and going far out of the way to bury or discredit even bury data that disagrees with their preferred narrative. As soon as you start selecting which data you want to pay attention to, you’ve left the ship of science!
Exactly. It seems a gradual narrowing of “normal” is happening, and instead of “normal” we now have “acceptable” or “appropriate.” Which is of course defined by the authorities in charge. I think it crosses the line from puzzling into evil.
I would submit that Buddhism, for instance, does not require or teach conformity, except to the extent that certain practices are recommended to improve one’s understanding of one’s own spiritual nature. I’ve also been to Quaker meetings, where there is no preacher or designed program, but the attendees are encouraged to get in touch with their “intuition” and speak as they feel moved to speak. I don’t see much conformity there, except that you need to be quiet while others are speaking and not invalidate or criticize what they share.
I definitely see that organized religion tends very strongly toward enforcing conformity of both belief and actions, and often uses fear to create compliance. I have never had any patience with such practices. I think we should all be in touch with our own inner sense of what is “right” and true, rather than following some outside interpretation of reality. That’s one of the reasons I love the Quaker approach. Nobody gets to tell you what God (or whatever spiritual reality a person might believe in) has to say to you. You get to seek those answers for yourself.
That’s the other good point – we know that healthy relationships can “heal” whatever changes to the brain occur as a result of trauma, at least to an extent. Why we waste time on all these biological cause studies when we KNOW that social conditions can be improved and result in improved outcomes is quite puzzling. Unless we postulate that those providing “treatment” aren’t really that concerned with people’s outcomes being improved?
I think we’re overgeneralizing a bit, though. Not ALL religious are about conformity. There are lots of brands of religions, and the same nominal religion can have sect with WILDLY different approaches! But I do agree that humans tend to turn any religious practice in the direction of conformity, and the more “organized” it is, the more authoritarian it seems to get. But that’s just my observation.
So are you saying that large pharmaceutical companies DON’T frequently promote their products by hiding data and lying to the public and overstating the benefits and downplaying the adverse effects of their product? Do you remember Vioxx? The lawsuits they “settle” out of court, like the one for falsely advertising antipsychotics for children? You don’t think that PharmA lobbyists are buying influence in Congress? And I’m not just talking about checking labeling – I’m talking about assuming that doctors are always telling the truth and have your best interests in mind.
Take the antidepressants as an example. It was a known fact that they caused aggression and suicidality in a small but significant number of recipients, way back in 1987. Prozac was initially banned in Germany for that very reason. But it took until something like 2003 for that warning to get onto the label. Why do you think that happened? Do you think no one NOTICED? Or perhaps they suppressed this information in the interests of making profits? Do you really think they are beyond this? Or that doctors are all above board and honest and well educated when they get a ton of their information from drug reps?
I don’t think the regulation of the drug industry is any better than it was 40 years ago – in some ways it’s worse! Did you know that you can get a drug approved with just TWO studies that show it’s even marginally better than a placebo, even if there are 80 studies saying it doesn’t work or makes things worse? It used to be three were required. Hardly an improvement in the regulatory system.
I’m really not sure why you seem to be making this into a black and white issue. The world isn’t divided into those who qualified to interpret medical information and those who are doomed to accept their judgment. I notice you have not acknowledged that an intelligent person CAN personally read scientific research and draw his/her own conclusions without the intervention of a “medical professional.” Do you think that is impossible? Are doctors automatically smarter than I am? Are there no incompetent or corrupt doctors out there who can’t be trusted with my body and my life? If I can’t decide that, who can? And how would I decide if I’m too dumb to do my own research?
Who said only trusting oneself? Clearly, I’m advising doing scientific research, speaking to other doctors and medical professionals for second opinions, looking at proven alternatives, etc. I’m saying that AUTOMATICALLY trusting that what a doctor is telling you is the truth just because they are a doctor is foolish and dangerous. It’s also bullshit that no one is smart enough to learn on their own a good bit of important information that doctors may or may not share with you. You don’t need qualifications to read scientific studies in many cases, or to simply read the patient handout for any drugs you are prescribed, especially when we’re talking about psychiatry/psychology. Not saying I would determine for myself what drugs (if any) to prescribe, but it’s not that hard to discover that your physician is talking through his/her hat with a little research.
My dad was taking blood thinners after a heart attack. He went to a doctor, told him all about every drug he was taking, and was given a second prescription. Within a day or two, he was having instant bruising when he put his elbow on the table or pressed his finger into his arm. He looked up the second drug he was prescribed, and it said in BOLD LETTERS: CONTRAINDICATED WITH BLOOD THINNER X. DEATH COULD RESULT. He was hemorrhaging at the slightest touch. A minor car accident or a fall off a chair or small ladder would have certainly killed him on the spot. Yet the doctor knew all his medications and still prescribed this deadly combination. Are you suggesting he wasn’t “qualified” to look up the drug and discover it is contraindicated with the blood thinner he was prescribed, nor to conclude quickly that his subcutaneous bruising was almost certainly caused by the noted negative interaction between these two drugs?
Every since that time, I NEVER take any drug until I’ve looked it up and examined side effects and contraindications. If my dad had fully trusted that doctor without question, he’d almost certainly have been dead at 40, instead of living until he was 85. Unquestioning trust in doctors is as dangerous as going it alone with no advice. In psychiatry in particular, going it alone may in fact be safer in many cases.
It is saying that you can’t trust that the doctors or Big Pharma are going to give you honest information. I don’t think it’s promoting the “untrained public” to “self medicate,” it’s promoting asking questions and doing one’s own research and getting multiple opinions before assuming that the “information” you have been given by the professionals is automatically to be trusted.
You are right, of course, I should have put “medication” in quotes, or used the term “drugs.” “Medication” is a euphemism, especially when the drug is given for no discernible medical indication.
I think it is EXTREMELY damaging to “put thinking suicidal back in the closet.” This will make it MORE likely that people will kill themselves because they can’t talk about it! I used to work a suicide hotline and have talked to hundreds of people who said they were considering suicide. The vast majority were not “threatening,” they were simply desperate to end the pain they were experiencing and wanted some kind of help.
I have heard of people, especially domestic abuse perpetrators or child molesters, threaten suicide when consequences ensue for their bad behavior. This is a different matter and should be dealt with much more harshly, I believe, as it is an attempt to use the threat of suicide to manipulate or control others and avoid accountability. But the vast majority of suicidal people are looking for someone to talk to and connect with.
Of course, there are also those who rationally decide that suicide is the best next step in their lives, based on health conditions or something of that nature that has a very grim future prognosis. It would seem cruel to deny such people the right to talk over the pros and cons of their options, including suicide, so they can make the best decision they can.
I am saying all of those things. When “ADHD” is defined by a set of behaviors, most of which are based on school behavior, and none of which are even slightly objective observations, you’re going to get a group that has little to nothing in common with each other except the behavior. It could be totally normal for that child at that age and stage of development. It could be the result of nutritional deficiencies, particularly iron, or sleep problems. It could be an indicator of problems in the home that are not addressed, particularly domestic abuse. It could be an indicator of prior trauma and possible “PTSD” symptoms, where there is a huge overlap with “ADHD.” It could be an incompetent teacher who doesn’t know how to manage a class and provokes resistance from the more sensitive or the bolder kids. It could be the child is bored to death because s/he is way ahead of the class and isn’t being challenged at all. All of the above considerations could cause the “symptoms” described as “ADHD.”
Here are a few of these “symptoms:”
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick to tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
Not one of the above is in any way objectively measurable, and none require any kind of medical “explanation.” Most are just ways that kids act when they are young and less mature. Ever know a kid who acts without thinking, or interrupts conversations, or had a hard time waiting their turn? More importantly, how many kids do you know who do NOT engage in these behaviors at least some of the time? How could you possibly tell when a kid “interrupting conversations” reached some critical level that it becomes a “symptom?” And why would we assume that any of this is caused by some sort of “brain problem?”
A very interesting study shed some light on the advantages this “ADHD” behavior actually conveys on kids and on society. They took groups of three kids and gave them a set of three problems to solve. One bunch had two “normal” and one “ADHD” kid in each group. The control groups had three “normal” kids in each group, no “ADHD” kids. They measured how often the group was “on task,” working on solving the problems. The control groups did significantly better on this measure, while the “ADHD” groups goofed off or screwed around more and spend a good deal less time working on the problems. But NONE of the control groups solved any of the problems, while all of the “ADHD” groups solved at least one and I believe a couple solved all three! So their goofiness and off-task behavior allowed for more creativity and outside the box thinking and meant these problems got solved.
Now if they’d had groups with THREE “ADHD” kids, it’s quite possible nothing would have gotten done at all! But it shows that we NEED these “ADHD” types to help us solve problems, and that having ALL conventional thinkers in our society will most likely lead to stagnation and failure.
It takes all kinds to make a world, as they say, but apparently psychiatry has no idea what that means, as they want to make all kids act in ways that keep the adults happy. And that’s what I believe “ADHD” is really all about.
Notice there is no “Hypoactivity” disorder? I think that says a lot!
Some have claimed that “ADHD” brains are smaller on the average, but those studies did not take into account medication use, which shrinks the very parts of the brain they say are smaller, particularly the cingulate gyrus. Additionally, even if these studies were accurate, they are AVERAGES, which means that lots of people WITHOUT “ADHD” diagnoses have smaller brains and lots of people WITH “ADHD” diagnoses have larger brains. It is obvious that if these were “causes,” it would apply to all of them. There is no evidence that everyone with “ADHD” has any kind of similarity in brain structures, so that claim is BS.
Of course, a lot of psychiatrists will tell you that your kid needs “treatment.” That’s just what they do. Until and unless they have some evidence that this “disorder” is actually a disease state, you are safe ignoring them. It’s also VERY important to note that kids who are “treated” with “ADHD” drugs do not do any better in the long run, academically, socially, or physically, than those who are “diagnosed” but don’t receive any stimulants. So the “treatment” is not worth anything much in the long run on the average, even if some seem to do better taking the drugs.
My final point is that even if the “ADHD” child is in some way biologically different, difference is not the same as disease. Species survival depends on genetic diversity. There is no reason to think that being less patient with boring stuff and wanting to move around and not follow rules is evidence of anything “wrong” with the child. I think the main problem is that we try to expect kids to do things that are abnormal to expect kids to do. The strong evidence of this is that fully a THIRD of kids diagnosed “ADHD” in Kindergarten prove NOT to get that “diagnosis” if they wait a year later to enroll in school. A third grow out of it in one year. That’s not a “disease,” that’s a problem of inappropriate developmental expectations.
Who is trying to take away your Adderall? Certainly nobody here. If it works for you, that’s your decision. The problem is not with people taking Adderall if they feel it’s helpful, the problem is telling everyone that these difficulties are the result of a “disease state” despite having little to no evidence that such a “disease state” is valid and verifiable.
It’s not about the drugs. It’s about the “diagnoses.”
I don’t think it’s broken. I think it serves a different purpose than it pretends to. It does quite well in making money for certain people and keeping other people under control or sufficiently diminished in capacity to not be threatening to the status quo.
It sounds awful! I don’t understand how psychiatry can look at this kind of result and feel “successful.” It is criminal what they’ve done to you!
Do you have anyone you can talk to who would understand and provide some support to you? I mean real PEOPLE, not “professionals” pretending to “be there to help.”
That is disgusting! The discrimination against anyone with a “mental health” label is bad enough, but these folks have used that to leapfrog their anti-gay biases into the forefront! Thanks for sharing your story!
Excellent counterexamples of the “need for forced treatment!” I’m so sorry you had to go through this kind of crap. And I think you are right, it remains invisible to most “insiders,” because those who have been essentially arrested and held against their wills are totally willing to say whatever they need to say to get the hell out of there. So if you ask a forcibly incarcerated person in a “mental” ward if they were OK with being detained, the smart ones will say, “Oh, yes, BLESS you, I’m SOOO lucky you put me in here, I’m SOOO much better now, can you please unlock the door and let me go home?” This is not even taking into account the phenomenon of “internalized oppression,” where some of the victims spend a lot of energy trying to explain why their abuse is “understandable” and somehow deserved, as a means of avoiding the conflict of being the adverse effect of an overwhelming power that they can’t possibly match. I’m usually all for asking the client to let us know the truth, but asking people in the hospital psych ward involuntarily if they agree they ought to have been detained is going to give you a very distorted picture of reality.
Thanks for sharing your stories. I hope some of those “insiders” take a good look at the utter randomness of these events!
REAL science DOES show psychiatry and the DSM to be fraudulent. The problem is, psychiatry pretends to be “scientific” when it is actually opposed to real science, which shows it up as a flop every time.
Not only do they “report” data, they distort it, hide it, or sometimes make it up from whole cloth. If they were real scientists, they’d have given up on the “bio-medical model” decades ago. These professions are more like marketing agents, only putting forward such “data” as promotes the products they are selling, and hiding or minimizing or distorting anything that might harm their bottom line.
I agree – noise is everywhere, both auditory noise and visual “noise,” constantly bombarding us with messages we don’t have a choice whether or not to receive.
It is quite clearly and obviously a violation of the concept of “informed consent,” which is supposed to be central to medical practice in any form. To simply justify lying as “It gets more people to accept our drugs” is not practicing medicine, it’s practicing marketing!
I would say that psychiatry shares many similar aspects with religion, but is not itself a “religion” per se. I’d say it’s more of an anti-religion, deleting any kind of theology but instead “preaching” that the spirit does not exist and that all of our behavior is the result of chemical interactions and that human beings lack any of the essential qualities of will, intent, values, priorities, and also lack the ability to have an impact on their own psychological/emotional welfare.
I would have no objection with psychiatry being a competing “philosophy of being”. The problem is, it is claiming to be a scientific endeavor and part of the field of medicine! This tends to give this nihilistic philosophy FAR too much influence far beyond what its arguments have merited. Additionally, Spinoza and Kant and Hegel did not have the power to forcibly detain people based on their philosophies.
So psychiatry can make all the claims it likes about “useful fictions,” but in the end, it’s not OK for “doctors” to use “fictions” of any sort to manipulate people into using drugs they don’t need or want, and particularly to use such fictions to forcibly detain and drug people whose only crime is having a hard time fitting into our strange and challenging social expectations.
I have warned you several times by email that failure to respond to email communication is a violation of the posting guidelines. As of now, I have heard nothing from you. Nothing you post will be published until you email me directly at [email protected] or [email protected] and agree to abide by the posting guidelines and respond to feedback given to you via email. This is not in opposition to posting viewpoints that are supportive of the mainstream psychiatric model, it is due to constant disrespectful posts and other violations of the posting guidelines which can’t be addressed without direct email communication with the moderator. Until I hear from you via email, your posts will all be blocked, no matter the content or form. This is the last time I will talk to you about it. The next step is to simply block all communications from the email you are using. It’s up to you to decide.
The lack of improvement in outcome measures is one of the most important open secrets in the whole field of psychiatry. What is the point of exposing kids to powerful drugs like these when there is no evidence it helps them in the long run?
As I’ve said before, in what other area of “medicine” do we have to have a discussion of “shared decision making,” with some doctors OPPOSING the idea of sharing with the very person being “decided” about? It is the CLIENT who should be deciding how much decision-making to share! What happened to “informed consent?” We shouldn’t have to be talking doctors into SHARING the decision making with patients. Patients should ALWAYS be the decision-makers if they are in any way capable of communicating their intentions, and doctors should be ADVISING them. The fact that patients have to ASK to be a part of the decision-making process shows how screwed up the power dynamics really are.
The only barrier to “shared decision making” is prejudice and discrimination by the practitioners.
The big error that the DSM perpetuates is the idea that a particular “diagnosis” has a specific cause in all cases. The DSM itself disclaims that they mean this, but that’s how people interpret it, and I don’t think it’s by accident that it works out that way.
It should be obvious that at least SOME of the time, crappy parenting IS the cause of a person’s “mental disorder,” and addressing that early life trauma is an essential part of their healing from the resulting injuries to their spirit (speaking metaphorically, of course). The idea that exploring parents’ behavior as a possible causal factor is “blaming parents” is downright childish, and plays into the hands of those parents (and they are NOT rare) who will use a “mental disorder” as a cover for their own abusive or neglectful behavior.
It’s also important to note that parents can do damage without intending to. They don’t have to be “bad parents” or be overtly abusive to simply not understand the child’s needs and make mistakes that contribute to their anxiety, depression, or inability to exert control over their behavior at times. So it isn’t a matter of “blaming parents,” it’s more a matter of helping the child/adult come to terms with ways in which their parents may not have been able to meet their needs fully.
It’s not a “black and white” thing. It’s just as bad (or maybe even worse) to let all parents off the hook as it is to blame parents for everything that goes wrong with a child’s life.
I think they are pretty much ALL the same. A list of symptoms or effects with no effort to deduce a cause, despite an assumption that all people having this “diagnosis” have the same problem. It’s quite destructive!
You and our society are combining two separate issues. Society needs to be protected from people who are behaving dangerously or disrupting the ability for society to function. That does not automatically mean they need “treatment” in the form of drugs, or that the drugs will automatically make it better, or that the full civil rights of a person need to be eliminated in order for society to be protected. There are people who have experienced both jail and forced psych hospitalization who prefer jail. Not saying that’s the answer, either, but forcing drugs on someone isn’t necessarily the answer, either. Maybe we need to be creative and start coming up with some new answers that nobody’s thought of yet.
A reminder that shooters at Springfield High School, Columbine, Red Lake MN, and many other places were taking psychiatric drugs at the time of their shooting sprees, not to mention the Germanwings guy who flew a plane into a mountainside on purpose. The media makes it appear that the drugs somehow magically make a person fine and stop any possible threat they may pose, but the hard facts of reality don’t fit that rosy picture. And the damage done by enforced psych hospitalization can be substantial.
How do YOU propose balancing the safety concerns you mention with the high rates of damaging adverse effects of both the drugs and the process of being essentially arrested without committing a crime and forced to take a drug that may not only not help but make a person’s situation worse, and take away any right of that person to place a rational objection to the force being applied?
My personal view is that once force is involved, you can no longer call what you are doing “treatment.” It becomes enforcement of social norms via drugs, and that is absolutely NOT the same thing as trying to help someone get better.
“The incidence rate of bipolar disorder was 30 times higher in people with a prior diagnosis of ADHD and anxiety than people who weren’t diagnosed with either.”
“The FDA notes that usual doses of stimulants like Adderall can cause psychotic or manic symptoms, like hallucinations, delusional thinking, or mania, in children. They also note aggressive behavior or hostility in children and adolescents with ADHD.”
“Emergence of New Psychotic or Manic Symptoms
Treatment emergent psychotic or manic symptoms, e.g., hallucinations, delusional thinking, or mania in children
and adolescents without prior history of psychotic illness or mania can be caused by stimulants at usual doses. If
such symptoms occur, consideration should be given to a possible causal role of the stimulant, and
discontinuation of treatment may be appropriate. In a pooled analysis of multiple short-term, placebo-controlled
studies, such symptoms occurred in about 0.1% (4 patients with events out of 3482 exposed to methylphenidate
or amphetamine for several weeks at usual doses) of stimulant-treated patients compared to 0 in placebo-treated
patients. ”
Very true. There can be good information in actual research which is not available to the public due to obfuscation or inappropriate framing of issues. One of the worst things about the DSM is that it prevents any real research on subgroups of any “diagnostic category” because it’s assumed that research has to be done on the entire cohort, heterogeneous as they all are. If 10% of “ADHD” diagnosed kids are improved by addressing low iron, this is viewed as a failure, because only 10% of the cohort is “helped,” while supposedly 70% are “helped” by stimulants. But this 10% can be COMPLETELY CURED by this approach and removed from the cohort! No one knows of this because such research is buried in drug company-supported study manuscripts intended to bury it. It’s not really science to corrupt findings in this way!
If only “following the science” led to big profits, they’d be all over it! But when science costs people money, they tend to cover it up rather than following it anywhere.
I hate the concept of “unmasking.” It’s more like CREATING psychosis by randomly drugging people without having the vaguest understanding of what is actually going on.
It sounds like you worked VERY hard to find the right practitioner! Not everyone has the resources, time, or freedom to do such a search, unfortunately. It is true, most of the people here had bad to horrible experiences, and in a way that’s a bias. But there are SOOOO many places folks can go to talk about their positive experiences, it’s super helpful to have a place where ALL experiences are welcome to be shared. I know of a person who got kicked off of a “bipolar support group” because she questioned psychiatry’s approach to her case. I’ve gotten ‘feedback’ on an “ADHD” site for using the term “Drug” – I’m supposed to say “medication” so as not to suggest any connection with street drugs, even though all the “ADHD” drugs are, in fact, sold on the street. There are many practitioners who view any skepticism toward “medication” as a sign of “lacking insight.” It is a lot of hard work to find the kind of help you need, and it shouldn’t be. That’s what MIA is about, IMHO.
Do we REALLY have to do a study to determine that inducing grand mal seizures by electrocution is NOT a healthy thing for children (or anyone else, for that matter)?
I am posting this here because I have no other means of sending this message to you, Thomas. I apologize for posting this publicly, but I appear to have no other option to contact you.
Thomas, a WORKING EMAIL ADDRESS is a requirement in the posting guidelines, as I have stated before. I have no email I am able to use to contact you. You sent me a home address, which is of no use to me at all. You are unresponsive to emails at the email address you have provided. Your posts have become increasingly problematic, and I am unable to talk to you about them due to your own choices, yet you complain in your comments that you are not informed of why your posts are being moderated.
At this point, I have no choice but to let you know that, if I don’t get a response BY EMAIL, or receive a functioning EMAIL ADDRESS from you to which you are prepared to respond within the next day or so, I will be forced to stop posting your comments. Please contact me by email WITH YOUR EMAIL ADDRESS at [email protected] or [email protected] if you wish to continue posting here.
I can read the list of “criteria” as well as anyone. They’re not exactly complicated. And I have an MS and experience as a counselor, and used to diagnose lots of people using the DSM (though I saw it only as a means of getting their insurance to pay, not any kind of scientific “truth” about their condition). It was pretty obvious that if I sent my oldest to a standard school classroom, it would be days before I got “the note” telling us to take him in for an “evaluation”.
Here are my responses for Patrick, our oldest:
Displays poor listening skills (yes)
• Loses and/or misplaces items needed to complete activities or tasks (frequently)
• Sidetracked by external or unimportant stimuli (frequently)
• Forgets daily activities (yes)
• Diminished attention span (Compared to whom? But less than most kids his age)
• Lacks ability to complete schoolwork and other assignments or to follow
instructions (not sure if it was ability or motivation)
• Avoids or is disinclined to begin homework or activities requiring concentration (Absolutely!)
• Fails to focus on details and/or makes thoughtless mistakes in schoolwork or
assignments (yes)
• Squirms when seated or fidgets with feet/hands (yes)
• Marked restlessness that is difficult to control (yes)
• Appears to be driven by “a motor” or is often “on the go” (dumb criterion, but if they mean he didn’t like to sit in one place, absolutely)
• Lacks ability to play and engage in leisure activities in a quiet manner (Are you kidding? No volume control!)
• Incapable of staying seated in class (maybe not incapable, but had a hard time with it)
• Overly talkative (not really – this is the only criterion that did not apply to our oldest)
Symptoms present prior to age 12 years (from birth, more or less)
• Symptoms not better accounted for by a different psychiatric disorder (e.g., mood
disorder, anxiety disorder) and do not occur exclusively during a psychotic disorder
(e.g., schizophrenia) (This is a fascinating criterion, meaning even if ALL the criteria are met, you might NOT have “ADHD” if, in someone’s OPINION, you might have something else. VERY scientific! But no, it wasn’t)
• Symptoms not exclusively a manifestation of oppositional behavior (Again, very silly. How would anyone ever make this determination?)
Well, good! We agree on that point. I’ve never, ever criticized someone for making an informed decision to use stimulants. I am only objecting to representations by doctors that that things are true which really are not.
Sorry, Thomas, but even the most mainstream of psychiatrists will tell you that there is NO brain measurement, PET scan, SPECT scan, MRI, or other objective measure that is diagnostic of ADHD or any other “psychiatric disorder.” The DSM itself admits that these “diagnoses” group together people who may have little to nothing in common physiologically – they are grouped based entirely upon subjective and unmeasurable criteria like “Acts like driven by a motor.” How would you measure THAT?
Your premise is contrary to research data. I’m not going to go into agreement with you that everything has been tried when it has not. If an open classroom has not been tried, it should be.
The other thing I’d look into is what kind of family life or conditions the child is experiencing. There is hard data showing that kids in foster care have MUCH higher diagnosis rates, and that the overlapping symptoms between “ADHD” and “PTSD” quite commonly lead to PTSD sufferers being “diagnosed” with ADHD without looking at the underlying trauma, which is often ongoing.
However, it is appears to me that you are not really interested in having this discussion, as I gave you a very legitimate answer to your question, which you intentionally dismissed on speculation without considering it at all. Two of my three kids went to “open classrooms” and did absolutely fine despite moderate to severe “ADHD” symptoms in elementary school. You make no comment and give no credence to the fact that similar results have been observed with many who fit the “ADHD” criteria. It appears to me by this behavior that you are simply selling your viewpoint and trying to invalidate others who have given perfectly rational responses. This is not productive and I frankly find it extremely irritating. I could be wrong, but it appears to me at this point that the only answer you will accept is, “You’re right, Thomas, I’d totally put my kids on Ritalin.” I’ve already faced EXACTLY the situation you described and HAVE come up with an effective plan to handle it without any stimulants at all. So no, I would NOT put my kids on stimulants, because I did not need to, as we came up with a more effective plan.
See my remarks on Thomas Edison. There are other examples (like Einstein) of kids who didn’t do so well in school yet contributed mightily to our society. The ability to apply oneself to concentrating on schoolwork is a massively overrated skill. And you’d have a lot more influence on the people you are so passionately trying to convince of your viewpoint if you’d start by acknowledging the multiple successes of “ADHD” people who have succeeded without “treatment.”
A person with diabetes has a measurable deficiency in insulin, and giving insulin directly repairs that deficiency and leads to physiologically measurable results.
No child or adult has ever been shown to have a measurable deficiency of Ritalin or Adderall, and giving Ritalin or Adderall is not repairing any such deficiency.
The situations are not in the least comparable, as anyone who looks beyond the surface arguments should easily be able to comprehend.
This kind of claim is completely disingenuous. You know very well that I’ve contacted you a number of times to discuss why your comments are being moderated, and you have chosen not to respond. If you don’t check the email you have included with your registration, please send me an email you DO read and I’ll be happy to keep you informed. It is extremely inappropriate to engage in this kind of backhanded attack in the comments section, and I normally would not have posted it or any reply, except for the fact that so far, your comment is completely contrary to reality and I want to know if there’s a legitimate reason you have not been reading the emails I have sent or if you’re pretending I have not tried to reach you in order to try and create dissention.
Do not respond to this comment, as it will not be published. If you care to have a genuine discussion of the problems created by some of your posts, please direct it to [email protected].
Funny how Edison is often referred to as a sufferer of “ADHD.” He did horribly in school and was kicked out of elementary school with the comment he was “incorrigible.” Educated at home by his mother. No stimulants. Yet he appeared to turn out quite well in the end, didn’t he? Why didn’t he become a criminal or a drug addict? How was he able to learn so well without the benefits of a standard classroom? Is it possible that he always had the capacity to learn, yet could not do so in the sterile and rigid environment of a school classroom?
“Edison had strong opinions about education. Most schools, he believed, taught children to memorize facts, when they ought to have students observe nature and to make things with their hands. “I like the Montessori method,” he said. “It teaches through play. It makes learning a pleasure. It follows the natural instincts of the human being . . . The present system casts the brain into a mold. It does not encourage original thought or reasoning.”
Frequently Asked Questions – Thomas Edison National Historical Park (U.S. National Park Service)
An open classroom, as I’ve already stated more than once. You are making the assumption that paying attention to schoolwork is necessary to succeed in life. The long-term studies on stimulant treatment belie this assumption. Kids taking stimulants complete more homework, pay more attention to the tasks at hand, yet don’t learn more as a result. This should raise questions as to whether they may be daydreaming simply because the “work” they are presented with is inherently dull and ineffective as an educational tool.
“Candidate gene…” “association/linkage…” These are speculative ideas, probabilities, not causal factors. A causal factor will be present when the situation is occurring and absent when it is not. In these GWAS tests, the “candidate gene” is present in the unaffected population in large numbers, just somewhat larger numbers in the “test” population. It doesn’t really explain anything at all.
And another 24 million who may have been told that “this is the answer” and remain in despair, and are prevented from seeking other solutions by the faith they put in their doctor’s promises.
I would love to see what percentage of doctors tell their clients there is about a one in five chance you will get a significant benefit, let alone how many inform their clients of the wide range of other options available. I talked to a woman on the crisis line I worked one time, and she’d been seeing a psychiatrist for well over a year and seen no benefits. She was frantic, telling me she thought nothing would ever work and she’d feel that way for the rest of her life! I asked her if anyone had told her there were other things she could do for depression besides drugs? She was silent for a moment, suddenly calm. “No,” she said. “Well, there are,” I told her. “Oh!” she said. “Well, THAT’S good!” Her despair was gone in a moment as soon as she learned there were other options, but NO ONE had discussed these options with her!
There is a very great harm in telling people that you know the cause of their suffering when you don’t, and even greater harm when you tell the person you have a solution when that solution has a 4/5 chance of failure.
I mostly agree, but I can’t really agree that science has resisted the colonization of its methodology and discoveries against the forces of greed and capitalism. The very existence of “biopsychiatry,” which is the only real psychiatry that exists today, is proof that greed and corporate control can take over a supposedly scientific endeavor and turn it into a gigantic marketing campaign. When we are hearing that more than half of today’s “discoveries” are false due to corruptions in the scientific method and in some cases outright fraud, it’s hard to see how science has been able to avoid being coopted by the forces of capitalism and greed. True scientific method is value-neutral, but how many scientists have the courage and integrity to continue to do real science when the results they discover are covered up or they are attacked for coming up with the “wrong” findings for those looking to make more money?
It really sounds like the medication was a life saver for you. I have also heard other stories of this nature, and I have no doubt they were true. Where I object is when you assume that “we” (meaning all students suffering from attentional issues for whatever reasons) will all benefit in the same way as you did. As you say above, many factors impact learning. Stimulants are only one factor, and according to the literature, not the determinative factor for most kids. Again, that doesn’t mean it wasn’t determinative for YOU and for others who had such a favorable response. It just means we can’t generalize from personal experience to scientific conclusions on a population level. I believe you, 100%. I also believe the statistics. I also believe the stories of people whose lives were made just as much worse by stimulants as yours was made better.
So I hear your personal experience, and your understandable passion for this subject. I’m just not down with the assumption that because you had this experience, everyone who is diagnosed with “ADHD” will have a similar one.
I’d still be very interested in hearing your response to the established fact that “ADHD” kids do far better in open classrooms than in standard ones. I have two kids who both qualified for “ADHD” diagnoses, and we used homeschooling and alternative child-centered schools, no medication or other “treatments,” and both graduated from HS with honors, and the youngest graduated from a university with honors. Both are gainfully employed, have never gotten into drugs or delinquent behavior, and appear to feel pretty good about themselves and their lives. I really think it is a possible answer for a lot of kids who get this label. What do you think?
From James Swanson, et al, who is a proponent of the use of stimulants for “ADHD.” This is a review of ALL reviews to date (in 1993) and so is a compilation of ALL research to that date, not just one study:
What Should Not Be Expected
1. Paradoxical Response
a. Responses of normal children are in same directions
b. Responses of normal adults are in same directions
c. Responses of affected adults and children are similar
2. Prediction of Response
a. Not by neurological signs
b. Not by physiological measures
c. Not by biochemical markers
3. Absence of Side Effects
a. Infrequent appearance or increase in tics
b. Frequent problems with eating and sleeping
c. Possible psychological effects on cognition and attribution
4. Large Effects on Skills or Higher Order Processes
a. No significant improvement of reading skills
b. No significant improvement of athletic or game skills
c. No significant improvement of positive social skills
d. Improvement on learning/achievement less than improvement in behavior/attention
5. Improvement in Long-Term Adjustment
a. No improvement in academic achievement
b. No reduction in antisocial behavior or arrest rate
“In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
There are also the RAINE study in Australia, the Quebec ADHD study, the long-term data from the MTA study in the US, and a comparison study between Finnish and US “ADHD”-diagnosed children showing that there were little to no differences between groups, despite the Finnish group using far less stimulant treatment. And the OSU medication effectiveness study, though somehow the original reports on long-term outcomes don’t seem to be available any longer.
I’m afraid the jury is in on this point – there is no general long-term benefit to stimulant treatment of any significance. One can certainly find individual studies that claim these effects, but large reviews of huge amounts of data show no real benefit of mass treatment of “ADHD” with stimulants. This of course doesn’t mean that some individuals are not positively affected, perhaps in very significant ways, but as a group, stimulants have not proven to improve long-term outcomes for “ADHD.”
Wow, even I am shocked and disgusted that “mental health” personnel would ever talk in such a fashion to clients! That is absolutely disgusting! Though I definitely have gotten the “let’s put you on a diet after making you fat with antipsychotics” energy a lot. Seriously, are these folks incapable of basic cause-and-effect reasoning?
I have responded many times directly to comments you have made, and asked you questions to clarify your position. If you ask me a question, I will always respond to it if we are engaged in a discussion. I have acknowledged points that you have made that seem to be supported by the literature. I simply have a different set of experiences than you. So far, I have not seen any interest from you in finding out why I hold the beliefs I do, nor have I gotten responses to clarifying questions I have asked you, nor do I recall having gotten any response to the research data I have provided regarding ADHD kids doing better in open classrooms or outcome measures not being improved in the long term by stimulant treatment alone. I don’t think it is at all true that I have not listened and responded to your comments. I don’t see you listening to or responding to mine. I don’t expect agreement from you, but I would hope some kind of acknowledgement would be forthcoming when I take the time to respond to your comment. If you don’t want to, that’s up to you, but I don’t appreciate being judged as unresponsive when the facts say otherwise.
It is. If you feel any specific post has been allowed that has personally attacked you or your character, please either hit the “report” button or better yet, email me and explain what you are seeing.
However, as I have said before many times, disagreeing passionately with a person’s viewpoint is not considered a personal attack, it is simply disagreement. It is important for folks to keep this in mind when evaluating whether a comment constitutes a “personal attack.”
It sounds very much like your parents were emotionally abusive, simply because you didn’t fit their expectations of you. I consider that horrible on their part, and I empathize with having to put up with that kind of horrible behavior. I would be very angry and disappointed by them, but I’d imagine I might always feel somewhat like I could “never be good enough” to satisfy them. Their behavior was cruel!
Consensus of “experts” has absolutely nothing to do with science, Thomas. Scientists agreed at one time that formula feeding was as good or better than nursing, that Thalidomide was safe and effective, that DDT had no harmful side effects, that Valium was not addictive, that Xanax was not addictive, that Benzedrine was not addictive, that Tardive Dyskinesia was a consequence of “schizophrenia” rather than the drugs given to “treat” it, that Viiox was safe and effective, and that SSRIs had a mild side effect profile and no withdrawal effects at all. None of these things that “experts” agreed to proved to be true in the long run. “Experts” have lots of conflicts of interest these days, making the problem even worse. You can hire an “expert” to claim almost anything these days.
And we already have a means to help these children that is drug free and proven by actual scientific research. It’s called an OPEN CLASSROOM. “ADHD” kids are indistinguishable from “normal” kids in such an environment. The only thing stopping us is laziness, narrow vision, and the financial conflicts of interest mentioned above.
I continue to notice that you tell other people what you think they should believe but do not respond to my comments relating to your assertions. Again, I ask you, are you here to have a conversation or to try to get others to agree with your pre-determined viewpoint? A failure to answer this will indicate the latter, and I will no longer bother trying to have a conversation with you, though I may still post scientific evidence to counter any claims about “experts” agreeing as some sort of proof of anything.
I do agree with you, 100%! But I guess I’d put it another way: people who have physical brain lesions resulting from accidents or actual diseases are NOT diagnosed because someone labels them with a psych disorder instead of actually finding out what’s wrong with them! I guess I have a big problem calling these labels “diagnoses” instead of recognizing they are meaningless labels, no different than saying, “He’s socially awkward” or “she’s pretty aggressive in conversations.” They are opinions based largely on biases and stereotypes and tell us NOTHING about what is really going on for that person. And as you point out, they also deflect attention from searching for ACTUAL medical diagnoses that we CAN do something about!
I am surprised that “placebo washout” is not seen as a biasing factor. Removing people who respond to placeboes is clearly not a scientifically justifiable action, as it biases the studies in favor of the drug (treatment) and against the placebo.
I would submit that there is no way to “misdiagnose” “bipolar disorder,” as there is no legitimate, objective way to “diagnose” it correctly. If we can’t objectively distinguish between those who “have bipolar disorder” and those who do not, the idea of a “diagnosis” loses all value except as simply a discussion term. If you can’t know you are “right,” how can you know if your “diagnosis” is “wrong?”
But I agree with you completely – the lion’s share of “mental illness” is simply each person’s response to trauma and difficulties in survival which we all face in one way or another.
“The findings suggest that the serotonin theory was endorsed by the professional and academic community,” the authors write. “The analysis suggests that, despite protestations to the contrary, the profession bears some responsibility for the propagation of a theory that is not empirically supported and the mass antidepressant prescribing it has inspired.”
Yet oddly, these behavioral changes contributed nothing to long-term outcomes, as multiple studies have shown no academic advantage for taking stimulants over the long term. Kids who took stimulants and kids who did not had very similar academic outcomes, including test scores, HS graduation rates, college enrollment, or even other measures of social outcomes like delinquency scores and self-esteem. So apparently, doing more problems more quickly might get approval in the classroom, but has no actual impact on learning.
I see no harm in looking at scientific data. The problem is when the “scientists” choose not to believe what that data is telling them, or to cover up what they know the data says because it undermines their self-interests. At that point, they are no longer scientists, but either cult members or marketing agents.
A wise man once observed that scientific explanations should make things simpler. When your theory makes things more and more complex over time, the theory is wrong! And the DSM and the “biological” explanations for “mental illness” certainly qualify as making things far more complex than they really are.
And my observation is that the most helpful professionals are the ones who simply back down from the “expert-user” dynamic and talk to the person like one person to another. Which is what they are!!! The most important lesson I learned as a counselor is that I never had the answers, the client did. Sometimes I had the right questions, that was about it. The rest was all an exercise in giving a shit about the other person’s life.
I have as well. I’ve also known insensitive, thoughtless, means-spirited psychiatrists. And I’ve known compassionate and intelligent psychiatrists who have done a lot of harm by following “protocols” instead of getting to know the patient. I’ve seen psychiatrists who insist on increasing the dosage of something that has harmed their patient or not been helpful.
I have also noticed something about you, Thomas. I notice that when I ask a challenging question, you don’t answer it.
Why is it so important for you to convince everyone here that your viewpoint is correct? At least, that’s how it seems to me. I see little to no effort to understand others’ feelings, experiences, and logical objections, and a lot of effort to promote your own viewpoint. Is that why you came here?
Just so everyone is aware, ALL comments are “held in moderation” initially until I or someone else can approve them. Since I am doing 5-8 hours a week in this role, it can sometimes take hours, or even up to one calendar day, for comments to be approved. There is no meaning to having a comment “held in moderation” unless it’s been more than a day, in which case folks should contact me to make sure the comment isn’t lost and to discuss any concerns the comment might have raised. But this one was approved as soon as I read it.
At this point, Thomas, I’m not sure you’re really willing to engage in a meaningful conversation. Are you here to discuss different people’s realities and to learn from each other, or to promote your own viewpoint? I’m not sure I want to waste more time trying to present an alternative viewpoint if you’re seriously not open to hearing alternative viewpoints. Are you?
“However, they also found a negative effect on the youth’s sense of self with youth reporting that they no longer felt like themselves, were happier off the medication and noticed a change in their personalities.”
Of course, the theory that “ADHD” is caused by a genetic malfunction is also not based on double-blind, controlled studies, despite what we’ve been told. Let’s not set a double standard. Of course, the idea that something so nebulous as “having difficulty paying attention” or “being overly active” is ALWAYS caused by the same thing is absurd. But here is one article supporting that poor parenting DOES have an effect on attention span and hyperactivity in some kids:
Other causal factors that have been identified include poor diet, low iron levels, high lead/heavy metal concentrations, and sleep apnea. And trauma has also been implicated, particularly kids who have “PTSD” symptoms have a huge overlap with “ADHD,” and a study I recall said that family doctors in particular are more reluctant to diagnose “PTSD” over “ADHD” even when children clearly meet the criteria for the former.
This in my mind is the inevitable result of having such sketchy, subjective criteria for “diagnoses.” Kids can meet the criteria for both “ADHD” and “PTSD,” and there is not a clinician in the world who can objectively tell the difference. All we have is their opinion on the matter, because the “criteria” don’t make the distinction for us, do they?
We all know there is no definitive cause of “ADHD”, despite decades of research. I’m not holding my breath that there ever will be, because it’s obviously caused by a whole lot of different things, since the only thing these kids have in common is that they have a hard time paying attention to things they aren’t very interested in, and similar subjective “criteria,” not all of which they have to even share with others with the same “diagnosis.”
From the DSM: “[In DSM]… There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.”
So we can’t assume that all “cases of ADHD” are “alike in all important ways.” This strongly suggests that the assumption all such cases are CAUSED by the same phenomenon is completely inappropriate.
We always seem to be “on the cusp,” yet those razor-sharp understandings and interventions never seem to have developed. I’m glad at least that you recognize that we’re trimming hair with a scythe right now. It is difficult to understand, though, why you don’t consider giving someone a shave with a scythe is a pretty dangerous undertaking, especially when there are less dangerous options, including letting one’s beard simply grow out!
The “proper diagnosis” of ADHD requires the subjective evaluation of “traits” with pseudo-scientific foundations. Such concrete and measurable things as “loses and/or misplaces items needed to complete activities or tasks” and “Appears to be ‘driven by a motor’ or is often ‘on the go'” or “is overly talkative.” You know, the kind of things that a Scientist can Measure with his “Talk-o-meter” and such.
It is also very obvious from my own observation that these criteria are almost never consulted. Most doctors simply go with what their “impressions” are, usually based on parent and/or teacher report. The main reason more and more kids are “diagnosed” is not because we’re looking better or there are more kids developing this “disorder.” It’s called “diagnostic drift” – when subjective criteria are used to establish a boundary, over time, that boundary gets pushed so that more and more people “meet the criteria” due to pressure from parents and/or teachers to “diagnose.” This was very clearly seen in autism as well as “ADHD.” I have also NEVER in my entire career seen a doctor document “more than one person” providing evidence in “more than one setting.” To the contrary, I’ve seen dozens, probably more like a couple of hundred cases where the school was the only source of “information” and where parents agreed to the stimulants under pressure from the school. I’ve also seen some where one parent decides to “get him/her diagnosed” when another (usually non-custodial) parent disagrees completely. I’ve seen kids who ONLY take stimulants for school time because they “don’t need it” at home. According to you, these kids should not be “diagnosed.” Yet they are, by the wonderful, caring, competent medical professionals you speak so highly of in your next post.
I get the impression that you really want us to believe that all or most mental health professionals are competent, caring and thorough, and track closely on family history and the success of their interventions as well as the potential side effects. I would bet big money I’ve seen a hundred times as many “ADHD” cases as you have in my career, and I can tell you that those assumptions are very, very wrong.
I recall one girl who had graduated from an eating disorder clinic. Shortly afterwards, she was put on Ritalin for “ADHD” by her caring and competent medical professionals. Oddly enough, she started eating less, an obvious and very well documented side effect of the stimulants which started almost immediately after their administration. They started talking about her “relapsing” in her “eating disorder!” It took my VOLUNTEER, LAY-PERSON advocate, about 5 minutes to figure out what was going on, and we eventually convinced them to stop the stimulants. Lo and behold, the “eating disorder” went away! Her argument was, “What’s more important, eating or finishing homework?” But the professionals were apparently unable to make that value judgment.
I also saw many cases where kids became aggressive when taking Ritalin or other stimulants, a fairly common adverse effect that is noted on the patient handout for every one of the stimulant drugs. Very frequently, instead of stopping the stimulant, such kids were put on antipsychotics, like Risperdal. Now antipsychotics, as you may or may not know, have the primary action of increasing dopamine uptake to lower the amount of dopamine between the brain cells. While stimulants have the effect of reducing dopamine reuptake and increasing the amount of dopamine floating around in the brain. It doesn’t take a neuroscientist to figure out that if giving something to INCREASE dopamine leads to aggression due to TOO MUCH DOPAMINE, the right thing to do would be to STOP INCREASING THE DOPAMINE SO MUCH! Why would it occur to ANYONE to give ANOTHER drug to decrease the dopamine you’re increasing with the stimulants???? Again, these are the same competent, caring mental health professionals who are trying their best to provide good service. But a high school student could figure out what’s going on in a 15-minute internet search. And this was not an outlier, Thomas. This happened ALL THE TIME. Probably seen a hundred or more such cases over 20 years, maybe a lot more than that.
I could give you a lot more stories, but you get the drift. I’m not saying the medical professionals are all incompetent or don’t care, I’m saying they are operating on FALSE INFORMATION which warps their decision making in very bad ways. It’s not a matter of incompetence – the basic assumptions of the system are faulty, and unless you luck out and get a maverick who does his/her own thinking, the training in those basic assumptions turns potentially good clinicians into feckless authoritarians copying behavior they don’t really understand but feel compelled to repeat because their boss/trainer/insurance company says that’s what they’re supposed to do.
I will allow that I did run into some really competent clinicians in my 20 years working with foster youth, some of them quite impressive. But they were very much in the minority. The majority, as anyone would expect, followed their training and pretty much locked up and stopped thinking when their training let them to poor results.
You are absolutely right, there are a lot of honest, hard-working individuals in the medical industry (though I hope you will concede that like any profession, there are also plenty of dishonest, lazy ones as well). The problem is, when you work in a SYSTEM that is designed poorly around false assumptions and is corrupted massively by financial conflicts of interest, even the best people will end up mostly doing damage control, and the bad ones will do massive destruction.
Fantastic post! I’m sorry about the abuse you experienced, but it’s awesome how you figured out how to heal, despite rather than because of the “help” you received from the psychiatric profession!
This is straight out of Irving Goffman (The Total Institution). The needs of the institution ultimately trump the needs of the individual, and the emphasis on “safety” in the short-term, physical sense is primarily a means of keeping the staff and institution out of legal trouble. To really change this would require a reconsideration of priorities that a large institution is rarely interested in or capable of, as it goes against their own interests, and the patients have no power to prioritize their own needs and have to simply put up with whatever the institution decides to do. Hence, the institution has no real incentive to do other than what they do – protect themselves first, whatever the cost to the patients’ emotional safety.
I do agree with you here – who cares what the “neurology of politics” is? The only reason I can see for it would be to select out people with the “proper” neurology to follow some pre-determined agenda.
Certainly, the correlations between childhood abuse and “schizophrenia” labels being assigned is orders of magnitude higher than the most optimistic estimate of “genetic contribution.” We’re talking over 80% vs. at best single digits, and that’s not even allowing for the biased research and reporting you properly identify. Plus, childhood abuse is something we CAN do something about!!!!
Someone simply doesn’t want that information to be discussed! I wonder who?
It seems I made an error in approving the initial comment in this thread. Now I’m feeling like having to allow each person respond to the last person’s assertions, but it has become increasingly non-productive as time has gone by.
At this point, I’m going to ask folks to swallow up whatever hurt feelings and misunderstandings and move on to other posts. I’m no longer going to publish the back-and-forth discussion about who said what. It’s clear there are some disagreements, and that’s OK, but let’s move away from the subtle personal slights that have started to emerge in this conversation.
Who here has said that chemicals can’t change one’s cognition? Nobody here would believe such a silly, obviously incorrect thing. It’s just that altering cognition does not constitute medical treatment per se. People have taken drugs to alter consciousness since the beginning of time. Tons of people drink coffee to increase alertness, a lot of anxious folks (like me) have used alcohol to moderate social anxiety, people use hallucinogens to have altered perceptions of reality. Sure, people can take stimulants to help them concentrate, or antidepressants to help them focus less on what is worrying them and more on what is happening now. Why the hell not? But it’s not like it’s some great technological discovery that drugs alter consciousness. The concept has been around for millennia, undoubtedly from before recorded history. They’ve invented some newer drugs recently, and MAYBE they are better in some ways for some things. But they have no idea what they are “treating” with these drugs, and they can’t predict ahead of time whether or not the drugs will “work,” they don’t really understand WHY they have the effects they do, nor is there any kind of broad agreement on what “works” even means (Is it better NOT to be anxious about the fact that your husband might come home drunk and possibly kill you and the children? Is it a positive to take a drug to be OK with your dead-end job and your crappy boss? Is it an improvement to be able to “stay on task” in school when the long-term studies show that those kids who “pay attention” don’t learn any more than the ones who are goofing off?)
And there are ALWAYS costs for taking any mind-altering substance, and almost every one of them leads to tolerance over time. One of the very worst failings of psychiatry is their unwillingness to be honest about the real costs vs. long-term benefits so clients can make an honest cost/benefit analysis.
You may not be a scientist, but I am by training (a chemist). And I’m telling you, the fact that a drug temporarily ameliorates a particular condition or state of mind is no big discovery in medicine. If someone could actually discover WHY a certain 20-30% of people responded to Drug X, that might be the BEGINNING of something of significance. But a pretty decent percentage of people respond to mega-vitamin therapy or changes in diet or improved exercise plans or meditation, too. So which is the real “treatment?” Or is the “disorder” not really a medical condition at all, but simply an inconvenient mismatch between one’s personality and the expectations of the society one lives in? And as such, would there not be multiple possible “solutions” to the problems so created, including the solution of simply not playing by the rules one is expected to comply with?
“It works for me” is not a scientific argument. It’s a personal testimonial, which is great, but there are a lot of varying testimonials out there that have to be taken into consideration, and some of them are VERY different than yours.
So why not simply have kids who struggle with Kindergarten wait another year to enroll, and have kids who don’t do well in standard classrooms assigned to open classroom environments where “ADHD” kids do so very much better? These are two things that we KNOW help and do absolutely ZERO damage.
Perhaps the need to “pay attention” to what other people think is important is very much overrated in our society. Maybe we need to help these kids build on their strengths rather than making them feel ashamed of not being able to or interested in doing what the adults have decided is “essential” for kids to do.
I pretty much agree with all you said, except that I don’t think “social defeat” is caused by the genetic phenotype, it’s caused by the society’s unwillingness/inability to be flexible enough to deal with the wide range of “phenotypes” that are around. “ADHD” is the best example. It is caused almost entirely by inflexible social expectations in schools. Kids who go to school a year later have a 30% lower chance of being “diagnosed.” Kids with an “ADHD” diagnosis in open classrooms are virtually indistinguishable from their “normal” peers. A great study showed that groups of 3 with an “ADHD” kid in the group did FAR better solving problems than groups of 3 “normal” kids. If we didn’t expect young people to sit still for extended periods of time “studying” subjects they have no interest in or have already mastered, “ADHD” would mostly disappear, regardless of the fact that some kids will always be ‘more active’ than others in any group.
Many people do better when they STOP taking their psychiatric drugs. Not everyone benefits, in fact, the latest solid review of decades of data suggest that perhaps 30% of users have a substantial improvement on psych drugs. You just happen to be one of those who benefited, and more power to you. It doesn’t mean that these people will deteriorate if they go off the drugs. Many have had no benefit or have been harmed by the drugs, and are pleased to get back to a more “normal” state, even if it is not optimum.
You are not doing anything wrong at all. You believe based on your experience that the antidepressants are essential for your survival. Not everyone believes or experiences that.
If you were made psychotic by your antidepressants, your feelings about them might be very different. If you were essentially arrested for saying you were suicidal, handcuffed, taken in a police car to the hospital, “evaluated” by a person who didn’t seem to care, locked in a ward with a lot of other people who are struggling and possibly acting out in a frightening fashion, given drugs you did not choose to take without any semblance of informed consent, and told when released that you HAD to take these drugs or you’d be hospitalized again against your will, your feelings about antidepressants might be very different.
There is nothing wrong with taking psychiatric drugs. There is also nothing wrong with NOT taking psychiatric drugs. Each person has to decide for him/herself, and we should not criticize them for making their decisions on their own best data. We SHOULD criticize the psychiatric industry for being dishonest with their patients, though, because they owe folks an honest rendition of what they do and don’t know, including that chemical imbalances are NOT implicated in depression and that only 30% of people taking antidepressants experience significant relief, as well as the common side effect and withdrawal effects of the drugs they are prescribing.
It may be optimistic to think so, but it is essential that these facts be expressed and publicized, as the current “it’s all in your brain” narrative will otherwise dominate, regardless of the scientific evidence to the contrary.
Though that last point seems to be contradicted in practice by the inappropriate use of “twin studies” to prove “heritability” and thereby infer genetic causation.
Science has been contaminated by the profit motive. There have always been concerns regarding authoritarian approaches to science, which is why a lot of new discoveries come from people not in the field of the discovery. But since they started allowing professors to profit from their work, and allow drug companies and others to fund fellowships and chairmanships, the situation has become far, far worse, to the point that someone estimated over half of recent scientific “discoveries” are actually false. The news media also contribute to this by blasting the commercially favorable results they are given in a press release when some new “discovery” is made, but never bothering to publish a correction or retraction when the original researcher had to “eat crow.”
Science is at this point highly corrupted, especially where pharmaceuticals are concerned.
I would add to that cultural dislocation and living in an urban environment.
The example I use is that not ALL kids who get hit by cars at a crossing near a school have their legs broken. Should we do research into why certain kids have “weak bone disorder” and try and come up with some “treatment” to make their bones tougher? Or should be maybe put in a traffic light and a crosswalk?
Well, since until recently the industry has DENIED that there are any withdrawal effects, they certainly wouldn’t bother HELPING you deal with the effects they are trying to pretend don’t exist!
It is criminal to let someone deal with that kind of crap without support, especially if you’re the one who created the dependency in the first place. But unfortunately, the industry appears to have no sense of shame.
Per Alice Miller, the only thing that would distinguish a “good therapist” from a “bad therapist” would be the degree to which they are aware of and have processed their own childhood trauma, so that they would not act those needs out on the client. The “school” of therapy or the degree of the therapist would have essentially no impact on the outcome. Which I think is why they found that talking to a friend is just as likely to be helpful as talking to a professional. Not all friends will be helpful, only the ones who have dealt with their childhood trauma, but the odds of finding someone who has are not improved by seeing a “professional.”
Truly. They find a SET of genes that has a 1.065% correlation with the “condition” in question (not even dealing with the impossibility of locating a legitimate study group with the subjective criteria used for “diagnosis”) and say, “We’ve proven that “ADHD” is genetic!!!” You look at the article and find that only 5% of the study group has this combination, while 4.7% of the control group has the exact same set of genes! How is that causation? But people lap it up. I guess if you WANT to believe something badly enough, you find a way to justify it.
And yet adults diagnosed with “ADHD” report on the average lower quality of life. Which means for every success story, there is someone made at least that much worse. Decades of research show no improvements in long-term outcome for ADHD kids treated with stimulants over those who are not. So whether it has a “biological etiology” or not, stimulant treatment by itself does nothing to make life better on the average for those so treated.
I do rejoice for your personal success, and hope it continues to go well for you. But the idea that we are “nearing an understanding” of “ADHD” is not supported by the literature. In fact, the BEST “treatment” for ADHD seems to be to put kids in a non-traditional classroom where they get more control of their activities. No “medications” needed. On the average, of course.
My favorite is “Treatment resistant depression.” Not, “We failed” or “we don’t know what we’re doing,” but “Your depression RESISTED my efforts to treat it!” What would we do if we had a plumber come by and we paid him $200 dollars and he said we had a “repair resistant toilet?” We’d fire him and get a new plumber! What kind of professional blames his/her client for his/her failures?
This community consists of a huge majority of “affected people,” Tmason. They just weren’t affected in the same way as you were. I find it disappointing to see how easily you seem to dismiss other “affected people’s” experiences while wanting others to value yours. It is not “at your expense” that people share their stories, even if you find these stories confusing or contradictory to your own experience. It is for their own benefit. If you want to be respected, you need to start with respecting the fact that not everyone experiences the “system” the same way you do. If you’re not interested in that kind of discussion, where each person is entitled to share their own story and experiences and no one is entitled to invalidate them for doing so, then I think you may have come to the wrong place.
I agree that “treatment” and involuntary detention need to be seen as COMPLETELY separate issues. It does not follow that because Person A is having a hard time managing in society without worrying or annoying people, that person needs “treatment” forced on them, or needs “treatment” at all. It makes sense that society might need to protect its members from someone who is out of control of his/her behavior, but as soon as a person is arrested (and let’s be honest and call a spade a spade, that’s almost always what happens, they are arrested and handcuffed and put into a police car), it stops being “treatment.”
I don’t see why there can’t be “calming centers” where people go to be away from chaos so they can regain their perspective without having to label that person as “mentally ill” or force drugs on them. Maybe there can be things on offer if people want them, but literally forcing pills down a person’s throat can’t really be seen as therapeutic, IMHO.
I also think Miranda rights are appropriate before every “mental health” detention evaluation, including the right to not answer and the right to legal representation.
I would add that there is no real way to TRAIN someone to listen respectfully in all cases. There are “techniques” that can be taught to a person who is really open to experiencing how others feel, think and behave and their motivations for doing so. But there is no way to guarantee that any individual is capable of or interested in having that experience, and if they are not, no amount of training can get them there. So someone having a degree in psychology or counseling is no guarantee that this person is any better than a random person on the street at listening and caring about another person. And research reflects this, as I recall. But for some reason, I can’t find the study that applies on the internet – it is drowned out by dozens and dozens of articles on “why therapy is different than friendship” and the like.
What people need is a non-judgmental listener who will support them in figuring out their own path. What they are offered is often VERY different from that, unfortunately.
I don’t think it’s fair to say everyone thinks anything in particular. There are plenty of people here who are still involved in the psych system, voluntarily or not, and who use psych drugs, voluntarily or not, and some who have found therapy helpful, while some have not. Some give credence to mental health labels from the DSM, some (perhaps most) do not, but no one is required to disbelieve in them or to believe anything in particular. There are people who post here who are supportive of the current mental health system and who report research findings in support of the status quo paradigm.
I think what most people have in common at MIA is that they have either been harmed or seen people harmed by the “mental health” system as it is. I doubt that ANYONE would question that the phenomena listed in the DSM as “mental health disorders” occur and exist and are troublesome or even extremely distressing to many people who experience them. From my own point of view, I think the question to be posed is, just because a set of phenomena happen and can be identified as happening, does that lead to the conclusion that the person experiencing them is medically ILL, or requires medical intervention? Does it automatically imply, as many doctors claim, that one’s brain is malfunctioning, and even further, that there is nothing that YOU as an agent in the world can do about such phenomena?
The second, and extremely closely related, question is this: Are psychiatrists, psychologists, the news media, entertainment media, the internet, telling us a true story of what science really says about these phenomena? For instance, if schizophrenia is a purely biological phenomenon, why is it so much more common among immigrants and urban populations? Why do sufferers in third world countries have so much better recovery rates if the don’t use our “state of the art” drugs to manage their condition? Why is it that people in countries that accept “hearing voices” as a culturally appropriate phenomenon tend to have “nicer” voices compared to those in cultures where hearing voices is shamed and looked on as a “disease?”
Also, the history of pharmaceutical research is rife with manipulation of results and downright dishonesty. This is not confined to the psychiatric field, but it seems to be far, far worse when dealing with phenomena that can not be objectively distinguished from “normal” situations. We’ve been told that antipsychotics were responsible for “emptying out the psych wards,” only to find that it was a policy decision having nothing to do with antipsychotics, and that people diagnosed with “schizophrenia” are much less likely to recover today in the age of pharmaceuticals than they were in 1955. We’re told that Prozac and other SSRIs have a very mild side-effect profile, only to find out that they can cause some people to become suicidal or homicidal, and can have devastating withdrawal effects that were swept under the rug for decades. We hear that “depression” is caused by low serotonin, only to find out that this theory was debunked back in 1985 or so, and psychiatrists now tell us that “no competent psychiatrist has believed this for decades.” There is a fundamental DISHONESTY about the system and how it “works.” A skepticism about the intentions of the system may be the thing most of us here have in common.
I appreciate your asking that question. I take it to indicate you are concerned with understanding the community you are entering.
You are welcome here to have your own views and share them, as long as you are respectful about it. Others may disagree with you, as long as they are respectful about it.
It will be called “Befriending therapy” and someone will write a manual and then copywrite it so that no one’s allowed to befriend children unless they have the proper license and certificate from “befriending therapy” training!
So what’s your take on putting kids with these personality characteristics into classrooms where they naturally do better and have a lot less stress, since we know that open classrooms can provide this kind of experience?
Judith Rappoport et al proved this back in the late 1970s. She and her colleagues gave stimulants in therapeutic dosages to teens who were not diagnosed with “ADHD”. They measured things like movement levels and activity levels and ability to concentrate. All were improved in a similar manner to those who were diagnosed with “ADHD” (or whatever they called it back then – hyperkinetic reaction of early childhood or MBD or the equivalent). She called the “paradoxical effect” a myth which was “an artifact of observation,” meaning that people noticed that the “ADHD” kid concentrated better because they were LOOKING for that, but did not notice the same effect in non-diagnosed people because they weren’t looking for that result.
Note that Rapoport has been a supporter of stimulant treatment for “ADHD” for her entire career. This study has been considered conclusive (in 1978) and the idea of the “paradoxical effect” was dropped afterwards by researchers, though the popular myth of the “paradoxical effect” survives in some communities to this day.
The idea that “ADHD” kids react differently to stimulants has long since been discredited.
As to WHY they increase concentration, we’d have to get into talking about the role of dopamine in concentration, an area where I have not studied extensively at all. But it is VERY clear that all kids (and by extension adults) taking stimulants will react in a very similar manner.
The idea of “using one’s voice” as a means to combat insensitive or bullying people is that it doesn’t work very well if you don’t have the power to make your own voice heard. Speaking up when involuntarily committed to a psych ward or living with an abusive partner or abusive parents can be extremely dangerous! Certain bosses specialize in firing anyone who “uses their voice” in any way that challenges the boss’s power and control. I do think we should trust our intuition, but we need to be selective where we “use our voices” if we don’t want to get injured!
Clearly, being “highly sensitive” is caused by a chemical imbalance in the brain. Research has proven that insensitive and thoughtless people fare better in society, experiencing less anxiety and depression and being more successful in certain professions like sales, law, or politics. There are special drugs now to help people care less, the most popular being “Fuckidall,” promoted by famous comedian, Robin Williams. Our next efforts will be to create psychoeducational presentations in schools and other places teaching people the importance of insensitivity and teaching them specific “Fuckidall” skills that can be practiced even without medical intervention.
Stop worrying! Stop caring! Buy some “Fuckidall” today!
There is certainly no denying that physiological damage CAN cause psychological phenomena. The problem, as you intimate, is the assumption that physiological damage is the ONLY thing that can cause psychological phenomena, or worse, that physiological DAMAGE (and let’s be honest, that’s what every drug intervention AND so-called ECT does to the brain, and usually to other parts of the body as well: physiological damage) is the only way to address psychological phenomena. It’s like saying insufficient memory can cause a computer to slow down, so the answer to any computer slowing down is adding more memory chips. Illogical. Except adding memory chips at least enhances the machine’s capacity, while psychiatric drugs without exception decrease the body’s capacity to do something, whether the reuptake of serotonin (SSRIs), the reuptake of dopamine (stimulants), or whatever process these drugs disrupt.
So if some observable physical defect can be detected, it should be addressed as best we can. But ASSUMING that we’re addressing a physiological deficit that no one can actually identify is a very dangerous pathway.
I have to disagree with you that “we” (meaning all ADHD-type personalities) “function at a level so far below our potential.” This is only true to the extent that you accept the normal capitalistic go-to-work-and-do-what-your-boss-says-for-a-paycheck kind of standards as one’s “potential.”
A fascinating study was done not too long ago where they took kids and put them into groups of three. The study groups had two “normal” kids and one diagnosed with “ADHD.” The control groups had three “normal” (non-ADHD) kids in each group. They gave them a set of three problems to figure out the solution to. I can’t remember the age level, but I think they were elementary, something like 8-10 years old.
They measured “on-task” behavior, and the non-ADHD groups did far better. The groups with the “ADHD” kid in them screwed around more, focused less on the problems and more on just hanging out together. But when it came to solving the problems, NONE of the so-called “normal” groups solved ANY of the problems, while each of the ADHD-inclusive groups solved at least one, and if I am recalling correctly, a couple solved all three.
Now if you’d run groups where ALL THREE kids had an “ADHD” diagnosis, it’s quite possible nothing would have been accomplished at all in terms of the problems at hand. But it’s clear from the results that the off-task, goofy, creative, “what about this” kind of behavior from the supposedly “mentally ill” child played a very important role in getting the task at hand done, even if less time was spent at the task itself.
I think the implications of this study are quite huge. Perhaps instead of trying to FORCE the “ADHD” kids into becoming more willing to do as they are told and focus rotely on the “task at hand,” we ought to be looking at figuring out how to make the most of this skill set that clearly our society needs to survive! I think that’s why the “ADHD” kids in the open classroom settings were almost impossible to detect – they weren’t being expected to be rigidly “on task” doing something they found dull or pointless, so they had far fewer problems than their counterparts in “regular” classrooms.
Another interesting study looked at employer satisfaction with their “ADHD” – diagnosed employees. One might expect they’d be less satisfied because these employees would come late, be disorganized, say offensive things to other workers, etc. But as it turned out, their satisfaction levels were quite similar to “normal” employees. The experimenter observed that the “ADHD” employees tended to CHOOSE jobs where promptness and adherence to assigned tasks were not as important. They became ski instructors, computer programmers, entrepreneurs, salespeople, whatever suited their personality best.
Which goes back to my original thesis: “ADHD” is a real phenomenon, but it is mostly a problem only because we expect these kids to do things that they are not ready or able to do, and then punish them for failing to do so. When they have more control of their environment, deciding what to do and when to do it and when to shift to the next task, as in an open classroom, on the whole, they do MUCH better than if they are being constantly directed by authority figures on what to do next and when to start and stop their activities. So much better that they look “normal” to professional observers who are looking to pick them out.
This does not even take into account the HUGE percentage of kids “diagnosed with ADHD” when something else is really the problem. 20 years working in the foster care system showed me how frequently kids with horrible home lives and super high anxiety levels or even frank PTSD symptoms are labeled “ADHD” because they “have trouble concentrating on their work!” Well, if YOU were removed from everyone you ever knew after years of being abused and neglected and were forced to live with a family who had to be PAID to take care of you and could dump you at a moment’s notice, you might find concentrating on schoolwork a bit difficult, too!
No one can be totally “nonjudgmental.” The best we can do is be AWARE of our judgments and decide not to act on them, but take them into account when evaluating what is the best thing to do. A person who pretends to be “nonjudgmental” is usually not being honest with him/herself and will have to rationalize any decisions as being “for the good of the client.” I always knew there was a danger I was acting to meet my own needs rather than the clients,’ making it a lot more likely I could avoid that danger. At least, that’s how I saw it.
Oh, absolutely, for me, any therapist who thinks s/he can be “above” countertransferrence (aka an emotional reaction to a relationship with another human being!) is highly dangerous!
In my relatively brief stint as a counselor, I viewed my reaction to the client as a) my responsibility completely, b) something that told me about how I might potentially make this situation worse by making it about me instead of them, and c) information about how the client is affecting me that may give me some insight into what’s going on with them. It is completely NORMAL to have an emotional reaction to an interaction with a client or any other person for that matter. The only thing that SHOULD distinguish the counselor from anyone else is that they understand how to use that information to get their own issues out of the way and make sure they are responding to the person asking for help. Anyone pretending they DON’T have an emotional reaction to their client is just plain lying to him/herself.
The only way I see to be able to be successful as a “counselor” or “therapist” is to have your own shit together enough that you don’t end up acting it out on the client. That means that far from being “above” your emotional reactions, you are 100% aware of those reactions AT ALL TIMES and are humble enough to know they are there and respect them, both as an expression of your own needs and as a conduit to information that might be of help to the client. There is no training for this ability. It means you have to have done your own “work” on yourself by whatever means you can. I found clients respected me because I was genuine and in touch with my emotions and was honest with them about what was going on for me without putting responsibility on them for my reactions. They liked it that I was human and real with them, and that I think was what worked when it did work – nothing to do with any training or “method,” just being one human honestly there with another and willing to share their pain without trying to “fix” it to make myself feel better.
It should be noted that EVERY person can experience “psychosis” if they go long enough without REM sleep. It is not an “abnormal condition,” it’s something everyone can experience under the right (or wrong) circumstances.
A few good studies back in the 1970s showed that “ADHD” diagnosed kids placed in open classroom environments were indistinguishable from “normal” children. Additionally, a bunch of studies in very different places ALL showed that if you wait a year to enroll kids in Kindergarten, the rate of “ADHD” diagnosis goes down by 30%! A very odd “disease” indeed that is reduced by 1/3 if you just let kids develop for another year before enforcing your expectations on them, and pretty much disappears completely when you stop enforcing those expectations entirely!
I was trying for some ironic humor. If they really did have the intention of helping, those committed to the system would NOTICE when what they did was not helping or making things worse, and then would try to DO something about it, instead of blaming the “patients” for their own failures.
My point was that the horse isn’t going to reply to you out of his own psychological issues or history or be hurt or angry that you don’t agree s/he’s “helping” you. They are just going to be a horse.
Maybe we should cut out the middle man and just hire horses to do therapy with us. A lot less “countertransference” to deal with that way, as we know the horse has no hidden agendas!
Isn’t it weird that childhood abuse, physical, verbal and/or emotional, is ubiquitous in psych wards, yet they continue to insist on “treating the brain” with continued crappy results? You almost get the idea that the system wasn’t created to help people get better…
It sounds like literal torture! I have also noticed that whatever “treatment” is being provided, there is no requirement that it actually improve the client’s condition, either by the client’s report or any of their subjective “screenings” that are supposed to be objective. If things get worse, it’s raise the dosage or try a new “treatment.” And then they say you are “treatment resistant” if their shit doesn’t work, rather than saying, “Well, I guess our shit didn’t work this time.” And if you somehow get better in some way despite all of this nonsense, they are the first to step up and give their wonderful drugs all the credit. No, logical reasoning doesn’t seem to be in much supply.
“You thought it was dead and buried…
But you were WRONG!
It’s BACK and it’s COMING FOR YOU!
The LOW SEROTONIN THEORY! It’s killed before, it’s died and come back to life, and now it’s dead and can no longer be killed!
THE SEROTONIN ZOMBIE! Coming soon to a psychiatric office near you!”
The amount of lithium used as “treatment” for “bipolar disorder” is many, many times the daily required dosage for nutrition. One estimate I just read suggests that one mg of Lithium a day is sufficient. Another measured the amount in micrograms (thousandths of a gram). A “therapeutic dose” is defined as 300-600 mg three times daily, or 900-1800 mg, one to two THOUSAND times the needed amounts. No one will specify what actual daily dosage of Lithium will kill you, but it is recognized that the “therapeutic” dosage and the toxic dosage of lithium are so close together that regular blood tests (once a week or so to start with) have to be done to ensure you are not receiving a toxic dosage.
Lithium at high dosages is most definitely a drug. And a potentially deadly one. For those who don’t happen to die as a result of overt toxicity, Lithium at “therapeutic dosages” is known to be very hard on the kidneys, and can lead to kidney failure.
They also seem to be drawing the subtle conclusion that “rats who are more active are more likely to be more active than rats who are less active.” Very deep!
There is more than a “dearth of long-term data on impact and safety.” There is PLENTY of long-term data saying that the impact and safety profile of these drugs is questionable at the VERY most optimistic. I’m not OK buying into this “more long-term studies are needed.” The studies we have are more than sufficient to call the use of these agents into question, particularly the blithe way they are prescribed so broadly with little to no standards of care. It is the job of the doctors and the medical community to prove they ARE safe, and they have failed to do so. No one should have to prove “beyond a reasonable doubt” that they are dangerous!
In other words, you know of no such stories you can share. Your are unwilling to support your claim with data, yet expect others to accept your claim or else they are “not hearing your voice?”
This is not a matter of viewpoint. Either the media is slanted toward success stories or it is not. I’ve given a long list of examples of that slant. You claim I am wrong. Where’s your data?
Consensus is not science. Scientists have had “consensus” on all sorts of things that were stupid or dangerous in the very recent past. Thalidomide was safe, bottle feeding was as good as or better than nursing, Benzedrine was not addictive, Valium was not addictive, Prozac had a only few mild side effects, Viiox was safe and effective, schizophrenia was caused by overproduction of dopamine, depression was caused by low serotonin, Tardive Dyskinesia was a consequence of being schizophrenic and was NOT caused by antipsychotic drugs… all of these things were agreed upon by “consensus” and turned out to be totally wrong. So scientific consensus is not worth wasting our time on. People agree to false ideas all the time and swear by them, even in the world of science.
You seem to have spent a great deal of time reading research on these genetic factors, which is great! I’m interested to know what PERCENTAGE of those “diagnosed” with ADHD have the specific CDH2 mutation you mention, and how many have that mutation who do not have an “ADHD” diagnosis? This information is essential if one is going to assume causality of a particular gene. Most of the genetic studies I have seen have found only probability correlations, and I seem to remember someone talking about this one and it was also a correlation – more people diagnosed with “ADHD” had this variation, but most did not, and a lot of folks having the variation did NOT get diagnosed with “ADHD.” Which suggests it could be A causal factor in SOME subset of those diagnosed with “ADHD”, but does not explain the phenomenon overall. Which might be good if that subset is in some way able to be identified and “treated” in some specific way. But it would not be proof that “ADHD is genetic.”
He has already made it clear he is not a millionaire, if you read prior posts. It is also completely irrelevant to the questions of science that are posed in his book. Are you implying that rich people have no right to comment on the condition of psychiatry and its impact on society today?
Lovely hypotheses. No actual facts presented. Who cares who yawns, seriously?
These presentations are 100% relying on emotional arguments. It is factual that people have been told for decades and still are told by some practitioners that they have a “chemical imbalance” that is “corrected” by psychiatric drugs. What you share is a bunch of professionals using plausible deniability to say, “Oh, we never really SAID that. Or at least none of us actually BELIEVED that, even if we did say it. So who cares if everyone still believes it’s true?”
The “black bile” comment is particularly egregious. No one has every told anyone in recent times that their depression was caused by “black bile.” While fully 80% of Americans in a semi-recent survey said they believed that depression was caused by a “chemical imbalance.” The latter circumstance did not occur in a vacuum. Whether they themselves believed it or not, psychiatrists sold this idea of “chemical imbalances” hard, along with the pharmaceutical companies, because it was good for business. They only backed away from it when forced to by hard scientific research, and many still promote it in their literature or their practices. These after-the-fact disclaimers are in no way convincing. If they thought this such a silly, simplistic theory, why have they not spoken to discredit it publicly until Moncrieff’s study finally shone some public attention on the subject?
I completely disagree with you. My experience is that the “success stories” are the only thing you ever hear in the media, and that those who have problems with this approach are silenced. Sure, there is the odd “horror story” that is sensational enough to make the news, but the idea that “ADHD” is a “neurodevelopmental disorder” that affects millions of children and can be specifically diagnosed (usually implied that “brain scans” or a response to stimulants are diagnostic) is almost never, ever questioned in the mainstream media. There are plenty of “celebrity stories” (Ty Pennington, Simone Biles, Michael Phelps, Justin Timberlake, Jim Carey, Howie Mandel) where the message is “Stimulant treatment saved my life.” I can’t think of one celebrity who has come out saying, “I tried this stuff but it really didn’t work for me” or “They tried to say my kid had ADHD but he moved to a new school and things went much better.” You’re welcome to prove me wrong by getting me some of these stories about how stimulants don’t work or made things worse or weren’t needed because X was really the problem, but that’s not what I see in the media at all. Seriously, I can’t think of a single story off the top of my head where such a story is told. I’m open to hearing evidence to the contrary.
But my point was not about Big Media, it is about each of us being willing to accept it when other people have different experiences and don’t agree with our own viewpoint. My initial impression left me wondering if you’d be open to hearing things that don’t fit with your own narrative experience. But I could be wrong. Everyone’s entitled to their opinion here, and we all have to respect each others’ views, even when they disagree with us, as long as it is done civilly and with respect for the diversity of experience that exists in the field.
You are absolutely welcome to tell your story here. We value all voices of anyone who has been through the system and want to hear how things look to you. At the same time, it’s very important to remember that others have had different experiences than you have had, and that you owe them the same level of respect that you are asking. Different people have different experiences, and hearing that one or two or ten or a hundred people feel their lives are turned around by by stimulants doesn’t alter that one or two or ten, or a hundred people share having experienced harm or confusion with the same approach. It also doesn’t alter the statistics and scientific studies about the overall results of stimulant treatment on the whole group of people diagnosed with “ADHD.” You may learn a thing or three from them as well, and it might help you not take it personally when other people’s description of their experience is quite divergent from your own.
I hope that makes sense to you.
BTW, I HAVE seen objective interviews of people diagnosed with ADHD and treated with stimulants or some other approach, and have spoken personally to a large number of such kids. I can assure you that there is a very wide range of responses, some of which reflect your own, some of which are more lukewarm, and some of which reflect feelings of resentment and betrayal. For instance, I worked with a ten-year-old foster kid who was put on stimulants while in foster care, and I asked her how she felt about it a year and a half or so after she was put on the drugs. She said, “Well, I guess it did help me focus better… but on the other hand, maybe I was just going through a lot of stuff at that time.” I would ask you to reflect on why she might not have been as enthusiastic about stimulants as you are. Food for thought.
I agree. Folks who are looking for help don’t need another person whose ego they need to protect. Most of the time, that’s what got them into the trouble they are in, having to take care of people who were supposed to be taking care of them. It is ridiculous for a professional to create this kind of expectation, consciously or not. It’s not the client’s job to make them feel good about their work.
If you would actually read Whitaker’s work, he was originally fully supportive of the status quo system. He only reduced his support as he observed SCIENTIFIC STUDIES showing that people AS A WHOLE were getting worse, not better. As far as I know, Bob Whitaker has never said that psychiatric drugs are worthless, that all psychiatrists are evil, or that no one has benefitted from psychiatric drugs. In fact, he has spoken out in favor of a targeted use protocol for psychiatric drugs, to use them for what scientific study says they are useful for, primarily for short-term symptom reduction, while seeking to look at other approaches which COULD be used by psychiatrists or anyone else to try to get past “symptom management” and create some viable long-term change. He even gives a couple of examples of how this mixed-use protocol would work, including real world examples of where it has been effective. Given the disastrous “recidivism” rate among users of psychiatric drugs and repeated studies showing that long-term use can make things worse for many users, indeed perhaps the majority, this seems a VERY rational viewpoint to take.
You seem to be making this a personal thing, as if critiquing psychiatry as a SYSTEM is the same as saying psychiatrists AS INDIVIDUALS are no good. This is simply not the case. You are arguing for a chance to have a civil exchange about these questions. It seems to me that would start with you as an individual dropping the assumption that people at MIA are out to destroy people’s “mental health,” which VERY clearly seemed to be your assumption from the first words you put down in your first comment. If you come into a web community and start off insulting everyone here, it should hardly be surprising if you don’t get a warm welcome. If, perhaps, you REALLY want to have a meaningful discussion as you claim, it would seem to me the most sensible thing would be to start by saying, “Wow, I have a really different experience of psychiatry from y’all. Can you help me understand how you came to these conclusions, and maybe I can tell you how I reached mine?” But I don’t hear you expressing any interest whatsoever in the people who have experienced psychiatry as something unhelpful, insulting, demeaning, or downright dangerous in a very physiological way. I am hearing in you a desire to tell such people their experiences are wrong, or their conclusions are wrong, but wanting them to listen to YOUR viewpoint “nonjudgmentally.” I don’t think that is a realistic plan.
Have you actually read “Anatomy of an Epidemic?” That might be a really good starting point before you start forming conclusions about Bob Whitaker and the entire community simply because they see things differently from you.
And I absolutely respect your right to have your opinion, and you are welcome to post it here. But others are also welcome to theirs, and I kinda want to see you find the same respect for them you are asking for yourself.
How can such a thing ever be ensured? I don’t think it can. Way too much depends on the personal needs of the counselor/therapist rather than what they are trained to do.
I think it’s a scientific fallacy for them to suggest that success of “pharmacological treatment” with a particular drug equates to some “pathology” of a “disorder.” They made that assumption for “ADHD” (that insufficient dopamine was indicated because increasing dopamine “helped”) and this was found to be false. They assumed low serotonin caused depression based on response to SSRIS/trycyclics affecting serotonin. Recent publications have finally put this idea to bed. They assumed that psychosis is caused by TOO MUCH dopamine, because of the response to dopamine inhibitors. Again, they have been proven completely wrong on this. I’m sure the same would be true of OCD. It’s undoubtedly FAR more complex than such simplistic answers want us to believe.
You are preaching to the choir. I disagree with people who say “The system is broken.” No, the system is doing just what it’s supposed to do. It’s just not ACTUALLY supposed to do what we are told it’s supposed to do.
Why is it a criticism of “antipsychiatry?” Sounded like a fantastic critique of psychiatry itself! And I agree with you, which is why I argue that the only person qualified to tell if something “works” is the client comparing what they got to what they wanted to get out of the deal.
No one has to tell you if your shoes fit or if you liked the meal you were served.
The challenge comes when someone is walking behind you, undermining the incremental changes you have gotten implemented before. That’s what drove me out of the profession eventually. I realized there are some people whose idea of “positive change” was very different than mine, and in fact, MY ideas of “positive change” were threatening and destabilizing to their safe (if utterly ineffective) worldview. And a lot of those people seemed to be the ones running the show.
I agree if you’re going to do therapy, the client has to be the one to decide on what a “good outcome” looks like! No one else can do it but them and have them feel self-determined about their successes. “Therapy” or any other intervention done “for the client’s own good” is almost always the opposite of “therapeutic.”
The biggest problem with THAT idea is that at the beginning, many of the clients I had did not know what they thought a “good outcome” would be for them. The first part of my approach for such people is to help them get to the point where they could make a decision as to what they wanted their life to look like, or what they wanted to change about their lives. Sometimes that’s 90% of the problem – the client has had so many people telling them what to do, think, or feel that they have lost any sense of their own purpose and intentions in life. They do NOT need a therapist or psychiatrist or anyone else piling on more “shoulds” and “should nots” to their already burgeoning heap of them!
But of course, every client is different. Those who already know what they’re trying to achieve have been the easiest to work with, as a few questions helps them identify such barriers as they are encountering (or putting up themselves) and they’re off to the races! But such folks are rare in my experience.
I think it was Hemmingway who said of psychiatry, “The operation was a success, but we lost the patient.” And for every fatality, there are a hundred or a thousand more damaged in various ways that are often not even noticed. It is baffling to me that they continue to get away with it.
We know psychiatry is responsible for a lot of early deaths, none more tragic than Jay. What other specialty would be able to get away with having its treatment “successes” dying 20 years earlier than those who manage to avoid their “treatment?”
I do agree that social indicators are a legitimate way to measure success – is the person working or involved in activities of some sort, do they have any kind of social interactions, are they sleeping better, are they off of disability payments, are they exercising, etc. But even there, we can’t assume one set of outcomes for everyone. For some, disability is an unavoidable reality. For some, working in a capitalistic 9-5 job is not going to be realistic, regardless of “therapy.” So again, there does need to be some sense of what “success” looks like, but I think we agree it needs to be very much individualized to the person in question, even if some kind of generalized guidelines are agreed to. And it seems we both agree that “symptom reduction” is not a very useful “outcome measure!”
Lithium has the closest range between “therapeutic” dosage and toxic dosage of any drug in use today. My belief has always been that the basic action of Lithium is to poison you, JUST A LITTLE, but not too much. The long-term kidney damage alone belies their claim that lithium will do no harm at “therapeutic” levels.
The brain imaging stuff is almost all smoke and mirrors anyway. They find that on the AVERAGE, people who “have major depression” have lower activity in X area. They DON’T tell you that not all people labeled with “MDD” have lower activity in the area, some have HIGHER activity, some “normal” people have lower activity and are NOT depressed. So their findings are meaningless.
Add to that the fact that the brain is constantly changing and that PET scans and SPECT scans measure activity levels, and the whole thing really comes apart. I recall an experiment where they had people think about something sad that happened. Their brain scans changed. Then they had them think about something happy that happened. Their brain scans changed back. So thinking a THOUGHT changes your brain activity levels, and the whole idea that higher or lower activity in a certain area means something chemically or structurally wrong is completely debunked.
They still “treat” these “disorders” with drugs, so I’d say they DO consider them “diseases,” at least from the point of view of “disease as opportunity to make a profit.”
You are making generalizations about therapists. Some of them very much DO tell you what to do. There are also plenty of inadequately trained therapists out there, or therapists whose own issues make them dangerous no matter how much training you provide. Since there is no agree-upon means of helping clients in the first place, it’s pretty presumptuous to assume all have “adequate training” and know what they are doing. There are competent and incompetent people in every profession. Why would therapists be an exception?
The problem I’ve seen over the years is that reform efforts are only funded initially, but once the “testing” period is over, they are either discontinued or left to scrabble for grant money every year, because the system “can’t afford them.” The reason we “can’t afford” the reform efforts is because all the MONEY is going toward paying for overpaid psychiatrists and overpriced drugs for overhyped ‘conditions,’ and no one is willing to get their snoots out of the trough so the money can go to something workable.
I’d also submit that if they have the same “outcome measures,” whatever that means, then mindfulness is MUCH more “effective” because no one has to tolerate the potentially horrific and even dangerous “side effects” of the drug. Any non-drug alternative that is judges to have similar effects should be considered a HUGE improvement over any drug option for that reason, even within their own strained structure of “reasoning.”
I always say the “Mental health” system is not broken, it’s just doing what it’s intended to do, quite well, in fact. The biggest problem is that they pretend they’re doing something else having to do with “helping the mentally ill,” and people believe them.
I think authoritarianism is the real enemy, the belief that those higher in the hierarchy have the right to order about those below them at will. It can happen in communism, capitalism, or any other system of economic power distribution.
I have observed enormous, open and unapologetic abuse and discrimination against folks with “BPD” diagnoses. At this point, I consider the label nothing more than an insult.
The importance of self-determination in any kind of “therapeutic” intervention cannot be overstated. I can see how the “home version” might have some real advantages in that the variable of whether the therapist feels safe to talk to is removed, as are the therapist’s own emotional reactions which so often interfere with that sense of safety.
I’d be interested to know if there is any data on the experiences of people who did this in the office, particularly as to whether certain therapists worked or didn’t work for people.
But anything that gives people more ability to chart their own course seems very much worth exploring. Not to mention the price!
All true. The problem is, the psychiatric profession, far from fighting “stigma,” has demonstrably increased it, and the psych diagnoses are actually BUILT on pre-existing social stigma and discrimination. And when we start talking about PSYCHIATRISTS being somehow “stigmatized,” we’re really leaving the original meanings far behind!
Well, I don’t know if this is true for her, but I associate the term “stigma” with sleazy psychiatric propaganda efforts to make it OK for everyone to be on psych drugs. So I don’t like to use it, either. Maybe that’s her take on it, too. I think we should not say “stigma,” I think we should say “discrimination,” and NO, that does not apply to the poor psychiatrists! They are the “discriminators!”
True enough! And the punishment for not adhering to the status quo can be quite severe, too, so anyone better be prepared for a battle if they want to go that direction! And I think that’s the problem – many people in the system SEE what we’re seeing, but very very few have the courage to act on that knowledge.
Wow, that is a grim but very feasible explanation for how “personality disorders” came to be what they are. So people are not human normally, but those who INSIST on being human are therefore BAD!
The idea that “all behaviors are purposeful” has been central to all of my work as a counselor and/or social worker, but it seems an utterly foreign concept to those steeped in the DSM/psychiatric worldview. If all “mental illness” is a result of “brain dysfunction,” then NO behavior has any meaning or purpose at all. Could not be a more opposite approach to what I know to work!
I know I’m not Dr. Murphy, but I think you have put your finger on a most important issue: how CAN one measure success when the “diagnoses” themselves aren’t even based on any kind of objective test, let alone the outcomes! But insurance companies have become accustomed to accepting DSM “diagnoses” for purposes of reimbursement. In fact, that is what the DSM was invented for and the only actual legitimate use for the manual. It is psychiatry itself that has tried to parlay a very subjective billing document into some kind of pseudo-scientific diagnostic tool for “disorders” that can’t be objectively defined, let alone tested for.
What, indeed, is success in such a scenario? And who gets to decide?
They probably wouldn’t phrase it quite that way, but I have certainly known psychiatrists, mainstream and considered competent, who had exactly this attitude. They express seeing the mind as some sort of mechanical device, and that they are simply tinkering with the parts like a mechanic with a car, to get it “running smoothly.” There seems from some to be no recognition that there is a person in there taking in information and making decisions and having emotional reactions to what’s happening to them, including what the psychiatrists themselves are doing. They seem to view people as bodies, and to discount any sense of agency that an individual may have. It’s not hard for me to see them discussing whether or not treating the “patient” as a human being is a good idea.
David Healy is certainly one example of a person who lost prestige and position for questioning the status quo paradigm. He was denied a position he had already been hired for in Canada because of his views. I’m sure there are lots more. How tenure comes into play is something I don’t really know enough about to comment on.
OCD is a description of a way of behaving. No one has ever said that such behavior doesn’t exist, only that it is not a valid medical “diagnosis” of a “disease state” or “disorder,” as labeling a set of behavior “OCD” does nothing to identify either cause or appropriate “treatment,” as any good diagnosis must do, of course. You seem like a bright fellow and that difference should be VERY easy for a bright fellow like you to understand. And the idea that drugs can induce or exacerbate a particular kind of behavior should also not be surprising to anyone with the slightest education in the area. I’m sure you can think of some examples.
I get the distinct impression that you are not really interested in understanding the answers to your questions. It seems you are trying to provoke people or prove “us” or Whitaker wrong. Am I wrong?
You are missing nothing. There is no objective means to assess “success” in any “mental health treatment” modality. This is why psychiatry/psychology are not actually scientific endeavors. There is no way to even select out a legitimate group for experimentation, let alone obtain an objective measure of pathology or success, for ANY DSM “diagnosis.” Perhaps it’s the last point you are missing after all!
Those are all assumptions on your part, which could be true or not be true. It does reflect where folks choose to spend their time, but I have no idea why someone chooses not to respond to comments. I am sure there are lots of reasons, and for some, your assumptions are probably true. But I’m not really in a position to know that. That’s my take on it, anyway.
And now the drug companies can create Tardive Dyskinesia and then sell you a “treatment” for it! TD was a big secret no one talked about, until they were able to make money off of it, now it’s on national TV!
Replying as me, this time: I don’t think we know whether or not she’s read the comments. I hope she has and that it informs her further work. I am glad she is challenging some of the psychiatric shibboleths with her work, but I also hear a someone apologetic tone in her critique, which I find inappropriate when critiquing those with great power vis a vis their “patients.” The fact that her colleagues are even having a discussion as to whether or not “patients” ought to be treated as human beings suggests that there is a lot worse going on here than a few people being misguided or not quite understanding the experience of their “patient” cohort. It seems there is a built-in dehumanization process going on which can’t be explained by individuals being “misguided” nor altered by a bit of “sensitivity training.” This is ingrained, systematic behavior that is encouraged and enforced by those in charge of the system, and needs to be recognized as being intentional and enforced, such that any (such as her) who challenge the dominant narrative will be punished. Given her own experiences and sensitivities, I’m betting the author will gradually come to that conclusion (as I did), but in the meanwhile, I see no reason not to point out this inconsistency, as long as we do it as respectfully as we can. I value her work and have hope for her in the future, but I do see a need for a more blunt assessment as to why her colleagues are not receptive to her observations.
I agree completely. Except that I also believe oncologists and other doctors of actual medical conditions damage their patients’ care by treating them as objects rather than people. It is well established that assertive, empowered patients actually live longer and have fewer ongoing issues than those who simply passively accept whatever “care” is doled out for them. So even oncologists ought to be engaging with their patients as human beings, for their own health and the success of their interventions.
If PHYSICAL health outcomes are significantly affected, how much MORE would mental/emotional outcomes be impacted by how the “patient” is treated? This is one more reason why the idea of providing “medical treatment” to those with mental/emotional/spiritual issues is so destructive – the transfer of the “patient as object” attitude so common (yet still ineffective) in medical care is transferred to an area where it does a tremendous amount of damage, being essentially the exact OPPOSITE of what is required for actual improvements in “mental health,” though that term itself reinforces the idea of illness that is not appropriate to the situation 99% of the time. It boggles the mind that anyone who actually has the vaguest comprehension of what people are suffering from and what they need would have to have a discussion, let alone an argument, about whether treating their patients “like a human being” was a good idea!!!!
It is bizarre that the world of physical healthcare is making more effort to alter this attitude while our “mental health professionals” seem to be arguing to continue it!
Many authors don’t read the comments, or choose not to engage in the commenting community. It can take more than a bit of courage to dip into the comments section! And it is by no means a requirement that authors respond to comments, and can’t be assumed to mean anything other than that they choose not to engage.
It is just an unsupportable claim, the sort the industry makes all the time. There are plenty of people who have no history of “bipolar” diagnosis who get manic on ADs, and it’s even worse for SSRIs or SNRIs. Aside from which, there is no way to actually determine if someone does or doesn’t “have” “bipolar disorder.” So they can (and often do) claim after the fact that the REASON the person became manic on their drugs is because they WERE ‘bipolar’ but didn’t know it. I recall specifically the rhetoric that “the drugs uncovered a latent underlying ‘bipolar disorder!'”
The fact is, these drugs can make ANYONE act in a manic manner, it’s simply an adverse effect, and no one has EVER drawn a connection between such a reaction and “bipolar disorder,” except anecdotally and after the fact. In other words, it’s bullshit!
Why would you think “this comment won’t survive long?” You haven’t violated any of the posting guidelines, have you? We don’t moderate for content here. You can say whatever you want, as long as you are civil and respectful about it. I hope the continuing presence of your comment makes this very clear.
We eventually had to invent an alternative school that was child centered. Our youngest went through this school from K-12 and was very successful in college and is now a very powerful, intelligent, and capable adult, despite his “ADHD” tendencies that might well have gotten him “diagnosed” if we weren’t well enough educated to avoid it. The school didn’t last long after we left, but a lot of kids did have a different kind of school experience, one where the kids actually had RECOURSE if they were being abused or mistreated by the adults or other kids. It was a beautiful thing while it lasted, but eventually it knuckled under to the forces of “human nature.”
It occurs to me that posters in the MIA community are ALSO a group, and I have unintentionally allowed slanderous generalizations about that group, as Nijinsky so powerfully reminds me. In the future, any comments about the MIA community of commenters will be moderated as generalizations about a group based on their membership in the group.
Nijinsky is also correct that any allegation of an inappropriate comment should be specific, and actually needs to be referred to me as moderator, rather than to the community as a whole. In an effort to be fair, I have allowed violations of the Guidelines, and will be correcting that mistake in the future.
Any criticisms need to be of specific ideas, not of the MIA community as a whole. It is acceptable to critique MIA as an organization, but not groups of individuals who contribute to it, especially in such a generalized manner.
Thanks to Nijinsky for reminding me of this requirement.
I thought about this very point last night. The Posting Guidelines forbid attacking a person or making attacking generalizations about a group. But there is nothing saying we can’t attack IDEAS. Perhaps some folks find that confusing. You are all welcome to visit and share your ideas, but your ideas are going to be vulnerable to attack and may need to be defended with logic and data. There is nothing mean about letting someone know you disagree with them, especially if you provide legitimate data, either research data or personal experiences or both. It’s part of the price of coming here. If a person wants to challenge the ideas of others, they should expect that they may be challenged in the same manner. That’s how this community works.
Have you ever read John Taylor Gatto? He was an award-winning elementary school teacher who wrote “The Seven Lesson Schoolroom.” He gets down to the actual meta-lessons that lie behind all of the supposed educational activities, and breaks them down into specific “lessons,” including “Never trust your own observations” and “Always ask permission from the authorities.” It is quite on the point of what you’re talking about. And sadly, though individual teachers challenge this thinking “under the table,” I would posit that it is essentially impossible NOT to reinforce these “lessons” when you participate in the system. I was a teacher for three years, and approached it with a growth and reform concept, and found it quite impossible to make more than a tiny scratch on the bigger system. It is a very unhealthy place!
I am TOTALLY down with rejecting capitalism AND psychiatry! I just don’t yet know what the better plan is. I think we’ll have to invent it as we go along.
I accused you of nothing. I simply disclosed my intentions. It appeared to me that you came her with a pre-existing viewpoint and have “attacked” others who don’t agree with you in exactly the way you are claiming others are “attacking” you. I consider it valid for people to express an opinion and to have an intention, and it is not an “attack” to me if someone expresses an opinion I don’t automatically agree with. Of course, you don’t need to justify being here. But in my experience, if one wants to actually relate to people, rather than merely irritating them, it might work better to spend more time listening and less time telling others what you think of their ideas. But of course, that’s just my viewpoint. If you want to disagree with people, you’re going to get a lot of arguments, that’s just how people are. If that’s how you want to conduct yourself, you have every right to do so. But you don’t have a right to have everyone respond supportively, especially when you don’t show them the same courtesy, IMHO. I prefer to have honest but civil exchanges of viewpoints, with each side presenting the evidence to support their views. It doesn’t have to be viewed as a “win/lose” “right/wrong” kind of thing. Maybe people just have different experiences and are sharing them with each other? Maybe no one means to “attack” you at all, but just want you to understand what has happened to them without you judging them for sharing it? Maybe you can share YOUR experience and let others know how you came to the beliefs you have? And they can do the same, and each of you will be a bit wiser for understanding the universe isn’t always the way we ourselves experience it?
If you are feeling abused by a specific post, please inform the moderator by emailing me or hitting the “report” button. It is unfair to community members to make blanket assertions that you are being “discounted, insulted or abused” without citing specific instances, not in the comments, but to the moderator to be handled, edited or removed. Everyone is welcome to their own viewpoint, and passionate disagreements to occur and are welcome, but only as long as they remain civil, which means no personal attacks and no generalizations about groups of people based on their belonging to a particular group.
Please contact me at my email address if you need further clarification. Respectful disagreement is not the same as insults or abuse, and I am here to make sure that we allow the former but not the latter.
“Rethinking” does not mean what you said here at all. It means having an open mind. I personally would appreciate you not intentionally interpreting what is going on here. If you want others to welcome your viewpoint, you need to allow that others’ viewpoints might also have validity. Otherwise you are asking of others something you are not willing to grant.
POSTING AS MODERATOR: Brenda, I want to clarify that EVERY viewpoint is welcome here, and we NEVER moderate anything based on the content. Clearly, anyone claiming that the medical model is “correct” is going to have to deal with a range of varying opinions, some expressed with more passion than others. But that is hardly different than what you have offered above. So everyone is always welcome to offer differing points of view, but everyone else is also entitled to respond with theirs, and there is no rule against disagreeing or challenging folks to come up with data to support their viewpoints. As long as those disagreeing with you are civil in their replies, they have the same rights as you do to express whatever opinions or viewpoints they have.
I’m afraid there is no science behind the medical model, either. Not one of the DSM “diagnoses” has a legitimate, objective way to differentiate it from a “normal” person, let alone differentiate those WITHIN the “diagnosed” group on the basis of what is CAUSING the problems.
The DSM itself says this: “In DSM, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” It also says that, “There is also no assumption that all individuals described as having the same. mental disorder are alike in all important ways.”
What do these two admissions mean? First, they are saying that they can’t tell which category a person fits into, they could fit into more than one category, and there is also no way to tell with any certainty if a person even has a disorder or not.
Second, and perhaps more important, the second comment says that even if two people fit the same diagnosis, center of the target, same symptoms etc., it doesn’t mean they necessarily have anything of significance in common with each other.
So in other words, any person “diagnosed” with a “mental disorder” is so diagnosed subjectively, with vague and undefinable boundaries deciding whether they do or don’t “fit the criteria.” AND any person diagnosed with a particular “disorder” may have nothing in common with another person having the same “disorder” diagnosed, meaning the “diagnosis” doesn’t even tell you what kind of “treatment” they would need.
Of course, everyone ignores this and pretends we somehow “know” that all “mental disorders” are caused by “biochemical/neurobiological” problems with the brain. Does that sound scientific to you?
It seemed to me you were selecting your examples with a bias toward making your point, and by selecting and mentioning them, you seem to be suggesting they are more valid. I showed that by creating a similar list of psychiatric disaster stories from people just as famous. Why did you select those and not others? Your comments also seem to imply that having a “diagnosis” means needing “treatment” and that the “treatment” in question will generally work. Have you take the time to read Whitaker’s book yet? Have you taken the time to read some of the comments and articles from survivors of the psych system? Try reading the recent podcast regarding a psychologist studying what happens to people who are exposed to “involuntary treatment.” Her commentary on her OWN forced “treatment” as a teen and a young adult is CHILLING. I only wish it surprised me.
I’m trying to get you to open your mind here. If you want validation that “treatment works,” there are plenty of places you can go. I assume you came here to look at things more broadly. There are very FEW sites where survivors can share their stories of what DOESN’T work about the system without being attacked or censored. This is such a place.
The “Reply” button sometimes disappears when you get too many comments in the same thread. You just go back to the last one that has a “reply” button and it will appear at the bottom of the comments currently approved.
So what? Who says he’d have been better off seeing the psychiatrist? Marilyn Monroe, Del Shannon, Stevie Nicks, Jordan Peterson, and Ernest Hemmingway, among others, certainly were not.
And Edison was a classic “ADHD” kid who was kicked out of school and his mom told he was “incorrigible.” Mom knew better and educated him at home and he became one of our greatest inventors and marketers of new ideas. Would he have been better off being “diagnosed” and “treated” in his youth?
Depression exists. People get depressed. Nothing new. Drugs can be used to alter people’s emotional reality. Also nothing new. Giving drugs to people without having a clue what is wrong with them and hoping that some of the spaghetti sticks to the wall when tossed is hardly an impressive medical approach. Proving that people have issues doesn’t prove they are medical problems, and CERTAINLY doesn’t prove that drugs are the answer.
Actually, long-term studies on antidepressants, stimulants, and antipsychotics have shown that NONE of these drugs improve long-term outcomes on the average, and that’s from studies mostly TRYING to prove they work. Read Whitaker’s work and see what you think afterwards.
You are operating at a level of privilege that allows you to ignore the fact that others don’t always “have a choice” like you do. “I don’t have to allow myself to be oppressed” sounds very New Age, but being born black or female or poor or in a third-world nation where multinational companies extract all of our resources and pay people pennies a day to work and there are no other employment options available is not a choice for those people. I’m guessing you’re privileged enough to insist on the ultimate privilege, the privilege of pretending you don’t have privilege and that others are suffering simply because they are too lazy to “insist” on becoming “unoppressed.” I hope you are able to open your mind and realize how incredibly FORTUNATE you are to be able to believe you “don’t have to allow yourself to be oppressed.” A lot of the world doesn’t have that option.
Here’s a hint: there are cultures where “postpartum depression” essentially does not occur. These cultures are characterized by providing instant and ongoing support to new mothers, surrounding them with folks to cook, clean, sew, heat the home, etc. so the mother has only to care for the child. In our “enlightened” culture, we give moms next to zero support and six weeks of “parental leave,” often unpaid, and threaten the mother and family with poverty if she decides not to come back to “work” soon enough.
I wonder why we have more “postpartum depression?” Must be genetic…
I do have a lot of respect for Marx. But I also think there are lessons to be learned from the Russian experiment and other efforts at collective living and governing. Clearly, something went awry between the Proletarian Revolution and the melting away of the ruling class. What happened? Why? Was it inevitable? What can be learned from the collective farming efforts? What is worth keeping and what part of it was problematic?
I think it’s fair to say that communism AS PRACTICED in the USSR and in China most definitely devolved into something pretty oppressive, which was what the joke was really about. And sure, you can say “That’s not really communism,” but you know what I’m talking about.
The Israeli kibbutz might have come the best to emulating what Marx had in mind. What worked about that? What did not? How did they come to be slowly undermined? How can that be altered?
Communism has yet to prove itself functional in the real world. Doesn’t mean it won’t. Capitalism has certainly proven to have some very serious adverse effects on a worldwide basis. I find these effects horrifying. I’d love to find a viable solution. Just not committed to the idea that Marx has the solution. We should keep working on it!
A shame that “stigma” kept him from getting the help he needed! Oh, wait! He DID get the highest quality psychiatric care available. And killed himself a few weeks later. Now THAT’S a psychiatric treatment success story!
The DSM III was specifically and intentionally designed to make psychiatry seem more “scientific” and claims of “biological causation” were intended to do the same. Its own creators admit this.
“While the successive framers of the DSM have attempted to base it on scientific evidence, political and economic factors have also shaped the conceptualization of mental illness. These economic and institutional forces have reinforced the DSM’s use of a medical model in understanding psychopathology. Though the scientific evidence for a medical model is mixed and evidence for other types of conceptualizations have been given less attention, the medical model provides for reliable diagnoses that allot diverse benefits to treatment providers and researchers, as well as to the pharmaceutical and healthcare industries.”
“During our interview, Spitzer mentioned openly, almost proudly, that one of the reasons he pushed for adoption of the term “disorder” for conditions such as anxiety was that it eliminated psychotherapy and psychoanalysis as treatment options. He added that opponents of the change could have mounted a legitimate defense if they’d spotted a key discrepancy with the ICD system, where the term “anxiety neurosis” was still included, in ways that made the DSM change look arbitrary and loaded. And he openly acknowledged that the addition of new conditions to the DSM was in part “a function of ‘Do you have a treatment’? If you have a treatment, you’re more interested in getting the category in” (qtd. in Shyness 75). Such pressure from drug-makers and their academic sponsors highlights a cart-before-the-horse dynamic often borne out by the DSM-III papers, as in the above linking of Panic Disorder to Upjohn Pharmaceuticals.”
It was about competition for market share with various therapists/counselors/support groups, and psychiatry could only claim primacy if they promoted the one product they could offer that others could not, which was drug prescriptions. So they designed the DSM to be “atheoretical” (meaning none of the “diagnoses” were concerned with WHY that person acted/felt/thought that way) and left the “theory” to be filled in by those applying the “diagnoses.” This left the door wide open for unscientific claims that because drugs affected people’s moods and behavior, these “disorders” must be caused by brain abnormalities, even though the DSM specifically avoided saying any such thing (knowing there was and continues to be scant scientific evidence to even suggest such a thing might be true). It worked a treat, especially with the massive marketing assistance they received from the drug companies, who could see a bonanza coming their way. What is better than a chronic condition which has no identifiable cause but which can be “treated” with drugs for the rest of a person’s life?
So it doesn’t have to be a “conspiracy,” merely a capitalistic coming together of financial and guild interests, which neatly dovetailed with a society who was anxious for an “explanation” for the vast emotional distress that citizens of more industrialized countries seemed to be experiencing, without having to question the basic assumptions of such a society’s status quo.
The DSM was not and will never be a scientific document. It was at first a list of billing codes, but Spitzer and the DSM-III committee turned it into a political document that intentionally redefined “mental illness” as a medical problem treatable by doctors and drugs. That decision was made intentionally and had nothing to do with the eventual well being of the clients. It had to do with psychiatry’s bid for domination over the less expensive and frankly more effective (though the bar is VERY low) therapeutic approaches that were threatening to take away their client base.
Ah, rehab centers are for drug and alcohol use, I believe.
I see your Dwayne Johnson, and I raise you Ernest Hemmingway, Marilyn Monroe, Stevie Nix, Jordan Peterson, Robin Williams, Michael Jackson. I could go on. All of the above were massively failed by psychiatry and report being damaged by their “help”. Some even died. Hemmingway’s famous line, “The operation was a success, but we lost the patient!” was in reference to receiving electroshock therapy. He committed suicide.
There are lots of people (including me) who have struggled with difficult emotional experiences, including feeling suicidal. That doesn’t mean the system will be of help to them. Perhaps it’s time to stop writing and start reading some of the many testimonials available here. Admittedly, it’s a skewed sample, but to claim that psychiatry is “there to help” seems a bit of a stretch, especially after reading the recent article referring to a study of psychiatric inpatient “treatment!”
Try to open your mind to others’ experiences. This website exists for a very good reason, and it’s not to make people like you feel uncomfortable. There are a lot of stories out there that you may not want to hear, but perhaps you NEED to hear them anyway.
You could also look at the illegal drug industry and say exactly the same thing. But we at MIA decide medical efficacy by science, not popularity. And BTW, there are PLENTY of “customers” of these drugs who are not voluntary in the least degree.
I think we can look at the amazing success of these companies, including their ability again and again to absorb multi-million dollar lawsuits, as a sign that marketing far outreaches science in terms of selling products.
My humor reflects the reality that people in any political/economic system will to a significant extent be tempted toward greed and the desire for personal power. This is what has happened throughout human history, and I’m not holding my breath for it to change anytime soon. I think Marx’s analysis of capitalism was absolutely brilliant, genius, unparalleled in any other writings before or since. I am not sure his solution is workable based on the fundamentals of human nature. And to date, history has proven my observations to be accurate.
You’re welcome to disagree with me, of course, but the real point of my comment is that psychiatry doesn’t really care who is in control, they simply want power. Or to put it another way, the problem isn’t which form of government or economic system we endorse, the problem is that we allow the exploitation of other human beings.
It is hard to see how you would twist that bit of humor into accusing me of suggesting that capitalism is the pinnacle of human achievement. The joke says that the essence of capitalism is that “man exploits man.” Do you see that as some sort of recommendation of capitalism as a superior form of economic system? That’s a pretty bizarre spin to put on a joke that clearly indicates both Capitalism and Communism (as practiced in the real world so far) to be flawed in their exploitation of human beings for power and profit. Perhaps it’s time to reconsider your political analysis of my joke. Or maybe simply file it away as a momentary attempt at humor in a very grim world.
Your psychiatrist is simply telling you what they believe. I know of no data suggesting that “untreated” anxiety is any worse than “treated” anxiety, and the same for every other “mental health condition” in the DSM.
As to whether or not it’s worth it for the “benefits,” that’s something each individual has to decide. My personal view, though, is that the less drugs I take, the better. ALL of them have adverse effects, and the list for antidepressants is quite long. Read up on the issue and see what you think. And remember, recovery rates were MUCH higher before antidepressants existed, and there are LOTS of other things you can do instead that DON’T have these bad effects on your body!
You are so right, there is no prevailing “scientific” paradigm! The current paradigm is the farthest thing from scientific, it is arbitrary, rigid, dishonest, and authoritarian, and denies any real science that speaks against it. It has much more in common with a religious practice than science. Maybe we should call it the “current propagandistic dogma?”
You are right, it is essential to find solidarity with people with similar realities! But that is VERY different than someone else deciding FOR you what group you belong with on some arbitrary criteria, and particularly telling us what we have to DO about our supposed “condition!” We should be the ones deciding for ourselves what group we belong to and who are our “people” and what it means to be part of that community!
I’m sure I’m preaching to the choir, but I just wanted to emphasize that point!
Not at all. Drugs work for all sorts of reasons. All it means is that that particular 15% responds positively to antidepressants. There is no other conclusion that can be drawn.
With all due respect, many businesses profited mightily from the Third Reich, and Hitler’s rise to power would never have happened without the huge support of capitalists in Germany and around the world:
So the evidence is not that Capitalism saved us from the Nazis. Rather, the Nazis and Capitalism were rather friendly. It was the courageous nations whose people sacrificed by going to battle on the air, sea, and ground and were willing to sacrifice their lives who ended Hitler’s power. And let’s not forget that this effort would never have succeeded without the enormous Russian army, from a Communist country at the time.
Hitler’s demise occurred because a number of countries agreed that they needed to stop him. Regular citizens of both Democratic and Communist countries battled Hitler while most of the Capitalists sat back and sold goods to one side or the other or both.
As to rebuilding Europe, perhaps you are forgetting the Marshall Plan, one of the most “socialistic” efforts ever put out by the USA, not to mention the GI Bill, where formerly poor kids were given college educations and cheap housing loans and started the biggest expansion in the middle class in the history of the world? Hardly the work of capitalism! More the result of smart investment of tax dollars leading to great results.
So very true! A lack of philosophical clarity about meanings and values and intent and language dooms any “scientific” effort to failure. In this case, the most basic tenets of science are violated from day one: You can’t do a scientific experiment by assuming a heterogeneous group has something in common with each other. Lacking a clear distinction of an “in” and an “out” classification, no further experiment can be done. Of course, there are tons of other problems with psychiatry, such as whom is it intended to serve, what the purpose of the enterprise is, who gets to decide what “works” means, and on and on. It astounds me that any thinking person can take psychiatry’s pretense seriously!
But the real problem is not having an objective way to “diagnose.” It is human nature to allow “drift” in any non-objective line that is drawn, and that drift will always tend toward what makes the powerful more comfortable and the less powerful even less powerful than before. When it was first proposed, “ADHD” (or MBD as it was called at the time) was supposed to affect a tiny proportion of the population, kids who’d had some kind of trauma or disease that made them unusual. By 1980, suddenly 3-5 % of the population “had it,” and they were 90% boys. Not long after, it was “discovered” that girls got it, too, and that kids don’t grow out of it, and that adults also had “ADHD.” The requirement that the child showed signs of “it” before 6 was removed, and now we’re seeing rates of 10-15%, and some places 20% of boys in a particular school or area are “diagnosed” with this “disorder.”
I don’t see any way to stop this slide without hammering away at the utter spuriousness and subjectivity of these “diagnostic criteria.” I really don’t see “better diagnosis” as a way out of the mess. You can set up the best “standard diagnostic interview” in the world, but people will use it in ways that fit their worldview, and the industry will continue to chip away at these soft boundaries until more and more and more of the population will be seen as “mentally ill.” Because that is the INTENT of the system. At best, a standard interview format can slow the drift, but it will not stop it, because the force is pushing in that direction, and there is no objective standard one can point to and say, “No, you’ve really gone too far on this one.” The “diagnosis” is, in the end, a matter of opinion, and that opinion quickly deteriorates into “whatever the clinician wants to see.” That’s the problem I see as unsolved by the diagnostic interview. Not that I want to minimize the thought and good work that’s gone into this for you. I’m sure if we had honest clinicians and an industry truly focused on helping people, such an interview could be conducted in the knowledge that these “diagnoses” are indeed only ways of describing situations and don’t actually tell us what (if anything) is wrong or how to “treat” the patient. Of course, that begs the question, what use is a diagnosis that doesn’t tell you what is wrong or how you should treat the patient? But that’s for another post.
Well, that’s not a bad standard if you want to set one. I get that you’re using this to battle the status quo. I’m just saying that the fundamental of the status quo that needs to be changed is not going to change by better outcome measures. I do care about the people who have to put up with the system as it is, and I used to be the clinician “behind the lines” and feel like I made a huge difference for some folks I encountered. But I got worn down by the general acceptance of the DSM diagnoses and the abusive treatment of clients that resulted. It’s hard to see what can really alter the deep issues with the current disingenuous “philosophy” of the system.
Of course not. But most people haven’t the first beginnings of a clue about what happens in the “mental health” system. Most still believe in the TV “psychiatrists” who are wise and compassionate and good listeners who do therapy. They see the MH system as protecting them from dangerous “schizophrenics” and dispensing magical pills, and the only reason a “mentally ill” person is suffering is because “they’re off their meds.” I’d love to see psychiatrists held accountable to some sort of client-based outcome measure, but they’ll fight anything sane and if it did happen, they’ll find a way to doctor the results (sorry for the pun!)
Sorry for being so cynical, but it seems we have an entire profession run on false assumptions and secret ill intent, and it’s hard to see any measures to create honest accountability being successful even if such a measure could be found and validated.
The fundamental error of the whole “DSM” model is the assumption that you can group people together based on how they feel, think or behave and that somehow all those people not only have something “wrong” with them but that they all have the SAME THING “wrong” with them. It is an absurd proposition, but I don’t think it’s by chance that they came up with it. It’s a great strategy for selling drugs!
You mean some kind of quasi-objective outcome measure.
I do agree that the status quo is able to CONTINUE because there is no “yardstick” of success that psychiatry has to adhere to. My problem is that any such yardstick is ultimately not really objective, largely for the reasons you enumerated earlier. Cancer can be tested for reduction in tumor size or in certain chemicals present in the bloodstream. Heart disease can show better outcomes through increased QT intervals or other such electrical measurements, as well as blood flow measurements. If a drug REDUCED blood flow through the coronary arteries, no amount of flim-flam could be used to say that this led to “improved outcomes.”
But there literally is no such measurement possible for matters of the mind/spirit. It is only when such testing and measurement fails that we should even be considering something a “mental health” problem. It’s not a body thing, and trying to pretend it is is just misleading. The real truth is, “mental health” intervention should not be considered part of the medical system, and demanding “outcome measures” is simply allowing the ruse to continue that any such objective measure is even possible. So I have a problem with the idea of “outcome measures” in the sense of “treating” some kind of physiological illness. Hell, they can’t even define WHAT they are “treating,” let alone what a good outcome would be! And of course, they always fall back on “symptom reduction” as their “outcome measure,” even when that may have nothing to do with the goals and purposes of the client. And “symptom reduction” is, of course, the area where the drugs are most likely to look “successful,” and I don’t think the choice of these “measures” is in any way disconnected from that fact.
Bottom line, the whole idea of “treating” “mental illness” as a disease state is wrongheaded and destructive. I can’t see any way to get around that, and I think we’ll be a lot better off simply stating that fact than trying to come up with quasi-objective measurements to keep the insurance industry happy. Impractical, yes, but at some point, I think we have to stop pretending!
I’m really talking about simply asking the person to tell you what did and did not work about their experience. Clearly, a third party not associated with the therapist or his/her agency would be ideal. But I’m not advocating for any kind of “outcome measures.” We don’t have a homogeneous group of people to apply this concept to anyway. We just have to give a shit enough to listen to the client, whatever s/he said. I do think that a person who REALLY cares and wants to know will be honest in their response, but there’s no guarantee. It’s more of an integrity thing to me. There is no mathematical way to evaluate the success of any “mental health” intervention.
Your explanation makes sense, and I’m glad we agree that the client is the only viable source of this information. It’s apparent you’ve studied this question much more in depth than I have!
I have always thought that the only one in any position to evaluate our “outcomes” is the person receiving the “help.” No “independent assessor” will be in a position to truly judge what is helpful, unless they are looking at therapy as a way to improve the behavior of the client for the benefit of society at large. Which is a VERY slippery slope!
The client is the one who knows IF something is wrong, WHAT exactly is wrong, and what an improvement would look like. The therapist’s job, in my view, is to help the client come to understand their OWN view of what they want and what the barriers are to accomplishing it, and to help them circumvent or remove such barriers so they can succeed. It is not the therapist’s job to tell the client what is wrong or what they “should” do or not do. Most people are messed up specifically BECAUSE other people told them what was wrong with them and/or what they “should” do or not do. As such, the therapist is not in a position to decide for the client if therapy “worked” for them. If I think therapy was great and the client said it was worthless, it was worthless. All the more so with drug interventions. There is a balance between “reduced symptoms” and reduced quality of life that only the client can assess.
So skip the outside assessor. Ask the client. They are the only ones who can define ‘success!’
Ways to help people get a grip on their own moments of “irrationality” and the reasons behind them, to manage to set boundaries on those who would harm us regardless of how they try to resist, as well as means to address ACTUAL health problems that are observable and can be addressed by physiological means, are all very welcome and needed. I do think it naïve to imagine that the death of psychiatry would lead to a sudden move to sanity and peace and good communication and respect in the world. But it sure would help NOT to have them around trying to make it worse by creating pretend “solutions” based on a complete misunderstanding (often an intentional one) of what a human being and a mind actually might be. We most definitely need to be working on real ways for people to learn to respect each other, to not react out of fear and hatred, to detect and avoid people who are dangerous to them, etc. But I don’t see physiological interventions being more than a tiny part of that approach. I don’t think we disagree on that point.
I always loved that one. It’s NOT that we failed the client, their DEPRESSION resisted us! It’s not our fault, not even the CLIENT’S fault, it’s DEPRESSION’S fault! As if it is a separate entity with an ability to resist despite everyone’s best efforts. Why not just say, “We haven’t been able to find a way to help her so far.” But that would mean admitting that their wonderful “treatments” may not be quite so wonderful! We can’t have THAT, so let’s “blame the disorder!” It’s a win-win! Oh, except for the client, who remains depressed and looses all hope, but hey, it’s not OUR fault that Depression is so mean to her!
“The Stepford Wives” or “Invasion of the Body Snatchers” seem to be the ideal from a psychiatric point of view. Mildly positive attitude toward everything, no matter how bad, never very excited or upset or afraid or hostile, just dull, socially accepted blather. Anything else is a “disorder.”
If we’re going to talk spiritual, I’d consider the mind to be more of a relationship or interface between body and spirit. I would still maintain “Mind” is not something that has a location in space or in the brain as psychiatry and related disciplines assume. What’s going on at a micro-microscopic level (electrons and fields and so forth) is beyond my current understanding, but it’s absolutely certain that “treating” the body per se is not going to be effective at this level.
It is silly, of course, to pretend that people don’t feel depressed or anxious, or behave in irrational ways that are not productive based on past experiences. I just don’t consider such things to be “illness” in the sense that a specific and measurable part of the BODY is somehow out of whack! The definition of “illness” is very problematic if we’re talking about disturbances in an electrical field around the body, let alone the damage to the “spirit” (whatever one considers that to be), which to me seems to be the main reason for the kinds of emotions and behavior that are currently identified as “mental illness” by the crackpots who created the DSM. I seriously think we need to get far away from that term, as it’s been claimed completely by the DSM propagandists, and doesn’t really describe the situation in terms that the average person can wrap their heads around.
In this case, I’m using the term “improvement” exactly as those claiming the “benefits” of psych interventions are using it. By their very own measurements, they are incapable of “improving” any situation, and their approach is about as “effective” as going to the bar after work to get a buzz on. They can’t even “succeed” in their own paradigm, let alone address the fact that the entire paradigm is based on a fantasy “model” with no connection to physical reality.
I think we’re talking about semantics here. Obviously, mental DISTRESS exists, difficult EMOTIONS exist, dysfunctional BEHAVIOR exists. But to call a mind “ill” in the same sense as a body is “ill” is a logical fallacy, which is what Szaz was talking about. If there are ways of helping with mental/emotional distress that folks are aware of, we absolutely need to engage with these approaches. But it’s not a MEDICAL problem. The mind can’t be “ill,” as it is not a thing of the physical universe. The term “illness” is an analogy or metaphor that can’t literally be true.
It’s only a “paradox” if one insists that “treatment” MUST a priori be effective. If one instead simply asks the question, “Does ‘treatment’ improve the ‘symptoms’ of ‘major depressive disorder’ over time?” there is no paradox. The answer is quite simply, “NO!”
It is fascinating how psychiatric apologists are allowed to distract from the topic with irrelevant associations of religion or politics. Science is science, and when there is no science behind your position, it doesn’t matter the political or religious affiliations of the person pointing that out, any more than the race or sex or country of origin has anything to do with it.
Lots and lots of people have questioned it, but they are shot down by the orthodoxy and massive “group agreement.” It eventually became so bad for me that I realized I could not ethically continue in the “mental health” field, as the purpose had shifted away from trying to find ways for people to live better to trying to find ways for people to “stop feeling bad,” and that drugs had taken the center stage despite all the very rational arguments against them. It became clear, I suppose, that rational arguments would never win the day, because the field had become predominantly irrational, and rational critiques led to shame, punishment, and shunning.
“Diagnostic Drift” refers to when a soft line is drawn with no objective determination of who “has” or “doesn’t have” a particular condition, the line tends to move to include more and more people over time. This has been proven over and over again, particularly when there are incentives in place to “diagnose.” For “ADHD”, the incentives include explaining failure to be able to teach children or manage a classroom, justification for failing to learn sufficient parenting procedures, finding an “identified problem child” to maintain a dysfunctional family unit, creating a cadre of “specialist” who can make money off of making these “challenging diagnoses,” writing books and giving lectures, and of course, the financial remuneration for psychiatrists, doctors, and pharmaceutical companies.
And of course, you are correct, when “treating” something that hasn’t been actually established as a bona fide physiological problem and includes an incredibly heterogeneous group of “diagnosees,” one will certainly see “treatment failures” over and over again. And the soft “diagnostic criteria” of course make it easier to put the blame for any failures on the client instead of the person administering “treatment.” Instead of saying, “My treatment failed,” you can say “X is ‘treatment resistant,'” or “It’s really Bipolar Disorder” and off you go down another “treatment” path. I suppose that’s “reification” in action. We’re “treating” a metaphorical concept that is indistinguishable from “normalcy,” so the entire “treatment” process is by definition fantastical, having no concrete connection to reality. Except the damage done to the victims, oops, I mean “patients”, of course. That is very real and concrete, unfortunately.
I would say that there was plenty of “depression” but it was transitory, and understood to be in most cases a normal reaction to adverse circumstances. It seems clear that “antidepressants” are quite capable of taking temporary “depression” and making it permanent. Another psychiatric success story!
Well, they will never be able to help the 1% until they start admitting that the 20% that are diagnosed are 19% having a hard time with a traumatic existence. And I agree, the severity is not related to whether or not it’s a “biochemical depression,” if such a thing is proven to exist. Many, many cases of experiential depression are incredibly severe! And as you say, there are some people who have depressive tendencies that are mild but chronic who may very well fit into the same category with someone who is genuinely “seriously depressed for no reason.” Until there is some effort to actually make this distinction, any case of ACTUAL biological depression will be totally submerged in the flood of experiential depression cases and will never be identified or detected as a valid group for study. And I don’t see psychiatry being willing to go there any time soon. There is WAAAY too much money being made under the current model, even when they themselves know it’s not a valid model at all.
But they have not yet realized what you said, that “depression” is not a “homogeneous disorder.” They continue to comment on and “diagnose” “major depression” based on subjective criteria, and studies are done over and over on groups of people “diagnosed with major depressive disorder.” The only way anyone will make ANY kind of progress on if there is a subgroup who actually DO have something physiologically wrong with them is to STOP grouping heterogeneous people together as if they all had one “disorder,” and instead start breaking down the subgroups and try to find some who actually DO have something in common with each other.
And I have no faith that brain scans are the way to do this. But even the link you mention still talks about “different types of depression” rather than “some depressive symptoms may have a biological cause.” They are still running on the assumption that ALL cases of depression are “medical,” that ALL of them are caused in some way by biological anomalies, and that sorting these “depressed people” into categories will solve the problem. Until and unless they begin to recognize that MOST cases of “depression” are NOT caused by biological problems, but by a wide variety of social, interpersonal, and individual psychological needs, and that even those cases which DO have biological causes need to be checked for things like sleep deprivation, nutritional deficiencies, anemia, and so forth before jumping to the unwarranted conclusion that something is wrong with their brains and that brain scans will somehow answer this very complex question.
And finally, if “they are not there yet,” why do “they” pretend that they ARE there and claim things are true that they don’t know about? Why do “they” get so threatened when people point out there are 80% or higher associations between MDD and childhood adversity/trauma and that attacking THAT problem will probably be a lot more fruitful than experimenting on people’s brains when you don’t really know what you’re doing?
I would frame it more as a lack of any concrete means to MAKE a “diagnosis” from the DSM. As soon as you create “diagnoses” based on totally subjective “criteria,” the process of “diagnostic drift” will almost immediately take place. First, only the “really severe cases” are “diagnosed,” then the “benefits” to a less serious level of “dysfunction” are touted, and pretty soon, any kid who doesn’t want to sit still for yet ANOTHER round of math instruction on a point he already understood 3 months back is now “disordered” and “needs medication” for his “attentional difficulties.”
It also lets the adults off for creating poor environments for kids. I’d have had a lot less “attentional difficulties” if I weren’t bored to death all day every day throughout my entire tortured elementary school years. Why should the kids have to “pay attention” to whatever drivel the adults turn out? Maybe the adults suffer from “Boring Teacher Disorder!” It is exactly as logical and scientific!
Dangerous to the psychiatric profession, because they might expose the truth that they know nothing about helping the “mentally ill,” and actually seem in most cases not to actually WANT to!
Indeed. Not sure how anyone could expect giving a street drug to little kids would be helpful to anyone but perhaps the adults handing the drugs to them.
Not only are academic measures not improved, but not one significant outcome measure is better for those “treated” with stimulants vs. those diagnosed but not “treated.” This study shows that not only is there no benefit of long-term labeling and “treatment,” it actually makes kids’ lives measurably worse! Yet MILLIONS and MILLIONS of kids are getting labeled and “treated” every day. More proof that psychiatry not only doesn’t improve lives, it makes them worse, and despite doing so and KNOWING it is doing so, it makes no effort to change its theories or approaches.
Interestingly, during my brief stint as an official “therapist,” my goal was always to have the person NOT need me as quickly as possible. I didn’t WANT them to keep being my “clients!” Of course, I got paid by an agency regardless of who I saw, and there were always more “clients,” so the financial conflict of interest really wasn’t there in that role. So we’d get down to business, almost from the first words out of their mouths. But when it comes to GOOD therapy, the least necessary to get the client functioning on his/her own should be the goal! Yet I know it often is not.
And they admit freely on the one hand that the conditions around the pandemic caused anxiety, yet on the other hand, they place the cause in the child who is feeling anxious. Contradiction much?
“Mental state” is also proven to dramatically affect biology, and the brain can be restructured to a significant degree by experiences. If we’re all brain, how does THAT work?
I am not arguing against anyone using Ketamine as a means of relieving their suffering. It is apparent that this works for some people. But to try and codify what appears to me to be essentially a spiritual experience, to market it and sell it at huge cost to people while representing it as “the latest breakthrough” without mentioning that it won’t help everyone and can be harmful and that similar or better processes are quite possibly available through religious/spiritual practitioners is very damaging. There are lots of ways for people to get help for their situations, and everyone responds differently to whatever approaches are taken. The sooner the psychiatric world cottons on to this fact, the more likely it is they might actually be helpful to people. There’s a big difference in my mind between trying something and seeing if it works and selling a supposedly scientific “treatment” based on flimsy evidence and a lot of marketing.
There are any number of critiques of psychiatry, and even medicine in general, identifying similarities to religious practices. Please don’t minimize this as related to Catholicism. Here are a few examples:
Wow, great article, Patrick! I’m kind of surprised they published it. Your analysis of the actual trial data is very informative. I only wish that more people would think with that kind of information. If you did a hundred trials, and 80 were negative, 18 were neutral, and two supported the “treatment,” you could still apparently get it through the FDA???? And they didn’t even manage to get TWO positive trials! I’d bet Jack Daniels would meet statistical significance in a four-week, controlled dosage trial. Why do we allow this antiscientific nonsense?
I really think that’s the core of it. We are taught not to trust ourselves and our internal intuitions, starting VERY young! We are taught to “trust the adults, they know what’s going on” and to dismiss our own valid observations over and over again. Then, as adults, if we find we’re having difficulties, once again, we are taught to ignore our own instincts and just do as we’re told. Well, that’s how we got INTO this mess in the first place! I have no objection to true collaboration and agreed restrictions based on the needs of a group or community, but simply dismissing a large proportion of the populace’s observations as invalid or unimportant is certainly not going to lead to a better world, or even better “mental health” for the individuals involved. It’s kind of like saying I slammed my finger in a door, and the “treatment” is to now hit it with a hammer! Doing more of what made us “crazy” in the first place is not a solution!
What happens when the “client” starts applying these skills to the staff that are teaching them how to do so successfully?
I had a young friend who was in 5th or 6th grade. The school had a training on Carl Rogers’ “reflective listening” skills. During the assembly, they even did role plays. Afterwards, Jeremy sat on the edge of the stage, and a teacher came up with a raised voice and told him he’d better get off the stage. Jeremy said, “I feel uncomfortable when you yell at me. I’d like it if you could talk in a quieter voice.”
He was immediately sent to the Principal’s Office for “talking back” to the teacher.
DISEASE: a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms : SICKNESS, MALADY
Clearly, the boundaries between medical disease and social “disorder” have become very fuzzy. But to me, a social disorder is something CAUSED by social conditions. As you can see, the definition of “disease” above reflects something wrong with the BODY, and because medicine (at least in the Western countries) consists primarily of prescribing drugs and surgery, as well as lifestyle recommendations (which are not considered “treatments”), the idea of “treating” a “social disorder” by medical means seems stupid, kind of like drinking alcohol to deal with having a dead-end job and an unsatisfying relationship.
Here’s a decent description of a “social disorder:”
“When disorder and immoral events occur in society, it is called social disorder. From the beginning of the world’s existence, there has been chaos, heartache, catastrophe, and disorganization all of which can mostly be attributed to corrupt human behavior. Societies, countries, cities, communities, and families all experience this disorder in different ways, depending on their environment, population, and circumstances. This lesson will review some of the immoral dilemmas and misconduct that influences social disorder.”
As you can see, this definition involves issues of morality, order, corruption, environmental circumstances, social expectations, and even geography. Why would medical “treatment” be appropriate to deal with immorality? Or geographic trends (did you know that schizophrenia rates are MUCH higher in urban environments?) Or environmental problems? Medicine addresses the body. The major error that psychiatry makes is assuming that physical “treatments” can be used to address social/emotional problems. That assumption is 100% wrong. The only thing medicine can do for “mental illness” or “social disorders” is to “medicate” away the emotions involved with feeling oppressed or alienated or angry about the social conditions that prevail. Unless you are more going down the line of eugenics, and want to use “medical” interventions to reduce the ability of rebels to take action, or in fact incarcerate or sterilize or even kill them, as psychiatry has done in Nazi Germany and in the USSR, among other places.
Social disorders are social problems and need social solutions. I’m not opposed to thinking differently about that, but I am having a very hard time seeing what doctors are able and willing to do about a social problem like boring classrooms or domestic abuse in the home.
Using your example, how is “ditention” caused socially, and what medical intervention would stop it from happening? Or are you just talking about ameliorating the consequences and allowing the cause to go “untreated?” Which I think puts us back in the Jack Daniels category of “treatment.”
BPD isn’t just dubious, it’s entirely subjective. So the only thing they CAN measure is “people who have been diagnosed with BPD.” Which is an extremely heterogeneous group, so the assumption that all will respond to the same or similar “treatment” is absurd.
I think you are correct, good therapists use what seems to work and discard approaches that are ineffective. It’s very intuitive, and the diagnosis is essentially completely irrelevant to good therapy. It’s also increasingly rare, as the DSM approach has dominated trainings and courses nationwide. So you’re right, measuring “effective therapy” for “DBT” is a fool’s errand.
Well, a “cultural disorder” is by definition not medical. So I actually agree with you there. The question is why we want doctors “treating” social disorders with drugs, when the obvious answer is to alter social conditions that are causing the “disorders.” Schools are a fantastic example. “ADHD” is actually DEFINED to a large extent by behaviors in school that teachers find inconvenient or annoying. The same kids who are “diagnosed” with “ADHD,” when served in an open classroom environment, where they have more choices about how to spend their time and when to switch activities, are literally indistinguishable from “normal” children by trained professionals, per controlled scientific studies! So why give them drugs, when transporting them to an open classroom alleviates most of the “symptoms” without any of the risks of drug “treatment?”
One could even build on your comments and suggest that the actual purpose of psychiatry is to deflect any attention from the social causes of these “disorders” and instead blame people’s biochemistry so that no changes will happen to the social status quo.
What are you recommending I read that I have not responded to? I don’t remember that. I’m almost always willing to look at anything that provides new perspectives. I’m not willing to spend much time rehashing psychiatry’s spurious arguments about “mental disorders” being caused by biological problems in all cases (even their own DSM says otherwise), but if you’ve got something refreshing to share, I’m all ears!
It remains a legitimate question as to whether this difference is a “disorder” or “medical condition,” which is a philosophical problem of great magnitude that psychiatry has always dodged. Difference is not disease. And there is still no clear line of demarcation as to who “has” or “doesn’t have” ditention or what causes the condition or situation.
Thanks for the interesting information. I’d also suggest that if the DSM were organized around things that could actually be distinguished from each other and from so-called “normal,” there might be SOME outside chance of finding a small subgroup of people who actually DO have something wrong with them. But this would require psychiatry to give up on their fictional DSM “bible” and start being a hell of a lot more humble about what they do and do not know. I’m not going to hold my breath.
I have to say, that particular course of events is VERY rare, in my experience. In fact, I can’t think of one person who ever went in and asked for ECT. It generally occurs when someone is told they have “major depression” and is told it is a “neurobiological disorder of the brain” and that there is no cure, but that antidepressants can make it so you can live with it, yet antidepressants don’t seem to work despite multiple attempts of different drugs and combinations, and the doctor tells the desperate sufferer that ECT is the only “treatment” left and in desperation, they agree with it. That’s my experience, having talked to at least a few dozen “voluntary” ECT clients.
As far as I recall, “ditention” is not a current DSM diagnosis. And I’d need to see how this “ditention” is objectively distinguished from “normalcy” in a consistent way.
That being said, if we have one example of a “biological cause” (though it sounds more like a correlation in any case), that’s not a very good advertisement for the idea that “mental illnesses” are biological “diseases.”
Reading the DSM would not have helped. Believing in the DSM was the doctor’s first error. Once you start down the path of “diagnosing” your clients based on prejudice and subjective checklists of behavior, any “intelligence” one might have will have to be suspended. It’s not a matter of “misdiagnosis,” it’s a matter of not having a clue to start with what the significance of anyone’s mental/emotional suffering is, and not caring enough to find out.
I believe the latest research says about 15% have significant improvements with antidepressants. And I’m very glad you managed to be in that group!
I think you might be missing the point a bit, though. The drugs are drugs, and they work for some people and they don’t for others. That’s not the sham. The sham is the PRETENSE that there is some way to “diagnose” people with the highly subjective DSM, and that these drugs “rebalance chemicals” in the brain that are associated with these subjective “diagnoses,” and that all ‘mental illness’ so defined is caused by faulty brain chemistry.
There is nothing wrong with finding that a particular substance works for you to enhance your life. But there’s no new “science” of the brain involved here. People have been experimenting with substances since the beginning of human history, from alcohol and inhalants to herbal medicine, not to mention any number of spiritual interventions from many different cultures. I object to none of these, as long as they don’t damage more than they help. What I do object to is people pretending to know things they don’t know, and using that pretend knowledge to sell things, despite data that belies their own assumptions. That’s the sham, not the drugs. It’s what they TELL you about the drugs and diagnoses that is fraudulent.
Looks like absolute proof that “stigma” is caused by the diagnoses, or the person applying them, rather than some pre-existing social biases. If it matters which “diagnosis” you have, it’s clear the discrimination experienced is applied to the diagnosis itself and what we have been “taught” about these “diagnoses” by our wonderful Mental Health System and drug industry. In other words, no “diagnoses,” and the “stigma” doesn’t happen.
I always found the best “screening” to be: “How are you doing?” Then ask questions depending on the answer and figure out what the person is worried about or frustrated about or angry about or whatever. Then try to help them come up with a plan. It ain’t rocket science, folks.
Of course, the PURPOSE of “routine anxiety screenings” IS to create “overdiagnosis and overprescription.” That’s the whole idea. That’s also not rocket science. Screenings exist to get new “customers” and sell more product. They are marketing tools, not medical screening processes.
A very interesting study was done a number of years ago. The experimenter created groups of three children who were assigned three problems to solve. One set of threes had an “ADHD-diagnosed” child and two non-diagnosed children, and the control groups had three non-diagnosed children in the group.
They measured “on task” behavior, meaning how much time did the kids spend trying to solve the problems rather than goofing off or doing something else. The “ADHD” inclusive groups did far worse on this measure, much more joking around and goofing off than the control groups. However, the primary outcome was which groups solved the problems more effectively. All of the “ADHD” groups solved one or more of the problems presented and as I recall, a few completed ALL the problems. NONE of the control groups solved any of the problems presented.
“ADHD” behavior still has survival value. Sure, if you put three “ADHD-diagnosed” kids in the same group, they’d probably have been very unproductive. But hard work from the “conventional” thinkers did not lead to solutions. We need ALL types in our society, and discriminating against certain children because they make life a little (or a lot) more difficult for adults to manage is both short-sighted and overtly destructive to our success as a society.
Not merely “not required,” but not CAPABLE of “diagnosing mental illness.” Of course, why would we expect they would be when “mental illness” is defined by a somewhat arbitrary collection of thoughts/feelings/behavior as “criteria” and set at TOTALLY arbitrary levels of how many “criteria” are required for a “diagnosis,” such that in many if not most “diagnoses,” two people can be “diagnosed” when they have not one single symptom in common with each other. The very idea that such a wide range of heterogeneous behavior/emotion/thought could ALL be caused by some specific genetic anomaly is absurd on the face of it. But logic is not the basis for “mental health treatment.”
With all due respect, this seems to shed more heat than light on the matter. Finding partial correlations doesn’t give us any real sense of cause, because most of the people diagnosed “ADHD” or “bipolar” or whatever don’t share these genes in common.
More importantly, these genetic findings provide absolutely NO guidance as to what, if anything, one can do to assist those having this highly subjective and heterogeneous “diagnosis.” What good is it to know that 10% of “ADHD-diagnosed” individuals have “altered dopaminergic firing patterns” if this doesn’t lead to any understanding of how to help even this minority of such individuals.
Finally, the fact that there are genetic variations between people that express themselves behaviorally means absolutely nothing about whether or not such states are, in fact, pathological. The assumption that kids who struggle in a standard classroom setting are ipso facto “disordered” deserves extreme scrutiny, which seems to be avoided by most advocates for the idea that “ADHD” is some kind of biological dysfunction rather than simply a common variant of behavior with survival value that teachers and parents tend to find inconvenient.
So again, not much light shed here. No one should be surprised that different behavior might be associated with different genetic makeup. Genetic diversity is the key to species survival. Different is not “disordered.” When THAT question gets addressed, maybe we can talk about some “light” being shed on the subject.
I think you are still making unfounded generalizations, as if you can read the mind of all therapists, and as if all therapists have the same thoughts and intentions. This is obviously untrue. I think it’s possible to make generalizations about psychology/therapy as an industry, but individuals have different experiences and individual therapists are a VERY diverse group.
I’m not making apologies for the horrible state of affairs that exists today. I’m just saying that you can’t know what every therapist is thinking or intending, nor can you judge the experiences of those who employ them as being invalid or unhelpful based only on your own subjective opinions.
I am wondering – do YOU personally have experience with therapy?
I’m also with you on political action being necessary, and I hope we can get organized enough to make it happen.
I generally agree with your sentiments, however, I have noted there are times in one’s life where the other party is simply not interested in collaboration. This is particularly the case when there are substantial power differentials and/or when there are financial conflicts of interest. I am afraid to me that psychiatry has reached the point where both of those issues have made them impervious to logic and compassion as a profession, even if individuals are capable of seeing the damage psychiatry has done and want to change it. The latter deserve to be reached out to and asked for specific actions that would be supportive, but the former are safe enough with their power to simply deny reality and keep on with the “theories” that have made them so much money and given them so much control over the industry and their “mentally ill” charges. Bob Whitaker himself has always been open to discussion regarding his findings, and has appeared with psychiatric industry luminaries to “debate” the issues at hand. The result is almost always the same – they don’t debate, but they attack and undermine and lie and manipulate their way into defending psychiatry’s entrenched position. They can’t AFFORD to face reality. How is one supposed to collaborate with that?
A psychotherapist, whatever their value, is not an attorney and is not required or expected to follow case law. It does not follow that a psychotherapist is conning anyone, though clearly some of them are doing so. Many people report improvements in their lives following therapy. How do you account for such people? Are you simply dismissing them as dupes because they don’t fit into your preferred narrative of reality?
I’m not a big fan of psychotherapy, especially when it serves as a handmaiden to the DSM and the psychiatric “mental health” drug-and-pray paradigm, which much of it does these days. But there have always been people with a particular ability to listen and be present for others who are seeking to make sense of their lives. Not too many attorneys are any good at this, but some of them are, too. So are some friends and acquaintances, doctors, dress makers, etc. Just by the odds, I’d say more than a few therapists must fall into the category of people who are good at listening and can help people sort out what direction they want to go with their lives. Just because YOU don’t value that kind of assistance doesn’t mean it’s not helpful to anyone.
I think it’s important we not fall into the trap of deciding what is right for other people. That’s the biggest problem with psychiatry, when it comes right down to it. It tries to force its views and actions onto other people without any concern for whether or not these things are actually of any assistance. I hope you will see that viewpoint and stop trying to tell everyone else what their experiences are supposed to be, instead of letting them decide for themselves.
That’s about right! My wife just got a note about “splitting” in her chart for SURGERY because she got in a conflict with a nurse who was being condescending. Her response would have made any competent DBT leader proud (if there is such a thing), she simply stated how she felt and asked for a change in the nurse’s behavior, but somehow, she had “Cluster B personality traits” because she complained about this person’s treatment of her. It’s a sleazy cover for saying, “This person’s a jerk and I don’t want to deal with them!” And it prevents any analysis of what the STAFF PERSON may have done to induce the supposed “cluster B personality traits” in their charge.
What ever happened to “The customer is always right?”
Quite so! Biological causes are popular because “no one’s to blame!” (Except the poor client, but really not, because it’s not YOU, it’s your DISORDER that’s at fault!) The idea of social causation might mean someone has to DO something, to alter their own behavior or the structure of our institutions, and that is just TOO HARD! So let’s all blame the brain, whether or not it makes sense, because it makes us all FEEL less responsible! (Except the client, of course…)
Weird how many people report things that “never happen!” Anyone who says something “never happens” is obviously either deluded or intentionally covering up. Humans are capable of all sorts of heinous behavior, and it’s naïve at best to imagine that nothing of this sort happens just because people belong to a particular profession. Reminds me of when a colleague who contacted a suburban school to offer a talk on sexual abuse, and the principal said, “We don’t have that sort of problem here.” RIIIIGHT.
It was actually apparent if you listened carefully to the ads that they were not supported by the literature. They always would say, “Some scientists BELIEVE that depression is caused by an imbalance in chemicals…” but then would say, “Zoloft can correct these imbalances…” So they admit in part one that this is NOT established fact, only something “some scientists believe,” but they follow it up with a sentence that assumes these “beliefs” are correct. Very sleazy advertising, should not have been allowed, but that’s how they got by the rules about “false claims.”
Do you mean coerced? I agree with you 100%. Actually, there can be no such thing as “involuntary treatment.” If the person has not genuinely consented, it’s at best “management,” and more likely punishment. Force is not and can not be part of any “mental health treatment.”
I am sure the Big Cheese of psychiatry are well aware that these drugs impair normal functioning in the brain. The problem is, they are not there to find the best solutions for their patients, but to assure their continued dominance and high incomes. So no amount of studies and proof will change their minds. Their intentions are not the same as yours and mine.
I like to say that the system is successful, it’s just successful in doing things that have nothing to do with improving anyone’s “mental health,” whatever that even means. If you go by making money, creating dominance for the psychiatric profession, selling concepts that have become part of society’s fabric despite their veracity or lack of same, it’s been wonderfully successful!
Loneliness is chronic in our weird society and is of course causal in many “mental disorders” as described in the DSM. But if they admitted that, they might have to DO something about the situation! Instead, it’s easier to assume that everyone should love our society just the way it is, and that anyone who doesn’t is deviant, oops, I mean “mentally ill” and must be “helped” to stop those “bad feelings” that are making the so-called “normal” people feel bad, because it reminds them that THEY are lonely and confused and hopeless as well.
One thing I don’t get is this: if they think you’re a hopeless case, why do they keep accepting payment for “helping” you, and indeed forcing you to be “helped” even though they themselves have admitted they don’t know anything that will help?
And as I have pointed out elsewhere, by this definition, alcohol, marijuana, and heroin also “work” in that they have discernible effects on the mind and on the brain, which some people find desirable or relieving to take. I would hope that a medical specialty would aspire to a higher goal that, “Here, take some of these, you’ll feel better.” Anyone with a drug-seeking auntie can get as good service from her: “I’ve got valium, Percocet, klonapin, oxy, what do you need?”
One cannot allow a fear of being accused of something deter one from doing the right thing. However, Bob Whitaker has of course been accused of being a Scientologist and all sorts of other things despite his determination to maintain a hard, factual stance. I actually don’t know that you or I or anyone else are in a position to criticize his approach, as he has had an enormous impact on exposing the truth about psychiatry, as much as anyone I can think of. So I say, WELL DONE, BOB WHITAKER! We need an antipsychiatry movement, but having a source of reliable information as well as a forum for discussing issues that aren’t discussed anywhere else on the Internet in these kinds of numbers is invaluable.
To translate into English: It’s more helpful to talk to someone who seems to like you and care about you than to someone who is treating you more or less like an object.
If that is their plan, why don’t they just give people niacin pills, and say the flush is proof that it’s working? Why make billions for pharmaceutical companies with super expensive placebo pills? Sorry, that argument does not hold any water!
It may also cause a decrease in distressing thoughts like, “If I killed myself, my mother would be so upset, maybe I’d better try something else” or “If I shoot these people, I’d go to jail and I’m really scared of that!” So instead we get a suicide or a homicide.
“Decreasing distressing thoughts” is not always a great thing. And even if it were, I can go down to the bar and suck down a couple of ales and a few shots of Jack Daniels and decrease my “distressing thoughts” without medical pre-approval, and with similar results.
The first day I met my (very competent) therapist, she told me the goal was for me to develop my own internal therapist so I would not need her or anyone else to help. The first day.
Exactly. A “true” finding should prompt a forceful attempt to disprove it. Only after vigorous efforts to come up with any and all reasonable alternative explanations and finding them wanting is something “true,” and then only until any further data that brings the “true” datum into question. Psychiatry certainly does not operate that way, never has, and most of Medicine is similarly plagued with favorite theories and beliefs that are untested or are believed because that’s what everyone believes, not because of any intent to find the actual truth.
When I say “ended his life,” I meant he died in a mental institution, not that he intentionally killed himself. It was a horrific tragedy, and possibly not an accidental one.
When half of the population is “abnormal,” how can you any longer call it “abnormal?” Isn’t it “normal” by definition when close to half of a population experiences it?
That’s a bloody understatement! He was fired from his job and treated with such derision that he eventually went mad with frustration – he had proven his point beyond all doubt, and yet was punished for it! I believe he ended his life in a mental institution. There is some question of whether he belonged there or was put there by his enemies. It is a story of arrogance, bias and mutual backscratching allowing the death of thousands and thousands of women in the face of absolute proof of the medical profession’s wrongheadedness.
Numbing seems to be the most common experience for ANY “antidepressant.” I think it’s the main “therapeutic effect.” If you’re too worried about everything, not giving a crap might feel like “relief.” Of course, if you were not murdering someone because you were worried about the consequences, not giving a crap might turn you into a murderer. It’s a very dangerous game.
Exercise is probably the #1 best health treatment for almost anything, but particularly good for depression/anxiety!
Remember there WILL be withdrawal effects, so be prepared for them and don’t give up just because it happens. You can do this!!!
It is my observation over time that “bipolar” is much more frequently diagnosed in women than men. There is some support for this, but not from a very critical viewpoint:
I agree 100%! The new axis should be “Big Corporate supporters” vs. “Representatives of actual voting constituents.” Of course, there may not be enough of the latter to actually form a party!
The reviews on antidepressants of all types are very similar. The fact that something that works on dopamine instead of serotonin is still considered an “antidepressant” shows that they doctors haven’t the slightest idea what is causing “depression” nor whether “depression” has anything to do with “disordered brain chemistry” at all. Any drug you use is an experiment on your own brain, which you’re entitled to do, of course, but it’s not based on any good literature support for Wellbutrin over any other kind of drug. I am of the opinion that it’s similar to trying alcohol or marijuana to deal with your issues. Some people find it helpful to have a few drinks, while others lose control of their lives. But alcohol is not “treating” anything, it’s just a way to temporary feel better. Same with Wellbutrin or SSRIs or any other psych drug. Until and unless someone really finds a subgroup of “depressed” people who actually have some specific, testable issue with brain chemistry, drug “treatment” is similar to taking aspirin for leg pain. It might make the pain go away temporarily, but it’s not going to fix what’s causing the problem.
It’s kind of a weird reversal to me when those who are in charge want their charges to be empathetic, curious, and respectful. Isn’t it a basic of “mental health” treatment that the clients shouldn’t have to take care of the clinicians? How about psychiatrists start by being empathetic, curious, and respectful toward their clients who are criticizing them? Maybe that mutual respect could be created on the impetus of the professionals instead of expecting the clients to set the tone?
I’d say screening works, in this case doing exactly what it was intended to do: create more customers for the psychiatric profession and the drug industry. The problem is the INTENTION of those doing the screening. If they actually wanted to help, the screening itself would look VERY different, and the range of responses would be much larger. So I agree with you, the screening itself is not the problem, it is the lack of intention of those providing “mental health treatment” to actually improve the situation that is at the core of the difficulties.
These claims of multi-gene associations are really just window dressing. It means absolutely nothing that 4% of those “diagnosed” with “ADHD” have a set of certain genes in problem, when only 2% of “normal” people have such an association. There are still 96% of the affected population who don’t even have the genes in question! Why does anyone take this crap seriously?
I know that. I was joking that their “treatment” doesn’t diverge much from saying to go get a drink at the bar. Alcohol can be incredibly destructive and is not a solution for anything. But the same can be said for the psych drugs as a general rule.
Thanks for the clarification. I am aware that the so-called “mentally ill” have few friends either side of the aisle. It is one form of prejudice and discrimination that all but the most enlightened “social justice warriors” seem to find AOK, and one area where “government overreach” is totally fine with the Right.
I find it interesting that the no votes ended up coming from Democrats, per your description. I remember you talking about several GOP members being opposed to this and speaking against it. What happened to them?
You are right, of course. If 16% are significantly helped and the overall benefit is barely noticeable, there must be a significant number who are harmed to balance out that 16%. That number rarely seems of interest to psychiatry. They don’t seem to be interested in finding out who the 16% are who DO benefit from these drugs and letting the rest look for other help. It would destroy their and the drug companies’ bottom line.
Excellent example! But since not ALL people appreciate French impressionists, there must be SOMETHING wrong in the brains of those who fail to recognize their beauty!
It’s actually even worse than that. What scientific information is discovered is intentionally denied by psychiatry when it contradicts their preferred narrative!
Having no measure of “success” dooms any of these interventions. If you don’t know what “improvement” means, you have no means to tell if your intervention is “working.”
Really, in my view, nobody can “have” “bipolar disorder.” They can be labeled with BPD, they can identify with BPD, they can “fit the DSM criteria” for BPD, but there is no way to distinguish who “has it.” It is completely subjective and almost totally arbitrary, having almost no coherent meaning except that someone acts in certain ways that other people don’t like.
I agree. The intent is pretty much sociopathic. Whatever gets the power and money is what they’ll do. They will serve communism, fascism, corporate capitalism, state-controlled capitalism, even anarchism, as long as they can gain the power and money they wish to compile. This is true of most industries, of course, but in this case, the scope of the damage done is so vast, and the insult to human self-determinism so blatant, and the lack of accountability so complete, I think it is a special case of extreme danger to the survival of any system which allows its participation.
I object to the statement that the “prevailing view” is that nothing can be wrong with a brain. I haven’t heard anyone say that at all. Just for the record.
But I do get what you are saying, and it ought to be carefully considered, whatever “treatment” is being administered. The mind affects the whole body (including the brain), and the body affects the mind. The idea that some little spot in a brain can be “treated” and have no effect on the rest of the body is a very dangerous idea. But it’s also true that imagining the body can be ignored when working on the mind can lead to a lot of errors and potential damage. Psychotherapy for Lyme Disease is not going to help any more than giving antidepressants to a mother in a domestic abuse situation. Everyone is different and deserves an individualized approach not based on dogmatic insistence of the “helper” that their approach is the RIGHT way regardless of how the poor client feels or reacts!
Well, I am sure that most on the front lines psychiatrists do their best and probably believe sincerely they are being helpful. What I don’t understand is why the thought leaders are so committed to biological explanations. It can not be a result of not having enough time. People in high places continue to alter the known research in order to continue to justify biological treatments.
A very simple example: Stimulants are claimed to be effective in “reducing the core symptoms of ADHD.” However, decades of long-term research have shown little to no benefit in ANY long-term outcome. This was first observed in 1978 by none other than Russell Barkley. It has been the same result in 1993 (Swanson) and 2003 (OSU medication effectiveness study). Several long-term naturalistic studies (Quebec, Raine, MTA, Finnish/USA comparison) have supported these findings. It was demonstrated in the 1970s that open classrooms work very well for these kids, to the extent that professionals can’t even tell them apart from “normals” in this kind of setting. It has also repeatedly and undeniably been demonstrated that fully a third of “ADHD” cases go away if you simply wait a year before enrolling a child in kindergarten.
So why are we still insisting that ‘untreated ADHD’ leads to negative outcomes, when “treatment” does not improve them? Why is it insisted that ADHD is a biological problem that requires a biological solution, when it appears that a change of setting resolves most of the “symptoms”? Why is most of the research money still invested in “medication?” It’s not because clinicians don’t have enough time in the field. It is because the profession supports biological research even when the data does not support it.
This is most definitely not about “serotonin.” It is about psychiatry as a profession/industry needing to continue to support “medication” as a primary intervention, because that’s where they make their money. As an INDUSTRY, not as individuals. So sure, the system is designed so that doing therapy is not remunerative, that “med checks” make more money in less time, and so that people who question the biological paradigm (like Moncrieff) are attacked for doing so. It is easier to follow the path of least resistance. But what that means is providing “services” that are either ineffective or sometimes destructive over time, meanwhile making any other approach unable to be researched and so criticized as “not evidence based.” All the while spreading misinformation about the nature of these “disorders,” which are in actual point of fact simply descriptions of sets of “symptoms” that tend to occur together. Perhaps the most egregious damage is the prevention of research into ACTUAL causes of these “syndromes,” because we spend our money researching the DSM categories which embrace totally heterogeneous groups.
I’m not asking you to fix all of this, or even explain it. I’m asking you to acknowledge that psychiatry AS AN INSTITUTION is committed to following the biological track, regardless of whether it leads to results or not, and are frequently quite hostile to folks like Bob and Joanna who have the temerity to point out the facts that diverge from their desired narrative. Why else would Joanna be so roundly attacked for presenting information that supposedly “psychiatrists have known for years?” If psychiatry has known this for years, why else would official sites and training literature and even textbooks continue to portray this falsehood as truth? And why is the search for some “deeper biological reality” instead of being willing to question whether the quest for biological explanations is simply misguided and should be dropped for some more fruitful path? It is hard to deny that psychiatry is not on this path by accident, and that it is committed to biological explanations in a way that a scientific enterprise can not be allowed to be.
I’m glad we are on the same page. Then I challenge you in this way: are you suggesting that most of your colleagues are NOT using the idea that drugs are the solution because these issues are primarily biological in nature? Does the evidence not suggest that such colleagues (and reading the comments here should disabuse you of any notion that your views are in the majority) continue to spend most of their time and energy trying to promote or prove that biological solutions are the best solutions? What else does the average psychiatrist have to offer besides the drugs?
Whether or not it is stated overtly, in practice, the basic business of psychiatry appears to be to get people taking pills. And what about the hostility that Dr. Moncrieff has received for simply stating the scientific conclusion that 50-60 years of research has provided: that a serotonin imbalance is NOT associated with major depression. If the psychiatric profession is NOT invested in promoting primary biological explanations for “mental illness,” why is it so upsetting to have the actual science on that question reported?
Very well said. It appears we agree once again wholeheartedly!
In my time as a therapist, I always assumed I knew NOTHING about a person I met, regardless of what I might have read in the file. I always knew that if anyone had the answer, it was the person in front of me, and it was my job to help them tell me about it, verbally or nonverbally. And every single situation had different contexts and reasons and possible solutions. Sometimes I had to be very quick on my feet and try something totally off the wall! And the most off the wall strategies almost always worked!
The fact that the person was “depressed” told me exactly NOTHING about what I had to do. I considered “diagnoses” mostly a waste of time, if not a detriment to progress. Every single case is different!
Sorry, I had to chuckle when you used the term “outweighs” in reference to Zyprexa! I think in this case the risks LITERALLY outweigh the benefits!
Not meaning to minimize the incredible harm done to folks by the massive weight loss and other health insults caused by these horrible “atypical” antipsychotics. There’s really nothing funny about it – it’s a systematic criminal act!
Sounds like another money-making scheme to me. As one commenter points out, why not take some wellbutrin and a few cold pills? A lot cheaper and more accessible!
With all due respect, is it possible that the reason we “don’t know what’s going on in the brain in the deepest and most important ways with depression” is because we’re making an errant assumption that all depression is related to something “going on in the brain?” If that assumption is wrong, every attempt to discover “the answer” will fail to provide an answer, because we are barking up the wrong tree. That seems to be what the research is showing. Sixty years later, we still don’t know of a biological ’cause’ for depression, despite billions of dollars and millions of person-hours dedicated to the project. At what point do we admit that this is most likely because there IS no biological cause? What if “depression” is simply a description of a very complex state that organisms go into when exposed to a threat they can’t immediately manage? Would not then each case of “depression” result from potentially completely different “causes,” with the only thing shared in common being the depressive experience? Pain is a great analogy. What is the biological cause of pain? Is it certain neurons firing in a certain pattern? Or is it putting one’s hand on the stove or getting one’s foot run over by a car or being unable to digest X or Y or having a cancerous growth on an organ or experiencing extreme emotional distress that is expressed as physical pain or just not getting enough sleep for 5 nights in a row?
Why is the psychiatric profession so dedicated to proving a proposition that has yielded no deep understanding of the situation despite over 60 years of intensive research? When is it time to admit that the theory you’re investigating simply is incorrect, and start on a new hypothesis?
There is another option to deal with “cognitive dissonance:” Accepting the fact that facts don’t fit with your conclusions to date, no matter how uncomfortable that process may be, and reconsidering those conclusions based on the new data. This is what we expect of actual SCIENTISTS, 100% of the time. Anyone who can’t deal with facts contrary to theory needs to stay far away from any scientific field!
“Treatment resistant” is a handy “explanation” for their chronic failures. There is no other industry where shortening your clients’ lifespan can be blamed on your clients!
Let’s recall that this thread is on “psychiatry, fraud that the case for a class action lawsuit.” I am not allowing further discussion of COVID on this thread, as it is far off topic. We all know it is controversial, and both sides have now been stated, so I’m calling a stop to further back and forth on this, because experience says that this will be unproductive and will escalate to hostility.
I think anyone with a truly therapeutic orientation would find this prioritization horrifying. To prioritize the needs of the therapist and/or program over the needs of the client simply reinforces all the bad “lessons” these folks have learned from teachers, parents, clergymen/women, and abusive partners or caretakers prior to showing up for DBT. It quite frankly is going to make the DBT provider into another abuser, and reinforce the very “coping mechanisms” DBT supposedly is there to help us learn how to circumvent.
I really related to what you said about “postpartum depression.” My wife did some cross-cultural research on “postpartum depression,” and discovered that there are several more “primitive” cultures where “PPD” simply does not occur. If it were hormones, wouldn’t the rate be pretty much the same across cultures? And guess what characterized the cultures with low or completely absent “ppd” rates? They provided excellent support for the new mothers, freeing them up from any other job besides raising the baby. Friends and neighbors cooked, cleaned, took care of the other kids, hauled water, whatever was needed so the mama could just focus on taking care of baby.
The idea that ingesting substances to alter consciousness is neither new nor particularly scientific. Pretending that a response to a drug means anything about cause or constitutes “treatment” is the central sophistry used by psychiatry to “explain” its outrageous corrupt actions. I have NO trouble with people ingesting substances to alter their consciousness, and I’m sure in some cases something good can come out of it. I have BIG trouble with calling such ingestions “medical treatment” and charging people and governments ridiculous amounts of money to run an uncontrolled experiment on our brains.
Well, you know that CAN’T work, because no one can patent it and make money out of it! So it must be a deception. REAL medicine makes millions for pharmaceutical companies! That’s the first criterion!
You are right, re-learning who can be trusted does require trusting someone for at least a period of time to find out if it will work. The key is figuring out WHOM to try it with. There are ways to gauge trustworthiness with some level of accuracy, and this CAN be taught to a willing student. But of course, the person playing the “helper” role has to be the first one trusted, and that can take some time and mean dealing with some hostility and other emotions. At least that’s my experience. But to keep in mind who is behind this and that it’s all about trust to start with can help me be patient with the process. Sometimes the FIRST level of trust is to say out loud, “I know you probably don’t trust me, and I don’t blame you for that.”
Wow, so it is worse to have criticisms or just a general dislike of your therapist than to be bulimic or massively depressed or be unable to go out of your house? Though I suppose the last might be “treatment interfering,” because you’d be inconveniencing someone who might have to come and get you.
This is sounding more and more insane. From what little I do know of DBT, this certainly sounds like some “interpretations” that were willfully entered into by people who just didn’t like the clients and wanted to whip them into line! How can anyone consider any of that “therapeutic?”
Well said! Most “mental illness” is in my view CAUSED by more powerful people deciding they know best and imposing their rules on those who have less power than them. I see no way that using power to enforce/attack/undermine/invalidate people can possible help them become more “mentally healthy!”
An interesting way to put it! Can’t say I can argue with you. We have center-right and right-right and crazy-right in this country for the most part. What would be a soft left-center in Germany is considered a wide-eyed radical in the USA!
You have an amazing DBT THERAPIST. There is excellent evidence that the quality of the relationship between client and therapist is more important than the school of therapy practiced. It is great that you found the right therapist taking the right approach with you. But I can tell you, after years of experience as a professional in the mental health industry, that not all therapists are capable of doing what needs to be done for people with traumatic pasts, and reading these stories should give you an idea that simply saying “I do DBT” does nothing to guarantee a positive experience, or even a neutral one.
The therapist’s ability to connect and create a safe space is more an art than a science, and you simply can not learn that ability by reading and abiding by a workbook. It’s MUCH more complicated than that, but the therapist/client relationship is at the core of quality therapy, regardless of the “brand” of therapy practiced.
Good for you for finding the right fit and getting yourself on a new path!
As I’ve said many times, the “right” isn’t friends to anyone who feels psychiatry has harmed them, either. They get money from the same pharmaceutical and insurance industries, who are happy to paper both sides of the aisle with warbucks. Looking to the current political parties to support this movement will lead to nothing much worth discussing. They will both be dragged kicking and screaming to any real resolution, because it will mean tweaking the noses of people who have lots of money and power and make big campaign contributions!
Wow, they SERIOUSLY tell you this nonsense? I’d think they’d maybe teach you the skill of “how to tell whom you can really trust” rather than “give everyone the benefit of the doubt.” How many abuse victims got that way partly BECAUSE they gave someone the benefit of a doubt whom they should not have?
I am finding that particular “skill” kind of disturbing!!
You got it right. This is NOT a left/right issue, it’s an issue of economic power and investment. Neither party will sign off on something that their contributors will freak out about because it loses them big, big bucks! Carlson is willing to put this on because he is famous for spitting in the face of anyone he wants to, and he’s tolerated because his comments are considered so biased as to not be believable. Mainstream media will not cover this kind of thing or will minimize or spin it somehow, because they depend on the same contributors who own our representatives.
We need to ditch the left-right axis. We need to replace it with the greed – integrity axis. People on the greed end of the axis should not be supported by anyone, regardless of party. Unfortunately, that doesn’t leave a whole lot of representatives left on the integrity end!
It is always a requirement to say “We know psychiatric medications can be life-saving for some” or something of that nature. Otherwise, your comments are instantly dismissed.
I am thinking you have missed the point of this article. Johanna did not say that SSRIs can’t work nor that all psychiatrists are telling their clients that they have a “chemical imbalance” or something wrong with their brains. She is saying that the claim that “depression” is caused by low serotonin is FALSE. It has been shown that over 80% of US citizens polled believed that depression is caused by low serotonin. Someone is telling this story, and if you read others’ posts, you can see that this story is indeed told to many by their doctors. The reactions she has received also seem to indicate that some of the psychiatric establishment is quite upset at her for stating this fact out loud.
Science is not built on individual experiences. Nor is culture. I am glad that you have had such a positive experience yourself. But that does nothing to invalidate Johanna’s summary of the research. Depression is not caused by low serotonin. That is all she is saying. She is saying nothing about what works for you. I hope I have made this distinction clear enough.
Very well said. The comment “Depression causes hopelessness” is an absolute meaningless sophistry. It’s akin with saying “A sore knee can cause your knee to hurt.” The attempt to make “depression” into some kind of an active, evil entity that “does things” to us is the most destructive and disempowering way one could possibly view the situation. It is the opposite of the kind of thinking that can actually help us move past feeling hopeless. It is hard to fathom how they continue to get away with these syntactical idiocies!
All too true, Rogier. The hard question is why their shenanigans and dishonesty are still not obvious to those in society at large. It’s not even a very good con. I think it’s only our culture’s faith in “science” and “medicine” that allows them to get away with it, that and a massive dose of pharmaceutical company marketing. Hard to know what to do with such irrationality!
I think it is less about holistic programs and more about having therapists who have done their own work and are actually emotionally available to their clients. There is no workbook for caring about another person.
It may be of interest to know that lots of good research has shown that the relationship with the therapist is much more important than what school of therapy is being followed. I am guessing that the reason it “worked” for you and “didn’t work” for others is because your therapist extended genuine caring to you while theirs followed a “cook book” approach to DBT without recognizing the damage their lack of engagement did to their clients.
It is easy to assume that “DBT” is the same for each person who experiences it. That assumption is absolutely wrong, as the evidence here suggests.
It also shift the blame to the “client/patient,” so the actual powers that be can pretend everything is OK and that anyone having a hard time with the status quo is themselves to blame for not “adjusting properly to reality.” It can be a seductive idea for troubled individuals as well, as it promises path to feel better without having to examine any of one’s own beliefs or behavior. Of course, this leads to further troubles, because no one is looking for root causes, but it does keep the Benjamins coming in to psychiatry and their close cousins in the pharmaceutical industry.
You sound like the kind of therapist someone would be more likely to benefit from seeing, and you clearly travel in such circles. I had a great therapist way back in my 20s. I know it can really help. But you can also see that many people do not have that experience. I believe the newest crop of therapists are trained much less in meeting the client where they’re at and much more in DSM diagnosis and brain chemistry and brain scans and a lot of pseudoscientific “facts” that get in the way of the real deal in therapy, which is getting to know and respond to your client as a unique individual rather than a collection of brain cells.
I am sorry, but the DSM is really a bunch of gibberish to me. And not because I’m not smart enough to understand it. It’s because I am smart enough to recognize gibberish when I see it. How, for instance, would one determine if a client is having an ‘untreated mood episode?’ It would be entirely a matter of the opinion of the clinician, and 50 clinicians might come up with 50 different answers. It also presumes that ‘treating’ the ‘mood episode’ would resolve it, and if it does not, the personality disorder should be applied, even though there is a ton of information suggesting that the ‘treatment’ of ‘mood episodes’ is extremely unpredictable and can make things worse. It also presumes that the ‘mood episode’ is not caused by another psychiatric drug, even though stimulants and antidepressants are well known to create manic episodes in some of their recipients. So we have an undefinable criterion (mood episode) ‘diagnosed’ by pure clinical opinion, being ‘treated’ with something that may or may not help, and assume that the failure for ‘treatment’ to help means the person has a ‘personality disorder,’ without considering that lack of treatment effect, or even the ‘treatment’ itself, may be responsible for the subjectively ‘diagnosed’ ‘mood episode’ which failed to be ‘treated’ successfully. Not to mention that the ‘personality disorder’ diagnoses themselves are even MORE subjective and vague than the ‘mood episodes’ whose ‘failure to respond’ to ‘treatment’ can apparently lead to such a diagnosis by default.
From a scientific viewpoint: gibberish! Science should make things clearer, simpler, more successful. These ‘diagnoses’ clearly make things vaguer, more complex, and impossible to even define let alone improve success measures. How on earth can anyone make sense of this bizarre and unhelpful array of subjective ‘diagnoses’ all of which lack any legitimate scientific underpinnings to speak of, and are essentially constructed by committee and most commonly voted in or out of existence by a bunch of ‘professionals’ without any resort to any kind of scientific verification?
Here’s the thing. In science, the hypothesis is considered FALSE until proven otherwise. It is not anyone’s job to ‘disprove’ the ‘chemical imbalance’ theory, it is the claimant’s job to prove that there IS such an imbalance present. Moncrieff is quite specific in stating that there is no proof of a ‘chemical imbalance’ in serotonin in depressed patients. That’s her conclusion, and her only conclusion. And that is sufficient. The claim has been out there since the 1960s, it is now 60 years later and there is no evidence that it is true. In the world of science, this means it is considered FALSE. Especially given how many billions of dollars have been invested in unapologetic attempts to prove it is true. At some point, we have to accept that failure to prove truth is ultimately proof of falsehood, and Moncrieff is saying we have reached that point.
Of course, it does not mean no one has a ‘chemical imbalance’ or that some other chemical might or might not be ‘imbalanced’ or that no one experiences relief from feeling depressed via taking antidepressants or other psychoactive drugs. It simply proves that what is currently defined in the DSM as ‘depression’ is not CAUSED by low serotonin. This truth was actually known as far back as 1985, before Prozac was even brought to market. The main reason people believe in this idea is pharmaceutical marketing, product placement and script alteration in TV shows and movies, and the support of the psychiatric industry for this fiction. There was never a time when the serotonin theory was supported by hard data.
Finally, the argument that the drugs make people feel better by mysterious means does not suggest that these drugs are correcting chemical imbalances. Alcohol is possibly the world’s best short-acting anti-anxiety agent. Are you arguing that getting mildly intoxicated corrects a chemical imbalance? Humans have taken in various substances to alter their mood since the beginning of history. Saying that ‘psychiatric drugs make people feel better’ is a trivial result. So do non-psychiatric drugs. Discovering that ingesting substances can alter moods is hardly new news. What would have to be in place to prove something of this nature is that people lacking a particular chemical ALWAYS or ALMOST ALWAYS feel a certain way, and that altering that chemical ALWAYS or ALMOST ALWAYS makes them feel OK again. People lacking in iodine have certain characteristic symptoms. Most have some or all of the same symptoms. Taking iodine almost always resolves the situation. This shows a lack of iodine is the cause of the symptoms. Nothing of this nature exists for any psychiatric ‘disorder’ or drug. That is what Moncrieff is saying. No evidence means no evidence. Depression is NOT caused by low serotonin, regardless of how people feel when they take serotonin-enhancing drugs. That is science, not opinion.
I agree with your general premise. But what if psychosis isn’t caused by one thing? What if different episodes of psychosis are caused sometimes by emotional stress, sometimes by reactions to other drugs, sometimes by Lyme Disease or syphilis, sometimes by nutritional deficiencies, sometimes by opening oneself up to a higher level of spiritual awareness? What if there is more than one ‘spectrum’ involved? What if the idea that finding THE cause of psychosis is like trying to find one cause for ‘pain?’
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‘Stigma’ is code for ‘prejudice and discrimination.’ It is rare that anyone in the system recognizes that they are facilitating and in some cases causing or perpetuating such discrimination by their own behavior.
In other words, our society forces us to adapt to circumstances that we are not adapted to genetically. Reminds me of the book ‘A Hunter in a Farmer’s World,’ by Thomm Hartmann, which critiques how we blame and devalue kids with so-called ‘ADHD’ characteristics for not fitting into a world they were not designed to fit.
Notwithstanding this important point, genetics are still the part we can’t change. Why not work on helping people figure out how to adapt better, or even work on creating a more flexible society where we appreciate and value differences and create niches where everyone can find a place to fit? Open classrooms for ‘ADHD’ sufferers is one very good example. The idea that all kids must ‘learn’ in a standard classroom and that those who don’t are ‘ill’ is simply nonsense. We force them to attend classrooms that are specifically designed to frustrate and defeat them and are surprised when they end up feeling frustrated and defeated?
Genetics may help explain certain problems raised by modern society, but it doesn’t do much to help us solve them, except by perhaps reminding us that rigidity of expectations is bound to reduce the quality of life for all of us in the long run.
Plus genes are the one thing in the equation that we can’t ever change! Why spend billions studying genetics and getting tiny little ‘correlations’ from sets of hundred of genes, when we KNOW that certain environmental conditions will cause or exacerbate these problems and those CAN actually be changed?
A great example is the so-called ‘ADHD’ child. It was shown in the 1970s that such children to incredibly much better in an open classroom, to the point that professionals can’t tell them apart from ‘normal’ children in that setting. Yet we spend tons of money promoting ‘genetic’ explanations that can never seem to be proven, instead of spending a lot less creating open classrooms as an option for kids who struggle in standard classroom settings.
Sometimes I think the only reason they are so married to genetic explanations is because it lets the adults off the hook for trying to fix anything. ‘Oh, well, it’s just genetics, nothing we can do about it.’ Highly irrational!
Psychosis is a definable phenomenon. It can be seen, felt, observed, verified by discussion.
Schizophrenia is a concept, and idea, that idea being that people who experience a very real psychotic phenomenon are ‘ill’ with a specific ‘disease’ or ‘disorder’ which is caused by a purported ‘chemical imbalance’ that can’t be seen or measured in any way and is now being denied by psychiatrists they ever claimed was true. Clearly, something is happening when a person is experiencing psychosis, and no one can rationally deny that. But for medical doctors to claim that they know this phenomenon is caused by a ‘disease state’ in the brain is reaching far beyond what any kind of scientific or observable data can tell us. It also gives power to the psychiatric system to claim the need to force ‘treatment’ on those who don’t want it or have observed already that it doesn’t help them or makes their situation worse.
So in my view, anyone claiming psychotic experiences don’t exist is full of crap. But it does not follow that those experiences are definable as ‘schizophrenia’ as described in the DSM, nor that they are caused by faulty brain chemistry, nor that drug ‘treatments’ will automatically help the person experiencing psychosis.
Again, I’d go to the mat to protect YOUR right to call the phenomenon whatever it is you believe best explains it. I do NOT support the idea that someone else can tell YOU that something is wrong with you called ‘schizophrenia’ until and unless they can objectively define this condition in ways that can be validated and verified objectively.
Perhaps an easier analogy is the term ‘ADHD.’ Do kids act in the ways described as ‘ADHD’ in the real world? Of course, they do. It is a very common set of behaviors, especially in boys. Does the fact that they wrote down descriptions in the DSM and voted on how many ‘criteria’ are needed for a ‘diagnosis’ mean there is anything at all ‘wrong’ with kids who happen to fit that description? Absolutely not. It doesn’t even mean that kids who act that way have anything in common at all – they may each act that way for totally different reasons, and assuming that just because they act that way means they are ‘mentally ill’ is ridiculous.
Same holds true in my mind for ‘psychosis.’ There may be one or ten or a hundred reasons why this phenomenon occurs. Maybe SOME such people really DO have a chemical or structural problem in their brains – but we don’t know if they do or which ones do. They may in fact be reacting to stress, but assuming ALL are that way because of stress is, as you correctly observe, not close to a valid inference. There may be thyroid problems, brain tumors, head injuries, huge anxiety, nutritional deficiencies – who knows? Because all they have done is collect a bunch of thoughts/emotions/behaviors that tend to occur together, described the behaviors and claimed it is an ‘illness.’
So no, saying that the DSM-invented description of ‘schizophrenia’ is not an illness does NOT mean someone is saying that people who have psychotic symptoms are making it up or should just get over it or are all victims of trauma or any such thing. It is simply saying that there is no scientific proof that all or most people fitting that description can be claimed to have something specific in common that is ‘wrong’ with them that can be measured, identified, and ‘treated’ by a doctor.
Do you think ‘mainstream physics’ is pretty much the same in all countries, or ‘mainstream biology’ [Q] [sorry my question mark isn’t working] If psychiatry is a scientific endeavor, as it claims, it is fair to assume that variance from country to country would be cultural, not in the mechanics or philosophy of psychiatry itself. Psychiatry portrays itself as the ‘scientific’ approach to ‘mental health’ and promotes very much the same messages around the world. How that is applied, of course, varies by country and community and even by facility to facility. But it is most definitely fair to say that ‘mainstream psychiatry’ is pretty much the same in all countries, as to its objectives and fundamental beliefs. Or all ‘developed’ countries anyway. It is interesting to note that recovery rates for schizophrenia in ‘less developed’ countries are far better than those getting the ‘full benefit’ of ‘mainstream’ psychiatry. When it comes to psychiatry, it seems that the dictum ‘less is more’ is supported by the data.
Seriously, when their ‘treatments’ don’t work, they get to blame the ‘patient.’ No other profession gets away with saying that their failures are their ‘customers” fault.
I agree with your sentiments in a lot of ways – insurance companies do drive what ‘services’ are available and reimbursable. However, if we really want to ‘just be friends,’ it is going to require an acknowledgement of psychiatry’s role in perpetuating a lot of dishonest nonsense. There is good quality evidence, not even disputed among research psychiatrists, that antipsychotics don’t have long-term benefits and probably decrease chances of survival over time, that the ‘seriously mentally ill’ die 20-25 years younger than their non-diagnosed counterparts, and that the drugs play a role in shortening lives, that antidepressants’ effectiveness is pretty limited and fades with time, that some who take antidepressants become manic and often end up with ‘bipolar’ diagnoses, that there are no long-term outcomes that are improved by long term use of stimulants, and on and on. When these studies and reviews are brought to light, just as with Johanna’s honest hard work, the authors are attacked with accusations of connections with unsavory or dishonest people, their motivations are impugned, their characters are attacked, their observations are minimized, and they are ridiculed and often shunned for speaking the truth.
Having any kind of respectful relations begins with psychiatry’s leaders agreeing to acknowledge and abide by honest research findings instead of trying to spin everything to make psychiatry look right and anyone questioning their absolute authority to declare what is ‘true’ as insane or ill-intended. And I don’t see that happening any time soon. Psychiatry in the institutional sense has cast their lots in with the pharmaceutical industry, and many people’s reputations and standing in the medical community depend on maintaining the fiction of the DSM and the fictionalized ‘research’ that is used to back it up. I’m not opposed to folks on the front lines who are trying to do the best they can. I am opposed to the massive amounts of false information that is forwarded and enforced on those who do have to do that hard work up front.
Still sounds like straight up philosophy to me. I have never doubted the value of instincts, but while they are an excellent guide to personal action, they don’t provide a structure to build a mutual understanding upon. To claim a scientific explanation for emotions, we need some kind of verifiable agreement, whether by measurement or by predictive ability or elegance of explanatory power – like the sun-centered view of the planets – which is clearly simpler and more useful in predicting future events. It seems you have an interesting hypothesis and some possible theories on how it might apply, but I don’t see a useful explanation of the origins and location of emotions that helps understand and predict emotional events and outcomes in the future.
OK, I did a quick search for concrete evidence of 4e cognition and found exactly nothing. I found a LOT of philosophizing on the ASSUMPTION that cognition is a full-body process, but there is nothing I’ve seen so far that even slightly approaches a falsifiable premise, let alone an actual experiment. To suggest that this very arcane theory is a scientific explanation of emotion doesn’t appear to be close to a valid claim, from what I’ve read so far. Perhaps you can direct us to an article that exemplifies an actual scientific experiment demonstrating the validity of 4e cognition and its applicability to emotions.
Sorry, my question mark doesn’t work. I urgently need a new keyboard.
There have been plenty of groups of ‘scientists’ who have been dead sure and published lots of papers and so on. Sorry, but if this makes any kind of sense, it ought to be readily explainable to the lay person. Einstein’s theory of relativity is as complex mathematically as any theory known to man, but it can be explained in terms of bending space and the effects of travel as the speed of light is approached, etc.
I have yet to hear anything from you that suggests any kind of grasp on the practical implications of this philosophy. Surely, you can come up with a simple example showing how this approach works out in the real world. But I am skeptical that such a thing can really be done, as we simply haven’t the vaguest idea what a ‘mind’ is or how it ‘arises’ or where it resides. Nothing, not a clue.
I will give this a quick look, but it sounds like a very complex and difficult theory to explain, and in the end, good science tends to provide simpler solutions, not more complex ones. In any case, we really need to see a falsifiable premise that is vigorously tested before admitting something to be scientifically valid. I see no such premise here. The idea that the mind is distributed throughout the body is not one I can see being testable. Though I’ve been wrong before, I’ll have to see the actual hard testing before I get too excited about a particular philosophical viewpoint.
I am not saying you are wrong. I’m just saying we’re not talking science any longer. When you have to talk about moving away from Cartesian dualism and ‘centering’ the mind in the body, not to mention declaring that something is ‘all the rage,’ we are definitely not talking about straight science anymore. We are talking about philosophy. Nothing wrong with talking philosophy, in fact, one of psychiatry’s most fundamental weaknesses is its lack of any coherent philosophical agreements and structure, but a possible viewpoint on what the mind or a thought or an emotion might be is a very far cry from a scientific understanding of it. I defy you or anyone else to design a scientific experiment to prove where the mind is located. I guarantee you can’t do it. So whether the mind is in the brain, in the body as a whole, or impinging on the body/brain from some exterior viewpoint, is simply not a question science can answer at the moment, and may never be able to answer.
But I am still interested in hearing the ideas involved. I love philosophy, actually.
COMMENTING AS MODERATOR – I appreciate the exchange here, but let’s not get too far off of the focus on mental/emotional wellbeing. We all know this is a hotly contested topic and that there is little chance that a lengthy discussion will lead to anything but a lot of conflict and disagreement. Everyone’s entitled to his/her opinions and views, but I don’t want to get into the kind of back-and-forth where one person’s opinion has to dominate and the other person has to be ‘wrong.’
‘Black propaganda,’ as I think it’s called. No interest in actually conveying information, just trying to make a particular person look bad. It’s appalling, yet surprisingly effective, as critical thinking seems to be fading into the land of never-never as a commonly held skill in the world.
You clearly get what I’m saying. Irony is a lost art.
Obviously, the only people benefitting from the most recent ‘improvement’ in ‘schizophrenia’ injections are the ones who save their monthly trip to have to visit their clients and inject them and only have to do it twice a year.
I really appreciated the first part of your comment – I agree that psychiatry has relied on ‘naming’ and ‘categorizing’ to the detriment of understanding and using actual relationships between two human beings as the primary ‘healing’ agent. But of course, it should be understood that relationships are not really within the aegis of medical practice in the first place, so perhaps the first error is for medical folks to try and ‘heal’ emotional/spiritual/relationship concerns.
As to your second statement, your explanation of emotions seems extremely shallow and limited, and not particularly scientific. ‘Seeing’ ‘mind’ as located in the body sounds a lot more like philosophy, as does ‘describing’ emotions in terms of ‘subtle neurological-muscular movements.’ I don’t think it’s fair to claim an irrefutable or even generally agreed-upon scientific understanding of emotions. Sure, there are lots of theories, but all that I’ve seen doesn’t come close to a fully tested falsifiable understanding of what emotions really ARE.
The ‘conservative media’ is honestly not much better. Both ‘sides’ are owned by their big corporate supporters, and greed and graft knows no political affiliation. I know of no nationally recognized leader who has a clue or gives a crap about the plight of the ‘mentally ill,’ on either side of the aisle, beyond the idea of giving more money to the ‘mental health’ authorities or refusing to do so.
If this is such ‘old news,’ why is it that so many clients are being told that they have a ‘chemical imbalance’ – I’m not surprised but I am disappointed. It didn’t take long for the propaganda machine to get started, did it.
Such a mass action would require the current beneficiaries of SSRI sales to agree that such a mass action would be beneficial, or for society at large to strip such people of their power to insist that we use “antidepressants” widely regardless of their actual utility and risks. That is the reason that “logic” becomes important in such cases, though it must be admitted that logic and facts don’t seem to have much effects on the beneficiaries mentioned above.
Your answer is disrespectful and invalidative of my personal experience, and that of anyone else who has had a positive experience. How is it possible for you to know if my therapy experience was or was not helpful to me? You have decided what you believe to be true and insist that the world conform to your belief, even if the evidence suggests a more nuanced approach would be closer to the truth.
Your contention is: “What the psychotherapist does is make you afraid of your feelings and instincts. It is very much like the religious doctrine of original sin. You are to believe that there is something innately wrong with you.” My therapist did none of those things. In fact, she encouraged me to believe in and respect my own experience and emotions and instincts, and to discard all kinds of crappy ideas I’d amassed to protect myself from those emotions and instincts. So she actually did the exact opposite of what you claim “the psychotherapist” does. By the end of our association, I felt a lot more “right” about myself than I ever had. It was the adults around me who wanted me to believe there was something innately wrong with me, and my psychotherapist who supported me in discovering that there was nothing “wrong” with me at all.
And ironically, with these comments, you are the one telling me there is something “wrong” with me for following my own instincts in evaluating my own experience, telling me that I should disrespect my own feelings and instincts.
I don’t think we help anyone by being as rigid and judgmental and bigoted as those we are criticizing. If we are going to defeat psychiatry as you say you want to, we can’t dismiss the experiences of its users as “you can’t have benefited, because it ruins my thesis.”
As I like to say, “Generalizations are always wrong.”
It should not surprise us that benzos, at least, will of course increase the rate of traffic accidents, as the effects and mechanism of action are very similar to alcohol. But this seems to be a very general increase, suggesting that at least in a fairly high proportion of users, a level of intoxication and impairment results from ‘therapeutic’ doses of these drugs. Of course, leaders in the psychiatric world would want this to come out. But I have long had concerns that many long-term benzo users are on the roads under the influence. Now there is even more to worry about!
I think the more relevant fact is that a century ago, most “depressed” people recovered without any help from the “authorities.” Depression as a “chronic condition” was very, VERY rare back in the day. The frequency of chronic “depression,” however defined, has only increased since the helpful insistence of giving everyone who feels bad a ‘diagnosis’ and prescribing drugs that can be harmful and giving up on the idea that a person has the resources to address their own emotional condition, even if they may need some assistance with that. Trying to redefine episodes as really ‘mixed’ vs. ‘manic’ vs. ‘depressed’ is very much an act of rearranging deck chairs on the Titanic. The iceberg has long since been hit and we should be trying to help people escape rather than sorting them out into which room they are to go down in.
I’m afraid I can’t agree with you. I had a very good psychotherapist. I would not be who I am today without her support and intervention. Sure, most of them these days are dogs, but it’s not right that there is no such thing. I think that is a bias you hold, but the evidence speaks to the contrary. I’m sure others here will agree with me that such people DO exist, however rare they may be today.
I’d more refer to that as “social problems that have medical consequences.” Defining the problem as “medical” is the first mistake. Feeling bad is not a medical problem. It could be the result of a medical problem in some cases, but emotions themselves are not medical problems. If it’s a social problem, no amount of “medical treatment” will solve it, and their pretense to the contrary is making things worse.
On the other hand, it’s also possible (and I think likely) that the “treatments” that have “improved so much” are actually making the situation worse, above and beyond any social problems that do exist. At least treatment for resperatory conditions improves those who are treated. In psychiatry, it may mean you die 25 years sooner with “successful” treatment.
I know you’re not arguing with me about these things, I’m just responding to the “Devil’s advocate” position you put out there.
Maybe I’m just not feeling too inclined to be “fair” to the psychiatric profession today!
Exactly! How can you hear, “Our treatments have improved, but people are getting worse” and not be stopped by the irrationality of it all? How CAN a medical problem require a social solution? Makes zero sense, but people just not their heads and “agree” to something they can’t possibly understand, because it literally makes no logical sense.
How does a rational person believe that “treatments have gotten better and better” at the same time as outcomes have gotten worse and worse? How can better “treatments” lead to worse outcomes??? Why is this contradiction not totally obvious to readers of his commentary?
My guess would be that it depends on the person/people you get to talk to, as well as the general philosophy of the hotline. The more “professionally staffed” the hotline is, the less likely I think it would be helpful.
I think that is a very insightful comment. It is the judgment about a particular mechanism adding emotion that seems to make it “automatic” and unable to be rationally processed. There is nothing wrong with having mechanisms to deal with reality. Feeling we HAVE TO or CAN’T or “SHOULD” or “SHOULDN’T” with intense emotion is what gets us stuck, I think. I can say in my own case that learning to view such mechanisms more dispassionately (“What was I trying to accomplish with that approach? Why did I choose to handle it that way? Did it work? If so, what makes me keep trying to use that approach?”) has been what has helped me gain more control of my life.
Alice Miller and I would both agree with you on that last point! In fact, I think one of the very worst aspects of the DSM is that it enables the “professionals” to blame the “clients” for their own (the professionals’) discomfort with the helping process. It is not only not helpful, it seems to me that the very WORST thing one can do in such a situation is to put the client at a distance by providing a label and to call his/her experience “symptoms” caused by a “faulty brain” that need to be suppressed! In actual point of fact, it is almost always the SUPPRESSION of their own emotions and experience that CAUSES their “mental illness” in the first place! Other than “surgery” on the brain, it’s hard to think of anything worse that one could do than the label/blame/drug model that the DSM was constructed to encourage and justify.
You are far from alone. I used to work at a crisis line (a volunteer-based one), and people would report calling us because they knew they couldn’t talk to their therapist or else they’d be sent to the “hospital.” This was especially true for people who cut on themselves and were not in any way suicidal. We never would send out police on those calls, but we did sometimes trace suicidal calls on those who appeared to be about to act on a plan to kill themselves. I know that this and other hotlines have been “professionalized” (no longer volunteer based) and are much more likely to send the police on callers than we were. I volunteered for a hotline here in Olympia, WA, who did not ever trace or dispatch on anyone unless they asked us to do so. But such hotlines seem to be disappearing. I also have known many who found being hospitalized so traumatizing that they’d rather suffer their “symptoms” forever rather than risk being sent there. It is a sad commentary on the level of “help” that is currently available.
Exactly! Every “mechanism” has a motivation behind it. Most of them made some sort of sense when we invented them, but aren’t very useful today, or we use them when they aren’t helpful. I think that’s most of what is classified as “crazy” in the DSM, people using coping mechanisms they once found helpful in places where they’re not helpful any longer.
I’m quite sure you’re right – the desire to somehow “rewire” people to be the way others want them to be is at the center of psychiatry’s motivations. And it will always lead to destruction!
Well, to me, it’s just a habitual thing we do with our minds to accomplish something. ‘Survival’ and ‘coping mechanisms’ that you mention would qualify in my view. In my analogy, it would be the equivalent of the “program.” I think there are mechanisms that are conscious and intentional (like how do you drive a clutch car, or how do you make a curried chicken dish). And some are unconscious (like how to deal with someone who tries to make you feel small, or how do you deal with your sister tattling to your mom). I think we get fucked up most by the unconscious kind, because we don’t remember why we feel like we have to “run the program,” but we just know we HAVE to. Conscious ones we can change if circumstances require it (like I buy an automatic!)
That’s how I think of it, anyway. Don’t mean to speak for lecox or anyone else. It’s definitely NOT a physical universe thing to me!
The DSM committees have never been overly concerned with scientific veracity. They are telling a story. Fact that get in the way are discarded without a second thought.
I don’t think that’s necessarily true. “Mental mechanisms” may have zero to do with the body. The “mind=body” equation is central to psychiatry’s worldview, but there is no reason to believe that “mental mechanisms” don’t exist entirely independent from biochemical operations. To use the hackneyed computer analogy, there can be lots of mechanisms in a computer program that are completely undetectable in the physical operation of the machine. From the outside, the computer looks the same no matter what program or calculation is going on. Just ones and zeros and switches and connections. But the code that is run is vastly, perhaps infinitely flexible. I don’t at all believe the mind is a computer or even like one, but I think the analogy is apt. Messing with the “hardware” is a dumb way to solve a “software” problem, let alone a problem with the programmer him/herself!
No specific “thing” causes “depression.” Depression is a state of mind, not a medical entity that can be “caused.” Many things may “lead to” depression, but this research thoroughly disproves that any commonality in serotonin processing or levels has the slightest thing to do with it in a general sense. Researchers need to get a clue and start looking for subgroups who might actually have things in common with each other.
It is sounding like your voice is being dismissed and they are treating you as if you have no understanding of what is going on and need them to make decisions for you. I’m so sorry you are experiencing this kind of behavior!
So their final recommendation is, “We have to do something, so let’s do something stupid that makes things worse, because otherwise we’d be ‘turning a blind eye.'” How does that make sense?
I also noticed that the study doesn’t mention the very high possibility that screening led to SSRI “treatment,” which is associated with INCREASING suicide rates, especially in youth. This seems a likely explanation for at least some of the increase in ED visits.
It is beyond silly to “screen” for something that you can’t objectively detect, and for which you have no effective “treatment” or intervention to offer. Such “screenings” are clearly an effort to increase their client base, and fit better into the rubric of marketing than they do of medicine. I recall a doctor once saying, “So I got a positive screen for depression. Now what am I supposed to do about it?”
Depression screenings are a scam and should be illegal.
I think it is unconscionable that they would increase your medication levels without so much as a “by your leave.” I wish I found it shocking. What is your best response to this? If you let them know your strenuous objections, are they responsive in backing off to where you were most comfortable? You are a voluntary patient – they ought to be consulting you at every turn in the road.
I agree 100 percent! People need HELP, but not because they are BROKEN and need some sort of “repairs.” They need compassion and interest and maybe a few ideas for new perspectives. And they need some HOPE for a better future. Some people can be helpful, but a big part of being helpful is NOT thinking that you know better than the person needing the assistance. The person him/herself is the only one who knows what is going on or what will end up being helpful. The best we can do is facilitate the process.
It has to be OK for people to experience suffering without having it “fixed.” Psychiatry’s main thrust is to STOP people from feeling x or doing y. Good therapy should rather make it safe for people to experience whatever they are experiencing without judgment or a need to “fix it.” A person isn’t broken because they are suffering. They are just suffering. It’s part of the human experience.
That is also my general experience. Once someone is labeled “borderline,” they are sometimes the butt of denigrating “jokes,” and are often spoken of in condescending terms, and regarded as “problem clients” who can’t really be helped. Not everyone behaves this way, but such behavior occurs without sanction or challenge, it is accepted to trash talk “borderlines” in a most dehumanizing manner.
It seems you will not be able to understand and/or accept what I am saying, as your response appears to again criticize without specifics, and does not seem to address what I see as the central conflict we are having. So I will choose to back out of this conversation. I would just appreciate it in the future if you do not accuse me of offensive behavior without giving a specific example and a specific reason, but if you do continue to make such nonspecific accusations, I will choose to ignore them.
I am concerned that you are making assumptions about the meaning of my comment that are not my intentions.
I have never stated or implied that TREATMENT BY SOCIETY is better/kinder/not abusive in every tribal culture. What I said was ONLY that the content of voices is affected by culture, per the studies I have read:
I find that fact very interesting. I think it adds some complexity to the picture of how one might best approach someone who hears voices to get a better idea of what might be helpful. It is not meant to disrespect your views of your own situation.
I have also not heard people here “denigrating your schizophrenia” in general, and I certainly have never meant to do so. There is general disagreement about whether “schizophrenia” is the name of a “disease” or “disorder” or merely a description of phenomena which really do occur but are not attributable to one, concrete, biological “disorder” or possibly a wide range of causes, such that one case may have little or nothing to do with another. This is very different from specifically attacking or “denigrating” you for your view of your own situation.
With all due respect, we all have a right to disagree about things that are not determined to be “factually true” in a general sense. I have never once disrespected your right to label yourself with “schizophrenia” and to believe that you personally have a problem with your brain that causes your voices and other symptoms to occur, and in fact have state repeatedly that you absolutely have that right and that I do not question it. I also agree with you 100 percent that bullying others into agreeing to comply with someone else’s belief system is a huge problem. I would like you to grant me and others the same right to believe differently than you about THE CONCEPT OF SCHIZOPHRENIA IN GENERAL, without taking it to mean I intend some criticism of you individually and your beliefs. In truth, I find it likely that some people do, in fact, have difficulties with brain functioning that lead to some cases of “mental illness” as described in the DSM. I just don’t believe that we can define a “disease” for OTHER PEOPLE by looking at their thoughts, emotions and behaviors. Until there is some way to distinguish which people have or do not have a biological problem, and what exactly that problem may be, I’m afraid the final assessment will remain up to the individual client, not to the psychiatric “thought leaders” or individual mental health professionals.
My objection is not YOU believing in schizophrenia and biological causation for you, and I have no criticism of you for choosing to approach the situation in ANY way you feel would be helpful. My objection is to DOCTORS and other MENTAL HEALTH PROFESSIONALS telling their CLIENTS that they “have a chemical imbalance” and “need drugs” when they have no real idea what is going on with that particular person. I have NO problem with the CLIENT identifying as “ADHD” or “Autistic” or having an “anxiety disorder.” I just don’t think it’s someone else’s job to pretend that they know things about the client that they do not.
If you believe I have in some way “denigrated your schizophrenia,” I would appreciate you directly stating exactly what I (or someone else) might have said that you find denigrating. That way, we might be able to come to some kind of an understanding. But I really don’t like being treated as if I’ve done something wrong without knowing specifically what it is that you are objecting to and why.
There is no way to be a failure at being a psychiatric survivor. All you have to do is survive. And if you can tell your story, so much the better. You deserve admiration for your courage!
An interesting fact you might want to know is that studies of voice-hearing people in cultures where hearing voices is accepted or viewed as a gift have their voices say a lot more positive things. There is excellent evidence from the WHO studies that people in developing countries have MUCH better long term outcomes, despite (or because of) using a lot less psychiatric drugs in the process. Culture and expectations apparently DO have a very significant impact on how “schizophrenia” is experienced.
The comment makes it sound as if stigma “rubs off” on the providers, when in actual point of fact, the providers themselves create the stigma they are complaining of. The main reason psychiatry is viewed as a sketchy, unscientific, unprofessional branch of medicine is because psychiatry IS sketchy, unscientific, and generally unprofessional. Psychiatry has earned and deserved the reputation is has. Its patients have not earned or deserved the prejudice and discrimination that the psychiatric “profession” has brought upon them by their own unscientific and unprofessional behavior.
I would have to disagree that these drugs are not coerced or that there is no visible violence, except to the extent that folks who have never seen the inside of a psych ward have not witnessed such violence being applied. There are tables in there with wrist and ankle and waist restraints, and people get wrestled into them, or held down and injected with psych drugs (as “masculine” an act as I could ever imagine.) Additionally, mothers do not own the market on telling people they aren’t responsible for their actions.
Perhaps more importantly, history shows us that women are, in fact, the targets for certain interventions, in particular ECT, and for certain diagnoses, in particular, “Borderline Personality Disorder,” among others. Phyllis Chesler has written extensively about this in “Women and Madness,” but she is certainly not the only one.
Finally, psychiatry is fully the invention of white European males, with very little contribution from other sources. While it has become more “diverse” as the decades have passed, the basic assumptions, particularly the idea that a “sane” practitioner can determine the “insane” patients by observation and can use force or coercion to get them to behave “properly,” have never actually changed. The more recent marriage to the pharmaceutical industry to use drugs and ECT to alter someone’s brain to stop them from feeling the “wrong” things and/or behaving the “wrong” way certainly fits with a historically “patriarchal” worldview, namely that the “authorities” get to decide what YOU ought to do, and dissenters are to be punished. It’s true that the “punishment” has taken on a different color, mostly due to the presence of mass media and drug company marketing of “diseases,” but when push comes to shove (sorry for the ironic analogy there!), psychiatry is a top-down, fully authoritarian effort to “make people behave,” and it is very much backed up with the full use of government and social force to make its pronouncements stick OR ELSE.
That is pretty damned offensive – makes “the seriously mentally ill” (who of course could be anyone “the authorities” so deem, given there is no objective way to assign such a label) sound like the enemy and psychiatry frustrated to be unable to defeat them and their “unattractiveness.” This kind of comment reveals a lot about the contempt in which such people are commonly held by those running “the system” that is supposed to be there to help them.
I agree, it’s worse in a way. Kind of like how the culture of Nazism in WWII allowed more “normal” Germans to feel OK about committing atrocities against Jews and Gypsies and so on. An individual narcissist can be dealt with once you know who and what s/he is. A culture set up with discriminatory rules is much harder to fight!!
And of course, it does make it easier for true narcissists to find a spot to do their dirty work!
I think you hit the crucial point here: the person has REASONS they choose to ignore the evidence, and WE DON’T KNNOW WHAT THEY ARE! Calling something “delusional” is a judgment placed on them by the “experimenter,” and as soon as that is done, we stop being scientific.
Isn’t it a shame that the title can’t just read, “Exercise makes people feel better!” Why do we have to talk about “lower risk for depression?” How about “Better chance of enjoying your life?”
Well, that’s what I eventually had to decide. I realized that it wasn’t because they “didn’t understand” that their interventions were harmful. The people in charge actually believed that “stopping symptoms” was the actual GOAL and that quality of life issues or trauma history or WHY people had the feelings they had were actually not relevant. I remember talking to one psychiatrist about the “medical model” and drug “solutions,” seemed like a perfectly nice person, and I asked him about PTSD. I said, “Well, at least for PTSD, we can say with certainty that it is caused by traumatic events, not malfunctioning brain chemistry.” And he said, “But not EVERYONE who is traumatized gets PTSD! So there must be SOMETHING different about their brains that makes them vulnerable!” I gave up on the conversation at this point.
But this guy was not “narcissistic” in his presentation in any way. I think he was just trained by and believed in a system that treats ‘the mentally ill’ as objects or lesser humans. As I’m writing this, I think that’s the basic problem. There are plenty of non-narcissistic people who believe that black people “should get over slavery,” that feminism means hating men, that gay people are dangerous pedophiles, and all sorts of stupid things, because cultural prejudices allow them to entertain these beliefs without challenge. Bottom line, the system trains people to DISCRIMINATE against “the mentally ill,” and those who resist are themselves ostracized, ignored, or attacked for challenging the system. It’s not a matter of individual narcissism in most cases. It’s a culture of bias and disrespect and prejudice that these individuals are participating in that makes them feel OK about treating “the mentally ill” as “less than” without any pangs of conscience disturbing them. And of course, Alice Miller’s considerations play strongly into this, as the culture provides ample cover for the “professionals'” need to punish or silence their clients for making them feel uncomfortable with their drama.
When you get better, it’s always because of the drugs. When you get worse, it’s always because of you or “your disorder.” The drugs always get a free pass, every time.
In fairness, I started out in the “mental health” system because I wanted to help people, as I had been helped by my therapist, who frankly did a great job in many ways and really helped me get onto a new path in my life.
Of course, I was never a “follower” and always was suspicious of the “medication” advocates and the DSM never made sense to me, and was viewed as a rebel and often tossed monkey wrenches in the system, but still I had opportunities to be helpful in a genuine way, and people seemed to appreciate what I could do, so I continued for over 10 years in the profession. It wasn’t until I worked doing “involuntary detentions” and saw what happened to people in psych wards and how many “mentally ill” people were labeled, drugged and forgotten, their quality of life total shit but their caseworkers interested only in whether they were “on their meds” and what their “symptoms” were, that I felt I had to get out for ethical reasons. Don’t get me wrong, the people who got me for their “evaluations” were quite fortunate, I had by far the lowest rate of detentions in our agency, and I sprung some inmates from the joint as well, but I could not ethically hold people against their will in such horrid conditions as prevailed in the psych wards.
So people do learn and grow and sometimes grow out of their excuses or explanations for overlooking the real horrors of the “mh” system. Of course, the system is far worse today, and I doubt I’d have lasted 3 months, but there are people in the “system” who don’t really believe in it fully, and we ought to give them some credit for operating behind enemy lines. It’s not a fun role to play!
I’m not totally sure about that. I think it may be that a certain “brand” of narcissist is attracted to the field, kind of like police and the military. There are also lots of people approaching it with good intentions, but the DSM does make it easy to indulge in narcissistic fantasies. It’s also true that when things get difficult in a “therapeutic relationship,” there is, in my experience, a very strong drive to “fix it” because it is VERY uncomfortable to have to sit with someone else’s pain right in front of you. But I’ve found the key to success is being WILLING to tolerate that pain being there and NOT knowing what to do about it and letting that be true while looking around and exploring what that pain is looking like. The DSM/drug model unfortunately allows someone looking for an “out” to simply say, “Wow, you must have ‘major depression'” or “I think you need antidepressants” instead of hanging in there and believing that a good direction will emerge if we are patient and willing to sit with that discomfort for a while.
So I think the major challenge is that therapists enter in totally unprepared, have NOT done the work to deal with their own pain, have that pain brought back to the surface by their client, and then feel they have to stop the client from having those feelings because they want to feel better themselves. And the label-and-drug model makes it all too easy to act out those “savior” fantasies within the expectations of your supervisor or “the system.” It’s pretty much a setup for failure. I admire those who are able to work within that system and still help people. I finally gave it up and decided advocacy was the better path for me to go.
The main qualification for a therapist is not degree or training or years of experience. It’s the degree to which they have dealt with their own childhood trauma and disappointments and enforced roles. Alice Miller got it right!
I agree. Embracing disagreement teaches us to be bigger people. Fighting to be “right” makes us smaller. My biggest challenge comes when I’m trying to be big and encounter those who want me to be small again. It is tricky to handle that without lowering oneself to the “make them wrong” viewpoint.
I think these are important insights. It took me a long time to realize that someone else disagreeing with me had to do with them, not with me. I mean, I understood that intellectually, but to get so I accepted that fact emotionally took a long time.
I am sure I’m not totally consistent, and you’re right, it depends a bit to whom I am talking. For some, they will be less able to hear what I’m saying if I use the term “drugs.” I try to use quotes whenever I use the term, but sometimes, I do get on a roll and get sloppy!
I think he meant he’d use quotation marks to show disbelief or contempt for the word usage, to indicate irony. But I’m with you, why not call a spade a spade and just say “drugs,” unless you’re referring to someone else’s use of the term? The truth is generally better than beating around the bush.
The term “overdiagnosis” itself is a euphemism for malpractice, drugging people for no known cause. Let’s not mince words here! It’s not “overdiagnosis,” it is FRAUD, and it is financially incentivized instead of penalized as it ought to be!
LISTENING to clients? No wonder you were blackballed! That’s radical crazy talk, that is! Next thing you know, you’ll be CURING people, and then where would the psych professions get their clients?
All I can say is, I totally shared your concerns and experience. What the kids said counted for nothing, parents or foster parents were snowed under with technical terminology and fear mongering, and anyone calling out the ill effects of a particular case of psychiatric drugging was in for an attack.
I don’t think that diagnosis is a priori wrong in the “mental health” area. I just think that such diagnoses should represent something actually distinguishable from a different “diagnosis.” The DSM itself admits it fails to do this (actually that it doesn’t even ATTEMPT to do this) in its introduction. CBT is just a way of engaging a person’s thinking process in interfering with their habitual behavior. It’s possible it may be more effective in disrupting anxious thoughts than in stopping, say, hyperactive behavior, but that’s just a percentage based on the kind of “symptom” we are dealing with. The fact that CBT may be more useful for someone feeling anxious does nothing to confirm that anxious people are anxious for the same reason, that anxiety is de facto a “disorder” or “disease” state in all or in fact in ANY case, and studying “anxiety disorders” means studying people who most likely are quite diverse and heterogeneous, meaning that even if 80 percent of people can apply the list of definitions and come up with the same “diagnosis,” there is no reason to believe that these people have anything in common other than the fact that they happen to fit the list. It’s sort of like saying that if 80 percent of people can be identified as suffering from “knee pain,” it means that “knee pain” is a valid diagnosis. Of course, it’s nothing of the sort. Knee pain can be caused by a score or two of different actual diagnoses, including a bruise, water on the knee, arthritis, a torn ACL, MCL, or other ligament, a torn cartilage, etc, etc, etc. “Knee Pain” is simply not a useful diagnosis. Pretty much every psych diagnosis is similarly useless. What if one person is depressed because of thyroid issues, one because of childhood abuse/neglect, one because he’s in a dead end job, another because she’s suffering from domestic abuse, another because he can’t figure out the meaning of his life, another because he just got diagnosed with cancer, and another because she’s got severe anemia. Feeling depressed, losing sleep, losing joy in things we used to like, these are subjective, almost arbitrary items that could all be caused by dozens of reasons. It’s scientifically incredibly weak to try and do “research” on these so-called “diagnoses,” not because diagnosis is wrong but because these diagnoses don’t provide any explanatory model for what is wrong and what might be done about it, except on the most superficial level. It’s very much like diagnosing “knee pain disorder.” If we accepted that as a diagnosis, guess what would always be the most effective “treatment?” That’s right, drugs. Do you think the “atheoretical” diagnostic plan was created by accident? Or is it perhaps intentionally done to make marketing biological “solutions” a lot easier.
Actually, advanced imaging has contributed to proving that the DSM concept of “mental illnesses” is complete bunk for almost all so “diagnosed.” It is showing that folks with the same diagnosis have almost nothing in common, except for common damage from the drugs they may be taking.
And my retort to your neurologist relative is this: I’m a very smart person. If you can’t explain it to me, it’s probably not because I can’t understand it. It’s because either you don’t want me to know, or you don’t understand it yourself.
By the way, I do support doing research on “diagnoses,” but only for the purpose of demonstrating the fecklessness of “diagnosing” people in this slipshod manner, or the lack of effectiveness of a given “treatment” for such “disorders.” I consider any research done using the DSM categories to be prima facia false, as the groupings of people on that basis have no scientific validity (they are heterogeneous groups having no known, measurable qualities in common). The main error in the DSM is assuming that people who have the same “diagnosis” have something wrong with them, or the SAME thing wrong with them all. The DSM itself even admits to this failing. But what is the use of a “diagnosis” that groups together people who have nothing in common? It is literally possible for two people to have “Major Depressive Disorder” or “Generalized Anxiety Disorder” and have not one single trait in common with each other! From a scientific viewpoint, the DSM is utter garbage!
How can a “diagnosis” be reliably made when the criteria are totally subjective in almost every case? What is the standard for reliability, merely that other people’s opinions agree with yours? And if that’s the case, shouldn’t we be using language such as “people typically labeled as ‘bipolar'” or “people typically labeled with ‘major depressive disorder?'”
I found the same thing with foster youth or their parents or foster parents. No one was really given informed consent. One facility had a “clients’ rights” sign on every wall that said they had the right to know the intended benefits and potential adverse effects of any medications they were given. When my CASA volunteer asked the therapist when that had happened for her charge, the therapist said, “No, we never do THAT! They might pretend they had the side effects or decide not to take the medication!” Which is kind of the point of “informed consent,” isn’t it? That was the attitude I met every day. Doctors knew best, people needed to do as they were told or horrible consequences would ensue, and anyone who said otherwise was brainwashed or “anti-science” or just didn’t understand how important these “meds” were. Yet 9 out of 10 kids stopped their “meds” or cut down to one almost immediately after they escaped foster care, and very few that I knew of suffered any adverse effects in the long run. And when asked at multiple “foster youth panels” what kind of intervention they found most helpful, not one of them ever mentioned “medication” as a key to their success. It was always a person or a relationship that they identified as what helped them through. Sometimes a therapist, but never once a psychiatrist or his/her “medications.”
Part of the problem is that “overdiagnosis” and “overmedication” are not concepts that can be applied to psychiatric “treatment,” because there is no objective way to determine who does and does not qualify for a “diagnosis” made from a checklist of behaviors. So we decry “overmedication,” but the next person who comes in “depressed” for whatever reason can be reasoned to “qualify” for “major depressive disorder” and thereby be drugged once again. Add in the strong financial incentives to drug anyone who comes in the door, and you get the disaster that is “mental health treatment” today.
I notice that you seem to continue to view clients from a viewpoint of “diagnosis” and “treatment.” CBT to me is simply one of many techniques that can help certain people get a perspective on what THEY can to do improve their lives in ways that they find helpful. I never cared one whit what “diagnosis” they had. All I cared about was what THEY saw as the problem (often requiring some pretty good interviewing skills to help them figure out) and what THEY felt was helpful in moving forward. Sometimes CBT was perfect, sometimes it was useless, not depending on the “diagnosis” but on the person’s personality and goals and viewpoint on what they are trying to accomplish. Similarly, some people did REALLY well with regressive techniques, others wouldn’t consider it or it wasn’t really realistic given the circumstances or timeline or it just plain didn’t work. Some do well “brief therapy” techniques (what did you do the last time this happened?), while some find them insulting. Sometimes I made stuff up on the spot specific to that particular person. My primary rule was, “Gather information. Try something that seems to make sense. If it works, do it more! If it doesn’t, stop doing it, gather more information, and and do something else!”
Milton Erickson said that therapy needed to be “reinvented” for every client/case. He was correct. I tried to approach each case with a “Beginner’s Mind,” as they say in Buddhist teachings, open to experiencing what is before me, no preconceptions or judgments or plans. I found that “diagnoses” did nothing but confuse and distract me from getting to know the PERSON in front of me, which was the key to my success in the field. The question to me was never, “What is his diagnosis” or “what is wrong with her?” or “what school of therapy should I follow?” It was more like, “Who is this person? What’s important to them? What are their goals and what do they see as barriers to those goals? What kind of fixed beliefs or behavior do they seem committed to that don’t make sense to me, and why do they make sense to them? How can I assist them in stepping out of their normal ‘scripts’ and see what alternatives might exist?” There is no formula for doing this – one has to simply roll up one’s sleeves and be humble enough NOT to “know” things about this client that you really don’t know at all.
People are mysterious. Psych “diagnoses” don’t help us understand the mystery, they trivialize and confuse the real issues that we ought to be looking at. If I were you, I’d consider dropping them from your vocabulary.
Commenting as moderator: I can contact each party and get their agreement to exchange contact info, then send you both an email so you can communicate.
I prefer to look at it as most people going through a series of learning experiences and coming up with a more effective way to conduct their lives. Psychiatric “diagnosis” and “treatment” interferes with that natural learning process, both biologically and psychologically.
We definitely agree on that, and that’s a good start to a deeper conversationn. It’s very important to understand not everyone has your kind of experience. I have thankfully never been held against my will, partly because I’m older and grew up in an era where “mental health professionals” were more interested in relationships and experience and less in proving biological causation, and because I lucked out and got a really good therapist on the first shot. Plus I am a white male with a college education, privileges the majority of those held against their wills don’t have. But in today’s environment, it’s quite possible I would have been “hospitalized,” because I definitely did express feelings of suicidal ideation during my therapy. I’m happy to have dodged that bullet. Others are not so fortunate.
My distrust/disdain for psychiatry is not based on my personal direct experience as a client, it is actually based on comparing the conclusions of real scientific research to what front-line psychiatrists and “thought leaders” tell us is true. It started with “ADHD.” My son clearly fit the criteria, and I was concerned it would come up when he got to school age, so I did some research on long term outcomes. I was STUNNED to find that there was no long-term research suggesting that ANY long-term outcome, including academics, school completion, college enrollment, delinquency rates, teen pregnancy rates, social skills, or even self-esteem, was improved for “ADHD” kids taking stimulants vs. those who don’t or who take them only short term. I’ve tracked on the research since then, and that continues to be the case. Yet I heard psychiatrists and school personnel saying things like, “Untreated ADHD leads to school failure and higher delinquency rates,” when “treatment” did nothing to improve those outcomes!
I have since tracked research on antidepressants, anti-anxiety drugs, antipsychotics, and to a lesser extent, “mood stabilizers,” and the exact same pattern emerges. Antidepressants are insisted on as “life-saving” for suicidal people, yet there is no evidence they reduce the suicide rate, and suggestion that they may actually increase it. Antipsychotics are supposed to be essential long term to prevent “relapses,” yet those who take them long-term are MORE likely to be re-hospitalized or otherwise deteriorate than those who use them short term or not at all (see Harrow’s work, referenced in Anatomy of an Epidemic). These are large scale studies of many people, and don’t imply that no one is helped by these interventions. It means that on the average, people are better off not taking any of these drugs for the long term. And people are not told this, and ought to be.
So the reason I distrust psychiatry as a profession is because they’ve been dishonest. They’ve claimed that all their DSM diagnoses are entirely or primarily biological in origin, despite a lack of research suggesting this is true, and a commonsense critique that claiming the same cause for everyone’s “depression” or “anxiety” flies in the face of reason. They’ve lied about the research that IS done, and have attempted to suppress real data that comes out which contradicts their desired narrative (Harrow, Kirsch, the WHO intercultural studies, etc.) They accuse people like Robert of being antiscientific or cultists just because their findings challenge that narrative. So no, I don’t trust them, and it’s not for emotional reasons, though I consider a person having been personally brutalized an excellent reason to distrust them anyway. But I’m not one of those. I worked IN the system for years, and I saw what really happened as a result of this system. Not saying that all psychiatrists are evil or stupid, nor that people for whom these treatments work should be denied access to them. But I don’t think medical professionals should lie to people about what they “know” in order to get them to agree to a particular approach. Do you think it’s OK for an entire “medical” industry to misrepresent the facts in order to increase their market share? I don’t, and that’s why I have no trust or respect for psychiatry as a profession, regardless of my positive interactions with some psychiatrists and the reported successes of some percentage of patients.
I hope that makes things clearer on where I’m coming from. If you haven’t read Anatomy of an Epidemic, you really ought to. It is very well researched and non-emotional in presentation, and might help you understand the “rest of the story” for people who have not been as fortunate as you and I have.
You are fortunate to have had that experience. In my long experience, it is not typical. Having money does give a person a lot of options that those with limited funds can’t afford. Not to mention those who are held against their wills. There are a lot of different experiences shared here, and I hope we can all respect that fact.
There is a LOT of effort to try and prove that it’s all biological, despite decades of failure. But as to actually trying to UNDERSTAND why these things happen, there is almost no research at all. And research that assumes a conclusion before it begins is not really scientific research at all.
I challenge you to show me hard evidence that there is “some kind of chemical disruption in the brain” of all or most people who fit the criteria for “MDD.” The idea of the “chemical imbalance” theory was disproven back in the ’80s, before Proac even came to market. Even mainstream psychiatrists are disavowing this theory and claiming that they never supported it. They’ve moved on to the idea of “circuits” and of “genomic analysis” because their original theories on cause have never panned out.
Of course, nobody knows if it’s nature or nurture, and as in pretty much everything, including hard biological illnesses like cancer, diabetes, and heart disease, it’s no doubt a combination of both. The “diagnosis” is not made by any kind of brain scan or measurement of brain chemicals or EEG or any kind of measurement – it’s just a list of “symptoms,” and most doctors don’t even bother using those. How would it be possible to distinguish “clinical depression” (supposedly caused by biology) from any other kind of depression just using a checklist of symptoms?
Your case may be particular, you may have some biological vulnerability, but I would bet that no one has shown you what exactly is wrong with your family inheritance. In any case, just because your case may be biological doesn’t lead to the conclusion that any other case is biological. The psychiatric profession makes a common but serious scientific error in assuming that all subjects with similar presentations have the same problem. This is, of course, nonsense scientifically, as something like a rash can be caused by dozens of things, including poison ivy, prickly heat, the measles, or syphilis. I’d sure want my doctor to be able to tell the difference before they started ‘treating’ my rash!
The other interesting scientific question is: If there is no objective way to tell who “has” “clinical depression” caused by a “chemical problem,” how would anyone be able to determine what “overprescription” would mean? What’s an appropriate level of prescription look like for a disease that has no reliable physical markers whatsoever? That’s one of the biggest problems with the DSM approach – no one can really tell if the doctor is right or wrong, because it’s all a matter of “clinical opinion.”
Again, I support anyone who finds antidepressants useful, or anything else that helps them. I don’t deny that depression can be a HUGE problem in a person’s life – been there, done that. But that doesn’t make it a medical problem. The burden of proof should be on those claiming it is, and they haven’t met the standard.
Additionally, the article itself makes it clear that most people do NOT benefit from antidepressants. Why do you think that is, if it’s a biological problem? Or how can you distinguish the bio-depressed from the psycho-spiritually depressed? Or those depressed because their lives are depressing? How can you tell?
Just to be clear, Maggie, I don’t think anyone here thinks a person should “just get over it.” That’s a trope that is tossed out by the psychiatric industry to try and discredit their critics, pretending critics are saying, “There’s nothing wrong, just quit whining.” But that’s not the critique here. The proble is the CLAIM that “depression” is a DISEASE STATE without providing any evidence that this is the case, and then pretending they can somehow TELL who “has clinical depression” and “needs medication” while in practice recommending drugs for pretty much every single case they run across.
I have suffered a lot from chronic depression and it took years, decades really, to truly get a handle on it, and it still is a problem sometimes for me. But I don’t hold that I have a “disease” that can be somehow cured by messing with my brain functioning, because there is no evidence that either of those things are true. I also know that some people find antidepressants helpful on a personal level, and I have no concern about that. But I do have a concern about professionals making claims of scientific support for something they have no actual understanding of, particularly when they approach it in a completely biased manner and deny evidence that really IS scientific, such as the fact that most people do NOT get better on antidepressants, as this article shows us.
See, you’re dangerous! You keep actually healing people, next thing you know, they’ll have to go looking for clients! And they’ll be expected to actually HELP the clients, too! Which means having to find even MORE clients! There is SOOO much more work that way!
The most obvious one was the Germanwings aircraft murder/suicide. The guy TOLD his psychiatrist he was having trouble with his “meds” and asked for her help. I don’t think she did anything but continue him on the same drugs. And 150 people died needlessly. But his “mental disorder” was blamed instead of the psychiatrist’s mapractice and neglect.
POSTING AS MODERATOR: It sounds like you two are not going to see eye to eye on this issue. How about we leave it at that? Just a suggestion. I don’t see either one of you attacking the other, but I don’t see you approaching an understanding, either. Just restating positions, which is OK, I guess, but where is the discussion heading?
“Treatment resistant” is such a ridiculous term! It implies that EVERYONE should respond to “treatment,” and that anyone who doesn’t is either personally resisting, or their “disorder” (a mental construct!) is resisting! Why not just say, “Our treatment failed” and leave it at that?
What would you think if you took your car into the garage, the guy worked on it for two weeks and then gave it back and said, “The problem is, you have repair-resistent fuel injectors! I can’t fix them, but if you come back once a week we can treat the symptoms…” You’d get a new mechanic double quick!!!
“Treatment resistance” is a loaded term meant to blame the client for the doctor/therapist’s failures.
I am so sorry to hear how distressed you are feeling! It sounds like you have a great love of life. I hope that will sustain you. While I don’t know what it’s like to have your condition, I do know what it feels like to wonder if life is worth living. I will be thinking of you today.
I agree. I think in the end we don’t even disagree that much. I just think we are missing each others’ meanings. Though our latest exchange has helped me with that.
If you’re ever in the Great State of Washington, there’s some great hiking just outside my door!
I think it makes it worse, because if Jim is right, it means the doctors are intentionally and knowingly lying to their patients in order to obtain compliance with their “treatment plan.”
No, that is NOT what I want. I simply want you not to classify people who experience hallucinations/delusions as “schizophrenics who believe they have that” or “schizophrenics who believe they don’t have that.” You are ‘diagosing’ that person against his/her will, even if you accept that they “don’t believe they have that.” Why not call it “people with delusions/hallucinations who call it an illness, and people with delusions/hallucintions who don’t call it an illness?”
It is more like a Muslim trying to convince ME that I have to do Ramadan, because she’s a Muslim and that’s her lens. I hope we are capable of rising above that.
But thanks for the clarification. I believe I understand your views much better now, and my prior confusion is quite fully cleared up.
You are clearly empowered to believe in your doctor – s/he may even be right! What I am saying has absolutely nothing about you or your diagnosis or your belief in your psychotic experiences as an illness or agreeing with your doctor. The objection I have is to you saying that because YOU believe your doctor and his/her diagnosis, it means other people who view it differently are “choosing to believe” something you regard essentially to be wrong. And you’re entitled to believe that, just as others are entitled to believe you are “wrong,” but most of your comments reflect an “open minded” attitude, live and let live, believe as you see fit, which I agree with. I was just pointing out that others should have the same right as you, not to be talked to as if their belief that their situation is NOT caused by biochemistry or is NOT called “schizophrenia” just because the doctor says so is irrational, which is what I was getting from your post. People don’t just have the right “believe their schizophrenia is something else,” they have every right to believe that they don’t have schizophrenia or that doctors’ “diagnosis” of schizophrenia doesn’t meet minimum scientific standards as a “diagnosis,” even if the condition described does exist.
“IF…
anyone has schizophrenia and prefers to regard it as not schizophrenia but some other ailment or stress or trauma or government plot or even extra terrestial indoctrination…
I will be encouraging of this YOUR CHOICE of way you know YOU”
It seems you are saying that others DO HAVE schizophrenia but are REGARDING it as “not schizophrenia.” This seems to violate your own principle – you are telling them that they DO have schizophrenia even when they don’t regard it that way. You want others to allow you to BELIEVE or ASSERT you have a disease called “schizophrenia.” Why do you not respect others rights to BELIEVE or ASSERT they do NOT have schizophrenia? If you respect that right, how can you say that they “have schizophrenia” by your own or the doctor’s definition and are REGARDING it as “not schizophrenia?” It sounds as if you are saying that you know they DO have it but are willing to tolerate them claiming otherwise. Is that how you see it?
Or does the other person have a right to DEFINE their experience as they please, since there is no objective way to “diagnose” schizophrenia beyond a list of thoughts and behaviors made up by a committee of psychiatrists? If everyone has a right to their own interpretation of reality, why would you or the doctor be in any position to define their condition as “schizophrenia” and then magnanimously grant them the right to “regard it” as something else?
Perhaps your concern is not that others won’t allow you to define your own condition, but that others choose to define it differently than you do?
I ask this with the utmost respect. I have had a hard time understanding where you’re coming from, and I sometimes think I do, and yet you sometimes talk as if you think I don’t. Maybe I didn’t really understand you in the first place? Some clarification would be appreciated!
I certainly never said any of those things. What I DID say is that DOCTORS should not be able to tell YOU or ME or ANYONE ELSE what is “wrong” with them when they have no idea or scientific or even intuitive basis for their claims. I get frustrated when you claim I am saying that you have no right to choose your label. I have literally NEVER said that. I have said that no one ELSE has the right to label YOU (or anyone else) without your (or their) agreement. I hope the distinction is now clear.
As usual, I agree with you almost completely. The one exception is your comment that you are sure the “mental health” meme was entered into with “good intentions.” Nothing expands that quickly without funding behind it, and that funding comes from our friends in the Pharmaceutical Industry. I am certain this phrase was chosen specifically because it had the effect that was wanted, and it was spread as propaganda through the usual “advocacy” groups and social media sites with the intention of making it ‘popular,’ as a means of marketing their wares. The more “mental health” is normalized, the less people look for other explanations, and the more drugs and “services” are sold. The intentions are NOT good!
Kinda goes to show that they DO know what’s going on. It’s not ignorance or gullibility, it’s straigt up corruption, at least at the higher levels of the hierarchy.
People who don’t want to change anything should be left alone. I was assuming we were talking about a person seeking assistance. I see no need for an outside “professional” to label their experiences as “mental disorders.” I think it should be up to the person seeking help to define what they want to change and whether or not a particular approach is of interest or appears to be “working.” I hope that is clearer. No one should be forced to entertain “help” for something they don’t want help with, nor should someone else be able to define what “help” looks like for a particular person.
Parents don’t have to be monsters to cause harm to their children’s psyches.
No one is all good or all bad. We are all human and make errors and do good things and mess up and recover. It’s not about good or bad parents. It’s a lot about what adults went through when they were kids and pass on, and about what adults/parents are expected to do in our society and what they are supposed to do with their kids.
Most people would say my parents were fine people. They did a lot of things right. But they did some things wrong, too. Additionally, schools were full of well-meaning folks who often did a lot of harm because “that’s how we do it.”
An example: Good parents were expected to leave their kids to “cry it out” in their cribs when I was a baby. They were expected NOT to nurse their babies and to feed them solid food at way too young an age. Some were told that taking Thalidomide was safe and ended up with hydrocephalic babies or other birth defects. All were expected to send their kids to schools without question, even though some of my teachers were absolutely crazy and dangerous. One hit me in the head after she tossed a book across the classroom in second grade and I protested. Was that my parents’ fault? The teacher’s fault? The school’s fault? Society’s fault? It doesn’t matter whose “fault” it was or whether the teacher was a monster or just a sad old lady who never was loved. What matters is that I had experiences that were not healthy for me. They hurt me, whether they were intended to or not. It was helpful to recall those hurts and what decisions I made at the time, so I could learn to make different decisions today. There were no monsters. Just adults trying to do their best. But I still got hurt, and I don’t have to make excuses for them. I can take care of my own needs and let them be upset about it if they want to. Which my parents were, but we healed some as I grew up and was better able to express myself. I loved them, they loved me, and we were better off facing up to the painful moments where things didn’t go so well.
I’m not sure they were ever “bedazzled.” If you listen to the discussions around the time of the creation of the DSM III, they were quite blatant about their political goal of establishing psychiatry as a “real science” by pushing claims of biological causation and treatment. Of course, Big Pharma was happy to help out for a price, and they developed a symbiotic economic relationship that continues today. Many lower-level “mental health professionals” are, in fact, bedazzled, but the leadership premeditatedly planned to sell this concept to the public, whether or not it was true, and they have succeeded.
How does he rationalize these as “valid illnesses” when there is no objective means to determine who “has” such “illnesses?” And by extension, how can these be “treated” when we are unable to distinguish those with the “illness” from those who have other problems or no problems going on?
Why bother forming a model of a “mental disorder?” The term is already so biased and polluted it’s not worth trying to rescue. Why not simply help people identify what they want to change about themselves and help them find a way to do it? Or work to alter the known social conditions which create such emotional distress in the first place? Why not work on building a world that respects people’s mental/emotional condition instead of making diseases out of them?
Humans’ biases will not ever allow for a rational “model of the mind,” let alone of “mental disorders,” in my humble opinion. It’s a case of Heisenberg’s Uncertainty Principle brought to life: as soon as a mind starts studying “the mind,” the mind itself is altered by the process.
Posting as moderator: After a certain number of layers of comments, the “reply” button disappears, so Mr. Cox has no control over this. What you have to do to comment is go back up the thread to the first one that still has a “reply” button and hit it. Your comment will appear next in line.
I think you have hit the most fundamental problem with the “helping” professions. Anyone who thinks they can tell another person what is wrong with them, what they need, and/or what they need to do about it is inherently dangerous. People don’t need someone to define things for them, they need someone to help them figure out what they need and how to get their needs met. Humility and empathetic listening, along with a few carefully-selected pointed questions, is what most people find most helpful, whether it’s from a professional, friend, family member, or a stranger on the street. As soon as a person forgets that the only one who knows the ‘right answer’ is the person seeking assistance, they become a hindrance rather than a help. And when they expect the person seeking support to “appreciate” whatever “help” they choose to provide, they become inevitably damaging to the person they are claiming to “help.”
It is also very possible that the best of parents make errors and their kids end up hurt. It is very important that parents are willing to take responsibility for their contribution to thhe problem, and the best parents are willing to do that, and make it OK for their kids to give them feedback about their experience as children. You don’t have to be a “bad parent” to contribute to your child’s emotional struggles!
I agree, that is exactly what happens, even to other health professionals. We’ve all been taught that “mental illness,” and suicide in particular, is very, very DANGEROUS and that anyone NOT a professional will no doubt mess it up, with the corrolary being of course that you’ll get sued if you don’t get it right. I remember a kid in residential treatment who would claim he was “suicidal” because he knew it meant a trip to the ER and he could get out of a day of school. The res staff were too afraid to handle it until they got approval from the psychiatrist to do a “planned ignore” and not automatically transport him every time he said the “s” word. It really is quite ridiculous – we are removing what is probably the BEST assistance a person thinking of ending his/her life can get – support from friends and loved ones – in favor of forced hospitalization and drugs that present no evidence of doing anything to reduce suicides, and may actually increase them. Who is insane, now?
Precisely. We must identify the real problem here. People often need help recovering from bad events, but they aren’t “diseased,” nor are the social conditions we allow and encourage something we should all feel OK about and be subject to “diagnosis” if we try to fight them!
The term “recover” is often used in terms of injuries or illnesses. It is the assumption that a mental/emotional challenge is an “illness” of some sort in the individual that needs to be challeneged. And I would submit that many people need help “recovering” or “recuperating” from the assault on their lives and their integrity that psychiatry itself has perpetrated!
Plus I figured out what they were talking about in minutes, or already knew about it, and yet we continued to ‘study’ the material for months!!! There was nothing to pay attention to. It was about as exciting as watching rocks eroding or paint drying. If it hadn’t been for daydreaming and doodling, I’d have probably done myself in by third grade!
You are quite right. There was a quite open discussion of this back in the 90s. They chose the term ‘medication’ instead of ‘drug,’ and substituted ‘discontinuation syndrome’ for ‘withdrawal,’ to differentiate as much as possible their psychiatric “medications” from their close cousins, street drugs (and sometimes they actually USED street drugs and called them “medications” instead.) There is no doubt what you say is absolutely and intentionally true.
“Severe and persistent withdrawal syndromes from antidepressants have long been neglected or minimised. Obscuring a potentially serious risk, the pharmaceutical industry coined the term “discontinuation syndrome” to avoid association of antidepressants with psychotropic dependence. This term is unnecessary and misleading, suggesting antidepressants cannot cause dependence and withdrawal.11,16 Thus, patients and prescribers may misattribute withdrawal symptoms as relapse or emergence of new mental disorders.11,16,21”
I think for some people, “recovery” means “accepting of diagnosis and taking all drugs prescribed by doctor.” The idea of recovery WITHOUT or IN SPITE OF medical intervention seems to be heretical in some circles. It’s almost like you’re saying it’s not a medical problem at all! Which might suggest that maybe THEIR acceptance of their diagnosis and medical intervention could be called into question. EEEK!!!
“You were misdiagnose.” What a classic line! Because our “diagnoses” are “incurable,” anyone who gets better must by definition be “misdiagnosed!” That way, they can never be wrong, just by redefining their terms whenever their assumptions are proven false. You can’t lose that way!
I’m afraid that the literature shows brain damage to be quite common in ECT. In this review, they suggest some level of damage is always present. ECT “works” by inducing a grand mal seizure in the individual receiving it. When people have seizure disorders, we do everything we can to STOP them having seizures, specifically BECAUSE there is damage to the brain when uncontrolled seizures occur.
I’m not trying to invalidate your personal reality, because what works for you is what works for you. But it is not accurate to suggest that loads of studies show no brain damage from ECT. It is most likely that any therapeutic effect for ECT is the result of minor brain damage. But sadly, it is not always “minor,” as many survivors of ECT can attest. It is, at best, a very risky procedure whose benefits are unpredictable and generally very short lived. That doesn’t mean that no one finds it beneficial, but it does mean that claims of “safety” are not supported by the scientific literature.
But wait, I thought it was all biological and genetic! You mean what KIND of life you’re living affects your emotional well being? Gosh, who would have GUESSED?
I agree with you for the most part. The only objection I’d make here is that psychiatry is not to me “science done badly.” It is pretend “science” used in the service of marketing drugs. You and I both agree that enforcing drugs on people as “the only solution” is oppressive, especially when done so without the consent of the “drugged.” I am adding that pretending that “science” supports such an action, that the reason you should “go along with the program” is because “you have X disorder” or “you have a chemical imbalance in your brain” is not science, but pure marketing, promoting something they know is NOT supported by science as if it were, because it sells drugs.
If psychiatrists said, “These phenomena happen to people. We don’t know why, but we have discovered some drugs that may stop some of these phenomena temporarily, with x and y adverse effects,” then they’d be a lot closer to being scientific.
So a person can believe fully in science as a means of determining the truth (or I should probably say, a means of determining what is NOT the truth, as science is a lot better at that) without having a minute to give for psychiatry’s effort to use people’s vulnerability to sell them drugs. I will add that I don’t worship science and recognize its limitations, and have a full spiritual life and believe in lots of things that Science can’t explain. But psychiatry has nothing to do with science, except to the extent that they can study what effects these drugs actually have on people, and they’re not even honest about that.
I never confuse psychiatry with science. It’s a marketing scheme, plain and simple. You or anyone else can certainly use the psychiatrists’ framing of disorders or diseases if you choose to, and more power to you for it. I even use some of them on occasion. But I don’t view such “disorders” as scientific entities, any more than describing someone as “courageous” or “a slow runner” or “has lovely hair” as scientific descriptions.
I don’t mind you viewing yourself as “ill” and describing yourself that way. I do mind a doctor pretending that they have proof that I am “ill” and therefore need to accept their “treatment” of me as a legitimate medical practice, especially in the absence of any evidence that they can identify a definitive cause and test me for it in some objective manner. Just as someone is free to be a Christian or a Muslim or a Hari Krishna if they want to, but I object when they start telling me I have to agree with them, especially if they try to claim that “Science proves that Christianity is the ‘right’ religion.”
The thing is, you just can’t make that much money off of helping people have better lives. Better income from keeping people “disabled” by the very “treatments” you provide, so they think they have to come back for the rest of their lives. Kind of like being a drug dealer, except with the power of an MD behind your name.
I think there is a big difference between one citizen telling another one what to think/not to think about their condition, whatever it may be, which I think would be a bad thing, and a person with big social power, like a doctor or psychologist, telling people that “science” says that you have “X disorder” and that it is biological in nature, and that drugs are the solution, especially when there is no scientific evidence that is the case. So I think the two of you may be talking about different subjects. It seems like DW is not liking it if people tell HER that she “is not ill” or that “schizophrenia is not an illness,” which I completely understand and agree with. What I understand YOU to be saying (and I agree with you 100 percent) is that the PROFESSIONS of psychiatry and psychology have intentionally perpetrated misleading or downright dishonest representations of the truth, and that these misrepresentations have damaged those they claim to help. To me, these are completely different subjects, and I hope we can all be careful to make sure we make that distinction. If DS or anyone else wants to frame their experience as an illness or attribute a biological cause, they are free to do so. When a psychiatrist or psychologist or an MD makes that claim about someone ELSE, then it is THEY who are bullying and telling others what to believe about their own condition, without scientific backup for their position.
In fact, the data suggest that antidepressants, far from saving lives, actually INCREASE the odds of someone committing suicide. And the fact that the suicide rate for folks leaving a psych hospitalization is so amazingly high does not speak well of the “treatment” they are receiving.
There is no drug on the market today that can legitimately claim to reduce the suicide rate. Even the drug companies don’t claim that in their advertisements. They count on psychiatrists to do that bit of marketing for them.
I guess we’ll have to agree to disagree. To me, the idea of talking to a “professional” who pretends to some “superior knowledge” in order to “diagnose” me with a “disease or disorder” is VERY different from sharing my experiences with someone who has been there and understands how it feels to be in a similar situation. Human beings have communicated and shared with each other in times of trouble or to mitigate traumatic experiences since the beginning of human language. It is a natural and healthy thing to do. The problem I see is that this natural, human process has been coopted by those claiming special skills or knowledge in the area of “helping,” while presenting no evidence that a degree or professional position confers any kind of advantage in doing so. Folks need to recognize when they’re being scammed. But to suggest that sharing one’s experiences with another human being is ipso facto proof of being a fool or a sucker is just plain nonsense to me. I’m all for fighting back against the system and have done my share over the decades, but I also know that without other caring individuals to listen and help me through life’s challenges, including one very helpful therapist in my 20s, I would not be in the excellent place I am today, and in fact, would never even have fully realized that I needed to fight, and whom I needed to fight against. Dismissing the need for human sharing of experience is simply not a workable theory, no matter how many barriers are manned. But people DO need to learn, or re-learn, since we all once knew how to do this intuitively, how to discern those who we can trust from those who are not really there for us. Many revolutions were brought to a standstill by people’s inability to realize which leader ought to be trusted and which should not, so it doesn’t just apply to therapists or “peer supporters,” either.
Actually, I respect people’s inherent ability to discern who are and are not their allies. Unfortunately, that ability has been messed with starting at a very young age, and it is the lack of that ability that allows people to be taken advantage of, including by “professionals.” If people need anything in terms of “help,” the thing they need most is the ability to learn whom they can and cannot trust. If you ask me which is more likely to be trustworthy, a psychiatrist, a therapist, or another person who has “been through the system,” I’d bet on the third by a mile. It’s true many such have been coopted, but that should become obvious in 5-10 minutes of conversation.
And I’d ask you this: if people are to join in some kind of resistance movement, would that not involve disclosing their affairs to people who may or may not be their actual allies?
“Y’all” meaning peer supporters and those who try to help without claiming some kind of superiority of station or knowledge. In other words, “real folks!”
No we don’t. We want real Peer Support to be paid for by all the money that we save when we fire all the psychiatrists and stop wasting so much money on non-working “Treatments.” I think the objection to referring to “mental health conditions” is mostly that it makes “peers” into automatic subordinates to the “mental health” system. I’d love it if the “system” were subordinate to y’all and especially the clients themselves, but that’s going to require a total re-do of the model where peer support is an “adjunct” or an “alternative” or “supporter” rather than the main deal.
I know how ETC “works.” After the “patient” gets 3-4 “sessions, they assure the doctor, “I feel SOOO much better now. THANK YOU for this wonderful experience! I don’t feel even a TINY bit depressed! Now, can you unlock that door so I can get far, far away from you and your ‘help?'”
I think it is also important to remember that not all “logic” is logical! But I agree completely, it is the suppression of feelings, not the feelings themselves, that lead to real trouble. Not all feelings need or deserve to be acted upon, but all of them can be safely EXPERIENCED, and in fact, feeling “negative feelings,” as people call them, generally leads to them being LESS likely to be acted upon in a destructive way.
You should keep in mind, though, that how a country is RULED (monarchy, etc.) is not the same as how the economy works. Capitalism is an economic model. We kind of know at this point that uncontrolled capitalism leads to monopolies, price-fixing, decreasing wages, and an increasing gap between the “haves” and the “have nots.” At the same time, we know that a fully government-controlled economy does not allow for sufficient freedom and motivation to create solutions to problems. Both are susceptible to corruption, of course. So it’s not a simple question of how the government is organized. Private enterprise has its own set of rules. There are plenty of capitalistic countries that have despotic governments or monarchies or even ostensibly “communist” governments like China or Viet Nam. It’s a very complex problem!
Actually, the best “treatment” for childhood trauma has been shown to be a healthy relationship with a caring adult or adults. Dr. Bruce Perry has written extensively on this point, as have others. The psychiatric community, as usual, has focused on the ostensible “brain damage” caused by childhood trauma, but have bypassed (or intentionally ignored) the brain-science solution, namely a safe environment with caring parents, which is shown to heal a good part of the damage you describe.
It is also “surprising” because doctors and other “wise ones” have blamed “hormones” for all cases of “postpartum depression,” in the interest of promoting their biological solutions to women’s “hormone problems.” This, of course, is an ancient trope used in service of oppressing women through asserting that their “hormone swings” make them incapable of thinking, voting, holding political office, owning land, etc. The idea that MEN might suffer from “postpartum depression” shoots a gigantic, cannonball sized hole in the side of the “it’s women’s hormones” ship, and so of course must never be considered. If MEN can become depressed after a birth, well gosh, that means it might have something to do with the CONDITIONS new parents have to tolerate rather than some random “hormone imbalances” caused by God’s poor design of women’s bodies.
Of course, the industry will now embark upon an effort to prove that MEN’S hormones are somehow altered after their partner gives birth, spending millions of dollars and assuring us that “the solution will be right around the corner” instead of observing the obvious and trying to work on improving post-birth support for both men AND women.
Good post, Jessica. It might be of interest for you to know that a number of studies in different places in the US and Canada show that simply waiting one year to enroll kids in Kindergarten reduces the “ADHD diagnosis” rate by a third! It should be obvious to anyone that this has more to do with developmental levels and adult expectations not matching, not a “disorder” centered in the child because they can’t do what the adults arbitrarily expect of them. And the worst of it is, “medication” over the long term does not improve ANY outcome that we care about vs. kids who were not “medicated” for the same “disorder.” The whole thing would be funny if kids weren’t getting hurt by it!
Not everyone has a choice whether to participate in the system. But I agree, the analogy to slavery is a bit strained. It’s more like incarceration without cause and without recourse. Which is pretty freakin’ bad!
I appreciate your scientific mindset in not ruling things out when you really don’t have data to draw a conclusion. I wish more folks had that attitude.
I will add here that it is in my experience very difficult, in fact often next to impossible, to detect “signs of akathesia” beyond a person telling you what is going on. There are sometimes external signs, like being unable to stay in one place for long, or restless legs and that sort of thing, but it is described as an INTERNAL sense of restlessness and agitation. It may or may not be accompanied by obvious externals symptoms, and a meaningful discussion with the subject would be necessary to make a definitive diagnosis. It is also easily overlooked or seen as symptoms of “the disorder” rather than recognized for what it is.
I am inclined to ask, “If you agree with so many of Bob’s scientific critiques, where exactly IS the baby that we don’t want to throw out?” Looks like a hell of a lot of bathwater to me!
Besides, this is not anything new. Been known for a couple of decades. Facts don’t seem to have much impact on “standard psychiatric practice” in my observation.
OMG, what a horrific experience!!! This sounds like malpractice even by their own standards. The doctor was warned by a pharmacist and the drug company but continued anyway. I’m SO sorry you have to go through all this! And I hope you find some sense of peace and justice in the future.
I agree absolutely. The veneer of “medical treatment” allow the adults to pretend they don’t really know what’s going on. But the kids pretty much always know, and will tell you if you ask them in the right way. They’ll tell you “I have to take drugs because I can’t control myself” or “They give me these because I get in trouble too much.” They have no illusions about “mental disorders.” Which tells me the adults know this on some level, too, but they’ve learned to suppress their awareness.
But stimulants for “ADHD” is not a question of whether you get caught. It’s all right out in the open. It is justified by the “medical diagnosis” of “ADHD.” But the idea of “treating” a young kid for “athletic deficiency disorder” would horrify most parents. Why doesn’t doing the same for school performance horrify most of us?
Oh, steroids are a different question, not pretending to be “medical treatment,” and all done under the radar. I’m talking about creating a “medical diagnosis” that X person has “athletic deficiency disorder” that is caused by “genetic abnormalities” and is “treated” by giving them stimulants. The reason I bring it up is because most people would find such an idea disturbing, but when it is for academic performance, they’re OK with it. They don’t get that it’s the exact same kind of activity, just with a different focus.
They would do it if they could get away with it, I’m sure. I think there is a visceral cultural taboo on “performance enhancing drugs,” and I think trying to “sell” that concept would make their intentions and their “treatments” too obviously counterintuitive for the general public, and start some unwanted scrutiny. I think they know this on an intuitive level and so they don’t try that play. Drug-enhanced school performance is OK. Drug-enhanced athletic performance is a no-no. So they go for what sells.
The analogy of athletics is a good one. I wonder how people would react if non-athletic kids were diagnosed as having “athletic deficiency disorder” and given stimulants to improve their performance?
It also stops people from looking for better answers. “If my brain’s not working right, there isn’t much I can do about it, is there? Might as well hope the drugs work, because otherwise, I’m screwed.”
Of course, brain imaging has its place and can be valuable. It’s just not valuable when looking at behavioral/mental/emotional/spiritual challenges. Finding that a particular area of the brain is “more active” or “less active” when someone is feeling depressed tells us practically nothing about causality.
Seriously, if that’s the problem, why aren’t they working on this with their clients, instead of drugging them into an apathetic state so that they’re less bothered by having their needs go unmet?
I particularly agree with your point that everyone’s “cause” is unique to their own life situation, both physiologically and psychologically/spiritually. Trying to come up with one answer for everyone denies this obvious fact. “Depression” is a false category of “disorder.” It is an effect, not a cause. If we want to handle the situation, we have to find the cause, and calling “depression” the problem implies that all “depressions” are caused by the exact same circumstances, which is a silly thing to think.
But pretending that we “know” the cause and providing “treatment” on those assumptions clearly leads to destruction. You can provide aspirin or morphine for a broken leg, but you’re not treating “leg pain disorder.” On that basis, getting drunk can be called a “treatment” for “anxiety disorders.”
And of course, in many, many cases, we DO know the actual cause of a particular case of “depression,” and it is usually NOT due to a physiological event, though sometimes it IS and we know it and we should “treat” the actual problem rather than the “symptoms” (low thyroid would be one example). We certainly know enough to know that “depression” is itself a “symptom” rather than a “disorder” that “causes symptoms.” It would be best for the clients involved if we dropped the whole notion of “depression” as a disorder and started viewing it a symptomatic of something else.
Well, I think the first mistake is thinking “depression” is a thing that is always caused by the same factors. But I agree, there are certainly many understandable causes for depression that are addressable, once psychiatry’s false categorizations are set aside. And there are many, many things that can be done to help, regardless of the underlying reasons.
“Poverty” has always been a concept psychiatry and other “mental health” disciplines have avoided talking about. It challenges their basic assumptions too directly and effectively.
I would define it a bit differently – I see “scientism” as being the believe that Scientists are Authorities and that we peons are too stupid to understand their deep wisdom, so we have to simply believe what Scientists tell us and do as they tell us, even if it makes no sense to us at all. Because Scientists are All Wise, and we mere mortals couldn’t hope to understand the depths of what they are telling us about.
This was another trope of the psychiatric/psychological community to justify their drug interventions. There was never any means to distinguish “endogenous” from “exogenous depression.” It’s kind of dropped out of use, since it has served its purpose and allowed the drugging paradigm to take full hold. Now most psychiatrists assume that all “depression” is biologically caused, despite still having no evidence to prove or even suggest that is the case. Note at the end it states “The exact cause of depression is still unknown.” Which really means, “We have NO CLUE of the cause of depression, and we’re making this up!”
“According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), anyone experiencing endogenous or exogenous depression will likely receive a diagnosis of major depressive disorder (MDD).
Medical professionals no longer give endogenous depression as an official diagnosis, and the DSM-5 no longer lists endogenous depression as a diagnostic category. Still, some researchers and mental health professionals find that locating the sources of depression — internal or external — could help you with finding treatment that best suits the specific needs.
Don’t think I ever claimed that “liberals” and Democrats have done anything but support psychiatry’s agenda 100 per cent. Most “conservatives” support it just as much, of course, but any of the rare moments of resistance I have seen has come from the political Right, based on the idea of “government overreach” or protecting the rights of individuals. Still, their numbers are tiny, tiny, tiny, and the overwhelming majority of both parties are fully bought off and supportive of the pharma-psychiatric industry.
I am surprised your psych professionals said that to you. I’ve almost never seen it. I actually got severely criticized for training our CASA volunteers in exactly this point, by a training coordinator who bought into the medical model.
You once again assume the condescending attitude that I somehow “misunderstood” when I have explained myself very carefully. I have misrepresented nothing. I have used quotations from the paper itself. Those who understand the demanding, rigorous logic of the scientific method will know what I’m talking about. And I notice that you did not even bother to try and refute my arguments logically, but resort to ad hominem attacks to try and make your point.
Meanwhile, it’s clear that you have already decided that you are “right” and are unwilling to accept the most rational possible feedback from me (did you even bother to read and digest my arguments?), so I am not intending to get into further discussion with you about it. The article says what it says, and I have directly responded to the logical flaws and the actual data presented. If that’s not good enough for you, please at least refrain from your condescending swipes at my intelligence and/or integrity. It is not a becoming look on you.
I agree completely with you. These attempts to “prove genetic causation” by finding some tiny correlation involving dozens or even hundreds of genetic markers really are a joke and can never prove anything close to what they’re claiming. Especially when we have massive correlations with traumatic events that vastly outstrip the most optimistic (aka delusional) interpretations of the genetics data. Basically, they REALLY REALLY want there to be a genetic basis, they REALLY want it to be true, so maybe if they close their eyes and click their heels together three times and say, “There’s no cause but genes… there’s no cause but genes… there’s no cause but genes…”
I have used the analogy, “If children are being hit by cars outside of a school, and 20 percent break their legs and 80 percent don’t, do we do genetic testing to see why some of them have ‘weak leg disorder’ because they can’t stand up to being hit by a car? Or do we figure out how to stop cars from hitting kids on their way home from school?”
Just to be clear, “white male authoritarianism” can be and is enforced or enacted by non-white people and/or by women. It is the “thinking” or the philosophy or the “system” behind the actions that is authoritarian, and that system was most definitely constructed by white, male authoritarians over many decades or even centuries. The question isn’t who is doing it, it’s more who is impacted, and history shows us that women are regarded “by the system” as being more “sick” or “disturbed” or “mentally ill.”
Consider the idea of “hypersexuality.” That concept is almost NEVER applied to men, but is a big “problem” for women, according to psychiatry. This reflects male privilege in our culture, in that men who sleep around are considered “players” or “studs” or “Ladies’ men,” whereas women who do the exact same thing are considered “sluts” or “whores” or “slags” or any number of unflattering things. No man was ever diagnosed with anything because he slept around.
That’s just one example, and it’s very clear that women have long been a part of enforcing this condemnation of women who are “promiscuous.” The term I think that applies is “internalized oppression,” where members of an oppressed group are expected to enforce “norms” that come from the group in control in order to avoid punishment themselves.
So in my view, psychiatry incorporates many biases and prejudices about women from the general society, and as a result, is even more likely to attack women than men for being “different.” It is also clear that racism is part of the underlying structure of psychiatry, as the disproportion of black people being diagnosed “schizophrenic” is way higher than the general population. The fact that black psychiatrists may participate in this set of discriminatory practices does not make it any less racist.
Just to be clear, Joshua, with almost no exceptions, “conservative” representatives are just as supportive of incarcerating the “mentally ill” as the “liberal” ones. Big Pharma donates big money to both sides of the aisle. I agree that the rare politician who opposes such efforts will likely be on the conservative side, but the vast majority believe strongly that the “mentally ill” are dangerous and need to be locked up. In fact, one of the most common arguments against increased gun control based on mass shootings is that the “shooters” are “mentally ill” and should not be out on the street, hence blaming the shooter’s “mental illness” to redirect attention away from gun availability as a possible cause. I’m not meaning to hash out the gun control debate here, just pointing out that “conservatives” in general don’t give a half a hoot about the plight of the unlawfully incarcerated “mentally ill,” an even less so about the damaging scourge of mindless labeling and “medication” of millions of their constituents.
Oh, believe me, I understand only too well how this kind of study is misinterpreted to indicate causation.
Here is the operative statement:
“…which damage functioning are found more often in people with schizophrenia than in controls.”
Clearly, if these genes are only “found more often” in those diagnosed with “schizophrenia,” there are large numbers of controls who have the same genes, and there are large numbers of people labeled with “schizophrenia” who do not have such genes.
Further, they state: “… here pathological changes in DNA sequence, can at least sometimes result in a severe illness characterised entirely by abnormalities in mental functioning.”
Of course, this statement is not a legitimate conclusion from the data presented. All that we know is that a certain genetic pattern is associated to some degree with the probability of developing the subjective set of symptoms that are called “schizophrenia” by the DSM’s authors. Since 1) that set of symptoms does not objectively define any specific “condition” that can be tested for and verified, and 2) the pattern is only ASSOCIATED with increased probability, with a huge percentage of the people having this set of genes NOT developing said “condition,” and a similarly large proportion of those “diagnosed” with this “condition” NOT having the set of genes in question, there is no way to conclude that this genetic pattern is causal.
There is also no specific evidence that the genes in question are “pathological changes,” since they don’t create any kind of “pathology” in the majority of people who have it. The comparison with smoking is, of course, odious, since we are talking about a carcinogenic agent being ingested vs. a genetic pattern possessed by many “normal” people. To claim genetic causality of “schizophrenia,” either all or most cases of “schizophrenia” must have this genetic pattern present, or an objectively verifiable subset of such cases, which can be unequivocally distinguished from those not so affected, would have to all have this same genetic pattern. It is not proper to assign causality to genes which neither cause most cases of the “condition,” nor which are present in large numbers of people without the condition applying.
Note that I predicted this would be the case before I even read the article. All recent claims of such “causality” are based on the same flawed “logic,” confusing correlation with causation, I would at this point say intentionally.
Do you always assume that someone disagreeing with your viewpoint can only do so because they “don’t understand?” I personally found that assumption both condescending and insulting, and I strongly suggest you avoid making such assumptions in the future. I am correctly interpreting the data presented in the study, and comparing it to prior efforts to make the same arguments, all of which fail for the reasons identified above. You may choose to disagree with my evaluation, but I think my reasoning is quite solid and disagreement would be difficult to rationally accomplish given the barriers cited above. You’re welcome to give it a try, but trying to deny the premise that causal conclusions can only be drawn when all or the vast majority of such cases have the specific genetic variations in question seems to be an unconquerable flaw in this and other such claims’ reasoning.
Honestly, I do think there is such a thing as “good therapy.” The problem is, there is no guarantee nor even probability that anyone advertising as a “therapist” has any clue how to do it. And there are any number of non-licensed, non-trained people who are quite capable of assuming an effective helping role. I think we need to respect folks who say they had a good experience (I did, 40 years ago, and I can still see how it was very important to my growth), but it appears that such experiences may be the exception rather than the rule. And it’s certainly not wrong to say that being randomly assigned to “a therapist” is potentially quite dangerous!
First off, there have always been claims of “causes” for schizophrenia and other DSM-identified “conditions,” and none so far have panned out. These “genes that contribute” will undoubtedly contribute in a small way to a limited number of cases, and such genes will no doubt appear in many in the general population who do NOT “have schizophrenia,” and will NOT be present in many cases who “have schizophrenia.” This is not to say there may be a small subset of people so diagnosed who will have a large genetic contribution to their situation, but so far, we have at best tiny correlations with large sets of genes, all of which overlap to a huge degree with the “normal” population.
Whereas correlations with events like sexual abuse, early childhood neglect, domestic violence, head injuries, sleep loss and others are much, much higher than any genetic correlation to date. So why are we spending so much time finding tiny correlations with genes when we have HUGE correlations with traumatic events?
Seriously! I always find it oddly hypocritical for the psych professions to claim that all of our “mental illness” is biologically based, and yet create their model animal subjects by scaring the shit out of them! Why don’t they just find some “genetically ill” mice to test their drugs on? Oh, wait, is it because they actually realize that the main cause of “mental illness” is being terrorized, tortured, or ignored or mistreated, and know that there are no “biologically ill” mice (or humans) in the real world?
And the correlations are usually dozens of times greater than the miniature “correlations” found in genome-wide studies looking for genetic causes. Yet where does all the money go?
He didn’t so much moderate this view as recant his earlier theory, which was of course very much on the right track, but made Victorian male society VERY uncomfortable (especially as so many of them had themselves engaged in sexually abusing girls and young women). He was roundly attacked by his colleagues and society at large for putting forward a theory that put the blame on the more powerful members of society, and under this pressure, he backed out and came up with a theory that was less threatening to the status quo. It was almost 100 years later before the incredible frequency of childhood sexual abuse and its connection to what is now called “mental illness” was finally revealed. Even today, there is great resistance in many quarters of the psychiatric world to understanding and attributing causality to childhood abuse and neglect when discussing ‘mental illness.’ It’s always easier to blame the victim.
To be clear, I never meant to suggest that YOU said anything about charlatans’ use of diagnosis. I am merely pointing out that there is a difference between YOU selecting the descriptor(s) or terms that YOU want or relate to, and other people (like the psychiatric hegemony) pushing diagnostic labels on people and NOT giving them the opportunity to choose. Based on what you have said many times, I think we agree wholeheartedly on this point.
I am kind of appalled by the invalidative attitude you take toward those youth who happen to reside in residential treatment facilities. I have known dozens and dozens of such youth, and have found them no less reliable in general than the staff who report on them. They have no particular motivation to lie to perfect strangers, and I’m quite confident that the collective statistics are indicative of a very real phenomenon. Their comments are also quite consistent with my own experiences that show psychiatrists in particular to overlook or minimize the importance of traumatic phenomena and cast blame upon the patient/client and/or their “disorder” or their brain for otherwise obvious connections between a child’s behavior and events in their lives.
I agree that these kids are often coerced into agreeing with statements their caretakers/doctors are forcing upon them, but that argues 100% in favor of the above observation, as the “mental health” personnel are usually very invested in proving their “diagnoses” are correct and explain everything, and that their “medications” are 100% justified, even if the kid is deteriorating in front of their eyes. The days of therapists coercing their clients into admitting to “abuse” are long gone. They are much more likely to coerce them into the idea that they have “bipolar disorder” and that the fact their father sexually abused them (or continues to do so) isn’t really that important.
And while I am not sure the 80% figure is verifiable (though SomeoneElse provided a link supporting that claim), there is no doubt in my mind that a large majority of those diagnosed with “mental illnesses” have experienced multiple “ACEs,” as the current parlance calls it, which contribute massively or actually are the primary cause of their distress. This is based not only on research, but on decades of personal and professional experience. The percentage of women I interviewed diagnosed with “bipolar disorder” who had enormous histories (and sometimes current experiences) of abuse as a child or young adult is probably at least into the 80s. Even higher for people diagnosed with “Major depression” or “anxiety disorders.” And there is plenty of evidence that the likelihood of childhood abuse (especially sexual) in diagnosed “schizophrenia” cases is many times the population average.
What you seem concerned about was common in the 80s, when everyone’s problems were attributed to bad mothering. Now parents are totally off the hook – it’s all the fault of the brain or the “disorder.” As you say, no one knows what a “disorder” really is, and yet these vague, spurious “disorders” seem to have amazing powers! In the 80s, a kid who never was sexually abused was convinced that s/he was in order to feed the egos of the psychologists/psychiatrists. Nowadays, a kid who WAS sexually abused is “diagnosed” with “ADHD” or “bipolar disorder” and no one bothers to look any further. That’s the current reality, at least in my very broad (25+ years) experience. Things are VERY different today than they were in the days of the McMartin Preschool!
Missing my point. I am not arguing that charlatans don’t use DSM “diagnoses” or generally accepted social concepts to fleece people – they most definitely do, in fact, that’s psychiatry’s stock in trade! I’m saying that phenomena do exist absent the approval or disapproval of a bunch of corrupt old mostly white farts, and the ridiculous behavior of many “modern” “mental health” personnel doesn’t preclude the existence of phenomena they have made such powerful efforts to misunderstand and abuse.
Well, I can tell you that “Penis Envy” is a verifiable phenomenon. It happens every time a man and a woman are out hiking together in the cold rain and they have to take a leak in the woods!
Sybil was not by any means the original case of “MPD.” The phenomenon has been reported since ancient times:
“The amazing history of dissociative identity (DID), some say, dates back to Paleolithic cave paintings in the images of shamans. Others suggest that the history of dissociative identity disorder dates back to reports of demonic possession that are now thought to be incidences of dissociative identity disorder. Either way, it’s clear that dissociative identity disorder has a long history and is not a new concept (while the terminology now used may be new).”
Of course, like any so-called “psychiatric disorder,” there is no objective way to determine if someone “has DID” or “is faking” or to do anything but express opinions. It is a phenomenon that appears to occur rarely, it has been sensationalized and abused as a concept, and I don’t trust psychiatry’s ability to define or evaluate the phenomenon or any other phenomenon in any meaningful way.
And we don’t know how the presence of childhood abuse was determined. There are plenty of people who experience childhood abuse and neglect who don’t realize that they have – they view their treatment as “normal” based on their experience. There is also the question of screening. I recall a research study where volunteers went into a children’s psychiatric residential facility and asked questions of the residents. As I recall, about 80% of the residents reported childhood trauma to the volunteers (total strangers to them), and yet less than 25% had this documented in their charts! So either the residents were more comfortable sharing their childhood trauma with total strangers than the staff they see every day, or the staff never bothered to ask, or the staff considered the presence of childhood abuse not to be of sufficient significance to write into the log.
I worked doing involuntary hospitalization evaluations in Vancouver, WA for a while. I spoke to at least a few dozen women diagnosed as “bipolar disorder” during that time. I’d estimate that 90% of them had significant trauma, right on the surface, which was ignored or never considered by their prior care providers. One girl was a MR/DD kid of 17 whose intellectual level was estimated at age 6. She had been raped a couple years before. For a year or so, she was very depressed and withdrawn, which was very different from her previous personality. After a year, she disclosed her rape to her mom. After this point, she became randomly aggressive at times. Her diagnosis? BIPOLAR DISORDER! I gathered all this information in a 20-minute interview with her mom. I actually got them to change her dx to PTSD, but seriously, how OBVIOUS was it that the rape was the event that caused the distress, as there was no distress before, and as she shifted from depressed to angry after disclosure?
It is important to be objective, but that also means being honest about the limitations and massive conflicts of interest that are part and parcel of the field. Underestimation of the impact of environmental impacts is absolutely a basic assumption of the current diagnostic system. It claims to be cause-neutral, but in practice, it is extremely biased toward prioritizing biology FAR over any other potential cause.
Given what you said about Aristotle and his impact on philosophy, I’m sure you’ll find it engaging on many levels. Truly one of the top three books I’ve ever read!
She is talking about the assumption that children exist to meet the needs of adults. Pedagogy is simply a way of codifying the expectation that children will do as they are told “for their own good” (another title of one of her books). Putting adults in the role of helping kids (or other adults, for that matter) figure out what THEIR needs are is a radical action, and people who do so are generally attacked by the society at large.
Or they were (and still are) designed to provide convenience and practical utility to adults who are responsible for caring for people with difficulties. I worked with a kid in a group home who refused to brush his teeth and so forth, and they asked the doctor to increase his Risperdal dosage. It is often very simply about compliance and control.
“Works” is the operative term often used by the psychiatry/psychology to justify their “treatments.” They often say, “The drugs work” or “treatment works” without any real criteria for what that’s supposed to mean. If a foster parent says that stimulants are “working” for their foster child, do they mean that the child feels better, the child is being more compliant, the child is feeling more successful, the teacher SAYS the child is “doing better,” the child is less annoying than previously, the child is completing more busywork while not learning anything new, the child is more willing to do things that are boring without complaining… the list of possible definitions is almost limitless. If we don’t ask what “works” means and for whom the intervention is supposed to “work,” we get kids/adults who are nearly catatonic being identified as “treatment successes.”
I can’t read my prior comment, but I’m guessing by “plays” I meant “participates in the agreed upon social processes/procedures.”
Well, I completely agree with you, of course. The overwhelming problem with the whole idea of “what works” is that we’re not talking about something concrete and measurable here. “What works” can be defined in many different ways, and there is no way to determine who is “right” about the answer to that complex, highly philosophical question. And absent agreement on that point, there is really no sense it trying to “scientifically” determine anything about this whole area! “Mind” is a mysterious thing, and “science” hasn’t even begun to touch on the vaguest understanding of “Mind.” Of course, they want to CLAIM that mind=brain, because it feels more “scientific” and less “superstitious,” but that’s really just a philosophical position, not a scientific one.
The first barrier to understanding anything is deciding that you already know all about it! Humility is in very short supply in the psychiatric “professions!”
Most movies and TV shows portray psychiatrists as therapists. I’m sure that’s not by accident. The confusion between psychiatrist, psychologist, and therapist counselor is important to protect psychiatry from people understanding that psychiatry is akin to drug pushing.
Is this supposed to be news? Peter Breggin wrote about this in 1993. I’ve heard many users describe this exact phenomenon, not as a “side effect,” but as the primary effect of SSRIs. Anyone who has actually listened to a dozen SSRI users will have heard this at least once or more. How is this only being “discovered” now, thirty years later?
Mind definitely does affect brain. There was a great study out of the University of Chicago where they did brain imaging on a number of Buddhist monks who mediated many hours a day. The part of their brain associated with calm and focus was significantly larger than those of “control” subjects. WE also know that taxi drivers, for instance, have a bigger part of their brain committed to geographical and spatial reasoning. Also, the folks studying the brain in the “Decade of the Brain” research found that damage can be done to the brain by early trauma, but also that healthy relationships with caring adults can actually heal the physiological damage done by early abuse or neglect (for some reason, that second part of the research always seems to get buried. I wonder why?)
What we think about and how we behave most definitely affect the brain. I don’t think it’s a “maybe.” There is solid evidence that it’s a “yes!”
Actually, I think Freud got it mostly right to start with (Trauma Theory) but then recanted under pressure from his colleagues, many of whom probably sexually abused young ladies in Vienna themselves.
That study sounds like a bit of semantic hocus-pocus. Of course, “benzodiazepine use disorders” is another loosely-defined, subjective description of behavior that no one can objectively verify. But be that as it may, 17.1 percent acknowledging “misuse” is pretty damned significant. I’d also submit that most who ARE dependent on these drugs are probably not aware of it, and would not be until they tried to come off the drugs. All in all, this article doesn’t seem to contribute much to my understanding of either abuse of or unintentional dependence on Benzos as a social/medical/philosophical problem.
It is important not to misinterpret Miller. She’s not saying that our parents are abusive assholes, she’s saying they are suffering from THEIR parents’ shortcomings, who were suffering from THEIR parents’ shortcomings, etc., and that unless the parents are able to face and feel the pain of their own childhoods, they will repeat what happened to them and pass it on to another generation. Blaming parents is NOT what she’s about – the idea is to learn where your parents went off the tracks and EXPERIENCE the pain you were avoiding, so that you have a chance NOT to pass this pain on to others. But if the therapist him/herself has not does their own work, they pass on THEIR parents’ pain and shortcomings (and maybe their therapists’) on to their clients.
So in the end, it is kind of dangerous to go see any therapist, as they may be working out their shit on you. You’d have to carefully screen for self-awareness, humility, and ability NOT to put their shit onto others before you ever consider a therapy relationship. That’s what I see, anyway.
“We don’t know how it works” is quite an admission. I’d challenge the “but it works” part with, “Works for whom?” or “Who gets to decide what ‘works'” means?
I was an advocate for nursing home residents at one time in my career. I visited one facility because a family member said her dad was overdrugged on Abilify or some other “antipsychotic”. I went to talk to the guy, and he could barely keep his eyes open, couldn’t even stand up without assistance. He had bruises on his forehead from running into the door jamb on the way to dinner. I talked to the activities director, who said a week ago, she’d been hitting a volleyball back and forth in the courtyard with this same guy.
Did the Abilify “work?” Well, if your intent was to induce a near coma so the guy was incapable of doing anything at all, I’d say it worked great. If the goal was to enhance his quality of life, I’d say it did the opposite. Those who claim it “worked” clearly consider his quality of life to be a secondary concern, or of no particular relevance. So it “works” for them, even though it destroys the client’s life.
Beware of anyone claiming something “works” on someone else!
The problem with this “reasoning” is that there is no evidence that “treatment” makes things any better. In fact, the more “treatment” is passed around, the more chronically “mentally ill” people seem to be appearing. So more and more of what doesn’t work is the answer?
I also know a person of privilege who had a hallucinatory experience, and was “diagnosed” as “bipolar” and discriminated against in their work and other settings for this label. It was interesting to note that this person claimed that they were “misdiagnosed” and were having a “spiritual awakening,” but continued to believe there were “real” bipolar people out there, only she wasn’t one of them. This person’s emphasis was on proving she was not “one of them” instead of identifying the labeling process itself as opening the door to very real and serious discrimination and abuse, which of course anyone labeled “bipolar” would likely experience, regardless of the reason for their label being attached. I understand why this happens, but I think it shows how hard it is to arrange a sense of “comradeship” when the entire process is so fraught with danger for anyone participating as a “client” or “patient.” When people are scared and isolated, they tend to search for a way to save themselves, and the plight of others may not occur to them until well after the incident, or in many cases, it may not occur to them at all.
I like your thinking here. Options without domination seems to be the best way to help people. Domination is often what created “mental illnesses” in the first place, so it’s not likely to make us better!
I think the biggest problems with screenings are a) screeners who don’t care (employed in a cold way is a great way to put it) and b) the person or organization doing the screening has no idea what to do about the situation. I read a doctor one time saying, “So we screen for suicide and the answer is positive. Now what the hell am I supposed to do about it?” Of course, the “right answer” is to refer them to a psychiatrist, but we know that doesn’t generally do much to solve the problem.
The problem I see is that there is no way to ever prove them wrong. If they claimed you had high blood pressure, you could have someone measure your blood pressure and say, “See, it’s in normal range.” But with psych “disorders,” it is always a matter of someone’s opinion, and anyone with an MD gets more autotmatic credence than the average Joe, and a LOT more than someone they’ve labeled with a “mental illness.” As long as there are no concrete criteria for deciding who “has” and “doesn’t have” a “mental illness,” the psychiatrists/psychologists/doctors will always be in control!
Yeah, I love it when telling them you don’t want their “help” is an indication that you NEED their “help” because if you were “mentally healthy,” you’d automatically agree with them about everything! Talk about “crazy!”
In my experience, the act of invalidating someone’s ability to decide what is happening and what to do is the very SOURCE of most instances of what the DSM calls “mental illness.” To provide “treatment” that involves further invalidation and “I know what’s best for you” energy is like putting out a fire with gasoline. It is literally the LEAST helpful thing you can do, besides overtly abusing the body of your patient. Yet people get paid to make other people’s lives worse.
If “psychiatric treatment” helps people overcome “mental illness,” why aren’t there fewer people suffering from “mental illness?” Seems like the more “treatment” is provided, the MORE “mentally ill” people turn up!
Isn’t the fact that there is no way to measure the quality of psychiatric care kind of proof that we’re not dealing with medical issues? What if heart surgeons said that there was no way to tell if they did a good job or not, so that everyone should just let them do whatever they want to? I don’t get why they get away with that kind of nonsense.
Because the “depression” was rude enough to refuse to get better with the drugs. Though no one bothers to ask the nice old lady why she might be feeling sad or hopeless.
I tend to laugh at the idea of “treatment-resistant depression!” As if “depression” is a sentient being that can “resist!” What they mean is, “My approach to helping you failed completely,” but instead of admitting this, they blame the patient. It’s like the car mechanic saying, “Your car has repair-resistant fuel injectors” instead of admitting he doesn’t know how to fix the car. That way, he gets to charge you for it and offer to charge you for another “treatment” next week, even though he hasn’t the first clue what he’s “fixing!”
Commenting as moderator: The phrase used in the last comment is not intended as an insult to Catholics or Christians, but as a metaphor for how the poster felt being abused at a Catholic institution for many years. No offense is intended to Christian believers.
True enough – horseshit at least can serve a purpose, while the DSM is useful only as a doorstop or extra TP or to start a wood fire in your fireplace. Maybe as a defensive weapon if attacked. It really has no productive purpose at all, and in fact is destructive in the extreme.
Some patients want someone else to tell them what’s wrong with them, even if doing so is the opposite of helpful. But some most definitely are looking for someone to help them explore their own needs and thinking and emotions to find a better way to live. There is also a group in the middle who are willing to believe the psychiatric story because “they’re doctors” and it sounds very “sciency,” but are to one degree or another disappointed that the promises they were given don’t come to fruition, and eventually, these people rebel, either quietly or loudly, but sometimes it takes years or even decades for them to really “get” what happened.
I remember when I worked on a suicide hotline, I got a call from a woman who said she’d been trying different antidepressants for over a year. She was quite frantic, saying she was working on her 5th antidepressant and none of them worked, and she told her doctor that it wasn’t working and all he would say was, “You have to give it time” or “let’s try another one.” She was panicked that she’d always feel depressed and be waiting for something that would never happen. I acknowledged that this was very difficult, then asked her a simple question: Had anyone ever told her that there were other things she could do besides taking drugs for depression? She was suddenly calm. She said, “No.” I said, “Well, there are.” She said, “Oh. Well, that’s good!” and then we got to talking about what else she could do.
I don’t think she “wanted” a diagnosis. She wanted help with a situation she didn’t understand, and the doctor told her what to do, and she tried it, having no other frame of reference. If the doctor had told her something more sane, she would have taken it up in a moment. Her only fault was trusting the doctor, not wanting to avoid responsibility for her condition.
It is easy to make generalizations, but as I like to say, “All generalizations are always wrong.” People are different, and we ought to consider that when making our analyses.
Well, you know yourself better than I do, and you should act in accordance with what works for you. As I said above, I tend to avoid doctors whenever I can, too. Even the nice ones have a lot of false information they’re working on.
I actually screen my doctors ahead of time. I let them know that I’m in charge of decisions, they’ll advise me but I may or may not take their advice, and if that’s not OK with them, they should let me know right away and I’ll find another provider.
Though I prefer to avoid doctors altogether. I usually get a nurse practitioner or a physician’s assistant to be my PCP. I actually now have a naturopath as my PCP. The less I see of doctors, the happier I am, generally speaking.
A doctor almost killed my father when I was 8, as he was taking blood thinners (which he reported to the doctor) and was prescribed something that created uncontrollable bleeding when combined with blood thinners! His arm bruised if he just set it on the table. If he’d fallen off a ladder or been in a minor car accident, he’d have bled to death in minutes. I learned at that young age never to take ANYTHING I hadn’t personally looked up for adverse effects, no matter what the doctor told me.
Ignorance or malfeasance or a combination of both, it doesn’t matter much to the client/patient/victim, they’re still harmed just the same. If they don’t actually know the adverse effects, they should not be prescribing it. It’s like saying, “I didn’t know guns shot bullets.” PUH-LEASE, take a little responsibility, medical folks!!!
Nothing irrational about being afraid of people who are dangerous to you!
As for depression screenings, my understanding is that it’s totally OK to refuse to do them. It is also completely legit to just answer in the way that reflects best on you – they have no right to know your inner thoughts and feelings!!! So if they ask me, “Have you felt depressed in the last three weeks?” of course, I always say, “No” no matter what I’m feeling. I’m sleeping fine, my appetite is fine, etc, etc. until they are done. But the more I think about it, the next time I hear them starting in on this, I’m going to say, “Is this a ‘depression screening?’ If so, I decline to participate and will not answer any questions on the screening.”
That may or may not be realistic for you. I find it obnoxious that they have the temerity to do such a screening when they have no idea what to do with a “positive” outcome (and of course are screening in the first place for something so vague and subjective that no one can tell if you “have it!”) But I do know I’m in charge of my own medical care, and the more I assert that right, the better I feel about my interactions.
“Unaware of adverse effects” is absolutely no excuse – if they don’t know the adverse effects, they have no business prescribing them! And the truth is, most know enough about the adverse effects to know they’re not being honest when they prescribe. I believe point #2 is the main reason – they don’t want the truth to get out because many of their clients would then refuse to take what they prescribe, and that will cost them in some way or another. It’s quite intentionally dishonest.
Psychiatry proved quite comfortable with both Stalin and Hitler, as well as modern western democracies. Like cockroaches, they adapt to whatever environment is provided.
It is clear that the DSM diagnostic process is DESIGNED to create “stigma” and justify discrimination against those who are perceived as “different” or danagerous.
One could almost say there is an effort NOT to understand the cause of severe emotional pain. My experience as a provider was that it was rare that most “clinicians” asked such questions, or if they did, they’d simply “catalog” them along with other “symptoms” in order to claim a “diagnosis.” Very few seemed to understand the significance of such events, and of those who did, most didn’t really know what to do about it. I used to say there’s a one in five chance of getting a competent therapist. Nowadays, I think that would be a gross overestimate!
The basic approach of psychiatry is to suppress the brain’s abilities and to impair normal functioning. Kind of like, if your hand hurts, numb your hand. If that doesn’t work, remove it. There is no effort to actually determine WHY your hand hurts or what else might be done. If “depression” is the problem, then the “answer” is to make the person less depressed. So “antidepressants” are the way to go. The idea that a person may have a good REASON to be depressed, or that some other physiological problem is causing it, doesn’t appear to be a relevant concern of theirs.
He no doubt overlooks the most obvious reason: more “treatment” CAUSES more suicides and mental distress! The BEST spin you could put on it is that “treatment” is completely ineffective, but there is plenty of evidence to suggest it is more dire than that. Plus the widespread false propaganda that “mental illness” is caused by and helped by physiological processes prevents people from doing things that actually DO work.
It is my belief and observation that the very act of labeling someone’s problems as an “anxiety disorder” or “major depression” is demoralizing from the get go, and even without the adverse effects of the drugs (which clearly DO make some people worse!), the labeling process most likely contributes both to mental distress AND suicides.
My impression was that she died early due to years of “treatment” for “bipolar disorder.” She did some PSAs for “recognizing bipolar disorder” or some such “anti-stigma” memes. She is not alone, as the average lifespan of those diagnosed with “bipolar” or “schizophrenia” is literally 20-25 years shorter than the average person. I wonder why?
There is also the question of grouping. If one treatment cures 10 percent of the “ADHD” population, but drugs “reduce symptoms” in 70 percent of the population, the 10 percent treatment will be regarded as “ineffective,” even though it cured one out of 10 people completely. If you have arbitrary and/or purely subjective groupings of subjects, you’re not going to get any meaningful information. A REAL scientist would look at that 10 that WERE cured, and say, “Wow, what is different about these people that treatment X worked so well?” Then they might actually be able to identify a true group that has something in common with each other, and THEN (and only then) can they actually look for causes.
But too many people are hypnotized by the “Gold Standard” argument and think that anything producing a p value under .05 is “evidence based,” regardless of the triviality of the result or the heterogeneity of the group. It is a setup for drugs to “win” every contest, and I doubt very much if that fact is accidental.
“Stigma” really is a euphemism for intentional discrimination. And of course, the ones complaining MOST about “stigma” are the ones who are most committed to this kind of discrimination themselves!
“Negatively influencing outcomes?” Don’t they mean “Negatively influencing profit margins?” As far as I can tell, outcomes for most any “mental illness” you define either remain the same or get worse with long-term “medication” (aka drugging). Stimulants, antidepressants, antipsychotics, all are associated with either no change or deterioration over time when used long term. Not to mention killing people off 20-25 years younger with the antipsychotics, hardly an “improved outcome!” How do the doctors get away with this nonsense?
I agree. It’s also true that correlation can be “significant” in terms of P values, yet there can be enormous overlap between those “having” and “not having” the anomaly in question. To be diagnostic, a particular “anomaly” has to occur in all or almost all of the test subjects, and in none or almost none of the control group. The fact that “ADHD” diagnosed kids have a 5 percent smaller brain volume (notwithstanding the issue of drug effects on brain size) means almost nothing, because 95 percent of the kids will have brain volumes that overlap with the “normals.” So the smaller brain size, whatever the reason, doesn’t indicate “ADHD,” because too many non-ADHD people have the same brain volumes as “ADHD” people. Of course, there is absolutely NO reason to expect that a random-ish list of behavior that adults tend to find annoying would somehow translate into a measurable “brain dysfunction.” So the whole effort is pretty much a waste of time.
The problem with this kind of research is that lumping all people diagnosed with “Major Depressive Disorder” together for study is kind of like grouping people by “pain tolerance” or “tendency to breathe deeply” or “having a poor appetite.” The “criteria” for “Major Depressive Disorder” do not distinguish valid groups of people likely to have something neurological in common. The very idea is based on a logical fallacy, and can’t lead to any kind of valid scientific answers.
“We examine the effects of a policy change in the province of Quebec, Canada which greatly expanded
insurance coverage for prescription medications. We show that the change was associated with a sharp
increase in the use of stimulant medications commonly prescribed for ADHD in Quebec relative to
the rest of Canada. We ask whether this increase in medication use was associated with improvements
in emotional functioning or academic outcomes among children with ADHD. We find little evidence
of improvement in either the medium or the long run. Our results are silent on the effects on optimal
use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the
community.”
The long-term MTA study results show no advantage to stimulant use over time:
“The latest follow-up, released in March 2017, further confirmed the association between stimulant medications and reduced height; patients who took stimulant medications consistently were an average of 2.36 centimeters shorter than their peers who had stopped taking medication or who took it only sporadically. But, in a confounding twist, the two groups (those who took medication consistently and those who didn’t) showed no difference in symptom severity — though members of the former had, on average, taken more than 100,000 mg. of stimulant medication over the course of their lifetimes.”
The researchers do some pretty good pretzel twists to try and minimize these results, but it certainly suggests strongly that there are no long-term benefits to stimulant use.
There is also a comparison study of Finnish vs. US students. Far more US “ADHD” students took stimulants, but there were no differences in outcomes. I can’t seem to find a link to this study.
So the jury is long since in on this question. There are no long-term benefits of stimulant use for “ADHD” diagnosed kids.
The power imbalance is the central conflict in any kind of “therapy.” In my experience, those who can step down from their power advantage are the only ones who are ever successful in helping their clients. People generally don’t need another boss – they need a human being they can feel safe with!
The problem is the “honest” part – those benefitting from these “diagnoses” are not interested in having an honest debate, because they know they have no solid data underpinning their approach. But they have the power to deny any other view through use of their “authority” to suppress actual debate and known research.
Pretending to “help” people for pay when you have no actual idea what is helpful or even what you’re supposedly helping with is a very shallow approach.
This has always seemed true to me, but everyone seems to think they are very “sciency.” I remember a study showing that including brain imaging pictures in an article, even if it had nothing to do with the content of the article, made people more likely to find it credible.
Humans are unfortunately too gullible in many cases.
But only if the adults took responsibility for creating the best environment for the kids, instead of expecting the kids to “adapt” to whatever the adults decide is “normal.”
I can’t seem to find it – not sure what I did with my old “ADHD” article copies! I think it might have been done by Dr. Sydney Zentall, because she’s been talking for decades about how changing the environment to create optimal stimulation is best for “ADHD” kids, rather than trying to artificially stimulate them with drugs. But I’m not sure. I’m sad I can’t find those documents! But I assure you, that was the result.
The other important result, and I can get citations on this one, is that “ADHD” kids taking stimulants don’t do better academically (or on any other outcome measure) than kids who don’t in the long term. So why are we doing this to kids, if it doesn’t even help their long-term academic outcomes????
It is somewhat stunning that people can’t see the utter shallowness of the psychiatric/DSM worldview. Just reading the names of the “disorders” is enough to make a rational person laugh out loud! “Oppositional Defiant Disorder?” How do you know you have it? Because you won’t do as you’re told!!! “Intermittent Explosive Disorder?” “Disorder of Written Expression?” How is any of this taken seriously???
I think you make an excellent point. “Crazy” behavior is almost always a result of someone feeling trapped or used or as if they failed based on someone else’s judgment of what they ought to be doing. It would have been interesting if you and the teacher could have sat down years later and talked about what happened, and maybe understand what was going on for each of you. But I do hold people in positions of responsibility to a higher standard of controllinng their behavior when vulnerable young people are in their charge.
I apologize for my use of that language and appreciate your feedback.
I have often used the “canary in a coal mine” analogy for the “ADHD” kids. If these kids are having a hard time paying attention, it means that 9 out of 10 of the rest of the class feels the same way, but they are restraining themselves to stay out of trouble. The only “problem” with the “ADHD” diagnosed kid is that they aren’t as skilled at repressing their boredom or sense of frustration or outrage as the rest of us. Hardly a “disease state!”
I also agree that we do try to change the kids instead of the environment. Some seminal research was done on “ADHD” kids back in the 70s, where two well-matched groups of “ADHD”-diagnosed kids were put half in a standard classroom and half in an open classroom. They then had teachers come in and try to identify the “ADHD” children. In the standard classroom, they were over 90 percent successful. In the open classroom, there was a very slight but not significant trend toward the “ADHD” being picked. In other words, put these kids in an open classroom, and you can’t tell them apart from “normal” children! Now this was done way back in 1978 or so. So why haven’t we created open classrooms for our “ADHD” children? I guess no one profits from open classrooms, while selling stimulants is a lot more profitable. Plus changing the environment means the ADULTS have to take responsibility, while “ADHD” means we can blame the kids and keep doing whatever we want as adults. It’s disgusting to me.
Except that “removing evil spirits” can’t actually harm you! Much preferable to the “active placebo effects” of SSRI antidepressants, for example. If someone can get better by an exorcism, so much the better for them, because they can dispense with the psychiatric system, which can really do some damage!
I actually prefer the idea of tying kids to a chair. At least they’re being honest about what they’re doing and can’t pretend it’s “for the good of the child” or some “educational intervention!” But well done for you for defeating that crazy teacher!
I am very much in favor of reading Miranda-style rights to anyone subjected to an “evaluation.” The right to remain silent and the right to consult with an attorney should be afforded to the “mentally ill” if an alleged criminal has those rights.
Yet somehow, Psychiatry pretends that all these people have the same “condition,” the same problem, and need the same “solution!” And 99 percent of people believe they know what they’re talking about!
I’d just add that is possible medical doctors don’t go for “mental health treatment” because they know better than most people how dangerous some of the “treatments” are. If you ever read the entire label for Abilify or Seroquel, or even an SSRI antidepressant, you’d be a lot more careful about ever being “treated” with one of them!
I am aware of a case from near the Mexican border, where all angles of “western” psychiatry had been tried on a so-called “schizophrenic” in a hospital there. They brought a shaman from Mexico over the border to do a spiritual exorcism. The person got better.
There are also shamans involved in the hospital system in Brazil, from what I understand. I don’t have any idea if “spirit possession” is a real thing or not, but spiritual cleansing of various sorts has been arguably more effective than anything psychiatry has to offer. And the side effects appear to be WAY less!
I am not sure if the title is meant to be sardonic, but of course, psychiatry’s real failure lies in the last part of the title. If your goal is to “stop” self-harming behavior, you’ve already missed the boat. Self-harming behavior meets a need, and the key is understanding the goal/purpose of self harm and to help the person evaluate for him/her own self whether or not s/he wants to change that behavior. Attempting to force someone to “stop” self harming has been demonstrably destructive any time I’ve seen it attempted. If self harming is about having control of one’s pain, how can trying to force a person to stop be a good idea?
Sure. A farmers’ market. People bring their goods, put a price on them, other people decide if they want to buy or not. No fakeo marketing, responsibility to the community putting up the farmers’ market not to violate basic rules, real competition for prices (no monopolies), consumers determine what is too high a price or what is popular enough to bring more of or charge more for. Workers have basic control of their workplace (most work for themselves or family). No money leaves the local community. If you’re mean or pollute the environment or are unsafe, you’re not asked to come back, or no one is willing to buy from you. It’s a nice model of what a free market COULD look like without billionaires and mass marketing and monopolization.
Right. It appears the only “normal” people are the mildly sociopathic, because they never get too excited or too upset about anything. Looking at the DSM, it appears that having any kind of emotional reaction to anything is the sign of “mental illness.” Even annoying OTHER people makes you ill! Those people with no personalities in “Invasion of the Body Snatchers” or “The Stepford Wives” are the epitome of “good mental health” by DSM standards!
Having worked at a number of “mental health” facilities in my younger days, I can tell you there is ALWAYS at least one psychopathic/sociopathic person on staff. Never worked at a place that didn’t have one. Half my time was spent undoing the damage of these one or two people who either had no clue or didn’t care or actually enjoyed messing with people’s lives.
The other thing they fail to mention is that these differences are AVERAGES. There are TONS of “depressed” people with higher IQs or larger hippocampi and non-depressed people with smaller ones. If there really WERE some kind of neuropathology, we’d see more like 90% of depressed people having smaller hippocampi, or 85% having much lower IQs. This kind of research is horseshit, but it passes for “scientific” because they can tease out a P value of .05 on an average of hundreds or thousands of subjects. Any meaningful finding would have to clearly distinguish the “haves” from the “have nots.” This doesn’t even come close. It’s a joke.
Not to mention having a depressing life: dead end job, stuck in an unhappy or literally dangerous relationship, dealing with childhood abuse and abandonment, or just dealing with the inherently stressful lifestyle that we’re all expected to “love” today, and if we don’t, we’re considered “disordered” for wanting to make major changes in our current reality.
Of course, such a project is a failure scientifically before it starts. Because it starts assuming that “Major Depressive Disorder” is a unitary THING that has a unitary CAUSE. Why would we assume that ALL people who fit a subjective list of “criteria” that have little to nothing to do with the body itself would have a “neuropathology” that causes them to fit this subjective list? It would be like asking, “What is the neuropathology of cowardice?” or “What is the neuropathology of spontaneity?” Why would we assume that all depressed people even HAVE a “neuropathology” without evidence that this is the case. It might be viable to ask if SOME cases of “major depressive disorder” might have neurological underpinnings, but we can’t assume the conclusion, as these “researchers” appear to have done. In order to do a REAL scientific inquiry, it would first have to be identified WHICH cases have some kind of neurological problems, how to distinguish them from people who just happen to feel really bad for a long time, and to create a group of people who actually DO have some kind of evidence of neurological “causes” as a study group.
But instead, these folks just assume that there IS a “neuropathology” and their “research” is to find evidence to support the conclusion they want to find. That’s not science!
I know. It’s not really capitalism when it’s part of a local community. The local community asserts its values and requires social behavior of local producers. It’s kind of like unspoken socialism – you have to behave or you are shunned. But that stops working pretty fast when the person doing the production is no longer invested in the community they produce in. As soon as people become expendable, things spiral very quickly out of control.
To be clear, I’m saying I have no problem with the local farmer bringing in food to sell, and using his money to buy shoes at the shoe store, with farmer, shoemaker, and whomever profiting from their honest labor. That’s the level where I see the “free market” working. As soon as the rich guy can move out of town and pollute the river or undercut local businesses to create a monopoly without any fear of community consequences, we are in trouble.
A good point, Yinyang. However, I would posit that one can actively oppose psychiatry in a most vigorous manner without having to give psychiatry the “respect” of granting it any kind of professional status.
I like your comment that no one needs to claim to be “anti-astrology” or “anti-phrenology.” All we have to be is “pro-truth” and “pro-rationality.” Psychiatry embraces neither of the above.
I don’t disagree with you, but I am quite sure that psychiatrists in both the Soviet Union and Nazi Germany made plenty of money. It is true, their malfeasance and ill intent appears to go well beyond that simple motivation, but my original point was that the psychiatric profession has absolutely no intellectual or philosophical connection to Marxism. It seems to be quite adaptable to whatever form of government is present, which I suppose provides more evidence that the intent goes beyond cupidity. But there is no question that greed plays a very large role in the current application of psychiatry, and the “profession” (if we may use that term VERY loosely) would be quite upset if a Marxist revolt took away their gravy train.
Do you not see pharmaceutical corporations as fully complicit in the structure and marketing of psychiatry in the 21st century? Or the 20th for that matter? How could psychiatry sell its wares without Big Pharma? And is not Big Pharma the ultimate end game for corporations – almost unlimited profits with almost no accountability? Isn’t this where unfettered capitalism inevitably leads? What forces oppose this natural tendency of corporations to get bigger and richer and to eliminate the competition? Isn’t that what international Corporate Capitalism has always brought us?
I think capitalism can work on a very localized scale, but only because there is a natural set of checks and balances whereby the local population can call the capitalists to account. If the local mill is dumping waste into the river, the citizens downriver can get together and say, “Hey, knock that shit off” and they have to listen, because they are neighbors and if people get pissed at them, they will stop buying from them. But if someone in Taiwan or Chicago or London is polluting my local river in Washington, what the hell can I do about it? There is no one to complain to, and the big company doesn’t give a crap if I live or die, as long as the money keeps coming in.
That’s why I see psychiatry as a fully capitalist enterprise they exist to make PROFITS, they collude with others making even BIGGER profits, and they are utterly unaccountable to the population they claim to serve. That’s as capitalist as it gets in my book.
Nobody’s saying the current system is working, Richard, or I’ve certainly NEVER said anything remotely like that. I told you I agree with Marx’s analysis of capitalism, which was and is indeed genius. I just don’t see him providing a workable alternative system, that’s all. Maybe more practice is needed, maybe I’m too cynical about “human nature,” maybe I can’t envision enough people being educated (or even interested) enough to learn the reasons why cooperation matters. My observation is that current society requires a HELL of a lot of cooperation, yet this is all very much taken for granted and people are easily manipulated and taken advantage of by posing “us vs. them” scenarios. I would love to see the “workers unite” and create some better conditions. I just don’t see Marx as providing us a pathway there. I get stuck in how the “Dictatorship of the Proletariat” leads to the classless society. It has not yet happened in reality. Israeli Kibbutzes are probably the very best example to date, but my understanding is that they are now a very tiny part of Israeli society.
You’re free to disagree, but I think you could ease off the suggestion that I think “capitalisms is the highest pinnacle of human organization.” You know very well I never said that, so please refrain from “strawman” arguments in the future.
Marxism as practiced has been a disaster. I think Marx’s analysis of what was wrong with capitalism was quite accurate, but his solution fails to take human nature into account. Humans need to feel like they are competing in some way, that their individual efforts make a difference. They don’t do very well working for “the good of the collective,” much as many like to think they do. Collective farming was the best example – production was very low, until they gave everyone their own 10 acres or whatever to farm. The productivity on the private land was many times that of the collective farms. I suppose you could say that people need a game of some sort, a way to “win” or “lose,” and collectivist farming doesn’t seem to provide it.
But of course, the other verity of humans is that “power corrupts,” and it was ironic to see the Communist Party leaders hanging out in the same dachas of the aristocracy they claimed to want to get rid of.
So sure, communism in practice was a total failure, and led to dictatorship in seemingly ever case. But that doesn’t make psychiatry communistic. It’s just plain authoritarian, and so naturally will do well in either fascist or communist or any other authoritarian state where the need to control other people is prominent. However, it should be observed that while the communists USED psychiatry to keep their rebels under control, psychiatry was part and parcel of the planning and implementation of Nazism in Germany, up to and including mass murder. So I’d still say psychiatry proved a better “fit” with fascism overall.
Regardless, it appears to me that psychiatry is less interested in economic theory and primarily concerned with making money and establishing power over others. They will do so in whatever economic system is in use. They are very, very comfortable with capitalism, as drug company profit margins on psych drugs should make very clear. Communists are anti-capitalists. Psychiatry, simply put, is not.
It is always ironic when they go on and on about the dangers of Vitamin B3 or others because they “haven’t been fully tested,” while they give out drugs that they KNOW reduce people’s lifespans by 20-25 years. Hey, I think I’ll take my chances with the “untested” vitamin B3!
I have a hard time seeing anything “Marxist” about the “mental health” system. There is no effort or intention to create equality between workers and the wealthy, nor any effort to redistribute control of the means of production to the masses. If psychiatry had “Marxist” roots, it would create collective wards where no one had any economic incentives to push drugs on another person.
Psychiatry is a strictly capitalist enterprise. It is about making profits, regardless of the effect on the “consumers.” It is about projection of the power of the wealthy over the rest of us. Nothing Marxist about it, in my view.
I agree 100 percent! And I don’t even consider them Western European and North American accounts. I consider them medicalized accounts of psychosis and mental illness, which work primarily for those providing “services” and selling drugs, and which work for almost no one of any culture otherwise.
We are now getting off the topic pretty far. I will allow this statement, but I do not want to deteriorate into a hostile exchange about COVID or about Gavin Newsome, and I see this as a very real possibility, based on past experience. The article is on “The Danger of Marginalizing People,” and comments need to be focused on that topic, specifically as it regards the “mental health” system. If we get into political discussions of other topics, I will intervene to keep the discussion on topic.
Well, of course, I agree 100%, a “personality” can’t have a “disorder,” it is not a thing of the physical universe, it’s a consequence of thought and decisions made by a person. And I’d say that of course, a personality CAN be changed – I see it more or less as an invention a person creates to deal with the decisions they need to make to survive in the physical universe. I like the question of “genetically inherent” or “culturally inherent.” I might also add “spiritually inherent,” because I see it as entirely possible we bring some history with us when we arrive on the planet. But that’s getting deeper than we need to here. The very idea that a “personality” is something that can be “ill” or “disordered” is pretty outrageous, and yes, obviously has to come from someone else judging a person’s “personality” as being good or bad or inadequate. It is observable, but I don’t think anyone but the person him/herself is in a place to judge the quality or usefulness or need for change of the personality. It’s something we own completely ourselves. Criticisms of a set of “personality disorders” is rank prejudice and nothing more.
So I’m totally with you – psychiatry is utter bullshit, because it starts from a false premise that there is a “right” personality or “right” mind that only THEY can determine, even when they have no idea how they possibly could begin to make such judgments. Such is the hubris of psychiatry!
Yes, I most definitely have considered that question in detail. I think you ask an excellent question, and one to which I nor anyone else I know of has a real answer. It could be viewed as a metaphor, certainly. I think it is one of those things that we only observe by seeing the results of it, kind of like magnetic force or gravity – you only know it’s there because of what effects it has on objects within its sphere of influence. That being said, the “mind” is a similarly problematic force. Assuming that the “mind” is simply an effect of the brain leads us to psychiatry or other empty conclusions. It appears there is something that is able to INFLUENCE the brain, to the point of actually altering its STRUCTURE (look at the studies on altered brain structure in meditating Buddhist monks, for instance), yet no one can really say what it is?
But I’m not one to say something is “bullshit” just because I can’t explain it. That’s not really scientific, either. I am much more inclined to simply say that personality is a pattern of behavior that a person tends to engage in, sort of the interaction between his/her mind and the environment s/he encounters, that some of it appears to be “inherent” and some learned, but that we don’t really know what it is or how it comes to exist, any more than we know what the mind is or how it comes to be. It’s a mystery, and I’m OK with that.
Eh, I still think you’re talking about rearranging deck chairs on the Titanic. “Effectiveness” is a very problematic term when your “diagnoses” are voted on by committees and there is no objective way to create any kind of legitimate study groupings. Beyond that, the concept of a treatment “working” requires some agreement on desired outcomes, and no such agreement exists in psychiatry/psychology, nor probably ever can or will. For instance, is the goal of working with an “ADHD” child to make them “less hyperactive, distractible, impulsive?” If so, then stimulants seem to “work” pretty well. But if the goal is to have them become more academically competent, stimulants are a complete bust, may actually make things worse in some cases. So what’s the goal? We all know that in practice, the goal is to make the kids more compliant (dosing studies bear this out in every case). Is that really a legitimate measure of “working?” If it is, gagging and tying someone to a chair would also be judged to “work.”
Psychiatry has massive philosophical conflicts preventing it from successfully studying anything it its realm of interest. I don’t see that changing any time soon.
HiTop still doesn’t bother to look at the causal factors in whatever presentation is seen. Ten people could all exhibit “OCD” symptoms for 10 different reasons and need 10 different interventions. Until a “diagnostic” system is based on finding the actual CAUSE of something, it is worse than useless. And since the causes of so-called “mental disorders” primarily exist in a realm called the “mind” which psychiatry has not the vaguest understanding of (still confusing “mind” and “brain” and insisting they are the same), the odds that they will somehow sort this all out are about zero.
I have talked to plenty of adults and kids before and after stimulants. Some do talk like you do about it. Of course, these are the success stories. Most in my experience appear to view it as a somewhat helpful intervention in the short term, but complain a lot about the costs. A small number complain that it nearly destroyed their lives. You appear to communicate mostly with people who found it worked for them, so you have clearly decided that this is “reality” and other people who have different experiences are “wrong.” That’s what I’m objecting to. I’ve never said that you or others like you did not have positive experiences. I have said that these experiences are not uniformly positive. I’ve also said that other people have managed to have very positive experiences without drugs. What is wrong with that? Why are you unwilling to hear that viewpoint, if this stuff makes you “listen better?” Not everyone has your experiences.
I’ve also shared hard research with you backing up my viewpoint that a) not everyone benefits, b) most benefits are short term, and long-term outcomes have been shown over and over again not to be altered by stimulants or the lack of stimulants, and c) there are other things that you can do besides/in addition to stimulants that really do help.
Again, what is your problem with any of that? Do you NOT want there to be other ways to help? If some kids can do well without stimulants, why do you begrudge them that opportunity? Why not keep a child back a year and see if they do better after a year of maturity? Why not put your kid in an open classroom if kids like him/her do well in that kind of classroom? Why take the viewpoint that a person (me) who has raised his kids successfully without stimulants has somehow deprived his kids of “clear vision” when it’s obvious they are none the worse for wear? Why can’t you simply allow that what you did worked for you, but others may take different approaches? I have NEVER told you that your approach was wrong, or that people who medicate their kids with stimulants are abusing them or doing them harm. Why am I and others like me not afforded the same decency from you?
Please don’t respond with more insults. I need an acknowledgement that your way is not the only way, and that people who use other approaches are not wrong for doing so. If you can’t manage that, please don’t say anything at all.
I think that comment is very telling, and it supports my contention that most of the suffering that occurs to the “ADHD” child is due to the unrealistic expectations adults put on them in order to attend school, as I stated above. This comports 100% with the observation that ADHD-diagnosed kids are found to be essentially “normal” in open classroom settings where they are encouraged to move around and have more control of their environment (fewer unreasonable expectations). That approach certainly worked wonders for our kids.
It also helps explain why a third of the ADHD diagnoses go away if kids go to school a year later – they are older and more developed and it’s easier for them to follow the expectations set for them by the school. It also helps explain why so many kids “grow out of it” in their teen years – they are developmentally older and more ready to adjust to outside expectations of the school and others (this was certainly true for my oldest).
More importantly, it also explains why kids who take stimulants over the longer term don’t actually end up with better outcomes, even though their grades and adult approval ratings are better on stimulants. The stimulants make the adults happier and less concerned with the kid. The child’s learning environment is not improved, he is not doing anything different than his non-stimulated ADHD classmates, but “everybody else is being a lot nicer.”
So effectively, stimulants create an environment where the adults are more willing to leave the poor kid alone!
I know this is a perspective that you, Donovan, may disagree with, but I think the logic presented here is very consistent with Insel’s report from his son. The main benefit to his son was not being able to concentrate or learn more, it was that others were nicer to him! I hope you are able to listen and hear this perspective as I have listened to and heard yours.
I agree with you. It is pure “cultural bias” to believe something like “borderline personality disorder” even exists at all. It is clearly skewed against women for starters. And how can you “overdiagnose” something that is not objectively diagnosable by any known standard? It’s like saying that beauty or cowardice or kindness is “overdiagnosed.” If there is no objective standard, there is no meaning to “over-” and “underdiagnosis.” We’re just making shit up, and no one’s “diagnosis” should be invented arbitrarily. But if it IS invented arbitrarily, it’s nonsense to talk about “overdiagnosis!”
I also find it fascinating that the Industry wants us to believe all these conditions are “biologically based,” yet when they do animal tests, they have to terrorize and traumatize the animals to induce the proper “mental state.” One might get the idea that these “mental illnesses” they are testing are, in fact, the result of terror and traumatization!
I am glad that you found stimulants helpful to you. But you continue to argue a point no one is making. And you are now getting insulting implying that those making these arguments don’t give a crap about the children involved. I can tell you that I spent over 30 years in the field of helping children and saw and talked to hundreds and hundreds of kids diagnosed with “ADHD,” as well as their parents, their teachers, their counselors, their siblings and others involved with them on a daily basis. So I am not basing my opinions on some intellectual exercise. They are informed by much direct experience, including with my own kids, and calling me “criminal” for drawing the conclusions I have made after decades of research and direct personal experience is most definitely beneath you.
Additionally, your personal experience is important, but does not mean that your own experiences are “average” or “expected” from all or most “ADHD” diagnosed people. In fact, decades of evidence show that there are no reliable improvements in ANY long term outcome areas for long-term stimulant use, including academic test scores, high school graduation rates, college enrollment, delinquency scores, social skills, employer satisfaction, or even self-esteem. However YOU may feel about YOUR treatment, or others you know, you can’t claim that children are being cheated out of this special advantage that science says does NOT happen for the large majority of recipients.
I’d really appreciate it if you can constrain yourself to presenting your personal experiences and such scientific data as you feel you’d like to share, as well as directly addressing the science and experiential data that has been presented to you in good faith, and leave off on the disparaging comments on individuals who happen to disagree with you, especially when those objecting have presented their own data to which you could choose to directly respond.
Bottom line, you have your experiences, others have their experiences, they aren’t going to be the same, and all such experiences are welcome to be shared. Please be respectful that not everyone is going to see things your way, and that disagreeing on science is not a personal thing.
I have never said that stimulants can’t be effective for people in the short term. My premise, if you will read more carefully, is that the appearance of stimulants “working” doesn’t mean there is something biologically wrong with the subject. Alcohol is an excellent “antianxiety” agent – used to calm me right down in social situations. Why? Because that’s what alcohol does. Not because I had some “diagnosis” that alcohol “treats.”
No one is arguing that psychotropic drugs don’t affect people in certain ways that some people will find helpful. I am trying to separate that easily observable fact from the scientifically tortured concept that we can somehow “diagnose” someone with a “medical disorder” based on a subjective list of behavior, or from their response to certain drugs, as you seem to be claiming is true.
As for humiliation, I want you to consider carefully how much of the “humiliation” that kids experience is based on how others treat them for not ‘fitting in’ with the schools’ expectations rather than because they “cannot concentrate as they need to.” There are kids younger than TWO YEARS OLD being “diagnosed” and “treated.” How on Earth can this serve the needs of the toddler to “concentrate as they need to?” Aren’t we talking about inappropriate developmental expectations at some point? Also, did you know that a couple of good experiments with open classrooms have shown that “ADHD” kids who are put into such an environment are almost impossible to distinguish from “normal” children? Or that a number of good studies in various locations have found that comparing kindergarteners who are 5 vs. almost 6 when entering Kindergarten consistently shows a 30% reduction in ADHD diagnosis rates SIMPLY BY WAITING A YEAR LONGER BEFORE ENTERING SCHOOL! And this finding has been replicated in a range of different geographic settings in different states and countries. That’s what I call a robust finding! Why aren’t we simply delaying the entry of kids diagnosed with “ADHD” for a year, or sending them to open classrooms, when that would give us a 30% cure rate?
If “ADHD” were a detectable biological problem, why would it matter what kind of classroom the kids are in? Why would waiting a year to enter school suddenly eliminate a third of these “biologically deficient” children? Isn’t this proof that maturation and developmental expectations play a huge role in who gets labeled “ADHD?”
Now, if you’re just going for the idea that, “We should be able to give kids stimulants if it makes it easier for them to fit into the classroom, and if they and their parents don’t mind,” that’s a very different argument. But the fact that some kids/adults happen to find the effects of stimulants desirable means absolutely NOTHING about the condition of their brains. It just means they like the effects, just like I like the effects of alcohol. Read some stuff from Johanna Moncrieff on the “drug model” rather than the “disease model” – she describes this WAY better than I can. You don’t have to have a “disease” for a drug to have an effect, and just because a drug HAS an effect doesn’t mean there’s something wrong with you. I hope you can agree to this rather obvious and scientifically unarguable premise.
They are “suggesting” that the structure of the brain is a problem. But there is no evidence whatsoever that this suggestion is accurate in the slightest degree. When the brain is compromised, you see a neurologist. “Mental illnesses” are not “brain abnormalities,” however much the psychiatric profession continues to pretend that is true. There is not one single “mental illness” in the DSM where most or even a significant minority of people so diagnosed have any physiological problem in common. And this is not for a lack of trying. They’ve been searching for DECADES for “brain problems” that explain “mental illnesses,” and have found nothing of the sort. Absent actual PROOF, the “suggestion” you mention is as useful as the idea that there are living inhabitants on Mars.
Great article, as usual. The one thing I might have included is the multiple studies on “ADHD” diagnosis and admission to school, showing that a one-year delay in school entry leads to a 30% reduction in “ADHD” diagnoses. This both undermines the idea that “ADHD” is something objectively diagnosable, and also extrapolates to say that if you just leave these poor kids alone, a third of them will most likely “grow out of it” in a given year. Probably even a higher percentage of preschoolers. Which anyone with “common sense” would expect. Though I guess it isn’t as “common” as it used to be!
I agree – since most of psych drugs’ effects appear to be placebo effects, a little “snake oil” might not do any harm to try out. Worst that happens is nothing, and your body still is allowed to grow and develop.
Again, I think you miss my point completely. It is not scientific to ASSUME that a cluster of behavior/emotion/thoughts that tend to occur together are a “diagnosis” that is caused by something biological. You are taking a PHILOSOPHICAL position, called Materialism, in assuming that there is no other possible cause. What EVIDENCE is there that any two cases of “depression” have or need to have a common cause? I already gave you a half a dozen reasons why a person might be feeling despairingly hopeless. Are you really suggesting that a person who is depressed because they feel trapped in a domestic abuse situation should have the SAME DIAGNOSIS as someone who is depressed because they are suffering from a low thyroid situation or Lyme Disease or a head injury? Do these cases have ANYTHING in common other than the similarity of emotional reaction? Would any sane person prescribe the same “treatment” for all four situations? If you gave antidepressants to a person in a DV situation, and they suddenly felt more comfortable being abused by their partner, could you consider that a good result? Are there times when feeling anxious and/or depressed is a NECESSARY, NATURAL process that helps humans decide to alter non-optimum living or social situations?
I am certainly not asserting that there are not biological correlates to the actions/experiences of the mind. For instance, we know that Buddhist monks who meditate regularly actually CHANGE THE SIZE OF PARTS OF THEIR BRAINS. But consider what that means – their CHOICE of mental activity alters the physical structure of their brains. So how can we assume that the brain is entirely causing their mind’s actions if their mind can alter the structure of the very brain it is supposed to be created by? Clearly, there is something far more complex going on here. Is the “biology” of depression (which btw has never been found to consistently exist for depressed people) the CAUSE of a person being depressed, or is it the RESULT of their framing of events as hopeless? If the mind is just a function of the brain, how is it that ASSUMING A DIFFERENT VIEWPOINT can “cure” depression or anxiety without any physiological intervention whatsoever?
It is incredibly simplistic to believe that there will EVER be a simple, scientific, objective, biological explanation for why people get depressed, because the number of variables is ENORMOUS, including the direct impact of the MIND on the BRAIN. Of course, being a materialist, you no doubt reject my premise that the mind can transcend the brain and act upon it, but that is again a philosophical and not a scientific position. You can provide no proof that people who meet the criteria for “Major Depression” have anything in common at all, and the DSM itself admits that the “diagnosis” does not lead one to that conclusion. So what’s the point of grouping those who feel depressed together at all? Wouldn’t it make a lot more sense to group together people who have domestic abuse histories with others who do, even if some are angry, some are depressed, some are anxious, and some are feeling pretty objective about the situation? But of course, being a “domestic abuse survivor” will also never be a biological “diagnosis,” because it’s not a biological condition. It’s a social one.
They work short term the same on everyone. Judith Rapoport et al showed this way back in about 1978. They gave stimulants to non-diagnosed people to test the “paradoxical effect” theory. She found that non-“ADHD” kids on stimulants had longer attention spans, were harder to distract, and lower motor activity levels, all the same things they do for “ADHD” kids. She said the reason people though the “ADHD” kids were reacting differently was because people were LOOKING for these changes and so found them, but would not notice on kids where they were not trying to “solve” attention problems. This issue was laid completely to rest scientifically at that point, and anyone being honest these days will tell you that you can’t “diagnose” someone by their reaction to stimulants, because most people react the same way, diagnosed or not.H
It has come to my attention that this mythology is still promoted by many sites who pretend to be objective about ADHD, but the science has long since proven them wrong. There is no “paradoxical effect.”
As to longer-term effects, I think we’ve exhausted the literature on that point.
Enrico, please give it a rest. You will not convince me by repeating the same things over and over again. I heard you, I read your evidence, I acknowledged your position, I’ve established mine with the necessary evidence. I’m sure I won’t change your mind, and you won’t change mine. Let’s just stop arguing!
Just to add a little extra evidence, I looked up “causes of depression” on Google. Here is a list of the titles that turned up:
The 4 major causes of depression
The 7 major causes of depression
3 major causes of depression
The 8 forms of depression
The #1 cause of depression (Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged work stress – are more likely to cause depression than recent life stresses.)
That’s on one search. Doesn’t sound like anyone has a grip on what “causes” depression, and there are as many theories as their are people tossing the label around. I think it’s because depression isn’t a “thing” that has one “cause.” It is an EXPERIENCE that can have hundreds of potential causes, and depending how it is handled, can lead to deterioration or to the opening of new perspectives on possible interventions that may improve one’s life. Any attempt to try and come up with one “diagnosis” for such a varied and nuanced experience is doomed to failure.
I think you are overlooking a rather obvious point – the manifestations called “diagnoses” in the DSM, however real the suffering involved, are assumed to be (even by you) some sort of physiological experience. Hence, if the person’s brain were “right,” they would not be depressed, anxious, intense, or whatever. This is an absolutely nonsensical assumption! These “illnesses” are “intangible” because they don’t actually represent physiological illnesses at all. These diagnoses represent a potpourri of different emotions and behavior that are literally VOTED into or out of existence. The emotions and behaviors so designated are all things that occur with some frequency in “normal” people, and the “criteria” are very much arbitrary distinctions between “normal” and “abnormal,” which the DSM itself admits in the introduction are not able to distinguish groups of people having actual problems in common with each other.
“One of these innovations was that the new DSM was “a descriptive approach that attempted to be neutral with respect to theories of etiology” (p. xxvi). So, even though diagnosis is the identification of the nature and cause of a phenomenon, the APA somehow reconciled publishing a diagnostic manual that made no reference to the cause of that which was being diagnosed.”
[Direct quote from the DSM:] “In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi). So, the categories that DSM offers us do not have boundaries demarcating one disorder from another or, indeed, one disorder from no disorder. This is an extraordinary revelation. This means, according to the DSM, there is no assumption that the category “schizophrenia” has boundaries that separate it from other mental disorders or from not having schizophrenia.”
In other words, the distinctions in DSM diagnoses are ARBITRARY, they are not based on any legitimate grouping of people who have a problem in common.
Take “Major depression” for example: It COULD be caused by physiological events, such as drug side effects, low thyroid, anemia, Lyme disease, brain tumors, etc. It could be caused by social events: death/loss, current abusive relationship, unemployment, neighborhood violence, racism or other discrimination, being stuck in a dead-end job, poverty, etc. It could have psychological causes, such as a particular attitude toward life and events, high stress, prior abuse/trauma history… you get the idea. It is just SILLY to think that a person who is depressed because his mother died when he was 17 and he’s feeling a deep sense of loss has the same needs/problems as a person who is currently being abused by her partner, or has the same needs/problems as a person who was just diagnosed with cancer and is having side effects from chemotherapy. These people CLEARLY do not fit into the same category for either study or for planning, and yet the DSM makes absolutely no distinction between these groupings – these people, if they meet the criteria, are “diagnosed” with “major depressive disorder,” regardless of the cause or what their actual needs of the moment are.
Now I’m not saying that individual practitioners don’t make these finer distinctions. I hope that most of them do. But the DSM itself is useless as a “diagnostic” manual if it can’t distinguish between a cancer patient taking drugs that affect the mind (not to mention having a big existential problem regarding their prospective death), and a person whose mother just died and a person who has a malfunctioning thyroid.
That is what people mean when they say “mental heath diagnoses are not real.” They’re not saying that people don’t experience depression or anxiety at sometimes severe levels. They’re saying that the DSM “diagnoses” are of no value in establishing either cause or optimum “treatment” or prognosis. They are scientifically meaningless labels that are at best useless except to bill an insurance company, and at worst can be extremely destructive by papering over the real issues involved and invalidating the knowledge and experience of the client.
Given all that, I very much doubt that a “more objective diagnostic system” can ever be achieved, because the very idea that people who have difficulties emotionally or behaviorally are medically “ill” is absolutely without basis in reality. There may be a very small subset of these conditions that can be attributed to actual medical problems, and they should be, but calling everyone who finds life pointless at a particular moment “ill” as if someone whose mom just died is supposed to be cheerful is an absurdity that is not redeemable except by scrapping that concept and starting over.
I am certain he deserves firing, as this was hardly “one misstep.” He really should have been fired long, long ago for corruption. He is almost singlehandedly responsible for making the “juvenile bipolar” craze happen, by creating a justification for millions and millions of unnecessary and damaging prescriptions. He actually PROMISED the drug company funding one of his trials that the trial would be positive for their drug, BEFORE the trial even started.
Maybe this particular tweet could be forgiven, but his other crime can not. He ought to be in prison, IMHO.
Gosh, who would have guessed that he’s an arrogant racist misogynist? Sounds like he hates children, too. I hope he spends some time behind bars some day.
So you mean actually helping people meet their actual NEEDS without forcing them to do anything improves their “mental health?” Gosh, who would have guessed it?
How about providing them with every other possible source of non-drug support possible, including full physical workups, checking for ongoing abusive relationships, nutritional analysis, exercise, spiritual guidance, support groups, reading, music, art, coaching, etc, before even considering giving drugs that by their very nature disturb the normal functioning of the brain and nervous system?
“Mental health diagnoses” serve a lot of social needs that have absolutely nothing to do with the health of the individuals so labeled. It has more to do with defining acceptable behavioral norms, removing blame from those in power, and silencing direct or indirect objections to the status quo. A kid gets “diagnosed” with “ADHD,” for instance, not because there is any identified medial problem, but because the child’s behavior is inconvenient for the adults involved. “Diagnosis” enables the adults to name and blame the child without the bother and the risk of finding out what is really happening. This is of course doubly beneficial to those who are guilty of abuse or neglect of the child, because they have something to cover up, and the “diagnosis” provides cover for them to continue to act out their own problems on the child without the danger of being called out or consequenced for it.
It’s more like alchemy than anything else to me. Just keep experimenting and eventually you WILL find a way to turn lead into gold. Just because it hasn’t worked 100,000 times before is no reason to think it won’t work in the future!
There are cases of infants under one year old being prescribed stimulants for “ADHD.” It is very disturbing that anyone could even CONSIDER such an option! Frankly, I’d rather see them use laudanum – at least they were being honest about their intentions!
That, of course, is the total downfall of psychiatry and the DSM – there IS no valid definition of “normal” on the psychological/spiritual/behavioral level. There is no way to extract “normal functioning” from the society and culture in which such functioning is defined. So their definitions are actually simply a collection of social biases described in some fancy language designed to obscure the fact that they’re basically saying, “Stuff that we don’t want” or “stuff that is hard for society to deal with.” And of course, completely denying that our social system itself is the proximal cause of most of the “stuff we don’t want.” The real challenge is why so many people believe this nonsense that is so easily debunked.
Have you ever made the legal argument that a person DOES meet the criteria for civil commitment (danger to self or others), but that this does NOT entitle the “doctors” to force “treatment” on them? It is very much taken for granted that civil commitment automatically confers this right on doctors and removes the “patient” (AKA inmate)’s right to informed consent. But why is this legally valid? It makes sense to get someone off the street if they’re walking in front of cars, but why does that confer anything more than the need to clothe and feed them and keep them warm until the crisis passes?
You know, sometimes people who get hit by a truck and have a near-death experience suddenly realize their life priorities have been wrong and make a big turnaround. Maybe we can start pushing people in front of trucks, testing out varying speeds of impact, to see if we can get the right force and level of shock to induce the intended reorientation. It would make as much sense.
Actually, I think I understand how “ECT” actually “works.” After two or three “treatments,” the recipient says, “Gosh, doc, I’m feeling SOOOO much better now! That ECT really did the trick. I’m TOTALLY healed! Now, can you please unlock the door so I can get the hell out of this place!”
It is hard to see how anyone who is in their right mind could possibly imagine that electrocuting someone to induce a grand mal seizure could possibly be “therapeutic!” It take some SERIOUS bending of reality to try and make that one work, yet somehow, they manage to justify it anyway. Fraud is right!
It is fascinating how the arrogance and corruption of these “leaders” are there right out in public for anyone to see, and yet so few see them. “Consideration” of the social determinants? As if THEY are in the position of deciding what is true, rather than observing the known facts? And their “customers’ mental health” – are we admitting here that the APA is a trade marketing organization that doesn’t give a crap about science as long as they maintain their market share? And why would a professional want to come and beg these folks to include something in their manual when it’s obvious that they don’t give a half a crap about the patients’ “social determinants” as long as they’re making sufficient profits?
I don’t want to denigrate the scientific knowledge of doctors. It’s just a shame most psychiatrists don’t have an scientific knowledge to speak of. Pretending to know things when you don’t is most highly deserving of denigration!
Actually, there is no way to judge “overdiagnosis,” because with the utter subjectivity of EVERY DSM “diagnosis,” there is no way to determine what the “correct” level of diagnosis really is. So how can you “overdiagnose?” That’s part of the brilliance of the DSM – you can’t tell the they’re wrong, because there’s no way to prove it!
Wow, such warmth and love! I’m so sorry your mom was such a jerk! But it seems she was already looking for an excuse to disconnect anyway. I hope you’ve found some other people to fill the role of family members. Your mom sounds like she’s failed you badly!
You upset them. You must be Borderline. Which means you must be suicidal. Which means they have to STOP YOU. Even if you aren’t really suicidal at all.
That is true, it should not be. Yet that is all too often what is on offer. My point is that it has to be done in the context of a bigger process of self-discovery. How to create a scenario which is “intellectually satisfying” is, indeed, the challenge. For some, it’s pretty natural, for others, it is quite a foreign concept and a lot of processing needs to happen before this is a reality to them. For others, it simply doesn’t work very well. I think a good therapist has a wide range of tools available, and CBT should just be one of them, and “tool selection” should be based on the needs of the client, not the need of the therapist to feel superior or skilled or whatever their needs may be.
It is also often a gross oversimplification. Yes, thinking about your mother having abandoned you IS painful, and it IS over, and you are not benefiting yourself by thinking about it over and over. But there are reasons why we are attracted to events in the past that are painful – we are still looking for some compassionate person to step in and make it RIGHT. And telling a person, “Just think of something else” when there is that much emotional charge on an event, be it fear, anger, grief, apathy, confusion, or whatever, is often counterproductive, leaving the client feeling like a failure for continuing to think “wrong thoughts” and feeling blamed for having “reacted badly” to the very real trauma they experienced. It also adds insult to injury if the “counselor” tells the client which feelings/thoughts need to be changed and/or what they need to tell themselves to change them.
I certainly used CBT techniques when I used to be a counselor, but only at times when the client appeared to be able to process the past experiences attached first, or was dealing with fairly recent material. I would never try to ‘change the thinking’ of a person to the thoughts I believed they should have, nor would I ever blame their suffering on their own need to process harmful things that happened to them before being able to ‘let go’ of thoughts and feelings they may at one time have felt essential for their survival.
Nobody should do CBT as a primary therapy approach in my book. It’s a set of techniques that have their place when carefully applied, but therapy had better be a whole lot more than that if you want your client to get anywhere close to where they want to go.
I am available to help people get together who don’t want to publicly share their emails. If both of you email me at [email protected] or [email protected], and both of you agree to share, I can send you each the other’s email. Let me know if that’s something you want to do.
And to use science for what science is good for, but not forget that it has its limitations. Science can’t absolve us of the ethical/philosophical activities such as deciding what is good and bad in society, determining the scope of freedom when one’s activities impact another, deciding what purpose society has, whether and to what degree to enforce compliance vs. encourage creativity and free expression, and so on. Science (if used properly) is great at helping eliminate bias when determining truth. But it doesn’t help much with ethical issues where there is no absolute “True” or “False” involved. The entire area of “mental illness” is fraught with these ethical conflicts, such that no real “science” is currently possible in the field, since there isn’t even vague agreement on what a “mind” is, let alone whether a mind can have “health” and what a “healthy mind” would encompass. Not to mention the question of whether having an “unhealthy mind” would ever qualify one for involuntary imprisonment in the name of “health!”
True enough! When you are engaged in a very unscientific enterprise, it is almost impossible to define an outcome. But I’d still maintain that under such subjective circumstances, the only one who can even formulate an “outcome” is the client. Of course, any clinician who tries to manipulate his/her client into deciding they had a “good outcome” just to make the therapist feel better deserves to spend eternity in purgatory.
Well said. When you start your “research” with a group that is inherently so diverse as to have little to no significant characteristics in common, your research is of course going to turn up nothing.
I never understood why disclosing one’s conflicts of interests somehow negated the attendant biases. Imagine a criminal case where the prosecuting attorney admits that they have been looking for a way to convict this person due to a personal grudge from 15 years ago. If they disclosed this conflict, would they still be OK to prosecute the case????
It means they’d have to deal empathetically with the patient’s actual needs, and be willing to admit it when they didn’t know what they were doing, which is most of the time. That would be intolerable, because they’d lose their superior status and have to be a vulnerable human being, just like the client is. Ironically, my experience tells me that the key to actually BEING helpful to a client is the willingness to be a vulnerable, genuine, humble, fallible human being who is willing to meet them where they are at and not think you know more than them about their own problems.
The difference between a good therapist and a bad therapist is that the good therapist is concerned with the perspective of the client, and a bad therapist is concerned with their own perspective. The bad therapist wants to look/feel good about their work. The good therapist wants the client to regain control of their own perspective. The only valid measure of success in a therapist is the empowered client’s satisfaction with the process.
The difference I see in your analogy is that no one is promoting cigarette smoking as a “treatment” for “ADHD” or any “educational disability.” Drugs can be useful for many things. I’d be dead today without modern medicine. But it sounds like we’d both agree that just because a drugs is perceived as helpful in a particular situation for a particular person, it doesn’t mean that person was “ill” or that the drug “cured” or “treated” a condition.
A shot of Southern Comfort definitely reduces my anxiety, but it’s hardly a medical treatment!
Unfortunately, most people are unaware of their philosophical assumptions, and have a hard time distinguishing these assumptions from fact. I agree, our educational system really needs to make the study of philosophy and its application to practical decisions a priority again. Back in ancient Greece, ALL learning was recognized to be a subset of philosophy. That’s why the highest degree is a Ph.D. – Doctor of Philosophy.
I think a lot of folks have been convinced that it is “unscientific” or “mystical” or superstitious” to entertain any possibility of a spiritual existence beyond our bodies. It’s odd, because most people in the world appear to believe in such a spiritual existence continuing beyond our physical existence in our bodies, yet somehow this doesn’t seem to conflict with claims that ‘science’ does not include the possibility of spiritual existence. I’m personally of the opinion that scientifically, there is no way to rule in OR rule out such spirituality to a certainty. But that means science ought to remain open to the possibility. There are certainly bits of circumstantial evidence, such as the placebo effect and neurofeedback, that suggest there is something about our existence as beings of whatever nature that allows our mental processes to control what happens to the body. How that effect occurs, no one really knows. So discounting the potential that we are spiritual beings that transcend our earthly existence on “scientific” grounds seems ungrounded in factual evidence.
Yeah, let’s not waste our money on the things that have a 50 times greater correlation! Let’s spend more money researching stuff that is barely better than chance at distinguishing “depressives” from “normals.”
You know what my approach was for distinguishing depressed individuals from non-depressed individuals? I asked them if they felt depressed! It was a remarkably accurate “marker.” People who say they are depressed are statistically FAR more likely to be depressed than those who say they feel fine!
It should be clear that any brain-affecting drug could cause brain shrinkage, based on your research. I’ve never found the “neurogenesis” explanation/claim for SSRIs to be particularly convincing. But you are very correct, depression is almost always a symptom of something else. In fact, I think it’s fair to say that “depression” is not the “cause” of anything. It’s an experience people have, which could mean a hundred different things. Calling it a ‘disorder’ is always euphemistic.
“Voluntary” electric shock “therapy” (no, I won’t use the euphemism) is also an abomination, since there is absolutely no way to give “informed consent.” Anyone who really understood what this “therapy” involves would run the other way full speed! Though it seems more than a tad counterintuitive that inducing a grand mal seizure through electrocuting the “patient” would in any scenario be advisable.
We must also remember that psychoanalysis was not accepted until after Freud disavowed his trauma theory and blamed the patients’ woes on his own “complexes” instead of focusing on the causal traumatic factors. I’d say that psychoanalysis was thoroughly defanged before it was allowed to become popular, and hence was reduced to a tiny fraction of its potential effectiveness. The removal of the right of the clinician to “interpret” seems like a critical move. But I wonder how many clinicians are fully capable of resisting the urge to foist their evaluations onto the client.
Remember always that such studies are not always controlling for psychiatric drug use. We know at least in “schizophrenia” that brain shrinkage is causesd by the drugs themselves, and there is suggestive evidence that this happens with stimulants for “ADHD” as well. Any generalized measurements like brain volume are not valid if substance use, legal and illegal, is not accounted for.
I particularly find the possessive form, “My mental health” or “My depression” or “My diagnosis” a disturbing trend. As I said once, depression isn’t something you HAVE, it’s something you DO. And framing it that way means you can do something to change it. Whereas if it’s something I simply HAVE, then I no longer have agency, I’m stuck with it, as if my own decisions and beliefs and actions have no chance of altering my fate of having “mental health problems.” I don’t mean to blame anyone for feeling bad, but the idea that someone else is making all that happen and that someone else can “fix” it sells lots of drugs and keeps people dependent for life instead of teaching skills to regain control of our lives.
If you ever come to the West Coast of the USA, I think we’d have a hell of a great lunchtime discussion! I hope we get to meet one day – there are few people who evoke that wish for me, but you’re definitely one of the top!
You know, it kind of sounds like everyone is more or less on the same page – don’t start suddenly, have a plan, adjust to individual needs, listen to your body, the person withdrawing is the best guide. Seems like good advice.
It has always seemed to me that everyone’s body is different, and so a different approach needs to be considered for each person. Psychiatry’s biggest failing is assuming that everyone who feels “depressed” (or whatever other manifestation they identify as “illness”) has the same problem and needs the same kind of help. We should not fall into this trap! I think the advice about starting slowly and observing how much a person can tolerate is very, very important, but assuming that 10% or 5% will work for everyone means that some people who could get off a lot faster are restricted, and others who may find this rate too fast will feel hopeless. I think flexibility and respect for each person’s own sense of what works for them should be the center of any effort to wean off of dangerous drugs.
Yeah, good question, isn’t it? I see this often – the experiment itself proves that there is no point giving antidepressants to teens, say, and yet the conclusion is that we should still do it. Clearly protecting guild interests over patients!
Everything you’ve said is speculative. There is nothing you provide that shows any actual EVIDENCE that a particular chemical problem in the brain is associated with depression. In fact, this idea was disproven way back in the mid 1980s, before Prozac even came to market.
I’m not interested in opinions of people. I’m interested in EVIDENCE. And so far, you have presented anecdotes and opinions. No one is saying that some folks don’t feel better when taking antidepressants. I am contesting the idea that the primary CAUSE of depression has ever been established as being biological.
“The chemical imbalance theory as a cause for anxiety and depressive disorders never was true. In fact, no experiment has ever shown that anyone has an ‘imbalance’ of any neurotransmitters or any other brain chemicals. The entire theory was hypothetical.
Over the last ten years, independent research has continually shown the chemical imbalance theory to be false. Furthermore, independent research has shown medications used to ‘correct’ the imbalance were largely ineffective with many fairing no better than placebo.”
Please read the following for an overview of scientific challenges to the “chemical imbalance” concept.
You might also benefit a lot from reading Anatomy of an Epidemic. It might help you understand the scientific reasons why Bob and others question the standard psychiatric narrative. It does not come from a place of hostility, it comes from a place of wanting to get it RIGHT for people who need the kind of help that drives them to psychiatrists.
Can you please provide citations demonstrating convincingly that, say, “Brain chemistry” or “biological differences” are “causes” of depression? I am very familiar with the research in this area, and am aware of no consistent biological difference that characterizes depression or accounts for more than a tiny fraction of cases of “depression,” even in the most optimistic interpretation. In fact, luminaries such as Dr. Ronald Pies and Thomas Insel have assured us that psychiatry never took the “chemical imbalance” theory seriously, and that it was, in fact, drug companies that made such tropes commonplace beliefs.
On the other hand, I can provide oodles of evidence that the correlation between childhood adverse events and cases of “depression” is extremely high, much, much higher than the most optimistic “biomarker” research has ever been able to accomplish.
You are welcome to your own opinion, but not your own facts. I’d like to see what scientific data you are basing your stated opinion about “causes of depression” on.
I feel I need to add that stating the COVID epidemic contributing to isolation, feelings of hopelessness and self-harm seems to completely undermine the idea that these “mental disorders” are caused biologically. Seems the professionals are talking out of both sides of their mouths here.
I have suggested “Math teaching disability” and the like before, too! If you’re being paid to teach me math, and you can’t do it, why is this my fault?
Thanks for sharing this! As a “therapist” who received almost no therapy training, I found exactly the same things you did. CBT is not a form of therapy, it’s a set of techniques, which have applicability to certain clients under certain conditions. It’s not something you can do with everyone, and the response easily determines the appropriateness if you’re using it poorly.
Most importantly, all therapy depends on an empathetic relationship with the client, and as you put it so well, an ability to respond dynamically to events in the therapy relationship and alter one’s course as more information comes to the therapist’s attention.
Milton Erickson said that therapy has to be reinvented for each client. I agree with him 100%. No workbook or theory or set of “skills” or homework can substitute for the hard work of legitimately gaining the trust of the client and helping him/her climb into the chaos and start sorting things out. The idea that one response will suit everyone with a particular ‘diagnosis’ is not just wrong, it’s utterly destructive.
And well done escaping that “funny farm!” Probably the greatest gift that you received from them – realizing that you are smarter than they are and can figure out what you need as far away from them as you can get!
I wrote a book about how to avoid abusive partners early on in the dating process (“Jerk Radar”). The last chapter, and in many ways the most important chapter, is called “Trust your gut.” It goes into how abusive people give off a ‘vibe’ or engage in certain behavior that raises one’s hackles, as it were, or sets of alarms intuitively. Little kids tend to go by these “gut level” assessments consistently, but I talk about how we are trained as kids by adults to not believe ourselves, and eventually stop believing our very accurate perceptions of reality. “Uncle Eddie is just being friendly, dear, they kiss on the mouth in his family” or “Don’t say such things about your grandfather, show respect for your elders!” or “Oh, Johnnie, your teacher doesn’t HATE you, they’re just trying to teach you some DISCIPLINE!” The ‘gut level’ instinct is trained out of most of us rather systematically, and this makes us extremely vulnerable to predatory people. Almost all of us need to find ways to re-learn how to listen to and respect our intuitive warning flags.
Of course, those subjected to abuse by caretakers have this sense utterly trampled in most cases. Up is down, in is out, love is hurting, you love me means I have to take care of you, and on and on. Your perception of reality is brutally attacked at every turn in the road. Is it surprising that a person subjected to such atrocities would have some difficulty knowing whom to trust? Why would you tell them to explain away their considerations by a call to “be reasonable” or “understand the others’ point of view?”
Clearly, the most helpful thing for such a person is to a) acknowledge that their sense of trust has been systematically violated and that difficulties with trust would be totally normal under the circumstances, and b) help the person to re-learn how to trust and act on their own gut-level instinct that has so thoroughly been invalidated, so that they learn that while not everyone is untrustworthy, it makes good sense to keep one’s boundaries up and to listen to and respect our intuition.
The idea of teaching such a person to automatically “give the benefit of the doubt” is quite outrageous. It’s the very last thing in the entire world you’d want to teach them!
Right! It would be very much like curing “pain” or curing “baldness” or “high blood pressure.” Except that at least baldness and high blood pressure can be objectively measured, but still, something that can be caused by dozens or more different causes and is in some cases normal can’t be “cured” without some kind of rational analysis as to cause!
Calvin, it sounds like you were looking for a way to establish more control over your life, and psychiatry gave you the opposite. I found it sad hearing you decided that staying silent was your only remaining way to accomplish that. I’d say your story is far more compelling than you may think it is. I found myself thinking, “Man, if they told me what they told him, and gave me as little hope, I’d have wanted to kill myself, too.”
You were VERY badly served by psychiatry. They did less than nothing – they undermined your belief that anything COULD be done, and I find that unforgivable!
I don’t know why this is published as if it were some kind of new news. The first review of stimuants for academic performance was done way back in 1978 by none other than Russell Barkley, the eventual advocate for putting massive numbers of kids on Ritalin. His review showed kids taking stimulants barely outperformed their non-medicated peers, and commented that the difference was so small it was “easily explained by reading the questions more carefully.” Repeated reviews by Swanson (1993) and by the OSU Medication Effectiveness Study in about 2002 or so found no significant improvement for long-term stimulant use in any academic measure. Naturalistic studies like the MTA, the Raine study in Australia, the Quebec study, the long-term MTA results, and a comparison study between Finnish and US children showed again and again that stimulants provide no improvement in any academic measure, and in fact, no improvement in ANY long-term outcome that adults would wish to see improved by “treatment.” This is just one more nail in that coffin, but the sad reality is that psychiatry has not noticed so far that the patient has been dead for decades.
You are right! How can you “overdiagnose” something when there is no objective way to determine who “has it,” and so no way to determine what the “right” level of “diagnosis” is? Perhaps we should talk instead about sexual minorities being more likely to be subjected to the most shaming and destructive label in the DSM arsenal.
Even if there WERE a way to make Ketamine-assisted therapy effective (which I still have very serious doubts about), it is a certainty to me that in the hands of the commercial/economic incentives of today’s system, any chance of general effectiveness will be very quickly overwhelmed by the authoritarian, disrespectful, and degrading conditions that pertain in almost all “mental health” agencies. It seems like another boondoggle for the drug companies and their minions.
What you observed for decades is absolutely correct. None of this was truly intended to help, except for those low-level people who think that forcing people to do things they don’t want to “for their own good” is some form of “help.” I can see how reading this stuff can bring back the pain, but don’t ever believe anyone who says that your observations were “wrong.” Honestly, I think the first step to healing from crap happening to us is learning to trust that we were RIGHT when we knew we were being fed a line of crap!
To be clear, we welcome those who feel psychiatric diagnoses are “helpful” to them – all are always welcome to post at MIA as long as they follow the Guidelines. We welcome all viewpoints. However, it is important that such posters respect the fact that they will encounter alternative viewpoints here, and to own their own viewpoint as theirs and not try to force is on others or to invalidate others’ attempts to communicate their own views. We are all free to disagree, but with respect. I am getting the feeling that some folks are feeling their views are not being respected. Which is ALSO a free topic of conversation, as long as we make sure it’s not getting to personal attacks on people for disagreeing.
So it is less the existence of these labels than the way they are USED. The DSM was originally used only as an insurance billing document, and no one took the categories as anything but vague categories used for general communication. They evolved into these pseudo-scientific labels which doctors and others can use to avoid looking at causes and to justify the use of drugs. I have never objected to an INDIVIDUAL choosing to identify with a particular diagnostic DECRIPTION. When it become untenable is when scientists pretend that “depression” is a unitary category with a unitary cause which should be “treated” by a unitary “treatment plan.” Such a viewpoint simply invites and justifies ignoring the complex causes and influences on something so universally present and natural as anxiety or depression, and the blaming of the patient as well as using drugs as a first-line intervention. None of this can happen if the DSM doesn’t serve as a means for doctors to justify condescending to their patients and subtly or not so subtly blaming them for feeling “too depressed” or “too anxious” instead of looking at what has happened in their lives (including known physical problems) that might explain one or another particular instance of “depression.”
So I have no hostility or disrespect for someone who calls himself/herself “ill” or “depressed” or “schizophrenic” or “autistic” if those labels work for someone. I do have a big problem with a doctor or other authority figure telling someone ELSE that they “have depression” or “have schizophrenia” as a means of labeling and downgrading the client’s experience without any actual scientific basis for their claims. It is very different to say that no one has the behavior labeled “ADHD” (which is NOT true) and to say that “ADHD” is not a valid scientific entity for a doctor or anyone else to assign to a person who presents to them, particularly over the client’s objection.
“You are too complex” seems to me to translate into “I don’t have the skills to figure out how to help you.” Same facts, very different framing. If you take your car to the mechanic, and he says, “You’re engine is too complex,” you’re going to know he means, “I don’t know what the fuck is going on.” There is no difference, except that MH “Professionals” are allowed to get away with it.
It is a very disturbing practice, surely violating the rights of the patients. They are not under arrest, after all! But it seems that almost anything can be rationalized in the name of “mental health treatment” no matter how brutal or disturbing.
I think the goal is seldom to make people feel better. I think it is to STOP people from feeling certain things, which eventually devolves into stopping people from feeling anything at all. This is the only way that anyone could look at a semi-comatose person slumped in a chair and consider it a “treatment success.”
Wow, great post! I’d only add that involuntarily committed people should not ever be charged for their “care.” This would remove a big financial incentive for locking people up. Prisoners don’t pay for their imprisonment, neither should psychiatric inmates.
Yeah, why don’t they tell you they’re “still learning” when they’re pretending they know you have a “lifetime biological brain disease” and that you have to take the drugs for the rest of your life and there is nothing you can do about it? Might be helpful to know that they might have no idea what they’re talking about!
Thanks, Ed. I have read parts of the article, though it is quite long. I get the idea we’d probably agree on a lot of things. I do think it feasible that psychedelics can be used in a helpful way, but there is little to no chance that the psychiatric profession, or even the profession of psychology, will be able to use it in a helpful manner. Psychiatry in particular specifically denies the validity of the spiritual world, while those who HAVE used psychedelics historically in a helpful fashion are shamans or other spiritual leaders who are helping expand one’s viewpoint of the world, not trying to “cure mental illnesses” that don’t even exist. Without a big change in viewpoint and philosophy, I believe psychedelics will be as dangerous in the hands of psychiatry as any of their “medications.”
Wow, that’s an awesome article! This guy sounds a lot like Bob Whitaker. My only objection is the use of the term “overprescription.” How can you “overprescribe” when there is no ability to determine what the “proper” amount of “prescribing” would be? But besides that, he hits on the key issues of ineffectiveness, permanent damage, long-term deterioration, and removal of personal agency. I’d love to see this guy write an article for MIA!
Without even reading the article, I found I objected to the title. Why are we calling this “psychedelic medicine?” It is NOT medicine! It is at best “psychedelic therapy,” not a medical intervention at all, but a mental/spiritual one. I find it continuously offensive when things that are potentially helpful to our spiritual needs are coopted by the medical establishment, such that going for a hike becomes “nature therapy,” and doing fun things becomes “occupational therapy” and on and on. “Psychedelic therapy” is distorted enough – PLEASE let’s get away from calling it “medicine!”
Similarly, taking the flashback phenomenon and giving it a “medical” name does nothing to advance our understanding of what is going on. Flashbacks are pretty mysterious, there appears to be no understanding if there is any physical reason for flashbacks, let alone what it might be. People who have flashbacks aren’t “HPPD patients,” they are people who have experienced flashbacks. Why do we feel this need to dehumanize folks by grouping them together, as if experiencing flashbacks is again a failure of the “patient” to respond “properly” to “treatment?” Just as we excuse the failure of antidepressant “treatment” by calling the victim “treatment resistant” instead of just admitting that the drugs have failed to help or have harmed the recipient?
I know that “medical language” tends to get things published, but it’s an insidious slippery slope away from treating people as human beings. I’m not categorically opposed to the idea of using psychedelics to help people find some level of mental/emotional perspective, but the idea that it can become some kind of standardized “medical treatment” is a very damaging absurdity that could very well ruin any chance that the use of psychedelics can develop into something that might actually be helpful to people’s spiritual growth.
No problem. You have been deeply traumatized by people you should have been able to trust, and it sounds like the destruction was massive in your case! I admire you for pressing on despite it all. That takes a lot of courage!
You got it. He was blowing smoke out his ass. I’m sorry you didn’t get the right information before you encountered him. But thanks for taking up the sword for making it better!
Are you trying to say that it is somehow arbitrary to say that amphetamine is safe when you get it from Big Pharma but not safe when you get it somewhere else? That’s CRAZY talk!
Don’t forget, Methamphetamine (under the name Desoxyn) is also sold as a “medication” for “ADHD.” So it’s also healthy only when Big Pharma is profiting from it.
More stunning research! This is somewhere on the level of “serious injury to the knees is associated with increased knee pain later in life!” Seriously, is anyone surprised that having major frightening experiences earlier in life might make it more likely that one is more easily frightened? “People who have been major car wrecks are shown to be more worried about getting in car wrecks.” And they get PAID to do this research???
If such studies existed, you’d think he’d have the decency to refer to at least one of them in his retort. But of course, he does not, because such studies do not exist, or if they do are not able to be replicated. He’s using the “resort to authority” approach to prevent further investigation into what is actually going on.
There has never been any good evidence, or even mediocre evidence, for the use of antidepressants in kids. There was one study that showed Prozac to have some positive effect on kids over 12, but that study had significant flaws and was never replicated. It seems to be pretty clear that prescribing antidepressants to kids is malpractice, plain and simple. But apparently, if enough doctors do something, no matter how stupid, it becomes “standard practice” and can’t be called malpractice for legal purposes.
The only issue I’d take with your comment is that some adults DO believe that restraining kids chemically IS “helping” them. Clearly this applies to people who don’t really like children very much. But such people do exist in significant numbers.
This is just a comment on the comment I just read, not a critique of anyone’s arguments.
I think it is relevant to note that “placebo effects” have taken on (largely due to pharmaceutical company pressures and narratives) a negative connotation, the implication being that “placebo effect” are not real or are imaginary. Placebos of many kinds, including group rituals, can have very powerful, very real effects. The only relevance of calling it a “placebo effect” is that the effect is not caused by the drug or whatever specific intervention is being looked at. I think this can create a negative emotional reaction when people hear “X appears to be a placebo effect” about something they’ve seen be effective.
I think the placebo effect is FASCINATING and says a lot about what’s wrong with psychiatry’s narrative. If believing something can actually change outcomes, even if the “something” has no direct effect on the brain or body, it suggests that what we believe or imagine or strive for is FAR more important than the “brain=mind” theory can possibly begin to explain.
It is interesting that clinicians are feeling the same kind of life stress and burnout that many if not most of us in late stage corporate capitalist societies are experiencing. It is a shame that the real causes are right in front of us, but that the mental health industry as a whole continues to pretend it doesn’t exist.
I think it helps people to avoid dealing with real but semi-conscious conflicts that are really at the root of feeling hopeless about life in many cases. Certainly was true for me! It’s a lot of work to re-think one’s view of life and one’s habitual behavior. It’s easier to blame it on the brain and take the pill. At least in the short run. Especially if someone in authority is doing the hard sell on it. I did not WANT to get therapy – I NEEDED to, but it took two other people dragging me kicking and screaming to get it started. Very glad I did.
Of course, a lot of “therapists” these days don’t do what I consider therapy. Many seem to use a forced and very shallow form of “cognitive behavioral therapy” and aren’t interested in childhood trauma or internal conflicts. I was very fortunate in getting a good one on the first shot, but it still wasn’t any fun, and I felt like quitting partway through. A pill would have been a LOT easier, but of course would never have been a tenth as beneficial in the long run.
Including “no treatment” when the “condition” is a result of normal reactions to external problems, such as child abuse, poor parenting skills, or dull and rigid classroom environments that lack the necessary stimulation for a bright and curious child.
How can you have “overdiagnosis” or “false positives” when there is no objective means to determine who HAS and DOES NOT HAVE a particular diagnosis? Isn’t the main reason for “overdiagnosis” the fact that there is no line between the “ill” and the “normal?”
I would say that physicians almost NEVER direct someone to discontinue ANY psychiatric drug. Additionally, “return of symptoms” is often a euphemism for “withdrawal symptoms” occurring upon withdrawal. Support is, indeed, needed, but medical providers almost never provide the kind of support that is helpful. If we all waited for a physician to “direct” their patent to withdraw, almost no one would ever get off psych drugs, no matter how bad the effects of the drug in question.
Wow, some really radical thinking there! You mean that people get depressed because their lives kind of suck? NAH, COULDN’T BE! If their brain chemicals were adjusted properly, they’d be HAPPY that they were poor, homeless, raped, sexually abused, abandoned or whatever. EVERYONE knows that!
Just to be clear, I’m not calling the article disempowering, I’m saying the concept of “shared decision making” presumes that decision making is normally NOT shared with the client, but made by the doctor without any input from the client whatsoever. And doctors are arguing as to whether they SHOULD consider “sharing” what is really the client’s decision with the client. I don’t see it as a salvageable concept, as it is tainted with the idea that sharing decision making with the client whose life is being impacted is somehow optional!
As I’ve said before, the very framing of this as “shared decision-making” is disempowering by definition. They are talking about DOCTORS deigning to “share” THEIR decision making with the client! And the doctors are ARGUING about this! The decisions should always be the CLIENT’S decisions, unless the CLIENT wants to share it with the doctor or someone else! The fact that they even need to TALK about including the client in the decisions, and that NO ONE sees this as hypocritical, shows just how far into authoritarianism the medical establishment has sunk.
That’s always been my biggest challenge with this whole “chemical cure” mythology. If I take a pain reliever and I still have as much more more pain than before, do I have “treatment resistant pain?” Or did the drugs fail to have the advertised effect? If I take an antidepressant and am still depressed, THE ANTIDEPRESSANT DIDN’T WORK! It’s not because I’m “resistant” or “need an adjunct medicine” or whatever. It means the treatment FAILED!!! Why is this not obvious? Why do intelligent people fail to observe this rather obvious conclusion?
Here is an article covering the issue of so-called “discontinuation syndrome” (aka withdrawal). I found this in a 10-second search. Many other articles on the topic are readily available in the mainstream psychiatric publishing world.
Do you actually want to know the answer to that question?
I would guess that most doctors have not ever read the 35 pages of warnings and could not tell you half of it. My father was almost killed by a doctor prescribing something when he was on blood thinners after a heart attack. He told the guy exactly what he was taking, and the drug warnings included a BOLDFACE warning NOT to prescribe this second drug with blood thinners because DEATH MAY RESULT! Yet the doctor prescribed it anyway, and my father luckily noticed he was getting bruises by simply resting his elbow on the table or pressing his arm with his finger. HE looked the drugs up in the PDR (the “internet drug site” equivalent of the 1960s) and discovered that the doctor had acted incredibly irresponsibly and could very well have killed him. A minor car accident, a fall in the garden, the most minor injury could have resulted in death. I have heard stories and had direct experiences myself over time to reinforce the idea that doctors don’t, and given the volume of new drugs, really CAN’T, know and convey the actual dangers of these drugs. I will NEVER take a drug that I have not personally checked out on more than one source.
So no, it is not hard AT ALL to imagine doctors either not knowing these things, or not caring to communicate them, or intentionally NOT communicating the possible dangers because they are worried that the patient would decide not to take the drug if they knew the actual risks. I would assume it far more likely than not that the doctors would NOT communicate such things to me, based on personal experience.
I’ll leave it to others to explain what ACTUALLY happened to them on antidepressants, though of course, you can easily find that out for yourself by searching this site. Sometimes other people have different experiences than you do. Maybe you could generate some interest in listening to them instead of dismissing their experiences as “hard for you to understand.”
How do they, Enrico? You don’t know any more than I do. Nor do you even know that cells DO create thoughts. That’s what you believe. There is no proof or evidence of what thoughts even ARE, let alone what creates them. You believe the brain creates them, because you are a MATERIALIST philosophically. Not everyone in the world is a materialist, and materialism isn’t inherently more “scientific” than any other philosophical viewpoint. There are other philosophical viewpoints that are just as valid as yours.
You are sharing your beliefs, not scientific verities. Which is fine, as long as you allow that every other person here is just as entitled to share their views and beliefs as well, and you don’t somehow entitle yourself to be the arbiter of truth when you’re sharing your personal views. I don’t see you granting others that right very often. I more commonly see you presuming to know more than those who are here, and talking down to others who don’t agree with you. It is not a very respectful way to conduct a conversation, in my personal view. I guess that’s philosophical, too – one philosophy is that conversations to be “won” by trying to overwhelm or dominate the other person until they submit. I don’t take that philosophy. I like conversations to be a sharing of information from different viewpoints so I can learn things and expand my viewpoint to include more data and observations and experiences beyond my own narrow path in life. You have a great opportunity here to open your mind and learn from others who have had different experiences than you have, to actually WANT to know why some people find the very things you consider to be miraculous advances in science to be sketchy, unscientific, and even dangerous and destructive. Do you want to know? Or are you primarily engaged in trying to convince the “misled” or “misunderstood” on this site to the “real truth,” which of course means the “truth” you’ve already decided is “right?”
The point re: Insel’s comments is a case in point. You “don’t understand” the relevance. Do you WANT to understand it? What if you actually asked the poster to HELP you understand it, and tried to put yourself in his shoes and see it from his viewpoint? I’d say the reason is quite obvious: Insel RAN the NIMH for years. He spent lots of time doing the kind of research you seem to value (at least when it fits with your narrative), and at the end of his tenure, states that the DSM approach has led to literally NOTHING of lasting value. That one of the key thought leaders in the psychiatric community would publicly announce this should be of GREAT interest to anyone with a real scientific bent. The fact that he was called on to walk back his comments by that very psychiatric community he is a part of should tell you a LOT more. My read is that the psychiatric community knows that the DSM is not worth the paper it’s written on, but they can’t admit it to themselves, or they don’t want the word to get out. Does it seem POSSIBLE to you that this explanation makes some sense? What is YOUR thought on the significance of the lead psychiatric researcher in the #1 center of psychiatric research in the USA says that the DSM actually makes it harder to make sense of “mental illness?”
I have noticed again and again that you do not respond to solid, well-argued, positions that don’t correspond to your views. Will this again be the case with this one? Will you pretend that I didn’t write this because it’s too uncomfortable to face the truth contained herein?
Are you now denying what the entire psychiatric research world now admits? That “discontinuation syndrome” (aka WITHDRAWAL) and Tardive Dyskinesia and Neurological Up- and Down-regulation are very real? One study is enough when the study agrees with you, but massive data over decades is not enough to convince you when it disagrees with you?
I am saying it is a contributing factor, and that at least SOME of the high rates of smoking among those diagnosed “schizophrenic” are due to the “treatment.” I’m also pointing out the irony of the psychiatric industry using “treatments” that are known to reduce lifespan, and yet trying to blame it on habits that their own drugs actually encourage/reinforce.
But you’re right, poverty, discrimination, and trauma are related to “poor lifestyle choices” AND to being swept up by the psychiatric industry as a “patient.” It is a very complex system. But a part of that system is a “treatment program” that doesn’t actually work in the long run in many if not most cases, and which can create or exacerbate the exact “symptoms” they claim to “treat.” And meanwhile reducing people’s quality of life and life expectancy, while trying to deny this is true.
I certainly believe you, Gina. And I think the vast majority of MIA posters believe you, too. Many of them have experienced similar things. Psychiatry sucks!
Why do you continue to post here if you find the basic premise of the site to be so wrong? Do you really think you’re going to convince your audience? Why not go somewhere else where people who agree with you share their views? I don’t see much interest on your part in hearing anything anyone else says, or learning anything you don’t already believe you know. So why are you posting here? What is your purpose? I’m not being snide, I really want to know what you’re trying to accomplish?
I would bet my bottom dollar you’ve never even read Anatomy of an Epidemic or Mad in America. Am I right?
I don’t believe from my observations here that you really want to engage in a conversation about any of these topics. I assume from your behavior that you mostly want to tell us all that none of us know what we’re talking about and you know better than us. Am I correct?
I predict that you will not respond to this question.
I understand that since cigarettes increase dopamine, and the antipsychotics massively decrease dopamine, many antipsychotic users (forced or voluntary) smoke in order to reduce the side effects of the antipsychotics. Many probably don’t even know that’s why they do it, they just feel better when they smoke. So ironically, the psychiatric industry wants to blame shortened lifespans in the “severely mentally ill” on “lifestyle issues” like smoking, while the drugs used to “treat” these “disorders” in fact dramatically INCREASE the rate of smoking among the “treated!”
Scientifically speaking, there is no need to “prove that ADHD isn’t real.” And the existence of people who fit the description is not proof of anything. It is the responsibility of those claiming it is a disease state to prove that it IS a disease state. Anyone can describe a condition and claim it is a “disorder.” As I’ve said before, genetic diversity is the key to species survival. I’ll remind everyone of the study where groups of three kids having one “ADHD” – diagnosed child were WAY BETTER at solving problems than groups of three who did NOT have an “ADHD” child in their group.
The point is not to prove that people can be identified as “fitting the criteria” that were chosen to describe “ADHD.” The point is to prove that such people a) have significant things in common besides acting a certain way, b) that there is some means of objectively distinguishing those so identified from the general population, and c) that the variation is a malfunction rather than simply a variation in genetic inheritance.
For instance, running slowly has a very large genetic component. Failure to be able to run quickly leads to significant psychosocial distress, as any such person who has had to go to PE classes can testify. Giving stimulants to such people would improve their running speed to some degree in most cases. Is slow running a disease state? Who would need to provide proof of this? Would I have to prove that it WASN’T a disease? Or would someone claiming it was be responsible for the proof?
Thanks for sharing this – it includes some good information that is new to me.
I would pose this question to you: if, as you show above, fluoridation of the water supply can significantly effect the rates of “ADHD” in the population, how does that jibe with your earlier researcher’s claim that it is entirely caused by a mutation in a certain gene? Does this not suggest that the environment can and does have a huge impact in the expression of one’s genetic inheritance? Does it not suggest that people who do NOT present as “ADHD” to begin with can BECOME “ADHD” cases due to environmental influences?
Taking this further, could there not be “psychologically toxic” environments that might “cause” a person to “become ADHD” when they otherwise would not have presented that way? Does it not similarly follow that there might be “psychologically healthy” environments that, if applied systematically, would REDUCE the likelihood that someone would present with “ADHD” syndromes or would reduce the severity of these “symptoms?”
Doesn’t it make more sense to suggest that a person may inherit a “vulnerability” or a “tendency” to engage in this kind of behavior, but that the expression of this tendency is strongly affected by the environment they are forced to contend with? That it is not a “nature vs. nurture” situation, but rather a combination of nature/nurture, as most behavioral syndromes (and even major physical health problems, like heart attacks and diabetes) appear to be?
If this is the case, which do we have more control over, nature or nurture? Genes or environment?
I would ask why do we spend so much of our time and money focusing on the one element in the equation, the genetics, that can’t be changed? If we really want to help these kids, why would we not focus our energies and attention on altering the environment to improve these kids’ lives?
Examples might include NOT fluoridating the water, creating open classrooms for kids who find them more workable, teaching parents how to handle these kids without accidentally reinforcing negative behavior, valuing and taking advantage of the kids’ strengths, and even holding kids out of school for an extra year to allow additional maturation?
(Did you know that there is a 30% reduction in “ADHD” diagnoses for kids who start in school one year later? THIRTY PERCENT! We could avoid a THIRD of “ADHD” diagnoses by keeping kids who aren’t ready out of school for a year! Why aren’t we doing this?)
I am not and have never been arguing that some kids don’t often “come that way.” My own kids are a good example – their personalities reflected an intensity, a need to be active and busy, an intolerance of boredom, that were certainly not a result of anything we did or did not do that we are aware of. My point here is that genetic diversity is the key to species survival, and being genetically “different” does not imply being genetically “disordered,” and genetics is in any case the one part of this equation that is completely unchangeable. Why don’t we acknowledge that both nature AND nurture are involved, and spend more time addressing environmental things (like water fluoridation and classroom structure and parent training) that CAN be changed to give these kids a better chance at survival?
I hope everyone will consider the full implications of these findings. Something that is completely genetic in origin (like, say, eye color) would not be so variable depending on environmental impacts. It’s got to be both. Let’s accept that differences most likely exist, but spend our energies on trying to control the environmental variables that we CAN control!
Yet in the 3-, 5- and 8-year follow-ups on this very same study, kids who continued or started to use stimulants did no better (and in some ways worse) than kids who discontinued or never used stimulants. Which fits in exactly with the data I just shared in another post, and which is generally well known but kept very quiet among researchers: stimulants do work to “control the core symptoms of ADHD,” as they usually put it, but have been shown again and again not to lead to any improvement in long-term outcomes. In other words, stimulants can make it easier for you to pay attention to your schoolwork and complete your homework, but apparently, paying attention to your schoolwork and completing your homework doesn’t lead to you becoming more successful later in life.
In fairness, there are many who claim that stimulants destroy kids’ lives, and while that may be true in individual cases, in the collective, there is no evidence of stimulants doing great HARM to long-term outcomes in the collective. But they don’t really help, either, if you care about things like delinquency rates or high school graduation rates or social skills. And there are risks, outlined in my other post, that a rational parent might be well advised to consider when that risk is set against only short-term gains. It is a matter of informed consent, and it’s pretty dishonest at this point to claim that stimulants are going to magically change kids’ lives for the better in the long run. Some may choose to use stimulants for their short-term ability to “reduce the core symptoms of the disorder,” but if they’re aiming for longer-term improvements, it appears they have to look for additional interventions to help.
Sounds like a very idealistic picture. I guess we will see how much of it comes true.
I thought this article speaks to the idea of long-term use and loss of efficacy. Have you considered WHY tolerance develops over time? In the world of substance abuse, tolerance is related to significant brain changes.
Have you ever heard of “neurological down- or up-regulation?”
“In 2013 they compared the brains of kids with ADHD before and after a year of treatment with stimulant medications. The studies showed an increase in the density of dopamine transporters—those molecules that take dopamine out of action—in the brain after treatment. This suggests that the increase of dopamine stimulated by the medication may have prompted the brain to develop more dopamine transmitters to clear it away. How long that change might last is not clear, as the level of transporters in the brain fluctuates. But it could result, researchers note in their conclusion, in the medication not working as well as it had to reduce symptoms over the long run.”
As I’ve already demonstrated, long-term studies show no difference between “treated” or “untreated” subjects on all major outcome measures, including academic test scores, high school graduation rates, delinquency rates, college enrollment rates, social skills, and even self esteem, which is the one even I would expect to be affected. I was actually quite stunned when I first discovered this fact way back in about 1989 or so, when I first started researching this topic for my own son’s needs. Stimulant treatment is simply not a major factor in long-term success in “ADHD” – diagnosed children. Other factors appear to completely overwhelm any benefits of temporarily paying more attention to or completing more school work. Stating that certain psychiatrists “believe the evidence proving it is a bio-chemical problem, is overwhelming” is absolutely irrelevant. The data speaks for itself, and saying otherwise over and over doesn’t change the science.
https://journals.sagepub.com/doi/abs/10.1177/000992287801700112 (This is Barkley and Cunningham’s study, where Barkley, one of the biggest ADHD advocates around whose income depends greatly on accepting ADHD as a valid construct, states that the VERY slight improvement in test scores for the “treated” groups was easily explainable by the subjects simply reading the questions a little more carefully than the control group. He called the long-term results “Disappointing.” But that has not stopped him claiming later on that anyone NOT putting their child on stimulants for “ADHD” is committing child abuse!)
“Jacobvitz et.al. acknowledged the short-term benefits outlined earlier but focused on the same limitations of stimulants noted by Schrag and Divoky
(1975), McGuiness (1989), and Kohn (1989). As a conclusion, Jacobvitz et al. urged “greater caution and a more restricted use of stimulant treatment” (p. 685). In contrast, Stevenson and Wolraich acknowledged the limitations outlined here but focused on the temporary suppression of symptoms.”
““Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors,
social achievements” and other measures.
What is absolutely fascinating is that they revised the report later to eliminate ANY MENTION of long-term outcomes, as if this conclusion were NOT drawn from the study. I think that says more than a bit about the desire of the psychiatric profession to cover up this embarrassing conclusion. (In fairness, they DID find one study of decent quality that showed a reduction in accidents for stimulant users. That was the only positive long-term outcome they found.)
“Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the community.”
“No significant differences based on medication-use were noted for the following
measures taken at 14 years of age: depression, self-perception, and socialfunctioning.
• Whilst no statistically significant results were noted, a trend toward slightly higher
depression scores was noted with the use of medication.
• A trend toward slightly lower self-esteem and social functioning was also noted with
medication use at one time point or two time points. However, consistent medicationuse at all time points, including at 14 years, trended toward slightly improved selfperception and social functioning.” There was also a finding of a MUCH higher percentage of grades repeated for those taking stimulants.
I can’t find the USA/Finnish comparison study right now, but it showed that medication rates were MUCH lower in Finland, yet outcome measures like delinquency and school failure were no different in these comparable populations.
The studies referenced above involved MANY THOUSANDS (probably more) of “ADHD” diagnosed children in the USA, Canada, Finland, and Australia. The OSU study looked at every single reference they could get their hands on at the time that had to do with stimulants and ADHD. There is a mass of strong evidence that stimulants don’t alter long-term outcomes, and at this point, most research psychiatrists have accepted this as factual.
This Web MD article is most significant in what it does NOT say about long-term outcomes. If there really WERE known benefits in the long term, don’t you think they’d mention them right here? But they don’t, do they? I wonder why?
“Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.”
The lack of long-term benefits from stimulant drugs for “ADHD” diagnosed children is an open secret. It is known but not talked about. Anyone claiming there IS some benefit for any of these long-term outcome measures has a big hill to climb. Simply stating that “I believe that” or “Dr. So-and-so says that…” is not going to come CLOSE to cutting it in this case.
For those who actually believe in unbiased scientific analysis, the jury is IN on this question. The burden of proof is now on anyone claiming some long-term benefit. Stimulants are effective in short-term suppression of “ADHD” symptoms in the majority of children so diagnosed. That’s about all that can be said. Depending on one’s philosophy of education, and to some extent, on available educational options, this may or may not be considered beneficial. But claims of long-term benefits are mythological, not scientific.
The average lifespan of the “seriously mentally ill” has steadily DECREASED since the advent of psychiatric drugs. Such people now die 20+ years younger than their non-diagnosed counterparts. A significant part of that decrease in lifespan is the result of treatment with antipsychotics. As many as 14.5 years lifespan may be attributed to antipsychotic use.
Well said. The only caveat, and a big one it is, is that whatever philosophical approach one takes, the results have to reflect some apparent improvement, at least within your own philosophical structure. It becomes a BIG problem when one becomes so committed to his philosophical views that actual data that doesn’t support one’s theories is ignored or minimized or denied.
I have seen way too many kids “flip” to bipolar in my career as an advocate for foster kids. It is not rare that a kid gets aggressive in response to stimulants, but it is unfortunately VERY rare that doctors see that for what it is, and it almost always leads to more drugs and more serious diagnoses, instead of saying, “Gosh, those stimulants seem to have made things worse! Maybe we should stop and start over!” I had one who went two years deteriorating, until she herself decided to stop all three drugs she was on. She had become psychotic and aggressive on the stimulants, but when she stopped, she was back to her old self within days. But the doctors never had a thing to say about it. Did not even acknowledge they’d done her wrong. That happens WAY too often for my comfort!
I have moderated the comments you reported, as I understand in context why these might have come across as offensive to you. I am sorry we didn’t catch them sooner.
In the future, please email me rather than posting complaints about posts in the text of a comment. I am very responsive to such complaints, but it doesn’t help the community at large to have to process these complaints publicly, and as such, it is stated in the Posting Guidelines to handle such complaints by talking to the moderator or simply reporting them through the “report” function at the bottom of every post.
I think another vitally important question is how/why the current “mental health” apparatus does not SEE the very obvious connection between childhood adversity and adult “mental health” diagnoses. They spend decades researching the “biological underpinnings” of these “disorders,” and come up with 2, 3, 5% correlations, when childhood abuse/neglect/abandonment has associations at 80% or higher to most “disorders.” Seems like a case of intentional blindness. We’ll never be able to teach kids sufficiently about neurodiversity and the importance of healthy child rearing when the bulk of the “mental health” industry appears committed to denying that it matters!
One study by one person does not begin to compare to 4 long-term naturalistic outcome studies and 4 comprehensive literature reviews. The jury is IN. There is no long-term outcome that is consistently improved by stimulant treatment. It’s a fact.
Thank you, Jonathan. As I have said, there are philosophical differences that lead to different approaches. Different approaches are absolutely allowable. Claiming that all kids who present in this way “have a biological deficiency” is NOT scientifically valid at this point. It is VERY important to make the distinction between philosophy, which entertains the possibility and effects of different worldviews, and science, which attempts to discern facts and predict precise outcomes. Confusing one with the other leads to a lot of false conclusions.
Your comments continue tot be insulting. I never said “no biomarkers exist.” I said that your study did not prove that all or even most cases of “ADHD” are biological. I have also proven again and again that there are other alternatives to stimulant “treatment.” You are assuming the outcome and dismissing my example of my own kids because you don’t want to accept that your viewpoint is limited by your own biases. “Misdiagnosis” is common because there ARE NO OBJECTIVE STANDARDS FOR “DIAGNOSIS.” In fact, if there is no way to know who “has it” or doesn’t “have it,” there is no way to determine if someone is “misdiagnosed.” This leaves the door open to biased advocates to decide that anyone who IS helped by non-chemical methods “must have been misdiagnosed” to preserve their preferred belief system.
My kids absolutely fit the criteria to a tee. They were helped to lead productive lives with no stimulants. You apologized earlier for minimizing that accomplishment, yet you continue to do exactly the same. You assert that I was making my blind children go around pretending to be able to see. That is incredibly insulting, and you don’t even realize it.
I don’t “strongly disagree,” I have the best possible example that your generalization, which you repeat over and over again, is not true. I also have presented excellent proof that your insistence that “treatment” with stimulants is essential is absolutely not true, since in the long run, there are no significant advantages to “treatment” over “non-treatment” or “medical treatment” over psychosocial intervention.
Seriously, PLEASE DO NOT RESPOND if you’re going to keep insisting that I’m a child abuser forcing my blind children to pretend to see! If you don’t agree with me, DON’T AGREE, but I don’t want to hear you telling me I’m wrong. If you can’t accept that the world is bigger and more complex than your data to date, you are no scientist and will fail to ever learn anything about why some people find your approach so horribly offensive.
Nonsense. Reviews by Barkley and Cunningham (yes, the same Barkley who makes millions selling the idea that “ADHD” sufferers are being abused if not given stimulants) in 1978, Swanson in 1993 (“Review of Reviews”), and the Oregon State University Medication Effectiveness Project (which looked at EVERY piece of literature on the subject every published in about 2002) ALL concluded that there are no long-term outcomes improved by stimulant treatment when comparing those “treated” and “untreated” who were diagnosed with “ADHD”. Also, long term studies like the Quebec study, the RAINE study in Australia, and the Finnish study (compared kids in the USA with very HIGH “treatment” frequency and duration to kids in Finland with much lower treatment levels, no differences found) ALL found that there was NO long term benefit to those “medicated” vs. “unmedicated.” The highly-touted MTA study showed that the stimulant group had some advantages in reading at the end of a year, but by the three-year followup, that difference had vanished, and later followups showed that those who continued to be “medicated” had DETERIORATING outcomes in comparison.
Here is a more recent revivew:
“In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
Have you actually READ “Anatomy of an Epidemic?” This is covered in Anatomy, though more data has come in since Anatomy to provide even more support.
Repeating quotes from some guy with a degree does not constitute evidence. The jury is in – long term “treatment” with stimulants DOES NOT improve long-term outcomes. 40 years of studies should be sufficient to prove this point. If you want to pretend it’s not true, that’s your choice, but don’t try to convince me or anyone actually familiar with the literature.
I have the data on this, Enrico. Probably best not to try and argue this point, and instead either retreat or consider the real implications of the REAL science, rather than relying on quotes from “professionals” who probably have a conflict of interest.
My kids NEVER felt they were lazy, crazy or stupid. Unfortunately, most of the kids I knew (and I knew dozens, probably hundreds) who were “diagnosed” with “ADHD” were pretty sure they were being told they were crazy. Some rebelled against it, some accepted that they were “crazy” or at least “incapable,” none of them I can recall escaped without feeling their “diagnosis” meant they were either dumb or crazy or incapable.
So why not dedicate yourself to creating better classrooms, rather than trying to pretend that this hypothetical kid can’t learn just because they are too bored and distracted to function well in a so-called “normal” classroom?
“I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration.”
I already gave you a clear and thorough demonstration of exactly how this can be done. Your latter claim is not supported by the literature. As I’ve said all along. It appears you already “know” the answers, so why are you bothering to have a “discussion?” It sounds more like you want to force anyone who disagrees with you into submission.
If you really care, do your own research. But I don’t think you’d accept it if the results were right in your face.
And talk about not answering questions – if chemical stimulation to enhance concentration in a regular classroom environment is such a great solution, why is it that study after study shows no improvements in long-term outcomes for medicated vs. non-medicated “ADHD” diagnosed cases? Answer that if you want others to ask your (possibly disingenuous) questions.
Some people’s lives transform after they’re hit by a truck. Near-death experiences can be life changing! Maybe we can come up with a “treatment” that involves killing someone and bringing them back to life! Very New Age!
Or maybe some kids learn differently than is expected of them.
Look, we’re not going to agree on this. It’s a philosophical problem, not a scientific one. You have a set of assumptions, mostly that kids learn best by doing what they’re expected to in a regular classroom, and that being unable to do that is a problem with the child. I have a different set of assumptions – that it is the adults’ job to figure out the best setting for children to learn in and that adapting your approach to the children’s needs obviates the need to come up with ways to get them to fit into the “normal” classroom. Within our own sets of assumptions, we’re both right. And it doesn’t seem that either of us are ready to accept the other’s philosophical assumptions. And it’s starting to get personal.
Let’s just agree to disagree and have done with it. Diversity of perspective is the sign of a healthy community.
How on Earth do you know that my children were “not as limited as many?” How could you possibly know that without meeting my children, and without attempting a similar intensive behavior program based on the individual needs of other similarly “impaired” children and seeing what the results were? Your comment continues to come across as condescending, as I find quite common with people who are advocates for stimulants, rather than objective observers looking for the best approach and open to new ideas.
Where in my comments have I ever criticized you or said you should hate or disrespect psychiatry or psychiatrists? And I don’t condemn teachers, I am criticizing the SYSTEM of education that requires children to engage in behavior that meets the needs of the adults and not the children. I’ve even given you alternative educational approaches that work for “ADHD” diagnosed children, in which you have shown not the vaguest interest. What would happen to those kids who “can’t learn” in a standard classroom if they were given a different venue to learn in? What if 70% of them suddenly did not “need medication” any longer? Would you consider that a GOOD outcome? Or a BAD outcome?
And if it’s all biological as you claim, why is it that there is a full 30% reduction in kids getting diagnosed “ADHD” if they wait one year longer to enter school, as has been shown in several quality studies? The 30% figure is remarkably stable over these studies, too. What would happen if these kids were given yet another year to mature before enrolling? Could we reduce that figure by 50%? Would you view that as a good thing, or a bad thing? Especially when there is NO evidence that taking these stimulants over the long term has any positive impact compared to kids who quit early or never took them.
Your view of the situation is extremely monochromatic. I’m just trying to broaden your perspective, not tell you that stimulants are wrong or bad. I’m encouraging you to take a wider view, instead of assuming that using chemical means to enable a child to sit still and pay attention in a standard classroom is not only the best but the ONLY way to help kids who are struggling to learn in that environment.
It doesn’t suit you very well to claim you are sorry for condescending and then continue to condescend. But maybe you can’t help it.
This time I’m REALLY done. I’d appreciate it if you did not add more disrespect and condescension to the pile. Maybe best if you just stop trying to convince me of something I very well have established to be a very narrow and ineffective view of “ADHD” to my own satisfaction.
I acknowledged early on in our discussion that short-term symptoms can be improved by stimulants. I point out that long-term outcomes are NOT improved. How do you deal with that conundrum? Pretend that it doesn’t exist?
After re-checking my post, I find your diminishment of the accomplishments described to be even more offensive. Did you even bother to read what I wrote? Do you have any comments or thoughts on the idea that using of rewards of intense stimulation to help kids learn new behavior? Do you have ANY experience in behavior change theories? Do you even understand the point I’m making, or are you just choosing to ignore it because it doesn’t fit your narrative?
BTW, I have used these same approaches professionally with lots of kids, and also with adults, with some modifications. They WORK. It’s not because “my kids didn’t need medical interventions.” It’s because these interventions are smart and on target and very, very effective. But they require analysis, creativity, and months or even YEARS of HARD WORK! Maybe most people just don’t know how or don’t want to do that kind of work, and stimulants give them an “easy answer.” But one thing you have NEVER responded to is decades of research showing that long-term outcomes are NOT improved by stimulant treatment. My way DOES appear to affect long-term outcomes, at least in my kids’ cases. No learning problems, no delinquency, no school dropouts, continued high academic test scores, academic honors, and for one, a complete college education, again with academic honors. Stimulants can make no such claims. If you’re so interested in science, why not look for better solutions? Why spend all your time railing about genetics when it’s the one thing in the equation that can’t be changed?
I assume you’re aware of the research on brain plasticity, that the environment molds and changes the brain based on how it needs to be used to survived. What if our approach altered the epigenetic conditions in the brain by teaching our kids to use their brains differently? Would that not be a great outcome, and exciting outcome? Why is that not of interest to you?
My children functioned without medical intervention, but with a HELL of a lot of non-medical intervention. We EARNED their positive behavior through YEARS of hard work. You are trivializing it by trying to pretend that “they functioned without medical intervention,” as if what we did had NOTHING to do with their success! You are building a strawman argument to bolster your own case, rather than listening to the story and trying to find the core of meaning behind it.
What if lots of children could function without medical intervention, and nobody ever tried? What then? What if we are exposing children to years of drug side effects without really addressing their issues? What if 90% of those children COULD “function without medical intervention,” yet never had the chance to because people like you insisted it was impossible? Are we not cheating them out of an opportunity to grow and learn by telling them and their parents it is impossible?
Poor vision is objectively measurable, and is nearly 100% correctible by lenses. “ADHD” is a social construct “diagnosed” by a list of behavioral characteristics, some of which are, frankly, pretty ridiculous. “Acts like ‘driven by a motor’?” Isn’t that just a BIT different than “Is unable to read letters of X height from a distance of 20 feet?” Additionally, there is a very significant minority of “ADHD”-diagnosed, probably 30%, who don’t even respond positively to stimulants in the short term, some of whom actually get demonstrably worse (aggression, lethargy, psychosis in over 6% – hardly rare, eating problems, growth retardation – the list is pretty long).
Your comment is clearly disrespectful to those of us who choose not to buy into drugs as the solution. And they ARE drugs. They are generally schedule II controlled substances that can be sold on the street for money. Pretending they are NOT drugs in order to preserve middle-class sensibilities is just plain dishonest.
But yes, you are being extremely condescending to anyone who disagrees with your approach. “If someone doesn’t want improved vision, fine.” That implies that I have somehow neglected my children by forcing them to go around unable to see. As you can see from the results, my kids are NOT blind or limited in their capabilities in any way. They are just as capable as you or me, absent any stimulant “treatment” in their lives. It appears you are extremely invested in your idea that stimulant drugs are the only answer for kids who have what is at best a behavioral syndrome that is “diagnosed” by utterly subjective means. It’s insulting in the extreme, and I ask you to stop doing it, to me, and to anyone else you meet. Maybe instead of telling everyone else what is “right,” you could start listening and perhaps expanding your viewpoint. Instead of an analogy that I let my kids go around with poor eyesight, perhaps you can open your mind enough to say, “Wow, that sounds like you did a good job! Maybe there are other options I haven’t considered that could work for some kids.” I am not ascribing ANY immoral motives to you or anyone else who chooses to take stimulants, and I made that point more than once in this thread. I have been arguing ONLY from the scientific perspective that one study on a very limited population does not establish a “cause” for “ADHD” nor that it is a biological phenomenon only, nor that it is even a legitimate entity for scientific study. Your comments have been and continue to be dismissive and disrespectful of other viewpoints, and I’m calling you out on it. If anyone is ascribing ill motives to those who don’t agree with them, it is you who is doing so. You might want to take a very hard look at your own behavior instead of spending all your energy criticizing those who have good reasons to disagree with your assertions.
And I have provided you a VERY concrete example of training that has had proven results. How is that “off the topic?”
If you want to learn anything, you have to open your mind to the possibility that you have not been told the whole story. So far, I don’t see much if any openness to hear anything that contradicts your own preferred narrative.
Just to be clear, there are plenty of women who embrace “patriarchy,” and also plenty of men who don’t. Internalized oppression is a very real thing, and there is no reason that a woman can’t engage in sexist behavior or operate on sexist assumptions and values. Remember Anita Bryant? I’d have to say that even proposing the idea that PTSD is caused by women being on their periods is offensive on the face of it. Though the I agree with the rest of what you said – the lack of “common sense” in such a study is startling!
How long to you have? I can write a book on the subject.
Just for starters: what do you know about “ADHD” kids? They need STIMULATION. They can’t stand boredom and routine. They often create behavioral issues in order to get the reward of adult engagement, even if it costs them getting in trouble. Which reinforces their negative behavior.
So why not create a situation where they get intense stimulation for DOING WHAT THEY ARE ASKED TO DO?
Example: My youngest didn’t like to lie still as we got ready for bed (reading time). He’d wiggle around, hide under the covers, smuggle in little toys to play with, and on and on. He was 5 1/2 at the time. I decided to create a program – I bet him a quarter that he couldn’t stay quiet for 1 minute without moving. Of course, he assured me he ABSOLUTELY could do that, NO PROBLEM! The first night, it probably took him 3 minutes to get settled down to the point I could even start the clock. But I waited until he was able to keep some semblance of calm for a minute, then I dramatically expressed GREAT frustration and coughed up the quarter begrudgingly. But I told him, “Tomorrow, we’re going to go for a minute and a half, and I KNOW you can’t do THAT!” We continued this process for a couple of weeks, and worked all the way up to 5 minutes. The last night, he took one deep breath, and completely relaxed, was totally still for five full minutes without a twitch. As I coughed up the last quarter, I said, “Well, I guess I was wrong. You CAN control your behavior, you just have to decide you WANT to do it!”
Several months later, he and a friend (who happened to be diagnosed ADHD and on stimulants, but I did not know this) were jumping on our trampoline. His friend was violating the safety rules (he was older, more like 7, quite bright, and knew and remembered what the rules were). I reminded him of the rules, closed the door, and a minute later saw him doing the same thing! I went outside again and asked him why he kept violating the rules? He said, “I ate red dye this morning, and it cancels my medication, so I can’t control myself.” And Kevin immediately said, “Yes, you CAN control your behavior, you just have to decide you want to!” This was a very real, very deep learning experience for him which he was now applying to his friend. And all for only
a few bucks and less than an hour of my time!
Did this mean he was never wiggly or disruptive or oppositional again? Of course not! But it gave a context to have further discussions and to face bigger challenges building from this solid base. Plus it taught ME an important lesson – he WAS capable of facing pretty significant challenges, if he could WIN at the end, and especially if I got “upset” about his “defeating” me. I used this principle again and again throughout his childhood, and even as he grew older and recognized the “game” behind it, he still was tickled pink when I got “upset” with him for “beating” me, even when he knew I WANTED him to win.
That’s just one short example of the kind of learning that can happen with a highly “ADHD” child when the adults, instead of getting angry at him for doing bad things, get “angry” at him for doing what we want!
So rather than deciding to define my kids’ behavior or actually their entire personality as “wrong” or “disordered,” we spent most of our time validating the strengths of their personalities and identifying and helping them overcome their challenges through fun and challenging reinforcement programs. We regarded every moment as a possible teaching moment, and always had a goal and a focus for what we were working on next. I don’t want to suggest this was EASY – it was a lot of work, me made a lot of mistakes, and there was plenty of yelling and tears and accidental reinforcement of bad behavior. But we had a plan and stuck to it, and it worked. Eventually, Kevin himself started to set his OWN goals and pursue them with the passion he always brings to his life. He continues to this day to challenge himself to do better and to discipline himself to make his life the best it can be.
There was never a need to pathologize their behavior, to label them as this or that, or to provide artificial stimulation through physiological means. We used what we knew about our kids and the behavioral patterns that were common, and we focused on building their strengths and using them to attack their difficulties and challenges.
Does any of that sound irrational, punitive, or harmful to our kids? I think the success we achieved together speaks for itself.
You are assuming that the “ADHD” child WANTS to learn but is UNABLE to learn. If that is the case, why is it that one review after another over decades shows that stimulants create more “on-task” activity but do NOT translate into more learning/understanding in the long run? Is it possible that the child is being forced to do “work” that is not actually educational for them? That they already understand the material and are simply bored by having to “practice” over and over and over again doing something they already have down? Or that if offered a more hands-on, active, self-paced opportunity to learn, they would thrive on it, but such an opportunity is simply not made available to them?
I’d also ask you to explain why long-term outcome studies show no discernible effect on self-esteem, if these shaming experiences are theoretically reduced in number? Is it perhaps that we are replacing one shaming experience with another, telling a child he “needs his meds” in order to learn things? Singling him out as “disordered,” often in ways that are obvious to everyone in the classroom? What does it do to a kid’s self-esteem when told that his brain “doesn’t work right” and that he needs a drug to “rebalance his chemicals?” What happens later on in life when he discovers that he was actually lied to about that supposed “fact” (because as we should all know by now, the “chemical imbalance” theory is dead, even in mainstream psychiatric research circles)?
I was a shy kid in school. I had no trouble understanding anything the teachers were trying to teach us, though I did get frustrated at the ridiculously slow pace. Frankly, I was BORED TO DEATH, and no amount of increased “time on task” was going to teach me anything I didn’t already know. And trust me, I daydreamed like mad, and often completely tuned out the teacher droning on about something I already understood. I needed some NEW TASKS in order to learn more, not more time on the same boring tasks that I’d long since mastered!
I was very good at “complying,” so stayed out of trouble, but was terrified to talk because of the potential shame involved in exposing oneself to possible ridicule from the teacher or the other kids. I got embarrassed, turned red, and could not respond. I was laughed at. I avoided talking so as not to keep having that experience.
So what was the problem, Enrico? Was I “disordered,” because I was sensitive and easily embarrassed? Was my constant daydreaming an indication of me having “ADD without hyperactivity,” or a sign that I was in an incredibly dull and unstimulating environment for hours on end every day? Was I “disordered” because I didn’t want to risk getting humiliated? Or was the problem PERHAPS that the environment was a complete and total setup for a shy person like me to be exposed to? Was the fact that no one gave a shit whether or not I was shamed or embarrassed, or that the teachers themselves often PARTICIPATED in the shaming behavior perhaps a factor in why I was so reticent? Today, I would no doubt be “diagnosed” with “Social Anxiety Disorder” and efforts would be made to make me more participatory and to be able to “control my emotions” so I was “tough enough” to handle the inevitable shaming experiences that would ensue. My needs would be invalidated, and I would be accused of being a failed person because I couldn’t easily “fit in” to what I was expected to do.
Kids should not have to learn in a shaming environment. They should not have to learn in ways that risk trauma if they participate. They should be able to learn in ways that work for them, instead of having to be forced into a rigid structure that takes their normal ways of learning and makes them a source of shame and embarrassment? Instead of trying to alter the kids’ personalities, maybe we ought to teach our teachers how NOT to shame kids and how NOT to set up situations where other students can shame them as well?
Another interesting study showed that kids diagnosed with “ADHD” actually LEARNED MORE WHEN MOVING AROUND! So by forcing them to sit still and “pay attention” to the teacher talking, we are STOPPING them from learning. If giving them stimulants makes them more willing to sit there and take in all the boring “information” being tossed at them, that apparently doesn’t translate into them learning any more than they would have if they goofed off the entire lecture. In fact, they’d probably learn MORE if they were allowed a half hour of searching the internet and reading about what they’re interested in than they do sitting through a lecture in a chemically altered state.
I’ll again refer you back to the 1970s era study on “ADHD” kids in open classrooms. They stood out like sore thumbs in a “normal” classrooms, but professionals COULD NOT TELL THEM APART FROM THE “NORMALS” in an open classroom. So instead of drugging kids so they can sit still through a boring lecture and get higher points for “Stayed on task,” why not create open classrooms for anyone who needs or prefers that style of learning?
Remember also the study showing that these supposedly “disordered” kids were a critical element in groups of elementary school kids actually solving problems. They brought something to the table that three “normal” kids would have benefitted from. Why do we want to suppress that strength, just so that teachers and parents have an easier time?
The fact that teachers and other students hurt, shame and confuse other kids who don’t function well in a standard classroom is the fault of the teachers and the system they work with. As I’ve said before, my own kids had NO STIMULANTS despite pretty severe “ADHD” symptoms, but both graduated high school with honors and are paying their own way in the world and have functional relationships and goals and are functioning in every way as a contributing member of society. No one today would “diagnose” them with anything at all. What was different? We didn’t try to force our “square pegs” into the “round holes” of the school system until THEY decided they were ready for it. We loved and respected them, but of course taught them things they needed to know, including how to discipline themselves and how to get along with folks they disagreed with. Neither of them were in the tiniest degree unable to learn. In fact, they are both brilliant, fast learners! But they did not learn the way that schools expected them to learn. We never considered that their fault.
You are asking others to consider your hypothetical scenarios. What about my very REAL scenario of my two kids, and the research that supports what we did to help them mature into functional adult citizens? Does that suggest that alternative viewpoints may not only exist, but in fact be viable ways to view the situation that lead to positive results?
This is a nice story, but does not reflect reality in the vast number of cases I see, nor does the research support the “transformed overnight” meme, except in the most mundane of aspects, namely that many kids behave more acceptably to the teacher’s (or parents’ or professionals’) eye on stimulants. Long term studies and literature reviews have repeated ad nauseum that long-term stimulant use does not improve outcomes in academic, social, behavioral, or emotional areas. I’ve listed some of these in another post. Try googling “long-term outcomes stimulants ADHD” and read through the results. There will be a few individual articles claiming positive benefits, but the reviews of the literature and the long-term outcome studies, including the Montreal, Raine, the Finnish study, and the highly touted MTA study, all show “disappointing” results.
I would also submit that your characterization of how adults treat these hypothetical “ADHD” children amounts to verbal and emotional abuse. Giving drugs to avoid verbal and emotional abuse by adults seems a little ass-backwards to me. Perhaps the parents need to learn how to treat a child who doesn’t naturally fit into the largely arbitrary social expectations foisted on them by schools and often by the parents themselves?
As I’ve said before, I speak from direct experience in this case. It is VERY possible to create a positive environment that is both nurturing and sets reasonable and attainable expectations for kids based on their personalities. It’s just that very few children ever experience these conditions, because parents are expected to send their kids to schools that are not suited to their needs.
I’m not resisting what Birk shows. Saying that this mutation is ONE POSSIBLE CAUSE of the syndrome called “ADHD” is absolutely fine. Saying it IS THE CAUSE of ADHD is not fine. That’s what it sounded like you were saying. The big problem I’m pointing out is taking a single finding and extrapolating it to everyone, going from a subset of “ADHD”-diagnosed people have this particular anomaly to “ADHD” is a disease state that is caused by this genetic mutation. It presents an interesting template for further study. But there are many other interesting templates for examination, including low iron, sleep apnea, nutritional problems, exposure to abuse/neglect, exposure to domestic abuse in the home, inappropriate expectations set on younger children, maturity at admission to school, classroom structure, skills of parents and/or professionals managing these children, and on and on. As I explained to you earlier, I have two of my three boys who fit the “ADHD” criteria to a tee, and both were successful in high school and one in college with no drug intervention whatsoever. Should we not be grateful that at least some “ADHD” kids can be TAUGHT the skills to concentrate when they need to? Would this not be a topic for investigation? Isn’t that information that can be used to help others? Isn’t that what we are all striving for?
The point is, response to stimulants is not diagnostic of “ADHD” or anything else except having taken stimulants. Again, if you LIKE the effects of stimulants, you’re welcome to take them. It is completely irrelevant to the question of biological causation.
OK, I’m going to try one more thing here and then that’s it for this discussion for me. I will keep it very simple.
Let’s say we did a study and found that poison ivy causes skin rashes. We had a large sample of people and found that 90% of those exposed to poison ivy got a skin rash.
Can we now conclude that skin rashes are caused by poison ivy?
Or can we conclude that a certain subset of skin rashes are caused by poison ivy?
What would we need to do to demonstrate that ALL skin rashes are caused by poison ivy? Would this one study be sufficient to show that?
This is what you’re doing here. You are saying that people who have this mutation are likely to fit the description of “ADHD.” This is not something I’m arguing with. I’m asking you how you could possibly conclude from this one study that ALL cases of “ADHD” have this cause?
The answer is, you can’t. If you can’t see that, you can’t try talking science to me. It’s a fundamental tenet of science – correlation does not imply causation. There could be 500 different, distinct causes of the syndrome called “ADHD,” and this could be one of them. We could do the same with abused children – take 100 abused children and 25 of them are diagnosed with “ADHD.” Does this mean child abuse causes “ADHD?” No. It means at most that SOME “ADHD” behaviors are caused or increased by child abuse. It could even mean that abused kids are more likely to be taken to a psychiatrist for a diagnosis. Or that foster care placement makes kids more anxious and that this creates more “ADHD” symptomology. And there are many people who are diagnosed with “ADHD” that have no child abuse in their background. But it is a factor that contributes. That’s all we can say.
Like I said, you could be right, maybe every single case of “ADHD” has this mutation. But this study certainly doesn’t come anywhere CLOSE to proving such a thing. It shows that people who have this genetic mutation are likely to show “ADHD” symptoms. And that is ALL it shows. The rest will require further study.
An excellent perspective! I doubt that hunter-gatherer societies spent a lot of time talking about “egalitarianism.” They just lived in the ways that worked for them, which included a level of collaboration and respect for differences, just because that was what worked best over their history.
Sorry, can’t agree with you here. I can’t argue with the result that a certain very small subset of people diagnosed with “ADHD” had the genetic mutation that Birk has located. I don’t want to argue with that. But science is limited to answering the question asked. This study showed that a small sample of humans diagnosed with “ADHD” had a certain genetic anomaly. That is ALL that it proved, whatever the researchers theorize it means. Science is inherently SKEPTICAL. It is supposed to doubt its own conclusions and try to come up with alternative explanations and to DISPROVE anything that it wants to prove. No real scientist has the attitude that one study, particularly with the small sample size involved, can “prove” that “ADHD” is biological! It’s an outrageous assertion scientifically. Consider that we all “knew” for a certainty the formulas for acceleration and force and the gravitational constant and so forth for CENTURIES before Einstein showed them to be an approximation rather than a precise description of reality. Science is always working to improve itself, and that means questioning assumptions and conclusions that are not established beyond a reasonable doubt, and even those that ARE established as “laws” are STILL subject to revision when contradictory data arrives on the scene.
Replication is the core of scientific verity, moreover, replication in the face of efforts to establish alternative explanations. You can’t take one study and extrapolate it to apply to the entire population in question, ESEPCIALLY when this population is defined by ridiculously subjective criteria like “displays poor listening skills” or “appears to be ‘driven by a motor’ or is often on the go.” Seriously, “Often on the go?” You think that every child who is “often on the go” would not be “on the go” except for some genetic anomaly? It is absurd to so readily believe that one study, which establishes nothing more than an ASSOCIATION with these “ADHD” traits, proves causality.
Anyway, you seem to have convinced yourself and are not really interested in discussion. I’m not sure why it is so important to you to make more of this study than it offers, but maybe you’ll be right and I’ll be wrong in the long run. But I certainly will not concede that a single study on a tiny subsection of this population proves “causality” of “ADHD.” Come back to me when you have at least three studies from different, non-biased sources that indicate that over 90% of those “diagnosed” with “ADHD” have this anomaly, and that less than 10% of the general population have the same anomaly, then maybe we can talk.
Your comment comes across as extremely arrogant. Neither you nor Dr. Birk has come anything close to explaining why a subjective list of behavior that adults and especially school personnel find annoying is 100% “caused” by a genetic anomaly that is seen in mice.
I am the first to say that kids (and adults) who have a hard time concentrating on the daily drudgery of the average school classroom should not be abused, neglected or treated as second-class citizens. But the problem in my mind is not the kids, it is the school structure itself and the ongoing justification of mistreating children who don’t do well in that structure that is to blame here. I totally allow that there are some kids who are born not being tolerant of boredom and repetition, not liking to sit still, etc. just because they came that way. Two of my three boys who fit that description. Both of them graduated high school with honors and have social lives and have successful jobs and are no less happy and productive than the average person, despite neither of them ever having had a milligram of stimulants in their lives. We did have lots of frustrations, especially with the older one (we learned so much from him that the younger was MUCH easier!) and I’m certain if we’d sent them to “normal” schools with “normal” classrooms, they’d have struggled and probably learned to hate school. So we didn’t do that. We sent them to alternative schools and homeschooled for several years, and spent a lot of time learning creative ways to approach discipline that worked better for their particular personalities. And yes, they COULD and they DID learn how to concentrate when they needed to, how to alter their approach to relationships, to accept losing and failure as learning opportunities, and even how to accommodate arbitrary restrictions an expectations in order to get what they wanted/needed out of life.
I would also add that if YOU find stimulants helpful to YOUR life, I certainly have no objection to your choosing to use them in whatever way seems helpful to you. I do object to your attempts to narrow the discussion to Dr. Birk’s single, small-sample, narrow and unreplicated study as some kind of proof that you have all the answers and that everyone else’s conception of “ADHD” is wrong and that it’s 100% biologically caused and that anyone who acts that way has a “disorder” and that anyone who thinks otherwise is sadly ignorant. There is PLENTY to talk about both philosophically and scientifically that is unresolved, and I am extremely well versed in a wide range of research on this topic, in addition to having personal and professional experience over many years in the area. So please, do not condescend to me and pretend that your single study has proven anything. I hear and understand and agree that there are most likely biological conditions that are ASSOCIATED with “ADHD” symptoms. But that is a tiny, tiny piece of a very large and complex puzzle that involves not only biology, but culture, history, sociology, philosophy, and education, among other variables.
I have not even touched on the very important question of long-term outcomes. There is at this point a pretty solid range of literature showing that stimulant “treatment” alone does nothing overall to improve long-term outcomes like high school graduation rates, college enrollment, academic test scores, delinquency rates, teen pregnancy rates, drug abuse rates, social skills, or even self-esteem (even if they may help one or more of these things in a PARTICULAR person at a particular time). Even if it is absolutely proven that EVERY person who fits the subjective “ADHD” profile has this genetic anomaly, which I hope you are able to acknowledge is NOT claimed nor proven by your Birk study, there is scant evidence that taking stimulants does anything more than temporarily make it a little easier to concentrate (just like it does for most adults, “ADHD”-diagnosed or not – see my other post), which doesn’t even lead to better educational outcomes on more than a short-term basis. So why spend all this time arguing about whether or not “ADHD” is caused by a genetic anomaly while not addressing the major concern that taking or not taking stimulants doesn’t seem to make a big difference in the long term for the “ADHD” sufferer? Maybe we should spend less time on arguing about genetic causation and more on figuring out how to make the school environment more workable for these kids (and for other kids who also find it oppressive but are “genetically” more able to pretend they’re OK with it)? After all, genetic diversity is the key to species survival. Why are we picking on these “ADHD” kids when we know that, for example, putting them in an open classroom environment (that’s what we did for our boys and it worked!) makes such kids virtually indistinguishable from “normal” kids?
I am sorry you have suffered at the hands of the system. It didn’t have to be that way. But I don’t think the evidence suggests a simplistic, biological answer to what is a complex sociological problem.
I’ll leave you with this: a recent experiment took groups of three elementary school kids and gave them three problems to solve in a specified period of time. The experimental group had one “ADHD” diagnosed kid and two “normal” kids, while the control group consisted of three “normals.” They were rated on percentage of time on task as well as on how many problems they were able to solve. Not surprisingly, the groups with the “ADHD” kid in them spent considerably more time “off task” doing and saying things that had nothing to do with solving the problems at hand. The surprising outcome (to the experimenters, though not to me) was that NONE of the groups of “normal” kids were able to solve any of the problems they were presented with, while the “ADHD” groups consistently solved one or more of the problems, despite spending less time focused on finding a solution. Of course, if they’d had groups of three “ADHD” kids vs. three “normals,” the results may have been quite different. But I think the lesson from this study is that people who are off-task, silly, have scanning rather than fixed attentional focus, are ESSENTIAL to the survival of our species. They are the ones that come up with new ideas, that “think outside the box,” the ones not constrained by convention but who can dedicate themselves to finding a way to make things work, regardless of what anyone else thinks of their approach. We need these kids and adults!
It has been observed that folks like Edison and Einstein and Gauss and Lincoln and Van Gough and Leonardo Da Vinci might have been diagnosed with “ADHD.” I have to wonder what marvelous contributions to the world might have been lost if these folks had been “properly medicated” in their day? Maybe the world just needs to make more room for people who don’t like to sit at a desk and do as they’re told all day long. Maybe it IS genetic, but why would 10% of the population have this particular genetic inheritance if it didn’t have a purpose in helping our species survive?
Could you PLEASE respond to my very valid points regarding the CDH2 mutation NOT being established to exist in all or most or even any kind of percentage of so-called “ADHD” sufferers? Or help us understand why early childhood abuse and neglect is associated with 4-5 x increase in “ADHD” diagnosis if this is all about the CDH2 mutation? I could add more, but I want to keep it simple so we can see if you have any kind of answer to these key questions. So far, you have avoided them and keep repeating the details of this rather limited study.
Just to be clear, Judith Rappoport, et. al., showed unequivocally (back in about 1978) that non-labeled people respond exactly the same way as “ADHDers” to stimulants. She called the claim of differential response “an artifact of observation” due to the fact that people are LOOKING for a particular response from the “ADHDers” and so notice and value that response, while the same response from “normals” doesn’t get any attention because no one is trying to “fix” them. So the improved concentration you attribute to “ADHDers” responding instantly to stimulants is the same improved concentration that ANY PERSON would gain as a result of stimulants.
“Since the positive effects of stimulants on disruptive behavior were described (Bradley & Bowen, 1941), further pediatric study has been limited almost exclusively to samples of hyperkinetic school-age children. Because these agents normally were viewed as arousing in their effects on the central nervous system, but were calming in their therapeutic effects on these children, stimulant effects on Attention Deficit Disorder (ADD) were interpreted as being ‘paradoxical.’ Investigation of effects in normal children and adolescents and in those with disorders unrelated to Attention-Deficit/Hyperactivity Disorder (ADHD), as well as in young adult samples, however, indicate that stimulants appear to have similar behavioral effects in normal and in hyperactive children. This brief report is an update (as of August 2002) on studies of stimulants in ADHD and normal children, with particular focus on MPH.”
All comments you have made should be approved at this point. They are not always approved in order they are submitted, as more than one person works on approving comments, and sometimes certain comments require more analysis than others, so their approval may be delayed in some cases. If there are any comments I have not approved, please let me know the thread and some of the content and I will see what has happened to the comment in question.
I have made my points, and you appear to have no response other than “Dr. Birk said so.” The fact that Dr. Birk said so is of absolutely no consequence to me or to Science as a whole.
I don’t need to contact Dr. Birk – s/he has overstated the case by any level of scientific analysis. It appears we will be unable to agree on these points. You are free to believe Dr. Birk’s analysis if you wish, but it is still important for any real scientific discussion to point out the limitations of the research presented. Since you appear to have no interest in responding to the points I have raised, it appears that no further discussion is possible.
Ah, now we get down to it. It is ASSOCIATED with “familial ADHD.” Associated means it occurs with a higher percentage in the “ADHD” population than in the general population. It does not mean it is a cause, as there may be many, many cases of the same mutation in people who don’t fit the “ADHD” criteria. “Correlation is not causation.”
We know for certain that familial domestic abuse is highly associated with “ADHD.” It occurs more frequently in the “ADHD” population than in the general population. Does that mean that familial domestic abuse causes “ADHD?” What about the many children who are exposed to the same kind of parental behavior who do NOT develop “ADHD” symptoms? What about the large number of “ADHD” diagnosed children who don’t have domestic abuse in their history?
Other associations are low iron, sleep apnea, younger age of starting school, being in a traditional classroom vs. an open classroom, abuse/neglect at an early age, etc. Are all of these “causes” of “ADHD” because they are “associated” with “familial” ADHD? Does a traditional classroom “cause” ADHD because more “ADHD” behavior is associated with it? Or does a traditional classroom structure simply not WORK for a certain percentage of children, for a wide variety of reasons?
Correlation is not causation. And you continue to avoid the most important question of why this particular set of subjective behaviors are automatically a “disease state” even if a consistent physiological cause were found.
Sounds a lot like “blaming the victim” to me. Of course, people don’t want to feel marginalized. But why is it their job to carve off parts of their personality in order to “fit in?” Why is it not the job of society in general to help people feel more welcome and accepted, even if their behavior is unusual or confusing, yet does no harm to anyone? Isn’t a lot of “mental illness” simply the consequence of society’s narrow view of what is “normal” or “acceptable” behavior?
That is more than possible, since they seem to know very little about either on the whole. But I think that would make you more of a shaman than a doctor. Of course, if I wanted to use psychedelics for any reason, I’d of course seek out a shaman and avoid anyone claiming to be a “medical practitioner” using psychedelics as “treatment” for some manufactured “disease” s/he decided I supposedly was afflicted with.
Again, claiming “cause” requires establishing that all or almost all “ADHD” sufferers HAVE the CDH2 mutation, and that no or almost no “normal” people have this mutation. To claim this from the data presented is pretty laughable. They’ve shown that a very small sample of people/mice subjectively judged to “have ADHD” without objective measures happen to have this particular mutation. Does EVERYONE with this mutation have “ADHD?” Or is it 10%, 20%, 50%? Does EVERYONE diagnosed with “ADHD” have this mutation? Do some have the mutation and NOT develop “ADHD symptoms?” Is the presence/absence of this mutation determinative of a person’s long-term success in life? Does “treatment” for this putative problem actually do anything to improve long-term outcomes for those so “diagnosed?” Is there even an objective way to determine who “has” or “does not have ADHD?”
It is scientifically absurd to declare that this mutation “causes” ADHD when the “disorder” itself is not objectively discernible, nor is there any indication that those so “diagnosed” have any kind of physiological problem or are just a normal variation of behavior that doesn’t work so well in modern society. After all, genetic diversity is central to species survival. Why is a genetic variation, even if it is 100% associated with this behavioral syndrome, automatically a “disorder” when our species depends on a wide variation of genotypes and phenotypes to survive?
There are no long-term outcomes that are improved by “ADHD treatment” with stimulants. This has been shown by Barkley in 1978, by Swanson’s “Review of reviews” in 1993 or so, and by the OHSU comprehensive study of long-term outcomes, which looked at essentially every study ever published on the subject up to somewhere around 2001. There were NO improvement in long-term outcomes for “treated” vs. “untreated” subjects noted in the OHSU study, including academic test scores, high school graduation rates, college enrollment, delinquency rates, teen pregnancy rates, social skills measures, employer satisfaction rates, or even self-esteem. The only variable that was improved is a slight decrease in accident rates. In Barkley’s 1978 review, he said that the improvements in academic test scores were so small that they were easily explainable by reading the questions more carefully. And yes, this is the same Russell Barkley who has become one of the keenest advocates for “treatment” for “ADHD,” so we can hardly blame researcher bias.
Additionally, long-term studies like the Quebec study, the Raine study in Australia, the Finnish comparison study, the long-term follow-ups to the MTA study in the USA, all lead us to the inevitable conclusion that long-term outcomes are not positively affected by stimulant treatment. To claim “we know there is a biochemical basis to ‘ADHD’ is, of course, utter nonsense scientifically. But we are not even at the point where we can say that “treatment” leads to any significant long-term improvements in any significant outcomes.
The small study that is referenced doesn’t even come close to touching any of these long-term effectiveness questions. It ignores the obvious environmental impacts on “ADHD” behavior, including later entry to school, having open classrooms, and the impact of psychosocial stressors on the “diagnosis” (studies have shown “diagnosis” rates of 5-10 times higher in children who have experienced serious abuse or neglect). Nor does it address finding some objective way of even determining who “has” or “does not have” “ADHD.”
Repeating something over and over again doesn’t make it true. From a purely scientific viewpoint, “ADHD” isn’t even something that can be objectively determined to exist, let alone to be a “disorder” or divergence from “normal.” This study barely scratches the surface on questions of etiology, differential “diagnosis,” and long-term effectiveness of proposed “treatments.” It is ridiculous to claim that this proves any kind of “biological basis,” when the condition you have identified hasn’t even been established to exist in all or most or who knows what percentage of “ADHD” diagnosed people, nor the percentage of the people having this variation who may NOT have any “ADHD” symptoms to speak of. And of course, the entire enterprise is called completely into question by an inability to objectively even define who does or does not qualify for the “diagnosis” of “ADHD” in the first place.
Nonsense. We would need to see that all or almost all cases of “ADHD” have this same mutation, and that no or almost no person with this mutation does NOT have the “ADHD” features. Given that “ADHD” is defined by subjective behavior and sociological variables, the odds that EVERY case of “ADHD” so “diagnosed” is caused by this mutation is exceedingly questionable. In any case, this question does not begin to be answered by a handful of mice, or even a very small number of “ADHD” cases studied. We also know that, for instance, waiting one year before enrolling a child in school leads to a 30% reduction in “ADHD” diagnoses (a number of studies confirm this), that sociological stress such as neglect and domestic abuse increases the rate of “diagnosis,” that placing such children in “open classrooms” makes it practically impossible for professionals to distinguish them from “normal” children, and that prior comparisons of “genetic markers” have proven extremely heterogeneous, that is, that many “diagnosed” with “ADHD” did NOT have the markers, and many who were NOT “diagnosed” did in fact have the same markers.
And of course, the entire line of inquiry ignores the rather obvious question of why a particular challenge in paying attention to boring activities is considered a “disorder” in the first place. I recall an article (which I can’t seem to locate now) that showed employer satisfaction with historically “ADHD” employees did not differ from those not so diagnosed. The explanation offered was that those with this “diagnosis” simply chose employment opportunities that fit with their personalities, rather than being forced, as they are in schools, to do what they are ordered to do with no ability to choose the activities they prefer. This is strongly supported by investigations in the 70s indicating that “ADHD” children are virtually indistinguishable from “normal” children in an open classroom environment.
In short, there is a huge number of variables involved in this analysis that are ignored, most particularly the problem of “selecting” subjects based on a subjective list of behavioral characteristics that are not truly measurable in any objective manner. This particular study does nothing to answer the bulk of questions that the diagnosis itself raises, yet even within the context of the accepted nomenclature, there is no way to draw the conclusion you claim from the extremely limited study you present.
My objections remain unanswered. This is a speculative effort to establish a correlation between “ADHD diagnosis” and a certain genetic pattern. It is performed on a very small number of MICE. It does not address questions of rearing variables, does not establish probability of the “error” being found in the “ADHD-diagnose” population, nor in the general population vs. “ADHD-diagnosed.” It does nothing to establish any kind of “abnormality” of this genetic combination to distinguish it from normal genetic variation. One more “promise” of a “biological cause” which is nothing of the sort.
So you’re really talking about THREE cases here, all related to each other? With similar juvenile environments? No comparison subjects/control subjects?
As usual, you are identifying an “association.” Nothing in your article speaks of a “cause,” nor does the degree of “association” appear anywhere here. There is no comparison stating what percentage of people who have this mutation who are “diagnosed” with “ADHD” vs those who are not, nor what percentage of “ADHD” sufferers actually have this particular mutation. To claim “biochemical cause” as you imply in your first sentence, we’d need to know that almost all “ADHD” sufferers had the mutation and almost no one who has the mutation is NOT diagnosed with “ADHD.”
The article also avoids the very important question of whether or not this is simply a normal genetic variation that has been pathologized because the associated behavior is annoying to adults.
It is tiresome to keep hearing of these “breakthroughs” which don’t address the most basic scientific questions yet claim “proof of biological causation.”
I like some of what you said, but I don’t agree that the DSM would shrink in the absence of child abuse and neglect. The DSM serves a purpose that is very different than helping people recover from trauma. It enables psychiatry to justify intervening in situations where they don’t have the first idea how to help, and it also justifies blaming the victim when their “treatments” don’t work or do harm. There are WAY too many people making money off of the current system to think they’d just back off if humans suddenly became more sane. I think the greater hope would be that humans who were NOT abused in childhood would find it easier to recognize the false “authority” of psychiatrists in the area of “mental health” and that psychiatry would die a well-deserved death in the face of actual approaches that help people learn and grow spiritually rather than ones that try to “help” by disabling people’s brains with dangerous drugs.
That data was from two WHO studies in the mid-90s, which Whitaker reports on in Anatomy of an Epidemic. They re-did the same study because the mainstream psychiatrists didn’t believe the results. They still try to explain it away by saying it is due to “cultural factors,” while ignoring the most obvious difference – fewer people on fewer antipsychotics.
You are fortunate to hear Seikkula in person! I’d love to have that opportunity!
That is a pretty MASSIVE disparity! Of course, the psychiatrists would like to blame it on “the disease,” but the almost certain culprit is the drugs they use to “treat” it.
Would love to see someone do a comparison with “untreated schizophrenia” and see the prevalence in that population compared with those “fortunate” enough to get the best of modern medical “care.”
I do think you make a legitimate point – Occam’s Razor aside, we can see that the results of assuming a material cause of the mind has certainly not led to any kind of success. From a purely practical viewpoint, materialistic assumptions about the mind so far appear to have led to a complete dead end.
I note that the blurb on the book you linked refers to “the mystery of the mind.” There are lots of opinions and explanations, but very little hard data to base those speculations on.
I appreciate that you say you “prefer it.” As I said, we’re talking philosophy here, not science. Until we know something of how neurons “generate inner realities,” we’re speculating. We don’t KNOW a single thing about the “mind” except indirectly by its apparent effects. My opinion is that we will not ever get there, because we’re using the mind to study the mind. The Buddhists have probably come the closest to getting a handle on it, but again, they are focused on effects, not on where the mind actually comes from or what it particularly is.
So how have these studies led you conclude that “mind” is an emergent property of neurology? What concrete observations show this to be the case?
BTW, I admire you commitment to these studies. I totally support the study of the mind/spirit or whatever you want to call “it” by individuals and groups. I just don’t see this leading to any scientific conclusions. But I’m open to new information, of course.
But why does the mind as a virtual extension of neurological activity “stand on its own?” It only does if we adopt a “materialist” philosophical viewpoint. Science can tell us that we have a brain and what the brain is doing and how it happens, but so far, it can’t really identify what “mind” really is. So how can we conclude that it’s a neurological phenomenon? That only holds if we pre-judge that it can’t be anything else. Which is not a scientific position, it’s a philosophical one. There are plenty who would say that the world doesn’t make sense without a “creator” on a spiritual level. They don’t have “proof” either but are just as convinced of their viewpoint.
Psychiatry, in fact, relies on a “materialist” interpretation of the world to conclude that “Mind must derive from brain, therefore Mind can be altered only by altering the brain.” I think it’s important to take a stand that psychiatry has NO IDEA WHATSOEVER what “mind” is. And my observation is that as soon as we concede that a materialist worldview is the ONLY worldview that is “rational,” we spiral very quickly down the slippery slope into pseudoscience and violent acts on the body to affect the mind. So I think it’s essential NOT to accept that we “know” that the mind is a function of the brain, and that it is, in fact, a mystery. I’m not claiming I know any more about it than anyone else, but the truth is, any speculation about the mind is not based on scientific knowledge, because we don’t really know what it is we’re talking about.
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Until you get me a spoonful of “mind” or in some other way demonstrate what it is in a replicable manner, it remains beyond the scope of science to study.
Worse yet! They only need ONE? It used to be three back in the 90s, then the lowered it to two. One is RIDICULOUS!!!! And how can 81% of applications be “critical” enough to qualify for an accelerated application? Corruption is rampant!
There is also nothing to prove that it is an emergent property, nor anything to prove it is NOT of a spiritual nature. The mind remains a mystery which Science has so far not made a dent in. Questions of philosophy must be answered (such as what IS a mind? or Do non-material things potentially exist?) before any claims can be made about the nature of the mind.
You write as if failure to prove a spiritual reality exists means that it doesn’t. It does not. Most people don’t realize that there are THREE conditions for any scientific question: True, False, and Insufficient Data to Determine. The Mind belongs to the latter designation.
They apparently need two “statistically significant” results from two separate studies. Unfortunately, there can be 150 studies showing no response or negative response, and it doesn’t matter. It also doesn’t matter if “statistically significant” changes are meaningful to the patient/client, nor whether the client regards the benefit as not worth the cost. Study dropouts are often not counted as failures in the results, placebo responders are often filtered out at the beginning to give the drug a better chance of “success,” and still the “improvements” are often tiny and not of clinical significance.
Reading this has led me to look at my own eating behavior and attitude towards food, and how pervasive this idea of controlling food and weight has become in our culture. It seems to happen without thinking. It seems “normal” for us to be anxious and compulsive about weight gain and about food!
It seems to me that we ought to be collectively attacking those attitudes, which it appears that many if not most of us share, rather than labeling those at the more extreme end of the spectrum as somehow “deficient” or “wrong” because their particular adaptation to these bizarre expectations and attitude about food and bodies happens to fall into a certain range. I will be thinking differently about my own relationship to food after this. Thanks, Shira!
It’s like trying to find the “cause” of abdominal pain. If you try to find one cause, you’ll be completely baffled and decide it is “incurable,” and spend a lot of money on pain relievers and Ex-Lax. There is no reason to believe that “schizophrenia,” itself definable in so many different ways even within the DSM paradigm, is a “thing” that is caused by another “thing.” It is, at best, a syndrome that could have a wide variety of causes and potential solutions. Should be obvious to anyone who understands science, but apparently a hell of a lot of “mental health professionals” aren’t in that group!
What if getting help from the medical field is not going to be that person? Is it possible that someone from a very different background could provide the listening and support you need?
I would submit that there is plenty of evidence from many sources indicating that doctors/psychologists/therapists, having an inordinate power balance vis-a-vis their clients, will not infrequently abuse that power imbalance to their advantage, consciously or unconsciously. Why this would somehow NOT apply to therapy using psychedelics would be a big mystery to me. There are capable therapy practitioners out there, for sure, but there is little to no accountability or quality control. Once you have your degree, you can do just about anything that can be framed as “for the client’s good” and get away with it. I am glad you’ve had good experiences, but I don’t think we can assume from either your or Will’s experience that any particular practitioner will not take advantage of his/her position. They may do so without even realizing it, and the client then has no recourse, and often lacks the sophistication to even know they’re being misled or taken advantage of.
First off, much of Western medicine is in fact based on fantasy, psychiatric care being the most prominent example. It is a TOTAL FANTASY that we can “diagnose” someone with a “medical disorder” by observing their behavior and comparing to some semi-arbitrary checklist created by someone laden with personal/cultural biases against some of the behaviors on the list. The clearest example is “ADHD.” We take a set of behavior that adults find annoying and put it in a list, and then “diagnose” kids who meet these “criteria,” which were created from whole cloth from the fantasy of the “acceptable student” that the creators have imagined. There is no possible way to prove you DON’T have “ADHD,” because there is no test – it is 100% “clinical opinion.” Moreover, there are studies showing that “ADHD” kids are indistinguishable from “normal” kids in an open classroom, that 30% of “ADHD” kids become “normal” if they just wait a year before starting school, or that groups who include an “ADHD” child in them are greatly improved in solving concrete problems. Yet they are “disordered” because someone didn’t like how they behaved, because they were inconvenient to adults.
Can’t get much more fantasy-based than that! There is nothing “scientific” about psychiatry when the “diagnoses” are meaningless fantasies from the powerful projected on the powerless. Basically, they have drugs, they hit you with them, they see what happens. Half the time, when it doesn’t work, or makes things worse, they raise the dosage or add more rather than removing the offending drug. There are no real standards and no clear accountability for errors or abuse. No science involved.
Second, there is plenty of evidence that many folk practices work just fine. In fact, the entire idea of drugs and pharmacies came from the use of herbal medicine, many of which have been in use for tens of thousands of years. I trust 10,000 years of human experience over a couple of biased 6-week trials from drug companies.
It is simplistic to dismiss 10,000 years of folk medicine and pretend that Western medicine has all the answers.
Oh, just to add, full operations have been done using acupuncture as anesthesia. Very unscientific? I don’t think so.
Wow, that is a horrible story! I am so sorry you have had to deal with this level of abuse and idiocy!
I really believe the only way any of this will change is when it starts costing them more money than they are making. We need some kind of class action lawsuit where psychiatrists and drug companies and hospitals and insurance companies (especially insurance companies!) have to pay for their errors in big money.
There are many who believe that drug residues are stored in our fat cells, and can be released at later time by activities of normal living.
But half lives have a lot to do with withdrawal symptoms. Short acting drugs like amphetamines act quickly, but also leave the system quickly. The withdrawals can be extreme but the half lives are short, so the recovery is quicker. Long-acting drugs, like “antidepressants” and “antipsychotics,” take a while to build up but have very, very long half-lives. So withdrawal can last a long time.
This is not even taking into account the brain changes that happen with psychoactive drugs. It can take a much longer time for a brain to fully heal, long after the drugs have mostly left the system entirely.
That would be part of the “pros and cons” discussion. Almost anyone who is considering suicide has some “cons,” and loved ones’ grief and anger is very often one of them. But I let the suicidal person make the list. Sometimes it is a bit surprising – not always what you expect it to be.
I wouldn’t rule it out – they can make up anything and call it a “disorder” and no one bats an eyelash, no matter how stupid or insipid. Consider that “Intermittent Explosive Disorder” and “Oppositional Defiant Disorder” are assigned with all seriousness by “mental health professionals” despite the ridiculousness of such “disorders.” The DSM is an absurdity, so one more absurd “disorder” won’t make it any worse.
Why should being “marginalized” be of the slightest relevance in a supposedly scientific field? Doctors don’t exist to feed their own egos! If you are not effective, you SHOULD be marginalized! It shows how invested psychiatry is in marketing over substance!
It depends on the drug. The best you can do is use the drug’s half-life (the time it takes for half the drug to be eliminated) to make an estimate of how long it’s been in the body. Every drug has its own half life, and if you don’t know the dosage, it may be impossible to tell anything about how long the drug has been in the body at all.
It seems to me like trying to tell someone it is NOT their decision to end their lives is counterproductive. What is the clinician going to do if they say they want to? The only option is to use force to stop them, which clearly is NOT their decision. So obviously, it IS the person’s decision whether they want to end their lives. When I was a counselor myself, I never told anyone that they should or should not end their lives. I simply asked them what was going on that made suicide seem desirable, or what problem was killing him/herself going to solve? Then we talked, with my effort being simply to understand and explore the pros and cons with the client. It actually was a very effective approach to help people consider other options. Whereas when I saw others take a more authoritarian approach, it tended to escalate the situation. I see no downside to acknowledging reality – it really IS their decision and it’s not the therapist/counselor’s job to “talk them out of it” or stop them.
OK, so is it fair to say that “There are a wide variety of observations and opinions about COVID and vaccines, and we all have to come to our own conclusions. We all hope that folks draw those conclusions from observable data rather than rumor and fear.”
I think this is as far as I want this discussion to go. It really is off the topic and is starting to move toward that “Right/Wrong” energy that I want to avoid.
I’d be OK with this idea, if the title were changed. It’s not “mentally unhealthy” to be worried about climate change.
It would be better to entitle it something like, “Climate Change is an Inherently Depressing Concept.” Or “People Feel Bad About the Idea that the Climate Is Deteriorating and there Is Nothing They Can Do About It.” Or “Climate Change is Pretty Fucking Scary!” Something that validates that it is not “unhealthy” to have real feelings about real events.
It is very possible to be clear about one’s relationship and still be warm and friendly and caring. You simply have to say what you are and are not willing to do. The fact that a lot of therapists are not good at this doesn’t make it not possible. People are looking for authenticity and genuine caring. They don’t want an artificial relationship with a semi-robot, who asks questions but doesn’t care about the answers. Caring is the essence of being a good helper to anyone else. A person who can’t muster up some genuine caring should do his/her clients a favor and go into some line of work where they don’t have to deal with people in vulnerable situations.
I agree. Any company who has sold drugs that create TD should provide palliative or corrective care FOR FREE as a condition of being allowed to continue as a company. Double if they denied or hid that their drugs created TD. It pains me deeply to see the ads now for TD drugs, yet further profits for companies to “treat” the very disease they CAUSED!
I appreciate the ongoing interest in this topic, but again, this is not the forum to argue about COVID. People have stated their positions, which I absolutely support, but I don’t want to see us getting deeper into claims/counterclaims on this subject. I will begin disallowing posts as “off topic” if it gets into that kind of exchange.
Thanks as always for everyone contributing their views to this discussion. As I’ve noted before, COVID and vaccines are a complex and controversial issue involving science and sociology and politics, and people have strong and sometimes passionately divergent views on the subject. I want to let people say what they need to say, but this discussion in the past has deteriorated into a very personalized and unproductive discussion. I’d like to make sure that does not happen, and I ask folks to own their own viewpoints and be very careful not to condescend or insult others who disagree with your views. If such a deterioration does occur, I will very quickly stop any further COVID postings as off topic. Though I know there is a relationship via Big Pharma, I’d prefer if we stick to talking about psychiatry!
If that is the case, then psychiatry as a whole is provably and undeniably bad. It is well established that those in psychiatric “treatment” for “serious mental disorders” (read “bipolar” and/or “schizophrenia) die an average of 20-30 YEARS earlier than the “untreated” person. I’m sure similar outcomes are observable for “anxiety disorders” and “major depression.” It is the only profession where treatment measurably DECREASES life expectancy!
It is odd that they are so afraid of “peer relapsing” while the professionals get off the hook for all kinds of mental/emotional lapses. Discrimination, at the least.
It seems to me that you’re saying a person has a right to view him/herself as ill if he/she sees it that way. I don’t hear anyone arguing with you on this point. I think you may misunderstand that when someone says, “ADHD” is a bogus diagnosis, they don’t mean that no one acts or feels that way, just that labeling that set of behavior and calling it an “illness” is not a scientifically valid undertaking. I’m all for people identifying as they see fit, as long as they don’t do it for someone else. So for you to say you have an illness called schizophrenia is your right. For Doctor So-And-So to tell Mary that SHE has an illness called schizophrenia, despite his complete lack of ability to objectively tell her what that means, THAT is where the problem arises. Some (like you, apparently) don’t mind that label, and that’s all fine for them. But what of the person who doesn’t agree that s/he is “ill” by the DOCTOR’S definition? Where are their rights? By your philosophy, don’t they have a right to refuse that label put on them by a doctor without consultation or agreement?
When there is no objective way to distinguish who “has schizophrenia” from who doesn’t, there is no way to actually DO a study, let alone draw legitimate conclusions from one. I agree with you, distinguishing what a person has DONE is much more useful that trying to tell them what the ARE, especially when the definition groups together people who have little to nothing in common other than certain arbitrary “symptom clusters” that are not subject to anything but the opinion of someone with letters after his/her name.
Another psychiatric “success story!” It is always stunning to me how absolute proof that the drugs were doing DAMAGE, let alone not helping, does nothing to move them from believing you are crazy for stopping their wonderful drugs!
Thanks for sharing your story, and well done for getting out of their clutches!
Higher standards would be an improvement, in that fewer truly useless drugs will get to market. But it doesn’t really address the fundamental problem in psychiatry, namely that we are dealing with subjective phenomena and pretending that we can objectively “diagnose” something that has no objective reality in the physical universe. So if we say the HAM-D scores need to be a 50% decrease from baseline, there is nothing to stop investigators from diddling with the data to create the apparency that there is such an improvement. There is also the problem of “negative” studies being buried and only the “positive” studies being published. This is, of course, anti-scientific in so many ways, including the idea that a study that proves a drug ineffective is “negative.” We SHOULD be after objective evidence, not a particular “positive” outcome. But that’s just the starter. The whole system is so corrupted, it’s hard to know what can be done to fix it.
Honestly, the attitude is worse than the worst of the drugs! You come in and they tell you, “Well, your brain is broken, this has nothing to do with your decisions and/or experiences, and there’s nothing you can do about it except take drugs and hope they work for you.” Talk about discouraging!!!! And then to tell you that “there are no good treatments” to your permanent brain disease? If you wanted to induce suicidal thinking, that would be a good way to get there. Very disturbing to think that is how far our “mental health” system has sunk!
It is hard to see what ethical standards can be applied to making a totally subjective “diagnosis” based on somewhat random, subjective criteria and “clinical judgment.” I tend to agree that the truly ethical approach to such assessments would be to simply not do them, or at a minimum, make sure everyone knows that the results are utterly subjective and only as useful as the person receiving the “assessment” chooses to find it.
It’s not about “assessments,” it’s about conflicts of interest. Unless those doing the “assessments” are completely free from any financial conflicts of interest, there will be both conscious and unconscious efforts to slant the data toward increased profitability. It’s not realistic to expect people to be objective when their financial well being and status are tied up in a “positive” assessment.
I think the real point of The Emperor’s New Clothes is not that the Emperor will become enlightened, but that those in the crowd who were afraid to say what they saw were now free to make that observation, because someone spoke up and validated what they all knew. I think that’s our role here – we have to keep pointing out that there ARE no clothes to new people who feel like something is wrong but haven’t gotten to the point where they feel OK saying it out loud. People will arrive at that point at different times and different ways, but at least when they do get there, they’ll hear someone else saying, “No, you’re not crazy. They really ARE completely clueless AND dangerous, and they ARE making your life harder instead of easier!”
OK, good to know. The reason I ask is that I’ve seen some excellent plans and projects funded initially and have great potential, but as soon as they have to compete with “mental health services” for actual dollars, they get defunded pretty quickly. The “mental health” industry is OK with things like this operating as a fringe or “alternative” approach, but as soon as they see their own funding threatened, the gloves tend to come off!
To what degree are these trauma centers funded by the “mental health” system, and to what extent by outside agencies, such as government grants, domestic abuse agencies, child abuse prevention programs, etc.? I do find this encouraging but want to put it in perspective.
“Could have been misdiagnosed?” What a ridiculous argument they make! If you STOP the drugs and you GET INSTANTLY BETTER, they OBIVOUSLY “misdiagnosed” you, because the DRUGS WERE CAUSING THE PROBLEMS! It is well known (and is on the consumer handout) that stimulants can cause mania and/or psychosis at typical, prescribed doses in children. What’s even more stupid is that anyone with the slightest background in brain biochemistry knows that stimulants increase levels of dopamine. Psychiatry’s own self-appointed gurus have long claimed that psychosis is a result of high levels of dopamine in the brain. So they “antipsychotics,” which you were no doubt prescribed, LOWER the amount of dopamine. So you were given one drug to RAISE dopamine levels, then another to REDUCE the artificially high levels caused by the stimulants. And they say you are “in remission?” The lack of responsibility is staggering! But unfortunately, not at all rare.
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This is what happens when you “diagnose” people with purely subjective criteria. Someone’s opinion becomes “your diagnosis,” and you have nothing to argue against them except for common sense. Yet, as we see here, common sense is NOT particularly common amongst the supposed “experts” in the “mental health” system. The most obvious things in the world, such as the induction of psychotic behavior by a drug that is known to induce psychotic behavior, can be completely denied despite an again obvious “recovery” immediately following withdrawal of the offending drug.
I’m so sorry you’ve been through this. I hope you and your family have drawn the proper conclusion that these people can’t be trusted to have your best interests or even basic logic at heart, and will stay as far away from anyone who tells you “you have X disorder” as you can possibly get.
Humans survived for hundreds of thousands of years without brain drugs. You can, too.
I think it’s a little presumptuous to state that they are “effective regardless of some minor unwanted side effects.” First off, they may be effective for you, but that doesn’t mean they are effective for everyone else, and it feels like it invalidates others’ experience to say otherwise. You wouldn’t want others to tell you they don’t work at all, so I think it’s fair not to tell others that they “work” as if your experience is true for everyone.
Second, let’s not pretend that the side effects are always “minor!” There are many people on this site who have had awful “side effects,” including loss of sexual functioning, loss of feelings of pleasure, psychotic symptoms, suicidal and/or homicidal feelings, loss of appetite, and many more. Again, you are assuming that other people have experiences similar to yours, and I can assure you that this is by no means always or even most often the case.
With all due respect, we work to be accepting of everyone’s experiences here. It would be appreciated if you would do the same.
Additionally, I am not aware of ANY research ANYWHERE that identifies a particular “pathway” or “circuits” (or that even is able to objectively identify a physical “pathway” or “circuit” in any manner) that is associated with ANY DSM disorder. The psychiatric profession has finally disclaimed the “chemical imbalance” theory, only after decades of pressure from many quarters, including researchers themselves. The idea of “circuits” being involved is just another theoretical explanation that lacks supporting evidence. When I see research where a “pathway” in the brain is objectively defined and where some objective measurement of “flow” through the “pathway” is obtainable, I’ll start listening to talk about “pathways.” The psychiatric profession has spent decades manufacturing and falsifying and exaggerating or minimizing research to suit its own agenda. I don’t really care what “the experts” have to say, I want to see the research myself before I believe it.
Finally, I will submit that, however well antidepressants or any other drug in question work for a particular person or group of people, the very idea that “mental illnesses” are purely physiological phenomena that will admit to a purely physiological cause in all or even most cases is, again, pure speculation, and indeed ignores obvious evidence to the contrary. If it’s all biology, why is it that immigrants and urban populations and people sexually abused as kids have much higher rates of schizophrenia diagnoses than the general population? Why is adult depression and anxiety associated at a 90% or better rate with childhood abuse and neglect? How do people get better without drugs or medical interventions at all? How did I overcome serious depression and anxiety with therapy, reading, and facing life’s challenges with support from friends and family and community? Do you wish to invalidate my experience by claiming that I “didn’t have depression, really” or that “it wasn’t that bad,” or is it that my brain chemistry somehow changed through my own thoughts and relationships and interactions with life? And if my brain chemistry can change (and there’s plenty of evidence that it can) through social experiences and alterations of thought and behavior patterns, why would you insist that drugs are the answer for everyone?
How do you explain the actual PHYSICAL changes in the brain that happen with meditation or other processes that don’t involve any kind of physical intervention at all if it’s all biological?
I am glad the drugs have worked for you. You are certainly not alone in saying that. But please, don’t try to talk down to people who have had different experiences. My belief is that “depression” isn’t even a legitimate category of “disorder” – people are depressed for a myriad of reasons, some physical, some psychological, some spiritual, some social. What works for one person doesn’t work for every other person. We all need to find our own paths. You have found yours – let other people find their own and explain to YOU how it is for them, instead of assuming you are in a position to tell the rest of us “what is true.”
Out of control children have been managed without a “diagnosis” or drugs since the beginning of human history. I think the problem is not so much one of “out of control children” as isolated parents lacking support. We were not willing to consider any kind of drug intervention for our boys, so we had to figure it out. Much as you did, we used dietary changes, good parenting skills, and a lot of patience. And we read a LOT about how to manage challenging children. They both turned out OK without a milligram of “treatment.” The one who had the most problems was the one who was NOT difficult as a young child! So you’re right, every child is different!
“True clinical depression” is completely subjective and indistinguishable from “mere sadness.” Not even the DSM has “criteria” for “clinical depression.” It sounds like a technical term, but it is literally meaningless in terms of any kind of research or statistical purposes, even within the sketchy confines of psychiatry’s own subjective “model” for understanding “mental illness.”
I also don’t find it convincing that we ought to prescribe drugs “until something better comes along.” There are lots of people (including me) who find their own pathway out of feeling severely depressed. It is an error to assume that all “depressed” people have something wrong with them, or that all who DO have something wrong have the SAME thing wrong and need the same kind of help. “Depression” is a catch-all category that says absolutely nothing about what the person is depressed about or what can or should be done about it. When someone says “depression is a fake illness,” they don’t mean that depression doesn’t happen, they mean that “depression” is not a real entity that is valid for study and conclusions. It is not helpful to group all “depressed” or “clinically depressed” people into the same category when any two “depressed” people may have little to nothing in common with each other beyond how they happen to be feeling.
I would say that there IS a consensual psychiatric model. That model assumes that 1) there are such things as “mental illnesses” which are distinguishable from “normal” conditions. 2) these “illnesses” can be “diagnosed” by “professionals” with sufficient training. 3) there are “treatments” available for these “illnesses” that can “reduce the symptoms” of the “illnesses.” 4) These “illnesses” are essentially physiological in nature and inhere in the person experiencing them rather than in the environment/culture or in the relationship between the environment/culture and the person. 5) That these “disorders” can be described and “diagnosed” using the DSM or the ICD or some other “diagnostic system.” 6) That these are “medical” problems that need to be handled by “services” provided by “medical providers” and paid for by insurance. 7) That sometimes, these “disorders” become so unmanageable that “treatment” must be forced on unwilling participants “for their own good.”
Admittedly, there are plenty of free-floating and irrational interpretations that are pulled out when necessary, but I’d say all of these interpretations are expected to fit into the above. As a former “mental health” professional, I can attest that violating these tenets results in hostility and in some cases even shunning by the system insiders. Not sure how “consensual” it is, but it certainly seems to be expected that people will agree to these basic tenets, and in fact, clients/patients are “diagnosed” as more serious to the degree that they deny the “validity of their diagnosis.” It’s pretty solid in my view.
Placebo effects are very real and very powerful. It is upsetting to take away someone’s belief in something they believe is magically helping them feel better. The fault lies with those who have perpetrated the lies their upset is built upon.
A model is useful only to the degree that it correctly explains predicts the effects of actions we take into the future. The psychiatric model explains nothing, obscures real causes, and fails to predict even the success or failure of its own interventions. Therapy models to date similarly fail to account for observable facts nor are they able to predict the outcomes of their own interventions. I’ve got nothing against models, but they need to work!
The other big question that is almost always avoided is, WHAT should the endpoint be? Is a “reduction in symptoms” really the result that is wanted? Is making a person “Less depressed” a legitimate outcome? Would we not want to look at “quality of life” variables as being more important to the client?
Plus, Irving Kirsch’s work has showed clearly that the FDA rule of submitting two positive studies out of ALL studies being done totally skews the results. How much research is never even released because it doesn’t say what the manufacturer wants it to say? How many drugs are on the market as “safe and effective” when the TOTALITY of the data says that it doesn’t really work or is far more dangerous than claimed (Viiox being a great example)?
There is much to be answered for in the area of “scientific” research, especially when it comes to psych drugs.
I think 20% is VERY generous. We know that half or more of all medical research is not replicable. I think we can extrapolate that much of the research that isn’t replicable is also lacking in integrity.
Harrow’s study showed that “psychotic” patients with WORSE prognoses did BETTER off drugs than the people with BETTER prognoses did ON drugs. So the idea that those with “less illness” go off the drugs is a marketing scheme. It’s not true.
I think the answer to the question is either 1) because it doesn’t work, or 2) because the “cure” is worse than the “disease.” As Hemmingway quipped, “It was a brilliant cure but we lost the patient.”
As I’ve stated before, the whole idea of “shared decision making” suggests that the CURRENT model is “non-shared decision making,” which equates to THE DOCTOR GETS TO DECIDE! In other words, “Shared decision making” means the DOCTOR deigns to “allow” the patient to “have a voice” in deciding what will happen to his/her OWN BODY! Something is VERY wrong with this whole idea!
Wait, you mean encouraging people to KEEP using drugs instead of quitting led to more overdose deaths? How can that BE, Patrick? It is SO counterintuitive! /s
I’m not sure the system is “broken,” I think it just has hidden objectives that most of us find abhorrent!
I had the same experience as you back in the 70s. I had a therapist, we met once a week, we talked about my motivations and barriers to my success, we reviewed some traumatic history, I practiced new ways of thinking and acting – no drugs were considered or needed! And I never got an official “diagnosis” from my therapist, though I’m sure she had to submit one to get reimbursed. It just wasn’t important. I wasn’t considered “ill,” I was considered one of the smart ones who realized that he could make his life better. My therapist and I both agreed that it is a lot saner to seek support than to continue pretending things are OK. It was a very supportive relationship – no “stigma” involved, and no drugs needed or wanted.
I agree. The news and entertainment media are also a HUGE part of why “everyone believes” in chemical imbalances, while even the most cynical psychiatrists nowadays have to admit it’s kind of a crock of horseshit. The message is out there in many forms, and I think a lot of people get their “Truth” from movies and TV shows. It is a lot to battle!
Just to be clear, all of the evidence suggests that Williams did receive what would be considered the top of the line in psychiatric/substance abuse treatment and therapy. This is not a case of someone “unwilling to seek treatment due to stigma.” This is a case of treatment failing him over and over again over many years.
“Froward” is a word. It means difficult or contrary or rebellious. It’s never used any more, but I know it from Lord of the Rings. “Oft faithful heart man have froward tongue.”
I don’t see this so much as a dilemma. The simple expedient is to treat people who present as dangerous based only on the dangerousness of their behavior, not on any presumed “mental illness.” The truth is, one could say that any person committing a crime is on some level “crazy” because they are risking prison for some drama they want/need to act out. What is to distinguish someone who is willing to hold up a convenience store from the lady who tossed the baby out the window? The only real criterion that makes sense is to say that they did harm or threatened harm to others, and are therefore held in custody until that situation is resolved. “Mental illness” doesn’t have to enter into it at all. And even if we do decide we can “hold” someone for these subjective and legally vague and rhetorically nonsensical “illnesses,” it does not follow that they can/should be forced into “treatment” against their will. Their job is to demonstrate that they are no longer dangerous.
Of course, help of many kinds can be offered, and people who don’t find a way to alter their circumstances might be incarcerated for some period of time, but that’s the same for any kind of criminal behavior. I’m all for completely decoupling the idea of holding someone for being “a danger to self or others” and the idea of them needing “treatment” of some kind. There is simply no way to figure out who is/isn’t “mentally ill,” let alone who will “benefit from treatment.” That being the case, it seems beyond unethical to force “treatment” on someone based on these totally subjective labels, especially when it’s entirely possible that the “treatment” you’re forcing on them may kill them before their time!
I have had similar epiphanies many times in my life. When “everyone knows” that something is “accepted practice” and no one ever provides another perspective, sometimes some very weird or dangerous or just plain oppressive things seem “normal” and people who don’t adapt “abnormal.” Sometimes it’s very odd looking back on it that I’d ever accepted that viewpoint, that the obvious injustice or irrationality of it did not just smack me in the head before the scales fell from my eyes!
The others are probably “antipsychotics” like Risperdal and Seroquel that act on both the serotonin and dopamine systems. It appears that messing with serotonin is what causes the increase in suicidal thoughts/behavior in some of the people who use them. Not that this deters doctors from prescribing them by the millions, mind you. But we all knew that!
Can we please leave the discussion of disease/not disease for this thread at this point? I think we’ve heard both sides of the issue thoroughly aired, and it’s starting to feel a little personal at this point.
Again, why the “shared decision making?” I don’t SHARE decision making with my doctor or medical provider. S/he gives me information and advice and I MAKE THE DECISION. There is no sharing, it’s my call, every time. Why is this glaring violation of the rights and the self-respect of so-called “mental health consumers” not obvious to anyone looking at the situation? The very concept infantilizes the clients. And remember, we’re not talking about the client choosing to “share decision-making” with their doctor. We’re trying to convince the DOCTOR that s/he is not entitled to just do whatever the f*&k they want to the client without his/her approval. The argument is now, “Gosh, don’t you think you might CONSULT the client before YOU decide what you’re going to do to them?” This is totally ass-backwards in my world. I will never see a medical professional who thinks s/he gets to tell me what to do, and I’m glad that I have the privilege and the skills to carry out that intention. But many people don’t even see or understand what is being done here, let alone have the courage and ability, or even the legal right in many cases, to tell the doctor to go stick it where the sun don’t shine. That is not an acceptable situation!
They don’t really use a scientific “model.” They use a marketing/business model, based primarily on what will convince the “customer” that their “product” is something they should buy. No science is involved, except the “science” of how to convince people to change their minds and do what you want them to do.
I wouldn’t so much mind agreeing to use GIVE skills, as long as the professionals made it their priority to do the same! And they obviously were NOT practicing those when talking to you! Hypocrites!
I think “therapy” deserves to be in quotation marks here! There is nothing “therapeutic” in intent or effect when hiring someone to shame and humiliate your child further than you as a parent have already managed!
Well, as I said, I agree with you in the main. People intentionally committing evil acts are rare, but I felt their presence needed to be pointed out. Most of us need MORE time in our comfort zones, not less.
Of course, I agree with you that most such people are indeed quite uncomfortable. But there appears to me to be a small but solid cadre of folks who actually are quite comfortable believing they are “helping” even when all the evidence points the other way. They are very blithe about explaining away anything that doesn’t support their viewpoint, and seem quite comfortable as long as there are enough people around them to support their viewpoint. Admittedly, there is a lot of anxiety underlying their apparent ease, and that comes up when they are challenged, but their “comfort zone” appears to be quite compatible with people being harmed “for their own good.”
I think it depends on what they are feeling comfortable with. I they’re comfortable harming or discriminating against or oppressing others, I’m all for making them uncomfortable!
The thing about this is, Buddhism and other spiritual approaches aren’t “treatment.” I don’t have a knee-jerk negative response to the idea of “alternatives,” but if they are “alternatives,” they should be alternatives to viewing emotional distress as “mental illness” and alternatives to pretending to provide “treatment” in the medical sense for problems that are not medical in nature.
The FDA is populated by people who are part of the drug industry. That’s what I meant by my comment. We need people who don’t have a financial interest in the outcome. There are plenty of scientists in other fields who know enough to evaluate the studies – they don’t have to be doctors or drug company investigators, in fact, we’d be better off if those evaluating drugs had zero attachment to the medical field or drug research at all.
I am sure that stuff like “neural atrophy” and other physiological phenomena both result from and contribute to what the DSM refers to as “mental illness.” I’m not familiar with the concept of neural atrophy, but it seems like it suggests that trauma causes certain kinds of neurons not to grow or to die off. This would not be at all surprising. There is also literal brain damage that comes from taking neuroleptics or other “psychoactive drugs” like stimulants or “antidepressants.” There are also real diseases like an underactive thyroid or Lyme disease or other conditions that directly affect people’s mental/emotional functioning. And of course, the fact that one has a chronic or terminal disease going on affects one’s psychological well being as well. So it’s very complicated. I don’t think a person severely traumatized in childhood can ever get to a point where their childhood traumatization is not relevant or impactful in their lives, probably on a physiological as well as a psychological/spiritual level. We know that traumatized people are more likely to contract or develop physiological ills, even controlling for ineffectual pseudo-medical interventions by psychiatrists and their subordinates. So there is a physiological effect of trauma, and there is a psychological effect of physical illness. It’s all interconnected, and we’re better off just focusing on individual situations and what works for a particular person rather than trying to generalize about “illnesses” that are not objectively discernible.
I have never said that there is no biological contribution to what is called “mental illness.” I am only opposed to ASSUMING that any one “mental illness” as defined by the DSM is CAUSED by “bad biology.” I’m not even saying that SOME cases of what is called “mental illness” are NOT caused by “bad biology.” My main point is that something defined entirely by a list of social/emotional/behavioral indicators is VERY UNLIKELY to have a biological cause in all or even most cases.
I hope you see the difference between a biological CAUSE that is consistent for all cases vs. a biological ASPECT that is present in some of the cases, which may or may not be causal. There are biological similarities between people who are feeling aggressive, as an example – elevated cortisol levels, for instance. But that doesn’t mean that elevated cortisol levels CAUSED the person to behave aggressively. It could be a cause, an effect, or simply a correlate of the body’s preparedness for fighting. It is biological, but “aggression” is not an “illness” caused by high cortisol levels.
I agree 100%. If a plumber promised to fix your leaky pipe, then ended up flooding your basement, and “fixed” that by burning down your house, they would owe you the cost of replacing everything they ruined, plus additional for the inconvenience and emotional turmoil you experienced as a result. Why would this NOT apply to psychiatrists? If you are paying them to improve your “mental health,” and it observably gets worse, and your physical health deteriorates as well due to their “treatments,” at what point are they responsible for damages? Seems like simple breach of contract to me for starters, with aggravating factors involved with worsening instead of improving your condition. I guess normal rules of contract don’t apply to psychiatrists?
I enjoy the exchange of views, and I do think political parties have some bearing on decisions to enforce “treatment” on people just because they happen to be homeless. I do want to make sure this doesn’t shift off onto a philosophical argument about which political party is “better.” Let’s keep focused on the issue of the article, planning to “force homeless into ‘treatment.'”
You’re right, of course. Psychiatry has not failed, it has succeeded admirably. People are just confused as to its aims. If it were designed to help people be more effective in managing their lives, it would be a failure. But if the purpose is to deflect attention from the real issues and blame the victims of abuse and oppression for their adverse reactions, meanwhile making boatloads of money, it has been an unqualified success.
I loved this article! It really gets to the heart of these eugenic, racial superiority themes, which have been around for centuries, probably millennia. It’s a bit shocking even to me how the exact same language is used today that was used 1-200 years ago. It goes to show that the real problem with psychiatry, and our society at large, isn’t a failure of honest people to understand the issues, the real problem is certain people believing they are superior to other people and looking for “science” to justify their continuing acts of oppression.
I can see that. Self-desensitization seems like it’s very possible. But if someone is going to try and help someone else, listening is the starting point. I agree 100% that there is no special advantage to using “EMDR” or other “specialized” procedures. There are some tricks or techniques that can be used to help someone feel safe to share, but the basic is not trying to tell the other person what to do or think, but instead listening to their story. I’ve certainly seen writing, art, music, pets, etc. serve an equally valuable role to a “therapist,” or to a listening and caring friend. Whatever works is what works, and therapists have no corner on the market of “helpfulness.”
It is a certainty that the action of Benzos is very, very similar to the action of alcohol on the brain. Both affect primarily the GABA system, and benzos have long been used as a controlled way to withdraw alcoholics from alcohol dependence without bringing on possible deadly withdrawal effects. I am quite certain it would work the other way if it were tried. So taking benzos is very similar to drinking. The only big difference is dosage control, and of course, lots of people increase their benzo dosage beyond what is prescribed. They are sold as street drugs, too. The one time I served on a jury, the defense tried to get his client off of a DUII by pointing out that he was taking Valium and that the effects were almost indistinguishable from alcohol. They are very close to being mimics of each other.
I’m absolutely sure that watching Queer Eye leads to changes in PET scan or SPECT scan patterns in the brain, and leads to positive changes in a range of neurochemicals believed to be involved in mood regulation! We just need to have some people watch it in a scanning machine, and we can start selling it as “therapy!”
Not sure what you’re saying here. What is there “more” than the fact that the therapist is listening non-judgmentally and interestedly? I know there are a few techniques tossed in there, such as the concept that if a trauma doesn’t lift, there is an earlier one of a similar nature that needs to be examined. But I’m saying the eye movement or tapping or whatever seems extraneous. Are you saying that “tapping” and that sort of thing was a staple of folk wisdom for a long time? I’d be very interested to hear what you have to share on that point.
The best plan, I think, is generally to refuse them politely. Remind them that you have a right to refuse medical treatment, and you’re choosing to decline. This would only be a problem if you are already on their “radar” as a “crazy person” (oops, I mean “Person suffering from mental illness!”), in which case, I think a very careful lying strategy would probably be safest. “Have you had difficulty sleeping?” “No, not at all. Sleeping great!” Etc. If you read up on the so-called “symptoms” of what they’re screening you for, it’s pretty easy to stay ahead of them.
I always thought the eye movement deal was hokey. I think telling one’s story to someone who knows how to listen and is interested is the primary source of “mental healing,” if that’s the proper term. A lot of folks really twist themselves into pretzels trying to come up with a “biological” explanation.
You are talking individuals vs. societies. Societies can agree on pretty distorted things without needing the “leadership” of a sociopathic person. You have a very rose-colored view of society if you think that simply removing bad players will suddenly make people bright and perceptive and assertive and planful. Doesn’t Dianetics suggest that people have to deal with their own traumatic pasts before they can become rational? Do you really think everyone will suddenly become rational just because intentional oppression by individuals is removed? With respect, I don’t. People working as groups is a totally different thing than individuals getting out from under oppressive control of other individuals. At least, that’s my take on it. Surely, the concept of mis-education and distorted belief systems in the minds of people of good will is real and meaningful to you?
Here’s the thing, though. Even if we eliminate the psychopathic types from our society, they have created ways of doing business that require sociopathic behavior in order to succeed. For instance, we could eliminate all the sociopaths from the field of psychiatry, but we have millions and millions of people who still believe that these “diagnoses” and “treatments” make sense, and these people will continue to pound this false data into those they train, and very little will change.
The sociopathic types prevent positive change, so eliminating or restricting their reach makes positive change more possible. But there needs to be a concerted effort by the pro-socially-oriented people to create systems that don’t reward sociopathic behavior.
Just as an example, I’ve always thought that “reading groups” were a horrible way to teach kids to read. It requires them to “sound out” words they don’t understand, and to pronounce words correctly that they have never said out loud before. There is little to no emphasis on actually understanding the passage being read, and those who decline to read out loud are shamed for it. I could go on.
But those who apply “reading groups” believe wholeheartedly that it is a viable approach! They would be upset if someone told them differently. “It’s how we’ve always done it.” “How would they learn to read otherwise? How would we KNOW they were learning?” It doesn’t require a sociopath to continue this process, because everyone believes it’s necessary without really thinking about it. So there is a massive re-education and re-creation that would need to happen if we wanted reading instruction to improve. It’s true, this process would be much easier without the destructive people who are interested in control and punishment rather than education. But the system they are implementing continues to be oppressive, even if none of the teachers are personally sociopathic in the least.
This same thinking can be applied to any system you’d like to think of. There are expectations, rewards, penalties, restrictions, processes, agreements, etc. that determine how the particular activity will be conducted. These systems have a “life of their own” in a sense – a complete turnover of staff can occur without the business/agency culture changing in any significant way. That’s what I’m talking about. Some people like to destroy stuff and people, and will try to twist whatever system that exists to their nefarious purposes. But that’s not the whole story. People need to learn how to communicate and work together as a group to improve or retool or trash the group agreements that exist but don’t really work very well, or to create new agreements. This takes a lot more than just getting rid of the bad players, IMHO.
I saw kids all the time in foster care who would be given Ritalin or Adderall for “ADHD” and then get aggressive or even psychotic. Rather than stopping the stimulants (which we KNOW can cause aggression or psychosis), they’d give them a NEW diagnosis and put them on yet another drug! It was very common, and very irrational!
I will choose to take your words as honest and not intended to hurt. But they do hurt. I think it best we abandon this discussion. It appears that we are unable to understand each others’ words, which is OK. But I can never agree to “keep women’s stuff” out of it when in my view it has been built in from the start. Obviously, you are unable to see what I am looking at, and that’s OK. But let’s not take it personally that we disagree on these points.
I can’t agree with your conclusions from this data. The fact that women are more likely to go into psychiatry does not mean psychiatry does not discriminate against women. This is where the individual vs. group viewpoint comes into play. The women as individuals are most definitely women, but they are buying into and implementing a model which at its core is discriminatory towards women. They are participating in an oppressive SYSTEM, regardless of their individual orientation, and after being trained in this system and surrounded by this system and criticized and sometimes attacked when they stray from the expectations of the system, they eventually quit or comply with the system. And if the system is based on assumptions that are sexist or racist or whatever, that person, regardless of sex or race or whatever, will enforce these norms and internalize them without even noticing that they exist.
Let’s take the example of “Borderline Personality Disorder.” The description of this label generally encompasses typical reactions of a person who has been abused and/or neglected intermittently from early life onwards. They are describe as having difficulty trusting people, having volatile emotions, using indirect (“manipulative”) approaches to get their needs met, having a hard time maintaining relationships, anxious, distractible, etc. I worked for years with foster children, and a large number of kids fit these descriptions. So what does the system say to DO with that person? Whether male or female, younger or older, black or white, feminist or not, the system says you DIAGNOSE this person and then you TREAT them. The person is identified as having a “dysfunction” and the fact that they have been abused/neglected, placed in foster care, moved around, separated from siblings and extended family, currently in an overcrowded foster placement lacking in affection, had their schooling interrupted and had to move repeatedly and lost friends and support people every time, is of no actual interest or consequence. Since a third of women are sexually molested or sexually assaulted in their lifetimes, and a quarter experience physical abuse from a domestic or dating partner, not to mention the myriad day to day abuses and “microagressions” women have to put up with, ignoring these experiences is highly invalidating and destructive to any effort to actually be of assistance to people who get these labels. In fact, having been labeled “borderline” opens them up to an entirely new brand of oppression, with of I am confident you are quite aware.
The fact that your psychiatrist happens to be female has absolutely zero effect on this process. They are trained just the same as their male counterparts, and generally believe that “Borderline personality disorder” is a real thing that can be “diagnosed,” and that this person needs “treatment,” normally in the form of drugs and some kind of other-directed “therapy” like DBT. The person that abused her is considered “normal” and never gets identified, let alone “treated.”
So the SYSTEM is discriminating against women, whether or not the practitioner is female. Unless the practitioner him/herself becomes aware of the anti-female, anti-abuse-victim mentality built into every aspect of the system of “diagnosis” and “treatment,” the practitioner will continue to perpetuate this mentality, regardless of the sex of the practitioner. That’s how systemic bias work. It transcends the intentions and experiences of the individual.
I appreciate the clarification, and I do understand what you’re saying – in the end, it is not helpful to identify as “oppressed” and to blame “oppressors” for your condition. What I am concerned about is not an individual’s attitude, but a recognition that oppression is a very real thing that actually happens to people, regardless of what attitude they assume. It’s a delicate balance, but oppression really does exist and needs to be called out for what it is. Otherwise, saying “don’t view yourself as oppressed” becomes another form of oppression – we are not only told how to identify, but we are blamed for not having a “positive attitude” and told our reactions to the very real oppressions that have and continue to occur to us are the problem, rather than recognizing and attacking the oppressive attitudes in those doing the oppressing! It does not help anyone to be told that you are “inviting oppression” by identifying that women, dark skinned people, or psychiatric “patients” are being victimized by those in power. As much as I believe in empowering people to take charge of their lives, the real story of how we got where we are and what forces are arrayed against us needs to be told. I don’t see it as “identifying as oppressed” to say, “Men are allowed to get away with a lot of shit in this society that women can’t.” It’s just plain facing reality.
I agree 100%. I was using the most concrete and unrefutable examples. I have worked with domestic abuse victims for decades and it is very clear that men and women doing exactly the same thing gets a very different response. There are way too many examples to cite here.
In fact, one of the huge and appropriate criticisms of psychiatry comes from feminist writers in the 70s and later on. (Probably earlier, too, but I just haven’t read them yet.) They point out that many manifestations of surviving abuse at the hands of men, often sexual partners or husbands, are treated as “mental illnesses” by the very male-centric system. I’d suggest that anyone who wants to get rid of psychiatry needs to be aware of the deep and fundamental connections between psychiatry and the intentional oppression of women who speak up and try to have power in our society.
Are you staying that you DON’T think men as a class have oppressed women throughout history, and continue to do so? I’m not talking about individual men, though many individuals do act oppressively. But do you realize that it was legal for a man to rape his wife until very recently? That there was very little legal protection for a woman being beaten prior to the 1970s? That women could not vote until 1920? These are very obvious manifestations. When one looks at more subtle forms of oppression, they are rampant, even today. Let’s look at the question of sexual activity. What do you call a woman who chooses to sleep with multiple men? Slut, whore, bitch, tramp, hooker. What do you call a man who sleeps with multiple women? Stud, player, ladies’ man, heartthrob. There are no negative words for men who sleep around. There are no positive words for women who sleep around. Why does that happen? Why are women shamed for being sexual beings, while men are applauded for it?
I could go on. There is real oppression out there. Enslavement of black people isn’t just a consideration. They were literally slaves, bought and sold human beings. I find it very hard to understand how this can not be obvious to anyone living on this planet. Women have been oppressed as a class by men as a class. It’s just a fact of life. Are you saying women should just have had a better attitude toward being treated as second class citizens (or non-citizens, as I said before, since they were not even allowed to vote)? If psychiatry is oppressive and its “patients” are targets of that oppression, why wouldn’t the same apply to other groups?
Of course, when there is no objective way to see who “has” or “doesn’t have” your purported “diseases,” it becomes easy for those greedy for power to act without accountability.
I’m not arguing against 1) or 2). I’m saying that Carrie Nation and Jane Addams and Emma Goldman and Emmeline Pankhurst and Elizabeth Cady Stanton were not all stooges of the Rockefellers. Like I said, attempts to coopt such movements are very common, but it seems obvious to me that such a movement is a natural outgrowth of oppression. It is exceedingly unlikely that those in control would undermine their own control by creating more rights for those they have a natural interest in continuing to oppress. It also makes zero sense that the Rockefellers would free people in order to enslave them. Why not just keep them enslaved? Though it DOES make sense that they might want to claim responsibility for something they had nothing to do with, something our “antisocial” types very typically love to do. Just because a Rockefeller said it doesn’t make it true!
I am not arguing the merits of the women’s movement, which is a much bigger topic than I can cover here. I’m simply saying that it is diminishing to the women who sacrificed their reputations and in some cases their lives to get the right to vote and many other rights as listed above, and more, to suggest that they were somehow dupes of some other forces. Women are certainly not monolithic, and I did not even vaguely suggest that in my comments. I dispute the idea that women were not the progenitors of their own movement toward freedom and civil rights. It seems nonsensical to me.
It seems utterly confusing to me why you would not credit women with starting and maintaining an effort to strengthen women’s rights, or darker skinned people with starting and maintaining an effort to strengthen the rights of the darker-skinned population. It’s not just “conventional wisdom,” it is plain old logic. Whether other less savory individuals or groups may have done their best to coopt such movements is an entirely different question, but I think it’s pretty insulting to women to suggest that the monumental struggle to get the right to vote, to be protected from rape and violence, to raise their children, to be able to be employed and paid as men are, to be able to dress as they wish (I just read an article how two lady motorcyclists in the 1910s were repeatedly ARRESTED as the crossed the USA for wearing pants!), to use birth control, and on and on, is the result of some sort of manipulation and control by antisocial personalities. Are we then to conclude that absent such provocation, women would have been happy with their lots as second class citizens (or actually, non-citizens who could not even vote) and never gotten together as a group to try and make things better for themselves and society as a whole?
Ah, but where does the “antisocial personality” come from? Personalities are not completely fixed, in my view. They are affected by experience! Suppose one could RID society of most of the antisocial types, by handling their fears and historical trauma, while containing those who were simply unable/unwilling to behave in a social manner? Or do you think people are just born antisocial, nothing they or anyone can do about it?
I agree. A truly culturally aware approach would START by trying to learn from the culture we are encountering, and being humble enough to understand that they have much to teach us. The “schizophrenia” recovery rate is 10 times better in the “developing” world. Our “thought leaders” have tried their best to explain this away, instead of finding out what they’re doing right and what we’re doing wrong. That’s the real problem. However gently it is framed, we Westerners believe our culture is superior and that these “primitive” people need to learn how to do it our way.
Humans make decisions. They have values, priorities, fears, desires, etc. Most of the ills of society come from humans making destructive decisions due to their lack of perspective or courage or their fears or desires to dominate others. The problem with psychiatry is that they don’t recognize this fact and instead try to pretend that these ills are the result of “bad brain chemistry,” as if people will suddenly all cooperate and be productive and stop hurting each other if only their serotonin levels were fixed! Psychiatry is about forced invalidation of reality, and about blaming people’s brains instead of helping them learn how to live better.
Removing psychiatry will not stop people from being violent, racist, abusive or neglectful to their children or other charges, thoughtless, sexist, or otherwise obnoxious. It WILL stop psychiatrists and Big Pharma from making money off pretending that they have “treatments” for these social ills. It WILL stop people being incarcerated and “treated” against their will based on these pretenses.
Improving society as a whole will depend on a lot of people working together. Eliminating psychiatry will be a positive step, but there is a lot more that we need to face up to before we have a functioning society. That’s my view.
Is it not possible that a headache is a part of the traumatic experience chain being examined? I have found that I and others I’m working with will have a pain that comes up when thinking about a certain event, which usually resolves upon relating what happened in its entirety, sometimes several times before I get it all resolved.
Non-compliant seems to suggest that the patient is a child and the doctor is in charge of discipline if the patient doesn’t do as s/he is told. It’s a pretty disturbing concept if you think about it.
Oh, believe me, I agree with your observation! I have to fight to have “informed consent” many times when I see any kind of mainstream medical practitioner. I avoid MD’s like the plague for that very reason! And when I am forced by circumstances to talk to one, I start them off with a preamble that I am going to listen to their advice and make my own decisions, and if that’s a problem for them, let me know right now and I’ll find another practitioner. I rarely have to do so, but I have. You have to be an advocate any time you go see an allopathic physician. Some of the younger ones seem a little better, but I assume they’re going to be arrogant and self-absorbed until proven otherwise.
I am getting concerned that this conversation is getting off topic and entering into one of those areas where people have strong emotions and where finding agreement is very difficult. This thread is about EMDR and should remain about EMDR. We do often allow conversations to wander off into other areas, as long as it is a productive discussion where people are learning and explaining thing to each other. When it degenerates into trading positions and making generalized statements without actual information or experience to share, that’s going too far. I know different people have had very different experiences with CCHR and the Church of Scientology, but this is really not the place to have that argument. I want to respect different people’s experiences, but I expect all of us to respect each others’ experiences as well. So I am not going to allow this to degenerate into a sparring match about the merits of a particular group or organization. I would ask you to keep to your personal experiences and respect and understand that others may have had different experiences.
I hope I’m being clear. Comments need to be productive, or they will be moderated as “off topic.”
You know, that’s a great point I never thought of! If someone is a client of a doctor or other professional, the doctor works for THEM! There is no “shared decision making,” the decisions are made BY THE CLIENT! And the interesting part is that the alternative to “shared decision making” is cutting the client out of the loop entirely! We’re supposed to be excited by the prospect that the PROFESSIONAL will deign to “share” decision making with the client. Whereas the CLIENT should be the one deciding whether s/he wants to follow the advice of the “professional” in every case.
I think the difficulty understanding how EMDR works stems from assuming it works on the brain, as most researchers have done. There are many regressive processes that have focused on reprocessing past experiences, and results have varied, I think mostly because it’s not necessarily what everyone needs at a given time, or because people have other more pressing needs in the present moment that make regression less likely to be effective. The most fundamental error of the psychiatric/psychological professions is assuming that everyone having the same presenting issues has the same problem and needs the same solution. I’m more inclined to think of there being problems in the physiological, psychological, and spiritual realms, and the proper solution depends on the actual cause. Someone who is depressed because of his dead-end job isn’t going to get better with biological “treatments.” Someone with thyroid problems won’t improve with the best therapy imaginable. But people who really do have what I will refer to as ‘spiritual issues,’ by which I mean difficulties figuring out the meaning of things, their place in the world, or how to manage past events that have affected their thinking, will probably benefit from regressive processing like EMDR, whether you tap or roll your eyes or just lie their quietly while you relate what happened.
The other critical part is that any regressive process MUST provide absolute safety from the listener, not to evaluate the meaning of things or stop or redirect the person or tell them that what they said wasn’t true or doesn’t make sense. It’s their story to tell and the processer, whatever the process may be, must be committed to letting the person tell their story without editing or invalidating or doubting anything in the story. I am guessing that’s where a lot of practitioners fall down on the job.
Anyway, I doubt anyone looking for biological explanations for why EMDR works is going to be looking for a long time. I don’t think it’s a biological process, even if biological events are involved.
The fact that these approaches are called “alternatives” is in and of itself a big problem. It implies that the MAIN way to do things is psychiatry, and these other “alternatives” are for either when it doesn’t work or someone wants to “try something different.” There is condescension in the very term. Same applies to “alternative medicine.” In fact, I’d prefer these approaches not be called “treatments” at all – I’d prefer they be called “approaches” or “strategies” or “opportunities” or “processes” or anything that doesn’t imply any kind of relationship to medicine or psychiatry.
Columbia has the worst press regarding drug trade. It looks like only 3% of their GDP comes from drug production and sales, down from 7% some years back. Hardly the backbone of their economy!
I am sure the promotors of the various Benzos have a strong interest in making sure that Heroin or other opioids get all the blame. I’m sure “opioid epidemic” was agreed upon as the name for the problem by people in high places of power.
I don’t know that Robert would identify MIA as a “social justice site,” but it certainly provides a safe space for survivors to have a voice, and the forums here are populated primarily by survivors, and we have discussions that center on issues that would get commenters tossed off of a lot of “mainstream” sites. And there are many articles posted by survivors, such as Christine’s this very week. I think it is exceedingly unfair to call MIA a forum for “liberal mental health professionals.” There is a hell of a lot more going on here than that. In fact, I seem to recall certain “liberal mental health professionals” either changing their tunes or stopping posting here because they could not handle the intensity of the appropriate feedback from the survivors who are the core of the commenting communities. So I respectfully and firmly disagree with your assessment.
Wow, they seem to be worried that you “voice hearers” will compare notes! Can you ask them what evidence they have that voice hearers getting together is harmful? The evidence I am aware of says that it’s quite helpful to get together with other voice hearers. Honestly, they have no idea what they’re talking about, or they’re lying. You should do what feels right to you, and to hell with what they think!
I continue to be concerned we are going too far afield, here, even though I participated myself in getting us here. My sense is that no one is disputing that a lab release is a very plausible explanation for what happened, and that this explanation was quickly and summarily dismissed without investigation at the beginning of the COVID pandemic. I’m not seeing that anything else can be inferred from this fact, and I don’t really want to see this conversation go down that pathway. The question of how to distinguish a “conspiracy theory” from a feasible explanation seems like a topic related to the
“mental health” system, but I want to make sure we do not get back into another endless loop about unprovable opinions regarding the intentions of various parties, good or bad. That is a conversation for another website.
Just trying to head this off before we end up going down that pathway.
The doctors almost killed my dad when he was 40. He was on blood thinners from a recent heart attack, and they gave him something that was totally contraindicated with blood thinners, with a warning it might kill the patient. He had sudden bruising from barely touching his arm. He looked it up in the PDR and found out what was happening. If he had trusted them, a minor accident, a fall, a bump on the head could have killed him!
Me, too! It’s a ridiculous idea! I personally think patenting GMO plants is a ridiculous idea. They did not “invent” a plant! They just messed with it. Otherwise, breeding a new strain of cow would be patentable. Capitalism sucks!
I know, it’s disgusting. And they are often even WORSE on the 4 drugs than they were before they started the first! But the answer never seems to be, “Gosh, this doesn’t seem to be helping – maybe we should do something else!”
They are seriously trying to patent an INDIVIDUAL’S genetic data??? Do they really think they can OWN someone else’s genes??? This is bizarre, even for our bizarrely capitalistic society!
“The road to hell…” as they say. Good intentions in a damaging system usually leads to either the person quitting or being coopted into doing things they know are wrong. The system needs to change. Changing the personnel without changing the model just leads to more of the same.
You can tell by the intensity of the response who doesn’t have the real data behind them. Why would there be a need to put down someone sharing their own negative experience if you are SO confident that the drugs are great? Couldn’t you just listen and say, “Wow, that sucks! That didn’t happen to me, but if it happened to you, I’m really sorry to hear it. I guess they don’t work the same for everyone!” Is it that hard to be a tad empathetic? Apparently.
But there is still that one out of 10, and that’s who we have to look for, I think.
I also think it matters what site you go on. I used to post occasionally on the CHADD site (very pro-drug ADHD site, or was at the time at least, kind of like the NAMI of “ADHD” parents). Man, you had to tread lightly not to be attacked or tossed off the site! I stuck to sharing studies and alternative approaches, and my own experience with MY own kids, but still got attacked. I told them I had two “ADHD” type kids who grew up fine without drugs. I admitted it was a lot of work and required a lot of creativity and research and just trying things out. Still, they said things like, “It’s great if your kid has a mild case and you can get by without drugs.” (There was nothing MILD about Patrick, I can tell you, and Kevin would have been just as tough, except we learned from Patrick how to handle him!) Or, “I know this worked for you, but we don’t want you to discourage or shame other parents who might need the medication for their kids.” They “corrected” me when I said “drug” instead of “medication,” even when I pointed out that d-amphetamine was actually a street drug of abuse.
I may have educated a few people but most of their minds were made up. So I stopped wasting time on it and started looking for sites that were less rigid and medical-model oriented. I still toss out some corrective data in that kind of site from time to time, but I don’t expect to be welcomed there! Mostly, I try to find communities like this one where my views are a little more “mainstream,” even when the site is totally NOT mainstream!
It matters to some people. Not all, or even most. We have to find that small cadre of people who really see beyond the surface. They are rare but they DO exist!
Interesting how an ineffective “cocktail” of drugs leads to the conclusion that a “new cocktail” needs to be devised, rather than the more obvious but less remunerative conclusion that “cocktails” of random drugs simply don’t lead to good outcomes, at a minimum in this case at least. The answer is always more or different drugs, it seems, no matter how many times that screw just WON’T HAMMER IN PROPERLY WITH THIS HAMMER!
They are also often used on children or the developmentally delayed or the elderly for “aggression.” As one can imagine, it’s pretty easy to conjure up some “aggression” in any of these populations by just putting hands on someone and trying to move them, and when they fight back, call them “aggressive.” Psychosis these days is the tip of a much larger iceberg when it comes to “antipsychotics.”
It is disturbing that the kind of stalking behavior you are talking about is laughed at and minimized. The view that he is obsessive and stalking because he “loves you so much” is a common one that is strongly supported by our media. How many “romantic” movies involve a woman turning down a man’s advances, and him engaging in “romantic” behavior like following her home, strewing her walkway with rose petals, serenading her outside her window while the neighbors look on, proposing to her in an extremely public venue, and other obnoxious behaviors that show he “loves her so much?”
I’m so sorry you were not supported by your coworkers. People who engage in that kind of behavior are almost always dangerous and need to be stopped very early in the process.
Your insight that the “voices” that people here are often them fighting with someone from the past is a very good one!
I agree, testing for those with “extra sensitivity” could easily be used as an excuse for not facing the fact that the drugs themselves are systematically destructive and don’t actually “treat” anything, any more than drinking “treats” anxiety by interfering with a person’s inhibitions. (Someone recently shared with me a study on using laughing gas to “treat” depression! The idea of it made me laugh out loud!)
That being said, I do think it’s good for the common person to know that such genetic vulnerabilities do exist and to insist that doctors check for these before prescribing them random drugs. Apparently, the genetics affect a lot more than just psych drugs, and people who have this particular vulnerability deserve to know about it.
That actually makes a lot of sense to me. I’ve seen kids get super aggressive on stimulants, then be put on Risperdal to “calm them down.” When someone prevailed upon them to stop double-drugging the kid, they always want to take them of Risperdal first, which of course then leads to the aggression they’d created with the stimulants, which leads to, “Oh, no, he’s having a relapse, we’d better abort!”
I like how you use the term “executors” rather than “experimenters.” They are more like technicians carrying out a designed task with a desired outcome, and have apparently not the vaguest interest in actual science experiments!
I tend to agree with you overall, but I think we need to reserve skepticism for both directions. Choosing to believe a “theory” because it “feels right” isn’t really valid, either. We need evidence. And as you describe it, it has been very difficult to get true and honest information from anyone in this COVID mess. So sometimes all we can do is gather the information we have and make the best decision we can based on what we know and our intuition. My intuition tells me that intentionally releasing a virus to create a worldwide pandemic doesn’t really benefit anyone enough to be worth the effort to make it happen. I could be wrong, but it just seems way too far fetched for me. Whereas an accidental release seems much more believable based on history and probabilities. Others will have a different take. But if we are going to have a group discussion of what is/isn’t happening, it has to start with what is known. If the answer is “little to nothing,” I suppose intuition is all that’s left to us, but it’s not really appropriate for people (I’m not referring to you, of course) to cast aspersions on others’ characters because of personal intuition. There is a very big leap from, “I’m feeling uncomfortable with the information about the last election” to “there was massive fraud, the election was stolen and we need to break into the Capitol and stop the transfer of power by violent means if necessary.” Just as an example.
I am not sure I can agree with you. I evaluate “conspiracy theories” like any other theory: 1) given what I know, how likely/unlikely is such a theory to be true? (Occam’s Razor, for instance – is it the simplest explanation? Does it require me to assume untestable proposals? How many times?) And 2) is there actual hard evidence to substantiate the claim?
An example would be the recent claims of a stolen election. As to 1), the simplest explanation is that Trump simply lost the election. For any other theory to hold water, it would have to have a plausible mechanism by which it occurred. The idea that millions of people “voted fraudulently” and ALL voted for Biden illegally and somehow local election officials missed it requires believing unprovable premises that contradicts many decades of experience. The idea that there was a giant conspiracy to intentionally overlook these millions of irregularities that involved life-long Republican election officials somehow joining in to get a Democrat elected requires even more unprovable and very unlikely assumptions to be true. Which moves us to 2). If I am to believe these less likely scenarios to be accurate, I will need hard evidence, and the more implausible the theory, the more hard evidence is required. Dozens and dozens of cases were brought before a wide range of judges, both Dem- and GOP-appointed, some Trump appointed, and not one case was found to have sufficient evidence to go to a full trial. So we have two unlikely scenarios requiring unprovable assumptions to be accepted, and a lack of any concrete evidence. These “theories” can be dismissed out of hand. They are simply false.
Whereas the “lab origin” theory does NOT stretch the imagination at all – historically, lab accidents have happened, if pretty rarely, including adverse consequences (remember the Killer Bees?), and safety protocols are not infrequently ignored (look at handwashing figures at hospitals for support for that premise). When it was denied initially, there was no specific evidence against it, nor was their evidence in favor of alternate theories. It was pure speculation, and I never did buy it. On the other hand, the idea that there was an international conspiracy to release COVID into the environment intentionally was a much more difficult premise to buy (WHY would “they” do this again? To sell vaccines???), and required a number of untestable assumptions, and is FAR less probable than a lab release origin. So until and unless I see specific hard evidence to show this far less likely scenario to be more feasible, I am ignoring that as a likely cause, and am putting my bets on accidental lab release.
An old medical saying goes, “When you hear hooves, think horses, not zebras.” Unless you’re on the African savannah, of course!
I don’t see how science could ever prove or disprove the existence of a Supreme Being. Science is the study of what happens under earthly/celestial rules. The idea of a supreme being transcends the rules of earthly existence by definition. They are simply different realms. Science could totally follow exact rules that are completely knowable and still be the product of some form of creation. At the same time, the world could be filled with one mystery after another and still be the product of physical forces with no creator in sight. So to me, science is not required nor likely capable of proving or disproving the existence of a creator, and it can happily go on being scientific and reliable and helpful and viable without the question of a supreme being even being raised. Science and religion are simply two different realms that have little to do with each other. As long as religion doesn’t invalidate the facts we observe in front of us, it’s all fine by me for people to have and exercise their faith. I only object when one’s faith says that what is observed is wrong because some book or prophet says so. Otherwise, who am I to decide how we all got here?
Ombudsmen can stand up for individuals in oppressive systems, and can collect data and stories relating to oppressive patterns that transcend individual cases. But advocates alone can’t create system change – I think it requires the “consumers” to stand up and demand different “solutions.” And some systems are simply too corrupt or ill-intended to start with and resist any effort to “reform.” Such systems need to be discarded and a new plan built from scratch.
I have never understood why the concept of a creator is contradictory to the theory of evolution. If God is supposed to be all-powerful, wouldn’t He (or She) be capable of inventing a way for species to succeed each other?
I used to serve as an Ombudsman for those living in nursing homes and other facilities for the elderly and disabled. It’s actually a great model! Unfortunately, there were never anything close to enough Ombudsmen to go around. Not a lot of funding for holding the powerful accountable!
I think that stuff about “free will” has very little to do with science at all. It’s essentially a philosophical argument, suggesting that because there is not enough time to “think” before making certain decisions (such as a batter swinging at a ball) that therefore the person can’t have made a decision and must be compelled to be acting the way that s/he is. They pretend that this is “science” by measuring reaction times and the time required for a conscious cognition to be put into effect. The measurement of such times is scientific, but the conclusion is based on the (I believe quite errant) assumption that a conscious thought is required in order to make a decision. This is NOT a scientific, but a philosophical premise. A common fallacy these days is to measure something (like PET or SPECT scans) and then draw conclusions based on unstated philosophical assumptions, which invalidates the conclusions entirely.
Anyone who watched Mike Schmidt (Hall of Fame third baseman for the Philadelphia Phillies back in the 1970s and ’80s) foul off one pitch after another after another when he had two strikes on him, waiting until he walked or got a good one to hit (as I did many times when I lived in Philly), has to conclude that the guy was doing it on purpose, no matter whether or not he had time to consciously decide where that ball was coming into the plate!
Sorry if that’s too far down the “rabbit hole” for others. Feel free to ignore!
The “Authorities” always say that this kind of intervention is “too expensive” and doesn’t get funded. Meanwhile, they spend billions on useless and destructive “treatments” that could easily be redirected toward this kind of help. It’s more like, “We can’t afford to fund this because it will take our snoots out of our comfortable troughs!”
A big part of the problem is that there is no actual standard on what “helping people” actually means. Of course, it can be vastly different for each person from their own perspective -forr one it’s getting married, another it’s getting out of a dead-end job, another it’s recovering from childhood abuse, another is working on serious health issues – naturally, when you lump together people who have little to nothing in common, it’s going to be hard to define any kind of “improvement.” The only thing that makes sense to me as a standard is that the person in front of you becomes more capable of handling his/her life in as self-determined a way as possible. Nothing else really can make sense for everyone at one time. Not very “measurable,” but I’d say the client/helpee will know if they are feeling more in control of their lives!
Your statements are unfortunately very valid. People are susceptible to being sold “wish fulfillment.” I’m not sure what anyone can do about that. What I think you’re leaving out is that this model primarily serves those who wish to label and dismiss the distress of others and have them take the blame for it. Is it really likely that the average person is going to stop believing in psychiatry, or in the infallibility of doctors in general, when they are blanketed with propaganda through their own doctors, the media, the schools, their churches, their friends, and so on? We can’t expect the mass of individuals to develop this kind of insight – action needs to take place on a MUCH larger scale than hoping that educated individuals somehow acting en mass to alter the economics of selling people drugs that don’t work at a premium price.
You are talking about internalized oppression here. No one is denying it exists. I am saying that it is still the full responsibility of the abusive “doctors” in the system to NOT “tell people what they want to hear” but instead to tell people the truth, regardless of what they want to hear. That’s the responsibility their power conveys upon them. We can and should help people NOT view themselves as helpless, by all means, but that does not for one instant relieve psychiatry’s responsibility for pitching that narrative with all they have the power and money to do. Most people would have a much harder time convincing themselves they are hopeless without the unscrupulous support of those in power who know better, but pitch that narrative only so they can make themselves rich at their patient/victims’ expense. And even those who DON’T view themselves as hopeless/powerless are relentlessly beat upon to accept that viewpoint, not only by doctors, but by friends and relatives and TV shows and movies and the evening news, not to mention DTC advertising. We need to stop the onslaught instead of wasting our energy trying to talk the victims of the onslaught into ignoring the enormous social pressure to conform!
Lawrence, I am not arguing that people are not making decisions. But a lot of times they are NOT aware of doing so, while the “mental heath” industry is quite aware and intentional in their deceptive practices, and takes advantage of common cultural beliefs to manipulate those who are not as aware of their ability or need to think independently. I don’t think it is proper to invalidate all responsibility for the clients, as reassuming responsibility is critical to improving one’s emotional state. However, there is a big difference in levels of responsibility. The client has a normal human desire to seek a quick and easy solution, just like almost all human beings on earth. They are responsible for choosing to trust and believe the doctors’ pronouncements and directions, which our society totally supports and even expects of people (I can’t tell you the flak I’ve taken over the decades for questioning doctors’ opinions, and not just from the doctors!) Whereas the clinician knows (or should know) about human nature and the tendency to look for easy solutions, and intentionally tells a tale that they know to be false, taking advantage of the subconscious need to trust them on the part of the client. They are also responsible for observing whether or not their intervention is helpful, for researching the outcomes for these interventions, and for changing the intervention if it doesn’t seem to be working. Failure to do all these things is 100% on the clinician, whatever level of awareness the client may or may not possess.
Psychiatrists as a guild, in particular, are responsible for creating an utterly dishonest narrative for promoting their own financial and guild power interests and using what they know about human nature to create incentives for people to avoid their real problems and rely on the psychiatric profession for a “solution.” They spend billions and billions of dollars on this, invent new “disorders” in cahoots with the pharmaceutical industry, create or alter “practice guidelines” in the direction that increases their power, influence, and income, and intentionally ignore or misinterpret their own industry’s research that says that none of this crap really makes a difference in the long run, and in fact can be quite destructive or even deadly.
So on the one hand, we have the clients, the “marks,” as it were, who are guilty of being human and seeking an easy way out, and we have the gigantic collaborative shell game which is utterly committed to milking the “marks” for all they’re worth by lying to them and making them think such easy solutions are real, in contradiction to data they are quite well aware of. We know who is really running the show here. And that’s not even talking about directly or indirectly “involuntary” clients, which encompasses a lot more people than most of us are aware of.
Blaming the clients for being gullible feels very much like saying that domestic abuse or rape victims should just learn to make better choices and avoid abusers, thus letting the abusers completely off the hook. Yes, it would be very good for them to learn to recognize abusers earlier (I wrote a book on this very subject), but the abusers are the ones making the problem. If there were no assholes out there looking to victimize them, they would not have to look out for them. The assholery is 100% the responsibility of the assholes in the world, and blaming the victims for having normal human emotions and reactions doesn’t help change the situation at all. The real goal should be for those authorities to actually BE trustworthy and tell their clients the real truth, even if the clients don’t want to hear it or believe it.
I have always found it utterly offensive when they give people a drug that makes them fat, and then tell them to exercise and go on a diet! It’s disgusting!
I think it mostly works great for those in positions of power who want to evade responsibility for the results of their use of the power they have. This can be a parent who isn’t willing to figure out how they might better approach their child, or a teacher who would rather blame the student than change their educational approach, or even a whole system like foster care where it’s easier and less uncomfortable to “diagnose” their charges than to figure out what is actually going on and how to help for real.
As in any oppressive system, internalized oppression is a very real problem. There have always been women, for example, who vociferously object to any discussion of altering gender roles, or foster youth who embrace the identity of “mentally ill” because that’s what is expected of them and rewarded, or kids who believe they are “stupid” or “bad” because they can’t make themselves fit into the abnormal expectations of the school system. But such internalization, in my view, is a consequence of the system, not a causal factor. It is true that being “diagnosed” with a “mental illness” can temporarily relieve a “client” from the responsibility of having to take action to move their lives in a positive direction, but it is psychiatry who is responsible for holding out this false hope of a ‘Medical solution’ and creating a Stockholm-syndrome kind of situation where hope of the “right answer” is always right around the corner, with the next “change of meds,” while the poor client gradually deteriorates and begins to blame him/herself for not being a “good enough” mental patient.
Training and education are a part of how any culture transmits its knowledge to another generation or to other members of the society as a whole. There is nothing wrong with someone with higher skills in a particular area teaching someone who doesn’t have all those skills how to do what they know how to do. It would be silly for an expert blacksmith to not teach others their blacksmithing skills because it somehow prevents them from a purely egalitarian relationship. And I also see no reason why the blacksmith would be wrong to charge for that service of training.
The serious problem we are really talking about is the cooptation of a movement to empower people by an institution dedicated to putting people down. The word “peer” has been so seriously coopted by the “mental health” system that it is difficult to use it in its original meaning. But KS is right, a “peer” is simply someone who is at an equal social status or standing as you are, rather than possessing some kind of power advantage. Co-workers are peers, as opposed to management. Students in the same class can be referred to as peers without any negative implications. It appears to me that it is only in the field of psychiatry/”mental health” that the term has come to mean something potentially nefarious. And of course, the “peers” who are buying into the system are no longer “peers” in the true sense, as they are granted a certain “power over” their ostensible “peers,” but only as long as they toe the party line.
So the problem isn’t “peers helping peers.” The problem is the authoritarian power distribution in the “mental health” system that pits people against each other and requires compliance with certain dogma in order to be granted “power over” those deemed beneath you in the system. In my view, there is absolutely nothing wrong with teaching certain approaches or techniques or ways of thinking about how we help each other, as long as 1) these approaches are offered in a “take what you need and leave the rest” style, rather than a “this is the right way and anyone who disagrees is wrong” approach, and 2) the training is not offered in the context of an authoritarian system where those higher in the hierarchy are permitted, nay, are EXPECTED to put those beneath them in their proper place.
My main objection is reframing what is likely a wide range of withdrawal effects as “relapse.” I find this quite disingenuous. It assumes that the “antidepressants” are automatically helping in all cases and that the psychotherapy is needed because not having the pills to keep their “disease” under control means they’d need therapy. The idea that they feel bad because of the known and often serious withdrawal effects of stopping the pills themselves is completely discounted.
Hey, I have a better plan: if you just take a couple teaspoons of Epsom Salts in warm water in the morning, you’ll completely lose your appetite for anything, feel nauseated at the thought of food, and have a bad case of the runs within hours! A lot cheaper than taking the drugs with the same result. People who purge have been aware of this for DECADES! But seriously, folks, what kind of an industry comes up with solutions like this? What’s next, they burn out our taste buds so nothing tastes good? At least the stomach staple is honest in its approach and doesn’t pretend to be “treating” anything. What is wrong with these people???
He must have “anosognosia” – doesn’t realize he’s still “ill” despite having no symptoms! Or else he was “misdiagnosed.” It COULDN’T be that they just had no clue what they were doing! Or worse yet, they DID know what they were doing and thought it was a “good result.”
I feel compelled to ask a question here, not as moderator but just as a person. It seems you feel that someone is telling you that you don’t have a right to “be ill.” You have talked at great length and quite articulately about the importance of allowing multiple definitions or understandings of what is called schizophrenia in the DSM, and have acknowledged the sketchy and subjective nature of these DSM labels. I have also seen many posters, including me, support you in being able to view yourself as schizophrenic or ill or however it is that best describes what is happening to you. I honestly don’t recall one person saying you are wrong to view yourself that way, though it is possible I have missed it.
So my question to you is – who do you feel is telling you that you don’t have a right to identify as ill or schizophrenic? And what are they saying that is giving you that message?
It seems pretty clear that you feel compelled to say this same thing many times, which makes me think you are not feeling heard, yet looking from my perspective, I don’t really understand what it is that is not being heard? Can you help me understand this, in specific and simple terms? What is it that people are saying that upsets you and gives you the sense that your right to be ill is being taken away from you?
I hope you will take this in the spirit in which it is asked. I really do want to understand.
“Normalization” was to me the most essential element in approaching people in distress. Letting people know that their reaction to their situation was pretty common, and that lots of other people had experienced similar struggles or engaged in similar coping strategies. Helping them see that their reactions were less the issue than the things they were reacting to. Which is pretty much the opposite of what most people experience when they encounter the “mental health” system.
Sleep disturbances and low iron are just two common causes of “ADHD.” And of course, exposure to various forms of trauma. Plus being enrolled in school too early. (30% fewer “diagnoses” if the child is one year older at admission to Kindergarten, in several studies.) It’s a wastebasket “diagnosis.”
Everyone is welcome to post at MIA, as you say. There are no restrictions on language, other than what is listed in the “Posting Guidelines.” This does not mean that others will always see things similarly or won’t argue or disagree. It’s OK to argue and disagree about concepts/ideas as long as you’re not attacking a person or group or people. It gets stickier when one person feels that attacking a particular concept or idea is attacking them personally. This can lead to difficult conversations, but again, that doesn’t mean anyone is not welcome, it just means that words/ideas have different meanings to different people. It is always my hope that such conversations lead to some kind of Hegelian synthesis where everyone understands each other at a higher level. But sometimes we have to agree to disagree, and that’s OK. MIA doesn’t take sides, we just try to make sure the conversation is fair and respectful.
Sometimes I am just trying to meet someone where they are and create some common reality. Not everything I say is intended as advocacy for the cause of ending psychiatry. Sometimes I’m just talking to someone. I don’t like the idea that you are hovering around waiting to pass judgment on the adequacy of my communication. It was not intended for your consumption, and frankly isn’t really your business to critique, IMHO.
You know, I find I agree with most of what you have said. The problem I see is, and I’m guessing you agree with me, it is (or should be) the job of the psychiatric profession to correct these misimpressions and to get people to focus on what really will improve their lives. So it’s definitely true that the residential treatment staff would often refer kids to a psychiatrist for such idiotic indications as “doesn’t want to go to school” or “stays in her room too much (isolates)” or “won’t complete their ADLs” (I kid you not, these are all three actual reasons provided by treatment programs to justify a “med increase.”) But I also think it’s true that the psychiatrists had a responsibility to say, “You know, it’s not OK to refer kids to me just because you can’t figure out how to get them to school. That’s really your job as a residential counselor.” Or “Yes, teacher, Joey can be hard to handle in class, but he’s super smart and tells me he’s bored to death. He needs to be challenged in class – what can we do to make things more interesting and challenging for Joey, instead of blaming him for being bored?”
There are a lot of “reasons” why this epidemic of labeling and drugging has occurred, DTC advertising being a very big one. However, psychiatry as a profession has paved the way for this to happen, by redefining mental/emotional problems as “probably biological” and by selling the drug solution as the first line intervention, instead of a temporary or adjunct intervention on the path to empowering the client. At least, that’s my view of it.
I think it’s important not to overgeneralize, though – there are most definitely “peer workers” who did whatever they could to empower their “peers” in taking on the system. Stephen B. is a great example.
I am sharing only my own experience as an advocate for foster youth and earlier as a mental health professional. I don’t recall many psychiatrists in community settings trying to taper patients from drugs they got from family physicians. Most of the time, they got referrals from physicians who had prescribed either stimulants (for “ADHD” diagnoses) and/or SSRIs (for “major depression,” which was a very common “diagnosis” for foster kids). They usually got referrals because the physicians’ initial prescriptions didn’t work or more commonly made things worse (usually made them MORE aggressive instead of less), and most of the time, they increased dosages or added new drugs, even if it was kind of obvious that the drugs were causing the problem. As advocates, we usually had to move heaven and earth to get them to EVER reduce ANY drug, let alone drop something from their regime. Every once in a while, they might do a “med wash” if things were super messed up, but that was one case in 500 probably. Most of the time the answer was more “meds” in bigger amounts. There were only two psychiatrists I ever met who even understood that stimulants could make kids aggressive, and only one who regularly did anything about it. I could count the number of med reductions on two hands, and most of them were prompted by us or by the child’s attorney not by the psychiatrists. So my experience is very different than yours!
I think the question of whether the “system is broken” depends on what we believe it was designed to accomplish. I think it is fair to say that the system works quite well for a certain kind of person, in particular, a person who is gaining money or prestige by pretending to know things about “mental illness” when they actually have little to nothing to contribute. To such people, any “improvements” in the system are seen rather as threats to their control. They don’t see the system as broken, they see those who challenge it as deluded or hostile!
That is a good way to put it. The error that many make, especially those with conflicts of interest, is that they try to find evidence to support their preferred theory, and despite never finding evidence to reject the null hypothesis, they continue to believe that their hypothesis will eventually be proven true. At a certain point, failure to disprove the null hypothesis repeatedly proves the null hypothesis true.
Your last line says it all for me. There is nothing “disordered” about reacting emotionally to adverse circumstances, whatever they may be. In fact, it is more likely the message from authorities NOT to be emotionally powerful, NOT to tell the story, NOT to “overreact” that creates most of what is so euphemistically referred to as “mental illness.” The label-and-treat (or -drug) method makes people worse!
I’m not sure if the intent is specifically to marginalize and minimize, but marginalization and minimization are required to accomplish the actual goal of making money and amassing power and deflecting attention from larger social issues. Marginalization and minimization may be “means to an end,” but it doesn’t make a lot of difference to the patients. The most important, certain knowledge is that the intent is NOT to make the patients’ lives any better, whatever else may be intended.
Very well said, and I thank you for taking the time to make this important point.
From a moderator’s viewpoint, an argument about whether or not “Critical Race Theory” is being taught in the schools or should be or is dangerous or not dangerous doesn’t really get to the point of the article, which is about “mental health activism.” However, comments connecting CRT to “mental health” oppression such as you have done will continue to be welcome. I hope the distinction is clear.
I’ve long said that the DSM categories make scientific research impossible, because they group together totally heterogeneous groupings of people, particularly if you’re studying physiology. Why would anyone assume that all people who feel depressed have the same problem??? Even if we assumed there WERE some physiological cause to ‘depression,’ which of course is also a ridiculous assumption, it’s like saying everyone with a rash has the same cause, or everyone with a sore knee should be diagnosed with “knee pain disorder.” (Of course, medicine IS moving in that direction, with things like “high blood pressure” and “obesity” being now accepted as “diagnoses.”) Naturally, if you studied people with “knee pain disorder,” you’d find that most did not respond to any single treatment, with only 20% responding to arthritis treatments, 15% responding to chiropractic adjustments, 20% responding to treatment for strained ligaments, 15% to orthotic shoe inserts, etc. All of these treatments would be dismissed because they only helped a small percentage of the “KPD” patients, and the only thing that would “help” the majority of them (temporarily) would, of course, be pain killers. So we’d decide that “KPD” is a chronic, untreatable condition, but that we can “manage symptoms” with pain killers for life. Works great for Big Pharma, but not so good for the person who could function fine in a few weeks or months if they got the correct treatment for their actual underlying problem!
Oh, it IS based on a misunderstanding of their philosophy – anything that minimizes discomfort and maximizes profits for the “clinician” is good! Anything that increases discomfort or dilutes profit is “bad.” If people understood the REAL philosophy behind this “model,” they’d have a lot easier time deciding what to do with the “recommendations” it generates!
At this point, I’d like to bring the discussion of the use of the term “schizophrenia” and the related issues to an end, at least as far as this particular thread is concerned. It seems that all the positions and viewpoints have been aired and are at this point being repeated. I think anyone reading this thread will get a very good idea of the issues and the various ways to look at it. I don’t want to have things deteriorate into a more personalized exchange that could be hurtful, and in truth, the thread has veered pretty far from the original topic of the difficulties being a “mental health professional” who is out of agreement with the status quo model of reality that is so vociferously enforced by the “authorities” in the field.
Thanks to everyone for their contributions – it has been a very interesting discussion!
Just to clarify, I was not talking only about “critical psychiatry” people from the “professional” ranks. I know of plenty of clients/survivors/victims who totally bought into the “mental health” narrative to start with, then began moving to “Critical” as they learned and experienced more of the failures and damage that the system doles out, and eventually to a more abolitionist stance. Laura Delano is only one good example. I agree it is true that most antipsychiatry activists don’t come from the professional ranks, but “peer workers” and some fringe therapist types (like me) who never did embrace the “medical model” are certainly worth spending time educating. Stephen was another good example of someone who worked in the system but never bought into it, and came to a more radical position through observing the way he was treated in his “peer” role. Such people to me are very much worth educating, as their evolution does happen with some frequency, in my observation.
Of course, I agree that being “scientific” is a necessary but certainly not close to sufficient criterion for any kind of claim of “medical treatment.” And that there are many areas where science is not able to really provide any answers, such as the nature and function of the mind itself.
Additionally, I’m not a pure “professional” type, as you may remember.
Yeah, how many times to you have to try and fail to prove something before you have disproven it? That’s kind of central to science – failed efforts to support a hypothesis means the hypothesis is regarded as false. Apparently, these rules don’t apply to psychiatric research?
That makes great sense to me. It is easy to see how that could bring comfort. And as I said, I think you should do whatever it is that gets you through the day. I have no criticism for anyone who personally wants to embrace whatever label they choose. It is, indeed, the bullying aspect that I object to. I do think it’s very possible to be assertive and strong without being a bully. But it’s a skill that few truly develop.
I am suspicious of the trope that any “mental illness” has a unitary cause at all. Trauma, nutrition, social conditions, sleep problems, immigration, urbanization, adverse drug events, grief and loss… there are many, many potential causes for any “mental illness” that exist and are routinely ignored.
Treating people as individuals and looking for root causes instead of categorizing and discriminating against people based on social constructs seems to me more likely to lead to better outcomes, regardless of what the DSM/psychiatry wants us to call these phenomena.
I hear and I think I understand what you’re saying, both of you. Here is where I think the conflict lies: I think that you, DS, are arguing about your right to view yourself as ill and having schizophrenia and find objections to these terms conflicting with those rights. I see you, Oldhead, saying that giving power to these words IN GENERAL means giving power to the system to label and judge people and also gives credence to the idea that psychiatry can define “mental illness” by coming up with a list of “criteria” voted on in a meeting of privileged “professionals” who are more or less arbitrarily condemning people to a label indicating that their brain is broken without any objective means of identifying what is supposedly wrong.
Oddly, I agree with both of you. I think the use of the term “schizophrenia” by an individual, and/or a reframing or believe that you as a person “have an illness” is your absolute right as a human being that no one should try to take away from you.
At the same time, I see the damage that these labels do to people, as you, DS, saw in my presentation on “ADHD.” So in general, having these labels ENFORCED on individuals who may or may not agree with these evaluations or the philosophy behind them is evil. And spreading the idea in society that psychiatrists have some inside knowledge of the causes and effective “treatments” for these “mental illnesses” that they claim to be able to identify is very destructive socially, as it reframes what are often completely normal reactions to difficult or oppressive social conditions as “diseases of the brain” or “of the mind” with no evidence that there is anything at all wrong with a person’s brain.
So it’s no big deal for YOU to believe in schizophrenia and view it as a disease, if that is what you see and believe is going on. However, it IS a very big deal when psychiatry as a profession/industry is promoting a concept of “mental illness” that is not actually supported by science, or in fact is even able to define its basic terms (like “mind”), and that has huge financial conflicts of interest driving its claims, and which claims are very destructive to our society at large.
And it is VERY difficult to engage in an honest discussion of the damage done by the current psychiatric system without directly criticizing the idea of “diagnosing” people with “mental illnesses” in the absence of any evidence that these sets of “criteria” they identify correlate with any kind of specific biological problem. This observation does not in any way suggest that you, DS, do NOT have an illness of some sort, nor does it suggest that you aren’t allowed to call it an illness or call it “schizophrenia.” What it means to me is that the PROFESSION calling EVERY situation where people have similar experiences to you “schizophrenia” is not supported by science, nor is it even philosophically sound for professionals to suggest that people have an “illness” that can’t be defined by any objective means. I hope that this difference is clarified by my remarks. This conflict is the cause of much consternation both by those identifying personally as “schizophrenic” and those who find the process of labeling BY PROFESSIONALS in general to be objectionable on the face of it. And this conflict, while understandable, is to me unnecessary. Because the first has to do with the right of an INDIVIDUAL to identify with their own terms and ideas, while the second has to do with the assumed authority of a large cohort of professionals to use their power to label a range of people as “mentally ill” without their agreement or even any objective scientific evidence supporting such claims. These are very different assertions that don’t actually conflict with each other, even though it may feel as if they do.
Thank you for your kind words! I’m glad you found the training inspiring. I’m not always full of “joyous excitement,” but I do try to get there at least a few times a day!
I think there is a more fundamental problem – your comments (and Laing’s) presume that “schizophrenia” is a unitary condition with a unitary cause, whether it’s biology or trauma or “refrigerator moms.” There is, of course, no accurate, objective way to determine who “has” or “does not have schizophrenia,” since “schizophrenia” is “diagnosed” by a list of thoughts/behaviors that allow for a broad range of “clinical opinions” to enter in, to the point where people who have literally not one single “symptom” in common can all be labeled as “schizophrenic.”
So we are left at a place where any explanation will fail, because no one explanation could possibly explain such a wide variety of experiences and behavior. So we get endless discussions of who “has it” or whether “it” really means anything specific at all, or what causes “it” if anything. And we have people like DS who perceive correctly that SOMETHING is not right, and yet the “help” she is offered is ineffectual, perhaps because they are given the idea that the psychiatrists “know” something that they don’t.
So the most sense that can be made of “schizophrenia” is that it is a name for a certain broad set of experiences, and that some people (like DS) identify with it and others don’t. It does acknowledge the idea that SOMETHING is wrong, yet it does nothing to determine what is actually wrong or what if anything should be done about it. People should be respected for the identity that makes sense to them, yet the general use of the term will never lead to any resolution or effective “treatment,” because we are expecting people who have a wide range of different issues going on to ALL respond to the same “treatment.”
I’m not aware that the requirement to do one’s own therapy before becoming a professional therapist is still in place in the USA, at least not in most places. It used to be a requirement, and in my view, it still ought to be. The big problem being that the “outcomes” for therapy are so disparate, and in fact, even the idea of what an actual positive outcome IS (lower symptoms? Less troublesome behavior for society? Opinion of the client? Achievement of agreed-upon goals? Avoidance of hospitalization?) that it would be very difficult to get any kind of consistency in our therapy candidates’ therapeutic “success” ratings.
I agree with this. Many who eventually become antipsychiatry activists begin (like I did) with a “critical psychiatry” stance. There is an evolution of viewpoint that takes place as people gather more information, and I don’t think it’s proper for me to judge where people need to be on that path. I don’t hesitate to lay out facts for people to hear, and I don’t for a minute buy that doing so is somehow “shaming” people who don’t want to know the information. But I don’t expect people to agree with me just because I said so, and I try to meet people where they are and help them take whatever next step seems right for them. Psychiatry takes away people’s ability to make their own decisions about things. I’m not going to do the same, even if people see things differently from me.
However, when we’re talking about systems of oppression, there is no mercy!
That is another of the bad things about the drug model – it gives psychologists and therapists an “out” so that instead of admitting they don’t know what’s going on or what to do, they can blame the client for “failing therapy.” Sorry, if you’re being paid to do therapy, and it doesn’t help, the only one failing is the therapist! You (the therapist) aren’t delivering your product and should step aside, instead of blaming the client’s brain and passing on your failure to your client.
There are lots of programs to help people with things that are not “mental illnesses.” Why would we not be able to provide a process for people to re-integrate their lives without requiring that they have a “mental illness?” Churches, support groups, hotlines, meditation groups, Tai Chi classes or meetings, community get-togethers, all of these things happen all the time with participants able to join without subscribing or being “diagnosed” with anything. Why not Soteria House?
I can’t promise anything, but I do try and facilitate contact between people who might want to talk. I’ll see if I can send the author a message and see if they want to share their contact info.
HIPAA should NOT prevent anyone from seeing their own records. It is designed to protect the CLIENT’S confidentiality. I’ve heard it interpreted in this way, but it is just plain wrong. There is no “confidentiality” of one’s on records from oneself. It is a contradiction in terms!
I am approving this post, as it does not specifically violate the Posting Guidelines. However, I am concerned that this will re-create the dive into off-topic interpersonal hostility, as it has done twice before. Richard has posted his view of things, others are welcome to post their view of things, but it is essential that this not deteriorate into an us-vs-them, “You are wrong and I am right” kind of discussion. I ask for your cooperation in keeping this a safe environment for all views to be expressed. I will be keeping a close eye and will intervene swiftly if I see this conversation deteriorating into personalized attacks.
I read a study one time where they sent volunteers into a residential treatment facility for teen youth with a handful of reasonable but kind of personal questions. Over 80% of the youth revealed a trauma history to these complete strangers surveying them. Yet less than 20% had their trauma history documented in their logs! So either the youth were more willing to trust a complete stranger than one of the staff they see daily, by a factor of 4, or else the staff never bothered to ask them, or considered their revelations so irrelevant they didn’t even warrant a log entry. I thought it said a whole lot about what “treatment” constitutes today.
The legal question would be whether he received “informed consent” as to the likely effects of the drugs. He would not have to have been forced onto them, the doctors would have to have been dishonest or have left out important information that could have prevented his death.
At this point, this discussion seems to be moving in a more personalized direction that I don’t think is going to be productive. A couple things are clear: 1) Everyone has a right to identify as they please; 2) Everyone has a right to object to terminology they find objectionable; 3) when there is a general objection a term that an individual might find workable for him/herself, there is a very distinct possibility of feelings getting hurt.
It seems to me that the primary conflict is around whether the general discussion of the damage done by psychiatric labels is in some way disrespectful to those who identify with such a label. I’m not going to try and be the final judge on this point, but I will say that the conflict is one that is inherent in the subjectivity of the diagnostic system itself, and is unlikely to be resolved by further discussion of this nature.
So at this point, I am going to ask that we leave this discussion where it is at, with the acknowledgement that the conflict is not resolved, and that different people have different feelings about it, to which each is fully entitled. Others who want to discuss this further with each other are certainly entitled to do so by direct communication off line. If anyone needs/wants to connect with someone through email for further discussion, I am always happy to assist with making such connections.
Now we’re not even supposed to talk about it. We’re supposed to take drugs and hope that we feel better, without even consideration of the actual source of our distress.
That makes sense to me. You are empowering the client to evaluate his/her own ability to admit being wrong about his/her perceptions, as well as normalizing a very human tendency to fight the possibility of being “wrong” about one’s ideas or perceptions.
Not trying to “bait” you, just wanting to clarify your position. I think you did so quite effectively. There is, sadly, more brain surgery for insomnia going on than any of us would like to admit.
It’s a difference between a decision or direction being wrong, and a PERSON or their feelings/reactions being wrong. I agree 100% with your statement that “most ‘mental health’ problems result when people have a goal and then are doing things that actually get them going in the opposite direction without their awareness of that.” So the goal of therapy is to help THE CLIENT to gain an awareness of what direction s/he wants to be going and what barriers, internal and/or external, may be preventing that, including false beliefs that seem to force them to go in the opposite direction. Again, that is very different from saying that the person is wrong for feeling anxious or depressed or angry. Long ago, I learned that the proper approach is to validate/normalize FEELINGS, while challenging BELIEFS/THINKING that is getting in the way of the client’s success.
And I think you are mistaking me if you think this is about the word “wrong.” It is about the invalidation of a person’s knowledge of or ability to know their own mind and ethics and/or to decide for him/herself what is right/wrong, effective/ineffective, valid/invalid. And it most definitely IS imposing one’s idea of rightness/wrongness when we tell or imply that a person’s emotional reaction is somehow “wrong” or that a person suffers from a “mental illness” simply because s/he engages in behavior that seems irrational or unproductive. I find it much more helpful to help a person identify the reason why something that I think is “irrational” makes sense to them. Once the problem they are trying to solve with the “irrational” behavior becomes clear, it may be possible to consider other solutions that are more coherent with their goals.
Of course, this is more complicated when a person’s connection to what we consider “reality” is more distant. But I think the same principles apply. It is clearly very ineffective to start off telling someone who hears voices that they are imaginary, or telling someone with a “delusional” belief that their belief is wrong. It’s a question of what really works, not a particular antipathy to the word “wrong.”
We do not withhold or approve comments based on opinion or topic. The only comments held back are those which violate the posting guidelines, which are available on the home page. You are entitled to post any opinion you have to share, as long as it’s done respectfully. Of course, others may respond in kind.
That being said, I have to ask: are you suggesting that the poster is making up this story? At least in terms of the dosages prescribed? Or are you simply shocked that your colleagues would engage in such unscrupulous and unethical behavior?
The point is more that I have no right to decide what they are doing is “wrong,” unless it is a violation of the rights of others. I would equally not want to tell someone that their behavior is “right,” as I also believe that is their job to evaluate. So telling them that “there is nothing wrong with you” is also not a viable position. It’s just plain not my call. This also doesn’t prevent me from expressing my concern for the direction someone is going, or pointing out potentially adverse consequences of their continuing on the path they’ve chosen.
I do also agree that there are “better” or “worse” ways to do a particular task, and that we are doing no favors NOT to tell someone they’re going the “wrong way to get to the Pacific Ocean.” But that’s a different context, where the person has made their goals and intentions clear, and you have information to convey that will help them accomplish their goal. That is very different from saying to someone that feeling depressed about something is “wrong,” that it is “right” to listen to your doctor or teacher, that you are “wrong” not to want to go to school or find it dull, that your perception of the world is “wrong” and that if you agree with mine, you will be more “right.” In a therapeutic setting, it is my job to empower the person I’m helping to become more self-determined and to apply their abilities to creating their own lives. Something is only “wrong” to the degree that it fails to move them in the direction they want to go, and again, no one else is able to determine that definitively besides the client him/herself. Again, the only exception to that in my view is when the client is violating the rights of others, and even then, it is ultimately the client him/herself to decide what that means and how to handle the conflict. Therapy is about empowering the client, not enforcing my view of reality on someone else. And the proof is in the pudding – people who are told what to think and do, in my experience, tend to do worse and worse. And the vast majority of the time, the reason they present as “mentally ill” in the first place is because their sense of self-determinism has been systematically snuffed out of existence. The last thing most clients need is someone else’s needs and wishes to accommodate!
It has become a remarkably common practice. Shows the ethical level of the average psychiatrist today, no personal disrespect intended. In fact, I respect you for posting your disagreement here. I hope you will hang around and read some stories and let it affect your practice.
I don’t agree. I would never say “there is something wrong with the way you are looking at yourself.” I would ask the person what they were trying to accomplish, and ask them whether they believe their current approach is getting them where they are trying to go. I would also listen for things they felt they “couldn’t do” or “have to do” and ask them to explain how they came to these conclusions. If the person had beliefs I saw as irrational or even non-reality based, I’d ask them to explain how they know these things to be true. I might challenge their beliefs with contrary facts and ask them to explain these differences. I might even say I disagreed with them about certain conclusions. But at no point would I ever tell them that something is “wrong” with how they were looking at themselves. That is simply not my job. It is their job, 100%.
Absolutely. To determine “overdiagnosis,” one would have to determine objectively the proper level of diagnosis. With the shifty, subjective, hazy criteria designed for “ADHD” or any other DSM “diagnosis,” there is no possible way to objectively diagnose even one single person. So yes, ANY “diagnosis” is overdiagnosis. Or in other words, DSM “diagnoses” are fraudulent, 100%. Not that human suffering isn’t real nor that people don’t need extra support sometimes. But calling these things “diagnoses” is, scientifically speaking, a complete joke.
I think there is a difference between a person deciding for him/herself that there is something “wrong” with their beliefs, assumptions, habits and someone ELSE telling us that something is “wrong” with us, or deciding exactly what it IS that is “wrong” with us. And deciding there is something “wrong” with our own belief systems is highly subjective and personal, very, VERY different than saying there is something wrong with my blood pressure or my ability to breathe or my immune system. The question of what “wrong” means and who gets to decide this is essential to having this kind of conversation make sense.
It always bothered me a lot when institutionalized children/adults had hands laid on them by staff, and when they fought back, they were accused of “assault,” and sometimes even charged criminally! The “CLIENTS” were assaulted by the staff and were fighting back! It is stunning that this obvious fact seems to be lost not only on “mental health professionals,” but on our entire legal system. Defending oneself can’t be considered an assault!
Couldn’t agree with you more! Detaining someone for being dangerous should NOT in any way be considered as or associated with “treatment” or “diagnosis” at all. Social control is social control. As I’ve said many times, without even arguing about the obvious failings of the destructive psychiatric model, as soon as you introduce force, it can no longer be considered in the realm of “treatment.”
I am never one to justify violent behavior, just because someone is enraged. But I find it predictable and understandable, even if it is ineffectual and counterproductive in most cases.
Of course, there ARE cases where violence IS justified, when one’s safety or the safety of others is involved. In such cases, the minimum force should be used, but the use of force isn’t always “wrong.”
Exactly. It is not aimless, it is the result of just too many days, weeks, months, or years of being invalidated and abused. Eventually, everyone reaches a limit.
Psychiatry residents need more training in the actual root causes and effective interventions for people who are suffering emotionally and come to them for help, and more training in the fact that the current system is utterly ineffective and in fact destructive in many if not most cases. Though going into another specialty sounds like a good option, too.
I would suggest that King was not advising or supporting violence (he was a VERY strong advocate of a nonviolent approach), but more putting the violence from the poor and disenfranchised into perspective. While he supported nonviolence, he understood that if you push people enough and deny them their voice, their frustration and anger will in many cases be translated into rage and violence. So a person wanting to reduce violence would be wise to start listening to those who are shouting but not being heard.
I would add domestic abuse and child abuse to your list. Both are highly associated with “mental health” issues. But of course, that must be because people being abused have bad genes or something. Couldn’t be that the trauma themselves cause “mental health symptoms?”
There is actually no data supporting the idea that “antidepressants” reduce the likelihood of suicide. Rather, the data indicates the opposite – that people are MORE likely to kill themselves after starting “antidepressants.” Yet somehow the idea that “antidepressants save lives” still lives on.
All I can say is, very well said, and I agree completely. I just wonder how many other people we see “acting normal” who go home and order takeout because they are utterly exhausted from “acting normal” and who lay on their couches crying or numbing themselves out watching Netflix.
This appears to be a very complex way of saying that DSM “disorders” are nonsense and cause great harm to people in general by making it appear that there is a black and white answer to the question “am I ‘mentally ill?'”
Bruce Perry is a man who tells it like it is, backed by solid research. The psych mainstream really WANTS to dismiss him completely, but can’t, because he’s so solidly based in research. They have chosen to coopt and minimize his contributions, focusing on “trauma changes the brain” as a means to justify more drugging, and forgetting Bruce’s main theme, which is, “Healthy relationships can HEAL the brain, even in adulthood.” The latter message is unacceptable and has been muted by every possible means the psych professions have had at their disposal. This looks like an important read. I hope that Oprah’s stamp of approval gets it the wide viewing it most likely deserves.
You might be surprised to learn how many “normals” are falling apart inside despite appearing “normal.” I sometimes think “normalcy” depends mostly on the ability to act.
The whole idea that people can be divided into the “mentally ill” and the “normal” is brought into sharp relief by your analysis. A “normal” person who gets intimidated by his/her boss and starts feeling anxious and avoids him/her is considered to be “under stress.” A “mentally ill” person with the exact same reactions to the exact same situation is considered to be “having symptoms” or “decompensating.” It is nothing but rank prejudice and discrimination, not dissimilar in structure to white people engaging in violent acts being considered “lone wolves” or “troubled men” when black people doing the exact same thing are considered “thugs” and Muslim people doing the same thing are considered “terrorists.” This is perhaps the most important reason that “mental health” labels in general are ultimately destructive, even if a particular person doesn’t mind or appreciates their particular label. These labels are more or less arbitrary, and enable folks to engage in systematic discrimination without consequence against people who have them. In fact, these labels make such discrimination virtually invisible to most people who observe it happening. Instead of seeing it as condescending disrespect, the discriminators can frame it as “helpful concern” and the observers allow that framing unless they are quite enlightened.
Same thing happens with “ADHD.” They give the kid stimulants to increase their dopamine levels. They often become aggressive, lose sleep, even hallucinate sometimes. Then they give them antipsychotic drugs to DECRASE the dopamine levels that they are INCREASING with the stimulants! Why not just STOP INCREASING the dopamine by giving them less stimulants? No, that would be too simple and not make them enough money, I guess! That is REAL insanity!
Yeah, for some reason, a lot of people seem not to appreciate all the helpfulness involved in being arrested without charge, held against your will, and forcibly drugged “for your own good.” Ingrates!
I don’t think it was a “mistake” – it was the usual support for their big Pharma donors at the expense of their constituents. It was effective for what it was intended for – keeping their donors happy!
Isn’t this sort of like saying, “Baseball bats are not useful for playing ice hockey?” Even if you buy into the antidepressant mythology, why would they be of any use for back pain? Unless they make it so you feel OK about having back pain and it doesn’t bother you as much?
Amazing how the exact same behavior is seen as “recovery” when they think you are taking their drugs, and the same behavior becomes “symptoms” when they realize you’re not. Pretty logical, isn’t it?
Notice how the emphasis is on “helping middle schoolers cope” rather than asking why middle schoolers have to cope with so much that they “need help,” or what it is that we’re forcing them to cope with that might be modified to ease their stress?
All too true! I’m tired of hiking being called “nature therapy,” or expressing oneself through artistic media being called “art therapy,” or meditating on the meaning and purpose of existence being called “mindfulness therapy.” Some things are just good things to do. I would hate to think they will turn Harry Potter into “fantasy fiction therapy” instead of just being a good read!
Apparently, accurately reporting on their own research can be “shaming” if the research doesn’t line up with their “Take your meds or else!” philosophy!
Bullying is, indeed, the more fundamental problem. Psych labels are merely the bully’s tools.
I appreciate your clarity about why you wanted a “diagnosis.” I’m sure your feeling is shared by many, that lacking a “diagnosis” means you are not taken seriously. But I would toss out the question: why in our society is it necessary to have a “diagnosis” to be taken seriously? Maybe that is a problem even more fundamental than bullying itself!
I agree absolutely. The word has been “polluted” by the cultural context surrounding it, at least for me. It is associated in our culture with violence, destructiveness, lack of value, and shame. It is interesting that in other cultures in which “voice hearing” is more accepted, “Voice hearers'” voices are actually more positive and helpful. How we choose to view phenomena and how we choose to name them has power. At a minimum, that power should not be usurped by the “professionals,” but I’m afraid most of these labels have already been appropriated culturally to the point that their personal meaning is difficult to untangle from their cultural meaning.
Another of those weird “Medicalized” headlines. Why not just say, “Financial debt is depressing and anxiety-provoking?” Why the resort to “mental health outcomes,” as if getting upset about financial problems is some sort of disease or “disorder” or failing of the person in debt? Why not just admit that being in debt sucks?
You write very powerfully! And I appreciate your comments very much, and your kind words for me as well.
I think the only REAL way to be non-judgmental is to understand that we are ALL judging all the time, and to become AWARE of and acknowledge one’s judgment, to the degree that one is able to view those very judgments themselves objectively enough to set them aside and not put them onto the other person. It is difficult to describe, but I do believe it is most definitely possible to accomplish, at least enough that the person we are dealing with doesn’t feel they are being judged and sees that you are able to hear what they really are saying instead of what you think they ought to say or mean.
I am reminded of a quote from the Princess Bride by your closing paragraph: “Live IS pain, Highness. Anyone who tells you different is selling something.”
I think the person suffering has every right to identify their “problem” or “issues” however they would like to view them. My objection is when another person tries to take that right away by deciding for you what your “problem” is. It would be one thing if they are saying, “You have a brain tumor” or “Your blood pressure is higher than normal.” But instead, they are judging their clients/patients/whatever based on some set of arbitrary rules and pretending they know what they’re talking about.
I respect YOUR views on your condition/situation WAY more than any “professional” who might come along and condescend to “diagnose” you!
I always figured the best assessment tool was to ask the client what s/he felt was troubling them, and then ask what they would like to see be different in their lives. Then ask them what barriers they saw to making that happen. Depending on what they said, there would be a whole lot of different things they could do to move in the direction they wanted to. No “clinical judgment” or “diagnosis” or “spectrum disorders” required!
Waste of time. The “model” fails to alter the most basic and incorrect assumptions of the DSM, namely, that a “clinician,” by virtue of some level of training and education, can look at someone’s behavior, mood, or thinking and objectively determine if there is something “wrong” with them. It doesn’t matter how you slice it, we’re substituting human judgment for actual scientific observation and attributing “medical” legitimacy to someone’s biases and opinions based solely on what kind of degree or training they have. As long as we pretend that we are “diagnosing” a “mental illness,” it doesn’t matter if we use HiTop or the DSM or the ICD or a dart board, we’re wasting a lot of energy categorizing what kind of iceberg hit the Titanic instead of trying to keep the ship from sinking or getting the passengers to the lifeboats!
But will this lead to a reduction in the use of “suicide screening tools” or the substitution of “clinical judgment” for actual communication with the client in front of the “clinician?” You bet it won’t!
Well, no community just IS that way, it has to be CREATED that way and continue to be created that way over time. I have experienced that from time to time in my life, but only for a little while. It is difficult to get everyone on board with that kind of ongoing creation. We’ve all grown up in an oppressive society and we all need healing!
Humans are social animals/beings. Most don’t do well when isolated. We seem to thrive when living in communities. The failure of psychiatry to even notice let alone try to understand this simple fact makes it impossible for psychiatry to ever be of any help to anyone. The Rat Park experiment alone puts the lie to the vast majority of psychiatric research – obviously, if community and activities can change even a rat from a cocaine addict into a “normal” community member, the idea that addiction or “mental illness” is inherent in the person seems pretty stupid.
Usually, when a practitioner “wants to protect you,” it usually means they want to protect THEMSELVES from the feelings you evoke in them. If YOU get “treatment,” then THEY will feel better. It has little to nothing to do with your needs!
Leave the grannies out of it, and I’d say your punishment might be a just one for a decent percentage of psychiatric practitioners today. I mean, it’s probably not their grannies’ fault they bought into the DSM.
Ah, you antipsychiatry types ALWAYS exaggerate! It CAN’T be over 400,000 a year, maybe only 350,000 deaths… Well, gosh, I guess that doesn’t sound very good, either… Uh, oh…
That sounds like an AWFUL experience! I ran into quite a few of these situations when I worked with foster youth. The easiest “disease” to attribute to your child is a “psychiatric disorder,” because there is no objective way to prove that the “diagnosis” is right or wrong. It is the “Munchhausen parent’s” paradise!
I hope you have found other adults to validate the bizarreness of this experience. I was not meaning to imply that you were validating the DSM “diagnoses,” I was just expressing my own discomfort with assigning a “disorder” that is in no way validated or validatable, rather than just describing the behavior that is of concern for what it is. You certainly did a fine job of doing the latter!
Quite so. It also implies the ability to discern legitimately between the “properly diagnosed” and the “misdiagnosed.” Which of course is utterly absent for any of the DSM “diagnoses.”
I have always considered “transparency” a joke. “I’m taking bribes from Big Pharma to promote their drugs. Here are the companies paying me off.” And then the get to go ahead and make “recommendations” based on who is paying them, and no one stops them. How about disqualifying anyone on the take from participating in making practice recommendations? How about forbidding researchers at colleges and universities from taking any funds from industry directly, as used to be the case when I was a kid? As soon as you can use your research grant to get a patent and make a ton of money, your scientific objectivity is shot to hell, I don’t care who you are. Publishing one’s conflicts of interest is a useless and ridiculous measure. Preventing conflicts of interest is what we need to be doing.
“Munchhausen’s by proxy” to me isn’t something to “diagnose,” it’s just another phenomenon that most likely has multiple causes and multiple effective interventions. Drugs obviously are not one of the effective approaches.
Rather than call it “Munchhausen’s by proxy,” why not just say, “This person likes/needs to believe that his/her children are ill to meet some personal need of their own.”
Generally, yes. If something doesn’t show up and I haven’t sent you a note, by all means, check in with me. Sometimes I think I’ve approved things that somehow don’t get approved, and sometimes I forget to write the note to ask you to explain. It is rare that I change or remove something without connecting with you in some way, so please check back in with me if you are wondering what happened.
Even by their own rules, these drugs don’t have any positive effects in the long run. This is not new news – Russell Barkley himself found this out way back in 1978! So why doesn’t anyone know this?
What it means is that the doctors are not prescribing based on scientific evidence. They are motivated by different factors, including keeping parents happy, feeling like they are “doing something,” fitting in with social expectation, and/or increasing their personal income, to name a few possibilities. It is not a problem of information or knowledge. It is a problem of improper motivation.
I am allowing this comment, despite stopping this thread earlier, because the poster relies on personal experience and research data in her comment and is presenting the evidence she has encountered in a respectful manner. I am not inviting a return to the personalized, escalating rhetoric that was occurring previously. Others who wish to present their own personal experiences with COVID vaccinations are welcome to do so, particularly as it pertains to any pressures, oppression, or neglect based on “mental health” labels. Personal experiences are always welcome. Personal attacks and invalidation are not.
A number of people have been saying they are not receiving notifications despite being subscribed to an article’s comments section. James is aware of this and is working on figuring it out.
I’m not sure I agree. There are power differentials that exist in almost any relationship. It is the negotiated terms of the relationship that allow or disallow connectedness. If the person in the higher power position chooses to be respectful and genuine and chooses not to use that power over the other person, I think connectedness is still possible. But if one person actually views himself as superior and is willing to disregard or condescend or otherwise use his/her “power over,” then I agree there can be no connectedness between them. To connect, there needs to be sufficient safety for both parties.
“Misdiagnosis” can’t be applied unless there is a way to objectively make a “diagnosis.” There is no way to objectively tell who “has” or “does not have” ADHD, so the idea of “misdiagnosis” is nonsense!
People act on incentives. If they are getting paid to do dumb and destructive stuff, they will continue to do dumb and destructive stuff. Few people have the courage to stand up to injustice or even garden variety ignorance.
It can never be caused by the “treatment” – it’s always the patient’s or the “disorder’s” fault, as if the “disorder” is some kind of animated being that is trying to thwart their “treatments.” It seems it is never, ever the doctor’s fault or failure, no matter the actual data.
Why would we want to “infuse” the view of despair with “biological perspectives?” Sounds like what they already do, and with horrible results. How about they let the actual sufferers “infuse” psychiatrists’ views with human and compassionate perspectives?
Conflicts of interest are an enormous problem in the government right now, at least in the USA. There’s a revolving door with Big Pharma. I believe more than 50% of the FDA membership should be people who have no relationship to the pharmaceutical or medical industries at all. Indeed, why would we believe the fox when he says he’ll guard the chicken coop for us?
They have not researched “deaths of despair” because they don’t recognize despair as a legitimate complaint. There should BE no despair, as far as their model is concerned. Despair is indicative of “illness,” even if it’s caused by being hung upside down in a dungeon and tortured by people who have promised you will never escape. The tortured person should apparently have a better attitude, or else the reason they’re so upset is because their brain chemistry is messed up. If they were “normal,” it would not bother them much to be tortured. They’d just accept it as another one of those crazy things that happen in life!
Well, they can’t TOTALLY go away, or they’ll have to find new customers. They mostly want them to be inert, except to have just enough energy to pick up their next prescription.
I am sure they don’t cure infections, but they have been noted to have strong effects on pain, nausea, emotional conditions, fatigue, etc. These effects are apparently measurable and observable in the brain.
More convincingly, how the brain is used has been shown to alter the function of the brain itself. Taxi drivers develop an increase in areas of the brain associated with geography; meditating monks have an increase in areas of the brain associated with calmness and relaxation, as well as alterations in brain wave activity.
One can say, “Well, they’re using that part of the brain more, so it’s more developed.” But WHO or WHAT is using that part of the brain more? And HOW is that decided? These are things we simply do not understand.
The mind is and remains a mystery. It appears to have effects on the body, but how these effects are created is not remotely understood by any in the world of science. What “the mind” even IS is not understood by scientists. I don’t claim to have any understanding of it myself, I’m just pointing out that claims that understanding the brain means understanding the mind are similar to claims that understanding electrical circuitry is the same as understanding computer programming. They are very different things.
I would say that the brain is an organ, while the mind appears to be an agent of controlling the body. It is certainly within the realm of possibility that the mind does somehow arise from the brain, but that is certainly not proven, nor is there even evidence to say it is so, other than materialists saying, “It must be, because what else could it be?” But regardless of that, there is tons of evidence that the mind, whatever that is, is able to control the body, including the brain, in many, many different ways. The placebo effect is a great example. How can believing that something will work help the body to heal or change? Obviously, there is some form of agency that uses beliefs and goals to move the body to do things. Perhaps the concept of a “programmer” is the best analogy. Lots of people refer to the “hardware” (the brain) and the “software” (whatever programs the brain is running), yet no one seems to remember that someone has to WRITE the programs for a computer to run! So who is the “programmer” of the human brain? That’s what I’d call the mind. And again, it is a mystery – no one really has a clue what it is or how it works, but it is clear that it DOES exist and it DOES work, and pretending that we’re just a brain is as dumb as pretending a computer is just a bunch of electronic components and wires. Try to run a computer without software and see what happens! Try to program a computer without a programmer and see how far you get.
I would say that psychiatry mistakes the BRAIN for the MIND. The mind runs the body, including the brain. Whatever the mind is. Which to me remains a mystery. But psychiatry doesn’t allow mysteries. It makes them, dare I say it – CRAZY!
Oh, I think they know very well who Karl Rove is. I just don’t think they consider him a person they’d like to be compared to. More somebody they’d wish to NOT be like at all.
I agree 100% on THAT point! I think I’m emphasizing more what people’s attitudes have become, and you are emphasizing more how that attitude has been used to mislead the public. There is nothing “rational” about believing some subset of humanity, with sufficient intelligence and training, can somehow determine what is “true” for the rest of us. It’s just as superstitious as believing in evil spirits. Maybe a little more so!
Right you are! The very essence of science is skepticism, the willingness to invalidate any and all conclusions in the face of new data, and in fact, the drive to do all we can to try and invalidate a particular theory that SEEMS to be true, and only accepting it as truth when all other explanations are proven to fail. And even then to be prepared for new data to force modification. The concept of “scientific truth” is badly misused, as “scientific truth” by definition is always subject to change. Even Newton’s Laws of Motion, long held up as the ultimate in “proven fact,” ended up being approximations. Who knows what we’ll discover in the future, if we stop pretending that some “smart people” already know everything and that we can stop looking and just let them tell us what is true!
True, but a slightly different issue from what I’m talking about. The idea of science being “value neutral” is extremely problematic, as Robert Pirsig so eloquently elucidates in “Zen and the Art of Motorcycle Maintenance.” But what I’m talking about is a form of almost religious worship of Scientists as the All Knowing, so smart and informed that us mere parishioners are too ignorant and easily misled to be able to understand their deep knowledge. Doing what the Scientists say makes us Smart and Clever free from the curses of Superstition and Blind Faith! The fact that this is another form of Blind Faith does not occur to the faithful. Science is Truth, and to question this is Sacrilege! Oops, I mean Unscientific! Psychiatry is able to use this kind of blind faith to maintain its hegemony despite the fact that their own scientific researchers (not to mention basic logic) have proven that their diagnoses are nonsense and that their “treatments” tend to make people worse rather than better, and in fact to shorten their lives. To question Psychiatry is to question Science, and who are we to question the wisdom of the Great Scientific Gurus!
It has always both fascinated and repelled me that those oppressed by abuse and social discrimination are the ones identified for “treatment,” while those who do the abusing and oppressing are not “diagnosed” with anything at all. What’s wrong with this picture?
“Mindfulness meditation” as promoted by DBT or others is at best distantly related to actual Buddhism. If you study Buddhist teachings, you will find that the idea of “mental disorders” and “treatment” would be considered absurd, and forced treatment would be considered a horrible affront to humanity.
It is also interesting that they admit to “neurological changes” due to antipsychotics, which is a nice euphemism for “brain damage” or “abnormal brain functioning.” They slipped that one in without admitting what it really means.
A lot of people are “pro-scientist” rather than “pro-science.” They thing science is something that other smart people in lab coats do, and they then report their findings honestly and all we need to do is follow their recommendations. The idea that scientists could be dishonest or corrupt or just plain incompetent and narrow-minded is too much for them to process. It’s more like a religion than a logical conclusion. Real science is scary to those people, because it requires them to personally sift and evaluate the evidence, instead of deferring to “the authorities.” So they get very upset at people who question their “pro-scientist” dogma!
“No result” is apparently no reason not to continue with “treatment” in the world of psychiatry. Continuing “treatment” is all that matters. If it doesn’t work, we double the dose. If that doesn’t work, we add another drug. We continue until the person either lapses into apathy or dies. That’s psychiatry in a nutshell.
You really know how to ruin a figure of speech! So what are you “seizing” right now? How many “seizers” does it take to “seize it?” And if everyone agrees, why is there any need to “seize?”
Only fair if I ruin your figure of speech in return…
So you’re saying it would have alienated his loyal followers to say, “Hey, these psychiatrists had no clue what they were doing!” or “I realized that I was failing to follow my own advice about fogging my feelings?”
Getting a Masters Degree in Education disabused me of any delusion that having an advanced degree means you’ve met some much higher standard of knowledge. My grad courses were WAY easier than most of my undergrad education, and a student could easily get through the entire curriculum while having not the slightest skill or motivation toward caring about kids’ learning. I’m absolutely certain the same would apply to a psychology degree. The only truly useful part was my internship, and that was because I was lucky enough to land a good mentor teacher to work with.
An advanced degree means pretty much nothing about someone’s skill level or integrity.
He is ABSOLUTELY a victim of psychiatry. I hope no one is disputing that fact. Again, my disappointment is only that a person with such a large platform has missed an opportunity to get the word out about his victimization, especially since his own philosophy as stated is so consistent with a critical attitude toward the kind of “solutions” psychiatry has offered.
The “Treatment” for akathesia is to stop administering the drugs!!! But apparently, that’s not an acceptable plan. The answer always seems to be more drugs, not less.
Yes, the magic of “cognitive dissonance.” Nobody likes to be wrong, even when it’s not exactly their fault. But most of what we learn comes from being “wrong” and trying to do better!
As for me, I feel no hostility toward him at all, just a certain sadness and disappointment that such a fantastic opportunity to direct his energies toward that profession which is most strenuously opposed to his philosophy, even when he was victimized by that profession. But it is very hard to admit when you’ve been victimized, especially for those who revere doctors as being automatically more trustworthy than the general population.
I wish him well, and hope he sees soon what seems clear to us who are further down the road.
“Indifference” and “equanimity” seem like very different things to me. The latter is being “above the fray.” The former is giving up, being “beneath the fray,” as it were.
It does seem ironic that he is telling people to face their emotions and not try to “fog” them, while taking antidepressants for years and then getting dependent on Benzos by following his doctors’ advice. Wouldn’t you think he’d see the irony here and come out and acknowledge that he’d been led down the garden path? I feel compassion for him, but he’s missing a great opportunity to promote his ideas by challenging the cultural assumption that “feelings” can be a “disorder” that needs to be “treated” rather than understood and faced as Peterson insists is necessary to get away from our overly “orderly” society.
I needed to read that last part. I think I need to stop fighting so much and let people be where they are in their journey. Yelling at them or being disgusted with them does nothing to help, and damages my own peace of mind. Not that I’m not ready to take to the streets when the time is right, but I don’t see that happening any time too soon.
I think the clinical approach is called either “corruption” or “stupidity.” We could give it a fancier name if you’d like.
Adderall can certainly counteract the effects of “antipsychotics,” especially the traditional ones like Haldol that act solely on dopamine. It appears that is why smoking is so very common for users of neruoleptics. (What, it’s not because they are all lazy, irresponsible addicts? But, but…) But what sense is there to raising dopamine levels with one drug while lowering them with another? Meth would absolutely work similarly. Stimulants are pretty much all the same, except perhaps for cocaine.
My understanding is that the shrinkage is primarily in the basal ganglia, where a lot of dopamine is processed on its way to the frontal lobes. (If I recall correctly, this was the part of the brain that lobotomies attacked, leading some to call neuroleptic “treatment” a “chemical lobotomy.”) This makes sense, because dopamine is the target of the “antipsychotics” aka neuroleptic drugs. I also seem to recall something about reduction in white matter, the stuff that surrounds the neurons. Tardive dyskinesia is clearly and unarguably caused by damage to the dopamine system, only seen in people taking dopamine inhibitor drugs like the neuroleptics, and it would stand to reason that damage to the dopamine system would associate with TD, though I have not researched that question.
Indeed it does! But apparently, they don’t even respect their own “experts” when they come up with the “wrong answer!” These are not people who are going to suddenly say, “Gosh, we seem to have gotten it wrong – maybe we should listen to our clients in the future.” They are dogmatically committed to their worldview and to taking down anyone who dares to challenge that view. I want to extend my love to such people and hope for their transformation, but we can’t allow such people to decide what is “helpful” for the people they truly don’t give a crap about!
New drug names have to have a Z or a Q or some other rare letter in it, or some weird spelling. So maybe we can go with “Taperz” or “Nottooqik” or “EventuelyOff.” Or “Qutdownz?” “UKANQiT?”
Of course, alcohol feels good, too, and I used to enjoy marijuana before it started making me a little paranoid. I have no objection to people using whatever drugs work for them, but it’s sure not a sign of psychiatric drugs “working” to “treat mental disorders!”
Not to mention denying the evidence from their own researchers: that “ADHD” is 30% more likely to be “diagnosed” if a child is a year younger, that there are no long-term outcomes that are improved by stimulants for “ADHD”, that “antidepressants” increase the likelihood of aggression and/or suicide rather than decreasing them, that taking “antipsychotics” for more than a brief time dramatically DECREASES the likelihood of recovery, that countries with less “antipsychotic” use have better outcomes, that the likelihood of “psychosis” is strongly affected by social conditions, in particular, migration, urban living, and childhood sexual abuse, that genetics contributes little to nothing to the probability of any psych “diagnosis,” that “antipsychotics kill people decades earlier than the general population… I could go on.
I agree, the most fundamental evidentiary problem is ignoring the actual experiences and feedback from those they are supposed to be helping. You’d think that would be the MOST important data, and it is considered the least. But even without that vital consideration, the profession’s ability to ignore cartloads of inconvenient evidence disqualifies them for even the vaguest consideration of being “scientific!”
I agree completely. School in its entirety was a total violation of any sense of safety or self-determination I had. I was in internal revolt for 13 years, but externally acted like things were OK, except for one or two incidents of acting out over the years. It is very damaging, and is only one of many ways in which we have to deny our intuitive sense of what is right in order to survive.
Most have given up on the idea of “bad parents.” Any suffering is caused by a faulty brain. Because if your brain worked properly, apparently, we’d all be happy with our circumstances, no matter how grim!
Thanks for pointing out the subtleties of your comment! Your writing borders on the poetic!
I don’t think it is inevitable that we are required to disrespect our own instincts and rhythms. It seems to relate largely to having too many people for the space we have, and having too few people with too much power to direct others’ behavior for their convenience. And we all accept it at this point, or most of us. I think a lot of ‘mental illness’ comes from internalizing these expectations.
It can hardly be considered coffee’s fault that our circadian rhythms are not respected. I’d view coffee as mostly an effect – an attempt by individuals whose circadian rhythms are PERFORCE disrupted by a society that does not respect them to do something to maintain their alertness in spite of the constant assault on their natural rhythms of sleep and lots of other things. This disrespect begins in the cradle (remember forced feeding schedules and intentional waking of babies who “slept too long” for their arbitrary schedules?) and continues through school (how many days were we all forced to “go to sleep on time” and get up at a ridiculous hour to spend a day of largely wasted time in a building we hated with people we were forced to associate with doing things that someone else decided were important?) and of course is brutally enforced in the workplace for most of us who have had to do a “job” to maintain survival for ourselves and our families.
Let’s not blame coffee for doing a job that our society has created for it! Remember the Rat Park experiment – rats DON’T prefer cocaine to food when their social and emotional needs are met!
I think you’re right. It is driven by profits, so making it no longer profitable to drug people for ostensible “mental illnesses” is the answer. But drug companies can apparently afford the fines, so going after the prescribing doctors or those creating the “practice guidelines” seems the most likely to be effective.
It is a typical, dense, heavy-handed, insensitive, context-absent psychiatric intervention. If someone doesn’t eat enough, let’s give them a drug to make them hungry! If they eat too much, let’s give them a drug to make them LESS hungry! If they take stimulants (which increase dopamine) and become aggressive, forget DECREASING the stimulants, let’s give them antipsychotics to decrease the dopamine we’re increasing with the stimulants!
It’s like watching someone try to do sculpture with a pickaxe. They have no tool to do the job, but insist on doing it anyway, and regardless of the damage done, never seem to conclude that perhaps they ought to find a small chisel and hammer, but continue to hack away with the pickaxe and require everyone else to admire their “work.”
And comments like that have been made for decades. Yet, no one fills the holes, the prescribers are not better educated, non-pharmacological treatments are not given attention, and patient feedback is minimized or ignored. What could possibly occur that would change this?
But cigarettes can also uncover a latent coughing disorder. Which, of course, we can treat with an anti-coughing medication. And later on, you may develop lung cancer. We have found that lung cancer patients seem to have a penchant for cigarettes earlier in their lives. We believe a chemical imbalance in those pre-disposed to lung cancer also leads them to crave cigarettes. Of course, the cigarettes are just a meaningless correlation – the couldn’t POSSIBLY be a causal factor!
This seems to be so difficult for some people to understand. To say “there are no ‘mental illnesses’ is not the same as saying that this kind of suffering doesn’t happen. It means that the categories they define don’t mean anything at all! You can group together people with brittle fingernails or people who clean out their ears with their pinkies or people whose hair falls out early or people who have larger breasts on the average, and any one of these can be defined by a list of “criteria” and people can be diagnosed with “Excessive Ear Cleaning Disorder” or whatever you please. But if the grouping of people has nothing in common other than the ostensible “symptoms,” what is the point of it? And to then attribute these “disorders” to “neurodevelopment” without a shred of evidence adds insult to injury! Plus, if some subset of these people really DID have a neurological problem, the psych “diagnoses” immediately become a barrier to discovering this, because they’d be grouped together with a large cohort of people who did NOT have the same problem, and no one would look at these people with an interest in finding the cause.
There is no scientific validity to any “mental disorder.” They are based on arbitrary judgments and assumptions that have no coherent meaning. This is not to say people don’t suffer these described syndromes at times. It’s saying that calling these collections “mental disorders” is worse than pointless – it actually prevents any recognition of any ACTUAL physiological problems that DO exist, while invalidating the importance of life experience as the most important contributing factor to most mental/emotional distress.
Seems a very likely connection. I mean, athlete’s foot is embarrassing, causing anxiety and depression, which no doubt leads to violence, since we know all depressed people are violent. I hope you will control for the presence of clotrimazole, though. Could be a confounding factor!
But seriously, I’d love to see a study where antidepressants take on controlled doses of chocolate or French fries. I bet there would be little to no difference. In fact, chocolate would probably win!
So you mean handcuffing someone and forcing them into a patrol car, dropping them in a locked “ward” and strapping them to a bed and forcibly injecting them with a drug that makes them feel half dead, discourages them from seeking out similar experiences in the future?
Exactly! If it were low lead, we’d have to start THINKING, plus, our stimulant sales might go down, and if the client is actually healed, well, I’d have to look for new clients, wouldn’t I?
I don’t disagree at all. The point is not that acting out of anger is always OK, but that feeling anger is not a “disease” and behavioral choices are not ma “disorder.” They are choices. And choices have consequences. And if we want different consequences, we need to make different choices, and we can use our feelings in different ways rather than trying to snuff them out or feel guilty for having them.
I certainly would not expect you to. I was only mentioning that it is not a rare thing or an abnormal one that people who have had their trust frequently violated have a tendency to be sensitive to others’ questionable behavior. Anger can be a good way to protect ourselves from danger!
Psych “diagnoses” most definitely discourage and undermine any effort to look for any cause, even an obviously physiological one like Wilson’s Disease. Once we “know” someone “has ADHD,” any further effort to determine a cause is immediately brought to a halt.
I don’t know if this applies to you, but I’ve known a LOT of people who have been traumatized in youth and adulthood, and it is very common that such people strike out when threatened or bossed around. I don’t think it’s “abnormal,” but it can be a problem sometimes.
Whew, sounds GREAT! Can you make sure to link us to the letter when it gets published? I want to see how this goes. You sound like a force to reckon with!
Thanks for the ongoing education! Difficult reading, but it says so very much about why this “profession” has roots in very dark and destructive places, and why trying to “reform” the profession is destined to complete and utter failure.
Clearly, that is central. The need to define “normal” and to attack or demonize anything that deflects from that “normal” seems to be critical to this effort. This way, everyone is focused on whether they are “happy enough” or “good enough” or “smart enough” or “pretty enough” and so on, instead of wondering where this anxiety and frustration is coming from!
I believe the “survivor” concept came from the world of domestic abuse/sexual assault intervention. Could be wrong there, but that is my impression. The intent as I understand it is to define someone by their strengths and accomplishments rather than by their victimization. But that’s my limited understanding.
“Neoliberalism is contemporarily used to refer to market-oriented reform policies such as “eliminating price controls, deregulating capital markets, lowering trade barriers” and reducing, especially through privatization and austerity, state influence in the economy.”
It is true that the US medical society is pretty obsessed with cutting out anything remotely related to cancer. However, at least there is an actual THING to be evaluated in that case. Psychiatry is the only profession I know that has done surgery for the sole purpose of destroying normal, healthy cells.
“A more recent analysis estimates 128,000 Americans die each year as a result of taking medications as prescribed – or nearly five times the number of people killed by overdosing on prescription painkillers and heroin. Sep 27, 2016”
Note that the now use the term “medical errors,” but over 120,000 deaths included in the original study (back in 2001 or so – more than half!) resulted from properly prescribed and properly administered drugs. So it doesn’t require an “error” for doctors to kill you. Standard medical practice does the job more than half the time.
Talk about missing the point! Her suicidal thoughts appeared to be directly related to the stresses of having to deal with the racism and classism and anti-American sentiments in the British nobility, so essentially, with social ostracism and discrimination. There is no “treatment” for abuse!
I agree. Cancer treatment kills lots of people! But at least in that case the disease itself can kill you, so the risk of death is more understandable. Risking death because someone behaves in ways that society finds difficult to manage? Seriously?
Receiving medical care is the third leading cause of death in the USA. But I would bet that psychiatry is at the front of the line in terms of iatrogenic deaths.
The ultimate subgroup is a single person. If you break it down far enough, you end up with individualized “treatment,” which is what should be happening anyway, if any “treatment” at all is considered appropriate.
Of course, there is “heterogeneity” in a group you put together based entirely on how they FEEL at a given moment in time. The idea that people who feel depressed are all the same is the most basic deception psychiatry is based on.
I’m just going from stats here. Most mass shootings are perpetrated by young men who are misogynistic and have a history of drug abuse, or are on psych drugs. I am certain older men would factor in there as well, as being MALE is the most common characteristic by far of all shooters. My point is, if we’re going to create a profile, we ought to base it on actual correlations, and “mental illness” doesn’t even come close to making the cut!
It is not UNCLEAR how it could be considered ethical. IT IS NOT ETHICAL, and should not ever be considered to be ethical. These people KNOW they are being unethical, or else they have no sense of ethics to offend. Why not call this out for what it is?
Actually, that is a good point! If they are advertising being “evidence based medicine,” isn’t that a tacit admission that their prior “medicine” was NOT evidence based?
Of course, it is impossible to have a real evidence base for “disorders” that are not objectively distinguishable from non-“disordered” conditions, which the DSM itself admits in its introduction is the case for any and all of the DSM “diagnoses.” Kind of like collecting “evidence” to “treat” laziness or cowardice or spontaneity or joy. It is an illogical proposition from the word go.
Reducing the placebo effect is anti-scientific. Drug companies hate the placebo effect because it shows up their drugs as mostly active placeboes. Keeps them from selling as much!
Well said. If we were going to “profile” the dangerous person who needs to have an eye kept on them, it would be a younger male domestic abuse perpetrator with a substance abuse problem (or on certain psych drugs) and an obsession with weapons. “Mental illness,” whatever that means, would not even make it onto the board as a risk factor. Most gun owners are safe, most people labeled “mentally ill” are safe. We should be looking at the actual risk factors if we are going to try and prevent such situations from arising.
Sounds like “refugee” applies pretty well! When you have to leave your home and avoid the “authorities” for fear of being “sent back,” you are a displaced person, in my view.
I see it as a constant struggle. There are people who believe they “know best” and should be the authorities, and others who resist are “wrong” and need to change their viewpoints or attitudes to comply with what “we know is true.” This kind of arrogance in a “helper” is incredibly dangerous, because the “helper” has no naturally occurring reason to stop or question his/her activities, since s/he is automatically doing good by virtue of being the authority!
The other group, which I think is a lot smaller, is those whose intent is to increase the self-determination of the people they help. People in this group would be horrified by the idea of telling someone what to believe or think about their own situation, and instead are focused on helping this person gain sufficient perspective to evaluate their own lives and tell their own stories, unencumbered by any “expected” way of thinking or acting.
Of course, there are many who don’t really belong to either group and can be swayed one way or the other. Unfortunately, at this time in history at least, Group One has control of the mass media and the main messages we receive are authoritarian ones, and those working for empowerment are considered foolish or dangerous.
I don’t think we are talking about the same thing if you are saying that “repressed” memories can’t be spontaneously recalled. If “repression” per se exists, it would involve an immediate action of putting this memory out of consciousness for purposes of self-protection. There is nothing in the concept of “repression” that would say such a memory could not later be spontaneously recalled or triggered, in fact, this is exactly what PTSD researchers find happens when a person gets triggered. They may have had some vague awareness that “something bad happened during the war” or “my uncle used to creep me out when he came in my room,” but then something reminds the person of what actually occurred, and the memory comes back up in more detail.
I am certain that there are people who have chosen to distort this admittedly theoretical mechanism to explain how such events happen in order to justify “pulling out” memories that the client is “repressing,” then I say they are behaving reprehensibly. As I think I’ve made clear, there is no excuse for such a shabby form of “therapy.” It sounds like we agree on most points, and are perhaps having different meanings for the term “repression” that are causing us to think we’re disagreeing.
I agree with you – not knowing is quite dangerous!
When I say “unethical,” I’m referring to acting on the therapist’s idea of what they “should do” rather than on the observable effects on the client. It would follow that there are a lot of unethical therapists practicing. A truly ethical therapist is humble, knowing first off that it’s better to do nothing than to do harm, and knowing secondly that anything they DO attempt needs to be filtered through the knowledge that inadvertent harm is easily done and not always readily observable. A competent therapist is one who is constantly getting feedback from the client, verbally and nonverbally, and altering one’s approach to meet the needs of the client rather than the therapist’s need to be perceived as “competent” or “insightful” or “skilled” or to prove that the therapist’s school of thought is “correct.”
In my experience, there is nothing that harms a client more than telling the client what to think about his/her own narrative. Telling them that their memories are “false” or telling them that they “have memories that they don’t recall” are equally destructive, and it should be obvious to anyone looking at the client’s reaction that such actions create confusion and uncertainty, and those are two things we should NOT be creating as therapists!
My biggest objection to the DSM is not the drugs, it is the action of the doctor/therapist telling the client what to think or believe about their “condition” or needs. Even if such an evaluation were based on facts, it is still not going to be helpful to tell the client “here’s what’s wrong with you.” When such an evaluation is based on raw speculation or invention, as the DSM “diagnoses” almost entirely are, it probably crosses over from unethical treatment to criminal fraud in my view.
Wow, that’s a pretty bent assumption there! I know many people who believe that people could recall prior abuse that they have not recalled previously who would find the idea of “recovered memory therapy” horrific and abusive. Perhaps we travel in different circles. There is absolutely no connection between the ability to recall memories previously not available to the conscious mind and the vindication of therapy that implants “memories” that never occurred, or assumes the presence of “memories” from a vague and subjective list of “signs and symptoms” that has no scientific validation.
And I would add that the possibility of this discussion is certainly NOT foreclosed upon just because of the observations that some abusers have used the concept to discredit their accusers. Both can be valid at the same time. There is no contradiction that I can see.
That’s more what I think of in terms of “False Memory Syndrome” – the therapist TELLS you that you had a traumatic experience, even if you have no reason to believe this is true. THAT is pretty scummy of a therapist to do that kind of thing.
So we are playing semantic games now? You know no more than I do about why someone doesn’t recall something that happens, or what mechanism is involved in them being “spontaneously recalled.” I hear no science about this, just a redefinition on your part.
So we can agree that a traumatic memory could be “forgotten” and then “spontaneously recalled” based on some environmental stimulus? In that case, there isn’t much we are arguing about. We’re both saying that something could be forgotten and then recalled later, and the fact that it wasn’t recalled doesn’t mean that the spontaneous recollection is false. Seems like splitting some pretty fine hairs to me.
You can say the same thing over and over, but it doesn’t make it true. First off, there is nothing “fantastical” about the idea that people would choose on some level not to consciously recall something that was troubling them. If they can “spontaneously recall” something they didn’t before, why could that thing they “spontaneously recall” be a traumatic event??? Your argument makes no sense at all!
My point regarding memories is that YOU are not in a position to tell ME what I recall is true or false. OF COURSE, people have inaccurate recollection that are contaminated by later experience or poor questioning or whatever. My point is that NO ONE can say if the recollection is true or false absent confirmation from objective data. As this is almost never possible, we are left with the subjective problem with memory in general.
For instance, the person who recalls what they believe was abuse may be confused or recall incorrectly. Absolutely. But why does this same reasoning not apply to the person who denies that it happens? Could the alleged abuser or other family members not have their recalls contaminated by later experience, or by their on conflict of interest in wanting to minimize the damage they have done or to avoid legal consequences? Do we require a “mechanism” to explain how people who are guilty of abuse claim to be innocent, and often BELIEVE themselves to be innocent in contradiction to actual facts?
It is very interesting how the recollections of those claiming abuse are so closely scrutinized, and frankly thoughtlessly invalidated on occasion, while the recollections of those denying the abuse are so readily accepted as true? Why do THOSE “false memories” not concern the “false memory” crowd?
Again, these two things have nothing in common. One is a spontaneous process that occurs within a person, the other is an effort to induce or implant memories in people who have none. The latter is NOT caused by the concept of repression, it is caused by unethical therapists who are either greedy or unable to deal with their own issues and act them out on their clients. If they did not have “repression” to use as a blunt instrument, they’d come up with another one. And many do. How many professionals believe they can “detect bipolar disorder” (or whatever other “disorder du jour”) and tell people they “have it” without any objective way to say it is true, and without the slightest consideration of the viewpoint of their “client?” This is not caused by the concept of “bipolar disorder.” It is caused by unethical practitioners, and is far, far more common than the “false memory” phenomenon.
It is important not to blame a concept or idea for how people choose to use it. No one should be telling anyone what they should believe about their own experience. THAT is the problem!
So what is the “known psychological mechanism” by which people spontaneously recall things which they have not had a conscious recollection of previously?
The majority of experts also believe that psychiatric drugs address biological anomalies in human brains, despite the complete lack of evidence that “mental illness” of any sort is associated with biological anomalies, nor that psychiatric “diagnoses” are meaningful entities that identify homogeneous groups, nor that people so “treated” do better in the long run (and significant evidence that on the average, they do NOT do better). The majority of experts are comfortable with a 30+% Caesarian section rate. The majority of experts believe that “treating” youth with “antidepressants” is good treatment, despite overwhelming evidence that there is no benefit to such “treatment” for children and that the recipients of such “treatment” are MORE likely to kill themselves or feel like doing so. The majority of experts once believed that Thalidomide was safe, that Benzodiazepines were not addictive, that Benzedrine was not addictive, that Tardive Dyskinesia was NOT caused by antipsychotic drugs, that there were no withdrawal effects from antidepressants, and that Viiox was a safe and effective pain reliever. They believed that sexual abuse was explained by “Oedipus complexes” or frustrated sexual drives in three year olds. Experts believe a lot of things that are not true. The “resort to authority” argument doesn’t hold a lot of water in the area of “mental health.”
I don’t agree. It is scientifically improper to assume repression can’t exist, just as it is scientifically improper to assume that it does. I agree that it is easier to prove that repression does occur than proving it doesn’t, but there is plenty of suggestive evidence that it does occur, even if it is not conclusive. The evidence that people do, in fact, recall memories that they previously did not and that these memories reflect actual events that happened is pretty powerful in the community of people who treat “PTSD” and other trauma phenomenon. It is not scientifically valid in any sense to invalidate such evidence simply because occasions occur where such memories are implanted by poor or unethical therapists or professionals. Stories of repressed memories have been recorded for over 100 years and cannot be simply discounted because someone says “prove it.” The proper scientific position on repressed memories should be, “We really don’t know for sure.” To invalidate memories of a person who recalls them can be just as damaging as trying to induce memories that don’t exist. In the end, the only real judge of the reality of a memory, absent confirmatory evidence, is the person doing the remembering.
Of course, these are not criteria that are generally accepted in the “mental health” system, which we know has pretty low standards to start with. I would say the important missing information is that the allegations were made after influence by a professional or other adult who has encouraged the person to believe they have memories which they don’t recall. I think denials by perpetrators are completely meaningless and should not even be a consideration, and denial by family members would also extremely questionable and need to be viewed in context. Not sure why the perpetrator would have to have any kind of dependency on substances, or “bipolar disorder” (which is, of course, totally unverifiable), or a history of molestation or abuse. Many, many perpetrators do so when stone cold sober, and many, many perpetrators have no record whatsoever, especially in family situations. As to “bipolar disorder,” it is a ridiculous criterion. Are they really suggesting that being diagnosed with “bipolar disorder” is a requirement for molestation? That “bipolar disorder” predisposes people to molesting children? I find such a suggestion utterly ludicrous in my experience (and I worked for 20 years with foster youth, seen plenty of abuse victims and perpetrators). And what’s that weird point about “bestiality appears in prehistoric art?” Are they trying to normalize bestiality? Or what?
These seem like extremely questionable criteria for any “diagnosis,” and the stakes involved here are enormous. Surely, the authors could do better than this!
Or they are dealing with a person who is overwhelmed, whose life has turned upside down and who has insufficient support or is being actively undermined. It is very common for overt domestic abuse to begin during pregnancy or shortly after the birth of a child. Additionally, the mother usually has to deal with loss of sleep, physical stress of nursing, change of body image, loss of connection through employment, loss of income, isolation, triggering of childhood memories of abuse/neglect, shock or disappointment about the realities of having a baby not matching social expectations… I could go on. There are a lot of good reasons to be depressed after a child is born that have nothing to do with the body. That said, I totally support nutritional interventions, as a lot is changing on a physiological level as well.
In short, the idea that “postpartum depression” is a medical problem is laughable for anyone who has actually become a new parent of an infant.
I don’t agree. There are people who are still receiving “treatment” involuntarily, including those forced by law and those who are in a bad position where detoxing from these drugs is dangerous or sometimes even not feasible due to alterations to the brain caused by the drugs. Additionally, I’d say that anyone who has recognized the contradictions and dangers the system has put them through and is trying to get out is also a “survivor” by any measure. They have survived, even if they are still being abused.
I think you summed it up very well. I have absolutely no problem with folks being careful about the details of such memories being potentially altered by mixing up with later experiences. We all know this can happen. But I take absolute exception to the idea that a vague, hazy recollection can be clarified and retrieved more completely by writing or talking to someone about what is recalled, nor that a memory can be brought to consciousness by external events that has not been held in conscious memory for very long periods of time. The phenomenon of PTSD suggests that memories being triggered by external factors similar to the unrecalled events can and does occur and has been very well documented. I have no problem saying that we don’t fully understand how memories work and how accurate such spontaneous recollections of previously unconscious memories might be. I have a BIG problem with one person telling another person such memories are false simply because they were forgotten (for whatever reason) and then later recalled. AND I have a big problem with someone telling someone they DO have a memory that they have NOT recalled as well!!! It is for the person having the recollection to judge how accurate or believable it is, absent any external proof regarding such recollections. The problem with the FMS concept is that it can very easily be used to invalidate the recollections of others that are NOT induced by bad therapists or malfeasant professionals. If a therapist is seen to have intentionally implanted or insisted on the presence of “memories” the client has never recalled, then I think “FMS” has some validity. But to say it is somehow “proven” that memory repression can’t happen is going WAY beyond where the science of memory can possibly take us today.
Richard McNally can say whatever he wants to say. “Recovered Memory Therapy” is a sham, and we all know that. But it does not follow AT ALL that “repression” does not exist. And there are certainly many in the “false memory crowd” who suggest that ANY memory that was not recalled all along is almost certainly false. One such post was approved (with provisos) just a moment ago and is in this thread for you to read.
I still see absolutely nothing in your post to even distinguish the difference between a “spontaneous recall” of a previously unrecalled memory and a memory temporarily “repressed” under stressful circumstances that is later “spontaneously recalled,” let alone evidence that the former exists and the latter does not. It is not logical or scientific to deny that something happens in order to address unethical practitioners who choose to take advantage of their clients’ vulnerability by suggesting that they have “memories” which the clients have never originated having recalled. The latter should be handled by the criminal courts and by stripping such practitioners of their licenses. Their unethical behavior has NOTHING TO DO with whether or not a person can “repress” a memory in a moment of stress and then “spontaneously recall” such a memory at a later time.
I will also counter your statement of “providing cover” by saying that the overreach of the concept of “false memory syndrome,” which properly applies ONLY to “memories” evoked or created by poor questioning or unethical acts by a therapist to implant memories the client has never said they recalled, has provided cover for people who have committed acts of abuse against children and yet can claim that their child’s recollection is a “false memory” in order to avoid the consequences of their criminal behavior. Surely, this should be as great a concern as therapists implanting “false memories” with poor technique or unethical attitudes toward profiting from creating upset in their own clients.
I am allowing this post to stand, ONLY because there is already a reply posted that indicates that the case in question is not about a person who is posting here. I have already asked that people be VERY careful not to intentionally or accidentally invalidate the recollections of any person who is sharing their personal narrative. This kind of post is extremely dismissive and invalidating, and if it were in response to someone’s own story, could be extremely hurtful. PLEASE do not post anything that could call another person’s recollections into question! This is NOT a place where people should have to “prove” their personal stories are correct, and those who demand such “proof” will be moderated without exception, and may ultimately be blocked from posting if this kind of thoughtless behavior continues.
I think you are splitting hairs here. The big question is not whether someone can introduce false memories with poor questioning techniques or intentional manipulation – we all know this happens, and there are systematic trainings on how to question kids to avoid such events happening.
The big question is whether memories can exist of which a person is not consciously aware, but which can come to awareness at a later time. If you call this “spontaneous recollection,” that’s your right, I suppose, but I fail to see any distinction between a memory a person files away to the “unconscious” file that can later be retrieved and the basic assumptions behind “repression.” Repressed memories, to me, would be memories that a person on some level becomes unaware of as a self-protection mechanism against being overwhelmed by pain or fear, or perhaps simply because they are unpleasant to recall. If those memories later become retrievable under less stressful circumstances, I think we have the full mechanism of “repression” in view, no matter what term you choose to refer to it. As long as someone isn’t “pulling” the memory out, I think “recovered memories” are a very valid phenomenon. Whether these memories contain all the information recorded with 100% accuracy remains debatable, but in the instance noted, a person is “triggered” to recall a memory of something that in all likelihood really happened. A lot of folks in the “false memory” school of thinking would question or deny that this memory could be a memory of a real thing that happened, and that I find to be a very destructive and unscientific viewpoint.
Sounds pretty damned legit to me. No one asking “leading questions” or encouraging “disclosures” of things that didn’t happen. Just a pure, spontaneous recollection. I see absolutely no reason to doubt such a recollection is valid. In fact, I’d think it rather evil to try and invalidate it.
I generally don’t remove moderated comments until the end of the month. At that time, it often occurs that a long string of “removed for moderation” comments appear at the same time. It is not the result of a change of policy, it’s just an administrative issue, based on the most efficient approach to saving copies of moderated posts before deleting them.
Are you suggesting that “precision psychiatry” would have to actually be focused on finding out what ACTUALLY WORKS and WHY, and applying it on a case by case basis?
“Precision psychiatry” can start as soon as psychiatry is able to precisely distinguish between an “ill” person and a “well” person. And I won’t hold my breath that this ability will develop in my lifetime, or ever. Because there is no way anyone can establish with precision that someone’s emotional condition is specifically caused by a “mental illness” that is based on committee consensus and voting.
A reminder that generalized comments about COVID-19 are going to be moderated at this point as “off topic.” The topic of the blog is whether or not those labeled “mentally ill” should be prioritized for the COVID vaccination. The wider discussion has led to deteriorating civility and increasing personalization of comments without contributing anything to the main topic, and also without much evidence that an actual exchange of information was going on. I apologize to those who are posting appropriate comments, but for the good of the community, this particular aspect of the discussion is closed.
Feel free to make comments on the basic premises of the article.
In the USA, receiving medical care is the third leading cause of death. Over 220,000 deaths in hospital settings alone are caused by errors or unnecessary surgeries, but most of all by side effects of properly prescribed and properly administered drugs. Seeing a doctor can be very dangerous!
I am glad to hear that you were able to heal, and I’ve known many who have been able to, probably a majority. But I have run into a number who seem to be set up now so that stopping the “antipsychotics” leads to massive “relapses,” and despite slow tapering and support, it seems they have now become dependent on these drugs for stability. Bob goes over the mechanism in his book, and it makes perfect sense. So I agree that keeping hope alive is critical to recovering from the “help” usually doled out by the psychiatric industry, but it does seem to become harder the longer one is on these (on the average), and there does seem to be some lasting damage that some folks are not able to shake, in my experience.
As in, “If you rail against abusive doctors, you must have a ‘personality disorder?'” And if the doctors are abusive, is there something wrong with railing against them?
I have no problem with “madness” as a self-description of a certain act or behavior – “I went mad!” Or “I had this mad idea…” I do see what you mean about it potentially becoming a counter-identity for someone being attacked or dismissed by psychiatry. I’m not sure I find that a bad thing – certainly better than kowtowing to the “authorities” and letting oneself be dismissed as “mentally ill.” But I can also see how it could still be viewed as accepting one’s “otherness.” In the end, I tend to agree that we’re all a bit “mad” in one way or another, and the distinction seems to fade away if it is viewed that way. Though it does provide a nice double-entendre, because we’re all freakin’ pissed at the system!
I think two years is just where the divergence becomes big enough to be obvious and undeniable. I am sure the damage is being done from Day One, but possibly it is more “healable” before the two-year mark, after which the changes become more permanent and deterioration becomes the rule of the day.
An excellent question. I do believe that self-healing has to happen before one can truly be of help to others in their struggle. What I hope we will work towards is communities of people caring about each other, as opposed to the “winner takes all” philosophy that seems to have the world it its grip right now. But this will mean challenging those who are benefiting so extremely from the status quo, and that will take love to a higher level of seeking justice for those we don’t personally know. It’s a big hill to climb!
OK, Richard, you get the last word here. We are now going to stop any further discussion of the generalities of COVID. Further discussion on this thread will be focused on the particular question of COVID vaccine prioritization for the so-called “mentally ill.” Any divergent comments regarding the possible causes and general approaches to COVID not specific to the article will be moderated as “off topic.”
Does it seem completely outside the realm of possibility that the virus DID accidentally escape from the lab and that the people who run the lab didn’t want anyone to know about it? I am pretty surprised at your complete confidence in the authorities to always tell the truth, given your experiences in the world of “mental health” where the authorities lie through their teeth as a matter of course. It seems contradictory to say that you can’t say with certainty that COVID 19 was not a lab experiment gone wrong, and yet say a moment before there is “NONE, WHATSOEVER” evidence that this might have happened. I think there is plenty of circumstantial evidence that such a release is quite a strong possibility, even if is is not a proven fact.
Does your question mean that YOU think it is a GOOD idea to create extra-infectious deadly viruses in labs, trusting that ALL the human beings in charge will ALWAYS act with complete and utter security to make sure there is NEVER an accidental release? If anyone really believes this is a good idea, I think I have some farmland near Chernobyl that they might be interested in.
It means the idea that somehow a coronavirus that is particularly virulent is coincidentally released just a few miles away from a lab doing research on making coronaviruses more virulent but that it is from bats at the local grocery stretches credulity well beyond comfortable bounds. Besides which, there is now some evidence emerging from China (via the US State Department) that some of the Wuhan Lab workers were ill with a flu-like illness just a few weeks before the huge outbreak was identified. I am by no means buying anything suggesting this is some kind of planned “plandemic” for some kind of nefarious but as yet vague plot of the Shadow Government to somehow obtain worldwide control by forcing everyone to wear masks or some such nonsense. However, history tells us that “High security” labs and the like are far from perfect, and escapes and leaks are not a rare phenomenon. Additionally, the Chinese have been quite protective of any information regarding this lab and how the pandemic got started. So while I can’t be certain of this, all the evidence leans toward the likelihood that this virus did, in fact, accidentally escape from the lab in some way. As the saying goes, “Never attribute to malice that which is easily explained by incompetence.”
Even if the virus did not escape from the lab, the possibility of such escapes is certainly more than negligible, and the idea of creating viruses that COULD cause a worldwide pandemic as a means of PREVENTING a worldwide pandemic seems quite foolish, to say the least. This research was discontinued by the Obama administration for a very good reason. It needs to be stopped, permanently.
I would appreciate it if you are a little more careful in your between-the-lines implications in your “questions” in the future.
I agree absolutely, modeling and education is what helps other people see the possibilities. As I said above, my only concern is that we need to go beyond the individual’s experience and work on system problems. I spent a lot of years advocating for foster kids, and despite repeated successes with individuals, saw the exact same situations arising again and again, because they were only responding to my or my CASA volunteer bugging them and pressing them to do the right thing, and never really learned why it was the “right thing” in the first place.
Oh, believe me, I agree with you completely, but it just can’t stop at the individual level, and we can’t allow those running the show to reframe all of this as “individual problems.” You know as well as I that the personal melds into the family which melds into the institutions we participate in which melds into the survival of the species as a whole. Each affects the other, back and forth, and I think that needs to be recognized for us to be successful.
You are probably right. I know of a few cases personally where the person had zero history of suicidal or homicidal impulses before the drugs. But I know from both research and direct personal conversations that the suppression of inhibitions is one of the cardinal effects of cranking up serotonin artificially. It is too consistent a report to be chance, according to my “inner p-value test!”
Although I think it is important to recall that this is not all about our individual abilities to empathize, listen, etc. There is also a very widespread lack of community connections that impact the most skilled communicators among us. There is more going on than a lack of individual skills here. It is, as they say, a “system problem.”
I am sorry if you thought I was referring to you when I said “beyond stupid.” I was referring to the authors of the DSM who make that claim, that if I’m not “over it” when my spouse dies within two weeks, I have a “mental illness.” It is the most absurd of many absurd things in the DSM.
It appears you are simply defining “illness” as “distress.” I don’t define it that way. I believe there is plenty of distress that is natural and normal and healthy and not a part of any disease process. I also believe that calling these things “disorders,” as the DSM clearly suggests we ought to, prevents research and interest in actual physiological problems that may be in play.
But it sounds like we are substantially in agreement on most points, except for that definition.
I don’t think we’re far apart here. You are choosing to define “illness” more broadly by far.
Just for the record, I have never regarded SUFFERING as metaphorical in any sense, and I don’t believe I said anything like that. The problem with the term “mental illness” at this point is that it is used intentionally as a means of denying that suffering has any kind of meaning beyond messed up brain chemicals. The idea of the “mind” being “ill” in the same sense as the body is the metaphor we’re talking about here. Suffering is very real. Saying someone “is mentally ill” because they are suffering is metaphorical.
Dang, we need someone to try and refute it! Of course, the fact that they haven’t even tried means they know how badly they would lose if they did. They want to preserve their ability to con most people by allowing those who have the resources to fight to get away with it.
That is, in fact, an excellent question. It is also worth asking how the other members of the family incorporate this destructive behavior with their image of the parent as a compassionate person?
Do you realize that the bulk of those “homeless mentally ill” who are talking with themselves are either taking “psych drugs” or have taken them without any real success? Do you know that some people have reported BECOMING psychotic after taking psychiatric drugs when they had none before? Have you noticed that the number of such people has dramatically INCREASED in the years since psychiatric drugs became the “treatment of choice” for such people? If these drugs are so great, why are there more and more “mentally ill” people living on the streets?
Were you aware that studies show that long-term use of antipsychotic drugs DECREASES chances of recovery? Were you aware that providing shelter for homeless people, with no other intervention, IMPROVES their “mental health” symptoms? Did you know that people are more likely to attempt suicide AFTER they leave the hospital than before?
I still don’t get why you don’t get what I’m saying here. There ARE physical illnesses that can be DIAGNOSED based on CAUSE. These are real illnesses/injuries of the BODY. They may cause what is currently called “mental illness symptoms,” but they are PHYSIOLOGICAL PROBLEMS that can be diagnosed as such. Would you say a person with low thyroid has a “mental illness” if they become depressed as a result? Is the child who is hyperactive because of disturbed sleep (sleep apnea or other sleep disruptions) “mentally ill?” Or do they have a physical problem that makes them act hyperactive?
Compare this to someone who is depressed. Diagnosing them with “major depression” can be done without the slightest reference to cause. They could be depressed due to a head injury, due to domestic abuse victimization, due to having a dead-end job and no chance of promotion, due to feeling unable to pay one’s bills, due to the loss of a loved one or a pet, due to confronting the difficulties of aging, due to lack of sleep, due to wondering what the point of life is, due to anemia, due to Lyme Disease… you get the idea, I hope? The “mind” is not “ill” because a person feels depressed. They may be struggling with something difficult, but that does not make them ILL. Their body can be ill/injured in a way that affects their mind via their brain (which is a part of the body). But being depressed does NOT suggest any sort of “illness” that can possibly be defined! It’s kind of like saying I pick my nose because I have “nose-picking disorder.” It is completely tautological and means nothing at all. It CAN be used metaphorically (“I experienced psychic injury as a result of my abuse” or “I need to heal from my difficult childhood,”) but until someone can show me the location in the body of the “psychic injury,” it is a metaphor and not an “illness” in the medical sense.
I think that is as clear as clear can be. I understand that “mental illness” is used generically to refer to any kind of emotional upset or reaction, but it’s obviously beyond stupid to say someone is “ill” because they feel sad that their dog died, or because they are anxious about asking a girl for a date, or because they find school boring. There is a clear and distinct difference between a physical illness that has emotional effects, and an emotional situation that has no physiological cause. If that’s not enough to explain it, I’ll have to just agree to disagree. It seems obvious to me that these are very different realities.
Of course, there is no actual way to objectively determine who “has bipolar illness,” so this provides a handy excuse to let the drug off the hook and blame the patient. I think it’s fair to say that suicidal and/or violent behavior can be caused by exposure to SSRI drugs, regardless of “diagnosis.” It may be that people with a “bipolar” diagnosis are more likely on the average to react in this way, though I have seen no scientific study ever done to prove this (and it would be difficult to prove anyway, as again “bipolar” is such a vague and subjective “diagnosis” as to defy any clear definition of who “has” or “does not have” such an ostensible “condition.”)
I am not in the least inclined to let doctors and drug manufacturers off the hook by blaming their victims as being “bipolar.” If they don’t know their craft well enough to judge who will and won’t become suicidal taking SSRIs, then they ought to admit that up front and warn everybody of this possible danger, rather than trying to hide it for decades and then complaining when the FDA forced them to put it on the label, claiming that “lives will be lost” if we tell people the truth. Well, guess what, making people suicidal and/or homicidal loses lives, too!
The hiding and denial of the adverse effects of SSRIs is one of the many heinous acts that prove psychiatry to be essentially a corrupt industry that is more interested in covering up their failure than in learning how to do their jobs better.
I am not saying that at all. I am saying that the legal definition is a SOCIAL definition, and that the legal system acknowledges the uncertainty and subjectivity of such judgments, and makes no claim to scientific verity (hence the need for a jury of 12 to make final decisions). The problem with psychiatrists in the legal system is that they claim to be able to KNOW who is and is not dangerous, who is and is not responsible, who is and is not aware of right and wrong, in some sort of expert or “scientific” way, such that other people’s judgment should be subordinated to them. It gives them WAY too much power, and is based on no actual knowledge that differentiates them from anyone else’s judgment, as has been shown again and again when the question of predicting danger or recidivism is concerned. Psychiatry has no right to claim expert knowledge of danger assessment or evaluation of a person’s state of mind at the time of committing a crime, because they as a profession have proven incompetent in such assessments. We are better off by far admitting that, and giving that latitude to the judges and juries who are appointed to make difficult, subjective judgments. Having psychiatrists in this role makes it way too easy for judges and juries to pass the buck and accept their judgments, rather than those parties having to personally wrestle with the difficult questions of capacity and safety.
Well, let’s say you brought the canon onto your third-story balcony then, and filled it up with dirt and planted petunias. I’d say it could serve that purpose, though a standard planter might be more practical!
It is true, the SSRIs most definitely can take away someone’s inhibitions, such that something which seemed horrible (I can’t kill myself, how would my mother feel?) can now seem acceptable, (“Ah, she’ll be fine, not my problem anyway…”) I had a friend once who called it “Zolofting” – where she simply didn’t care about what anyone or society thought about anything. This might seem like a relief to someone who was always worrying, but if someone was always repressing a desire to go on a shooting spree for fear of the consequences, it might not be such a great idea…
Still, there are plenty of reports of people who had no suicidal and/or homicidal impulses beforehand contemplating these actions after being “medicated” with SSRIs. And in any case, removal of inhibitions is NOT the same as “providing the energy” to do something. It is an alteration of one’s moral compass, a muting or deletion of the sense of right and wrong. And it is pretty damned dangerous! Though I’m sure you’d agree with me on that last point.
I would love to see someone challenge psychiatric “science” in court using the Daubert standard. The falsifiability standard as well as the discernible error rate standard would exclude any psychiatric testimony relying on DSM “diagnoses.” Has this ever been tried?
My research into the subject supports Cabrogal’s assertions. The recidivism rate, at the least, for intrafamilial sexual abuse is dramatically lower than for extrafamilial abuse. This doesn’t of course mean for a moment that serial sexual abusers don’t abuse their own children, but I think if we’re talking statistics, this pretty dramatic differentiation should be noted.
“Insanity” as a legal principle grew up as a completely separate concept from “mental illness” in the psychiatric world. Psychiatrists have made every possible effort to co-opt this judgment, and I find this extremely problematic. There is no objective way to determine who “has” and “does not have” a DSM diagnosis. While the concept of “diminished capacity” and “awareness of right and wrong” can be executed in the legal arena without any “help” from psychiatrists. Psychiatrists need to get out of the legal arena, because their claims of being able to determine “legal responsibility” are not grounded in science or even in legal tradition. They are grounded mostly in fantasy and in social biases that have no place in courts.
I also want to note the subtle but damaging implication in the statement, “…you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others.” The word “enable” is the problematic term. It makes it sound as if the depressed person is lying in bed, thinking about suicide or murder, but only doesn’t kill people because s/he lacks the energy to do so. It buys into the mythological trope that the “antidepressants” are not themselves creating suicidal or homicidal impulses, but that depressed people are ticking time bombs just waiting for the burst of energy enabling them to act on their dastardly deeds.
SSRI antidepressants, at the least, have been tested on non-suicidal people and a small but significant number of those become suicidal. THey were not “lacking energy,” they BECAME suicidal after taking the drugs. Similarly, these drugs were initially banned in Germany due to an increase in aggressive behavior in those taking the drugs. This information has been known for decades. Pretending that the “activation” of the SSRIs “enables” suicidal or homicidal people to act out their impulses is a false narrative created to absolve the SSRIs and their prescribers from responsibility for their known adverse effects.
I don’t want to seem impertinent, but I feel I need to ask one question: is it still “psychiatry” if it is focused on moving people through art and writing to change how we relate to each other’s suffering? That doesn’t sound like a “reform.” It sounds like an utter repudiation of everything psychiatry currently represents. Sort of like transforming a cannon into a flower planter. It’s not really a cannon any longer, even if it’s the same shape.
Just for the record, there are uses of the word “mad” (and I don’t just mean “angry”) that do not imply insanity. “Crazy” comes from the little cracks that appear in the patina of a glazed piece of pottery as it ages. So being “crazy” means having an interesting array of fine detail that transcends the original design.
But I do understand what you’re saying. No one has to identify as “disabled” to attack the status quo.
I am getting the very strong impression that this conversation is on the verge of escalating into a more personal one. I am not really seeing an exchange of views as much as an exposition of different positions, any of which have their perspective and reasoning behind them from the viewpoint of the poster. What I’m NOT seeing as much of is 1) exchange of statistical or scientific data or studies supporting one’s position; 2) personal stories to support the viewpoint being taken; 3) attempts by one “side” to understand where the other “side” is coming from.
The original point of the article was not to debate COVID or even the safety profile of the vaccines released to date. The article is about whether or not it makes sense to prioritize/encourage/enforce vaccines for people “diagnosed” with “mental illnesses.” There are many issues that this raises, including the question of what message it sends to make this kind of “prioritization,” whether force is being contemplated, whether or not the vaccine interacts with psychiatric drugs, etc. I think we’d do better to focus our energies on those questions. I think everyone has stated their positions fully and with passion, and further discussion along these lines seems likely to deteriorate as it has in the past.
If folks have actual articles, research, statistics to share, please feel free, but we really aren’t learning much by simply restating our positions louder and with more emphasis, and stating or implying that those who disagree with us are irrational or dangerous. Let’s either start listening and focusing on known facts, or get back to the topic at hand.
It is also because of an unwillingness to acknowledge ANY adverse effects of drugs used to “treat” the “mentally ill,” and the easy discriminatory biases toward blaming “the illness” for any escalation of “symptoms,” while of course crediting the drug “treatment” with any improvement that is noted.
Perhaps I misread your comment. Good to know we’re on the same page.
Though I don’t agree with your last statement. You are, I believe, referring to the “governmental” meaning of authoritarian. Being “Authoritarian” in my view does not require you to be the “authority” yourself. Every authoritarian leader requires followers who are unquestioning in their loyalty and allegiance to the leader. In fact, there are generally power hierarchies where the people at the top expect compliance from those beneath them, and those in the middle have to comply with those above, but get to order about those below, and it’s only those at the absolute bottom that don’t have anyone to dump on. To me, an authoritarian is anyone who believes in and subscribes to this kind of structure. As you can see, the key is unquestioning allegiance to those above you in the chain, and the absence of independent thought at anywhere in the hierarchy. Those who say that psychiatry must work “Because they are doctors, and they know what they’re talking about, and you aren’t, so I don’t care what you think” are as authoritarian as the psychiatrists that set up the system.
“According to Adorno’s theory, the elements of the Authoritarian personality type are:
Blind allegiance to conventional beliefs about right and wrong
Respect for submission to acknowledged authority
Belief in aggression toward those who do not subscribe to conventional thinking, or who are different
A negative view of people in general – i.e. the belief that people would all lie, cheat or steal if given the opportunity
A need for strong leadership which displays uncompromising power
A belief in simple answers and polemics – i.e. The media controls us all or The source of all our problems is the loss of morals these days.
Resistance to creative, dangerous ideas. A black and white worldview.
A tendency to project one’s own feelings of inadequacy, rage and fear onto a scapegoated group
A preoccupation with violence and sex”
Just to clarify: to assume that vaccines or any drugs are likely to present unknown dangers until proven otherwise is rational. To assume that all vaccines ARE unsafe or that the dangers out weigh the benefits REGARDLESS of actual evidence is irrational. I am not advocating for mindless acceptance of drug company or CDC assertions, as your post perhaps seems to imply. I’m arguing against automatically rejecting the possibility that something might be helpful based on past bad experiences with vaccines or drug companies or governments, or based on someone suggesting without evidence that there is some nefarious purpose behind such efforts and therefore not bothering to do one’s own research on the subject.
In other words, I’m opposed to authoritarian approaches, regardless of who is the “authority.”
Because not all of them have proven dangerous. It is irrational to assume that even all drugs are dangerous without evidence one way or the other. I do think it’s wise to be SAFE, namely to assume it is LIKELY there are unknown risks of ANY intervention until proven otherwise. But SSRIs are of course a horrible example. They are factually known to be dangerous, and those claiming otherwise are just ignoring the facts. But it would be foolish to assume that any new drug that came to the market would automatically be dangerous just because SSRIs are dangerous. That doesn’t mean I’d take something just because it wasn’t yet PROVEN to be dangerous. It means I would be extremely cautious about taking a stand before I knew the evidence. I generally never take ANY drugs, largely because EVIDENCE suggests that drug companies don’t do safety testing and hide bad information from the public. But if I do need to take a drug for any reason, I do a thorough research of what is known about it, and have no problem whatsoever telling the doctor or pharmacist that I’m not going to do what they say I should, even if they get snide or condescending with me. In fact, I avoid doctors as much as possible, and use nurse practitioners or physician assistants instead. And I currently have the good fortune to have a naturopath as my PCP! So I’m not apologist for the drug industry, which you should know very well by this point. However, being rational means allowing that despite their history, the drug industry may develop some useful things from time to time, and I need to be open to that possibility, particularly when a whole society is being affected by this particular “viral phenomenon.” It doesn’t mean I assume they are not lying to us or pretending to know things they don’t, as I think I made VERY clear in my prior comment. It just means I don’t rule out the possibility that the vaccine may be an overall benefit without gathering actual data as to the pros and cons. Which seems to be just what you advocate for in your other post.
So just to clarify, there is a difference between being “completely unaware” of something and “recovering” a memory of it, vs. knowing that SOMETHING happened and recovering more details and specifics at a later time. The latter is something I have observed many times.
Exactly! There is no known “additional risk” that comes with “mental illness.” It’s mythology. The only think Brendan Kelly missed is domestic abuse as an indicator of likely violence and danger. “Mental illness” doesn’t even come into the equation!
I want to be clear in my view that seeing all vaccinations as dangerous and ill-intended is foolish, but assuming that all vaccines are effective and benign and are intended to help is just as wrong. Each vaccine needs to be evaluated on its own merits. At this point, it does appear from what I’ve seen and read that the COVID vaccines are, in fact, generally effective in preventing infections. However, there has certainly not been enough time or research to determine what the long-term effects of these vaccines will be, and which people may have more severe reactions than the average. It also remains to be seen if those so vaccinated can still pass COVID to someone else (are they not able to be infected, or if they just become asymptomatic). It does appear that people with a history of allergic reactions may be at risk. There is also some suggestion, though this has not been studied, that older folks may be more likely to have adverse reactions.
So it’s never a black and white thing. I’d welcome people submitting actual studies or epidemiological statistics on the pros and cons of this particular vaccine, but I don’t think it’s particularly helpful to either condemn anyone supporting vaccines as a fool or a dupe, nor is it sensible attacking anyone who expresses concerns about the lack of safety testing or long-term experience. We are doing a rather uncontrolled experiment here, and folks do have a right to do their own research, and are not obligated to automatically assume that “these vaccines are safe” just because the authorities say so. But I also think we do a large disservice to assume that the vaccines are dangerous or intended to harm without gathering data to actually support or refute that position. Again, just because someone says it’s true, doesn’t make it so. Let’s allow people to do their own research and come to their own conclusions, helped by whatever data and research can be shared with each other.
And when force IS used as a last resort, that does not excuse forcing “treatment” on someone regardless of their agreement and intentions. I believe detaining someone for a criminal act needs to be completely separated from any idea of “treatment.” “Forced treatment” by definition is no longer “treatment” at all. It is force.
How is “forgetting things and later remembering them” any different from “recovering memories?” My experience as a counselor who does not EVER try to tell any client what to think or believe about their own experience is that many clients have the vague notion that “something” happened to them but can not recall at all what that “something is.” Yet when a safe enough space is created, they feel OK about remembering the details, without any prompting from me. Did they “forget something and later remember it?” Did they choose not to be aware of the information that they knew had happened so they didn’t have to deal with the consequences? Should I automatically discount these recollections because they did not have them before?
I used to have a vague recollection of my second grade teacher tossing a book across the room after yelling at us and shaking that book for some reason. I seemed to recall standing up in my seat, and then being out in the hall with another kid. That was it. I wasn’t really sure it had actually happened. It had a dreamlike quality about it. At my 30th high school reunion, I told this recollection to a classmate of mine. She remembered it really happening! She remembered me standing up in my seat and saying, “Miss Vaughn!” in an incredulous voice. She recalled her marching down the aisle, hitting me on the side of the head, and tossing me and Freddy Baughman out in the hallway. She even knew the name of the kid who was out there with me, which totally validated my recollection.
After hearing this, I recalled more information about it – what Freddy said to me, going to the office, seeing the nurse who checked out my left ear (which would have been the one exposed to her right hand as she hit me). I still don’t recall being hit, but it all made sense and checked out with what she remembered, and she was completely certain about it happening. She had “forgotten” the incident as well until I mentioned it, but instantly recalled it in detail.
So was my original haziness an indication that the incident was made up? Or that I had altered recalls? Do the additional tidbits I later recalled qualify as “recovered memories?” Or did I just “forget” and then “remember?” How on earth can anyone make that distinction? Who can possibly judge the accuracy and validity of these recalls besides ME, the person who was there? Of course, I will never know for certain exactly what happened, and it is possible that the details I recalled may be somewhat of an alteration of the actual events. But I have absolutely NO DOUBT that such an incident did occur, and that I had invalidated the reality of this recollection before getting validation and additional details from my friend Susan’s perspective.
I find the act of inducing “recovered memories” based on some therapist’s idea of what “signs” they see in the client to be utterly reprehensible. If that happened to you or your family, you have all my sympathy. However, to extrapolate from “memories can be induced by unethical therapists” to “clients are not able to remember things they may in the past have chosen to forget,” is unforgivably unscientific.
You are correct that “proving a negative” is particularly challenging for science. But just because science can’t “prove a negative” doesn’t mean the phenomenon does not exist. It just means we don’t know the answer. Practically speaking, I’ve found without exception that respecting the client’s recollections and perception of reality as their own, and respecting their right to create and modify their own narrative, is essential to any kind of effective therapy. Many people are suffering specifically because they have had their narrative invalidated or manipulated by others, including by unethical therapists. Each of us has to evaluate the quality of our recollections based on our own standards of judgment.
Let’s not make the leap to invalidating someone’s recollections for our own comfort. Each of us is entitled to define our story, and it’s not you job or mine or any other person’s to tell people what is and is not true for them.
I am not going to get into the semantics of what a “repressed” vs. “unconscious” vs. “forgotten” memory means. It seems like splitting of hairs to me. But I can state unequivocally that someone whose comment invalidated someone’s individual recollections/narrative would not be allowed to be published, so you would of course not read it. I trust you can read between the lines on this point.
NOT posting as moderator, I believe there is a pretty massive distinction between saying “repressed memory therapy” is nonsense and probably quite dangerous, and saying that no one can bring an unconscious memory (whatever you’d like to call it) to greater consciousness and awareness. The two factually have nothing to do with each other. One is a method of ostensibly “helping” someone recover assumed “memories” at the insistence of the “therapist,” the other is an observation of a process of how we recall (or don’t recall) things that are in our past. I think it is fair to say that scientific research has thoroughly invalidated the first, but that the second remains as much a mystery as the nature of the mind itself.
To be clear, this is NOT a response to andersone’s comment, I just put it here because I have to put it somewhere I think it will be read.
I want to note here for everyone that this is a VERY sensitive subject, and folks need to be EXTREMELY careful what they say, in terms of how it might affect another person who is reading. There are many people posting on this site who have been abused physically, sexually, or otherwise, and it is absolutely their right to tell their own stories and have their own reactions and opinions to this essay. The main way “false memories” are implanted or altered is by a person in a power position telling the person they are working with what is/is not true and invalidating the clients’ own recollections and sense of “rightness.” Please, let us NOT do this to each other here!
My read of the data is that 1) false memories CAN be implanted by poor technique by questioners, and 2) the question of whether “recovered memories” can happen is one that remains undetermined. As such, it is NOT going to be accepted by me as moderator for anyone to tell anyone else that their own memories are false or that recovered memories don’t exist. We need to respect that each person has the right to make their own evaluation on this question, which I believe is a question that actually goes well beyond what science can tell us today, and maybe will ever be able to tell us. Additionally, there are an unknown number of posters on this site who have already been TOLD by clinicians and family members, and in some cases even the courts, that their known, certain, clear recollections are “false memories!”
So please, tell your own stories, share what research you have, but be very careful not to suggest or imply that others’ recollections and experiences are not valid!
So you are saying the incident is recorded but “unconscious?” That’s what I always considered to be the case with “repressed memories.” They only appear to be “forgotten.” It’s more they are inaccessible, for the protection of the person who was traumatized. That really does make sense to me.
Agree 100%. The whole subject and industry is corrupt from top to bottom. But that’s another reason that these DSM “diagnoses” are so dangerous – they allow the industry to continue the fiction that these drugs are “treating” some sort of “medical condition,” rather than prescribing them to suppress feelings/thoughts/behavior about which they have no rational understanding, nor any intent to come up with one.
Sounds like some censorship there. If the Powers that Be are so convinced at the correctness of their opinions, why do they have to suppress anyone’s voice who disagrees?
Oh, and just by the way, DO you tell your clients that long term use of antipsychotics can lead to permanent movement disorders, diabetes, heart disease, weight gain, and possibly an early demise? If you don’t, why don’t you?
I am sure that lots of people who have been forcibly psych “hospitalized” would give your approach a big thumbs up. I think you are missing the context of these comments that doing a better job of using less force and coercion and attending more to social conditions would be an IMPROVEMENT, but that it does not address fundamental issues of power and pretense of “scientific-ness” in the current model, that are both misleading and potentially dangerous.
I once worked at a nursing home ombudsman’s office for the State of Oregon. I recall a home that was shut down and put into federal receivership still received over 80% “good” or “excellent” ratings. A lot of folks are willing to go along with whatever is offered and feel like if they’re treated with some level of respect, they’re AOK. They are generally unaware of the damage that may be done to others, and sometimes even to their own potential growth, because they’re doing what they’re “supposed to do” and they don’t know of any other way.
There are any number of folks who post here who might in the past have given in-home treatment high marks, and only realized over time that the “treatment” wasn’t really helping or was making their lives worse. And like I said, it sounds WAY better (in most cases) than being locked up after being arrested by the police! I mean, who can’t see the relative advantages there! Yet the basic assumptions of the system, that people “have bipolar,” that they “need treatment,” that drugs “correct chemical imbalances” or some physiological/genetic problem, are all still there.
So the question to me isn’t what your customer satisfaction ratings are, or whether “acceptance of treatment” is higher. The real question is what COULD happen to these folks if the current paradigm were scrapped and they were approached from a standpoint of people who have experienced difficult times and need support, rather than people who “have” a “disorder” and need to be “fixed?”
I want to say that I do appreciate your efforts. But I would encourage you to listen a little more deeply to the feedback you are receiving, and don’t be so quick to dismiss it as people who “don’t understand” or “reject treatment.” I’d suggest you listen from a standpoint of saying, “These are people who report having been severely damaged by the system I essentially believe in and promote. How and when is this happening, and am I inadvertently contributing to this kind of event, even when I think I’m doing things right?”
I would agree with the “multiple cause” theory, and that overt or specific trauma is not required to fit the “criteria” a “mental illness.” Of course, the fact that someone “fits the criteria” means essentially nothing at all if the “diagnosis” has a wide array of possible causes.
The main problem I have with these “diagnoses” (and others will raise other problems, I’m sure) is that they lump together people who have nothing else in common besides feeling, thinking or acting in a certain way and ASSUME that 1) all these people have something wrong with them, 2) they all have the SAME thing wrong with them, and 3) some form of “treatment” should help ALL of them “get better” in someone’s eyes. Of course, these “diagnoses” have absolutely no scientific validity at all, as Thomas Insel, the head of the NIMH, himself admitted years back. He said it’s like someone diagnosing “chest pain.” It is meaningless to make such a subjective and broad “diagnosis,” because it includes people who have literally nothing in common with each other besides a surface manifestation of some sort. It is not possible to conduct any meaningful research on a group of people who have no common trait. What would you be studying?
As to “innate vulnerability,” I’ll go to an analogy. If 50 people got hit by a car at a certain intersection, and 35 of them broke their legs, would we be studying that group for a diagnosis of “weak bone disorder” and find out what kind of “genetic vulnerability” they had to their leg breaking? Or would we study the intersection or crossing and find out why it is that so many people are getting hit by cars there?
Just for a little icing on the cake, the most optimistic estimate of the “genetic” contribution to any single “mental disorder” is well below 10%. Whereas people diagnosed with “schizophrenia” correlate with childhood abuse/neglect at an 80% rate or higher. Correlations between abuse and “anxiety” or “depression” are even higher. So the very idea that these “disorders” have a “genetic etiology” is over 90% mythology.
One question to leave you with is this: If there is a less than 10% genetic component and a more than 80% environmental component, and the genetic component is the one thing in the equation that can absolutely NOT be altered by any means, why are 90% of the dollars spent on studying genetics and physical interventions and a paltry sum being spent on studying environmental effects and how to ameliorate them? I think the answer says a lot about the ostensible “objectivity” of the current system leaders, don’t you?
I agree. I’ve seen many articles on the high suicide rates among doctors, and there is not a single word about “chemical imbalances” or “genetics” or even DSM “diagnoses.” It is all about stress, burnout, loss of sleep, rough schedules, inability to maintain relationships, poor training… not a word about “mental illness” is raised. And the remedies are all about creating better working conditions, selecting for a wider range of personality traits, improving the training process, changing expectations. In short, changing the environment rather than blaming the person who has a hard time adapting to it. Why does this reasoning not apply to kids in school, or foster youth, or victims of domestic and sexual violence, or victims of racism, sexism, and other oppressive structures?
While there is no doubt that some people would find this approach far less oppressive, it does not reduce the power imbalance and the frequency of coercion or abuse. I’d say that a person who agrees to “voluntarily” be treated at home under fear of being forcibly “hospitalized” is in no wise voluntary. Additionally, if the recipients of these voluntary “services” are only offered biological interventions, or are forced to accept biological interventions as a part of the package, or are misinformed about the limited benefits and potential long-term costs of these interventions (including the very real possibility of a significantly reduced lifespan), or are not offered the full range of alternative options (including sending y’all away at the door), we are still dealing with degrees of coercion, and the “voluntary” nature of these services is undermined.
Just a question: does your service tell those who are recommended to take antipsychotic drugs that they are risking shortening their lives by a decade or two by accepting this “service?”
How do you know she “had a mood disorder?” By how she acted? How do you know that how she acted was not simply a reaction to her abuse and oppression? What objective means do you have to distinguish who “has a mood disorder,” other than your own opinion or a subjective behavioral checklist?
When I used to do hospital evaluations, I ran into many women who were diagnosed with “bipolar disorder” or “anxiety disorders” who were feeling suicidal or panicky. I asked every one of them about their current relationships and abuse history, and every one (except two who would not talk to me) shared horrible abuse that occurred when they were young.
Maybe a “mood disorder” is no more or less than what happens to people when the stresses in their lives overwhelm their coping measures. In which case, do they have a “mood disorder,” or are they victims of a thoughtless and oppressive culture that continually puts people in a place where they can’t cope with the harm that they are repeatedly exposed to.
I totally agree! I’ll talk with anyone who wants to change things, no matter what they think the “new solution” is. Even those who are “reformers” are potential recruits for a more radical analysis. Heck, I was a “reformer” once upon a time! And we can work to get agreement with “reformers” on certain goals that will help in either purpose, like getting Miranda rights read to people receiving an “evaluation.” We need to generate power, and ideological purity isn’t a requirement to get things done.
At this point, I often bring up the fact that there is NO evidence, despite 50 years of biased research LOOKING for such evidence, that “ADHD” drugs improve ANY long term outcome, including delinquency rates, academic test scores, high school completion, college enrollment, mental/emotional well being, social skills ratings, teen pregnancy rates, drug abuse rates, or even self-esteem ratings. A number of long-term studies suggest diminished functioning in one or more of the above areas. So we are exposing millions of kids to the risks of stimulants, including psychosis, mania, weight/appetite loss, reduced adult height, alterations in personality, and a small but not insignificant chance of heart damage or death, to name just some. And yet there is no evidence to suggest that these risks are associated with ANY long-term benefits at all, in any area.
I think that is an important distinction. The conceptualization of emotional distress as existing in the BODY of the distressed person is the central evil that psychiatry is based on. The rest is all footnotes to blaming the patient/client for their own suffering. If it’s in their bodies, then it’s not something the powerful (or anyone) in society needs to worry or think about.
The first “choice” should be to choose to decline any “help” that the person finds unhelpful. And that should include the “choice” to reject the framing of his/her problems as a “mental illness.” That choice is seldom if ever afforded by those in “the system.” Once that choice is denied, any further “choices” become fairly illusory.
“How can you reduce your exposure to violence in your life?” rather than “How can we work together to stop people and institutions participating in violence against citizens?” Or even more so, “What is going on in our society that creates and encourages violence and oppression, and what can we do to. change those conditions?”
I want to post an interesting question here, David: is it “treatment” to help the victim of an extended set of violent criminal acts to avoid further victimization?
This is my experience also. Practical considerations sometimes requires using the language of the oppressor to get one’s point across and have the desired effect. Real advocacy requires a focus on getting the product, however it has to be gotten. The finer points of philosophy can be addressed in a different forum.
SOME correlation? The correlations with biological markers come in at single digit correlations at best, while here we’re talking 50-80%. I’d say there is a VERY STRONG correlation with “mental illnesses,” and that’s not counting the damage that does not show up at the “mental health system’s” door.
Let’s simplify by expanding the list to include: EVERYONE! NO ONE who isn’t voluntarily asking for it is appropriate for psychiatric “hospitalization.” In fact, calling it “hospitalization” is a misnomer. “Psychiatric detention” is the most polite term I could come up with. “Incarceration” is closer to the truth.
I am aware that “mindfulness” is part of DBT, and a significant number of commenters on MIA have stated that they were coerced into doing “mindfulness” during DBT, or else suffering some kind of consequence from the group leader. While this is completely contradictory to actual meditation practice, it is being done, and frankly gives a very bad name to what I’ve found to be an extremely powerful and helpful practice.
Absolutely not. I’m always amazed that the same doctors who hand out drugs that demonstrably cause earlier death in recipients, and warn strenuously that taking large doses of niacin or vitamin C is dangerous, or that homeopathic stuff is a terrible hoax and waste of money.
I have seen brain studies on Buddhist monks who have meditated for decades. It indicates that the areas of the brain associated with calmness and focus are larger. Now that doesn’t mean that people being forced to “meditate” are going to see any benefits, and I’m guessing they probably are likely to be harmful in some cases. I do have serious doubts about actual brain damage occurring, but psychological damage seems likely whenever force or coercion is involved.
The only real benefit of these spy cameras would be to catch the evil actions of the staff toward the patients. But somehow, I don’t think that’s the purpose of it.
There are dupes who believe this is for the benefit of the “patient,” but these people are duped. The forces behind anti-stigma campaigns are not concerned with the welfare of the “mentally ill.” They are trying to protect and expand their markets. It’s true that NAMI feels like they are helping out, but they are funded to a very large extent by Big Pharma.
I don’t see awareness campaigns as “symbolic,” I see them as marketing schemes for the psych system. They are selling the idea that people have “mental illnesses” and that the system has solutions to these “mental illnesses” and that anyone who says otherwise is “shaming” the “mentally ill.” It has no other real function than to publicize and sell the concepts above, as far as I can see.
The “mental health” version of “mindfulness” was also appropriated from Buddhism and Hinduism, and as such, misses a lot of the substance of what “mindfulness meditation” is really about and what it is intended to accomplish. It’s not about breathing deeply to make us feel less anxious, even if it happens to have that effect. But anything spiritual seems to be anathema to the mental health industry, and in particular to most of the psychiatrists I’ve encountered.
Just to be clear, there was never any kind of ban on the SUBJECT of COVID. The last conversation was shut down because of the tone of the participants, and the escalating personalization and attacking nature of the comments. Facts and experiences on any subject are always welcome to be discussed, as long as it is within the Posting Guidelines.
My point has nothing to do with the “learning” aspect of school. I always knew from the start that school was not about “learning,” it was about COMPLIANCE and HIERARCHY. Knowing your place. Dumping the shit downhill on the person on the next lower step. Not challenging the basic assumptions. Trusting the “authorities” to have the answers and subduing any independent sense of reality.
The advantages of online school for me would have been
1) No need to be with rude and obnoxious and bullying teachers all day. Having a mute button or the ability to walk away from the screen if they were abusive. Not having to stay in at recess because I talked to someone at the end of lunch. Not having my teacher be able to throw a book across the room and hit me on the head when I objected.
2) No need to be with obnoxious and bullying peers all day. No recess sitting wondering if anyone would want to play with me. No having to stand by and watch when other kids were being abused.
3) No need to get up at the wee hours and take the bus. ‘Nuff said there.
4) Ability to proceed at my own pace on things without having to wait for the class to catch up.
5) Plus, I could have gone to the bathroom without getting their freakin’ approval!
Naturally, it is quite possible to make distance learning just as obnoxiously authoritarian as in-classroom school. But it would have made me feel a lot less anxious just to know I could be where I was and not be subject to the whims of the teacher and can turn my camera off at my discretion, even if they got mad at me. I’d have given a lot for those privileges.
The lack of a means to objectively determine if something “works” is the achilles heel of psychological therapy. People argue endlessly about what “works best” without any definition of what “works” really means.
Are you suggesting we have to TALK to these people? Whatever for? Much quicker and more remunerative to just drug ’em and blame any bad results on them.
That’s a pretty tenuous hypothesis, Oldhead. I think it would require extensive study, including multiple replication studies, to prove such a connection. Correlation is not causation, you know. I think we need to set 20 million or so aside to make certain!
I agree. The title should read, “Antidepressants can cause manic behavior in many who take them.” Honestly, from talking to a number of people who have taken them, I kind of think that’s what they do. For people who are really withdrawn or super anxious, it probably feels good as long as it doesn’t go too far. But I’ve never taken them myself, so I really don’t know. In all likelihood, different people have totally different experiences. Which is really not a good thing if everyone who “has depression” is encouraged/forced to take them.
I am going to agree here that this has most definitely veered in too personal a direction. I think everyone has had a chance to make their points, and folks can go ahead and read and make up their own minds about it. Or better yet, visit the site and see what you think.
At this point, I am not going to post any further comments along this line of discussion. It is apparent that there are personal feelings and disagreements here that are best resolved by individual conversations. I’m happy to connect people who feel the need to talk to each other via email, but for purposes of this discussion, we need to refer back to the content of the article, and any personal complaints or criticisms will no longer be published.
Though I will say on my own behalf that being IN school was what was making me feel suicidal. “Distance education” would have been an amazing gift for me.
Which goes to show that trying to do the same thing for every child is dumb.
Psych “diagnoses” are opinions, every one of them. It is ridiculous to apply such a term to a so-called “illness” that is not objectively observable or determinable. Like saying someone who doesn’t acknowledge that they’re “cowardly” is suffering from “anosognosia.” There is a proper application of the term to a known, observable neurological problem that can be tested for and verified. Saying someone has “anosognosia” because they disagree with your opinion is about as far away from scientific as you can get.
I don’t expect him to. I don’t know of any politician, “liberal,” “conservative,” “independent,” or anything else, who has done diddly squat for the survivors/victims of the psychiatric industry. They mostly are partly owned by the pharmaceutical industry. But that’s kind of a weird question to ask in the context of my question. I just want to know if there is any initiative that I need to get my energy behind.
Can you let us know what exactly happened under the Trump administration to help those victimized by the “mental health” industries? I have not heard anything about that, but I’m happy to learn more.
Additionally, since 90% or more of the funding goes to drugs, naturally, the only “evidence base” that exists is for the drugs. So anything else, except DBT apparently, can’t be considered “evidence based,” because the lack of financial incentive means no one has bothered to study it!
Enforced “mindfulness” is a contradiction in terms. If you’re being forced, how can you remain “mindful?” People who choose to use it may find it helpful. And they may not. And the “mental health” authorities should do some themselves before they even think of trying to force people to do something meant to help people feel more self control in their lives!
Right you are! What if he said, “Well, we don’t know what really causes depression, but microwave radiation from cell phone towers may play a role?” Everyone would be immediately (and appropriately) up at arms! Science doesn’t speculate, except in the formation of hypotheses. It makes zero sense to share hypotheses that are purely speculative as if they were somehow sharing some budding scientific discovery that is “just around the corner.”
If Pies’ theories on the delicate balance of the “symphony” of chemicals are true, I’d have to say that how psychiatric drugs are used by psychiatry would be akin to tuning a fine violin with a pair of barbecue tongs and a ball peen hammer.
“The authors emphasize that many intervention techniques currently available to relieve CMDs miss the mark. Tension exists between some orientations to intervention harbored by mental health professionals, and issues of access and effectiveness continue to compromise the impact of existing supports.”
This is impressive double-speak! To say that an intervention “misses the mark?” Doesn’t that mean that we are spending money and time and energy on things that DO NOT WORK? If an engineer “misses the mark,” his bridge falls down and he gets fired! And tension between “some orientations” and “effectiveness” seems another way of saying that practitioners continue to insist on using interventions that DO NOT WORK!
Sounds like job protectionism for the incompetent to me!
There were lots of “good people” who participated in atrocities in Nazi Germany, and lots of other places around the world. The Milgram experiment ought to have taught us all that years ago. “Good people” who don’t think for themselves are always vulnerable to being manipulated or “educated” into doing horrible things.
Meaning that his behavior was pretty predictable to a person who had no particularly advanced training in “psychology” or “psychiatry” or anything beyond an ability to observe the obvious.
His behavior is consistent with a person lacking in ethics and willing to bully and harm others in the interests of pursuing his own goals. His speeches from day one appeared to be calculated to play on peoples’ fears and prejudices and to bring out the worst in terms of hatred and division between Americans. It was also clear from the people he hired and who traveled in his circles that he had criminal connections and engaged in his own personal forms of corruption. Not to mention the constant lying about everything, and his tendency to turn violently against his “friends” as soon as they said or did something he found threatening or even disagreeable. I didn’t even consider his personal life, though of course, it is totally coherent with my observations that he is selfish and bullying and corrupt. (Paying off prostitutes to keep quiet? Cheating on his wife? Bragging about grabbing women’s private parts?)
As to the insurrection, he started telling everyone back in March or April how the election was going to be “corrupt” because of “fraud” due to voting by mail. It was obvious that this was going to be his backup strategy in the likely case that he lost the election. It became more obvious in the summer how desperate he was, as COVID raged and his popularity ratings tanked. The hiring of a postal service head who intentionally slowed the mails showed just how lacking in any kind of ethics he was. The civil suits aimed to make sure that the mail-in votes (likely to be heavily Democratic due to his previous lies about the unreliability of mail-in votes) were counted last were a pretty obvious ploy to make it look like he was ahead at the start and have Biden catch up later in the evening, leaving him free to claim “victory” before all the votes were counted and to claim “fraud” and being “cheated” out of his supposed victory by those evil mail-in ballots. The eventual end game was for him to inflame his supporters to go to bat to keep him installed as “President for Life” regardless of the electoral count.
So yes, it was utterly predictable that something of this sort was part of the plan. The “stand by” message to the right-wing militias should have made it obvious to anyone whose eyes were open.
Actually, according to quantum mechanics, all matter has both a wave and a particle aspect. The wave aspect of large, solid objects is so small as to be negligible, but when you break it down to a molecular/atomic level, the chair you’re sitting on is a particle/wave phenomenon, and there is an infinitesimal possibility that it could suddenly become empty space and you’ll fall on the floor on your butt!
I am actually working on a comedy routine and am ready to roll it out for the public as soon as “open mic night” is back in operation. I call it, “Intelligent design.” I agree with folks that design by a Creator is a reasonable position to take. But then I ask the question, “If we were designed, I have to ask – how intelligent is it?” Of course, psychiatry is going to have a place in the routine at some point.
That is my feeling. A person should be removed from office based on their inability/unwillingness to execute the duties of the office with integrity. Corruption, neglect, malfeasance, poor judgment, dishonesty for personal gain, these should be the things that are considered. Behavior, not “diagnosis,” is what matters.
Or why not just stick your finger in a socket 3 times a day for a few weeks? Makes about as much sense, and it would be cheaper, plus you can stop if you don’t like it.
There is no data indicating that psychiatrists or psychologists are any better than anyone else at determining levels of dangerousness than the average Joe on the street. And there are plenty who are “diagnosing” him at a distance.
I personally think “religious cult” is a much better descriptor than “conspiracy theory.” They are not operating ON a conspiracy theory, THEY are conspiring themselves to make money off of misrepresentation of truth and off of their status as “doctors.”
Can’t argue with you there – the intention to avoid inconvenient realities is pretty widespread these days. Or to put it another way, no good discovery goes unpunished!
I would say that true science has helped accomplish a great deal in terms of technology and knowhow. You can’t program a cell phone or create an electrical grid or fly a plan without science. However, what PASSES for science these days is often corrupted, either by money or desire for status, or the need for society to have “answers” to questions that science can’t address. Psychiatry is NOT a science in any sense of the word. It masquerades as a science and pretends knowledge that it does not have.
This doesn’t mean a true scientific approach can’t be taken toward human beings. It means that science has to be honest about what its findings are. For instance, 50 years of genetic research has failed to indicate any genetic basis for any “mental illness” identified. This ought to be considered proof that “mental illnesses” don’t have a genetic origin. But this result is not accepted. In fact, psychiatry fails from day one in being a science, in that its terms are not definable by any objective means. If you make up “diagnoses” without any reference to objective observation and measurement, any claim to being “scientific” are already out the window.
But wait, not everyone’s hair gets as wet as everyone else’s! Maybe we should be more careful to study how those with wetter hair may be suffering from “wet hair disorder!” Or are the dry ones the ones with the disorder? I’m not quite sure… well, let’s just study it further anyway…
And so what? If they actually had something worthwhile to offer, it might be worth some risk of offending people or risking some false positives to get them some information. But they offer hopelessness and dependence on life-threatening, soul-flattening drugs that may or may not even work to “reduce the symptoms” of a “disorder” (and may in fact bring about the very “disorder” they’re supposed to address) that there is a 50-50 chance they won’t even develop??? Are these people serious????
Even geneticists don’t believe in genetic determinism any more. Except for simple one-gene traits like eye color, environment massively changes genetic expression through epigenetics. Genetic determinants are the “holy grail” of psychiatry, always on the horizon but never actually in hand.
Wow, is this only the 100th time or so that this finding has been made? Maybe we need to spend 20 more years testing to REALLY make sure that there isn’t the SLIGHTEST correlation…
They are saying that psych research has a “replication problem.” Maybe that’s because they’re framing it wrong – they DO get replication again and again that their hypotheses and theories ARE WRONG. But since it doesn’t validate their preconceived prejudices, they consider it “failure to replicate” instead of the clear and repeated replication that their hypothesis holds no water.
Yeah, I know – why put all this energy into the one element in the equation that can’t be changed, especially after all these years of no results? You’d almost get the idea they don’t WANT to look at abuse/neglect/stress as causal factors…
As I read this, I think you’re both right. The DSM is, by design, not based on understanding of “mental health” (whatever they claim it to be), nor is it intended to heal anyone. It was originally a billing manual. But the use of the DSM is determined by people who don’t really want to help. So it is evil because it enables abusive “mental health treatments,” but it enables those because it is designed by people who are actually committed to making sure no one gets better.
It certainly does provide all the “cover” needed to do lots of disguised harm and have people believe you know what you’re doing. And the DSM III forward were designed specifically to allow psychiatrists to pretend they were doing “science.” There are no doubt many ways to screw our fellow humans over, but there can be no doubt that the DSM exists for the purpose of making the whole psychiatric worldview/deception viable.
Human needs don’t sell drugs, and take way too long to discuss, so one can’t bill $300 for 15 minutes any more. Besides which, you might actually make your clients better, which means you have to look for more clients.
There is every indication that the very fact of being “diagnosed” leads to stigma, particularly to the degree that such “diagnoses” are associated with biological explanations for the “diagnosed” person’s suffering. It is built into the psychiatric system – the system itself stigmatizes those it serves as a matter of course. The only way to avoid this kind of “stigma” is to develop a different system.
That is SO true! Anxiety is almost always associated with abuse, in women especially. Yet I have seen many, many “evaluations” done and “diagnoses” reached without any attempt to even screen for abuse. It is appalling.
The “free market” is a scam. There is no “free market” today. Even Ayn Rand agreed that “free markets” require a way to avoid monopolization. Real “Free markets” exist only in a social context, where there are rules of competition that are either agreed upon or enforceable. They seem to work well in smaller communities where there are direct and immediate consequences for mistreating community members. But to think that today’s corporate grift and corruption even vaguely approximates a “free market” is a joke. Most of those objecting to “regulations” really just want the regulations that keep them from risk-free profits to be eliminated, and love the regulations that protect their market share. There is a sociopathic drive to “profit” regardless of the social effect, or even the legitimacy of the product, as psych drugs definitively prove. The Koch Brothers, supposedly super-advocates for the “free market,” advocated for increasing taxes on rooftop solar in Oklahoma the minute it started threatening their profits. This kind of thing happens all the time.
I agree that complacency is a huge part of the problem. Unfortunately, a lot of complacency is disguised apathy by people who don’t see any way to “win” or even break even in the current economic structure. The “criminals on the planet” are running the show, whether through manipulating/corrupting government officials, controlling media messages, undercutting or buying out the competition, destroying small farms/businesses with the assistance of the government, and so forth. How much can even the most vigorous individual do against the evil of Novartis or Monsanto? To challenge this requires organized resistance, no matter how spiritually aware and capable the individuals are. Where does this organizational energy and MONEY come from?
Well, I don’t disagree. I think Sanders said “AT LEAST” they should be able to afford to live, and the fact is, people making minimum wage and even well above minimum wage do NOT have enough income to feed and shelter themselves and their families. Clearly, that is a VERY low bar, and yet we fail to achieve it. So yes, something is drastically wrong with a system that values real work so poorly and yet rewards screwing around in the casino of Wall Street producing NOTHING of value so well. Better pay and fewer hours for everyone should be goal #1 to help create a better society. People shouldn’t have to work three jobs to make ends meet when others make $10,000/hour or more. But try to tell that to those benefiting from the status quo.
I think you get my drift. People should be paid relative to their contributions. There is no “law” to determine this – it is a matter of personal and group ethics, a subject that sorely needs more study and commitment, obviously. So I agree, spiritual growth is at the center. We don’t need a society where some group enforces the rules on value of work, we need a society where those who are in management recognize and reward the contributions of those who contribute well, or better yet, a collective-type workplace where the group agrees on what people get paid for what work. But that takes emotional/spiritual work and courage, and that seems in short supply in our industrialized, corporatized society.
I think the point here is not that we should just give people money. It is that the stress of economic poverty is a huge causal factor in “mental illness” as “diagnosed” by the DSM. Creating a plan to deal with poverty will improve “mental heath” more than an army of therapists ever could. To paraphrase Bernie Sanders, anyone working a full time job should be able to make enough money to pay for food, shelter and the basic necessities of life. So, people should get more money as compensation for the valuable work they are already doing. If this were the case, “mental health” would improve dramatically, as well as the economy expanding due to more people having disposable income. No “communism” necessary!
Or course, the “mental health” industry will object to any such efforts, as they will lose clients and income. But we can come up with re-education programs to train them to become more productive contributors to society. And those rich criminal types (not all rich people, but a large subset who are getting paid lots for doing little) who are skimming money off the top while producing little to nothing will, of course, object strenuously, but what do we expect from non-productive criminals?
Isn’t it a form of stealing not to pay people wages that reflect the actual value of their work? Why do the well off get to blame it on a broken system, when those whose lives are being stolen from then via the wage slavery this broken system rewards don’t have that luxury.
Some are, some are not. It’s not possible to make generalizations about MSWs. Some work in psychiatric centers, but I’d say most do not. Some do individual therapy. A lot just work in various social services roles, like child protection, domestic abuse survivor support, working with the homeless, and so on. Social workers are a pretty diverse lot.
In other news, death threats are noted to increase anxiety, and permanent incarceration in a dungeon without charge or hope of release has been linked to depressed mood. It is noted that not all respond to death threats with anxiety, and is postulated that this reaction is due to a chemical malfunction in the region of the amygdala which amplifies the fear response. Of course, those who don’t experience increased anxiety score high on tests of psychopathy, but hey, it seems like psychopaths are better equipped to deal with direct threats to their welfare, which is quite adaptive when confronting other psychopathic killers.
The only point I’d disagree with is your use of the terms “contamination and degradation” in regards to psychiatry. Psychiatry was already contaminated and degraded plenty long before neoliberalism arrived. I’m sure they were absolutely thrilled to meet each other, as psychiatry as an institution was already committed to the goal of making money and maintaining the status quo, whatever the cost to its patent base, and they have proven a perfect support for Neoliberalism’s most damaging premises, without having to modify themselves in any way.
If the car itself had a flaw which only occurred in one car in 100, but that one driver got killed, I’d care a lot about that, and the fact that you had no trouble with your car would not convince me that the car did not pose a danger to drivers. I hope that distinction is clear. The assertions here are not that someone had an accident with the car, but that there is an “intermittent” problem with the car itself that most people won’t see, but those who do see it can be seriously harmed. This is a very real problem seen frequently in psychiatry. Only one person in 20 becomes psychotic on stimulants at normal dosages, but those 1/20 can be severely impacted. Only perhaps one in 200 have a violent outburst due to being on SSRIs, but those small few include murderers. Should we not tell people that this is a risk, even if the risk is small? It is not reasonable to minimize or dismiss real risks just because they don’t happen that often. The stories being told tell me that such risks are very real and should be taken into account as a person considers this treatment, even if some people choose not to risk it as a result.
As I said before, I expect people to respect that others’ experiences are valid. That goes both ways. It sounds as if some are experiencing your comments as invalidating the experiences of those who have had different experiences than you. It sounds like you have felt the same way about others’ comments. That’s what I am concerned about.
Interesting. What are these perceived “barriers to implementation,” and from whom do they come? It seems to me that almost any patient would be foursquare behind being actually told the truth and being consulted before agreeing to a treatment plan. It seems to me that the only barriers to implementation have to come from the rigidity of authoritarian practitioners who want their patients to blindly follow their dictates and are afraid that telling the actual truth will lead to pesky difficulties like the patients actually discovering that these “professionals” don’t actually know what they’re talking about.
MissDolittle, of course, TMS *can* help people because that’s how the placebo effect works. What hasn’t been demonstrated is that the help you believe you got from your treatment should somehow have more weight than the stories of harm from those who were not helped by this treatment. There will always be people who feel that TMS or ECT or psych drugs helped them. There will always been people for whom these treatments were neither helpful nor harmful. But we also have to sit with and reconcile the pain from those who’ve been deeply harmed by these treatments.
You seem to think “screw you, I’ve got mine” is a reasonable response to someone else sounding the alarm about the damage these treatments have and continue to cause to people who weren’t as lucky as you.
You haven’t done anything to prove the efficacy of TMS, only your lack of compassion.
I am concerned when you say you don’t care what anyone else says. TMS may have worked for you AND harmed others. Does it not concern you that others may have been harmed? Does it invalidate your success that other people may not have experienced the same thing? It is OK that you found it very helpful and other people found it unhelpful?
I am not speaking to a particular poster in saying this, but I think it needs to be said.
I think this discussion will be a lot more productive if each person allows that others may have had different experiences, and not try to “explain” how other peoples’ experiences have happened. I think we need to respect that different people experience the world differently, and the fact that something “works” for one person does not mean the other person’s experiences are not due to the “something” that person one feels like works for them. Or vice-versa.
It seems to me that the science on TMS is not very well determined, and the “science” on “mental health” is almost completely absent. So we’re going to get into different opinions and experiences, and that’s OK. Especially when dealing with something as amorphous as “depression,” there is no reason to believe or expect that any two people will have the same experience just because they’re both feeling “depressed.”
Of course, it is possible – genes play some role in everything we do. The point is, the psychiatric profession WANTS to blame the genes and distorts the research to try and force that conclusion. And despite that, genes still fail to explain anything about any psych disorder consistently, even a small percentage.
I look at it this way: we all have genes, they are pretty much fixed from birth. They are not something that can be changed. There are LOTS of other variables that CAN be changed, through epigenetics, through individual efforts, through improved social structures, through community supports, etc. Why focus our attention on the one thing that can’t be changed? Why not focus on the things we HAVE control over, especially as genetic research so far is a huge bust, despite billions of dollars having been invested in it?
The other thing about genetics is often overlooked – a particular set of genes may allow vulnerability to certain conditions, but might also make other conditions possible. A hugely disproportionate number of our poets, writers, playwrights, graphic artists, etc. have had psychotic experiences. Perhaps a certain set of genes opens us to alternative experiences of life and enables artists to flourish? And snuffing out those genetic variations snuffs out a lot of creativity and motivation to change and grow in society?
The way psychiatry approaches genetics borders on eugenics. They want to “stamp out” the “bad genes” without any real interest in understanding the purposes of those genes. Species survival depends on genetic variations. Genetic differences are not “diseases” or “disorders.” We would do best to simply understand that we have the genes we have and learn to work with them.
I fully acknowledge not knowing what these things mean, mostly because I don’t think they mean anything specific, but are simply descriptive syndromes that don’t really hang together in terms of cause.
As for politeness, I find it perfectly viable to be both polite and firm. Of course, there are people who won’t respond to politeness, but that’s no reason to toss it out in every single case. There are plenty of people who will listen better if the person speaking doesn’t start off being presumptuous and offensive. I save that for those who don’t seem to be capable of hearing things presented more rationally. Which, admittedly, is a lot more common in this particular field of endeavor.
I have a hard time thinking there can be a unitary cause for psychosis, since we know that it can be caused by things as disparate as several days of no sleep and excessive stimulants and childhood sexual molestation and living in an urban environment. But I’m interested to hear – what does Jung say is the cause? I have read some of Jung’s work but this one has not come to my attention. And any explanation that gets away from brain-blaming seems very worth considering to me.
If the opinions of those who say it doesn’t work for them are questionable, why aren’t the ones of the people saying they work wonderfully similarly questionable?
The point of putting quotation marks around “psychosis” is not to deny such experience exists, but to take away the implication that “psychosis” is a “thing” that can be viewed as a unity. It’s an experience that has many potential causes, which have been lumped together into one purported entity for purposes of making money and saving the trouble of having to seek out the actual causes.
Tell you what – I won’t correct your language in the future, and you don’t correct mine. If you wonder why I’m using a particular convention, maybe you could ask instead of assuming and telling me my own reasons? It would seem a lot more polite to me.
If I had a repair manual for a lawnmower and tried to apply it to an airplane engine, you’d be pretty disturbed if I said, “If somebody has something better…” you’d think that I was pretty stupid or unethical. Either the model works or it doesn’t. If it doesn’t work, you work on developing a new model. You don’t continue using the model that doesn’t work, and you especially don’t claim that the principles of this model apply to the situations where we know they do not apply.
Did I say otherwise? I think you are interpreting. My point is that denying the cognitive damage due to antipsychotics is contrary to known facts. It seems you agree with me.
If we are not “bound” by the DSM, and the DSM is de facto not useful to determine what we need to do, what is the freakin’ point of the DSM? Is he finally admitting that the only real purposes of the DSM are as a billing code manual and as a doorstop and back up toilet paper dispenser?
They only make sense when we assume the objective is making money. If we assume the objective is helping people get better, of course, it all seems bizarre. But in terms of turning a profit, it’s all quite logical and effective.
I agree 100%. There are the intentionally evil, a small cadre in charge, and a lot of dupes or petty tyrants who go along with the program. None of it is designed to assist those receiving the “aid.” There are many things that can be done which are not conceived or are actively suppressed by the “mental health authorities” because they disturb the larger agenda of making money and keeping people from gathering together to protest.
What about the insanity of the people who continue to push and enforce these drugs on people despite consistent evidence of harm and early death? There is plenty of evil that is not caused by psych drugs.
“I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan;…”
I think “work” and “job” have become synonymous. “Job” used to be a term of disparagement, implying a low-level means of making a living. It is very different from “work” or “employment” or “calling.”
“job. (1) A low mean lucrative busy affair. (2) Petty, piddling work; a piece of chance work.”
Actually, I don’t think you get what I’m saying. I’m not suggesting that “lived experience” per se automatically gives one natural authority. It is based on one’s competence in accomplishing the tasks at hand. And you’re right, hierarchy does seem to be a natural outgrowth of human groups. I’m saying that the optimum situation is where the official “authorities” conform as best they can to natural authorities, and that such authorities that do exist in the hierarchy respect the fact that their position does not preclude someone else knowing more than they do about a subject, and that the ostensible “subordinates” don’t assume that the authorities automatically know what they’re doing.
“Benefits exceed the harm” is a very different standard than “First, do no harm.” It seems to be what is currently adopted, but it’s not the oath they take.
I think the problem is more one of designating certain people to be in power based on the number of hours they spent in the classroom or the amount of property they own or the kind of asses they have kissed. There is such a thing as legitimate authority, but it’s not based on a person’s degree.
Unfortunately, that is how sciences is taught and viewed far too often. What you describe is the opposite of science, but most people don’t seem to really understand that.
I find the ability to temporarily step out of one’s own biases is helpful to making rational decisions. But I agree, engagement is inherently subjective, and trying to permanently remove subjectivity is a road to a dark place.
The first step toward neutralizing one’s subjectivity is to notice that it exists. Most do not get that far. Those who assure you they are “objective” are usually the most dangerous of all!
I find that the term “doctor” when applied to those focusing on mental distress reinforces the idea that there is something wrong with the distressed person, and that medical “treatment” may be needed. Does that seem true to you?
It is actually a false expertise, kind of like being an expert in alchemy, but a lot more dangerous. Being an expert in “psychiatry” has no relationship to being an expert in human relations or human suffering.
Oh, I WISH they bothered to listen and encouraged patients to talk! Most of them don’t give half a hoot what the patient says, except to convey their “symptoms” for the doctor’s guidance in prescribing something to suppress them.
I would say that I DO respect professional expertise whenever it is demonstrated. The problem is, a doctorate is neither necessary nor sufficient proof of “professional expertise.” I’ve know PhDs and MDs who were so incompetent and/or malfeasant as to be extremely dangerous, and I’ve known volunteer crisis line counselors who were incredibly capable and successful in helping their charges consistently and effectively. I don’t really see a direct relationship between training and professional expertise, especially in the “helping professions,” and the pretense that such a relationship exists is part of why the current system fails so badly. I mean, why would someone trained as a medical doctor be expected to have ANY expertise in helping people with emotional/spiritual/behavioral problems they might identify? Let alone the expertise to “diagnose” such people according to the subjective and largely arbitrary rules of the DSM? It’s kind of like hiring a plumber to repair your car.
I meant in a large public forum like the WSJ. I know there are plenty of people (like me) who don’t think getting an advanced degree confers some special status on you that entitles you to a special name. But purposely writing an article in a national journal saying that someone shouldn’t be called “doctor” specifically because they’re the First Lady smacks of sexism to me.
Precisely. Asking the question gets you attacked in such institutions. It’s like living in an alcoholic home – certain things are NOT discussed, and those who mention them are punished. Kind of the definition of oppression, in some ways.
As to whether it is “sexist” or not, I think the question to ask is, have you ever heard this kind of argument being used to tell a man not to call himself “Doctor?” And how would it fly if a high-ranking male cabinet member were called “kiddo?”
It is, at best, intentionally demeaning. Of course, I don’t call my doctors “Doctor X” anyway, so she wouldn’t be getting that honorific from me, but I wouldn’t try to rub it in by writing an article or do a TV bit about it!
This is only true for short-term usage. It can take much, much longer the longer you have been using the drug, according to well-researched drug abuse studies, which are completely analogous. In fact, with really long usage, no one really knows if the brain ever fully recovers.
I guess it depends who is stating the dangers. It may be that detractors overstate the risks, but it is clear to me that the psychiatric profession understates them, to the point of violating their own ethics of “informed consent.”
Again, I’m glad that it worked well for you. But I have talked to many people whose lives were destroyed or severely damaged by ECT. My point is that it makes logical sense that since seizures can and do cause brain damage, ECT would pose a risk of brain damage. It is the responsibility of psychiatry to evaluate this risk, or else acknowledge that the risk exists. This does not appear to be happening with the people I’ve talked to or read about.
Notwithstanding that scientific reality, there is plenty of evidence that brain damage can and does occur as a regular effect of ECT. The existence of such evidence should in itself be sufficient to insist on a serious warning that this is a significant danger.
So it is possible that “Autism,” whatever that is, is simply a combination of high intelligence and certain personality characteristics? Yet there are plenty of “autistic” people who have lower IQ, correct? So are those people “Austistic”? Or are they something else?
Perhaps we can just go with describing people’s behavior instead of having to slot them into “categories” that limit our ability to see the differences between them?
Promoting acceptance of those who don’t automatically “fit in” is among the worthiest of social goals. Psychiatry, unfortunately, appears committed to doing exactly the opposite!
Of course, we also know that science is not a matter for consensus. People have agreed to a lot of “facts” that were scientifically proven false. And still do. Witness psychiatry as a whole.
I truly have no problem with social sciences, as long as they learn to limit themselves to actual observations and understand the problems of variable control that are so prominent.
Let’s take the “ADHD” diagnosis as a very simple example. We can look at a classroom and say, “Wow, there are some kids who do really well in this classroom, and others who do poorly.” That is an observation. We can say, “A certain subset of those who do poorly seem to have characteristics in common – they have difficulty sitting still, they seek out constant stimulation, they seem impatient with the process, interrupting the teacher and so on, and they don’t like to do exactly as they are told.” These are still legitimate observations.
We stop doing science when we say, “Those kids who don’t do well in the classroom have something wrong with them.” We are now in the realm of judgment and behavioral control. I suppose we could continue with the assumption that behavioral control is our goal, and then scientifically study better ways to control behavior. But that decision, that behavioral control is the goal, is in no way scientific, even in the very loose social sciences sense.
If we REALLY want to be scientific, we’d have to break down the classrooms into groups. We’d have to do backgrounds on the groups to see if the ones who hate it have anything in common, and if the ones who tolerate it have anything in common. We may find that the majority of the tolerant group ALSO hate being there, but simply have more skills to cope with feeling oppressed. But maybe that means THEY are the ones with the problem! “Over-accommodation Disorder” could be attached to them, and we could give them drugs or do behavioral training to make them LESS compliant and tolerant of oppressive environments!
Of course, the question of whether the environment is “oppressive” or not is social and political and not at all scientific, either.
And we could go on, but I think you get the idea. As soon as VALUE JUDGMENTS get involved, we are leaving the path of science. We can observe behavior and even draw conclusions based on these observations, but what we decide these conclusions mean about how we as humans should act is very much outside the realm of science, and always will be.
It is also valuable to recall that science is a subcategory of philosophy. So something can be philosophical within the boundaries of science, but if it is a “mix” of science and higher level philosophy, then it’s really no longer science, strictly speaking.
I think we’ve both made our points. I’m guessing we’d actually agree closely on what should be done to help people with perceptual or behavioral differences, and I certainly have never claimed in anything I said that biology does NOT impact behavior or perception – I actually said the opposite several times, as I recall.
The only point I am making is that claiming neurological SAMENESS of people who don’t happen to stand out as “different” does not make scientific sense. We have close to zero idea why people act the way they do. All we know is that certain patterns to emerge, and that expecting people to simply change their perceptual or behavioral style because it’s inconvenient for others is rather oppressive. I am encouraging us to focus less on whose brain is more “different,” and more on how we can help people whose behavioral/perceptual/personality styles don’t fit our largely arbitrary social expectations can find their place in our social system. If someone has to have a “diagnosis” or a “spectrum” identity to be considered worthy of special consideration in this regard, we are leaving millions and millions of kids behind just because they happen to be better at adapting to irrational and oppressive conditions than others.
I say “seizure” because that is exactly what ECT does. This question is not in the slightest dispute, even amongst the most fervent supporters. The very idea, as I recall, came because they found that people hospitalized for psychotic episodes were less psychotic after having a seizure. They used to induce seizures by drugs like Metroconazole (I think). The whole point of ECT is to induce a seizure.
I am not “angry” at ECT – I am angry at psychiatry for pretending they don’t know what the limitations and dangers of ECT really are. I’m glad you found it helpful. But I can’t allow the claim that no one has proven that ECT does damage to the brain stand. It is a basic tenet of science that the person making a claim is responsible for proving the claim – the “null hypothesis” (that there IS no effect) is assumed true until proven otherwise. If you’re trying to prove something has a positive effect, the assumption is that it does not, until proven otherwise. If you’re trying to prove that something which reason would suggest is unsafe is safe, the assumption is that it is NOT safe until proven otherwise by the data. Otherwise, I can claim that “cars are run by angels” or that “sleeping in the rain without a coat at 35 degrees F is safe” and you’d have to prove that cars are NOT run by angels, or that sleeping outdoors in a 35 degree rainstorm without a coat is unhealthy. In the case of ECT, reason would suggest that a grand mal seizure is dangerous, so it’s the promotor of ECT who has to prove it is not.
The smoking industry and drug manufacturers in general apply the reverse approach – they say, “No one can prove that cigarettes cause cancer. We don’t have to say it can until someone proves it does.” As you can see, this is not “science,” it’s a form of marketing, and the same kind of BS marketing has been done in favor of ECT.
As you can see, ECT induces seizures, and there IS evidence of brain damage. But again, it is not the job of critics to prove it ISN’T safe, it is psychiatry’s job to prove that, despite the logical conclusion that seizures can and do induce brain damage, the process of ECT somehow is exempt from this general expectation.
As you can see below, no one in the medical field outside of psychiatry pretends that seizures are not potentially dangerous to the brain. Why ECT should magically be different is theirs to prove, and they have not even attempted to do so. They just say it isn’t and dare others to prove them wrong, just as the cigarette manufacturers did for decades.
I do agree. I get very upset sometimes when they take things like going for a walk and call it “Nature Therapy!” I call it, “Doing normal things that make you feel good about life.”
I agree 100%. But for some reason, this kind of argument flies over most people’s heads. Whereas pointing out that there is no evidence of long-term benefits almost always has some “bite.” Some people get upset about it and try to tell me I’m wrong, others are shocked, but a small few are induced to explore the question further. I’m afraid the idea that “ADHD” exists is too firmly planted in the minds of at least US society that pointing out its spurious nature seems to induce too much “cognitive dissonance” for most people to handle!
And as I said, we are now getting into philosophy, not science. While stating that “all things have a cause” is pretty solid scientifically, the assumption that cause is always biological is a philosophical one, that is often presented as “scientific” (in fact, people are often accused of being “unscientific” when proposing other philosophical positions), but actually in no way proven by any scientific means, and in all likelihood unprovable by such means. We get into a discussion now of what is the MIND vs. what is the BRAIN. The position you present is a “materialist” position, that all causes must be material in nature, and therefore changes in the mind must be caused by something in the physical universe. Yet there are traditions of thousands of years duration that place the mind as transcending the body but being in charge of running it, and would see the brain as more of a “switchboard” used by the mind/spirit to run the body. Less esoteric ideas include the idea of “emergent properties,” in other words, the physiology of the body creates an effect that then is able to act on the physiology itself. It seems pretty clear to me that humans can do a lot to control their bodies, including their brains. Biofeedback and meditation are two examples. There is also the science of epigenetics to consider, which falls within the purview of materialism, but allows that environmental changes are able to change the way the body works and what genes are expressed or muted or turned off.
So the idea that the brain is the causal factor of all phenomena of the mind is not something I would automatically accept. I have no interest in denying either the very real experience of being a “different” person in a world that ACTS as if there is some “normal” we should aspire to (I am such a person myself, as you might surmise.) I also don’t deny that biology may play a significant role in such differences. I see the problem more in society’s unwillingness to recognize or accommodate to the factual existence of such differences, whether they are obvious or subtle or disguised by the person pretending to be “normal.” I doubt you’d disagree with my last statement, given what you seem to be doing.
So you ask some excellent questions. They are just more philosophical questions than scientific.
As a closing example, let’s suppose for the sake of argument (and I suspect that there is some truth to this) that a certain percentage of the population is biologically predisposed to hate sitting still and is very intolerant of boredom and is constantly seeking stimulation. We put children with these characteristics into a standard classroom, and they act out and get into trouble and are extremely unsuccessful. Is the problem that the child is “too active” and “unable to focus” (even though they seem to focus just fine on things involving big movements and interesting experiences)? Or is the problem that the classroom is too dull and rigid and unable to accommodate the needs of these children?
Not a scientific question. It’s a philosophical one, and a very good one, especially when one makes the scientific observation that children of this personality type do quite well in an open classroom setting where they can set more of their own agenda. We can study these kids in different environments and observe what happens scientifically. But deciding what it means transcends science.
Again, I do really appreciate the work that you’re doing. I’m sure it would have been a big relief to me as a kid to know I wasn’t alone and I wasn’t so “weird” as I thought. I fully support those efforts. I just don’t want to concede that there is some “normal” neurological configuration that “normal” people have and that we need to only accommodate for those who diverge far enough from this purported “norm” to stand out. There are plenty of “normal” kids in any classroom who are in intense pain and hate every minute of their experience, yet are able to act “normal” as a performing seal might in order to keep their masters happy and less dangerous. I was one of those kids. I could pretend to “fit in” and do what was expected of me, but I was miserable for 12 1/2 years of school. Was I really neurologically “normal” because I could accommodate? Was I neurologically “abnormal” because it was painful to accommodate? Or were the adults simply unreasonable to expect children to comply with such an oppressive system?
I vote for #3! But science can’t answer that question for us.
The question isn’t whether “being autistic” is the cause, it’s whether brain alterations are the cause of “being autistic.” It sounds like there is some evidence in a number of spheres that differences in brain operations, aka how the brain is USED by the person running it, between different groups. But we walk down a VERY slippery slope when we assume without scientific evidence that these differences are necessarily structural or causative.
The following link shows how imagination can cause changes in brain imaging that mirror real experiences. This demonstrates the power of the individual to alter his/her own brain operation, which to me tells us that there is no way to causatively link brain images to structure – they are simply different measurements that in most cases have little to nothing to do with each other.
I don’t mean to try and refute that there are people who experience the world differently from the “average” person. I just don’t see at this point any means to objectively distinguish between them. I much prefer to look at it as a human problem – how do we as a society deal with the inevitable differences in needs and skills and preferences that will exist in even the most homogeneous group or community.
And it is worth mentioning again that 50 years of research have yet to produce any evidence that “medicated” “ADHD” youth have any better long-term outcomes than those who don’t. So why are we exposing young children to the risks of Schedule 2 narcotics when there is no evidence they help for more than a few months at best?
At the risk of repeating myself, it is not the responsibility of critics to present evidence that inducing a grand mal seizure through electrocution damages one’s brain. It is the responsibility of those claiming therapeutic effects to prove that inducing a grand mal seizure through electrocution does NOT damage one’s brain. We all know that seizures are dangerous and can produce brain damage, which is why people with seizure disorders are immediately put on anti-seizure drugs. Why would we imagine that an intentionally-induced seizure would somehow NOT create brain damage?
I get that. But your definition is philosophical, not scientific. There is no objective way to distinguish your two groups. It is a judgment call, which I think is why the term “spectrum” was introduced. I have no objection to philosophical definitions per se, I just object to them posing as scientific ones. You have proposed no specific neurological “structural differences” nor presented any evidence of such. The burden of proof falls to those claiming there is some way to distinguish these groups neurologically, and I have seen nothing that meets even a very loose standard of proof. What I hear is that certain people tend to behave in certain ways, and that some people believe these differences are neurological in nature, but no one can show what the difference is. The definition is entirely based on subjective assessments how people act, feel and think (as all psychiatric “diagnoses”) and so falls into the category of philosophy. I see no scientifically valid entity of “autism” that can be distinguished beyond someone’s opinion or assumptions.
As I suspected, these results are based on functional brain scans, rather than structural differences. Additionally, these patterns are based on averages among participants, rather than specific, consistent differences between the groups being measured. So there very well may be many individuals in the study group who do NOT have the characteristic pattern, and many individuals who DO have the characteristic pattern, who are in the control group. The differences do not distinguish between the groups.
An illustrative quote:
“No research has uncovered a ‘characteristic’ brain structure for autism, meaning that no single pattern of changes appears in every autistic person. Studies of brain structure often turn up dissimilar results — there is great variety across individuals in general. But some trends have begun to emerge for subsets of autistic people. These differences might one day provide some insight into how some autistic people’s brains function. They may also point to bespoke treatments for particular subtypes of autism.”
So SOME people diagnosed with autism have certain characteristics in common in terms of FUNCTION. They state clearly that these findings can’t be considered causal, as they might be the result of rather than the cause of “autistic” behavior, and as they are not close to consistent for anything close to all people so labeled.
The studies are suggestive that there may be some correlates among people labeled as “autistic,” but does not establish that these are either genetic or neurological in origin. Of course, we might expect that from a group of people who are “diagnosed” based on subjective behavioral checklists and clinical judgment. In short, I would conclude from these studies, and what else I know, that “autism” is a loose connection of people who have certain behavioral/emotional/intellectual characteristics in common, but that this group is extremely heterogeneous and that the causes of these shared behaviors have not been determined, nor has it been determined that such behaviors even HAVE a shared cause.
This is the problem with “diagnosis by checklist.” I don’t mean in any way to suggest or imply that people who fit this description don’t have anything in common, nor that such people gathering together isn’t a great idea (it IS a great idea!), nor that there couldn’t be some biological similarities between a big part of such a group. I’m saying that there is no direct evidence that people so grouped have a neurological problem, have a shared neurological problem, or even have a biological problem at all.
As to “neurodiversity,” my opinion is that the idea that there is some kind of “normal” neurological configuration that can be used as a basis for “neurodiversity” to be determined. I am of the opinion that we’d be far better to consider EVERYONE “neurodiverse” and needing individual, creative interventions that respect our individual rights and needs. Which it sounds like you are making every effort to provide, so WELL DONE!
As Whitaker outlines, there are actual physiological changes forced on the brain by these drugs, and depending how long a person’s been on them, it can take a very long time to get back to “normal.” It is exactly the same process as happens with street drugs, yet of course, the psychiatric guild continues to deny that such things even happen, despite the science.
I do think it important to remember that something can be intentional without being fully conscious. A lot of times, the staff’s motivations go to maintaining order and avoiding emotional discomfort on their own parts. They are mostly completely unaware of these motivations, yet make decisions with these motivations in the back of their minds. The DSM contributes greatly to making this easier, because rather than admitting they feel uncomfortable because they don’t know what to do or because their own issues have been brought to the surface, they can blame the patient by saying, “Her borderline symptoms are escalating” or “He’s decompensating, we need a PRN injection stat!”
So the staff may not be aware they are intentionally oppressing their patients, and yet be intentionally oppressing their patients nonetheless, with the full support of the oppressive system.
What kind of evidence are you aware of for consistent and objective “neurological differences” in autistic-diagnosed people? I have not seen any such evidence, and have been working with this stuff since the mid-90s. I’m always happy to be educated, but if there is any such evidence, I am not currently aware of it.
It depends on what you mean by “works.” If you mean, “Can I manipulate my mental and physiological states by experimenting with mind-altering drugs,” then yes, they “work.” If you are asking can such drugs improve ones’ biological well being, balance brain chemicals that are theoretically “out of balance” (with no evidence, of course), or “heal” some sort of purported “Mental illness,” the answer is a resounding NO.
As Peter Breggin pointed out almost 20 years back, these drugs don’t fix anything. Every one of them acts by disrupting normal functioning of the brain (and other parts of the body). If someone likes the way this disruption makes him/her feel or think, that’s up to the user. But it’s past time to stop pretending that these drugs “work” in any sense of healing the body, or helping the body heal. They absolutely do not.
Not sure where you heard that, but it sounds pretty outlandish. No one is advocating to abolish the second amendment that I’ve heard of, and even if they did, there is NO way 2/3 of the States would support it. Biden can’t change amendments even if he wanted to. I don’t think it’s something to worry about.
Certainly. But a very important question that is generally avoided is this: genetics contributes to behavioral decisions. SO WHAT? Genetics is not something that can be modified, except through epigenetics, which is directed by, guess what, EXPERIENCE. So why do we spend millions and millions studying genetic vulnerability when we can’t do anything about it? Wouldn’t it be more productive to direct the bulk of those dollars toward finding what kind of environment helps people succeed emotionally and mentally and toward creating such environments?
As an example, it’s likely that a certain percentage (but very far from all) of “ADHD” cases are no doubt strongly influenced by a genetic tendency to be more active than other kids. These kids don’t succeed in a regular classroom very easily. So is the answer to try and alter their brain chemistry (seeing as the genes are not changeable)? Or is the answer to create environments that allow such kids to be active and to learn in the way they learn best?
Finally, before we ascribe specific behavioral tendencies to genetics, ought we not to have evidence of what genes affect what behavior? Yet decades of research provide almost no information about this. Why do we imagine that’s going to change somehow?
In other words, there is NO EVIDENCE that these “disorders” are in any way genetically caused. Why not just speak the truth, rather than couching it in arcane jargon? Oh, right, then people might actually get the point, and their sales would drop!
Second, restrictions on long-term use appear to be advisory at this point, and the recommendations for short-term use only are well established and long standing. There are exceptions to every rule, but it seems to me that it would be irresponsible not to give appropriate warnings regarding the difficulties of discontinuing Benzos. The guidelines seem appropriate to me, just as it is appropriate to warn adults and youth that stimulants are drugs of abuse, even though it appears that a certain percentage of users report being pleased with the results.
You may be correct in your evaluation, but my point still stands: until someone comes up with an objective standard that is based on a real-world, replicable measurement that doesn’t depend on the opinion of “experts,” the boundaries of any “diagnosis” will continue to expand and no argument regarding “overdiagnosis” can ever be made, because there is no standard for diagnosing. The rest is all philosophy, and generally not even very good philosophy at that.
It seems scientifically sketchy at best to suggest that something is “overdiagnosed” or “underdiagosed” or “not overdiagnosed” when there is no way to measure what the correct level of “diagnosis” could possibly be. It’s like arguing whether kids need more or less recess or more or less discipline in school. There is not a “right answer,” and it is silly to talk about it as if there were. More or harsher discipline has certain consequences, which some people like and some people don’t. It’s totally subjective. Same with basically all of these psych diagnoses, including autism. There is no way to “over- or underdiagnose” because there is not correct level of “diagnosis,” mostly because these are not definable medical conditions but socially-bound, subjective definitions based on beliefs and values rather than any kind of scientific observations.
From a medical/scientific viewpoint, it is a meaningless grouping of people who have little to nothing biologically in common. People can identify that way for themselves, but to me it has all the scientific validity of “diagnosing” people as Catholics or French or greedy or sexually promiscuous. People can be all of those things for as many reasons as their are people. People can identify however they wish to, but it doesn’t make their identification a “diagnosis.”
Or is it just a description of certain behaviors that tend to occur together, like being an impulsive person or being conservative and cautious or being a risk-taker? Maybe it’s just a personality presentation that can have lots of reasons for occurring?
Once again neglecting the important question of why a sweet, even tempered young man would kill himself in the context of his school experience. (Not to mention where he got the shotgun.)
I don’t know that anyone here wants to prevent you from doing something you find helpful. However, it becomes different when doctors lie to people about the supposed causes of their problems and try to force “treatment” on them that is really just giving a drug and hoping it works. Not to mention the incredible levels of denial that occur when the clients themselves report that the drug is making them worse.
I’m interested by your comment that “Anxiety has been proven to be real and heredity.” Anxiety is certainly real, but I’m pretty familiar with the research on this point, and I am not aware of anything that suggest that “anxiety” IN GENERAL is hereditary. I’m not denying the possibility that some people may struggle more with anxiety (including me) for reasons that may be significantly affected by heredity. But these same anxious people may have lots of other good qualities, like empathy, commitment to bigger goals, willingness to sacrifice, sensitivity in social situations, and so on. And of course, it is obvious that anxiety is HUGELY impacted by environmental factors. It is, in fact, a survival mechanism to help us avoid dangerous situations. So to decide that anxiety is hereditary is, as far as I know, not supported by evidence (please share if you have some!), but more importantly, anxiety is not a “disease state” that needs to be “treated,” even if some people find that there are drugs or other physiological interventions that can ease anxiety.
Of course, I agree. I just don’t see that much difference, except that stressed parents have to be there with their kids and try to enforce the teachers’ dictates. Virtual learning will work better for some kids, worse for others, be the same for others, but it does not begin to address the flaws within the system, which is my point. Rather than simply observing that some kids are less anxious when they aren’t forced into an unnatural setting under the control of a person they may or may not respect with kids selected at random that they can’t get away from having to do things that may or may not make any sense, maybe they should be asking why going to such a setting induces so much anxiety in so many children, and maybe stop doing those things that make the environment so utterly oppressive? But that would presume that there is a desire to empower rather than oppress the students, which is probably a highly erroneous assumption.
So you are saying that “virtual learning” on a large scale amounts to child abuse?
I’m a little surprised if that’s what you’re saying, since I’d expect you to see the school system as a primary means of keeping the unruly masses from rebelling. The whole enterprise is massively authoritarian from day one, and I believe a lot of what is not working in US society, at least, has to do with little kids being trained to invalidate their own perceptions and being forced to accommodate the “party line” on what is “right” and “wrong.” Not to mention the number of kids routed to the psychiatric system by schools.
The improvements due to “virtual learning” were entirely accidental, and those who have made these observations are scurrying for cover, having no intention of discovering why such a large contingent of kids are less “mentally healthy” when exposed to the oppression of the school system.
Or should the system recognize that he is a child harmed by abusive parents, and provide the appropriate supports without having to “diagnose” him with anything except being treated like crap by the people who are supposed to love him?
Or people with the same “diagnosis” sharing nothing in common except for their behavior and/or emotions. If people with low thyroid, childhood sexual abuse, and a dead-end job all get the same “diagnosis,” something is pretty wrong!
It’s kind of a joke to talk about ‘differential diagnosis’ when there is no objective way to differentiate between one group and another. I think it’s fine to talk about personality characteristics and how to deal with them, but the idea that these utterly subjective categorizations somehow represent “diagnoses” is laughable, and to talk about “differential diagnosis” as if that were somehow a meaningful phrase is ludicrous to me.
“Jerk Radar” concepts are most definitely applicable to psychiatry. They try to charm you initially with promises of a better life, try to quickly engage you with them intensely to isolate you from other help, interfere with other relationships by explaining how they have your best interests at heart and that anyone disagreeing with them is undermining the relationship. Big egos abound, with willingness to lie or manipulate to maintain control, and willingness to blame others for anything that goes wrong. Low responsibility – goes without saying. History of abuse, encouraging others to use drugs, employing denigrating labels and comments… the concordance is quite thorough.
This is very well spoken! I would add that what people have in common is more likely to be the stresses that CONTRIBUTED to their “symptoms” rather than the label. For instance, survivors of domestic abuse have a lot in common with each other, even though they might qualify for “PTSD,” “Major Depression,” “Bipolar Disorder,” “Borderline Personality Disorder,” “Anxiety Disorder” or many other possible labels. It would be more functional AND politically powerful to organize around experiences, rather than “reclaiming” a label that was never even relevant to most of the people who had it applied to them.
There is no rule here that participants in comments are or are not “supposed to hate Trump.” I am concerned that this thread is about to go off topic into electoral politics or some other disrelated conversation that will end up being unproductive and hostile, as has happened recently.
The point of the article is that the White House refused to pay for “mental health care” for separated migrant families. Arguments about whether this is a good or bad thing are welcome. I don’t want to see an argument about whether this means “Trump is bad” or not.
How does anyone distinguish what is “endogenous depression” from “exogenous depression?” If you feel the drugs were useful to you, I have no reason to doubt you. But you are extrapolating from your own experience to assumptions of physiological cause that are not supported by scientific observation.
I agree with you. I think having your own observations and conclusions invalidated without reason is the most painful of circumstances, short of physical harm. It is extremely destructive especially when engaged in by someone who is supposed to help you.
Which of course means that the only “evidence based treatments” are going to be drugs, because they’re the only ones with enough research to provide an “evidence base,” however corrupt or flawed or sketchy that evidence base is. For instance, they still call stimulants “evidence based treatment” for “ADHD” even though decades of research show that they do NOTHING to improve long-term outcomes for children. What good is an “evidence base” that doesn’t take long-term effects into account?
And that’s not even getting into how the grouping of the “DSM disorders” puts together heterogeneous groups who will respond differently to the same approach, so that only the heavy-handed “symptom suppression” approach will be viewed as “effective.”
I don’t know that I have one to hand, actually. Whatever you call it, there is a power differential, and any person who is really good at it knows this is a huge part of the dynamic and knows how to step down from their power and return the power to the client, and appreciates that the “peer worker” is actually in a BETTER place to do this. But the DSM attitude/philosophy speaks directly against this, encouraging and even in some ways requiring the “clinician” to see the “Mentally ill” as below them. And by analogy, the “peer worker” is below them, too.
Maybe we can call them “coaches” or “mentors” or something that doesn’t delineate their value as being a “peer” with people who are identified as being “beneath” the “professionals.” But the real problem isn’t the name, it’s the attitude of the professionals toward their clients, and by analogy to anyone who as been on the “client” side of the relationship. Condescension is both a consequence and a cause of the disempowerment of clients, and I see that condescension clearly indicated in attitudes toward “peer workers,” who are automatically seen as less wise, less emotionally stable, less effective, and less important than the so-called “professionals,” even when the opposite may well be the truth.
The “peer” designation appears to me to be intentionally condescending, to mark these people as “not REAL professionals” so their views can be overridden when they threaten the status quo too directly.
Maybe they mean “lived experience” of the nonsense and discrimination so many people experience at the hands of the “helpers” in the “mental health system?”
I honestly have not seen anyone saying that a response to life’s tragic circumstances is not absolutely needed. Perhaps you can let me know what quotes or statements lead you to this conclusion? I think there IS a sense in a lot of people that a “professional” response to human distress is condemned to failure from the get-go due to differences in power and intention between the “helper” and the “helpee.” Perhaps that is what you are referring to?
It is oddly euphemistic, as I was trying to point out. I mean, who the f*&k else would be at the “center” of your considerations? It’s kind of an admission that the “care” they have been providing has had nothing to do with the person they are “treating!”
The fact that anyone has to suggest that “person-centered services” should be a model of care tells us enough about the usual attitude of the “mental health” professions toward their ostensible “clients.” What other kind of help could possibly be envisioned, that is not centered on the person one is purporting to “help?”
I think my response DOES answer your question, and quite clearly. Each person will need something different, and the first error of psychiatry is clumping people together based on how they feel or act rather than on what their experiences, life conditions and motivations are. The only way to help people in distress is to get to know each and every one of them personally and help them figure out their path. It is much more a spiritual than a physiological thing, though physiology certainly does play a role (exercise, sleep, nutrition, etc.) Psychiatry is destructive largely because it invalidates the humanity of its clients in the interests of money and power. Restoring connections and respect and caring leads to a wide range of solutions that depend on the person and his/her situation. There is no “prescription” for mental well being.
Maybe they should just pay the “patient” the amount they WOULD have paid the drug companies and the doctors. I bet that “depression” would drop markedly as a result!
Reminds me of the Star Trek Next Generation episode where people from one planet got everyone on another planet addicted to a substance only found on the first planet, and then said they all had a “disease” for which their drug was the only “treatment.” And of course it was VERY expensive, but what’s it worth to be protected from this horrible “disease!”
It is beyond despicable to create a “disease” with one drug and then sell another to “cure” it!
I think I lucked out. Plus, it was a different time. I am not sure psychology/counseling students are even taught about the subconscious mind any more. But they get LOTS of “differential diagnosis” training in the DSM, sadly.
I actually had a very good therapist who worked with me to meet MY goals, never once told me what to think about my life even when I asked her to do so. But this was back in the 80s before the DSM took full hold. I think such people are harder to find these days, but I do think there are times when having an objective person who is willing to listen and ask pointed questions about your thinking and decisions WITHOUT telling you what to do is extremely valuable. The problem is, most therapists seem incapable of being there for the clients without meeting their own needs at the clients’ expense. The DSM structure makes it that much easier to avoid the real issues or to work out the therapists’ issues on the client. And I’m not sure there is a way to actually train therapists to do this. It seems to have a lot more to do with the therapist’s own grasp on his/her personal issues and needs, and corresponding ability to set those needs aside and truly LISTEN to the what the client is saying instead of trying to “fix” the client’s life.
I think the problem is connecting psychiatry, which is NOT designed to help people except in the crudest sense of deadening “negative emotions,” and society responding to suffering and misery, which I agree society is responsible to do. In fact, as long as psychiatry is around, our society at large can pretend that psychiatry has the answer and that they don’t need to bother responding to your or anyone else’s emotional difficulties, as they will buy psychiatry’s story that it’s all about flawed brains and doesn’t require any social changes at all.
As to what society can and should do, I think there is a major problem assuming that there is one answer for all those now considered “mentally ill” by the DSM system. There are many different responses possible, which can be adapted to many different situations. For instance, the main “cure” for ADHD appears to be to restructure schools so that they are more adaptable to the needs of kids. Things like “anxiety” and “depression” can have many causes, and the response should be different for different situations. Does society need to respond the same way to a person in a dead-end job or an unhappy marriage, as opposed to someone abused as a small child, or a person who is being discriminated against systematically because s/he is an immigrant or a black person or a woman?
Grouping “the mentally ill” together as if “they” are some monolithic entity plays into the hands of the psychiatric community and the drug companies’ needs. It is a false grouping of heterogeneous people into pseudo groups, which obscures any real attempt to analyze and help with a person’s actual situation.
I do get your point. But I think we can be a LOT less concerned about the safety of a sugar pill or a dose of niacin vs. a chemical that has known adverse effect on brain chemistry as well as a wide range of known and unknown effects, some of which can be deadly.
They are most DEFINITELY symbolic to the “practitioners,” especially those who have a big financial and/or status investment in the system. This symbolism is a large part of what makes them deaf in the main to the actual experience of their “clients.”
Placebos have “symbolic meanings” and don’t do any damage. Or maybe they can start in with crystals or Tarot cards if they’re looking for symbolism. Symbols don’t have to screw with our brains!
Yeah, Freud was a huge improvement over anything else that preceded him, because he at least started from the idea that the what the client says is the most important thing to consider. That postulate alone would invalidate the entire edifice of the DSM and all that passed for “psychiatry” throughout history. It is just a shame that he backed down from his accurate observations. But as we all are, he was a product of his time, and his revelations were just not tolerable in the society he lived in, however accurate they may have been.
But I don’t recall Jung reviving the observation that children (especially girls) were frequently sexually molested and abused by adults in society and that many of their “mental illness” manifestations resulted from these abuses. Maybe he did and I’m just not aware of it.
Freud’s main contributions were that he believed that listening to people’s stories was a path to healing, and that early life trauma unconsciously affected decisions and emotions on an ongoing basis. He was the first to recognize that sexual abuse of children (especially girls) was rampant, and at first he believed these stories and attributed women’s “hysterical” symptoms to the abuse they had experienced. This outraged the Viennese society of the time (one has to wonder how many of his psychiatric colleagues were suddenly worried they’d get busted!) and he came under tremendous pressure to recant. Unfortunately, he did so, and devised all the weird “drive theories” like the Oedipus complex and penis envy and whatnot and the secret of childhood sexual abuse went back under wraps for another hundred years. Most of what he is remembered for is the crap he came up with to explain away his original observations. He may have saved his career by doing so, but his betrayal of his integrity condemned another four generations of children to unrecognized sexual abuse.
There is no question that these drugs have an EFFECT, and sometimes the effect seems positive or worth the cost. This does NOT mean there is something “wrong” with the child, or that the child is being “treated” for some “disease” or “disorder,” or that other children experiencing similar problems will be “helped” by whatever you felt worked for your child. Individual stories are valid, but scientific claims need to be made on overall data, not individual stories.
I have noticed that when something the researchers WANT to be true is proven false, “More research is needed.” Whereas when there is the slightest hint that what they want to be true MIGHT be supported, it is broadcast all over the world as if it is utterly proven true. A little bias there?
I’d be pretty f-ing insulted if I were called a “treatment non-responding anxiety patient.” Isn’t it clear how dehumanizing this whole idea is?
I also wonder that the model here is to only provide therapy to those whose drug “treatment” seems to have “failed.” Why not start by talking to them before you decide to mess with their brain matter?
It sounds like we’re substantially on the same page. He has recently revealed some childhood trauma we did not know about, and he was operating with that inner secret (from himself, too), which no doubt made it difficult to make sense out of things. He also had an emotionally abusive partner he was escaping from, and I think the drugs provided escape for him, too. He was guided at first, but the person guiding him also had some serious issues and told him some very not helpful things. I think certain people just don’t do well with any kind of drug intervention. Nothing works for everyone, and we all have to find our own paths.
I think we’re getting into the difference between individual actions, which vary widely, and the system that has been devised, which is very narrow and rigid. There are most definitely individuals who can do great things within the system, and those who fight the system itself to do better (I was one of those for a while). I had a great therapist who really helped me back in the 1980s, though in fairness the DSM-III was just taking hold and therapists were more conversant with Jung and Rogers and Hoffer and Maslow and Bowlby and the like. But the system has changed, and is now rigged to encourage labeling and drugs and a discounting of the importance of experience and personality development as well as to ignore social impacts on human experience.
I’d use the comparison of individual vs. systemic racism. There are individuals who really do choose to hate people based on their skin color or national origin or class. But the majority of people are able to manage relationships with individuals of varying backgrounds without overt hatred. Unfortunately, ALL of us are steeped in a culture of racism, and carry around images and assumptions and reactions that are “programmed” in by the society we’re a part of, to the extent that much of it, we don’t even notice. Some people are able to rise above this training to one degree or another, but most are only partially or marginally aware that such things are even happening.
That’s how I see the psychiatric system. There are individuals within the system who can rise above the system’s assumptions, but the training and the culture surrounding “mental health” is warped in the direction of believing that “the mentally ill” are a specifically identifiable population, whose value and capabilities in life are less than the “normal” person, which of course the majority practitioners believe themselves to be. So even if people within the system do challenge the system to do better, they tend to make temporary stirs in certain areas which quickly settle back down into the status quo, because the system is supported by a huge culture of discrimination and condescension and power dynamics, and most of the practitioners are comfortable enough with it to keep supporting its basic assumptions.
This is why I got out of the business myself. I decided at a certain point that continuing to participate, even as a rebel behind enemy lines, was a tacit approval of the system as it was. I saw the damage being done and realized that one person can’t change the entire culture. So I became and advocate, and earned a lot more inner peace.
I can testify that they really screwed up my son’s life, too. Testimony is evidence only in the most limited sense. And the process you describe is not a “medical” intervention, but a spiritual/religious ritual, and so does not belong in the realm of “treatment,” even if it does work.
I am most definitely saying that psychiatry as a pseudo-scientific philosophy/religion denies or minimizes the causal role of stress and trauma in any of their “diagnostic” categories. At the same time, they also systematically overlook REAL physiological problems, like sleep apnea or low iron for so-called “ADHD,” and deprive the client of actual medical care that they may need.
Looking again, I just thought it was an important distinction to make. It is common to use the term “illness” in a metaphorical sense, like “that is SICK!” or “she has mental illness” without any actual attempt to look for physiological illnesses, and without the consideration that stress and trauma cause physiological symptoms that can easily be interpreted as “illness.” Of course, these ostensible “symptoms” are intentionally framed as “illness” by the psychiatric community.
Throwing up suggests “ill.” Feeling depressed suggests “stressed” or “traumatized.” There are some people who are depressed because they are ill (low thyroid, chronic pain, iron deficiency, etc.) There are some people who throw up because they’re stressed or traumatized. To assume someone’s ill because they are depressed is dangerous and unscientific. Screening for illness makes sense. Assuming illness does not.
‘Kwanzaa’s second principle, Kujichagulia, Swahili for “self-determination,” which reflects a sense of “defining, creating, naming, and speaking for oneself.” ‘
If this second principle were put into place, the DSM and the standard of “care” in the “mental health” system would be immediately put to rest. The DSM’s purpose is to “define, create, name, and speak” for the “patient” and prevent the patient’s voice or viewpoint from being taken seriously.
The author may actually have been fortunate that her colleagues didn’t immediately call the authorities and allowed the author to exercise her own self-determinism in deciding how to proceed with the assistance of her psychiatrist. I was a bit disturbed to hear her talking about the “stigma” of “mental illness” and even moreso being “stigmatized” for being black. I think the proper word here is “discrimination”, not “stigma!”
I think psychiatric practitioners who “treat” imprisoned “patients” are worse than the criminal justice system. At least alleged criminals have to be “Mirandized” and can have an attorney present during questioning, get a full trial and have to be convicted “beyond a reasonable doubt,” and have a specific and limited sentence. The “committed” have almost no rights, other than a “preponderance of evidence” trial in front of judges who are generally heavily biased against them. And they can be “held” indefinitely, or at least as long as their insurance holds out.
“Needing help” is not synonymous with “being ill.” We all need help in this crazy, bizarre, heartless world we’re trying to survive in. It’s no sign of “illness” to find our modern way of life distressing.
Actually, the village shaman is on a higher ethical plane, because at least s/he is not pretending that s/he is engaged in some kind of objective “science.”
The other huge problem with “EBM” is that “evidence” will only accumulate when studies are done, and most studies are funded by the pharmaceutical industry. So any non-drug interventions (like peer support) will never gather enough evidence to be called “EBM,” even if the results are far superior to “treatment as usual.”
And of course, the article does not take on the more fundamental problem, namely, that helping people suffering from emotional distress is not really “medicine” in the first place. Studying “depression” will never lead to a proper “evidence base,” because the researchers are studying a heterogeneous group, where some will be helped by one intervention and others will be not helped or harmed. If people are treated as individuals, we’ll get a lot better result than by lumping together a whole bunch of people with a wide range of issues and trying to “treat” them as if they had a medical problem that no one apparently can actually identify.
Thanks for the excellent summary. While most of this has been easily knowable for decades, it is good to have it capsulated for those who have been propagandized by the “mental health” industries, including the practitioners themselves, in many if not most cases.
Yeah, if owning guns reduced crime, we in the USA would have the lowest crime rates in the world!
But you are right, there is nothing to suggest that having a “mental illness diagnosis” makes one more predisposed to violent gun use. Heavy drug use (including LEGAL drugs like antidepressants and benzos) and domestic abuse are the highest associations with gun violence and have been for a long, long time. The “mentally ill” angle is just to create a scapegoat so those much larger REAL social problems can be ignored or minimized.
I think MIA provides a degree of “informed consent” that the industry finds embarrassing and threatening. It could be “therapeutic” for people who sensed the truth but haven’t seen it in black and white before.
I recall an experiment where someone designed a computer program to act like a non-directive therapist. It asked basic questions like, “Tell me about your childhood,” and gave generic acknowledgements like “I see” or “Uh huh…” If someone went off on a tangent, the computer would say something like, “Let’s get back to your mother.” The users reported feeling better from using the program. I think it showed how desperate people are just to have someone listen to them, even though the “listening” was totally artificial. Perhaps the machine had an advantage, in that it was unable to give unsolicited advice or demonstrate prejudice or evaluate for the user what the computer thought their “real problem” was.
Anyway, I think we’re sinking down pretty low when we’re trying to have computers provide “therapy.” Though the computer program may have a big advantage over a psychiatrist with a prescription pad. At least it won’t make you worse.
Very true! The problem is not that the information is not known and available, it is that there are so many people invested in the status quo who stand to lose money or status or both, that the facts are no longer relevant to their analysis. The only consideration is how to maintain power as long as possible before one is caught and held accountable. And this attitude extends very far beyond the boundaries of psychiatry.
Weird, since so many deteriorate ON the “medication.” And of course, their answer is “they’re not taking a big enough dose!” If the “treatment” isn’t making the person better, why would we continue “treatment?”
Why is the conclusion not that “The risks outweigh the benefits for children and they are contraindicated in children. The proposed benefits for youth are slight and do not appear to outweigh the risks, so prescription in adolescents is also inadvisable.”
I recall seeing a film of a nice, German family, small house with a garden and a white picket fence. The father was a German officer, was dressed up for work. Walked out the front door, said goodbye to the wife and kids, and turned up the street. The camera shows Buchenwald rising in the background and the father heading off for his job at the death camp.
Individual humans do not have to be evil for their behavior to be evil, or for the institution they work for to be evil. Many “good” people are able to justify bad actions in a wide range of manners, and evil institutions are very generous in providing plausible justification for the actions they want people to be able to justify. Remember the Milgram experiment!
Don’t sweat it! As long as you’re not calling someone names or telling them off, swear words will generally fly without attention, at least at this moment in MIA history.
Biederman and company also cherry picked their non-placebo-controlled studies. Studies in Quebec, Australia (Raine Study) and in Finland showed that taking stimulants don’t improve any outcome measured in the “meta-analysis” discussed. Additionally, the OSU Medication Effectiveness Study showed no improvements in any outcome, except for a slight reduction in accidents for “medication” users. This issue has been studied for over 60 years now. If this stuff were so awesome, why aren’t there clear and unambiguous indications of positive results? How many “no result” findings have to happen before we conclude that it simply doesn’t have any long-term benefits?
It’s tenable if you’re trying to make money and expand your client base. If you actually care about science, it’s nonsense. But these are not scientists we’re talking about, they’re either dupes or snake oil salesmen.
That is my observation also. “Peers” are rarely considered equal partners, but more someone who can “talk at the client’s level” and thereby explain why the system is “right.” I’ve seen plenty of “peers” who intentionally and consistently buck that trend (Stephen Gilbert/Boren, for instance), and they can sometimes get some stuff done, but they are never considered actual peers to the professionals. As long as that condition pertains, “peer support” remains mostly coopted and lacking in significant influence beyond the level of an individual person’s situation.
Posting as moderator: It is possible that past moderators handle things differently. The Posting Guidelines do mention profanity, but in the context of being respectful to others. It could be interpreted that all profanity is banned, but I’ve read it as meaning profanity in reference to someone’s person or ideas would be out of bounds.
There is no rule against using profanity. The rule would be against using profanity toward a particular person or group. Hence, you can say “Fuckk it all” or “This is a fucking joke!” but you can’t say, “The moderator should fuck off!”
How can there be “digital markers” of “mental disorders” when there are no actual BIOLOGICAL markers to distinguish whether or not someone has a “disorder” or not?
Something can’t be “overdiagnosed” if there is no objective means to determine the “proper” level of diagnosis. In essence, EVERY diagnosis is “overdiagnosis,” since there is no observable malady to diagnose in any individual.
The difference is that I get to define what I think. is “wrong” in the mental/spiritual realm. If a doctor tests and finds I have low thyroid, s/he can then tell me what is “wrong” and we can make a plan. But no one can tell me it’s “wrong” for me to have flashbacks or feel anxious. Sometimes feeling anxious is absolutely RIGHT – it is my body warning me that I’m in danger! Sometimes it is right but not very helpful, like if I’m going for a job interview and there is a “danger” that I won’t get the job. Sometimes it was right at an earlier time but is being applied to a situation today where the application doesn’t work. So I would be “wrong” for applying it to this situation. But the anxiety isn’t in itself “wrong.”
Establishing order is what we do as humans. So “disorder” can certainly be perceived as “wrong.” But someone else telling me that my emotional state is “wrong” because it doesn’t meet their criteria for “normal” is judgmental and is frequently destructive.
As a therapist, I have no problem asking a client, “What’s wrong?” from the perspective of the client. But I would NEVER tell a client, “Your reaction to being sexually molested is ‘disordered’ (AKA WRONG!)” It’s not my job to decide, and that’s why the DSM labels are problematic. It makes people feel “wrong” for feeling the way they do, instead of helping them see the challenges they face in a new light, which is what therapy should be doing.
“…by convincing them that their troubles are just an inevitable result of what happened to them, and there is no possibility of them changing their reaction to something else and so getting more control over their lives.”
I don’t think someone needs to believe there is something “wrong” with them to consider the possibility of changing their reactions/coping mechanisms. My emphasis has always been on how they WANT their lives to proceed as opposed to how they can be “fixed” in the sense of “returning to ‘normal’ (as defined by our social norms).
Harrow showed that people with more favorable prognoses prior tom the study had worse outcomes on drugs than those with less favorable diagnoses had when off drugs. So “favorable prognostic factors” did not associate with better outcomes, whatever Harrow might have speculated about it. I also understand that he reconsidered his first analysis in the light of further data and critiques, and I’m wondering if you were reading his first assessment.
There is a difference between saying there is “disorder” vs. saying I “have a disorder.” One is a temporary condition of the self and surroundings, the other is a judgment of insufficiency that is inherent in me. At least that’s how it comes across to me!
If there are specific posts that aren’t there, please let me know. Your posts are pretty much always posted without moderation, so I’m not sure what could be missing. E-mail me directly if you find something specific I need to look for.
Well, how about they finish their research before they are allowed to prescribe these “mystery drugs” that just MIGHT make you sick or kill you, we’re just not sure…
I agree, children are their weakest point. They can’t portray a two-year-old as a potential mass murderer needing to be “treated.” When you tell people about kids under one year old being on psych drugs, they are stunned. When you let people know that over half of foster youth over 12 are on psych drugs, people pay attention. A lot of the arguments for psych drugging and incarceration don’t sound nearly so convincing when kids are the victims.
That’s why I always avoid the term “misdiagnosis” when applied to DSM labels. It implies that there are people who are “correctly diagnosed” but you’re just not one of them. I think the correct label is “malpractice!”
It is also not known or readily forgotten that these “neurotransmitters” affect a lot more than the brain. 90% of the serotonin receptors in the body are apparently in the gut. We are doing more than messing with people’s brains here. Hence, the obesity, diabetes, and early death figures.
I guess I have a little concern about the idea of “diversity of opinions” in this context. My problem with it is this: those in the psychiatric world have a MUCH greater power and privilege than those that they ostensibly “treat.” I believe that conveys a much higher responsibility on them to insist that their “opinions” are based firmly upon scientific facts and knowledge. I think one reason you don’t have an answer is because opinions or “voices” can be valued differently by different people, and it is of course very, very easy for those in power to simply ignore the voices of those they have power over. So if we REALLY want to have a conversation where “all voices are heard,” I think we have to start with amplifying the voices of those who receive the services in question, such that their EXPERIENCES (not their OPINIONS) are considered the most vital data being examined. At the same time, those who have the power to ignore such voices would have to be restricted from positing their opinions as fact – they would have to present scientific data to support their opinions, AND would have to have their positions jibe with the reports of their “patients” or else not be considered valid.
It is, indeed, difficult to manage, but not because there is a diversity of opinion, but because there is a differential of power, and those who have the power to make their opinions sound like facts are unwilling to set that power aside long enough to hear what the real effects of their “treatments” are. Present company excluded, I think.
I agree wholeheartedly – the tendency of the “professional” is often to force the person to be “reasonable,” and to re-a. ssume the roles they are rebelling against. Which is actually the very WORST thing you can do! A “mental health” crisis generally means that whatever role a person HAS been playing is not working. Maybe they need to reconsider how they’re living their life! Forcing them back into their old roles would drive them into apathy.
Having a crisis is not an illness! And the solution is not to. force someone back to “normal,” whatever that is.
I was pointing out that state legislators also have that power, and in fact it is state legislatures that are in charge of civil commitment laws. So both need to be addressed, and wherever one gets access is the best place to start.
In fairness to Oldhead, I have posted this last response (since Richard specifically referred to him in his post).
I will be following Robert’s directive from here onward, and post things that relate to Terror Management Theory. Comments re: COVID are welcome as long as they are presented in that context. Any attempts to personalize negative responses will not be posted.
Pretty much, yeah. They don’t have to agree with each other or with US law, though US law can supersede them depending on the issue. “State’s Rights” vs. centralized government control has been an issue since the first Continental Congress back in the 1700s. It continues to play out today, right in front of our eyes. The intensity of the conflict over “mask mandates” is a reflection of that ongoing conflict. “Let’s act together in everybody’s interests” vs. “Washington isn’t going to tell US what to do!” Our current “liberal-conservative” spectrum is closely related to that theme, IMHO. Unfortunately, I think it can blind us to bigger issues on different spectra.
I agree, we know what we need to know about them. We know: 1) They mess with our brain chemistry, and indirectly, our brain structure, just like any “psychoactive drug,” including heroin, meth, alcohol, LSD, etc.; 2) there is no identifiable “illness” being treated, no means of distinguishing the “ill” from the “well,” so at best, these can be considered palliative drugs, similar to heroin for pain or aspirin for headaches; 3) all of these drugs have serious and in some cases deadly adverse effects, such that people taking the APs die 20-25 years earlier than the average person in society; 4) they all have withdrawal effects that generally lead to MORE of the “symptom” they are supposed to be suppressing; and 5) whatever unstudied long-term consequences exist, the evidence suggests that they are not good or helpful.
What more needs to be known? A simple cost-benefit analysis says that we’re “treating” an unknown condition (if it even is a condition) with a drug that has largely unknown long-term consequences (other than early death and diabetes) and known short-term adverse effects which can be severe, and known withdrawal effects which can be worse than the “condition” being “treated.” The only benefit appears to be a temporary lessening of uncomfortable “symptoms” for an unknown proportion of the population using them. What argument is there for their continued widespread use? What happened to “first, do no harm?”
I totally get that these laws are often ignored or treated in a lackadaisical manner. Your situation clearly screams criminal prosecution. But once you’re labeled “mentally ill,” anything you say can be ignored or attributed to “your illness.” It’s a crazy catch-22.
Certainly, state legislatures have done a ton of things that have forced the national government or national/international corporations to take notice. For instance, California set fuel emission standards that were higher than any other state. Because they wanted to sell cars in California, auto makers targeted making cars to meet those standards, even if other states didn’t require it.
Laws governing “involuntary commitment” are made by the states and differ from state to state. Setting a different standard in a particular state and proving that it worked better is one very legitimate approach to handling the problem. The city of Berkeley, CA banned “electroshock therapy” for a while back in the 80s, and even though a judge overturned it, it got plenty of news coverage. It’s a legit strategy.
It seems there is some idea that someone has to “do something” about people feeling bad, instead of just being there and allowing people to feel whatever they feel.
And I agree with you – it is one of those arguments like nature/nurture that can go on forever but not be resolved. Some of it gets down to values and priorities, and some comes down to perceptions vs. reality. The second part can be addressed through research, at least in part. The first is not resolvable except through quality communication, which I find few take the time to learn or execute.
I have a suggestion. It is clear that we could go on and on about how this is proven or not proven or this is the right approach or that approach is really dumb and anyone who agrees with it is a fascist traitor and on and on. But I think you’re right – science does not make political decisions, and political decisions themselves can’t be altered by science. So let’s stick to the stuff that CAN be determined with more certainty!
If someone believes hydrochloroquine works, please, share the studies showing that is true! If someone believes it’s dangerous, please share the source of that information – what side effects have been shown in studies to occur, and what’s the cost-benefit analysis? If someone thinks masks are dangerous, where is the data? If you believe they’re helpful, let us know the scientific reasons why.
The last time this discussion got started, it degenerated into a rhetorical shouting match that had to be discontinued. I don’t want that happening again. Let’s debate the issue like the intelligent, mature adults we all are, and put out the pros and cons without the hype and fear. After all, we’re not going to change the minds of most people by telling them they are wrong. Let’s put the data out there and let people decide for themselves! I’d be happy to be educated, especially about the value of Zinc and Vitamin C and D.
So my suggestion here: instead of wasting time about whether Trump’s or Biden’s plans are good or bad or bad and worse, why don’t WE bring the science together and examine it? How about educating each other in a mutually respectful environment, and then we can all decide which plan(s) seems best to us? Does that sound do-able?
I very much doubt bringing psychiatry to an end will realistically occur if people on the same side can’t work out a way of communicating respectfully about things we don’t agree about. Thoughts?
I certainly agree that it will require mass numbers of complaints to the people who make our laws. Perhaps local or state governments might be an easier starting point, as they are representing fewer people at a time. Or perhaps a candidate can be put on the slate who already understands what is going on!
Wow, I never thought of it that way, but that really does make sense! I don’t suppose anyone could be convinced to study that point, though. The conclusions might cost people too much money and status!
Working as an advocate for foster youth, I saw this same pattern over and over. Stimulants for “ADHD” leading to deterioration/aggression, leading to more drugs, leading to more deterioration, eventually leading to kids on 4-5 drugs who can’t maintain in a foster home and end up in residential “treatment” centers. And yet mentioning that the “treatment plan” seems to be leading to more and more deterioration is met with hurt feelings and outrage, or with complete dismissal. Isn’t “treatment” supposed to make you better?
Yeah, there was some study way back that claimed that “combined therapy was better than either medication or therapy alone.” It became some sort of mantra such that any challenge to it was met with derision, at least in the circles I was traveling in at the time, even though many future studies showed no such thing. It’s one of those myths like the “broken brain” myth that has little to no support, and yet persists like a bad case of poison oak.
Are these people freakin’ serious? What about a voice pattern could POSSIBLY be considered a “biomarker” for anything? I suppose that they will discover that “depressed” people speak in a flatter and less variable tone. Or we could just ASK the person how s/he is feeling instead of using all this technology to analyze their voices? How does this kind of idiocy pass for science?
And a lot of people given antidepressants don’t feel better or feel worse. See Kirsch’s works for the minuscule difference between AD’s and placebo when you look at all the trials together instead of cherry picking the ones they submit to the FDA. As for antipsychotics, yes, they do tend to reduce hallucinations and in some cases delusions in the short run, though certainly not for everyone. Unfortunately, long-term followup studies suggest that this is very much a temporary phenomenon, and that over the long term, people chronically using antipsychotics have MORE episodes of psychosis than those who use them intermittently or not at all. If you would read “Anatomy of an Epidemic,” you could see this research for yourself.
I’m afraid a lot of what you’ve been led to believe about psych drugs is not actually true.
I’d be interested in hearing your “evidence of brain pathology” for any “mental illness” you’d like to name. Of course, all such research is tainted from the beginning, since the definitions of “Schizophrenia” and “bipolar” and “Borderline Personality Disorder” are all extremely vague and subjective, leading inevitably to heterogeneous groupings who can’t possibly have significant shared biological traits. But even accepting such vague definitions, the research I am familiar with shows at best very small correlations with any biological “cause,” the most optimistic being around 15% correlation with a mess of a hundred or more genes, and using multiple “disorders” for the correlation. Whereas the correlation between traumatic events and any of the “mental disorders,” including “schizophrenia” and “bipolar,” is extremely high, usually over 80%.
And if you’re talking instead about fMRIs and PET scans, this research has long been critiqued for not being able to distinguish cause from function. What I mean is, if a “depressed brain” has a certain pattern (which has NOT been consistently shown, by the way), there is no way to know if that pattern CAUSES depression or RESULTS FROM the person feeling depressed. In fact, there is evidence that thinking depressing thoughts shifts the brain’s function in the direction associated with “depressed brains,” and thinking of something else returns to a more “normal” pattern.
The other problem is that these scans are AVERAGED. So even if there is a tendency, for instance, for people who are diagnosed with “ADHD” to have a certain pattern when confronted with difficult tasks, only SOME of those so diagnosed have this pattern – there is a wide range of individual results, some of which conform closely to the pattern and some of which vary widely. This is why PET scans can’t be used as a diagnostic tool – there is NO consistent finding across large numbers of “ADHD”-diagnosed people.
So the science I know of says that biology probably plays some role in how we react, but that there is no consistent biological pattern with any of the “mental illnesses” as defined in the DSM. The science also says that traumatic experiences are MUCH more highly correlated with any “mental illness” than any biological findings to date.
I’m happy to read any research you have that would speak to this question. But so far, I can’t agree that the science to date agrees with or even suggests the conclusions you propose.
In other words, listening to a black young person’s experience and validating it can help them feel better? This title makes it seem like “discussing racial stress” is some kind of a special “therapeutic technique” for black youth with “mental health problems.”
Systemic change will happen when we stop talking about common experiences and reactions to our social and economic system as if they are somehow “illnesses” that need to be “treated.” And when listening to someone is considered what kind-hearted and compassionate people do when meeting someone in distress, rather than some sort of “treatment” for “mental illness.”
Of course, they don’t really have an opinion of you. They haven’t bothered to find out who you are. They have an “opinion” of “bipolars” or “borderlines” or whatever box they want to put you in. The only “success” with such people is escaping their boxing game and finding someone who actually cares about you as a human being.
You can’t bill for drugs administered to a dead person. Not economically viable. So it has to be keeping people alive but inert. Works for everyone, except the “patient,” of course.
Trying to “explain” your behavior is often regarded as more signs of “illness.” You haven’t accepted their explanation, so you must “lack insight into your condition.” It’s a no-win situation!
“Overtreated” suggests that there is a proper amount of “treatment.” It seems a devious term to be used in this context, as of course, having no objective way to “diagnose” “bipolar” or any of the other so-called “disorders,” it is impossible to even establish what is being “treated,” let alone what the “proper amount of treatment” would look like.
Maybe the title should be, “Overheated, then overwhelmed with attempts to define and control my life.”
I think you’re right on that indifference is the big problem that underlies the ability of some “mental health professionals” to continue to do harm and feel OK about it, and that the public has unfortunately largely bought into this idea to a large extent.
I do want to take a moment to remind everyone that psychiatrists are human beings, like everyone else, and they come in all varieties. I don’t think we can say that all of them are “soulless” and “cynical.” Certainly, there is an attraction to the soulless and the cynical to a profession that handles pain by repression and blaming, and makes lots of money for its followers while creating permanent clients. However, my experience of rank-and-file psychiatrists is that most are more “hypnotized” and think they are doing good works. They have been trained, as it were, in a cynical system of thought, and behave in accordance with that system. And there are a handful who see the foolishness of their training and are trying to do something better, some ow whom post on MIA.
But in the end, you are correct in saying that it will require organization and resistance from the potential clients/victims of such a soulless system to bring it to an end. Connectedness is the cure to soulless cynicism, in my book.
Half-life has to do with immediate drug effects, including withdrawal. It doesn’t account for damage and changes in the brain or body resulting from the drug use. Especially after long-term use, these changes can be profound and take a LONG time to repair themselves, if it ever even happens.
I don’t think we really disagree with each other much here. I think we’re just emphasizing different aspects of the problem. Being biased against someone for differences is certainly not something invented by psychiatry. They just tend to make it a lot worse, and then blame others for their poor outcomes.
It is true, we ought not to think less of people regardless of whatever struggles, physically or psychologically or whatever, they may experience.
My point is that how a problem is framed has a lot to do with what people believe can be done to resolve it. The placebo response is a perfect example – if people are given hope that they will improve, they can often rally their internal resources and they actually DO get better without intervention. This is particularly true of so-called “mental/emotional disorders.” Telling someone they’ve “had a rough childhood but that other people have experienced the same and have overcome it, let me connect you with some of them” will give the person both validation and hope. Telling someone their “brain is genetically defective and they’ll have to take drugs for the rest of their lives to deal with the symptoms, but there is no cure” removes agency and blunts hope. Since the latter has not been shown to be true in the overwhelming majority of cases, why would we not start with a framing that provides hope and agency, rather than one that promotes hopelessness and passivity?
There is a reason psychiatry frames things the way they do, and it has not much to do with helping people achieve better control of their lives.
I would add that suggesting Open Dialog might work is no more of a fantasy than suggesting that taking antipsychotics for the rest of one’s life is a viable solution for most people. Or more of a fantasy than NOT telling clients the known potential adverse effects of the drugs being recommended because it might make them decide not to cooperate. Or the fantasy of choosing a list of undesirable behaviors that tend to occur together and calling it a “diagnosis” and then claiming that “it” is caused by a “biological brain disease.”
The entire enterprise of psychiatry seems to be founded on fantasy. Not sure why trying Open Dialog would be any more fantastical than what is already accepted as “standard treatment.”
“They were dysfunctional before I treated them.” I always find this a very lame line of “reasoning” and don’t understand why it seems to work to deflect so many people’s concerns. If I went in for a sore shin and came out of the doctor’s office with a broken leg, I don’t think they’d get away with saying, “Well, the leg was dysfunctional before I treated it.” Treatment, if we may even use such a term, is supposed to improve the condition. Even accepting that the person was “ill,” if they continue to act “ill” despite your “treatment,” how does that let you off the hook? If your “treatment” doesn’t work, why are you accepting money for “treating” them in the first place?
Anyone who wants to post here is allowed to post, as long as they follow the Posting Guidelines. We have never moderated family members who chose to participate based on their being family members or on their not having a family member embroiled in the system. It is true that some of our community distrust family members’ intentions, based on their own experiences. But family member voices have always been welcome at MIA. I’m not sure where you are getting the idea that family members are “not allowed to post” if their loved ones are not caught up in the system. What would stop such a person from posting?
Multiple studies have indicated that the process of telling someone they have a “Brain disorder,” or telling someone else that “mental illness” results from brain malfunction, increases “stigma,” in contrast to telling people that it is the result of struggling with difficult life experiences. So a large percentage of the “stigma” is the result of the very psychiatric system that later decries it.
I want to be clear that voices of those who feel they are helped by psychiatric drugs have always been welcome here. It is admittedly sometimes a challenging environment, as they will hear stories and feelings which don’t comport with their experience, but attacking or downgrading people because they choose a pathway that includes psychiatric drugs is never accepted here. Now if someone starts arguing that people HERE need to accept their reality and validate the reality of DSM diagnoses or something of the sort, they’re going to be in for an argument. But civil exchange of views is the central theme of the comments section, and no one is allowed to be censored or attacked for having a contrary view.
I made a couple of comments on the original article, which initially got published. But I just checked and the comments section appears to have magically disappeared! I wonder why…
The other problem with “evidence based” is that the only things that get an “evidence base” are the things that are funded, and we know who pretty much decides what gets funded. Hint: it’s not the recipients of the “evidence based therapies.”
Akathesia is often not reported and not understood by people who work with children, even the psychiatrists. I had a young lady (14) who specifically reported being “unable to sit still” (the literal meaning of “akathesia”), and was on a special program where she could raise her hand to leave class because it was so hard for her to stay in one place. They had a goal of staying in class longer. After my CASA volunteer and I got them to reduce her Risperdal and Lithium dosages, her in-class percentages went up significantly. But the psychiatrist still denied that akathesia had been an issue. A survey of the residential staff showed that none of them had been trained on what to look for as adverse effects, nor were they told that watching for adverse effects was a part of their job. The level of denial is unbelievable.
“Policing by consent” is the only possible policing that would work. And of course, with the huge prejudices and power imbalances in our current society, we’re a long, long way from “policing by consent!” It seems the less power you have in your position, the less “consent” is required for you to be “policed.”
I’m saying that not all the individuals who play the role of police are acting in defense only of the rich and powerful. I suppose the same could be said of psychiatrists, though in my observation, there are a hell of a lot more police of integrity than there are psychiatrists. The school system is very similarly messed up to me. There are a goodly percentage of teachers who care, but they work in a system that disempowers the students and they can’t really fix it themselves.
I’ll look at your links, but I was interested in YOUR answer – what do YOU think we do about bullies and aggressive people when there are no more police?
I have to take issue with this to some degree. I have known many police/sheriffs who have done a fantastic job of “protecting and serving” the community they are in, including handling some situations involving “mental health clients” with particular aplomb. I’ve also seen unwarranted brutality, dismissiveness, and threatening behavior that would make anyone distrust the force. Both kinds of officers exist. And while accountability issues are critical, particularly with darker-skinned people, and systemic racism is very, very real, I am not sure we really want to live in a society where there is NO police function at all. We saw what happened in the CHOP zone when there was no law enforcement – people got shot and died. Every society has some form of law enforcement, formal or informal. There will always be people who threaten the community in some way. While the current system appears to have been coopted by the rich and powerful, and this has been true for a long, long time, I have to ask what means will we have to deal with people who want to harm and take advantage of others if the police are entirely “defunded?” And even if they are defunded, what’s to prevent psychiatry from coming in to take over their role by “diagnosing” people who don’t behave as society expects, for whatever reason?
Ah, but the ones who are in denial are the ones deemed “mentally healthy!” If you’re too worried about it, you have an “anxiety disorder!” If you’re working hard to stop it, you’re “Manic!” If you give up and feel hopeless, you have “major depression!” The only acceptable response is to not be too worried about it and assume it will work itself out.
The problem with this is that once you make it OK to use these in “extreme cases,” very quickly, it becomes OK to use in ANY case, because there is no objective standard to justify their use. And making people more tractable isn’t really a “medical” issue, anyway, it’s a social management issue.
There are also lots of ways to intervene with dementia patients that don’t involve drugging them into submission, and these are rarely even considered before going to the drug solution. Yet information on these is buried deep! I just did a search on “alternative approaches for dementia” and got only drugs and “complimentary medicine” (herbs and homeopathy, etc). I had to go for “psychosocial approaches to Dementia” to get any hits worth looking at. This is because dementia has been redefined and captured by the psychiatric industry and all other approaches have been suppressed.
My wife’s dad had Alzheimer’s and was put on Risperdal because he was grabbing the nurses arms too hard. He went from being quite interactive and gregarious within a very short time to being unable to sit up, head thrashing from side to side, trying to but unable to talk, obviously in utter misery. No one at the facility seemed to know or care that the drug had done this. Ginny got her mom to take him off the drug, and within three days, he had recovered most of his personality and communication ability. When he grabbed her arms to tightly, she said, “Dad, you’re grabbing too hard, it hurts!” And he stopped grabbing. That easy! And yet they felt it was OK to drug him into insensibility and near paralysis because he didn’t just do what they wanted without having to communicate with him respectfully.
Yes, dementia is very difficult to deal with, and yes, antipsychotics make them easier for caretakers to manage, but the dangers of abuse of power by the facilities or other caretakers are extreme, not to mention the risk of early death that they convey. I would not allow my loved ones to be put on these drugs. They are for the convenience of the caretakers, and remove any incentive for them to actually figure out a loving way to handle the difficulties such people present.
OK, that’s it! Everybody out of the pool! This thread has deteriorated and has become nothing but a back and forth between people completely fixed in their positions. It is time to end it. Again, I am not “banning posts on COVID” or “censoring,” I am stopping this deteriorating thread of subtle insults, straw-man arguments, defensiveness and disrespectful analogies. EVERYONE has had their say. I will not post any more comments on this theme on this thread.
Richard, it is too difficult and time consuming for me to address the various assumptions and implications in your responses. You’ve made your point, people can read it, and I’ve made my point, people can read it. It is time to end this conversation, as it is not only going in circles, but going on extreme tangents at this point. We agree that COVID is real and that it needs to be taken seriously and that there are people with hidden agendas opposing taking it seriously or taking advantage of it for political gains, and that those forces need to be opposed. Let’s focus on what we agree upon and move on.
Oh, believe me, you’re not the only one! I’m still waiting for that moment of crystallization when suddenly it becomes clear to enough people that something shady is going on. In the meanwhile, I keep trying to educate and support, educate and support. But it doesn’t feel very hopeful.
Still, I never thought the Berlin Wall would come down, and it did. So the world can surprise us sometimes. I’m hoping it will be sooner rather than later! What will it take for the masses to rise up and say “NO!”
POSTING AS MODERATOR: So we are in agreement that black and white rules of moderation are not possible?
I tend to agree with you that using terms such as “fascist” out of context would constitute ad hominem attacks. I will continue to try and be more sensitive to this kind of language, and will appreciate people reporting posts where I have missed such statements. Of course, it is quite legitimate to say, “My therapist was a bully, because s/he would tell me I was stupid every time I questioned her.” Or to say, “This person subscribes to fascist ideology, as indicated by his references to quotes from Mussolini and his use of nationalistic slogans and identification of external threats as excuses to curtail civil liberties,” or that sort of thing. The issue would come if the person is trying to discredit an author or another poster by the use of such terms to refer to them or their writings without any such context. My preference is for folks to simply refer to the offending comment, such as “Mr. X uses the term ‘redskin,’ which I and I think most people consider racist” rather than “Mr. X is a racist because he said the word ‘redskin.'”
So there is always a degree of subjectivity. But I don’t think we want a community where someone can say, “Oldhead is a slimy bag of feces” without being called out on it. Nor do I think we want a site where someone can’t say, “I think vaccine policy is highly influenced by unethical government agents in cahoots with the drug industry” without being called names or shunned or having his/her opinion censored just because their position may be viewed by others or MIA staff as controversial. Which is why we have the posting guidelines. But again, they’re guidelines, not rigid laws, and the goal is to have a free-flowing conversation while avoiding as far as possible unnecessary personal hostility, bigotry, and hurt feelings. As long as we keep that goal in mind, I think we can all live with the uncertainty of it. And as you know, I am always willing to listen to and discuss if anyone feels they are being treated unfairly. I am not sure how we can do any better than this.
Well, if we’re talking about whom we support politically, there are sides. I took your comments to be referring to the larger questions of knowledge/facts regarding COVID and other issues that are in conflict. I was objecting to the idea that there are “sides” when it comes to exploring the truth of a particular assertion. I don’t consider science to have “sides,” except for seeking the truth and using “science” to avoid or distort it. But using “science” to distort truth is not science at all.
I do know the song you refer to. But as I recall, it was in reference to being on the side of those who are exercising power for their own benefits, vs. on the side of those who are attempting to come together to resist them. This seems pretty different from questions regarding what the actual threat from COVID is and how best to deal with it. As I have already stated clearly, politicians from both sides have tried to engage in “information management” or “messaging” to take advantage of this world-shaking issue and benefit themselves. I’m definitely NOT on their side. But I can’t embrace the idea that there is a “side of truth” and a “side of dishonesty” in this particular case. (Well, OK, there MAY be a side of dishonesty!) The sides I see are the side of using a disaster to manipulate people to support or oppose a political agenda, and those who are trying to figure out the best thing to do to ensure the safety of our population while remembering the limitations of our knowledge, and maximizing our ability to remain engaged and productive in our lives. That’s the only side I support fully.
What I don’t support is the idea that there are those who believe and agree with everything you said above and those who don’t think COVID is real and don’t give a crap about anyone else but themselves (or those who are too foolish to avoid the deception of the Forces of Evil). I’ll provide a simple example: should one wear a mask while hiking in the woods, or at least when passing someone else on a hike? If I told you that the science suggests that outdoor mask-wearing outside of a close gathering of people is pretty much pointless, would you consider me part of the “other side?” Well, a recent tracking study in China tracked 7000 cases as to origin. Exactly ONE case out of 7000 was caught outdoors, and that one case involved a person talking to an infected person at close range for more than 15-20 minutes. So I don’t wear a mask outdoors, unless I am in a crowd. This is in violation of the CDC guidelines, which from a scientific point of view appear to be wrong. Does that make me one of those deceived by the forces of evil? Do I have to wear a mask while hiking to be considered on the “right side?”
To reiterate: Politics has sides. Science does not have sides. Things are proven true, proven false, or are uncertain. Very, very few things fit into the first category. Generally, things are scientifically false or are uncertain. Uncertain situations require judgement, and judgement is based on data, not political agendas. Mixing science with politics creates bad science.
I hope that clarifies my point. As to the Bush comment, it was just what came to mind when you said what you said. I’d certainly never compare you to Bush II, with whom I’d guess you have almost nothing in common. But I’m also not going to apologize for what thought came to mind when you said it, nor for sharing it. I hope it gives you pause to consider that you may be creating an impression that you don’t want to create.
POSTING AS MODERATOR: I challenge you to find an objective way to decide whether someone’s comments are “shaming” or make generalizations based upon a label or are an attack on a person vs. on what that person said. Moderation is unavoidably subjective, no matter how objective I try to make it. If we are in grey areas, I tend to use consultations with others, but again, not purely objective. Sometimes I pass something through and it ends up offending others for reasons I could not have understood until explained to me, and I have to reconsider.
Sorry, but there will always be grey areas in moderation. Nature of the beast.
POSTING AS MODERATOR: When a certain number of “levels” are reached under a particular thread, the “reply” button disappears on new comments, and you have to go back to the last one that has a “reply” button and use it, and your post will end up at the end of the thread. It’s a feature of WordPress and not something we have control over.
Just because it seems preposterous doesn’t mean they can’t make big money making that claim! Doesn’t matter if it’s true, as long as enough people believe them.
POSTING AS MODERATOR: Oldhead, you cut off the part of the last sentence you quoted about insisting that others agree with their personally-derived “truths.” MIA is and should continue to be a place to explore the truth, but when the discussion itself becomes increasingly authoritarian as it progresses, there is a point at which it is no longer productive of truth, as both sides are merely stating and restating their own ‘truth’ in a louder and louder voice, and things get more personal and insulting and it gets plain ugly.
Admittedly, it is hardly an objective standard, but in the thread I asked people to let go of, it was most definitely getting into that realm and very far afield from the original topic.
Sorry, there are no black and white rules in moderation! But I’m not moderating for content, except to the degree that off-topic conversations on any subject, when they become unproductive and backbiting, will be discouraged.
Your idea of a different place to have this discussion is a good one. Not sure exactly how to bring that about, though. I’ll give it some thought.
I appreciate your inclusion of a lot more factual material in this comment. However, I do find using language like “Which side are you on?” does contribute to divisiveness. It reminds me of GW Bush’s “You’re with us or you’re against us” rhetoric back in the Iraq Ward run-up. I do agree that these issues are serious and we need to make our decisions based on facts rather than rhetoric, and that there are political agendas behind much of the supposed “facts” that we have been provided with. But not having reliable fact sources does put us all in the position of having to educate ourselves about how to evaluate what information is true. I’m hoping MIA will run an article or blog on this point, because I think people need help sorting out what is or isn’t true, and many don’t even know they need that help. I believe that acknowledging the point that it is difficult to know whom to believe is very important if we want to help more people make better evaluations of what “information” to believe.
Note how cleverly they say that “chemicals… MAY be unbalanced,” but then claim that the “medication” helps “restore the balance” of chemicals that they later admit they don’t know are actually “imbalanced” (which is why they say MAY). It is a clever workaround of “truth in advertising” laws, but I think it should never be allowed, because by claiming to restore the “balance,” they are essentially asserting a truth that is actually not known to be true.
Posting as moderator: COVID is a valid point of discussion if it is relevant to the article at hand. In this case, there is a claim that COVID is somehow moderated by psychostimulants, so that would be the topic of the conversation. Clearly, comments relating to COVID would be germane to the discussion. However, if the thread gets hijacked into talking about related issues that go too far afield from the article’s topic, I might end up asking folks to end the discussion, particularly if the discussion is becoming repetitive and escalating into personal attacks, as happened in the thread I believe you are referring to.
I have never said that talking about COVID is off limits, just that we need to stay on the topic at hand and be respectful to each other in the discussion. The difficulty seems to come in when instead of sharing their perspective, folks begin to assert “truths” that are not objectively established and telling others who disagree with them that they are fools or dupes for believing it. I think we can all agree there has been a lot of disinformation about COVID coming from various people with political or personal agendas. I would just call for restraint in staying on the topic of the article and allowing for the possibility that our viewpoint may not be “right” in an absolute sense of the word.
“… give him the result that HE wanted.” There, indeed, is the rub. The psychiatrist wasn’t concerned with the result the client wanted, only the result the psychiatrist wanted. Paternalism/authoritarianism in a nutshell. He knows better than the person he was purporting to help. If they disagree with him, they’re a “resistant client!”
I think the first thing to remember is that things like “anhedonia” and “fatigue” happen for a hundred different reasons. Labeling these phenomena as “illness” obviates the need to look further for the actual causes and potential cures for any REAL illnesses that might exist (such as anemia, low thyroid, heavy metal poisoning, etc.), and ALSO prevents the consideration that such phenomena may in fact be NORMAL reactions to adverse circumstances. Depression, anxiety, anger, hopelessness, excitement, all are part of the human experience, and to relegate them to “malfunctions” when they are in fact essential survival factors in life is in itself depressing and discouraging to people trying to make sense of their experience.
So no, people aren’t lying about what happened to them – no one denies that suffering occurs. The problem is the simplistic reduction of suffering to a “malfunction” in a person, as if suffering were not a normal part of life, as if everyone should always be “happy” regardless of their circumstances (but not TOO happy – that might be MANIC!)
It is not a choice between denying suffering exists and calling it an illness. We can all acknowledge suffering as an unavoidable and necessary part of life, as well as recognizing that people need support when they ARE suffering. We can also acknowledge that there MAY be physiological causes for SOME psychological suffering, but that absent an actual understanding of the cause or evidence of specific physiological pathology, we should assume that psychological suffering is the simple result of living in a confusing and at times challenging world, and that compassion, not medicine, is the best place to go to help.
I am very sorry to hear that you had such a bad experience! Apparently, you are not alone. However, I would not necessarily agree that you have nothing to lose by trying “ECT.” There are many people who have described horrific “side effects” of ECT, especially loss of memories, including the good as well as the bad. I strongly suggest you read up carefully and read some stories from people who have tried it out. I’ve never actually met someone where it “worked” for more than a very short period of time, and I’ve met a good number where it did essentially nothing or where they deeply regretted the damage it did to their brains. I don’t want you to feel like a fool yet again!
I really see two very separate issues being argued here. One is that people can promote misleading information on the internet. It appears that both of you agree that is true and there is no real argument about it. The COVID discussion seemed more about what to DO if such information is put out by people who believe it is true. It seems the real point of disagreement is whether or not it is helpful to use pejorative language like “nonsense” and “dangerous” and “conspiracy theory.”
Clearly, people can disagree about the wisdom of using particular language. I guess the question I would ask is how it helps the discussion to use this kind of language? Does it discourage people from considering such information? Does it drive the proponents deeper into defending their positions? Does it create a meaningful discussion or does it undermine opportunities to truly examine the data that is presented?
I tend to agree with Nijinsky on this point. There really ARE conspiracies operating, and the term “conspiracy theory” has been used broadly to discredit any questioning of the status quo, no matter how rational or well supported. Antipsychiatry activists have been accused of being “conspiracy theorists” or “anti-science,” and it is a very effective way of silencing dissent. If we don’t want that kind of language used against us, I think we need to be more creative in our language rather than relying on general put-downs and characterizations that don’t involve any kind of analysis. I liked learning, for instance, the very low number of deaths claimed by the website in question. This was MUCH more influential in my assessment of this person’s claims than saying he is “promoting conspiracy theories” or “spouting nonsense.” To me, the more we stick to citing and responding to actual facts or claims, the more effective we can be in undermining inaccurate sources and theories. Calling names makes the name-caller less credible in my book, plus it legitimizes the kind of fact-free attacks that are often leveled at those who oppose psychiatry’s hegemony.
One of the worst things about the DSM is that it immediately disempowers the labeled person. Instead of seeing your emotions, pains, fears, joys, etc. as a result of your ACTIONS, they take away your agency and tell you that you feel this way because you are broken in some way. And they give you no hope of anything YOU can do about it, except to try their drugs and hope you’re one of the lucky ones that they work for.
Most don’t even bother with the DSM any more. If they think someone is “disordered,” they declare them “disordered,” and no one has the right to argue.
I don’t disagree with your assessment that psychologists and psychiatrists are involved with the COVID response, and not in a particularly helpful way, and discussion of this connection or similar material relating to our mission here is more than welcome. The issue becomes unclear when we are talking about whether or not COVID is a serious risk, whether or not masks help prevent infections, whether or not there is some international conspiracy to use COVID to accomplish some other political goals and so on. These are certainly legitimate areas of concern and valid for conversation, but threads have been completely hijacked and gone way off topic when I have allowed this kind of discussion to expand beyond the boundaries of the effects on behavior and emotions and the way that the psychological/psychiatric industries have tried to capitalize on COVID to convince us that a “wave of mental illness” is occurring instead of recognizing that being afraid of a pandemic virus is a normal thing, or comments of that nature. There is a moment when it stops being about the psych industries and it starts being about political issues that transcend psychiatry/psychology by a very large distance. For instance, arguing about whether or not COVID cases are overcounted or undercounted or whether or not “shutdowns” were needed or whether the Democrats are fear mongering to help their election chances or Republicans downplaying it to appeal to their base and so on have nothing to do with the psych industries. Those kind of posts are not going to be allowed without a direct connection to the material in the blog/article in question.
I have allowed a lot of off-topic remarks regarding COVID on threads that have nothing to do with COVID. I think it is time to stop this. We are not a site about COVID, and it is a very controversial subject that goes very far afield from rethinking or ending the practice of psychiatry. I am not going to allow any more COVID posts that are not directly relevant to the article at hand. There are plenty of other forums where such discussions are more appropriate to conduct.
I have allowed a lot of off-topic remarks regarding COVID on threads that have nothing to do with COVID. I think it is time to stop this. We are not a site about COVID, and it is a very controversial subject that goes very far afield from rethinking or ending the practice of psychiatry. I am not going to allow any more COVID posts that are not directly relevant to the article at hand. There are plenty of other forums where such discussions are more appropriate to conduct.
“Stopping suffering” or “controlling symptoms” are extremely nihilistic concepts that deny the reality of being human. Instead of “stopping suffering,” any real help has to focus on making SENSE of suffering and helping people assume more control of their lives, including dealing with the ongoing effects of past and current abuse. If we focus more on stopping ABUSE (including the abuse of power) than stopping the feelings of those who have been abused, we’d be getting more onto the right track.
There is not only “not a lot of evidence,” there is NONE. The only “help” that neuroleptics provide in those with dementia is for the staff who have to deal with it. It makes the residents more “manageable”, that’s all. And of course, it kills them off early, too, per the black box warning. But that doesn’t seem to bother most of the people involved in the adult care industry.
I agree, the “false memory syndrome” thing was originally about implanting memories by asking questions to kids the wrong way. Somehow it got altered into the idea that recovering memory from moments of limited awareness somehow never happens. It’s bullshit, but met the needs of those who want to blame clients or their brains for what happened to them.
It is difficult to live without hope. Hope means having some intention for the future to be better than the present. I hope you can find a way to connect with some kind of purpose and intention for your future, because you deserve to feel safe and well!
Great data! I will just take a moment to remind people that prescribing drugs within the standard of care is not a “medical error,” it is standard medical care. So the fourth leading cause of death in the USA is STANDARD MEDICAL CARE! There have been efforts to spin this as “medical errors,” so they can make it seem like these are mistakes made by “bad doctors.” But the truth is, this is not a result of “bad doctors,” the vast majority of these deaths, over 200,000 yearly, up to 400,000 in some estimates, result from standard medical care. This should be a terrifying statistic, yet somehow we are much more worried about the very rare possibility of a terrorist attack than we are about the carnage going on around us every day due to the awful outcomes of our own medical system.
I totally feel you on the “coping strategies.” There was a recent article on “ecotherapy” that made the same impression on me. Don’t take my hikes in the woods and turn them into some form of “therapy!” They are walks in the woods, and I love them, and that’s all that needs to be said! I don’t need “coping strategies”, I need meaningful and fun activities that make my life feel worthwhile. It’s not therapy, it’s called LIFE!
I think the first mistake of psychiatry is to assume that everyone who acts or feels a particular way should be grouped together and “treated” as if they have the same “disorder.” The evidence you report supports this. There most definitely could be biological factors that cause any sort of “psychiatric symptom.” But then we need to detect and treat the REAL problem instead of just suppressing the overt manifestations with drugs. I know I’m preaching to the choir here, but biochemistry can easily be addressed without resorting to the subjective and largely nonsensical DSM. Real science looks for causes and relationships, which I’m hearing you call for. I have no problem with that, as long as we don’t assume that “schizophrenia” is a legitimate category that groups together people who have some causal factor in common.
Ah, I get it! But someone else had resurrected it first, I believe. I was just responding to a comment someone else made, otherwise I would never have seen it. Good to know it’s still breathing!
That is so sad, Kate! I can say that I absolutely believe you. It is not hard at all to believe. There are others who will believe you, too. I think you can connect with those who really do understand. As for the rest, they can go ahead and take their drugs and deceive themselves. But once you’ve seen “the man behind the curtain,” you can’t believe in the Wizard any more.
Nadine Lambert did some good work on this line. She also showed an increased risk of smoking relating to the use of stimulants in childhood or adolescence.
“…clinicians often problematize the sexual needs and practices of residents.”
That’s pretty damned euphemistic! Why not say, “Clinicians tried to shut down any opportunites for sexual expression due to their own discomfort, and used their power to deny residents their civil right to meet their sexual needs without interference.” This is a matter of a violation of rights, not some philosophical discussion of “problematization!”
I actually don’t consider the problem to be complicated at all. One side knows it doesn’t have the data but is making money hand over fist. The other side has the facts but extremely limited power. Power outstrips facts if it wants to.
I think the hook for me is that anyone who recognizes psychiatry is messed up and is doing damage is someone I want to engage with. Most “antipsyciatry” people have had less radical views earlier in their lives/careers. We don’t like to believe that a social institution is actually intending the opposite of what it purports to be doing. That is an awareness that occurs only after long examination of the facts, unless someone is thrown into the system and experiences it directly and undeniably, and even for the latter, it often takes a long time to come to full awareness. This group appears to have come a long way down the path to understanding what is wrong with psychiatry. My view is we should welcome such folks and try to help them see further, rather than criticizing them for not being “antipsychiatry enough” to meet our exacting standards.
I would CERTAINLY object to tracking people who have not been convicted of a crime. Mask use is certainly no reason to track or punish people. We should be working on getting agreement on how to help each other.
Actually, it is the job of the researcher to prove that genetic/biological causes exist and are causative, not the job of detractors to disprove it. Scentifically speaking, lack of proof of genetic causation means it is assumed to be scentifically untrue, at least for the moment. And the fact that something “runs in families” is certainly no proof of a genetic origin! Speaking Chinese or using silverware to eat with both run in families, but are not in the least genetically related. Culture is passed on through families, and explains a great deal of similarity between parents’ and children’s behavior.
If we want to be scentific, we have to be VERY careful about what we assume to be true. 50+ years of research have failed to demonstrate a specific biological cause of ANY of the “mental health” diagnoses in the DSM. Scientifically speaking, this suggests that such causes are very unlikely to exist, at least in a general sense. Specific instances of these “diagnoses” may have biological origins, but unless ALL or almost all cases of “depression” are shown to be biologically caused, we can not say that “depression” is biologically-caused condition.
I am agreeing with Oldhead that this topic has been thoroughly hashed out and further argumentation is not going to add much to anyone’s understanding and may lead to hurt feelings. I’m already seeing things getting more emotional and some hurt feelings being generated, yet little to no progress toward agreement for the effort. It seems there are strong feelings on both sides of the issue, and we have seen some links to data enough that people who are reading this can hear the arguments and make up their own minds.
Besides which, this is pretty far afield from the original topic. So I’m going to ask that we wind this down quickly. There are a couple more comments that I have to consider whether to post or moderate, and that may engender a reply or two, but let’s try to bring it to a civil end. Sometimes we just need to agree to disagree.
So what’s the beef with the masks, then? And I did not intent to imply that KS was engaging in conspiratorial thinking. There were other comments (including some comments from your source person, Berensen) that suggested required mask-wearing was part of some larger conspiracy to gain control of people through fear. I am trying to decouple the idea that people are promting fear (which they are) and the idea that wearing masks can reduce the passage of pathogens from one person to another (which they can).
Like I said, I know there is a lot of shimmy-shammy with the statistics. I think I noted way back that the death rates from other things dropped suddenly when COVID came in, most likely due to a preference for labeling deaths COVID-related (I think there was some financial incentive involved). I also remember the stuff about how the flu killed 60,000 a year, but we discovered that this was an “estimate” based on pneumonia deaths, and did not actually count flu deaths at all!
But again, there IS a virus, it IS contagious, it is almost always spread with extended time together indoors through breathing, and it therefore makes a lot of sense to wear a mask indoors. If it doesn’t help, it doesn’t, but there is nothing irrational about the concept, nor is it a new idea invented to expand the “plandemic.” There is plenty of real conspiracy going on, and arguing about masks seems like a pretty useless distraction at this point. It makes as much sense to me as telling people not to cover their mouths when coughing because the CDC said we should.
Are you not allowed out of your house? Where are you exactly? We’ve gone shopping and hiking and biking and gotten takeout the whole time. It’s a big jump from “try not to pass it on” to “permanent isolation.” Maybe things are different where you are?
I did not hear Kindred or anyone else saying this was not a political issue. I heard her specifically say that she understood there WAS politics going on but that politics does not cancel out basic precautions that are known to be effective. She pointed out the general recommendation of covering one’s mouth and nose when sneezing. Do you really think that recommendation is based on “conspiracy” to make people more anxious? Or is it based on the knowledge that people who are sneezing may be ill and possibly pass on a virus or bacterium to others? How big a leap is it from there to saying that selective mask-wearing could help protect individuals and slow the spread of the disease, regardless of how many scare tactics are in use?
I absolutely think that political entities are using COVID to grind their own political grist, as they do with almost anything that comes up. It doesn’t mean COVID isn’t real or that masks have no effect. It seems irrational to me to assume that because people may be trying to scare us, that everything they say should be resisted. The proper approach is to discount scary but unsupported “data” from ANY source, and to research from real data and draw our own conclusions. I also think there are people who want to scare us about the possibility that COVID is an intentional “plandemic” and I find them just as non-credible as those who claim that it’s all from some bat crap on a piece of fruit that just happened to be in the same town as a wet lab working on making coronaviruses more virulent.
We’re all getting lines of crap, and it’s coming from all directions. It’s time to calm ourselves down and return to “common sense” and rational discussion of actual data.
Of course, I don’t consider the CDC to be “scientific” – I think I made it clear I was talking about research, and that should havee been very obvious from my comments.
This is from Vox, but cites and summarizes research directly, and appears quite rational, and even goes into how false research led people to believe that running past someone put them at risk:
I don’t disagree at all that the mainstream media is primarily propaganda from the current elite and is not trustable. Which is why I said I use the internet to look at actual scientific studies and data rather than trusting anyone else’s interpretation of events. There are huge exaggerations and manipulations of data from both the “left” and the “right,” but mostly from those who have an interest in keeping control of society so they can make money.
One of the things which makes me doubt that the release of COVID was planful is the fact that a lot of folks are losing money as a result. At the same time, the current surge in stock prices does suggest that some insider knowledge may exist that we don’t know about. But we will never know about that stuff for sure. What we CAN know is that there IS a virus and it IS contagious and we have some means of lessening the spread of it. That is not from the mainstream media, that is from direct research published in scientific journals. Most of the good stuff to argue against psychiatry’s insanity also comes from that kind of research. Of course, some of that is biased, but we are also capable as intelligent, rational humans to evaluate that as well.
So perhaps I didn’t make myself clear: I don’t accept anything from a media source that interprets the data for me. I look at the data as best I can. The data does exist and can be located if one is persistent enough and can filter for conflicts of interest. Far better to do the research than to assume that no truth can be found because the MSM and others with their own agendas alter the data that is easiest to find.
I have to evaluate the information for myself. It doesn’t really matter to me if someone does or doesn’t want me to use a mask, I have to decide based on what I know about science and diseases and this particular disease. It is not a matter of “deciding who I believe.” But unfortunately, most people are not scentifically literate and don’t seem to have learned how to evaluate data. So they are depending on someone else to do their “evaluation” for them, and instead of deciding WHAT to believe based on data, they have to decide WHOM to believe, based on God knows what standard.
Hence, we get “infowars” and “left-right” unresolvable arguments, because one person believes Person X who says “all psychiatrists are helpful people who are doing all they can to help humanity, despite a few mistakes” and others believe Person Y who says, “All psychiatrists are evil and they are the cause of all that is wrong with the world.” But neither person really KNOWS what psychiatrists do, so there is no real end to the argument, and it becomes easy for the powerful to dismiss antipsychiatry activists as “anti-scientific” despite evidence that they have no interest in following any scientific principles at all. Because they are doctors, after all, and so they should be trusted. And so on.
So I revert to first principles: let me see the data. The data right now indicates that masks make little to no sense to enforce outdoors (unless you are in close proximity to someone who appears to be ill), whereas indoor mask wearing makes scientific sense, since we know that all the “superspreader” events involved indoor contact and that cumulative intake of “droplets” appears to be the means of transmission. I’ve stopped washing off surfaces unless they are already wet, I don’t wear gloves. I do wash my hands when making contact with a questionable person or surface based on my perception of what may or may not have been “shared” with me, just like I always have. I was advised to consider washing off my shoes after cleaning our bathrooms – I ignored this advice. I don’t do something because the CDC says so, I do it based on the data. I did not wear a mask initially, but have become persuaded by the data regarding how the virus is passed that masking does have a positive effect indoors. So I wear a mask while shopping, etc, and avoid being in indoor spaces with other potentially infected people for extended periods of time. That’s my analysis of the data collected so far.
There ARE real scientists out there doing real work. They DO collect actual data. Some of it is hidden, some sensationalized, but with the internet, we can get back to the real source of the data. While I have no doubt whatsoever that lots of people are trying to manipulate this set of events for political or economic gain, and that we can’t trust any source without full vetting, I also know that COVID is a real thing and I neither want to get it nor to pass it along to anyone else whose immune system is less vigorous than my own.
I think the real challenge that we have failed to meet is that this is a COMMUNITY problem, and we are an extremely selfish society. Calls to reduce selfishness and work together on finding workable solutions should be supported and not denigrated, and we should be evaluating what to do based on actual information, not on “theories” propounded by people who actually have a conflict of interest in getting power or money or attention for spreading “news” that is of a questionable nature. The fact that this encompasses a large proportion of our news media is discouraging, but should not prevent us from seeking out real data and acting on it.
Just as in warfare, justification of such things depends on dehumanization of “the enemy.” The only way “decent” people can do horrific things is when they have been convinced that the person they are doing it to is not fully a person.
I think the point, though, is whatever conspiracy might be behind it, COVID is a very real disease and can kill people. The point about masks seems to be a big stretch to associate with any conspiracy, as I hardly see how any international criminals will be served by people wearing surgical masks, besides which, they are recognized as a reliable way to reduce the spread of disease.
Personally, I think the science says that outdoor transmission is practically nil, so arguing that people should wear masks while jogging in the park seem over the top. But big transmissions have happened in indoor spaces where people are in the same place for a longer time and where the air circulation is poor or recycled. So indoor masks are of value for both the user and for others possibly vulnerable to infection by a maskless person.
There is a lot of hyperbole on both sides, but there are people doing real research, as there are on many subjects. While spreading fear certainly can be an intentional means of controlling voting behavior or preventing or encouraging certain mass activities, mask wearing seems sensible when applied to indoor spaces. I’m not sure how any “international conspiracy” could possibly be served by people wearing masks. But having people arguing about whether or not to wear them and creating political upset over this pretty minor issue most definitely COULD serve the purposes of these ostensible conspirators.
I would also remind everyone that a great number of people who eventually become antipsychiatry activists started out as “reformers.” I am one. People evolve over time, and I think that insisting on “ideological purity” does a lot of damage to progressive and radical causes. That is not to say that people should not be firmly educated regarding the truth about psych drugs and the DSM and the history of psychiatry as a “profession” and their knee-jerk refusal to consider any research data that conflicts with their incomes. But harshly criticizing people who are beginning to understand the destructiveness of the psychiatric system for not “getting it” tends to drive away people who have a real chance of “getting it” if nurtured toward that understanding.
There are, of course, power issues involved that have nothing to do with reformism vs abolitionism, but I think these need to be dealt with as separate issues. My personal view is that anyone who thinks psychiatry as practiced is messed up, I welcome in for further discussion. And I try to find out why they think it’s a problem and what they think should be done about it before I start telling them where I want to see their thinking go. After all, we all agree that self-determination is a primary issue in any critique of psychiatry. I don’t think any movement is going to get where it needs to go if we don’t support the self-determination of adherents to the movement itself.
Remember the Helen Keller story? Told to us to show how “if we work hard enough, we can overcome adversity?” As it turns out, Helen Keller fought her whole adult life against that message, and in fact was a passionate advocate for workplace safety and other socialist issues, as she discovered that most blindness came from preventable accidents and poverty.
“But there is much more to Helen Keller’s history than a brilliant deaf and blind woman who surmounted incredible obstacles. Helen Keller worked throughout her long life to achieve social change; she was an integral part of many important social movements in the 20th century. She was a socialist who believed she was able to overcome many of the difficulties in her life because of her class privilege—a privilege not shared by most of her blind or deaf contemporaries. “I owed my success partly to the advantages of my birth and environment,” she said. “I have learned that the power to rise is not within the reach of everyone.”
Her story was intentionally turned around from the idea that she had privileges and protections that should be but are not extended to everyone, to “You can make it if you try hard – just look at poor Helen Keller.” There is active hostility toward the idea that success is largely moderated by privilege.
Oh, I’ve talked to more than a few psychiatrists who are convinced they are fixing brains, or that the brain is the cause of all forms of distress. The usual argument is, “It has to be, because if it’s not the brain, what is it?” A complete denial that a mind may be something that transcends the operations of the brain. I really do believe they are taught that, a reductionistic philosophy that disguises itself as “science.” Naturally, I’d love to do all I can to support the Kelly Brogans of the world who are trying to do something different, but they’ve got a lot of money and power aligned against them. But I really think removing the idea of mind=brain has to be central to undermining the mindless drugging and surgery that is proliferating under the guise of “treatment,” because if we are not “treating” problems in the body, the idea of drugs and surgery immediately stops making any sense at all.
It is true, people who get pulled into psychiatry are looking for something, some way to change or improve their lives. It is the deception and chicanery that characterizes psychiatry that is problematic. Lying to people in order to make money does not improve their mental/emotional/spiritual condition.
It does seem to me that differentiating between treatments for the BODY need to clearly be separated from efforts to help someone make sense out of his/her life and be more effective in living. I think the term “mental illness” implies a “wrongness” that is pseudo-medical in nature, which is why I think we need to strongly object to the term. Offering someone help with “life goals” or “spiritual distress” or “dealing with the effects of historical trauma” allows for some differentiation in both apparent cause and in what approach might be taken. A person who is depressed due to having a dead-end job but being too finanically strapped to quit requires a very different approach than a person who is long-term depressed due to having been abused as a child and developing some unhealthy ways of avoiding further damage, and yet a different approach from someone who feels depressed due to a thyroid condition or anemia. I also believe that allowing/encouraging the person in need to both define the nature of their problem and to fully agree with the strategy to address the problem is going to be far more helpful than having someone “diagnose” him or her (absent any actual, objectively observable illness or injury). These things will not happen as long as “mental illness” is something handled in the medical system.
There are also some major philosphical problems that are ignored or hidden by the DSM diagnostic process. The question of “what is the mind?” is one that no one really talks about. The psychiatrists assume the mind is the brain, and therefore they try to “fix the brain” by mechanical means, which makes as much sense as fixing a computer program by removing transistors or capacitors or deleting memory chips. But they are doctors (or claim to be), and doctors deal with bodies. If we are something more than a body, then we don’t need medical personnel dealing with our challenges in planning and executing our lives.
The term “ecotherapy” has an interesting effect on me. It feels like taking a normal activity that feels good and makes me happy and turns it into some kind of “treatment” for whatever “ailments” or “disorders” I might be having.
I can more easily wrap my head around “ecopsychology,” because it suggests more of an understanding of how poor environments lead to feeling anxious or sad, and that respecting our need for nature and growing things is important to our welfare. Perhaps it is more appropriate to identify the damage done by forcing people to live in eco-poor environments, rather than to suggest that nature is some kind of “therapy” for those who can’t tolerate the stressful living conditions we “modern” humans are forced to put up with every day.
The “peer movement” was mostly created to undermine the “patients’ liberation” movement that was effectively undermining psychiatry’s bottom line in the 70s or so. They never did value “peers,” but they wanted to coopt those who were objecting by allowing them a limited role and paying them a little money. They gave the idea that “peers” would have an influence on policy and practice, but in reality, they were expected to toe the party line and not do anything “radical” like suggesting that people might be better off without “taking their meds.” That’s my read on the situation.
That’s the biggest problem of all I see with “the system.” No matter what great approaches are invented, no matter what level of training is offered, no matter what written expectations are, the staff have the power over the clients, and “power tends to corrupt” is a very true statement. “Mental health professionals” will say they are doing “Trauma informed care” or whatever, but simply continue their dominating way and put a veneer of “trauma informed care” over top of it. They can’t really ever be “trauma informed” until they are aware of and deal with both their own traumatic histories and the times they have traumatized others intentionally or inadvertently. And there are no real incentives to do this. Anyone with the proper degree(s) and/or credentials can become a “mental health professional.” There is no requirement of emotional stability or emotional availability or personal insight or sensitivity whatsoever. A jerk doing “WRAP” is going to be a jerk, no matter what you try to do to “train” him otherwise.
As long as the power differential is there, any form of “therapy” can be potentially destructive.
I worked with a girl who was temporarily in residential “treatment” for issues having nothing to do with “depression,” even by their own loose standards. When she would spend a lot of time in her room reading, they said she was “isolating” and tried to force her to join the group in “voluntary” activities! It was ridiculous. She was fortunate to have an assigned advocate who stood up for her and to have a fairly strong ability to assert herself respectfully. I’m sure lots of other kids were criticized for “isolating” when they were just taking care of thesmselves in various ways. It was highly disrespectful!
Or even simpler: “Treating people like crap makes them feel like crap. People who feel like crap sometimes do crappy things, too. So let’s quit treating people like crap!”
That is very true. I also see “marketing” of surgeries and various drug interventions like anti-cholesterol drugs and flu shots and blood thinners and “ED” drugs and even botulism toxin injections to smooth out one’s wrinkles. It isn’t always for money specifically, either. Sometimes it is a need for their training and system to be “right” and to assert control over the patient. Which is one reason that nutritional approaches and chiropractors and acupuncturists get attacked by the mainstream – they are elbowing in on the MD’s control of the market. It’s not only financial, but also prestige and power that are at stake.
The first thing I do when I meet any doctor I need something from is to explain to them that I’m an intelligent and well-educated individual and will be making my own decisions about what to do, which may or may not coincide with their expert advice. I’m paying them mostly for information and suggestions, but bottom line, it’s my body and I get to make the final call. And I let them know if they have a problem with this, I can find another practitioner. They almost always assure me that it’s my right to decide what I do, but I don’t think that happens with all of their patients. I think most doctors like to BELIEVE they are empowering or providing informed consent, but a lot of them don’t like to be questioned or contradicted by their patients and will use pressuring tactics and outright dishonesty sometimes to get the patient to do what they want. Of course, this is easiest and most pronounced in psychiatry, where there is no actual accountability for even defining the entity being “treated,” so they can say almost anything and can’t be “proven wrong.” But that kind of attitude is what makes US medicine more expensive and less effective than most other industrialized countries.
But should marketing be a part of “medical” diagnosis? Would you want your doctor to tell you the truth, or to sell you on a concept which will make you more willing to accept his drug-based “solution?”
And so you see the true intentions of the “mental health professionals” you were dealing with. There is not any real interest in making people healthy in evidence there. As soon as you started threatening their control of the situation, their interest was in fact to stop you by any means possible. One can only conclude that their real intent was to maintain these people as “disabled patients” for as long as they could get away with it.
When I am speaking of marketing, I’m talking about the self-centered kind, where you have no concern for the truth but only for convincing the person to buy your product, regardless of the quality. This is different than couching one’s message in terms the other person can understand. But it’s a slippery slope as soon as one starts assuming one knows better than the subject what is or is not going to be helpful. Educating about real ideas can certainly require a certain about of framing or consideration of the other person’s ability to receive the message. But that is different in my mind from knowing that something is false and attempting to convince someone otherwise by manipulative means. And if you think about it, even if something IS helpful, if a person feels coerced or manipulated into doing it, they’re not usually going to be able to realize the benefits, are they? Compared to a situation where they drew their own conclusions from the honest data?
I’d say the first problem is seeking a “treatment for depression.” This assumes that “depression” is the problem and that all people having “depression” have the same thing wrong with them and need the same “treatment.” I certainly don’t know enough about you to say what you might need or benefit from in terms of intervention, but “depression” has multiple possible causes that vary from past abuse/neglect/trauma to dietary problems to physiological issues like thyroid malfunction or Lyme Disease to current life circumstances like domestic abuse or a job you hate to existential questions about the meaning of life. Everyone is different, and the idea there is one “cause” for depression is a myth created by psychiatrists and the pharmaceutical industry in the interest of selling their wares.
This is not to say that antidepressants or any other intervention can’t be felt to be workable by a particular person. It’s more that pretending that you have a medical problem when they actually have not the slightest idea what, if anything, is wrong with you is never going to lead to any real solutions. If you think about it, drinking controlled amounts of alcohol can and does provide direct relief from intense anxiety, and frankly with fewer side effects than the benzodiazepines so readily prescribed for that “diagnosis.” But drinking alcohol would never be considered a “treatment” for anything, and benzodiazepines should not be, either. They are just a drug people take that makes them temporarily feel better. Unless you really understand what is causing the anxiety, there is no “treatment plan” that will predictably handle the problem. There are drugs that create all kinds of effects, some desirable, some undesirable, some desirable to people dealing with the “problem person” while undesirable to that person him/herself.
So I don’t think there is a simple answer to your question. Every person is different. But I think telling people that they have a “chemical imbalance” or that something is wrong with their brains is utterly irresponsible and lends to further feelings of depression and hopelessness.
I say this as a person who has struggled plenty with depression in my life, including feeling suicidal at times. I no longer feel depressed most of the time, and have learned to recognize when I’m going down that path and have things I can do to redirect my attention and behavior into a new route. For me, things that helped have been meditation, caring friends, inspiring work that forced me to face my fears, real talk therapy (none of this “evidence based practice” crap, just a real person who got interested in my life and helped me realize some things about my family and my own way of thinking about the world), self-help books, exercise, and creative activities like singing, home film making, and the like. Others will have their own approaches. You can develop one, as well. Maybe it will continue to include antidepressants. Maybe it won’t. That’s your call. But the beginning of wisdom is realizing that the psychiatric profession has nothing else to offer but their speculative “disorders” and their pharmaceuticals, and there are SO many other things that can be done! It starts by recognizing that you are not “treating an illness,” but dealing with a life circumstance that has its reasons for being there, whether they are physiological, psychological, or spiritual in nature.
True. It would be more accurate to say, “We are trying to eliminate emotions” or “we are drugging reactions” instead of “alleviating symptoms.” Unless symptoms is used in a very broad sense to mean “effects of an underlying cause,” not implying anything medical. It seems to buy into the pseudo-medical way of thinking, doesn’t it?
It seems you consider the facts I’ve presented as “arguments.” They are not. What I have presented are scientific conclusions arrived at by psychiatry’s own researchers, clear statements made by psychiatry’s own spokespersons, and hard facts about how the DSM is put together. None of these things are my opinions. They are all known to be true from research or from direct statements from unbiased participants. Actually, in the case of Pies, a participant highly biased in favor of psychiatry, who still admits there is no “chemical imbalance” and attributes this idea’s promotion to the pharmaceutical industry, and asserts that psychiatry has never supported this claim (though there is also plenty of evidence that they have done so vigorously).
Have you read Anatomy of an Epidemic? It sounds like you have not. I’d strongly suggest you do so if you want to undestand what is going on here. There is plenty of research supporting a view questioning the validity of the psychiatric worldview.
If you have, as you state, scientific evidence of the ability to identify and detect “chemical imbalances,” I would be very interested in reading these studies. I’ve been studying this area for decades and have found nothing but the most circumstantial “evidence” presented on this, and as I’ve stated, even the psychiatric community is now backing away from these claims as being, at best, “simplistic.”
It is true that everyone is entitled to his/her own opinion, but we’re not entitled to our own facts. I would like to discuss the actual research you’re talking about. If you choose not to, that’s your choice, but I absolutely do not accept the characterization that I am “anti-science” simply because I don’t agree with your point of view.
I’d be interested to hear where you’re saying that people are being anti-scientific. I believe it is very much possible to feel that psychiatric drugs are USEFUL to you without accepting that you have a “chemical imbalance” or that the drugs are actually “fixing” anything wrong with your brain.
I like your comment that the environment and the brain/body are interacting all the time and affecting each other, and that early trauma does sometimes lead to alterations in the operation of the brain. What most people do NOT know is that the “decade of the brain” was also the time of discovery of “neuroplasticity”, or the idea that the brain can adapt later in life, including the idea that the brain can and does adapt in POSITIVE ways to a positive environment. Psychiatry has grabbed onto only the half of the story that suits them, and portrays that a “broken brain” from childhood can only be “fixed” with their drug interventions. This is NOT science, this is a marketing ploy. Science tells us that brains are not “broken” by trauma, but that they adapt to survive in the environment they are in, so the real key to healthy brains is healthy environments.
Additionally, the DSM “diagnoses” (I’m sure you’ve been given some of these over time) are also NOT scientifically determined, but are voted on in committees, and are based on subjective evaluations of another person which are ripe for bias and discrimination to enter in. There is no test for any “chemical imbalance” in anyone’s brain, nor even a concept of what a normal “balance” would look like. Mainstream psychiatrists like Ronald Pies and Thomas Insel have acknowledged this, and Pies called the chemical imbalance theory an “urban legend” that no well-informed psychaitrist takes seriously. Yet you have clearly been told that you have a “chemical imbalance,” even though no one knows that such a thing exists. This, again, is not scientific, and opposing it is not anti-scientific.
So while many views expressed her are not accepted by the psychiatric mainstream, my experience is that folks here are MUCH more interested and committed to science than the psychiatric industry itself, and that’s a gigantic understatement. This may be hard for you to believe, and I can certainly see how the statements made here seem shocking and out of line with what you’ve been told. But I encourage you to read some of the articles, especially the scientific research articles. There is solid scientific research showing that antidepressants increase rather than decrease the suicide rate, that people diagnosed with “schizophrenia” do better in the long run the less “antipsychotics” they take, that twin studies don’t actually prove any genetic heritability of any “mental illness,” and that labeling someone with DSM “diagnoses” increases rather than decreases the “stigma” that they experience, both from their own view and from other people’s treatment. All of these things are scientifically shown to be true. It sounds odd, but to find out what is scientific, you have to start by unlearning whatever you’ve been told about “mental illnesses” and “medication” and “diagnoses” and start over with an open mind, looking at the actual data. You may still draw the same conclusions in the end, but the psychiatric profession has some gigantic conflicts of interest that make them a very unreliable source of information.
Hope that helps a bit. I’m really interested to hear what parts you find “anti-science.” It should be an interesting discussion if we all are respectful and keep open minds.
For me, it gets down to genuineness. A person can use a lot of different ways to express regret that they have harmed you, whether accidentally or intentionally. I have no button on “sorry” per se, but it is often used in insincere ways. Something like, “I’m sorry you feel that way,” isn’t really acknowledging any causal responsibility on the part of the speaker, whereas something like, “I’m really sorry you’re feeling hurt – it wasn’t my intention, and I want to understand what I did that hurt you,” would come off as a person who really regrets his/her action. So the term “sorry” isn’t really the issue for me, it’s whether the person is interested in understanding my experience and making sure it doesn’t happen again, or is just “apologizing” without really recognizing what happened or having any intention of doing anything differently should the same situation arise in the future.
There is also a very legitimate use of “sorry” in the sense of, “I’m so sorry to hear you had to go through all that shit!” Or “I’m sorry to hear that you were treated disrespectfully.” This works OK for me if the person has taken the time to hear and understand my story and is acknowledging the pain/frustration or whatever involved. But it can be a slippery slope. “I’m sorry that happened to you” or “I’m sorry things didn’t work out the way you wanted” can come across as dismissive or condescending.
Bottom line, to me, it’s about the sincerity of the message, not the specific words used. But others may feel differently.
Wouldn’t this kind of be like standardizing “measures of courage” or “measures of sponaneity?” Or perhaps “measures of phlosophical insight” or “measures of esoteric-ness?” How can you measure “mental health” when it is is metaphorical in nature?
Agreed. There is nothing more to expose, and they are not interested in “facts.” They want to keep their power and their money, and no number of studies will change that. If they cared about science, they’d have stopped doing it long, long ago.
And what does it say about the psychiatric industry that they were NOT excited to hear that genetics is not a significant contributor to “schizophrenia?” Can you say, “Conflict of Interest?”
“Messaging” is marketing. The public should not be “given a message,” they should be given the truth, in terms they are able to understand and personally digest. “Messaging” is already a move into authoritarian thinking, that we should tell people the things that make them do what we want instead of just informing them of what we know and don’t know and allowing them to make adult decisions about how to proceed.
I often use the car accident analogy – if people at a certain streetcorner are being hit by cars at a high rate, and only 35% of them break bones in the process, do we diagnose those people whose legs break with”brittle bone disorder” and try to find out why, or do we put in a stop sign or traffic controls to ensure fewer people get injured?
I’d suggest that the American Psychiatric Association and their “opinion leaders” are the ones who are trying to control the narrative, along with their friends in the pharmaecutical industry. That’s an oversimplification, but what it comes down to is that there are people whose salary depends on promoting the label-and-drug model in the biggest possible way, and such people are not the least interested in learning anything about the actual needs of individuals, and in fact will argue in the most intense and irrational ways about how “wrong” anyone is who questions their paradigm. The recent Phil Hickey article critiquing Ron Pies and his associate gives a little meat to that comment.
I don’t quite get what you mean by “Unselor” still.
The fact that you are able to say, “Of course I could be wrong…” puts you miles ahead of many others. I think that humility is the core of being a good helper, because it’s the only antidote to the power imbalance. We have to each realize the potential damage we can do and how possible or even likely it is that we will misapprehend things, so that we are constantly checking and re-checking things to make sure we’re on the right track and continuing to be helpful.
I am certainly not in any place to say someone is “born with” the ability to connect or if it is learned over time or more likely “unlearned” (I like your point about too MUCH training – people can get very invested in their group’s agreement as to what is going on). There are also financial incentives involved for a lot of people in the “mental health” industry that make the idea of the client having his/her own ideas about what is the right thing to do rather threatening. And there is also internal pressure from those who have such conflicts of interests upon clinicians to maintain the status quo. General education in life can be a big counter to our inappropriate concepts and training, but I have no idea how to specifically train someone to be compassionate.
A good example would be “cultural competency training.” There ARE people who benefit from such training, but these are generally people who are already oriented toward wanting to create that kind of environment. Those who are committed to NOT being culturally competent, for whatever reasons, tend to avoid such trainings like the plague. And if they are forced to go, they go under protest and generally make fun of the process. There may be one or two here or there whose eyes are opened by the process, in which case, I’d say it’s well worth it, but the bulk of people attending are going to trend they way they’ve always trended, because they’re not motivated to do differently.
Can you “train” a person with deeply-held racist views not to be racist? Most of the time, no. Can you train a person who sees “the mentally ill” as someone beneath them on the scale of life, who doesn’t understand what he needs and requires the pateralistic wisdom of his/her counselor/psychiatyrist, to see that person as a person instead of “a schizphrenic” or “having ADHD?” I’d say usually not.
So training for sure has value, but only if some preconditions are met. And if those preconditions are NOT met, training people on techniques or skills or whatever is going to have a limited effect. I wish there were a way to train people to be more sensitive. Perhaps the only real answer on that line is for the person to do his/her own healing to the point where s/he can recognize when his/her own issues are getting in the way, and can differentiate between the counselor’s needs and those of the client. But the person would have to recognize that need before such healing could even begin.
Or another way to say it: disempowered counselors are not going to be able to empower their clients. As long as we have to subordinate ourselves to some control system, whether external or internal, that tells us how we have to do or think about things, we won’t be able to be flexible and sensitive enough to know what will be helpful to the client.
It very much sounds like the right idea (see my other post). However, you already have seen at least one person who can not process whaet you’re talking about. I don’t think it’s likely because they lack training. I think it’s likely because they lack the perspective and strength of character, or have not done sufficient work on their own issues, or come from a strongly authoritarian viewpoint, such that the idea of the client finding his/her own path seems impossible to imagine. I could be wrong, of course – maybe a round of training in IFS would open her eyes. But I would bet you a whole bunch of money that if you took 100 psychiatrists and put them through intensive IFS training, at least 95 of them would be completely unmoved in their views on what the human mind is capable of. Fixed ideas don’t yield to training very easily, and people’s vulnerability is generally their first and most important concern. Given the ability to use one’s power to protect oneself vs. opening up one’s mind and being vulnerable to feeling confused and wrong and hurt, etc., the vast majority of folks will choose protecting themselves every time. I think this is particularly true for the field of psychiatry, which pre-selects people who already see their roles as “fixing” other people’s brains. Maybe if you could get to them when they’re still undergrads, you’d catch a few more, but most of the psychiatrists I’ve known over the years would die on the hilltop of “drugs are the answer” before yielding to any counseling concept, let alone one which emphasizes empowering the patient to make his/her own choices.
That’s my experience, anyway. It sounds like IFS might be a wonderful thing to learn and develop from, but it would be profoundly threatening to the psychiatric establishment, and would be rejected out of hand by a large percentage of those in control of the industry.
I am saying that training in and of itself is neither necessary nor sufficient to make someone a competent counselor, if that’s the term we want to use. Naturally, a person who has the gifts/understandings necessary to connect with someone else can benefit from some wisdom and experience that others have gleaned from their own efforts. But no amount of training can teach a person how to connect emotionally and safely with another person. Someone can use all the “I” statements in the world, and to do “active listening” and to follow all the precepts of DBT or CBT or whatever and still be incompetent or totally destructive as a counselor. You can actually use the skills taught in your training to give someone the idea you CAN be trusted, and after they share with you their deep secrets, you find your own issues get engaged and you get annoyed or bossy with them or turn cold or send them off for antidepressants and you have SCREWED them over. A person would be MUCH better off seeing right up front that a person doesn’t really care about them than to have the person learn “skills” that make it seem like they care more than they do.
So sure, one can train in skills. But it doesn’t make you a counselor/helper, and it can make you more dangerous. And a person who has zero training and excellent empathy can actually CREATE skills and approaches or help the CLIENT create such skills and strategies him/herself! Becuase they start with UNDERSANDING the person in front of them rather than seeing the client through some clinical “lens” or applying some “evidence-based practice” in a mechanical or robotic fashion without being able to observe the needs of the client or the effect of the intervention on him/her.
Setting up a patient/client relationship sets up a power imbalance automatically from the word go. The number of people who can operate in such a situation without taking advantage of their power is, in my experience, pretty small compared to the number of people selling “clinical services.” I recall a study telling us that a person is just as likely to experience relief/improvement talking to a good friend than to a counselor. I find this very easy to believe, because the degree and training confer no assurance that the person is competent or caring, and a caring friend is a far better resource, however untrained they may be, than a supercilious or insensitive “counselor.”
I have to agree with you. I don’t think anyone can be “trained” to be a counselor/advisor/mnetor in more than the most rudimentary way. There is a presence that a person can adopt with me that is healing, and that presence has mostly to do with being willing to be there and accept who I am and genuinely respond to me as one person to another without putting me in the position of having to edit or explain or justify my own thoughts and feelings. There is no “technique” involved, no “method” that one could emulate, no “treatment plan” involved – it is simply the proper mindset and attitude of being present and caring and being willing to experience whatever is coming up and in fact NOT knowing or deciding what all of it means or what the helping person should DO with it. I think this has to be experienced directly, and some people are not really able to do it for whatever reason, no matter what training they receive, and others seem to come by it naturally without any training at all. I’m not saying it can’t be learned, but it’s not something you can teach someone else, like how to repair a car or make a recipie. It’s not some kind of “program” you can put in a manual – it requires genuine outreach of one human to another and a willingness to be vulnerable and to NOT know ahead of time “what to do.” We need to ditch the idea that getting a PhD or whatever makes anyone any better than anyone else in the realm of caring!
Not only weren’t you given “informed consent,” you were actually given intentional MISINFORMATION that deflected your own observations of reality. Maybe we should call it “Misinformed non-consent.”
I am amazed that they can write this stuff seriously! Especially the stuff about how “anxiety disorders” are shown to CAUSE anxiety and are not mere labels, yet in the same sentence state that the anxiety could be caused by any number of very different things. It seems they disproved their own statement by the end of the paragraph, yet did not seem to notice.
Well, if this leads to a reduction in “medication” use, I’m sure the psychiatric profession will want to oppose it in every way they can. We don’t want people getting better – how will they sell more drugs?
Reliable tests are very dangerous to the psychiatric hierarchy. They threaten to prove that psychiatry is full of crap. The last thing the psych profession wants is any kind of reliable test!
I agree – removing the incentives for lying and minimizing adverse effects and overblowing “positive” results is the real game here. If you pay people more when they lie, a lot more people will lie. Also, taking away Big Pharma’s power to influence academic research is very “do-able” but would require a lot of piggies to remove their snouts from the trough, and we’ll hear a LOT of unpleasant squealing if we do that!
I like that example and have used it myself. What if we dianosed kids who aren’t good at sports with “athletic deficit disorder.” It would be “treatable” with stimulants, too! Stimulants would improve athletic performance, speed, quickness, concentration, intensity… what would parents and teachers have to say if stimulants were recommended “treatment” to make kids better at sports?
It’s also fascianting that they INDUCE “depression” in mice by creating high-stress situations, and then use them for subjects in their experiments. All the time claiming that “depression” is a “biological brain disease” not caused by the environment!
Repeated failed attempts to prove something scientifically is the definition of DISPROVING that very thing. If these psychaitric “professionals” were truly scientific, they’d realize their experiment was successful – they have successfully proven that none of these “diagnoses” have a physiological cause or even correlation. Convincingly proven.
Which leaves us with the sad conclusion that they are not scientists at all. I think they are mostly either dupes or marekting agents.
And “progress” includes reducing lifespans by 25 years on average for the “seriously mentally ill.” More “treatment” seems to lead to shorter lives. Where else in medicine would this be remotely acceptable?
Just for the record, though, the “medical model” has deep roots that go back at least to Kraepelin and probably long before. I think the DSM III just codified the ‘medical model’ and launched the most complete takeover of the “mental health” industry by doctors in history. But doctors back in the 19th century still had an investment in the idea of biological causation, which meshed very tightly with the eugenics movement, of which psychiatry was always an integral part.
“Fritz et al. propose transdiagnostic interventions that can “correct” these disruptions.”
If interventions need to be “transdiagnostic,” then what is the point of having a diagnosis? Isn’t the whole point of a diagnosis to figure out what’s going on and what plan to make to address the cause? If a diagnosis doesn’t tell you how to intervene, it needs to be trashed! Which pretty much means the entire DSM.
This whole set of ideas is ridiculously complex! A good scientific theory should make things easier to understand. It seems like a very complicated effort to “explain” the DSM “diagnoses” that really don’t merit explanation. There is no need to do intense gymnastics to try and make these false concepts “work.” Just admit they don’t, and start over, preferably by ditching the whole idea of “mental illness” and “psychopathology” for starters.
The psychiatric worldview seems to imply that we are little to nothing more than animals. In fact, the psychiatric worldview probably disrespects even higher animals’ abilities to make decisions about their lives.
I was being ironic. If there were a success story, it wouldn’t be psychiatry’s, it would be your heroic success in healing both despite them and FROM their destructive efforts!
I might say that psychiatry is not responsible for initiating stigma, but they ARE responsible for capitalizing on and exacerbating existing stigma/prejudice in the interests of controlling their patients and making a profit.
If I had to gamble on psychiatrist vs. library assistant on helping me with my “mental health,” I’d definitely start with the library assistant. At a minimum, they are trained to help people find what they want rather than deciding what book the peson “needs” to read and trying to force or manipulate them into reading it.
I do see some importance in this line of discussion, but I also do see things getting a little personal on both sides, to the point that I was considering how best to intervene. I think we need to stick to the concepts and move away from more personalized comments that seem to accuse the other commenters of insincerity or mean-spiritedness. There is plenty of room in the general concept of “socialism” in our society for lots of confusion and different viewpoints. Perhaps if each person can simply discuss what definition they are operating from, it would be more productive than trying to state or imply that the other person’s definition is “wrong?”
Another psychiatric success story! I’m so sorry you’ve had to go through all of this nonsense. We ought to be able to trust our docrors, but apparently, it’s “caveat emptor!”
In other words, they CLAIM they are providing “involuntary treatment,” but in fact, they are imprisoning people and forcing them to comply with the psychiatrists’ authority, and there is nothing “therapeutic” about it in either intent or in effect.
This is one of the most extreme dangers (of many) regarding the idea of DSM “diagnoses.” Once they decide on a psych label, they stop looking, as if the label somehow explains anything relating to WHY you are having these difficulties. The book itself says it makes no representations as to cause, and yet, once that label comes down, they think they “know” all about it and stop looking for anything else. It is incredibly destructive, as you unfortunately now know from direct experience!
Sadly, and predictably, no one really ever studies the long-term effects of these drugs. So it’s hard to say. But most people I’ve talked to who take these drugs, especially if it’s not for a long period of time, report at least some significant recovery after stopping. There are exceptions to that, but most get back to some semblance of “normal functioning” over time.
What issues are you struggling with that you think may be related to the Zyprexa?
Gotta watch the psychologists, too. Many are wannabe psychiatrists who believe fully in the “biological brain disease” concept, especially for “schizophrenia” or “bipolar” diagnoses. If you are looking for a therapist who might have a chance of being really helpful, start by finding one who firmly believes the DSM is a useless doorstop and is more interested in what YOU think you need than in slapping some label on you. Just being a psychologist is no guarantee you won’t be routed down the same label-and-drug pathway!
“Forced” and “help” in the case of mental/emotional issues are contradictory. The presence of force belies any purported intention to “help.” At best, you are stopping someone from doing something that you don’t think they should do. But many other and worse things happen as soon as you decide that you get to decide what “help” another person should get. There is no such thing as “involuntary treatment.”
You’d have to be in denial to take up the sword for psychiatry. The “mentally ill people commit more suicide” trope is easily debunked, because most every trial ever done removes suicidal people from the pool before starting the trials. So there should actually be FEWER suicidal people in the trial than the general population, and an increase in suicide rates is even MORE condemning of the drugs. Besides, that’s the whole point of the control group. They are “mentally ill” too, and commit suicide at a lower rate. That’s all you need to know, except if you don’t WANT to know.
In fact, there are many situations where the emotion involved is quite logical and necessary. If one is being chased by a bear and does NOT experience fear, absent a VERY powerful shotgun or other effective weapon, NOT feeling fear would be quite illogical!
Not sure I agree on that last point. There have been healers as long as there have been human beings. Though I do agree it has been coopted by a certain set of commercial interests to a degree.
It helps temporarily to drink a couple of beers after work, but I don’t think we can call it “healing” quite!
You’re absolutely right – in the realm of the mind, there is no “healing” through drugs. The idea of using drugs rests on the hard materialist assumption that the only thing “wrong” with a person must be a physical thing, and the elitist assumption that anything that doesn’t indicate full agreement with the current status quo is de facto a ‘disease’ that needs “healing.” Both assumptions are extremely dangerous!
“ACT OUT” – I like it! Now we have to come up with some words that spell that out as an acronym. Start off with “Anti Categorization Team for Opposing Ugly Treatment?”
I agree. It is only a “controversy” because certain people continue to make money from this destructive and barbaric act. Seizures aren’t good for you, folks. Why should anyone have to “prove” that fact? Those proposing intentionally invoking seizures by electrocution better have some pretty AMAZING data proving what wonderful benefits exist to justify damaging someone’s brain and life in this way. And we know they don’t. So where is the “controversy?” Whether or not we should harm our patients for profit?
Well, of course, there are medical issues that affect someone’s mind/behavior/emotions. These ARE real medical problems that a physician should deal with. Equally obvious, the system of “disorders” prevents the differentiation between actual medical issues and mental/emotional/spiritual issues which have little to nothing to do with any kind of medical problem at all.
It is aimed very much at detecting Romantic Jerks. But a lot of the principles do apply to other Jerks, particularly the tendency to blame others for one’s own shortcomings, the tendency to charm someone into agreement before altering the terms unilaterally, and the tendency to group people into those who are above or below each other in the hierarchy of life (not to mention a strong need to make up or blindly follow the rules of such a hierarchy and enforce them on those the person sees as “beneath them” on the ladder of life.) And perhaps the most important – we get a kind of a sick or uncomfortable feeling around such people, which we often try to explain away to ourselves. Lots of it is very applicable, though hopefully their sexual behavior doesn’t come into play!
An excellent question. In the Lakota tradition, it is my understanding that healers don’t charge anything, but only accept whatever gifts are given in appreciation. I think they probably do OK for themselves.
I think the psychiatric industry is deeply threatened by anything that actually has a chance of working, and the more it humanizes the “mentally ill,” the more threatening they seem to find it. Their response to “Open Dialog” is pretty solid proof of this. 80% success without drugs should be considered a miracle, but it is relegated to a fringe approach that no serious psychiatrist can take seriously without being attacked by his/her compatriots. I think that says a lot about the actual purposes of the psychiatric “profession.”
Well, certainly. It is not the individuals per se but the structure that is abusive. I have worked with these folks and know well that there are some sane or at least semi-sane individuals who do this work. And I’m not opposed to the concept of “healers.” I just don’t think that it has much if anything to do with medical “treatment” in most cases. But I think you’ll agree with me on that point.
The answer to the question of “what happened to ‘radical psychiatry'” is contained in the question. It was, of course, rubbed out by “real psychiatry,” which could no more be “radical” than water can be dehydrated. Psychiatry is based on oppressive assumptions, and the only “radical psychiatry” possible would be to oppose psychiatry itself. Now that WOULD be pretty radical, but would it any longer be “psychiatry?” I would say not. Why not be a “radical empowerer of the downtrodden” instead of a “radical psychiatrist” and eliminate the inherent contradiction in the terms?
True words. Unfortunately, we have mostly been exposed heavily to indoctrination most of our lives and are pretty used to it. Plus, stepping outside of the “normal” viewpoint can be dangerous, including being labeled “mentally ill” and being punished for diverging too far from “acceptable” emotions or behavior, even if nothing you say or do is really a danger to anyone else’s rights. The entire school system is pretty much all about indoctrination from start to finish. Why it is that I somehow escaped the worst of it remains a bit mysterious to me, but I now realize that the “problems” I had in school were mostly due to me maintaining my integrity and not going along with the crowd. It takes courage to educate and empower, because we have to have faith that the other person has the capacity to think and reason sufficiently to observe reality with reasonable acuity. Certainly, schools lack that courage in the overewhelming majority of cases.
Glad to know there are some of us working for the same goals, though!
I tend to focus on a person by person effort to educate and empower, attempting to consolidate and group together with people of like mind. I think we’d both agree that people have a right to make their own decisions about things, as long as that right doesn’t run afoul of the rights of others. So trying to indoctrinate people into any “right way of thinking” is ultimately doomed. The only effective approach appears to be to help each person see things in a new light and to assert their own truth and follow the path that seems rationally and spiritually right for them to follow. But it’s a lot of work, and it takes time, and the opposition has no compunction about indoctrination and brainwashing! I suppose we have got to find each other and support each other in expanding people’s understanding of people and of sanity, and to build a stronger and stronger base of rational and respectful group ideals, but society is improved in a pretty gradual manner, while it can be wrecked quite precipitously. I get discouraged sometimes!
““To this day we continue to disproportionately incarcerate black people and coerce them into treatment. Moreover, if you are black you are more likely to die under restraint whilst receiving mental health care than if you are white.”
Maybe the first action should be to look in the mirror and see how your profession is structured to maintain oppressive conditions and excuse the oppressors while “diagnosing” the oppressed. Or would that be too simple?
This is so utterly blatant and predictable. And I don’t believe it is a choice of “easy” vs. “effective” in most cases. It is a choice of “making money” vs. “makinig a lot less or no money,” at least in the USA. Providing “no treatment” not only makes doctors feel less valuable, it means they can’t bill for their continuing “services” to their drug-dependent patients. Hence, WORSE outcomes mean MORE MONEY for the doctors, so the science has no impact, because improved outcomes (consciously or unconsciously) don’t appear to be the goal of many if not most psychiatric practitioners. Otherwise, they’d be excited to learn about this kind of thing instead of pretending it doesn’t exist.
Yeah, it doesn’t really mean anything to be “diagnosed” with a “personality disorder.” I’m just saying that it has no more meaning than calling someone an “asshole.” I’ve actually been very fond of a lot of people who have gotten “borderline” “diagnoses” in the past. I put no weight on them. I’d be more inclined to say things like, “This person has a hard time trusting others” or “he likes to exert power over people arbitrarily.” This is a more realistic way to talk, such that others could compare notes or agree or disagree or work together to come to a better understanding of a particular person and his/her motivations. Labeling stops the discussion at the label, and I don’t like any of them, whether you say “asshole” or “narcissistic personality.” It’s all just opinion posing as fact.
I agree that we can all do a PERSONAL evaluation by talking to someone, but obtaining agreement in a society as to who is considered “antisocial” and who is not is a more challenging process. There would have to be agreement as to specific acts which are taken that qualify someone as a danger to society, which should, of course, be enshrined in rational laws and social mores regarding behavior. The unfortunate fact is that “antisocial” people, as you describe them, are often part of creating said laws, which means that people who are genuinely productive get attacked, while those creating havoc are too often rewarded, particularly if they are privileged in the power structure. Our current national government is proof of this point. “Narcissistic” people are grossly overrepresented in US CEOs, according to my research.
Additionally, some “antisocial” people are pretty crafty, and you and I may be trained to recognize them, but others less savvy are too easily taken in by their “charming” behavior. (That’s what my book, “Jerk Radar,” is all about.) To teach everyone to recognize them is a Herculean task. I think it is more realistic to expect those who are able to detect them to work to rid the world of their influence by education and collective action and leadership. But it’s a tough row to hoe!
Saying someone has a “personality disorder” is very similar to saying “he’s an asshole.” It has exactly that degree of scientific validity, but it’s certainly possible to look at someone and observe that s/he commits a lot of criminal acts and decide that s/he needs to be removed from society or stopped in some other way. It’s the conflation with “mental illness” and “diagnosis” that creates the problem.
They are re-proving that which is already known, because somehow the profession of psychiatry has shifted the burden of proof such that detractors need to prove that their “treatment IS dangerous instead of them being responsible for proving it is not.
As often happens, the authors are way too careful in their analysis. The title should not say “misleading” but “false” beliefs, and the attribution of responsibility to drug companies belies their own data that doctors who are fully aware of the science about both placebo and withdrawal effects continue to prescribe despite their knowledge. This suggests that the problem is not merely with pharmaceutical companies nor with academic interests alone, but that many individual psychiatrists are themselves corrupt, most likely receiving either direct kickbacks or gifts and perks provided for prescribing sufficient numbers of a particular drug, or else establishing some kind of prestige in their profession for supporting this kind of narrative, in contravention of the facts. It is apparent from this research that knowing the facts does not deter psychiatrists from believing whatever belief serves them best. So it is a much bigger problem than insufficient medical education. It comes down to an entire profession committed to a false narrative, and knowing on some level that backing away from full support for these beliefs that they KNOW to be false will lead to the collapse of their profession and their personal prestige and wealth.
Quite so. The most fundamental requirement of social sciences is to select a group that is homogeneous in the specific trait to be investigated. Otherwise, any research is meaningless. But if you’re not actually concerned with facts, I guess it works pretty well.
I agree with you, stigma and discrimination do emanate from the society at large, and the society needs correction. Unfortunately, psychiatrists, on the whole, rather than helping demystify and normalize emotional distress and behavioral difficulties, appear to have doubled down on labeling and stigmatizing those who don’t “fit in” to our society. There is scientific proof that assigning biological causation to “mental illnesses,” as you are clearly promoting, INCREASES stigma and discrimination, while framing them as reactions to stressful events DECRASES stigma and increases empathy for the victims of trauma and social stresses.
GIven that there is not one “mental disorder” that has a physical cause or even a physical CORRELATION associated with all or most “cases,” and given that these “disorders” are all defined by social criteria which are based on the very social assumptions and stigma you are trying to elminiate, it seems a lot more sane to frame “mental disorders,” if we need to define them as such, as common reactions to stress and trauma.
Since we know that the current system supports and increases stigma and discrimination, what do you suggest be changed in the system to ameliorate that? Can you see ways in which psychiatry itself is contributing to the stigmatization?
“When the only tool you have is a hammer, everything starts to look like a nail.”
No one here is labeling psychiatry as a “stigma.” Psychiatry is stigmatizing its own clients by labeling them based on socially sanctioned/unsanctioned behavior.
Appalling! Very much like Kindergarten, except we didn’t have to take drugs and weren’t labeled as malfunctioning. They at least recognized that we were children, not robots.
It seems particularly ironic when they tell you on the one hand that you have no control over your symptoms, only the drugs can help, and yet they punish you for failing to participate or to control your behavior in the way they want you do. Which is it people?
Wow, that sounds like Kindergarten but worse. And just so you know, I found Kindergarten to be daily torture. To be graded on your game performance… that’s ridiculous!
You really think that any drug that has an effect is somehow neuroprotective???? Improvement is not a sign of neuroprotection. Look it up. Alcohol is very effective at reducing anxiety. Does that mean drinking alcohol is “neuroprotective?”
I’m not doing your research for you. You obviously don’t have any research to hand and have simply swallowed up what someone wrote or said in your training classes. I’m not interested in hearing quotations from your “abnormal psych” professor. Come up with some real data or drop it.
If you’re hearing this for the first time, you’re obviously out of the loop. But I don’t see much point in talking to you, since you want to preach rather than exchanging views. So I’ll be signing off of this conversation, since I pretty much can predict whatever it is you’ll say already.
Once again, your views are equated with scientific truth. Just saying things don’t make them true. If we want to have dueling personal experiences, I have helped people who have “severe suicidal ideations” to huge turnarounds in their lives with no assistance from any drugs whatsoever. I’ve also talked to many people who have taken drugs and become MORE suicidal, or suicidal for the first time ever in their lives, and it went away when they stopped.
The scientific evidence is strong that antidepressants DO NOT prevent or reduce suicides, and they likely increase the probability on the average. Perhaps you simply lack the skills to help these people, which is not a black mark for you, just a fact. But claiming that the fact you can’t help them means that nobody else can is very much an arrogant and self-centered viewpoint. A little humility might be a good starting point, rather than simply stating your opinions louder and louder when actual scientific data goes against your viewpoint.
That is an interesting statement. You understand that scientific analysis of the data from multiple studies has shown that there is an increase in suicide for those on antidepressants over placebo. Perhaps you don’t understand that the people in these studies are screened for suicidality before the studies begin. So these are people who were NOT suicidal who BECAME suicidal during the study. This was so clear that the US FDA demanded that a black box warning be put onto the label. And yet you state your BELIEF that suicidality is not caused by antidepressants? How do you expect to have the slightest credibility when making such statements of faith that directly contradict scientific data? Because of your personal observations, you get to invalidate actual scientific studies?
Don’t bother responding if you’re going to continue just telling us you’re right because you say so.
There is no such thing as “overdiagnosis” when you can’t objectively establish what the “proper” level of diagnosis really is. Lacking any way to objectively determine the presence or absence of ANY of the DSM diagnoses, the idea of “over-” or “underdiagnosis” is a scientific absurdity.
They are also frequentely accused of assault and sometimes charged criminally, especially in institutional settings, when they react defensively to what is actually an assault by the staff. Any time a staff person lays hands on a person, any defensive reactions should be considered expected and understandable efforts to defend one’s person from attack. It is a manifestation of the power imbalance between patient and staff that the staff can assault patients with impunity and yet any attempt by a patient/resident to defend him/herself is automatically considered an assault.
And I just looked over my last two comments to which you appear to be responding. I see nothing there that sounds the least bit grumpy. Not sure what you’re talking about there. Perhaps you only have hammers and I look like a nail to you?
Your point is very well taken! There is no such thing as “rights for the mentally ill,” they are the same rights everyone else has. The question is why they are not regualrlly afforded to those labeled as “mentally ill,” and why the failure to enforce them doesn’t seem to bother people too much. It is an issue of prejudice and discriination, not of a lack of “rights” under the law.
There is really nothing “scientific” about the idea that the mind is synonymous with the brain. It’s a philosophical position posing as a scientific one. A real scientific approach would be to postulate what would predictably result if the mind WERE inside the brain and what would predictably result if it were NOT insde the brain, and then start reasoning from your observations. But since no one can truly define WHAT the mind is, let alone WHERE it resides, the proper scientific knowledge in the sphere is simply, “We don’t know.”
Why, you rebellious good-for-nothing, disrupting the group experience like that for no reason at all! Obviously showing clear signs of “oppositional defiant disorder.” Oh, but there’s no drug for that, so maybe we’ll roll with “Bipolar” and go from there… /s
“These results suggested a differential effect of antipsychotic agents on BDNF levels inpatients with schizophrenia. Peripheral BDNF may play a role in the disease process of a subset ofpatients, related to the use of antipsychotic agents”
The authors are talking about a “differential effect” with SOME patients, and it says it “MAY play a role,” so not clearly established. There is nothing about protection from harm to the brain in this link, so claims of “neuroprotectiveness” are not shown by this link.
Additionally, we’d need to know what kind of ostensible damage naturally happens in cases of “schizophrenia,” which is, of course, extremely problematic in that there is no objective way to diagnose who “has schizophrenia” and who does not, so any study on “schizophenia” may be and is most likely being done on heterogeneous populations, making any claims of neurological damage due to “schizophrenia” moot, let alone claims of “neuroprotectiveness.”
Of course, we DO know for certain at this point that “antipsychotic” drugs, formerly known as “major tranquilizers” and “neuroleptics,” do actually CAUSE brain damage, in that they create a loss of grey matter over time (on the average): “Viewed together with data from animal studies, our study suggests that antipsychotics have a subtle but measurable influence on brain tissue loss over time, suggesting the importance of careful risk-benefit review of dosage and duration of treatment as well as their off-label use.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/
I find it a bit hard to see the argument that something which reduces grey matter volume in the brain (the actual NEURONS are less dense!) is somehow “neuroprotective.” In fact, the mechanism of “synaptic pruning” is well known in studies of long-term street drug users, and there is plenty of evidence to suggest that the exact same process occurs when other psychiatric drugs that mess with neurotransmitter levels are used. Hardly an indication of protection of the brain from damage.
Sorry, you’ll have to do a lot better than that to have any credibility in this quarter.
As for your suggestion regarding antidepressants, I can only refer to the best insult in the history of film, from the Wizard of Oz:
Auntie Em (To Miss Gulch): “Elmira Gulch! Just because you own half the county doesn’t mean you can run the rest of us! For twenty-five years, I’ve been DYING to tell you what I really think of you. And now… well… being a Christian woman, I can’t say it!”
Yeah, gotta love that concept of “treatment resistant.” If our “treatment” doesn’t work, it’s not our fault, you are “treatment resistant.” Which justifies us doing MORE of the “treatment” that didn’t work or forcing a worse “treatment” on you against your will. “I KNOW this will work, if only she’d stop RESISTING…” Why do people believe this kind of obviously illogical nonsense? Hammering harder on a screw will not screw it in!
It sounds like you are here to promote a viewpoint. It’s my expectation that a person claiming research needs to provide their own links rather than saying “do a search on Google.” Do you have anything specific? I’m pretty familiar with the literature and any study I’ve seen on “neuroprotective effects” of psychotropics has been refuted or is not replicable. Please correct me if I’m wrong, but I’m not going to search for studies that you claim exist. Please provide some links and we can talk.
As for “side effects,” sure, all drugs have side effects. The question is always whether the risks outweigh the benefits, remembering the Hippocratic Oath to “first, do no harm.” When people diagnosed with “serious mental illnesses” are dying 25 years earlier than the general population, when studies show that people NOT taking antipsychotic drugs do BETTER than those who take them in the long term, even if they had a worse prognosis to start with, when people in “developing” countries do far better in terms of recovery than those who have the “benefits” of modern psychiatry, arguments about “neuroprotectiveness” start to sound pretty foolish.
Your assumption that a “suicidal patient” will die or kill is, of course, a ridiculous one. I have talked to hundreds of suicidal people in my role as a crisis line supervisor and doing involuntary “hospitalization” evaluations and advocating for foster youth and just being a human being encountering other human beings in our crazy culture today. I would suggest that 98% of the people I talked to felt better JUST BECAUSE THEY FOUND SOMEONE WHO WAS INTERESTED IN THEIR STORY. Not once did I ever recommend or require psychiatric drugs to “prevent suicide.” But you might be interested to know that I did encounter a significant number who were suicidal ONLY AFTER they took one of psychiatry’s magic “antidepressant” pills. I met many, many more who found the drugs marginally helpful, utterly useless, or making things worse.
The message that we are somehow taking a huge risk by NOT drugging a suicidal person flies in the face of massive evidence that a) “antidepressants” do nothing to prevent suicide, b) “antidepressants” actually CAUSE suicidal feelings or actions in a small but significant proportion of those who take them, and c) there are many ways to help a person considering suicide that have nothing to do with giving them drugs of questionable value and unquestionable risk.
I think you have come to the wrong place if you want to sell the idea that we only have a choice between drugging people and letting them die. We know better. I hope you’ll read some of the stories here and you can learn that there is another viewpoint.
I thought psychiatrists didn’t believe in souls. This would suggest that psychiatry doesn’t have one to save. Or that psychiatric theory is based on false premises. Or both.
I am not able to answer that question, as I don’t meet or talk to most of the authors personally. My guess would be that the percentage is considerably higher than the general population, but that’s just my educated guess.
Shouldn’t it be the responsibility of the “scientists” involved to prove that antipsychotics DON’T damage the brain? It seems the evidence is sufficient to suggest strongly that they do. That should be the end of the story.
I know what you mean. I was just being flippant, as I have a tendency to do. Naturally, if a person has experienced lots of rejection over his/her life, rejection by psychiatry will at least initially feel like other rejections. It is to be hoped that over time and with education, a person might come to understand that s/he may have “dodged a bullet,” but it is hardly reasonable to expect a client to see this up front.
I fully acknowledge that the overwhelming majority of people in the “mental health” field should be doing something like flower arranging that doesn’t involve pretending to “help” people. The humility to accept feedback is a very rare commodity, and seems to be becoming rarer as the years go by.
I agree. It is the psychiatrist who should make certain that any such interactions happen in a non-threatening manner for the PATIENT! Te psychiatrist has all the power, and expecting the client to protect the psychiatrist’s ego is very much like expecting the victim of an assault not to upset his assailant too much for fear of “provoking” further attacks. The person with the most power is the most responsible for creating a safe atmosphere for discussion. If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.
I went to a counselor one time. I told him I would feel angry sometimes when I got home from work. He said, “So you get angry when you come home from work?” I said, “Yes, I just said that!” He was like a freakin’ parrot! Just repeated back what I said to him, and then invited us to join his church. At least he didn’t “diagnose” me. I’d have had to tell him what my “diagnosis” was and no doubt he’d have repeated it back to me. How can people feel OK taking money and not providing a service of any value? I mean, they have to know that they aren’t helping, don’t they?
I don’t have any comments from you in moderation, Bradford. Email me if you are still getting this message, with the link, so I can see what’s going on.
Perhaps instead of saying, “Opposing corruption in psychiatric science,” we could just call it “opposing psychatric corruption posing as science.” As I commented in another post, it’s a pretty big stretch to even use the term “psychiatric science.” It’s kind of an oxymoron, because if psychiatry were at all interested in science, it would have to tear down the entire structure and start over again.
Unless they mean the “science” of making lots of money through clever marketing of destructive ideas…
It seems to me that the conclusions, as usual, were dramatically soft-pedaled compared to the actual conclusions one ought to draw from this. If the most experienced professionals in the field can’t draw a common conclusion from the same data, there are only two possible conclusions: SPECT scans or PET scans actually tell us nothing significant or meaningful about the brain or its functioning, or that the people analyzing the data are either so incompetent or so utterly biased as to remove any possibility of gaining any reliable intepretation of ANY data from these scans, at least as far as “mental health” is concerned. Or both may be equally true.
These people are taking in millions of dollars, including our tax dollars, doing worthless research and making claims that are not substantiated, otherwise known as LIES. This is a dire situation and calls for a complete reconsideration of the value of spending significant money on what is either a fraudulent field or one in such a stage of infancy that nothing of value can be expected for decades to come. Particularly given that such studies are granted such high value and yet are almost worthless, these studies are contributing confusion rather than knowledge, and should be discontinued or else relegated to a very cool back burner while somebody figures out if there is anything of scientific value that will ever come out of this kind of study.
I see no alcohol wipes, no blood drawing equipment, no stethoscopes, not even a blood pressure cuff or thermometer or a scale. Usually just a desk, books and a filing cabinet. Pens, papers, coffee, whatever, but no sign of a medical exam being even a possibility. And clients I’ve spoken to almost never report any kind of medical workup, and most that do are sent to someone or someplace else to do it. Psychiatrists don’t do medical exams in the vast majority of cases, based on my observations and data.
Having an open mind includes being open to the possibility that other people have experiences you have not yourself had or imagined. Remember that we’re not only dealing with withdrawal here, we’re dealing with brain changes that happen over time and take a lot longer to heal than simply removing the drug from the system. Meth, for instance, should be out of the system within a couple days at the most, but the consequences of bathing one’s brain in dopamine for years are evident in a range of difficulties that can last months or years after the last dose.
Power dynamics really are the ultimate problem, which Mirandizing the potential victims does not resolve in any way. It might just let a few more people escape from knowing what they’re up against. But I’m sure it would only stop a very small proportion of the current batch of forcibly “hospitalized” people (inmates). At the least, giving such a warning would be an acknowledgement to the larger society that we are not talking about “treatment” when we lock someone up.
I’d say it is an extreme rarity that any psychiatrist performs even a rudimentary medical exam. They don’t even seem generally to have the equipment to do so in their offices. It’s clearly not an expectation, which says a lot right there.
It sounds like you found a bunch of things that helped you move forward. It also sounds very clear that “medical intervention” was not one of those things, and was in fact worse than a waste of time, it did overt harm.
People need to hear these stories. Thanks for sharing yours!
I think it is very possible to have therapy of many kinds without a doctor/psychiatrist’s involvement. And I don’t think it’s a problem of “inadequate training.” It’s more a problem of following a completely false and destructive model, which they are very adequately trained to apply. The model they are applying is the problem, as it is based on the ideas that 1) behavior outside of the “social norm” indicates a “disorder” just because it isn’t “normal,” and 2) that any such manifestation must indicate a physiological problem with the person acting that way, since apparently everyone should be moderately satisfied to moderately dissatisfied with the current status quo, and anyone who has more extreme reactions is defacto “ill.”
I don’t think ANY positive change can be possible when operating on such a nihilistic and destructive model of the human mind and behavior. As long as no agency or decision-making capacity is assigned to the client, there is nothing that psychiatry can do but destroy lives, and it does that very well, indeed.
And “insufficient numbers of psychiatrists” would not be on my list of things to be fixed. We have far too many, and they appear for the most part to wreak destruction wherever they go. The average 12 year old has a better grip on how to help a person in distress than the average “DSM-trained” psychiatrist. At least the 12 year old would have the sense to ask a person WHY they are sad, instead of blaming it on his/her brain!
I would say any time the “professional” is considering the possibility of “hospitalization,” it becomes an assessment. If someone asks questions that lead them to decide you need to be “hospitalized,” and they haven’t warned you they were “assessing,” none of that data is useable for petitioning the court. It’s thrown out, just like an illegal search. And no one gets to “prep” the official “assessor” with any lead-ins, like “He’s my patient and I’m really worried about him,” or anything like that. Just facts, with any self-disclosures eliminated that have not been “Mirandized.” That’s my thinking.
Ping pong can be therapeutic, at least temporarily, but one doesn’t have to go to the psych ward to get it, just the garage or basement of a middle-American teenager’s home. It boggles my mind what they are able to pass off as “therapeutic!”
Those who are pretending but don’t have an actual grasp of their subject are always threatened by any person with real knowledge and understanding, as they know they are always vulnerable to being “outed” as the charlatans they are.
I have seen this many times. A staff person puts hands on a kid in residential “care,” the kid reacts by slapping his hands away, and they say, “The patient assaulted the staff.” The reality is, the staff assaulted the patient, and the patient defended himself. But history is written by the victors, as they say.
I think what you just said agrees wholeheartedly with the concept that “mental illness” is a metaphor (“Thus a mental “illness” might be called an “illness” just because there might be certain behaviors connected with it that mimic physical illness, like expressions of pain.”) With which I agree, but my reasons for not using the term “mental illness” still stand. It adds confusion and makes it easy for the psychiatric industry to continue to convince people that they need to see a DOCTOR, rather than a friend or spiritual guide or wise elder or another person who understands what it’s like to be in your circumstances.
But of course, his “illness” lies to a large extent in the society in which he practices. His behavior is sanctioned by the social mores of the time he lives in, so he is considered “sane” while his victims are considered “ill,” simply because he pronounces it is so. This “illness” would not be possible without the huge power imbalance he enjoys. So again, if the psychiatrist is “mentally ill,” what is actually ill? Him? His theories? His group (psychiatrists)? Society at large?
Let me ask you this. From a purely personal viewpoint, what do you think a “mind” is? Is it a part of the body, a section of the brain? Is it an outgrowth of the brain, like a computer program creates images on a screen that are not understandable in terms of the structure of the computer? Is it something external that resides in the brain, a spiritual entity? Or an interface or control mechanism for running the body?
If the mind is NOT a part of the body, what would it mean for the mind to be “ill?” Can the concept of “illness” extend to a spiritual entity? Certainly, distress is obvious, as is happiness or confidence. But is lack of confidence an “illness?” Or is it a lack of an ability to believe in oneself? If we’re talking about beliefs, it’s hard for me to see beliefs or ideas or even spiritual entities as having “illnesses” in the same sense that a body has infections, cancer, broken bones, etc. How can a mind be ill if it is not a part of the physical universe? And who would decide what “ill” would mean?
The other point I made already is that the term “mental illness” has been utterly claimed at this point by the psychiatric profession and their allies, and is fully associated in the public mind with “brain disorders” or “chemical imbalances” and such. To me, it makes no sense to use a term that feeds into the hierarchy of psychiatric dogma, as it is way too easily misunderstood or misappropriated. I much prefer to speak of “mental/emotional distress” or “suffering” or “confusion” or “altered perceptions” or “sadness” or “worry.” You may think it is splitting hairs, but in terms of reclaiming power from the “mental health professions,” I believe discarding this very confusing and coopted term is essential, regardless of what other considerations exist.
I agree that “mental illness” at this point is such a tainted term, it can’t even be referred to in the metaphorical sense without instant connection to the DSM and all the stupidities inherent in assuming a “real disease” is present and exists in the brain. It is a term that needs to be tossed and never used. For certain, people experience confusion, illogical urges, emotional distress, even experience seemingly unavoidable sensations, voices, etc. that other people don’t perceive. None of this implies “illness.” It might very well imply some sort of causation, which in SOME cases COULD be physiological, but the idea that we lump all “depressed” people together as having an “illness” that needs to be “treated” is reductionistic and scientifically invalid.
I very much favor the idea of simply describing what the person is experiencing and going from there. “I feel hopeless and am not sure why my life is worth living” is something I can related to. “I feel like killing myself because I’m mentally ill” is not something that I can find any shared reality with. It doesn’t really mean anything. The first one allows that a person is doing something and can potentially take action to remedy the situation by answering some of these difficult questions or refocusing his/her attention on meaningful activities. The second implies powerlessness and lack of agency, and that for me is enough reason to bag the idea of “mental illness” altogether, bad “science” notwithstanding.
The only thing “known about mental illness” is that there is no such thing. Not saying there is no mental/emotional suffering, but it’s not because a person is “ill.”
Well said! If you can’t convince them, drug them. If that doesn’t work, electrocute them. Sounds like a great plan if you’re tying to immobilize your “patient!”
I so agree. I think a “Miranda”-type warning should be given to anyone undergoing such an “assessment.” “You have the right not to say anything or answer my questions. Anything you say can be used against you to lock you in a psychiatric ward against your will. You have the right to have an attorney present during this ‘assessment.'”
“Random specificity!” Nice one, Bradford – you nailed it! “Precision” and “psychiatry” don’t even belong in the same paragraph, let alone the same phrase.
New title: “The use of induction of grand mal seizures by electrocution should no longer be allowed or justified through pretending it is some sort of ‘treamtent’ when it is actually electrically-induced brain damage.”
Or “Induction of seizures is not ‘treatment.’ It is intentional brain damage.”
There are many other options, but you get the idea.
I love this – when we use proper mathematical analysis, the findings are “no longer valid.” Meaning they were NEVER VALID in the first place! Isn’t the real conclusion, “The findings were fraudulent, as the researchers used inappropriate methods to draw the conclusion they wanted to find?” Why not call a spade a spade?
I agree with you, except that a professional degree alone doesn’t convey the privilege of being heard – that privilege quickly evaporates as soon as you challenge the necessary status quo belief system, as Peter Breggin, Fred Baughman, John Read and many others can attest.
Laughter is, indeed, the best medicine. I heard of a program in the Eugene area where people suffering from mental/emotional distress (I don’t believe they have any “admission criteria” except that you’re feeling like you could use some help) get trained and supported in doing standup routines as a means of helping them. It sounds like a lot of fun!
Well, by all accounts, sneaking in wouldn’t be very difficult. “Empty, hollow, thud.” (The Rosenhahn Experiment.) The challenge would be getting the phone in. Perhaps one might find a staff person who is concerned about abuse who is willing to assist. Inmates get phones and drugs and other contraband inside jails, and it’s usually with the help of the guards.
Or screw telling them at all, and get it published by some media outlet or other, maybe in a compiliation with others who have had similar experiences. If you tell a psychiatric “professional,” they’ll most likely tell you, “Well, if you got better, you must have been misdiagnosed, since we know no one gets better from that without our drugs.”
Yeah, the placebo effect kind of refutes the “brain disease” concept all by itself. But most psychiatric researchers view it as an annoying impediment instead of real and meaningful data. If a third of your cases can resolve based on BELIEVING that they’re going to resolve, it sounds like there is something pretty powerful about believing things that affects the entire body and all its systems! But it’s hard to make money off of that kind of data, and it keeps making their drug trials look bad!
Maybe we need to put up some videos of someone being “restrained” in a psych ward, or someone in four-point restraints, or someone before and after their last Haldol injection.
Not sure I said what you think I said. I have no problem with the term PC. It was objecting to it being turned into a term of hostility because it undermines what was a very legitimate effort to look at the purpose and effect of certain terms from a perspective of power in relationships. But that’s what the term has come to mean, and it is used that way, and everyone understands that. So I wasn’t criticizing you or anyone else for using the term. I was only observing that the real purpose of looking at “correcting” language wasn’t to make people wrong, it was to address issues of inequality, and it’s been coopted to another purpose by those in power who don’t want the power dynamics to change.
I’m sorry if you got the impression I was criticizing you. I was not, not at all.
Wow, who would have GUESSED that feeling like killing oneself could be related to unmet needs? Such radical thinking! Just when we were all convinced it was a brain disorder that had nothing whatsoever to do with the person’s place in the world and experiences!
It is sad that such research is even needed. Seems to me kind of like discovering that “based on interpersonal theories of infant communication, crying in babies is often caused by unmet needs for food and nurturance.”
I agree. It appears to me to be a term that has been appropriated and turned into a negative. It is unfortunately true that a lot of shaming has gone on in the name of “political correctness,” but in reality, words have great power and choice of language generally frames both what people see as the problem and what solutions are to be considered.
MIA is a news magazine. It operates on a skeleton staff and accomplishes an amazing amount with a tiny budget and a lot of volunteer work hours. There is no bandwidth to start creating other organizations, but of course, if readers see such a need, they are encouraged to come up with ways to make it better. We put the information out there for others to use in whatever way seems productive to them.
Way to see the silver lining, O.O.! You’ll be feeling better in no time, and you can help cheer up your jailors, too! After all, they’re just caught in the capitalist system, trying to survive like anyone else. Give ’em a smile, and next time, they may smile right back at you!
OK, that humor’s getting a little too grim, even for me!
I agree, most people go to NAMI because they need support, just like most people go to psychiatrists because they feel desperate and are looking for answers. But the organizations themselves have to answer for being corrupt and misleading people intentionally, because that’s what they do.
NAMI is a very interesting phenomenon. There are plenty of people who go to NAMI genuinely looking for support, and some even find it to some extent. There are also a good segment, by my observation, who go to NAMI to be absolved of responsibility for any contribution they may have made to their child’s distress, and these are the ones who really grab onto the “bioligical brain disorder” terminology and ideology. The people in the second group, I have found almost impossible to talk to, because their identity is very much tied up in blaming their child’s brain for everything, which means toeing the party line on the “liftime brain disorder” and “drugs for life” concepts.
I truly wish there were other places for families to go for support. I mean, there ARE, but NAMI pretty much has taken all the air out of the room so any such effort is generally small, local, and relatively unknown (sorry, bad pun there!) And it becomes a real problem when families really do need genuine support and they get a choice between NAMI and nothing. But the needs of family members are very different than those of the survivors of psychiatry, and in all too many cases, those needs conflict too strongly for both to get support in the same venue. Open Dialog appears to make an effort to bridge that gap, which I’m sure can be very helpful in many cases, but it’s also generally not available, and depending on the family members’ attitudes, might or might not provide what they needed.
I don’t disagree. It is amazing how many normal activities are coopted into “therapy” so that someone can charge you for it and still maintain the fiction that they are “treating” some “disease state.” I get apoplectic when they start talking about “mindfulness” or “exercise as therapy” and that kind of nonsense. “Therapy” appears to be anything that can be marketed to convince people that someone else has an answer to their problems.
My point in that comment is that people in the “biz” try to come up with some magical “therapeutic school” such that if everyone does this, their clients will all get happy. And of course, whenever the client does not, they are “treatment resistant,” because our “treatment” is “evidence based,” so any “failures” are the fault of the client, or the “disease.” It’s 99.9% hogwash. Deep breathing isn’t therapy. It’s breathing. Available to anyone for free.
When I was a “counselor,” I had the great advantage of having no training whatsoever to be a counselor. So I basically just listened to people and tried to understand their issues, and occasionally came up with an idea or suggestion for them to consider at their own determinism. There was no need for a “school of therapy,” I considered myself just another human being who had somehow earned the privilege of their trusting me with their thoughts and feelings, and I acted accordingly. If that’s “therapy,” then “therapy” is pretty much anything that someone finds helpful in confronting life. The idea that telling everyone to “change their thoughts” is somehow going to produce uniform results is stupid. Just be human. That’s what people need.
I always thought of CBT as a technique, not a “therapy” by itself. It works great in some situations, and is awful in others. Works really well for some people, others find it intrustive and invalidative. Any therapist worthy of his/her fee would adjust his/her approach to the person in front of him/her. The best therapy is what gets the person you’re working with to where they want to go. Rigidly applying one technique as the be-all and end-all is a sure sign of incompetence.
I think this is a great clarification. Allies can be ESSENTIAL! But only if they are supporting the survivors. And as long as the power disparities exist based on race, class, education, etc., there will always be an awkwardness in negotiating this kind of advocacy.
Sam, I really DO think the way you describe your approach is an exception. Most family members are neither committed nor skilled enough to find a way to either elude the “helpers” who “know better” or find people who actually CAN help or develop his/her own approach. Family members most defintely CAN be incredibly helpful, but as often as not, they can also be incredibly harmful, and are sometimes the very reason the person was traumatized and overwhelmed in the first place. So it is possible, even likely, that there is some bias toward distrusting family members who claim to be “here to help.” Personally, I think each person is different and should be considered individually. But I’m in general agreement that the voice of the person ostensibly being “helped” has to be raised above that of any family member, however well intended, because in the end, that is the person who has to live with the results of any “helping” that is going on.
Being locked in a dungeon and being fed barely enough to survive on just so they can come and torture you every day is NOT the cause of your depression. It is your INTERPRETATION of your circumstances that causes your depression.
Think of positive things: what can you be thankful for today?
But being OK with your “symptoms” is a sign of Anosognosia, so if you’re OK or not OK, they still think you’re nuts. Oh, oops, I mean “experiencing mental health challenges.”
I’m not saying at all that he didn’t say that, just that I am not sure it means what you think it means. I don’t think you are casting aspersions, either. I just see the logic in the decisions he’s made, and the effect it has had.
I did check the mission statement, and it is a “reimagining” statement. So it may be you are right. But I’ll leave it to Bob to say.
This is NOT me as moderator. I will let Bob answer for himself on this, but my view is that this is a misperception of what he has said. For sure, he wants to be seen as scientific and objective, and I think the pursuit of disseminating information and letting people draw their own conclusions from it is the most effective way to make that happen. And I certainly see that his work AND MIA has had a huge impact on causing people to question the dominant paradigm, more than any other person I can think of. I think his impact speaks for itself and I have certainly not accomplished 1/100th of what he has, so whatever approach he is taking, my hat is off to him.
Posting as moderator: I do want to point out here that MIA is not taking any specific point of view regarding reform vs. abolition. MIA was created as an alternative news source to put out any and all information that questions the validity of the current paradigm of care. It is not intended to take a political position on an antipsychiatry vs. critical psychiatry viewpoint. It is intended to encourage discussion of a range of viewpoints that are not normally made visible, and to allow voices that are normally silenced to be heard. As such, MIA is not taking any particular viewpoint supporting or opposing the abolition of psychiatry. That is up to the readers to determine for themselves.
Exactly. Mainstream schools are a positive for a small minority of kids, I think. Most are bored to death, feel resentful of the many restrictions on their activities, feel restless and anxious to do something of their own choosing. Bullying and shaming are generally epidemic, often due to institutionally approved bullying by school staff.
I remember very well being in 6th grade on the last day of school. The last 5 minutes, no one said a word. We had a clock on the wall that had no second hand, but which gave a buzz 4-5 seconds before moving to the next minute. As we went through the last minute, the tension was palpable. The clock buzzed, the minute hand ticked, and the bell rang. Suddenly, pretty much every kid in the room stood up cheering in joy and picked up their stuff and ran out of the school as fast as they could go! If school was such an appropriate and helpful place for kids to learn, why was everyone so elated and relieved to be allowed to escape?
In “mainstreaming,” there is an unspoken assumption that adaptation to the “mainstream” is good, and that the “mainstream” way of “educating” kids is the ideal, and that kids who can’t manage that are “special education.” I disagree with all three of these assumptions. I think that “Mainstream” schools are actually quite damaging, both educationally and emotionally, to a majority of kids who attend. The lack of creative alternatives condemns all of our kids to this unproductive and at times destructive “mainstream.” When kids can’t manage it and fall out for one reason or another, it should be a sign that this “mainstream” is not working for these kids and that there is a need to approach them differently. But instead, we assume that the child is flawed for finally letting us know that our system doesn’t meet their needs. How many kids are in the “mainstream,” suffering every day (as I did) and yet swallowing their needs and “fitting in” to avoid punishment and humiliation?
Assuming “mainstream” schooling is healthy or appropriate allows schools the luxury of not confronting or improving on their failures. They can blame the child and keep on doing what they are doing. It is very much analogous to the assumptions of the psychiatric worldview.
Plus, people probably DO feel better when they take Ketamine. Until they stop taking it. Or until they become addicted and tolerance builds up. That is not a solution, even if the study WERE really double blinded, and really were positive for Ketamine.
I could do a double blind study for alcohol, and I guarantee that alcohol would show significant anti-anxiety properties. There is no doubt about it. But does that make it a “treatment” for anxiety? It is ancient history that taking substances can alter one’s mental state temporarily. Is this really all that has to be proven for a drug to become a “treatment?”
People come out worse from psychiatric interventions all the time, and it is almost always blamed on “the disease”, aka blamed on the “patient.” Take a look at “treatment resistant depression.” All it means is “our approach failed.” But rather than take responsibility for failing and looking for another approach, they blame “depression” for “resisting” their “treatment.” It is a pervasive tactic that absolves the psychiatric “professionals” of any responsibility no matter how much worse the “patient” is upon release that at admission. It remains baffling to me that this is not obvious to more people who watch the process.
I think you’ll find Oldhead in particular agrees with both of us that the difference between “mind” and “brain” is vast, and that psychiatry’s efforts to equate the two are at the center of the deception or idiocy, whichever we consider it to be.
I think it means that they have given up on testing on drug-naive patients because 99% of the patients they deal with are or have been drugged, usually with multiple drugs. A pretty weak argument scientifically. Reminds me of how they used to say they can’t ethically have “control groups” with “schizophrenia”-diagnosed patients because it would be unethical to deprive half the group of their wonderful “treatments.” Even though their odds of recovery would improve as a result. Go figure!
When I worked at a crisis line, we used to get calls all the time from people who used cutting to cope. They said they could not tell their doctors or therapists because they’d be hospitalized. They were uniformly NOT interested in killing themselves, they used it as you describe, as a way to reduce tension or frustration or pain. It was clear to me that it met a need and was not specifically dangerous, so enforced “hospitalization” even by their own “danger to self and others” standards didn’t apply. I found it quite ironic that they were doing “therapy” with people who could not handle talking to a person who used cutting as a a means of coping with a difficult reality. How could any therapist be helpful if they aren’t actually safe to talk with?
And that figure of 60-70% is still valid for those living in “developing” countries where they haven’t yet discovered the wonders of “modern psychiatry” and don’t hand out drugs to everyone who has any kind of difficulty.
Posting as moderator: Just a reminder that most MIA articles are either already on the internet or are submitted by folks who are telling their own stories or summarizing their own research. MIA doesn’t decide whether the author uses quotations around certain “mental health” related terms except when it is an article published by MIA itself.
I question the use of the obfustacory term “problemetized.” Why don’t we just say the image of ‘schizophrenia’ as a “Chronic life-long disease” was disproven? Or shown to have no scientific basis? Or exposed for the subjective and prejudicial term that it is? Or something like that.
I don’t mean to be disrespectful in asking this, I’m interested: What do you see as non-biological psychiatry? If there is no physiological disease state, what purpose does a medical doctor have in this area?
They do. I used to work with foster kids and I always attended foster youth panels where the kids presented on what THEY thought should be different in the system to make it work for them. At one such meeting, I asked them what was good or not good about their “mental health” support. They talked a bunch about therapy but not a word about “medication.” When the topic came up later in the discussion, it became clear that they did not see “medication” as a “mental health treatment” but as a means for adults to manage “bad” behavior. They understood it as something that happened if you acted out and the intention was to stop you from acting that way. They knew intuitively that it had nothing to do with their health, “mental” or otherwise.
That was my immediate take – we have to STUDY to see if playing games and interacting positively with other people and eating well are going to be helpful? And yet “ECT” is considered “helpful” until proven otherwise???? Some people really have got their priorities out of whack!
“Moving cars are a “risk factor” for broken legs, but clearly, there is a biological vulnerability for people whose legs break when hit by moving cars, because after all, not ALL people who get hit by cars break their legs, so there MUST be something different about those “weak-legged people” who just can’t take the hit and keep on walking!”
Of course, that begs the question of how any person could be determined to “have a mental illness” when these “illnesses” are clearly subjective judgments about a person’s behavior or character, without any objective way to determine who does and doesn’t “have” these spurious “disorders.”
Most people would allow that electrocution and grand mal seizures would be things that anyone would want to avoid at any cost. It shows how utterly distorted the world of psychiatry is that opponents of “ECT” have to do anything at all to debunk the obvious harms that inducing a grand mal seizure would create. People who have near-death experiences often recover an appreciation for the fragility of life and make big changes to make their lives more meaningful. Does this suggest we should push people in front of cars as a form of “therapy?”
I also doubt the patient ratings are reliable. After 3-4 “treatments,” I’m guessing most of the “patients” are very much inclined to say, “I am feeling SO much better! I feel COMPLETELY cured! Now, can you please open that door and let me the hell out of this place?”
I think we would have to create a bank of lawyers who were serious about enforcing the laws, not the “reasonable” lawyers generally employed in these roles today. Of course, some of these lawyers would be excited to actually be able to defend their clients and would be happy to step into the new role. But it would mean hiring lawyers who would actually be willing to challenge the system. It would also mean collecting stories and data to change the laws so that they are enforced and effective. It would be a big change from the status quo.
Are psychiatrists really challenged by this question? It seems likely there will be no actual research into what happens or why. Perhaps the challenge they don’t want to face is why more people will suddenly qualify as “mentally ill” when it’s all supposed to be a “biological brain disease.” But we know that no one will really challenge them on that point except their “patients,” whom no one will listen to, because, after all, they are “crazy.”
I would add that the “overreach” is driven by intentional bias in the direction of making genetic explanations stick even when there is no or only circumstantial evidence for them being true. This, in turh, is driven by both professional and financial conflicts of interest, as there is more profit to be made and more responsibility to be evaded by those in powerful positions if the “biological explanation” can be propped up enough for people to buy into it.
On the other hand, some people won’t make it to the doctor to get “evaluated for depression” and hence will not start on SSRIs or other such drugs, which may bring the suicide rate down. I know a person who has gotten off of antipsychotics because the doctors were unwilling to come to his/her home to administer it. This person is doing quite well in the aftermath, despite trying many times to stop in the past without success. I’m using s/he construction to obscure any guesses at the person’s identity.
So I guess I am a “danger to self and others” if I choose not to wear a mask while hiking, even when all data suggests that casual outdoor contact between individuals is essentially never going to result in transmission?
I guess it seems like a sneaky way to suggest that somehow Covid19 and “harm to self and others” are connected. I guess as I read it again, the implication is that people with “serious mental illnesses” could be incarcerated because they are judged as too stupid or incompetent to take proper protective measure against Covid19. Which is, of course, is ridiculous, because COVID19 isn’t necessarily dangerous to everyone, and because the fact of someone “having a mental illness” is probably completely unrelated to their ability to protect themselves in the first place. Hey, people with “OCD” characteristics or who are afraid to go out of their homes would actually be at an advantage! But naturally, they can’t just come out and say what they mean, they have to raise fears by vague generalizations. That guy is a dangerous person! He is a “danger to others” with his whacky ideas!
“• PROVIDE GUIDANCE ON INTERPRETING STATE CIVIL COMMITMENT LAWS TO RECOGNIZE THE RISK OF CONTRACTING OR SPREADING THE CORONAVIRUS AS A FORM OF “DANGER TO SELF OR OTHERS” AND A BROADER INTERPRETATION OF “GRAVELY DISABLED” THAT CONSIDERS COVID -19.”
Does that sentence even make grammatical/syntactic sense? Sounds like gobbledygook to me.
It is hard not to “blame the field” when they have plenty of information, from research science to individual testimonials to epidemiological statistics that says their approach is failing, yet they continue to attack those who speak the truth and to promote the failed model despite these facts. Who else is to blame?
There used to be a crisis line whose name was “Let’s talk.” It seems like such an obvious thing. What do you do when you see a car wreck? First thing you do is tell someone, go over what happened and how you felt, they ask you questions, etc. It’s what you do when something scary happens. It is only massive propaganda that has moved people away from this basic, intuitive understanding of what people need from each other. Any “therapy” that isn’t primarily based on listening should be immediately shitcanned!
Well, there have always been suicides, but it appears that using “medications” can make people kill themselves or want to who never had that impulse before, that’s for sure. How SSRIs ever got the reputation for being helpful for suicidal people is beyond my comprehension.
“Hospitalizing” someone for suicidal thoughts or plans is one of the most counterintuitive things I can think of. And someone PRETENDING you are suicidal is far worse!!!! I can’t imagine my rage – but of course, my rage would be “evidence of my disorder” and be held against me, too.
In fairness, there are some rational helpers scattered about in the “mental health” system, and if you’re needing someone to listen and they have the capacity and skills and proper attitude to do so, it would be a shame to blot them out by generalization. On the other hand, Muhammad Ali used the analogy that if you’ve got a hundred snakes outside you’re room and 90% of them are nice snakes and only 10% are planning to bite and kill you, are you going to go out and check and see which ones you can trust, or are you going to just keep your damned door shut?
Yup. Nothing says, “I care” like handcuffs, a squad car, and being forcibly injected with mind-altering and body-altering drugs. Cheers me up every time.
I LOVED the graphic! I am envisioning a potential client approaching a “professional” with this in hand. “Before I agree to share my feelings and experiences with you, I have a few questions I’d like to ask. First off, do you feel you are in a better position to know what to do that some of your client? Please elaborate…”
Milton Erickson used to say that therapy has to be reinvented anew for each client. I believe he was absolutely correct. Labels only distract from the fact that all people have unique needs and strengths and that nothing is going to work for everyone based on some external characteristics.
There are some educational techniques we can use with kids who have difficulty communicating, just like there are approaches that work better or worse for kids who are seeking lots of stimulation or don’t like to sit still. But these are adaptations to personalities and personal needs, not “diagnoses” of “disease states.” Any kind of “treatment” requires creativity and a willingness to communicate with the person you’re trying to help, verbally or non-verbally. The rest is all window dressing, or more often, marketing.
Scientists are supposed to be critical of everything. Skepticism is the core of good science. If something seems right, try every way possible to prove it isn’t. Only when you have eliminated all other possible explanations can a scientific datum be considered “true.”
In the real world of science, “spectrum” always denontes a continuous range from one extreme to another. As much as people are defined as “on the (autism) spectrum,” a real spectrum has no defined point of differentiation except at the extreme ends. If there is a spectrum involving people, then EVERYONE is on the spectrum somewhere. I know that’s not how the word is used by most people in this context, but scientifically/mathematically speaking, that’s the nature of a spectrum. It doesn’t suddenly stop at a certain arbitrary distance from “normal.” The recognition that there ARE spectra of human behavior and emotion that exist around any definable “norm” is a very good thing, but deleting the idea that there are people “ON” the spectrum and those “OFF” the spectrum is really not a sustainable concept.
I tend to agree. We don’t know in any case even whether it’s “neuro”, that the person is somehow neurologically different, nor do we know if that difference in a particular case is a result of any kind of abnormal disease process. There are probably some people “on the spectrum” who actually do have something physiologically wrong with them, but we don’t know what it is or how to differentiate those who really do have a physiological problem from those who simply act in ways that are unusual or that make some “normal” people unconfortable for some reason.
Excellent analogy with “sex offenders.” A sex offender has committed a CRIMINAL ACT, and his/her label is based on that act(s). This is defined by law and enforcable with known penalties. A person who “has a personality disorder” is so labeled based on a general opinion of what some people have decided is a “problem personality.” Such a label does not require ANY specific act, it is NOT defined by law, or actually by even any objective meausrement at all, and the penalty can be whatever the people in charge want to assess, including incarceration on a more or less permanent basis, enforced drug-taking, public shaming, discouragement, being discriminated against in employment or education, and on and on. It is not in any way a legitimate analogy.
He also discredits anything, including “double blind studies,” that doesn’t fit with his preconceived agenda. In a word, he cherry-picks the studies that make him “right.”
“I’m trying to track down on the study that allegedly shows that people avoid artillery ranges for fear of being blown up.” Gotta have a study before we decide things, don’t we?
I would add that asking people questions, per the Socratic method or something like it, is a better way to lead people into making observations that conflict with their own assumptions than telling them they are wrong. Most people hate being wrong. As Albus Dumbledore wisely stated, “Most people find it much easier to forgive you for being wrong than they do for being right.” Or something like that.
My concern is not with fairness or unfairness to Donald Trump per se. My concern is that allowing “professionals” of any stripe to “diagnose” public figures reinforces the idea that “mental illnesses” CAN be objectively “diagnosed” and that these professionals have some inside knowledge that makes them more capable of validly assessing the capacity of a particular person to continue in the office of President. It empowers the DSM and its adherents in a way I find unacceptable, regardless of the reasons given. Since the author acknowledges early in the piece that the DSM “diagnoses” lack any sort of validity, the labeling process he is describing is no more nor less meaningful than any lay person getting together with another lay person and saying, “I think Trump is crazy!” Or “I think people opposed to him have ‘Trump Derangement Syndrome.'” Sure, any psychiatrist or psychologist has the right to come up with a descriptive label of Trump’s or any other President’s behavior or conduct, just as any other citizen has that right. We still have freedom of speech in the USA, last I heard. The question is, why should their label carry any more weight than the guy in the machine shop or the woman serving her country in the armed forces or the teenager trying to figure out what politics is all about? Why should a Ph.D. or M.D after someone’s name privilege them to provide a “professional” opinion regarding labels which the author himself admits are essentially fraudulent?
It shows an incredible degree of defensiveness and insecurity. What’s the big deal about admitting that you don’t know what’s going on and are trying to figure it out? Or that you’re disappointed that the drug didn’t live up to its advertising? If a doctor cares more about patients than ego or income, we wouldn’t see this kind of behavior.
As much as I dislike government bureaucracy and corruption, it is hard to see how government-funded researchers could do any worse than the current situation. What’s your solution? I’m interested in hearing your thoughts.
True enough. But the strange part is that they get away with it. I mean, who would take their car back to the mechanic who told them their car was “repair resistant?” He’d be laughed out of business in a trice.
Hear, hear! It is the responsibility of the researchers to prove their intervention is safe and effective, not the responsibility of detractors to prove them wrong. If there is no proof that “depression,” let alone “treatmeant-resistant depresssion,” actually even exists as an entity, it’s pretty rich to accuse people of being “treatment resistant” just because you don’t know how to help them or are making them worse.
The concept of “treatment resistance” is utterly ridiculous. If I am being paid to fix a car, I don’t get to say the car is “repair resistant” when I can’t figure out how to fix it. It irks the crap out of me that they get away with this kind of nonsense. If they need a label, why not just say, “People who are not helped by our interventions?” Or why not just admit that their whole “treatment regimen” is guesswork and there is no actual expectation that any drug will necessarily be helpful?
Fava does some really important work. We need more researchers willing to challenge the status quo. But I wish they’d been a little more blunt about calling out the nonsensical and defensive nature of this entire concept.
I was talking more about perpetuating and supporting habits, ideas and institutions through our training, mostly on an unconscious level. I contrast this to the idea that somehow it’s always “those other people” who are racists, sexist, violent, abusive, etc. Naturally, there are people who are more or less aware of these tendencies and are more or less active in combatting both the internalized and external forms of oppression, such as not allowing ourselves or others to blame “the mentally ill” or black people or even gun owners as the “cause” of violence, but instead reminding everyone that violence is possible in any of us, and its more frequent emergence in our society is not caused by some external force or group of “other people,” but is actually a function of the society in which we are all participating (however voluntarily or involuntarily).
Yeah, apparently you’re supposed to be HAPPY that you’re physically ill or that your life may be in danger. God help us we should find it discouraging or overwhleming to have an actual phsyical disease process going on! Apparently we’re supposed to face pain and death cheerfully (but not TOO cheerfully – that would be manic!)
We are also encouraged to group people into “those oppressive bad people” vs. “the rest of us,” rather than recognizing that all of us participate in some ways in maintaining oppressive systems. It’s easier to maintain the status quo if we can blame “those other people” for being the cause of the “bad stuff,” so we can pretend that if only we get rid of the “bad people,” the rest of us “good people” can get on with doing good. And of course, “the mentally ill” (as conveniently defined by the status quo) are often put into that scapegoat role of the “bad people” who are causing all the problems and need to be “controlled” for “their own good” or the good of society.
I do like a spectrum approach to these discussions – it allows for variation without discrimination, and also includes the possibility that people who aren’t near the center of the graph can still have a lot to contribute that those closer to the “average” would not be able to provide. Ironically, every population biologist knows that diversity of phenotypes is the core of species survival – adaptation is only possible if there is a range of potential responses available within the species, and those who are too adapted to a particular niche are wiped out when change becomes necessary. As long as the concept doesn’t lump people into those who ARE and ARE NOT “neurodiverse,” I think it works, but we both know there are forces who can take any reframing and smash it back into two-valued “logic” for their own nefarious purposes!
The only problem I have with the concept of “neurodiverse” is that it seems to imply or could be thought to imply that there is a “neuro-normal” that describes most people. I don’t think that is the case. I think we’re all “neurodiverse” to a large extent. Unfortunately, our society picks on certain “neurodiversities” and condemns them, which is pretty sad. But I do get that normalizing “different” presentations is a very sane thing to do, and I totally support that idea!
I think the biggest problem with even quality therapy is that it is not really the proper mode to deal with current or ongoing abuse or oppression. It can be valuable for a person to discuss the pain of living with a dead-end job, and may even help motivate a person to seek a better one, but it can’t take care of the question of why so many jobs are dull and lifeless and why so many people are forced to work in them for inadequate pay in order to merely survive to face another day. Therapy can be valuable, but it is limited and can’t really handle the bigger social issues with which our current Western society is riddled.
Yeah, I think I’d volunteer for that one. Except if you’re a kid, they might lock you in a “residential treatment home” until you learn to knuckle under.
The best diagnosis is “don’t know what happened to that guy – he seems to have disappeared.”
Lack of long-term outcome data means you have no idea if your “treatment” is actually effective. Which means from a purely scientific viewpoint, your “treatment” is not legitimate. We assume something doesn’t work until proven that it does, not the other way around. That’s how science is supposed to work. Anything else is marketing.
Well, of course, the algorithm is only as good as the programmer. I’m sure someone could program a discriminatory app. But at least they won’t have to manage their emotional reactions to our statements, appearance, etc. I’m sure they’d totally suck, because they’d be made by people who have no comprehension of what is helpful, otherwise, they’d realize that a computer can’t provide what is needed.
Hey, people do it all the time. I was just making it clear that there is a difference between people calling someone names because they don’t like their behavior vs. calling someone official names with the power of a medical degree behind it. It’s still name calling, and I am generally opposed to name calling, as it is usually very unproductive and avoids planning to overcome the problem. But there is a very important difference in quality between being called a name by someone who is no more or less powerful than you are vs. being officially sanctioned by the medical profession to call people names as “medical diagnoses.” The second is far more insidious and destructive.
Hope that makes my point clearer. At least in the colloquial situation, we KNOW it’s a matter of name calling or generalizations with no scientific basis. No one is pretending that the other person “has” some brain problem or whatever. They’re just saying the othe person is a jerk.
Right, the DTs are evidence of “their disorder returning” or “relapsing” and obviously indicates that they “need” alcohol in order to function. I’m sure many an alcoholic has used this very “evidence” to prove they “can’t quit.”
Nah, they just liked high school for some inexplicable reason. I guess maybe they would miss their friends, but I didn’t have that many, and in any case, I could still be friends with them absent the authoritarian regime. And that was in the days when we had MORE freedom in high schools, right at the end of the 60s “student rights” movements. Student rights have massively deteriorated since that time, in my observation, other than that physical abuse has been MOSTLY outlawed.
My high school was in suburban Philadelphia. Supposedly one of the top 10 public high schools in the country. And there were a lot of good teachers. But it was still school.
And there were still a few, like Mr. Mims, who probably belonged in jail. Even as naive as I was back then, I suspected he was sleeping with at least one of the students.
I guess I’m impatient with injustice and authoritarianism. Probably a “mental illness” of some sort. Otherwise, I would have loved being pushed around and bored and bullied and neglected and prevented from exploring anything not on the curriculum. What was wrong with me?
“Narcissistic” is a colloquial description of a certain kind of behavior, kind of like “cowardly” or “noble” or “conscientious.” “Narcissistic Personality Disorder” is an alleged “mental disorder” that can purportedly be “diagnosed” by people with a “professional background.” What would you think if they diagnosed someone with “Cowardly Personality Disorder?” Wouldn’t that seem pretty far out there, to take a set of personality characteristics and call it a name and then claim it is somehow a “diagnosis?”
You could replace “narcissistic” with “childish” or “selfish” or “ill tempered” or “thoughtless” or “mean-spirited” and it would still just be a description of a person’s behavior. A description of a person’s behavior can not logically be a medical “diagnosis.” That’s the difference.
I remember they had an overnight party the day of graduation, with a hypnotist and dancing and punch and the usual entertainments. I saw different clutches of kids hugging each other, some with tears in their eyes, talking about how sad they were it was all over. I was thinking, “What high school did YOU go to?” I am sure that their experiences were very real to them and I admire them for being able to emote about them publicly, but it was TOTALLY unreal to me. I felt a huge weight off of me, along with the thought, “Wow, I’m free! Now what am I going to do with my life?”
I think you’re making total sense. My point is only that there are, in fact, any number of imponderables, and it is possible, even likely, that some measures in place are not particularly helpful while there are others we will later learn we ought to be doing. We’re flying blind to a large extent, as there is not much prior experience to draw on, and we don’t have time to do controlled experiments. So “playing it safe” and reducing risk is probably the best we can do. But I do think it’s important to acknowledge (not saying that you aren’t) that our knowledge is limited and to some extent we’re making educated guesses as to what will be most helpful, which explains at least in part why at first we were told no masks, then we were told to mask up. New information is coming in and best practices will change as we learn more.
Because traditional meditation approaches are grounded in Hindu and Buddhist spirituality, I see meditation as being utterly incompatible with psychiatry. “Mindfulness” is something appropriated from Buddhism without the nasty entanglements of silly questions like “What is a person?” and “How should I conduct myself on Earth?” and “What happens when I die?” Buddhism is based on the assumption that we are spiritual beings who suffer because of our own attitudes toward life, and offers a means of attaining greater peace and satisfaction through expanded use and understanding of our minds. Psychiatry teaches us that we are bodies, that there is no spiritual existence, that the mind is just a function of the brain, and that the mind is incapable of having more than a marginal influence on a person’s “mental health.” Meditation in every way contradicts the basic tenets of psychiatry, unless you go for “McMindfulness” that says you can sit there and breathe and it can calm you down. Which can be true, but it certainly misses the point, especially when people are told they HAVE to meditate or are shamed for failing to “succeed” at it.
Do we know that reduction of droplets extruded reduces the likelihood of infection when distancing and surface sanatiziation and hand washing are all in effect? A recent study showed that outdoor transmission almost never has been shown to occur. So maybe we should only wear masks indoors? There are lots of imponderables, which is my point.
Not only is psychiatry not intersted in what stress from the past is affecting us, they’re not even interested in what it is in the PRESENT that we’re finding upsetting! Apparently, we’re not supposed to ever be upset by ANYTHING, or else we’re “mentally ill.”
It seems that only a certain number of comments in a thread can “nest” as replies, after which they are just listed one after the other, with no “reply” button. You have to go back up the chain to the last one that had a “reply” button on it if you want to continue on this thread.
I agree that there are things which are concretely known and some which are purely speculative, but there are also partly-knowns which have to be evaluated, and that’s where a lot of conflict occurs. For instance, it is known that COVID19 virus can be found in droplets in the air 2-3 hours after they have been deposited. But what does that mean? Are they still infectious at that point? Do ACTUAL cases get passed that way or don’t they? Is this important for people who are infected to prevent spread, or people who are trying to prevent infection in themselves? These are all questions that people are willing to weigh in on heavily, either shaming people for not wearing masks or dismissing the possible risks as nothing but hype. The truth is, we don’t know if masks help or not, or how much, or on whom. A lot of this stuff is guessing.
As to how Trump is handling all this, again, I think this subject is pretty well pooped out, and I’m going to ask more directly that the two of you move on from this subject, as it is now deteriorating into a more personal “thing” that is not productive.
Polypharmacy is the usual term, but I think polypharmacology works just fine! Or we could just call it “masses of drugs tossed together willy nilly with no idea how they’ll interact.”
I agree that this exchange has been interesting, but has perhaps reached as far as it can go. I think we’ve seen both perspectives fleshed out pretty thoroughly, and I doubt very much if either of you will sway the other. Part of the challenge of this set of events is the inability to know what information is reliable or not. I think this exchange makes that point very clear.
“The problem is that common approaches to deploying AI tools are not improving outcomes.”
No, the problem is that common approaches to “helping” with mental/emotional/spiritual distress don’t improve outcomes, and no amount of AI is going to change the fact that the basic model of distress and helping is fatally flawed. Well, flawed unless your “outcome” is increased profits. Maybe that’s what they mean – AI isn’t improving income, therefore, it isn’t working?
This study should not surprise anyone, except for those who like to keep their heads in the sand. Anyone with a modicum of experience in this area, first or second or third hand, knows that these drugs interfere with your thinking processes. The disturbing part is that this viewpoint would still be in any way controversial.
I wasn’t so much bullied by peers as by teachers (we had some mean ones!), plus very lonely and bored out of my mind. I hated taking arbitrary orders from anyone, and still do. Particularly when I was smarter than most of the teachers and was always way ahead in almost every subject, which instead of counting as a positive made me a problem for them. The kids who liked school were the ones who had lots of friends, mostly, or the ones whose home lives were so bad that school seemed like a big step up. I was neither, and I hated every minute of elementary school. Junior high was only better because they had sports and I was a good athlete, and so finally got a few friends, too. When I graduated high school, I felt like the allied troops had freed us from the POW camp!
Well, we wouldn’t want to get in the way of commerce, now, would we? What about the danger to the individual of a poorly-programmed driverless truck? Oh, but I guess actual PEOPLE would be expendable in this futuristic world.
Plus ditching the daily commute HAS to be a big plus. And when I was a kid, I’d have given my eye teeth to be allowed NOT to attend school for ANY reason. I LIVED for summer vacation!
That’s been my experience, both as a helper and as a “helpee.” These “disorders” are just a way of experiencing the world, and we have to be the ones to decide what is and isn’t the best way to approach it. Most of the time, people have adapted to difficult circumstances by developing a way of thinking about the world or interacting with the world that seemed to work at the time. So accepting that these thoughts/behaviors/emotions have served a purpose, and then asking oneself what purpose they continue to serve, has been a successful path for me. Others would frame that differently. But in any case, what is helpful is NORMALIZING the experience as part of your own process, rather than externalizing it and making it seem like “OCD” or “ED” is some external agent that is attacking you! It reminds me a lot of demon possession. Not saying some people might not find it helpful, but it sure seems counterproductive to me.
A lot of science is also rooted in what is known NOT to be true. It’s a lot easier to disprove a hypothesis than it is to prove one unequivocally. The most certain data in science are which theories are absolutley wrong. Unfortunately, these days such vital information is often buried or at least not published. Especially when conflicts of interest are involved. Peer review’s job ought to be to poke holes in the methods or conclusions of the researcher based on the data. Unfortunately, that role is not always played fully by the reviewers these days.
Wow, that seems titanically dumb! Give your “eating disorder” it’s own personality and power and indepencence, as if it were a separate entity. How the heck is THAT supposed to help? So you can tell your “ED” voice to go f*&k itself? Seems utterly idiotic! Has anyone ever seen this idea be helpful in any way?
If there are driverless trucks careening around the roads, they might not have to work hard to keep me from driving anywhere! Sounds like a scary scene to me!
I think calling it a “disorder” IS shaming! THe non-shaming approach is to assume that it is a normal reaction to circumstances, or else a manifestation of a legitimate and observable physiological problem (lack of sleep, thyroid problems, etc.) It is hard to think of a much more shaming approach than to say your emotions mean nothing, your brain is broken, but there’s nothing anyone can do to actually fix the problem, it’s just you have an inherently bad brain. Tough luck!
An excellent point. Though perhaps if it were scientific, it couldn’t be what it is – it would be something entirely different, because it ISN’T sceintific at all!
A point I have always shared and agreed with. Corporations are a force of their own and are often subject to no government at all, yet can do as much ore more damage than any government, and many of the problems with government (though certainly not all) are due to their being in bed with Corporations and/or Crime. And I do see an increasing crossover between Corporate and Crime that also needs to be addressed.
I stand by what I said. And it does appear that you misinterpreted my comment. While it does come across as rather flippant, nothing in that comment says that JWR or beer or “antipsychotics” have no effect. All I am saying in this comment is that just because something DOES have an effect that someone likes does not make that something a “treatment” for a “disorder.” Alcohol reduces anxiety significantly. It’s a fact. Why isn’t it considered a “treatment” for “anxiety disorders?” I certainly used it as a teen and young adult to reduce my anxiety in social groups, and so do lots of other people. How is this different from taking Xanax?
You say “APs” saved your life. I have no desire or data to disagree with or refute your reality on that point. Other people say “APs” ruined their lives, including ruining their health. Neither you nor I have any data to disagree with or refute their reality, either.
The only real point here is not to confuse a drug’s effects, which may be perceived as positive, negative or neutral, as evidence of any particular “mental health” issue being present or absent. We don’t diagnose cancer based on whether people feel like cancer treatment worked. We don’t diagnose a skin rash based on whether steroid cream makes it go away or not. We look for the CAUSE.
We should not diagnose “mental disorders” based on people’s reaction to drugs. I don’t want to prevent people from using substances they find helpful. I just want to keep doctors away from “diagnosing” people with speculative “diseases” that no one can objectively observe to exist.
OK, I broke my vow. That’s really it, Martin. No more.
I absolutely agree, Trump is NOT the problem. Which is why simply removing him is NOT the answer. He’s a symptom of a much larger, more difficult problem that besets our whole society. But it’s easier to blame Trump and imagine that somehow if Biden gets elected things will magically improve. I hope people aren’t holding their breath for that one.
Sometimes we believe we can change things, or the pile of data doesn’t reach critical mass until a certain point. There are many of us here who had “epiphanies” at one time or another in our lives/careers. At a certain point, I think a person comes to see that it’s not just a matter of confusion or needing training, it is the intention of the SYSTEM that is wrong headed. I’d guess a DSM IV conference would make that point pretty clear to anyone who was participating.
So you can’t see the difference between, “The majority (defined as more than half) of scientific studies can’t be replicated” and “Scientific data is not replicable?” Even when I stated clearly that TRUE scientific data IS replicable (around half of the studies I’m talking about), and that this is the only way we can tell if it is true? To put it another way, half of what is put forward in journals as “scientific data” later turns out to be false. Does that state it more clearly? Data that can be replicated are true, those which cannot are false, scientifically speaking. So SOME scientific studies can be validated, but according to the article, more than half cannot be replicated. Which leaves us with plenty of valid scientific data, it’s just a lot less than we’ve been led to believe by leaders in the medical/psychiatric industries. I refer you again to the Viiox scandal. We were told that it was safe, when there were plenty of studies saying that it wasn’t. But those studies were hidden and not published. The studies used to promote its safety could not be replicated, and the drug company promoting Viiox knew this but chose not to share. The studies they used were false. They were put forward as if they were true by people who knew they were false, but who had an interest in profiting off of Viiox’s sale and use. That seems pretty simple to me.
You never did read the article, did you? It would really help if you did.
We really need to end this. It seems we are unable to listen to or understand each other’s viewpoints. For you to suggest that I have ever said that antipsychotic medication has no effect on people shows how far we are from being able to communicate.
I am not going to respond to further comments from you on this topic. I would suggest that if you find the comments here offensive, you might do better to seek another community that is more comfortable for you and aligns more closely with your values. I certainly have no intent to frustrate you, but it is apparent from our conversation that you are not getting what I’m saying, and I’m sure you feel the same way. So let’s just stop, OK?
There is nothing in the first statement that contradicts the second. Both say that the majority of today’s scientific research is not replicable. Majority means more than half. If you read the article, you’d perhaps understand why I’m saying that. Scientific analysis of the data says that over half of scientific studies are not replicable. I suppose that study could be wrong as well. But that’s why I read them, so I can make up my own mind. I wouldn’t believe the article unless I read and analyzed it myself. Which is the real point here.
Nah, they give you stimulants for “Binge Eating Disorder” to supppress your appetite. But if you eat TOO little, they’ll pull out the Zyprexa. Of course, there is the option of giving someone Zyprexa until they balloon up, then diagnose them with “Binge Eating Disorder” and give them stimulants as well.
Again, I did not say that scientific data is not replicable – you are putting words in my mouth. You either did not read the article, or did not get the main points it makes. The point is that TRUE scientific data IS replicable. But data that is NOT replicable is, BY DEFINITION, not scientifically true. Just because one study shows that X drug has Y effect, that doesn’t make it scientifically factual. Other studies would have to be done testing this hypothesis, and actually working hard to look for other explanations (like the placebo effect, selection bias, statistical manipulations, etc.) to undermine the result that the original researchers may WANT to be true. Only when a theory can withstand the rigors of repeated testing with intent to DISPROVE it or provide an alternate explanation, and yet continue provide the same result, is it regarded to be scientifically “true,” and then only as long as conflicting data don’t come in to create more questions. Unfortunately, this re-testing seldom happens today, largely because it is rarely funded. And even when it does occur, such retesting results are rarely published. This is especially true when these studies clash with the preliminary results that have been shared worldwide as if they were a new and amazing breakthrough rather than just a promising lead, or when some person or corporation stands to reel in healthy profits from the preferred “truth” reported in the initial study.
So the point of the article is not that scientific studies can’t be replicated. It’s that people often have preexisting biases that make them WANT a certain result, and that they regard studies that don’t provide that result as “failure” and therefore unworthy of pubication, or in need of overt suppression. It is also a problem that many “positive” studies are only positive because of intentional design changes (like “placebo washouts” or not counting dropouts as failures or changing the primary outcome measure when a secondary measure gives you the answer you want) or sometimes outright dishonesty in reporting the data. THOSE are the studies that are not replicable, the biased studies that DON’T follow true scientific method, and they are not replicable because their underlying hypothesis IS NOT TRUE, and for no other reason.
So those area my views on the finer points of the scientific method, and I ask that you respect what I am saying as what I really mean and not try to “interpret” some other meaning that is not contained in these words.
Suffice it to say, I think we’ve had our talk, and it’s starting to deteriorate into a more negative exchange. I think we should leave it at this point, and agree to disagree. It seems unlikely that further discussion will be productive.
Well, you were very fortunate. Bullying was common in the schools I attended. There were plenty of good teachers, but also some totally crazy ones. My second grade teacher was screaming and yelling at us one day and tossed a book over our heads against the back wall of the classroom. When I stood up to object (and I NEVER talked back or did ANYTHING to get in trouble, but this was just too much even for me), she came down the aisle and smacked me in the back of the head and took me and another kid who was crying and tossed us out in the hallway. I never even told my mom, it was so NOT surprising that such things happened. A friend of mine was shoved down onto the gravel track by Miss Cooper at the end of recess in front of 100 kids and some staff. Yelling at kids and forcing them to stand at attention for a half hour, flicking them in the head with fingers – all of these were totally normal and accepted by the school staff.
I think it is pretty biased to say that homeschooling automatically deprives kids of anything. It obviously depends on how it is done.
Wow, you REALLY need to stop projecting your assumptions onto me, dude! I AM a scientist (chemist) by training and I would be DEAD at the age of 8 from a ruptured appendix and peritonitis without modern medicine. I am ABSOLUTELY a full supporter of modern medical science, and I fully understand what good and bad research looks like. Where we appear to disagree is that you believe psychiatrists are scientists. I think there is massive SCIENTIFIC evidence that the vast majority are not, and that the entire edifice of psychiatry is built on a foundation of sand and wishes. This does extend to medicine as a whole to some extent, but psychiatry is entirely based on unscientific or antiscientific premises. Look into how those DSM categories are determined, and if you have any degree of intellectual honesty, you will agree with me.
And in case you think my skepticism re: modern medical research is misplaced or based on emotion, try reading the following, which outlines why the majority of scientific research done today is not replicable, which from a REAL scientific perspective, means it is scientifically untrue:
Again, I am NOT saying that the drugs prescribed for “psychiatric conditions” can’t be perceived as helpful by those taking them, even life-saving by some. But you and I both know that anecdotes don’t make science, and there is a lot of good science out there that is buried because monied interests don’t want it to come to light. This is covered in the article. Please read it before you come back and try to imply that I am antiscientific again.
Yeah, I would have felt the same way! I’d have been SOOOO happy to be at home and able to pursue what made sense to me instead of being bossed around by bullies and teacher/bullies and forced to be together with people I didn’t choose doing activities I had mostly no interest in at all. Homeschooling must be a Godsend for a good percentage of kids, at least the ones who don’t need to escape from their parents/siblings.
Although the vast majority of “the right” also supports psychiatry, if often for different reasons. There are few of any political stripe willing to really challenge the psychiatric status quo or the drug companies who line our politicians’ pockets in a very non-partisan manner.
Maybe they should just get the drug companies to buy them coats, and they can wear the “colors” of their sponsors, kind of like race car drivers. “And now, in the southeast corner, in the bright red coat, representing Eli Lilly, Dr. JO-seph… LIEEEEBERMAAAAAN!”
Given the widespread agreement amongst professionals and informed laypeople that “scientific” studies are massively affected by economic and professional conflicts of interest, I’d rather trust my own ability to judge amongst the many stories that told, both by journalists and by professionals, and by those who have experienced the effects of the drugs directly. If we start with the rather obvious and undeniable facts that these drugs cause huge weight gain, diabetes, and heart problems, and knowing that any number of studies have shown extremely shortened lifespans in those diagnosed with “serious mental illnesses” since the pre-drug era, and actually KNOWING people who have died early directly as a result of taking these drugs, the prospect that they shorten lives seems by far the more believable story. Scientists who are schooled in analysis and methodology are also those most capable of abusing their abilities, and recent history is replete with examples of their having done so (Bidedermann’s “juvenile bipolar disorder,” the Viiox scandal, the lies about antidepressants and suicide, the lies about Benzedrine, then Valium, then Xanax being “non-habit forming,” the denial that Tardive Dyskinesia is caused by neruoleptic drugs – shall I go on?) So someone being a scientist does not convince me of their superior reasoning ability OR superior ethics. Maybe that’s where you and I differ here. You trust psychiatrists to be legitimate scientists. I don’t. You believe you have very good reasons for trusting them. And I have very good reasons for not doing so.
Fair enough, but still there is no actual way yet established to measure that difference, let alone studies that have actually done so. How many become suicidal coming off their “meds” and becoming psychotic? How many become suicidal going ONTO antipsychotics? How many because sucidal because they are WITHDRAWING FROM antipsychotics? How many would never have been suicidal in the first place if they’d taken another path? These are things we do not know the answers to, so claiming that “lives are saved” when we also know that lives are lost is very, very premature at this point. We don’t know the cost/benefit analysis and will never really find out what it is when so-called “scientists” are dishonest and manipulate data to serve their own interests instead of the interests of the public.
Nothing is more stunningly idiotic in recent years than the idea of giving stimulants for “Binge Eating Disorder.” The disorder itself is laughable, clearly invented solely to sell more drugs (not saying that people don’t binge eat, but the “disorder” is defined in the usual superficial, blameful manner). But to “treat” it with stimulants is ridiculous. As if the problem is appetite. And of course, there is no effort to actually look at WHY the person may be eating in this way, only an attempt to bludgeon the body into submission. I find stomach stapling more rational.
I would submit that the moment when we are “two people talking” is when real therapy can take place. As for “countertransference,” it is totally and completely normal for therapist and client to form a bond, and for them each to have feelings about the other. The difference SHOULD be that the therapist uses his/her feelings in the service of therapy, and does not take advantage of the client’s vulnerability in even the slightest way. I often found it helpful to share my feelings of the moment with the client when it seemed likely to increase trust or open up a new perspective. After all, they’re sharing their feelings with me, shouldn’t they get to know that they are having an impact, that I’m not a block of wood trained to say, “Go on” every three sentences? People want to talk to another PERSON, a REAL PERSON who interacts with them in a meaningful way. Nobody wants to talk to a “blank slate.”
That’s my experience, anyway, but I was not a DSM-trained standard therapist. I pretty much made it up as I went along, depending on the client. Kind of Milton Ericson style. I’d probably be fired in a second from most places nowadays.
It sounds like you agree that antipsychotics do play a role in shortening lifespan, but that poverty’s role is greater. This is possible but certainly we don’t have data to prove or disprove this hypothesis. But saying “studies show you live longer if you stay on your medication” is a misstatement of fact, and actually contradicts your earlier statements that antipsychotics do, in fact, contribute to the undeniably shortened lifespans that have been reported. The truth is, there are studies claiming one and the other, and the question as to why lifespans for the so-called “SMI” and the role that antipsychotics play is at this point is very complex and can not definitively be answered as you claim.
The point of this article is that the claims that people live longer on “APs” put forward in THIS set of studies are based on manipulation of data. I think you should be able to admit that there is a major conflict of interest when people who make their money selling drugs and drug prescriptions do such research, and that intentional manipulation of data has been shown to be extremely common in all branches of medicine. The studies in question clearly don’t prove anything, especially given the basis of “person-years” on medication, which even a layperson can see is a pretty poor substitute for the actual lifspans of actual human beings who are on/off antipsychotic drugs.
I think there is a big difference between saying, “Corporal punishment won’t destroy kids’ psyches in and of itself” and “It’s really no problem for parents to use corporal punishment.” It’s one of those things where the truth sometimes hurts, and it feels like a criticism of the person who has used spanking, but it’s still the truth. I think it’s fine to say, “You don’t have to worry that you’ve destroyed your kids’ lives just because you spanked them now and then,” and certainly removing kids to foster care for spanking is massive overkill (given the incredible damage done by the very act of foster care placement), but I think it is important to be honest and say that spanking has been shown to be ineffective and potentially damaging, and that there are more child-friendly ways that work better in accomplishing the same goals.
What continues to baffle me is why psychiatric practitioners continue to see things such as “catatonic mutism” as some kind of “treatment success.” What does “failure” look like to them? Is it any wonder so many people won’t “remain compliant” to their insensitive and destructive label and drug based paradigm?
Poverty is, of course, a factor in the lifespan differential. But even between the most rich and the most poor, the differential does not even begin to approach 20 years.
“More precisely, the study shows that in the U.S., the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.”
Why is it difficult to believe that drugs which cause obesity, diabetes, and heart disease would be responsible for shortening the lifespan of those who take them? I should think it would be almost impossible to believe they would NOT shorten lifespans, as heart disease and diabetes are very high on the list of killing diseases in the USA and around the world. I find it difficult to take anyone seriously who doesn’t see the almost certain impact of these drugs on lifespan.
Of course, we should also be asking why our “mental health” system is leaving the huge majority of its “seriously mentally ill” in lifetime poverty. Does that not convey a responsibility for decreasing lifespans, when our “treatment” fails to take into account the quality of life of those being “helped?”
To say that one is “misdiagnosed” implies that there is some way to make a “correct” diagnosis. To me, all psychiatric “diagnoses” are “misdiagnoses” because they claim an understanding of whatever problem(s) are going on when they don’t actually have one.
Well, of course. I was responding with the idea of “psychiatry” as “carers for the spirit,” psychiatry as it COULD be if they started off by actually believing that such a thing as a human spirit exists.
Psychiatry is worse than nonsense, or it would already be interested in all the above things I mentioned. The “ADHD” example alone proves that they will bury useful evidence that would reduce the number of diagnosed/drugged kids and promote things that will sell more stimulants. They are a bankrupt profession.
I was not being facetious at all, John. You like to write and you write well. Why shouldn’t you write a book? I really think you should consider it. You have a lot to say that needs to be heard.
For example, looking at indigenous healing practices and indigenous cultures and seeing what they do for “mental health problems.”
-Looking into why people diagnosed who hear voices have more positive content in countries where culture supports voice healing as a normative experience, and exploring how altering our cultural attitude toward voices might help those suffering right now.
– Looking at different classroom settings and observing that “ADHD”-diagnosed children do so much better in “open classrooms” than those who are in standard classrooms that they are indistinguishable from “normal” children, and then advocating for revisions in classroom settings instead of drugging the kids who don’t “fit in.”
– Looking at why it is that certain cultures have almost ZERO incidence of “postpartum depression” while in our culture, it is almost epidemic. Helping move our culture in a direction that emulates those who support new moms in a way that they don’t suffer, based on the evidence of the absence of this suffering in their culture.
– Studying the interesting phenomenon whereby immigrants develop Western maladies, both “mental” and “physical,” by three generations living in a Western culture. See what it is about Western culture that makes them ill and see if we can stop it.
– Look at the impact of racism on group experience in terms of emotional experience and behavior.
– Examine the connection of job satisfaction/”stuckness” to other life indicators, such as mood, marriage success, etc.
The list is endless. These are things that could be studied using social science methods and might lead to improvements in our social welfare. None of them require labeling anyone as “ill” or “bad” for diverging from what the society considers “normal.” In fact, a real “doctor of the spirit” would dbe working to redefine “normal” toward what works for people instead of what works for the institutions of society. Psychiatry appears to be doing the opposite. If you don’t “fit in,” you’re abnormal and need to be “fixed.” Those who don’t create any problems for the status quo are “normal” and don’t need fixing. “Fixed” is defined as being happy with the status quo (but not TOO happy – then you’d be manic!) It is not working in the interests of improving people’s lives, unless you count the people who are making big bucks out of the enterprise. Sure, there are a number of people who feel better taking their drugs. But people also feel better smoking dope or drinking beer every day. Drinking beer to feel better can be helpful for some, but it’s not a medical treatment.
So there’s lots to do, but drugging people unhappy with their lives is not particularly productive, IMHO. Especially if you label them as “abnormal” for feeling, thinking or behaving the way they do.
Once we allow for subjective “diagnosis” based on observer opinions, there is no end to who and what may get “diagnosed.” I think that’s the clear and obvious conclusion from this observation – when there is no objectively definable line of “normal,” sooner or later, everyone is diagnosable. Which, as you say, makes “abnormal” the new normal!
There are a couple of things you say that I have to take issue with. First, there is plenty of evidence of significant brain changes due to trauma. This was the primary finding of the “Decade of the Brain” research, which was actually quite different than what was anticipated. More importantly, and less well known, are the findings that the brain can continue to change in a POSITIVE direction when a traumatized person is supported by a healthy adult caretaker or support system. Dr. Bruce Perry is one of the best resources for this. Easy internet searches for these items. Here is one just to get you started: https://www.psychologytoday.com/us/blog/the-mindful-self-express/201809/how-ptsd-and-trauma-affect-your-brain-functioning
You also seem to conflate “cognitive disability” with “mental illness.” You suggest that most of those severely affected by the syndrome called “schizophrenia” are affected by brain damage. I know of no evidence that this would be true in most cases – there has been a long, intense and frankly biased search for brain damage associations with “schizophrenia” and many other “mental disorders” with little to no results. There is evidence of brain matter loss in people diagnosed with “schizophrenia” over the long term, but Nancy Andreasen’s own research, which she really didn’t WANT to believe at first, showed that antipsychotic drugs cause loss of brain matter when used over the long term, so such studies are meaningless unless controlling for AP use, which is almost never done.
Finally, you also assume that the “schizophrenia syndrome” is due to different types of “brain malfunction.” As I’m sure you are aware, science proceeds from hypothesis to proof, and it doesn’t work to assume the conclusion that brain malfunction is the cause when that has not been shown to be the case. And your suggestion that the fact that certain drugs “work” to decrease these loosely defined groups of “symptoms” proves an underlying disorder is similarly flawed. Under that reasoning, alcohol must be addressing an underlying “brain malfunction” because anxious people feel better when they get mildly intoxicated. Correlation can’t be used to diagnose anything.
I very much respect your reframing of “schizophrenia” as a syndrome, something which would really help if we all operated from that assumption. Unfortunately, the current reality in “mental health” research is that these syndromes are being treated as unitary entities for investigation, and that leads to a lot of misleading, trivial and/or meaningless results. I also agree that it is easy to “throw the baby out with the bathwater” if one is too committed to dogma on either side of these questions. I’m a scientist in the end, and at this point, I see no science that really proves that “schizophrenia” is caused by any kind of a brain malfunction, and I am doubtful that continued research will prove any such thing. Partly because, as you say, it is a syndrome, and there may be (probably are) some subgroups that DO have biological causation, but these will never be discovered as long as research is done on “schizophrenia” with the assumption that all cases have the same cause and that this cause is necessarily biological in nature. It is clear from research that trauma has a very high correlation with the syndrome in question, as does urbanization and migration to a foreign culture. It’s also very clear that the manifestations of this “disorder” vary widely depending on the culture in which they occur and how the culture in question responds to such issues. It is, as you suggest, a much more nuanced picture, and until proven otherwise, I think it makes a lot of sense to assume that both nature AND nurture are involved.
No, I don’t disagree that we can make factual observations about what people believe. My only point is that science can’t determine “what is right” by the scientific method, and it appears we agree on that point. Sorry if my post sounded dismissive – I was kind of in a hurry last night! And I do think qualitative research is a valid means of studying ethics, though it gets more into sociology/anthropology and is a far distance from medicine. I guess that’s what I’m really getting at here – we can study history and use scientific means to determine certain things about history, but using those methods to make claims about medical treatment of one’s body would be ludicrous. Medicine can be studied from an anthropological/sociological viewpoint, and it has been (“Medicine and Culture” was a great read, comparing medical practices in France, England, Germany and the USA and demonstrating how much of even non-psychiatric medical decisions are made based on cultural beliefs), but this is not a way to determine what is actually wrong with someone or what kind of treatments are effective. Psychiatry would be FAR better off if it viewed itself as a sociological/anthropological soft science and proceeded accordingly, but there’s a lot less drug company money in such an approach.
I love your last paragraph! I think it gets to the core of why very few within the ranks question the basic assumptions of psychiatry. I was a dissident voice in the “mental health” field and I can tell you, it is not a comfortable position!
I do take issue, though, with your assertion that “there is absolutely no possibility that eventually a psychiatrist could not come to the conclusion that it is all a lie.” There are certainly psychiatrists and other “mental health” workers who have come to this conclusion from observing the fact, though admittedly, it is a small minority by my observation. I would suggest that it is very difficult to work in this field at all after having drawing such a conclusion, and most who do so will be unable to live with themselves if they continue to practice as they have done in the past. So they mostly leave an do private work or find another profession. Very few remain in the public “mental health” system once they see what it is actually doing, and those that do, I admire for their courage.
It is pretty common for people recovering from a traumatic experience to want to help others do the same. I’d say you’re on the right track in contacting people who have experienced similar things. I wouldn’t waste a lot of time on the “true believers” who can’t consider anything but their own rigid beliefs for fear of their world collapsing, but there are plenty of people who are “on the fence” or who haven’t been helped as promised or who have deteriorated in “psychiatric care” who need people like you to help them out. It’s just a matter of connecting with such people, which isn’t always easy. I also think it’s very important to stay connected with others who agree with your view of things so you don’t start feeling like you’re the “only one.” MIA is really good for that.
I hope someone who has been exactly where you are can chime in and share how they managed to move forward after this kind of trauma.
Ethics is a branch of philosophy. Philosophy is senior to science. Science depends upon a certain philosophy of what is true vs. not true. Ethics has to do with what is GOOD or NOT GOOD. Science can’t answer those questions, except in a mechanical way of measuring X outcome when ethic Y is agreed upon by a society. The decision of what is good or bad is both an individual and a social one and is not really subject to scientific analysis, as it does not provide measurable inputs or outcomes.
Read Zen and the Art of Motorcycle Maintenance for an incredible exploration of this very subject. It is one of my favorite books of all time.
Consensus is completely unrelated to scientific truth. Scientific truth requires proof, usually in the form of vigorous efforts to DISPROVE a particular hypothesis repeatedly failing. The fact that “scientists agree” to something does not make it true or untrue – opinion is not science. And while “beyond a reasonable doubt” certainty is not always attainable, it should be the goal. Instead, what we see is so-called ‘scientists’ collecting evidence to support their own views and hiding things that would cause doubt. That is not science. That is marketing.
Well, sure, it comes from trees that grow in the wild, so of course, it’s “all natural” and organic and no GMOs and all that stuff, too! Zero carbs, cruelty-free, fat-free, gluten-free, etc. MUST be good for you!
Doctors can prescribe drugs for any indication. It is not a requirement that they have a DSM “diagnosis.” Lots of people get antipsychotic drugs prescribed with no DSM “diagnosis” at all. They prescribe them for sleep problems, for “behavioral disorders,” to “augment antidepressants,” etc.
Besides which, billing codes are not the same as actual medical diagnoses. If they need to invent a billing code, let them invent a billing code, but let’s not get confused and pretend that a billing code means anything more than that you get paid by the insurance company. The original DSM was, in fact, invented so they could bill insurance companies for “therapy.” The idea that these codes represented actual disease states is quite a distortion of their original purpose, and is utterly unscientific, as there is little to no evidence to suggest that any of these arbitrary groupings by symptom create groups who actually have anything physiologically relevant in common. It would be like billing for “stomach pain.” Sure, you can bill the insurance company for that, but is it indigestion? An ulcer? A gall stone? An intestinal blockage? Appendicitis? Bowel cancer? Each of the things I listed could cause “stomach pain.” So doctors neither diagnose nor treat “stomach pain,” not if they are in any way competent. They’d look for the CAUSE of the stomach pain and treat THAT.” Psychiatry as a profession makes no effort to differentiate between depression due to a loss vs. depression due to a bad boss vs. depression due to insomnia vs. depression due to a low thyroid condition vs. depression due to a long struggle in a dead-end, meaningless job vs. depression due to my husband beating me randomly and controlling everything I do and trying to drive me nuts on purpose. So saying someone “has depression” is pretty close to meaningless.
I believe the same is true for “schizophrenia.” Many people in the psychiatric field even agree with me on this, and there have been proposals to scrap it as a concept altogether. The fact that professionals in the field disagree as to whether it exists should be reason enough to see that it is not a real scientific concept. Nobody argues about whether cancer or broken legs or syphilis actually exist.
So if you need a “diagnosis” to get the drug that you feel is necessary, by all means, get a “diagnosis.” I just ask that you not confuse this with an actual, scientific analysis of what is happening that is causing this phenomenon, nor even what to do about it. Antipsychotics can diminish hallucinations, and to a lesser degree, delusions, at least temporarily and at least in some people. That’s about all you can say about it. It is not “treating” a known disease, because no one knows what causes “schizophrenia” or if it’s even a “thing” that has a cause, vs. a phenomenon that is associated with many different causes and possible interventions.
And it is an organic solvent and will dissolve fatty tissues, so it’s perfect to attack a fat-based virus like Covid-19! Why didn’t we think of this before?
“Many scientists argue that turpentine, despite significant adverse effect in some cases, has potential benefits that outweigh the risks. Most users of turpentine find the adverse effects diminish over time, often quite suddenly (death generally ends all such complaints). But all drugs have side effects. It is certainly worth further study. “
I’ve seen kids put on a diet and told they need to exercise more as a response to “antipsychotic” weight gain. Of course, they almost never told the kids there was any relationship with the drugs. I saw one girl’s diabetes disappear within a week or two of discontinuing Seroquel. Crickets from the psychiatrists, of course. I saw one kind graduate from a year-plus long eating disorder program, only to be put on Adderall for “ADHD”. Strangely enough, she stopped eating again. If my CASA volunteer hadn’t intervened, no one would have noticed that the “treatment” for “ADHD” was eliminating her appetite, and would have said her “eating disorder” is “coming out of remission.”
Not much real medicine being practiced by psychiatrists, at least for the kids in the foster care system.
I would even go so far as to say for some people, figuring out how to know what they want is the core job of therapy! So of course, such people won’t be certain what they want to start with, and a good therapist would know this. Sadly, there aren’t very many therapists out there whom I’d describe as good.
Exactly. It is abuse, yet if you have the nerve to call it out, then you are “treatment resistant.” There is no way to win that game except not to play.
And it is totally “Caveat empor” (buyer beware) when it comes to counseling. If you don’t already know what you want, you get pot luck, and pot luck usually isn’t very lucky.
This is a great point, too. I was a “dissident mental health professional” in my day. It was obvious how quickly marginalized I would become if I just came right out and said “I don’t believe in all this DSM/drugging nonsense.” I had to learn to couch it all in proper “scientific language” and refer to studies and make it all into a big academic discussion. And mostly keep what I did in my own sessions pretty quiet. There is a lot of force brought onto any professional who won’t toe the party line, or at least that was my experience.
It is not always possible for people to choose to walk away from psychiatry – many are forced either by forced treatment orders, threats of hospitalization, threats of loss of children, decisions made by parents or relatives of people in nursing homes, and on and on. Additionally, the propaganda that has been spread regarding these DSM “diagnoses” has had other destructive effects, to the point that people are so confused they don’t even know they have another option.
I had a caller on the crisis line I worked for one time who had been trying antidepressants for over a year with no success. She was frantic and thought that she’d never get any kind of relief and was condemned for life to suffer this kind of emotional distress. Then I asked her, “Did you know there are other things you can do besides drugs?” She was suddenly calm and said, “No.” I said, “Well, there are.” And she said, “Oh. Well. That’s good!” She had been asking for help for over a year and had NO IDEA there was any other option besides drugs. Nobody had even discussed that with her. THAT is what is wrong with the system. If people want to take a drug because it makes them feel better, I’m totally OK with that. I am opposed to a system that lies to people and pretend to know things they don’t know. I’m opposed to a system that profits from hurting people. Yes, people do have a level of responsibility for their own decisions, but the issue with psychiatry extends far, far beyond individual choices to participate or not.
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I don’t disagree with your analysis. I just don’t see the path forward. Perhaps I’m just more cynical about humans changing how they are trained to behave. It does appear that our economic situation is going to be in the toilet for months at least, maybe longer, so people’s tolerance of the “status quo” may indeed reach a breaking point. It is also true that the need for socialist-oriented interventions has never been clearer. But I’ve already heard people in positions of power saying in effect that socialism is OK in a crisis but not for day to day living.
Nor that it is back “in whack” when they are “properly administered.” No one knows what a “proper chemical balance” looks like, because it varies massively from minute to minute all day long.
I think you are assuming a context for my comments that was not in evidence. I’m not talking about political revolution, I’m talking about whether or not someone should use his/her “professional expertise” to decide if a particular president is doing his/her job. The efforts to “diagnose” Trump do, in fact, contribute to the idea that if somehow he were removed, things would be “back to normal.” Aside from the very relevant question of whether “back to normal” is a legitimate or sane goal, focusing on Trump as the problem avoids the more salient question of how our system created a situation where such a person could even be considered as our “elected leader.” I think your analysis is a lot more relevant when we get to that more nuanced point, but it is certainly obvious that our populace is so far away from even asking that question that, in order to meet people where they are at, we have to answer less overarching questions and start with ones like, “Who gives these people the right to decide whether a particular president is fit too serve?” My bet would be that the majority of people would have a great deal of difficulty coming up with a rational answer to THAT question, let alone have the capacity to even think about the larger issue of what to do about a system that produces “column A/column B” type choices where both options lead to continued deterioration in the average person’s ability to survive with some measure of dignity.
It is a means of establishing facts. It doesn’t deal with ethics. Ever read Zen and the Art of Motorcycle Maintenance? It totally handles that exact question with eclat!
Fancy way of saying, “We know they don’t mean anything at all.” Kind of like when they say, “The effects of X are not fully understood,” which really means, “We have not the slightest idea what it does.”
I think “Microaggression” is meant to refer to acts which are not obvious to a person who is not receiving them, but are significant and harmful to the person who does. For example, saying to a person who is in a violent relationship, “Why don’t you just leave?” might not seem like a big deal, but it comes across to the recipient as something like, “If you were any good as a human being, you would have left by now.” The person saying it might not even intend it as harmful, but it is invalidating and distressing for the person on the receiving end.
So I think “microaggression” is a pretty legitimate term that I find useful. Others are free to disagree.
I don’t disagree with your last statement entirely. The problem is that psychiatry has coopted such definitions of “illness” and tried to intentionally warp them into the realm of physiological disease states, with little to no scientific evidence that this framing is in any way legitimate.
I don’t dispute that social sciences can be approached in a scientific manner, but I don’t see much point in trying to define a “personality disorder” as some kind of entity that can be identified, because scientifically speaking, it isn’t really possible to do that. We could theoretically choose a particular kind of behavior, like selfishness, and attempt to measure aspects of this behavior in a reliable fashion. But there is absolutely no reason to assume that the constellation of behavior that psychiatric leaders have agreed upon by committee consensus have any kind of legitimate standing as a viable object for study. A study group needs to have sufficient homogeneousness in a particular aspect in order to yield any relevant data. I’d argue that “personality disorders” do, in fact, describe behavior that people find annoying and clumps them together in a somewhat random fashion. I’ll note, for instance, that selfishness is an aspect of “narcissistic,” “Borderline,” and “sociopathic” personality disorders at a minimum. The overlap between these pseudo-entities is so great that they are essentially useless for any kind of social science research.
Hence, it really is no different than calling someone a “jerk” in my mind. And btw, I do define “jerk” in my book, but I would make no claim (and in fact, I clearly state the contrary) that there are “jerks” and “non-jerks” that can be clearly distinguished from each other. It is a spectrum of behavior which, at one end, people find offensive and unacceptable. That this distaste is related to social evolution seems likely, yet the idea that such disapproval of behavioral traits can be considered a scientific definition is belied by the wide range of what is considered acceptable behavior depending on the culture one grows up in. We are most definitely in the area of sociology and anthropology rather than psychology at this point, and certainly a long, long way from the pretense of medical precision that the psychiatric community would like us to adopt.
I am trying to distinguish between scientific answers, which need to be proven beyond reasonable doubt with actual facts, and social answers, which are massively influenced by culture and social conditions in ways that transcend scientific analysis. For instance, I wrote a book called “Jerk Radar” that characterizes certain behavior as “Jerky,” and even ends with a quasi-mathematical “quiz” to see how your date measures up to the principles introduced in the text. These principles are not in the least scientific – they are based first off on certain social agreements on morality, such as that it’s not OK to promise you love someone and want to marry them when all you really want to do is get them to sleep with you. There is no scientific reason that a person should not do that – in fact, from a pure “evolutionary” (scientific) standpoint, one might say that the man (in most cases) is ensuring that his seed will be spread more widely and thus increasing his chances of his DNA’s survival to the next generation. But from a social/moral standpoint, this kind of behavior is condemned as dishonest, manipulative, and self-serving. There is no scientific test for selfishness or dishonesty – it is entirely a social judgment. It is not possible to objectively measure who is and is not a “jerk,” though it is possible to define a certain behavioral spectrum and to look for behavior that tends toward one end of that spectrum as something to avoid. But what you or I or a different person would view as “jerky” behavior is totally a matter of our personal opinions, values, and priorities. It’s not scientific.
By contrast, someone who has cancer has a very specific growth that can be identified on an x-ray or MRI, can be biopsied to test the cells for certain tendencies, can be viewed under a microscope, etc. This is science, this is medicine – the identification and treatment of observable conditions of the body. There is no moral argument about cancer – you have it or you don’t. Yes, there are boundary conditions, pre-cancerous cells, but there are still observable conditions being discussed.
As far as Trump is concerned, there is nothing in his behavior that suggests he is “ill” in the sense of having a physiological problem that could be observed, diagnosed or treated. The definition of “personality disorders,” as Lieberman himself proclaims in the article, is vague and subjective and “lacks validity,” meaning that it has no concrete meaning or value as a scientific/medical concept. It is a list of behaviors that most people don’t like very much. To say someone “has a personality disorder” is about as meaningful as saying, “He’s rude” or “He’s got a temper” or “I don’t like his attitude” or “He’s such a jerk!” It puts a pseudoscientific sound on something that is very much a moral judgment, and in this case, there really is no overlap with medical conditions at all. Unless you can show me how to distinguish “personality disordered” people from the “normal” population by some reliable, objective means, it remains a moral judgment, and in essence, a slam or put down in most cases.
I want to be clear I am not arguing against making moral judgments – I hope it is clear from my comments that I do believe in people being held to minimum moral/ethical standards by their social group, and that there ought to be significant consequences for failing to fulfill one’s social agreements, including possibly removal from one’s job. This applies even more to a President than other people, because the sweep of his responsibilities is so large. But those judgments have NOTHING to do with medicine, unless a doctor is able to come in and say, “Yes, he has a brain tumor,” or “Yes, his heart attack has left him unable to engage in the stressful duties of being President, and resuming his office will probably lead to his death,” the medical profession has no business poking their noses in and pretending to be able to evaluate his “fitness for office” based on some vague and subjective label that they are applying to a person they have not even met. It gives a veneer of ‘scientific authority’ while lacking any of the necessary conditions for any kind of scientific conclusion to be drawn.
Wow, Brett, I missed that point entirely! This should be copied and reprinted over and over and brought before judges and legislators all over the world. I find it a bit awkward to be in agreement with Lieberman, but I guess it goes to prove that these guys are pretty much all aware of the lack of scientific credibility in their “treatment model,” but chose to “forget” these inconvenient facts as long as they are being sufficiently reimbursed for their troubles.
Or apparently even those they HAVE met, as their odds of getting it right are apparently worse than the odds of the 10-day weather forecast in the Pacific Northwest in March being correct.
Are you suggesting that psychiatry may be caused by a genetic anomaly? Perhaps one that blunts one’s sense of empathy or leads to an unremitting need to control other people’s lives?
Finding “schizophrenia” in the genome is such a joke at this point. They have to go to lists of hundreds of “markers” to get even 1-2% correlations, when the correlations between what they call “schizophrenia” and environmental stress are in the 80+% range consistently. It is such an obviously self-serving process that assumes the conclusion before doing the work, it is laughable to even consider it in the realm of science. It is more of a religious faith, and as we all know, you can’t use logic to counter religious faith. They operate on completely different rules. Which would’t bother me quite as much if they weren’t pretending to be scientists!
Exactly! That’s why I don’t use “stigma” and just call it “discrimination.” Stigma refers more to an internalized oppression – I feel bad because other people don’t accept me. Discrimination puts the responsibility where it belongs – on the person mistreating you based on their perception of your “otherness.”
You provide an excellent example of a SOCIAL label. I have no problem with social labels as a shorthand way of referring to a set of characteristics, as long as one understands that it’s shorthand and doesn’t come close to fully describing the person behind the behaviors. Trying to take a SOCIAL label and turn it into a MEDICAL label is not something I support, and it is especially pernicious when the pseudo-medical label is used to “other” the person involved and enforce a worldview and possibly a “treatment plan” on him/her. I have no problem someone saying, “My ex was such a narcissist!” I have a big problem with a professional saying, “Your ex has ‘narcissistic personality disorder,’ and his bad behavior is the result of a malfunctioning brain.”
I certainly agree that at some point in any process, a person wanting to be effective has to take a moment to ask what part of this s/he controls. Otherwise, we can waste a lot of time banging our heads against big walls rather than looking for doors or digging tunnels or climbing trees or perhaps choosing another direction to travel. In particular, we can’t directly control how other people choose to view us, and I have spent decades learning slowly how to let go of that urge. But again, to have this kind of discussion presupposes a level of trust that isn’t always present. I also get the idea that saying to “focus on what you control” out of context can very much come across as, “Don’t worry about those people with the rifles over there. You can’t decide whether they shoot you or not, so let’s look for something positive in the situation.” True, there isn’t much we can do about “the people with the rifles over there,” but it is essential to acknowledge their presence and the effect they are having on us before moving to “focusing on what we can control.”
I hope that makes sense. I most definitely ask that question frequently when I’m working with someone, but certainly not to start out with and always with a sensitivity to when the client/friend/person I’m helping is in a place where that question can be taken on board without feeling shamed or invalidated in their fears or frustrations.
I think that is a very fair point. I’d like to pass the “McCrea Rule” that says they can’t diagnose anyone, but not sure that will get too far. The whole discussion seems rooted in the idea that they have this capacity to “diagnose,” which of course I don’t support, but at least if they have to see the person first, they will be limited to applying their social biases to those whom they have at least spoken to.
Ron, I think the objection here may be more to the idea that if you “focus on what you can control,” you will somehow magically feel better and solve whatever problems beset you. Naturally, focusing on what you can control does help a person feel more able to make decisions instead of feeling stuck, but just as naturally, advice to “focus on what you can control” when one of the things you CAN’T control is eating or having a place to live or dealing with an abusive partner can come off as just a TAD insensitive. I think it has a lot to do with the relationship between the parties and the timing of such a question. If you haven’t take the time to really understand and empathize with the difficulties of the situation to the satisfaction of the other person involved, suggesting to “stay positive” or “focus on what you can control” is going to come across as condescending or pollyanna-ish, as it feels more like a brushoff than an attempt to understand and be supportive.
I like your analysis. I had not seen those last few stories from his childhood, but they don’t surprise me. The best predictor of future behavior is past behavior. Most people don’t change unless they are forced to by external circumstances. Someone born with a silver spoon in his mouth has very little external motivation to change anything. If Donald solved problems as a kid by throwing rocks or hitting kids with a bat or pushing people out of windows, there is no reason to think he’d be much different today, other than finding different means to bully people whom he finds threatening.
I appreciate both your viewpoint and the civil tone of the discussion. I think the challenge that professionals (and I qualify as one) face here is that concern for safety of the nation can be very legitimate without invoking any kind of “mental illness” as a causal factor. There are plenty of people who are willing to kill other people who have no “mental illness” at all, even by DSM standards. They just think killing people is a good way to solve certain problems. They may even have their own internal “ethics” of when it is and isn’t OK to kill. In some cultures, it may even be required to kill someone if one’s honor is sufficiently undermined.
It is in my view utterly impossible to disentangle “personality disorders” from problems of ethics, morality, and social values. Until and unless there is an objective way to “diagnose” someone with a verifiable “mental illness,” we’re building castles in the air. I’d rather go back to philosophy and ethics to handle this kind of situation. Bringing in “mental illnesses” just adds confusion and controversy.
I guess we’ll have to disagree on this point. Saying he is a “malignant narcissist” or combines “traits of three or more personality disorders” is to me simply a rarified way of saying he lacks ethics and empathy and is willing to hurt others to get what he wants. I’d rather call him “A person who lacks ethics and empathy and is willing to hurt others to get what he wants.” It describes him in more precise terms that are understood by most laymen and doesn’t assume any special knowledge due to my advanced degree (yes, I do have one) or my position in society. I’m actually more comfortable with “evil” than “malignant narcissist.” For one thing, the latter seems to imply that he is suffering from some sort of “health problem” when what he is really suffering from is a moral/ethical problem. There is no evidence that can identify a “personality disorder” besides a set of descriptions. Why not just be honest and give the descriptions instead of pretending we’re dealing with a medical problem? It doesn’t require any special knowledge to observe and conclude his lack of integrity. It only requires an honest and sufficiently mature person observing his dishonesty and corrupt behavior.
One of the major confusions introduced into our society by the DSM III and psychiatry’s marketing of the “chemical imbalance” concept is a confusion regarding what are medical issues vs. what are social/ethical issues. There is no scientific way to determine if someone is maintaining their oath, is dealing honestly with those whom he encounters, is playing by the rules, or any of the things that come into assessing a “personality disorder.” All these things are matters of opinion and of social expectation. The likelihood is that he is NOT suffering from any “disorder,” he is simply acting out HIS morality in a world where the majority find that morality unacceptable. Again, this is a matter for social judgment, not quasi-medical analysis or treatment.
The problem I have with your commentary here is that “malignant narcissist” isn’t an objective medical decision, but a moral/philosophical one. I think rather than “diagnosing” Trump, what is needed is a coordinated effort to honestly evaluate his behavior in terms of whether he’s doing his job and adhering to his oath of office. It is more akin to a boss firing his/her subordinate than a psych evaluation. People are hired and fired every day without the assistance of the psychiatric profession. We have a means for removing incompetent or corrupt presidents from office. The unfortunate reality is that at this point, those responsible for making that decision are too corrupt to execute their duties of office as well. But corruption and meanness are not “mental disorders.” They are corruption and meanness. If Congress doesn’t act to remove him, the voters have a responsibility to do so. If they do not, well, as they say, people get the government they deserve.
I’m not sure anyone is arguing in favor of the APA setting standards for anyone. I certainly am not. And I also agree that the APA should not be weighing in on such things, nor do I think the media should be giving it any kind of weight in their coverage. But these are the times we live in.
I wish I could argue with anything you said here. The system COULD work if Congress had the interests of their constituents as their primary objective. But it is clear that they do not.
I think this is an excellent clarification, Bob. It demonstrates how political psychiatry is as well as their lack of coherent philosophical or scientific structure to be able to answer a basic question that is supposed to be central to their own “expertise.”
But I still think the Goldwater Rule makes a lot of sense!
I tend to agree with Kindred here. This is NOT a time for psychiatrists to start weighing in on whether a given President is “sane” or “insane.” We should expect our presidents to follow the rule of law, and remove them when they show they are unable or unwilling to do that. Whether or not a president is fit to continue in office is an assessment that needs to be made by the people working with him/her at the time, and is ultimately a decision Congress needs to make. I think the Goldwater Rule was put in place for a good reason and should remain.
The article also tiptoes around the giant elephant in the lecture hall. The fact that people within the profession can so vehemently disagree in a public forum without any objective way to determine who or what is “right” speaks volumes about the profession itself. That lack of any objective standards alone should preclude them from weighing in on whether or not a president (or anyone else, for that matter) is “sane.” If there is no means to come to an objective answer, it begs the question of why they feel qualified to give a “professional opinion” in the first place.
Any “diagnosis” that boasts a 75% “false positive” rate is worse than a waste of paper – it’s overtly destructive. Besides which, what does psychiatry have to offer for these “psychotic risk” patients BESIDES drugs? Is there some intervention they are touting that will lead to fewer of these people developing more serious “symptoms” and hence reduce the total number ultimately smacked with the “schizophrenia” or “bipolar” diagnoses? Or, and I think this FAR more likely, will this simply bring people to the attention of the system whose only tool is a hammer, leading such people to become another set of “nails” to be hit with psychiatry’s biological sledge hammer? (Not to mention ongoing “customers” to help pay for their yachts or their kids’ college educations?)
I hear what you’re saying – you were in distress and you found the diagnosis and the drugs very helpful. I don’t want to invalidate that. But I have to disagree that the DSM helped you. The DSM did nothing except provide a billing code so they could charge the insurance company for neuroleptic drugs. The drugs seemed to be very helpful to you and worth whatever side effects you have to tolerate. Reading here, I hope you understand that your experience is not shared by everyone who takes these drugs.
You might want to read some of Joanna Moncrieff’s work. She talks about the drug-centered (instead of disease-centered) approach to drugs. Drugs have effects. Some people find these effects helpful, some do not. There is no need for any “diagnosis” for them to seem helpful. And the diagnosis does not contribute to understanding why these things are happening to you or how to solve whatever problem is going on, or even to predicting which people will find them helpful or harmful. . The drug simply suppresses the manifestations you wanted to have suppressed. And that works for you, and well done. But your one personal experience does not necessarily apply to everyone who is involved. Not to mention that the DSM “diagnoses” a lot of other things besides “schizophrenia” that can be extremely damaging or can justify extremely damaging actions taken against a client, including discrimination and involuntary detention by the police, which understandably is highly traumatic to people who are forced to live through it.
I would strongly suggest you read “Anatomy of an Epidemic” and also do some research into other peoples’ experiences so you can really see both sides of the situation. I’ve seen lots of people who feel like you do. I’ve also seen lots of people who feel their lives were destroyed by psychiatry. I think it would help a whole lot if you can try to understand why so very many people find psychiatry dangerous or unhelpful rather than just dismissing their stories and their observations as misguided without really trying to hear where they’re coming from and why.
It certainly provides the justification for everything they do. And it alters societal perception of distress in ways that are extremely harmful but difficult for the average person to notice.
I think that’s the point here. Some people may find it helpful, some may find it harmful, some may find it does nothing. But the practitioners don’t know what, if anything, is being “treated” nor what “improvement” means. If you don’t know what the problem is, you’re just shooting craps claiming to have a “solution.”
It goes right back to “beating the Devil out of them.” It is assumed you must DO something to people who are suffering, to toss out the “evil entity” that is possessing them. We have changed from “The Devil” to “Your Disorder” but the rest of the game is exactly the same. And as in the past, all kinds of barbaric activities are justifiable to eliminate the “forces of evil” from the patient/victim.
One of the problems I see with the concept of “recovery” is that it is a co-opted term that presumes that “mental illnesses” are real, scientific entities which can be “treated.” The truth is, “depression” and “anxiety” and “psychosis” are just descriptive terms that don’t reflect any known pathology. What this means is that the “solution” may be totally different for each person, even if they have the same “diagnosis.” So when these “disorders” are studied, no “treatment” will be shown to be generally effective, because we’re not “treating” any kind of unified condition or illness. So it is that some people who “have depression” thrive in therapy, others find it useless or damaging. Some people benefit from nutritional approaches, some need thyroid treatment, some just need to get a new job. Some have to escape from violent relationships, some need time to grieve, some need to move away from their parents, some need to learn how to manage their children’s behavior more effectively. Some need more money or healthcare, some are old and their bodies are deteriorating and they need to move on to the next life. ALL of the above people could be classified as having “Major Depressive Disorder!” Do we REALLY expect each and every “depressed” person to respond to the same “treatment,” when I have just listed over a dozen possible causes/approaches that are completely unrelated to each other? Of course, lumping them all together does meet the interests of one particular group: pharmaceutical companies. Because if you only look at “symptoms,” and measure all “treatments” of these issues, pharmaceuticals will have an advantage, since they are focused only on making the symptoms go away rather than detecting fixing anything that’s actually amiss.
So I’d say, don’t wait around for the “mental health” industry to come up with answers. There are too many conflicts of interest involved. I think each of us has to find our own path, except that we ALL need to work together to reduce poverty, racism, sexism, and other social ills, and to challenge the institutions of this society to become more humane and just. Beyond that, I think what “helps” is only going to be determined by the person seeking help, and anyone claiming to be able to “fix” our problems is immediately to be distrusted.
I would add to this that the main reason unprocessed foods are so unavailable or un-affordable to so many of us is that our government has been corrupted by big food industries and that damaging things like high fructose corn syrup, sugar, and highly processed grains are massively subsidized. We now have to pay premium prices to get food that used to be normal fare before food industrialization. I hope we can go beyond saying, “Hey, it’s OK for poor people to eat crappy food if that’s all they can afford” and toward saying, “Hey, why is it that we are subsidizing the production of crappy food at all, and why don’t we create a system so that healthier foods are available and affordable to all of our population?” And that doesn’t even get started on why there is such widespread poverty in what is held to be the richest nation on earth!
Someone should tell a real story about what happened in a psych ward, but pretend that they are describing a stay in prison, and see how outraged people get. I bet prisoners would get more empathy and concern than “the mentally ill” do.
I really do agree that any therapist who is stuck to a particular “school” of therapy is one to steer clear of! It suggests lack of depth and inflexibility, and, dare I say it, immaturity!
I actually think “Science” should be put in quotes, because REAL science uncovers what is known AND what is unknown. “Science” that is manipulated by corporations or other conflicts of interest is NOT science at all. It’s religion or it’s marketing.
I would not call what most psychiatrists do “science.” It’s not common sense, either, of course. It’s largely parroting of pharmaceutical marketing, though I’m sure a lot are deceived into thinking it has something to do with science.
There is no evidence that antidepressants reduce suicide, yet these claims are still made wholesale. As for Prozac, it is the ONLY “antidepressant” that has ANY support for its use in those under 18, and the one study that supports it has been harshly criticized as flawed. But there is NO study suggesting it is “safer.” Where do they get these claims????
The main “outcome measure” used by most “mental health services” these days are whether people “have symptoms” or are “on their meds.” I have rarely seen employment used as an outcome measure by any such agency, in fact, they often seem to discourage efforts of clients to find employment, encouraging them instead to get on disability for life. As for quality of life, it doesn’t even enter into the discussion in most situations.
An excellent and important distinction! All of us can engage in negative or destructive behavior from time to time. What I think we’re talking about here is people who are COMMITTED to negative and destructive behavior, people who genuinely believe that the best way to live is to be selfish and disingenuous and to mess with other people’s success and even their very sanity. To be raised by such a person is a nightmare and has lasting adverse consequences. But even accidental or unconscious role assignments can be extremely damaging. I also appreciate the observation that our larger society creates and exacerbates such negative flows, as they benefit capitalistic ventures. Insecure people buy deodorant, more makeup, and more insurance. Not to mention more “mental health” services!
“If so, then even the DSM-5 needs to be examined as to whether it’s more of a cultural document of social moral values, reflecting the subjective moral socio-cultural opinions of those who voted the DSM-5 into existence – rather than a list of objectively tested medical diagnoses?”
I think you have described EXACTLY what the DSM manuals are, and I don’t know how anyone examining the DSM-5 honestly can’t see this obvious truth.
I don’t call them “narcissists.” I just call them “jerks.” Or “assholes.” Less clinical, more accurate, no free justifications offered. It’s a way of acting, not caused by anything in particular except deciding to be a jerk. I can have compassion for such people, but only after they decide not to pass their pain on to others.
I think the real question is, what do you DO with such information once you realize what is/was going on? That’s where even the best of our “mental health” services frequently let us down.
I suggest you re-read what I stated in my earlier comments. I have never been accused of inconsistency.
I think you’re right, we’ve aired this out as much as we can air it. We may just need to agree to disagree on the extent to which genes vs. environment are responsible for these phenomena. Since the scientists can’t prove what is going on one way or the other, I think we’re on solid ground saying that no one can say for certain at this point what causes these phenomena to occur.
As for immigrants, it is a specific risk factor, independent of poverty. But even if poverty IS a risk factor in itself, it still supports my observations regarding the relative contributions of genes vs. environment:
I never said that genes play no role in schizophrenia. I said that it is not a “genetic disorder” like Down Syndrome or Cystic Fibrosis. And I said that there are small correlations with certain genetic patterns, but that the correlation with childhood adversity is much higher than any genetic correlation. It sounds like we are in essential agreement that genes and environment play a role. I ask that you be more cautious not to read things into what I’m saying that I didn’t actually say.
Similarly, I didn’t say that psychiatrists shouldn’t be trusted in the present or future because they were dishonest or misinformed in the past, though I think it would be a very reasonable thing to say. (How do YOU decide if someone can be trusted? Don’t you decide based on how they acted in the past?) What I said was that psychiatrists agreeing about something is irrelevant scientifically. I pointed out that psychiatrists have agreed almost to a man/woman about some “facts” in the past and right on up into the present which are now known to be false. This simply confirms that agreement among psychiatrists does not equate to scientific reality. I am certain the same observation can be made in almost any field of study we could mention. Science does not operate by expert consensus. It operates by experimentation and study and the ruthless questioning and retesting of any theory proposed to be true. It is also important to remember that scientifically speaking, any claim is assumed to be false until proven true, so the lack of evidence for something like a genetic basis for schizophrenia means that from a scientific viewpoint, it is not a valid theory.
Bottom line, we both agree that both genes and environment are most likely involved in what is called “schizophrenia.” So what are we arguing about?
From your article: “Rather, researchers discovered that risk for psychiatric illnesses tends to be “highly polygenic.” This means that many combinations of DNA variations— cumulatively occurring in as many as 1,000 of our 21,000 genes—contribute to risk, when viewed at the level of the entire human population.
In light of this discovery, the question for an individual becomes: Which of these many variations, if any, do I carry in my own genome? And how, if at all, might the variations that I have in my genome affect my mental health and that of my children and grandchildren? Answers to these questions involve understanding what “risk” means in the genomic context.”
Note that this research is a) in the earliest phases and b) involves “risk variations.” This does NOT represent the genetics of a “genetic disease.” A genetic disease is something like Down Syndrome or Cystic Fibrosis or Huntington’s. These diseases involve a clearly identifiable gene which leads unerringly to the same result in every single case.
So far, as have already mentioned, such research has led to groups of often hundreds of genes which are estimated to contribute very small proportions of the “risk.” How that risk is assessed remains unclear to me, but even the most optimistic efforts have never shown even a 10% contribution, meaning that even if we take all this at face value, 90% of “schizophrenia” is environmentally mediated. In fact, the very use of the concept of “risk genes” acknowledges that environmental insult is REQUIRED to create the syndrome in question.”
Your own first comment, suggesting that immigrants have higher rates of “schizophrenia” due to having harder lives due to poverty, is an acknowledgement that “schizophrenia” is NOT a “gene disorder” and is highly affected by environmental situations. If it were purely genetic in origin, it would not matter what kind of environment was involved. Poor kids with the Down Syndrome genes don’t suffer more from Down Syndrome than rich kids with the genes. Every kid who has it, gets it. No kid who doesn’t have it gets Down Syndrome, no matter how s/he is treated.
And for the record, poverty is not the risk factor for “schizophrenia.” It is being an IMMIGRANT that specifically confers the risk. And there is no gene for immigration.
As for the genome, I believe the analogy to an “operating system” that I offer is a much more appropriate one. The most superficial observation of human beings makes it very clear that most of our “programming” comes not from our genes, but from the decisions and priorities and education and training and experiences we have after birth. Ants’ “programming” is all in their genes. We have the obvious ability to reprogram ourselves (or to be reprogrammed) based on experience. Which would include adapting to childhood adversity by various means. Not suggesting that such adaptations are not INFLUENCED by our genes, but we are not pre-programmed in our responses in the way an ant or even a mouse might be.
Of course, the fact that a bunch of psychiatrists agree on something adds not one iota of confidence that it is true. Psychiatrists agreed that Benzedrine (and later Valium) was not addictive, that Thalidomide was safe, that Haldol and Thorazine did NOT cause Tardive Dyskinesia, that antidepressants did NOT increase suicidality (some are still denying this), that antidepressants do NOT create withdrawal symptoms, and on and on. Psychiatrists still deny the decades of research that show stimulants do not lead to any improvement in long-term outcomes, nor that “unmedicated” people with “psychosis” more often than not do BETTER when they are not on long-term antipsychotic drugs. Again, this is NOT to say that some people don’t find these drugs helpful in their observation, just that the idea that EVERYONE who has any kind of psychotic episode MUST be put on antipsychotics for life. You yourself acknowledged earlier that this is true, yet the majority of psychiatrists still insist that every psychotic patient be immediately and permanently put onto antipsychotics. So the agreement of psychiatrists as a group means very little in terms of what is and is not true. Science should be our guide, not “resort to authority” arguments that “most psychiatrists say it’s true, so we should believe it.”
I really am sorry that you feel you were misled and it sounds like you had an awful outcome! I also want to acknowledge and validate your experience. I certainly agree that all people should vet any and all concepts claiming to “help” people with “mental illnesses.” The fact of the matter is, nobody really knows what a human mind IS let alone how it works and what helps when it doesn’t seem to be working well. It is the arrogance of psychiatrists insisting that they KNOW things when they really don’t that rankles. I have no answers, either, but trusting psychiatrists is a risky business as well, as you should be able to observe by reading the stories on this site. You have your reality, but other people have different experiences, as I’m sure you can see if you have any empathy at all for the many people on this site who have experienced harm at the hands of the “mental health” system.
Two viable explanations: 1) the researchers are less able to get away with hiding “negative” results with new laws/regulations regarding availability of unpublished research. 2) Placebo response is a large part of the recorded “benefits,” and as is common among drugs of any sort, decreased confidence by the public in a particular drug over time leads to an increase in placebo effects.
I do find it amusing how they say that “traditional” mental health interventions don’t work with “indigenous people.” For whom DO they work?
I was at a training regarding systemic bias against African Americans in the child welfare system some years back. Someone said that the “mental health” system didn’t work well for black people. I stated, “It doesn’t work that great for white people, either!” Got a big laugh from the crowd. I think people know this deep down.
Well, individuals certainly report perceiving them as beneficial. But then, many people perceive a snort of Johnny Walker Red or a couple of beers after work as beneficial, too. Doesn’t make beer a “treatment” for “Work-Related Stress Disorder.”
Apparently, hospitals are reporting a dramatic decrease in admissions for heart problems and other acute incidents. Is it possible that staying home from work and not having to commute in insane traffic to keep a ridiculous schedule may be beneficial to one’s health? Or perhaps fewer visits to the local MD may result in fewer incidents of iatrogenic heart attacks?
There is excellent and undisputed evidence that diagnoses of “schizophrenia” are much higher in immigrant communities. How do you explain that genetically?
No one is saying that medication/drugs can’t be beneficial. But the fact that you find them beneficial does not imply that you are being “treated” for a “disorder.” It just means that you find them beneficial. Lots of people do, but lots of other people don’t. Is that not a fact you have to consider in your analysis? What about the “schizophrenics” (who are many) whose lives are not improved or are made worse by these same drugs?
“In the fields of molecular biology and genetics, a genome is the genetic material of an organism. It consists of DNA (or RNA in RNA viruses). The genome includes both the genes (the coding regions) and the noncoding DNA, as well as mitochondrial DNA and chloroplast DNA.”
Your statement is the same as saying that a computer program is the same as the computer hardware. The genes are hardware. They contain instructions, which is programming of a sort, sort of like the “operating system,” but the incredible complexity of human behavior is no more explainable by the genome than a computer’s behavior is explainable by the operating system.
Not to mention, the computer has an OPERATOR as well as a program and hardware. I challenge you to provide a genetic explanation for who/what is operating the brain?
You make my point for me. If we don’t know how the brain works, then we can’t say that “genes cause schizophrenia,” at least not if we are being scientific. All we can say is that “genes create the brain.” We’re on safe ground there. See my other post for the requirements of a real “genetic disorder.” Being related to the brain that is created by genes doesn’t qualify as proof. Makes as much sense to say that running is genetically caused, since the leg muscles are created by genes. It is, indeed, a nonsensical argument.
I am guessing that you are what is called a “reductive materialist.” Do you believe that everything that happens must be directly explainable or measurable in terms of physical reality? And therefore that the mind must be created and run by the brain, and therefore every manifestation of the mind must be caused by the brain?
I read the entire article. All it says is that gene expression is altered over time and that these alterations can be tracked. It does NOT place responsibility for “schizophrenia” or any other “mental disorder” in the genes. It talks about an identified “risk group” of genes, providing no information as to what level of risk is entailed by these genes, nor any correlations to a particular “disorder”. The total effect of these genes is not calculated or estimated. The article clearly mentions methylation, the core of “epigenetics,” as a big factor that they will be looking at. All indications I’ve read are that epigentics is primarily and deeply affected by the environment.
So the article you provide provides no evidence of a genetic origin of any “mental disorder,” and allows for a huge possibility of variation of outcome due to environment. The presence of “risk genes” is mentioned in passing, but risk is not causation, as I’m sure you are aware. I’d be really interested in hearing a comparison of the level of risk attributed to “risk genes” as compared to the level of risk attributable to childhood adverse events. I feel quite certain that the “risk” from environmental abuse is much higher than that from any set of “risk genes.” But your article doesn’t bother to do that comparison. It is an interesting and telling fact that the article makes no mention of non-genetic risk factors, and seems bent on finding a genetic explanation, even when such an explanation is not really viable under the huge variation of environmental factors impacting these “risk genes” that are postulated to contribute to these “disorders.”
It is also worth noting that the “risk gene” group is correlated with more than one “disorder”. A truly causal gene would be associated ALWAYS with the disorder in question. For instance, children with the Down Syndrome genes will ALL have Down Syndrome. That’s a genetic disorder. Having correlations with “risk genes” does not make any kind of argument for a “genetic disorder.” The “risk genes” could be associated with other survival traits that are essential to the species. To use the obvious example, even if they found a gene which made kids more active and intense than average, and even if that gene did so 100% of the time (which by the way has never been shown to be the case, nor have even “risk genes” been identified), it would not prove that “ADHD” is a “gene disorder,” because the genes convey a general personality tendency that could be positive or negative or neutral depending on the environment.
You are entitled to believe what you want, but I’m pretty well versed in the research and am quite certain that there is no proof that “schizophrenia” is even a distinct an definable entity, let alone a “genetic disorder.” If you claim it is such, you’ll have to come up with a lot more convincing article than that one to sway my opinion. Mind you, I can be swayed with adequate research, but this doesn’t do it for me. I certainly don’t deny that genes can be involved in mental/emotional states, but “can be” is a pretty broad statement, while claiming that a specific “disorder” IS genetic requires a lot of proof to establish.
Just the kind of “reasoning” that got us where we are. There were days in the not too distant past when wanting to escape enslavement was considered a “disorder.” Most of the victims of this “disorder” happened to be black. Must be genetic, eh?
I would suggest that any “therapy” that is not “trauma-informed, is based on shared-decision making and promotes personal choice in charting the direction of one’s life” does not qualify as therapy. The essence of quality therapy is enhancing one’s self-determinism and ability to exercise one’s options with confidence. “Therapy” that promotes dependence, that blames the client, or that enforces another’s worldview (especially if it is a chemically based worldview!) should instead be called by another name: ABUSE.
You miss my point, in a couple of ways. First off, there is no “genetic variant” that “causes” schizophrenia. I ask you for evidence of this and you have not presented any, so it is just as right to say “there’s a correlation but no causation” when referring to genetic claims as well. Which leads to the second point, that the correlation (which I called a correlation, not a causation, if you will review my post) is about 10 or more times higher for childhood adversity than it is for genetic markers of any type. And the relationship is dose dependent. And even the research for markers has to use something like 100 potential markers to get anything like 5-10% correlations. There is no one gene that contributes more than a tiny fraction of that, even in the most optimistic assessments that have been done. So yes, it’s ALL correlations, Martin, including the overblown claims of “heritability.” Here is just one link, found in seconds on google:
“Those that were severely traumatised as children were at a greater risk, in some cases up to 50 times increased risk, than those who experienced trauma to a lesser extent.”
The real problem, of course, is that “schizophrenia” itself is just a name given to a certain set of behaviors or experiences, and these “criteria” may exist in people who have little to nothing in common, genetically OR environmentally. The idea that behaving in a similar way means that people have the same problem and need the same “treatment” is scientifically nonsensical. It’s quite possible that SOME people who meet the criteria for “schizophrenia” have something genetically wrong with them, but to suggest that “schizophrenia” is caused by genes or by any one specific thing is absolutely not supported by science, whatever your personal feelings may be on the matter.
Maybe their genetics somehow magically attracts abusive people to them. THAT would explain it! /s
Seriously, if there were ever a “disorder” that we KNOW the cause of, it’s PTSD. Efforts to make THAT into a “genetic brain disease” is far beyond the pale!
If schizophrenia is a “genetic defect,” why have 50 years of genetic research fail to identify any genetic cause? Why are the correlations with childhood adversity in the 80% + range while the best specific genetic correlations are in the single digits?
One might easily feel overwhelmed and overworked if one’s efforts were constantly unsuccessful or damaging to one’s clients. I am sure many psychiatrists recognize on some level that they are not being helpful or are being destructive, and the weight of that must indeed be heavy. The denial of contradictory data is needed to maintain some semblance of being a “good person,” and few seem to have the moral courage or integrity to simply admit what is going on. Instead most seem to be avoiding their own pain and guilt by focusing on convincing others of the “rightness” of their approach or the supposed lack of any “alternatives” and blame insurance companies or short sessions or “the disease” or the client or anyone else except for the processes they are engaging in that are so obviously failing. I MIGHT feel sorry for those who recognize this, but only once they decide they can’t live with themselves doing it any longer and stop.
Sometimes recently I’ve been thinking that individual people can be forgiven and healed, but organizations and institutions don’t have their own independent “souls” and so can’t be “forgiven” in the same way. They can only be reformed or eliminated. And as someone wisely noted, the first goal of every organization is to perpetuate itself, so efforts to reform are often doomed, as the internal need to continue doing what has been accepted as “right” is very powerful, especially if rewarded with funds and/or prestige. It is only the most enlightened of organizations that is able to evolve when new data or ideas are brought forward. The “mental health” professions, at least at this time in our history, are seeming to be pretty much the opposite of enlightened. It is almost certain that they will continue to perpetuate the nonsense that their industry is built around unless they are met by some massive force that prevents them from getting rich or powerful by doing so. It has become clear that facts and research are no impediment to the continued psychiatric delusion.
The primary “science” Big Pharma relies on is the science of marketing. Actual medical science serves only as marketing’s handmaiden, and when medical science stops serving marketing, it is quickly and unceremoniously discarded.
Wow, thanks for that inspiring story! And well done for maintaining your integrity despite efforts by the system to distract and deflect your attention away from the real issues. We need leaders like YOU!
The irony is that “clients” of the “mental health system” are exposed to the same kind of treatment that created their distress in the first place. Being forced to pretend to agree with an enforced reality is very familiar to children growing up in unloving or emotionally distorted home situations, where they have to “manage” those who are supposed to care for them in order to survive and avoid further harm. How is dealing with a rigid, authoritarian bureaucracy bent on labeling and blaming its victims any different?
Excellent points! I often wondered why so many people identified as “SMI” smoked cigarettes, a factor many in the industry blamed for their early deaths. It was only in the last 10 years or so that I became aware that people on “antipsychotics” often use cigarettes to offset the assault on their dopamine systems, to try and slightly lift the severely depleted levels of dopamine caused by the drugs. And I always found it particularly offensive when clients, often children or teens, were told to go on a diet and to exercise more because of the huge weight gain they experienced on Zyprexa or other “antipsychotics.” Their doctors didn’t even bother to tell them that the weight gain was directly related to the drugs. How is that not malpractice? But as usual, the individual or “the disease” is responsible for anything bad that happens, while any positives are attributed to the drugs.
There is nothing inherently “aggressive” about filing a complaint. It is everyone’s right to do so. Only those afraid to deal with the consequences of their actions regard a formal complaint as an act of aggression. Unfortunately, there seem to be a lot of such people working in the “Mental health” system!
Originally, psychotherapists were expected to go through their own therapy before taking any clients, for this very reason. I think the real difference between helpful and unhelpful therapists is their ability NOT to project their issues onto their clients. But since this is no longer a focus in training, I am afraid very few therapists these days meet this standard.
I agree. Victim is in reference to an EVENT. It does not define a PERSON, it defines the action of one person or group against another that causes harm. I can be a victim of a crime without victim defining my identity as a human being. In fact, it is the confusion of events with identity that is what most characterizes the stupidity of the psychiatric worldview.
Those who need to convince others to agree with their beliefs clearly are lacking real conviction in what they say they believe in. If you really feel certain something is true, the fact that someone else doesn’t agree with you is of very limited importance!
These are great tips. The sad part is that someone has to be so careful to strategically approach those who represent that they are there to help you. Something is SERIOUSLY wrong with this picture!
I would say from experience that condescension is the most common attitude. The “professionals” feel like they’re being helpful and want appreciation no matter what they do or how bad it is for the client. Unappreciative or difficult clients are most definitely made fun of by some, and it is difficult for those who are uncomfortable with it to speak up. (Though I used to do so a lot of the time.) The truly successful professionals were the ones who saw the clients as just other humans not very different than anyone else, except as to the particulars of their personal circumstances. But they were in the minority. Not saying that a lot of professionals didn’t care at all, it’s just that so many viewed the clients through a lens of inferiority or failure. They often viewed the clients with pity rather than true compassion. There were plenty who did not, but again, they appeared to me to be in the minority.
I suppose that is an “effect” of a sort, though of course it is of no use to the actual “client.” Maybe they should use future financial reimbursement as their “primary endpoint?” It would eliminate a lot of confusion!
Wow, they call it “poor results” and encourage continued investigation? A true scientific analysis would call these approaches utterly useless based on the data, and recommend giving up on these approaches entirely!
Thank you for this, Miranda! It has really bothered me how the normal anxiety to the Coronavirus situation has been framed as “triggering mental health issues” for those with a label. You did a great job of showing the disparate and confusing coverage of this, and the intense but unspoken struggle to define what a “normal” reaction to such a situation must be. I’d only add that the fears of a sudden wave of “mental illness” sweeping the country completely puts the lie to the idea that these “mental illnesses” are somehow biologically determined. I also appreciate very much the observation late in the article that many of those already labeled “mentally ill” may actually have a lot to teach the so-called “normal” person about living in isolation or being extra safe or managing anxiety about situations we don’t control.
You are so right! Corruption of “science” has led to an inability to distinguish what is true from what is profitable, which is exactly what real science is supposed to be preventing!
I’ve never heard the word “cruel” used, but they certainly believe that life will be exceedingly painful if one does not develop an awareness of reality as it is and begin living with the knowledge of constant change and impermanence. And I agree with them on that point.
Accepting and normalizing one’s own feelings is an essential step. Looking at “positive thinking” may work for some people and be disastrous for others. The first mistake is telling the other person how to feel or what will “work.” The only one who knows what works is the person who is trying to make the changes.
I personally think that’s a distortion of Buddhist thinking. They don’t teach that we should just suffer or that those who accept the Buddhist path won’t suffer. They teach that suffering is primarily caused by wishing/desiring that things be other than as they are, as well as clinging onto and trying to keep things the same that will inevitably have to change. But they also teach that compassion is central and that the easing of suffering is very realistic and something to be valued for all, whether Buddhists or not.
In particular, “Pospartum Depression” has been massively promoted as a “disease state” when the vast majority of cases consist of very understandable reactions to difficult life circumstances and the incredible lack of support available for new moms in our culture. My wife did some research on this and found that there are cultures where there is practically zero incidence of “postpartum depression.” Not surprisingly, these cultures put a big emphasis on supporting new moms in doing their job as parents so they don’t have to do much of anything besides spending all their time and energy learning how to care for themselves and their new babies.
Lucy gets it 100% correct here. I have never seen a clearer example of the ludicrousness of claiming “mental illness” to be the cause of anxiety/depression/anger/fear relating to this huge, worldwide concern. I wince every time I hear someone say, “Mental health issue can be TRIGGERED” by the Coronavirus fears. Totally “normal” and undiagnosed people are losing sleep, hoarding toilet paper, worrying about finances and the economy, etc. It is NORMAL to be worried about something like a potentially deadly virus and the social disruption it is causing! In fact, people who are NOT worried are the ones making the problem worse!
This is proof that the MH paradigm is completely bankrupt and needs to be scrapped!
Good news from my home state of Washington: hospitalizations DOWN this week by about 20% over last week. Social distancing does seem to be working for us here. Keeping my fingers crossed!
Sometimes what you have to do is do anything you can to convince them you agree 100% and are now happy and healthy due to their wonderful interventions, and then escape once they open the door and don’t ever come back! You clearly have sufficient “insight” to understand what they are about and that convincing them is impossible. So the next best thing is to escape their influence in any way you can! Easier said than done, though. WAY easier.
Of course, a lot of the “treatments” adversely affect their “patients'” physical health, making them more vulnerable. Not to mention the impact of being given the idea that your brain is permanently broken. It has been shown that having hope and purpose improves health and resistance, too, though this is pretty much common sense. Though it appears not so common in the world of “mental health treatment.”
I’m afraid way too much money is being made keeping people in “coping mode.” If we really taught people or helped people to become more capable of managing their own lives, a lot of people might need new jobs!
But remember that corrupt politicians could not be bought if someone were not out there buying them. As long as taking “contributions” from big money corporations is allowed, we will have corruption. It needs to stop!
I know, right? Instead of taking a walk, I’m engaging in “ambulatory therapy?” Surprised they haven’t tried to patent it and forbid us to take a walk without paying our therapist for it!
I agree 100% – why all the focus on genes? Let’s just allow that some people will react differently to the same situation than others, and that genes probably play some role in it. So freakin’ what? It’s like studying people’s bones to see why some people get broken bones in a car crash instead of trying to reduce the risk of collisions. Idiocy!
Of course, Major Depressive Disorder is a social construct, so how would you know if somebody “had it” or not? It would be similar to saying that someone “has courage” or “has racism.” It makes no logical sense if you can’t distinguish between those who do or do not have a particular “condition.”
I think that is a legitimate distinction. I was talking about moving from a strong core protest to a larger mass movement. I agree we are not really at a point where that can happen yet, and building a strong intellectually/scientifically viable base is essential to any movement succeeding. It’s just that a lot of people aren’t able to process on the level that is needed to understand the viable base and need their memes and leaders in order to get with the program. It will happen one day, but again, we’re not there yet.
There is a difference between pandering and taking the facts of human behavior into full account when planning a strategy. I would challenge you to show big changes happening against the status quo that were not created with emotional appeals to the masses. Of course, there need to be solid, real, honest ideas that have strong logical backing, because otherwise they don’t WORK. But I can’t think of a major change movement that didn’t employ emotional appeals as a big part of their strategy. I could be wrong, of course, but I’m not seeing examples of “intellectual revolution” being successful. I’m open to hearing examples if you have some. Like I said, it’s not my specialty, just going by what I’ve observed.
One can be right all day long and get nothing done. That’s how I’ve experienced attempts to change the system from within. I have no interest in denying reality or polling anyone on what they want to hear about psychiatry, and frankly, given my history, I find that suggestion a little disrespectful. I absolutely agree that calling psychiatrists “doctors” or psychiatry “medicine” is a fraud and needs to be called out as such. The question is how you get masses of people on board with that idea. Most people don’t think with ideas, they react with emotions. That’s why a story in the paper about a poor kid living on the streets with his parents gets tons of donations, while a request for an increase in the welfare budget is met with disinterest or scorn. People have to be grabbed emotionally. Facts don’t convince most people of anything much. Most people are driven by emotional “reasoning,” which is one reason psychiatry has been as successful as it has – it appeals to people’s desire to feel like someone understands something that they don’t, and to people’s desire to blame someone/something in a way that keeps them from having to make any significant changes. It’s how people in groups tend to act. You have to get them excited or angry or worried about something or they will roll with the status quo. At least that’s my experience. Maybe I’m just too cynical!
You say you learned schizophrenia is genetic? Who told you that, and what proof did they offer? A full review of massive research has shown a complete failure to demonstrate any specific cause for “schizophrenia,” or even significant evidence that “schizophrenia” is even a valid entity for research. Mainstream psychiatrists (including the head of the NIMH, Tom Insel) have recognized that these diagnoses “lack validity,” and some have even proposed dispensing with “schizophrenia” as a diagnosis, or saying that there are “schizphrenias” which have no necessary relationship with each other in terms of cause.
I’m sorry that OD did not work for you. The folks who invented and developed it have made it clear that 20% of clients don’t respond to OD. You may have been one of them. That doesn’t make the data wrong.
I’d also be the last to deny that biology COULD cause a person to have hallucinations and aggressive behavior. But calling all such cases “schizophrenia” and asserting that they all have genetic causes is absolutely contrary to actual science.
If anyone had an agenda, it was the person telling you this stuff.
We are appealing to anyone who is uninformed and who needs to become educated. The world isn’t broken up into those who agree with eliminating psychiatry and those who sing its praises. Most people don’t really HAVE opinions, they make their opinions based on rhetoric they hear from those whom they assume know more than they do. There is no reason not to reframe psychiatry as a human rights abuse because it will garner more support than trying to convince everyone that psychiatry is a fraud (which it is), because we need the general public opinion to turn against psychiatry. That seems to me the most effective, practical way to do it. Any mass movement requires a mass of people to participate, by definition. It seems to me that the way to get a mass movement going is to have memes that people can get behind in large numbers. Take “MADD” for instance. They didn’t argue that no one should drink, they argued that people should not DRIVE drunk. And they came up with the meme of the “designated driver,” which resonated with big numbers of people.
I’m not a master of group dynamics or mass movements, but it seems to me that people can wrap their brains around the idea that people deserve to have their rights respected more easily than they can that their doctors are a bunch of charlatans, even if the latter is observably true.
True compassion, in my opinion, can’t come from a place of hierarchy and authority. Authoritarians are capable of pity (hence the “anti-stigma” campaigns), but true compassion requires stepping away from the superior role, and a true authoritarian can’t ever allow that.
I personally think the human rights approach is the broadest and would have the most general appeal, especially if combined with honest rhetoric regarding oppression of particular subgroups within the general abuse of rights that psychiatry represents. People want to believe in doctors, but they also want to believe they ave rights which can’t be violated willy-nilly. How we can connect the abuse of rights of the psychiatrized with the rights of people who haven’t yet had that experience is a bigger challenge, but one that I think eventually can be overcome.
It’s a classic tautology. Since it’s not “normal” to do antisocial things, anyone doing something antisocial is “abnormal.” But since we’re not allowed to say things like “evil,” we say such people are “crazy” because “only a crazy person would do something like that.” So they did it because they’re crazy, and they’re crazy because they did it. Then, by analogy, anyone who is “crazy” (aka “Mentally ill) is dangerous, because by definition “crazy” things are done by “crazy” people. QED.
I do want to distinguish somewhat between you as a layperson saying this vs. a medical professional saying this. You are not purporting to be representing the latest scientific knowledge in the field, so it’s more understandable and less damaging to use analogies to explain things. That being said, I still consider it a damaging framing of the reality of “mental illness.” What you said at the end is much more relevant to understanding most people’s situations – that we have trauma, neglect, and other harm from how we grew up, whether from parents, siblings, school, church, or other institutions. Finding someone to talk to who really understands these experiences is what I’ve found helps people the most. Most folks don’t “need medication,” they need UNDERSTANDING. This is not to say that some people (like you) don’t find these drugs USEFUL. It is to say that the idea that you are “treating a brain malfunction” is simply wrong, both scientifically and sociologically. It is not a “disease” or “disorder” to feel bad, act in antisocial ways, or think unusual thoughts. Some disease states DO cause emotional distress, weird thoughts, or antisocial behavior, but those disease states have specific causes and usually specific remedies. To say that someone “has clinical depression” is totally subjective, and it is highly misleading to create an analogy with diabetes, as diabetes is objectively measurable and has a specific treatment that is effective almost 100% of the time. This is simply not true of “antidepressants” or any of these psychiatric drugs. They are very simply efforts to make someone feel better or act better temporarily. There is nothing observably wrong with the person, and there is nothing specifically being “fixed.”
I think you’d be far better off telling people that “I’ve taken these pills and they have helped me feel better. That apparently doesn’t happen for everyone. Nobody really knows if there is something biologically wrong with you, but I can tell you that I understand your plight and am very happy to listen. I find that listening and caring for each other is the best ‘medicine.'”
Most people who become suicidal as a result of taking any drug are unaware that the drug is the cause. And those who are aware or are becoming aware are roundly invalidated by their doctors and “mental health professionals” in the majority of cases.
The point about lung cancer is very well taken. The fact that some people like the effects of cigarettes and don’t suffer much long-term damage doesn’t mean that “stop smoking” campaigns are “shaming” those who continue to smoke.
This really is the key question. “Medications” are measured intentionally only against “symptom reduction,” mainly, that a person feels LESS of the “negative” feeling or engages in less of the “undesirable behavior.” Quality of life is almost NEVER the overt measure of success. If it were, “medications” would be relegated to last-resort status or banned altogether. One of the great things Bob has done in Anatomy is to demonstrate the massive REDUCTIONS in quality of life with the current paradigm. And to me, what is the point of any “mental health” intervention if the recipient isn’t more satisfied with his/her quality of life as a result? What other measure of “mental health” (if such a thing can even be defined, let alone measured) could be identified?
It does seem odd in the extreme that “treatments” which reduce the average lifespan of the recipients are seen as “lifesaving.” A little Newspeak if you ask me.
I hear that you’ve had a good personal experience. It concerns me that you seem not to want to hear that not everyone experiences things the same way you do. You write a number of philosophical assumptions regarding the brain, but provide no scientific proof that the brain is the cause of “mental disorders.” If you read the article, you’ll see that the primary difference is that we KNOW that insulin is the singular causal factor in high blood sugar – it can be measured, blood sugar can be measured, and adding insulin or coming up with a way to increase insulin reduces or eliminates the problem in almost 100% of the cases. Add insulin, reduce blood sugar – it is that simple.
With psychiatric “diagnoses,” there is no known missing substance that needs to be replaced. There is no substance that can reliably replace the mystery “missing substance” and create beneficial results 90% of the time, or even 50% of the time. Compared to placebo, Kirsch’s work showed that ADs are barely better than taking a sugar pill. Compare that to the almost universal success of insulin in reducing blood sugar. Heck, we don’t even know if there IS any chemical causing ANY of these conditions, let alone are we able to MEASURE those chemicals.
SO the analogy fails completely. There is no SCIENCE saying that “depression is caused by low serotonin,” and lots of evidence saying that it is not. Doctors are GUESSING as to what drugs may or may not be perceived to “help” by reducing the experience of depressed emotions. The analogy with drinking a controlled amount of Jim Beam whiskey daily is a much more accurate one. People DO feel better when they drink alcohol, but there is no “condition” being addressed by the alcohol – it has a general numbing and elating effect on everyone. All psych drugs work similarly – they create effects that some find agreeable, and some don’t. The “diagnosis” itself is made by listening to a list of feelings and behaviors, not by measuring something concrete like blood sugar levels.
So in essence, the “insulin for diabetes” analogy is a complete deception. Vague philosophical assertions about the nature of the brain (unproven, except that the brain is of course nervous tissue 100%, not a muscle) do not count as hard science. If there is nothing to measure and no reliable approach to improving such a measurement, we’re talking about something VERY different than diabetes.
Your clients are relying on you for honest information. I don’t believe it is ethical to provide them with unscientific ideas based on your personal belief system. I believe you are responsible for telling them the facts, including the fact that we don’t know WHAT causes “mental illnesses,” or indeed whether they are “illnesses” at all.
The irony of the “Decade of the Brain” is that they discovered that the idea of specific “mental illnesses” due to “brain disorders” was wrong. The real results were that the brain is FAR more flexible and malleable than anyone believed, and that experience can change the brain through adulthood. And the most significant brain-healing action we could take for kids is a positive relationship with a mature adult. TOTAL contradiction to what they wanted to find, and of course, these results were largely ignored, except to emphasize that early abuse/neglect “damages the brain,” which serves their narrative if looked at in isolation. If they REALLY applied the lessons from the Decade of the Brain, the DSM would be ditched and we’d be spending a lot of time would be spent improving people’s relationships with each other and creating positive environments that promoted grain health for kids and adults. Who would have guessed?
I’d love to have a link to that article posted! I’ll have to look it up, but it is amazing (and yet not surprising) how hard proof of damage is provided and yet to claim that it is “safe” to use something that induced a person to kill his child and almost kill himself! How is that “safe?”
Beautiful writing, as usual, Noel! This is the kind of talk I recall back when I initially broke into the field of therapy. I don’t know that this kind of discussion even happens in most peoples’ training these days.
I do want to point out that one of the many reasons trauma survivors die 20 years earlier than the general population is the drugs they are given/forced to take by the “mental health” system itself. Further physiological and psychological traumatization does not appear to be particularly helpful in “treating” the effects of chronic trauma!
Thanks for all you do to bring sanity to the crazed world of “mental health treatment.” I wish that all “mental health” workers took their cues from your philosophy.
I like the article, great history there. However, I would argue that these efforts at transformation were ultimately coopted and that the basic fundamental beliefs of the system have not changed much at all. Women are still told that their anxiety/depression the the face of childhood sexual abuse, rape, domestic violence, and general oppression by the mainstream of our society are personal problems. They are still proffered new versions of “mother’s little helpers” in the form of benzos and SSRIs. They are still blamed for not “adapting to their roles” properly, and still diagnosed for being “too emotional.” These seminal writers’ critiques are just as valid today as they were in the 70s. We are still waiting for the ensuing “transformation,” and will most likely wait forever for this utterly patriarchal and oppressive system of thought to actually become responsive to the actual needs of clients and society at large.
It is not the inability to trust, but the inability to know WHOM to trust that is a problem. Anyone who says “trust me” without taking adequate time to earn that trust is someone who goes on the “don’t trust” list for me right away!
Yes. It was a known concern before it was approved.
“Those who developed akathisia or who had any suicidal tendencies were excluded from the trial data on the basis that they would otherwise obscure the results of the drug’s success in treating depression. Yet the German licensing authority, the Bundes Gesundheit Amt (BGA), on scrutinising the results, expressed concerns about the drug’s safety. On May 25, 1984, according to Lilly’s internal documents, a letter from the BGA stated: “During the treatment with the preparation [Prozac], 16 suicide attempts were made, two of these with success. As patients with a risk of suicide were excluded from the studies, it is probable that this high proportion can be attributed to an action of the preparation [Prozac].”
I agree. It is not absolute poverty, but the power differential from income disparity that causes the greatest distress. The sense that you are somehow unable to succeed at life because the rules are rigged against you separates you from others, while working together with others struggling toward the same goals brings people together in a sense of community that is what really helps people feel good about their lives.
So being unable to provide sufficient resources to survive, being worried about losing electrical power or heat or even housing, being unable to eat sufficient food and having no recourse, all of these things could make a person more “depressed?” Golly, jeepers! These poor people must have chemical imbalances, mustn’t they? Or they need to sit and have someone understand the difficult feelings associated with having your family lose their home or slowly starve to death?
I’m glad this research has been done and is published, but how many times to we have to study the obvious? Anyone with half a brain could figure out that poverty feels like crap and will lead to more suicides. Time to DO something about it instead of continuing to blame the victims of our heartless economic system!
I have known plenty of people who were on “maintenance antipsychotic treatement,” in fact, almost anyone who had been to an ER for “psychotic symptoms” got on one. Many were forced to take them and had no choice. A lot of foster kids are put on them daily for behavioral problems that have nothing to do with psychosis. Old folks in nursing homes are put on them to manage difficult behavior, again without any “psychotic disorder” diagnosis or even symptoms. It is no myth. It is true that many people (like mathematician John Nash) go off antipsychotics as soon as they are safely away from the authorities. But the standard recommendation I’ve seen for ‘psychosis’ or ‘bipolar disorder’ is “maintenance antipsychotic treatment.” And those who refuse to “comply” are pressured, manipulated, or incarcerated for it. There is no myth involved here.
Prozac was actually NOT approved in Germany, and I believe Italy as well, due to suicidal and aggressive impulses being aggravated or induced by the drug. This was known information from day one.
The main valuable expertise I’d be looking for is the ability to convey interest and compassion while I told my story. And from psychiatrists, I can count the ones I’ve see do this on one hand and still have a couple of fingers left over. Most counselors/therapists these days are also bought into the DSM and have stopped talking about unconscious motivations and life goals and sense of purpose and spend their time on “symptom reduction.” It’s a sad situation, and I would value the clients’ expertise over the “mental health professionals” at least 9 times out of 10. Most of what I learned about therapy, I learned from clients letting me know what they felt helped and did not help. There is no other standard for success. It should be the #1 most valued information there is, not relegated to third place after “research” and “clinical expertise.”
It is interesting that they refer to “clinical expertise” but to “patient preferences.” What about “patient expertise?” or “Patient knowledge?” It seems that framing a patient’s/client’s decisions as “preferences” is disempowering, in that it implies that the patient’s information is irrational or emotionally-driven, rather than being rationally-derived information based on the patent’s own experiences and knowledge base. A normal power distribution would require the patient and the therapist to negotiate an agreement on the actual facts of the situation, assuming each one had an expertise of their own that legitimately informs the mutual understanding of both the problem and the possible solutions. “Preferences” is a very weak term for what is being expressed by the clients in these situations.
Additionally, the author neglects to observe that the “evidence base” for “EBPs” is based on the categories in the DSM, which psychiatry’s own leaders (like Tom Insel at the NIMH) and the DSM introduction itself acknowledge to be invalid, heterogeneous categories of behavior that do not necessarily indicate any commonalities between those who “qualify” for a particular diagnosis. So saying that “X treatment is more effective for major depression than Y treatment” becomes a nonsensical statement, since depending on which client with that diagnosis presents to you, the required “treatment” may vary wildly.
If you really want to do “evidence-based treatment,” you have to start with a legitimate grouping of candidates for study. Absent that, the “scientific evidence base” for these therapies is worse than useless – it is actually deceptive.
Don’t know that I was always “eager” to see my therapist, but what was clear is that my therapist, who was wonderful, was focusing on doing whatever she could to help ME meet MY goals. She never told me what to think or believe, never told me what I should or should not do, never criticized me for making a particular decision. She was genuinely INTERESTED in finding out more about me, and even when there were some hard times going through material I would most certainly have avoided without her being there, I always knew she was on my side and would make it safe for me to say whatever was on my mind.
This was way back in 1982-3 before the DSM took over and when therapists actually listened to their patients. I know there are a lot less such people out there these days. If I were screening a therapist, my first question would be their opinion on the DSM diagnostic approach. If they showed any respect for the DSM, that would be it for me. And if they started talking about “mental illness is a disease, like any other” or “insulin for diabetes,” I’d run from the room!
Did I not read fairly recently that receiving “more intensive psychiatric care” actually leads to an INCREASE in suicide attempts? It seems to me that psychiatric care encourages a belief that one’s situation his hopeless and intractable and that one can personally do nothing about it. At least blaming it on bad toilet training meant you had a chance to get over it. Now it’s all in your warped brain and the only “hope” is that the drugs might make you feel a little better, if they don’t kill you in the process.
Absolutely! Even within their own framing of things, which of course, lacks any real scientific basis, there ought to still be the expectation that TREATMENT WILL IMPROVE THE SITUATION! It’s probably the first and easiest place to attack psychiatry, without even getting into the DSM idiocy. If I have a skin rash and take a drug for it, the skin rash NEEDS TO IMPROVE! If it doesn’t improve, WE NEED TO DO SOMETHING DIFFERENT. Why does this reasoning not apply to psychiatry?
Great point! When working with foster youth, I often found the kids accused of “assault” by staff in institutions when a very short investigation proved that the child was fighting back against the staff assaulting THEM! But that part never got recorded in the logs, did it? “History is written by the victors.” Certainly, the residents of any kind of institution are not the “victors” and their version of history is never recorded by the institution’s staff.
The article fails to mention the rather uncomfortable fact (for psychiatry, anyway) that the indigenous approaches are FAR superior to anything psychiatry has to offer, if we actually care about the quality of life of the “patients.”
After reading the article, the answer is clearly “nothing,” unless by “adding” you mean “providing yet further distractions and justifications for avoiding looking at environmental/social/spiritual causes.” It also appears to avoid looking at ACTUAL physiological causes of emotional distress, such as poor diet, thyroid issues, anemia, sleep problems, etc.
They mention early on something about “issues of the relationship between mind and brain,” and yet the actual research seems to be all brain, all the time. Not one more word about “mind” in the entire article.
In other words, “Meet the new boss, same as the old boss.” Nothing new to see here.
Well, I’m doubly sorry no one has told you that! It is a sad state of affairs we are in, and a lot of folks are getting harmed for no reason. Lots to be sorry for!
It seems important to distinguish between medical ERRORS (doing the wrong thing or overlooking something) vs. medical HARM (patient has a worse outcome despite following standard medical practice) vs. MALPRACTICE (doing something that the doctor knows or should have known is harmful, or failing to inform patients of risks of medical harm prior to treatment, etc.) Most medical harm is NOT due to errors, it’s due to adverse drug effects. And of course, those drug effects are MALPRACTICE if they result from neglecting to do proper differential diagnosis, or failing to provide proper informed consent to the patient. The medical profession has tried to reframe medical HARM as medical ERROR, even though most of the harm is done by standard medical practice. This appears to be an intentional effort to downplay the dangers and inadequacies of standard medical practice and to make it seem that failures and harm are due to a few “bad apples” rather than the standards of care being inadequate and frequently dangerous and corrupt.
But then they might CURE some of their patients, and would have to look for NEW patients, which is SUCH a hassle! Better to keep them “ill” so you can keep selling them drugs and “services.”
Why should you automatically trust them? Isn’t trust earned by trustworthy behavior? Isn’t one of the “deficits” of “borderline personality disorder” (as they frame it) a difficulty deciding who can and can not be trusted?
It is clear that these people don’t really know what they’re doing, and they get very insecure when anyone starts making it clear that they don’t, they get defensive and start blaming the person telling them the truth. It’s like The Emperor’s New Clothes! Lord help anyone who points out that the King is naked!
I think you start by pointing out the power differential overtly, acknowledging your power advantage and the general advantage of the other staff people and asking how they think it will affect the conversation. I would then humbly ask what YOU can do to make it more comfortable or easier for people to say what they are thinking without feeling like they might get into trouble. But I think the first discussion would be a huge one, if it gets going, and will pull you in the direction you need to go. I think the main thing is to bring it out in the open as an unavoidable fact of life, and get them talking about how it affects their experience. It will be a lot more interesting than Nietzsche, I’m thinking!
Another psychiatric success story! How can these people not see when their “treatment” fails utterly? In what other profession are the professionals allowed to blame their failure on the person/machine/process they are supposed to be fixing? “The bridge collapsed because it was a span-resistant river.” “We couldn’t fix your breaks because they are repair-resistant.” “You were poisoned because our chef had the misfortune of serving health-resistant food.” Come on, who the hell else would ever get away with it?
Plus they’d have to define sentences and let people out when they’d served their time, instead of when the psychiatrist decided they were “ready.” Nowadays, your sentence seems to be as long as the insurance will pay.
They’ve done a pretty good job with the “scientific” smoke and mirrors job so far, and I’m guessing they will continue to do so as long as it works. Pretending to be the “scientific” voice is usually a winning play these days.
Somehow, I found the entire article alienating from the start. The language is very “clinical,” and there is a confusion between social conditions and “mental health diagnoses” that the authors never begin to address. If loneliness is caused by social conditions, then how does it even become a “mental illness?” If “mental illnesses” as defined by the DSM can be caused by loneliness, which is itself caused by adverse social conditions clearly identified in the research, how are they “illnesses” at all? Should they not instead inform the need for changes in the social structure that is increasing the difficulty people are having creating meaningful relationships?
A lot of fancy words that seem to obscure more than they illuminate.
It seems likely that such a group would not be fully successful unless it started with a full discussion of the power dynamics entailed in you being the “professional” and organizing the group. It is apparent from your description that they patients viewed you as the “expert” regardless of any provisos you may have put out there. In fact, your ability to frame the conversation in terms of your role is already an exercise of power over the participants. Unless this set of assumptions, which may have largely been unconscious or subconscious, are fully deconstructed, the group as you envisioned it was unlikely to develop.
Of course, if you HAD conducted such a discussion, your hierarchical peers would have felt their power threatened and almost certainly would have shut you down, just as they did with the “du” vs. “Sie” issue. Why would it bother them for you to use informal pronouns, except to the extent that it threatened their role as the “experts” speaking down to the “patients?”
I have to wonder what Nietzsche himself might have said about the process.
Wow, so the satisfaction ratings for these drugs are 6% approve and 60% disapprove. So the odds are 10-1 that these will make your life subjectively worse. And that’s not even counting the long-term effects like diabetes, heart disease, weight gain and early death, which may yet effect the 6% who approve. Yet this is the standard of care?
This is why I’ve said again and again that psychiatry itself is not the enemy, it is only one manifestation of the enemy. The real enemy is AUTHORITARIANISM, the belief that people have the right to order about and take advantage of those below them in the power structure, and the belief and experience of those below that they must acquiesce to such behavior or be punished or ostracized from the group. Regardless of the name and stated purpose of a group, the ability of the group’s membership to hold the group’s leadership accountable is essential to any movement toward justice and equal rights to be successful. In other words, we have to have our own house in order before we’ll succeed at changing the external circumstances. And that is not an easy task!
No, they don’t. Generally, the psychiatric line is that we are just a bunch of chemicals swirling around and have no free will or motivations. So the only way to intervene is to swap chemicals. There is no person there, just a body.
Twitching wrecks make for better customers – you can sell 4-5 drugs at a time, and they don’t even have the wherewithal to object. And even if they do object, they’re “crazy” (oops, I mean “mentally ill”) and their opinion doesn’t count. It’s a win-win! Well, except for the client, I guess…
It is also very important to note that these “differences” are AVERAGED over large numbers and are generally quite small. There is a huge overlap between the “disordered” and the “normal” population on any such measure. In other words, even if the average brain size of an “ADHD” diagnosed child is smaller, there are many “ADHD” diagnosed children who have larger brains than the average “normal,” and many “normal” kids who have brain sizes smaller than the average “ADHD” diagnosed kid. When you then take into account that the “ADHD” diagnosed population contains large numbers of kids on stimulants, which we know decreases brain size in the area of the basal ganglia, even these average differences reflect nothing at all.
SO in other words, it’s all smoke and mirrors. There is no “difference in the brains” of “ADHD”-diagnosed kids. It’s all PR.
But there IS a point in telling parents that their kids have a “brain disorder,” even though this has been disproven decades ago: they will be more willing to accept and administer a drug to their child. That is the ONLY purpose for this deception to have continued this long, and the fact that it does continue makes the intentions of the profession eminently clear.
Where did they ever come up with that 51% suffering from trauma statistic? The real answer is in the 80-90% range from everything I’ve ever read. Did he provide a reference or was he just spewing hot gasses from his mouth?
The “It’s not all about medication” meme is just a cover for the fact that “medication” prescriptions are 99% of a psychiatrist’s business these days. My experience (and I have a lot from advocating with foster youth) is that the vast majority of psychiatrists exist solely to prescribe and “monitor” drugs, though the term “monitor” must in most cases be used very, very loosely.
They need to believe in their doctors and in “Science.” It violates basic mythology for most people to question that doctors are knowledgeable scientists with their patients’ best interests at heart. We have to undermine this mythology before any real change will happen. I do feel bad that kids have to deal with parents who are deceived, but most parents are trying to do the right thing and need to be educated. Of course, there is a minority of parents who are more interested in controlling and subduing their children than in helping them live well, and such parents get very little sympathy from me.
The 6% (I actually think it was more like 6.7%) was from a file review, and only included those reactions noted in the kids’ files. Naturally, there would be doctors who would not notice these symptoms or would not write them down, and also kids/parents who did not report them or did so in a way that the doctor did not make the connection. So if 6% of doctors both knew and recorded these reactions, clearly the actual number so reacting would be considerably larger.
That being said, even a 6% rate is large enough that it ought to be discussed at every “informed consent” conference with parents and children considering this “treatment.” Of course, many doctors don’t really do an informed consent consult in the first place, but even those who do rarely if ever mention to watch for psychotic symptoms as an adverse effect. In 20 years of experience as an advocate for foster youth, I never once heard or saw it mentioned to any of the 20% of kids in care who were diagnosed with “ADHD.”
Few parents indeed are ever told that psychotic experiences are a possible adverse effect of stimulants, even though one study indicated over 6% of kids on stimulants had psychotic symptoms noted in their files. Most kids who start showing these signs are diagnoses with “bipolar disorder” or a “psychotic disorder” and put on antipsychotics. I saw this many, many times in the foster kids I advocated for.
Because THAT’S how we do Science – we choose our model based on what makes the “experts” feel comfortable with their delusions and never challenges their pre-determined reality.
Especially if you can find at least one study whose data when sufficiently manipulated support your “yearnings,” at least on paper, even if there are 50 others that oppose it. I mean, THAT is science at its best, right?
I think what it does is help create and sustain an alternate narrative of what is going on. It helps people see that an attitude critical of psychiatry is not “nuts” and is based on actual data and research as well as lots and lots of people’s experience. This in itself doesn’t change the status quo, but it helps bring people together that are opposed and provides tools and information that will help them do so. That’s my take on it, anyway.
It also provides a space where survivors of the psychiatric system can speak their truth and not be brushed off or attacked for doing so.
You can only “overdiagnose” if there is an objective way to determine a diagnosis. If there is such a means, then it’s not “overdiagnosis,” it’s called a WRONG diagnosis! If there is no such means, then ANY diagnosis is “overdiagnosis,” otherwise known as FRAUD.
It frustrates me when they call this process “overdiagnosis” or “overmedication.” They should refer to it as MALPRACTICE. Because that’s what it is. Generalized and incentivized malpractice to make money while not helping or harming patients.
In other news, hitting people on the head is associated with bleeding and broken skulls. Though not everyone suffers from broken skull. Perhaps we should study “weak skull disorders” to figure out why certain people’s heads are too weak to withstand being hit by a big hunk of wood?
As I like to say, species survival depends on genetic diversity. We need a range of “phenotypes” in order to get the work of our society done. We’re in big trouble when we start deleting certain presentations because they are inconvenient or uncomfortable to confront for those in the seats of power.
That is true. But by definition, anyone who opposes the psychiatric mainstream is “controversial.” The fact that he used to support it and then was harmed by it might give him more credibility. Of course, I’d LOVE for a mainstream figure to take up the sword, but that seems a long shot at the moment.
I wouldn’t really classify him as “right wing.” He’s kind of “wingless,” says what he thinks with no real allegiance to any political viewpoint and offends both ends of the political spectrum. Though some right wing folks have attached themselves to some of the things he has said, because they can be made to fit the right-wing narrative. But in my view, he’s an equal opportunity offender.
My apologies to you and others. I’d approved a bunch of comments last night but somehow it did not process them as approved. It’s now posted. Thanks for prompting me.
This is a very well-spoken and well-known public figure. I hope he can be encouraged to join the ranks of the movement to discredit psychiatry and remove its unchecked power. He would be a strong ally.
In what other situations can these diagnoses be given out? They are ALWAYS given on in a subjective situation, because they are all utterly subjective by their very nature. A lay person is just as qualified as a psychiatrist to give a subjective opinion on someone’s “mental health condition,” which is why so many feel like the can do so.
“Recovery” on their terms, though. Someone like John Nash who recovered in spite of rather than because of their interventions is an embarrassment, so much so that they had to change the movie and make it seem like they’d helped him, in order to protect their interests.
Anyone who really has an idea to DO anything is generally regarded as “crazy.” In a weird way, it could be considered a badge of honor that “normal” people recognize that you’re not one of them!
“By their fruits shall ye know them.” Indeed, it is easy to see where they are coming from by their vicious opposition to any attempt to look at the actual consequences of their policies and “treatments.”
I should have said that HIPAA protects AMERICANS against having their medical information spread around. I can’t speak for any other country. Sounds like Australia may have some catching up to do in this area!
It is clear from the focus of the “studies” that the definition of effectiveness is “reduction in symptoms.” This may or may not be of interest to the client specifically, but it certainly makes it obvious that resolving the actual issues that created the “symptoms” is never the goal. It’s like spending a ton of money on topical rash treatments without bothering to figure out if you have poison ivy, the measles, prickly heat, or syphilis. But it certainly is “effective” for creating lifetime patients and blockbuster drug sales!
I’d prefer to have “regular people” running for office rather than letting the ignorant and uninformed do the voting. There was an influx of new candidates in 2018, mostly women, who were NOT career politicians but just seemed tired of “business as usual.” But of course, we have to get rid of corporate money donations as point zero in any change plan, which is one thing Bernie has been very strong about.
Though I must ask who, besides Marianne Williamson, is even opposed to increasing forced “treatment?” The political landscape is indeed grim from the point of view of our intentions here. Sanders might at least be able to listen to those who wish to educate him further. But my hopes are slim.
Such euphemisms! What we REALLY should say is, “Schools as designed are extremely stressful for a large percentage of children. We need to rethink how schools are run so we don’t keep traumatizing our young citizens.” You don’t have to be “vulnerable” for school to stress you out. In fact, schools appear to MAKE a lot of kids “vulnerable” in ways they would not be if they participated in a more child-centered, respectful institution.
That’s rich! If Bob were interested only in making money, he’d become a psychiatrist instead of railing against them! Or invest in Big Pharma stocks. But people hear what they want to hear.
From my observation, antidepressants essentially induce a manic-like state, where a person is more spontaneous and less concerned about consequences. A friend of mine called it “Zolofting.” It’s kind of a “who gives a f*&k” attitude that can feel really good, especially for someone who has always been worried a lot about what other people think or feel about them. But as with all drugs, messing with the neurotransmitter system, however good it might feel, has long-term consequences that are often quite destructive. Some people seem to be able to tolerate them long term, but it’s a very risk way to “feel good,” and of course, does nothing to address why you might have been feeling bad in the first place.
The problem is, nobody has a clue what to test for. What’s SUPPOSED to happen is that a cause is postulated, and things that would be present when that cause exists would be extrapolated, and then we develop a test for those events/conditions. We haven’t even gotten to first base (identifying a cause), mostly because “schizophrenia,” like pretty much all the DSM “diagnoses,” is a very vague concept that could not possibly represent one specific malady, and may not represent any malady at all. So how to you test for something that is defined socially instead of physiologically?
For some folks, “bias” means saying or doing anything that interferes with pursuing their own interests without consideration for the impact on others.
There are any number of celebrities who had bad experiences with psychiatric “help” as well. I wonder how many of them might get on the bandwagon? Stevie Nix is one that immediately comes to mind.
“Discontinuation syndrome” was obviously an intentional euphemism for withdrawal. It was invented to keep a distinction from street drugs, as no one wanted the similarities between the two to be noticed or talked about. Another example of the disingenuousness of the psychiatric industry.
Nothing makes the moral bankruptcy of the psychiatric industry clearer than the violence with which they protest and demean any effort to have a rational, fact-based discussion of their methods and philosophy. If they really knew what they were talking about, why would they have to discredit the critics instead of answering them with their “science?”
I did mean in the USA. I am certain that similar circumstances pertain in most other “western” countries. Our culture seems to depend on the oppression of portions of the population for its full functioning, if we can call it that.
It is important to keep in mind that the first child abuse case was brought by the SPCA on the theory that children should be treated at least as well as dogs. Protection of women from abuse came 100 years later than children. We have always afforded pets more compassion and rights than humans, at least the humans that we have decided don’t deserve to be considered human.
There is nothing in my statements that conflicts with the idea that certain people’s conditions might have a physiological/medical genesis. All I’m saying is that calling these “mental illnesses” obscures the fact that there are multiple possible causes and multiple possible solutions, and that in many cases, there need not be anything physiologically wrong at all. Once we say someone “has depression,” any attempt to understand the real causes, be they physical, psychological, spiritual or social in nature, come to a rapid end. This is particularly true when the system automatically assumes that every single possible divergence from complete satisfaction with the status quo is caused by a “chemical imbalance” or other physiological problem.
There are most definitely physical illnesses that manifest with psychological “symptoms.” It just doesn’t work the other way. As Socrates pointed out, if all men have facial hair, and Bob has facial hair, it doesn’t follow that Bob is a man. The logic flows from known physiological conditions to psychological effects, but not the other way.
The problem resides in trying to come up for a “solution” to something that can not be identified or defined as a single entity. “Mental illness” is a concept, not a disease state with a defined cause. Why would we imagine for a moment that something so nebulous and subjective as “mental illness” could possibly have a unitary cause or solution?
Unfortunately, long-term statistics and models suggest that continuous “treatment” with “antipsychotics” makes any problems with the dopamine system that may theoretically exist into observably greater dysfunction.
True enough. If the facts supported the pro-psychiatry viewpoint, why would they be so bent on suppressing any kind of dissent with these sleazy tactics? The only reason people viciously “attack the messenger” instead of addressing the concerns raised is because they know they have something to hide.
I’m glad this is coming up, and it looks very interesting! I have only one suggestion: let’s see if we can find a way to talk about “people who are suicidal” without lumping them all together and implying there is some “treatment” that is going to “help” all such people. There is a subtle but powerful subtext through most of the titles of the presentations that buys into this idea.
How about “people who are feeling despair” or “people who are wondering if their life continues to be worth living” or something like that? Or “helping people find hope when their lives seem hopeless to them?” Something that makes it feel like “feeling suicidal” is actually a pretty common experience that doesn’t necessarily reflect anything “wrong” with the person having that experience?
I think Leah’s title gets to this best: “The Way Forward: Pathways to Hope, Recovery, and Wellness with Insights From Lived Experience.” Hope, wellness, insights… no mention of ‘suicidal people’ at all.
It is also important to remember that the “differences on brain scans” are AVERAGES, not diagnostic indicators. And you’re right, of course, they could mean anything. But even if some so-called “ADHD” kids do have a different genetic presentation, SO WHAT? Tall people have different genes than short people, red haired people have different genes than blondes or brunettes, men have VASTLY different genetics in the XY chromosome area… genetic differences are the key to species survival!
As for the heart events, this was being discussed way back in the mid 90s in antipsychiatry circles (see the “Ritalin Death” website), though it was massively denied by the mainstream. Now, once again, we find that the protesters were correct and the “professionals” were lying. Anyone see a pattern emerging here?
Yeah, I get that. And you’re right, the title WAS quite misleading to me as well! I kept waiting for the “solutions to poverty” part to come up, but it never did. I just attributed it to the source. As the Buddhists say, misery is caused by the expectation that things will be different than they actually are. (or words to that effect).
And they so often exclude those who drop out instead of viewing them as the “treatment failures” that they should be considered. Even within their own rules, these drugs don’t often do the job, so they change the rules to protect the concept.
I personally thought this was quite enlightening for anyone looking at the gap between what supporters of the DSM approach say and what is really true. I don’t expect an interview with the APA head to get into Marxist analysis, I expect it to report accurately what the APA head has to say. This can be VERY important in laying out a counterattack, as once a person is on record making specific statements, it is a lot easier to counter their position with factual research and descriptions of real events. I don’t see it as supporting the idea of “mental illness” just because MIA interviews someone who believes in it. But maybe that’s just me.
I read the quotes from the pamphlet in the article. It seems to be pretty straightforward, and the criticisms forwarded are generalizations and don’t appear to address any of the specific claims in the pamphlet at all. Saying something is “misleading and inaccurate” without saying what is inaccurate or misleading about it is a pretty lame criticism!
Is there any other field of medicine where people “favor” certain philosophical viewpoints toward the “diagnoses” and “treatments?” Do we vote on whether or not someone has cancer or a broken leg?
You are correct, of course, and I do apologize. Though benzos CAN be drugs of addiction as well, and are sold on the street for that purpose. My point is rather that trying to say Klonapin isn’t a major drug is incorrect. It creates a physiological effect that is more difficult to get off of the longer you take it. AND it is a drug of addiction as well.
It is certainly the ability to force others to accept “treatment” that is the most reprehensible power of psychiatry, especially when they know their ‘disorders” lack all validity. But propaganda and status are other powers that can still be used to enforce the psychiatric worldview, even without the courts’ backing.
No, that’s “anosognosia!” EVERYONE is mentally ill because we SAY they are mentally ill! True insight is giving up on rationality and accepting psychiatry’s nihilistic worldview. At least, that’s THEIR definition of it.
In psychiatry, “insight” means “realizing you’d better go along with the plan or you’ll get punished.” That’s a valuable insight if you’re in their clutches!
Klonopin is plenty powerful. Many people report becoming addicted. It’s a benzo. Sure, there may be worse things, like having a hand cut off is worse than just a finger. But it’s plenty dangerous.
I’m not entirely certain that people are looking for relief from suffering, at least not all or most. I think a lot are looking for UNDERSTANDING and CONNECTION, but they are offered “escape from suffering” as a weak alternative by the psychiatric industry, and told that’s all they can hope for. Understanding is more nebulous, requires more work, and can be scarier, but those who have genuinely experienced understanding from another person after working through some pain know it is far superior to merely escaping. Because the escape offered by the psychiatric industry is not very different than getting drunk to forget one’s pain – once one “sobers up,” the pain remains in place and needs to be avoided yet again. To reconsider that pain from a new perspective can not only ease the pain, it can provide meaning for one’s suffering and pathways to create a better life going forward, something no drug can ever begin to deliver.
I don’t disagree with you on that point. There are certainly diseases and medical situations that cause what has come to be known as “mental illness.” My objection is only the idea that they are “mimicking a mental illness,” because there is no such thing as a “mental illness” to mimic, at least not as defined in the DSM. It is an absolute certainty that anything which is called a “mental illness” COULD be caused by real physiological problems (there are literally hundreds of examples), and one of the greatest harms done by psychiatry is to stop doctors and patients looking for actual causes and allowing the “mental illness diagnosis” stand in place of actual research into causes.
SO in essence, it seems we agree with each other, terminology notwithstanding. I appreciate the feedback.
What are the odds they controlled for psych drug exposure? About zero. Perhaps the article should read, “Exposure to neuroleptic drugs causes reduced links between brain cells?”
I agree they have no idea of the cause, but I highly doubt further study of the brain per se is going to yield any more information. It is their primary error to believe that the brain is the causal factor in these “disorders,” in the same sense that solving a software bug or issue can not be resolved by studying the hardware. The mind runs the brain, not the other way around.
Right! If we even acknowledge a “mimic” of a “psychiatric disorder,” we are allowing that there are non-mimic situations where there is a “real disorder” going on. It’s insidious but very powerful.
It is kind of amazing how they have to include an “explanation” of the third point, without any evidence, and without mentioning the obvious, likely hypothesis that the drugs themselves are increasing the suicide rate.
Lawrence, can you please address the issue of long-term neurological damage that extends beyond the technical withdrawal period from the drug itself? This is not really a controversial issue, at least in the world of substance abuse – it can take a long time for the brain to recover from years of drug-induced altered functioning, and in some cases, there is evidence of permanent damage. Why would this not apply to psychiatric drugs?
Isn’t “precision psychiatry” one of those oxymorons, like “Jumbo shrimp,” “civil war,” or “low-carb beer?” I can’t think of a less “precise” profession – even predicting the weather is more certain!
I agree. It bothers me when they chant “don’t blame the parents, don’t blame the parents!” Sometimes (not always) the parents ARE partly or largely to blame!
I would add that “withdrawal” may not be the proper term for this experience. It is more like “recovery from brain damage.” Most people know that the specific withdrawal period for cocaine, for instance, is pretty short – a matter of hours. But for someone taking cocaine long-term, the recovery period can literally take years. I find it pretty easy to believe that the exact same kind of mechanism would be at play for any psychoactive drug, in fact, I’d be stunned if it were not at play. There is plenty of research regarding neurological up- or down-regulation in the brain when the brain is flooded with/deprived of normal brain chemicals. Recovery from this kind of damage is going to take a hell of a lot longer than it takes the drug to exit the body, and I think it is pretty disingenuous to suggest that people suffering months or a year later are automatically suffering from some psychological problem when it is very possible they are continuing to suffer from brain damage induced by neurochemicals provided by their friendly “medical professionals.”
Gosh, who would have considered such a thought? No it’s not radical, it’s common sense, but as Tim McCarver once quipped, “If it were that common, more people would have it!”
Perhaps they should measure how much their drugs increase kids’ sense of belongingness? Something tells me the drugs will not perform very well with that as the outcome measure.
Speaking Chinese also runs in families. Do you think there may be genetic roots?
They can’t even find genetic vulnerabilities for heart disease or most cancers. There are a few clearly genetic diseases, but even physiological diseases are influenced heavily by environmental impacts. To suggest that “mental health” is analogous is pretty ridiculous.
Might as well call alcohol an antidepressant. People drink when they feel depressed, and then they feel better for a while until it wears off. What’s the diff?
This is the fourth loss of a significant MIA contributor and antipsychiatry activist in the last month or so, and it is hitting me and others very hard. Bonnie in particular always seemed so immutable, so inexorable and so powerfully present, it is hard to imagine her succumbing even to death. Her spirit will continue to be with us as we fight on, but this is a huge loss to us and to the world. RIP, Bonnie, and keep fighting on, wherever you are!
This happened all the time with kids I knew in foster care. They’d give the kids stimulants for “ADHD” and then they got aggressive, so they’d give them an “antipsychotic” to calm them down. Raise the dopamine with one drug, decrease it with the other. Idiocy, but it was done ALL THE TIME. No science going on here!
You mean gathering together everyone who experiences knee pain together and giving all of them the same “treatment” without any further analysis isn’t going to work? Wow, what a pessimist you are!
Though I suppose it “works” if your business is selling pain relievers.
That was my thought, too! If meditation can change attitudes toward distress, doesn’t that toss the “genetic brain disease model” in the garbage bin? But expecting consistency from the psychiatric “thought leaders” is a sure way to get a headache!
Yeah, they should say, “…divergence between commonly accepted pseudoscientic and self-serving ‘explanations’ for depression and the actual experience of those having those labels slapped upon them without any attempt to understand the context of the ‘symptoms.'”
Maybe you can select options: “If you’d just like a prescription, press 1. If you’d like a spurious but scientific-sounding ‘diagnosis,’ press 2. If you’d like to have the context of your ‘symptoms’ specifically invalidated, press 3. If you’d like a psychobabble explanation of why you need to keep taking your drugs forever, press 4. If you’d like someone to actually listen and understand your struggles, hang up and call somewhere else!”
Well said! It is the responsibility of those claiming to “treat the mind” to come up with a coherent definition of the “mind” they are supposedly treating. Those criticizing the approach don’t need to define “mind,” they just need to point out that those claiming to be “treating” it can’t define their terms.
Yeah, kind of like saying, “Broken legs are highly associated with specific blows to the leg region. People who were not struck in the leg were far less likely to have their legs broken. Very high level of certainty on this one!”
Well said! There is no excuse for any “professional” not asking every client about relationships and family history. It seems today that such professionals are the exception rather than the rule.
I don’t disagree with anything you said. I was making the point that I do support individual people in making their own decisions and try not to make generalizations about “psychiatrists” as individual practitioners. There are many subtle points on “effectiveness” of drugs – as I’ve often pointed out, alcohol is a great “antianxiety” agent, but no one would prescribe it as a MEDICAL TREATMENT. It’s just something that makes you feel better temporarily. There are always dangers of ANY psychoactive drug, and I would certainly not recommend Ritalin as a way to make oneself fit into the capitalist mold. My point is only that individual decision making is one issue, but group-wide intentional corruption is something completely different. The first is complex, the second is not really all that complex at all. People do things that bring them money, unless they are motivated by caring first. It’s clear that psychiatry as a profession is motivated by greed and power over individual results.
I would suggest that there are, in fact, many caring individual psychiatrists out there, and I have certainly met some of them. I think there is a distinction to be made between psychiatrists (who vary widely as individuals) and “psychiatry,” which is an institution that has its own objectives and strategies and fears and blind spots. It is the institution that I am criticizing, the APA and its group objectives to promote a biologically-centered viewpoint and a drug-centered approach and the DSM strategy of de-contextualizing people’s suffering and blaming them for their “wrong” reactions to trauma and stress in their lives, and the constant hostility and dismissiveness toward even their own research when it conflicts with their agenda. I also feel it is very appropriate to criticize the corruption coming from the pharmaceutical industry that has informed the above goals and strategies.
I also would never criticize an individual for doing whatever works for them or their families. I have stood by and watched while a friend’s husband got ECT (which didn’t work) and eventually came up with moving to another part of the country as a solution. I’ve known domestic abuse victims who used antidepressants as a means of becoming less worried about their abusers’ feelings and it helped them get away. I know people who feel that they can’t live without Prozac or who feel they’ve benefited from stimulants helping them concentrate better. I have no problem with people doing what works for them. And I have no problem with individuals, professional or not, helping other people. But I do have a big, big problem with an entire profession intentionally lying and manipulating data so that they and their drug company counterparts can increase their income and power, and I make no apologies for doing so.
I like this post. The distinction between trying to “make the bad behaviors go away” and understanding their origins so that a person’s needs can be met in another way is huge! Once we understand the emotions driving behavior, CBT can be a useful technique to practice doing something different. But CBT alone often comes across as minimizing or invalidating the emotional components of behavior. People choose a particular action for a REASON, and without understanding the motivation, changing the behavior in isolation doesn’t work very well, in my experience.
I don’t know, maybe it would be fun to interrupt someone’s tirade and say, “You know I was considered one of ‘those people’ once. Do I seem crazy, dangerous or hopeless to you?” Might toss a monkey wrench in their works.
BUt I also get why you wouldn’t want to go there. People who are on that kind of trip really NEED to believe what they are saying, and even a big dose of “cognitive dissonance” rarely has any effect.
Having spent half my career advocating for foster youth, this article resonates with me. Foster youth are the most disempowered group of citizens in the country, and they need all of our help. The rates of drugging tend to be around 20%, but increase by adolescence to over 50% in most states. Claims of “genetic inheritance” and “chemical imbalance” are particularly offensive and egregious in these cases, as we KNOW the main reason why these youth are suffering, yet somehow they continue to be blamed and “treated” for not being happy with their second- or third-class citizen status in life. Many are groomed for the adult “mental health” system and are told they have no chance of surviving without public assistance/disability payments for life. Yet many also rebel when they are able to escape the system and ditch their “mental patient” identities, acting on impulses and beliefs that have been subdued since they were very young in many cases.
These youth need and deserve all the support we can give them. They are the ultimate “market” for the psych industry and are almost helpless to resist.
Consider supporting your local CASA (Court Appointed Special Advocate) program, or volunteer to become a CASA in your jurisdiction, and you’ll have some direct and substantial influence upon this most undesirable course of events!
Most of them don’t even know the adverse effects of the drugs they personally prescribed. I’d bet that 90% don’t even know there ARE withdrawal effects from Cymbalta. I just figure I have to educate them every time, but avoiding MDs whenever possible is much more effective. I only see them when I have no other choice or need something specific that only they can provide, like antibiotics. Don’t trust them as far as I can toss them.
1 in 4 women are on antidepressants. 1 in 5 women is in an abusive relationship at any given time. What do y’all think the overlap is there? It’s gotta be huge. Has this question ever even been asked?
I’ll go with Oldhead on this one, and say that a MIND is an idea, or a set of ideas and processes, and ideas can’t be “ill.” There are neurological illnesses, which should all be detectable by some physiological means. But it is a mistake to equate neurology with “mind.” No one really knows what “mind” is, and until we do, it is going to do nothing but add confusion to call a mind “ill.”
It is not lack of training, it is the ability to dehumanize the victims that leads to this kind of mass unethical behavior. It works very much similar to a gang rape. What is the likelihood that ALL members of a certain sports team are rapists? Simply not possible. So how does an entire team participate in such an atrocity, as has been documented numerous times? It happens when the victim is sufficiently dehumanized that other group members can treat the victim is a non-human so that normal rules of ethics don’t apply in this situation. Same thing with group torture like Abu Ghraib. And it is psychiatry’s own DSM labeling process that makes this mass dehumanization possible. Those people providing “treatment” have been “trained” to see the “patients” as a subgroup who don’t deserve the same rights as other humans. So, in fact, it is not a lack of training, but a training in the use of dehumanizing terms and beliefs that leads to this result.
Right you are, Sam! Genetic diversity is the core of species survival. Even if it’s proven that genetics, for instance, affect activity levels and that some “ADHD” people have a genetic difference means NOTHING about whether or not “ADHD” is a disease state! Men and women have VASTLY different genetics in the X/Y genes, heck, men are MISSING a whole bunch of DNA that women have, and men certainly act differently overall than women. Are we prepared to call having male sex genes a “disease” based on that fact alone? (Testosterone poisoning, anyone?)
The large associations with individual violence are drug use/abuse and domestic/family/pet violence. “Mental illness” and especially “Schizophrenia” are tiny blips in comparison. But it’s easier to blame than it is to deal with big societal problems like why so many people are using and abusing drugs and why so many feel it is OK to beat up their wives and children and dogs.
I think the larger question, Daniel, is how do you feel about the use of psychedelics IN THE HANDS OF PSYCHIATRISTS as you know they currently practice their brand of “medicine?” Hell, we know that alcohol can be a great antianxiety agent, and has a better “side effect” profile than benzos. But it’s not a MEDICAL INTERVENTION, it’s a way of holding anxiety at bay. That’s the level psychiatry is working at right now: Anxiety BAD. Benzo make anxiety go away. GOOD. Benzo patentable. GOOD. Alcohol not patentable. BAD. WE USE BENZO! There is no sense of mission or analysis deeper than that going on at the practice level, and for those operating on the “theoretical” level, the situation is even worse! “This research disproves our theory. WE MUST BURY IT! This person speaks uncomfortable truths. WE MUST ATTACK THEM! This group opposes us. WE MUST DEMONIZE THEM!” Do you really want people in such positions promoting psychedelic drugs for traumatized people? A profession that systematically denies that traumatic events are even causal factors in their lists of “disorders?” And who can then force psychedelics against their will on anyone they decide is unable to make informed decisions for him/herself?
It is much more than a question of whether there are positive research results. It’s a question of putting trust into an utterly corrupt system of decision making and control.
That’s what I was thinking. What psychiatrist would possibly be remotely qualified to engage in guiding someone through this kind of experience? It seems beyond ludicrous, having known some folks rather intimately who have used this drug. It is shocking that even psychiatry would be so arrogant as to think just giving someone a dose of this and “objectively” watching what happens would be anything but an invitation to disaster.
Wow, you are suing? Let us know how this goes. I think the only real success in undermining the psychiatric worldview and control is to hit them in the pockedbooks and in the public realm of discussion. I am sorry all this crap happened to you, but t would truly be awesome to have national news about the psych professions getting their butts sued for hurting people they are claiming to help.
There has been some amazing work showing that the best way to get people off the street is to, wait for it… provide them with housing!!! Who could have guessed it?
I can’t quite agree with that last statement. While individual psychiatrists may have some concern over their individual clients, it would appear that psychiatry as a profession not only doesn’t care if their clients get better, they actually fear them getting better because it will cost them too many “customers.”
Psychiatry and big pharma have ALWAYS claimed miracle cures. Remember when Benzedrine was all the rage, safe, effective and non-habit forming? When that disaster was finally admitted, we had Valium, which was, wait for it, safe, effective and non-habit forming. Except that it’s one of the most addictive drugs known to man. Later on, we have claims that Prozac and the SSRIs are effective and have virtually no side effects. Well, except for increasing the rate of suicide and the occasional outburst of homicidal rage. Oops! So forgive me if I’m a tad skeptical when a party drug/tranquilizer is suddenly claimed as the miracle cure for everything. As for “rewiring the brain,” that’s a pretty tired analogy that doesn’t really correspond to any reality at all. There are no wires in the brain, and nerve channels are not in any way remotely similar to wires other than the ability to conduct and electrical signal.
It’s important to sift through the rhetoric. EVERY drug is “safe and effective with no side effects” until the patent runs out.
Are you trying to suggest that the DRUGS may make people violent? Well, we can’t have any of THAT kind of testing around! What will happen to our big donors’ bottom lines?
There is also some discussion of how abusive the music industry was to her, and how she had one hour a day to herself and was constantly pressured to produce more and more. So Capitalism has contributed massively to her breakdown. But it’s still all blamed on genetics. Pretty baldfaced BS, but everyone sucks it up.
I just did a little research on Britney Spears’ life. It sounds like she had a very traumatic upbringing, exposed to domestic abuse by her dad, dad was an alcoholic, and of course, her mom most likely meeting her needs through having Britney perform as a kid. There is evidence she most likely experienced domestic abuse herself. Seems she grew up very insecure, for rather obvious reasons, and was easily taken advantage of by others because she was constantly seeking approval. Of course, NONE of this is discussed in the explanation of her “disorders.” It is all blamed on her “condition,” but it is easy to see that the controlling behavior of her family members continues to the present day. Instead of acknowledging the abusive behavior by her parents, they talk about her being the victim of “very bad genetics.”
This shows the destructive nature of the DSM labeling process, even for the rich and famous.
Waste of time. The only measure of whether or not any “therapy” is effective is whether the person receiving it thinks it’s effective. To think that one “therapeutic school” will magically be proven more effective, regardless of the therapist or the client, is simply a fantasy. Therapy is a HUMAN INTERACTION, not a mechanical undertaking that can be quantified and measured out like some weight of ground meat!
It is true. I never saw one kid who ever needed to be restrained during my school years. Even the “special education” kids. It just was never done that I could see. What’s different? We know what’s different. Way too much “treatment” and not enough compassion.
Mostly ignorant, I think. They are authoritarians, and the “experts” told them it was true, so they just accepted it. After all, it happens that way in the movies and on TV, so it must be real, eh?
Amazing how long they can claim that they “haven’t found the right combination” as if that is an inevitable outcome given enough time, instead of admitting that “our drugs have not been helpful to her, and stopping them makes a whole lot of sense under the circumstances.” How many times can you take your car to the mechanic and hear, “We haven’t found just the right ‘treatment’ yet for your engine…” before you fire them?
That’s a great way to put it, Al. We have to be willing to not know and to sit with the person we’re helping and feel their discomfort and pain and despair and not run away from it. Even if we don’t know how to help, knowing that we’re willing to confront the situation with them and NOT try to “make them better” in and of itself is the core of actual helpfulness. And if a possible solution then DOES emerge, both know that it’s a real possibility rather than something you cooked up to make yourself feel better.
I read up a bit on it, too. It sounded like the big objection was that people from the Lower 48 were going to be shipped to Alaska for “treatment.” Seemed like the article was a whitewash. Definitely see some very real concerns about THAT idea!
If you haven’t read about the “Rat Park” experiment, you should. It kind of says all that needs to be said about addiction. Classic experiments have been done where rats in a cage are given a choice between pushing a button for water/food and one for cocaine, and the rats eventually choose the cocaine so often that they die, which is held up as proof that cocaine is “physically addictive” and that the rats have no choice once they’re addicted.
But the Rat Park people put the rats in a healthy rat environment, with dirt to dig in and tubes and wheels and stuff to play with and other rats for company and so on, everything a rat would need to live a happy rat life. And they were given the same choices, and guess what? These rats picked the food and water and left the cocaine alone.
To me, it is total proof that the “physically addicting” theory of drugs is hogwash. People, just like rats, take drugs because they’re in pain and they’re trying to alleviate it. Some of these drugs are legal, some are not, but it doesn’t matter, because if they can’t fix up their environment to meet their needs, they will instead continue to use the substance to numb out their feelings of anxiety and depression. The answer is not more drugs, but an approach to modifying the environment so it is easier for folks to meet their basic needs. We need to set up “human parks” and see how many humans choose drugs over life!
“Remember, there is no shame in being labeled a worthless, helpless, permanently brain-damaged drain on society of whom other people are taught to be irrationally afraid and who will remain on disability for the rest of his/her medically forshortened life, no matter WHAT those other people say!”
Great strategy! This actually comports with my theory on how “ECT” gets people rating it as improving their conditions. After several “treatments”, the patients/victims become more and more likely to say, “Wow, doc, that was GREAT! I feel SO much better, not a HINT of depression any more! What a miracle! Now, can you please unlock that door and get me the hell out of this place?”
And the irony is, they are now starting to prescribe more and more “medication” to stop people drinking. Drugs to stop taking drugs. What could go wrong?
Unfortunately, recreational drugs and psychiatric drugs are very similar in action, and attempts to convert street drugs into psych drugs are a natural progression from the “bad brain” viewpoint. After all, taking cocaine makes you feel better, doesn’t it? So it’s an antidepressant! Maybe a tad addictive, but hey, you have to deal with the side effect, right? They’ve already converted amphetamine sulfate into a “medical drug,” and tried to do so with meth, with a lot less success, luckily. Why not esketamine, or heroin? The difference between taking Xanax and drinking a prescribed amount of alcohol three times a day is essentially zero. The line between drug dealers and the average psychiatrist is a thin one, indeed.
First they’d have to invent a special mallet, and give it a different and technical sounding name, then they’d need a name for the “therapy” that would sound “sciency,” get a patent on both the mallet and the process, and then “mallet therapy” could become a reality.
Well, they based their research on client feedback! No wonder no one pays attention – who cares what the CLIENTS think helps? We’d rather engage in mutual pseudoscientific banter about stuff we don’t understand, rather than actually asking the end user what s/he thinks. Then we might actually have to CHANGE what we do!
“If you were Jello,” seriously??? That is majorly warped.
I’m glad you brought this up, especially regarding the obvious financial advantages the “mental health professionals” display. It seems like quite the slap in the face. I mean, I get someone wanting to have a nice office that doesn’t have paint peeling or sticky spills on the floor or broken blinds, but these opulent offices just scream “I’m making a boatload of money off people like you, and when push comes to shove, that’s what really matters to me.” I think it’s inherently offensive. But I guess if the “professional” really believes their clients deserve less because they are that much less important or valuable, maybe they don’t notice how insensitive and greedy they’re being.
Of course, they don’t really even do laboratory science, either. They do experiments on heterogeneous groups, don’t identify proper outcomes half the time, if they do identify outcomes and they come out negative, they shop around for positive outcomes instead of reporting, and when their own research condemns their process, they ignore it or “explain” it away and keep on doing whatever they already decided they wanted to do. Not very scientific.
It really shows the intense differentiation made by many or perhaps even most “professionals” between themselves (sane people) and their clients (insane people). It is this differentiation that makes it next to impossible for such professionals to be genuinely helpful to their own clients.
I can’t disagree with a word. Anyone who is any good as a counselor/therapist that I’ve ever known is totally opposed to the DSM and the psychiatric worldview. Not all are actively antipschiatry, but they all recognize that the idea of “mental disorders” and “disorders of the brain” are crap.
What I find fascinating is that in the entire article, getting feedback or information from the actual clients is never mentioned once. Perhaps that’s the real reason clinicians can’t get together – they’re aiming as usual at the wrong target.
Maybe we start with asking clients what or whom they find helpful, then find out what those people do that the clients find of value. Nah, too simple and effective…
That is a beautiful post! I can absolutely relate to having to learn that my rage is essential to my survival! And you truly show how destructive idea that you are “disordered” for having your feelings can be. It destroys people’s idea of themselves and keeps them from learning how to direct their righteous indignation for the purpose it is intended.
I was fortunate enough to have such a therapist in my 20s, back before the DSM took hold. It is unfortunately much more difficult to find such a person these days. Almost impossible for some people.
Perhaps it is the word “thought” that bothers me. Not a lot of “thought” involved, unless you mean thinking how you can pull one over on the general populace for financial gain.
“Szazian” is just another way to discredit both Szaz and anyone else who dares to question the fact-free psychiatric dogma on which the entire system rests its ugly head.
I apologize if I seemed to minimize the incredible damage these drugs can do. I find them abominable and the lies about them and the pretense that they are so wonderful and that the “side effects” are someone’s “disorder” reasserting itself incredibly offensive. The point I am making is that the presence or absence of the drugs doesn’t address the bigger issue. I totally agree the drugs are bad news, and it’s my belief that anyone who gets TRUE informed consent about them would be VERY reluctant to use them at all. It is the framing of the problem as “biological” and the promise of FIXING the “imbalance of brain chemicals,” as well as the societal propaganda pushing all the blame for any behavioral or emotional issues that make the ‘status quo’ uncomfortable on the person with the emotions, or worse yet, on their brains, that allows these drugs to be marketed and sold. If that structure is removed, psychiatry is left with, “This might make you feel better temporarily or it might not. It has a bunch of risks and no long-term positive effects. It won’t solve any problem you have, the only thing it might do is temporarily make you feel better, and even that is not a guarantee.” If that is the marketing pitch, they’ll be right down there with the corner drug pusher, which frankly is where the bulk of psychiatrists belong.
The question I ask is this: is psychiatry really a “school of thought?” It purports to be a MEDICAL SCIENCE, with no actual support for that claim. It ignores its own research when it conflicts with the basic dogma of the belief system. People who don’t support those dogma are attacked and/or purged from the group. It seems a lot more like a RELIGION than a school of thought. A school of thought implies a philosophical viewpoint that is open to argumentation and new data. Psychiatry is unwilling to admit that it is promoting a philosophical viewpoint with which others may honestly disagree, and relies instead on having social power to enforce its dogma regardless of the truth. Which really prevents any kind of civil discourse with those who are unwilling to recognize the speculative and frankly dishonest nature of psychiatry as a “medical” field. For that reason, having a discussion about it feels like a big waste of time.
I think perhaps you are confusing these drugs, which people may find useful on occasion, and psychiatry, which comes up with socially-biased “labels” in committees of entitled old (mostly) men and lies consistently to people about the “biological origins” of their “disorders,” despite masses of evidence showing that 1) there are no identifiable physical indications of ANY of their so-called “disorders,” and 2) the “treatments” for these “disorders” are essentially an uncontrolled “experiment” where the experimenters declare success whenever anything good happens and blame any unexpected or undesired result on the client or the “disorder,” and 3) any and all evidence invalidating their “theories” is dismissed with unfounded “explanations” or ad hominem attacks on anyone who dares to challenge their dogmatic “reality.” I’d be happy to make drugs available (with GENUINE informed consent) to those who want them once the lies and excuses and pressures and marketing bullcrap area taken out of the equation.
The problem isn’t the drugs – it’s the lies and the abuse of power that are the real core of psychiatry. And that core is, in fact, totally rotten.
“Therapists should have innate understandings of themselves, life, and the possibility of themselves being completely wrong.”
You said a mouthful there! Success of “therapy” of any type has a lot more to do with the qualities and attitudes of the therapist than what “school” they subscribe to. In my experience, the very best counselors have no commitment to any particular approach, and do instead whatever works for their client. But such therapists are rarer than hen’s teeth!
I suppose if we define a “real leftist” as someone committed to actual empowerment of the masses, then I would agree with you. But there might not be a lot of “real leftists” around. There could certainly be people who are sincere but confused, or who have difficulty overcoming their authoritarian programming. The folks at the school I refer to for the most part really did believe in the model, at least to start with. They just got nervous and started panicking. It takes a lot of courage to really stick to one’s mission in the face of the training and pressure to the contrary. And there are a few people around pretty much any group who are mainly interested in gaining control of the group, and are only faking commitment. One school I helped create was destroyed by such a person.
As to legitimate authority, of course, I’d agree with you 100%. When I talk about authoritarianism, I’m talking about the acceptance of certain people as authorities regardless of legitimacy, and authorities expecting compliance with their demands without question, as well as both authorities and members attacking on those who are willing to question the dogma of the authoritarian group.
Again, I’m not trying to say this is hopeless or that we should give up. I am merely saying that one needs to be constantly vigilant about authoritarian types making their way into such an organization, as well as being vigilant that one’s own subconscious needs for control and safety don’t overshadow the goal of empowerment of the populace.
By all means, we should never stop working toward that goal. We simply need to do it in awareness that AUTHORITARIANISM is a deadly foe that is larger than capitalism itself. Freedom and mutual respect and support are the goals we need to pursue, not a different system with different bosses and different people in powerful and oppressed roles. But I think you agree with me on that point.
And just for the record, I don’t equate efforts to maintain the status quo at all costs, which tends to be the ‘right’ leaning form of authoritarianism, with efforts to force one person or group’s vision of change on society by force, which tends to be the ‘left’ leaning form, in my view. Fascism is fascism, it’s authoritarian for sure, but not all authoritarians lean toward fascism. As you well know, there have been plenty of ‘socialist’ dictatorships and lots of human rights abuses done in the name of “socialism.” My only real point is that ONLY looking to the “right” for authoritarianism fails to take into account the internalized oppression we’ve all experienced which leaves every one of us vulnerable to either kowtow to or engage in authoritarian tactics in the service of what seems to us to be a worthy goal. It is something that must be consciously identified and resisted if we’re going to create a different kind of society.
I think I understand you better at this point. I was simply stating that SOME authoritarianism can be found everywhere, because it is endemic to our society. By no means do I mean to suggest (or did I suggest) that it simply “human nature” – I believe, as I stated, that it is TRAINED into us from birth onwards, both explicitly by parents and churches and educational institutions and so forth, and implicitly by being the only game clearly on display, and by the hostility expressed toward those who refuse to go along with the status quo. It is a challenge to overcome that kind of training for anyone. For instance, in the “dictatorship of the proletariat” concept, the idea is that there is a temporary period during which the new ideas will become held by a majority of the people in the society, allowing this dictatorship to melt away. But during that period, there is an authority in charge of what should be taught and how it should be taught, and those doing the “teaching” ALL grew up with these authoritarian models of education. So it requires real care and attention not to replicate the same forms that we’re comfortable with, as my example of the “democratic school” shows so clearly. It is not enough to just believe in a revolution, we have to pay attention to how it will happen and what will happen afterwards. I don’t think it’s doomed to failure, but I do think these challenges are great, because a lot of the ideas and models we carry are not conscious (kind of like implicit racism or other unconscious biases). I have always found it of the greatest importance to address the dilemma of being a person of privilege and authority trying to help others to find their own freedom. How easy it is to fall into saying, “Do it my way, it works for me.” It is a challenge we must all keep at the top of our awareness any time we’re working for real empowerment of ourselves and others. That’s my experience anyway.
I didn’t say a lot of what you think I said, Richard. I think it’s important to be careful not to read into posts things that are your assumptions. I’d prefer if you’d simply ask for clarification if what I said is confusing.
I believe that a lot of the current population is authoritarian, at both ends of the political spectrum, based solely on my own observation of people’s behavior. I believe this is mostly because of our authoritarian means of educating people and our ubiquitous authoritarian structures which seem to be “the only way” because people don’t SEE another way ever demonstrated to work. I certainly know people who are not authoritarian and believe that non-authoritarian structures can be found and/or created, and have spent a good proportion of my time on Earth working to create that possibility. However, it’s not as easy as it sounds, because we have all had this stuff hammered into us from birth, and people who are NOT authoritarian are punished for following their path. Naturally, authoritarianism occurs on a spectrum, and people are pushed back and forth based on how their efforts are perceived and reacted to by those around them. So encouraging anti-authoritarian thinking is possible and will push people in the direction of seeing things that way. But just as obviously, those who are running the current society are very invested in maintaining the current power dynamics and use authoritarian tactics to maintain them and push people to a more authoritarian view of the world. Revolutions have historically not always led to real change, because the internalized authoritarian underpinnings of the social system were not addressed, and the new rulers step into the authoritarian roles that they and the society they are part of feel comfortable with. This is a big part of why the current “liberals” in the USA have such a hard time supporting antipsychiatry as a movement – they are unable or unwilling to challenge the idea that doctors generally have their best interests at heart and should be trusted to make up rules that the rest of us should follow. That’s authoritarianism, and you see how strong it is when you try to talk to some (not all) “liberals” about the human rights concerns of those labeled “mentally ill,” with whom their stated philosophies should have great solidarity. But they don’t, because it’s not in their own structure of what is “right” and “good” and “wrong” and “bad.” They accept the authority of the doctor without questioning it. I saw a lot of this when working on creating democratic schools, where kids are mainly responsible for making up their own school rules and enforcing them. Parents and teachers SAID they believed in these principles, but when the kids’ standardized test scores started to come into play, or the District started complaining about the vagueness of the curriculum, they started getting unconsciously very nervous and bit by bit re-instituted authoritarian structures that were opposed to the mission, because they really weren’t quite comfortable themselves trusting kids to wield all that power themselves, much as they wanted to believe that they backed the mission 100%.
The world is not a black and white place. I can certainly go into examples from our current world where people on the “left” engage in authoritarian behavior and don’t recognize it as such. Examples on the “right” are perhaps more obvious and easy to identify, but the idea that all authoritarians are right-leaning politically is just plain not borne out by the facts. There are also people who identify as “conservative” who are actually quite anti-authoritarian. We need to become more aware of this if we really want to change the way we’re doing business. Because in the end, “society” exists within the people who create and participate in it, and if we want to create a new society, we have to understand our internalized oppression and deal with it, or else we will perpetrate it in our new society as well. As the Who sagely suggested, we want to avoid a “Meet the new boss, same as the old boss” situation. It is not enough to change the external structures of society. We have to change our own internalized structures, too. And that’s a lot of hard work that few are ready to take on, in my experience. That may seem jaded, and maybe it is, but it doesn’t mean I don’t think it can be done. I am saying that, as discouraging as it sounds, this reality MUST be dealt with, and pretending that it doesn’t exist will doom further revolutionary efforts to failure or limited success. We do ourselves no favors by ignoring this particular set of facts about human behavior.
The trick is, they portray anyone who actually gets caught as a “bad apple” and an outlier and assure everyone that they are HORRIFIED that any doctor would act this way, and THEY certainly don’t ever do anything like that! It is a great way to distract attention from any deeper investigation or analysis.
NA might not be a bad idea, I don’t know. It seems that familiarity with dealing with withdrawal might be valuable. I knew a former heroin addict who took SSRIs for a time, and she had bad withdrawals. She said she felt lucky she’d had to withdraw from heroin, because otherwise, she would not have understood what was happening or how to deal with it. Of course, the doctors never bothered to tell her that she might experience withdrawal.
A message from Sharon Crestinger, who has been an MIA poster in the past:
I am thinking of Julie Greene today and am very sad for her transition from this dimension. I have many comrades and friends, but few contemporaries in the world of survivor and abolitionist essayists. Julie was usually the first one I could name. This was the context of our relationship.
Writing was never a problem for Julie. She wrote and wrote, every day. It’s beyond an outrage that she was murdered by psychiatry at 62 with so much left to say. And, I am glad she said so much while she was here. Julie got discouraged and frustrated sometimes that her work didn’t find a wider audience, but she never gave up. I greatly admired how she kept going through the discrimination, marginalization, health problems, and everything else she faced as a survivor. She believed her writing and her activism made a difference and that if she and others just kept going, abolition would be a real possibility one day. Julie believed the work of abolition would eventually succeed in a very real and material way I greatly wish I could share.
Julie was my best editor. The way she lived her life inspired me.
I see a lot a grief for the end of Julie’s life. I’m trying hard to be outraged, but I am so sad and tired.
I wish more people were outraged. I wish more people used the words murder and genocide to mark our passings.
Safe travels, comrade. I’m so sorry you won’t see your writings elevated to the place of importance they will eventually occupy in our history.
Your point about the “hostile takeover” is very well taken. There appeared to be little in the way of hostility – it was more of a merger made in the interests of monopolizing the market. Both sides agreed from the start, and both sides benefited massively from the collaboration. The only hostility was toward any whistle-blower who tried to point out what was really going on.
Of course, he’s dangerous! We can’t be helping people CURE themselves! Then we’d have to find more clients, and some of them might figure out that we have no actual idea what we’re doing!
You seem to be coming from the assumption that all people with the “ADHD” label have the same problem or need the same kind of help. “ADHD” is just a name for a certain set of behaviors that have been identified as problematic. There are all kinds of reasons why people act that way, and hence all kinds of different things that might help different people. It makes total sense that some “ADHD” labeled people would do better with meditation and some would not, because they’re all different. Acting in a certain way doesn’t make people actually similar – it’s just a surface manifestation. Unless you know why it’s happening, you can’t say they are similar at all.
Besides which, some people who act in ways that are called “ADHD” don’t believe they have any problem, just because other people have a problem with their behavior. And I tend to agree with them.
I’m so glad you said that! Science is MUCH better at disproving things than proving them. Scientific proof really consists of vigorous attempts at DISPROVING a hypothesis failing over an extended period of time. A scientific finding that can’t be replicated isn’t scientifically true any longer, but of course, psychiatry does not hold itself to such standards.
I am so sorry to hear of this! I only wish it were some anomaly, but unfortunately, she is far from alone. I am glad you guys are trying to make some sense of this by warning others of the dangers.
Ditching the DSM should be on the list. The DSM a highly trauma-misinformed or trauma-denying or trauma-delegitimizing document, and to attempt to provide “trauma-informed care” while working in a DSM framework is utterly impossible to accomplish. Those who really do effective trauma work either ignore the DSM entirely or use it for insurance billing. It has no place in actual therapeutic intervention for trauma survivors.
I think what bugs me about this is that it begs the very important question of why there would be debate in the first place. I bet you can’t find 8 or even 4 different audience critiques over clinical practice guidelines for heart attacks or broken limbs. Sure, there will be different opinions on particular approaches taken, and on the possible conflicts of interest with drug companies and others which plague the entire medical profession, but no one will be arguing that heart attacks don’t really happen or that it is a medicalization of a normal human variation. The main reason there are debates of this nature is specifically BECAUSE there is no scientific basis on which these “diagnoses” are formed. So yes, it is a social document, for sure, but one that has little to nothing to do with science and a lot to do with economics and sociology.
The problem with the label “PPD” is that it implies something you HAVE rather than something that is happening to you as the result of complex circumstances. Anyone who has had a child knows there are 50 reasons why you might be feeling depressed after the birth of a child. To mention one that never gets mentioned, domestic abuse often starts or escalates immediately after childbirth, and DV is hardly a rare occurrence. How many cases of emerging domestic abuse are papered over by the term “PPD?”
I know I’m preaching to the choir here, and we are not in disagreement, but I wanted to make it clear from my viewpoint why the term PPD is particularly offensive to me.
Anecdotal evidence can be useful, but these studies are controlled and more intentionally screen out “false positives” and “false negatives.” The placebo effect is a HUGE part of why some people find their antidepressants effective. There are also many who find them effective to start with and then the effectiveness fades over time. There are also many who start on ADs and then have trouble coming off due to withdrawal effects, and many of these are told that this is their “depression coming back” and proof that the ADs are “working.” And of course, there are some who derive actual benefit from them in terms of feeling better, however that may be defined.
Talking about understanding the “nuances of psychiatric care” is likely to be considered pretty insulting in this particular community, as most of the posters have been exposed to those “nuances” personally and can tell you a thing or two about just how “nuanced” the approach was in their particular case. I get that you have found ADs helpful for you or your clients, but it should be clear very quickly from reading these posts that this is NOT the case for everyone, and I think it would be wise to listen a little more to what people have to say about their own experiences before leaping to the conclusions that they “don’t understand” what psychiatric care is all about.
BTW, have you read Anatomy of an Epidemic yet? You really should read it. It is the basis for this entire site and community, and might open your eyes a bit to what people here are protesting. Hint: the use of medication is not the main issue.
I guess some kids must not be “tough enough” to deal with the abuse and need to be diagnosed because their brains just aren’t up to the task of being forcibly separated from their families and kept in overcrowded little rooms or cages without knowing if or when they’ll ever be released. I guess the “mentally healthy” ones either lapse into total apathy or “look on the bright side” because “they control their own narrative.”
Exactly! “Enforced meditation” is an oxymoron. And only someone who doesn’t really understand it will try to force it on another, including forcing them to do it “the right way.”
The idea of common sense suggests that a person with little to no education should be able to see the truth in it intuitively. I truly believe this is the case when it comes to understanding human beings and what we need from each other. Too much training, as you say, creates more and more confusion, because they’re making things more complicated than they really are. And then we get weird studies showing that “racism and oppression increase mental illness symptoms.” Gosh, who knew? It really isn’t that complicated, though it requires courage and willingness to experience intense feelings to fully understand, and that’s where a lot of “professionals” fail.
All I can say is, wow, what a powerful post! Thanks for sharing your story. Your son sounds like a very special person, the kind of person more kids need to meet when they are young!
Though Oldhead may disagree with you, I do not. While psychiatry as a “profession” may not be a legitimate “service” that actually intends to meet anyone’s needs but their own need for money and power, most people who seek out psychiatry DO have a need of some sort that our society is not meeting. While there is no real hope for reforming psychiatry, as its intentions are not actually to help (though individuals within the system may have that intention), there are people who need real support and caring which our society fails to provide (or at times actively opposes). We need a plan to help such folks (which let’s be honest has included most of us at one time or another), and I do think that having such a plan will make it easier to get rid of psychiatry, as it will remove one excuse/justification for psychiatry’s existence. Naturally, the psychiatric hierarchy will attack any such attempt with vigor, but that is to be expected, as they will see their gravy train being derailed. So we’re not talking of an “alternative to psychiatry,” but a viable way to help folks who are suffering from the oppression of our patriarchal, authoritarian and capitalistic greed-and-power based system of social control.
Do you know of any evidence that any of these “disorders” are physical problems? I don’t. For sure, physiology can be involved, including things like sleep, diet, exercise, drug intake, physical pain, etc. And there ARE physiological conditions that can cause mental/emotional effects (like Lyme Disease). But so far as I know, there is no proof that any “mental illness” is consistently CAUSED by a physiological problem. Remember that these entities are defined by committees voting, not by any kind of scientific process. How would they even know the cause if they are defined by a list of behaviors and feelings?
Right, they’re just effective for something different than what we assume they intend. That’s where people get confused. They think that the goal is to make people better, when it’s actually to make themselves rich.
“How do you FEEL about being $10,000 in debt and being unable to pay for food and rent? I know you can’t control your hunger or being evicted, but what can you focus on that you DO control?”
I have found the same. You can’t fully trust someone until they’ve seen you let loose with your most difficult feelings and behavior and find they still want to be around you. There is no intimacy without vulnerability, but we’re taught all the time (which actually starts making it true) that sharing our true selves is foolish and dangerous and we’d better keep those masks on, or else!
I personally found school particularly awful in this way. Keeping one’s own integrity in place in a standard school environment is next to impossible for most kids.
And our society as a whole makes it even harder, as even those women with no trauma history are taught that their value lies in sexual attractiveness and acceptability of appearance to others. But naturally, this kind of issue does not appear to carry any weight with the paternalistic psychiatric profession, which seems myopically committed to blaming the victim and letting social institutions off the hook.
Yeah, surprising outcome, isn’t it? Who could have guessed that dehumanizing conditions caused people emotional distress and upset? Sure glad we have Scientists to figure out these difficult questions for us!
The reason it seems arbitrary is because it IS arbitrary. The research on “antidepressants” rarely extends beyond 8 weeks. No one knows how long one would continue to “benefit” from taking these drugs. Or if a particular person would benefit at all. Or actually what “benefit” really means in this case.
I heard an almost exact replica of your description from a coworker who was taking Zoloft for migraine headaches, not “depression.” She was shocked with how “reasonable” the idea of suicide seemed to her, just a casual thought, like, “I could go to the store. I could kill myself.” I do think the “positive effect” of SSRIs is a lessening of empathic connection to others. For some people, this will feel like a relief. For others, it will make things seem reasonable that would have seemed outrageous before. Including suicide or murder in some cases.
Commenting as moderator: Just so you know, I will never moderate you for including accurate descriptions of your experience, no matter how ugly it was. Moderation is only for things that attack or distract, not for things that are true but uncomfortable. Sharing the true but uncomfortable is a lot of what this site is all about!
I think you hit it on the head. “Mentally healthy” in these circles seems to mean not experiencing any strong emotion of any type. Like Stepford Wives or Invasion of the Body Snatchers. “Once you do the transformation, you’ll understand.” If those pea pods from Invasion of the Body Snatchers really existed, the psychiatric profession would be very excited about them.
Yeah, at least a demon is an external agent that you can get rid of, not something that is embedded in your faulty DNA. I’d go for demon exorcism before psychiatric labels and drugs!
Wish they’d be a little more definitive in their conclusions: “The use of ADM for adolescent depressive symptoms is not supported, as the risks far outweigh the ostensible benefits.” Or “Doctors should not use ADM as a treatment modality for children or adolescents having depressive symptoms.”
Of course, the idea of “treating” depression is problematic in itself.
Of course, it’s impossible to really define “relapse” when you haven’t bothered to objectively define what the “illness” is in the first place. Not to mention the huge number of “relapses” that are actually withdrawal syndromes.
““Partnership-based relationships seem to promote personal recovery more than traditional expert–patient relationships. Our findings also indicate that mental health services need to be organized, more individually tailored, and “bottom-up,” starting with the needs, preferences, and goals of service users.”
This is a very euphemistic way of saying that seeing a doctor is not likely to be helpful, and that services that ARE actually helpful are ones that start from the client’s needs and preferences. Is this news to anyone? But good for them for making it explicit.
I had not thought of that, but it makes complete sense that they’d want to subsume sexual assaults under “PTSD” so that it can be palmed off as combat trauma or something other than what it is. When will we learn?
That was my experience as well. I remember being a safety patrol and having to keep the kids outside the building when it was 20 degrees out while the teachers walked around inside drinking coffee in their comfy sweaters. I think that was the first time it really struck me clearly just how systematically abusive the system was.
Parkinsons is a malfunction of the dopamine system. Antipsychotics mess with the dopamine system. Most “bipolar”-diagnosed people are put on antipsychotics. The first line of inquiry should be regarding the impact of antipsychotics. Occam’s Razor.
Well, ugh! But in addition, what does he think the chemicals in the brain are made from? Food, obviously. Even if one fully embraces the “chemical imbalance” myth (which even psychiatrists are now finally backing away from), it would still make sense that nutrition would be a viable intervention.
I wonder how much money he gets from Big Pharma every year? Sounds more like a drug salesman than a doctor.
That story is truly disgusting. It reminds me that a century plus of “progressive educational reform” has had little real effect on the authoritarian basis for schools. Lipstick on a pig, I’m afraid.
And I’d probably be much more interested in talking to one who did than one who simply believed in the “status quo” mythology.
It is my understanding that traditional healers are part and parcel of psychiatric care in Brazil, and they do, in fact, come in and deal with spirits. I also know of a case in Texas, I believe, where a spiritual healer came over from Mexico and cured a person deemed “severely treatment resistant” by the doctors.
Compared to “standard treatment,” I’d take spirit dispossession any day of the week.
I would suggest that it’s not possible to be “misdiagnosed” and/or “overmedicated” when there is no objective means to determine a proper “diagnosis” nor what an effective level of “medication” actually would look like. What is the proper dose of exorcism for casting out demons? Though casting out demons is probably a more effective approach…
The authors’ experience is not in the least bit surprising, and they properly identify the privilege and power of the academic elite who don’t want their authority challenged. I would have liked to hear more of a connection made between that power and the money flowing to institutions from psychiatry, from equipment makers, and from the pharmaceutical industry. Academia has been largely corrupted when the door was opened to big corporations essentially buying research that promotes their product, including the right to not publish research which is critical. This ethos permeates the entire academic world (not just in psychiatry) to the extent that it is almost invisible to those who swim in that particular water. We don’t bite the hand that feeds us, especially when the owner of the hand can now bite back so painfully. We have to get big corporations disconnected from academic research!
The term “social psychiatry” appears to me to be an oxymoron. It fails to recognize the corrupt nature of the current biomedical model and suggests that it is feasible to “integrate” this model with more social/psychological views of emotional distress. This is in my view impossible, because the biomedical model is driven by profits and the interests of the APA to control the narrative, and is not in any way directed toward “health,” even in the metaphorical sense. It is directed toward profit and control, and as such, can’t be integrated into anything rationally focused on improving people’s lives. If you want a socially responsible and flexible approach to people’s emotional well being, don’t bother with the current model. You’d need to start over from scratch.
If someone were NOT a therapist, just a friend or colleague, do you believe that that person might listen to someone else’s experience in a non-exploitative way? And that such listening could be helpful to the person telling their story? Is it possible that those “on the barricades” might tell each other stories during lulls in the fighting, and that they might benefit from sharing their stories with each other?
If I really wanted to reform schools to improve what they metaphorically and euphemistically refer to as the children’s “mental health,” they could start by reforming the authoritarian nature of the student-teacher relationship and give the students more control and some genuine recourse when they have been wronged by the staff or other students. There are any number of “democratic schools” around the country and the world, starting with Summerhill way back in the early 1900s. At Summerhill, students got to choose what classes they attended, including not attending any class at all. And yet the students chose to attend classes most of the time and would ask kids who were not serious about studying to leave. They made their own rules and had their own justice system for kids AND adults who might have transgressed the school’s agreed laws. The students and staff all got one vote at the meetings, and staff were frequently overruled in their suggestions. This is the kind of approach that is needed if we want our students to be “mentally healthy” – an environment where they are trusted, where they have responsibility and control, where they are able to protect themselves from abusive or coercive behavior of others, where adults are there to help the students pursue their own goals instead of forcing the students to pursue the adults’ goals. Most adults are horrified by such an arrangement and believe that students will never learn anything unless they are forced and coerced and punished into compliance. This is because our culture hates and disrespects children, and most of adult “mental illness” starts from the disrespect and mistreatment of children as they grow up.
It is laughable in my view for schools to talk about improving students’ “mental health” when the reality is that schools do a huge amount of mental/emotional damage to our kids that many never recover from.
You seem to automatically equate healing with pity. Pity does not heal. Nor does healing remove the need for justice. In fact, justice is often critical to healing occurring, as Alex relates in his post. There is no reason why healing and justice can’t both occur together.
I agree with you. The idea that any one intervention will help in ALL cases of “depression” or “ADHD” or whatever label psychiatry wants to toss out is the central problem. There are real, physiological problems that can affect mood and behavior, and they ought to be identified and dealt with through testing and smart interventions. I only protest when someone suggests that ALL such issues can be handled by nutrition or any other specific intervention. Everyone is different, and how they feel is a very sketchy guide for intervention. Good research and exploration is the key to finding out what is actually needed, instead of assuming that someone feeling depressed or anxious is enough information to know what to do.
Hear, hear! Unfortunately, a degree and a license is not even close to a guarantee that a person has the ability to be a healing presence in someone else’s life. We need to select our healers very carefully!
I can’t say that, and I didn’t say that. I’m saying that no doctor can tell you that your depressed moods and experiences are due to genetics, nor can they say in general (and this is more important) that depression is always or usually due to such genetics, because they don’t know that. They’d be lying to you if they claimed that they did. YOU can make your own observations and believe as you see fit, and I totally support your right to do that for your own situation. It’s when one person starts telling another what THEY should believe that things become dangerous, especially when the person (like a doctor) has a special societal role of translating what is known scientifically for lay people. For a doctor to claim that you or anyone else is suffering from a “genetic predisposition” to depression when they have no way to know if this is true or not is not only dishonest, it should be considered malpractice. Whereas your own assessment of your own situation harms no one and hopefully helps you get a better grasp on how to help yourself to move to a better place. That’s the big difference.
Hey, I have never said that I “rule out” biology! I’ve always agreed that there are real biological problems that cause problems with moods and behavior. (One such problem is the adverse effects of drugs one is taking, for instance). What I have said and continue to say is that the fact that one FEELS a certain way or ACTS a certain way does not say ANYTHING about why they feel or act that way, and to suggest that simply because someone feels depressed it means they have a problem with their brains is absolutely ridiculous. It’s very much like a person having a pain in their leg and being diagnosed with “leg pain disorder” and to “treat” it by giving drugs to dull the sensation of pain. There could be 50 reasons why a person’s leg is hurting. Let’s suppose they were hit by a car, or stung by a bee, or have a piece of shrapnel in their leg. Is the pain in the leg the problem? Or is it information that leads us to investigate what is going on?
I don’t know why it seems to be so hard for you to see this distinction. No one is denying that physical conditions can cause changes in mood or behavior. What we’re objecting to is the idea that ALL changes in mood are behavior are ALL caused by physical conditions, especially when there is absolutely NO physiological finding to support such a ridiculous assertion.
If you want to believe that you have a genetic condition, you’re welcome to believe that. But there is no scientific evidence showing that there is any genetic basis for depression, and assuming or implying that everyone else who is depressed has a genetic or biological problem is going to be viewed as a problem by most of the people who post here.
Why “reduce” coercive practices, since they are seen as human rights violations? Why not eliminate them? In fact, why call them “coercive practices?” Why not entitle this “Eliminating human rights violations from any human services agency or practice?”
I actually do think that words define our reality. For instance, if a person is kidnapped and threatened with death, and as a result has moments of intense anxiety that this might happen again, do they have an “anxiety disorder?” Or are they responding pretty normally to a violent and terrifying experience?
I’d say it matters a lot to the victim whether you tell them that their response is a normal reaction or a “disorder” that needs to be “treated.” Having worked with a lot of traumatized people in my career, I’d say that it makes a HUGE difference to have a person think of their reaction as an understandable response to a difficult or impossible situation. The more I was able to have the person understand why they reacted the way they did, the easier it was for them to recognize that the present moment was different and that perhaps a different response in the present is a possible option. Whereas telling someone that they “have a disorder” tells them they SHOULD have reacted differently to the situation and that the fact they are upset about it is a personal failing that needs to be fixed.
Words do matter. A lot. Especially words about who you are and what your behavior and feelings mean.
The clinical guidelines do need to be reconsidered, starting with, “Depression will no longer be diagnosed as a disorder.” The rest will be a lot easier once they get that part over with.
Dang, these guys are really making things complex!
What’s wrong with mind-body dualism, anyway? Why would that philosophical position be outdated? I’d say the majority of the world’s cultures see the spirit and the body as being separate entities that interact with each other. This viewpoint could also have explanatory value if it is not dismissed out of hand. Without knowing what “the mind” really is, how can it be considered “disproven”?
What needs to change is demonstrated in the article – the masquerading of philosophy (such as ethics, epistemology, etc.) as scientific inquiry. Asserting materialistic philosophy as established “truth” does not do science any favors. It’s best to acknowledge when the unknown is unknown, instead of calling a viewpoint “outdated” because it isn’t currently fashionable.
It appears to me that most DBT practitioners don’t have the first clue about “mindfulness.” The whole thing comes across as highly authoritarian, which is totally counter to mindfulness. You can’t force someone to be “mindful.”
This is true, of course. Medical care is the third leading cause of death in the USA. But I consider it even more egregious when the “conditions” being “treated” aren’t even objectively definable, and actually represent social assumptions and biases rather than medical conditions. It’s bad enough we have to trust doctors to treat actual illnesses. I sure don’t want them “treating” my emotions and thoughts!
Let’s get rid of the “mental health” language here!
How about: “Survivors’ reality is badly messed with when people don’t believe them.”
Or: “Survivors of sexual abuse find it invalidating, infuriating, and depressing when people pretend that what happened to them wasn’t real.”
Or: “Denying the reality of sexual abuse survivors is another form of abuse.”
It doesn’t “affect the mental health” of abuse survivors. It attacks them directly and undermines their safety and sense of reality, and it does so intentionally. It is normal to be pissed and confused and self-blaming after someone abuses you, and even more so when those entrusted to protect you protect your abusers instead.
How would we react if our doctor told us, “Well, I can’t say for certain what’s wrong, but we think you have a little tiredness disorder, plus a rashy skin disorder and an insomnia disorder plus a headache disorder and a right leg numbness disorder. We have a drug for each of those conditions, but it won’t cure them. It might keep the symptoms under control, but the drugs will make you gain weight and possibly raise your risk of early death through heart disease and/or diabetes. And we still don’t really know what’s causing all of this.”
I think we’d all realize we were visiting a charlatan.
The burden of proof is always on the person supporting the hypothesis. So one can say a hypothesis can’t ever be proven absolutely, because there is always the possibility of new data having to be incorporated into a system. Even Newtonian Mechanics, the ultimate in a set of certain laws of the universe, had to be modified eventually due to relativity and quantum mechanics.
But science is actually very capable of disproving things. All that’s needed is for the theory to predict something that doesn’t appear to be true in reality. For instance, if there is a claim that “low serotonin causes depression,” it would follow at a minimum that all people who are seriously depressed will have low levels of serotonin compared to normal. That isn’t sufficient to prove it, because of course low serotonin could be an effect rather than a cause, or simply a co-occuring phenomenon that has no relationship to depression. But if depressed people DON’T have lower serotonin on the average than non-depressed people, the theory is shown to be false, because the results conflict with the hypothesis. And in fact, this is the case. People who are depressed don’t always have low levels of serotonin, and people with low levels of serotonin aren’t always depressed. Moreover, increasing serotonin levels doesn’t consistently improve depression, and many “antidepressants” don’t even attack the serotonin system.
So yes, the theory of low serotonin causing depression has been convincingly disproven. We know it is not true. It isn’t just a lack of data – the data show that that hypothesis does not predict realty, and is therefore false. Similar arguments can be shown for the high dopamine theory of psychosis, and the low dopamine theory of ADHD. The idea that “mental illnesses” are caused by “chemical imbalances” can’t entirely be disproven, but in every case where a concrete hypothesis has been put forward, it has been disproven.
I agree with you. I’m not sure whether I was responding to you or just to the topic in general. I think it’s important not to generalize about how to handle specific manifestations as if they all require the same handling. I actually think that point is quite consistent with yours, as the nature and meaning of voice hearing could also be very different depending on the person in question.
It’s not “controversial” to rely on secondary outcomes, it’s a violation of basic scientific principles and any study relying on secondary outcomes should never be published. So much for “peer review!” And even their sketchy “Secondary outcomes” did not support their conclusions.
I tend to agree. There are other forces not obvious to the doctor-patient relationship that act to make it more difficult to avoid psychiatric “treatment” even in the absence of overt force. For instance, doctors are pressured from insurance companies and their own organizations, as are counselors and therapists, potential patients are pressured by friends, family, workplace, schools put pressure on parents to psychiatrically “treat” their kids, the news media makes it seem like people are foolish for not “taking their meds” as prescribed, movies and TV shows dramatize again and again how those who “don’t take their meds” deteriorate and become dangerous, and yet are magically fixed when they are back “on their meds.” Maybe it’s not “force” but “social coercion,” but there are a lot of people on these drugs against their own better judgement, or lacking any kind of informed consent, who were not ordered by the courts to take them. Lying to people can be a form of coercion if the lies create fear that the person will be damaged or do something dangerous if they don’t comply with the doctor’s “suggestions.”
Apparently we’re all supposed to be mildly bored to mildly engaged with everything. No strong emotions are “normal” per the DSM. Sounds like Invasion of the Body Snatchers would be the psychiatric ideal.
And maybe the answer is, “It all depends on the needs of the person hearing the voices.” Maybe there is no “correct way” to handle voice hearing, because it’s an individual phenomenon and not something we can generalize about.
It seems this is where we disagree. If I want to challenge someone regarding psychiatry, it’s not the time pr place to speak out against Scientology, because I see it playing into the hands of the person trying to avoid the question.
Now if a person GENUINELY thinks that all antpsychiatry activity is started or supported by Scientologists, that’s an opportunity for education. Very different in my mind from a blatant effort to intentionally deflect attention away from a critique of psychiatry by implying that anyone taking such a stance must be irrational and unscientific.
Anyway, as I said, we can respectfully disagree on this point. I don’t see much point in continuing the discussion, as we’ve both made our positions and arguments clear. People can consider either one and do what works for them.
Another clever approach was suggested by another poster: “Actually, I’m a Buddhist. What about you? Now that we’re done with talking about religion, let’s get back to talking about psychiatry.”
Precisely. They are only threatened by those who question their basic premises, because they know that “the emperor has no clothes” but they don’t want anyone else to notice it. If there were a mindless and dangerous cult that promoted their product, they’d be four square behind it. Oh, wait… there already is one…
BTW, do you really think that most of the psychiatric profession is asking protesters about Scientology because they are concerned it is a “dangerous cult” and don’t want to interact with it? Or do you think they
are using a preexisting social reality/fear to manipulate people into thinking that anyone who opposes psychiatry is only acting out of the dogmatic insistence of Scientology’s leadership? I personally doubt very much that any psychiatrist actually has such a concern or would be in the slightest degree reassured if you told them you were not. It seems to me that the goal is to tarnish all resistance with the brush of irrationality, and my preferred response is not to allow that goal to be put forward unchallenged. Because people are easily manipulated by innuendo.
That’s my position as well. Social control should be named what it is. It’s not “treatment” of “mental health issues.” It’s an attempt to control “deviant” or “undesirable” behavior from the point of view of the status quo. Naturally, it’s a very slippery slope when we start reframing “He’s doing something that annoys his neighbors and should be stopped” as “He’s got a ‘mental disease’ MAKING him do something annoying and heneeds to be ‘treated.'” Again, what is “deviant” is defined socially, not medically, and it’s a pretty big scam to pretend otherwise.
I am never arguing for any kind of “broken brain” theory. I am saying that there ARE brain problems, which are handled by neurology or some other actual medical specialty. I was trying to explain within Rassel’s context of materialism why “mental illness” still does not make sense as a medical problem. I’m not a materialist by any stretch of the imagination!
Well, that could work just fine, but it still leaves you potentially vulnerable to someone changing the topic to how bad Scientologists are or how “most” opponents “are Scientologists” even if you are not. It is an attempt at distraction, whether they are accusing you of being a Scientologist or a Zoroastrianist or a Communist or a Nazi. I think the best approach is not to take the bait. But I know we will respectfully disagree on this point.
I don’t think anyone here doesn’t believe that a brain can malfunction. I don’t agree that a brain malfunction is the only thing that can be behind someone being violent or depressed or whatever. It sounds like you believe the brain creates the mind and therefore HAS to be responsible for any actions that occur. I don’t see it that way – I see the mind as being the mechanism for controlling the brain, at the minimum an “emergent property” that extends beyond the mechanism that created it. I also hold the strong possibility that we are spiritual entities that are responsible for our bodies, though it is difficult to prove or disprove this kind of premise. In any case, it is pretty clear from direct observation that the mind can and does control most aspects of the brain. Even the revered PET scans show that when someone simply THINKS something different, the PET scan changes. For instance, someone can think of a sad event and their brain shifts gears into a “sad” profile, and shifts back when they think of something that isn’t sad. This belies the idea that feelings “just happen” because our brains are bad.
Even if we accept the premise that it’s all in the physical universe, there is still the “computer model” to consider. While I don’t believe that the human brain is much like a computer really, it is fair to suggest that we have “hardware” and “software” operating, in the sense that there are physiological structures that are used while thinking and making decisions and emoting, but there are also “programs” in the sense that we make MEANING out of things and we make decisions based on values that are programmed in starting early in life.
Using this metaphor/analogy, what if the problem is not in the hardware, but in the programming? You can’t solve a programming problem by replacing memory chips or rerouting the power supply. The program is contained within the chips, and really consists only of on/off switches. It is only because the programmer assigns MEANING to the switches that the computer works at all. It seems to me that what is wrong with the “mind” most of the time is faulty programming, or perhaps more accurately programming that doesn’t create the desired result from a social perspective. Of course, then we get into the question of who gets to decide what the “desired result” is, which is a whole different question. However, it is likely that those who are violent have, in most cases, grown up with and/or developed value systems in which murdering people is not wrong or is justifiable under certain circumstances. This is something that can not ever be improved by physiological intervention.
So the catch-all of “mental illness” does not necessarily imply any kind of problem in physiology, even if you take a strict materialist point of view, any more than a computer malfunction has to be a function of the hardware. The vast majority of computer problems are programming issues, and the same analogy almost certainly holds true for “mental illnesses” as identified by the committee-driven DSM.
Actually, even allowing the discussion of whether antipsychiatry and Scientology are the same or not still gives in to the tactic. When we were at the APA protest in Philadelphia, a psychiatrist said she’d talk with us, but wanted to know if we were Scientologists. We shouted her down, saying, “Oh, no, you’re not pulling that crap! We’re here to talk about psychiatry, not religion!” And various statements of that order. The topic of Scientology vs. antipsychiatry was never breached, because she understood we were not willing to play that game with her.
Oh, I thought you were going with, “We’re not the Judean People’s Front! We’re the People’s Front of Judea! Our greatest enemies are the Judean People’s Front.” “Well, except for the Romans…”
Psychiatry claims to be helping with “mental health problems.” We are seeing a VAST increase in the use of psychiatric “treatments” (especially drugs), and yet we’re seeing a steady worsening of the “mental health problems” that these “treatments” are supposed to solve. Isn’t it psychiatry’s job to address these “worsening conditions of society” through their helpful interventions? Doesn’t seem to be working too well, does it?
And this trend is seen to happen again and again in countries where drugs and the “treatments” are introduced – more and more people on disability and unable to participate in normal social interactions and expectations. What exactly is psychiatry claiming to be doing about these societal problems? It seems at best to be drugging the brains and bodies of those harmed by these societal woes, and at the same time denying (through their claims of physical causality) that there is any connection whatsoever between the suffering experienced and the social issues that you have identified. In all likelihood, psychiatry as practiced is not helping, but in fact making those conditions worse by providing a handy way to blame and silence the victims of our post-industrial society’s insanities and adding to that insanity by its stigmatizing labels and “treatments” for “disorders” that are voted into existence by committees.
If mental health problems are caused or exacerbated by social conditions, what exactly does psychiatry propose to do about them, Stevie? Maybe start by discontinuing the blaming of people’s “malfunctioning brains” for their suffering?
Of course, the bitter irony of you blaming psychiatrists’ high suicide rates on social conditions while the profession blames their clients’ genetics is not lost on anyone reading your comment.
It comes from a fear of how others who don’t understand may characterize you. Depending what position one is in, it might make sense not to advertise it. But I don’t think it’s something one needs to defend or explain. It’s the psychiatrists who need to do the explaining. But they are way too often let off the hook by people buying into these rhetorical tactics.
I call it the Ad Homenem Attack, based on ancient Greek definitions of rhetorical techniques. The Greeks recognized that attacking the character of the person involved through generalization or implication is a tactic relied on when someone is lacking a logical argument. Ad Hominem means an attack “on the person” rather than on the subject or the argument or the data.
My usual retort to such an effort is, “Why are you talking about religion/philosophy/(whatever they’re using to distract) when I was talking about scientific facts? Is it possible that you don’t really have a counter argument and are resorting instead to trying to attack my character due to the weakness of your argument?” This immediately shifts the discussion back to the topic at hand and identifies the tactic to the listener. If the person continues the attack, it’s easy to say, “Well, I guess we know who has data to back up their argument and who doesn’t. Come back when you have some actual science to share with the audience.”
The biggest mistake people make is trying to prove they are NOT “antipsychiatry” or “a Scientologist” or whatever. As soon as you take that bait, they have won, because now the topic is your credibility instead of the data you’ve presented.
That’s my take on it, anyway. I know not everyone agrees with this.
Not only because of, but in support of the demonization of Scientologists, antipsychiatrists, or anybody who threatens their control of the market. The idea that people who oppose psychiatry are anti-scientific, biased and/or irrational is a PRODUCT that has been SOLD by the psychiatric industry in order to deflect criticism. Robert is quite clear about this in Anatomy, where he outlines how the psych profession collaborated with Time Magazine to do a cover hit piece that established and connected any resistance to psychiatric hegemony to irrationality and self-serving bias. To suggest he doesn’t understand this suggests that perhaps a person might need to reread Anatomy again, because they’re forgetting what RW has said about this very subject.
Scientific theories are not based on “popularity,” or should not be. The general exception to psychiatry is not that one of its theories got shot down, but that the entire edifice is based on false scientific premises, namely that one can group behaviors together and define “illnesses” based on checklists of behavioral characteristics, all of which might exist in people who might have little to nothing in common except for certain aspects of their external presentation. There are actually diagnoses where people could literally have NO criteria in common and still both have the same “diagnosis.” Additionally, psychiatrists have been chronically resistant to actual data that contradicts their theories. The “chemical imbalance” theory was essentially disproven in the late 80s, and yet continues to be perpetuated to this day by many claiming “scientific basis” for these DSM “disorders.”
I would not have an objection to an honest science of the brain, as long as it adhered to basic scientific processes and assumptions and admitted to error when conflicting data shot down a theory. Oh, but there already is such a science – it’s called neurology!
I just want you to know that now ALL comments are held for moderation, so yours was not singled out as such, it just joined the moderation queue like every other comment.
It sounds like you are defining “mental illness” as any condition that results in people behaving in dangerous or destructive ways. Do you really see these behaviors as “illnesses” in the medical sense? Do you believe that something is physiologically wrong with someone who does these things, and that this explains fully why they do so? Or are you simply stating that these people may meet the “criteria for mental illness” as defined by the DSM, which we all know is something decided on in committees and voted on by the APA, rather than detected by any legitimate test of “health” or “illness?”
If it is the latter, then claims that all shooters are “mentally ill” is pretty meaningless, as it seems to be defined simply as behavior that a society disapproves of.
I agree, and that was actually my point. It’s not “fragile” to need and want safety and agency in one’s life. It’s a normal part of being human. What is abnormal and unfortunate is when humans intentionally take away other humans’ safety and agency in order to profit or dominate others. We should, indeed, be focused on stopping abusers instead of accusing their victims of “fragility.”
I agree with this thinking 100%. The primary error in the DSM is the assumption that all depressed people are the same, all anxious people are the same, all hallucinating people are the same… these assumptions are absolutely not true, and there is no reason to suspect they would be. Some people who are depressed love meditation! Others find it completely useless or damaging. Same with CBT, regressive therapies, micronutrients, etc. Every person’s needs are different, and what will help is different, too. There is nothing to suggest that all depressed people will be helped by the same approach.
I know it’s not the article’s point, but I have to remind us that RECEIVING medical care is the third leading cause of death in the USA. More reason to separate helping people with psychic or spiritual damage from the medical profession.
I am still “agnostic” but find this concept totally feasible. It is the assumption that the “mind” or the “spirit” is a known quantity and is generated and controlled by the brain on which the entire edifice of psychiatry is based. Admitting that the mind is a mystery destroys their entire philosophical structure.
“Working well” is the key phrase here. The vast majority of conventional systems do not “work well” for the majority of those exposed to them. The WHO cross-cultural studies bear this out. A person who hears voices is far better off (in terms of effective help) living in Brazil or Nigeria than in the USA or Great Britain.
They are both important. You focus on getting good sleep, eating well, working with supportive providers to address any possible physiological problems. But you make sure that they have a real way to TEST for these problems, rather than just telling you that you “have a disorder” because you meet some biological checklist of criteria voted on in some meeting at the APA convention. AND you focus on environmental factors, managing stress, deciding on healthy vs. unhealthy relationships, creating the kind of life you want, staying away from destructive people, etc. AND you focus on social things – connecting with other people, making sure you are engaged in productive activity that has meaning for you, etc. They are all important. The problem with the DSM is that it ASSUMES biological cause without testing it out, and at the same time minimizes the impact of the psychological, social and spiritual issues that create most of the “mental health” issues that are “diagnosed.” I say this as a person who used to be VERY anxious much of the time, who had frequent thoughts of suicide when under stress, who was tremendously shy and isolated as a child with really limited social skills. But now I’m very easy to talk with, have excellent social skills in most situations, am willing to engage with total strangers, have learned how to have difficult conversations with hostile people – LOTS of things that I could never do before. Do I get anxious sometimes? Sure. Depressed? Absolutely. But I know what to do about it now, and I don’t get stuck there.
I managed all of this with no “treatment” except for 15 months of weekly therapy in my 20s. The rest I learned by reading and sharing with others and by challenging myself to do things I was scared of through my employment and my drive to improve myself. I have learned that lack of sleep leads me to being more depressed and anxious. That’s biological. But I don’t need a drug, I need SLEEP! And when I get it, I find it easier to deal with stress. It doesn’t cure it, but it makes it easier.
So I do believe it’s all of the above, but I don’t believe, based on research and observation and stories from others, that the psychiatrists have the slightest idea what might be “biologically” wrong with someone who is anxious or depressed or whatever, if anything. Their claims about ‘chemical imbalances’ are outright lies, and some (like Ron Pies) admit that this is the case. Yet they still try to tell you it’s all because of your “bad brain.” I see the system as being corrupt and misleading and very destructive. Each of us has to come up with our own approach that works for us. Any therapy or other help should be focused on helping YOU find YOUR path rather than telling you what they think is wrong with you and providing false explanations in order to sell drugs.
I have no problem with that framing. The problem is that the DSM categories have nothing to do with biology – literally NOTHING AT ALL to do with biology. If you have a thyroid problem, or anemia, or syphilis, you’d better get medical treatment! But that has zero correlation with any DSM category – they are real medical problems that are treatable, unlike the DSM labels. Other issues like food, sleep, exercise, physical pain, all can contribute to feeling bad or being confused or whatever. Those are biological. “Depression” is not biological, “Anxiety disorders” are not biological. They are catchall phrases made up for lazy clinicians who don’t want to bother to actually figure out what’s going on.
I have done this, actually. Just heard back from the guy today. He’s doing a lot, a lot better than when I started, but it’s taken years. He was in and out of “hospitalization” and on lots of drugs, now has worked for a year plus in construction, is studying, is able to communicate effectively with others, not using, has made amends to a number of people he’s hurt… still on a very low dose of “antipsychotics” to stave off withdrawal, but tapering gradually. I had no professional relationships with this guy. He was a friend of my oldest son, but everyone had disconnected from him and I was the only one who believed in him.
I’m not sure I see the similarities you mention. As I understand it, Scientology is based on the idea that we are spiritual beings being held back by physical and emotional pain, and that the answer is reexperiencing this pain to release it. It seemed very individualistic as I have read about it. That’s my understanding, correct me if I’m wrong about that. I’m unaware of any kind of family approach, and there was no talk about “different internal voices” or a lot of talk about “different parts” of people and so on as Schwartz seems to go on about. I don’t really see what is so similar about them. Do you have any specifics?
Wow, that is kind of bizarre! They acknowledge it’s unsafe for “normal” people, but somehow it’s not unsafe for someone with a metaphorical “illness of the brain?” Got to be a way to make some hay out of that admission!
I think you hit the key point – people can label themselves whatever they want, and more power to them. But when credentialed doctors who have the trust of their patients and the general public start promoting “theories” they know to be wrong or speculative as if they are certain and settled science, they are being extremely unethical. And when their clients are concretely harmed by such deception, they have moved from unethical to criminal behavior.
There would be a lot more money available if we saved it by not enforcing ineffective or destructive “treatments” on people who don’t need or want them.
Forced mindfulness is an oxymoron. By definition, mindfulness has to be voluntary – it is a choice that one makes to be aware of one’s presence and relationship to the world. Anyone who tries to force it without full agreement is being abusive.
OK, in order to honestly prescribe benzodiazepines for anxiety caused by chemical imbalances in the brain, would you not have to be able to establish a) what a proper “chemical balance” is, and b) how to measure deviations from that normal expectation? Would you not also be required to show that anxiety is CAUSED by such an “imbalance” rather than the “imbalance” being a natural occurrence when someone feels anxious? And if neither of these criteria are met, how could anyone be considered to be practicing medicine when they prescribe a drug based only on behavior and emotion rather than any actual measurement of normalcy/deviation?
I know that you’ve been told by many sources that “chemical imbalances” are real and that drugs “treat” them. But were you aware that mainstream psychiatrists like Ronald Pies, a great champion of the current model of “treatment,” have said that the chemical imbalance theory is false, that it is, to quote Pies, “an urban myth” that no respectable psychiatrist takes seriously? That the idea of a “chemical imbalance” was actually debunked as far back as the 1980s?
You have been lied to, XxXxXx. I’m sorry to have to say it, but it’s true. There is no evidence of a chemical imbalance even being measurable, let alone “treatable”. Benzos make people relax and not worry about things. It is the same effect on anyone. It’s a crude effect that certainly does nothing to “balance” anything, but actually pushes the brain very far past its equilibrium. This can feel good at times, but it also causes dependence and addiction. Long term use actually does damage to the brain, including damaging cognitive functioning. All of this is commonly known from psychiatry’s own mainstream researchers.
The idea of “treating” chemical imbalances is 90% drug company propaganda, supported by mainstream psychiatry from day one. There is zero scientific truth to it. Even Ronald Pies says so.
So how would anyone know if someone has an “organic problem” with their brain? Can you name any one of the DSM “Diagnoses” that can be detected objectively as an organic problem?
It is ironic that they give a drug that makes a person sedentary and lethargic, and then recommend getting more exercise. Maybe the exercise should be tried instead of the drug in the first place?
The connection between misogyny and mass shootings is just beginning to be recognized for what it is. But it doesn’t make good copy or help either party politically, so it’s not out there where people can read about it.
So how would you define a “mental illness,” Milan? How would you distinguish it from “normal suffering?” That’s the part I really struggle with. Plus, if your distress is caused by abuse and oppression around you, is it an “illness” to be upset about it? Seems like a pretty strained concept, even though you’re right, there is lots and lots of agreement about it.
But how would we decide who is better or worse than us? How could we survive without a hierarchy of “goodness” so we’ll know that even though we suck we’re not as bad as THAT guy over there?
The need to establish dominance hierarchies seems to be central to Western culture.
I don’t disagree with this at all, in fact, I’ve said the same many times. We’re living in the resurrection of Calvinism – your financial success proves that God is with you. This, however, doesn’t mean that we can’t help each other to deal with the consequences of these destructive postulates, whether in formal or informal ways. Naturally, the psychiatric/psychological industry is an industry and is driven by profits, and that’s the real problem we’re all dealing with.
The USA exists only as a result of violence and oppression, a fact which colors every aspect of our society. We are not alone in this, of course, but the particular history of the USA, from the treatment of the native population to the use of slave labor to create wealth to the continued second-class citizenship of certain populations in the USA continues to place violent conquest and subjugation at the center of our politics. And of course, the entire business model of Western society is based on conquest and the implied violence of starvation and hopeless poverty for those who fail to comply with “the rules,” and even for many who do.
e) They are ultimately corrupt and will “treat” their patients based on their own profitability rather than what is actually helpful to the client/patient.
You know, I had not even thought of that until you just said it. I assumed that he realized he was busted and had no hope of preserving his self-absorbed and abusive lifestyle and therefore decided that death was better than living such an ignominious life. But it is quite possible this process was initiated or exacerbated by antidepressant drugs.
I would agree that the conclusions from this study are very limited, but there doesn’t seem to be any evidence that hospitalizations the way we do them is decreasing the suicide rate. Again, it is the responsibility of those advocating for more hospitalizations to prove that they DO reduce suicidality, not the responsibility of those opposed to prove it does not. There is no evidence here that a reduction is taking place, therefore, the scientific conclusion must be that to date, we can’t say that hospitialization is an appropriate action to prevent suicide, at least as it is done. This doesn’t mean that certain individuals might not choose not to commit suicide if they are kept alive a while longer, but there is no data to suggest that the “treatment” is anything more than simply preventing a person from acting upon impulse and giving them time to consider their decision in a new light.
What I am uncomfortable with is starting from the assumption that hospitalization DOES reduce suicidal behavior and forcing someone to prove that hypothesis wrong. We should assume that it DOES NOT until those in favor of it prove otherwise, just as a drug has to be proven effective against placebo or it is assumed that it is not effective.
There is a very distinct difference between not accepting psychotherapy IN GENERAL, and I actually agree with you on this point, and invalidating the personal experience of someone whose experience in something that happened to be called “psychotherapy” who describes specific ways in which it helped that person accomplish the very things you claim to value, including feeling one’s unwanted feelings and taking political action. The first is an opinion, the second is disrespectful to someone else’s experience. The first is allowable, the second is not.
This is not about you “going along” with anything or about me “feeling better.” It’s about your chronic attempts to make gross generalizations and being disrespectful about others’ experiences. Coming back with, “Well, it sounds like your therapy experience worked well for you, but it is not consistent with my experience” might work. Suggesting that I am wrong in my assessment of my own therapy experience is a totally different act, and borders on abusive on your part. There is absolutely no inconsistency with receiving therapy and being willing to fight psychiatry, as my case and the cases of many other people on this site can attest. Your inability/unwillingness to accept that anyone else’s experience might not comport with your predigested views massively undermines your credibility. It seems impossible to have an exchange with you, as you appear to be preaching to your own choir and deleting any notes that don’t fit with your song. At a certain point, it moves beyond expressing your opinion and into the realm of suppressing others’ experiences, which is something I’d think you of all people would be against. You don’t want to be one of those that you’re fighting against, do you?
I can testify as an advocate for foster kids for 20 years that the system often does more harm than good. There are most definitely some situations that turn out much better for the kids or the families, but there are just as many where the kids continue to be abused, neglected, or forgotten, including being abused by the “mental health” system during their time in care. Most of our advocacy was done to prevent further harm by the system itself. And statistics most definitely show bias against black people, Native Americans, Latinx people and poor people, all across the country. Child abuse is awful, but foster care is not a great answer, either. We need to look at other ways to deal with the problem.
It certainly suggests to me that at the minimum, psych hospitalization doesn’t appear to reduce suicidal acts. And from a scientific viewpoint, it’s the responsibility of the “treaters” to prove their treatment works. Saying they are worse to start with and that’s why so many kill themselves afterwards suggests that “Treatment” has had no positive effect.
So help me understand how someone learns to face what happened to them as Alice assures us we must do? It’s easy to say that, but as Alice would explain, our defensive symptoms make it very difficult for us to face our pain and instead we tend to pass it on to the next generation. So how does one get through this defensive system so one can feel these undesired feelings?
Yes, but… is still an invalidation of my very real personal experience. What you need to be acknowledging, from my viewpoint, is your insensitivity toward my own experience. Repeating your philosophical mantra doesn’t really do the job here.
Again, it’s clear you argue from your own personally limited viewpoint and nothing anyone says will sway you from it. You tend to repeat the same statements over and over, but they are full of assumptions, such as the assumption that therapy itself must lead to legal redress, or that therapists are going out of their way to force people to adjust to their circumstances instead of fighting back, which is, of course, only your own assumption and in my case is directly contradicted by the facts I’ve presented.
You’re also invalidating my assertion that taking on my own parents and reclaiming my power is plenty of redress for me, as it freed me to follow my own path instead of spending all my time worrying about what they think or do. If that is not a positive outcome, I’m not sure what if anything would ever qualify. Perhaps you’d have been satisfied if I’d sued my parents for being insensitive and overwhelmed and not being able to do what they needed to for us kids?
And you yourself admit that some “stuff” IS between your ears, in the sense that “feeling your feelings” per Alice Miller is an essential part of becoming a whole person, at least if you really believe what Alice was saying. I would think you would support whatever efforts did that for a person, regardless of what it’s called. But you don’t seem to do that. You want to tell everyone else what to think and believe, even when the person him/herself tells you that your beliefs are incorrect in their case. This kind of invalidation doesn’t help anyone, and in fact reminds me of the very failings of the “mental health” system you and I both so vehemently disapprove of. You would be a lot more credible with me, and I think with a lot of people, if you stopped telling me/others what they should believe and started listening a little more and trying to incorporate what you hear from me and others into your philosophy, instead of just ignoring or arguing with me down when I don’t agree 100% with your preconceived philosophical notions.
Again, agreed 100%. Cultivating that gut level feeling is something I talk about in my book as the ultimate tool for detecting abusive people, but our society teaches us from early on how to mute that “little voice” and talk ourselves out of believing what we have legitimately observed. A big part of healing on the spiritual level, to me, comes down to learning to listen to those intuitive messages and to take the time to figure out what they’re really about. It’s not always clear exactly why we get those messages, but they are there to be respected and listened to!
I agree. Most psychologists and counselors are 4 square with the DSM model and believe most of the mythology about “biological brain diseases.” Some psychologists in some states have even fought for prescribing rights! The therapists/counselors I’m talking about are generally mavericks who aren’t interested in playing along with any system, but are committed to meeting people where they’re at and being present with them to help them figure out their own solutions. I’m not in agreement with any kind of authoritarian approach to counseling, where the counselor somehow “knows more” or tells the client what to think, feel, or do. The only good counselors are the one that help increase the power and capabilities of their clients so that they are able to follow their own paths, not a path the counselor wants them to follow.
I don’t disagree. That’s one of the big reasons I moved out of that realm into advocacy. Even the “good ones” are embedded in a system which rewards compliance and challenges any attempt to improve services or humanize clients. At a certain point, it starts to feel like you’re “sleeping with the enemy” and supporting a system that is generally much more damaging than helpful, and not by accident. My personal ethics would not allow me to continue to collaborate with the system.
It appears to me that you are unable to accept data from my personal experience that contradicts your philosophical premises. It should be easy enough for you to simply acknowledge that I had this experience and that my therapist, at least, did not have the intention of preventing me from becoming active in asserting my rights or was encouraging me in any way to “adjust” to my environment. Why is this so difficult for you to accept? What would be wrong with recognizing that not all therapists are the same? And that some do, in fact, encourage their clients to stand up against those who are mistreating them, whether in the past or the present or the future, even if the majority do not do this? Is maintaining your philosophical purity more important than respecting the actual data you get from people who actually use this kind of service? Maybe you would do well to stop telling everyone what to think and instead listen to people’s experiences? Maybe you could learn something from listening to survivors yourself?
I don’t at all disagree. Most therapists are either ineffective or dangerous. There are a small minority that can be very helpful, but most people either lack access to such people or don’t realize what they are really looking for. Just signing up for a therapist is a dangerous act, because the power imbalance is so profound and so few professionals are able to recognize this problem and address it.
They have stopped talking about “endogenous” vs. “exogenous” depression, first off because there is no way to actually tell the difference, and secondly, because if they really looked at this question, it would be clear that the vast majority of their client base has very good reasons for being depressed, which would eliminate their justification for drugging anyone they encounter with these “symptoms,” regardless of the reason they might occur.
Not necessarily. There is no requirement that a therapist listen from a point of view of superiority or of instructing the client on what is going on or what to do. Certainly the majority of therapists these days DO operate in that way, partly because they’re now trained to look down on their clients, partly because they haven’t done their own work on their own issues.
But a truly good therapist would, in my view, listen only from the point of an outside observer of their client’s narrative of their own life and experiences. Their job is to ask questions to help the client make up their own minds about what is causing their distress and what THEY want to do about it. The therapist’s job is not to tell the client what to think, in fact, my own therapist years ago pretty much refused to EVER tell me what she thought even if I asked her to. She did share some things from her own life to help me understand that she was NOT coming from a superior point of view, but had been through similar pain and frustration herself. But she never, ever told me what to do or think. She simply helped me unwind my own story and realize some important things regarding “feeling my feelings,” which you correctly point out is so essential to moving beyond the abusive/neglectful/oppressive environments that most kids grow up in. She empowered me by listening without judging, asking pointed questions about what I said, and supporting me in feeling my feelings and acting on the logical consequences of those feelings. It was my parents who viewed my viewpoints as invalid. She never did, and in fact, strengthened my confidence that my own views were, in fact, valid, in contradiction to what I’d come to believe from listening to and being worried about my parents’ and siblings’ views of what I should/should not be or think or do.
Because not all therapists are the same, and saying they are is inherently insulting to people who either provided or received care that conflicts with your generalized assessment.
I always felt it important to be transparent when I was playing the role of counselor/social worker. The more real and human I was, the easier it was for the person I was helping to be open to communicating with me about how they want to change their lives.
It is not a majority that go on psych drugs, but it is WAY more than the average for non-foster kids. Over half of teens in foster care are on psych drugs. Usually around 20% of all foster youth are on psych drugs, including even 1-2% of infants! Interestingly, though, kids placed in relative foster care have only slightly higher drug use rates than the general public, whereas non-family foster placements have 3-5 times higher rates of psych drug use.
Foster kids are most definitely at higher risk of being diagnosed and drugged than the average kid.
Well, I still think you’re making generalizations that aren’t true for every therapy relationship. My therapist didn’t specifically suggest that I do anything or not do anything in particular, because she saw her role as helping me process those unconscious feelings you and Alice Miller talk about, and then to decide FOR MYSELF what I should do about it. It certainly did involve confronting family members about how I had been treated, and seeing roles that other family members had been thrust into and helping protect them against the (mostly unconscious) tyranny of my mom and my brothers. There was also a raising of social consciousness regarding the plight of others who had experienced similar family dynamics and were suffering. This led me eventually into social work, and then when I observed what social work systems were doing to people, into advocacy. She most definitely helped me move from being angry at myself to being angry about social injustice, not because she told me to feel that way, but because she helped me find and connect with my own sense of righteous indignation. And as I said before, without this experience, I would never have gotten to advocacy as a career and life path.
So my therapist did not fit your model of “teach you to adjust to injustice” or “accept your lot in life.” It was much more about, “If you have an issue, what are you going to DO about it?” Which certainly fits into your framework of encouraging people to take action against their oppressors.
Now this was in the 80s, and I fully acknowledge that such therapists have become more and more rare as the DSM has taken hold. But to pretend that there is some generalized agreement among therapists that their job is to prevent people from holding their oppressors accountable is to me simplistic and not supported by the fact. Therapists are not lawyers, nor are lawyers therapists, but there’s nothing to prevent a therapist from making referrals to lawyers for class action suits and the like, and I certainly have done that with many a person in my social worker days.
As a wise man once said, “Generalizations are always wrong.”
I am saying that it depends very much on who the psychotherapist is and what they’re about. I would say that it is true that most therapists these days are fully indoctrinated into the DSM system and see people’s problems as “mental illnesses.” But as Bonnie points out, there are therapists who take a very different view of what therapy is or should be, and there are many people, including myself, who have had very positive therapy experiences themselves. I can pretty much guarantee you that I would not have become an antipsychiatry activist and advocate for stopping the mass drugging of kids in our society (and adults, of course, but kids were my specialty) without having gone through that experience myself. You have talked about Alice Miller and the need for people to get in touch with, feel, and validate their own experiences in order not to perpetuate the same offenses on the next generation. I agree totally with Alice, and I would also submit that most therapists haven’t done this work and are either useless or dangerous. But not all.
So my objection is not to making generalizations about the practice of therapy as a profession, but to generalizing that all THERAPISTS have the objective of removing someone’s honor and having them accept themselves as inferior beings. That was not at all my experience, and others report finding therapists who have helped them gain new and helpful perspectives on how to live their lives without worrying about how “the system” or “the middle class” would judge them. I think this is very valuable when it happens, even if it is rare, and I don’t want folks who have had that kind of experience or who have provided that kind of experience to be invalidated by sweeping generalizations about what “all therapists” are intending to do.
I would agree that psychiatry is an organized system with a specific purpose and a political apparatus to support it, including mass funding through the drug companies, and it is much easier to make accurate generalizations about psychiatry. I would still maintain that saying that “all psychiatrists” are the same is inaccurate, but in the case of psychiatry, the defectors from the status quo are much fewer and much more exposed to blackballing and other punishment from the powers that be.
Posting as moderator: It is important not to make generalizations about large groups of individuals, even based on profession. I’m not going to publish any more comments that make negative generalizations about therapists.
That is what I have always suspected. SSRIs appear to create a sense of not caring what others think about your behavior. This might be seen as a good thing of someone is spending a lot of time worrying that others don’t think they are good enough. Being able to say, “Screw mom, I’m gonna do what I want to do,” might feel really good to some people. But what if someone is being prevented from doing something violent because s/he is concerned about the consequences, that they might be shamed or put in jail? In that case, removing empathy or concern for the views of others may be deadly!
This is more proof that anyone can take any concept and turn it into a means of oppression. The attitude is what has to change, and calling one’s oppressive attitude “trauma informed” is just another way of coopting the drive to expose abuse of power for what it is and turning it into a way to protect the perpetrators.
The problem is that the concepts being introduced don’t actually make sense, while the cultural practices do. “We don’t need pills for fear” sums it up completely.
This is kind of sad to me. Talking about the person’s neighborhood they grew up in or other aspects of their culture should be standard practice for anyone who actually wants someone to feel safe talking to them. Sharing about one’s own background is also helps build trust. If psychiatrists understood that building trust is the beginning of doing anything remotely helpful, this would not be a necessary exercise.
We might also add “Have a higher likelihood of being viewed as dangerous by system personnel when engaged in the exact same behavior as their paler-skinned counterparts.”
I wish I had one! Big social changes take time, and also usually money. I think maybe we have to start with getting money out of politics so our representatives are representing us rather than big corporations. But that in itself is a huge task, and probably starts with political organizing at a local level and commitment for years to making changes. It is a daunting task!
It is hard to accept. I think that’s why so many people get so upset when this kind of information is brought up. It undermines confidence in the people we’re supposed to be able to trust.
I would submit that we don’t KNOW anything that we haven’t personally examined and found to be true based on our own standards. You don’t “know” something just because someone else told it to you. All you know is that this is what you were told. The lack of intellectual curiosity and rigor amongst people who claim to be representing scientific or technological advances is disheartening, though no longer even slightly surprising.
As a psychiatrist whom I respect greatly, I’d be very pleased to hear whether you have seen psychiatrists or the APA promoting the “chemical imbalance” or “brain disorder” hypothesis. It’s hard for me to imagine you have not heard this being put out there all the time, as I ran into it frequently just in the foster care system. What’s your experience?
So either they are not psychiatrists, or the entire psychiatric profession in New Zealand has to be regarded as “not serious” by Pies and his ilk. Of course, there is also the possibility that they are lying for the purpose of increasing their “market share,” but no, that COULDN’T be true! Psychiatrists would NEVER be corrupted!
Even if psychiatrists did not promote the “chemical imbalance hypothesis” (which of course we all know they did and continue to do), they certainly said and did NOTHING to correct any “misimpressions” created by the Pharmaceutical Industry or whoever else made them look like they believed in it. Failing to take action to correct false information is pretty close to promoting it, in my view.
Too many people making too much money and getting too much professional status with the current system to allow for something more effective to elbow its way in.
How about if they are informed of the multiple long-term studies showing that stimulants do not improve ANY long-term outcomes for “medicated” vs. “unmedicated” students, including academic test scores, high school graduation, college enrollment, grades passed, delinquency rates, teen pregnancy rates, social skills, or even self-esteem ratings? Why is this rarely if ever mentioned in critiques of stimulant drugs for “ADHD”-diagnosed children? If long-term outcomes are not improved (or in some studies, made worse), what is the purpose of drugging these kids, even if one accepts the concept that “ADHD” exists as a disease state (which I do not)?
The dogmatic proponents of each viewpoint have intentionally created this dichotomy, so that it sounds as if there is a choice between doing what they believe in or doing nothing or something stupid. It isn’t a real dichotomy, but a lot of people have a hard time with uncertainty.
I have also worked with foster youth, and found that the “trauma brain” trainings, rather than increasing empathy as they ought to, for some people provide yet another way to say that “his brain is broken because he’s traumatized” and use it to justify more drugging and diagnosing. What is needed for traumatized people (which is pretty much all of us!) is empathy and kindness and honesty and human vulnerability. It doesn’t matter how many trainings are done – we need to impact the ethics of the people involved such that they start thinking about how they might accidentally be harming someone rather than assuming that everything they do is magically helpful.
The problem with mindfulness is that it has been abstracted from its spiritual roots in Buddhism and is now being used as a gimmick to deal with anxiety. Which it does help with, but it seems a shame (but typical) to remove the spiritual focus that provides a context for why one might meditate and what one might get out of such a practice over time. It should not be a means to escape the rigors of capitalism. It is a lot bigger than that.
I would say more that psychiatry as a profession tends to attract more arrogant people on the average, because people who are more humble will be turned off by the apparent hubris in the authoritarian approach promoted by most all psychiatric training schools.
That is very well said. Unless someone has an identifiable neurological disease that one can accurately test for, whatever people do is “neurotypical.” Genetic diversity is the key to species survival. We need all different kinds of people, and the sooner we learn to value what gifts everyone brings to the table, the healthier we’ll be as a society. But I’m not holding my breath on that one…
I respectfully disagree, based on personal experience. You appear to be committed dogmatically to a viewpoint that is not supported by the reported experiences of many people. I agree that the run-of-the-mill therapist is likely to be supportive of the status quo, and that there are certainly a significant number who are married to diagnoses or other client-blaming theories, and that such “help” is not very helpful. However, to say that all psychotherapy has the client yielding as the goal, or the client putting all problems in the past, is simply not true, no matter how many times that idea is repeated. It feels very disrespectful both to people who have found counseling/therapy beneficial and to those therapists (admittedly a minority these days) who work very hard at helping the client meet his/her own goals in an empowering way.
Have you done a study to prove that? Can you prove that hitting a person on the head with a 2×4 decreases their cognitive functioning? We need more studies!
I don’t think that everyone knows what is good for themselves, not by a long shot. What I do believe is that everyone has a right to make his/her own decisions, and the job of a helper is to assist that person in gaining sufficient perspective to see the options available and the likely consequences of whatever decision they make. Forcing someone to do something “for their own good” is so fraught with problems that it is far better to decide never to force someone to do anything at all in the name of helping. Sometimes we do need to use force to keep them from hurting someone else, but at that point, we’re helping the potential victim, not the person we’re using force on.
It is very painful to watch someone doing things you know will lead to pain, but everyone has to learn in their own way. We can provide information, show love, set boundaries, share perspectives, but in the end, each person is responsible for charting their own course in life, even if we don’t like the results.
I would say that DIAGNOSIS is based on that principle. As I’ve said before, generalizations about psychotherapy are really not possible to make, as there are all kinds of services offered as “therapy.”
“We do need a model to help clinicians and service users understand why their emotions and behaviors are maladaptive for them.”
I would respectfully disagree with this statement, as a former counselor/therapist. I believe any “model” needs to understand why their emotions and behaviors are, or were at one time, ADAPTIVE for them, and help them decide if that behavior is still adaptive or if different options might be more effective in accomplishing their goals. Calling clients’ behavior “maladaptive”, in my experience, leads to defensiveness or self-shaming, whereas acknowledging that “all behavior meets a need” (as the saying goes) and that people aren’t acting or feeling random things, but are making decisions based on their own perception of what makes sense in their world. And of course, no one can really understand what makes sense in their world except the client him/herself. As soon as an helping person starts deciding for the person they’re helping what is and isn’t “adaptive,” they stop helping.
In my experience, this is very much the norm – it takes an act of Congress to get a doctor to support withdrawing from psychiatric drugs, and the desire to do so is often regarded as a “symptom of the illness” rather than a rational decision based on the pros and cons of the situation. Many docs seem to believe that being “mentally ill” eliminates the ability to think and reason and make decisions.
It is true that it is getting easier to find clinicians to help someone wean, but such professionals are still the exception rather than the rule. And even when one does find someone “willing” to help them taper safely, there is an almost constant message that it’s a bad idea and will probably go wrong soon. Plus a lot of the “supporters” don’t appear to understand how to taper safely anyway. So it’s not really a very easy process, and some people can’t find anyone willing to help at all.
Sauce for the goose, sauce for the gander. If any person or group wants to have their identifications and views respected, they would do well to return the favor to others who respectfully disagree with them.
It depends who uses them and how. I have no problem with a person him/herself identifying as “mad” or “neurodiverse” if that is an identity they find helpful. The problem comes in when we start studying “neurodiverse” people to find out “what is different (aka wrong) with them” based on the same brain-based reasoning that the psychiatrists use. So “neurodiverse” in particular doesn’t challenge the psychiatric paradigm to recognize that THERE IS NO NORMAL in terms of “brain function” – everyone’s brain is different, and should be! After all, genetic diversity is the key to species survival. The term also tends to imply for me that one’s brain condition is fixed – I’m “neurodiverse” because I was born that way, you’re not, because you “fit in” better to our society’s expectations. Now, I understand that some people do believe that they were born particularly different, and that may even be absolutely true in their particular case. But brains change and develop over time, and everyone has their gifts and challenges biologically. I do very much appreciate the reflection that people who get diagnosed “ADHD” or “Autistic” or whatever can find positive characteristics associated within the groups that are diagnosed that way, and I often pass on or comment similarly when someone starts talking about “brain-based disabilities” and such crap. But those labels are still based on the DSM and the “adapt or you are diseased” way of thinking, and I’d rather do away with them altogether.
So again, I’m not against a particular person identifying that way as a person, I just don’t like to use these terms myself because they reinforce the biological model for me. Others are certainly very much entitled to their own views on this, and those views may be far more informed than my own. It was just that the comments on this article brought to my attention why the term bothered me, as I would guess I’m pretty “diverse” based on what is actually expected of human beings in our society, but because I chose a quiet way to rebel and to deal with the oppression I was experiencing, I am considered to be somehow a “normal” person. I don’t think such a “normal” person exists on this earth.
Interesting spin in the title. Shouldn’t it be, “Maintaining on antipsychotics diminishes cognitive functioning?” Or better yet, “Continuing administration of antipsychotics makes people duller and less intelligent?” Why frame getting off as a benefit, rather than noting correctly that getting ON does measurable damage?
All comments are put into the moderation queue upon receiving them. Some comments are approved by other people than me, depending on length, complexity, and/or potentially controversial content. I only get to look at them once or twice a day, depending, so some of your shorter or simpler comments might be approved by a different person while one that is longer or more complex may have to wait until later when I get to it. Which means some comments may be approved earlier, even if posted later.
I do support that kind of use of the word – I have never had any problem with people advocating for “mad pride” or seeing themselves as “neurodiverse.” I think my issue is more one of assuming, for instance, that the kids who don’t act out in school and do their homework and try to keep the teachers happy are “normal” while kids who can’t manage that intense effort are “diverse.” I was one of those kids who did what he was told and tried to play the game so that I wouldn’t get in trouble. But I hated every minute of it. It was totally traumatic on a daily basis. So I was no more “neurotypical” than the kid who was being sent to the principal’s office for acting out. I was just being harmed in a different way because I did have the capability of pretending I was OK more than other kids did. I totally support anyone identifying as “neurotypical,” because I know some people have a rougher time than I have had. I just want to make sure everyone is clear that the kids (or adults) acting “normal” may be suffering in their own way from the oppressive system that we have to deal with. Just because I can “fit in” doesn’t make me “typical.” Those who “fit in” are an extremely diverse group that have little in common beyond their ability to dance to the masters’ tune well enough not to be singled out for special discrimination.
You are so right, the “helpers” seem to believe that they are automatically being helpful and are incapable of abuse and harm, and so are blind to the damage they do. People believe that taking a kid from an abusive situation and putting them into foster care makes it all better for them, but it does not. There is automatic instability and craziness inherent to the situation, not to mention unavoidable breaking of almost every social bond the child has had to date, but kids are frequently overtly abused by the system itself beyond those unavoidable challenges. Any helping agency that can’t admit it could inadvertently do ill should not be trusted for human beings.
I just realized what it is about using the term “neurodiverse” that’s bugged me. It seems to imply that there is some monolithic mass of people with “normal” brains from whom the “neurodiverse,” well, DIVERGE. But isn’t the real truth that ALL of us are “neurodiverse,” and that it is the practice of expecting everyone to think and act the same that is causing the distress? Shouldn’t the concepts of allowing people to think and feel as they see fit apply to ALL of us, rather than just a category of people who are already judged to be “weird” by the judgmental “mainstream” of oppressive social institutions?
I’m not saying this as a criticism, just asking what folks think about it?
Hmmm, who was out of touch with reality there? So you have to believe that being locked up against your will is NOT incarceration in order to convince them you’re sane?
Thanks for sharing your story. I’m glad you saw it for what it really was.
And yet studies where they simply provide food and shelter and basic necessities to people living on the streets, without any requirement to do anything else (the “Housing First” concept) appear to start getting better without any further intervention. Imagine, getting enough sleep, being able to have food and shelter and to be able to wash and use the toilet safely actually helps people feel better and stay safer. What a concept!
Your comments reflect my experience completely. There are people who are able to be helpful in more than a run of the mill way, but they are rare and a degree or license or “school of therapy” certainly does nothing to identify such people. They are human, real, caring, and allow themselves to be affected by our stories, and even share some of their own experiences when it is helpful. They make mistakes and apologize for doing so, they are properly horrified by horrific things, they are, in short, real humans who are there to help in whatever way they can. And again, they are quite rare.
Yes, they are supposed to be the experts, which is the main problem. I have always felt I was the most helpful when I was the most humble and least expert-like, just talking one human being to another. No one is an expert in another person’s life!
Little irks me more than when they give someone a bunch of fat-inducing “SGAs” and then put the person on a diet because they “make bad food choices.” Saw it happen all the time in the foster kids I advocated for. Then there was the kid who spent two years working through a tendency not to want to eat anything. She was eating well and doing great, then they decided she had “ADHD” and put her on stimulants. Lo and behold, she appeared to “relapse!” I was apparently the only one who saw the obvious causal factor. They were totally ready to see it as a resurgence of her “eating disorder.”
I agree completely that confronting propaganda and sharing factual knowledge is essential for changing the system, and that is sometimes going to be uncomfortable for some people. I’ve certainly been accused of “pill shaming” or “being biased” or “not sharing both sides” many times in the past, and it does not deter me from sharing the information. I do think that “peer pressure” plays a big role in how people decide things, and knowing that there is someone who questions this paradigm and has data to back it up can be a big game changer for some people.
The only point I want to emphasize is that this kind of work has to be done with a sensitivity to the potential backlash for some people who are very committed to believing in the paradigm for whatever reason. Again, if it is a professional, I have no problem “shaming” them when they are using their power to do harm. I feel different about how to approach a person who has been a believer in this system from a “service user” point of view. I think it’s important to find out where the person is and how much they are able to process to avoid unnecessary pain and confusion. That doesn’t mean not to share the truth with such a person. It just means it’s important to do it in a way that is at least marginally digestible given their present viewpoint. It has been a path for many of us to get here, and it’s sometimes way too easy for those of us farther down the path to think that the truth is obvious, and to forget that we were once farther back along that path and that it took time and patience and multiple experiences for us to get to where we are today. And it’s also important to remember that others’ paths may look different than ours. We don’t want psychiatrists and “mental health” workers to assume we’re all the same – we ought to make sure not to do that to ourselves.
You as a client should NEVER have to give the “benefit of a doubt” to your supposed caretakers/helpers. It is THEIR responsibility to figure out what is helpful, or to admit that they don’t know how to help. It infuriates me (though it’s not surprising) to hear the staff telling YOU that you need to understand and take care of the staff who are supposed to be there to help YOU. I find it disgusting.
Have you looked into “Hearing Voices” groups? They are run by other people who have had similar experiences and can make suggestions of what may or may not be worth trying. If I were in your situation, I think I might start there.
Seems like the first thing to do would be to remove the perverse incentives. But that’s a big task, as lots of schools will be upset when the idea of them losing extra funds is brought up!
It is certain that feelings of self-deprecation are present in most of us who grew up in this highly shaming society. They are exploited by the system in order to create more compliant “patients,” and this can be very effective. It’s easy to say “not to be open” to shaming, but that has been a journey of decades for me, and I don’t think we can expect most people to be free from it. The real shaming that goes on is the labeling of someone as inadequate or insufficient in the first place, and the responsibility for that shaming lies squarely on the shoulders of the “professionals” who engage in it.
I totally respect yours, Julie. I’m simply saying that therapy experiences are all different and that I have an issue with making gross generalizations about what therapists intend, even if in most cases it ends up being fruitless or counterproductive. Believe me, I recognize how fortunate I was to find the person I did! I also recognize that she could have taken the same approach with a different person and not gotten good results. (To her credit, she recognized and stated this to me as well.) It was a good match, for whatever reason, and worked for me.
I also recognize that therapists such as Elissa would be much harder to find nowadays, since so many people have been trained and propagandized into the DSM model of reality.
I agree with you, Richard, except in one point: I think that Oldhead and Auntie Psychiatry are correct in saying we should not use the term “pill shaming,” as it was invented by and is continuing to be used by those in charge of the system to discredit any criticism. But the phenomenon of someone from an anti- or critical-psychiatry viewpoint acting in ways that effectively disempower those who are being victimized by the system or who are trying to sort out what to do does in fact occur and is harmful, and often gets into what seems like victim blaming. I just think we need a new name for it.
I think we do best when we recognize that people are where they are and that it’s not our job to “convert” people in low-power situations to our viewpoint, as it reinforces the idea that this person is foolish or incapable of making his/her own decisions with the right information. I do think we are responsible for educating anyone who is in any way receptive in the truth about these drugs, but it needs to be done in a way that respects their autonomy and power to make and live with the consequences of their own decisions.
Compare that to the most optimistic genetic studies. The amount of bias in this area is astounding. And that’s not even getting into the issue of what “schizophrenia” really means, if it means anything at all.
I am not sure you’re really getting what I’m talking about, and I find your comments here more than a bit dismissive of my reality. I ABSOLUTELY was encouraged to fully experience all the pain and confusion and loss that was the reality of my childhood, with tears and hopelessness and anxiety and angry swearing and the whole 9 yards. So your comment that therapists are always about stopping feelings or distracting oneself from reality is not accurate, at least in my case.
Moreover, though this therapist didn’t specifically suggest getting involved in political activity, she certainly inspired me to understand how widespread my experiences as a child were and how important it was to try to change the real conditions that exist which create understandable fear, anxiety, anger, apathy and other strong emotions in children and continuing into their adulthood. It is fair to say that one of the first steps on my path toward political enlightenment was my engagement with this particular therapist. And led to my eventual career advocating for abused and neglected children in the foster care system, including getting a law passed to help protect them from psychiatric drugging.
So while I agree with you on the fact that most therapy is crap these days, I don’t agree that all therapy can be categorized that way. I agree completely that feeling emotions that are repressed or intellectualized is essential to becoming a fully functioning human being, but I’d have to say that any therapy that does have that effect will help you get folks to the barriers protesting the injustice of the world.
Not much mystery there. Psychiatric intervention appears to make things worse. The only mystery is why those facts don’t seem to make headlines, or why the media continues to make excuses and fail to ask the pointed questions this kind of data suggests.
Wow, THAT was a “trauma informed” therapist??? I think they missed the boat by a pretty wide margin, there. It goes to show again that training and qualifications don’t mean much in this world of contradictions and power trips. Finding a person who actually cares enough to get to know you is the real winning game, and there is no guarantee or necessarily even improvement in odds that a person with a degree or training in “trauma-informed therapy” will be that kind of person for you. It absolutely disgusts me to hear this kind of story – thanks for sharing it and good for you for seeing what was really going on!
I guess by their reasoning, speaking Korean or using forks and knives or having birthday parties must be genetic. After all, your parents did the same thing…
And I would add that she was ANYTHING but protective of my parents. In fact, my mom said to others (naturally, I never heard about this for YEARS later and from a third party) that my therapist was “driving a wedge between us.” We spent most of the time talking about my historical relationship with my mother and her denial of any kind of emotional reality except that “everything is just fine.” And it was VERY helpful to me, and I doubt that selecting an average person off the street to share my issues with would have been remotely as helpful. She had a very useful skill, and I was happy to pay her for the excellent service she provided.
You’ve said this stuff before, and I’ve finally realized why some of it bothers me. You claim that all therapy is about making someone “feel OK” without dealing with emotions. But I had a fine therapist back in the 80s (before the DSM III and the “chemical imbalance” theory had taken hold), and it was ALL about me learning to feel the feelings I was avoiding. That was the whole point of it. So while I agree that much if not most therapy today avoids dealing with these awkward realities (and that the DSM III and later editions were, in fact, carefully constructed to allow for this shift in emphasis), there have always been therapists who viewed their jobs as doing exactly what you are saying needs to be done. So I think you are overgeneralizing in these statements – there are a lot of different therapists doing a lot of different things, and with a lot of different competence levels, but the idea that ALL of them are aiming to help people repress their emotional experience and side with their parents against abused kids is just not true in my experience.
I’d be the last person in the world to argue against some increased sanity in the foster care system, as I worked as an advocate for foster kids for 20 years. The Kibbutz/commune idea has a lot of merit, and I’d love to see it worked out.
However, I do think it is important to remind everyone that today’s parents were yesterday’s kids who were usually abused and/or neglected and/or misunderstood by THEIR parents (and other adults responsible for them). While there are certainly parents who overtly wish their kids ill, and I see no reason to have mercy on such parents, there are a hell of a lot more who are just passing on what was done to them. You are an Alice Miller fan, as am I, so you know what I mean. Of course, this does not excuse the parents from the damage they do – I personally find the “don’t blame the parent” meme offensive and destructive to kids (and adults) who are the victims of inadequate or abusive parenting. It’s not the kids’ fault that the parents had a rough upbringing, and the parents are responsible for not passing that on. But most do so inadvertently or unconsciously, and I therefore see no reason why sane approaches to raising kids should not be a legitimate subject of study, as long as we aren’t providing excuses for parents or other adults to continue harming their children with impunity. It is very possible to talk about improving one’s approach to child rearing without making excuses for the parent or supporting child abuse, neglect or exploitation.
The correlation between “schizophrenia” diagnosis and childhood abuse (especially sexual abuse) is orders of magnitude hither than any genetic correlation that the most optimistic study has every come up with. Yet we still spend millions on gene studies and almost nothing on researching childhood abuse effects and how to help people resolve them. At this point, it is clear to me that those leading the field are either utterly blind to the obvious or extremely corrupt, or both.
It beggars belief that anyone would be so arrogant as to claim neuroleptics increase lifespan. Just based on weight gain, increase in diabetes, and increase in heart disease, it is obvious that these drugs kill people more quickly than if you left them alone. Add in the increase in smoking cigarettes as a means of dealing with “side effects” and you know the death rate will climb.
This article reinforces my observation that what people need to “heal,” if that is the proper word for it (a bit medical for my taste), is for someone to connect with them on a real and personal level. There is no technique, training, school of therapy, medical intervention, or special approach that will create this kind of connection. It requires a person being human and being willing to experience with another person what is happening in their lives.
When therapy works, it’s because such a connection is formed. Most of the time, it appears to me, such a connection is not formed. And having a degree or a license is no guarantee of better odds that a person will be helpful.
You are blessed and fortunate to have found such people, and others are no doubt very fortunate to have found you so you can pass it on. I wish there were some way to teach people how this works, but I don’t know that such a thing is really possible. Everyone follows their own path, even therapists. I guess a person who wants such an experience needs to know what they’re looking for and spend a lot of time shopping around.
That is such a good point! The shame is what comes from the system labeling someone and exerting power over them. Then the system comes and accuses anyone who wants to tear the veil of secrecy over their own shame and tries to project it onto those who is trying to get the facts on the table. It’s classic projection.
I also agree that “no-pill shaming” is a lot more common, and yet no one seems the least bit disturbed by “did you take your meds?” humor or the pressure that people come under to give in to the psychiatric worldview and accept their shaming label without complaint.
Very true. In the world of mediation/negotiation, it’s long been recognized that “shared decision making” is impossible in the presence of large power disparities. It’s hard to think of a greater disparity than a person who is highly distressed talking to a person with high social standing who has the back pocket option of imprisoning them if they don’t go along with the program.
Some parents won’t listen. There are a lot of parents who are working on doing the right thing very, very hard. And the answers aren’t always as simple as to take away the video stimulation. Parents are fed a lot of bad information, and it’s hard to sort out what makes sense, especially when so many of them have been treated less than respectfully by their own parents growing up.
Parenting is a tough job, but at the same time, parents should not be let off the hook for the damage that they may do, intentionally or inadvertently.
OK, I was overgeneralizing a bit. There are moments when it IS the correct thing to say. But mostly not, and I’d have to gather a lot of information before deciding to go that route. A person has to be at the right point to be able to process that kind of a push.
But you’re right – there is a difference between personal communication that is unintentionally shaming and the use of this concept of “pill shaming” in a shamelessly (sorry!) political manner as has been done. Acknowledging that there are moments when people can’t process the idea that their pills may be dangerous really doesn’t connect with the idea of “pill shaming” as put forth by the leaders of the psychiatric/drugging movement.
Not at all. I’m saying that if you really want to bring someone to a different place, you need to meet them where they are and understand why they believe what they do rather than starting off by telling them that they’re making bad decisions and should change their minds. I’m by no means tolerant for a second of the concept of “pill shaming,” as it was invented for the purposes of stifling discussion. I’m merely saying that an approach that recognizes the person being harmed as a victim of the system who needs some gentle guidance, vs. someone who needs to be rescued or fixed by again doing what someone else says they should do. What I want from these encounters is to maximize the odds that the person’s going to be able to hear what I’m saying. Anything that smacks in any way of me judging the other person’s decisions as being “bad” or “wrong” or me “correcting” their views generally leads me no where at all. I learned this by much trial and error, and believe me when I say, I have had plenty of time to discover what works, and telling people they’re wrong doesn’t do the job.
Again, very different from how I’d approach someone accusing ME of “pill shaming.” No need for gentle measures there generally, though there are those who are brainwashed and don’t really believe it themselves who still engender my compassion, even though I have to call out their judgmental behavior. But if I want to be in a position to call out judgmental behavior, I kind of have to avoid it myself, don’t I? Or I end up being way too similar to those whose behavior I am trying to stop.
Hope that makes a little more sense this time. It is a kind of subtle point, but as far as dealing with domestic abuse survivors, it’s tried and tested over hundreds and hundreds of people who have found my interventions generally very helpful, once I figured out what NOT to do. I haven’t done half bad with psych survivors, either, based on what feedback I’ve gotten. I’m not talking through my hat – I’m sharing what I’ve found to work best for those I’ve worked with.
I think this is a very good observation. It being such a normal reaction, I think we all need to be sensitive enough to expect it and not judge people who have been understandably pulled into a system they don’t understand for displaying this predictable sign of resistance to being “wrong” about their investments.
I have to say, I have seen some pretty serious insensitivity from some folks about the impact of their statements on the person in question. It seems to me that, as we care about the welfare of the folks we’re trying to educate, we need to start gently and from where the person is rather than overwhelming them with information and pressure to agree with us.
A useful analogy may be someone in a relationship we see as domestically abusive. We may be absolutely right about our observations and assumptions, but I can assure you that it’s not very helpful to say to someone, “You’re in an abusive relationship – you need to leave right away!” Now, the person who says this may have no intention of shaming the survivor, but the effect will nonetheless be one of shaming – the survivor will almost always feel inadequate and defensive, and will in fact often go into a reactive defense of the abuser as a means of avoiding the perceived judgment that s/he is too stupid to see the obvious reality that we “outsiders” are kind enough to point out.
I have found it MUCH more helpful to enter into a discussion with the person, to find out his/her own view of what is going on, what the pros and cons are, what they’ve thought about as possible solutions, or just to hear their story and listen supportively. It has become very, very clear to me over time that people are in different places in their processes and that the last thing they need is someone else telling them what they should do or that they are wrong.
Of course, we also have to consider the possibility that we are wrong, that the person is not feeling abused or mistreated, and that the situation is not the same to them as it looks to us.
This is a very, very different approach than I would take toward the PERPETRATORS of such ill treatment. I see no reason not to pull out all the stops in challenging those in the position of power to deal with the actual facts of the situation and to let them know we see and know what they are about. But they are the ones committing the heinous acts, whether intentionally or not. Those who are being victimized deserve a high level of sensitivity to how our approach may come across, including making sure that our efforts don’t have the unintended effect of making them feel LESS empowered and more shamed. We can absolutely create a shaming situation without intending to.
I would also suggest that this is very different than presenting objective DATA to a person in a difficult situation, while allowing that person to decide what it means and what to do with that information. My big objection is when people start objecting to providing objective information on the grounds that “it might discourage people from taking their meds” or “it might be perceived that you are shaming them.” I think sensitivity is still in order, but there is nothing “shaming” about sharing research data, statistics, personal experiences, cross-cultural studies, or whatever solid factual information is known with anyone who is interested in hearing about it, and even with some who aren’t.
I guess the big difference for me is whether one believes that the other person has the right to make their own decisions based on their own assessment of the data, or if one believes that anyone who doesn’t agree with one’s own interpretation is de facto wrong or deluded or deceived or victimized. I think it is a minimum level of respect to grant to any person in the low power situation the right to make up their own minds about things without having to worry about how I’m going to react or judge them if they make a different decision than I would want them to make.
The data suggests strongly that anyone interested in increasing the long-term rate of recovery from “schizophenia,” whatever that may actually be in each case, would do best to minimize the use of neuroleptics in every possible way. It is clear that the more neuroleptics are in use, the more chronic the “condition” becomes.
Sometimes the article titles are from the journal or publication that published them. But I agree with you – I’d like to see articles with titles more like, “Kids enjoy school more when they have lots of exercise” or “Active kids learn better when allowed to be active.” Or even, “Kids who are allowed to be active are less likely to end up with an “ADHD” diagnosis.” We can talk about issues without labeling kids.
I’ve always found that people considering suicide have good reasons for feeling that way. Trying to “stop suicide” is a very short-sighted approach that leads to bad results. Finding out what the person is finding hopeless about his/her life and helping them regain some measure of real hope is a lot more effective.
I do think we’d agree on most points. My issue is the professionals pushing these “diagnoses” when we know they are BS. But they have permeated society, and some people do take offense or get confused when I communicate my disagreement with these concepts. I think it’s an inevitable part of the problem, and I blame the doctors and the profession for promoting ideas they know to be false for the bulk of the confusion.
The most important part of helping anyone is, as you say, recognizing that everyone has different experiences. Unfortunately, the main thrust of the DSM (in my view) is to invalidate those differences and suggest that we can lump people together based on how they feel or behave rather than taking the time to actually find out what’s going on. I am guessing we’d be of a mind that the job of any helper should be to find out from the person they’re trying to help what works or doesn’t work for them, rather than forcing one’s own view of the situation down their throat (in some cases literally). As to how the average clinician views the situation, it might be interesting to do a survey and find out for sure.
I know what you’re talking about, as I trained as a chemist undergrad and have done some programming as well. The most important element of creating a functional model is feedback from the model in action. If the model doesn’t predict reality accurately, you have to start redefining your assumptions. And you’re right, the most basic assumptions affect the outcomes most significantly.
So what I see here is that the psychiatric industry, for reasons of economics and prestige/power/status, made a decision to regard the brain as the source of all mental/emotional/behavioral distress or wide variance from the norm. We are seeing now a lot of the feedback from that model in application and it is not pretty. However, rather than doing what a good scientist would do, and understand that the original assumptions were erroneous or at a minimum simplistic and go back and start altering those assumptions, they have a financial and power-based investment in maintaining the original assumptions as true regardless of any feedback they might receive from the model’s outcomes.
In other words, they have abandoned the scientific method and have decided to do what makes them the most money/power instead of what helps their clients.
I think you underestimate the importance of and the damage done by the DSM. To start with, there is no reason that we can’t say, “X has difficulty eating enough food” or “Y has a difficult relationship with food” or “Z has a very negative body image that she wants to change.” Not labeling something doesn’t mean denying the circumstances that prompted the labeling process. In fact, we can get a MUCH more accurate description of what is going on by simply asking the client to describe the circumstances they feel they are facing and having them identify their own description of the problem. So there is no need to tell someone “you have an eating disorder” to provide helpful intervention. Now if the person him/herself identifies that “I have an eating disorder,” I would certainly not invalidate that. But that’s very, very different than a professional telling you, “You have an eating disorder” and defining your reality for you. This is especially true when the doctors start telling you that you suffer from a “chemical imbalance” or that your “disorder” is hereditary or due to some kind of brain malfunction that no one has even come close to identifying as true. And if you don’t believe this happens, you need to read up on this site or talk to a lot more people who have engaged with the “MH” system.
More importantly, the DSM is taken VERY seriously by both professionals and the society at large. Not all, but lots and lots. Saying that a person “has depression” implies that there is something wrong with THAT PERSON for feeling that way, that they have a “medical problem” and that they need “treatment.” A survey in the late 2000s showed that over 80% of Americans believed that “depression” was caused by “low serotonin.” This belief did not just happen – it was the result of a large and coordinated effort to convince Americans that “mental health problems” were, in fact, biological. There is plenty of documented evidence that the thrust of the DSM III, which prompted a huge expansion of biological explanations for “mental illnesses” defined in the book, was to expand psychiatry’s market share. It was, in fact, a quite cynical effort to position psychiatry as a “real branch of medicine” and to promote its practices as “scientific” and “proven effective.” Naturally, the pharmaceutical industry was happy to team up with psychiatry in this effort, and continues to provide most of the funding for the continued propaganda campaign to that end.
It’s easy to think that those who made the DSM are just trying to understand better and refine their model, but the origins of the DSM series belie that suggestion. It is more than possible to provide good support to people who face mental and emotional suffering without the slightest reference to a “diagnosis.” Again, if an individual wants to view him/herself through that lens, they’re welcome to do so, but the profession has no right to promote the idea that these “diagnoses” represent real, biologically-distinct entities when they know absolutely that they do not and never will.
What if the “diagnoses” are known to be manufactured and to not represent any kind of medical problem? Is it not a fraud to pretend one is practicing “medicine” beyond “symptom management” when “treating diagnoses” that are known not to be scientifically definable? What’s to stop someone from inventing “nose-picking disorder” or “excessive skipping disorder” or “unreasonable political protest disorder?” If we can just invent “disorders” out of anything we don’t like or find uncomfortable or confusing, where does it end? Hell, they’re prescribing STIMULANTS for “Binge Eating Disorder” now! As if the person is suffering from excessive appetite and suppressing the desire to eat is “treating” the problem! I’m sorry, but these utterly unscientific “disorders” are not advancing the understanding of people’s mental/emotional distress or well being, but is instead creating further confusion.
You are absolutely right, the proof is in the pudding, and so far the psychiatric pudding is falling pretty flat. Making more people disabled, reducing people’s lifespan, reducing hope and increasing stigmatization and discrimination – nothing that could be called a success in any sense.
Real science makes things simpler and more effective over time. The psychiatric model makes things more complex and more confusing and is ultimately very ineffective.
I agree that people are programmed to categorize, but categories are only as useful as they create better understanding. And any real scientist knows that categories are always approximations and that incoming data has to be considered to improve the model of reality over time. A model is not reality, but psychiatry seems to think the model is more important than the results. Unless you count financial results for their corporate buddies.
I’m not going to try and explain myself again. You seem to have difficulty following what I’m saying for some reason. I never assumed that bad brain chemistry causes anything – to the contrary, I think the whole thing is a bunch of pseudoscientific chicanery invented to sell drugs. Anyone who has ever read anything I wrote knows this about me. All I’m saying is that sometimes having hard scientific data proving such assumptions FALSE is helpful in counteracting pseudoscientific propaganda put out by the proponents of the DSM “model” toward their potential victims. You’re free to disagree with me, but not to put words in my mouth that I not only didn’t say, but which are in direct contradiction to what I’ve clearly expressed myself to believe over and over again on this forum.
I think you misunderstand me. The only research I’m talking about it that which debunks any idea that there is some medical issue at play. For instance, I have found it extremely valuable to read decades of reviews of the literature on “ADHD,” not because I believe in that bogus concept, but because those decades of research prove what we all intuitively know to be true: giving kids stimulants doesn’t improve their grades, their academic test scores, their social skills, their high school dropout rates, their rates of delinquency, or even their “self esteem,” however they measure that subjective concept. This is very useful to me when someone tries to explain to a parent how “untreated ADHD” leads to high school dropout and delinquency, and I can say, “What most people don’t seem to know is that 50 years of research have shown that “treating ADHD” with stimulants does not change those outcomes one iota, and in some studies it makes them worse.”
I’m certainly not in favor of wasting good money on studying these idiotic constructs. But I do value people (like Giovanni Fava or Jonathan Leo or Peter Breggin) who do or assemble research showing that the institution of psychiatry has its collective head in a very dark place. Yes, even if they use “those terms.” Because sometimes people just need to hear that psychiatry is lying to them as a place to start their journey to understanding how deeply harmful the industry really is.
I agree absolutely. I’ve said to people that even if they DID prove that people “with ADHD” have a difference in their brains from the average person, it would not mean that there was anything wrong with them. After all, genetic diversity is the key to species survival! Or as one foster youth once wisely said to me, “Maybe different people should be allowed to have different brain chemicals.”
I think they should be called “Antimotivators” or “Anticreators” because their real effect is to blunt the functioning of the frontal lobes, which are the seat of creativity and planning and motivation.
That one gags me every time! It’s even worse than “mental health” to me. As if behavior can have “health!” It is an utter absurdity, and yet people talk about it as if it is a real thing.
I also think research is needed to debunk claims of “chemical imbalances” or other pseudoscientific claims of physiological “causes” of these metaphorical “disorders.”
That is my general practice, and I think it says what needs to be said. This particular use of quotation marks is meant to indicate that this term is used by others but is considered by the “quoter” to have a different value, and usually indicates a degree of disrespect or scorn for the term. Kind of like saying, “So-called schizophrenia.” I have also used “persons who have been labeled as” when talking about research. This allows us to communicate the intent of the researchers without buying into the terminology. That’s just my personal take on it, but I agree with Oldhead here that the quotation marks are the easiest way to show disagreement while still using the recognized term for those who are new to the idea of critiquing the DSM “diagnoses.” (See, it works!)
I should add, the concept of “mental illness” would itself have to be trashed as job one, because it is most definitely NOT “trauma informed” to tell someone that their understandable reaction to being beaten, sexually abused, or otherwise oppressed is a “disorder” that needs “treatment!”
I don’t think that it’s possible to be truly “trauma informed” as long as you are relying on the DSM-driven standard “mental health” system. The only “trauma informed” thing to do is to erase everything people claim to know about “mental illness” and start over from scratch, and rebuild from the viewpoint that the people who have been traumatized are the ones who actually know what they need.
The problem is that there is no profit in it for any big corporations, so there is no motivation to do anything different than what is being done. If Maori methods actually help “cure” people of their ostensible “disorders,” that would be a strong reason for many in the industry to try and bury the idea as deeply as possible so they don’t start losing “customers,” whether voluntary or not.
It kinda seems like the mainstream psychiatrist doesn’t even really recognize there is a person out there to connect with. I think they really believe they are working with a body.
Yeah, I guess “healthy” people feel OK regardless of how they are treated by others. Sounds like the old macho “get tough” crap I got from my football coaches. The “healthiest” people are apparently those who need nothing from anyone else and keep very quiet.
I am impressed at how complex and confusing they have made a very simple correlation. Burnout and depression “overlap” because they are both descriptions of how people feel and act when they are overwhelmed, stuck,hopeless, and/or disconnected or unsupported by their communities. Making it seem like they are somehow different things that “overlap” is just a sleazy way to continue to legitimize their medicalization of “depression.” I found it particularly amusing that they assert that “burnout” is a syndrome that can’t be clearly defined, as if “depression” were somehow different.
Anyway, you can tell when someone’s explanation doesn’t hold water if it continues to make the situation seem more and more complicated instead of simpler.
Thanks for your kind words. It baffles me beyond belief that a person who knows they feel lonely and unloved would be secluded in a room and put in a straight jacket and drugged!!!! How could ANYONE think that would help you feel LESS lonely and unloved? Seems like the best way I could think of to make you feel MORE lonely and unloved?
I can only surmise that a lot of these people don’t really understand or care how other people feel. The lack of empathy is astounding to me. There is nothing wrong with a person who is feeling lonely and unloved! Maybe what they need is connection and love? Radical thought!
They often even tell you when you DO experience these effects that they are NOT caused by the drugs, but are a sign of “relapse.” The lack of ethics in the field is shocking, or would be if I didn’t already expect it at this point.
The problem I see with “Disability Rights” is that by even engaging them, we are allowing that being “diagnosed” with one of these pseudoscientific “disorders” means we are “disabled” in some way. I think the resistance will not be coming from that direction.
Wow. That’s some seriously strained thinking! I can think of a hell of a lot of better “substitute behaviors” over holding a frozen orange! Why not talk to the actual client him/herself about what they would choose as a substitute? What, too empowering? Don’t want to encourage people to think for themselves?
Wow, that last is very revealing! I have heard people smoke to deal with the adverse effects of neuropleptics, but I didn’t know there was research that objectively supports the idea.
The system itself is organized along racist/classist/sexist lines, and unless the field suddenly and miraculously divorces itself from the DSM and all the attendant “diagnoses” and similar medicalized language toward people in distress, it will continue to function as an agent of oppression, despite the scattered patches of sanity that one finds here and there fighting for their own survival. The fact that the psychiatrist could make that incredibly racist statement without an outcry from the entire staff shows how completely accepted it is that psychiatrists get to do whatever they want and the rest of the staff either go along with the bully or get bullied themselves. How anyone could get “saner” in such an environment is a miracle that occurs in spite of rather than because of the system itself.
Way to get complex about it, researchers. The explanation is both simple and obvious: ADHD is diagnosed based on the degree to which the child creates problems for the teacher. Younger kids are more likely to create problems for the teacher, and are therefore more likely to get a referral or pressure to get diagnosed and “medicated.” The other explanations (2-4) are clearly just attempts to rationalize continuing to drug kids because they are annoying.
The first problem is grouping all people who fit the “PTSD” criteria into one group and trying to find one intervention that helps everyone. Some people may like “exposure therapy,” some hate it. Some people find meditation to be a very difficult experience, I personally found it very helpful. People are all different, and different approaches help different people. Why anyone would try to force a “therapy” on someone who said it didn’t feel right is beyond my comprehension.
Except that you’re insulting real clowns. At least a clown’s purpose is to make you laugh. If the psychiatric docs and other MH workers went a little more “Patch Adams” on their patients, we’d all be better off!
I recall doing an excellent exercise on distinguishing facts from opinions/projections. A person would be asked to look at a picture and say what they know about the person in the picture. People would say things like, “He’s sad.” The facilitator would say, “Do you KNOW he’s sad? What do you actually see that you know to be true?” “Well, he looks sad.” “Looks sad to you – that’s your opinion, too. What do you SEE?” “Well, his face looks sad.” “What about his face looks sad?” “He’s frowning.” “How do you know he’s frowning?” “Well, his lips are turning down at the edges.” “THAT is a fact. The rest of the things we think we “know” are assumptions or judgments.” It was a sobering exercise. Most of what we “observe” is not really an observation at all, it’s a judgment. I would also submit that any “observation” made would need to be checked back with the person being “observed” for accuracy, but far better for the person to make his/her own observations without any suggestions from the “helper.”
Solid advice. I’d add that there are some “patients” who have bought into the system as it is and will be difficult to engage on these points. I’d also add that the system personnel will sometimes ask if you are “antipsychiatry” or “a Scientologist” or “anti-science.” You want to be prepared not to engage with this kind of attack, and I’d suggest responding by asking, “Why are you changing the subject? I thought we were talking about whether or not psychiatry works?” But of course, anyone who attacks you in that way is probably not really worth trying to convince, as they are invested in the status quo and maybe even making money off of it.
I actually agree with you, and efforts to be “objective” are often a big barrier to helpers connecting emotionally with the people they are trying to help. Perhaps a better description is for the helper to understand that s/he is NOT objective, and to make strong efforts to double and triple check his/her observations and ideas with the person whom they are supposed to be helping.
Well, I’d say the doctors should know better and are engaging it outright deception, vs. being credulous in believing that doctors would not lie. So both are responsible, but the doctors have more power to change the narrative, and I therefore hold them more to account.
It is possible, but it is my firm belief that only a tiny percentage of people who are suffering will have any kind of neurological difficulties at all. Because being scared, or angry, or depressed, or bored, or even having fantasies are all completely normal activities that every human being experiences at one time or another. It makes no sense at all that 20% of the population is “mentally ill” – they are in the vast majority just people having normal reactions to life. The idea that there will be some physiological cure for something like “depression” is a fantasy. It’s just as likely as curing something like “pain.” It isn’t going to happen, because pain is a part of life, and so is depression and anxiety and all of it.
Actually, beyond direct force there is a lot of manipulation using parental fears. For instance, they tell parents that “untreated ‘ADHD’ leads to delinquency and school dropouts and etc etc.” Of course, they don’t bother to tell them that the “treatment” doesn’t do anything to improve any of those outcomes, nor that most “ADHD” diagnosed kids turn out just fine as adults. So parents are afraid if they don’t “medicate” their child, the child will suffer these awful outcomes that the “treatment” doesn’t even touch. It’s pretty evil!
The first and most important thing anyone for who really wants to help is to start from the awareness that we don’t actually know ANYTHING about the other person except what we observe and what they tell us. Humility is the beginning of wisdom!
Though it is true that many capitalists claim to be “libertarians” in order to justify their opposition to anything that might help the working stiff have a chance at a better quality of life. The Koch brothers are a great example – they claim to be libertarians who are in favor of minimizing regulations and supporting the “free market,” but when rooftop solar started to out-compete other energy providers in sunny places like Oklahoma, they were first in line to propose a tax on rooftop solar. So much for the free market, guys…
He clearly states that the use of the term “illness” to refer to a state of mental or emotional suffering is not a proper use of the term. He (and I) believed that some illnesses could have impacts on thoughts and emotions, such as low thyroid or anemia or a head injury. But those are identified as real illnesses and treated by real branches of medicine. He always was clear that if there is no known physical cause, it’s not an illness. I wanted to make sure you knew I wasn’t denying that things like loss of sleep or the side effects of certain drugs or poor nutrition can cause mental/emotional problems. But to call something like “depression” an “illness” doesn’t make sense to me (or to Szaz), because it assumes that everyone who is feeling depressed has something wrong with them. Indeed, it assumes that all people who are depressed have the same problem. This is about as silly as saying that all people who feel pain have “pain disorder” without bothering to see what is actually causing the pain. Actually, it’s even more silly, because feeling depressed is a normal part of living, it’s not even an indicator of something physically wrong, as pain most often is.
So to be clear: “Major Depression” is not caused by a physical problem. It is an invented category that does not correlate to any physical abnormality. It is just a label for a phenomenon that could have many different causes. Low thyroid IS a physical problem that can cause a particular person to feel depressed. In this case, “depression” is just an indicator of the problem, no different than weight loss/gain or tingling in the hands and feet. So “depression” is never the “illness.” It is just an emotional experience people have, which in rare cases can be caused by a physiological problem of some sort, but which in most cases is simply a normal emotional response to a difficult environment where one has difficulty figuring out what to do.
I hope that makes things clearer. But Oldhead is right – Szaz did not believe that “depression” was or could be a “disease” or “mental illness.” He wasn’t opposed to treating actual illnesses that might cause a person to feel depressed, but he was very much against any kind of idea that “depression” as a whole was or could ever be the result of a biological problem.
That is exactly what I mean. He is pretty clear about saying that if something is discovered to have a real physiological cause, it is moved into one of the actual medical categories, like neurology or nutrition or internal medicine. Psychiatric “illness” is only reserved for those manifestations that DON’T have an actual known physiological cause, which he properly identifies as a metaphorical use of the term “illness,” since there is no reason to believe there is anything physiologically wrong with the person in question. I’d say his take is, “If you know it’s an actual physical ailment, show me the test and treat it as such. If you can’t show it to be physiological, stop calling it an ‘illness,’ because it isn’t.” I’m no Szaz expert, but that’s what I most recall of his writings.
Your point is well taken. The biggest problem with the psychiatric/DSM viewpoint is the absurd assumption that all people or even most people who behave or feel or think in a certain way have something wrong with them, or that all such people have the same thing wrong with them.
I think it means that of all the people who end up diagnosed with “schizophrenia”, only 2.28 out of every 100 had some gene that supposedly conferred vulnerability to “schizophrenia.” Or to put it another way, the idea that “schizophrenia” is caused by genetic variation is BS.
Makes sense to me. Having a degree or license or training in “mental health care” appears to me to bear little to no relationship to actually being able to help someone who is struggling with their life.
Not at all, and neither does Szaz. The important point is that you can’t DIAGNOSE A DISEASE STATE by looking at HOW SOMEONE ACTS OR FEELS. There is no question that certain physiological conditions can cause mental/emotional symptoms or adverse effects. The problem is claiming that a person has such a condition BECAUSE they have certain mental/emotional effects. For instance, it’s legitimate to say that a person might be depressed because he’s had insufficient sleep, but it’s not legitimate to say that you know he has insufficient sleep because he’s depressed. He MIGHT be depressed due to lack of sleep or due to having a dead end job or because he was abused as a child or because he is lonely and has no connections or because his wife just left him or he lost his job or etc., etc, etc.
An analogy might be diagnosing a person with “knee pain disorder.” It is meaningless to say that a person has “knee pain disorder” because their knee hurts. You’d have to know WHY the knee was hurting. Maybe it’s arthritis, maybe it’s a muscle cramp, maybe it’s a bruise, maybe it’s nerve damage, who knows? You’d have to analyze it further to find out what was the cause before you made a diagnosis.
Same with “depression.” Saying “he has depression” tells you nothing at all, except that he’s feeling depressed at that particular time. It may be physical, mental, emotional, social, spiritual, political, or any mix of the above. So calling “depression” a “disorder” is not only meaningless, it is destructive, because it gives people the idea that the psychiatrists have some understanding that they actually don’t have.
You should read his books. Essentially, he says that the idea of “mental illnesses” is only metaphorical – they are not really “illnesses” but “difficulties in living” that have been labeled as such for the purposes of those in positions of power in society. That’s all I’ll say for now – you should read some of his writings. I think they would be very helpful for you to understand why some people say “mental illnesses don’t exist” – very different meaning than “people don’t suffer mentally/emotionally.”
They say a lot, but it’s mostly speculation and nonsense. The one thing we do know is that brain chemistry is constantly changing as we encounter different stresses and needs. So to suggest someone’s brain is “chemically imbalanced” means practically nothing. We also now know that the actual physical structure of the brain is changed by experience. So it seems to me we waste a lot of time studying genetics, which can’t be changed, instead of studying which EXPERIENCES help people feel more strong and capable.
Very true. And what’s wrong with being more active than the average person, or not liking how the world is doing right now, or having difficulty reading others’ cues in social situations? Sounds like being human to me.
All of those elements are involved in creating or alleviating distress, for sure. For instance, loss of sleep definitely increases my feelings of hopelessness or anxiety and reduces my ability to communicate effectively. So sleeping could be said to be a “treatment” for my negative feelings, but really, all they are “symptoms” of is a lack of sleep.
So by all means, we should be addressing deficiencies in our social environment, eating better food, working on our own attitudes, working to improve the economic situation, etc. The problem is that my reacting badly to, say, a very oppressive school environment as a child (I was deeply depressed, did act out one time, had a psychological evaluation, etc.) meant that I had a “disorder” or “disease” or “condition” – it meant that the school’s rules, expectations, and processes and the complete lack of recourse that I or any of the other students had to address any kind of injustice or arbitrariness provided a horrible environment for me to grow in. The real answer wasn’t to ‘treat’ me, but to get me the heck out of there or to change the environment so I didn’t feel so hopeless about having to go there and be bored and lonely and angry and frustrated 5 days a week, 6 hours a day.
Do I have a tendency more than other people to be anxious or depressed? Yes, I do. Could some of this tendency be built into my personality? Sure, it could. But so is empathy, compassion, willingness to fight for justice, humor, and lots of other things that go along with being “sensitive.” I don’t think I needed to be “assessed” or “evaluated” or “treated,” I needed to be loved and listened to and provided more opportunities to take more control of my own life.
So I’m all for looking at all the factors that contribute to someone’s distress. I’m just opposed to the idea that being distressed in a particular way that is inconvenient for those in charge means that I have a “disorder.” I think it means I’m human, and we humans are all different and unique in our needs and goals and values and deserve to be treated that way. We don’t deserve to be slotted into categories of “wrongness” for the convenience of those who want to pretend that life is a garden of delights and that anyone who is not loving every minute of it needs to be “fixed.”
Given what the “mental health” world has done with ‘mindfulness’ by abstracting it from the Buddhist philosophy that underpins it and in some cases making it a requirement in someone’s “treatment plan,” I am very skeptical that Western Psychiatry will do anything but distort and ruin any helpful practice the Maori may have developed. Maybe we should skip reforming psychiatry and instead pay the Maori what we used to pay the psychiatrists rather than expropriating their spiritual practices and turning them into yet another bastardized western product for sale?
I don’t think anyone should invalidate your own perception of what works for you. Certainly, lots of people report finding psych drugs helpful. But that does not make psych diagnoses legitimate. They are not discovered, but literally voted on by committee. Read “So They Say You’re Crazy” by Paula Caplan, who served on the DSM IV task force.
And yes, they do invent “disorders”. Look at the cases if Juvenile Bipolar or Social Anxiety Disorder or Binge Eating Disorder. Not that such things are not issues for some people, but there is solid documentation that pharmaceutical companies conspired with leading psychiatrists to create these “disorders” in the DSM to sell pharmaceuticals and psychiatric “services.” I know it’s hard to believe, but it is true.
True. Most suffering by children is caused by adults’ mistreatment of them. My biggest objection to “diagnoses” is that it lets adults off the hook and blames children for having “bad reactions” to adult abuse, neglect and mistreatment.
If Leonardo “had ADHD”, he seems to have done quite well in his “unmedicated” state. Maybe we need to let our “ADHD” kids explore their creative sides and we’ll have more Leonardos. Just a thought…
But it is important to acknowledge that people DO suffer in various ways, and often need help dealing with their emotions and their experiences. This doesn’t make them ill, but I think it is important to distinguish that these “diagnoses” are crap, in that they are social inventions, but that suffering is real and that we need to get together as a community and look for solutions that actually help but don’t blame the sufferer for suffering too much or in the “wrong” manner.
I do see what you’re saying. I think it involves a confusion about language. When people say, “There is no such thing as ‘Bipolar Disorder,'” I think they mostly mean that “Bipolar Disorder” is an invention that doesn’t have a scientific basis as a medical diagnosis. I don’t think people mostly believe that those behaviors defined as “bipolar disorder” don’t occur, or that they don’t cause distress, or that help is not sometimes required. I think the objection is that someone with medical authority is DEFINING these behaviors as a “medical disorder” without cause. But it is often intepreted by readers as meaning that people don’t have these feelings or behaviors, which leads to lots of confusion and, as you say, distraction from the key points. At the same time, I really do understand why people who have survived the system often are very strongly against using these terms, which is why I put them in quotation marks whenever I use them. These generalizations have been used to harm people, often intentionally, and if that had happened to me, and I later found out the “disorder” I was assigned was voted into existence by a committee, I’d never want to see that word in print again!
I mean the goal of being “normal” as defined by the social norms promoted by our cultural system of values. It is the slavish adherence to this artificial “normalcy” and its conflict with people’s actual reality that is behind many cases of “mental illness.” This is very different from accomplishing what the client personally wants to create as their own “normal” mode of operation. What I find abhorrent is when therapists/counselors/psychiatrists define “normal” for the client and feel their job is to make them “fit in” better to society, rather than finding their own definition of “normal” that allows them to be comfortable in their own skins.
As for pissing of psychiatrists, it depends if the psychiatrist is in a position to influence your reputation or your employment potential. There are definitely situations where one’s survival as a therapist in a particular institution depends on not being too vocal about critiques of the DSM or “medication” use. I respect anyone who can operate “behind the lines” without being beaten down or giving up. You appear to have established a certain level of respect and independence that has allowed you to be a maverick with limited consequences, but that takes time and skill to develop, and for some, it appears to be beyond their capacity. Working in a psychiatric institution or one controlled by psychiatric thinking can be extremely oppressive toward the workers as well. It takes a lot of courage not to pass on that oppression to the clients.
I never really thought about it, but you’re right, the concept of “baseline” is totally bogus. It assumes a person is a fixed entity that is only temporarily impacted by life circumstances. This is rot, of course. People are always developing, and the whole idea of “therapy” ought to be to help someone move onward to their next step in life, rather than returning to some “baseline” equilibrium defined by another person.
The link between psychotic experiences and childhood trauma (especially sexual abuse) is dramatically higher than the most optimistic estimate of genetic contribution. Yet billions continue to be spent on genetic research and almost nothing on the connection to abuse and cultural dislocation. And they call that science?
I think there is a big difference between a person preferring a particular framing of their situation and a doctor claiming that everyone having a particular behavioral manifestation is suffering from “X disorder.” We are all entitled to view our circumstances in a way that makes sense, but doctors are claiming to have some superior knowledge of the situation. Making unsubstantiated claims of understanding situations that are scientifically inconsistent or mysterious or invalid is something no professional should be allowed to do. I see it as extremely damaging to our society as a whole to allow these false claims to be viewed as some kind of scientific truth. At the same time, I have no problem with anyone choosing to view their own problem as a “mental disorder.” I just don’t support doctors making this kind of assertion unless there is actually evidence it is true. Medical diagnoses should not be something people choose because they prefer them. They should be objectively measurable conditions that can be reliably identified and treated. OCD certainly does not meet those criteria, nor does essentially any other “mental disorder” in the DSM.
I have to respectfully disagree with your assertion regarding therapists not being allowed to practice if they don’t follow the priorities you mention above. I have tons of experience with therapists, both as a part of the MH system and as an advocate for foster youth for 20 years. I can assure you that therapists are all over the place in terms of practice, and any generalization you’d like to make is not going to be accurate. Some are unwilling to give any direction at all to the client, no matter how bogged down they get, others think they know everything and constantly tell the client what to do. Some believe that everyone’s issues come from poor parenting, others believe that nothing in the past has any impact on the present. Some have people go over past traumatic events in detail, others avoid them like the plague. Some believe religiously in the DSM, others consider it ridiculously simplistic and only use it for billing purposes. Some seek to be empowering, others seek to define and solve the client’s problems for them. Some feel that sharing personal details of their lives is essential to a successful relationship, others consider any sharing a violation of “professional boundaries.” The only generalization that can be made about therapists is that there is no consistency regarding expectations or results.
I do get that the CONCEPT behind therapy suggests that fixing the person to make them more “normal” is the goal, and I of course find such a goal abhorrent. But therapy for the most part can be whatever the therapist and client make it, and some people report very positive experiences with therapists that have helped them change their lives for the better. (Though I have to admit that such reports seem to have become rarer over the decades.)
Bottom line, I think comments about the therapy industry as a whole can be reliably made, but generalizations about what would happen to a particular therapist if they didn’t toe some imaginary party line do not line up with what I’ve seen. Therapists can generally do whatever the heck they want, as long as they can bill the insurance company for their work, and as long as they don’t piss off any psychiatrists they have to answer to by threatening their label-and-drug gravy train.
The fly in that ointment is how one decides which person is qualified to be a therapist. I personally think the only measure of success is the experience of the client in meeting his/her own goals during the process. At this point, unfortunately, it appears that “Caveat Emptor” is the rule of the day.
This would not surprise me much. There has always been a strong undercurrent of racism amongst our ruling classes. It became unfashionable to say such things in public, but it’s amazing how many people still express this kind of feeling behind closed doors.
Once again, I think we see how the labeling process actually does as much or more harm than the drugs themselves. What if we just said, “Here are some strategies for those who want to figure out a way to reduce unwanted compulsions” or something like that. Why not just describe the problem in terms that are meaningful for the client, and work toward the client’s goals? Why do we have to ascribe some critical label to the behavior, rather than just identifying that it’s something the client wants to change?
It is unfortunate that some good tips and ideas can be obscured by these medicalizing terms. I hope we as a community can work to tell the difference between our cultural training to use medicalized terms and the actual potential of the interventions being discussed. Some people with good ideas haven’t yet figured out the problematic nature of these terms just yet.
I think the problem is that the FDA is loaded with industry insiders who think like Big Pharma and don’t ever question their intentions. And those who do challenge the industry have reportedly felt attacked for speaking up. It may not be direct corruption, but it’s certainly “insider trading,” or as you called it, “Cronyism.”
Exactly. That’s why I believe in many ways the labels are far more destructive than the drugs they prescribe. The labeling alters social perceptions of the PERSON who is so labeled, and alters our attitude toward trauma – it moves from compassion to “let the victim beware!”
Not sure I agree with you, Ron. I think of survivors of domestic abuse – they are or should be proud that they have survived such horrific abuse and continue to lead semi-functional lives in the wake of it, even if they fully know and understand that they have to continue to work on overcoming the damage done to them. It’s possible to be proud that you came up with ways to get through something difficult while still recognizing that one’s life can be improved yet further by continuing efforts.
They will always tell parents that “untreated ADHD” is associated with higher rates of delinquency, school dropout, drug use, lower test scores, lower college enrollment rates, lower self-esteem and so forth. What they DON’T ever tell them is that “treatment” in the form of stimulant drugs has never been shown to improve ANY of these outcomes! It’s a real flim-flam job, though I sometimes think the teachers themselves have mostly been flim-flammed and don’t even really realize what they are saying. It’s like a robot or computerized message, they just all say it because they’re programmed to do so.
Posting as moderator: I would also add to Emmeline’s comments that choosing to publish a summary and link to a research article in no way implies that MIA approves of the research or supports the conclusions. It is simply a summary of research that some readers might find helpful. If you don’t, it’s fine to ignore it. I personally find MIA to be the best place to gather ammunition if I’m trying to influence a professional person to take another look at their belief system. Some people make up their minds based on research, and this kind of information is sometimes essential to counteract their narrative.
I agree 100%, and this should be obvious. How can you send a “therapeutic current” when you don’t even know whether the brain is the causal factor, let alone what part is involved? Why is it not obvious to people that these folks are deceiving them?
And I think the challenge for me is that the degree confers some kind of confidence in people that this person knows what they are doing. If therapists are to be licensed, there ought to be a much more practical way to do so that is based primarily on the person’s actual impact on the client(s) s/he serves, rather than how many years of education s/he may have consumed.
And in too many cases, that bullying is passed on down to the kids, who then pass it on to the lower status kids among the group. Bullying doesn’t start with kids, it starts with adults mistreating each other and then mistreating the kids in their charge.
It is my understanding that lot of the “paraprofessionals” used by Mosher at Soteria House were people who had used hallucinogens and had experience as “trip guides.” There are many ways to learn the necessary skills to be a good helping person. And it should be very, very clear that obtaining a Masters Degree or Ph.D. is no guarantee that a person will learn these skills. It is unfortunate that the conferring of an advanced degree is assumed to indicate a minimal level of interpersonal competence when there is really no way to assure such competence by any educational approach now known.
I think “trauma” can only realistically be defined by the person reporting the experience. Trying to set some kind of standard only gets us confused. Some people are sexually molested by a family member, yet are believed when they tell their parent or loved one and are protected, and some of those people reportedly have relatively little long-term impact from the experience, while others find it horribly traumatizing. Some folks are yelled at by a parent or teacher or left on their own very young and feel frightened enough that it ends up being a lifelong issue for them. I think you get to decide how traumatic an incident that you experience is for you. Anything else is just authoritarian invalidation of your experience.
There are all kinds of fundamentalism, which is why I say that the real enemy is not the Right or the Left, but AUTHORITARIANISM in any form. A certain amount of agreed authority is needed to accomplish many tasks, but the assumption that there are authorities who are “right” and that those who want to be successful have to merely follow the instructions of the wiser “guide” or “leader” without having to think too hard is what screws us over. This happens with a lot people who are hard-line conservatives and a lot of people who are hard-line liberals/progressives/whatever and it happens to lots of folks who don’t identify with either end of the spectrum. It’s not a left-right issue, it’s an issue of whether people want to actually solve real problems or feel safe being in the middle of an ideological herd and not have to tax their intellect or their emotions too much.
A little confused by this, because I didn’t suggest that Marxism was a solution. I’m asking what it is? I agree that good must defeat evil, but what is the mechanism by which that happens on a societal scale? I don’t think there are any simple answers, but I think humans tend to be easily mesmerized by attempts to present simple answers, whether it be total government control over everything or elimination of all regulations and letting the “free market” save us all, or following some spiritual leader who seems to “have the answers.” Saying “socialism is bad” is no more sensible than saying “socialism is good.” There are clearly elements of socialism that are embedded in any Western democracy, and there are free markets operating in the most totalitarian economies. It’s not a black and white thing to me – it seems we need a balance between freedom to exercise our own ideas and objectives and the need to act together as a society to make sure that people’s rights are not violated.
Or to put it in terms of an old joke: What’s the difference between Capitalism and Communism? In Capitalism, man exploits man, while in Communism, it’s the other way around.
We can do better, but I think we have to have a practical way for “good to fight evil.” I don’t think it’s simple, and it most definitely doesn’t involve trusting all or most corporations to be on the side of “good.” Especially Big Pharma!
I do feel compelled to add to your narrative that the current “drug first and ask questions later” approach to “mental health” is driven to a very large extent by pharmaceutical companies in the interests of maximizing profits at the expense of the “patients.” This is not Marxism in action, but the profit motive. Of course, we can go off into explaining how “big government” makes this all possible, but government corruption is also a function of too few people having too much money and using it to influence politicians to do their bidding. So as much as an actual “free market” arguably has shown some large-scale benefits, at least for a proportion of people participating, the redistribution of money to those who already have money and power is something that has to be addressed in my view. How do you see this happening? How do we reduce the vast influence of big pharmaceutical money that is driving this “epidemic” of invented “disorders?”
I would add that there is plenty of evidence that maternal SSRI usage is associated with increased autism rates, and that the increase in autism diagnoses corresponded to big increases in SSRI use by adults.
Of course, there is also the loosening of “criteria” for autism and the constant seeping in of the idea that “diagnosing” kids is more effective than understanding them.
Sorry, it seems to have been moved off. Essentially, all comments are going to be read first before they are posted. This will eliminate spam as well as rude or disrespectful comments in advance, rather than have them posted all day before I can get to reading them. It will slow down the rate of posts, but we have extra people looking over and approving comments at different times of the day, so it shouldn’t be too much different than it is now. But if it really affects your experience, Bob Whitaker is available to answer questions and take feedback.
So what I think you’re saying is that the very act of calling something an “alternative” validates psychiatry as providing a useful service. Am I getting that right?
The “therapeutic” and toxic levels of lithium are the closest for any drug in use. That should tell us something – it sounds like we are adding enough lithium to ALMOST poison the “patient.”
The other problem is that the FDA is often staffed with people who come directly from the pharmaceutical industry. There is a lot of pressure to approve things that are not effective and/or to minimize the adverse effects.
Yeah, kind of like “researchers discover that planting strawberry plants frequently leads to strawberries growing.” When you set up incentives to cheat, people are more likely to cheat. No research needed.
In other words, people who are abused as kid are more likely to abuse their kids than those who aren’t. The old cycle of abuse idea. Hardly groundbreaking research here. The disturbing part is that everyone in the field doesn’t already know that childhood abuse is behind much of what is called “mental illness.” Treat kids better and “mental illness” will be reduced. But oh, that’s “blaming the parents,” isn’t it? Safer to blame the kids’ brains.
Again, you are clearly overgeneralizing. There are therapists, admittedly fewer and fewer as the DSM is more dominant, but there are therapists who support taking action to alter one’s circumstances for the better, including taking political action if one is so inclined.
I actually think there is another factor – I think people often become worried that THEY are the “crazy ones” and are happy to find someone else to be labeled “crazy” so they can feel more “normal.” I think most people suffer confusion, anxiety, depression about our current society and the fragmented and often conflicting and competitive roles they have to play to survive, from grades in school right up through competition for jobs and wages. They seek some sort of order that they can hang onto, including looking for someone “below” them in the social order so they can feel like, “At least I’m not as messed up as THOSE people!” Psychiatry is happy to take on that role so that this kind of “othering” has the backing of the “authorities.”
I think it is an excellent and important question. It is the kind of question that gets people tied up in knots when someone suggests eliminating psychiatry altogether. While they don’t understand that psychiatric practice appears to actually increase the suicide rate, people will want to know where they can go for help if there is no doctor/psychiatrist/hospital to go to. I’m not sure I have a great answer yet.
Soteria House provided this kind of option back in the 80s. Naturally, it was quickly de-funded, as it threatened to undermine psychiatry’s market share just at the time they were trying to expand it.
The lack of objectivity of these “diagnoses” makes the concept of “overdiagnosis” essentially meaningless, as there is no way to ever tell what the “correct” rate of diagnosis should be.
I’m not saying that at all. I’m saying that grouping people together based on their emotional state is not going to lead to any positive conclusion. Most emotional states are the result of our interaction with the environment. Anxiety is mostly caused by experiencing scary things, depression by hopeless experiences. Now anxiety can also be created by deprivation of oxygen or by taking a lot of stimulants, which are physiological causes, but the idea that there is ONE physiological cause of anxiety is just plain wrong. So what I’m objecting to is not the idea that biology can cause anxiety in some cases, but the idea that anxiety is all caused by the same thing every time, or that anxiety is even always a “disorder.” Anxiety is our body’s way of telling us that something scary is happening and we need to take action to remedy it. What it is that is scary can be very different, depending on the person and the situation. It is not a “mental illness” to be anxious. It may be an indicator of some other illness, but anxiety itself is not an illness. It’s a natural state of the body under stress.
I concur. Guilt, like all of our emotions, has a survival role to play in our lives. Psychiatry’s first mistake is identifying emotions as being “good” or “bad,” and trying to eliminate the bad ones. Emotions aren’t good or bad, they send us messages about how we are surviving and what we can do to survive better. Learning to listen to our emotions is a part of being a rational human being.
I have not found that to be true in all cases. I’ve certainly seen many who do, and you may not have encountered any who don’t, but psychotherapists are human beings, too, and since they don’t really have any specific guidelines, my experience is that everyone pretty much does what they think works. Whether they support political activism for their clients is a function of their personal beliefs and goals. If they are a “top-down” therapist who believes that they know best, they can be extremely invalidative. But there are therapists (admittedly in the minority in my experience) who truly do believe in empowerment of the client to be more capable of living his/her life the way s/he wants to, including taking action against oppressive agents if need be. And there are a whole lot who are in the middle, trying to be helpful at they can but not really having a good idea of what they are trying to accomplish.
As I said before, generalizations about “therapists” lead to mistaken ideas. Not all therapists are alike or believe in the same things.
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Making gross generalizations about therapists leads to errors in judgment. There is a huge range of therapists/counselors out there with different orientations and priorities. I was fortunate to have one who was very empowering and focused on me getting better at accomplishing my own goals. She was very much “trauma informed” and the results were quite significant for me. Of course, this was back in 1981 before the DSM III and the ‘chemical imbalance’ model had totally taken over, but there are still folks out there doing good work, though I most definitely consider them to be very much in the minority these days. I’ve certainly spoken to folks who became more radicalized through therapy, not because the therapist wanted to “radicalize” them, but because as they woke up to what led to their so-called “mental illness,” they realized that radicalization was the path they needed to take. I’m one such.
In fairness, I know a lot more stories about therapists who were either ineffective or were invalidative and destructive, and more and more these days believe wholeheartedly in the DSM and in drugs for “mental illnesses.” So I’d be super careful looking for a therapist, actually, I probably would not consider it for myself these days because I know more than most of them. But there are still some competent people out there.
That’s the basic lie, I agree. Calling it “mental illness” means it is the client/patient’s problem instead of a natural outgrowth of living in a social system that is designed to allow a small number of people to thrive at the expense of the masses. “Diagnosing” people clearly and intentionally puts the problem on the individual and exonerates social institutions from any responsibility.
Angry is definitely more productive than guilty, but both are understandable and totally to be expected. Unlike what the psychiatric profession wants us to believe, feelings are actually a normal part of being human!
I found this very moving. It seems to me that you have learned that humility is the beginning of understanding and being of help to another human being in distress. Sadly, humility is sorely lacking in most of our ‘mental health’ services and professionals. The entire enterprise is based on hubris and prejudice. I wish your attitude would spread among those who errantly believe they are helping. Being willing to hear that kind of feedback is painful but really the only path to gradually unraveling the truth.
It’s pretty freakin’ bizarre. I am sure if you thought I said otherwise, you misinterpreted. I have always wondered how ANYONE could look at this idea, “Gosh, I’m feeling depressed, maybe passing an electric current through my brain and inducing a seizure might help,” has got to be pretty darned confused, and anyone who would do it to someone else is either completely lacking in judgment and empathy or else enjoys making others suffer. I am totally against drugging people for “mental illnesses,” but “ECT” seems even worse.
I agree 100% that it is an attempt to “get ahead of the story” and control the narrative. I believe it only is happening because the true information about the ineffectiveness and dangers of psychiatric drugs are coming to the surface. They have to deflect attention somewhere, so they are choosing to focus on “withdrawl effects” in order to keep their “diagnostic” and “treatment” systems as intact as possible. So as distorted as the story itself may be, it is a sign that the recent increase in pressure to get the truth out is having an impact. “Cracks in the armor” make space for a well-placed sword strike to do some real damage!
Just to be clear, “Biological psychiatry” was alive and well long before the DSM III. Insulin coma therapy, lobotomies, “hydrotherapy,” and all sorts of weird practices went back decades or even centuries before 1980. I would say, though, that 1980 and following was a shift toward a more systematic marketing and disinformation campaign to intentionally and vastly expand the scope of psychiatry’s influence, especially into the “markets” of children, the elderly, and those formerly considered “neurotic.” There was also a coordinated campaign to minimize the impact of social conditions and trauma that served the purpose of improving psychiatry’s “brand.”
I believe the reference to “materialism” refers to the idea that the human is just a body, and that nothing can exist outside the physical plane. Whether that philosophy bred psychiatry, it has certainly been seized upon by psychiatry as a means of “proving” their point that “mental illnesses” are in the brain – “because if they aren’t, where could they be?” You and I have both made the point repeatedly that the assumption that mind = brain is at the crux of psychiatry’s “brain disorder” concepts. I think that is the aspect of materialism being referred to here.
“Biological psychiatry” goes back way before Thorazine. But I certainly don’t hear Bob calling for a return to the “good old days.” I see him identifying the DSM III as a big shift toward “diagnosing” teens and children, which was a lot less common before that time. They were identified as a new “market.”
But you make a good point that the attack on the patients’ liberation movement appears to have been coordinated with the release of the DSM III. It stands to reason that if psychiatry was interested in altering their “image” to appear “more scientific,” silencing those who would tarnish that image would have to be part of the plan.
As long as there are tests that can reliably and objectively distinguish one category from another, we can have actual diagnoses. But I very much doubt that all or even most of the people currently diagnosed will fit into any of these measurable categories.
There is actually no reason EVER to give “antidepressants” to a child, as there is no evidence that they “work” even in the short term. Of course, they don’t really “work” for anyone in the long run, but apparently the placebo effect is stronger in adults, I guess. Even psychiatry’s own researchers admit that kids don’t benefit from “antidepressants.”
They might also consider altering the structure of schools to lessen the performance pressure and increase the sense of safety and acceptance for the kids they are trying to teach.
I will say, though, that there appears to be a move to acknowledge withdrawal symptoms from “antidepressants” in many media stories all of a sudden. Someone else said this, but I think it is a “damage control” approach, where things are so bad they have to admit something, but want to direct the “flow” to a place where it will minimally interfere with their financial concerns. So it IS a victory of sorts that the narrative has changed, if only in this one respect, and I don’t think it would have happened without MIA and other efforts to make the truth known to the public. Keep the heat on!
I actually think Laura’s story is very common. Many people become ensnared in the system because they trust that the “professionals” know what they are doing. Once they are in, many are scared into compliance by stories of what will happen if they go off the drugs, and if they do try, no one is there to explain about or help with the withdrawal symptoms. So they start falling apart when they go off the drugs, and it seems that the psychiatrists were right so they stay on for years or decades. It’s not a rare story.
The obvious point that is overlooked here is that the psychiatric profession “diagnosed” these people “treatment resistant depression,” when in fact there was nothing wrong with them that some artificial hope and time passing could not change. How is it possible that these people were deemed “treatment resistant” when they were completely capable of “self-healing,” if there was even anything to heal in the first place? Rather than “regression to the mean,” is it not in fact likely that the withdrawal of psychiatric diagnosis and “treatment” and the hopelessness that it conveys was the biggest variable in these miraculous recoveries from a supposedly hopeless condition?
It seems so odd that those in the field are comfortable with the idea that we can choose the theoretical framework we like or don’t like. Can we decide we don’t like the “theoretical framework” for cancer? If some people don’t like the idea that it’s an overgrowth of cells, and prefer to think of it more as a focus of negative energy, and others see it more as a new evolutionary pathway, do they get to pick?
Real diagnoses refer to real, observable, measurable physical phenomena. No one has to vote on whether a broken leg is broken, or how you fix it. The very fact that we’re having this kind of discussion is proof enough that the “professionals” don’t have any idea what is going on. STOP DIAGNOSING, at least until you actually figure out what small percentage of the “mentally ill” actually have an observable physical problem you can see, measure, and effectively address!
“Transitive diagnosis” still seems to medicalize distress as being somehow abnormal. Why bother with diagnosis at all? Why not talk about ongoing learning and development of new understandings of the world or new skills for approaching problems facing the client?
That is what I have always found. If we assume that the person has a purpose for their behavior, and that our job is to understand it rather than just stopping anything we find inconvenient or uncomfortable, we can make real progress in creating better communication and understanding. And guess what, when we do that, a lot of the “bad behavior” goes away on its own.
Taking a stand against the Viet Nam war in the mid 1960s, not to mention marching the streets to end racism and getting locked up over and over again, and having poor people march en masse to Washington DC to protest, certainly doesn’t seem very “middle ground” to me.
I’m glad you mentioned oppression. The big shortcoming of this article is that it makes it seem like there are two equal ideas competing to see which one comes out on top. This is not what is going on. One idea is being FORCED on people, both practitioners AND clients within the system, and the other is being actively suppressed, not because the dominant one is “better,” but because it is more financially rewarding for certain people and because it helps those in power relieve themselves from any responsibility for the damage they cause. I eventually concluded that I had to get out of the profession completely, because change from within seemed impossible and because I felt I was colluding just by participating in such an oppressive system, even if I could help a small number of people along the way to escape or minimize their experience of oppression within the system.
I am not at all being facetious. You write very well and articulately, and have important things to say. I say this as a writer myself. Sometimes writing the book is in itself a very empowering exercise, regardless of who reads it. Mine has not sold a lot of copies, but I figure if even one person is helped by what I have written, it makes the entire process worth my time and energy.
I am not sure the “middle ground” you’re talking about is what was meant in the article. Your sounds more like a Hegelian “synthesis,” or like the Buddhist concept of the “middle way,” selecting neither of the two opposites. I think what the article is talking about is something more along the lines of, “Well, ECT does do some brain damage to some people, but let’s not forget that other people say they really like it!” Or, “Let’s not be too extreme in how we talk about psychiatric drugs, because some people who take them might have their feelings hurt.” It’s a call for not speaking the whole truth because it’s uncomfortable. Very different than collaborating to find a solution that works for a wider range of people involved in a conflict.
I totally get this. A ton of foster youth I worked with were diagnosed with “bipolar” or “emerging schizophrenia” based 90% on the fact that a parent had such a “diagnosis.” Despite the fact that not one of the “diagnoses” has ever been connected to any genetic anomaly, it’s assumed that “he got it from his mom.”
The expectation of “medication compliance” from “therapists” is also not surprising to me. Sometimes it seemed they spent more time on that than on actually trying to help the kid sort out how to deal with all the bizarre dynamics of being in an abusive family and then being in foster care. I mean, if you can’t get why a foster kid might be feeling depressed or anxious or angry, what the heck are you doing trying to provide “therapy” to them?
Yeah, I know. He does not check in here or post responses for whatever reason. It might be very helpful to be able to get clarification from him, but I suppose he gets to decide where he wants to put his energy.
It has always bugged me when someone says, “Oh, they JUST need attention!” As if needing attention is some trivial thing, or that the child is being somehow selfish by needing it. Attention is survival for young kids, they will literally DIE without attention. And the need for social connection is vital to all humans. The minimization of kids’ need for attention is a sign of people who really don’t like or understand children at all. Which says a little something about the psychiatric profession.
Nah, if their brain chemistry were right, they’d be totally OK with being poor and hungry and having to work two jobs to barely survive. I mean, what’s depressing about THAT?
I agree, very few non-medical folks know anything much about benzo withdrawal. Many have been told that benzos don’t create dependence if used as directed, in direct contradiction to the published product information. There is a lot of misinformation out there.
I doubt that Peter Breggin would disagree with you on that point. I took it that this was what he was talking about in the article, the lack of love and compassion coming from the “professionals,” not from their victims.
There is certainly a VERY large difference between arbitrary and ambiguous. Arbitrary would suggest a complete lack of any kind of standard except a person’s whim, whereas ambiguous would suggest that the standard is not black and white, which is certainly the case in any moderating scenario.
It would certainly be possible to censor people based on the content or position their comment takes, but I think a look at the wide variety of comments and views that are allowed to stand that at least in general nothing of a censorship nature is occurring. Of course, when there are subjective standards, individual bias comes into play, and if there is any preferential treatment of which I am unaware, it would be coming from this kind of place rather than an intent to suppress or promote different views. That said, I can say with absolute certainty that I leave most posts up, including ones with which I personally disagree or some of which are critical of MIA or Robert Whitaker or a particular article or author, and the only intent I have is to make sure that people are “playing nice.” There ARE standards, and they are published standards, and decisions regarding moderation must be held to those standards. That’s what moderation is about. It is not based on any intent to sponsor or suppress any particular viewpoint as long as it is expressed within those rules, which everyone can read and which everyone implicitly agrees to by choosing to post.
Yes, sadly, wisdom can not be mandated. It can only be arrived at through experience, and there will always be fools aplenty for the unscrupulous to mess with.
We do not moderate for content here. People are free to express whatever views they want to express. The editorial staff also selects a wide range of articles, many of which are not written for MIA but are gleaned from various places on the web. The only moderation that occurs is for potentially offensive or hostile language that would make the comments section an unsafe place for people to express their views. You are, of course, welcome to respectfully express your opinion on the value or lack of value of such questionnaires or articles regarding them.
I think you are perhaps not taking into account the impact of the lies and mythology spread so widely by mass marketing. I personally think it should be illegal for ads to claim things that aren’t true (actually, I think Pharmaceutical ads should be banned, as they are in every other industrialized nation except New Zealand), and I think it should be illegal for doctors to lie to their patients about what is supposedly known about “mental illnesses.” I also think it should be illegal to invent “diseases” by committees.
The suicide rate may also be related to the “treatment” they are receiving, i.e. “antidepressants” and benzos and sometimes stimulants. Besides, who says you have to be in combat to see or experience atrocities or trauma in the military?
Horrifying, but not entirely shocking to me. People who like power and control like to find jobs where they “care” for vulnerable people so they can get their jollies.
I had a similar thought. I believe he’s talking about the caretakers in people’s lives starting from a place of love. I say this based on past reading of his works. He’s very big about the adults being responsible for creating a safe and loving environment for their children, and doesn’t think kids should have to worry about taking care of the adults in their lives. By extension, it would make sense that he means that the “mental health professionals,” if that term applies, would have to be loving toward those in their care. I doubt very much that he means that if you meet your psychiatrist with love, that s/he will somehow magically become a good and loving person. We don’t live in fairy tales!
Your sense of responsibility is orders of magnitude higher than that of a big corporation. Or apparently than most individuals. I wish more other people felt the same as you do about it.
I don’t have a lot of time to make comments, John. I am mostly moderating others’ comments for appropriateness, so I don’t have a lot of time to make lengthy remarks. Additionally, you have summed things up so well in most cases that there isn’t much to say besides, “I agree, and I’m glad you said that!” You’re talking about a lot of things that occurred just as I was coming to adulthood. I grew up in the 60s and early 70s and related to the student protest movements big time. The election of Reagan was such a grave disappointment to me, yet the media and a lot of Americans somehow continued to portray him as some kind of hero or amazing leader when he was mostly a figurehead B-movie actor acting out his greatest role. The same scum that were really behind him were behind Bush, Bush II, and continue to have influence on Trump, though Trump is pretty hard to control. These are not nice people, and you are absolutely right that they were terrified by the youth movements and did all they could to shut them down. Limiting employment and creating economic anxiety were not accidents that happened, but in my view were part of the plan to get us so worried about our daily survival that we (especially the young) had no time or energy left for organizing. It’s been very effective, unfortunately.
There are most definitely “secondary gains” for people who’d rather pretend that emotional distress doesn’t exist or is pathological. Makes it easier for folks to discriminate and dismiss anyone whose behavior they don’t approve of.
John, I understand your feelings, and a lot of people feel that way. I’m going to post this not only for you, but for anyone who is feeling that way. It is an act of power for me or another moderator to choose to remove what someone has posted, and that can easily feel like bullying to anyone. I try to be very, very sensitive to this fact when I make moderation decisions.
I guess the question is what is meant by “censorship.” If I or anyone is removing comments because their content is considered unacceptable by the management, that would be censorship.
Definition:
“the suppression or prohibition of any parts of books, films, news, etc. that are considered obscene, politically unacceptable, or a threat to security.”
What happens here is that we have certain standards of behavior that are expected and are implicitly agreed to by anyone who posts. These standards are posted and available for anyone to read. When we remove comments, it is intended ONLY to reflect concerns about whether or not it violates the guidelines that are written on the site. I always try to work with anyone whose comments are moderated and give them an opportunity to re-post an edited version that doesn’t violate the guidelines. And I have in a few cases been talked into leaving the post unchanged once I understood the intent.
So no, we don’t do censorship here, though I understand why it might feel that way. Anyone is free to post any idea or thought or story they have, as long as it fits within the posting guidelines. In fact, I sometimes get pushed to censor certain viewpoints that aren’t popular in the community, and I always refuse to do so. Everyone has a right to their viewpoint and to express it here, as long as it is done in a way that respects others’ rights to do the same.
I hope that clarifies things, and I do apologize for any hurt feelings that may have happened along the way.
It sounds awful, John! No one should have a parent who doesn’t care. Sadly, it happens far too often. I have worked with foster kids for over 20 years and I have seen a lot, including a teen whose mom in fact backed over her in the driveway. She said she THOUGHT it was accidental, but couldn’t be sure. It’s just wrong to have to feel that way about a parent or caretaker!
Woah, wait a minute – are you suggesting that being depressed MIGHT be related to having depressing things happening in your life?? Nah, that’s just TOO far fetched – makes so much more sense to blame our brains. Or more profitable at least…
Once again, your analysis is spot on. He broke the ATC union which had a chilling effect on unions nationwide, and he also promoted the idea that if you’re not doing well, it’s all your fault. “It’s Morning in America,” and if you’re not happy, you’re not trying hard enough. Very good fit with the psychiatric worldview, which not coincidentally began to expand its influence at just about the same time.
I agree absolutely. Americans in particular are awful about remembering even recent history, which means they don’t really understand what’s going on today. “Those who forget history are condemned to repeat it.”
You said a mouthful! I think that is the real key to good parenting – to teach kids that it’s OK to be who they are and it’s safe to bring up stuff that is uncomfortable. Of course, kids need a lot of guidance and love, but it is so important for them to be able to “bring what’s inside to the outside.” In fact, that sounds like a great title for a book!
Of course, you are grieving. It is hard for me to understand how people can be so callous? Is it just because they don’t want to feel the grief themselves? But in any case, it means nothing about you. You’re entitled to feel whatever you feel, and the heck with anyone who says otherwise!
This is such a sad story, and really illustrates one of the many unintended consequences of forced “hospitalization.” It is also pretty awful that you are “used to” being looked at in a negative way. I am certain you do not deserve such treatment, yet a “diagnosis” (especially of “Borderline Personality Disorder”) seems to leave one open to any sort of denigrating comments from those claiming to be “helping.” It kind of makes me ill.
I have not moderated any of the comments between Krista and Kindredspirit, but in both cases, some of the comments are getting pretty personal. I’d ask you both to back off and refocus on the content of the article, or to come up with a more respectful way to discuss the cat issue so I don’t need to intervene. Thanks!
I really don’t think it is, if the “bashing” is coming from the victims of the system. I consider it quite natural and necessary for oppressed people to gather up their energy and get good and angry before they can fight back against the oppressors. I don’t consider it quite reasonable to expect those who are being harmed to differentiate between the “good workers” and the “bad workers.” While I think intentional meanness and cruelty should not be practiced against anyone for any reason, but I guess I see it as the job of the “good mental health workers” to listen and hear the harm done by our colleagues and to help the person in question come to terms with it and decide what they want to do about it. At the end of that, it’s up to them to decide if you or I are an exception to the rule or not, no matter what we think of ourselves. And perhaps if we do a good enough job, we can introduce the possibility that not ALL “mental health workers” are abusive or condescending.
I experienced plenty of oppression from my supervisors when I spoke up and called out things that were wrong and hurtful. But I can’t say I ever experienced the kind of uncontrolled harmful environment that was enforced on those our system claimed to be “helping.” It is different in both kind and in degree.
I absolutely did. But I also saw it as kind of a negative turning point in our political dialogue, where leadership was being undermined by the corporate media in the interests of protecting the well off and the powerful.
A lot of people read the comments but don’t respond. But you’re talking about a topic near to my heart, and most people aren’t old enough to remember the 70s any more.
I think what he’s getting at is that psychiatrists pretend to offer the “quick fix” and take advantage of people who are looking for it. I think he’s said elsewhere that he’s not criticizing the patients, but the system for setting up rewards for being compliant and not asking a lot of questions but instead accepting their assigned “identity” as “mental patient.”
The way the system is constructed, and in particular, the faux “diagnoses” found in the DSM, make it easy to dehumanize “clients” and decide that treating them badly is “helping” them.
There really is more than one. They’re rare, but they do exist, in my experience. That’s why I try not to overgeneralize – I do want to support anyone who is working to stop the current label-drug-bill-and-forget plan.
This is an excellent example about how “privilege” works. Those running the show can do almost whatever they want and get away with it. Some choose not to, but they all have that privilege in the system. Those below them have to accept abuse from their superiors as they dish it out, but they have the privilege of dumping it on the person below them. They may or may not exercise it, but they do have that ability to do it and get away with it. So people can be and are oppressed and yet still have privilege over someone lower down in the hierarchy. I feel bad for those line workers, but they do have a choice not to pass it on and to challenge the oppressive environment they are working in instead of taking it out on the inmates. Someone has to make a decision to toss a monkey wrench in the works, and yes, it’s scary, but continuing to work in the oppressive system without challenging it is tacitly approving of it. That’s what eventually drove me out. I could no longer live with what I had to do, or should I say what happened to some of the people even when I did my job well.
But perhaps taking the problem out of the realm of “medical care” would be facilitated if we stopped calling normal emotional reactions to difficult or painful circumstances “illnesses.”
Thank you for saying this. I think your experience is pretty typical of “voluntary” patients. They have been told that this is the place they should go for help and that these people know what they’re doing. It’s quite a shock to arrive at the conclusion that they don’t.
I also very much appreciated that a PTSD “diagnosis” “allowed me to reframe how the trauma in my life had led to my mental distress.” This seems in my experience to be what most people really are looking for – a way to reframe their experience that makes sense to them. Sadly, the DSM “diagnoses” generally do the opposite – cause more confusion and minimize or invalidate completely the role of trauma in the genesis of one’s so-called “mental illness.”
I think you may want to add one more incentive: parents or caretakers benefit from “diagnosis” by having the responsibility for figuring out what’s going on and how to help taken from their shoulders. It’s not because you need to develop more effective parenting skills – she has Bipolar Disorder! It’s not that you’re a boring teacher with poor classroom management – he has ADHD! It’s not that we’re neglecting our child – she has Depression! It makes it easy for parents, teachers and other caretakers to blame the child for their inability to care appropriately for him/her or to figure out what s/he needs.
Looks like shuffling deck chairs on the Titanic. Same “disorders” clumped around into different groups. Same focus on “symptoms” instead of life conditions. “Meet the new boss, same as the old boss.”
When the huge bulk of the research is paid for by industries who profit from it, it should not surprise us at all that any problems or concerns with the technology in question are buried as deeply as they can dig.
If there is any hope of a scientific understanding of the human mind, Chaos Theory appears to be the only sensible way to start. But psychiatrists aren’t mathematicians for the most part, except that they do know how to calculate income as related to type of “treatment” offered, apparently the only graph of any real importance.
Two excellent points, Lee. Morality and ethics are not scientific endeavors, and no amount of scientific experimentation can determine right from wrong – that’s an entirely human individual and social effort.
I have also argued that the “null hypothesis” for these drugs should always be that they ARE dangerous, and the burden of proof should be on the company selling the drug to prove convincingly that they are not. If they can’t prove safety, we should assume dangerousness and act accordingly. If we did, medical care wouldn’t be the third leading cause of death in the USA today.
Wow! Well, at least they were direct and honest about their biases. No need to bother with THAT support group ever again! Did you ask the facilitator why this was a requirement?
I think it goes even beyond that. There is an underlying need to believe in materialism, the idea that nothing can exist that goes beyond the physically observable and measurable universe. Any suggestion that there may be such a thing as a spiritual existence beyond the body, or even the idea that there are extra-physiological phenomena (like the mind) that might arise from the body but transcend it, seem anathema to such people. They seem to believe that materialism is the only way to be “scientific.” Ironic, as they are operating on a non-scientific assumption but are unable to recognize it because they’re so committed to making others whose beliefs are based on non-scientific assumptions wrong.
You make a valid point. However, in terms of brain damage specifically, it seems likely that both could cause such damage in a similar way due to similar effects. They use benzos, for example, to detox someone from alcohol, so they’re almost interchangeable in terms of effects on the brain. As such, their damage profiles in the brain should be similar. It may be that the livers and hearts of the benzo users are not impacted in the same manner, though again, it may be very much dependent on dosage control, or lack of same.
Too true, John. We’d be far better off if the “professionals” started off with, “We really don’t know what they’re doing.” That way, we’d at least all be on the same page starting out.
They mention “heterogeneity of groups of interest.” This is a very oblique way of saying that the people “diagnosed” with these “disorders” have little to nothing in common. Which can even more directly be reframed as “These diagnoses are all bullcrap!”
If opposing human rights abuses is labeled “antipsychiatry” (in its most pejorative sense), doesn’t that suggest that psychiatry is in favor of human rights abuses, and that to oppose such abuses is to oppose the mainstream psychiatric system?
Seems not unlikely. It’s a point I try to hammer home wherever I can. Few things irk me quite as much as the commodification of spiritually meaningful activities. Corporate capitalism can turn almost anything into crap.
Since Benzos and alcohol both act on the same systems in the brain, if alcohol causes brain damage, it stands to reason that benzos would do the same eventually. Perhaps it depends on the person, dosage, and length of exposure, but it seems we ought to expect benzos to do such damage and be surprised if it doesn’t.
Mindfulness is, in the end, a SPIRITUAL practice, which is grounded in Buddhism. Efforts to make it into a utilitarian tool for surviving the rigors of a heartless and isolating modern society I think disrespectful to the true purpose of meditation, which is to free the mind/spirit from its bindings to the cycle of life and death. There is a lot more than “brain activity” going on here!
At this point, it appears that this thread has had plenty of time for everyone to air their views, and it feels like the comments have in some cases become excessively personal and disrespectful. My appreciation to those who have maintained equanimity throughout the discussion.
I will try to summarize what I see happening at this point. It appears that one side of the discussion is focusing on the need for survivors to take a leadership role in the antipsychiatry movement, and it appears that the other side is saying that professionals have a lot to contribute and that it should not be framed as an us-vs-them dynamic between professionals and survivors. I think both of these viewpoints have some validity and that it is very understandable that professionals and survivors are likely to have different points of view, and indeed are likely to have difficulty completely understanding where the other side is coming from. I’m also not certain that either side is actually trying to say what the other side seems to believe they are saying.
I don’t think there is a lot more to say, and it seems that further discussion, rather than leading to further clarification and understanding, is instead leading to more frustration, hurt feelings and hurtful comments. As such, it seems best that we close this discussion on this thread.
I am closing the thread for further comments. I will continue to moderate comments that have already been made, as it appears there are some which will need to be addressed, but we will now be ending further discussion on this topic thread.
I would add that most people remain unaware of the frequent escalation of domestic abuse during pregnancy or after birth. A good percentage of the “postpartum depressed” are in such escalating relationships, but of course, everyone wants to blame “hormones.”
I agree, John. There is frequently a collaboration between the parents, who want the professionals to “fix” their child, and the professionals, who want the parents’ support in keeping the child in “treatment,” with no respect for what is going on for the child. Often (not always) it is the parents or the family that needs to be “fixed.” It sounds like you needed support you didn’t get.
That is one of the less obvious problems with the DSM – it allows abusive parents and professionals to blame the children for their own inability to appropriately handle the children in their care. I read a study at some time in the past where children with abuse histories were significantly more likely to be diagnosed with “ADHD.” Some psychiatrist actually commented that this was because “ADHD” kids are more difficult and it makes it more likely that their parents will abuse them! The least powerful person always gets the blame when the DSM is involved.
My understanding is that esketamine is just one of the steroisomers (two different mirror image molecules) of ketamine, which contains both stereoisomers. What difference that makes is not something that is obvious. It could make a difference in some cases, but I’m guessing (as a chemist) that in most cases, the actions of stereoisomers would be very similar unless they’re engaging some system that only accepts one isomer over the other. And even if only one isomer is active, the ketamine contains both, so if there is a difference, the most likely one is that it would be a more powerful impact of the same effect.
I merely commented that Ketamine has been used as a date rape drug.
“Ketamine
What is Ketamine?
Ketamine was developed in the 1960’s as an anesthetic for surgeries. Today it is used mostly by veterinarians. Ketamine causes unconsciousness, hallucinations, loss of body control and numbing. Overdose can be fatal. Ketamine is found in a white powder or a liquid and has a horrible, strong bitter flavor. Ketamine works very quickly, so if you tasted it in your drink you would only have a few seconds before losing consciousness.”
I think you are more than a bit optimistic about the intentions of the psychiatric profession when you say it’s obvious that “mental health is not a medical issue.” In fact, this is the song the profession has been singing loud and clear since the DSM III came out in 1980. Millions of the so-called “mentally ill” have been told by their doctors, their psychiatrists, the Oprah Winfrey show, TV shows and movies, and of course, those wonderful DTC advertisements showing Zoloft “rebalancing” the chemicals in our cartooned synapses while failing to mention the dramatic reduction of serotonin receptors that results from this supposed “balancing.” It is thus VERY far from “obvious” that “mental illnesses” are not biological entities. A few years back, over 80% of surveyed Americans believed that “low serotonin” causes depression, despite the fact that this idea was convincingly disproven by the mid 1980s.
I’m glad you “get” that, but I don’t think you’re going to convince anyone that the psychiatric profession agrees with your assessment or shares it with their clientele in most cases.
This was my strong reaction! For every case where someone was dense enough not to recognize that stimulants were causing the problem and instead the child was diagnoses with a “psychotic disorder” and prescribed another drug, there have to be at least 10 where the doctor or the parent or the child him/herself was smart enough to say, “Hey, this shit’s making him/her nuts! We need to get them off immediately!” If this is true, then suddenly we’re going from .2% to 2%, which is hardly negligible. And we’re only talking about psychotic episodes here. A Canadian Journal of Psychiatry retrospective study of 100 kids’ files showed an over 6% rate of psychotic symptoms in kids taking stimulants for “ADHD,” which means it’s happening in one kid out of every 16 kids who is taking the drug. With millions of prescriptions out there, there are at least hundreds of thousands of kids experiencing psychotic symptoms as a result of their “treatment.” Yet we’re just “discovering” this now?
“And in other news, people who are cut have a tendency to bleed…”
I have seen many, many cases of this working with foster kids. Stimulants cause aggressive behavior, or less commonly, mania and even frank psychosis, and instead of stopping the stimulants, they add more drugs to “treat” the adverse effects, and of course that requires new “diagnoses” as well. Part of the “juvenile bipolar” explosion was due to stimulant adverse effects being diagnosed as ‘bipolar disorder.’ Ironically, they are often prescribed antipsychotics, which reduce dopamine transmission, while still being given stimulants, which INCREASE dopamine transmission. But as many times as I pointed out this contradiction, only one psychiatrist ever listened to me that I remember.
I guess I see this more as a way to demonstrate that, once again, the psychiatric profession is lying and prescribing something else that doesn’t work.
But if you tell someone that they might be getting a “real drug” or a placebo, the placebo response is stronger if people feel “something happening.” There is, however, a placebo response for both groups, which says a lot about the idea that these “disorders” are purely or primarily biological in nature.
I actually believe the medical education system chases off critical thinkers from the word “go.” The hypercompetitive atmosphere, the extreme authoritarian approach, the intentional overstressing of trainess by loss of sleep and ridiculous expectations – an antiauthoritarian or non-authoritarian would run the other way screaming. I think the field also attracts authoritarians because being a doctor conveys status and financial success, which are less important to antiauthoritarian types.
Commenting as moderator: “Report comment” means you have concerns about the civility or appropriateness of a particular comment. Lots of people push it by accident – it’s not a big problem.
Yeah, you’d think that if SSRIs prevented suicide, there’s be a lot more NOT taking SSRIs who would end up in the hospital, eh? I guess the manufacturers and their psychiatric handmaidens have a different concept of what “works” means. Perhaps “works” means “creates profits?”
“Narcissism” is just a description of a way of behaving, nothing more or less. A pretty obnoxious way, admittedly, but it’s just a description. Anyone who thinks that people fall into two classes, “good” and “evil,” will not be very successful in understanding human behavior.
As one wise person once said, “There is so much good in the worst of us, and so much bad in the best of us, that it ill behooves any of us to talk about the rest of us.”
And Conduct Disorder has been disproportionately assigned to African-American children, in my observation, and I believe statistical research backs me up on this point.
I agree with you about antiauthoritarian vs. anarchist. It is very much a real possibility to have government that respects people’s rights to make their own decisions. Such governments are, sadly, very rare, as most people are in the end authoritarians, and are in fact heavily trained to be so by our school system and other institutions. But I have, on rare occasions, been part of a group that governed itself in a truly democratic fashion, and it is a joy to participate in.
This has become our policy ever since our 18-year-old son was “screened” for depression by a doctor, who afterwards went into the usual tirade about how “depression is a disease, just like diabetes” and “it’s now treatable” and so on when he told them he’d been suicidal. The doctor never for ONE MOMENT asked why he had felt that way. It actually pissed him off big time, as he had been struggling with an assault and other issues and so had many good reasons to feel hopeless or discouraged at the time. Now if someone asks, we simply decline to answer those questions, or else say, “I’m just fine!”
120,000 people annually are killed by adverse effects of properly prescribed and administered drugs in the USA. It’s a scandal, but no one wants to look at it.
The fact that stimulants can be perceived as helpful for some people doesn’t make “ADHD” a “disorder.” It appears to me that people who “have ADHD” are simply different in that they are less tolerant of arbitrary rules and boredom, and have a more difficult time getting organized and planning things. This is no more a “disorder” that being a person who doesn’t like big groups of people or who lacks athletic skills or who finds doing artwork challenging. I’m not for a moment suggesting that these challenges are not real or difficult, or that stimulants can’t be helpful in dealing with them. I have two (of my three) boys who all fit the “ADHD” criteria, and believe me, I know what the challenges can be! But to call something a “disorder” just because people have particular personality characteristics that are difficult for them or for people dealing with them is just not scientific. People can “have ADHD” for dozens of different reasons (at least 50, by one author’s count), including sleep apnea, low iron, rigid classrooms, high intelligence relative to peers, poor parenting skills, abuse/neglect/trauma at home, nutritional deficiencies, allergies, and on and on and on. Or maybe that’s just the way they are.
If folks want to take stimulants to help them focus or pay attention to dull things they need to do, I have no problem with that. I do have a problem with a doctor telling you that you are deficient simply because your personality doesn’t fit with the expectations of modern society. “ADHD” behavior has survival value for our species, and it should not be disrespected or diminished in value.
One quick example: a recent study put groups of three kids together, elementary age. One half the groups had an “ADHD” diagnosed child in it, the other half did not. They were each given a set of problem-solving tasks to do. The groups with the “ADHD” child in them spent significantly less time working on the problems and significantly more goofing around, while the other groups stayed with the problem most of the time. But in the end, the “ADHD” groups solved all the problems, while those without the “ADHD” child didn’t solve any.
Staying “on task” is overrated, especially when the task is mindless and pointless and repetitive. Being able to look at things from different angles and try out new ideas is critical to solving problems. Of course, if we had a group with THREE “ADHD” kids, who knows if they’d ever get anything done? But the “ADHD” types were essential to the more straight-ahead reasoners, and when they worked together and valued each other, they had more fun AND they came up with better results!
It is SO reassuring to know that if the drug makes you unconscious or psychotic, it will probably go away eventually if you stop. Really makes me want to try it out! /s
There is definitely incredible value in reclaiming one’s own narrative, telling one’s story in public, defining one’s own experience. It’s vital to empowerment. It’s just that it doesn’t sound like that’s the true purpose of this arrangement, as the people running the contest seem to have their own agenda as to what an acceptable narrative is. At least that’s how it sounded in Sera’s case.
I see it as a PR thing, as well as providing protection to those who are so unfortunate to run into this kind of situation while we’re trying to unravel it. Psychiatry’s not going to end tomorrow, and even if it did, there are still plenty of other options for extrajudicial incarceration that will arise. I think they all should be viewed as what they are, namely arrests, and be treated accordingly. Otherwise, people are tricked into “confessing” their “symptoms” to someone they thought was there to help.
Yeah, the 80s was kind of a nightmare from a dating perspective, wasn’t it? I remember avoiding discos at all costs because I didn’t want everyone judging my dancing or my clothing as “not cool enough.” Plus the music I grew up with was all about protest and revolution and fun and love, not about money, sex and drugs! OK, well, there was a lot about drugs in there, too, but you get my point.
“… far from that lean and hungry supermodel all guys demanded.”
I hope it has become clearer by now that not all guys demand a lean and hungry supermodel look. I personally find such a look unattractive and sometimes a little disturbing, as it seems to represent a desire to punish women for looking like, well, like WOMEN!
I don’t think the stories themselves are what folks are objecting to. It’s the apparent use of these stories to perpetuate the status quo and the apparent enforced limitations put on the stories so as not to “upset” anyone, not to mention the choice to threaten civil commitment when someone’s story is too scary for them to hear.
I think the Miranda Warning makes it more clear to non-involved people that this is not about helping, it’s about incarceration. Plus it increases the odds that the potential prisoner will get legal counsel, which means fewer people locked up. Naturally, it’s not anything close to a total answer, but I think it would be an important statement and provide needed protection.
That was my first thought – we have more and more kids “in the system,” and particularly taking one or more psychiatric drugs, and we have more kids with worse “psychopathology.” If this shit remotely worked, wouldn’t our “new technology” be REDUCING the burden of “mental illness?” Yet this theme is essentially never, ever heard in the media or the psychiatric research world. At best, we can easily conclude that all the extra drugs are not helping. But based on the long-term research, there’s a good possibility that they are actually making things worse with their “diagnoses” and “treatments.” WAKE UP PEOPLE!
It also occurs to me that even these “candidate genes” in the most POSITIVE light presented by biased researchers never came within orders of magnitude of the known effect of trauma and environmental stress on so-called “mental disorders.” Most likely, nutrition, exercise, sunlight exposure, change of environment, laughing, hugs, and all sorts of other things have more measurable effect than the most optimistic estimates for any gene. Yet somehow, these studies continue to get funded. It’s a total dead end, and high time the research literature stated this out loud.
Yikes! “Tell us your stories, but not so as to make anyone feel UNCOMFORTABLE. If you do, you will be censored and possibly incarcerated.” And they charge you 10 bucks for the experience? Excuse the term, but that’s “insane!”
The real question is why placebo so often equals or beats the drugs. I often wonder what would happen if active placebos were used to avoid accidental unblinding.
Additionally, remember that most psych drug trials are 4-8 weeks at the longest. There are lots of drugs that can temporarily make you “feel better.” Alcohol is a great example. It’s a superb “antianxiety agent” and would certainly beat the pants off of placebo in a 6-week trial for anxiety. Unfortunately, the withdrawal effects have a tendency to counterbalance the benefits, don’t they? Especially after 10 years. Of course, the exact same thing can be said for Xanax, Valium, Klonapin and the other benzodiazepines. But somehow, these are considered “medications” rather than simply a way to distract oneself temporarily from the pain of living. What’s the difference? Someone’s making a lot more money off the benzos. That’s about it.
Yes. Because panic attacks have never been shown to be caused by one thing only. They are caused by many different things, including physiological (like insufficient oxygen), psychological (such as reactions from childhood abuse), social (as happened to me when I retired, sold my house and bought a huge camper to live in), and spiritual (such as losing faith in God and not knowing what happens when one dies). There are as many causes as there are individuals, and the idea that genetics would cause such a temporary and conditional situation is actually so unlikely as to approach zero probability. And to date, there is absolutely not one iota of evidence, despite decades of research, to suggest a genetic cause to ANY “mental illness.”
We should look at what is going with each individual and stop trying to blame normal emotions like anxiety on “bad brains” with zero evidence that it is true.
“Little boxes on the hillside
Little boxes made of ticky-tacky
Little boxes, little boxes, little boxes, all the same
There’s a green one, and a red one, and a blue one, and a yellow one
And they’re all made out of ticky tacky
And they all look just the same.”
“And they all play on the golf course
And drink their martinis dry
And they all have pretty children
And the children go to school,
And the children go to summer camp
And then to the university
Where they are put in boxes
And they come out all the same.”
I am pretty disgusted by the movement to silence ANY discussion of vaccine science that doesn’t totally support that every vaccine ever invented is safe and necessary. I got temporarily tossed off another site for mentioning that the flu vaccine is not generally very effective against the flu, and should probably not be a priority for anyone who isn’t in a high-risk group. I provided a link to scientific research on the point I raised. But I was accused of posting “antivax propaganda.” Pretty authoritarian, and ironic, as people accusing others of being antiscientific are denying anyone else the right to post scientific information and to discuss its implications. I complained to the moderators, to no effect. Disgusting.
Very true. The first thing a scientist should do when presented with evidence that a particular hypothesis is true is to generate any other possible explanation that might also be valid and start testing those, too, while setting up to have others try to replicate the experiment you did. Apparently, something like 50% or or more of recent accepted studies fail when replication efforts are made. We would be much better off being a lot more humble about what we “know,” especially in a “soft” science like psychology. Unless, as you say, our purpose is marketing, in which case we spin every “positive” study to make it seem better than it is, and either spin “negative” studies to sound positive, or make sure they are never published. That’s Marketing as Science, and it seems to be how business is done these days.
Very true. The main effect and probably the main purpose of these “diagnoses” is to keep anyone from looking into what’s really going on. Calling “depression” a disease is absolute idiocy! Unless you’re trying to bilk people out of a lot of money, of course.
Quite so, and that is my point. What is called “major depressive disorder” could be caused by childhood trauma, iron deficiency, low thyroid, chemotherapy, finding out about a serious life-changing diagnosis, having a dead-end job, being in a domestic abuse relationship, not knowing the meaning of life, having Lyme Disease, or a long, long list of other possibilities. As Kindred Spirit points out, they don’t even bother to check for well-known biological causes. All of which tells us that “mental disorders” AS DEFINED IN THE DSM are nonsensical entities that have no meaningful value, and that claiming any such “disorder” is caused in the main by a “brain disorder” is rank idiocy without a shred of scientific evidence.
If we ditch the DSM, we might actually find out what IS causing the problem, be it biological, psychological, social, or spiritual in nature.
It is perhaps a generalization, and as I often say, “All generalizations are wrong.” However, what I’m talking about here is an extreme of strong reaction to normal feedback, for instance, a person says, “I’ve felt really weird since taking this drug, it doesn’t seem to be working and it’s keeping me from sleeping and making me itchy.” The doctor says, “This has nothing to do with the drug. You have to wait for it to work, you can’t expect instant results, besides, maybe you’re just not used to feeling good and it seems weird.” Or even worse, “I’m the doctor here, and I know what these drugs do. Just report your experiences and I’ll decide what’s working. I have medical training and experience, you can’t possibly understand these things.” This person is clearly uncomfortable with plain old FACTS as presented by the patient. To me, it’s a bad sign. Sure, it might be caused by something else, but the odds are very strong that this person is trying to establish authority over you for some reason, and very often that reason is that they don’t know how to help you and that this drug is their only tool, but they can’t admit it. To me, it would be a HUGE red flag that I want to go elsewhere for advice.
There is no reason for a professional person to feel threatened by a client reporting the results of an intervention. At a minimum, it would take a very insecure doctor to find this kind of feedback disturbing or upsetting. But I guess there are a lot more insecure doctors around than one might expect, especially in psychiatry.
Well, THAT was an impressive list! Perhaps we’re missing each other a bit because of what is defined as “mental illnesses.” I have never had any interest in denying that there are biological causes of mental DISTRESS or CONFUSION. What I have a problem with is when the DSM creates a “disorder” like “ADHD” or “bipolar disorder” and claim that ALL people with these ill-defined and subjective “diagnoses” have the SAME biological cause! What you said toward the end is what I believe also – that each case is different and no one-size-fits-all approach will suffice for any “disorder,” especially those defined by behavioral observation rather than any kind of scientific measurement and analysis. In fact, one of psychiatry’s great crimes (and there are many) is their insistence on “diagnosing” people without even bothering to do a physical workup to see what might be causing their “symptoms.” This doesn’t even get into environmental stresses (both physiological and psychological) that contribute beyond a person’s own biological variables.
So sure, there are biological causes of mental/emotional distress, and you’ve documented a ton of them here, which is appreciated. The question I pose is, can anyone name one DSM-defined disorder that is reliably caused by any specific biological problem? I think we all know the answer to that one.
Quite so. In the “mental health” system, it’s essential to start off playing defense until you know who you’re dealing with. The consequences of getting connected with the “wrong” kind of counselor could be devastating to your life!
I think you are right on. Any time a supposedly professional person gets defensive with someone they’re supposedly trying to help, it suggests that the person doesn’t actually know the subject matter at hand and their client/customer is hitting too close to home.
Yes, it is, unless your goal is to “capture a maximum market share” by implying that any divergence from being mildly happy to mildly irritated is a sign of “mental illness.” It is also rooted in the assumption that “normal” people are always happy (but not TOO happy, that would be MANIC!) with things just the way they are. This kind of thinking lets our leaders off the hook for the damage their institutions, agencies and corporations are doing by blaming anyone who is unhappy for having a “bad brain” instead of seeing if maybe we have some bad institutions creating problems.
Just to clarify, I’m not a fan of “crazy” or “bonkers” either. But I’m saying that I find “mental illness” a far more damaging term, even though professionals claim that they use it to decrease “stigma.” If you say I’m nuts, at least I know you’re not trying to help me out!
I think “mental clarity” is a very different term than “mental health.” Clarity is a much more specific quality than “health”, especially in the “mental” sense of it. I’m also OK with “spiritual well being.” I think the problem now is that “mental health” as a term has been coopted by the industry, and brings a whole lot of negative assumptions along with it. I’m for not using it except in quotation marks. But that’s just MHO.
The underlying problem is trying to categorize all these people who are suffering some kind of emotional/mental distress as being in a group that has anything in common with each other. Kind of like talking about Native Americans as if they were a group who are all the same, or children, or women, or gay people, or any large group. It’s bigoted at the least to view people as being the same based on one shared characteristic. The terms “mental health” or “mental illness” both seem to imply that there are some people whose brains work right and others whose brains work wrong, and that being in the second group implies some kind of pathology. It’s not a good starting point for a positive discussion of how to help people who are suffering for whatever reason.
My understanding is that “neuroleptic” generally refers to a class of drugs that act by decreasing dopamine transmission in the brain. Thorazine, Haldol, Stelazine, were the original neuroleptics. The “second generation” antipsychotics are hybrid neuroleptic/SSRIs. There are lots of neurotoxins that are not neuroleptics, but all neuroleptics are neurotoxins.
You may be an exception, or your school may be. But I don’t think this has changed. Schools are very concerned with liability and try to “counsel” students with “mental health difficulties” to go on leave, at least in the USA. The confidentiality violations alone in this story are hair raising. I think the advice to be VERY careful about college counseling centers is very much on target.
Following up on Miranda’s comment, I find it interesting that the fact that the clients are feeling too intimidated to speak up is not considered to be the central problem in this interaction. If you want “shared decision making”, you need shared power, and the current model goes against that. “Clinical authority” is simply the asserted right of the psychiatrist to dominate the decision-making process. In other words, most psychiatrists don’t BELIEVE in shared decision making. This should be the primary focus if someone really wants to change that dynamic. I actually make it very clear to any doctor I have to see that I am, in fact, the one making decisions here, and that their advice is advice which I may accept or reject, and if they don’t like this attitude, they should let me know now so I can find another doctor. But most people are very uncomfortable taking that assertive a position.
This also belies the “blame the patient” approach to explaining away the steady increase in prescribing by doctors in every area of medicine. These things are not happening because the clients saw Drug X on TV and are demanding it. In most cases, it is the doctor who is deciding what the patient is supposed to take, and it’s clear from this discussion that most patients don’t have the skills or the wherewithal to challenge the doctor’s opinion on any recommendation.
I think the problem with “mental health” is that it implies that people who are suffering are somehow “ill” and that “healthy” means not being upset in any way with the status quo. I’d rather go with “crazy” or “nuts” or “bonkers” than “mentally ill.” But there are better terms that can be used. I believe that controlling language is part of controlling the narrative.
Wow, well done! There are SO many things that can be done to help a kid succeed, but we have to actually both observe and care about the child instead of trying to shut him/her up! It’s not rocket science, but it starts with understanding that kids do what they do for a reason – and it’s NOT because they have broken brains!
My understanding of “intentional communities” is that their original purpose was, in fact, to undermine the capitalistic assumptions underlying our culture. I could be wrong, but that’s what I associate with the concept.
For a lot of us, the function of a family is to raise capable and empowered children and to support each other in surviving the insanity that is our modern world. Admittedly, it would be a lot easier if we had much bigger units than “nuclear families,” but I see that more as a symptom of the larger problem of intentional community destruction by our “leaders.”
I think the correct statement is that people who TOOK ANTIPSYCHOTICS showed brain shrinkage, regardless of their spurious psych “diagnosis.” But I agree that avoiding psych terminology is an important strategy in decreasing the power of the psychiatric profession to control the narrative.
“Our” case means the case of anyone who wants to ditch the current DSM label-drug-and-shock paradigm of doing business. These folks aren’t going away without a fight. I don’t see the “brain shrinkage” argument as being about permanent brain damage (though we know that does occur – Tardive Dyskenesia and the like) so much as being about undermining the disingenuous and unsupported arguments from the psychiatric mainstream that there are good reasons to believe these “disorders” are biological in nature, and that their wonderful drugs actually repair some “imbalance.” The entire enterprise is founded on that faulty mythology, and I don’t think it’s possible to undermine people’s faith in it without some hard evidence that the psychiatrists are full of crap. Science alone won’t do it, but it is part of the picture if ending psychiatry is the goal.
I have always viewed authoritarianism as more of an attitude as a system. An authoritarian believes that some people are above and others below, and that those above get to give orders and do as they please, while those below have to follow orders and do as they’re told. Of course, one can be below someone and above someone else, so the basic rule of authoritarianism is “fecal matter descends to the area of lowest gravitational potential.” Those higher in the structure have entitlements and different rules, but any frustration the authoritarian may feel can be dumped on those lower than them in the structure. It’s all about in-groups and out-groups and hierarchies and entitlement and force and power.
As Oldhead properly observes, any political party or structure, as well as commercial and religious groups, or really any group of people can have an authoritarian set of social expectations. It is more about how people interact with each other and how decisions are made in the group than it is about political orientation.
I think the importance of this particular study is that it was done by a mainstream psychiatrist whose interest was to prove that “the disease” was causing loss of brain matter, and accidentally proved it was the drugs which did so. The loss of brain matter (on the average) claimed to be seen in long-term “schizophrenia”-diagnosed people was used to support the idea that “untreated schizophrenia” was dangerous and was used to promote “early intervention” for anyone with the slightest indication of what they call a “thought disorder.” This study has almost silenced that argument. I think it’s important to know about and use these studies to make our case, even as we all know that every individual case is different, and that recovering even from long-term use of these drugs is possible for many so exposed.
As much as I appreciate comments in defense of my efforts, I’d appreciate it if this poster and or similar could be ignored or reported and ignored. It simply encourages more of the same nonsense.
The drugs create brain shrinkage on the average, according to studies. How each individual responds is, of course, different. Also, brains can heal, so some may only experience temporary damage.
The challenge I see here is that you can’t really compare a car accident to being suicidal or hearing voices. In a car accident, you can see broken bones, bleeding, bruises, you can check pupil dilation or reflexes or a hundred other little things that tell you what’s going on. But as you say, you can’t do this with psychiatric diagnoses. In fact, one could easily invent a psychiatric diagnosis by choosing any behavior you think is “unhealthy” and calling it a “disorder.” We have stupid things like “internet addiction disorder” and “mathematics disorder” and “oppositional defiant disorder” which are obviously just observations and judgments about certain behavior. There is, as you say, no test.
The part I’d like you to think about is the question of why, when there is so much research and information on the dangers of these drugs, the psychiatric profession is not interested in investigating things like Soteria House or Open Dialog or even stuff like nutritional approaches or other forms of helping like “hearing voices” groups and other peer support? While they often give lip service to some of these ideas, they are always considered secondary or additional to the REAL treatment, which is drugs. Do you really believe the billions of dollars raked in by the drug companies don’t come into play here? There is now strong data showing that long-term use of antipsychotic drugs leads to a LOWER likelihood of ever recovering. And yet the profession continues to recommend immediate and ongoing drug “treatment” to every single person who presents as “psychotic.” Why is this?
I’m not suggesting that the individuals at the front line are all bought off and corrupt. I’m suggesting that they all participate in a system that is based on a dishonest model of reality, and that model was constructed with the idea of making money in the forefront, not the idea of helping people get better. You said you have read “Anatomy of an Epidemic?” Bob Whitaker talks about this at length in his book.
Most of those who buy the current paradigm fully actually think the brain IS the mind, that there is nothing else to “treat” except the brain, in my observation. They get quite confused when I talk about mind being more than just brain. They think they are being “Scientific” by not believing that anything beyond “brain” could exist.
Which is rank discrimination, plain and simple. I could easily have been diagnosed, in fact, I probably was in my 20s when I went for therapy for a year or so. I’ve been tremendously successful as a counselor and social worker, according to my clients, which is the only measure that’s worth looking at. Why would they not want me as a social worker? Some of the best social workers I’ve known have had rough lives. It helps them empathize with the clients.
They did this in one high school, I want to say in Wisconsin, and their behavioral referrals went down, grades went up, and everyone seemed to be doing a lot better. Of course, this experiment didn’t make the news…
I am so sorry! That is just awful! Your story is emblematic of exactly what is wrong with this whole idea of “broken brains.” There is no healing that way, only more and more damage. And I HATE how they minimize memory loss as no big deal, just a minor “side effect,” when it is evidence of brain damage and can ruin someone’s life. I know a survivor who can’t remember her own wedding. It is too sad for words, but it also pisses me off big time!
A very sad tale, that the doctor himself was taken in by the psychiatric/big pharma mythology, to the extent of being told he was condemned to a life of drug “treatment” and anxiety. No one apparently told him there was anything else he could do, and the “diagnosis” itself appeared to be the final straw. How very sad – no one created a safe space for him to talk about why his life wasn’t working for him, about the pressures and tensions at work and whatever else was happening, including the pressure to keep pretending everything was AOK. It is a classic example of how and why the psychiatric paradigm is not only not helpful, but significantly adds to the kind of problems it purports to know how to fix.
I believe those suffering from what are metaphorically called “mental illnesses” might be much better off if “mental health” were NOT a central plank of the candidates’ platforms. Unless there are some uniquely well-informed and courageous candidates who are willing to argue for the removal of “mental health” from the field of medicine altogether, or to prevent any kind of forced “treatment” (which is an oxymoron to me), it would be better for all if “mental health” is left in the background, as it will be easier that way for those wanting to avoid the system to fly under the radar.
I’d advocate more for any “mental health” worker to take Haldol or Abilify for a few weeks before they’re allowed to prescribe anything. Might create a little more compassion, though the compassion bar is pretty low at this point.
I agree. Calling something a “last resort” is admitting that you’re desperate and don’t know what else to do. Any “medical” person in a state of despair will no longer be providing ME service, that’s for sure! I’d much prefer if the person says, “I’m not sure what to do that would help you” than have them engaging in some desperate “treatment” that might kill me or leave me wishing that it had.
I wish I were surprised by this. Good for you for having the guts to speak up! The idea that they are somehow able to induce “different” seizures is beyond comprehension. Do the other doctors really BELIEVE this? Or are they in on the not-so-funny “joke?”
Ah, but WHERE and HOW HARD do you hit the person so that just the right amount of brain damage is done in the right region of the brain? That is the fine art you have yet to study.
I think the problem with your statement is the word “treatment.” People deserve HELP, but the term “treatment” redefines these issues as medical problems and invalidates the reality that trauma, pain, physical illness and social conditions all impact what is defined as “mental illness.” This may be very different from what you’ve been told or read about, but that’s because most people seem to have bought into this very idea that “mental illnesses” are something a psychiatrist can measure and identify and “treat.” You just stated yourself that there are no tests. To me, this means that “diagnosis” is completely subjective and could be given to anyone for any reason. Which means the “treatment,” including ECT, can be given to anyone for any reason.
I think the link you provide is moving more in the right direction – nutrition, exercise, change of environment, listening, all of these serve to return the power to the person with the problem. Drugs and electrically-induced seizures do nothing but damage the brain and do essentially nothing to help the person even figure out what’s going on, let alone what the person can do about it.
So by all means, let’s offer help and support to anyone who is suffering! But there is no need to redefine their suffering as a “disease” nor the helping as “treatment.” Let’s just call it helping each other out!
Sigh… This is what happens when you brand “anxiety” as a problem instead of looking for its cause. Their conception of “anxiety” is a disembodied head with a weird expression on its face and the word “anxiety” written across the forehead, as if anxiety were just some “thing” associated with heads and having no relationship to the school, its staff, its students, their parents, or the community in which the anxious person lives.
Where is the curiosity? Doesn’t anyone wonder WHY the kids are feeling anxious? Is “school refusal” in a particular case due to some disembodied “anxiety,” or is it due to being worried about the bullies waiting for you at school, or the mean teacher you have to put up with all year long, or the incredibly DULL class periods where you always fall asleep and get in trouble, or the reading group where you’re forced to read out loud and are so worried about making an error and having kids laugh at you that you can’t read at all and they laugh at you anyway?
This kind of idiotic research shows how the DSM “diagnoses” prevent meaningful research from actually occurring, because everyone stops at the “diagnosis” as if this means they understand the situation.
All I can say is, “WELL DONE!” But you are right, no one should have to fight off the people who are claiming to be helpful. It is baffling that they still get away with it.
I have known plenty of people with physical disabilities, and very, very few ever lived lives of luxury, and none did so on the government. The amount provided by SSI is generally barely enough to survive, and many of the “mentally ill” who are so disserved by the “system” have physical disabilities, too, many induced by their “treatment.” I don’t think it’s proper to make generalizations about people with physical disabilities – they are an extremely diverse group!
Hope you can find your way not to feel guilty about your thoughts. There is no harm to thinking thoughts, as long as you don’t act on them. There are lots and lots of people who have similar fantasies, as well as parents with thoughts about killing their children. My wife and I always share our brief homicidal impulses with each other – most of the time, we just laugh about it!
I also find that a good percentage of alternative practitioners have adopted the DSM “diagnostic” terminology, which affects both how they talk to people about their difficulties and the kinds of strategies they tend to employ. I’d keep clear of anyone who is still talking about “natural remedies for bipolar disorder” and the like – they are still steeped in the medical model, just coming up with other “magic bullets” within that model.
I agree completely. There is an entirety of Buddhist theory and beliefs that underlies the whole idea of why we meditate and what is to be gained from it. It is ironic that someone could think of scheduling a “mindfulness seminar” in the midst of an insane, “monkey-mind” world where real mindfulness would create nothing but horror as the person gained real awareness of what was going on!
Psychiatry aims at removing any idea of spiritual existence and awareness in favor of worshiping the material world under the guide of corporate capitalism. Buddhism moves away from materialism to spiritual awareness of the meaninglessness of striving to control the material world. It is in some ways the essence of anticapitalism.
“Treatment-resistant depression” translates loosely to “I have no idea how to be helpful to you, but want to pretend that it’s your fault, or better, your DEPRESSION’S fault.”
Would we ever want to take a car to a mechanic who told us we had “repair-resistant fuel injectors?” Or a tutor who said we had an “education-resistant child?” How do they get away with this nonsense?
Glad you posted! Sounds like you have seen “the man behind the curtain” but are still entangled with “the system.” Let us know how things go and if there’s anything we can do to help out.
Instead of calling it “sinking,” let’s call what happened to the Titanic “assuming a lower floating equilibrium.” That way, everyone will feel better as they go under.
What the heck difference does it make if it’s renamed? Do we have to “gain consensus” before we decide whether cancer is an illness? If “schizophrenia” is decided NOT to define a “disease” category, why would you rename it instead of just tossing it out?
Or maybe we can rename each person’s experience without forcing them all into a category – maybe ask the client him/herself what name seems most appropriate to them? But then where would the research money come from, and how could we justify drugging if every person’s needs are different and can’t be categorized?
When people have grand mal seizures in any other context, doctors will do anything they can to stop them. It is known that people with seizure disorders experience brain damage if the seizures are not controlled. Why on earth would anyone expect that inducing a seizure would have a different effect?
I would add that in Buddhism, participation is always voluntary, and no one is “the authority” who can tell you that “you are doing it wrong.” It is understood that it is a practice that will unfold differently for each person, and that the person him/herself is the judge of what it all means. VERY different than the “mental health” version.
It is one of the underrecognized ill effects of the DSM and the “chemical imbalance” concept – it gives adults permission to not take responsibility for their condition, or more nefariously, to blame their children or others in their care for not “appreciating” their abusive behavior sufficiently. I think the problem is painting with too broad a brush. This is one of the forces at work, but even that force is created and encouraged by the psychiatric profession for power and profit. The fact that other misguided or ill-intended people are willing to buy into the fiction in no wise alleviates the responsibility for the psychiatric “profession” for creating this mess in the first place.
I totally agree that there are individual physicians who are corrupt and evil and know absolutely what they’re doing. I don’t think most of them are – I think most are simply entitled and believe they know a lot more than they do. Some are also report being afraid to “disappoint” patients by not prescribing something. But there are definitely evil docs out there – I have met more than a couple.
I agree 100%. We do seem to have lost some of this “grit” over time, for many reasons, and of course, every person is responsible for their own attitude toward the current dire set of circumstances. But the psychiatric profession has led the charge to promote this idea – their concept is that “no one should have to suffer,” even though suffering is a key part of learning how to live, and even though of course they have no real solution for suffering and generally create more and more suffering in the long term. I’m all for helping create cultural change, and it starts by recognizing the economic and power incentives for those telling the tale that we can’t handle adversity. I believe most people still have this in them, but some of us need help bringing it to the surface, usually through moving from fear or hopelessness to righteous indignation. Casting blame on the victims of these evil machinations doesn’t help them get there. Educating them regarding what’s happened and why and that they are not alone is a much better path, IMHO.
Psychiatrists are almost ALWAYS portrayed in movies and TV as caring therapist types who know how to listen and help people safely explore their conflicts and issues. If someone’s only image of psychiatrists was from the media, it’s easy to see how they might expect that they could be helpful. I don’t think it’s by chance that such portrayals so massively predominate. I think it’s part of the propaganda effort, just like it is to show “patients” who “go off their meds” and do something dangerous. They’re painting a picture, and it is hardly surprising that most people expect that picture to reflect reality.
I am NOT trying to minimize medical errors as a cause of death! I’m trying not to allow a reframing of this issue as one of “errors” in medical care when a huge proportion of the deaths come from “standard care.”
“Estimates dating back nearly two decades put the number at 100,000 or more deaths annually, which includes a study published in the Journal of the American Medical Association in 1998 that projected 106,000 deaths. A more recent analysis estimates 128,000 Americans die each year as a result of taking medications as prescribed – or nearly five times the number of people killed by overdosing on prescription painkillers and heroin.”
While medical errors in and of themselves are a HUGE problem, looking like something over 200,000 annually, I don’t want to minimize 128,000 deaths as “errors” when the doctors were simply following the standard protocols and dosages. Even a “good doctor” could kill you!
I realize the real problem with Lawrence’s statement: that people “knowingly” turn over their lives to psychiatry. If they did this “knowingly,” it would mean that they knew and understood the likely outcomes, including the potential negative consequences, and that they knew and understood the fictional nature of the idea of “mental illness” diagnoses and related concepts. VERY few people who actually know this would be willing to turn their lives over to those in charge of such a mass deception!
Actually, it wasn’t “medical errors,” though it has been spun that way by the propaganda machine. It was actually MEDICAL CARE that measured out as the third leading cause of death in the USA. And the most common cause of death by medicine was not an “error,” but side effects of properly prescribed and properly administered “medication.” I think the attempt to spin this as “medical error” is an intentional PR effort to make it seem like “bad doctors” are the problem, rather than bad drugs and bad medical training.
I would add that some people don’t “walk away” because the difficulties of withdrawing from psychiatric drugs can be an incredible barrier to escaping.
I think you may be confusing intent to avoid responsibility with trust. We humans need to develop trust with our clan. These “doctors” are selling trust – “We’ve got you covered, don’t worry, we have the answers!” While it is true that looking for simple answers is part of the problem, I think it’s pretty unrealistic to expect the entire culture to decide not to trust doctors when they are told from birth onward that doctors can be trusted. I think there is a difference between WANTING to give up responsibility and BELIEVING that someone can be trusted when they can’t. It takes a lot of courage to challenge cultural mythology, and I personally think fear plays a much larger role than desire to avoid responsibility. That being said, I do believe that learning to assume maximum responsibility for what we control is critical to our getting out of the current capitalistic trap. But I don’t think framing it as laziness on the part of those who succumb to the propaganda machine really helps move us forward.
Just to clarify, there really WAS an epidemic of falsely accused people, which led to some much-needed reforms in forensic interviewing of children, which have taken hold nationwide, and maybe internationally as well. The McMartin Preschool case was most definitely an example of implanted or extracted “memories” of things that did not happen, and the therapists were in the main culpable for creating this disaster.
What I’m objecting to is jumping from the clear and fully supportable observation that false memories CAN be implanted to the conclusion that there is no possibility of suppressing a memory of something that really did happen. There are people who can’t remember anything before they’re 10 or 12. I doubt that they really can’t remember anything during that time, but I do believe it’s possible not to WANT to remember bad stuff and to wall it off from conscious recollection.
But it’s a very delicate area, and it is very easy for a person to inadvertently (or intentionally) encourage or induce “recollections” of things that did not happen. I’m not in a position to know what has happened in your family’s case, nor do I really want to weigh in on that question. I just don’t want you to come away thinking that I believe implanted or created “memories” are a fantasy. They are very real and very, very destructive to all involved.
I don’t think it requires encouraging people to alter their beliefs about past events to validate that such events may not be entirely conscious in their memories. I have a clear example from my own past where my second grade teacher hit me in the head and tossed me and another kid out in the hallway. I shared this story with a classmate at our 30th high school reunion, and she remembered the incident, including some parts I was not aware of (like the part after she hit me in the head!) While I still did not recall this part of the event, I did remember going down to the nurse after heading to the office, and I remember her checking my head for signs of injury, which I did not recall previously. I also knew there was another kid in the hallway, but she reminded me of who it was, which helped me flesh out the memory.
Was that recollection 100% accurate? I very much doubt it. Did my teacher hit me in the head? I am absolutely certain that this is what happened. And the parts I recovered were not manufactured or imaginary, but were very much connected to the events I had recalled before. There is no reason to doubt that I was hit, that Freddy Baughman was crying (which I also recalled after telling the story) and was tossed out in the hallway with me, and that I did make a visit to the nurse. The exact details of the event will no doubt never be known, and I’m sure different people who were present would have different recollections of what occurred. That’s the nature of memory.
So I don’t think it’s anyone’s job to tell anyone else what is true or not true, and especially to tell anyone what to BELIEVE about their historical trauma. But I do think it is absolutely wrong to deny the possibility of recalling or fleshing out memories of abuse that a person comes up with themselves. In fact, telling them NOT to believe their recollection IS telling someone what to believe about their historical trauma, which we both agree is wrong. It is up to that person to determine for him/herself what is and is not true about their own past. And I agree, the relevant point is to process the emotion attached to such events, including any conclusions or decisions the person may consider they have made in regards to their interpretation of such events. But the client owns the recollection and their own sense of how certain that memory is in their reality.
It is also important to recall that the large majority of serotonin receptors are in the gut (90%, I believe?) So screwing with the serotonin system screws with the gut, and Lord knows what this does to our “microbiome.”
Bummer!! Two years can feel like a VERY long time!
Where I live (West Coast USA), there is an organization that does legal advocacy for teens in difficult legal situations. Have you looked for that kind of service near you? The “age of consent” is generally regarded to be around 14-16 in most states, so you may have a legal right to decide this for yourself. I would definitely recommend you talk to an attorney in your area and find out the laws in your state. Of course, a parent can always claim that you are “a danger to self or others,” but from what you’ve said, you’re not threatening to kill yourself or anyone else, and are obviously rational and articulate enough to care for your own basic needs, by a very long margin. Who knows? Maybe you can win this one!
You’d be surprised how many doctors actually believe in “chemical imbalances” despite the research. They are almost as susceptible as the average Joe to Big Pharma’s lies.
And we are often trained NOT to look at these experiences honestly, and if we don’t find a way to become aware of the feelings we repressed, we generally end up doing the same things to our own offspring accidentally. Alice Miller writes eloquently about this phenomenon.
Not just the experts, but the news media, movies, TV shows, their family, neighbors, friends, and most people they meet in the world. It takes some serious courage to stand up to that kind of mass agreement, no matter how deceptive or ineffective the agreement may be.
You may be right on some level, Lawrence, but it seems to me that such motivations as you discuss are largely unconscious and are fed by general social agreement and expectations. It’s true that we have the free will to challenge or refuse to comply with these expectations, but that often comes with consequences that people aren’t willing to contemplate. I’ve found plenty who are seeing psychiatrists because they literally have no idea that there is any other option. While I’m all for empowering them to realize they have other options, blaming such people for lacking the levels of awareness and responsibility to recognize psychiatry’s shenanigans and manipulations is unproductive and in some cases could be seen as downright hurtful.
Interesting discussion – clients are certainly going to do better with such an approach than “treatment as usual” (and I use the term “treatment” very loosely).
Unfortunately, the discussion doesn’t go deep enough to get to the core of what is really going on here. The two client examples are people who were TOLD that their “moods” and “anxiety” were, indeed, things that descended upon them for no reason, and they were TOLD this by the “mental health professionals” they were seeing. The fact that the client had “never been asked” these questions before tells us enough to know that the people dealing with him either were completely incompetent or were corrupt and didn’t care about the outcome. It’s time to move beyond the question of “what to do when people ask for ‘medication,'” and start informing them of the misinformation they have been fed, and the actual hope that they can go way beyond “not feeling bad” in their lives.
So “allowing” youth to select adults whom THEY find supportive leads to better results than forcing them to do “therapy” with a total stranger or be “diagnosed” by a disinterested “doctor?” Who would have guessed?
Glad you mentioned this. We seem to have moved quickly from “false memories can be implanted” to “there is no such thing as repressed memories.” The latter is part of the “blame the victim” attitude psychiatric leaders have assumed towards those who are traumatized early in life.
In rereading this, I agree – researching “mental illness” automatically feeds into the idea that there is such a thing. But researching the real impact of what the corrupt profession really DOES and what impact it has can be very useful, as Bob’s work has proven.
But you CAN prove that the “treatments” provided make things worse, which Harrow and Wunderlink and many others have successfully done without setting out to do so. The studies proving that antipsychotics cause brain shrinkage, done by someone who deeply believed in the “medical model,” were particularly useful in debunking the idea that “schizophrenia causes brain shrinkage.” There is no need to embrace psychiatric terminology or “diagnoses” to debunk the bullcrap “research” that is out there. Obviously, this by itself does little, as the APA and their profiteering supporters will simply discount such research as irrelevant or biased, but it does provide a base for making deeper strikes into the PR machine.
I always get worried when someone is interested in “stabilizing” someone else. It generally is code for “get them to stop bothering everyone else with their personal needs and concerns.” Or sometimes “beat them into submission.” Please, don’t “stabilize” me!
Are you suggesting that the current dilapidated and destructive state of psychiatry as a profession is not strongly linked to corruption within the field, due to huge financial incentives and the desire for professional credentials and power? I can’t agree that the current state of affairs is solely the result of confusion and fear on the part of professionals and others who want to make things more comfortable. This plays a role, but what I see is the APA and the drug companies SELLING an idea that somehow they have a magical solution in the form of a pill that will obviate the need for the kind of personal work and commitment that you and I both know is really necessary to do things like healing attachments and gaining insight into the impact of traumatic experiences and learning how to love oneself enough to stand up and take action in an increasingly hostile world.
So I agree that the psychiatric model is a tool, but I don’t believe it’s designed to actually accomplish the things that you have spent much of your adult life working towards. I see the model being designed to make things more comfortable for those in control and to increase financial gain for big corporations and associated “professionals” who profit from having clients that never get better. If this were not the case, why is the APA so resistant to the evidence that these drugs are only useful, if they ever are, for short-term suppression of symptoms, and that long-term use creates the very problems that they purport to address? Why the powerful resistance within the ranks to the results of their own research, if not to protect their personal prerogatives and their funding?
You are not encountering lack of interest. You are encountering protectionist oppression because you’re threatening too many people’s gravy trains, and you’re also pissing off abusive adults who don’t want to be called out on their bad behavior.
I am feeling that this back and forth regarding who is really saying what about how antipsychiatry should move forward is unproductive and is getting kind of personal. I am not inclined to go through and moderate/edit all the negative comments and tones that are emerging, but I really think we’re all in position to hear where both parties are coming from, and I don’t see much point in trading competing accusations. I am still going to go through and remove anything egregious, but if the two of you could please take this discussion back channel, I’d appreciate it. It’s really gone quite far off the topic of the article at hand.
Thanks for that, Sam. Loving oneself is not sufficient to change the world, but I do see it as a prerequisite to making real change. Believing one deserves to be treated with respect means it becomes OK or even necessary to stand up for what is right. And all sorts of things become possible once we’re at that point.
I would be of the opinion that scientific studies do provide ammunition to be used in the fight to shut down psychiatry. If nothing else, I believe science is necessary to demonstrate the level of dispassionate lying involved in their “diagnoses” and “treatments.”
I don’t buy that it is ignorance. I believe it is not so simple to revise one’s beliefs without understanding the emotional reasons for adopting one’s original belief system, especially when early life trauma or attachment issues are present.
You probably told us this already, but if so, I missed it. Are you under 18? If not, is your mom your guardian? There ought to be some way an articulate person such as yourself could be in a better position to make your own decisions!
Absolutely! Cognitive therapy methods are, in my view, only ethical if the client identifies what thoughts (if any) they find troublesome and what kind of changes they would want to make. If the therapist has an agenda, the process is going to go south quickly, though many therapists don’t seem to notice when this happens, and mistake compliance for engagement.
Well, you do make a good point here. We have to start somewhere, and building strong attachments always seemed to me to be the easiest place to make the biggest impact, because the kids aren’t messed up yet! But of course, the kids are raised by parents who have their own attachment issues, and have also been trained by our social system to believe certain things that aren’t necessarily very helpful to creating a connected community of human beings. So we have to somehow help the parents attach to the children despite their own fractured attachments. A monumental task. Alice Miller has a lot to say about this. I guess my wife and I decided to simply start with our own kids and build out from there. It wasn’t perfect, but they are certainly some of the least sexist, racist, whatever-ist boys I’ve ever met. Modeling is the most important part of learning, including learning that the world is a safe place to be who you are.
Stigma is a euphemism for prejudice and discrimination and bigotry. “Stigma” suggests that the poor “mentally ill” are unable/unwilling to “get help” because they’re afraid their families or friends will be ashamed of them, or that they’ll be ashamed of themselves. It is intended to be rooted in the unreasoning fear of the potential “patient.” Whereas prejudice and discrimination clearly lie in the treatment of the potential “patient” by the very system that purports to “help” them. It’s a very important distinction, I believe. These terms are chosen strategically.
I do agree that attachment is central, as I’ve said, however, there are plenty of outside influences, such as racism, sexism, etc., oppressive schools and churches, our mobile, disconnected society (lack of community), and other influences which can result in anxiety, depression, anger, distractedness, and anything else in the psychiatric hierarchy. I want to make sure that people who don’t perceive themselves as having been mistreated or having had poor parental attachment are not considered of less importance or have their suffering minimized.
I think you are missing the point here. It’s not that people are arguing against being happy, it’s the EXPECTATION that everyone is happy, all the time, regardless of circumstance. The corollary to this is that if one is unhappy, it’s one’s own fool fault for not “thinking the right thoughts.” While it is helpful to maximize one’s ability to choose his/her reaction to events, we do not control all of the events around us, not even vaguely.
For instance, I was miserable in school. I was a very smart kid who was very shy. Elementary school in particular varied between weeks of massive, soul-crushing boredom and discrete oppressive events, the majority of which were perpetrated by the teachers. Now, one could say that I had a choice – I could have “made the most” of the situation, I could have left in protest, I could have learned to meditate so the boredom and anxiety I felt were reduced… sure, I had options, but realistically, I was in a very bad situation and had no way to really change it. I think depression is a very natural reaction to being trapped in a miserable situation. I think if I were cheerful about it, it would have been at the cost of utterly denying my humanity.
Was I “disordered” because I was massively depressed and anxious and “maladjusted” to the school environment?
You hit the nail. Compassion and empathy come first. Without them, “techniques” are worse than useless – they become a new form of abuse and oppression. And with them, “techniques” become of only secondary importance, as empathy will lead us down the right path toward knowing what best to do to help.
And worse, it often gets passed on to another generation when the scapegoat or the witnesses have children of their own. It’s literally a vicious cycle.
I agree, attachment is fundamental, and without it, a person has no sense of safety and can’t relate to others. Naturally, any kind of therapeutic intervention (the real kind, anyway!) depends on connecting to the counselor/therapist/helper/group, and absent the ability to attach, it’s almost impossible to process traumatic experiences of any kind. It is the most overlooked and most important element in a child developing what is so euphemistically called “mental illness.” So I don’t minimize the importance at all. I only wanted to be clear that there are other people who have good attachments but experience other kinds of abuse and trauma and oppression that lead to “mental illnesses” as defined in the DSM. Of course, the psychiatric profession doesn’t want to look at any of these valid and real sources of distress, because it upsets their political and financial power base.
I agree 100%. It’s not because people are stupid, it’s because they are brainwashed and cowed and unable to use the intelligence they have due to the oppressive conditions they face. Waking up is, indeed, job one!
That was my philosophy – you do what works for the client, and if it doesn’t work, you stop doing it. Pretty simple, really, but it is based on the idea that the therapist actually gets to know and care about the client, and is able to empathize with the client’s suffering and understand how s/he thinks about things. In other words, human connection guides a helper toward things that work. In fact, a person in excellent communication with another can actually invent “techniques” on the spot, specific to that person. Eric Erickson said, “Therapy has to be reinvented with each client.” I believe he was right.
I’d say that attachment is one important factor in development, but there are many others. We don’t want to go down the same path as the psychiatric profession by assigning all distress to one single cause and approaching it with one single approach. That being said, the current reality in the “mental health” field is for the most part to excuse parents’ behavior as “doing the best they can” while refusing to acknowledge the damage parents (and siblings, BTW) can do inadvertently, even with the best of intentions. So it’s good to have articles talking about attachment – it really does affect everyone, but it doesn’t explain everything.
Perhaps I worded that carelessly. Helping people find some ACTION they can take to improve their lives provides hope, whereas telling them their brains are broken and that there is nothing to be done about their “lifetime illness” drives people into despair, unless they are smart enough to understand that they’re being scammed. I don’t believe in broken brains, or if there is brain damage, it is observable and is dealt with by neurologists based on actual evidence.
In my experience, CBT is simply one of many potential techniques one can use depending on the person you’re working with and their needs and goals. To make it a “therapy school” has always seemed like a delusion and a deception to me. Why would someone restrict themselves to a particular technique and apply it to everyone? Different people have different needs. I’ve also seen/heard of CBT being used to blame the victim of abuse for not “thinking correct thoughts” instead of dealing with the traumatic experiences that led a person to the kind of beliefs they have.
It seems like the movement was driven by ego and money-making. Starting from the assumption that someone’s thoughts are somehow “wrong,” and that these thoughts occur in a vacuum, having no relationship whatsoever to past or current experiences, is both idiotic and guaranteed to create bad effects. I’m glad someone is writing about this, but as usual, the facts will do little to nothing to disturb the professionals from their greed and egotism.
I remember very clearly that being said about the Viet Cong during the Viet Nam war when I was just a kid. I recognized it for what it was then and it made me extremely uncomfortable even as a young person. It’s an ancient trope, and should be easily recognizable, except to those who don’t want to see it.
I also wonder if OrthoPsych contributes to increasing hope and a sense of agency in the recipient, beyond whatever concrete physiological health issues are being addressed. One of the worst things about the psychiatric model is that it tells people there is nothing they can do about their “broken brains.” It seems that OMP challenges that directly and says, “Yes, you can!”
This truly accomplishes a new level of idiocy. We now want a pill so that people don’t care if they are isolated and disconnected from their community? The need to communicate, organize, and work together is as fundamental to humans as the need to breathe and eat. It seems that the drug industry and psychiatry are bent on making sure that basic humanity is drugged out of existence.
I used to be a staff person for the Long Term Care Ombudsman program in Oregon. I was called once to a nursing home to see a guy whose daughter thought he was “overmedicated.” I could barely get him to open his eyes. He had bruises on his head because he’d walked into the doorframe instead of through the opening in the door. I interviewed the activities director and she told me that a week ago, he’d been hitting a volleyball back and forth with her in the courtyard! The difference: he was now on Risperdal.
How anyone could call this an “improvement” is beyond my comprehension. It shouldn’t take an outsider coming in to point out that they’ve now disabled a perfectly capable person for nothing but the convenience of the staff.
Wow, that sounds like the kind of things people say to dehumanize our war “enemies.” “They don’t have the same respect for life that we do.” Amazing that she could say such a thing and not expect you to have a horrified reaction.
The fact that many people “in treatment” continue to do (or START doing) what the “treatment” is supposed to prevent seems to be completely ignored or suppressed. You’d think that improving “symptoms” would at least be a minimum standard for effectiveness, but apparently, there are no such standards.
Ever see Invasion of the Body Snatchers? Sounds like psychiatric utopia – no one excited or upset about anything, and no purpose but to snatch more bodies.
Quite so. Intuition is information – it’s usually a warning to look more deeply. It can’t always tell you WHAT is off, but it does tell you SOMETHING is not right, and that further investigation is warranted.
Exactly. If they don’t have time to do that kind of work, they should not be pretending they are in a position to help. They should be honest and admit they are not qualified to help, and refer the person to someone who has the inclination and the skills to be a patient listener and an interested friend in time of need.
Excellent questions! It seems bizarre to think that a person who has just had a stroke would be anything BUT depressed, anxious, and confused. Why does this need to be “fixed?”
“Moreover, the study suggests that although it may seem that further questioning about suicidal ideation would elicit more information to facilitate accuracy in assessment, it is also associated with a higher false positive rate. In other words, detailed questioning increases the likelihood of inaccurately assessing people as at-risk for suicide when that is not the case.”
“Clinicians sometimes rely on suicidal ideation as a crucial test for short-term suicide risk, and it has been argued that asking about suicidal ideation could form part of a screening test for later suicide.”
I think these paragraphs highlight the real problem with this kind of questioning. The clinician is “assessing” or “screening” or “testing” for “short-term suicide risk.” They aren’t having a real conversation with the client – there is nothing here about establishing rapport, about finding out what is going on in this person’s life, about exploring why the client would feel that ending his/her life was a good or necessary idea. It is no small wonder that their clients/patients aren’t willing to share the truth with them. Would you tell someone whom you knew was “assessing” you that you were considering suicide, when that their “assessment” could get you locked up if it went the wrong way?
There is nothing wrong with asking someone if they’re thinking about suicide, IF you have a sufficiently trusting relationship and have the clear intent of listening and helping rather than “evaluating” the person you’re talking to from some elevated pseudo-“objective” viewpoint. The problem isn’t the question, it’s the intent of the person asking it that causes the difficulty.
True, and it’s frequently not obvious at all to outsiders, or even to those in the family itself. Thanks for your kind words – I appreciate you as well!
That is the title of the last chapter of my book: “Trusting your gut!” We all have intuitive knowledge that we can’t explain regarding other peoples’ priorities and intentions. When we learn to trust that knowledge, it is much, much harder for others to get away with this kind of subtle control.
Ah, the power issues! It’s easy to claim you’re trying to help when your social power protects you completely from the consequences of your help being so terribly harmful.
I think perhaps you are confusing the effect on certain individuals with the character of the institutions involved. The fact that there may be some psych wards that get good reviews, or that some teachers run very democratic and engaging classrooms, or that some kids love school for whatever reason, does not change a thing about the underlying purpose and structure of the institutions involved. If the basic design of schools is to teach children compliance and snuff out creative thinking, and that is the general effect on the population as a whole, the fact that a small or even moderate number enjoy their time being brainwashed and trained to bark on command doesn’t alter that effect.
A similar argument is commonly made about DSM diagnoses – “Some people like their diagnoses.” Well, sure, they do. But does that change for one second the fact that the diagnoses themselves are complete social constructs with no actual validity in the real world, or that they are used to undermine and blame those who experience psychological and social oppression by claiming their adverse reaction to their oppression is due to malfunctioning brains, rather than a malfunctioning social and economic system?
When I worked as an advocate in nursing homes, a home was taken over and put into federal receivership because it was so awful in terms of patient care. Yet they received approval ratings in the mid to high 80% range. Most people are satisfied with the status quo, even if it isn’t something they ought to have to put up with. They simply aren’t aware that other options exist.
In addition, there are misunderstandings and personality misfits between parents and children which contribute to later “mental illness” diagnoses. Moreover, there is research showing that sibling relationships can do a lot of damage, especially in families where feelings are not processed and problem-solving is done in a mostly unconscious manner. No overt abuse or trauma need necessarily be present. For instance, I was assigned a role as a “scapegoat” in my family and was picked on by an older sibling. I became seriously ill and was no longer an acceptable target, and my youngest brother was born about the same time, so my next youngest brother got the job of “scapegoat.” I suddenly became aware, though I could not have verbalized it, that I wasn’t the scapegoat because of some flaw, it was an assigned JOB.
Anyone looking at my family would have thought that all was well. There was very little in the way of overt trauma per se, but plenty of subtle undertones of hostility and unspoken emotion and unspoken rules and defined roles, all of which caused a great deal of emotional damage without any discreet “trauma” on which to hang one’s hat.
We should not forget that the adults are often mean to the children before the children are mean to each other. I mean parents and teachers and administrators. Kids don’t just become mean, they learn it from someone.
I would recommend it. DV professionals seem to be the ones who really understand and speak from a position of empowerment and understanding of oppression and the pain it causes. I don’t know Seattle at all (I live in Olympia, and before that Portland), but the DV programs there might be able to help you find a good person to help. At the least, you will experience that you are very far from the only one to experience such disrespect and foolishness in the Court system.
I don’t disagree with what you’re saying. The research in question is about children healing while still children, and the ability to have a safe dependency on a caring adult appears to be the most important aspect of their psychic healing, which apparently manifests in the brain as well. When we get to adulthood, we have to figure it out on our own if we are not fortunate enough to have had such a person, but similar considerations still come into play. What is quality therapy but a person listening to and caring about another person in a safe space? And why can’t non-professionals do the same for each other? Of course they can, and they do, as you (and I) have observed.
Ornish was absolutely on target when he started writing this stuff back in the 70s. Naturally, he was roundly attacked and ostracized by his peers at the time. Now everyone makes Ornish’s recommendations, but I never heard any apologies or crow-eating on the part of the big medical system. It is amazing how often truth is obscured in medicine when it conflicts with habit or profits.
It’s always easy to think of what to say after the fact. I seldom come up with these zingers when I’m actually talking to the person who is messing with me. Maybe I need to learn to stop and say nothing for a while instead of immediately responding, and I can come up with some better routines on the spot!
As JRR Tolkien wisely said, “It takes but one enemy to make a war.” And we know who created THIS war. It’s not the fault of the downtrodden who rise up against the oppressors that the oppressors fight to maintain their power. They could simply acknowledge that these drugs have little positive effect and a lot of potential harms, and redo their “algorithms” accordingly. No war would be necessary if those in charge would simply admit the facts and work from them.
I often do the same. If we’re going to use a label, I use the ones that indicate damage from trauma. Though I talked to a psychiatrist once who said “PTSD” was not caused by the trauma, because not everyone who was traumatized got “PTSD.” What? So being hit by a car doesn’t cause broken bones, because not everyone’s bones break when they get hit by a car??? The problem is apparently “vulnerability,” because I guess everyone should be able to handle being traumatized without having flashbacks or nightmares. Very weird!
OMG, that is awful! “Are you sure?” Maybe you should have said, “You sound so disappointed. Would you feel better if I were suicidal?” Nah, probably would have gotten you locked up for “excessive snideness disorder.”
I am SO sorry to hear all this! I wish it were an isolated incident, but it is not. What amazes me is not that abusers engage in this behavior, but that the “professionals” seem so ready to fall for it. The fact that you’re teaching school all this time despite the abusive crap he’s been spewing at you should be enough to make it clear you’re a very sane person in an insane situation. Additionally, his focus on controlling how much time you spend with your child and ACCUSING you of wanting to spend more should be an obvious indication that he is abusive and controlling and doesn’t care a whit about the child.
Are you connected with any kind of domestic abuse agency or services? They can be really helpful! And keep reading your Lundy Bancroft – he is the best guide to how to deal with these suckers.
Wouldn’t it be great if we can mistreat people and they wouldn’t mind? That’s the ultimate pill – to make people willing to accept whatever crappy treatment those in charge want to dole out without complaint.
There is also great work from the “decade of the brain” which is largely ignored, showing that the BEST thing to reduce the damage from early childhood abuse or neglect is, wait for it… a positive relationship with a caring adult!
It’s not brain surgery, but they apparently want to make it into brain surgery. Sometimes literally…
That is an excellent point! The psychiatric worldview is in actuality a religious one, and it attempts to supplant other belief systems. Perhaps enforced “treatment” can be objected to on the grounds of freedom of religion?
I very much like your first statement – if anyone is “mentally ill,” we all must be, because there is really no way to distinguish “normal” from “abnormal” people.
I would rather suggest that the new/old way of thinking is not at all compatible with the DSM or any of its definitions. If things defined as “mental illness” are to be considered common reactions to difficult circumstances, we need to dispense with the idea that a particular emotional/behavioral reaction is in any way a “disorder” or “disease.” Moreover, the idea that lumping people together based on their particular reaction to their particular history and context and saying they all are “suffering from the same disorder” is, to me, inherently invalidative of the very context it seems you and I both want to see brought to the forefront. I hope that makes sense!
I have seen this many times in my work with foster kids and Juvenile Court. I got to the point where when I saw a crying, emotional, seemingly out of control mom and a super calm, confident, under-control dad, I thought, “OK, we know who the real problem is here, and it’s not her.” I also saw how things changed in the cases where the survivor was believed and things started turning against the abuser. All of a sudden, the calm, confident person became increasingly angry, agitated, and even bizarre as the control slipped away from him. But someone has to start by believing that the person who is upset has a reason for it, and the reason is usually sitting across the courtroom from her.
I have to agree. The very fact of being told that your brain is broken and there is nothing you can do about it would make anyone feel hopeless. Add to that the frequent invalidation of one’s own experience and internal knowledge about what is going on, and you don’t need a drug to make someone give up. Not even getting into the horrors of “involuntary treatment.”
meanwhile adverb
Definition of meanwhile (Entry 2 of 2)
1 : during the intervening time
meanwhile, however, new projects are being undertaken this year
— Jonathan Eberhart
2 : at the same time
You can set the table, and meanwhile I’ll start cooking dinner.
Seems like you were thinking of the first definition, while I was intending the second.
As usual, the solution devolves into doing things to the patients instead of the doctors looking at how their practices and beliefs led to the problem. Easier to blame the least powerful.
I don’t disagree with a word you said. Helping people “game” the system and helping them recognize the true sources of oppression in their lives is a huge effort that has its own challenges and rewards, and is very clearly distinguishable from “helping people accept their illness” and other such nonsense. Domestic abuse is a good analogy – we all want to stop domestic abuse from happening, and working at a societal level to alter perceptions and biases and privileges enjoyed by abusers is the ultimate game. But meanwhile, helping those ensnared in such a situation is most definitely needed and contributes to the larger goal, especially when part of the process is political engagement for the survivor.
I guess the distinction here would be that one’s support of current victims of the system would need to be in a frame of helping them understand that the system is in itself a part of what they need to “recover” from. The Underground Railroad is, I think, a valid analogy.
For one thing, many “antidepressants” don’t affect serotonin and still are considered “antidepressants.” For another, studies back in the 80s showed that lots of “normal” people have lower serotonin levels. For a third point, no one knows what a “normal” level of serotonin is – serotonin levels vary widely from moment to moment. Have you read Anatomy of an Epidemic yet?
Gotta say, I see both viewpoints here. On the one hand, we don’t want to do anything to validate the dangerous nonsense that is the current system. On the other hand, I don’t want to simply abandon those in the clutches of the system when they are suffering. I think we need to do both – provide practical support to those in trouble while still insisting that the current system is utterly wrong from the ground up. How to do that is the tough question, but I think both/and is the essential way to go.
Yeah, I get what you’re saying. Spiritual harm is a very real thing to me, but it’s very different than a physical injury. Metaphorical vs. physiological.
It is my understanding that his withdrawal of the trauma theory was made under great pressure from his colleagues and Victorian society in general. However, we can’t absolve Freud of his decision to create a confusing and dishonest counterexplanation that served to baffle and mislead the public and the profession for generations. His cowardice in the face of social pressures had enormous negative consequences for millions of people.
There are definitely points at which men experience bias, but on the balance, women are far more likely to get the short end of the stick, even today (though it is better than it used to be by a long way). For instance, there is this idea that women usually get custody in divorce proceedings. But this is mostly because men usually don’t contest. Many studies done in many US states in different jurisdictions have showed the same thing: men who contest win custody 60-70% of the time.
There’s a lot more I could say about this, but suffice it to say that while things are better than they were in 1965, men still receive plenty of protection just because they’re men. The Kavanaugh hearing and DT’s comments on how “hard it is for young men” now that they have to worry about being called to task if they’re too aggressive toward an unwilling “partner” should be enough to remind us that there is a LOT of work still to be done.
They still often portray psychiatrists as talk therapists or hypnotists on TV and in movies. There are some that show what the current reality is, but I’m sure it’s a PR effort by the APA to make sure psychiatrists are shown as kindly therapeutic types rather than drug front people.
The word “pretend” bothers me here. I don’t think people are pretending they are in pain or are confused. Perhaps you could call it “spiritual injury”. Or don’t you think it damages someone to be, say, abused by one’s parents? Do you think they are pretending that it hurts them beyond the physical damage?
It is also important to keep in mind that while women can be abusive, emotionally and sometimes even physically, men are supported and protected by social structures and gender role expectations in ways women are not.
I actually think SAMSHA is a great example of why a survivor leadership is critical. It’s way too easy for any other structure to be coopted by the status quo defenders.
Just my two cents here. I don’t hear anyone wanting to deny membership or participation to people like me or others who don’t fit the “survivor” description. And I’m not sure the most important issue is honesty or trust, either, though I don’t want to invalidate Kindred’s raising of this as a vital issue. It seems to me that the issue is one of social power. It is pretty easy for those in the one-up situation to believe they are being “fair and equitable” when they are actually exerting their unearned authority based on social biases. So making sure that the direction and priorities of an antipsychiatry movement are not only informed by, but directed by survivors seems a very important point to me. It’s not that others can’t help and be passionate and come up with new ideas. To me it’s that the ultimate test of any idea is whether those who have been through the ringer think it makes sense and would work. Survivors have to ultimately direct the effort, even if a lot of hard work is done by people from all walks of life who interact with the system in some way.
It is so important to call out these “ad hominem attack” strategies for what they are! The reason they resort to these tactics is because using actual data and logic will be a losing proposition. Unfortunately, the tactic is often extremely effective in silencing dissent!
That is a fantastic idea!! I would love to have that data to toss out when someone claims “the mentally ill” are causing most of the violence we see or hear about.
Maybe we could create ways to afford an education WITHOUT going to prison. The GI Bill had pretty amazing positive effects. A similar program of service would add a lot to our economy and end up with a lot fewer criminals, I’m betting. (Except the white collar kind who already have educations and commit their crimes “legally.”)
Wow, that doesn’t even make any kind of sense! “However, given the increased risk of suicide in untreated depression and the absence of an increased risk of suicide associated with pharmacotherapy, currently available evidence does not support the avoidance of initiation and continuation of pharmacotherapy for depression in children and adolescents.” Didn’t he just say there WAS an increased risk of suicide with SSRIs???
Such a fantastic story of how your own “commonsense” understanding of the situation was repeatedly invalidated or ignored by the “professionals” in favor of their own worldviews and beliefs. It is wonderful that you had the courage and historical models to tell the doctors to shove off when you needed to do so. I also find it important to note that your political analysis of the society you grew up in factored into your ability to resist the inappropriate and abusive authorities. I think such political awakening is often critical to folks “recovering” from their ostensible “disorders.” In the end, our social system has abuse built right into it from the foundations, and recognizing that may be the most “therapeutic” act a person can engage in.
I appreciate the perspective of unearned privilege that you lay out in this piece. I had not really thought of it that way, but it makes total sense. “There are some good ones out there” doesn’t do a thing to address systemic oppression, and in fact impedes the effort. I love the idea of convincing local NAMIs who “get it” to go rogue and disavow the NAMI moniker and all the nasty history (right up to the present!) that goes with it. I’d love to see that happen, but even people with respectable levels of integrity have a hard time walking away from privilege, however unearned it may be.
I agree with all of this, and could go on for days talking about it. My book is in part an effort to raise consciousness, especially in women, regarding how our culture tells us men and women should act, and how acts of abuse are normalized and even romanticized (fighting over a woman, pursuing someone who says “no” as a sign of how much he “loves you,” etc.) I think this is particularly true for those victimized early in life,o or who witnessed their parent being abused, who have little or no model of what a loving relationship looks like and who are therefore less able to distinguish grooming tactics from genuine affection. Our culture does them no favors by romanticizing “bad boys” and making excuses for abusive behavior by men, and putting women in the role of “peacemakers” or “fixers” if the relationship doesn’t seem to be working as it should.
Domestic abuse is a very, very complex dynamic. It is perhaps natural for those who aren’t aware of this to ask, “Why doesn’t she just leave?” but too few are willing to look at the very real and very dark and difficult answers to that question when they make the perhaps understandable mistake of asking it.
Depression may “feel like a disease,” but that doesn’t make it a disease. I say this as a person who struggled with depression and anxiety for the first 30-40 years of my life, including times of feeling suicidal and seeing no point in life at all. I am GRATEFUL that no one ever “diagnosed” me with a “brain disease,” but instead people (including my therapist) encouraged me to believe that I could DO something about it, and helped me take small steps, one at a time, that led me to a place where I actually spent most of my day NOT feeling anxious or depressed, and where I knew what to DO if I felt that way to find my way quickly to a more effective approach to whatever was bothering me.
Some approaches that helped: recognizing being over tired or having low blood sugar, learning to meditate, learning to emotionally process difficult experiences from my past in a safe place, spending time hiking and biking, finding meaningful work, listening to clients about their own experiences and seeing what they seemed to find helpful, challenging myself to confront injustice when I was scared of the outcome, raising some wonderful but at times incredibly difficult children, learning how to grow with my wonderful but at times incredibly difficult partner…
ALL of these things and more have contributed to my learning how NOT to be depressed, and it took a couple of decades and a lot of support from a lot of people, some professionals but mostly just “regular people” who cared about me, or for whom I was responsible in some way or another. How could such a complex interaction of forces be considered a “disease?” Depression didn’t just HAPPEN to me – it was the result of many years of experiences and decisions and goals and accomplishments and failures and relationships. The body was certainly involved, and may perhaps have colored the way I reacted to things. But to reduce my feelings of depression to a random problem in my brain would be absurdly reductionistic and invalidative – it would take away the meaning of the work I’ve done and the things I’ve learned in the process.
There may be a tiny percentage of depressed people who actually have something wrong with their bodies, and they certainly deserve medical help if it is available. But the vast majority of depressed people have a history of their own, very different than mine and yet in some ways very similar. Reducing their suffering and their emotional experiences to a malfunctioning brain is not only insulting, it is ultimately disempowering in that it denies that person’s ability to look at, sort out, and address whatever range of experiences lie underneath their emotions and behavior. If the indications of depression can be in any way viewed as “symptoms,” they can only be considered “symptoms” (aka clues) of the actual problems or challenges a person has to face. And those problems and challenges are intensely personal and unique to each person, and will never be able to be categorized as a “mental illness” in the physiological sense.
“I thought I just had eyes that got dry all the time. Then I realized I had a real medical problem – chronic dry eye! Then my doctor told me about Zaquejex!”
Again, we know from scientific research that meditation can change the actual structure of the brain – MENTAL activity can restructure the brain! So to suggest that fixing the brain can fix the mind seems to fly in the face of evidence that it is the mind (whatever that is) that affects the brain, or that at a minimum, it’s a two-way street.
Not sure how else I can put it. Mental/emotional suffering does exist. That is not in dispute. The dispute is the idea that “mental illness” can be defined in scientifically precise terms. “Mental illness” is an analogy, a metaphor, a squishy-soft social construct that has no scientific definition at all. Even the former head of NIMH agrees with this. But it is a common argument in favor of the concept of “mental illness” to say that, “saying mental illness isn’t real means that you’re saying that mental suffering isn’t real.” It’s a false equivalence.
Your statements are very consistent with my experience with hundreds of domestic abuse survivors. Accusing partners of being “mentally ill” is a very common and very effective tactic used by abusers in domestic relations hearings and in juvenile court child abuse cases. There has been a lot of improvement in terms of professionals’ understanding of domestic abuse, but this strategy still works in way too many cases. And intentionally pushing a partner to retaliate is also very, very common in domestic abuse situations. The threat of involuntary commitment and/or loss of children is a very powerful tool that a “diagnosis” puts into the hands of the abuser, yet a lot of mental heath professionals seem to have no awareness of this kind of manipulation.
Expert opinion is, in my view, not relevant to this discussion. We’re talking about science, or I thought we were. The concept of “neural connections” is very soft science at this point – there are not “connections” in the same sense that wires connect to each other. It is certain that neurology comes into play when talking about distressed states, but saying that provides no evidence regarding the causes of distressed states, which is the really relevant point here.
I’m not arguing against studying the brain, Shaun. I’m arguing against the idea that you can assume that the brain and the mind are identical, and that studying the brain will yield an understanding of the mind. And I reiterate: the results to date suggest strongly that we are barking up the wrong tree, and in fact probably in the wrong forest. Studying the brain gives information about the brain, which may be very useful information. But so far, the study of the brain seems to have created nothing but confusion about what the mind even is, while studies like Buddhism, which look at the mind as a separate entity, seem to have let to much more satisfying results.
And c) Science actually SUPPORTS the idea that “mental illnesses” are not physiological in nature, and in fact, don’t define homogeneous groups at all. I think Shaun is confusing the idea that no one SUFFERS from the idea that there is no scientific way to define the concept of “mental illness” in the sense of a physiological problem.
The question is not whether distressed states exist. No one disputes that. The question is whether these states can be explained and understood by studying the organ of the brain. I suggest that they can not.
Of course you can see no distinction, because it violates your basic beliefs. I do assert that the mind boils down to the decisions we make, but more importantly, WHY we decide to make the decisions we do. And I defy you to show where values and principles and priorities are stored in the brain. We don’t even have a clue how memories are stored. You can’t tell me where to find values.
Perhaps a clearer way to put it is that the brain is kind of like the computer processor. It doesn’t work without a program, which you can NEVER understand just by studying the circuits. But more importantly, the computer requires an OPERATOR. To me, the mind is the operator of the brain. We may one day find the operator within the brain’s structures, but as of now, no one can say where the operator is or how it works. A true scientist would have to admit that this is the case.
Millions of people believe a lot of stuff that isn’t true. What is the scientific underpinning of any “mental illness” you can name? How is a person objectively determined to “have” vs. “not have” a particular “disorder?” And even if such “disorders” could be objectively identified (which they can’t), what evidence is there that all people with the same “disorder” have the same thing wrong with them or need the same kind of help?
The DSM itself proves that neither of the above conditions can be met. It admits in the introduction that there is no line between having one disorder or another or no disorder at all. It also states that there is “no assumption that people with the same disorder are alike in all important ways.” In other words, they admit that these “diagnoses” are actually heterogeneous groups of people who may have little to nothing in common with each other. What on earth is the use of a “diagnosis” that labels people arbitrarily into groups where the people don’t even share common characteristics? It makes about as much sense as saying someone whose knee hurts has “knee pain disorder” which causes his knee to hurt.
If you claim to believe in science, you ought to think carefully about how these “diagnoses” are arrived at. There is very little science involved, actually.
So in other words, yes, you do think the mind and the brain are the same.
The fact that all information goes back to the brain to be processed proves nothing. The fact that science can’t distinguish between “mind” and “brain” simply means that science has no idea what “mind” is and is incapable of speaking intelligently on the topic.
MIND, to me, is that part of us that has intentions, valued, priorities, goals, scruples, etc. It demonstrates such qualities as courage, anticipation, regret, integrity, faith, etc. As long as none of these qualities and qualities like them aren’t definable in terms of the brain, then science can not claim the brain is the same as the mind.
For materialists (like you, I guess), there is no possibility of anything existing beyond the physical. This forces them into a position where they can have no clue what “mind” is, and yet be completely certain it must be part of the brain, “Because where else could it be?” But again, that’s a matter for philosophical discussion, not scientific.
Science is supposed to be skeptical. This means that if something is not shown by data to be true, it is simply unknown. It can’t be assumed to be true, in fact, any such hypothesis would need to be thoroughly tested and all alternative possible explanations eliminated before we could conclude this is the case. Obviously, nothing remotely close to this has ever been accomplished, or as far as I know even attempted. The fact is, the mind is a MYSTERY to science. It can’t even be defined, let alone located in the brain. (Let me know when you find where “courage” or “integrity” are located in a brain.) Just because you or others are materialists doesn’t mean materialism is “right” or “true.”
I don’t disagree with you. I’m just saying the task is easier for psychiatrists. But psychiatrists are a predictable product of the medical system, almost inevitable. Psychiatry is a symptom of a much larger problem.
For a very long time, producers of any product had the luxury of dumping their waste into the environment for free. It’s only recently that the levels of waste have gotten so high that people demand some action, yet it is still not accounted for when calculating the cost of production. There is still this sense that making corporations pay to clean up their own messes is somehow unfair or undermining of “competition.” But of course, anything that is dumped leads to a cost, and most of the time, the taxpayers end up paying that cost and the producer gets off with little or no responsibility for the effects of their production.
It looks from my angle like a guild war – psychologists want in on the 15-minute med check action and psychiatrists want to protect their turf. Nothing to do with caring for their supposed clients.
Any psychologist who wanted to be able to prescribe would be immediately scratched from my list of possible helpers.
True enough! Or give them enough Risperdal that they’re unable to stand or walk, and suicide rates would be expected to drop. The only problem is “underdosing” such that the patient is still able to move and formulate any kind of plan of action.
There is one difference in psych research, though. They are researching “entities” that can’t be objectively defined or observed, which is perhaps the worst possible sin in science. When we start dealing with metaphorical entities, we’re dealing with philosophy, not science. Not that most doctors are concerned with science, either, mind you. It’s just harder to get away with pure BS when you have to at least demonstrate that your drug has a measurable effect theoretically considered positive by the recipient rather than the doctor and the family and the society at large.
Your answer avoids my most important point. Your comments seem to reflect a belief that the mind and the brain are the same thing. Is this your belief?
Your points regarding brain development are well taken. However, you’re still not dealing with the question of what the mind is. We know that actions of the mind can not only “reprogram” the brain (to use an idiotically oversimplistic metaphor), they can actually cause the structure of the brain to change. It can alter the expression of DNA. So what is this “mind” that can fix up the brain itself? Is the mind more than the brain? And if so, should we not engage the mind in overcoming unfortunate developmental results of early neglect or abuse?
I’d also add that we know that 90% of serotonin receptors are in the gut region, and that there are some who theorize that some level of “thinking” is moderated by the gut. People don’t say they have a “gut feeling” about something for no reason – they really do appear to judge things with their guts!
He felt resentment against Whites, eh? And that’s a sign of “mental illness,” per the authors? What would be the appropriate response to being treated as a second-class citizen your entire life? Cheerfulness? Or would that be too “manic?”
Of course, having the largest percentage of armed people of any country where stats are kept hasn’t really helped the USA avoid oppression much, has it?
Akathesia happens while taking the drugs, too. So it can’t be a withdrawal reaction, or not just a withdrawal reaction, anyway. But it’s definitely a reaction.
NAMI Santa Cruz used to have a really interesting website, very much supportive of individual empowerment and questioning the dominant paradigm. Somehow, they seem to have removed it years back. But I assume they may be one of the “rogue” local NAMI branches that actually do some good work.
Of all the idiotic things they do in psych hospitals, waking up “patients” in the nighttime or early in the AM may well be the most idiotic of all. Anyone alive knows that sleep deprivation impacts the emotions and the brain’s operation in a destructive way. Especially someone suffering from any kind of hallucinations needs, above all, SLEEP! A “normal” person deprived of sleep for a long enough time will start hallucinating. Why the f%$k would you wake up someone who was hallucinating once they fell asleep? Unless you WANTED the person to keep hallucinating…
I like the sound of it! We’re living in an RV ourselves these days, which is about as “off the grid” as we’ve been able to manage for the moment. It doesn’t surprise me that our monied elite is opposed to such a concept!
You seem to be operating on the reductionistic assumption that mental distress is “driven by” something wrong with the brain. I don’t agree. There is, at this point, no evidence to suggest that malfunctioning brains create any “mental illness.” Even if you choose not to believe in the possibility of non-material entities, the evidence to date strongly suggests that there is a process (or a SOMETHING) we call “mind” that transcends the mere interaction of cells, just as a computer program transcends the diodes and transistors and capacitors in the processing unit. It is clear from research on Buddhist monks, for instance, that directing the mind to do certain activities changes the actual STRUCTURE of the brain.
It seems you go back and forth between the idea that caring for people and creating safe spaces is paramount to hoping that studying the brain will somehow provide some answer that transcends the human needs and priorities that occupy our attention as human beings.
I don’t think you can have it both ways. The brain is certainly a participant in all human interaction, but so is the heart and the spleen and the liver. Participation is not the same as causation. In my view, the problem with the “medical model” is not the complexity of the brain, but the effort to seek a generalized solution for problems of the mind by trying to study and manipulate the body. We can see from the results to date that this approach is doomed to failure, and further study of the brain is highly unlikely to lead to anything but further confusion.
It is not always the same symptoms that were “treated,” but it’s very common for the target “symptoms” to come back with a vengeance. Which is frequently considered by our “mental health professionals” to mean you’re having a “relapse.” At least that’s my understanding.
The first thing we have to learn about “mental health” is that you can’t and don’t need to “cure” an emotional reaction to circumstances. An emotional reaction doesn’t need to be cured, it needs to be understood through communication. Doctors need to realize that they can’t treat the mind as if it were an organ of the body. It is a lot more than that.
Hey, it scared me as a “mental health professional” when the big steel door locked behind me! The locked psych ward was a scary place, every one I visited.
Sounds like a SUPER healthy environment! Especially for people who are anxious or paranoid – to actually spy on them and reinforce their sense of insecurity? Brilliant plan. But I guess “normal” people don’t mind being spied on…
Disgusting! They are residents and should have the right to make phone calls and whatever else residents do. They aren’t supposed to be in prison, but apparently, they are.
I think I got it all. The identities of the spammers were particularly helpful! Thanks for your civic contributions to the welfare of the community. I shall recommend you for the Despammer’s Award!
From my understanding, it is not drug-based, but does use drugs in a minority of cases. Mostly, it’s about talking and listening as a group. I had a training on it and drugs were never even mentioned. I think they would use them only if their standard intervention wasn’t taking hold, and for a short period of time in most cases. Not saying that doesn’t raise concerns, but the data I have read suggests that 80% come out without any drugs at all, and that’s a pretty big improvement over 85% ON drugs in “standard treatment.”
I don’t disagree at all, and I believe chosen labels are more relevant for critique than those foisted on one by someone else. But I still hold that making complete assumptions or generalizations, even about psychiatrists, should not be allowed. Saying “all psychiatrists are NAZIs” neglects the fact that some psychiatrists, such as Peter Breggin or a handful of others, have been major critics and providers of helpful data to fight the status quo.
A very good point, though, and I’m glad you raised it.
I don’t personally believe people are saying that to you, or most are not. I think they’re saying that this particular point was powerful enough to distract their attention away from the real point of your article.
True. In a system that was truly trying to be helpful, this kind of intervention would be central rather than reported as an interesting sidelight to “standard treatment.”
I appreciate you sharing your views on this. I want to make sure to clarify that there is no requirement that people avoid the use of “psychiatric language” and that people will never be moderated for that reason. The reason many posts on this thread were moderated was a specific violation of the guidelines against making assumptions regarding a group of people based on their psychiatric label or other chosen or assigned identity. The issue of “psychiatric language” is something that people in the community get to hash out among themselves.
That said, I do agree with you that folks would do well to consider the potential impact on a poster, including authors, when they comment. It’s important to remember that many of us were at a different place when first exposed to the kind of views one hears here, and that we may be running off potential allies by being overly harsh in our assessments and our language, because most people can and do learn if they are able to hear and process the information. But that goes well beyond the purview of the moderator.
Commenting as moderator: Posts are moderated ONLY for violating the posting guidelines. I have explained clearly the reason why posts making generalizations about “personality disorders” or any other diagnosis will be removed, and provided a specific quotation from the guidelines that outlines this exact situation for purposes of clarity. You agreed to these guidelines before you started posting here, and you should not be surprised when violations of these guidelines lead to posts being moderated.
It is not appropriate to raise these issues on the threads, and I have explained to you each time why the post removed has violated the guidelines. Any future comments about “censorship” will be immediately moderated. I have only allowed this to stand so I can explain to any readers who may be confused the actual cause of posts being removed, which has nothing to do with any political agenda and everything to do with the posting guidelines that everyone has agreed to by choosing to post here.
It sounds like you had VERY real reasons to be afraid! While you might have identified some “wrong targets,” your fear of your ex appears to be very well founded. Good job getting away from him, and well done to your husband for doing what the “mental health experts” were too blind to figure out. Just goes to show you don’t have to be a “counselor” to understand how to help someone in distress.
I agree that this is often the case. Unfortunately, due to the sketchy way these “diagnoses” are made, it’s unlikely that one cause can possibly be identified for any of these “disorders.” But we most definitely should be looking at prenatal pharmaceutical exposure. We know that street drug exposure does damage to the growing embryo/fetus – why would pharmaceuticals be any different?
I find it understandable that you were upset by all the negative feedback. It takes a lot of courage to post a personal story. I’m glad you’re working to make it a learning experience.
Thanks for sharing that. You’ve outlined the basics of how these “PD” diagnoses are used to invalidate and dismiss clients who have abuse histories. A minimum qualification for any counselor in my world is someone who recognizes that the DSM labels are BS and who understands that most “mental illness” is a result of being treated shabbily when one is vulnerable.
You sound like you’re quoting from my own writings. What you’re describing is very real. I don’t think it’s always due to “low self esteem.” I think women in our culture are trained from early on to like “bad boys” and believe they can “save them.” Some men do this, too, but women are primed for it from the first time they read “Beauty and the Beast.”
A fair criticism. I’d like to focus attention on the horrible conditions you were exposed to, what created them, and what kind of resolutions may be possible.
You are 100% correct. There is no excuse for such actions. You describe specific behavior here that is horrific, and I very much doubt that one single person here would disagree that you were inexcusably abused by these people.
To a large extent, I have failed to moderate this thread effectively. Comments which are generalizations regarding people with a particular psychiatric label are expressly identified as violations of the posting guidelines, to wit:
“We are an oppression-free zone. Comments that are racist, sexist, transphobic or otherwise oppressive may be subject to removal. Statements that attack or assume things about a person based on a label they carry (i.e. “psychiatrist” or “schizophrenic”) are similarly not condoned.”
I take full responsibility for failing to intervene effectively, and I intend to change that starting immediately.
That being said, it is acceptable for people not to appreciate certain aspects of an author’s blog and to say so in the comments section, as long as the comments themselves are within the guidelines. I know this can be tough for authors, but it is a reality that has to be respected if we are to have any kind of meaningful conversation about these topics. It is a balance that has to be struck, and the guidelines are the best way I think we have to strike such a balance.
I will add that anyone seeing a post violating the guidelines is again welcome and encouraged to report it. It helps the community when the members of the community participate in setting standards they would like to see respected.
I have been very soft on my moderation of this thread, and I think that has been a mistake. That time is over and I am returning to full moderation policies as always. Comments that generalize about “the personality disordered” or any other psychiatric label will be moderated from this point forward. Please restrict your comments to the specific people you have direct experience with. “The people in the ward I was in” or “the other residents” is acceptable language. Generalized statements about “Drug addicts” or “people with personality disorders” is a violation of the posting guidelines, specifically,
“We are an oppression-free zone. Comments that are racist, sexist, transphobic or otherwise oppressive may be subject to removal. Statements that attack or assume things about a person based on a label they carry (i.e. “psychiatrist” or “schizophrenic”) are similarly not condoned.”
All commenters are to follow these guidelines, and further comments in violation will be removed. If you see a violation, PLEASE do not react with further escalation – report the comment to me via the reporting button, or by e-mailing me at “[email protected]”
I think the point you are missing here is that nobody disbelieves your story or that you were harmed by other “patients” in the “hospital.” The problem arises when you speak of “the personality disordered” as if they are a homogeneous group who can all be assumed to believe and behave in the same way. If you were talking about “people who are violent” or “people who are emotionally abusive,” you would have no objections from this quarter.
Of course, it makes no sense to have placed you there. My point is only that it is the STAFF who make these decisions, and the staff are the ones who are responsible for making sure that the residents are safe. They failed you, miserably, and you suffered extreme and unnecessary harm as a result.
Thanks for that reply. Almost all of what you say, I agree with. The main purpose of the DSM is to allow billing, and if it were used just for that, I would have a lot less problem with it. And I don’t really have a problem with a CONCEPT like “narcissistic” or “antisocial” – these can be used as descriptive language to characterize someone’s behavior for purposes of discussion. But when such subjective concepts are somehow codified into purported scientific entities or medical “diagnoses” that can be assigned to someone by a person in authority, we are very quickly into deep trouble.
I agree, any of the staff/psychs who toss about “personality disorder” toward clients ought to look in the mirror. A lot of them meet their own subjective “criteria” for Narcissistic PD. Though I prefer more colloquial descriptors myself. I won’t specify, but use your imagination.
In my mind, what happens is that a particular client is unable to get his/her needs met by the standard system of “care.” Because they have learned a certain set of coping skills for whatever reason (usually a totally abusive childhood and and almost complete lack of love or caring in their lives), they are unwilling to sit by and just accept that their needs go unmet, so they call more often or figure out ways to try and pressure the clinicians into meeting those needs. (I have to acknowledge here that very often, the needs are more than a clinician alone can meet, but the clinicans should know that and understand the paramaters of working with this person). The person then gets labeled as “uncooperative” or “high service user” or “frequent flyer” and is then treated with even less concern and is dismissed more easily due to the group’s agreement that they ‘need boundaries to be set.’ Such a person then seeks other caregivers, who are warned ahead of time not to trust this person or put in too much time on them, so the client is more and more frustrated, escalates to more extreme behavior, thereby “proving” that “they’re borderline” and are not deserving of the clinicians’ time. Word gets around, and soon this person is treated as a pariah almost everywhere they go. That’s what I’ve seen, anyway. I think such people are to a large extent created, first by having their childhood needs go so dramatically unmet, and then by the “caregivers” putting the blame back on them instead of helping them figure out what needs they are trying to meet by their behavior.
I think this is more to the point. The staff are responsible for protecting those in their “care” from harming each other. This responsibility is chronically ignored, and that’s the issue for me. And if we are talking about “mean people” (AKA people who engage in harmful behavior), that’s a big difference for me than focusing on what label these particular “mean people” may have been assigned.
I think I see what you’re saying here, but I don’t think anyone’s upset about a “diagnosis” being “insulted.” I think the point is that when one is LABELED with such a “disorder” (usually against one’s will), one experiences prejudice and discrimination, even if one believes the labels are crap. I don’t personally want to continue to further the concept that people “have personality disorders” which can then be used to categorize them behaviorally as “mean.”
This is not to dispute that mean people exist and indeed suck it big time. I am only disputing that such people can be identified by seeing if they fit a list of “criteria” invented by a bunch of arrogant wealthy folks meeting in conference rooms in a hotel in San Francisco for a few days.
That’s just what I was talking about below! What business does your mom have telling you that “you have Borderline Personality Disorder?” Or any other such label? How is that helpful to anyone? And you can also see, apparently, how the label is used to distract from or disguise the abuse that happens to children, instead blaming the victim by labeling them “BPD.” The very act of labeling creates this opportunity. I sometimes wonder if that is the actual point of the DSM.
I would disagree slightly with your last comment – I believe most people here believe the DSM is invalid as a guide to “medical diagnosis” and is, from a scientific point of view, completely lacking in scientific validity. This does not mean that the DESCRPTIONS in the DSM don’t describe things that actually happen, or that a certain framing of a person’s experience might not be helpful to them, even if it is framed in terms that parallel or even totally reflect the DSM. In my mind, the objection is to claiming scientific or medical meaning to these “disorders,” when a simple review of the “criteria” for such “disorders” show them to be utterly subjective and lacking in any kind of cohesion. Moreover, the DSM itself states in its introduction (apparently not read or pointedly ignored by most psychiatrists or other “diagnosers”) that the DSM “disorders” don’t assume any kind of firm boundary between those who “have” or “don’t have” a “disorder,” and even more tellingly, don’t assume that people with the same “diagnosis” “are alike in all important ways.” The last quote is particularly telling, as it essentially admits that even people who completely fit the criteria to a tee may have completely different problems or issues and may have completely different needs which can’t be met by one approach or intervention type. Well, if the people who fit the criteria don’t have important things in common, what the heck is the meaning of the “diagnosis?” I mean, everyone with cancer has tumors, everyone with thrombosis has a stuck blood clot, everyone with diabetes has problems with his/her insulin system. But these “diagnoses” apparently don’t work like that. A person who is “depressed” may be grieving, escaping from a violent relationship, stuck in a dead-end job, suffering “empty nest syndrome,” reeling from the shock of having a new baby, or living with the long-term consequences of early childhood trauma, just to name a few. What is the point of labeling all of those people as “having major depression?” Why not just deal with their actual issues?
I could go on, but I hope that helps clarify a little why I, at least, find these “diagnoses” utterly objectionable. It’s not that people don’t get depressed, and even seriously so. It’s that labeling them as “suffering from Depression” provides no extra help in understanding what is happening, and in fact, makes it easier for clinicians to ignore the causes and simply try and make the effects go away.
Wow, I don’t think I’m familiar with a hospital that has a “psychotic ward” and a “depressed ward!” Not that I’ve seen that many, but the ones around here seem to just put all of the “patients” into the same place. There was a differentiation between the ward for people with good insurance coverage, where actual therapy was practiced (or at least attempted) and people were allowed to come and go, and the locked ward, where most of the people were involuntary and where the only apparent “therapy” was trying out different drugs until the person seemed “stable” enough to be released into the community.
The issue you raise here seems to be twofold, to me – one, that people are put together randomly and without any sense of self-control or even rational selection criteria, and that this sets up bad patient dynamics. And two, that the staff do a crappy job of providing any kind of protection from physical or emotional traumatization by other patients. I think both of these are very important issues and are pretty widespread. I’m not sure that selecting out the “less damaging” patients for one ward and putting the “mean ones” in another would solve anything, though, as the “mean ones” would then be hurting each other, even if you had been protected from them to some degree. Mean people are everywhere, and if the “hospital” is going to take on patients and put them together in a ward, I’d say they have a responsibility to create safety for all the patients, regardless of the “diagnoses” of the people on the ward of the label characterizing the ward itself. Does that make any sense?
I appreciate your comment very much. It is a particularly sensitive subject for a lot of folks who have been exposed to that particular label. I think I understand that you are talking about a particular behavior pattern or patterns that tend to get that diagnosis assigned. I also know that such terms are used colloquially, not by “mental health experts,” and that the concept of, for instance, someone engaging in “narcissistic” behavior, or being “a narcissist, can actually be quite helpful to some people who have been victimized and need a frame to understand it.
I agree that people who do engage in that kind of damaging behavior can be incredibly difficult to be around, and that staff often do an incredibly poor job of protecting clients/detainees or whatever word we want to use to describe them from each other. I’ve dealt with many folks who have had similar experiences, and in some cases, the staff even joined in on bullying the scapegoat. Such behavior is awful, particularly if you are forced to be there and can not escape!!! I wish I had included that proviso more clearly in my comment, and again, I very much appreciate your willingness to recognize the charged nature of that particular label in this community. I apologize for any distress my comments may have created for you.
“Frequent Flyer” is often used as a derogatory term for clinicians to distance themselves from people they perceive to be “difficult clients.” It doesn’t surprise me that such a person ends up having their needs ignored, even to the point of death. Once those in charge stop caring (if they ever did), anyone in their care is in danger.
Well, we agree on THAT point! Ending open-ended political contributions, especially from corporations, should be a high point on any political agenda if I’m to support it.
I agree with you on this point. I think we have to meet people where they are at. Many people who post here today with very radical views acknowledge that they were once taken in by the system. Change starts with education. It’s not enough, but it is a start.
It is, indeed, daunting. However, one strategy followed by those in power is to create the impression that nothing can be done about it. If we all accept that, it makes their position into the truth.
Fight back where you can! Even if you only accomplish making other clinicians aware that you feel the same way and that their perceptions are correct, that’s still something important.
The list of “symptoms” of “personality disorders” are simply a list of behaviors that most people find obnoxious or disturbing. It should not be surprising that people who are addicted to substances might more frequently engage in behavior that most people find obnoxious or disturbing. I will also note that many of the “symptoms” on your list don’t apply to all or even most “personality disorders. It looks like what you wrote mostly applies to the “symptoms” of “Antisocial” or “Narcissistic” PD diagnoses, which is a small subset of all “personality disordered” people, even if we accept that such categorizations are valid, which I do not.
It would be much preferable to me and I think many others here if you would stop talking about ‘personality disorders’ and instead talk about “people who are self-centered and disrespectful to others.” PD “diagnoses” are extremely problematic for many reasons, and it can be very hurtful to some so diagnosed to be grouped together with “people who are self-centered and disrespectful to others” and dismissed without any effort to differentiate whether or not those people fit your pre-determined assumptions about what “having a Personality Disorder” means about them.
I don’t see any difference in definition. Both are defined by subjective judgments made against a person without their agreement, and both represent generalizations which don’t appear to have any consistent basis in reality. They are both decided on in committee by consensus or vote, and there is no way to objectively determine if anyone has either type of “disorder.” All the DSM diagnoses suffer from similar limitations.
I don’t believe that would work. Big Pharma has plenty of money to buy ads and sell their false ideas on TV without any help from the government. In fact, they could lie even more effectively with even less accountability – at least the FDA puts some limits on what they can claim is true. They have tremendous power through their billions of income, and smaller government won’t do anything to change that. Or am I missing something? Can you explain how having less government will lead to less control by big corporations over our lives?
Less CORRUPTION would definitely help. Less restrictions on pharmaceutical company crimes? Not what I would recommend.
Yes, that was FASCINATING! Physiological changes in the brain’s STRUCTURE result from meditation. Similar observations have been made about taxi drivers – the part of the brain dealing with geography is bigger and more functional. Epigentics explains all of this – our activities alter how our genes are expressed. But that doesn’t fit with the DSM philosophy, so it is quietly dismissed or not talked about, even though it has everything to do with how to help people deal with whatever distress they are experiencing.
Ah, well, psychiatry and science, nay truth, never had much to say to each other.
My point would be that at least in part, women are less resistant to authority because they have been “feminized.” So the war is not on men. It is on men AND women AND children, and has been going on for a long, long time against the women and children. It feels like women are being blamed for “emasculating” men when in fact it is for the most part OTHER MEN who are trying to create a more docile population so that they can continue to dominate. To suggest that there is a “war on men” denies the fact that there has been a “war on women” since at least the appearance of Cro Magnionoid culture tens of thousands of years ago.
I think sometimes rage is necessary to get out of the less empowering emotions, like fear, grief, and apathy. I personally had to go through a rage “phase” to stop being anxious all the time, and I’ve seen many who do the same.
Rage has its uses, but it’s not a place I want to get stuck.
Wow, that is a seriously long list! This is big corporate “mental health” at its worst. And apparently there are no substantive consequences for their general failure to do anything but suck.
I do think there are a lot of clinicians who think the way you do. But it takes a lot of course, and willingness to accept harsh consequences, for people in the system to take a stand. Maybe you can create a subgroup of those who think differently and start supporting each other in speaking up?
Actually, I think the biggest confounding factor is the fact that no one can objectively decide who “has bipolar” and who does not. So whatever groupings you create, they are likely highly heterogeneous and not really comparable to each other.
The best we get from these studies is “the drugs do something. Some people think it’s good. Other people don’t. They also do bad things. We don’t know who will get the bad things. So essentially, we’re guessing. Try it out and see if you like it or not.”
Seems like a pretty disempowered viewpoint. Why don’t we do research on how to get people to value and take care of their environment, instead of giving up and dealing with the grief of failing to have done so?
Now you’re talking about dissent, and I agree with that sentiment. Why do you try to make it into a gender/sex thing? Don’t you believe women are capable of effective dissent? Or perhaps you should also be critiquing the feminization of WOMEN, who are driven into a far more disempowered role in society than the men you are complaining of. Are you not complaining of men being forced into behavior that women are expected to accept and deal with every single day? And which gender, I may ask, is the one engaging in this ostensible “war on men?” Are not the Captains of Industry and the rich elite primarily comprised of white MEN?
I think it’s time to broaden your analysis. The war is not on men. It is on anyone who is willing to stand up to the authorities, and women and children get hit far worse than what men are exposed to, often quite literally.
I don’t disagree. I was referring more to the idea of deciding that “mind=brain” in order to avoid the rather obvious fact that nobody really understand what “mind” actually is. Thinking that somehow studying the brain will lead to an understanding of how/why people act in a particular way, or even the idea that all people act in a similar way for similar reasons, is mythological.
Posting as moderator: This is not directed at a specific person, but it seems we are diverging from a discussion of the topic at hand. It is best not to make comments that characterize other people’s actions or beliefs. I’d like to see the commentary return to the subject of the blog. I’d add that if another commenter is feeling hurt or misunderstood, it is best to attempt to find out why rather than continuing to insist we were correct in our original comment. Or simply to apologize and clarify or move on. I hope everyone reading can apply this here – I don’t want to start removing posts, but this exchange is getting too personal and hurtful to allow it to continue in the same vein.
I agree, philosophy transcends all sciences. There is no science absent an underlying philosophy. It is a shame that many if not most modern “scientists” neglect to remember that fact.
There is a lot more to science than the scientific method. The scientific method is a MEANS to accomplish the ends of science. Science is based on the assumption that there is an objective reality that can be studied and understood independent of the person observing it. It also assumes that humans are inaccurate observers of reality, and that special means must be employed to assure that we are objective despite the inherently subjective nature of our lives.
Other scientific values are that the primary means of proof is negation of alternative hypotheses; that given several explanations to explain a phenomenon, the simplest is most likely the best one; and that a hypothesis is true only for as long as data doesn’t contradict it. There are a great number of smaller postulates that are in operation as well, such as the idea that a hypothesis is assumed false unless it is proven true, and that replication of an observation is required to substantiate its validity, among many others.
Use of the scientific method doesn’t define science.
Commenting as moderator: Wow, thanks for doing that! I am not sure where these were residing, but I really appreciate you hunting them up. I have spammed all of the above. If they are still there for some reason, please let me know. I will look into finding out how/why these are not being blocked by the SPAM blockers.
“Social sciences” are only concerned with probabilities and statistics, and can never be precise and accurate in the sense that the hard sciences are. I’m not saying the “scientific method” can’t be applied, but it requires a great deal more humility and willingness to tolerate ambiguity, because the number of variables is overwhelming. Naturally, psychiatry chooses to ignore that fact and even the results of its own soft-scientific studies, in the interests of maintaining power and profits.
The idea that psychiatry is trying to implement or support socialism is lacking in any kind of empirical support. Psychiatry works closely with large, multinational pharmaceutical corporations to maximize profits. In classic socialism, such corporations aren’t even allowable. It is basic to socialism that corporate control of the means of production is the central problem to be resolved.
As an aside, are you suggesting that only MEN are being controlled by this approach? Or that “masculine” behavior, whether undertaken by men or women, is the target? And if “masculine” behavior is the target, why is so much of the DSM focused on not engaging in any kind of emotional interaction?
There are plenty of psychiatrists and also some therapists who are told and believe that one should not talk to a client about the content of the voices they hear. They are told that engaging in such discussions strengthens the voices. Some are told that they are actually supposed to tell people that the voices are imaginary and that they have no meaning, being simply random outputs of a diseased brain.
You may not have been trained that way, but I’d be willing to bet that lots of commenters here have heard similar messages. I’d be interested in seeing how others have been treated in this regard.
I would not argue that all of the above are involved. But the arguments made by the psychiatric mainstream, while claiming to be “bio-psych-social,” in actuality deny the validity of the psycho-social-economic-political aspects of suffering and spend all their energy on “bio.” I think that’s that this article is really about.
Further consultation has led me to reverse this decision. Direct, gratuitous criticism of MIA’s editors will in the future fall under the rubric of disrespectful/shaming comments and be moderated. It is OK to critique a particular decision, but implied disrespect for those having to make the decisions is crossing the line.
I think that is the key point – psychiatry’s pretentions to science are false and disingenuous. They know well themselves that the data doesn’t support their contentions, but they proceed anyway, because it’s not about science, it’s about convincing people to believe you no matter what kind of BS you spew out. AKA MARKETING!
I wouldn’t call Buddhism a science per se, but I think it can be approached in a scientific manner, and it appears that many Buddhists (and the Buddha himself) have done so. I think the variance in Buddhism is that it studies the human spirit, and the number of variables is huge. But I think it is a far more honest and humble study of it than psychology, and the conclusions it draws have much wider applicability.
I’m a total science nerd, and back in middle school or so, I was very much committed to the idea that materialism was the right viewpoint. Thankfully, I have matured a lot since then, but part of my transition away from that view has been following science itself and observing its limitations, as stated in my earlier post. I think the need to believe that science will answer all the questions there are comes from the same need that religions often fill: the need to believe that there is an explanation and the fear that if we don’t know the explanation, we will be vulnerable. For me, though, I get a lot more security from acknowledging that much is beyond our grasp, and may remain that way. Isaac Newton once remarked that everything he knew was like a handful of sand on an endless beach. One of the greatest scientific minds of history recognized that the mysterious is much, much larger than the sum total of everything we humans know, or believe we do.
I agree – the implication is that the only acceptable response to stress ranges from mild annoyance to mild amusement. Any strong reaction, even enthusiasm, is “diagnosable” as “abnormal behavior!” Apparently, “Invasion of the Body Snatchers” or “The Stepford Wives” is the ideal human society.
There have been social systems which do not create the kind of suffering we see in “modern” societies. Is it not possible that the very nature of our society and what it expects of its members is the primary cause of this added distress?
It is an assumption that all mysteries will eventually yield to the methods of science. There is no scientific proof to back up this assumption. As soon as we’re operating on unverified assumptions, we’re in the area of philosophy, not science. It IS arrogant to presume that science will answer all questions and to thereby dismiss anyone who believes otherwise. Both operate on assumptions that are not provable or disprovable by science.
Having a scientific attitude begins with admitting what is not known. Science is most effective at proving hypotheses false. What is true scientifically is always subject to change given new data. Even the most scientific field of all, physics, eventually leads to unexplainable conclusions, such as matter being able to move from one space to another without occupying the space in between, or being unable to actually make 100% accurate measurements (Heisenberg’s uncertainty principle). It is extremely unscientific to assume science will answer all questions. Scientific proof of such a thing is required but will never be available.
I do think that humans enjoy engaging in productive behavior. I think the problem comes from who gets to define what is “productive.” Nobody enjoys slaving away for someone else’s benefits. Nobody likes someone else telling them that if they don’t do as indicated, they will starve to death. The concept of “work” has been co-opted by our exploitative culture into meaning “doing what someone else says you have to do.” This starts early in school, where “work” is defined as what the teachers make you do, while anything you personally enjoy is considered “play” and defined as non-productive or even wasteful. If we can overcome this kind of brainwashing, it can be true that “work” as in productive activity as defined by ourselves and those we care about is in fact extremely valuable. It is wage slavery that reduces the concept of “work” to something odious.
After long thought, I have left this comment up, but I find it problematic. MIA makes editorial decisions all the time about which blogs do and do not get posted, often based on the content, quality of writing, number of other blogs to be posted, and other factors. It appears you may have had some difficulty finding out why, but it seems the appropriate approach would be to communicate further with the editors, or with Robert Whitaker. The post seems to have criticizing MIA’s editorial policies as its main objective, and while there is no ban on criticizing MIA by any stretch of the imagination, it would seem to me to be more responsible to find out what the actual policy is before publicizing such a critique.
I think you’re missing my point. First, I’m not defaulting to the idea that SOs are automatically unhelpful. I don’t know how you get that from my comment, but I suggest you re-read it. What I said is that in SOME cases, SOs can be incredibly destructive. I would think that should be kind of an obvious point. It is not fair to assume that someone’s SO or parent or other relative is going to be helpful – it’s something the client has to be able to decide. I’ll happily acknowledge that this kind of decision is a lot more complex in a situation involving multiple identities.
Second, it is certainly your right to decide what YOU think is helpful, based on your own observations. However, it is NOT your right to decide what your wife or anyone else thinks is helpful for them. Obviously, caring people try to do the best thing for the person they are trying to help, and sometimes we have to proceed on our best estimation of what is likely to be helpful. However, and this is critical, we MUST OBSERVE HONESTLY from the behavior and reactions of the person we are trying to help whether or not our plan is helpful FROM THEIR PERSPECTIVE. This is where psychiatry fails utterly as a profession and an industry. They don’t do what they hope might help and observe if it is helpful. If they did this, they’d have recognized long ago that their labels and their drugs are making people worse on the average, both from direct personal observation and from looking at the research. They’d be talking about taking individualized approaches with each client, about the high correlations between adult “mental illness” and childhood abuse and neglect, about the long-term damage to the brain done by the drugs they so happily prescribe.
It’s not about assuming all SOs are destructive or dangerous. It’s about not assuming the opposite. I’ve seen way too many situations where family members increased their power over their partners or children, with the assistance of the medical/social services system. Clients need first to be protected. SOs can be extremely helpful, but I would by no means make that assumption about any SO without looking carefully into the situation first.
“What started out as an effort to make sure everyone had a basic understanding of the three Rs…”
I would contest that this was the original purpose of universal public schooling. Documents from the time (mid- to late-1800s) suggest that the main purpose was to create “good citizens,” which pretty much meant people who could read and write enough to participate in society but who were conditioned to behave and know their stations in life. There was big concern at the time regarding both freed slaves and immigrants from Italy, Ireland, Poland, China, etc. threatening the supremacy of the white male elite of the time. They wanted to train compliance to authority, and you can see the essential principle of compliance to authority running through all but very unusual schools. So like psychiatry, the idea that “the system is broken” doesn’t necessarily hold true if the purpose is not to help people, but instead to control them.
Responsibility requires knowledge. We can’t be responsible for what we don’t know. This is why false advertising and DTC advertising of drugs have to be a target for our efforts, as well as challenging media characterizations of violent or dangerous people as “mentally ill.” Misinformation is a huge part of how this whole juggernaut gets away with what it does.
All such decisions are now structured around psychiatry’s worldview, unless you’re lucky enough to find a dissident practitioner who actually sees you as a human being.
I agree that both occur and are related to how the DSM views people who are suffering – it is both blameful and destructive of society’s “misfits”, however it may be that they don’t fit in. So whether poverty exposes you to the MH system, or the system makes you poor, it all pretty much adds up to “disposable people” as the central problem.
Ah, but pathologizing and drugging IS the core, Shaun! It’s like saying that the school system is controlling children and discouraging independent thinking because they are misguided. Sorry, but that’s the purpose of the school system, and many documents from the mid- late-1800s verify this. Good teachers or administrators can make it more tolerable, and there are schools that exemplify a totally different approach. But it doesn’t change the essential purpose of the system.
The DSM III was created in order to improve psychiatry’s standing as a “medical specialty” and to increase their market share, which was being undermined by non-MD therapists. This is all clearly documented at the time of these decisions. The decision to make the DSM “atheoretical” was specifically done to make it possible to engage in creating “disorders” and coordination with the drug companies was started very early in the process. To suggest it was anything else than a power play is rewriting history.
And as such, I continue to maintain that psychiatry is rotten to its core. I won’t even go into other “core” practices such as lobotomies, ECT, insulin coma therapy, etc., nor their participation in eugenics and total support for the NAZI war atrocities. I’m not saying that people can’t help people by listening and caring and asking the right questions and being real. I’m saying that psychiatry itself is based on false premises and corrupt practices, and there is no way to “reform” it other than starting over. Psychology or counseling/therapy may be salvageable in some form, but psychiatry is not. If you take away the DSM diagnoses and their drugs, what do they have left?
Or perhaps people experiencing poverty, unemployment, homelessness and unsafe housing are more likely to be “diagnosed” as “mentally ill,” especially when they let people know they aren’t willing to accept these conditions?
I think “antipsychiatry” folks are also pretty diverse as a group. It’s hard to make generalizations about such a group. I find it more productive to address particular concepts or ideas rather than critiquing the whole idea of “antipsychiatry.” The bottom line for me is that I don’t see psychiatry as it is practices doing anything but harm. Such “help” as they provide is, if it even works, temporary and dangerous. I’m not against the concept of “professional help,” but in the current system, it’s pretty dangerous to even engage with a “therapist” unless you’re already well educated on how the DSM is used and how to avoid it. You found your own pathway forward, but a lot of people can’t do that for a lot of reasons. So on the balance, I think we’re much better off without the psychiatric profession and its antiscientific “theories” and “treatments.” It’s not that people shouldn’t help each other. It’s that people shouldn’t be pretending that they understand and can “help” when they actually have no idea how.
I have to point out here that sometimes, SOs are very much the cause of great distress for the “identified patient.” Every situation is different, and the client is ultimately the one who has to decide if they are helpful or not helpful. The real problem is when the psychiatrist or mental health professional thinks they can decide for the client whether or not the parent/SO or other involved person is an ally or not.
I believe the honest study of human beings and how they develop, learn and grow is extremely valuable. The issue is, it needs to be done honestly. Piaget, Eric Erickson, Carl Rogers, William Glasser, and plenty of others have presented very valuable information that has helped us learn to be better parents and better human beings. I see this as very separate from the current “mental health system” and its pseudoscientific pretensions of being able to “diagnose” someone with a “disorder” based on a set of unusual or inconvenient behaviors. Psychiatry appears to be a total wasteland today, if it ever had anything at all of value to contribute, which history suggests is an extremely long shot. Psychology has been more of a mixed bag, but to the degree that psychologists subscribe to the DSM labels and attendant pseudoscientific concepts of “chemical imbalances” or “bad circuitry” as the causal agents in “mental illness,” it needs to go as well. I’d add further that the need for “therapy” seems to suggest some deep failings in our social system that need to be addressed, rather than have to “heal” people from the resultant damage. It is possible to view therapy as an enabling concept that again puts the cause of one’s suffering in oneself and not one’s relationship to the expectations and demands of the society one is part of.
So for me, I’ve seen good ideas come from psychology and I’ve known some good therapists, and like to think I’ve provided some quality experiences to people who came to me for help. But I don’t think it matters much how good or kind or capable the individuals in the current system may be – the system itself is rotten to the core, and if that doesn’t change, no amount of honest study will help.
There is, of course, zero evidence that “depressed” people are more likely to be violent than non-depressed people. In fact, depression by its very nature suggests a restriction of action and a turning of hostility toward oneself rather than others. I’d guess that the rate of violence from non-“treated” depressed people would be lower than the general population.
I find it sad that people want to come that far and spend that much time going to a place of such artificiality as a “mental health center.” While it may be better than nothing, it is a sad commentary on the deterioration of our communities. Folks ought to be able to find people who care about them and can relate to them within easy walking distance of their homes, maybe even right on their blocks. The “need” for “mental health centers” is a result of the bizarrely dysfunctional social system we’re living with, and in many ways, such outlets “enable” the current system to continue to be as screwed up as it is, because those being harmed are siphoned off into enclaves rather than gathering with their neighbors to protest or revolt. I don’t want to take away the idea that some good work happens in “mental health” centers. But there were always people who treated their slaves well and men who didn’t abuse their partners and children and teachers who didn’t use the arbitrary authority they had to harm their charges. When the system is messed up, individuals being kind within the system doesn’t really create the kind of change to the system that is needed.
The evidence says that they don’t. If the pills were working, would we not have decreasing rather than increasing suicide rates, since so many people are now taking them.
I agree. Speaking of “mad people” in and of itself shows bigotry, as if all “mad” people have in common is their “madness” and as if such a grouping could even be logically made.
Oh, those POOR psychiatrists, having to deal with people in crisis! It is SO hard, how can we expect them to… wait a minute… isn’t that what they’re being paid to do?
I also wonder what the onslaught of one vaccination after another does to a little child’s immune system development. It was one thing when there were 3-4 vaccinations spread out between 0 and 5. Now kids are hit with a dozen or more, many happening shortly after birth. It can’t be a good thing.
This is true for basically all the DSM diagnoses. All contain a social judgment about what is “good” and “bad” behavior, and try to explain “bad” behavior by arguments re: faulty wiring or brain chemistry. The DSM is a clever way of disguising social judgments and criticism as a neutral “medical diagnosis.” It’s quite insidious.
Understanding what is actually going on is what helps. Diagnoses may in some cases help understand what is going on, but in most cases, my observation is that they act to obscure what is going on, or trivialize it. Saying someone has “Oppositional Defiant Disorder” tells you that the person tends to not go along with what they’re asked to do. It tells you NOTHING about why or what one might do to improve the situation.
In your wife’s case, it appears that the diagnosis helped create some understanding of what was going on so you’d know what to do. But you didn’t do what the “mental health” system would have told you to do, you figured it out yourself. So what was helpful wasn’t the diagnosis per se, but your ability to use that information to craft a good approach. The key elements of the improvement were you and her. The diagnosis would have been useless or perhaps even destructive if you’d followed the advice of the “professionals.”
This is very much reminiscent of my wife’s father’s experience. He really did have some dementia going on, but they put him on Risperdal and had him close to paralyzed. He was showing obvious signs of distress, trying to talk, rolling his eyes, moving his head side to side, but couldn’t make any coordinated movements of his body.
Once my wife got her mom to take him off, within three days, he was sitting up, making eye contact, talking, joking, laughing, feeding himself. Yet in his nearly frozen state, not one of the staff people or the doctor showed any concern that this previously vigorous and energetic person suddenly was unable to move or talk. The doctor, in fact, was very angry that Ginny’s mom had exercised her right to informed consent and stopped the drug!
One can only conclude that a) they don’t care, or b) the inert state achieved is considered the desirable outcome. It is amazing that 20 years of complete and utter treatment failure, in your dad’s case, led to absolutely no reassessment of the situation or any attempt to try something besides more drugs. It is sickening, yet all too common. I’m glad you were able to find your way out of the maze.
Flu vaccines are notoriously ineffective; I seem to remember one year when it was estimated to protect a paltry 10% of the population. I’ve had the flu a number of times in my life, last in 2009 or so. It’s a pain in the ass, but unless there is some reason you’re weakened, it’s most likely just a temporary discomfort. Most of the deaths are in the very old or the very young. It looks like this year’s version is 60% effective, meaning there is slightly less than a 50-50 chance you’re being immunized for zero benefit. Everyone has to make their own decisions, but the flu vaccine is definitely overhyped (sorry, bad pun!) in my view.
One of the big psych researchers, whose name escapes me for the moment, has pretty clearly demonstrated (kind of by accident, actually) that the gray matter loss, at least, is almost certainly due to long-term use of neuroleptic drugs.
I think you’re absolutely right. It’s clear that the focus is on everything a person can’t control, so they can claim there’s nothing you can do about it but submit to their “treatments” and pray. At the same time, if it’s all biological, we don’t have to change any of our institutions that are causing distress, because after all, it’s all in the brain, eh?
I think evil is a characteristic of behavioral decisions, not people. That being said, sometimes people choose evil so very often that the temptation to simply decide they are irredeemably evil is strong. It can be a pretty good approximation to the truth.
Have you considered finding a group of people who have had similar concerns – a support group? You have to be careful that you don’t get one of those sponsored by the drug companies or the MH system – a lot of those are spouting propaganda and will tell you to get “back on your meds.” But I think other people who have had similar experiences are the best source of good advice about how to move forward, including others who have come off “ADs” in the past. This website can be a good source, and other internet communities can help, too.
Hope that helps a bit. There are a few good counselors around, or life coaches, so that might also be worth exploring, but you definitely have to shop around very carefully, because these days, it appears that most of the “professionals” involved in the system have bought into the label-and-drug philosophy.
It is always interesting to get specifics on what his “improved behavior” constitutes. It is usually what the child DOESN’T do (He doesn’t yell anymore, he hasn’t hit me, I don’t have to get him from school, etc.) There is no focus at all on the child’s quality of life. “He stares blankly out the window for minutes at a time.” “He is very isolated.” “He falls asleep in class.” “His hand vibrates and twitches unceasingly.” These observations are not noted. The focus is usually that the child is less annoying to the adults around him/her.
“Belief perseverance?” I think they mean arrogance and pride and need for power. Semmelweiz wasn’t chastised because they didn’t believe he was right. It was because he insulted the powerful men of society by suggesting they had “dirty hands.” The question of whether or not he was right was never even raised. “Belief perseverance” makes it sound like some benign and inherent human trait, but it is, in fact, quite a pernicious and often violent effort to protect the status quo power brokers from accountability for their actions.
I have also noticed that the criticism of the troop withdrawal never gets into talking about how they got there in the first place and how they contributed to the current mess and the mass migration and other consequences of our own stupidity.
When has our intervention in another country to alter their government ever led to anything but disaster? And yet we never seem to learn or even talk about it.
Pain to the consumer base will be directed toward the consumers taking out their animosity on each other based on race, social class, ethnic origin, gender, religion…
That is a very good description of what happens. For most psychiatrists (or physicians or police officers or teachers or whatever), their behavior is governed by how they are trained and by what their peers believe, as well as what their supervisors will reward, tolerate, or punish. Real independent thinkers are rare in any profession, and tend to be seen as threatening. And with psychiatry’s complete lack of objective statistics and decision-making tools, they are particularly vulnerable to this group-think kind of “logic.” The issue isn’t whether the individuals in the system care or don’t care (well, that IS a big issue, but not the main one), it’s what the system expects and incentivizes that determines most people’s behavior. Which gets into power dynamics and oppression, which is probably too much for a response to your well-written comment.
The destruction of Obamacare means going back to the old system. There is no ‘new plan’ except to continue to let the insurance companies suck us dry. Obamacare, as flawed as it is (and I am NOT a fan, trust me!), was an effort to solve the problem. If we “destroy Obamacare,” what is the solution?
Well, I don’t really disagree with you, Richard. However, I think change of power has to start somewhere, and I choose to start with making people aware that they do have some kind of power. The kind of revolution we’re talking about isn’t going to happen in the next few months. People have to wake up, and it starts by reassuming responsibility for the government we DO have. At least, that’s how I look at it. Abandoning electoral politics or the use of media to distribute information doesn’t lead toward resolving the situation. Sure, using FB does pay off the enemy, but it’s a great organizing tool. I don’t see any magical path forward, especially with the huge majority of people being convinced daily that their efforts to assert their power are doomed to failure. Help me with a better practical way to get that started beyond getting saner people elected, and I’m happy to listen.
Anyone telling you there is “irrefutable proof” that “schizophrenia is caused by structural abnormalities of the brain” is having you on. There is increasing agreement even among mainstream researchers that “schizophrenia,” like pretty much all of the DSM ‘diagnoses,’ is not actually an entity that can be scientifically defined. I believe Japanese researchers have scrapped the term altogether and are looking at multiple causes.
We do all agree that drug company money creates corruption, but it is sometimes hard to see the full scope of that corruption. Have you read “Anatomy of an Epidemic?” It will be a great education for you if you have not. It explains how the entire DSM model is built on a desire for psychiatrists to give an impression of scientific competence to a field that has never demonstrated scientific support for its models. If you haven’t, READ IT. It is essential at this point in your education.
I consider harm reduction legitimate and very important. We can’t abandon those who are currently suffering while we work on stopping psychiatry altogether. People need support, and they aren’t getting it. That’s how psychiatry continues to justify itself.
I think you hit the nail when you talked about profiting from harming people. We, the people, theoretically own the government, and if we get the right people making decisions without their own views being polluted by corruption, we can remove the incentives for hurting people. That IS possible, even if it seems very difficult, and to my mind, humans being what we are, changing incentives is the key to changing how people act. If you pay people to hurt other people, you’ll find people willing to do it.
I never thought of it that way – they are trying to teach you on the one hand to be mindful and to respect your inner voice of wisdom, but when that voice contradicts the authoritarian structure, then you’re supposed to stop listening. Very confusing!
I never have found these simulations very realistic. Of course, I’ve never had the experience, but some of them seem to be designed by other people who are totally speculating and have no such direct experience themselves. How real are these simulations? Do people who actually KNOW what it’s like participate in making them? How many are dedicated to the purpose of compassion and understanding and how many are designed to sell drugs?
Very weird framing here. Why go to “Increasing physical activity improves mental health?” Would it not be more correct to say, “Kids shouldn’t have to sit still all day” or “Kids need exercise?” We’re not “preventing mental health problems” or “improving mental health,” we’re actually meeting the needs of children in ways that have been known for millennia to be necessary.
Exactly. No one, and I mean NO ONE, tried to exercise their 5th amendment right or any other right. Some resisted physically, but you know what THAT got them.
I agree 100%. We start with removing direct force, but we have to also remove false advertising, manipulation, lying, and use of authority to intimidate or pressure one into submission. What we really need is a change in the basic mythology that underpins our understanding of people’s emotional needs, starting with ditching the idea that it’s all individual and all genetic, and expanding to include the fact that much of what passes for “mental illness” is a result of our decaying communities and ruthless economic system.
But I’d be happy if we could start with removing force.
Almost all totalitarian societies (I know of no exceptions) are run by men, who, far from being emasculated, have masses of unearned and undeserved power. Women in such societies (on the average) are generally FAR more disempowered than men, though of course, there are many men who are also lower in the power structure and have limited power. These societies are generally organized in authoritarian structures where people are considered above or below other people and where those considered “above” in the system are allowed to abuse those “below” but have to accept the abuse of those “above” them in the system. So the problem isn’t the “emasculation of men,” it is the authoritarian structure of entitlement based on power, regardless of gender. That being said, when gender IS taken into consideration, it is clear that, at least on Planet Earth, women are in almost every case held below men in the hierarchy. I’d challenge you to come up with an example of a totalitarian society where women were in charge, outside of the world of science fiction. Blaming it on “emasculation” of men appears to me to be missing the point.
Do genes determine brain? To an extent, yes – they appear to determine development potential. But the Decade of the Brain research and more recent research into “epigenetics” has proven unequivocally that large structural and functional changes in the brain occur as a direct result of personal experience. So the idea that genes determine brain is not entirely true – genes PLUS experience determine brain.
Does brain determine mind? This is a question that transcends the realm of science. No one really knows that the “mind” is, and the assumption that the mind is a direct result of the brain is based on the philosophical school called “materialism,” that assumes there can be nothing that is not observable and measurable in the physical world. Of course, quantum physicists have already shown that this school of thinking doesn’t explain everything, including such fascinating phenomena as a particle being able to move from one place to another without occupying the space in between, or the fact that you can’t measure anything to 100% accuracy, so in fact, all scientific measurements are approximations, which is not a big deal with big objects, but gets very significant when looking at tiny things like electrons. So the idea that “Brain determines mind” is not established scientifically, but is a conclusion drawn from a particular philosophical school. There are many schools of philosophy that draw different conclusions on that question.
“Brain determines emotions” – True in a very physiological sense, though apparently gut and other organs can also influence emotions dramatically. But without knowing what MIND is, to say that “brain determines emotions” cuts out the possibility that mind affects brain which then determines emotions as a result. That’s the reality I observe.
Brain drives survival and reproduction – for sure this is true, but again, without the question of what MIND is being answered, we can’t really say that all is driven only by the brain.
I suppose I’d ask you the question: do you believe humans can exercise free will?
Depending on your answer, I might present some other questions or arguments that have a bearing on this. Suffice it to say, it is not such a simple question as you seem to want it to be, in my view. The interaction between brain and mind is the biggest mystery of human beings, and anyone who tells you this mystery has been solved scientifically is blowing smoke. The main reason that decades of genetic research has turned up close to nothing regarding genetic underpinnings of mental/emotional/behavioral phenomena is that, in most cases, such underpinnings either don’t exist or are so incredibly complex and subtle that they provide no explanation whatsoever as to why a person is acting the way they are.
Obviously, it would be modified to the situation. The most important parts are “What you say may be used by the evaluator to hold you in the hospital against your will and force you to accept drugs which you may not wish to take” and “you have a right to an attorney, who may be present during your examination by the evaluator.” I think both statements would put both the evaluator and the potential victim in a much clearer relationship to each other. I used to do these evaluations (briefly – worst job I EVER had!) and no one ever said, “I’d rather not talk to you because it might result in my being held here against my will.” I really think most people in the situation don’t understand what is at stake until it’s too late.
People will think what they think. And if they invite reviews, I don’t think you can get in trouble for giving them feedback. I think the Court’s view would be, “Well, if you don’t want to hear feedback, don’t accept reviews.” I do think how you write it might have an impact on whether people take it seriously. I think the best reviews are mainly factual, with a brief introduction and conclusion to add a little emotional context. Simply, “Dr. X insisted I had Y disease and recommended treatment Z. When I asked what the side effects were, he said there were none. I looked it up and found a long list of adverse effect about which he failed to inform me. I quickly decided he could not be trusted.”
That feeling of rebellion is a good one to drive you forward. Unfortunately, the urge to rebel by itself doesn’t necessarily lead to the right path. It provides good energy but needs you to provide direction. At least that’s my experience. Keep rebelling!
I think armchair diagnosis reminds them that there is no technical skill or know-how involved, and that, in fact, the entire process is simply a matter of judging others’ behavior that we find uncomfortable or inconvenient. They have to protect the image that only a “professional” can “diagnose” someone with a “mental disorder.” Though a 5-minute perusal of any “diagnosis” would quickly result in the conclusion that it’s about as complicated a process as making chocolate chip cookies from scratch. But the results aren’t nearly as tasty!
That’s my view as well. The idea would be to divorce the idea of imprisonment from the idea of “treatment.” Calling out force for being force instead of pretending it is helpful.
Yeah, it’s weird, huh? Why would we have to CONVINCE anyone that inducing a seizure by electrocution is a bad idea? Should the onus of proof not lie on the person claiming it is helpful? Or is not the very act so obviously damaging that any argument to the contrary should be dismissed out of hand?
HIS “treatment” failed because YOU have the wrong “diagnosis?” Even for a “real” doctor with a meaningful diagnosis, this would be an idiotic statement! If he knew you “had Borderline Personality Disorder,” and that “ECT” didn’t work on “BPD” clients, why would he have offered you this “treatment?” Or was he saying he “discovered” that you “had BPD” simply BECAUSE the “ECT” didn’t “work?” Sounds like pure justification to me!
It is quite ironic, to “diagnose” someone for being afraid of an abusive partner who actually does them physical harm. Do they ever believe it’s appropriate to have feelings?
OMG, what a liar! How can he say that with a straight face? Or is he really saying that he never bothered to check with his patients so he can honestly say he’s never heard of any memory loss.
I would agree. It is incorrect to generalize that all counselors/therapists/treatment providers are dangerous or misguided. It’s not incorrect to assume that they are until proven otherwise, however. I’ve certainly known a significant number of professional people who actually care about those they are trying to help, and some who have helped me significantly, particularly my therapist in my 20s. However, such people are in the minority in my experience, so assuming that a person cares BECAUSE they are a MHP is, in fact, very dangerous. The other thing that’s VERY important is to remember that there are plenty of people who are NOT “MHPs” who care and are skilled in connecting and helping others. The key is not to seek out or avoid people with a particular title, it’s to understand that what is needed is not a professional so much as someone who cares and is willing to listen and be real and help you sort things out rather than acting to enforce his/her views in the name of “help.”
I am a parent, and this is fantastic advice. It provides a sane way out of the ‘don’t blame the poor parents’ distraction that is used to blame kids for their own distress. Well done!
I think it’s high time that doctors were simply forbidden to prescribe certain drugs to children. We’re talking about killing children here. Do we really think “advisories” are going to work?
Hmmm, I don’t think I’ve ever heard anyone take that position with me… I agree, it would be just as wrong to expect everyone to be unhappy as to expect them to be happy – people have a right to feel whatever they want to feel. It’s just that psychiatry has put such a focus on erasing any “negative” feelings, the message seems to be that everyone should be at least mildly pleased with the current state of affairs no matter what kind of indignities or stresses they might experience.
That is exactly why this seems important to me. On the path to getting rid of enforced “treatment” to go away, the first step is a public acknowledgement that enforced “treatment” is potentially extremely damaging, and that denying a person’s right to free movement and free association and informed consent to medical “treatment” of any sort is something one has the right to resist as an offense against one’s basic rights as a citizen.
People’s opinions are amazingly weak and changeable in general. There are always hard core believers at either end of the spectrum, but many people’s opinions are formed and altered by what they hear in the media. (For instance, it was nearly impossible to find anyone who would admit to voting for GW Bush in 2008 after the Iraq mess and the economic collapse, even though obviously a lot of people voted for him not once, but twice.) So influencing public opinion is very, very important, and a legal fight to ensure the right to real legal protection against involuntary commitment would make very, very good press, IMHO.
It’s very similar to “supersensitivity psychosis.” If you block a pain receptor, the brain compensates by creating more receptors, and when you stop blocking, the extra receptors make one extra sensitive to pain. This is very well known in the world of substance abuse, yet somehow, the exact same or very similar drugs aren’t acknowledged to create the same effect, apparently because they are prescribed by doctors which magically prevents them from doing the same things as their street drug cousins. It is amazingly idiotic, and yet that’s what people continue to believe. And now the solution is to pull them off the drugs that the doctors have gotten them addicted to, without any plans on how to deal with the induced damage to their nervous systems? It is beyond comprehension.
And is justified with similar false claims and denial of actual data, and is pitched as either a “safety measure” to protect against urinary tract infection (even though circumcision scars get infected at something like 100 times the rate of UTIs in uncircumcised male babies), or as protection against the supposed shaming they’ll get in the middle school locker room, despite the fact that over a third of boys in the USA are no longer cut. It’s a travesty that very much mirrors the kind of idiotic “reasoning” and religious commitment to stupid procedures that one sees in the world of psychiatry.
There is something disturbing about viewing “loneliness” as a health problem, rather than a consequence of our loss of community and our hypercompetitive social and economic system. It feels like we’re removing any chance of confronting what is really going on for people and setting the expectation that no one should feel lonely and anyone who does is “defective” in some way.
It would provide some protection of the rights of citizens while we work to eliminate the process altogether. It would undoubtedly prevent some people at least from being incarcerated.
And in my experience, most people being “evaluated” do NOT know that they can remain silent, nor that what they say can be used to hold them against their will. You think it’s obvious, but most people assume a psychiatrist or mental health professional is there to help them.
I think that is an excellent strategy. Personally, I think that people ought to get their Miranda rights or the equivalent before they are allowed to question you about your mental status.
Posting as moderator: I read what I think is the post (the BMJ references) and was myself confused as to what is yours and what is quoted from someone else. That said, I didn’t find anything in there particularly offensive – it just seemed like an outline of the kind of “thinking” one sees in medical journals, contrasted with the very important comments on the article about side effects. What I got out of it was that, rather than recognizing that the so-called “ADs” are ineffective and even destructive in what appears to be the majority of “patients,” they blame the patients or their “TRD” and continue to insist that their “treatments” are effective.
If there is another interpretation, let me know.
If you do want me to delete part of the post, please let me know which part you mean and I can do this for you.
I think it proves unequivocally that the “diagnosis” itself is utterly subjective, and that a huge percentage of kids who are “diagnosed” are simply later in maturing and would be just fine if they were left alone and allowed to grow up.
I don’t think that’s a psychiatric diagnosis, is it? Maybe we can call Virgos “Obsessive-Compulsive” and leave it at that. I mean, what’s the point if you can’t prescribe a drug for it?
Very, very little. The most optimistic estimate I’ve read is that 15% of the variation in behavior/mood related to “mental disorders” is correlated to a set of over 100 genetic markers. And these markers didn’t correlate with a specific “disorder,” but with people who were diagnosed with “ADHD,” “Bipolar,” “Schizophrenia” and/or “Major depressive disorder,” I believe. So these genes, considered as a WHOLE, might represent something like sensitivity to others’ emotions, or a tendency toward getting angry more easily than the average, or a tendency to worry, or something completely unrelated.
As a contrast, any “mental illness” you consider has high correlations with abuse, neglect, and stress. 80% or more for “schizophrenia,” for instance, and the more trauma experienced (especially sexual abuse), the higher the rates of “psychotic” symptoms.
So the correlation with environmental factors is MUCH higher than even the most optimistic estimates of genetic “vulnerability.” Yet psychiatry as a profession insists on spending all its time and money on drugs and physiology and genetic research and brain scans. That’s where the disconnect is. There may be genetic contributions to mental/emotional distress, but whatever they are, they pale in comparison to the known contribution of environmental factors, and yet psychiatry pretends it’s the other way around.
I agree. There is no way anyone should be allowed around a “helping profession” with power over vulnerable people without making certain they have their own childhood issues under control. Unfortunately, that means most of those doing those jobs would be out.
Closed head injuries frequently result in a temporary euphoric state. This is well established. It is also a possibility that memory loss can sometimes be viewed as a “positive,” if they are negative memories. As for “psychosis,” I suppose destroying some of the dopamine system would result in less ability to creatively imagine anything, which would reduce “psychotic” symptoms. So it’s all easily explainable as brain damage, and you acknowledge there is no other known reason why it “works.” Per the concept of scientific parsimony (Occam’s Razor), the simplest explanation is the most likely. Since we know seizures damage the brain, and brain damage easily explains the “benefits” as well as the long-term damage, I’d say it would be up to psychiatry to prove that it’s NOT brain damage causing the “benefits.”
Psychiatry is also notorious for not defining its endpoints, so they can claim “benefits” based on “observer ratings” or “clinician assessment” while the client him/herself is incapacitated or feels their life is ruined.
The fact that you would eschew doing animal experimentation suggests that you yourself see it as having a high potential for pain and suffering for animals who might be subjected to the “procedure.” Why would that concern not apply to humans?
Electrocuting people to induce seizures can’t be a “treatment” and doesn’t deserve the dignity of being “studied.”
To me it’s very similar to saying, “Well, we have to study whether or not hitting people on the head with a 2×4 is effective in a certain subset of the population.” No, sorry, I don’t care how many people feel better after a blow to the head, it’s not an experiment we’re allowed to do. It’s just plain wrong.
As I’ve pointed out before, a near-death experience is often life-changing for a person who survives. Does that make killing a person and bringing them back to life a “treatment?”
I find the title misleading, though. It should really say the link is between school admission age and “ADHD” diagnosis. The month appears only to be relevant when it’s the month where they draw the arbitrary line between admitting to school one year vs. the next.
Honestly, astrology would be just as legitimate a way of diagnosing people, though. Maybe better, because at least being a Virgo doesn’t imply there is something wrong with you.
Pisces is more likely to get the “ADD without hyperactivity” kind of diagnosis, unless Taurus was rising at birth, or the moon sign is an earth sign. It’s all very specific, in a general sort of way, most of the time, anyway.
That’s how birth should be handled – assume things are normal unless there is some indication to the contrary, rather than assuming something will go wrong and constantly messing with the process and ultimately causing something to go wrong and saying, “See, I told you birth was dangerous!” So glad you had that “corrective” experience – not many people get to see birth the way it’s supposed to happen.
You do make an excellent point. Robin Williams, Marilyn Monroe, Stevie Nicks, Ernest Hemmingway, Judy Garland, Heath Ledger, … the list goes on of rich and famous people whose lives were damaged by “mental health treatment” in the form of prescribed psychiatric drugs. They can afford better “treatment”, but can they find it, or do they even know enough to look?
It doesn’t say that. It says that the twin studies PROVE nothing. That means the question is not answered by twin studies. It doesn’t mean genes exert no influence on people’s mental state.
People often confuse conscious decisions with intent. Intent is very frequently not conscious, so saying someone is “trying to do the right thing” when there are obvious and undeniable destructive results doesn’t really cut any ice with me. The real intent is reflected in one’s response to results. Does the person continue doing destructive things despite bad results? Do they stop or prevent things that seem to be working? Are they unwilling to accept any data that might undermine their own theory or beliefs regarding what is “best,” no matter how well-founded the data? Do the observations, preferences and beliefs of the person they are “helping” seem to have no impact on their calculations of “what is best?” If these things are true, they have ill intent, even if they claim and/or personally, genuinely believe they are acting in your “best interests.” Which is why “best interests” is an extremely fraught and dangerous legal standard to apply!
Yeah, like, totally, Aries are MUCH more likely to get “ADHD” diagnoses because they’re a fire sign, you know, because fire is like, TOTALLY moving all the time…
Another errant comment in the article is that the “numbing effect” is an adverse effect. It would appear from my reading of the research and my personal discussions with users that far from being an “adverse effect,” the numbing IS the therapeutic effect, such as it is. For some people, being numbed out feels like an improvement. For others, it feels horrible. But it’s not an accidental “side effect” – it IS the therapeutic effect that is offered. People should know that.
True enough! The main cause of “mental illness” is our sick society and its prioritization of profits and its ignoring of the real needs of the human beings that live in and sustain that society.
I am with you on this one. We’d never give birth at a hospital again, even though our first was “not too bad” by hospital standards, there was one little thing after another after another where they seemed bent on interfering with any and every aspect of the process. Two homebirths later, the difference was startling and difficult to describe to someone who hasn’t experienced it. Obstetrics is the one branch of medicine (besides psychiatry, though the brand “medicine” doesn’t really apply there) where perfectly healthy people are “treated” for entirely normal processes that are somehow regarded as being abnormal and dangerous. A hospital is a much more dangerous place to give birth than your home.
There is actually no evidence that they are of any use, especially anyone under 12. Even under the most generous interpretation of their own data, there is absolutely no indication for the use of “ADs” for children.
And the pharmaceutical companies make billions off of the label-and-drug model, while talking therapy leaves them broke. So it must all be about brain chemistry, because that’s what pulls in the big bucks. Plus, if you start actually CURING people, you’ll have to find new clients, and that’s SO much work…
The difficulty starts with the fact that “depression” is not caused by one thing, but tons of different events and effects. For that reason, calling “depression” the problem is both misleading and confusing, and as long as psychiatry starts from this false premise, it will continue to come up with one wrong answer after another.
Sadly, more people believe in childhood bipolar disorder than the Easter Bunny and Santa Clause combined. Perhaps it should say, “Deconstructing the myth of ‘childhood bipolar disorder.'” Or “delusion” might be particularly ironic.
How many people will actually read about this study? Any way we can make it more available? This is stuff that everybody should know but that many people don’t want to believe.
As I recall, there is a section it Anatomy of an Epidemic where he goes over some of this history. I looked around for an unbiased source on this, but it was all either totally for or totally against the article from what might be biased sources. However, the article, entitled “Scientology: a Cult of Greed,” seems to suggest a certain lack of objectivity, to say the least. I’ll see if I can get Bob to let us know what he knows.
Would you deny that one of the primary motivations for proposing and supporting the “chemical imbalance” theory and the DSM worldview is simple greed, the drive for money and power? There are documents from the mid to late 1970s where psychiatric leaders acknowledge that this is their aim. “It is difficult to make someone understand something when their salary depends on their not understanding it.”
I agree that in most cases, “anxiety disorders” are fairly predictable developments from mistreatment or neglect of children by their caretakers. In fairness, the caretakers themselves are often suffering from their own childhood mistreatment, but that is the cycle we need to look at if we actually want to help reduce unnecessary anxiety in our world. Problem is, no one makes money off of treating children well.
As well you know, being viewed as something doesn’t make that viewpoint correct. Pharmaceutical companies are viewed as saving lives, despite the well-established fact that receiving medical care is the third leading cause of death in the USA, the majority of deaths coming from properly prescribed and administered drugs.
What is viewed as mainstream is determined in a lot of cases by what is most effectively publicized by the people who make money off of the practice.
Not arguing with your example, but I do want to point out that a large percentage of women are partly or fully supportive of patriarchy. Remember Anita Bryant? Internalized oppression is very real and necessary for the elite to maintain their authority and control. I think there’s plenty of good evidence that psychiatry has been biased against women from way back, starting with Freud first believing and then recanting his belief that women were, in fact, being sexually abused in large numbers. (I’m sure it really started long before that, but “modern” psychiatry started off with the invalidation of women’s experiences by the wealthy white men who ran the show. I don’t think things have changed that much in terms of the attitude of the psychiatric professionals toward women, even if their rhetoric has gotten more subtle.
Bob goes into this in his book, how Scientology was specifically and intentionally targeted by psychiatry to make it into a go-to criticism of anyone who opposed their activities. The attacks, including a heinous hit piece by Time magazine in the early 90s, did not intend Scientology, but antipsychiatry, as their main target. Not even just antipsychiatry, but any critique of the psychiatric drug pipeline or anything that affected it. Hence, nobody cares if someone is a Moonie, as its not useful as a tool for psychiatry to undercut their enemies. This is not a critique or defense of Scientology, simply an observation that the choice of Scientology as a whipping boy was intentional and utterly disingenuous, and it continues to be used in that way to this day, which is why I think it’s so important to call it out any time someone tries using this kind of ad hominem attack to distract from the facts on the table.
The last point isn’t necessarily true at all. The things that get used aren’t always the ones that work – they are often just the ones that make the most money for the practitioners.
Exactly. Science is supposed to be both objective and skeptical. Psychiatry, under the influence of their partners in crime, Big Pharma, are, aggressively and intentionally, neither of the above.
I certainly did not intend to imply that at all. Taking an antipsychicatry viewpoint is 100% supportable by rational arguments, which is something a pro-psychiatry viewpoint can not claim at all, especially since the current model starts off with a huge logical error of not bothering to objectively define what it is they are “treating.”
Precisely. It is obviously a very different process than, say, suing someone for demolishing your car. The removal of someone’s rights is, or should be, a very, very big deal, very much on the same plane as being imprisoned (since that is effectively what it is). So why not require a fair warning as to the consequences of one’s actions? If prisoners and murderers deserve that kind of protection, why not innocent people who just happen to run afoul of societal expectations in some way?
A “hearing voices” group could also be helpful, but I would only make such a suggestion after a good, long chat about what the “patient” thinks is going on. There could be lots of other ways to go, but I’d never know until I actually connected with the person having these experiences.
As an example, a friend of mine’s husband (in his 80s) was losing his hearing and was increasingly in despair about his life. He took lots of drugs that didn’t work, then was “offered” “ECT.” I tried to discourage her from considering it, but they were desperate and she still trusted psychiatrists. So they did it and it had no discernible effect. Soon after, they spent 6 months in Palm Springs and other places in southern California. His depressed state lifted and he required no further ‘treatment.’
Every person is different, and the idea that “depression” is the problem is almost always incorrect. It’s an indicator of a problem the person feels unable to figure out, whether physical, mental, emotional or spiritual, and the key is finding out what the problem is, not making the “depression” go away.
I agree that rigorous science is the path to sane practices. Unfortunately, there seems to be such a commitment at this time to perpetuating the model regardless of or in direct contravention to science, that doing research alone doesn’t appear to be sufficient. Consider that Wunderlink and Harrow and others have shown consistently that long-term use of antipsychotics does not generally lead to recovery, but instead increases the likelihood that recovery will never occur. This is known, proven, consistent with observation. And yet it has barely made a bump in the road for psychiatry’s continuing drive down the ‘let’s drug ’em early to head off psychosis’ roadway.
Science is wonderful when practiced well, but it appears that politics and economics have to be addressed before this mess is ever going to change.
I am actually not going to take down any of these posts, even though some might find them offensive, because I want this discussion to be read and thought about and maybe learned from. It is important to note that MIA does not promote or oppose any particular viewpoint on the “MH system” and moderation is not invoked simply because people have differences of opinion regarding what should be done. Some commenters appearing “hostile” toward a VIEWPOINT is part of a discussion board experience. When comments get hostile toward individuals or groups of PEOPLE, that’s when the moderator steps in.
That being said, it seems kind of destructive to make general criticisms of “MIA” just because the comments don’t reflect what you want said. MIA is a community, and it has its own characteristics, just like any community. Depending on one’s viewpoint, these characteristics may be considered good, bad or indifferent, but the answer if one is not connecting with the community is not to criticize the community to others within the community. It’s either to listen to the viewpoints you’re finding challenging and seeing where those others are coming from, or to choose to spend one’s time elsewhere.
Some of the comments on this thread are edging toward personal, even though they are couched in general terms. I’d like to see that stop. You can see in the case of MedLawPsych that extremely contrasting opinions are being exchanged in a mostly quite civil manner, so there is no prohibition on expressing opinions not generally agreed upon by the community. However, the community being what it is, one can expect to encounter some strong disagreements if expressing approval of processes or concepts that most people here find objectionable. That’s just human nature.
There are few places where survivors of the psychiatric system are welcome to express their experiences. While it is by no means perfect, nor is my moderation flawless, it is the priority to allow the widest expression of viewpoints and to recognize that everyone has their own experience. This includes the experience of having seen such horrors perpetrated by psychiatry that one wants to eliminate it from the face of the earth. That some people take that position, and express it passionately, should not be a surprise, nor should it deter others from respectfully expressing their own personal viewpoints, even if they are more “revisionist” positions, or support some things that most people in the community might not support. Just be prepared to defend your position!
So let’s try to get back to respecting the fact that people have differences of opinions, and try to learn from them instead of getting into attack/counterattack mode. If a comment really does appear offensive, please report it to the moderator, and we will make our best judgment about whether to remove it or ask for it to be edited. But please don’t make comments that are calculated to escalate the conflict. It is that kind of comment that makes people feel unsafe in sharing their experiences, and that’s the opposite of what we really want here.
Rejecting the DSM certainly does not imply a lack of or a nihilistic theory of the mind. In fact, I find the DSM rather nihilistic – it seems to suggest that people’s “symptoms” have no cause or meaning and are simply random fluctuations of brain chemistry that are to be controlled by external means. There are many theories of the mind that are far richer and more consistent with actual human evolution and behavior.
I think the problem with this argument is that the basis of eugenics is an assumption that certain human lives are worth less than others. While the specific arguments for eugenics (eliminating “bad genes” from the gene pool) have been discredited scientifically, psychiatry, besides a few mavericks, continues to perpetuate the belief that there are certain people who have genetic defects, which make them less valuable as human beings. The ongoing denial of the impact of traumatic events and stress, which began in Freud’s day or before, continues to be central to the DSM model and the label-and-drug approach used by today’s “modern” psychiatrists. It’s all about “blaming the brain.”
We have progressed from leeches based on scientific analysis of what causes physiological diseases and the substitution of rational approaches developed from increased understanding of what is really going on. Psychiatry has not made any similar progress, and in fact, seems to have deteriorated in effectiveness and respect for research data as the years have moved onward. It is not valid to compare psychiatry’s failures with primitive medicine, as in psychiatry’s case, the data is there but is denied due to conflicts of interest.
There most definitely is a moderator here, namely me, and if there is a comment you feel is inappropriately hostile, please hit the “report” button at the bottom of the comment. I moderate about once a day, so there is not a flashing red light that goes off when you report it, but I will get to it within 24 hours or so.
I’m not sure one can call it “alleged” damage. As I’ve said, we know that seizures cause neurological damage. That’s why people get treatment for seizure disorders. There is nothing else going on with “ECT” than the induction of a seizure, and we know the effect of “ECT” is to cause a closed head injury. The fact that not everyone suffers permanent damage doesn’t take away from the fact that there is damage to the brain, and that this is, in fact, the entire effect of the “treatment.”
I think that is a legitimate argument. It is a very real dilemma, and I’ve been on both sides of it, but in the end, I had to get out of the “mental health” system because I felt I was implicitly approving of things that I could not truly support, and in fact found abhorrent.
I think this is an important clarification and deserves emphasis. Other means of dealing with mental/emotional distress aren’t “alternatives” to psychiatry, they are means of dealing with mental/emotional distress. As soon as we call them “alternatives,” we accept the idea that psychiatry is a means of dealing with mental/emotional distress, and that, in fact, it’s the main one and the others are options for those who don’t like the main options offered. Kind of creates an equivalence, rather than observing that a “hearing voices” group is an attempt to provide information and support leading to mental/emotional/spiritual growth, while psychiatry is dedicated to keeping people’s unwanted or inconvenient emotions in check and keeping people from acting in ways inconvenient for the status quo economic/social system. They really have nothing to do with one another, but calling it an “alternative” diminishes it to a second choice in an array which includes psychiatry as the mainstream option.
This is true. However, there is nothing preventing requiring a Miranda-type warning for specific civil cases. With the level of rights potentially being curtailed, it seems more than reasonable.
It sounds like there was a pretty large percentage who were abused but felt it was justified. Classic internalized oppression. That’s a big part of what I think we’re up against.
Sorry, unless you have some objective means to know what is happening and why, intentionally inducing brain damage in patients should be malpractice in every case.
BTW, there was a recent article on MIA showing that when depressed vets were given sham “treatments” of (I think) cranial magnetic stimulation, they got significantly better, even though they were classed as “treatment-resistant” (aka did badly on “antidepressants”) before the study. The real “treatment” they got was hope. Might be a much better starting point than electrocution and seizure induction.
You seem to believe that psychiatric “diagnoses” are legitimate “other conditions” that can be properly diagnosed in some people. I would strongly disagree with that assessment. There is no objective means to distinguish any psychiatric “disorder” from other “disorders” or normalcy, as the DSM itself admits in its very own introduction. How could you possibly know if someone suffered from “psychotic depression?” If it is merely based on the person being depressed and having delusions or hallucinations, how would you know what the cause of this condition was, let alone what the best approach to intervening is?
It is possible that passing electricity through one’s head may, for some people, create some kind of subjectively “positive” change in their life. It’s also a possibility that someone having a near-death experience after being hit by a truck could have positive changes in his/her life as a result. That doesn’t suggest pushing someone in front of a truck is a good “treatment” for “depression.”
ECT causes a grand mal seizure. Know anyone who has a seizure disorder? Do their doctors recommend allowing or inducing seizures, or do they want seizures to be avoided at all costs if at all possible? Clearly, seizures do damage to brain tissue, sometimes leading to death, and are avoided for that reason. Why on God’s earth would anyone want to induce one?
I would pretty much guarantee that “commonly accepted knowledge” about Mumia Abu Jamal and the MOVE incident(s) are quite significant distortions of reality. History is written by the victors, as they say. It was a very ugly time in Philadelphia history, and I am absolutely sure that no one wanted the full story to emerge.
A sad story. I only wish it were a rare story. It is baffling when an obvious failure of the system like this doesn’t prompt people to observe that the system has obviously failed.
I think that’s kind of the point. Psychiatric patients need to be informed that they are not simply being admitted to a hospital, they are potentially having their legal rights taken away, completely analogous to being arrested. They need to understand that they are not talking to a therapist with an interest in helping them out. They are talking to a legal agent who has a great deal of arbitrary power to take away control of their life for an indeterminate period of time.
I believe they should be informed that what they say can be used to hold them against their will, that they don’t HAVE to stay anything at all, and they should be afforded the right to speak with an attorney to go over their rights and assist them in deciding what they should or should not say. In this way, the patient/potential inmate can be maximally empowered to make their best decisions with a full understanding of the potential consequences of their decisions.
I really get both sides of this, and I don’t think either side is “wrong.” I see the viewpoint that radical change takes a long time, and meanwhile, other people are being damaged. I also get that people (actually MOST people) DO suffer from the negative effects of our bizarre social system, and such people need and deserve all the help they can get.
On the other hand, I’ve experienced first hand that being a “good player” in a bad system doesn’t really change the system. In fact, participation eventually felt like collusion, tacit acceptance of the system’s legitimacy. I believe we need to come up with new ways to help each other that don’t convey that kind of acceptance, that remains 100% opposed to the dismissive and abusive concepts behind the psychiatric worldview.
I don’t know the answer, but I think we need both – new ways to help people, and direct resistance to the system aimed not only at dethroning psychiatry, but at addressing the social power imbalances that make psychiatry appear necessary to the general population.
Most likely people did like it, but the advertisers did not. Challenging psychiatry is pretty much challenging capitalism, and capitalists don’t like that much.
I don’t know all the details, but I was in Philly during the MOVE events, and I assure you, the Rizzo police force/mayoral administration would be quite capable of framing someone for murder.
If one can’t think of something better to do than inducing a seizure by electrocuting one’s patient, it is time to step out of the way and let someone with a little more creativity and compassion take a turn.
It pretty much establishes the enforcement purpose of “hospitalization,” as well as helping folks know they can avoid trouble by not talking to the “enforcers.” Why did Tina think it a bad idea?
I really believe this is important for the short term. It may even be realistic to accomplish with a good court case. Probably have to go to the Supreme Court, but I think it’s a very winnable proposition, and I hope some hotshot attorney who is not too worried about money will take it on.
I have to disagree here. I think it is very important that research be done to disprove the lies that are being spread by psychiatry. I think it’s also important NOT to use their language to describe the research, except to the extent necessary to undermine psychiatry’s facade of “scientific” pretensions. There is always the danger of being coopted, and it’s also true that many researchers have not really “got” the reality that the DSM is a science fiction novel. But in the world of academia, research speaks loudly, and most of our society believes that people who claim to be scientists will give them accurate data. I don’t see any way to undermine people’s confidence in psychiatry without presenting solid, scientific data that show it’s a bunch of crap. That certainly isn’t enough in itself, but I don’t think we can win without it.
I know what you’re saying. My comment was not to suggest that New Amsterdam “got it right,” but my utter surprise at the very fact they brought up the possibility that the drug might be the problem and that communicating with compassion might be the solution. It is quite a contrast to the idea that brain scans can predict “sociopathic” behavior, or that the reason people are being violent is because they are “off their meds.”
Of course, the psychiatrist is totally unrealistic – they don’t much exist in the real world. But the show DID show a psychiatrist doing evil due to laziness and making excuses based on “lack of resources” – very real representations of what happens in most situations involving psychiatry or other “mental health” systems (not to mention the school system itself).
I have noticed that, too. “Chicago Med” also shows people magically coming around within seconds or minutes of an injection, and also asserts that they can determine if someone is a “sociopath” by looking at a brain scan, which is, of course, utter blather.
On the other hand, “New Amsterdam” ran a show where a kid’s difficulties were proven to be severely exacerbated by a school psychiatrist putting him on antipsychotics and completely ignoring the context of his distress. The hospital psychiatrist took on the school psych and assumed some personal risk to his job in order to prove that bullying and the loss of his dad were the real issues for this kid and start him on the path of feeling heard and cared about. I wrote the network to let them know how much I appreciated their raising this issue in such a clear manner. It gave me a little hope!
I agree wholeheartedly. This is in my view the most serious damage psychiatry has done to our society. It has removed context from our suffering and made it a trivial matter, as well as making it an entirely individual problem, as if any upset or disagreement with our social system is proof of personal malfunction, and the system itself is flawless.
A good analogy! “Your bones broke because you have ‘brittle bone syndrome,’ a genetic disorder. Most people are able to take that kind of hit without their bones breaking, so really, it’s your body that is deficient. It has nothing to do with the crowbar.”
I don’t disagree with you. For one thing, there is no way anyone can determine which “professionals” can help you re-learn these functions and which will drive you further into the “pit of despair.” (Sorry, I’m just running the Princess Bride lines today!) So what’s the point of having a “profession” where being a “professional” provides no guidance as to what the professional is able to provide?
It’s kind of the ultimate application of the profit motive. But it also shows that the profit motive is ultimately degrading, reducing even our own bodies to mere commodities to be bought and sold. No one should be reduced to the point that they are forced to do this. Those who genuinely choose to do this is a different issue, but let’s be honest, the vast majority of prostitutes are not in it because they think it’s a fun way to make a few extra bucks.
I am afraid there are no “quick fixes.” A quote from “The Princess Bride” movie applies here: “Life IS pain, highness. Anyone who tells you otherwise is selling something.” Psychiatry promises a magical no-effort solution to “mental illness” where no one needs to change anything and no one needs to take responsibility for everything and we can continue to pretend that life’s a lark and anyone who doesn’t feel that way needs to be “fixed.” Have you ever read “Brave New World” by Aldous Huxley? That’s the direction the psychiatric industry is taking us. “A Gramme is better than a Damn!”
I agree. There is nothing minor about a therapist (or a doctor or an attorney) taking advantage of their position to have a sexual relationship with a client. It is often extremely destructive.
I think it took courage to write this, and that it raises a vitally important issue for professionals, one which ultimately drove me away from the field: even if an individual can do good work with individuals, does participation in the system convey tacit approval of the “status quo” ideas of chemical imbalances, subjective pseudo-medical “diagnoses,” and paternalistic force applied to “noncompliant patients?”
Well, we wouldn’t want any PASSION to slip out… that would be a sign of bipolar disorder, or maybe ADHD, or something pretty scary… no passion allowed in THIS society…
I would add to that the fact that womens’ burden of abuse, poverty and discrimination is much higher on the average than men, yet psychiatry continues to refuse to take such stresses seriously as causal factors, and this attitude has spread to GPs as well. The Kaiser study showed that physiological problems like IBS and fibromyalgia, lupus, and others occur more frequently in trauma victims than the general public. But we can’t seem to get together as a society and admit that oppressive circumstances are preventable and are causal factors in many of the problems we see in adults.
Back in the 70s, feminist writers were all over this idea that women’s reactions to an oppressive society were minimized and trivialized and hidden by the psychiatric professions’ approach to diagnosis, and that real physiological issues were often also hidden through accusations of “hysteria” going back 100 years or more. But I don’t see much writing from feminists on these points lately. Am I missing something?
I am glad you said this. Many cases of “depression” involve chronic pain or other chronic conditions that impact quality of life, and of course, the psychiatric profession tends to ignore these completely, as they don’t fit with the “brain disorder” worldview the profession is trying to promote. Dealing with daily pain is draining and has dramatic effects on one’s view of life and the world.
As I’ve said many times, the first error of psychiatry is to believe that the same “symptoms” are always caused by the same thing and always require the same “treatment.” This goes for chronic pain as well, in my view. What works for one person won’t work for another, and the person who is best situated to determine what the best approach is would be the patient. Rigidity in either direction leads to stupid and often dangerous results.
CCHR is a controversial subject, but their genesis or purposes are not particularly relevant to this discussion. I will ask that folks leave off on this aspect of the discussion, understanding that some people will find CCHR’s information and purpose worthwhile while others will find it disingenuous. Let’s leave it at that.
Commenting as moderator: It is a tough one when we’re talking about public figures. It’s generally accepted that being a public figure, especially a politician, leaves one open to attacks regarding one’s policies and actions. However, the comment threads ought to be focused on the goal of revising/eliminating psychiatry, and political discussions can pose a serious distraction.
I appreciate you bringing this up and will give some serious thought to when a “Trump” or other political figure comment is actually contributing to the conversation or detracting from it.
Totally understandable. It’s hard to keep calm when you know the damage that is being done. But I also agree that taking a strategic approach is crucial, and sometimes that means focusing the anger/rage toward a particular approach that is most likely to work.
I have frequently accepted a lot of other peoples’ “shit” into my life – it’s almost like opening my heart to it draws it to me like some kind of magnet. I have to be sure I’m fully ready to go where I need to go before I agree to enter into such an engagement, but I seem to have many such encounters per week, and actually on some level seem to seek them out. Some of these have been professional encounters, some have not, but I think I have a pretty good idea what is needed to be helpful in most cases. And when I don’t, I’m perfectly comfortable letting people know that. Which in itself seems to be helpful much of the time.
But I agree, I can’t always be prepared to “be there” for others, and I have moments of self-centeredness, sadly most often with the people I care about the most (and am most comfortable with, easiest to take for granted, but also most capable of draining my reserves). We all have our limitations, which is why we need more people to be available to provide love and caring to our fellow humans.
I agree, rage and righteous indignation are the drivers of major social change. But I believe that strategic focusing of rage is the most effective strategy.
Maybe we can start a new therapy model – we’ll call it the “Give a Shit” (GAS) model of therapy. We can study the results when therapists appear to give a shit about their clients compared to control groups whose therapists are uninvolved or actively controlling and/or hostile. We can publish papers on GAS and sell workbooks and do national seminars showing people how actually caring about the person you’re talking to seems to help them feel as if you care about them, whereas not caring about them seems to have the opposite effect.
It IS important. That’s the sad point. There is clearly some powerful denial going on if this kind of research conclusion is ground-breaking or controversial!
We also moved to the West Coast to escape East Coast rigidity and artificiality. Haven’t escaped it completely, but we have found the West Coast much more amenable to us feeling like a part of it.
Kids know this instinctively. If you can get them to stop parroting the lines they’ve been given, most kids on psych drugs will tell you they take them “because I act bad” or “because I get in trouble.” That’s my experience, anyway, and I have talked to lots of kids about this issue.
They forgot the third factor: school! Being grouped together with kids the same age and “assessed” and “evaluated” and compared to “norms” is the beginning of the shaming process that eventually leads to the kind of bullying she experienced. Of course, labeling her “ADHD” and giving drugs only adds insult to injury, not to mention the emotionally destructive adverse effects that some kid experience. It is hard to imagine a less effective approach, yet we continue to do the same thing, expecting different results.
Another no-brainer study. Time to quit focusing so much on ‘techniques,’ which anyone can learn, and focus instead on the qualities that actually distinguish a capable helper, regardless of label. Empathy is, of course, the number one quality that is required, and no matter how many years of college and grad school one attends, it is not something that can be “trained” into anyone. It’s a very personal thing.
Sounds like you found your own form of “mindfulness.” As someone said above, there is no guarantee that being present in the moment means you’ll be happy or relaxed. You appear to have contacted the present moment and remained in it despite the pain, and it had positive results.
No one should tell anyone else “how to meditate.” It’s an offense against the concept.
We don’t know. Every generation of frogs will be slightly different than the last. If there isn’t any great change in the environment they have to live in, they’ll probably just become better frogs. But if there is a sudden big shift, a lot of the froggies may die off, leaving an odd lot who may have some characteristics that “normal” frogs lack.
The antibiotic example is the easiest to get. We kill off 98% of the bacteria in a person’s body with an antibiotic. Of the 2% that remain, a lot of them may have a particular genetic mutation that allows them to sometimes live through an antibiotic attack. Normally, they’d only be 2% of the population, but now they’ve suddenly become most of the population. These are the only bacteria to reproduce themselves, so that the next generation is made ONLY of survivors. If these survivors are attacked by the same antibiotics, a much larger percentage survive this time, say 20%. These are even MORE strongly selected for the resistance gene, and they’re the only ones again to reproduce. After a few rounds of this, we find that 80% of the bacteria are no longer killed by the antibiotics! New species. Can’t kill them with these antibiotics any longer, and we need to develop a new approach. Keep this up with a course of 3 or 4 different antibiotics over time, and you have “superbugs.”
It’s way quicker with bacteria because they reproduce multiple times a day. But there are classic observations with moths in England turning from black-brown to grey because of ash being deposited on trees due to coal burning in the early 20th Century. The color change took a few years to happen, but it was observable pretty easily. The light ones used to get eaten, but when the trees got ashy, suddenly the black ones got eaten and the light ones survived. That’s natural selection. Continued through hundreds or thousands or tens of thousands of years, if two parts of a species are living in different environments, it can lead to new species entirely.
That’s the theory, anyway. Makes sense to me, and it fits with all the data we know about species. There may be some things not explained by evolution, but it explains a hell of a lot.
What that article doesn’t really address is the additional problem of WHO IS RUNNING THE BRAIN? A computer can’t operate without an operator telling it what to do. So even if we accept that the brain is running itself, the computer analogy completely fails us.
You’re not the first person I’ve heard this from. Being forced to do “mindfulness” is ironic in the extreme. It’s not mindfulness if you’re feeling like someone else is making you do it. Any Buddhist monk would cringe at the thought. And two hours is also a VERY long time, especially for beginners! I’ve been advised that you have a person work UP to 20 minutes at a time. Only a person who has practiced for a good long while can do two hours without needing to alter their activity. Way to ruin a good practice, folks!
That’s my theory on how “ECT” “works.” After receiving several “treatments,” the victims say to the psychiatrist, “You know, I feel SO much better now. THANK YOU, thank you SO much for all that wonderful ‘treatment!’ I’m sure I’ll never feel depressed again! Now, can you please unlock that door so I can get out of this place?”
Frogs are still evolving. It just takes a really, really, REALLY long time! But it’s a lot quicker for bacteria, hence “antibiotic-resistant” strains are developing all around us.
I would suggest that lack of love by those who have power over us is what he’s really talking about. When we are kids, we have little power to do or change anything in our world, and we’re totally dependent on those who care for us. How those people care for us teaches us a lot about what to expect of the world and how to treat ourselves.
In adult life, a lot more goes into success than giving and receiving love, as others have remarked. And adults don’t HAVE to rely on their parents for care any more. But there are still plenty of areas where “big people” have power and control and don’t use it in a very loving fashion. It is also difficult to escape those lessons we learned as kids when dealing with people we consider more powerful than us.
I think you said it well. Being who we are without concern for others’ opinions about it (except when consciously deciding to work with others’ opinions to get something done) is at the core of getting clear of most of what gets labeled “mental illness.” I have similarly used meditation as I have come to understand it to work for me. I would not expect the same approach to work for anyone else. The only measure of success is that feeling of authenticity and calmness that comes with rejecting the “lessons” someone else has forced down our throats, including “lessons” about how we should meditate.
But what if psychiatry is based on things that are not really true? You’ve seen the damage that can be done – isn’t the loving thing to do to stop the damage and expose the lies so that people (including those doing the hurting) can start to heal?
But why call it a “disorder?” Why not call it “stuckness” or “lack of self love” or “unwillingness to risk connection” or call it what it IS rather than pathologizing it? I’d say “stuckness” is pretty much a universal attribute of anyone growing up in Western social/economic networks. It’s not a “disorder,” I regard it as a way of coping with a difficult reality. If we can find yet better ways to effect change in that reality rather than merely coping, more power to us, but it doesn’t mean that our means of coping were “disordered.”
Nah, that’s not right. Species develop into whatever fits into the niche provided for food, shelter, etc. Obviously fish can’t develop into humans because they have to live underwater to breathe. Humans are just one branch of many thousands of developing branches.
Darwin certainly hasn’t explained everything, any more than the “big bang theory” explains how the universe began. (What was it that banged? WHERE did it bang? WHY did it bang? What happened right before it banged?) I just wanted to make sure we’re clear that he would never say that all species ultimately have to evolve into humans. If they did, we’d have nothing for food but cannibalism!
I think this is very well said, and resonates with my own experience. I’d only add that there is a general hostility toward “attention seeking” by children that goes back many generations, and that this is particularly evident in the structure of the average school classroom. Even kids with loving and rational parents are exposed to massive anti-attention-seeking propaganda and punishment from their school in the majority of cases. To intentionally seek attention in an assertive way is very much discouraged in society. It is much preferred if we keep quiet and go along with the program, in my experience.
I think healthy relationships with other human beings are the key to recovering from abuse, neglect, etc., in combination with having sufficient means to survive in the current seemingly heartless world. These relationships COULD be with someone called a “counselor” or “therapist,” but there is no guarantee (or even necessarily odds in favor) that a particular person in that role will be of any assistance, or that a person who does NOT have that label might not be just the person needed to promote healing. The idea that “counseling” can be quantified and delivered by someone who has X training is nonsense of the highest degree. The only judge of what is helpful is the person ostensibly being helped. I don’t judge anyone as disqualified because they happen to carry the moniker “counselor,” but I’d estimate that each such person must be judged on his/her own merits.
Thanks for sharing this sad but moving story. It is a perfect example of how wrong-headed the current form of “help” really is. Well done to you and to her for figuring out what the issues were really about. What they call “symptoms” are not meaningless, but full of meaning, and the invalidation of this meaning is perhaps the most heinous thing they do to their “charges.” I hope that you will find peace and a pathway forward.
You might consider a “moving meditation” like Tai Chi or Qi Gong. Some people have a hard time sitting in one place, especially after drug damage from your friendly psychiatric pushers.
That is the correct spelling. I’m not sure that MIA does the redlining – I think it may be your spellchecker on your own computer, in which case, adding “akathisia” to your computer’s spellchecking dictionary (usually an option if you right-click the word) will make it go away.
I mean “left-right” politics as described and played out in today’s media and public conversations in the USA. It’s a long time since the USA has an actual “left” in the old 1930s “let’s organized and take on the capitalists” sense. When Bernie Sanders is considered a radical leftist and Hillary Clinton is called a “socialist,” the term “leftist” has long since lost any rational meaning in the USA. So perhaps “Democrat/Republican” is a better description, but in truth, that’s what the vast majority of US citizens think of when someone says “left” and “right” these days, at least over here.
Some people improve over time, but apparently some do not. I’d advise talking to other people who were victimized in this way, and see how they have learned to deal with it. Professionals are not going to be a lot of help here, unless it’s a dissident professional who is willing to admit to how TD is caused and to really work to find solutions. Alternative medicine might also be an option, though I’ve never explored that avenue specifically regarding TD.
But of course! But calling it “treatment-resistant depression” or whatever even takes that level of agency away from the patient. They couldn’t HELP resisting! They were powerless to their “depression” which is what resisted! Imagine, a concept resisting a drug! It is beyond ludicrous, but they get away with it. Why not just say, “My treatment failed” or “I don’t know how to help you?” At least that keeps alive the idea that someone else might have a better idea.
Don’t forget that big businesses buy influence by their campaign contributions, and actually like and want the kind of regulations that allow them to succeed and small, local businesses to fail. And TV advertising is also a huge factor in selling brands rather than useful products, which goes well beyond the purview of government control. Government can’t do it alone – they collaborate with big businesses, including Pharma, to create the environment we see before us.
Though nobody in the medical world is claiming that alcohol is a “treatment” for anxiety or depression. Force must be eliminated, but so must the veneer of respectability that pseudo-medical diagnoses give these mind-altering drugs.
“She added: “We have underestimated the power of social interactions. We see people who’ve been in the system for years, on every med there is. How is it possible that such people have recovered, through the process of talking with others? How has that occurred? That is the question we need to answer.””
Psychiatry hasn’t “underestimated the power of social interactions,” it has almost entirely dismissed it. The reason people have recovered from interaction and not from drugs is because drugging the brain is not a solution, whereas often, communicating with someone who understands you is, or is at least the beginning of a solution. This very statement should make that point obvious, and yet the psychiatrist in question appears to find the result incomprehensible. Could the simple answer be that your model is wrong?
And of course, it’s utterly ridiculous to claim to be a “trauma-informed” agency and still use the DSM as anything other than a billing code document or an emergency toilet paper roll. Any real “trauma informed” agency would have to START by abandoning the “medical model” altogether and start over from scratch, preferably with a lot of honest interviews and focus groups with their clients.
There is some good research showing that the CONTENT of voices heard by people is dramatically affected by the attitude of the culture they are in. If the person lives in a culture that accepts or even values voice-hearing, the voices are more positive and encouraging. If the person lives in a culture that fears voice-hearing, the voices tend to be more destructive and hostile. How that is explainable by a disease model is beyond me! Though psychiatry has long since given up on actually evaluating data – it’s more of a religious practice at this point, so contrary data can safely be ignored.
But even within their own system, when the person gets worse, shouldn’t this indicate that they are barking up the wrong tree? I’ve pointed this out a number of times as an advocate, and always seem to get bafflement from the audience. It’s like observing that “treatment doesn’t seem to be helping” is some weird taboo! It’s not just that there is no objective way to determine success, they don’t seem to want to even THINK about whether or not their approach is successful! I find it utterly baffling!
You are right, doctors are often threatened by intelligence and independent thinking.
I always give any doctor I have to see a preamble that I’m an intelligent person who will appreciate their ADVICE, but will consider it and do my own research and come to my own conclusions, which may be to refuse their advice completely, and if they have any problem with this, to let me know right now so I can seek another provider right away. It generally shuts them up pretty quickly.
Oppression is not a left-right issue. The sooner we peons realize this, the sooner we can stop buying into the idea that voting in a new set of oppressors will solve the problem. Not that I’m against voting, mind you, as some oppressors are objectively worse than others, and there are still a few bright lights out there in the darkness of politics, but it should be clear now that direct and unified action is the answer, and left-right politics is a divide-and-conquer tactic that serves all the elite from whatever side of the aisle.
Quite so. I also wonder how folks can read that the amount of “treatment” is dramatically increasing worldwide, and yet the “burden of mental illness” is also increasing lockstep with increasing “treatment.” If the “treatment” worked, shouldn’t the “burden of mental illness” be dropping? What happened to our new technological understanding and wonder drugs? At what point does the obvious question rise to the surface: “What are we doing wrong?”
Not at all. Just making sure that we’re all on the same page. I’ve accidentally offended folks with my facetious sense of humor on many occasions. It’s always a hazard of using indirect humor.
I know, who would have thought that poverty could actually cause people to feel depressed or anxious? I mean, wow, what incredible insight is required to make such a leap of reasoning!
I think we are taught to fear our own poverty, which is always lurking right around the corner even for people with reasonable jobs/incomes. As a result, I think we fear the poor, which turns to anger and hatred, because we KNOW there has to be SOMETHING that separates them from us, otherwise, we could end up being poor, too, which would be awful! And when they survey actual poor people, most of them don’t think they are poor, and instead find someone yet poorer to heap their pity and hostility on.
Oh, we all wish it were relegated to the realm of mythology over here. Unfortunately, though the “thought leaders” have had to disclaim this notion, it is still very much alive in the trenches and is regularly used by doctors to manipulate their patients into taking the drugs. I think probably the majority of doctors actually believe it themselves and are pretty impervious to even their own leadership telling them otherwise.
Sounds like things in Russia are pretty grim, though. I wish you good fortune in turning that around!
Well said. I’d only add that suggesting that everyone who is experiencing these phenomena is experiencing a “spiritual awakening” makes a similar mistake to the DSM – assuming that all people having a similar experience are having it for the same reason. Some may be experiencing a “spiritual awakening.” Others may not have slept for a week or taken drugs that have messed with their sense or reality or be having flashbacks or, or, or… The basic fallacy of the DSM/mental health viewpoint is the idea that we can categorize people by their mental or emotional experiences, and I think we would all benefit from being vigilant that we don’t fall into the same trap.
Brilliantly written. We all think we’ve already got it right. We don’t learn anything until we can step out of that place and note that the places we are MOST assured of our “rightness” are the ones where we are least likely to see where we might be missing something. Humility is the core of good science, and good living, at least I think so.
So why not use the terms “visions,” “thoughts,” and “voices?” I have found that being as specific as possible about describing the actual experiences of the person in layperson language is the best antidote to the psychiatric song and dance routine.
Posting as moderator: I am assuming the poster is being facetious here. Calling someone “a psychiatrist” would certainly be considered an insult of the highest order in this particular community!
Giddiness, spontaneity, impulsive behavior… sounds like a manic episode to me, Eric. We only accept people who are mildly interested in society as it is, and if they get upset about anything, they keep it to themselves. Creativity and spontaneity are particularly dangerous, as people like that start THINKING for themselves, and who knows WHAT will happen if that is allowable?
That is horrible! Especially when we can be pretty certain the psychiatrist at least observed these reactions and knew what they were. Though some psychiatrists are astoundingly ignorant about their own drugs. I am appalled, even with what I know about psychiatrists and their practices and have seen similar situations ignored. It is a criminal act.
You are right, I meant that the psychiatric profession considers it LESS dangerous to pass electricity through your head than using fasting or nutritional approaches. Thanks for the catch. The same kind of thing applies to childbirth – it’s more dangerous for the physician to have the laboring woman take a bath than it is to cut the baby out of her womb, because Caesarians are so very common these days that one will essentially never get sued for doing one, while baths are outside of “standard practice” and so to be assiduously avoided. Very strange set of perverse incentives.
They pretty much all cause at least temporary damage to the brain. That’s how tolerance occurs and why there are “discontinuation effects” (AKA withdrawal) for essentially all of these drugs. With antipsychotics, we KNOW there is long-term neurological damage. It is suspected that SSRIs and especially Benzos cause cognitive impairment that lasts well beyond the use of the drugs, and may be permanent.
Ekaterina, what about the word “hallucinations?” “Visions” would be better, but to meet your need for a word that those in the medicalized system recognize, a “hallucination” is an event, not an “illness” or “disorder.” I think the issue with “psychosis” is that it invalidates the very premise you are setting – namely, that the event is not an indication of “illness” but is a step in a process that could be embraced rather than denied and pushed away. Am I reading that correctly?
I got that when one of my foster youth clients had a horrible hand tremor that she spent all day, every day dealing with. “What’s a little hand tremor compared to all the behavioral benefits she’s getting?” Without questioning the so-called “benefits,” my inclination was to say, “That’s easy for you to say – it’s not your hand!”
Maybe we should require all “ECT” patients to listen for an hour to a panel of survivors who have been damaged by the process before they can agree to it. Though it seems so odd – if a person has a seizure, doctors will take immediate and extreme measures to bring it to an end, because they know it’s damaging to the brain. Why would inducing a seizure be any less damaging?
I do believe that the main purpose and effect of psychiatric drugs is to suppress emotional reactions to things. Consider that the drugs are categorized that way – anti-anxiety drugs, anti-depressant drugs, anti-psychotic drugs… they are categorized based on their purpose, to STOP emotional reactions, rather than deal with or process them. Very similar to why many people get drunk or use other drugs to numb their emotions. When you stop using, whether legal or illegal drugs, all the stuff you were working to suppress is still there, in addition to withdrawal reactions and potentially damaged processing ability. Life presents extremely painful situations for us all to deal with, and the urge to escape from that pain is understandable, but calling it “treatment” would be laughable if it didn’t do so much damage.
Is it possible you can connect with other people who have had similar experiences to process? Maybe some who experience the world similarly to how you do?
Internalized oppression IS the definition of “insight” to those dedicated to the psychiatric worldview! “Insight” means realizing that they are right about everything they say and that your best course is to just do as you’re told and not think about it too hard.
We’re in a bizarre place when passing electricity through someone’s head and intentionally inducing a seizure is considered more dangerous than having someone try a fasting program or vitamin B3. They probably meant it was more dangerous for THEM, as they can’t be sued for inducing convulsions, since it’s “standard practice,” whereas if something went wrong with someone who is fasting on their advice, they could get in legal trouble. Or maybe they are simply so blinded to the dangers of electrocution that it genuinely seems safer?
Posting as moderator: I found the comment – it had somehow been labeled “spam,” most likely based on the link you included. I have restored it to the thread.
It irks me particularly when they give someone Zyprexa or some other fattening drug, and when the person predictably gains a bunch of weight, they say they need to go on a diet!
OK, I get what you’re saying. I could see Bob being against using that term, but I can’t really see him in any way opposing the complete deconstruction of the psychiatric profession or the way of thinking they currently represent, as I know he finds both odious and laden with contradictions, corruption and greed.
Just going for a walk or a hike or a bike ride is the best therapy I know of. 5 minutes and I already feel better. And you’re right, there is not a “right way” to do it. I never listen to fitness gurus, I just do what feels right to me, and it works.
Well, then, I guess what I received wouldn’t have been “psychotherapy” by your definition. But she did call herself a therapist and the experience was pretty amazingly consciousness-raising for me.
He asked survivors for their hands up. I don’t consider myself in that category. The only “treatment” I received was some psychotherapy in my 20s, and there was no force, no drugs, and the therapist did nothing to “diagnose” or explain what was “wrong” with me. She was, in fact, very empowering to me. I later discovered how fortunate I’d been to find her, though this was in the early 80s before the DSM III and the “chemical imbalance” meme had taken hold. So I don’t feel I can claim being a “survivor,” except to the extent that I may very well have “dodged a bullet” by avoiding the “system” for the most part.
Can you give me an example of him disparaging an antipsychiatry viewpoint? I agree that his research leads almost inevitably in the antipsychiatry direction if followed through to its natural conclusions. How can one support an industry whose entire basis is an intentional falsehood regarding the nature of mental/emotional distress? If you remove that falsehood, what is left beyond greed and a drive for power and control?
And if there were, the “subgroup” would be the actual diagnostic category, and they’d admit there was nothing wrong with the rest of the group. Also, the “subgroup” would have to have something more in common than “reacting positively” to a drug. Lots of people “respond positively” to alcohol when anxious, but we don’t categorize them as “mentally ill.” They just like how it feels when they drink alcohol.
I still think you are missing the point. It’s not whether antipsychiatry is good or bad or holding opinions “because of one’s socialism” is acceptable or unacceptable. They are changing the topic! Why allow the other person to take control of the communication by making it about antipsychiatry or socialism or Scientology or Catholicism or whatever else? Why not point out that they are trying to distract from the point you just made by bringing up a philosophical discussion of some external explanation of “why” rather than the very obvious factual reasons you have just brought to light? Are the long-term outcomes for ADHD any better or worse based on my philosophical or religious orientation? Are we talking about science or philosophy? I prefer to keep the topic on scientific facts, because when we do that, the forces of psychiatry lose every time. Which is why they want to talk about something else, ANYTHING else besides the actual facts! And I don’t allow them to do that, and point out their deceptive intent into the bargain.
They have also tried to change the topic into admiring me for all of my great advocacy work and how wonderful it is that I’m willing to stand up for foster kids, etc, etc. I do the same thing: “Thanks for your kind words. Now let’s get back to talking about why this kid is having hand tremors. They are listed as side effects for two of the drugs she’s taking – what are you planning to do about this?”
I hope that makes my point clear. It has nothing to do with antipsychiatry or socialism. It has to do with calling out the evasive tactics used to distract from talking about the real subject.
Or perhaps they ought to attribute their “mental illness” to being refugees torn from their countries by violence and warfare and poverty and systemic corruption. Or is that not one of the options?
I believe any “therapy” worth calling that name has to include a strong element of consciousness raising. If one isn’t able to become more aware of the oppression one is or has been under, it’s unlikely any radical change will happen in how one approaches that oppression.
I would also add that whatever you or I or anyone else thinks of the term “antipsychiatry,” it is USED by psychiatric proponents as a means of discrediting someone. I don’t think they care what YOU think about the term, they use it in a way to try and convince other people that you’re irrational. That’s the problem I’m talking about here.
One of MIA’s missions is to provide a voice to survivors. My understanding is that it has never taken an “antipsychiatry” stance, but is more intended as a discussion forum for folks of any philosophical viewpoint, as long as it is focused on the facts at hand and not on promoting psychiatric propaganda. Actually, propagandists have always posted here, too, but they don’t really have a lot of fun in general. So it might be a good place for antipsychiatry folks to get together and communicate, but MIA and Bob Whitaker have never taken and antipsychiatry stance, and that is reflected in the diversity of topics presented and commenters.
This is just me talking, not representing MIA formally, it’s just always been my understanding of the situation.
Perhaps a poor choice of examples. I apologize for any offense. I had no intent to compare Scientology to antipsychiatry or either to antiscience – these are simply the “accusations” commonly used by pro-psych forces to try and get off the topic of whether there is any truth to psychiatry’s claims.
My point is that any attempt to distract from the discussion should be confronted and labeled as such. I would submit that even if one got into a long discussion of why one is an antipsychiatrist and made a great argument, that person would still be off on a tangent and their antagonist would win a round. My point to that person would be that PSYCHIATRY IS BASED ON LIES AND THE DATA PROVES THAT, and you choosing to try and discredit me by labeling me in any way is simply a tactical distraction from the point at hand, whether it’s true or false, or positive or negative in my own view.
Perhaps the better analogy is if I said I see large corporate contributions are dangerous to our society, and the person said, “You only believe that because you’re a socialist.” I don’t need to “defend myself” against an “accusation” of being a socialist, nor do I have to explain that I am a socialist and explain what it means or why it’s not a bad thing. My reply would be more along the line of, “No, I believe that because it happens to be true” and present my evidence. A more snide response might be, “No, I’m a socialist because what I said is true and it needs to be changed.” Or I might ask them, “So are you saying that buying votes by making “contributions” to politicians in exchange for access and favors is a good thing?” But I’d bring it back to the point, whether the accusation was good, bad or indifferent in my view. It’s a distraction tactic and I think it plays into their hands to fall into that discussion at all.
Does that make it any clearer? Or at least less offensive?
I think that is very well said. We don’t need an “alternative to psychiatry,” we need some alternative to being involved in the “mental health system” altogether, where folks can get the help and support they need without having their lives controlled or invalidated by so-called “professionals” who have the power to destroy their lives with impunity.
I would submit that that the judgment involved in determining whether or not something is “not caused by an external source” and/or is “not recognized to be real” means they are ultimately not objective criteria. For purposes of philosophical or lay discussions, I think these are workable definitions, but for any kind of scientific work, they are hopelessly vague and unfalsifiable.
I agree. The very act of diagnosing is a power trip, especially when the “diagnosis” has no basis in the physical universe whatsoever. To take a social construct and apply it to another as a means of diminishing their power is an unquestionable act of aggression.
This is very true, but at least we can remove the idea that some “sciency” doctor with lab equipment can tell me what’s wrong with me and what I have to do to “fix it”.
The “mental health” system is based at this point on the spurious claims of the DSM 5 to be able to identify “disorders” of the “mind” which can be “treated” by some medical modality, in which I include any form of reimbursable “therapy” of any sort. Until the DSM is completely deconstructed and the truth about the non-medical nature of most “mental illnesses” defined therein widely publicized, and the entire edifice removed from any semblance of “medical treatment,” we’re still screwed. So being anti-mental-health-system definitely involves a large degree of being antipsychiatry, as psychiatry is the progenitor and main profiteer from the DSM and its multifarious cultural offspring.
I’ve said this before many times – being called a “scientologist” or an “antipsychiatrist” or an “antiscientist” is a tactic of distraction, and should be labeled as such. Such tactics are used by people who don’t have actual data to counter your arguments. I believe the proper reply is to ask why they are distracting from the question at hand. If you defend yourself in any way, you have allowed the topic to be changed to whether or not the label fits you, rather than whether or not psychiatry is a legitimate medical field, which is what we need to be talking about. That’s my humble opinion, and others can disagree if they wish, but decades as an advocate have taught me that the “ad hominem” attack generally means you have your opponent on the ropes, and you should continue your attack rather than let yourself be pulled off topic.
It is remarkable how gender, which is BY FAR the highest correlation with violence with guns or otherwise, is completely ignored by the MSM and mainstream psychiatry/psychology, while the tiny correlation with “mental illness” as diagnosed by the subjective DSM is made into the biggest issue. It is a clear case of scapegoating the less powerful instead of looking at the facts, protecting the powerful at the expense of those who can’t defend themselves.
Well said. Sharing differing beliefs is not the same as shaming someone for their particular belief. This same kind of thinking is behind the concept of “pill shaming,” where pointing out legitimate critiques of the facts surrounding psychiatric drug use is conflated with telling people who use them that they are wrong. If we can’t talk about differing beliefs and observations, we can’t have an honest conversation. The key is respecting the right of others to their own beliefs and observations, rather than insisting that yours must be “correct” for everyone.
A related question here: do psychiatrists have the right to represent themselves as experts and to make recommendations of destructive “treatments” just so they can make money? Truth in advertising has been a concept since at least the 1800s. I’m not sure I think it’s depriving psychiatry of its “liberty” if we require honesty in all representations about their supposed “knowledge” about people and the apparent effects of the drugs they are peddling. Where do you stand on that point?
Done! I encourage others to add to the comments. So far there are two. This is a very big deal, and I would like to see lots of people help make it even bigger. I happen to know Deborah personally, and she has fought for many years to make this happen. Time to take “ECT” down!
Very true. Since there is no way to determine “proper indications” with the current subjective diagnostic criteria, that claim you quote is ludicrous. Additionally, there has never been any evidence to suggest that antidepressants reduce the suicide rate, and in fact, there is evidence suggesting they most likely increase the suicide rate. “Antidepressants save lives” is drug company propaganda.
Actually, more are killed by properly prescribed and administered pharmaceuticals than by medical errors, by a fairly large margin. Which is not to minimize the damage due to errors, but to emphasize that NORMAL MEDICAL CARE IS DANGEROUS!
You are correct. I believe it also matters a lot how the people around you respond to the trauma. I understand that those who are sexually abused as children but have a supportive adult believe and protect them are much more likely to come through functioning pretty well, whereas those who are not believed suffer more greatly, even if the traumatic event appears less severe.
You are assuming that they want to help in the manner you are describing. Many can’t even imagine such a means of helping, and think they are “helping” by stopping “bad” emotions. And others are just helping themselves to a bigger payday.
I believe this is true and well established. One piece of evidence is that the more warlike a culture, the less nurturance they provide to their little boys. Learning to “grow up tough” is important for warrior cultures. We no longer live in such a culture, but we still raise our boys that way, I believe.
BTW, I agree 100% that the male-violence connection is incredibly strong and obvious, much stronger than any other association that exists. It is kind of amazing how little attention it receives.
It is also true that the vast majority of traumatized males don’t become violent killers, either. Obviously, there is more at work, much more, but it is so much more convenient to blame “the mentally ill.”
Understanding the intentional driving of people into “right” and “left” camps is rarely commented on, but central to why we are where we are today. It’s great to see you identify it with such clarity. I only wish it were possible to help those enamoured of those labels how they are being played!
I have to disagree to some extent – I think it is fairly easy to observe that psychological damage exists. Look at a child who is constantly berated, or beaten, or sold to someone else for sexual favors, and compare to a child who is raised in a rational and loving manner, and you will consistently see the former showing evidence of having been damaged by the treatment they received, in the sense of lacking trust, being aggressive or withdrawn, having flashbacks, having difficulty relating to others, etc. Where I do agree is that such phenomena are not really amenable to study and classification in the same way that something like a broken leg or an infection would be. We are, indeed, operating on the borders of metaphysics here. However, we all need metaphysics to make sense of the world we live in, and I think it is this very process of making sense that is distorted and blunted by abusive treatment by those who have power over a person. Whether you call that “injury” or “trauma” or something else is all semantics, but I do think such damage is very clearly observable.
The problem is that people are approaching the data with an agenda. A true scientist will believe what the data says, even if it contradicts expectations or future income potential. Conflicts of interest have fueled a massive breakdown in scientific integrity across all areas of science.
I wouldn’t say that faith requires you to believe things that are CONTRARY to facts, just that no facts are required to sustain your belief. I think there are people who have faith to a point, but if consensus reality conflicts with faith, are willing to change their view. There are lots of Christians, for example, who don’t believe that God created the world 5000 years ago by blowing on a bunch of dust, because scientific evidence contradicts that version of reality. But they may still believe in God or Jesus without any need for evidence.
I’d have to agree, though, that the religion of psychiatry goes more along the “religious literalist” line of faith – even contradictory evidence doesn’t shake their faith in the DSM/Broken Brain mythology.
You are right, everyone has a right to their beliefs. Stating one’s beliefs in general is not a cause for being moderated. Telling someone else their beliefs are wrong may very well be cause for being moderated. Sometimes, we have to just allow people to state their beliefs and let them have those beliefs, even if they seem misguided or contradictory. Naturally, it’s always acceptable to ask why, and to share one’s own beliefs that conflict, but I don’t think we want to be in the business of moderating people’s belief systems, unless they intrude upon the rights of others to operate successfully (such as racism, sexism, etc.)
I guess it’s worth asking who has the right to force “treatment” on someone, even in the name of saving a life. Of course, we never know if we really DO save a life or just feel like we’ve done so. It’s also worth asking how many have lost all hope of help after being detained against their will, and how many of those killed themselves when they might not have. I ask all of this having been the person deciding whether or not to suspend someone’s civil rights for reason of “mental illness.” It was an agonizing job and one that I don’t recommend to anyone. The decision between holding someone in a psych ward, one of the most un-healing kind of places I’ve ever seen, at least where I was, and letting them go home and possibly hurt themselves – well, there are nothing but two bad options.
Sounds pretty disgusting. Ironic, too, as capitalism drives both the denial of services AND the denial of your feelings and needs about the denial of services. But capitalism is always held harmless somehow.
It is also a religion in the sense that it is not based on any kind of rational fact-finding process. You believe because you believe, it is not required that the things you have faith in make any kind of logical sense or fit with the evidence of the physical world, or even the spiritual world for that matter. You can collect data that support your beliefs and neglect or minimize data that doesn’t. Of course, not all religious people behave in this way, many are very rational, but a religion doesn’t REQUIRE that your faith fits the facts. Psychiatry definitely acts this way – when the data doesn’t fit the desired hypothesis, “we need more data.” When someone presents a more workable explanation, “You’re antipsychiatry” or “you’re a Scientologist.” There is no possibility of engaging in rational discussion when someone is taking that kind of a position. No matter how much actual science contradicts it, psychiatry must maintain its central belief system at all costs. That’s a religion, not a scientific discipline.
The DSM labels have coopted common human terms and turned them into “medical diagnoses.” Certainly, no one is wanting to ban words like “depression” and “anxious.” I just want the psychiatric “profession” to stop pretending that people who are depressed all have a problem, all have the SAME problem, and all need the SAME “TREATMENT.” In particular, I want to end the idiotic concept that someone is depressed because their brain doesn’t work properly, in the absence of the slightest evidence that this is the case.
As for insurance payment, surely we can come up with something more real and less stigmatizing to tell insurance companies and still get payment.
I see “provider” as simply a description of a role a person has chosen to play. I see this as very different from a high-power person assigning a label to someone who has no voice to object.
And yet when the low-power person expresses discomfort, it’s regarded as some kind of insult to the high-power person for not being “appreciative” enough. The game is fixed!
As I said in another comment, in the hands of a person who doesn’t genuinely respect the person they are trying to help, any language is quickly converted to condescension and disrespect and becomes yet another power play.
I think there is an insincerity when words or stories are coopted. I worked with foster kids for many years. They had many forums where social workers “listened” to the youth describing what worked and didn’t work for them and how the system should be altered. The listeners seemed sincerely interested and always congratulated the youth for their courage and wisdom, and yet the system changed not one iota. Language is important, but the attitude of respect for the voice of the recipients of one’s service is not contained in the language itself, but in the intent of the service provider. A person who doesn’t respect the person they are serving comes across as condescending regardless of the language they choose. Which has ruined many excellent terms and ideas.
One can also recover from an injury, which is often what is happening in the cases of the “mentally ill” as identified by the DSM. Psychiatry’s insistence on denying this obvious connection is one of its most evil acts.
I very much like that approach. Asking where they got the information doesn’t challenge their identity, just makes it clear that it has an origin, which automatically moves in the direction of “bipolar” being a way of viewing things rather than a solid reality. I have also used “What led you to that conclusion?”
Agreed. Independent is dangerous to the status quo, but at the same time is held up as a mythological goal that we’re all to strive for. I think what our “leaders” mean by independence is not needing anything and accepting our lot, not actually thinking for oneself and making our own decisions. Real independence is easily classified as a “mental illness” in a lot of cases.
Of course, internalized oppression is usually very well established well before any contact with the “mental health” system. It usually starts at home, and if not there, is certainly put in place for most people by the schools or their family church.
There are times when the reason they don’t “get” what you’re saying, it’s because they have another agenda that your ideas conflict with, and they aren’t really that interested in doing the “right thing” if it means they’d lose power, money or influence that they want to have.
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And those supporting the status quo will be uncomfortable and threatened, no matter how you phrase it. So might as well call it what it is, while maintaining a respectful demeanor, so that when they start attacking you, it will be clear who has the moral high ground.
Dependent is different from compliant. We don’t want people to be clingy and dependent – we want them to DO AS THEY ARE TOLD! People that refuse to knuckle under are the most likely to get “diagnosed,” followed by those who get upset about being abused and start to complain about it.
Unfortunately, the entire DSM diagnostic scheme is the opposite of “trauma informed.” It’s essentially impossible to do “trauma-informed care” within the diagnostic system in place.
I think it says a lot about the diagnostic system that so many more women than men get diagnosed. It’s not that women necessarily suffer more (though you might want to read up a bit on how much energy women vs. men spend on trying to avoid being raped or sexually assaulted every day), but that women’s emotionality is interpreted as “disordered” while men’s emotions are generally channeled into anger and competitiveness and are seen as “good” as long as they remain within these bounds. It is easy to note that the DSM disorders often center around strong emotions – depression, anxiety, intensity, hopelessness, grief. I think the message is pretty clear: strong emotions are not acceptable, especially in those who don’t have the power to control others but are expected to be controlled. Hence, the biggest groups diagnosed are women and children, schizophrenia diagnoses are more common among black people, etc. It is impossible to separate the DSM diagnostic system, which you may recall is created by committees (mostly of older white men) VOTING on what constitutes a “disorder,” from the efforts of the larger society to deny or minimize problems of oppression of the less powerful elements of society and preventing them from gathering any force to demand a change in the power structure. So sure, women may be more likely than men to seek “help,” but this is all part of a much bigger social problem involving the suppression of emotional expression in both men and women. My view is that those higher in power deal with it by beating up those lower in the hierarchy, while those with less power are judged “mentally ill” when they start to object or react to their mistreatment.
I have always thought that should be a “diagnosis!” If being excessively oppositional and defiant is a disorder, it’s only fair that being excessively compliant and submissive should be a “disorder,” too. Just like there is no “Excessive attention hypoactivity disorder.” The fact that only one extreme is emphasized shows the moral bankruptcy of the process. We LIKE compliant kids, so they are “healthy.” We only label the ones that give us trouble!
Yeah, that’s why that BS about “Anosognosia” or whatever really steams me! The basic attitude is, “We know what you need, and even if you say it’s not helpful, it’s because you don’t understand yourself. So just do what I say and shut up.” About as arrogant and authoritarian as you can get.
That totally sucks! I have never understood how anyone can justify inducing a seizure in another person as a way of “helping” them. It makes no sense whatsoever, and it is hardly surprising that memory loss and other cognitive impairment is a result. If someone has a seizure, we consider it an emergency situation and dangerous to the person. Inducing seizures is not “treatment!”
There is such a thing as “natural authority” – some times a person has knowledge, skills or understanding in a particular area that makes them able to plan and direct a project or undertaking in a way that most others can’t manage to the same level of success. This is very different from “structural authority” due to position or education or money or political position or whatever. Natural authority is specific to an area of activity or a specific project, and is gone when we change to another area. It is logical and emerges naturally, as opposed to structural authority, which is maintained whether or not the person in authority is competent or ethical.
I have always wondered about that – if exercise is so good for us, why is it that it’s so damned painful to start with! I suppose in nature we are forced by circumstances to exercise just to survive, so we don’t have a choice about it.
Good point about sex, too. It’s a particularly excellent sleep aid!
National NAMI has taken a lot of money from the drug companies, and is often a mouthpiece for the drug industry. They have promoted the “chemical imbalance” theory and talked about “mental illnesses” being “neurological brain disorders”. They have historically minimized or avoided any implication or suggestion that poor parenting or other trauma have anything to do with “mental disorders” or emotional or behavioral difficulties. “Blaming the parents” is a HUGE no-no at NAMI – it’s always the fault of the child’s brain, and the answer is always biological.
There have been some changes over the last few years and their presentation has softened, and more time has been given to alternative approaches, but they are still very committed to the idea that “mental illnesses” as defined in the DSM require “treatment” and are not the fault of the parents.
Local NAMI chapters vary widely in what they present and what kind of discussions are allowed or encouraged, but the danger is always that NAMI is generally very supportive of the status quo and preaches “mental illnesses” as “biological brain diseases” and are generally very supportive of forced “treatment” and “Assisted Outpatient Treatment” that forces people to take drugs no matter what effect they may have on the recipient.
I hope this is a good primer. I’m sure others will chime in with more direct personal experience.
You are right, of course. Relapse implies a specific condition from which one is recovering, and none of the “mental illnesses” can meet that criterion. Perhaps addiction, but there you at least have the measurable question of whether one has returned to the use of substances or whatever one is addicted to. “Relapse” is pretty meaningless when applied to “depression” or the like, particularly when withdrawal or other drug effects are in play. It all starts with the mistaken concept that saying someone “has depression” or whatever has any scientific meaning, which it does not.
The number is most definitely higher. One study in the Canadian Journal of Psychiatry found that 6-7% of kids taking stimulants had some psychotic symptoms (hallucinations or delusional thoughts). That’s hardly a rare phenomenon.
Bipolar psychosis with grandiose and paranoid delusions and command hallucinations – thinks God is telling him what to do, feels persecuted by the Romans, believes he is some kind of “savior” of mankind… obviously needs acute hospitalization!
Hey, Jesus Himself would have been a mental patient today, for certain! Spiritual healing, preaching that the meek would inherit the earth, creating insurrection with his crazy ideas – a sure candidate for “AOT!”
Not only did he not take neuroleptics following his early hospitalizations, as I recall, he describes actively avoiding contact with the authorities to avoid any engagement with the “mental health” system. Apparently, as unclear as he was about many things, he was very clear on this one point and committed himself to staying under the radar so he would not be forced back into the hospital again. His mind cleared eventually without any further intervention from the “professionals.” Not a story Big Pharma wanted to have told.
The psychiatric community has even admitted this was true – those that Biedermann’s “criteria” identified as “bipolar” apparently rarely ended up diagnosed with “bipolar disorder” as an adult, and most adults so identified never had these “symptoms” as children. Which is why they invented “Disruptive Mood Dysregulation Disorder (DMDD),” so they could continue to have a DSM justification for drugging these same kids despite their admittedly being completely wrong about “Juvenile Bipolar Disorder.” So we see that, in the end, the diagnosis is of no actual consequence, as long as prescribing of drugs can be continued.
It shows just how weak their actual belief in their own theories is that they have to force someone to like in order to protect their drugs’ “image” and the validity of their profession. They really are afraid the truth will get out!
I have moderated all comments since yesterday regarding the “abortion debate.” Oldhead reminded me above that these comments are all off topic, which is regarded as a violation of the posting guidelines. I often allow off-topic conversations to continue if they are productive and focused on the objective of critiquing psychiatry and its practices, but in this case, the thread is not contributing to the mission of the site. All further abortion-related comments will therefore be moderated from this thread, regardless of the opinion of the poster, in the interests of consistency. It is a topic simply not appropriate to this site, particularly in the way in which it has been presented, as I think LavenderSage reminded me as well. Thanks to those who responded in a respectful manner despite the temptation to do otherwise.
Excellent point! Some sneaky word-play here to preserve the concept of “psychosis” as an abnormal state, even though it appears to be common among “normal” people.
Right! My view is that I’m a smart person, you ought to be able to explain things so they make sense to me. If you can’t, the most likely reason isn’t that you have an advanced degree and are dealing with issues that are over my head. The most likely reason is that what you’re saying doesn’t make sense.
A very important point that is often ignored when people look at “outcomes.” What a real outcome is depends a lot on one’s objectives. And of course, the objectives are almost always defined by the “treater” rather than the “treated.”
It seems like we’re coming from a similar place. I’m only pointing out that talking about “depression” as if it were a real clinical entity implicitly supports the worldview we’re trying to break down. Joanna Moncrieff writes well about using the “drug-based model” of intervention – we’re using a drug because some people like its effects, not because we’re “treating” some medical entity. I think language is very important at this stage – we need to make folks conscious of the implicit assumptions in suggesting that someone “has depression” that “can be treated.” It’s part of the marketing scheme to use such language.
That being said, if doctors or anyone else spends 90+ minutes actually listening and asking compassionate questions, the client is much more likely to actually get something they need. I just think it’s important to convey to them that there isn’t something “wrong” with them for feeling or reacting as they do – it’s just their current condition, and if they want to work to change it, that’s their decision. It’s not up to me to “diagnose” them with some spurious “condition” and pretend that means I know something that they don’t. The client is the one who has the answers.
There you go talking about that pesky EVIDENCE again! Just because there’s no evidence doesn’t mean my “treatment” isn’t wonderful! What ever happened to blind faith in professionals? It’s people like you that make charlatanism much harder to sustain!
The absurdity of forcing someone through a “program” that doesn’t allow discussion of historical trauma, even when the client specifically states a need to do so herself, is beyond comprehension. Sometimes these manualized programs are almost as bad as the drugs, because they still adopt the idea that you “have something” that needs to be “treated” and that everyone who “has” the same “diagnosis” is treated in the same way. It’s beyond disrespectful!
I’m so glad you found MIA and have been able to reclaim your narrative to a large extent, by all appearances. I am not surprised that some of your “diagnoses” melted away when you got off the drugs. Many people here have shared similar experiences.
Thanks for sharing your story! The more we talk about these experiences, the sooner the truth will float to the surface of our blind and deaf society.
The way you discuss this makes it appear that “depression” and “episodes” are the problem, rather than symptoms of other difficulties. “Depression” is not a scientific entity, it’s a lay-person’s description of a state of the mind at a particular time. “Depression” as described in the DSM can result from early childhood trauma, thyroid dysfunction, nutritional deficiencies, a dead-end job, relationship instability, lack of sleep, lack of a sense of purpose, side effects of other drugs, a range of actual physiological illnesses, and more. It is ABSURD to consider “depression” as a unitary “disorder” and try to “treat it” without bothering to discover what is actually going on. Sure, drugs can make anyone feel better, if it’s the right drug at the right time. That’s why people go out drinking after work or smoke some weed when they get home. But no one thinks drinking alcohol is “treatment” for “anxiety disorders”. It’s a drug, plain and simple. Same with SSRIs or any other “medication.” They are drugs, plain and simple. They can’t “treat” depression any more than they could “treat” boredom or excitement or pain or irresponsibility. Depression isn’t a “treatable” entity. It is usually an indication of something else going on, and “treating” it without consideration of the causes is about as smart as “treating” pain without looking for the source of it.
What you’re talking about is analyzing what is actually happening to a person’s body, rather than just saying “all anxious people need B1” or other such generalizations. I’m right there with you. Everyone is different, and pretending that all people need therapy or B1 or meditation or ANY single intervention based on how they feel is never going to work. But for some, nutritional interventions have been very successful. It needs to be case by case.
All this “new” information about withdrawal symptoms was documented by Peter Breggin back in 1993 or so in Toxic Psychiatry. I wonder why it is suddenly acceptable news?
The most basic error of psychiatry in the DSM era is the assumption that all people presenting certain ‘symptoms’ have essentially similar needs and causal factors in place. This, of course, could not be more wrong. So it is that some people will do wonderfully with magnesium supplementation, and some will experience no effect at all, and some might even do worse. True, it is much safer and smarter to try nutritional interventions or supplements of this sort, as the consequences of a “no result” are pretty minor compared to “antidepressants” or, Lord help us, “antipsychotics.” But the idea that a person experiencing intense anxiety automatically has a need for magnesium supplementation is just as scientifically wrong as believing that all anxious people need SSRIs. It is dehumanizing to lump people together based on some arbitrary category of emotional “disorder” defined by subjective observation and judgment regarding basic human emotional responses that could literally mean almost anything depending on the person experiencing them.
Thanks for that inside information about life in the UK. I know things are different in different countries. I’d have to say, though, that sounds like the facts on the worker level. I am guessing that someone higher up the food chain is still making a lot of money or it wouldn’t be so important to make sure workers are prescribing.
The damage to one’s trust in humanity can be even worse than the damage to your body. It is utterly demoralizing even to just hear about it. To have been through it must be absolutely devastating, body and soul.
My understanding of socialism is that each person contributes work based on their skills and abilities without concern for salary per se. “To each according to his needs, from each according to his abilities.” Perhaps not the most realistic approach given human nature, but certainly not a call for people loafing around doing nothing.
Their pretensions of “science” in the face of total denial of the actual evidence is, indeed, an evil of monumental proportions. All in the name of profits and power.
I really appreciated this comment. It is important that we don’t allow ourselves to deteriorate into labeling and dismissing, as that is the tactic used by “the system” to keep dissenters down. We need to recognize the humanity of everyone we encounter, even if we have to decide to keep someone’s views or behavior in check due to the damage done to others. There is no telling which antagonist might at some time have “the scales fall from their eyes” and start to see things differently.
Psychiatry’s biggest crime, in my view, is undermining and defeating people’s hope. We have to continue to have hope that people are human and are never entirely hopeless.
You speak very wisely! I still feel guilt sometimes but have learned to acknowledge it as a voice from the past and let it go in most cases. But it is still a struggle some times. It’s hard to kick those early childhood lessons.
I’ve often said how senseless it is to focus all this energy on genetics, which is the one thing about a person you CAN’T alter, and take it off the environment, which is ultimately highly modifiable given sufficient motivation and skill (whether society’s or an individual’s motivation, it’s still modifiable.) So what if some people are more ‘susceptible’ to PTSD genetically? QUIT FREAKIN’ TRAUMATIZING PEOPLE and the ones who are more ‘vulnerable’ will be just fine!!!
I do think it’s possible to be direct without being antagonistic, but I agree that there are times when setting good boundaries requires doing things that others might find hurtful, mostly due to your violating their sense of entitlement.
Wow, prophylactic “antidepressants?” First time I’ve heard that one. Let’s give people drugs BEFORE they have any “symptoms” just in case, eh? Disgusting!
That’s my understanding. Doctors can commit any manner of destructive or deadly actions as long as their colleagues agree that this is considered “standard practice.” So it is that in the realm of childbirth, it is more dangerous for a doctor to recommend a hot bath than it is to perform a Caesarian section.
Psychiatry is certainly linked to eugenics by history – the psychiatrists were part and parcel of efforts to eliminate “bad genes” by sterilizing or killing the “mentally ill”.
How many “reviews” does it take before the obvious truth is accepted as truth? This fact has been known for decades – why is it still being “researched?” Not criticizing the researchers here, just the fact that the psychiatric community has not yet accepted the obvious reality that so-called “antidepressants” cause dependence and withdrawal.
I like the term “coalition.” It suggests that the people involved don’t have to agree on all their goals, but have common interests that allow working together toward an agreed upon goal that forwards both/all groups in the coalition. This kind of thinking is vitally important for a movement relating to “mental health”, because it is a form of oppression from which no one is entirely immune, and which cuts across all other identity groups to some degree or another.
I will reiterate Poison Ivy’s point, which I also think is important: the term Identity Politics has been hijacked by the extreme right and I think we need to be very careful to define what we mean when we’re talking about it. I very much appreciate the clarity of your definition.
In fact, I don’t think I would have survived school without daydreaming. It was the only thing I could do to keep from running screaming from the building. Though maybe the latter would have been a healthier response.
Too true! A lot of psychiatry and therapy ends up being about “stopping” those uncomfortable feelings that the “helpers” have projected/externalized onto their “clients.” This is one of the most destructive things about the DSM – it allows and even encourages the ostensible “helpers” to externalize their own demons to be symbolically wiped out in the “clients” who are making them so uncomfortable. If I can drug away everyone else’s “depression,” maybe I don’t have to become aware of or deal with my own.
Not sure I entirely agree with you. There is such a thing as social/system manipulation, whereby choices are arbitrarily limited or directed in one preferred direction by the use of shame, isolation, authority, financial incentives/punishments, etc. If you define “force” as including all those other manifestations of power, then I think I can agree.
The usage you describe here is, indeed, the way I understand the term. I was I interested in what Richard meant when he uses the term, as I absolutely know he is far, far away from being a “white nationalist”. I find it difficult to see how the term at this point can be used in a different way, but I don’t want to make any assumptions as I am pretty well aware of Richard’s political leanings.
I can see how that could happen. Thanks for sharing that perspective. Unfortunately, for more serious situations, this effect is unlikely to have the necessary effect. It also doesn’t address structural problems in the school which set kids up for failure. But at least there is some awareness that these behaviors don’t happen in a vacuum. Most bad behavior by kids IS caused by adults failing to meet their needs, as the Rat Park experiments have shown.
I had similar thoughts. As helpful as these methods may be in certain cases, the article ignores the fact that many children engage in aggressive behavior because they see it modeled at home (especially domestic abuse situations) or are subjected to it themselves. Additionally, many kids have outbursts because they are being expected to do things beyond their developmental capabilities, and this happens more and more in school. Bullying is also referenced, but the solution seems to be for the kid to learn not to react rather than to address the bullying. And it is important to remember that sometimes the adults are the ones doing the bullying.
It is great that kids can learn skills in not reacting to abusive behavior. But to try and address aggressive or tantruming behavior without looking at the social environment and expectations they are exposed to will in many cases lead to the student accepting that abusive behavior by adults and more aggressive children is OK and that their reaction is the problem rather than the abusive behavior or unreasonable expectations they are exposed to.
Your comments remind me of the “Rat Park” experiment. It’s always been accepted in addiction research that rats given a choice between pushing a button for food and one for cocaine will eventually choose cocaine over food to the point of death. This is supposed to prove that the substances themselves are the problem. But when the Rat Park guy put the rats in a healthy environment with lots of stimulation and socialization opportunities, the rats were no longer very interested in the cocaine, and didn’t become “addicted.” When we see lots of addiction, we’re seeing people whose needs are not being well met in their environment. Yet we want to blame the drugs, because it lets our social leadership off the hook.
So when you refer to “identity politics,” are you simply referring to a group identifying itself as a “survivor based” group leading such an effort? Or are you objecting to the creation of such identity-based groups, or using the ‘survivor’ identity as a means of organizing people who have been harmed by the system? Or the exclusion of “non-survivors” from such groups?
I remain genuinely somewhat confused as to what you’re objecting to, and would appreciate some clarification of what you mean in this case by “identity politics” diverting us from our goals.
It’s funny, because I think you’re both much closer together than you think you are. Frank (if I’m getting this right) believes that removing psychiatry won’t deal with the issue of coercion, because something else will take its place. Richard (again, if I’m understanding correctly) also believes that trying to remove psychiatry in and of itself won’t handle the situation, because there is a bigger power structure behind it that would continue the oppression. So it seems that both of you agree that psychiatry is problematic, but that removing it without dealing with the underlying patterns of coercion and oppression would not accomplish the end of keeping the “mentally ill” from being mistreated, labeled, and jailed.
The only thing we can say about “everybody” is that “everybody is different.” The most fundamental problem with the “mental health” system is that it tries to categorize people’s “problems” and prescribe “solutions” that are supposedly going to work for everyone. It’s a fool’s errand, except if your goal is to confuse people and make a lot of money.
I think this is very well said, Bonnie. The political situation is very complicated and neither mainstream “left” nor “right” truly grasps the issues involved.
The other part people don’t think about is that those who are NOT drugged and have that somewhat wild, hate-to-be bored kind of personality LEARN HOW TO COPE with people who don’t like their style or with situations where a less spontaneous approach is helpful. They learn SKILLS. But those who are on the stimulants don’t have to face those challenges, and can blame any failures on “my meds aren’t working” or “I have ADHD, I can’t help myself.” The psychological damage that can be done is quite substantial, beyond the obvious physiological damage of flooding the brain with dopamine every morning for a decade or more.
Can you possibly figure out what they want to hear and say it to them often enough to have them let you out? Agree with them how incredibly helpful they’ve been and thank them, because you’re “symptoms are under control?” Or won’t that work? It doesn’t sound like rational argumentation is going to work. I feel so bad for you being stuck in there!
But, but, but… if it’s a DIET problem, that would mean the PARENTS or the SCHOOLS would have to do something different! Isn’t that “blaming the parents?” Why should the ADULTS have to change when we can just use a handy “diagnosis” to blame the child?
Clearly, in my view, only a fully vetted peer-run organization with at least a critical view to the DSM and standard psychiatric practice could possibly certify “peer workers.” And of course, the powers that be will not support that kind of approach. Hence, the problem that has been noted with co-optation of “peer workers.” Unless there is a real shift of power, the psychiatric establishment still gets to make the rules and gets to decide who is “certified” and who gets fired for being a little too honest. Same for professionals, actually. I was thoroughly discredited at a place I worked as “the guy who doesn’t like meds” and my opinion on the subject was completely discounted. That was just for voicing my opinion. If I had tried to talk to folks about actually getting OFF their “meds,” I am sure I’d have been in hot water, and probably got fired.
So it all comes down to power, which is why deconstructing our authoritarian economic and power distribution system is critical to really making any changes stick over time.
More than a bit! And the percentage keeps going up and up. Now they have toddlers on Ritalin. Seriously, what’s a “short attention span” for a toddler????
It is certainly not a pathway to revolutionary change. At best, a way to make a bad system a little less dangerous for the few who can benefit. I left because I felt like continuing to work in the system was giving it tacit approval, but I think everyone has to make that ethical call themselves. Because as bad as the system is, those who happened to run into me were a hell of a lot better off than they would have been if I hadn’t been there. I quit for my own peace of mind, but I still struggled with the awful situation the clients were left in. I just knew I couldn’t change it from within.
I think that is very true. It takes a lot of courage to work behind the lines, and it takes a toll on one’s psyche to have to make compromises to be able to keep close enough to the clients to be of service. That’s why I eventually quit and went into advocacy. But I still have great admiration for folks who are able to walk that line successfully and be there for folks, because as much as we’d like to be rid of “the system,” there are still a lot of folks enmeshed in it and they still need to know that someone cares, even if it’s “the secret resistance.”
Who says basic principles need to be diluted for conservative-identifying folks to come on board? You’re assuming again that all “conservatives” are the same and that none are able to work together with people who see things differently and learn from them. Yes, there are even conservatives who are pro-choice. There are a growing number of younger conservatives who are very environmentally conscious. I just read an impressive story about a super right-wing Tea Party US representative who went to jail and had his eyes radically opened to the oppression of prisoners and of black people and has done a total political 180.
I say, you create the organization on the principles you believe are necessary, and if someone identifying as “conservative” is interested, they are welcome to come. They’re not welcome to undermine the values of the organization, however.
I was privileged to work for 20 years with the Court Appointed Special Advocates program in Portland, OR. I managed volunteers who went out into the homes and lives of foster youth who were abuse/neglect victims and tried to get them back to a safe home and protect them while in care. Many of my volunteers were of a conservative bent, though on the average, they tended to be liberal. Some of the more conservative folks were EXCELLENT advocates, including helping get kids off of psychiatric drugs. And some had their own epiphanies or growth experiences in terms of understanding poverty, racism, domestic abuse, and the oppressive psychiatric system. So I know from experience this can happen.
Of course, I did have to fire a couple of folks for making unapologetically racist or sexist comments or otherwise violating our policies or our values as a group. They still had to live within the group values and expectations, and some couldn’t do it. (I fired a few “liberals,” too!) But we’d have been a poorer organization if we excluded all “conservatives” from our ranks.
Not arguing with you there. Psychiatry is the handmaiden of neoliberalism. Problems aren’t caused by capitalism and cronyism, they’re caused by bad brains or bad characters. The blame flows to the least powerful. If this central part of the equation is ignored, as Frank often points out, we will most likely exchange psychiatry for another form of oppression.
Looking at that link, I can’t really agree with you. Unless you are saying that ALL observations of racist behavior are of necessity “trial by accusation?” Surely you would agree that racism still exists and is in regular practice today? Or are you really saying that racism is a thing of the past? People do use accusation to affect people’s opinion of a person, but it’s also true that some people do rape other people, and some of them are in positions of power. Are you denying the right of anyone to tell their story, because their story might damage someone’s reputation? Aren’t psychiatric survivors “accusing” psychiatrists and the field of psychiatry by telling the truth about what has happened to them?
I think that as long as anyone admits to the possibility of “legitimate ADHD”, the problem will continue to expand. When you come up with “diagnoses” that are convenient for those in power and have no rational or objective bounds that can be established, “diagnostic creep” is inevitable. And there are a lot of “diagnostic creeps” out there happy to be making big bucks supplying the fixes!
I think this is an unfair generalization about peer workers. I agree that this is what the “MH” system WANTS them to be, and some, perhaps the majority even, knuckle under to those expectations, but there are certainly dissident peer workers who do their work “behind enemy lines”, as it were, and are providing such support as they can within the limits of their power. I think it is very important to distinguish the intent of the system from the actual behavior of individuals within the system. I say this as a person who was a “behind the lines” dissident counselor, and I can name any number of situations where the person I encountered was very fortunate that they got me instead of a run of the mill system drone. Eventually, I couldn’t keep it up because of my own sense of ethical conflict, but to suggest that there aren’t others in the system doing this kind of work is, I think, quite inaccurate.
So how would you feel about engaging antipsychiatry folks who identify as “conservative” and finding out what made them decide to be “antipsychiatry” and to see where they’re at politically and to discuss your reasons for taking a “leftist” political analysis as essential to attacking psychiatry’s validity and power? Isn’t that the same thing we have to do with other left-leaning folks who are shouting out for “parity for mental health” and against “pill shaming” and other such unhelpful belief systems?
Let’s be honest, there is not a big “left-leaning” (or “right-leaning” for that matter) movement to eliminate psychiatry. Why not collect all the allies we can find who are open to looking at the bigger picture? I’ve talked to lots of conservative folks who recognize the role of corruption and the impact of Big Pharma on medical practice. Why not start from a point of agreement and work toward educating in the areas where a person may need more information?
I think it’s important not to make generalizations about “conservative” people. Sure there are some who are very rigid and who don’t really think through their positions, but there are others who are thoughtful and intelligent and open to reason. While I agree that an analysis that doesn’t include the impact of the profit motive and a harsh critique the neoliberal/neoconservative capitalistic society we’re part of will always fall short of the mark, but since most people aren’t there and need to be educated regardless of their political affiliations, why not just try to educate anyone who is compassionate about the plight of the survivors of the system, and work from where they’re at? If we don’t, we’re going to have a very small “movement,” IMHO.
I think it depends entirely on who the “peer” in question is and what kind of support or opposition they area getting from the institution where they work. In some institutions, peer work is valued or at least tolerated, while in others, it is openly attacked any time it conflicts with the institutional objective of compliant and well-drugged “residents.” At least that’s my experience.
Not only the training programs, but the support or lack of it received from the institution you’re working in. It’s hard to work effectively behind enemy lines, and I admire anyone who is willing to take on such a dangerous and potentially life-changing role.
Actually, it’s ironic that the “Decade of the Brain” research that was expected to find specific genetic or structural problems associated with “bipolar disorder” and “schizophrenia” and the like actually showed the opposite: that the human brain is incredibly flexible and capable of enormous growth and change, even in adulthood, in response to the environment. Other than the part about how early trauma causes brain changes (which fits with the “broken brain” agenda), very little of this research has seem the light of day, as it conflicts massively with the “bad genes” theory of “mental illness” and actually deeply supports the idea that positive relationships and a positive, supportive environment is the key to people avoiding or working through what has euphemistically been called “mental health symptoms.”
I am the biggest critic of the DSM and psych “diagnoses” as you’ll find anywhere. I’m not suggesting that nutrition should be promoted as “treatment” for psych “diagnoses.” What I said was that “I don’t think that an ‘antipsychiatry’ position in any way prevents one from believing that nutritional variables affect one’s mental/emotional state.” This is in SUPPORT of people who are saying they don’t believe in psych diagnoses, not opposed to it! I’m countering the implied or stated criticism, which is pretty common, that people who identify as “antipsychiatry” are denying that nutrition or any other physical body variable affects mental/emotional state. Try not sleeping for three days and you’ll see what I mean. A person who hallucinates after three days without sleep is not “mentally ill,” they are sleep deprived, and there’s no reason why an antipsychiatry activist would deny that obvious fact.
I hope that clarifies my point. I’m the last person in the world to advocate for using “nutritional cures for ‘ADHD'” or that sort of thing. It totally supports the idea that “ADHD” is a “disorder” that needs to be “treated,” and I find that kind of marketing disingenuous at best, as well as having the unfortunate “side effect” of supporting the “broken brain” view that I so heartily detest.
Essentially, I try out gradually more and more potentially emotional or controversial topics. I often start with humor to see what this person believes is humorous. Then I try talking about something that has some meaning to me, and see if this person reacts as I might expect to something more personal. This might happen over multiple interactions, of course, and if I get feedback that this person either a) has no interest or is uncomfortable talking about non-standard topics, or b) grabs on a little too hard and is trying to control the conversation, I back away from sharing anything personal or intimate with that person. It’s hard to exactly describe what I’m looking for, but genuineness and compassion are definitely a part of it, plus a willingness to allow themselves to be a little vunlerable and share some of their own stuff. A person who is empathetic but not compassionate is most likely willing to hear what you’re willing to share (as it might come in handy later in meeting their objectives), but will rarely share their own experiences, or will do so in an artificial and probably dishonest way.
That’s the best I can do. It’s something I started developing as a kid, long before I knew what it was I was doing, so a lot of it is pretty ingrained and hard to describe. I kinda just do it.
Thanks for that feedback. I struggled with that a bit, as “con-people” or “con-persons” doesn’t really work. But “people who play con games” would have done the job.
That’s not how I understand it. I participated in a training on OD a few years back led by Will Hall, and got a pretty good idea how it works.
“Open Dialog” starts without any assumption regarding what, if anything, is “wrong.” It also steps down the power of the therapists by including larger numbers of people and regarding all as having important things to say, including the client, which is a VERY big shift from most US psychiatry in my experience. The therapists further break down their “authority” by talking about the case with each other in front of the client and other participants, acknowledging when they don’t understand things and asking the other participants for their ideas of what is going on or what might be helpful. It was about the most empowering therapy modality that I’ve ever seen. And it works not on techniques, but on principles of how people should treat each other in the present moment to give the best chance of finding a solution or a path forward.
Does this mean someone might not coopt the name OD and do something else with it? Of course not. But it is not a “manualized therapy” like DBT where all of the “clients” are lumped together and assumed to need the same things. It is VERY individualized and requires therapists who are comfortable not knowing where exactly they’re going to end up or how they’ll get there, and are not afraid to show that vulnerability to the other participants in the process.
I have wondered if this is how SSRIs really “work.” Maybe increasing serotonin induces a “who gives a crap” attitude that might seem a big relief to those who have spent a lot of time worrying about other peoples’ opinions of them. It would also explain why a small subset, like the Germanwings air pilot who flew his plane full of passengers into a mountainside, do bizarre things on SSRIs that appear out of character and totally irrational from an outside viewpoint. Perhaps they stopped caring about the consequences of their actions, so suicide or homicide suddenly became acceptable.
It has always seemed to me that learning I can work my way through difficult emotions and even understand their origins was a much better approach than trying not to have those emotions or making them go away. If I know I can handle feeling anxious BY EXPERIENCE, then having anxiety is less worrisome to me, and my anxiety actually lessens over time. And I know that I am the one who did that, rather than someone coming in and messing with my body from the outside.
I don’t agree in this particular case. It appears he uses it in reference to to a specific comment, saying that the term “so-called racism” as used suggested that no racism currently exists and that people are making it up in order to accomplish some objective or other. You’re welcome to respond as to your actual intent in using that phrase, or dispute that the comment is racist, but it’s not an insult directed at you, it is an attempt to characterize a particular comment in terms of its implications. If we didn’t allow that, then we really would be in an “echo chamber.”
It is ironic that the shame so often falls upon those who are victimized instead of the ones doing the harm. Psychiatry is highly complicit in continuing and enhancing that pattern.
It is a very common tactic for domestic abusers to label their partners as “crazy” or more subtly “Bipolar” or “borderline” as a means of either directly confusing them or convincing others intervening in the situation that the victim is the one making the problems. Psychiatry unfortunately plays right into this tactic by tossing out labels that abusers can then use to discredit or attack their partners.
Calling someone a “racist” is most definitely an ad hominem attack. Saying that a comment is “racist” may or may not be, depending on the context. There are definitely comments that could be called “racist” legitimately by the definition of the term. It is true that claiming “racism” can sometimes be used to shut down discussion. It is also just as true that there are plenty of racist memes and beliefs floating around and there is nothing wrong with confronting them if the content truly puts down an entire race or promotes the superiority of one race over another or justifies racist behavior.
I know what you’re saying, but it comes across a bit like “victim blaming.” It is not the fault of a person working to create change that the protectors of the status quo attack to keep control of their little or big fiefdoms. It is for sure to be expected, and strategies should be in place to keep such things in check to the degree possible. But the harm is not done by the person challenging the status quo. Those who engage in the “blowback” and especially those who ORGANIZE and PROMOTE such “blowback” are the ones who deserve to be chastised. I know this does no good for the victims of a “blowback” experience, but I think it’s important to make certain we’re not saying people shouldn’t try to make big changes just because there will be a reaction from those in charge of the status quo. It’s part of the price of change.
Communists and trade unionists were among the first ones jailed by Hitler, long before he got around to concentration camps for Jews and Gypsies and the “mentally ill.”
I think I understand what you’re talking about. I’ve only found a very small number of people able and willing to talk about “what’s happened to you,” and the majority of the “mental health” system are focused on “what’s wrong with you.” Most of the support I’ve found has been people who know little to nothing about the “MH” system but have worked on their own issues personally and can share the perspective of how to move forward. Such people are rare but do exist. I have a way of testing out people to see how far they can go down this path. I don’t think one in a hundred can even go there. It’s frustrating and disappointing, but I am afraid that is reality.
I do think this is an important distinction to make. I’d add that there is another type of dangerously empathetic person, though. There are definitely con-men and -women who just get into your head to mess with you. I think there are also those who genuinely get HOW you are feeling but don’t get WHY. These folks project their own “reasons” onto you and can thereby justify their actions as “being in your best interests” from their point of view. If confronted as you suggest, they would assure you that OF COURSE, they care about you, THAT’S WHY THEY ARE FORCING YOU TO TAKE THESE DRUGS (or whatever)! Because they are GOOD for you because they’ll make you FEEL BETTER.
What they really mean by this is that if you take the drugs, it will make THEM feel better because they have done something to show they care for you so very, very much. If you deny they are helping, it hurts their feelings and a much less empathetic side will often emerge.
Such people don’t appear to be moved at all when you tell them (or when observation shows them) that their “help” isn’t really helping or is making things worse. Because their worldview depends on believing that their model of “helping” has to work. But they do recognize how you are feeling and try to pressure and manipulate you, very similarly to the con man. I suppose the real difference is that in this case, they are “conning” themselves as well.
Anyway, bottom line is that a person showing empathy for how you feel isn’t necessarily going to be able to help you get to a better place, and may in fact victimize you in the name of “helping.” Real compassion feels very different.
An excellent analogy, Oldhead. A little arsenic goes a long way. Same with Lithium. I would guess that it messes with your sodium/potassium balance really badly (since they all three are in the same group in the Periodic Table and easily replace one another in solutions and compounds) and those kidneys have to work double overtime to get the lithium out of there and get the sodium and potassium levels back to normal.
At this point, this conversation has gotten out of hand. I apologize for not getting to it sooner, but it appears we are degenerating into making negative comments about the authors and taking up personal issues that should be handled in other places than a comment section of an article. I have removed a few comments, but I am more concerned with the general tone of this conversation. The article focuses on the question of whether the TED organization is intentionally editing who is able to present talks and what they are allowed to talk about based on keeping their financial supporters happy. The conversation needs to stay on that point, and not stray to personal opinions as to whether or not TED was right or wrong regarding the author. Some of these comments are more subtle but are still aimed at attacking the character of the author, which violates the posting guidelines.
Let’s please get back to the subject of TED and possible corruption and the marginalization of non-mainstream viewpoints in general.
There was a very well-documented and very successful effort by allopathic doctors (MDs) to wipe out every other form of competition in the late 19th and early 20th century. They went after midwives, naturopaths, homeopaths, chiropractors, and of course, patent medicine marketers, calling them all “quacks” and other more insulting terms and assuring everyone that MDs are the only ones who can be trusted. Their success was so complete and widespread that even today, we hear remnants of these marketed beliefs, where chiropractors are all quacks or where midwives are “dangerous” even though their safety records and Caesarian rates are far, far better than MDs. It was an incredibly vicious mass marketing effort that we have yet to recover from.
Have you read “Anatomy of an Epidemic”? Read the part about neurological up- and down-regulation and the impact it has on trying to withdraw from these drugs. The fact that people have a bad reaction to withdrawal doesn’t mean they “need these drugs.” It could mean that their brains have adapted, just as brains adapt to cocaine and meth and heroin, and that withdrawal effects occur when the drug is discontinued.
Anyway, you really should read the book. That’s what this whole website is based on.
The obvious answer to the last question is “yes.” As to the rest, seems like we’re getting WAY off track here. But I’d bet that very, very few posters are in favor of nationalizing all industries and completely eliminating corporations and private ownership of stocks and that sort of thing. Marxism is the most extreme version of anticapitalism. Most “liberals” are in favor of stuff like Sweden and Denmark and Japan, where the government makes sure that people are able to survive the worst fallout from the profit motive, but companies are still privately owned and driven by profit. I don’t think that point is even worthy of debate – it’s simply obvious from the kinds of policies they promote. Even Bernie Sanders, avowed “Democratic Socialist,” has never even started to go down the path of nationalization of any industry or corporation. He just wants everyone to have healthcare coverage and decent wages and that sort of radical craziness.
Sorry, but Marxists are very, very rare in the US of A, including on MIA.
You may be right. I think that’s because social causes have been so vigorously and systematically eliminated from consideration by the DSM and the APA. However, medicine in general has always given short shrift to nutrition and sleep and other variables that affect mood. I see nothing wrong with these aspects of someone’s mental/emotional wellbeing being handled by medical folks who actually KNOW about nutrition. My objection to psychiatry is the presumption and marketing of the idea that ALL “mental illnesses” are PRIMARILY caused by biological problems, and that the DSM was created without ANY consideration of the actual cause of any of the so-called “disorders,” including the complete denial of any role for nutrition, exercise, sleep or any other physiological cause or contributing factor.
I could go on, but I think it’s important for you to recognize that most people in the antipsychiatry camp would never deny that biology plays a role in how we feel. The main objection is to the field of psychiatry deciding who is and is not “mentally ill” and the lies perpetrated in the interests of selling more pharmaceuticals, including forcing some people to take them against their will.
I said the majority. There’s also a very big difference between Marxist and liberal, as Richard I’m sure will passionately agree. And there are definitely conservative folks who post here, as well as “centrists” and anywhere else on the political spectrum. There is no requirement that people believe in any particular political worldview to post, only that they are respectful that their views are not the only ones that can be heard.
It’s also in Western cultures that reject and/or fear voice hearing where voices appear to be the most aggressive and destructive, according to cross-cultural research. Fascinating, eh?
I agree essentially with all you’ve said, Cassie. I’d only be cautions about using the term “mental healthcare,” because that term has largely been coopted by the forces advocating for the medicalization of all forms of distress, in service of the ideas that a) social conditions have nothing to do with why we are distressed – it’s all a malfunction in our own bodies or processes, and b) doctors and medical professionals are the ones who are knowledgeable about this area (after all, aren’t doctors in charge of “health?”) I prefer to use the terms “emotional support” or “processing” or “external perspectives.” I absolutely believe that therapy can be a wonderful experience – I had a great therapist in my 20s who helped me very much to get where I am today. But therapy is very different than medical care, in my book.
Anyway, it is a sad reality of our society that many people don’t have good support networks, and that our “always productive” model says that it’s NOT OK to break down or to need to be unproductive for a while as you process your experience. Heck, the DSM 5 now thinks we should be productive and fully functioning again TWO WEEKS after the loss of a loved one! It is no surprise that people appreciate having an anonymous person to hear their struggles when there is so much shame attached to not being able to “roll with the punches.”
And you’re totally right about insurance – it is at the very core of how this whole mess came into being.
Never heard that one, but it wouldn’t surprise me. He is an arrogant prick, or to avoid labeling, he engages regularly in “arrogant prick-like behavior.”
Honestly, I try to stay away from using psychiatric terms to refer to Trump and his minions. I don’t want to give more credence to DSM labels, nor ignore the fact that Trump’s agenda has been embraced by many folks who don’t like him personally but are themselves corrupt enough to see how they can profit from his fear-mongering approach to politics.
Lithium IS required in the body, but only in very small amounts. The amounts given to “treat bipolar disorder” are huge and very close to the toxic dose.
Yes, DMDD was actually invented to allow doctors to continue to prescribe drugs for what was called “Juvenile Bipolar Disorder” after Biedermann essentially created THAT disorder out of thin air in the late 1990s for the benefit of his buddies at Johnson and Johnson Pharmaceuticals. When it was discovered by research that kids labeled with “Juvenile Bipolar Disorder” did not tend to develop symptoms of “Bipolar Disorder” as adults, and that those who did end up with “Bipolar disorder” diagnoses did not engage in Biedermann’s list of behaviors as kids, they realized they were in a bad spot. So they invented “DMDD” to allow doctors a diagnostic category for the annoying kids that Biedermann had decided were “bipolar” so that they could still bill for drugging kids who were annoying to the adults around them, despite no evidence that these kids actually ever had any medical problem whatsoever. It really is a study in disease invention and shows the complete lack of credibility and ethics in the development of these DSM categories. They seriously do invent them out of whole cloth with the intention of “covering” as wide a range of behavior as possible to increase their market share.
It’s actually the lightest metal that exists. Right near the top of the Periodic Table, atomic number of 3. But it’s still poisonous in large doses, and people receiving “treatment” with lithium often develop serious kidney problems and can die if their dosage gets just a little too far beyond “therapeutic.”
I pretty much agree with the above. If someone’s using “mental health” terminology, I think it’s important to talk about why that can be harmful to people and why it might reinforce the current mythology about “mental illnesses” and suggest or request some changes. But I also think it’s important to look at the meaning of research findings no matter what language is used, and the idea that nutritional interventions could help some people who find themselves embroiled in the world of “mental health treatment” actually helps UNDERMINE the idea that people have broken brains and there is nothing that can be done about it.
As long as the proviso is in place that not everyone who happens to get “diagnosed” with a particular “disorder” is given some nutritional “therapy” specific to their “diagnosis” and expected to be “cured,” I think nutritional research can be a very, very important part of undermining the current psychiatric hegemony over “mental health.” I also think it’s possible to provide honest feedback regarding the use of this kind of terminology without tossing out the baby with the bathwater. I think these women have been quite courageous in challenging the status quo and deserve our support for doing so, even if there is legitimate feedback that folks want to provide regarding terminology.
Lithium at “therapeutic doses” comes very close to poisoning people. That’s why they have to check lithium levels so carefully – the distance from “therapeutic” to “deadly” is smaller than any other drug on the market. So you are absolutely correct, calling it a nutrient would be laughable if it weren’t actually promoted by some as the truth.
I don’t think either left or right is particularly supportive of stopping human rights abuses and protecting the so-called “mentally ill” from being lied to and having their lives shorted by doctors claiming to understand and help them. But such POLITICAL objections that I have heard have come mostly from the right, who assert excessive government interference when people are forced into “treatment.” I have not heard any coherent objections from the political left to this kind of “treatment.” Of course, when someone with a gun does something scary, the right are the ones quick to blame “mental illness” while the left blame lack of adequate gun control, so let’s be honest, it comes from both sides of the aisle.
I agree. When the “left” and “right” are reconfigured into the “authoritarian” and the “anti-authoritarian” or “non-authoritarian,” we may make some progress. Some folks on both left and right agree that corporate corruption of government is a huge issue. If we can get together with such folks and come up with some agree-upon tactics, we’d be in great shape. But my experience is the majority of people asserting “left” or “right” politics are really following some authoritarian dogma, regardless of what they claim. And it’s hard to get dogmatic people to think beyond their dogma.
If you are honest with yourself, the vast majority of comments don’t even vaguely reflect a Marxist viewpoint, and very few truly do. I think it’s a gross overgeneralization to suggest that more than a small fraction of people who post here identify as Marxists (not that there is anything wrong with being a Marxist, mind you.) Even if they were, you have been a strong advocate for making sure that certain possibly minority or at least less empowered viewpoints get a full hearing here. I think this should hold also for any and all viewpoints, no matter whether they are popular or not, as long as they are consistent with the purpose of this site. I think we want to try and create an environment here where people don’t get to shout other people down just because their viewpoint is not popular or is threatening or because one person simply disagrees with it. After all, aren’t most of the views that are expressed here unpopular or threatening to the general public?
I’d like to make sure that we are open to and supportive of all viewpoints that are consistent with the goal of protecting people from the lies and power dynamics of the “mental health” industry as it stands today. Maybe for you, Marxism isn’t a valid answer, but it is certainly a valid topic for discussion and should be viewed as such. You’re welcome to challenge why a particular person believes Marxism will work or to provide evidence that it won’t or provide your own alternative ideas, but not to generalize negatively about people who identify as Marxists simply because you don’t like Marxism. In other words, I challenge you to critique the ideas of Marxism, rather than trying to downgrade the people who might find them convincing.
Actually, we kinda do know. Robert Whitaker talks about it at length in Anatomy of an Epidemic. Any time we make long-term alterations artificially in the brain, the brain adapts to re-establish “homeostasis,” a condition of stability that it is programmed to see as optimal functioning. So if there’s a lot of serotonin around, the brain reduces the production of and sensitivity to serotonin. Same for dopamine or any other neurotransmitter. This fact is well known and accepted in the field of addiction, and it’s called neurological down- (or up-) regulation. Why psychiatrists would not full expect and accept that the same thing happens with their “miracle drugs” is only attributable to wishful thinking or utter corruption. So yes, tolerance happens and yes, withdrawal effects happen for very well known reasons. It’s just that the pharmaceutical industry and the psychiatric industry are committed to not knowing it, or at a minimum, to denying the obvious truth of it.
The “rat park” experiment was VERY telling, though no one wants to really examine the meaning of the findings. If rats don’t get addicted when they live in healthy environments, what does that say about our society that appears to result in huge numbers of addicted people? We ain’t livin’ in the equivalent of the Rat Park, that’s for sure!
I have never put doctors on a pedestal, and understand how destructive and deadly they can be. I have broadly published the fact that receiving medical care is the third leading cause of death in the USA. Not medical ERRORS – RECEIVING medical care at all! Pretty disturbing.
The reason I discourage bashing doctors rather than medicine is that doctors are individuals and some are not corrupt or evil or even misguided. From a very practical standpoint, if a person happens to have a doctor they have thoroughly screened and found workable, someone saying “All doctors are sellouts making money off of addicting you to drugs” is going to sound crazy and wrong to them. Instead, I make it clear that the MEDICAL PROFESSION is what has become corrupt, and that individual doctors, no matter how competent or well-intended, can’t stop the juggernaut of money and power that is corrupting the entire industry. It’s kind of like saying “All teachers are tyrannical control freaks.” No, they aren’t. There were lots of very nice teachers that I ran into in my elementary and secondary school experience. Unfortunately, this did not for one minute change the utterly oppressive environment of the school system they were a part of, and I still suffered miserably at the hands of that system, and kids continue to do so today. Not ALL kids, but plenty of them.
Or to put it more briefly, “Generalizations are always wrong.” There are always exceptional individuals in any system, and the system also takes potentially competent individuals and makes them incompetent and destructive, if it’s a destructive system, as both psychiatry and the school system are. I think it is more powerful to talk about the system and allow that individuals within the system may vary widely in their capabilities and their ethical integrity, but that this variation doesn’t change the fact that the system itself is an ongoing source of oppression.
I have never put doctors on a pedestal, and understand how destructive and deadly they can be. I have broadly published the fact that receiving medical care is the third leading cause of death in the USA. Not medical ERRORS – RECEIVING medical care at all! Pretty disturbing.
The reason I discourage bashing doctors rather than medicine is that doctors are individuals and some are not corrupt or evil or even misguided. From a very practical standpoint, if a person happens to have a doctor they have thoroughly screened and found workable, someone saying “All doctors are sellouts making money off of addicting you to drugs” is going to sound crazy and wrong to them. Instead, I make it clear that the MEDICAL PROFESSION is what has become corrupt, and that individual doctors, no matter how competent or well-intended, can’t stop the juggernaut of money and power that is corrupting the entire industry. It’s kind of like saying “All teachers are tyrannical control freaks.” No, they aren’t. There were lots of very nice teachers that I ran into in my elementary and secondary school experience. Unfortunately, this did not for one minute change the utterly oppressive environment of the school system they were a part of, and I still suffered miserably at the hands of that system, and kids continue to do so today. Not ALL kids, but plenty of them.
Or to put it more briefly, “Generalizations are always wrong.” There are always exceptional individuals in any system, and the system also takes potentially competent individuals and makes them incompetent and destructive, if it’s a destructive system, as both psychiatry and the school system are. I think it is more powerful to talk about the system and allow that individuals within the system may vary widely in their capabilities and their ethical integrity, but that this variation doesn’t change the fact that the system itself is an ongoing source of oppression.
I don’t know that this is true. The influence that psychiatry has over the narrative of what is and isn’t normal has a huge impact on how schools are run, for instance. If there is no DSM, there is no “ADHD” and no justification for putting kids on Ritalin. Most parents do “voluntarily” put their kids on stimulants, but it’s not really voluntary when they are lied to about the “causes” and the “consequences of untreated ‘ADHD'” and the “mildness” of Ritalin, and even how supposedly kids with ‘ADHD’ react differently to stimulants than “normal” kids (which has long since been disproven). For sure, let’s get rid of overt force, but I think we also need to get rid of the redefinition of social problems as medical ones, because most of psychiatry is ostensibly “voluntary” based on misleading the patient or their representative.
Wow, I knew about Semmelweis but I didn’t know he died in the asylum, let alone that he was essentially beaten to death! His experience is a great example of how even clearcut, scientific proof is not sufficient to override social mythology and power.
Not noted in the conclusions: more psychiatric drugs associated with MORE criminal actions on the part of these kids. Not really helping much, are they?
So what you’re saying is that society still needs someone to control the outliers and if psychiatry didn’t do it, some other institution will be created or will step in to fill the vacuum. Is that correct?
So how do you see us proceeding in reorganizing our society so that such a function isn’t perceived as necessary any longer?
I have to say, though, that “science” that is coopted for the purposes of making money or projecting power over people is no longer science. Science, by definition, is dedicated to discovering the truth of a situation, no matter how anyone feels about it and no matter who does or doesn’t profit from it. So what you’re talking about is not anti-science to me, it’s anti-corruption.
I think it’s pretty clear at this point that you and Oldhead have different views on this matter. I personally see getting rid of coercion as the #1 goal, but I don’t think we’ve really succeeded until we get rid of psychiatry’s power to define “mental illnesses” by their whackadoodle DSM manual. This manual helps decide who does and doesn’t get “treatment” and what kind of “treatment” is paid for, which has a huge influence on what is available to the general public. Many people would seek other options if they knew that they had them. So yeah, legal coercion has to go, first and foremost, but I will not be happy until other less obvious manifestations of force are also addressed and eliminated.
There is a difference between bashing DOCTORS, who are individuals who vary widely in their intelligence, competence, and ethics levels, and bashing PSYCHIATRY, which is a set of assumptions and beliefs and processes that are organized and promoted as a way of dealing with people who are seeking some kind of help with mental/emotional issues, or who are behaving in ways that are not illegal but are judged as upsetting or “weird” by our society (or certain powerful members of that society).
There are doctors (including psychiatrists) who are ethical, hard-working, open-minded, and/or kind-hearted people. There are also doctors who are insensitive, lazy, rigid, and corrupt. And everything in between.
But the psychiatric system of thought, including LABELING people based on subjective “disorders” with no scientific validity, JUDGING people for not fitting into society or having certain kinds of difficulties, LYING to people about their supposed understanding of the causes of these invented “mental illnesses,” as well as about the serious adverse effects of their “treatments,” CREATING AND SELLING diseases or disorders, DENYING real research that contradicts their dogmatic worldview, and FORCING people to accept “treatment” that is damaging and potentially deadly. I could go on.
So it’s not DOCTORS I am criticizing. It is the intentional distortions of fact being passed of as “science” by the psychiatric leadership in collusion with the pharmaceutical industry. There is a BIG difference.
I would have to disagree. It is very clear that Big Pharma and private insurance are huge reasons why healthcare is much, much more expensive here than anywhere else in the world, with poorer outcomes. Any developed country with national health insurance (which is basically everyone but us!) has better outcomes for a lot, lot less money. If Medicare and Medicaid were the problem, these other countries would have much higher healthcare costs, as all of their healthcare is paid for by Medicare/Medicaid type of services. Fee for service payments do encourage inventing things to pay for, like extra testing and the like, but that happens with private pay just as much as Medicare/Medicaid. The evidence is strong that national healthcare plans save lots of money and provide better care.
Ah, the magic of the “free market.” Worked great in the early industrial revolution, leading to sweatshops and kids working 80 hours a week and slave labor and… oh, wait, that’s still happening, isn’t it?
Anyone who believes that the “Free market” will solve everything should visit Malaysia or Indonesia and see how our running shoes are assembled. Capitalism unchecked leads to a few rich people and a lot of poor ones.
Private insurers like psych drugs because they seem to be cheaper than paying for therapy. And of course, they scratch the backs of the pharmaceutical industry and Big Pharma scratches theirs. Removing the profit motive for healthcare would be a big move in the right direction. We also need legitimate, objective and firm regulations regarding what is and is not safe in terms of pharmaceuticals, including criminal penalties for violations. A quick start would be eliminating paid DTC advertising for any pharmaceutical product.
Private insurers like psych drugs because they seem to be cheaper than paying for therapy. And of course, they scratch the backs of the pharmaceutical industry and Big Pharma scratches theirs. Removing the profit motive for healthcare would be a big move in the right direction. We also need legitimate, objective and firm regulations regarding what is and is not safe in terms of pharmaceuticals, including criminal penalties for violations. A quick start would be eliminating paid DTC advertising for any pharmaceutical product.
I would say not only does psychiatry suggest biology is a COMPONENT – it seems to insist that biology is the PRIMARY or ONLY component of what they call “mental illnesses,” again, with zero proof. That doesn’t even get into the question of why a difference in biology constitutes and “illness.” For instance, I’m sure there is some biological variation in children as to how active they tend to want to be and how willing they are to sit still and listen to someone else tell them what to do. So what? Kids have a disease because they are unable or unwilling to sit around and do whatever boring crap the teachers want them to do? Ever notice there is no “hypoactivity disorder?” Gee, I wonder why?
It appears we would agree on this point. I was actually quite shocked to hear the first time that any kind of enforcement was applied to mindfulness, but since hearing this the first time, have heard from others who verified that it happened to them as well. I think it comes from not really understanding what mindfulness meditation is all about. It is, indeed, a practice that takes a lifetime to fully develop, and I can’t claim to be much more than an amateur, despite years of practice. I’ve just never put in the length of time daily to accomplish the fuller benefits. But it is still a go-to place when I get to feeling crappy about something, about anything, really. It’s a lot more than a “coping skill” to me.
I think that’s a good way of putting it. Unfortunately, it is a very common human attribute to consider one’s own worldview to be the “right” way. It’s encouraging that mindfulness has spread as a practice to help folks survive better in their lives, and I fully support that effort. However, I do think a great deal is lost when the practice is divorced from its roots in observations on the nature of the ‘self’ and the ephemeral nature of physical reality.
And I most definitely object to it becoming a “required curriculum” for those who have not chosen to explore it, though I suspect we are on the same page on that point.
I don’t think anyone’s offended by the concept of mindfulness. I think some may be offended by efforts to “monetize” mindfulness as part of a manualized program of “treatment,” rather than seeing it as a spiritual practice emerging from an Eastern philosophical view that would be very inconsistent with both the Western “mental health” system and with the profit motive.
I don’t “charge” Shaun with being a materialist – there’s nothing inherently wrong with being a materialist, it’s a legitimate philosophical viewpoint to assume. I’m just reminding him and other readers that it’s not the only viewpoint, and checking to see if that is, in fact, where he’s coming from. I’m not a materialist myself, so it may be that disagreements he and I encounter come from diverging views on the nature of the mind. It’s not intended as a slam or criticism, just a clarification.
I agree that this is the case. But what that means is that we are in the area of PHILOSOPHY, not science or medicine. We don’t assign medical diagnoses because people “find them helpful.” Cancer is not a way of thinking about yourself – it is an observable THING or that is growing inside you that will kill you if you don’t do something about it. If people want to think of themselves as “ill” or “neurodivergent” or whatever, that’s their choice. That doesn’t make it OK for the psychiatric profession to pretend that these phenomena are “illnesses” in the same sense as diabetes or cancer or a blood clot in your artery.
You are correct. I absolutely distinguish between the brain, which is an observable organ of the body, and the mind, which is a conceptual phenomenon which science has only the vaguest grasp upon, of they have any grasp at all. It is psychiatry’s insistence on failing to make this distinction (in addition to baldfaced greed) that leads to their complete inability to do anything helpful for human beings beyond temporary suppression of certain thoughts and feelings through chemical/mechanical means.
It is exactly in DBT where I have heard of “mindfulness” being required. And if you really think that DBT is always voluntary, you need to look around closer at the world of “mental health treatment.” DBT is often a requirement of courts to get kids back from child protective services, it is sometimes ordered in criminal cases, and of course, there are those who manage to escape psych “hospitalization” by agreeing to “participate in services,” and whether it is overtly stated or not, the fear of re-hospitalization can make it feel very much like “I’d better do what they tell me or I’m gonna get in trouble again.” There are also housing programs that require “participation in services,” and again, whether correctly or not, people perceive that noncompliance with “treatment” can get them tossed out onto the street.
I am not at all against offering mindfulness meditation to anyone who wants to learn it. However, I do think you’d do well to listen more carefully to those who are expressing concern with HOW it is presented to them. The power differentials in “mental health services” are VERY real, and a lot of things that seem “voluntary” to you seem anything but to those who have to deal with the consequences of “noncompliance.”
At a minimum, it certainly seems to indicate a LACK of correlation between AD use and suicide. And scientifically speaking (though we know that most who make these claims aren’t really being scientific at all), it is the responsibility of the person CLAIMING the correlation to prove the correlation. Hence, if there is no proof that AD DO reduce the suicide rate, we have to assume that it does not, especially when evidence such as what you present is present to undermine the case.
The analogy is quite apt, I think. But people who believe we’re just a brain seem unable to comprehend that a sense of purpose is essential to our emotional/spiritual well-being, and there is no drug that has ever conveyed a sense of purpose.
Actually, bar owners CAN be held responsible for continuing to serve a drunk person. So there are actually more serious legal sanctions on bar owners than on psychiatrists.
I think mindfulness can also be misunderstood by practitioners who don’t practice it themselves. There are a lot of different forms of meditation, for one thing. Some people have a very hard time sitting still and closing their eyes, as it may bring up flashbacks or anxious feelings. There are moving meditation forms like Tai Chi that can be employed for people who find the sitting forms difficult. There are also often arbitrary timeframes attached, rather than allowing each person to figure out how it works best for them personally. I also find it diminishes the power of mindfulness meditation when it is only recommended as a “treatment” for “symptoms of mental illness.” It can be and should be MUCH more than that. It is an opportunity to get in touch with deeper personal truths, and it can require a sensitive leader to make it safe for such truths to find the light of day. It’s not just a “skill” like deep breathing, but it is often taught that way, in my observation.
I’d love to see mindfulness presented in the full context of Buddhism and an Eastern philosophical world view. Of course, the Eastern worldview completely conflicts with and threatens the Western psychiatric theories of the primacy of the body and the brain, so it is unlikely that we will see this kind of shift any time soon.
I was not referring to the article, but to comments I’ve heard from system users/survivors, who have been told that they “need to practice mindfulness” as a part of their program (usually DBT). I was pointing out the ironic fallacy of such an approach, not downing mindfulness in general. Mindfulness meditation is very powerful and something I have practiced over many decades. I fully encourage anyone to explore it, but only from a self-determined position. One person I know was totally turned off to the concept of mindfulness and meditation in general by being forced to do it as part of a program. I find this kind of outcome very sad, as I know the benefits when it is allowed to unfold properly instead of dealt with by force or manipulation.
I agree. I was horrified to discover that clients were sometimes forced to practice “mindfulness!” It is such an utter contradiction, it’s hard for me to wrap my head around it. “You will be mindful or I will punish you!” Sort of like telling someone they have to have fun or else. Anyone who knows the first thing about true mindfulness meditation would realize that making someone do it is totally destructive to the actual purpose of the activity.
I will point out that we are now making arguments regarding philosophy, not science. In science, a proposition is considered false until it is proven, not true until it is not. If a scientist proposes that such a thing as “mental health problems” exist in a physical sense, it is his/her responsibility to show evidence that supports this, as well as looking at any other compatible explanation and proving that they do NOT explain the data at hand.
Statements about the presence/absence of God are entirely philosophical/religious in nature. That you choose that particular analogy I think says a lot about the ground on which psychiatric diagnoses now stand. There is a hell of a lot of faith, and little to no science involved. The fact that such phenomena as anxiety, dissociation, hallucinations occur is not proof of “mental illness.” It’s simply a recitation of observed phenomena, such as “stars appear at night in the heavens.” The DSM diagnoses are exactly that – descriptions of observed phenomena, with no scientific analysis of why these things occur or if even more than one manifestation of these phenomena would necessarily have the same cause. The DSM itself admits as much. So were not talking science here. We’re talking beliefs.
You are sounding like a strict materialist – you seem to imply that dissociation must be a problem of some body part. Am I understanding your view correctly?
I assume you intend “normal” and “mentally ill” as if in quotation marks. Based on your earlier writings, you appear to find such distinctions meaningful.
Glasser has always been a stalwart opponent of the idea of labeling people with “disorders.” He is a big advocate for working with what you have and taking responsibility for moving in the direction you want to go, no matter what the barriers. He never identified as “antipsychiatry” but he really has been.
“Another psychiatric success story!” It simply amazes me how many stories like this exist where the person receives the best “mental health care” that our system has to provide, and yet spends decades of suffering before ending their own life. How is it that those providing this “help” are not held accountable, or at least forced to acknowledge that their efforts were a failure? How is it that such stories always seem to end with a call for more funding for “mental health care” despite the fact that this person had plenty of it and it still ended as badly as possible?
Is it even considered that the reason he could no longer write the way he wanted to was BECAUSE he was receiving “help” in the form of mind-altering chemicals? That the absence of such chemicals might have made him MORE able to write and hence LESS likely to end his life?
It is a strange phenomenon to watch, when a profession’s utter failure leads to calls for more of the same but harder.
I would agree. The vast majority of psychiatrists I’ve encountered are completely disinterested or threatened by my view of the “mental health” world. There are a few odd exceptions here and there, but I’d say over 95% are not worth wasting my breath on. And that’s not a generalization, that’s a summary of my own observations. In fact, I’d say that the less advanced degree the person has, the more likely they are able to hear contrasting viewpoints without feeling threatened.
Stephen, I sent the all the email addresses to you and Oldhead and LavenderSage, but yours bounced back. Can you send me your proper email to [email protected]?
That is an excellent point! It is absolutely true that many “mental health patients” have their livelihoods threatened if they fail to comply with “treatment recommendations.” Sometimes it’s less overt force than implication and manipulation: “I guess you can go off if you want to, but you know what happens when you try that – you’ll probably end up being thrown out of here and living on the streets, and back in the hospital. And you know how disappointed your mom will be if that happens…” Sometimes it’s literally, “If you don’t do as I say, you’ll be out of the program.” That certainly is not a “voluntary” situation!
Your comment assumes that there is such a thing as a correct interpretation of someone’s “manic” behavior, and that a “competent psychiatrist” is capable of such a translation. Surely you are well aware that the psychiatrists “interpretation” is almost always based on the DSM, which translates every behavior into a problem in the person who is acting a certain way, based on a highly culturally biased view of what is “acceptable” or “disordered.” And the DSM itself admits that it makes no attempt to determine cause or group “disorders” by cause. So the psychiatric translation of “manic” behavior would be only that “the person is manic” or “the person has Bipolar Disorder because they’re acting in ways described as ‘Bipolar’ in the DSM.” It hardly seems remotely similar to an accurate translation of meaning from one language to another. Now, it’s possible the psychiatrist may have a drug to offer that could possibly mute the person’s manic behavior (at least temporarily) at some potential risk to the taker, but that hardly qualifies as translating his behavior into any kind of meaningful frame, IMHO.
I did not, though I will say that I’ve seen a lot of people with “process work” training and it appears to me to have all the key elements of empowerment, humility, etc. that we mentioned.
Well, I think there is a pretty big difference, in that someone in the hospital involuntarily can’t legally leave and has many rights taken away, and is often acted upon violently or abusively without recourse.
This is not to say that pressure, manipulation, lies and chicanery don’t happen in an outpatient setting. It’s just that a person can walk out the door without consequence, unless of course they say the “S” word or act “psychotic” enough to allow someone to call the cops on them. And that last part wouldn’t be possible without involuntary commitment laws.
I’d say at the least that it would be a whole lot easier to take on the psychiatric establishment if involuntary commitment was no longer an option as a tool of “enforcement” of their “treatment.”
Not so much a “method” as an unconscious “out” when things get uncomfortable. I think that the general acceptance of such categories makes it easier for someone to say, for example, that the reason they feel uncomfortable with a certain client is because “they’re a borderline,” rather than because the clinician didn’t know what to do or had their own history triggered by something the client said or did in their session together. There may be a small cadre of particularly sick individuals who would intentionally stick a label on someone as a tactical approach to induce distance, but I’m guessing for the vast majority it’s pretty unconscious, and simply presents and easy way out of their own personal discomfort.
Of course, in my experience as a counselor, being able to tolerate my own personal discomfort and remain available to communicate with the client is probably the most important element of good counseling, so providing the DSM diagnostic scheme to counselors is one of the most destructive things one could ever do to the field. That part may, in fact, have been quite intentional on the part of the architects of the DSM III, as they were angling at that time to win their ‘market share’ back from the counseling professions. There are clear and unambiguous documents of this motivation from that time in history, in case anyone doubts me that this was the intent of the DSM III.
I’ll just gently remind us all that we don’t diagnose heart problems or cancer based on how someone feels about the diagnosis. The fact that such criteria are even considered in such a discussion proves the point that these “mental illnesses” are not objectively observable and are, in fact, social constructs that people choose to use or not use as best fits their needs and cultural belief systems.
Unfortunately, the need for outside funding at universities has led to the profit motive driving a lot of university research, at least in the USA. Add to that a change in law allowing university researchers to patent discoveries they make and to make profits off of their “neutral” research, and things are indeed very messy even at universities. As for government entities, the picture is perhaps better, but they are still heavily influenced by the politicians who lead them, who in turn are heavily lobbied by the pharmaceutical industry. And that’s not even getting into publication bias. It’s difficult to find an objective scientist these days!
Right, if what we are teaching is living with uncertainty, maintaining humility, being flexible, and empowering the client, I can agree that such things are helpful. What I’m objecting to is the idea that some workbook can teach you steps to follow that will help anyone with a particular set of “symptoms,” as people are all different and have different needs and motivations and reasons for their anxiety or whatever, and thinking that there is some formulaic way to address this that works for everyone is at best misleading, and can be quite dangerous.
But I think I’m preaching to the choir at this point.
I think there is a big difference between saying that clients often appreciate the services you provide and that the concept of “mental illness” is metaphorical and to a large degree mythological. It’s important to remember that “mental illnesses” are GROUPINGS of “symptoms” that are categorized as “illnesses” by the medical profession, and that the DSM is the current set of such definitions. If you think the DSM is bullshit, you’re agreeing that “mental illnesses” as construed by the DSM are mythological.
I think the point has been made too many times to count that saying that “mental illnesses” as medical entities that can be studied, diagnosed, or “treated” are mythological does not mean that SUFFERING is mythological, or that genuine help for such suffering is not possible. The myth we’re talking about here is the idea that a person can run someone through a checklist of “symptoms” and conclude that they “Have depression” or that someone can magically distinguish between “situational depression” and “clinical depression” or that we can conclude that “mania” is a brain problem because the brain does stuff differently when someone is elated or intense. Those are the myths. The fact that you are able to help people or at least not harm them when they come to you for help is a worthy accomplishment. But the fact that they appreciate your assistance does nothing to show that “mental illnesses” are anything more than the social constructs you see in the DSM.
I looked but did not see the “disinfomercial” you refer to. The only thing I saw with The Lancet was a critique of their publishing an article that was not valid. Am I missing something?
Wise words, Fred. If you have any specific feedback regarding my posts, I’d welcome it, either on the thread or through back channels. My e-mail is [email protected]. I agree 100% that humility is the beginning of wisdom, especially for anyone who likes to imagine they are helping another person find their way on the tangled pathways of life.
That is a truly beautiful and inspiring poem. It strikes at the heart of why the current approach to people’s emotional/spiritual struggles fails so completely and so miserably! I’m going to copy this poem for later use.
I think it’s fair to say that the very fact that doctors are “diagnosing” instead of listening and empathizing and trying to sort out what’s going on is what makes them appear disgusted and contemptuous. To really help someone who is experiencing emotional distress, in my view, requires stepping out of the one-up power relationship afforded doctors by society, and to get ‘real’ with the patient and make it safe to talk about what’s going on. As soon as the doctor slaps a label on a person who is baring their soul, they have stepped away from connecting and understanding, and almost every patient understands that immediately, even if often unconsciously.
I appreciate the fleshing out of your views. I do believe that QUALITY counseling has a role to play for people lacking support systems or struggling with complex issues that might be difficult to impossible for a friend to really get their heads around. Unfortunately, the operative term is quality. So much of the counseling world has been coopted by the DSM worldview that it is harder than ever to find someone who is empathetic enough to really sit with a client in his/her darker emotions and not try to “fix it” by some magical intervention. The DSM provides excellent cover for any “professional” to react to a moment of discomfort by blaming the client or his/her “disorder” for the behavior that is disturbing and then send a psychiatrist or other doctor in to snuff out the inconvenient feelings or behavior. There are still quality counselors out there, but if you can’t really shop around, it can be dangerously misleading to assume that the person you are assigned will really know how to be helpful.
I do think that it is vitally important to help empower anyone who has the rising awareness that their distress is not theirs alone and that the system in which we are all expected to participate is largely responsible for the rising levels of distress and confusion that we see all around and inside us. I think it’s part of the process of fighting capitalism – if people don’t know what it is they are fighting, they won’t make very good warriors. I suspect you are not in disagreement on that point.
I am certainly not arguing against that being a possible narrative for people reaching new heights of awareness and sensitivity. I’m in many ways an example, though my childhood was hardly unusual in its challenges. I guess your answer leaves me with another question: while you or I might find a particular kind of narrative of someone’s history to lead to better results, it’s the person we’re trying to help who is in charge of the narrative. Many of the complaints I’ve heard re: BT and CBT models are that it feels like the therapist is telling you that “things really weren’t that bad” or that “how you think about it is the problem” or “if you just think THIS way, things wouldn’t feel so bad.” This feels invalidating to a lot of folks I’ve talked to, as it feels like they SHOULD feel OK about their childhood and they are “wrong” for not finding a way to do so. I find it much more productive to acknowledge that they did NOT have a “happy childhood” from their perspective and then help them re-focus on their strength and ingenuity in having found ways to survive it.
I’m not a fan of wallowing in the past and blaming our parents for everything they did wrong. And I did discover after my own quality therapy and after having my own kids that I had in many ways misunderstood their intentions and more importantly their limitations. But that was possible only AFTER I was able to recognize the many things I HAD been upset, sad, angry, disappointed about which were not an allowable topic of conversation at home. In fact, we were encouraged to be cheerful ALL THE TIME and never talk about anything negative. Even after a huge emotional blowup with screaming and slammed doors, we would just come back to the dinner table and watch baseball and pretend nothing had ever happened. If someone had started my on a therapy focused on “looking on the bright side,” I would have either sunk further into depression or jumped across the desk and strangled the therapist on the spot.
You do seem to acknowledge varying needs for different people, and I think this is the key. Expecting the same approach to work for everyone with the same emotional challenges is the first place the psychiatric system went off the rails.
I have known about “Brief Therapy” for years and agree that the concepts involved can be useful in a lot of situations. However, there ARE people (lots of them) who have been screwed up by abusive parents or other adults, and have developed belief systems based on having to cope with being mistreated as kids. Many of these folks, I’ve found (including my wife!), have reported finding the concepts of “brief therapy” kind of insulting and frustrating. Much like CBT, it seems the therapist is telling the client, directly or indirectly, that their past is not a relevant consideration and that they just need to “change their minds” or “develop new skills” without acknowledgment of where their current survival skills (which are often demonized as “symptoms” these days) developed and what purpose they have served and perhaps continue to serve in the present.
I’d be interested in your comments on this. I personally have found great value in lightly using psychodynamic concepts with some people to help them come to grips with why it was IMPORTANT for them to act in the ways that they are now being criticized for or personally seek to change. I often find that when a person is able to see (for themselves, no “analysis” from me going on here) the role their coping measures played in surviving their own historical trauma, they are often able to realize that it is a skill that has value but doesn’t have to be used ALL THE TIME, and can be reserved selectively for moments it is useful, or modified in some ways to allow it to continue to be effective with fewer adverse consequences from their social contacts or society at large.
Or to put it another way, the problem isn’t that people with anxiety don’t need assistance, it’s the idea that we can somehow classify ALL people who “have anxiety” as needing the SAME assistance, which I believe is observably false. And in my view, the very act of classification of people as “having anxiety” immediately takes it out of the realm of normal human experience, which as Frank points out, is also not coherent with observation of human reality.
This does raise a serious question, though, and I’m going to ask it here: if I’m understanding the abolitionist position correctly, all forms of professional psychiatric/psychological assistance are eliminated. So where do you see the support for people who are struggling to survive for psychological/emotional/spiritual reasons coming from? I am genuinely interested in hearing your thoughts on that. I actually think it’s an important question, since the most common argument from the “reformer” point of view is that people need something when they are unable to cope with the expectations of society, and if we remove everything, where do people go?
Naturally, I am not getting into the question here of why we have a society that drives so many people “around the twist,” as they say. I’d love to reform our corporate capitalist marketing-based exploitative social status quo. But supposing that would take more than a couple of months, how do we help the casualties in the meanwhile? Seriously very interested in hearing anyone’s thoughts on this matter, especially those on the full abolitionist end of the scale.
I think it also shows the insecurity of many of those trained in and committed to (sorry, bad choice of words there!) the current system. I believe most of them KNOW on some level that they are missing something big, and if someone went to a “hearing voices” group and got better, it would point out to them the thing they are trying so desperately not to admit – they really don’t know what they are talking about, and their way of “helping” doesn’t really help the way they’ve been told it should.
It reminds me of a group of volunteers who went into schools in Oregon and read to the elementary school kids. They did nothing but read to the kids, and have the kids read to them, and give the kids two books a month if they participated. The volunteer training was something like 4 hours. And kids reading levels went up immediately to the point that a study showed that the program made the difference between meeting the reading benchmarks and not meeting them for an average child. The educators were astounded, and started asking the people who ran the program what their method was, how they did it, what was their “secret.” The leader explained that they just read to kids, nothing more. The educators could not accept this. It bothered them no end that a layperson simply taking the time to interact with a child around reading would be sufficient to teach them to read, and were sure there was some “trick” the program was holding back that would explain these (to them) unexpected results. They’d spent all this time learning all these “educational methods,” and the study showed their educational methods to be of little to no value in terms of teaching kids to read – an average untrained person could do the job with only 4 hours of very general training.
I think the same fear exists for psychiatrists/psychologists/therapists. If peer support can create positive change, it means their own years of training were misleading or maybe even worthless, and it’s even possible their actions were making things worse. It takes a courageous person of integrity to allow such an observation to really impact their view of the world.
I’d kinda say it was more or less invented by the “mental health” industry. I’d be that if you looked at documents from say 1900, the term “mental health” would never be used. I have always considered it euphemistic at best.
I have no problem with “damaged” or “injured.” I do have a problem with somewhat arbitrarily deciding who does or does not qualify for being “injured enough” to deserve compassion (if they even receive compassion for a PTSD diagnosis, which for many doesn’t happen, either). And saying that others may qualify for different diagnoses clearly misses my point: these people are harmed by being in a war zone and killing people and watching people be killed or maimed around them. They are all damaged in some way by this experience, or so I have to imagine. It seems very odd and counterproductive to me for vets to have to “prove” that they “have PTSD” (or some other form of “disorder” approved by the APA) before they qualify for help. (And again, I’m not commenting on the quality or effectiveness of said help, which has been copiously covered in other posts). Why doesn’t ANY vet returning from service qualify to get ANY kind of help s/he believes s/he needs WITHOUT ANY KIND OF STIGMATIZATION OR DISCRIMINATION based on being “diagnosed” with some “disorder?” Why don’t we call it “Fucked over by warfare disorder” and leave it at that? At least that label puts the blame where it belongs – on the incredible traumatic stress of war, rather than the “weak character” or “disordered brain” of the person who has to live through that particular form of nightmare.
And everything I’ve said goes times 5 for kids who were traumatized by their parents or other adults. Let’s diagnose them all with “fucked up childhood disorder” and “treat” the parents or other adults who screwed them over. Sure, they all deserve help and support, but there is no need to blame them for having a bad reaction to being treated like crap.
I would add to this that the statement that “most vets don’t come back with PTSD” shows a huge part of the problem with diagnosing people. We have selected out a certain proportion of people who have the most extreme reactions to warfare and tell them that they have this “disorder,” and those who don’t “qualify” are considered to be “normal.” As if there were some LINE we could draw, and decide that some people are “overreacting” when they are across this line, and that those who DON’T cross the line are AOK. This is, of course, utter nonsense. EVERYONE who experiences warfare is damaged, EVERYONE is traumatized, except perhaps those (if such exist) who were so damaged beforehand that killing people doesn’t bother them that much. Ironically, with the current diagnostic system, the psychopathic killer is the one who is considered the MOST normal, as s/he doesn’t have any reaction to killing and watching people be killed.
Additionally, those who don’t meet the criteria for PTSD are given the message that they have “successfully handled the transition” back to civilian life, and the damage that has been done isn’t validated or brought to light, because, after all, to talk about this stuff is to admit that you are “disordered” and “need professional help.”
The problem with returning veterans who qualify for a PTSD diagnosis is not that they have reacted too severely to warfare – it’s the warfare they were exposed to! And those who don’t qualify were also traumatized by that same warfare. It reminds me of being in school, when I was quiet and did exactly what the teachers told me. They all assumed that I was AOK and that the kids who were acting out had problems. In actual point of fact, the ones who acted out were probably a lot mentally/emotionally healthier than I was, because they objected to the arbitrary, authoritarian and at times outright abusive behavior we were exposed to, while I pretended it was not a problem while seething inside. But they’d be the ones getting diagnosed with “disorders” because they didn’t force themselves to fit into the status quo.
I’m the last person in the world to suggest that returning veterans should “pull themselves up by their bootstraps.” But I don’t support making people feel wrong or “disordered” for finding the experience of orderly and intentional violence and killing disturbing to their sense of meaning and stability in life. ALL veterans deserve support, and it should start by an acknowledgement that warfare SUCKS big time and that having negative reactions to being forced to experience such systematic violence is completely normal and expected and not a manifestation of something “wrong” with the person having those experiences, even if they are pretty extreme experiences.
I have allowed more to pass than I ought to in the discussion of personality disorder diagnoses, because I thought it was an important discussion. However, it has more recently deteriorated into a more personalized and hurtful place. I am calling a halt to that right now. I think we’ve established that there are people who view personality disorder labels as having positive applications and others who believe they are generally used harmfully. We’re not going to resolve this issue by further discussion – people are allowed to disagree with each other on this point, and neither side is going to “win.”
I would ask that the comments return to the topic of “ableism” in psychiatric practice and get away from making any generalizations about people who happen to be labeled with a particular diagnosis. It is find to share one’s own personal experiences, but it’s not OK in this space to talk about “borderlines” or any other diagnostic category in derogatory ways.
I would say the vast majority find it neither particularly helpful nor particularly unhelpful. Most drug regimens are taken for only a few months and discontinued, and most therapy these days is a couple of months at most. I think there are lots and lots of people in distress, and they seek out help or they don’t, but I think the long wait list probably reflects the isolation and unmet needs of most of society that people are seeking to meet at the mental health clinic. Some people do find some help there, and I agree that most are not dramatically injured, but in talking to many, many hundreds of people over time who have sought out therapy, the average person has not experienced any breathtaking life changes as a result, one way or the other.
The part that is harder to gauge is the impact of the DSM mindset on society at large. It’s possible that one reason for the increase in demand for your agency’s services is simply that the marketing of “mental illness” has led people to believe that any time they feel anxious or depressed or angry, they need professional help. What with 20% or more of the USA “diagnosed” at any given time, it seems like there is a lot of push in the direction of “getting help”. I don’t think this is a legitimate gauge of how helpful the services really are overall.
Shaun, I don’t buy into this idea that either you accept a diagnosis or you are somehow telling people to pull themselves up by their bootstraps. I’m guessing Frank’s answer would be to find support among your friends and associates, though of course, I could be wrong, and Frank is capable of answering for himself. That may or may not be realistic for everyone, as some people have limited support or need support that the average person can’t usually provide. However, the idea that the only two options are professional intervention and bootstraps is a meme heavily used by the psychiatric industry to promote their own agenda, and I find it kind of repugnant at this point to make it seem that critics of psychiatry are advocating that as the only other option.
I think a lot of “peer workers” went into it for the same reasons you did. I think they also experience similar frustrations, based on my limited experience talking to people who have occupied those roles. It’s true, there are some who go into it because they want to enlighten everyone how important it is to “take your meds” and follow the program. But I think it’s more common that the system does everything it can to make sure no real “peer support” happens outside of the confines of the dominant pseudo-medical paradigm. I can see why some see this as “collaborating,” but I totally see and recognize your courage for fighting behind enemy lines, as I was there once myself, and it is no fun at all!
This is why maintaining labeling is so important to them, despite the industry’s ironically deceptive “Anti-stigma” campaigns. As long as “the mentally ill” can be automatically deemed not credible, any facts about wrongdoing by “mental health professionals” can remain hidden. It is appalling.
“Unintentionally Negatively Outcomed” – really? Is that a thing? Totally new one on me. Sounds like an awesome euphemism: he wasn’t harmed by being hospitalized, he experienced an UNO! That’s right up there with “Treatment Resistant Depression” in terms of obfuscation of the truth.
You speak wisely. There is no “last word” on parenting – it’s always an evolving subject, and every parent has to make their own decisions as to what to do or not do.
Apparently, in the USA at least, we’re more likely to drown in our bathtub or be shot by a toddler than be killed by a terrorist. Big Pharma is certainly a bigger threat by many orders of magnitude.
Yup. Government by focus group. What’s true is less important than what people are willing to believe or are afraid of. If you are told your child will suffer if you don’t do as the authorities say, it takes a pretty strong parent to say, “Wait a minute – whose agenda is being served by your statements?” Most people aren’t up to it, especially when the media and their friends/family are siding with the psychiatrists.
I’m actually more thinking that the lack of a clear path to economic success is the big driver for adolescent anxiety. When I went to college, I knew for certain that I’d be able to get a job that paid enough for me to raise a family. Kids going to college these days come out with often $100K or more in debt and no guarantee of a job good enough to pay off their loans, let alone raise a family. Not to mention our bizarre political situation that seems to be plunging downhill fast, global warming, and the insistent sensationalization of mass shootings and international terrorism. Overprotection may play a role as well, but I’d also point to parents having fewer children per family and therefore putting more unconscious expectations onto their kids in order to feel competent as parents, and I believe that overprotection often comes from that frame.
BTW, do you have any data on to what degree “overprotection” has increased in parents over the last couple generations? I’d be interested to hear about it.
It sounds like a good initiative. I just wonder how this could possibly apply to psychiatry, when the diagnostic system itself doesn’t allow for figuring out what the “right care” should be, since it assumes that all “depressed” or “manic” or “hyperactive” people have the same issues and needs. Is that addressed specifically anywhere in the grant?
I absolutely respect your right to make your own mind up about your own relationship with your father, and if thinking of him as a “narcissist” helps you maintain that connection, why would anyone criticize you for using it? I’m not talking about colloquial usage such as what you’re describing, but about the way these labels are used by professionals to judge and condemn people and to limit their options with the full power of the medical community behind them. I’m sorry if my comments came across in any other way.
Gosh, I kind of find myself wishing that hadn’t posted those comments! These are complex issues, and I hope that people can understand that people will have different views on this kind of issue and it’s OK.
I don’t know what to say except to reiterate my position: people make judgments about other people’s personalities and behavior all the time. This is normal human behavior. And societies judge what is acceptable and not acceptable behavior. This is normal human behavior, and occurs in every functioning society that has ever existed.
The problem, in my view, comes in medicalizing someone’s distress or (socially defined) poor behavior or both as if there were some way we could categorize all people who act a certain way as automatically “diseased” or “disordered,” and therefore “treatable” in a certain way.
In a sense, you could say it is semantics, but I’d submit that words do, in fact, have great power. “Borderline” is a label that has been used to denigrate people and not offer them help or limit them to certain kinds of help. Believe me when I say that I’ve seen this many, many times and I find it awful. I’d much prefer if someone says, “This person has a hard time trusting people and sometimes uses indirect ways to get his/her needs met.” It’s more honest and also allows for more chance of change, because the behavior is identified as the problem rather than the person. And again, I’ve helped many, many people with this label with this kind of approach. I’ve never found the label to me helpful or necessary.
As for the “Narcissistic” label, I have certainly used it as a social shorthand, but it is almost entirely pejorative in intent and meaning. It’s an insult, not much different from calling someone a jackass. To suggest that being self-centered is a medical problem while at the same time condemning the behavior, and let’s be honest, the person, seems more than a bit inconsistent. And again, all such people are not alike – some have simply learned to be that way and are open to education and change, while others seem completely fixed in their need to act in self-centered and hurtful ways. I’d rather focus on the behavior and work at changing it if they are able than to lump all of “them” together into a group.
These are my personal opinions, and I understand that others may disagree with them. But in the end, I find it more important to try and understand each other rather than distancing ourselves from each other with labeling. I totally understand and agree that sometimes, the best or even only thing one can do to be safe is to put distance between oneself and a destructive person. But whether or not someone falls into that category is determined by each individual and what they are willing to put up with, rather than medicalizing such judgments into “diagnoses” which, in my view, which again others are welcome to disagree with, tend more to isolate and condemn rather than to help.
Do you not believe a person can decide to alter their behavior without having something medically “wrong” with him/her?
I am certainly not denying the need to help people with their challenges in life. I’m saying that calling someone “borderline” doesn’t really mean much, because people who qualify for that label are all over the map in terms of what, if anything, is “wrong” with them and what actually might be helpful. I say this as a person who has helped many, many people with this diagnosis and has been particularly successful at helping such folks. And often, they needed plenty of help. I’m objecting to the idea that needing help = having a disease, and that we can judge someone’s “diagnosis” based on their behavior.
I very much appreciate the clarification. I guess my issue with what you’re saying is that you’re talking about “personality disorders” as if they were somehow “diagnosable” and “treatable.” For certain, people can behave in ways that are harmful to others, and we can group such people into groups and put labels on them. And there could even be some value in that – after all, my book, “Jerk Radar,” groups a bunch of people with similar behaviors into the category of “Jerks.”
The problems I see are A) the people in the groups defined by psychiatry as “personality disorders” don’t actually have any specific thing wrong with them, and are actually quite divergent in both behaviors and needs (as you at least partly acknowledge above), and B) as a natural consequence of the above, there is no “treatment” that can be said to consistently improve any of the categorized “disorders.” In essence, saying someone has a “personality disorder” is not much different than saying “He’s a jerk.” It’s a social label that shows our disapproval of their behavior, but it does nothing to help the person or even identify what is wrong or IF anything is wrong with them at all, let alone what to do about it.
So should people be protected from other people who are harmful? Yes, absolutely. Is it a health issue? IMHO, I’d say it is not, because engaging in socially unacceptable behavior is not a health problem. It’s a problem of ethics and respect.
In your last comment, you talk about the “untreated personality disorder” – what is the “treatment” that you recommend?
Finally, you refer to “borderlines” as if they are a group of people who have a shared identity. There are many people on this site who have been given that label, and if I were one of them, I think I’d find it offensive to be referred to with that as my primary identity. People are not “borderlines” and to use such a term seems condescending at best and I think comes across as highly disrespectful. I think the behavior labeled as “borderline” can be confusing and frustrating, but again, I can’t condone heaping people together with such a pejorative label and referring to them as if they are “all the same.” Especially as the Mental Health system has an unfortunate habit of labeling uncooperative people as “borderlines” and using it as an insulting term meaning that these people are unworthy of attention or support and can safely be looked down on or dismissed entirely as “manipulative” and/or “untreatable” or be herded into “special programs” which become the only source of “treatment” they are eligible for, whether such programs work for them or not.
I’m all for providing help to people who want it, and I’m all for protecting the vulnerable from the dangers of self-centered behavior, but I think we’re better off focusing on the behavior itself rather than the labels/diagnoses. If for no other reason that such labeling incorrectly suggests to the partner of a “narcissistic person,” for instance, that there might be some “treatment” for their abusive behavior, rather than realizing s/he needs to protect him/herself from further damage. Avoiding these labels also prevents us from joining in with the psychiatric industry in demonizing those who object to or don’t do well with their standard brand of “treatment.”
I actually never heard of Bernays, but his ideas certainly seem to be the dominant ones of our time. We are all being governed by the “herd mentality,” and most people aren’t even aware that it’s happening.
Very common for those with that label. And then, you get to be called fat, ugly AND clingy, plus crazy. I never got how anyone could think that adding a new negative label to someone’s list could help them do better. The research supports us, but hey, who reads research? It’s more fun to just feel superior.
RR, I think that sometimes your dark humor is a little difficult to translate. I think I’m understanding your comment that Rachel took exception to as a sardonic illustration of how damaging that the labeling process can be, as well as how “entitled” the labeler appears to feel in using the label. Hence, you DON’T think the label would apply in reality? But I can see how that would not be obvious to all readers. Is my interpretation correct?
No, that’s true. But I am talking about the psychiatric INDUSTRY, the LEADERS of psychiatry. They are, in fact, pretty crooked. As you can see in this article, “thought leaders” continue to conspire to “spin” the data to make it look like a reduction in adolescent AD prescriptions is behind the increasing suicide rate, when there is no evidence at all that this is true. I’d call that pretty crooked.
There are always individuals even in the most evil of empires that try to do good (Shindler’s List, for example). But that doesn’t make the empire itself less evil.
Were the psychiatrists impressed by this “spontaneous remission,” or did they ignore it and act as if she was still “ill” as she had been before? Or did they somehow take credit for her getting clearer without their magic pills?
The term “overdiagnosis” is inappropriate to use when referring to psychiatric “diagnosis.” As there is no means to objectively “diagnose,” there is no meaning to the term “overdiagnosis.” It’s good that the authors mention the problem of definitions, but this is much more destructive in the psychiatric realm. The problem becomes not overdiagnosis, but the invention of diagnoses that are not objectively illnesses in the first place.
Yes, but that is AFTER you are already on a hold. I’m talking about when they are evaluating you, just like if the police interview someone to consider charges against them. If you’re “arrested” (aka awaiting an evaluation), you should get your rights, including the right to have an attorney present during the evaluation.
I mean that, and also the right to have an attorney there during the process. It seems like an obvious need, but apparently those charged with crimes actually have more rights than those who act in ways deemed “mental illnesses.”
Maybe this is a real area where advocacy could lead to a change in the system as it is.
I agree 100%. That’s why I put “mental illness” in quotes and said “what is CALLED ‘mental illness.'” The concept of “treating” something like not wanting to do what your teacher tells you in class or feeling angry that your dad abused you is beyond ridiculous.
That’s a great point, actually – how many of those in the study were given drugs that made any kind of exercise activity feel incredibly onerous or even dangerous?
Because the term “mental illness” has been co-opted by the “mental health” industry and is used to refer to DSM “diagnoses” that are not valid or scientific and are employed to blame the victims of our oppressive society.
One thing I note here is the concept of “adherence,” which is a short step from “compliance.” I’d be interested to know if there was any attempt to identify the person’s perception of internal and/or external barriers to exercise, including past bad experiences, perceived lack of time, joint or other pain that makes exercising uncomfortable, lack of understanding of how to gradually build up to higher levels of exercise, etc. I’d be willing to bet that getting to know the person and their perception of what exercising will be like for them would lead to more people choosing to participate.
I’ve known plenty who have been essentially forced to take psych drugs for decades. First off, there are “AOT” orders that continue for a year at a time, and those who fail to take their drugs religiously are re-hospitalized without really any evaluation beyond whether or not they are complying with “treatment.” Then there are the psychiatrists (and sometimes family members) who threaten calling the police if a person is not “compliant” with “treatment.” Then there are the care facilities who only allow the client to live there as long as they are “in treatment” which means taking drugs.
It is true that the majority of “mental health” clients are able to stop taking drugs if they choose to, which is why the average length of “compliance” with these drug regimes is something like a year or so. But once enforced “treatment” comes into play, there is literally no legal limit to how long they can continue to force you to comply, except for getting the AOT order renewed annually. There is no “maximum sentence.”
Well, that’s a whole different point. You can’t really “treat” made up “diseases” anyway. Which makes calling forced “hospitalization” a form of “treatment” all the more ridiculous.
I by no means meant to imply that the justice system is just. All I am saying is that if you have a term of three years, and you serve three years, they have to let you go. Whereas the sentence for being labeled “schizophrenic” or “bipolar” can be a life term without possibility of parole.
I look it up at Drugs.com or Medscape. They don’t hand it out to you at the pharmacy generally speaking, though I think they should offer it up to those who are interested. It has a LOT more data about adverse effects, as well as what the drug is supposed to be doing, what drug-drug interactions may occur, and situations for which it is “contraindicated,” AKA should never be used.
I always look at the doctor’s handout rather than the patient handout. The patient handouts, in my experience, are often sanitized so that the patients won’t be as alarmed by the possible adverse effects.
I make no excuses for such behavior. All I am saying is that being incarcerated for presenting a danger to the community isn’t a form of treatment. It’s a form of protecting the community from danger. And yes, there are some very practical considerations that come into play. First off, a person incarcerated for presenting danger in a police setting is afforded and informed of the right to remain silent and the right to have an attorney present during questioning. Second, the incarcerated prisoner requires a higher level of evidence to convict them – “beyond a reasonable doubt” rather than “preponderance of evidence.” Third, and perhaps most important, there is no assumption that those who arrest and guard and control the prisoner are there to “help” the prisoner become a “better person,” nor is their any assumption that the prisoner has something internally “wrong” with them other than that they made decisions that were illegal and/or dangerous.
Finally, the prisoner is assigned a term of punishment according to the crime they commit. Whereas a “mental patient” can be afforded a life sentence of enforced “treatment” that could very well kill them decades before their time, and they have NO right of protest.
So I’m not talking about some pie-in-the-sky impractical reality here. I’m talking about providing protection from having one’s civil rights violated with impunity. I believe at an absolute minimum all involuntary “evaluations” should start off with Miranda rights, and that a client should be able to ask for an attorney before being questioned by authorities. I would certainly want some legal advice before being put in the hands of someone who can lock me up or force me to take “meds” for the rest of my life. And the very fact that such large legal issues as incarceration and enforced drugs are involved means this is NOT and never will be a “treatment” situation.
I can’t agree with you. This is simply expropriating medical terminology for a non-medical cause. There is nothing medical about preventing people from doing harm – it is entirely behavior-based and comes from a moral viewpoint that some behavior is ‘wrong’ or ‘bad’ or ‘unacceptable.’ You can’t “treat” a social/moral problem in the same way you treat a broken arm or high blood pressure.
The key point is that from the point of view of the person being “treated,” s/he may not see any need for “treatment” and object to the entire enterprise. In the world of real medicine, a person who protests treatment has the right to say “no.” Take that right away, and we’re talking law enforcement, not medicine. Law enforcement is needed in society, but it is not a form of medical treatment. It’s law enforcement. And the sooner we divorce law enforcement functions from “treatment,” the sooner many of the arrogant and presumptuous attitudes we’re up against in the psychiatric industry will be forced to soften or at least be held up to some level of accountability.
I think some confusion enters in as soon as we conflate protecting people from danger with “treatment.” It is NOT and can NEVER be “treatment” if the person is forcibly engaged in the process, no matter how well-intended the person exerting the force. Treatment is an agreement reached between a physician and his/her patient. In cases of unconsciousness or inability to communicate, the patient’s interests may have to be represented by someone else, but in this case, we’re already on shaky ground as far as “informed consent” is concerned. But if there is no “informed consent,” the concept of “treatment” is out the window. We are now managing social problems, not “treating” anything. Again, a police function exists in essentially all societies, but it should never be confused with a helping agreement between client and professional.
Well, there is nothing wrong with checking someone’s thyroid or their vitamin levels or for actual medical problems. Unfortunately, I have not know many psychiatrists who bother with anything along those lines. Mostly, they ask people to list their “symptoms” and then “diagnose” them and prescribe something.
What is the “new neuron?” What is its significance?
Being opposed to psychiatry doesn’t mean not believing that biology plays a role in what is called “mental illness.” For instance, anyone who doesn’t sleep for 3-4 days will start hallucinating, just as if they were “schizophrenic.” It is the LYING about what they pretend they know but really don’t that is the big problem. I’m always interested in new research, just not in dishonest “interpretations.”
This might be helpful for a person who is in a relatively strong and safe position and who CHOOSES to try out this approach on their own CHOSEN points of anxiety. To suggest that this would be a good idea for all or most people qualifying for a c-PTSD diagnosis is ridiculous. Actually, suggesting that any one approach will be helpful to everyone in this category is ridiculous. It would completely depend on the circumstances, preferences and personality of the person who is suffering these effects, as well as the relationship between them and the therapist.
The big mistake the psychiatric model makes is assuming that they can group people together by “symptoms” and somehow know what will help everyone in the group.
I love the saucers on the asphalt plan! I used to volunteer to do glass recycling and would throw the glass bottles as hard as possible into the glass bin. I found the shattering most satisfying, especially a nice, thick olive oil bottle into a big wine jug. Crash!!!!
It’s a massive conflict of interest situation. They’re not going to honestly report things that will hurt their bottom lines. So it’s more marketing than it is science, but sadly, most people don’t know or want to know this.
Reminds me of school. Sure there were “good teachers” and “bad teachers,” but the very essence of the system was to teach kids that they have no power and need to kowtow to their superiors. Good teachers made it more bearable, but the school was oppressive from top to bottom, and no “good teacher” could really change it.
I absolutely agree. He shows over and over that the profession has long since sold out concern for the patient in favor of protecting the powerful and blaming the victim. I am sure he was ostracized from his profession for doing so, but I think writing this stuff was him deciding to bail on a totally corrupt profession and telling the truth about it.
It is almost never really bio-psycho-social. It has become bio-bio-bio for most psychiatrists, and a lot of psychologists, too, these days. And really, it should be the social-psycho-bio model if they’re serious about it, because if bio’s at the front, it will always dominate, especially when that’s where the financial rewards are.
8Anafranil used to be used both as an AD and an anti-anxiety drug. It was more used for anxiety, but I saw it used for both, even in kids. Also used as a sleep aid at times, though the side effect profile was so bad it was abandoned. Oh, and they used to use it in the early 90s to “treat ADHD.” I had to advocate to get a kid off of it because he was having extrapyramidal symptoms, which they were calling “making funny faces” at his school. They had him on a behavioral reward system to discourage the “funny faces” which he had zero control over. I guess they used it for whatever they could pitch it for.
Masson’s book is really important reading. It shows that the suppression of trauma as a causal factor in what are now called “mental illnesses” has a long history, and is very highly motivated toward protecting the white male aristocracy from any kind of scrutiny or accountability for their criminal actions against children. It is a shame that Freud knuckled under, but his retreat from the “trauma theory” reflects our entire culture’s “blame the victim” attitude that continues to the present day, and is now embodied in the “blame the victim’s brain” meme that is central to the current DSM/label-drug-and-dismiss approach to mental/emotional distress.
Again, I get what you are saying, and from the point of view of an adult who has sufficient control of his/her own environment, this kind of thinking can in fact lead to healing. But what about you or me at the time we were IN school? Did we really have a reasonable alternative at the time? I’m not talking about holding onto resentment – I’m talking about POWER here. There are times when a person is unable to exercise much if any control of his/her environment. To me, this is a totally separate issue than how one views one’s experience in retrospect. There IS real oppression toward black people, toward women, toward the so-called “mentally ill,” and it does genuine, real damage, both spiritually and physiologically. I’m all for dealing with the spiritual damage after the fact, or even learning to deal with oppression directly when it is happening. But it definitely feels very judgmental to suggest, as you seem to, that the only variable in gaining control of one’s life is internal. There are times when one is under suppression and at such times, simply adopting a different attitude is not sufficient to maintain one’s integrity. This is not because I don’t understand what you’re saying. I simply don’t agree that it is as broadly applicable as you seem to think.
I find it unlikely you will allow this perspective, so I don’t plan to comment further on it. I simply ask that you recognize that your framing of your philosophy comes across as invalidative to those who have been injured by the oppressive conditions in the “mental health” system.
There are “housing first” programs developing in a few places and they have shown exactly what you say – providing logistical support reduces “symptoms” (whatever THAT means!) without any kind of “treatment” at all. Forcing people to accept drugs in order to get a home is not only morally offensive, it’s proven not to work!
I’m not sure you got my point, though. I definitely agree that people sometimes need to be reminded that their attitude and beliefs are within their own control. Where we diverge is the idea that all forms of suffering come from attitude or belief issues. I think it comes across as insulting to people who have been in places where they don’t actually have control of their environment and they are directly and specifically harmed by that environment. It sounds like you’re saying that the ONLY reason people are suffering is because of their attitudes/beliefs, and I don’t think that is factually true. I gave a couple examples, such as me going to school as a kid for me, where a person realistically doesn’t HAVE a choice about the environment. Sure, I could choose an attitude toward school that might make it feel less onerous to me, but it was still an oppressive environment where I had to, for instance, hold in my pee or suffer consequences for going to the bathroom without permission. I don’t think there is an attitude that could make that kind of decision feel anything but oppressive. I probably would have felt LESS disempowered if I’d gone ahead to the bathroom and accepted the consequences, but seriously, why should I have had to make that kind of choice?
I think it’s quite appropriate for me to object to this kind of double bind and to feel and express righteous indignation toward such situations, and I don’t think it’s helpful at all to tell people anything that suggests “if you just change your attitude, you’ll feel OK.” It provides a great cover for abusive people to claim that they’re not really being abusive, you just have a bad attitude.
I don’t want to say that applying your kind of reasoning can’t be helpful at times, because it really can. I’m saying that it doesn’t apply to all situations, and that saying it does can really feel invalidative to people who are in bad situations that a change of attitude simply won’t be sufficient to address.
John, I seriously only know about you exactly what you’ve shared and nothing more. I don’t doubt your perception of the situation, as you’re the only one there to tell us about it. I don’t really believe there is much we can do here except to talk about it, as we don’t know where you are or what it is you’re up against. Which is why I don’t really see what we can do to help you, other than hearing, empathizing, and providing some ideas of what you can do yourself. I wish we could do more!
I think it’s OK for people to gather together and identify themselves by something they feel they have in common. “Voice hearers,” for instance, is a group of people who get together to talk about their experience hearing voices. No pathology is assumed, no power differential gives some more authority, no one is the “diagnoser” and no one is the “diagnosee.” I think it’s really different when a doctor or counselor diagnoses YOU with something and tells YOU what it means or what to think about it. I know some folks have grabbed onto psych diagnoses as a means of identifying themselves and others who have similar issues, and it’s great if that helps them find a community. But it’s a slippery slope when we start taking what are supposedly medical “diagnoses” and instead using them as cultural constructs and use the fact that they may be useful in the second role to justify their use in the first role. No one asks a person how they feel about their “broken leg” diagnosis – a leg is broken because an x-ray says it’s broken, and we can not only tell what we need to do about it but also continue to monitor it objectively until it heals. Until and unless psych diagnoses can be objectively determined and monitored in this way, they remain very dangerous, because they mislead folks into thinking that the doctor understands what’s going on when in fact they are simply categorizing things based on outward appearance, kind of like diagnosing someone with “pain.” I agree, we’re lacking a word for it, but it lives more in the realm of “distress” than it does in the realm “disease.”
Thanks for clarifying. I’m not sure what you would want an internet website to do about that problem, though. We are here to communicate. What would be helpful to you?
The damage that parents can do is enormous. One of the things I really hate about the DSM is that it lets the adults off the hook and blames the child. It is truly inexcusable.
I see that this kind of thinking can be really helpful for certain kinds of issues. However, there really ARE situations where people have limited control, whether economically, socially, physically or whatever. Children are a great example. A baby who isn’t being fed is genuinely in crisis and is a victim of poor parenting, regardless of how they think or what they believe. They NEED someone to feed them. They will die if they don’t.
Other examples: a person has to take antipsychotic drugs or else they’ll be arrested and tossed back into the “hospital” and forcibly injected. More control than the baby has, but a lot there the person doesn’t control, and his/her options are limited.
A black person can’t alter society and make it so that the person they’re applying to for a job or an apartment suddenly isn’t going to go against them because they have dark skin.
The “victim identity” concept has applicability, but it can also be used to allow those with social power to abdicate their responsibility for doing harm. I would have LOVED to escape from school as a child, and yet I spent 13 years there. Was that because I had a victim mentality? Or because I had no practical option to survive?
I have been a passionate opponent of diagnoses before the DSM III even came out. There is nothing that enrages me more than the DSM. Check out my past posts and you will see where I’m coming from, and was coming from long before I was moderating.
I would submit, at the risk of generalization, that psychiatry is almost never “right”, at least in the scientific sense, because it starts from invalid assumptions. Assumptions such as the mind=the brain, chemicals are causal agents in the brain rather than messengers influenced by the environment and the decisions of whoever or whatever it is that runs the body, that “negative” emotions are problems because they are inconvenient, that “delusions” or “hallucinations” have no meaning but are just random events… So while I would not say all PSYCHIATRISTS are always wrong, I’d say that anyone who adheres to the DSM/brain chemistry model is going to come up with wrong answers nearly 100% of the time.
Such arrogance! They have no idea what the mind actually even is or means, and yet they are trying to find a relationship between this vague, undefined entity and the brain?
Well, I guess I should not have gone to sleep yesterday without checking the comments!
I appreciate the reporting of several comments on this thread, and it does appear to have gotten well out of hand. I have removed a number of posts, and may need to remove some more. This is the kind of disrespectful exchange I was talking about in my blog. I’m not laying the blame on anyone at all, but asking everyone who posted to take a look at their own approach here. Some did a great job of returning to the topic, or making observations of what was going on without attacking back. Some chose to throw more fuel on the fire.
I would seriously ask those in the latter category to do some self-policing here. I’m not sitting by my computer day and night, checking each comment as it comes in! It seems unfair, at the least, to be judging publicly how the rules are being applied when I haven’t even had time to look at the comments. As I said in the blog, the most helpful thing to do is to report the comment and not reply. If a reply seems called for, stating how you are feeling about it or observing what you see going on is much more helpful than attacking back. Again, my thanks to several posters for doing just that – that’s the kind of response that keeps a community like this functioning effectively.
I’d ask those who find this kind of exchange challenging to recall that each of us is here as part of his/her own larger objective(s) and that not everyone’s objectives or strategies will line up. Bob wants this site to be a place where all of those who are concerned about or resisting the system of labeling and drugging are able to communicate safely with each other. We have enough antagonists outside of this community without being antagonistic to each other. At least that’s my humble opinion.
It’s hard to pick one book. I suppose Alice Miller has been one of the strongest influences on me (The Drama of the Gifted Child), but far from the only one. I think I got most of my insights from my own therapy (back in the days when therapists still asked questions and listened to their clients) and from working with people over many decades. I was fortunate to start in the “mental health” field with almost no training, so I went with what I observed and learned from the clients I was talking to. I don’t think there is a better teacher than approaching the person needing help with humility and creating a safe space where they can honestly explore their own intentions and motivations and fears. What I found is that almost all behavior, no matter how odd it seemed to me, made sense from the point of view of the person engaging in it, once I understood their lives well enough. I’d say that’s where most of my learning originated.
Steve as moderator: you said “in some cases,” which means you’re allowing that it’s not all cases, so I would not see that as a derogatory generalization. I’d be interested if others would see it differently.
Very well said! And I would add that the less “professional” (in the sense of “distant” and objectifying) the professional is and the more human the professional comes across, the more successful the intervention. Which makes one wonder, is the real problem a lack of human connection?
I agree 100%. Without these bogus “diagnoses,” nobody can bill for “treatment,” which stops the train in its tracks. Of course, a lot of people’s salaries depend on keeping that particular gravy train rolling, so it won’t be easy!
Hey, I don’t disagree with you at all! I certainly don’t expect the psychiatric profession to ever admit to its own failings and venality – Venality is the basis on which it’s built, and the failings we recognize aren’t failings to them – they have succeeded beyond their wildest dreams, because they’re making money and everyone believes their bullcrap.
Great post! You have encapsulated my own feelings about the “therapy industry” quite well. I had to leave the field eventually because I could not stand it any more. A little dose of humility would go a long way, but humility seems to be anathema to those who are invested in “the system.” It’s the only place I know where you can screw your client over and then blame them or their “treatment-resistant depression” for your own failure.
Amazing – they somehow made the sexual side effects go away without altering the drug in the slightest! Could be a little “data management” going on here?
But, but, but… I thought “ADHD” was a “genetic brain disorder?” And if it’s not, why are we “treating” it with drugs? How did those 10% of adolescents (and 4+% of the control group!) develop “ADHD” if they didn’t have it at “baseline?” Could it be that “ADHD” isn’t inherited at all?
NO, NO, NO, look the other way people – drugs are god, bow down and worship, never mind about those pesky facts…
They are so tepid in their recommendations! They SHOULD be saying, “Prescription of SGAs causes almost instant disruption of metabolic function and weight gain is substantial in just 20 weeks. These drugs should NEVER be prescribed to children except in the most dire of circumstances, and if they are, children should be weaned off of them as quickly as possible. The dangers far outweigh any benefits, especially for off-label prescribing.”
Or they could go with, “These drugs are dangerous – don’t prescribe them to anyone!”
The idea is to discredit the widely held belief that psychiatrists are able to prevent or mitigate violence with their “treatments,” and in fact most likely INCREASE violence, which is contrary to what many subconsciously see as their mission. If a commission of independent scientists concluded that many murders and suicides would not have happened in the absence of psychiatric drugging, or that psychiatric drugging increased the rate of homicide and suicide, it would be a massive blow to psychiatric credibility, as they will be shown to have failed in their unspoken role as protectors of the populace from the purported dangers of the “mentally ill.” Of course, this would have to be combined with other efforts to show that “the mentally ill” aren’t even a definable category, that their “diagnoses” are a pile of crap, and that the odds of recovering from so-called “mental illness” appear to be greater the further away from psychiatric “treatment” one is able to remain. I’m sure you can see the potential impact on AOT orders if the “danger to self and others” was recognized NOT to be mitigated by the drugs, but in fact, made more likely.
Of course, this is just one action, and it may or may not have the desire effect. But that’s the concept, as I understand it today, and I think it makes a lot of sense. There are “fatality review” committees all over the country (I used to serve on one) and it would not take a lot of effort for these committees to simply add collection and analysis of legal drugs to their reviews. I am confident that the results would show what we know to be true. I am also confident that the psychiatric profession knows this and would fight such efforts tooth and nail. But perhaps in doing so, they will reveal too much of their hidden agenda.
Quite so. Carey has run stories critical to psychiatry before, but he’s in very sparse company. Of course, major media outlets get a lot of advertising money from Big Pharma, so this should be no surprise.
It is difficult to balance empowerment, which depends on assigning agency to the person making decisions and reminding them they have options, and recognizing oppression, which often makes people feel or believe that they don’t have choices that they actually do have. Striking that balance is key to being able to be helpful. Responsibility (literally, the ability to respond) is not the same as blame, but the term “responsibility” is very frequently used in a blameful manner. I find the use of these terms to be very delicate! But I do get what you are saying – it can be vitally important to help folks remember their power to make decisions, as long as its done in such a way as to make sure not to blame a person for being deceived and victimized by the lies and manipulation and force of organized psychiatry.
I think we are all gullible to our parents’ need to protect themselves. Because we need our parents to protect us. Unfortunately, much of what is called “mental health” issues stems from this very tendency, at least in my observation. Alice Miller writes eloquently about this – we protect our parents in order to make sure we’re protected, but we also know better on some level and end up resentful and confused. The smart ones eventually come to see this is what’s happening, but seeing it isn’t the same as working through it. It totally sucks that this happened to you, and I wish you continued success in sorting out what it means to you going forward.
I agree with this wholeheartedly. Unfortunately, I have had endless frustration in talking to most people coming from a social justice perspective about these issues. I get the impression that the “proper” social justice response has been defined for most people as avoiding “pills shaming” and supporting more funding for “mental health.” Has anyone had any kind of success in communicating past this kind of barrier?
At a minimum, they sure didn’t make everything AOK! It is amazing how many people who commit suicide have already been using psych drugs for years or even decades, and yet their suicides result in a call for more “mental health treatment.”
I think this gets at the most basic fallacy of the psychiatric system – that people’s “disorders” can be identified and categorized and that one “treatment” can be implemented for one particular category. This is observably untrue and extremely destructive. Different people travel very different pathways to get where they are, and each of them needs different things at different times. Anything that promotes healing has to humbly invite participation and be humble and open to being totally ignorant of what is really helpful to this particular person. The only person who knows what is helping is the person being helped. They may not consciously be able to tell us what they need, but if something’s not helpful, they will know it. It is arrogant for any of us to assume we know what will be helpful to another.
I think these results come from believing that a particular “school” of therapy is more important than who is delivering it. Rigidly adhering to a “CBT” or any other particular school of therapy is likely to be damaging to a certain percentage of people even if delivered “perfectly,” because it is likely not what some people need. Additionally, therapists who haven’t dealt with their issues are likely to mess up anyone they see, regardless of what approach they take. The researchers act as if someone doing “CBT” is the same as someone else doing “CBT.” In my observation, humility and flexibility are the keys to success in helping another person. Deciding ahead of time what is going to “work” leads to blaming the client when it doesn’t, as well as other damaging interactions.
This is a common phenomenon, and one of the reasons I really despise the DSM. It provides cover for the adults who are not doing their jobs, or are outright abusive. If the kid protests his/her treatment, s/he is “ADHD” or “Oppositional Defiant” or “bioplar.” Saves anyone having to ask the difficult question of why the child is protesting and what is going on in his/her life?
I have worked both with the elderly in nursing homes and with foster youth, and have seen massive use of these drugs for behavior control alone. It is disgusting!
I agree completely. It’s always puzzling that the data supports a conclusion that is inconvenient, and then it’s explained away or buried. Obviously, we’re not talking about science here. We’re talking about marketing, and in marketing, “bad data” is hidden and the good is overblown as much as possible, if not frankly invented.
I know of one person where this is true. Zoloft for migraines, and she started having random suicidal thoughts, which she found bizarre, because she was never suicidal. She also took months and months to get off, due to withdrawal effects of some severity. I think this is a good idea.
I agree completely. The whole concept presented here, that “side effects” can even be measured by clinicians, seems ridiculous. Since we are not “treating” disease states, the only legitimate measure of success is whether the client feels they have accomplished what they wanted out of the therapy. I can tell you for certain that any therapy that didn’t involve “distress” or “strong feelings involving the therapist” would have been a total waste of time for me. But another client might have different goals than I did.
My experience is that there are two kinds of helpers. One believes that helping means making people do what you think they should and using rewards, punishment and force to ensure compliance. The other kind could care less about compliance and focuses on helping the other increase personal power. These two subgroups exist in any profession and across the political spectrum. I try to hang out only with the latter whenever possible.
I think “contagion” is most likely to happen in environments which do NOT allow discussion of these difficult feelings, ironically. Too many MHPs are afraid of “negative feelings” and try to stop them instead of listening.
I agree with this from my own observation. My emotions often alert me to problems that exist or conflicts I have not dealt with or things that would be rewarding and my rational side helps decide whether or how these things can best happen. We’d all be crippled in our decision-making ability without both sides.
I will do so. I’m going to shut down the comments at this point, because we appear to have gotten very far afield from the topic of how to conduct a more welcoming community.
I don’t disagree with you there. As I said, generalizations are a more challenging point, more of a gray area, and the relative power level of the group in question and the person speaking will definitely play into how a comment is judged. I hope you did pick up that the comments I make toward survivors suggest more protection of their voices, while those toward professionals posting encourage developing more understanding and a thicker skin.
Thanks for the feedback. I hope you’ll be kind enough to let me know if you see me going too far astray!
You’re welcome. I really appreciate your mentioning Alice Miller. Some of her thinking has been very central to my understanding of why clinicians so often take the side of the parents or the authorities when clients/patients/victims report abuse by their parents or by the system as a whole. I have concluded that the best qualification for a therapist/counselor is that they have taken a good look at their own historical crap and have it under a good level of understanding and control.
I like the “Miranda Rights” idea. I used to do this when talking to kids who were in difficult situations with their parents (and sometimes with the parents, too) if it appeared they were going in a direction of reporting abuse. I wanted them to know I was a mandatory reporter and that there may be consequences that neither I nor they could fully control if they disclosed abuse to me. That way, at least they had the option of choosing not to talk about details, or presenting a hypothetical case instead of telling me what happened. It seemed the fairest way to give them the most control I could.
Midwives in the USA experience similar dynamics. Doctors can have babies and even moms die in their care and their colleagues just shake their heads and say how sad it is that “we can’t save everyone.” But any kind of bad outcome for a midwife is proof that anyone who doesn’t give birth in a hospital with a doctor attending is a fool, and that midwives are dangerous butchers who don’t care about the lives of their patients. It’s amazing they get away with it, but I guess it’s one easy way the people in power continue to exert their control over anyone who poses a threat to their unearned authority.
And another thought on this point: just because the person continues to feel suicidal or even plan suicide doesn’t mean we have NOT been helpful. The goal should not be to stop the person from doing something or making them do something. It should be to understand their viewpoint and priorities, and in so doing, perhaps help them understand themselves a little better.
I agree 100%. For whatever flaws it has, MIA appears to be the only site where survivors of the system and people who think the system is nuts rather than the people it claims to help can have this big a national voice. It is also kind of unique it the attempt, however awkward, to bring dissident professionals and survivors as well as their friends/family that support them together in one place. Not an easy task!
The point about “system failure” resonates deeply with me. Systems that can’t identify failure never grow and develop. If I can’t help a depressed person, it’s not because they have “treatment-resistant depression,” it’s because what I did was not effective. This is not a place of blame, but one of learning from experience, and if one really wants to be more helpful to those in distress, one must be humble enough to admit when one’s efforts were not helpful or made things worse.
BTW, BRILLIANT idea to ask him what he wants to do before he dies! I’m definitely going to have to remember that if the occasion arises in the future.
I am glad the author included the sad and lonely and abused childhood that Williams experienced. While it is obvious that the environment always interacts with the person’s goals, intentions, preferences, etc., the correlation between what is called “mental illness” and childhood adversity is enormous. Those who wrote about Williams purported “mental illness” after the fact almost completely failed to provide this important context in their zeal to advocate for “treatment” for Robin’s “brain disorder.” I found it disgusting, and appreciate this more nuanced and humanizing biography.
In other words, kids who are more likely to take risks as children are more likely to take risks as adults. Wow, enlightening results here. In other news, kids who run fast tend to run faster as adults, kids who like to paint are more likely to paint as adults, and the sun is very likely to come up in the East tomorrow morning.
I think that is the healthiest response. Of course, then you get labeled with “Anosognosia,” but if you’re far enough away not to hear it, it doesn’t matter what they call you anymore.
All very true. We seem to toss out any respect for all the good work on developmental expectations and the range of appropriate development as soon as they reach Kindergarten. Suddenly, everyone’s expected to be on the level the teacher wants, and if they are not, they have a “reading disorder” or “mathematics disorder” or “Oppositional defiant disorder” or “ADHD.” And I agree, school for me was AGONIZINGLY dull! It’s only because I was possessed of an extraordinary level of self control as a child that I didn’t run screaming from the room!
You might be interested to know that a good study of employees who had been diagnosed with “ADHD” at some time in their lives. The employer ratings were compared to non-ADHD employees and were found to be essentially the same for both. The researchers posited that once the “ADHD” youth were freed from the bounds of the school system, they chose jobs that allowed them to take advantage of their strengths. So when they were able to select the environment, their “ADHD” had little to no impact on their ability to perform up to standards.
And you’re right, our kids were fortunate in many ways. What I find sad is that our school systems are so rigid that they are unable/unwilling to do what is necessary to adapt to these kids’ needs. It’s already a known fact that open classrooms are the best setting for most of these kids. Instead of drugging them, why aren’t we creating open classroom environments so they can succeed in school?
I always found it particularly egregious when they’d put someone on Zyprexa or some other fat-inducing antipsychotic drug, and then talk to the client about “bad food choices” and “needing healthy exercise,” as if being fat were somehow the fault of poor eating habits or laziness. I often brought that point up, but it only seemed to get the staff upset with me. Almost no one (except me or my CASA volunteers) ever told the kid they were beefing up due to the drugs.
Posting as moderator here. If you re-read my blog, you will see very clearly that no one will be moderated for posting antipsychiatry comments (or pro-psychiatry comments, either). You can also see my lean toward protecting survivor voices even if they are perceived as expressing anger toward the psychiatric profession, and advising professionals to develop a bit thicker skin. I’m not sure how this can be characterized as protecting professional voices at the expense of survivors. It seems rather to lean a bit in the other direction. Am I missing something here?
Maybe the profession should start off aiming to PREVENT brain damage by stopping this practice until it is proven safe, rather than continuing to potentially damage millions of brains until someone proves it is not.
You bet. It’s a very sore subject for me, too. We found that alternative schooling was absolutely essential to maintaining any kind of sanity, and home schooled for years. We also helped create a few different alternative school environments where kids got more control of their own educational goals and activities, as this has been proven long since to be the best environment by far for them (educators asked to distinguish between “ADHD” and “normal” kids back in the 70s were unable to do so in an open classroom, while they were 90+% accurate in a standard classroom environment). We also found that standard disciplinary tactics were often totally ineffective, and we had to be VERY creative. We used to often “bet” each other or our son that he could not or would not do what we wanted him to do. He hated us predicting anything about him and enjoyed making us “wrong,” so this worked pretty well. The best we ever came up with was what we called “energy points.” He started every day with zero energy points. If he did something to make me feel more energetic, or saved me energy in some way, he got “plus one.” If he did something to drain or waste my energy, he got “minus one.” If he got below zero, I stopped doing ANYTHING for him – talking, making lunch, driving him anywhere, playing with him – I did nothing at all. Of course, arguing about receiving a minus meant another negative point. He then had to do something to elevate my energy in order to get back up to zero or above. This usually meant some kind of work, and doing work in and of itself often brought him out of his negative state. In fact, I used to try and start the day giving him a useful task or two in order to set the tone. The only thing I had to remember was not to go more than minus two, because then he felt like he was so deep in, there was no point in trying.
You know your child and will figure out what works. Schools don’t know your child or try to get to know them, and the DSM diagnoses simply make it easier for them to blame the child and evade any kind of professional responsibility for figuring out how to teach him what he needs to learn. I encourage you to seek alternatives. I don’t know that we would have survived if we had not.
Thanks for sharing your story, and I wish you the best of luck in finding a better path forward!
I am quite sure that it does. In fact, if you wanted to drive someone to “mental illness,” telling them constantly what they were doing wrong or telling them what was “wrong with them” would be a very efficient method!
I think they were hoping to prove that “ADHD” kids did better when receiving “treatment.” They were, not surprisingly, sadly disappointed. But ever hopeful, rather than admitting that they have their answer and need to give it up, they will continue to apply for and receive grants to “study” this “condition” that is only definable in the vaguest and most subjective terms, and whose “treatment” apparently does little to nothing to improve the ostensible “condition” it is supposed to “treat.”
Of course, trying to get anything about systematic traumatization into the DSM is going to be a failure. PTSD only got in there due to war vets, not abused children and partners. It is absolutely against the guild interests of psychiatry as a profession to give any acknowledgement of the role of trauma in creating “mental health disorders.” If they did, the entire edifice of the DSM would collapse under the weight of its on corruption. They only hold their power as long as they can convince people that they can “diagnose” people with different “disorders” that are driven by “brain diseases.” As soon as it becomes clear that traumatic experiences and social stresses are at the center of most “mental health problems,” the psychiatric leaders are exposed for the charlatans that they are. Plus the drug companies lose profits, and we can’t allow THAT!
Posting as moderator here. Are you talking about in the articles, or in the comments section, that you see the “dialog degenerate into projections and defensiveness?” I’m interested because if it’s in the comments section you’re talking about, I want to be looking for this tendency, and would really appreciate it if you let me know when you see it happening in your perspective.
And if it is sometimes “neurological,” so what? Species survival depends on genetic diversity. Everyone has challenges and strengths. My kids (two of which would definitely have qualified for “ADHD” diagnoses) always heard what they were good at and what they needed to work to improve, and THEY were a big part of deciding for themselves what those “work ons” were and what they were going to try and do to make improvements.
And there are upsides to any personality tendencies as well. The unfortunate reality for so-called “ADHD” kids is that they are forced to contend with a school system that specifically does almost everything it can to frustrate them (albeit mostly without evil intent. Mostly.) “ADHD” is pretty much synonymous with “hates a standard classroom.” Put those same kids in an open classroom with freer choice and movement, and “ADHD” is almost invisible. That’s what we did with our kids (homeschooling or alternative schools with open classrooms) and all three are doing very well as adults, with nary a milligram of stimulants. Not saying it was easy, because it wasn’t, but just because a kid is frustrating for adult does not make him/her “mentally ill.” Sometimes they are just being normal and it’s inconvenient for the grown ups. I think it’s the adults’ job to adapt.
Thank you very much! I worked very hard on that blog, and it’s nice to have it and my prior comments appreciated. So far, it appears everyone is adhering very well to the guidelines, which is great!
I relate very much to your comments here. In particular, it’s become clear to me that verbal connection between a counselor and client, or any person trying to help and the “helpee”, is insufficient. It is the emotional connection on a real level that matters the most – that sense that the other person really GETS where you are at on a visceral level. And I think that’s also what babies are looking for, and you’re right, their very survival depends upon making such a connection. My sense is that it is terrifying for a baby not to be able to connect with a caretaker many, many times a day, essentially whenever they need something. Once the baby gets the idea that the parent figure is going to respond every time (or almost every time), s/he learns to relax some and be able to tolerate distress without panicking. I think that life can be very difficult for those who never have this primary experience of safety and trust.
The analogy is, unfortunately, all to apt. Including the fact that the general populace is not going to be protected by their cowardly avoidance of the gang. But as in the movie, it’s hard to convince the regular folks to stand up to evil, especially when evil has such firepower!
Increased “civility” is the goal here, not discouragement of people’s views. I see what you mean about people feeling unsafe in sharing their stories at times. A recent acquaintance of mine wants to submit under a pseudonym for exactly that reason. I just want to make sure everyone knows I have no interest or intent in moderating away anyone’s voice, and I have a particular interest in protecting the space for survivors to feel safe in sharing their stories, since those are the voices most likely to be silenced in other arenas. I think my blog above reflects that intent.
What would you suggest could be done to make it feel more safe for survivors to post?
I think you make a great point – not only the scales themselves, but the decisions of what to “measure” are very much culturally bound, which prevents them from ever really being “scientific” in the sense of truly objective. And I also have found, for me and for others, that thinking in terms of what I don’t like and want I want to change and what I do like (learned this one a LOT later in life) and what I want to preserve and appreciate is much more helpful that thinking of “what is wrong with me?”
I’m sorry that my comment came across that way. I don’t believe and never have that “some people are fundamentally bad.” I agree 100% that intergenerational trauma is usually at the core of any misbehavior by children, and I’m the biggest advocate you can imagine for family work and attachment parenting and dealing with childhood trauma. I was perhaps being too flippant in my statements, as I was thinking more about the attempts to characterize “ADHD kids” as “needing treatment” to avoid bad outcomes. Two of my three met the criteria for ‘ADHD’ and we did a lot of work to avoid getting them enmeshed in the psychiatric system/paradigm, including some very creative discipline and home schooling. Lord knows what would have happened if we’d put the oldest in school – he probably WOULD have gotten at least an “ODD” diagnosis.
Anyway, my intention was not to insult kids or their parents, but to point out that if a certain behavior occurs as a child, predicting that the same kind of behavior would continue as an adult is not really an accomplishment. I most certainly should have chosen my words more carefully, and I apologize for that.
Thanks again for sharing this. It only just occurred to me yesterday how sensitive this issue with “likes” could be for many people. You have stated it very clearly here, and I appreciate this. Again, if you ever feel that I am discouraging certain voices because of their position rather than the tone of their presentation, PLEASE tell me right away.
I will add that I intend to always communicate directly with the writer about their intent in writing anything I feel needs to be moderated, unless it’s really blatant and obvious. I want to make sure no one is feeling they are having posts removed without any opportunity for feedback. It’s kind of a big deal to me to remove someone’s post, and I know I’d want to be fully in the loop about the whys and wherefores if it happened to me. Which it has, BTW.
Again, thanks for letting us know so clearly what your concerns are. I’m sure it will be a further topic of conversation among the staff.
Nixon made his name on the House Unamerican Activities Committee when he was a representative. He was a total McCarthyite. My understanding is that McCarthy finally buried himself when he started attacking folks in the Army, who had sufficient organization and power to defend themselves and take him out.
Thanks for sharing that. I think it’s important to consider how powerless WE feel as professionals with degrees and positions of respect, and then consider how it must feel to be a CLIENT in such a system where the supposedly powerful people themselves are feeling oppressed! At a certain point, I just couldn’t stand it any more. I felt like I was colluding with the occupying army.
Thanks for pointing that out. Of course, it was not a conscious intent, but we all have lots of these images in our language and there is a lot of confluence of aggressive and sexualized language, particularly toward gayness in any form. I will be more thoughtful of such phrases in the future.
As a moderator, I absolutely see your point, and I encourage you to keep that viewpoint in the editors’ minds. We are all human here, too, and it’s sometimes difficult to anticipate the impact a particular piece might have on the readers. All I can personally assure you is that I have no intention of creating an special protections for anyone based on their role as MH providers. They are here on the same terms as the rest of us. And my experience so far is that my colleagues here are very open to feedback regarding what articles are posted, so I encourage you strongly to let one of the editors know if you feel an article that’s posted is or has been offensive to you or to the survivor community in general. It’s very easy for those who have not been there to misunderstand why some subjects or comments or attitudes might be hurtful to those already hurt by the system.
Most “treatment providers” have no idea what “individualized treatment” actually means. I think they believe it’s about choosing the drugs they give you on an individual basis rather than giving the same drugs to everyone. I’m not surprised you have not experienced anything that looks like it.
Speaking as the moderator here, I wanted you to notice that I never used the term “civility” in my blog, and that was a very purposeful decision. I don’t want us to ever convey that it’s not OK to express anger and rage toward those who are in a position to harm us. There is, in fact, no actual shift in what will and won’t be allowed – I was being very specific in stating that the main issue is PERSONALIZATION, not the position being expressed. If you will re-read my blog, you’ll see that I was very clear about stating that any position on the spectrum is welcome to be stated and supported, from “psychiatry saved my life” to “psychiatry should be abolished.” I had hoped that would provide some reassurance that there is no intent to censor or discourage any viewpoint here. I’ve seen some legitimate concern expressed that professional voices have felt more protected in the past, and I specifically addressed that too, by suggesting that we be very cautious about attacking people’s personal experiences, while counseling professional commenters to develop a thicker skin.
It is hard to see how else to conduct a discussion forum without some expectation of decent treatment of posters. Otherwise, we get de facto censorship, as people with certain views will be too intimidated to ever post. Like I said in the blog, I’m sure this happens anyway with “mainstream” folks – 5 minutes reading comments or even half the articles would drive most of such committed pro-DSM folks running from the building! But I want people to be able to post whatever content they feel is relevant, and I want a principled discussion of facts and experiences to be the way issues are resolved, rather than by ad hominem attacks or resorts to degrees or other authority or humiliation and condescension. I have faith that the truth will win out in any such discussion, and it seems to me that sinking to personal attacks actually undermines the power of the truth to break through the mythology that passes for “mental health care” these days.
What’s the other solution? “Moderating” anyone who is not sufficiently ‘antipsychiatry’ or who expresses a view that people here don’t like? It seems to me that allowing an open expression of viewpoints to compete in the “marketplace of ideas” is the best way to boil down the truth and break through the psychiatric religion’s dogma. While I don’t relish the idea that folks with pro-psychiatry views come and post here, I think enforcing the commenting policies on everyone will in the end empower those who can be most easily shouted down, namely those who have directly experienced the massive power of the psychiatric juggernaut aimed at their bodies and their persons.
I’m seriously asking, though. What do you think would be the best moderation policy? What could we put in place that is better than saying, “You get to say anything you want, but you can’t attack people in a personal way?”
True enough! And there is lots of money in selling drugs, while there’s a lot less in investigating whether drugs really work or whether other approaches work better. There are many effective “alternative” approaches to pain management that have been known about for decades, some for centuries, but unless someone can get a patent on it, we’re probably not going to see mainstream medicine supporting it any time soon.
Apparently not. Or else they are writing only to their colleagues, considering the actual patients/clients to be too far beneath them to bother talking to.
I think doctors work in a ridiculously over-competitive and stressful environment, and at some level recognize the degree to which their profession has become subservient to the all-powerful pharmaceutical industry. Psychiatrists in particular, at least those with consciences, must feel pretty hopeless at the utter ineffectualness of their approach, and their inability to pursue another course without quitting their profession or going completely rogue. I would further guess that the profession weeds out those with high “emotional intelligence” early in the process, so those who remain will have relatively high authoritarian traits that prevent any real self-examination. Sounds like a pretty hopeless place to be.
Though I do find it interesting that articles I’ve read about physician suicide rates all talk about the stresses of the training and the job, the lack of sleep, etc. but when these same physicians see “depressed” patients, they spend all their time talking about “bad brain chemistry.” Kind of a disconnect there, eh?
That is exactly how I experienced it. I held to my integrity as best I could, but it was not safe to talk about certain things, and certainly not safe to challenge the status quo. When I did so, I was most definitely marginalized. To maintain my ability to empathize with the clients and at the same time fend off the wrong-headed approach that was almost a 100% agreement among the staff was a constant stress that eventually drove me out of the field entirely.
I’m just writing as myself here. I’m a little confused as to where there was a desire expressed to court NAMI or “the pro-psych crowd” to become “fans” of MIA. I’ve seen what happens to anyone who comes here to post with a pro-NAMI or pro-medical model viewpoint – they are properly put in their place in short order, and I don’t see anything suggesting that will stop happening. I’m honestly asking this question – where do you see that position put forward?
In fact, what the title REALLY should read is, “Experts show that ADHD diagnosis does not predict adult functioning.” That’s what the experiment showed.
Posting as moderator here. I would have to say that I have no intention of making the comments section “less controversial or passionate” or even “less lively.” I think if you read through my blog, you’ll see that there is still plenty of room for controversy and passion without being insulting or attacking.
You make a good point regarding more specific details of the feedback perhaps being shared. As for the survey questions, also legitimate points worthy of careful thought for future surveys. Crafting survey questions is an art form that I certainly have not mastered by any stretch of the imagination!
Do you have hard data on that point of chronic pain not being specifically linked to suicide? I’d love to see a link or two if you do. The claim of such a connection is very common in claiming the need for “antidepressants” for those with chronic pain, and I’d love to have something scientific to use against such arguments if you have it.
I am absolutely committed to the same standards for everyone, and if you see me flagging from that commitment, please let me know right away.
Personally, (meaning that I’m NOT representing MIA below), I see any advocate for AOT or “Anosognosia” or any other kind of dehumanizing crap having their views quickly and effectively dissected by this group without any help from me. That’s the beauty of an “open forum” to me – those who claim such positions need to defend them, and there is more than enough intellectual clout and knowledge of the real data, as well as brutally contradictory personal experiences, to show up any such claims as the BS that they are. The reason I think it’s important to have moderation on these comments is that such presentations come across MUCH more effectively when they are presented without personal attacks or rancor. In the field of psychiatry, the truth speaks for itself very loudly, and our job is more undermining the mythology that the truth doesn’t fit with. Unfortunately, calling names and attacking categories of people makes it easier for the myth-makers to say, “See, those guys are all crazy, don’t listen to them.” I’ve always found that a passionate but respectful recitation of the true facts, followed by some solid Socratic method towards the misguided poster, is much more effective than calling them names.
It seems the proper conclusion would be, “We (the professionals) really suck at predicting anything to do with ‘depression’ and should give up on our ridiculous tests and just ASK people what’s going on, since that appears to give much more accurate and useful results.” Your point about pronouns is very well taken, as well – why does “we” not include the client “we” are supposed to be helping? Perhaps this is the center of “our” difficulty in predicting “depression?” Perhaps “we” need to give up on the idea that “depression” is a thing to be measured in the first place?
I just scratch my head when I read these things. Are they not scientists? They are SO biased, they are searching for certain results, and when they don’t get them, they are “disappointed.” This is actually a very helpful study, because it shows that “having ADHD” as a child is NOT associated with negative long-term outcomes. The conclusion should not be that “predicting the course of children with ‘ADHD’ remains a challenge.” It should be that “Our original hypothesis was disproven – an ‘ADHD’ diagnosis does not lead to worse outcomes as an adult.”
As for the proviso about children with “conduct disorders,” that’s meaningless, because it’s been determined long before that kids with ‘ADHD’ and ‘conduct disorder’ diagnoses do have later troubles in live, while those who “just have ADHD” do just as well as their peers. And when you consider that “conduct disorder” just means kids who are mean and selfish, what we have is that mean and selfish kids grow into mean and selfish adults, a trivial result that should surprise no one. It was, in fact, very smart to isolate “ADHD” in kids not diagnosed with “conduct disorder,” because now we can see that having the “ADHD” characteristics in and of themselves has NO EFFECT on whether or not a kid turns out to be a successful adult.
But I guess the authors just can’t accept the conclusion that the data tells them is true. They need to hold onto their reality despite the data, which means they’re not scientists after all.
Right, we wouldn’t want people trying things and not always succeeding – it will torpedo their self esteem! The proper action is to discourage them from trying anything at all by telling them they are incapable of both the action they want to AND of handling the disappointment if they are unsuccessful. THAT is a SURE way to make someone feel good about themselves!
Seriously, if you wanted to make someone feel as bad about themselves as you can, it would be hard to imagine a more effective course of doing so than telling someone they can’t handle trying something they are not assured of succeeding at. It makes me wonder how “accidental” this approach could be. It’s pretty freakin’ evil!
The government can apparently read anything we post anywhere if they’re really interested. I have personally stopped worrying about it. I’m sure they are bored to tears with most of what I write.
I wonder also how a refocusing of attention away from external environmental factors and toward brain chemistry manipulation contributes to people losing hope and increasing self-blame for their “condition.” Perhaps it’s easier not to feel hopeless if you can find an external condition that you CAN change and focus your energy on regaining control in that area. I’ve found that the most helpful thing for people who are feeling depressed is acknowledging that their feelings are a normal or at least not unusual reaction to the conditions of their life, and then focusing on one aspect of their lives, no matter how small, that they can exert some control over. Suggesting that “it’s all in your brain” may create a sense of hopelessness, as what can one do about one’s own brain chemistry?
Of course, there really ARE things one can do about one’s own brain chemistry, but that’s material for a different blog.
This was pointed out by another reader. I thought I was being “funny,” but it turns out I was being insensitive. I appreciate your observation – it shows how deeply these concepts of power are embedded in our culture and how easy it is for a person in a power position (like me) to make such “jokes” without understanding the impact it might have on someone in a less powerful place in our social hierarchies.
Your last point is probably a good one. And I wouldn’t mind using the DSM as a conflict resolution tool in the way you suggest, but I would hate to send a penny to the authors. Perhaps we can use toilet paper instead – the value would be the same, but at least the toilet paper manufacturers are honest about its intended use.
I very much appreciate your support and advice. Sarcasm is probably the hardest thing to moderate. And I agree that there will be some hot items where this could get VERY interesting…
Exactly what I’m talking about. Thanks for clarifying and extending the concept – credibility of the poster AND of our site is what is at stake! I think we are MUCH better off when we are specific and pointed in our criticism. When we drop to ad hominem attacks and sweeping generalizations, it is much easier to attack or dismiss us as unstable or uneducated. First-hand experience with specific details is what really gets past people’s defenses.
Sometimes anarchy is, indeed, what is needed. Unfortunately, anarchy and discussion boards don’t go together very well. Perhaps the discussion board can be a place to organize some effective anarchy, eh?
I don’t intend to be a censor. I intend to make sure that people aren’t mean and nasty to each other. That’s all. It really won’t be that different from what’s been happening all along. I’m just trying to be clear about what I’m intending so no one is surprised. So far, I’ve moderated two posts out of the last 5 days, so I don’t think it’s going to be as much of an impact as some folks are imagining.
Thanks for your perspectives – you are clearly a person of great intelligence and learning. I’ve still GOT to read Hillman – got any suggestions on where to start?
Thanks for your comments and your willingness to give me a shot!
I can say from my viewpoint that I don’t think there is any resistance to the idea that “rethinking” may include abolition. Bob and all the top editors looked over this blog and supported it 100%. I believe I’ll be supported fully in allowing content from across the spectrum of opinion, as long as it is stated within the guidelines.
I agree (and said so in the blog) that there is a lot more “wiggle room” in the insulting a group concept. A big part of my desire to make this a priority is that I believe making generalizations about “the mentally ill” or some diagnostic category is very much accepted in our society, and not even noticed in many cases. So I’d really appreciate it if you let me know if you feel like I’m missing such instances. I think it is very good discipline for anyone to think carefully about generalizing, because generalization is the beginning of bigotry. Even if the generalization applies to 80% of a group, there is still 20% being unfairly disrespected. That’s my take on it, anyway. So I really want us to be specific about who we are talking about and to own our own experiences, whether we’re professionals or survivors or family members or just interested parties checking out the site.
You may also note that “feeling insulted” isn’t the standard for moderation. I provided 5 different options for people who feel insulted, including reporting the comment. Just because it’s reported doesn’t mean it will get moderated. The one thing I wish I had was the ability to communicate to the person reporting a comment to find out what they are upset about, because sometimes I can’t figure out what the issue was. I suppose someone could e-mail me with their concern to add clarification. Anyway, my point is that the standard is not someone FEELING insulted, it’s if a reasonable person would consider it insulting. And it is sometimes going to be a close call. This is why I included the “thick skinned” comment in the blog.
Anyway, I’m going to do my best, and I’m sure I’ll make errors, and I’ll count on you to help keep me on mission. Thanks again for your comments and your good wishes!
As I like to say, “Generalizations are always wrong!”
I appreciate your support. I think the distinction between attacking ideas vs. people is the most important part of this approach. I know that there is some concern that certain views are more likely to be edited because they are uncomfortable for professionals to hear, and I wanted to make clear that is in no way ever going to happen.
I agree. Most of the “data” in support of long-term antipsychotic use is based on withdrawal studies, which completely fail to take supersensitivity and withdrawal effects into accounts (primarily because they want to pretend that such effects don’t actually exist). It’s pretty warped!
SSRIs are associated with an increase in behavior that gets labeled “autistic.” Massive increases in SSRI use by pregnant women may be a contributing factor.
I think there is a LOT of room between “expand the mental health system” and making career patients or “peer specialists” who support the system and the suggestion that some seem to make that any form of assistance offered to people experiencing mental or emotional distress from a professional source is de facto oppression. I guess that’s my definition of “strict abolitionist position” – no professional assistance may be offered for any form of mental/emotional distress. My understanding is that you have no objection to the latter when force is eliminated. I have absolutely agreed with you that the use of force as “treatment” (which includes manipulation, threats, lying, enforcing “diagnoses” to get insurance reimbursement, and so on) is wrong and needs to be eliminated.
What about my example of altering the system to meet the needs of kids (or adults), rather than “treating” those who don’t “adjust” to the authoritarian system that we’re supposed to all love?
And as for “playing favorites,” we’ll have to see how it plays out, but I have trust enough in the MIA community to believe that well-articulated antipsychiatry comments that are truthful and compelling in their presentation will get plenty of “likes”. They’ll definitely get some from me!
If there is no coercion, the decision whether or not something is “wrong” would be up to the person seeking “treatment” or “help.” Of course, there are also ways of making one’s life better that don’t start off with the assumption there is something “wrong” with you to begin with. For instance, we know from research that so-called “ADHD” kids are virtually indistinguishable from “normal” kids in a less structured classroom where kids have choices about what they do and how long they do the activity. Such classrooms have been around since the 70s and before, but they fell out of political favor. Would it be too “revisionist” to create classrooms that these kids actually enjoy being in? This could “cure” most cases of “ADHD” without any diagnosis or force whatsoever. (Of course, there is also the much larger question of the use of force in the educational system, or with kids in general, but that’s a bit bigger than this moment’s discussion.)
There are all kinds of ways that people seek help, and some people find things helpful that I don’t. I think that should be up to the individual, but I also think that sharing these viewpoints and experiences is very valuable to many who read here. I think that’s the part of the discussion we lose out on if we insist on a strict “abolitionist” viewpoint. Besides which, a lot of people start out as “revisionists” and become more radical by reading stuff by folks like you. I don’t think we want to chase those people away because they are not “radical” enough yet, do you?
Yeah, how do they get away with that? Not, “I wasn’t able to help you” or “I haven’t been able to figure out what you need” or even “We seemed to be unable to connect,” but instead, “You have ‘treatment resistant depression?'” What a freakin’ cop out!
“Decent people following orders” is the core of why the system doesn’t collapse of its own weight. If these “decent people” followed their instincts, there would be a huge uprising against the system as it is. I am not saying it is easy to resist, as I was an “insider” for many years and found that resistance to the status quo was punished in various ways, from ridicule to ignoring to dismissing me as “one of those anti-med guys.” I had very little support from colleagues, even though behind the scenes I found that many agreed with my basic principles. It’s scary to stand up, but if you don’t, it’s tacit approval of the system. That’s why I eventually got out of the “mental health” world and into advocacy. I could no longer deal with the moral compromises I needed to make to stay in there, even though the ones who managed to see me instead of someone else were probably much better off because I was there.
It’s a tough line to draw, but I eventually concluded that participation was becoming collusion, and I had to bail.
I have heard many people make this exact comparison, including people who have experienced both. Are you suggesting that the people in the hospital ER have no other option besides Haldol injections, or that we ought to be well informed enough to know this and therefore avoid getting taken to the ER?
I agree with you – some medical diagnoses do have their own attached stigma. But I think psychiatric diagnoses are the only field where stigmatization occurs primarily BECAUSE of the label put on a person. “AIDS” is associated with being gay or being a needle-user and those categories are a primary the source of the discriminatory attitudes, although any communicable disease can certainly create anxiety and discrimination (remember leprosy!) My point is that in the realm of psychiatric diagnosis, this trend is avoidable by simply choosing not to toss the label at a person. A person with AIDS has AIDS, and there may be attached discrimination and prejudice, but the person gets the label because they literally have something wrong with their bodies that is observable and undeniable. But someone who feels anxious in social situations – well, they’re ANXIOUS, it’s a normal human emotion, and it’s not necessary to go out of our way to identify that person as “disordered” and bring on additional distancing and discrimination when we could to the opposite by reminding people that everyone is anxious sometimes and that it’s OK to be anxious and that we can all be sensitive to shy people and help create circumstances where they will feel more welcome.
So yes, I get it, there are stigmatizing labels associated with medical diagnoses. But I see that as different from the CREATED stigma that result from the idiotic practice of labeling people’s behavior or emotions as “disordered” instead of trying to help the person or alter the social circumstances that create such anxiety/depression/distress in the first place.
Right you are! “Antipsychiatry” has been rebranded by the psychiatric profession as “anti-science,” which ironically and subtly supports the idea that psychiatry is somehow scientific despite it’s own admission that not one of its diagnoses can be objectively distinguished from another diagnosis or from “normal” (the admission is right in the intro to the DSM!)
I’m not sure I agree, Frank. It appears entirely possible that the “likes” would go toward those posts which do have an abolitionist slant. It’s also possible they’d go toward the ones which are most thoughtful, regardless of the position taken. I think it will be interesting to see how it pans out, but it also sounds like you don’t have to “filter” if you don’t want to. My guess is that it will bring more readers who don’t want to or have time to wade through every comment.
Of course, I agree with you that the system as it is has essentially no redeemable qualities. Forced drugs, locking people up, lying about “causes” to make money, creating permanent customers, creating “diagnoses” that have no basis in reality, blaming the resultant prejudice and discrimination that arises as “stigma” and asking for MORE money to continue to stigmatize their “customers,” ignoring trauma and social conditions… it’s hard to think of one thing “the system” does right. But I’m also very willing to listen to people who see it differently, not because I necessarily agree with them, but because their reality deserves to be heard, and also because anyone who is having problems with the current paradigm is a potential ally.
I actually align pretty well with your “free choice” concepts, which does allow for various kinds of services to be sold to people who feel they need them. Some of the “rethinkers” who post here are developing that kind of service, and I always find it interesting to see what people are finding helpful. My biggest objection of all to the system as it is would be that it assumes that we can classify people based on their behavior and emotions and somehow know that they all need the same “treatment” regardless of their individual circumstances. Anything that moves us in a direction AWAY from that concept and TOWARD an individualized and empowered approach is worth reading about in my book.
Richard, a great outline of the social/emotional motivations that may lie behind “manic” behavior! We’d be so much better off if we started there. But who would make profits off of helping people understand their motivations better?
So “manic” is a kind of shorthand to describe this set of behaviors. I get that. The question, I think, is whether by using this kind of technical jargon as shorthand, we induce or support the belief that the problem lies solely or primarily in the person showing the behavior. To take a less loaded example, “ADHD” can be used as shorthand for a certain set of behavior that tends to occur together. However, saying that this kid “is hyperactive” or “is ADHD” or “Shows ‘ADHD’ symptoms” immediately brings the child in as “the problem.” As I’m sure you’re aware, family systems theory talks extensively about assigning roles to different people in the family, including the role of “scapegoat” or “identified patient.” I believe the same thing happens among professionals, and of course, the likely “identified patient” is the patient, the client, the person with the least power.
So for me, I think we’d be better off saying, “Mary is staying up all night, engaging in seemingly random sexual encounters, and speaking rapidly without allowing interaction” rather than “Mary is manic” or “Mary’s having a manic episode.” I know it costs more words to say, but it requires us to be more precise and doesn’t imply any particular “wrongness” of the behavior, but simply allows it to be described in a less judgmental way. It also, I think, encourages a further discussion of causes and environmental conditions, rather than automatically situating the cause with Mary.
From one point of view, it does make sense. I guess the question people struggle with is whether a real change in how things are done can be accomplished without challenging the “guys with power.” I think on an individual level, your approach is probably very wise. However, it seems unlikely that the people making so much money on this racket are going to give up their power without a fight. So if enough people get together, maybe it DOES make sense to take on the “big guns.” Hope that makes some sense!
We should start by listening to them. Children are the most disempowered group in the world. The odds are tremendous that their feelings of hopelessness have to do with being in a hopeless situation that they are unable to fix or escape.
“Mania” is simply a description of a certain set of behaviors that tend to occur together. I don’t think anyone said a person who is struggling doesn’t need any help. However, I think using the term “mania” does tend to pull things into a medicalized viewpoint. It seems more legitimate to me to talk about exactly what is happening for the person, rather than creating a generalized category like “mania.” It’s similar to talking about “depression” as if it were a “thing” such that everyone who “has depression” is the same or very similar. It also suggests that “depression” (or “mania”) is the problem, rather than a manifestation of a set of much more complex circumstances that can’t be described by a single word or phrase. Calling it “mania,” I think, discourages looking for causes and environmental conditions and focuses the attention on the “wrongness” of the behavior.
I agree, it is easy to make generalizations about therapists. There is a huge range of therapists out there with different philosophies and priorities. It is unfortunate that more and more new therapists are being trained in the DSM terminology and that insurance companies are expecting DSM diagnoses for payment. Which means that only people with enough money to afford private pay can have the range of choices that are available. But it is certainly not right to generalize about therapists as a group – they are really quite diverse, especially once you get outside of a public “mental health” agency setting.
I had a similar reaction. The ability for the first child to act out his fantasy knowing that his family is there to back him up and help him out of things go badly has to make a huge difference in his ability to let him self go in this way safely. And there is a HUGE correlation between sexual abuse and what is generally considered “psychotic” behavior. (I won’t even get into the gender bias in the descriptions of the behavior, as I feel it’s been covered well by two other posters). While I respect the effort to contextualize “manic” behavior, the author really doesn’t provide any means to differentiate between “healthy” and “unhealthy” manic behavior. Which reinforces my own belief that behavior isn’t “healthy” or “unhealthy,” it is just how someone acts, and is meaningless without understanding their motivations and experience and the social supports and/or barriers they may be facing.
Yeah, too bad most psychiatrists don’t seem to have gotten this memo. I have rarely seen any psychiatrist pull back on antidepressants or stimulants due to an induced manic episode.
As baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were that common, more people would have it!”
It is fascinating how this discussion completely avoids the subjective and speculative nature of these diagnoses as the major reason why their is a discussion of “to diagnose or not to diagnose.” Diagnoses shouldn’t be decided on based on how someone FEELS! They should be decided on by an objective observation of a specific problem that can be accurately identified and potentially intervened upon. No one talks about whether a “cancer” or a “flu” diagnosis has potentially positive or negative social consequences! When you have the flu, you have the freakin’ flu, and we all know what that means (more or less) and what your options are. It is only the subjective and frankly disrespectful and invalidative nature of these diagnoses themselves that lead to such questions. No one feels their identity enhanced or invalidated by a diagnosis of “cancer.” They might be able to connect with other cancer patients because they have something in common, but the diagnosis isn’t given for that purpose. It’s given so they’ll know what they’re up against and have some idea how to attack the problem. It is ridiculous to talk about the social benefits/costs of any real diagnosis. The fact that it is even a discussion for psych diagnosis indicates the complete lack of scientific validity behind the diagnostic process.
It was proven decades ago that stimulants don’t affect “ADHD” people any differently than “normal” people. There is no “paradoxical effect,” as seems to be implied by this article’s title. As you say, any difference that may exist is at most attributable to tolerance effects if someone has been using for a while. So if it impairs cognitive performance on “non-ADHD” students, it impairs it for “ADHD” students as well!
The fact that professionals have to be so careful about giving out legitimate information shows just how oppressive the system has become. If we, the ones supposedly with the power, are afraid to speak up, just think what that would mean about the position of the poor clients, whose lives can be destroyed by saying the wrong thing!
This is pitiful but not at all surprising to me. That’s how crazy it has become. The doctors are gods and no one can question them, or even provide missing parts of “informed consent.” It is an incredibly dangerous scenario, and we see the kind of damage that this set of assumptions can do.
I agree 100%. My first question to anyone I’d see now in a therapeutic setting would be, “What other ‘treatment’ have you received before? And how did you feel about it?” Same question re: diagnoses. It’s essential at this point, because so many have been harmed by their “treatment.”
We had our own “Adam.” He was definitely a tough kid to work with, and our own issues definitely contributed to his lack of discipline. I really don’t subscribe to this “don’t blame the parent” concept. OF COURSE, it has something to do with how you’re treating the child. It is silly to imagine that a parent’s behavior has no effect on the child’s. And OF COURSE, the child also contributes by virtue of their own personality and intentions. To solve the problems in any family, it requires everyone to work together and own their own contributions to the system. It’s not a matter of blame, it’s a matter of shared responsibility. No judgment needs to be passed – it’s just a simple fact of life that a system is composed of all of its parts, and any change in one part of the system affects all the other parts. If we can stop worrying about who is “being blamed” and instead focus on what can be DONE to alter the situation in a positive way, we’ll make a lot more progress.
Hey, some people change their lives for the better after near-death experiences from car crashes and the like. Maybe we should push people in front of cars as a form of “treatment?” Sure, a lot will die, but a few may get a new lease on life, and the rest can keep taking pharmaceuticals for decades.
I don’t know anybody who doesn’t think biology plays a role in how we feel and act. The objection to psychiatry is not that it involves biology. The objection I have is that 1) psychiatry claims to understand the causes of “mental illness” when it does not; 2) psychiatry pretends that those causes are primarily or exclusively biological (ignoring psychological, social and/or spiritual issues entirely, and also ignoring nutrition, btw); 3) psychiatry lies about the effectiveness/dangers of their drugs (because they are corrupted by pharmaceutical company money!) and 4) psychiatry relies on the legal system to force “treatment” on people who knowingly decline to use it, violating people’s human rights with impunity.
Biological impacts on behavior are very real, as anyone who has missed a couple nights of sleep in a row or not eaten all day can easily attest. It’s not about denying biology – it’s about resisting a false narrative that’s driven by corruption and power dynamics which doesn’t really lead to healing in most cases, and in many leads to further damage that the psychiatric profession is unwilling to take responsibility for.
Another amazing study result. People who are treated like crap end up feeling bad compared to those who aren’t. Glad we spent THAT research money well…
I don’t hear any “antipsychiatry persons” complaining about this article. I think it’s awesome that people are researching how nutrition affects our mental/emotional well being. The main objection I’ve heard in the past to Julia’s commentaries is only that she uses DSM categories in her published research. I understand her reasons for this AND the reasons why people object to it, and both have good points. But that doesn’t take away from the rather obvious fact that what we eat affects how we feel. I don’t think that an “antipsychiatry” position in any way prevents one from believing that nutritional variables affect one’s mental/emotional state.
I read parts of a couple of the articles and some comments on the latter link you shared. ABSOLUTELY DISGUSTING! This guy is not a “therapist,” he’s a mysogynistic creep!
I agree. The oppressors mostly need some kind of motivation to alter their view of things, and they will usually violently resist altering that view, because their viewpoint benefits them and altering it causes them to lose their comfortable and dominant position in the hierarchy.
Wow, that is truly horrifying and disgusting! I only wish I were surprised by it. One of the DSM’s primary purposes was to avoid looking for actual causes of any “mental disorder,” which of course means that the powerful get to blame the powerless and use their “reactions” against them. I only wish the Courts were more aware of how this works, because an incredible amount of damage is done by abusers using the court and “mental health” system to drive their victims further into the mud!
In other words, everyone is an individual and what an individual needs or wants in order to move forward will be, well, gosh, INDIVIDUAL! This certainly supports my contention that the first rule of quality therapy, or any helping effort, is HUMILITY! What we know about groups is, at best, a probability distribution. Trying to apply the same approach to everyone based on a “diagnosis” or even a similar set of “symptoms” is both dangerous and foolish. Which kinda undermines the entire mental health system, doesn’t it?
This is very true, and was proven back in the late 70s. And the higher the dosage, the more the impairment. Anything more than a very small dosage led to cognitive decline. The slant of the article seemed to be “if you don’t have ‘ADHD,’ you shouldn’t take these drugs,” but it appears that no one really “benefits” from them for more than a very short time of “mood enhancement” (aka getting high).
Naturally, they neglect to mention that stimulants have the same lack of enhancement of cognitive effect and all the rest on “non-ADHD” students. Judith Rappoport et. al. proved way back in about 1978 that stimulants don’t act differently on “ADHD”-labeled students – they have the same effects on everyone.
The replacement will only be better if those who replace it have different intentions in designing the new system. Otherwise, it will be “meet the new boss, same as the old boss.” So we have to work on being clear ourselves about our intentions and keep that clarity as we work for change. But there is no way that change happens until/unless the reality of the current system is thoroughly exposed and discredited.
Systems may evolve, but the basic purpose behind them generally does not. Look at the public school system. It’s initial purpose, back in the 1800s, was to create “good citizens” out of freed slaves and incoming immigrants from Ireland, China, and southern and eastern Europe. This meant teaching these kids to grow up and become good factory workers. Public education has gone through huge reforms in waves since the early 1900s, and in many ways looks very different today than it did then. And yet, the main message of school is for kids to follow the authority of the teachers, to start and stop when the bell rings, and not to create any problems. In essence, they are still training factory workers, and they don’t even remember why. The “mental health system” will be the same. Its purpose was never to heal – it was to remove problematic people from the general populace and to make a lot of money for certain people. This is not to say that individuals within this system are not sincere and even very capable in helping people figure out how to empower themselves and improve their lives. It is saying that the system will always keep such people under control or fire them if they get too far out of line, because truly empowering people challenges the power of those running the show.
I agree. I believe most clinicians are fearful and unconscious of their intentions and the motivation behind their actions. There are some at the top of the food chain who are very much aware of what is happening and are involved in intentional obfuscation, but most of the rank and file are either uninformed sycophants who are trying to do what they were trained to do by “the system,” or (a smaller number) people who enjoy having power over others and like being in a position of dominance for whatever reason. There are some who actually understand how to connect with patients/clients, but they are always in the minority and are oppressed at any time they try and question how the system works, because those power people don’t want to give up their power.
So in my view, those in power don’t really understand or particularly care whether or not they are harming their clients. They are absorbed in their own needs and act that out toward their clients, mostly without even realizing what they’re doing. I’d estimate that the large majority genuinely NEED to believe they are helping, which is what makes it so damned difficult to communicate this kind of viewpoint to them.,
Any group you name will have a percentage who commit violent crimes. It is only bigotry that LOOKS for examples to prove that a particular group is “worse” than others. I am reminded of the rhetoric about “immigrants” being “criminals” and “rapists” when the actual data shows that the illegal immigrant population has a slightly LOWER rate of crime than the general US population. But you can pick out an example where one Latino immigrant is violent and say, “See, he’s right, THEY are so violent!” There is really no difference between this and saying “mental illness causes violence.” It’s bigotry, 100%.
It actually goes beyond the idea of “drug treatments being the last resort.” It goes to “treating” things that aren’t unhealthy but are merely inconvenient or threatening to the adults. So it moves away from helping kids who need help into suppressing dissent or oppressing indications of stress or failure of the classroom or school system. I don’t see it as a matter of “overdiagnosing” or “overtreating” – it’s a matter of overt oppression that is built into the ‘education system.’ For reasons which I could go into in great detail, these childhood “diagnoses” are incredibly destructive toward kids who just don’t happen to fit into what the adults expect of them. And mostly, what they expect is for kids to do as they are told and not make too much noise or trouble. To use drugs to keep kids in line when there is strong evidence that there are many other, more effective and more supportive ways to accomplish these goals, is nothing short of evil.
I think it’s a lot more subtle than that, Shaun. I think people’s “dissidence” is what is being drugged, not specific to a particular instance of political dissidence. It’s much more preemptive. For instance, a kid doesn’t like going to school, it’s boring, seems pointless, the teachers have arbitrary power over the kids, the other kids are suffering but say nothing, etc. This kid (a 6 year old) starts to rebel in whatever ways he can, maybe not even conscious of why, but knowing he is encountering oppression and must oppose it. He is punished for this but continues to rebel. He is then routed to the “mental health professionals” because he “can’t pay attention” and is “oppositional and defiant.” He is diagnosed with ADHD/ODD and given drugs so he will fit in better to the artificial school environment. Somehow, he is thwarted despite his efforts, and he knows it, but not exactly how or why. He’s given the message that his rebellion was a mistake, a failure of his brain, but more importantly, he gets the message that he will never be able to succeed against the power of the system. So he never grows up to be the rebel or the political organizer or the radical songwriter, because he’s learned that there is no point.
Obviously, this doesn’t happen to all rebels – some avoid drugging, some see it for what it is and push through it anyway, but it thins the ranks considerably. And it makes it easier for society as a whole to dismiss such people as “mentally ill” and pay no attention to their ideas.
There should be safe places for people to go when they are feeling unsafe. No “treatment” is needed, just a place where it’s OK to be who you are and not have to “fix things” and not have to “be productive” and “manage your symptoms” and so on. Soteria House is a great example, as was the Quaker concept of taking folks out into the country and having people walk and talk with them in a calming environment. The idea that one needs a hospital because one is feeling stressed and finding the environment overwhelming is ridiculous. It puts the blame on the person having a hard time with the crazy environment rather than looking at what is going on around them in their lives. It is sad that the hospital seems to be the only option for someone feeling unsafe and seeking support.
I also think it’s important to recognize that the urban environment itself, which has massively increased as a result of industrialization, contributes to deterioration of people’s “mental health.” Disconnection from community, absence of green spaces, high mobility, large income differential, planning dominated by commercial interests – all of this contributes to the emergence of mental/spiritual distress, as it is not a healthy environment to live in. Adolescence itself appears to be a consequence of the industrial revolution. There is something in the very fabric of how we live that makes people “crazy,” IMHO.
It is very easy to make gross generalizations about rap. My son has exposed me to a lot of highly socially conscious rap, including rap that makes fun of commercialized rap itself. It is a very diverse medium.
Well, we really don’t, because obviously the ER is not a safe place. You are in constant danger of being forcibly detained, restrained, drugged, or whatever if you say/do the wrong things. I’m talking about a safe place, like Soteria House, where people will listen to you and not hurt you and be there with you. It’s not an “alternative,” it’s a completely different concept. And it’s very possible, if we can all wake up enough to make it happen.
As a person who has seen a lot of court hearings, I concur with Oldhead that this is way too much information for the judge to digest. It’s also important to keep in mind that most judges are incurably biased toward believing the “mental health” narrative.
My suggestion would be to keep it short and simple. Bullet points would be best.
What the judge wants to know is:
1) Does the person in question qualify for a “mental disorder” diagnosis. This one is a tough argument to handle, because they’ll have their “experts” and there is no objective way to argue against it. If you want to argue this point, you’d probably need an expert witness on your side to show how you no longer “meet the criteria” for whatever “disorder” they’re claiming you have. Arguing that psych disorders are subjective and meaningless won’t get you anywhere, in my view.
2) Are you a danger to yourself and/or others? This is the one where you have the best odds of success. I’d focus on what has been happening in the last X period of time, and challenge them to point out any time that you have endangered yourself or anyone else in recent times.
3) The AOT argument: Will you deteriorate and BECOME a danger to yourself or someone else if you discontinue “treatment.” Expert witness would again do you very well here. I’m not sure where the burden of proof lies, but I’m guessing it’s a mere “preponderance of evidence.” You’d have to look in your state. This is where you would demonstrate that you have already been successful in behaving in safe ways when you have NOT been “in treatment”. Not sure what evidence you have, but this is a trickier one to prove, since it’s speculative.
It might be worthwhile making an argument that important civil liberties are taken away by an AOT order, and that this should be something that is not done except in the most extreme circumstances. The main argument is that you are not posing any danger to anyone and that the idea that you MIGHT pose a danger at some time in the future is speculative and is not sufficient grounds to deprive you of your civil rights and enforce drugs on you that you do not find helpful.
It might also be helpful to note very BRIEFLY and SPECIFICALLY what harm the drugs have done to you and why you want to discontinue, as well as what other “treatment” or other interventions you are engaging in to ensure emotional support and stability.
I know this is all pretty obnoxious, but I want you to WIN, which means you have to look at the law and make your arguments accordingly. Judges have to act on laws and evidence, and they are not, in most cases, going to challenge the “accepted wisdom” of the psychiatric profession.
Can you find an attorney to consult with prior to the hearing?
I think you missed my point. The analogy isn’t between the human brain and a car. It’s between the mechanic and the psychiatrist. The mechanic, in being unable to fix your car, will tell you one of two things: I don’t know what is wrong yet, or the part involved needs to be replaced. They will not tell you that your car is “repair resistant” and yet ask you to bring it back for a “treatment” every week that doesn’t actually fix it but “reduces the symptoms.” Either they can fix it, or they can’t. They might even suggest taking it to a specialist who is more expert in the area of fuel supply, as it’s possible the injectors are working fine but some other part of the fuel system is malfunctioning. But under no circumstances would they tell you that your car is to blame but you should still pay him money to “treat” the car’s “symptoms.”
The psychiatrist, on the other hand, is dealing with a situation that is inherently uncertain. S/he does not have the same kind of objective understanding of what is going on in the mind as the mechanic does with the car, so s/he should be even MORE cautious not to make bold pronouncements of cause. To blame the patient they are unable to help for being “unhelpable” is actually far MORE egregious than the mechanic saying, “Your injectors are shot.” Because the psychiatrist has NO IDEA why this particular person didn’t respond the way they expected to this particular “treatment.” To me, the ONLY proper response to a treatment failure is to say, “This treatment did not work for you.” To blame the client by calling him/her “treatment resistant” is a complete and total cop out. This is reinforced by the recent MIA article showing that something like half of the “treatment resistant” veterans in a study improved with sham “magnetic stimulation”, in essence, improving solely because someone paid attention to them and gave them hope. The concept of “treatment resistance” should NEVER be applied to “mental illness,” because the psychiatric profession is not in any kind of position to even pretend to know what they are “treating.”
This is not to say that a brain can’t be damaged. It’s to say that they have no way of knowing this just because someone doesn’t “respond” to their “treatments” the way they want them to. Any honest clinician would start from a place of saying, “We don’t know what’s going on, and we’re going to try some things and see if they work.” There is no “resisting” of “treatment.” The “treatment” works or it doesn’t. If it doesn’t work, then treatment failed. It’s not the patient’s fault that the clinician doesn’t really know what s/he is doing.
Perhaps the problem is looking for a total system of thought, rather than constructing our own over time and modifying it as seems best in light of new experiences?
True enough. However, the point is that when one’s approach fails, it’s not the patient/client’s (or their “disorder’s”) fault. Just because you can’t help a person doesn’t mean it’s because s/he is “unhelpable.” A more humble approach might suggest that you, perhaps, need to learn more about the person you’re trying to help instead of doing the same thing you did before harder and harder and being baffled when it continues to fail.
Did you see the recent article where “treatment resistant” veterans got better with sham “magnetic stimulation?” The fact that people paid attention to them and gave them some kind of hope suddenly changed their “treatment resistant” condition. So were they “treatment resistant,” or were their clinicians incompetent? I think we know the answer.
An important question: why does the need to protect some people from other people’s behavior (a social control function) have to be connected to some sort of “treatment?” Why can’t we simply create a space where people who are dangerous can be safe until they’re no longer dangerous? The Quakers did this in England centuries ago – took people out to the country and walked with them and held their hands and communicated with them and created a safe place for them to be, and most of them seemed to “get better,” if that’s the right term. To me, enforced “treatment” isn’t treatment. It’s just plain force. Force is sometimes necessary, but it’s never “treatment.”
I have seen plenty of socialists who are authoritarian, and plenty of conservatives who are not. Authoritarians exist in every social group that there is. They are simply people who believe that rank and status and group membership is more important than what is true or effective or good for the whole society. Authoritarians believe that they need to follow the directives and ideas of those who are perceived as “above” them in the hierarchy, and in exchange, expect obedience from those below. This can happen in any group, liberal, conservative, socialist, or fascist.
“Overdiagnosis” is a problem in other areas of medicine. But the concept is VERY different in the realm of “mental illness.” Because at least when you’re talking about cancer, you can later go back and say, “Actually, this person never developed cancer but this one did.” Whereas with “mental illnesses,” there is no objective measure of what constitutes a “proper diagnosis.” So the concept of “overdiagnosis” is meaningless in a psychiatric context.
Using “motivational interviewing” to convince someone to do something they don’t want to do is a perversion of the approach. Motivational interviewing is supposed to engage the person’s internal motivations and goals and engage them in the process of deciding what it is they need/want and how to get it. It’s supposed to be very open-ended and put the client in the position of deciding what path to take next. Not really compatible with the “accept your disease” paradigm, though the psychiatric profession can coopt and poison anything that works.
I hate that term. It’s not “our treatment stopped working” or “our treatment doesn’t work” or “we don’t know how to help you.” Instead, you are “treatment resistant.” In other words, it’s the CLIENT’S fault that the PSYCHIATRIST failed. I wonder how long you’d take your car to a mechanic who said your car’s engine doesn’t work because it has “repair-resistant fuel injectors?” INFURIATING!
In my view, there is no direct correlation between belief in religion and rationality. Lots of irrational people don’t believe in any religion, and lots of rational people do. I personally find lots of good, rational statements in almost any religion I’ve approached, especially Buddhism and Quakerism, and I’m about as rational a person as I think I know. Following a given “religion” (of any sort, including pseudo-rationalistic religions) blindly, or in other words, AUTHORITARIANISM, is the real enemy of rationality.
Sheesh! Did they even bother to ask him what he was depressed about? My son had just been assaulted by a roommate and was coming off of a run of several drugs over a few months, but all they wanted to do was tell him how “depression is a disease just like diabetes” and never bothered to even ask him why he’d been thinking about suicide. He was totally pissed and insulted by the insensitive approach and never wanted to see that doctor again.
Holy crap! What an insane (forgive the choice of words) story! And the part that continues to baffle me again and again is that they don’t see that you were made WORSE by their ‘treatment!’ It should be obvious that going from feeling bad to feeling completely numb and overdosing on every drug available is moving in the wrong direction, and yet at no time do they ever stop and say, “Wow, this really isn’t working – maybe we need to consider a different plan?”
Thank you for having the courage to share your story. I hope you are able to find a different path that moves you forward. I think coming forward and telling your own story in your own words is a great start.
I think you perhaps underestimate the ferocity with which the psychiatric industry protects its own interests. As soon as the “peer service” movement got on its feet, the big guns in psychiatry set out to undermine its credibility and at the same time co-opt such peers as had gotten hired into handmaidens of the psychiatric community. In other words, this is not about the “free market,” but about monopolization of the market by a single, very powerful industry that doesn’t allow for competition. Any ideas that threaten their control over their market, even if these ideas are 100% scientifically and economically viable, or perhaps ESPECIALLY truly viable options, must be shut down at all costs. There are HUNDREDS OF BILLIONS of dollars at stake annually, and those with their snouts in the trough are not willing to give up their free mass feeding without a fight.
I had that thought, too. It appears that in order to succeed, the effort needs to embrace a “business model” that emulates the very conditions of life that bring about “mental illness” in the first place. I absolutely agree that peer-centered and peer-delivered services (or perhaps “escapee-delivered!”) are going to be much more likely to be helpful. But competing with the “standard services” on a capitalistic basis will ultimately fail, because the Big Behemoths will get upset when they start losing “market share” and crush the upstarts like a bug. I think we have to get at the idea that the current system is motivated by better service delivery and lowering costs (because they aren’t) before we can really set up anything else that would be helpful. It’s a big task!
I have never agreed with the concept that “the system is broken.” The system works quite well. The problem is, we assume that the goals of the system are consistent with point #5 above, to wit: “My job is not to get people into the mental health system, my job is to get them out.” If that’s the goal of the MH system, it’s definitely broken. But if the goal is to increase the number and intensity of “permanent customers” who will never get better but depend on the system and bring in big bucks, well, I’d say the system is pretty darned effective.
I have always considered that there is no “cause” of any particular set of “psychiatric symptoms.” I have always believed (due to decades of personal observation) that every single case is different, or as Milton Erickson put it, therapy needs to be reinvented for each different client. Some people may have biological problems (sleep, nutrition, illness, chronic pain, etc.), some may have been traumatized, some are experiencing social stress (racism, sexism, etc.), some may be in bad environments (oppressive schools, psychiatric hospitals, domestic abuse relationships, etc.), and so on. The problem is that the psychiatric profession wants to group these varied circumstances together and act as if there is one “cause” for a particular set of reactions, instead of honestly and humbly looking at each case as its own special set of needs and circumstances.
The analogy with domestic abuse is quite apt. This from a person who has extensively worked with and supported hundreds of domestic abuse survivors over the last 30 years. Gaslighting, blaming, threats, abandonment, manipulation, charm – it’s all there.
It is my believe that this website exists to distribute information to anyone who wants to resist psychiatric hegemony in any way possible. It is not an “action site” in the sense of planning some specific action to combat psychiatry. I see the value in the comments section to be that people can take from it what they want.
It’s important to remember that some people who come here are just barely on the verge of awareness that psychiatry is dangerous or misguided, some are well-versed in the challenges of the DSM and the medical model but still have hope in the creation of some other means of providing support, and some are focused on the political struggle of complete deconstruction and elimination of psychiatry. ANY of these people from ANY of these groups can get together and plan some kind of action. I am part of a couple different groups, one of which educates people about the realities of the current system and helps people consider getting off of drugs, the other of which is very much focused on the destruction of psychiatry’s power base.
My hope is that MIA assists in informing people and bringing people together to take action in their own communities or nationally or around the world. MIA doesn’t appear to me to have the specific purpose of promoting a particular action agenda. As a result, I don’t expect MIA to assume a particular editorial position or to organize any particular action (though I’d be happy if it did). It seems to me that it’s my job and my community’s job to create that kind of action, and that a wide range of actions can be helpful in making our society less oppressive and more responsive to the needs of its citizens.
Precisely. I was the scapegoat in my family for the first 8 years of my life, at which point I got seriously ill (ruptured appendix) and I had a younger brother born. The job passed on to my next younger brother, who used to be in “the baby” role until my youngest brother was born that year. By this strange twist of fate, I got to see first hand that being the scapegoat was not who I was, but a job I’d been assigned, and saw it reassigned to my little brother. This gave me a sudden and deep insight into my own family, and probably led me into social work/counseling as a profession. But only after I got my own very good counseling to get my own head straight.
This is something I believe and used to hear a lot, when Family Systems theory was taken more seriously. While I am not fond of psychological schools of thought in general, Family Systems theory has some really excellent points, including the idea that the family offloads their issues onto the kids (who have the least power) by assigning them “jobs” or “roles” that they don’t understand or even know they are playing. A lot of our adult issues come from exactly this, and that’s why it’s so important to talk to kids (or adults) about what’s happening instead of blaming the kid for acting in ways the adults find inconvenient or confusing.
There is also an incentive to find “positive” study results, which is perhaps the most disturbing distortion of science. Real science puts MUCH higher value on NEGATIVE outcomes, because those are the only ones that can be definitively proven. Positive outcomes are only positive until a study contradicts them. Only after attempting to find any other better way to explain the data or to disprove the theory at hand fails can we call something a “scientific fact.” Focusing on positive studies and ignoring negative ones is no longer science – it is a form of marketing.
And it might help if the adults started by recognizing that these kids are reacting to the way the ADULTS are treating them. Most of the kids’ anxiety could be relieved by removing the kind of pressures, stresses and traumatic experiences they are being expected to deal with.
Wow, so now you’re not allowed to feel depressed about your kidneys failing and you needing dialysis for the rest of your life? What, are you supposed to be cheerful about it? And where is all this bullshit about how we’re not “treating” things that would be called “situational depression?”
How can anyone take this crap seriously? Thanks for sharing this. I continue to be amazed at the depths to which psychiatry will sink to make a few more bucks.
Can’t really argue with you. Pills should not be a “caveat emptor” undertaking. But in a way, it’s worse when they are prescribed, because then you get the “seal of approval” from someone who is supposedly objective and concerned with your welfare. Wish I had the answer, but I KNOW that the DSM has got to go, and if it did, the dropoff in pill consumption would be massive.
Yeah, I love that – your approach failed completely, but instead of saying, “I don’t know how to help this person” or “my method was totally ineffective,” you get to blame the client, or actually, the client’s CONDITION for “resisting” your approach. “It would have worked, except that bastard Depression didn’t want to cooperate!” Idiocy, and yet they continue to get away with it.
I was using a prejudicial, negative term to make the point. You can’t create pejorative terms for a group of people, call them pejorative names, and then ask us all to not stigmatize the people you yourself have stigmatized. It feels like that’s what psychiatry does. They claim this kid over here who hates school “has ADHD,” they call him “brain disordered,” and then ask everyone “not to stigmatize the poor sod, after all, he’s disabled.” It’s pretty hypocritical, to say the least.
It is because the “treatment” and “diagnostic” system allows the staff to dehumanize their “clients.” Nazi Germany is proof that people don’t have to be evil to do incredibly evil things, or to stand by while evil things are done by others. All they appear to need is an authority to tell them what to do, and a big enough group of people to agree with them that it’s OK, and all sorts of awful things can happen. Most of the clinical staff at these facilities were nice enough people, but few really empathized with the plight of the youth they were serving. They were trained to look at the kids as a set of “symptoms,” and from that point of view, drugging the kids “made sense” and anyone (like me) who questioned the practice was seen as odd or perhaps even dangerous.
I only wish we could weed out a few monsters and things would be OK. It’s the “normal person” that we have to watch out for!
It is astounding how researchers get away with this kind of euphemistic crap! “Study Shows Poor Outcomes for the Treatment for Childhood Anxiety.” In other words, “STANDARD TREATMENT FOR CHILDHOOD ANXIETY DOES NOT WORK!” That’s what the title should be. But they talk all around the issue talking about ‘short-term outcomes’ and “extended treatment and attention paid to relapse prevention could potentially improve outcomes for children exposed to acute treatment for anxiety, but that further research is needed to explore long-term effects of various approaches to therapy over time.” Blah, blah, blah.
And this is in light of their own statements earlier in the piece that “Increased adverse childhood experiences (ACEs), increased academic expectations imposed, Common Core curriculum initiatives, and the general emphasis in schools on teaching to promote test success are some of the environmental features that breed stress among student-aged children.”
So why the F*&K don’t we stop traumatizing our kids, stop demanding developmentally inappropriate behavior from our kids in school, drop Common Core, and knock off the high-stakes testing? But no, instead of actually facing up to what they KNOW is causing the increased anxiety, they try to “treat” the children for the anxiety that the adults cause. And they are surprised when their “treatment” doesn’t work?
I worked for 20 years with foster kids, and they were “medicated” in many cases at the first sign of any behavioral problems, and it got worse and worse over the 20 years I worked with them. They are probably the most disempowered group in the USA (at least), and it should not be surprising that they get the most drugs as a result.
I do have a certain amount of knowledge about the CoS. A close friend was a staff person for a time. It appears to be a highly centralized and bureaucratic organization.
I think you make a good point. These drugs can cause tremendous damage, and they are not easily handled by the body. The thing is, though, there ARE people who appear to feel better when they take these drugs – just met one the other day. And I really don’t want to take that away from them. And I don’t hear too many people demanding straitjackets or ECT. We live in a drug-based culture and it’s hard for me to see a way around that. Certain drugs should absolutely be banned, and maybe some of the psych drugs fit into that category. But banning drugs won’t undermine psychiatric hegemony, whereas exposing the fallacious “science” behind the DSM and the idea of “medical treatment” of social constructs voted on in committees will. And if the mythology of these “diagnoses” can be dissipated, I doubt that most people would be interested if given a fully informed choice.
You might consider starting by finding a doctor who isn’t going to lie to you and will support you in making your own decisions about what you need and what does and doesn’t work for you. Has anybody ever worked with you on non-drug approaches to anxiety issues? There are plenty of them and I use some myself all the time. But it sounds like your psychiatrist is out of touch with reality and thinks Klonapin prescriptions for the long term are AOK, even though the package insert says never to prescribe for more than two weeks continuous use, and to be cautious about prescribing to anyone with substance abuse issues. So he’s either ignorant or he doesn’t care. I’d guess the latter. I would most definitely never see him again, and I’d start off my next psychiatrist (if you still think you need to see one) by asking him his views on the long-term prescription of benzodiazepines, particularly to someone with substance abuse issues.
The short answer is, it’s time to take control of your treatment plan. The very act of taking responsibility for making your own decisions and shopping around for a doctor may in and of itself help reduce your anxiety and increase your sense of personal power.\
Sexual feelings are a part of being human. I agree with Shaun that ideally this would become a part of the discussion with the therapist if it seems appropriate to the issues at hand. Behavior, on the other hand, is a choice. I would have no problem with a client letting me know they felt sexually attracted to me. I WOULD have a problem with them getting physically close, touching me in inappropriate places, using suggestive language, etc. The actions of that director do, indeed, seem very creepy and bizarre. Clearly a person who has not dealt with his own “sexual transference” and is projecting it onto his trainees like crazy. I’d hate to be his trainee, but even more to be his client.
And you’re right about therapists, too. I knew a guy who had sex with one of his marital therapy couple. Disgusting!
They changed their rhetoric after they finally had an actual service user as their ED. But they’re still heavily funded by Big Pharma and still argued in favor of the new “mental health act” that discourages “alternatives” and encourages locking up and forcing “treatment” on the unwilling.
Sounds like pure rumors to me. One thing you can say about the Church of Scientology, they are very, very clear about who is in charge and what the chain of command looks like. I’m sure he’s as influential as he wants to be, but this reporter sounds like he’s talking through his hat to me.
I bet that would work! But you can’t make billions off of tinfoil. They’d have to come up with some titanium-infused superheated alloy that has to be made in outer space so they could charge bunches of money for their tin hats.
Yeah, they’re a bit slow on the uptake, aren’t they? How can you call these people “treatment resistant” when you haven’t even tried talking to them? Does this not strongly suggest that it is not “resistance” but “incompetence” that is the reason they have not recovered?
Well, they both suck, but as you point out, the DSM creates the justification for labeling and drugging. Also, the DSM doesn’t just affect “diagnosis,” it has become absorbed into our society as part of the “bad brains” mythology about the “mentally ill.” So in the interests of making more money, the psychiatric industry has intentionally warped our entire cultural thinking about the mind and emotional distress in a blameful, undermining, disempowering way that supports the status quo and marginalizes those whose behavioral or emotional reactions tell us that we’re on the wrong path as a society.
As for the drugs, there are people who like taking them, and as long as they are not forced or lied to, I see no reason why people should not be afforded this opportunity if it works for them. It’s the reframing of these drugs as “medical treatment” that creates the horrible dynamics, including the use of force to make people take them who find them worthless or harmful. So if you take away the DSM justification, it’s easier to help people see emotional damage as an attempted adaptation to their environment, and also to see value in condemned traits like “hyperactivity” or “anxiety” or “compulsiveness” which are demonized by the diagnostic process.
Anyway, that’s why I put the DSM as a more damaging entity, even though the drugs have wreaked havoc on many lives. I guess I’m focusing more on the overall social effect rather than the effect on an individual. For sure, the drugs can be far, far worse for any individual to have to cope with!
OK, so this is important. These people were judged “treatment resistant.” Translated into “responsible adult” language, this means that anything they’ve done to date has utterly failed to have any lasting impact. Then we find that pretending to do something that is supposed to help now “remits” 39% of these people for whom STANDARD ‘TREATMENT’ did ABSOLUTELY NOTHING! And Nemeroff, the Big Pharma shill, is “puzzled” by these results, and attributes them to “engagement with the treatment team!”
Obvious conclusions:
1) “Standard treatment” doesn’t work for these people, but pretending to do something while doing nothing does work. Seems less like “treatment resistance” and more like “incompetent clinicians” to me.
2) “Engagement with the treatment team” is MORE IMPORTANT than the “treatment” that you are providing
3) Ergo, STOP PROVIDING ‘TREATMENT’ and START PROVIDING ENGAGEMENT!
Why does this seem obvious to me and yet it is “puzzling” to Dr. Nemeroff?
EXACTLY! If they created “remission” by essentially doing nothing but telling them they might get better, and more than a third improved as a result, there’s no telling what might happen if they actually started giving clients the impression that THEY could do something about it without any “clinical intervention!” Add in specific, empowering supports and a caring support system, and the “treatment resistant” suddenly start getting better in droves!
Not meaning to imply that YOU were saying it was a momentary decision – I’ve just heard way too many people send out the “Just think positively, have a good attitude and everything will go well” message, and it’s crap. It’s not that easy to do – it’s something I work on every single day, and it’s literally taken years to get to where I have a pretty good handle on not letting others’ attitudes and beliefs affect how I see myself.
I absolutely agree that there is the possibility of internal freedom from stigma or anything else having an adverse effect on how we view ourselves. But this is a very great challenge, the challenge of a lifetime, really, and not something a person can just decide in a moment. It it, in fact, where real therapy should be pointing us.
That being said, there are external manifestations of prejudice and discrimination that no amount of internal insight or attitude can change. Being denied housing or having medical concerns ignored or having one’s employment options curtailed due to a “mental health diagnosis” is very real and isn’t something that attitude can change.
Perhaps the most important point, though, is that if we want to lead a movement to overcome prejudice and bigotry and to alter the unerlying myths of the “mental health” system, we really do need to model a new way of being together and supporting each other and apply that even to those who insist on promoting these prejudices. So Ghandi or whoever decided he said that was correct, in my view. We can’t be hypocrites if we’re going to create a better society. So yes, we have to start with ourselves, but then we have to expand it out into the rest of the world. And it’s a long, slow process.
That is my view as well, and the point of my sardonic comment. They start off by stigmatizing all of their clients, claiming their brains don’t work right without any evidence that is even true, and then bemoan the fact that people discriminate against those they have themselves stigmatized? And there’s even research now showing that their own actions cause the stigma they complain of. Are they evil, or stupid, or both?
But I do think there is hope, because somewhere inside of us, we all know it’s bullshit. If we can break out of the social “niceties” and assumptions and look reality hard in the eye, most humans understand that emotions are, well, HUMAN, and not a sign of “illness.”
I am saying that taking the drugs can do damage to one’s brain over time. I’m referring to the “neurological down- and up-regulation” that Whitaker talks about in Anatomy of an Epidemic.
As for the “weirdos” comment, I was using that as an example of someone creating a pejorative term and labeling someone with it, and then complaining that people mistreat the group they have so labeled. I would NEVER call anyone a “weirdo” or any other such label! In fact, the biggest rule for our kids and our household was NO NAME CALLING, no matter what. I was going for something so ridiculously over the top that it could not be taken seriously.
I am truly sorry if this was confusing to you. I can see looking back on it how it could be interpreted that way. I was not critiquing the group labeled “weirdos,” I was critiquing the psychiatric profession for effectively calling people derogatory names by labeling them with “mental disorders.” I was trying to point out the absurdity of giving a derogatory label to a group of people and then acting surprised that they experience “stigma.” That’s what I see the psychiatric profession doing. I have always been a strong advocate for eliminating the DSM entirely, because I find the labels to be worse than the drugs, for the reasons asserted above, and other reasons.
I have the utmost respect for those I have tried to help with mental/emotional pain over the years, because I’ve suffered such pain myself and know the struggles involved. I guarantee you that I am the biggest advocate you can imagine for viewing “mental health issues” as normal reactions to difficult circumstances. I’m sorry if I ever gave a different impression.
The concept of “pill shaming,” no doubt generated by the psychiatric establishment, show a great deal of confusion between the choices of an individual to use/not use a particular intervention vs. the intentional deception of generations of “consumers” regarding the nature of their difficulties and the kinds of solutions that might be available. People who want to use pills can use them, and not too many people are going to argue with you. But doctors telling people they have a “chemical imbalance” when they know it’s not true, just so they can increase their “market share,” THAT is truly despicable and can’t be allowed to go by unchallenged. I’m sorry if that’s upsetting to people who find these drugs helpful. I know there are plenty who do. But it’s not the fault of the person telling the truth that the public has been deceived. The anger should be directed toward the appropriate place – the people who lied to you in the first place.
I’m not sure why you think I’m not a fan of your work? I thought the video was excellent! Can you let me know what I said that gave you that impression? I’ve always thought you were one of the most thoughtful and rational posters on MIA. I think there is a misunderstanding of some sort here.
He really isn’t. I know this. Unless he’s joined the “Sea Organization” lately. As far as I know, he’s just a “public person” with no official role in the church hierarchy. Let me know if you can find any documentation to the contrary, but I just looked and found nothing of the sort. I’m sure he contributes tons of $$$, but he’s not a decision-maker that I can tell.
As soon as we group any bunch of people together, “stigma” (aka discrimination and bigotry) will emerge. Particularly when these people are grouped by subjective traits that most people (including the labelers) view as “negative.” It’s kind of idiotic to create a group called “weirdos” and then say, “There is great stigma against weirdos. We need to treat weirdos with respect and offer them our support despite their weirdness.” Let’s face it, as soon as we called them “weirdos,” we stigmatized them! And making it more “sanitized” or “medicalized” by calling it “Bipolar disorder” or “ADHD” fools no one – everyone knows they are categorizing people by their problem behaviors, and the stigmatization is done the minute the label is applied.
They actually do brain damage over time, which makes it very hard or sometimes perhaps impossible to completely get off of them. But of course, nobody warned you of that possibility, did they?
But it is good to see someone in the scientific research field reinforcing these ideas. It’s hard to claim that the authors are being “antiscientific!”
“Maladjustment” in this case is only seen that way from the point of view of the oppressors. They want everyone to adjust and accept their lot in life, because they don’t want to have to change out of their comfortable seat of superiority and privilege.
I agree 100% that we are all weirdos. We have a refrigerator magnet from many years ago that says, “Remember, nobody is normal. Everybody is weird!” from Melissa Chen, age 11. If we all did that, we’d be on the path to a whole new society!
He’s not really a leader, he’s just a celeb who happens to be vocal about being a Scientologist. But I agree, involving anyone who is a Scientologist as a spokesperson would open us up to attacks, no matter how articulate and on-point their presentation. And to be quite honest, I didn’t find Cruise’s presentation about antidepressants particularly effective. He seemed to simply attack psychiatry without using any research or statistics or even specific anecdotes. I wouldn’t think of him as a good spokesperson, for both reasons.
I think they’re making the insightful observation that telling people they’re second class citizens and depriving them of basic rights is upsetting to them. Glad we have some research to back up that extremely complex point.
Well said! I laughed with absolute recognition at your last paragraph. Krishnamurti knew what he was talking about. The sad part is, even those most ‘successful’ in the system are still subject to its pressures and abuses. Your comments that there is one or a small cadre of abusers and a whole lot of scared “hangers on” is right on target. It is my hope that places like MIA can encourage “creative maladjustment” in those who have begun to see what’s really going on. Of course, the psychiatric profession is 100% on the side of enforcing social norms at this point, so getting an understanding of that fact is crucial to people finding the pathway toward greater self-respect.
Excellent points! Mindfulness should be applied to individual spiritual growth. It should not be a substitute for or a distraction from the myriad causal factors in our society’s increasingly anxious and depressed population. It’s always easiest to make recommendations for the victims to change, so the victimizers can blame them for not “meditating more effectively” when they continue to find the current status quo soul-crushingly depressing.
The author states that: “It is imperative to distinguish between actual clinical depression, and “healthy depression…”
Yet there is no even marginally objective means offered to do so. Any of the “healthy depression” causal factors could eventually plunge a person into an extremely depressed state that seems unescapable. How about living in a domestic abuse relationship that you are unable to find the resources to escape? Living in a society where every day you are judged harshly because your skin is brown or you don’t speak the common language? What about realizing that you are trapped in a dead-end job that brings no satisfaction but can’t be stopped without risking homelessness and starvation for your family? I could go on…
The author also fails to note that most of the people meeting his vague “clinical depression” criteria have experienced childhood abuse and/or neglect, often in very extreme ways. I have known many childhood sex abuse victims who suffer from “ingrained pessimistic thinking; disturbances in sleep and appetite; lethargy; difficulties concentrating; pathological guilt over real and imagined transgressions; isolation; dire hopelessness; and, a despondent mood.” Does this merit a “medical diagnosis?” On what basis? Is this not just a more extreme version of a call for “the emotional impetus to revamp one’s life commitments in line with new, emerging beliefs and values?”
I absolutely appreciate the focus on normalizing depression. I just don’t think you’ve gone quite far enough. The concept of “clinical depression” is seductive, but separating “clinical depression” from “normal depression” is simply not a scientifically viable process. There MAY be some people who DO have a medical problem that causes them to feel depressed, but it is not possible to make that distinction based on how bad someone feels or whether or not they have sleep issues.
Thanks for the article – lots of great stuff in there for the medical profession to chew on!
True enough! It is more a symptom of a very challenging and potentially unsatisfying social system, where connectedness is a rare and extremely valuable commodity.
Well, it is from Psychiatric Times, so we should expect a fairly mainstream rhetoric. I think the reason this one appears is that it promotes the radical concept that doctors should actually try LISTENING to their “patients” before telling them what to do. If this really happened, if the doctors actually dropped their arrogant attitude and started really hearing those they are purporting to help, a revolution would follow soon afterwards, I think, if only because most of them would realize that they have their heads up their butts.
I am sure that MIA editors can’t pre-select only such articles as meet some “radical sufficiency” standard, or it would be a very thin read. I don’t think they intend approval of everything they publish – it’s an attempt to keep us all informed of what’s going on in the “MH” world, and in particular, any efforts to diverge from the standard paradigm of what passes for “care,” even if it’s still mostly mainstream. Makes for more interesting discussions, don’t you think?
I do agree, but try to tell anyone in the mainstream “MH” system that. It’s amazing how many simply panic at suicidal thoughts, despite the fact that it’s very, very common to have them.
True enough, and I also have raised my kids to do the same. It’s about all I can personally do about it, but I don’t hold my breath for the world to catch up. Actually, I do think that very slowly, there are more and more raising their boys this way, and I’m hoping this will eventually create bigger waves. But there are also a lot of young Trump supporters around, so clearly we’ve still got a very long way to go.
How did you end up becoming an empathetic champion for the downtrodden?
So just to clarify, I am a big supporter of GENUINE toughness. I am not a supporter of “toughness” being defined by people in power and enforced on people they see as “subordinate.” The first is a skill that is very valuable in the right situations. The second is an effort from the controlling elite to suppress empathy toward those being harmed by their dominant position.
There is a difference between having the personal value of toughness as a voluntary identity vs. being TOLD that you HAVE TO be tough and that having or expressing emotions is a sign of weakness. This kind of pseudo-toughness is very different than REAL toughness, which often involves dealing with strong emotions effectively and without having these emotions deter you from your intentions. In fact, teaching boys that feeling or expressing emotions is “weakness” is actually a cowardly viewpoint, not a “tough” one. A truly tough and courageous person knows that emotions are part of life and expects them to happen. Moreover, allowing emotions to happen provides good information to guide one’s decisions toward accomplishing one’s goals and improving one’s life.
My son is a great example. If something upsetting happens, he gets frustrated or withdraws or cries, but he lets these emotions wash through him and soon after focuses on why these emotions happened and how he can deal with the kind of problems or activities that led to them. I’d suggest he’s a lot tougher than the fragile hyper-males who are terrified of crying in public for fear that their “tough” facade will crack and people will see just how fearful they really are.
I’m not so sure it’s lack of empathy for white men, Steve. I rather suspect it’s that by buying into the “white privilege” game, white men who do so give up empathy for others AND for themselves. The game becomes about dominance and aggression and emotions are suppressed. What people who are not white males don’t recognize is the degree to which compliance with the norms required to remain a part of the dominant group leads to anxiety, self-denial and hopelessness. Ironic as it seems, those married to the power structure often feel powerless themselves, because any move toward recognizing the reality of their position means vulnerability, and vulnerability means being attacked or ostracized. I know for me that showing empathy towards the more vulnerable kids meant I got teased or laughed at, which I tried to avoid when in elementary school. By high school, I’d pretty much given up on being in the “popular” (aka privileged) crowd, but I was still pretty quiet about the obvious injustices I saw going on around me, because speaking up brought on bullying and humiliation. I have to imagine that all but the main leaders of the most privileged group felt similar anxiety, and I wonder how many of them actually saw the injustices and violence around them and yet felt unable to speak up for fear of becoming a victim of their “friends.”
Right. It’s multiplicative. If a person is black, they’re worse off. If the person is poor, they’re worse off. If they are poor AND black, they’re a LOT worse off! Add in “drug user”, non-English speaker, having a “mental health” diagnosis, etc., and it gets more and more dangerous to be in contact with the police.
It certainly CAN act as a spy! That is its intent, to track on “compliance” so that doctors and their enforcement minions can locate “uncooperative” clients, especially those who are on conditional release agreements/AOT orders. There is no other real purpose for this system – it was designed for forced “treatment.”
Can you admit that you are powerless over your addiction to blogging? Do you need the help of a Higher Power to help you gain control of your addiction?
Oh, you’re getting ANGRY again! We can’t have ANGRY patients around here – you’re supposed to be HAPPY because you’re getting such wonderful help. (But not TOO happy, of course – that would be manic!)
Good for you for saying it. There are plenty of rank assholes out there, and some to whom far worse terminology applies.
I never used a contract per se. I simply asked the person how long they believed they could go without going through with suicide. I’d then invite them to contact me again at that point and we could talk some more. It was more an acknowledgement of their own capabilities. I don’t know if it helped or not.|
Having been suicidal myself, I agree 100% that dealing with the strong emotions attached to that urge was the MOST important aspect of any kind of therapy or helpful assistance I ever received. Along with that, validation that it is OK for me to feel that way and in some sense a NORMAL experience given my history was also extremely helpful.
I used to work at a crisis line, and we got calls all the time from people who felt suicidal but could not tell their therapists for fear of being locked up. Same with people who cut themselves. I often thought that having therapy with someone you couldn’t talk to about how you’re feeling must be worse than useless, actually kind of re-traumatizing.
That is what 99% of the people I’ve tried to help really needed to hear. There is HOPE and you can DO SOMETHING ABOUT IT. Whereas the bio-psych message is, you can’t do ANYTHING about it, and the ONLY hope is trying out more drugs and accepting that your life will not be what you want it to be.
Forcing someone to engage in “mindfulness” is ironic in the extreme. The origins of mindfulness are in Buddhism and Hinduism, where the purpose is to establish individual spiritual freedom from the “wheel of life.” Forcing someone to meditate would completely contradict the intention of the whole enterprise. Anyone who tries to force someone to be “mindful” doesn’t understand the concept. Idiocy!
Didn’t mean to cause dejection, but it seems an inevitable result of looking at the reality of the system as it is. And your agency appears to be one of the better ones! The arrogance and lack of humility behind the whole DSM strategy pervades everything that happens in the system. Which is why I eventually bailed out and got into advocacy. I started feeling I couldn’t live with myself.
Can’t disagree with you there. If you’re not interested in the goals, purposes, feelings of the person you’re supposedly “helping,” they are no longer your “client.”
This article reflects an extremely ironic contradiction in the “mental health” world – those running the system are invested in keeping expressed emotion to a minimum, while those IN the system are often suffering from being forced (historically AND in the present) by safety concerns to suppress their emotional expression! So in essence, these supposedly therapeutic people are unable to deal with someone being angry. What the f*&k kind of help can they provide if they’re not willing to deal with anger? Don’t know about the rest of you, but 90% of my own (very helpful) psychotherapy was dealing with suppressed anger at how I had been treated as a child, and I never would have gotten to where I am today if I had not learned how to feel OK about being angry and expressing my anger to those who are transcending my boundaries. Sure, I’ve learned “better” or “more effective” ways to express anger over the years, but sometimes I still “let someone have it” if they’re really being disrespectful.
It looks to me like those in charge are simply cowardly and unable to deal with their own emotions. If so, they have no business claiming to be in a “helping profession.” If you can’t handle anger (and other strong emotions), you’re not going to be much help to anyone.
Since it’s clear that the lifespans of those diagnosed with “schizophrenia” have significantly declined since the beginning of the drug era, and since it’s clear that social outcomes do NOT improve as a result of “TAU,” why in the hell is “TAU” even considered “treatment?” Especially when you combine this with the WHO cross-cultural studies showing massively higher recovery rates in “developing” countries that use less drugs, any real scientific reading of the data says we need to reduce the use of these drugs to the absolute minimum or eliminate them altogether.
Of course, we know the answer. “Follow the money.” Sigh…
The fact that one would have to say “these people deserve to be taken seriously” shows that they are not treated as people. That’s the central problem. The point of honest engagement with one’s clients on an equal power basis isn’t just a “good idea” that people “ought to consider.” It is the key to being able to be helpful in any way at all. How could anyone think they’re being helpful to another person if they don’t take that person seriously? Wouldn’t that other person’s framing of reality be the CENTRAL point that a helping person would be trying to discover and flesh out? Even using the term “these people” is insulting in itself. As if “these people” are somehow different than “us?”
Why not just take EVERYONE seriously and treat each other with respect at all times? Why categorize people as “mentally ill” and then insist that people treat “these people” respectfully? Isn’t the very act of labeling them as “mentally ill” without even consulting “them” an immediate act of “othering” and disrespect?
Amen to that! The difficulty from my viewpoint is that the DSM diagnostic system is specifically designed to discourage clinicians from assigning any validity or importance to the clients’ viewpoint and experience. It’s a natural progression from “we get to define your ‘disease’ for you” to “we get to tell you how to think and feel” to “your comments are irrelevant.” It’s a power thing, and it’s built into the system as it is, intentionally so. Listening to the clients immediately starts undermining basic assumptions of the system, and so it can’t be allowed. Clients’ voices threaten those in power, because those in power know at some level that they are emperors without clothing. So any clients who start complaining have to be shut up before people start to realize that “the man behind the curtain” is the actual Wizard of Oz.
“In light of his self-analysis…” What a bunch of crap! He recanted his “trauma theory” under intense pressure from the medical community, who was horrified by what he was saying and could not allow him to continue pursuing such a line of inquiry. Probably because so many of them had engaged in or knew about molestation that they didn’t want to have come out. It was a classic example of the power structure continuing to support the powerful at the expense of their victims. To leave that point out of the Wikipedia article reflects a continuing denial of the reality that power politics rather than concern for health drives a lot of what happens in the medical community, and especially in the psychiatric/”mental health” world.
Great story! It proves that the framing you put on a problem or issue has a large impact on the results you get. Choosing to label has consequences. Choosing NOT to label has consequences, too.
Your explanation doesn’t really explain anything to me. Even if I accept your premise about the possibility of “real” mental illness, the fact that we could define such an “illness” doesn’t mean that we should or that it helps. It’s true that it can help people to identify with others and feel less isolated if they know they’re not the only ones experiencing a certain condition, but reframing and normalization can easily done without any illness concept being invoked. IMHO, the purpose of the DSM-III forward was to medicalize mental/emotional/behavioral experiences so that drugs can be sold for them. The APA said as much prior to the DSM-III coming out. They were losing market share and needed to promote something that they could do that other therapists could not. That means drugs. Practitioners who “operates from a solely medical-paternalistic or deterministic approach” are the majority, and justifying this approach is, in fact, the purpose of DSM diagnosis. One could very easily accomplish the same goal as you mention without any reference to diagnosis, and the possibility of such reductionistic justifications would be eliminated at no cost.
Thanks for that. But I’d really like an answer to that question: why do YOU, Mark, think we need a concept of “mental illness” in order to help people improve their sense of freedom and responsibility? Doesn’t the very fact of saying someone “has a disorder” instantly reduce their sense of responsibility? Why not simply say, “You appear to experience a lot of feelings of anxiety, and it seems you want to find a way to make sense of and get a handle on those experiences?” This enables one to engage in both psychological counseling and lifestyle coaching without any disabling labeling process (and remember we have solid evidence that labeling in and of itself creates a sense of “otherness” and a loss of hope for resolution). Unless one is holding out for a drug or surgical intervention, what possible benefit is there to calling someone’s behavioral or emotional struggles an “illness?”
I agree that high-quality therapy can be a life-changing experience, and I have been fortunate to have had such an experience. My concern is that the number of quality therapists has been declining steadily since the 80s and the DSM-III and managed care have taken over. As Chris states, there has been a big push toward “brief therapy,” toward manualized therapy, and toward diagnosis and drug interventions. Many therapists I have encountered in the foster care system seem more like case managers, talking only about “current events” and “symptoms” and avoiding any effort by clients to seek more significant understanding of deep emotions and historical behavior patterns. I asked one therapist what they were doing to deal with trauma issues for a kid who was literally having flashbacks in the juvenile courtroom hallway. She stated, “Oh, we’re not dealing with THAT!” “Emotional management” is the watchword of the day, and while I definitely value “skills development,” it is not what I think of as therapy in the transformational sense.
Worse yet, many therapists now take on the role of medication compliance monitors, pressuring and manipulating clients toward “accepting their diagnosis” and “cooperating with treatment.” There are definitely exceptions out there, but they are exceptions, especially in the world of involuntary clients. I’m sure it’s easier to find a quality therapist for those who have money, but no insult intended to you or your clinic, for poorer and more powerless people, therapy often varies from ineffective to downright dangerous, in my observation.
It seems the real question is, why do we need a concept of “mental illness” in order to assist people in increasing their levels of freedom and responsibility? Why do we need artificial and heterogeneous categories of metaphorical “illness” to accomplish what are essentially the basic tasks of being a human being in society with other human beings? Don’t all humans struggle with exactly the same questions of freedom and responsibility? Without a clear indicator of physiological ill health, what purpose does it serve to call such people “ill,” other than to distance them from the rest of the so-called “normal” population?
Fair enough. I appreciate that you appeared to hear my feedback.
The only place I’d diverge here is that the term “mental illness” has been almost completely co-opted by the psychiatric profession, to the point that if someone has a problem that affects his/her mental functioning, most people will NOT assign that condition the term “mental illness.” In fact, the DSM (prior to the 5) was specific about pointing out that symptoms caused by a medical condition were NOT indicative of “mental illness.”
I think it’s fair to say that the use of the DSM to categorize these metaphorical “illnesses” based only on external symptoms is the central problem we face in figuring out what to do. When such a mainstream luminary as Thomas Insel comes right out and says the DSM categories lack validity, we’re not talking about an extremist position here.
Thanks for hanging in there through a challenging discussion. I very much respect you for continuing to communicate even though the conflict level seemed pretty high.
“…mostly filled with the typical anti-psychiatry rhetoric…” Sounds like typical anti-antipsychiatry rhetoric to me. You’re being a tad hypocritical accusing others of propagandizing when you are doing the same thing.
As for your comments on “metaphoricity,” there have been several very valid challenges to your comments which remain unaddressed. Simply referring people to your earlier comments doesn’t make them any more convincing. If you want to be credible, you’ll need to take on the legitimate points that are raised rather than simply ignoring them.
It appears that a rational person who is NOT engaging in propaganda could extract the truth from reading both your and Slaying’s comment threads and pulling out commonalities and contrasts. Your comments would be a lot more credible if you gave credit where credit is due (Slaying’s comment is full of quotes from Szaz that contradict some of your earlier comments rather thoroughly) and sought to find agreement instead of dismissing his entire, well-researched post as “antipsychiatry rhetoric.”
Your comments suggest that you may have a rather large axe to grind, IMHO. This conversation would proceed a lot better if you put it down.
I am very glad you raised these parallels, Noel. I worked in foster care as an advocate for children for over 20 years, and I saw this happening first hand. The less power a person has in society, the easier it is to “diagnose” them and “treat” them whenever their behavior is inconvenient for the authorities. Of course, this leaves children of any color the most vulnerable group. Add other rationalizations for dehumanizing these kids, be it race, sexual orientation, country of origin, or immigration status, and the power differential soars to the point that these kids have no protection against randomly being drugged for the convenience or malice of the staff involved.
It is good that this crisis is bringing some of these issues to a head, but they are, indeed, only the tip of the iceberg, the inevitable result of policies where we are allowed to define and “treat” kids for “diseases” that only manifest when they do and say things that the powerful adults don’t want to deal with.
Your comments seem confusing or confused. A metaphor specifically uses imagery that is not literally true, otherwise, it’s not a metaphor. Saying, “That bridge looks shaky!” doesn’t mean the bridge is shaking. Saying, “That murderer is SICK!” doesn’t mean he’s sick. It means his behavior is so far outside the norm that describing it as “sick” emphasizes that no “normal” person would act that way.
This, of course, has ENORMOUS implications for the use of the concept of “mental illness.” There is a good hunk of very consistent evidence that telling people they have “an illness like diabetes” leads to them losing hope and others viewing them as “abnormal,” in very much the same sense as they viewed the killer as “sick.” That’s the impact of that particular metaphor. And of course, to suggest that they are literally “ill” in the sense that it becomes literally dark when “night falls” is a massive distortion. Humans understand literal illness as something that can be identified in the body and that medical intervention can help ameliorate or cure. Psychiatrists, far from using “mental illness” as the metaphor that it is, have spent billions of dollars (along with their handmaidens in the drug industry) convincing people that “mental illnesses” are LITERALLY illnesses in the physiological sense. And yes, sorry, that IS a lie, because they know better, as the estimable Dr. Pies has himself repeatedly pointed out.
“Biological involvement” is only “discovered” in terms of probabilities of people falling into these subjective categories that are not defined by any objective measure. I think Szaz would be very clear that any PHYSIOLOGICAL condition that can CONSISTENTLY be connected to a specific “mental state” could be considered a disease, but that disease (like Parkinson’s) would then be dealt with by diagnosing and treating the actual physiological condition. The fact that some people with physiological issues of some sort HAPPEN to fall into these heterogeneous categories like “major depressive disorder” or “bipolar disorder” doesn’t indicate that these categories are legitimate entities for study, let alone suggest “biological involvement.”
Naturally, there will be biological correlates that are connected with emotional states, but the research has shown over and over again that none of these correlates are consistently present in ANY “mental illness,” and in fact large numbers of “non-mentally ill” people have the exact same genetic markers or biological indicators as those purportedly “mentally ill.”
Furthermore, any such correlation is likely to be associated with very general characteristics, such as higher energy levels or emotional sensitivity, which have undoubted survival value for the species and are only problematic when someone is under unnatural levels of stress or is forced into an unnatural situation (like a 5 year old sitting still for hours a day) or is lacking in the basic necessities of social and logistical support that our species is adapted to expect.
There is no logical reason why we should anticipate that everyone who “fits the criteria” for “major depression” or any other “diagnosis” will have any physiological similarity to each other besides the surface similarities in behavior and/or emotion. That is why these “diagnoses” have to be given up completely before any meaningful research can be effectively done on causality. It may very well be that a certain subgroup of depressed or anxious people DOES have something physiologically wrong with them. But we will NEVER find such a subgroup if we insist on grouping people together based on external manifestations like “anxiety.” It makes about as much sense as seeking a cause for “pain” or for “courage.” There is not and likely never will be a single cause for any DSM disorder, no matter how much reductionistic “science” is thrown at those “diagnosed” by the Bible of the Psychiatric Religion.
It’s not a question of liking or not liking names. It’s a question of pretending to know things that we don’t. For example, pretending that all people who ‘have depression’ are alike and have the same needs.
You can call yourself “unipolar” if that explains things for you, but it’s different when a whole profession pretends it can reliably identify “unipolar” people and assert that they know what is “wrong” with that person and what they can do about it.
Think about this: do you have to decide if you “like” the name of a broken leg, a syphillis infection, or a heart attack? Of course not. Because you can easily and reliably separate people with broken legs from people who don’t have them by a simple x-ray. It’s not right to tell people that they “have depression” when they may literally have NOTHING in common with another person who “has depression” except for how they feel.
You can describe your own condition in any way you like. Professionals are held to a higher standard – they need to be honest about what they know and don’t know and can’t diagnose you based on how you or how they feel about the label they put on you.
I have to say, nothing lifts my depressed mood more quickly than deleting my sex life, disrupting my relationships, and reducing my “quality of life.”
It continues to astound me that “professionals” continue to prescribe these drugs so copiously when so many people suffer as a result. Some kind of weird disconnect is going on when professionals trying to “treat” depression feel like ruining the patient’s sex life is an acceptable “side effect.”
This kind of research provides some good information, but it always feels like it’s making things SO complex! Fucking with parents fucks with their kids, who then grow up to be parents, and so on. The cycle of abuse – not really new news, and the disturbing part is that researchers have to actually point this out to clinicians when it should be so obvious. I think we have the “biological model” to thank for removing our attention from the obvious fact that treating children well is the key to improving our society at every level.
And we need to remember that today’s children are tomorrow’s parents. Foster care is awful, but so is growing up with abusive parents and feeling like nobody cares. Whether they are in care or not, we need to reach out as a society and show kids that we care about them, ALL kids, and help them make it better for their own offspring. A challenging job, to say the least!
Nobody said your clients didn’t value your services. I specifically addressed that elsewhere. If they didn’t like your services, they’d leave and you wouldn’t hear a thing, would you? Additionally, you are assuming other clinics provide similar levels of respect to clients at yours, which you have no reason to assume. Furthermore, clients have a habit of telling their providers what they want to hear, especially if they can sense that their clinicians need that reassurance. So the situation is much more complex than you describe. You make it sound as if clients being dissatisfied with the MH system are outliers. I can tell you from talking to many hundreds of clients that this is not the case. This is where you are sounding insulting to those who are not satisfied with their services. It feels like you’re dismissing their complaints by saying things like “I do find it interesting that my clients’ experiences are minimized by MIA.” A subtle but pretty barbed comment attacking the entire community here, or at least suggesting that those who post here are, as I said, outliers or extremists.
I continue to note that you avoid commenting on the very critical question of whether you think depressed people all have something/the SAME thing wrong with them, regardless of external circumstances, and that they all need “treatment” of a similar sort (therapy and/or drugs). I find it interesting that you choose to avoid that particular question despite several attempts from me to get it answered. My guess is that your answer is “yes” but you either don’t want to admit it to yourself or don’t want to admit it to the commenters on this thread.
The power balance is so skewed that most clients are afraid to use any “grievance process” for fear of being further abused. This is especially true for anyone diagnosed with any kind of “psychotic disorder.” It is very easy for those in power to dismiss any complaints as “symptoms of their disorder.” I am aware of a situation where multiple sexual abuse complaints against the same person in a MH facility were dismissed out of hand because the clients “were not reliable witnesses.”
This is what I mean by disrespecting the voices of those who have been there. It’s easy for you to say, “Use the grievance system.” You are a person in power. It’s very different to ask clients who are IN your power to do this. There ARE people in the MH system who abuse their power, and they are NOT rare. Consider the implications of filing a complaint for someone who has been forcibly hospitalized and “treated” against their will on multiple occasions. Don’t you think the impact of the huge power differential and potential costs of complaining would weigh heavily against trusting “the system” to do the right thing?
Your ability to believe the best of your colleagues is remarkable, but not supported by the reports of those using the system.
I’m talking about clients’ negative feedback about the mental health system. And my questions about the heterogeneous origins of the so-called DSM diagnostic categories.
This helps me understand why I got confused. I asked you for the link to your post that you’d mentioned, and you gave me the link to Jaffe’s article. So, not TOTALLY my bad after all!
Sorry, my bad on that one. Still, referring to Jaffe as representing anything close to your views puts us at very distant ends of the “respect for the experience of the recipient” spectrum. Jaffe’s review seemed confused and unfocused, and at times he clearly was promoting his own “we know better that the clients” viewpoint, as he always does. You seem to have an agenda, too, and you reflect it by choosing not to respond to certain central points I have made. It seems clear you are more interested in promoting the interests of therapists and mental health professionals and seem very uninterested in talking about very important philosophical questions like why the f*&k anyone taking a remotely scientific viewpoint would ever expect all depressed people to be suffering from the same difficulty. But that’s your decision. It just makes me feel like I wasted a lot of time talking to you, because you don’t seem to be nearly as open-minded as you think you are.
I think it shows where he’s coming from. It seems to indicate a person who feels superior to his “clients” and is unwilling to listen to any feedback from his or any other participant that undermines his view.
He did, however, post the Jaffe review when I asked him for a link to the Huff Post review he’d written. So he at least suggested that he’s Jaffe. Not that it likely makes much difference. He’s coming from the same kind of viewpoint.
Philosophy transcends scientific investigations, in fact, science is a tiny subset of philosophy. Philosophy doesn’t ask the question, “what’s the relationship between the microbiome and the CNS?” It asks questions like, “What is a human being? What is consciousness? Is our awareness a result of our body or are we beings who become aware of the body? Who or what makes the decisions that tell our bodies what to do? Are feelings a function of body, spirit, or the interaction of them? What IS spirit? Do we HAVE a spirit, or ARE we spirits that HAVE bodies?
Psychiatry runs on the philosophical assumption that we are bodies and that our minds are a result of brain activity, and they conclude therefore that the only solution to altering the mind is altering the brain. That’s “materialist reductionism” from a philosophical viewpoint (or some such name). What they don’t tell you is that there is no SCIENTIFIC reason to believe in reductionism any more than there is to believe in spiritual implantation at birth. The reality is that Science has NO answer as to what the human mind really is or where it comes from. These are questions for philosophy, because they transcend the questions of material reality.
You gotta be kidding me. You’re DJ Jaffe? No wonder I feel like I’m swimming up the river. Your reputation precedes you. I understand why we are unable to communicate, but I feel like I’ve been scammed. I am no longer surprised at your lack of compassion for those harmed by the psychiatric system.
I did not see your Huff Post article. I’ll see if I can find it.
I think again you miss my point. At a certain point, it doesn’t matter what “services” you offer if the context in which they are offered is not workable for the person seeking it. No doubt, you have many people who continue to use your services for extended periods of time, and no doubt, they mostly find it helpful or they would not continue. I am not telling you that CBT/DBT are THE SAME as psych drugs. I’m asking you to open your mind and LISTEN to those who are telling you why it did NOT work for them, rather than generalizing that “these things are not damaging.” Heavens to Betsy gives a great example above – she needed help with a domestic abuse situation, and was provided with CBT or DBT. NOT GONNA WORK! Again, you can claim these are all “outliers,” or you can start to realize that there are some who do NOT avail themselves of your services or anyone else’s because they don’t meet that person’s needs.
We’re going to have to part company on the idea that somehow “science” will discover “why people are depressed.” In my view, as I explained above, there is no logical reason that anyone truly dedicated to the requirements of science could possibly believe such a thing is possible. To even DO a scientific study with humans, you’d have to establish a homogeneous group to study, and as I clearly outlined, “depressed people” is not a homogeneous group. Now there may be a SUBGROUP of “depressed people” that actually have a physiological problem, but this subgroup is more likely to be divisible into half a dozen or a dozen or more subgroups ALL who have different problems, just like 10 people presenting with shortness of breath will have 10 different reasons that explain it. This is why “shortness of breath” isn’t a diagnosis – it’s not a homogeneous category. The idea that all people with “major depression” will all turn out to have the same problem is even LESS likely as that all 10 people turning up with chest pain will have the same needs and treatment.
And stretch yourself a minute, here. Isn’t it a bit disrespectful to suggest that a person who has lived a life of trauma and abuse, who learned distorted coping measures and never knew a healthy relationship in his/her life, has something physiologically WRONG with him/her if s/he has learned not to trust authority figures or not to ask directly for his/her needs to be met? Doesn’t it seem much more likely that s/he learned some crappy things from experience, some of which might be valuable to retain but some of which that person might wish to “re-learn” at his/her discretion? And would this person really be likely to respond to the same “treatment” as someone whose thyroid is out of whack and who can’t sleep well at night as a result? Or a person who just found out that s/he has cancer and has 6 months to live? How on earth do you think that those people all need the same “treatment?” Is there something “wrong” with finding the fact that you suddenly are going to die in half a year in a slow and painful manner extremely depressing, even to the point of considering suicide? Is that really the same as feeling like your life isn’t worth living because you have no friends and a dead end job? Or feeling like you’ll never recover from the flashbacks and anxiety you experience as the result of being raped by your abusive husband?
You sound like a kindly person, but I gather you are still really connected with the idea of diagnoses and treatments, and don’t see how that, for at least some people, the very ACT of being “diagnosed” for a “mental disorder” could be demeaning and insulting. I see it very differently. I find that labeling people tends to leave them feeling negated and misunderstood. I find that reaching out to them and having them tell me what’s going on and what they want to accomplish and what they think might help to be much more humane and effective.
Interesting statement. “May never be.” Do you hold out any kind of hope that the “chemical imbalance theory” MIGHT be proven valid? To me, it is completely illogical. Why would we assume that all people who experience anxiety or depression do so for the same or similar reasons? Do people feel pain for the same reasons? Do people feel joy for the same reasons? It makes zero sense that something as biologically essential as anxiety or depression or high activity levels could ever be reduced to an “imbalance” or any universal cause, or could even be clearly identified as “excessive” by any reliable measurement that could ever be invented. It is simply a fantasy (IMHO) to think that any kind of generalization can be made about why people feel chronic depression, for instance. It may be a result of early childhood abuse, lack of sleep, feeling trapped in a boring job, low thyroid, being involved in a violent or abusive relationship, lacking essential nutrients, being lonely, feeling out of control of world events… the list could go on and on.
The fact that some people feel better (or less bad) when taking a particular drug is not an indication of anything specific wrong with them, any more than finding aspirin or tylenol a relief is an indication that someone has a broken bone vs. muscle aches vs. the flu. Johanna Moncrieff has written very effectively on this point – you should read some of her stuff.
Again, I think you’d do very well to listen to some of the people who have experienced DBT and CBT and EMDR. Some have found any of these helpful, and some have found them to have little to no effect, and some have found them damaging. It seems to me that you feel empowered as a clinician to decide that “these things are not damaging” and regard any reports of harm as outliers. It comes across as dismissive of the experiences of those who have “been there.”
I’m glad you understand some of the barriers that people diagnosed with “mental illnesses” often face. At the same time, I am not sure you come across as really understanding or WANTING to understand why so many folks here object to the entire system and don’t see things like “CBT” and “DBT” as much different than the drugs. There is still a disrespect, an air of condescension/superiority, and implied “put down” in the whole dignose-and-treat process, even if there may be some services offered that could be helpful under the right circumstances. For many people, the idea of being considered “broken” or “damaged” or “emotionally disturbed” is in itself enough to be traumatic and diminishing, and sometimes pretty insulting. It’s as if some other person gets to tell you what the “right” reaction to a traumatic event or an entire traumatic childhood should be, and you are judged inferior because you didn’t react in the “right” way. For this reason, I eschew DSM diagnoses at all turns and consider them a fundamental evil of the system. They warp how we think about people and how people think about themselves. They are ultimately dehumanizing labels, and even when I had to use them to get reimbursement, I always explained to my clients that they were just names and numbers that I had to submit so I could get them the kind of help THEY needed, and that it was THEIR job to define what (if anything) was wrong and what kind of help was actually “helpful.”
BTW, I notice that you never told me whether you read Anatomy of an Epidemic yet. Just wondering…
I guess for me the question is more is the person attacking the comment/concept or the person making the comment. It is easy sometimes for one to drift over into the other. I’ve been moderated a few times myself, but it always made sense to me (even when I didn’t like it or might not have interpreted my comments that way). But it seems a pretty grey line to me. Tough job being a moderator. I’ve been there on a very different kind of site. Kind of like being a referee – no matter what call you make, someone’s gonna be yelling at you.
Hmmm, that doesn’t sound right. I’ve certainly seen plenty of articles and comments criticizing therapy and advocating for a wide range of other alternatives, including the abolition of the mental health field entirely. But I trust you and I’m sure you would not make up something like that, so it’s a bit puzzling to me.
Parents or family members are often hurt when family members speak about things that were painful. It isn’t necessarily about blame, it’s about understanding that we all have limitations and that good intentions are not protection against hurting those we love. The “let’s not blame the family” meme has been used to powerful effect by the psychiatric mainstream to keep people from examining their history and culture as contributing agents to their distress. It is possible to be honest about what has happened without being blameful. We all fail our children to some degree or another, and making it safe for our kids to tell us what we did well and poorly is one of the best ways to help our kids mature to their greatest potential.
A common but misleading language that supports the power of those providing “treatment” over those who are its recipients without providing explanatory power of any significance.
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I have recently learned that racism was quite intentionally introduced by early capitalists (at least in the USA) to keep indentured servants and enslaved Africans from getting together and rebelling. It is all about economics and dominance of the owner class.
True enough, but that doesn’t excuse psychiatrists for putting out the press release, and claims that they were “misunderstood” by the press are totally bogus. The press repeated exactly what they were told.
Oh, please! Don’t know where you’re hearing this, Frank, but there is no moderation for content, just violating the guidelines we all agreed to. Do you see anything about “discouraging therapy” in there?
Very well said, Rachel! It is the passing on of abuse and trauma that we need to address. Blaming parents’ brains or demonizing them avoids the reality that they, too, are the products of the distorted and traumatic culture in which we all participate.
Actually, there is no evidence that SSRI users are better off in the long run, and some that suggests they may be worse off (in terms of being less likely to recover). So the analogy to street drugs isn’t really that much of a stretch – they do create dependency and withdrawal, we do develop tolerance to them, and they do apparently create some long-term damage to the brain. Just because they don’t make you euphoric doesn’t mean their effects on the brain are any different than street drugs – they just affect a different part of the brain. Neurological down-regulation is still in play, and the long-term effects of down-regulation are very similar for cocaine, stimulants, and SSRIs.
Well, I can’t say my experience is very different than yours regarding clients “wanting” drugs. I think it is an unfortunate “side effect” of the cultural shift toward believing drugs are the answer to everything, brought to us by our lovely pharmaceutical corporations in concert with a very corrupt psychiatric profession. I simply don’t believe it’s possible that these folks would all “want” drugs without the advertising. 80% of Americans believe that depression is caused by low serotonin, even though that idea was debunked scientifically in around 1985. What does one do about that? There is a much bigger picture here that I think we have a responsibility to attack. I encourage you to have a look at Julie’s article on Lauren Slater’s new book to see how a person who ‘Needs her drugs’ is living her life.
Have you read “Anatomy of an Epidemic”, by the way?
This story broke my heart. So many stories like it, where the drugs “work” and yet the person they are “working” on lives an increasingly limited and restricted life, beset by continuing “symptoms” and advancing physiological deterioration leading to an early death. It is the story of psychiatry, the “good news.” This is what ‘success’ looks like for many, many users of psychiatric “services,” and it is appalling.
Oh, and by the way, I’ve historically been a treatment provider, including doing involuntary hospitalization evaluations, and nobody here has ever been particularly hostile toward me or my views on the possibility that people can be helped by quality communication and emotional connection. Some have disagreed with me on the hows and the whys of it, but no one has rejected my views out of hand or personally attacked me for having a different viewpoint. I think it’s because they feel that I understand and deeply care about their viewpoints and experiences and craft my posts accordingly. As a capable ‘mental health professional,’ it seems that applying your skills in human relations that you use in your therapy practice might help your messages be more readily received. Could be wrong there, but it might be worth considering.
Wow, 99% voluntarily? I find that more than a tad difficult to buy into. Do you actually have figures on that, or is that just your impression?
Furthermore, how many of those “voluntary” clients have been lied to, pressured, misled, partially informed, or not informed at all about the effects, potential adverse effects, possible long-term deterioration, withdrawal effects, other treatment options, non-treatment options, etc.? How many were told or learned elsewhere that they had a “chemical imbalance” and had heard drug advertisements telling them that drugs were the main or only answer? How many were told that this was not really known to be the case, and that doctors actually have little to no idea what a “mental illness” really is? How many were children or others not in a position to provide genuine consent? Do you have any stats on those questions?
Your post sounds like an advertisement for your treatment center. I seriously doubt there is a treatment center in the USA which gives 99% of its clients full informed consent about psychiatric drugs and alternatives, or even comes close to doing so. There is plenty of solid evidence that clinicians are not very good at evaluating the value of their own services. My personal experience tells me that those who ARE good at evaluating this are generally very humble and recognize fully the possibility that they may feel great about providing services that the clients actually are not benefiting from.
I have been trying to feel sympathetic to your position, as I recognize that there is high potential value in QUALITY therapy with a gifted individual who is able to connect emotionally to his/her clients. I was fortunate to have found such a person myself in my 20s, back in the 80s when most therapists used psychodynamic approaches and a year or more was considered a normal length of therapy. But I can guarantee you that your clinic is not filled from top to bottom with such capable clinicians, because my experience tells me that they were never common and are becoming rare as hens’ teeth. And because such clinicians are to a person EXTREMELY skeptical about the current paradigm of care, and are generally quite original in their approach to each individual and are not committed to a specific “school” of therapy, it is highlyk unlikely that a community clinic would appeal to very many of them.
Your confidence in the current model of therapeutic delivery at your clinic creates great skepticism in me as to your ability to be objective about the services your clinic provides. Again, this is not because I feel hostile to you OR to the concept of therapy – it’s just that the percentages say that your view has to be grossly overinflated.
Perhaps I am wrong and your clinic is an impressive outlier. Nonetheless, your comment that you don’t see the system as keeping people helpless and dependent seems very far beyond your own ability to observe. There are many, many commenters here who have been the recipients of such services, and I take their word for their experiences as being the most valid source of information available. The number who report intentional and extensive efforts to create and maintain dependence and helplessness and total, unquestioning compliance with the authorities, is quite impressive. There are a handful who felt they got good services, and there are a larger number whose experience was mixed, but the majority report at least at some point serious pressure to limit their dreams as far as education and employment, to get onto social security/medicaid, to expect to be on psych drugs for the rest of their lives, and most report rather extreme measures, including often incarceration and enforced “treatment” with drugs, as the typical response to any attempt to empower themselves to move beyond what the system provides.
While there can be at times a perhaps excessively rigid (IMHO) hostility toward any kind of ‘treatment’ from some posters here, my sense is not that you are experiencing hostility for being a treatment provider, but for trying to defend a system that has committed egregious harms against many people who post here. If you’re unable to accept the viewpoints of those who were so harmed, it is difficult to see how you will be able to engage in any kind of productive discussion on this site. I think the #1 value that underlies Bob Whitaker and the entire MIA community is that clinicians should not empowered to define their clients’ experiences for them. It appears to me that you have not embraced that value, and hence, you garner a lot of negative comments. Read some of Sandy Steingard’s or Johanna Moncreif’s comment threads and you will see a big difference.
A little humility goes a long way, especially for folks like you and me who have not been on the receiving end of the ‘helpful services’ that “the system” provides, often without the consent of the “helpee.” I think we need to listen first and incorporate the reality of the commenters’ experiences into our own worldview. I hope you can hang around long enough to do that, but really, I don’t think it’s proper to blame the posters for responding the way they do if you’re not willing to listen to and validate their direct, personal accounts of their own experiences.
A new and disturbing trend. This will certainly open the door for indoctrination about the DSM and “brain disorders” and “chemical imablances” foisted onto unsuspecting youth.
I have heard more than one similar story. The amazing part to me is how the teacher suddenly starts reporting problems when they realize the kid isn’t “medicated.” Talk about confirmation bias! Are they that stupid that they can’t see and admit that they were wrong? They just TOLD you how much he’d been improving! I guess being “right” is sometimes more important than actually meeting the kids’ needs. Disgusting!
I agree, the profit motive is at the core of the problem. People should not profit from others’ poor health. Healthcare workers certainly deserve to be well paid for good work, but no investor should be banking on making money off of healthcare. It’s one area where the “free market” appears to lead to worse and worse outcomes.
He and his cohorts are busily pretending that people from Mexico and South American (and even Puerto Rico, apparently) are not really human. So punishing them by taking their kids away is OK, since the kids aren’t really quite human, either. This apparently goes too far even for his sycophantic Republican Congress, which kind of surprised me, actually. But it’s reassuring to know that there is SOME level of moral depravity that even the Republican leadership can’t stomach. About time they stood up to him.
I’d say practice defensive engagement. Let the doc know up front that you are consulting them for information, that you’re an intelligent person and will take on their information but will be making your own decision as to what to do, even if they don’t agree. Tell them also that you will want ALL your options, and will take their suggestions home and research them yourself. Ask them if they have any problem with any of this, and if so, you’ll be seeking a new provider.
I never take or do ANYTHING from a doctor without doing my own research. Doctors almost killed my dad when I was 8 or 9 years old and I learned early to verify anything the medical profession claimed to know.
OK. So you didn’t accuse me of saying this was good for suicidal youth, but I was “championing this show as a good thing for suicidal youth.” You are either unable to articulate your point or are contradicting yourself.
And saying I probably won’t be able to understand you isn’t insulting? Is your intellect so superior that even a bright person won’t be able to understand your subtle prose?
You clearly have your well-molded and impermeable viewpoint in place and are unable/unwilling to see anything different. It is not worth my time to try and explain to you how honest the portrayal of adults being unwilling or unable to meet kids where they’re at due to their own authoritarian or self-absorbed attitudes, nor the repeated references to Hannah’s missed opportunities to reach out for help, nor the honest treatment of bullying that is almost never seen in film or television, nor the direct confrontation of rape culture, nor the message to peers and adults that they ought to ask more questions and offer support to kids who are suffering has ANYTHING whatsoever to do with reducing suicide.
I’ll end by observing that your insistence that they show the “real symptoms” of “major depressive disorder seems ridiculous. The reason this was the most popular Netflix original ever is not because people want to watch someone commit suicide. People watched because it felt REAL to them. Again, I’ve worked with tons of suicidal people and have been so myself. You are one person with a few contacts with similar experiences. Your claims to superior moral authority are utterly baseless, as I believe anyone reading these posts can see. I think the proof is in the pudding – kids and young adults LOVED this show. It’s not perfect, but it has great value for kids who deal with these issues and never hear them talked about, IMHO. You’re free to disagree with me.
Suicide is a complex decision. Your generalizations are unsupported by anything but your own experience, as for the most part are mine. People are entitled to their own opinions, but assuming such a superior attitude doesn’t encourage discussion. If you opened your mind, you might find that not everyone who is suicidal or depressed is alike, or sometimes even remotely similar. It is this tendency to try and put everyone who is suicidal (or whatever) in the same “basket” that makes the “mental health” system as screwed up as you claim to believe it is. If you want it to change, you’d best start by dropping your assumption that you already know everything and can lecture people you don’t even know from your very limited personal experience.
But in any case, PLEASE quit attributing things to me that you have no reason to know or pretend to. Speak from your OWN experience and stop generalizing about people you don’t know, including suicidal people you’ve never met. Real healing starts with respect, and you will be a lot more helpful to others if you start by respecting them and listening when they tell you that you’re behaving in an insulting manner, instead of defending your own “rightness.”
You are probably quite correct, and I did have that consideration that it’s possible I might not notice or might not have time to respond before I’d lost all touch with reality. Just for the record, I have never had any objection to people being offered genuine help in a respectful way. It’s just that most of the time, “mental health clients” receive neither the help nor the respect they deserve.
Of course, medical problems should always be the first place to look, particularly when there are other drugs (legal or illegal) involved. I think each person deserves a full workup, including checking any possible medical causes. The problem is, this almost never happens. So my answer reflects that I’d want to know what I was looking at BEFORE I saw the medical professionals, because I don’t trust them at all. Given that receiving medical care is the third leading cause of death annually in the USA, I don’t think my concern is unwarranted!
Well, you start your comment off with an insult and then avoid almost every comment I made, and then simply declare that you are right, and that Alex’s brutal shooting of himself is “romanticized” or “glorified?” It is very hard to take you seriously when you approach conversations in this manner. I’m not simply contradicting you. I made very specific points, such as the clear and severe consequences of Hannah’s suicide for others she loved, and the completely cold and pointless and totally UNGLORIFIED nature of Alex’s act. And of course, you utterly avoid the rest of the show and focus only on two scenes, one of which you don’t even really discuss at all but simply claim to have been “glorified” through some mysterious psychological mechanism.
Your comments about “mental illness” continue to be confusing and illogical to me. If “mental illnesses” are just “symptoms that present in a psychological manner and have no clear somatic cause,” then my statement is completely true – there is nothing to say about Hannah’s “mental illness” except that she hated her life and wanted to die. I’ve never asserted anywhere that people don’t feel depressed and have related ‘symptoms’ or don’t “meet the criteria” for these DSM “disorders.” Hannah would 100% meet the criteria for “Major Depressive Disorder.” So you can easily say she was “mentally ill” just by watching the show. What did you want from the producers? That she be “diagnosed” during the show? If being “mentally ill” is simply grouping together unexplained “symptoms,” how is that different from saying that a person, for whatever reason, is overwhelmed by the conditions of his/her life? Any fool knows that a person’s experience is a combination of their own view/perception of things and the experiences that they have in the world. So what’s it mean to say she was “mentally ill”? And why is that important?
These two questions are what is bothering me about your post. There is no logical path from “Hannah’s suicide was romanticized” or “The show had a bad impact on me and people I know” to “Hannah should have been depicted as ‘mentally ill.'” It makes no sense at all. Hannah WAS depicted as “mentally ill” by your definition. So what should the producers/directors/writers have done differently that would have made it better in your view, other than not writing a show about teenage issues from the teenage viewpoint?
Oh, and just to be clear, you also completely dodged my comment that I did NOT recommend this show for people who are suicidal. I said that it showed teenage issues from a teenage viewpoint, and that’s what makes it valuable. Apparently, you don’t find that point worth responding to, even though it was the main point of my original comment, which made me wonder what your agenda really is here. Based on that observation, it did not appear to me to be your agenda to have a reasoned discussion. I’ll see how you respond to this one and draw the appropriate conclusion.
I would probably start by researching myself and asking when this started and what set it off. The answer might be in the realm of the physiological (it started right after I took X, which can cause “psychiatric” symptoms), or psychological (it started just after an ugly confrontation with my mother in law) or a combination (I haven’t slept well for four days due to worrying about Z). It could be something altogether different that I am unable to imagine now. But I’d look for the source before I decided what to do.
And yet the overwhelming majority of people who are killed by someone else are killed by people who are not experiencing a “psychotic state,” and the overwhelming majority of people in a “psychotic state” never attack or harm anyone at all. People who use drugs and alcohol to excess, domestic violence perpetrators, sex offenders, gang members and wannabes, all of these categories statistically are MUCH more dangerous than “psychotic” people. Not to mention the professional business CEOs (like pharmaceutical companies) who murder millions indirectly and get off with no consequences. Raising the “dangerous psychotic” meme here doesn’t really hold a lot of water, because we know better.
I do respect, however, your statement that psych drugs and even non-psych drugs do cause violence at times, just like street drugs do. Unfortunately, the “treatment” for “psychotic states” is giving more mind-altering drugs to the people who are so diagnosed, which as I think you are intimating can actually increase the odds that they’ll do something dangerous. And when they do, lo and behold, it’s all blamed on their “psychotic state.”
So apparently, for him, tardive dyskinesia is not a negative long-term outcome, and the death as a side effect is not greater than the “positive effects” of antipsychotics. He sounds VERY rational…
So you were SEEKING support for your decision from Kurt Cobain’s letters. People can seek and fund such validation if they want to find it.
I also very much doubt that anyone watching the entire series could view that Hannah’s suicide was “worth it.” It was clearly an act of despair following many attempts to find a way forward with her life. The consequences for her mother, her father, her friends, and her school were obviously devastating. How does it seem “worth it?” Just because she lit some candles before slashing her wrists? It is clearly a TRAGEDY from start to finish. I’d suggest that seeing what her mom and her dad and Clay had to go through as a result of her decision would discourage anyone from considering suicide. The idea that “they’d be better off without me” is clearly and completely dashed by the production.
You continue to suggest that someone has to be “mentally ill” before they’d consider suicide. What on earth can you mean by that? Many people (including me) have suicidal thoughts that stem from having difficult experiences that they have difficulty coping with, including rape or incest or child abuse or neglect or war or gang violence or any of a myriad of crappy things that life has to offer us sometimes. Unless you define “mentally ill” as “having a hard time coping with life”, you have no grounds to stand on here.
I am assuming that you are one of those who believe that “chemical imbalances” are behind “mental illnesses,” and conclude that Hannah or someone like her could never consider taking her own life unless such an “imbalance” was present. If that is the case, it is understandable why we disagree. However, I would love to see any actual evidence you can present to support such a hypothesis. At this time, no “mental illness” can be defined by any physiological process or measurement, including depression. As such, saying someone “has a mental illness” has as much meaning as saying someone “feels like crap because s/he has been abused and mistreated all of his/her life.” The idea that a person has to be “mentally ill” in order to commit suicide is simply an opinion with no scientific backing, if only because “mentally ill” is a vague and subjective term that doesn’t allow any kind of scientific conclusions to be drawn.
In other words, people kill themselves or feel like doing so for a million reasons. Saying they are “mentally ill” avoids looking at the individual’s experience and values and process of decision making, which is, of course, what the series is really all about.
Last comment: how is it glorifying suicide when another kid shoots himself because he can’t deal with the reality of your actions? Was Alex’s suicide romanticized? Was it?
I find your post confusing, as you seem to accuse me of things that I didn’t say. Of course, the suicide scene is overdone, and of course, they’re trying to make money. Obviously. I never said otherwise.
You clearly have your own view of “mental illness” being the cause of Hannah’s suicide. I find that view somewhat bizarre in the face of all the crap that happened to her. Do you really think that people aren’t driven over the edge by bullying, by lack of support, by rape or sexual assault? What is the meaning of “mental illness” in this context? Are you implying that Hannah or a person like her would NOT kill herself despite all the abuse she tolerated if she were not “mentally ill?” Is there a proper, “normal” way to respond to being raped by a peer and then having to face him in school the next day?
If you have specific responses or comments you are upset with, please let me know what they are before you go off on me. It’s impossible to really understand what you’re saying. However, I want to be clear that I NEVER said that this was ‘a good show for suicidal people to watch.’ I said that it depicts the dilemmas that kids face from the kids’ point of view, and that is why I found it valuable.
I will end with the observation that I’ve talked to many, many suicidal people over decades, and not one has ever said they became suicidal because they watched a show or read a book or watched a movie. They all had difficult life circumstances they were trying to navigate, and were struggling to find a way forward. The idea that a show would put something like this in someone’s mind is, again, naive. People don’t suddenly become suicidal just because they see a show. You of all people should know this, having been there yourself. I also have been there, and the things that put me there or kept me there were real things that happened to me, or that didn’t happen, or that I imagined or feared would happen, and while a show or a song might remind me of a certain dilemma or depressing event, there is no way that any show could possibly have affected my decision to kill or not kill myself. Maybe other people are different, but that’s my reality.
This was published in the Journal of the American Medical Association, as mainstream a journal as there is in the USA. The data is from the Institute of Medicine, one of the most trusted government organizations. Here is a link to a summary.
I agree with most of what you said, though I see your clinic as being an anomaly compared to the low-income clinics I am aware of.
Also, the woman I was talking about wasn’t too depressed to consider taking action (and honestly, I don’t buy that such a condition is anything but exceedingly rare – people CAN take action, but they have to find a REASON to take action and have HOPE that it will make a difference!) She was EXCITED to hear there was something else she could do. No one ever bothered to tell her that she had options.
Glad to hear your clinicians are up on the BS involved in DSM diagnoses. I hope it spreads!
Unfortunately, my experience is that the majority of psychotherapists these days adhere closely to the “medical model,” including applying DSM diagnoses uncritically and referring clients for drugs when they fit certain diagnostic categories. In particular, people who don’t have great insurance (which includes probably the majority of Americans) don’t have much choice and are not informed of options that are or should be available, nor are they informed of the potential damage these drugs can do.
I recall talking to a woman on a crisis line who was frantic after a year plus of trying different antidepressants without results. She was feeling completely hopeless until I asked her, “Has anyone ever told you that there are other things you can do for depression besides drugs?” She stopped for a second, and said, “No…” When I told her that there were, she was SO relieved! Imagine, a whole year plus interacting with mental health professionals, and not one had told her there was another alternative?
The idea that therapy is better today than in 1970 doesn’t seem right to me. At least back then, they had the idea that talking and listening was part of the process. Today, it’s much more about categorizing and changing “symptoms” rather than exploring meaning and options. At least that’s my experience.
What do you think about the euphemistic use of the term “overprescription,” Frank? Wouldn’t it be more accurate to say “unneeded prescription” or “Unjustified drugging of children?” To me “overprescription” implies that there would be a ‘right’ level of prescription, which of course is impossible to determine when your criteria for diagnosis include such objective measures as “sometimes fails to wait his turn in line” or “sometimes acts as if ‘driven by a motor.'”
Very true. The first mistake is assuming that all “hyperactive” kids have a problem, and then assuming that they all have the SAME problem, and then assuming that the problem lies in the CHILD (or more specifically, the child’s BRAIN). None of these assumptions are supported by even a slight degree of evidence. Catering to individual needs is, indeed, the answer, but that would require the adults in charge to take responsibility, and it is SO much easier to blame the kids, especially when billions in profits are to be made into the bargain.
Perhaps it is a success, because the proponents had a different goal in mind than actually helping people. I agree that if we assume the purpose of psychiatry is to assist people in becoming more functional and dealing better with emotional distress, it is a disastrous failure. But if the actual purpose is making a lot of people rich by creating permanent “clients” who can be forced to accept “treatment” even if it doesn’t work or makes things far worse over time, and establishing power for the psychiatric profession to define what is “normal” in support of the current status quo hierarchy in society, I’d have to say it’s been a roaring success.
People’s biggest mistake in engaging with psychiatry (and to a lesser extent, the entire medical/pharmaceutical/insurance industry) is making the assumption that helping us obtain better health is the primary objective. Receiving medical care is the third leading cause of death in the USA annually. If patient health were really the objective, this statistic would horrify the medical world and lead to massive efforts to find and eliminate the causes of these unnecessary deaths and harms. The fact that it has not led to such an outcry and effort should be enough for us to realize that their objective is something very different, that has very little to do with maintaining their clients’ health and well being.
I think this is a very important clarification. We have spent way too much time attacking each other for being “too extreme” or for not being “antipsychiatry enough.” Both goals are legitimate and necessary to move forward, because however much we’d like to remove psychiatry from the face of the planet, people are suffering TODAY as part of this system, and such people need help TODAY and can’t wait for capitalism to collapse and some other better system to take its place that recognizes that psychiatry as practiced today has no place in a civil society. At the same time, it is VERY important to recognize the degree to which participation in the system suggests a degree of tacit approval of some of its principles, and that those very principles are the things that need to be tossed out!
There are a lot of aspects to this whole process of moving in a new direction, and I agree that identifying one’s goals is important, but it’s equally important to recognize that others may have different goals and that as long as we’re all working toward ending the abuse of the “mentally ill”, having different final outcomes in mind should not keep us from working together.
The title is unfortunate. These are not “mentally ill students,” they are any student whose behavior is sufficiently inconvenient or uncomfortable for the college to deal with. Better to excise the “problem students” than to examine the conditions in the university or our culture as a whole that lead students to a sense of despair.
Like the story of the frog in the slowly-warming water. Apparently, if you heat the water up slowly enough, the frog never realizes s/he’s heating up and dies despite being able to leave the water at any time.
Of course, we might want to ask who exactly thought up this experiment…
“Very few” doesn’t mean “nobody.” I have never argued for an elimination of the drugs, as I am well aware that a significant percentage of those labeled as “mentally ill” find them helpful in one way or another. I simply object to the psychiatric profession defining your reality for you, and especially to them forcing “treatment” onto you whether you find it helpful or not.
They claim that the increase in stimulant prescriptions is “unexplained.” But it is easily explained! When you start with a “diagnosis” that has no objective criteria to “diagnose” with and which has no boundary between it and “normal,” and you add a drug which provides both a financial incentive to the prescriber AND a social incentive to the parent/teacher looking for a prescription, you have a formula for an ever-increasing rate of “diagnosis” and prescription.
One thing that would help is if we stopped saying “overprescription” or “overdiagnosis” and we started saying “unjustified drugging” and “malpractice.” These euphemisms make it seem like it’s just a little “whoopsie” instead of a massive and continuing abuse of both a “diagnosis” and a drug that are being used mainly to control unruly or active kids for the convenience of the adults involved.
It is also important to add that this trend toward increasing “diagnosis” and drugging flies in the face of decades of long-term studies showing that the kids who receive stimulant drugs do not improve in any long-term outcome area relative to other “ADHD” kids who are forced to take stimulants only in the short term or not at all. Given the clear risks that giving a kid stimulants entail, there is no excuse for this continuing malpractice.
Great analysis! And despite these biases and limitations of the HAM-D, “antidepressants” STILL have difficulty reaching even a three-point improvement on the scale. Pseudoscience at its best!
It appears I have not communicated clearly enough. I had no intention of minimizing your suffering or that of those who have similar experiences. I have worked for years with people who have difficulties that get labeled as “mental illnesses” as both a therapist and an advocate, and I have a very good idea of the kind of pain and confusion such conditions can bring about. I am also not opposed to using drugs for those who find them helpful, and never have been. Nor am I arguing against individuals such as yourself embracing a particular label or identity that you might find helpful, nor am I proposing that I have some magical understanding of “what is wrong” with people who get these labels or what you or anyone else should do about it.
What I object to, and I make no apologies for it, is a profession getting together and deciding to create these arbitrary names and categories that they give to people based solely on how they act or feel, and then act as if these names are some kind of scientific reality that they can apply with confidence to anybody that comes through the door. I object even more strenuously to the “profession” blaming people’s brains for any kind of distress or upset that they exhibit, as if their surroundings and experiences and the people and stresses they have to deal with have nothing whatsoever to do with their suffering. I object most strenuously of all to those embracing the DSM categories using them to look down on those so categorized and treat them with disrespect and prejudice and discrimination based solely on the category that the “professionals” have chosen to put them into, including locking some up and forcing “treatment” on them that may or may not be helpful and may or may not be totally destructive, without that person having a word to say about it.
As the person who is suffering, I consider that you have every right to decide what your suffering means to you and what you think may be helpful or destructive. I don’t think it’s someone else’s job to make up subjective or arbitrary categories and then tell you what is “wrong” with your brain (even when they have almost zero knowledge of your brain) and what you have to do about it, and it’s especially not their job to force you to do it if you disagree with them. There is good evidence that this approach encourages a lack of empathy and a prejudiced approach to people who receive such labels, all of which I believe makes your life a lot tougher.
So by all means, identify as you feel is appropriate and use whatever means you think will best help you deal with your reality. My comments are not about you and your choices, but about the intentional efforts of the psychiatric profession to create a false, pseudoscientific narrative to keep people like you under their control and to make billions for their profession and its big corporate allies. I will never apologize for attacking these efforts, but I want to be very clear that you and your needs are a completely different story, and I’ll fight for your right to define your own experience and needs.
Except that the labels create the culture that supports the drugs. If there were not the belief that psychiatrists “know something about the brain,” and that their labels represented some kind of scientific truth, the whole edifice would fall on its ugly ass. It’s people’s belief in the labels that makes all of this possible. I really believe that if pseudo-scientific labeling were eliminated, very few people would want these drugs.
I’m confused by this particular conflict. It seems to me that the Spotlight report reframes the mistreatment and abuse of the so-called “mentally ill” as the human rights issue that it really is. I don’t expect a mainstream bunch of attorneys who are pissed at their clients’ treatment and are trying to do something about it to meet some “antipsychiatry” standard. They are fighting for the rights of their clients, and GOOD FOR THEM! I think there is a lot there that is very useful for the most radical antipsychiatrist to use, and for the mainstream language and the rest of it, I consider it simply the reality that not everyone has come to the same degree of awareness of how the system works and what’s behind it. My thought is that we should engage anyone of goodwill in this discussion, and that anyone who understands and is genuinely opposed to the status quo (as opposed to having a financial interest in the outcome) is AOK by me. If we expect everyone to be in favor of eliminating psychiatry, we’ll be preaching a lot to the choir.
The problem I see is that those in power are factually opposed to the idea of peer specialists and/or patients having any increase in power or voice. It’s possible to create little pockets of enlightenment, and I truly value and admire those who manage to do so (having been such a person myself at one time). I just think it’s too easy to co-opt or silence those whose interest is to genuinely empower the clients. Lots of clinicians talk a good game, but when push comes to shove, they are disturbed and threatened on a very deep and usually unconscious level by anything that supports clients making their own decisions and being let out from under the full control of the clinical staff.
There really are such things as “scientific values,” but unfortunately, anything can be co-opted.
My understanding of scientific values includes: 1) Observable data is the only basis for determining what is true; 2) Human beings are inherently susceptible to confirmation bias, therefore, the primary role of science is to be skeptical and to intend to disprove potential hypotheses rigorously rather than searching for data to support them; 3) Scientific models are only as “true” as they are useful in predicting real data and events, and they are true only as long as they consistently produce this kind of result; 4) ALL data relating to any particular hypothesis must always be made available to all researchers – per #2 above, any data potentially REFUTING a hypothesis is particularly important to make available.
There are more and there are other viewpoints on what makes an inquiry scientific, but the idea that scientists have some special knowledge and ability to determine truth and that those less qualified should stand back and let the scientists do their jobs is certainly not valid. Many scientific discoveries (or invalidations) are made by people in a different field entirely. Science is about finding the truth, and no one has special access to the truth.
It’s also important to remember that “works” is defined here only as “temporarily makes ‘symptoms’ less bad than they were.” It does not imply feeling good, nor does it imply long-term improvement in prognosis or outcomes. Whitaker has done a great job showing that even if these drugs “work” for the short term, they tend to make things worse in the long run. And for many, even the short-term results can be disastrous, even if they are judged “helpful” on the average.
Your point is very well taken. Heisenberg proved that even the most precise measurement is an approximation. Perhaps the focus on measuring is not really relevant to helping people survive better, eh?
Not sure why we appear to be arguing here. I have never spoken against using science to study human behavior. I am a scientist (chemist) by training and am well aware of the advantages and limitations of the scientific method. I also posted my clear understanding that general trends can be arrived at scientifically using norms and averages. What I objected to is the idea that certain therapy “brands” can be identified as “evidence based” and therefore considered reliably better or more effective than those lacking this “evidence base” in most or all cases. I and others have outlined in several posts both the limitations of such evidence when applied to individuals AND the financial and other biases that warp the “evidence base” in favor of certain kinds of interventions (drugs being the MOST supported by “evidence” because, of course, they get the most funding for research since they make the most MONEY.)
It seems to me that your arguments mostly support an evidence base for certain very specific signs/symptoms being best approached (at least initially) by certain means. I don’t have any real argument with that. The problems arise when we either overgeneralize (if phobias are most likely to improve with exposure therapy, then exposure therapy is the best therapy for ALL forms of anxiety) or fail to adapt to individual circumstances (some people WON’T improve with exposure therapy but will with something else, and some don’t have elimination of that “symptom” as their goal). So the science involved in psychology is mostly applicable to people considered as a group, but only if that group has very specific characteristics in common, which we all know that most people working in the field don’t grasp.
The greater danger of “EBP”, though, is when it is applied to entire DSM categories, or to therapy in general. I can’t tell you how many stories I’ve heard where CBT or DBT (or drugs) have been forced on someone because “that’s what works” or “it’s evidence-based practice.” I recently heard from someone that they and others were FORCED to do “mindfulness” exercises every day as part of a DBT group (they got in trouble if they refused). I’m not sure how familiar you are with mindfulness, but I think it’s fair to say that forcing someone to do mindfulness exercises is deeply ironic and defeats the very purpose of the concept, kind of like your Dad saying, “We’re going on a trip and you are going to have FUN, do you hear me? FUN, whether you like it or not!” Oddly, this person did not find “mindfulness” very helpful…
You can (perhaps rightfully claim) that this isn’t really the “EBP” that was studied, and that it’s being misapplied, but that is what clinicians tend to do when presented with this EBP concept. As a scientist, my observation over many years is that science is by far the best at showing what DOES NOT work by falsification. This is particularly true when humans are involved. It is, again, arrogant, in my view, to suggest that a particular therapy is THE BEST for any diagnosis, or that ANY particular therapy is bound to work for a particular person. I think that science itself has shown us that the DSM categories are not scientific entities and are grossly heterogeneous, such that proposing any single solution based on grouping people together by how they feel or think is bound to lead to unscientific practices.
BTW, I noticed you didn’t address my point regarding “EBPs” for a diagnostic category like “Major Depressive Disorder.” It seems to me that your example of phobias is a very focused and specific category compared to any DSM diagnosis. Do you think there can be an “evidence based practice” that applies to all people who are diagnosed with “MDD” or “Bipolar disorder” or “Borderline Personality Disorder?” Do you see a danger in prescribing a particular approach to take with ALL people in such a category? Do you see potential corruption in marketable “workbook strategies” that would encourage the marketers to claim more general success than is actually observed?
In my experience, what these “EBPs” provide are concepts that can be applied or attempted in specific situations, but the bottom line continues to be whether or not the client him/herself accomplishes his/her goals in his/her own opinion, and any clinician who considers his/her school of therapy more important than the client’s response is going to have a lot of failures, and will be very tempted to blame his/her clients for those failures instead of coming up with a different approach.
I agree with oldhead that it is not possible to objectively measure emotions, behaviors, and beliefs with behavioral rating scales. First off, we are relying on either self-report, which depends on the reporter both being honest and sufficiently self-aware to answer accurately, or on observer report, which opens us to prejudice and value judgments that are almost impossible to sort out. Additionally, what we are measuring doesn’t really have width or weight or pressure – things like “do you sleep well at night” or “do you frequently have trouble concentrating?” don’t have yes/no or scalable answers. Normalization allows for some kind of statistical studies, which makes it possible to look at large groups and draw some very general conclusions about probabilities, but as for measuring individuals’ emotions or thoughts or anything of that sort, we’re getting into a realm so subjective that the term “measurement” can’t really be applied. And applying probabilities to individuals is part of what doesn’t work about “mental health” interventions.
I agree 100%! There is NO evidence that I’ve ever seen that assigning homework is correlated in any way to improved learning. My son had to do sometimes 3-4 hours of homework every night for days at a time. He was also on the wrestling team which had meet run until 9 PM a couple nights a week. It was ridiculous, and for what?
I’m also a great believer that free time is at least as educational, probably moreso, than any work assignment kids ever receive. We learn best from things we’re interested in, not something we’re forced to do to make someone else happy.
I agree in principle. However, the problem right now is that “training” doctors in the area of “mental health” would mean they’d be trained in the crappy DSM/chemical imbalance/Drugs first paradigm. Before we start training doctors, we would need to figure out how they need to be trained. Moreover, just training someone doesn’t make them able to handle difficult issues with compassion and skill. I have no idea how we could assure that all doctors are capable enough to be a safe place to go with this kind of intimate issue. My personal belief is that peer support is a much safer and more reliable option.
That’s why I find the DSM to be more problematic than the drugs themselves. It provides a rationalization to distance oneself from both the clients and one’s own personal issues. Instead of making oneself open to hear where another person is coming from and feel compassion and help them figure out what action they might take, clinicians are now allowed and expected to categorize people based on their particular “brand” of suffering, and their suffering IS the problem instead of an indication of some personal problem they may have. It also makes it easy to blame your “client” if your own approach fails, as the article points out.
Now I’m really confused. Laughing gets me committed, but failing to laugh somehow means I’m denying my “illness,” and I get committed anyway? This would certainly wipe out any tendency I’d ever have toward excessive cheerfulness. I think I’m cured! (Oops! Still with the exclamation points…)
The situation is even more dire than your comments suggest. If the suicide rate is higher amongst the “treatment group”, and the treatment group has been PRE-SCREENED for suicidality and suicidal people are removed in advance, it means ALL of the suicidality reported is caused by the drugs! So the drug doubles the suicide rate AMONG THOSE WHO ARE NOT SUICIDAL. What it would do when we include people with suicidal feelings into the cohort? Frightening to think.
I remember those ads where “more doctors smoke Kools” or something of that nature. Disgusting!
The psych wards I have visited usually have smoke breaks maybe 2-3 times a day. Many of the inmates are pushed into nicotine withdrawal as part of their “treatment.”
I agree with the captioned statement 100%. Unfortunately, I think many people don’t understand what that means. I think a lot of people think it means that all white people are racists, or all white people are bad people. It doesn’t. It means that we’ve all been exposed to racist images and stories and ideas, and that it take a strong, conscious effort to be aware of that and to set it aside as best we can. I think acknowledging this fact is a fantastic first step for people to realize that racists beliefs and ideas aren’t something held by some small percentage of evil people who use the “N” word and beat up black people. They are a part of our entire culture It is much bigger than some bad individuals doing bad things. It’s a part of our culture, and to change it, we have to start by being aware of it, and that good people, even the best people, still have to work to be aware of and counteract these racist images which have become embedded in our own experience.
I agree with you 100%. Epigenetics and neuroplasticity directly undermine the “broken brain” model and are therefore conveniently ignored by the mainstream of psychiatric research. This is not new information, either – neuroplasticity was uncovered back in the late 1990s, almost 20 years back. But you can’t use neuroplasticity to sell drugs, so it seems to get very short shrift.
For those who don’t know, I’m moderating this week while Emily is moving to her new digs in another state.
I’m speaking with my moderator hat on here. Personal attacks of any sort are not allowed, regardless of perceived provocation.
If a post seems personal or inappropriate to you, the correct handling is to report the post and let the moderator handle it. At this point, we’d like to see everyone get back to the topic of the article.
Well, it sounds like we’re not too far apart here. I think just approaching the problem from different directions. My big concern about manualized therapy approaches is that they convey the idea that if you follow certain steps, you’ll get results, regardless of who you are or what the client’s full presentation is. The corollary to that quickly becomes: clients who DON’T respond to the ‘recommended technique’ are “resistant clients” or have “treatment-resistant depression (or anxiety or whatever)” and are classified as somehow “difficult” clients because they don’t cooperate with the therapist’s biases. In addition to the problems with warped data collection and some approaches failing to ever BE researched (as I discussed above, and as I THINK you agree), calling some therapies “evidence based” has been used to dismiss anything OTHER than the “evidence based” approach, so that instead of saying, “Let’s start here, as this is what is most likely to work,” the field quickly devolves into “This is the only way to do it, and anyone who denies this or tries anything else is “antiscientific.” There is simply NOT enough scientific research available to make such claims, especially (a point you have not really addressed) as the groups being so “treated” are by definition highly heterogeneous in nature.
As to your quote at the end, the discussion of “classification” and “misclassification” really does suggest a power relationship of the therapist to the client with which I strongly disagree and have found to be detrimental to any kind of help. No one needs or wants to be “classified.” They want help finding a way to survive and thrive better in their lives. It is exactly this kind of “classification” that concepts like “evidence based practices” enshrine. And of course, it is not by chance that both classification AND “evidence based practice” are most strongly supportive of the sketchiest intervention of all – giving drugs for every ailment. I sometimes wonder if that was the original purpose of the concept.
While I hear your views and totally get where you’re coming from, I can’t agree that psychiatrists always go into the field because they want to help. Just like some police go into it because they like to be able to run stop signs and give orders, and some join the army because they like to shoot guns, and some teachers go into teaching because they want summers off, some psychiatrists (like any field) go into it for less than altruistic reasons. I’ve seen some psychiatrists with such incredible power needs and egotism that all the staff at the facility are terrified of them, not to mention their clients. I’ve seen some who appear “nice” on the surface but actually enjoy setting up double binds and manipulating both clients and staff. Sure, the majority probably believe they are helping, but the fact that they chose this particular way to help does say something about who they are. There are a few wonderful psychiatrists out there, but I am afraid to say that most I have known are neither thoughtful nor very sensitive to their own clients, and many stories support this.
I’m glad your son is able to tolerate the drugs and they have the desired effects for him. I know there are many others who feel similarly. But there are also many who feel their lives have been destroyed by psychiatrists and the mental health system, and those people don’t have advertisements and celebrity endorsements to support them. A lot of them come here to be heard.
You are too right. Doctors are accused of “overtreating” or “overmedicating” instead of MALPRACTICE. Additionally, most of the deaths are not from medical ERRORS, but from the side effects of properly prescribed and administered drugs. So accepted medical care is killing off over 100 million people annually, no errors involved. Scary situation, but no one seems to want to do a thing about it.
I think we’re speaking to two different issues here. Is it possible that a certain approach works better for a certain kind of problem? Yes. Is it scientific to suggest that you can train anyone to use a workbook to apply such approaches to anyone who comes to them and expect success? No. You’re talking about probabilities with an incredible number of variables. I do believe in probabilities, but the variable of who is talking to the person and how they treat the person is AT THE LEAST as important as the technique they choose to use. Moreover, suggesting that “CBT”, for instance, is a “better therapy” because a larger percentage of people with a certain kind of condition respond positively by some subjective measure is a gross oversimplification.
Let’s get off of your one example of phobias and talk about something more general. Is CBT the “best” therapy for “major depression?” You know and I know that the name “major depression” can be assigned to a huge range of conditions that vary from childhood abuse to low thyroid function to a bad job situation to domestic abuse in a current relationship to existential concerns about the meaning of one’s life to feelings of hopelessness regarding a chronic medical condition that is drastically reducing one’s quality of life. Do you think that one brand of therapy is going to address every case of this “diagnosis?” Do you think that the style, emotional health, flexibility, creativity and life experience of the therapist would not be at least as important a factor?
I have used CBT techniques plenty. I’ve also used Motivational Interviewing (though I kind of invented that myself before I realized I was using it), regressive techniques, exposure, “rejection therapy,” spiritual guidance, meditation, journaling, dreams, empowerment techniques, reflective listening, reframing, positive reinforcement, and a few inventions of my own that I won’t get into trying to explain. It all depends on who the person is and what needs they have. My experience is that a) what works for one or even most people won’t work for everyone, and 2) the PREREQUISITE for ANY of these techniques working well is the establishment of sufficient rapport and trust with the client, which is not something that ANY manual can teach – it is learned through having good therapy oneself and/or through humility and the hard work of introspection over many years. Again, I’m not saying that techniques don’t have their place, or that a particular technique might not work well for a lot of people with similar “symptoms.” I’m saying that pulling out a workbook and going through the steps of CBT or exposure therapy or any kind of manualized therapy doesn’t work without these other elements, and I’m also saying that trying to suggest that one particular therapy is “evidence based” and therefore BETTER than other techniques creates unfortunate dynamics that don’t really connect with the intangible stuff that HAS to be present, nor does it allow for the observable fact that people presenting with the same “symptoms” don’t always have the same problem or the same needs.
Not being argumentative here, just trying to be clear. I have NO problem with knowing a range of techniques AND knowing such data that informs when they may be more likely to be effective. What I have a problem with is deciding that “CBT” or whatever is the ONLY approach that can be applied and that any other approach is “less than” because it doesn’t have an “evidence base.” None of what I’ve said even gets into the sketchy research techniques used to gather such evidence, nor the effect of financial incentives to research or not research particular techniques or areas (impossible to be “evidence based” if no one is motivated to pay to research your particular approach). Bottom line, I think that knowing how to handle a wide range of techniques is important and helpful, but will never overshadow the essential elements of establishing and maintaining genuine rapport and flexibility with clients, which of course will never be a focus of any research.
I would add that while I think techniques are handy and valuable to have around, and do not in any way diminish their potential value to a particular client, it is more than possible that the next client you have will not respond well at all to the approach that worked so well for this particular person. The idea that a therapy is “evidence based” appears to suggest that it is the better therapy for everyone with a particular problem. Since the problems that we’re talking about can’t be defined in any kind of objective way, it seems arrogant, at the minimum, to suggest that “science” has somehow come up with the “best way” to deal with problems that are heterogeneous in both origin and in meaning to the client.
So I’m not dismissing therapeutic techniques here. I’m saying that suggesting one school of therapy is superior for all based on the fact that it has been “studied” and that more people with a particular complaint on the average seem to benefit is a very big leap. It may well be that exposure therapy is more likely to be helpful for a specific phobia, and we should all know that, but that doesn’t make exposure therapy better for everything, nor does it mean that a particular client will do better with exposure therapy for their particular phobia. It also doesn’t mean that some goofball who is thoughtless and insensitive and has lots of personal issues that make him/her emotionally unavailable and difficult to relate to can take out the “exposure therapy” manual and be trained up to do “exposure therapy” on anyone successfully.
Evidence is important and should be considered, but making out that one school of therapy is the best and should be used on everyone, or that the characteristics and interpersonal skills of the therapist are irrelevant, is simply not true.
My personal approach is, “What does a person’s religion have to do with whether or not science supports the short- or long-term use of psychiatric drugs?” It generally stops people in their tracks, and if it doesn’t, it makes it obvious they are avoiding the issue.
Reality CAN be a bit inconvenient at times. I’m not against a little healthy denial from time to time, but not when people in power use it to continue to hurt those who are already hurting, just so they can feel more comfortable and make more money.
I agree – it appears to me that the very choice to identify “mental illness” as anything at all immediately creates “otherness” and invites prejudice and discrimination. Instead of saying, “She has depression,” why not say, “She is sad a lot of the time and struggles to find anything positive to look forward to in her life.” The latter formulation affirms the person’s individuality and implies a possibility of change and development over time. The former simply slots a person as belonging to some group of afflicted people whom we can readily decide are not like us, so we can feel pity for them while at the same time not really bother to care, since they have a “disease” and it’s now the doctors’ problem.
Seems like nobody believes anything until there are brain scans these days. Anyone with an ounce of common sense (though as baseball announcer Tim McCarver once said, “If it were all that common, more people would have it!) would know that most “mental illnesses” are caused or massively exacerbated by high stress environments. Of course, no one in power really wants to tell this story, because it doesn’t sell pharmaceuticals, so this kind of report is relegated to the back pages of “Science” and no one ever reads about it, even when the conclusion is so obvious.
You are clearly obsessed with the silly idea of being treated respectfully by the psychiatric profession. You’re also delusional because you imagined such a thing was possible. You’re only healthy when you believe all you are told and stop worrying about silly little things like being listened to and respected. After all, you’re just a brain, and how can something like respect or listening make a difference to a big mass of chemical reactions?
(Just in case anyone is unclear – the above is intended to be utter sarcasm!)
While I am not well versed in the various arguments and data in favor of one form of therapy over another, I am agreement in the author that calling “CBT” an “evidence-based therapy” privileges it in a way that is not deserved. In fact, my observations and my limited exposure to research on particular therapeutic schools suggests that the school of therapy is a very small part of what makes therapy effective. I regard CBT as ONE tool (or maybe one TYPE of tool) in a large toolbox, and psychodymanic approaches are another set. But bottom line, what seems to matter most is 1) the relative emotional health of the therapist, and 2) the ability of that therapist to support the client in his/her own discovery process by whatever means appear to be most effective in his/her case. This requires therapists to be genuine, real, honest, non-judgmental, safe, creative, thoughtful, and sensitive regarding verbal and nonverbal feedback they receive from the client. It also requires the therapist to be aware of his/her own unresolved issues and constant vigilance to keep these from directing his/her intervention and support in any way.
None of this can be taught in a manual, and I doubt it is even measurable. Nor is a client’s progress really measurable in real terms. Most studies use “symptom reduction” as their outcome measure, but clients generally have a lot more than symptom reduction in mind when they come to see a therapist. How do you measure things like an increased sense of personal power? Hope for the future? Ability to set boundaries? Ability to connect with difficult emotions without recoiling or acting out to avoid them? These things are subtle and don’t improve on a 1-10 scale. They are things that are more FELT by the client than observed by the therapist directly, and even if they were measurable, “evidence based medicine” doesn’t have either the means or the interest in measuring them.
Evidence Based Medicine is more appropriate to actual disease states where outcomes like lowered blood pressure or failure of a tumor to return can objectively be recorded. There is no objective measure of even who HAS a particular “mental disorder.” How can we measure improvement when we have no objective measure, or even any real objective CONCEPT, of what improvement looks like? Given the circumstances, the only possible worthwhile measure of success in therapy is the client’s opinion of whether or not it was worth his/her time and energy. And of course, no one is ever going to care enough to try and measure THAT!
I agree that power is the real issue, and that eliminating psychiatry might very well lead to some other “profession” taking their place in exercising the same kind of power and control. I will note, however, that money is absolutely power in our society, and that Big Pharma and the psychiatric “profession” have used finances to sell the “broken brain” story, and that a large degree of psychiatry’s accepted authority comes from marketing. It seems to me that even if psychiatrists are unable to force “treatment” on the unwilling (which I agree 100% is Job #1), their use of massive funds to manipulate people’s perception of reality also needs to be address.
Such people have no business calling themselves therapists. I am very familiar with this type and have criticized their “trade” since my earliest days in the field. Eventually, I couldn’t stand being around such “services” and went into advocacy. I was fortunate that my therapist actually cared about me and knew how to be helpful. No diagnoses, no drugs, no hospitals, just good, solid questions and good listening. A vanishing breed.
ALL Starbucks employees? I have met many Starbucks employees who appear to be decent or even very interesting people. While I am not a black person and can’t say I’ve been able to directly test out your comment, I’d say it is important not to overgeneralize about people just because they happen to work at Starbucks. Which takes nothing away from your argument that “designer coffee” joints like Starbucks definitely promote snob appeal and elitist attitudes to sell more coffee for more money.
Nope. Dogma is dogma. This doesn’t mean we don’t have values that drive our decision making. The point is whether other people are bent on defining my values for me. I get to make my own decisions regarding what is a priority for me, just as you do. I have plenty of issues with folks in groups claiming to be “social justice” oriented groups using hostile language toward people deemed to be “less than.” I also am not afraid to point out when a person is being inconsistent or irrational, whether they are “left” or “right” leaning or lean some other direction. Not saying I don’t have my own biases and “dogma,” but they are MINE and not foisted on me by some outside group demanding I comply in order to belong.
I think that is an excellent clarification, and I believe I truly understand where you’re coming from now. Never really thought of it that way, but it makes total sense. Thanks for the enlightenment!
Though there are societies where adults simply move into adult roles but continue to be cared for by the community. These societies seem to be a lot better at figuring out how to find the value in community members who don’t “fit the mold” as we in industrial societies seem to expect everyone to do.
I think it’s very legitimate to let someone know how s/he is affecting others. I’m not sure it’s quite true to say that someone “wants to suffer.” But there are “secondary gains” that sometimes make it harder to throw off the “suffering victim” role. It can take a lot of strength to be willing to examine what you’re really doing to harm other people, especially if you have “professionals” backing you up on your inability to make any changes.
I have lately heard from an increasing number of people that their therapist diagnosed them and sent them for drugs rather than providing real therapy. I’m afraid it’s happening more and more often, and that our up and coming therapists are spending more time learning DSM diagnoses and less learning how to connect effectively with a client’s reality.
Well, I can’t really argue with that, though the same can be said for many academic disciplines. I believe all education should lead to action. What I would object to is setting up a course of study that did not allow a range of viewpoints and honest discussion of potential strategies, or even a questioning of the goal itself. I detest anything that even vaguely smells of propaganda and/or dogma, even if it’s something I tend to agree with. I don’t want to replace one set of dogma with a new one!
This has certainly been a fascinating discussion, and I’ve mostly just watched so far. I have to say, I’m a little puzzled by the critique of MIA for hosting such a seminar. If Bonnie Burstow is endowing a “Chair for Mad Studies,” then I feel comfortable assuming that “Mad Studies” has a distinctly rebellious intent. That being said, MIA has a mission and part of that mission is to show a wide range of views and information on the topic. That this information is slanted away from supporting the status quo can not be doubted, but MIA doesn’t appear to have some “litmus test” regarding who is ideologically pure enough to post here, and I’m glad they don’t. Some of the blogs that are closer to mainstream views generate fascinating and important discussions, as do some of the clearly antipsychiatry blogs. I personally prefer to have a wide range of information and views available rather than being limited only to the “acceptable” range of opinions on the topic. My assumption would be that
“Mad Studies” would similarly look at a whole range of data and opinions and experiences and encourage students to draw their own conclusions, which I personally think is how education should work. If the administrators decide ahead of time what you’re allowed to read or hear, then it’s indoctrination, not education.
Interesting that caring about the needs and context of the student’s experience doesn’t seem to make the list of important counselor qualities. Let’s be honest, the whole idea that you can “assess” a child and label them provides excellent cover for continuing ineffective classroom and schoolwide practices. Maybe we should keep it simple and just work on teaching each child in the way s/he needs and leave all the “assessment” and “evidence based practices” to those with too many degrees to play with?
Where did I say that? I’m merely differentiating between psychological impacts (which are to some degree within the control of the one being mistreated) and the physical and social consequences, which are not controllable by the victim. It’s all well and good to say “don’t care what someone thinks about you,” but if they don’t hire you or won’t speak with you or won’t rent you an apartment or shoot you or lock you up for being “mentally ill”, your attitude doesn’t stop them. So attitude is important, but wanted to make sure to clarify that attitude is not an antidote to oppression.
Not sure what you’re arguing about. I agreed with you regarding psychological freedom. I’m merely pointing out that not all effects of prejudice and oppression are psychological.
Let’s be honest, the system’s biggest fear of “peers” is that they will talk about the possibility of not following orders, especially as regards “medication.” Their second biggest fear is that the “peers” will call them out on their lack of knowledge regarding how to help, or will show them up in some way that embarrasses them. Both very “patient centered” reasons to be worried, eh? It’s all about control, and those who fear “peers” fear losing control, usually because they have no idea how to establish any kind of helpful relationship with anyone.
Not at all, but liberating oneself from PHYSICAL slavery or analogous conditions of abuse and oppression takes more than “not caring” what your owner thinks of you.
Unfortunately, it IS used to interpret the nature of human experience, even though it is a billing document. It takes a special kind of idiot to use a billing guide to make determinations about human experience, but apparently, there are a lot of idiots out there pretending to provide medical advice.
True, Julie. Looking at movie stars and TV personalities of the late 50s and early 60s, it’s obvious that a more full-figured woman was more than merely acceptable. Times have changed, and once again, the rigors of corporate capitalism and TV advertising seem to be pushing the trend.
Yeah, I hear you. Unfortunately, if you insisted on full scientific rigor in psychiatric/psychological research, MIA wouldn’t have much left to publish, since it all starts with the disproven assumption that people who act the same way as described in the DSM have something “wrong” with them, and in fact have the SAME thing wrong with them which has to have the SAME “treatment.” Kind of like prescribing medical treatment based on someone’s astrology chart. Probably not going to get much that’s truly of scientific value!
I think MIA sometimes just reports on relevant research, most of which is written from the “medical model” viewpoint. It is a bit frustrating, but the report does offer up some good information that actually supports the idea that external conditions and events (in this case, physical activity) have a major impact in how people feel and behave. So I’d rather read the information and put their comments into perspective rather than filtering out anything that uses medical model language, which would mean missing a lot of interesting data.
I agree with you here. “Not caring” is really more of a coping measure than a means of addressing abuse. It’s something I’ve learned to get by, but it is less and less easy to do the lower down a person is on the social hierarchy. As I said, “not caring” doesn’t stop people from ganging up on you or discriminating against you or the group you’ve been identified with. Not so easy to “not care” when you’ve been locked up in a psych ward and then put on an AOT order that threatens to lock you up if you don’t “take your medication” per their orders!
Because the ruling powers in society need them, and because their “diagnoses” shift the blame off of those with the most power and place it onto those with the least. Because it absolves our society from having to do anything about the adverse conditions we create, because those who can’t “adjust” are found to be failing, rather than the conditions they are expected to tolerate.
Why not just categorize people as violent based on their acts of violence? “Schizophrenia” doesn’t need to enter into it, any more than “black violent person” or “rich violent person” or “Canadian violent person” would be legit labels. People from ANY category can be violent. It’s the intentional association of violence with “mental health issues” that needs to be negated.
I do the same. I have actually gotten to the point where I really DON’T care what a lot of people think, but still, people who I care about have an effect. I’ve worked on being honest about this effect, but it’s still a very natural source of anxiety for me and a lot of people. Not caring means being disconnected, and we all want to feel connected to someone or something, or most of us do, anyway. It’s the disconnected ones who are OK with it that scare me!
Thanks, Julie! I am well aware that some women choose not to worry about glamour and whatnot, as my wife is one of them. Nonetheless, she and all of us have received countless messages that say “women can’t be fat.” The fact that some rise above it doesn’t make the shaming any less real, or any less differentiated by gender. I’m glad you’ve somehow managed to like yourself the way you are – I find that you are a rare person in our culture!
In fact, they both do the opposite – undermine confidence and remove any remaining sense of agency, as the patient is required to put him/herself in the hands of the doctors, and accept that there is nothing s/he can to about his/her broken brain.
I am SO glad someone is finally talking about this issue. Look at those stats – 3/4 of the women diagnosed with “postpartum depression” were current domestic abuse victims!!! The authors neglect to mention that physical abuse is known frequently to begin or significantly increase before or soon after a baby is born.
It is simply inexcusable for anyone to conduct any kind of research or scientific discussion of “postpartum depression” without taking domestic abuse into account, yet this topic is almost NEVER discussed by anyone supposedly researching the area. This is one more way that psychiatric labeling is not only inaccurate and unhelpful, but actually PREVENTS genuine research into major causal factors that contribute to the distress psychiatry is claiming to want to ameliorate.
The thing is, I don’t think she said that; I think she said that what is healthy/unhealthy or that what is a priority or not a priority is not something that an outside person can determine for someone else. And if you read my posts carefully, you’d see that offering support and perspectives is most definitely an important part of how I see people helping each other. It’s the paternalistic part that I object to, and it’s very, very easy to slip into that mode once we decide that WE know what is “better/worse” for someone else without bothering to consult them on their priorities and reasons.
I’m kind of working from Kate’s assumption here – a person identifying as female, regardless of their sex, would most likely experience similar pressures to be slim, attractive, well made-up, shaved legs, etc. I could be wrong, but that would be my assumption. Naturally, there are people of any gender who are working to challenge these assumptions, but that seems to be the pressure society places – females have to be sexy, slim and attractive, while males who are powerful can be fat, ugly and stupid and still be OK.
Uprising: I thought I said that. It’s not about smoking or eating certain foods or whatever is good or bad for your health. It’s about judging and shaming and making assumptions about others because they are fat, smoke, or are diagnosed “mentally ill.” Unlike some who post here, I totally think it’s possible for one person to help another person in a professional or non-professional capacity. But the first prerequisite is to not judge a person’s actions, but instead to find out what’s going on. A person who drinks all the time is going to kill him/herself eventually, but I’m not going to start on a tirade on how drinking’s bad for you – I’m going to get to know that person and build some trust and perhaps find out what drinking does for that person (what need it meets) and why they think it’s important and what is underlying it and whether or not they see it as something they want to change or if perhaps there is something else that they want to change but don’t feel they can and hence the drinking as a means of coping. You get the idea. It’s not about whether smoking is healthy. It’s about assuming you know better than the other person what they should or shouldn’t be doing.
In what way (besides smoking) do people assume smokers are failing in their lives? Isn’t smoking just smoking? It doesn’t seem to imply anything else except that the person smokes.
Same arguments apply to the extent that telling smokers they are bad people for smoking is disrespectful and unhelpful.
However, there are pretty big differences in the situation:
1) You can’t quit eating. Everyone has to eat something, and there are a ton of cultural forces that determine what’s available, what’s portrayed as desirable, and what is “forbidden fruit.”
2) Assuming fat people eat poorly is neither respectful nor correct. Lots of skinny people eat like crap and lots of fat people eat healthy diets and exercise plenty. There is no similar association that cigarette smokers are somehow inadequate in some part of their lives that is reflected in their smoking.
3) Smoking has never been used as a means of disparaging a particular gender in the way fat-shaming has been used. Nothing even close. Worry about being fat vs. skinny vs. “normal” is driven into every woman in the USA from birth onward in a way that smoking/not smoking never has been or will be. In fact, smoking was long considered a strong sign of “coolness.” Pretty sure there is nowhere in US or Western industrial culture where being fat is considered “cool.”
I am sure that others can contribute further to this list.
I didn’t read that she’s saying that. What I’m reading is that it’s not OUR job to tell the other person what the best path is for them. Certainly, I don’t think anyone is unaware that drinking soda or beer is not good for your body. This is about judging PEOPLE for doing things you personally would not do. This includes giving unsolicited advice about “healthy choices.” If you have a friend who is doing things that seem destructive, I see nothing wrong with trying to communicate about that, as long as you’re not taking a position that you’re superior to them. If we get interested in their situation, other people can teach us a lot about what’s going on behind the behavior that is bothering us. This may lead us to realizing that our concern was misplaced, or that the actual issue is something very, very different than what is presented. But it’s not our decision what is or is not an issue someone wants/needs to work on or change – it’s the person’s decision, and the entire “mental health” industry invalidates that decision almost every time they encounter someone whose behavior seems “unhealthy” to the mainstream/status quo. The correlation between trying to “fix” someone who has a larger body and trying to “fix” someone who acts in ways you don’t understand is quite apt, in my observation. It all starts with the paternalistic assumption that you know better than someone else how they should behave.
I so totally agree with you – labeling people as “privileged” seems to imply for some people permission to dismiss all that the “privileged” person has to say and to engage in all manner of generalizations about them, often subtly or not so subtly justifying putting down someone who happens to fit into a particular category.
At the same time, privilege is very real and I’m totally down with pointing out when it is being used to avoid thinking about their condition and blaming other people for NOT having their condition. So the problem isn’t being or not being privileged so much as grouping people together and dismissing them based on some apparent group association or similarities. Of course, it’s way easier for the privileged to get away with dismissing other people’s realities, but treating a person with disrespect BECAUSE they fit into some privileged category is pretty bad, too. We all have some degree of privilege, and it should never be a means of putting someone down or disregarding their feedback.
I think you misunderstand me. I don’t regard ANYONE as being “normal.” I see “normal” as an attempt to control and direct people into behavior that others find more comfortable for them, and if there are enough people agreeing to act a certain way, they are then defined as “normal.” There is nothing more “normal” about this behavior except for the agreement that it is called that, and setting up that standard of “normal” enables those in power to label those who don’t comply as “mentally ill” or whatever other label they want to sling. So I agree 100%, people with “mental illnesses” are for the most part completely normal and either don’t fit in or are reacting to difficult circumstances. It’s the claim that other people are “normal” and the “mentally ill” are not that is the core of what I’m calling “normalism.”
The NRA appears to consistently oppose any form of gun control, no matter how focused or practical it may be. Two recent examples are straw purchases and the “gun show loophole.” The NRA would be far better served if they simply looked at current gun control laws and people’s objections to them and proposed their own form of legislative fix that would protect honest peoples’ right to own firearms while preventing them from getting into the hands of people with known histories of violence. I have not seen any effort in this direction. Instead, they seem to want to create maximum alarm in the public toward any sort of gun control proposal, equating any efforts at resolving current issues with an attempt to disarm legal gun owners. Choosing Ollie North as their leader says a lot.
Not so great for your “patients,” but fantastic for drug company bottom lines! A drug that you can’t get off and have to keep taking to keep from being miserable – sounds a lot like a street drug dealer, doesn’t it?
Hey, I have no problem with the second amendment. But I do have a problem with people who have been proven violent being allowed to own firearms. Most gun owners are AOK, but just like if you drive drunk or drive on the sidewalk, you lose your car, if you’re unsafe with your firearms, you should lose them. Not sure why anyone would disagree with that concept.
Consciousness transcending corporeal existence? You are operating on questions WAY beyond the comprehension of the psychiatric field! They are still having trouble with the idea that someone actually decides what they’re going to do rather than being determined to do everything they do by chemical reactions!
I think it’s because they hit him where he lives and he knows that he can’t answer without further prevaricating, which the gentlemen writing him will quickly suss out.
“…without having to reduce Western medicine to a caricature…”
With “disorders” like “Intermittent Explosive Disorder” and “Oppositional-Defiant Disorder” and “Disorder of Written Expression,” Western medicine appears to be reducing itself to a caricature without the help of any outside forces.
The irony is that efforts to define what is “sane” or “healthy” drive people’s ability or willingness to communicate about any perceived “non-normal” experience underground, which is, in itself, the cause of much of what is called “insanity.”
I had a new idea about the concept of “sanism.” I don’t like that word, because it implies that there are “sane” people who look down on “insane” people because they are “insane,” and the answer is for the “sane” people to be nicer to the “insane.” I propose the word “normalism,” which represents the tendency to dismiss or denigrate or abuse anyone who veers away from the sacred “norm.” Of course, no one is entirely “normal,” so it creates the possibility of the problem not being deviation from the “norm” so much as the bizarre expectation that everyone should strive for “normal” in the first place.
There are stats showing a recent severe decline in public opinion regarding the NRA, starting from when they made such rude and degrading comments about the teenage survivors of the Parkland shooting massacre. Their stock is most definitely down, at least for the moment. I can’t see how having Ollie North as their “face” could possibly help matters, though I know he’s a “hero” in certain very irrational circles.
It is, indeed, the criminal Oliver North, returned from notoriety to head the NRA. The NRA is in a strange way a natural ally, in that they want to distract any attention from gun control. However, being supported by the NRA may be as helpful as an endorsement from NAMBLA (the North American Man-Boy Love Association) the way their reputation is sinking lately!
Of course, labeling this whole group “ADHD” would prevent us ever finding out if there are a very small number of people who actually have something wrong with them biologically, since the “ADHD” group is wildly heterogeneous. The serious problem with allowing stimulants for a theoretical small group who can’t be differentiated from the masses so diagnosed is that once you do, “diagnostic drift” takes over and you get what we have today. Until there is some way to actually determine who has this ostensible disorder in some objective way, protests to “never say never” come across as avoiding the issue.
If you hit a screw with a hammer and it doesn’t go into the wood, hit it harder or with a different hammer, or maybe two hammers at once, or maybe a power hammer will work or…
Does it ever occur to them that if drugs don’t improve the situation, maybe they should try something else besides drugs? Maybe, just maybe, this situation is not resolvable by drugs?
It is almost laughable to see these efforts to “standardize” the “diagnosis” of an abstract entity that can’t be defined in any kind of objective terms. Researchers substitute consistency (do people come up with the same answer with the same people) for validity (do these “measurements” actually represent a legitimate homogeneous grouping of people based on that which is being measured?) If you know which people have cancer by some objective means, you can run tests to see if these tests detect cancer and perhaps start identifying it earlier. But these checklists don’t identify anything, or specifically, they identify people who answer the questions in a certain way that they have decided means something they want it to mean. If you find out if a person’s depressed by asking them if they feel depressed, you’ll get a pretty high agreement amongst raters – they will diagnose “depression” if the person says “I’m depressed.” These checklists are a little more subtle than that, but it amounts to exactly the same thing. You might as well just talk to the person and ask them how they feel and not bother with the trappings of pseudo-objectivity. At least you’re being more honest that way.
I am glad that you recognize the chances of psychosis or “manic states” being brought on by stimulant use at accepted dosages. What I wonder is this: since you don’t seem to think that “ADHD” is really a disease state at all, it’s confusing that you talk about people who “actually have the underlying mental disorder.” Do you actually believe there are people who “have ADHD”? If so, how are they differentiated from those have “a mismatch between their attention spans and the required attention of their lives?” Or is that what “the underlying mental disorder” actually means in your observation?
“Treatment-resistant depression” is such a bizarre turn of phrase! “Depression” is resisting somehow, as if it were an animate object of some sort. And the doctor/therapist who is unable to help is off the hook, because it’s not that they are unable to help, it’s the DEPRESSION that is RESISTING their efforts!
If you took your car to a mechanic who said he couldn’t fix your car because it had “repair-resistant fuel injectors,” but you can come back next week and pay for another “treatment,” I think you’d go find another mechanic pretty quick. How do they get away with this kind of chicanery?
Mat, thanks so much for sharing your moving and heartfelt story! And VERY well done for coming up with so many approaches that worked – you actually invented for yourself stuff that people go to universities to learn!
One thing struck me about the start of your story – you said that you grew up in an “affluent, happy home and community.” If that was really the case, why were so many people so intentionally mean and hurtful to you? I have to wonder how happy those other people really were when they seemed to be unable to accept you but instead attacked you for being different. It also sounded later like when you were finally finding your way despite the “help” of the system pushing you further in the mud, your family was not only not supportive, but continued to work to undermine your recovery. It sounded to me like they were very busy blaming you for making them feel uncomfortable.
I’m very impressed by the path you’ve followed and really appreciate you sharing it with us. It saddens me that you had to figure out so much of this yourself, but it’s also a joy to hear that at least the folks at Howie the Harp center understand how to truly support someone. Hang in there and keep on moving forward – you are a tough and smart person who survived a lot of crap!
Yeah, I wonder how “the authorities” would act if a parent said, “Well, he has trouble concentrating, so I slip him half a bennie in the morning and it really helps. Can you give him the other half at lunchtime, please?”
Thanks for the laugh! “ITD” – inadequate teaching disorder, characterized by restless kids, boredom and yawning in class, rebellious pranks, and kids screaming with joy as they run out of the room when they are finally allowed to escape your classroom. Treatment? Go into flower arrangement or something where you can’t hurt vulnerable children!
Good article! The author did miss one point I’d like to see added: 40-50 years of long-term studies have failed to show ANY improvement in ANY significant long-term outcome as a result of stimulant use. High school graduation, college admission, academic test scores, social skills, delinquency, substance abuse, even self esteem – NONE of these areas are improved by long-term use of stimulants, and in some studies, outcomes were WORSE for the stimulant users. These studies were largely done by mainstream psychiatrists, and these conclusions aren’t even controversial. But they are kept VERY quiet.
It should be obvious to anyone that there is a risk involved in giving stimulant drugs to children. When we see that there is NO benefit in quality of life in ANY domain, what could possibly justify their being prescribe to these poor kids?
So Mischa, it sounds like you agree with the people you’re arguing with (and with Szaz) on the main issue, namely, that psychiatric diagnoses are bullshit. So what’s with the endless stream of ad hominem attacks? If it’s all semantics, why not just find the part you agree with and agree with it and move on? Your behavior has become obnoxious and rude and I have reported it to the moderators. What’s your beef? Why can’t you just have a civil conversation?
I can’t speak for Slaying, but I have helped and supported hundreds, probably thousands of people as a counselor, advocate, friend, parent, teacher, listening ear, etc. I had next to zero training in psychology, absolutely zero training in psychiatry, and have never for one minute subscribed to the physiological reality of any of the “DSM” concepts. Remember they are VOTED ON in committees and are “diagnosed” by checklists! It’s like basing a diagnosis on one of those Reader’s Digest “Are you an introvert or an extrovert?” quizzes. It is BULLSHIT! And refusing to use or believe in these diagnoses has never provided the slightest impediment to me helping lots and lots of people who would fit any number of these “diagnoses.” In fact, I think it worked strongly to my advantage to avoid them. Because it allowed the person I was helping to define both the problem as they saw it and the possible solutions, and empowered them to address THEIR problem rather than the one foisted on them by well-meaning but condescending “professionals.” Suffering is not a myth. The idea that suffering can be categorized and “treated” in the same way a broken leg or a hernia can is absolutely a myth. And admitting this to be true actually opens the door to finding REAL solutions for people who are suffering.
So did you miss my main point? I’m saying that the CATEGORIES dreamed up in committees by the psychiatric profession are not real categories that identify real “disease states” that can be “treated” by the proper “medication.” Not denying that it sucks to be depressed all the time (used to be that way myself, actually), or that there may be some depressed people who actually DO have something physiologically wrong with them. It’s just that lumping all depressed people together and saying they have “Major Depressive Disorder” based on a checklist of unwanted behaviors and feelings doesn’t make it a “disease.” Can we agree on that much?
Perhaps darker-skinned Americans are savvy enough from experience (on the average) to recognize that the “authorities” can’t be trusted when they promise “help.”
The confidence with which they convey this totally unsupported disinfirmation that conflicts even with itself is quite astounding to me, even now. No provisios, no “we’re still exploring this area,” no “some people have different experiences…” Such arrogance in the face of no scientific support, it’s just baffling!
I didn’t phrase that quite correctly. I should have said that the SUFFERING that is sometimes named a “mental illness” can be very real, but the act of labeling it a “disease” or “disorder” is still mythological. I agree 100%, there are no “things” that “mental illness” labels actually identify – they are fictionl and mythological. But some people seem to think that this position means we are denying that people experience negative feelings or thoughts or have a difficult time making their way through the world, and I don’t think anyone here would pretend that such emotions and experiences don’t exist.
I don’t think anyone here is denying that the things that are called “mental illnesses” exist and need and deserve help. I think we’re saying that the idea that these are “illnesses like diabetes” is a complete and utter lie, designed to sell drugs and “services.” I have no problem with people using drugs to assist them in dealing with whatever issues they need to deal with. I have a BIG problem with the psychiatric profession telling us that ALL depression is caused by “brain chemistry defects” when there is no evidence that this is the case.
I think it’s easy to get hung up on rhetoric. But the bottom line is, regardless of individual success stories, which exist in plenty, the psychiatric profession itself is corrupt, and the model used to “diagnose” these “disorders” is fatally flawed and does a lot of damage. Real informed consent means admitting that they don’t know what causes ANY of their “mental disorders” nor do they even know if these categories they have identified are valid entities to study, as the people grouped together as having “major depressive disorder” or “ADHD” or even “Schizophrenia” often have little to nothing in common with each other except the label.
Until the day when someone can objectively divide those who “have a disorder” from those who don’t, I will continue to hold that the DSM labels that psychiatrists so breezily hand out to all and sundry are, indeed, scientifically mythological. And the people who actually DO need help will be best served if they scratch the DSM concept and start over with trying to find the REAL reasons why these phenomena happen, and more importantly, come up with a legitimate way of approaching these problems that actually leads to large numbers of people recovering, instead of leading to an ever-increasing number of people becoming disabled and unable to lead their lives.
Frank, I’d say we also have to outlaw false advertising about psychiatry and psychiatric drugs in all of their forms. And preferably lying about “diagnoses,” too. A lot of psychiatry’s power comes from marketing lies. However, removing coercive power is definitely the most important step, and the one where the law can most readily be modified. People have always sold snake oil, but holding one down and pouring the snake oil down your throat is taking it to a different level.
I do agree that it’s an important distinction to make. Coming up with arbitrary labels for someone else’s problems and telling them “what is wrong with them” is harmful. Working with a person to come up with ways for that person to understand his/her own situation and strategize how to more effectively approach it FROM THEIR OWN VIEWPOINT can be incredibly transformative!
The same critique could be applied to any DSM “diagnosis”. The DSM itself admits in the introduction that there is no way to draw a line between normal and “disordered,” and that those labeled as having a particular “disorder” may not “be alike in all important ways.” In other words, the DSM is unable to distinguish any “disorder” from normalcy, and even those identified as having the same “disorder” may have different things wrong with them or nothing wrong with them at all.
The whole thing is based on smoke and mirrors, and the DSM itself admits it. It is amazing that professionals can waste their time and energy talking about “differential diagnosis” and “misdiagnosis” when the “diagnoses” are admitted not to even represent a homogeneous grouping. It reminds me of the debate about “introverts” and “extroverts,” except no one is claiming that “extroverts” are healthy and “introverts” are sick. It’s 100% fantasy!
This is such an important topic, but gets very little attention, even in the antipsychiatry/psych reform community. Back in the 70s, feminist writers were VERY strong about the role psychiatry plays in enforcing the norms of patriarchy, and how psychiatric diagnosis is used to pathologize the (predominantly female) victims of violence and protect the perpetrators of such violence. I am not sure how this thread has been lost, but I rarely if ever hear modern-day feminists talk about this issue, even though it appears far worse today than it ever was in 1975. What’s going on there? What can we do to re-link with current-day feminist activists and get onto the same page?
Of course, you are right, Frank, and institutionalized “help” has been generally disastrous over time and seems to be getting worse, whether it’s asylums or “residential treatment” or schools or churches or whatever you want to pick out. However, I do believe it is very possible for individuals, and even institutions on rare occasion, to be helpful, and that’s what I’m talking about here. Some helpful people may carry the label “therapist” or “pastor” or “teacher” or “mentor,” while others may carry the label “friend” or “partner” or “parent” or “son” or “cousin” or “guy I met at the bookstore.” The label or professional credentials are not the determining factor, it is how you treat the other person that makes a difference. And a person can get better at it with practice, and can learn from reading others’ experiences in helping and being helped. I don’t think helping each other is impossible, or even tremendously difficult. Psychiatry’s problem isn’t that it’s trying to help, or even that it’s an institution, it’s that its purpose is NOT to help others. Its purpose, as well as many if not most social institutions in Western society, is self-perpetuation and amassing of power and wealth, and the willingness and ability to lie and use force to accomplish its goals makes it all the more heinous.
I think it is misguided for people to dismiss helping because the institutions of psychiatry and psychology have failed to accomplish it. I think the important shift is to dismiss the idea that there is some kind of “treatment” that will “cure” these DSM “diseases,” and instead get back to realizing that people are people and that life is tough sometimes and that we need to be there for each other in helpful ways. I see no problem with trying to study the question of what is or is not helpful to other people, as long as we define “helpful” from the point of view of the person purportedly being “helped.”
It becomes apparent fairly quickly, at least to me, when someone isn’t really interested in help. It has to do with whether they are interested or willing to take some kind of action in the direction of accomplishing their goals or intentions. I sometimes spend a little time figuring this out, but I’d say 10-15 minutes is generally sufficient. I’m not willing to waste my time on someone who isn’t interested in real change, but I have found it much more common that people are happy to work on changes that fit with their own needs rather than the needs of their clinician. Happy to share a story or two if you’re interested.
But I do agree with you, there is no such thing as “healthy” or “unhealthy” coping mechanisms, except by someone’s personal preference. Society wants us to believe in these ideas so they can control us into thinking the way we are ‘supposed to.’ It should go without saying that I find that particular concept obnoxious.
I don’t try to help people who don’t want my help, not ever. And if they do want help, I try to find out what they think “help” means to them. I do find that a lot of people who supposedly “don’t want help” really do, except that they don’t want the kind of “help” that has been forced on them. Avoiding force, manipulation, invalidation, evaluation, condescension often leads to situations where people actually feel safe enough to reach out, and I’m happy to help them, formally or informally.
It also allows others to empathize with our experience, whereas psych labels, as Rachel points out, are shown to encourage distancing ourselves from the victims of “bad brain chemistry.”
I agree with your comments. My only proviso is that anyone I would consider a valid therapist (and they are rare, I admit) would never tell someone what to think, who they are, or what their problems really are. If that’s what “therapy” has become (and as I say, it frequently is exactly that), a walk in the woods would be safer and more effective by a long ways!
Why not call it “unhappiness?” And what I would say to the psychiatrist is “This approach isn’t really working for me. Do you have any other suggestions besides changing medications? What can I do day to day to help manage these feelings?” But don’t be surprised if the psychiatrist, as nice as s/he may be, doesn’t really have any other ideas. Searching the internet for others with similar issues might be more helpful. Hope you find something soon!
Having a pipe wrench, some plumbers’ tape, a snake, and a toolbox doesn’t make one a plumber. Focusing on one particular school of thought as somehow “evidence based” creates detachment from the client and inflexibility in approach. I certainly have lots of tools in my toolbox, and as I said, “techniques can be handy tools for specific situations.” Not being married to a school of thought isn’t the same as having “no theory or principles for making sense of the client’s experience.” It simply means being flexible and building one’s model of reality from direct experience, and being willing to alter and adapt that model when new experiences and data enter the scene. I would maintain that some therapists can and do accomplish this, but many, perhaps most these days, do not. I would also maintain that most untrained folks can do this, too, if they have the right perspective and attitude. It doesn’t require an advanced degree, and it doesn’t require commitment to “evidence based practices,” except to the extent that one needs to observe the evidence of one’s own efforts from the point of view of the client’s goals and intentions. It DOES require sufficient perspective on one’s own emotional needs so that one does not judge or react adversely to the client’s own description of reality. Again, some therapists can do this, but a lot of them can’t, in my experience. And plenty of people with no formal training ARE able to assume this attitude. I would maintain that, with enough practice and attention to their effects on the people they are trying to help, a completely untrained person could become a very effective helper without any kind of formal training at all. (Not that some kinds of training might not be helpful, but again, they are simply adding tools at that point, and are in a position to decide which tools appear to work and which do not.) And it is a CERTAINTY that having training as a therapist in the latest “evidence-based practices” provides no assurance that the therapist would be even marginally capable of connecting with and understanding another human being.
So I guess I see specific training in specific “schools of thought” as a minimally relevant variable in this case. And I see unflagging commitment to a single school of thought to be deadly to any chance of even marginal competence.
“Panic attacks” are generally caused by something scary happening to you. Sometimes the scary thing happens long before the “attack.” But there is some process going on for you that you feel somehow that things are going to go badly and you need to prepare to run or to do battle.
The only thing a therapist can do to help (if they can do this, which many can not) is to help you identify what it is that you are reacting to. They can’t TELL you this, but a good therapist (or a good friend or support person or parent or brother/sister or grandma) can listen and ask questions to help YOU figure out what was going on.
It seems pretty clear from your comments that the current model of label-and-drug has not really changed things for you. Maybe time to look at it differently? Maybe there IS a reason you panicked, even if it’s not obvious to you what it was about?
I think I get what you’re saying. Just because “professionalizing” helping others creates a lot of problems, it doesn’t mean it is simple or easy to know how to be a helpful person to someone in a difficult situation. It behooves us to study what is and isn’t helpful, but more importantly, it is most important to put our own houses in order so that we can really be there for those who need us. And that is NOT a no-brainer!
Not sure why “depression pills can’t cure anything” leads to “people claiming to be depressed are malingering.” People DO feel depressed, sometimes severely, sometimes for a long time. No one is denying this reality. The problem is calling “depression” a “disorder” implies that it is ALWAYS caused by the same thing, is ALWAYS pathological, and is “curable” by these pills in most or all cases. You and I both know that none of these three statements is true. It is VERY easy to say, “Depression as a state of mind exists and can be extremely painful. However, efforts to “cure” depression with pills have not been effective.” These two premises do not contradict each other in any way.
I doubt you’d find a mainstream psychiatrist anywhere who claims that antidepressants cure something. They will almost universally say that they are “treating symptoms” but that there “is no cure.”
Sounds a lot better than rambling on about “evidence based practices” and whatnot. Being honest about what is not known and about the very subjective aspects of both “diagnosis” and whatever form of “therapy” is provided would be essential, but I’d bet my life savings that the number who actually provide this is infinitesimally small.
Techniques can be handy tools for difficult situations, but I don’t think any set of techniques guarantees success in any situation, because people are different. My personal approach to assessment is, “gather information until some picture of what might help emerges. Try that out. If it doesn’t work, gather more information and try something else.” And “work” must be defined by the CLIENT’S perception of what they are seeking, which is where I think most therapists fall down on the job.
Just as a fer instance, I tend to use “motivational interviewing” techniques a lot when I am trying to help someone out. But I didn’t know it for over a decade! I had no training in “motivational interviewing,” but simply followed what seemed to be working and essentially “invented” a style of motivational interviewing based on the needs of my clients. As such, I am never married to using those techniques – I only use them when they appear to be workable. And when they aren’t, I do something else.
Sounds like the best basis for any kind of helping!
CBT and any “school” of therapy is mostly just techniques that can be applied. Applying techniques can be done in a connected, caring way or a disconnected, condescending way. Absent the caring part, I don’t think it makes a bit of difference what techniques you use, you will screw someone up in the name of “helping” them. And if you really care, the techniques become secondary, because you’re seeking a real understanding of the person and that is what guides you forward. The search for the “gold standard therapeutic approach” is doomed to failure.
Interesting. I definitely felt torn about the PTM concept. On the one hand, it is awesome that the professionals involved are prepared to publicly challenge the DSM/ICD madness in a direct and public manner, and provide an alternative explanation for how/why people act in these ways. On the other hand, when I was reading the list of coping measures, I could see how easily they could become their own “labels” or “illnesses” and it still kind of felt like there is something WRONG with the people doing these things, even if they now have a reasonable and less blameful explanation for them.
It is certainly a vast improvement over “your brain is broken.” Vast improvement. And the recognition of societal power as a force creating these effects is something I have not ever seen in the world of psychology/therapy, other than some individual writers. So I see some hope here, but also a real possibility of the new framework being co-opted into just another way of creating or reinforcing superior/inferior divisions.
All of this is based on the weird and incorrect idea that “mental illnesses” are uniquely identifiable and should all respond to a particular “treatment.” The truth is, all people are unique and their needs and strengths are unique, and so what is needed to help them is unique to their situation and personality. Milton Erickson opined that therapy needs to be ‘reinvented’ for each new client. I agree 100%, and would go further to say that “therapy” itself assumes that some professional needs to intervene to help someone make their way through whatever they are struggling with, and this assumption is also 100% wrong. Sometimes the best therapy is no therapy at all.
Glasser was both a visionary and a very practical problem-solver. “Reality therapy” is about as fully empowering a concept as I have ever read about or seen applied. He does a fantastic job of separating responsibility for external circumstances (which we don’t control) and responsibility for attitude and decisions (which we DO control). He focuses on the intentions of the person asking for help, rather than having some “plan” for the other person that is outside of their control. His goal is higher self-determination for the client, not “compliance” with “treatment.” He is most definitely worth the read.
If they have been doing it for 60 years despite repeated “education,” it should be clear that “education” isn’t going to do the job. They will stop when it’s made illegal and that the doctors are fined and/or jailed and lose their medical licenses when they do it. Nothing else will work, as the facilities really don’t care about this issue – they are meeting their own needs, and their clients in many cases are an afterthought.
So again you use the term “overmedicating.” How can you “overmedicate” when there is no objective means to determine what “appropriate” medicating is? Isn’t giving “medication” for a non-medical condition called “malpractice” rather than “overmedicating?” What is the standard?
First off, WOW! Amazing work, and thanks for the wonderful guide/pathway for others to create similar successes!
Second, WOW! It is amazing the lengths to which the industry and its beneficiaries will go to snuff out anything that threatens their domination of the field. Your persistence is incredible in the face of such systematic direct and indirect attempts to derail your intentions. You really have exposed the incredible fear these people have of being exposed, and now created a means of furthering their exposure. They must be terrified of you!
So I am a little confused by your comments. You refer to Szaz, who very clearly and articulately took the position that “mental illnesses” are social constructs, not disease states. Yet you use the term “overprescription,” as if there were a “right” level of prescription that has been exceeded. How can there be a “right” level of prescription for a social construct? Unless we had a real diagnostic system that allowed people with actual, physiological problems be sorted from those whose metaphorical “diseases” are a consequence of social and interpersonal stress, or “problems of living,” as I believe Szaz called them, how on earth could we ever arrive at an “appropriate” level of “medicating?”
Or perhaps you are in the Moncriefian camp, and view drugs as simply having effects that we find desirable/undesirable? If so, how does the profession distinguish between effects found desirable by the individual him/herself and effects found desirable by the society around him/her?
To me, this issue of “diagnosis” is central to the whole problem of “overmedication,” as drugs are being used to “medicate” people who are not objectively ill in the physiological sense.
The fact that folks other than Big Pharma-influenced psychiatrists came up with some of the diagnostic categories is neither here nor there – the categories lump together people who have little to nothing in common and presume that they ALL have the same problem and need the same solution. This is not science, it is fiction, and to the extent that it is known to be fiction, can only be regarded as a hoax, as Phil outlines.
Prominent psychiatrists have admitted out loud that the chemical imbalance concept has been known to be false for decades, and research backs them up on this. Yet they have publicly justified telling patients this is true in order to make them feel more comfortable with taking their prescribed drugs. Doesn’t that sound pretty “hoaxy” to you?
I do see them as different. Psych labels are external and fixed. “Patterns of distress” are more of a philosophical categorization and are both flexible and applicable by either “clinicians” or the people experiencing the distress. Plus, you can’t arrest someone for a “pattern of distress.”
The average person is easily deceived by the perception of “sciency-ness.” We have a tendency to want to believe that some smart, “scientific” person is going to figure things out and explain them to us, and if we agree, we’ll feel smart, too. I am afraid our educational system helps make us this way. “Science” in school is not about experiment and discovery, it’s about getting the “right” answer as “discovered” by some other person smarter than we are. Not sure what is necessary to change that, but science teaching most definitely has to change.
I have to agree with Phil, here. The evidence is in that psychiatric diagnoses are almost totally subjective, that the “chemical imbalance” theory was disproven (at least for serotonin and dopamine) back in the 1980s, that psychiatric drugs are not specific to any problem with the brain, but are general agents that impact the brain and body in a wide range of ways, sometimes very unpredictably. There is evidence that psychiatric diagnoses and the chemical imbalance theory cause discrimination against those so diagnosed, there is evidence that long-term “treatment” with these drugs does NOT create better outcomes, and increasing evidence that it actually may WORSEN outcomes overall. There is a ton of evidence that the main thing those who are diagnosed as “mentally ill” have in common is a history of trauma, and that the psychiatric system ignores or minimizes traumatic experiences in favor of biological explanations. There is evidence that being a minority, being an immigrant, or living in an urban environment contribute significantly to the development of “schizophrenia.”
In the face of all of this evidence, what evidence do YOU have that Phil’s line of reasoning is wrong or is biased?
I just want to say how wonderful it is to see your name back on MIA again! It sounds like you have really created a sustainable way of supporting people in thinking and acting in an empowered way when dealing with the pressure to label and drug. WELL DONE!
Surely you would agree that psychiatrists and psychotherapists fall under the rubric of “mental health professionals?”
You still haven’t pointed out any “fact” that I mentioned that you felt was a criticism. You are certainly validating my point that there is a power differential that exists between “mental health professional” and “client.” Doesn’t that give the mental health professional a “privilege” vis-a-vis the “client?” Am I being judgmental when I point this out?
“All stakeholders — service users, carers and practitioners — could benefit from moving towards a space where we can enter into dialogue as equals…”
Yes, but if such a space/conversation were held, it would require the “professionals” to step down from their place of power. Their chronic and continuing unwillingness to do so is the exact reason why such efforts at analysis will not create the needed changes.
You know I agree with you, a good mamma can make all the difference. However, I do think it’s important to keep in mind that not all mammas are good ones. Pappas, too. There are some who do incredibly destructive things and then use psychiatric labels to blame their own kids for their failings. As in all things, “Generalizations are always wrong.” It comes down to whether the mamma/pappa in question is focused on the needs of their offspring, or their own need not to feel bad about their own mistakes and misunderstandings.
Absolutely! A consultant is what is needed, someone to observe what’s happening and provide perspective and options, not someone who thinks they have the right to tell you what to do, think and feel!
I do support the message – I just think the title is very “erudite” and confusing to the person on the street. There has GOT to be a more intuitive name for it!
Can anyone think of another area of medicine where a discussion of how we or the clinicians FEEL about the diagnosis has an impact on what the diagnosis it self will be? Something is VERY wrong with a diagnosis process that is so subjective that people’s opinions play a primary role in arriving at the diagnosis. Shouldn’t diagnosis be based on facts and objective observations?
As a person who worked as an advocate for kids in the child welfare system for 20 years, I absolutely agree that white, middle class parents (and even more so upper class) are held to much lower standards and are assumed to be “good parents” because of their social position, education, and ability to afford a good attorney. Not meaning to disrespect the indigent defense bar, because some of the most amazing attorneys I have ever met are indigent defense attorneys. But the ability to hire a private attorney is seen as very intimidating, and Child Welfare seldom wants to go up against a doctor or attorney or well-regarded white citizen if there is any way to avoid it. 98% of the parents in child welfare were poor, and we KNOW that the poor don’t commit 98% of the child abuse in America.
I hate the name “Power, threat, meaning” and hereby vote to rename this viewpoint the “get off my back model.” Or perhaps the LMTFA model – “Leave me the f*&k alone!”
Gabi, I think you hit on a VERY important point here – feminism focused on giving women more power WITHIN THE CURRENT SYSTEM THAT EXISTS. When women became more able to work in high-paying jobs, they also discovered that even those in high-paying jobs experience oppression on a very serious level – long hours, not being able to take time for family needs (I had to ARGUE to get THREE DAYS off when my first son was born in 1983!), being bullied by abusive bosses, and being at the beck and call of the corporate capitalist juggernaut that determines how everything runs. The absurdity of our “parental leave” policies in the USA is a huge contributing factor to “Postpartum depression.” As is the fact that decreasing average wages have created a situation where instead of being ABLE to get a job, women (and men) are now forced to work full time when their babies are young in order to survive economically. But I don’t blame all this on feminism – it is a result of our sick and sickening social/economic system which demands that close to everyone, male or female, has to sell his/her soul to the Company in order to survive. Feminism, in my view, never actually intended initially to deal with these power structure issues, and they remain substantially unchanged (actually worse) than they were in the 1970s.
All that being said, I don’t want to take away the effective work in balancing power and creating more safety for women and children that has resulted from the feminist movement. There are hard stats backing me up on this. Like I said, there is still a hell of a lot more work to do, and perhaps the current challenge among activists of all stripes is to start banding together to deal with the larger social power dynamics that really drive racism, sexism, classism, etc. Because even having totally equal access to opportunity in a society built on oppression will not end the core assumptions that power over someone else is the most valuable commodity available.
How many more studies like this will it take before reality undermines the psychiatric myth of the ‘chemical cure?’ This looks like as well-controlled a naturalistic study as could possibly be arranged, and it comports with the data from every other naturalistic study on the subject already published. How many does it take before the industry is held accountable for promoting ineffective and destructive “solutions” that don’t even identify the real problem, let alone solve it?
I would put it that a person could USE a competent therapist as a catalyst to improve his/her OWN happiness. The operative word here is “competent”. I was fortunate enough to hit upon a very competent therapist in my 20s and was much the better for the experience. However, the number of therapists who actually know how to play that “catalyst” role (who were never in the majority even back in 1980) appears to have decreased dramatically since the introduction of the DSM III and the push for biological explanations. More and more appear to have become handmaidens of the psychiatric industry, and such “therapists” are more than dangerous, as they not only harm the individual but give the idea that there is no real help out there except for drugging up your brain.
Who said that was the basic premise of the feminist movement? The basic premise is that women are human beings deserving the same rights as men. Our society has always (and to a large degree continues) allowed men to get away with things that women are punished for, allowed men to make decisions and rules and control the lives of women and children, allowed men in power to behave abusively toward other women, children, and other men lower in the hierarchy than them. Consider domestic abuse: in 1970, there were NO shelters, NO domestic abuse laws, NO protection at all for an abused spouse – if you complained to the police, they’d ask you what you’d done wrong to deserve it. We have come an INCREDIBLY long way (though we still have a long way to go) in reducing the #1 cause of injury or death to younger and middle-aged women. That is not a “side effect” of feminism, that was one of the primary areas of intentional focus of feminism, and it’s pretty disrespectful of the women who in some cases risked their own lives to bring about these changes to suggest that it was all about saying that men and women have the same bodies and the same needs.
On the other side, feminism helped make it possible for men like me to become nurturing dads and to be there for their kids with full social support. When I stayed home with my son back in 1986, a visit to the park with my infant son (and I was the ONLY man there on almost every occasion) led to suspicious glares that seemed to indicate I was probably a child molester. Nowadays, there are men walking through the park in droves every weekend and plenty on weekdays as well. This has nothing to do with men and women having the same needs and the same bodies. This is major cultural change that would never have happened without feminism.
I can certainly entertain the idea that feminism may have had side effects (to use your term) that may not have all been positive. But your concept of what feminism is reflects a complete misunderstanding of the subject. It’s not about bodies. It’s about POWER and the abuse of power by men over those they deem below them in the power structure. To consider that a side issue is factually inaccurate and again very disrespectful to those who fought to give you the increased power you now enjoy in society. And I was there, I lived through those times, and I know what it is I’m talking about. You don’t want to go back to 1970, trust me on that point. And one major reason our society is better for you is because of those early feminists who risked their lives and reputations to make it so. Maybe you should read up on it and see if I’m making this up.
The article seems spot on, except that I would add that other causes are also ignored, including boring classrooms, bullying by other kids OR by teachers and staff, meaningless busywork, lack of free play time, requiring kids to do things they are not developmentally ready for, and more. Psychiatry also disregards nutritional or sleep problems, ongoing or prior trauma in the home environment, and social issues such as racism, sexism, homophobia, and many other issues that lead to anxiety, depression, rage or even psychosis. The DSM-III intentionally created labels that disregard cause, and these labels have removed almost any effort to figure out why kids are acting how they are, replacing meaningful analysis with empty and meaningless labels that discourage any effort to figure out what is actually going on.
I think it’s very easy to take for granted the many, many improvements that have happened in society as a result of the feminist movement. It is quite disingenuous to trash feminism while enjoying the benefits you deny have accrued to you. It reminds me of people getting down on unions, but try to take away their 40-hour week or their vacation or sick time and see how upset they get. Feminism, like any movement, has its downsides and its extremist members and is not perfect, but to claim that feminism has not brought a very large and dramatic change in the US and world culture is just plain unappreciative denial.
I don’t have stats, but I absolutely believe you are right. Psychiatry’s “no-fault” view of “mental illness” has in part been in service of protecting the powerful from scrutiny, both in individual family situations, as well as society in general. If “mental illness” is all in the malfunctioning brains of the sufferers, then we don’t have to look at how our families or schools or government or corporate institutions are contributing to creating this suffering in our citizens.
Plus, the fact that it pays out billions to stockholders makes it that much easier to support.
Thanks for your comments! It appears we are in substantial agreement across the board. I do object to the term “privilege” being tossed about as a derogatory term, because it truly is not the fault of the person with privilege, and also because privilege can be used in very positive ways. Making it an insult stops healthy conversation – in fact, the original intent in creating the word, as I understand it, was to get away from judgment and to create a neutral term that simply described the situation as it is, without casting blame on either the privileged or those whom they may be overlooking or harming (whether accidentally or intentionally) due to lack of understanding of their condition. This certainly applies to parenting – there are many parents who have every intention of doing a good job yet end up doing harm (my parents certainly qualified) based on their freedom to do as they will without consequence and their failure to realize the impact of their actions on the powerless children in their care.
You are welcome to share any perspective I have put to paper (or “to screen” in this case!), as I am completely open regarding my observations and opinions regarding these issues. Thanks so much for engaging in a civil and positive way on what I think can be a very touchy issue!
The staff psychiatrist named in the article claims that disabling side effects are “extremely rare,” yet admits there is “no data” on this point. What arrogance! How do you know something is “extremely rare” without data?
Deeply disturbing. Maybe we should just set up self-service kiosks on campus, where you type in your symptoms and a remote psychiatrist approves your prescription?
Whew! I apparently barely passed out of the realm of shortness humiliation at 5′ 9 1/4″.
Thanks, Noel, for your beautiful rendering of a very sad picture. I very much doubt that social prejudice and bullying will be part of the narrative, but you do a great job of bringing that reality to life.
The removal of context from experiences labeled as “mental illness” is the central tenet that allows the DSM and psychiatry to dominate the definition and discussion of care of the human psyche. It must be identified and challenged whenever and wherever it appears!
Right. “Headaches can cause pain in your head!” It is hard to understand why people can’t see this tautological idiocy for what it is.
And I appreciate your expansion of my list! As I said, the list can go on and on. One I did not mention is the differential attention before and after birth – suddenly while pregnant, everyone is all excited and wants to touch your belly and wants to share their baby stories, but after the birth, everyone drops off a casserole and then doesn’t talk to you again for 6 months or sometimes ever.
My wife did a brief sociological study of postpartum depression around the world. She found that there are cultures where there is essentially NO postpartum depression AT ALL. Interestingly, those cultures were the ones where the mother had the least to do besides caring for the baby and the most continuous support from other members of the community for the longest period of time. I’m sure the same would be true for pregnancy – lots of attention and genuine support would ameliorate a lot of stress and bad feelings for everyone in the family.
I also appreciate your mentioning our bizarre childbirth practices and their contribution to prenatal/postnatal feelings of depression. Obstetrical care is almost as irrational and destructive as psychiatry, with treatment decisions made through myth and tradition and attempts to intervene with actual science met with scorn and ostracism. Consider that a third of US babies are born by C-section, and no one finds this alarming. The unnecessary anxiety and disempowerment of moms by birth practices in the USA is criminal.
As to the subject of “meritocracy,” without going into a specific critique of the idea, the concept itself depends on the assumption of equal access to resources and opportunities. Which of course is bullshit. So not really possible to have a “meritocracy” when merit is rewarded more for some than others having the same “merits.”
Well, the fact in this case is that psychotherapists and psychiatrists have more power than their clients. That fact in itself doesn’t make psychotherapists or psychiatrists bad people or mean that they are doing harm. It just makes it easier for them to get away with doing harm if they want to, and easier for them to blame their clients if the clients don’t get better. So having more relative power doesn’t make one evil. Using that power to fuck someone up makes you evil.
It is also true that a psychotherapist may have power over his/her clients and yet be abused by his/her partner or be discriminated against because s/he isn’t white. So power is relative to the relationships and institutions involved. I’m not sure how any of those things constitute criticisms. It’s often interpreted that way, but I don’t see one thing I said that isn’t factually and objectively observable. If you do, please let me know which statements you consider critical, and who is being criticized. I think our society is very uncomfortable with any discussion of power, so saying someone “has power” seems equivalent to saying they abuse their power. But it isn’t. We all have power, and all have people with power over us. How we use our power is up to us, but we can’t control how others use their power, which is why high power often leads to abuse and oppression. But there is no rule that says it has to.
And it’s not just psychiatry. As SE points out, receiving medical care is the #3 killer in the USA today. Most of the deaths are from properly prescribed and administered drugs. So far from slowing down the production of “new and helpful medications,” setting more restrictions will SAVE lives by making sure that new and HARMFUL drugs don’t make it to the market. Viiox, anyone?
My observation is that “conservative Americans” overall like to pretend that differential privilege doesn’t exist at all. It makes it easier to beat up on the poor and blame them for their own poverty. This is a gross generalization, but it’s certainly a very common phenomenon for those claiming conservative values. The idea that all Americans can accomplish whatever they want if they just work hard enough is embedded in American mythology, but it isn’t really true. There is not a level playing field, and those calling themselves conservatives often choose to overlook that fairly obvious fact.
I’m not a big fan of the left-right political spectrum divisions anyway. I believe those who really have power in our society like to see “liberals” and “conservatives” fighting each other, because it keeps the attention off of the fact that big corporations increasingly own our government and our representatives. If the left and right could get together on getting big money out of politics, we could get back to the days when each side recognized that the other had value to contribute to the discussion. We seem to have come a long way from that idea.
Having worked as an advocate for kids in the child welfare system, I can validate your observations about who does and doesn’t get the State involved in their kids lives. It is, quite literally, the ones who can’t afford an attorney to sue the state who end up involved. Over 90% of the kids in Oregon’s DHS system were very low income. The only time the State got involved with well-off familes was with sex abuse, and occasionally with very severe domestic abuse involving arrests and criminal charges. So the privilege in this case was afforded to the parents – the privilege of being able to avoid State involvement despite their abusive behavior, drug abuse, interpersonal violence, or more commonly, physical and emotional neglect of their kids.
Again, I agree that kids are disempowered in our culture, whatever level of financial privilege their parents may have, and I would encourage others commenting on this thread to make that important distinction.
Saying someone is “privileged” is not “calling them out.” It’s just a fact of life. All societies have more and less privileged members. Some of this is earned, but some of it is not. And of course, privilege is different in different areas of examination. My kids are privileged to have caring, intelligent, emotionally healthy adults raising them. They are privileged to have had access to alternative educational opportunities rather than attending standard public schools. They are not so privileged economically (though they are compared to some in our society or around the world). There are many who have economic privilege from birth, but don’t have the privileges my kids have had in the emotional/educational realms. These are just facts of life, not criticisms. I think it’s sad that people view the term “privileged” as a put down. It isn’t. There is no need to be defensive about having earned or unearned privileges in life. But it IS important when considering other people’s ability to succeed in society. It’s easy to be judgmental of, say, inner city kids for being so often involved with crime and/or gangs. But when we look at what opportunities these kids are or are not offered, it becomes understandable, and we may be moved to help change the conditions of poverty and crime surrounding them instead of judging them as morally or genetically inferior. Just for example.
Why is “privilege” something you “call out?” Do you see the term as an insult?
Childhood Bipolar Disorder has been shown to be even more delusional fiction than the adult version. “Irritability” was INVENTED as a criterion by Joseph Biedermann in service of his Big Pharma masters at J&J so they could sell more Risperdal. There was never any evidence that these kids had anything wrong with them, and longitudinal studies showed NO correlation between which kids got “bipolar” labels in childhood and those who were labeled “bipolar” as adults. “Irritability” is pretty damned common among kids (and as Frank points out, among their parents as well!) Telling doctors there is some way to “correctly assess irritability” is about as stupid as saying you can assess “emotional immaturity” or “oversensitivity” or “aggressiveness” in children. In other words, it’s meaningless, and the reason doctors are confused is because they’re being lied to!
“…the suffering caused by the depression itself is horrible.” I object to the idea that “depression CAUSES suffering.” Depression IS suffering, and calling it “depression” is only a way of categorizing this suffering. It is highly misleading to make it seem like “depression” is some outside force that takes over your brain and MAKES you suffer. There is no evidence, nor even any kind of mechanism, to support this kind of far-fetched conceptualization, though of course lack of evidence has never been a barrier to psychiatric hubris in the past.
Moreover, there are lots of REAL REASONS that women get depressed during pregnancy. These include biological reasons, like loss of sleep, rapidly changing nutritional needs, and hormonal shifts that alter normal expectations and routines; psychological reasons, such as the fear of parenthood, childhood issues being brought up by the idea of being pregnant, changes in body image, conflicts between the desire to continue working and the desire to stay home with the baby; and social issues, including changing relationships with and expectations of others, loss of connection with single or non-parenting friends, challenging behavior from older siblings, and most often ignored but very important, the common initiation or escalation of abuse by a partner that so frequently occurs during this vulnerable time in a person’s life. That is a very abbreviated list that could easily be expanded on at great length. Being pregnant is stressful and brings up a lot of crap. Being depressed during this time is hardly surprising and often 100% normal given the context. None of this is discussed in the article.
In my view, “depression” is not a “disorder” to be “treated.” It is a (usually) temporary condition that arises when a person is in a situation s/he is not happy about but can’t immediately get away from. It is not something that needs “treatment,” it needs understanding, patience, and empowerment to seek one’s own solutions. Until we stop framing “depression” as something that “happens to” people rather than something they are experiencing and over which they have some degree of control (however difficult that control may be to exercise), we will continue to have dilemmas like whether or not we want to pass on brain-damaging chemicals to our vulnerable fetuses in huge numbers.
You got that right! Funding defines what is provided, and who decides what is funded? Hint: it is NOT the people who are actually supposed to be helped by the services!
Oh, and vis-a-vis social class, of course, it does belong on that list, and it is one of the easiest ones to leave off. Rich kids get abused as well as poor and middle class kids, and there are some unique difficulties for privileged people to get in touch with historical feelings of powerlessness. Thanks for reminding me to include that.
Thanks for your thorough answer. I agree that, in essence, most of us are projecting our rage/powerlessness either on those who appear to have the most social power (left) or those who have the least (right). Dealing with our own disappointment/rage/grief regarding our own upbringing and the adults who were supposed to care with us but failed is the first job of anyone trying to be helpful to others or to society at large. Unfortunately, few people do this, and once a person has ripped open this veil, other people’s motivations seem all to obvious and yet often impossible to discuss. It is, indeed, a lonely experience. Thanks for sharing it with me!
Which proves that the real problem is NOT the drugs themselves, it is the ATTITUDE that allows the idea of prescribing drugs for behavior problems to be accepted. The essential purpose of the DSM III and beyond was to provide cover and justification for drugging normal human beings for profit. Until we address that approach and eliminate it completely from anyone’s idea of “care,” stopping “overprescription” of one drug will simply lead to a new drug to replace it. It is the idea of labeling and drugging people whose behavior is inconvenient that has to go!
Patriarchy as a concept most definitely includes children. The term “patriarchy,” as I’m sure all are aware, comes from Latin for “father,” hence, means the rule of the father literally.
Thank you for the clarification. I agree that children in general are the least powerful and most oppressed group on the planet, and that their oppression is often ignored or minimized by all folks across the political spectrum. It’s kind of sad, because it is the one kind of oppression that most of us can deeply share and relate to, regardless of what race, religion, sexual orientation, gender, or national origin label may apply to us. I think it’s crucial that we come together on the point of the oppression of children, because that’s where all the other forms of oppression have their birth, IMHO. But sadly, children don’t vote and have no real social power at all, so it falls to us who used to be children to speak for them, and for the most part, we have failed them miserably.
I’m interested in your views on what I said above, namely, the difficulty or unwillingness of those leaning left on the political spectrum to find a way to see the oppression of the psychiatric system and work it into their “intersectionality” analysis.
The term “meds” evolved to get away from calling them “drugs”. It’s been apparent from the first that these drugs were in a different category than normal medicine, and the fear of people creating an analogy (essentially correct) that these drugs are not dissimilar to street drugs. So we call them “meds” to make it seem like it’s somehow different.
Wow, great blog, Chaya! I particularly liked the analogy of candy bars for emergencies vs. long term health. I also appreciated your elucidation of how mainstream views are always presented as “the other side of the story” while the mainstream speakers are never required to be balanced by other points of view. This is stuff I’ll be able to use in talking with others about the strange anti-critical bubble that seems to surround the psychiatric worldview. Thanks!
Personally, I find the very process of “diagnosing” people with these largely arbitrary labels like “OCD” and “mental retardation” and “schizophrenia” to be problematic in itself. I have rarely used them except as a means of getting insurance companies to pay for their client’s needs. I find them dehumanizing.
I agree about assessing each individual as an individual, but even the term “assessing” suggests that I’m somehow above them and able to tell the client “what is wrong” or “what to do.” My approach is more humble: I try to help the client clarify what s/he needs and what is happening to him/her without me trying to evaluate or direct them beyond simply helping them gain some perspective on what is happening. I figure that the only one who knows what’s really going on is the client. It seems your approach supports that idea, but still uses diagnostic labels. I wonder, is it possible to accomplish the same or better results with no labels or “assessment” whatsoever?
I think the missing first step here is recognizing that our so-called “objective medicine” IS a culture in itself, and is a reflection of the larger culture. Pretending that it is objective in the first place is the starting point for allowing medicine to avoid dealing with the truth shown by its own research. There IS no separation of culture and medicine, so it’s impossible to “rejoin” these, since one is embedded in the other. Pretending to be objective is what gives this cultural phenomenon its unearned power.
“Zen and the Art of Motorcycle Maintenance” is a fantastic book that takes about an ECT survivor whose personality is erased by the process. It is a true story that shows his slow recovery of himself, but meanwhile completely and effectively takes down the idea that science is somehow separate from and superior to “subjective” areas of study. (Though he places fault not with the Romans, but with the Greeks, and specifically with Aristotle). It’s an amazing read!
Yeah, some people benefit from Jack Daniels, too. Alcohol is a great anti-anxiety agent. Doesn’t mean getting drunk is “treating” a “mental illness.”
What do you think about the DSM/ICD classification of “mental illnesses” based on behavioral checklists?
Ich habe einmal in Deutschland gewohnt (Freiberg i. Br.) und verstehe die Einschrankungen des Deutschen Sinn fuer Humor! (Ungluecklicherweise habe ich kein Umlaut auf mein Computer!)
Thanks for your reply. I was not referring to individuals who have distortions, but somewhat sardonically referring to the DSM diagnostic system and the mainstream’s religious adherence to it in contradiction to actual data. The idea that all or most “mental illness” is due to physiological malfunctions of the brain is completely unsupported by the data (the “low serotonin” theory of depression was debunked back in the 1980s, before Prozac even came to market), and yet is still held to be undeniably true by many in the field. It is a shared delusion, given more power by the agreement of powerful people, despite a complete lack of evidence that this belief has any connection to reality.
So my post was intended as dark humor, as in my view, the entire psychiatric worldview is based on a mass delusion, namely that the DSM diagnostic categories represent some as yet undefined physiological malfunction, despite years of research failing to find any such malfunction for any such diagnosis. In fact, the very idea that all people meet the criteria for a particular disorder have the same problem, or even have anything wrong with them at all, is another shared delusion. Unfortunately, those who have power can safely maintain their delusions, while persecuting those whose beliefs don’t comport with the official version of what people are supposed to believe.
I’m not convinced that “the left” is throwing privileged children “under the bus,” nor that “they” are racist toward white or privileged people. My concern is that “the left” (whatever that means) is so worried about offending people that it fails to act on the oppression that those receiving “mental health” diagnoses experience.
Saying something over and over again doesn’t make it true. Where is your evidence? Your Edgar Cayce link on Depression is simply a stating of opinion with no facts, and his opinion conflicts with even mainstream psychiatrists these days who have admitted several years ago that the “chemical imbalance” theory is completely unsupported by evidence and has no validity.
“…attributional distortions (especially one-sided attributions; module 1), a jumping to conclusions bias (modules 2 and 7), a bias against disconfirmatory evidence (module 3), problems in theory of mind (modules 4 and 6), overconfidence in memory errors (module 5), and depressive cognitive patterns (module 8).”
Well, this looks like it might be an EXCELLENT therapy for the PROVIDERS of “mental health care,” especially the psychiatric community. All of these except perhaps Module 8 are regularly evidenced by mainstream practitioners. “Attributional distortions” are, of course, built into the DSM diagnostic system, including the infamous “chemical imbalance” trope. “Jumping to conclusions” is facilitated by the DSM, as fitting the checklist allows one the luxury of pretending you know what’s happening in the absence of evidence. “Bias against disconfirmatory evidence” – well, that one’s kind of obvious. “Problems in theory of the mind” – again, completely obvious. “Overconfidence in memory errors” – such as Dr. Ron Pies’ confident statement that no well-informed psychiatrist would ever put the “chemical imbalance theory” forward, despite evidence he’d done so himself in the past. As for “depressive cognitive patterns,” if you changed that to “depressing cognitive patterns,” psychiatry would be 100%!
Let’s require them to go through this before they’re allowed to talk to a client. I bet 80% would drop out of psychiatry rather than face up to the delusion on which their profession is built.
I had a similar experience, despite telling the guy that I never took drugs for anything if I could help it, and was only there for antibiotics. I think they get kickbacks. Why else would they push so hard for us to get a prescription we’re making clear we won’t use?
Yeah, really, it’s not rocket science. Listen empathetically, be interested, care, be real… don’t need to go to school for those, and in fact, no school can really teach them. What it requires is being in touch with your humanity and putting out your energy to be there for someone else. Apparently, that skill is in short supply, though!
Exactly. I’d much rather have people exposing themselves to light rather than drugs, but why do they have to be “diagnosed” to do so? And what about the impact of the society that deprives its members of sufficient natural lighting?
Lots of other sources of abuse, too. School was a huge one for me. Just for one example, I got hit in the head in 2nd grade BY THE TEACHER when I had the temerity to object when she tossed a book over our heads in a rage while spitting venomous words at the whole class. Of course, nothing happened to hear at all, while me and another kid had to go to the principal’s office. That was the worst, but stuff like this happened all the time, with kids getting intimidated, punished and humiliated just for acting like kids. Churches and businesses and many other institutions are similarly abusive. To limit trauma to family of origin stuff (though that is VERY important!) will miss a lot of the harms that our society perpetrates on those not in power positions.
You’re not making sense, Pat. What does a critique of psychiatry have to do with “white privilege?” And why would the fact that some people scam the system mean that the system is working fine? People scam ANY system. The question is whether or not people on the average are getting better with the current model, and the answer appears to be no. Have you even READ “Anatomy of an Epidemic,” the basis for this website? Please answer this question – failure to do so will terminally undermine what credibility you currently maintain.
Almost every TV show or movie with psychiatrists shows them as therapists who talk and listen to patients. It is very different from reality. I recently saw an episode of Chicago Med where the psychiatrist was claiming that a man’s “scan” (of his brain) could show that he is a sociopath. So it’s weird – they support the “medical model” but still portray the psychiatrists as being interested in the patient’s experiences. Best of both worlds, I guess, but it’s pretty much all BS.
“Rather, trauma exposure is posited to create an initial level of heightened vulnerability for later psychopathology, including but not limited to psychosis…”
Wow, way to make it sound as complex as possible! Why not say, “Being traumatized makes it very likely you’ll get a later DSM diagnosis.” Or better yet, “Trauma is bad for you.”
With Someone Else’s great contribution, we see that over 80% of “psychotic” adults have been traumatized. Compare this with the fact that the most optimistic genetic studies have showed less than 15% of “mentally ill” adults have any correlation with even a wide range of genetic markers (over 100, as I recall). Seems like we’re wasting a lot of time looking at genetics, when the most obvious “contributing factor” is childhood trauma.
Not sure I like “negative” behavior pattern, because it still leaves room for others to decide what is “negative”. Struggling to come up with something better, though. Maybe it’s better not to call them anything except “what the client wants to work on.” Categorization of behavior patterns into “good” and “bad” may just inevitably feed into authoritarianism rather than empowerment.
The flaw is that they created the categories first and then tried to make the neurology fit. The should be testing for neurological problems on a case by case basis until they see some pattern, and then group people together based on their actual, observable neurological issues (assuming they are not simply a common variant and not a real biological problem at all), and create and apply treatments ONLY to those circumstances where actual neurological problems have been identified, and ONLY if they are shown to improve the problem. Examples include Parkinson’s, epilepsy, Multiple Sclerosis, etc.
No psychiatric disorder comes close to meeting these criteria, because they are manufactured from the completely errant assumption that all people who are depressed (or anxious or highly active or whatever) ALL have something wrong with their brains, and ALL have the SAME thing wrong with their brains. There is NO evidence that these assumptions are true, and as long as psychiatry operates on these assumptions, it will never find any neurological evidence for any of its “disorders.”
And if there WERE some actual physiological problem in some small proportion of people with a DSM “diagnosis,” it would be completely obscured by the vast majority of people in the category being completely healthy. The DSM is a huge deterrent to any real research, and I don’t think that’s by accident.
I think the important question is whether the RESEARCHERS had an open mind doing their research. It appears pretty clear that they WANTED to find a correlation and worked hard to find one. If they had found that 80% of people with, say, and “ADHD” diagnosis had a particular variant, vs. 20% of the general population, it might get my attention. But they had to combine 5 DIFFERENT “disorders” together to get a less than .5% correlation! It literally means nothing when the VAST majority of those with these “disorders” did NOT have the gene pattern in question and a good portion of the “control group” did have the pattern. I’m open to any real data that challenges my observations to date, but this one certainly doesn’t challenge anything except for any shred of remaining confidence that the “scientists” doing this kind of research actually care about the truth.
Perhaps you may need to read more over time. Many people (including myself) have written about the damage done by social institutions, including and perhaps especially the nuclear family, to people’s ability to thrive. Child abuse, neglect, and even thoughtless parenting have lasting impacts on people’s view of themselves. Kelly Brogan just put out an article today that directly addresses both REAL physiological problems (like nutritional deficiencies, lack of sleep, etc.) as well as exploring traumatic origins of habitual coping measures in one’s family of origin.
I, for one, believe that nurture makes the most sense to focus on, not only because the VAST majority of those diagnosed with “mental illnesses” have experienced family and social trauma to high degrees, but also because even if there are genetic contributors to our “mental illnesses,” it’s the one area we can’t do a damned thing about! And with the new research on brain plasticity and epigenetics, the idea that “biology is destiny” should be dead in the water. Unfortunately, financial incentives and political ambitions as well as guild interests don’t support applying this concept, which I think is why we see so much energy focused on these perverse incentives and evil intentions. The question of “what replaces it” is a much more challenging one, and in the end, perhaps is only answerable by the person needing assistance.
Of course, I agree with you. I guess my two objections to the term being applied to people by professionals are 1) lumping all people with a certain set of behavioral characteristics together prevents any real analysis of whether it is a meaningful grouping of people with real similarities, or simply a social prejudice masquerading as a “diagnosis,” and 2) labeling a group is in and of itself a means to differentiate and “stigmatize” (aka be prejudiced against) the members of this group, which I find inherently dehumanizing. There may be, and perhaps likely is, a certain subset of such folks who actually DO have something physiologically malfunctioning, but we can never identify such situations if we lump all people together who act in similar ways without any understanding of the underlying mechanisms. So if it’s just a means of communicating about and between people who share some behavioral characteristics in common, no problem. But when applied by one person to another, I really have a problem with labels of this sort, as they make it way too easy to dehumanize them as a group instead of trying to understand.
As for “neurodiversity,” as one of my old foster kid friends put it, “Maybe people should be allowed to have different chemical balances.” Viva la difference!
Well, as I said in my definition, I would see “scientism” as a complete repudiation of science, the opposite, in fact, because science involves the absolute unwillingness to have faith in anything that is not supported by evidence. So clearly, believing scientific authorities without or even contrary to existing evidence is not scientific in the least. However, given the cooptation of this term to mean something different, I’m going to have to agree with you that the term is confusing and unclear (partly because most people don’t really understand what science is). I have to say, though, that none of your terms actually identifies a dogmatic belief in or blind faith in science as a specific term. It is really a lot more than reductionism – it is a religious faith based on the belief that there are some smart people called Scientists and these people are Smart and Know Things that the rest of us can’t know, and that if we simply follow them, then the world will be a good and happy place. It is a form of “blind faith,” but specifically blind faith in purported “SCIENTIFIC” AUTHORITIES rather than SCIENCE. Perhaps “authoritarian pseudoscience true believers” describes it, but really doesn’t provide a very catchy meme, does it?
Personally, I think “causal agnosticism” is a BS cover for the true intentions of the DSM III+ series. It appears clear in hindsight that this approach was taken to specifically AVOID looking at cause so that the biological causation theories could be safely inferred. Grouping “disorders” without regard for cause, including things like high cholesterol and obesity, makes it easy to avoid bothering to look for one, which plays right into the hands of Big Pharma and professional guilds who want to create a “helping” industry and get paid for it. Because let’s be honest, if we start curing people, or providing free or low-cost home interventions, then we need to find more clients, which is a lot of work.
So in my view, the DSM is a far more nefarious enterprise than you appear to give it credit for. If there were no “ADHD,” for instance, then we’d have to look at each individual kid and figure out what was going on. We might discover that some DO have something physiologically wrong (like low iron, heavy metal poisoning, sleep apnea, or just plain lack of sleep), or psychologically challenging (very anxious, angry, hopeless), or social oppression (child abuse, racism, bullying), OR, we may eventually conclude that our schools are not meeting the needs of a lot of kids and we might have to re-think how we run our classrooms (“ADHD” labeled kids do WAY better in open classrooms than in standard classrooms!)
So in the end, creating the cause-free label undermines scientific inquiry and rewards lazy professionals for failure to look deeper into the real conditions behind the behavior they see.
My definition of “scientism” is accepting the pronouncements of credentialed “scientists” as infallible and having a religious commitment to following their dictates, whether they make sense or not. It suggests a dogmatic approach to “science,” and an unwillingness or inability to take personal responsibility to separate truth from propaganda. It also involves so-called “scientists” claiming such authority and attacking anyone who disagrees with them as “unqualified” or “hostile to science.” Within that definition, psychiatry fits quite securely. “Pseudoscience” covers some of that, but for me it doesn’t cover the religious commitment aspect as well. Not that I completely disagree with your concerns, because I do see “scientism” used to mean believing that science is a valid way to determine truth, as opposed to having faith in a spiritual reality. But I most definitely do see people who view anything with the trappings of “science” as an article of faith, and who accuse anyone who does their own thinking about it as “anti-science.” Most mainstream psychiatrists fit into the latter category, and they train their subordinates and “patients” to think (or not think) in the same way. Perhaps there is another term you can suggest that covers this unquestioning faith in the Scientific Authorities having special knowledge that we mere mortals are unable to attain?
I don’t really think that’s what the article says at all. I think it says that autism is not a scientific term because it’s not definable, and that we should not be prescribing “treatment” for entities that are not definable as different from “normal.” I think a lot of folks who identify as autistic would agree with this, based on my own experience. To say that autism was “discovered by science” is not really true, and that is the main point of the article. Autism was defined by agreement between professionals, but that’s not the same as being scientific, not at all.
My experience of the author is that he is, in fact, deeply committed to the principles of science, and in fact he is stressing in this article is the need to be scientific in defining “mental disorders.” Sammi has been a stalwart defender of the basic principles of science despite being castigated by his own profession for his integrity. You may or may not agree with his conclusions, but to accuse him of “hating science” is an extreme misunderstanding of his viewpoint and principles.
We just have to write in our comments as well. I did write one on that article. It was actually the first mainstream news article I’ve ever seen that addresses the issue of adverse effects seriously. Too bad some of the commenters didn’t appear to read it!
Well said. I’d point out that “obesity” itself is now a medical diagnostic category. The tendency to look at symptoms or outcomes as “diseases” is most definitely not confined to psychiatry. There are profits to be made and power to be established by denying social determinants of health, all across the board. It’s just easier with psychiatry, as there has never been any slight requirement that the categories have anything to do with physical reality, and as the social benefits of being able to categorize people’s behavior as “diseased” far outweigh the related but far less powerful benefits of categorizing people’s cholesterol levels or BMI as unhealthy.
I think you frame the issue well – it is a social/political issue rather than a scientific one. That being said, I do see the author’s legitimate critique of the term “autism” being used, as it is both a pseudo-scientific label and a means of putting down a heterogeneous group of people based on their inconvenience to the status quo. It’s a difficult conflict to resolve – I don’t want to be disrespectful to those who choose to view themselves as “autistic” nor to disrespect the fact that this group does have different experiences based on how they are viewed and treated by society. At the same time, I definitely don’t want to do anything to reinforce the idea that diversity of behavior necessarily associates with diversity of neurology, because in the vast majority of cases, it does not. I’m interested in your views on how to resolve this conflict – any thoughts?
I’ll just note that if only a tiny percentage of depressed people commit violent acts, then it should be obvious that being depressed doesn’t cause violence, nor is it even associated with violence, so giving drugs to prevent depressed people from committing violent acts is nonsense. A more intelligent approach would involved looking at VIOLENT people as a group and see if they have anything in common. When folks have done this, they’ve found a few commonalities: most violent people are males, most violent people are younger in age, many are taking drugs (legal or illegal) at the time of their violent acts. Many are perpetrators of domestic violence, child abuse and/or pet abuse. A certain subset are involved in or supported by violent philosophies that support their violent beliefs. Having or not having a “mental health issue” of any kind has not been correlated with violent acts, except for a very small subset of those suffering from “delusions” of some sort. We should NOT be trying to stop violent acts through “mental health treatment,” we should be working to figure out how to intervene with young men who have shown violent tendencies and who gravitate to drug/alcohol abuse, or better yet, figure out who these people are when they’re kids and find out how to intervene when they first start to show signs of violence.
I’d also add that even if there is a very small subset of people who become less violent on psych drugs, this and many other stories, not to mention the product label information, suggest that such small numbers are more than negated by the number of less violent people who become violent as a result of taking these drugs. In other words, as a violence prevention measure, the data suggest that psychiatric drugs are at best useless, and probably make violence more likely, just like intoxication with other mind-altering drugs will do.
And I gave up on fitting into mainstream society back in my 20s. It’s a lot easier to just be me and feel OK about driving away those who don’t appreciate me. It leaves me with fewer connections, but the ones I have are real.
I thought the same thing. How about, “Malpractice through unethical prescribing is a result of our society prioritizing drug solutions and failing to invest in necessary psychosocial, educational and political priorities.”
I heard him speak. He acts as if these brain scans are diagnostic of something. Sounds very convincing when he talks, until you look into the data and find out he’s completely talking through his hat. Mostly suggests bio-bio-bio solutions, but to give him credit, he does outline other options for altering brain activity besides taking drugs. Charlatan about sums it up.
This should be obvious to us all. Genetic diversity is the key to species survival. Being all the same spells death to a species, as recent disasters resulting from mono-cropping have demonstrated. Also, a “negative” trait can have unexpected positive correlations. I recently read that the “killer bees” that were released way back around 1990 or so have bred into the general honeybee population, and have conferred greater resistance to the mites that are killing off so many bees. Nobody could have been expected to know this would happen but it did.
It’s time to start appreciating that people are not supposed to all be the same, and that being different is not a disease state.
Actually, I think even Ayn Rand would find Trump’s version of crony capitalism objectionable. She at least recognized that monopolization of markets is incompatible with a true free market economy.
I do see the pendulum swinging back. I just hope the young folks don’t get discouraged. We really need a full-scale revolt!
Oh, “Trickle down” worked just fine. The problem is that people didn’t realize what it was designed to do. The PLAN was to redistribute wealth upward, and it was very effective in doing that. What needs to change is that regular folk need to become aware of what is going on and insist that it come to an end. We need to start with “percolate up” economics, where regular folk prosper and those at the top can reap the benefits of the general prosperity, as sort of happened in the 60s. But I’m not holding my breath…
So 94% of negative voice content is related to adverse childhood experience. Yet “schizophrenia” is a biological phenomenon that has nothing to do with traumatic experience? How psychiatrists continue to maintain this fiction is astonishing.
Sounds like what any sexual abuser would say about his/her victim(s). “They really wanted it.” “I did it for their benefit.” “It wasn’t a big deal.” “They’ll get over it.”
What I don’t get is how they don’t get in serious legal trouble for failing to report these crimes, especially when their own staff is involved. It’s as disturbing as the Catholic priest scandal, but no one seems to be scandalized.
Psychiatry has developed as one face of capitalism, especially corporate capitalism. It both provides cover for and protects the elite from the masses by dividing people into categories so that one can look down on another, and also allows those too “out there” to follow the rules like good drones to be singled out and punished, oops, I mean HELPED to “adjust” to the status quo.
And I agree, socialism is neither good nor bad, but works as well as the people running it. Which is why I say the enemy is authoritarianism, and unless we deal with that, any revolution ends up with “meet the new boss, same as the old boss.”
I think it is also true that therapy was constructed by well-off white men, and so it tends to pathologize things relating to poverty, sexism, and racial oppression, as a lot of well-off white men really want to believe that such things are either trivial or don’t exist. While there are exceptions, the majority of therapy is focused on adjusting to the status quo, rather than questioning the roles we’ve been assigned and/or working to change the oppressive structures that dominate our experiences. Naturally, black people are likely find this a lot less appealing, both as a profession and as a means to improve one’s life condition. Therapy’s got to get a lot more “real” if it is going to be helpful or even relevant to those who experience daily oppression in our society.
Very well said. Economics drives oppression in almost every case, and general opposition to psychiatry necessitates general opposition to oppression which necessitates economic reform. While the comments regarding psychiatry under communism are points very well taken, it illustrates my biggest stress, namely, that the enemy is not liberals or conservatives but AUTHORITARIANISM under any name. The idea that there are people “at the top” who deserve to run things and decide what’s OK for the rest of us is the core of oppression, and both capitalism and soviet-style communism are built upon that same bedrock oppressive assumption. Real democracy/equity is not possible when the power is hoarded by a few individuals who dictate to the rest of us. But it starts with economic power needing to be more evenly distributed. Lots of folks will say, “Oh, but wealth redistribution is bad!” Unfortunately, wealth redistribution is occurring every single day, but it’s not from the rich to the poor, it’s from the working people to the rich! If we want to ditch psychiatry and the victim-blaming philosophy that goes with it, we have to attack the problem of wealth redistribution to the wealthy, too.
Psychiatry is driven by the concept that all “depressed” or “psychotic” people have the same problem and need the same intervention. Real medical care is not the enemy, but psych diagnoses often have the effect of obscuring any physiological problems that actually ARE going on, by lumping everyone into a category and not looking further. So yes, I agree absolutely, real medical care is sometimes essential, and there are real physiological conditions that can cause “mental health” symptoms. But you’d have to actually LOOK in order to find them, and 99 out of 100 psychiatrists don’t even bother to ask those questions.
I would ask you to consider this: are depressed people generally know for violent acts when they are NOT taking antidepressants? Depressed people in general are known for NOT taking action, for withdrawing and feeling like there is no point in doing anything. This does not describe a person who is contemplating violence in general (though of course, there are exceptions).
I’d also ask you to consider the poster’s story. Does this sound like a person who would be violent if not intoxicated with a psychoactive drug?
Remember that the fact that some or even many people feel better with antidepressants does NOT mean that a small or even fairly large number don’t feel awful or do awful things. The idea that all “depressed” people are the same and need the same thing is the central fallacy of the psychiatric system. Different people are different and respond differently to the same intervention. True in general medicine, why would it not be true for psychiatry?
We could start by dropping the term “overdiagnosis” and replacing it with “malpractice.” If someone “overdiagnoses” my car with problems it doesn’t actually have, it’s called fraud. Why doesn’t this apply to medicine, or specifically to psychiatry?
One thing my wife found worked really well for her was blackstrap molasses. It has a lot of iron and the iron is very easily absorbable. May or may not work, but it’s cheap and easy to find. Has to be BLACKSTRAP, though. Hope that helps!
I should mention that the author of “Zen and the Art…”, Robert Pirsig, is an ECT survivor whose personality and historical memory was completely erased by the process, and he unravels his amazing philosophical discoveries during a motorcycle trip with his son during which he gradually rediscovers reclaims his true self that was taken from him by the psychiatrists. It’s one of the best books I’ve ever read and would be very meaningful to anyone recovering from the grasp of psychiatric abuse.
A good observation. Science can only go so far. At a certain point, we’re really talking about philosophy. What becomes important is what we VALUE rather than what is objectively true, or rather, objective truth only becomes available in the context of what we value and prioritize. If you’ve never read “Zen and the Art of Motorcycle Maintenance,” you should. He goes right at this question of “What is Best?” and comes up with some valuable conclusions. Among them, he very effectively debunks the idea that science is or can be “value free” – what we consider a “good hypothesis” or a “true result” is determined in part by what we think is “good.” It’s a great read.
Well, perhaps I should qualify that it is BAD for those incarcerated. It provides income and status and power for those who run the asylum. The reasons it continue include 1) people make money out of it , 2) people get to feel superior, 3) people get to take out their aggressive feelings on those less powerful and feel OK about it, 4) society gets to scapegoat the “mentally ill” and avoid having to deal with the real challenges of our society. There are probably more reasons, but they all kind of fit into that mold, I think. There is no patient-centered reason why mental hospitals should be the way they are. Even if one could justify arresting and incarcerating someone on the speculative ground of “danger to self or others,” the conditions in the average psych ward, as you describe, are anything but healing. If the people in charge really cared, these institutions would look very different.
I sometimes thing “neurodiversity” cedes way too much to the psychiatric model, and in doing so makes things more complex than they need to be. If we keep it as “The human species is made up of a wide range of different people, all of whom are potential contributors to our survival,” it gets a lot simpler. I don’t think we need to give extra credence to the idea that we are how we are because of our “wiring”. Some difference is sure to be due to genetics, and some due to education/programming, but who cares? People survive as best they can with the tools they’ve been given. Why not just focus on finding the gifts that each of us brings to the table and helping each other expand on what we have to offer? No “neuro” explanations are required!
I certainly would. And honestly, I don’t think we need scientific proof that institutionalization is bad! It is BAD! So let’s get on with fighting it and stop bickering about whether psych drugs cause “cell death” or “temporary brain damage” or “sedation leading to atrophy.” They are also BAD for your brain and your spirit! Science can assist us in the battle, but truth transcends science, and we all know the truth: labeling, drugging and incarcerating people for feeling or acting in inconvenient ways is BAD!
Great blog, Chaya! I appreciate your weaving in of social context in all of the sections of your blog. People should have to pay when they harm others, even if they’re not intending to. Psychiatrists and Big Pharma as well as the medical profession as a whole have a lot to answer for, and it’s sad that they make billions while people like you get criticized for charging too much for cleaning up their messes!
Your psychiatrist and I agree, it would appear. Unfortunately, it appears to me that he is a rare bird in the forest of psychiatry. The majority believe in labels and drugs, as their leadership directs them to do. You are very fortunate to have found someone with a different perspective.
I would add the general and increasing ripoff of wage earners in order to flow maximum wealth to those already ridiculously wealthy. Since the Reagan Administration, productivity has massively increased while real wages have remained stagnant. The middle class shrinks, the super wealthy own more and more, and no one wants to do anything except admire those who manage to survive the deteriorating conditions that pass for “normal.”
Which of course no manufacturer or psychiatrist (well, the overwhelming majority, anyway) would be willing to even consider for a second. It would appear they are not really interested in solving anything at all. I guess the status quo is working for them, even if it is killing off their clients.
“Simple logic” is not science. Science is built on evidence. You present no evidence whatsoever. For instance, saying “chemically impaired brains can’t learn or remember anything.” You provide zero evidence for this assertion. Logic would suggest that what can or can’t be learned would differ depending on who is drugged, how drugged they are, what they are drugged with, how long they are on the drugs, what they are taught, etc, etc. There are far too many variables to even make such a statement, let alone evidence to support it. It’s kind of ironic that you’re criticizing my evidence as potentially circumstantial, and yet running solely on your own “logic” without any evidence whatsoever.
In summary, your assertion that cognitive decline MUST BE due to disuse and atrophy, and CANNOT BE due to the drugs, is completely unsupported speculation. It COULD be due to disuse and atrophy, but it COULD also be due to drug use, and only an experiment controlling other variables and testing this question could say for sure. As a result, your assertion that people supporting the idea that drugs COULD cause cognitive decline are somehow unwitting supporters of biological psychiatry is ridiculous. There is evidence to support the possible link between cognitive decline and long-term drug use. There is NO evidence supporting the idea that DSM diagnoses are due to brain diseases, and plenty of evidence (and logic) that they are not. There is and can be absolutely no comparison.
Here is just one example of many where evidence of a connection between long-term drug use and cognitive decline is presented:
Thanks for your reply. While I can’t refute your assertion that cognitive decline is directly caused by brain damage, you also can’t refute that it is caused by the drugs. Studies that have been done have specifically correlated the use of benzos and antipsychotics with cognitive decline. I am not aware of any studies that correlate cognitive decline with institutionalization. I also know of nothing that compares institutionalization to psych drug use as relates to cognitive decline.
So given the data to date, the hypothesis that cognitive decline is associated with psych drug use IS supported by evidence, if not conclusively. There is also ancillary evidence from drug abuse studies showing long-term cognitive decline with alcohol and other drugs, and alcohol is particularly similar to benzos in its effects and mechanism of aciton.
Your hypothesis is not supported by any evidence at all that I am aware of. So it seems very rational to me, and not brain-blaming in the least, to say that damage from psych drugs is or at least is likely to contribute to difficulties in recovering from psychiatric “treatment.” This is VERY different from saying that someone’s brain is damaged at birth due to some theoretical “chemical imbalance” that is unsupported by even the slightest degree of evidence, or that diagnoses like “major depressive disorder” and “ADHD” are real disorders despite no evidence that people in such subjective groupings have anything in common with each other. It’s hard to understand why the difference is not as obvious to you as it is to me. One case involves an actual, physical substance being put into the body and measurable differences in cognitive ability being associated with using that specific drug. The other case involves using subjective social constructs to create groupings of people having no known connection besides their behavior, and postulating brain damage in the complete absence of any evidence whatsoever. Do those sound the same to you, Lawrence? Is it so hard to see why it would be insulting and infuriating to be accused of the latter type of assertion, when actually working from real evidence measured from real events that happen to someone’s body in the real world?
I would be very interested to know if there is any actual data to support your hypothesis. Until I hear such data, I’d say “Occam’s Razor” applies here. The most likely explanation is the simplest one: the drugs cause the decline in cognitive ability. The drugs directly impact the brain, brain damage from other drugs has already been shown to occur (Tardive Dyskinesia is only one example of many), there is a correlation directly between these drugs and cognitive decline. Any alternative explanation needs some kind of evidence beyond that you think it’s probably true.
So Lawrence, can you please answer the oft-placed question: is Tardive Dyskinesia a result of institutionalization? Or is it evidence of old-style brain damage? What about the demonstrated cognitive decline in long-term antipsychotic or benzo users? Or the development of Tourette’s Syndrome in a subset of stimulant users?
Your definition of brain damage is pretty narrow here. I’d suggest that brain damage should be defined as something that makes the brain unable to effectively function as it is supposed to on a long-term basis. But however you define “brain damage,” the adverse effects of long-term psychiatric drug use are well documented above and beyond the effects of institutionalization. At a minimum, you are speculating without evidence. It might be an interesting area to explore, but as a scientist, you can’t assume your hypothesis to be true, you have to test it.
Your lack of response to this question continues to concern me greatly. Are you unwilling to deal with data that don’t fit with your hypothesis?
He’s having a hard enough time admitting that psychiatric drugs actually can damage the brain. I doubt the victim blaming piece will be resolvable. But we’ll see.
And you STILL have not explained to us how Tardive Dyskinesia is not a result of brain damage. I find it disrespectful to have avoided this question several times, which I believe Stephen Gilbert also put to you.
Sorry, but saying that suicidal feelings can result from taking or withdrawing from drugs is not a “pro-psychiatry” position. If it were so, psychiatrists would be promoting this idea instead of going into apoplexy every time it’s brought up. It is not necessary to deny that substances can change feelings. I used to get drunk as a kid to overcome my shyness. And it worked! I was a lot less shy when drunk. I felt different and acted different. This is not news. Psychiatry is not based on the idea that substances change mood and behavior, which long predates it. Psychiatry is based on the idea that people can be “diagnosed” with a “brain disease” based on how they act and behave, absent any biochemical intervention, and that such “diagnoses” are caused by unproven brain malfunctions.
Denying that substances affect mood and behavior is just plain denying reality.
Not sure why this is a radical thesis. Maybe because it takes the blame off of the victims of poverty and puts the responsibility back on those with the power to change those conditions?
People heal from damage all the time. People break their bones in car accidents, have heart attacks and strokes, have their appendix removed and then recover. There is absolutely no assumption that brain damage is not recoverable, as many people with TBIs can tell you. But the brain is no less damaged just because recovery is possible. Talk to someone with Tardive Dyskinesia and ask them if they think it is a result of institutionalization or drugs.
I want people to have hope, too, but it’s not helpful to give dishonest or unreliable information to people. The first step toward recovering from harm is admitting the harm has happened, and the second is understanding what that harm is and what can be done about it. I consider it frankly insulting to those who have struggled to overcome the known, direct adverse effects of these drugs to suggest that their problem is “institutionalization.” Institutionalization DOES occur and is a legitimate phenomenon to explore, but suggesting that these powerful drugs have no damaging effect on the brain, in the face of strong evidence to the contrary, is just plain dishonest. It makes about as much sense as saying a heroin addict who is chronically impaired from long-term use is suffering from being a part of the drug culture, and if he’d stop, he’d just recover his prior functioning.
Drugs do damage our bodies. 120,000 people a year die from properly prescribed and administered medications. A lot of these are psych drugs. Is it really your position that these drugs can kill your body but have no deleterious effects on your brain?
I’d be very interested in hearing where your psychiatrist is coming from. What big changes does he foresee or recommend?
Unfortunately, most psychiatrists I have known and/or heard about are not interested in “big changes” and are unable to even accept hard scientific data from their own researchers. It is hard for me to imagine any kind of reform when the majority of practitioners appear allergic to any kind of factual analysis and are instead religiously committed to their “bio-bio-bio” views.
Understanding personal meaning and cultural context – what a concept! Who’d have ever thought that personal meaning and cultural context would be relevant in how someone thinks and feels? Sheesh…
How can you say this? Tardive Dyskinesia is an acknowledged outcome of long-term neuroleptic use, even among the most mainstream psychiatrists, and it is understood as damage to the dopamine system. Brain shrinkage from neuroleptic usage has been proven by psychiatry’s own minions in research labs. How can you say that there is no evidence of long-term neurological damage?
I agree, Julie. It’s easy to attack people who don’t support psychiatry as being “anti-science” or “not believing in biological causes.” These are handy ways to discredit people, but that argument assumes that psychiatry is scientific and deals in biological causes. Nothing could be further from the truth. There is not one psychiatric diagnosis that any psychiatrist could tell you the cause of in even a small percentage of cases. And the psychiatric profession ignores the actual science that should inform its practice. There are plenty of real biological conditions that can cause hallucinations, agitation, anxiety, or depressed feelings (including, of course, reactions to the drugs they give you to “treat” such feelings), and we’d be a lot better off if we tried to actually look at real biological causes and peel off those cases of “major depression” or “psychosis” that really DID have a biological cause, and admit that the rest are not “treatable” in the medical sense. The big mistake psychiatry makes is creating a set of labels for conditions they don’t understand, and then assuming biological causation for everyone who fits their subjective criteria. Any real scientist would never put up with that kind of shabby pretense.
I am so very, very sad to hear your tragic story! I appreciate you sharing it so the public can keep hearing that people can and do develop suicidal and homicidal feelings from taking SSRI antidepressants, sometimes even people who have zero such feelings beforehand. I can’t imagine how you would feel about this, but it is clear that the action of promoting these drugs without sharing these rare but incredibly serious side effects is criminal.
What about the increased autism rates for kids of moms taking antidepressants? What about the brain shrinkage/expansion studies for people on antipsychotics/stimulants over time? What about the measurable cognitive decline in folks taking antipsychotics and/or benzos over time? What about the induction of Tourette’s Syndrome in kids taking stimulants? And those are just the ones that come to mind right off the top. What about those, Lawrence? Do these issues (especially brain shrinkage!) not speak to physiological harm done by these drugs?
I would also submit that admitting these things happen does not minimize or deny the impact of institutionalization as you describe. However, acknowledging these known facts is very, very different than the harebrained and totally unscientific proposals that things like “major depression” and “ADHD” are biological “diseases” resulting from “broken brains.”
It really IS possible to break someone’s brain. A crowbar to the head will do the trick, but electric shocks to the brain and mass screwing with neurochemicals will do it, too.
I must say, I didn’t really notice that section of the blog. I agree 100% that psychiatric practitioners take advantage of social power to deceive and manipulate people into believing they are able to help, and that blaming their “patients” is blaming the victim. I agree also with your later comments that assigning responsibility is different than assigning blame. It is true that the vast majority of those engaged with psychiatry do so “willingly” and have the agency to make another choice, but the combination of our deification of doctors as “scientists” that near godhead, as well as the intentional misinformation provided by doctors, drug companies, and the psychiatric profession as a whole makes such agency extremely difficult to exercise. Not only are trusted doctors providing bad information and pressuring their patients to “take their meds,” our entire society has embraced this “solution” and there is now mounting social pressure from friends and family and even acquaintances to get with the program. We have seen the lengths to which psychiatry and the drug companies go do attack reputable physicians and clinicians and to deny people with personal experience who critique the psychiatric model with hard data from psychiatry’s own research arm. It is difficult to get one’s head around the full pressure that is put on untrained individuals without our level of knowledge and advocacy skills to simply knuckle under and accept the doctors’ advice uncritically, or the attacks they receive if they decide not to take such advice.
So you are absolutely right, Richard, and I apologize for not supporting you fully. Clients can NEVER be responsible for the decisions of the profession to manipulate and pressure them into complying with their misguided or downright nefarious “advice.” Thanks for clarifying the issue for us all!
I didn’t hear anyone denying this. I heard people objecting to being told they supported the “medical model” by insisting that brain damage from psych drug use is very real, above and beyond the institutionalization that Dr. K rightly identifies. He appears to be saying that damage from drug use is NOT a key factor and anyone that says it is would be supporting the “chemical imbalance theory.” This assertion is just plain wrong and needs to be challenged. It’s too bad, because the bulk of his essay makes a whole lot of sense. Breeding dependency is psychiatry’s stock in trade.
How do you explain tardive dyskinesia if not toxicity? How do you explain the cognitive decline evidenced by people who take “antipsychotics” or benzodiazepines over extended periods of time, or the increase in autism diagnoses for children born to mothers taking antidepressants, or the neurological up- or down-regulation that has been shown for antipsychotics (up) and stimulants (down) and appears to also be happening for SSRIs? (Not to mention ECT, which clearly causes irreversible brain damage.) While we may not yet have demonstrated significant levels of cell death (but who is researching that question, I ask you?), we certainly have plenty of evidence of brain damage on a broad scale. How can you suggest that this kind of damage does not impede the recovery of even the most hard-working and dedicated citizens working their way out of psychiatry?
It is certain that dependency on the psychiatric system is encouraged at every turn and that institutionalization contributes significantly to challenges in recovery. But the question of brain damaging substances is 100% a different question. It is very possible to have both/and in this situation, and that’s what I think is happening.
Well, that is the most basic thing. I think what people got upset about was being accused of being biological determinists simply because they believe that drugs can alter one’s mood and behavior in negative ways. Other than that, I think it’s a fine blog, but I think that sentiment has been properly taken as an insult.
That being said, I believe the #1 issue we should pursue is the elimination of the psychiatric hold. Arresting people and locking them up is not “treatment” and should not be allowed to be called that. If people need to be arrested for threatening or harming people or otherwise violating their rights, it should be called arrest and jail, not “treatment.” If we can accomplish that, antipsychiatry will be so far ahead of the game as to almost have won.
Drugs purport to present an easy path, and any kind of quality therapeutic process requires hard work and a willingness to experience pain and discomfort. Naturally, the promise of an easy fix is appealing to a lot of people by comparison. Drug pushers know this. So do doctors and especially psychiatrists. Of course, it’s easier for the doctors, too, in the short run. Of course, only one of these approaches actually helps a person improve over time, and we know which one that is.
The problem is, the drugs DO have adverse effects on the brain. I think it’s a combination: the adults have distanced themselves from the kids partly due to the DSM/bad brain theories, and the drugs make it easier to do that, but the drugs themselves make it easier for the kids (or others) to distance themselves from their feelings and their oppressors. They are not mutually exclusive, and there is plenty of evidence to support that certain drugs in and of themselves make violence more likely. It’s not blaming the brain to note the evidence supporting the drugs’ adverse effects.
I agree. It is very possible that both have an effect on deterioration, given that suicides INCREASE after hospitalization. However, the evidence Whitaker presents shows a DIRECT relationship between increasing use of drugs and dramatic increases in disability. He also presents a clear mechanism by which this occurs. It is not possible to dismiss his hypothesis without refuting the data, and the author fails to do so.
I would also add that the REMOVAL of genuine supportive services over time contributes to the deterioration of clients over time, but that still does not invalidate the data showing strong correlation with the use of psychiatric drugs and the vast increase in disability.
Words are a reflection of intent. The author wants to move the words around without changing the intent. Is the purpose of “mental health treatment” to engage with and empower the client, or to make uncomfortable people stop acting the way they do? Is it about encouraging perspective or enforcing social norms? If the intent is different, the words will follow.
So now they’re allowed to simply invent data points by “predicting” what people would report! This has to be a new scientific low. How are they not held accountable by their peers or the journal editors for this inexcusable departure from anything vaguely resembling scientific procedure. I know, I know, corruption drives the train…
I agree. What passes for “the left” in the USA would be center-right in most European countries. Most Americans are completely ignorant about this. Although neoliberalism is having its effect over there as well.
It is like a religious cult. There are dogma that simply can’t be transcended without being attacked or ostracized. It baffles me why this is such a challenging issue for the new Left to handle. Feminists in particular used to be brutally critical of the psychiatric profession for targeting women’s reactions to violence and sexual abuse as “mental disorders.” What has happened?
There is a definite disconnect on the left (as well as the right) about this issue. It is regarded as “pill shaming” by many on the left to criticize the psychiatric establishment, and those who don’t feel this way are afraid of being labeled by those who will attack them for doing so. The left’s general approach seems to be “let’s advocate for more money for the “mentally ill,” without realizing that grouping people as “the mentally ill” is a highly oppressive action. It’s a big blind spot, and I have not yet figured out how to reframe this as a civil rights/social justice issue for people coming from that viewpoint.
Something being “mainstream” or having agreement in the field doesn’t make it true. There is no evidence presented here. It’s an argument from authority. Not really worth reading.
Well, ya can’t make a buncha money curing people with food, man! You can’t expect psychiatrists to embrace such a ludicrous notion just because it WORKS, can you? How will they get clients if you start giving people the means to cure themselves?
Or maybe, just maybe, being mistreated creates fear or anger in the victim, which is later expressed as distrust, hostility, anxiety or depression as an adult. Do these people actually believe that human beings exist and have the ability to affect their own bodies?
Beautifully spoken! This is one of the best description of the subtle but pervasive oppression that are an integral part of our public school experience in the USA. Until this changes, we can have little hope that the pattern of angry young men will abate. Thanks, Bruce!
Transparency doesn’t solve this problem, or any other conflict of interest problem. The only answer is to stop direct contributions to advocacy groups directly affecting their market. If they want to donate, they should donate to a fund administered by and independent board of directors who can donate to whomever seems worthy. It’s not a donation when strings are attached!
Perhaps we could start by making such contributions no longer tax deductible?
I am sure the number is quite high. I’ve even heard rationalizations from the psychiatric community – people have a manic reaction to SSRIs because they have “uncovered an underlying bipolar disorder.” Not because their drugs are doing it, but they totally know it happens – they just blame the victim, as usual.
I get the impression that you think an antipsychiatry position is not compatible with the possibility of biological causation. This is not accurate, in my view. I think an antipsychiatry view would say that biological causation exists, but should fall into the categories of neurology, immunology, nutrition, sleep apnea, or whatever real medical category applies. The problem is not that these phenomena called “mental illnesses” don’t exist, but that they are grouped together AS IF they all had the same cause. You acknowledge that they don’t, so what’s the point of calling someone “bipolar” if it doesn’t tell you what’s wrong or what to do about it?
If someone has hallucinations due to a brain injury, they should see a doctor who knows about brain injury. Not a psychiatrist, because they don’t know anything about brain injuries. They just know about drugs and labels, and that doesn’t help people get better.
You are absolutely right, Frank. The Fed starts raising the interest rates whenever the unemployment rate drops below 5%. They say it’s because they’re afraid of inflation, but it’s really rising wages they hate. Recently, the rate has dropped below 5% and rates started to rise a little, but wages remain stagnant, so they’re not too worried. I think this is because most of the jobs available pay crap, but in any case, it’s definitely a conspiracy to keep wages low and profits high.
Thank you so much, Sera! You put into words much of what I was feeling about this article. The intent seems good, but the execution is both confusing and at times disrespectful of people who are working to end the current oppression both in and out of the system. And I VERY much appreciate your deconstruction of the concept of “saneism,” which seems to suggest that there IS some differentiation and the “sane” people are beating up on us poor, unfortunate “insane” folks, and they just need to stop being so “stigmatizing” and let us be nuts in peace.
These designations are completely arbitrary and subjective. They’re based on scores on a depression questionnaire, which relies either on patient reports on subjective questions, or caregiver reports on the same subjective questions. It’s kind of like someone saying, “I feel severely depressed,” and you saying, “That means you have severe depression.” It’s all BS.
Not really saying there needs to be an “alternative.” I’m saying that the underlying social forces that lead people to seek out and/or accept psychiatric “treatment” need to be addressed. Otherwise, something else will emerge that is based on the same principles, namely, that reacting badly to the status quo is proof there’s something wrong with you. Schools are also run on this principle. Religions are often run on this principle as well. Oppression goes way beyond the purview of psychiatry, even if psychiatry has come up with a very efficient way of managing it.
Not sure you’re getting what I’m saying. Psychiatry DOES fill a need for society to keep us from getting together and rebelling.
But a crisis line was originally a rebellion AGAINST psychiatry. It was regular folks volunteering to help their neighbors in the community. As I said, most have been co-opted by psychiatric institutions, but the original concept was completely independent of psychiatry, and it was conceived of as a way for people to help each other WITHOUT “professionals” sticking their noses in. Or are you suggesting that people don’t need other people to talk to or a community to support them? Our communities ARE shattered and dispersed and it is the absence of such real communities that is at the heart of the angst and despair so common in industrialized countries, IMHO. So there is a need for people to connect, and it’s very real, even if that need is preyed upon by those trying to make a quick buck off of shutting up the distressed and the disenfranchised.
Capitalism has focused a lot of energy on undermining communities so they could have a mobile work force and so they could pollute and trash the environment without people being organized enough to resist. That’s what the Luddites were saying way back a couple hundred years ago.
That question is kind of like the game, “Would you rather?” Would you rather have one finger cut off or have to sleep every day in a dumpster for 20 years? Guess what, I wouldn’t want to do either!
I can’t entirely agree about crisis lines. I think they are an outgrowth of the disturbing level of disorganization and oppression in society at large. They are more a symptom than a problem. The original crisis lines were entirely community based, manned by volunteers who were there to listen and care. They have been largely co-opted by the “mental health” system at this point, but there are still a few like the one I’m currently volunteering at in Olympia, WA, which runs on the old principles, including never tracing a call or dispatching the police to anyone who isn’t specifically asking for that kind of help.
In order to really eliminate psychiatry, there are some fundamental changes to our society that will have to be made, starting with encouraging community and putting some limits on the ability of commercial interests to keep the bulk of humanity in poverty.
#18: Refocus research and intervention on individual and social trauma and disempowerment rather than blaming the biology of those who are traumatized or socially outcast.
It is also bad science to propose new hypotheses to explain away experimental results. They are supposed to state their hypotheses BEFORE running the experiment! Their new hypotheses might form the basis for another experiment, but are IRRELEVANT to their current experiment, as they are pure speculation without further testing. One can almost always come up with multiple ways to explain an outcome, but only pre-existing hypotheses that predict the outcome before it happened can be considered legitimate scientific results.
We could start by disconnecting the need to detain people who are creating problems from the idea of forcing “treatment” on unwilling detainees. What’s wrong with the idea of “keep[ing] the individual securely locked up until such time as they had recovered?” Why does holding someone who is threatening to burn down the house imply enforcing drugs or other violent
“treatment” on their unwilling bodies?
Good to see her challenge the chemical imbalance mythology. Unfortunately, there is little emphasis on changing away from the biological model or exploring trauma and social conditions as the main (and most modifiable) causes of psychiatric “disorders.” There is also no questioning of the DSM diagnostic model, which drives the biological intervention train. So maybe some sign of the pendulum starting to swing back, but still not entirely encouraging to me.
There are limitations on our potential, but I don’t think there are limitations on our free will. It may be more difficult for some of us to do certain things (and it’s also easier for us to do certain other things!), but that doesn’t limit our ability to choose what we’re going to do. For instance, I can’t suddenly develop good small motor skills, as it’s a gift I don’t have, but I CAN develop my small motor skills to a higher level with practice and dedication. Taking action is always a choice, though the outcome isn’t ever guaranteed.
Lots of people buy into the system. There is lots of propaganda and social pressure to do so. We who see through it should consider ourselves fortunate and help educate those who have not come so far. I don’t see it as in any way helpful to criticize those who are just now beginning to see they’ve been had. We should instead encourage them to learn more and join the fight!
Humility is required for learning. People who already think they know everything don’t learn much, but still feel superior. It’s a baffling conundrum. The only thing I’ve extracted from my experience from such people is to stay as far away from them as I possibly can. Sounds like you learned the same lesson!
Glasser was a freaking genius, but of course was marginalized by his peers. The adults actually taking responsibility for altering the family dynamics? That’s crazy talk!
I agree, this myth is still firmly embedded in the public mind and continues to be propagated by many practitioners, whether out of ignorance or malfeasance or whatever. It appears on many websites across the internet. The tide does appear to be turning, but we’re a long way from having general agreement that this idea is mythological.
It’s like you take your car to the mechanic, they can’t fix it, and they say it’s your fault for having a “repair resistant car.” How they get away with it astounds me. So sorry you had to go through with it.
Besides, “mentally ill” people aren’t supposed to have sex lives, you know? They only exist to consume “meds” and to sit on their couches and watch TV. Anything else is “a danger to self and others.”
Well, there goes 80% of psychiatrists’ business! If only they would abide by this, involuntary “treatment” would come to a swift end. Frank’s right, the problem is who gets to define “torture”. If you asked the “patients,” you’d get a very different answer than if you ask the psychiatrists.
“In educational contexts, a student is more likely to become intrinsically motivated to learn if a specific task is inherently interesting and enjoyable, and the associated behavior is based on an internal perceived locus of causality.”
So kids are more motivated to do thinks they are interested in and enjoy? WHY DO WE NEED A STUDY TO FIGURE THIS OUT???!! I get so baffled by all the obfusticatory language being used to describe the obvious. I suppose it’s needed to make their papers sound erudite and scholarly, but really, isn’t this the most obvious thing in the world? Who is motivated to do things they find dull????
Wallenfan, of course, there are such conditions, but why call them “mental disorders,” rather than “bad reaction to prescription drugs” or “physiological damage from street drug use” or “hallucinations secondary to stage 3 syphilis infection?” To me, it’s kind of like calling a rash a “disorder”. Well sure, there’s a rash, and you want it to go away, but the real “disorder” is what’s causing the rash – the rash is just the indication that you ate something you’re allergic to, or rubbed your hand in poison ivy, or have the measles. A rash isn’t a disease, it’s a sign. Same with depression. It’s usually a sign of something wrong, but calling it the problem is like diagnosing “pain” when your hand is on a burner. Pain isn’t the problem. It’s the hand on the burner that’s the problem.
RFS, of course, I agree 100%. The big problem with these DSM labels, beyond blaming the victim so effectively, is that they don’t differentiate cause at all, or even attempt to. They assume that all depressed people are depressed for the same reason and need the same kind of help. This is, of course, nonsense, but for some reason, it sells big time with people who are too lazy or too scared to look deeper for the real reasons. It also keeps our leaders from having to look too hard at our institutions, like schools and churches and government programs, and see how they might be causing or perpetuating anxiety and distress, because that would be too inconvenient for our elite to have to deal with, and might cost them some money, which is the ultimate sin.
Your points are very well taken. I was merely objecting to “too much empathy” being blamed for suffering, when too much brutality is the real problem. And I agree 100%, the point of empathy is to create more cohesive communities where violence and brutality is minimized because it’s not something anyone wants to experience. So dampening empathy is not the answer, though you’re right that limiting exposure can be important to one’s sanity!
This seems like a lot of very complex language to explain a simple phenomenon. I can’t imagine anyone trying to follow these “directions” and ending up doing anything helpful.
“… this involves the therapist’s stepping out of an interpretative role and assuming a stance of curiosity, interest, and respect toward the client’s experience.”
This seems very, very basic and is essentially ALL I have done in therapy sessions of whatever sort – be interested and respectful, seek to understand the client’s viewpoint, and try to help him/her obtain some kind of perspective on his/her own process. But it’s not complex at all. It involves being present and NOT thinking about all these theories and strategies and rules that get in between the client and the person trying to help them.
This also (properly) suggests violating the idea that a therapist/helper must remain “objective” by not getting “emotionally involved” with the client. To the contrary, emotional involvement is the only thing that makes it possible to know what to say or ask! And it enables the client to sense that you actually care about what they’re saying. Because you DO actually care! I defy anyone to truly care about another person without some level of emotional involvement. All the body language, nonverbal cues, etc. that the article talks about are readily available to someone who is paying attention and not trying to “accomplish something” with the client, but instead is just trying to understand the client’s worldview and create a safe environment to communicate together.
I think these traits are heavily discouraged by our society. There is an article in the “In The News” section about how being too sensitive makes one more vulnerable to trauma, instead of talking about how trauma is damaging to us all but some are more sensitive and feel others’ pain.
Most definitely not a “normal” trait, at least as far as our society is concerned, but I’m guessing it would be a lot more common if it weren’t punished so consistently.
Empathy doesn’t hurt. Being empathetic in a world filled with violence and cruelty is what hurts. It seems like they think the answer is protecting yourself from empathetic experiences, rather than working to eradicate violence and cruelty, which really cause the suffering.
You present no evidence that this is true. Since the USA was to a very significant extent founded on the institution of slavery (and this is factual, not deniable) and the institutions of Jim Crow and the KKK and many others continued well into the 1960s and institutional bias against black people existed (and still does) in voting rights and loans and housing (remember redlining?) and many other areas, I’d say the burden is on YOU to prove that somehow this has all magically disappeared. As I said, there is plenty of hard data supporting my viewpoint, and Uprising has been kind enough to provide a couple of links, and telling stories and using ad hominem attacks against me does nothing to address this data or the obvious and undeniable history of institutional racial bias which has been a major thread in this country’s identity since before it was a country.
Nonsense. If you lived in a very oppressive society, the USA would feel like a breath of fresh air, even if you had to put up with some crap due to your race. Also, if you were starving, it would be worth whatever you needed to suffer in order to find a place where you could earn money and live a decent life.
I your last sentence, you admit you are a bigot. You also clearly imply that darker skinned people are “racist” toward white people when saying that “liberals” are the same. It doesn’t take fantastic hearing for that dog whistle to come in loud and clear.
As for systemic racism, you will have to educate yourself on that point. I will assure you that there is hard data that black people and Native Americans are treated differently by our police, our court systems, and our child welfare systems. This is not to say that ALL or even MOST police are racists (remember, grey areas, grey areas). It simply means that black people and native people are treated differently ON THE AVERAGE than white people. It is factual and supportable if you actually believe in data. I question whether you do or not, but I am guessing you don’t really want to think about this area, you just want to attack anyone who disagrees with you as “insufferably self-righteous and dishonest,” because it’s easier to generalize about people than it is to acknowledge that people are complex and that good and evil can exist in the same person and that people can behave in what they believe to be a fair and equitable way while actually being quite unfair and biased. No, that’s too complex to allow for dogma. So I won’t bother talking further with you about this topic. Anyone who is actually in touch with the data knows which of us is talking through his hat.
Why is it SO important to you to prove racism doesn’t exist except against white people? I suspect I know the reason, but help me understand why this argument is so important to you?
I agree 100%. Therapy to adjust to oppression is totally out of order. Not to say that support can’t be helpful, just like supporting someone abused as a child can be helpful. But it’s not a “mental disorder” to get angry or upset or anxious when you’re kicked around by people who are more powerful than you are. It’s a normal reaction.
That is a foolish analogy. Obviously, people come here because of a) economics, and b) relative freedom from oppression in their own country. Obviously. Do you really think it’s rational to assume that because the USA appears a better option than their home country, the USA has no problems with racism? Do you really believe there are only two options, that the USA is perfect and wonderful (except for those awful liberals and dark people, of course) or that the USA is horrible and that everyone needs to escape it?
Every country has its strengths and weaknesses. I’m happy to be an American and I believe the American Constitution and other elements of our political system (especially the court system) are admirable and worthy of emulation. At the same time, I’m realistic – no country is perfect, and it should be clear to anyone who isn’t closing their eyes that this country was partly built on slave labor, and that the consequences of slavery and the subjugation of the native population still affect us all today. To believe otherwise is simply closing one’s eyes. It’s not “politically correct” – it’s factually observable, both in statistics and in millions of anecdotes that anyone who is actually interested in the truth can easily obtain.
It’s easy to use confirmation bias to support your belief system. It’s a lot harder to look at actual data. The truth is almost always very gray. It is uncomfortable to love this country and still believe it can be improved.
OH: Your presumption that there is a conspiracy to disarm all Americans is unsupported by any kind of facts. Anyone can speculate, but the Constitution prevents the disarmament of the general citizenry. I am far more concerned with Frank’s point, that the “mentally ill” will be targeted for disarmament, not because it’s safer but because the “mentally ill” make a good scapegoat.
As for the causes, obviously “violent people” commit violent acts, by definition, but that’s a pretty tautological argument. I certainly am not suggesting that “the mentally ill” are to blame somehow. For one thing, there are no more “mentally ill” people here per capita than anywhere else, but a hell of a lot more mass shootings. Obviously, the possession of guns doesn’t cause it either, because the overwhelming majority of gun owners don’t commit crimes. Drug use IS associated with increasing levels of violence, but I think the causes are very complex, and as to why it happens in the USA so much, even more complex.
All that aside, my point is that once someone credibly says “I’m planning to shoot up the local school tomorrow,” I think they give up their right to own or use a gun. If someone shoots his wife (or her husband) with a gun, I think it’s reasonable to restrict their access to a gun. If someone has a history of armed robbery convictions, I think it’s reasonable to restrict their access to a gun. Would you disagree?
As I said, “Gun control” doesn’t mean disarming all citizens. It is reasonable to stop certain people from having guns if they use them to hurt or threaten people. Your choice to believe that there is some secret plot to disarm everyone doesn’t make it true, and I guarantee you there are enough Americans who would protest if such a thing were attempted. And a lot of them are armed!
I am not sure why people so often say that having some level of gun control laws means “disarming the public?” I have rarely seen anyway but the most extreme radicals advocating for disarming citizens, and it can’t be done anyone, because of the second amendment. What I’m mostly hearing is making it harder for people with known violent pasts from getting their hands on weapons, while regular citizens are free to hold as many guns as they want. It’s true that banning semiautomatic assault rifles is on the table, and I see the arguments on both sides of that, but as for “disarming the public” – who is arguing for that????
I hope you’re right, Oldhead, but I have my doubts. Both sides of the aisle appear to be sold out to their contributors, and until that changes, the priority will be making sure the big corporations make money. The rest is mostly window dressing.
This sounds like psychodynamic therapy, not psychoanalysis. The thing that set psychoanalysis apart, for me, is that it focused on interpreting (analyzing) the content of a person’s conversations, dreams, etc. It’s very possible to do psychodynamic therapy without resorting to any analysis or interpretation for the client, instead letting the client tell his/her story without any attempt by the therapist to tell the client what it means or what they should do about it. It is very possible to bring unconscious thought to consciousness without any evaluation whatsoever on the therapist’s part, just by being patient, listening well, and asking the right questions at the right moment.
The article also seems to ignore another important reason why psychodynamic therapy went out the window – the DSM III and the intentional marketing of the idea of mental illness as biological defect. We can’t have people getting better without drugs if these things are biological, so any kind of deeper therapy has to be eliminated in the interests of profits.
Sorry, but whatever prejudice (and prejudice is not the same as racism, the proposed dominance of one race over another) is directed toward white people by people of color pales in comparison (sorry, bad pun there!) to what darker skinned people have to put up from their Caucasian counterparts in the USA. The fact that you refer to “leftists” as a group and talk about anyone who disagrees with “them” suggests some prejudice on your part, as you are grouping “leftists” together and assuming that you understand “them” and know how “they” act and believe that “they” are all the same. I do get what you are talking about – there are some subgroups on the left who are highly authoritarian and who are intolerant of disagreement. But this is clearly just as true for some subgroups on the right, who often target gay people, minorities, women, and anyone who doesn’t share their worldview.
Personally, I see the left/right conservative/liberal spectrum as a distraction pushed on us by those REALLY in power, so that we’ll fight with each other instead of joining forces with each other and demanding a more equitable sharing of the fruits of our incredibly productive society with the people who work so hard to keep it productive. But that’s just my opinion. You’re entitled to yours, but not to your own set of facts.
I somewhat agree, though I believe the labeling process in itself is unnecessary and disempowering to many if not most who receive them. But I am interested to note which of the DSM disorders you see as being capable of guiding one to effective treatment? My experience is that almost all guide only to blaming the victim and ineffective and disingenuous drug “treatments,” and those that don’t (like personality disorders) lead instead to condescension and shaming. I am also unaware of ANY psychiatric “disorder” per the DSM that has a known cause. I’d truly be interested if you have any information to the contrary, but as far as my experience goes, anything that can be done with a DSM label that is actually helpful can be done just as or more effectively without the label, other than getting insurance reimbursement.
Not everyone has had your experience. Many people have been badly damaged by the system, and want changes to happen. You appear to be a reformer yourself, so obviously some of the things that happened to you weren’t so wonderful. Is it that hard to understand why some people would be angry at a system that mistreated them so badly?
It is also often forgotten that even with good parenting, the stresses of our bizarre society can lead to madness. The current system not only doesn’t acknowledge this fact, it actively goes out of its way to deflect attention away from social and environmental causes and back to blaming the person who is reacting badly to them.
That’s the sad part about the whole DSM-based worldview – it encourages individuals, professionals, and society at large NOT to take responsibility for environmental and lifestyle impacts, but instead to blame the brain of the person suffering from those impacts. As a person who used to be chronically depressed/anxious and sometimes suicidal, I can honestly say that good therapeutic support plus improved living strategies have almost completely changed how I feel and interact with the world. The thing is, it takes YEARS of hard work and a willingness to become aware of some painful things we’d all like to keep under wraps. Labeling someone with “Major Depressive Disorder” or “Bipolar” or “Anxiety Disorder” makes it seem like it’s all in your brain, you just HAVE this “disorder” and there is nothing you can do about it. It also makes it easy for professionals to blame YOU when their interventions don’t actually work for you. I mean, would you take your car back to a mechanic who said your car isn’t working because it has “repair-resistant fuel injectors?” I hate the DSM, not because I don’t believe people suffer from depression or anxiety, but because it removes power and agency from the person having those experiences.
All of this would presume that those in power actually CARE about the impact of poverty and toxic waste. They are forgetting that ADHD and similar “disorders” were invented so we don’t have to think about such things and can instead blame the victims.
Do you really think Republicans have been better? Other than a few oddballs here and there, I don’t know any Republicans OR Democrats who have taken up this issue. In fact, Republicans seem even more willing to blame “mental illness” as a means of avoiding a discussion of any changes in gun laws. So it’s not a Democrat/Republican thing in my view. It’s a rich/powerful vs. poor/powerless issue, and of course, both sides of the aisle are buddies with psychiatry, because psychiatry is on the rich/powerful side of the scale.
They do, but if they’re used more than occasionally, they actually make the problem worse, just like street drugs or alcohol do. In fact, alcohol is very, very similar to benzos in actions and side effects and addictive potential. Benzos may actually be worse. One COULD prescribe drinking three times a day as a “treatment” for anxiety, and it would “work,” but I’m pretty sure most people would recognize it as, at best, a very temporary and superficial solution.
I think you are right. The majority of therapists are apologists for the status quo, and would consider your resentment or criticism of your past psychiatric “treatment” as either irrelevant or misguided. There are exceptions, fortunately. I know one foster care survivor who had a therapist start off by asking, “What have professionals like me said about you in the past?” The therapist spent the entire first session helping the young lady reject all of these historical labels and get ready to start over with real, client-focused therapy. It was the first time she realized that therapy was supposed to be for HER. It had always seemed more like a punishment for behaving badly.
Thanks for sharing your story – it breaks my heart to hear, but I’m glad you are finding a new way forward!
That is hilarious! I certainly hope it was a farce, but with the state of psychiatry these days, I can totally see this being taken seriously if presented to a bunch of psychiatrists by someone with the proper credentials.
You are so right. Unfortunately, parents ARE sometimes responsible for at least not knowing what to do to help their kids, and sometimes really DO create these problems by abuse or neglect, and the ADHD label lets them off the hook. More significantly, though, it lets SCHOOLS off the hook for not knowing how to educate these kids. The fact that going to school a year later leads to a 30% reduction in ADHD diagnoses tells us that a lot of this is just development, expecting things from kids before they are ready. It’s also a well-kept secret that kids with “ADHD” diagnoses do immensely better in more child-centered classrooms (think Montessori) where they have more control of their time and activities, to the extent that they look quite “normal” in such circumstances. There are no doubt a small subset of kids who really DO have something physiologically wrong with them, but the ADHD label also obscures any attempt to understand about the real physical causes (such as sleep apnea, drug side effects, low iron, thyroid issues, etc.) On the whole, the main thing that ADHD does is let grownups off the hook. But I mainly hold the professionals responsible for misleading the parents into thinking this is a real thing. The behavior is real; the idea that all kids who act that way have something WRONG with them is a fantasy.
I like “satisfaction” as the goal. Of course, the Buddhists would say that “striving” for anything is what keeps us from experiencing satisfaction or contentment. Being OK with the world as it is, even if it’s not what you would ideally want, does seem to be the best way to feel OK about myself and the world.
And it pisses many of them off that their abusive histories and unstable present environnments are ignored. I worked with foster kids for 20 years and rarely met one who had anything but contempt for psych drugs.
‘Under National Socialism [Nazism], psychiatrists showed contempt for their fellow man. They lied to and deceived the patients in their care and their families.’
I hadn’t thought of it that way. It’s supposed to be so absurd as not to be close to true. Hard to believe they’d show that movie to involuntary psychiatric inmates!
A great perspective. Goes to show that people with the exact same “diagnosis” need totally different things. What works for one won’t work for the next. Which makes me wonder what the meaning of the “diagnosis” is, if diagnosis doesn’t tell you what you should do to help. But well done to you for finding your way, Pat, because of or in spite of outside efforts to help. It is a very personal journey.
“…identifies “connectedness and meaningful activities” as crucial components of recovery journeys.” But wait, I thought it was all about brin chemistry!
I am kind of amazed that the media has avoided the obvious major causal factor in this mass murder: racism and hatred, promoted and supported by a white supremacist militia this young shooter belonged to. Why do we need to go to the “mental health” argument when white supremacy appears to be the clear motivation? If the guy were Latino, we’d be shouting about illegal immigration. If he were Muslim, we’d be shouting “terrorism” from the highest buildings. But he’s a white supremacist, so he must be “mentally ill?” Help me understand this!
I am also wondering if he was being “treated” with benzos or SSRIs, but we’ll have to wait for more data on that point.
Maybe “changing their minds” isn’t really the right phrase here. Perhaps “helping them remember their purpose” or “helping them process their pain” are what really make the difference. I agree that we can’t “change people’s minds,” but I’ve intervened in the lives of hundreds of people who were considering suicide, and helped almost all of them by helping them take a good look at what problem they were trying to solve by dying, and helping them come up with other ways that might solve the problem in a less final fashion. Most of the people I encountered did not WANT to die, they wanted to stop suffering and saw death as a certain means to do that. Of course, I worked at a crisis line, so those calling were almost all ambivalent about their intentions. I know there are people who genuinely want to end their lives and have their reasons, and I agree it’s not society’s job to “stop them” or “make them change their minds.” But that doesn’t mean we can’t help people who are suffering through compassionate listening and support.
I still don’t understand how anyone can claim “overdiagnosis” or “misdiagnosis” of something that has no objective diagnostic criteria. It’s good they recognize that “Adult ADHD” is a marketing scheme, but how is it any different than “childhood ADHD,” which they still claim to be able to diagnose accurately?
Very well said! In my view, the power elite LOVE it when the rest of us are divided by left-right politics. We do best when we find things we agree about and pursue them regardless of political background or affiliation.
I don’t agree that it’s oppressive to have rules and expectations for civil behavior. Oppression comes from the rule of one “in” group over another “out” group. There are many examples in Western democracies, but the most encompassing is the oppression of the poor and the working laborer by the rich and the propertied classes. This oppression is chronic in Western societies, but societies have been observed where such oppression does not exist at all.
Laws in a democracy are supposed to be made by general agreement, with all having either direct or indirect input through representation. If such is the case, problematic laws can be changed by communication, and any oppressiveness is temporary, accidental, and remediable. Looking at psychiatry, we see the opposite. “Patients” or “clients” are clearly considered less valuable than “professionals,” leading to the latter feeling justified in making decisions for the former, including forcing “treatment” on them “for their own good.” The main thing a Soteria-type model provides is freedom from this kind of oppression. If people are allowed to be themselves, yet still expected to maintain some kind of respect for other people’s rights, it is possible to create a society where oppression is not a major force. Unfortunately, psychiatry is clearly and violently opposed to any such creation, and will stamp it out wherever such creations begin to blossom, as Mosher learned to his dismay.
Oppression starts with a significant imbalance in power, and the person in power can and often does use that power to do harm. It has nothing to do with creating laws for a just and smooth-functioning society. It’s not oppressive to expect societies’ members to treat each other with respect. It IS oppressive to expect some to accept disrespectful treatment while not holding those treating them poorly accountable for their violations.
US healthcare is WAY more expensive than most other countries, mostly due to the profit motive and to perverse incentives, such as paying $200/hr for 10-minute “med checks” vs. $75/hr for therapy vs. next to nothing for “peer support.” So we have plenty of money to afford this kind of system. It’s just not profitable enough for the powers that be.
Thanks for the excellent article. I notice at a few places that you say that the professional staff “doesn’t understand” true peer support principles. I don’t agree with this. My observation is that they don’t BELIEVE IN peer support principles, and the more they understood them, the less they’d believe in them. Peer support presents a THREAT to the status quo, including threatening many professionals’ deeply held belief that they are inherently superior to “the mentally ill” and therefore have a right to condescend to and feel superior to them. Accepting a true peer support concept would be tantamount to admitting that they (the professionals) are not substantially different from the clients they are supposed to help. While such an admission would, of course, be tremendously helpful in allowing professionals to actually understand what works and what doesn’t work, the vast majority of professionals don’t have the courage to face the uncomfortable feelings that come up when they step down from their place of power and face the truth of their own oppressive behavior and their own prior experiences of oppression.
As in any movement, cooptation is an effort to disempower a threatening group. No amount of education, training, or regulation will make peer support acceptable to the mainstream. They won’t give their power away voluntarily, with a few exceptions, and those exceptions will be hounded and driven out (as I was) by the violence and corruption of the system.
What we need is not “peers” in the current system, but a new system not based on power differentials.
Most of the psychiatric armamentum would qualify as “unnecessary care.” But if you pay people to prescribe drugs, they’ll prescribe drugs. If you pay people to do tests, they’ll do tests. For profit healthcare is problematic, because as soon as the need for profit drives care, then we receive what is profitable, not what is actually helpful to us. Something’s got to change!
You’re right – it should be Job #1, as the threat of involuntary “treatment” (aka torture) contaminates any system that tolerates it. Job #2 should be to eliminate psychiatric “diagnosis.” I don’t hold my breath that either of these things will be a part of ANY “Integrated Care” initiative, which is why I doubt there is any value in the concept.
Like I said, it’s a viable strategy. It’s not a panacea, and it can be and often is used in an authoritarian manner. The enemy isn’t CBT, it’s AUTHORITARIANISM. An authoritarian thinks s/he is better than “the mentally ill” and so believes clients need to be “fixed” by having something done TO them. Quality therapy (and I admit it is rare) involves empowering the individual to take action in the service of improving the conditions of his/her own life. It should never be driven by the needs of the therapist, but it too often is, and the DSM lends tremendous credence to authoritarian views and encourages this kind of abusive, controlling behavior in the name of “therapy.” I can completely understand that even one visit with one of these charlatans would turn one off of therapy forever. I was fortunate to have run into a capable therapist early in my life, and I learned what good therapy can do, but I don’t think most people in therapy get therapy at all. They get authoritarianism and/or ineffectual sympathy, neither of which helps anyone get anywhere good.
I agree – the truth is messy and requires a lot of tolerance for gray areas. Anyone who says they have it all figured out is suspect. Or as Westley said in “The Princess Bride,” “Life IS pain, Highness. Anyone who tells you otherwise is selling something!”
CBT is often used in an authoritarian manner – instead of the client deciding what thoughts or beliefs s/he wants to change, if any, the therapist decides what beliefs THEY think the client should change and tries to force the client to change them. When approached that way, it can be extremely oppressive.
Also, CBT is just one strategic approach that could be used, doesn’t work for everyone. A therapist who is committed to being a “CBT therapist” will continue to force the issue even when it isn’t working or is harming the client.
A really good therapist will have a range of options available to apply, and will adjust his/her approach to the needs of the client. But I’d estimate that 80% of therapists are not fully capable of doing this kind of work, and as such, they become dangerous.
Now someone will develop a manualized therapy program involving involuntarily hospitalizing people and forcing them to listen to Metallica until their symptoms remit. They could call it “Metal Health Treatment!”
It should also talk about stopping involuntary “treatment,” which is both very costly and highly ineffective, not to mention a gross human rights violation into the bargain.
A dialogue often involves asking interested questions, Pat. I am really interested in knowing how YOU personally decide if something is a disease or not. It’s actually a very interesting philosophical question, certainly worthy of intelligent dialogue, IMHO.
The list is very thorough, though incomplete in one regard: to put an end to “ADHD” diagnoses, we need to revise the oppressive nature of our educational system and take an approach that respects the individuality and internal motivations of our students. The industrial educational model is responsible for probably 90% of “ADHD” diagnoses. Consider alone the fact that 30% of the “ADHD” cases go away if kids go to school one year later. Clearly, schools (and now even preschools!) are expecting things from kids that are not appropriate, and alternative models already exist. Time to start doing what works instead of what’s politically expedient!
I so agree with you, Julie! There is nothing beneficial to being considered having a “disease,” especially when the psychiatric profession is involved!
“Standard Protocol” – Jeez! This is why it is really, really dangerous to have these things viewed as “medical diseases.” They start acting like they have some scientific handle on how to “treat” it and your opinions stop meaning anything at all. This is horrific – they almost killed you! I hope you are someday in a position to sue their asses!
I agree. Ultimately, real community is the answer. So how to go about rebuilding communities in a system that is designed to destroy them? How to dismantle that system in a way that allows communities to be reborn and to flourish? That’s the truly big question at hand. “Therapy” almost by definition assumes a society that fails to meet the needs of a large percentage of its members.
Finally, someone who knows how to design and honestly report on a social science study! Notice that he reports on both his original hypotheses and outcome measures, and whether nor not the measures support his original hypotheses in full or in part. And he honestly reports the results when his hypotheses are not supported or only partly supported. If only psychiatric research were supported this way, psych drugs would be rarely used.
Rate of prescription is not the same as rate of “depression.” If the definition of depression is arbitrary, the rate of prescriptions written will be, too. The question is, given the subjective and frankly arbitrary definition of “Major Depression” in the DSM, how can any rate calculation be anything but subjective and arbitrary? We already know that rates of concordance on diagnosis for any of the DSM “mental disorders” are mediocre to poor. So talking about “rates of depression” is just not meaningful.
I think it’s simple to explain. “Mental illnesses” as defined in the DSM are not scientifically true. What is called “mental illness” is very real. It’s the names they put on them, or the way psychiatrists group people together that have little to nothing in common that is the trouble.
OK, it’s not simple to explain, but it isn’t that hard, and NOT explaining it means allowing the mythology of the DSM to continue unchallenged.
I had the same thought. Industrialization forces us all to comply with many arbitrary schedules and rules, often starting as infants. This is highly stressful and screws not only with our sleep schedules but any other part of our circadian rhythms. Not to mention disruptions in nutrition, toxic chemicals in the environment, noise and light pollution, and on and on. Psychiatry is the handmaiden of industry, helping blame individuals for the costs of industrialization.
You mean that actual medical testing led to discovering actual medical conditions that could actually be treated by objective alteration of actual measurable quantities? How frighteningly scientific!
I think it is perhaps a mistake to say that “EDs” are caused by any one thing in particular. Every person is different, and the big error (if it is an error and not a tactic) made by psychiatry is to assume or pretend that all people who behave, feel or think in a particular way have something wrong with them, and in fact have the SAME thing wrong with them and need the SAME “treatment.” This sells drugs well, but does not serve their patients. I am certain that every case of “binge eating disorder” is different, having different causes, different needs, and different things to be done to help.
That said, your comment about reconnecting with the passions of one’s life is a good recommendation for almost any condition one may have, regardless of the cause. While medical intervention may be temporarily needed or helpful, living a full life and engaging with the world on one’s own terms is what life is always about. I know that not everyone has the means or the capacity to do that, but I think that should be a primary target, if not THE primary target, of any psychological therapy/help that is offered.
How can you “overestimate” the prevalence of “depression” when there is no way to identify the “actual rate of depression,” since there is not an even close to reasonably accurate way to measure what “depression” really is? It’s like estimating the “accurate rate of anger” or “accurate rate of itchiness.” There is no such thing as an accurate rate of “depression.”
What you say seems so clear and obvious to me. It’s baffling that so many “mental health professionals” don’t see it this way. If someone’s angry, you can bet they’re angry at something or someone. Why not find out who or what is involved instead of snuffing out the anger to make yourself feel more comfortable?
Thanks for sharing this – I am sure many readers will relate.
Well said. Too many folks WANT to conflate the actions of certain people claiming to be “Muslims” with the entire religion. Many of the same folks WANT to distance the actions of certain people claiming to be “Christians” from the entire religion. Therein lies the hypocrisy.
Pretty good article. The writer speculates a whole lot about purported biological causes near the beginning without research basis, but toward the end, the discussion of holistic care is quite interesting and probably very useful to many who are looking beyond the narrow-minded “modern” bio-bio-bio lens. Thanks for sharing!
A “myth” in this sense means a belief system that is not necessary ENTIRELY false, but is based on assumptions that are not factual and verifiable. It is a “story” told not for the truth of it, but for the symbolic content. In other words, for psychiatry, these “disorders” are “disorders” not because there is proof of it, but because believing that makes their job seem more meaningful or confers more power to them. A myth is a way of structuring the world through a system of beliefs which are not verifiable, but are held so strongly to be true that questioning them often feels like some sort of attack on reality.
In my personal observation, it appears you have been both exposed to and indoctrinated into these myths to a heavy degree, as many people here have been initially. It appears you have become aware that the truth varies from what you have been told, but it seems like it’s hard for you to conceive that this mythology is both intentional and known to be less than truthful. It’s very hard to emerge from this mythology, because it means accepting you’ve been deceived and that the general field of psychiatry has not had your best interests at heart.
Remember that something mythological doesn’t have to be entirely false. It can be true, for instance, that some people feel better when they take psychiatric drugs, or that biology plays a role in at least some people’s “mental illness” as identified by the DSM. The fact that there is some truth in the myth doesn’t make it any less of a myth, because the point of the myth is not truth or falsity, but control over the belief system of those who are exposed to it.
How do you know they “do have biological roots,” Pat? Would it not be more correct to say “Some of these symptoms MAY have biological roots in some cases?”
I think it needs to be worked together. In other words, eliminating psychiatry goes along with making other changes. I don’t think either psychiatry or capitalism is going down without a fight, and both are going to be undermined step by step. But just as we can’t eliminate capitalism without another means of people having a medium of exchange, people will have to have some way of dealing with challenges in operating in our weird society.
I was thinking about this last night: here is a short list of “needs” psychiatry fills: 1) gives people an explanation (however poor) for why some people act or think or feel in ways that are outside the “status quo.” This is a real need for people and it will have to be filled in some other way. For instance, trauma, nutrition, social stress are all potential explanations that can be substituted for psychiatry’s “chemical imbalance.” But people need a way of thinking about psychological/spiritual issues.
2) Psychiatry provides an excuse/justification for avoiding revising or examining current institutions. Naturally, avoiding these things is not healthy for a society, so in order to eliminate psychiatry, we need to create some ways to deal with institutional problems that require accountability and responsible change. Eliminating psychiatry won’t handle this need, because our social system will come up with new ways to justify the continuation of the status quo and the blaming of the victims of their shortcomings.
3) Psychiatry provides an “authoritative” view on what’s “wrong with people,” allowing rank and file proletarians like you and me to avoid having to think about the issue. Clearly, this is also not healthy, but authoritarianism is rampant in our culture and we need to start addressing this and encouraging people to think independently. This would involve revising schools, at the minimum, as well as many other authoritarian institutions.
I could go on. You see where I’m going with this? There are reasons why psychiatry has been able to be so successful in today’s society. It fulfills certain niches that our current system demands, and unless that system changes, removing psychiatry will simply open the door for some other charlatans to move into that role.
Thanks, Julia and Frank. I agree, moving beyond writing information and comments is needed, some form of political action. I really think we need to get the “left” activated around this as a human rights issue. I also agree with Julia that simply saying how bad it is doesn’t accomplish much. It has been seen over and over again that revolutions that don’t address the underlying social issues end up replacing one oppressor with a new one. “Meet the new boss – same as the old boss…”
It may not be a “system” per se. As I said in another comment, it may simply mean rebuilding communities along collaborative lines. It may mean creating sub-communities and support networks of folks who are interested in and capable of supporting each other, much as has happened in the domestic abuse survivor movement. My point is only that being against psychiatry will not be effective if people ask, “Well, what do we do to help people with these difficulties if we don’t lock them up and drug them?” We do need an answer to that question, or panic will ensue.
Perhaps I might reframe this to say that psychiatry meets a SOCIETAL need in our modern neoliberal corporate capitalist society. Some big changes need to happen in the system or there will continue to be people rebelling against or collapsing under the pressure of this system. That has to be part of our approach. Just screaming “lock up the psychiatrists” doesn’t get us there.
Perhaps it’s more correct to say that psychiatry proposes to meet a need that is real, but does it in a very destructive way. People are LOOKING for something, and psychiatry purports to provide it, just as drugs purport to meet a need and end up being destructive. I’m making no argument that psychiatry actually does anything helpful, but that folks are genuinely attempting to get help with real problems, and that’s what leads them to psychiatry’s doorstep. Failing to provide or create some way for those needs to be met will allow psychiatry to be “replaced” with something just as destructive or worse (if that is even possible).
This is a great example. It’s quite possible that the professionalization of therapy has prevented other more natural means of resolving conflicts and traumatic events. Perhaps at the core it’s about the loss of community and the psychiatric profession is an attempt to redirect the sense of loss and disconnection that the loss of community entails. Perhaps the answer is creating more intimate communities where people actually care about each other. But there’s definitely something needed that our society is not providing.
I am only saying that such needs will have to be addressed, in essence, that the presence of psychiatry in its current form is a consequence of the disturbed and disturbing society we inhabit, and that some means to address these needs has to be developed. It seems we agree on that point. The disagreement is whether psychiatry meets a need. I contend that it does, or no one would voluntarily get involved. Of course, drugs and alcohol, prostitution, and other heinous things meet a need as well. They do need to be addressed, but to eliminate drug abuse without addressing why people crave these drugs in the first place would not work. Same thing with psychiatry, IMHO. So yes, it needs to go, but just saying “get rid of it” I don’t think is enough. There needs to be another path, or preferably MANY other paths, for people to follow to get those needs met along with the drive to eliminate the coercive, corrupt and evil practice of “modern psychiatry.”
I’m with Oldhead. The average street psychiatrist might not be “evil” per se, but those in charge KNOW they are using marketing and KNOW the DSM is invented and KNOW the drugs do long-term damage and don’t work very well, and that they make people die young, and intentionally hide these facts so they can make more money. That’s pretty evil in my book!
Why would people seek out psychiatric “treatment” if they didn’t have a need to meet? Most psychiatric “patients” are voluntary, and most psych drugs are handed out by regular doctors, not psychiatrists. There is a need there, and it’s being manipulated, but if we banned all psychiatric drugs tomorrow and the DSM the day after, there would still be people saying, “I hate myself, I don’t have any friends, I have no idea what to do, why don’t I just kill myself because my life is meaningless.” Our society is abusive in many ways, and people need some pathway to figure out what to do about it. I don’t know what that pathway is, and I know it’s not taking drugs to numb out your feelings, nor is it categorizing different kinds of difficulties into “diagnoses” and blaming the victims. But there IS a need there and it will still exist even if there is no psychiatry.
The idea that “depression” is somehow a unique and different state than feeling sad/hopeless/despondent is a myth. There is no evidence that one can make such a distinction based on how bad someone feels or how long it lasts, as the DSM pretends we can. I suffered for a long time from chronic anxiety and depression, including suicidal thoughts and feelings. A psychiatrist would have certainly diagnosed me with a depressive disorder. I don’t feel that way any more. I like myself, I like my life, and I am very comfortable interacting with people I don’t know at all. How did that happen if my brain was not functioning properly and it was genetic and out of my control?
There are almost certainly people who are feeling depressed for biological reasons alone. If that’s the case, those reasons should be found and addressed. But to suggest that somehow we can distinguish these cases of “biological depression” from a list of “symptoms” that are created by committees is ludicrous. I would submit that MOST depressed people got that way because of how they were treated by other people. Pretending there is a biological explanation prevents us from actually looking at the psychological/spiritual causes that underlie most “depression,” hence the desire of many of us here to use a different term that reminds us that there is no special “depression” that can be “diagnosed,” but rather than sadness and despair, even the most extreme forms, are part of the human condition and require a human response.
I believe eliminating involuntary “treatment” is the first step toward a more rational approach. The second is to eliminate the DSM, or to return it to it’s original role as an insurance billing document. The drugs will eventually sink under their own weight if the DSM/psychiatric mythology supporting their use is eliminated.
The challenge inherent in Bob’s post here, though he does spin it in a very negative (dare I say nihilistic) way, is that in order to eliminate the entire “mental health” system, we’d have to create a world where folks could get their physical, mental, emotional and spiritual needs met in a more consistent and safe and rewarding fashion.
It’s worth pointing out that mental/emotional struggles appear to be a part of human life, and that every culture in history has had both formal and informal ways of dealing with these challenges. So while abolition of coercive “treatment” and the DSM are very realistic goals, it does appear that something needs to be in place to assist people who are having difficulty figuring out how to respond to the stresses of ANY society, especially our bizarre Western post-industrial culture. I’m all for eliminating psychiatry, but there is a need to be met, and something needs to be in place to meet that need or our efforts will ultimately be fruitless.
Or white males in general, or even white people in general. “Intersectionality” is very real, but somehow oppression of the “mentally ill” appears not to have made the scene yet. The real enemy is authoritarianism, and that is found all over the place, including in “liberal” enclaves.
I always find these articles both amusing and disturbing. How can you “overestimate” the number of people who have a “condition” that is entirely based on social assumptions and subjective lists of “symptoms” that have been agreed on by consensus but have no objective, measurable quality whatsoever? You can rate how many hours people sleep, what percentage try to kill themselves, what they eat for breakfast, whether they meditate or not, but you can’t accurately measure “depression,” any more than you can measure “courage” or “hostility” or “tiredness.” It’s idiotic!
I have found mindfulness-based meditation very helpful. Also talking about traumatic experiences to someone who cared. I had a great therapist for a while back in the 80s who actually LISTENED to me and asked good questions and helped me sort out what had happened to me and what it meant. I have read a LOT of self-help books and tried to apply them.
I have also done work to help other people, including advocacy work to try and change the system. It required me to face my own fears, because I was working for someone else rather than just myself, and I was willing to do for them what I was afraid to do for me.
Those are just some things that worked for me. The biggest problem with psychiatry isn’t the drugs, it’s lumping everyone who feels similarly into the same group and expecting the same thing will work for all of them. Everyone is different, and different things work for different people.
The USA has objectively become less socialist since the Carter administration or before. Even the ACA, which everyone accuses of being socialistic, is a market-based attempt to address unaffordable healthcare while assuring no interruption in insurance industry profitability. I suppose you could call it socialism for the insurance companies, but it’s nothing like what exists in Europe, Japan or other truly socialist countries.
You seem to have a knee-jerk opposition to socialism. I don’t see it as a cure-all by any means, but neither is the “free market”, at least when you get larger than a small community. Almost every Western government today mixes capitalistic and socialistic policies, for very good reason: unfettered capitalism leads to sweatshops and crime and rampant poverty, and unfettered socialism leads to the Soviet Union or something of the sort. People need incentives to work, but corporations can’t be trusted to work in the interests of anyone but themselves, as the recent developments in psychiatry should assure anyone.
Given that this is what has developed almost anywhere you can think of as a first world country, it appears to be what works. Why the emotional rejection of “socialism” when it’s part and parcel of every country’s success, including ours?
Right, Steve. The DSM is the biggest hoax, and it allows us to dehumanize those who are suffering. It also allows our social institutions like families, doctors, schools, etc. to get off the hook for having done harmful things. I’m never against helping people figure out their path in life, but I’m VERY much against categorizing and dismissing people with arbitrary labels and using drugs to suppress their reactions to living in our crazy society!
I am glad you are recognizing that you are getting triggered, Pat. I’d be interested in knowing what kinds of things you find triggering. I think it’s important to be aware of our triggers and take responsibility for having them, even if they are often the result of other people doing stuff to us that was harmful. That way, it’s more possible to have a rational discussion instead of going off on attack/defense mode. It sounds like you had some traumatic experiences both in the “mental health” system AND in the recovery movement, which is not uncommon for folks. I’m glad you’ve found your own path.
I am being sardonic, Pat. Dark humor. Of course, no one would actually SAY those words to anyone. I suggest you consider the intent of the poster before responding.
The problem is the system will continue to abuse people as it has always done regardless of “ACE screening.” Any well-informed and sensitive person will ask questions that lead to information about “ACEs” in the course of a normal conversation intended to help. In fact, even calling them “ACEs” diminishes the power both of the experiences themselves and the survivors’ ability to create their own narrative of the meaning of such experiences.
A more honest approach would be that “crappy things that happen to you often lead to you feeling crappy and getting sick.” And to allow the person to share such experiences if they like, without giving them a “score” and labeling them as a victim of “ACEs” as if these were some disembodied entities that need to be “assessed.” Same with depression or any other “screening tool.” Sure, doctors and others should be aware of these issues and be willing to talk about them as needed, but “scoring” people on their past difficulties will only serve to dehumanize them even further.
In my observation, the best answers come from others who have panic attacks. They DO happen, but they don’t get better (as you have no doubt observed) by being labeled and blamed and having things done TO us! I don’t suffer from long-term repeated attacks, but I have had a few, and have also helped a lot of other people get through them and eventually reduce their frequency, mostly by listening to them and understanding what was going on behind the attacks. There is also an immediate intervention path involving things like meditation, food health, breathing, exercise, supplementation, etc. that many find helpful but that you will almost NEVER find any doctor (and especially any psychiatrist) telling you about. And of course, there is also the need to look at the big-scale SOCIAL issues that create so much of the anxiety that many if not most members of Western society feel – the need for employment, lack of healthcare, corruption in government, institutionalized violence, racism, sexism, and so on.
One thing I HAVE found helpful in reducing years of chronic anxiety is to start recognizing that beneath my anxiety is ANGER and RAGE at how I have been treated. As I have learned to stop and SPEAK UP when I feel wronged or dismissed, I have had less and less experience of generalized anxiety about my life. Of course, I feel anxiety big time in the moment I take on my antagonist, but I feel SO much better when I just handle it in the moment it occurs – I feel self-respect and a sense of power, things I never felt much as a kid when I learned anxiety as a way of dealing with a world where I was small and my voice counted for little to nothing. That’s just my path, I’m sure there are many other paths, but the answer for me lay in identifying and feeling OK about my own RAGE regarding how I’d been treated as a kid, and feeling more and more OK about expressing my CURRENT rage (usually very respectfully, but not always) when I was feeling mistreated in the here and now.
SO good to read another blog from you – I was thinking recently it had been a while, and I always find your blogs energizing and affirming!
You really struck a chord with me this time. I was one of those “insider” dissidents in the “mental health” system for a decade or so, and I ran into the very same kind of dismissive attitudes once my views were known. In particular, I relied a lot on knowing the latest research on a topic as a means of balancing the power for clients, but I encountered exactly the same resentment from folks, as if I’d somehow “outfoxed” them by presenting actual DATA that they were unfamiliar or uncomfortable with. It was, indeed, VERY tiring, and I got out of the field and into advocacy as a result. Advocacy pays like crap but at least I could go home feeling OK at the end of the day. Still, most advocacy is for individuals, and system advocacy is much harder and much slower.
Bottom line, we’re working against CORRUPTION, and corruption is not changed by data or even by good working relationships. It’s changed by deleting the financial incentives toward corrupt behavior, and it’s rampant in our society today. I truly believe that’s where we have got to put more of our energy, yet the thought of taking on THAT juggernaut is even more exhausting!
Thanks for putting so much of my experience into words. Sometimes helping individuals who are brutalized by the system doesn’t feel like much, but it DOES make a huge difference for those individuals, and in the end, the country IS made up of individuals and maybe we need to help wake up a lot more before the big-scale changes we need to see become possible.
It’s not just a matter of identity or ideology – it’s also a matter of power and financial remuneration. Social determinants require large-scale social ACTION, and this threatens the bottom line of big corporations (and the politicians who depend on their donations) as well as threatening the hold of dominant groups on power over those they deem below them in social value.
Taking Risperdone PRN is about as idiotic as I can imagine. It takes weeks to get to full effect. It sounds like a formula for keeping him in a constant withdrawal state.
If you read about and look at most people’s experiences with psychiatrists these days, you will see that many if not most propose that the MAIN cause of “mental illness” is biological. They need to do this in order to justify using drugs as their first line treatment.
Clearly, there are situations where a person is very easily injured from almost no impact. However, the psychiatric field is taking NORMAL reactions to traumatic situations and blaming the brain of the patient for their “wrong” reaction. I had this conversation with a very mainstream psychiatrist, smart guy, generally rational. He argued that people who react with flashbacks to a traumatic event are “disordered,” simply because not everyone reacts that way, so there “must be something wrong with their brains.”
As for people claiming no genetic impact, I think you have to be careful not to confuse the idea that genes may influence people’s reaction to trauma and stress, which most people would agree with, with the concept that any of the DSM “disorders” are caused by genetic defects, which is nonsense. The real problem is in the diagnoses, which are made up by committees based on things that are uncomfortable or difficult for society, rather than being based on any common biological problem causing these “diagnostic” categories. If you think about it, why would they? Why would all “depressed” people have the same thing wrong with them? Why would they all need the same kind of help? They have nothing in common except for feeling a certain way. Diagnoses should flow from biological findings, not the other way around.
Some people make radical changes in their lives after near-death experiences, like almost being killed by a car hitting them. Should we use pushing people in front of a car as a means of “treating” “mental illnesses?”
No one would deny that genes are INVOLVED in how people react to stress and trauma. What I object to is two ideas: one, that genes are the ONLY thing (or even the MAIN thing) that causes what is called “mental illness.” The other is the idea that what the psychiatric profession calls “mental illness” is anything but a collection of biases and social constructions that are most likely caused by a bunch of different things, and sometimes aren’t even “disorders” at all.
For the first idea, I would ask you this: not everyone who gets hit by a car breaks bones. I would guess there is some variation in genetic bone strength that makes some able to withstand a greater impact. Does it make sense to diagnose people whose bones break from impact with “weak bone syndrome?” Should we research the genetics of bone weakness so we can provide extra protection to the weak boned?
Or should we try to reduce the number of cars hitting people?
As for the diagnoses themselves, let’s take a look at “ADHD,” the one I’m most familiar with the research on. Possible causes of “ADHD” symptoms include anxiety, trauma, low iron, low or high thyroid activity, nutritional deficiencies, sensory issues, sleep apnea, poor parenting, inappropriate classroom structure, kids being admitted to school too young (a one-year wait reduces “ADHD” diagnoses by 30%), boredom, foster care placement, and many other reasons. Of course, every one of those casual factors would require a different approach. So what’s the meaning of a “diagnosis” that doesn’t tell you the cause and doesn’t tell you what you should do about it?
The final point I’ll raise is that even if we discover some genetic cause of any of these “disorders” (and 50+years of research have failed to find ONE “mental illness” that has a consistent, identifiable genetic cause), genes are the one thing in the scenario that CAN’T be altered. Why would we spend all of our money and time researching about the one thing that we can’t do anything about? If we know that both genes and environmental impacts combine to create “mental illnesses,” why wouldn’t we want to focus our energy on the environmental issues that can actually be modified?
A horrific story! Thanks for having the courage to share it. It continues to astound me that a person under their care can deteriorate SO horribly over SUCH a long time, and yet at no time do they ever question that their “treatment” is necessary and effective, and that any “failure” that occurs is the fault of “the disease,” never their treatment at fault.
As I like to say, “Another psychiatric success story!” So glad you’ve figured out how to escape.
I would not refer to these as “somatic therapies.” They don’t really address the body so much as perceptions from the body. “Somatic therapies” would be things like drugs, shock therapy, magnetic stimulation, electric brain inserts, etc., and these have been almost all complete failures in bringing about long-term improvements in survival and quality of life.
This is all politics. The Trump Administration decided that “Evidence based” is a dirty word, so they’re not allowed to do it any more. I’ve always had mixed feelings about “evidence based practices.” It’s often used as a way to promote the status quo over anything else, as status quo “treatments” are the ones that get research funded, and hence are the only ones that have any “evidence base” to draw on.
“Unlikely” isn’t the same as “impossible.” If you said “most” or “the vast majority” instead of insisting on “every” I might be able to agree with you. As I like to say, “Generalizations are ALWAYS wrong!”
Wow, that sounds like just like what you need! It’s really incredible, isn’t it, how they just talk about what they’re going to DO to you right in front of you, as if you don’t even exist? Stunning that they’d even admit Zoloft is screwing you up, but of course, the solution is another drug or another. Glad you’re getting away from them!
It is hard to find a holistic doctor. Most would not call themselves “psychiatrists.” PTSD is one label that can be addressed by talking therapies along with good diet, exercise, meditation, and many other approaches that don’t involve drugs. The Zoloft and Klonapin are both potentially going to make things worse in the long run. The lack of sleep may very well be related to Zoloft.
I wish I had a great idea, but it comes down to searching and searching and interviewing people and seeing who is available and sane in your area who might be able to help. Perhaps finding peer support groups that are not psychiatrically oriented and talking to the other members can be helpful?
Wish I had more to offer. You can see how how completely incompetent and delusional these psychiatrists and their allies really are. They have NO idea what they’re doing and you’re just a “brain experiment” to them. Get as far away from them as you can! Best of luck to you!
A good friend of mine was prescribed Zoloft for migraines. She had never been suicidal in her life, but suddenly had these odd thoughts when struggling with a problem: “I could kill myself.” She was stunned and disturbed! It took her over a year to get off of it due to withdrawal reactions, had to cut the pills down into tiny fragments to wean off. So yes, this does happen, and it’s a horrible idea!
Does credentialing actually provide any assurance that the practitioner is competent or ethical? Studies seem to indicate that para-professionals or untrained peer counselors do at least as well as professionals with advanced degrees. What does licensure provide, other than job protection for those so licensed?
I can easily explain that. The globe is warming, of that there is no denial. Average annual temperatures continue to climb. However, many who don’t understand climate issues complain that “Hey, it’s been super cold this winter, so that proves there is no ‘global warming.'” I think that in order to address this misunderstanding, the term “climate change” began to be used, because a warming earth doesn’t mean it’s warmer everywhere all the time, but it does mean that the expected climate for different regions becomes less predictable, including significantly more or less rainfall than average, extremes in temperature, more extreme storms, longer dry spells leading to a longer fire season (as happened in the US West this year), and rising sea levels.
The degree to which this is caused by human activity is debatable. The question of whether or not it’s actually happening is not debatable. This, I think, distinguishes global warming from psychiatry in a pretty dramatic way. Psychiatry simply makes up categories and counts them based on arbitrary checklists that don’t measure anything at all. Global warming is measurable by averaging the temperature around the globe, and can be verified to occur. Climate changes relating to warming temperatures are also predicted by mathematical models, though as we all know, climate prediction is a much more imprecise activity than measuring the average temperature. Temperatures rise, glaciers melt, sea levels rise – all completely predictable and measurable. Psychiatry has nothing remotely similar to measure or report on.
This is an excellent point. The entire economic system we operate in is organized around oppressive principles and assumptions, and unless that’s fair game for discussion, we end up colluding with that system, no matter how helpful our individual interventions might be.
I like this. I have also approached it from the other direction – “What were you hoping to accomplish when you did this – what was your goal?” Or “What need were you trying to meet with this behavior?” Not always an easy question to answer, but I found it digs down very quickly to the key issues that are hanging the person up. Whether or not it worked, or continues to work, I come from the point of view that all behavior is intended to meet a need, to accomplish something, and once we find the goal, we can talk about other options that might meet the same need at a lower cost.
Oh, and I CERTAINLY didn’t discourage any impulse to strike back at the perpetrators of harm – to the contrary, I always felt that anger and intent to act against oppression was a sign of progress, as the person was moving AWAY from being a victim and toward taking ACTION, which seemed in most cases to be the best antidote to feeling bad about him/herself.
You keep saying that, but it’s not necessarily the case. I provided therapy from the point of view that the person came in needing/wanting some change in his/her life, and that my job was to catalyze whatever change that was, as they conceived of it. Part of the job was to help them figure out what it was, but that’s not the same as me having an agenda. I agree that most therapists these days lack the skill to do that, but that doesn’t mean EVERY therapist has an agenda for the client. I had a therapist who was very helpful to me in accomplishing MY goals, and actually refused to tell me what she thought about anything I said or did, instead insisting that what I thought of it was what mattered. I can’t see that she had an agenda, other than to help me make sense of my world and decide what I wanted to do differently.
Right, I’m agreeing with you. Any real scientist, would, of course, be 100% opposed to “scientism,” as it undermines the most basic tenets of science, namely, that we need to be humble and skeptical about our own assumptions and that any theory or assumption can be disproven by data. To use “scientism” as an ad hominem attack on real science is only possible when used on the ignorant. Unfortunately, as stated above, the ranks of the scientifically ignorant are legion.
Pseudoscience is pretending to be scientific when you’re not. I think “Scientism” is more of a religious belief system where there are “smart” people who “know science” and we can be “smart” too if we just agree with them and do what they say, and we don’t have to think about it too hard. The second is a much more encompassing concept, but also more complex, as it involves the development of religious/philosophical dedication to a set of dogma, whereas pseudoscience is just straight up deception. I think Scientism certainly applies to psychiatry, but Richard’s point is well taken – it is too complex for people to understand fully and is too easily used by demagogues to promote an anti-intellectual agenda.
The truth is, very few Americans actually understand science and most are unable to differentiate it from pseudoscience. Most are ultimately either proponents of “scientism” or are knee-jerk opponents of “those left-wing intellectual communists” without any real comprehension of what science is about and what it can do when unadulterated by corruption and politics.
I think you’re right, we don’t know very much. It’ OK for scientists not to know very much as long as they ADMIT they don’t know very much.
The problem Dr. Timimi is outlining here is that psychiatry as a profession PRETENDS to know things that it doesn’t know, and uses its authority to convince people that it knows what it’s talking about when really their ‘science’ is mostly just made up.
Exceptional article! Not that I expect less, as Dr. Timimi has been a leader in fighting psychiatric “scientism” from the inside for decades. Thanks for putting it into words so succinctly and effectively!
Kind of ironic, isn’t it? Hope that perhaps it makes some of them stop and think what it’s like for their clients to go through the same process of labeling and invalidation.
It’s just that you’re mostly a one-trick pony, Pat. People don’t want to debate you because there’s no point, since you’re not open to new data, so once we’ve heard your presentation, there isn’t much else to be said. It might be different if you actually were willing to incorporate others’ views and data into your worldview. But I won’t hold my breath on that.
No one slams anyone for choosing to use medication, Pat. You’re projecting your own fears out there. You should know by now that the critique is of lying and intentionally misleading people with false data. You and anyone else is welcome to use whatever medications/drugs they choose to use. You’re even welcome to find your psychiatrist useful, helpful, or wise. We’re not talking about individuals. We’re talking about a system that’s intended to create customers instead of promoting health and truth.
I have to say, as a therapist myself, I see what looks like victim-blaming in your post. If I am receiving funds to provide help to a person, it’s my job to figure out a way to help. If I take my car to the mechanic, and he can’t figure out what’s going on or how to help, he doesn’t get paid. There were certainly people I was not able to reach, but I considered it my own failure, not theirs.
I also find that labels, and Borderline in particular, provide a handy excuse to infantilize the client and to avoid facing up to the real issues behind the label. I have no objection to teaching skills to someone who wants to learn them, but so much of the DBT approach seems to focus on how WRONG the client is for “lacking emotional control,” and many therapists take a very condescending attitude toward their clients, referring to them as “she’s a borderline” or saying “she’s manipulating” or making many statements indicating severe judgment against the client. This is, in my experience, the OPPOSITE of what is needed.
I’ve been very successful with so-called “borderline” clients, mostly because I approach them with a very genuine, direct, and caring relationship that builds trust with them. Trust is the big issue for most of the people who get this label, because most have been abused and/or neglected. Treating them like children or disabled people tends to lead to resentment and disrespect, while acknowledging what pain they area suffering and normalizing their coping measures as necessary to confront the situations they had to deal with works far better, IMHO.
Anyway, it sounds to me like you are operating very much within the confines of the psychiatric paradigm. Maybe that works for you, but I never found it worked for my clients, and most of the time, once I opened the door for genuine discussion of their experience, most of them described extremely frustrating experiences, even with caring therapists, mostly because they got the impression that they should “get over it” or that their emotional damage was their own fault, or they got the message that they were permanently damaged and should lower their expectations for life. It might be really helpful to increase your perspective by taking to some clients who have hated DBT or other forms of therapy, and genuinely inquire as to what they hated about them. It might be an eye opener for you.
I knew that, but thanks for the clarification. I think she’s using a different definition of “patriarchal” than me, more focused on gender and less on privilege and oppression.
I’d continue to assert that women being in charge of a social service organization does not make it not patriarchal, if the women are required by the structure and their superiors to adhere to the rules made up by men or else be castigated or shunned by their peers. Many women are business leaders, for instance, but sexual harassment is still rampant in the business realm, and is chronically ignored or suppressed, including by women in charge. And guess what, it’s almost always men harassing women. Obstetrics is another great example – more women OBs than men by now, but they still do all they can to disempower the woman and do things to her and in any possible way prevent the natural birth process from going forward. Caesarian rate is over 30% nationally, and much higher elsewhere, but there is no outcry about cutting open so many women without need. Because, after all, they are women, so their rights are secondary.
It is more complicated now that absolute apartheid can’t exist, but I don’t think matriarchy can be claimed in social work in all but the most formal definition. We’re still living with male privilege. The fact that many women can work their way around to grasp some privileges at lower levels, and that a few can even make it up to higher levels, doesn’t change the fact that men are granted power advantages simply by being male, nor that the rules are created to favor men.
To give a more simple and amusing example: My wife and I split the housework 50-50. If someone hears this about me, what do they say? “Wow, what a great guy, he splits the housework 50-50!” What do they say about her? “Wow, she’s so lucky, he does half the housework!”
Same amount of work, I’m great, she’s lucky. All I have to do to be a “great guy” is not be violent or disrespectful and clean up after myself. Men have much lower standards than women to adhere to. That’s privilege!
Well said. The point of the article is that individualizing reactions to trauma and oppression obviates the need to examine the cultural/structural reasons why they occur. Black people probably “need help” dealing with the effects of racism, but providing a diagnosis and “therapy” seems like a pretty thin cover for letting racism continue to drive social and political behavior.
Thanks for the clarification. I hope you’ll consider whether a different term might be better, because the term “mental health” has been so critically co-opted by the industry that saying “a right to mental health” sounds immediately to me and others like “a right to mental health TREATMENT.”
How about a right to “an environment that supports healthy physical, mental and emotional development?”
Again, I appreciate the article and your work. Thanks for sharing it with us!
Are you seriously suggesting that patriarchy doesn’t exist in the USA? Have you looked at the composition of Congress, at pictures of most of the CEOs in the USA, at how rape victims are treated in the USA? Not to mention, patriarchy goes WAY beyond “women are oppressed by men.” It seems your view of what constitutes patriarchy is very, very narrow. It really comes down to relative privileges in society, and to suggest that white males don’t have an overall advantage economically and politically is quite naive, in my view. Men and boys being abused by the system is not evidence of the absence of patriarchy, but its continued domination of our system.
It’s also naive to suggest that being democratic, female, or liberal in any way absolves someone from abusing one’s patriarchal privileges. Weinstein, Bill Clinton, Al Franken, all liberals, all Democrats, all still felt superior enough to or had enough power over women that they could take advantage of them with impunity.
In order to progress as a society, we’re going to have to transcend this liberal/conservative axis anyway. Those designations don’t mean what they once meant, and we need to reorient. The new axis, I think, is authoritarian vs. non-authoritarian, and their are authoritarians on both the left and the right. The question is whether you believe some other person smarter or more powerful than you has the right to boss you around or not. This goes to the very heart of what is wrong with psychiatry, and even to the internal struggles within the field. Those who are non-authoritarians rebel in ways they can, but the authoritarians are in control and punish any deviation from the party line, whether rational or not. That’s what we have to overcome, and it will require both the traditional left, favoring protecting the rights of the poor and downtrodden and regulation of big business/big money, and the traditional left, favoring maximum freedom from unwarranted intrusion and direction from the government or other groups pretending to “help” for those who aren’t looking for it.
We are spending billions and billions on fighting terrorism, which has killed something like 4-5000 US citizens since the late 90s (20 years, mostly on 9-11), and yet NO effort is expended to stop over 200,000 deaths EVERY YEAR from poor quality “medical care.”
You summarize the problem succinctly. The neolib solution to “mental illness” is to try to make the downtrodden “feel better” about their subordinate role in society through chemical means. The neocon solution is to “leave it to the free market,” aka social Darwinism. Both sides protect the business class and the wealthy. Neither gives a crap about the victims of our current social institutions.
But the SSRIs became much more common in the early 1990s. Prozac was licensed in the USA in 1986, as I recall. Listening to Prozac came out in 1993, which had a huge effect in normalizing “AD” use.
It is amazing how they manage to retain the fiction of “bipolar disorder” while clearly indicating that people so diagnosed don’t have all that much in common with each other, and probably have different causal factors involved.
Additionally, I noticed how they talked about genes conferring “vulnerability to bipolar disorder,” but make no mention of what percentage of variability is attributable to these ostensible genetic causes. Given the history of such reports, a 10% concordance would be amazing, and I’d guess more like 2-5% tops. It’s probably nothing to boast about or they’d tell us the numbers. Sleazy.
Very well put, Richard. And Lawrence, too – I do get your point, but I still think it very important to note that a huge part of the purpose of psych drugging is to cover up and/or minimize the impact of oppressive adult individuals and institutions.
I laughed when I read the title, because “bipolar” behavior is pretty synonymous with teenage behavior.
I like the arguments and the conclusions you draw, as far as they went. I especially like the idea of “active addressing of kids’ issues via meaningful social interaction” as a means of handling behavioral issues.
I would love to see you work in a couple more concepts, though. For one thing, the school system itself is the cause of most “ADHD” and thereby at least indirectly a lot of “bipolar” behavior in kids. We expect young people to do things that don’t make sense to them and to comply with adult authorities unquestioningly, and this exacerbates the natural rebelliousness of youth. Additionally, schools are increasingly focused on forcing academic learning on kids who don’t need it and/or can’t handle it, and vocational options are often not available, so non-academic kids have no means to feel any sense of accomplishment. These structural issues contribute greatly to ALL kids’ struggles in school, and providing alternative avenues to success would to a great deal to improve “discipline,” as it’s hard to be truly disciplined without a purpose to pursue.
Additionally, parental abuse/neglect/lack of skill is a huge contributor to the group designated “bipolar” in adolescence, and the drugs provide cover for parents and other “professionals” who are mistreating kids or neglecting their needs.
Finally, I have to take exception to the comment: “Even if hospitalized for violence, the experience may be so supportive, friendly, and cushy that teenagers find it more rewarding than punishing.” There may be a facility here or there that is “cushy,” but most psych hospitalizations are humiliating and disempowering in every possible way. The only times I saw kids wanting to go to the hospital was to avoid other institutional mistreatment (by schools, foster homes, group homes, etc.) that seemed even worse.
None of this is to invalidate your arguments regarding the disturbing underlying message of diagnosing kids just because they are struggling. Struggling is part of human experience, and should be a call for learning and development, not pity and infantilization. But I did not want our other institutions, including the institution of the family, to be let off the hook in our zeal to identify the myriad shortcomings of the psychiatric model.
Hey, on this one, I’ve got to disagree with you, though I generally support almost anything you post. We are operating in a Western industrialized society, and in such societies, voice-hearers and the like are feared and treated like lepers. If there is an approach based on COMMUNICATION that allows 80% of such people to sort out what’s going on and figure out how to make their way in this insane world, I have to support it. It’s true that the concept of “mental illness” is a crock, but sometimes people still need help finding their way, and Western industrialized society isn’t making any big changes any time soon. If we can get people free of a life sentence of incarceration and forced drugging, I don’t think we have to be such ideological purists as to oppose the workable concept on principle.
I don’t think we all have a “right to mental health.” What does that mean?
I’d suggest we have a right to live free of abuse and oppression, and to have those responsible for such oppression held fully accountable for their actions. If those rights are enforced, “mental health” will improve for all of us with no “treatment” whatsoever.
Good for you! Your efforts are greatly appreciated! And yes, that nebulous concept of “reputation” for some reason seems to mean more to folks than actual DATA. Go figure!
Sorry, are you suggesting that my comments are somehow labeling and judging with my comments? If so, I’d like to know where and how, as this is not my intent. I raised two kids who would have been labeled with “ADHD” if I let anyone near enough to “diagnose” them, and I have great compassion for how challenging it is to raise such kids. In my view, it is the system who is judging and labeling these kids instead of respecting that their behavior is indicative of efforts to meet a need. I’m all for nutritional solutions being offered, and 50% is a very good percentage and should be respected. Unfortunately, micronutrients don’t make big bucks for Big Pharma and the APA, so they will remain a marginalized intervention until the DSM is challenged, IMHO. That’s my only point here. I get that you have to work within the system to get the research published, but sometimes working within the system can inadvertently provide tacit approval for its destructive aspects. I found this to be true myself – I was a very effective alternatively focused therapist within the system, but I ended up feeling quite powerless to change the system, like a toy tugboat trying to tow the QE II. That’s why I got into advocacy instead. It was too hard to live with myself.
Thanks for hanging in on a difficult conversation!
I agree 100%. It’s not a black and white issue. Many people report great benefits from therapy, while many others report great harm. My guess is that most are in the middle, not particularly harmed or helped. But there are some very skilled people whose time and perspective are tremendously valuable, whether paid or unpaid. Such people are worth their weight and should not be dismissed as cranks even if they accept payment for their services.
I suppose you are right – slavery is a matter of degree. The parallels are legitimate, even if slavery as an institution was clearly more horrific than anything the psych profession has yet come up with.
Correction: the third leading cause of death is not medical ERRORS, it is RECEIVING MEDICAL CARE IN ANY FORM! Most of the annual death rate is due to PROPERLY PRESCRIBED AND PROPERLY ADMINISTERED MEDICATION. Tens of thousands are killed by psychiatric drugs alone. And these are just the ones they ADMIT are due to medical treatment.
Such a law is crazy, as it lets the medical system off the hook for the damage they are causing every single day.
I’m reading, and I totally agree that despite parallels between psychiatric incarceration and slavery, they are not really comparable. The point that the racism that has descended from the institution of slavery continues to be a pernicious force every day in the USA and other places is also very well taken. Privilege is a relative thing, and the fact that psychiatry is oppressive as hell doesn’t make it comparable to having one’s body and life bought and sold as if one were a head of cattle.
That’s the point I’m making above: “ADHD” is a hodgepodge collection of behaviors that can have a mass of possible causes, from sleep apnea to iron deficiency to poor discipline to poor classroom management to childhood traumatization. To imagine that any one “treatment” could be effective against all of these myriad causes is foolish, unless your goal is to sell more stimulants.
That makes sense to me. I appreciate the clarification.
I guess my point is mainly that I consider it important for you to establish that even if a small percentage of so-called “ADHD” sufferers improve with nutrition, those kids should NOT be labeled with “ADHD” at all, as “ADHD” assumes an unidentified neurological problem that could not possibly be remedied by nutrition. Of course, there are many other contributing factors, including high lead or heavy metal exposure, low iron, sleep apnea, and so on. Naturally, sleep apnea will not respond as well to nutritional interventions (unless they somehow help address sleep apnea).
I guess what I’m saying is that you have a golden opportunity to undermine the idea that “ADHD” is a unified “disorder” and that every remedy must address ALL “ADHD” cases or it is not considered effective. Not sure exactly how you do it, but it seems very, very important to taking down the current hierarchy of “diagnoses” that psychiatry’s success in subverting all other forms of help has relied on.
I am very pleased to see this kind of research getting published. However, I do believe you would do better to challenge the ADHD label, for very practical reasons.
You note correctly that not all kids respond to nutrient interventions, but those who do often respond strongly. This is most likely because only SOME of those labeled as “ADHD” have nutrient deficiencies. Grouping all “ADHD” kids together therefore dilutes your results and makes it appear that what could be large effect sizes in the right target population are much smaller.
It would seem to me the best way to challenge this arbitrary grouping is to start with a group of “ADHD” labeled kids and to do nutritional testing or dietary analysis on the group. Once it’s established which kids may likely have deficiencies, split THAT group into nutrient vs. placebo. I would bet your effect sizes would be quite substantial.
The DSM labels are not just arbitrary – they were actually created to remove any analysis of causality and to make groups that can be spun as responding to drug “treatments.” Unless we break these labels down and look at subgroups who actually have something in common with each other, drugs will almost always get the “best results” because they are targeted to decrease the “symptoms” that are used to identify the “disorders.” If 20% of “ADHD” sufferers improve substantially from taking B-complex vitamins, that’s a FANTASTIC outcome – 20% of kids are now FINE just from a nutritional intervention! But if you compare all “ADHD” kids on this measure, you’ll get only 20% effectiveness, and the drug companies can claim 70%. See what I mean?
I believe it is of the utmost importance to your research being taken as seriously as it should be that you identify subgroups of those diagnosed as “ADHD” and instead of saying you’re treating “ADHD,” say that you’re treating NUTRITIONAL DEFICIENCIES that are identifiable within the group, and that those so identified DO NOT HAVE “ADHD” OR ANY OTHER DISORDER, as proven by their dramatic improvement with nutritional interventions alone.
Hope that makes sense. Thanks for your great work!
European-style socialism has existed for many decades without leading to totalitarian rule. I think you’re letting your imagination run a bit too freely here. The most successful modern societies combine ideas of socialism and capitalism. It’s the modern neoliberal/neoconservative movement of the last 40 years that has really led us to the crappy situation we’re in today, and blaming it on the left is very myopic.
Well, there is the “change through total collapse” approach. With Trump in the White House, perhaps a complete unraveling of neoliberal society is not far ahead.
A thoughtful reply. I agree that incremental inside change is happening and is very important. I’m just very doubtful that this by itself can really bring about the necessary change. The financial and psychological/social benefits of the current system are way too large for this model to die easily. After all, the models let EVERYONE off the hook, even the clients, who never have to do any of the hard work to change their lives. But of course, the main benefit is it allows the current neoliberal system to continue unreflective about its destructive aspects. It’s a tough nut to crack!
Again, I totally believe that inside evolution is relevant and should occur. I just don’t see MDMA being successful as catalyzing some sudden and dramatic realization that the DSM should be scrapped and that clinicians should start viewing client trauma as central to their work. System change is slow, and as the quote goes, “It’s hard for someone to understand something when their livelihood depends on them not understanding it.”
Agreed. Not only do psych diagnoses end up leading to drugging healthy people for no reason, they also obscure actual physiological problems that CAN cause “symptoms” that are labeled as “mental illnesses.” Low thyroid, iron deficiencies, drug side effects, sleep problems, chronic pain, nutritional deficiencies and many other things can result in emotional/mental “symptoms” that could actually be resolved by a real analysis of the body.
I think it’s a bigger problem, and that the corruption at the top has to be attacked. My more conservative friends will hate me for saying this, but I don’t think it happens without specific government action to forbid a) DTC marketing, b) any kind of kickbacks, gifts, honoraria, etc. for any doctor hawking a drug for a drug company c) colleges and universities using public research dollars to parlay professors into big business opportunities d) the revolving door at the FDA (and other regulatory agencies) where industry insiders “regulate” their old bosses, and so on. This set of events will only happen when a larger movement of citizens demands that government corruption by lobbyists and big business campaign contributions come to an end. It will take a lot of people getting together and demanding change. People in power generally don’t give it up voluntarily, Nelson Mandela notwithstanding. Unless corruption is addressed, Big Pharma will continue to run the show and the APA will continue to Emcee their performances. That’s how I see it. Dissident action inside the system is important, but it’s too easy for them to be silenced or minimized by those in control. I know this from personal experience. It’s gonna take a revolt, starting with the clients themselves and their family members, friends and supporters (and whatever dissident professionals have managed to survive in the system) saying NO, we are not going to play this game. What it takes to create that is beyond my personal imagination and planning skills. Any ideas from your end?
First off, I am SO sorry for your son’s untimely and very preventable death. It is hard to imagine a more painful kind of loss, and my heart goes out to you.
Second, I REALLY hope you can and do take legal action against the psychiatrist. While they are protected by the “standard of care” language, so that doing stupid things is not malpractice as long as your colleagues do the same stupid things that you are doing, this psychiatrist appears to have violated informed consent standards and failed to do standard tests, and I believe that should be sufficient to make him legally liable for his negligence. The courts appear to be the ONLY area of viable accountability for doctors, and finances appear to be the only motivation to get them to avoid bad behavior.
Finally, I’d add to your analysis that CORRUPTION is at the center of this problem. The reason doctors prescribe off label and the reason the psychiatric drug crisis is ignored and that things like Open Dialog are suppressed is because Big Pharma and many, many physicians are profiting massively from keeping the status quo in place. Unless this is addressed, tragedies like your family’s will continue to occur.
Thanks for sharing your story and helping push for some much needed changes in the system!
Again, not arguing against (and I never have) the strategic use of a short-term drug intervention (with proper informed consent) as long as it has an established positive effect that outweighs the risks involved. I’m arguing against the idea that MDMA being successful in this context would have the slightest positive impact on the demise of the medical model. At best, it will allow a few lucky souls to slip through psychiatry’s net if they manage to connect with the right provider. At worst, it will be trumpeted as proof that the victims of trauma who react poorly are at fault for their negative reactions, which is all the diagnose-and-drug model needs to continue to function. The fact that this argument holds no water is not relevant – NONE of the arguments for arbitrary diagnosis and drugging hold any water. It will provide a PR opportunity for the greedy and malfeasant industry, but even if they miss that, it won’t even make a tiny chink in their armor. And if it does, they’ll find a way to blackball anyone using it by relegating it to a permanent “experimental” status, as they have with neurofeedback and other promising interventions.
It is hard to overestimate the venality and ruthlessness of the psychiatric juggernaut. I think it is a big delusion to think that this kind of intervention will knock some kind of hole in their boat.
And of course, I’ve made the “Weak bones” argument myself, and it makes total sense, but it doesn’t stop the psychiatric mainstream from telling those with PTSD diagnoses that their reaction is a disease because not everyone acts that way. Apparently, the only acceptable response to trauma is to shake it off and get back to work. We get a whole two weeks now to grieve the loss of a loved one, why should being sexually abused or seeing a friend blown up by a bomb require a longer recovery period?
If there’s a way to hijack it, they will do so. And it’s very possible they CAN get a patent for a form of MDMA if it’s used for a new purpose. Drug companies do this all the time. My point is, whether or not this pans out as a helpful intervention, it doesn’t change the power dynamics of the Big Pharma/APA juggernaut as the author suggests it might, and I see a good chance, even if they can’t patent it, that it gets used to further their context-free agenda that’s worked so well for them since 1980 and the DSM III. That’s the central problem we face, and MDMA will do nothing to create sudden “enlightenment” of an industry which has made billions by denying known scientific facts such as those Whitaker so thoroughly outlines in his work. Why would they change what’s been so profitable, just because a few inconvenient facts suggest they are wrong? The general public still believes in them and their marketing, and that’s not going to change as a result of MDMA’s projected successful use.
My reaction is not knee-jerk “all drugs are bad.” It is a rational expectation, given history, that any successful drug intervention will be taken out of context and promoted as the “new miracle pill” and promoted to make billions while undermining any chance of it being used in its proper role. Psychotherapists all over the nation will be recommending MDMA use to “cure” PTSD without any understanding of the subtleties you mention, and those who don’t improve, rather than having the therapeutic approach looked at, will be labeled “treatment resistant” and re-routed to the same old, same old list of psych drugs for further “treatment.” Meanwhile, psychiatry will be revitalized because they finally have a drug that “works on mental illness,” proving that it really WAS all in your brain all the time, and providing continued cover for the fiction that environmental impacts are of secondary or no importance in the “treatment of mental illness.”
Just as an example, a fairly recent qualitative study sent student volunteers into residential treatment facilities for youth with a list of questions. Something over 80% of the residents reported to a TOTAL STRANGER that they had significant childhood trauma that impacted their mood and behavior. Only 20% of the kids had any traumatic past documented in their charts!!! So either the staff is so unsafe that at least 60% of the kids felt more comfortable disclosing to a total stranger, or more likely, trauma is so low on their radar that they don’t ask about it, and even if it’s mentioned, it is not considered relevant enough to write down.
So it’s not that psychiatry hasn’t found a way to help trauma victims – psychiatry doesn’t WANT to help trauma victims and has a vested interest in MINIMIZING the role of trauma in creating adverse emotional/mental experiences – they don’t even consider it worth noting as a factor! They want to blame the trauma victim for their failure to “adjust” and any biological intervention, no matter how helpful it can be in the proper context, will be used to further their agenda of minimizing any discussion of psychosocial causation so that they can promote the much more profitable “chemical cure.” This situation will pertain until and unless the DSM concept of “diagnosis by committee” is dead and buried and pharmaceutical company influence over the profession is deleted.
You can’t cure corruption with science. It’s about power.
Ron, I think there are a couple of points you are missing. This is not a critique of MDMA or the possibility that it might catalyze healing for some. I’m critiquing the idea that finding a drug-based solution will somehow lead to the dismantling of the DSM-diagnosis-based and drug-based “treatment” paradigm we’ve all come to despise. Until and unless we do away with the idea that the “patient” is “ill” based on some arbitrary criteria, a drug-based solution, however well-intended, will lead instead to an INCREASE in drug-based arguments and interventions and a further deflection away from looking at root causes for these “disorders” and a continued and redoubled effort to blame the client’s brain for his/her difficulties. There will, as there always are, be practitioners who use this information and possible intervention responsibly and in an empowering way that respects the social context of a person’s suffering. But the industry, with the help of Big Pharma, will be saying, “MDMA is the new miracle drug! Psychiatry’s big breakthrough proves that they CAN heal the brain with new and better medications!” MDMA being successful will not alter the current power dynamics. In my view, it would make them worse, no matter how effective MDMA might be if used in the right context.
It is wonderful to see the relationship between food and emotional experience outlined here. This relationship is very complex, as it’s well known that traumatic exposure dramatically impacts eating habits, and that food can take on a role as a comfort measure or be used as a means of controlling self or the environment (eating disorders), which would naturally lead to poorer nutritional habits for those who have been traumatized on the average. Additionally, poor diet is going to be associated with poverty and lower educational levels, which of course impact “mental health” variables assessed. A bidirectional relationship seems intuitive, but to really flesh this out requires looking at the relationship between psychosocial stressors and diet.
One perhaps seemingly picky but actually kind of important critique: The use of terms like “patterns of overdiagnosis and overmedication” give credence to the idea that there is such a thing as optimum diagnosis or optimum medication, which is not actually possible given the subjective and socially-driven criteria used for “diagnosis” in the DSM, and the damage done by such arbitrary categorization of distress.
More appropriate would be to say that we want to curb “The use of psychiatric drugs to mask the results of psychosocial stress and the likely causal link between nutrition and common expressions of psychosocial distress through mood and behavior as outlined in the article.” Or something like that…
Or how about, “Antipsychotic use is killing those prescribed them at high rates, and reducing their use is the most important factor in improving the health of those with “mental health” diagnoses.” I agree 100%, call a spade a freakin’ spade!
Well said, Bonnie. The disconnect between the very relevant critique of the medical model and the absence of ANY kind critique of the view of PTSD as a “treatable disorder” is glaring. The victim is still blamed and the psychosocial origins of PTSD remain obscured behind the “diagnose and treat” model. Far from undermining psychiatry’s medical model view, any success of MDMA will be grabbed upon and trumpeted from the rooftops as proof that PTSD IS a biological problem (because after all, a drug solved it, so it MUST be biological!) Meanwhile, the root causes of PTSD, including parental abuse/neglect, dysfunctional schools and other social institutions, structural poverty and unemployment, domestic abuse, racism, sexism, and other institutional oppression, and the generally oppressive nature of our corporate capitalist social system will all be given yet another free pass.
Oh, and just for the record – psychiatry doesn’t stand “just outside” of medicine, IMHO. It’s miles away in the area of self-promotional delusion. Admittedly, some other medical specialties spend time in that area, too, but psychiatry is at this point almost completely divorced from any honest effort to comport itself according to the scientific findings of its own researchers. It’s closer to religion than it is to medicine, or even to sociology.
A good answer. Science needs to allow for all perspectives and all data to be considered objectively, and for any theory or law to be revised based on conflicting data and observations.
The biggest barrier to understanding the mind is the materialistic assumptions of many claiming to be “scientific.”
Sounds like some beginning awareness that something is wrong in the State of Denmark, which I guess is a good thing. I notice a couple of things – first, they’re still using “illness” language, like “symptoms,” to describe the effects of these institutions, continuing to allow and encourage victim-blaming. Second, it’s fascinating that of all the institutions listed, they fail to mention school and family, which are the institutions that most seriously affect young children and are the cause of a great deal of suffering regardless of race or gender. The other factors mentioned are, of course, very important issues that can’t be disregarded, but the specific failure to mention childrearing practices as a major contributor to what they call “mental illness” seems significant and suggests continuing energy to protect the parents and adults rearing children from accountability for their impact.
They do not HAVE to be that, Tireless. Most people WANT to feel better, but good therapy catalyzes their ability to feel better by reassuming control of their lives. This is the opposite of what you’re saying. I most often found that clients NEEDED to get in touch with their anger and outrage in order to move forward to a new path, and that, in fact, learning that they don’t HAVE to live up to ANY social expectations is essential to being able to find a way to move forward in the crazy world we have to live in. There is a big difference between “adjusting” to social expectations and becoming CONSCIOUS of social expectations that one may have felt compelled to follow against one’s own will or interests. If you want to fight for justice, being aware of your own emotions and expectations seems an important starting point.
I think this is a wonderful analogy. The lack of empathy that is at the core of Scrooge’s rapciousness and heartlessness is very similar to the lack of empathy displayed by “the system” towards those it tries to “help.” The main difference is that Scrooge at least admits he is out for money, whereas the psychiatrists would feel very comfortable institutionalizing Tiny Tim and putting both of his parents on SSRIs to deal with their “distress in excess of what would normally be expected” from having your kid taken away.
You make a lot of generalizations about therapists. Not all therapists are the same. Many have been taken in and are participating in the psychiatric mainstream effort to pathologize anything but being mildly happy regardless of circumstances. But some (a minority, I acknowledge) really are there to help their clients sort out the meaning of their experiences and move on to take meaningful action, as I explained in another of my posts. It just doesn’t work to label “therapists” and to say they all do the same things. It has a haunting similarity to the kind of labeling we all agree we hate when it happens to us. Therapists are people, too. Some are empowering, some are power tripping. Some haven’t dealt with their own issues, and some have dealt with them quite well and are in a good position to help others find their way.
Or as I like to say, “Generalizations are ALWAYS wrong!”
I think that’s very accurate. The other thing is, a lot of those who provide such services have not dealt with their own issues. So instead of being there and supporting their clients, they try to “make the bad feelings go away” because THEY feel uncomfortable, not because it’s good for the client. Unfortunately, the DSM plays right into this – instead of understanding what’s going on, we can label it as “bipolar disorder” and blame it on the client. Clients also are afraid of facing their historical pain, and psychiatrists give them an “out” by saying “It has nothing to do with your past – it’s just brain chemicals.” Also makes it easier to blame kids for not behaving instead of learning new parenting/teaching techniques.
Basically, psychiatry works for those in power and less and less the lower you are on the power scale. I believe that power imbalances are really at the center of most “mental illness” symptoms, and resolving abuse of authority is the best way to stop “mental illness” for ever developing.
I don’t think so. I think it is about control, yes, but about whether the client should be put in more control or if the professional is supposed to control the client. There are plenty of psychologists who believe in controlling the client and a few odd psychiatrists who believe in empowering clients. But the DSM system is 100% about the professional dictating to the client, usually in the absence of evidence that following their orders is even likely to be helpful in the long run.
An excellent question, Oldhead. One would not feel the need to deny one’s “boogerheadedness” and assure the attacker that one is categorically opposed to “boogerheadedness” to label the attack as an immature avoidance of the question at hand.
Liberals tend to be supporters of “mental health parity” and other means of increasing funding for psychiatry and its allied forces. What support I have seen politically has come from the libertarian right. There is a small sliver of progressive activists, most of whom have had “services” from the “mental health” system, who are trying to take on psychiatry, but it’s definitely not a “progressive” thing at all. Though it really should be, if human rights and addressing oppression are their supposed goals.
Being an advocate ABSOLUTELY involves holding the system accountable! What exactly do you think advocacy IS? Advocates support their clients in speaking up, in organizing together, in proposing legislation and testifying at the legislature, and all sorts of other political activities. I worked with a group called Oregon Foster Youth Connection, composed of current and former foster youth, which did speaking engagements about what it’s REALLY like to be a foster kid, and which proposed new legislation to the Oregon State Legislature every session (and they have never yet failed to get a bill they wrote passed). They very much needed and benefited from adults helping them with planning and organizing their activities, as well as helping them sort out the feelings that commonly come up when a kid used to being totally disempowered starts “speaking truth to power.” It would never have happened without the adult supporters (the first of whom was the founder, who was herself a survivor of the foster care system). Advocates also appear in court and in other meetings with their clients and make sure their rights are protected. Advocacy is all about holding the system accountable.
Sorry, but I think you’re missing the point here. If a person is injured, we are not BLAMING them by helping them heal from the physical injury. You are interpreting the desire to help as meaning blaming the victim. I can assure you that plenty of supportive environments exist where such blaming doesn’t happen. I would present a “hearing voices” group as an example. Do you think it’s “blaming the victim” to let folks know that other people also hear voices and that you can meet with them and talk about what it’s like to live in a society where you’re treated like a pariah, and talk about different approaches to dealing with both the voices themselves and society (and especially the psych system) treating them like less than human?
Are you suggesting that the ONLY thing that will help a rape survivor or domestic abuse survivor is sponsoring political action? Would a friend listening to a person telling his/her story be victimizing the person by supporting the idea that they need compassionate listening to help them work through the traumatic event that happened to them?
I totally get that organized “mental health treatment” is by and large focused on eliminating difficult people from our midst, and that the DSM was created to shift the blame from social conditions onto the victims of them. However, I think it’s going way too far to suggest that someone who is psychologically/spiritually injured by violent or oppressive actions can’t “heal” without being blamed. The kid who got hit by the car isn’t blamed for the car hitting him. Why would it automatically imply blame to let someone know that being abused is painful and that it’s possible to feel better through reconnecting with others who understand and have worked through the kind of pain you are experiencing? Or even through just talking to someone who cares about you?
I believe the definition part is the problem, Littleturtle. As I’ve said before, and I don’t think you’ve responded to me about this, no one denies there is suffering nor that biology is involved. What folks are fighting here is the idea that some “professional” can come a long and define “what is wrong with you” based on a book that was written in committees and that denies that the abuse and neglect and oppression experienced by most they define as “mentally ill” (including such abuse as is dished out by the system itself) is even RELEVANT to their “diagnosis.” “Mental illness” is NOT “just like any other illness” nor are drugs given to dampen out the “symptoms” in any way like “insulin for diabetes.” It’s the idea that someone with some advanced degree can label and box you up without even consulting you for your view on it that’s offensive. Plus the idea that “mental illness” is IN YOU, rather than being a consequence (as it usually is) of what has happened to you and your body in this oppressive society in which we live.
You’re absolutely entitled to view yourself as “mentally ill” if that is a workable view for you. I’d argue that no one else is in a position to define for you “what is wrong with you” unless they actually know both the CAUSE and a range of potential REMEDIES for what is ailing you. THAT is the trouble with “mental illness.” Not that the manifestations so described don’t exist – the trouble is that psychiatrists and their minions have no right to define for you “what is wrong” and “what you should do” (let alone FORCE you to do these things) when they themselves know and sometimes even admit out loud that they have no idea what a “mental illness” really is or whether their “treatments” actually address a physiological problem or are just one more substance to make you feel better (or feel less) without any connection to a physiological problem at all.
Maybe the reason people in high-income countries anticipate discrimination more is because they encounter it more often. Maybe our Western idea of “progress” breeds such discrimination, and breeds depression as a result? Maybe our Western approach to labeling such people “mentally ill” is in itself a form of oppression and discrimination?
BTW, I think the two of us together in a room could map out a lot of good solutions. I personally think that “liberal” and “conservative” ideas are like yin and yang – you need both in balance to create a good society. Unfortunately, we lately seem to be going in the opposite direction!
Oh, and many unionists and supporters DID die fighting for rights we take for granted today, so if “life on the line” is the criterion, there were plenty who took that risk and some who paid the price. There are also many, many deaths that result from the current corporate capitalist culture where folks don’t even have a chance to identify their enemy, let alone fight back.
I’m with you on term limits, except that we also have to stop corporate campaign contributions as well, as that is the largest factor creating corruption in our representatives. It shouldn’t take 10 million dollars to run a campaign, and campaign funding should not require becoming subservient to ANY special interests, whether left or right on the political spectrum. To do this will require a transcendence of the left-right split and a recognition that ALL working people have common interests in preventing the takeover our our government by rich multinational corporations.
I agree about laziness – we should not reward people for doing nothing. But I have to add that accusing people as a group of “laziness” denies certain realities that impede progress and set unfair and unnecessary barriers for certain subgroups of Americans. To use your example, the fact that slavery ended in the 1800s does not mean that all or even most barriers are gone, as any honest reading of recent history should make clear. Black folks and Native Americans, in particular, can do the same hard work and not get so far ahead for a lot of reasons. Consider just one example: many poor white men (including my dad) came home from WWII and took advantage of the GI Bill, including buying a house in the ‘burbs for $30k. They sold the house in 2008 for $750 K. No black person could possibly have bought that house, no matter how hard they worked – the owners would not have sold it to them, and the banks would not have lent them money, and if they did buy it, the property value would have gone DOWN as white people fled the neighborhood. Many such families expanded their wealth in a large way by investing in real estate. Not something black families could do at the time.
Just one of many examples. Not saying it’s valid to say, “Hey, society is screwing us over, so screw them!” but I don’t think it’s a fair analysis to suggest that everyone has anything remotely close to a “level playing field” in the USA today. And that’s not even mentioning poverty as a limiting factor that affects people of all races and genders.
There is one other variable they did not consider: the escalating use of “antidepressant” drugs in teens and young adults.
The other point that is completely ignored is that they may be using cell phones a lot because they’re feeling disconnected from relationships and are seeking intimacy through technological means. Remember the Rat Park experiment – rats didn’t become addicted to cocaine when they had a health environment to live in. Same applies to humans.
Don’t confuse “liberalism” with “political correctness.” Political correctness is an illness of both sides if the aisle, as Trump’s recent orders to his agencies about what words they’re not allowed to use clearly prove. The real enemy is authoritarianism, the belief that there are some who have a right to exercise their authority over others arbitrarily and without basis in reality.
Liberalism brought us 40-hour weeks, minimum wages, healthcare benefits, vacation and sick time, and safety provisions in the work place. And Americans and others around the world fought for and DIED for these goals. Plus there are plenty of liberals who have fought in wars, including my father. So it’s not true that “liberals” sit back and loaf while “conservatives” fight for freedom. There are also plenty of “conservatives” who make millions and billions off of unnecessary war and never put themselves at risk of any kind of danger. Our current President is one such, as our many of our representatives.
Freedom takes many forms and many have fought for it in many different ways. The liberal-conservative split is an intentional fiction that has been pushed by those in power to keep citizens fighting against each other and prevent them from joining forces. Things are not going to get better until those of us who are not in power get together and stop buying into these false divisions like black/white, liberal/conservative, urban/rural and start realizing that those in positions of power want to keep us from getting together and forcing them to cough up some of their power.
This is a critical point, Richard! There are some biological aspects that can be controlled or directed, such as food, exercise, sleep. But as for genetics, it’s the one thing we can’t change! So why are millions and millions being spent on exploring genetics and brain structure and so on, when it’s clear that the ENVIRONMENT is the big variable that we DO control? It makes no sense at all, unless you’re interested in keeping people sick and dependent, and that, littleturtle, is the part where I think we are having some difficulties communicating. Nobody here denies that biology is part of the picture. But environmental impacts are the big variable we control even regarding the “bio” part. The problem with psychiatry is not that they focus on “bio,” it’s that they don’t really focus on whether their approach WORKS or not! They focus on “symptom control” without any THOUGHT as to why a person might have these “symptoms” or whether they are really “symptoms” of anything at all.
You seem to believe that the field of psychiatry is seeking to find the best way to “treat” these “diseases” of the mind. I believe that psychiatry is seeking the best way to make a lot of money for themselves and their allies, even if individuals believe they’re being helpful. If they REALLY cared about their clients, they’d be a lot more open to hearing when new data contradicts their theories. All they have is their drugs, and they HAVE to believe that “broken brains” are the problem or their justification for prescribing is gone. So the big variable that we CAN change, our environment, is the one thing they can’t ever consider. The results speak for themselves.
Perhaps instead of un-dismantling Freud as a person or clinician, we try to resurrect the parts of his observations that appear relevant and effective today. For instance, the idea that listening to your client is the beginning of any attempt to know what might be helpful was a breakthrough. Initially, he believed his clients’ stories of trauma – that was helpful. He identified that people are not generally completely or sometimes even vaguely aware of their motivations for doing what they do – the idea of the unconscious mind was probably his moment of greatest genius. And his initial idea of bringing the unconscious motivations to consciousness seems to be important to effective therapy, especially as regards historical trauma.
There’s a lot to toss out, too, but that’s how real science works. We take what comports with the data and toss the rest. We don’t expect one person to come up with a theory that explains everything, we continue to explore and build on and discard pieces as needed. That’s what’s important here, not whether Freud is a good guy or a bad guy. Lots of good guys come up with dumb theories, and bad guys sometimes have moments of genius. We need to focus on the ideas and models that work and not concern ourselves too much with the character of the person who thought of them.
I’m not going to make a blanket condemnation of a group based on rumors and anecdotes under any circumstances. The US government and most governments of the world have acknowledged them as a religious organization, and the Scientologists I’ve gotten to know seem no more bizarre or extreme than members of other fundamentalist religious groups – I have a harder time with fundamentalist Christians, to be honest with you.
But even if Scientology were a devil cult, I’d still take the same approach. The point is not whether or not Scientology is evil, but how to handle an attack against one’s integrity. Let’s say that someone accused you of being biased because you’re a Szaz follower. What would you do then? Maybe you’d tell them you think Szaz was the bomb, or say that you don’t agree with everything he said, or say that he was way off base – and guess what? You’re talking about Szaz and not psychiatry and you’ve been diverted. THAT is my point. Why give fuel to the idea that your personal belief system is relevant when we’re talking about the legitimacy of psychiatric diagnoses and how research contradicts their version of reality?
Actually, this conversation is a great example. We stopped talking about Freud and antipsychiatry a long time back. Though of course, I’m always more interested in off-topic discussions with someone of intelligence and perspective such as yourself, so I don’t mind. But if we allow someone attacking us to change the subject, IMHO, I believe we’ve done ourselves a great disservice. The use of ANY group association as a means of trying to degrade my status is unacceptable to me, and I make sure that any attempt to do so is dealt with firmly and directly. That’s my view. Like I said, you can take your own approach, but I don’t buy that it’s a requirement to agree to the depredations of Scientology in order to challenge someone’s use of smear tactics to distract from the point at hand.
You are letting your personal feeling get in the way of rational discussion, Richard. I don’t know why you are so passionate about the CoS, and maybe you have good reason, but the point is, it is being USED as a distraction tactic. The more negative things you say about it in any discussion, the more ammunition you give your antagonist, and the further off topic you go. By berating the Church of Scientology, you are giving credence to the idea that Scientology’s opposition to the Church of Psychiatry is a legitimate reason to doubt any opposition. It doesn’t matter at all who it is they are using as a distraction. They are distracting from the point. Psychiatry is not good or evil based on the beliefs of the person involved. It is evil based on the FACTS, and any distraction from that point is a victory for their allies. It is simply not the appropriate forum for that discussion to happen, and my belief is that we TACTICALLY do much better if we go on the offensive by identifyinig the fact that our antagonist is using smear tactics, instead of defending ourselves against meaningless allegations. That’s my view. You don’t have to agree, but I really don’t think you’re being objective about this question here. You seem to be more looking for a forum to promote your view than the best tactics to stop a distracting attack on a rational critique of psychiatry.
I believe that giving the Scientology smear ANY play at all simply gives it more force. It’s really clear at this point that any association with the CoS is going to be damaging as it invites this tactic. However, bringing up Scientology is a TACTICAL DISTRACTION and needs to be labeled as such. It’s similar to discounting a person’s opposition to abortion because s/he’s Catholic. It’s not relevant. I not only want to be sure this doesn’t work on me, I want to make sure that it doesn’t work on anyone, and that they think twice before ever bringing it up again. I know that most people are not as willing to be as assertive as I am, and I consider it my responsibility to make sure that everyone watching hears that the Scientology smear is BULLSHIT and will not be tolerated, by me at least.
That’s my view of it. The less energy I give it, the better, but what energy I do will be directly confronting the person using it for evading the issue.
As for the last comment, I’d say, “Well, it appears that I’m talking about data and you’re talking about religion, so if anyone’s got something to hide, it’s you hiding the fact that you have no data to counter my argument.” And I’d restate what I’d said just to make sure we’re clear what the person’s avoiding.
Again, it’s not really failed for me yet. Applicable to any situation where someone’s deflecting from the original topic. The worst that happens is that they look like assholes and I look like an intelligent person of integrity. Which works for me.
Nope. I come right back at them with, “Since you’re continuing to deflect attention from the question at hand, I am assuming you have no actual data to counter my argument. Is that correct?” It has never failed to drive the antagonist away or get back on topic. We did this much more aggressively when protesting the APA in Philadelphia, and it worked even better because we had a half a dozen or more simply saying, “Oh, no, you’re not going there!” Your approach may work just as well – that’s just how I approach it.
I take a different approach. I say, “I thought we were talking about science here? Why would you want to change the subject to religion? If you have scientific data to discuss, I’m happy to do so, but religious affiliations are simply not relevant to this discussion.” I find that even entertaining the subject lets them control the conversation, and I’d much rather point out their sneaky tactics so the public would be aware of them as tactics, rather than focusing on whether or not I am associated with any particular group.
Little Turtle: I’d add to this that Big Pharma and psychiatry actually INVENT diseases to seel their products. The best example is “Social Anxiety Disorder.” Some Paxil experiment suggested that people were less shy while taking Paxil. So the APA and drug companies got together and decided that shyness could be added as a disease and Paxil would then be prescribed to “treat” it. Childhood bipolar disorder is another one. There is solid documentation that Joseph Biedermann colluded with Johnson and Johnson to create “data” that would support the idea that millions of children were “bipolar” and needed “treatment” with Johnson and Johnson’s drugs.
I am sure you would find this to be a problem. But the problem is much bigger than these two examples – the entire DSM is filled with such speculative “disorders,” and the creators of the DSM III made clear statements at the time that moving to an “atheoretical” categorization was the intent (in other words, they no longer cared about the CAUSES of these “disorders”) and the reason for this was so they could claim a larger share of the market, not because there was some scientific advantage to using the DSM categories. The DSM was invented to bill insurance companies – it’s not based on any kind of science at all. Again, it’s not that folks like you and me don’t suffer from emotional/mental problems, and it’s not that biology doesn’t play a role – loss of sleep, for instance, can cause psychosis eventually, and thyroid problems can lead to depression and lethargy. But categorizing shyness or aggressiveness or not liking to sit still in a boring classroom as “diseases” is not only not scientific, it’s intentionally misleading and destructive, as it prevents real analysis of causes and solutions, including biological ones, from happening.
Any scientific theory needs to be open to re-interpretation when new data comes along. Evolution is open to new data, psychiatry is not. So comparing them (as the original poster did) is just plain wrong-headed. That was my original point. Even Newtonian mechanics, long considered the most obvious and stable of scientific postulates, had to be modified when scientists looked at very small objects or very high speeds and masses. While there are some who subscribe to the idea that “science is truth” in a quasi-religious kind of way, any real scientists know that all theories can be revised based on new information. This is why psychiatry is not a scientific enterprise, while evolution is.
Probably true. But I’m guessing they were the only ones fighting that fight at the time, and he took an ally where he could find one. It is unfortunate when comments by Tom Cruise can be used to characterize opposition to psychiatry, but if it weren’t them, it would be someone else.
Do people need to recover from being hit by a car, even if it’s not their own fault? I think you’re conflating two disrelated ideas: recovering from injury and acknowledging the political underpinnings of oppression that support those injuries and deny their effects. It is very possible, and in my view ultimately essential, for part of the recovery process to involve becoming aware of the forces of oppression behind one’s injuries. A long-term domestic abuse victim, for instance, seldom moves beyond self-hatred and self-blame without recognizing that their “loving” partner was in fact taking advantage of his situation and using threats and manipulation to keep her “in her place.” The process of moving responsibility off of her own shoulders and onto the person it belongs to is often a great relief, though it is often accompanied by a lot of grief at the lost dream of the abuser somehow “reforming” himself. In many cases, survivors become the next generation of advocates for safe relationships and become politically active as part of their “healing.”
If you perhaps redefined “healing” in a broader way, this conflict could be resolved without anyone being “wrong.”
Perhaps part of why most people consider it to be a scary cult is because they teamed up with Szaz and posed a threat to the hierarchy? If you re-read Anatomy, you can see that the psychiatrists intentionally smeared Scientology so that they could attach any critique of psychiatry to Scientologists? Not saying Scientology doesn’t have its issues. but let’s be honest, psychiatry has done all it could to make Scientologists look like brainless drones and make anyone who criticizes them look like they are drones as well.
They also fail to mention that these “brain scans of normal/depressed people” are AVERAGES. Many, many individual comparisons have been done and it’s been shown over and over that many depressed people DON’T have this kind of brain scan, and many non-depressed people do. Brain scans are the new phrenology – it sounds “sciency” but it’s mostly smoke and mirrors.
I do think that’s what good therapy is all about – understanding when and why you had to submit to the irrational and unreasonable wishes of an authoritarian authority figure and how that may have altered your life, as well as coming up with plans as to how to deal with future authoritarians one might meet. Alice Miller does a great job talking about this, though she is rather pessimistic about whether we can really break the cycle and not pass on our own authoritarian reactions to the next generation.
To me, the most unfortunate thing about the DSM (though there are many unfortunate things about it) is that it makes it easy for the “helper” to assume the authoritarian role and to “help” their client become a “good authoritarian” and submit properly to higher authority. Any therapist worth his/her salt is an anti-authoritarian.
The other element is that while authoritarians are required to be submissive to those above them in the hierarchy, the payoff is that those below them must be submissive to them or face punishment. It’s a weird tradeoff where you trade in your personal freedom for the unquestioned right to abuse those who you deem beneath you.
“Power disparities” are most definitely behind abuse at all levels. Our entire Western culture was built on oppression, and oppression still lies at the heart of it. Any effective “therapy,” if we really wanted to call it that, needs to acknowledge this fact and apportion responsibility where it really lies. The best “therapeutic” results I’ve gotten involved the person I’m working with either getting away from or directly taking on the forces of evil in their lives. It’s about taking back control from the oppressors, in one way or another. Otherwise, we’re just putting wallpaper over giant holes in a person’s foundation. But guess what, the establishment doesn’t want people becoming assertive and politically astute, and it’s much more effective to blame the victims and tell them they’re “sick” so they can go “heal themselves” and “adjust” to the sick society they’re a part of. Unfortunately, I’d have to say the majority of counselors appear to pursue this kind of goal, and as long as the persecutors are running the show, that will continue to be the case.
My point is only that there are some people who do have exceptional skills in helping a person look at why they do what they do and take a more conscious and active role in deciding what kind of life they want to have. I make no claim that having a professional degree delineates such folks (I actually have an undergrad in Chemistry!) – I’m only saying that I don’t find anything wrong with someone charging a reasonable fee for helping someone make changes they want to make in their life. But they need to PRODUCE THE DESIRED RESULTS. Most counselors and almost all psychiatrists fail to meet this standard. A lot more untrained folks with personal experience and skill can meet that standard, and I have no problem if they get paid for doing something that most people can’t do.
I guess I tend to agree with you that professionalization, particularly licensing and medicalizing and involving insurance payments, has almost certainly done far more harm than good in the collective.
I have to say, Nathan, that I had quality psychotherapy (NOT psychoanalysis) for 15 months back in the 80s, and I very much doubt that any friend or family member could have provided me with the kind of support that I received. I was very fortunate to find her, and would be even more so today.
Such therapists have, indeed, become rare, but I have also provided this kind of service professionally, and I am very comfortable saying that I have been able to help people in some very unusual ways that would be unlikely to be available to the average person.
I do think there is a place for professional helpers. I don’t think there is any place for professional arrogance and hubris. Unfortunately, the vast majority of “mental health” workers are short on humility or too afraid to speak out about the destruction happening in the name of “healing.”
Freud’s genius was in listening to what was behind his clients’ complaints, and recognizing that people are generally not fully aware of their motivations. It is, perhaps, understandable that he knuckled under to the pressure of the times, but the profession was irrevocably damaged by the choice to suppress the truth. It make psychoanalysis ineffective and even destructive, and ultimately opened the door to biological psychiatry’s takeover, based on legitimate claims that psychoanalytical theory was not valid and didn’t lead to effective growth.
So while I admire Freud’s genius, I can’t help but deeply regret his failure to stick to the truth instead of kowtowing to social pressure. We might be in a different place today if he’d stuck with believing his clients.
Freud’s real betrayal was backing away from his Trauma Theory. He initially listened to his female clients, who told him that they’d been sexually abused in their childhood in large numbers. When he published this data, he was brutally attacked by his peers, many of whom no doubt were the perpetrators of such abuse themselves. Rather than sticking with what he knew, he decided that the women were FANTASIZING these sexual contacts, and his drive theory saved his career, but of course sentenced a century and more of women to continued sexual abuse and molestation supported by the psychiatric profession. The unwillingness of the psychiatric profession to admit that such abuse is common and harmful and is responsible for much of what is called “mental illness” continues to the present day. Freud was brilliant for listening to his clients, but in the end was a coward and betrayed them all.
It might be helpful to define what you mean when you say “I have a mental illness.”
I am with you that people can help each other, and I was very fortunate to have an excellent therapist who actually helped me sort out what was going on in my muddled head. However, it appears to me the term “mental illness” has been co-opted by the Forces of Evil and is used not to help, but to demean and blame those who don’t “adjust” to our weird Western capitalistic society. While most psychiatrists are most likely not intending to do harm, most are massively misinformed by their leaders, and many of those leaders ARE in fact quite aware of what is happening and are more concerned for their financial welfare and power than they are for your welfare or mine.
Nobody here wants to deny that people experience mental and emotional stress and difficulties. But I lack any confidence that the psychiatric profession is genuinely engaged in trying to help minimize such stress, and in fact, the profession mainly denies that such stresses have ANYTHING AT ALL to do with why people are suffering. Hence, the distrust and in some cases the desire to dismantle psychiatry and all of its manifestations. I hope you can understand the difference.
Truth, are you suggesting that more “rightists” that “leftists” are knowledgeable about history? My experience is that, at least here in the USA, most people speak freely without any comprehension of history at all, regardless of which end of the so-called political spectrum they choose to occupy. Most people who actually DO study history agree with progressives on some issues and conservatives on some issues and don’t agree with either on other issues. It’s called being a rational person – a person of reason doesn’t simply agree with a point of view because it’s convenient or his/her friends believe it or because it feels good. Any real analysis would show that both liberal and conservative viewpoints are needed but neither is sufficient to understand history or current events.
Actually, I’ve observed a huge gray area between people seeking these drugs and people being forced to take them. Kids, for instance, often have no choice at all about it. Same with elderly or disabled folks in many cases. And many adults “voluntarily” take these drugs because they understand that refusing will mean trouble for them. Beyond that, there are many more who “voluntarily” take these drugs because they are lied to about their “condition” and about the drugs’ effectiveness and dangers, and have been denied any access to or knowledge of any alternative options, and they are also often pressured by counselors, doctors, and/or family members to take the drugs against their own intuitive discomfort. So it’s not really very easy to distinguish between those seeking drugs, those taking them because they think they should, those taking them because they’re afraid of what would happen if they refused, and those who are overtly forced to take them. It’s an ugly scenario by all accounts.
Oooh, I LIKE it! The parents and siblings have to undergo screening for abusive and crazy-making behavior, and THEY get locked up if they fail the screening!
Not really, of course, because they’d just lock everybody up and put the whole family on drugs, but I like the concept of the “kind, caring parents” who often contributed to the situation in significant ways putting their scapegoat in the psych ward and getting off without consequences.
To be clear, I understand that the majority of parents do care about their kids and are trying to do the right thing, and many people end up in the ER despite caring and sane parents. But there’s a huge overlap between abusive parents and emotionally upset children, and psychiatry has been working hard to eliminate any knowledge of that fact.
Soon they will do a study showing that racism makes structural and chemical changes in our brains, and recommend giving all minority groups prophylactic antidepressants just in case.
I can understand that, too. What I can’t understand is how someone can praise or compliment a system or approach that has failed to have any positive impact. At what point do you say, “Hey, these people don’t seem to really know what they’re doing. Maybe I need to look somewhere else for a solution.”
Any doctor who is alienated because I want to make my own decisions is a doctor I want to avoid at all costs. And any doctor who even THINKS the word “noncompliant” when considering his patient’s decisions should not longer be a doctor. A doctor is not a jailer or schoolteacher or general – s/he is a professional adviser, and his/her client is entitled to listen or not listen to his advice. That’s what “informed consent” is about.
I would bet that James trusted his psychiatrist and paid the price. It’s kind of arrogant to suggest that he should trust them again. I don’t trust any treatment I haven’t personally researched. With doctors having been shown by the JAMA itself to be the third leading cause of death in the USA, such caution is very well warranted, and any doctor who can’t understand that is not going to have me for a patient.
I heard a news magazine report on NPR about a guy diagnosed with autism that got this process done on an experimental basis. It did make him more sensitive to others’ emotions, in fact, dramatically so. This unfortunately was overwhelming for him and altered his relationship with his wife, who felt he was withdrawing and didn’t need her any more. It ultimately led to them getting divorced. And when the experiment was done, they left him on his own and the effects faded. He said he would do it again because it helped in his relationship with his son, but reported it created tremendous chaos in his life. Again, we humans are arrogant when we believe we can mess with someone’s emotions and not have serious adverse effects occur!
Which goes to show that emotions are important survival entities, even “negative” ones, and generally speaking, screwing with them does not improve our survival.
Actually, sexual harassment is incredibly common and it’s not surprising that this stuff comes out in bunches. When someone makes it safe to disclose, lots of disclosures often come out. I am sure that there are some “copycats” who want attention, but based on the stats on sexual harassment and abuse, the odds are that most of these allegations are true. This is especially the case when one person has multiple accusers who don’t know each other at all. Unless the person has some specific motivation for making something up, why would a bunch of people decide to gang up on a Roy Moore or Harvey Weinstein? Especially when we look at the character of both of these people, it would hardly be surprising if multiple people were in fact harassed and/or abused by them, and once one person makes it public, it seems not at all surprising that others now feel safe to tell their stories as well.
The DSM and any similar “diagnostic” manual would be gone, there would be no forced “treatment,” and psychiatrists/psychologists/therapists would not be able to testify about someone’s “mental health” in court, they could only talk about observed behavior. No drug ads on TV, and lobbying of all sorts would be taxed and the funds invested in real research. Doctors are held liable for the actual results of their actions, rather than being let off the hook if they are adhering to the “community standard of care” no matter how ineffective or destructive that “care” might be.
Of course, corporate contributions to political candidates would have to have been banned long since for such events to occur, so that’s part of the picture.
They were looking at those taking SSRIs, not depressed moms in general. Plus we know the autism rate has skyrocketed since the early 90s. We also know that the SSRI prescription rate has skyrocketed since the 90s (though there are obviously many contributing factors to this). There were plenty of depressed moms in the 60s. At this point, the evidence seems pretty strong that there is a specific connection between SSRIs and later autism diagnosis.
That kind of crap is not therapy. It should be called “client management” or something more honest. Most “therapists” these days don’t know how to help someone and are handmaids for the system. Sorry you had to deal with this crap, and well done for escaping it!
I don’t really see charging for quality therapy and charging for life coaching as being fundamentally different. The question is only whether you provide a quality product. I have helped tons of people (in their own opinions, not mine) over my career and don’t feel bad having been paid to do so. There are things an independent third party can provide that a friend can’t. The big problem is that most therapists have not dealt with their own issues and act them out on their clients. Can’t say I’ve never done that, but in the main, I understand the difference between what I need and what my clients need, and they can tell the difference. People who can make a difference should be able to be paid for their efforts. People who don’t help or make things worse should not.
The only possible useful application of psych drugs is for acute care in the vast majority of cases. I know there are a small minority of folks experiencing paranoia and voice-hearing, etc., who are willing to accept the horrific side effects because they can’t seem to find another path, but for most people, whatever benefits (if any) they experience diminish rapidly, or are pretty quickly outweighed by the increasing adverse effects. In my view, except for temporary sedation during a crisis, going to psych meds should only be an act of final desperation.
Thanks! I do think the wheels are starting to come off the psychiatric cart, but it’s a big cart with lots of wheels, and the psych profession isn’t averse to dragging the cart along the ground even if the wheels are gone. As long as they’re making billions of dollars off of selling psych drugs, they’ll do whatever they can to keep the cash flowing. And you’re right, I’ve been attacked and/or undermined for speaking my mind about psych drugs. You kind of learn a way of maintaining balance between honesty and protecting your job, but it’s not really safe to speak up in these settings. That’s why I got into advocacy instead of working directly in a mental health agency – the ethical conflicts were just too intense for me to feel good at the end of the day. But researchers have more latitude, and I would really like to see more of them come out and be honest about what the data suggest.
Please provide even one article showing solid, scientific evidence that “schizophrenia is a brain disease.” Even the psychiatric mainstream admits that this is not the case – those who are up with research have long said that “schizophrenia” is a collection of observations that may or may not even have the same or similar causes. Japan and other countries have stopped using this label altogether in favor of something more descriptive. Are the Japanese psychiatrists wrong? “Schizophrenia is a brain disease” is a propaganda piece published by Big Pharma with the support of the APA and “support groups” owned by Big Pharma like NAMI. There may be SOME people with the symptoms labeled as “schizophrenia” who DO have a brain disease of some kind, but we’ll never find it as long as we treat “schizophrenia” as if it were a disease rather than just a description of how some people behave. Heck, the DSM itself admits that people fitting the same diagnosis are not necessarily “the same in all important ways.” So they admit their categories are heterogeneous, and hence that 10 people with the same “diagnosis” can have 10 different things wrong with them (including nothing at all being wrong) and have 10 different possible solutions or pathways forward.
This website may well be biased toward finding issues with psychiatry, but in terms of understanding research, folks here are WAY ahead of mainstream psychiatry. So if you want to make bold pronouncements like “schizophrenia is a brain disease” here, you’d better be able to back it up with real data, cuz we know the true story.
Precisely! Except that at least with a fever, you can agree on some measurement that tells you what is too high, even if you have no idea the cause. Psych diagnosis is like diagnosing a fever, but without a thermometer.
While I’m glad you were able to find relief in this way, your example is one anecdote. Anecdotes (single stories) are data of a sort but no one can draw a any conclusions from them. I know it’s confusing, but the same drugs you found very helpful have destroyed the lives of others with the same or similar diagnoses. That’s the problem when we are deciding on “diseases” by committee, and based only on surface manifestations rather than causes. A legitimate diagnosis leads to consistent treatment results. This is most definitely NOT the case in the psychiatric world. “Treatment” is mostly by trial and error, and summaries of scientific studies seem to suggest that your experience is the exception rather than the rule. Not meaning to invalidate your personal experience in any way, but in a word, what works for you may not work for everyone, or even for most people. We can’t generalize from one example.
This looks like very solid research. It remains disturbing that such articles are written so cautiously and in such arcane terms that the impact is minimized. “Overprescribing” of antidepressants should be referred to as “malpractice” or “harming patients through the harmful side effects of unneeded drug prescriptions.” Instead of saying “Providing medication may be counterproductive,” why not say, “Prescribing drugs appears to harm many patients by preventing their seeking of other approaches that are likely to be more effective.” And why not recommend that “antidepressants should not be prescribed before other less damaging approaches are fully explored?” It’s time to stop being so mealy-mouthed about this stuff. Scientist need to confidently state the conclusions of research to date: antidepressants don’t help most people (5 out of 6 in this study), and long-term use of antidepressants makes things worse for many users. Those two facts together should be enough to make doctors very, very reluctant to prescribe ADs as a first or even second-line treatment. But nobody in the mainstream seems willing to say that the emperor is, in fact, quite naked.
I agree. I would also add that some analysis of WHY these 10 simple and in some cases rather obvious steps are not taken – the level of corruption underlying the assumptions of the current model can not be overemphasized!
I can agree, except that syndromes don’t necessarily represent a disease process or medical condition. The consistency of their appearance can suggest a medical issue, but there is no requirement that a medical issue be present, or else it would be a diagnosis, not a syndrome. An example: insomnia. You could break down insomnia into a couple of syndromes, such as failing to fall asleep, waking and being unable to get back to sleep, or waking repeatedly and reducing quality of sleep. We could map out “symptoms” that occur together with each of these sub-syndromes and outline the adverse consequences. But there is no distinction as to why a person “has insomnia.” Could be any number of medical conditions, could be psychological in nature, could be the dog wakes him/her up every night at 3 AM. Obesity and high blood pressure would be two more syndromes that may or may not be caused by a medical problem nor “treatable” by medical means. Some psych “diagnoses” qualify as syndromes (“ADHD” probably does) and some certainly do not qualify, but being a syndrome doesn’t imply medical treatability or causality, in my opinion.
Comparing evolution to psychiatry in terms of scientific legitimacy is like comparing astronomy to astrology. While evolution doesn’t explain everything about how inheritance of traits and natural selection work, it is based on observation and experiment and is modified when new observations occur. Compare to the DSM, which is invented in committees and is based on subjective opinions of “clinicians” and is impervious to any new data and whose authority is based entirely on social position and bias instead of evidence.
There is no denying that environmental effects alter the brain, even to the epigenetic level. My objection is when people claim the brain is “hard wired” as if it were some sort of an electrical appliance. The brain is incredibly complex and mysterious, and even if the brain were fully understood, it still would most likely not fully explain human behavior, as there are questions as to the “software” of the human mind, as well as the “operator.” It is very easy to oversimplify what is probably the most complex biological situation in nature.
I agree that plasticity is well established, but the important point in your comment is that any “mapping” is CORRELATIONAL. There is no way to actually map “circuits” – it is all related to the ACTIVITY of the brain, not specific linear connections. So while there are “maps” of areas that
associated with certain kinds of activities, no one really knows what causes what, and as to circuitry, it’s mostly a fantasy.
But I agree 100% with the rest of your comment, and the flexibility of the brain in response to experience makes the idea of “genetically wired” problems in the brain causing “mental illness” completely unsupportable.
You are naive if you think that chemical-based treatments are not forced on people – they are forced on hundreds of thousands or more around the world every day. ECT is also forced in many other countries, even though it’s not allowed to be forced in the USA thanks to Peter Breggin and others. As for ECT, it induces a seizure in the brain. This can not be considered anything but a violent act. We know that uncontrolled seizures damage your brain, which is why there are such things as anti-seizure medications.
I’m glad it worked for you, but millions report long-term brain damage from ECT, including long- and short-term memory loss. Many people report being suicidal after ECT due to forgetting important events in their life like their weddings, births of children, important childhood events, etc. Reviews of ECT show that such benefits as do occur are usually short term, and such damage as occurs is usually long term. The fact that a few lucky people like yourself benefit without serious damage doesn’t change the fact that for most people, the risks far outweigh the benefits.
A lot of speculation posing as science here. No one really knows what a “brain map” is or how it would change, “circuits” are almost totally speculative, and the piece ignores some important questions as to how things like purpose, intention, values, and meaning are “brain phenomena.” That being said, it’s an important counterargument to biopsychiatry to note that almost any human activity changes brain chemistry and can even change structure over time, so arguments about the “need” for drugs to change the brain are spurious. Examples include taxi drivers having more development in the geographical/spatial parts of the brain, and Buddhist monks having expanded areas associated with peacefulness and contentment.
So brains change depending how you USE them. The big mystery is, who exactly is choosing how the brain is used? The brain? The mind? If the latter, what exactly IS the mind, and how does it apparently control the brain in which most people assume it resides?
We know next to nothing about the mind, and abstract claims about “mind maps” do nothing to alter that fact. The important result to extract from this presentation is that we can change our brains by how we employ them, and that should be good news for anyone trying to escape the biological determinist worldview.
The drug they used is called Inapsine. It is very fast acting, and as a result, you can see if it works in 20-30 minutes, and it’s out of the system in several hours. It is (or was) used mostly in ERs for acute cases, often people on meth overdoses. It could certainly be used coercively, but it seemed to be very helpful as a temporary intervention in a crisis situation. Got some people quickly to a place where informed consent became possible, at which point, any perceived coerciveness could be dispensed with completely.
How does a drug get approved that has marginal “benefits” and clear and dramatic adverse effects? Corruption is the only answer. Abilify should NEVER have been approved for this use. Taking neuroleptics for depression is like taking speed to help you sleep.
And some police officers ARE intentionally oppressive. Clearly, the profession would be attractive to those with big power issues. Even though most officers do try to do a good job, it is essential to have police accountability, or the minority of abusive officers end up controlling the culture and making even honest officers more likely to do bad stuff.
Drug suppliers and sellers actually put in lots of hard work. The problem is that they get financially rewarded for their efforts. There are plenty of legal businesses (like making money off of forced “treatment”) that are just as slimy and evil as the illegal drug trade. The problem is when people are financially rewarded for doing destructive things. No amount of policing will ever stop the drug trade as long as people can make so much more money than they can doing honest work.
Wow – incredible effort! Way to speak truth to power! I am consistently astounded that these psychiatrists can claim that they NEVER have seen these reactions, NEVER, in all their years of practice! Are they simply that ignorant, or are they that venal and corrupt that they are willing to lie on the stand just to protect their own egos????
The irony is painful – they are complaining about being told that they need to change themselves and their attitudes, rather than addressing the environment. Isn’t that what the medical profession has been doing to its patients? Isn’t that exactly what we’re complaining about? Don’t they get it?
That is an excellent question! I also wonder what percentage are actually sympathetic with a critical view but feel unable to talk about it because they will be attacked by their more avaricious colleagues. Probably a much smaller percentage, I’m guessing, but they do exist.
Because the power structure assures that any dissident is knocked out of the running early on. Kind of like how our political parties work.
I agree that it was a complete error to every subsume the care of the human spirit into the world of medicine. That being said, I appreciate psychiatric insiders doing what they can to revise the current model of understanding (or misunderstanding) why people feel and act the way they do and what can help. Like it or not, our current culture puts extra value on the opinions of MDs, and the more MDs and former psychiatrists we can get supporting a change, the better off we will be.
Sometimes it’s necessary to understand that all of us have to figure this out somehow, and some figure it out faster than others. I appreciate insider who can figure it out and be a voice of reason in a world of irrationality and greed.
Why would being “antipsychiatry” mean being “anti-biology?” Psychiatry’s problem isn’t that it CONSIDERS biological causality – it’s that it postulates biological causality without any evidence or understanding of what causes anything, and invents “diseases” without knowing the first thing about what causes them or whether they are “diseases” at all. Psychiatry’s other problem is that it’s totally corrupt. It denies facts and data in favor of what is profitable. There are certainly biological issues that inform how people behave, but those are the province of neurology, nutrition, pain management, endocrinology, etc. Psychiatry itself is a sham – it has become the pretense of knowing something that they don’t know so they can make money and control people’s behavior. Very, very different than working towards understanding the causes and possible interventions for mental and emotional distress.l
I have no problem with taxpayers subsidizing actual medical care for those who can’t afford it. I have a big problem with taxpayers subsidizing the unnecessary creation of “disability” so psychiatrists and drug companies and others in the “mental health industry” can make bunches of money off the taxpayer!
Of course he’s not. Why would anyone think that he cared about this area? It appears he is no different than most of his predecessors – as long as his buddies in the healthcare/pharmaceutical industry are making good money, as long as stock prices are up, he doesn’t give a crap how much waste is occurring.
I agree 100%. That’s why I find it best to focus on evil ACTIONS. The Rosenhahn Experiment and Nazi Germany, as well as many other examples, prove that many “regular” people can commit evil acts under the wrong circumstances. Let’s work at changing the incentives so that doing evil things doesn’t pay off!
So we focus on the evil of the ACTIONS involved rather than trying to figure out which PERSON is evil or not evil. It feels a lot cleaner to me to say that the psychiatric paradigm was designed with evil intent than to try and sort out individual motivations, which in my view are all over the place. This protects us from the “counterattack by anecdote,” saying that we are wrong because psychiatrist A is really a nice guy and helped get me off of the stuff that was hurting me. Psychiatrist A may be a stellar human being, but if he’s labeling people based on behavior and prescribing drugs without consideration for their long-term negative effects and is not providing informed choice to his clients, he’s engaging in evil actions, regardless of his intent.
There is a difference between those who knowingly perpetrate evil in the name of profits or power, and those who are genuinely deceived and believe they are helping. I’d agree that those at the top of the APA/psychiatric hierarchy are, indeed, evil, but many front line psychiatrists are simply confused or frightened of bucking the system. Of course, it doesn’t make that much difference for the recipients – it’s still evil, but it’s important not to let the leadership off the hook by blaming poor results on “bad prescribing practices” or “a few bad apples” or “a lack of training in the field.” The leaders are the ones intentionally perpetrating evil, though as noted, there are a lot of evil folks who go into psychiatry because it gives them power. There are also a number of dissident psychiatrists doing research or organizing projects to alter the status quo, and such people are most definitely NOT evil.
So organized psychiatry, IMHO, is organized around an evil purpose. Individual psychiatrists may or may not be evil, and need to be judged on a case-by-case basis.
“Psychiatric diagnoses are poor indicators of treatment, and also of outcomes.”
What use is a “diagnosis” that doesn’t correlate to either effective treatment or case prognosis? Answer: no use whatsoever! Might as well call someone a “dunce” or a “spoiled brat,” as these labels have equally poor relationship to any concrete intervention or outcome. The DSM is just a rarefied way of name calling those whose behavior we don’t like and/or don’t understand. While I think it would be BETTER if we required diagnostic reports, it still would give credence to these nonsense labels, which as Lawrence points out are actually no more or less than a list of insurance billing codes. The best approach would be to call the psychiatric profession out and demand the DSM no longer be used as a diagnostic manual at all. If they want to put down little numbers for the insurance company, I guess that’s their problem, but these labels have next to nothing to do with helping clients, whether the clients like the labels or not. After all, we don’t decide someone has cancer or doesn’t based on whether they like their label or not. It’s idiocy and it needs to be abolished!!!
This is some sick shit. Emotions are an organism’s guide to survival. What arrogance to believe that somehow another person is going to be able to improve on nature’s guidance system! Is it going to be helpful to a soldier to be “happy” during a battle? Should the domestic abuse victim be “calm” while being beaten nearly to death by her abusive partner? Should a person crossing the road be “content” despite the danger of being hit by a car on the way across?
Very dangerous idiocy! I can only hope that the trials will be so disastrous as to prevent any attempt to apply this kind of futuristic nightmare to the general run of humans!
One thing I think you missed, Phil. Psychiatry is now claiming meditation/mindfulness as a psychiatric intervention???? Really?
I would think the answer to your product being disliked is not better advertising. It’s making a better product! One can hardly claim that psychiatry suffers from lack of awareness – in fact, those who lack awareness of psychiatry are more likely to think they’re going to get something valuable out of the experience! Almost all critiques of psychiatry come from people who are very well aware of exactly what it represents. You can con people into coming into your restaurant, but when the food sucks and sometimes kills people and the door is closed and locked behind you so you can’t escape and they force the crappy food down your throat, your restaurant is going to get some bad reviews, no matter how well you “brand” your food.
I think this is pretty conclusive as to the integrity and real intentions of the field of psychiatry. There are hard data showing that using non-drug interventions first is better, and there are hard data showing that outcomes are no better or sometimes worse for long-term use of stimulants, yet stimulants remain the first-line intervention for “ADHD” despite even their own recommendations to the contrary. “ADHD” has become an excuse for blaming kids and adults avoiding their responsibilities to go through the struggle of finding the right way to help children become functional adults. It’s not a medical intervention, it’s an excuse for adult intellectual laziness, plain and simple.
Have you picked up on the thread that the psychiatric leadership is not really “working on it” due to corruption? That they are dedicated to biological “explanations” regardless of what the research shows? I think there’s a lot bigger issue here than understanding the mind or behavior. The problem is that the profession has stopped honestly looking at the data. Sure, there are undoubtedly physiological issues that cause SOME of the manifestations of “mental illness” in some cases. But psychiatry is not interested in making these distinctions. They appear to be interested in selling their “services” and the drugs that go with them. That’s a very different problem than figuring out what a particular person needs to assist them with their mental/emotional distress.
Yup. That sums it up. Anyone who thinks they can tell anyone else what they’re supposed to think or do is a dangerous person. A profession dedicated to that purpose is deadly.
The fact that we’re even considering using smartphones as a remedy for “mental health symptoms” is an ironically sad commentary in itself. That said, it appears they do as well as antidepressants, and with no real side effects. Which is an even sadder commentary on the state of “mental health care” in the world today.
It is also true that those who have been traumatized are more likely to develop physiological issues like endometriosis. But it’s good that the piece recognizes that chronic pain causes people to feel emotional distress. I just wish it weren’t called “mental illness” in the piece.
I agree. Shame in our culture is heaped upon its victims to protect the powerful from accountability. Such shame, is in my opinion, the result of repressed RAGE against the powerful using their power for evil. It’s not safe to express the rage, so it turns into shame. It is also true that there is no obvious target for the appropriate rage, so it ends up that we turn it on ourselves. Which to me makes the violations that much worse – there is not even an opportunity to fight back!
If not government, than what? Government is SUPPOSED to be collective action by the people. It has become corrupted, and psychiatry is just one aspect of that. And the collusion between industry and government is central to that corruption. But I would suggest we need to take government BACK from the corporate elite. I don’t know any other way to control the power of the corporate giants. What do you think?
Actually, those are not all or even mostly from medical “Mistakes”. The majority of those deaths are from properly prescribed and properly administered pharmaceuticals. Visiting a doctor is dangerous, especially a psychiatrist!
Awful! I just wish it were surprising or unusual. I’m glad you’ve found a pathway out, though I understand you’re still working on escaping, at least you have that as a goal. Hang in there, and thanks for sharing!
I have seen moments where acute use of psych drugs have brought a completely incoherent person into a state where communication was possible within 20 minutes. I think that’s good medicine. But it’s kind of like pain relievers. A person comes in with a broken leg, you use opioids to help bring the pain under control. THEN YOU MEND HIS LEG! You don’t prescribe opioids for life because he has “excessive leg pain disorder!”
I honestly have no beef with Susan or her efforts. I’m simply commenting on how this kind of intervention seems to go, based on too many years of watching “promising new treatments” become marginalized by this process. It is very encouraging to see homeopathy, naturopathy, chiropractic, acupuncture, etc. reach some kind of mainstream acceptance. But the MDs and their drug company allies are still in charge and will make sure they stay that way, and that’s the real issue I think is not dealt with by this approach. I know you agree with me there, but I just wanted to clarify that point.
OMG, that is just AWFUL! I can see no rationalization, even in the crazy rules of the psychiatric world, for restraining a person who is not violent, and this catheterization is just plain abuse. I can only imagine the rage I would feel after having this done against my will!!!! You are kind not to have beaten them to a pulp at the first opportunity. The shame you felt should be THEIRS! THEY are the ones who deserve to feel awful about the violence they perpetrated for you!
Well, exactly! The thing I learned VERY early on in my experience was that I had to always ask the question, “Whose needs am I meeting?” If every action I took was run through this question, both before and after I took it, I rarely if ever ran into problems. Of course, this requires a brutal level of self-honesty that is not a part of training for most therapists, and that I achieved through personal work and an unrelenting observation of what got results, not any kind of “therapy training.” If something helped the client feel safer, more connected, or more in control of his/her life, it was good. If not, I trashed it. Case by case. I used to joke that my assessment procedure involved: “Try something that seems like it might work. If it works, keep doing it. If it doesn’t, do something else.” All these theories and manualized approaches simply don’t take into account the uniqueness of each human relationship. For some, self-disclosure was an essential element of moving forward. For others, it got in the way. There is no “rule” that governs when it’s helpful – it’s helpful when it is, and it’s not when it’s not. I guess it’s called “being human.” There is simply no formula for good helping behavior!
Your wisdom shines through in this thread! Being present and allowing others to be who they are safely – that’s what we all need! And you’re so right, no matter how great a relationship is, there are conflicts that need to be worked through. How we work through them is what differentiates a successful from an unsuccessful relationship.
Oh, and BTW, “oversharing” is my specialty. They always warned me against “self-disclosure” as a counselor, but I self-disclose in sessions all the time! I find that it’s essential to make me seem more like a real person to the one I’m trying to help. The less like a therapist I acted, the more helpful my actions seemed to be. It seems that the most helpful think we can do is to just be a caring person who is willing to be with another in experiencing their pain.
Dang, that sounds like the OPPOSITE of what I have found helpful for me and those I’ve tried to help! What most people need is what you said at the end – to be encouraged to accept their feelings as NORMAL RESPONSES to abnormal events and an abnormal society. What gets us into trouble in the first place is being unable or unwilling to experience our strong emotions. It sounds like DBT, at least as you experienced it, is a sure way to keep someone agitated and upset! Thanks for sharing your experience, and I hope it helps others prepare to avoid that kind of experience in the future.
I tend to agree. “Integrative mental health” gives credence both to the DSM and to the concept that psych drugs are a legitimate “medical intervention,” which they are not, at least beyond acute/emergency care. While “integrative medicine” is an improvement over the allopathic-only standard we’re all used to, it still privileges MDs, drugs and surgery as the “real” interventions, and is mostly an attempt to coopt alternatives into the Big Healthcare machinery. This is bad enough for physical heathcare, but when we go to “mental health,” it is an outright disaster. “Integrative mental health” is a way for psychiatry to maintain its dominance and avoid any real accountability for its dishonesty and the harm it continues to do.
I think you said the most important thing – they get sued for not following the “standard of care,” no matter how stupid or dangerous that standard may be. So who sets that standard? It is the more powerful “thought leaders” of psychiatry who have colluded with the drug companies to develop these “standards,” often white directly and shamelessly (see the TMAP in Texas as a telling example). It’s not accidental, it’s profit-driven, and the on-the-street psychiatrists, no matter how cool they are, can’t as individuals alter the standard of care. Also, those who DO follow the standard of care CAN NOT be sued, no matter how many people they kill! Antipsychiatry, to me, is opposition to this SYSTEM of harming individuals in the name of profit. There have always been psychiatrists who see through this, and I am certainly not opposed to those people trying to help. But the profession as a whole is organized to stifle ANY resistance, even from within their own ranks. That has to change, and it won’t until the financial incentives for establishing and following a destructive “standard of care” are eliminated.
I will also add that I have worked with DV victims for many years, decades actually, and I have not seen any evidence that any drug stops or even decreases domestic abuse. However, I have seen domestic abusers use the “My meds aren’t working” and “my psychiatrist is screwing me over” and “I have bipolar, what do you expect of me?” lines to justify continued abuse of their partners. Enforced Abilify will have no impact on that area, either. IMHO.
You did not answer my question. Do you want to live in a world where a person, without any legal authority beyond their own opinion and a rubber stamp court hearing, can force you to take Abilify, even if it makes your life miserable? I’m not talking about some theoretical violent teen, I’m talking about YOU.
And BTW, as you yourself have seen, taking Abilify or any other drug doesn’t necessarily make things better. There are plenty of people who committed violent crimes while taking these very drugs that are supposed to prevent it. Is there any real evidence that forcing people to take a particular drug has the predictable effect of stopping them from committing violent acts?
I think you are missing the point here. It’s not about whether the drugs help YOU in your perception. It’s about whether you should be FORCED to take drugs, whether you think they help or not, and be tracked remotely and punished if you fail to follow the orders of your superiors! You said Abilify didn’t work for you. What if your psych insisted you take it anyway, and sent the police around any time you skipped a dose? Is that the kind of world you want to live in????
Well, this should not be a surprise to anyone. This has been known by anyone not in denial for well over a decade now. Of course, facts never have had much impact on psychiatric practice – they prefer to blame early death on the “poor life habits” of their charges.
One thought that you could change (if you wanted to) might be the idea that you have to change who you are to be acceptable. It sounds like that message was pounded into you by your parents, your school, your peers AND your therapists. I had to learn that same lesson in my 20s, and fortunately had a quality therapist who understood what it was I needed to do. A therapist telling you how you should feel/react is the worst of all of your story – it’s unforgivable! Therapists should be on YOUR side, 100% of the time!
Thanks for sharing your story. I have to say, I’ve worked with lots of people with the BPD label and didn’t know a single one who didn’t have a story of being abused, labeled and misunderstood in their past. I also found school to be particularly traumatic, but no one wants to look at our society and how it contributed to making people “mad”, figuratively AND literally! I hope you can continue to connect with people who love and accept you for who you are.
Well, maybe they SHOULD shut it down. Even the administrators aren’t following their own rules, and it sounds like some of the staff actually HATE the patients!
The challenge I found working in the system wasn’t that I was forced to recommend drugs or any particular “treatment,” it was that the system was so committed (sorry, bad pun!) to that approach that I could make no impact on it. So introducing someone to that system meant introducing them to drugs in most cases, even if I personally did all I could to to keep them on another path. I couldn’t live with myself after a pretty short while! Though I have to say, when I started out doing residential care for teen moms, NO ONE was on drugs (1986). Things have changed dramatically for the worse.
Grief coach sounds good! How do you get “qualified” to do such work?
I tend to agree, bullying is more or less a consequence of our industrialized society where communities have been undermined by the need for mobile workers and homogeneous (if shallow) belief systems. I find it interesting that bullying programs in schools always focus on bullying of kids by other kids, but never address bullying of kids by adults, or the bullying of one adult by another. Kinda missing a big part of the picture, IMHO.
My caveat to that is that there ARE biological events and processes which affect “mental health,” such as sleep, nutrition, physical pain, other drugs, toxic environmental exposures, thyroid problems, etc. These should be looked at as potential causes or exacerbating factors. But the concept that you’re depressed or whatever because your brain is acting badly is pitifully lacking in any scientific validity. The vast majority of psychological/emotional issues are indeed stress-induced, as any bright 10 year old already understands. The amazing thing is how marketing techniques have overridden the commonsense understanding that most people have of how and why people get depressed/anxious/angry and how deeply this biological brain disease concept has become embedded in our society!
That’s where I’m at, too. There might be some minority percentage of depressed people who have something demonstrably wrong with their brains, but until there is evidence that this is the case, and these people can accurately be identified, medical approaches are dangerous and inappropriate except perhaps in acute and very temporary situations (like pain killers for a broken leg). Using psychiatric drugs to “treat” depression is like doing surgery with a jigsaw. You don’t even know what you’re fixing but you start throwing stuff at it and hope it goes away. We can all accomplish this at the corner bar. It’s not medicine.
What would stop a therapist from encouraging and supporting his/her clients’ need for justice through political action? I have been a therapist in the past, and I encouraged many domestic abuse victims to get involved in political action to protect survivors and their kids. I’ve also encouraged youth in foster care to get involved with a group of current and former foster youth that lobbies the legislature and even submits laws every two years (they’ve never failed to get one passed!), and I was an adult supporter of their efforts. And in truth, I had no “doctrine” except that “every person is different and deserves their own unique approach and relationship.” Of course, I had an advantage – I never got any actual training to be a therapist!
Yeah, if we’re going to label people, let’s go with “He’s a freakin’ asshole” rather than “He has Bipolar.” We’re both admitting to the fact that we’re making a moral judgment and also creating a context to expect him to behave otherwise, rather than making an excuse for his abusive behavior and creating feelings of pity rather than the appropriate righteous indignation.
I had what I consider quality therapy in my 20s, and far from teaching me not to have my feelings, I learned to be more aware of the injustices I’d experienced and to feel properly angry and hurt instead of pretending that nothing happened or that it was my fault or that “they couldn’t help themselves.” There were no excuses made for my parents, brothers, the schools, church, or any other injustice I’d experienced. She just made it feel safe for me to experience what I’d repressed in the past. Sure, it didn’t make the world more just, but it put me in a position where I could avoid or fight injustice where I saw it, and where I could recognize that the injustice that occurs is not caused by the recipient nor does it mean anything about the one being attacked or mistreated. I learned a LOT of important lessons, not because she taught them to me, but because she made it safe to FEEL again. Which is kind of the opposite of what you’re suggesting therapy is about. Now I’m the first to admit, I lucked out, and would be a lot more lucky today to find such a quality therapist, what with everyone trained to diagnose and judge these days. But to suggest that all therapy is about denying injustice and suppressing your feelings is not true, at least in my case.
They don’t include them because they have an agenda. Look how hard they worked to explain away Harrow and Wunderlink and the WHO studies! You’d think they’d be interested to find out how they could accomplish 60% funtional recovery rates. But their finanical conflicts of interest drive everything they do, and anyone in the fold who tries to go another direction is shouted down or driven out. It all comes down to MONEY. Psychiatry is hopelessly corrupt, and no amount of data, no matter how convincing, will change their attitudes.
“Draining the swamp” appears to mean letting those in industry “regulate” their rich buddies at an even more alarming rate than was already occurring previously. Probably better not to have an FDA than to have one rubber stamping for the industry!
You know what I’ve found the best marker of distress to be? I ask the person, “How are you feeling?” If they tell me they’re depressed, or describe a depressing outlook, I conclude they are depressed. I think this whole biological marker idea is just a waste of time. People know how they feel, even if they have a hard time explaining it to you. The only real thing a therapist can do for a person is to help them become aware of their own observations, and perhaps become aware that they can view the situation from a different perspective. I think biological changes are usually effects, not causes, and as such deserve very little scrutiny. And those that ARE causal (such as thyroid problems, lack of sleep, chronic pain, etc.) should be treated in their own right and not in the context of “depression.”
Impressive array of studies! Thanks for pulling this all together – must have taken a LOT of research. It will be very helpful to me in conveying this info to those in need of some education on the matter.
Yeah, they had the radical concept that being with someone in a loving fashion was the best way to help. Let’s imagine what the “mental health” system would be like if it was based on that concept! It would be unrecognizable.
Which is why it’s pretty much a waste of time. We know that heart disease is heritable, but there is no gene or set of genes that “cause” heart disease, because there are SO many variables that go beyond genetics that there is no way to even identify the genes that might convey vulnerability. Stress, style of eating, exposure to toxic substances, lack of exercise, diabetes, smoking, legal drug exposure (antipsychotics are particularly horrible in this area) and on and on. If this is true for heart disease, something you can visibly see and measure, how much MORE true is it for “mental disorders,” which are defined solely on behavior and emotional experiences that are far more affected by post-birth variables than heart disease.
It’s just a losing proposition, which is why they’ve never found a genetic basis for any of these “mental illnesses” as defined by the DSM. The definitions are made up based on social concerns. Why would all people who are depressed, anxious, intense, easily bored, etc. all be that way for the same reason? Why would we assume they have anything at all in common besides their behavior?
We’d be much better off spending our time and money reducing poverty and childhood trauma, and assisting immigrants with their integration into new cultural milieus. We might also learn a lot from studying cultures where recovery rates are WAY higher than ours, like Columbia and Nigeria and India. Interestingly, one thing those countries have in common is using a lot less antipsychotic drugs!
You’re not the first to observe this similarity. It is disturbing, but the use of power and control tactics permeates our society, and any time there is a power imbalance, those who enjoy feeling superior and humiliating others will gravitate to those positions. It also appears that our system is based on the assumption that their must be “authorities” who decide what to do and “clients/patients” who have things done TO them, so the power/control dynamics are built into the system, and even those IN the system who oppose such behavior are often powerless to stop it, as they are themselves abused if they step out of line.
The disconnect between the data and mainstream practice is so profound, and it seems that logic and research make no dent in it. It seems obvious that if you could safe 20% of people, or even 10%, or 5%, from the long- and short-term consequences of antipsychotics, anyone who cared about their patients would want to know. I can only conclude that caring about patients is a secondary concern (at best) of our leading psychiatric “opinion leaders.”
Supposing you identify a subgroup that has a certain gene. What would you suggest could be done to help these people as opposed to those who do not? This is not even considering the fact that 40 years of genetic research has failed to turn up any gene that explains more than a tiny fraction of any psychiatric disorder, or even of the vast majority of known physiological problems like high blood pressure and heart disease. But say we did discover such a gene – what would be the intervention?
Let’s say we discover that, say, 10% of cases of “schizophrenia” (whatever that is) have a genetic contribution. What do we do with that? What benefit is there to know this? How will it help us help people who suffer in this particular way?
We already know that traumatic exposure in childhood has an 80+% correlation to psychotic problems. We have not found anything close to even 15% correlation with genetics, even when multiple genes are included as well as multiple “disorders.” And you can’t do ANYTHING about genetics anyway! Why don’t we spend our time and energy dealing with the 80% effect that we actually CAN do something about, instead of wasting billions researching something that isn’t even within our control? Does that make sense to you?
I don’t think the suffering that is called “mental illness” in our society is made up. I think that the CONCEPTS they put forward as “mental illnesses” are in fact made up. In other words, people DO have mood swings, hallucinations, anxiety, etc. But finding someone who is genuinely depressed and saying “you have depression” really is an invention, especially if we regard “depression” as a brain illness of some sort. People are depressed for all sorts of reasons, some of them physiological, some of them psychological, some of them social, some of them spiritual. Calling them all “depression” takes away their meaning and prevents us from really looking into what is going on.
It’s easier to see with something like “ADHD.” We decide that being active and disliking boredom and not liking to sit still or take orders are bad things because kids like that are harder to manage in a classroom. And instead of talking to the kid or finding out when he is bored and why or creating more interesting and engaging things to do or challenging him with more advanced work or putting him into a different classroom with a more stimulating teacher or structure, we say “He has ‘ADHD’ and that’s why he’s having trouble” and we give him stimulants. I’m not saying he isn’t highly active and intolerant of boredom and disorganized, etc, etc, but why do we assume that all kids who act like that have something wrong with them? And why do we assume that all of them have the SAME thing wrong with them, and need the same “treatment?” Especially when we now know that this “treatment” doesn’t actually lead to better long-term outcomes, it seems pretty silly to just group everyone together who acts in a similar fashion and say they have a “disease.” Why not just say, “He likes to run around a lot and doesn’t like doing boring things” and go from there.
A description of behavior can’t possibly be a disease. It’s the IDEA of these “diseases” defined by behavior and emotion that is invented.
If “mental health problems” explain mass shootings, why does the USA have such a disproportionate number of mass shootings, when “mental illness” frequencies, by psychiatry’s own claims, are similarly common around the world?
I hate to tell you this, but in the USA, where we don’t have “single payer,” you still can’t really get a second opinion. Or you can, but it will almost always be the same as the first opinion, because the system tells providers what they can get paid for. The only way to get a real “second opinion” is to find a rebel who bills with the DSM but otherwise ignores it and does what helps. Such people are rarer than hens’ teeth, even in our “free choice” health system. Besides which, most people don’t have a free choice – their provider is chosen by their employer, and they are stuck with what they get. Of course, if you’re rich enough, you can afford to purchase decent therapy, but for the common man, single payer is not the barrier – psychiatry and its selling of delusional “diseases” is the barrier.
Few people would argue that the biological has nothing to do with what are called “mental illnesses.” The difficulty is one of objectivity. Even if the number’s arbitrary, you can at least say that someone has “high blood pressure” when their blood pressure exceeds a certain agreed-upon standard. There is no such standard for “mental illnesses.” In fact, just taking the biological aspect of depression, you are no doubt aware that depression can be caused or made worse by sleep loss, physical pain, vitamin deficiency, poor diet, lack of exercise, thyroid problems, low testosterone, other hormonal variations, and other physiological things? Does it make sense to say you “have depression” when your problem is low thyroid, and that someone else “has depression” when they are suffering from chronic sleep loss due to chronic leg pain? Why would these conditions be lumped together as being the same thing? They have different causes and different effective treatments. So how could you possibly develop an objective scale to measure something that is not really the same thing? It’s like diagnosing “pain” instead of looking for the cause of the pain.
That’s not even getting into the wide range of psychological/social reasons someone may be depressed. Does the person who was sexually abused as a child need the same kind of intervention as the one who is currently being beaten by her husband weekly or the one who is using methamphetamine or the one who is in a dead-end job and sees no future for him/herself? What about the one who is using heroin because she’s got chronic pain and looses sleep because her husband broke her jaw and she’s afraid to go to the hospital to get it repaired? How could these extremely variable presentations be considered the same “disease?”
Again, no one is denying that biological factors play a role. But to reduce “depression” to a disease denies the fact that people are depressed for a hundred different reasons and need a hundred different interventions. What is the point of defining a “disease” when the diagnosis doesn’t tell you what kind of help the person would need?
Exactly. I worked with foster youth for 20 years. No matter how badly they were beaten, abused, abandoned, humiliated, and unstabilized, it was always the kid who got diagnosed. I like the idea of the “holy fool” – certainly can’t be anything but a step up from the “cursed victim” approach we are taking today.
It is sad in the extreme that our system is so warped that no one even wants to hear about how traumatized you were as a kid, or even as a wife on an ongoing basis! But you are far from alone. The best I can suggest is that you figure out what to tell them so they’ll let you out, and then fade into the woodwork so they can’t find you again, and meanwhile, find a support group for domestic abuse victims or those sexually assaulted as children. Your peers will be a much more reliable source of support than these sadly mis-educated, insecure “professionals” who are too scared to feel anything at all.
I agree that Borderline PD has been used as a means of silencing or ridiculing those who have experienced abuse. In the end, it is simply a description of how some people act when they have not been protected from harm early in their childhoods. It means nothing about you, but a lot about them that they need to use this label to defend themselves against the reality of childhood abuse and molestation.
I wonder if you can redirect your anger toward a mission to simply escape their clutches and find another pathway forward for yourself that allows real healing?
Another no brainer study. Loss of sleep almost always precedes psychotic episodes, and anyone deprived of sleep for long enough will start to hallucinate. But of course, the DSM is “cause neutral” – God forbid we should actually try to UNDERSTAND why a person is acting as they are!
ADHD voices seems pretty slanted to me – a little genuineness mixed in with a lot of propaganda. Or am I missing something? Psych.ox, on the other hand, seems more genuinely objective and willing to critique the status quo.
The other aspect of psychiatry that is cult-like is the intolerance of any facts that conflict with the agreed-upon dogma. This is where psychiatry is most like a religion – they have their “scriptures” (the DSM) and any attempt to question the scriptures is punished by shaming or ostracism.
You’re actually saying the same thing I am – science is not able to study the mind because the mind transcends the physical plane of existence. Studying the brain will never lead to understanding of the mind. Materialism is a school of philosophy, not a requirement for being “scientific.” I do believe that science can study the manifestations of the mind IN the physical universe, but there is no way science can determine that the actions of the mind ” are all automatic.”
Hey, I am all about mindfulness and meditation and Buddhism. But it’s still not science. It’s philosophy, which I consider VERY important, but it’s not science. My contention is that science has nothing to say about free will, determinism, or mind streams, and my objection was to the statement that “scientific research has shown that all our experiences are automatic.” My philosophical assertion is that this is impossible to prove by any scientific means. Science has no clue what the mind is, and as long as psychiatry or any other discipline insists on studying only the body, it will never have any clue. I agree that Buddhism does the best of any discipline in defining and understanding the mind. But again, Buddhism is not science.
By the way, I understand what you’re saying about the mind stream, and it is arguable that the decisions a person makes are inevitable, since all events and input led them to that decision at that time. But that seems to be freezing time and the moment of decision, and time is not frozen. A person has a decision to make, and they make a decision. Perhaps it is true that they are inevitably going to make that decision under the exact same circumstances, but of course, that premise is completely untestable, since we can’t go back in time. For this reason, I contend that there is no way to “prove” that a decision could or could not be made another way than it is. It is pure philosophical speculation, not science.
Sorry, I see absolutely no way that scientific research could possibly determine that all our experiences are automatic. And people do things for their own reasons, not always due to social pressures. In fact, some times people choose to go against advice, suggestion, social convention because of some value-based decision regarding higher priorities. It seems likely to me that you and the other scientists are simply assuming materialism to draw your conclusions. If you can provide me a live link, I could analyze it further, but on the face of it, I see no way that anyone could conclude anything about how decisions are made simply by studying brain scans and the like. Perhaps you could explain how this conclusion is drawn. I am not saying that the belief in independent will power is any more or less scientifically supported. I’m saying that science has nothing to say about it, as the human mind is the most complex and mysterious phenomenon in the world, and I doubt that it will ever be explained by science.
I do like this analogy also. The painting is more than the paint and the canvas, and you can study the components of the paint and canvas for years and years and learn exactly nothing about what makes a painting. Because there is MEANING in the painting, there is an intended communication of an idea which is in no way reducible to the medium used to communicate it. It is actually pretty insulting to any human being to suggest that their life and decisions have no meaning. It’s about the same as saying that a painting is no different than a can of paint being spilled on the floor.
So are you suggesting that I can’t decide to teach myself to dance or to pitch a base ball or to memorize a list of spelling words? Are you saying that something “leads me” to decide to learn to pitch and that I have no choice about it? Again, determinism is a PHILOSOPHICAL viewpoint, not a scientific one. I’d suggest that it is apparent that humans do, in fact, intentionally reprogram their brains based on their personal intent. This is a free-will argument, and I don’t see you have said anything that suggests it is not true, other than that you don’t believe in that concept personally.
I think you can at least conclude that the treatments offered don’t improve the situation. If you looked at knee pain, people with more severe knee pain might get more pain relievers on the average, but one would assume that the overall TREATMENT for knee pain would REDUCE the knee pain over time. What is the point of “treatment” if more severe sufferers don’t accomplish a bigger reduction in suffering from receiving increased treatment? The “more depressed people get more antidepressants” argument doesn’t hold water.
That’s a very good point. Unfortunately, psychiatry has defined the terms of engagement, and if one wants to make an impact within the system, one has to start from their definitions, no matter how irrational or subjective. The good news is, even using their own terms and measurements, their drugs fail miserably! Proving such may be a key part of establishing a new paradigm where recognition of the idiocy that underlies defining “diseases” by behavioral or emotional manifestations becomes the new reality.
Of course. The point being that the program is independent from the “hardware,” though it may be stored in the “hardware” and/or use the “hardware” to execute.
This site exists to distribute actual DATA from scientific studies, as well as anecdotal stories such as your own. Your story is data of a sort, but all it demonstrates is that sometimes these drugs work well for some people. The study, however, looked at many hundreds or thousands of people, and it showed that ON THE AVERAGE, antidepressants made no difference or in fact made things worse, and that most people are better off without them. This finding does NOT conflict with your story in the least. It says that your experience is not what most people will experience, that’s all.
My question to you is this: if you are so comfortable saying that this approach worked for you, why does it bother you when an honest research study is published whose results are not what you expected? Do you believe that your personal experience must translate into everyone’s personal experience? Do you think psychiatry should be based on science, or individual stories? Why is it difficult to accept that a study might find that most people are not having the same positive experience you have had?
Of course, the REAL mystery is who the “programmer” is and where s/he resides. This is a mystery that materialism has not even vaguely approached, and has only dealt with by denial.
It appears to me that knowledge is synthesized information that is useful for the purposes of solving a problem in survival. It does not appear to me that there is a requirement of social interaction to have knowledge – merely a sentient relationship to the environment. A hermit still has the knowledg of how to build a hut, set a trap, light a fire, etc.
As for mind-body dualism, most definitely not required in the sense of body-spirit as separate entities (though I will note that no one has presented scientific evidence that eliminates that possibility – the requirement that all things reside in the physical universe is a philosophical one, not a scientific one.) It should be very clear that the brain runs the body, but that it is clearly and obviously “programmable” by experience and education. It is easy to observe that the “program” can be massively altered without any change to the “hardware” at all. So it is that some people speak Chinese from birth because that’s what they are taught, but they can learn English or Swahili by reprogramming. I would suggest that the MIND is the analogy for the program. This theory effectively explains all actions of the mind without resorting to mind-body dualism at all.
The “mind-body dualism is wrong” argument is a bunch of hot air. Too bad so many folks confuse science with the philosophy of materialism. They are not even close to the same thing.
If someone hits you with a car, and your leg is broken, is it invalidating to talk about your leg healing? Is it blaming the victim of the car crash to say, “Hey, if you set that bone and splint it, you will probably be able to walk normally again?” Does it make it like the bone was never broken? No. Does it mean you’re able to function better, even if you’re not back to 100%? Yes. Does it excuse the person who hit you with the car? Absolutely not. I am the last person in the world to blame children for the abusive behavior by their parents or by the system. I am simply saying that there are things that a person who is hurt can do to make their lives more livable. Part of that healing might very well involve taking political action to fight the systemic abuse of kids and others.. It often does. But healing does not, in my mind, imply even forgiveness of the abuse, and absolutely does not include blame of the person so harmed. It’s just a question of whether you have to sit on the road with your leg broken for ever, or to take action to help it mend after the trauma of the accident. Hope that makes things clearer.
I met a guy when I was advocating for nursing home residents who was so drugged that he could barely open his eyes, and had bruises on his head from running into the doorframe, as he could not navigate through the door. I talked to the activity director, and she said they’d been hitting a volleyball back and forth in the courtyard only a week or so before. They put him on a neuroleptic for “aggressive behavior,” not for a “mental illness” diagnosis. Something tells me his sudden inability to play volleyball (or get out of his chair for that matter) was not because his “mental illness” was so severe.
I am with Chaya. I have worked for many years with foster youth and I can say that hitting, beating, burning, sexual abuse are by no means restricted to the poor or working classes. That being said, I do agree, Tireless, that rich and middle class folks are often able to avoid the consequences of their violence and abuse, as they can afford to hire threatening attorneys, they live further away from neighbors and mandated reporters, and their status enables them to claim “I wouldn’t do something like that” with more credibility. That’s the nature of privilege.
I would also disagree with you that no healing can occur. It’s true, like any injury, that spiritual injuries leave a scar behind, but I have known many people who have made very workable lives for themselves and who have achieved a large degree of happiness and peace of mind despite abuse they experienced. It can never be like it never happened at all, but it is possible to find a way forward for many folks. I think each has their own path to get there, but don’t give up hope – it can and has been done!
Gosh, if you are SO concerned about the “sedentary behavior” of people with “SMI,” maybe you should stop giving them drugs that make it difficult to move and difficult to get motivated to do anything! And if you’re so concerned about heart disease, maybe you should stop giving them drugs that give people diabetes! Sheesh!
As usual, they miss the point. The reason they lack “cross-cultural validity” is because the scales are “measuring” cultural constructs loaded with bias. Naturally, different cultures have different biases, so the “tests” look different if you run them in another cultural milieu. The real answer it to stop pretending they are “measuring” anything real, and remember that “psychopathology,” as academic as that word makes it seem, is almost completely a matter of cultural values, and is, therefore, not measurable as a “real” quantity.
I have always thought that “boundaries” have become an excuse for avoiding genuine human interaction. And you’re right, they have also become a power exercise for staff who have big control issues. I find it pitiful, as genuine human contact appears to me to be the #1 antidote to “mental health disorders.” The whole industry is corrupt and disturbed. They are the ones who need healing!
Seriously? People are worried about “power poses” when millions are dying decades earlier due to the dishonest and often forced prescription of antipsychotics and other drugs? Give me “power poses” any day!
If only today’s working class and poor of all races would learn this important lesson! As they said in “The Hunger Games,” “Remember who the REAL enemy is!”
Fantastically written, very moving testimony! As always, it is love and compassion and shared humanity which heals. Perhaps the psychiatrists and the mean staff have never had this experience themselves and are in need of some hugs from the residents/inmates, who appear to understand far more about “mental health treatment” than the staff does!
I think the underlying issue is that we live in a culture that is fundamentally based on oppression. While oppression affects people of color more severely, the fact is that ALL of us operate under some degree of oppression, whether from being female, being children, being elderly, being poor or even working class, or whatever. Even powerful white males experience oppressive conditions, because in order to keep their dominance, they have to agree to operate within certain very restrictive and dehumanizing rules, including being expected to fully support the oppression of others lower on the economic/power scale than themselves. This is easily seen when a kid in school stands up for the “weird kid” or the gay kid or the bully’s victim – even if that kid is not in a despised group, s/he quickly becomes the victim of bullying him/herself as soon as s/he steps outside of the expected behavior of the dominant culture. This will only change when folks band together and realize that the dominant culture itself is the problem, and that bullies can’t bully when the group rises together in resistance.
It is interesting that they talk about “differing demographics impacting imaging results” or some such, but overlook the more important conclusion: BRAIN DEVELOPMENT IS MASSIVELY IMPACTED BY ENVIRONMENT! This kind of research should immediately put any speculation about “brain illnesses” explaining “mental health issues” to rest, but of course, the authors don’t even notice this very important issue and focus instead on “sampling problems.” It shows how biased and unbending the medical model worldview really is.
Why anyone would believe that all or most cases of a “disorder” identified by behavioral or emotional characteristics would possibly yield genetic causality is beyond my comprehension. It’s like trying to find the cause of car accidents. Yes, they have the similar appearance of one car crashing into another. But they can be caused by sleepy drivers, ice, poor road signs, aggressive driving behavior, distractions, mechanical malfunctions, and on and on. To postulate that EVERY car crash is caused by something wrong with the car is idiotic. Similarly idiotic to suggest that a particular behavior pattern MUST always be caused by some kind of genetic fault in the person engaging in the behavior. Unfortunately, facts don’t seem to deter these fanatical researchers, because they just KNOW they will find a genetic cause because it HAS to be genetic because, because, well, you know, SCIENCE!
Part of the larger issue of corruption and propagandizing by the power elite. If the focus is freedom to make one’s own decisions without lies and force, I think there isn’t as much room between you and the “reformers” than you might imagine. It is for the most part only the hopeful and perhaps delusional belief that these guys will listen to reason that differentiates the two groups, IMHO.
Sounds like Alice Miller’s work. She’s amazing if you’ve never read her. Totally gets the impact of even more diffuse trauma, like constantly getting the message you’re not living up to parental expectations, or being expected to emotionally care for a parent who is not specifically abusive but needy and self-centered. Of course, she has been ignored or castigated by the mainstream.That’s usually a sign you’re onto something, when the Powers that Be get upset with you!
Right – that’s my objection, because saying “overdiagnosis” suggests there is a correct level of “diagnosis” that is being missed somehow. But how could the correct diagnostic frequency ever be established when there’s no measurement to refer to? Even hokey medical diagnoses like “obesity” have a numerical standard, if a somewhat arbitrary one. You can measure someone’s weight and height or BMI and say where they fall on the scale. You can’t even do that with “mental illness.” You’re ill because someone decided you are ill, and the culture supported it. It’s such BS, but unfortunately most of our society is brainwashed into thinking it makes sense when it does not.
I have also known lots of foster kids who were “diagnosed” in their younger years, but who miraculously “recovered” once they escaped the foster care system and their enforced “mental health” treatment. Certainly, many foster youth go on to the adult “MH” system or to the prison system, but I strain to think of even one “recovered” foster youth who attributed his/her success to proper diagnosis and medical “treatment” of his/her “condition.” They always describe a PERSON or RELATIONSHIP or ACTIVITY they engaged in as critical to their success.
They tend to recover when they have a sense of purpose and are able to assert some control over their own lives. Weird, isn’t it, how having more control of your life and decisions and environment helps make you “mentally healthy?”
They are missing the most basic reason – there is no definition for “overdiagnosis” when there are no objective criteria for “diagnosis” in the first place. The main reason for “overdiagnosis” is that anyone can be diagnosed with anything based on someone else’s opinion, and there are HUGE incentives to diagnose and therefore blame kids for creating problems that are actually created by adult inflexibility, neglect, or abuse.
This is the ultimate truth that psychiatry and the drug companies have been empowered to cover up. And it’s not just parents – our social institutions are very responsible for abuse, physical and emotional. Churches and schools promote fear of authority. In my case, this included being hit and sent out of the classroom in second grade for speaking up when the teacher tossed a book across the room in a rage, as well as being laughed at and abandoned in a hallway by a Sunday school class at the age of 4. These are only the more obvious manifestations. The maxim “It’s no one’s fault” was created to protect adults from responsibility for their hurtful behavior toward our society’s children, and also from becoming conscious of the fact that they were abused in the same way when they were kids.
Thanks for speaking the truth, Chaya, and eloquently!
This would mean that our bought-off congresspersons will have to bit the hands that feed them. The flow of money from big corporations to our politicians will have to stop before this kind of scandal is actually taken seriously. I just read that Trump’s new appointment for Drug Czar helped right a bill to hamper the DEA investigating drug companies involved in this very problem. Corruption is at the core of these problems, and needs to be our real target!
It seems a shame that the same kind of thinking (not hiring all-or-nothing thinkers) does not apply to the “professional” staff in our hospitals and mental health institutions. It seems that “placing your views on others when they don’t ask for it” is allowable only for those who have degrees and sufficient power in the system.
This article provides an excellent analysis of how the diagnosis-focused viewpoint impedes actual investigation of real issues, and how parents can influence school behavior. It unfortunately does not directly address school staff behavior or structural issues that help create these “ADHD” problems. However, it does a great job of showing just how totally subjective this diagnosis is, and why the very concept of diagnosing creates more problems for kids AND schools than it ever can possibly solve.
Corruption is, indeed, the key to why things keep staying the same. We have to develop incentives for people to do the right thing, and penalties for doing the wrong thing that are much larger than the profits gained by doing it. It is a very complex process to accomplish this, however. In the meanwhile, people are being hurt TODAY and I believe providing and promoting alternatives is essential to minimize the harm that’s being done, as well as providing a direction for our incentives to push people once we gain control of the wheels of power.
The real problem is that “power corrupts,” and it is always possible, maybe even likely, that if people within this movement gained control, they would perpetrate similar oppression on those without. So the ultimate goal, I think, is shared power, and that CAN be promoted both locally/immediately to those in need, as well as politically, as we work to get money sidelined in political matters. But that will not happen without a big fight, and we need to join together with other anti-oppression/human rights movements on some shared goals and strategies.
So I don’t agree 100% with the “failure” assessment – every movement has to have a base, and again, we can’t forget those who are suffering today in pursuing larger goals. But you are absolutely correct – financial incentives drive the current system, and it won’t change without changing the incentives, no matter how much data or stories we present.
It is fascinating that this whole article regards “social isolation” entirely as a failing or deficiency on the part of the individual, rather than recognizing that our social and economic system CREATES social isolation as an inevitable “side effect.” This fits with the entire psychiatric paradigm where the individual is always responsible for any ill effects that occur as a result of our social institutions. Those in power to effect changes in these institutions are, as always, let off the hook.
The concept of using “CBT” to enforce “medication compliance” violates the most basic tenets of therapy. The therapist is supposed to form an alliance with the CLIENT, not to “collaborate” with the psychiatrist or the client’s parents to enforce their will! It shows just how far “therapy” has drifted from actually trying to help the clients to becoming a part of the oppressive system that creates “mental health issues” in the first place.
Well, dogs got protection from abuse before children – maybe if dog owners start getting upset about their doggie friends being screwed up by SSRIs, the idea will eventually translate into protecting children, and maybe someday even adults!
Pat, so you admit you just like screwing with people? Essentially, admitting you’re trolling? On that basis, I’d suggest that no one should respond to you ever, as you are clearly not serious about establishing the truth of the situation. I will begin applying the policy of “ignore the troll” starting immediately.
‘Common in the literature are statements like “While the short-term efficacy of stimulants for ADHD is well established, information about their long-term effects is sparse.” ‘
This kind of claim is rather disingenuous – it leaves out that the fact that what studies have been done (and there are several at this point) suggest that stimulants have either no effect or a deteriorating effect on the outcomes that ADHD supposedly puts at risk. Extensive reviews have been done in 1978 (Barkley), 1993 (Swanson) and 2001 (Oregon State University), all showing that there is no major long-term outcome area in which “treated” kids do better than “untreated,” including academic test scores, high school completion, college enrollment, delinquency scores, social skills, or self-esteem measures.
Moreover, the naturalistic studies which have been done, including the Quebec study, the Raine study, the MTA (mentioned above) and the USA-Finland comparison study all showed NO positive long-term effects for stimulant users as compared to short-term or non-users. The Quebec study showed higher rates of emotional issue for stimulant users, especially girls, and the Raine study showed much more likelihood of being held back for stimulant users.
So to claim that evidence is “sparse” denies reality. Such evidence as has been collected is uniform in showing no long-term effect on social or academic outcomes for stimulant use. It is high time the academic psychiatry world acknowledges what should now be an accepted fact.
It is unfortunate that you seem incapable of a civil conversation, Pat. Why do you insist on insulting posters just because they express a point of view you don’t agree with? Is it just possible that other people had different experiences with the MH system than you have?
No argument from me on those points. Though it is indeed obvious to a child, I have unfortunately found many “mental health professionals” to whom this appears to be a foreign concept.
People with privilege don’t need to be denounced; we simply need to be aware of such privilege and how it arises. It is not the fault of the privileged that they are privileged, but it does create a much higher level of responsibility for critiquing and altering the system when it harms those with less privilege. Ultimately, the goal I would pursue would be to minimize privilege differences, which is actually part of the “American Dream” we’re all supposed to be allowed to pursue – essentially, everyone deserves a fair shot at success, but the game is rigged.
I’m a white male from an upper-middle-class background and so have plenty of privilege automatically sent my way by this society. I don’t need to feel bad about that or apologize for it, but I do need to use that privilege consciously and wisely to help empower and improve the lot of my fellow humans. I am sure I fail at this all the time, but that’s one of the reasons that issues of psychiatric oppression, as well as racism, domestic abuse, and the mistreatment of children, have been big focus areas in my life – the folks I mentioned don’t have social power and I do, and it’s my job to try and alter the system so that those with less power are able to get more of it and have a better chance at survival.
It is unfortunate that “privileged” is seen or is even intentionally used as an insult or put down. It should be neither. It should be a call to action to empower those lower on the privilege scale, as well as a call for compassion and understanding for those who are not so fortunate as yourself, rather than blaming those without privilege for their condition when a large part of their condition is a result of social dysfunction and is not within their control. The parallels to the “mentally ill” being drugged and institutionalized should be pretty obvious in this context.
It is a possibility, but marketing is not really something I’m any good at. CatNight also outlined some of the limitations – when you work without insurance, you’re working with the rich or well to do, and those who are most in need of help can’t afford it. My adjustment has been to go into advocacy, which requires no specific license and enables me to help change the system which creates much of the distress which I would end up listening to in therapy. My bottom line is that real therapy has to involve engaging in a reassessment of the social system in which one lives, not only a re-examination of one’s own beliefs and values. And that can be done from other perspectives besides being a therapist. Of course, a lot of folks get free counseling from me on a short-term basis, just because that’s the way I am and sometimes I’m called into service. But I have never figured out a way to make a business out of it. It’s kind of not me, I guess.
Thanks for your interest, and thanks to CatNight for your in-depth response as to why it’s not as easy as hanging out a shingle.
This seems off the topic of the blog. The question at hand is whether psychological phenomena are the consequence of brain activity, or independent phenomena that can be studied or acted upon independent of the brain. You seem to be saying you accept the former. However, I wonder if you are recognizing the fact that both positions are philosophical, not scientific, positions. As I think has been stated multiple times directly to you, there is no actual evidence that any of these “mental disorders” have a consistent biological cause or treatment. So depression may SOMETIMES be the result of a bodily system breakdown or even of “low serotonin” in specific cases, but there is no GENERAL condition that “causes depression,” because “depression” is not a thing that can be caused, it’s a natural body reaction that is caused by many different potential things. The idea that “depression” is a specific state that is always caused by the same thing and requires the same “treatment” is exactly the concept that has led psychiatry down the false path it currently follows.
* Exercise
* Sleep
* Support groups
* Journaling
* Talk therapy with a COMPETENT trauma-focused therapist
* Meditation and other spiritual practices
* Changes in life circumstances that create unresolved stress (boring job, bad relationships, kids out of control, etc.)
* Active volunteer work
* Political activism to resolve poverty, racism, and other issues that impact lots of people’s emotional state
* Seems silly but highly underrated: stop watching/reading the news!
Love to hear others’ ideas on this! Great question!
Not sure where I read that communism or even socialism were antidotes to psychiatry. I don’t think capitalism is, either. It appears to me that the fundamental issue with psychiatry has to do with believing that humans can be grouped into those who “live correctly” and those who “have problems,” and that “having problems” with the status quo means you are “mentally ill.” I think it’s pretty obvious that this kind of oppression is not dependent on political beliefs, but on an unwillingness to face the true level of oppression that exists within our society and a willingness to “blame the victim” when something goes wrong. In other words, those in power, regardless of party affiliation or of political orientation, are happy to use the “mental health system” to keep their populations under control. We saw Stalin use psychiatrists to herd dissidents into internment camps. We saw Hitler use psychiatrists (or was it the other way around?) to herd Jews and other “undesirables” into concentration camps for forced labor or extermination. Psychiatry is an equal opportunity oppressor – it can be and is used by both ends of the political spectrum to keep the common person in line.
Or as Mad Magazine once cleverly put it: what’s the difference between Capitalism and Communism? In Capitalism, Man exploits Man, while in Communism, it’s the other way around.
I meant my last “mental health job.” I have worked in several other jobs since, but that job did me in as a participant in the “system as usual” approach.
I haven’t been “in the biz” for decades. My last job involved evaluating people at the hospital for involuntary detention in the psych ward. Three days in, I knew I had to get out of that job, though it took months to find something else. Don’t get me wrong, those who met me were very fortunate, as I worked my ass off to keep them as far away from the hospital as possible, and had some pretty amazing results right in the ER. But I couldn’t help everyone, and it tore my heart apart when I saw what happened to them in the psych ward. That was when I knew I had to go into a different role, and have been an advocate for either the elderly or for foster kids ever since. Which is perhaps a shame, because I was the kind of therapist that people really wanted to see – I actually cared about their viewpoint and tried to help them come up with their own plans, and even shared a lot of my own experiences as needed to help create safety and common reality, and I was always interested in any current or past trauma and how these affected them, as well as checking eating and sleeping habits, work stress, etc, depending on what was called for. But I felt like I was in collusion with an evil system, especially as DSM diagnoses and drugs took over from listening and caring.
So that’s my story. I still consider myself a caring and competent therapist, but any work I do now is informal and on a volunteer basis. I can’t work with a crazy system!
The greatest privilege of those who have it is the privilege of pretending or believing that your privilege doesn’t exist.
The concept of privilege is by no means supportive of a victim culture – to the contrary, it is a concept that deals very directly with power dynamics such as those shown by most “mental health professionals” when they are confronted with their patients’ reality. Because they have power, they can freely ignore or minimize their clients’ complaints – they have a whole system of diagnoses they can use to blame the clients for not liking their “treatment.” Rather than hearing that “your treatment made me barely able to move and I lacked the will to even complain, so I stopped,” they can claim that you have “anosognosia” and therefore “don’t understand you are ill” and therefore can be forced to receive “treatment” at their discretion. To understand psychiatry’s ability to ignore facts and feedback from their own clientele is to understand privilege. It really is that simple. They abuse you because they have the power to do so and you don’t have any recourse within the system when so abused. It’s not a victim culture, it’s very simply the reality of the power dynamics that exist within the system, and the exact same or very similar dynamics exist at all levels of our social system and are very highly responsible for much of the “mental illness” that same system later feels compelled to “diagnose.”
As a former “mental health” professional, I can only say that you nailed it (as usual). Humility is the starting point for any attempt to help another. They are the only ones who know what is really going on and what will help. If you won’t even listen to the person you’re “helping,” don’t be surprised if your “help” ends up being resented and leading to worse problems.
I love how “scientists” continually state that their inability to observe something means it is not there. How could you prove there is no such thing as a “true self”? We’re clearly outside of the realm of science and into philosophy, but pseudoscientists like this insist that anything outside the realm of science to explain simply isn’t there.
Wait, you mean that inducing a seizure by electrocuting someone’s head DOESN’T make them feel better and has a high risk of doing permanent damage? Whoda thunk it???
I think the comparison is around attempts by adults to “heal” those being abused instead of asking why society mistreats them and working on society instead of blaming the victims.
The graphic comparing smoking and psych drugs is a great resource! Thanks for sharing this perspective – I admire your persistence in trying to work with NAMI and other groups still invested in the medical/blame the victim model.
This is exactly what happens when you create “diagnoses” that are based on subjective criteria. People “diagnose” what they don’t like or don’t understand. The DSM can say whatever it wants about how it “should” be used. People will use it in the same way people use most things – they will act in ways that are self-centered and that avoid discomfort. There will be exceptions, of course, but the incentive is there to blame the victim, and the DSM makes it very comfortable to do so. It needs to be banned!
Amazing clarity as usual, Sera. Power dynamics lie at the center of why there is an antipsychiatry movement. Embedding “peers” in the system and then taking away their ability to proceed from an empowering viewpoint is cooptation at its most pernicious. I would ask Patrick to look at some of the comments of Stephen Gilbert, a peer worker of great integrity, who is constantly barraged with complaints and threats and disrespect when he stands up for his peers in a truly peer-like way. Certification per se is not the problem – the problem is that the professional “mental health” workers don’t want to give up their power over their clients. A true peer-to-peer model means clients get to make their own decisions and have those decisions respected, even if if those decisions are now what the peer would decide for him/herself. Those currently in charge of the mental health system will never stand for it, and that’s why certification is popular amongst the professionals – it enables them to disempower the peer movement and make it the handmaiden of their own need for control.
Actually, my experience is that good, active listening does, in fact, provide something practical – it removes the barriers of confusion and overwhelming emotional intensity and helps the person involved get to a place of doing their own practical problem-solving process. I’ve done this with dozens and dozens of suicidal people, and had excellent success in helping them achieve some sense of greater control over their lives, and sometimes even a plan for moving to a better way of surviving and thriving in their lives. I could share a story or two. The truth is, no one can really develop a practical plan for someone else – they can only help that person develop perspectives that enable the person him/herself to come up with such a practical plan. At least, that’s my experience.
That is an excellent point! A lot of kids are “oppositional” to things that don’t make sense, or they are generally opposed to being bossed around arbitrarily. When given more control of their environment, they seem oddly enough to be a lot more cooperative.
The many psych patients I worked with (mostly foster youth) were not even screened for CURRENT stress and trauma. None were EVER screened for nutritional issues nor were 98% even screened for physical conditions that might lead to their symptoms. All the psychiatrists were primarily interested in was a list of symptoms and their severity so they could decide what drug to prescribe.
I see nothing here to provide evidence that these interventions help kids in any way. They merely provide evidence that setting up a program leads to “more treatment.” That is not what I want from a review!
It doesn’t sound like we disagree much, except on terminology. I have never been opposed to people choosing to try drugs if they seem to work for them. I am opposed to psychiatrists lying about what they know and pretending that all cases of “mental illness” are caused by faulty brain chemistry or wiring or and that the drugs are specific “treatments” for specific “conditions” which they supposedly understand. Beyond that point, we seem to be in agreement on each person needing their own approach. “You use what helps.”
As for science, I’m afraid the inability to make a distinction between who “has” and “doesn’t have” “schizophrenia” makes any kind of scientific conclusions absolutely impossible. The first job of science is to distinguish an experimental group from a control group. If we are unable to consistently parse these two groups, any scientific conclusion is meaningless.
For instance, let’s say that 10% of cases of “ADHD” are due to low iron (a known cause of “ADHD” symptoms). If we treat 100% of “ADHD”-labeled kids with iron, only 10% get better. If you compare this treatment to stimulants, which at least temporarily reduce symptoms in 70% or so, stimulants look like the better “treatment,” even though there is no specific understanding of what is being “treated” and even though people without “ADHD” diagnoses react to the drugs in the same way.
So we conclude (erroneously) that stimulants are a better “treatment for ADHD” than iron, even though 10% of subjects would be cured by being given iron alone. The 10% should not be diagnosed with ADHD, they should be diagnosed with iron deficiency.
So you see, if you can’t properly divide your participants into objectively discernible groups, your research leads to meaningless or misleading results. If you grouped them into “hyperactive – low iron” and “hyperactive – normal iron”, you’d have gotten 100% success, but when you call it “ADHD,” 10% of your population never gets the help they really need.
Intimidated? Seriously? I have given you plenty of coherent replies. The most relevant here is the question you were already asked: if some cases of depression/psychosis are caused by biology alone, how specifically do you distinguish which cases are or are not? Drug response is not an adequate answer, not even close – all of these drugs have similar effects of those diagnosed vs. not diagnosed. Just like alcohol relaxes most and removes inhibitions, these drugs have effects on people’s brains that are not specific to a “disorder.” Until you can sort out the conundrum of diagnosing which people have which condition, your theories remain theoretical.
You also appear to forget that while the best correlation with genes and any “mental disorder” is about 15%, the correlation with trauma is more like 85%. Which seems more likely to be the relevant causal factor?
Please knock off the insults. They diminish the credibility of your presentation.
Who ridiculed you, Pat? As I recall, you were ridiculing others and that’s what got you into trouble. You want others to respect your choices. Why don’t you respect the choices of others, including their choice to take a position you don’t agree with?
I completely understand your objections to certification – it is simply an invitation to co-optation and control by the system. I would also be very interested in hearing if there are some areas where the two of you agree. Maybe there isn’t anything, but it’s hard to build a movement with so much fragmentation! I guess that’s the point of co-optation, isn’t it?
The challenge here is that many of his supporters don’t recognize even his bald-faced manipulations and support for the corporate-capitalist status quo. This hard core of supporters genuinely believe he will change things for the better by chasing away dark-skinned immigrants and magically bringing back anachronistic industries like coal, as well as somehow increasing salaries while he does all he can do make sure workers are unable to organize and that employers get to set the standard for what they feel like paying. I could go on, but the point is, Trump supporters (the poor and working class type) don’t appear to understand that he is completely antithetical to their interests, even though it is “out of the closet,” as you say. It’s a conundrum!
I would more put it that “care” in the context of schools comes from an adult viewpoint and denies the legitimacy of kids’ actual, valid complaints about the injustice that occurs so frequently and for which they have no recourse whatsoever. The huge controversy over the TV series, “13 Reasons,” proves the point. It’s OK to “care” about kids as long as you don’t talk about what’s really going on, especially when the cause of their distress is the adults running the system they are forced to comply with. The problem is a chronic power imbalance that allows adults to act with impunity while punishing kids for objecting to their mistreatment.
Great summary. This guy has it all laid out in one article, but of course, logic is not part of psychiatric research, so the truth will have little to no impact on psychiatric practice or research.
In other words, the goals of psychiatry, namely to assure that a person DOESN’T feel depressed or anxious, are calculated NOT to lead to happiness. Big surprise.
This is some tortured reasoning. The fact that people with food issues latch onto the “clean food” movement doesn’t mean the movement itself has any causal relationship to eating disorders. Clear case of correlation not meaning causation. Some people use nursing a baby continuously as a means of “purging.” But nursing babies doesn’t cause bulimia. Total logical fallacy.
Glad they are taking a stand, but I wish they’d take a similar stand regarding the serious human rights issues affecting their own clients at the hands of their fellow “mental health professionals.”
I agree 100% that the DSM is at the core of the evil rot that is being perpetrated across the world. Unfortunately, the DSM’s claptrap is supported by a general belief, almost religious in nature, that doctors are smart and ethical and can be trusted. How do we accomplish undermining the DSM without running afoul of the worship of “medical science” as a stable point for many people’s security?
“Freeman and Honkasilta note that the DSM-5 itself requires that a disorder not be comprised of cultural difference, or socially deviant behavior that is not harmful.”
And how exactly does that differ from any other “disorder” in the DSM? If the DSM really required that a “disorder” not be comprised of cultural difference or deviant behavior, it would be a VERY thin manual! It would, in fact, be essentially EMPTY!
It invalidates the child’s voice completely. But that’s what school was all about, as far as I recall. My voice was rarely if ever of interest to anybody there. When I graduated high school, I felt like I’d been released from a POW camp. It was 13 years of torture for me. But nobody ever bothered to ask how I felt about it.
#1: Don’t send your kid to a school that scares them!
This is a fantastic example of ignoring your child’s cues. If a preschooler cried and tantrumed and told you they were afraid to go to preschool, you wouldn’t just force them to go, would you? You’d at least look into it and find out what was bothering him/her. But somehow we’re supposed to assume that school is a great place and that any kid wanting to avoid it is malfunctioning. Maybe the kid wants to avoid school because school is a place of fear, abuse, disrespect, and humiliation. Maybe you should take a good look at what’s happening in your child’s school before you decide that his/her complaints are lacking in substance!
I think you’re missing the point. I am certainly very concerned about addiction to street drugs and think it reflects major failings in our society that so many people feel they have to drug away their feelings of anxiety, rage and hopelessness. My point is that using psychiatric drugs is not at all a different approach, and implies that there is something WRONG with the people who choose drugs as a means of coping with that distress. It also implies that “medication” will somehow be a BETTER means of dealing with their “disabilities.”
I would also love to see your response to my other points. How we talk about these issues has a very significant impact on how people themselves think of their own distress and the kind of “solutions” proposed by our social system is willing to propose or support. Most importantly, it absolves our society for creating these conditions in the first place. For instance, “ADHD” is simply a critical description of a child who doesn’t fit into a standard classroom environment. By calling them “ADHD,” we prevent any research into the following questions: Are our classrooms failing to meet the needs of kids in general, or these kids in particular? What is causing this behavior for the child? Are there multiple causes? Are we expecting more from our kids than is reasonable for their age? Is it sometimes a function of variable development rates? (A third of ADHD diagnoses appear to evaporate if you wait a year before sending your kid to school!) Boring classrooms? Stress in the home environment? Poor parenting or poor classroom management? Poor diet or dietary deficiencies? Poor sleep? Calling it ADHD prevents ANY research into these potential difficulties!
And the issue of testing stands on its own: how can you propose testing for a “disorder” that is defined with completely subjective and unmeasurable criteria? And without objective criteria, how would “overmedication” ever be determined? Are not the subjective criteria the reason why “overmedication” can’t be defined, leading to ever-increasing levels of drugging for the convenience of the authorities in charge?
With all due respect, Joel, the diabetes analogy is an anachronism, or should be for an educated person by this point. Diabetes results from the measurable lack of insulin leading to a measurable increase in blood sugar levels. Successful treatment by diet can be achieved and measured by observing blood sugar and HA1c levels, and if unsuccessful, can be augmented by providing the NATURAL SUBSTANCE (Insulin) which is known to be missing.
There is no “mental disorder” which has a comparable known missing substance, nor is there any “mental disorder” with a known means of measuring success objectively, nor is any psychiatric drug a naturally-occurring brain chemical that is being replaced in measured amounts. There is literally no point at which diabetes and “mental disorders” have the slightest similarity, other than the fact that drug companies sell drugs that are supposed to treat them.
And while I will agree with you that there are acute situations where the use of psychiatric drugs may have application, it should be clear to one as educated as you that there is not one such drug that does anything but disrupt normal brain processes (as well as similar processes elsewhere in the body) in a manner no different than using alcohol or street drugs used to achieve similar purposes. The similarities between drinking alcohol and taking benzodiazepines are MUCH greater than any purported similarity between taking psychiatric drugs and the treatment of an identifiable deficiency with insulin. If you want to be taken seriously in an educated community critiquing psychiatry, you’d do very well to leave the “insulin for diabetes” analogy in the dustbin of history where it belongs.
I agree with the general sentiments expressed here, namely, that a one-size-fits-all inflexible approach to life leads to higher levels of distress and sometimes to emotional collapse in youth. I’m also glad you mentioned that not everyone goes to college, or needs to.
That said, there are some distortions in the article that I need to point out. First off, a person who reacts badly to this tracking and enforced life schedule is not DISABLED or suffering from any disorder. They are reacting NORMALLY to an abnormal set of expectations, as the author’s original presentation suggests. It’s important to use that kind of language and to avoid “disability” language or we play into the medical model concept that everyone should “adjust” to whatever expectations society throws at them and that anyone who doesn’t is a failure or is “disabled” by definition.
Second, you mention “self-medication” (I HATE that term – it implies again that they are deficient or “disordered”) without mentioning the huge and increasing numbers who are legally drugged by their doctors, and the damage done by such legal drugs is not discussed, but is a very important part of the equation. The use of drugs to delete the negative emotions mentioned in my first paragraph is simply one more way to keep our young people “on track” to do the proper things at the proper times and to avoid any discussion of whether such tracking is healthy or destructive.
Third, and most important, giving counselors more power to “emotionally test” our youth is an EXTREMELY misguided concept! We have already seen that 1) there is no kind of “emotional test” that gives any kind of useful, objective data that would help modify the bizarre expectations of our modern world, and 2) people given this kind of power have been coopted by drug companies into “screening” youth for “disorders” and into routing them to psychiatrists so they can be identified with the proper labels and forced to take the proper drugs, all in the name of keeping them “on track” with the very social expectations you so properly criticize as you open your essay.
The proper thing to do is not to scan for “disabilities,” but to alter the expectation that every kid goes to college and to re-focus our efforts on providing a wide range of options for youth, and to convey an understanding of and compassion for the very real challenges of moving from youth to adulthood in our screwed-up society. There is no simple “test” that can do this – it requires compassionate, caring, supportive human interaction, starting with overtly stating and recognizing that the world they are entering is, in fact, a bizarre one that provokes anxiety in almost all of us who live in it. Honesty goes a lot further than testing in helping kids cope, though of course, the BEST solution would be to work at revising our society in ways that don’t make its participants quite so “crazy” by expecting abnormal things and pretending they are normal.
I would also challenge the author to define “overdiagnosis” when the ADHD diagnosis is totally subjective. The reason the diagnostic boundaries can expand is because they are simply made up by a committee of psychiatrists who vote on what they should be. There can be no “overdiagnosis” without an objective standard, and lacking one, the whole concept of diagnosis becomes meaningless.
As for the “paedogogical” effectiveness of stimulants, this is an illusion. Every review of long-term literature on stimulants confirms that there is NO academic or social benefit from long-term stimulant use, including completion of grades, academic test scores, dropout rates, and college enrollment. While I appreciate your description of the many possible causes and alternative approaches for this particular behavioral syndrome, you do your readers a grave disservice not to mention that any academic benefits that may accrue are small and fleeting, according to the Raine study, the MTA study, the Quebec ADHD study, the Oregon State University Medication Effectiveness study, and the Finnish/US comparison study, just to name a few. The very best reason NOT to consider stimulants for your kids is that in the long run, THEY SIMPLY DO NOT WORK, at least not if you care about outcomes beyond reducing adult frustration.
Getting drunk can sometimes be helpful, especially for anxiety. That doesn’t make it a medical treatment. Sometimes people like what drugs do, sometimes they don’t. Altering the mind and emotions with substances is as old as humanity. Pretending we’re “treating” a “medical condition” is the big issue.
There has been a frantic (dare I say “manic?”) search for “genetic or chemical predispositions” to “bipolar disorder” and any other “mental illness” you care to name. The success has, to put it mildly, been “disappointing.” The BEST correlation they’ve come up with is about a 15% correlation of people having SOME of a range of about 100 genetic markers being diagnosed with a RANGE of “mental illnesses,” including ADHD, depression, and schizophrenia.
Meanwhile, correlations with early life traumatic events such as abuse and neglect or loss of parental figures, etc., reaches well over 80%. PHYSICAL illnesses are also correlated highly with early childhood traumatic experiences. Epigenetic changes have been proven to occur when people are traumatized, especially in childhood. So 15% AT MOST correlation with genetics, 80+% correlation with environmental trauma, not even considering larger scale social stresses like bad jobs, racism, poverty, etc…. So what exactly makes you believe that “genetic or chemical predispositions” are the main cause of “bipolar disorder?”
Sounds like she may have been having delusional adverse effects, which either stimulants or SSRIs can cause. The commercials may have provided the material (most commercials are very much anxiety based), but I doubt she’d have had this reaction without the “help” of the drugs. And as usual, the doctor completely discounts the idea that the drugs could be causing this, despite it being on the label and despite this behavior never occurring before the drugs. Wouldn’t you expect to get BETTER with the right treatment, even if you totally buy into the “medical model?” Baffling!
Wow, what a surprise! Psychiatric researchers develop a new “wonder drug” but overstate its effectiveness and intentionally hide the large adverse effect profile. THAT’S never happened before…well, except for Benzedrine, Valium, Xanax, older antipsychotics, second generation antipsychotics, SSRIs…
This sounds like what therapy should be about. It should be flexible, focused on developing options rather than “reducing symptoms,” and should change based on direct feedback from clients. The therapists should LEARN from the family what is happening, what works, and what doesn’t, rather than following some pre-digested set of “techniques” approved by someone else based on some statistical probabilities about outcomes that may be of no interest to the family involved.
Thanks for the inspiring article. If only this would develop into the standard of care!
Wow, they seriously think that life conditions might affect a person’s “mental health?” Dude, what a radical concept! Next thing you know, they’ll discover that running into something causes pain in the parts of the body that are impacted! Or that hunger can be alleviated by eating food!
We’re in a bad place when this obvious fact comes as a revelation to the field. What’s sadder is that it will be ignored by the psychiatric mainstream.
I agree in large part with the author’s assertions. The very fact of being told you have a “chemical imbalance” that you can do nothing about is demoralizing, and it’s far worse if you’ve tried their magic pills and found no improvement, because this suggests that you are DOOMED to permanent depression!
I used to work a crisis line and handled a call where the person was absolutely frantic. She had tried a half a dozen or more drugs over a year or more and had gotten no relief. She was absolutely desperate and terrified that nothing would ever help. I asked her, “Has anyone ever told you that there are other things you can do for depression besides drugs?” She stopped, seeming kind of stunned. “No,” she said. “Well, there are.” I said. “Oh. Well, that’s good,” she said. She was 90% calmer just knowing that she might be able to take some kind of action, without even exploring what action was possible! The idea that she was limited by her “chemical imbalance” and had no power to do anything herself to stop it. The concept is more depressing than anything that might have brought on the depression in the first place!
Interesting fact: there are many, many more (probably hundreds of thousands or even millions) people taking “antidepressants” worldwide, and yet “depression” is worse than ever! Could there be a connection? Hmmmm…..
I agree 100%. There is proof that our Western society makes people ill. Some group did a study over three generations on health outcomes for immigrants to the USA. At the start, their health outcomes were all over the place, but after the third generation, they had American problems like heart disease, cancer, anxiety and depression in numbers similar to those who had been here many generations. Part of psychiatry’s job is to keep the focus off of “the system” so the rich can get richer and the powerful more powerful. But I fear I am preaching to the choir now!
Oh, Frank, you’re SO naive! Thinking that people having a PURPOSE and a means of supporting themselves will help with their mental/emotional state? I mean, how can ANYONE make money off of that model!
And psychiatry plays right into this mythology, by insisting that any deviation from being mildly happy all the time is proof of a “neurochemical brain disorder” requiring “treatment.”
This is what happens when you invent “disorders” based on arbitrary or socially constructed “symptoms.” There is no objective way to “diagnose,” so anyone can decide to move the goalposts. Add in the financial incentives to prescribe, and you have a perfect storm for corruption disguised as “medical treatment.”
This is a powerful case study and a startling indictment not only of Prozac, but more importantly, of the damage our “label-and-drug” system does to real human beings, minimizing what is important and isolating those suffering from any possibility of real help. What would have happened if people had TALKED to these kids instead of giving them the message that their brains were messed up and that these drugs would somehow magically make everything all better? What kind of message does it send to say that being upset about your grandparents dying in succession is something “normal” people don’t get upset about, or that your problems are all in your brain so don’t bother telling us what you’re thinking because none of it means anything?
Thanks to Peter Breggin for this lucid and disturbing account of the poor impact of this approach and the incredible disconnect between what the news media reports and what is really going on.
Does anyone have to forbid armchair diagnosis of heart disease or cancer or a broken leg?
This is merely reflective of the negative power of psychiatric “diagnosis” in society at large. People make “armchair diagnoses” all the time, all over TV and movies and in cafes and living rooms around the country. The very subjective and judgmental nature of these labels play into the human desire to lump people into “us” and “them” and to spread blame and hostility toward someone we want to downgrade or humiliate or feel superior to.
While I personally can’t stand Trump due to his immaturity and his deep involvement in corruption, slapping a “diagnosis” on him is simply a childish exercise of acting out against the “bad daddy.” Not only should psychiatrists and psychoanalysts be forbidden from diagnosing public figures, the whole concept of “diagnosis” based on behavior and emotional state should be scrapped, because it serves no real purpose besides stigmatizing and distancing us from those who are so labeled.
Appalling article. They spend most of the article talking about “depression genes” and “treatment-resistant depression” and the “new breakthroughs” that are “just around the corner,” just as we’ve heard since Benzedrine came to the market back in the 60s. They toss in a few “other things you can do” at the end but they feel like an afterthought. They also comment on the STAR-D study as if there were no methodological issues with it, despite lots of criticism even from the mainstream. No comment section, either. I wonder of one of our respected professionals can write a letter to the editor to complain of the one-sided and disingenuous treatment of the subject?
Nothing wrong with doing so. But there IS something wrong with calling it “medical treatment” and claiming that the condition is caused by a “chemical imbalance” just so you can make buku bucks off of insurance coverage.
Why the focus on homeopathy, when so many approved drugs kill so many people? At least homeopathy has next to no adverse effects, while Risperdal can and does kill many people. Where’s the effort to debunk Big Pharma’s scamming? Referring to Thalidomide as the reason Big Pharma isn’t trusted is pretty disingenuous, with Viiox and many other more recent examples to refer to.
They overlook the obvious reason for the inconsistent findings: THERE IS NO CONSISTENT FINDING TO BE MADE! IN other words, there is no correlation between depression and a particular “aberrant” brain function. This is the clear SCIENTIFIC conclusion when multiple experiments lead to no result. It is only the lack of a scientific intent that allows these experiments to continue to be funded. Any real scientist wouldn’t be blathering on about methodology and statistical issues. If 50% of experiments point to increased activity and 50% point to decreased activity, you have your answer – there is no effect to be measured. Why is that not the conclusion of the study???
I agree. It is only an assumption that we are all chemicals and nothing more. Lots of cultural traditions, indeed almost every cultural tradition, posits that we are more than that. The concept that we are only material is a PHILOSOPHICAL assumption, not a scientific fact. The mind is a mystery that science has not even begun to unravel in the slightest degree.
That being said, the author recognizes that “we” (the entity possessing the mind in charge of the body) can cause things to happen, and that biochemical changes are the response. That’s the most important starting point, regardless of what we believe “mind” to be or how we believe it to be generated. The latter question is one of metaphysics, and I doubt hard science will ever be able to find a concrete answer to it.
The other problem with this kind of research is that it only establishes probability. Some people with less white matter are not depressed, and some people with more white matter are. Unless EVERY depressed person presents with reduced white matter, there is no possibility of even a high correlational link, let alone a causal one. It’s really an idiotic conclusion to draw when 80-90% of your sample overlaps with “normal.”
I agree it is likely that SOME depression/anxiety is caused by nutritional problems or inflammation from stress. Is that the cause of ALL depression/anxiety? And might not “treating” the resulting inflammation from stress provide an excuse for society not addressing the many causes of avoidable chronic stress in our modern society?
So not counting the large number of dropouts, . which would no doubt lower the response rate, still half of the users didn’t have a strong response, and 30% barely had a response at all. This also doesn’t include placebo response. This suggests that probably half of the users didn’t benefit even in the short run. Not a very impressive display of effectiveness, was it?
I agree that attachment-based therapies get to the core of what’s going on much more effectively for those with long-term trauma. CBT is favored largely because it avoids such issues, as there is a huge “don’t blame the parents” meme that is central to the biological viewpoint. EMDR I think has sensible components to it, including recognizing that traumatic events are the core of the person’s suffering, and I am guessing it’s much more effective than what most people get as therapy or “case management.” I do agree that the eye-movements and tapping and other stuff seem hokey, and I’m guessing they’re probably somewhat ancillary, but telling a narrative of the events in question is no doubt therapeutic for those with specific traumatic events to process. And let’s face it, most people in “the system” have plenty of traumatic events to process. So if it’s a choice between EMDR and treatment as usual, I’d go for EMDR every time, even though I believe attachment-based therapeutic interventions will have more long-lasting results. The other difficulty with attachment-centered therapies is that the therapist has to have their attachment issues under control, and most therapists do not, and engaging in that kind of approach can do a lot of damage with an unenlightened therapist.
So more than half are able to discontinue successfully, and are happy with their decisions to do so, despite an almost complete lack of support by professionals. If half of your cohort can discontinue and are happy with the results, why the f*&k would you not be encouraging folks to try it? Kickbacks or meeting one’s own security needs at the expense of the client seem the only reasonable explanations.
A Science Court for psychiatry would have to be staffed by totally disinterested citizens. Best to select people from totally different professional backgrounds, like a sociologist or ecologist or computer scientist, and an equal number of consumers, selected by random or from consumer-based (NOT parent-based) support organizations. No psychiatrists or psychologists allowed!
Obstetrics is an area with similar ignoring of evidence in order to maintain the status quo. The national Caesarian rate is around 30% or higher and no one bats an eyelash, while midwives have as good or better of a safety record with rates under 10%.
Another great example is Semmelweis. He introduced handwashing into labor and delivery wards and reduced the childbed fever rates from very high to almost nothing. He was fired because the doctors were insulted he thought their hands were dirty, and his successor eliminated the practice and rates soared again, sending Semmelweis to the mental ward with frustration.
Freud himself was intimidated away from his original finding that many adult women had been sexually molested, and completely changed his “trauma theory” and developed the “drive theory” in order to accommodate the community’s need not to admit what was going on. A hundred years later, it was shown that his observations were absolutely correct, but psychiatry remains committed not to look at abuse and trauma as the main cause of “mental disorders.” Not much money in trauma, I guess.
True dat! I also rarely see the disheartening social and political consequences of our current “system” identified as contributing factors. Interestingly, these factors also massively contribute to the food-based environmental issues to which you so rightly refer.
As long as they depend on drug companies for their campaign funds, you’re right. That’s why campaign finance reform, in the form of banning ALL corporate contributions to candidates, is the issue of our age.
In other words, when people experience scary things, they get scared. Big surprise here. But wait, I thought it was all biological? Perhaps we’re supposed to be totally bland about terrorist attacks and not react at all?
Thanks for telling a great story so effectively! It sounds like the last therapist you saw was the only one who got what was going on. It kind of sounds like your need to go along with what others were suggesting was a big part of your struggle, but “the system” saw that compliance as the ultimate in good patient behavior. Does that sound right? I say this as a person who worked years to overcome my need to keep everyone but me happy. I was very fortunate to strike gold on my first therapist, but this was back in the 80s before the DSM was in place. It was particularly disheartening to hear how much time they spent trying to figure out which DSM box you should be fit into and so little time actually listening to your view of things. It seems they actually did the exact OPPOSITE of what you really needed, and it predictably made things worse.
Thanks again for sharing your story. It’s very important for people in similar situations to see that there really IS a way out, but that finding the right label is not part of the path to a better life.
Too true. I am familiar with some of Connors’ work and can attest that the “objective” screening tools he developed are totally based on teacher and parent ratings of children’s behavior as it affected them or their classrooms, and zero consideration was given to family stress or personal trauma history. You do the checklist, the kid gets a score, and no one ever even talks to the kid to find out why they might be acting the way they are. It’s a joke.
I’m glad he came to the conclusions he did toward the end of his life, but it’s telling that neither he nor many like Allen Frances who decry the “over-diagnosis” of this or that “disorder” appear to understand that the “diagnostic” process itself leads to this result inevitably. As soon as you have a subjective element in diagnosis, especially when it involves people in a relationship with a significant power differential, the victims of abuse and neglect will be subjected to ever-increasing criticism in the form of “diagnosis” of anything they do that is inconvenient or uncomfortable. Allowing subjective “diagnosis” based on the opinions of parents or professionals opens the door wide to blaming the powerless victims of their irresponsible behavior, and given the opportunity, I’d say the majority of adults in the power-up situation are only to happy to open that door the moment a crack of light shows a possibility of passing through.
I agree. I can only speculate that mania may be harder for the person him/herself to notice, as it doesn’t necessarily feel bad to the person experiencing it at the time it’s occurring. I also wonder what kind of questions they asked – if they were very open ended, a person might report, say, agitation and feelings of restlessness and loss of sleep and suicidal thoughts, but not put them all together and call it “mania.” We know mania is a reasonably common reaction, and it is puzzling that it doesn’t appear in the manuscript.
There is no drug war against the recipients of ANY of these drugs. The war (if that is the right term) is against the PURVEYORS OF LIES who pretend that these drugs aren’t addictive or that they have no adverse effects or that anxiety is “treated” by giving these drugs over the long term. Informed consent merely gives people like you the information needed to decide if you want to or don’t want to use them. There is no hostility intended toward the users of these substances.
The basic problem starts from treating “symptoms” as “disorders.” Giving up on the idea that we can “treat” an emotional condition without figuring out what’s behind it, whether mental, physical, or spiritual, would be a great first step toward a rational approach. I guess this is better in that it at least doesn’t denigrate the person with the “symptoms,” but you’d think the lack of results for “causes” would lead an intelligent person to abandon the labeling process that gave us “disorders” that don’t have unitary or even similar causes.
Missing the #1 reason these evaluations are unreliable – they are relying on subjective “diagnoses” and sketchy “objective” tests that aren’t the least bit objective, because they’re “measuring” things like risk of violence that are not actually measurable in any real sense. Admitting this will help us realize that the courtroom is a place of moral judgment, not medical, except as far as medical expertise can objectively shed light on guilt or innocence. As such, psychological/psychiatric pseudo-experts should not be considered to provide valid testimony, and the judge should consider the case on more objective facts. For instance, instead of testimony on whether someone is “mentally ill,” why not hear testimony from people who know the person in question as to his/her volatility/violence potential in their direct observation? A person’s actions are a much better predictor of their future actions than some “expert” who barely knows the person and tosses a few Mickey-Mouse “tests” at them.
No one is suggesting that people don’t act the way BPD and others are described in the DSM. We’re only saying that it’s a DESCRIPTION, not a DIAGNOSIS. The “diagnosis” (though I don’t think that’s the right word at all) for most BPD people should really be childhood abuse and neglect, because it’s present in almost all cases. This way, we’re looking at actual causes instead of blaming victims. Saying someone “has BPD” places the problem within the person who was abused, and lets the parents and/or cultural institutions and/or other perpetrators off the hook for their destructive behavior.
You say that people with these “disorders” come for help. So I guess there are two questions: one, is it really OK to “diagnose” a person with a “disorder” that is simply an observation of how someone acts and has no connection to any kind of objective physical cause or measurement, just because it allows them to get insurance reimbursement? And two, is “diagnosing” someone with BPD actually helpful TO THE PERSON who is diagnosed?
I think on the latter, the concerns are pretty obvious. As a person who has worked in the field, I can tell you that people with a BPD diagnosis are commonly feared and even reviled by mental health “professionals” in the system. People find their behavior frustrating, and the label BPD allows them to blame the client for his/her frustrating behavior and allows clinicians to act out their anger punitively with the support of their fellow professionals while denying any kind of real connection or empathy with the client. It also often disqualifies a person for therapeutic support, since “BPD” is considered by some to be “untreatable.” So I think the answer to the second question is a resounding NO in most cases.
As to the first, I again ask you if it makes sense to “diagnose” someone with a description? To get more concrete, would it make sense to diagnose someone with “a rash” and leave it at that? A rash is an indication that something might be wrong and that further investigation into causes is needed. If we diagnosed a rash like we do BPD, we’d give everyone topical steroids. It would work for some cases, would do nothing in others, and make it worse in yet other cases. Some cases would really be caused by poison ivy, others by measles, others by syphilis. The ones with poison ivy would resolve better with the steroids, the measles would be unaffected. The syphilis rash would go away, too, but the person would later die an excruciating death as the bacteria ate up his/her brain. We’d say that the syphilitic person was “treatment resistant,” and no one would ever suspect that the problem was with the diagnosis itself, or rather the pretension of diagnosis that prevents actual diagnosis from ever happening.
It would be a lot easier for people to be “diagnosed” with “Badly mistreated by parents and learned coping measures that are ineffective in current life” than “BPD.” They could still get help without someone blaming and denigrating them for having what is a very common reaction to very poor conditions in early life.
Disclosures are very close to meaningless. What we need is a prohibition on conflicts of interests, not disclosures of conflicts of interest. Disclosed or not, the conflict still drives the research, and that’s simply not science any more.
Again, not suggesting that the suffering of the privileged isn’t miserable. The point is only that the privileged have more options as to how to escape or mitigate the effects. Trauma is trauma, and no one is immune, regardless of privilege.
What a great treatise on the realities of privilege! Privileged people DO get abused and otherwise traumatized, but they have many more opportunities to have alternative outcomes, because they have funds, more connections to other privileged people, more sympathy, better educations, and so on. I have compassion for all folks who have been traumatized, but it is very important for privileged folks (like me) to recognize that trauma for those less privileged are more constant, more systematic, less avoidable, and less recoverable. Reducing poverty is probably the #1 way to reduce what is so laughably called “mental disorders” by our cold and unforgiving system.
So in other words, these people aren’t “disordered,” they have adapted to the environmental needs of their upbringings. So why do we keep focusing on them as problems, instead of seeing the poor environmental conditions as the problem?
True enough. And it happened under Democrats and under Republicans. When push comes to shove, they all hang together to support corporate power over human rights, and the further from US soil you get, the less we give a crap about the human rights of the citizens involved.
As to Sanders, one of the great things about him is that he IS open to being educated about things he is not fully informed of. If there is one politician who might be able to be influenced to take a stand contrary to Big Pharma, Bernie is that guy.
Why is it that doctors have “mental health issues” “due to the unrelenting pressure, inhumane working hours, brutal competition, and workplace bullying that is commonplace in the field of medicine,” whereas the rest of the world is suffering from chemical imbalances?
I wish I did! We could perhaps start by supporting efforts to end corporate contributions to political campaigns, shorten those campaigns, and massively reduce the cost of running for office. Physician groups have already come out against DTC advertising – perhaps that’s a good place to start? I suppose another goal might be to make it so that lobbying expenses can’t be taken off on a corporation’s taxes, but I’m guessing we’d get ENORMOUS resistance to that kind of idea!
This sounds kind of sketchy. How do they explain that other reviews showed different results? How did they select their participants? What did they measure? Who paid for this study?
I like the focus on finding points of agreement, Gary, and I found the points you mentioned excellent. I believe you are, however, missing one of the most, if not THE most important one. Financial corruption! I think we can get strong agreement that pharmaceutical companies purchasing influence in various ways, including sponsoring “educational” seminars promoting their products, ghostwriting articles, and engaging in DTC advertising and promotion to doctors which massively impacts prescribing habits and research priorities, is an evil that needs to be eliminated in the service of accomplishing any of the other goals you mention. Corporate malfeasance is also an area where many who occupy different ends of the left-right political spectrum can find solid agreement.
It is truly a religious system. The doctors are the holy priests, and people go to them for magical cures. They even have holy vestments. Nurses could be considered “vestal virgins” of a sort. The Holy Scriptures, in psychiatrists’ case, are the pages of the DSM, which ironically enough is often called the “psychiatrists’ Bible.” Doctors are the priests of Scientism, the belief that Science will provide us with Ultimate Truth. Hence, doctors are believed regardless of the sense of anything they say, and those who speak ill of them are considered apostate or heathen. Real science often inconveniently undercuts many Scientist dogma, but that doesn’t seem to bother the True Believers. Hence, we have electronic fetal monitoring as a standard of care (increases Caesarian rates massively with actual reduction in outcomes), cholesterol drugs massively prescribed with little to no improvement in outcomes, and of course, the entire field of psychiatry, whose clients are sicker and die younger than those who manage to escape their notice.
It is very hard to undercut basic mythology in any society.
Once again, the intervention is wrong-headed – it is focused on trying to stop self-harming behaviors instead of trying to figure out why they’re happening and addressing the underlying causes. The first thing I learned as a counselor about self-harming behaviors (and I learned this from the clients, not any training I had) was that self-harming behaviors served a purpose, and understanding the purpose was the key to moving forward, regardless of whether the person continued to self-harm or not. The very concept of hospitalizing someone for self-harming (non-suicidal) behavior is stupid in the extreme. Most self-harming behavior is not intended to be lethal or anything close to it, but “professionals” end up punishing the coping measure instead of looking for what the client is coping with. When I worked a crisis line for 3 1/2 years, we had many cutters call us instead of their therapists, because they knew telling their therapists meant either shaming of them (you know you’re not supposed to do that) or being sent to the hospital. As long as we’re studying how to “stop self-harming behaviors,” we will continue to create “interventions” that do more harm than good.
Well, your fear seems rational to me. I’m sorry no form of therapy has seemed helpful, either. It sounds from your story that your early life experiences lie at the core of your distress most likely. There is no drug for that.
Two things you didn’t mention that some people have found helpful: 1) support groups of people who have had similar past experiences, and 2) mindfulness/meditation. Now I know the latter has been commodified and mutated so as to remove any spiritual significance, and I know that some support groups have been coopted by the authorities and are no longer worth going. But if you find something through a YWCA or a women’s program, you can probably find a support group for survivors of childhood abuse, and there are plenty of genuine meditation practitioners out there who have no association with the so-called “mental health” system. I’ve personally used meditation practices to handle high-anxiety situations with lots of success. Of course, nothing works for everyone, and you have to find your own path, but both of those I’ve seen work for many people.
I’m so sorry you’ve gone through such horrors! It sounds like almost every authority figure you’ve ever known has betrayed you. I hope you are able to find some comfort and support from others like you, because your suffering is by no means unusual, though your particular experiences may be unique. It’s a crappy world sometimes, and we have to be careful whom we trust, but there ARE trustable people out there. Just not a lot in the places we’re told to look.
I agree. However, these syndromes should be called syndromes, not “disorders.” And the explanations given for them claim that they are something a lot more than syndromes. Clients are frequently told that they “have a chemical imbalance” or “their brain doesn’t work quite right” or “I know you want to pay attention, but your brain won’t let you” or “mental illness is a neurobiological disorder of the brain.” I could riff off half a dozen more “explanations” that are simply lies, given out of ignorance or malfeasance, it doesn’t matter. I have no objection to people using shortcut terms to communicate, but syndromes are syndromes, and when they’re treated as if they are something else, you get idiocy and destruction as a result.
Not to mention doctors doing a RIDICULOUS number of Caesarian sections in the first place – over 30% of babies in the USA are delivered by Caesarian. WHO recommendations say no more than 15%, which I think is very high. Midwifes often sport figures like 2-5%. US Obstetrics is almost as irrational as US psychiatry.
The video is an anecdote. It’s one story about one person. We should never make decisions based solely on personal anecdotes. We should look at hard data gathered from many people over time. And the data says that people exposed to electric shocks to their brains have brain damage, lose important memories, sometimes feel despairing and hopeless, and lose whatever “benefits” they gain within days or weeks of the “treatment.” I would never use ECT even if I thought I had no other options.
I have no problem with diagnosis as a means of getting insurance reimbursement. When I had to do psych diagnosis, I told the clients exactly what the diagnosis meant – essentially a description of what seemed to be happening on the outside, chosen for the purpose of getting the insurance company to pay for the needed services. I assured them that I was not in the least concerned with this label, which had to do with payment, and was very much more interested in what the client has to say about what’s going on, when it started, when it stops, what THEY thought it was related to, what has helped in the past, what has made it worse, etc.
As for psychometrics, sure, you can give someone the HAM-D and count up points and some will have higher scores than others, but what does it mean? I never, ever bothered with such silly nonsense, but instead simply asked the person the kind of questions that might be on such a questionnaire in the context of a normal conversation. As to whether they improved or not, well, they were of course the best and in many ways the only way to make that determination. I feel the same way about IQ tests (somewhat more reliable, but still, what the heck are you really measuring?) and any other psychometric tests. They are mostly very unscientific, because they measure undefined and undefinable entities. To compare a HAM-D scale score to a blood sugar measurement is absurd. One measures a physically determinable quantity. The other “measures” a concept. Measuring depression is as ridiculous as measuring courage or shyness or integrity. They are not measurable entities – they are social constructs that have meaning that varies widely based on both the reporter and the “measurer,” and can’t ever be standardized. They can be “normed,” but of course, “norming” makes the assumption that the average of scores on a questionnaire establish how things ought to be. There is no objective norm possible.
Diabetes is of course BASED on signs and symptoms, but it is not itself a SIGN or SYMPTOM – it is a concept or model that EXPLAINS why low blood sugar and other signs and symptoms are happening, and PREDICTS with some accuracy what kind of intervention will help. As I outlined very clearly above, an “ADHD” diagnosis does neither of these things – it provides no explanation as to cause, nor does it accurately predict what will help, because of course the same thing will not help all members of an utterly heterogeneous group. So what’s the point of saying someone “has ADHD” when it tells you neither the cause nor the treatment for the “disorder?”
As for psychiatrists, I defy you to name where I said they were all evil bastards. I believe there ARE some evil bastards at the higher levels of the hierarchy, and a smattering of evil bastards lower in the ranks, but most are simply grossly misinformed, and are committed (as you appear to be) to believing in these subjective and misleading categories of “disorders” which don’t serve them or their clients well.
I could go on all night, but I’ll stop here. You’re simply stating things without addressing my clearly expressed concerns with the system. You admit that psych diagnosis creates heterogeneous categories, and yet still feel the diabetes-insulin analogy is appropriate? It’s very hard to fathom how an obviously bright person as you appear to be can’t see how very different answering a questionnaire is from having one’s blood sugar measured. I’ll leave it at that.
The difference between your diabetes example and psych diagnosis is that at least for diabetes, there is a MEASUREMENT of something that is out of range, even if the range is arbitrary, and treatment can be gauged by whether the measurement moves in the right direction. The “measurements” for psych diagnoses are completely invented based solely on social/behavioral criteria. There is no actual measurement of something “out of balance,” nor is there any way to determine if the situation has been corrected, as there is zero attempt to discover or differentiate cause. Hence, totally heterogeneous groups are lumped together. To take ADHD as an example, a kid could meet the criteria due to low iron, sleep apnea, poor parenting at home, poor classroom structure or a rigid teacher, understandable boredom, prior or ongoing trauma, or lack of sleep, to name only a few. The range of potential solutions for diabetes is pretty narrow – improve diet and exercise, or alter insulin levels in some way. The range of potential solutions for ADHD is huge and totally variable depending on the situation. If you alter the diet of a kid whose mom is being beaten up, it will have little to no impact. If you assign parenting instruction for a kid whose teacher is a poor classroom manager or who bores the kids to tears, it’s not going to help. So calling “ADHD” a diagnosis isn’t just unhelpful, it’s destructive. It is like saying that a “rash” is a diagnosis. A rash can be caused by poison ivy, measles, or syphilis. You MIGHT want to know which is which before you start treatment, eh? A rash is not a diagnosis, it’s a sign. ADHD is not a diagnosis. It’s a sign that needs to be interpreted.
The prevalence of ODD is estimated between 2 and 16%? Any scientist would be filled with shame at such a massive range for a prevalence estimate! It’s like saying your IQ is between 100 and 110 with 45% accuracy. An 8x variance in prevalence might as well be admitting that you don’t know what you’re talking about or are just plain making it up from whole cloth. Which pretty much describes the DSM.
While I agree that attributing all early deaths to psychiatry is factually incorrect, still, psychiatry is the profession who has chosen to group clients in this way and the comparison between the labeled and unlabeled is their comparison. We would expect those labeled with heart disease and treated to do better than those with heart problems who receive no treatment. The opposite appears to be the case. I believe THAT is the point we need to hammer away at. I don’t want to spend a lot of time talking about the “other reasons” that this cohort dies earlier, because, as I have said, it is impossible to sort out that complex of a causal structure. HOWEVER, when we compare those receiving to not receiving “treatment” who have been so grouped by psychiatrists themselves, the “treated” group dies earlier, among a host of other problems that ensue. That point is factual and undeniable, and is more important than trying to figure out what percentage of people who took “atypicals” and developed diabetes would have developed diabetes anyway without the drug. I hope that makes sense to you and others on this thread. The idea that “not all of these deaths are caused by psychiatry” is a distracting straw-man argument. Obviously, they are not ALL caused by psychiatry, but the statistics tell us clearly that psychiatrists are killing a large number of their own patients.
Perhaps you can propose some language that takes the admitted uncertainty into account, and yet doesn’t give psychiatry an “out” for their failures?
Right. The difference is in science, when your “opponent” wins, you acknowledge it and thank him/her for furthering your understanding of science. Science is not about BEING right, it’s about GETTING IT right. Anything else is propaganda and politics.
If you’re offended, please stop reading and unsubscribe to any posts you’re subscribed to. Sounds like we’ll all be happier if you do. Deleting your account is not necessary.
A computer could literally do a better job. At least it would be consistent and not influenced by drug company inducements, and could be programmed to actually tell you about the potential side effects and alternative options. Most psychiatrists seem to provide negative “added value” to the process.
Actually, that would not be sufficient to diagnose a brain disease. It would diagnose a brain INJURY, but the “disease model” suggests that addicts are somehow different from “normal” people and that their addiction is a result of these biological differences. So in order to demonstrate a “brain disease,” they’d have to show that “normal” people can somehow be distinguished from “potential addicts” BEFORE exposure to the drugs, and that “normal” people do not develop the same brain injuries upon use. My guess is that most anyone using these drugs would accumulate the same incremental brain damage, and that addicts and non-addicts are not distinguishable before this damage occurs. I would surmise that the main difference between addicts and non-addicts is that the addicts gain something from the drug use that seems important to them, whether physiological, psychological or social, and that non-addicts are not seeking that same kind of relief or experience.
So, Ron, how would we distinguish between the lives they are responsible for ending early that those they are not? I agree it’s unwise to overstate the case, but I find no reasonable way to determine what percentage of the 25 year earlier death rate is caused by psychiatrists. For instance, if someone on Risperdal dies of heart disease, would they have died on their own without Risperdal? If so, would they have died later without it? Did Risperdal contribute to the person’s decision to smoke, as smoking is often reported as being a means of reducing the side effects of antipsychotics? Is the person’s decision to smoke their decision, or is it a consequence of antipsychotics? If the person dies earlier due to smoking, is psychiatry in any way responsible?
I find it much simpler to frame it this way: receiving treatment should improve the quality of life for the person receiving the treatment. If the person’s quality of life is reduced instead, including increasing health issues which create impairments and sometimes even death, it doesn’t really matter what percentage is whose responsibility – the “treatment” is making the patients worse on the average, and killing some of them early. I suppose it is possible to acknowledge that other factors are also involved, but this, of course, provides an “out” for psychiatry – they can claim that this death was caused by smoking and that one by suicide and the other by diabetes, without ever taking the slightest responsibility.
I’d be very interested in hearing how you would approach this dilemma.
I would also submit that whatever we say, the psychiatric “thought leaders” will ALWAYS paint anyone who doesn’t 100% agree with their dogma as an irrational extremist. It is an unavoidable side effect of trying to pull the pigs’ snouts out of the trough.
I also suspect that non-white families are more likely to distrust the “standard of care” and to stop at the first sign that things aren’t working well for their kids. There is an advantage to not trusting the medical system, especially when psychiatry is involved!
One of the fundamental core principles of science is skepticism. You’re always supposed to look for evidence to DISPROVE your hypothesis, and only when vigorous efforts to disprove it fail is it considered true. You aren’t supposed to try and skew the data to prove the hypothesis you want to be true! Something is scientifically true only if it is THE BEST hypothesis among all possible hypotheses. You don’t get to pick your favorite!
You don’t have to read or post, Pat. You’ve already said you’re leaving like three times. Is there something in this article that throws you over the edge? You do realize, don’t you, that there is no evidence that any of the SSRIs work with kids under 12, and the one study showing only Prozac working with teens was considered badly flawed? Does this not concern you?
Pat, I actually agree with your post. My only complaint about you is when you create conflict for no reason. Sharing your own experiences is great, as is making suggestions as to how people can come together, which you did above. I happen to agree that a synthesis would be the best solution. The only problem is that some folks are making so much money that coming together to build consensus will most likely never happen.
The recommendations include SSRIs for kids, when SSRIs have never been shown to be effective for kids (even by psychiatry’s weak and biased “evidence” base), and when SSRIs increase the suicide rate for kids. Brilliant.
WE means those of us who are committed to the truth rather than dominance of the current elite.
Another example: US outcomes for “ADHD”-diagnosed kids vs. Finland, where drugs are rarely used. No difference in outcomes. Stimulants do nothing to affect outcomes, and this study provides more proof that is the case.
The real question is how to get this actual DATA through the screen of BS that those wishing to dominate the world are able to put out there as propaganda. When you figure that one out, let me know!
You may be mistaking political multiculturalism for attending to scientific variables. The latter has no agenda except for truth, otherwise, it’s politics, not research. The WHO study was actually very important in this whole movement we’re involved in. They were hoping it would show that those poor, underprivileged countries would benefit from our benevolent drugging paradigm, but in fact, the opposite was proven to be true. They were so incredulous they forced the WHO to repeat the experiment, which had exactly the same results. It was one of Bob Whitaker’s “aha” studies that prompted him to write “Mad in America” in the first place.
The problem isn’t honest multicultural scientific studies. The problem is when fake science becomes the mute handmaid of politics. Real science is our friend, and showing that psychiatry’s cultish practices don’t work is easier, I think, the further away from Western society we look.
I don’t know, Cat, I think it’s totally legit to question research that doesn’t include cultural variables. What about those WHO studies showing that third-world countries had much better “schizophrenia” recovery rates than in the US/UK? I am against globalization as a manifestation of corporate dominance but in the context of science, I think it makes sense to realize that what “works” from a Western viewpoint won’t necessarily be seen as “working” by people from a different culture.
Arrogance and stupidity are certainly dangerous partners. A stupid person who is humble enough to know he is ignorant and seeks enlightenment can get better. An arrogant person who knows his or her business and gets good results is perhaps worth tolerating. But to be both arrogant and ignorant or stupid together is unforgivable, and that’s unfortunately a good description of the average psychiatrist, in my experience.
Of course, there is also the arrogance of knowing you’re doing evil and profiting from it, and continuing because you just don’t give a crap, and that’s the worst of the three.
Pat, there’s a difference between your psychiatrist and psychiatry as a profession. The conflicts that you keep bringing up and even creating seem to be related to this confusion. You have had your own experience and no one is entitled to invalidate that experience, and no one is trying to. However, you can’t extrapolate from your experience to all experiences, because then you are invalidating others who have had very different experiences than you. When someone has a different experience, it’s your job to listen, just like it’s my job to listen to your experience. That’s how this works. If you have a comment on the article that comes from your own experience, that’s totally your right. It’s just not your right to say that those who want to abolish psychiatry because of their own crappy experiences or their own research are not entitled to their own conclusions. Please feel free to communicate any DATA that you have that might refute the article, or please feel free to give your own personal ANALYSIS of the data that is presented, but it’s just not OK to keep accusing people of being horrible because they don’t agree with you. This is a free country. People are entitled to draw their own conclusions about psychiatry. If you want to have that freedom yourself, you need to grant it to others. Otherwise, you will get into endless arguments and accomplish nothing but annoying yourself and others.
More arrogant than stupid. Unwilling to look at actual data or actual PEOPLE in front of them. More interested in being right than getting it right. The field breeds narcissism.
The other thing is, even if a dietary change helps only a little, it starts the person down the path of realizing that THEY THEMSELVES CAN CHANGE THEIR CONDITION! The very worst thing about the current psychiatric model is not the drugs – it is the nihilistic message that you have no control over your own brain, mood, thoughts, and behavior. It is the exact opposite of what actually helps people. So if they find that reducing copper improves their behavior, even if it’s still not great, the psychiatric message is broken – they realize they CAN do something about it, and perhaps even realize that the psychiatrist they were trusting has no idea what s/he is talking about.
Angry is up the scale from depressed. I had to go through a very angry period before I came out the other side and started feeling rational. I think anger means you’re getting in touch with how YOU have been mistreated, instead of blaming yourself. Because depressed people mind their own business and don’t bother anyone, but angry people DO things – they FIGHT! I’d say respect that anger and see if you can use that energy to take action, as we talked about before. And too bad for them if they don’t like the “new you.” They have contributed to that anger and it’s about time they saw the real results of their behavior. That’s my take, anyway.
Oh, they don’t want to annihilate them, they want to keep them weak and dependent so they can bilk insurance companies out of billions without having to look for new customers. They don’t MIND if they annihilate its victims, but only after they’ve squeezed them for a bunch of pharma dollars first.
I’d be desperate, too! What amazes me is that someone with an obvious historical and ongoing trauma background is drugged because of “brain chemistry problems.” WTF – did they think you’re supposed to be HAPPY about all this? It’s total victim blaming to me, and I’ve seen it a LOT.
I think waiting to taper the Effexor makes a lot of sense. That’s another principle I try to apply – one thing at a time. Depression is also a reaction to being overwhelmed – kind of like “playing dead” when you can’t fight off an attack. It seems like getting clear from your parents’ influence has to be the priority. You’re like a Viet Nam vet with an apartment under the helicopter pad across from the gun range!
OK, so it sounds like you’d like to get away from your parents, but feel you can’t afford it. Is that the basic problem? It sounds like they are the ones making you nuts or reinforcing your upsetness.
What would you like things to look like if you were moved away? See if you can visualize what it would look like if things were better.
$733 a month isn’t much to start with. Where do you live? Are there housing agencies near you? Would you qualify under some other category for extra assistance – for instance, if you’re a domestic abuse survivor, there are funds that are specifically available to help AND specific housing resources reserved for that kind of problem.
To really help, I’d need to know the resources in your area. I am sure there are many others who have suffered similar problems and found a way – I’m sure you can find something. But I know it’s really tough moving forward with all of the withdrawal effects, too! So maybe the first step is accepting that you’ll be there a while, and that your parents will be kind of jerky, and to make a plan of how you can respond that will minimally sap your energy? My wife came up with a plan to simply acknowledge the possibility that her mom was right about things – “That’s a good point.” “I can see how you might be worried about that.” “You’re right, life can certainly be dangerous at times.” Never actually agreed to DO anything her mom suggested, but it stopped the arguments when she seemed to agree. That’s just one approach. Sometimes you have to be creative, but that in itself can start to be almost fun if you take the right attitude – namely, this is a problem and I’m going to try different approaches and see what works, meanwhile not bothering to explain how I feel or try to alter their behavior one iota.
The other thought for immediate improvement is instead of hiding in your room, to get outside, preferably to a wooded or grassy area where there aren’t too many people around. I find walking to be very rehabilitating, and sometimes I walk around and touch the trees and plants and say hello to the insects and birds and just get in touch with present-time reality. The further away you are from your parents, the easier it will be to relax and think straight, at least that’s what I’m guessing from what you shared so far. My guess is that they have been a big part of how you ended up being drugged in the first place. My parents were both really nice people, but they still contributed big time to me being fucked up as an adult. In some ways, I understand they did the best they could, but it was NOT good enough and they caused a lot of pain for us. Dealing with that was the MOST important thing I did to regain my emotional balance, but I had to not be living with them to do it. You can’t move away now, but you don’t have to spend all your time in that house.
Don’t know if any of that is helpful at all – just kind of sharing what’s worked for me. Another path that can be helpful for some is to find a support group of adults dealing with childhood issues. It can help to tell your story and sometimes you can make friends or at least have colleagues who share your pain. Doesn’t work for everyone, but just thought I’d toss it out there.
Bottom line, you can’t change how other people act. The only thing you completely control is your attitude toward their behavior. Not saying it’s easy, because it isn’t, but any small step you can take away from being under their control and observation will be a step toward becoming healthier and more capable and less depressed and hopeless.
I think job one is realizing that depression is a normal reaction of the body/mind to being in a place and time that isn’t working for you. It sounds like you recognize this yourself. What is it that you would like to be different about your life? What seems to be in the way of making that happen, internal or external? That’s pretty much how I worked with most of the clients I had, and I was very successful in helping them. Another aspect of depression is that it is generally engaged when we feel there is nothing we can do to alter the situation. It’s a self-defense mechanism so we don’t waste energy in a hopeless situation. But there are almost always things we CAN control that we often take for granted or fail to recognize as options. If you can start finding where you want to go, and find things you DO control that can lead you even slightly in the direction you’ve identified, you’ll start feeling a little better. It’s a lot harder than taking drugs and it takes longer and sometimes it’s scary because we have to do things we don’t want to do, but the solution ultimately takes us to a new place and we learn things that help us solve future problems.
I’ve suffered a lot of depression in my life, but rarely do today. It’s been a long, long road but I’ve stayed on it and it’s led to a better place.
I think this is a very wise post. Us vs. Them is the oldest meme in human history. We have to find ways to let the person who disagrees know it’s OK to disagree, and to listen to WHY they believe what they do. It is also almost axiomatic that a person being defensive about something is ambivalent, or they wouldn’t have to be so emotional – they’d just be kind of incredulous or scoff but they don’t get upset about it if there isn’t some uncertainty there, usually a LOT of uncertainty. Helping the person locate the pro vs. con in him/herself can enable them not to project the con onto you as the “enemy.”
And the DSM admits it’s not powered up to designate causes, but it’s used as if it is. Most of the folks I know who went to psychiatrists (and I worked 20 years with foster kids, so I have known A LOT!) say that the psychiatrist told them they have an imbalance of brain chemicals that causes their difficulties. It is not the beginning of an investigation – it is THE END.
Again, there is no point to “diagnosing” someone with something where those with multiple causes are lumped together based on external observation alone. It only adds confusion. Syphilis is a diagnosis. A rash is a sign. If ADHD is the start of investigation, it’s a sign, not a diagnosis, just like a rash.
I know of at least three different studies from different locations – one in Kentucky, one in Canada, and I can’t recall the third. All found the same result. I think there were even a couple more that someone else talked about, but I didn’t read them. They looked at kids just before the age cutoff for admission and those who were just after the age cutoff, and so started almost a year later. All three reported something around 30-33% reductions in diagnosis rate.
Too true. Good experiments in the 70s showed that “ADHD” kids are indistinguishable from “normal” kids in an open classroom setting. Too bad we don’t care enough to create them. We actually helped create a charter school for our kids that allowed for lots of free movement, interage classrooms, signing up for desired classes instead of just assigning kids to teachers, democratic classroom rules, etc. Our youngest, who would TOTALLY have qualified as “ADHD” in Kindergarten (his nickname was “Wild Boy!”), had no behavioral difficulties whatsoever and graduated with honors. I’m just sorry that most kids never get that chance.
I commented this on another thread, but I always wonder how many “assaults” on staff are actually assaults on the “patients” who then retaliated or defended themselves? Nutrition is important, but traumatization and oppression are the big drivers of violence and “mental illness.” Hell, oppression is the big driver of crappy nutrition, too!
I think the problem is that while the behaviors so labeled do exist, there is no reason at all to believe that all people so labeled have anything wrong with them at all, or have the same problem if they do have something wrong. The DSM itself admits this in its introduction, saying that, it is not assumed “that all people having the same diagnosis are alike in all important ways.” So what’s the point of labeling something based solely on external observations when the group so labeled is completely heterogeneous? It’s like saying that everyone with a skin rash has the same problem. Some of them have poison ivy, some have prickly heat, some have the measles, some have syphilis. Might be a good idea to figure out which one the person has before you start treatment, eh?
Not to mention, a lot of kids labeled “ADHD” have nothing wrong with them at all. A number of studies have replicated the finding that admitting a child to school one year later reduces the “ADHD” diagnosis rate by 30% or more! So while there may be a small number of “ADHD”-diagnosed kids and adults who actually have something biologically wrong with them, there is no way to distinguish these from those kids who are simply bored or who have a naturally active personality and don’t like to sit still or who don’t get enough sleep at night or who have low iron or whose parents are violent or whose parents are neglectful or lack parenting skills. Calling all such cases “ADHD” simply creates confusion and prevents us looking into what might really be causing these subjective “symptoms.”
An excellent point! I’d love to see how many “Aggressions” or “assaults” by residents follow actual hands-on aggression by staff on the “aggressive” resident/inmate.
We don’t really disagree, except on the point that calling this an entity “ADHD” to me really just confuses things. Why not say “Hyperactive behavior” or “inability to pay attention” and study the underlying various reasons for it. Since the people grouped together as having “ADHD” may have nothing in common as to the cause, calling it a disorder is nothing but misleading. Of course, the REAL reason that ADHD was constructed was not to figure out the cause but to sell the “cure,” and many other “disorders” were constructed for the same purpose. Rational people like you and me without conflicting interests could certainly study “ADHD” as to underlying cause with little confusion, but sadly, there is a huge financial and social incentive to call these things “disorders” so that drugs and patented therapeutic interventions can be sold for a profit.
The only way psychiatry will change is if the financial incentives that reinforce it are altered. It is very clear that psychiatry chose its current direction out of a desire to maintain control of the field and to assure that psychiatrists could make lots of money with less work. It is also supported by the “permanent disability” concept that keeps their biggest funders, the drug companies, making billions. No amount of data can overcome the greed and power drive that is behind the current psychiatric paradigm. It will only stop when it stops paying off.
Actually, the article is kind of disturbing. First, they blame “fear of stigma” for African-Americans not seeking out counseling, overlooking the more obvious explanation that on the balance, they are less likely to trust any institution and that the “mental health system” doesn’t feel at all helpful to them. It also avoids the rather obvious question of why more “treated” kids have more problems with anxiety and depression by claiming that “treatment has allowed more kids with mental health issues” to enroll in college. They really don’t seem to have a clue, but they’re going to keep operating on their misguided beliefs.
Hmmm… more and more college students are taking psychiatric drugs, yet the number of students with “mental health concerns” is rapidly increasing. Ya’d think all that “treatment” would drive the numbers down instead of up. What could be going on here? Of course, no one will really ask that question.
I believe it was the other way around. Dianetics was wildly popular in the 50s and the psychiatric field saw it as a big threat to their hegemony. The AMA and the APA attacked Scientology viciously and consistently all through the 50s and 60s and the IRS continued to pursue them even into the 80s, until George HW Bush decided to change the tenor of the IRS and told them to accept that Scientology was a religion. I think it’s fair to say that Hubbard decided that the answer to being attacked was to attack back. I suppose you could say a vendetta developed, but from what I understand, psychiatry threw the first punches. Scientology also very strongly believes that drug use is damaging to the human spirit in severe ways, and so as psychiatry has relied more and more on drugs, the antipathy has become greater in both directions.
And there are also kids who naturally hate sitting still and love exploring their environment in a physical way. Such kids have NOTHING wrong with them at all, but are inconvenient for adults to manage, and “treatment” is usually nothing more than an attempt to make them easier for the adults to deal with.
That is very true. It’s important to keep the statistics very simple, and to have stories available as illustrations of what the stats mean for normal folks who don’t have advanced degrees. That’s why I tell the stories first before getting into the data. But for some people, data is irrelevant, at which point, I would stop using it as an argument.
There is a lot of “secondary gain” from going along with the system. For people who have little, it can provide an identity, sympathy from others, an excuse for failure, and protection from dealing with emotional pain from the past, just to name a few items. It can also be scary to try and escape, as one faces isolation, anger from friends and family members, condescension and/or outright hostility from providers, and serious but unacknowledged side effects of withdrawal, just to name a few. It’s kind of like an abusive relationship – it requires a lot of courage to leave and it’s a lot easier to stay, despite the intermittent or even constant pain and disrespect you receive.
As a dad who helped raise two classic “ADHD” boys, I can empathize with your statements. It sometimes feels like others expect us to “control” our children when it is very clear that these kids make their own decisions and HATE being controlled in any way that feels arbitrary to them. And I would say I also resented anyone who felt they “knew” how I should parent my kids without any actual knowledge of what it’s like to be in my shoes.
That being said, I am a scientist and a mental health professional as well as a parent. I appreciate Timimi’s work because he’s always been objective and not afraid to disagree with the establishment if the data tell him they’re wrong. If you look at the long-term DATA regarding “ADHD” interventions, it is VERY clear that long-term outcomes are NOT improved by the long-term use of stimulants. That being the case, it seems pretty shortsighted as a society for us to insist on stimulants as a primary intervention and to disregard or minimize the potential benefits of psychosocial interventions which have a greater chance of making these kids’ lives better in the long run.
Additionally, you and I may not be interested in controlling our children, but there are most definitely parents and especially teachers and other professions who have control as their main objectives. There were a number of studies done back in the 70s showing that the optimum dosage for academic attention was much, much lower than the average dosage, and that most doctors increased the dosage to the optimum for behavioral control, which dosages actually diminished the child’s ability to attend to schoolwork.
So I urge you not to throw out the baby with the bathwater. You seem an intelligent and committed parent with the best of intentions for your children and all children. I strongly suggest you re-read the article and pay attention to the actual DATA that is presented, and forget what it means about you or me or your particular situation. If we think about the welfare of all kids, the data is pretty clearly telling us that we need to look at stimulants as at best a short-term intervention, and we need to look at a whole range of other options as a means of really helping these kids become functioning adults. Some examples are: alternative schooling (child-centered classrooms), meditation, exercise, nutritional interventions (low iron is particularly common), addressing sleep apnea, teaching parenting skills specific to intense or oppositional children, teaching self-management skills, and many others. If we really care about helping these kids, we have to get past our own personal fears and ego and look objectively at what has proven to help. At least with regards to the kind of long-term outcomes that matter to most of us, like delinquency rates, college attendance, high school dropout rates, social skills, and self-esteem, stimulants fail the test.
You might want to read Corrina’s MIA post on anecdote vs. aggregate that was posted just today. It is very much applicable to this discussion.
The main reason anecdotal information is preferred is because of the financial incentives. Unless those change, it’s hard to imagine the industry actually respecting the real data. There is no money in honesty.
As for those who are themselves convinced by the propaganda, it’s very important to start by acknowledging the reality of their personal experience. I think the next question would be to ask, “Do you think that everyone has the same experience as you do, or do you imagine that some people have different experiences?” If they can’t handle that possibility, I would not bother with further discussion. Some people are like that. If they can, I’d ask, “Would you like to hear some more about that?” and then share some anecdotes (after all, this person is basing their assessment only on anecdote, right?) where things didn’t work out so well. At that point, you can introduce the concept of aggregate data, maybe starting with, “So let me ask you to imagine this: imagine that some people (like you) feel like they do better taking these, some people feel like they do worse, and a lot of people don’t feel very different. Can you imagine that happening?” If they can, you’re in a place to start educating about aggregate data. But you have to get the person to allow that aggregate data is relevant or important before it will be a viable argument.
It is also VERY important to recall that they screen out actual suicidal people before starting these trials. So ALL suicidal participants developed suicidal thinking and/or behavior AFTER they started the trials (outside of the possibility of dishonesty in an odd participant here and there). The actual suicide rate in community practice would be considerably higher.
I also think it is very possible to be civil regardless of whether the articles are big or small. We can be honest and still be respectful. That goes double for authors who post here, as it should be clear that reactions are expected and normal, and that not all posters will necessarily communicate as diplomatically as could be wished.
I agree 100%. There is no training for the kind of ability to be present and non-judgmental and patient yet firm that is needed to be a true helper. I started out in the field by the back door, and had only a three-hour group processing class under my belt. I think this worked hugely to my advantage, because I knew I didn’t know anything and I also knew the only source of the information I needed to figure out what to do was the clients themselves. So I asked them questions and learned from them and I developed my own “theories” based on what actually seemed to work.
I had one other advantage: I had already had some very good therapy and worked through a lot of my childhood issues, so I knew what good therapy looked like, and I also knew how to separate what was my emotional reaction from what was the client’s need. This is the real “training” for therapy, the only training that will really help – learning to understand and respect how your own life was shaped by your childhood and adult experiences and how to change your perspective on your own life. Absent that, 20 years of “clinical training” will do little besides make you feel like you should know something that you really don’t.
I agree with you, when we’re talking about a lay person being a caregiver. When it is a paid staff person, however, the client should be the focal point and the caregiver’s goal should be to be as helpful as they can to the client without letting their own immediate feelings drive their decisions. Not saying that having and sharing feelings in a therapeutic setting is always a bad thing (I do it a lot) but it needs to be done because it’s good for the client, not because it makes the professional feel better. And I’m speaking from very direct experience here. Happy to share an example or two if need be.
I am afraid I can’t agree with the idea of a genetic basis for “mental illness.” So far, the best correlation that has been found explains about 15% of cases of a range of “mental disorders” as described in the DSM, and this was a set of over a hundred genetic markers and was the most optimistic interpretation possible from the data. On the other hand, well over 80% of those diagnosed with “schizophrenia,” the most “genetically linked” of “disorders,” report histories of abuse and trauma. So it’s pretty clear that environment is MUCH more important than genetics in explaining “mental illness.”
Beyond this, there may be genetic patterns that leave one more vulnerable to stress, but such patterns might also make one more sensitive to others’ feelings or more capable of bringing people together socially. Genetic diversity is the key to species survival, and we need people with a wide range of genetic presentations in order to succeed as a society. Arbitrarily defining certain emotional or behavioral responses as “disorders” denies both the importance of genetic variety and the fact that such responses are almost always related to unresolved stress, much of which comes from the bizarre expectations put on us by this bizarre society we live in and for which we have not had time to evolutionarily adapt.
When a helper takes on the experience of the “helpee,” they generally set up a situation where the “helpee” feels like they have to take care of the helper because of their distress. I’ve always felt the best approach is to put oneself into the helpee’s shoes long enough to get a sense of what is going on, but then backing away and looking at the situation from a more removed perspective. That way, I can ask relevant questions and suggest options without being invested in whether the person I’m helping agrees with me or not about my assessment. This is critical to the person feeling empowered, and empowerment is at the core of any kind of healing, IMHO.
Wow, those reactions, especially the movie comment, really do sound like antidepressant-induced numbness. She is being portrayed very unsympathetically by the media, but it sounds like she has been a multi-generational victim of both child and pharmaceutical abuse.
This was known back in 1987. Prozac was banned in Germany initially for this very reason – suicide plus aggression. I think in Italy as well. The rest is all smokescreen. There is no question that SSRIs increase suicidal and homicidal thoughts in a small proportion of users.
Well, I certainly can’t argue that all of that abuse and disrespect and injustice isn’t a big contributor to suicide rates and serious health problems! And I very much appreciate your attending to these very important issues that almost never get mentioned by any writers.
That being said, it seems very hard to deny that drugs which induce diabetes and heart disease, and as many report, create a stronger urge to smoke cigarettes as a means to minimize side effects, are not HUGELY contributing to a 25-year earlier death rate. And in truth, I regard it as the responsibility of the pharmaceutical industry or mental health industry to show that these are NOT causally related, as safety should be the primary concern with any form of “treatment.”
In any case, whether the drugs or the surrounding environment of disrespect and injustice are more important factors, it seems very clear that spending time in the hands of the “mental health” industry is currently hazardous to one’s health.
Can you elaborate on the correlation/causation comment? It appears to me that Whitaker’s summation of the evidence pretty clearly shows more than correlation, though I think it’s fair to say that further study is needed. I agree 100% that incentives drive what care is provided, but a pretty radical rethinking of the current model (beyond mere capitation) would have to happen for psychiatry to get itself back under control. It is a highly corrupt field, as you yourself have experienced.
Your comments don’t make sense to me. I never compared you to anyone, I simply gave examples of people who had worked through delusions and hallucinations without drugs. You also evaded the main point of my comments, namely that you are making gross generalizations about “people at MIA” without reference to specifics, and your comments are not relevant to the article above. I think you’ll be happier at another website, but blaming folks here for not approving of your hostile comments seems out of line.
Pat, please find a forum that meets your needs better. It is not helpful to have you constantly looking for a reason to lash out. I’ve reported both of your last two comments, as they are hostile and have nothing to do with the topic at hand. I’m not sure why it’s so important for you to be right about MIA being wrong, but I would really like you to take a look at your motivations.
It seems that anything you, Ron, are suggesting could be prescribed by a GP or family practitioner. There is nothing medical that is really helpful that is specific to psychiatry, except perhaps for the few who know how to wean people off of their wonderful psychiatric drugs. There are real physiological things that could cause “psychiatric symptoms,” but again, these could be provided by the appropriate medical specialist. There is really nothing “medical” that psychiatry brings to the table that isn’t based on their subjective and deceptive DSM diagnostic scheme. And we know exactly how scientific that scheme really is. So I guess I’d ask what psychiatry as a medical specialty can bring to the table that can’t be addressed by another doctor?
It’s important to remember, I believe, that it’s not just a matter of creating dependency – psychiatric treatment can and often does make clients WORSE and psychiatrists deny this, and it also creates massive health issues that kill clients 25 years sooner (in the case of those taking antipsychotics) than the general population. Further, it creates a lack of trust in ANY helping person, which creates further isolation from potential help from any source.
I assume you have read Anatomy of an Epidemic? If so, you will realize that these “treatments” on the average make a bad situation worse in the long run, even if they may temporarily provide a respite in the short run. I believe the evidence is pretty clear that the only real utility of these drugs is for the short-term reduction of undesired feelings or difficult behavior (and I am talking from the CLIENT’S viewpoint, not difficult or undesired by others, which is the usual standard), and the long-term use of these drugs should be avoided in any way possible.
Would be interested in your take on these issues. Thanks for being so available to talk about your views and experiences!
I think the difficulty in this conversation is the association of the word “psychiatry” with “anything that can be done to help a person suffering from mental/emotional distress.” If psychiatry is defined as the latter, than antipsychiatry doesn’t make sense. If psychiatry is defined as “the medical ‘treatment’ of any form of emotional distress, regardless of the cause,” I think antipsychiatry makes a whole lot of sense.
The huge problem is that there is no way to guard against “overmedication” because there is NO OBJECTIVE STANDARD for when “medication” is needed.
Hey, I just thought of a new word: “mendication.” It combines “medication” with “mendacity” (the intentional telling of lies to deceive or mislead). What do y’all think?
It is true that Freud originally believed his patients and attributed their difficulties to having been abused as children. It was only after the Viennese aristocracy excoriated him for saying such horrible things about them that he developed his “drive theory” to explain away his observations. He chickened out, for which I can’t forgive him, but we do need to give him credit where credit is due.
One more example of the social/psychological causes of “mental illness” as defined in the DSM. It amazes me how the “profession” continues to maintain its fiction in light of the overwhelming evidence against it?
FeelingD, that is a very good reason why I would like to see this. Being arrested is being arrested, and it’s often not pretty. Once it’s clear that people are being taken into custody and their words are being used against them, the general public might start to get an inkling that “involuntary treatment” isn’t some benign act by caring individuals – it’s often an act of the severest brutality!
I have often thought that a Miranda warning would be very appropriate for psych hold evaluations. Maybe that’s a fight we can win?
Sorry for your HORRIBLE experience! It is hard to believe that such a thing could be considered “treatment” by anybody but a Nazi death camp commandant.
Actually, the history of psychiatry exhibit was amazing. They had it in Portland. Definitely needed a “trigger warning,” though – especially the exhibit on the “lobotomobile!”
Hey, maybe we can get together and write a “consensus statement” on the use of daily alcohol consumption as a “treatment for anxiety!” We can get papers published and maybe get a grand from Seagram’s or Jim Beam or Budweiser. What do you think?
Oh, come on, no one can make a profit from recommending walks! We have to re-name it as “therapeutic perambulation treatment” and patent it, and require the person to go do a doctor to get it prescribed, but only, of course, as an ADJUNCT to their “medication.” Otherwise, you start losing customers!
There were much more egregious things going on than Pauling. Why don’t they talk about the intentional suppression of nursing in favor of formula, the Thalidomide scandal, the denial that Benzedrine was addictive, then that Valium was addictive, then that Xanax was addictive, the denial that Tardive Dyskenisia was caused by antipsychotics, the denial of violence and suicidal behavior caused by SSRIS (known before it was ever on the market), the promotion of electronic fetal monitoring, which caused a huge increase in the Caesarian rate without any improvement in outcomes… I could go on.
And sadly, these two issues (corruption and appeal to authority) play very well together in our current climate. If we taught our kids to question authority, we’d be miles better off, even with the perverse incentives in place.
You avoided my question, so I will take that as a tacit admission that you were wrong but can’t admit it.
As to your question, it’s not even coherent. “Only white peoples messing with big pharma?” What does that even mean? If you are suggesting that only white people are victimized by Big Pharma, you’re really out of touch. The disproportion of black men diagnosed with schizophrenia and drugged accordingly is admitted even within mainstream psychiatry. Of course, they blame the black men…
Sounds like you’d be better off on another forum that is more in line with your values, but it’s really not cool to come here just to make trouble.
I guess you see what you look for. It’s a shame you are looking to find negative things. Monica is only one author, but you get stuck on her and spread it out to everyone else?
Besides, you still are avoiding my question: can you admit that you misinterpreted the author’s intent? That she never suggested that you were a “good little boy” for following your psychiatrist’s advice?
So it sounds like you get a catharsis by intentionally annoying other people who don’t agree with you? Is that right?
I’d really appreciate some clarity about what is cynical about the article, and more importantly, that you misinterpreted both the author’s and my comments about the “good boy” comment. It is very clear in the article that the author was APPALLED that the psychiatrist would call his client a “good girl” for following orders. You seemed to think she was somehow expressing contempt for you or “your kind.” You were clearly way off base. Can I at least get an acknowledgement on that point?
You are saying the author referred to “your kind” as being “a good boy” for “taking your medicine.” I assume you feel this characterization is disrespectful, which I agree with. That’s what I mean by “your views.” My point is, the author did not use that term at all – the psychiatrist used it to refer to the patient, and the author objected. So on that point, you two agree.
I find it challenging to communicate with you about simple stuff like this. You seem to get upset by things that aren’t even intended, and seem kind of ready for a fight even with those who don’t disagree with you. This is just one example. It’s frustrating. I have no intention of insulting you, but your comments seem sometimes very far off base to me, and in this case I am trying to simply refer you to the actual statement made by the author so we can have a common ground to discuss things.
I also fail to see how the author is being cynical by reporting her direct observations on how cases are handled. She is simply sharing case histories that she has been a part of. She has had a different experience than you, as have many posting here. I have acknowledged a number of times that you have had a different experience and have every right to your perception of the value of psychiatric treatment. It seems you have a hard time doing the same for others who have found it less than helpful for them or their clients. Why is that so difficult for you?
There has always been a disparity between men’s a women’s “treatment” by the “mental health” system, going way back to Freud and before. Women who don’t fit in get rough treatment from our society.
You have missed the context. It was the PSYCHIATRIST who called his patient a “good girl” for taking her medication. The author found such behavior appalling, as it reflected the psychiatrist’s authoritarian and paternalistic view of the patient as a little child, almost sub-human. I am not sure why you’d be angry at the author, as she agrees with your views on this point 100%.
The first time I visited a psych ward, my first thought was, “Wow, if you weren’t depressed before you arrived her, you’d sure be depressed afterwards!
Incarceration is deeply harmful, but insisting on calling it “treatment” and expecting the prisoner to appreciate your kindness is even worse! If they’d at least admit they’re imprisoning you, it would be a step in the right direction!
Dream theories also put the locus of control back on the client, and that is very much counter to the financial interests of the psychiatric drug lords.
How did no one notice this for 17 years? Answer: they did notice it but ignored it or thought it was OK. This should be proof enough that enforced institutional “treatment” is extremely dangerous and should never be allowed!
That’s a great analogy! Didn’t know Jung was such a critic, though perhaps I should not find that surprising. Of course, he’s right on target. I use the analogy of trying to figure out why a computer program isn’t running by looking at the memory chips and other circuitry. The computer certainly can’t run without chips, but to reduce a computer’s function to chips and printed circuits and to try and resolve every issue by altering the electrical functions of the computer will lead to a lot of broken computers and very few that actually work. Even a rationally materialistic approach has to allow that there is a PROGRAM running to tell the computer what to do, and you can’t re-program by altering the circuitry!
Awesome recommendations – looks like this guy gets what’s not working about the “mental illness system.” Unfortunately, he fails to address the main driver of the current distorted paradigm – finanical incentives. Until and unless these financial incentives are addressed, the “social determinants” he mentions will never be the driving force behind decisions, because profit will always be prioritized over patients in the collective. Changing incentives is the key to changing the system. Don’t pay people well to do stupid things!
They seem to be missing one very important aspect of help-seeking behavior: whether or not the “help” sought in the past has been helpful! My guess is that educated white folks are more likely to see the current model as likely to be helpful, while lower income, darker-skinned, and immigrant folks are more likely to view “the system” with suspicion based on bad experiences in the past. This is especially true for those who have sought help and found it damaging, which I would bet my mortgage is more likely to occur the lower in income or SES the person “seeking help” is.
So exactly how much ARE you allowed to cry as a result of bullying? Is there an “excessive crying scale” to judge when you’ve gone too far? And who gets to decide where the “cutoff” value is? You’re right, “feminine” traits like emotional self-expression and tears are most definitely pathologized at a much higher rate, and we boys learn that VERY early on. One of the worst insults as a boy is being called a “pussy,” which means not being “man enough” to handle abuse without complaining or getting emotional. The hatred of gay men is also very related to the male fear of the feminine. And yet they look to the BRAIN for causes of “mental illness?!!”
The idea that you have to “stabilize” in the therapist’s office is about as offensive and anti-therapeutic as I can imagine! If you can’t cry in your therapist’s office, where the F*&K can you cry? Clearly, therapists like this are more interested in protecting their own psyches from their own repressed childhood rage and grief than they are at helping you. Such people should not be allowed to be in any “helping profession.” They should arrange flowers or pour concrete or do something where they can’t hurt people.
I know the “MH” system is crap, but this I find astounds even me.
“Stigma” is also code in the mental health industry for “don’t do anything that might make someone feel bad about taking any drug we prescribe them.” The “stigma” created by their own labeling and “treatment” system rarely seems to enter into their view. “Stigma” has become a loaded word in the MH community, and its most common use is not in any way empowering.
Crying in public is now cause for involuntary hospitalization? Things are even worse than I thought! That’s RIDICULOUS! I am a sensitive person and as a male I had to learn to control my tendency to cry by about 1st grade because of all the shaming. It’s one of the worst impacts on my “mental health” that ever happened. I spent years learning how to cry again. To consider you “dangerous” because you’re crying – I just find that stunningly inane!
It appears that many therapist/psychiatrist trainees don’t even learn about the unconscious mind, or relegate it to some quaint historical place in history when we didn’t understand that the brain is everything. It is a disturbing trend.
And there are excellent examples of it already being done. Switzerland being perhaps the best. Insurance companies still participate in the market despite single-payer government controls and they make plenty of profits. The real problem isn’t lack of interest, it’s conflicts of interests, as in our legislators being bought off by insurance companies.
Now they’ll probably come up with a range of “spiritual-informed therapies” and get patents on them and then sue people who use their approach without a license.
Thanks, that is very educational and comports very well with my own observations. Techniques are like tools that one can use or options that one has available, but without client motivation and a good relationship, no particular technique is of the slightest use. Given that placebo effect is just as strong as technique, I think we can dispense with spending a lot of time talking about which approach is “best” and recall that all good therapy starts with good human relationships.
While I of course disagree with the medical terminology used in the article, I am very pleased to see mainstream psychiatrists finally taking a stand and putting out some real data. The lack of scientific support for the diagnosis, the association with younger age, the multiple reasons why this kind of behavior might occur, the total lack of evidence that ANY long-term outcome is improved by stimulants, the adverse psychological impact of being labeled – short of saying that ADHD is a fraud, this article covers all the important bases (except maybe for diet/exercise and alternative medicine) and I’m just astounded that this is published in a mainstream journal. This presents a great opportunity for us to build on an excellent summary of the data from a source that psychiatry itself can’t invalidate. Though I’m sure they’ll still try…
A truly competent therapist should never consider that s/he knows best what is good for others. I’ve never operated on that assumption – I figure the client is the ONLY one who knows what’s really going on, and my only job is to help them sort it out and get some kind of perspective on it so they can look over their options as consciously as possible. The arrogance in assuming that someone knows better than someone else what’s good for them is a sure path to harm and destruction.
A lot of practitioners do CBT (or DBT) in a way that presumes superiority on the part of the therapist/counselor, and the professional feels OK about forcing the client to “create positive thoughts” or other such nonsense without the agreement or cooperation of the client. As has been observed many times in the past, how the therapist relates to the client completely alters how the client experiences whatever modality is uses, so in fact, the therapist’s ability to create a bond with the client and be a safe and real person to whom the client can relate is much more important than what school they subscribe to. CBT is really just a set of skills. They can be useful if approached and offered in an empowering way, or they can be experienced as oppressive if forced on the client or presented as the only possible approach to healing. When I did therapy, I used a variety of approaches, psychodynamic, CBT, motivational interviewing (though I didn’t know I’d basically invented that approach until years later), or whatever was helpful to the client in the moment. Milton Erickson said that you have to re-invent therapy for every client you meet. I agree with him 100%. There is no mechanical approach that works for everyone. What works is listening and caring and being creative and responding to the client’s needs. The rest is window dressing.
Did the author say she opposed AA? I didn’t read that. Why don’t you try to focus on the article instead of picking nits? Seems like you’re looking for an argument!
Teens and young twenties I’ve talked to about it have said that they find it kind of insulting that adults argue they can’t “deal with” this kind of material – they say they ARE dealing with it and it feels like someone’s finally TALKING about the realities they face. I would agree that a person who is already feeling suicidal, especially if they are a sexual assault victim, might need to be very careful about whether they want to watch it or not, but it is rare that teens get to hear something in a teen voice that is so real and relatable for them. That’s why it’s so popular. And you’re right, the absence of any focus on “mental illness” is one of the series’ primary strengths – it focuses on the fact that there ARE reasons for feeling suicidal and it’s NOT abnormal and that there are THINGS THAT ALL OF US CAN DO ABOUT IT! To me, that was the most exciting and positive message – that any of the 13 people could have made a difference in her mind, and perhaps if only one of them made a different choice, she’d still be alive. It was tragic on the one hand, but on the other, it ended with a message of hope, which is more than I can say for most shows addressing “mental health issues” like suicide.
I had forgotten that point, though I have observed it – there is a great deal of shame in “failing” to kill oneself, and the hospital venue TOTALLY reinforces this, with everything from condescending pity to messages that the client’s “disease” made them do it, implying they are “wrong” for wanting to kill themselves. I wonder how much that contributes to the huge increase in suicides AFTER hospitalization. The whole thing is humiliating, especially if it’s involuntary, and no one seems to be willing to simply acknowledge that to the clients.
Thanks for sharing and reminding me of that important perspective!
You are so right, and if the psychiatric community would deal with reality instead of their financially-fueled fantasies, they could help route a LOT more families down the right road! That’s what I’m saying – not that families can’t face these facts, but that when given an easy path that lets them off the hook, it is very seductive. To help parents really understand attachment theory, it would mean helping them face their own attachment issues, which requires sensitivity and skill and compassion, which usually means the clinician has to face THEIR own attachment issues, which is painful and hard work. I still think many COULD do that work and WOULD do that work, but they aren’t required or even encouraged to, because the DSM provides them an easy out: it’s the client’s brain that is the problem, nobody has to deal with all this hard stuff. Most people take the path of least resistance unless they are prompted to do otherwise. That’s the worst effect of the DSM – it prevents real healing by letting people avoid their pain and instead pass it on to those who were harmed by their own mistakes or bad actions.
Attachment theory also puts responsibility on the doorstep of the caretakers, while psychiatry blames the victims. That’s why a lot of abusive or neglectful parents, educators and “mental health professionals” prefer psychiatry – it lets them off the hook!
Well-meaning parents are often the cause of extreme distress. They often love the “mental health” system because it absolves them of responsibility to alter their own behavior, and allows them to blame “your disease” for the fact that you’re upset with how they treat you so disrespectfully.
Moving away might be the best “prescription” for your “mental health disorder.” The more you can associate with people who like you just the way you are, the less “crazy” you will feel and the more you’ll be able to live the kind of life you need to live.
The problem with this argument, which I essentially agree with, is that the financial conflicts of interest in the “mental illness industry” (thanks, Frank!) make a rational dialogue difficult if not impossible. Add on how the “biological brain disease” story helps parents, teachers, and other adults absolve themselves from responsibility for kids’ and adult children’s suffering and the task seems monumental. It’s difficult to imagine having a rational conversation with Lieberman or Jaffe about any of these issues, and until they are no longer funded by Big Pharma, it will be an enormous uphill battle. Perhaps the proper focus is to provide more support to parents of children/adults experiencing extreme states or other emotional distress and provide some kind of alternative to NAMI. It seems disheartening to think about.
The similarities between childbirth and psychiatry are legion. They are the two branches of “medicine” that enforce “treatment” on perfectly healthy, normal people. They both use interventions that make outcomes worse instead of better, and neither is willing to respond to actual data about their interventions, instead adhering to quasi-religious dogma that are not able to be questioned without being branded a heretic. Both insist on hospitalizing perfectly healthy people and treat them as if they are bodies rather than human beings. In both cases, they deny the impact of the mind/spirit and insist on treating the “patient” as a body and ignore social and environmental context. Both professions need to be razed to the ground and started over from scratch, because they hurt and kill people gratuitously and make money off of creating medical problems when none are there to start with.
Well written article, Aaron. My only question is: what if you really did fit the criteria for “schizophrenia?” Would the “treatment” have been any less brutal and ineffective? I don’t think the problem is that you were “wrongly diagnosed.” I think the problem is that you were “diagnosed” at all, instead of what you suggest at the end, which is to be looked at as an individual human being with a story to tell.
Thanks for sharing – it takes great courage to put this kind of story out there, but it’s VERY helpful to others still receiving “treatment” that is ruining their lives!
It doesn’t follow that if drugs appear to help someone, it means there is something wrong with them. I appreciate the rest of what you said, though. I think the big, BIG problem with schizophrenia is that it’s just a description of some things that happen for reasons unknown. If they were really honest, they’d admit that psychosis was a phenomenon that could be caused by many things and would look at each case and look for subgroups of people who may have similar experiences or physiological findings. But they don’t. Because they WANT their “biological dysfunction” story to be true because it brings them money and professional power and status. That’s pretty much the definition of corruption.
So they’re worried about kids practicing mindfulness, but putting kids on stimulants for years when there IS science saying that it does them no good is not of concern?
I do think he’s pointing out a real phenomenon, though. It’s another big downside of this whole labeling craze. Having a label gives teachers an excuse why they can’t teach kids, gives parents an excuse why they don’t have to learn better skills, and gives kids and adults a built-in excuse for why they “can’t behave.”
My son had a friend whose little brother was allowed to annoy him on purpose for years, and every time he objected, his mom would say, “Oh, you know he has a disability, he can’t help it!” Of course, it took a very short time before the kid (who was only 6 or 7) figured out the deal and would himself tell his brother, in a teasing and sarcastic way, “You know I have a disability, I can’t help it!”
Of course, I’d ditch all the arbitrary labeling for other reasons, starting with the fact that the labels are just made up from cultural bias and the convenience of those in power and have no validity whatsoever, but I do think it’s important for us to note this as one of the bad things that starts to happen the minute you start blaming brains and absolving humans of responsibility for their actions.
Additionally, I think the inclusion of this article on MIA is important because of the number of women who experience sexual assaults and trauma who have these experiences discounted and are told they are “mentally ill” because they are anxious, depressed and/or angry about their experiences is enormous. When I briefly did involuntary detention evaluations in Vancouver, WA, I found many women who were diagnosed with “bipolar disorder” who were sexual assault or child molestation victims. It seemed that their history of trauma was either not known or was intentionally discounted in favor of a biological explanation and a drug-based solution. So this issue is very relevant to our work here.
I think the important point you may be missing, Cat, is that while abuse and even sexual violence can happen to men at the hands of women, our CULTURE justifies and minimizes the presence and impact of sexual violence and rape culture on women. While a man may have a specific bad experience with an abusive female, almost ALL women have to almost constantly work to assure their safety from rape and abuse. As one person said wisely, “When a man gets a woman’s number, his biggest fear is that she gave him a fake number because she doesn’t like him. When a woman gets a man’s number, her greatest fear is that he might rape or kill her.” Women have to put up with a constant onslaught of come-ons, unwanted touching, lewd remarks, “jokes” about their sexual value, and put downs about their appearance, day in and day out throughout their lives. There is simply no comparable experience in a man’s life, unless he’s part of some other disempowered group, but not just because he’s a man.
I hope that clarifies things. Men and women have very different cultural experiences, even if some men do experience abuse by women in relationships.
They’re kind of overlooking the most basic (incorrect) assumption: that one group of people (namely these researchers) are in any kind of position to decide for everyone what is “moral” and therefore to be “enhanced!” I think the people in most need of “moral enhancement” are the ones running the experiment!
Even more important, 50 years of long-term studies have failed to show ANY benefit of long-term stimulant use in ANY major outcome area. This includes delinquency, test scores, teen pregnancy, college enrollment, illegal drug use, social skills or even self esteem. This should be in EVERY textbook so that doctors realize that AT BEST, stimulants provide some short-term changes in the “core symptoms” (meaning that they mostly make kids more manageable). The biggest selling point used to push stimulants is that “untreated ADHD” leads to all these bad outcomes, but as it turns out, NONE of these outcomes is improved by stimulants! What a scam!
Oh, I bet they objected – but they weren’t afraid of stigma to the “mentally ill,” they were afraid of well-earned stigma for their own warped professional history!
Semmelweis is a very sad story. He was apparently hospitalized after this happened because it drove him totally nuts that he had PROOF that hand washing worked and they just ignored it! So we have more proof that “mental illness” is CAUSED by the medical system!
You are correct that there is a high suicide rate among the group, which is a contributor, but certainly does NOT explain a 25-year (nearly a THIRD of an average lifespan!) decline in average life expectancy! Consider also that the suicide rate INCREASES with increasing contact with the psychiatric profession, partly because of the drugs they sell. And there is no denying that antipsychotics cause an increase in diabetes, huge weight gain, and a very significant increase in cardiovascular disease. To think that these don’t increase the death rate very significantly is, forgive the term, delusional. Additionally, cigarette smoking is commonly used by those on antipsychotics to reduce the side effects (it increases dopamine, which is what antipsychotics decrease), and we all know the impact of cigarette smoking on lifespan. So indeed, psychiatrists kill people.
If you were reading the other comments, you’d see that many (including me and the author) that local chapters can provide valuable services, particularly those like yours who allow or encourage leadership from survivors/consumers.
Your last comment I agree with completely, and that is one of the huge problems we face. Without an objective definition, almost anyone could be identified with a “mental illness,” and it is also very possible to redefine “mental illness” in a way that allows the drug companies to create “science” that supports their drugs. They do this by seeing what the drug does and then defining a “mental illness” based on whatever “symptoms” it “treats.” “Social Anxiety Disorder” is one such fake “disease” that didn’t exist before they decided to market Paxil to “treat” it. Juvenile Bipolar Disorder is a similar scam, long since proven to be utterly bullcrap by psychiatry’s own researchers, and yet many youth are still “diagnosed” with this non-existent “disorder,” and given these life-shortening drugs to “treat” their inconvenient childhood behavior.
8 years of medical school is actually a big DISADVANTAGE if you are being trained in things that are absolutely false or are based on false assumptions. Hence, it is actually often parents who are more adept than doctors at sensing what is really going to be helpful, but in any case, the invalidation of the client’s viewpoint is ultimately the most destructive thing that can be done if we have any hope of recovery, yet such invalidation is the core of how psychiatry is practiced today.
Have you read “Anatomy of an Epidemic”? I believe you really would benefit from reading it if you have not. It would help further your understanding of where this big protest energy is coming from. It seems you are not at all far away from my views on what is helpful, though our views on whether national NAMI can provide it seem to diverge.
Well, a lot of people have a similar belief about doctors always being wise and scientific and reliable. It’s a very solid cultural belief, even when evidence speaks loudly to the contrary.
Are you aware that the august Journal of the American Medical Association published an article verifying that receiving medical care kills over 200,000 Americans every year? Which makes it the third leading cause of death in the USA, behind heart disease and cancer. And over 120,000 of these deaths were attributable to properly prescribed and administered medication. A LOT of those deaths are from psychiatric drugs. The average lifespan for those diagnosed with psychotic or bipolar disorders is 25 YEARS shorter than the average American. These doctors kill people. Can you imagine a cancer drug that killed off its patients years earlier than those who don’t receive treatment?
In steps NAMI. They promote a VIEWPOINT that “mental illnesses are just like diabetes” and have nothing whatsoever to do with how people are treated or what kind of stresses they are under, or even what they eat or whether they exercise. They are “genetic brain disorders” and no one needs to “feel guilty” about the damage done to our young people or to adults who have to experience this life-threatening “treatment.” The potentially deadly side effects, though very well documented, are minimized or denied, and the supposed benefits promoted under the tutelage of the drug company sponsors.
In addition, the people running NAMI are not “mentally ill” individuals, but parents and professionals who “know what is best” for their adult children/clients, and when the “recipients” complain, they are accused of having “anosognosia” or of acting out their “symptoms” instead of listening to their views.
Remember also that psychiatrists assured us that Benzedrine was not addictive, then assured us that Valium was not addictive, then Xanax. They also assured us that tardive dyskenesia was caused by “schizophrenia” and only later were forced to admit it was the drugs. So they have a very poor track record of reliability.
So being skeptical about a doctor’s advice is not silly or dangerous – it’s very, very smart. Trusting doctors blindly, especially psychiatrists, can get you killed. But national NAMI does not appear to care much about these problems, and is all too happy to blame them, including the 25-year earlier death rate, on the victims.
I hope that clarifies why it is that I and many here trust neither NAMI nor psychiatrists. I’d be very interested in hearing your specific response to this information. You seem like a smart guy, so perhaps a bit of hard data can help you see another viewpoint, even if you don’t agree with it.
Psychiatry is founded on violence and the judgment of others as “defective” in the eyes of society. “Modern” approaches are simply another way to force the “aberrant” back into line with society’s expectation. While individual psychiatrists may or may not be specifically committed to authoritarianism and invalidation, the entire field, starting with the diagnostic system, is still based on the primitive thinking that gave rise to “insulin coma therapy” and the like. While lobotomies are “out”, the barbaric ECT is still widely practiced, and of course, the drugs used on the brain are all based on stopping the brain from engaging in its normal functions in some way or another. So violence and invalidation continue to be the linchpins of the psychiatric worldview, even if individuals in the field are able to escape that viewpoint.
I think it’s also important to clarify that not all local NAMI branches are as bought out as national NAMI. NAMI Santa Cruz (or maybe Santa Clara) used to have an awesome website with lots of empowering articles and discussion boards. But they don’t appear to any more.
I encourage you to look on the national site and see how many times they talk about “biological brain diseases” and how infrequently traumatic experiences like child abuse are emphasized as causes. See how supportive they are of forcing “treatment” on the unwilling and how often they talk about “anosognosia” and how little they talk about hearing voices groups and peer support (except in the context of supporting peers in following their psychiatrist’s orders). They have improved somewhat since the late 90s when I first encountered them, but the national website is loaded with inaccuracies and power trips that have nothing to do with those who willingly or unwillingly engage in “mental health services.” The unquestioning support for enforced outpatient “treatment” (aka forcing drugs on people who aren’t even endangering anyone just because the psychiatrists think they MIGHT some day be dangerous) should be enough to convince any objective person that they are at best very far down the wrong track. Looking at their Big Pharma connections just explains why.
So yes, lots of people have found local NAMIs helpful, though lots have also found them awful. But national NAMI does not represent the “mentally ill,” it represents their family members and the pharmaceutical industry. Which is a VERY dangerous combination.
MePat, not sure what your issue is, but you seem to be intent on provoking conflict here. I am not in favor of making personalized attacks, but your comments appear to be personalized as well in a more subtle way. Monica made a totally legitimate post, and your comment is simply attacking due to whatever issues you are bringing to the table. I suggest you take a step back and look at your reasons for doing this.
I think the MIA staff is creating a safe space for discussion, or trying to. The only “side” I think MIA is on is that the current way of doing things doesn’t work and needs to be “rethought.” And I agree, more “sides” means less cooperation and less success. We should be emphasizing what we agree on, and your postulates are a great starting point.
I agree. Perhaps they will feel compelled to publish it, as it is a direct response to the article they wrote. Perhaps you can even get other dissident MHPs to sign on to the article?
Absolutely true. Unless you have the courage of your convictions and the skill to know how to help, the safe play is to hospitalize even if it’s totally uncalled for and totally destructive to any chance of further therapy. It’s no wonder that clients don’t tell their therapists when they are suicidal, but when they don’t, they’re then called “manipulative” and get labeled “Borderline Personality Disorder.” If you wanted to create a system to discourage healing, the current one would certainly do the job.
A very good article! I’ve always been very suspicious of “EBT” for the very reasons mentioned in the article, namely that it is both politically and financially motivated. The one issue not addressed in the article is that in order to be an “EBT”, someone has to spend the money to research something in a systematic way. Guess who has the most money to fund such research? Drug companies, of course. Drug companies can afford to run multiple research studies (and of course can afford to buy “results”) in a way that other entities can’t. So of course, most “EBTs” are drugs. Pretty sneaky!
I also like the emphasis on humility and individualized approaches, even in the purely medical world. That thinking is 50 times more applicable to the “mental health” world, where there is no concrete way to even say who is “ill” or if anyone is “ill” at all.
I did a training on suicide intervention with mental health therapists many years ago, when I worked at a volunteer crisis line. Our volunteer crisis counselors knew 10 times what the professionals knew about helping suicidal clients. Our emphasis was listening and understanding, focusing on what can be controlled vs. what could not, building relationships, and inviting further contact as frequently as needed. Most of the professional therapists didn’t seem to even have an idea what to do besides calling 911. They didn’t even have the skill to figure out who was contemplating doing something immediately vs. those who were feeling despairing but mostly needed to talk and connect. They were effectively clueless. That was in 1992. Things are far, far worse today, because at least the ones we were training knew they didn’t know, whereas now they can just diagnose them and send them to the psychiatrist or the hospital as soon as anyone even talks about the word “suicide.” Many therapists are simply scared by any suicidal statements and go with the safest approach for THEM, rather than the best approach for the client. Of course, there are many exceptions, but I’d say a majority of therapists are not really prepared to deal with a suicidal client, both in terms of training and in terms of their own emotional reactions. In fact, many therapists appeared to hospitalize people for much less serious things like self-harming in ways that are neither intended to nor capable of killing or even seriously hurting themselves. Which meant the self-harming people couldn’t even talk to their therapists about their urges without risking being hospitalized, so they called the crisis line to stay anonymous and to actually find someone who would listen.
So you’re not wrong. A lot of therapists don’t actually have any training in helping suicidal people, and as often as not, it is not really safe to tell them if you want to just talk without being hospitalized.
Can’t ask for more than that. Sorry your first go was a little rougher than expected! I appreciate you hanging in through a difficult conversation, and I hope we’ll be hearing more from you in the future. I think in the end it was a very important conversation about topics that are central to this project of “rethinking psychiatry,” and while I wish we all could figure a way to have these discussions with less rancor, it’s a very emotional subject, especially for those who have been “helped” in some not very helpful ways by the system.
Without feedback form the client, how would you ever know if you were making progress? This seems to obvious as to be trivial, but it’s clear from the data that the majority of therapists don’t practice this way. It’s a head scratcher, for sure!
Fantastic article, Kelly! I once handled a crisis call from a woman who was frantic about her ongoing depression and anxiety. She told me a list of at least 4-5 antidepressants she’d been on and nothing had changed and she was worried that she’d ALWAYS feel this bad and it was driving her crazy! That’s kind of how she talked. So I asked her one question: did anyone ever tell you there are other things you can do for depression and anxiety besides drugs? She stopped cold for a moment. Calmly said, “No.” I said, “Well, there are.” She said, “Oh. Well that’s good!” She instantly felt better knowing there was something she could do herself, but had been seeing mental health professionals for A WHOLE YEAR and no one had told her there was more she could do.
I’ve worked for years with foster youth who are put on these drugs sometimes in elementary school, despite the data saying they don’t work, and I can’t think of one who was told that s/he might become aggressive or suicidal on these drugs, nor were their parents or even their caseworkers informed. I ended up being the one who shared these facts. It is a very disturbing reality when people are given drugs that don’t work, not told of potentially dangerous or deadly side effects, and not given any alternative that might actually help them out. Not saying some people don’t feel good about their antidepressant use, but informed consent basically doesn’t exist for these drugs!
Wow, I just realized how appropriate the title of this article is! This really is a clash of perspectives, but not necessarily the perspectives outlined in the article. I think the real clash of perspectives is between the more powerful (professionals) and the less powerful (let’s just call them “recipients” for now) who meet in the crazy world of “mental health.” Maybe it’s easiest to understand if looked at that way – as a clash of worlds. The problem being that when worlds clash, the more powerful are able to continue to maintain that their world is the “right one.” Similar comments apply to the recent intense discussion of “reality” vs. “delusions.” Hence, my comments that power dynamics are the most important aspect of a helping relationship, and if they are not resolved, it’s hard to get beyond a fairly rudimentary level of “helping.” At least that’s my experience.
I really do get both sides if this conversation, and I understand why it is uncomfortable for you, Kurt, and I also understand your frustration, Sera.
I don’t think Sera is trying to be hurtful but is speaking from the heart as a person who has experienced the “help” of the mental health system and found it quite harmful. It appears you have embraced the science that Bob has published, which is great. But I think. Sera’s getting at what I was talking about earlier, and it goes deeper than Big Pharma corruption.
Perhaps the clarity comes from your response to my comment when you said that “power dynamics have to be considered.” I think a different viewpoint, which I am trying to convey, is that “dealing with power dynamics between provider and client is central to ANY effort at creating healing.” I believe that people who have been harmed by the system tend to take the second view. I think it is hard for a professional person who hasn’t been in that position to really understand why, and it often comes across as hostility, and actually can BECOME hostility if enough frustration builds up. But what Sera says is absolutely true – the privilege of being “the professional” allows us (and I include myself as a fellow professional) to dismiss or minimize the impact of our power differential, and this gets in the way of or sometimes completely prevents a healing relationship from forming.
I don’t know why I have been granted the ability to bridge this gap, but somehow I really see and understand deeply the cost of resting comfortably in our “professionalness,” as well as the true power of stepping out of those shoes and meeting our clients where they are without the slightest judgment or condescension.
It is hard to describe if you haven’t been there, but it really does come across in your presentation that you don’t quite grasp this reality, although I am quite sure you do excellent work within the context of your role and that clients would be VERY fortunate to see you vs. the average mental health professional. There is just a possibility that you might be able to take one step further to seeing the reality of your clients, and I am hoping this discussion might make you aware of that step. Again, I’m not saying you’re doing something WRONG or that you are a bad actor and I’m not minimizing the work you’re doing to make the mental health world more respectful of those it serves. But Sera’s viewpoint is (I believe, not trying to put words in your mouth, Sera, so please correct if I’m off) just the viewpoint I was wanting to point out – the idea that it is the CLIENT (if that’s even the right term) who has the right to define his/her experience and whose viewpoint and needs must be the touchpoint of any intervention.
If you had been a recipient of these services yourself, I think you’d see a different perspective that comes from chronically being in that one-down power situation and having to be careful not to say the wrong thing because some “helpful professional” will decide what is “good for you” and make you have it whether you want it or not (and I don’t just mean drugs here). It’s like being a kid in school again, except the punishments for stepping out of line can actually imprison you, disable you for life or kill you.
Not sure what else I can say. I know not everyone is always a diplomatic as they might be on this site (though in fairness, I thought Sera’s first message showed a strong effort in that direction), still, a similar message has been communicated a number of times by a number of different people, and maybe there’s something there you’re not hearing. That’s all I’m saying. If I didn’t think you had it in you, I wouldn’t have put this much energy into it. If it’s not something you can get your arms around, that’s OK with me, but I don’t think the message is intended to hurt, it’s intended to inform, whatever form it has taken. I think there’s something there for you to take a look at, and I believe you’re enough of a real professional to hear that message if you can sit with it for a bit.
I would have to amend that to say I’d suggest being VERY CAREFUL about whom they might trust. There are definitely a few diamonds in the rough, and clients/patients/inmates are sometimes fortunate to find them, but I would most definitely counsel them that sharing in a hospital could be dangerous and to be very selective about whom they might trust. In fact, I’d tend to apply that to any counselor/social worker/mental health professional in any role. A lot of damage can be done by trusting the wrong person with sensitive information, and sometimes the very best thing we can teach our clients is how to figure out whom they can and cannot trust.
Thanks for sharing your story. It sounds just plain awful! It has always stunned me that they can forcibly “hospitalize” you against your will and then CHARGE you for the privilege! Stunning!
And we have to remember that it takes only one or two bad experiences to shut down trust in service providers for the long term. Even if 80% of providers are safe, the client doesn’t know which are dangerous until they open up and potentially get hurt. A bad experience often means no one else gets a chance. I always thank clients who extend their trust because I understand the risk the are taking. All clinicians should learn to appreciate how precious and delicate that trust is for the vast majority of clients.
Wow, what a sad and infuriating story! Good for you for standing up for yourself! Did you say your “symptoms” are decreasing but they still want to force you onto antipsychotics? Do you have a good attorney? Wish I lived in Michigan – I’d come and support you!
Sam, your comments are incisive and effective as always – thanks!
Kurt, I would very much be interested in hearing more about that project – do you have a link? It’s easy to give lip service to “informed consent,” but how many clinicians really do that even for adults, let alone kids? In my experience, not only do foster youth not get informed, they are outright lied to about what is being “treated” and what their options are, let alone the common fear of telling them about medication side effects. It sounds like this program would directly address that issue, and I’d love to hear more about it.
Personally, I think we should do a lot more than “consider the perspective” of the youth we’re treating. Their perspective should be the main jumping off point of any planned treatment, and should constantly be consulted as our guide to whether or not we are being effective in our work.
Fair enough. The ACE study has brought an increased awareness if the impact of trauma, though my experience is that the mental health system has been very slow to respond. Perhaps you are fortunate enough to travel in more enlightened circles than those I have worked in.
However, years of advocating for foster kids has shown me that very often, we as adults really do care and BELIEVE what we are doing is right and helpful, and yet those receiving our services don’t feel that way at all. I suppose the lesson I find is that kids have a lot to say but the adults don’t often create safe spaces to listen. I just had occasion to talk to a young couple in their early 20s last night who had seen the whole series (I’m only about halfway through, and most definitely NOT looking forward to the suicide scene, it sounds AWFUL!) and both of them said that the conditions represented in the school in the series were not an exaggeration and seemed very familiar to them. I think it’s way too easy for those with power to imagine we are doing good without bothering to consult those we are purporting to help, and I hope that is the real takeaway from this provocative series.
I am quite sure that YOUR students are trained in a different way, Kurt, but I’m pretty confident that many if not most in the USA are trained in DSM diagnosis and brain-disease theory, even if some rebel psychologists/therapists provide different perspectives. And just like the kids at Hannah’s high school, whatever their prior training and beliefs, they have to deal with the oppressive system that they will be operating in, and that system challenges anyone who wants to look at “mental illness” in more human terms. I say this as a mental health professional who got out of the field and into advocacy after I could no longer stand seeing what happened to my clients who were hospitalized or even “treated” by the agency I worked for. I have many more than one anecdote to share (though it was actually a study, not a single anecdote), and the comments I make apply not only to the mental health system, but to almost any institution in US society today. That’s the point I was making – that Hannah’s difficulties were not a result of a “mental health issue,” but of her and her friends/associates having to survive in an oppressive environment day to day and the absence of anybody in a position of power willing to or capable of intervening. Perhaps I have put this in better terms this time and you can comment on this aspect of suicide prevention, which I believe is the main point the series is trying to highlight, namely, that someone has to acknowledge and challenge the power dynamics in the school and the larger environment for this kind of depressing hopelessness really to be challenged.
You captured what I wanted to say in many fewer words. The teens’ behavior is a response to the structure provided (or not provided) by the responsible adults. Those setting up the system are responsible for making sure it works, not those who are powerless participants. Thanks for your comments!
Perhaps you misunderstand me. I have helped run a suicide hotline and have done involuntary hospitalization evaluations. I’ve placed many people into involuntary holds, directly or indirectly, and have also intervened with many, many more suicidal people and prevented many, many hospitalization with on-site or telephone crisis interventions. I have also spoken with many folks who have been hospitalized after the fact. To suggest that traumatization by involuntary hospitalization is rare suggests a Pollyanna view of reality. Sure, clients in the hospital often express relief that they didn’t end up killing themselves, but they also learn very quickly that telling the staff you’re pissed about how the situation was handled or that you feel powerless is both pointless and dangerous. I don’t know if you watched the show in question, but you ought to, and you ought to look at how often the teens tell the staff and/or their parents and even each other that everything is “fine” and there are no problems, even though they are seething with discontent, fear and grief. You have to develop sufficient trust for people to tell you their true feelings. I am very good at doing so, and I guarantee you that feeling traumatized is far from a rare thing.
As for suicidality from antidepressants and antipsychotics, gosh, there are warnings on the labels to this extent. Not sure how you can actually argue that point. New evidence more recently has shown rather conclusively that these effects are not limited to teens and young adults. Aggression is also sometimes a consequence of messing with the serotonergic system, as is listed on the label of all of these drugs, and as a recent MIA article has documented.
Naturally, preventing immediate suicide IS important and is the priority in a crisis situation. That was not my point. My point is that IN THE CONTEXT OF THIS SHOW, talking about methods to reduce the likelihood of suicide without looking at the causes misses the entire point of the production. The point is, people had MANY opportunities to intervene and perhaps prevent this suicide LONG before the crisis situation ever began to arise. This is true in many, many situations and the main intervention is to have people care about you and have the guts to stand up to bullying, sexual assault, and harassment instead of keeping quiet until the victim can’t stand it any more.
The secondary lesson also appears to bypass you completely based on your comments. The show demonstrates how our INSTITUTIONS, parents, police, schools, and the mental health system itself, fail to create a safe place where talking about the above issues is realistic. To give you an illustration, a recent survey of kids in residential treatment centers showed that they revealed significant trauma histories to complete strangers in 80% of the cases. Oddly, only 20% of the cases had traumatic events documented in the file! So at least 60% of the kids were willing to share their abuse stories with TOTAL STRANGERS but were either never asked by staff, didn’t feel safe telling them, or worse yet, told staff who didn’t feel the information was significant enough to include in their files.
Perhaps you have to watch the series to know what I’m talking about. Perhaps you need to step down from your professional pedestal and actually meet your clients where they live. Maybe you should ask a couple to DESCRIBE what being taken into custody was like, rather than asking them if they are grateful to be in the hospital. You might be surprised how many people appreciate that someone cared enough to try and stop them, but most definitely did NOT appreciate the violence and invalidation involved in being taken into custody. I’m sure you’ll hear from many of our regular posters on this point.
Lastly, your comments on how benign the SSRIs have since been found to be are questionable to me and lack any reference. It might help if you can provide links to these statements.
Appreciate your candor in responding, but you might want to avoid questioning my experience and credentials before you know anything about me. It is that kind of approach that encourages people to say they feel fine when they really don’t.
While I appreciate the important emphasis on compassion for suicidal teens, I’m really not sure what to say about this article. While I agree that putting resource numbers at the end of each episode is a good idea, I’m kind of astounded at how badly the author appears to miss the point of the series. The comments about not needing to understand the “why” and simply removing “means” seem to invalidate the important issues that the series raises, namely the importance of understanding the context in which suicides occur. The whole point of the series is to show that there ARE whys and that many people COULD have done something about the situation but did not! It also emphasizes that systemic changes are needed, as administrators and the counselor don’t appear to understand that bullying is rampant in the school, and the kids are unable/unwilling to trust the adults BECAUSE THE ADULTS HAVE NOT SHOWN THEMSELVES TO BE TRUSTWORTHY! The counselor and assistant principal had Clay on the verge of talking about the whole situation, but their authoritarian and accusatory approach caused him to clam up. The similarities to the situation in the “mental health” system can’t be missed by anyone who has been on the receiving end of “services.”
The incredible challenges involved in reporting sexual assault are also highlighted, and contributed very significantly to Hannah giving up. One very good way to reduce suicides is to make it easier and less traumatic to report events like sexual assault and domestic abuse, but the author fails to even mention these points in the article.
From the article: “Part of the problem here centers on what happens after a person is hospitalized and the time immediately after discharge. As clinicians we can sometimes be lulled into a false sense of security that as long as the acute crisis is dealt with, we are out of the woods. Regrettably this is often not true.” This suggests that suicidal feelings somehow “sneak up” on clinicians because the clinicians are overconfident that “the crisis is over.” This ignores more significant reasons why suicide happens AFTER hospitalization. First, hospitalizations are TRAUMATIC for most clients, especially if they are enforced or not entirely voluntary. This trauma is denied or minimized, just as the administrators at Hannah’s school deny or minimize the enormous reality of bullying in their school. As a result, no one talks about this to clients, nor acknowledges the feelings of powerlessness that often occur in the context of a psych ward. Additionally, many clients describe being unwilling to communicate their feelings to their professional support people after being hospitalized against their will, because they are afraid to be hospitalized and traumatized yet again.
Second, the main thing that happens during psych hospitalization is that the client is tried out on a new drug regimen. It is well established at this point that antidepressants and antipsychotics, the two most common prescriptions given in psych wards, both can induce suicidal ideation or action. To ignore this important variable shows a limited commitment to scientific reality.
To talk about “suicide prevention” outside of the context of why people kill themselves seems bizarre and disconnected. In fact, it seems to reflect the same kind of disconnectedness that kept Hannah and Clay and the other students from reaching out for help. I think the author does a great disservice to both clients and professionals by suggesting that preventing the ACT of suicide is more important than preventing suicide by understanding our clients and by revising and reforming our institutions so that trauma is less common and easier to talk about with authorities and less traumatic to resolve.
I object to the labels because they are not scientific, as not a one of them defines a group that can be accurately and objectively distinguished from a group not having the “disorder” in question. That’s not a political objection, it’s a scientific one. If you can’t establish a reasonable amount of variable control, you can’t do science. You can’t do studies on heterogeneous groups and expect to learn anything. It’s about that simple.
Jill, this simply can’t be true. There are many, many people who experience similar disruptions in their dopamine system temporarily and yet don’t become addicted. It is claimed that this difference proves a biological underpinning, but I don’t think there is much evidence that that is true, because it should be very evident from both research and a casual survey of the addicted population that there is an ENORMOUS disproportion of people who have been severely traumatized in their childhoods or later on who then become addicts. While it is possible that there is a subset of addicts who simply “can’t stop” for biological reasons, this subgroup has never been identified, as is usual for all psychiatric “disorders,” simply because the profession is comfortable sorting people into boxes based solely on behavior and have never bothered to try and make any kind of distinction between the reasons that people become addicted. It is both more convenient and more financially remunerative to dismiss the importance of causes, but it doesn’t serve the addicted person very well at all. As a result, neuroscience can tell us a lot about what happens to a brain after it’s soaked in dopamine for long periods of time with some accuracy, but it can tell us essentially nothing at all about why some people choose to so bathe their brains while others choose not to.
Arguing about which drug “relieves stress” more effectively is a ludicrous proposition. Alcohol can make anyone feel less anxious in the short term. Getting drunk is not a medical treatment.
Your comments make sense to me. We need to seek a balance, and stop trying so hard to be “right” at the expense of someone else being “wrong,” which to me is the very essence of authoritarianism. I’m sure we’d have some fascinating discussions in person! Thanks for sharing your thoughts so articulately.
Exactly. It’s about having the power to define one’s own experience. Parents “advocating” for “eliminating” what some people view as parts of their personality is more than a tad invalidating!
I know what you mean. I think it’s hard to really understand the level of trauma and disrespect and outright shaming and humiliation many of these survivors have experienced, usually from the hands of authorities like their parents or teachers or “mental health” professionals. I find their anger quite understandable, having spent enough time in “mental health” agencies and a couple of psych wards and heard enough stories to see what really goes on. It is unfair when overgeneralizations are made, and it does make some folks anxious about posting. And some of those comments, like calling you a “NAMI Mommy,” are just insulting and inappropriate. But it is important to realize how much hurt is there and that such comments are not really directed at you personally, they are directed at all the “mommies” and “professionals” and other authorities out there who have hurt them and not even noticed or cared.
You are clearly a good person who likes to deal with facts and has done some great work confronting the system with its own failures and mean-spiritedness. I’m glad to have you hear with us, despite the challenges you have faced!
It is also important to note that a lot of parents are unable to recognize how they are harming their children or encouraging or creating the very behavior that bothers them. Giving them this “explanation” prevents any meaningful dialog with caring parents who might actually be willing to CHANGE their behavior if they understood what was going on. The whole point of the DSM labels seems to be to blame the person who is suffering and absolve those with the power to actually do something about it from any responsibility whatsoever.
Wow, you mean you’d try to distinguish between possibly disparate CAUSES of “depression” instead of treating all “depressed” people in the same way? Wow, what a concept!
Thanks for your comments – glad I can beat out the catfish for empathy, but sad that a catfish beats out the psychiatric profession!
“The criticisms of small effect sizes raised by these letters imply that we should only use the term brain disorder when everyone with the disorder shows the same pattern of brain abnormalities. By that definition, no psychiatric disorder would be a brain disorder.”
Excellent point! They have accidentally drawn the correct conclusion – no psychiatric disorder can qualify as a “brain disorder.” This is like saying that not all people with cancer should show the same indications of inappropriate growths, or that not all people with high blood pressure need to have higher than average blood pressure. Such idiocy is what passes for “science” in the world of psychiatry!
I’d add also that the support of the pharmaceutical companies for these supposedly “patient advocacy” groups and the pushing of pharmaceutical solutions to every problem adds to the lack of trust in these organizations. Further, the lack of any apparent interest in consumers/survivors contributing to their agenda is a barrier to trust.
I’d have look at the youtube from Autism Speaks if you had any doubts of their lack of connection to the actual needs of autistic people:
I think the anger toward Autism Speaks and toward NAMI is not a result of people denying the existence of conditions that are called “mental illness” or “autism,” but rather of the “professionals” and parents of such people deciding how to define what is “wrong” with their clients/children as well as what they HAVE to do to “fix” themselves to the satisfaction of the parents/professionals. It is a very undignified position to put someone in and folks are understandably upset/angry about having that done to them.
It is important to distinguish also between saying that no one SUFFERS from conditions that are called “mental illnesses” in the DSM, and saying that the DEFINITIONS of the “disorders” in the DSM are unscientific and damaging. No one is saying that people don’t suffer or that they usually want their “symptoms” back if they go away. What I think most people are saying is that LABELING someone with a “disorder” and prescribing “treatment” based on fraudulent notions of “chemical imbalances” while completely ignoring trauma, social conditions, nutrition, sleep and other factors that may cause or contribute to the distress. It’s kind of a shorthand to say “mental illnesses are a myth” when we mean “mental illnesses as defined in the DSM are unscientific and misleading.” Based on what you’ve said earlier, I don’t think you and I are very far apart on that question, though I’m happy to be corrected if I got that wrong.
People definitely experience all forms of distress and difficulty, and no one is saying they don’t need or deserve help. All I’m saying is that DSM labels and condescending “professionals” who are unable to see past their own biases and issues are not helpful to anyone.
I tend to agree with Richard in that it seems kind of over the top to suggest that “matriarchy” is anything close to a power in the USA. I have heard from my own son that there is a certain authoritarianism that can arise in his left-leaning college and that he finds that offensive. However, this is not a manifestation of “matriarchy” so much as of AUTHORITARIANISM. Anyone who believe the right has cornered the market on authoritarianism has something big to learn, and there are also plenty of conservatives who are open minded and not sexist or racist. So we shouldn’t be making over-generalizations as if they are the truth, because that’s another form of authoritarianism right there.
I think authoritarianism itself is the real enemy, and both Martin and Richard are recognizing it in different forms, but I find we get into trouble when we allow ourselves to be herded into the classic “liberal-conservative” discussion frame, as this seems to me to be an anachronistic frame. Richard and especially Frank hit hard on this – it is this belief that the global capitalists/corporatists have our “best interests” at heart and the unchecked power they now wield that should be our target. And I gather that all of us agree on that point. So I’d suggest we get away from blaming liberals or conservatives or those under 35 or their parents or matriarchy and direct our energy toward the hegemony of the rich and powerful, as well as all the manifestations of authoritarianism, both on the left and the right, which impede our ability to attack those targets. At the same time, civil discourse, including cross-cultural awareness and sensitivity, is going to be very important to moving forward with these goals, not because people “aren’t tough enough,” but because people are very susceptible to being misdirected into foolish discussions such as whether Democrats or Republicans are responsible for the mess we’re in (or for that matter, which party is more likely to be “mentally ill”) and it requires diplomacy to help get people over these barriers and to see what’s really going on and that their enemy isn’t black people or women or white people or liberal universities or matriarchy, but CORPORATE POWER AND AUTHORITARIANISM. It’s not a matter of rightness, it’s a matter of effectiveness.
So here’s the big question, Pat: how exactly does one distinguish between these two purportedly distinguishable groups? Psychiatry has no answer for this, none at all. They give lip service to the idea of “endogenous” vs. “situational” depression, but their DSM checklists don’t even attempt to make that distinction that I can discern. I’m quite serious when I ask this question – how would you tell the difference?
You are so right! The diagnostic process itself is a means of “blaming the victim” and distancing ourselves from the “mentally ill” individual, as well as avoiding any and all responsibility for doing something about the situations that may have caused the problem. ADHD is a great example. The fact that a child can’t stand sitting through your class does NOT mean there is something wrong with the kid! Maybe your class is incredibly boring, or this kid simply hates to sit around doing nothing with his body, or the kid is super smart and figured out what you’re “teaching” about two years back, or you’re talking over the kid’s head and he has no idea what you’re talking about but is embarrassed to admit it, or the kid is distracted by the fact that his dad threatened to kill his mom last night and he’s wondering if she’ll still be alive when he gets home today… you get the drift. But with “ADHD”, no one has to ask any of those uncomfortable questions, and the teacher doesn’t have to change a thing! We simply blame the kid’s brain and put him on a drug that makes him less annoying to the teacher, despite long-term evidence that this does NOTHING to improve the kid’s overall well being down the road.
It’s a cop out. The least powerful person in the room takes the blame, which is probably what got them to be labeled “mentally ill” in the first place!
I agree. It is also important to recall that these studies showing increased suicidal thinking or behavior SCREEN OUT suicidal people before starting the experiment! So the results are actually reflecting not the total number of suicidal thinkers in the group, but the total number BECOMING suicidal as a result of “treatment.” Especially when we look at the long-term outcomes being so poor, “antidepressants” are not only generally ineffective, they are overall more dangerous than they are useful.
You know, not everyone who gets hit by a car has internal injuries. Probably 90% escape with no internal injuries at all! There MUST be something wrong with that other 10%… Let’s do some genetic analysis and see if there are commonalities among those who appear vulnerable to internal injuries so we can counsel these folks to wear extra protective gear when walking around near traffic, or perhaps prescribe some organ-toughening or bleeding-suppressing drugs for them to take all the time, just in case it happens again.
What, install a traffic light? What kind of naivete is that? “Common sense” has failed these poor people who are obviously genetically vulnerable to damage from being hit by cars, so let’s dispense with it altogether! After all, 90% of those hit by cars had NO internal injuries whatsoever! What’s wrong with the rest of you wimps?
I actually believe that this discussion was a very healthy one in many ways, and is full of learning opportunities if we can all put our hurt feelings aside.
There are some comments which possibly could have been moderated, but the rate of comments is so fast, I’m not sure it’s realistic for anyone to intervene quickly enough. But I still find discussions like this INCREDIBLY valuable, because we are now discussion one of the most fundamental problems/issues/conflicts with the current system, not just the mental health system but our social system as a whole: WHO GETS TO DEFINE WHAT IS TRUE/REAL/VALID? And it’s not an easy question!!!
I would exhort ALL posters to take this thread as a lesson on how important it is to be respectful and to own our own views without invalidating others who post. After all, isn’t that the very thing our most passionate posters are objecting to? The idea that “mental health professionals” are allowed to invalidate your reality? Well, let’s not do that to our allies in the mental health professions, either, or better yet, let’s all commit not do that to ANYONE who posts here!
There are many professionals who have been extremely courageous in their battle to make things better for those condemned to interact with the system for whatever reason, and Brett and James are certainly two who qualify. If they say something that we object to, let’s treat them the way we’d want to be treated, respecting their viewpoint while respectfully disagreeing and expressing our own. Let’s model how helpful human interaction SHOULD be right here on our site! Similarly, we who come from a more professional background, let’s understand that feelings will get strong in this kind of discussion, for very good reasons, and let’s not take it personally and use our best professional skills to moderate the conversations ourselves rather than escalate them with our own emotional reactions.
“Be the change you want to see in the world” – we can do this, all of us, right now. It’s really the best, maybe the only way to counter the crappy treatment that so many authorities dish out.
In the end, this was a very valuable discussion. It will be more readable and will affect more people in the way we want it to if we ALL take the time to moderate our own comments, as well as accepting it if we may have offended someone else and taking steps to make it right. Stephen is right (as usual) – if we consider that we’re dealing with very different cultures colliding here, and act accordingly, we’ll come out much stronger and more effective in the end.
— Steve
P.S. One last thought – I wonder if we might have a cadre of “on-call” moderators available for the times when a discussion like this one gets big and deep and powerful? I’d be happy to volunteer for that role. Emmeline, let me know if you’re interested!
Brett, I really appreciate this reply – it certainly reflects that you fully read and digested my comments, and I feel fully heard. It is actually quite a conundrum to me: I’d really LIKE to have lots of mental health professionals join this site and the movement in general, and I know that angry survivor voices most likely impede that; at the same time, the main REASON I’d like to see more professionals is because we generally don’t pay attention to or block out the very voice that is being expressed here. I don’t see any real progress in the field until and unless hearing the voice of those harmed by the system, and even those not yet harmed but who are at high risk to become so, becomes the PRIMARY voice by which we operate.
I was fortunate to come into the mental health field by the “back door,” so to speak (my MS is in Education, actually), and I was in a position initially where I had very little theoretical training but a lot of compassion, and I actually developed my initial knowledge base almost entirely from talking to clients and seeing what they needed and how they reacted to my approach. Of course, I made lots of mistakes, but I did so with an open heart and an open mind and was almost always prepared to be corrected by the client’s verbal or nonverbal communications. I think this last part is what many professionals are lacking, and the DSM and the current system of dismissing trauma and blaming the victim makes it WAY too easy for professionals to dismiss their clients’ righteous indignation (at them or at their previous traumatizers) as irrelevant or “inappropriate” (I HATE that term!) That absolutely HAS to change – the client’s emotions and reactions and information HAVE to be the basis of all we do, or there is really no point in putting ourselves out there as helpers. Which is why my initial reaction to this idea of “correcting” the perceptions of others was so strong – it just plain doesn’t work, and it leads to exactly the kind of anger we’ve seen on this thread. Survivors of the MH system are not ever going to be OK with having their own realities invalidated, because it’s happened WAY too many times both before and after entering “the system.”
That being said, I really do appreciate your efforts and I also really do understand your frustrations. As I said, it is a conundrum of major proportions. All in all, I’m really glad this discussion happened, and in my view, by taking the risk of expressing your own experience here, you were a catalyst for the conversation going much deeper than it otherwise would have gone, and I really appreciate you for putting yourself out there and taking some hits to get folks to dig down deeper. I hope you can reflect back on what’s happened and see the value in the discussion, even though I know it caused you some personal pain to participate.
Thanks again for all you have done to move this project along!
It feels like entitlement – that “professionals” somehow are entitled to be protected against anger and being perhaps unfairly targeted of others’ rage. Naturally the recipients/victims of the “mental health” system are not entitled to any such protections.
An important contribution of Freud was the idea that clients who have been unable to speak their rage and helplessness will make us FEEL their rage and helplessness through their behavior. Professionals worthy of the name ought to know that well and understand that especially if they are “safe” professionals, they WILL be targets of these emotions, and they should expect it. I would go so far as to say that any professional who can’t handle this should stay far away from trying to “help” people and do something where they won’t have to deal with the discomfort of people’s real emotions.
I agree, Sandy sets the ultimate example of how to handle criticism professionally. Her humility and her willingness to learn from other viewpoints makes any attempt to needle or provoke negative responses from her fall flat. That is the kind of professionalism we need from professional bloggers and from professionals in general who want to change the system. If we can’t listen to the distrust and anger our wonderful “system” has helped to create, how will we ever be able to alter things in a healing direction?
I would also add Johanna Moncrief and Lucy Johnstone to the list of professionals who are not afraid to roll up their sleeves and swim into the seas of conflict!
Brett, I am sorry you have felt so attacked by this discussion, and definitely can see how you might have felt that way, as some comments did seem very personal.
I generally find your comments highly enlightening and thought provoking, but I have to say, this last set of comments makes me wonder if something has triggered your own issues here. I could be wrong, but it doesn’t feel to me like you’re simply working to improve the quality of the comments or improve the likelihood of the mission being effective – you sound angry and irritated, and you’re making gross generalizations, for instance, about people in general being anti-science or positing that there is no objective reality, which characterizes a VERY small proportion of the comments I’ve read.
I agree that professionals posting here are sometimes attacked unfairly, but again, I think that is a function of the kind of audience this type of a website will inevitably attract, and I agree with Richard that it is part of our job as professionals to be able to respond to such apparent attacks without rancor or judgment. The voice of the oppressed can be harsh, especially toward the perceived authorities, but that is a function of the trauma they have experienced and their righteous rage, not necessarily any reflection on you and your contributions to the movement.
Which gets to the real point of the discussion, which I wish you had tried to hear behind the anger. The point is not whether there IS an objective reality, the point is whether PROFESSIONALS like you and James and Richard and Stephen and Ron and I are entitled by virtue of our professional titles and experiences to DICTATE what reality is to our clients? Or is it our job to negotiate, test, communicate, question, probe, and encourage our charges to look at things from different viewpoints and make their OWN evaluation of what reality is. I heard one commenter only who pitched the idea that reality is whatever we make it – the vast majority accept objective reality exists, and are objecting instead to the idea that it is James’s or my or any of our jobs to CORRECT the client’s perceived misconceptions of reality, but suggesting instead that our job is to explore with them how and why their “misconception” makes sense to them and move forward from there. Of course, there are times of danger when we may feel we have no choice but to act protectively, but the VAST majority of the time, the client’s “delusions” are no more delusional than the psychiatrists’ idea that their lives can be fixed by drugging their brains, and actually far less dangerous. It’s a question of whether reality is something that the authorities dictate to their subordinates or is something we discover together, understanding that none of us has the full scoop on what “objective reality” truly means.
I hope this clarifies at least where I and where I think a lot of other posters are coming from. It is really not personal, even if it may seem like that. And being a professional means being able to make that distinction. You are getting the suppressed rage from every time these posters had something to say to a professional but didn’t feel safe saying it or was punished for doing so. It may not be good politics, but it is a natural outgrowth of a certain part of objective reality that professionals in similar roles to you and me have historically tried very hard to deny exists. It’s gonna happen, and it’s not fair, but it’s reality. For all this talk of clients denying reality, I think we as professionals need to be honest enough to admit that the clients’ reality as conveyed, whether fair or not to us individually, is a VERY big reality to be dealt with, and the system change we want to see happen will NEVER happen until we as professionals can not only accept but embrace that reality, the reality of the very clients we are trying so hard to help.
Actually, I think a goodly percentage are actually that delusional. The ones at the top know what they’re doing, but a lot of the rank and file are just emotionally crippled people who have been trained to say certain things, so they say them.
I am with Richard. I think being a professional means taking responsibility for the effect you have on your audience/client base, whether intended or not. I always figured that people have the reaction they have, and whether they were polite about it or not, there was almost always important information to be gained from hearing and clarifying their reactions. Part of being a professional is understanding that the client is going to have reactions and that it’s your job to set the tone of respectfulness, not theirs. Not that this means a professional has to put up with abusive behavior, but the professional has a responsibility to handle it, well… professionally.
“I’m learning that I don’t have to agree to find things of value.” I think this sums up the big lesson of this comment thread. There may be “objective reality” but no one is the final authority on what “objective reality” is, and it looks different from different perspectives. Even when I think someone is totally “out there” in terms of what’s actually true, there is a lot to learn from finding out WHY the world looks the way it does to them. As long as no one is being hurt, I think we do best to simply realize that agreement is not required to respect someone’s viewpoint on reality.
I don’t think so. I think Vlado is trying honestly to provide his perspective, and I think it’s important that we respect his experience, even though I think most of us would not adopt his suggestions as a good general policy on how to engage with someone in distress. He’s found a way that works for him – good for him! And I think his argument holds elements of empowerment – that psychiatrists should enable their customers to utilize the offered drugs in ways that work best from the customers’ point of view. This would, of course, involve psychiatrists admitting that their entire approach is not scientific, but is basically the offering of substances to make people temporarily feel better subjectively while making no effort whatsoever to figure out what is really wrong, which they would never allow, but still, there is a legitimate point in there that deserves recognition.
“Consensus reality,” by definition, requires consensus, doesn’t it? The word itself is basically an admission that many viewpoints can constitute reality, and that common reality is defined by consensus. Hence, the only thing really “wrong” about “delusions” is that they defy what most people choose to believe is true. Your point about slavery is very well taken. There are plenty of “consensus reality” beliefs (such as the belief that psychiatry is a scientific field!) that are of pretty questionable validity.
I do believe there is a “reality” out there that we all perceive, but even physics, the most reality-based discipline there is, has run up against the problem that even perceiving reality alters that reality. So any perception of reality, no matter how precise, is always an approximation. Admittedly, some approximations comport more closely with the actual DATA of reality, but they are still approximations and subject to modifications when new data comes in.
Bottom line, reality for humans exists as a relationship between the perceived and the perceivers, and no two people perceive reality the same way. Consensus reality is always a negotiation, and I think you’ll agree that we get into big trouble when only a small subset of humans get to be involved in the negotiations and the rest of us have to live in their “reality!”
A fascinating study looked at US immigrants’ health measures over three generations. While health indicators for first generation immigrants were all over the map, by the third generation, they had all “normalized” to USA-typical health problems, including increases in obesity, heart disease, diabetes, anxiety and depression. So much for genetic causes of “mental health problems,” or even physical health problems, for that matter! Our way of living makes people ill!
Well, you never seemed too interested in hearing others’ views, which is kind of the point of this forum. Since you already seem to believe you’ve got it all figured out, I encourage you to go back to toenail picking.
The law of gravity and all other scientific laws/theories are human inventions. Gravity (as in the tendency of massive objects to move toward each other, at least in the 3-D conception of space) does appear to exist, but it can be viewed in a number of different ways, both mathematically and philosophically.
While reality does clearly exist, we know, even in physics, that perception can and does alter the very nature of reality itself. Without a consideration of viewpoint and perception, any description of reality is incomplete, hence the need to create AGREED-UPON reality between the clinician and the person they are trying to help, even if the client’s viewpoint appears to us to be distorted or “wrong.”
I would suggest that you add the provisions of the Harrow study, which found that patients with BETTER prognoses did worse on neuroleptics than patients with WORSE prognoses off neuroleptics. This really undercuts the idea that only the “less ill” do better off drugs. I don’t think you should concede that point at all.
Otherwise, great data, well argued. Thanks for keeping up the fight!
Not to mention that there is no objective way to even approach determining who the “right patients” are except by giving them the drugs and seeing what happens. And the claim that they are “life-saving” flies in the face of the horrific early death rates for those taking the major tranquilizers aka “antipsychotics.” I agree 100% – it is the responsibility of the medical and psychological professions to actively discourage the long-term use of these agents and to explore other options that are more likely to lead to a real improvement in life quality.
Your comments also remind me of the qualitative study showing that “psychotic” people in countries where voice hearing was accepted or even valued as a special gift had friendlier voices, whereas ones where “psychosis” was rejected and feared had scarier experiences. It appears the social environment not only affects the presence of voice hearing, but also the quality and content of the voices! So your thesis makes total sense – it may be that suppressing the voices may be the WORST approach we could take!
These studies also generally fail to distinguish between SYMPTOM REDUCTION (usually the clinician’s goal) and QUALITY OF LIFE (usually the client’s goal). If you focus only on symptom reduction as an outcome measure, neuroleptics will be judged “beneficial,” at least in the short term. But if you look at quality of life measures, it appears that neuroleptics are at best of limited use, and more likely generally destructive. I think that’s where a lot of the conflict and confusion comes in – psychiatrists are often only concerned with making the “symptoms” go away, and frequently have little to no concern for long-term quality of life outcomes.
Thanks! Honestly, I really don’t know what others are perceiving or why they are perceiving what they are. And I’m genuinely interested in understanding how and why they believe what they do. Perhaps it’s because I didn’t receive any formal training before starting my work as a counselor, so I had no illusions that I understood anything except as the client explained it to me. That approach has never failed me yet!
I agree 100%. But the way you frame that is YOU think the truth is x” vs. “You are wrong and need to listen to what I say.” There is all the difference in the world between letting the client know what you honestly think vs. telling the client that they need to think the same way you do. It is subtle but can make the difference between eating the rat poison and not eating it.
I find your last paragraph to be the most important. We fail our clients, or the people we’re trying to help in any capacity, when we believe we know more than them and are entitled to dictate reality to them, and when we believe our knowledge is “right” and infallible. Being open to our own vulnerability and potential lack of understanding allows the client to also be open to the possibility that their viewpoint may not be the only “right” way to view the situation, either.
I am not sure the critique is exactly what you’re suggesting, at least in my case. You might want to see my post above. I believe, from direct observation, that it is not only quite possible to influence someone’s views while still being totally validating of their viewpoint, it is actually the key to good therapy. A woman living in a domestic abuse situation and imagining she can make it better if she tries harder is not a situation I want to see continue. However, it’s very clear from my experience that telling the person she’s wrong about her ability to make her abusive partner change either alienates me from her or makes her feel stupid and incompetent, neither of which leads to the desired reconsideration of her reality. What I have found DOES work is exploring her belief that something good is happening by staying or at least that something bad is being prevented by staying, and validating that reality, which almost always makes a lot of sense when you take the time to hear the reasons behind it. I then try to turn the discussion to one regarding what THE CLIENT wants and whether or not the current situation provides it IN THEIR VIEW, and honestly explore the pros and cons of staying vs. leaving, at NO TIME telling the client she is wrong for staying, and in fact letting her know that many if not most DV victims stay for long periods of time trying to fix up the situation, and for very understandable reasons. Of course, I am also willing to share my personal thoughts on what is happening and why if they are interested, and also how likely I believe it is or is not that this will work out, but I don’t present them as REALITY, simply as my personal views based on my own experience with this kind of situation.
So one doesn’t have to AGREE with a “delusional” (is there not implied negative judgment in even using that word?) viewpoint to validate that it looks that way from the client’s perspective. Nor does one have to invalidate that viewpoint in order to help the client see that other viewpoints also exist and may have validity as well. It’s the difference between saying, “There are no voices talking to you – you are imagining it” and “I understand you are hearing these voices, but I personally can’t hear them and don’t know what they’re saying.” The first invalidates the other person, the second merely states the reality that you’re having two different experiences, and doesn’t privilege the therapist/helper to having the “right” viewpoint.
Not sure how validation and confidence/independent thought are not compatible. While I have very strong personal ideas about what is right and wrong, I also understand that I don’t always see how things look from others’ viewpoints. I’m not shy about sharing my views, and strongly, but I’m also always interested in hearing where others come from, and especially WHY they come from that viewpoint. In the cases where I do think a person would benefit more from being able to see things my way (I’m a pretty smart and observant guy and I think have a lot of insights to share in many situations), it still works much, much better if I understand what the person is thinking before I intervene.
A great example: I used be a supervisor for a community suicide/crisis hotline. Once I got a call from a woman who was suicidal, and I asked, as I always did, what benefits they thought would occur from suicide, or in essence, what problem they saw suicide solving for them. She said, “Because the pain would end.” Now I don’t know why I said this, never have said it before or since, would probably be criticized roundly by most “mental health” professionals for doing so, but for some reason, it seemed the best thing to do. I said, “How do you know that?” She said, “What?” I said, “How do you know the pain would end?” She said, rather heatedly, “What are you talking about??!!” I said, “What if when you die, the pain doesn’t end, but you have no body but you still have the pain?” She said, “Oh, my God, I never thought of that!” We were then able to talk about other options she might have short of suicide to reduce her pain, keeping in the background that suicide was always an option she could return to if need be, but a rather uncertain one at best. At no time did I tell her that she shouldn’t commit suicide, nor that committing suicide would NOT end her pain, I merely pointed out the possibility that her certainty about the outcome might be misplaced.
So I validated her pain and her desire to be rid of it, but I neither validated nor invalidated her solution. I simply created grounds where we could talk honestly about the pros and cons. I showed I understood her and accepted her viewpoint and needs, but let her know that other viewpoints might be possible, as well as other solutions. I was certainly both confident, even bold, and quite independent in my approach, while still validating her reality. It can be done.
Well said. My oldest is super gifted in math – could translate negative 100 Centigrade to Fahrenheit degrees IN HIS HEAD at the age of 6, and even knew without being told that he had to add 32 degrees to adjust for the difference in the zero points of the two scales! But he was failing 6th grade math. Found out that the teacher gave them “steps” to memorize and repeat, and they got one point for each “step,” and if he skipped half the steps, he got 50%. Her most common quote was, “Math is just a mechanical process.” The next year, he did independent study and covered two year of material in 7 months and was taking math at the high school by 8th grade. But this dumbass lady was flunking him for not following her steps. Idiocy!
Very true, Hugh. Recognizing that we’re not alone and that our reactions to abuse/trauma/oppression aren’t all that unusual is most reassuring and often the first step to healing. Unfortunately, as this study seems to indicate, that first step is often never encouraged or allowed by those purporting to “help” those with “mental health problems.”
Sad but true. It also allows more profit-taking when you blame the victims, and it also absolves all the people who actually have the power to make a difference from responsibility, even if they are the perpetrators of the abusive or oppressive behavior. It’s a win-win, as long as you’re the one in power!
There is a need for a consensus reality of some sort for us to operate as a society. But that reality needs to be a negotiation between different viewpoints or else it degenerates quickly into an authoritarian mess. Kids have very important information about their experiences as kids that both parents and teachers need to know about and respect. Dismissing every kids’ experiences as wrong if they conflict with the adults leads to rebellious or demoralized children.
An example: I was acting as a classroom aide in a school for kids with behavior problems, but sometimes I helped the teachers with reviewing the kids’ work. I got a true-false quiz from one really bright first grader, and I saw that he answered several questions “wrong” according to the answer key. Knowing how smart he was, I went and asked him about his answers to each question. In all cases, he had a completely rational and sensible reason why he answered as he did. Marking these “wrong” would have invalidated an unusually deep kind of thinking for a first grader, but that’s what happens all the time to kids in school.
The proper response to “the blackboard is red” is to say, “What makes you think it is red?” If you find disagreement, it’s fine to say, “Well, I have to say, to me it looks green.” But it is not necessary to “correct” him/her and insist your viewpoint is correct.
When it comes to things like classroom rules, I’ve always found that having the kids make them up with you is the best approach, and creates an excellent consensus reality to work from. But that’s an AGREEMENT between parties, not the dominance of one viewpoint just because the person has more power than you.
It seems there is always a way to let someone know when your viewpoint differs from theirs without invalidating their viewpoint.
Why do they even need to “study” this kind of question??? It’s the most obvious thing in the world! Why don’t we spend our time trying to stop abuse and trauma instead of “studying” whether it affects adults’ “mental health???”
“Overtreats” is an interesting word. Don’t they mean, “recommends ‘treatments’ that are unnecessary and potentially dangerous, in violation of medical ethics?”
So running electricity through your brain and inducing a seizure can induce cognitive impairments? Who would have guessed it? Next thing, they’ll discover that being hit in the head by a speeding car has adverse impacts on brain function!
I always ask what we’d think of a car repairman who told you that you had “repair-resistant fuel injectors” but to pay them $300 and bring it back next week for another “treatment” to reduce the “symptoms.” We’d find another mechanic REAL quick! So how does psychiatry get away with blaming the people’s “depression” for “resisting” their efforts to be helpful? Wouldn’t it be a lot more honest to say, “Our approach didn’t work and we don’t know what to do to help?”
You are right, Richard, that true science does not eliminate the concept of the mysterious and the unknowable, but I hope you can acknowledge that many folks use the cloak of “science” (I call this “scientism”) to promote ideas of strict materialism (that which can’t be measured doesn’t exist), and that psychiatry itself is dependent on this very phenomenon. The big argument I hear many times in favor of bio-psychiatry states “the mind is the brain” or “the mind is a product of the brain” because “what else can it be?” It is a very short step from there to “treating the mind = messing with your brain.” The unwillingness of psychiatrists and other “mental health professionals” to acknowledge the unknown and their lack of understanding is pivotal to psychiatry’s continued existence. They “know” that genetic causes for “mental illnesses” exist and they just haven’t spent enough time looking. Soon they think they will have “designer psychiatry” specially created for your own personal brain. Meanwhile, receiving medical treatment is the third leading cause of death in the USA annually.
I think it is very important to deconstruct this kind of hyper-materialism as part of deconstructing psychiatry. Most people I have encountered who espouse a materialist philosophy around psychiatry don’t even understand that it IS a philosophy, they just think that it is TRUE, and even those who recognize it as such don’t have the subtle understanding of the implications of a true scientific materialist viewpoint. The recognition of the unknown and even the unknowable is a fundamental lack in psychiatry and all of its allies, and is central to its continued existence. Once their pseudoscientific “certainty” is undermined, it becomes much easier to show lay people that they are full of crap.
Not to mention that there are other possible philosophies that can’t be eliminated by science, leaving us open to a lot of possible views on the nature of reality, even while maintaining a scientific viewpoint, as uncomfortable as that may make us feel. Consider the uncertainty principle, or the quantum mechanical fact that a particle can move from one place to another without having occupied the space in between, or the nature of a quantum of light that when perceived in one location, it becomes unavailable to be perceived in all other locations. It appears that perception can and does create and/or modify physical reality, and that the goal of science to create hard and fast rules regarding material reality can’t actually ever be met. Even material reality appears to be affected by viewpoint, so relativism is a scientific reality even in physics. How psychiatry can deny the essential reality of relativism in the realm of the mind and get away with it remains baffling to me.
That’s because guys like Murphy aren’t conservatives. They are neoconservatives, AKA supporters of big businesses and the well-to-do. They don’t care about free markets but use that kind of rhetoric to make it seem like they are conservatives. They are really in favor of monopolization of markets by their big corporate contributors. Same is true for neo-liberals like Hillary Clinton. As a result, you are right, they don’t give two figs about their voters as long as they can fool them into voting for them next time around.
I do think we can help ourselves by getting rid of anyone who is taking money from big business as their main source of campaign funding. We can also support an amendment/court decision/whatever to get corporate funding completely out of politics. Anything that will reduce our congresspersons’ dependence on corporate donations will help our cause immensely!
I am afraid Trump is not a deep thinker. It seems he is more easily swayed than I would have guessed, and he travels in very rich, elite business circles. In such circles, profits matter more than whether something works or not. IMHO, anyway.
Why would this be surprising, as they suggest in the subtitle? Only because of the HUGE propaganda to the contrary. Common sense tells anyone who possesses it that environmental influences are both very large and modifiable, while genetic are pretty much fixed and immutable. Why do we spend all these billions studying genetics, when there is little to no evidence they are the primary influence, and when they are the one thing in the equation that can’t be changed anyway?
It would seem to me that the conservative view of this would be that the “mentally ill” are responsible for their own decisions and would experience the consequences of their decisions, and also have inalienable rights to freedom of speech and association. I believe that’s one reason that we tend to get more support for these issues from the right. However, this appointment is not about “right” vs. “left,” but it is about corporations and the elite vs. the rest of us. There appears to be little to no room for hearing the voices of the actual recipients of their “help,” but plenty of space for those in power to expand their power base. I would hope that any compassionate person would oppose this kind of oppressive behavior, regardless of political affiliation. Unfortunately, many otherwise rational people appear to have a hard time getting their heads around this issue, largely because of the massive propaganda from the drug corporations and the psychiatric hierarchy.
“Rates of sexual violence are so high for college women that some researchers recommend that counselors ask any female college student who presents with “mental health distress” about experiences of interpersonal violence.”
I always asked ANY client presenting with any kind of distress about their past experiences of interpersonal violence. Especially women. This shouldn’t have to be a recommendation – what the f*%k else are they talking about?
It also seems like they are making this a lot more complex than it needs to be. “Communication accommodation theory?” Really??? How about just talking to them and listening to what they have to say? Too radical?
Or an even more basic question: Is “ADHD” actually an entity that can validly be studied at all? That’s my point re: genetic variation. We can pick any spectrum and choose to cut of the end of it we don’t like, and call it a “disorder.” Why would we assume that just because some kids don’t like sitting still, there is something wrong with them? I know, I’m preaching to the choir here, but I think studying “ADHD” is idiotic. If there really were a small percentage who DID have something wrong with their brains, we’d never find it by studying a group of kids who happen to have a hard time tolerating the generally very oppressive atmosphere in the average elementary school classroom.
Feeling, you need to discover the magic of placebos! Just put some Niacin or something in one of your old pill bottles and make sure to pop one in front of your mom and you’re home free!
There is also no distinction made between detention and “treatment.” If it is deemed that someone be held against their will for threatening others or for otherwise being dangerous, why does that automatically confer the right to “treat” the detainee with some enforced drugging regimen that can do irreparable harm and end one’s life years early? Why not be honest and admit we’re simply arresting and detaining a person to avoid speculative and ostensible harm, and stop pretending we’re “treating” or “helping” the person, thereby justifying all manner of paternalistic abuse in the name of “help?”
And most of the rest by chronic psychological pain, for the most part as a result of traumatization or unrelenting stress. Depression is a natural reaction to feeling trapped in an untenable situation and having (or perceiving) no ability to escape. Address the pain, find another way to move from the apparent trap, and suicide no longer seems like an appealing option. Unfortunately, psychiatry does the opposite – tells you that you have no control and the only hope is to keep things “less miserable” through their drugs. They are purveyors of hopelessness for the most part.
This has no bearing on your insulting remarks above. Accusing people of being “fakes” is the problem. I expect an apology to all the people whose suffering you have minimized or ridiculed because you don’t agree with how they handled it. Accusing people of fakery is absolutely not acceptable, a violation of ANY community’s standards for posting if they have any standards at all.
This is not a “beat down.” You are directly insulting people who suffer from similar problems to your own and claiming they are not “really” suffering because they had different experiences than you did. That is disrespectful and hateful behavior in ANY context. I never gave you a “beat down” for your opinions and have ALWAYS respected your own experience as finding the drugs a positive for you personally, and have only argued that you can’t assume that because you personally had that experience, it meant there was scientific proof that your or anyone else’s brain was faulty. You can call that a “beat down” if you want, but I have NEVER suggested that your own experiences and suffering were not legitimate just because you didn’t agree with me! That is absolutely outrageous behavior, and I believe you owe an apology to others on this site who have suffered similar experiences to you but chosen different paths to healing/recovery or whatever word you want to call it.
There are people here who have been to hell and back several times over and you have NO IDEA the severity of their suffering, but choose to arrogantly assume that “real mentally ill” people could never have “recovered” without drugs, despite my even providing you with some very cogent public examples of people who have.
You are entitled to your beliefs, but you’re not entitled to insult people with impunity. And you’re not entitled to accuse me of “beating you down” when I step in to defend the folks you so blithely consigned to “fake suffering” status just because you want to protect your own ego.
This all reminds me of the movie, “What About Bob?”, where the psychiatrist (Leo) behaves in a more and more crazy fashion while his client, Bob, gets more and more rational. In the end, he attempts to murder Bob, but calls it “Death Therapy” – “It’s a sure cure!”
What is wrong with these people??????? It would be funny if it weren’t really happening!
“Mimic the real thing?” Now you have gone too far. How do you know what the people writing here have suffered and how do you dare insult them by suggesting their suffering isn’t real???? How would you feel if someone minimized your suffering and suggested it wasn’t bad enough to be real? Just because others find different solutions than you have doesn’t make them wrong and you right. I strongly suggest you take a big dose of humble pie before you post again! BTW, I am reporting your post as a violation of the posting rules, and I am hoping it will be removed, but in any case, your insensitivity is hurtful to others who have worked hard to get where they are, even if they traveled a different path than you chose.
It’s not because stories about domestic abusers are boring. It’s because these stories challenge the powerful and empower the victims. Whereas blaming the “mentally ill” blame the powerless and protect those in control. Domestic abuse is symbolic of the dominance model that most of our Western institutions are organized around, including Psychiatry.
I especially agree about the “don’t blame the family” meme. Sometimes, in fact often, the family is a BIG contributor to any of the “mental health diagnoses” that the psychiatric profession has manufactured in order to eliminate the hard work of figuring out what would really be helpful. The Authorities are always spared and the weakest and most vulnerable always blamed. Unless that dynamic changes, there is no “healing” going to happen.
In other news, scientists have discovered that striking people in the head with a hammer repeatedly leads to both head pain and cognitive decline. It is unclear whether this is due to the particular kind of hammer used or a genetic vulnerability to hammer strikes, or perhaps simply the course of sore head disease causing the deterioration.
Seriously, the problem isn’t that some people have privilege and others don’t, it’s that the entire capitalist system is based on the powerful keeping the powerless in their place. Sure, some are lower on the hillside than others and get more shit dumped on them, but the problem is people dumping their shit on people below them. Readjusting and having some with less “privilege” get higher up the hill so they can have someone to dump on really doesn’t change the dumping system in the least.
I don’t agree that a drug “working” is evidence of a medical problem with neurotransmitters or anything else. Alcohol is widely used as an anxiety-reducing drug, and is very effective for that purpose. Does that mean everyone who takes a drink or two to relax has a medical problem? Coffee is a stimulant that helps increase alertness, especially if sleep is somewhat lacking. Do people have to have a neurotransmitter problem for coffee to keep them awake? You can’t use reaction to a drug as evidence of a medical problem.
It should also be noted that changes in brain chemistry and PET scans happen when people talk to someone about their issues, or even when they change what image they are thinking of. Brain chemistry is very fluid and changeable. The idea that there are such things as “neurochemical deficits” is pretty much delusional.
Hmm…. I didn’t really find anything about Dewey supporting whole-word reading. I believe that is a much more recent development. But the entire school system has always been geared toward creating an authoritarian society, whether “Socialist” or “Fascist” in philosophy, even before Dewey. Consider the history of “black schools” and Indian schools – they were clearly designed with cultural re-education in mind. Again, a technique used by both the right and left political wings, though with different justifications. The dysfunction in the educational system most definitely predated Dewey, though I have never been a Dewey fan, as I consider him to be a manipulative authoritarian slimebag.
Genetic variation is the key to species survival. It is only our weird society that requires certain variations to be eliminated for the benefit of those in control.
Besides which, there is no evidence to support a general conclusion of a “dopamine dysregulation” in all or most “ADHD”-diagnosed children. I’m open to hearing something to the contrary, but I’m very familiar with the literature on the subject and know of nothing supporting that other than a few odd studies which have never been duplicated.
And why would we expect to see that all or even most kids that act a certain way have something “wrong” with them, or the same thing “wrong” with them? It is not a logical conclusion that you can diagnose a physiological problem from behavior. Kids act hyper for tons of documented reasons – chaotic families, trauma histories, boredom,lack of sleep, malnutrition, iron deficiency, sleep apnea, certain drug reactions, the list goes on and on… It is ludicrous that you can tell that someone’s brain is malfunctioning based solely on a somewhat arbitrary collection of behavioral indicators, all of which can be summed up as behavior that makes it inconvenient to have this kid in a classroom or to parent them.
I say this as the parent of two “ADHD” type kids who turned out to be very productive adult citizens without a milligram of stimulant drugs. If you feel these things help you out, by all means, use them, but don’t make out that all kids who don’t like to pay attention to boring lectures or follow adult directions are in some way diseased or disordered. There is simply insufficient evidence to even vaguely support such a notion.
Your observations are quite accurate, but I would question blaming “the Left” for this state of affairs. I grew up in the 60s, when “the Right” was running the schools, and it was just as oppressive, though in different ways. Boys were expected to wear boy clothing and be aggressive and go out for football and not cry, and girls were expected to wear skirts and take Home Ec and only go to college to get a husband. But kids were humiliated and shamed and sometimes hit and had zero power.
The problem is not “the Left” or “the Right” but AUTHORITARIANISM from either end of the spectrum. The idea that we can take kids and put them through some kind of grinder and have them all come out the same is the core problem. Whether it is right-wing authoritarianism, enforced through violence, fear and shame, or left-wing authoritarianism, enforced through fake sympathy and drugs, the effort to make everyone comply with the status quo is the problem with our public schools. And that problem is part of the design – if you read back when public schooling was invented, the effort was to create “good citizens” out of freed black slaves and a large influx of immigrants from Ireland, southern Europe, and Asia, whom the powers that be were worried might decide to become rebellious and take power from the ruling elite. “Good citizen” meant someone who could read and write and who followed the rules and was prepared to be a factory drone in the new industrial America.
So it’s not about left or right. It’s about authoritarian vs. individual freedom, and putting right-wing authoritarians in who want to bring back prayer and corporal punishment will not make things better for our kids or our society.
I am amazed that even the initial research gets so much press and excitement! Even if the findings were true (and I am not the least surprised that they aren’t), all it shows is that a certain small percentage of sufferers may have a certain genetic pattern. The genetic pattern doesn’t occur in all depressed people, nor do all people with the pattern get depressed. So what the fuck? Who cares? And now, shockingly, we find that the link so celebrated is not even valid! Why don’t we just accept that we can’t change genetics, no matter how much or little they are involved, and focus on changing the environmental variables (food, sleep, chronic stress, trauma, etc.) that we actually have some control over?????
Being a non- or anti-authoritarian in today’s society can be a major cause of feeling suicidal. It has certainly been my experience. Calling it a “mental illness” is society’s way of continuing to assert the dominance of the status quo.
I have known a ton of therapists and psychiatrists who practiced for years while fully qualifying for a “mental illness” diagnosis. Anxious, depressed, delusional, emotionally unstable – all the labels they throw at their “clients.” There is ZERO accountability until something horrible happens. It seems very clear to me that these “peers” will be held to a much higher standard, based on pre-judgment and bias against their role and them as persons. I find it offensive to assume that “peers” have “mental health issues” and assume that the “real professionals” don’t!
I think what it reflects is the bias of the investigators, who claim that “ADHD” diagnosed kids have smaller brains (however unsupportable that claim) and yet intentionally buries the data that these supposedly “smaller-brained” individuals appeared to have higher IQs. The higher IQ point is less important than the fact they chose not to comment on it when it didn’t support their thesis.
That’s a very interesting point! I do think part of the reason for a therapist not disclosing too much is supposed to be so the client can kind of project his/her own feelings/needs/expectations onto the therapist without worrying how the therapist is actually feeling about it. That’s kind of a “Freudian” concept, but my therapist seemed to use that approach to some degree. I do find that it’s a balancing act – I don’t want the person I’m talking to to worry about my reactions, but knowing what they are worried about is important to knowing where to go with the person. I have found that honesty is very important, but don’t share details unless they seem relevant to the person I’m trying to help. Sometimes it’s really good for the client to know that I’ve struggled with suicidal thoughts because it makes him/her feel like s/he’s not alone or weird. In other cases, it seems more important to just listen to the client’s story and not tell anything at all about me. I just have to gauge it for each individual.
Class I am sure is a huge variable, one that is very far beyond the scope of my understanding. I do think a history of trauma IS helpful, but ONLY if the therapist has done his/her work and can use it as a tool of understanding rather than using therapy as a way of working out his/her own issues on the client.
So I think you’re right – it helps a lot to trust the therapist if they can share some personal information, but at the same time, it’s very important not to set up a situation where the client needs to “take care” of the therapist. The therapist does seem to need to have some “elevation” or “authority,” but I found that a big part of my job was to step down from that authority position and help the other person re-tool his/her relationship with authority figures in general. It’s a weird role and one that I don’t think you can really train someone to assume. It requires a lot of tolerance of ambiguity, both in terms of roles and in terms of emotions. That’s my experience, anyway.
Getting “peer specialists” “out of the way” seems to be the point of this. If they won’t be handmaidens to the “authorities,” they have to be bumped off. And Lord help us the “peer” should have any kind of “mental health issues!” Do psychiatrists and psychologists have similar requirements to resign or go on leave when they “have issues?” Are the authors unaware that psychiatrists are at the top of the charts for professionals who commit suicide?
Oh, it’s not broken. It works quite well at creating docile, unquestioning, anxious sheep. We only believe it’s broken because we have the mistaken impression that schools exist to create truly educated citizens. In truth, that’s the last thing our corporate owners want.
I have been a therapist in the past, and without being egotistical, I have had great feedback from those I have helped. My main thrust was to a) listen very carefully to what the other person shared, trying to help them shape and frame exactly what the problem was from their perspective, b) asking questions to help get at how/why the person came to look at things from the perspective they did (for instance, a woman had never left her kids with a babysitter in 5 years; she shared that she was worried they’d be molested; not surprisingly, she had been molested by a babysitter…), and c) help them generate some other things they might try that would help them look at the problem differently. My caution was always to make sure I did nothing that was focused on making myself feel better – I had to be able to sit comfortably with their pain and NOT try to make it go away just because it was hard for me to hear – but to put all the focus on helping the other person feel safe and confident enough to gain some perspective on his/her situation, normalize and understand how/why they got there and maybe consider thinking/acting in a different way that might help them move forward. Sometimes it meant going back and hearing about some rough stuff that happened in the past, sometimes it meant working out some new things to try out in the present, sometimes it meant looking at new ways of thinking about things that have plagued the person in the past – it all depended on who the person was and what they seemed to need and how they responded to me. Everyone’s “therapy” was different and pretty much invented on the fly as I found out more about them. I never assumed I knew ANYTHING about a client that they had not told me themselves.
As for honesty, I never hesitated to share personal things with someone coming to me for help IF I thought it would help that person find a new perspective or feel more OK about their decisions in the past. I found it important to be very real and warm and present and this idea that “boundaries” meant being somehow distant or “clinical” always seemed totally wrong to me. Boundaries, for me, meant not putting my crap on the person I was working with, and not taking on their issues as my own so I “had to solve” their dilemmas. I think the most important point was simply being willing to hear their story without making any judgments and being genuinely empathetic to their situation so I could see things from their perspective.
Of course, I had one huge advantage in being a therapist – I had never had any training in therapy at all! I figured out how to help almost 100% from the clients themselves, who often talked about what other therapists had done that was or wasn’t helpful, and whose reactions and perspectives taught me everything I know about how to be helpful. I wonder if being “trained” would have ruined me?
I am used to skewed studies, but this one seems like a record-setter! I am stunned that The Lancet or any other journal would accept such a questionable study, especially the unwarranted conclusions. It is disturbing that such crap is passing for “science” these days. I wonder who got paid off?
The problem is, they are getting paid big money to provide “low-value treatment.” Stop paying doctors for committing malpractice and they’ll be more likely not to commit it!
I certainly don’t mean to minimize the incredible damage done by the drugs! What I’m trying to say is that while some experience horrible drug effects and some don’t, the labeling process harms almost everyone who comes in contact with it, and is in fact a large part of how and why they are able to convince their clients to take the drugs they offer. If they really told you, “We don’t know what is going on, but this drug may or may not make you feel temporarily better,” a lot more people would just say “NO” or would contemplate other options for the longer term. The drugs are horrible, horrible abominations, but they would be much less of a problem if the diagnosis and labeling process could be dropped. Additionally, the labeling process invalidates each person’s own knowledge and certainty of what is going on and what might help, and encourages dependence on doctors, which of course helps them to peddle their evil pharmaceutical wares more effectively.
Exactly my thought. Why do they have such a need to find these spurious “links?” Even if they found a gene that “influenced” depression, so what? First off, these studies show probability correlations, so it’s quite possible that even with such a link, most depressed people still won’t have the gene in question. Second, what would you do if you found it was true? Splice in a new gene? Feel sorry for the person? Give them more Prozac? There is no real solution that would be rendered even if they find some small percentage of people with a gene that “makes them more vulnerable” to depression.
Last but not least, if such a gene exists, is it not possible that it is also linked to other positive characteristics like empathy or thoughtfulness toward others? The idea that a gene influences one and only one trait is ridiculous when considering emotional variables.
Instead of wasting time finding one gene that affects only a percentage of depressed people who are exposed to stress, why not spend our time and money trying to reduce the stresses that might trigger such theoretical vulnerabilities? Why not focus on something we actually have some control over, instead of spending billions trying to find some gene that we don’t really understand and couldn’t change if we wanted to?
This is the core problem with the psychiatric model. It’s not the drugs, it’s the MESSAGE that comes along with them – you are permanently faulty, and you personally can do NOTHING to change it. You are doomed to a life of dependency and half-living, never capable of moving beyond because your had the bad luck to be born with an inadequate brain. The message of hopelessness is far worse than any drug side effects, if the poor patient buys into it.
I would have a lot less trouble with someone saying, “You feel like crap right now. A lot of people have similar experiences, and there is nothing wrong with them. I can provide you with a drug that might blunt those feelings a big while we work on another plan.” That’s at least an honest assessment of what the “doctor” can actually offer. But to say “you have a lifelong disability and will have to take drugs for the rest of your life” – well, if you weren’t depressed before hearing this, you sure would be afterwards!
Thanks for a very direct and compassionate description of what is really needed – HOPE!
It is hard to imagine neuroscience fully or even mostly supporting the psychiatric worldview, primarily because the “diagnoses” they have promoted have no actual connection to any physiological reality, and as such, the “groups” they are purporting to study are almost completely heterogeneous. It is quite possible that SOME members of a particular group may have some kind of genetic or physiological problem causing their “mental” difficulties (such as porphyria) , but these would only be a small proportion of the whole and might even span a number of different “diagnoses.” Medicine can’t even find genetic causes for obviously physiological things like heart attacks – what is the likelihood that such causes would ever exist for such a nebulous and subjective category as “depression” or “anxiety disorders?”
I agree, psychiatry as practiced is a form of spiritual abuse. It insists that you believe in a set of dogma and punishes you if you don’t. It involves a set of “scriptures” which are not something that can be questioned. It is authoritarian – the “parishioners” have no say in the rules, and even the higher authorities (the psychiatrists) have no power to question the rules set by THEIR superiors, and they are attacked or shunned if they challenge the dogma of the group. All they are missing in being a solid cult is a single charismatic leader. They also invalidate any effort of the “parishioners” to empower themselves, and in fact are able and willing to use force to gain “membership.” I think the analogy is pretty complete.
I agree 100%! If someone (like a certain political figure) is an evil bastard, let’s call him that and not give him the “out” of a “mental illness” (especially since all of those “mental illnesses” are made up anyway!)
I like “labeled with X” as a way of describing the reality without buying into it. “X”, of course, always in quotation marks. Sometimes I even add “so-called” in front of the quotes to make sure no one is misinterpreting.
I usually say “emotional distress” rather than “mental,” but it is a shame that the term “mental” has been so co-opted by the current system. As soon as one says “mental,” people either think “mentally retarded” or “chemical imbalance.” Sad, but that seems to be where our culture has moved.
SO the long and the short of it is, it is always a very bad idea to assume that ALL cases of “mental illness” or a particular “diagnosis” are caused by the same thing or require the same kind of intervention. Even the DSM admits as much: “There is also no assumption that all persons qualifying for the same disorder are alike in all important ways.” (From the intro of the DSM IV) That’s the real problem with psych diagnosis – it is based literally on NOTHING except a set of social assumptions and biases about a certain set of behaviors. The idea that we can “diagnose” a particular problem simply by looking at how a person is acting or feeling. To postulate that all “eating disorders” are caused by sexual abuse is dumb; to assume that all “eating disorders” are caused by nutritional problems is equally dumb. Everybody is different!
Yeah, I wonder if the “savages” had any “mental health consequences” of surviving genocide? Perhaps if they were able to return to their original healthy diet, their accommodation to the dominance of the violent European culture and over a century of intentional suppression of their culture and way of life would be much simpler, eh?
They HAVE to say “remission,” no matter how complete the recovery. If they say “recovered,” the are admitting that their “permanent brain disease” meme is a bunch of crap.
So you really are saying that all “mental illness” is caused by poor nutrition? Can you PLEASE answer that question with a simple YES or NO?
As for “what is the proof of that?”, I think the ACES study by itself is absolute proof that early childhood stress and trauma is a causal factor not only in “mental health” problems as defined in the DSM, but also in a wide array of physical health problems. It seems absurd to suggest that a person being abused by his/her parents systematically and then being removed and put into multiple foster homes while separating him from his siblings and other relatives would not cause anxiety/depression/anger issues, not as “disease states” or nutritional deficiencies, but as very normal reactions to very abnormal childhood circumstances. To deny that these circumstances substantially affect kids’ emotional well-being, mood, and ways of thinking seems just plain ridiculous.
I think you risk substituting nutritional dogma for psychiatric dogma. Again, I agree 100% that nutrition is massively ignored in both psychiatry and general medicine as both cause and treatment of a wide variety of conditions, and that SOME conditions will resolve with nutritional interventions (and in some cases ONLY by nutritional interventions), but it is a very, very large leap to move from there to saying that all “mental distress” is caused primarily or only by nutritional deficiencies, as if how you were raised or the social conditions that affect you are irrelevant. I think it would be insulting to the vast majority of my foster youth clients to suggest that all they need to do is eat better to overcome 15-20 years of abuse and neglect by their parents and the system.
Nobody is saying you are wrong, just that there is more to the picture than ONLY nutrition. It is misleading to tell someone who was raped by his dad repeatedly for 15 years and whose mother didn’t protect her and who later got into an abusive relationship because this guy put her on a pedestal at first and she had no way to screen his behavior for abuse that if she just ate better and got some exercise, all of that past trauma would no longer concern her. I think giving her nutritional counseling is not only good, but excellent advice, but it would only be the beginning of how to reconsider the meaning of the survival strategies she learned in all those years of abuse.
I hope that is clearer. Thanks for hanging in the conversation!
I’m certainly not arguing against anything you said. But there are often issues much more deep-seated than a current bad relationship. I have worked for 20 years with foster youth and even longer with domestic abuse victims and adults with childhood sexual abuse issues. I guarantee you that nutrition alone, or even spiritual practices, are not sufficient in most of these cases to create a positive outlook. These people need help sorting out why their lives went the way they did, why they hate themselves and/or others, why they can’t make friends, etc. so they can DO something about the coping measures they adopted to survive the awful situations they were in. What is your approach to such people BEYOND improving their nutrition or exercising or even practicing mindfulness? Or do you believe all such cases can be addressed by nutritional approaches alone?
Good to see the NIMH putting some emphasis on this. However, until we lose the DSM, such efforts are doomed to failure, because we’re still “treating” depression or anxiety as if they were “the problem” instead of a manifestation causing us to be curious regarding the cause.
So the big question I still need to hear your answer to: Do you believe that nutrition is always the best approach to what we call “mental health” issues in our culture? Do you or do you not think that traumatic experiences or chronic unresolved stress can cause “mental health” problems as defined in the DSM? If so, what would you do or suggest beyond nutrition and exercise?
Excellent example of the complexity of these issues. The physical affects the emotional and the spiritual and vice versa. Any attempt to come up with one solution for every case is going to end up creating havoc!
All very true. My wife has been a doula and I used to live with a homebirth midwife, plus I worked at a teen moms’ home, so I’ve seen plenty of “standard of care” obstetrics, and its brutality and disrespect and complete disconnection with both science and common sense is exceeded by only one other discipline – psychiatry! The parallels between psychiatry and obstetric care in America are legion. Both need to be started over from scratch!
Just to clarify, are you saying that the ONLY reason people feel mentally/emotionally unwell is because of poor nutrition? Do you discount the impact of childhood trauma, poor relationships, the incredible stress of working a mindless job in an industrial society, exposure to racism, sexism, etc. as contributory factors? Because I agree that nutrition is very important and can resolve some cases, but to suggest that ALL cases are caused by poor nutrition seems a very large leap!
Perhaps the real problem is assuming that “mental disorders” all have the same cause or type of cause. My belief is that SOME depression is the result of physical things like diet, sleep, other drugs, etc., but that much or maybe most is stress-related. Of course, unresolved stress also results in loss of sleep, poor nutrition, etc., so there is no way to separate the effects entirely. Bottom line, it is the idea that “depression” is a disease state that creates the impression that there should be a “treatment” that works for all situations. That impression is absolutely false.
Wow, whod’a thunk it? Did they REALLY get funding to study something this obvious? It says a lot about how distorted our view of “mental health” is that this conclusion isn’t a basic assumption of “mental health” practice!
Sheesh! Talk about making things more complex than they need to be!
‘The researchers also find, “the more that a mother identifies as a mother the less likely she is to experience depressive symptomology after giving birth.”’
My wife has done research into “Postpartum Depression” (I HATE that term!) in other cultures. She found that there are cultures where there is essentially NO incidence of the “PPD” phenomenon! Not surprisingly, these are cultures where the new mother is supported by a big social network and rituals that welcome them into motherhood. The more the mother can focus on just being a mother and taking care of her baby, with the other women in the group providing cooking, cleaning, childcare, and emotional support, the less likely the women will be depressed. DUH!
Finally, the authors make a somewhat bizarre statement near the end: ‘The authors state, “given that the vast majority of mothers refuse pharmacological treatment due to concerns about side effects and breast feeding, a program that targets social (rather than individual) dysfunction may be preferable for many women.”’
So now, despite what should be the obvious conclusion that social support should ALWAYS be the provided BEFORE “PPD” develops, they are saying that the reason they should provide this “SMIC” (otherwise known as “being a supportive human being”) is because most moms refuse to take antidepressants! As if the two were somehow equivalent????
Again, SHEESH! Way to make the obvious conclusion as obscure as possible!
Agreed. The critiques offered don’t get to the fundamental problem with the DSM concept – namely, that adaptive strategies to cope with unrelenting chronic stress are somehow diseases or disorders or dysfuntions, as if the “normal” reaction to every situation is to be mildly happy or mildly annoyed, and any more severe reaction to the status quo, however horrible that status quo might be, is an aberration. There is no acknowledgement that what they call “mental illnesses” are 90% or more of the time normal reactions to abnormal circumstances. And since there is no way to refute one’s diagnosis, they also provide excellent cover for drugging any manifestations of stress into submission without the slightest effort to understand the origins or purpose of the person’s behavior or emotions.
I agree wholeheartedly, and think the harm done by diagnosis is substantial and sometimes irreversible, even more so in cases where overt abuse is involved. I worked with foster youth for 20 years, and saw so many cases of hurt, insult, confusion, and anger created by the invalidation of the youth’s difficult experiences prior to and during their stay in foster care. It is the very opposite of what is helpful, namely, NORMALIZING the youth’s experiences and reactions and helping them make sense of what happened to them and what they want in their lives. There is not much you can do worse than taking the meaning away from someone’s painful experiences.
The answer is obviously NO. Science, for starters, needs to be self-skeptical, needs to test and re-test its own assumptions in the search for new knowledge. It also needs to have clear definitions that can be verified by external observer. Neither of these most basic assumptions of science are even vaguely attended to by psychiatry. They invent unverifiable categories based on untestable criteria, and insist on the correctness of their theoretical framework despite any and all evidence to the contrary. Those who challenge them from within are ostracized, those who challenge them from without are ridiculed and attacked. They have no interest in advancing their understanding of the people they are trying to help. They use technology and shiny lights and biochemical smoke and mirrors to obfusticate and distract from the fact that they don’t have the first idea what causes ANY of their spurious “mental illnesses” nor what anyone could do to actually “cure” their “diseases.” It is, in fact, the antithesis of science, with much more in common with a religious practice than a medical one.
I’d say we have to discount anyone who says they are “necessary for the treatment of my disease” as being genuinely positive. Such comments don’t support a positive experience, merely an assumption that things would be worse if they stopped, which is really a fear-based rationale. Obviously, there are some good experiences that people have with antidepressants, but if that’s the main “positive experience,” it’s not very convincing, because “treating a disease” isn’t an experience, it’s a belief system, one that many are indoctrinated into believing.
As an example, my wife and I were asked in our childbirth class for our second son how the birth of our first son went. We both replied it was “pretty good,” until we were asked some more specific questions, during which we recalled not being allowed to eat, not being allowed to open a window, my wife being called out of the shower to visit the doctor who never arrived, my wife being given sleeping pills under pressure from the nurse, only to be awakened an hour later by someone taking her blood… but none of these experiences were conscious as we said the birth was “pretty good,” because we did as we were told we had to, and were not aware of any other options. Today, having experienced two homebirths, one with Ginny in a hot Jacuzzi tub, with capable midwives in attendance, I can say that our first birth pretty much sucked. Antidepressant users who don’t know of other options are likely having similar experiences and reporting similarly unmeaningful responses to the question of “do they help?”
Weird how they try to provide such a range of provisos. But it seems pretty clear – long-term stimulant use provides no benefits, even at the symptom reduction level. It’s a waste of time. And this is from JS Swanson, a long-time mainstream researcher who has supported stimulant use his whole career. Yet despite this dismal record, there are recommendations for expanded treatment?
This article really sums up the difference between helpful or unhelpful interventions: do they validate or invalidate the experiences of the people needing help? Do they bring hope or destroy hope? Do they move people toward feeling more capable or less capable? Too bad the world of psychiatry will never pay any attention, because empowering people doesn’t pay well enough!
They are missing another important aspect of this finding: part of the reason antidepressants come out with positive results is BECAUSE so many people drop out. Dropouts are commonly NOT counted in figuring the final success figures, but most people drop out because of ineffectiveness or bad side effects, so discounting those people skews the results (quite intentionally) toward a positive outcome. Combine this with the nefarious “placebo washout” protocol (where they test people for placebo response and remove them from the study before starting), and it’s easy to see how and why antidepressants are reported to be a lot more effective in treatment studies than they are in the actual reality of life.
This is an excellent point. Many more privileged people engage freely in oppression of lower-status groups in order to project their own feelings of inadequacy onto someone else. This is particularly obvious in domestic abuse situations, where the person who has all the power seems to NEED to confuse, oppress and control their partner, even when the partner is doing everything she can to accommodate. I think it’s wrong to think that the powerful have no anxiety. They just have more options on how to deal with it, including making others feel even more anxious than them.
You didn’t answer my last question, though. Is it possible that a human being has a significant level of control over how and what fires in the brain? Is not the simple expedient of breathing slowly and deeply universally understood to alter pulse and blood pressure and to calm the body and reduce anxiety? There is also excellent evidence that long-term Buddhist monks, when their brains are studied, have built up certain regions of the brain associated with calmness and focus through their meditative practice – they can change the actual PHYSICAL STRUCTURE of the brain through meditation!
Everything human has a “biological component.” That doesn’t leave us in a situation where we are dependent on chemical or physiological interventions to alter our psyches. A smart man once drew the analogy of hardware and software – a computer is totally dependent on its electrical structure, but without a program it’s totally useless. The programs have an “electrical component,” but if you try to solve a software problem by altering the hardware, you’ll be in big trouble.
So far, there is neither proof of any specific hardware problem, nor any specific universally effective solution, for ANY of the so-called “mental illnesses.” It seems to me that psychiatry would do very well to be a hell of a lot more humble about their pronouncements, especially as they are completely and utterly unable to explain the John Nashes or Elanor Longdens of this world.
So sure, drugs may “work” for some people by creating what they consider positive effects, but that’s a long, long way from your claim that schizophrenia (and what is that, really) or any other “mental illness” is caused by misfiring neurons. I think we have a lot more to say about which neurons fire or don’t fire than you’re giving us credit for.
If that’s the case, how do folks like John Nash or Elenor Longden or Will Hall recover without any drug interventions, in your view? Why do their nerves suddenly start firing differently? Could it have something to do with how they respond to their situations? Do we as human beings have the ability to alter how our nerves fire?
It seems you are confusing your own personal experience with scientific data. You may have found these drugs to be helpful, even life saving. This doesn’t mean that others have the same experience you did. The data show the likelihood that any particular person may or may not benefit, and people can make their choices based on that data. I think it is important to acknowledge that some people do report benefits, even very strong benefits, from taking antidepressants. However, it is JUST as important to acknowledge that some people have damage, even very strong damage, from taking these very same drugs. I think it should be very clear from the postings here that doctors not only don’t share this information with their clients, they go out of their way to deny it or blame their patients for not reacting the way the doctors want them to.
The DATA say that antidepressants should not be recommended for everyone, and that each case should be treated differently. They also say that we should be very aware of the possibility of serious side effects in every case, and remove people immediately if they emerge. I’d venture to say also that the data tell us that antidepressants alone are VERY unlikely to make things better for most people, and in fact may make things worse ON THE AVERAGE over the long run. So kudos for you for finding your own path that works for you, but it feels quite disrespectful to suggest that everyone having a different experiences should shut up, especially in light of this kind of study.
As to Robin Williams, I would suggest you study up on his childhood before you attribute his long-term depression to biological causes alone. It appears he had a miserable upbringing and used comedy as a way of coping with feelings of inadequacy that went back to his earliest childhood. I don’t want to pretend that biology doesn’t play a role, because it most likely always does, but I am saying that we DO NOT KNOW the degree to which biology affects someone’s reaction to abuse and neglect, and we DO no for sure the impact of abusive behavior on a range of behaviors and emotions. EVERY “mental health” diagnosis is correlated with early childhood trauma and abuse. And since there is nothing we can do about genetics, and there is LOTS we can do about childhood abuse, it appears the conversation has been badly, badly skewed in the direction of biological causation. This site provides the rest of the story. You can call it biased, but it is vital for you and others to understand that the standard viewpoint on “mental health” is badly biased in the other direction. It is an absolutely vital counter-narrative to the constant droning on about how it’s all biological and antidepressants are the only answer.
I hope that clarifies things. You’re entitled to your viewpoint and experience, but I strongly urge you to remember that others have had dramatically different experiences and they are just as valid. And beyond that, I want you to respect that conveying scientific data is never wrong, even if it conflicts with your personal experience, as decisions depend on good data and everyone is entitled to it, even if it messes with the accepted “take your drugs forever” narrative.
The first problem is, how would you be able to tell who “needed them” and who didn’t. The second problem is that when they DON’T work, which (looking at the data above) appears to be very frequently, are the doctors able to notice and admit that they are making people worse? My experience, and I have lots of it over 20 years working with foster kids and ten more working as a counselor, is that they don’t.
The bloggers here appear to me for the most part to be trying to tell a story that the “mental health” industry doesn’t want told, and this article says it well – most of the time, drugs do more harm than good, and doctors are just plain incapable of being objective enough to sort out who they do and don’t work for, or to even bother to ask. The data in this study basically say that if there is a group the antidepressants work for, it is either very, very small, or thoroughly offset by an equally large group who are made worse. This is important information. I have no idea why you would not want folks to share it. Perhaps you can explain why asking these questions or sharing this data is bad?
A change of venue can be an excellent “treatment,”especially when the old environment has assholes in it who are committed to making you miserable. But none of that counts in psychiatry. You’re supposed to be happy and effective regardless of whatever abuse you may be experiencing, and if you’re not, it’s your brain that needs fixing, not the bully. Idiocy, but that’s “modern” psychiatry for you.
Two answers: one – too much money being made to allow any critique, however rational, to stand. Two: the narrative fits a lot of cultural needs, such as blaming the poor for their poverty or black people for objecting to their subjugation, or blaming children for asserting their needs when we’d rather control and abuse them. In short, the powerful elite love the idea that “mental illness” is a physiological thing, because they get to make money and resist any inkling that we might have to make changes to our system rather than blaming the victims.
Wow, so legalizing same-sex marriage apparently improves “neurotransmitter imbalances” all by itself! Nah, can’t be. Must be that the populations in same-sex-marriage states share some genetic commonalities that make them more sensitive to changes in political climate. Need to do a study there…
“Overdiagnosis” is kind of an oxymoron when it is impossible to actually determine who merits a diagnosis by any kind of objective criteria. There is no objective standard for diagnosis, therefore, no standard for “overdiagnosis,” which is a fundamental problem with the entire idea of diagnosing “mental illness” based on social constructs that have no valid, objective indicators of their presence or absence.
Real science does everything it can to DISPROVE any hypothesis before accepting it as truth. Science is crappy at proving things true, but very good at proving things false. Every other reasonable hypothesis or explanation needs to be considered and eliminated before a model is accepted as “truth.” And then it’s only true until further data invalidates or modifies it.
Unfortunately, these days “scientists” are allowed to run with biased data and positive results are published and studies disproving popular theories are buried as deep as possible and those profiting from the current “truth” spend time and money discrediting known facts. Even in physical medicine, we’re getting increasingly crappy results, and as for psychiatry, it left the vaguest impression of scientific integrity in the dust decades ago.
As I said, “PPD” is an invention like any other diagnosis. Most “PPD” is caused by high levels of stress – loss of income, deteriorated body image, interrupted sex life, changes in relationship due to change in status to “mother,” loss of friendships, increased isolation, loss of sleep, and on and on. Not to mention that a huge percentage of domestic abuse starts during pregnancy or right after birth. To suggest that “postpartum depression” is a disease state is rank ignorance or else intentional greed and manipulation. As I stated above, there are cultures where “PPD” DOES NOT HAPPEN AT ALL. If it is “biological,” why is it so much more common in modern industrial societies and so rare in tribal cultures?
My wife saved her dad from a similar fate. I wrote a blog about it a while back. He was put on Risperdal and became rigid and tense and unable to sit up or talk. After she got him off, in three days he was chatting and laughing and trying to feed himself. And yet somehow, none of the staff seem to have noticed that the drugs had almost completely disabled him. Or more likely, they considered it a “successful treatment.” Honestly, it would be kinder to kill the people outright, but I guess they couldn’t collect insurance for them if they were dead.
The normal psych world is dark enough, but what they do to senior without even the pretense of something actually medically wrong with them is downright evil.
“Encouraged” to discuss the realities with their patients???? Why aren’t the authors calling for doctors engaging in these practices to have sanctions on their licenses? Why should there not be class action lawsuits against doctors for ignoring the most basic instructions for the use of Benzos?
And I agree with Richard – the problem is not failing to provide psychotherapy alongside benzos, it is ignoring the fact that Benzos are not recommended for us for more than two weeks due to the risk of dependency, and that they are simply not appropriate for the uses they’re being prescribed. The only potential legitimate use (and I find this questionable) is for short-term use in anxiety attacks. These doctors are engaging in MALPRACTICE and should be called to account for it.
I agree. “Postpartum depression” is an invention to cover the fact that we set up mothers for stress and disappointment in our oppressive society. It is a fact that certain cultures have essentially ZERO cases of “postpartum depression.” mostly because they provide continuous and ongoing support for the mom and baby after birth. “Postpartum depression” is a Western industrial society disease that is a function of how we treat new moms and babies. It is NOT because of hormones – it’s because of unresolved stress in 99% of cases.
Evergreen State, where my son attends, includes this kind of critique in their first-year statistics course. I was very pleased to see it there, though my son, of course, is already very savvy about detecting statistical BS.
Odd that they identify increased contact with providers as a confounding factor. Isn’t that the point? That contact with caring people reduces feelings of isolation and hopelessness?
And notice we’re talking about 6 group sessions, four before and two after the birth. There is no specific intervention based on the needs of the specific mother in question. And despite this, double the number in the control group fell into deep depression in the control group.
Given the anemic response level for antidepressants, the broad side effect profile, and the lack of any evidence of long-term advantage, even within psychiatry’s own warped viewpoint, this intervention is clearly superior. What would happen if someone actually paid some individual attention to the mothers’ specific stressors and helped them plan for their families’ futures?
Never heard of the HOD or the EWI. I personally never bothered with testing of any kind when I worked with people in distress. I generally found that asking them the questions instead of having a test do it for me allowed a lot more nuanced approach. The challenge is maintaining sufficient objectivity and being OK not knowing what you have to do until you get enough information. I wish there were some “objective test” but I haven’t seen one yet that even comes close. I will look into those, though.
Do you really think that assigning a DSM diagnosis improves one’s understanding of the problem? I totally disagree. Even mainstream psychiatrists like Insel have acknowledged that the DSM categories don’t relate to any particular physical anomaly or problem, and that in fact we are clumping together heterogeneous groups and assuming they have the same causes and effective treatments. If a mainstreamer like Insel is saying this, please explain how lumping people into subjective categories like this helps us understand them better? Isn’t it more effective just to talk about what behavior they engage in that is distressing or problematic? Wouldn’t we understand more if we asked the client about his/her perspective on what the problem is in their terms, rather than trying to force them into our artificial frame of reference?
So are you going to the “brain problem” model here? Do you think Trump is an asshole because he has a “brain problem?” Or do you think he’s learned to be an asshole because it’s gotten him power and control in the past and he continues to use what works?
Not to mention the people who are depressed because they are trapped in a dead-end job or an unhappy or dangerous marriage or kids (like me) who are forced to attend school every day for 13 years in a soul-crushing environment and have no sense of self-efficacy. Sometimes depression is not due to bad nutrition, it’s because depression is a normal expression of distress when in distressing circumstances, regardless of someone’s nutritional state.
It is just too much work for them to figure out what’s actually going on. Much easier to blame the patient and drug them into submission!
When you say “mentally ill,” I think you mean what I would call “irrational.” He is most definitely irrational and makes decisions based on emotions and biases. But that doesn’t really address what Sera is saying here – that using labels to identify his irrationality both validates these subjective and irrational labels AND minimizes our ability to truly analyze what is not working about Trump as President. It is his irrationality and dedication to being RIGHT at all costs that leads to many of his bad decisions and allows him to be manipulated by others who are “handling” him to their own advantage. It seems far better to me to describe what he’s doing that is dangerous or irrational than simply labeling him as “mentally ill.”
Great article! The one thing I think is missing, though, is a recognition that OF COURSE not all instances of depression are caused by poor diet or will be remediated by improved diet, because DEPRESSION IS NOT A LEGITIMATE DIAGNOSTIC CATEGORY. But we DO see that at least a third of depressed people could be dramatically improved in their mood by eating better. What is going on with the other two-thirds should be investigated, of course, but we would expect that not all of them will improve with ANY particular intervention, because DEPRESSED PEOPLE NEED DIFFERENT THINGS.
This is vitally important, because analysis of this kind of study is dramatically hampered by the categorical clumping of depressed people into one group. This subjective grouping serves the interests of the drug companies, because they can say, “Well, nutritional counseling only helped a third of depressed patients, while antidepressants helped 45%, so antidepressants are better.” I strongly encourage you to write unequivocally on this point, as it is a very important argument to undercut any efforts by mainstream psychiatry to minimize the importance of these results.
“5-HT6 receptor functionality is much more complex than initially defined.” In other words, we have not the slightest clue what we’re doing, and once again, our guess was wrong.
Well, that’s a bit deeper analysis. Our economic dominance is, of course, based on stealing our land from the native inhabitants and enslaving both them and Africans and profiting off of their free labor. And so on and so on. But most people are not willing to ever go there, are they?
Sorry, Cat, but bolstering the stock market has not helped the common laborer one iota. The stock market broke 2000 sometime in the early 80s, as I recall. The gap between rich and poor was MUCH lower back then than it is now, as the stock market just broke 20,000. The stock market is a measure of how the wealthy are doing. Meanwhile, the middle class has shrunk and our long-term prospects as a country have shrunk with it. Our greatness economically was based on a large and prosperous middle class. Both parties have worked for big businesses and against small businesses and local workers since Reagan, and Trump is just doubling down on the failed policies that got us here. As Sera suggests, Trump isn’t “crazy,” he’s just entitled and will be the advocate for the other entitled folks he hangs with. The rest of us will continue to suffer.
The fact that we are even having this discussion on a national level shows just how bankrupt the idea of DSM diagnoses are. Would there be a national argument on whether Trump had cancer? Over what his cholesterol levels were or whether his blood pressure exceeded 140/90? Could there be a pro/con discussion over whether or not he had AIDS or syphilis?
Only in the world of “mental health” can such an idiotic discussion be conducted by laypeople arguing with professionals. Any other medical profession could answer this question quickly by providing actual evidence that something was or was not wrong, or at least that some measurement indicated that he did or did not have a condition. Even something as vague as “obesity” has some kind of measurable standard. Only “mental health” disorders can be diagnosed solely by opinion, because there is no way to actually determine ANYTHING objectively in the “mental health” world of smoke and mirrors.
Let’s be honest, we had a choice between two rotten candidates. Saying Hillary was worse doesn’t really solve anything. The real question is, how did the system we have select the two MOST UNPOPULAR candidates as the main party nominees?
There is great wisdom in what you say, Tina. The “sickness”, as it were, is in our disconnection from each other and the system that we have “agreed” to that keeps us separate and at each others’ throats.
Inertia to me implies continuing to move in a direction already selected due to lack of sufficient force to divert one from this course. It’s very passive. Whereas active opposition is a force that attempts to push the profession in a certain direction in opposition to other forces. Inertia certainly comes into play, but there’s a lot more going on. And yes, it sounds like we agree on most all points, which doesn’t surprise me at all.
Right, reminds me of Rudolph Semmelweiss, who cured childbed fever in the 1800s by having doctors wash their hands before before “helping” deliver babies (some apparently came straight from cadavers to the maternity ward!) He reduced the rate to almost zero and then was fired from his hospital for insulting doctors by implying that they were killing their patients with their dirty hands (which, of course, was 100% true!) He spent some time in the asylums of the time because it infuriated him so much to be proven 100% correct but to be stopped by convention, arrogance, and lack of concern for the patients’ welfare.
Very well spoken, Liz! The sad part is that despite this evidence of the subjectivity and arbitrariness shown by these studies, people continue to believe that “ADHD” is something that can be discerned from just being a kid who doesn’t like to sit still and follow directions. Very sad!
Yeah, I just love that one. The child simply provoked the poor parents into abusing them! This is also a disingenuous “explanation” for why abuse is more common in homes with kids diagnosed with “ADHD” (by a significant margin, BTW – diagnosed like 4-5 times more frequently in foster kids). The kid was so obnoxious it increased the odds of the parent abusing it because it HAD “ADHD.” Makes me sick. I’ve also heard it said that soldiers who develop PTSD must have something “different” (AKA wrong) about their brains, because not everyone who fights in a war develops PTSD! Pretty outrageous stuff, but if you need to believe something, you’ll come up with a way to justify continuing to believe it.
Humility is the key. Real scientists understand that science is intended to undermine their confirmation bias, and want to know the truth, even if it is not convenient. Wolfgang Pauli, one of the founders of the theories of quantum mechanics, said that he really WANTED his findings to be false and did everything he could to try and falsify his findings, but could not. He begrudgingly admitted his original hypothesis was wrong. That is what a real scientist does, but we don’t have a lot of real scientists at work any longer, because they have other priorities, including making money.
Absolutely. Depression is a reasonable response to a crazy way of living. I recall reading research that immigrants to the USA develop USA levels of anxiety and depression after only two generations following immigration. We live in depressing times!
This is good stuff. I just find it too bad we have to call it something. I’d call it “being with someone in a caring way.” But I guess it would be hard to get research money with a mundane name like that! Anyway, the point that the “help-ee” has to make the “helper” feel better is fundamental to the weird relationship that psychiatry has with its clients. The psychiatrist gets to define the problem, and the patient needs to reassure him/her that a) s/he will do as instructed, and b) the patient will at least say they feel better. It’s most extremely disempowering! And a lot of therapists are just as bad.
Learning to be with a person in their pain and NOT try to make it go away, and NOT know what you are going to say or do but helping the client look around in the swamp, that is what makes therapy or whatever you call it really work.
It always amazes me the lengths to which “alternative therapies” like acupuncture have to go to prove their effectiveness, despite in many cases THOUSANDS of years of experiential data, while drugs are given a pass after two pre-screened 6-week trials show that they are slightly better than doing nothing at all. Double standard, anyone?
I agree, This goes well beyond inertia – there is active resistance to the very idea that non-drug therapies can ever be anything more than ancillary support. This is true because the drug and psychiatric industries DON’T WANT PEOPLE TO GET BETTER OR EVEN CONSIDER OTHER OPTIONS BECAUSE THEY LOSE CUSTOMERS! The medical profession in general practices similarly, but they are at least required to show some kind of physiological indication that the body isn’t working properly, whereas psychiatry has been allowed to simply invent “disorders” and re-define the entire field and control the terms of discussion in very self-serving ways.
And there ARE absolutely nefarious bad guys. There may not be that many, but they are in positions of huge power and influence, including the ability to spread dollars around to support their model of reality, despite all evidence for better ways of understanding the truth.
Consider the “Open Dialog” model. It’s been around since the 70s! It has much better outcomes than any other approach, even if you accept psychiatry’s subjective definitions of “schizophrenia.” But efforts to promote this approach led to nothing, even in Finland where the approach was well known. This isn’t inertia – they intentionally suppressed this information and removed the effective approach from most Finnish hospitals. Same thing happened to Loren Mosher. These are not benign forces. They actively suppress any attempt to redefine “mental health” in any way that cuts into their profits and their control of the “mental health” market.
It is interesting that you posit that the scientific method can lead to errors. However, the scientific method was devised specifically to avoid the kind of confirmation bias you and the earlier author are reporting on. Hence, the errors in psychiatry are not errors of the scientific method, but errors that arose from failing to apply it in favor of personal, institutional, and/or financial conflicts of interest.
I think it is VERY important to stress that good science had already invalidated many of bio-psychiatry’s main premises in the 1980s, and any serious application of the scientific method at this point would completely destroy the idea that giving people drugs for life for “schizophrenia” is completely invalid, not only because it doesn’t help in the collective over time, but also because the category of schizophrenia, like almost every artificial “diagnosis” in the DSM, has no scientific legitimacy whatsoever.
Thanks for your intellectual honesty and your willingness to tolerate the masses of feedback and emotion your posts sometimes stir up. It’s a sure sign that you’re on the right track when lots of people want to comment on your discussion!
I thought it notable that the psychiatrist didn’t even notice that she was totally threatened by his approach. She was not hard to read, in my estimation. The DSM makes it SO easy to blame the client when you irritate or frighten them!
Wow, way to make something simple insanely complex! What they’re really saying here is that human thought and behavior can make the brain do different things. Big news. The REAL news is that using drugs to alter the human brain is not only unnecessary but ultimately totally destructive. But I guess the authors have to kowtow to the “neurobiology” gods in order to get funding. Kind of disturbing, but I’m glad they are proving what anyone with common sense already knows.
Great blog, as always! I have known several multiples and have provided brief counseling to one for about 6 weeks, and I can say that your description of their reality is SO much more accurate than the stupidity this movie represents. In particular, the movie plot seems to represent that calm and rational alters can suddenly become violent, which I have never seen (alters seem VERY consistent in their presentation, and I think they have to be for the whole system to work properly), and it was also very common for such people to be diagnosed as Borderline and treated as such. (The one I did the most work with had a ‘teenager’ personality with a major attitude that she pulled out for dealing with threatening people, which she used with the psychiatrist who evaluated her. Not surprisingly, he diagnosed this alter with ‘BPD’ and that was that.)
I so appreciate the reality you are able to create for people who get these diagnoses of whatever type. You really have a gift for portraying others’ reality in a compassionate way. Thanks for being you and for sharing!
Believe me, I feel your pain. My oldest put us through the ringer! We had to create our own plan as we went along, as no one really had a great approach that respected our values. I was fortunate to get training in intensive behavior management for my work, but most of that still didn’t work unless we adapted it to his unique needs and strengths.
Pretty disgusting. They have no right to treat their “residents” this way. They’re not kids, nor are they prisoners – is the Bill of Rights suspended because of staff inconvenience?
This article really bugged me for a number of reasons. The most disturbing is the apparent bafflement of the psychiatric community as to why antipsychotics are being prescribed to kids with “ADHD” diagnoses. The answer is obvious to anyone who knows the biochemistry of stimulants and antipsychotics. The reason is because the kids are taking stimulants.
Stimulants’ main effect is to INCREASE the amount of available dopamine in the brain. It is well known that increasing dopamine is associated with increases in aggression and moodiness (anyone who has ever worked with meth addicts can attest to this). Sufficient dosages of stimulants can lead to frank psychosis in otherwise healthy adults or kids. Some kids who take stimulants predictably become aggressive at “therapeutic” doses.
Antipsychotics’ main effect is to DECREASE the amount of available dopamine in the brain. Note that this is the OPPOSITE effect of the stimulants. So the obvious reason for so many prescriptions for Risperdal et al is because they are making these kids aggressive with stimulants, and then “treating” the resulting aggression with antipsychotics. In chemical terms, they are upping dopamine with stimulants and then decreasing dopamine with antipsychotics. There is nothing surprising about it.
What SHOULD be disturbing is that psychiatrists are so corrupt and/or ignorant not to recognize or acknowledge that their own “treatment” is causing the secondary problem they are “treating” with the antipsychotics. If they really wanted less dopamine in the brain, why don’t they just stop increasing it by reducing or eliminating the stimulants???? But that would require logic, something noticeably lacking in most psychiatric settings.
To add insult to injury, the authors separate amphetamines from “methylphenidates,” when the mechanism of action is so similar as to be essentially identical. Ritalin is an amphetamine in both structure and action.
None of this even begins to address the infinite stupidity of using behavioral variables to diagnose a “disease” that is then “treated” in this ham-handed fashion. This article is a complete repudiation of psychiatry’s approach to kids who are active and don’t like to sit still or follow directions. They can’t even evaluate the effects of their own interventions, and are baffled by something so obvious that a college biochem student could figure it out in their spare time.
Your point is very well taken. I have written on this topic in the past for MIA, maybe it’s time for me to take another swing at it. There have been some articles about foster kids, but regular old kids like yours and mine who just happen to be very inconvenient and difficult for adults to manage just don’t have sufficient cache to pull in big numbers of readers.
Do you have any thoughts as to a better venue to get the attention of parents who are loving and well-intended but need some help figuring out their options?
You state with confience that “Antipsychotics decrease the length of psychosis.” However, you provide no evidence to support this. Studies by Harrow, Wunderlink and others show the opposite – short use or no use of antipsychotics is associated with shorter length of “schizophrenia,”even if short-term use does decrease psychotic symptoms.
You also clam that they reduce mortality. However, the mortality rate among the “chronically mentally ill” is MUCH higher than the general population, 25 or so years earlier, often due to medication-induced diabetes and heart disease. I think you’re believing what you’ve been told, but not looking at the totality of the evidence showing that long-term use of antipsychotics has very negative consequences that outweigh the benefits more and more significantly as length of use continues.
Thanks for the good article. I’d add that your argument will be strengthened by noting that psychiatric patients are more likely to kill themselves AFTER a psych hospitalization than before. You might also want to note that the psych drugs sometimes make non-suicidal people suicidal, and a non-drug alternative is essential for people for whom the drugs either don’t work very well (a solid majority) or for whom drugs make the situation even more dire.
Of course, the real problem is that to fund these initiatives, money must be redirected from the ruling elite of psychiatrists and drug companies, and this will never be tolerated without a big fight. Sadly, the benefit of our rich elite is more important than the benefit of the patients they are supposed to be helping.
Actually, defunding SAMHSA is attacking the wrong target. What needs to be defunded is enforced involuntary “treatment” with drugs, as well as the constant flow of money to drug “research.” Such money should be redirected toward psychosocial interventions, especially peer-based services. SAMHSA is actually the only federal agency I am aware of who has ever supported peer-based services. The NIMH would be a better place to start.
The problem is that there are so many variables that affect “mental health” that none of them will ever be “the cause,” but if a researcher wants to create a study to suggest a correlation, they can often find one. I am sure green space improves “mental health” variables, but so does good nutrition, sex, having parents who love you, having current positive relationships, being in chronic pain, the list goes on and on. Bottom line, it is pointless to look at the brain as the cause of any “mental health condition,” as they are all made up from social biases anyway and there is no reason to think any of them has one single cause.
Interesting to note that HALF of the participants in the control group got better with NO intervention. Also interesting to note that the improvements here appear far superior to antidepressant drugs, which barely beat a placebo. Once again, talking to a caring human being beats the crap out of screwing with brain chemistry.
The real question here is “What was a ‘good response’ to Risperdal? And by whose estimation?” As usual, no one bothers to ask the “patient” why they stopped taking the drugs.
You need to read more carefully. The author clearly states that there are ASSOCIATIONS of particular brain states with particular identified psychiatric “conditions” or “disorders”, but a) there is no real evidence that such brain states are in any way abnormal, and more importantly b) there are many people showing the same brain state who do NOT qualify as “disordered,” even by the DSM’s own subjective rules, and there are many people who qualify as “disordered” who don’t have the brain condition. EVERYONE who has malaria has a malaria virus, and almost everyone who gets infected gets malaria. Saying that 15% of “schizophrenia” cases are associated with a handful or more likely an armload of genes leaves 85% of schizophrenia sufferers with no such influence. Any REAL scientist would recognize that this is a dishonest attempt to get a result when no result exists. Hence, “pseudoscience” is most definitely an applicable term.
It is obviously not difficult to accomplish anywhere. The idea that helping people solve their problems helps them live better is basic to any culture. Sadly, the real reason that it would be difficult to accomplish in the US is because the entrenched business interests here would oppose it with every bone in their bodies. And every dollar in their wallets!
“That is, beyond improving the psychological health of the patient, the HAP intervention appears to actually improve the context of the patient’s life, particularly for women.”
This statement seems to suggest that the psychological health is somehow an unrelated variable to the context of the person’s life! Really? Do the authors think it’s POSSIBLE that the reason they were less depressed is BECAUSE THE CONTEXT OF THEIR LIFE IMPROVED????? What a radical concept!
Glad someone’s doing this work, but this should not have to be proven. It shows how far we’ve moved away from “common sense” that someone’s psychological well-being is not seen as directly resulting from the conditions of his/her life, or that talking to someone about how to improve those conditions, even a fairly untrained person, is the best way to improve psychological welfare.
The saddest part of this study is that it seems to be considered a radical concept to ask the recipients of a particular drug “treatment” about their experiences. What other profession would ignore the response of the recipients of their product????
This is scientific reductionism at its very worst. The obvious hypothesis to explore is what the prior living conditions of the people in the studies were like to find correlations that really connect physical and emotional difficulties. For instance, the ACE studies at Kaiser showed that kid who experienced abuse and neglect or other childhood trauma were more likely to have both physical AND emotional difficulties in adulthood. Additionally, physiological insults like lead poisoning and other pollution effects have also been shown to associate with both physical and emotional difficulties as life progresses. They are looking at effects instead of causes, and postulating that two effects which occur more likely together are somehow causing each other. This is particularly idiotic, since of course not all depressed people have the physiological difficulties nor do all with the physical difficulties have the correlated emotional problems. It should be clear that looking for an earlier cause for both conditions is the simplest explanation if you want to be scientific. But these folks either don’t understand that or don’t want to. Baffling, disappointing, but not really that surprising. The level of scientific integrity in the psychiatric world is remarkably low.
Right – CBT didn’t really work much, but Prozac actually made it worse. It’s hard to understand how a comparative study overlooks the fact that neither intervention is significantly helpful more than randomly selecting a person to talk to, and of course, the Prozac was worse than doing nothing overall. We are living in a world of marketing and mythology and actual fact seem to have little to no effect on people’s views!
The study is presented as if these were equivalent treatments, but the data said that the drugs made CBT LESS effective. Why is it so taboo to say that?
So let me get this straight. Non-drug treatments are minimally effective overall. However, when compared to “antidepressants,” they are AS effective, or MORE effective, and have many fewer side effects. So if they are minimally effective, but MORE effective than “antidepressants,”what does that say about “antidepressants?” They are obviously barely more than useless, and expose people to a wide range of risks when the same or better benefit are available from homeopathy, individual therapy, or exercise. What a fraud!!!!
They increase the mortality rate for anyone. This should be old news, and only the media’s suppression of this kind of information keeps it from being common knowledge.
I saw this in residential “treatment” homes for teens with behavior problems. The staff not only didn’t screen for side effects, they had not even been trained on what the side effects were. In one case, the therapist readily acknowledged that they never told the teens about the side effects because they were afraid the teens would then refuse to take the drugs (definition of “informed consent,” please?) One girl in this facility had a constant hand tremor, was taking FOUR drugs that cause involuntary movements (TWO “antipsychotics” and TWO “mood stabilizers), two of which specifically noted HAND TREMORS as an adverse effect. They told her that her hand shaking was because she was “nervous!” I was never quite so appalled in my sometimes quite appalling career working with kids. So no, this doesn’t surprise me one bit. Most doctors and facilities approach adverse effects with either minimization or complete denial. To actually screen for them would be most out of character for most facilities I’ve seen.
Until a pet can be patented and hundreds of dollars charged for a “pet therapy” prescription, they will be viewed as a marginal contributor in the field, regardless of the actual data. The term “Animal Assisted Therapy” kind of turned my stomach a bit. Why don’t we just call it “Getting a pet whom you know loves you and gives you lots of affection?” Nothing fancy, really. People need to be loved.
Wow, way to hit ’em where they live! I was particularly struck by the story of the guy who has received standard psych treatment for decades and is still a mess, which any sane person would conclude was a story of complete and utter failure of the system and the paradigm that drives it, and yet they use that same story to argue for MORE “treatment” that we know has failed him! It’s hard to understand how people can’t see through this. I guess it goes back to Joseph Campbell and people’s need to believe in their own cultural mythology no matter what. I wish I knew what to do about it, because it’s obvious that logic is not a part of the support structure for the psychiatric myth.
This is not new information. Known for decades, actually. The physical deterioration of the brain is NOT sufficient to bring about Alzheimers. But no one really wants to know that, do they?
This is even more dismal than I had imagined! Even in the short term, you’re talking 70-80% treatment failure rates (dropping out of getting worse or not improving). That’s without any psychosocial interventions, either. These quacks should be embarrassed, if they were capable of shame!
I would bet my mortgage that the survey did NOT include people living out in the community who are refusing “treatment” or using it in their own more empowered way. Sleazeballs!
To add to your critique: not only does the author not provide any data supporting that people off drugs have worse social and medical outcomes. The author does not provide any data suggesting that “treatment” leads to improved outcomes for those who receive it. This is psychiatry’s biggest dirty secret of all – people on the average don’t improve in key outcomes for any psychiatric intervention that have been studies. This should not surprise anyone – taking mind-altering drugs is known to have bad outcomes in the long term, but for some reason, folks want to believe that somehow the fact that a doctor prescribes the drug protects from the predictable long-term deterioration that messing with the brain inevitably creates.
And I have to say, I’m impressed by their utter hubris in comparing Wunderlink and Harrow to cancer treatment! How is it that folks can’t see through this kind of smoke and mirror chicanery?
The other question is: so what? Let’s say we discover some biomarker that is more frequent in people who have a “schizophrenia” diagnosis. How would that help? We can’t change their biology, and psychiatry has no “cure” for any “disorder” they identify. The only purpose of studying biomarkers appears to be to try and “prove” that “mental illnesses” are biological so we don’t have to face the myriad ways our society makes people crazy.
NAMI is not a reliable source, nor is the NIMH necessarily, as they engage in lots of propaganda that simply is false (such as claiming that all mental illnesses are ‘brain diseases,” stated unapologetically on their website and in many of their publications and their courses. It should also be noted that a large segment of those “untreated” recover and are no longer counted as “mentally ill.”
You really should read “Anatomy of an Epidemic” if you really want to have productive conversations on this site. I know a lot of what is said goes contrary to the “conventional wisdom,” but a lot of the “conventional wisdom” is shown to be false by psychiatry’s own scientific studies.
It remains a fact that more treatment leads to earlier death. What you say is, of course, important, but the author makes it very clear, with good research support, that dying 25 years younger on the AVERAGE can not be explained by “not understanding that they have a disease.” I would add that there are PLENTY of non-diagnosed people who deny or minimize diabetes or many other conditions and/or fail to seek or maintain treatment, so that factor would be even more reduced in overall impact with the general population.
The fact is, the drugs given for “schizophrenia” and “bipolar disorder” DO cause diabetes, heart disease, and strokes, AND also encourage smoking and other drug use to compensate for adverse effects. This is NOT an arguable premise – it is known and published on the side of every bottle of the drugs. There is a black box warning regarding antipsychotics leading to early death in the elderly. This is NOT imaginary – it is a FACT.
I will add that while your mom may not be willing to accept treatment for her medical conditions, if she is diagnosed with a “major mental illness,” I am guessing that the drugs she has been taking psych drugs for them. Am I wrong? If so, is it possible that she would not HAVE diabetes or congestive heart failure to be worried about if some other approach had been taken from day one?
It is important to look at our own potential biases as well as any potential biases the authors may have before offering a critical analysis. I think things may be much more complex than your own description of your mom’s experience may suggest.
It remains baffling in the face of such strong evidence that the medical community in general has not been more accepting of this data. A needed–to-harm of 16 is pretty small, and means that almost every doctor with a sizable practice will see this effect dozens or potentially hundreds of times a year. And the fact that it’s seen with women with no psychiatric diagnosis or history cuts out any argument that it’s “the disease” causing the effect. The level of denial is quite astounding!
Thanks for your excellent summary of the recent data!
I guess I read this article differently. I think what it says is that while there are differences between males and females, they are AVERAGE differences and can’t be generalized to all members of either gender. I think it also says that researchers are biased in their interpretation of data based on their own cultural stereotypes. I don’t think it’s possible to deny the huge impact of large amounts of testosterone on the brain and body – it is, in fact, what makes a body turn out male rather than female. But it’s also very easy to ignore the huge impact of social and cultural training on how men vs. women act in a given culture.
As is frequently the case in the nature vs. nurture argument, it’s not one or the other, but both.
It may be a relief, but it is misleading, and intentionally so, as you yourself indicate. Sure, it could be a relief for parents to feel like it’s “not their fault,” or for teachers to be told that the kids’ lack of progress in their class is not a result of poor teaching or lack of a stimulating environment or a child’s inappropriate or dangerous home environment, but if it is NOT TRUE, then the parent/teacher/psychologist is being let off the hook, as my son’s doctor was. And if you’re saying that only a “poor psychiatrist” would act upon a person without asking psychosocial screening questions, I would have to say that there are a lot more poor psychiatrists in practice than you seem to recognize.
As for your other examples, you’re correct that “high cholesterol” is not a verifiable illness, either, and that many medical diagnoses are subjective and lack an understanding of cause. However, one IS able to establish that a person DOES have a specific cholesterol level and that all persons can be measured and compared and a standard set above which it is considered “high.” We all know that politics enters into both where that line is set and what recommended treatments are allowable, but that does not excuse psychiatry from engaging in the same unhelpful political nonsense, which again you seem to agree is the case with the DSM. But at least we can measure blood pressure and weight and cholesterol levels. What the heck are we measuring in psychiatry? How can we create “nose-picking disorder” without any measurement of what is supposedly wrong?
And of course, your assertion that there is no such thing as science is completely specious. Science does exist, even if many people practice it in a corrupt or distorted manner. A call for psychiatry to actually respect the findings of their own scientific literature, including, for instance, the fact that “ADHD” diagnosed kids are no better off in the long term whether medicated or not, is certainly not unreasonable, nor is calling them out when they repeatedly ignore known scientific findings in favor of their pet biological theories, which is what the DSM really encourages. We’d be far better off to drop the whole thing and start over if we really care about helping people instead of getting more insurance reimbursement for less time spent with the client.
I reiterate, why is it important to defend labels that you yourself admit are arbitrary and socially determined, driven mostly by insurance reimbursement and irrelevant to treatment decisions?
It sounds like you see the real point of these labels as justification for getting paid for treatment. That’s the only thing they are useful for, so we agree on that point.
As for disempowerment, you are really not trying very hard if you can’t understand this. Your “good psychiatrist” may not use the labels to define a person’s condition, but if that’s the case, most are not good psychiatrists, because it appears very, very common in the folks I talk with. Best example is from multiple foster youth I’ve spoken with, most of whom have been through hell and back and have understandably difficult emotions and behavior to deal with. These kids are almost always told that the reason they are depressed or angry or anxious is because their brain isn’t working properly, and that medication will help “balance out” their brain chemistry. Psychiatrists as a rule have almost nothing to say or ask them about why they are acting the way they are or what their history is. They medicate based on symptoms and explain away any causal factors. The kids find this confusing and/or downright insulting. And I’m talking multiple examples from a fairly specific sample of people who do NOT respond well to that kind of treatment. So disempowerment is VERY real and damaging both to the kids’ desire to continue treatment of any kind and of their chances of success, since the actual reason for their “condition” is not examined or validated or directly addressed.
Or for another example – my son went off the rails temporarily and was living a dangerous life for a couple of months, including taking drugs and ultimately being assaulted. He went to see a doctor and in a depression screening endorsed suicidality. The doctor went on a lecture about how depression is a “disease just like diabetes” and that “treatments are available” but never ONCE asked him why he might have considered killing himself! And he would certainly have told her what was going on, and it might just have been helpful, but the “MDD” label allowed the doctor to feel like she’d “diagnosed” him without bothering to even find out what was going on.
You’ll try to tell me this is rare. In my experience, it is not. It is, in fact, extremely common, and the labeling process makes that possible for doctors to get away with.
Of course, you are again being intentionally obtuse if you don’t recognize the difference between telling someone they have influenza, which is a verifiable fact that leads to a verifiable treatment that is almost uniformly effective, with diagnosing “Major Depressive Disorder,” which is nonspecific, non-verifiable, and does NOT lead to a uniformly effective treatment plan, since the wide range of people diagnosed with MDD are incredibly heterogeneous, and what works great for one person could actually ruin someone else’s life.
I am afraid you are so committed to your position that you are unable to look at any other perspective. I am not going to bother trying to convince you further that other rational viewpoints are viable and have value. You can remain rigid if you want, but I am not going to accept that you are somehow more knowledgeable about this area than I am, because it just ain’t so.
You seem to be suggesting that the only way to help someone with a problem is to diagnose them with a disease. I have helped hundreds, probably thousands of people professionally over many years without feeling the need to diagnose a single one of them. The only purpose psychiatric diagnosis served for me is to get insurance to pay for people to get certain kinds of help, and whenever I did so, I clearly explained to the person that the diagnosis was simply a description of what is going on with the purpose of getting insurance reimbursement, but that their conception of the problem is the only thing I was really concerned with.
Psychiatric diagnosis, in my experience, tends to invalidate people’s own experience and takes away their ability to define their own problem and potential solutions, and is therefore extremely disempowering. It puts people in the position of having some “expert” tell them what’s wrong with them and what they have to do. This is particularly egregious when the “expert” has no real clue what is going on.
As for “biological correlates,” well gosh, we all inhabit bodies and there are biological correlates for everything we do. So what? Are you intending to say that anger is “caused” by “excessive adrenaline and other neurotransmitters?” Or is it caused by someone deciding that something pisses them off and the body responds to their thought by preparing to fight?
As for not diagnosing someone with “Nose-picking disorder” being somehow a barrier to helping him/her with that problem, you have now descended into the extremes of absurdity. I am thinking you are being perhaps intentionally obtuse in order to be “right” about your point. Perhaps you are suffering from “Irrational Need to Win an Argument Disorder.” It seems to be interfering with your ability to hear others’ viewpoints. Do you think there are biological correlates for your condition? Perhaps I can offer some kind of treatment?
I hope you get my gentle jest above. Not meaning to be insulting, just to point out the absurdity of taking any condition you consider undesirable and labeling it as a disease. At a certain point, it reduces to total absurdity.
SO you really do think that it’s OK to say someone has a “nose-picking disorder” if nose picking is getting in the way of their social success???? That’s a very weird way of defining “disease.” Seems to me like you are perhaps invested in defending the current paradigm rather than really listening to how/why people find this medicalization of normal behavior disturbing and destructive.
I would have to add, though, that different kids require different disciplinary approaches. Kids who get diagnosed with “ADHD” generally are seeking stimulation, and knowing that does help decide HOW to approach discipline with them. Of course, needing something different does not make someone diseased, especially if what is different is simply behavioral style and personality.
I’d also add that there are kids who have been abused and/or neglected by their parents, or have been injured by society at large, and they may choose stimulation-seeking as a means of coping. So we do have to be careful to posit a lack of discipline as a universal commonality – trauma also plays a role, as can easily be seen by the massively higher “ADHD” diagnosis rates for kids in foster care.
Thanks for continuing to fight this fight – this topic is near and dear to my heart!
I think your argument is rational, and I don’t object to defining “disease” in that way. What I object to is psychiatrists and other doctors or professionals telling people that they are depressed “because they have a chemical imbalance” rather than admitting they have no idea exactly what is happening biologically or psychologically and they are treating symptoms. It’s obviously idiocy to tell someone with a rash that they have “irritated skin disorder” that is caused by an “overactivity of the immune system” and that suppressing the immune system response is the only answer. And I would still submit that calling “anxiety” a mental disorder leaves the door open to “nose-picking disorder” or “ball scratching disorder.” Where is the line in your view? How insipid and subjective and culturally bound does a condition need to be before the definition of a disease becomes absurd?
He is absolutely correct. There is no proof that the mind is the product of activity originating in the physical brain. It is a philosophical assumption that many “modern” people make, and there is a tendency to dismiss anyone who doesn’t automatically agree as “superstitious” or “mystical” as you have. However, I defy you to show us any specific proof of that postulate. I know you can’t, because there is no way to prove what “mind” really is. What you’re saying is that you believe there IS no possibility of non-material existence, therefore the mind must originate in material reality. But there are many, many cultures and individuals who would disagree with you, and you have nothing less mystical than their assumptions to fight them with. You believe that because you believe it – what other proof can you provide other than “It has to be because it can’t be anything else?”
There have actually been plenty of long-term studies, starting back in the 60s. The MTA is the most referred to, but most only refer to the firts 14 months, when the medicated group did slightly better on reading scores. By three years, these advantages had evaporated and those maintained on stimulants actually did slightly worse. Same is true with the Raine study in Australia – no advantage for long-term stimulant use, with worse academic outcomes. Montreal study – no improvements in academic outcomes, worse psychosocial outcomes for girls on stimulants. Finland vs. USA comparison study – Finnish kids much less likely to be on stimulants, no difference in academic outcomes at all. Plenty of other studies have been reviewed, including Barclay’s 1978 review, Swanson’s 1993 “review of reviews,” and the Oregon State University’s Medication Effectiveness Project, which looked at every piece of research ever published on the subject that they could unearth, over 2000 articles. None showed any improvements in long-term outcomes for long-term stimulant users, whether academic, psychological, or social, except for kids taking stimulants being somewhat less likely to get into major accidents as teens (OSU study). True, those not taking stimulants still had significant struggles, but it is clear that assuming the risk of long-term stimulant use did little to nothing in the long term to help with those struggles. Scientifically speaking, long-term use of stimulants to “treat ADHD” is a complete failure and should be abandoned.
Of course, individuals may have different experiences, and I don’t want to invalidate that. But it is absolutely wrong for doctors or teachers or psychologists to say that “untreated ADHD leads to X” when the proposed treatment doesn’t alter those outcomes at all, or maybe even makes them slightly worse in some cases.
Don’t mean to be difficult – this is just an area I’ve studied intensively and I know that what people are told generally is not supported by the literature. If folks said, “Stimulants may help you pay attention in the short term, it is not likely by itself to make any differences in your long-term performance, and we should talk about other strategies to get you (or your child) to where you want to be.”
And just for clarity’s sake, I don’t really support stimulant use at all, as I’ve raised two “ADHD”-type boys using creative discipline and alternative schooling, and they are thriving without any “medical” intervention whatsoever. And they were not “mild cases,” either. My person opinion is that the major cause of “ADHD” is our idiotic insistence on making kids sit still and follow teachers’ directions when they’re not developmentally ready to do so, and don’t benefit from being forced to in any case.
You neglect to mention that such long-term studies have shown little to no effect on key outcomes like high school graduation/college enrollment rates, academic test scores, delinquency rates, teen pregnancy rates, self-esteem, social skills, or any major outcome that people claim “untreated ADHD” purportedly damaged. If you’re going to quote the long-term literature, your credibility would be enhanced if you told the whole story. Not only does long-term stimulant use not appear to have much impact on substance abuse one way or the other (though you should read Nadine Lambert re: possible connection with stimulants, especially smoking), but it doesn’t appear to have much impact on ANY important outcome measure. The honest conclusion should be that long-term stimulant use makes little to no difference in the aggregate, and should not be supported by doctors. Stimulant use, at best, should be considered a short-term intervention to make kids more manageable while other psycho-social interventions are attempted.
Luke, it is not the responsibility of anyone to establish that there is NOT a biological marker. As a scientist by training, I can tell you that it is the responsibility of the one claiming a connection to show that it exists. There has been plenty of research attempting to find such biological markers over many years, and it has yielded very limited results. Interestingly, the same is actually true for physiological issues like heart disease – even though there appears to be a significant level of “heritability,” there is not a specific gene or genetic combination reliably connected even with many measurable disease states that are much more objectively diagnosable than “BPD.”
We both agree that the situation is very much more complicated than “he was abused as a child and that’s why he acts this way.” What I’m asking you to agree with is the counter proposition: that the situation is very much more complicated than “He has a chemical imbalance and that’s why he acts that way.” In no way have I ever stated that I did not believe there were a range of possible causes – to the contrary, my very point is that you CAN NOT determine one cause for a set of behaviors, and that research into the range of possible causes is the way to go, rather than ASSUMING that all people exhibiting “bipolar” symptoms are suffering from the same problem or need the same kinds of interventions.
If you are really listening, you should be able to hear that many different people had a wide range of different experiences with the mental health system – some (like you) seem to have found it very helpful, while others feel it has destroyed their lives. That should be evidence enough that there is no “one size fits all” solution to these issues. It is a logical inference from that observation that different people with the same behavioral manifestations may have different problems requiring very different solutions, and that forcing the “standard solution” down someone’s throat (sometimes literally) can lead to disastrous outcomes.
You call for more open-mindedness, and I think with some fairness. I’m calling for you to do the same. There are parts of this we absolutely agree about – why don’t we build on those instead of each person taking terns invalidating those they feel have invalidated them?
Sorry, I have not dismissed anything you’ve said except your insistence that “bipolar” is a disease, and I’ve given solid, logical explanations why I don’t agree with using that term. I have agreed that there may be people who have a “chemical imbalance” but have asserted that it is impossible to determine that based only on a person’s behavior or emotions. I’m sorry if we are not agreeing with your philosophical views, but philosophy is not science. You can say “It IS a disease” all you want, but it does not change the fact that NO ONE has any proof that people with “bipolar” have anything specifically in common biologically, as the only definition of “bipolar” is their behavior. I am not sure how you can accuse others of not being “open minded” when you’re not able to accept that the definition of “bipolar disorder” is subjective and behavioral and does not require or establish any kind of biological problem in order to be diagnosed.
Which leads me to believe that rather than psychiatric disorders, they should be referred to for the most part as “psychic injuries.”
I do agree that some form of “treatment” can be proposed for things that aren’t understood (though bleeding is not a good example, as we know VERY clearly why a person is bleeding and what we can do to help), however, treating SYMPTOMS is not the same as treating a DISEASE. For instance, a person whose knee is swollen for no reason we know of might benefit from pain killers or antiinflammatories or some kind of drainage to reduce the pressure. But we would be extremely remiss to call a swollen knee a DISEASE and stop looking for a cause just because the antiinflammatory reduces the swelling. Psychiatric diagnoses are very much like saying someone has a “swollen knee.” You can describe what’s happening and try to reduce the “symptoms,” but only an idiot would assume that all swollen knees are caused by the same thing or needed the same treatment. Hence, a swollen knee is NOT a disease, even if it is amenable to symptomatic treatment.
You also have not addressed my rash analogy. Is a RASH a DISEASE? Or is it a condition that could be caused by many things, some disease states and some not? No one’s saying you shouldn’t help a person in distress, but it is presumptuous in the extreme to tell people they “have bipolar disorder” when bipolar disorder is simply a description of how they are acting. If that’s an OK way to define a disease, what is to stop us from diagnosing people with “nose-picking disorder” or “excessive digital-nasal insertion disorder” if you want something more erudite? After all, nose-picking is something that disturbs social functioning and leads to bullying and exclusion. Why not diagnose and “treat” anything that people find annoying?
My understanding is that the idea that depressed people consistently or even more commonly have low levels of serotonin was substantially disproven back in the 1980s, before Prozac even came to the market. Read “Anatomy of an Epidemic” and catch up with the actual research!
I don’t think anyone is saying or implying “Get over it” because they are saying that traumatic experiences can cause “bipolar” symptoms! Trauma is a BITCH, and it is tough as hell to get over. Imagine being forced to go to school every single day, when the majority of people at the school call you “retard” or “dummy” or “fatso” or far worse things, physically abuse or threaten you, refuse to let you sit with them or play with them, threaten others who try to make friends with you… and remember that TEACHERS are sometimes the biggest bullies of all, and kids often have zero recourse if they get stuck with an abusive teacher. The point is not that you need to “get over” being abused, it’s that a person with an abusive background will be more likely to be helped by interventions intended to resolve that background, rather than being told “it’s all because of bad brain chemistry.” I’ve worked a ton with foster youth, and I can tell you, saying they have a “chemical imbalance” is every bit as insulting to them as you seem to find the idea that your symptoms result from abuse that you don’t identify as having ever occurred.
The point is, “bipolar” is just a description of a bunch of emotions and behaviors that tend to occur together – there is no proof and not really much evidence that it is uniformly or even commonly caused by faulty brain chemicals. That does not mean it CAN’T be caused by such faults, but it is unscientific and foolish to ASSUME that such behavior is always caused by this and dismissing abuse history and social context as secondary or even irrelevant, as many if not most psychiatrists tend to do.
I do agree 100% that different learning styles should be respected, and that more discipline to force “ADHD” kids into regular classroom environments is stupid. Of course, the real purpose of “medication” is to do exactly that, to force kids who don’t fit to modify their personalities and learning styles so as to be less inconvenient for the adults involved.
I raised two of my three boys who had this range of behavior, and we used home schooling and alternative schooling with a child-centered approach, where they were allowed more room to explore and pursue their own interests at their own pace. They both did much, much better in this kind of environment, to the point that both graduated high school with honors, without a milligram of stimulants passing their lips. They DID require some unique approaches to discipline as well, but more or tougher discipline wasn’t the issue, it was more a matter of adjusting disciplinary techniques to their unique needs, most specifically, to take their need for stimulation as an opportunity to be smart and effective, rather than continuing to do what doesn’t work and expect that more of the same will somehow magically change the situation.
I think he does answer that question, if indirectly, with his pneumonia example. He is saying that an identifiable disease is something where the cause is known or at least knowable, that some kind of specific test will indicate the presence of said cause, and that the cause is distinguishable from a recitation of symptoms. His critique of ADHD, and I think it is quite valid, is that the symptoms define the “disease,” hence, “He has ADHD because he’s hyperactive and impulsive and lacks focus,” when the very definition of the disorder is “he’s hyperactive and impulsive and lacks focus!” We could just as easily say that someone is picking his nose because he has nose-picking disorder, or that his knee is swollen because he has swollen-knee disorder. The diagnosis is neither explanatory, nor specific, and doesn’t distinguish for the likelihood that these same “symptoms” could be caused by a wide range of different factors.
ADHD is at best a syndrome, a set of “symptoms” that tend to occur together and are troubling, but for which no known cause has been determined (as the author of the original article clearly states himself). If the definition of a disease is “anything that is uncomfortable or difficult to deal with,” perhaps it would qualify, but the purpose of medical treatment is supposed to be to differentiate between causes rather than just treat symptoms.
My best example is a rash. Any rash could be “treated” with calomine lotion or with corticosteroids, but you’d REALLY want to know if you have poison ivy, prickly heat, or syphilis. Syphilis is a disease. A rash is a condition or syndrome that may or may not be caused by a disease state. ADHD is much more like the rash. Except that in some cases, the behavior is an entirely normal reaction to abnormal circumstances. So treating the symptoms is both cowardly and ineffective, and we really should be looking for the cause, be it poor diet, lack of discipline in the home, boredom, or an overly rigid school environment, or whatever. If there ARE odd cases of purely physically determined “ADHD”, we should be trying to distinguish them from the various other causes, rather than lumping together everyone who acts a certain way into a huge, heterogeneous group and trying to suppress the “mysterious” (again from the original article) manifestations with a drug “treatment” for a “disease” when we haven’t the vaguest comprehension of what we are “treating,” let alone what the long-term impact of “treatment” might be.
” This suggests that whether or not there is a genetic component to the disorder, the impact of experiences such as neglect and physical and sexual abuse cannot be ignored.”
Actually, it suggests that whether or not there is a genetic contribution, the impact of these experiences is MUCH MORE IMPORTANT than whatever genetics are involved. Because we’re seeing a factor of 2.6 times increase in BPD diagnoses, and no genetic study has ever shown anything remotely close to that kind of association. In other words, the biological determinists are barking up the wrong tree and need to shut up. But it is interesting that the authors are unable to draw this obvious conclusion, and as usual, soft-pedal the effects of trauma, abuse and mistreatment in deference to the biological paradigm that is supported by so much money and prestige. The truth is there but they don’t want to look!
Again, did we really need a study to find out that alcohol has short-term antidepressant and anti-anxiety effects? I think the more important aspect of this to highlight is that taking pills to reduce depression is not substantively different than drinking to reduce depression. It’s not a “treatment,” it’s a temporary way to feel better that has unpredictable long-term consequences, including a good shot at making the depressed and anxious feelings worse. Why should we pretend we’re doing anything else? Just because it makes people feel less bad about being dependent on a substance to make it through the day if a doctor prescribed it? If so, why not just prescribe controlled doses of alcohol as “treatment?”
They suffer with and without “medication.” Hence, the “medication” is not specifically helping them with any particular “disease” but only in some cases suppressing symptoms. Do you consider the fact that some people drink after work to reduce anxiety a sign that they have “anxiety disorders” and that alcohol is “medication?” In truth, benzos have almost the same effects and side-effects as alcohol. Why isn’t alcohol prescribed as a “treatment” for anxiety?
If you really want to know why Bonnie has lost all hope in psychiatry, read some of the stories here, and read “Anatomy of an Epidemic” by Robert Whitaker, or read his more recent publication, “Psychiatry Under the Influence.” There is very good reason to doubt the efficacy and the integrity of psychiatry as a profession.
Thank you for this generous gift, Bonnie! This is a great model of how we can create evolutionary change without ever buying into the idea that the profession of psychiatry will somehow miraculously come to its senses.
Matt, thanks for an incredibly passionate and well-researched article. The truth is out there, but unfortunately, too many people don’t want to hear it. I’m sure glad you figured it out, and have given others the chance to look the truth straight in the eye!
The REAL horror attraction would not be the inmates being freed from the asylum, but the participants being exposed to the psychiatrists and their procedures. Set up an “ECT” exhibit if you really want to scare the shit out of your Hallowe’en guests!
Of course. The error is in thinking that these “conditions” share a common cause, and that the cause is necessarily biological. There are lots of things that can “cause” depression, from crappy parents to lack of sleep to chronic pain to nutritional deficiencies to existential angst about the meaning of life or one’s purpose on the earth. Why anyone would imagine for a second that all “depression,” which is clearly a NORMAL physiological signalling and survival strategy of the human organism, is a disease state that is necessarily a result of some brain malfunction is idiocy of the highest order. Unless, of course, you’re trying to make a lot of money off of duping people…
I agree about the term “Misdemeanors.” These are high crimes, the equivalent of medical “treason!” They completely violate the trust of the public that pharmaceuticals are intended to be safe and helpful. They are crimes of the highest order.
Interesting that they felt that talking to patients about their assessments is a change in “style.” It seems like a very radical change in values to me.
Maybe the reason they can’t find biomarkers is because most “mental illness” is environmentally activated and has little to do with biological causation.
Well, that CLEARLY explains why it’s been ignored. You can fix it with nutritional supplementation? How’s a guy supposed to make billions of dollars on THAT?
Oh, the IRONY! It is painfully delicious! Their biological solution to their purported biological problem is thwarted by – THE ENVIRONMENT!!!!! I am just loving this result!
I pretty much agree, though it is important to note that SOME kids diagnosed with “ADHD” are suffering from trauma and poor parenting, even if that’s hard for the parents to hear. But my observation is that the majority of “ADHD” diagnoses are a result of unrealistic expectations of kids by institutions like public and private schools. And the idea that letting kids “cry it out” as babies causes decreased “ADHD” diagnosis rates is absurd in the extreme. I think the only real point is that French parents appear less likely to be willing to excuse a child’s behavior based on the idea of “bad brain chemistry.” I do think that’s a healthier viewpoint, as it empowers the child, parents and teachers to actually work on making improvements in behavior. Additionally, French kids, as I recall, don’t go to school until later, which is associated with much lower ADHD rates.
I only want to add to the healthy discussion that “ADHD” symptoms aren’t always the result of psychosocial causes or trauma. Often, they are the result of normal kids being expected to act abnormally by adults who have unreasonable expectations for the age. Most kids don’t “get ADHD” until they enter school, because “ADHD” is basically a description of a kid who doesn’t fit in well to the standard school classroom’s structure. While good discipline and structure in the home can help with this, it’s also very possible to have kids engage in an educational environment that doesn’t demand they act like they’re not kids.
Just as an interesting side note, kids in France are not expected to attend school until 7, as I understand it. This may be a huge factor in the lower diagnosis rate.
It always bugs me when they say things like “subjective or vague criteria make it easy to misdiagnose ADHD.” What they SHOULD be saying is that vague or subjective criteria make the ADHD diagnosis invalid and useless in planning any kind of “treatment,” because it is impossible from the diagnostic criteria to even determine if anything at all is wrong with the “patient,” let alone determine what could or should be done to help. How would you even judge what a “misdiagnosis” is if you don’t have any concrete criteria for the diagnosis in the first place?
Dave, that was perhaps the most cogent and concise letter on the subject I’ve seen in a long time. I hope you’re willing to continue to engage in political and legislative action to force some action on this point. Your calm and rational approach as well as your status as a veteran having honorably served this country make you an ideal spokesperson for these issues in the legislature, where any real change will have to originate, as the field itself is, as you so eloquently describe, corrupted beyond the point of being capable of any kind of honest self evaluation.
Gotta agree with you there. As soon as you say “He’s got narcissistic personality disorder,” you’ve taken away the layperson’s ability to do their own assessment, and validated the DSM in the process. I prefer to say “He’s a self-centered asshole.” Just as unscientific a pronouncement as the prior one, but much more accessible to the layperson!
If the doctors were sensitive or thoughtful enough to even consider the impact they were having on the family, none of this would happen. The kind of extreme bullying behavior and rank dishonesty the author experienced is not reflective of a lack of understanding, but of a lack of empathy and a desire and need to be “right” at all costs and to punish anyone challenging her authority. He was very fortunate, indeed, to have landed with a sane psychiatrist who recognized the difference between normal teen angst and an actual medical condition. I’d estimate that 90% of psychiatrists would have backed the family doctor to the hilt.
It is most definitely a case of “caveat emptor” – “Let the Buyer Beware!”
Insulting, indeed. Anything bad that happens is caused by “the disease.” Anything good is caused by the amazing effects of their miracle drugs. The profession spent 10-20 years denying that tardive dyskinesia is caused by neuroleptic drugs, even though there was no rational way to deny the connection and there was an excellent scientific mechanism in place to explain it. There is no science going on in this field – it’s a religion.
LOL!!! It’s also true that double amputees have much slower average times in the 100 yard dash. I wonder if slow running could be a causal factor in leg amputation?
Excellent points! The proponents of the current paradigm aren’t even looking at biological causation in any kind of thorough way. They’ve simply decided that it’s all genetic and ignore even simple stuff like sleep and anemia and thyroid dysfunction.
I have to say, though, this is another of those “duh!” moments for me. Why would you even have to study this? Do we really need a scientist to tell us that a person who lost his job and whose house is in foreclosure and who has no idea where his/her next meal is coming from is more likely to be anxious, depressed, angry, or disoriented?????
In re-reading this, I’m inclined to think that the Western approach to viewing “mental illness” or anything else having to do with human beings from a detached, analytical perspective is what creates a lot of the problem. People aren’t “problems” or “hypotheses.” Maybe being “scientific” takes the humanity out of the equation.
As a chemist by training, I have given this a lot of thought historically. By my understanding, a scientific model is an attempt to provide an explanatory mechanism for a phenomenon that is observed. Any good scientist knows that a model is only as good as its ability to predict the phenomenon in question and/or intervene to alter the outcome in predictable ways. Clearly, the “medical” or “disease” model has proven a total and abject failure in both ways.
The “oppression model” would be a means of explaining why people experience intense anxiety or depression or extreme states from the point of view that such experiences are likely a result of experiencing abuse or traumatizing experiences at the hands of another. We would also hope it might suggest ways of intervening to either prevent the oppressive conditions or to assist in analyzing how a person experiencing such conditions might act or be helped to act in order to alter the predicted outcome.
It doesn’t necessarily imply that the phenomenon in question is an aberration or in fact pass any judgement whatsoever about the phenomenon. It’s more like “when people are traumatized, they’re more likely to hear voices in their heads” or “people who hear voices in their heads are likely to have had a history of individual or social oppression.” The model certainly doesn’t require an acceptance of “mental illness” as a concept.
I am astounded at the euphemistic avoidance of reality in the psychiatric research world!
“Antipsychotic medications have little impact on improving cognition…”
Really? Don’t you mean, “Antipsychotic medications appear to cause deteriorating cognition over time?” Who ever thought or expected that antipsychotics would IMPROVE cognition? They make it WORSE!
“…exercise may also reduce the physical health problems associated with schizophrenia, such as obesity and diabetes, which contribute towards reduced life expectancy.”
Are obesity and diabetes REALLY associated with ‘schizophrenia?’ Don’t you mean “health problems associated with drug ‘treatment’ for ‘schizophrenia?” Or more bluntly, health problems frequently CAUSED by atypical antipsychotic drugs?
It seems like you would need a separate medical expert opinion to challenge the hospital in court. I wonder if he can get a current mental health assessment or psychological evaluation along with an official “risk assessment” tool being used to get at least the impression of a quantitative measure of his current risk? I don’t think you can counter the hospital on legal grounds alone. The judges respond to experts differently, so you’ll need expert counter-testimony to get him out.
I’m surprised they aren’t claiming that “Singulair uncovered a latent psychotic disorder” in those who reacted poorly. We can’t actually be blaming the DRUG now, can we?
An amazing tale, all the more amazing for its having been edited previously to delete his involvement in the psychiatric mainstream. I agree with Frank, it’s hard to fathom how many creative geniuses or even just plain creative contributors to society have been and continue to be wiped out by our “mental health” paradigm. Glad that both you and Law were able to survive it!
Great work, as always, Bob. Being sneered at by these guys is the ultimate compliment.
I’d love it if you could comment further on the “Placebo washout” approach described so clearly in the first study. It appears that they systematically removed anyone who got better when coming off antipsychotics. This always seems like a pretty sleazy maneuver to me. If you have people whose quality of life IMPROVES when they STOP the “treatment,” wouldn’t that be very important data? I’d love to compare the “washout” folks at 52 weeks to the Zyprexa users at 52 weeks.
All that being said, the most important point is that the study is meaningless, as they couldn’t even record their primary measure due to an incredibly high dropout rate. Not to mention that they only compared the QOL of the RESPONDERS! Isn’t that like saying that “people who experience pain relief when taking aspirin have less pain than those who didn’t experience pain relief?”
And of course, the other huge deal is that they selected out only these two studies as their best evidence to support their point, rather than looking at the whole of the literature. Such “cherry picking” is systematically criticized (and rightly so) when committed by those who disagree with them. Why are they allowed to get away with it?
The real message here is: “Trust us and don’t ask too many questions like that guy over there.” Or “Don’t confuse yourself with facts.”
I get sick of this “Stigma against the profession” crap. Do they really believe that some bunch of people got together and decided to stigmatize psychiatrists for some mysterious reason? The main reason there is a “stigma” against psychiatrists is because they dogmatically promote “treatments” that often don’t work and even more often are damaging even if they help in the short term.
Are people “biased” against Walmart when they refuse to shop there? Or are they correctly observing that Walmart’s policies hurt their communities and their own employees? Are we biased against a mechanic when we choose not to take our car back after he fails to diagnose or correct the problem?
Psychiatry’s poor reputation is well earned. Time they stopped blaming it on public ignorance. Maybe the public is smarter than they think!
Or perhaps “Science is the belief in experts regardless of their ignorance.”
And I’m just SURE that these low-powered experiments that are more likely to produce a positive result are just a result of naivete on the part of our poor, under-educated scientists. It’s just IMPOSSIBLE that they conduct this kind of experiment specifically BECAUSE it is more likely to give a positive result. Or is it?
Can’t argue with you there, although the ability to blame the victim provides a great cover for the failures in controlling (and sometimes success in CREATING) the social behaviors that are deemed undesirable. Whether it succeeds or fails in quashing the “bad behavior,” those in power are always let off the hook, because the “mental disorder” is the culprit and ALL of us are its victims!
I have a question, though. Is the system really broken? Or is it working well at doing something that you and I and most of us here don’t approve of as a goal?
I recall my brief stint as a public school teacher. I went in naively believing that the school system was there to educate students and prepare them for adulthood, and that the failures of the system were due to lack of insight or skills. What I discovered is that the school system appeared to be geared less to educate and enlighten than to cow and demoralize students into automatic compliance, either out of fear or desire for conditional reward. It is designed to create compliant citizens, not to teach people to think, and it’s not broken – it works quite well at doing exactly that. My efforts to individualize and to empower students who were struggling were not only not admired, but generally ridiculed and dismissed as a waste of time.
I think the same is most likely true of the “mental health” system. I think it serves two purposes: first, to give society the opportunity to control difficult behavior that doesn’t fall into the realm of criminality, so that people engaging in such behavior can be cleared off the streets legally. Second, it gives society, or the powerful in society, excellent cover for their domination and oppression within the currently accepted social structure, by blaming those who don’t “adjust” to the current crazy expectations and “treating” them as deficient people, rather than looking at the circumstances producing such anxious, depressed or angry people. And again, it does both of these things quite well.
I think our error is to imagine that the powers who construct and maintain this system really have any other intent. I am sure they would say they are there to “help people,” but what they mean is to help people adapt to society as it is and stop creating problems for those busy trying to run things efficiently. It means to help them either feel OK about living in the oppressive society we’re in, or to help them suppress their rage/anxiety/despair about current conditions. There are, of course, very notable exceptions, and I admire such workers greatly, as I’ve been one of them. But the system itself is not designed to create mentally healthy, highly effective adults. It’s designed to keep creative, oppositional, critical, and insightful people from messing with the machinery that the powerful need to keep in place.
Excellent point regarding language. Can’t remember who said it, but someone said “language is power.” By selecting certain words, we pre-set the context for the conversation. Suffering isn’t a disease.
I think what they do is make people care less about stuff than they would. I think they make people more emotionally numb. I believe some people find this beneficial – for instance, if you’re constantly worrying what your mom will think if you refuse to come to the expected Sunday dinner every week, it might feel good to take a drug that makes you not care so much. But it’s pure anesthetization. And supposing you’re being kept from killing yourself by thinking how hard it would be on your kids, or you refrain from shooting someone because you’re worried about the consequences? A “what the f*&k” attitude can be and is very dangerous!
I’ve talked to a number of people who took SSRIs, one for a migrane, and all have reported similar effects – it simply made them less engaged in or concerned about the feelings or experiences of other people. One woman even had a term for it – she called it “Zolofting.”
I suppose it might be easier to “push forward” in some circumstances if you are immune to caring how others think about you. But it’s hardly a medical treatment to make a person less empathetic and more apathetic! How is it different from getting drunk to “drown your sorrows?” Seems exactly the same to me.
The early comments she makes are actually quite significant. Loss of pleasure, loss of empathy, loss of the ability to emote. Seem like things that would be associated with an increase in suicide or violence. Very important observations.
Imagine. Being under intense financial stress is not good for your mind. Who’da thunk it?
Why do these things even need to be said? Isn’t this kind of like “Scientists have discovered that having one’s foot stuck in a bear trap increases emotional distress?”
Research also shows no significant improvement in ANY long-term outcome area for kids using stimulants vs. none, including educational, social, and emotional variables. The only “success” that stimulants have shown is that they successfully make active kids a lot less annoying for the adults who have to manage them. I know from personal experience (two of my three kids) how annoying that behavior can be, but that’s who these kids are, and the comment about changing environment vs. changing the kid quoted in the article really describes the direction we need to go.
“…supported by significant success of pharmacologic intervention. ” Not really. I’d say that the bio model was supported by billions of marketing dollars from the pharmaceutical industry, not from significant success of pharmacologic interventions. Unless you count success in elbowing out the competition and success in making more money in less time and success in drugging a significant portion of the “mentally ill” into inertia and an early grave.
One quote jumped out at me: “Why is organized medicine failing to grasp the significance of this dangerous prescription pattern…”
My question is, how could they possibly NOT grasp the significance, when even many lay people are well aware that benzos + opiates can equal death? My thought is that they DO grasp the significance, but choose to deny it, because of the powerful interests who need to sell both prescription opiates and benzos for profit. They don’t want to bite the hand that feeds them.
Until we deal with the corruption in the medical field, these “significances” that should be and really are obvious will continue to be ignored. As Upton Sinclair is quoted as saying, “It’s difficult to get a man to understand something when his salary depends on his not understanding it.”
Language does matter, very much. Using the term “medication” most definitely is part of the effort to legitimize “medical treatment” of these “conditions”. We should use the terms “drugs” and “labels” every time we refer to these fictions!
Right you are. Different people respond differently to alcohol or meth, too. Doesn’t mean meth is “medication” for some people and others have “side effects.” They are both drugs. They have effects. We may like or not like the effects, but the effects are not “treatment” just because we like them.
You’d think that, but only if the current system was really aimed at helping people recover from their condition, whatever it is. The actual focus of the current system is making money and asserting authority over “lesser” people diagnosed as “mentally ill,” so such interventions are not welcome. If nothing else, they’d potentially undermine the base of chronic clients consuming their drugs and other “services.”
Well said! I realized that by wanting people to like me, I was not only letting them control how I feel, I was actually trying to control how THEY feel, too! People should get to feel however they feel, without someone imposing their needs on it, one way or the other. And it should not change that we act with compassion and responsibility toward all. But we don’t have to be friends with or feel sorry for someone just because their assholish behavior got them into difficulties!
I think what we need to let go of is the desire for a different outcome, for our tormentor to suddenly understand their error and try to make amends. It is a form of mourning to let go of that, especially if the tormentor is someone who was supposed to love and care for us. But I agree, it doesn’t mean you accept that the other person is “OK” or that you have to forgive them. You have to simply stop imagining that there’s anything you can do to cause them to willingly reform. Their crappy behavior is their problem, not yours.
This study should be a caution to all those AOT/reduced civil rights advocates out there. But of course, it will be ignored, because its conclusions don’t fit the desired narrative of “lock up the dangerous crazies and drug them into submission!” Or should I say, “Provide ‘treatment’ to those poor crazies and drug them into submission!” Comes to about the same thing.
More like bringing a submarine to a dairy farm for repairs. Though a dairy farm would be highly preferable to a psych ward as “treatment” for “insanity,” IMHO.
And it continues to amaze me that despite not only not helping, but making your situation WORSE, at no time does even one of them stop and say, “Wow, it doesn’t really seem like our treatment plan is working. What else could we try instead?” It’s beyond infuriating!
Thanks for sharing your story – I hope you’ve escaped!
I am not so sure that murderers or violent criminals experience worse, but I am sure that if they do experience worse, it does nothing to mitigate the stupidity of the system or the cruelty and injustice of enforced “treatment” on a person who has nothing wrong with them. Perhaps you missed the part where he went two years without using the drugs and had NO issues, yet once he was “outed,” their first mission was to punish him and force him to take the drugs he’d proven he did not need or benefit from? What kind of insanity is THAT?
Comparative oppression is a zero-sum game to me. Being “less oppressed” than a comparable population is no cause to put up with it or fail to document it.
I think the act is strongly mitigated by the drug use, especially any drug use that is forced or engaged in without informed consent. That being said, I agree that abusing substances, or even being intoxicated on a substance involuntarily, doesn’t completely remove responsibility for the action taken.
I am not sure you’re getting the point of the article. This is not a rogue doctor engaging in anything unusual or outlandish. These are the STANDARD RESPONSES that people receive. Despite absolute, unremitting proof of TWO YEARS with no drugs and no psychotic reactions or episodes at all, the IMMEDIATE response is to punish the subject for FAILING TO COMPLY WITH ORDERS. So this is NOT about whether or not medications work for you or someone else. This is about a system that is IRRATIONAL – that believes that their patients need drugs EVEN WHEN THERE IS ABSOLUTE PROOF TO THE CONTRARY. I am not sure how you can argue with the label “junk science” when the supposed scientists involved are unable to see the actual results of an actual experiment right in front of their own eyes, just because it conflicts with what they want to believe is true. Any real scientist who encountered this story would immediately be very INTERESTED: when did you stop taking it, how did you do it, what if any symptoms did you have as a result of discontinuing, how long did they last, how did you get this diagnosis in the first place?
Instead, these psuedo-scientific pretenders focused on the patient’s unwillingness to follow their orders, as if the patient were a wayward young child or the doctors were military commanders whose orders must be followed without question. Please tell me, where is the science in that scenario?
And I appreciate your perspective and your willingness to share and have a civil exchange of views. It’s how we all learn and do a better job. Honestly, I have never had a problem with people doing whatever they need to do to overcome feeling hopeless and depressed about life, because I’ve been there, many times. My objection to the modern medical viewpoint is the idea that depression is always the result of a failing in the individual, rather than failings in their social system or society as a whole. As you can see in my comments above, I believe we’re living in a rather sick society right now, and I kind of see depression as a pretty reasonable response to a rather dismal political and social picture out there. Maybe if I weren’t “depressed,” I wouldn’t feel upset about global warming and the current political contest or the US policy of overthrowing foreign governments we don’t agree with and so on. Maybe I’m supposed to be OK with all that. But I kinda think that’s my decision to make, not some MD psychiatrist who is more interested in making my bad feelings go away than addressing the actual issues that those bad feelings relate to.
Best of luck to you, and thanks again for the exchange!
Does anyone find this surprising? It is an indicator of how inane and corrupt the “mental health” system has become that such research is even necessary. This should be an obvious conclusion.
I know what you’re saying and don’t really disagree. People can’t be trusted to “care” for someone when they have authority over them. I do think it’s important, though, to distinguish that being opposed to enforced treatment does NOT mean being opposed to law enforcement being involved when someone’s doing something dangerous or illegal to someone else. I often get the argument, “What, so people should be able to run around threatening or hurting others and nothing happens to them?” I always am clear that violating social rules should result in being restrained, but that does NOT mean that I get to label you as “ill” and “treat” you against your will. It means you have to stop hurting people in order to maintain your freedom, just like anyone else who commits a criminal act against another in society. It is the automatic coupling of detention with “treatment” that makes that argument even possible, so I want to be sure and decouple them, so people know I’m not advocating for anarchy or mayhem, but I’m against labeling and forcing “treatment” on someone just because they behave in a way that violates social expectations for safety and respect of others’ property.
Well done, and thanks for telling your story so articulately! It sounds like you are yet another victim of SSRI-induced “bipolar disorder,” which led to year of “treatment” that left you far worse off than the original condition they were trying to treat! I also appreciate your description of the vague and hazy state of disinhibition that was the “positive” part of your psych drug experience. I believe this kind of “who cares what anybody things?” experience is what people find helpful about the drugs, especially people like you and me who have histories of shyness and anxiety. But that very effect, I believe, is why suicide becomes a more “reasonable” option for some users, and why extreme and bizarre forms of violence suddenly seem less foreign and repugnant to a significant minority of users.
It also amazes me that after years of obvious failure, the psychiatric system at no time took a look at the results and said, “Jeez, she came in complaining of anxiety and now she’s totally psychotic! Where did we go wrong?” No, instead they blamed you or your “condition” for every failure they produced.
It is a frightening prospect being sucked into such a system. I’m very glad for you that you escaped. Thanks again for sharing your story!
True enough. However, the choice to end his/her life based on excessive suffering does not lead me to the conclusion that this person or anyone else is victim of a “disease” simply based on the idea that they are suffering. My point is that, as Emerson famously quoted, “To be great is to be misunderstood.” To be misunderstood, is also, to some extent, to suffer, at least for most of us. Much suffering, including suffering to the point of committing suicide, is caused by a sense of alienation from the society in which we currently live. While not all people get to feeling suicidal, plenty experience huge distress because of “not fitting in” to their prescribed social roles. How many depressed moms in the 60s got Valium or Benzedrine instead of someone recognizing that their life as a housewife was isolating and unfulfilling? How many kids get drugged in school because they are unable or unwilling to cope with the stifiling boredom of their classroom? Would Edison have been better off if he’d been drugged into sitting still for his teachers, who clearly couldn’t begin to cope with his energy and creativity? How many domestic abuse victims get Prozac instead of someone asking them what they’re depressed or anxious about? Hell, we’re now supposed to diagnosed a person with Major Depressive Disorder two weeks after the death of a loved one if they’re still having trouble functioning!
Great people suffer. Normal people suffer. Oppressed people suffer. Suffering is part of the human condition. Cherry picking certain famous people who chose to end their lives as proof that they needed “treatment” is reductionistic nonsense.
There’s a study that will quickly be buried in the bottom of the psychiatric dustbin! We can’t have proof out there that locking people up doesn’t help! How can we make sure we have clients if we can’t lock them in?
Oh, and CREEP OUT about the therapist getting a hard on in front of you! At least he had the decency to realize he was unable to help, though again it sounded like you were blamed instead of him admitting he had boundary problems that kept him from being a good therapist.
“BPD” is, of course, just another label for behavior that psychiatrists/psychologists decided needs to be “treated.” It is never true that you can “have” or “not have” “BPD” in the same sense that you have or don’t have an ulcer or pancreatitis or a ruptured spleen.
That being said, the vast, overwhelming majority of people I’ve known (and I’ve known a lot, as I work with a traumatized population) diagnosed as “Borderline Personality Disorder” had significant childhood trauma histories. From what I understand of DBT, it focuses a lot on developing emotional management skills, to which I have no real objection. But if people are receiving DBT for “BPD” and no one is discussing the likely traumatization that underlies this “condition,” I agree, they are doing their clients a huge disservice.
Bottom line, I regard “BPD” as a description of a common set of coping measures used by people whose parents or other caretakers were usually inconsistently abusive or neglectful when they were very young children. I find that describing and treating these “symptoms” as a rational set of coping techniques adopted by a powerless child in a very confusing and scary situation provides many potential avenues for resolution, whereas viewing it as a “mental disorder” that somehow resides in the client reinforces the idea that 1) your reaction to being traumatized was WRONG, and 2) you should get over it and to the extent you haven’t, you’re the problem.
I find the labels themselves more problematic than the proposed “treatments.” If you’re honest with people from the start in a compassionate way, almost any situation or “condition” can be improved upon, but it never helps to label and blame the victim of abuse.
Sera of all people should not be accused of “throwing away” anyone. She has dedicated herself and her career to helping folks in the so-called “4%” as well as many others to find a path, particularly those who have not been served well by the mainstream psychiatric system. In fact, I’d guess that Sera and her program have done more to keep the “most ill” out of incarceration and homelessness than any mainstream psychiatrist can ever claim. Your need to believe that “AOT” is the answer for everyone is based solely on your own very limited personal experience. I don’t mean to deny that experience (there is no question that “AOT” has positive effects in many cases, at least as seen from the viewpoint of a concerned family member). But I think it is very presumptuous of you to assume that all or even most people have that positive an effect when you don’t know anything about their lives. Sera talks to these people EVERY DAY and hears their stories of trauma and disempowerment and abuse by many of the “helpers” in the current system. She isn’t just making this up – she hears the stories personally, and feels driven to make sure that their stories are told. That’s advocacy. You are coming from a very personal place, and I respect that. But don’t try to enforce your experience on others who have experienced something very different. AOT is a violation of civil rights on a grand scale, because it goes way beyond recognizing that some people need help that don’t recognize it, and moves to deciding exactly what kind of help they “need” and punishes them for refusing to accept such “help,” even if it is harming them dramatically and even if they are perfectly capable of analyzing the damage it is doing.
We have commitment laws already. The civil restrictions on commitment laws were made because those laws were being abused by system members, parents, and society at large. Moving away from that toward enforcing more “treatment” on those who are competent to refuse is a very, very dangerous step that does damage to many that it claims to help. Even if some are “saved” in the way your suggest, how many more are harmed? And who are you to say what the harm/help balance is? Isn’t that the right of each of us to determine?
They also neglect to mention that the huge bulk of these famous individuals accomplished all they did with no “treatment” of any sort! Edison clearly met the criteria for “ADHD” and got tossed out of school at a young age, yet ended up being one of our greatest inventors without a milligram of Ritalin ingested. Who’s to say what greatness we may be suppressing in order to “help” our exceptional offspring “fit in” to a warped and unhealthy social system?
And this is exactly the state that those currently in power do NOT want us to accomplish by ANY means! I think this is why the resistance to common-sense ideas like peer support and nutritional changes and improved listening skills is so high. The current paradigm is popular specifically because it keeps power with the powerful and blames the “mentally ill” for their own predicament. Teaching the “mentally ill” to not be worried about others’ opinions and to act in empowered ways TERRIFIES the supporters of the status quo! Hell, the entire CONCEPT of “mental illness” is based on labeling disapproved behaviors/emotions as “different.” Self-approval is the last thing in the world the psychiatric profession wants to promote!
Can’t argue with you there. It’s almost laughable when doctors critique natural remedies and herbs because there is a “lack of controlled studies” supporting their use, when such things have a 10 thousand year or longer evidence base, compared to a couple of biased 6-week studies run by pharmaceutical companies or their minions. I prefer the 10,000 year data track. Arsenic may even be safer, because at least everyone knows and admits it’s poisonous!
I think you are conflating two very different issues, as is very common in this kind of article. The first: do people experience distress to the degree that they are unable to care for themselves and/or present a danger to the community? The obvious answer is YES, and I don’t think there is a single person posting here who would object to a person engaging in dangerous or intentionally threatening or violent behavior being arrested and held until such time as they are safe.
The second question, which I don’t think you’re addressing here, is what is supposed to happen to such a person once they are taken into custody? Does the fact that a person is acting in a way that isn’t considered socially acceptable give the community license to do whatever they want to them? Even criminals have to be convicted based on evidence, and their sentences are limited based on the crime. But the “mentally ill,” when so labeled, are now subject to the doctors engaging in almost any “treatment” without their consent, even when such “treatment” is shown to result in early death, or is clearly not helping or making things worse.
How do you suggest we address the problem of people being taken into custody based on some subjective perception of “threat to self or others,” and then losing most of their civil rights, including the right to protest to harmful treatments? Are you following the case of the guy in Australia, who has clearly and repeatedly elucidated rational reasons for his wanting them to stop electrically shocking his brain, but has been ignored for years and years?
I am not opposed to the idea of someone being taken into custody for their own or others’ safety. I am opposed to forcing “treatment” on them, especially when they are in a rational enough place to honestly understand the pros and cons and communicate their objections.
I agree so much – LABELS are the big problem! Drugs have always been around and people have always used drugs to alter their mental/emotional state, sometimes for the better, sometimes for the worse. The problem is not the drugs themselves, but the pretense that they are being “prescribed” for “treatment” of some “condition” that is essentially invented by those holding the strings of power in society. Without the labels, the concept of “medical treatment” dies a swift and well-deserved death, and the drugs can be viewed as what they are: mind-altering drugs that have effects on the body and brain, which effects are up to the user alone to determine whether they’re worth the cost or not.
Truly, it is authoritarianism that is the real enemy. I hate someone else telling me what is supposed to work and getting upset if I don’t agree. Everyone’s got their own path to follow.
I don’t knock it at all. In fact, if someone wanted a short-acting anti-anxiety agent, I’d definitely recommend alcohol over Benzos any day. Of course, dosage control CAN be a problem…
An excellent point. As I said above, the counter to the Scientology attack is not to agree that Scientology is horrible and claim you have nothing to do with it. It’s to separate the ad hominem attack from the substance. “What’s religion got to do with psychiatric treatment?” is always a good line. The Scientology attack is a distraction, and should be labeled as such right away. “You’re trying to use people’s feelings about religion or Scientology to distract from the facts I’ve presented. Let’s get back to talking about science!”
Which goes to show that Peter Goetze is right – doctors can’t be trusted to even follow their own guidelines, let alone honestly evaluate the effectiveness of a drug or honestly inform their patients of the pros and cons and other viable alternatives.
I agree about the placebo response. Most people who are depressed feel better within several months or less without ANY intervention, psycho-social or medical. But AD users understandably attribute the changes to the drug they are taking, rather than other actions or decisions or changes in environment or diet or exercise or thinking or beliefs that have contributed. And of course, withdrawal effects reinforce the idea that getting off ADs is a bad idea.
It’s also important to remember that the fact a substance makes one feel better doesn’t mean it’s an effective medical treatment. A shot of Jim Beam three times a day will definitely reduce your anxiety levels, as will smoking a small amount of marijuana in controlled doses. This doesn’t mean marijuana or alcohol are treating a medical condition. It just means you’ve found a substance that makes you feel better temporarily. Just because a drug is prescribed doesn’t make that any less true. Unless the doctor has an actual understanding of what condition they are “treating” and how the drug works, antidepressants or any other psych drugs are simply a way of temporarily altering your emotions. While that may seem appealing to some, this kind of action is no more medical than getting drunk on Saturday night to forget your troubles.
I think you used them in the best way they should be used – short term, help get over a hump and get active again, then OFF. The idea of taking the long-term is increasingly being shown to have an increasing downside over time.
Quite so. I was channeling our old friend in the post above. He provided the best way I’ve known yet to completely nix the biological argument without getting into metaphysics. He is a man of great insight.
“Associated with” doesn’t mean “caused by.” It means this gene is more likely to occur in people having these experiences, and/or that people with this gene are more likely to have such experiences. It does not mean that all people who are paranoid have this gene variation, nor that all people who have it are paranoid. It’s an association.
The idiocy of psychiatry is not in assuming that genes play a role in personality and behavior – it’s in assuming that ALL behavioral and personality variation is caused by genetics, and that ALL interventions should focus on the physical body as a result. There is PLENTY of evidence that psychosocial interventions, both formal and informal, not only can change personality and behavior, but can change the expression of such genes as you identify.
So which should we study? The genes that create greater vulnerability for certain people to certain reactions, over which we have essentially no control? Or the environmental variables that can help turn such genes on and off to the benefit of the person involved?
Or to put it another way: does it make more sense to try and figure out why some people react more severely to being dropped in a war zone than others? Or would it make more sense to figure out how to keep from having to put people into war zones in the first place?
First off, that statement is as much a statement of faith as the idea that the soul is implanted in the body. You are assuming that nothing can exist outside the physical realm, and have zero proof of that. Not saying you’re wrong, just saying that you are stating a BELIEF, not a scientific fact.
Second, WHO CARES? The personality is clearly something that transcends any analysis of individual brain circuits, in the same way that a computer program like the one I’m using to communicate with you transcends the circuitry I’m using to make it run. Sure, the computer program RESIDES in the circuits of the computer – ultimately, it’s just a series of ones and zeroes. But the location and order of these ones and zeroes has MEANING that is in no way discernible from examining or fiddling with the circuits.
Psychiatry trying to fix mental/emotional problems by studying brain circuits makes exactly as much sense (or maybe even less) as trying to de-bug Windows 10 by fiddling with the printed circuit board or memory chips. It is an effort doomed to failure from the outset, because it fails to recognize that personality is about meaning and intent, which do not and never will translate into circuitry.
You really believe human beings are in a position to decide who is allowed or not allowed to reproduce? Are you unable to see that it is the same belief in the US eugenics program that led to Hitler’s excesses? It’s not a door that should be opened. We’re clearly unable to handle even the responsibility for those detained “for their own good,” as we drug and shock them and ruin their brains and don’t even listen to what they tell us is happening. Don’t try to pretend we as a species or as a culture are some how able to constrain ourselves to act responsibly when given power over someone else’s life. We have proven again and again that we are not.
Love what you say about Scientology. Bringing it up is just a distraction, and should be labeled as such. Forceful denial plays into their hands. I think the proper response is, “What would someone’s religious beliefs have to do with the facts I’ve just presented? Are we talking about facts or religion here? If you have some actual facts or research to present, I’m anxious to hear it, but stop trying to distract people from the point at hand.”
Always demand that your antagonist come back to the scientific question at hand.
I agree. I’m looking forward to reading your book. You write well and will be hard to discount, as you have no actual label of “insanity” that can be used to discredit you. Thanks for sharing your story with us. I continue to be appalled that such treatment is legal in Canada or any other civilized nation!
This was just posted above your post by Christopher J:
“ChristopherJ
on July 26, 2016 at 2:35 pm said:
Six years ago, against medical advice, I weaned myself off of my medications. My ” time in dungeons and on the streets” occurred while I was on medication. Since going off of my medication, I have been able to go back to school, work full time, and become a productive member of society. I am one of those who will never see a psychiatrist again.”
What do you have to say to Christopher? Is he not standing proof that your assumption that those taken off antipsychotics will deteriorate into street people is not necessarily true at all?
Perhaps you didn’t read the article. The ones who DIDN’T take medications functioned BETTER in society and were MORE likely to have a job. I know this goes against what you have been told and apparently really want to believe, but this is a scientific study with controls, and they are simply reporting on their findings. The findings happen to contradict what you have been taught and/or want to believe is true.
This and other research shows that “schizophrenics” do better when the drugs are used sparingly or not at all. The point of scientific research is to minimize confirmation bias and untested assumptions. If you have a scientific worldview, this research should, as the author suggests, give you pause to wonder whether your current set of assumptions as to what helps people having psychotic experiences is actually true or perhaps needs to be modified.
Interesting. The “spin” on these things is always that “the less serious ones self-select to go off “medication.” Yet we’re also told ad nauseum that the mayhem in the community is being caused by people who self-select to go off their “medication.” Can’t really have it both ways, can we?
We now have four major studies (they failed to include Wunderlink) directly supporting that long-term use leads to more disability, as well as the two WHO studies confirming that people living in countries with low use patterns have better outcomes, plus a couple of well-known treatment protocols (Open Dialog, Soteria, etc.) showing that low- or no-use approaches work for the majority of people with “psychotic” experiences. Yet still no energy from the psychiatric community to question their “medicate everyone forever” protocol for “psychotic disorders.” They don’t even pay attention to their own research.
Many, many of the cases where “antipsychotics” are prescribed for “ADHD” are a result of kids becoming aggressive as an adverse effect of the stimulants they’ve been prescribed. I see this regularly in my work advocating for foster youth.
The truly bizarre nature of this approach is only apparent if you know a little of the biochemistry involved. Stimulants increase levels of dopamine available in the brain, which can cause aggression, especially in those who have a trauma history. Antipsychotics DECREASE the same chemical (dopamine) that the doctor has been INCREASING with the stimulants!!! So they raise dopamine with one drug while suppressing it with another. And our tax dollars pay for this stupidity????
I don’t know why people are so willing to allow this chicanery to pass unnoticed!
A good point. We could actually get a lot of mileage out of simply pointing out that they don’t even follow their own research based on their own idiotic diagnostic protocols and categories. Within their own paradigm, giving antipsychotics for ADHD would be like giving blood pressure medication for someone with back spasms. I have no idea how they get away with it, really. Mass hypnosis, I guess.
It proves only what it says: that people labeled with what we call “mental disorders” more often then not get better with or without any kind of formal treatment. It proves or disproves nothing about brains healing or not healing themselves. It only proves that treatment per se doesn’t make a difference on the average. It also doesn’t mean that certain individuals won’t improve more with treatment – it only suggests that if such “improvers” exist, there are an equal number of people who get worse receiving treatment vs. those receiving none, balancing out to no gain.
As a side note, the only actual proof of healing of brains came from the Decade of the Brain, and ironically, the thing that healed brains was not a drug, but relationships with healthy adults who care about you. See Dr. Bruce Perry for more data on that fact.
You can’t treat a lack of love with a drug!! Trust me, I’ve talked to hundreds of foster youth, and not one has ever identified a drug as helping them cope with a lack of love. The thing they report as most healing is ALWAYS a relationship with someone whom they found they could trust, someone who cared about them despite them not always being polite or kind or rational. Lack of love can only be treated with LOVE! Drugs simply make it easier for the adults involved to avoid their responsibility to figure out a way to understand what is going on and DO something about it.
Wayne, I have seen a lot of therapists who, while perhaps not exactly talking their clients out of their perceptions, very invested in minimizing or ignoring the effects of these abusive experiences, or trying to talk them into “forgiving and forgetting.” It’s certainly not true that anything close to all therapists work this way, but it’s a very substantial minority, and I think their numbers are growing as the years pass. I can’t remember the last time a therapist I’ve encountered (and I encounter a lot of them) talked about subconscious motivations or the specific long-term impact of the specific child’s traumatic history. There’s a lot of lip-service to trauma history recently, but it’s more focused on how trauma damages the brain, rather than on how to PROCESS their traumatic experiences and/or deal with the currently traumatic people in their lives. There is a lot of focus on developing emotional coping skills, and very little on creating a more empowering way of looking at the world that helps put their abuse into some kind of perspective that helps them move on with their lives. I don’t take the position that most therapists collude with the abusive parties in a child’s life, but most are also not comfortable directly confronting the oppression that kids experience from parents, teachers, foster parents, caseworkers, mental health professionals and/or psychiatrists in their lives. We can do a LOT better!
Wow, Peter, can you come work in our child welfare system in Oregon? I have worked for the CASA program locally for almost 20 years, and have seen exactly what you document here. Kid after kid is diagnosed with a “brain disorder” and their traumatic histories are ignored. Many kids get WORSE under the “treatment” of these doctors, and yet the answer isn’t changing the treatment plan, but adding yet MORE drugs and MORE diagnoses. Bringing up any kind of objection is often met with disdain or outright hostility. The system is set to meet the needs of the adults, just like it was in the kids’ abusive homes. It sounds like you and your team set up the best system possible to counter the systemic issues, and it still didn’t really get to the core of what is needed to help these kids. Thanks for all your commitment to these kids, who really need folks like you to help them see that not everyone in the system is untrustworthy or corrupt!
The thing is, if a “disease” is found to be heterogeneous, it no longer qualifies as a “disease.” It is, at best, a syndrome for which a small proportion can be explained by a particular disease process. The big error psychiatry makes (scientifically, I mean – from a marketing standpoint, it’s brilliant, if evil) is lumping together people who have little to nothing in common biologically into a “medical” category based on surface manifestations such as emotions and behavior. It actually PREVENTS any effort to discern those few who DO have some kind of physiological problem from the many who are simply normal people reacting to highly stressful circumstances.
The implications of this for psychiatry should be obvious. Even if their specious “chemical imbalance” theories are true, does this not demonstrate pretty convincingly that the action and thought pattern of the patient himself can, in fact, alter whatever chemistry may be going on? Of course, even the neurologists don’t want to hear this. How much harder for psychiatrists, whose model is largely based on faith rather than science, to admit that they’ve been barking up the wrong tree all this time.
They DO know, many of them, but they for the most part seem to dismiss any such person as a “crank” or a “menace” without actually reading what they write. That’s the insidious thing about psychiatry – since it’s really more of a religion than a science, you can just dismiss people for not following the dogma without having to actually entertain the possibility that your faith may be misplaced.
And that antipsychotics somehow “fix” this ephemeral “imbalance,” despite the evidence that it would make any such “imbalance” worse over time, or create one when it never existed in the first place.
You sound like Joanna Moncrief. You should read some of her stuff – she says pretty much the same thing. We’re altering states chemically. Some people like the altered state, some don’t, but in either case, we’re not curing or even “treating” any disease state. We’re just messing with brain chemistry and hoping it turns out OK.
Wow, that is REALLY disturbing! Apparently they don’t know or choose to ignore the fact that many peoples’ “caregivers” are very invested in their remaining “ill” and under control of the system. In fact, a lot of “mentally ill” adults got the way they are because their “compassionate caregivers” treated them like crap for years or decades leading up to their deteriorating state.
Sums up again to having your civil rights removed based on some subjective assessment by a person who doesn’t know and maybe doesn’t even care about what’s really happening in your life. SCARY!
They seriously just figured this out? Seems kind of obvious to me, notwithstanding the specific receptors involved. Parkinson’s results from low dopamine production, suppressing dopamine produces Parkinson’s symptoms. Should not be surprising to anyone.
Sorry, Mayara, but antidepressants, like any other psychoactive drugs, don’t have specific effects on depressed people. They have the same basic effects on all people, and some people in any group have adverse reactions to them, whether they officially count as “depressed” or not. Moreover, the idea that there is some way to distinguish reliably between “depressed” and “normal” people is a delusion promoted by the psychiatric profession and the pharmaceutical industry. There is no clear line between “depressed” and “normal,” nor between “situationally depressed” and “clinically depressed.” There is no way to test for this or any other psychiatric condition – they are “diagnosed” by checklists of behavior and emotion that are completely subjective and have no necessary relationship to any “disease” state in the person being so “tested.”
And that doesn’t even address the question: if she wasn’t “depressed”, why did she get the prescription? Why wasn’t her doctor able to see that she didn’t need it? Or why, after she had the classic adverse reactions that she did, would the wise doctors not realize that they were on the wrong track and take her OFF the drug that was making her worse? Why, instead, did they give her a new set of diagnoses and drugs and send her down a pathway to disability and insanity?
It seems you are getting your information from limited sources and would really like to believe that doctors know what they are doing and are basing their decisions on scientific reasoning and fact. I’d suggest you start reading some alternative viewpoints. I think you’ll find that trusting a doctor to make good decisions on your behalf is a rather dangerous thing to do, especially when it comes to psychiatric drugs.
True enough – PCPs are actually doing the lion’s share of prescribing of both “antidepressants” and stimulants for “ADHD.” (I decided it’s time to start putting quotes around “antidepressants” to indicate “so-called antidepressants,” since it’s becoming clear that they are at best active placebos for most and something much more sinister for some.)
When I did a brief and painful stint doing involuntary hospitalization evaluations in Vancouver, WA, I discovered an inordinate number of women with obvious trauma histories diagnosed as “bipolar” because they had “mood swings” that were very obviously related to their history of (or ongoing current) traumatization. It really opened my eyes completely to how easy it is to blame the victim for having the “wrong reaction” to their traumatic experiences, or worse yet, to simply ignore that such trauma exist or have an impact on someone’s “mental health.” That was part of my impetus to get out of the field and get into advocacy – I couldn’t support a system who wanted to drug a person’s trauma history out of view. It really is quite revolting, but it’s sadly very common.
I agree completely. However, it is important to understand that not everyone is at the same place on taking risks, and that the risk of retaliation, especially for those working on or subject to the whims of the current system, is very, very real.
There are plenty of alternatives offered in articles throughout this site, and in comments offered after the articles. You don’t appear to be open to hearing much of it, though. Start with the Open Dialog model in Finland if you need an alternative. Or read the WHO studies in the 90s that showed that one of the best things you can do to “treat” psychosis is to move to a developing country where they don’t use drugs as a primary intervention. Or read a bit about peer support services, which Sera actually participates in providing to the “mentally ill” in her center every single day.
Sera, in fact, is the last person in the world you should accuse of failing to provide alternatives. She is LIVING the answer to your question every day. I hope you’re able to put your need to be “right” aside and actually listen to the answers to your questions. It is not necessary to deny people’s need for support and financial assistance in order to critique the current model of service delivery.
Stop defending and LISTEN and you might just learn something.
What’s wrong with working on a farm? Lots of people make a happy living doing so. It’s been the primary mode of survival for humans since the beginning of the modern age. I think you should visit the place before you make any assumptions about how miserable and enslaved the workers are. In any case, it certainly seems a big step up from prescribing a lifetime of brain-disabling, life-shortening antipsychotics, doesn’t it?
This is doubly idiotic! First off, they are identifying RELATIONSHIP problems and then prescribing a PHYSIOLOGICAL intervention to “help” – do they really think that taking a drug will improve your relationships? Second, they ignore the obvious fact that having a challenging relationship situation would LEAD to depressed or anxious feelings NATURALLY. This totally belies their claim that they only treat “endogenous depression” or “clinical depression” with drugs – they’ve got a hammer, so everything that comes their way is a nail.
This is not even mentioning the sexist assumptions under which these “diagnoses” and “treatment” plans are made.
The message is clear: if you have relationship problems of any sort, or even if you aren’t in a relationship, stay away from psychiatrists. Or perhaps more generally: if you’re alive and human, stay away from psychiatrists. “Quackery” doesn’t even begin to describe the venal stupidity behind this kind of “treatment.” These people are either evil or dumb, or probably both.
Wow, what a sad story, though I’m glad it seems to be moving in a happier direction of late! I work with kids in foster care and I see this dynamic all the time. Not only the parents, but foster parents, the school system, caseworkers, and even mental health professionals supposedly trained to help kids who are victims of abuse have blamed foster youth for being angry, sad, anxious, or inattentive, or for having “mood swings”, all of which are clearly related to their horrible upbringings and the traumatic experience of being in foster care. Instead of normalizing their emotional reactions as an understandable reaction to a very abnormal life pathway, these kids are told that THEY have a “mental disorder”, and that faulty brain chemistry is at fault, all of which implies pretty obviously that they SHOULD be happy about their situations and that any adverse emotions or behaviors they experience are an indication of their own “disorder” rather than their crappy lives. It is most infuriating, and truly represents the exact OPPOSITE of what is actually helpful to traumatized individuals, in my experience.
I wish I had some answers, but the pathway forward seems to lie in finding individuals you can trust and develop relationships with, so you can learn, just as you say, that there are people who care and won’t abuse you, if you look around and learn how to judge who is legitimately on your side.
Well done to you for hanging in there and getting on a positive pathway!
Agree 100%. There was one NAMI branch in Santa Cruz, I think, which had a website with great articles and comments from survivors – kinda reminded me of David Oaks and MFI’s website. At some point, it simply disappeared. I can only assume they lost their NAMI charter for being too “off message” for the national organization. As long as national NAMI continues to be owned by Big Pharma and promotes the protect the powerful/blame the brain model, local NAMIs with a different agenda will simply be anomalies who can only go so far before being excommunicated.
As far as I understand, your only recourse is to complain to the medical board in your area regarding a lack of informed consent. It is difficult to convince medical boards to do a whole lot, though, as they are made up of doctors and a lot of the things you are complaining of are kind of standard practice, and the docs on the board may do them as well. I wish there were something else that could be done, short of a class action lawsuit, which would require a lot of folks like you sharing notes and hiring an attorney to work for a piece of the settlement.
It sucks, but at least you’re now enlightened and will never trust them again. Jerks!
Michael, you are a heretic and are being the modern equivalent of excommunicated. Which I think you should consider a badge of honor. I did not receive the same degree of hostility when I made my views known, it was more a degree of marginalization – people knew I was one of “those people” who “didn’t believe in medication” and therefore my views could be discounted whenever the topic came up. Eventually, I “excommunicated” myself because I felt bad about participating in such an oppressive system, plus there were fewer and fewer dissident professionals to whom I could talk openly about the situation. At this point, those with integrity have mostly quit or been tossed out of “the system” and outside advocacy seems like the only path toward rethinking/reforming/rejecting the current dogma and faith-based “treatment” protocols.
Well done for standing up and calling out the fraud for what it is. When people suggest I’m a “conspiracy theorist,” I say, “I never said it was a conspiracy. It doesn’t require a conspiracy to be corrupted, only a nice, reliable conflict of interest.”
The Brits did a TV show based on this same concept. They had something like 10 contestants, 5 of whom had MH diagnoses and 5 who did not. They got to see them interact over some extended number of days, and then had to guess their diagnoses and who was and wasn’t “mentally ill”. Not only couldn’t they get the diagnosis right, they didn’t even sort out who had a label and who didn’t. They did embarrassingly poorly. Not that I’m surprised. I’ll have to look that up and post it.
I think it’s mostly because people need to distance themselves from their own emotions and fears. I also think that people on some gut level KNOW that there is no real objective difference between them and the “mentally ill” and they really NEED to believe the “chemical imbalance” crap because it reassures them that “those people” REALLY ARE DIFFERENT and that they don’t have to worry about “becoming schizophrenic.” It’s not dissimilar to the incredible hostility in the USA towards the poor. If the poor are poor because they’re lazy or stupid, then I don’t have to worry because I’m protected and I don’t have to do anything about it. If they’re poor because our system assures a certain percentage of poor people in order to keep wages low and keep the populace at odds with each other, then they COULD be a poor person and the poor person COULD be where they are and MAYBE there is a problem they have to do something about.
That’s my take on it. It’s just beyond unfortunate that the psychiatric system has chosen to make it easier and more socially acceptable to be biased against people who are different, but I guess they’re making lots of money and have more power and prestige as a result, so they’re not really willing to take a look at how their model harms the people they’re claiming to help.
I agree that NAMI is bought and paid for by Big Pharma, and that its original intent was to help family members avoid blame and make it easier for them to force their adult kids into “treatment.” It’s a very toxic combination, parents looking to avoid self-examination and organized psychiatry teaming with drug companies profiting from providing them a model that does just that.
But it’s also true that a lot of people go to NAMI because they don’t know any other support network for family members of people struggling with these issues. I think it’s great that someone is going in there and providing a different point of view, and letting people know that NAMI’s framing of reality is not the only way to look at the situation.
I’d also add that there are some local NAMI chapters who do take a much more survivor-based approach than the national office, so it can be a mixed bag. But I don’t trust NAMI further than I can heave them collectively, and I think suspicion of or even contempt for their motives on a national scale is very well deserved.
“Anosognosia” is the cooptation of a real phenomenon happening when a very specific kind of brain damage occurs to a pejorative word for anyone who disagrees that they are “ill” when a psychiatrist or similar MH “professional” say that they are. Since there is no hard evidence that can distinguish ANY “mental disorder” from “normal” behavior (and the DSM admits that quite frankly in its introduction), how can one claim that a person “doesn’t realize they are ill” when you can’t even prove whether they are ill or not? Denying your leg is broken when you can’t walk is one thing; denying that you “have schizophrenia” when there are mainstream voices in psychiatry who admit or even assert that “schizophrenia” isn’t a specific disease state is something completely different.
In the end, “anosognosia” is just a calculated excuse for enforcing “treatment” on the unwilling.
I guess I have to disagree with you on this point. There are dissident psychotherapists/counselors in any system, just like there are dissident teachers in public schools and dissident doctors at mainstream hospitals. Such folks may be hard to find, but as Chaya has so clearly laid out, it can be a goldmine if you manage to get connected with one. I say this because 1) I did luck out and find a very competent and helpful therapist when I was in my 20s, and 2) I was one of those dissidents who gave people what I think most would report was great service that was respectful and empowering. Eventually, working in the crazy system did drive me out, but while I was there, people were, in fact, very fortunate to find me, because I believed neither in diagnoses nor in drugs, and I was able to truly listen and care about the people I interacted with and focus on empowering them rather than telling them what to do or forcing them to do anything.
It doesn’t sound like you’ve ever had that experience, and I agree that the system is set up to suppress such behavior by any therapist, but some are able to resist and can maintain their integrity even in the mess of the “mental health system”, at least for a while.
Why would psychiatric leaders want to promote full long-term recovery? It would totally mess with their bottom line! Where would they get customers if people started actually recovering?
Not unless they can make buku bucks prescribing these things without having to do any work. I’m with knowledgeispower – we already know a range of effective alternative approaches. Organized psychiatry’s only real objection to alternatives is that they undermine psychiatry’s lock on their market share and prevent them from profiting from the misfortunes of others. It isn’t just that they’re not interested, they have an interest in suppressing this information and continue to do so because it benefits them in terms of power, prestige and income to suppress it. They don’t want an alternative – they’re just fine with the status quo and will do almost anything to preserve it, whatever the impact on their patients.
Of course, the problem is that when you have no actual objective criteria for a “diagnosis,” how would one ever tell if something is “overdiagnosed?” Just the use of that term sets my teeth on edge, because it presumes there would be a right level of diagnosis, and there is absolutely no non-arbitrary way to accomplish that. In the end, the ultimate result of any kind of diagnosis based on a spectrum is that the line of “disorder” will be pushed closer and closer to the line of the average, especially when there are folks with strong financial interests in moving the line in that direction. Same thing has happened with blood sugar levels, cholesterol levels, and various other tests (how many cases of “pre-cancerous cells” will never develop into cancer?) It works great for Big Pharma, but not so great for the recipients of this kind of “care.”
Eight studies shut down. Doesn’t sound like a bad apple, here. Sounds like unethical practice is now the accepted norm. I bet she’d get the same results in most universities around the USA today.
Couldn’t agree with you more. The only thing I’d add is that schools are often the worst enemy of this kind of kid, because they are as dull as dull can be, but it doesn’t have to be that way. We used homeschooling and alternative schools for our very active, bright, easily-bored boys and had no complaints about “ADHD” and actually very few complaints about ANYTHING. It wasn’t easy, but who said raising kids was supposed to be easy? The dumbest thing we can do is tell kids, “Oh, well, the reason you aren’t paying attention is because you can’t because your brain won’t let you.” Instant off-the-hook excuse for the kid, his parents, and his teachers, when the reality is, paying attention, like anything else, is a skill that can be learned. They may find it harder than other kids, and they may never be great at it, but they can learn to be better than they are and at the same time learn that you can overcome any shortcoming in time if you work at it, which may be the most important lesson of all.
I agree, the main point is that exercise addresses the physiological side of depression in the short term, just as antidepressants are supposed to do. And it appears that exercise is both more effective and has fewer dangerous side effects. So in direct comparison to antidepressants, exercise should be by far the first choice. Naturally, one would need to address causal factors such as childhood abuse, bad relationships, boring, dead-end jobs, and so on to have a long-term impact in most cases, but if you just want to feel better today, an uphill hike in a nearby forest is probably a way better bet than a visit to your local psychiatrist.
I think your math is right on, and I also think you’re entitled to make simplifying assumptions, since your counterparts in this argument have done exactly the same. You accepted their simplistic and inaccurate premises and still proved what we already know – the bulk of violence is committed by people who have no “mental health” diagnosis, despite the subjective nature and questionable genesis of these highly culture-bound “diagnoses.”
Tranquilizing people is not a new concept, and I have to say, when I did mental health assessments, I was super impressed by what a shot of Inapsine would do to a previously incoherent person, allowing me now to have a conversation with them. However, this is VERY different than deciding to force a person to continue to take a drug for years that they may hate or that may not really work for them or whose side effect may ultimately kill them decades early, based on some speculative, subjective label that’s been applied to them without any actual scientific evidence that such a course is generally beneficial, and with increasing evidence that such a course is generally quite disabling and may ultimately be fatal.
For sure, we need to find better ways to help, but the current paradigm actually impedes or prevents this, because all “schizophrenics,” for instance, are assumed to be the same, assumed to have a biological reason for their distress (despite almost no evidence this is true and plenty of evidence to the contrary), and are assumed to “need medication” for the rest of their lives (again, in direct contradiction to established long-term data). The hard fact is, long-term “treatment” with these drugs does not really work, as you’d know if you would read “Anatomy of an Epidemic” and consider the scientific record described in the book. They are, at best, a short-term method of reducing symptoms while other needs are sorted out.
A look at the Soteria model or the Open Dialog model should convince a rational person that it is not only possible for so-called “schizophrenics” to recover without drugs, it’s actually easier and far more likely to happen via these methods. If such approaches are available and have been shown to be effective, why aren’t they being used? I think you know the only viable answer: the field is corrupted and is not interested in real solutions that might cost them profits and prestige and force them to look for new clients.
So it’s not as simple as you suggest. It’s not a choice between drugs and no help – it’s a choice between sticking to a failed paradigm or working hard to come up with a better way, including actually applying the knowledge we have of what DOES work to our clients.
This, of course, would be exactly what would be expected based on years of research on illicit drug use and its effect on the brain, much of which was solidly established as early as the 1980s. Why anyone would think that a doctor prescribing a substance that impacts neurotransmitters would make any difference in its long-term effects is baffling in the extreme.
An excellent question, one that I as a former provider have struggled with.
I think the first answer is to know that there is no specific answer to “treating mental illness,” because “mental illness” as it is defined doesn’t have one “answer,” since there is no requirement, assumption, or observation that says that all people with the same “diagnosis” have the same problem or require the same intervention. If you read the introduction to the DSM-IV, the authors state this very point in a very direct way.
Milton Erickson used to say that you have to reinvent therapy for each client you meet. I agree with him 100%. The biggest failure of the mental health industry is that we have not bothered to ask the client him/herself what the meaning or purpose of his/her behavior might be, or provide an opportunity for him/her to figure that out for him/herself. There is no medication/drug that can ameliorate years of abuse, for instance, nor is there one that can embolden one to quit a dead-end job, or adjust more effectively to a foreign culture (migration and urbanization are highly associated with “schizophrenia” diagnoses, for instance), or to analyze a nutritional deficiency. There is not even an effective drug to deal with sleep issues, for that matter! We’re simply barking up the wrong tree, in essence, giving someone painkillers for a bum knee without bothering to find out whether they have a bruise, arthritis, a poor exercise routine, fallen arches, or a torn ACL ligament. If we want to do a better job, step one is to recognize that each and every “diagnosis” is simply an insurance billing code that tells us essentially NOTHING about what is wrong with a person or what might help them make progress toward a happier or more effective life. And the long-term research bears this out. If you have not yet read Anatomy of an Epidemic, the book which inspired this website, read it right away. It will answer a lot of your questions as to why rejecting medication, at least over the long term, as a first line “treatment” is, in fact, an important part of the answer.
Dan, I think the point you may be missing is that, OF COURSE, if you label a bunch of people who are experiencing emotional distress for whatever reason as “mentally ill,” a somewhat disproportionate number of these will be more prone to be violent, if only because you’ve pre-selected people who are experiencing some sort of emotional distress. It’s sort of like saying “Angry people are more likely to yell than non-angry pe0ple.” It’s a meaningless correlation. Despite the subjectivity of the sampling technique, we find that, even with the distorted “statistics” the Globe “collected,” 90% of violence is still committed by people who don’t qualify for ANY of these diagnoses, even with their very soft and non-specific criteria!
Just as one example, domestic abuse permeates our society. A certain percentage of domestic abuse perpetrators are designated as “mentally ill,” but the vast majority are not. Do you really think it appropriate to lump all domestic abuse perpetrators who happen to be diagnosed with a “mental illness” in with people who are scared to leave their homes and people who are too depressed to get out of bed in the morning and people who are super active and have trouble focusing on boring activities? Or would it make more sense to address DOMESTIC ABUSE as a phenomenon, and not spend unnecessary time focusing on a variable that has a very small correlation with the larger topic, and in fact has never been shown to be a causal factor in any scientific way?
Similarly with substance abuse. Some substance abusers are considered “mentally ill,” others are not. Substance abuse is known to be highly associated with violence. Should “mentally ill” substance abusers be categorized with other “mentally ill” but non-violent people, or with other substance abusers, who share a known causal behavior that correlates with violence?
In fact, it has been reported scientifically that if you eliminate substance abuse as a risk factor, the “mentally ill” are no more violent than the general population. Maybe we should be spending more time talking about the dangers of substance abuse for ALL citizens, regardless of their “mental health” status?
The idea that “mental illness” is the cause of large swathes of violence across the USA is popular because it allows us to exercise our pre-existing stereotypes and let the larger society off the hook for creating violent circumstances. If nothing else I say is convincing, tell me why that “mental illness” prevalence is claimed to be essentially the same worldwide, but the USA has massively higher violence rates than about any other industrialized nation in the world? How can “mental illness” be the cause of all this violence, when the “mentally ill” in other countries don’t behave that way?
Time to stop scapegoating and look for the real culprits in this scenario, including domestic abuse, substance abuse, and general societal oppression, all of which not only contribute to increased levels of violence, but also contribute to higher levels of “mental health problems” that the Globe is so happy to blame.
Jack, you speak as if torture and abuse no longer happen in mental health facilities, which you can see by reading the comments here is just not true. Also, you say that “medications are reserved for the absolute hardest cases,” but that’s not true, either – they’re handed out like M&Ms in most facilities I’m aware of – in fact, it’s hardly possible to escape a psych ward or even a voluntary visit to a psychiatrist without a prescription in your hand. These pills are given out absolutely in lieu of any kind of psychosocial interventions, however inept they might end up being. I can share a number of stories of folks who were told they had a “chemical imbalance” or “needed medication” when just one good therapy session with me or another competent therapist was enough to put them on a much better pathway.
I am afraid you have a somewhat rose-colored view of what happens to most people who enter the mental health system. Few receive the kind of help they need, and many deteriorate under the “care” of the mental health professionals. I agree that most are not evil people, but they work for a dangerously ineffective and flawed system that ends up turning their good intentions to damaging interventions.
There are other options besides, prison, homeless, and forcibly treated, Jack. There are programs in several cities now that focus on getting people places to live and food without any requirement that they participate in any treatment. Not only do they get more people interested in voluntary treatment this way, the ones who don’t get ANY treatment also improve on their “symptoms” and quality of life.
The fact that someone is homeless or suffering in some way doesn’t give us the right to force our idea of “treatment” down their throats, in this case, quite literally. Please remember that these people are being forced to take drugs that make them feel awful, often prevent them from working at any kind of meaningful employment, and create conditions that lead to early deaths. It is not a trivial thing to force a person to receive “treatment” against their will. The long-term negative consequences are pretty dramatic, and as I said above, there are other options besides neglect and force.
I agree 100%. Even saying that “only 4% of violence is attributable to mental illness” is still likely a distortion. What if 4% of any health-based sample engaged in violent acts? This seems like a reasonable number, considering the frequency of violence in the USA. Would anyone ever report that “only 4% of violence is attributable to high blood pressure” or “only 4% of violence is attributable to rheumatoid arthritis?” There is an automatic assumption that any violence committed by a person with some “mental health” label is “attributable” to their “mental illness.” Wouldn’t it make more sense to suggest that violence has many causes and occurs in all cohorts, which is clearly the factual truth?
As is very common, Duncan confuses the need for protection/safety of citizens in society with the “need” for enforced “treatment” of the “mentally ill.” Certainly, there needs to be a mechanism for policing society and assuring that people don’t hurt one another. How do we jump from that to pretty arbitrarily labeling certain people “mentally ill” and forcing them to take drugs or have electricity passed through their brains against their wills? It does not follow that a person being unsafe to themselves or someone else needs to be “helped” by having their brain chemistry forcibly altered in ways that are neither understood nor predictably positive. We need as a movement to STRENUOUSLY make this point over and over again: policing our society and making sure people are not hurt by other people is a legitimate government function. Forcing people to take drugs just plain isn’t.
At least when someone is arrested, no one is trying to pretend that the inevitable trauma of the experience is intended to “help.”
The only way to identify a “serotonin deficiency” would be to determine a “normal” level of serotonin and then measure another person’s serotonin against that measure. Of course, this has never been done, and is actually impossible, because serotonin levels vary widely from day to day and moment to moment, depending on what is happening to you. You know someone has low iron because you know what a normal iron level is and you can measure their iron levels. We have no standard for normal serotonin levels, and no way to measure someone’s current levels meaningfully, so why the hell is anyone even talking about this any more?
It seems more than unfortunate that folks are overlooking that the prime motivation for this act appears to be homophobia, not “Islamic terrorism.” This guy was not acting to promote some political goal – he wasn’t a member of ISIS or acting in coordination with any group. He chose a gay bar because he was uncomfortable with “gayness” as evidenced by his statements to his father the night before, when he was deeply disturbed by seeing two men kissing.
It’s amazing how ready we are to see conspiracy in anything an Islamic person does that is violent, even when there is evidence that suggests other, clearer motivations. As for dismissing what that representative of CAIR says, that’s just rank prejudice, folks. I know dozens of Islamic people who are as sweet and loving and kind and “normal” as anyone else I know. Not one of them is promoting violent overthrow of “the West,” but they all do report being treated disrespectfully or in a discriminatory manner because of their appearance or their faith.
We can do a deeper analysis than “He is Islamic and read something about ISIS online and therefore all Islam is trying to kill us all!”
Yes, it makes me ill when they say stuff like “untreated ‘ADHD’ leads to…” without mentioning that stimulant treatment does NOTHING to improve the outcomes they’re spending time making you anxious about! I’d love to be there to ask her, “What review of the literature are you referring to when you suggest that treatment for ‘ADHD’ improves kids’ likelihood to reach their full potential? Because I’m pretty familiar with the literature and every review I’ve seen suggests that stimulant treatment makes no difference in these outcomes.” Would love to see her squirm!
I loved the article, but I do have one addition: sometimes kids “have ADHD” because they are normal kids who are being asked to do abnormal things like sit still all day doing boring, repetitive, meaningless tasks that don’t fit with their active personalities. I never acted out in school, but I still viscerally recall the agonizing, stab-a-pencil-in-my-eye, daylong, torturous boredom I suffered at the hands of the educational system. I specifically recall doing subtraction with borrowing problems for MONTHS AND MONTHS ON END in second grade, even though I’d gotten the hang of it on day one and had mastered it in probably a week or two. It was horrible and painful and miserable but I tolerated it and “acted in” with fantasy and depression. Some kids, however, simply can’t stand that, not because they’re experiencing any stress at home, but simply because the expectations were ridiculous and they lacked either the motivation or self-denying self-discipline to put up with it. Looking back on it, in many ways, those were the HEALTHIEST kids – the ones who said, “This is bullshit and I’m not putting up with it.” But they were punished and ostracized and held up as the ultimate models of “bad” behavior, and the rest of us compliant cowards were identified as “good students.”
I am sure you’ll agree with me that it’s not sick to object to a sick system!
I agree with Sera 100%, and would add that self-harm is not necessarily an act of violence at all. I’ve spoken to many, many people who self harm, especially when I worked at a crisis line, and almost to a person, they explained to me that they were not suicidal or even feeling masochistic, self-harming was simply a way of coping with overwhelming pain. They often called the crisis line because they could remain anonymous, and reported that telling their treatment providers of their actions often resulted in hospitalization, even though they had no intention of doing serious harm to their bodies. I’ve always viewed MOST “mental illness” as a person’s means of coping with a difficult reality. Our judgment of these choices to cope in ways that society at large doesn’t like is actually the source of the “stigma” you are so worried about. The only path away from “stigma” (which I also agree with Sera is really a euphemistic term for oppression and discrimination) is to accept that PEOPLE DO WHAT THEY DO BECAUSE IT MAKES SENSE TO THEM IN SOME WAY. Instead of trying to STOP someone from self-harming, why not try to understand why they feel they benefit from doing so? You will become more enlightened and less stigmatizing in moments! Same for drinking and drug use, suicidal thinking and attempts, intense activity labeled as “manic”, withdrawal labeled as “major depression” – 98% of it is coping with pain and distress caused by circumstances or the society we’re in impacting an individual in a bad way. And the other 2% actually have something wrong with them that an actual doctor can detect and treat FOR REAL once the patient gets away from the psychiatrists trying to explain that it’s all about bad brain chemistry.
It seems that while you reject psychiatry’s solutions, you’re still buying into their framing of reactions to distress as “disorders” that need to be “treated.” I hope these comments help you reconsider that maybe that framing itself is the bigger problem that leads to ineffective and destructive “treatments” in the first place.
Geez, this guy sounds both lazy and dangerous! Have you looked for someone more competent to help you? It almost sounds like there’s no place to go but up from this dimwit!
I always point out that NAMI and other anti-stigma mouthpieces are constantly saying that ‘mental illness’ (whatever THAT means) is not more common in one country than another. So if “mental illness” is the problem, why are there such a disproportionate number of these random-type shootings here in the USA? And it can’t be “untreated mental illness” either, because our “treatment” rates are among the world’s highest. (Of course, the idea that the “treatment” itself could be contributing is rarely mentioned…)
So logically, the “mental illness” explanation has no legs. But as you point out, people aren’t necessarily looking for true explanations, just convenient ones.
Research has never had much impact on religious mythology. People WANT to believe that narrative, because it lets adults and people in power off the hook for their oppressive behavior. It’s not how we treat them, it’s their BRAINS that are at fault, so I don’t have to do anything about boring, authoritarian classrooms, child abuse, or racism, because if their brains worked properly, they wouldn’t MIND being mistreated!
Not to mention the profit motive… as Upton Sinclair said, “It’s difficult to get a man to understand something when his salary depends on his not understanding it.”
Yup. That Est. As you can see, Scientologists have a longstanding grudge against Est. They view Est as having misappropriated their stuff.
I agree, Richard, that authoritarian approaches to morality are not a good bet and can be very dangerous. But it does seem to be amazingly popular in the prison system for some reason. I’m not that familiar with it, but it’s definitely a thing.
Glad they are publishing this, but it should not be news. There has never been any real data supporting effectiveness of antidepressants in youth and especially in children. The younger you are, the more useless they appear to be. Maybe it’s because the placebo effect doesn’t work as well on kids, since it looks like 80% or more of the AD’s actions are placebo effect.
Sounds like this MRT stuff is based on EST, not on Scientology. The EST founder was a disaffected Scientology adherent who modified/borrowed/stole a lot of stuff from Hubbard and gave it a different spin. It doesn’t surprise me there are similarities in the presentation, but if the founders were trained in EST, the history suggests that this similarity comes from the similarity of EST to Scientology. It does not appear to be “based on Scientology” except in a very indirect way through the EST movement.
Not that this means anything pro or con about it. I don’t give a crap what something’s based on, as long as it works. I just like things to be factual, and if you read the article, there is no evidence of any historical connection to Scientology, only to EST. So the headline was definitely misleading.
Interestingly, I tried searching Google for history of MRT and came up very empty. Whatever connection they may have to any other organization seems to be completely unavailable.
As I said above, rape, slavery, enforced psychiatry are all forms of oppression that can be parsed in many different ways. There are most definitely similarities between them, but also differences, yet they all fall under the rubric of OPPRESSION, the use of political or personal power to dominate another person and force them to do your will despite their lack of willingness and the inevitable harm to them as a result. There is intersection between all these and other forms of oppression. Slicing and dicing the semantic differences or similarities between one and another form of oppression doesn’t really forward the discussion. We can all agree that slavery, rape, and psychiatric force have a great number of overlaps and are all oppressive efforts to subdue another to one’s will, with an attendant set of justifications based on privilege and power. We don’t all have to agree with each other about which word subsumes which other word to agree that these forms of oppression have much in common and are all worthy of battling to the last breath.
We are wasting time on a sematic distinction about something we all generally agree about. I think we can all agree that enforced psychiatry (including using the force of authority and the manipulation of recipients with known misinformation) is a form of oppression that overlaps with many other forms of oppression. Whether it qualifies as “slavery” or not appears to be a contentious point that will never be resolved and distracts us from the things we do agree about. Let’s just call it OPPRESSION and have done with it. If individuals want to think of it as “slavery,” they can think that, but it’s not helping anything to keep having this discussion, which distracts from the more important point of the justification of the abuse of power by those in privileged positions to keep victims of abuse and oppression of any form in their place and quiet.
True enough. It is fortunate I work for an organization whose purpose is to help amplify kids’ voices and make sure they’re safe while in care. We can’t change the whole paradigm, but we can and do change the reality for a lot of individual kids, and also continue to pressure the system to change in the right direction for the kids they’re supposed to be helping. It is an uphill struggle, though. Good to know others are pushing in the same general direction.
Wow, Sera, I always look forward to your posts and find them valuable, but this one was incredibly powerful! I’m so sorry you had to go through such trauma, and am doubly sorry that the adults/professionals who should have seen the obvious and helped protect and validate you did the opposite, hid their heads in the sand and blamed you for your own victimization. It is appalling to hear about, but sadly is not an uncommon experience in our warped culture. I really appreciate you sharing your personal experience, and especially the tie-in to how the “mental health” system ignored and exacerbated the situation with their slavish compliance to their own model of reality and their complete lack of empathy for your situation. I unfortunately see the same thing happen all the time to the foster kids I work with – they’ve been abused at home, forcibly removed and put with people they don’t know, separated from their siblings, pets, possessions, neighbors, extended family, school friends, teachers, etc., and given little to no sense of either why it happened or how long it will continue or what they can do to regain some control. And yet when they express rage, or anxiety, or hopelessness, or are distracted or unfocused on the daily trivia of school, they are told they are “mentally ill” instead of someone saying, “Gosh, you seem really angry! I sure would be, too, if I’d been through what you’re experiencing! Help me understand what you’re angry about and let’s see if there’s anything we can think of to make it a little better for you.” It is often received by the youth as insulting and condescending when they are told, as one kid put it, “Not only am I an abused foster kid, now I’m crazy, too?” Same kid once said, “They told me I had a chemical imbalance. Well, maybe different people have different chemical balances and should be allowed to have them. Why does everyone need the same “chemical balance” in their brains?”
Blaming the victim or minimizing their experience is the most destructive and harmful thing someone could do. I am so glad you have brought this to light in such a powerful way.
This person is not providing therapy. The most basic aspect of good therapy is the ability and willingness to assist the recipient in finding his/her own narrative and ability to make decisions on his/her own behalf. Telling someone else what to do to prove they are “healthy” is no part of any sane or effective therapy. I think you would be wise to consider finding a therapist who respect you and doesn’t try to control you in the name of “therapy,” but rather helps you feel in better control of your own life.
I think the comment about “independence” was more targeted at the idea that no one should need anything from someone else or the society at large, and if they do, it suggests some failing on their part. Independence is a fine goal, but being told that TOTAL independence is the ONLY worthy goal and that ANY kind of dependence or need is a sign of pathology is quite sick. This is particularly true for children, the elderly, or disabled people in our society, who clearly can’t function without support. We do, indeed, live in a pretty cold and heartless culture when it comes to supporting those who are dependent by definition. And a lot of the childhood attachment trauma we’ve talked about results from parents who were forced to be “independent” way too early and who continue to pass on this expectation to their infants or toddlers.
I think talking about helping adults develop a sense of autonomy and agency is a very different point than what Noel is trying to get at in that sentence.
Chewable speed. Definitely something particularly disturbing about this. Some mainstream psychiatrists are disturbed, which means it must be REALLY bad!
The biggest cause is sending them to a standard school classroom. “ADHD” is basically a description of “a child who won’t be able to tolerate a standard classroom environment.”
Look at the criteria – they have to do with blurting out answers, being unwilling to wait one’s turn, failing to persist on tedious tasks – sounds a lot like “doesn’t cooperate with the teacher’s agenda.” We homeschooled or used child-focused alternative schools (even helped to create one!) and our kids thrived without any kind of medication or even any attempt by others to convince us there was something wrong with them.
The other issue is discipline. These kid have a hard time thinking ahead, and they need to learn about the consequences of acting without thought, hopefully without getting severely injured. But punishment approaches don’t seem to work well at all with them (generally don’t work great with most kids, but they seem to be particularly damaging for these kids). So we spent a lot of time making it FUN to go along with the program and BORING to act up or break the rules (and let’s be honest, the one thing these kids have in common is that they HATE being bored!)
We did try to make sure they got enough sleep and ate well – less sugar seemed to help, but sleep helped a lot more. Of course, they also hated any kind of schedule, so we had to be creative there. Setting up rituals around bedtime and being willing to spend a couple of hours getting them to sleep seemed to be the important points.
There are also nutritional conditions, like allergies, heavy metal poisoning, low iron, that can contribute. Also issues with “sensory integration” can be part of the problem, and addressing these can make things a lot easier. And of course, trauma or family conflict can create or make worse this kind of behavioral issue, so that really needs to be looked at in any case, no matter how “normal” the family seems from the outside.
That’s just a short list. I could write a book! There are tons and tons of things that can be done, including just accepting that your kids are like that and not trying to make them be too different from their natural temperaments, while helping them learn some skills for situations where some restraint is required rather than doing the first thing that comes to mind. But it takes all kinds to make a world, and while these kids will never like sitting still and doing as they are told, they’re fun, funny, creative, often athletic, and can be incredibly committed to justice and fairness or other goals or values they consider important.
Hope that’s at least a partial answer to your question. The real bottom line is that all kids are different and have their own challenges, and it’s up to the adults to help them figure out how to succeed, even if the adults find their behavior inconvenient or annoying. It’s not the kids’ job to follow our agendas – it’s our job to help them find a way to execute theirs.
They are forgetting another long-term study on human behavior: that which people make more money on with less labor or discomfort involved will be repeated more frequently, regardless of the actual effectiveness of that behavior. Thinking that docs are prescribing ADHD drugs because they actually know the research data and think it’s the right choice is naive. Most do it because it’s quick, cheap, and lets the adults off the hook for doing any hard work. Add to that the fact that some insurance companies don’t pay out for “ADHD” treatment unless you have the kid on a prescription, and you’ve got a formula for ignoring what is actually needed for the kid in favor of what improves prestige, control and income for the adults involved.
I am afraid you may be having a somewhat rosy picture of medical training, slc8. Perhaps you were fortunate to attend a more holistic school. Or perhaps their training didn’t translate into appropriate behavior in the field, but the assertions in this piece are very much what I hear when my foster youth clients are sent to a psychiatrist. They are told they are upset because their “brain chemistry” is messed up (apparently nothing to do with being abused at home and then yanked into foster care), They are told that the drugs are safe, they are NOT told about side effects, the side effects they do have are seldom attributed to the drugs and more likely attributed to “their disorder”, they are frequently diagnosed with “bipolar disorder” which is “uncovered” when they have an aggressive reaction to stimulants or antidepressants, they are told they need to take these drugs for life because there is no cure… If these things aren’t taught in medical school, they certainly ARE taught in the culture these doctors emerge into after they graduate.
The problem with identifying injustice from within is that there is always huge agreement within a profession that the standard protocols are basically sound and that bad results are anomalies and not a result of a malfunctioning paradigm. Look at a public school classroom as an example – the standard classroom has been critiqued as not meeting kids’ needs since the early 1900s, and yet it has changed remarkably little since then. Or look at obstetrics – we’re seeing 30%+ Caesarian rates nationally, and no one appears to be alarmed or wanting to do anything about it, despite the fact that the midwifery care model has as good or better outcomes with well under 15% Caesarian rates.
The status quo isn’t always functional, and the peer-review process (which you seem to recognize is warped and corrupted by capitalism) does not guarantee that the correct data is what gets published, nor does it assure that the best results actually result in changed treatment protocols. I think the critique is quite legitimate, and you might do better to seek to understand where this critique is coming from rather than being upset by its direction.
Just as a case in point, what about the increasing evidence that long-term antipsychotic use may worsen the course of “schizophrenia?” Have you ever heard that stated in your training or clinical staffings? Try bringing up the idea some time and listen to the reaction. Then you’ll have some idea of how open the medical culture in America is to data that don’t fit in with the dominant narrative of what is supposed to be “true.”
And we’re not beyond racial stereotyping either. “The Bell Curve” is not that far back in the past, and I still see people referring to it and talking about how black people supposedly have lower IQs and that’s why there is more poverty among black people. Racial/genetic “explanations” are very handy for those in power who want to explain away their acts of oppression and blame the effects on the oppressed.
No surprises here. When you have a totally subjective set of criteria for a supposed “disease” and huge financial and professional incentives for prescribing, you’re going to get a pretty big range of variation, based on both the lack of objective standards and the bell curve of variance in peoples’ integrity/corruptibility levels.
Well, it’s kinda like saying that torturing someone for months or years creates “epigenetic changes in their brain.” I would think it does! But does this suggest the torture victim’s brain is flawed, or that the torturers are evil and should be stopped? This should be a call for alleviating poverty, not for drugging its victims!
Are you freakin’ kidding me? Here they have PROOF that poverty increases the rate of depression, but instead of advocating for fighting to reduce poverty, we’re going to modify the brains of those so affected so they find poverty more amenable and tolerable in the future. THESE PEOPLE ARE TOTALLY IRRATIONAL!!!!!
I think a reporter would be AWESOME. I also think that some on-line journals may be willing to publish stuff that WaPo and NYT and their ilk would not go near. Huffington Post might be an option worth exploring – probably as close to mainstream as we can get. More radical publications like Mother Jones might be willing as well.
Thanks again for all you’ve done – you have really catalyzed a movement!
Of course, I agree. Losing connection to others is tantamount to losing our humanity. It’s never a good thing to reduce someone’s empathy for others. Leads to bad ends, like mass murder in some cases!
I think it’s because white folks, on the average, are more likely to grant that “s/he’s the doctor and must know what s/he is talking about” while black people are more likely to be suspicious of powerful white folk giving them drugs to make them more accepting of the status quo.
I appreciate your comments, and would just say that perhaps the main reason that no cause for “major depression” has been found is outlined in your summary of the situation. You state, “It is about time we start developing more refined approaches for accurately sorting out the underlying CAUSES of major depressive disorder… [emphasis added]” A true illness doesn’t have “causes”, it has one single cause and that indicates a range of treatments specifically targeted at the specific cause. If depression, as you correctly assert, can have many causes, framing it as a “disorder” simply creates confusion, as we should not be treating “depression,” but trauma, nutritional deficiencies, sleep problems, work issues, or whatever the cause or causes might be in a particular case.
So in an odd way, in disagreeing with the author, you actually are making his point for him. He’s not saying depression isn’t a problem to be addressed, he’s saying it isn’t a DISEASE STATE, even though it could in certain cases be caused by some other disease state. Just as syphyllitic psychosis is real but very different than amphetamine psychosis or spontaneously-occurring psychosis without a known cause, depression resulting from the loss of a parent is different than depression caused by a poor diet which is different than depression caused by 25 years in a dead-end job. Depression is a condition and a set of circumstances that could be caused by many different things, and is therefore NOT really a disease or illness, in my view.
True words! The psychiatric worldview removes all responsibility from the power elite for social conditions and blames anyone who is unhappy or protesting by “diagnosing” them with not supporting the status quo. Remember “Brave New World” and Soma? “A gramme is better than a damn!” Prophetic.
I think the numbing effect IS what they do. I think for some people, who are hyper-concerned with what other people think about them or whether they are measuring up to some outside standard, a small degree of numbing feels good, because they’re able to say, “Who cares what my mom thinks? I’m going to do what works for me!” But for others, numbing itself is probably very uncomfortable, and for a small but significant number, it becomes dangerous, because they no longer care about the consequences of their actions and are now willing to do things that they previously only fantasized about, like running an airplane full of passengers into a mountainside or shooting up a school or shopping mall.
Calling them “antidepressants” is, indeed, a huge fraud. Perhaps they should be called “numbing agents” so people who are taking them will know what they’re really getting into.
Or perhaps they simply shouldn’t be prescribed by doctors at all.
As a man who works in the foster care system as an advocate, I have observed that there is another factor at work. Kids who have parents who care for them are much more willing to have their parents or guardians ask questions and challenge authorities who are trying to drug kids into submission. The real problem is that the treatment staff don’t really empathize with the kids in their care. They believe they are “helping” by “calming down” kids or “helping them learn emotional regulation” or “setting appropriate boundaries” when they are, in fact, behaving oppressively. Most workers in such places (and I used to be one) have almost no training and are not required to have done their own therapy, so they’re making it up as they go and/or responding to the pre-existing “structure,” which is often a culture of disrespect and aggression toward the youth. The staff are protected at every turn – they can put hands on a youth and physically redirect them, but if the youth fights back, the youth gets in trouble for “assaulting” them and can sometimes even have criminal charges filed, while the staff have an automatic protection against any lawsuit for that kind of event. In other words, the kids have zero power and any staff person who is untrained or unhealthy enough to act out against them can pretty much get away with it unless called on it by other staff.
So in the end, while I agree 100% that the pro-nuclear-family propaganda is thick in this country and is quite harmful, the kids who have a parent or committed parent figure do have a better chance of avoiding drugging. In the 2009 GAO survey of foster youth and “medication,” they found that kids in stranger foster care had 4-5 times higher rates of drugging than the general population, but kids placed with relatives had only slightly higher rates of psych drug use. The difference, I think, is that the relatives were more likely to actually see the kids as people and to advocate against drugging them until other things have been tried. I think relatives are also more likely to tolerate annoying behavior as just being part of their personalities, whereas institutions want kids to be convenient and are willing to use any means, including drugs, to make them more manageable.
Privilege is a relative thing. I agree that large males are more likely to be assumed to be aggressive, but large BLACK males are most definitely considered more dangerous. Look at the number of shootings of unarmed people by race. Unarmed black men are shot at MUCH higher rates than white. I don’t think it’s because a bunch of overtly racist police officers are out there looking for a black guy to shoot. I think it’s because they’re more likely to GENUINELY believe their lives are in danger when the person is black, regardless of any other variables.
We should also not overlook the finding that 73% of clients were offered drugs, while only 34% were offered psychotherapy. This belies the claim that drugs are only being used on “endogenous” conditions that are not based on external circumstances, as the figures on traumatized individuals with “mental health” diagnoses show the rate to be in the 80+% range at least. It shows that drugs have become the first-line intervention regardless of the cause of a person’s distress.
I agree that the euphemism “discontinuation effects” should be called “WITHDRAWAL” because that’s exactly what it is. I would further suggest that the “poop-out effect” (an even more horrific euphemism) should also be called by its proper name: TOLERANCE. We need to clearly establish that there is NO essential difference in effect of these drugs to any other psychoactive drugs, including street drugs. Anyone with training in the area knows that cocaine, amphetamine, heroin, etc. all create TOLERANCE because they increase the presence of a particular neurotransmitter, and the brain/body reacts by DECREASING that same transmitter’s production and pruning off of receptors for that transmitter, a process long known as “neurological down-regulation” in the field. The drug becomes less effective because the brain adapts. Similarly, longer-term WITHDRAWAL effects are not just the result of the drug leaving the system – they are also caused by the fact that the brain’s down-regulated state doesn’t work well when there are normal neurotransmitter levels around. It takes the brain time to readjust, and it’s not clear if full readjustment happens if the person has been using a long time.
Why would we imagine that these same processes don’t happen just because a drug is prescribed????
Yeah, you’d think, wouldn’t you? Perhaps there is something about the training our psychiatrists and mental health professionals receive that somehow trains this compassion out of them. If you go into a field where you’re dealing with emotional distress, you ought to be the kind of person who wants to and is capable of dealing with emotional distress. It’s just common sense. Although as Tim McCarver once quoted, “They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
A “mental health professional” who has no idea what to do about trauma is a danger to his/her clients. Yet that’s what clients get at the psych ward every day. It’s what actually drove me out of the mental health field in the end – when I saw the inside of a psych ward, it was clear that no one with an ounce of empathy for the patients could allow this kind of scenario to exist or imagine for a moment that there was anything therapeutic about it.
Thanks for sharing your observations from “behind the lines!”
When I worked at the community crisis line years ago, there was always a huge surge in suicidal behavior and thinking after the holidays. Expectations almost always fell short of reality and people were reminded by too much time with their families that they weren’t a part of the Norman Rockwell image that we’re all “supposed to” experience.
We used to see “Conduct Disorder” diagnosed in foster youth for a lot of teens who acted out. There was a 95% chance anyone with a “Conduct Disorder” was black, and probably a 90% chance they were male. It’s fallen out of use because of it’s loadedness and an improving awareness of bias in the child welfare community, but there was a time in the not-too-distant past where someone would say, “He’s got a conduct disorder diagnosis” and I’d say, “Oh, you mean he’s black?” I don’t think I was ever wrong when I asked that.
Does the study control for withdrawal impacts, euphemistically known as “discontinuation effects?”
Also note that you’re quoting a single study, whereas the article is referencing a review of the literature, which as I’m sure you are aware is considered a much more accurate way of assessing the overall impact of a particular intervention, as individual studies are always prone to both bias and more random fluctuations that appear to be significant, hence the emphasis on replicability in all areas of science.
But I’m sure I’m preaching to the converted on that point, nec pas?
I was, of course, referring to psychosocial approaches when I suggested that it helps to have been through the process, and I’m assuming Gary was talking about that, too. No one should have to experience drugging, though of course it might make a psychiatrist think twice about prescribing Risperdal or denying someone’s reported side effects if he’d have to spend a couple of weeks trying not to drool and trying to conjure up complete sentences while on a solid dose of that crap.
And yet licensing has clearly provided a sense of legitimacy to a set of practices that are not actually supportable and effective, and in some cases are overtly destructive. Licensing can be good if there is an understanding of what “good care” is supposed to look like. But if we don’t even know what we’re supposed to be taking care of or what a “success” actually looks like, licensing becomes less about assuring quality and more about job protectionism and creating an illusory impression of relative competence that is not supported by actual fact and experience.
Julie, it is also very sad that in both cases, doing the actual “right thing” was not only not standard practice, but was discouraged to the point that both workers felt they were putting their jobs on the line by doing what was actually needed by their charges.
And Gary, I 100% agree with you that being human and vulnerable is often the most important aspect of being able to help – stepping away from the power relationship and just being one human talking to another about life. I was fortunate to get into the mental health field with essentially NO training (I had an MS in Education and they somehow thought this qualified me to do therapy – go figure!) and therefore never had the misconception that I knew more than the people I was helping. In fact, it was they who taught me how to do therapy, and they were awesome teachers.
This is not new news. And the conclusion is almost comical – “Clinicians should prescribe them only for patients with a clear need.” Oh, so clinicians should only risk doubling the person’s chances of death by heart attack if there is a “clear need.” What kind of “clear need” would justify this, and how with the mental health industry’s subjective “disorders” would a “clear need” ever be established?
This is very true. Freud’s genius was that he listened to his patients and believed their stories, and thereby uncovered the trauma and the scandal of widespread sexual abuse in Victorian society, a hundred years before these facts came to be generally accepted. But the reaction of his profession says all that needs to be said about psychiatry’s roots and true intentions – they did everything they could to suppress this truth, and Freud knuckled under and became the progenitor of a hundred years of further denial of the truth.
Psychiatry has never really been all that interested in the truth, at least when it has conflicted with the interests of the elite and the powerful.
“But ordinarily we do not discover the wisdom of our feelings because we do not let them complete their work…”
That sums up the real problem with the psychiatric worldview in a sentence. They have defined FEELINGS as the problem, rather than an indication of a process that needs help in unfolding. Fearing emotion means suppressing it, which is generally the exact opposite of what is needed for healing and growth.
Thank you for this beautifully written piece, Kelly!
“Mental illness” is a “mystery” for the simple reason that psychiatry is looking in the completely wrong places. The idea that knowing more about the brain will help cure “mental illness” is the central fallacy that keeps them from learning the first thing about it.
A recent article on this site mentioned that over 90% of people on the inpatient psych wards had trauma severe enough to cause PTSD in their past, vs. something like 3.5% of the general population. Yet psychiatry consistently overlooks or denies that trauma plays a central role in almost every case of “mental illness,” and spends billions looking fruitlessly for genes that will “explain” what is very obviously NOT a genetic phenomenon.
I have no hope that psychiatry will be able to change its path, nor even want to. They’re making lots of money even though they have no real idea what they’re doing. It’s not a lack of information, it’s a lack of compassion and intention to find out what they don’t know.
Being required not to talk about the truth because it might upset someone is at the very core of what makes us mentally/emotionally unwell, in my opinion. Good for you for sticking to your path and saying what needed to be said. Those being paid to help you should not be worried about being traumatized by what you say. It’s their job to be able to absorb and process that trauma, and if they can’t do so, they’re in the wrong job.
As for professionals, I was reminded of a saying: “Always remember that the Ark was built by amateurs; the Titanic was built by professionals.”
It is often considered more “scientific” to be a materialist and discount the belief in higher order events or spiritual existence. But I’ve pointed out many times that materialism is a philosophy, and as such is no more “scientific” than spiritualism or the belief in life after death. There is absolutely zero evidence to support that the mind and brain are the same thing, but it is stated as if this is so obvious that anyone who doesn’t automatically agree is a superstitious fool. At a minimum, I do think there’s plenty of evidence that the mind operates at a “software” level, being more akin to programming than wiring, even assuming a materialist jumping off point. To reduce the mind to chemical interactions in the brain is at best similar to saying a computer is just a bunch of on-off switches. It is composed of those switches, but a computer without a program is useless, and the same is true of a brain without a mind, whatever this mysterious “mind” phenomenon might be.
Maybe we should promote your oral surgeon to be in charge of the psychiatric hospital. It seems likely we’d get better results.
I have heard similar statements from others, that psych hospitalization was worse than whatever trauma they’d experienced in the past. It is hard for me to comprehend how anyone could consider that kind of intervention “therapeutic.” The pro-force movement bemoans the fact that the poor “mentally ill” are languishing in our jails instead of getting “needed treatment.” I’m kinda getting the impression they’re better off in jail, if for no other reason than they have to let you go when your sentence is over.
No one who is threatened by someone figuring out how to get better should ever be allowed to “help” someone, especially in the psychological/spiritual realm!
I think there are a lot of unfortunate parallels between obstetrics and psychiatry. Both involve “treating” people that have nothing wrong with them, both tend to rationalize and use physiological interventions on what is primarily a psycho/social/spiritual set of needs, both disciplines use interventions that have been proven useless or even harmful despite evidence to the contrary, both areas have had strong movements opposing their inappropriate practices, and both have reacted to these movements with a combination of ignoring, hostility, and co-optation. I’d love to see both disciplines disbanded and to start over from scratch.
Lots of people have given birth for millions of years with little or no intervention. While it’s true that a lot of women died in childbirth as well, and it’s certainly good to have modern surgical procedures on hand in case such becomes necessary, we are now running at a 30% + Caesarian rate in the USA, and no one in the OB field seems to bat an eyelash. It’s also worth noting that the number of deaths in childbirth radically INCREASED when hospital births were instituted on a large scale, mostly because of a complete lack of hygiene techniques. When Ignatz Semmelweiss attempted to introduce hygiene techniques, with an immediate and dramatic drop in postnatal maternal deaths, he was fired and shunned by the medical community in his time. It’s grim but educational reading and the parallels with psychiatry, again, are legion.
These are the two medical professions I know of where failure of their approach is blamed on the victims, and the bad results of “treatment” are mitigated by increasing the amount of “treatment” being used. In both cases, 90% or more of patients would be better off being cared for by someone who is less “trained” but more compassionate.
If people tend to get better over time irrespective of treatment, what’s the point of treatment? We were clearly better of before we started “treating” every time someone feels bad.
Isn’t it stunning that the nurse could not just sit down and say, “Wow, this sounds really interesting – do you mind if I join you?” Instead, they try to STOP whatever is going on.
Well said. The desire for and willingness to have human connections, even if they may be painful for you, is the center of what being able to help others is all about. The rest is window dressing. If you can’t allow yourself to feel what the client is feeling, you’re at best useless, and most likely dangerous. In fact, removing the client/helper relationship and as much as possible being just two humans communicating is what quality therapy looks like in my experience.
Exactly so. A person who has experienced traumatic events can very much be helpful to others, but ONLY if they’ve processed their own trauma and its ongoing impact on them THOROUGHLY. I had zero training in “mental health” when I started out in a teen mom’s home. The one thing I did have is a great therapy experience and a willingness to admit I didn’t know what was going on and needed the young ladies to help me understand their own behavior and inner process. So I asked questions and listened deeply, and discovered that that, and nothing else, is what was needed to assist 90% of the people there.
Self-acceptance and humility are the keys to being a good therapist. Any sense of having to defend oneself against the distress of your clients just makes you dangerous!
Subjectivity is Psychiatry’s stock in trade. You’re lucky you weren’t perceived as a black male – you’d either have Antisocial Personality Disorder or Schizophrenia. To call psych diagnosis “racist” doesn’t begin to get at how divisive and destructive it really is.
Thanks for sharing your experience – I’m going to keep my eyes open regarding African-American women in a different way now. (I’ve already observed that white women who are unhappy with their roles are mostly labeled “borderline” or “bipolar” or have “major depressive disorder).
It was commented by one of the participants, and I shared this view, that the providers who REALLY needed to be there would run a hundred miles to get away from it. I don’t think we can truly find reconciliation when the folks willing to admit to and talk about what’s really going on are marginalized and punished by the powers that be for speaking up. I think it will increase the courage of some to speak up who haven’t, but might also cause others working within the system to conclude, as I eventually did, that collaborating with the psych system is not consistent with keeping one’s on integrity intact.
I admire you for being able to continue the good fight, despite the discouraging odds. It is quite dispiriting to be “behind enemy lines” like you are, and it’s impressive you have been able to maintain your integrity despite the obvious threats to your reputation and even your employment. You are a remarkable person!
I agree – it is clearly a religion, the DSM is the Holy Text, and the Psychiatrists are the Priests of the Order. The biggest difference is that this Church allows members to be forced to “join” against their will. Which kinda makes it worse than even the worst cults around. At least most of them allow people to choose not to come in the door.
I think you missed a key requirement. Anyone allowed to provide professional assistance to others for a fee should be required to undergo their own therapeutic process to assure their own sanity and emotional availability to those coming to him/her for help. This should involve structured interaction with “service users” or “peers” who can grill them about their ability to be open-minded and safe and to avoid condescension and arrogance. They should have to be passed by a panel of mostly service users before they’re allowed to hang out a shingle.
It’s way too easy to go through the motions, or to even believe one ‘gets it’ about patient empowerment and trauma-informed care and the like. The challenge is that under stress, almost everyone reverts back to their own primitive coping measures to deal with the situation, and only those who can recognize 1) what their primitive coping measures are, 2) when they are happening, and 3) what they should be doing when such emotional reactions surface, are going to be able to be of assistance to anyone in distress.
There is no “class” for emotional health and sanity. It’s something people earn by hard work and a willingness to be brutally honest with themselves. Needless to say, the majority of “mental health professionals” today have not done this work and are therefore potentially dangerous to anyone being vulnerable around them.
I am so sorry! This is an awful story! I’m glad you at least tried acupuncture. It sounds like you need to find a doctor who specializes in getting people off of psychiatric drugs. It’s been done, but it’s not easy. Maybe there is a group of people who have been “patients” and are working on this in your area?
Wish I had more to say that might help. Good luck!
“Under-recognized?” Geez, talk about the understatement of the year! So we have 91% of the psychiatric hospital residents reporting traumatization vs. less than 5% of the general population, but their “mental illness” is caused by brain chemical imbalances and is unrelated to what happened to them. The relevance and primacy of trauma is ACTIVELY SUPPRESSED in the psychiatric community, in my observation. It is at best considered an “additional stress factor that contributes to their illness” and is often not even considered. I once evaluated a 17 year old developmentally delayed girl (maybe 6-years-old developmentally) hospitalized for aggression. She had been fine behaviorally but suddenly became withdrawn, and a year later disclosed to her mother that she’d been sexually abused, after which time she became aggressive. Her diagnosis: “Bipolar Disorder!” Apparently, the rape, which marked both the time of her initial withdrawal, and the time of her aggressive behavior emerging when disclosed, had nothing to do with her “mood swings” and aggression. Idiots! Is it possible they were really THAT stupid???
Well, Julie, OBVIOUSLY, you must have been misdiagnosed. The drugs don’t do those things to people who NEED them. If you’d REALLY been sick, you’d have killed someone for sure by now. Although aren’t most of those ones killing people TAKING the drugs at the time they started killing people? I guess they were misdiagnosed, too…
Way to get out and stay away from the trap. Too bad more people don’t know about “dangerous” folks like you who seem to magically improve once they stop being “helped” by their “treatment.”
Why, I’m just certain the Emperor is wearing clothing. Look at all those people who agree with me! While your evidence of direct observation of naked skin might be of some merit if it were verifiable, the tailors have carefully explained that this lack of visibility is due to your own personal disloyalty, not any lack of clothing on the Emperor’s part…
Thanks for hanging in there, Bob. It is a Kafkaesque world at times that we try to impact. You have done more than anyone I know to keep that boulder from rolling back down the hill.
Yes, but I think the proper SCIENTIFIC conclusion is that they do not prevent suicide. Scientific hypotheses are held to be false until proven otherwise, and the burden of proof is on those claiming there is a positive effect. This shows that there is no evidence of a positive effect over many studies, and the trend suggests it is more likely that a negative effect is present, as even in the non-significant result studies, there were still more suicides and suicidal ideation in the antidepressant arms. Hence, a rational scientist must conclude that the data does not support the hypothesis that suicide rates are decreased by antidepressant use, and for all intents and purposes, we have to conclude that there is no such effect.
Unfortunately, many scientists are not rational on this particular point. Wanting something to be true or thinking that it should be true is not relevant to science, though it appears to be quite relevant to marketing!
I’m saying that it’s valid within the timeframe that is being measured, as all people in that timeframe are being similarly impacted by these macro variables. I agree that comparing, say, 1958 to 1995.
Sounds like the UK is “catching up” with us, sadly. But perhaps it’s been caught a little sooner – it certainly sounds like the question of whether this is working or not is much more “askable” in the UK than it is over here.
My thoughts exactly. Might as well say, “People who reject being labeled and ‘othered’ by the system and insist on their own solutions have better outcomes.” 80% of stigmatization is the result of the system itself stigmatizing its clients, or making it easy for others to do so.
Or perhaps a move to a school environment more suited to their strengths and needs. We put our two intense and active boys into alternative schools that allowed them more freedom and self-direction, and even home schooled the oldest for four years. Both have become productive and functional adults without a milligram of stimulants.
Perhaps its time we stopped hammering square pegs into round holes and blaming the pegs when they are damaged?
As to the “occupational system,” the only study I’m aware of on the topic showed employers to be just as satisfied with their “ADHD” employees as they were with any other employee. As you say, they no doubt made their way into professions that are compatible with their strengths and proclivities. It is unfortunate that they don’t have that option in school, because the research suggests that if they did, they’d select classrooms where they could move around and make decisions and start and stop things when they were ready to do so, and that in such classrooms, they’d be indistinguishable from “normal” kids. That is exactly what we experienced with our own boys when put into an environment that was flexible enough to meet their needs for autonomy and stimulation.
I’ll send you a note if I’m heading to NYC, though it’s been a long, long time. I do get Upstate sometimes, as my brother and his family live in Ithaca. And my family is in Philly, a mere 90 miles away. So who knows? Let’s stay in touch!
Sorry, but the idea that “ADHD” sufferers can be identified through PET/MRI scans is not validated through the scientific literature, whatever Daniel Amen may say about it.
That being said, I very much appreciate you sharing your experience with supplementation and diet, which can make a difference for many people with this behavior pattern.
The problem is, not ALL people labeled as “ADHD” have nutritional issues or can alter their situation through nutrition. Some have very unstable home lives. Some suffered early life trauma and are highly anxious and easily triggered. Some are very smart and get bored easily because they are not being challenged in school. Some are just tactile learners – they need to move to learn and they’re doing what works for them, but the teachers won’t allow it and they get in trouble. Some have sleep issues. Some have lead or other environmental poisons on board. And some are just in need of a year or two of development before they are asked to make themselves fit into a school classroom environment. There have been a few studies now showing that delaying Kindergarten a year reduces ADHD diagnosis rates by 30% or more! Such kids don’t need nutritional counseling, they need some time to grow up. Yet others are suffering from dietary issues or sensitivities and need that kind of help.
The problem is the label and the resultant lumping together of people with disparate needs into one category based solely on their behavior. People are different and need different things and do well in different environments. Instead of pathologizing kids who don’t do well in a standard classroom, we ought to be approaching each individual case and finding out what’s going on. You’ve done this for yourself, which is admirable. But most kids never get the chance to learn what you have learned, and as I said, it will only work for a minority where nutrition is the issue.
Yes, people do act in the way described as “ADHD.” There may even be some biological reasons for this. But genetic diversity is the essence of species survival. There is nothing inherently “wrong” with “ADHD” behavior, and in fact there are some substantial benefits in the right venue. It is only labeled as a “disorder” for the convenience of the adults involved, who don’t want to go to all the trouble of getting to know the child and his/her circumstances sufficiently well to actually map out a solution to their dilemma.
I can really get where you’re coming from, and certainly don’t want to minimize the challenges of being an “ADHD” kind of person in our current world. I think where we may be getting some confusion is that the hoax referred to, and I don’t think that’s really too strong a word for it, is NOT that having the symptoms or behaviors designated as “ADHD” is not real. There are absolutely people who, whether because of their biological makeup or their experience or a combination of both, have difficulty paying attention to dull things, like to be up and about and hate sitting still, and can get frustrated and impatient when constrained to do things that don’t have an immediate reward, and so forth. Such people ABSOLUTELY do exist, and such people ABSOLUTELY do have a different set of challenges from the “average” person in the population. I have two kids who grew up with this kind of personality, and I can say with certainty that neither suffered any kind of severe trauma, though the first did have to suffer through us learning how to parent a challenging child such as he was.
The hoax, though, is in suggesting that such people 1) have something WRONG with their brains, just because they operate in a manner that is inconvenient for adults, and moreover, that 2) ALL people exhibiting these traits ALL have the SAME thing wrong with them and need the SAME “TREATMENT,” usually meaning drugs.
Now I can see from your post that you don’t believe this yourself – you clearly state the need to view such “disorders” as having multiple possible causes and solutions. But the psychiatric profession and their allies in the education field for the most part don’t agree with you. I’ve heard countless situations where education professionals or psychiatrists or family doctors explain that “you have a chemical imbalance in your brain” and that “untreated ADHD can lead to school dropout, delinquency, teen pregnancy, etc.” The latter comment I find particularly offensive, as multiple long-term studies over 50 years or so have failed to show ANY improvements in these outcomes from long-term medication use.
So again, it’s not that people don’t have this kind of behavior pattern, it’s that the psychiatric, education, and pharmaceutical industries have intentionally labeled these kids as defective and insisted on a “treatment” that makes them big bucks without actually leading to any better outcomes for the children involved, and in some cases, doing specific long-term damage to kids’ welfare in the process.
I and many other people have had “ADHD” kids and raised them without medication with excellent results. The most important thing for us was to get them out of standard school classrooms and into homeschooling or child-centered alternative schools. We were fortunate to have the resources to do that, which I understand many people don’t possess. However, this does NOT excuse the school system for continuing to hammer these “square pegs” into the round holes that are available in standard school classrooms. The “ADHD” label allows schools to get off the hook for providing the kind of environment that so-called “ADHD” students actually thrive in (which has been scientifically been shown to be an open classroom setting where they get to move around and make decisions rather than being bossed around all day).
I hope you can see the distinction. No one here (I hope) is trying to invalidate your own challenges or even your perception that stimulants were essential to your ability to navigate your life to adulthood. What we are objecting to is the pathologizing of what is in most cases simply a normal behavioral/personality variation that makes it difficult for adults to manage these kids in a herd such as teachers in public schools are required to do. It’s very understandable why teachers in particular want to believe this description of reality, as it validates their experience that these kids are difficult and provides some sense that there is an easy solution. But the long-term outcome studies prove that there IS no easy solution, and supports that each child is different, and that labeling and treating them all the same does not lead to better results.
I hope that provides some context and reduces your sense of invalidation. This is not about individual people and their struggles. It’s about the efforts of an industry to capitalize on those struggles by pathologizing normal behavior in order to make a profit and normalize social institutions (like schools) that aren’t actually working very well for these kids, and most likely for a lot of other kids who are simply better at biting their tongues and putting up with the oppressive environment they’re expected to tolerate.
This is awesome news! It sounds like a real debate, not the kind of “investigations” we get in the US congress where they only invite those who preach the party line. I find it encouraging to know that this kind of honest examination of data is going on at such a high level of government. I hope there is a plan to get this story to the media, especially if the committee recommends action to reduce long-term antidepressant prescriptions. It is a very exciting prospect!
I agree with what you say. However, I think the research studied controls for that effectively, because it’s randomly selecting people from the whole population, all of whom are affected by the variables you mention. Those variable would explain a GENERAL rise in disability rates, but the one study directly compares disability rates after receiving “treatment” and finds clearly that that variable alone leads to a fairly dramatic increase. Also, the bipolar conversion rates, especially for kids, are quite dramatic, and further support that the increase we see in disability rates is likely due to adverse reactions to the drugs rather than or in addition to other social factors.
However, stimulant treatment over the long term has NOT been shown to help kids sustain friendships OR learn information more effectively. It suppresses these “symptoms” temporarily. And you’re right, the pill often causes adults to decide that “the problem is solved” and stop doing other interventions. There was a good study in the 70s that showed kids who got stimulants received LESS academic support after getting onto the drug, mostly because the teachers felt that they were going to be OK now that they had been “treated” and were demanding less attention, regardless of whether or not they were actually learning anything.
The fact that you can share one anecdote that contradicts the author’s premise, without us even knowing the actual case details, has zero value in answering the question at hand. The author is collecting data, not anecdotes, and when that much data is assembled, it tells a story. It appears that there are some people who are made manic or even homicidal by these drugs, even if it doesn’t happen to most people. Let’s say it happens to one in 200, or one in 500 – does that not still merit concern? Should people not be informed about this? And why is the FDA, who is supposed to be sharing this information, trying to keep it under wraps? Doesn’t tha bother you at all?
As to the title of “Doctor,” remember that Doctors brought us insulin coma therapy, frontal lobotomies, thalidomide, a 20-year or longer suppression of nursing, 4-hour feeding schedules, the Juvenile Bipolar Disorder hoax, telling us not to pick up our crying little babies for fear of spoiling, lying about the addictive properties of Benzedrine, and later Valium – I could go on. Having an MD after one’s name does not prevent one from being corrupted by big money.
I was indeed fortunate to be in Portland where there is an alternative public school that allows that freedom (a survivor from the open classroom movement of the 80s) and where we were able to create a charter school of the right nature, again with support of public funds. We were also fortunate enough to be able to work complimentary shifts so that homeschooling was a possibility for us. But I object to a system where only the lucky have such options! The research I’m referring to is decades old (from the 1970s) and we should already have been designing such classrooms in every district in the country!
I honestly have no objection to people using medication if they feel it is helpful to them individually. I do, however, have an objection to folks overgeneralizing from a set of behaviors that could have a number of causes and possible solutions (including classroom expectations inappropriate for a child’s age and development) and blaming the child’s brain when the adults have a lot to do with both what is expected and what happens when those expectations go unmet. It’s just too easy for adults to blame kids for their own failure to create an effective environment. I think the “hoax” is not that such kids don’t exist, it’s that such kids all have something wrong with them and all need the same interventions, while absolving the adults involved from any responsibility for mitigating the environmental factors that make it hard for such kids to thrive in this particular society.
I acknowledge having a lot less knowledge about how best to intervene in the non-hyperactive attentionally-challenged child, but I am sure that there would be ways to help that extend beyond medical intervention. Again, I have no trouble with individuals choosing this path, but I have a BIG problem with all individuals having such struggles being lied to about “chemical imbalances” and told that stimulants are the one and only solution, especially when the long-term outcome studies I cited above show that on the average, stimulants don’t lead to better outcomes over the long haul.
Anyway, thanks for the respectful exchange. I think we can both agree that the situation is more complex than a simple pro- or anti-argument can encompass.
Right you are. And many of the “negative” studies never even get published. That’s NOT how science really works! In fact, negative studies are MORE important than positive ones, because only a negative study can give a definitive answer to a hypothetical question. Positive results continue to support our preconceptions, but science is supposed to be about reducing subjectivity, preconceptions, and “confirmation bias.” So in truth, ALL studies should be submitted, and only the consistent presence of a positive result despite many attempts to disprove or explain the phenomenon in a different way should be accepted as evidence that something is true or helpful.
I relate to your comments, Prefer, but I think they may reflect less about “ADHD” diagnosed youth and more about the oppressive and inappropriate nature of our school system. I agree 100% that kids like this are often damaged by insensitive or thoughtless teachers or administrators, but I believe that is a result of how the school system and its expectations are constructed.
We have two boys, both adults now, who were poster “ADHD” children – active, busy, intense, impulsive, often going from one task to another quickly, hated being bored, seeking stimulation always, rarely willing to “go along with the program” unless it was THEIR program. After doing our own research that supported this idea, we had them go to alternative schools with a more open-classroom focus, where they had more choices and control over their environment. The oldest we even home-schooled for four years. Neither had any medication, and both are functioning well as adults, the older (32) working two jobs, including training people to create websites and managing the administration of a busy educational business, and the younger (20) maintaining a very high academic and athletic (s0ccer) reputation at Evergreen State College.
I believe the smartest move we made was to avoid the standard public school classroom, at least through the end of elementary school. It is poison for these kids, but it doesn’t have to be this way. There is good science supporting the idea that “ADHD” kids do much better in open classrooms, and if you read my response above, you’ll see that there is no evidence that their medicated counterparts learn more or do better in the long run in any significant way.
So “ADHD” exists, in the sense that yes, there are kids like that, but that doesn’t mean that medical treatment is the answer. The research suggests that such kids should be provided with a different structure that has less ordering about and more freedom of movement and decision-making, and that they will thrive in the right environment. But the standard classroom is not the right environment for active, curious, impulsive, hard-driving kids.
I am glad my thoughts resonated with you! I am cautious about trying to speculate about situations or experiences that I have no personal knowledge of, but this felt right to me, and I’m glad it felt right to you, too. The power of social repression and denial is incredible, and it always seems to be the most sensitive and the least powerful who have to carry the pain for the privileged and the boorish masses. Pisses me off, really. I have found that getting in touch with my own anger at social injustice helps keep me going when it all seems to be too depressing to think about.
We have long had a quote from a Melissa Chen, aged 11, on our refrigerator. Melissa’s wisdom: “Just remember, no one is normal. Everyone is weird.” True words!
While your rendition of history is, for the most part, accurate, I think you are supporting a very subjective and therefore dangerous re-categorization of a behavioral/personality tendency, which of course could be described and identified in a number of people, as a “need” for medical treatment, which should be defined by something observably malfunctioning in the person’s body. You mention the possibility that a brain chemistry anomaly might be present, and yet despite decades of research, you will have to acknowledge that no such anomaly has ever been verified in most or even a large number of “ADHD” cases.
You are also not taking culture into account here. There are a wide range of expectations that we put on our 5-year-olds which are developmentally inappropriate for their age and yet are accepted as “norms” for our youth, and when kids very understandably don’t meet those “norms,” we diagnose them instead of questioning whether our expectations are inappropriate. Supporting data include that French kids are admitted to school a year later and yet still learn more than US kids by the time they reach high school. They have VERY low medication use rates compared to the US, and yet their kids don’t appear to be adversely affected. Add this data to several studies showing that delaying a year before starting Kindergarten reduces “ADHD” diagnosis rates by about a third (!) and it becomes hard to deny that inappropriate developmental expectations play a role in “ADHD.”
Consider further that in tribal cultures, where kids are allowed the freedom to roam and experiment and explore, the behavior described as “ADHD” doesn’t really present any problem whatsoever, and in fact, such kids may be valued more highly for their creativity or their willingness to take risks or their ability to stay “hyperfocused” on a task like shooting arrows or throwing things.
Finally, I am not sure if you are aware of the increasing mass of data suggesting that medication use for kids in elementary school has no significant impact on any of the outcomes that adults care about for their kids, including high school graduation rates, academic test scores, delinquency rates, teen pregnancy rates, social skill development, or self-esteem. Studies supporting this conclusion include Barclay and Cunningham’s 1978 review, Swanson’s 1993 “Review of Reviews,” the Oregon State University Medication Effectiveness Project, the Raine study in Australia, the Quebec ADHD study, a comparison of Finnish and US “ADHD” – diagnosed students, and of course the long-term outcome studies associated with the MTA study, which showed that the nationally-touted small advantage for stimulant users at 14 months had disappeared by the three-year followup study.
So all in all, the argument for “ADHD” as a discrete “disorder” requiring “treatment” with stimulant drugs is quite weak. It seems the parents who have been skeptical about this were correct – paying attention in class in the short term is less important than learning the important lessons on how to control and direct one’s own intentions, emotions and behavior, and those skills can’t be taught with a drug. They require patience, persistence, and creativity over a long period of time. There is no shortcut to raising kids.
As a parent of two boys who clearly fit the “ADHD” diagnosis, both of whom became productive and functional adult citizens without a milligram of “medication,” I can attest to the fact that some kids are different and more difficult, but parents can and will rise to the occasion given the proper training and support. And kids can and do succeed if you alter the environment and stop expecting them to behave in ways that young kids were never designed to act.
Your story reminded me a little of some of Jung’s ideas about the “shadow self” and how what we repress has power over us. I’m thinking on a more global scale – that our society represses a lot of who we are, and that folks like you and your visitor are sensitive to and able to express the repressed or “shadow” side of society and bring it to the light. But of course, most people don’t WANT to see the ‘shadow’ (that’s kind of the point, isn’t it) so YOU become the enemy instead of being able to see their own very similar internal conflict of having to repress who they are in order to “fit in” to a more and more unaccepting and restrictive social norm.
We do, indeed, live in dark times. Thanks for sharing your light with us. I am saddened (but not surprised) that you have encountered so much prejudice and resistance that you no longer want to risk sharing your reality with people you don’t know will be receptive, and I’m very glad you were willing to share it with us here.
I am afraid I can’t agree with you, because this is not about better practice, it’s about POWER, and people don’t give up their power without a fight. Not just psychiatry, but the entire medical profession is very much in the control of Big Pharma, and they see only drugs and surgery as options to improve any condition. Psychiatry is just the natural extension of this “thinking” to the realm of the mind, which is unfortunately much more subjective and more easily manipulated, because at least if you’re making billions in the cancer industry, you have to show by some test that a person you’re treating actually has cancer.
Such a change will be a revolution, and will most likely start with alternative practitioners elbowing their way into the mainstream and getting some amount of insurance dollars. But just as midwifery has much better outcomes than obstetrics and yet remains an ancillary and often resented alternative in most hospitals, alternative practitioners alone won’t take over the practice by being more effective or less dangerous. It will take a POLITICAL revolt that takes the money and power away from the current promoters of the joke of the DSM and the intentionally distorted way of looking at people as bodies to be manipulated rather than beings to engage.
Institutional change is difficult and doesn’t come from talk. It comes from elbowing the powerful out of their seats of power, or from a mass uprising of the citizenry demanding something better. I don’t see incremental change being possible with the level of corruption that exists in psychiatry and in the larger medical profession. It will require some level of a revolt.
Except that when you are in prison, you did something wrong (usually) and also have an idea of how long you’ll be there and what you need to do to make your sentence shorter. Not so for the mental ward – you’re there as long as they want to keep you (and as long as the insurance keeps paying), and they can still exert massive control over you even after you are out of there. There is no maximum sentence for “the mentally ill.”
I agree with Oldhead – let’s certify Keith Richards or ZZ Top members to be our specialists – they have more direct knowledge and less of a conflict of interest, and are more likely to keep the best interests of their clients as their focus.
New definition of “hallucination:” instead of “Seeing things that aren’t there,” it is now redefined as “Seeing things you’re not supposed to have seen and talking about it.”
Well, I have to say, this was not an argument for maintaining a limited role for psychiatry, because in my experience, psychiatry generally does absolutely none of the things you mention. Because they believe that “mental illnesses” are biological and can be “diagnosed” by behavioral checklists, they never bother to look for any actual physiological causes that might exist, like lack of sleep, low iron, thyroid problems (low or high), side effects of other drugs, nutritional deficiencies, etc. Nor do they bother to ask about psychosocial causes in most cases. A recent study of kids in residential treatment centers showed that over 80% readily disclosed childhood abuse or trauma to the total strangers who interviewed them, but something like 20% actually had this identified in their files. This suggests that in at least 60% of the cases, they didn’t bother to ask the kids about their history, or if they did, didn’t consider childhood traumatization to be relevant enough to write in the chart!
The profession is corrupt from top to bottom. While there are some “good psychiatrists” out there, I don’t see how the profession will ever garner the humility to admit it has misled us and choose another path. Perhaps a new specialty, starting from scratch, might be able to work OK, but we’ll have to do a ton of damage control on the huge mass of mythological misinformation the profession and its Big Pharma allies have already unleashed upon the public.
Sorry, but there is a huge difference between finding purpose in your life and “navel gazing!” A person who has to work a dead-end job for years on end in order to barely put food on the table and who can’t afford healthcare or any entertainment or luxuries and feels he is simply walking a treadmill every day toward the end of his meaningless life is very likely to be deeply depressed. I have certainly helped many people find reason or purpose even in negative events that have happened to them (I have worked with domestic abuse survivors, child abuse survivors, and foster kids and their parents for years), and also see that when a sense of purpose is achieved, these people feel a lot better about themselves and their lives. In fact, it is one of the ost critical aspects of good therapy, for the client to find ways to turn suffering into meaningful action. Comparing this to some sort of es0teric meditation practice (though I remind you that meditation has been shown to have positive effect not only on the psyche, but on the brain itself) feels like a distracting minimization of the potential power of human contact and relationship on depression.
Actually, I hate that term, “Overmedicating.” How about “We’re using drugs to make our toddlers less like toddlers.” Or “We are MEDICATING kids under %!” Overmedicating indicates there would be an appropriate amount of medication to give a toddler. Sorry, but drugging toddlers for behavioral control is just plain WRONG.
I know how the FDA works, and even I find this disturbing! This is not negligence or minimization, this is overt and intentional suppression of knowledge that they already have. This should be a scandal of monumental proportions. Any way to get 20/20 or 60 minutes interested? You’ve done all the research – they have their story and just have to tell it.
Thanks for all the research. This is INCREDIBLY valuable!
True enough. I read something just yesterday where they suggested that SSRIs sometimes “unmask” an underlying bipolar disorder! It’s beyond outrageous, not the least because they have no way of actually determining if someone has “an underlying bipolar disorder,” while a very simple expedient will tell them if the drug is at fault – STOP THE DRUG AND SEE IF IT GOES AWAY! I am never quite sure if it’s intellectual dishonesty or just garden variety ideological stupidity driving this kind of remark – do they REALLY not see that psychoactive drugs can have unintended psychological effects? What kind of idiots are we dealing with here?
69 consecutive days in restraints. If that’s not torture, I don’t know what is.
And when you’ve been “treating” someone for 20 years with no improvement, it’s time to admit you don’t know what the f*&k you’re doing and graciously give way to someone with a different plan of action.
Thanks for this thorough though stomach-churning report.
And the alcoholic has at least some idea that alcoholism is a possible outcome of his/her decision. Most psych drug takers have no clue what might happen to their brains as a result, and some never do figure it out.
That’s not what my therapy looked like, either what I received or how I handled clients myself. I was always about POWER – getting more power for the client, both internal and external. Some of it is obviously exploring options outside of what you’d normally consider, but a lot of it was helping understand how NORMAL it is to be upset about a life and a society where you’re constantly disempowered and at the mercy of others. Finding ways to be LESS at their mercy was the core of what I found helpful to anybody, regardless of what was bothering them. That’s what I think real therapy should be about!
It should be noted that Abilify affects serotonin levels as well as decreasing dopamine levels. Both of these could easily lead to impulsive behavior, as increasing serotonin is associated with manic behavior, and lower levels of dopamine are associated with poorer executive functioning and hence impulsive decision making.
Or in layman’s terms, randomly messing with your neurotransmitters can have unexpected and unpleasant effects!
Could not agree with you more. This is NOT a liberal/conservative issue. It is a human rights issue, and crosses all political boundaries. After all, the pharmaceutical companies aren’t particularly selective where they spread their Pharma dollars, why should we be worried which side of the political fence someone is sitting on, as long as they get what is going on?
If the placebo arm was associated with a 2.22 times greater risk of suicidal acts, they’d be all up at arms about how dangerous such an experiment was and how unethical it was to “withhold treatment” from those in need. Interesting how it is so differently interpreted when the shoe is on the other foot…
It all makes too much sense to me. I don’t know why this is not obvious to anyone trying to help. In the end, empathizing with the person who was victimized is more important than any degree or professional role a person might have. I would really suggest you try out a support group, unless the idea just freaks you out too much. I think it would really help to hear that you’re not alone, that others do the same things for similar reasons and get the same treatment from “professionals” that you did.
Wow, I am used to hearing stories of incompetence and abuse from psychiatry, but I think yours hits me harder than most, because the causes of your suffering are SO obvious and right on the surface, and yet they seem to want to blame YOU for being upset about what happened to you and coping with it the best you can! It does anger me that the victim “needs treatment” while the perpetrator appears to get away with whatever they did with no particular consequence. Who is the sick one, the one who intentionally does damage or the one who us upset by the abuse they suffered? Isn’t it NORMAL to be hurt and angry and scared after being taken advantage of and disbelieved by the people who are supposed to care for you?
It sounds like you need to talk to someone who is an expert in helping people heal from the damage of abuse. Such a person would not label you and make it seem like you have a “disease” of some sort. They would validate your pain and normalize your efforts to keep your pain at bay through whatever means you have come up with. They’d let you know that many, many people who suffer from sexual abuse in childhood use food or other more extreme means to re-establish some sense of control of their lives. And I would hope they’d give you some idea of a path to making things feel a little better so you won’t be constantly fighting off the pain. Food would be a very, very small part of the conversation, and drugs would not even come up.
If you can’t find a professional to help with this, have you considered going to a support group for others who have been through this kind of painful experience? I bet you’d find a lot of folks who found the psychiatric system unhelpful or even damaging and abusive, as you have experienced it yourself. You might also find some people who have found some ways to make it a little easier to move forward and heal. It might be worth looking into.
Bottom line, you’ve been massively disserved by the people purporting to help you. I wish there were more I could do to help myself, but I appreciate you sharing your story and giving an excellent example of exactly what I was saying above – “eating disorders,” if we must call this common coping measure something, are not about food. They’re about managing emotions. And there really is no drug for that, nor will there ever be.
Thanks for having the courage to share. I hope you’re able to find someone who can help, because there really are people out there who understand your situation and how to help. You will have to look around, because these people are very much in the minority these days, but they do exist.
I don’t disagree – I think the very concept of calling them “peer workers” frames them as less valuable and less important than the “Real Professionals” with degrees. And I have also become disillusioned with the idea that change from within the system is going to be successful, at least by itself. At the same time, I value the courageous contributions such people make, and have to also remind folks that sometimes “insiders” minds are actually changed by their interactions with people in the system who know what it’s like to be a patient/consumer/victim of their services. Such people may disconnect from the system and work on alternatives and join our movement, as we have done.
I see the concept of “peer workers” as being problematic in that there is disempowerment in the very structure that “allows” them to work in what feels like the “professionals’ realm.” And until and unless we do something about the essentially authoritarian structure of the mental health industry, that will not be changing any time soon. But I want to validate that individuals within the system can contribute to both the health of individuals and the growth of our movement. It is a very tough role to play, and it wears on you over time, as it did on me, and eventually, I think a lot of folks get to the place where they feel like you do, and I do now, that it becomes collusion when you can’t really say you’re impacting significant change within the system and people are getting hurt. But when and where that line comes is up to each individual to decide, and I will not judge anyone for trying their best to make a difference for people who have to tolerate the horrors of psychiatric hospitalization or enforced outpatient “treatment” – those folks have little enough support, and kudos to anyone having the balls to stand up to psychiatry and spit in their faces right on their own turf!
We are all needed in this movement, including dissident insiders. The Viet Nam war was brought to an end partly as a result of dissident soldiers and commanders in the army. It can make a difference.
The only way to stop psychiatry is to cut off its food supply, aka MONEY. Which also means cutting off its main supplier of money, the pharmaceutical industry. Which is very challenging in today’s neoliberal oligarchic world!
Two things come to mind. First, the kind of genome-wide associations they are looking for are so broad and so infrequent that even if they did find such an association, it would apply only to a tiny percentage of the people so diagnosed. Far from a key to understanding the larger cohort, such a finding would at the VERY best provide a possible explanation for a tiny subset of the whole. And even such an “explanation” is only an association – there is really no way to establish causality simply because of the presence of such an association, as you so clearly explain above.
More important, let’s suppose there IS an association of some sort that is found. SO WHAT? Does that give us the SLIGHTEST clue of what to do about the situation? Other than giving genetic counseling to parents whose children are affected by these genes (who would then be advised that their children had a less than one in a hundred chance of developing an eating disorder???), what would be DONE differently as a result of a positive finding for a tiny percentage of all anorexia sufferers?
On the other hand, sexual abuse, witnessing domestic abuse of a parent, and abuse in general are all associated with eating disorders. Something like 30-40% of eating disorder sufferers acknowledge having been sexually abused as children. Compare this percentage to the paltry results that the most positive spin possible could put on their figures for genetic correlation. Obviously, abuse as a child kicks genetics’ ass as a likely causal factor. And you can actually DO something about an abuse history!
So we spend billions on analyzing someone’s genetics, when the correlations have historically been very low even for PHYSICAL disorders like heart disease and cancer, and when there is basically NOTHING we can do to change the suspected genetic defects, yet we minimize or ignore the abuse history so often associated with anorexia, which is something we actually could help a person process and move through toward a healthier and happier life. Talking about misplaced priorities!
Of course, this doesn’t even talk about the cultural impact of our thin-focused culture. It is well established that non-Western countries have much lower rates of eating disorders, and that as Westernization moves in, eating disorder rates rise accordingly.
It never ceases to amaze how much money we waste studying genetics when genetics are the one thing about a person that is essentially unchangeable. Though when one reads the list of conflicts of interest, the motivation, I think, becomes clearer. They only want to find some excuse to CLAIM that eating disorders are genetic so they can market a drug to “treat” them, as well as selling expensive testing methodologies so you can find out if you “have” the dreaded Anorexia Genes. The actual needs of the clients are obviously secondary to the marketing and moneymaking festival that is anticipated by the authors, and probably by the funders as well.
Yeah, I always wondered about throwing someone into nicotine withdrawal during a depressive crisis. For all their yammering about “chemical imbalances,” they don’t appear to understand the first thing about the impact of drug withdrawal. Can’t think of a worse time to force someone to quit smoking against their will!!!
It should have been discussed, if you really want to have people providing “first aid” in this kind of situation. This would be like forgetting to mention that blood spurting from the body intermittently means an artery has been cut and immediate action must be taken. You could end up getting someone killed if you handle that situation poorly. I find it inexcusable, but not surprising.
I think it supports people’s denial systems all too well – “I’m not a crappy parent – my kid has Oppositional Defiant Disorder!” “My classroom isn’t boring – I just have a lot of “ADHD” kids for some reason – bad luck!” “I’ve always been depressed – I’m sure it has nothing to do with the sex abuse history I’ve been trying so hard to repress!”
And as you say, it lets all the professionals off the hook as well. Blame the brain and you don’t really have to do anything. Seductive, indeed!
I wonder if anyone brought up the possibility under question 1 that the person threatening suicide might be a domestic abuser. Suicide threats are a common tactic used to make a departing partner feel guilty and re-engage with the abuser. Any discussion of this question that doesn’t raise that point is, in my view, extremely irresponsible, because the answer should be VERY different than in a non-coercive ex-relationship.
The whole thing sounds like a very juvenile attempt at indoctrination. I admire you for being able to sit through it without becoming physically ill.
I have to say, as a person who worked in the system for a number of years, you are perhaps being overly simplistic about the conflict between trying to help the people IN the system vs. trying to change the system from the outside. While I admit I did not fully understand what was going on, and when I eventually found out the truth, my personal ethics would not allow me to continue to working in the system, I would have to say that the people who encountered me were VERY fortunate, because I was one person who did not buy into the system paradigm for “helping” and was always helping them think about and develop alternative approaches to just going along with the program. I helped a lot of people stay out of the hospital or avoid self-harm because they knew I cared about them as people and was not judging them or labeling them with a “disease” just because they were upset about having horrible things happen in their lives.
One of our posters here is a “peer worker” and appears to do a LOT of great work in a hospital setting, despite the adverse conditions. Another worked in a hospital for years as a counselor, and had to deal with that same ethical conflict in the best way he could. I admire the courage of such people, and applaud them for being able to tolerate “sleeping with the enemy” and bringing hope to those “behind the lines” of the psychiatric oppression that we all abhor.
So let’s not be so judgmental of those trying to make things better from inside the system. I know there are “peer workers” who believe the medical model wholeheartedly and are basically cheerleaders for the psychiatrists’ agenda. But there are others who are courageous reformers who risk their jobs and reputations every day to help people who are not out here reading MIA, but are incarcerated by the MH industry and have little to no hope or perspective on their situations.
As I like to say, “Generalizations are ALWAYS wrong!” Let’s judge people by what their actions and intentions are, rather than what role they use to try and accomplish them.
There are certainly plenty of oppressive attitudes amongst “liberals,” and some “conservatives” I have found to be quite rational. I don’t think we should make assumptions about peoples’ openness to this kind of thinking based on political affiliations or beliefs.
But I think Sera’s point is well taken – the question is not whether we should ally with such liberals as see what is going on and understand the overlap and interaction between racial, gender, and psychiatric oppression. I think she’s saying that liberals IN GENERAL should be open to making this connection (“Intersectionality” is all the rage theses days, after all) and yet a large majority appear to be unwilling to see the similarities and connections between these various forms of oppression and are all to ready to let psychiatry off the hook, and usually advocate for “more treatment” rather than looking at what the diagnostic and treatment protocols commonly practiced really DO to clients.
In the end, psychiatric oppression isn’t a liberal/conservative thing. It’s about connections and compassion for the human condition, and frankly, a small minority of Americans seem to be able to muster these for the “mentally ill” regardless of what end of the political spectrum they represent.
I do think that during the time of involuntary commitment and control, the analogy becomes closer. But there are still ways to escape psychiatry that slaves do not and did not have. John Nash is a good example. He recognized who the enemy was and kept a low profile, didn’t tell anyone what he was thinking or doing and years later “came out of” his altered state spontaneously. He managed to escape by avoiding notice, something that a slave doesn’t have as an option.
That being said, I’ve never had either experience, so I’m probably not qualified to really say.
I suppose this must be because people in intensive care units have a biological predisposition to anxiety and depression that makes it more likely they’ll be severely ill or injured leading to worsening depression/anxiety from their stressful experience.
It couldn’t be that depression/anxiety/PTSD is caused by exposure to highly stressful events… Nah…
Yeah, I hear that too, as if there were some way to distinguish objectively between “endogenous” and “reactive” depression. The whole thing starts with the error of defining “depression” as the problem, rather than an indication of other potential problems, which could be physiological, psychological, social or spiritual in nature. And of course, you’re correct, the real driving motivation behind this is to be able to assume some medical “knowledge” whose purpose is not to cure, but to control and profit from those too naive or ill-informed to understand that they’re being played. It is sooooo obvious to me at this point that it’s hard to understand why so many people are taken in by this ruse.
I very much appreciate your thoughtful reply. I find it rare that someone is able to reconsider their initial emotional reaction when faced with some rational counter-response, and in fact I would consider that ability the heart of a truly progressive attitude.
I also totally get that there are plenty of other methods and approaches that are put forward as panaceas for your “condition,” and some folks advocating for these approaches can be just as rigid and oppressive as their psychiatric counterparts. None of that is helpful, honestly. Empowerment is what heals best, even if there is something physical that is objectively malfunctioning in an individual. Empowered heart or cancer patients have been shown to do better than those treated by an authoritarian and dismissive doctor – would this not be even more critical when mental/emotional distress is involved? I have never understood why this is not obvious to many in the mental health industry.
There are also practitioners of every art and technology who are just abusive and use their approach to enable them to find victims more easily. Sounds to me like that might be what happened to you, and I can’t stress enough that in my view, you are NOT responsible in any way for that kind of reprehensible behavior from that criminal posing as a professional.
It is an unfortunate reality, again in my view, that psychiatry as a profession has co-opted many people’s desire to reduce suffering and turned it into a propaganda campaign against anyone questioning their authority. This doesn’t mean people don’t sometimes or even often do better with the assistance of certain substances. It means that the profession at the highest levels is engaged in manipulation of known facts in the service of an agenda that has little to do with helping the likes of you and me.
I strongly suggest you read Robert Whitaker’s book, “Anatomy of an Epidemic,” which was the inspiration for this site. It will, I think, explain a lot about why so many folks here are against the general concept of labeling and drugging everyone who is experiencing mental/emotional distress as a first line of “treatment,” when the evidence shows that such an approach in the collective appears to have some significant adverse consequences, even when in individual cases it may work out to a benefit. I am very hopeful you will find it eye-opening and educational.
Thanks for hanging in and reading our replies!
—- Steve
P.S. As you can see from my comments, I agree with you about the “slavery” analogy being inappropriate, and I can understand your reaction. However, I think those referring to forced psychiatric intervention as analogous to rape have a lot of evidence to back up their views.
And that two-week line was, of course, chosen after years of precise scientific research into EXACTLY when “normal” people are supposed to start feeling better after the loss of a loved one, and EVERY person who doesn’t feel better at that time is PROVEN to have a “chemical imbalance” that prevents them from just freakin’ burying Mom and getting on with their lives.
I most definitely still hear the “behavior vs. mental health” dichotomy. I’ve never been able to figure out what the hell they are talking about, since every “mental health disorder” is essentially defined solely by behavior! It’s like “situational” vs. “clinical” depression. We are always told that there is this big difference and that those with “situational depression” need therapy and support but that this won’t help “clinical” depression, yet there are not even any ham-handed, subjective DSM criteria requirements that attempt to make this distinction. Depression’s severity is solely evidenced by the clinician’s subjective assessment of the severity and duration of the “symptoms” that define the “disorder.” The question of “situational” vs. “clinical” doesn’t even come up, yet we continue to be fed this BS, meanwhile, the DSM 5 committees decide that being immobilized by the loss of a loved one for more than two weeks now qualifies us for being diagnosed as MDD!
And yes, the skew to the biological does appear to be worst here in the USA, where drug companies have a stranglehold on our government and can charge obscene prices for their questionable products.
As a person who has worked inside the system, I can tell you that the right to benefit from treatment is never at issue. It is the right to decide that one is NOT benefiting from treatment or would benefit more from another approach that is denied to clients/patients. In my view, a Liberal person, in the way you describe it, would be in a place where s/he wanted the PATIENT/CLIENT to be able to decide what their experience was and what it means, much in the way you describe wanting to have your own experience and viewpoint without having it invalidated. I absolutely grant you that right, and I think Sera has proven over many years of hard work that she respects the right of people to do whatever they need to do to take care of themselves.
The bigger issue that comes into play is the DEFINING of people’s experience as “mental illness” based on a list of
“criteria” agreed upon by a group of mostly male, mostly white, entirely middle- or upper-class American doctors (with a few psychologists tossed in here and there) who have little to no understanding as to what is or may be “wrong” (if anything) with the people they so label.
Certainly, no one here would deny the reality of suffering, and as Sera has said many times over, she fully supports the use of these drugs by anyone who finds them to be helpful (given, of course, an honest “informed consent” discussion prior to them being given out). But finding a substance helpful for your own condition is VERY different from another person defining for you both what is “wrong” with you (based on the subjective and culturally-bound process described above) AND what you HAVE TO to for your “condition,” even if you don’t want to or have tried it and found it extremely destructive. I would think that any Liberal worthy of the name would be deeply opposed to the idea that someone else gets to both define your experience and command what experience you will have in the future based on a set of culturally-bound, subjective, and frankly deeply biased criteria invented by a committee at the APA!
If, as you say, the Liberal mindset is one in which all experiences are valid, why is it so difficult for those same folks to understand that not all people have the same experience with the “mental health” system, even if some people (like you) report very positive experiences? Would you not expect that a Liberal mindset would involve acceptance that each person receiving such services would be entitled to his/her own perception and reaction to the services provided? Would s/he not be in favor of providing maximum information, choice, and empowerment for the recipients, rather than favoring the enforced intervention of the State “for the client’s own good?”
I am more inclined toward the rape analogy, where someone exerts power over another for his/her own satisfaction. Slavery involves ownership of another, which is something different than exerting inappropriate CONTROL over another under the premise of it being “for his/her own good.” It certainly qualifies as abuse of power and intentional, systematic oppression, but I think of, say, trafficked youth and the total control the “pimp” has over the child’s life, including extracting financial benefit from forced labor, and it seems there is another element of slavery that is not present in the psychiatric survivor’s situation, as horribly oppressive and abusive as I see that situation being.
I was truly disturbed when I read that “treatment resistant depression” only meant two trials of antidepressants, with NO requirement of any kind of psycho-social interventions, and NO proviso that the “depression” not be “situational” (as if there is any way to objectively determine THAT question!)
The woman was, indeed, fortunate to talk to me, but this was also back in 1992 when citizen-based crisis lines were common and had not yet been co-opted by the “mental health” profession, as many of them now have (including the one I used to work for). I am sure it is much worse now. That was a huge dilemma for me – I felt ethically compromised working within the system, and yet if I had not been there, so many people would have had a worse experience. Eventually, I could not stand it any more (after several months doing involuntary detention evaluations and finding out what REALLY happens on a psych ward!) and got into advocacy instead. But I feel so badly for anyone innocently calling in for assistance these days, because there is a 90+ chance that the first thing that will happen to them is to be labeled and sent for drugs without any further exploration of options, and ECT has become a much more “acceptable” option than it was back in the 90s.
Well, now they have invented “Binge Eating Disorder” to flesh out (ha, ha) their range of potential victi- oops, I mean CLIENTS to include the overweight as well as the underweight. Fascinatingly and frighteningly, the “treatment” is taking stimulants. We’re right back to the 1960s and Benzedrine!
And “obesity” has been classified as a medical disease. Soon to be “treated” with new drugs, probably more stimulants re-branded as “anti-0besity” drugs.
I used to work on a crisis line, and talked once to a woman who had been trying different antidepressants for over a year at the behest of her various physicians/psychiatrists. She was absolutely frantic and becoming convinced that there was something desperately wrong with her that she would not respond to this ‘treatment’ despite her doctors having ‘tried everything.’
I asked her, “Has anyone told you that there are other things you can do about depression besides antidepressants?”
Suddenly calm. “No…”
“Well there are.”
“Oh. Well, that’s good…”
And of course, she was completely open to trying out a range of suggested remedies that we were able to come up with in a 5-10 minute further conversation, and felt MUCH better by the end, if only because she’d been given some sense that SHE could do something about it instead of waiting and hoping that the “experts” would come up with a magical cure.
Seriously. An entire year had gone by “trying everything,” and no one had so much as mentioned there might be something else she could do besides trying different drugs. Idiocy, but it masquerades as “treatment-resistant depression.” Sets my teeth on edge every time I hear of it! And they wonder why there is “stigma” attached to “mental illness.” They cause it themselves by blaming the patient for their own failure to help!
Looking at the comments in the article, most people attribute the rise in suicidality to the constantly disappointing economy and the lack of hope for the future. The common person seems to understand that “chemical imbalances” don’t cause depression – crappy life and cultural situations are the most common culprit. That being said, this data certainly belies the old psychiatric saw that “antidepressants cause a decrease in the suicide rate.” More antidepressants than ever, more suicides than ever. Not saying ADs are necessarily the main or only cause, but it was interesting to note that female suicides have increased much more than male suicides, while female use of antidepressants has increased much more than male use of antidepressants. Sounds like a fertile area for further research, but I won’t hold my breath for Eli Lily to fund that kind of experiment any time soon.
“Mental illness,” being a social construct, is incapable of discriminating. But mental health professionals sure can and do discriminate with impunity!
Exactly my point! Denying the possibility of a spiritual reality does not make them “scientific,” it makes them stupid and reductionistic. I think there IS good evidence that there is such a thing as a human mind/spirit, though we have no real idea what exactly it is from a scientific viewpoint. To deny or minimize the role of the human mind/spirit in how we live is absolutely a denial of reality. Just as an example, there is a great case from Dr. Gabor Mate where a “schizophrenic” youth from the US, who had received all the usual “treatments” was taken to Africa to a shaman and came back a few months later, cured. He went to MIT and became a fully functioning member of society.
From a scientific point of view, that was an intervention that WORKED, and it should be explored whether it will work for other people. But such an idea would be ridiculed as “superstitious” or “mystical” right off the bat, because “spiritual” solutions can’t be “scientific” unless they deny the existence of the spiritual element of humanity. Totally irrational, but they’d smugly call Dr. Mate the irrational one.
If I’m going to subscribe to a mystical belief system, I at least want one that seems to work! Psychiatry’s mysticism is clothed in “scientific” language, but is indeed just as superstitious as belief in the shaman, and in at least one case, has been proven a lot less helpful.
Richard, I think the key word here is “believe.” When we’re talking beliefs, we’re talking philosophy. Of course, there is no science possible without some underpinning of philosophy, but philosophy is not science and the assumptions and beliefs of our particular philosophy, while vitally important to be clear about in order to be scientific, remain beliefs. Beliefs also do have validity and can often have scientific support for them, but the belief that the mind is a byproduct of brain activity isn’t one of those beliefs. It’s an assumption, one that folks are entitled to make, but when I talk about “scientism,” I’m talking about turning assumptions into “facts” that can’t be disputed, because “scientists say it is so.” Any real scientist understands that even well-founded theories (like Newton’s laws of motion) which seem intuitively obvious can be disproven (i.e. by Einstein and quantum mechanics) by later experiment. To confuse assumptions with scientific facts is central to Psychiatry’s worldview. And one of their central assumptions-as-facts is the idea that we’re a collection of cells and that the mind is nothing more than the reactions of chemicals in our bodies. If that assumption is identified for what it is, the entire edifice of thought and justification for their reductionistic worldview comes crashing down.
So if we’re talking about recognizing that there is a material reality separate from our own thought processes, I think there’s some pretty good evidence that that is the case. (Though some Eastern thought may call into question the actual nature of that “material).) That’s a pretty different matter (ha, ha) than jumping to believing that the mind MUST BE an illusory artifact of the operation of the brain, and that anyone who believes otherwise is “not scientific.” There are other materialist models: for example, one might describe the mind as the “programming” and the brain as the “hardware,” which I find appealing personally, but again, it’s not something there is any objective proof of, or perhaps any objective way to even prove.
I agree, you, me and Oldhead at a pub would make a really fascinating evening’s entertainment and education! Either of you ever come t0 the Portland, OR area?
I’m with Sera. I have worked in the mental health field, including doing involuntary detentions for a very short and very painful period of time, and I can tell you, it’s oppressive as hell, even though people believe genuinely that they are helping. Consider what kind of warped thinking is required to believe that forcibly putting electricity through someone’s head against their will and inducing a grand mal seizure is “helpful.” Consider that the introduction of Benzedrine and later Valium was intended to “help” suffering housewives “adjust” to their roles in the home. Consider “conversion therapy,” still being done in some places to “help” gay people decide to be straight, even though it’s been shown to be a very destructive process. Consider how “helpful” doctors in the 1950s convinced millions and millions of women not to breastfeed their children, because the new “scientific” baby formulas were better for them.
There is no reason to assume that a system intended to “help” is not oppressive. I remember 13 years of slow torture in public school, all done “for my own good,” including the crazy second grade teacher who hit me on the head for confronting her about tossing a book across the room. When I finally graduated from high school, I felt like I’d been freed from prison! Oppressive? I think we can call it that, don’t you?
I suppose the key point is that you “believe that everything is knowable.” I am not sure if I agree with you, but whether I do or not, we’re talking philosophy here, not science. In fact, I can’t think of a way to test the hypothesis that “everything is knowable.” It’s something we either believe or don’t believe based on our observations and understanding of the world. A person could be very scientific and believe that there are unknowable things in the world. Heck, look at Heisenberg’s uncertainty principle – maybe there is proof of the “unknowability” of certain things after all!
Perhaps “mechanical materialism” is more what I’m talking about when I refer to these folks. But the real point I’m making is that materialism of whatever sort, just like idealism, is a philosophical viewpoint, not a scientific verity. There is no requirement that a person subscribe to materialist or reductionist views to be scientific, nor is the presence of that kind of philosophical viewpoint a guarantee or even a suggestion of a person being scientific.
It would be quite possible, for instance, to do scientific experiments into “ESP” to see whether it exists and if so under what circumstances. Many would think it unscientific to consider the possibility that “ESP” might exist, just on the face of it, because it would violate their reductionist philosophical assumptions.
Now I’m not saying that ESP exists or that there is valid evidence for its existence. I’m simply saying that it could be studied scientifically as a question, with one’s hypothesis being that it did or did not exist, and measurements or conditions defined that would be considered evidence of its existence or lack thereof. That would be scientific.
Psychiatry and its minions shy away from any real scientific thinking, because they already “know” that they are “right” about these things, and people who argue against them are “stigmatizing the mentally ill” or “parent-blaming” or what have you, and it sells partly because of the reverence that we have for doctors of any sort, who are viewed as “scientific” by virtue of their role. Most people unfortunately are unable or unwilling to dig beneath the surface and really look at what the basic assumptions of psychiatry are and whether they are borne out by actual experiment, while at the same time being willing to completely dismiss other possibilities without evidence because they conflict with the ‘scientific’ view purportedly being put forth by psychiatrists. It is indeed disturbing and for some simply not digestible that psychiatrists have simply made most of this shit up from a combination of greed and social bias, and have little to no shred of actual scientific evidence to support it. After all, they are DOCTORS, they must know what they’re talking about.
Doctors are the priests of “scientism” and to question them is heretical to many seemingly well-educated folks.
There is something particularly heinous to me about “treatment-resistant depression.” First off, “depression” can’t resist anything. Second, “treatment” is very narrowly defined as drugs. Third, and I think most importantly, failure to help someone with one’s standard approach does NOT mean that the subject is “resistant.” It means your treatment DID NOT WORK! These should be regarded as “treatment failures,” but somehow the recipient, nay, not even the recipient is so empowered, the DEPRESSION resisted and refused to respond to the treatment as expected! That dastardly “disease” is responsible for our product not working – it can’t be that we are just doing the wrong thing!
What would you think of a garage mechanic who said that your engine failed to work because it had “repair-resistant fuel injectors,” but to come back once a month for a three-hundred dollar “treatment” to minimize the “symptoms?” I think you’d look for a new mechanic.
What’s wrong with just admitting that your plan didn’t work?
I really agree. I think this is really about class and privilege in a way that is too painful for those having such privilege to recognize, at least until it happens to them personally. By which point, it may be too late.
MANY of those forced into the criminal justice system are criminals, perhaps even most. But that doesn’t mean the system isn’t biased. Since the advent of DNA evidence, it has been discovered that huge percentages of death row inmates are innocent, causing the Illinois governor to declare a stop to all executions until the cases were reviewed. Look at the case of Hurricane Carter if you doubt that this can happen. Additionally, you are apparently forgetting that lots of criminals DON’T go to jail, and that a lot of that particular cohort are white and well off and get away with horrific crimes without penalty. How many fraud cases were filed in the wake of the 2008 financial disaster? If it wasn’t zero, it wasn’t far from it, despite evidence of widespread fraud that cost more money than ten thousand AM/PM holdups. This is also injustice and bias.
And as Sera has said, the “mental health” system is by no means an “equal opportunity” oppressor. Women and darker-skinned people have been shown to receive more and more serious diagnoses and often more serious and dangerous treatments, from large swathes of women getting “ECT” in nursing homes to the hugely disproportionate diagnosis of “schizophrenia” in African-American males. It’s not a “leftist platform” – there are hard data out there showing that this is the actual truth.
I agree and was by no means suggesting that a non-materialist viewpoint was needed to counter psychiatry’s ill-founded philosophical bases. I was merely commenting that people get “scientific” and “materialist” confused all the time, and the most materialist folks are quite intolerant of any kind of ambiguity or mystery, whereas a REAL scientist knows that mystery surrounds him/her at every turn of the road, and that the best scientific “knowledge” is merely an intellectual model to predict the behavior of a complex and highly mysterious reality into which we have only the opportunity to take an occasional glimpse. Newton himself said something along the lines of that all his knowledge was like a handful of sand out of a beach that reached as far as he could see in both directions. That’s a true scientific viewpoint.
The good news is, psychiatry’s own research disproves its own theoretical underpinnings at every turn, as Bob Whitaker has so aptly pointed out. The bad news is, most people are so scientifically illiterate and so married to the infallibility of the medical profession that even good data is not sufficient to convince them that the psychiatrists have their heads up their butts. I mean, who can take a book seriously that has something called “Intermittent Explosive Disorder” or “Oppositional Defiant DIsorder” or “Disorder of Written Expression” as proposed “disease states?” It is absurd on the face of it, but folks simply assume that, as a colleague once put it, “there are years and years of solid scientific research behind” the DSM and are unwilling or unable to listen when I describe the actual conditions under which such “disorders” are invented.
Sigh… It is hard to be an actual scientist in a world where pseudoscience is hailed as the height of technological brilliance.
Yeah, I especially hate that “when left untreated” crap, when the literature shows that stimulant “treatment” does essentially ZERO to improve any of the major outcomes that people care most about, including educational test scores, high school graduation, college enrollment, teen pregnancy, delinquency, social skills or even self esteem. It’s just a song they’ve been taught to sing, but they’ve never actually listened to the lyrics and tried to figure out if they made sense or not.
“We need to work hard to avoid stigmatizing those poor disabled folks whom we posit to be biologically different from us and from whom we want to make sure to distance ourselves with dismissive labels and speculative and self-serving theories of their biological deficiencies.”
The whole “anti-stigma” campaign crap is more stigmatizing than leaving things alone. It is condescending at the minimum and postulates “otherness” while claiming to preach “acceptance” of the otherness it puts forth as fact.
I think you may have something there. To not believe in psychiatry’s view apparently means being “superstitious” or “mystical,” which for many educated folks is almost the worst thing you could say about them. I’ve had many a discussion about the nature of the mind, and have often pointed out that it is no more mystical to insist that the mind is generated by the brain than to insist that it is an external entity occupying the body, as neither of these positions has the slightest degree of scientific evidence to support it. But I am accused of being unscientific for saying so. Apparently, accepting the philosophical doctrine of materialism seems to be a requirement for being considered “scientific” or “rational,” and the mind “must” be generated by the brain, because “where else could it come from?”
I agree 100%. And I like how you include “misunderstandings,” because a lot of harm comes from parents simply not getting where their kids are coming from, and the kids not having the words to describe what is happening, or being too worried about their parents’ reactions to tell them. That’s why MOST of us need therapy, even if our parents (like mine) were not overtly abusive the vast majority of the time. It is not “blaming” to correctly assign responsibility where it belongs, and if done respectfully, it can lead to healing for all parties involved.
I think the right’s support is more straightforward – they tend to be suspicious of any kind of government intervention into private lives, and arresting people for being “weird” and forcing them to accept “treatment” from the “nanny state” would be abhorrent to the more libertarian folks on the right. That being said, when a mass murder occurs and gun control is threatened, the Right is very willing to throw the “mentally ill” under the bus, and the Left is all too willing to join them.
I do understand what you’re saying. “Peer” implies a lower status – you’re not a REAL professional like the doctors or the psychologists or therapists. It’s condescending from the word “GO.”
I have to disagree with you, Jack. I don’t think that most people know that violence is a risk from antidepressants, because the mainstream medical profession has done all they could to dismiss or minimize this risk. I have worked with lots of people who received antidepressants as part of their treatment plan, and can honestly say I haven’t met one yet who was told, “Let me know if you start having any violent fantasies or feel agitated, because that is a side effect of the drug.” (You do hear some being warned about suicide, finally, but that was a long time coming as well, and is still not done in the majority of cases, in my experience.) And when I have brought this up in my role as an advocate for kids in the foster care system, more often than not, I’ve been met with the message that I’m being an alarmist, or that it’s “the disease” causing the violence, or that the new diagnosis explains these behaviors.
I agree with you that taking antidepressants doesn’t automatically make everyone or even most people violent. But for a small segment of those taking antidepressants, they feel disconnected from other people and seem to sometimes find violent things acceptable that would normally seem horrible, as the author so eloquently points out. There are many, many more people who experience a less severe version of the same thing, who find it hard to relax or connect with things they used to like, who report feeling agitated and “crazy” as a result of these drugs, and who become moody and rude in ways that are not congruent with their historical behavior.
The situation is complicated, but I think there is plenty of evidence that in the absence of antidepressants, many people who have engaged in violent acts would not have done so. That makes antidepressants partly responsible for what happened.
Look at the latest info on the Germanwings air crash. Recent documents from his psychiatrist indicate that the pilot specifically told the psychiatrist that the drugs were “making him crazy” and he was worried what he might do. The psychiatrist did nothing to reduce his medication or change it, or apparently even advise him not to fly an airplane until she could look into it further. There was no question in my mind from the moment I heard about that crash that antidepressants were involved, and I was proven 100% right. It is a very real pattern and should be faced up to, not palmed off with the idea that “violence has always been around” or “most people don’t have that reaction.” People are being killed that might yet live if we confronted this problem head on. But the psychiatric profession is more interested in suppressing this information so they can continue with business as usual.
This is indeed a thorny issue. I have always found myself well to the left of most “liberals” on a lot of issues, but for some reason, this issue of psychiatric oppression seems to resonate a lot more with people on the right. I am not sure I can answer your question on why, but it most definitely seems that the mainstream left has bought into the notion that it is politically incorrect to challenge the mainstream psychiatric view of mental distress as a biological disease.
Perhaps there are too many users of psychiatric services in the liberal camp, or perhaps the idea of challenging doctors’ supremacy as Arbiters of Truth is too much of a challenge for folks who are still benefiting from the current system. Perhaps recognizing the oppression of psychiatry means looking deeper into our own complicity in the economic oppression of others around the world. Or maybe the idea that social conditions are the main causal factor for “mental illness” is just too depressing to be accepted.
I suppose the other possibility is that the mainstream media has specifically targeted this group of people, by which I mean the middle- and upper-class liberals, with their “anti-stigma” messages and it’s had a powerful effect. It might be easier for someone personally victimized by general economic oppression to “get” how psychiatry fits into the oppressive picture.
It is an odd situation, though. The people coming out to defend Justina Pelletier, for example, were almost entirely conservative columnists and activists. It’s definitely a thing. You’ve inspired me to start asking some people I know to help me understand why they don’t get this particular form of oppression and how it intersects with all the ones they appear to care about.
Yeah, I agree about the website – no one should be allowed to make money by stoking people’s desire for murder and mayhem! I just thought, given the comments of that one young lady, that it might be a good place to contact folks who have been through what you have. It did occur to me that the owner of the website might not want to ‘cure’ anyone of their obsession with violent and degrading images – bad for business!
Anyway, it really does add credibility to the idea that disconnection from emotion is how SSRIs “work”. I can easily see that if someone is worried all the time about how other people feel or what others think of them might find the idea of caring less about others to be quite beneficial and positive. Unfortunately, disconnecting from emotions means disconnecting from our humanity, a point which psychiatry seems to be unable to fully grasp. So folks who already have some violent fantasies but were restrained by the fear of consequences or of what someone else would think or say if they did it may suddenly be unencumbered by such scruples and end up doing things they’d never actually do without the “help” of their antidepressants.
I think, if I am not off base here, that the implicit question in Oldhead’s comments is whether “recovery” is construed to mean whatever the client thinks it means, and if they are supported in pursuing their goals and preferences in whatever way makes sense to them, or if “recovery” means following the treatment plan you have been given and staying “on your meds” and not causing unnecessary trouble for the authorities. “Peers” have often been coopted into the role of helping explain to clients/patients/victims of the system why the system is right and why they should follow the doctors’ orders even if they don’t want to. In other words, are the clients TRULY empowered and are the “peers” TRULY empowered to do what makes the most sense from the client’s viewpoint? Or are the “peers” simply agents of the medicalized system helping enforce social norms and ensure compliance with directions from the authorities in charge?
Great article. I agree 100% that the effect of antidepressants appears to often be to have a person feel LESS rather than feeling good. And I have long believed that the increase in violence and suicide by some people on SSRIs is a result of a lack of concern or awareness of consequences that the drugs themselves induce.
Thanks for writing this courageous narrative – I hope it is read by many readers who are having similar experiences. Perhaps you can post it on the Ogrish website?
Oh, but that would mean we’d have to DO something about lead poisoning, and that would require time and energy and money and might also require us to take a look at who is getting poisoned and confront the ugly economics and racial politics behind these realities. Just much more convenient to blame the kids’ brains. That way, no one gets hurt (well, no one in POWER gets hurt), people make money and the problem sometimes goes away, at least temporarily. Best of all, if the “treatment” doesn’t work, instead of admitting that you are not helping, you can say he has “treatment resistant ADHD” and avoid all responsibility while still making buku bucks. What a deal, eh?
I call that “Scientism” vs. actual science. “Scientism” involves the belief that certain super smart people do “science” that determines “what is true” and that all the rest of us have to do is listen to these smart experts in lab coats and we can be considered smart by association. It is a very authoritarian religion that punishes blasphemy severely by excommunication and/or shunning. Real scientists are, of course, considered a great danger to “Scientism” because they threaten to expose the flimsy assumptions on which it is based. Psychiatry is all about “Scientism” and condemns any real scientist who questions their dogma as heretics.
Actually, a lot of abuse victims don’t become abusive as adults, and are in fact dedicated to not repeat what was done to them. That being said, you are right that many abusers were abused themselves as kids. What is unfortunate is that as our society as a whole looks the other way or minimizes the impact of abuse, it makes it more likely for abuse victims to turn to abuse as a way of coping with their history of pain, because awareness and acceptance of that pain seems to be critical to healing from the damage.
But I do want it to be clear that this is not the only choice, and many abuse victims make a different choice for themselves. Some of them have been among the most caring and loving people I’ve ever met, because they KNOW what it’s like to be a kid and not be heard or respected, and do their damnedest to make sure they never put their own kids in such a situation.
I agree with what you say, Wayne, but I have to say that I’ve heard a lot more about how early childhood trauma damages the brain, and a lot less about research by Bruce Perry and others showing that RELATIONSHIPS WITH HEALTHY ADULTS are the best way to heal a traumatized brain. I’ve even heard the neurological damage done by early childhood trauma used as an excuse for why drugs are needed, because after all, these kids’ brains are damaged, what else can you do?
Unfortunately, almost any research can be turned on its ear to serve the needs of those making up the rules. TIC is no exception. I really do think it’s a vitally important movement, but cooptation is a danger that is always looming.
Too true. Psychiatry and the “mental health” industry often colludes with abusive, neglectful or just plain unaware parents to exacerbate the damage already done. This has been talked about long ago in family therapy circles, casting blame on the “identified patient” and letting the rest of the family off the hook, but that’s exactly what the DSM and the current model does to kids who have been abused or harmed by their parents or other adults in their lives.
I agree, a lot of the professional response to the ACEs research is “we need to do more self-care so we don’t get burned out.” It seems that most miss the point regarding stopping oppressive practices, including those oppressive practices we use to “help” our clients that end up traumatizing them yet further. As for looking “upstream” and ending oppressive practices across society, it’s not even on anyone’s radar.
As many projects, it has become another way to get grant funding, rather than an effort to transform how we do our work. Of course, to REALLY apply “trauma informed care,” the first thing you’d have to do is toss the DSM and stop “diagnosing” people who are reacting to trauma. And we all know how likely THAT is to happen any time soon.
As Upton Sinclair once said, “It is hard to get people to understand something when their salary depends on their not understanding it.”
Of course, the real mistake is taking a phenomenon and labeling it “schizophrenia” and deciding that all such phenomena are caused by the same thing without any evidence to suggest that is true. I like to use the analogy of a rash. What a confusion we’d be in if we decided that all rashes have a common cause and must have a common solution! All we could do would be to try out drugs that suppress skin irritation, and in cases where it didn’t work or wore off, call it a “treatment-resistant rash.”
Rashes, like most conditions, can be caused by a lot of different things, ranging from poison ivy, which will go away on its own without any treatment at all, to syphillis, which will eventually kill you after driving you crazy by eating away your brain function bit by bit. It sure would be good to know which of these you have before starting any treatment approach!
So parents sometimes contribute to their child’s mental stress and deterioration (actually, quite frequently), but sometimes it has nothing to do with parents at all. Why we’d expect all cases of some arbitrary selection of “symptoms” voted on by a committee of biased middle-class mostly white men to all or even most have the same cause is beyond my comprehension.
I agree, people who aren’t easily cowed or who are very sensitive to hypocrisy and injustice are the most likely to display “symptoms” and to be psychiatrized into submission. Those who “See the man behind the curtain” are the most dangerous to our society’s ruling elite, who are, as you say, VERY insecure about their positions of power!
I think it is also important to note that most parents who do harm to their kids don’t actually realize they are doing harm (though there are certainly a minority who do realize it and get some perverse satisfaction out of it). Most parents err by reproducing what was done to them or by following misguided professional advice that does damage to their kids. There are also sometimes personality mis-fits between parent and child that cause conflict or stress that can’t really be called abuse, but is still very painful for the child, often in ways s/he is unable to articulate.
That being said, while parents are the most likely source of traumatization, there are still plenty of folks who can’t point to poor parenting as a causal factor. Our society at large adds a whole raft of additional stressors, such as attending school or daycare away from parents before being ready, needing to “get a job” to survive when not enough jobs are available or jobs don’t pay enough to live on, being part of an economy based on oppression of other people, and so on. It is somewhat short sighted to limit to specific individual traumatic events as a potential cause of mental/emotional distress, as there are broad social causes and cumulative impacts that can lead to the same “symptoms” via another path.
Finally, I agree that blaming parents is very different from identifying their potential contributions to a person’s mental/emotional welfare. The first is dismissive and judgmental, while the second can be quite empowering (though painful) if done effectively. And denying such effects for the comfort of the parents or other adults is simply compounding the injuries done to the child. The kindest thing that can be done for injuries of this sort is for the parent to acknowledge the possibility that they may have done harm and listen to the viewpoint of the person who is suffering. Unfortunately, that is the exact opposite of what our current system encourages adults to do.
That’s what I’ve said many times! Why does a person’s need for protection automatically translate into giving doctors the right to do whatever they want to you in the name of “protection?” Protection is pretty simple – keep away the poisons and sharp objects and don’t let the person attack someone else. Why that leads to the assumption that you need drugs or electricity through your brain to “help” you with your “mental illness” is way beyond rational. If you feel the need to protect someone, protect them. Don’t attack them further in the name of protection!!!
You are right, both the authors and the NIMH have ignored that physiological input and experience massively impacts behavior. For example, low iron levels and sleep problems are both associated with “ADHD” symptoms and are rarely ever considered by a physician diagnosing “ADHD”. As the author aptly points out, the diagnosis provides an label that lets the adults off the hook for trying to find a more explanatory and resolvable hypothesis of what is going on, whether it’s in the physiological or psychological or social realm.
That was a very moving and horrifying story! It seems completely wrong that the psychiatrist has the ability to manipulate the facts and have his/her opinion prevail without any objective discharge criteria. Whatever happened to the “danger to self or others” standard? You clearly didn’t pose a danger to anyone. Without that standard, anyone could be held for any length of time for any reason. Talk about a Kangeroo Court!
Thanks for sharing your story, and I hope you’re able to escape from their scrutiny soon.
Wow, this is an amazing story! Wish I’d been able to witness it first hand. It is kind of amazing that any doctor prescribing this could claim they had NEVER seen such a reaction when we know how frequently it occurs! I immediately thought of that famous Upton Sinclair quote: “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”
This should not surprise anyone. It sounds like neurological down-regulation of dopamine receptors, which Peter Breggin was talking about back in the early 1990s, and which has been known to happen from substance abuse research long before that. It is the mechanism by which we develop tolerance and also long-term withdrawal syndromes that last beyond when the drugs leave your system. Of course, no one making money off this kind of venture wants these dots to be connected, but there is nothing new about this revelation.
Could not agree with you more. I’d also add that culture appears to exert a great influence on how psychotic experiences play out. In cultures where voice hearing is accepted, the voices themselves tend to be much more positive and supportive, whereas in cultures (like ours) where voice hearing is denigrated, the voices appear to be more hostile and menacing. This certainly supports the idea that voice-hearing is a very culturally-bound phenomenon and that how it is viewed dramatically affects the experience of the person having these phenomena. Is this true of any other “disease?” Does diabetes or heart disease present differently depending on a culture’s acceptance of it?
The idea that psychotic experiences are always a direct consequence of some kind of malfunction is nonsense. While there can be physiological causes (such as lack of sleep or some of the wonderful drugs given to supposedly combat it), viewing it as a coping measure that any of us could potentially adopt is both more accurate and more helpful to anyone having such experiences than blaming their brains.
Even if your 3x claim is true (even the most optimistic reviews I have seen only claim a doubling of the risk), that still leaves an extremely large group of people sharing the exact same or very similar genes who don’t develop the same condition. And the association with trauma is the same or higher than 3x.
“Researchers at the University of Liverpool have found that children who have experienced severe trauma are three times as likely to develop schizophrenia in later life.”
So a strict biological causality argument is pretty well dead in the water at this late date. Genetic vulnerability is still a viable position to take, but there is oodles of research now showing that trauma, as well as other psychosocial issues such as immigration/emigration and racism, contribute at least as much and probably a whole lot more to the development of psychosis than any genetic pattern ever studied.
I can’t agree with you when you say schizophrenia is “strongly associated” with over 100 genes. First off, being associated with 100 genes, some of which are present in some cases and some in another, is a pretty weak way to demonstrate genetic causality. Secondly, the strongest correlation I’ve ever seen is about 15%, but that was for a range of “mental health” conditions including depression, bipolar, schizophrenia, and ADHD, and despite the large number of markers they considered and the wide range of “diseases” they included, they still got only a 15% correlation. Whereas correlations between schizophrenia and childhood trauma range in the 80%+ range, and are especially high for childhood sexual abuse.
No one is saying that genes and/or biological processes don’t play a part in any form of mental/emotional distress. What I think the author IS saying is that the idea that depression (or any other “mental disorder”) can be categorized as a biologically-caused “disease” in all or most cases is absolutely not scientifically supportable.
It is also interesting that you claim that no one seriously promotes the idea of chemical imbalances who is familiar with the literature. Well, there must be a lot of docs out there who are not, because this language is used very, very commonly all across the country. Some docs have even admitted during radio interviews that they know it’s not true, but that it provides a “useful metaphor” (as one of them put it) that helps convince people to consider taking medication. So the idea that this is some urban myth that educated professionals don’t really use is not true, in my observation.
I’d strongly encourage you to read “Anatomy of an Epidemic,” the book which inspired this website, as a means of understanding better where folks are coming from. This effort is not from ignorance of the literature – it is actually based on a thorough review of the literature from a very different point of view, namely looking at long-term outcomes vs. short-term symptom management. You may find it an eye opener.
First off, yes, psychiatric diagnoses are just names for manifestations of humans struggling with some aspect of existence. It’s not that there can’t be biological causes in some cases (sleep, diet, exercise, other medical or recreational drugs, and toxins all can play a role in a person’s distress). It’s that lumping ALL cases of depression together and seeking a biological explanation and/or “cure” for ALL such cases is just raw scientific nonsense. People are depressed, anxious, angry, delusional, etc. for a wide variety of reasons, and simply slapping a label on a person and giving them drugs to “make it go away” is the most primitive approach imaginable.
As to the question of why she is suffering so much, it is my belief and always has been that the only person who knows the answer is her. There are a lot of shabby therapists out there who don’t know what they are doing, but finding a really good one can be hugely beneficial in helping sort out what is going on and why. It is also important to remember that specific trauma are not always the cause of these manifestations – there can also be accumulation of stress over time from negative environments, such as living in a rough neighborhood, being exposed to bullying or more specific oppression due to weight, skin color, sexuality, social preferences or whatever else, or such as having to go to a school that forces you to engage in spiritually deadening experiences under uncaring teachers for years (this was a big contributor to my own issues). It is also possible that you or other family members may have been inadvertently doing things that were perceived as hurtful or stress-inducing without knowing it, because kids don’t always tell you what is going on, especially the very sensitive ones who don’t want to hurt your feelings.
In other words, it is a very, very complex question why someone feels anxious or depressed, and someone outside simply can’t figure it out without some direct help from the person in question. And in the end, that person is much better off if someone helps him/her to find his/her own solutions rather than imposing our idea of “help” on an unwilling or unwitting participant.
It sounds like she is finding her voice. That is the first step toward empowerment. Encourage her to respect her inner voice and keep looking for a person or process that helps. Ones that have helped me are hiking/biking/athletics, playing piano, meditation, reading self-help books, and talking to a quality therapist, who helped me challenge myself to do things I used to be afraid to do like telling someone off for being rude or sticking up for myself when I feel I’m being taken advantage of. These things may or may not work for her – she has to find her own path and her own options. But thinking about what she can DO about it is a lot more productive than trying to blunt her emotions with drugs.
It is shocking to realize that these diagnoses are actually made up by committees and have virtually no research basis, but that is the reality we face. It’s better to recognize that “the emperor has no clothes” and that she has to find her own way than to continue to delude ourselves that these people know something we don’t. She has to become the expert on helping herself, and on finding other people or activities that she sees as helpful. No one else can do it for her.
I have no problems with using drugs to function. I do have a problem with posing that kind of solution as a medical treatment. Lots of people smoke dope or head down to the bar for a few brewskis after work as a means of improving their functioning. I don’t think they are receiving medical treatment, even if their “dosage” of beer were carefully controlled.
Making ourselves feel better through substance use is as old as humanity. But it ain’t doctorin’. And pretending it is medicine is dangerous and diminishes the legitimate practice of medicine in other arenas.
I have always despised the phrase “Behavioral Health.” Behavior doesn’t have health! Individual people have health. Behavior is simply an indicator of a person’s values, priorities, fears and motivations. Defining certain behaviors as “healthy” is a purely cultural phenomenon bound to be rife with bias and power-driven value judgments. It sets my teeth on edge every time I hear it!
I most definitely appreciate your perspective and do not want to in any way invalidate your personal experience. That being said, I think it’s important to remember that brutal trauma in the form of overt abuse is far from the only causal factor in the psycho-social arena. There are many, and I’d be one of them, who view our society itself as “diseased” and peoples’ reactions to the stress and insanity of modern society to be actually very normal and understandable given the craziness of modern life. For instance, the fact that we live in isolation from each other and are constantly moving away from our extended families and support systems and have no sense of connection to community is very unhealthy, even for those from a healthy family background. Having to work at a job away from your family, doing something relatively meaningless 8-10 hours a day in order to ‘earn’ a two-week vacation in the summer is not healthy. Expecting 5-year-old children to be separated from their parents and sit in a classroom with other 5-year-olds being “taught” things that may be of no interest and expected to behave in ways that are not appropriate to expect of a 5 year old is not healthy. These things lead to distress and ultimately to “mental illness” as defined by our current psychiatric community.
There is solid research showing that people coming to the USA from another country have a wide range of varying health issues when they arrive, but within three generations, their offspring move solidly toward “American” health outcomes, including increasing diabetes and heart disease, and yes, increasing anxiety and depression.
My big problem with the mental health system today is that such psycho-social stressors are not considered a valid topic for discussion. If a child can’t sit still in a standard Kindergarten classroom, s/he is diagnosed with “ADHD” and given stimulants to “help” him/her adapt to these abnormal circumstances, instead of altering the environment to meet the needs of the child in question. Similar comments can be made regarding “depression” as an adult. Are there kids who are genetically programmed to be more active? I’m sure there are. Are there people whose psyches are more attuned to the pain and oppression inherent in modern society? Absolutely, and I am one of them. I suffer bouts of depression, and they have been fairly severe at times in the past. I have attributed these to the poor “fit” between what society expects of me and who I really am. My solution has been to live my life in a way that gives me a maximum sense of purpose, while using meditation and other means to re-center myself when I am going down the depressive tubes. And I still suffer times of depression. Yes, I do. I don’t consider that a sign that my brain doesn’t work right, but more that I am aware of many things that others are able to more effectively pretend don’t exist, and that awareness is at times exquisitely painful.
Again, that doesn’t mean your view of depression as inherent in your brain is wrong. What it means is that the psychiatric view that depression is inherent in anyone’s brain that “has depression” is not founded in science, and denies the huge impact of large-scale social forces that have been proven scientifically to induce depression in immigrant populations, as well as denying the impact of the individual severe trauma that you mention in your post. That’s what this forum is really about. Personally, I think everyone is entitled to define their problems in the way that makes sense to them, and to seek whatever solutions seem to work, including drugs if that’s part of your worldview. But that’s the exact opposite of what the “mental health” industry is doing. That industry has a vested interest in minimizing the impact of abuse, neglect, and social oppression and blaming individuals’ brains for every kind of mental/emotional distress that occurs. They do this will little to no evidence that their story is remotely true, and in contravention of good evidence that it’s a crock of hooey. Their story is only “true” because it’s been told over and over again, by people who have a vested interest in profiting from other peoples’ misery and in maintaining the current oppressive power structure that keeps us peons in our places.
And yeah, that’s a depressing outlook. But that’s what I see as the current situation. Being cheerful about it would seem irrational to me. I see depression as a message that something needs to change, and the large number of depressed people in Western countries suggest that our society is in need of radical changes. Medicating large swathes of the population because they find modern society excessively burdensome is not a real solution, even when individual people may themselves find benefit in the drug options that are offered up.
I hope that helps understand that the issues at stake here are much larger than the question of whether you or any other particular individual find antidepressants beneficial or even essential to your survival. We’re talking about a massive social mythology designed to disguise the real causes and possible solutions to the problems that plague our modern world. It is a very important issue that transcends any of our individual needs and feelings.
So owning a cat causes one to be mentally ill? Or does being mentally ill make people more likely to like cats? Very important research questions, don’t you think? Hard to believe anyone gets paid to do this kind of pointless study!
I am really hoping that this inquiry will open the door to other areas where similar damage is being done. It’s hard to miss that veterans’ issues are the direct result of being exposed to warfare and death on a daily basis. If the ineffectiveness and even dangerousness of using drugs to numb or dampen these effects in veterans is observed, it’s a short path to pointing out the same thing regarding the children, the elderly, and eventually the population in general. We should keep a close eye on this project and look for openings to expand the scope!
I agree 100%. I also found the absence of analysis of prior-life trauma to be conspicuously absent. It seems a likely hypothesis that transgenered females, fitting into two “othered” categories at once, would be more likely to be victimized in various ways by both their family members and the society at large. Ignoring this makes the research pretty meaningless, and leads to the expected, “Those poor women, they need mental health treatment to assist with their suffering!” rather than looking at why suffering might be greater in this particular population. I suppose that would require the uncomfortable admission that oppression, violence and abuse are actually quite common, an admission that would also tend to undermine the mental health system’s bottom line, and hence an admission that is not likely forthcoming in the near future.
I agree wholeheartedly. Adults often don’t give kids credit for being able to make decisions about what things mean, but they do, and often very early, and we take these beliefs and assumptions forward with them into adulthood. Often we don’t remember WHY it is that we know something to be true, we just know that it is and that our survival depends on remembering this belief. We are often trying to prevent the recurrence of a dangerous situation from our early lives and are very committed t0 a particular way of acting that we think worked at the time. Of course, each person may respond differently to the same kind of stressors, so some decide that “you have to be careful around adults” while others decide that “you have to connect with a lot of different people, because you can’t count on any one person” while others may decide that “you have to attack anyone who crosses you.” But the common thread is that they have decided these things based on their early experience, and it is very difficult to change these deeply-held certainties that once might have meant life and death to us, or at least seemed to do so at the time.
The more we recognize the NORMALCY of having behavioral and emotional defense mechanisms to fend off a difficult childhood environment, the easier it is to actually be helpful to someone who is trying to sort out what of their primitive defenses are still needed and when, vs. what they can now safely let go of as an adult who can fend for him/herself.
Yeah, but it doesn’t even work for that purpose. A certain percentage of the “doped up” are far more dangerous than they were before starting their “treatment.” But of course, it’s always easy to blame “the disease” for their outbursts of violence, rather than looking at the fact that the best “treatment” available appeared to be unable to prevent and may have caused the violent behavior psychiatry is charged with deleting out of existence.
I wrote a pretty scathing reply to the above blog. I hope others will join me in attacking his conflation of someone presenting a danger to society to someone “needing” treatment that they don’t want to be literally forced down their throats.
I find the technique of blaming the disserved, abused and angry former “patients” on misdiagnosis or poor treatment protocols particularly rich. Where is his evidence of that? Or are we supposed to take his word for it? As I’m sure he is well aware, and even documents above in his own blog, the current treatment protocols are pretty primitive and are almost always followed to the letter: interview the “patient,” get a list of current symptoms, come up with a diagnosis that justifies your intended prescription, and send them away with a drug to “reduce the symptoms of his/her disorder.” These angry patients are not the results of outside the norm doctoring – they are the results of your standard of care, and blaming them for your failures or suggesting that a few crazy outlier docs doing bad work caused millions of former “patients” to be critical of your lame efforts at peacekeeping is just plain lame.
Yeah, you’d think at least we’d hold them to the standard that their drug treatment would actually improve the condition, wouldn’t you? Yet the patient is ALWAYS blamed when the “symptoms” get worse. If you got something for a swollen knee and two weeks later the knee was still swollen and now your ankle and hip were also sore and your toenails were turning blue, would you say, “Oh, my knee disease is so bad, I need more medication!” or would you say, “Hey, this drug is making it worse! I need to stop and try something else?” But apparently common sense is not applicable to psychiatric “treatment.” I guess it interferes with profits too much!
“Documented instances and case studies suggest possible confusion between the spiritually advanced and schizophrenia patients. Clinical practice contains no clear guidelines on how to distinguish them.”
Because there is no objective way to do so, nor will there ever be! The distinction is cultural and arbitrary, and comes from lumping people together based on what annoying behavior you want them to stop doing, rather than what might actually help them move through their current crisis.
“Unfortunately, our current diagnostic schema for bipolar disorder, which is based on descriptive nomenclature rather than clearly delineated causal mechanisms, has not given rise to treatments that provide sustained, symptomatic, and functional recovery for many patients.”
Or to put it in plain English, “We have no freakin’ idea what we’re doing – stay away from us!”
They have surveyed doctors on this point, and the vast majority claim they are unaffected by company front-man visits. The data collected from those same docs completely proved the opposite. Many don’t even realize they are being corrupted!
Too true. I work in foster care and have seen how kids balloon up from taking Risperdal or Seroquel or Abilify. And then they try to put the kids on a diet, as if “poor eating habits” were the problem! The sudden increase in diabetes is very close in time to the sudden increase in atypical antipsychotic prescriptions, and to not even investigate a relationship is either stupid or sleazy. I’m sure soft drinks played a role, but we had tons of soft drinks when I was a kid, and didn’t see this kind of impact. I think the drugs are a huge causal factor.
Thanks for taking on a difficult topic directly! I have to agree that there is a spectrum of behavior and dependency and that it is not possible to categorize folks into “addicts only” and “iatrogenic dependency”, even though there are some who would fit rather clearly into one category or another.
Perhaps the meta-message of this entire discussion is that the act of labeling, and especially labeling in a pejorative way, is at the core of the problem. It’s clear that our view of “addicts” is very judgmental and negative as a society, and that this view has been reinforced and exacerbated by the medicalization of addiction treatment and intervention by requiring those who want to get paid to adhere to the DSM criteria. It is important to remember that psychiatry coopted addiction intervention after the DSM-III came out (part of the plan), and that of course, like any other psychiatric label, the result is that the people so labeled would be stigmatized. And it seems more than understandable that someone who became dependent on benzos through following their doctors’ advice would resist being so labeled.
I think the larger problem is that “addict” is just as vague and subjective a label as most any other in the DSM, and I’d like to make a pitch for not applying such a stigmatizing label to anyone. Instead, we need to look at each case and talk about b0th what behavior is happening and what is driving it, just like we would with any other of the spurious “mental illnesses” in the psychiatric Bible.
I also appreciate the call for others to be sensitive to the needs of this unique group of folks who have been victimized by their own physicians, and would advocate for very specific kinds of support for people who identify in that way. But the identification should be left up to the individual, not appended from the outside by some well-meaning professional. It seems to me that this is the core issue that affects both “addicts” and “Iatrogenically dependent” people adversely, and should be tackled head on.
There is a physiological withdrawal process from benzos that can be deadly if not handled properly, and appears by all reports to be very tricky and require careful management. That is a medical issue. But beyond this point, addiction and addiction “treatment” are no more medical than the “treatment” of “bipolar disorder” or “major depressive disorder.” The labels are invented and voted on by DSM committees in just the same way, and are just as political and just as fraught with social biases and judgments. For some reason, we as a reform movement seem to have shied away from saying this quite so bluntly about addiction issues, and I think the lack of clarity about that adds a great deal more discomfort to this discussion than needs to be there.
Anyway, thanks for the thoughtful and thought-provoking article. I feel much more educated about the distinctions between what is called “addiction” and the unintentional dependency on benzos (or opiates) caused by following doctors’ orders, an issue that wasn’t until recently on my radar. I also appreciate the commenters who have most definitely enriched the conversation and educated me even more!
Clozapine can cause a very serious blood disorder, agranulocytosis, occurring in less than 1% of patents, but possibly deadly. Other blood problems are observed in up to 10% of the population, according to Drugs.com, a very mainstream source. They identify tachycardia (racing heart) as “very common” at 25% of cases, and weight gain is also very common. More info is readily available on line. It’s generally not something that’s prescribed until you’ve tried everything else, because the side effects can be deadly.
This guy got off VERY easy for all the hundreds of lives he put in danger just so he could make more money. Still, it’s good to know someone got busted.
This should not be news. The Raine study, the Quebec ADHD study, the comparison study between Finnish and American “ADHD” kids (American kids did no better despite massively higher medication rates), and the long-term MTA study results all lead to the exact same conclusion: stimulants are essentially irrelevant in affecting any kind of long-term outcomes for kids diagnosed with “ADHD.” Of course, the starting problem is that they are lumping kids together based on behavior alone and then assuming some kind of biological cause and therefore biological solution, which is doomed to failure from the word “go.” But this data proves that they’ve got their heads up their butts. Again. Still.
I know, that one is one of my favorites for pointing out the absurd to people who believe in the DSM. That and “Intermittent Explosive Disorder.” We used to call them brats (ODD) and assholes (IED). How can anyone take a document seriously that uses such obviously contrived and meaningless “disease” titles? It’s about as much sense as saying that a kid who kicks his mother has “maternal kicking disorder.” Madness!
Why is this even a topic of dispute? It has long been proven that some kids develop psychotic symptoms from stimulants at prescribed dosages. In one study in the Canadian Journal of Psychiatry, it was over 6%. This should not be a question – the answer is YES. The real question is, why aren’t people being told this fact?
This same finding has been made in Canada and in at least one US state, and I think more than one. There should be no need for further experiments – the jury is in. Some kids get diagnosed with “ADHD” because they’re too young for school and would be totally fine if they enrolled a year later. In the Canadian study, it was over 30%. So about a third of kids “grow out” of “ADHD” with no “treatment” within a year. What would the figures be for two, three, or five years?
Perhaps this explains why we see short-term improvements in behavior with stimulants but no long-term effect? We’re essentially “treating” varied speeds of development as if it were a disease, instead of recognizing the obvious truth that kids develop at different rates, and some skills may develop earlier or later than the “sacred norm” without being in any way indicative of any kind of problem. Some kids learn to talk at 10 months, others at 20, and they still manage to develop into “normal” adults. Why wouldn’t the same apply to “attentional skills?”
The chemical structure of Ritalin is similar to both amphetamines and cocaine, so your description doesn’t surprise me.
The idea that “if you have ‘ADHD’ the pills don’t get you high” is ludicrous on so many levels! First off, how would you ever determine that when we have no actual way of figuring out who “has ADHD” and who doesn’t. And it’s long been proven (since the late 1970s) that kids not diagnosed with “ADHD” react just the same to stimulants as those who are. Bottom line, the whole idea is based on getting someone marginally high without getting them to be obviously impaired. The “high” of amphetamines at lower dosages is very much what the schools want kids on stimulants to display – narrowed focus, willingness to engage in what would normally be boring activities, lowered need for outside stimulation, reduced socialization. And kids taking stimulants at prescribed dosages also show the same signs of people taking high doses of amphetamines: increased agitation, increased aggression, anxiety/paranoia, and psychotic symptoms. How anyone can pretend that there is a distinction at this late date is beyond me.
And if exposing kids to second hand smoke is bad for them, how about bathing their brains in excess dopamine through ADHD drugs for years? Think that might have some long-term adverse effects?
It will not be “spun,” it will be ignored or suppressed, because it doesn’t fit the narrative they want to see published. If it’s brought up, it will be downplayed as a one-off situation and those citing it will be accused of cherry picking anecdotal data to make a point. The fact that this accusation would be remarkably hypocritical will be lost on most people. But unless you live in Germany or a German-speaking country, it’s unlikely you’ll even hear about this in the mainstream press.
I’ve actually heard a seemingly rational psychiatrist argue with me that trauma doesn’t cause PTSD, because not everyone reacts that way, so SOMETHING must be different (implied meaning: WRONG) with a person who develops PTSD symptoms. I was pretty stunned that a seemingly rational person would try to make that argument. I pointed out that, while their reaction might be different, they wouldn’t have had any reaction if there were no trauma, hence, I saw the trauma as the major causative factor, even if different people reacted differently to the trauma. Not much progress was made.
Commitment to medical explanations is very much like a religion. Speaking against it is heresy, no matter how much sense you’re making or how little they are making.
Note that I said “many” and not “all.” In my view (and I’ve been a therapist for many years), it’s not the therapist’s job to decide for the client what the meaning of his/her experience is. Forcing the client to adopt a belief that his parents are the cause of his distress is probably just as damaging as telling him that it isn’t and that it’s all in his brain. It is for the PATENT to discover the meaning of his/her symptoms and experiences, not the clinician.
That being said, it is VERY common for kids to idealize their parents and not be willing to look at the possible dysfunction that may exist in the home. This person is just one of many examples I could cite. I recall a girl I worked with (16 years old) who said she’d never thought she was abused, even though her dad beat her black and blue on a regular basis. She just thought that was how parents raised kids.
It is also common for parents to want to believe they did a great job and to not want to hear about whatever shortcomings may exist in even the best of homes. Kids learn very early that calling out mom for yelling or dad for being drunk at the dinner table is not tolerated, and they learn to keep their observations to themselves. To suggest that this kind of message does no damage is very wrong.
There are certainly adults who have “mental illness” problems as defined by the DSM who did not have troubled childhoods. We live in a difficult society, and there are many stressors and expectations that may be difficult to address, even for people who had basically supportive upbringings. However, the association of childhood trauma with adult mental health issues is FAR greater than the most optimistic estimate of the genetic contribution.
The following article provides some perspective on how biased the field has been AGAINST viewing childhood trauma having anything at all to do with adult mental/emotional distress, despite massive evidence that it does. It is that bias that I am trying to address. Going to a bias that ALL “mental illness” is caused by childhood mistreatment would be a very large leap from what I am suggesting.
Knowing Rachel, I don’t think I can agree that she is any more “under the sway of the medical model than most of us posting here.” That being said, the point is very well taken. “Medication” is clearly a euphemistic term adopted to avoid the obvious similarity (and in some cases, absolute identity) of psychiatric drugs to street drugs. I try to use the term “drugs” unless I am specifically talking to an audience where doing so will in some way impede my bigger message. Language does make a difference – it is a way of exerting power, and reframing the conversation away from euphamistic avoidance of the reality of these drugs is an important part of our message, I think.
Oh, yeah, all those quacks selling vitamins are SOOOO dangerous! They are bilking people out of money for treatments that don’t work, unlike us psychiatrists, who… um… uh, oh…
My comment to anyone who says that is very simple:
If they were taking all these drugs to help with their “mental illness,” why did they still go off the deep end and do these crazy things? At the very least, we have strong evidence that for at least some people, these drugs do not prevent them from being violent. If they were working, something like this would not occur.
If they can’t accept that, it’s hard to think what else could be said. Unfortunately, your daughter, like all of us, has been exposed to massive propaganda and she appears to simply be spouting what she’s heard. I know it must be hard to hear one’s own child coughing up this nonsense, but it’s hard to avoid.
The other approach is to suggest the possibility that the drugs may work for a large proportion of the population, but suggest that WHAT IF a very small proportion have a very bad reaction? It doesn’t require a “conspiracy” for this to occur – you can use Viiox as an example of a drug that helped a lot of people with pain but also killed a significant number of people. Point out there are always tradeoffs between positive and negative effects of drugs, and you’re not calling to ban them but to be honest about these rare but very serious side effects.
As I said above, I have never seen a clearer example of a case where this could have easily been prevented if the doctor would just have listened and said, “Oh, wow, that’s NOT what these drugs are supposed to do! We’re going to take you off them, but meanwhile, you are not to fly, and I’ll be happy to write you a note so your bosses will not get you in trouble.”
The psychiatrist is very much culpable in this scenario!
I agree. I’d use the school system as an analogy. There were good teachers in the system as well as evil ones. I loved my fourth grade teacher (Miss Zeller) and would have happily been adopted by her! But she worked in a system that required her and the other teachers to act in ways that allowed and supported oppression, even if they as individuals did not choose to act that way. I recall being in first grade when Miss White (also an incredibly kind and warm person!) asked a poor youngster to read a book aloud. He sat there looking at the carpet, his face turning red, saying nothing for at least a half a minute, while I said to myself, “Move on, move ON!” I felt so bad for that kid, I remember it to this day. But Miss White wasn’t being intentionally cruel – she was just implementing the system as required, and having your kids read aloud is part of that system. I’m not sure she would have had the authority to say, “You know what, I find this reading aloud is traumatizing to some kids. From now on, only kids who volunteer will be reading aloud.” She’d have experienced danger to her professional career if she’d done that.
So the system sustains itself, and even those within the system appear powerless to change it for more than an instant. I did involuntary detention evaluations for 9 months, and I helped a lot of folks in the ER get some on-the-spot quality therapy and freed a lot of people who would otherwise have been detained against their wills. They were VERY lucky they got me to do their evaluations. And yet, I had to quit the job, because I knew from the first week that I was supporting an unhealthy system that forced people to do “treatment” that often didn’t help at all and sometimes made things dramatically worse. I felt I was colluding by even participating, and could not ethically continue the job, especially after I saw what happened to the few people I felt compelled to detain for their own safety when they made it to the psych ward.
Being a good person in an evil system can’t change the evil that is intended and performed on the larger scale. While you might be a breath of fresh air to someone who is otherwise starved for a real human connection, it doesn’t change the fact that the bulk of the time, these folks do not have that kind of experience and you are not in a place to make that different without a wholesale re-thinking of the system from top to bottom.
I have to say, I called this one as soon as I heard the details of how it went down. This is one of the clearest cases of antidepressant-induced violence I’ve every seen. I’m glad it’s getting a lot of press in Germany, but folks over here need to read this stuff, too.
One fascinating aspect of this story is the revelation that this person’s “normal, healthy upbringing,” which he himself believed in, was a myth created to cover up some very ugly family dynamics. It is an excellent example of the fact that many people can have very stressful childhoods and not actually realize this was the case, as they generally accept the family narrative and consider the behavior they had to tolerate from their parents or siblings as “normal,” not knowing that any other alternatives exist.
Additionally, it demonstrates how easy the current paradigm and diagnostic system makes it to ignore such causal factors or even collude with abusive/neglectful parents in blaming the child or young adult for developing “symptoms” which are actually indicative of unhealthy family dynamics. In our large scale social enthusiasm to “not blame the parents” when kids don’t fare well, we’ve forgotten that parents are very frequently primary contributors to the eventual “mental health problems” of their offspring. By ignoring the likelihood of traumatic childhood experiences, which we have now learned are widespread and very common in our society, we place the blame on the child for not adapting to the unreasonable expectations that their family and/or society place on their shoulders at an inappropriately young age.
It is particularly ironic for psychiatry, the ultimate in privileged, power-based authoritarianism, claiming “stigma” against their profession! They, who are such purveyors of the very stigma that causes their own patients to revolt, they, who are the most arbitrary wielders of State power and authority with the least accountability, they, members of the most privileged class of society (doctors) and reaping all the advantages thereof, they are somehow victims of prejudice! It is as bizarre as the domestic abuser stating that his partner/victim is out of line for criticizing his abusive behavior and wanting to leave as a result.
If psychiatry is an unpopular profession, the answer isn’t a slick PR campaign. In fact, psychiatry is BASED on a slick PR campaign and that’s why it is in disrepute! The answer, if there is one, would be a humble self-examination, combined with a seeking of feedback from those damaged by their supposedly helpful practices. If over half of the people protesting your services are those who received them, I think you’ve got more than a PR problem, folks!
Thanks for sharing your story and making some very important points. I find it arrogant for anyone who hasn’t gone through the experience to speak for those who have, and even those who have can’t assume that their experience is the same as others who had similar experiences. One huge problem with calling voice hearing a “disorder” named “schizophrenia” or whatever else it’s called is that it assumes that all people lumped into this category are the same (in addition to assuming without evidence that they are “disordered, as you point out), and that leads to all sorts of false assumptions and conclusions and in the end is harmful to the very people the labelers are ostensibly trying to help out.
If you really want to help another person, start by listening to them, because they’re the only one who really knows what’s going on!
I participated in a model Open Dialog session. It appears to mostly involve gathering the people a client feels connected to in a room, and discussing the issues and possible solutions as a group. The most interesting part is that there are two therapists involved, and the two of them talk to each other about what they’re thinking and wondering right in front of the group! A major contrast to the obfuscating language and secret notes and meetings that characterize “treatment planning” in most mental health settings. There is a big emphasis on being comfortable with the unknown and letting each person have their own experience respected and validated. There is also an emphasis on reconnecting the support network emotionally and communicationally, and it is believed that this process if engaging in dialog with the supportive community around the person is key to reducing or even eliminating “psychosis” by creating a common, shared reality among the participants, including the idea that all participants, even the therapists, are learning as they go and are as vulnerable and as human as the identified “patient.”
I hope that helps a little. I’m no expert, but that was my experience of the process.
I agree, that is the one comment that really bothered me, though I want to thank Sandy for having the courage to speak up about this issue despite no doubt receiving a lot of flak about it. It is important to characterize these diagnoses as subjective and to a large extent arbitrary collections of people who for myriad reasons have some kind of similarity of “symptoms.” I even object to the word “symptom,” as it implies some kind of medical malfunction, while many who are diagnoses literally have nothing wrong with them at all and are simply displaying the emotional effects of abuse, stress, and an unsupportive cultural environment.
Of course, this idea doesn’t sell well, and maybe Sandy’s ability to get her message across would be limited if she started using words like “fraud” and “deception.” But I do think it’s important to get that on the table – these “diagnoses” aren’t lacking refinement, they’re lacking VALIDITY, and even Dr. Insel has admitted the same.
I am disappointed at the unsupportive tone of some of the comments on this thread. Language absolutely does matter, and if I’d become accidentally dependent on a drug that a doctor prescribed to me with assurance that it was safe and with no warning about addictive properties of the drug, I’d be totally pissed if people lumped me in with someone who decided that using street drugs was a good way to manage their emotions or physical pain or to have some fun or whatever. The two are certainly very different. And while I agree that the “addiction language” that has become accepted in our culture has some rather disempowering aspects that should be changed, it doesn’t alter the fact that a doctor lying to you about the drugs you’re prescribed is a very different process than knowingly engaging in taking a drug that you already know to be dangerous and/or addictive. I don’t think it should be too hard to make that distinction, and am having a hard time understanding why some posters seem to be unwilling to acknowledge that very simple error in grouping that I think would very naturally lead members of the iatrogenic group to be massively pissed off.
The real lesson of all this is to not trust your doctors’ assurance that anything is safe. I learned this early in my life when a doctor almost killed my dad. I don’t take anything I haven’t researched, and most of the time when I research it, it leads me not to take it anyway. Unless death is the alternative, I avoid drugs like the plague, as they are one of the biggest causes of death in the USA, even when taken as prescribed. It’s caveat emptor in the medical world!
He seems to be classified as an addict, but he took this stuff as a sleep aid, and the doctors did not tell him it was addictive, according to his own words. Why is that not the focus of this story? And their use of new diagnoses and “treatments” instead of recognizing that he was fine before he started on this addictive substance is very typical and disheartening behavior from the system.
Is there some way to get someone to cover this story from the angle of a guy who was misled and effectively killed by his “medical treatment?”
It would not surprise me if longer durations of therapy are also harmful.
Your comments appear to skirt the question of whether you’re familiar with Wunderlink and so on and how you think that affects the decision to use drug treatment in the long run. There is a new but increasing trend toward delaying initial drug treatment in favor of psychosocial options, and then adding medication temporarily and in as low a dose as possible, based on these findings. I’m interested to hear your take on this new thinking, which I personally find is much more consistent with the literature findings than the classic, “You need to take these for the rest of your life” model.
Quite so. If the child’s brain is to blame, then the parents are off the hook, the teachers are off the hook, the psychiatrist is off the hook, even the child is off the hook, and only “the disease” remains to be blamed. This may be reassuring in the short run, but in essence says that no one can do anything to change the situation, which is the ultimate in disempowerment. We wring our hands and try drugs, and if they don’t work, the psychiatrists wring their hands with us and bemoan “the progress of the disease” instead of admitting they don’t know what the heck to do other than give the kid more drugs.
I’ve talked to lots of foster kids coming out of the system to adulthood about this issue, and they generally find it insulting. “You mean to tell me that despite the abuse and neglect I experienced and the involuntary placement with people I don’t know and separation from my family, friends, neighborhood, teachers, and apparently random moves to yet other foster homes over many years, that I’m supposed to be CALM and HAPPY about all this, and if I’m depressed or angry or anxious or hopeless, it’s because my BRAIN is broken?!!” It is hard to convey the contempt in which most of them hold the “mental health system” and especially attempts to medicate them into compliance or emotional neutrality.
When you see what else can be done, and how totally empowering it is when parents are able to start to face the demons of their own upbringing and/or learn some new skills that WORK, it is simply shocking that the psychiatric community continues to get away with the fraud they are perpetrating on the public.
I think it’s also important to note that much of “bad parenting” comes from cultural influences and expectations, many of which came from the field of medicine or even directly from psychiatry itself. Remember how worried we were all supposed to be about picking up our babies for fear of “spoiling” them? Whose idea was that, I wonder? What about the widespread and systematic suppression of nursing in favor of formula feeding in the 50s and early 60s? Directly from the medical profession. Feeding schedules, advice NOT to read to your kids when they were young, advice that parents should never disagree in front of their kids but should always present a “united front” – all of these pieces of culturally accepted advice came from medicine and from psychiatry/psychology.
Parents can try their hardest and still not do what their kids need, sometimes because they have had bad information or advice, or have never had positive parenting modeled for them. Rather than blaming, the process of identifying these issues EMPOWERS parents to re-learn the wrong information and poor modeling they received and to become the kind of parents they want to be for their own kids. Denying that “good enough” parenting is an absolute requirement for adult mental health is about as smart as suggesting that eating poor quality food doesn’t affect a child’s growth and development. It’s a straw man put up by NAMI and the psychiatric profession to justify the medical model. The “don’t blame the parents” argument doesn’t serve parents OR kids well at all.
I love it – “I’m here from PAW – Pills Against [your] Wills!] They could have a big puppy holding out a little white paper cup with a couple of Abilify inside.
I agree with you, I don’t see how psychiatrists as a group aren’t ashamed and embarrassed by their apparent complete lack of ability to deal with the problems they are supposed to handle. Perhaps the problem is that most of the “compassionate, knowledgeable, and curious psychiatrists” quit the profession early on and choose to engage in a more ethically clean and effective profession, leaving mostly the hyperauthoritarian, the slow-witted and the sociopathic to ultimately get their degrees.
Sorry if that’s insulting to the handful of ethical psychiatrists out there. I really appreciate you folks fighting the good fight, but you shouldn’t have to fight so hard for the obvious!
A more radical view of recovery would be something like, “Learning to deal with the shit that’s been and continues to be heaped on me by this insane society I have to live in.” “Recovery” is almost always from the effects of oppression and mistreatment, not some mystical “mental health disorder.” I suppose we also have to “recover” from our own overwhelmed initial or habitual reactions to said oppression, but the mental health world’s view of “recovery” is “no one is to blame,” which is accurately translated into, “It’s your problem, not ours, you figure it out, except that you have to keep taking our drugs.”
More specifically, “recovery” in the mainstream is often defined as “having your symptoms under control so you can live a somewhat more normal life instead of being in the hospital and bugging everyone so often.” In other words, staying on your meds and staying out of trouble. To recover WITHOUT the mental health system, or DESPITE the mental health system, or FROM the mental health system itself is all inconceivable to most of the insiders.
“Recovery” has become a loaded term, and we need a new one, one that doesn’t allow cooptation by the very system of oppression that almost always contributed massively to the “mental health symptoms” arising in the first place. “Recovery” without presenting the context of systematic societal oppression is more disempowering than the system just being honest and saying, “We want to control you so you won’t waste our time and resources and annoy those of us enjoying our privileged status.” At least that’s something you can wrap your head around and fight against if need be.
Well said. I’d also add that improvements in “academic performance” have not been consistently noted, even in the short run, and when they have showed up, they are very mild and transient. Long-term research has never revealed any consistent improvement in academic performance for medicated vs. non-medicated kids with “ADHD” diagnosis. So his resort to “improvements in academic performance” is either ignorant or disingenuous, or both.
If you combine the lack of long-term outcome improvements with stimulants and the data from this latest research, it becomes very clear that the BEST that stimulants can ever be is an adjunct “treatment” for the short term, and that it is psychosocial intervention that actually change the long-term outcomes for these kids. Of course, it’s somewhat questionable to even call it a “treatment,” when what it’s “treating” is not something wrong with a child, but behavior that adults find annoying or difficult to manage.
Seriously. Don’t know why that argument is considered radical in any way – if something doesn’t work, why are we spending money on it?
I remember one woman who was voluntarily signing herself into the psych ward for suicidal feelings, who told me, “For the cost of this, they could probably put me up for a few weeks in a nice hotel on a beach in Hawaii. And it would probably be at least as helpful.”
I would suggest you start by reading Anatomy of an Epidemic, by Robert Whitaker, who does an excellent job of summarizing this research over many years.
Key research: the two WHO studies in the 1990s showing that people diagnosed with psychotic disorders in developing countries like Columbia and Nigeria have much better FUNCTIONAL outcomes (relating to employment, relationships, community involvement, etc.) than those in Western countries where medication use is much more common.
The Harrow Study, showing that even those with a better prognosis in the beginning did worse on medication over the long term than those who had a worse prognosis but did not use medication over the long term.
Thanks for being interested. I hope those help get you started. It’s all very counterintuitive from the short-term symptom management viewpoint, but I find the research compelling and replicable at this point, and I see no credible replicated research that contradicts it.
I like to say, “The Hand of Providence will at times reach down and gently guide you in the direction your path leads… and if you resist… the Foot of Providence will come around and kick you hard in the behind over and over again until you relent!”
Best to let the Hand guide us. It’s a lot less painful than the Foot!
CBT’s effectiveness is very much dependent on the practitioner. I always considered it a tool rather than a therapy modality. I think the problem happens when CBT is disconnected from compassion and listening and being guided by the needs of your client. CBT can be very useful in the right context for the right person, but can be harmful if applied to all people in an emotionally disconnected way. It is most dangerous in the hands of a person who has not done his/her own internal work, because it provides a great way for the clinician to avoid his/her own personal discomfort by “making” the client change his/her thinking, and rejecting/punishing the client who won’t/can’t do as they are told.
And his reaction was of course regarded as more “symptoms,” because any sane person would simply accept the bizarre environment of locked wards, beds with leather restraints, cameras everywhere, and nurses and doctors writing notes about you that you can’t read in a private room you can’t access.
The final nail in the coffin of my inability to work within the system for reform was my first visit to a psych ward. I’d rather have spent time in jail than there – at least in jail, they’re being honest about what they’re up to. I can’t see how anything remotely related to healing could have happened in that place!
Pelham was one of the lead investigators in the MTA study, and was gracious enough to acknowledge that the long-term data did not support the initial contention of stimulants providing benefits over behavioral treatment or no treatment. He was, not surprisingly, castigated by many in the mental health industry for his courage in putting science above personal benefits. It’s good to see him doing this work. I applied very similar approaches to my very active young children with excellent long-term results. To relegate “medication” to a secondary role would be a very big help to a lot of kids, second only to providing alternative open-classroom environments making the diagnosis primarily irrelevant and unnecessary.
Well said. It is a strange irony that being aware of what is going on, while extremely painful at times, appears also to be the only pathway to transcend them. But by definition, anyone having that awareness and acting on it is going to be on the margins, as the status quo is defined by oppression from top to bottom. So you can be “inside” and live with the security of the herd, but never really know you’re being herded, or be “outside,” and make the herders very, very nervous. I, for one, prefer the second choice. And really don’t have any choice to go back at this point, as once we have “seen behind the curtain,” it’s not really possible to believe in the Wizard of Oz any longer.
I am not talking about short-term remission rates, but about long-term recovery, and I think Whitaker’s summary of the literature, followed by more supportive evidence from Wunderlink and the 20-year followups from Harrow et. al. certainly support that medication interventions have a very disappointing long-term impact on functional recovery.
As for side effects, I’m certainly the last to say that poorly-executed therapy is free of side effects, but if we are talking about antipsychotics, we are now seeing lifespans 25 years less than the average population. Of course, some of that is attributable to life choices of those so treated, including suicide, substance abuse, and very high smoking rates. On the other hand, users of antipsychotics describe the use of cigarettes as a way to minimize the side effects of the drugs, which makes logical sense, given the dopamine effects of nicotine opposing those of the antipsychotics.
But regardless of that, it is clear that not all of the lifespan reduction is due to poor lifestyle choices. We know that antipsychotics can mess badly with metabolism, inducing large weight gain and diabetes, as well as heart problems. It should be obvious that some of the lifespan reduction is due to antipsychotic drugs, as neither smoking nor substance abuse per se are associated with that kind of reduction in life span expectation. As bad as formulaic application of CBT can be, it is unlikely to kill the subject except by driving them to suicide, which is not something I have heard occurs very frequently. Correct me if you have data to the contrary.
I completely agree with you about not being ideological, and that CBT or any other therapy can be damaging. I just think you are looking only at short-term data for your evaluation of the effectiveness of drug therapy, and that misses perhaps more than half the picture, as most people are more interested in quality of life than in immediate symptom reduction per se (quality of life would be a desired RESULT of symptom reduction in most people’s minds – being miserable with fewer symptoms is not an outcome most would desire). One need only look at the much higher recovery rates in the developing world, per the two WHO studies in the 90s, to sense that we may have a lot to learn about what really facilitates recovery. Simply saying that CBT is no better than psychotropics begs that more important question.
Sadly, the evidence base for antidepressants is just as weak or weaker than the evidence for CBT that you properly critique. Most people who “successfully” use antidepressants improved an average of something like 3-5 points on the BDI, leaving them “moderately sick,” as you so aptly put it.
So the real question is, what else can be done? It does not appear that either of these interventions are particularly helpful, although it seems that at least the side effect profile for CBT is less severe.
Because it is not allowable to feel or especially express rage against systematic social abuse. You’re supposed to grin and bear it, and any signs of getting “uppity” are punished with further discrimination and violence. I think this is one reason many more women are labeled with “mental disorders” than men – they are not supposed to acknowledge any kind of oppression they are experiencing, and are expected to be happy with second-class citizen status. Being depressed, anxious, hopeless, or most horribly, ANGRY about it is simply too frightening to those in charge to be allowed. So instead, your anger or depression or anxiety is redefined as the problem, and our authoritarian system will “make it go away” for you, but only if you do exactly as we tell you. And if our approach doesn’t “make it go away,” well, it’s not OUR fault, it’s the DISEASE!
Yeah, kind of a no-brainer, isn’t it? “Which would you prefer, to be treated as a malfunctioning ‘unit’ that needs to be tinkered with and ‘fixed’ by ‘professionals’, or to have someone provide support for things that weigh on you and cause you stress?” I wonder what percentage of people would select the first option?
Richard, great letter! The one thing I’d add is that not only have recovery rates for
“mental illness” not improved, as Bob Whitaker has shown, they have gotten dramatically WORSE as the age of medical intervention has taken over from our earlier focus on communication and experience as the primary interventions, including even shorter and shorter average lifespans for “patients” in the system. If this happened in the field of cancer or heart disease, there would be a huge outcry, but for some reason, worsening outcomes (including early death) among the “mentally ill” disturbs no one particularly much. I think it’s a point worth emphasizing.
Interesting that you find the evidence for peer support for bipolar and schizophrenia to have no positive effects. I’m wondering if you are familiar with the emerging research demonstrating that long-term treatment with medication appears to have a detrimental effect on those outcomes you mention?
These data don’t reflect only “greater improvement,” they reflect dramatically greater improvement, particularly in “hopelessness” (41% vs. 3%), better by a factor of 14! I’m kind of surprised (though perhaps I should not be) that their conclusions are so muted given the results. If any actual MEDICAL intervention showed a 14x greater chance of significant improvement over TAU, it would most likely be immediately proposed as the new standard of care. Yet this is published in some journal and will be forgotten within days or never read by most psychiatrists. This should be BIG NEWS!
Fascinating, isn’t it? No matter what evidence is presented that trauma is a primary causal factor in essentially every “mental disorder” they have identified, they seem to be religiously committed to bringing it back to brain chemicals. It seems very intuitive to think that racism drives people mad, and very counterintuitive to think that only people with “bad brains” are susceptible to be driven mad by systematic racism. And yet…
Do they think they’re being more “scientific” by talking about brains? Or are they just so completely immersed in their worldview that they are incapable of stepping outside their comfortable paradigm of thought?
Nice smackdown, Vivek. It continues to amaze how strong the “confirmation bias” is in those who really, really want to believe it’s all in your brain chemicals, despite the almost total lack of evidence supporting that theory. They just haven’t identified the right chemicals yet, if only we keep researching… More like a faith community than a group of scientists.
Very much appreciate your objective assessment of the literature and your willingness to call out the deceptive marketing practices of those who don’t always want to face the real truth about their practice of medicine.
I never cease to be astounded how easily the medical profession (and I’m not just talking psychiatry here) completely ignores extremely significant scientific discoveries when their financial/professional interests are challenged. This study should be reason for a complete rethinking of the medication/brain disease paradigm. It offers a free and empowering alternative that can make patients independently able to address their own distress without having to report in to the psychiatrist for prescriptions. How would this not be huge news? Unless, of course, you WANT your patients to be disempowered, dependent, and to have to report in for prescriptions for the rest of their lives…
Death has been proven to eliminate every single mental health problem every identified. How about “death therapy” for all. “It’s a sure cure, Bob,” for those who have seen the movie, “What About Bob?” for those who haven’t, you really, really should watch it!
Tepid recommendations when looking at the actual conclusions of the data! What it SHOULD say is “Antidepressants should only be used as second line treatment when acupuncture, yoga, exercise, St. John’s wort, and individual therapy have been attempted without success. Antidepressants have no more effect than any of the above, and yet have a much more serious side effect profile, so the risk/benefit analysis speaks strongly against antidepressants unless other less risky efforts have proven fruitless.”
And that’s not even getting into the question of why we’d expect “depression,” which could result from a wide range of causes, to always respond to one particular approach.
Joel appears to have his mind made up and seems to want to criticize anyone who disagrees with him. To say that nothing of substance has ever been posted here is ridiculous in the extreme, and of course, he is disingenuous in claiming that Whitaker or most people here are categorically opposed to the use of psych drugs in any and all circumstances.
It is interesting that he “defies” us to come up with alternative approaches for the theoretical depressed person who can’t function, when there are dozens of alternative approaches that he, as a bio-psycho-social psychiatrist, should be very familiar with. So while on the one hand claiming that people here are rigid and don’t understand flexible and supportive psychiatrists like himself, on the other, he suggests that medication is the only solution for a person disabled by depression.
As for his dismissive wave at the questionable validity of DSM diagnosis, many of his own colleagues appear to disagree with him. To not even consider the importance of the validity argument doesn’t show much in terms of openness and flexibility.
Joel provides no substantive arguments to validate his points, and is probably not worthy of responding to unless he changes his style, which I find unlikely.
Noel, I have to say, that was impressive! Your grasp of both the issues and the research is obvious, and your writing style allows the lay reader to understand the research without being bogged down in technicalities. And you make SO much sense! Thanks for sharing this – I hope it can be published elsewhere as well, as it is a remarkable review of the data as well as an overdue critique of the media habit of trumpeting almost trivial results as if they were earth-shattering.
Minimization I am sure is a symptom of some mental disorder or another. I think these docs have personality disorders. They’re always willing to make apologies for the drug. Does is not concern them that 90% of the youthful antidepressant users received NO benefit from using them, while increasing their risk of suicidal thoughts and aggression? And saying, “Well, they had increases in suicidal thoughts, but no one ACTUALLY COMMITTED suicide” is hardly reassuring, but apparently makes them feel better about continuing to prescribe these essentially useless drugs to kids.
That is a trend I have noticed before. I found out that Time and other newsweeklies have a European edition, in which they talk about world politics and economics and important issues of the day, and an American edition, where they’re more likely to talk about Hollywood or the President’s vacation and “lite” news items that won’t upset anyone. Whether this is marketing to the sensitivities of US readers or an attempt to keep us in the dark, I can’t really say, but it is beyond question that the USA gets sanitized news that the rest of the world would find trivial and banal.
You speak wisely. Psychiatry has thrived here partly because of our unwillingness to allow that our culture is flawed and damaging to its members in many small and large ways. It’s much easier for those in power to blame the victims of an unfair or oppressive system rather than trying to listen and change it, and unfortunately, psychiatry’s need for power and funding plays right into the hands of those inclined to that kind of thinking.
I agree. Another great example is “continuous fetal monitoring” of women in labor. It ties a person to the bed, usually means having to lie on their backs, and creates anxiety when the baby moves and suddenly the monitor flatlines and there’s no one there to intervene or interpret. This became 100% standard practice back in the ’80s, the idea being that this heart rate monitoring would lead to improved outcomes. But it was already known that these devices did not provide any better outcomes than intermittent checks with a fetoscope or stethoscope! They did, however, change one outcome – they dramatically increased the rate of Caesarian section. And yet they became standard practice, and may yet be today.
Tests are fine when there is an identified problem that needs to be further analyzed, but universal screening tests often have unintended consequences for the patient. I suppose in this case, they also have intended consequences for the industry, aka more patients, but the health and welfare of the patients themselves appear to be a secondary consideration, if they’re even a consideration at all.
I love that! Screen for happiness and reinforce it! What a paradigm shift THAT would be!
We could also screen for righteous indignation over real wrongs that exist in the world. We could validate the indignation instead of finding it a “disease state.” We could make the person RIGHT for feeling angry at injustice and cruelty. How would that impact our “mental health” system?
Right, ’cause everyone is SUPPOSED to be thrilled and happy 24-7 about their new baby, and if you’re not, well, have we got a drug for you! It’d be more honest if they prescribed vodka tonics three times a day. But, of course, there’s no way to patent a vodka tonic, so we have to go more esoteric to make the big bucks.
Impressed that Dr. Paul is actually looking at this scientifically. I have to say, if I were a parent (even not knowing what I know) seeing a 1 in 10 chance that my kid might feel better vs. a 1 in 33 chance they may turn aggressive and a 1 in 50 chance they became suicidal, I’d probably look for other options.
All in all, I’d say a person would be better off smoking three joints a day or taking controlled doses of alcohol than experimenting on their brains with SSRIs.
Thanks, Harriet! People are people and should not be characterized by their associations – that’s part of what we’re fighting, isn’t it, classifying all people who act/feel/think a certain way as being “the same?”
As I like to say, “Generalizations are ALWAYS wrong!”
I was thinking of a first baby, but of course, sibling rivalry and confusion and attendant behavioral issues are very common responses to a new baby, which often leads to feeling even more overwhelmed. My mom had three of us under three, and four under 5. I’m amazed she didn’t beat one or more of us to death, or slit her wrists!
Not only does telling a mom she is “disordered” for having these reactions not helpful, it my experience, it is the exact OPPOSITE of what should be done, and does overt and lasting harm. The mom is already feeling inadequate and overwhelmed. Now you tell her that her brain isn’t working right because she should be happy and shiny about all of these wonderful changes? I think if a psychiatrist had told even me that after our first, very challenging child was born, I’d have wanted to knock his teeth in. I can only imagine how invalidative that would be to a new mom!
1) Sleep deprivation
2) Complete change of daily routines and expectations to accommodate new, helpless infant
3) Breastfeeding problems
4) Shift of focus from pregnant mom to new baby
5) Difficulties with body image resulting from pregnancy/birth changes, which are often not entirely reversible
6) Loss of income
7) Loss of connections with fellow employees
8) Loss of sense of purpose provided by work environment
9) Changes in relationships with friends who don’t have a baby
10) Birth brings up own childhood issues
11) Mythological social expectations fail to meet with reality of new baby
12) Sex life essentially non-existent
13) Potential contact with abusive/disrespectful family members
14) Domestic abuse frequently starts or escalates during or after pregnancy
15) Increasing sense of dependence or “trapped” feeling
16) Challenges of dealing with unwanted pregnancy
17) Baby presents medical challenges or other difficulties that violate expectations and prevent good bonding
I could go on. Feel free to add to the list.
Note that not one of the above even mentions the mother’s physiology or hormone changes, which of course can contribute in other ways, such as malnutrition or low blood sugar due to dieting to regain pre-pregnancy weight, or low iron resulting from difficulties with appetite during pregnancy. Being a new mom in today’s society is extremely difficult and often isolating, and also leaves new moms vulnerable to abuse or mistreatment by family members, including their spouse in too many cases. To suggest that “PPD” is some kind of a biological disorder of the brain in all or even most cases is laughable in the extreme. This is especially highlighted when we look at cross-cultural studies, which show that there are some cultures where PPD essentially never occurs.
While it is always worthwhile to explore physiological factors like diet, sleep, and illness, the vast majority of depression following birth is an entirely normal response to a rather abnormal society’s lack of support for new motherhood. Normalizing feelings and helping the mom identify the reasons and some actions she can take to get more in control of her new life situation is much more effective than trying to dismiss these feelings as a “mental disorder” and drug the sufferer into numbness and increased disconnection from her emotions.
I once stated in a room full of mental health and social work professionals talking about protocols for medication oversight that “there is no indication for antidepressants in kids under 5.” Nobody said a word! I said it again. No response, as if I had not spoken. Talk about denial! If anyone had had a counterargument, they would have said it, but no one said a word. Everyone knows they don’t work in kids, and yet they are unwilling to simply say, “Don’t prescribe them to kids!” It’s sick.
But I will make note of what you said and will keep pointing to the elephant in the room, even if they continue to turn their eyes another direction.
Wonderful to see employment practices linked to mental and emotional suffering! It is way past time we started recognizing that our society itself is a crazy-making environment and that we need to take some action to address the constant low-level anxiety and hopelessness that pervades many of the well-integrated members of our society. Those on disability are the “canaries in the coal mine” that should warn us that we are on the wrong track!
Right you are. This phenomenon is “unique to the US” because we are uniquely brutal and relentless in pushing these drugs on people whether they need/want them or not. It is typical of oppressive forced to blame someone less powerful for their failures, but an honest assessment would tell anyone who really cared that a huge negative response from your clientele is a message that YOU need to do something different!
Any real scientist would not need this article. There is no such thing as a “negative result” to a real scientist. There are only results and their implications. A “negative result” implies that the researcher had a desired outcome, rather than objectively seeking the truth. Of course, we all know that such researchers are the norm today, and that most have substantial financial and professional conflicts of interest, but it’s time to stop allowing these biased technocrats dominate the language we use and get back to the real scientific method. Real science values “negative results” even MORE than “positive results,” because when a hypothesis is defeated, it gives a degree of certainty, whereas validation of a hypothesis only calls for more research to verify that the result can be replicated. The only absolute truth from science lies in “negative results,” so not publishing them is scientific suicide.
Exactly! Not being anxious about anxiety (or any other emotion) appears to be the most important key to overcoming intense anxiety or “attacks.” Unfortunately, the current model perpetuates the opposite framing – anxiety is a problem, is THE problem, and STOPPING anxiety (or depression or paranoia) is the goal, rather than learning to observe the mind’s machinations from a safe distance and identifying the cause and the process by which the anxiety manifests and ultimately resolves.
Psychiatry’s labeling process is not only not helpful, it appears to be the exact opposite of what actually helps people come to terms with difficult emotions!
As anyone with half a brain, or perhaps half a heart, would know, stigmatization results from grouping people as “different” from the mainstream. That energy of “differentness” comes directly from the mental health industry, which is profiting from convincing everyone that they need “treatment” for the emotional experiences that come with being alive.
A real anti-stigma campaign would not say, “You shouldn’t be prejudiced against these people just because their brains are fucked up.” It should be saying, “There is nothing different about the ‘mentally ill’. These folks are just the same as you. Many of them have had tough lives and have had to fight to survive. Love and care about each other and ‘mental illnesses’ will drift away.” In fact, even identifying “them” as people with “mental illnesses” is still stigmatizing! How about, “All of us suffer from the struggles of life sometimes. Anxiety, depression, anger, and hopelessness are all a normal part of life’s many challenges. Help each other when you see someone else is struggling – tomorrow it may be you who needs their support!”
So much of the “stigma” is caused by the system itself, it just makes me gag every time they develop a new “anti-stigma” campaign that just rubs more salt in the wound. It makes as much sense as saying, “Don’t be prejudiced against Spanish-speakers, even though they aren’t really Americans.” It would be better for them to say nothing than to explain why “mental illness” is just like physical illness, and you shouldn’t be prejudiced against people just because their brains don’t work right.
It is now well known that SSRIs can increase suicide risk, especially for adolescents. I’m glad that Cochrane also mentions increased aggression, which I see frequently in my work with foster children. This problem is almost never mentioned by “opinion leaders” in the field, and kids who become aggressive on SSRIs are very often diagnosed with “bipolar disorder” and put on antipsychotics. This study needs to get some big publicity, as a lot of kids’ lives could be improved and stigmatizing diagnoses avoided if this “side effect” of SSRIs were noted.
Of course, the more important finding is that SSRIs don’t really improve the “depressive symptoms” for youth, and the younger you are, the less effective the SSRIs become. There is really no benefit to offset the risks, and the proper conclusion is that these drugs should never be given to children for any reason. But that message will be obscured, because it is inconvenient to those profiting from the delusion that SSRIs are helpful to kids.
I agree – it still posits Abilify as something that will instantly and magically end their delusions of running for president. There is no attempt to deal with the real impact Abilify has had on so many lives.
I used to work at a suicide hotline, and I learned to ask those very questions (or paraphrases of them) very early in any conversation with a person who stated suicidal intent or thoughts. There was almost always a very good reason for the person to feel suicidal, and I found that agreeing that the situation was depressing and felt hopeless led to lots of helpful conversations.
I also learned that almost no one in the mental health field had any training in suicide prevention beyond “ask if they have a plan and if so get them to the hospital.” Our volunteer phone counselors had more training than the average MA counselor in suicide intervention. Most counselors were completely at sea in dealing with any kind of a suicidal person.
Maybe my favorite call ever was from a woman who was depressed about her boyfriend breaking up with her. She went on at some length about how her mom had told her she’d easily find other men, and her girlfriend said he was a jerk and she’d be better off without him, but despite all this, she still felt depressed. They’d broken up four months ago after a four-year courtship. I told her, “Not only do I think it’s totally normal for you to feel depressed right now, if you weren’t at least a LITTLE depressed, I’d think there was something wrong with you.” She said, “Really?” I said, “Yeah.” She said excitedly, “Wow, thanks!” and hung up the phone!
Sometimes giving a person permission to tell their story and validate their reaction to difficult events is all that is needed. Unfortunately, psychiatry and our mental health system these days almost always provides the opposite – disinterest in the story and distress and disempowerment about the reaction.
Not to mention release from the hospital usually occurs right in that 1-3 week range when the most suicides from new antidepressant or antipsychotic prescriptions are most likely to occur.
There is a distinct difference between blame and responsibility. The first says, “You made this happen because you screwed up!” This is rarely if ever helpful to anyone. But responsibility means, “You have had and continue to have an influence on this situation, and your decisions can make it better or worse. Let’s look at what you can do to make sure your influence is positive.” This presumes no ill intent or foolishness on the part of the parents, and yet acknowledges the reality that parent behavior can and does impact the presence and/or expression of psychosis, and so gives the parents credit for some power to help change the situation. Sure, this may lead to some painful self-examination and acknowledgement of errors made in the past, but if presented in the context that “parenting is hard, kids are complex, and sometimes things don’t turn out the way we expect,” it’s pretty easy to create a safe place to explore what may or may not have gone wrong, and more importantly, what to do TODAY to make the situation easier for everyone.
Avoiding blame is a natural reaction, but avoiding responsibility leads to disempowerment, and that helps exactly no one.
There are efforts afoot to create alternatives to traditional mental hospitals, like Soteria models or other sanctuary models where people can go to a calm environment with low stress to get re-oriented to consensus reality safely. But such efforts require funding, and the psycho-pharmaceutical complex has a stranglehold on most of the “mental health” dollars. I personally find psych hospitals to be horrible places to heal, but I do agree that safe spaces are critical to helping people like your son to get to a better place. Unfortunately, today’s model involves giving people drugs and trying to make sure they stay on them for life, while the rest of life’s needs are considered of secondary importance, if they are considered at all. This site isn’t really about stopping medication as much as it is about finding better ways to help. I hope you’ll join us and give us your perspectives going forward, as you have clearly seen both the serious drawbacks of the current system and the lack of viable alternatives.
I also understand that smoking is often adopted by people taking neuroleptic drugs, as it appears to reduce some of the side effects. This makes total sense, since nicotine increases dopamine, which is drastically reduced by neuroleptics. So we can’t count cigarettes out as a side effect of psychiatric drug use, and we know the kind of effects smoking has on lifespan.
I agree with Ron, it is important to be precise about our facts so that we can’t be viewed as careless or ideological to the point of being sloppy about the truth, as that prevents us from distancing ourselves from those we are critiquing.
That being said, I think the vitally important fact is that the “treatment” for “serious mental illness” is making people’s lives shorter than they would have been without it. What other specialty would allow a treatment that shortens your life, even if only by a year or two? Extended lifespan is one of the key measurable outcomes for any medical intervention, and if psychiatry wants to pretend to be a medical specialty, they need to be called out on killing people earlier. I’d love to see the specific data on relative life expectancy for this group before and after neuroleptics, or reflected as a graph over time. I am quite sure we would see that as the “chemical age” in “mental health” has proceeded, lifespans have been reduced. It is one of the clearest pieces of evidence we have that psychiatry is not really “treating” anything at all, but instead manipulating brain chemicals in somewhat random ways that have unintended outcomes of great significance, including, in many cases, an early grave.
I did see this happen once in my role as an advocate for foster kids. Two divorced black parents of clearly educated backgrounds had their kid at a special school that recommended stimulants for “ADHD.” The parents listened, researched and then refused to agree. They were brought into court on allegations of neglect, and the child welfare agency was asking to have the child removed to foster care! Fortunately, the judge saw reason and dismissed the petition out of hand, which gave me some reassurance that here, at least, the judges are not so easily convinced that a parent loses their right to make medical decision because a school said they should do something different. But I’m not sure it’s like that everywhere in this country. The whole thing seemed completely absurd to me, but apparently not to the social services worker. Kind of scary!
The one thing I appreciate about the author of the article in question is that he actually admits that the psychiatric worldview “requires no proof” IF and only if you are a reductionist philosophically. He calls it a “monism,” and thereby acknowledges (if inadvertently) that psychiatry is, in fact, based on religious or philosophical faith in a particular monism, rather than any actual scientific data. This is the hard truth that most will never admit, so I have to give the guy credit, even though he continues to write afterwards as if his monism were absolute truth.
It probably also means they had a hard time finding anyone with this diagnosis who wasn’t already being “treated” chemically. Don’t know how it could be “unethical” not to “treat” with antidepressants after Kirsch’s work showing that they are barely better than placebo for most cases.
I find it odd that they recommend CBT for “treatment resistant depression” when it’s clear that it should be the first line treatment, and drugs only used when therapy of some sort fails. Of course, there are tons of other options outside the paradigm that says depressed people need “treatment” for a “disorder,” but operating within their own paradigm, this suggests that drug treatment should be ancillary and therapy primary in all cases, which is the opposite of what we see today.
I think what you are really talking about is that some people may actually have some sort of neurological problem that makes it difficult for them to control their impulsivity. I would not deny that this may be the case. However, the diagnosis of ADHD is not made based on any kind of neurological measurements or observations, and in fact, lumping all these people who have similar behavior together has the effect of OBSCURING the rare but probably extant cases where there really IS something wrong neurologically. Let’s say that your brother had some kind of, I don’t know, benign tumor in his frontal lobe. He goes to the doctor. Doctor says, “Oh, this is ADHD, seen it a hundred times. Give him some Ritalin, he’ll be fine.” He did the same thing with the kid who had sleep apnea, the one whose iron was low, the one whose father beats up his mother but he’s never told anyone, and the one who is really smart and bored to death with his dull teacher and classroom. How will he ever detect the tumor, or the low iron, or the domestic abuse, or the sleep problems if he can just lazily lump all these things together and call it “ADHD?” It gives the adults an “out” from admitting they don’t know what’s going on and actually doing some specific research on the causes of this particular person’s difficulties.
There may very well be neurological problems that cause someone to have difficulties with attention, but if they exist, they should be identified and called what they are rather than lumping them into some catch-all garbage can diagnosis like “ADHD.” Anyone can make such a diagnosis by simply listing off characteristics of an annoying type of person and calling it a disease. In fact, the DSM has done that in at least two other cases, “Oppositional Defiant Disorder (characterized by being unwilling to be bossed around by authorities) and Intermittent Explosive Disorder (characterized by having occasional outbursts or temper tantrums). There is, of course, no reason in the world to imagine that ALL people who have temper tantrums or ALL people who don’t like being told what to do have the same problem, or indeed have anything physiologically wrong with them at all. It’s just lazy diagnosis, made easy by the deceptive idea that the DSM diagnoses are somehow linked to some kind of scientific research. Once you realize they’re voted on in committee, you can see that the whole enterprise is pretty shady and not worth much.
If someone has something really wrong with their brain, we should look at their brain and find out what it is. But assuming that some annoying behavior is due to a brain malfunction is dangerous, and the epidemic of drugging you see is both the purpose and the predictable result of such delusional thinking.
It seems to me you are missing the point, Joel. It seems the article is about claiming that adjusting serotonin is the ultimate treatment for depression, not that antidepressants do not have a positive effect in many cases. There are plenty of folks who have made similar arguments, and the response is almost always protective of the role of drugs/medication vs. acknowledging the lack of conceptual and scientific backing for the idea that depression is a primarily biologically caused phenomenon.
I’d be interesting hearing your comments on that point, rather than your rather generalizing put-downs regarding this particular website.
I had a professor in college (chemistry) who used to set up the first test to be so tricky that most of the class failed. He then expected you to come into his office, where he sat in a chair behind a desk, and expected you to sit in a very comfortable chair that was about a foot and a half off the ground! The impression was very much of being a supplicant at the Delphic Oracle or some such power imbalance. I KNOW he enjoyed the spectacle of good students coming to him with their hats in hand and having to supplicate to him for relief. He was a total narcissist, and there was no protection or recourse.
Of course, it was worse in elementary school, where among other things, my second grade teacher, after a typical bout of yelling at the class, threw a book across the kids’ heads and destroyed a poor kid’s diorama that he’d spent hours putting together. I was the shyest kid in the room and almost never spoke, but I was so incensed on my friend’s behalf that I stood up and said, “Miss Vaughn!” She came down the aisle, hit me in the back of the head, and threw me and the kid whose work she destroyed out in the hallway without any further instructions. Talk about bullying!!! But everyone knew she did these things, it was her reputation, and nothing ever happened to her as a result. I didn’t even bother telling my parents about it, it was so unsurprising to me. What a great message for kids – “speak up to an authority abusing her power, you get hit in the head and tossed out of class.” I wish I’d gone home and never come back again, but that did not seem possible at the time.
Bullying by teachers is a poorly-kept secret, hidden only by the fact that we expect authorities to be abusive in our society. Same applies to mental health professionals, in my experience. If you have sufficient authority, bullying becomes “discipline” or “intervention” and the victim is always to blame for “forcing” you to use force on them.
And I would opine that one reason some people read the book with that bias is because their own biases blind them to any possibility but the dominant paradigm being 100% right. There are many reasons for this, practical, psychological, and financial, but whenever I see someone jumping on an honest critique and claiming the person is biased, I know it’s time for them to look in the mirror, because they’re almost always projecting their own bias in the opposite direction.
I so totally agree with you! Why is it that when a person is acting dangerously we automatically consider that we have carte blanche to “treat” them against their will? What would be wrong with holding onto someone until they calmed down and then finding a safe place for them to go? Of course, we’d have to create safe places, and it’s much easier to blame the client for making our lives difficult.
It is indeed the fear of those in extreme states and our own feelings of loss of control that make it challenging not to use force to intervene. But as I said above, most interventions are really designed to make the intervenor feel better, not specifically to help the client, who may or may not want the kind of “help” we wish to force on him/her. Far better to simply create safe places like Soteria House where people can chill out and decompress for a while without fearing for their own safety, and letting them decide what would help and what would not. Drugs could be a part of what is offered, but only offered with honest informed consent. My guess is that no one would choose that option for more than the very short term if they were not intentionally misinformed and pressured to do as the authorities told them to do. When one is already feeling out of control, taking away more control is not a good solution!
I think you strike on an important issue – there is a difference between what is scary to the person and what is scary to the clinician or friend or family member watching it. And it is accepted in this particular society and culture that it’s OK for us to try and stop something another person is doing by blunt and even violent means if it is scary to us. Not saying that extreme states are not scary to individuals who experience them, because they often are, but I think we have to be honest that a large amount of psychiatric intervention with people in extreme states is PRIMARILY meant to make the practitioners, friends and family feel better, not to assist the patient, though of course it is rationalized in the latter way.
It is fascinating to me the cross-cultural studies I’ve read showing that in cultures where voice-hearing is accepted and not feared, the voices themselves are much more likely to say positive things about the hearer! This shows that culture plays a huge role in how voices are experienced and how we choose to intervene or not. And you are absolutely right, to reduce this to a chemical-mechanical problem is never going to yield any long-term results, though it may yield plenty of dollars and prestige to the companies and practitioners who promote the practice.
Gotta agree with you. We need some regulators who have been victims of the mental health system! A fine of this magnitude is like a small tax they are more than willing to pay. How about the fine is proportionate to the estimated additional profits made from dishonest marketing? Hit them up for a billion or two and maybe you’ll get their attention.
Of course, you are right, but it will never deter the determined biopsychiatrist from wetting his pants about the next “great breakthrough.” In the end, psychiatry is so determinedly non-scientific in practice that actual failures to produce results over time seem to have not the slightest impact on the hope for the new Holy Grail to appear.
Take ADHD and stimulants for an example: we now have 50 years of research trying to prove that giving kids stimulants over time improves their academic and social outcomes. No such evidence has ever emerged, despite some fairly biased attempts to infer it. Any real scientist would say, “Gosh, we’ve got 50 years and hundreds of studies that fail to find an effect. It sounds like there is no such effect.” But in psychiatry, all they’ll say is, “There is insufficient evidence to prove that ADHD children do better in the long term with stimulants, but we’ll keep working and we’re sure such evidence will emerge when enough studies are done.”
Intellectual dishonesty lies at the core of the DSM-based psychiatric worldview. No amount of reasoning or scientific facts will dislodge their faith in their interventions. It’s more like a religion than a medical practice.
Psychosis is just a name, similar to saying that you have knee pain when you tell a doctor your knee hurts. They don’t know what it is, what causes it, what to do about it, or anything. Best not to say too much about it to them.
The real question is, do YOU think you are sometimes paranoid? If you do, what do you think is behind that? Is it something you want to change? What can you do to get control of that process?
Don’t let the doctors fool you. They have no more understanding of your situation than you do, and may in fact have less, because they are most likely brainwashed into thinking that your “condition” is a result of a “chemical imbalance in your brain” and to try to do everything they can to make it go away without ever bothering to figure out what is actually going on. Kind of like pain relievers for a broken leg. Not really going to address the problem, are they?
Right you are. Receiving medical care was found to be the third leading cause of death in the USA in an article published in the JAMA in around 2000 or so. The biggest cause was properly prescribed and properly administered medication (120,000 deaths a year). The idea that Good Medicine somehow magically leads to people getting better is delusional. The hard truth is, most of medicine is so corrupted by pharmaceutical and other money that you’re better off doing your own internet research and using alternative and folk medicine for most conditions, especially anything chronic.
Wow, this is indeed discouraging! If a person of your experience and stature can be so systematically ignored, it’s pretty obvious that no one in Government wants to go up against this industry! And of course, a referral to the Medical Board would have been useless, because they’d simply claim that the doctors were engaged in “common and customary practice” and could not be sanctioned, even if people were dying at their hands. As long as a lot of other docs are killing people in similar ways, you’re off the hook.
It makes me wonder what can be done about this? Is it even possible to generate public outrage when everyone appears to be so mesmerized by the training and degrees that the psychiatrists use to protect themselves from criticism or accountability?
Another stunning revelation that everyone should already know. It just goes to show how hard and consistently the psychiatric mainstream has worked to promote their “biological” theories that something like this should even have to be studied! Anyone who has experienced the powerlessness of being bullied and not knowing what to do and having the witnesses all join in or remain silence would instantly realize how demoralizing such an experience would be, especially if repeated.
I wonder if they bothered to include teachers and staff in their count of bullies. The worst bullying I ever experienced in elementary school was from the teaching staff!
Can’t argue with you there, Steve. He totally sold out and the consequences were dire. My point was more that the psychiatric/medical establishment of Freud’s time was no more interested in hearing the truth about trauma and its effect on the mind than today’s psychiatric leaders. I think it’s about more than just money – the people in power positions don’t want to believe that their arbitrary use of power is or can be harmful to the rest of the populace. Blaming the victim is an old game, and it’s very unfortunate that Freud decided to go there, but he’s in very good company!
School is a common trauma that many of us share from our own childhoods. The very idea of a standard school is triggering for me!
I am fortunate to live in Portland, OR, where we have some alternatives built into the public school system. Notwithstanding these less oppressive options, we still opted to homeschool our oldest for four years, helped develop a child-centered alternative school within the system, and ultimately helped create a charter school that allowed kids some power to be who they are and study what they were interested in at the level they were capable of, and even have some recourse if teachers decided to behave badly. It has been a rousing success (the school is in its 20th year of existence!) but more importantly, it allowed my youngest, who would have been considered highly distractible and disruptive in a standard classroom, to develop at his own rate and in his own unique way. He’s now in college and doing great. I have to wonder how many other “square peg” kids would thrive if they were just allowed to be in an environment which adapted to their needs instead of expecting them to adapt to the adults’ version of reality.
I hope you find your way for your son, and I wish and hope there are some alternatives you can take advantage of.
Hey, isn’t the Sudbury Valley school right in your neighborhood?
I see nothing more absurd in Freud’s “id” and “ego” formulation than anything in the DSM series since Spitzer. Actually, I like Freud’s conceptualization better, because at least it’s simple and easier to apply, and doesn’t completely remove behavior from its context.
Of course, the real truth about Freud and psychoanalysis is that Freud was the first to honestly observe that women were being sexually abused in massive numbers as children, and to say that out loud. He was so severely castigated by his colleagues at the time that he reacanted and invented his “fantasy” theories including the Oedipus complex and so forth, and thereby helped set us back 100 years before the truth once again came to the surface. But compared to Spitzer, Freud appears to have been much more genuinely interested in understanding what was really going on with people. It’s unfortunate that even in his day, organized psychiatry was already suppressing any effort to contextualize suffering and severely punished anyone who did so.
It is important to distinguish between unconscious motivations and lack of free will. A person acting out of unconscious or subconscious motivations is still exercising free will – s/he is making a decision, but is simply not being honest with him/herself of the reasons for doing so. This is very different from not being able to become an NBA star due to lack of athletic skills, height, or other abilities. It’s also different from being able to decide to be attracted to a particular person or gender.
A great example is child sexual abuse. I’ve heard it argued that certain people are sexualized toward younger children and molest for this reason. But I would bet you a whole lot of money that there are many, many people who feel sexual attraction for younger children and choose not to act on it, because they know it is socially inappropriate. Or perhaps a less threatening example: I can readily admit to finding certain high school girls very sexually attractive. But I’d never choose to engage in a sexual relationship with someone of that age, because I know it would be harmful to them (in addition to being illegal). We always have a choice as to whether we give in to a particular impulse. It may be harder for some people to make that choice, but it’s still a decision that is being made. To say that prior circumstances force a person to act a certain way dehumanizes us all and makes efforts to change and to address personal challenges appear pointless and meaningless.
Humans make choices. It’s what we do. Conscious or not, we’re still making choices, and saying we have a “disorder” preventing us from making those choices takes away both agency and meaning from our lives.
Szaz took that very position, as I recall. He believed people should be held accountable for their crimes, regardless of mental state, and that incarceration should be based on what one did, not on some theoretically perceived risk of harm to self or others based on a spuriously-defined “mental disorder.” I tend to agree with him. Unless it can be proven that the person was in a condition where they genuinely did not understand what they were doing, they should be 100% accountable for their choices. The fact that someone has some speculative “warrior gene” is neither here nor there.
It is interesting that the IED description says that the person can’t be using this for any kind of specific gain, such as power 0r control over another. This would disqualify 99% of domestic abusers even by their own definition.
“Intermittent Explosive Disorder” may be the most ridiculous “disorder” in this entire ridiculous volume. That anyone can read that name and still take this book seriously is indication of how gullible the public has really become.
“…which attempted to obfuscate the findings by referencing the heterogeneity in persons who exhibit social anxiety.”
Well, if social anxiety is “heterogeneous,” then what’s the point of calling it a diagnosis and trying to “treat” it chemically? How is this any different than someone smoking a joint or taking a few shots of Johnny Walker’s Red to make themselves feel better?
If it’s not homogeneous, it can’t be “caused” by anything specific, by definition. So it’s not a medically treatable entity, it’s just a name you are giving for feeling a certain way. And any drug you’re taking isn’t a “treatment,” it’s just a way of temporarily feeling better. Why is this not obvious?
—– Steve
BTW, I could certainly have qualified for a “Social Anxiety Disorder” diagnosis as a child and a teenager. I can tell you that sufficient alcohol was a magical “treatment” for the condition – enough drinking and I stopped worrying what people thought about me and became quite the social butterfly! So why don’t we just use alcohol as a “treatment” for “SAD?” Rhetorical question…
I agree, this should not be news to anyone, but apparently it is in the delusional world of psychiatry. A retrospective study in the Canadian Journal of Psychiatry some time around 2000 showed that between 6-7% of all children prescribed stimulants in a 100-chart survey had psychotic symptoms noted in their charts. This, of course, does not include those children for whom these symptoms were not detected, nor those who may have later developed such symptoms due to increasing dosage of continued use over time. The only thing that makes this news is years of institutional denial.
This is a fantastic article and helps make our argument that mental illness is not a function of brain as much it is a function of society and culture. It appears that our unwillingness to let our kids make and learn from their own decisions is part of what is making them anxious, depressed and ineffective. Worth reading!
Pregnancy is a huge psychological and physiological stress on a woman’s body and on a family. It is 100% NORMAL for anxiety, depression, anger, and all sorts of emotions to emerge during this time, and yet we do little to nothing to prepare new moms for this experience. We’d be FAR better off normalizing pregnancy as a natural period of adjustment and depression as an indicator that some thing or things need to be changed in the mom and family going forward.
Other stressors include the potential loss of income, loss of role at work, changes in sex life (which can lead to frustration by her partner), body image problems, expectations from partners and/or extended family members, planning for childbirth (including paying for it in some cases), loss of sleep, big changes in schedule, increasing isolation after the birth, the list goes on and on and on.
There is also a huge increase in the incidence of domestic abuse during pregnancy that is almost never discussed in the context of PPD or maternal/prenatal depression. The shift of attention from a self-centered partner to the developing baby often triggers jealousy in such partners. Additionally, pregnancy often provides a sense that the mother is now under more control of the abuser, and abuse can escalate without fear of her leaving.
Add to that the tendency for pregnancy to bring up childhood abuse/neglect issues, and it seems very understandable that depression increases during pregnancy and childbirth. How someone can view depression during pregnancy as a disease state is beyond me. I’m surprised that anyone isn’t filled with anxiety and dread at the idea of starting a family in this culture and economy! Antidepressants should be the very last choice of desperation by any doctor, as there are so many other things that can be done. And the very process of diagnosing and prescribing for this “condition” kind of automatically invalidates the long and yet non-exhaustive list of legitimate reasons to be worried or dismayed that I have provided above. It is beyond idiocy to diagnose a pregnant woman with “prepartum” or “postpartum depression” when it is such a normal part of a very stressful process and doing so I think does a lot of damage to our chances of ever really finding out how to help.
Terror does not harden us. Being bombarded with massively, hysterically overblown “information” that suggests terrorists are around every corner and that drastic emergency action is needed is what hardens us. In essence, we are being “hardened” on purpose by those who benefit from the population living in fear. That’s the core of how fascism gets started, and there are a lot of fascists vying for power these days.
If we were in Israel or Palestine or Syria or Iraq right now, it might be fair to look at how terrorism affects the population. The USA has no claim to have been a major victim of terrorism since 9/11. Poverty, corruption in politics, domestic abuse, substance abuse, and the killing of people by our pharmaceutical industry are all much more vital issues that are being intentionally sidelined by our obsessive focus on “Islamic terrorism” to the exclusion of all else.
And the implications for the world of biological psychiatry are, of course, systematically ignored. If therapy can change brain chemistry, it stands to reason that brain chemistry is readily altered by environmental experiences. Logically, the idea that “mental illnesses” are uniformly caused by fixed problems in the brain is therefore completely disproven, and all those brain scans of the “ADHD brain” or the “depressed brain” can be completely dismissed as anything but evidence that different people are simply reacting to differing sets of circumstances. So why are we trying to drug brains into submission, when they appear to be responding to the survival needs of the environment? I know, I know, rhetorical question… as long as there are financial and social benefits to a certain “truth,” it will stay “true” regardless of the data.
An intriguing and in my view extremely accurate and meaningful article. I have to say, though, I was surprised that you didn’t take the next step when talking about parents’ reaction to their children’s separation. It seems clear to me that parents who have their own issues with attachment have a much harder time with this, as they perceive abandonment and/or rejection by their own child/children, as well as having their identity as a parent, which for some is their primary identity, become increasingly obsolete. I experienced this to a degree with my own mom, though she appeared to show some uncharacteristic awareness of this and took some steps to make it a little easier on me. My wife experienced this phenomenon to a much more intense degree with hers. Her mom was literally in tears when she moved out, saying things like “You held the family together!” and “What will we ever do without you here?” It was quite appalling to me to hear about, partly because I was toward the end of my own course of quality therapy at the time and could see the awful bind she was putting her daughter in.
I like to think we’ve been able to avoid passing most of this on to our kids, but it is a very hard time for parents like us who haven’t had the greatest attachment experiences, and making it clear to parents that their pain is not caused by their kids leaving but by their own unresolved history seems like a very important point to keep in mind.
Thanks for sharing your insights and excellent writing skills!
Indeed, I think it is the opposite of blame to honestly re-examine one’s personal behavior and ask if there is something that needs improving or healing. Blame is hurtful and aims at pulling someone down. True healing can be painful, but leads to opportunities that don’t happen if we act out of the fear of being blamed. It is not a choice between blame and blamelessness. It’s a choice between assuming and avoiding responsibility. Very, very different questions.
And BTW, I think it is normal and healthy for a parent to search his/her soul as to what s/he might have done to contribute to a child’s eventual experiences, even if they ultimately decide it was out of their control to influence. I had that experience with my son who went off the rails on drugs for a year or so and went through exactly those machnations and doubts. It can be very painful, but can also result in some insights that can help figure out what to do. Ultimately, I think it’s not healthy to go to a place of self-blame, but neither do I consider it healthy to go to a place of self-protection. We all contribute in one way or another to our children’s mental and emotional wellbeing, and to deny that is the case is just plain childish. Normal adults work to take responsibility for what they control, and to let go of what they do not. This is a very different process from self-recrimination – it’s an effort to assume responsibility for healing whatever damage may have been done and to help the child move on from it. To deny that opportunity to both parent and child is truly unhealthy for both.
Discussing family dynamics as a factor in mental illness IS taboo in many circles, and in particular in any kind of event or posting I’ve ever seen from NAMI. There are many NAMI local chapters who are branching away from the national narrative, but the one thing you can count on is that “blaming parents” is 100% taboo, and all discussions of family dynamics are framed as parent-blaming. The “refrigerator mother”/autism concept is the one that is usually hauled out to make the speaker feel guilty and ignorant for raising the issue. The fact that every single “mental disorder” is highly associated with abuse history is not an allowable topic of conversation. “Trauma informed care” is starting to be allowable, but it appears that only extreme abuse is given credence as a possible contributing factor. Something as simple as a parent having unrealistic academic expectations or treating one child favorably over another can have long-term mental/emotional impacts of great significance, but this is not something we’re allowed to discuss.
There is unfortunately a conflict of interest for many parents who may not have done the best possible job raising their kids, in that it absolves them from responsibility if the “chemical imbalance” narrative were true. This is the bread and butter that NAMI was originally built around. The truth is unfortunately much more subtle and nuanced, but NAMI appears to allow only two positions: either you agree that parents play no causal role in mental/emotional challenges (unless they beat or sexually abuse their kids or something of the sort), or parents are “to blame,” i.e. 100% responsible for everything that happened. Both of these positions are absurd, of course, but that’s the propaganda that NAMI appears to put out there.
If all parties thought like you, we’d be able to have a rational discussion, but unfortunately, there are many (some on both sides of the issue) who aren’t willing to look at the actual facts of the situation and aren’t really interested in the truth.
I always find it disingenuous, at least, when a study like this finds equivalent outcomes and then suggests that both therapy and medication are equally valid approaches. Aren’t we forgetting something important? Namely that therapy doesn’t attack your brain with foreign chemicals or create an array of side effects that vary from annoying to potentially deadly? If both have the same outcomes, and one has much, much lower risks, an honest conclusion should be that PSYCHOTHERAPY MUST BE OFFERED IN ALL CASES before antidepressants are even considered.
Of course, considering Kirsh’s work that suggests most of antidepressants’ effects are placebo effects, this isn’t exactly a ringing endorsement of psychotherapy, either. But at least it’s very unlikely to end your sex drive permanently or induce you to kill yourself or go on a mass shooting spree.
It looks to me as if holding the perpetrators accountable would result in the loss of a significant percentage of the military command personnel. If this kind of thing is tolerated or even promoted, it means the administrative authorities know all about it and are either looking the other way or encouraging or even perpetrating the retaliation. To have nearly two-thirds of reporters experiencing retaliation says that this isn’t the action of a few outliers – it is military policy being enforced from the highest levels. It also reflects the highly sexist atmosphere that exists in the military and our society as a whole.
This is not a matter for policy change – this is a matter for culture change, just like the prosecution of police officers abusing their power. Only when the higher-ups are held accountable for what happens under their command, as well as for creating a new culture of support for victims and intolerance of rape and the sexist harassment that goes along with it will we see any real change in these statistics.
While you are correct that some local branches of NAMI can be quite supportive of survivor voice and choice, and while NAMI on a national level appears to be trying to emulate that effort, my direct experience with NAMI programs tells me that recovery almost always means “recovery with medication.” The classes are organized that way, the national promotional material looks that way, and the politics clearly leans that way. Look at NAMI’s support for the Murphy bill, as an example. How can they claim to be pro-survivor voice and choice and advocate eliminating SAMSHA, who has been the biggest cheerleader and funder of efforts to increase survivor participation in decision making and shifting to a recovery focus? How can they support more use of force and a lessening of the civil rights of individuals with “mental illness” and maintain that they are pro-recovery and pro-voice and choice? How can they be anti-stigma and yet allow Murphy and Torrey and their ilk to continue to peddle the disproven concept that mass shootings are caused by “untreated mental illness?”
NAMI may be mending their ways in some respects, but they’ve done a HUGE amount of damage over the years in promoting the medical model and the medication-first treatment paradigm for decades, and they have a lot to answer for. If you can’t see why folks would be appropriately suspicious of their motives, given both their behavior and their primary funding base, you perhaps need to try to extend the empathy for other points of view that you’re asking for to those who may have had a very, very different experience than you with NAMI and with psychiatric treatment.
I have long maintained that this phenomenon is more damaging than even the drugs themselves can be. Conceptualizing mental health issues as “brain problems” is inherently disempowering. Interestingly, in Harrow’s longitudinal study of those diagnosed with “schizophrenia,” one commonality amongst those who recovered was an internal locus of control – essentially, the idea that they could do something about it rather than waiting for a doctor to cure them. This is the opposite message of what most clients receive. What could be more demoralizing than hearing, “The reason you feel bad is that your brain doesn’t work right. It has nothing to do with your history and life experience, and there isn’t anything you can do to fix it. We’ll give you drugs for the rest of your life that might make it more tolerable, but that’s all we have to offer and it might not work. Good luck!”
If I weren’t depressed before getting that message, I sure would be afterwards!
“Mind,” I think it is safe to say, is an intellectual construct used to identify the processes that encompass things like beliefs, values, motivation, perspective, which are not easily attributable to any known location or physiological process we know if. Who knows, some if not all of the functions of mind may someday be explainable in physiological terms, but they aren’t as of right now, that’s for sure. Steve, I read your website and some of your document, and while it’s fascinating and well-reasoned, it’s still philosophy to me. A scientific finding that “mind” is a function of “brain” would have to tell me what exactly in the brain makes “mind” occur and how we know that this is the case. There would need to be measurements and testable theories and replicability of results. I’m not seeing that. I’m not surprised, either, because I think mind is a very mysterious phenomenon, and it may never be fully understood. I don’t believe it’s unscientific to acknowledge what we don’t know. In fact, that’s one of the core values of science – we assume we don’t know until proven otherwise, and then we only know what the data tells us and when conflicting data arise, we once again don’t know. Science is inherently skeptical, and it’s much more scientific to say, “I have this data suggesting this may be true” than to say, “The mind resides in the brain” when there really isn’t the data to show that with confidence.
I love philosophy and think it is VERY important to understanding our world, but it’s different than science.
And don’t forget receiving standard medical care, the third leading cause of death in the USA, behind heart disease and cancer, and an almost completely preventable one. MUCH more dangerous than terrorism!
Wow, seems unnecessarily complex to me! I think the concept has some validity, but a much simpler chart would be needed to make it effective and efficient. Perhaps starting with a single “cycle” and building from there would be more helpful that creating this gigantic map, which to me would feel overwhelming and demoralizing to look at.
I hate to say this, Steve, but your proposition is also philosophical. You say, “I also do not believe in emotional ‘states'” and “I believe that the ‘mind’ and the brain are the same thing.” Those are most definitely philosophical positions, not known scientific facts. I think it’s fine and important to discuss all of these philosophical viewpoints, but in truth, we don’t KNOW what “mind” really is and almost have to resort to philosophy to even discuss it. I think it’s important to remember that science itself is based on certain philosophical assumptions, and was originally conceived as a branch of the more overarching subject of philosophy (which, in fact, was originally seen as overarching ALL subject, and I think properly so).
It’s OK with me for you to take a materialist viewpoint on the mind, but I don’t accept that it is automatically more “scientific” to argue from that particular viewpoint.
I like “trauma adaptations” better, by far. The reason I suggest “mental injury” is because I think it could be adopted more easily and doesn’t sound too “PC” for those who are not so far along in understanding the power of words to redefine thought and political decision making. It’s kind of a “middle ground” term that might catch on, or that was my thought, anyway. In our alternative worldview, “trauma adaptation” is definitely a more empowering alternative.
I have often thought that rather than “mental illness,” those with a normal reaction to trauma would be better conceived as having a “mental INJURY.” This puts the blame where it belongs – on the injury and the person or events that caused it. It recognizes the suffering that results, but also is more empowering because injuries generally can be healed. It’s still a little medical for me, but I think it’s a much better frame than “mental illness” that might be more palatable to the mainstream but still get the point across that reacting with fear to a terrifying experience is hardly abnormal.
I have been clear if diplomatic about my opposition to DSM labeling and the wholesale drugging of foster kids for many years. I am fortunate to be in an advocacy job where we are expected to take contrary positions sometimes. It has affected me professionally in some ways (I believe it prevented me from getting a particular job at the State level that I would have been great for), but my agency has never wavered in their support for my taking on these issues publicly. I’m somewhat of a celebrity in the world of CASA (Court Appointed Special Advocates, my organization’s affiliation) and in the local courts, where people know me as the psych med guy. And the local foster-youth-driven advocacy agency loves me.
So it is possible to survive in a professional job while being “out” about my views, but it most definitely has costs.
It would be great to have more community, but I have found that my very well researched views are not welcome in many communities where people are very invested in the “chemical imbalance” viewpoint. I think there are a lot of political reasons for this, and most of them do NOT come from fist-raising by consumers, but from job protectionism and corruption within the industry. And sorry to say, when you remove the pig from its accustomed feeding trough, the pig is going to squeal.
It really is a bullying type situation. We can tell people to “get along” all we want, but as long as the bully has everyone afraid of being beaten up if they don’t support the status quo, “getting along” quickly deteriorates into “capitulating to avoid a fight.” That does not lead to community.
So if you have a pathway where those who are invested in their either pro- or anti-medical viewpoint can find some common ground, I’d love to hear it. But in truth, it’s not the “mentally ill” who started this fight. Your comments remind me a little (just a little) of black people being told that white people can’t hear their message because they’re too strident and angry about it. Well, gosh, I think they have good reason to be strident and angry, and it’s not the job of the person experiencing oppression to take care of the oppressors to make sure they feel OK! In fact, to capitulate to that reasoning seems like collaborating in their own oppression. I think the same applies to those with mental health labels. If some people are OK with or even like their labels, that’s their choice, but why is it that people rejecting labels is so threatening to those who accept them? Or especially to the parents who are concerned about their adult children and see force as the only answer?
I know it’s not easy to navigate these waters, but remembering that the recipients of dishonest and sometimes deadly psychiatric care are not equal players on a level playing field, but are in fact the victims of forces vastly beyond their own control, it becomes a lot more understandable why ANGER is an appropriate response, rather than endless attempts at “respectful dialog” that do nothing to enhance the power position of the victims in this power play.
It must be an epigenetic response tied to inherited economic crisis sensitivity genes which modify the brains of vulnerable persons to be upset about being unemployed and potentially starving to death with one’s family. The truly mentally healthy person has a brain adapted to handle this kind of stress by stoically continuing to look for unavailable jobs until one expires from starvation or physical exhaustion.
In other words, since not EVERYONE commits suicide or becomes otherwise mentally unhealthy as a result of loss of a job, it MUST be that the people who become upset are ill in some way, otherwise, they would find a less upsetting way to either scrabble out an existence selling pencils on the street corner or to quietly expire in some remote place where it won’t cause any upset to the general population.
Wow, that started out funny but got kind of grim towards the end there!
When you start dispensing drugs based on subjective and spurious behavioral characteristics without any measurable way to distinguish between those who “have” and “don’t have” these “disorders,” this is the inevitable result. Anyone can go into a doc and claim to be having “difficulty concentrating” and get a prescription, because there’s no way the doctor can actually test to see if they have a problem or not! Works well for the pushers, but not so much for the addicts we’re creating. And of course, the medical veneer of acceptableness of a drug is known to cause the public to view it as safer, leading to more experimentation without concern for consequences.
It is interesting that they did not do a comparison of side effects. I have to imagine that the side effects from light therapy are little or none, whereas we know the side effects of Prozac can be substantial. There is so much emphasis on “symptom reduction” as the ultimate measure of success that quality of life measures are almost systematically ignored. If you add in the side effect profile, this should make light therapy a first-line treatment for depression and relegate Prozac to the place it belongs – an adjunct treatment that can be tried when all else has failed – an act of desperation when we are ready to give up.
And of course, BPD is right that the whole premise of these studies is faulty when they act as if they are “treating” a “disease” called Major Depressive Disorder, rather than just experimenting to see if exposure to light makes people feel better, which is what is really happening.
It is obviously not guns alone, because lots of other countries have lots of guns and don’t have this problem. it’s also obviously not about “mental illness,” because we are assured by the Church of Psychiatry that mental illness prevalence doesn’t vary much from country to country. Why would the USA, the most “treated” population in the world when it comes to “mental illness,” have these ridiculously higher rates of mass murder? (Unless, of course, the “treatment” was a factor, but I’ll let that rest for now.)
There is clearly something CULTURALLY DIFFERENT about the USA that allows and encourages these events to happen. The argument against the Murphy Bill is almost absurdly easy: “They have mental illness in France, don’t they? Germany, Italy, China, Japan, Australia, right? So why don’t they have mass shootings then?”
He is the creator of the Connors scale for assessing “ADHD” symptoms. Making plenty of money off the mainstream conception of “ADHD.” So if he thinks the diagnosis is out of control, you KNOW it’s out of control.
Right! It’s artificial stimulation to make up for the lack of expected natural stimulation. Why not instead make the environment more stimulating? But that would require the ADULTS to make the adaptations, and it’s much easier to put the blame on the powerless and continue with our own misconceptions unchallenged.
I agree. In terms of scientific validity, I’d say astrology beats psychiatry hands down. At least there is some way to actually measure and agree upon terms, and the labels don’t automatically imply disease or disability. Plus it’s a lot more fun than psychiatry, by a long shot! But that’s kind of like saying it’s more fun than waterboarding…
This is not new, but also not published. Apparently, people who are at peace with their lives are much less likely to develop the full range of Alzheimers symptoms even if their brains are falling apart. They may not remember things, but they don’t get disoriented and confused and hostile and delusional. So even Alzheimers, which clearly has a physiological component, is not entirely a “brain disease.” Experience and attitude are factors even when your brain is dying off.
And despite that, there is no single “diagnosis” that can be even close to predicted by brain scans of any type. The pictures they show you of the “ADHD brain” are AVERAGES over many people. Not all “ADHD” people have that particular brain scan, nor do all with that kind of scan show any signs of “ADHD.” Daniel Amen, the brain scan’s biggest proponent, even admits that the so-called “ADHD” brain is also seen in people with brain injuries as well as diagnoses of schizophrenia and one other “disorder” I’ve forgotten.
Also remember that these are brain ACTIVITY scans, not structural scans. So they reflect how you USE your brain at a given moment. They are fluid and active and respond to external stimuli (the “ADHD brain” is apparently only observable when you make the subject do something they find tedious or stressful, so maybe it’s the “bored brain” or the “stressed brain?”) There was a study I recall where they had people think of something sad, and their brains went in the direction of the “depressed brain” averages. When they then thought of something happy, their brains changed back.
Brain scans should be renamed “Brain scams.” They don’t diagnose anything.
Except you can’t make money off them if they’re dead, so they have to create a near-death state that persists for years. Otherwise, you’re no longer billable.
Truly. What if we found that treatment for heart disease or cancer REDUCED people’s life span by decades? Would such “treatment” be tolerated? I don’t think so. It’s only because of the marginalization of the so-called “mentally ill,” which the DSM so effectively operationalized for professionals and society at large, that such outcomes could be considered anything short of outrageous and criminal.
I have plenty of outrage – my question is, where do I direct it? There are some gigantic social forces at work to keep these outrages “hidden in plain sight.” How do we, such a small and easily marginalized movement, counteract such massively funded antagonists?
Wow, these guys appear to have hit the nail on the head! It surprises me that this ever got published, but it’s encouraging to hear those in academia honestly reporting the lack of long-term benefits and the myriad of problems these drugs and the disingenuous promotion of their more widespread use have caused. When Keith Connors, who is the ultimate psychiatric mainstream guy, is telling you that you have a disaster on your hands, it’s time to wake up and listen!
Exactly. The only legitimate measure is the impact on the client, and if it’s negative and the treatment persists, it’s abusive. I don’t really care why the perpetrator acted that way – s/he had the power and abused it to harm his/her charge. There really is no legitimate excuse.
I think it has to do with whether the professionals have dealt with their own abuse issues. A lot of abusive behavior is simply accepted as “normal” in our culture. Consider this: if a parent is taking his/her kid to preschool, and they’re crying every day or pretending to be sick or begging the parents not to make them go, almost any parent would investigate and if necessary pull their kid out of that daycare setting, as it’s obviously harming their child. But a kid in Kindergarten doing the same thing is told they have to go, that school is difficult but it’s part of growing up, that they have to adjust, etc, and if they can’t, they earn a trip to the psychologist or psychiatrist and are pathologized. Yet we all know that school environments can be abusive, and are often neglectful, especially in terms of setting unreasonable expectations of children based on their development. We accept this as “normal” because we all went through it and nobody believed our cries for help and it’s uncomfortable to think about trying to confront this behemoth, so instead, we do to our kids what was done to us and the cycle continues.
How much harder to face that your PARENTS may have mistreated you, intentionally or not, or that your needs went unmet when you were very young! And if this is true, and you personally haven’t faced it, how much EASIER is it to diagnose and prescribe a pill than to sit and listen to the helplessness of another person that reminds you of your own unresolved feelings of helplessness?
The inability of professionals to deal with their own pain leads to them acting out those issues on their clients. The DSM facilitates this process very effectively, as it’s simple to find a label for the distress in another and to make your objec tive to WIPE OUT THE DISTRESS that is making YOU uncomfortable, rather than facing the uncertainty of recognizing that the distress may have a very real and understandable cause that reflects your own distress that you’ve been trying so very hard to avoid experiencing.
Great post! I mostly do agree, but I think there is one point that is missing from your analysis: people who haven’t done their own work on their own trauma or childhood distress are often eager to see ways to work out their issues on others on whom they can project their problems. I think a lot of psychiatrists and other MH professionals fit into this category. The absolution from guilt you so correctly observe is a big part of the appeal of this labeling system. But I can’t absolve those who grasp onto this from all responsibility – because their decision IS intentional (albeit unconscious) and they are acting out of their own interests rather than their clients’. Your description is accurate and makes their behavior more understandable, but I don’t think it makes it more excusable.
You are, of course, correct that it is hard for someone high in the IQ department to really understand what it’s like to be in the lower 50%. I try to be compassionate, but when a person has a power OVER another person, my compassion goes first to their victim, regardless of their own limitations.
But like I said, it’s hard to know who to be mad at. Somewhere at the top of the food chain, there are people who know EXACTLY what is happening and are very conscious and intentional about their actions. But I can’t believe that all psychiatrists are just dumb and misled. I am sure that some have heard data and arguments that counter how they have been trained, and if they are real professionals intending to help their clients, they are responsible to explore and examine this data. Not to do so makes them guilty of severe neglect, at the very least, and I don’t think it’s correct to let them off the hook just because they’re mistrained. After all, the clients’ responses can tell them what is and isn’t helping if they bother to listen, but that would mean exhibiting a humility that all too many seem unwilling to embrace.
Thanks as always for your great and stimulating post!
I absolutely agree, these articles are VERY helpful in providing education to the miseducated masses. It just pisses me off that those in power to do something about it are so married to the status quo that we have to “discover” these obvious things and encounter resistance to “reeducation” from people who have a hard time believing their doctors would wittingly or unwittingly deceive them.
I also agree it requires great patience when dealing with folks who are steeped in the “conventional wisdom.” It makes me sad, as most are decent folks just looking for answers. It is those who know better, meaning the professionals in charge of mental health institutions and agencies, who are most at fault for allowing their charges to be mis-educated due to their own lackadaisical attitudes or venal greed.
It’s hard to know who to go after, though, because a lot of doctors are consuming the same propaganda as their patients. Where does the buck really stop?
Too true. It is ironic that the drugs that “treat” ADHD also cause lower appetite (which of course leads to lower blood sugar levels) and less sleep, both of which contribute to the very symptoms it’s supposed to be treating!
Bottom line, messing with the brain is a bad idea and should be avoided if at all possible. There are so many other options, but of course, none so profitable, and profit drives policy in this sad world we live in.
Again, this all seems to obvious to me as to not even need investigation. It’s sad that these folks have to work to convince the mainstream that this is true.
Depression is the physiological reaction to being in an untenable situation that you can’t fix. It’s essentially a response to being powerless, an effort for the organism to conserve energy until such time as an attack or escape becomes available. There is nothing abnormal or unhealthy about a kid being depressed when s/he is in a situation of powerlessness – it is the obvious and actually most rational approach to take.
That this has long-term consequences should also surprise no one. The real question is how and why the professionals have allowed this obvious conclusion to be “news.” It continues to astound me that so-called professionals can minimize this obvious causal factor and waste so much time and money exploring biological explanations that obviously explain very, very little.
I do agree with you about recovery. Unfortunately, too many of the patients have been trained to believe the mantra that we are talking about. That might be a difficulty for some people regardless, but one thing we CAN change is to stop convincing them it is true! EMPOWERMENT is the key to recovery. Teaching people what they ARE capable of, sometimes against even their own deep inner belief, is what we should be doing, not teaching people that they are condemned to a lifetime of disability!
Change is slow, but it’s slower when people with vested financial and power interests don’t want the change to happen. Sadly, I think that’s what we’re up against here. There are too many people making big bucks off of the “lifetime disability” meme to allow a few inconvenient fact stand in the way. After all, if we start empowering everyone to recover, they’d have to start finding new clients!
I agree with your basic premises, but would add one thing: expectations (at least in US schools) have become higher at lower grade levels, and young kids are more commonly asked to do things (like sitting still or working on worksheets or even doing homework) in the early grades that are simply developmentally inappropriate for their age. As evidence, a few studies have now shown that waiting a year to start kids in school reduces ADHD diagnoses by 30% or more.
It is also worth noting that there is no “hypoactivity disorder:” kids with low levels of activity are never critiqued, because they’re not inconvenient for adults to manage.
“admitting subclinical phenomena into a classification system is a very slippery slope. The lifetime prevalence of mental disorders could easily come to approach 100%.”
It is also important to remember that these brain scan studies always use averages of a large number of scans. Any individual person’s scan may vary widely from the average, and the scans you see represent at best general correlations of what is MORE LIKELY to occur in one condition than another. Of course, this is to be expected, given the heterogeneity of people who happen to get any one particular label, and it’s always important to keep in mind that any similarities are more likely to be related to treatment effects than to any similarities the participants may have had preceding “treatment”.
You should read “Anatomy of an Epidemic” if you want to understand why most of us disagree with your assessment of optimum care for the “sickest people.” There is actually good evidence that simply providing housing for a person without any expectation of treatment participation improves their symptoms, as does giving them money to buy essential items in their life. Whereas the long-term outcomes associated with psychiatric drugs are looking more and more discouraging. It seems they may actually make it LESS likely that a person will recover from a “serious mental illness.” Don’t you think that’s something people deserve to know?
People should not be shamed for not “recovering” the same way someone else expects them to, any more than they should be shamed for rejecting Psychiatry’s worldview that their condition is a chronic and incurable disease. We’re generally not talking about individual cases here, but about big-scale trends. And the big-scale trend in the world of “chronic mental illness” is that psychiatry, on the balance, is making things worse in terms of the probability of recovering a functional life. The biggest objection I have is not to offering the drugs, but to lying about what they are and what they are “treating.” A couple shots of Jack Daniels “treats” anxiety just as well as a hit of Xanax or Valium. They all reduce anxiety and bring certain side effects. But “treating” someone with alcohol would be considered horribly unethical, while prescribing Benzos like the above chronically over many years is totally accepted psychiatric “treatment.”
Individuals should have the right to make informed decisions. Lying by doctors (0r pharmaceutical companies) on a grand scale prevents such decisions being truly informed. “Recovery” is a personal thing, but enforcing “treatment” that can make you worse is a political one and should not be allowed.
This is VERY good news! I had to laugh when they write that pharmaceutical companies claim that “ads help consumers learn about diseases.” Those guys are SO sociopathic, it makes me ill! At least they could admit what they were up to – why would they spend 16 billion dollars on DTC if it didn’t bring back a whole lot more in profits?
It is sort of ironic that they settled on the “insulin for diabetes” meme when the main “treatment” for certain “illnesses” actually CREATES diabetes. It’s also the only area where “good treatment” leads to a shorter rather than longer life expectancy, which of course would be a disaster in any other field of medicine!
If he is attributing “little white lie” to Whitaker, he ought to present it in context. Whitaker was clearly using that phrase to highlight psychiatry as an institution displaying a marked tendency to minimize what is in fact a very crucial and dramatic alteration of the narrative of what a “mental disorder” actually consists of as well as how to “treat” such a disorder. Whitaker was certainly not suggesting it was a “little white lie,” he was suggesting that Pies and others of his stature are painting it that way, as a little something they did to make it easier for patients to accept their need for treatment, rather than a primary means of diverting clients from other kinds of help, or even convincing people without any substantive problems that they needed “treatment.” The corollary of benefit to the profession and the pharmaceutical industry should be a pretty obvious motivating factor for such intentional duplicity. To suggest that it’s “not a big deal” to lie to patients about the etiology and treatment for their purported condition is the very thing that Whitaker is critiquing, and that Pies is displaying in his responses.
As stated, the critique is not of Dr. Pies, nor of Dr. Carlat, but of the issue of psychiatric key opinion leaders, which both Carlat and Pies most likely qualify as, remaining silent on the issue if the “chemical imbalance” myth. It is Hickey’s contention that responsible psychiatric thought leaders knew this idea was at best “simplistic,” and in certain cases, out and out disproven and false. And yet nothing was said or done to dissuade the public from adopting this convenient viewpoint, which specifically is noted to make people feel more comfortable taking prescribed pharmaceuticals. I think he also does an excellent job of outlining how “unrestricted grants” could wittingly or unwittingly steer even a person of high integrity subtly down the road of promoting something that was not actually proven to be the case. I’d be interested to hear your views on those points, rather than a critique of Carlat, who I’d say has made himself a relatively easy target at times, but whose candor in recent years I think has shed some significant light on how the psychiatric community views the chemical imbalance mythology.
You can probably get more funding for the second to last than any of the others. We don’t really want to know how social variables affect mental health, because then those in power would have to DO something about it, and that’s nothing but work, work, work… not to mention the lost profits if people start to get BETTER! We can’t have that, now can we?
My thought exactly! The number of kids on antidepressants in college is something like 25%, and even more are taking stimulants, licitly or illicitly. I wonder two things: first, are we seeing the long-term impacts of messing with serotonin emerging, as a whole generation becomes more anxious due to counterproductive medical intervention in their brains? And second, as we increasingly substitute pseudo-medical interventions for genuine human-to-human problem solving, is this generation arriving at college with diminished skills because they’ve never been taught to cope with adversity?
I suppose my third question would be: what is the impact of gr0wing up in a world where even going to college does not give you a reliable key to economic success in a world that seems increasingly unforgiving of any deviation from a narrowing “norm” of behavior?
Not to mention, it’s objectively false. But lying is apparently OK to get people to “take their meds,” which is the main function of “mental health treatment” for the “seriously mentally ill” today.
I’m sure it’s the bacteria. Couldn’t be that our modern lifestyle is just plain unhealthy, could it?
We all need green and natural environments. It isn’t something we need to study. All this will lead to is patented earth bacteria capsules so that people can eat dirt while continuing to live in a sterile environment doing things they hate with people they barely know and don’t care about without going completely around the twist.
You sound like the kind of therapist that was common when I started in the field. Unfortunately, your kind are becoming rarer and rarer over time. I hate to say this, but the main reason the DSM 5 diagnosis appears to indicate a fate of never recovering is not because the clients somehow infer that, but because THAT IS WHAT THEY ARE TOLD by mental health professionals. They are told they have a chemical imbalance in their brains, that it is incurable, but that if they take their medication faithfully, often for life, they may be able to function. Many with bipolar disorder of schizophrenia diagnoses are told that they should give up on their ambitions and accept that they have a disability and will be in treatment the rest of their lives. It is a most disheartening message, but it is delivered by our professionally-trained mental health workers, including psychiatrists.
And it is a self-fulfilling prophecy, especially for those for whom the medications don’t work or have adverse effects of major significance, which is actually quite a high percentage, especially when looking at those diagnosed with “bipolar” or “schizophrenia.” These people are dying years earlier than their non-drugged counterparts, mostly because of the very drugs they’re taking to supposedly improve their lives.
A fairly recent survey asked people with mental health diagnoses who gave them anti-recovery messages after hearing about their “disorder.” The #1 culprit, at something like 75% of the cases, was mental health professionals.
Folks like you may be helping, but you are a small fish in a very big ocean of distorted training and messaging. I’m glad you’re there to help counteract it, but the truth is, a large hunk of the negative stigma around being diagnosed “mentally ill” comes from the diagnosis and the people who assign it.
Bottom line, Mark, is that you or whoever are setting arbitrary standards of “illness” that would never be accepted in the world of physical medicine. What is and is not considered problematic is very much a socially-mediated question. “Normal functioning” is defined differently in every culture and subculture, and pretending that interference with “normal functioning” constitutes an illness is most definitely a scientific fallacy of a high degree.
As to whether people have a choice or not, we seem to have dropped the concept of unconscious motivation out of our discussion of “bad behavior” in the last 40 years. People make choices, but they’re not always aware of why they do so. The hoarder is CLEARLY deciding to prioritize keeping unnecessary things because it meets some internal need that s/he is not aware of. The fact that this need and the attendant choice is not conscious does not make it any less of a choice. In fact, really good therapy, in my experience, is very much about making people aware of WHY they feel they have to act a certain way, which enables that person to make a more conscious and intentional choice rather than feeling s/he has to go along with the script unconsciously laid down by his/her past experience. I’d say the same applies to drugs or alcohol, although long-term use does make quitting a much more challenging decision to make. No one stops drugs without deciding to stop. It is a decision to continue, even if it doesn’t feel like it’s in the addict’s control.
I would add that this is also part of the Gun Lobby’s effort to deflect attention away from gun control. If we can blame “the mentally ill” for these events and lock more of “them” up, they figure it takes the heat off of guns as a possible target for legislation. Of course, what they don’t realize is that they’re opening the door for more oppressive gun laws targeting the “mentally ill,” which given the DSM’s charge toward pathologizing any emotional reaction to anything, will soon include them and all of their constituents. It’s actually a great back-door way to disarm and disenfranchise Americans who object to the status quo, used effectively in the USSR and other places in the past. They really ought to be careful what they wish for, but as long as they can see “the mentally ill” as someone OTHER than them and their constituents, they will continue to support this odious legislation as a means of scapegoating someone other than their contributors for the problem.
This is SCARY! Why are conservatives, who are always expressing concerns about World Government, outraged by this attempt to control others’ behavior under government auspices? Why aren’t liberals, who are always expressing concerns about civil rights, outraged by this attempt to invade the privacy of anyone declared “severely mentally ill” by this ridiculously subjective set of criteria?
I agree, Alex, power is at the center of all of the “isms,” the desire to have power and the fear of losing it. Psychiatry is built on this desire and fear, from its very foundations, and it is only through our own humility and willingness to step out of power roles and create the space to be human that this can ever be healed.
Sera, thanks for writing this and putting it on the table for all to see and engage with. Not sure what else I can say – it’s a vitally important issue and I’m glad when folks speak out about it. I’ll make every effort to be all the more attuned to these dynamics in the groups I’m part of, including this one!
Actually, I think it would be interesting to see what percentage of psychiatrists take their own prescriptions. Psychiatrists have one of the highest if not the highest suicide rate among professions. The first Fort Hood shooter was a psychiatrist. Just makes me wonder…
I agree 100% and intended no criticism of the posting. It is the fact that it is considered NEW INFORMATION in the mental health field that is so distressing! I really appreciate your making this public so that others may recover from the misinformation they are flooded with on a daily basis.
Don’t forget receiving medical care on your list of most dangerous activities! As of about 2000, receiving medical care was the third leading cause of death in the USA, after cancer and heart disease. Readers here will not be surprised to hear the #1 cause of medical death induction: side effects of properly prescribed and administered medication.
The relevance of gun control to the Murphy bill is that it is that opponents of gun control are using the “mental illness causes mass shootings” meme to promote the Murphy bill as a deflection of attention away from guns. They really are completely separate issues, and should be treated as such, but we do have to be aware that in their zeal to protect gun rights, some activists are promoting discrimination against “the mentally ill” as the scapegoat for a very complex cultural problem. Perhaps some people in the survivor movement should try to link up with gun rights advocate groups and point out that this kind of law promotes exactly the kind of tyranny they are concerned about. Once we establish “mentally ill” people as dangerous, we can remove their arms, then label more people as “mentally ill” and remove their arms, too. The USSR used “mental illness” legislation to imprison thousands of political dissidents. It could happen here, too.
Of course, they’re skeptical. They’re skeptical as to how this could be profitable to them and their brand. They can’t really allow competition to become mainstream – people might start getting better, and there goes the client base!
Laughable indeed. This sounds about as brilliant as saying, “We are going to eliminate all back pain by 2099 by studying the genetics of back pain.” While I have no doubt that there are genetic constellations that might make one more vulnerable to back pain, back pain is a sign to your body that something is wrong and should be addressed! Same with depression – it’s a message that something isn’t working. Why would anyone think that an emotion so central to our survival as a species should be eliminated? Or that it even could be?
These people are delusional. But apparently so are their funders.
Because when you actually try to help people who are depressed, you quickly discover that all of them have different needs and the same approach does not work for all of them. At least that’s what I’ve found. Take your light example. Some people who are depressed get better when exposed to more light. Most do not. All of them may qualify for “Major Depressive Disorder” diagnosis, but only a small percentage benefit from light therapy. If we study “MDD.” We may conclude that, say, only 15% improve with light therapy, therefore light therapy “doesn’t work for depression.” Whereas if we take Johanna’s approach, we say, “Let’s figure out who amongst this diverse group of “depressed” people will benefit from light therapy – that will help 15% of our population, which is awesome! Now let’s see what we can do for the next client who wasn’t helped by that. Let’s also see if there are other things that some of the light therapy clients might need to help them succeed even more!”
“When we go against nature, we are bound to become depressed.” That’s about the best description of the etiology of depression I’ve ever heard! Our society from our earliest days, even before birth, requires us to do the unnatural, from forcing babies to be born before they’re ready and snatching them away from moms to put them under lights in a box, to encouraging parents to let their babies “cry it out” in another room without responding, to sending kids as young as 6 weeks off to daycare, and later on to a school that has little respect for their developmental needs to explore and create and interact, to requiring adults to work 8 hours every day at something they find little to no meaning in in order to survive, and live under the constant threat that this job will be taken away and they will starve to death and die.
Depression is a natural reaction to unnatural circumstances. Kinda sums it up.
This is the third no-brainer research article I’ve read on here today! Anyone ever been depressed? Does it help when people come by and connect with you? Why do we have to pay people to “discover” these obvious human facts?
First off, I hope no one was actually surprised by this revelation.
From the article: “For depression, the activation of a highly central symptom means that impulses will spread through the network and activate a large number of other symptoms, whereas a peripheral symptom is less relevant from a dynamic systems perspective because it has few means to influence the network.”
What an incoherent collection of blather! No actual mention of a human being or his/her experience in this paragraph or the article. We should send this to Ron Pies and ask, “Is this what you mean by psychiatry working on the bio-psycho-social model, Ron?” Looks like the bi0-bio-bio model to me!
I’m afraid more “education” isn’t going to change anything, because most of these prescribers know very well what the risks are. They continue to do this because it benefits them either financially or professionally or both. What is needed is not education, but ACCOUNTABILITY. Doctors should not be able to get away with “standard and accepted practice” when that standard practice is harmful.
How about a ban on off-label prescribing for starters?
I agree, there is a big difference between blaming someone and identifying the actual antecedents to a bad set of circumstances that has arisen. Blame implies judgment, but finding the contributing factors is more a matter of communication and honesty than blaming someone. I do get worried, though, when the author generalizes to “mothers” as the default cause of trauma. There are plenty of other traumatic sources besides our moms. My brother was a huge one for me! And I don’t think he was or is a bad person. He was just a kid and so was I and we were close in age and probably were not really meant to live together. I don’t blame him, but I do recognize that he was mean to me a lot and that it had an effect on how I grew up. To deny that in order to save his feelings would, in a word, be “crazy!”
You know, there was actually an experiment at a university where students used a computer terminal to provide programmed “therapy.” The computer asked non-directive questions like, “Tell me about your childhood,” or “What was school like for you?” It was programmed to acknowledge the person’s answer appropriately (like, “Go on…”) and ask followup questions. If a person got off the track too far, it would say something like, “Let’s get back to talking about your father…” The funny thing was, the students reported feeling significantly better after interacting with the computer program! Maybe people mostly need to tell their story and not have it invalidated or questioned or be given a bunch of ill-conceived advice about it. But that’s not what they get in today’s mental health system.
You speak very wisely. I am sure you’ve helped a lot of people, because you’re honest and compassionate. As you say, it’s not quantum physics. But most mental health people seem to be clueless or simply don’t care enough to try. What it mostly requires is being humble enough to know that you don’t and can’t know all there is to know about another person. So you have to care and listen and be willing to feel their pain. Not something our system seems designed to encourage.
Had a client I saw in the hospital one time. She said, “For the cost of all this, I could take a two week vacation in Hawaii.” I said, “Yeah, and it would probably be more helpful!” She agreed and laughed. Probably the most therapeutic conversation she had had all day.
Yup. It’s narcissism, plain and simple. I must be right, therefore, you must be wrong if you oppose anything I say or do. They go to the gallows protesting that they are the real victims.
I also had a charge placed in a facility that was obviously inadequate and dangerous. They placed this kid on two “antipsychotics” and two “mood stabilizers” at the same time. When her hands began to shake all day long, they told her it was because she was “nervous.” When I told the psychiatrists we were worried about the side effects she was experiencing, he said, “We haven’t noticed any side effects!” And they ironically had a poster of “client rights” on every hallway wall that included “the right to know what medication you’re taking, what it’s for, and what the side effects are.” When the volunteer assigned to the case asked the therapist if she’d gone over the side effects with the kid (who was 14 and quite bright), she said, “Oh, we don’t tell them about side effects!”
When they were shut down a year or so later, one of the repeated complaints was “an unwillingness to respond to feedback from the community.” They stuck to their distorted views to the bitter end.
There are some very dangerous people in this field, and the biases and structure are such that they literally can sometimes get away with murder!
Too true! And women and children are usually left to take the blame when male-dominated institutions fail us. I think that’s a big part of what the DSM is about – shifting the blame from social institutions onto its victims, and the less powerful are the easiest to target, hence, women, children, the poor, the elderly, the darker skinned and the incarcerated are the scapegoats for any social ills that may emerge. If they’re unhappy or upset or angry about their role in society, it’s proof that their brains don’t work right, because if they were “normal,” they’d simply accept their subordinate victim roles without bitching about it and making things uncomfortable for the ruling elite.
This should surprise no one, and yet nothing will be done. Doctors can basically do whatever they want, however stupid, as long as lots of other doctors are doing the same. Something needs to be done to create some accountability, in psychiatry and in medicine in general. Doctors really are handing these things out like M&Ms.
As to incentives, who said Socialism is averse to incentives? I think most social democrats would agree that incentives to, say, invest in green energy are good, while incentives like cleaning up oil spills without charging the company who spilled the oil are bad. I think they’d just advocate for different incentives.
Additionally, as B says somewhere below, I think socialistic structures in a capitalistic economy actually encourage innovation by allowing small entrepreneurs to make money more easily, while creating barriers to large corporate entities to dominating markets and suppressing wages and suchlike. I have no doubt that small businesses feel oppressed by regulations. But how many of those regulations are advocated for by Big Businesses themselves in order to assure their control of the markets?
The problem is not socialism, but corruption. Any government can be corrupt, but a combination socialistic/capitalistic political economy appears to minimize the incentives for corruption by assuring that beyond a certain point, trying to squeeze more money out of the workers and consumers of the country no longer really pays a big dividend, while investing in the community starts to look more appealing.
If you have doubts about this, look at how the city of Burlington, VT did under Bernie’s leadership. The business community did everything they could to keep him out at first, but in the end, they saw that their businesses thrived under his approach to government. That’s why he keeps getting re-elected – he really does know what he’s doing.
I had the same misgivings. The biggest improvement in the “trauma theory” inherited from Freud (before he recanted and started blaming kids for “fantasizing” their traumatic sexual abuse stories) is recognizing that trauma comes from many sources, including the very social fabric we live within. Lots of folks with good mothers develop mental/emotional challenges due to bullying, abuse by teachers or other outsiders, racism/sexism/community violence, or just growing up in the unforgiving atmosphere that pervades our “modern” world. And of course, we can’t forget the trauma of receiving “treatment” from “mental health professionals” who invalidate the trauma that underlies most if not all “mental health” problems.
That being said, I’m also not inclined to let moms off the hook entirely, as NAMI so disingenuously preaches. Bad parenting practices are frequently behind anxiety, depression, aggression, or even psychosis. While they may not be the direct or only cause, the best way to minimize trauma is to have kids experience warm, loving, and safe homes. It’s also important to remember that parents are traumatized as kids, and often pass on what was done to them without being aware of it, unless they’ve taken some significant action to recover from their own traumatic upbringing. Alice Miller has written eloquently on this subject.
Blame is never actually helpful, but helping parents deal with and resolve their own issues with their own childhoods is an excellent way to help the next generation experience happier and less stressful and more productive lives. And we can hope that these healthier children will then raise yet healthier children and the world will become a better place. I think that’s really the only way the world will get better, if each of us can reach inside and accept and get OK with what’s happened to us and take concrete action NOT to pass it on.
Very cogent points. I also observed above that the NIH director spent a lot of time emphasizing the need for “early intervention in psychosis” and ignored the real point that more human interaction and less drugging led to better results. And of course, as Robert B points out above, no one bothered to try NO drugs as an option. I don’t think they really want to know what the result of that experiment might be.
It is my understanding that the atypicals affect the serotonin system, and accordingly, some people do appear to have increased suicidal ideation, at least anecdotally. I think there is a warning at least on Zyprexa.
That was my concern as well. It’s quite a spin to take a study that shows LESS drugs and MORE social interactions and job training, etc. lead to better outcomes and say it means that untreated psychosis is the problem! Of course, the psychiatric field will never acknowledge that its interventions are less than miraculously helpful, despite evidence to the contrary, but it would have been great if the NYT authors hit that point a little harder. This is not just a new approach to treatment – it is a total indictment of the “lifetime med management” strategy that is encouraged and at times enforced on the unwitting victims of their “helpful” paradigm!
Good one! I wish all docs had to take neuroleptics for two solid weeks before they were ever allowed to prescribe them. Only the totally sociopathic ones would be unmoved by the experience.
I am sure they had to include medication in the mix as a way of placating the psychiatrists. It’s interesting that when I went to the “NIH Director’s Blog” link, the coverage stressed the importance of not waiting to start treatment and of adding therapy to the mix, and totally minimized the large reduction in drugs used. I made a comment on it, too. Doubt it will be read much, but hey, trying to do my part.
Those brain scans studies are ALL correlational. They take averages over time with a lot of subject and then highlight correlational trends. Not everyone with the “disorder” has the brain activity they show you, nor does everyone who shows this brain use pattern have symptoms of the “disorder” in question. There is no attempt made to determine causality (did the person’s brain become this way because s/he was feeling depressed or thinking about depressing things, or did the brain becoming like this cause the depressed thoughts or feelings.) And, as B points out, they are only usage patterns and reflect nothing at all about structure or chemistry underlying the pattern.
I’m glad this has finally gotten some national attention. Of course, they still have not considered how many of the clients would do even better with little to no neuroleptic “treatment” at all. Still, it’s definitely a step in the right direction, and appears likely to have a bigger impact than Wunderlink or Harrow, even though both showed similar trends.
When it comes to psychiatry, less is most definitely more!
And also because of the lack of adverse effects, which are very real and can be extremely damaging. It’s one thing to take a placebo like Niacin that just gives you a facial flush and some discomfort. It’s quite another to take a “placebo” that can result in agitation, violence, anorexia, or permanent loss of libido, among other fun things.
Though it might be thought more ethical than an experiment giving a bunch of people antidepressants and not bothering to watch whether they become violent or not, which is what we’re doing on a massive scale worldwide today.
Kids with developmental challenges really show where psychiatry is coming from. They claim to be scientifically “treating” medical “disorders,” but Meili and her cohorts for the most part had no indicatio of any such “disorder,” if such are even assumed to actually exist. Despite this complete lack of any even pseudo-scientific rationale, they continued to push you to put Meili on drugs. But if she doesn’t have a “mental disorder” that is “treatable” with drugs, what are they proposing the drugs for? The truth is revealed. The primary purpose of these drugs is to control inconvenient behavior and make it easier for the adults to manage their difficult charges. There is no other reason, and they’re not even pretending there is one. This should give anyone pause who is prescribed these drugs for any reason. Not only are they willing to prescribe drugs for any purpose that suits the adults’ needs, regardless of “diagnosis,” they are also apparently willing to lie about their true intentions and the drugs’ adverse effects without compunction.
Well done holding the line on the “professional” insanity!
What I have heard from many users, and this is verified by studies looking at side effects, is that many people using these drugs experience a degree of emotional numbing, a sort of “I don’t care” or “WTF” attitude toward things that they previously might have cared about. A friend of mine who had used SSRIs called this condition of her mind “Zolofting.”
Now for some people who were worried a lot about their mom’s approval or whether they’re socially accepted, this might be a good thing, for them to start feeling like “who cares what my mom thinks, I’m going to do what’s right for me!” And these folks would report a positive effect. But what if the thing that’s keeping someone from committing suicide is the knowledge that their mom will be devastated? The result of “who cares what my mom thinks?” could be that an actual suicide attempt is made. Or perhaps the person is repressing the urge to kill people because it’s socially frowned upon and jail might result. A change to a “WTF” attitude may mean carrying out on ideas that might have remained fantasies.
I don’t think the drugs by themselves necessarily cause violent outbursts – I would guess that other factors need to be present as well. But I absolutely believe there is evidence that they may catalyze a latent thought or fantasy into an active plan. There are just too many of these shooters taking or withdrawing from psychiatric drugs for it to be a coincidence, especially when increased hostility, agitation, or suicidal thinking are known side effects. Increased hostility plus decreased inhibition probably won’t cause murder in 99.9% of people, though it may cause a host of other problems. The mass murderers are a tiny percentage of users, but they should be seen as canaries in a very dangerous coal mine, indicating that disinhibition of negative or dangerous behaviors is a very real risk with SSRIs, which should be carefully considered both before and after any person is allowed to take these drugs.
And the goal of mass extermination was not accomplished by disarming anyone. It was accomplished by creating “other” groups and demonizing them, assuring the general public that they were in danger from the “others,” not the government. Group by group, they peeled off larger and larger segments of the society, until those who would resist were so marginalized that resistance was not realistic.
It was xenophobia, nationalism, corporate domination of the government, and the acceptance of eugenics theories that made Nazi Germany possible. Arms control had about zero to do with it.
My thoughts exactly! The are blaming “depression” for their inability to do anything helpful, or even making things worse. Instead of saying “he has treatment-resistant depression,” what if they said, “We don’t have any idea how to help” or “our approach clearly didn’t work.” But such honesty appears to be anathema in the world of “mental health treatment.”
What would we say if the mechanic said our car had a “repair-resistant engine?” We’d fire them and find someone who knew what he was doing!
“Pathological overreaction to the restraints?” Really? How can a person even talk like that? I wonder what she’d say after she spent several days being unable to do so much as scratch her nose! It makes me feel panicky just thinking about it.
Thanks for sharing your story. It is astounding how few people are able and willing to hear that a “helping” place like a psych ward can be such a nightmare. Perhaps it’s related to people’s need to distance themselves from the “mentally ill,” because empathizing means realizing that they, too, could be in the same place under the right or wrong circumstances.
I’m also glad you had at least one person who supported you through it all. I think that’s the minimum we all need – one person who can validate our story and believe in our ability to overcome the oppression that we encounter. I am also glad you’ve found MIA and I hope it continues to be a place where you can get your vital message out to those many who need to hear it.
Nothing really radical in this piece. More funding for mental health programs. Even speaks positively about “ACT.” Not really worth watching, except for a few chuckles. Jon needs some education from us, I think!
What is also real is that classroom expectations have always been developmentally inappropriate in the lower grades, and are becoming more so over time. When I went to Kindergarten, we did a lot of pre-reading and psychomotor activities, like singing songs, identifying letters and letter sounds, counting to ten, finger painting, throwing balls, building with blocks, etc. No one thought that a Kindergartner should be learning to read. Certainly, the concept of being BEHIND in school was completely foreign. Now kids are expected to learn basic reading skills by the end of Kindergarten, they’re given worksheets and even HOMEWORK in some places, their free play time has been reduced bit by bit to a tiny proportion of the day, and they are expected at times to stay focused on things that most adults would find dull, let alone a 5 year old. We need to acknowledge that part of the “ADHD” epidemic is setting unreasonable expectations for kids and blaming them when they don’t measure up.
A recent Canadian study showed that waiting a year before admission to Kindergarten reduced ADHD diagnosis rates by over 30%! So a THIRD of ADHD is just plain starting too soon, and probably even more would drop off if we waited yet another year for them. In France, they don’t start school until 7, but by high school, their kids have surpassed US kids in every academic department. And France has one of the lowest ADHD diagnosis rates in the developed world.
We need to stop “treating” kids for being young and immature. They deserve the time and respect to be allowed to develop normally rather than being pathologized for being unwilling to sit still for things they’re not developmentally ready to do.
I used to work at a community-volunteer-based suicide/crisis hotline. I spoke with one woman who had been trying different antidepressants for over a year, and was absolutely desperate since none of it has worked at all and she thought maybe she was just condemned to feeling awful forever! I asked her, “Has anyone ever told you there are other things you can do besides trying antidepressants?” She was instantly silent for a moment, and then calmly said, “No…” She’d been exposed to an entire year of the message that antidepressants are the ONLY answer, despite their obvious failure to be of the slightest assistance, and no one ever even intimated there might be another solution! She was quite willing to try anything, and we quickly came up with both a short- and long-term plan for her to start moving in a totally different direction. But it astounded me that she’d been misled in this way! And this was in about 1993 or so. I am sure things are far worse today.
I actually read something recently that showed how a dose beyond a certain range is not going to improve the likelihood of response, and that in fact most psychiatrists used way too HIGH of a dosage, leading to avoidable adverse effects and even reducing the likelihood of anything positive coming out of the experiment. They recommended getting a person OFF of something that did not improve matters at the recommended dosage rather than continuing to increase it. Which makes way too much sense, even if you buy into the whole psychiatric paradigm, which I absolutely do not.
That is great news, Bonnie! It added some inspiration to what has been a somewhat discouraging day so far. I also sense a shift in the social fabric – I do mental health trainings for our volunteer foster youth advocates, and I used to get a lot of flak for critiquing the dominant paradigm just 4-5 years back. These days, most of the class is already halfway there before I even start. “Anatomy” was a catalyst that came at just the right time. Both your book and Bob’s new one are on my short list of things I must read ASAP!’
I kind of agree with both of you – I think it is dangerous that so many Americans trust their doctors (in all specialties, not just in psychiatry) to know things and give them good information, when the evidence of the whole field being sold out to Big Pharma is so substantial. At the same time, it’s not reasonable to expect the average consumer of medical care to be educated and assertive enough to deny the pronouncements of doctors, who in many ways are the holy priesthood of our society. For a lot of people, questioning doctors is akin to questioning the entire underpinnings of everything they believe about life in the USA – if doctors are on the take, what does it mean? Whom can I trust? Where do I go for advice? It feels very unsafe and insecure.
So by all means, let’s encourage everyone to educate themselves, but that does not absolve doctors from blame when they intentionally lie to their patients or don’t bother to inform themselves about key aspects of their own profession. We don’t expect everyone to know how to fix their car or install new plumbing fixtures – we expect mechanics and plumbers to be experts in their field and if they don’t know their jobs, we appropriately blame them for ripping us off. Why should doctors have any lower expectation? In fact, shouldn’t they be expected to be even MORE responsible and careful in what they say, based on the amount of trust people are putting in them?
That many docs and most psychiatrists don’t set that expectation does not mean those who listen to them are any less victimized. We should stand to fight oppression, and the first step is self-education, but those who are not educated are still being harmed, and it is 100% the doctor’s responsibility to make sure that doesn’t happen.
Which is why most psychiatrists don’t do that. As BPD says below, it takes away their market advantage. Plus it warps their brains too much to think they might actually be harming their clients in some if not most cases.
BTW, I have no objection to them talking about what psych drugs might be useful for – I remember a lady who was totally incoherent due to meth use, and they gave her a shot of Inapsine (a fast-acting antipsychotic), and in 20 minutes, I could talk rationally to her. Very useful! But only for the acute situation in order to be able to have the necessary conversation about what happened and why and what her options were to deal with it. Having her take Inapsine every day to prevent her from getting high or psychotic when she took Meth (the Methadone model) would be rank stupidity.
A little honesty would go a long way, but it would mean a total repositioning of psych drugs and psychiatrists as an adjunct intervention in short-term emergency situations rather than something that 20% of the society supposedly needs based on the warped concept that their brains don’t work properly!
Wow, not quite sure how best to respond here. I guess my first reaction is that a psychiatrist’s or medical doctor’s first duty is to inform their patient of the truth, even if it’s hard to hear. So if someone comes seeking a pill to make things all better, the first response should be, “I need to be totally honest – there is no pill that can fix your situation.” Handing out pills because patients demand them is just plain irresponsible. You’re the doctor – you get to decide what you prescribe.
When I was briefly involved in the horrible job of deciding whether or not someone was to be held against his/her will in a psychiatric ward, I ran into a guy who was clearly asking for antidepressants. His friend insisted that there was no reason for his depression, that it was one of those “biochemical depressions” and that he needed drugs. I told the guy the honest truth: that there was no drug that would make him feel better tonight, that he’d most likely have to try out two or three or more and that it took weeks to see if it helped or not, and that it would not address any underlying issues that might be causing the depression. He looked increasingly distressed by the information I gave him, so I decided to ask him why he was depressed. I found out he had broken up with his girlfriend a few weeks back! And he thought it was all his fault! I ended up conducting an impromptu therapy session in the ER and ran him back to a time he was hiding from his dad behind his bed, knowing that his dad was going to ask him what he did wrong and would belt him if he didn’t have an answer, even though he had no idea what his dad was upset about. The guy felt MUCH better after only 15-20 minutes of conversation and was very excited where he could get more of that kind of help. He was a perfect therapy client who really WANTED to know what was going on, but had been duped by social messages and his “helpful” friend into thinking a pill was what he needed.
Just because the person is asking for drugs doesn’t mean s/he wants drugs. It usually means s/he wants hope of improvement and has been told that drugs are the answer. And certainly, the friends or family members who are asking us to drug the patient have their own agendas and should not be considered decision-makers in any sense at all.
I appreciate Hugh’s honest description of how these events occur, and I agree 100% that the doctor is often trying to appease a patient or his/her friends and family, or even protect him/herself from social and professional consequences. But the fact that this occurs speaks volumes about the moral bankruptcy of the psychiatric profession, as well as their almost complete lack of skill in understanding and handling human beings in states of distress. As the example above shows, most people want real help, not band-aids or symptom suppression. They’d love it if there were a magic pill to make everything all better, but we do them a huge disservice by pretending such a pill exists or ever will exist. They are best served when we assist them in learning that they have within them the capacity to find a path forward, and that we are there to assist them in finding the path that works best for them.
Psychiatry provides little besides temporary symptom suppression (in some cases) and empty promises (in the vast majority of cases). If psychiatrists started with the unvarnished truth about the risks and limitations of their “magic bullets,” most people who come seeking drugs will start to realize that drugs in themselves are not the answer. It is psychiatry’s ethical duty to get them that message, whatever the patients may have heard on the Zoloft ads, but I see very few doctors honest enough to admit that they don’t have the answers or to empower the client to seek real solutions that transcend momentary numbing of the “symptoms” of life being a rough go.
And given the individual nature of these “issues,” it is also ridiculous to think you can have some objective outcome measure, since each person has different objectives and values that inform both their use and their evaluation of the services offered. “Evidence-based” therapy is tainted from the beginning in that their “evidence” is based on the same assumptions as “treatment” with drugs: namely, that “symptom reduction” is the ultimate goal and that the client’s assessment of the goals and success of therapy is, at best, a secondary consideration, if it is even considered at all.
You can’t create an evidence base without an objective way to determine who belongs in a particular group and what a “successful outcome” looks like. Psychiatry and psychology have both consistently failed to provide either, and have used their “checklist method” to cover for the fact that they don’t even know if their “treatment group” is a legitimate study group with a common variable to evaluate, let alone whether those so “treated” have made any measurable progress, since we really have no agreement or means of establishing what “progress” even means.
The only appropriate measure of whether therapy “works” is whether the person receiving it says that it works, and that will never be a scientifically measurable outcome. Different approaches work for different people. There is no cookie-cutter way to do it, and efforts to provide one only create confusion. Which, no doubt, is the real purpose of “evidence based” therapy evaluations.
It also serves a political purpose: medicalizing suffering allows the privileged in society to continue to believe that they are better than the masses and that any objection or upset with their “benign” rule is due to failure in the person who is upset, rather than a flaw in the system that allows them to rule and look down on those they consider to be “the rabble.” It further allows those who are directly or indirectly expressing their dismay to be numbed into quiescence so that they will never be able to join forces and undermine the control of the privileged class.
I get what you’re saying. There is an assumption that psychosis just somehow “develops” and that stimulants bring it on sooner. Of course, it begs the very important question of whether stimulants themselves are causing the psychosis to occur. Given what we know about stimulants, it seems a very reasonable question to ask, but this is one of psychiatry’s “blind spots,” whether intentionally or unconsciously, I don’t know. All I know is that they generally adopt language that assumes biological causation and inevitability all the time without ever noting the “metacommunication” that is implied. I guess if that’s your view of the world and you’ve never considered another, it doesn’t sound quite so odd.
This totally reflects Irving Kirsch’s work. A 10% difference between placebo and active treatment is essentially zero when you take into account unblinding by side effects. If we used active placebos, it is likely we’d see no difference whatsoever.
Taking side effects into account, it seems that active placebos would be the preferred “treatment.”
I agree. I do a quarterly training of new volunteers advocates for foster youth and take on the DSM and the mass drugging of foster youth pretty directly. I used to get objections from people who thought I was biased against drugs or psychiatry, even though my presentation is pretty diplomatic in its approach. But the last two-three years, I mostly get strong agreement from most of my audience, and even those who have doubts are still open to questioning the dominant medical paradigm. We are definitely making progress in the larger social sphere, though such progress is, by the very nature of culture, hard to notice on a day to day basis.
I think what it means is that some kids who are prescribed stimulants later develop psychosis, and that it starts earlier than for people who develop it with no stimulant use. It doesn’t exactly prove that these kids might not have been psychotic without the use of stimulants, but it certainly suggests that may be true. Personally, I’m quite certain that a small number of kids forced to take stimulants when young do develop psychotic symptoms as a result. I am not sure anyone really wants to find out if that’s true or not, as there are so many billions of dollars to be made selling stimulants to help kids cope with the standard, rigid classrooms our society accepts as “normal.”
I see why it is confusing, but I think they have to put it that way so as not to overstate what they actually learned from the experiment. The next experiment is to match kids who are taking stimulants with similar kids who aren’t, and see if there is more psychosis in the first group, but that one will never get funded, for reasons I mentioned above.
That would make an interesting qualitative and quantitative study. Gather up randomly selected focus groups of people who have received “medical care” for “mental health difficulties” and among the questions, ask them what messages they were given about why they were having difficulties and why they should accept drugs as a treatment. This would pretty quickly put the lie to Pies’ assertions that it’s just a few misinformed people making these representations. In my experience, it’s the most common explanation given, even to foster kids who have been massively traumatized over many years.
Exactly. All emotions serve a survival purpose. It would be like a pill that made us not feel pain. No one WANTS to feel pain, but if we didn’t, we’d never know when to move our hand from a hot stove or when to come in out of the sun or that we had just stepped on a nail. Emotions are just the same – they exist to help us survive. Psychiatry’s biggest crime isn’t pushing damaging drugs – it is convincing people that their emotions don’t have meaning or purpose and that the thing to do is to eliminate them rather than figuring out what they’re trying to tell us.
A “conflict of interest” is not pejorative – it is just a plain fact! What is insulting about saying to, say, a psychotherapist, “Providing therapy to someone you have a sexual relationship with is unethical because you are likely to lose objectivity” or “you can’t evaluate the drug that you yourself submitted for safety because you’re likely not to see flaws in your own arguments?”
Humans are not objective about their own work, especially if there is profit or social status to be gained. That’s not pejorative, it’s just the way it is. For them to try to “newspeak” this into something else suggests that they are trying to avoid the real facts and pretend that conflicts of interest don’t affect any of THEIR people…
They discredited themselves in the first sentence. Ridiculous!
I think the correct statement would be that the “mentally ill” are no more violent than the general population when controlling for substance abuse. There may be a slight trend for the “mentally ill” to be more likely to be violent, but when compared to the impact of substance abuse, the trend is negligible. Of course, when we include the misuse of psychiatric drugs that can cause violent side effects, it may well be that there really is no difference at all.
Mind-altering drugs are by far more correlated with violence than any other indicator. In addition, domestic abuse and other forms of economic and social oppression are far more significantly implicated in the widespread violence in the USA. “Mental health” experts assure us that the presence of “mental illness” is similar around the world. Why, then, is mass violence so common in the USA? Can’t be because we have more “mentally ill” people, since the rate is supposedly the same world wide. So why is “mental illness” getting the blame?
I read somewhere recently that something like 4% of all severe violence in the USA is associated with “mental illness.” Even if we drugged all the “mentally ill” into a stupor, as appears to be Murphy’s general intent, that would still leave 96% of the violence untouched.
I’m glad someone is standing up to this convenient but inaccurate narrative and laying the truth on the line. More oppression is not the answer to violence!
“Caring Rulers,” eh? Well, at least they’re getting around to admitting the “ruler” part of it. Of course, the real answer to improving their image would be to put more energy into “caring” and less into “ruling.” But as far as I can tell, there isn’t as much money in caring, so ruling always takes precedence, with “caring” being the justification for the right to rule. As in “caring” enough to protect us from our poor, mentally disturbed selves by making all our decisions for us, and drugging us into a stupor if anyone has the temerity to object.
Dang, that was DEPRESSING! No joke intended. I am always amazed at people saying “My psychiatrist is great” despite trying 30+ drugs and ECT without any improvement. I can’t even imagine being in a state where allowing the surgical insertion of such a device in my brain would even enter in as a possibility I’d ever consider.
But wait, I thought these were “brain disorders” were were talking about! Do you mean teaching children skills and concepts of respect actually might improve their behavior without drugs? What a radical concept!
Good for Chile. Once again, the USA is lagging behind the curve and needs to look to South American to improve its treatment of its children.
Beautiful writing, as usual! Your analogy with the sports training process is so appropriate, I’m going to use that in the future when discussing this issue. I’ve used the rape analogy before, but some people really can’t process the intensity of that one. This gives a great example of drawing a moral line between helping and domination/oppression.
And it IS a moral issue, and the attempt to redefine it as a scientific one is a big part of why they get away with continuing to do this. It may be helpful and acceptable to remove the means of suicide from a person’s access temporarily, but it’s impossible to see how to morally justify locking people up and shoving pills down their throat as anything but rank oppression and abuse.
I have faced the dilemmas you describe and ultimately decided I couldn’t work for that system any more, and got into advocacy, but I still believe it is fortunate that people ran into me rather than someone else when they were in crisis and at the emergency room. I hope you can find a way to continue to live with your principles and still be there for the people inside the system who so badly need someone like you to connect with!
There is a feedback form at the bottom of the page. I gave my feedback, and I encourage anyone else who has strong feelings on this to do the same. I quoted Harrow and Wunderlink, which would be great if others reinforce so they don’t think I’m just one “nutcase.”
The idea that messing with neurotransmitters can make you feel better is hardly new – it’s existed a long as humans have existed, as long as we as a species have been able to ingest foreign substances into our bodies. My objection is not attending to neurotransmitter function, but calling the use of drugs to alter their function a medical practice. People should be free to experiment with substances to help their mood and behavior if they so wish, but of course, we all know that this generally leads to bad ends for those using this approach in the long term. Why would we be surprised that pharmaceutical drugs that mess with the brain also lead to bad ends? Again, how is this medicine? What is the difference between taking Xanax for an anxiety attack and taking a shot of Johnny Walker Red for the same purpose?
Many individual psychiatrists may well be dupes, but the profession as a whole behaves in every way as a sociopathic individual, by their own description. While they may not be AWARE of their sociopathic beliefs, the profession at the highest levels justifies harmful and criminal behavior as “in the best interests” of its clients, so lying or forcing treatment or causing long-term physiological illness or even death are justified, because it meets the needs of psychiatry to believe so. Maybe narcissitic is a more appropriate description, but by their own definition, the entire profession is “personality disordered.” And it is important to recall that just because a person isn’t aware of his/her evil motivations, does not make the motivations any less evil. It just means they have good defense mechanisms, including justification of evil as being “helpful” to the victim.
Is there really a QUESTION that his ties will bias him? Is there really a question that those ties were fundamental to his even getting the nomination?
I’m sure it won’t, but I agree, this is amazing news and I am hoping perhaps the beginning of a trend toward reanalyzing questionable data or conclusions, many of which have been driving practice in the complete wrong direction for decades. It should be front page news on the NYT. Maybe The Guardian will pick it up?
Sorry, Len, but that link is just a bag of propaganda to “explain” something without providing any basis. Ritalin was supposedly introduced “as scientists began to develop a better understanding…” but there is nothing about what the original “understanding” was or what was “better” about their new understanding.
Remember also that Bradley’s experiments were on encephalitis victims whom we KNOW had actual brain damage. A REAL history would note that researchers ASSUMED that kids who were inattentive had “mimimal brain damage” that reflected Bradley’s cohorts but was not visible or testable, and that despite 50 years and hundreds of millions of dollars of research, no such brain damage has ever been detected. It would also note the history of the DSM, as it changed from the DSM II to the DSM III and altered the criteria to avoid any stated theories as to the cause of ANY disorder, including “ADHD”. And that this was done in large part so that psychiatry could regain their market share by pushing the idea that these “disorders” were biological in nature and required drugs to “treat.” But none of that appears in the “history” you quote. For some REAL history of ADHD, try “The Myth of the Hyperactive Child” by Peter Shrag and Diane Dvorky.
His focus is on “the neurobiology of complex social behaviors.” The study of which has yielded almost nothing after decades. Sounds like a sadly wasted career to me. I hope his replacement has a broader view of behavior as an adaptive response to environmental factors, but I’m not holding my breath…
hing I was going to, and said it so very well. BPD is a creation, a description of what happens to many adults who received inconsistent and/or abusive care when they were very young. It’s no more a “disorder” than having a limp is a “disorder” after having had one’s leg broken. The “symptoms” of BPD are scars from psychic injuries that were perpetrated upon a helpless infant. To blame the victim the way psychiatry does just adds insult to injury.
Additionally, many so-called “clinicians” treat “borderlines” as if they were pariahs, subject to some untreatable condition that renders them chronically annoying and intractable. I have never found that to be the case. Some of my greatest successes in the realm of helping people were with victims of childhood abuse who bore the “borderline” label. It’s really just a way of stigmatizing and dismissing clients that our so-called “clinicians” are too incompetent or too lazy to deal with.
Thanks for your tireless efforts to bring attention to this travesty of a “diagnosis.”
I so agree. Even if we accept psychiatry’s model (which I most strongly do NOT), the emergence of NEW symptoms after “treatment” should cause any doctor with an IQ over 85 to consider that the drug is most likely the cause of the “symptoms.” But for some reason that never occurs to them, and adding another drug is always the solution. If one drug fails, let’s try two. I’d call it stupidity, but too much money is involved. I think the proper name is “corruption.”
Great summary of the issues and attendant literature. I’m glad that you mentioned the absurdity of increasing dopamine (or serotonin) on the one hand and then blocking its activity when the increase causes problems. The one aspect I’d like to highlight is that stimulants and/or antidepressants often CAUSE the very symptoms that are then identified as “bipolar disorder” or “psychotic disorder NOS” and then “treated” with antipsychotics. Working with foster youth, I’ve seen many, many kids who were started on stimulants and then became aggressive as a result, and instead of stopping or decreasing the stimulants, they get a new diagnosis and a prescription for Abilify or Risperdal. It does not surprise me that a significant majority of the kids taking antipsychotics are on stimulants. It is very likely that absent the stimulants, the “aggression” being treated with the “antipsychotics” would not even be an issue.
It is hard to overstate my frustration with this particular brand of criminal activity on the part of the psychiatric profession.
Arm amputation, coma induction, and murder all have high efficacy in reducing aggression and conduct problems in youth. Murder is 100% effective in every case. “Death therapy” could be the psychiatric trend of the future, except once they’re dead, you can’t bill their insurance company any more.
Using behavior as “symptoms” and “reducing aggression” as a drug efficacy measurement is fraudulent in the first place. Behavior is behavior and can have a million different “causes.” It is this slick translation of effects to “symptoms” that underlies psychiatry’s shift of focus off of causes and toward blaming the client for any negative experience they may have.
There are also plenty of free support groups in pretty much any urban or suburban area for trauma survivors, including domestic abuse victims, sexual assault victims, victims of childhood sexual abuse, adult children of alcoholics, and many others. There are also groups like “women in transition” that offer support for changes in life circumstances, such as returning to work after childrearing.
Your analysis sounds spot on to me. Sad that they are requiring “diagnoses” now – college campuses are one of the few places left where you could get therapy/counseling without having to prove you fit into a DSM slot.
Another no-brainer research study. People do better with social support and worse when they don’t have it. Unfortunately, they missed the biggest point: the other “treatment” did nothing to maintain any gains they made from receiving social support! Drug “treatment” should, at most, be offered as an adjunct temporary aide toward the goal of social reintegration, which is the real solution. The WHO studies and the Open Dialog and Soteria experiments should have convinced anyone paying attention of this, but I guess there are a lot of people in the industry who make money off of not paying attention to the actual research.
Fascinating that the number of kids taking antidepressants before admission has skyrocketed, and the number of kids experiencing anxiety and depression has skyrocketed. Wouldn’t you think that all of this “treatment” they are receiving would have REDUCED the rates of anxiety and depression? But no, it seems the more treatment is received, the more anxiety and depression is reported! I guess maybe Bob Whitaker has a point…
Right you are. Certain groups get shot more often because they are more vulnerable and easy to target, but the real problem is an almost total lack of accountability. Police in England have to make a special request to sign out a firearm. They shoot almost no one – like one or two a year or less – and yet have a much lower violent crime rate than the USA. Why can’t we do that?
First off, DUH! Foster kids in EVERY state are inappropriately medicated and are not provided appropriate psychosocial assistance, all with the agreement and support of the psychiatric community nationwide. They’re a great market – plentiful and powerless and with insurance.
Second, I don’t know why people don’t get the “ADHD”-antipsychotic connection. These kids end up on antipsychotics because the stimulants make them aggressive and sometimes frankly psychotic! Stimulants INCREASE dopamine, which is associated with increased aggression in a decent proportion of the population. Having made these kids aggressive through stimulant “therapy,” they then apply antipsychotics to DECREASE the dopamine levels that they have been increasing with the stimulants! It is absolute biochemical insanity, but it’s a very obvious explanation for anyone who knows the biochemistry of those two drug categories. I wish more people would speak out about this, because I see it ALL THE TIME in the foster kids I work with, and the stimulants are almost never recognized as a causal factor, even if the kid was less aggressive or not aggressive at all before starting “therapy.”
Finally, it disturbs me that 5% of the GENERAL POPULATION of kids on Medicaid are on antipsychotics! That is a scary figure, especially when considering the extreme negative long-term health impacts of these drugs.
I think the assertive way to answer those questions is something like this:
“I appreciate why you are asking me these questions, and it’s nice to know you care, but I prefer to keep discussions of my emotional state private at this time.”
Or: “I am choosing not to answer any questions today that aren’t directly related to the condition I’m coming in for.”
Or, of course, you can just tell them the answer most likely to get them off your backs. They have no actual right to force you to answer any of those questions. If they are written down, just write in “N/A” as in “Not Applicable.” If they ask you why, just say that you’re a private person and you object to sharing personal information unless you believe it is necessary. You can even be humorous: “Information will be shared on a need-to-know basis” or “Do I look suicidal to you?”
If you simply maintain a calm demeanor and politely let them know that this is not anything you think they need to ask about, most of them will stop pretty fast. I am actually even more pre-emptive with my care providers. I tell them right up front that I’m not interested in getting into any kind of “mental health” treatment and that I avoid drugs at all costs, so there is not really any point in asking me about that kind of stuff. They can then write “patient refused” and their job is done.
How do you know what might or might not have helped her? Was anything else tried besides drugs? How does she function today? Have the drugs led to a recovery of normal social and occupational functioning?
Some people do appear to do better taking psychiatric drugs, or at least report that they do. That’s not the point of the article. The point is that there is no way to determine that something is physiologically wrong with your relative based only on how she behaves. And the fact that she responds positively to a drug does not prove this point, either. For instance, I was very, very shy as a youth. When I drank alcohol, it made me less inhibited and more likely to introduce myself to a stranger or engage in a conversation with a group of people. Was I “disordered” or “ill” because I was shy? More importantly, since alcohol made me feel less anxiety, was alcohol a “treatment” for my “illness?”
Additionally, one never knows what goes on behind closed doors in a family. Sometimes things look very “normal” on the outside but are quite tense and uncomfortable for the family members, or sometimes just for one of them. That was true of my family – both my parents were very ‘nice’ and not abusive (within the cultural context of the day – we did get hit and in a pretty terrifying way on a couple of occasions), but the environment was quite unhealthy emotionally, with everyone pretending everything was just fine until tensions built and someone blew up and we scattered. A half hour later, we’d all get back together and pretend nothing happened, never talked about it again. It was not overt abuse, but it WAS traumatic over time and unquestionably contributed to my anxiety around other people.
So was I sick or healthy? Or was my family sick? Or do we just live in a sick society that thought beating your kids was OK at that time? How would you decide? If I had cancer, you could see it. Even something as nebulous as obesity has a measurement associated with it. There is no measurement for “bipolar disorder.” It’s someone’s opinion, nothing more. Drugs may or may not be helpful to a particular person, but telling them they have a “brain disease” based only on their behavior or emotions is a plain lie that helps no one and has the potential to do great harm.
This is one of those situations where the jury is in but the psychiatric field just plain doesn’t want to hear the verdict. There is no doubt that brain cell death is caused by antipsychotics, and if they were anything close to honest scientists, they’d deal with it. This fact has a lot of explanatory value for both cognitive decline and in the increasing relapse rates in long-term users. You’d think that would be of interest, but since it goes against the financial and guild power interests of the profession, they will continue to argue that “we don’t know for sure” until and unless someone forcibly stops them.
That’s what they do. It would be laughable if people didn’t swallow it hook, line and sinker. Consider such luminous examples as “Oppositional Defiant Disorder,” characterized by not doing as you’re told and liking to argue with authorities, “Intermittent Explosive Disorder,” characterized by having a bad temper and acting out physically at times, and “Mathematics Disorder,” characterized by having difficulty doing academic math work. They will take anything considered “non-optimum” and turn it into a disorder, especially if there is a drug company waiting in the wings to sell a drug to “treat” the “disorder.” “Social Anxiety Disorder” was essentially invented by the makers of Paxil, once they found that their drug tested out as being able to reduce the “symptoms” of the yet-to-be-defined “disorder.” “Juvenile Bipolar Disorder” was created out of whole cloth by one Joseph Biedermann, who of course was taking payola from a drug company.
The whole DSM is constructed that way – they take a bunch of behaviors that often occur at the same time, make them into “criteria,” decide how many “criteria” you have to meet before you have the “disorder,” and bam! you’re mentally ill! They might just as easily take a nose-picker and say he has “Excessive digital-nasal insertion disorder” characterized by … It is just that scientific, aka not scientific AT ALL.
It makes me ill that they get away with this crap!
Too true! And it’s especially easy when the medical profession provides “cover” for the practice.
In what other specialty would it be allowable for doctors to prescribe drugs to patients who have no diagnosis whatsoever? The use of steroids or stimulants for athletic performance comes directly to mind. This is considered ILLEGAL and can result in criminal punishment! And yet, to give an antipsychotic to a little kid without even bothering to find out why they’re acting that way – standard practice now.
This is repulsive and shows how low the psychiatric profession and medicine in general has sunk. It’s time for an avenging angel to sweep those promoting the current way of “thinking” about kids and behavior into the sea. The criminals are running the show!
Thanks as always for your exceptionally solid scientific analysis, Jay.
I have to ask, if we accept that each gene contributes only a tiny amount to this mythical “heritability,” and hundreds or even thousands of genes could be involved in a single personality trait, what the hell would be the point of discovering which set of 350 genes contributed to say, “ADHD”? Especially as not everyone with the postulated “disorder” would have the same subset of those 350 genes involved? And as none of these genes would be modifiable in any case once their presence was discovered?
Wouldn’t it make a lot more sense to study things that are controllable variables that have a more direct and knowable impact on behavior, such as poverty, education, parenting styles, nutrition, and protection from toxic exposures pre- and post-natally?
What is wrong with these people? It appears all they are worried about is being “right” even if their “rightness” is of no use to anyone. Oh, well, I guess if you’ve wasted your career on a fruitless line of research, it might be hard to admit it. Though of course, if they are real scientists, proving the null hypothesis isn’t fruitless – it’s just more information – you’ve proven that specific genes don’t create specific behavioral traits, and that’s a good thing to know. Too bad their egos and their mis-education in the sciences forbids them from observing the actual data!
Thanks for a very powerful recounting of your experience and your movement toward creating a new narrative! I think choosing our own descriptors and reclaiming our right to tell our own stories is central to any real healing. I also love the focus on society as the ill party who needs the real healing, because that’s what I see as well.
A couple of thoughts struck me during my reading. The first: do you think that most of those “normal” people that you and I both strove to be like are really “normal?” Or are they also suffering the same kind of oppression but have better ability to deny and repress their discontent and internal sense of rage? I really don’t know the answer to that question, but I am inclined to think that there are very few among our fellow citizens who really feel free to be who they are in this oppressive society.
I also noticed that you did not mention children among oppressed and invisible groups. I would submit that the oppression of children is almost completely sanctioned by society at large and lies at the base of many of society’s other maladies. A look at a typical school classroom supports this view: children herded together in age-specific groups with no choice of either where they go or with whom they care to associate. Teacher gives orders that children are expected to follow without question, regardless of their sense or offensiveness. Children who resist or rebel in any way are punished, or increasingly, labeled and drugged until they submit. Parents who object are marginalized in similar ways, either by shaming or patronizing behavior or by fear-mongering regarding the dangers of allowing the child’s “disease” to go “untreated.” Children have almost zero recourse when abused, neglected, or otherwise mistreated, with certain very limited exceptions, and even those are often overlooked or minimized when reported. And that doesn’t even get into the much larger area of parents’ ability to emotionally and even physically abuse their own children with impunity. I’d be interested in whether you agree with this assessment, and how you see it fitting into your analysis of later life as a “mentally ill”-labeled person.
Bottom line, I see “mental illness” as an effort of the dominant forces of society to deny the built-in oppression that all of us (at times even those in the dominant groups) frequently experience. You have gotten to the point of being able to express that out loud, which of course makes you dangerous to the elite, but also creates a new path of freedom for you to follow. Thanks again for sharing your story and inspiring me to keep my “madness” alive!
Because psych patients are not considered actual people, so the laws apparently don’t apply. Seems like an excellent point for a mass protest – have a hundred people come by one or two or three at a time to visit patients on the psych ward, bearing copies of the state law, make sure the media is aware of it, and watch what happens!
I am not arguing with you. I’m saying they do it to kids who are NOT diagnosed as “autistic” or anything else, who are just labeled as “aggressive” and are difficult to manage. The answer, of course, even when there are neurological differences is to use whatever strengths are present to help the person overcome the challenges presented by their unique neurological presentation.
I wrote a book that lightly touches on this very phenomenon. It’s called “Jerk Radar” and is about how to prevent abusive relationships by detecting the fake “nice” behavior of the abuser before s/he lets his/her true colors show. You might find it of interest given your studies in the area.
It reportedly “reduces aggression,” most likely because the recipient is unable to generate sufficient intention to move his/her fist toward someone’s face. They do this with kids all the time, too. There really is no “diagnosis”, the kid is just obnoxious and they want to keep them from acting up. To call it practicing “medicine” is a total farce. It’s social control, plain and unvarnished.
It should be very interesting to compare the classic Zoloft commercial cited above and this link to a very simple description of down-regulation in stimulant addiction:
They even use the same graphics. It should be obvious to anyone comparing these two videos that the use of Zoloft (or other SSRIs) would lead to the same kind of down-regulation and ultimately to drug dependency and withdrawal effects.
I even found another you-tube link suggesting that down-regulation IS the mechanism of action of antidepressants!
It is unfortunate that none of the commenters seemed to notice that a huge percentage of the shooters are ALREADY RECEIVING PSYCHIATRIC TREATMENT in the form of drugs! Yet the call is for MORE drugs, even when the drugs haven’t solved or may even have helped create the circumstances surrounding the mass murders. Kip Kinkel, Columbine, Red Lake, the Batman shooter, possibly Adam Lanza, both Fort Hood shooters… the list is long. If psych drugs stopped violence, why would all of these “treated” shooters have been violent? And why is that question not asked by the Times?
Good to know that a 4 year old is able to understand basic science concepts. Maybe they have a few things to teach our renowned psychiatric colleagues.
My son got the “insulin for diabetes” lecture from a doctor, despite the fact that he was withdrawing from using multiple street drugs and also recovering from an assault by his roommate, among a lot of other stressors at the time. They did a depression screening and he said he’d been suicidal in the last two weeks, and the doc was totally prepared to prescribe. Didn’t even bother to ask, “Why would you want to kill yourself?” A four year old would have done a better job – at least they’d have the sense to ask, “Why are you cwying? Why are you sad?” My son was actually quite insulted by the whole approach, trying to encapsulate his wide range of human suffering into a “brain disorder.”
Well, they can’t directly measure serotonin levels, but they can measure changes in receptor density, at least in animal studies, and it’s pretty clear that increasing a neurotransmitter in any area leads to a decrease in receptor density in that same area. So increasing serotonin leads to a pruning of serotonin receptors. This is not new information – it has long been understood as the reason why addicts develop “tolerance” and require more and more of the same drug to get the same effect, and also explains longer-term withdrawal issues that continue after the drug is out of the system. You often hear it described as “your brain has ‘gotten used to’ the drug,” but what that really means is that the brain has adapted to whatever change you made by making the opposite change in receptor density.
What should be clear is that if you decrease serotonin receptor density and then go back to a more normal level of serotonin, the brain will respond as if there is a serotonin shortage, because it won’t have enough receptors to receive the serotonin that is there. It appears the brain then adapts back in the direction of more receptors to compensate, but it is not clear how complete this process is or whether long-term use leads to permanent damage to the receptor system in question.
You are so right, Joe. The biggest problem with training people on TIC is that a practitioner really has to be willing to get in touch with his/her own traumatic past and be willing to feel that pain before they can really be present to do good trauma work with someone else. When it comes to “mental illness,” the diagnostic system makes it WAY to easy for practitioners to project their insecurities and pain onto the client and victimize them yet further. I don’t think any amount of training can make it less traumatic to have your emotional reactions to a difficult childhood relabeled as “bipolar disorder” and “treated” by suppressing those reactions. I believe most DSM “true believers” really NEED to believe in the DSM because it protects them from seeing that they’re not so very different from their clients. But in my experience, it is the very ability to find those similarities and to empathize with the client’s situation that leads to an understanding of how to help.
TIC is wonderful, but without a total scrapping of the DSM, I don’t think the mental health world can really incorporate it, because it is totally counter to everything the current paradigm encourages clinicians to do to their clients.
Alex, unfortunately the support group and mad pride movements have been coopted by the establishment. It doesn’t surprise me that peer services you encountered were “normed” just as the rest of the psych world is “normed.” I’m thinking more of things like the domestic abuse survivor groups or groups for spouses of soldiers in Iraq or other more free-floating groups that haven’t been coopted yet. Still you’re right, the same thing doesn’t work for everyone. It just seems to me that labeling your own reactions or coping measures designed to deal with a traumatic environment as “disabilities” or “disorders” is so automatically disempowering that almost anything you could do would be less harmful. A lot of people focus (properly) on the dangers of psychiatric drugs, but I find “diagnosis” to be the more insidious evil. Convincing people that they are abnormal and damaged is never a good way to promote healing!
I understand how Will chooses to tread a careful line between saying what needs to be said and maintaining his credibility with the mainstream. He’s actually done a great job of this and gets invited to places where “antipsychiatrist” – labeled people never get to come. So I respect his ability to tread that line, but felt it needed to be said.
Can’t agree with you more about the incarceration of marijuana users. It is increasingly ironic that these psych drugs are touted as the “treatment” for everything from inability/unwillingness to pay attention to boring things to the natural grief from the loss of a loved one, and yet others who devise their own “treatment” that absolutely parallels the “reasoning” behind psych drugs are put in jail!
There really is no distinction in my mind between getting high/drunk and using psych drugs, except for who profits. Dosage control is more of an issue with the self-applied approaches, as is purity of product, but in terms of what is trying to be accomplished, you’re giving a person a drugs in the hope s/he will feel/think/act “better” by some person’s definition. To call it a medical intervention is as silly as calling a shot of Jim Beam to relax after work a prescription.
Great article, well-researched, balanced and informative. My only objection (and I understand your reasons) is in the title. It would seem more correct to say “interest in marijuana for making people feel or function better.” It is no more a “treatment” than Zyprexa in my mind – it’s just a drug that can improve some people’s mood and functioning and could potentially damage that of others, as you describe so well. To call it a “treatment” buys into the idea that mental distress is a “disease,” which does not appear to me to have ever been shown to be the case.
That being said, I’ve often thought it would be interesting to do a head-to-head competition between marijuana and psych drugs for anxiety or depression. I bet it would match or beat any psych drug for helping with those experiences, and would certainly have vastly fewer side effects. The issue, as noted, is dosage control.
Thanks for the additional info about the different types of marijuana as well. It seems that a well-informed clinician should be able to help advise a person on some viable options that are much less dangerous than the ubiquitous psych drugs that are so readily handed out without a tenth of the concern people give to this relatively innocuous plant.
I agree, Fichara. NORMALIZATION of our feelings and experiences is primary to healing. Yet psychiatry does the opposite – it pathologizes normal reactions and makes people feel inadequate and embarrassed about their own at least semi-successful methods of coping with a less than optimum reality. Support groups are radical because the whole idea is to connect with other people who understand just how normal your reactions are. The support group movement was and is very threatening to the psychiatric establishment.
You’re right, of course. Parents do the best they can, and blame isn’t really appropriate when someone is doing the best with the tools they have. But allowing parents to accept responsibility for their contributions to whatever issues are going on for kids allows them to address and change their own behavior in a way that can help. Instead, we are denying them their own power and claiming there is nothing they can do about it! I don’t see it as blame at all, I see it as empowerment for both kids and parents. Unfortunately, the NAMA/APA line has been the opposite – any suggestion that parents might be able to impact the situation is seen as “parent blaming” and is shamed out of existence. It’s actually a quite insidious way to take away parents’ control and responsibility for their offspring.
I do think it is swinging that way, and about time. I am just predicting that it’s going to take some serious force to keep it moving that way, because I think psychiatry as an institution (not talking about individual psychiatrists here) has been denying this fairly obvious truth ever since 1980, and is not likely to decide to change paths, and in fact will continue to actively oppose this kind of thinking. I sure hope this momentum continues, because I view it as a return to sanity!
I agree – it all fit in very well with the Reagan Revolution and the “Me Generation” and the deifying of greed and rugged individualism and the de-contextualizing of poverty, racism, etc. And I also think things like support groups (non-professional people helping each other? Heresy!) were very threatening to the authorities. Psychiatry’s move was very coherent with larger society’s backlash against the rebelliousness of the 60s and early 70s. Which probably helped the selling of the “chemical imbalance” story – it’s a story the elite establishment also liked and related to, because it let them off the hook for the oppression they were creating and advocating for.
Great article, Wayne. I love the vision. However, I am afraid I don’t see things going that way in the long run unless the institution of psychiatry is dethroned as the ultimate arbiter of what makes someone mentally ill or well.
When I first got into the MH field (1896), the DSM-III was new and just starting to have an impact. At that time, everyone KNEW that mental health problems were caused by childhood trauma! Although too much blame was probably put on mothers and not enough on fathers, siblings, communities and societal institutions, it was generally accepted that we learned to be the way we were as a means of coping with our childhood environments at home. Carl Rogers was in the ascendancy, everyone was recommending using “I-statements” and having family councils at home and avoiding spanking and letting your kids feed when they wanted to and picking them up when they cried. Counseling and support groups expanded explosively at this time, as did grassroots political efforts to reduce social oppression, such as domestic abuse shelters and programs and volunteer community crisis lines.
This changed primarily because of the DSM-III and psychiatry’s selling out to the pharmaceutical companies in the interests of increasing their market share. The narrative was changed because it didn’t fit with the needs of the new paradigm, namely that mental illness was in your brain and you needed drugs to fix it. The propaganda to that end was remarkable in both its volume and its effectiveness, and within a generation, it became an absolute taboo in the MH profession to attribute any responsibility to a parent for how his/her child turned out, and of course, social causes of mental illness were ridiculed into oblivion.
With this amount of investment in their “model,” however fictional they may know it is, it is difficult to imagine the profession of psychiatry allowing this new (old) narrative, which, let’s be honest, is what most of us intuitively know is really the case without having to look at the ACEs study, to get more than minimal footing, because it will cost them buku bucks. And of course, Big Pharma would be even more upset if we started talking instead of prescribing, and maybe even curing people to the point they don’t need their “helpful” drugs any longer. I really wish that the facts so clearly demonstrated in the ACEs study were sufficient to convince Psychiatry to join the movement and to join reality, but unless the profit/loss balance sheet changes significantly, I see them as likely to fight any such efforts to the death.
John, I think the issue is not so much about whether biology is connected to emotion and behavior, which it obviously is and which few on this website would ever deny.
It’s more that the psychiatric profession helped to promote the mythology of the “chemical imbalance” in order to promote their product, namely psychotropic drug prescriptions, as the ultimate answer to mental health problems of all types. Naturally, they had a great deal of help from the drug companies who stood to profit far more than the psychiatric profession from this viewpoint. But the issue isn’t really about the brain, it’s about institutional corruption and the intentional deception of patients to further the professional and financial interests of those who profit from this “story.”
To that extent, it IS important whether psychiatrists were simply misguided and overenthusiastic, or were blinded by their own guild interests despite believing they were doing right, or were consciously and intentionally engaging in dishonest propaganda with the full knowledge they were lying and probably hurting their clients. The answer to this question has a great impact on whether one believes psychiatry is a redeemable or reformable entity, or whether its very purpose is destructive and dishonest. A misguided psychiatry should be able to be redirected with the truth, whereas a consciously corrupt psychiatry would resist any attempts to undermine their market advantage, regardless of the truth of their position.
As I remarked above, your “Moncrefian” view of drugs as a practical aide for particular symptoms neatly avoids this pitfall, but I think you are a minority viewholder amongst the many psychiatrists I have interacted with over my career. I think most fall into the blinded category, believing what is generally believed and not wanting to rock the boat too much, even if they see some issues with the current model, but I also see evidence that there are a large number at the higher echelons of the profession who do actively suppress any data contrary to the psychiatric storyline (Jeffrey Lieberman would be a perfect example) and attack the presenters of such information rather than deal with the actual information presented. Such people are not just following the herd for career reasons – they are setting the tone for the profession, and their continued support for purely biological explanations for “mental illness” and for the factual validity of the DSM diagnoses that even the head of the NIMH admits are of questionable validity and utility shows that they most likely are corrupt rather than misguided, and are probably not amenable to change this side of criminal charges or death.
This should not be surprising, as Risperdal and all the “atypical antipsychotics” cause heart issues in adults of whatever age. I’m glad Australia is finally doing something about it and hope the USA follows suit, but it should have been done long before. This is not new news.
Agree completely. The big error is believing that what is now defined as “mental illness” represents distinct entities that require distinct treatments, rather than suggesting the need for a thorough search for what is causing these manifestations to occur. Which requires humility and respect for the client and a willingness to recognize the complexity of both the brain and of human behavior. As in general health, drugs can be very useful in acute situations, but long-term use almost always becomes problematic over time, even with the most beneficial drugs. But of course, it’s hard to make massive profits on psychosocial interventions, and as long as capitalism drives medicine, we’ll get this kind of profit-driven oversimplification rather than a more considered look at the big picture.
Both very good comments, Alex. I agree, forgiveness is for the forgiver more than the forgiven, and it does NOT imply acceptance or tolerance of bad behavior.
Your comments regarding abusive people are also right on. I’ve worked with domestic abuse victims a lot, and the most successful strategy I’ve recommended is not reacting to the abuse. At first, it leads to some degree of escalation, but if that doesn’t work, they change tactics, and if that doesn’t work, they become puzzled and dismayed, and ultimately bored, and start looking for other victims.
Compassion for the gaslighters of the world is best accomplished at a safe distance!
I like your understanding of how medication is best used – sounds like you and Joanna Moncrief would agree on a lot.
I understand your point about the loss of randomization, though of course the real world works much more like the post-study period of time and less like the experimental conditions. Still, I would not consider this definitive, but there is a lot of other data published since that supports it. The Raine study was referenced on one link in the article, and it drew similar conclusions. The Montreal ADHD study also found that kids who stayed on medication over time did the same or worse on major outcome measures. There was a recent study comparing Finnish children and US children, where the rates of ADHD dignosis were similar, but stimulant treatment was much more common in the USA, and yet treatment outcomes were no worse and maybe even a bit better for the Finns. And then there was the OSU medication effectiveness study done somewhere in the early 2000s, where they found that no major outcome measure, social, educational, or emotional, was positively impacted by stimulant use, after looking at basically every study ever done on the subject that they could dredge up. So I think the jury is in on this one – stimulants do NOT improve long-term outcomes for kids. And it is to me disturbing that despite what is now a fairly solid set of literature data showing this to be the case, no one, and I mean basically no one, in the mainstream discusses this fact, and they still tell parents willy-nilly that “untreated ADHD” leads to delinquency, school dropout, drug use, teen pregnancy, and low self-esteem, without telling them that on average, stimulant treatment improves NONE of these measures over time.
Psychiatrists have been trying to present themselves as being “scientific” by focusing on the brain and chemicals. They may appear “scientific” to the lay public, but if they were real scientists of any sort, they’d be willing to admit when their primary hypothesis is not supported by the data.
Cool! I will definitely look into this. It makes total sense. But hey, if you can’t patent it and make a big profit, why would it making sense be of interest to the powers that be?
Your read of my comment is absolutely correct. However, I do think it’s helpful for this study to be published as support of the idea that it is schooling and other institutionalized or personalized experiences that contribute to the ultimate experience of “psychosis,” rather than just faulty wiring. The suppression of any natural and spontaneous activity on the part of children appears to be central to the modern school model, and I literally mean it that it drives us crazy.
Alex, you speak wisely, as usual. However, I have to say that my compassion for the gaslighters is limited during the time they are doing the gaslighting. I am interested in hearing their stories, but only after I have tried to help protect their victims from further harm. Yes, they have stories, but so do most of us, and most of us choose to try and find a way not to pass it on, which is the minimum I really ask of a person who has other people in his/her charge.
I agree 100%. Singing is also one of the things dementia patients remember the longest. There should be singing going on all day at these places, instead of giving them drugs that stop them from singing!
Indeed. It should not be legal to drug someone just because you find them inconvenient, without even the poor excuse of a “psychotic disorder’ to justify it.
I agree, Alex. Bullying only occurs when it is supported by the status quo. Even the typical school targets of bullying (gay, dark-skinned, physically weak, lacking social skills, to “brainy”) are determined by social criteria and are condoned to some degree by the society at large. The only way to stop bullying is to confront oppression on the larger scale. I’ve always thought it deeply ironic that people talk about kids bullying other kids in school and say, “Kids can be SO mean!” Guess where they learn it? From the adults, many of whom run the very oppressive school system these kids are forced to attend! If I had to name 5 kids who bullied me in school, I don’t think I could come up with the names, but 5 teachers would be exceptionally easy to identify. Bullying is always a sign of living in an oppressive society.
Gutsy is right! It amazes and appalls me that no one thought to ask you about your family life growing up in all those many years. You are a very strong woman, and I am so glad you have recorded your experience. Looking forward to your book!
It is laughable to compare the few farthings you pull in from speaking engagements and book sales to the hundreds of billions of dollars involved in the pharmaceutical industry corruption of psychiatry and our society as a whole. I for one appreciate the sacrifices you have made to get this message out, and I seriously believe the publicity surrounding your book has had a dramatic impact on the conversations going on nationwide regarding the “mental health” system. I hear SO much more critical thinking and so much less acceptance of medication as the panacea for “mental illness” than I did even 5 years ago, it’s quite remarkable. So thanks for putting your passions before your pocketbook. If the majority of those in the psychiatric field did the same, we’d be having a very different conversation today.
I should have mentioned – his funeral was the most hilarious event of its kind I’ve ever experienced, by a long shot! People were rolling in the aisles as 9 speakers talked for over an hour about his lively and eccentric personality and behavior. This was followed by a moving rendition of “Jesu Joy of Man’s Desiring” by Ginny on the flute, and the tears flowed freely. It was a true celebration of his life!
There’s been plenty of railing against psychotherapy on this site, especially the ubiquity of CBT in its increasingly reductionistic form.
I think the main reason you see more passion against psych drugs is because there is more long-lasting damage from their use, including serious physiological damage, including death. Psychotherapy just doesn’t have the scope and power to do that kind of damage. The other reason is that the chemical imbalance-chemical cure “story” has become the prominent explanation and justification for pulling more and more people into the realm of “mental illness” while spending less and less time trying to figure out what is really helpful to people in distress. Consider the millions spent on researching genetic causes vs. the paltry sum by comparison spent on the impact of trauma, when the association of early-life trauma with almost any mental disorder you could name is an order of magnitude higher than the most optimistic data on genetic associations.
The third and perhaps most important reason you hear more against drugs is because the bulk of the money corrupting the influence of psychiatry comes from the direction of selling more diseases to sell more pills. It’s just as profitable to talk to people over weeks and months when you can drug them in 15 minute segments and make more money at it. Besides which, people who get psychotherapy sometimes actually GET BETTER, and this really cuts into the bottom line and forces you to have to look for new clients. The therapy business can get pretty shady, and I’d recommend extreme caution and assertiveness to anyone looking for a therapist, but dollar for dollar, it can’t hold a candle to the drug industry’s incredible corrupting influence over psychiatric research and practice.
One thing to remember also: the patients you continue to see are the ones who continue to participate in the MH system. This creates a large bias, in that “dropouts” who are successful will almost never come to your attention. Reading this board, and looking at the WHO research and the prior research from the 50s on schizophrenia recovery rates, should convince you that there are a lot of such people around whom you would never, ever see in your practice, because they either don’t need your help or are terrified of getting enmeshed in the MH system. Look at John Nash as an example. He was still very symptomatic but intentionally flew under the radar to avoid being hospitalized again, and then he somehow came out of it again years later. Not a medication success story, but his story would normally never even be told, because no one in the system would ever hear about his recovery. They’d just say, “I wonder what happened to that guy? Must have either died or moved away.” He’d never get counted as a recovered client who recovered by escaping the system.
I appreciate your efforts to be rational. I encourage you to look a little further outside your normal field of vision. There’s a lot of healing going on in the community that you will never see in the office or the clinic. Don’t dismiss it.
Too true, I’m afraid. I’ve seen it way too often. I was called to see this one guy who couldn’t talk or get out of his chair, and literally kept walking into the doorframe because he was so zoned out. I couldn’t get him to wake up long enough to talk to me. I talked to the Activities Director at the home, and she said that a couple weeks before, she’d been hitting a volleyball back and forth with him in the courtyard! How can they consider that a “success,” unless the goal is to induce complete inertia? It would be more honest to just kill them outright, but I guess you can’t bill for a dead patient, so a half-dead zombie is the best they can do.
I agree, it is a very oppressive violation, and the analogy to rape is drawn by very many who experience it. And the very righteous indignation that arises when you actually start confronting what is being done to you and start objecting is considered yet another manifestation of your “mental illness!” Like my father in law grabbing Ginny’s arm too hard – it wasn’t a “mental illness symptom,” he was trying to tell them something and was frustrated that he couldn’t say it or they weren’t listening! How is expressing yourself honestly a sign of mental illness?
Anyway, thanks for your kind words. I admire your courage for standing up for yourself and deciding your own path. It takes some real chutzpah to tell these doctors where to shove their “meds.” And of course, when you do get better after rebelling, they say you’re “in remission” rather than admitting they had their heads up their butts. Glad you’re able to keep them at a good, long distance!
Thanks, Richard! I also enjoy your contributions, both formal and informal – you are one who really “gets” what good therapy is about, and such peopel are rare.
My father in law passed away on January 1, 2010. Ginny’s mom moved him from that nursing home to a hospice care place pretty soon after her visit, which appeared to be more humane, though Ginny never had a chance to visit again after that. I think we were both a little relieved that he went pretty quickly once he became dependent on the nursing home for care. It was very hard on her mom and sister, who lived nearby and saw things going downhill. Alzheimer’s is tough, but the drugs don’t make it easier, unless you’re a staff person who is able to emotionally detach from the suffering of your charges and are only worried about your own workload.
Of course, there is also the little caveat that they only have to consider any two studies submitted by the company, even if there are 15 that say it doesn’t work or makes it worse.
Don’t I know it! While I was highlighting the inappropriate use of these drugs for the convenience of nursing home staff, I see the same every day, as I work with the CASA program as an advocate for kids in foster care. I see kids on 3, 4 or 5 psych drugs whose behavior is massively out of control, who are getting kicked out of home after home and are in institutionalized care, but at no point does anyone (except some of our wonderful volunteer advocates!) stop and say, “Hey, I thought these things were supposed to make him better? How come he’s throwing bricks through windows? Do you think we might be missing the boat here?” No, all behavioral manifestations are the fault of the child or “the disease,” and even obvious stuff like obesity resulting from antipsychotics is dealt with by putting the kid on a diet! It is quite oppressive, and most of the foster kids coming out the other end will tell you all about it.
That’s not to mention the millions of non-foster youth on psych meds who are equally being harmed without notice or concern. There was one state where over 1% of the INFANTS in the state were on a psychiatric drug! Under one year old! Who would do that? How would they have ANY clue what the long-term impact would be?
The elderly and kids are the most vulnerable, but this basic approach of medicating “symptoms” without bothering to find out what’s wrong or even whether these drugs are helping or harming is ubiquitous in the “mental health” field. That’s a large part of why I don’t work in it any more!
Have to agree with you, Mark. It seems a general lack of concern for the welfare of those we are supposedly “helping” is endemic in the mental health system. I see a ton of it at the other end, with youth, but it’s the same from preschool through the nursing home – we suppress “symptoms” inconvenient to the authorities and deny or don’t bother to ask about the experience of the client we’re supposed to be helping. The results are obvious to anyone with the ability to empathize with the less powerful in society, but apparently, there aren’t enough of these folks in mental health fields, or they are too intimidated to speak up.
Niemoeller’s quote is most appropriate to the situation, unfortunately!
It is the lack of empathy that I found so disturbing in re-reading these notes. I am glad they are doing more training, but there seems to be a more fundamental issue of disconnection from the consequences of these decisions that allows professionals to sit on and watch while someone deteriorates badly and blame them or their “disease” rather than saying, “Wow, that sure didn’t work!”
Additionally, you are right that taking a moment (as Ginny did when her dad was squeezing her hands too hard) to find out what is going on and to help the person calm down and refocus seems like a natural thing to do. But you’d have to be able and willing to put yourself in the place of the resident, and that seems to be something that a lot of our “mental health professionals” and nursing home staff seem unable to do.
It is my first, and thank you for your kind words!
It is amazing how married people are to the idea that these doctors always know what they’re up to, and that we can always trust their word. It’s also disturbing how willing many doctors are to abuse that privilege and use their power to intimidate rather than to educate.
Ginny’s mom is pretty “0ld school” regarding doctors and took a lot of convincing. If her two daughters hadn’t been there, it is almost certain he would have continued on the drugs to his death. He was fortunate to have advocates in the family!
Thanks – most informative blog. It is amazing that someone who knew he was obsessing about killing people was never even held accountable for failing to act. And of course, Sertraline (Zoloft) gets a free pass as always…
And of course Klonapin’s product information sheet says that it should never be prescribed for more than two consecutive weeks due to its addictive nature. But psychiatrists and other doctors systematically ignore this and benzos are very commonly given for years. It’s a sick, sick system.
Binge eating, like almost any behavior, meets a need for the person. If you help the person find out what need s/he is meeting through binge eating, and then try to find another way to meet the need, it becomes a lot easier to stop the binge eating. It doesn’t just happen randomly.
Psychiatrists would have us believe that we have no volitional control over ANYTHING, that our choices are meaningless and that we have no more self-control than a bird taking a crap as it flies overhead. If humans really just responded to genetics, we’d all be tearing our clothes off copulating in the streets and taking a dump wherever we felt like it. Human behavior has MEANING in a way that primitive creatures like ants never can. It is only by studying the meaning of the behavior that we can understand how to change it.
Psychiatry acts like the only two choices are to say to someone, “STOP DOING THAT” or to absolve them of all personal responsibility and give them a drug. I can’t think of a more stupid thing to say to a person who binge eats than to say, it’s just a matter of your genetic makeup. If I were the person you said that to, I’d be inclined to slug you in the face and say, “Well, I couldn’t help it, it’s just my genetic makeup that hit you.”
We also have to remember that in almost all RTCs, actively suicidal people are removed prior to the investigation beginning. So we’re seeing 4% increases in suicidal thinking in people who WERE NOT THINKING OF SUICIDE BEFORE TAKING THE DRUGS!!! How this doesn’t merit a warning of the most serious kind is beyond my comprehension.
It should be 100% illegal to use these drugs just to “calm” someone who is difficult, especially the elderly and children. I’ll be sharing a blog next week about what happened to my wife’s dad on Risperdal. It’s pretty awful what these things do, and yet, as B says, there is zero accountability. The are literally getting away with murder.
We should not forget that this guy was taking Klonapin and Zoloft at the time of his murder spree. Not saying that was the whole story, but these drugs may well have put him over the edge. At a minimum, they certainly did not make him safer.
First off, it is not the job of non-psychiatrists to prove there is NOT a brain pathology – as the ones making the claim, the burden of proof is on THEM, and as long as that proof is lacking, if we’re being scientific at all, we must assume that there is no such pathology or differentiation that explains the behavior.
Second, individuals with markedly poor care during childhood are generally NOT taught to control their temper, in fact, they have complete emotional dysregulation modeled for them and reinforced by their environment, which is one of the reasons that they continue to display that kind of behavior into adulthood.
Third, while there MAY be physiological changes resulting from abuse that may make it HARDER for individuals to regulate their emotions, we are insulting and diminishing individuals we are trying to help by implying or suggesting that they are unable to learn that skill. It absolutely IS a skill and it CAN be learned, and letting folks know that 1) their emotional regulation difficulties are a common and natural result of growing up in a chaotic environment (not a “disease state” at all, but a normal and common coping measure to deal with their world), and 2) that with proper motivation and hard work, they can learn other coping measures that may work better for them in the future, you give a person HOPE and DIRECTION, instead of encouraging pity and a sense of permanent disability.
I think we would be doing our clients a huge disservice by suggesting that something like temper control can not be taught. My main approach as a counselor is to maximize the empowerment of the individual to learn to take control of his/her life. Suggesting that they are unable to control their emotions provides a ready excuse for not trying and discourages the seed of righteous indignation that generally is found deep inside any abused person and whose presence adds strength and motivation to any attempt to make their lives what they want them to be instead of what others say they should be.
I also don’t agree with letting parents off the hook. Lax or even abusive or neglectful childrearing practices very often ARE at fault, but it’s never too late to learn, for parents or for their children. But no one learns anything until they have the courage to face the fact that THEY and no one else are responsible for deciding what they are going to do with their lives. Taking that responsibility away is one of the worst effects of the DSM process, because it tells people they can’t change themselves, and that is exactly the wrong message to send.
Thanks for the laugh! My son actually had a similar experience after a few intense months trying a bunch of drugs and living with a seriously abusive roommate after running away from home. He had to call me at 3 AM to get me to retrieve him when the roommate was arrested, and a couple weeks later was still recovering from the drugs and the shame of having to come crawling back home and feeling like a failure.
He went to the doctor around this time for a skin rash condition. They did a depression screening, which asked “have you been suicidal in the last two weeks,” to which he answered “Yes.” The doctor came back with a lecture about how “depression is a disease like any other disease, and we have treatments now so you don’t have to suffer…” At no time did the doctor every say, “Wow, you said you were thinking about killing yourself recently! What’s going on that would lead you to think that way?” or “You said you had been suicidal recently – would you be willing to share a little more about what’s been going on?” My son was quite infuriated and insulted by her approach, which amounted to a sales pitch for antidepressants. Needless to say, he didn’t buy into her crap, but it shows how completely useless and downright destructive these diagnoses really are. They allow the clinician to completely avoid the uncomfortable gray area of “what is really happening and what should I do to help?” and go straight to a formulaic response that avoids any need to actually understand what is going on.
Seriously, the average four year old could have done a better job. At least they’d know enough to ask, “Why are you so sad?”
I think you may be missing the point. We are unable to determine the etiology of most psychological conditions because THEY DON’T HAVE ONE ETIOLOGY! As long as we keep treating “depression” as if it is the problem rather than a human reaction to some other underlying problem, which could be social, psychological, or physiological, we have no chance of figuring out ANYTHING about etiology! “IED” is not a condition, it’s a description of behavior that could be caused by a dozen different conditions, as Norman describes. So how will research on “IED” ever yield any results, if a tenth of those diagnosed have “IED” due to difficult social conditions, 30% act that way because of childhood trauma, another 10% have physical health conditions, 20% are in inappropriate educational environments, 15% suffer from poor parenting environments at home, 15% are having adverse reactions to drugs they’ve been prescribed, etc.? Diagnosing by symptom is stupid and counterproductive, as dumb as prescribing nitroglycerin to everyone who has a racing heart or doing knee surgery for everyone whose knee is swollen up. Medical problems should be organized around their CAUSES, not their EFFECTS! Otherwise, research gives you stupid answers which relate only to the suppression of the effects and allow the causes to go undetected and untreated in every case. That is what the state of psychiatry is today. We have a bunch of invented “disorders” that don’t have common origins and that don’t respond to the same kind of interventions, and because we lump all these things together and try to “treat” them as measured through symptom suppression, drugs always end up looking like the “best treatment.” And don’t think the drug companies don’t know this, either. That’s the whole game, beginning to end. Find out what your drug suppresses, get those symptoms into the DSM and defined as a “disorder,” and sell your drug to “treat” it. “IED” is only one of many similar examples. “Social Anxiety Disorder,” “Childhood Bipolar Disorder,” “Oppositional Defiant Disorder,” “Premenstrual Dysphoric Disorder,” ALL invented to sell drugs and other “treatments” aimed at making the symptoms go away without having a clue what is going on.
It’s a multibillion dollar industry. There is no impetus to create alternatives. In fact, there is an incentive to suppress them. And as for actually understanding the causes of people’s distress, that is the biggest threat to the market and the profession that there is!
You are naive if you believe that the profession of psychiatry is interested in finding and resolving the cause of any of their vaunted “disorders.” Curing people loses customers.
Psychologists do diagnose “IED.” As to disputing the diagnosis, I’m not sure how anyone would really do that, except by maybe measuring the length of time between incidents or disputing whether the property damage done is “serious” or not. There are simply no concrete criteria for determining who does or does not “have” this “disorder.” It is literally anything the clinician wants it to be, as long as there is some kind of anger outbursts in there somewhere. Along with “Oppositional Defiant Disorder,” I have always “IED” the most ridiculous, nay ludicrous and absurd contribution to the DSM, and evidence in and of itself that the whole manual is a worthless bunch of biased social judgments and pseudo-scientific jargon based on absolutely nothing of substance whatsoever. The title itself is ludicrous: “Intermittent Explosive Disorder?” I always visualized someone strolling down a street past some small businesses and suddenly, KABLOOEY! They explode and splatter their brains and body parts all over the sidewalk!
It would be more helpful and intellectually honest to say, “Joe seems to have some difficulty managing his temper when he gets angry,” but you can’t really justify drugging someone for lacking a skill, can you? The range of drugs offered as “therapy” also prove the lack of integrity of the “disorder.” Anything that can be “treated” by antidepressants, benzodiazepines, OR mood stabilizers is something you’re just chucking drugs at. Why not just let the guy smoke a doobie three times a day? Or provide a dose of smack at mealtimes? It would make just as much sense as a “medical” treatment. In fact, marijuana would probably be a better choice than SSRIs, since occasionally the SSRIs actually CAUSE something very much like the very symptoms they are supposedly “treating.” But you can’t get much money out of selling marijuana compared to SSRIs, so that’s just not a solution, is it?
Of course, they are also creating a lot of the symptoms themselves with medication side effects, especially of stimulants and SSRI antidepressants. I can’t tell you how many foster kids I’ve seen who started out on stimulants for “ADHD” and ended up on antipsychotics because it made them aggressive or manic. It always appalls me how incredibly irresponsible this prescribing is, and believe me, it’s NOT because non-psychiatrists are prescribing – psychiatrists do this all the time, and I almost never hear of them taking a kid off of something because the side effects are making him/her more aggressive or agitated.
Actually, a lot of times they are prescribe antipsychotics because the stimulants have made them aggressive. Since stimulants increase dopamine and too much dopamine can lead to aggression or even hallucinations, it’s not rare for these to be seen in stimulant users, even at “therapeutic” doses. Of course, in their rigid and narrow-minded stupidity, instead of saying, “Wow, too much dopamine, better give them less stimulants!” the stimulants are in most cases let off the hook, and the child is diagnosed with bipolar disorder or some psychotic disorder and then put on antipsychotics, which ironically REDUCE the very dopamine that the stimulants are so effectively increasing above tolerable levels. One can imagine that the result of this push me-pull you kind of “therapy” are not very happy, but as always, the drugs are never to blame and it’s always the patient’s fault, so if the kid doesn’t get better with the two drugs, they get onto three, four or even five and usually end up in residential treatment. Even if the two drug plan “works,” the child is generally left overweight, unmotivated, and kind of hopeless. It’s a great plan, if you’re trying to drug someone into apathy.
I would add that despite the huge positive publication bias, when long-term studies or reviews do support the null hypothesis, or even worse, show that the treatment is destructive over the long term, they are generally explained away or dismissed. Examples include Wunderlink, Harrow, the WHO studies, the long-term arm of the MTA, the Quebec ADHD study, the Raine study, and many more. Knowing that we’re already dealing with a bias toward believing Psychiatry’s story, it should be considered all the more important and relevant when data comes out that breaks through that barrier and says we have something more to think about. And yet folks like William Pelham, who honestly assessed the long-term MTA outcomes, are condemned as biased or ill-informed and business continues as usual.
This really does make me question whether any kind of research or factual data will ever bring about major reform in psychiatry. I’m afraid the field is simply based on false premises, and looking at the data will ultimately undermine its very foundations. And yet millions of people are making billions of dollars off this chicanery. So rather than reforming, I expect psychiatry as a profession to dig in and defend itself to the last inch of ground, yielding nothing to actual research. To allow the actual facts to surface will bring about the complete downfall of the current paradigm, and those with their snouts in the financial trough are not about to let that happen without a monumental battle!
Cognitive Dissonance Theory sounds like a rarified way of saying “insufficient courage to face the truth.” We ALL experience cognitive dissonance. It is how we choose to address it that shows who we are. The seemingly easy path is to deny the data that conflicts with your preferred theory, because it’s either more convenient or safer or more profitable to stick with the status quo. That’s what the mental health industry is doing today. Everything that questions the current paradigm, from the long-term MTA studies to the WHO studies to Wunderlink and Harrow, is brushed under the rug with “we need more research” or “the sample is probably skewed,” or if all else fails, “The author is a Scientologist or and Antipsychiatrist and can’t be trusted.”
The path to enlightenment is to realize that cognitive dissonance is a learning opportunity. It means your operating model of the universe is not predicting reality. The adjustment needs to be made to your own model, rather than denying the incoming data that conflicts with it. This is called HUMILITY, and it is something that is strikingly missing from most of the KOLs in the psychiatric world today. It admittedly requires a lot of courage to stand up to the current power brokers in psychiatry, but the truth is not compliant to our social needs and fears.
It is also important to recall that Freud originally recognized the primacy of trauma in women’s “hysteria” back in the late 1800s, but he was bullied by the medical establishment of the time into recanting this theory and attributing these recollections to “fantasy,” in essence, “false memories.” So psychiatric denial of trauma has a long and pretty intense history that has never really been dealt with. There have always been those in the mental health field who understood the central role of trauma in all forms of psychological suffering, and such people have ALWAYS come under attack from mainstream authoritarian thinkers who have tended to dominate both psychiatry and medicine as a whole.
Admitting the importance of trauma means acknowledging that authorities can not only be wrong, but can also be abusive and evilly intended. Most of those currently holding power don’t want that possibility to be considered, because in many cases, they are abusing their current power and don’t want to be called to account. It’s always easier to blame the victim and maintain your power.
“False memories” were caused by therapists insisting that people (especially children) had memories they were suppressing and engaging in a search for them. This is VERY different than invalidating someone’s own recollections. Of course, the concept of “false memories” was grabbed onto with both hands by those who prefer an authoritarian world where kids do as they’re told and women know their place and pharmaceutical companies and doctors can make money without too many questions being asked, and what was a relatively brief error in therapy technique became a ringing critique of the idea that someone might ever have a vague recollection of something that actually occurred, or that repressed memories of abuse even existed.
I agree that one of psychiatry’s greatest crimes is to minimize the impact of abuse and trauma. The VAST majority of people suffering from ANY “mental illness” (except perhaps “ADHD,” which as we know isn’t an illness at all) are victims of trauma. We waste billions seeking for genetic explanations when the real explanation is before our eyes. “Mental illness” is primarily caused by oppression and trauma, which is rampant in our crazy society.
It is a dilemma. Even when I just used the best diagnostic code I could to get the service I needed, and told the same to the clients, it felt like I was being coopted. I think a mass boycott is the real answer, but that requires a critical mass of people committed to boycotting, which is not yet forthcoming. For the moment, I think educating as many as possible about the subjective, culture-bound political nature of these so-called “diagnoses” and remind everyone that they’re just descriptions of behavior is the best we can do. I don’t think taking someone who chronically picks his nose and saying he has “excessive digital-nasal insertion disorder” does anything but confuse the issue, but that’s what most of the DSM really does. Just giving something a clinical name doesn’t mean you understand it any better. But you already know this. Preaching to the choir.
Agree 100%! There is no “right” way to respond to stress and bizarre social expectations. Sensitivity is not a disease, except to those who want to be thoughtless and insensitive with impunity!
Deck chairs on the Titanic, I’m afraid. It’s just a bad idea from the ground up, unless you are a pharmaceutical company trying to make as much money as possible by pathologizing every emotional reaction a human being can have. They really need to give it up.
My wife did some research recently on the impact of culture on rates of postpartum depression. (She has an anthropology degree and has been active as a birth doula and La Leche League leader for years.) She found that in cultures where mothers have supportive people around them to assist with making food, washing up, and caring for the baby, postpartum depression is almost completely non-existent. Yet we are told it is all hormones…
And I’m quite sure having a mother who feels supported and having multiple available adult supports leads to less anxious adults.
Thanks for the additional data. We could learn a hell of a lot from traditional societies!
I am sure this is because their “disease” caused them to miscarry in some way. It could not be the drugs, because that would mean the authorities would have to actually think about what they’re doing to people’s bodies.
Or else they’ll say, “Oh, it’s very said, but the benefits outweigh the risks.”
I agree that social connection is something we have lost as a society (and not accidentally – there is writing back into the 1700s about the need to break up communities in order to serve the needs of industrialization) and that this causes a great deal of existential anxiety that we see around us. Relatedly, it is easy to underestimate the effect of the huge effort in the 50s and before to undermine mothers nursing their children and parents picking up their kids when they cry. The current 40+ generation was subjected to early childhood 4-hour feeding schedules and enforced “cry it out” strategies when we wanted comfort, and most were denied the physiological and emotional benefits of the nursing relationship. Additionally, most of us were removed by hospital protocol from our parents’ care immediately after birth during the imprinting period, causing yet further damage to the normal parent-child bonding process.
Some of this has changed (nursing figures have increased dramatically, for instance), but the damage is far from repaired, as our nursing rates remain unacceptably low, and there are huge swathes of society where mythology regarding sleeping arrangements, feeding schedules, and fears of “spoiling” one’s infant still reign supreme, including with some of our medical professionals. There remains, for instance, a constant message from the medical community that having a baby sleep in the same bed with you is extremely dangerous, when most of the world has used this arrangement for most of human history with little to no difficulty.
It is difficult to quantify the impact this has had on our society as a whole, but one almost certain result of babies not being picked up and cared for when they cry and not being held and fed when they’re hungry and being forced to sleep alone when they are frightened is that these babies grow up into more anxious adults.
It is not surprising that we live in a society where anxiety is so common. It’s actually a pretty scary society to live in!
Or we could say, “The kid has a challenging temperament and his parents treat him poorly, understandably resulting in a lot of acting out behavior.” Or “His needs are not being met by his parents and his behavior reflects that lack.” Why bother diagnosing at all? Just describe the problem we need to address and go from there.
Typical reductionistic “research” based on untested assumptions and ignoring of inconvenient variables. Thanks for bringing it to light. Unfortunately, the mainstream will no doubt latch onto this as proof of the “biological nature” of “bipolar” without giving any thought to the extreme limitations of the study, which frankly make it almost completely meaningless.
I so agree with you! I think the DSM diagnostic process is more damaging than the drugs in the long run, because the psychiatrist/therapist becomes allied with the forces in the client’s world that have told him/her, directly or indirectly, that s/he is no good. The concept of trying to cure the bad parent/authority figure of his/her abusive ways is a powerful one that I find is essential to doing good therapy. If you haven’t read Alice Miller, you should do so – she talks about this as the central concept of therapy. We have to learn how to stop making excuses for our parents, and taking on our our own parents’ failings and trying to fix them, instead accepting that our parents have hurt us or failed us and that there is nothing we could have done or can do now to make it better, and really feel the grief of that loss. But instead, the labeling and distancing process inherent in DSM diagnosis conveys that YOU are the one with the problem, and that YOU need to be fixed, and that your feelings toward your parents or toward the psychiatrist are part of the problem, because you SHOULD be happy with what you got and the fact that you aren’t is proof that YOU are failing, not your parents.
It is a sick, sick system full of the very delusions they accuse their patients of harboring. If anyone “lacks insight,” it’s the people who take these made-up childish diagnoses the least bit seriously.
I think there are two huge issues that need to be addressed but are never talked about. The first is that clinical people confuse restraint to protect people with therapy. There is nothing therapeutic about restraint, chemical or otherwise. It serves the needs of the people doing the restraining. Admittedly, sometimes those safety needs transcend the needs of the client, and that has to be recognized. But often the restraining is couched as some sort of assistance to the client to “help get him/herself under control.” This is especially true of chemical restraints, and doubly true with kids.
The other issue, which B mentions above, is that restraint is very frequently “necessary” because of abusive or thoughtless or incompetent behavior by staff people who end up provoking the client by putting them in a no-win situation. It’s so easy to always blame the client for such situations. Any time I read a report that says “Client assaulted staff” I want to read what exactly happens. More often than not, what happened is “Staff assaulted client” by putting hands on him/her or trying to take something away or force them to take medication or some such power struggle, and the client was defending him/herself, at least in his/her mind. Remembering that huge proportions of the “mentally ill” population have had multiple and serious traumatic events, often perpetrated by other staff in this or another facility, their sense of threat is naturally heightened and staff absolutely need to take responsibility for not threatening them. If staff can’t do that, they should not work at such a facility. Sadly, the staff almost always get a pass, no matter how poorly they behaved, and the client always gets the short end of the needle.
A restraint ought to be a rare event and be handled as a critical incident by the facility, with a full debriefing (including with the person so restrained, whose version of events must be fully respected) and proper discipline of staff as appropriate, including firing and/or criminal charges if they apply. It should never become so routine that 25% or more of the clients are experiencing it.
If staff people were held accountable for practicing good deescalation techniques and for avoiding power struggles, we could eliminate 99% of such situations without any physical intervention. Unfortunately, the people with the most power are the most likely to be held blameless, and the result is that restraint is common and unjustly and inappropriately applied daily at most facilities I have gotten to know.
Hey, Joel, I sure don’t expect you to change the tune of the KOLs in the psychiatric profession, nor do I hold you personally responsible for their pronouncements! I do recognize that there are and always have been responsible psychiatrists (several of whom have blogged for MIA) and I appreciate that such people are swimming against the stream. It is definitely not acceptable (though it is in some ways understandable) to tar all psychiatrists with the same brush, based on the APA’s intransigence.
But the buck has to stop somewhere, and I’m not OK allowing the institution of psychiatry off the hook when they really have created the circumstances under which things have come to this pass. I really do think it comes down to the DSM (which again, I understand you have practically speaking zero influence over) providing an opportunity for the pharma companies and corrupt elements at the top of the APA to create a marketing strategy that doesn’t put patient/client best interests at the top of our considerations. Does the same thing happen in oncology, pain management, and obstetrics? (Oh, God, especially obstetrics!) Yes, yes, and yes. But I think that’s a job for another blog.
Corruption is a huge issue in medicine and in our modern society in general. It appears to me you are well aware of that, and I am guessing doing what you can in your limited circle of influence to change that. That’s all I’m trying to do here, and I think most of the posters as well. While some may express themselves more artfully than others, and some may have more direct reason for hostility toward specific psychiatrists, I think we all know this is a systems issue that starts and ends with politics. It’s an unfortunate fact that professionals don’t always make decisions based on what’s best for their clients, but instead on what benefits them personally, but again, that’s human nature. What I really think we need is a system where the incentives to medicate normal behavior and emotions are taken away, and where serious interventions are limited to acutely serious situations where they are merited. (And I could use almost exactly the same words to describe my views on childbirth and obstetrics!) I am guessing from your comments that you’d agree with me. I just wish we were in somewhat better company in forwarding that viewpoint.
Joel, it is definitely true that people come to the doctors demanding benzos and other drugs, and certainly the pharmaceutical industry has much responsibility to bear for this state of affairs, as well as our government for being foolish enough to allow DTC advertising, which most enlightened Western democracies are smart enough not to allow. And you’re also correct that non-psychiatrists write the lion’s share of scripts for benzos, stimulants, and SSRIs. Where I find psychiatry as an institution to be grossly at fault is for providing a socially accepted pretext for this kind of prescribing behavior. When there are “diagnoses” available that are so speculative and subjective as “anxiety disorder,” and when the pharma companies have free rein to “educate” both doctors and the general public about these vague “disorders” (and in the meanwhile gradually distort the diagnostic boundaries so that more and more people appear to “fit” the criteria), the current scenario is an almost inevitable result, human nature being what it is.
This advertising and distortion could not occur without sanction of the APA’s DSM diagnostic criteria, and patients could not demand medication for an “anxiety disorder” if there were no such disorder to provide cover for their demand. Of course, it is 100% the doctor’s responsibility NOT to prescribe based on patient demand, but again, human nature says that the pressure to do so will mean more docs will give in and more patients will be prescribed drugs that are not needed or helpful.
I believe psychiatry’s institutional responsibility is to speak out loudly and firmly against this practice. Every benzo, as you well know, has written on the product information that it is not to be prescribed for longer than a several week period of time due to its addictive nature. Yet doctors all over the country are prescribing these for regular use over many years. I think it is incumbent on psychiatrists, who define these disorders and their treatments, to demand that this behavior stop, both within their ranks (which you yourself amount to 30% of the prescriptions or more) and within general medicine. I’d also expect a fully ethical psychiatric profession to speak out against DTC advertising, as it is obvious the impact this is having on patients and their increasing self-diagnosis and increasing demands on doctors for prescriptions, compounding this problem.
I see none of this. I see psychiatry as a profession sitting on its hands and blaming drug companies and family docs and even patients for the situation and taking no action whatsoever to remedy it. I don’t blame psychiatry for the entire problem, because psychiatry does not control the actions of patients or non-psychiatric docs or pharmaceutical companies.
But I do blame psychiatry for failing to take the responsibility to correct the massive amount of misinformation and mythology out there about benzos and psychiatric drugs in general. There is in my view a significant degree to which psychiatry promotes these very practices, but at the least, I’ve heard little to nothing from key opinion leaders concretely working to correct misimpressions about “chemical imbalances” and deteriorating long-term outcomes and the inappropriateness of long-term prescriptions of highly addictive drugs based on very soft and subjective criteria that almost any patient would be smart enough to fake. Silence in this case is appropriately interpreted as acquiescence to the status quo.
Similar arguments could be made about the use of opiates, but of course, the blame in this case would not be on psychiatrists, but on the pain management specialists for not making it clear to doctors and patients around the world that the long-term use of opiates for pain management is dangerous and generally counterproductive, and other more effective and/or less addictive options exist.
Psychiatrists are supposed to be the leaders in the field of medical treatment of mental health issues. When will the profession speak out against pharma manipulation and against the inappropriate long-term use of benzodiazepines?
I agree 100%. And the insidious underbelly of this assumption is the belief that the status quo is completely healthy and functional and any adverse reactions to it must be due to failings in the individual, never the society or institution with which they are interacting.
A great example is ADHD. The entire “disorder” is predicated on the idea that all kids should be able to do well in a standard classroom. But that has never, ever been the case! And we also have proof that “ADHD” diagnosed kids do much better in classrooms that are designed with more freedom of movement and choice of activity. And yet the “ADHD” label protects schools and society at large from having to examine whether classrooms as designed are effective or need to be re-thought, or whether different kids may need different kind of classrooms or instruction, or whether the whole idea of herding kids into groups of 30 to be taught by one trained professional is just a dumb idea in the first place. No, the institution can have no flaws, so we must diagnose the child who doesn’t like or fit into the mold we’ve created.
Looking around society today, I’d say a certain level of depression and anxiety is completely to be expected. But those in charge don’t want to face the consequences of that observation, and psychiatry is only too happy to help label any dissidents as “mentally ill,” with the real standard being that we’re all right out of “Invasion of the Body Snatchers,” and anyone who is not “happy” with the current state of affairs is the one who has the problem.
And my point would be that the ONLY thing science could ever prove is that “chemical imbalances” don’t exist. It can’t prove that they do. There is some possibility of proof by induction, namely that if chemical imbalances existed, certain things would be observed, and if they aren’t observed, than they are disproven. For instance, Bob refers to research in the 1980s showing that serotonin metabolites don’t differ between depressed and non-depressed subjects. That alone is enough to disprove the “serotonin theory” of depression, at least temporarily, as the expected outcome doesn’t occur if the condition were true. But as you say, human behavior is quite complex and we know next to nothing about the causes or processes involved.
I think scientifically, though, that the burden of proof for a “chemical imbalance” lies with those claiming it exists. The evidence doesn’t have to contradict this theory, it just has to not support it. So far, there is essentially no concrete support for the existence of a chemical imbalance, so from a scientific standpoint, it is wrong to suggest that this is the case. We can’t say FOR SURE that no such imbalance exists, but again, science is skeptical. Scientifically, we have to assume there is no such imbalance until evidence suggests this to be the case, while we can still retain the possibility that such imbalances might some day be discovered in some cases.
Of course, the more fundamental problem with this whole idea is that we’ve lumped “depression” case together without any real knowledge that they belong in the same group. If you study ALL depressed people, you will probably never find anything of use except for the crudest methods of suppression (as we have seen). If some depressed people actually DO have a “chemical imbalance,” you will never find that out by studying all depressed people and treating them as a homogeneous group.
Good science actually begins with a good definition of the problem, and in this case, the DSM has completely failed to provide one. Even Thomas Insel has recognized that as long as we rely on the DSM diagnostic criteria, we will never discover anything of scientific value.
I am an advocate for children in the foster care system, and mostly manage volunteers who do the front-line advocacy. It’s called the Court Appointed Special Advocate (CASA) program and there are such programs all across the USA. I like it because I can help kids get better lives and I can also speak my mind and follow my conscience without having to worry about offending my bosses or colleagues. My history as a counselor/mental health worker is very beneficial in being able to talk mental health jargon with the arrogant elite in the mental health world, and in being able to see through the usual deceptions in proposed diagnosis and treatment of these poor kids, most of whom have nothing at all wrong with them except having had the bad luck to have parents who have not provided what they needed.
And then they blame you for getting worse, don’t they? I am so sorry you have had to go through this awful experience! I’m glad you’ve at least identified the culprits, however. Thanks for sharing your testimony as to the incredible lack of integrity and dishonesty the so-called “mentally ill” are exposed to! Hope things get better for you over time.
“Control interventions are not ideal because they counter a patient-centered approach to care and can damage therapeutic relationships while further stigmatizing patients.”
“Not ideal?” Seriously?
How about “control interventions are inherently and uniformly harmful to patients and must be avoided by all means possible. They often occur as a result of inappropriate or abusive behavior on the part of facility staff, and frequently provide an easy excuse for failure and incompetence by professional personnel.
“They can only be considered appropriate when violent or criminal actions are involved, and are never a method of therapy, but are an absolutely last resort means of protecting someone from physical harm when the full range of other de-escalation efforts have been honestly attempted without achieving safety. They should never be considered a part of any therapeutic intervention plan.”
Wow, I never thought of that! A “midwifery” model would be the perfect counterpoint to the “medical model,” as the basic focus of midwifery is to help the mother realize that it’s her birth and that it’s normal and that she has the capacity to do it, and the midwife is only there to gently assist the way through any sticking points. I also like the idea of “giving birth” to a new spiritual awareness – definitely comports with a lot of what I hear those experiencing “spiritual crises” describing.
Great information – too bad the mainstream of the field appears to have forgotten their origins so completely.
Hey, way to let him have it, you rebellious radical, you! I hope you thanked him for the compliment of calling you “radical.” He obviously finds any alternative viewpoint threatening, and doesn’t want to hear about “recovery” unless it fits his pre-established and accepted pathway.
I bet he will remember you forever. I hope you were able to establish a few cracks in his defense system!
I am glad there are still folks like you in the profession. Your description of a professional attitude toward counseling completely reflects my own. Your clients are very fortunate to have found you.
Don’t be too lonely – there are others like you and me out there if you look hard enough!
That’s exactly right, and is a big part of why the disability roles continue to dramatically expand in the era of “biological psychiatry.” We are biochemically creating an inability to work, and then claiming that the “disease” caused the disability. The psychiatric luminaries clearly can’t accept the proposition that working could possibly be more important than “taking your meds!”
Science is actually never able to prove anything. But it is quite adept at DISPROVING certain things. Scientific truth only lasts as long as it is impervious to vigorous efforts to disprove it through logical contradictions. A lot of my issues with psychiatry relate to their unwillingness to try and shoot holes in their own theory, and their apparent need to attack anyone else who does find those holes. Additionally, psychiatric researchers appear particularly susceptible to the urge to find convenient or comfortable explanations. For instance, when people in third world nations have better schizophrenia outcomes, it must be the culture, or different diagnostic criteria, or the study was flawed in design, because it COULDN’T be that our modern approach is just plain not as helpful as what more “primitive” people do. That ain’t science!
Real science is ultimately very skeptical, and should be even moreso when dealing with the vagueries of human behavior. Putting any theory under intense and unrelenting scrutiny is the core of good science. Only when it survives a brutal onslaught of attempts to disprove or provide alternate explanations can any scientific theory even approach anything remotely resembling a “scientific truth.”
Whitaker never claimed to be doing more than examining the extant research and reflecting on its implications. His great value lies in his ability to contrast the “story” commonly reflected in the media and in most doctor’s offices with the actual data that is to hand. He has not claimed to be a scientist or a physician, or a clinician, but his work has started a vital conversation that has been absent for decades in the mental health field. You have your personal experience, and I would not want to take that away from you, but you seem to be wanting to trash Whitaker’s work for some personal reason that has nothing to do with its real value. It frankly diminishes my respect for your comments when you are unable to recognize and acknowledge that Bob Whitaker has put decades of research into this topic and has radically changed his own views based on what he’s learned. You seem to claim that others are not open to hearing what you have to say, but it seems like the pot calling the kettle black to me.
Bob’s a journalist and never claimed to be anything different. A journalist deals in stories. He’s called the mental health consensus story into question and proposed an alternate reading of the facts. That’s what an investigative journalist is supposed to do, and he’s done it with tremendous success. I think your scorn is very much misplaced.
What of the fact that his psychiatrists were providing him with stimulants prior to his development of manic episodes? I am sure an educated person like you is aware that stimulants can cause mania even in “normal” people? And that stimulants increase dopamine while antipsychotics decrease dopamine?
Diagnosis on a live person who can give immediate feedback is an extremely subjective and dicey operation. I find post-hoc diagnosis on the deceased to be particularly odious and disrespectful. You can believe what you want, but none of us really know what happened, and there are certainly a range of possible explanations for his behavior that prevent a blithe statement that he couldn’t play without his medication.
I would add that there are plenty of folks who will give positive testimonials about the benefits of these drugs, and there are plenty who will give equally negative testimonials for the same drugs. While both constitute data of a sort, this kind of story does little or nothing to illuminate the real issues facing psychiatry today. Let’s say for the sake of argument that Monk really did feel he couldn’t play without his medication. That is one person’s experience. I am much more interested in the collective experience, which I would have to say is very nuanced and politically charged, but is on the whole much more honestly reflected by the articles and data here than those put forward by the psychiatric community as a whole. Namely, that drugs can suppress symptoms in the short run, but IN THE COLLECTIVE, they do not appear to lead to better outcomes for those exposed to them, and in fact, can lead to significantly worse outcomes (like drug-induced mania and early death) in some of the drug categories.
It seems foolish to spend a lot of time arguing about an individual case of a person who is unable to clarify the facts for us due to his having moved on to a better world. It certainly does nothing whatsoever to answer the question as to whether depression is a physical or mental illness. Perhaps we should get back on topic.
Thank you, Susan! I had a sense that this was at least a distortion of what really happened, but it sounds like almost the opposite was true of what TM claimed above. It is always easy to make someone a poster child for a cause after they’re no longer alive to defend themselves. They even did it to John Nash while he was still alive.
Besides which, whose quality of life are we improving? Theirs or the staff’s? I’ve advocated in nursing homes and can attest to the quality of life of some of these poor victims. Death would be kinder.
Note that it says “in some people.” The huge mistake that people studying this field make is assuming that “depression” is an entity that can be “treated,” rather than a bodily response to what could be any of a huge number of potential provocations, both physiological and psychosocial. Trying to “treat depression” is about as dumb as trying to “treat soreness.” If you could isolate causes, you would probably find that SOME depression is caused by vitamin deficiencies, SOME is caused by inflammation, SOME is a result of prenatal drug insults, SOME is caused by early childhood abuse and neglect, SOME is the result of sensitive personalities interacting with a very insensitive world, etc., etc. “Depression” does not have a single cause, and all efforts to treat “depression” are therefore doomed to failure absent concerted effort to search for the real problem that caused the person to become depressed.
This kind of study really emphasizes the absolute idiocy of diagnosing kids (or adults) with a “disorder” based only on symptoms. The authors write that “substantial heterogeneity in effect sizes was seen across studies,” seemingly blind to the fact that “substantial heterogeneity” is seen across the cohort who receive this subjective and socially-derived diagnosis! It should surprise no one that different interventions implemented by different people toward different students would have a range of different results. The real lesson is that EACH CHILD IS DIFFERENT and that we should be creative in finding out WHAT WORKS FOR EACH SPECIFIC CHILD!!!! To think that ONE approach will always work for EVERY child who doesn’t like sitting still or doing boring repetitive work is the height of scientific stupidity. Unless you know WHY they aren’t sitting still, you are simply lumping together kids who are irritating to the adults, and you will never find a single solution that will help all of them, because they each need different things.
Of course, this kind of blunt and crude “diagnosis” does grant a huge advantage to the drug intervention, because it is aimed only at the symptoms and is completely unconcerned with causes or long-term effects. As long as we utilize these reductionistic and inane labels to classify kids, research will always show that drugs “work” best (at least in making the kids less annoying), because they are the crudest and most simplistic tools that attack the identified “symptoms” directly while doing absolutely nothing about the wide variety of possible causes and needs that are not being addressed, hence assuring a steady flow of customers over time.
It is interesting that it is generally assumed that caregivers have the best interest of the patient at heart. This is often true, but is also often false. In fact, many (but certainly far from all or even most) people suffering from severe “mental illness” symptoms have been abused or are continuing to be abused by their caretakers. It does not surprise me that half of the sample did not want the caretaker contacted, nor does it surprise me that the caretakers on the average saw less coercion and more fairness than the patients themselves.
I think you hit the nail on the head, Norman. Not only are the drugs used to evade examination of massive social dysfunction, but the entire DSM is designed primarily for that purpose. As long as those in power can blame any adverse response or objection to the status quo as a “disease of the mind,” they don’t have to think about the actual impact of their policies and activities, and meanwhile can continue to enrich themselves at our expense.
Isn’t this kind of like saying “I know your appendix is infected, but it’s a lot easier to remove your tonsils?” Why would you focus on changing something that isn’t causing the problem????
Bless you for sharing your heartbreaking story! I am so sorry you had to go through all of this, and it makes me very angry at all the so-called “professionals” who continue to be too arrogant to listen to anything their clients tell them. You are very brave to go public with this, and it will help others to know it’s not their “depression” and they are not alone.
My thoughts exactly. If psychiatric drugs are helping so many people become less disabled and more functional, why are violence rates among the “mentally ill” increasing as the use of these drugs becomes more common? Rhetorical question, of course…
They need to do something similar with people who haven’t taken them before and are NOT diagnosed with “bipolar.” This makes it sound as if you avoid them if you already have a “bipolar” diagnosis, and doesn’t acknowledge that this happens to people who have never had a manic episode in their lives.
Who needs these “regulators” messing with the “free market?” Why should a little thing like safety interfere with corporations’ rights to make profits?
Whoever voted against funding this agency needs to be voted out of office!
When I was briefly doing involuntary hospital evals (and I let go almost everyone I saw!) I ran into at least a half a dozen young women diagnosed with “bipolar disorder,” all of whom had severe childhood abuse histories, none of which were documented or considered of particular importance to their psychiatrists. One was 17 and developmentally delayed, emotionally about age 6. She was raped. Was depressed for about a year, then disclosed the rape, and immediately became aggressive. I learned this in a 10-minute conversation with her mom. No note of this in the chart. “Bipolar disorder.” Not even a rule out of PTSD. I got her diagnosis changed so at least they’d have to give her some kind of talking therapy, but I was appalled. After that job, I knew I could not work in the mental health system any more. It is more insane than any of the clients it purports to serve.
Bipolar has become a catch phrase for anyone who is emotionally unstable for any reason. It’s total BS. I did see a few “classic” bipolar presentations, but they were not served well, either – drugs and “case management,” which meant making sure they stayed on their drugs. No kind of therapy or exploration of how and when this started, and very little skill development on how to cope when things started to feel out of control. It was a joke, except it was not at all funny. And don’t get me started about foster kids…
Your case is an excellent example of what Alice Miller was talking about. If you have never read her, you should check her out – you might find her viewpoint validating, if more than a tad discouraging. Our current system, intentionally or not, consciously or not, aids and abets those in authority projecting their own shortcomings and anxieties and aggression onto their clients. If Alice is right, and I believe she is, this is the thing we must absolutely avoid if we’re to actually assist anyone in healing. It can NEVER be the child’s fault that the adults have failed him/her, regardless of what the adults were struggling with themselves. And covering up the truth is often a worse crime than what actually happened to the child (0r powerless adult) in the first place.
I actually agree that it is less harmful to posit a negative outcome with unclear data, because the negative assumption is always the appropriate scientific assumption until proven otherwise (the “null hypothesis”). It is the job of the person claiming benefit to prove it occurs, and if they can’t, it should be assumed that there is not one. In the case of side effects, any indication that they may exist should be considered significant, regardless of the clarity of the data, because we have an obligation to protect against negative outcomes. It is the researchers’ job to prove safety, and in the absence of that proof, we should assume lack of safety for the protection of the patients. The research has enough to suggest that an increase in suicide rate MAY have occurred as a result of the drugs, even if it’s not clear that it was directly caused by the drugs. This should be a very big red flag, especially as it comports with other data raising the same issue. Trying to explain away such a result by data manipulation seems to me far more egregious than overstating the concern, and I do believe the data does suggest a potential significant danger, even if it does not prove the danger comes from the drugs. Unfortunately, psychiatric researchers (including those doing this study) generally take the opposite approach – their drug is assumed to be safe until proven otherwise. This is a very anti-scientific approach.
Even if the critics are taking some liberties with the data, it is very important that this kind of critique be raised. It should probably be framed more cautiously, but cautiously framed concerns don’t seem to get a lot of attention in the psychiatric world these days.
Not sure what else could be done with the data after the hash the investigators made of it. I think the big news here is that the investigative team appeared to be both incompetent in terms of understanding and adhering to the study protocols as well as intentionally deceptive in their findings, and we must assume significantly biased regarding the results. It illustrates that many studies that purport to have some important finding are deeply flawed and that the researchers are often either “on the take” or bring personal or professional biases to the table. It seems like we may need researchers from other fields to take over for psychiatric researchers, because the bulk of them appear to be either incompetent or corrupt or both!
Indeed. As Alice Miller points out so eloquently, the adults almost always expect the children to acquiesce to what makes the adults feel comfortable, thus passing on the pains of the last generation on to the next. This is really my biggest objection to modern-era psychiatry – not the drugs, but the overt and covert invalidation of people’s history and right to frame their own narratives. It takes away the client’s freedom to create meaning from their lives, which I believe is critical to any real healing. Psychoanalysis did this, too, in a different way, but there have always been and always will be therapists who see through this and start from understanding and validating the client’s own personal experience.
We all need to make sense of our own “stuff,” and it does a lot of damage when others presume to tell us what our own experiences are supposed to mean. It may make parents and clinicians feel better, but it is hell on the actual patients we’re supposed to be helping!
Wow, another little dose of sanity from the world of psychiatry. I think that’s twice in less than a week! It is rare that anyone in the profession appears to pose the correct question, which in this case can be formulated as: “Does the fact that you are inconvenient for your teachers and other adults in your life mean there is something wrong with you?”
Too true. Anxiety is often a function of being hyper-conscious of what others are or may be thinking, and a lack of ability to focus on one’s own needs in the moment. I say this as a lifetime anxious person who has learned other approaches. I’m as empathetic as all get out, but it doesn’t stop me from worrying about rejection and embarrassment and humiliation, which are very real possibilities when dealing with other people who really DON’T have empathy for others. It is only through refocusing in a less purely empathetic way (because I KNOW I’m only rarely going to err in the direction of being too self-centered!) that I am able to set boundaries and reasonable expectations that reduce my anxiety considerably.
The important aspect of this study is that they were randomly assigned to the groups, so the drug proponents can’t claim that “only the better functioning ones went off the drugs.”
Agreed, Norman. But I would add also that kids are expected to do things at younger ages, such as reading in Kindergarten or doing homework in first grade, that my teachers knew better than to expect. Additionally, recess and PE and art and music have been reduced and in some cases practically eliminated from the curriculum, and hours per week of classroom instructional time (generally dull times when kids have to sit still and do as they are told) have increased. Homework loads for older kids also appear to have climbed dramatically. And class sizes are at an all-time high for our recent history in the USA.
All of these are in-school variables that could be altered in order to reduce the “ADHD” diagnosis rates. Consider the Canadian study where they noted that a one-year delay in school admission led to a 30% reduction in the “ADHD” rates! Clearly, there is a disconnect between children’s development and what is now expected of them, and this is a big contributor to “ADHD” diagnosis rates. We’re also expecting too much of teachers to manage classes of 30+ Kindergarteners. Reduce class size, increase time spent on “non-academic” pursuits like art, PE, music, and plain old garden variety RECESS and FREE PLAY, and the “ADHD” epidemic would fade out rather quickly. Except, of course, that there are forces at work which don’t want such things to happen.
Excellent article – I wish all practitioners could assume your sense of humility and commitment to seeing the actual facts and results of our interventions. It is way too easy to believe our own perceptions and take credit for anything positive a client does, but blame failures on our clients.
Interesting that you should bring up psychoanalysis in the context of “recovered memories.” I think a lot of people forget or never knew that psychoanalysis went off the rails early in Freud’s career. His original thesis was that “conversion reactions” or “hysteria” were caused by abuse, often sexual, by people known to his clients during their childhood. He drew his conclusion not from recovered memories, but in large part from people actually telling him what happened to them. He chose to believe them and published his early works on the “trauma theory” of mental/emotional distress. But his work was so severely criticized by his colleagues of the time, as no one wanted to believe or admit that sexual abuse was widespread in Victorian society, that he recanted this and came up with the concept that the children were somehow projecting sexual fantasies onto their parents, uncles, etc.
Of course, we now know that childhood sexual abuse is extremely common in our society, and was most likely just as common back in Freud’s day, so his initial theory was right on target. It was society’s unwillingness to acknowledge the primacy of traumatic experiences in childhood that led to 100 years traveling down the wrong path, and once again, our current paradigm continues to make it easy to minimize or dismiss damage from social and cultural reasons and to blame the individual for the suffering s/he experiences. Of course, individual responsibility is critical to any path of healing, but so is the acknowledgement that we are all to a large extent the products of our upbringing and our times. Denying this reality really does prevent psychiatry from ever getting back on the right path again.
Bottom line, everyone is different and everyone has their story. To deny a person the right to tell his/her own story from his/her own viewpoint will always be the biggest mistake we can make, whether it results from telling them that things happened to them which didn’t, or telling them that things didn’t happen to them that did, or worst of all, telling them that what happened to them isn’t even relevant to their current struggles, as so often happens to people entering the MH system today.
I think they are generally a waste of time, even if they make people feel better. A shot of Jack Daniels reduces anxiety just great. But it’s not a medical treatment. It’s just a temporary way to feel better. Using psych drugs to improve mood, even if they “work,” is a false approach, because it subverts any real attempt to figure out what’s going on. Some people report feeling better when they take them, but to me, that’s not the goal.
As far as I can tell, the Murphy bill is unconstitutional on the face of it. Based on prior Supreme Court rulings, you can’t force a person into treatment without a demonstrated immediate risk. This is a constitutional issue, not something they can legislate away.
That said, I wonder how many people were bribed to bring this back after its earlier ignominious defeat?
Looks like a BS study to me. The people aren’t even experiencing anxiety – wouldn’t it make more sense to create an anxiety-ridden situation and watch what changed? Oh, but that would suggest that the environment causes anxiety and that the serotonin increase is in response to stress. Which would be a much more reasonable hypothesis, but it doesn’t fit the desired narrative. So they get to freely “speculate” as to the supposed “relationship” they never actually tested out.
I do agree with Paula and Bonnie that more of a proviso would be helpful – perhaps the title could state “researchers CLAIM that anxiety is caused by increased serotonin, despite serious study limitations.” Something to alert readers who don’t regularly visit that this is a claim to be looked at very skeptically.
It is also worth mentioning that SSRIs have claimed to be helpful to people with anxiety for a long time, maybe with more actual supporting data than claims about depression. If they actually are reportedly helpful, how could this be if increased serotonin leads to more anxiety?
Awesome article, Jay. I have a whole new understanding of “heritability” and some new examples and explanations for folks who have an understandably hard time wading through the rhetoric.
Some are totally against it, others are the worst perpetrators who have personal physicians they go to who will prescribe what the foster parent wants. It’s totally pot luck.
Interestingly, when kids are placed with family members, their psych drug rates are only slightly higher than the general population. So there is some protective effect of being placed with someone who already knows you. But foster kids are totally vulnerable and rarely have anyone looking out for them. They are possibly the most disempowered population in modern society.
That last is probably the biggest lesson I’ve learned in my adult life – while everyone has been hurt and their acting out comes from hurt, there are some who choose to pass their hurt on and choose not to empathize as a protection. Such people are dangerous in that they continue to dramatize what was done to them and pass their pain on to another generation. So while I remain as compassionate as I can, there are times when I have to set boundaries to stop the damage of myself or others, and that’s OK.
Compassion can’t be taught – it has to be felt, and it comes from being willing to deal with our own pain and to feel it rather than passing it on. Only a small percentage of folks are really able to do that. Most of the rest harm mostly themselves, but there are enough of those others to do a lot of damage. And sadly, a disproportionate number of trhem seem to become psychiatrists!
And in both cases mentioned, there is at least some objective measure being used to determine when the level of “obesity” or “hypertensive” is reached. While these levels are somewhat arbitrary, they can at least be argued about, objectively researched, and treatment can be determined to be effective/ineffective based on these measures. No such objective measure exists with psychiatric labels. They are entirely at the discretion of the labeler, and the label-ee has no logical way to disprove or modify the label they have been assigned, other than to find another “professional” to disagree with the first one. And research becomes confused hogwash, because people are arbitrarily lumped together who have little to nothing in common besides their emotional reaction to whatever has happened to them.
Such entitlement! They believe it is right to lie in order to convince people to go along with their plans, and are baffled and upset when people object. Sounds extremely narcissistic to me! Maybe that’s why they 86ed “Narcissistic Personality Disorder” in the DSM 5 – it fit too many of them a bit too closely!
Which is kind of what I was originally saying. The label does not cause the bias, but it builds on existing bias and allows biased people to feel OK about continuing to categorize and other-ize people who aren’t like them. Whereas real healing happens when we start to find the SIMILARITIES between us and the “other,” and can truly empathize with their experiences, which are unique for every person and defy easy categorization.
Thanks for your articulate passion. I always enjoy reading your posts!
While not technically “uppers,” SSRIs are acknowledged by mainstream psychiatrists to have a stimulating or “activating” effect on people.
There absolutely is a documented increased risk of an early death from antipsychotic drug use, due to diabetes, other metabolic disturbances, obesity, and heart effects of the atypicals. It is perhaps somewhat hyperbolic to blame the entire 25-year shortening of the lifespan of the “seriously mentally ill” on antipsychotics, since there are other impacts, such as smoking, drug use, and suicide. On the other hand, smoking is often reported by those taking antipsychotics to help with reducing the side effects (makes sense, as smoking gives a little boost to dopamine, which is massively decreased by AAPs), and there is also some evidence that the AAPs do increase suicide rates somewhat (makes sense also, since they usually mess with serotonin as well), though not as much as the SSRIs.
So while Al may have used a little poetic license, he is essentially speaking the truth here. Antipsychotics do reduce people’s lifespans dramatically. And Paxil and Prozac are “uppers” of a sort. As for Ativan, I hope your correction was for educational purposes, not to somehow discredit the author. Not knowing how to spell the brand name for a drug hardly disqualifies someone from speaking on this important issue.
Well said, Norman! Too bad “common sense” isn’t all that common. It seems like what you said should be obvious to anyone who is truly interested in helping.
Dang, these guys actually sound semi rational. Social issues require social solutions? What a radical concept! Are we sure they are really psychiatrists?
But why should they need to be labeled to get necessary services? I have issues with that concept.
And I agree, the labels are often used in a way to let the real perpetrators of harm in our society off the hook.
Why do we bother spending so much time and money on genetic research, when decades of research have given us, at the very best, a probability distribution of genes that MAY be involved in at most 15% of the origin of “mental illness,” when we KNOW that 85% or more of “mental illness” is associated with trauma and childhood abuse and neglect? It only makes sense if your strong interest is to direct attention away from the very common causal factor and toward something that is more comfortable (and profitable) for those in power to attribute as a source. The fanatical dedication to finding genetic causes to these “disorders” says a huge amount about the real purposes of psychiatry as a profession.
You are correct, as usual, Alex. The problem is not the labels themselves but the inherent disrespect that lies behind them. It gives people, including your own clinicians who are supposed to be helping you, total cover for dismissive and disrespectful attitudes. Those diagnosed as “mentally ill” are treated in undignified ways that no one would consider acceptable with so-called “normal” people.
Thanks for articulating that important point so clearly!
I would certainly agree that SOME cases of “Oppositional Defiant Disorder” or “ADHD” occur in the absence of other stressors or explanations. The point, I believe, of the article is to suggest that the labels have some added utility that makes them worth the downside of inappropriate use. That’s where we have the disagreement. Two of my kids, especially the oldest, were certainly oppositional, hyperactive, and intense from birth. Not disputing that at all. But I dispute that this represents any kind of an illness or disability – it was just the way they were. The first, we struggled with mightily. With the younger, 11 years later on, we were a lot smarter and started doing some things early that we didn’t do till a lot later with Patrick. But we adapted to their needs, found schools that worked for them, set up positive disciplinary programs that took their oppositional natures into account, and built on their many strengths. Both got excellent grades in high school, both are now functional adult citizens. There is and was nothing “wrong” with them just because they tended toward a personality style.
I would still maintain that labeling either of them would have been harmful, both because it would provide them with a built-in excuse to feel sorry for themselves and avoid responsibility for their actions, and because those dealing with them would have a built-in excuse if they failed to figure out how to adapt to their unique personalities and needs.
I would also acknowledge that there are people who are disabled severely by their “mental health” problems and who need extended care and who will not succeed in society without ongoing support. Those people may, indeed, be appropriately considered disabled by their mental/emotional condition, but I still don’t see that lumping them together under one vague and subjective rubric does anything but confuse the issue. As with my kids, each and every one of them deserves a full and individualized analysis of what is troubling them physically and emotionally and an individualized plan of action that takes their unique needs and perspectives into account and is driven by their own goals and preferences. DSM labels, in particular, appear to me to impede any efforts to make this kind of thing happen.
I am sure we would agree on many things, but I don’t agree that the fact that people naturally deviate from norms means they should be assumed to be malfunctioning, if only because it makes it way too easy for those in power to dismiss legitimate concerns (like a rigid teacher or a boring classroom or a gifted child) as “mental health problems,” as is occurring to millions of people across the country today. Again, disagreeing with DSM labeling doesn’t mean that kids and adults don’t have different needs or that they don’t suffer from emotional pain and behavioral dislocation. It just means that it doesn’t help to lump people together that really have very little in common with each other besides a bunch of behaviors (of potentially widely diverse causes) that the powerful don’t want to have to deal with.
Ron, I agree with you 100%. I think we’re seeing more intractable cases of depression mostly because we’re seeing more antidepressant-exposed clients.
Additionally, I am guessing that the further we get away from the fundamental relationship-based approach to therapy, the worse the results will become. CBT becomes something you do TO someone instead of helping them decide if it’s a tool they want to use.
I agree that labels can be comforting, but that doesn’t make them valid scientifically or fully descriptive of reality. For instance, I kind of like the Myers-Briggs system. It creates labels, but they are soft labels with acknowledged fuzzy edges, and each label carries with it both important strengths and assets as well as challenges and frustrations. It is not particularly stigmatizing to be an INTJ (that’s my “label”) because INTJs are acknowledged to be important contributing members of society, and their characteristics are recognized as necessary to the functioning of a team or group. Whereas “ADHD”-labeled people are generally considered deficient, annoying, impossible to care for, and likely to grow up to be criminals without “treatment.” There is no recognition of the redeeming strengths of such a personality, which include persistence, creativity, divergent problem solving, high energy, courage, and willingness to challenge authority, all of which can have great value if properly channeled.
So it’s not the label itself, but the pejorative implications that are most disturbing to me. These labels are inherently stigma-producing in the collective, even if some individuals may find them temporarily or permanently reassuring. And there is science backing that up – people who believe in the biological model implied by the DSM system have been shown to have less empathy for and more fear of the “mentally ill” than those who understand mental illness as an understandable human response to excessive stress.
Words do have power, and choosing words that isolate and exclude people as contributing members of society can be very dangerous indeed.
Sigh… I think you should re-read what I said. I was very careful to say that the removal of labels was NOT the same as saying that people were not in distress or requiring assistance. I quote: “Some people seem to believe that saying no to psychiatric labels means saying “there is nothing wrong” with people who are suffering. This is objectively not the case. ” I am the last person in the world to make such a suggestion. The point I am making is that schizophrenia, for example, is a concept that emerged from social discomfort with people who heard voices or experienced similar odd phenomena. There is no actual evidence that all people with “schizophrenia” have the same problem or need the same kind of help – the DSM itself acknowledges this in its introduction, which unfortunately no one seems to bother reading. Even more to the point, “disorders” like “ADHD” and “Oppositional Defiant Disorder” are clearly based on kids not fitting into the slots that we expect them to occupy, and there is not the slightest degree of effort required to determine why a kid is oppositional or hyperactive before such a label is affixed. To assert that all oppositional children are oppositional for the exact same reason or need the same kind of help is a reductionistic absurdity that has zero factual basis in reality. It is entirely a social construct, end of sentence.
So to re-assert my original point, something like “ADHD” exists because teachers (and many adults) don’t like having to deal with kids like that, and never have. A pre-existing bias LED TO the decision to label “ADHD” as a “disorder” rather than deciding to re-examine how we teach children and why it doesn’t work for a significant proportion of children we encounter. It allows the adults to put the blame on the child and not bother to explore the best ways to help. This is not saying that “ADHD” type “symptoms” aren’t problematic for the student – they definitely can be a big problem! But there are ways to help these kids (and I know this from both professional and personal experience, having two “ADHD” type boys) that do not require us to label them as defective or use harmful drugs to force them to fit into an environment that is not health for them.
As to creating a “situation of parts,” it seems to me that the current diagnostic system is responsible for doing exactly that. “Anxiety” is viewed in isolation from any context, and is “treated” as if anxiety itself were the problem, rather than a reflection of physiological or psychological loss of equilibrium in the person as a whole. As a result, analysis and solutions are limited to what will reduce the “symptoms” without concern for the long-term impact on the larger social context. Hence we have “miracle drugs” that reduce psychotic symptoms very quickly but kill you very slowly, and the symptom reduction is considered vitally important, while the loss of quality of life is denied or trivialized as a sad consequence of “the disease.”
So I agree with your last point of recognizing all factors that prevent an individual living up to his/her highest capacity, but I would assert that psychiatric labels do the exact opposite of this, by encouraging people to indulge in their projections about the dangers of the “mentally ill” and distancing themselves from the kind of empathy that is really needed to take a holistic healing approach.
As to other physiological conditions engendering stigma, this is certainly true and unfortunate. But this doesn’t counter my argument that these are all more objectively observable and falsifiable, protecting someone from false diagnoses, and are also not associated with the use of social force against a person.
Again, I understand that people suffering from anxiety, depression, psychosis, etc., need and deserve our compassion and assistance. I am simply noting that there is nothing about being diagnosed with “Major Depression” or “Generalized Anxiety Disorder” that helps me or anyone else know what to do to help, because the people in these groupings are heterogeneous and are grouped that way for the convenience of our own social comfort and prejudice. When we really dig into these “diagnoses,” as again I’ve had ample professional opportunity to do, we find a huge range of differences and nuances between people who are supposedly suffering from the same “disorder,” to the point that the categories themselves quickly lose any real meaning. They are generally descriptions of things that most people feel are odd or uncomfortable to deal with, and the unfortunate side effect of labeling is that it keeps most people from looking any deeper to find the rich tapestry of context in which the person exhibiting these “disorders” actually lives.
I could go on, though I’m not sure we’ll come to any agreement. But please, do not EVER suggest that because I don’t believe in these subjective and somewhat arbitrary categories it means I don’t believe that depressed, anxious or otherwise suffering individuals don’t need help. It is a very common and frankly insulting insinuation that the psychiatric community inevitably throws at those who disagree with their approach, and it is absolutely, 100% wrong.
So a 1% risk increase isn’t significant, because they’re going to die soon anyway? Why don’t we just kill them outright and save ourselves the bother of caring for them? These researchers are sociopathic!
I understand the MTA study quite well, as well as the Quebec study and the Raine study and the comparative study of Finnish and US youth with ADHD diagnoses as well as the Oregon State University medication effectiveness study as well as Swanson’s 1993 “Review of Reviews,” all of which find that stimulants have no long-term positive impact on a child’s school performance, school completion, college enrollment, delinquency rates, teen pregnancy rates, self-esteem, or social skills.
JD is correct in warning parents about this kind of research. The fact that the psychiatrist doesn’t know it or wants to keep it quiet does not make this less true. Strategically, it might have been better for him to share his concerns with the psychiatrist ahead of time and talk over what the psychiatrist’s beliefs are about the implications of the study, but bottom line, professionals have a duty to give clients the best information they have, and professionals are allowed to have professional opinions that disagree with each other.
I have to wonder what qualifications you have to tell JD what he does or does not understand, especially based on such limited information as he discloses in a single post? Perhaps he’s a lot more educated than you think he is. Perhaps he knows something that you don’t.
Your lack of humility in approaching this controversial and subjective topic lowers your credibility significantly in my eyes.
Well spoken, Saul. It is always interesting that the pro-label, anti-stigma campaigns always seem to equate a lack of support for labeling with blaming the sufferer. How is this the truth? In fact, the psychiatric labeling process itself is a study in blaming the victim. You are not suffering because of poverty, or childhood tramatization, or an unknown infection, or being part of a bizarre society that expects unreasonable things from its members, or worrying about a world that is being ecologically destroyed when there is little or nothing you can do about it. Apparently, you’re not ever supposed to get upset about ANY of those things, and if you are, well, you’re “mentally ill.” I once said to a psychiatrist that PTSD is clearly caused by trauma. He said, “You can’t say that, because not everyone who is traumatized develops PTSD. There must be something about that person’s brain making them react differently.” As if there is a correct way to respond to trauma, determined, of course, by psychiatrists and their associates, and anyone who reacts in the “wrong way” has a mental disease!
That’s my main objection to labels – it subverts the process of actually understanding what is going on. And I agree 100% that the purpose of anti-stigma campaigns is mainly to normalize labeling and psychiatric drug use among the population, even though the research shows that the very process of labeling increases the very stigma they are supposedly opposing.
A difficult topic, indeed. I admire your courage for taking it on.
That being said, I think the essay misses the most salient point: psychiatric labeling is unique in being almost entirely BASED ON preexisting stigmatization, while at the same time PROMOTING AND EXACERBATING these stigma in society. There has always been a degree of stigmatization of those who act or think differently than the general population. This is generally based on a genuine fear of those who are different, but has also been co-opted in the past by people interested in manipulating the population, such as the Nazis in WWII and before, or Jaffe and his minions at the TAC.
Psychiatric labels differ from genuine medical labels in that they are almost entirely social constructs, but they are given the weight of medical “science” to cement them as “real” entities in people’s minds. No one is upset when someone says “she’s a cancer patient,” because it describes an objectively observable condition. And while such spurious or sketchy labels as “pre-cancerous cells” and whatnot, these do not carry the social weight of judgment that psychiatric labels do.
Furthermore, psychiatric labels can be used in ways that no other medical label can be. They can provide a pretext for removing children from a parent’s care, for influencing the outcome of a custody proceeding, for incarcerating a person in jail or letting them out of jail or for incarcerating them indefinitely in a psychiatric institution and forcing potentially deadly “treatments” on people against their wills, based merely on the clinical judgement of someone who may be as biased and even hostile toward “people like you” as any unobjective and uneducated lay person could be.
And since these social constructs have no objective basis in reality, they can’t be tested for, so the person who is said to “have” these disorders has no defense. At least if they say your cholesterol levels are too high, they have to identify a number and measure it, and you can argue about what the right number is or do things to lower your number, but at some point, there is a way you can say, “No, you’re wrong, I don’t have what you are labeling me with.” In psychiatry, there is no such recourse.
Finally, psychiatric labeling plays into the ability of the powerful to project their inadequacies and fears onto the labeled subject. I can’t tell you how many domestic abuse survivors have been labeled by the medical community with a psychiatric label, allowing the abuser to use this as an explanation for why the victim is reporting abuse. I’ve seen abusers get someone committed for exactly that purpose, and the psychiatric community almost always seems to go along with it. Moreover, clinicians who have not done their own work are absolved of any need to question their own inability to connect with a client and do useful therapy, because the client can be labeled with “borderline personality” or “bipolar disorder” and we can treat their brains instead of figuring out what is really going on with the client or with ourselves.
Some people seem to believe that saying no to psychiatric labels means saying “there is nothing wrong” with people who are suffering. This is objectively not the case. Lucy Johnstone and others have identified ways to characterize psychological struggles without attaching the stigma associated with being “mentally ill” in our society. Schools can also make provisions for children’s needs without having to label them with “ADHD” or “ASD” or anything else. While these labels can provide a common language for professionals, the cost in terms of allowing professionals to use their power to blame the child or client for the professionals’ inability or unwillingness to be genuinely helpful dramatically outweighs any benefits, in my view.
Social stigma against “mentally ill” people exists independent of the psychiatric profession. Unfortunately, rather than actually working to subvert these stigma by helping us understand that any or all of us could suffer from similar difficulties in sorting out how to live in our modern world, psychiatry has chosen instead to use and build on those prejudices and constructed a system that reinforces that the “mentally ill” are “different” from us biologically and so we can safely distance ourselves from them and leave it to the doctors to fix up their presumably screwed-up brains. There is recent research showing that believing in the biological model decreases empathy and increases the likelihood that “mentally ill” people will be feared and avoided. I am afraid that whatever small benefits may accrue are wiped out by this larger trend. Additionally, this labeling process lets society completely off the hook for creating a system where labeling and disabling language is required before someone is allowed to be helped. A truly compassionate system would not require that you prove yourself disabled before your needs can get met.
Yes, but they are often willing to make exceptions when it involves using force against a hapless or helpless population. Anything that can lock up, deport or kill more poor and minority people will fly with the Neocons, regardless of the economic impact.
This link was known before Prozac even came out. It was banned in Germany initially for exactly this reason. They are full of crap pretending that the connection is “anecdotal.” It is well established.
Good to know someone is writing about a behavioral perspective on ADHD, as many, many cases are simply a matter of the child finding a way to meet his/her needs when presented with a situation that is dull or frustrating or overly constraining. The author does not appear to identify one other reward of “ADHD” behavior – it makes things more interesting! The only thing most “ADHD” kids have in common is that they don’t like to be bored. Our own often seemed to create arguments just for the sake of seeing the adults getting upset or getting themselves removed from a dull environment. Pre-emptively creating interesting or exciting or stimulating activities is often an incredibly effective way to redirect “ADHD” behavior to something productive. Additionally, getting “upset” when they do what is wanted is an excellent and humorous way to reinforce the more oppositional kids when they are induced to cooperate.
It is also important to remember that this kind of behavior can actually be caused by a number of other physical and/or psychological conditions, such as low iron, sleep difficulties, and a traumatic or chaotic home environment. It’s always critical to keep in mind that “ADHD” children are for the most part very different from one another, other than the fact that their behavior is annoying to adults and especially teachers who have an interest in children who can more easily be herded efficiently into doing what they are asked.
Karen De Sa deserves a Pulitzer Prize for the amazing work she did on this topic. The legislation would not have been so easily passed without her amazing work. We really need to get some media allies to write this kind of article in support of our cause.
Sounds like the parents are smarter than they expected.
This kind of sounds like “black people are unaware of their role as an underclass in American society” or “women are unaware of their role as housekeepers and raisers of children for the more privileged male class.” Why the F(*K would I take my kid to the doctor if s/he had trouble completing his/her homework? I’d take them to the kitchen table or the desk and say, “OK, it’s time to do your homework!” And sit there with them until they got into the habit of doing it without my help and assistance. No doctors required, thanks.
This reminded me of a study I read many years ago, comparing kids with the “ADHD” diagnosis AND aggressive behavior to those who were labeled “ADHD” and not aggressive. Predictably, the children in the “HA” (hyperactive-aggressive) group had more run-ins with the law and more delinquent behavior than the general public. However, those in the “H-NA” group (not aggressive) showed exactly the same levels of delinquency as those not labeled with “ADHD” at all.
So in essence, studies finding that “ADHD” leads to more delinquent behavior are actually making the profound observation that young kids who are aggressive are more likely to continue to be aggressive when they are a few years older. (And they got PAID to discover this?)
When you consider the high correlation between aggressiveness and early childhood abuse and neglect, and the very high frequency of abused kids being diagnosed with “ADHD” and having their trauma unrecognized, it’s quite possible to conclude that “ADHD” is completely unrelated to delinquency, except through the probability that many kids with abuse/neglect issues will get swept up into its subjective range.
I have spoken to many hundreds of suicidal people on the phone and in person in the emergency room. I have yet to find one yet who would talk to me that I have not been able to help using communication alone. Depression is almost always related to a sense of being unable to control or master the environment you are living in. It is a biological coping mechanism for the organism not to waste energy when in a situation that doesn’t allow for an immediate solution, such as being trapped and unable to move or starving in a cave when there are still weeks before food becomes available. Depression is not in and of itself the problem in almost every case. It’s an indication of another problem. Finding out what is going on, what the person has tried, when they’ve done well in the past, what brought that about, what has changed, what do they wish were different, what do they control vs. what don’t they control, and so forth, almost always leads a person to feeling a little more in control of some aspect of their lives and a little less depressed. Does this instantly change the situation? No. Is ECT faster. Sure. But ECT does not convey hope or increase control – it conveys victimhood and a lack of control, hoping that somehow having an electrically-induced seizure will make everything OK.
The husband of one of my volunteers was becoming deaf and feeling it was impairing his functioning and made him feel useless as he approached the age of 80. He was chronically depressed and hopeless for some time, but it seemed to me the reasons were pretty damned clear. His doctor recommended a course of ECT, and they did this for many months. His wife tried to remain positive and saw short-term improvements following “treatment,” but he predictably returned to his baseline within weeks, or sometimes days, just as the research suggests most commonly happens. After a year of this, they vacated Portland and lived in southern California for a year. He was cured! A change of venue was all that was required, but he was being electrocuted three times a week for a year with no benefit, while no one bothered to even discuss why he might feel this way or what could be done to help besides inducing seizures and damaging his brain.
That’s “standard practice” ECT today. It is appalling and it is NOT effective, except in the most crude and short-term of measurements. There is ALWAYS something better you could do.
But are you really having an open dialog? “No one enters psychiatry in order to practice sadism and tyranny on vulnerable patients.” How do you know this is true? Aren’t their psychopathic and sociopathic people in virtually every field? And if they aren’t entering to practice sadism and tyranny, why are patients experiencing their “treatments” in that way, and why are they as a profession so unwilling to listen to their own patients?
“…we are far more accustomed to criticism and personal attack from people essentially ignorant of the nature of our work.” Do any of the criticisms come from people who are quite well aware of the nature of your work? Why would the fact that someone is critical suggest they are ignorant? Does that statement really suggest openness to feedback and differing perspectives?
Ted is himself a survivor of a long string of shock treatments before the euphemism “ECT” had been invented. I’d hardly suggest that he is ignorant of the nature of psychiatry, as he’s experienced it on a first-hand basis. He sees himself as a victim of psychiatry because he was actually victimized by psychiatry. I doubt that you telling him anecdotes about people who got better after ECT is going to convince him that what happened to him was beneficial. If you want others to have a dialog, you have to be really open to hearing their point of view, and not relegating it to either “things used to be bad but we don’t do that any more” or “you were the victim of an unethical or incompetent practitioner but your experience doesn’t reflect the general reality.” People here have experienced horrors at the hands of your profession. They are by no means ignorant, but they have a different perspective than you based on very real personal experiences. If you can’t hear that, you have no business critiquing anyone for being unwilling to engage in dialog.
Though you may be right about what the public will accept as a framing, ECT has been shown to be ineffective in more than the very shortest term temporary symptom relief. As has been documented by a number of writers, the “benefits” are very similar if not identical to the symptoms of a closed head injury. The reason I think we get confused is that psychiatry as an institution has redefined these “mental disorders” purely in terms of “symptoms” which are somewhat arbitrarily grouped into “disorders” that have no actual etiology. So saying that ECT “works” is only based on the assumption that feeling less depressed temporarily is evidence of efficacy. On this basis, drinking three shots of tequila at breakfast lunch and dinner is an effective treatment for anxiety. And really, it would be. But it’s not a medical treatment. It’s an attempt to make the person feel better temporarily without any understanding of what one is “treating.” ECT is a crude approach which has no mechanistic basis for understanding why it might “work,” not to mention that there is no mechanistic understanding of what it is “working” on. So claiming it is effective is about as silly as saying that getting buzzed all day is effective, except the side effects are far, far worse.
Sending electricity through someone’s brain as a “treatment” is a complete admission of failure. If hitting someone on the head with a 2×4 made them feel better temporarily, I’d say the same thing. It is not a treatment for anything – it is an intentional induction of a seizure causing intentional brain damage. There is nothing “effective” about it. If you can’t help someone without damaging their brain, it’s time to hand their care on to someone with some better ideas.
Of course, I am a proponent of flexible planning for every case, as no two kids are alike. My biggest beef with the DSM is that it lumps together kids that aren’t very similar. I appreciate your recognition that effective trauma screening is rare (a recent survey of boys in California residential treatment centers found that over 85% had trauma histories, but I think it was less than 20% who actually had this documented in their records!), but this suggests that most kid in the community are getting substandard treatment. Unfortunately, when enough practitioners engage in substandard treatment, it becomes standard treatment, much to the detriment of the clients being served.
To be quite honest, I am not a believer that “ADHD” is a disease in any real sense of the word. It appears to be a social construct designed to describe and isolate kids who behave in certain ways that are inconvenient for the adults around them. Fitting the criteria for “ADHD” shows nothing except that you fit the criteria, as there is no solid evidence that this cohort of kids has anything much in common other than being difficult for the adults to manage. Only by doing a much more thorough analysis does one ever find an real physiological problems (like FAS/FAE or low iron or sleep apnea) or psychological underpinnings (like current or past trauma) or social causes (like poor or inappropriate school structure or limited parenting skills or developmentally inappropriate expectations). The act of diagnosing appears to absolve most clinicians from giving any further thought to possible diverse causes or creative treatment approaches. While there clearly is a phenomenon that “ADHD” describes, calling it “ADHD” seems to preclude any further thought from any but the most responsible clinicians.
But it also found that both groups did make improvements in symptoms, regardless of treatment or lack thereof. Which kinda suggests that formal “treatment” may matter less than other variables, such as the school structure, parenting styles, “fit” between parents and kids personalities, and simply allowing for the child’s development over time. We know from developmental psychology that kids develop different skills at different times and are still within the normal range of development. Is it possible that the main “cause” of most “ADHD” is the unrealistic expectation that all kids will be capable of performing the same level of academic work at the same time and in the same kind of setting?
Supporting this is the fascinating finding in a Canadian study that waiting one year to admit a child to Kindergarten reduced the “ADHD” rate by over 3o%! Think of it – almost a third of all cases go away if you admit the child to school a year later. Why are those kids getting drugs?
There is evidence from a number of sources over the years that putting these kids in open classroom environments where they have increased control over their activities and schedule almost eliminates any disruptiveness in the classroom environment. We used this with our two ADHD boys and they had no serious difficulties and never used medication, even though both would have been in the moderate to severe category in terms of hyperactivity and oppositional behavior. The fact that such environments are not available is not an excuse for putting kids on drugs unnecessarily. I would ask and expect that you as a young and evidenced based practitioner would be interested in helping assure that kids in schools across America have this kind of environment available, rather than allowing our society to medicate healthy children because they don’t conveniently fit in to the standard classroom model.
The other confounding factor you’re not mentioning is that “severe ADHD” is often actually the result of or compounded by historical or ongoing traumatization. The DSM criteria do not attempt to distinguish the cause of the “ADHD” behavior, hence many traumatized kids are labeled “ADHD” and prescribed stimulants, which often make the situation even worse, since stimulants can exacerbate anxiety, depression, and aggressive behavior. Kids whose behavior is so provoked are often labeled with yet another “disorder” and given even more drugs, rather than removing the offending stimulants. I speak from experience on this point, as I work with foster kids, who have an ADHD diagnosis rate that is 4-5 times the general population. Clearly, if “ADHD” is purely biological, we would not expect to see this kind of differential rate of diagnosis. The obvious conclusion is that traumatized kids are frequently being diagnosed with “ADHD” and their actual needs are being obscured or neglected by their diagnosis and treatment plan.
Sorry, MT, but I don’t think your accusation of “cherry picking” holds up, especially as to #3. As Jonathan points out, the study did not stop treatment at 14 months, but it allowed people to choose which treatment they wanted to use, and they compared those who continued or added stimulants to those who discontinued or never started them. The three- and 8-year followups showed the same thing: it didn’t matter whether kids used or did not use stimulants, the outcomes were the same for all groups.
The Raine study in Australia showed similar results when children’s outcomes were compared based on long-term stimulant use or avoidance. In fact, the kids taking stimulants were more likely to repeat a grade by something like a factor of 9. Additionally, there was a study in Quebec that compared outcomes after a change in medical coverage allowed the widespread use of stimulants for the first time. Kids who took stimulants did not out perform those who did not on any measure. Girls who took stimulants were more likely to experience emotional problems like depression and anxiety. Finally, a comparison of outcomes for Finland vs. the US showed that the rates of ADHD to be similar, the US rate of stimulant use to be massively higher, and the social and educational outcomes to be no different between the countries.
If that’s not enough, there is the OHSU medication effectiveness project, which reviewed over 2000 different studies, basically the entirety of the literature on ADHD that they could find, and there was no proof of any improved outcome on any measure, except a small improvement in the rate of serious accidents for stimulant users.
The data is in. Stimulants don’t improve long-term outcomes. They just don’t.
I thought they needed at least two studies to get a drug approved? And of course, the study design is ridiculous, as if the only options are a long-acting injection and immediate withdrawal to nothing! They should have had a maintenance group with medication as usual and a slow tapering group for comparison. They could also have compared the impact of psychosocial supports between the groups, which I bet they did nothing about. Not to mention the ones on placebo still thought they were taking the drug! What if they came into their physician and said, “Doc, this stuff doesn’t seem to be working for me any more – I’m feeling really weird. Can we make an adjustment?” Would they completely ignore this person’s needs for the interests of the experimental design?
Cruel and stupid, and it’s amazing that the FDA swallows this crap. Copy cat’s point is also well taken – if it’s not working or making things worse, how do you stop?
Let’s say that genetics and nature have equal contributions to behavior. Which of these do we have control over? Since genetics are fixed before birth, why don’t we focus on the part we can actually change?
Exactly. The one measure that is MOST likely to respond to placebo is “do you feel better?” It’s harder to say that you’re sleeping well when you’re not, etc., but the “feelings of depression” question they choose to focus on is probably the most vague in the questionnaire.
It’s also VERY bad science to change the measurement used after the experiment is done. If they believe this, they would have to design and conduct another series of experiments and use this as their only measurement, and report on the results. It’s not OK to re-interpret results after the fact in any scientific study, as it enables you to choose the variable that you already know has changed in the direction you want it to. Which is exactly what they are doing here. It’s totally bogus and clearly just an effort to justify what they already believe.
There is actually some very good evidence that sleep apnea is a causal factor for “ADHD” symptoms in many cases. I’m not sure what treatments are available or whether they work well or not, but I agree that this is an area that needs further research. It is an actual measurable phenomenon, unlike “anxiety disorder” or “Personality Disorder NOS,” so people can actually determine whether or not a particular approach works on some objective basis. That there are charlatans who will use this to peddle some useless or overly expensive intervention is beyond question, but it is definitely not in a class with the fictional psychiatric diagnoses in the DSM, IMHO.
I agree wholeheartedly. Even if we want to discuss nutritional options with a person, the first thing we need to do is reach out and understand the person and their needs and values and fears. Maybe nutrition is something they relate to and it will be easy for them to integrate into their thinking. Maybe it’s way outside their realm of reality and they need to spend more time talking about their past abusive relationship with their mom. Maybe they simply want some skills around how to stay calm when they get triggered. Everyone is unique and communication should always be the first and most important part of any attempt to be helpful. After all, how do you even know if you’re helping if you aren’t connected enough to even know what the person wants help with, or if they want your help at all.
Moreover, love is healing in and of itself. Regardless of what else may be going on, including whatever nutritional deficiencies a person may have (which are alarmingly common due to our incredibly corrupt and unhealthy food production, marketing and distribution system!), a person who feels loved, accepted, and not judged for not “fitting in” to our society’s expectation is going to feel better and make better decisions for him/herself. Love is not all, but love is central to healing, and without love and empathy, there is no guide for one person trying to assist another, and much harm results.
I’ve had the same issues, despite an MS and many years of experience. The reason is because we’re dealing with a religious creed here, not a scientific enterprise. You say the wrong thing and you’re shunned. They come up with a “reason” that maybe sounds semi-legitimate to someone who doesn’t know much or is a “true believer,” but your real crime is not supporting the status quo. Alice Miller writes eloquently about the important message that the child must protect their parent in order to be protected, and identifies this as the source of most human emotional suffering. The same absolutely applies to most “mental health” settings – the biggest priority is making sure the staff feels OK about whatever they are doing. The clients who figure this out fastest are the ones who are declared “stabilized” and let out the door. It is a rare treat when they find someone like you or Stephen who actually cares about what they are saying and doesn’t require them to kowtow to your needs in order to be safe. It’s actually the most healing thing you can provide, in my view. But how to be there and do that in the mass of counterforce and oppression? It’s an incredible challenge. I got out of direct mental health care for that very reason, and now work as a supervisor for volunteer advocates in the foster care system.
The system definitely punishes anyone who strays too far from the party line. I guess it’s human nature in some ways, but unfortunately only the most vulnerable people are the least able to defend themselves from this kind of oppression.
I agree the language is ambiguous, but usually what they are doing is measuring the difference between the beginning of the trial and at a certain set point, or points. So what it suggests to me is that at 4 weeks, they were at best minimally “better” than at the start. It doesn’t necessarily imply there was an improvement followed by a dropoff. To gauge that, they’d have to do a symptom check at two weeks, and “antidepressants” are generally not expected to have any significant effect for at least that long in any case.
I see – sort of the inverse of what I’m saying, but comes to the same thing: they don’t really expect there to be a difference. My guess is that often, the whole thing probably seems pointless to them anyway. I think in order to have a real placebo effect, you have to be investing some hope that the “real” pill will make things better, but if the kid doesn’t even have or understand the objective, it would be hard for their personal hopes and expectations to influence the outcome one way or the other.
It’s not that science is flawed – it’s more that people don’t understand or chose to pursue real science. Science is inherently skeptical – a new finding, rather than generating enthusiastic excitement and automatic acceptance, should instead generate a raft of efforts to disprove or qualify the finding. Rigorous science assumes that human beings are flawed observers and that only repeated, measured observations by multiple people over different times and settings can provide sufficient data to establish an actual scientific truth. And even such truths are only true until further data contradicts them.
Nowadays, “Science” is used as a marketing tool to promote products, professions, or viewpoints, and anyone who looks can find a “scientist” to support his/her pet theory or product. That is not real science. The only thing science is supposed to promote is a search for what is true and reproducibly real, regardless of whether it turns someone a profit or advances their career or not. Marrying profit to science inevitably corrupts the process, as the scientist is no longer objective when his/her livelihood depends on turning out a particular “right” answer. Even very honest people can be corrupted in this way.
The only real way out is to stop any funding of academic scientific research by industry. Industry can do their own studies, but they have to pay for them and the public knows the source is biased. Academic research should be funded only by government or non-profit sources who have no interest in the outcome. And of course, industry folks need to be completely removed from any kind of oversight role in the government. The FDA should be manned primarily by lay people who have no stake in the industry they are regulating. To do otherwise brings about exactly the situation we face today.
Two of my sons were in the frightening 40% of “untreated ADHD” sufferers. The oldest has two jobs he is very successful at both, after graduating high school with honors. The youngest had a straight-A high school GPA and is now a freshman in college, and is also a college soccer player. Neither every got hooked on drugs, committed a crime, crashed a car, failed a grade, dropped out of school, or got a girl pregnant. Both have friends and active social lives. Neither appears to be suffering one iota from their “lack of treatment.”
It is now well established that long-term stimulant treatment does nothing to improve any social or academic or psychological outcome. Yet we are still intimidated with scare-tactic stories about “untreated ADHD” causing havoc. When will people catch on?
Exactly! How could half of the population have a “brain disorder” and our species still survive? And why isn’t the general public or the media smart enough to see this obvious logical flaw?
This is also not news. It is clear that the younger the child, the less effective antidepressants of any sort seem to be. My personal assumption is that this is because the main effect of antidepressants is an active placebo effect, and the younger kids are, the less likely they are to understand or buy into the “magic pill” concept. Which is interesting, since younger kids are supposedly more prone to “magical thinking” than us more mature older folks. But in this case, it seems the psychiatric providers have cornered the “magical thinking” market, and the younger kids are still enough in tune with their gut-level instincts to not buy into the deceptive worldview.
Not to mention that depression is also associated with higher adverse childhood event (ACE) rates, which have been shown to directly relate to physiological illness rates, including strokes. Additionally, there is no evidence presented that those “treated” for depression did any better, so the call to “identify and treat depressive symptoms before…” is really out of order.
No, no, no, brain damage causes odd thoughts, not the other way around! And having odd thoughts proves you have brain damage, because, well, what else could cause them? They’re ODD, damn it! They can’t be caused by a “normal brain” because they’re ABNORMAL, because they BOTHER us and that is BAD, BAD, BAD. So the fact that there is no brain damage yet is only proof that we need to work harder to find the brain damage that we KNOW is there.
Oh, and it can’t be the drugs, despite the evidence, because, well, because the drugs are GOOD, because we thought of them. And all we do is good, so they must be good, so it must be the brain’s fault that it shrinks. That’s it, only BAD brains shrink when we drug them! GOOD brains get better! The bad brains are genetically malfunctioning so they aren’t able to benefit from our wonderfully helpful drugs! It’s all the brain’s fault, because by God, the psychiatrists and the system MUST be protected from any possibility of wrongness!
I worked briefly doing involuntary hospitalization evaluations. My greatest service was keeping people from being committed by doing emergency therapy in the ER. Almost every person who was committed was put onto psychiatric drugs, and that’s basically all they were offered. Any therapy that happened was post-discharge. After discharge, the “clients” had case managers whose main job appeared to be to make sure people “took their meds” and stayed out of trouble. People with “bipolar” or “schizophrenia” diagnoses got no therapy whatsoever. I always tried to diagnose people with “PTSD” or “Adjustment Disorder” so they’d have to get them some kind of talking therapy.
There were also a handful who were discharged with the stipulation that they had to keep taking their drugs, and if they stopped, they could be immediately apprehended and detained in the hospital. There was never a clause saying that if they didn’t attend therapy they’d be re-detained. The focus of involuntary detention was almost 100% forced drugging. There was really no other option offered up, unless the client was educated enough to object and ask for alternatives. I am sure it is even worse today than it was in 1995. That’s how the system “works.”
Mostly because the media, with the help of the TAC and other industry front groups, continues to portray anyone with a “mental illness” as a danger, and blames every shooting on “mental illness” (unless it’s committed by a person of color, in which case it is caused by “thugs” or “terrorism”). Getting the counter-narrative into the media seems like Job One.
I didn’t even see an age limit. So a 5 year old can provide “informed consent” to psychiatric treatment, an action that is challenging for an educated adult in today’s very warped and Orwellian “mental health” world where “treatment” and “damage” are almost indistinguishable?
I did not know this, and I agree it is very important to continue to shift the narrative not only away from confabulated “diseases,” but also toward reintegrating CONTEXT into people’s mental/emotional suffering. When 85% of “schizophrenics” relate a significant abuse/trauma history, while the wildest data manipulations can only account for less than 10% of such cases with genetics, it is quite bizarre that we spend billions researching genetic causes and almost nothing on the wide range of known environmental insults that impact the rate of psychosis experienced by the affected people.
Interesting that Dr. Marder gets away with making his statements of what “he believes” about most “schizophrenics” requiring long-term neuroleptics in contradiction to all that Johanna and Hugh presented, and in contradiction to the WHO cross-cultural studies, without having to provide any evidence on his own behalf. Or did he come up with something other than his personal clinical experience? Did anyone call him out on ignoring or minimizing the hard data that had been presented?
There really is no difference, except that the guy downing the whiskey at least knows he’s “drowning his sorrows” and not engaging in “medical treatment.” I’d be a lot more tolerant of the drugs if the docs were at least honest about what they are used for – a temporary means to feel better that does nothing to address the underling cause, and can have long-term adverse effects that could damage your health. Just like drinking alcohol.
They also sometimes physically hold them down and sit on their back or legs and hold their arms behind their backs until they calm down. I was trained in this technique when I was doing day treatment for 6-12 year old kids. Another intervention is locking them in a padded 4×4 foot room with a tiny window for extended periods. We were not allowed to use this for more than 5 minutes and had to check on them every minute, but I know there are many places that don’t follow these protocols.
Wow! So despite all the claims that people are just going off their meds because they “feel better and don’t think they need them any more,” apparently as many stopped by DYING as stopped by “patient choice.” The main reasons, as I’ve always said, are lack of effectiveness and intolerable side effects. Good to have this in black and white to help counter the claims that “if these poor people would just stay on their meds, everything will be better.”
Wow, you have the plot all worked out! Start writing the screenplay and someone will do it. Anyone have Hollywood connections? Or other filmmaking credentials or connections?
One of the main functions of the psychiatric worldview is to deflect any suggestion that your suffering may be caused by the social conditions you are exposed to and make sure that all the blame lands on YOU, the sufferer, for not “adjusting” to the wonders of modern life. This is particularly absurd when thinking about First Peoples, as each and every one of them has good reason to be depressed, anxious, hopeless and/or righteously infuriated by the way both individuals and the group as a whole is represented and is treated by the larger society. But this view is completely inimical to what psychiatry stands for – it is all about preserving the status quo and assuring that those in power don’t have to worry about the peons of various sorts getting together and objecting to their continued running the world into the ground.
Instead of taking pills and accepting passive and dependent roles, it’s time we channel this appropriate rage and disaffection into altering the conditions that perpetuate the misery of so many people of whatever race and history. A handful of “mental health workers” will do nothing but try to shove the oppressed further into the mud!
I also found that fact disturbing! Apparently most Americans are unaware that medical care is the third leading cause of death in the USA. And don’t forget the increasing evidence of a connection between antidepressant use during pregnancy and “autism spectrum disorders.” The FDA is completely sold out at this point. Disgusting, indeed.
Wow, talk about manipulating the data! You have twice the prematurity rate and twice the neonatal death rate, but they are “safe” because other people exposed to different psychotropics at different times in their lives or pregnancies did just as badly? It is hard to imagine a more warped form of “logic!”
I also thought it odd that they mentioned an increase “risk” of vaginal birth. Is a vaginal birth now considered a bad outcome?
This is a marriage of the two most unscientific and corrupt disciplines in medicine: psychiatry and obstetrics. Both are expert at taking normal human processes and pathologizing them, and both chronically insist on intervening in situations in ways that predictably lead to worse outcomes. It is no surprise that they teamed up to come up with something sleazy and dishonest, but even I am shocked at the disingenuousness of this ridiculous approach!
I am so glad you were there and asked that question, and it doesn’t surprise me that many people appreciated your doing so. I think the answers he gave are less important than the meta-message, which the people in the audience who were really listening are sure to have heard: 1) he has no real answer to your question; 2) he doesn’t care about the real answer, and 3) when attacked, he will resort to platitudes and ad hominem attacks rather than the actual data. Of course, there were many in the audience who are just the same and agree with his authoritarian approach, but there are many others who are open to ideas and have now heard about Harrow and Wunderlink and Whitaker and the long-term data that stimulants don’t improve outcomes. I am guessing not a few attendees got on the internet and looked up some research as a result.
Well done for planting some seeds, and for standing up in the belly of the beast and speaking truth to power!
Seriously. If the “treatment” were working, why are they on three or four drugs and still having anxiety and behavior problems? And if it’s “the child’s age,” then why are they prescribing drugs for what they are saying is normal developmental behavior?
When things get better, it’s always because the drug is working, but when they don’t improve or get worse, it’s always the child or the “disorder.” There is zero accountability.
There was also a protest in Portland, and shock survivor Deborah Shwartzkopf was arrested in a peaceful act of non-violent resistance at the Kasier-Sunnyside hospital. There was no media coverage that I was aware of, except for KBOO Community Radio.
Note the increase in antipsychotic “therapy” as the years of stimulant “treatment” go forward. This is true insanity. Stimulants increase dopamine levels in the brain. Antispsychotics decrease them. The longer kids are on stimulants, the more their brains adapt by lowering dopamine transmission, and the higher the dosage required to suppress the “symptoms.” The higher the dose, the more likely there are side effects like aggression and psychosis, and the more likely they get diagnosed with “bipolar disorder” and put on antipsychotics to decrease the dopamine cascade caused by the increased dosage of stimulants.
Stupidity. If you want less dopamine, stop increasing it with the stimulants! Instead, we have over 10% of these kids taking antipsychotics with all the attendant side effects (including dramatically decreased life expectancy) for iatrogenic reasons. And no one has the insight or the kahunas to call BS on the psychiatrists. I see it every day working with foster youth, and it really is a very disgusting situation.
And I wonder what the results would be if they held drug interventions to the same standards? Oh, no, I don’t wonder – we already know that drugs are less and less effective the younger the user (can anybody say “placebo effect?”) and that in anyone younger than teens, there is no evidence that they are in any way helpful, even from the biased research of the pharmaceutical companies.
I don’t know if Lieberman is a chronic liar (probably is), but I think we all know that Torrey lies like a rug and is willing to swear to the truth of stuff that is known to be false. Of course, anyone who would take Torrey’s word for something is stupid. I don’t know how the guy has the slightest credibility left.
Well said, B, as usual. I agree with acidpop – we adapt as we need to, and there’s nothing “crazy” about coming up with creative ways to survive an oppressive environment!
The researchers always appear surprised when communication works, and surprised when drugs don’t work or make things worse. A little bias in the expectations, you think?
I think the area of kids is a tough one. If we all waited until we were fully healed to have kids, there wouldn’t be many kids in the world. Which might be a good thing, except the people who haven’t done any healing at all are having kids by the bushel without any such compunctions.
My feeling is that the therapist’s choice to have or not have children is not particularly important – the question to me is whether the therapist has done his/her own work of healing and is continuing to do that work as part of making sure s/he is doing a good job as a therapist. I would tend to agree that quality therapists are rare as hens’ teeth, because becoming a therapist in no way requires that the person have accomplished any degree of emotional health or sanity before offering his/her services. I am very much in the camp of Alice Miller (whom I know you value highly as well) in believing that unexamined issues from our own upbringing prevent our being really available to our clients (or our kids) and that we tend to act out those issues that we haven’t consciously faced on both our clients and our children.
I would never claim to have completed my healing process. My childhood was no worse than most and better than many, but there were traumatic experiences in abundance, and I am quite certain there will always be more to learn about that. What I think makes me viable as a therapist is that I am aware of what happens when my own issues get triggered, and I have processes in place to recognize and get assistance when that occurs. I like to believe that I am very good at keeping my own issues out of the discussion with clients, and I think the results I’ve had speak for themselves. I don’t think clients need a perfect person as a therapist. I think they need a HUMBLE person who recognizes the potential harmful impact of everything s/he says or does, and is very gentle and respectful in all interactions with the client. A good therapist is also constantly working to put the client in the seat of power and helping him/her see ways to regain control of his/her life, rather than advising or critiquing or in any way pushing the client toward the therapist’s goals. This is not easy to do unless you’ve done your own work first.
I was very fortunate to have found a good therapist on the first try back in my 20s. She helped me get started on the path of understanding my childhood and my own reactions to it, as well as helping me see that I always had choices and options. She had a young daughter she was raising and it did not prevent her from being a very helpful agent in my life. I find it very sad that others aren’t able to find a person like that, and I hope that I’ve been able to be that person for a lot of other folks who have encountered me. I’m sure I wasn’t for every one of them, but I know I have been for some, and it is something I feel very good about.
I agree that therapy is an art form, and that it takes a different form in each person I am trying to help. As to forgiveness, I think that is completely at the option of the person who has been harmed. Pushing forgiveness would be a giant red flag, because people who do that are usually not comfortable dealing with their own anger and grief towards those who have hurt them. But I also agree with Alex that a time comes when forgiveness makes sense and is healing, at least for some pe0ple and situations. I have certainly forgiven my mother for the most part for her failings early in my life, partly because of my own parenting experiences and partly because of good therapy helping me recognize the impact her limitations had on me. But I still recognize those limitations and have been able to reconsider my expectations of her as an adult so that I don’t keep hurting myself by expecting things that I know she will never be able to deliver.
Therapy is very complicated and emotionally challenging. A good therapist is very rare, and bad therapy can do a hell of a lot of damage. Perhaps the most important point in the essay is to screen one’s therapist hard and thoroughly, and to trust your gut if it feels like this one isn’t right for you. I’d say the odds are at least 9 out of 10 that the therapist you are in front of will be at best of marginal help. Do your homework and find a good one if you can. They are out there, but you can’t tell by the degree. You can tell best by how you feel when you are talking to them.
This is extremely important news – it has implications for every other “mental disorder” in the DSM. Their biggest support for their “genetic inheritance” theory is these twin studies. If anxiety can be transmitted early in life, why not depression, aggression, or even paranoia or delusions?
Unfortunately, it will probably get buried somewhere and no one will really talk about the results. Between those who feel sorry for the parents and don’t want to say anything that “blames” them (even if it would actually help them do a better job!) and those who are currently profiting financially and professionally from the “genetic inheritance” assumption, most of the luminaries in the “mental health” industry will find this study terrifying.
I assumed that the title was completely intended as sarcasm. To think that a serious article could start off with such a title is disturbing. I personally find the words “f0rced” and “treatment” very difficult to say in the same sentence. To give CHOICES of forced treatment is a ludicrous oxymoron.
In addition to the author’s very valid observations, there is another contaminating factor, and that is that the actual definition of what is “better” can differ depending on values and priorities of the party doing the evaluating. Most psych drug studies focus only on symptom reduction as the goal of treatment. Using this as a guide, we could easily and correctly design a study showing that alcohol is an excellent treatment for anxiety, probably as effective as the benzos with a somewhat better side effect profile. In fact, I’d love to see low doses of marijuana tested against SSRIs for antidepressant effects – I’d bet marijuana would come out on top with ease.
But if you measure other data points, like long term health, employment, relationship stability, community engagement, personal satisfaction with life, you get very, very different results. I think part of the mesmerization has been the act of convincing everyone that symptom reduction is the ultimate measure of effectiveness, because the drug companies can ask “what symptom can we say this drug reduces” and then find or invent a disorder that encompasses the symptom in question.
Part of the reason Whitaker’s work has been so influential is that he cuts through that assumption and asks the important question, “Does symptom reduction in the short term lead to better lives for patients in the long term?” And the answer in every circumstance appears to be NO.
My wife’s dad had dementia and was in a nursing facility where she visited him. She saw that he was thrashing his head from side to side, had very rigid muscles, and appeared to be trying to say something but was unable to talk. She called me and I told her to check what he was taking – sure enough, they’d put him on Risperdal because he was gripping the staff’s arms when he was trying to tell them something and felt he wasn’t being heard. She and her sister convinced her mom to take him off of it. Within three days, he was talking, laughing, telling stories, and seemed as much his normal self as possible under the circumstances. The doctor was FURIOUS that her mom had taken him off without consulting him and tried to insist he go back on. No one at the nursing home appeared to notice his incredible distress, and the fact that it resolved within three days when the drug was stopped had no impact on the doctor’s view of its usefulness. Apparently, a person unable to move or talk is preferable to one who expresses his needs in a way that is inconvenient for the caretakers. I think it’s pretty clear why in most cases this stuff is given to seniors. It is a chemical restraint, no more.
Too true! The distinction between what they think of as “mentally well” and “I just don’t give a crap” is remarkably fine, if there is one at all. It seems the goal is to never be upset about anything that happens, no matter how bad. Very convenient for the promoters of the “status quo!”
Cats have as good a chance as anything else at being helpful. This is another example of “scientism” – nothing without double-blind studies counts as helpful, and the same thing has to help everyone or it doesn’t count, even when the categories we’re helping are arbitrary and subjective. Why not just let the person try out having a cat. If they feel better, it worked. If they don’t, it didn’t work. Kinda how they do medication anyway, except with cats, the only side effects are fleas and having to change the litter box.
I think that is its main advantage overall, unless you happen to luck out and find one of the small minority of therapists who actually knows what s/he is doing.
It reminds me of some good stuff from the family therapy literature: there is an “identified patient” who is the person who acts out the repressed conflicts in the family, and is scapegoated in various ways for doing so. The family asks the professionals to “fix” the identified patient and believes once s/he is “fixed,” all will be well. Of course, none of them changes their behavior and the identified patient is still subjected to the same stresses as he was before and is still scapegoated, and if in treatment, any success is undermined by the “family system” so that he continues to be “ill.” If, despite all this, the identified patient improves, someone else ends up acting out and stepping into the scapegoat role.
I think this very much reflects our society, which is in huge denial about problems caused by the status quo, from poverty to pollution to unemployment to depression to violence. We need a scapegoat to avoid dealing with this denial system, and the “mentally ill” are a perfect match for that need! These people are “weird,” they “act out,” they don’t accept the current reality and complain and want changes – they are clearly “ill” and need to be “fixed.” And the biological/medical model provides the perfect opportunity to act as if we’re trying to “help” the identified patient(s) while making sure that they don’t really address the underlying issues that are causing their distress. Hence psychiatry’s subtle but consistent hostility toward looking at any kind of trauma-based model of treatment – it means holding the entire “family” accountable instead of the identified patient(s) who happens to protest the current state of affairs.
Treatment is, indeed, designed to benefit society, but only in the limited sense of providing the appropriate scapegoat so as to avoid dealing with real issues. Helping the individual is most certainly a secondary consideration, and in fact could create some problems if too many people get better, because then we’d need to create more “patients” to take the blame for the discontent that our current social system so effectively generates.
Antidepressants don’t work against suicide, either, which gives these programs a big advantage – at least they don’t have side effect like violence, and actually INCREASING the risk that a non-suicidal person will become suicidal!
CPU, I’m not arguing that such folks need and deserve all the support and care that is available (and I’ve been one of them from time to time, too). All I’m saying is that you can’t assume that just because a person fits a particular list of symptoms you somehow understand what is wrong with them and what is needed to help. I’d never argue against pain relievers if someone has a lot of knee pain, but I’d be very disappointed in any doctor who didn’t look for the cause and try to treat it. It seems to me that this is what psychiatry has become – we list off a bunch of obvious “symptoms” of a condition that often occurs, such as being depressed, and call it a “disorder.” We disclaim technically that these people necessarily have the same problem and claim to be doing research to find causes, but in actual practice, all the research focuses on the “disorder” as defined and all “treatment” focuses on reducing the listed “symptoms,” with no attempt to differentiate between the various possible reasons the person is suffering. I see this as harmful, but my view of this labeling process as being harmful doesn’t mean I don’t respect that you, for instance, have suffered very real hallucinations/delusions and that you’ve found psychiatric drugs at least somewhat helpful in suppressing these manifestations. And I’m not even denying that you or someone experiencing similar might have something physiologically wrong with you. I’m just saying you don’t KNOW what if anything is physiologically wrong just based on that DSM symptom checklist.
I think we agree about a lot of things, but the sticking point seems to be that when I say “DSM diagnoses as described aren’t discernible diseases” you hear “people with psychiatric diagnoses don’t have any real problems.” I am not saying the second, I’m saying the first.
I suppose there isn’t as much profit in trauma, besides which, they’d have to admit they have no tools to actually deal with it. I actually had a psychiatrist (one I even have some respect for) tell me that PTSD isn’t caused by trauma, because if it were, everyone who was traumatized would develop it, so there must be something wrong with the person who develops PTSD beyond being exposed to the trauma. Seems to presuppose that there is a “right way” to respond to being traumatized, and those who “overreact” are somehow wrong or deficient for doing so.
I also read a recent study (I think on MIA) where they discovered that over 80% of the kids in a psychiatric residential facility (or maybe it was more than one) had trauma histories, but less than 20% had any documentation of this in their files. So 60% of the residents either had reported trauma and it wasn’t considered important enough to write down, or simply weren’t asked, despite their residing in a facility for kids who have major behavioral or emotional issues that are very highly associated with trauma.
I’d suggest you listen to Van der Kolk and send the psychiatrists packing. There really is nothing they have to offer to trauma victims in the vast majority of cases, even though trauma is present in the vast majority of cases they encounter. They just don’t appear to think it’s important enough to bother with, if only because they can’t sell drugs as easily if working from that frame of reference. But it does seem like they often do the opposite of what would be helpful, doesn’t it? Makes you wonder how invested they are in people actually getting better…
And what is fascinating is that the way they get depressed monkeys is by exposing them to isolation and social/emotional stress! But it’s all chemicals…
This is very true. The parallels between psychiatry and obstetrics are quite common and most alarming. Unnecessary interventions that increase morbidity and mortality are promoted intensely, helpful non-intrusive interventions are demonized and discouraged, and anyone daring to critique the holy writ of the orthodoxy is subject to social ostracism and high legal risk. It’s actually more legally risky to recommend laboring in a bathtub than it is to do an unnecessary C-section. But most “consumers” are completely ignorant of all this until it happens to them personally.
That is exactly what I meant. Even given the horrific physiological effects of the drugs, I’d still wager that if you compare folks getting the same script based on their relationship with their psychiatrist, the ones with the more compassionate psychiatrists would win, not only because they’d actually listen more when the person said it wasn’t working or complained of intolerable “side effects,” but also because having someone listen is therapeutic in and of itself. I think this would be especially prominent in cases of “active placebos” like antidepressants.
On the other hand, it’s been shown that a friend who is a compassionate listener is about as helpful as any therapy, so maybe the better comparison would be “compassionate psychiatrist” to “any other compassionate person.” In that case, I’m sure the psychiatrists would lose, even the “good ones,” as long as drugs were the primary intervention.
We need more menaces like you! In fact, let’s ALL be menaces to the comfortable world of psychiatry. When the start in on the ad hominem attacks, you’ve got ’em on the ropes, Bob. Keep hitting!
And the meta-message here is: It is true because Liebermann said it is so. It irks me incredibly that a journalist lets him get away with that. Easy response: “I hear what you’re saying, but Whitaker has given us several long-term studies to back up his contention – do you have any studies saying the opposite?” And continue to ask for studies if he tries to deflect, finishing with the clear statement, “So am I understanding that you don’t actually have any studies you can cite that say this?”
That being said, being cursed by Liebermann is proof that Bob is really making an impact and the psychiatrists are running scared.
I don’t hear anyone saying that mental emotional distress doesn’t exist, only that it isn’t an illness per se, as I’ve described before. You seem a bit stuck on this point. People suffer and we should help them, but emotional suffering has many, many causes. A disease should be something where you can identify a cause and recommend a treatment. A rash is a condition but not a disease. It can be caused by lots of things, and depending on the case, requires nothing or intensive treatment.
What are called “mental disorders” in the DSM are not identifiable disease states. It doesn’t mean no one gets depressed or has hallucinations or that those people don’t deserve help. The question is whether all people having those conditions require medical assistance because of a physiological condition that causes the “symptoms”. The answer is clearly no.
This is one of those things where I wonder why we had to pay someone to do research to figure this out. It seems inherently obvious that seeing a therapist you don’t like isn’t going to help and may make things worse. And this is not the first time that the therapeutic alliance has outweighed the school of therapy applied. Basically, people need kindness and respectful listening. It’s not rocket science.
Exactly. I’d like to see them do the same thing for “medication” interventions. I bet the people whose psychiatrists treat them more like human beings have better outcomes regardless of the prescription.
BTW, I just wrote a scathing review of Liebermann’s “Shrinks” on Amazon. It’s something like 34-10 positive, so I encourage others to add your two cents worth and bring down the average. It is kind of interesting – people are either 5 starring or one-starring for the most part – they love it or they hate it. You can guess how many stars I gave it.
Maybe, but pre-emptively lumping them together into categories actually obscures any chance of really finding out of there is a brain function disorder that is verifiable. For instance, “ADHD” is diagnosed for kids fitting a range of symptoms that are common for many kids but appear to a greater degree in those so diagnosed. What if 20% of these kids had a B vitamin deficiency? If we treat a whole group of 100, only 20 get better. But if we give them stimulants, 70% get better. So stimulants are “more effective” for treating “ADHD.” But 20% of these kids got better with a nutritional intervention!!! We lose sight of those 20% if they are lumped in with the rest as all having “ADHD.” There may be another 15% who suffer from sleep apnea, another 5% have low iron, another 30 % (this figure is actually validated in a Canadian study) who went to Kindergarten a year too early, and 10% more who are really smart and are so bored by the curriculum they have to do something to break up the monotony. Add in another 10% who are in abusive homes or in foster care, and we’ve taken care of 90% of the cases without a milligram of stimulants. But they each had different issues, and none of these issues will encompass more than a minority of kids so labeled.
There may be a hard core 10% or less (of those diagnosed) who really have some kind of brain damage, though that figure seems ridiculous high for kids who haven’t suffered head injuries), and maybe we can then study those 10% and see if they have anything in common that is malfunctioning or can be fixed. But we’ll never actually find THOSE kids, either, because they’re lumped in with the 90% whose brains are actually fine!
It may seem like a small thing to simply name a condition of non-optimum operation in order to talk about it, but words absolutely have power and they alter and restrict how we think about a problem. There are consequences to labeling that go well beyond simply a recognition that a particular set of behaviors or emotions objectively exists.
I think it is easy to get confused between saying “the mental illnesses defined in the DSM aren’t really illnesses per se” and that “the experiences that are labeled mental illnesses aren’t real.” No one’s saying depression isn’t a real thing that happens. At least I’m sure not. I’m saying that “Depression” is a state that a person is in which 1) is not a disease state in itself, as all of our emotions have survival value, and 2) there are literally hundreds of different situations, some physiological and some not, that could result in a state of “depression.” What is ridiculous is to assume that ALL states of depression result from the same cause and require the same “treatment.” What makes sense to me is to look at depression as an indicator of something ELSE that is wrong, rather than defining depression as the problem. For instance, a person can be depressed due to the loss of a loved one, a vitamin B-12 deficiency, a lack of purpose in his/her life, the side effects of a medication s/he is taking, loss of sleep, the long-term consequences of childhood abuse, a thyroid condition, or any combination of the above. Why would you assume that all of the above conditions are a result of an “imbalance in the brain?” Why would you prescribe an antidepressant for all of the above conditions?
For sure, people get depressed. They always have and they always will. It’s real. And it CAN be caused by a disease in some cases. But it is not in itself a disease state. It’s a normal state of the body that communicates something about the survival conditions in the environment. Are some people more prone to assuming that condition, perhaps even biologically? Probably so. But that doesn’t mean there is something wrong with those people, either.
If people feel bad and want to take drugs to feel better, I have no problem with that. But I do have a problem with taking a normal human emotion and defining it as a disease state without bothering to look at why it is happening or what other options you might have to get yourself to a more favorable condition.
And in any case, she received the full-on psychiatric standard of care and still ended up killing herself. At one point in the article, she says, “Since I’m going to hear voices anyway, I may as well stop the medication.” That sounds like the voice of a person in despair, who has been told that following this path will make everything all better and finds out that it does not remotely come close to fixing her situation.
It astounds me how bio-psychiatry’s proponents manage over and over again to take stories of psychiatric failure and turn them into advertisements for more psychiatry!
Here’s the thing: in real science, we operate from the null hypothesis, and the person claiming the null hypothesis is wrong has the burden of proof. So if someone says antidepresssants work but has not proof of it, the assumption is they don’t work. As for dangerous effects, I think it’s the opposite: the appropriate assumption is that all drugs have side effects that could be dangerous until proven otherwise. If there is any suggestion that, for example, SSRIs cause certain people to go berserk and commit mass murder, it is not the person observing this who is responsible for proving it is so. It is the manufacturer’s obligation to demonstrate that this is not connected to the drug. Of course, there has to be at least an apparent connection – the bad behavior has to follow administration of the drug in more than one case. But the recipients should not have to submit double-blind proof that the drug is dangerous. If there is indication it is dangerous, then we should assume it is dangerous until proven otherwise. That’s the null hypothesis. It makes no sense to assume no side effects until proven otherwise, because that goes counter to huge amounts of general experience that drugs do have side effects. In fact, aggression (euphamistically called “manic behavior”) and suicidal behavior are noted as side effect possibility on all SSRIs.
The drug is not innocent until proven guilty. If there is any reasonable chance that such a drug could cause such a reaction, it should be eliminated before the drug is assumed to be safe.
I had the same experience. I thought the odd expressions and movements and vocalizations were a result of “schizophrenia.” Once I learned about Tardive Dyskinesia, the scales fell from my eyes. In fact, I was in a bus station on the way back from the training and saw a person waiting who was making all these grimaces and twitches, and I thought, “Tardive Dyskinesia! There it is!” Apparently it was quite common but I had no idea what I was looking at before that training.
I agree with B – I hope they do the study, and won’t they be surprised to find that the people receiving LESS mental health “treatment” do BETTER over the long run? This is perhaps the only benefit of states refusing to implement expanded medicaid – less clients for the mill!
I can’t believe I used the term “resistance!” What I mean is a client’s unwillingness to engage in what the therapist thinks will be helpful to them. The term “resistance” kind of blames this on the client, whereas I think it is a sign that the therapist may be barking up the wrong tree and needs to stop deciding what the client needs and instead listen to what it is they are saying they need themselves.
Thanks, Tim, for an inspiring read. I agree with Duane’s proviso that we should be looking for and eliminating real physiological diseases before assuming psychological causes, but that being said, your analysis of the reasons for client resistance are quite on target. One of the great evils of the “medical model” is that it provides what seems like an easy way to avoid looking at what is behind our distress, which seems good in the short run but ends up preventing a more basic solution to our woes. Of course, there are also plenty of non-psychiatric ways to address immediate pain/distress reduction, the most obvious being meditation/mindfulness breathing, but to discover these options requires a much more honest and humble discussion with the client than many professionals are willing to engage in.
The other barrier you don’t mention, and I really think you ought to, is that many therapists/counselors are extremely limited in their scope of practice. Many these days are trained not to even consider the review of historical trauma as relevant, but to focus entirely on present-time “new thoughts” (CBT) to replace the old “bad thoughts” without any consideration of what service those supposedly “bad thoughts” may have provided in the past. There is also often little discussion of unconscious or subconscious motivation or the effects of present-day harm a person may be experiencing at the hands of an individual or social forces much larger than him/herself. In short, many therapists today have adopted the psychiatric view that the problem/illness lies in the client him/herself, and that the solution is to help the client “adjust” to current reality. This approach has severe limitations, especially when dealing with trauma victims or others experiencing high levels of emotional distress. Naturally, when these therapists fail to have the desired effect, they are encouraged by our system to pass these people on to psychiatrists, because their problems “must have an organic component,” to use one of the common phrases.
Bottom line, getting quality therapy is about more than just getting it funded, though that is a big barrier. It’s about knowing what quality therapy even is, what it intends to accomplish, and finding someone really capable of delivering it. I was very fortunate to find one on the first try, but that was back in 1982, when psychotherapy was in the ascendency. I think it’s a lot harder today, not only because of social mythology speaking against it, but because many therapists aren’t actually trained to get to the root of a person’s struggles effectively, and clients try it and find it doesn’t really get them what they need.
No, that’s one of the POSITIVE effects! We don’t want “schizophrenic” people having sex – it creates ALL kinds of difficulties on the unit.
Seriously, this does not surprise me and should be expected. Antipsychotics basically shut down the dopamine system, and dopamine is definitely a big part of sexual arousal and satisfaction. If anyone bothered to think about it, it should be an obvious “side effect,” but psychiatric myopia knows no bounds. I doubt that most psychiatrists ever even ask their “psychotic” clients about their sexual lives – they most likely assume or try to pretend that they don’t have sex at all, or at a minimum, that it is of little to no relevance to their “mental health.”
I appreciate your civil tone and clarity in this discussion.
I really don’t agree that there are significant numbers of people suggesting that you are lacking in moral fiber if you can’t think your way out of a mental illness. I think that particular line is used to distract from the legitimate arguments of psychiatry’s critics, because it throws down the unstated assumption that either you buy into psychiatry’s view of “mental illness” or you are automatically stigmatizing victims and blaming them for not “bucking up.” Those are not the only two viewpoints. It is possible to take the position that life is challenging and that it’s perfectly normal and acceptable, not a moral failing in any sense, to struggle emotionally and mentally with the challenges we face, especially in our crazy modern world. It is my contention, in fact, that the psychiatric labeling process does more to stigmatize sufferers than even the “buck up” message does. There is research showing that people view sufferers more negatively when given a biological explanation for their suffering. I think it is much healthier to identify the source of conflicts between what the person wants or needs to survive and what the world has provided them to date, and to help them start to figure out some new and more effective ways to get their needs met. There is absolutely no criticism in this approach – I generally frame it as what the person has been taught or learned to date has not prepared them for what the world is expecting them to do, and therefore some new learning is in order. I don’t recall anyone ever telling me that they felt I was judging them for not having it all figured out, because I spend a ton of energy normalizing their struggles as part of the challenges of life. To the contrary, most people report feeling very safe with me because they know I do NOT judge them for not “adjusting properly” to the world as it is.
Psychiatry is actually very much built on the assumption that people should automatically adjust to whatever expectation the world puts on them. For instance, it takes kids who don’t fit in to the standard educational classroom and tells them they have a mental illness and need to take drugs, when research shows that putting them in an open classroom environment, or even waiting a year before starting them in school, can reduce or eliminate the “symptoms” of their “disease.” Talk about stigmatizing! I do NOT expect the child to “buck up” and make it in the standard classroom. I expect the teacher to modify his/her approach or the school to be restructured to meet this child’s actual needs.
I hope that makes my point clear – being opposed to psychiatry as currently practiced does not equate to “blaming the victim.” I believe most antipsychiatry activists find that it is the larger society that is being let off the hook for first creating unnecessary distress and then putting all the blame on whatever person doesn’t fit into the status quo paradigm.
There is a difference between denying that the current conception of “mental illnesses” as discrete categories defined by the APA in the DSM and having assumed biological underpinnings that are similar for all sufferers and denying that the phenomenon of “mental illness” exists. Szaz never denied that people suffered depression or hallucinations or such things, he merely pointed out that you can’t assume that someone has a physiological illness based only on psychological symptoms. It’s a position I can readily agree with, and yet I have worked as a “mental health professional” for many years and believe that quality psychotherapy is a godsend to those who are able to process their experiences in that fashion.
Most “mental illness” is the result of people’s reaction to stress and trauma in their lives, current and historical, and “mental illness” is itself clearly socially defined and mediated by assumptions of what is “normal” (see the DSM categories for proof of this). It makes little to no sense to me to take what is so clearly a social phenomenon and deny or minimize the social contributions to it, as psychiatry has done. Again, these things do occur, but I don’t view them as essentially medical problems, even though medical issues can contribute to them. I think that is what most “antipsychiatry” activists believe as well. So the dichotomy is not accurate to me, and I think I have answered your question of “what is it, then?”
I would love to see a comparison between countries, comparing psych drug rates with death rates. It seems likely that would be possible from the data at hand. The US stats appear to be much higher, with 20-25 years being commonly quoted, and the US is the #1 psych drug consumer and purveyor in the world.
It is quite unconscionable that they did not make any attempt to factor in “treatment,” and explained away the association between intensity of treatment and earlier death by blaming it on the victims. It is amazing the degree to which this profession will go to protect its dogma in the face of contrary data.
Fascinating! So not paying attention to stupid things and paying attention to things you personally care about is associated with living longer? Go figure! But don’t worry, with the one-two of stimulant “treatment” creating manic episodes, leading to a “bipolar” diagnosis and an antipsychotic, should quickly shorten up their lifespans and thereby negate this uncomfortable and inconvenient finding.
Nah, Vyvance may be worse but this has been going on for years, ever since “juvenile bipolar” was invented, oh, oops, I mean DISCOVERED by the estimable Dr. Biedermann, who interestingly worked a lot with “ADHD” kids before he made his “discovery.” It happens with any amphetamine-type stimulant, though Vyvance may make it even more likely. It sounds nasty to me!
Precisely. I have seen this many, many times in my work with foster children, where stimulants cause increased aggression and this is “treated” by antipsychotics instead of reducing or eliminating the symptoms. You’d think that basic scientific reasoning would speak against this practice, which is about as logical as roping a rock climber and pulling him/her both up and down at the same time. But apparently scientific logic does not apply, and we are operating either from blind religious adherence without any scientific understanding at all, or from blatant profit-making evil motivations. Either way, anyone prescribing this combo should be called on the carpet, but it is common enough that they can get away with it by calling it “regular and accepted practice,” even when it is totally irrational. Pisses me off big time!
“Epigenetics” is simply the discovery of how our body adapts to our environment. Why it was ever a question that our body adapts to our environment is what I find baffling. Human survival in so many different climates and niches happens solely because we’re the most adaptable species on the planet. It is only economics and ideological rigidity that ever made the “genetics only” argument seem viable.
It is also interesting to ask why even those still believing in the nature/nurture dichotomy would focus all of their energy on genetic inheritance, when that is the one thing we have absolutely no control over. Why not focus on the environment, which contains thousands and thousands of possible variables that we actually can change?
I agree with Rob – whether these things were “claimed” by “mainstream psychiatrists” or whether they merely stood by and allowed this gigantic misimpression be spread without a word of caution or contradiction is not that important. What is most relevant is that psychiatry benefitted both financially and in terms of status from this belief, and they either actively or tacitly approved of it, depending who you talk to. Bottom line is that many if not most consumers/survivors who have directly interacted with mainstream psychiatrists have been told that a “chemical imbalance” is a causal factor in their depression (or almost any other “mental illness”).
It is also interesting that Scott does not acknowledge the misdirection involved even in the “chemical imbalance” concept itself, which he seems to acknowledge is promoted by mainstream psychiatrists. It it really better to say, “We don’t understand this complex disease of the brain” while still assuming it IS, de facto, a disease of the brain when there is no convincing evidence that any particular disease state is involved, and while there is HUGE piles of confirmatory evidence that trauma is a robust predictor of almost any “mental illness” you can name?
The issue is not the specifics of a “serotonin imbalance.” It is the continued insistence that somehow, with more research, we will eventually “prove” what mainstream psychiatrists really want to believe – that depression is ultimately a primarily biological “disease” that requires drug “treatment.” This premise, in my view, has long since been proven false. The “complexity” of depression as a “brain disease” is observed largely because the researchers are not bothering to take in the myriad social and psychological and even non-brain-related physiological factors that are almost always involved.
“Wilfully?” Do you really mean that word? As if the users were somehow intentionally violating some social agreement or contract by seeking these services?
Clearly, you have not watched the myriad ads nor ready the many news articles letting everyone know that “depression is a disease just like diabetes” and implying that treatment is for everyone. The message that “no one has to suffer” is clearly out there for one and all to see, and we are supposed to trust doctors to know whether we need the given prescription or not. It is the DOCTORS’ lack of ethics that lead a person to be misdiagnosed and forcibly “treated” with something that is either of no use or destructive. For instance, should the doctor not have said that Benzos are addictive and that using them more than a week leads to severe withdrawal reactions? Or is it “caveat emptor,” where the poor patient is forced to look up every drug personally or suffer the consequences? Of course, I know that “caveat emptor” is totally the current reality, but do you really blame the victim for being duped by the guys who are supposed to be telling her the straight scoop?
The main reason the “worried well” are getting so much “treatment” is because psychiatry and the pharmaceutical industry have sold us on the idea that we all need drugs any time we feel badly. We are supposed to trust doctors to tell US if there is “something wrong with us.” We shouldn’t have to avoid checking in with our physician for the fear they’ll prescribe us something addictive or deadly in the name of “treatment” without even bothering to tell us what the dangers are.
— Steve
P.S. I have reported this poster. While we’ve been cautioned to avoid using the “T” word, I think it applies in this case absolutely.
If “insight” means “agreement with the professionals,” then “insight” means accepting that your brain is broken, that you won’t ever be able to do anything about it, and that you should adjust your expectations in life to being partially to totally disabled and to be dependent on drugs to manage your emotional states for the rest of your life.
With that kind of “insight,” it is small wonder that people feel more depressed and hopeless! Other than a diagnosis of a terminal disease, it’s hard to imagine a more disheartening message than what most people are told about the nature of their “mental illness.”
I clearly am not assuming that if you read my full post. My issue is that the psychiatric orthodoxy assumes the contrary. MOST of the time it is psychological, and if psychiatry claims to be scientific in its approach, it must begin by recognizing that absolute fact. If there are physiological issues contributing (such as poor folate assimilation or processing), those issues should be addressed (in this case, most likely through nutritional counseling). Many physiological things like loss of sleep, sleep apnea, low iron, thyroid imbalances, chronic pain, side effects of other drugs, etc., can contribute to depression and should be addressed. The problem is lumping ALL cases of depression together and assuming ALL of them are physiological in nature and treating ALL of them with antidepressants, regardless of the context and without any reference to any valid test of what may, in fact, BE wrong physiologically. For instance, I’ve never yet seen a psychiatric evaluation that tested for anemia or low thyroid, and they often don’t even ask about sleep patterns. I’ve almost never seen a recommendation of dietary changes or working on sleep issues as a primary intervention in a case of a depressed patients. CBT and drugs are the only things offered, and often only drugs. It is, in my view, a very distorted and unhelpful paradigm of care, as it tends to do the exact opposite of what is generally experienced as helpful by the people I’ve worked with. I don’t deny the importance of taking the physiological issues into account, but psychiatrists don’t do this, either. They basically assign a diagnosis and prescribe in 90% or more of the cases I have encountered.
And the diagnosis itself is a problem, first, because it invalidates instead of normalizing the client’s reactions to stress, and second, because it generally stops any efforts to discover a valid physiological cause, since they already “have depression” and are “under the care of a psychiatrist,” so why should we look any further for a cause?
There is no such evidence. The high dopamine theory was discredited in the 1980s, along with the serotonin hypothesis for depression. We’re dealing with mythology at this point, not science.
So if a person is known to have that particular polymorphism, then THAT is the problem and THAT is what should be treated. But we’re talking about a tiny, tiny percentage of all pe0ple who have issues with depression. The vast majority of depressed people I’ve talked to (and I’m a mental health professional who has worked a suicide hotline and done involuntary detention evals, so I’ve talked to A LOT) have very good reasons to be depressed. Most appear to be helped by hearing their story and acknowledging the absolute NORMALCY of their depressed reaction to difficult circumstances. This sets the stage for an empowering discussion of what THEY can do about the situation, rather than placing the blame on their brains and the control in the hands of their doctor, in effect totally reinforcing the idea that there really IS nothing that they can do about their situation, which is why they’re depressed in the first place!
A case in point: a young woman called me up on the crisis line, telling me she’s depressed about losing her boyfriend. She has talked to her mom and a coworker and both insist that she’s lucky to be rid of him and will soon find someone else, but she still felt depressed. I asked her how long they’d been together – 4 years. I asked how long ago they’d broken up – 4 months. My reply, “Not only do I think it’s totally normal for you to feel depressed at this point, if you weren’t a little depressed, I’d think there was something the matter with you.” She says, “Really?” I say, “Yes.” She says, “WOW! Thanks!” and hangs up the phone!
Validation and normalization work better than labeling and drugs. Not that some people don’t find the drugs helpful, and I don’t wish to ban them, but in the long run, finding someone to understand you and help you make plans is almost always the real solution. There may be the odd exception where a genetic condition really does exist, but these have been proven over time to explain only a tiny percentage of cases. Such cases should be detected and dealt with accordingly, but assuming that ALL cases of depression (or even most) are biological in origin ignores both the evidence and basic common sense.
That is the logical fallacy we’re dealing with. We are told that “all behavior arises in the brain” as if there were no agent OPERATING the brain. We decide to be angry and then we get the surge of adrenaline. True, we could probably eliminate anger by excising everyone’s adrenal glands, but is anger really the problem?
ALL of our emotional states are survival mechanisms and are a result of our working to survive as an organism. Randomly selecting certain biological states as “disordered” is bad enough, but the current paradigm takes away the entire concept of personal agency and acts as if we are mere leaves in the wind of biological determinism and that our emotional states have no meaning or utility. I guess everyone is supposed to be mildly interested at all times and everything else needs to be medicated out of existence!
I agree. People get upset about messing with their mythology, and that’s what this is really about – not science, but a mythological worldview where nothing upsetting is anybody’s fault and where magical medicines can make everything all better without anyone having to take any responsibility for changing anything. Your very existence challenges that mythology, and that’s probably the biggest reason your funds are first to go on the chopping block.
I guess my thinking is that when they ask you about effectiveness, you raise the question, “Are you talking about quick symptom reduction, or long-term outcomes? Because where we make a difference is in the long-term.” I guess there is no politically correct way to do it, though. Maybe passing a copy or two of Anatomy around the statehouse is a prerequisite. But I think facility visits and stories from people who use your services are probably the best argument you have.
There is increasing evidence that SSRI use during pregnancy increases the risk of autism. Autism rates have skyrocketed in the years since SSRIs were introduced. I’m sure it’s not the only reason, but I have to believe it’s a contributing factor.
It seems that psychiatry’s love affair with eugenics (including their complicity in forwarding the goals of Hitler’s Germany in the 1930s) is left out of this analysis. Does he talk about that in the book at all?
Ah, Hemmingway – sounds like another psychiatric success story! I suppose once he killed himself, his symptoms abated completely – a total cure.
It is disheartening to know that people are still so mesmerized by doctors’ aura of scientific exceptionalism.
— Steve
P.S. It is important to note that many of the deaths due to medical care are NOT due to accidents or malpractice – they are due to side effects of properly prescribed and properly administered medications. Remember Viiox…
The good retort to this is to ask, “What is the evidence that the standard approach leads to better outcomes or saves money?” The trick that the mainstream employs is to focus on “symptom reduction” rather than long-term outcomes. There is basically NO evidence that psych drugs improve outcomes (and increasing evidence that it makes them worse) and plenty that peer support does improve those outcomes. Maybe give out some copies of Anatomy for them to read.
Perhaps in addition to defending your own program’s value, it’s time to discredit “business as usual” as one of the biggest wastes of money in the State budget!
When you say “mental illness could very well be genetic,” are you aware that you are talking about a huge range of issues, varying from difficulty paying attention in class to hearing voices to having flashbacks of historical trauma? How can you or anyone say “mental illness could very well be genetic” when there is such a range of things that “mental illness” is now purported to cover?
One simple example: how and why is “ADHD” a mental illness? Even if there is some genetic variation in activity level and intensity, which there no doubt is, who gets to decide that kids all need to sit down at desks in a herd and do as they’re told for 6 hours a day, and that kids who can’t do that are “ill?”
Or at the other end: how can PTSD be genetic, when it is clearly a reaction to a severe environmental stressor? Are you saying there is a “right” way to react to being sexually abused or seeing your mom murdered by your dad, and those who don’t respond “correctly” are mentally ill?
It is a completely untenable proposition that “mental illness” is genetic, if only because the definitions of “mental illness” are so heterogeneous that the idea they’d all have the same or similar causes is delusional in the extreme. I really don’t understand why all this focus on genetics anyway, when that’s the one part of the equation you can’t even change? Why don’t we focus instead on changing school environments to be more responsive to kids’ needs, or stopping child abuse and domestic violence, or reducing poverty, or assuring good prenatal nutrition, or providing quality healing environments for people who have been overwhelmed by stress? Why are we always blaming the genes? Because, Logan, blaming the genes is effectively blaming the client, and lets society completely off the hook. I don’t think that is a very accurate or helpful view to take if we really want to help people avoid and/or heal from extreme mental distress.
Wow, that was hard to read! Your daughter is very fortunate to have you – she could very well be dead if you had not stood up for her. It is terrifying what these maniacs can get away with!!!!
Good point. Lobotomies “worked” in a similar way. The person was never upset or agitated again. Of course, they could hardly find their way to the kitchen and drooled a lot, but the “symptoms” went away. With that reasoning, murder makes a very effective treatment for any mental disorder – the symptoms are permanently erased, along with the life force.
You might be interested in reading some of John Nash (“A Beautiful Mind”) writing about how he avoided getting imprisoned and ultimately recovered. The movie makes it seem that he’s rescued by a prescription of atypical antipsychotics, but in reality, he says he recognized even in his delusional state that he’d better not tell these people what he was seeing, hearing, or thinking or they’d lock him up. So he decided to just keep a low profile and lie to anyone about his “symptoms” if asked. Then one day, years later, he sort of came out of it and said, “Wow, I’ve been thinking some really weird things.” And he recovered from there. He is clear that he only felt he recovered because he avoided psychiatrists and hospitals like the plague, and he lied like a rug when needed to stay out of their custody.
It also ignores the problem of the social context for what is considered “abnormal behavior.” Psychiatry would make a great leap forward if it could start acknowledging that much of the suffering of the depressed and anxious folks out there is a result of living in a very depressing and anxiety-laden environment. The impulse to take every uncomfortable behavior and emotion and designate it as a “disorder” avoids dealing with the huge impact of the social context that both helps produce these behaviors and also judges them as being “abnormal” in the first place.
As I like to point out, people who experience a near-death experience, say by being hit by a car, often experience elation at having escaped death, and in some cases even make major changes to their lives to incorporate their new awareness of their mortality. But we don’t push people in front of cars as “therapy.” How any sane person can consider inducing a grand mal seizure through electrocution a form of therapy is baffling to me. It makes just as much sense as improving their mental health by hitting them repeatedly in the head with a hammer until they pass out.
My other theory is that the reason electroshock is found to “work” is that a significant percentage of people understand that they won’t be allowed to escape until they say they feel better. “Oh, yes, THANK YOU, doctor, I feel SO MUCH BETTER NOW! Can you please unlock the door and I promise I’ll never be depressed again as long as I live! (Or at least I’ll never tell YOU about it!)
I agree 100%, as long as they are willing to have a real dialog. Our big volume of posting is going to push us up on the search engines, and non-affiliated people are going to wander in. It’s not surprising that they get upset when their view of the world is challenged – it is called “cognitive dissonance” and is the precursor to deep learning. Some will not be able to make the shift, but I think we’re a formidable group with a lot of facts at our disposal, and we should not be upset or in any way intimidated when folks come by quoting the “common wisdom.” We can continue to challenge them to produce their references and to let them know the data we’re working from. Most will probably bounce off, but a few will find cause to question the status quo, and that’s one of the things we’re really here to do, I think.
I am so sorry to hear of your difficult circumstances! Like I said, it’s not as simple as “pull yourself up by your bootstraps.” People who have been through the wars like you do experience chronic depression and anxiety, and I’ve never been inclined to criticize anyone in your situation for doing whatever you think works.
That being said, I am a counselor by trade and have spent a lot of time working with trauma victims, especially childhood abuse victims and domestic abuse victims. I don’t believe that there is nothing that can be done, and my biggest objection to the psychiatric paradigm is not the drugs, but the basic message that you have to accept that you’re disabled for life because your brain is broken! It appears to me you’re doing a courageous job fighting that message, but I still think it is inherent in the label-and-drug approach that ignores the impact of trauma on a person’s life.
Of course, I don’t know you and can’t presume to suggest what might or might not work. You have your own path to walk, and I admire your courage for pushing forward despite the challenges. My only thought is that you may find more help in actually getting to a better place in the long haul by hooking up with other survivors of abuse and with therapists who really understand this kind of trauma and what it does to you. Most therapists I encounter nowadays are quite shallow in their conception of what therapy should look like – they tend to be very present-focused and skill-based but don’t really take a look at the impact of historical trauma. And psychiatrists are generally far worse – their only nod to trauma is “your brain got wrecked by all those bad things that happened and that’s why you need to stay on your meds.”
I wish I had something more than my compassion to offer, but I do feel for you and hope you’re able to find a better path forward. You shouldn’t have to suffer because someone else was an asshole in your past. I wish I could take your suffering and send it to the perpetrators, who are the ones who really deserve to feel that pain.
Take care and thanks again for sharing your story!
Wow, you make me seen conservative by comparison! I certainly have former clients that became friends and have attended some ceremonies, and one actually did live with us for a while and left a lot of storage at our house for years. Her abusive partner also came to the house to visit us once, which was really fun! And I certainly made mistakes, though I would have to say that anything we learn from that does no lasting harm is a learning opportunity that we’d miss if we didn’t take the risk of making “mistakes.” I found clients to be quite forgiving when I was humble enough to admit my not knowing what to do, in fact, it sometimes was quite empowering for me to say, “Wow, that sucks! I understand why you feel so awful, but I’m not sure I have any great ideas about what to do.” Often, they’d reply, “Well, it’s not THAT bad” and start telling me some things they could try.
It’s all about being human, and being human is messy. Boundaries are all fine and good when they benefit the client by keeping them from having to deal with your crap, but they are often an excuse for keeping one’s distance from the client and avoiding being vulnerable. I found that a degree of self-disclosure and vulnerability was the key to people trusting me to really be on their side.
Thanks for your kind words and for your fascinating answer! You really do go the extra mile!
Depending on the label, this is absolutely the case. For that reason, I avoided using “bipolar disorder,” any “psychotic disorder,” or “borderline personality disorder,” because those are the ones that are most likely to have long-term consequences. Have to be a little careful about “Major Depressive Disorder,” too. I tended to favor giving “Adjustment Disorder,” because by definition, it was temporary and therapy was the only intervention, or sometimes PTSD, of course with a strong recommendation of trauma-based individual therapy or groups rather than any psychiatric intervention. It was, however, quite an inadequate approach and I could not sometimes avoid those diagnoses, especially when people were unsafe and I could not let them leave the hospital and still keep my job. It was a pretty awful experience, though I have to say those that encountered me were very fortunate, because I’d do anything I could think of to prevent them from an involuntary hospitalization, including some pretty impressive ER therapy sessions! But it finally convinced me that by even participating in the system, I was colluding with the forces of evil. If I ever do therapy in the future, I’ll have to do it without insurance reimbursement, because I’d have to do what I thought was right even if the insurance company disagreed.
I agree, I think packaging and therapy are unable to coexist. Real therapy helps the client rethink power dynamics in his/her life, and requires incredible sensitivity and flexibility. Manualizing or branding therapy approaches takes us away from that flexibility and puts us back on the path of correcting the client and making him/her follow our steps instead of his/her own. Instead, therapy needs to focus on assisting the client in reclaiming the right to define both his/her own experience and his/her own power, and to determine what “success” means for him/her and what pathway leads in that direction. I don’t really see any way to create “evidence based” therapy that is replicable in the scientific sense, because the same action may help one person but make another one worse.
Quality therapy requires precisely a stepping down from that place of power and privilege the therapist is granted by society and usually by the client as well, and I think one of the main reason the OD approach has been successful is that it requires exactly that. The therapists talk right in front of the client about their inability to understand the situation given the current information, and speculate about possible explanations, and check back in with the client and his/her support system about their ideas and perceptions. This is about as far from standard psychotherapy and especially psychiatry as one could get.
I agree, Eugene, that the bottom line is the assumption that the client is not only capable but is currently making the best choices s/he is able to make, and the only measure of those choices is how they are working for the client. The less we evaluate the meaning of things for people and the more we help people learn to make and value their own meanings, the healthier people appear to become. But most professionals would find this thinking anathema, and it certainly doesn’t lend itself to double blind studies.
Those in power are seldom willing to give it up without a fight. That’s what’s really “wrong” with most “mentally ill” people – they are subject to a power structure they don’t feel capable of managing. Those in the power structure are usually more interested in oppressing than empowering such people, as they pose a danger to the status quo. Manualizing, branding, and packaging therapy techniques takes the power out of the hands of the clients and gives it right back to those who feel qualified to decide for the client what is “Acceptable therapy.” Which generally means any therapy that makes the client less of a problem for the authorities to deal with.
I agree with this wholeheartedly. I am an activist for abused kids in foster care and for domestic abuse victims as well. The intersection of all of these things is the abuse of power that is justified in our society for those entitled to wield it. We need to be part of these other movements and help them become part of ours.
Of course, the antipsychotic drugs that “schizophrenia” sufferers are prescribed make it hard to move around freely and increase weight and decrease cardiovascular health, all of which make exercising much more difficult. I’d love to see exercise incorporated as an option for folks in a Soteria-like setting. I know the Quakers in the old days did a lot of long walks which seemed to be very healing.
As usual, the standard of care makes actions leading toward genuine healing more difficult rather than easier to do.
So in essence, what we’ve proven is that some people feel somewhat better taking Zoloft than they do when taking a sugar pill. It is also true that some people feel somewhat better when drinking alcohol or smoking marijuana or even taking heroin than similar people taking a sugar pill. Using drugs to modify consciousness is not a new idea, and “symptom reduction” in a short term study proves nothing about the causes or ultimate outcomes for people who are depressed for whatever reason. Common sense suggests that people are depressed for a wide range of reasons, some of which are interpersonal, some social, some financial, ans some physiological. Lumping them all together and giving someone a drug to make them feel better is a stupid plan in the first place.
Reality is that depression (and anxiety and anger, etc.) is an evolutionary survival mechanism that comes into play when the body feels it is necessary. It is not a disease, not ever. There are diseases that might CAUSE a person to feel depressed, and we should screen for those, but to think that ALL depressed people are depressed for the same reason and need the same kind of help is scientific reductionism of the worst sort. (And it’s even contravened by the introduction of the DSM itself!).
Pharmaceutical companies and organized psychiatry have chosen to focus all research on symptom reduction rather than longer term outcomes, mostly because that’s what drugs do and they will almost always be superior if you use that measurement. However, when we look at long-term outcomes like employment, education, intimate relationships, and community involvement, it’s clear that the label-and-drug model is not successful. If Nigeria and Brazil are beating the crap out of the US and the UK in terms of schizophrenia outcomes, it’s time we ate a slice of humble pie and started questioning our own paradigms.
Symptom reduction by drugs can be perceived as helpful, but so can going to the bar after work. The real deal is improving lives long-term, and I defy you to find a Zoloft study that shows it improves that kind of outcome.
You really should read “Anatomy of an Epidemic”. If you really believe in science, it will blow your mind.
Kay, that is simply a restatement of the rhetoric we’ve all been exposed to. There is no solid evidence to support this viewpoint. If you look at the DSM criteria for “Major Depressive Episode” or “Major Depressive Disorder,” there is no distinction between “clinical depression” and any other kind of depression.
As to depressive symptoms returning when someone goes off an antidepressant, you really need to read Anatomy of an Epidemic. There is a well-understood physiological mechanism from research into addiction that explains why “symptoms” that a psychoactive drug suppresses will return with a vengeance when they are discontinued, called neurological up- and down-regulation.
I do agree that stress is the culprit, but there are many, many things an individual can do to reduce his/her unresolved stress and feel more in control of his/her life. I used to work at a crisis line and talked to hundreds of depressed and suicidal people. The number that I could not help through communication to get to a better place I could count on one hand. Genuine human communication, whether through therapy or some other means, that is focused on helping a person regain a sense of personal agency and control in his/her life is healing and leads to a more permanent solution. Labeling and medication, on the other hand, seems in my observation to lead many people in the opposite direction – feeling that the depression is inherent in them, rather than related to how they are living their lives and what has happened to them, and feeling that there is nothing they can do about it (after all, it’s all in my brain) except wait around for the drugs to make them feel better. I recall speaking to one woman who had been trying different antidepressants for over a year without result and was positively frantic about her prospects for a productive future. I asked her if anyone had told her there might be other things she could do besides medication. She was silent for a moment and then said, “No,” in a much calmer voice. She was stunned at all the alternatives I was able to suggest.
“Clinical depression” is a cultural construct. It has no real definition and no actual scientific basis in reality. While many people report finding their antidepressants helpful, this does not mean that there was something wrong with their brains. It just means that the drugs make them feel better. More power to them, but using drugs to make us feel better is an action as old as humanity and does not qualify as medical care. I believe folks deserve more and better than a label and a prescription, and for the most part, they are not receiving it.
Stress is a real issue that can be addressed and changed. This is the key to recovery from depression or any other condition – resuming responsibility and control for a larger and larger portion of our lives. This is not to blame the victim – our society places a lot of barriers in the way of feeling in control of our way of living. But it is those barriers that constitute the real problem, not the individual’s brain, IMHO. And my opinion is backed by years of clinical success stories. Depression can almost always be reduced by effective and loving communication.
Shineone, I am afraid the evidence that SSRIs prevent suicide in the aggregate is completely lacking. It appears that they actually increase the overall risk of suicide, especially in adolescents and young adults, but really for all users, according to the scientific data.
And admitting that SSRIs do cause aggressive and manic reactions in some people is not blaming the drug – it is very simply informing people honestly about what can and does happen to some people. It is admittedly a minority of people who experience this reaction, but it is hardly rare. It is, after all, on the label of the drug. So what’s the big deal about letting people know this can happen so that clinicians and patients and family members can watch for it and take the patient off as soon as any such side effects are evident?
Wow, I had no idea you had been so close to “the belly of the beast!” Your story completely comports with my experience helping foster youth recover from the devastations of an impossibly difficult and inadequate upbringing by abusive and neglectful parents followed by an often abusive and neglectful foster care system. All issues that come up are blamed on the child, including any adverse reaction to psychiatric treatment. Kids often are started on stimulants for “ADHD” and have aggressive reactions, which are then regarded as signs of “bipolar disorder” and medicated with antipsychotics, while still being prescribed stimulants. Biochemically, this makes not the least sense, as stimulants increase dopamine availability while antipsychotics decrease dopamine availability – raising dopamine with one hand while lowering it with the other! Not surprisingly, this often leads to further behavioral or emotional symptoms, similarly blamed on the patient and similarly treated with yet more drugs. Sometimes we end up with kids on 4, 5, 6 or more psychiatric drugs who are still breaking windows, throwing furniture, and assaulting people. At no time during this process do the mental health professionals ever seem to say, “Gosh, our treatment plan seems to be making this kid worse! Maybe we’re barking up the wrong tree!” No, it’s always a new diagnosis and usually a new drug to boot. It is up to our advocates or the kid’s attorney or parents or social worker or foster parent to put their foot down and demand a different approach.
SSRIs clearly have their advocates, but to suggest that they are effective for the vast majority with minimal side effects is just not true. Kirsch’s work has shown marginal effectiveness for mild to moderate depression, most likely due to an active placebo effect. And the stories of withdrawal difficulties are legion. Shineon is entitled to her opinion about her own treatment, but it seems unfortunate to invalidate the experiences of so many who come here for a little dose of sanity.
One real challenge we face is our society’s deification of doctors as the ultimate arbiters of scientific truth. Even very reasonable and rational people still have this bias, and letting people know that doctors not only don’t always get it right, but are downright corrupt, is something that many folks are unable to tolerate emotionally. It undermines some folks’ basic beliefs in “progress” and the basic goodness of our modern social system. Many of our posters and bloggers (Laura Delano is a great example) describe being completely mesmerized and taken in by the idea that Modern Medical Science had an answer for their woes.
I’m interested in how folks think this can be approached. It is a big part of our conundrum, because attacking Psychiatry means attacking Medicine, which means attacking The Holy Order of Scientific and Technological Progress, which means attacking the core values of Western Civilization! If Scientists don’t have all the answers, where does that leave us? I think this unspoken question pushes many who might join us to the sidelines of this fight, even when they are sympathetic with our cause.
This is a great overview of the complex political machinations that drive decision making in healthcare. It is notable that patient outcomes are a very low priority, with saving money and “public safety” (as perceived by those in power, of course) at the top of the priority list. While the kind of changes you suggest can happen, there is and will continue to be no political will to do so until and unless the masses rise up and demand these changes. At the moment, the foxes are guarding the henhouse and enjoying their delectable easy meals and aren’t going to give up their dominance without a very big fight. And politicians don’t engage in that kind of fight unless their election to office depends on it.
So let’s get the grassroots going and make some noise! We know that these changes can happen, but we have to show that the danger of going against the pharmaceutical lobby pales in comparison to the danger of going against the citizens of the nation.
More proof (if more were actually needed) that Big Pharma, in collusion with our sold-out government regulators, will always put profits before health and safety.
Most likely one more reason why those labeled “seriously mentally ill” are dying 25 years before their peers.
Most psychiatrists seem to practice without application of their knowledge of general medicine. And it sounds like their leaders support them in doing so, even when it’s killing off their clients.
I agree with Ted – it starts with working to be the way we need others to be when we’re with each other. Love is not owned by a profession!
Sarah, I’d be very interested in hearing which rules you felt you were breaking, other than the obvious (I sense you give out a lot of hugs!) I have been a renegade therapist myself and pretty much ignored most of the rules and was guided by my conscience and my heart, but I had the good fortune of being a mental health professional without ever having been trained to be one (undergrad in Chemistry, grad in Education). So it might be fun to look back and see which rules I was breaking!
I am sure you were and are one of the most helpful people for the clients to meet, regardless of what the so-called professionals felt about it. I agree 100% – what helps people heal is first off getting real with them and stepping out of any power advantage and helping them connect with the idea that their suffering is OK and human and that you accept it and them as they are. There are lots of different tricks and techniques and approaches but none of them are worth crap without the human connection, and once you have that connection, the person seeking help is almost always able to generate a raft of his/her own “tricks” that you might never have thought of.
Thanks for an inspiring article. Glad it’s not just me!
For anyone who is a real scientist, the failure to publish “negative” results is an obviously unacceptable situation. Anyone can cherry-pick positive studies and make a drug appear effective. But that’s what the FDA actually encourages – all you need are two positive studies to get a drug approved, even if there are 45 negative studies saying it doesn’t work! It should be obvious that this approach asks for bias and corruption. And the larger suppression of even publicizing the negative studies makes it impossible for anyone to really know and understand whether something is effective or not.
Which brings us all back to not being able to trust medical science. Caveat Emptor!
I understand what you’re saying, but I don’t think that anyone is saying “don’t stress and worry about life situations” here. I hear that a lot, as if there are only two options, either ignoring the impact of stress, or somehow minimizing the person’s suffering by implying they should “get over it.” Those are not the only options.
I doubt there is a person here who doesn’t understand how debilitating and exhausting and hopeless it can feel to be in a deep depression, and I doubt equally that anyone believes you should just “pull yourself up by your bootstraps.” I think the author’s intent is to say that understanding and acknowledging the role that current and historical stress and trauma has on our current mood leads to a much better understanding of how to help. The author is certainly not judging a person for being depressed about really depressing things happening to him/her!
As for the diabetes analogy, I am afraid that one has been thoroughly discredited. Diabetes is something you can objectively test for and observe – the body is not making sufficient insulin. It is also something you can objectively treat and observe if the treatment works – if the medication is effective, blood sugar levels will stabilize. It it isn’t, they won’t. Whereas there is no way to measure if someone’s brain chemicals are “imbalanced” (not to mention the fact that no particular “imbalance” is consistently associated with depression – the low serotonin theory was discredited back in the 1980s). As a result, there is also no way to figure out if the chemicals are now “correctly balanced,” since we don’t know what a “correct balance” really is. In truth, the chemistry of the brain is constantly changing, depending on the environment and the needs of the moment, so the idea that there is a “correct balance” may be completely wrong.
To summarize, the author is not trying to say that depression isn’t real, that people don’t suffer, or that they should just “buck up” and get over it. He is saying that the depression is almost always a normal response to abnormal conditions, and that we’d do a lot better to focus on alleviating the stressful conditions rather than essentially “blaming the victim” by pathologizing the person who happens to feel depressed. As an example, I work with foster kids who have been abused and/or by their parents and removed forcibly from their homes. They don’t know where they are going to grow up, they have conflicting feelings of loyalty and anger at their parents, and they are totally confused about why all of this is happening to them. It seems very understandable that they’d be depressed about all this, especially when they have had to endure multiple foster placements and separation from siblings while in care. Why would we assume that they are depressed due to a brain malfunction? Wouldn’t it make more sense to try and help them make sense of what’s happened and help them achieve a greater sense of certainty and control of their future lives?
There is a lot of propaganda out there about “depression,” but John Read is cutting through it with this piece. People are almost always depressed because they’ve had depressing things happen to them. That doesn’t mean they aren’t suffering or that they should get over it. It means that we should compassionately listen to their stories and try to help them find a way to put some meaning and perspective onto their suffering. Counseling is one way to do that, but there are many others. While medication may help some people deal with the pain they’re experiencing in the moment, they will never help anyone to process and digest either the problems in their current life or their historical trauma. The analogy is not insulin for diabetes. It’s more like opiates for a broken arm. They’ll take the pain away temporarily, but you’d be foolish not so look for the actual cause of the ongoing pain and try to fix it more permanently.
You did what “treatment” should d0 – you provided hope, confidence, and a pathway forward. You also provided unfiltered information regarding the truth. I’m totally impressed and ready to nominate you for sainthood! But while what you did is remarkable, I wish that it weren’t. None of these things are rocket science. They require courage, empathy, and the belief in the human spirit. You obviously possess all three in abundance.
Thanks for sharing both of your experiences. It is discouraging but not surprising that the psychiatric profession is not interested in “human interest stories,” though I suspect what they really weren’t interested in was your questioning of their basic paradigm and providing an alternative viewpoint on what does and doesn’t help a person suffering from “extreme states.”
I was forced to use it in one job (in order not to get fired, I mean – of course, I still had a choice). I simply told the clients that it was just a description of what they’d told me and had no real meaning except that I needed to put it down for our agency to be paid for providing service. I told them that I selected the label that I believed would lead the insurance company to pay for the kind of service I felt they would benefit from based on our discussion. I was always clear that their own description of the situation and the perceived causes and possible solutions was what really mattered, not the diagnostic code. I am not sure that covered me, but I felt like it did with the client at least. Perhaps I should have staged a larger protest, but it felt like spitting in the ocean at the time (1995), as there was no real organized DSM resistance movement back then that I was aware of. I definitely felt like an outlier, if not a pariah, but I also felt my reframing was doing some good subversive education and advocacy with the client base.
It is not by chance that I moved into advocacy after finishing that job.
I generally agree with all that is said in the article. It is kind of obvious that most people who take SSRIs never experience anything like this, and it is equally clear that the overwhelming majority of depressed people would never even consider such an act, regardless of whether or how they are being “treated” for their condition. So blaming either SSRIs or depression simplifies an obviously extremely complex situation.
However, I don’t think this absolves us of raising the possibility that SSRIs may have been a contributing factor. I believe the evidence supports that under the wrong circumstances, taking SSRI antidepressants can lead to a person doing things that they might otherwise not do. There is evidence that many people taking SSRIs experience a sense of disconnection, a “WTF” attitude toward others, which I believe may be a large part of why they seem to work for a lot of people. If you’re constantly worried about what others think of you and it consumes your day and you feel like no matter what you do, you’ll never gain approval in others’ eyes, this WTF effect could be quite a relief! To be able to say, “You know what, I really don’t CARE if my mom is upset with me, I’m not going to suffer through another dinner with her this week!” could be quite freeing and empowering.
The dark side is this: if a person is fantasizing about doing something dangerous or deadly, the “WTF” factor could take away the social inhibitions that are preventing him/her from taking this action. Obviously, the person would have to be in a place where they had such fantasies, and equally obviously, some people don’t have that kind of inhibition in the first place and don’t need any drugs or alcohol to get there. But if, say, Eric Harris was fantasizing about shooting up the school, but normally would have thought, “No, I can’t do that, there are too many innocent kids” or “I’m sure I’d get caught and spend time in jail – fun to think about, but I can’t really go through with it,” it is possible that the SSRI might make those social impediments seem less serious. Or encourage him to come up with a novel “solution” like killing himself after shooting the rest of the pe0ple, hence avoiding the jail problem.
Of course, that’s a lot of speculation, but my point is that this effect would not seem adverse for most people – only those who are holding themselves back from some kind of vengeful or rageful feelings would end up acting out as a result, and most highly anxious/depressed people would experience some sense of relief, or maybe feel no big effect, just like most people who get drunk feel more relaxed and socially uninhibited, while a percentage of those with underlying rage/violence issues are likely to act out violently when drunk.
So violence doesn’t have to be CAUSED by SSRIs – the point is, like alcohol, they can be a contributing factor, a catalyst, as it were. There is enough evidence that this should be thoroughly investigated, but it hasn’t been, and I see it as very proper, and not “stigmatizing” in any way, to demand that this rare but potentially deadly side effect be discussed and taken seriously by the medical community and the public at large.
My rather tame and very professional comment was present for a couple of days, but now appears to have been removed from the Psychiatric Times by Dr. Pies or his moderator! I will have to re-submit it. My point was that resistance to labeling was not necessarily a function of how the information was presented, but had more to do with the values and priorities of the person being so labeled. Pretty radical stuff, eh? Not sure why that bugged them so much, but we’ll see what happens when I re-post it.
First off, nobody does all those tests, or almost nobody. Second, the vast majority of psychiatrists don’t even screen for current or past stresses in my experience. I read an article very recently where they interviewed kids in a residential treatment home and discovered that some ridiculously high percent, 90% or more, had been traumatized in the past. This was not surprising to me or probably most people. The surprising part was that only 22% of these situations were actually noted by the staff!! How can you have a residence full of “mentally ill” children and not even bother to ask them what’s going on in their lives? Why does it take an outside researcher asking a set of questions to bring out this information?
That is what happens when people take the current system too seriously. They forget that the main reason most people are “mentally ill” is because shitty things have happened to them. DSM diagnoses let the professionals off the hook from having to ask these difficult but obvious questions.
The fact that psychiatrists or their subordinates could in any way not notice or epathetically respond to the distress and fear their patients experience is the biggest indicator of what is wrong with the system. Professionals are trained and encouraged to act without empathy for their patients. If they were truly empathetic, they’d get the feedback on the spot and make the needed changes. I’ve worked with a huge range of people with all kinds of diagnoses, and can count on one hand the number who were unable to feel some kind of safe connection with me, enough that they felt calmer and more in control by the end of the conversation. This includes frankly psychotic people and some who were extremely aggressive and hostile to begin with. Sometimes the feedback is not verbalized, but the information is almost always right there in front of your eyes. The main reason professionals don’t get to hear this feedback is because they really are not listening. When you respond in a non-judgmental way to that feedback, the client feels more in control and feels like you care about them. In fact, the best way to give the client the impression you care about him/her is to actually care about him/her.
Any “treatment” that does not start and end with empathy and honest communication, including the humility to accept both verbal and non-verbal feedback from patients/clients, will be traumatizing. It’s kinda that simple.
Actually, if we’re actually being scientific, the lack of a test for it essentially does mean it doesn’t exist – the concept, not the condition. If your hypothesis for the explanation for depression doesn’t test out, your hypothesis is scientifically wrong. Science is predicated on the ability to predict a particular result and test for the presence/absence of that result. Anything less is “professional opinion.”
You say “it is an illness for some people, who have it chronic for the rest of their lives.” This is where the problem comes in scientifically. You are relying entirely on anecdotal evidence. There is no proof that depression needs to be chronic in general or for a specific person (even if they report that it is), mostly because there is no way to distinguish “clinical depression” from a normal reaction to adverse life events. For instance, a person may be chronically depressed because his/her mother abandoned him/her at a young age, or because s/he was bullied in school and never fit in, or because s/he is gay and has experienced and continues to experience ongoing discrimination and abuse, just to name a few examples. S/he may also be chronically depressed due to low iron, thyroid dysfunction, metabolic problems, sleep apnea, or chronic pain. And there may be things that can be done for any of those situations that will vary widely from person to person and condition to condition.
There is no effort whatsoever in the DSM to actually distinguish any cause for depression – if you fit the criteria, you’re in, regardless of why. Scientists should be working to distinguish between real situations that cause depressed feelings, and devising specific responses to those situations, some of which would be medical and some of which would not, rather than trying to “treat” the feelings as a disease and provide a one-size-fits-all solution that really doesn’t work very well for any of the above conditions.
Sure, some people are depressed chronically, and there are always some people who will view antidepressants as helpful to them. Scientifically, that is almost useless information. Lacking any systematic way to distinguish potential causes and the effect of possible treatment options on different circumstances, we are basically throwing painkillers at a broken leg. It may feel better, but the damned leg is still broken!
And just to address your example, cancer can be tested for biologically, and we can objectively observe whether or not a particular treatment works. It’s a completely non-analogous situation. A better analogy would be “chronic fatigue syndrome” – yes, it happens, but no one really knows why, and different things seem to help different people. Of course, CFS sufferers have often been routed to psychiatrists and told it’s “all in your head” and prescribed drugs for it. Which maybe some of them find helpful, but it’s not a scientific approach at all.
My last comment: a lot of people suffering job stress go down to the bar after work and heft a few brewskis to relax. It is a chronic condition (they feel this way every day), there are clear symptoms (tension, anxiety, depression), and the alcohol in the beer has a remarkable and direct positive effect on the symptoms. Does this mean that chronic disenchantment with work is a mental disorder, and that beer is an effective treatment for it?
Just because something makes you feel better doesn’t make it a medical treatment.
Just to be clear, “Anxiolytics” includes benzos like Ativan, Klonapin, Valium, and Xanax. Taking these with opiates can absolutely kill a person – very similar to drinking and taking opiates. If a person drinks and takes both of these – well, I’d be pretty scared for them. That this is even allowed shows how low our medical professionals have sunk in terms of taking any kind of responsibility for their own patients’ safety.
Thanks for your kind comments, Travailler-vous! I do agree with Duane that good therapy is not and never really will be science. It’s about being human together with another human. What works is what works for you, and it might not work for someone else. My biggest beef with the psych industry (and I have many) is the denial of the right of the recipient of the “help” to decide what is and is not helpful for them. A good therapist (admittedly not the norm or average) is one who can adapt what s/he is doing to help the client from the client’s own viewpoint, and will be creative in finding an approach that will get that job done. The idea that some “manualized” approach will work for everyone with a particular set of “symptoms” is nonsense.
CBT is just a way of thinking about making changes. As Duane says, one of many. Everyone’s path is different. All a good therapist can do is help the person find their path, and encourage them to walk it.
It is also easy to “blame the disease” when the drug was what pushed the person over the edge. It’s not the fact that he was suicidal that makes me suspect antidepressants, it’s the bizarreness of the way he went about it. Depressed people in general aren’t into hurting bunches of other people – they just want to end their own lives. This was a very dramatic and destructive way to go out, and it is consistent with other stories of people who were adversely affected by antidepressants.
Most suicidally depressed people don’t commit mass murder.
I am SO on it! This is both a particularly egregious issue, and one that people are particularly willing and able to relate to. Whether you have personal lived experience, know a child who has experienced this, or have a professional relationship to foster kids, you should really put your energy into helping this campaign. It may become a model for foster care systems across the country!
Just to clarify: not saying that some people don’t find these helpful. The scam is the idea you can diagnose someone with a “mental disorder” based on a checklist of inconvenient behaviors or emotions. And believe me, lots of psychiatrists prescribe promiscuously for people who don’t qualify for any diagnosis – I work with foster kids and I see it all the time. You’re right about the ignoring of trauma – it is systematic and very troubling.
These drugs have their (in my view very limited) applications, but they should be a last resort, and we should not lie to people about what we’re doing – we’re medicating away symptoms, not treating a disease. And the millions of people now taking them for normal reactions to difficult life conditions or even just unreasonable expectations (see the “ADHD” epidemic for an example), well, it’s a travesty.
Yeah, but it does show that they don’t really even follow their own sketchy and subjective invented standards. Which really does reinforce that the whole damn thing is a scam.
I totally called this one as soon as I heard the details. This has all the earmarks of an SSRI suicide/murder case – distressed and isolated individual takes new or increased prescription, inhibitions and empathy are reduced or eliminated and he acts out a bizarre fantasy that he would normally never have actually acted on because he’d have felt restrained by not wanting to hurt so many innocent people. I am so glad to have someone actually cover the real story!
Bummer about the school situation! I totally understand why lacking alternatives you do whatever you need to do to get your son through to the other side. You’re obviously a caring and well-educated mom. I’m sorry to hear that charter schools in your locale have not provided the promised range of options. Do you mind sharing where you are? I kind of like to track on the Charter School movement, even though we’re out of the school-seeking business now that all our kids are grown up.
Your last comment is also interesting. There was a good study on employer satisfaction with “ADHD” employees that found that employers are just as satisfied with them as anybody else. The author’s hypothesis is that this was due to the fact that the adults could choose a profession and work environment that works for them. It is a crying shame that school students don’t have the same options. Wish I could ship you the money to pay for him to go to the private school – it sounds like the perfect kind of setting.
Life is most definitely not fair, especially to kids!
I know that this solution requires a lot of work and time and that currently kids don’t have time to wait. We were fortunate to be able to homeschool our oldest for 4 years after two years in an alternative magnet school within our regular Portland Public School system. For our youngest, we actually helped create a public charter school that did what we needed it to do for him, and he attended that school from Kindergarten through high school. He’s now a freshman at Evergreen State College after graduating with a 4.0 from the Trillium Charter School. The great thing about Trillium was that it was all individualized – there was no “keeping up” to be done. Kids who could do third grade math did third grade math, whether they were in first grade or fifth grade, and there was no shaming or weirdness about it – everyone accepts that everyone has their own program. It almost completely eliminates those artificial comparisons that are caused by the bizarre expectations that all kids learn all things at the same time and rate.
I feel badly for others who aren’t as fortunate as we have been, but I also want to stress that charter schools are a realistic option in many states now, and I encourage disgruntled and disempowered parents to band together and create this kind of alternative, as that’s what the Charter School movement is supposed to be about. Additionally, many people are worried about homeschooling, but it was really not as hard as we had originally feared, as there are many groups and even community school classes that cater to home schoolers these days.
My point is not to criticize parents for making the best decisions they can in a dysfunctional school system. What I think we need to do is pressure schools to create these alternative options that the research says works for our kids, and if they’re not willing, to go ahead and create them ourselves. The schools will not change unless we make them, but in the end, we are the taxpayers and they work for us.
Hang in there and I hope things work out well for you and your unique and special son!
I signed up for their newsletter, and I encourage anyone here who cares about this issue to do the same. I’m also offering my professional assistance, though I don’t know what exactly that will mean.
This is such an important issue, and as Ted always points out, it’s places like this where the psychiatric storyline most easily comes unraveled. Almost anyone can understand how and why a kid in foster care comes to have behavioral or emotional problems, and the idea of drugging them at 4-5 times the national average is almost instantly offensive to most lay people. It’s a great political platform if we can all get behind it.
Real science is about the outcome, not the theory. A hypothesis is only as good as it is useful in predicting outcomes. We can spend all the time in the world arguing about whether “ADHD” or any of these dumbass labels is a “disease” or not, but the bottom line is, their theory has zero predictive value in altering outcomes.
Even if you don’t know the mechanism, it’s hard to argue with a 5000-year-old practice that allows complete anesthesia in a waking human. That’s what I call a result! The fact that modern researchers can’t or don’t want to find an explanation is their problem. The results speak for themselves. As to the results of psychiatric “science,” but their message is quite a bit different…
I agree 100% that people with concentration or attentional difficulties deserve help, and I also believe from direct experience with my own kids that attentional skills can be learned. I applaud you for applying CBT principles systematically to this population and wish your enthusiasm would spread. In addition to working better than medication, these techniques impact the long-term welfare of kids and adults in a positive way long after treatment has discontinued, a claim that stimulants are still unable to make after 50 years of research.
That being said, I don’t know why you need to take personal offense at this article. It posits, very simply stated, that some kids are born with different personalities and temperaments, and that having a different temperament doesn’t mean a child is ill or disordered mentally. What’s offensive about that? Sure, there will be evidence that on the average, “ADHD”-diagnosed kids’ brains may work differently. However, the evidence to date suggests that far from being a unified diagnosis with a common cause, “ADHD” brains are all over the place in terms of what is different. The bottom line is, some kids find paying attention more difficult than others, and we really don’t know the reason, or that there is one reason causing all of these cases. In fact, it’s a very fair assumption that they are NOT all caused by the same thing, as we know that issues as divergent as sleep apnea, anemia, domestic abuse, poor attachment, and fetal alcohol exposure can all cause “ADHD” symptoms.
I guess my bigger question for you is this: if we can teach kids and adults to improve their attentional capacity in the large majority of cases, and if we can mitigate what appears to be somewhat delayed development in these areas by admitting them to school later (Canadian study shows a 30% reduction in diagnosis for kids admitted a year later to Kindergarten), or by putting them in open classrooms, why are we giving drugs to so many of these kids instead of doing things that actually have a positive long-term impact? I actually don’t give a crap if you call it a disease or not – the point is, individual kids need different approaches, and using the right approach “heals” these kids’ “mental illnesses” and they are able to be productive adults. Whereas there is no consistent evidence that long-term stimulant use does anything to improve those long-term outcomes that we care about.
I suggest putting your personal feelings aside and asking yourself instead why so many people are so strenuously objecting to “treatment as usual” for “ADHD.” You yourself seem to acknowledge that the current treatment is not what is actually needed. What’s wrong with simply viewing these kids as having different needs instead of pathologizing them? What’s wrong with teaching them the skills they need in the context of an educational environment instead of making it a “mental health disorder?”
The fact that someone’s brain is different is not de facto proof of disease. Men are much more likely to commit rape or other violent crimes, to beat up their partners or their children, to use drugs, to be arrested and serve time in jail, and so forth. They clearly have a “chemical imbalance” in having a huge overproduction of testosterone in comparison to women, and the genetic linking to this behavior is simple enough for a 9th grade biology student to see on a slide. Their brain scans are different from women’s brain scans, and even the size of certain parts of the brain are different. Does that make mean diseased, just because their brains are male brains and that these brains are associated with higher violence and crime? Or did men develop differently because our species needed men to be more aggressive and impulsive and more willing to attack prey or defend their homes from other species and other humans?
Species survival depends on genetic diversity. There is no reason to assume that those who have an extra hard time coping with dull and repetitive tasks assigned by others are ill in any way. Nor does NOT finding them ill mean that they aren’t entitled to help in developing the skills that they need to survive in today’s economy. No insult is intended – it is just a different way to look at the behavior, and in my view, it’s a way that leads to much better solutions, including your skill-building approach, whose effectiveness (in my experience) is almost always passionately denied by most who are invested both emotionally and financially in the currently accepted treatment paradigm.
To the contrary, I think the evidence in the psychiatric field is that drugs can be useful in acute care, but are increasingly dangerous the longer you use them. I’d be interested in your comments regarding long-term damage due to therapy. If you’re talking psychoanalysis, I might agree, but I think it likely that quality therapy can have a very positive long-term outcome profile, even though it is likely to take a lot longer to take effect than the drugs.
I would add that ALL trials must be submitted to the FDA or other approving agency for consideration, and approval should reflect an analysis of ALL data submitted, rather than the “best two” approach that is currently used.
Of course, your other requirements are more than reasonable.
Oh, and no “placebo washouts” are allowed, either. Placebo effects are legitimate effects, and removing them biases the research in favor of a positive finding.
I have recently learned that acupuncture is not based on some mystical energy fields, but on lines of connective tissue beneath the surface of the body. These connective tissues are ignored completely in Western medicine, which puts all the emphasis on organs, but they are very important in Chinese medicine, which puts more emphasis on connections and relationships.
Additionally, anyone who has been through and honestly evaluated an acupuncture session with a skilled practitioner can attest that it is most definitely scientific and mathematical in approach. We may not understand exactly why this or that point is associated with this or that organ or this or that extremity, but it is observable that they are connected and has been so observed for thousands of years. They can do SURGERY on an AWAKE SUBJECT using acupuncture – they obviously have a pretty damned good idea what they are doing!
The problem with complaints against doctors is that they’re not held to the standard of being helpful or at least non-damaging – they are held to the standard of “accepted community practice.” Hence, doing what other doctors do, no matter how destructive, is a safe play that will never get you into trouble. Whereas trying to look at new approaches or to individualize care to your particular patient can get you sued if things don’t go according to plan. As a result, in obstetrics for instance, it’s safer to do major abdominal surgery and remove a baby by C-section than it is to counsel a laboring mom to labor in hot water, which often obviates the need for drugs and ultimately surgery. Of course, a C-section is MUCH more dangerous for the patent(s) than a bath, but the bath is much more dangerous for the doctor. So we have gigantic C-sec rates and tiny percentages of women offered laboring in water as an option.
Just one example. Psychiatrists are quite safe drugging you to the gills, as long as their colleagues are doing the same. It’s the ones who really try and help that are at risk of being sued.
“”The take-home message of this study shouldn’t be that children with ADHD are more likely to become drug users. Rather, seemingly ‘normal’ teenage behavior, such as experimenting with tobacco or alcohol use, may occur at younger ages for individuals with ADHD,” lead author Eugene Dunne, a doctoral student in clinical and health psychology, said in a university news release.”
Basically, what this says is that “ADHD” diagnosed children, who are obviously pre-screened to be more likely to take risks, are more likely to take the risk of trying drugs earlier than their more risk-averse peers. There is no indication in the article that these kids are more likely to use drugs chronically or abuse them or become addicted – they just experiment earlier.
My “ADHD” boys were definitely experimenters – risk-takers from day 1. Again, this is not indicative of a disease. It just means they are willing to take more risks. Weirdly, they were both less likely to get hurt than their much more cautious middle brother. Maybe they were so used to minor bumps and bruises that they were more confident with their bodies and hence were able to deal with dangerous situations more easily? Or maybe they were just great athletes and good at avoiding injury even when they did something foolish. I don’t know. But bottom line, it shouldn’t surprise us that kids who are screened for being impulsive are more likely to be impulsive than the general population. It is, after all, what they have in common that identifies them as part of the group.
We had to be very crafty about such things as cleaning up. Mostly, I learned to make them into games. I’d ask how fast he could do it and put on a timer, or I’d race him to see who could get more in the box, or I’d bet him a quarter he couldn’t clean up in less than X minutes. We also did contracts and positive reinforcement (sticker charts, etc.) It was a lot of work, but it was worth it. Both my “ADHD” types are healthy adults with great work ethics, despite no official “treatment” by the authorities. But we had to avoid standard school classrooms, especially in elementary school, as they are quite toxic to any kid with this kind of temperament!
Which is why I advocate for open/informal classrooms for these kids. It has been shown many years ago that “ADHD” kids are not distinguishable from “normal” kids in an open classroom, as they have more control over their time and activities and so can more easily head off boredom that leads to behavioral problems. Since we know that stimulants DO NOT lead to increases in self-esteem in comparison to kids not using stimulants, clearly, this “square peg into round hole” approach is meeting the needs of the teachers and the system, not the needs of the kids.
The difference is that in France, they recognize that this kind of behavior is not a medical problem and they work with the child’s temperament and help them grow to adulthood.
Ridiculous comparison. It is clear and easy to tell who has hep C and exactly what causes it, as well as whether any treatment prescribed works or not. None of this is true for “ADHD.” Impossible to objectively distinguish from a normal condition, no universal cause, and no measurable variable to tell if treatment is working. Of course, I’d be thrilled for a Hep C cure. But the most ardent ADHD proponent acknowledges that there is no “cure.” Absolutely no comparison. Not to mention that you can’t improve Hep C by moving the child to a different classroom!
Great post – you have really captured the dilemma parents find themselves in. We avoided standard public schools like the plague for exactly that reason – we KNEW our boys would not be successful in that environment, because they are NOT robots or clones and we didn’t want them to be. I’m sorry you and your son have had to go through this. I wish I could have your son enrolled in our charter school – it was a great place for Kevin!
I’d appreciate it if you’d stop saying that! I already showed you proof and there is almost universal agreement in the psychiatric world that ADHD drugs DO NOT have a different effect on “ADHD” kids or adults. They are general stimulants and have a generally stimulating effect on everybody. Rapoport concluded that the only reason we saw this effect as different with “ADHD” kids is because we wanted to see it and felt relieved that it occurred. Non-ADHD kid had EXACTLY the same range of reactions as those diagnosed with ADHD. End of story.
But it doesn’t say, “prevents the mind or body from working properly in certain settings where properly is arbitrarily defined by adults with their own agenda that may or may not be appropriate for the child’s age and development and temperament.” Context is critical in evaluating what is a “disease.” Culture most definitely comes into play.
Try this one on: stimulants are known to improve athletic performance in the short term. What if athletic excellence instead of academic performance were the standard required for adult success in society? Would we be willing to say that non-athletic kids have ‘athletic deficiency disorder’ and consider stimulants a “treatment” for it? After all, it does create social and emotional distress, creating low self-esteem and self hatred in some – ask any non-athletic kid about gym class some time! So why not give stimulants if they help kids perform more on a par with their peers, so they can stay out of trouble and feel better about themselves?
Think hard before you dismiss the analogy. It really amounts to the same thing. Certain kids don’t do well in a certain environment that we’ve decided they need to function in. They are diagnosed and given performance-enhancing drugs so they’ll be more successful. But these kids are almost always skilled and successful in other areas that aren’t valued, or are so academically talented that they aren’t really learning anything in the school environment. Why not change the expectations instead of trying to force these square pegs into round holes year after year?
Which reinforces what I’m saying: the schools are 90% of the problem. We operate on distorted assumptions about kids and the economy that are not even consciously considered. They are very, very unhealthy places for children in my view.
I didn’t really see anything in the article sliming honest and approprate and sincere doctors. I saw a critique of a MODEL OF THINKING, which is being promoted by Lieberman as if it were scientifically proven truth, when in actuality, increasing evidence shows it to be lacking in credibility on almost every level. This is not to say that drugs have no utility in mental/emotional distress. It is to say that LYING to clients and the public about what is known and not known, and PRETENDING that we’re making progress toward a goal that looks to be a false one in the first place (to treat all mental/emotional distress as a “disease of the brain”) is wrong and evil, and for Lieberman to go on a national radio station and proclaim this “truth” to millions is quite reprehensible. While the comments section will, of course, contain more extreme views, as in ANY comments section of a controversial issue, the article does not appear to me to do anything but juxtapose the statements of one APA-invested arrogant thought leader against the actual known facts regarding the long-term history of the APA and the DSM. It doesn’t look like demonization to me. I’d be interested to hear where you see this occurring.
Given your username, I assume we’d agree aboout a lot of things. There are a lot of people who area angry at psychiatry for very good reasons and need to vent their frustrations, but Whitaker has never been an abolotionist. I suggest you really take a good look at what you are terming “antipsychiatry” really looks like, lest you do a bit more demonizing yourself than is really appropriate. We could use your wisdom and experience if you can find a way to appreciate that people here come from a variety of viewpoints, many of which aren’t nearly as extreme as you seem to assume.
And why, indeed, is he denied that privilege? What evidence is there that denying a child the right to run around and have fun leads to a better education or a more satisfying life? That is the gigantic elephant in the room that the “ADHD” industry and our school systems are completely unwilling to look at.
Bored kids don’t learn much. Those suffering from “ADHD” are the canaries in the coal mines. The biggest difference between me and them is that I was too scared to let the teachers know what I really thought of the bullshit I was expected to tolerate, especially in elementary school. I would have done anything to escape that slow torture. I admire these “ADHD” kids for making it clear they aren’t willing to put up with it, and I feel very sad that the adults in our society are too narrow minded and cowardly to listen to their message.
The point I was making is that the rarity of stimulant treatment in Finland does not lead to worse outcomes for the Finnish youth in comparison to the highly-medicated US population. So regardless of whether it is considered a disease or not, stimulants don’t improve long-term outcomes. Hence, my conclusion that we are wasting tons of time and money on something that doesn’t help except in the short term. I’ve presented the evidence on the huge advantage of “ADHD” kids educated in informal/open classrooms. Why not get on board in helping these classrooms become more common, rather than arguing about whether “ADHD” is a disease when we know the “treatment” doesn’t actually create the long-term improvements in the general population that have long been expected but have never materialized?
And BTW, the fact that Norwegian or Finnish psychiatrists agree that “adhd” is a real disorder doesn’t mean anything much to me. Physicians have in the recent past agreed that Benzedrine is not addictive, nor was valium, that cigarettes did not cause cancer, that midwifery care was dangerous (even though it appears to be as safe or safer than doctor care), that formula teeding was as good or better for babies than nursing, and that thalidomide and Viiox were safe and effective drugs. Professional agreement is subject to bias just like any other agreement.
Sorry, but this is an opinion article, obviously “dumbed down” for the lay person. There is no actual reference to any study or scientific evidence for any of these claims. I’m certainly in agreement that “ADHD” kids are seeking stimulation and have little to no patience for things they aren’t inherently excited by. But we found that by making the more tedious activities into games, we could teach them to develop their attentional skills in a fun and non-coercive way, so that they learned how to persevere at less exciting activities because of the exciting rewards available at the end.
I am not and will not be convinced by some authority making pronouncements about “ADHD.” I have a very solid knowledge base, both experientially and research-wise, and I KNOW that it is possible to teach these skills. And if they are teachable, it suggests to me that the problem is not a lack of capacity to create these amorphous chemical connections in the brain, it’s more a need for a lot more practice than the average kid. And there is no drug that can provide that practice. In fact, it is possible that medicating the problem may actually defer the need to learn these skills much later than they can actually be taught. Again, the adults (especially the schools) have to learn to be a lot more flexible for this to occur, and I’m not holding my breath for that to happen. But it’s not the kids’ fault that the schools are rigid and lack creativity. We actually went to the length of helping create our own school that would work for our youngest. And it did and he is doing awesome. I think that ought to count for just as much as any anecdote of someone whose kid’s academic life was saved by stimulants, don’t you?
The fact that a genetic variation is “more common” in the ADHD population proves exactly nothing. First off, correlation doesn’t mean causation – just because they occur together doesn’t mean they are related in any way. Second, if it’s only “more common,” it can’t be causal, because a lot of people who don’t have “ADHD” have the variation, and a lot of people who do have “ADHD” don’t have it. If it were causal, we’d find that 90% or more of “ADHD” people have it, and only a tiny percentage of non-diagnosed people showed the variation. Third, even if it were causal, which it clearly is not, genetic variation is not automatically indicative of disease. Genetic variation is the core of species survival. Consider that some people are born with good athletic skills and some are not. Are those lacking athletic skills disordered? Or is it just a variation, because we need some fast people but not everyone has to be fast, because they have other gifts that the fast people lack? Finally, even if it is a disease state, which is by no means even vaguely proven by this research, the “treatment” still doesn’t improve the long-term outcomes for the recipient on the average.
Such research is, to my mind, almost completely worthless. What I really want researched is what actually helps these kids succeed better. We know that informal school classrooms are one element in a helpful environment for these kids. I’d suggest we spend a lot more time working on these classroom variations and other social ways of helping that don’t involve messing with their brains.
Assuming you are genuinely interested in examining this question, a quick look at the FDA approval procedures will cast appropriate doubt on your assumptions of thoroughness and scientific validity. Simply stated, all a drug company has to do is to present two studies showing some statistically significant benefit in order to gain approval. That benefit could be as small as a three-point gain on the BDI, which is hardly evidence of a cure. More importantly, there could be 5 or 10 or 50 legitimate studies that showed no benefit or even show a destructive trend. This leads to a dramatic overestimate of the effectiveness of drugs in general. Irving Kirsch’s work re-examined the antidepressant data including all studies instead of just the ones submitted to the FDA, and the effectiveness was reduced to barely better than a placebo. Kirsch concluded that if active placebos were used, there would be no difference – in essence, the SSRIs are very expensive active placebos.
Additionally, the longest studies submitted are generally about 8 weeks. I have recently heard of three-week studies now being accepted. So on the strength of two three-week studies, cherry picked from whatever literature actually exists to maximize the chances of acceptance, we are to conclude that a drug will be safe and effective over the course of years. Not a realistic conclusion at all, in fact, a very dangerous one. Certainly not a scientific conclusion by any stretch of the imagination.
To get the whole picture, read Anatomy of an Epidemic cover to cover, and check into some of the references, especially the WHO studies and Martin Harrow’s work. I hope you are genuinely open to learning, because we need a new breed of psychiatrists, but I worry when you use the word “antipsychiatry” as a pejorative, as it suggests you may already be indoctrinated into the worldview that your patients strongly need you to critique.
Wow, Jay, I always love your stuff, but this one really grabbed me. What I’m seeing behind the presentation is that the very CAUSE of much distress that exists is the commodification and branding of everything (and the power dynamics behind that process), and that any real and effective therapy has to be in the place of looking at and potentially undoing those dynamics. But the therapy industry has an interest in maintaining the status quo and hence promote branding and controlling of therapy, and specifically controlling it away from any examination of the external conditions that may be creating these “mental diseases” in the first place. Don’t know if I’m saying that clearly enough: therapy (if we want to call it that) should help resolve power and control issues, with parents, school, work, society as a whole, whereas the industry wants to keep the patients in the low power position so that the powerful can profit and the powerless won’t rebel. And CBT fits the bill perfectly – if you are distressed, it’s because you’re thinking the wrong thoughts. It has nothing to do with your history or events that you were involved with, and it has nothing to do with political or social conditions you are exposed to. If you just learn to think happy thoughts, everything will be OK!!!
I have always been of the opinion that good therapy is different for each person, and I have never been a fan of manualized therapy approaches. This blog has helped me realize what was behind this intuitive sense of distrust in this “evidence-based therapy” movement. It always seemed biased toward more “present-time” approaches and against any attempt to put a person’s narrative history into perspective, even though the latter seemed to be at least an essential part of any effective therapy I’d done or seen done.
I’ve always been eclectic in my approach, as was my own good therapist years ago. I use CBT concepts and teach them, but only as a possible skill-based option for those who seemed to find it helpful. My measure has always been, “If it works for the client, it’s good. If it doesn’t, stop it and do something else. It has always bothered me how CBT took over, and this has given me a much more thorough grasp of both the politics and the fear and greed behind the politics. So thanks again, Jay!
Apparently even people who are being tortured are supposed to maintain between mild amusement and mild irritation or they are also mentally ill. A well-adjusted person would never be upset about being tortured. He’d realize he was a terrorist and know that he deserved it. Or maybe he’s a terrorist BECAUASE he has a mental disorder! THat explains it!
My thoughts exactly! To think that anyone would have been paid money to study this question shows how far we have fallen. I consider this as sensible as saying that “Chronic loss of sleep leads to symptoms that appear very similar to exhaustion.” The authors can’t even see the stupidity of their own title.
I am not aware of any data to support that contention. The Raine study, the Montreal ADHD study, the long-term arm of the MTA study, and a recent Finnish vs. USA study all indicate that high school dropout rates are not improved by stimulants. In fact, the Raine study found kids who took stimulants were much more likely to drop out (9 times), though that has not been replicated anywhere I know of. And the data on drug abuse has historically been equivocal – there is some indication that cigarette smoking is more common with kids who were exposed to stimulants, and kids who are still taking stimulants in HS appeared in one study to be less likely to abuse substances, but the rest of the research has shown no consistent differences.
Two of my kids “actually had” ADHD, to the extent that they fit the criteria perfectly and had no particular trauma or other explanation for their behavior (other than two young and semi-clueless parents!), plus a mom and grandpa who also would qualify. Neither of them abused substances, and both graduated from HS with honors. The one who dropped out of HS and got into drugs was the “normal” one! Which goes to show that no one is really “normal” and who does or does not drop out of HS or use drugs is a very, very complex affair, and simply medicating or not medicating a child who fits these criteria is not a very powerful variable in determining their ultimate outcomes and experience.
I’d still love to see a link to the article about dying prematurely. Accidents are the only outcome that has scientific backing for being affected by stimulants, according to the OSU Medication Effectiveness study back in 2002 or so. Saying they have twice the likelihood of dying prematurely sounds concerning, but I’d have to see what the absolute probabilities are to determine how important such a difference would be in the real world. (I.e. the difference between .001 % and .002% is pretty tiny, whereas the difference between 10% and 20% is huge, even though both are “twice as frequent.”)
I agree that the “not real” framing is not helpful. It is certainly very “real” that there are kids that meet the “ADHD” criteria, and that these kids are difficult to manage (I know mine were!) The problem is that these behaviors, real as they are, don’t constitute a DISEASE as they have been purported to do. The reason I say that is because there are a ton of possible REASONS why a child might behave this way. Some of them probably are medical – low iron, sleep apnea, certain allergies, sensory integration difficulties, fetal alcohol syndrome, lack of sleep, side effects of medications, head injuries, and many more medical problems can manifest these symptoms. But there are also social causes: child abuse/neglect, especially early in life, lack of boundaries in the home environment, inappropriate expectations by parents and/or teachers (look at what is expected of Kindergarteners today vs. in the 60s!), reduction in recess and outdoor time, emotional immaturity, domestic abuse at home, all have been associated with these very same symptoms. AND there are some kids who just are like that, and it’s normal for them to be that way. Kids who are bright and very active get bored easily, and the average school classroom is, let’s face it, pretty dull. Some kids (I was one) are able to just white knuckle it and do what they are asked, no matter how repugnant or painful, but some are not able to, and these kids act out. Is the fault in the child’s brain chemistry, or the classroom that fails to challenge them?
I ultimately agree with the author: kids are all different and need different approaches. We had no idea what we were doing with our oldest and made some serious mistakes that made his childhood harder on him and us. But as a result, we were prepared for our youngest and took a different approach, and he’s a much healthier and more functional young adult. Not that our oldest is dysfunctional – he’s got two jobs and works hard, never got into trouble with drugs or the law, is loved by his employers, etc. Has a little trouble with girlfriends, but otherwise he’s a totally normal and functioning grown up, despite no “treatment” for “ADHD”. There is nothing WRONG with him other than that he is a unique person who meets his needs in unique ways some times. The younger is just an amazing young man and no one would ever think he had a “mental disorder” in his life. He’s a super athlete, has lots of friends, does great in school, and is a highly responsible college freshman, no drugs or alcohol or dangerous activities or teen pregnancies or any of the horrible predictions for “untreated” ADHD. It’s because we learned that staying away from standard schools is important, and we learned that discipline looks very different for active, oppositional kids. I really do need to write a book on the subject…
Anyway, I have great compassion for those raising such a child, because they’re a HELL of a lot of work and it’s not always so rewarding in the short run. But difficult is not diseased. It’s not that “ADHD” doesn’t exist as a behavior pattern, it’s that just because you kid fits that behavior pattern does not mean that s/he is “mentally ill” and needs “treatment.” Sometimes there is a medical problem. But sometimes, s/he just needs the time and space to grow up, with some extra discipline and skill-building along the way, and some freedom from the bizarre and unreasonable demands of today’s standard school classrooms.
You are too right about the educational system. My biggest problem with the labeling is that it takes our professionals off the hook for trying to actually find solutions for our kids. We actually had to help create our own charter school so our youngest could be protected from the kind of crap they get in school. If you look at the “ADHD” definition, it’s a list of traits that makes it difficult to teach you in a herd-management school classroom. Luckily, we had the means and support to make a better plan!
Ah, but they don’t have Voc Ed curricula in most schools now, do they? It was understood in my day that not every kid was bound for college. Still is that way in Europe, but nowadays, US schools train everyone for college, even though only 20% of our population gets a 4-year degree. If our schools were more flexible and allowed for different temperaments, a lot of these kids would do just fine. I believe 80% of the problems for these kids are caused by our school system. Alternative ed made ALL the difference for ours!
What is interesting is that Finland’s rate of medication is much, much lower than the USA, and yet a recent study showed a very similar array of outcomes for their “ADHD” diagnosed kids. I have no problem with adults choosing stimulants for themselves if they think they are helpful, but it’s pretty clear after 50 years that despite the horrific warnings that “your child will be more likely to drop out of school and become a delinquent if you don’t get him treated,” stimulant treatment does NOTHING to alter these outcomes on the average.
I do believe that lots of kids (including two of my own) exhibit these “symptoms,” and I KNOW they are a whole lot harder to raise. They also do much worse in standard school classrooms. But I think it’s the job of the adults, especially the schools, to figure out how to help these kids learn self-management skills, because in the long run, stimulants don’t help these kids develop the skills they need in order to survive, and may even make it easier to think things are going OK until it’s kind of too late.
Another recent study showed that just waiting a year for Kindergarten admission reduced the “ADHD” diagnosis rate by THIRTY PERCENT!!! Think of this – almost a third of kids diagnosed ADHD could be saved this diagnosis if they waited a year to start school! I am sorry, but it’s a pretty sketchy diagnosis if a third of the kids who “have it” no longer “have it” a year later.
I empathize with parents who have to meet the challenge of these kids, but I can say from experience that there are other ways that work better. Alternative classrooms and creative discipline methods (which you can’t just learn from any old book or professional, because a lot of professionals don’t know these techniques) were the keys to our success. Read “Raising Your Spirited Child” for more on this.
Just because kids are hard to raise or don’t fit into standard classrooms doesn’t mean they are mentally ill!
It has long been understood that stimulants do NOT act differently on the “ADHD” brain. Judith Rappoport gave stimulants to “normal” teens back in 1978 and found that they had the exact same reaction to low doses – reduced motor activity, increase focus, decreased distractibility. She suggested that the reason it appeared different in “ADHD” kids is only because people were looking for that result.
The current understanding is that “ADHD” kids are hyper and intense because they are seeking stimulation. The drug provides artificial stimulation and so they appear “calmer” to someone who was finding their activity level annoying to them.
There is absolutely no evidence that children with “ADHD” have a “chemical imbalance” in their brains. There is some emerging evidence about some small difference in dopamine receptor density, but of course, we should expect that any population will have some differences in dopamine receptor density, as they would in height, weight, eye color or muscle mass. I think the author would suggest that such differences are a natural variation and only become a “disease” when these kids are forced to do things all day that they are not genetically programmed to find very interesting or enjoyable.
I don’t think the author means to demean loving parents! It is the psychiatric industry, and frankly, our school system that has done so much damage to our children and our families. I say this as the parent of two “ADHD” boys, neither of whom had any medication and both of whom can be regarded as successful adults. This might not have happened if we enrolled them in a standard school education, but we instead used alternative schools and homeschooling and avoided labeling and unnecessarily forcing them to engage in boring busywork.
There is good research over time to show that “ADHD” kids are indistinguishable from “normal” kids in an “informal” or “open” classroom (think Montessouri). I fully recognize that these kids have a very hard time functioning in a standard classroom, but I blame the standard classroom structure, which is rigid, boring, and overly concerned with compliance to adult authority. When our kids were in an environment where they were allowed some freedom of choice to pursue things they found interesting and valuable, and to stay obsessed with something if they wanted or to change to a new task if they were “done” with the one they were on, they had much fewer problems. And that environment, which was naturally motivating for them instead of de-motivating like a standard classroom would have been, also gave opportunities to teach the SKILLS involved in organizing and focusing attention, which are definitely teachable skills but are NOT taught to these kids in a standard classroom setting.
I am not a person to say that “all these kids need is a little discipline.” They were TOUGH to raise! But I agree with the author, there was nothing WRONG with them – they just had a more challenging temperament.
It might also interest you to know that 50 years of l0ng-term outcome studies have shown that kids taking medication don’t do better on the average than those who don’t. This isn’t saying that no child benefits, but it is saying that for every child that does better, there is another that does worse to the same degree. Ours used no medication and are doing just fine.
I’d like to see a link for that article, if you have one, BTW. I am always interested in new research on the topic.
I also work in the foster care system, and I have to disagree that relationships don’t heal kids with RAD or even FAS. In fact, the research from the “Decade of the Brain” in the 1990s showed that relationships are the MAIN thing that heals children who have been abused and neglected in early childhood, and that brain changes can and do occur into young adulthood. It is true that certain “windows” do close for true attachment and other developmental steps early in childhood, but it appears that other parts of the brain can compensate, if the child is able to grow in a safe and supportive environment. The works of Dr. Bruce Perry might be of great interest to you in supporting your adopted children.
That being said, most people here are not criticizing folks like you who are dealing with real problems finding the best solutions available at the current moment. What I think Phil is correctly criticizing is the use of these drugs in lieu of actual efforts to figure out what the children actually need and trying to provide it. The diagnostic system in the DSM allows almost any behavior or emotion to be reframed into a “mental disorder,” regardless of how appropriate the behavior or emotion. For instance, a bright child in a boring classroom with a rigid teacher who picks on him/her might lash out and be sent to the principal’s office frequently, and be diagnosed as “oppositional defiant disorder” or even “bipolar disorder,” regardless of the provocation or circumstances surrounding the behavior. This is even worse in foster care, where kids come from backgrounds where they were mistreated badly or were never properly socialized, and engage in behaviors that they needed to in order to survive, or experience emotions that are completely to be expected given their difficult circumstances. I’ve talked to dozens of foster kids who are “aging out” about their experience, and most find medication to be at best an annoyance or distraction, and in some cases a deep insult. They tell me that they are medicated because they are upset or protest their situation, and ask very legitimately, “So you’re saying the fact that I’m depressed and anxious about the fact that my mom abandoned me and is living on the streets with a violent boyfriend and shooting up meth and I have no idea where I’m going to grow up is a sign that my BRAIN IS BROKEN? What, am I supposed to be HAPPY about all this?”
Foster kids are difficult. They’ve been hurt and trust is always a challenge for them. Some have even had physiological changes as a result of either trauma or drug exposure. But assuming that ALL foster kids who have behavior or emotional issues are “mentally ill” is patently absurd. And allowing these diagnoses prevents professionals from having to exercise their responsibility to view each child as an individual and help figure out what’s bothering them most and what will be most helpful. I always ask these foster kids what they found most helpful, and I can tell you that NO ONE has ever said that a diagnosis or a drug was key to their survival. It is ALWAYS a person and a relationship – a foster parent, an attorney, a CASA volunteer, a caseworker, a therapist, a teacher – someone who cared enough to hang in and believe in them when things were tough. Giving out diagnoses and biological “explanations” that aren’t even scientifically true does not convey believing in the child. To the contrary, it pathologizes normal behavior and gives the discouraging message that your brain is broken, rather than the much more empowering message that “your behavior and feelings are absolutely normal, and we can help you learn to cope with your difficult situation and feelings.”
Yes, they are supposed to have at least two. They used to require 8 week trials, then 6. Now they are down to three? The other thing people don’t realize is they can have two positive trials and 25 negative or no results trials, and they only have to submit the positive ones. This makes no scientific sense, but I guess we’re more worried about what makes money than what makes sense.
There is no effort in the article to articulate why this is happening, and they let the psychiatrists off the hook big time. None of them really seem to give a crap.
I totally agree! The more upset they are, the more you know that they’ve done some things they’re not proud of and are afraid on some level will come out. Not consciously, mind you, as they’ll mostly assure you that NOTHING like this EVER happens in THEIR facility. That denial is essential for them to continue to feel OK about doing their jobs, even though deep down they don’t really feel OK about it at all.
Serotonin is also in many other areas of the body, especially the gut, which has more receptors than the brain. Your accurate observation certainly explains why there is such a high rate of emotional and behavioral “side effects” to SSRIs. It’s like trying to fix a fine watch with a hammer and a Phillips head screwdriver. You’ll have an effect, but it’s probably not going to make your watch work better.
Still, probably better to provide the body with building blocks it can use as it sees fit rather than forcing it to engage in an unnatural increase in serotonin levels throughout the body.
Yeah, odd that stakeholders does not appear to include the people they are supposedly trying to help. I guess you’d have to be considered human before you can qualify as a stakeholder.
I stand by my statement 100%, though I know you’re far from the only source of support. Though I have to say, the bar isn’t very high – I’d imagine talking to the average 4 year old is probably more helpful than the average psychiatrist. At least when you were crying and looking depressed, the average 4-year-old would know enough to say, “Why are you cwying?”
If the choice is between funding the current, admittedly less than vibrantly empowered, forms of peer support vs. funding the standard psychiatric treatment system, peer support wins out hands down. Even having it there as a token is a reminder to the system that “peers” exist as people and have voices and that recovery (or perhaps escape is the better word) is a very real possibility. Of course, it’s in some ways spit in the ocean, but if even a handful of people get more of the kind of support they need, it helps our cause.
Can you imagine the difference between meeting for 15 minutes with a conventional psychiatrist and spending 15 minutes with Sera Davidow? Orders of magnitude difference in experience!
Given the frequent analogy that survivors make between enforced “treatment” and rape, I am forced to ask the following: Is it helpful to a rape victim to debrief with a caring professional after the fact? What about debriefing with the rapist or his/her associate?
Wouldn’t it perhaps be better to do something to help the person that doesn’t involve a forced violation of his/her bodily integrity?
We don’t want to actually halt the spread of disease. We just want people not to get too upset when their friends or their family members die unnecessarily because no one in the “modern” world gives a crap about whether West Africans live or die. Because if they start getting upset, they may start rebelling, and we KNOW how upsetting rebellion is to the status quo…
I believe the call for humility is the most likely cause for much of the uproar. All sorts of theorizing is allowable, as long as you don’t start suggesting that the patients/clients/survivors may have some knowledge that the “professionals” may lack. Suggest that, and the gloves are off!
Well said. I think this particular psychological impact can be far more damaging in the end than the drugs themselves. It is a message of disempowerment and disability, and it is almost never an accurate evaluation of the reality that faces the person in question. Telling people they can’t do anything about their issues is always a very bad idea.
I would add that even the ones who have a sincere desire to help their patients don’t actually know how to do it. They’ve been given a hammer as their only tool, and so every problem is a nail. Most psychiatrist have limited to no training in psychotherapy, and have also been given rafts of bad information about “chemical imbalances” and genetic underpinnings of “mental illnesses” that are both inaccurate and helpful. Beyond this, the DSM (which was created primarily by the profession of psychiatry) is taken WAY too seriously and seen as representing real “diseases” when the document itself says that there is no clear line between normal and “disordered” and that any two people having the same disorder may have totally different causes and totally different needs. The serious application of this document causes great harm, even when the person doesn’t mean to, because it tends to focus all the attention on the client’s symptoms and conveys some mystical understanding of the situation that simply doesn’t exist.
If psychiatrists really mean to do no harm, they would need to start with a much more humble attitude, admitting to their clients that mental health problems continue to be very mysterious, that many people find many different things helpful, and that they are interested in understanding the problem from the point of view of the client. To say that this is rare is a gross understatement, in my experience. Most people experience a professional categorizing them via the DSM, telling them that their brain is broken, but that there are treatments “like insulin for diabetes” that can make the situation much better. They also tend to convey that the client him/herself can do little or nothing about the situation themselves, and invalidate or minimize the importance of environmental factors and past emotional experiences as possible causal or contributing factors to their problem. In short, regardless of their intentions, the practitioners who follow the script they are trained to follow will not only fail, they will do damage and not even realize they are doing it. Only the more antiauthoritarian types who question the dominant paradigm will find their way to being helpful, and honestly most of those people would stay very far away from psychiatry, as it appears to be one of the most rigid and authoritarian fields one could possibly study.
First, I want to say, Tyler, that I appreciate your acknowledgment and recognition of the damage that other people have experienced, even when your own personal experience has been different. I find it rare that folks are able to maintain that kind of “grey area” perspective when talking about these issues.
That being said, I agree with Jeffrey – I work with foster kids and they are promiscuously drugged for behavioral manifestations and emotional reactions that are completely understandable given their circumstances. These drugs are almost always credited for any good things that happen, and are almost never blamed for anything bad that happens, regardless of sometimes obvious causal and temporal connections between drug prescription changes and behavioral deterioration. I don’t want to invalidate that those positive stories exist and are real, but I don’t think you end up hearing most of the negative stories, because they tend to be buried by those who have an interest in maintaining the myth of effective chemical treatment for all.
To take “ADHD” as an example – you, Tyler, describe a positive experience over time, but the research shows that on the average, “ADHD” kids who take medication do no better than those who don’t. That suggests that for every positive story like yours, there is at least one person whose life was made as much worse as yours was made better. You sound like a compassionate person and I know you would not wish that on anyone, but I want you and others to realize that it’s not a rare phenomenon. I’ve worked with multiple kids who started out with an ADHD diagnosis, got aggressive on stimulants, were put on antipsychotics, showed signs of depression as a result, were put on antidepressants, had manic episodes as a result, and were put on mood stabilizers. These kids will be on 4-5 psychiatric drugs and still be behaving horribly, breaking windows or beating people up or even threatening to kill themselves. It is incredibly rare that the doctors ever look at this situation and say, “Gee, what we’re doing doesn’t seem to be working very well – maybe we should start over!” No, they continue to add more drugs or change dosages or change to different drugs despite the fact that the kid just gets worse and worse or at best continues to be a huge problem. And sometimes, when my advocates are able to prevail on them to try reducing or eliminating medication, we find that the child is no worse or even much better WITHOUT the drugs in his/her system.
It is a very ineffective and insensitive system. You are smart enough and independent enough to judge for yourself whether something is working or not. Most kids don’t have that ability or that luxury. Many are drugged at the behest of parents, foster parents, teachers, counselors, doctors, whose main interest is controlling the child and deflecting blame and discomfort from the adults. The 100/1 ratio you postulate is very much counter to both science and my personal and professional experience.
Thanks for writing, though. I wish all medication proponents were as rational and reasonable as you are.
Todd, I am so sorry about what happened to you, and I thank you so much for sharing your story. Folks really need to hear that these “symptoms of ADHD” are absolutely and commonly caused by children being abused and neglected at home and/or in school. The list of drugs you were on is appalling, and anyone thinking rationally about it would see that they were obviously barking up the wrong tree if they had to “try” all these drugs and nothing appeared to actually help. Yet they seem to feel they have to continue to try one drug after another after another until you either escape or die. They are unable to recognize when they are doing harm.
I am glad you found your voice and hope you keep speaking up and education those who really haven’t got a clue that this is happening in this country.
But of course, psychiatrists mostly DON’T listen to people all day – they ask a few “symptom” questions and write a prescription. They should, indeed, be ashamed.
As to common sense, baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were that common, more people would have it!”
I know, it’s a far-fetched theory. I really shouldn’t be making people feel uncomfortable by pointing out the obvious. After all, charlatans have feelings, too!
So I guess that being unemployed causes people’s brain chemicals to become unbalanced as a result of a predisposition toward depression that was exacerbated by the stress of being unable to eat or afford shelter or protect his/her family. Conclusion: people at risk of unemployment should receive prophylactic antidepressant treatment.
Or perhaps we should work at reducing unemployment…
It’s way too easy to do, since there is no way to refute their nonsense. Of course, everyone has “mood swings,” especially when you have been or are being traumatized, but if you speak up and complain, well then you’re “irritable” and that’s another mark against you. Then they give you drugs to “help” and create more “symptoms” which reassures them that they were right all along, even though they created the “symptoms” themselves! It is an incredible scam.
I agree, the Woozle analogy is awesome. Every time around the tree, they find more and more “evidence” that they are on the “right track”, when in the end, all they are doing is chasing their tails. The big difference is that Pooh and Piglet are humble enough to see their foolishness when it is pointed out to them, whereas Psychiatry will continue ’round the spinney until they wear a 10-food trench into the ground.
I agree, the term “behavioral health” sets my teeth on edge! Behavior doesn’t have health! People have health! It goes to show that the current paradigm is intent on reducing us to mechanical devices so that the only thing that matters or even really exists is our “behavior.” BF Skinner would be proud.
Andrew, I would have predicted that you would respond that way! I wish I could send you some clients.
I think having a really good sense of boundaries requires having a good perspective on your own needs and issues, and I think that’s what differentiates people who can do this from those who can’t. It’s not “good boundaries” when you are holding back your own humanity and acting like a cold or robotic person with no heart. But I think some clinicians interpret it that way because that is what keeps them safe from the uncertainty, pain, and messiness of really connecting with someone on a personal level. It is just plain safer to avoid that discomfort and “diagnose” from a distance. It also explains why medication is so appealing to some clinicians – if they can make the client’s discomfort disappear, they don’t have to deal with their own.
I find that the ability to sit with that discomfort is what helps the people I talk to end up feeling better. It is also what helps me figure out what to say and do that might be helpful. If I kept a big emotional distance, I don’t know how I’d ever figure out what to do! The information I need is internal to the client, and I have to connect with them in order to find out what their needs are and why they might be acting or feeling the way they do. I really don’t know any other way to do therapy!
You are seeing a psychiatrist but still appear to be suffering disabling anxiety. I assume you are taking medication, but do you feel it is really helping you the way it should be? Is it possible it may even be holding you back? Have you read “Anatomy of an Epidemic,” the book which inspired this website? Some of your comments make me wonder if you are suffering from deterioration of your condition BECAUSE of the drugs.
I used to be an incredibly shy and socially incompetent person. I do believe it is possible to learn the skills to change that. It’s a lot of work, but I am sure it can be done, as I have seen it done and done it myself. True, I don’t have Aspergers, but I still believe you are a human being with a natural capacity to learn. I hope your therapist is helping you develop these skills.
You state that you are the obstacle standing in your own way. I found that to be true of me as well. I had to figure out a way to get out of my own way and stop worrying what other people thought of me. I had to get comfortable with the idea that some people would think I’m weird and not want to be around me and that’s OK. I have gotten to the place where I can actually give presentations to big groups of people, even though when I was a kid I did anything I could not to have to talk in public.
I am glad you have had the courage to post here. I actually do know what it’s like to be afraid to put myself out there. It is good to hear your perspective as a person who doesn’t find the “neurodiversity” concept very helpful. Everyone has their own path, and I send you my very strongest wishes that you will find yours and travel it with the courage that I know you have.
I think there are many people trying to figure out how to help someone who has “Aspergers Syndrome.” I think the big message here is that it’s very easy to label and dismiss someone, as it seems you are feeling happened to you. I think it’s totally OK to hate having those limitations. What do you think would be helpful? Are you hoping for some medical treatment that would make it easier? Or do you think there are ways you can adapt that would make your limitations less onerous?
In any case, I don’t think that the concept of “neurodiversity” is meant to say you should not seek or find help with these challenges. I think it is more about saying not to judge someone to be a drain on society or unworthy of help because of a particular label that society has affixed to them. Obviously, it’s only one way to think about it, but it seems to help a lot of people regain some sense of power and control over their own lives. Clearly it hasn’t done so for you. What do you think would help you feel like you’re more in control?
Oh, don’t go bursting my bubble! I lived in Germany for a year in 1978-79 and had a few occasions to encounter the healthcare system, and it certainly was a lot simpler and less contentious than the US system. My son also was over there in the late 2000’s and was sick and got seen immediately for free. Of course, he still got standard “medical model” care, but no one really asked him to prove he was sick or destitute in order for him to be seen. He was really stunned – he was sure they’d bill him later for being a foreigner using up their resources.
Of course, I never applied for financial assistance and can’t speak to the level of shame there, and I am sure the mental health system is just as oppressive as ours. But seriously, it would be hard to be more humiliating and degrading than what the US system does to people who need help.
I am sure you are correct. The whole idea of “depot” shots is disturbingly disempowering and lazy. I am quite sure that they are not able to determine precisely the level of release, as everyone’s body is different. Unfortunately, they have the cover of these subjective “diseases” to blame for anything that goes wrong. It’s pretty disgusting!
I agree that these terms are commonly used pejoratively. “Low functioning” is a PC way of saying “dumb” or “incompetent” or “frustratingly inconvenient.” “High functioning” often means “faking” or “doesn’t really need help” or “low priority.” While I understand the first poster’s concern that these terms are embedded in the system and are required in order to get help, this should not be the case. It speaks to the larger issue of the US social welfare system, where people constantly have to “prove” that they are “really needy” before any help is offered. I much prefer the European system, where people seek out the help they feel they need without having to prove “low functioning” to merit assistance. That approach also allows people to continue to receive support as their “functioning” improves, rather than punishing folks who get better with loss of medical care or housing or financial support because they are now too ‘high functioning’ to deserve it.
I use self-disclosure all the time as a way to create better trust and a sense of personal credibility. I do it in a way that doesn’t require the person I’m talking to to take care of me in any way, but as a means of reducing the power imbalance and letting them know that their suffering isn’t that unusual or “bad.” Unfortunately, the DSM now allows clinicians to completely distance themselves from their clients and “analyze” them and “categorize” them and “treat” them as if they were somehow a different species altogether.
Boundaries means doing what is good for the client rather than what is good for you as a clinician. It does not mean avoiding any impression of your own vulnerability and humanness. Selective self-disclosure is a powerful way to help clients understand that they are not malfunctioning, but are part of the human race’s struggle to make sense out of this confusing, horrific, and wonderful world we are a part of.
Karen Sa deserves a Pulitzer for this amazing investigative journalism. Foster kids are the most powerless group of people in this country, and it’s not surprising the pharmaceutical industry and the psychiatric profession take profit at their expense. I see it every day, and it breaks my heart.
No one is suggesting that your experience is invalid. You clearly found stimulants helpful with minimal side effects – more power to you! My problem with the tenor of your posts is that you seem to assume that everyone has your experience, or that difficulties are rare and easily resolved by simply “talking to your doctor.” This is not most people’s experience who are posting here.
When you get “kicked in the teeth” is when you make unsupportable statements, like that brain scans can be used to diagnose “ADHD,” and that kids who attend “open classrooms” don’t learn anything, and that you can tell if someone has “ADHD” because they respond differently to stimulants than someone who doesn’t have that diagnosis. None of these things have scientific backing, and people have taken the time to show you the science 0r shared anecdotes refuting your claims. If you want your own anecdotal evidence respected, then you need to do the same with others’ stories, which are all just as valid as yours. When I tell you my kids had full “ADHD” characteristics as kids and were raised using alternative schooling and turned out to be functional adults, I expect you to recognize that there are at least exceptions to your way of thinking. When I give you references documenting that kids who receive stimulant treatment don’t turn out better on the average than those who don’t, I expect you to acknowledge that as factual. When I or Jonathan acknowledge that stimulants do have a short term positive effect on “ADHD” symptoms, I expect you to remember and give us credit for that rather than claiming we said something else.
You seek respect from others, but you are not respectful of others’ viewpoints. We have lots of heated debates here from people seeing things differently than each other. You can do that, too, but not when you dismiss or ignore or invalidate or intentionally misrepresent what other people are saying.
I shall try to use simple words here. Yes, everyone has better concentration than they otherwise would on stimulants. Are you disputing this fact, despite scientific evidence from your friend Judith Rapoport that it is true? This is not the same as saying no one needs improvement. It means that this effect is not specific to “ADHD” sufferers, as has been claimed in the past (i.e. the “paradoxical effect.”) People point this out because you claim in another post that such an effect does occur. They are merely giving you the science to back up their claims that this effect does not happen.
No one has said that chemicals don’t alter the performance of the brain, sometimes in ways that are regarded as positive by the recipient. We are merely saying that the fact that someone likes the way a drug affects them does not mean they were ill. You may remember my illustration that alcohol reduces anxiety. Some people appreciate that about alcohol. It makes them feel relaxed. That doesn’t mean they have an “anxiety disorder” and that alcohol is a “treatment” for it. It means the drug does something they like so they choose to use it.
No one has said that disease does not cause deficiencies in the brain. What we actually said is that you can not TELL if a person has a deficiency in the brain just by checking off behavioral items on a checklist, or just by the fact that they like how they perform when taking a certain class of drugs.
Your conclusion, and in fact, your line of pseudo-reasoning, is not something anyone here would subscribe to. My personal conclusion would be more like this: Different people have different brains/bodies and different experiences in their past. As a result, they behave differently from each other and like and dislike different things and are good and bad at different things. A teacher’s job is not to identify people who don’t like how they teach and label them as defective. A teacher’s job is to modify the environment and their instructional methods to assure that all students, regardless of their personalities and preferences, are able to learn the material they need to function as an adult.
There is no doubt that people are born with differential skills. Some are good at focused attention to detail, some are not. Some have artistic gifts, others are incompetent in the area. Some understand mathematics intuitively, some struggle with it their entire lives. Some are great runners and jumpers and athletic talents. Others are clumsy and slow. That’s how people are. I would not label a person who has difficulty with or limited interest in academics defective, any more than I’d call the person who can’t play football well defective. They are different.
If we valued athletics over academics, we could come up with an “Athletic Deficiency Disorder” manifested by clumsiness, slow running, lack of coordination, and a lack of competitive attitude. We could, in fact, “treat” that disorder with stimulants, and this would allow the less athletic students to run a little faster, be a little more coordinated, and be a little more competitive. Or we could have them spend more time in the science lab, where we discover they are particularly gifted in understanding and designing scientific experiments.
Most people would consider giving kids stimulants to make them better at sports to be a borderline criminal act. We tolerate it with academics only because it is sanctioned by the Doctors who make all things OK when they say so. It is really not so different from a performance-enhancing drug for sports. Some people feel OK about it. I really don’t, especially when we know we can teach the same stuff with less stress by creating a less formal classroom setting and allowing the child more control. Unfortunately, schools in general don’t believe in giving kids control. They believe in controlling kids. So they opt for drugs instead of changing their own behavior.
Your explanation is insulting and seems kind of immature to me. I would suggest you try listening rather than automatically condemning anyone who doesn’t agree with you.
I didn’t make that statement, but I can tell you that kids in foster care, clearly trauma victims one and all, are diagnosed with “ADHD” at a rate around 4 times higher than in the community. Many I have seen are first diagnosed with “ADHD,” given stimulants, react by becoming aggressive, are then diagnosed with “bipolar disorder,” are put on antipsychotics, and so forth, so that some have 5 or more psych drugs and are breaking windows and beating people up and are being removed from care and put into residential treatment facilities and so on and so on. And it is rare that ANYONE (least of all their various psychiatrists) appears to recognize that stimulants were the starting point for this deterioration and advocate their discontinuation.
Kids in foster care are generally given psych drugs at a rate 4-5 times the general population. This is clearly not because they are “genetically determined” to develop “mental disorders,” but because they are traumatized and the adults don’t know how to deal with their predictably challenging behavior.
When over half of all the teens in Massachusetts’ foster care system are on psychiatric drugs, I’d say they are being “given out like candy,” at least in this population, and continue to be given out like candy, even when they have proven ineffective or even harmful to the youth taking them.
There are, of course, people who feel these drugs have benefited them. They have discussion boards all over the web, many of them partly or totally sponsored by their friendly pharmaceutical company representatives. The kind of stories we tell here are generally unwelcome on such discussion boards. This is a place for people to explore alternatives. If you don’t want to do that, please, find one of the pro-medication boards where you will feel more at home. But don’t come here insulting our writers and posters and demanding that we give your views “equal time.” We’ve been more than patient with you, and you got a lot of very calm, rational, research-based responses to your queries, most of which you seem to have ignored completely or dismissed out of hand. If you’re expecting us to agree with your viewpoint regardless of your presentation, you’ve come to the wrong place. Please, feel free to share references to support your views, but it is less than helpful to have such an accusatory attitude toward people who are just as dedicated as your psychiatrist friend to trying to help people get better, even if you don’t personally agree with their conclusions.
I agree as usual, B. There are absolutely parents who create “ADHD” symptoms with bad parenting, and such should never be let off the hook. And I have to honestly acknowledge, we made it a lot worse than it needed to be with our first, because we had no clue what we were doing and were learning on the fly. But you are so right, the biggest problem with “ADHD” and most of these “diagnoses” is that it allows the adults to pretend they “understand” a situation without having to do the hard work about figuring out what’s really going on. I just read about a kid who was almost diagnosed with Tourette’s Syndrome as the result of a bacterial infection. Good thing the mom didn’t just “trust the doctor.”
In the end, the diagnoses do far more large-scale harm than the drugs ever could.
Interesting that they don’t take into account the type of care the baby receives. Many premature babies live in isolation, with lights on all day and little to no regular holding or stimulation. By contrast, “Kangaroo Care” was developed in Columbia, where the premature infant is given lots of skin to skin contact and is exclusively nursed. Kangaroo Care improves cognitive outcomes as well as a host of other improvements. Or perhaps it is more accurate to say that FAILURE to promote Kangaroo Care leads to a DECREASE in cognitive or other skills.
This is not new information. It should be universal practice, but of course it is not. Obstetrics is second only to psychiatry in its insistence on maintaining ineffective practices in the face of contrary evidence.
The number of rape, domestic violence, and childhood abuse victims I’ve encountered professionally who were diagnosed as “bipolar” is quite astounding. I’ve even heard psychiatrists argue that trauma didn’t really cause their suffering ‘because not everyone reacts to trauma that way, so their brains must somehow be different.’ As if there is a right way to react to being raped!
And of course, the first application will be for “schizophrenics” who “don’t know they’re ill” and need to be forced to “take their meds.” Brave New World, we have arrived.
You sound remarkably similar to Excedrin, asking the same questions s/he has already had answered many times by me and others on this forum. Makes me wonder…
No one can say with absolute certainty that you do or do not have “ADHD” or any other psychiatric diagnosis, because the criteria are not objective, but are based on clinical judgment and opinion. Hence, two professionals can freely disagree in a way they could not about whether your blood sugar is too high or whether your leg is broken or whether you have congestive heart failure or cancer. Until there is some objective way to test for these “mental disorders” that allows a repeatable measurement that is not subject to personal bias or whim, the diagnosis of mental disorders will remain the collection of voodoo and sleight of hand that it is today. Which means any 5 doctors can diagnose you with any of 5 “disorders” based on exactly the same symptoms, and not a one of them will be “wrong.” Sadly, there is no examination they can do to answer your question with even a modicum of certainty.
The widespread suppression of nursing in the 50s and 60s was also most likely a contributor to obesity and eating disorders, possibly due to the baby learning to self-regulate food intake early rather than having to wait for someone else to decide when and how much to feed them:
While I think it is great that the psychiatric inmates have gotten this right back, I think the fact that you had to fight so hard for it and that it was a “nail biter at the end” goes to show how completely unhealthy and destructive our current paradigm of care has become. Even criminal prisoners in the US have a right to daily exposure to fresh air. And anyone with half a brain knows that sunlight and fresh air are nature’s best antidotes to depression. To think that anyone would have to fight for such an obvious right and benefit for people who have done nothing wrong just shows how far we have our collective heads up our butts when it comes to providing “care” for the “mentally ill.”
I am not aware of any evidence on that. They generally don’t even do long-term studies on side effects, because no one who wants to know that badly has the money to fund it.
I think anecdotes are all we have to go on. I can imagine that messing with the dopamine system over time could have all sorts of interesting effects, including chronic insomnia.
Just wait. “Obesity” was recently adopted by general medicine as a disease code. I am sure it is in prelude to prescribing “anti-obesity” drugs, and stimulants will be at the front of the line. Scary!
I’ve also heard people get down on parents of “ADHD” diagnosed kids who use stimulants, saying they are “lazy” or that “basic discipline will put these kids on the right track in no time.” I can say from personal experience that this is not generally the case. The mismatch between this type of personality and the expectations of the school creates massive difficulties that are not easily addressed with even the best of parenting approaches. And there are parenting strategies that work well with this kind of child (those who seek intensity and stimulation and hate being bored or told what to do) that are not necessarily obvious or commonly known.
Again, I see this as a small minority and not even necessarily from people who are very well informed on the issue. It is not something I see on this site, for certain, but I think the group that congregates here is generally extremely well informed scientifically.
Just as an example, some people say, “We are making drug addicts out of our kids by giving them Ritalin!” But the science is kind of equivocal on that point. It is likely we’re making more smokers, but the jury’s out on whether stimulant abuse is any different for stimulant users. So far, there isn’t really good data to suggest that it’s more likely, though Nadine Lambert’s work suggests it is possible that they are sensitized to later stimulant abuse to some degree. Which may explain the smoking increase, though that’s also common with antipsychotics.
The biggest difference, though, is when I provide some information to someone in this movement, they are generally interested in hearing about it, or at least will modify their remarks. Unlike certain recent posters on here, who shall remain nameless, that repeat the same message over and over again despite massive evidence presented to the contrary. On the whole, I think the antipsychiatry movement is much more firmly grounded in science. Not even close, actually. Orders of magnitude more grounded.
I am stunned that people continue to fall for this crap. Any fool knows that taking amphetamines reduces your appetite. I suppose there is some tortured logic involved in someone taking it if they are desperate to overcome these urges, but from a scientific point of view, positing it as a “treatment” is ludicrous! They aren’t even bothering to identify the problem, but as usual, calling the “symptom” the problem and selling a drug to make it go away without bothering to find out what’s going on, and of course, creating some handy addicts along the way so they’ll always have a market for their product.
Why don’t we just go back to selling Bennies as diet pills again? It is absolutely no different.
You are so right about that! If a loving parent is told their child will become a delinquent unless they take Ritalin, most parents will be worried and at least consider the drug as an option. If they are instead told that SOME kids with this condition are more likely to be involved in delinquent acts, but that MOST kids in this category do not, and also that the Ritalin does nothing on the average to change that probability, nor does it increase the likelihood that your child will do any better academically or in any other way, the parents will make a very different calculation. If you go so far as to tell the FULL truth, that “ADHD” is a social construct derived from these kids difficulty managing in a regular classroom, and that alternative classrooms have been shown to be a much better place for them to learn, but that Ritalin is an option that may help them “fit into” a regular classroom better at least temporarily, while exposing the child to a range of risks that could be avoided if we changed the classroom structure, I doubt that most parents would seriously consider making that leap of faith.
Truth is the enemy of toxic psychiatric interventions. I am completely OK with informed choice, at least for adults, but the key word is INFORMED!
And as another scientist, I have to say that even when real scientific models (like neurological down-regulation) are utilized by Whitaker and others writing in this area, their concerns appear to be viewed as anti-science. My personal view is that “scientific anarchy” is not so much the problem as pseudo-scientific authoritarianism. And while I see this occur in the antipsychiatry movement at times, it is a much more prominent theme among mainstream psychiatrists and the institutions they inhabit and promote. Real scientists, as you point out, are always anxious to hear other points of view, or are at worse tolerant of them, knowing that science is created out of the crucible of constant skeptical review of what we know. If psychiatry wants to be viewed as an actual scientific enterprise, it needs to stop using illogical rhetorical arguments and phrases like “scientific anarchy” and show some respect for the actual DATA that they are being presented with, including the vitally important data of their patients’ own reports of their experiences.
It’s in the product information. Insomnia is one of the most common side effects. Ritalin is also “contraindicated” for people with depression or severe anxiety, as it can make these conditions worse. I’m very close to quoting the product insert there. This is on the label, but it is systematically ignored. A good starting point might be to have your friend read the full product insert, including the contraindications.
There is also good evidence that sleep problems are highly associated with “ADHD” behavior. But they “treat” it with something that disrupts sleep. Makes sense to me…
I love that experiment! You should gather the data from your erstwhile classmates and publish it.
And I agree with your last – this assumption that because “ADHD” kids are miserable it’s because of their “ADHD” is tautological. We know that they are much happier being homeschooled or working in non-traditional self-paced or open classrooms. Wh aren’t we “prescribing” this kind of classroom if we’re so worried about their “happiness?” Because schools are not about happiness, for the most part, nor are they primarily about learning. They are about COMPLIANCE WITH AUTHORITY.
95% of “ADHD” goes away when the kids are no longer required to function in a traditional classroom.
Well, since there is no evidence that antidepressants reduce suicidal ideation, except maybe in the extremely depressed, who are generally excluded from the trials, I’d say the ethical risk is pretty low. Actually, there is little to no evidence that antidepressants are even effective in children, and there is definite evidence that they INCREASE the likelihood of suicidal feelings and acts in those who didn’t have them before. The only one even approved for under 18 is Prozac, and that was based on one single study that has been roundly criticized in hindsight.
So perhaps the real ethical question is why we would give antidepressants to children at all?
Shhh! Start talking like that and people will get CURED, and what will they do for clients then?
I will watch that video. But if people like you and me know these things, there is no excuse for the bigwigs not to know them. Which means they really do know them and are very intentionally lying. Which kinda pisses me off!
I reiterate: alcohol works great to reduce anxiety. Many people use it, swear by it, find it helpful. It is not treating a disease, it’s just helping them relax. The condition of BEING ANXIOUS exists and alcohol eases that condition.
The condition described by the “ADHD” criteria also exists, because it’s a description. People who fit that description are more able to pay attention, stay focused, whatever you want to call it, on stimulants, just like anyone else. Similarly, people who are anxious are able to relax, be more social, worry less, etc. if they’ve had a couple of drinks. Completely analogous situations here. Calling the one condition “ADHD” is just a way of naming people who find concentration/organization, etc. challenging.
Perhaps a better analogy: stimulants make people eat less and lose weight. Some people have a “condition” of being overweight. Taking stimulants can make them less overweight. But being overweight isn’t a disease state. It’s just a description of a person who is a good bit fatter than average. Skinny people would lose weight, too, but they wouldn’t be interested in losing weight because it’s not a problem they want to solve.
I am thinking you are going to be unable to understand this because of your worldview, but just because a drug makes something “better” in the sense that the person likes the effect doesn’t mean they were “ill” or that the drug was “treating” something. Unless you think that people who go down to the bar to relax after work all must have some sort of “excessive tension disorder” and require medical treatment, saying that the drugs “improve a condition” is almost tautological. The drugs do what they do. Some people find it helpful, some don’t. That does not in itself make the condition maladaptive or medically relevant or requiring “treatment.” Remember, the same kids also find the open classroom improves their condition dramatically. Does that make an open classroom a medical treatment?
Why would you not believe them? What interest would someone have in coming to that site other than informing others of their experience?
Perhaps the more important question is why would be inclined to assume they are lying, just because their experience doesn’t comport with your own? Perhaps you are not being as objective as you would like to believe?
Goebbles and Torrey would have agreed on many points.
And even if it’s true, which I seriously doubt, Columbia and India and Nigeria still kick our ass by a factor of 2 with very little use of antipsychotics. If my data is correct, we’re talking 4 times better recovery rates in these “primitive” cultures who have not yet seen the wisdom of drugging people who behave differently than the scared “norm.”
I have covered this already. They have the same kind of impact on anyone, because they are stimulants and act like stimulants. If a person is looking to be better able to concentrate, stimulants will do that, just like drinking alcohol will reduce your anxiety levels at low dosages for most people, regardless of “diagnosis.” The fact that stimulants increase concentration levels proves nothing except that the person who wants that outcome will get it. The problem I have with this is that 1) kid get no sayso about whether they take them or not, 2) informed consent is almost non-existent, as people bandy about mythology about stimulants having positive long-term benefits that they don’t have, and 3) the stimulants have a side effect profile that can be very serious in some cases, including anxiety, depression, and psychotic symptoms (which is almost never shared with the client/patient). And we know that there are other approaches that work better, such as a less rigid classroom structure that allows more movement and decision making. So why spend so much time and money promoting a drug that has short-term effects that are viewed as beneficial, but has no long-term benefits for the group as a whole and has risks that could otherwise be avoided.
My own kids are proof that the alternatives I’m talking about can work. There are others who have done the same, and I think our testimonials should carry as much weight as those from folks like you who found stimulants to be remarkably helpful. A look at Jonathan’s site should easily convince everyone that stimulants are not always benign, and that the adverse effects in some cases are pretty dramatic. Why not look at alternatives? My experience says that attentional skills can be learned with the right approach, not easily, but they can be taught and learned. That’s where I think the emphasis needs to be placed, because a learned skill can be practiced and developed over time, whereas a drug can only be consumed with the hope of this outside agency providing relief. The skill-building approach is more empowering, and I believe much more likely to lead to the improved outcomes we’re all looking for.
I was also disappointed that there was no mention of the WHO studies in the 90s showing much higher recovery rates in countries using less antipsychotic drugs. It seems he hangs his recommendations on that one study, rather than looking at the entire database on recovery.
Citation please? I have understood it is closer to 10-15%.
“Sustained recovery occurs in less than 14% within the first five years following a psychotic episode2 ” [http://www.nimh.nih.gov/about/director/bio/publications/rethinking-schizophrenia.shtml]
Jeez, I guess this guy doesn’t read my posts at all. It has been shown in every review since 1978 (the first was done by none other than Russell Barclay himself) that stimulants DO NOT REDUCE THE LIKELIHOOD OF CRIMINALITY in “ADHD” youth. There is NO DATA, NONE, to show that kids given ADHD are less likely to be delinquent or to be jailed as adults. It is a fantasy.
Additionally, most psychiatrists agree at this point that giving SSRIs to people with bipolar diagnoses is probably a bad idea, as it makes it more likely for manic episodes to happen. Manic episodes are clearly stated side effects in the product information for SSRIs.
Finally, the WHO studies both showed unequivocally that employment is much more likely ( 60% or more) for those diagnosed with schizophrenia in developing countries who are less reliant on drugs for treatment. Whitaker also cites studies showing the social recovery rate for schizophrenia in the USA in the 50s (pre-Thorazine) to be much higher than today. Whatever your beloved drugs are doing, they aren’t saving people from the disability roles.
Your “facts” appear to be fantasies that you really need to be true. You should really read the book before you bother to comment. You have a lot to learn.
Too true. Alcohol is an awesome anti-anxiety drug. But I wouldn’t prescribe it as a “treatment” for “anxiety disorder.” Just because something makes you feel better temporarily doesn’t mean you’re sick or that you just received “treatment.” That substances alter our emotions and perceptions is not new information, but messing with consciousness is not a form of medicine.
The real political mission of psychiatry appears to be to deflect all criticism of the status quo as “mental illness” and to medicate anyone who isn’t willing or able to play ball, so the rich can get richer and the rest of us can shut up.
One guy in there does a good job of outlining the major schism between what is known about adverse social and emotional environments and “mental health” vs. the biological model. But he really doesn’t address the social-political-financial reasons this split with reality has occurred and continues to thrive. Without addressing corruption by pharmaceutical dollars and competition for “market share,” any analysis of psychiatry will fall short of addressing what is really going on.
I don’t get why it is legal to prescribe a drug that has little to no positive effects for children and known severe side effects. It makes no sense whatsoever. Should be a crime. It is a crime, but it should be illegal and punishable by prison and loss of medical license.
Wow, great site! I think it does a great job of demonstrating the tradeoffs. So many people talked about being socially withdrawn or irritable and hostile. Interesting that one person mentioned feelings of superiority…
I’d think real informed consent would involve having someone read a site like this and consider what the possible pros and cons are. Clearly, some people felt it benefited them, but some of the other stories are quite harrowing. It seems to show a thin line between successful treatment and the development of OCD, and there are a number of people talking about feeling great initially but having the effects wear off over time, very much in line with our knowledge of stimulants as addictive substances.
This really supports Johanna Moncrief’s view of these agents: they are drugs with nonspecific effects. Some people find these effects helpful, some don’t. They are not a “treatment” for a “disease,” if only because their effects are so unreliable and variable that for each person who calls them a “miracle” there is another who says “they ruined my life.”
“I think you have ADHD, Steve. ” Sounds like a diagnosis to me. And I don’t think this guy really understands the meaning of the word “condescension.” “Characterized by a patronizing or superior attitude toward others.” If the shoe fits…
I am currently renting rooms to a former foster youth who was on Adderall for 8 or 9 years. I just talked to her about this last night. She describes Adderall leaving her feeling like a zombie, having no emotions, and feeling trapped. She did not feel she had a choice whether to take it or not, and attributes some of her wild behavior in her mid-teens (including cutting on herself) to trying to get her emotions back from her zombified state. She said it did help her concentrate on one thing at a time, but this also had a negative side effect of having her stay focused on some of the bad experiences she had while at home and in foster care and being unable to redirect her attention to something else.
She was in an emotionally abusive foster home for most of those years, but of course, no one ever asked her about why she had a hard time concentrating or what her home life was like, because they “knew” that her difficulty concentrating was due to her “ADHD” and no other reason was ever considered.
She said she hated Adderall with a passion and would never take another psychiatric drug as long as she lived. She said she liked being able to feel things, even if they are hard feeling sometimes, and she needed to feel them to work through them and to heal. She is a hard worker and has a great sense of humor and also has gained a lot of insight into people and social situations as a result of some good therapy and her own hard work on gaining personal enlightenment. Drugs were not a part of her healing; she saw them as a barrier to her healing and learning how to let go of her past.
For every “success story,” there is another story like this one to balance it out. Stimulants are not a panacea – they are a short-term symptom relief measure that works for some people, and makes some people’s lives worse. Some people like the effects – more power to them, as long as they understand the attendant risks. But acting like they are some miracle cure for anyone who has trouble paying attention in school for whatever reason is absolute nonsense. These drugs are quite capable of doing serious emotional harm, and they also often prevent adults from looking deeper for causes and possible solutions to their children’s behavioral challenges.
Well said. The biggest problem with this phenomenon is that giving the “ADHD” label provides license for the adults to blame the kids for acting in a natural way, instead of reconsidering the bizarre and developmentally inappropriate expectations we are putting on them. I remember Kindergarten being about finger painting and singing the ABC song and reading stories and PLAYING! Now they expect kids to READ by the end of Kindergarten, and some even have homework!!! I never saw homework before fourth grade. It’s ridiculous what we expect of kids. They’re supposed to run around and tease each other and jump from one activity to another when they’re bored. They aren’t supposed to sit still and all do the same thing at the same time without complaint. It’s time we stopped blaming kids and started looking at our own behavior.
The writer should know that response to stimulants is not a valid way of diagnosing “ADHD”, even within the accepted DSM heirarchy. Judith Rappoport disproved this back in 1978 by giving stimulants to “normal” teens, and found the exact same response to low doses of stimulants: decreased motor activity, narrowed focus, reduced distractibility. She called the believe in the “paradoxical effect” an “artifact of observation,” because people were LOOKING for a change in those features and were happy to find it. Whereas in a “normal” child, such a change is not particularly noticeable because no one felt these kids were overactive or distractible to start with.
Bottom line, stimulants are not specific “treatment” for “ADHD” and don’t affect “ADHD” diagnosed people differently. They are general stimulants and affect everyone’s brain in pretty much the same manner. It is unfortunate for the writer to be indirectly implying this discredited myth to be true.
But wait, I thought that we had somehow proven that sugar doesn’t cause hyperactivity – it’s all genetic, right?
I agree, waste of money, but it’s good to have scientific validation to counter the constant onslaught of propaganda saying “ADHD is not caused by diet.”
Related question: why do they allow these drinks to be sold in schools? (Answer: the schools make moneh off of it!)
More condescension. Please quit referring to “my ADHD.” I don’t have any and don’t want any diagnosis, especially from you.
They are still using averages. Give me a link to the research if you have one – all I found was a summary and it seemed that Rappoport was pretty cautious about overinterpreting these results because there was no specific finding for individuals that was consistent. I respect Rappoport’s work and was not accusing her of being a hack. She was one of the ones back in the 70s studying open classrooms and found that there was a dramatic reduction in “ADHD” symptoms without medication if kids spent a year in an open classroom. She also disproved the “paradoxical effect” theory with finality. She’s one of the more honest researchers in the field, though I have to say the bar seems kind of low sometimes.
Averages aren’t diagnostic nor do they prove anything except that some people are different than others. I haven’t even launched into my “genetic differences don’t mean an illness” speech yet. Men and women have very different brains. They’re supposed to. I bet women have better dopamine transmission on the average. Doesn’t mean men have “testosterone poisoning.” Genetic diversity is the core of species survival. Read up on population genetics some time. People should be allowed to be different from each other. Difference does not equal disease, especially when you’re dealing with averages.
Sorry, it’s condescending to “diagnose” another person in my view. If you wanted to be complimentary, you’d simply state what you observed to be my strengths. This is one of my objections to diagnosis – it comes across as a power play, that you somehow “know” something about me that means you can categorize me in a little box. Well, I reject any boxes or categorization. I see many strengths in most of those who get put in this box, but I don’t tell them about the box, I tell them about the strengths, as well as encouraging them to address the challenges they may face.
I also find it condescending to believe you can identify the source of a person’s pain or passion. It’s more polite to just ask them.
And BTW, you know bupkis about my career and what I have achieved. I won’t bother with details, but just add that once again, you are 100% wrong, I’ve been extremely successful at almost every job I’ve ever had, and I am very proud of the many things I’ve accomplished over the years, including being a published author and getting a law passed to protect foster kids from condescending professionals who think they can “diagnose” and drug them without bothering to find out who they are or why they behave the way they do.
Please save your diagnoses for someone who is sufficiently deluded to give a rip what you think.
The study reports averages over the cohort. Not everyone studied had low dopamine transmission. And including 53 non-medicated adults doesn’t help unless you compare them to the stimulant users. And you’d have have medication naive people, not just current non-users, because earlier use could have disrupted the dopamine system (since that’s what stimulants DO).
Stimulants increase dopamine flow. Anyone familiar with the basics of amphetamines knows that. The question is whether increasing the dopamine flow does anything helpful in the long run. Science says it doesn’t make a difference. And it probably makes the dopamine situation worse, if there is such a situation to begin with.
My last response to you: Kids in free academic settings learn a ton. My oldest and youngest went to such settings, both graduated with honors from HS and the youngest is currently attending Evergreen State College and is incredibly engaged in his own education. The oldest is a website developer and trainer and makes a solid salary, and has been lauded as an employee everywhere he’s worked. Both fully met the “ADHD” criteria as kids, neither experienced a milligram of stimulants, both are very successful adults. Colleges are actually very anxious to accept kids who are homeschooled or educated in open settings, because they are much more self-motivated. From what I recall of academic testing results, these kids didn’t do as well as “standard” classroom kids at 4th grade, but were caught up by middle school and exceeded their “standardized” peers by high school. You are again operating off of bias and “conventional wisdom” without looking at the other side of the issue.
It is also scientifically extremely tacky to criticize a study based on how long ago it occurred. The periodic table of the elements was fleshed out in the 1800s. The Rutherford Gold Foil experiment showing atoms to be mostly space was performed in 1899. Atoms still are mostly space over 100 years later. And “ADHD” kids still do better in open classrooms, despite your bias against them, 40 years later. Again, you only want to say things that support your own views. I’m not playing any more, but I want to make sure people see what you’re really up to here, which appears to be to argue and discredit anyone who disagrees with you.
I’ll close with the fact that those who claim “a mountain of indisputable information” are usually ones who are trying to disguise the lack of actual foundation for their arguments. I’ve addressed your claims above, as have others. Your mountain is by no means indisputable, because I and Michael and many others have plenty of data to dispute it. That you are able to blithely dismiss anything you disagree with does not help your case. Perhaps you should open your mind and listen instead of preaching the “c0mmon wisdom” to those who know better.
Your condescending attitude marks you out as a “true believer” in the psychiatric religion, and as such, I don’t expect you will every be able to hear anything that doesn’t fit with your DSM “bible” and your psychiatric priesthood.
You also don’t appear able to read very carefully. I am not talking about whether the “symptoms” continue to adulthood sometimes, which I would not argue with in the least. I’m observing that yet another large-scale, long-term study shows that kids who get stimulants don’t do any better than kids who don’t get stimulants. They are a short-term symptom-reduction strategy and nothing more.
The authors clearly state that the differences are a result of averaging and that you can’t assume any individual would have these characteristics. So we are unable to even clearly define who “has ADHD”, and the “treatment” doesn’t make any difference in the long run on the average. Again, why are we “treating” millions of kids with these stimulants on the basis of such sketchy science?
Additionally, you don’t bother to respond to the obvious “diagnostic” issue – if ADHD is purely biological and distinguishable from other “disorders,” why is it so much more common in people who have been traumatized in childhood? Are you suggesting that “ADHD” children are causing themselves to be abused by adults? Or is it just possible that being traumatized can cause “ADHD” symptoms that are indistinguishable from biological “ADHD?” In which case, what is the difference?
I do have a deep, deep source of pain in my life, but it is not because I have “undiagnosed ADHD.” It’s because I see the wasted potential for positive interventions in kids’ lives, like open classrooms and positive adult supporters and the freedom to explore what drives them, because people like you dogmatically insist on having all kids marching along dully to the same boring curriculum, day after day, week after week, year after year, leading to increasing dropout rates and disaffection with society. The pain is because I see people like YOU pathologizing kids and adults for being “bright, passionate, and big hearted” as you put it, instead of critiquing the social institutions that are designed to snuff out passion and big hearts like mine. I feel sorry that yours has apparently been completely smothered.
Your arrogance to assume the ability to “diagnose” me based on a few posts is simply beyond the pale. I don’t have words to describe how disgusting I find that behavior. I am not prepared to “diagnose” you just because you annoy the crap out of me with your dogmatic narrow-mindedness, but I am prepared to ask you to keep your presumptuous and insulting “diagnoses” to yourself in the future! I can only assume that you haven been deeply hurt yourself and I hope you are able to find a way to heal, but insulting me while saying you don’t mean to isn’t a likely path to healing.
— Steve
P.S. I was a very compliant and hard-working student in school, even though I hated it and was bored out of my mind. I was the farthest thing from “ADHD” that you can imagine. Not that I need to defend myself, but your assessment, besides being inexcusably arrogant, is 100% wrong!
That stuff about “ADHD” kids reacting differently is complete nonsense, btw. Judith Rappoport et al disproved that back in about 1978. I am glad it worked for him. We chose to take a different path for our boys, and they are also doing quite well as adults.
So, Excedrin, when you say “We don’t drug kids to make money,” who are the “we” you are talking about? Because there are lots of docs who would not fit into that “we.”
Also, the insulin-for-diabetes analogy is a pretty weak one, since we aren’t providing controlled and carefully titrated dosages of dopamine to kids after measuring a specific shortage. We’re firing a dopamine shotgun at a speculative target and hoping it does more harm than good, IMHO.
No problem identifying problem issues young and addressing them. The problem is that by calling it “ADHD” and a “mental disorder,” the tendency is to pathologize the child rather than addressing the issues at hand.
For example, it’s by now pretty clearly established that kids with the “ADHD” label do better in an open or informal classroom where they have more control of what they do when. But you NEVER hear any of the lead researchers talk about this option, even though many parents (like me) discover that this is a much better option for their kids. Such classrooms would be a welcome addition to the mix of options for kids in elementary school, but they are seldom offered or available.
I’d be the last to deny that some kids are harder to raise than others, and need more specific assistance early on in their lives, as I raised two of them. But being difficult for adults doesn’t make a kid mentally ill. And giving it the “ADHD” label (as well as providing the option of drugs) allows parents, teachers, and clinicians off the hook for trying to do something more specific to help the individual child succeed. And the child is the one who suffers when the adults are let off the hook.
Joseph Biedermann would be one clear-cut example. He was sanctioned briefly by his university, but is apparently back at work full time. He promised Eli Lilly that he’d deliver a positive study result before he even did the study! He is certainly not alone in his corruption.
There are no doubt many others who aren’t explicitly working for a pharmaceutical company, but who are influenced deeply by how things are framed in these discussions and what kind of results are easily accepted vs. what kind of results will lead to controversy. This is a lot harder to track, but it’s clear from reading about the experiences of people like David Healy and Peter Breggin and even Alan Sroufe that psychiatrists who don’t follow the “party line” will frequently be attacked professionally.
They also seem “surprised” to find that PTSD rates are much higher among the “ADHD” population. I am not at all surprised, since PTSD symptoms overlap extensively with ADHD symptoms. I work in foster care, and a highly disproportionate number of traumatized kids get labeled with “ADHD”. There is literally next to no way to distinguish them from each other. But since they want to believe “ADHD” is entirely biological, they are somehow “surprised” to find that trauma is highly associated with “ADHD” traits. This should, of course, call the entire diagnostic approach into question, but naturally, the facts are conveniently “explained away.”
“Researchers also found surprising results regarding the effectiveness of medicine in treating ADHD. In contrast to children in United States, youth in northern Finland are rarely treated with medicine for ADHD, yet the ‘look’ of the disorder — its prevalence, symptoms, psychiatric comorbidity and cognition — is relatively the same as in the U.S., where stimulant medication is widely used. The researchers point out that this raises important issues about the efficacy of the current treatments of ADHD in dealing with the disorder’s long-term problems.”
Those results were not surprising to me at all. That’s what the long-term literature has been saying since at least 1978.
First off, these statements about 3-year delay in development are not based on any clear science that I am aware of – I’d be interested to see if you have a link to a real review of the literature, rather than an opinion piece or a single study. Second, any such estimate is undoubtedly the product of averaging and norming, as there is nothing close to a definitive “test” for “ADHD.” Third, I’d be interested in seeing/hearing whether those with delayed maturation are controlled for stimulant use, as stimulants are known to cause alterations to the brain, even at low doses.
Fourth, and perhaps most importantly, it appears that the “ADHD” brains do, in fact, catch up in time, according to this three-year delay theory. Combined with the clear but generally unacknowledged fact that 50 years of research have failed to show long-term stimulant treatment to convey any advantage in terms of long-term outcomes, how can we possibly rationalize drugging millions of children annually, down to preschoolers and toddlers, when we know that the “treatment” won’t make a difference and that the kids will eventually mature out of it anyway?
I, too, have suffered from “oversensitivity,” for me in the emotional realm. I was told many times as a kid that I was “too sensitive” or that I encouraged bullying by reacting emotionally to it. It appears that sensitivity is a curse in modern society, and the people who do best are the most insensitive. That doesn’t make a lot of sense to me.
Now, of course, I’m a social worker and volunteer manager, and my sensitivity is an incredible strength that makes me exceptionally good at what I do. So is it good or bad? Or is the general insistence on people judging other people’s experience as “good” or “bad” the real problem?
No, hating your job isn’t a cause of depression – you hate your job BECAUSE you “have depression!” Apparently, if we healed all of these “disorders,” no one would hate their job, or feel out of control of their relationships, or wonder what the point of life really was. Everybody would always be happy no matter WHAT happens. (Well, unless someone died – then we’d be upset for no more than two weeks and be back to normal!)
Those poor, poor psychiatrists, once again picked on by the NYT. just because they prescribe drugs for conditions they don’t understand and claim to be scientific. I thought it particularly rich that Liebermann accused the author of “equat[ing] symptoms with illness,” when that it exactly what the DSM does from page one onward. I was frustrated I could not make a scathing reply, even though I was logged in. Maybe you have to be registered as a medical professional to comment or something. The comments were pretty offensive to me. One would think the fact that there is such a thing as an ‘antipsychiatry’ movement would give one pause – have not heard of an “anticardiology” or “antiimmunology” movement recently…
I love Giovanni Fava – he is a real scientist. I am so glad to hear this stuff finally making it into the mainstream literature. In maybe 15-20 years, prescribing psychiatrists might even figure out that they need to worry about this. Sorry, I’m cynical at this point…
Blake, buddy, I’m getting tired. You talk like you’re open minded, but you really aren’t.
I made myself clear – it is the school’s job to figure out what works. That’s what they’re paid for. If there is something medically wrong with the child, like he’s had a head trauma or can’t see or hear well or is malnourished, by all means, he should get an assessment, but if he “can’t pay attention,” it’s the teacher’s job to motivate him. If they can’t or don’t care to bother, they don’t deserve to be called teachers. Anyone can assign work to someone and grade it. Real teaching is an art and it involves addressing the needs of each learner. It’s not the child’s fault that we have developed a factory-style school system that is too impatient and authoritarian to care for his needs.
The open classroom is the ideal scene for most ADHD-diagnosed kids. But since ADHD is a fiction and doesn’t reflect an actual group with the same issues, it won’t work for every one of them. But it will work for a hell of a lot more of them than the standard classroom. So tell me, Blake: why don’t we have this kind of classroom for this kind of kid.
The citations you requested: Jacob, J.G., Oleary, and Rosenblad, “Formal and Informal Classroom Settings: Effects on Hyperactivity;” J Abnormal CHild Psychol 1978 6, P. 47-49.
I have given you enough information for you to easily conclude that open classrooms would resolve 90-95% of “ADHD” cases, and yet you persist on harping on the one or two kids out of 100 who won’t do well in this environment. Shouldn’t you be focusing on why the school system doesn’t care enough to create this kind of school classroom for kids who need one? What does it say about the intent of those schools? What does it say about the intent of the psychiatric profession that they aren’t “prescribing” this kind of classroom?
I’ve done my part. It’s your turn. I’m not going to try and convince you if you don’t want to question the “ADHD” paradigm. I’m sorry it’s hard for you to learn that this paradigm has some gaping holes in it, but I can’t make you feel better by pretending they don’t exist.
Good luck, and don’t believe everything the professionals tell you.
I don’t disagree with you, Duane. My issue is not that there are no cases where physiology causes what we think of as “mental disorders,” it’s only that we can’t say with any accuracy that based on BEHAVIOR or EMOTION or THOUGHT, we somehow KNOW there is a biological problem. A person with sleep apnea should be diagnosed and treated – for sleep apnea, not for some fictitious “bipolar disorder.” Same with B vitamin deficiencies. Psychiatrists almost never check for anything other than the “symptoms” that define the “disorder,” even when their own drugs are the cause of the “imbalance” they are now ostensibly treating.
The biggest problem with the DSM is NOT the drugs – they are a consequence of the warped thinking behind it. The biggest problem (scientifically speaking) is the lumping together of people with a wide variety of conditions, some physiological and some psychological, and people with no condition at all, and claiming they all have the same “disorder,” when the only thing they have in common is a set of symptoms. It would be like treating everyone who has a rash in the same way – topical steroids for all, whether it’s poison ivy, measles, or syphilis. It prevents any actual research into the real causes such as the ones you are presenting.
Hope that clarifies things. I don’t agree that therapy is the right thing for everyone. It depends on what problem you’re trying to solve. Real diagnosis means finding CAUSES, not simply categorizing things in ways that make someone’s product more marketable.
But the second question is how to get those involved in the system to pay attention to the actual science that is known.
Some examples: 1) the ‘low serotonin’ theory of depression was discredited in the early 80s, before Prozac came to market, yet millions of doctors continue to promote this discredited theory.
2) Parents by the millions are told that “untreated ADHD” leads to delinquency, drug abuse, school failure, and vocational instability, despite the long-standing and consistent research finding that stimulant treatment does nothing to improve any of the listed outcomes.
3) SSRIs were known to cause suicidal thinking and attempts as well as aggression as far back as 1987, and Prozac was temporarily not approved in Germany for that very reason, yet it took until 2002 that the “black box warning” made its way onto the label, and there are still many researchers and “thought leaders” who deny this is an issue and disingenuously blame a temporary surge in teen suicides (which started before the warning and did not appear to be correlated, yet alone causal) on reduced AD prescriptions in teens.
I could go on. This is more than a problem with science vs. pharmaceutical company marketing. There appears to be a high degree of disease and drug marketing occurring WITHIN THE PSYCHIATRIC PROFESSION AT THE HIGHEST LEVELS. And people who raise these scientific issues, even insiders like David Healy, are accused of heresy and blackballed by the profession. And the media continues to trumpet these untruths and helps organize attacks on those who have the courage to demur from the “conventional wisdom.”
I only wish the absence of the juvenile marketing agents would solve the problem. I think it’s more akin to the scientist having an abusive partner who hangs up the phone on her every time she tries to make a call to someone who would want to hear what she has to say. It’s more than just marketing – there is bullying going on here by people who stand to lose big bucks if the truth comes out!
You don’t seem to be accounting for the problem of whackadoodle diagnosis through the DSM. According to your criteria, alcohol is a treatment for an anxiety disorder. It reduces the symptoms, and could be prescribed only to those who benefit by ethical prescribers. I’m not saying alcohol doesn’t address anxiety – it does, and better than the benzos, in my opinion. Dosage control is a bit of a problem, but it is with benzos as well. I have no problem with recommending a snort of brandy before a plane flight for your anxious flyer mentioned below, and I guess no real big problem with a benzo, either, given informed consent. But that’s basically just a substance to reduce the anxiety temporarily, not a treatment for a “disease.”
Perhaps you are taking a “Moncrieffian” view of these drugs – a drug-based rather than disease-based paradigm? Otherwise, it seems your argument sinks very quickly in the quicksand of DSM diagnostic chicanery.
My point is that we should provide the kind of instruction that works for the kid involved, rather than trying to change the kid to fit our instructional style. If the coach lecturing his football player doesn’t work, he should take him aside and show him, or have another kid show him how. My youngest, Kevin, learns soccer mostly by watching videos and trying out the things he sees. Probably doesn’t get a lot from coach lectures. Oldest was even more that way, but both are absolutely amazing athletes and learn what they need to learn on the job. “Kinesthetic learners” is the term they use in education. Look it up.
For the odd child who can’t make it in an open classroom, you come up with another plan that works for him. But don’t you think it would be marvelous if you could “heal” 95% of “ADHD” by simply reorganizing the classroom to a style that works for the child? The other 5% probably have more serious issues going on at home – abuse, neglect, domestic violence, or whatever else, and may need more specialized attention. So we provide it to them.
Teachers are paid to be experts in teaching. They should know how to approach kids who learn differently. They should be able to recognize and build on strengths. They should know how to use positive behavior management to encourage success. It’s not my kid’s job to change his personality so the teacher’s job is easier. It’s the teacher’s job to find a way teach my kid.
“ADHD” is just a way of describing a kid that is annoying for adults to deal with. While there COULD be something wrong (low iron, sleep apnea, thyroid issues, etc.) that is causing or contributing, just being active and impatient with boredom and having a hard time concentrating on someone else’s agenda is not a disease. Kids are all different. They’re supposed to be. That’s the challenge of being a teacher. If someone doesn’t like that, they should choose a different profession.
Key proviso: these are AVERAGE findings on the group as a whole. It is not true that each individual with an “ADHD” diagnosis has this pattern, hence, we can’t assume that dopamine transmission issues are causal.
Second proviso – no information on the medication status of the people being scanned. Using stimulants over the long term has long been known to reduce the density of dopamine receptors in the brain. This is observed with both amphetamine and cocaine abuse, and is called “neurological down-regulation.” It is responsible for the development of tolerance to a drug with regular use. Anyone who has used stimulants extensively over time, even at “therapeutic” dosages, would be expected to have a lower density of dopamine receptors. This is a meaningless experiment if it’s not done on drug-naive subjects.
Additional point: If low levels of dopamine receptors really is the cause of all or even some cases of ADHD, prescribing stimulants appears to be long-term counterproductive, based on what I just said above about down-regulation. This may very well explain why stimulants seem to “work” in the short term but produce no better results in the long run – kids taking stimulants are going to have their dopamine receptor density REDUCED over time, rather than increased, as would seem to be indicated by the direction this study is suggesting.
Bottom line: “Swanson SPECUTLATED that people with ADHD may even have a net deficit of dopamine.” This is speculation. It proves nothing. And honestly, even if it did, it does not suggest stimulant treatment as a long-term solution, because stimulant treatment will bring about a worsening of the supposed causal conditions.
Sorry, it was in 1978, but I now left my reference at home! Thanks for the reminder, I’ll get it to you. There was also one in 1976 by Judith Rappoport, et al, that showed kids in an open classroom having dramatically reduced ADHD symptoms after a year in that kind of environment. I’ll get you that one, too.
Zombie like states? Isn’t that like saying that drinking alcohol makes you drunk? I thought inducing inertia was the whole point. Being a zombie is not a side effect – it’s what they DO!
I suppose you make my point for me to some degree. “ADHD” is not an entity, it’s a heterogeneous collection of people so labeled because of social expectations. (Notice that there is no “hypoactivity disorder?) This particular way of being can make it harder for a kid to succeed in the pathway our culture expects him/her to travel. For some of these kids, they are motivated and can use their intelligence and drive to come up with ways to overcome their difficulties in organization and focus. In other case, they don’t care about going to college and do other things instead. Why is that wrong? My brother, Jim, was a pretty classic ADHD case. Never liked school, always dabbling on the edge of trouble, liked riding motorcycles above the speed limit – definitely a risk-taker and not an academic type. My high school still had voc ed and he learned to be a mechanic – work with hands, lots of noise and moving parts and power, practical results he can put his hands on. He now owns a garage and earns three times what I do annually. He found his niche.
Not everyone needs to go to college. It’s a cultural bias that is rampant in our schools (unless you’re black, of course, in which case, you’re not expected to do much but fail), but it is not based in reality. School as designed doesn’t work for some kids. That doesn’t make the kids “disorderd” or “disabled.” It suggests to me that the school, who is being paid to teach them, needs to take another approach.
And while there may be an odd kid who can’t function in an open classroom setting, they appear to be extremely rare in the “ADHD” diagnosed population. This setting works for most of them with zero medication. So you can eliminate probably 95% or more “cases” of ADHD just by changing the educational approach. Seems worth a try, don’t you think?
That’s a good way to eliminate the objection that ADHD is not really a singular disease, by eliminating all possible alternatives and saying “If that’s the problem, it’s not ADHD.” Kind of a scientific cheap shot. The fact is, ADHD is not objectively distinguishable from a number of other conditions based on the criteria provided, nor is it particularly distinguishable from normal childlike behavior. Until there is a way to know who specifically “has ADHD” and who has something else and who has nothing but a boring classroom or incompetent or abusive parents, it really is nothing more than a description of kids who the teacher/parent finds annoying.
I am about to give a talk on that subject this very evening. There are many, many things that can be done besides overcontrolling rigidity. In fact, a structured degree of flexibility seems to be a much better way to proceed, hence the effectiveness of the “open classroom” I described in another thread. Power struggles are to be avoided at all costs. Putting the child in a position where s/he has to think about consequences and about others’ feelings in order to get what s/he wants is also a very powerful approach. The key is to teach them the skill and value of planning and forethought without crushing their exuberant spirits.
All these kids who are so labeled have in common is that they are looking for extra stimulation. We can provide it artificially through drugs, or we can provide a stimulating environment where they are challenged to learn to overcome the drawbacks of their particular personality traits. All personalities have pros and cons to them. The trick is to use the strengths to overcome the challenges. It can be done, because I’ve done it with my own kids. Twice, even. But non-traditional classrooms were an essential part of the plan.
A really good therapist never tells you what the problem is. That’s perhaps my biggest of many beefs with psychiatry – they are so arrogant that they think they can tell a person what is wrong with them and what will help. A good therapist is humble – they know that the client is the one with the answers, and their job is to work to help the client get those answers to the surface, rather than telling them what to think or believe about themselves. But I’d say 80-90% of counselors don’t manage that adequately. It requires being willing to sit with the client in uncertainty and discomfort and not blurt out an answer that makes you feel more comfortable at their expense.
There was actually a diversity of opinions in the Comments section, as well as a few stories from survivors who got clear of the system. I added my two cents worth. I encourage others to do so as well. I thought the article did a great job of showing how dehumanizing it is to be viewed only through the lens of your “symptoms.” And the psychiatrist came right out and said, “Medication is all I have to offer.” It’s good for people to hear that is the case, as lots of folks go to psychiatrists thinking they’ll get therapy.
“It” exists, because “it” is a list of behaviors that make it inconvenient for these kids to function in a standard classroom environment. Being artistically talented exists, as does being athletically clumsy and being short or being fat. Fatness is a good example. Some people are more likely to be fat because of genetics. This can be enhanced or reduced by exercise, diet, and other environmental factors. Fatness is more common among poor people and among those who are abused as children, so there are clearly stress-related variables, but some people don’t get fat regardless of stress or diet.
Does that make “fatness” a disease? Or is the genetic variation in body weight a natural distribution of genetic traits that might be beneficial to the species? Fat people, for instance, are more likely to survive a famine, while the skinny ones die off. On the other hand, the skinny ones are probably better runners and hunters, and the fat people might die without them.
A wide range of genetic variables are important for species survival. Just because something is partly genetic doesn’t make it a disease. Read what I wrote about the open classroom. Why aren’t we creating classrooms that work for these kids, instead of forcing the “square peg” into the “round hole” of a standard classroom? It’s not the peg’s fault it’s square. It’s just a bad fit. We used just such a classroom with our youngest, who is classically ADHD (helped to create the school, actually), and he graduated with a 4.0, was all-state in soccer, and is attending college with over $20,000 in scholarships. Guess he turned out OK without “treatment,” didn’t he?
You should re-read my post. Saying there is no proof that it isn’t a biological disorder is nonsense scientifically. If there’s no proof that it is and no proof that it isn’t, then scientifically, it isn’t. There may be evidence later to change that conclusion, but you can’t assume your hypothesis is true in the absence of evidence to the contrary. It’s kind of the most basic law of the scientific method.
An open classroom is a classroom where there are activities available for children to engage in, but there is not a teacher in front directing everyone to do the same thing at the same time. Generally, there are work stations of some sort, with suggested or designated activities outlined, but within those guidelines, kids are encouraged to experiment more and learn from doing rather than from hearing. Additionally, kids aren’t usually kept to a rigid schedule – they can attend one activity for a short or long time and transition to another when they feel they are ready to do so. The investigator in the study in question believed that the constant starting and stopping at the teacher’s behest is part of what frustrated the “ADHD” kids in the regular classroom and led to their inappropriate behavior.
I don’t have the reference ready to hand but will look it up tonight and hope I remember to get it to you tomorrow.
I do think ADHD is a characteristic or trait that is at least partly inherited. But I don’t thinki it’s a disease. Human beings and other species survive on genetic diversity, as it allows adaptability to varying environments. In a hunter-gatherer society, the “ADHD” person would have been in high demand as a hunter or warrior, both occupations that allow lots of flexibility and have an element of risk and adventure. I think we end up creating problems for these kids when we put them in an environment that is unavoidably dull, especially if they have to take a lot of arbitrary orders. The difference in the open classroom shows that this characteristic behavioral pattern isn’t necessarily a detriment. It depends on the environment and the expectations. We don’t expect a geeky scholar type to be an excellent athlete. Why do we expect a creative and adventurous type to be an academic?
It is my theory that the reason white males are the ones who go on shooting rampages is because they belong to the privileged class, but don’t feel they are able to participate in its privileges. If a poor black man is feeling oppressed, it’s easy to find a target for your rage: rich white people. Women can band together around being oppressed by men, immigrants by the majority culture, and so forth. But if a white male is a failure, it’s his own fault. He had all the advantages and STILL failed – he has no excuses, he’s just a loser. I think this may give rise to a rage that is very unfocused and random, and if the person additionally is isolated, he has little to no opportunity to be pulled back from the brink.
The one thing not addressed in the article is that such a person, when exposed to antidepressant drugs, may lose whatever inhibitions that had been restraining them from acting out their fantasies. A hugely disproportionate number of these shooters were on SSRIs, or to a lesser extent, stimulants, during or just prior to going on their rampage. Kip Kinkel, the Columbine boys, the Red Lake MN killer, the Batman killer, the V-Tech guy, at least one of the Fort Hood killers, all had recent or current exposure to antidepressants. There is some soft information suggesting that Adam Lanza may have been as well. While I don’t believe that antidepressants alone would get anyone to this state, I have observed and heard and read that they often create a “what the f*&k attitude (a former colleague of mine called it “Zolofting”) that may feel like a good thing to someone plagued with anxiety, but is definitely NOT a good thing when the fragile inhibition against doing something horrific is set aside by excess serotonin in the brain.
It is good to hear more people pointing out that mass killings are not always or primarily the work of the “mentally ill.” But we have a long way to go before any possibility that American society is the likely cause will be entertained by the general public.
Science operates on the principal that an experiment has to verify the hypothesis, otherwise, it’s assumed to be false until proof arrives. Additionally, one contradictory finding can be sufficient to disprove a theory.
Psychiatry operates on the principle that what it says is true until proven false by its opponents, and allows that one positive study is sufficient to negate any number of negative ones.
If we are being scientific, your first question makes no sense. The real question is whether psychiatry has any proof that any “mental disorder” IS a molecular medical disease. In the absence of such proof, we have to assume that it is not. Such proof has been sought for years, but is not forthcoming, and every “proof” that’s been offered has been discredited. There is no currently supportable theory for the cause of ANY mental health disorder. And why would there be, when these “disorders” are decided on by committees of psychiatrists, many of whom sport long lists of conflicts of interest with pharmaceutical companies?
Science is the ultimate form of skepticism. A real scientist doesn’t try to prove his theory correct, he does everything he can to prove it wrong. Only when it holds up to that kind of scrutiny is it accepted, and then only pending new data that may conflict with it. If psychiatry operated on that basis, there would be no psychiatry.
Nor is there any long-term social or emotional benefit to stimulant use over time. I have no problem with individuals using stimulants if they know the risks and are willing and able to take responsibility for them. But forcing kids to take stimulants that don’t enhance their long-term benefit just because it makes them easier to deal with is just plain dumb.
By the way, I don’t know if you are aware of this, but there was a great study back in the 80s showing that “ADHD” kids were indistinguishable from “normal” kids in an open classroom environment where they had more control of their time and activities. We had all our kids (two of which are classic “ADHD” types) enrolled in this type of schooling, and none took any medication and the two “ADHD” types both graduated HS with honors, and the youngest is currently enrolled at Evergreen State College. I don’t think they needed amphetamine “glasses.” They needed to learn in an environment that respected their personalities and learning styles. They got it, and they did just fine.
Carl must finally be feeling heard by someone! Good for Gov. Carlson for publicly taking a stand on this. I’ll be interested to hear how it goes forward.
I agree completely. My parents modeled kindness and tolerance, but they also modeled sweeping conflict under the rug and denying the presence of emotional suffering. They are good people and tried their best, but my mom was overwhelmed by 4 kids under the age of 5 in a day before support groups and indoor parks and the like. So we were neglected, emotions were stuffed, and we had scapegoats, none of which were able to be talked about. I managed to have some more healing conversations with my dad later in life, but going back over what had happened in the past continues to be taboo to this day, including among my brothers.
I have no intent to be hostile or blameful toward parents, but it is important to recognize the damage that can be done, even from innocent behavior on the part of the parents. They were children once and were hurt as well, just as we were, but it is my belief that being able to consciously face those hurts allows us not to pass them on to our kids. It’s something we can actually do something about, rather than blaming our brains and waiting for magic pills to make it all better. It just bothers me that discussion of family dynamics, beyond overt abuse, just never seems to be allowed in many current therapeutic circles. Just like my family, come to think of it!
Very true! Until you change the lens people are looking for, campaigning for “justice” may be interpreted as meaning you want more of what’s already being doled out!
This is a very important and intense discussion, and I thank the author for provoking it!
I found myself both strongly agreeing and strongly resisting parts of this article. I do think there are many factors contributing to the increasing disability rates mentioned by Whitaker, and most are social and economic in nature. The collapse/undermining of community, the removal of other forms of economic support, the general move of dollars from the poor and middle class to the rich, all of these create a powerful push toward using disability as both an explanation for “failure” and a form of income.
I also agree to an extent that focusing EXCLUSIVELY on medication misses the larger point of how and why this is happening. However, I can’t agree that medication should be relegated to some kind of a background issue, as it has been a huge tool in helping to encourage and enforce the distorted view of “deviance” that supports the current status quo.
I believe that a critique of psychiatry needs to focus on the use of both DIAGNOSIS and “TREATMENT” as a means of blaming the victims of the very oppression you rightly identify as central to the disability trends we see. Framing any discomfort or upset with the current system as a “disease” avoids confronting the real social issues that face us. While I’m sure you agree with that last statement, what you don’t identify is that psychiatry has PROVIDED this “out” to both the victims and oppressors.
Second, I think the data absolutely shows that psychiatric drugs do, in fact, increase the likelihood that a person will not recover from his/her “disability,” whatever the social and political reasons they may have been driven down that path. Whitaker provides a strong biological explanation for how this happens, and it is completely coherent with prior research into drug addiction and withdrawal. Interestingly, the exact same thing has been recently observed about pain medication, the other arm of increasing disability – short-term use of pain medication leads to relief, but long-term use leads to the drugs becoming ineffective and pain levels actually increasing. Managing long-term discomfort with drugs is simply not a viable plan, and that is absolutely true, over and above any of the socioeconomic issues you correctly raised.
Additionally, I agree with Alex 100% – in the move to stop demonizing parents, we’ve supported the ridiculous idea that parents are never responsible for their children’s mental/emotional suffering. This is, of course, a ridiculous proposition for anyone who has worked with abused kids or adults. Parental mistreatment is a primary cause of “mental health” problems, and this is actually part and parcel of the very oppressive structures the author has described. The family is a unit of society and often has embedded the same authoritarian social structures, including power imbalances, punitive structures, and excuses for the powerful continuing to be abusive. Alice Miller has written eloquently about this phenomenon. We will never make any inroads into addressing inequality and oppression if we let parents off the hook for harming the most oppressed and least powerful social group, namely, our children.
Finally, even if the huge rise in disability is not primarily driven by the drugs, it’s clear from the rising disability rates that we are seeing that the diagnosis/drug paradigm is not successful. The whole idea was that “medical” treatment of these “diseases” is going to lead to people who were previously unable to work and participate in society becoming productive citizens. It appears the opposite has occurred. Whether or not the drugs are directly to blame, this is a failed paradigm and it needs to be scrapped. And the main reason it has NOT been scrapped, and that “antipsychiatry” has gotten a bad name, is because psychiatry supports the oppressive social structures that continue to be viewed as the status quo.
In essence, it’s only a failed paradigm from the point of view of helping “mentally ill” people get better. From the point of view of institutionalizing oppression toward anyone disturbing the status quo, I’d say it works like a charm. I think the analogy with slavery is quite apt.
In some cases, they probably don’t want to see themselves as “mentally ill,” which I find a very understandable position. Normalizing rather than pathologizing seems to be a much more healing path for trauma victims (which means most of us!) Also, they may have a sense of what “treatment” they will likely receive and have decided it’s not something they want.
Another psychiatric success story. It is sad to hear how her body deteriorated over time due to the treatment that she received, and yet she continued to get worse over time. It is pitiful what passes for mental health treatment in this country today. The image of her getting a box with her stuff says so much about the lack of compassion with which these people are treated by the system that is supposed to help them. 99% of the focus is on medication, and almost none on any kind of social or emotional support. And when other programming is funded, it’s for the short term and is often stopped even when it’s successful.
I can easily see why this woman is opposed to loosening constitutional protections against enforced treatment, and I hope anyone reading can as well. This is not just a story about the ravages of “mental illness.” It is about a system that fails its patients again and again, and often ultimately results in their early death. We have to do better than this!
Agreed. Most Americans fully support a wide range of socialist ideas and programs, but don’t think of them as socialism because of the incredibly distorted view of socialism we’ve been fed. (Most people believe Socialism is the same as Communism, which most people also don’t really understand, but they know it is REALLY, REALLY BAD! I’ve also seen people equate socialism and fascism, which is a REALLY big confusion!)
Medicare, Social Security, and the GI Bill are three excellent examples of socialist policies that very few people would argue with. My favorite example of this ironic fact is an anti-government protester’s sign that proclaims, “Government, keep your hands off my Medicare!”
What side effects? What we will “discover” is that many people with “binge eating disorder” actually have a latent “bipolar disorder” which will be “uncovered” by the helpful Vyvanse. What could be bad about that?
Once again, a new disorder is invented so that a new indication and a new patent can be gained by a drug company. Any dimwit knows that taking stimulants reduces your appetite. Why are people so dumb as to not see through this transparent slimy manipulation????
Agree 100%. The “side effect” profile from at least decent therapy is much lower and of shorter duration if you decide to stop. The question of an evidence base for ‘switching techniques’ is a red herring, in my opinion. The time to switch techniques is when the ones you are using aren’t having a positive effect from the client’s viewpoint. If a therapist is in good communication with his/her client, and is committed to empowering the client to gain more control and agency in his/her life, it will be obvious if they are being successful or not and that it may be time to change the approach.
Bottom line, good therapy is not about techniques, but it’s about being present and emotionally available and creative and responsive to the needs of your client. There is no real training for that, except perhaps experiencing quality therapy yourself.
I also agree that the odds of finding such a therapist on the first go round are very small. Folks need to shop around for a person who works well with them and with whom they feel comfortable. I’d say three quarters of the therapists out there are mediocre to poor, so don’t give up if the first one isn’t great, but don’t put up with half-assed therapy, either. It’s definitely “caveat emptor” in the psychotherapy realm, but luckily it doesn’t usually result in permanent brain damage. (Unless they refer you to a psychiatrist, of course, at which point it’s time to run!)
Her respect for one client’s religious believe didn’t stop her from inducing seizures through electric shocks. I’d rather have my psychiatrist pray with me by a long, long way.
It is actually very strange how psychiatrists in particular but also many therapist are so reluctant to explore spirituality with their clients. Do we really believe that a person’s mental conditions are NOT related to their spiritual belief system in any way? Never? I suppose that’s the result of the pure biological model – those who believe this would view one’s spiritual beliefs as accidents of neurology having no relevance to your “symptoms,” or perhaps being a “symptom” in themselves.
Maybe they are asking the wrong question. Maybe it’s not what religion someone is, but whether they believe you are more than a collection of randomly interacting chemicals that needs to be asked. Of course, that last point is a religious belief as well, but is seldom recognized as such.
But you can’t patent this stuff, so it will never be mainstream. Besides, if you start making people better, you have to look for new clients – very inconvenient!
Oh, I don’t think it was due to a lack of imagination. It’s more an unwillingness to yield control. They have rigged all the outcome measure around “symptoms” so that the drug paradigm will be able to prove “success” (though even there, they often fail). If they moved to qualitative quality of life measures, the current programs would almost all be shut down. They know this very well, and so they stick with what they can control, namely, symptom management. It is not accidental – it is very much by design.
Can’t argue with you. It’s beyond odd that something like Tardive Dyskenesia is barely mentioned, and that the establishment is upset when telling people their drugs might cause suicide or homicide reduces prescription rates, but we’re very upset about male breast development. Maybe it’s a distraction tactic so that it can seem like they care when we know they really don’t.
Still, anything that makes people question the validity of these “treatments” is a good thing in my book.
Great article as usual, Kelly. I would add one caveat about which drug to start with: it may be important to start with the drug that causes the initial side effects that another drug is “treating,” regardless of half-life considerations. For instance, it is common in the foster care population I work with to see kids started on stimulants (and less frequently, antidepressants) and then becoming aggressive. At this point, they are diagnosed “bipolar” and put on antipsychotics. When someone complains that they are overmedicated, it is common to eliminate the antipsychotic first, which then exposes the aggressiveness caused by the stimulant, and the parties draw the conclusion that “he still needs” the antipsychotic. Whereas removal of the stimulant first generally leads to a better outcome, if people are willing to tolerate the brief but sometimes intense withdrawal/rebound period that almost inevitably occurs.
Thanks for your work – I hope you become a mentor for others who have seen through the chicanery that is modern psychiatry.
How is more people getting treatment a measure of better health? Would we consider that more people getting bypass surgery or more people taking antibiotics an indicator of improved physical health? What warped thinking!!
It also bothers me that anyone uses the term ‘behavioral health.’ Behavior doesn’t have health. Health is a characteristic of an organism or being. Behavior is something a being chooses to do.
When half the population is “mentally ill,” either something is wrong with what you’re measuring, or something is drastically wrong with the society that is making that many people suffer. In this case, I think both are true.
Yes, it is always easier said than done. It’s almost insulting sometimes the tone that they assume. But I have learned to read beyond that and check for the substance of what they are saying. I do believe that thinking certain thoughts leads to feeling certain feelings, but it is a big challenge to really change one’s thinking – that’s what good therapy is supposed to help us do, I suppose. But good therapy is exceedingly hard to come by. I lucked out, but that was back in the 80s. I’d say the odds of getting a savvy, flexible, empathic therapist on the first go-round these days is probably in the 1/20 range or less. Everyone wants to diagnose you, but nobody has much to offer in terms of the “how to” question you so aptly put. I guess my only answer, in referencing my own path, is that it is a lifetime journey that continues every single day. And nobody is “just happy.” Life can be very tough, as yours has, and the world we live in isn’t exactly overflowing with empathetic concern for those who are struggling. I guess we who see more clearly have to be there for each other, ’cause no one else is going to do it!
Unfortunately, US Government websites are often similarly inaccurate. Part of the problem is that inaccurate information is actually accepted as medically and scientifically accurate by such a large part of the medical community that dissenting voices are drowned out. Consider the “chemical imbalance” concept, discredited for depression in the early 1980s and yet alive and well in millions of websites and doctors’ offices across the country. Marketing has long since trumped science, in all of medicine, but especially in psychiatry. “Caveat Emptor” indeed!
Meditation has been a life saver for me. I was fortunate to have lucked into a good therapist on my first try, and this was in the 80s before every manifestation of emotional discomfort was a reason to drug someone. (Though she did offer to connect me with a doctor who could prescribe Valium, as I recall, which I immediately and scoffingly rejected). Self-help books have also been a godsend. I particularly like Dr. Wayne Dyer’s “Your Erroneous Zones” and “Pulling Your Own Strings,” as well as “When I say ‘No” I feel guilty,” by a Dr. Emmanuel Smith (I think). Walking in the woods, riding my bike, and just sitting in the sunshine breathing in the clear air can also be highly therapeutic.
I know you feel broken, but you sound like a person with a strong spirit. Sometimes those of us with strength end up seeing things from a deeper perspective, and that can be painful. I consider myself one such person. There is a lot of ugly crap going on that can obscure how beautiful the world actually is. Sometimes just getting into the moment and appreciating the miracle of life is the best therapy of all.
Another option to consider is a hotline. There are lots of local, statewide and national hotlines for a variety of purposes. It can be super helpful if you’re feeling lonely and just need someone to talk with, or if you’re having an immediate crisis and need another perspective. Many are staffed with volunteers who have been through similar things and can empathize.
I think the hardest thing is finding people who can accept what is going on and don’t condemn or look down on your for having some difficulty dealing with what life has been like for you. The best thing of all is to have someone really listen deeply and be interested in hearing your story. Keep looking and don’t give up until you find at least one person who can do that, and then don’t feel bad about using the help they offer. You deserve and need some support that you are not getting, and I can promise you that conventional psychiatry will never be able to provide that support. There may be individuals in the system who buck the trend and really care, so look for them and latch onto them if you find one, but anyone who is trying to tell you that drugs are the answer is selling you down the river. You’ve tried that, and it clearly has not led to a better life. Time to try something else, eh?
Sounds like a new psychiatrist might be helpful, but only if s/he listens to you! You sound like a poster child for why drugs as a primary solution don’t work very well. If they were effective, they would help people become less disabled and more able to work, but it’s clear that you have not had that experience. You are absolutely right that Lorazepam should not be prescribed for the long-term, and yet the doc continues to prescribe it contrary to the manufacturers’ own recommendations. The Paxil stopped working but the doc doesn’t want to change it. Why not? Is he getting kickbacks from these companies? That’s just bad doctoring, plain and simple. If something doesn’t work, it needs to be discontinued, but that almost never happens in the world of “mental health.” Instead, you get a new diagnosis and new pills.
Based on your diagnoses, I’m going to hazard a guess that you have experienced significant levels of trauma earlier in your life, and perhaps right up to the present day. I get the impression that this doctor doesn’t give any credence to the impact of earlier experience on your current functioning, but is focused exclusively on manipulating your brain chemistry. Many years of experience as a counselor have convinced me that dealing with the impact of history is the most effective way to actually reduce anxiety, depression, and emotional instability. How to do this varies greatly from individual to individual, but I have never seen drugs do anything more than temporarily decrease symptoms, and without any other substantive intervention that deals with things like PURPOSE, SELF-CONCEPT, POWER, and RELATIONSHIPS, giving drugs does not usually lead to anything but ongoing dependence and disability.
I say this not to discourage you, but to encourage you to seek other pathways to healing. One very simple and generally free option is a support group for people who have been through similar experiences – not based on diagnosis, but on history, such as exposure to violence between parents, to child abuse, or to domestic abuse in adulthood. These groups connect you with people who understand your emotions and reactions, rather than treating you like there is something wrong with you. From there, you may be able to get some recommendations for therapists and even psychiatrists who actually deal with the consequences of life trauma, rather than treating you like a brain on legs that needs to be chemically manipulated, rather than understood and supported.
I hope this is helpful to you. I want to validate that your psychiatrist is missing the boat, and is clearly not listening or treating you with basic respect. S/he is treating you as a subordinate whose opinions or observations are of no interest. This is insulting and hurtful, and certainly does not lead to any kind of healing. There is a better way to go.
Take care of yourself, and feel free to respond – I will check and continue the conversation if you would like to do so.
A class action lawsuit is very much overdue. I’m sorry you have been damaged so badly by this senseless paradigm. I hope it helps to know you are not alone.
All of what you said COULD be an explanation, but it is no more supported by data than any other explanation. As a matter of fact, if you read the book, you’ll find that Whitaker’s explanation is much more consistent with the data than the possible hypotheses you put forward. There is a clear biochemical mechanism that explains why taking antidepressants in the short term can produce more chronic depression. And you also fail to take into account that if antidepressants really work as promised, a good percentage of those taking antidepressants would become well again and be able to work.
There are confounding factors, but considering that this phenomenon is occurring in multiple countries around the world, with big variations in government assistance programs and employment rates, it’s hard to argue that it’s all because of social variables.
You need to read the book. Your explanations are more comfortable for society at large, but that does not make them true.
Oh, don’t assume they can’t get patents. They’ll come up with a new name and a new time-released dispersal method or claim that it’s for a new indication, and they will be able to patent it. Zyban happened when Wellbutrin’s patent ran out, and it’s exactly the same stuff, except being repurposed as a smoking cessation drug.
Again, if people find this helpful, it is up to them to decide to use it. I’m glad that for now it’s not academic psychiatry doing the research, but the concept unfortunately reinforces the “chemical cure for a chemical imbalance” theories that psychiatry is based on. I am more of a Moncriefian regarding drugs – they have effects that people may find helpful, and if so, people can use them, but they aren’t treating “mental illnesses” unless we have objective evidence of a physiological anomaly that can be tested both before and after treatment. As an example, alcohol is perhaps the best antianxiety agent available, and it’s available at a low cost at your local bar or grocery store. People who feel tense have used it for time immemorial to relax, and I have no difficulty with that. (Of course, dosage control can be a bit of an issue…) But when someone starts telling me that alcohol is a “treatment” for an “anxiety disorder,” I would draw the line. It’s just a drug that makes you feel better temporarily. The psych drugs are the same.
So if you can figure out a way to divorce it from “mental health treatment,” I’d be on board with the experiment. I just worry that it will be another opportunity to blame distressed and suicidal people for suffering in a society where suffering is the common outcome of the bizarre ways in which we’re supposed to live.
I think the issue here should be less whether psychedelics may have some potentially beneficial effects on certain people under certain conditions, but rather on whether psychiatry will attempt to co-opt this possibility and turn it into yet another life-threatening product promotion to make bunches of money while continuing to deny the reality of oppression and abuse that lies behind most emotional suffering, and especially behind most suicidal thinking and behavior. I totally support people being free to seek spiritual enlightenment by whatever means make sense to them, but I don’t support psychiatrists or anyone else repurposing such drugs as “medical treatment” for suicidality. I agree with commentors who see this as a potentially dangerous line of research, not because I think LSD or psychedelics are inherently bad or dangerous, but because I think the current tenets of psychiatry are dangerous and will certainly be able to generate dangerous outcomes out of any potential good that might come out of psychedelic use.
Once again, you write an incredibly forceful and moving blog about such an important topic! Much of what you say gets to the roots of why the DSM-based paradigm is so destructive. It’s easy to get caught up in arguments about medication side effects and scientific bases for treatment and forget that the entire enterprise is based on one big delusion.
Of course, the real difference between a “delusion” and a dogmatically held irrational belief system is how many people you can get to agree with you. The psychiatric/DSM delusion only works because so many people believe in it. I prefer the “delusion” you are spinning here, as it’s far more likely to actually lead to people becoming more aware and more competent and in control of their own lives, which in the end is what any good therapy needs to do.
Thanks again for sharing your beautiful and scientifically grounded essay!
Kind of a misleading title, considering that some of the approaches did appear to have some effect.
I’d also love to see the question of whether any pharmocological approach actually reduces this behavior (other than drugging the person to the point they are unable to act). What I know of the literature suggests the answer is “no.”
I suspect a more sinister motive. I believe Big Pharma doesn’t want this research done because their antidepressants will be identified as a big causal factor.
Yes, medications DO change receptor density. Unfortunately, it’s in the wrong direction. Have you read up on neurological up- and down-regulation, where the brain reacts to increasing a certain neurotransmitter by decreasing the number of receptors for that transmitter, and vice versa? This is not new science, and lies behind both tolerance of and addiction to psychoactive substances. The analogy with psychiatric drugs is complete, and Whitaker summarizes the research showing that the same thing happens (as any rational person knowing the data might expect) when we increase Serotonin or decrease Dopamine. Look up “supersensitivity psychosis” and “tardive dysphoria” if you don’t believe me.
“These patients come to us very sick, and leave not much better.” That quote from you above says it all. The drug paradigm is good at addressing short-term acute episodes but does not address long-term recovery, and may in fact impede it. This is not that different from other parts of the medical profession, where we are great at addressing a heart attack, but engage in pointless and expensive protocols like prescribing daily Lipitor to everyone with a history of heart disease, even though the drug’s track record shows little to no improvement in outcomes and a massive increase in side effects.
And you’re not going to get away with the “must have been misdiagnosed” evasion either. People are diagnosed with schizophrenia based on behavioral/observational criteria, not on some underlying physiological defect that can be tested for. Hence, anyone who meets the description, unless there is some other known cause, qualifies as “schizophrenic” for the purposes of research. If these people do better in Finland or Columbia, you can’t get away with saying “Oh, they didn’t really have it.” The phenomenon called “schizophrenia” plays out differently depending where you live and how you treat it, and treating it with drugs appears in many cases to take what might have been an acute episode and turns it into a chronic disability.
I noticed you did not respond to my comments regarding Wunderlink and Harrow, which I think are pretty devastating to the idea that “schizophrenics need drugs for life,” as both come from very mainstream researchers. Nor did you address the 80% social recovery rate reported by the Finnish using the Open Dialog method, nor the exceptionally better outcomes for second- and third-world nations for schizophrenia compared to ours.
I haven’t really seen an intelligent rebuttal of Whitaker’s work. I’ve seen a lot of disingenuous ones. I’d like to see you take on the actual data. So far, you are talking from personal anecdote and the assurance that you’ve somehow done all this research which you have not shared with us. It is hard to take you seriously when you are not dealing with the actual data that is known.
The bottom line is, whether they expressed discomfort or not, they ultimately went along with the program despite their internal sense that it was wrong. That was the real lesson of the experiment. Not that people are horribly sociopathic on the average, but that when told by an authority figure that something was acceptable or necessary, even if they found it personally repugnant to do so, few could seem to muster up the courage to refuse to participate, even in the absence of any looming punishment. If we add in additional negative consequences for failing to comply, and the odds of a human acting against his/her own conscience in the face of authority directing them to do so seems sadly to be very small.
Once again, we prescribe these things without the slightest idea of their safety profile, and wait until kids are harmed before even bothering to ask these questions. We should be assuming risk until safety is proven, not the other way around. Crime, indeed!
I think it depends a lot on the attitude of the professional you are working with. If they are able to see the label as a shorthand description of the challenges the child faces, and providing some professional guidance for how s/he may intervene to improve the situation, that is one thing. The difficulty comes in when the professional begins to see the child in terms of the label, as “disabled” rather than “differently abled” and having strengths in other areas that could be used to help with the challenges they face. I think the analogy with ADHD is quite apt – these so-called “ADHD” kids genuinely DO have difficulty attending to something they find dull, and it does create difficulties for a standardly-structured classroom. However, they also often bring other strengths such as stubborn commitment to a goal or objective, willingness to tolerate discomfort or conflict to accomplish their mission, an ability to think creatively and find alternate ways to solve a problem, and so on. Not to mention that they may have other challenges they face that are only expressed in the classroom through their lack of interest or distractibility, but might be something that could be addressed if anyone bothered to take the time to ask them why being in class is difficult. Further, it’s been shown through research that these kids are virtually indistinguishable from “normal” kids (on the average) in an open classroom structure where they get to make more decisions and have more control of their time and activities. Yet it is rare that they have the opportunity to try out that option, because people think that the label means they are deficient and need to be “fixed” rather than considering changing the expectations they’re exposed to.
I am sure much of this is applicable to kids with the “dyslexia” label. I am always happy when people recognize that there are unmet needs, but I hate to see these kids channeled into some “program” without someone bothering to take the time to figure out what is behind their reading challenges. Calling it “dyslexia” may be a good first step toward making folks aware of what is going on and starting to think through what options may be available to help, but too often, I find it’s a last step toward lowering expectations and creating “programming” that is more designed for the convenience of the teachers than the needs of the kids.
Don’t get me wrong – there are plenty of smart, creative, hard-working special ed teachers out there who do a great job. But I do find the labeling process dangerous, because it allows people to begin to think they know something about a kid and to stop looking further for both causal factors and possible solutions.
My new analogy is this: if two people were hit by a car in the leg at the same speed and angle, and one of them got a broken leg and the other one did not, we could perhaps surmise that the one whose leg was broken was somehow more genetically susceptible to broken bones. Would we spend a lot of time doing genetic research to determine what caused his potentially weak bone structure? Or would be place the blame on the actual causal agent – THE FREAKIN’ 2000 LB CAR that just whacked into your body!
I am going to start trying to change the terminology when people say “mental illness” and substitute “mental injury.” It’s a more accurate term and puts the blame where it belongs – ON THE FREAKIN’ CAR!
There is actually solid evidence from more than one study showing that doctors rarely believe they are being influenced by pharma marketing reps, but that based on their prescription writing, they are in actual point of fact dramatically affected by these visits. It is hard to combat subconscious influences, especially if your pride prevents you from honestly asking yourself if you are being influenced, as appeared to be the case for most doctors. Bottom line, if it didn’t work to increase prescription writing, the pharmaceutical companies wouldn’t spend the billions they do sending these guys out.
I also recall when I worked at a large mental health program how a client may have spent weeks or months getting onto a stable medication regime they were comfortable with, only to be required to change psychiatrists, and I’d say three times out of four, the new psych would change the prescription despite the client’s hard-won stability. Why would they do that, I wondered? It eventually occurred to me that each psychiatrist had his/her “favorite” drugs, and that it was more than possible that their favorite was at least partially determined by financial relationships to the manufacturer. Later research has shown this to be true – many practicing psychiatrists get funds in a number of ways from big pharma companies, and I can’t imagine it happening without a level of demonstrated loyalty from the psych. I can’t even rule out the possibility of direct kickbacks, but it wouldn’t have to be that corrupt to have an effect.
I’ve worked in the system, too, and I’ve certainly seen people who did better while maintained on some kind of medication regime. But I’ve also seen people punished and humiliated for disagreeing with the doctor or demanding some more helpful treatment than they were receiving. And I’ve seen many people diagnosed with “bipolar disorder” or “ADHD” when they were clearly severe trauma victims, and I’ve seen many BECOME “bipolar” as a result of stimulants or SSRIs, but almost never see anyone stop the offending treatment to see if the symptoms will abate.
There have been plenty of successful weanings off of antipsychotics, and the more enlightened psychiatrists of today (though few in number) are realizing that episodic drug treatment combined with psychosocial support and therapy is a lot less damaging to their patient’s brains and makes actual recovery MORE likely.
You really should read “Anatomy of an Epidemic,” the book on which this site is based. It may slay a few of your sacred cows, but it may also open your eyes to the fact that not everyone finds these medical interventions as helpful as your somewhat biased sample reports.
Plenty of “schizophrenics” return to pre-morbid functioning. And more used to, before the prominence of drug treatment, which (if you would take the time to read Anatomy of an Epidemic, which I doubt you have) is increasingly being shown to increase the likelihood of chronic mental dysfunction, rather than decreasing it as promised. Some examples: the WHO studies, done twice in the 90s, showing that people in countries that use less antipsychotics have much better recovery rates; the Wunderlink and Harrow studies, showing that long-term recovery from schizophrenia is fairly common, but is made less likely by long-term use of antipsychotics; and the Open Dialog program, which boasts an 80% social recovery rate (people fully participating in normal social functions like employment, relationships, community engagement, etc.) with only 20% of the participants continuing to take antipsychotic drugs on a regular basis.
I am afraid your faith in doctors is also quite misplaced. Look up the saga of Joseph Biedermann, who promised J&J to get a positive result for their drug, Risperdal, before he even did the experiment. Consider also the well-founded research showing that head-to-head drug studies almost always favor the drug from the company funding the study, and the continued promotion of the idea that depression is caused by a reduction in serotonin, when that theory was disproven in the 1980s. Also consider that Peter Breggin was talking about the increase in aggression and suicide in SSRI users in 1992, but it took the psychiatric industry over 10 more years and a black box warning from the FDA to admit it is an issue (and many still argue that it is not, despite solid evidence supporting the concern.) Add other medical scandals like Viiox in the non-psychiatric field, and it’s hard to understand where your faith in the medical profession is founded. Doctors cause over 200,000 deaths annually, according to a study in the JAMA, clearly a mainstream source, and more than half of the deaths were due to medication side effects. I am sorry if this disturbs your faith in the medical community, but I am afraid the actual facts say that such faith is dangerously misplaced.
There was a somewhat similar study back in the 70s looking at the impact of the ADHD label on teacher behavior toward students. They found that those kids who got the ADHD label got LESS academic attention and support after they’d been labeled and medicated, because the teachers believed the medication had solved the problem and they did not need to attend to it. Identifying the specifics of a problem and the child’s strengths can really contribute to a better solution, but I don’t believe labels, including dyslexia, are really very helpful in making things better for kids. And this study confirms my own observations.
If I had the choice of a year in jail or a year in the psych ward, I’d choose jail for sure. At least there is some kind of regulation as to what guards are and are not allowed to do. In the psych ward, you are truly at their mercy, and a lot of them don’t have much of that.
Allowing people with power to justify their violence is a core principle of our society, and it runs from a parent physically abusing a child “for their own good” right up to starting wars with foreign countries because they are somehow “a danger to the world community.” As usual, you have hit the nail on the head, Sera, and we need to really get past bias toward a particular group and see the similarities in all of these varied situations. People in power need to be held accountable or they are capable of horrible things, even those who are not horrible people. Nazi Germany, Abu Ghraib and the Milgram experiment all tell us that no one has to be evil to do evil things when the system allows or encourages it. Perhaps it’s authoritarianism that is at the base of it all and that’s what needs to be attacked.
Another mind-blowingly powerful post, Sera! Thanks as always.
The reasoning is quite simple, actually. Antipsychotics are, by assumption, automatically good. Antipsychotics cause brain thickening, therefore, brain thickening must be good. If they also cause brain thinning, then brain thinning must be good. As long as antipsychotic drugs caused it to happen, it must be good, because we know how tremendously helpful antipsychotics are.
I think the main reason people resist the term “antipsychiatry” is because it’s been used to marginalize critics and associate them with radical/irrational/religious motives and paint them as “anti-science.” All of this, of course, is predicated on believing that psychiatry has anything to do with “science.” Personally, I prefer to avoid generalizing labels of any type, and view myself instead as a person who is opposed to oppression in all of its forms, and who sees psychiatry and psychiatric diagnoses as fundamentally oppressive in nature, and therefore something to be opposed. Not as quick to say, but a lot more descriptive!
Or as Don Juan would have reminded us, reality is simply a matter of perception. Agreed-upon reality exists as such because so many people agree on it. What happens when we let the idea that this consensual reality is the only way t0 perceive the world?
I wish I knew! I think time passing allows some healing to take place, but I’m not aware of anything that can undo the damage other than the body’s own natural healing capacity. Anyone have any ideas?
Glad you resigned. Everything you have said about NAMI resonates with what I’ve heard and experienced. There are some well-intended people in there, but they as a rule tend to freak out when anybody questions the dominant paradigm or starts talking about the rights of “mentally ill” people to make informed decisions. Not all branches are like that – there are a few exceptions, but the national leadership tends to be 100% behind the diagnose-and-drug strategy, and lets parents and society off the hook completely as possible agents of mental distress.
And Sera is correct, this board doesn’t turn over fast enough to expect a 4-hour response, especially on an older thread. It’s more reasonable to expect something in a couple of days, unless it’s a very new and hot thread.
Hope you’ve found someone more helpful than NAMI in your community!
It all rests on the assumption that deviation from “the norm” is de facto always bad. If that assumption goes away, the whole argument is ditched.
I also think it’s fascinating (in an aftermath of a train wreck sort of way) to see how certain bell curves are only considered “abnormal” at one end. Does no one notice, for instance, that there is no “Hypoactivity disorder?” Why would that be, if deviation from the norm is bad? It’s clearly because low activity doesn’t cause problems for teachers and other adults caring for the child. I think it would be a lot more honest to call it “Adult Annoyance Disorder,” because it’s clearly based on how annoying the kid is, rather than his/her activity level per se. And that would also make it clear that it’s the adults’ needs that are at issue here, not the child’s.
Anyway, I’m happy to have such a clear elucidation of why using a bell curve to define “disease states” is both stupid and unproductive, unless you’re interested in profits and/or social domination. Not everyone is “normal,” or needs to be. Otherwise, we’d have to drug all of our creative geniuses into an inactive stupor. But wait a minute… that IS what we’re doing, isn’t it?
The lack of a model for these problems is, indeed a huge issue. But perhaps more concerning is that the definitions of these “disorders” get in the way of developing such models, because it is assumed that everyone meeting the criteria for “bipolar disorder” has the same problem and requires the same solution. So not only do we not have a working model, we have a confusing, non-working model that is purported to work, and all research is filtered through these warped lenses. I only wish Psychiatry as an institution were interested in finding a logical model for understanding “mental illness” differently, but it’s clear that this is not going to happen within the field, as they are married to their warped “chemical imbalance” model, regardless of evidence to the contrary, and even a REAL iatrogenic chemical imbalance (like that caused by antidepressants resulting in a manic episode for some users) is still dismissed as irrelevant and forced to fit into the pre-existing paradigm.
Totally agree. People mistake “professionalism” for not having or displaying any emotions or reactions to the client. This just makes you seem cold and unfeeling. In my experience, people need to know you’re real, need to see you step down from your power position and let them know that you’re just another person trying to figure out how to get through a complex world. I very commonly share my own emotional responses, in a rational way (not ACTING on them but describing them) in the context of helping understand what is going on. I also find those emotions I experience to be quite informative as to how the client may be feeling. Acting like you have no feelings is yet another way for the “professional” to protect him/herself from experience the client’s reality. Unfortunately, it usually prevents you from helping them as well.
I am guessing that the two facts are related – few people fill them out because they know that most of the time, they will be ignored. It says a lot about our lack of respect for the so-called “mentally ill” that we can’t even respect their clearly stated wishes in writing. Most discouraging.
They may not reduce aggression, but they are quite effective at reducing lifespan, apparently, leading to a black box warning against using these drugs on the elderly. But of course, they’re still used every day, all over the country, with impunity. Class action lawsuit, anyone?
LOL! You are so PRIMITIVE, B! Why bother actually communicating when there is a technological way to get information without the discomfort of actual personal interaction?
If your conception (or psycyhiatry’s) of psychosis is credible, how do you explain the fact that schizophrenia-diagnosed residents of developing countries (like Columbia, Brazil, India) do dramatically better in terms of long-term outcomes than those who receive all the best of Western medical technology? Or that Open Dialog, which uses antipsychotics extremely conservatively and focuses primarily on a family/community intervention, has the highest success rate of any known treatment approach, by an order of magnitude? Or that schizophrenia is more common in immigrant populations and racial minorities and in urban settings?
I do agree with one point – research is showing that providing housing and food and meaningful work are much more important than insisting someone “take their meds.” Unfortunately, that’s the exact opposite message from what most people diagnosed in America today get. They are told they have a lifetime illness, that they should give up on their aspirations and resign themselves to living on disability, that they will be unable to work or otherwise have a normal life and won’t be able to survive without constant psychiatric support. And at the same time, we consign them to lives of poverty and don’t even provide the minimum support for survival.
And as for the “bad mothering” argument, the association between psychosis and early childhood abuse and neglect is quite robust, 10 or 20 times stronger than the most optimistic genetic correlation currently percolating around. The fact that most abused children don’t develop psychosis by no means should leave parents and society off the hook. As an analogy, if two people are hit by a car in the leg at the same angle and the same speed, and one of them breaks his leg and the other one does not, we don’t blame the guy with the broken leg for having weak bones. We know the car caused the damage, but each person’s body is different and responded differently to the harm. Psychological injury is very real and can cause any of the manifestations we call “mental illness.” It’s pretty disingenuous to suggest that war is not a cause of PTSD because only a minority of soldiers develop it. It wouldn’t have happened without the war, the war was traumatic, so the war is a cause. Maybe not the only one, but you really can’t say that everyone who doesn’t respond to our social system the way our society wants them to has a disease of the brain.
The “Dr. Feelgood” approach, when not motivated by unfettered greed, is often motivated by a desire to make OURSELVES feel better by making the other person’s pain go away as quickly as possible. Because the truth is, their pain is making us uncomfortable, and it’s our own pain we want to alleviate. The current paradigm makes it all too easy to rationalize taking this approach under the guise of “relieving suffering.” Of course, our goals should not be to merely relieve suffering, otherwise we’ll all end up on Xanax or Oxycodone and living in a daze.
What seems to be most helpful to people who are experiencing this kind of suffering is to have someone willing to BE uncomfortable with them and to sit in and feel some echo of the pain they are experiencing. Only then does the person stop feeling like they have to make the “helper” feel better and feel able to open up and be honest with you and themselves about what is going on. At least that’s my experience. So in essence, the whole idea of diagnosing and medicating appears to be diametrically opposed to what I’ve found people in distress need the most: an open, safe listener who isn’t going to judge or direct or control them but is simply going to listen and be interested in understanding the problem, and help the suffering person start to generate some potential solutions that might make the situation a little better from their own point of view. Anything that puts the sufferer in the place of feeling like they have to make the caretaker feel better prevents any real psychological healing, in my view. So I agree with Richard, the current system appears to meet the needs of the helpers more than the people being “helped.”
That’s good information to know, Darby! So I guess it would only be radical or new if this kind of approach was adopted as standard practice. I guess it’s not surprising that this isn’t a new idea, but it seems quite contrary to everything I am seeing in day to day practice. I hope the concept catches on, but I’m not holding my breath…
The biggest joke is that these “correlations” they “discover” involve dozens of genes, and yet are associated with these “diseases” no more than 15% of the time, even in their most optimistic and probably distorted estimate, even when you include a range of diagnoses instead of just schizophrenia. If something were CAUSED genetically, we should see specific associations of 90% or higher with a very specific condition, and that condition should rarely or never occur when the causal factor is absent.
It is also fascinating how completely the associations with trauma and social conditions are dismissed, even though the correlations with these environmental events is always many times higher than the most optimistic estimates they’re ever able to generate.
It is truly a ridiculous and fruitless effort, akin to the alchemists’ efforts to transmute lead into gold, or perhaps even more reminiscent of middle age religious philosophers trying to figure out how many angels fit on the head of a pin. But they can’t be faulted for lack of loyalty to their principles, even in the face of impending humiliation and utter defeat! Great characteristics for a religious leader. For a scientist, not so much…
This is an amazing series! I recommend that everyone reads all four parts. I work in foster care advocacy and this series captures what is going on incredibly well. I only wish we could get the NYT or someone big to pick it up. It’s great research and great writing telling a story that really needs to be told.
It is worth noting that they say that behavioral interventions are difficult to implement due to high staffing ratios. So that they’re really saying is that we’re not willing to deploy the human resources necessary to actually meet their needs, so instead we can use shock treatment to force them into a more quiescent state while still shortchanging them on attention and effective intervention. It’s particularly offensive to read this when considering that many if not most of these folks are in for-profit nursing facilities who make more money for their stockholders by minimizing personnel costs. Naturally, drugs and ECT are much more appealing to people who are more interested in the bottom line than the actual quality of life of their charges.
It is sickening that this is even spoken of in such polite terms.
I find it very telling that the discussion of “convergence” (collaborative efforts between disciplines to achieve a higher-order result) discussed neurobiologists working with engineers and physicists, but did not include a collaboration between neurobiology and psychology or spiritual studies or social work or sociology, or even economics. And of course, his analysis of why studies are hard to replicate completely dismisses malfeasance and corruption as primary causes, despite strong evidence that studies tend strongly to favor the institutions funding them. It goes to show both how far on the wrong track Insel and his minions are, and how completely dedicated they are to continuing to travel down that track regardless of the gaping chasm with the bridge out that lies ahead. These guys are only interested in controlling and manipulation and treating human beings like machines to be tinkered with. They have no interest in the experience of the “machines” they believe us to be. It is such a completely bankrupt institution, yet it continues to be funded to the tune of billions a year. I hope he will manage to work himself into the anachronism status he deserves.
Legitimate critique and skepticism is not “stigma.” This would be like suggesting that there is a “stigma” against child molesters, who after all just have a particular preference, which may even be genetic, they can’t help themselves, so why all the hoopla? Psychiatry as a profession has been incredibly dishonest and manipulative, not to mention dogmatic and defensive when legitimate critiques are raised. Dr. Read’s article is the one that gets to the point – when psychiatrists stop being arrogant know-it-alls who aren’t really interested in either scientific data or their own patient’s reactions to their vaunted “treatments,” then may be the well-deserved “stigma” toward psychiatry might begin to abate.
Or as one person shared as their one-line wisdom for life: “Don’t be a dick!”
It is pretty astounding to see this research in a professional journal. I will definitely be referring to it in the future, because this is what I’ve observed over and over again. People stop taking the drugs either because they don’t work or because the side effects are intolerable, or both. It also affects the way people think about themselves, and many feel they are better off finding a way without the drugs because these other approaches are sustainable and self-determined, rather than relying on an external force to alter their moods. Very few don’t feel they are suffering or believe there is no issue to be addressed. The “lack of insight” explanation needs to go on the trash heap of self-serving theories that don’t bear much if any relationship to reality.
I agree 100% with your analysis. I would only add that in psychiatry, there is an element of intentionality that isn’t always present in other areas (like childbirth) that are plagued by mythology and perverse incentives. History tells us that psychiatry made a conscious decision to “sell” the concept that mental illnesses are biological and treatable by drugs. This was clearly a marketing tactic not based on even a warped misconception about what the science says or on some pre-existing traditions that conflicted with current knowledge. It was a marketing decision by a trade organization that was palmed off as science, at the very same time that scientific investigations were showing that the theories underlying the “message” were false. Given the subjective nature of psychiatric diagnoses, I consider the level of irresponsibility to be much higher when a political decision led to a huge change in how people were categorized and treated, which was knowingly embarked upon despite known contradictory findings. It is similar to the intentional suppression of nursing in the 50s in order to sell infant formula (and continued to this day in third world nations by Nestle Corporation, among others) despite knowledge that nursing is the superior option.
While medicine as a whole is massively corrupted by money from Big Pharma, and some similar scams like “erectile dysfunction” have a familiar feel to those of us knowledgeable about psychiatry, the degree of systematic and intentional distortion around the entire field I think puts psychiatry on a uniquely unstable footing ethically, even in comparison to the general corruption of medical science. While I agree that there are plenty of practitioners who entered into this with an honest desire to help, the field itself is so corrupt in its very foundations that it is hard to see any way it can be salvaged, except, as I said above, by removing it from the field of medicine entirely, where it really does not belong.
There is clear emerging evidence that psychotherapy does, in fact, work for psychosis, at least initially when not complicated with brain damage caused by psych drugs.
There is also plenty of evidence at this point that antipsychotics, far from helping people become more functional, end up creating increasing numbers of disabled persons over time, as you’d know if you read Whitaker or were even up on the latest research from Harrow and Wunderlink, among others.
Tusu, you’re going to have to do better than repeating platitudes to convince anyone that your views are anything more than a stance you’ve chosen to adopt. You make these claims but provide absolutely no basis for them in research. It’s kind of an “everybody knows” sort of an approach, and it is frankly a bit insulting to those of us here who’ve spent a lot of time reading the actual research. If you have studies in mind, please provide us names and links if available. Otherwise, I don’t think anyone here is going to take you seriously.
It seems the centerpiece of this well-argued piece is that psychiatry as a sub-specialty of medicine is part of a much larger movement toward promoting illness when none exists. The only conclusion I can draw from this is that including psychiatry as a medical specialty is a mistake and that it should be eliminated as such, leaving psychological/emotional/spiritual healing to the lay public and to agencies whose job is to care for people rather than just bodies.
I appreciate the inclusion of childbirth as an area with a great deal in common with psychiatry, including warping of informed consent and the de facto use of force and unnecessary medical interventions on a routine basis.
Yes, there is definitely something very, very wrong with modern medicine, especially in the USA, and it has a lot to do with financial incentives and corruption. It’s hard for me to imagine psychiatry, with its inherently subjective and socially-embedded definitions and dogma, to function in a truly helping way within the confines of the medical establishment you so aptly describe.
I agree with you, there is no sense in completely denying that biological causes may exist or that biological processes may exacerbate psychological problems. For instance, few who have experienced the psychiatric adverse effects of prescription or non-prescription drugs will be able to deny that the brain is massively effected by these chemicals and a number of unusual mental states can be induced by them. (Only time I was really paranoid was after being slipped mescaline in a drink!) I think the biggest problem in psychiatry is the semi-arbitrary grouping of people by their “symptoms” and assuming that all “symptoms” have the same cause and require the same intervention. It seems quite bizarre to me that they are spending SO much time trying to “prove” some degree of heritability when you can’t really do anything about that anyway. Why don’t we focus on the things we DO control, like the stressful environment, and just accept that different biological substrates may be associated with different reactions to the same stressors. Seems like a lot of time wasted to prove something kind of obvious and not very useful in determining how to help.
Yes, that’s the ticket! We restrict guns for all white males. Or for males altogether. I bet that reduces the gun violence rate dramatically, and without even needing a diagnosis. Or I suppose we could invent a new one: Excessive Testosterone Disorder (ETD).
I agree with Stephen, and I’ve seen this and heard this reported from SSRI users – one even had a name for it – she called it “Zolofting.” It’s basically a “I don’t give a rip” kind of state where normal social strictures on behavior don’t seem important. This might be a relief to someone who is constantly worried about what other people think, but if someone is not killing him/herself because his/her mother would be devastated, or is repressing a feeling of violent rage because s/he knows that there might be legal consequences, removing these social prohibitions can be deadly. I don’t think the drugs by themselves cause any particular behavior, but much like being extremely drunk, my observation is that they help mute one’s inhibitions and make it seem feasible to do things that otherwise might seem selfish, stupid, or dangerous.
I don’t think that he is blaming the drug’s recipient for being selfish, just saying that normal social rules are often discarded in the “Zolofting” state of mind brought about by the drugs.
Most of this research can be summed up as “People feel better when they take drug X.” Until and unless there is a mechanism to explain what is wrong and how the drug is fixing it, they’re grasping at straws here. I feel more relaxed when I drink a beer, and I’m sure there are some biological reasons beer relaxes me, but it doesn’t mean it’s fixing something wrong. I am sure from your writing you agree, but that’s my answer to how we put this research into perspective. And I agree with your thought that they need new substances and processes to patent because the old lines are tapped out and won’t sell any more, since people are catching on to the scam.
As to drugs causing pathological psychological states, this is certainly true, and I agree 100% that saying all forms of depression are psychological/spiritual is a generalization that is not always true. However, it does appear that MOST depressive episodes are amenable to being worked through by psychological counseling, coaching, changing life circumstances, rallying support, and taking time to develop new coping skills. I think it’s always good to check for signs of other problems like diabetes, low thyroid, sleep disturbances, dietary deficiencies, etc., but those are all things that can be tested for. And of course, drug side effects should always be suspected if someone is taking any medication at all, regardless of its purpose.
Basically, I would say that none of it should be labeled as depression, except as a vernacular way of talking about how we feel. The big mistake is thinking or postulating that all “depression” has the same cause and that the same approach is needed regardless of the cause. But without that assumption, psychiatry doesn’t have much left to call psychiatry.
Just to be clear, I don’t really see psychiatry as reformable, as its basic premises have been skewed far back in history toward viewing differences as something to be stomped out. There have always been enlightened reformers in the system who have worked to change that, but at its core, psychiatry appears to have always been about controlling and eliminating anything (and anyone) uncomfortable and challenging from human experience. It is hard to imagine that basic orientation ever changing. Of course, I never thought the Berlin Wall would come down, and I was wrong on that point, but this may be an even tougher change to make.
It sounds like it may be an important trace element, but in amounts hundreds of times smaller than “therapeutic” (aka near toxic) doses prescribed by psychiatrists.
“Significantly superior” is kind of a gross understatement! How about “dramatically superior,” and that’s without even the consideration of bothersome “side effects” like diabetes, heart disease, permanent neurological damage and early death.
I’m glad to hear the news is spreading, though. It seems like the availability of an MS in Diologic Practice seems to legitimize the enterprise. But it never ceases to amaze me how mainstream folks can see these dramatic differences (80% vs 20% recovery) and be skeptical, when they accept a 10% difference between placebo and a drug as legitimate support for effectiveness.
Of course, the answer lies in profitability and ego…
I have to say, I didn’t read Vivek Datta’s post as an effort to absolve psychiatry of anything. It seemed a pretty biting critique to me. I don’t know enough about him or his writing to really say where he’s coming from, but the comparison with Frances seems odious. I can’t see Frances ever writing anything as powerful or honest as Vivek’s post, since he’s still spending most of his time trying to distinguish between the DSM IV and 5, while not substantially critiquing the basis of the diagnostic criteria themselves. Vivek’s post seemed to suggest that psychiatric diagnoses are entirely social constructs that can be voted in and out of existence on the whim of a bunch of entitled white guys who have a change of heart, and that they lack any real scientific validity. Which is absolutely the case.
I don’t really disagree with anything you’re saying about psychiatry’s real intent and choices (I rarely do), but I just had to say that my reading of Datta’s last post was quite different than the take you had on it. I found it powerful and very much contributory to our intent, as opposed to Frances’s whiny after-the-fact hand wringing.
This is an absolutely true story. I worked at a mental health agency briefly (which drove me out of the field and into advocacy as a result!) with a psychiatrist who was actually pretty good as psychiatrists go. He went to talk to a Native American guy who was hearing voices. In as empowering a way as he knew how, he offered that he had some medication he could prescribe that might make those voices go away. The guy’s response: “You white people – you’re all the same. You hear voices and you want to make them go away. We hear voices, we go someplace quiet and see if they have anything interesting to say!”
A Native mother I spoke with described her son (who heard voices) as having a “gift” that required that she take extra care of him. He was quite unable to care for himself much of the time, but she was concerned that Western “mental health treatment” would be damaging to his spirit. She did not see him as being ill.
This is a difference in attitude toward hearing voices that I think reflects exactly what you are talking about here. There is simply no belief that hearing voices is a malady or “disorder” of any kind. It’s just something that happens to some people, an experience to be pondered and made sense of, rather than something to fear or eliminate.
I agree 100%. DTC advertising has been a huge part of creating the culture of “meds” that is so prevalent today. People come into docs or ERs looking for the pill that is going to make it all better, and continue to have faith in the docs despite disastrous failures because they’ve been told over and over that their problem is a “chemical imbalance in the brain.” Of course, we’d have to handle the APA as well, but DTC advertising is a big part of the problem and should definitely be banned, not just for psych drugs but for all of them.
Exactly my thought. This supports Kirsch’s assertion that response to antidepressants is primarily or entirely placebo response, and the ADs themselves do nothing of clinical significance. Of course, the authors appear to skip over that important finding…
And of those few who did have mental health diagnoses, the vast majority were receiving treatment at the time of the event. Forced drugs don’t stop violence; instead, they appear to frequently cause it.
I was struck that the two did have quite a bit of overlap, and I actually do agree that starting on where they did agree might actually lead to some beneficial changes. But I don’t think an alliance between Whitaker and Frances is going to make things very different.
Political change is difficult and never clean, and people do what they do sometimes for not the most moral purposes. I guess my answer to your last question is that what we need to do is to make it not profitable for people to adhere to the brain-drug-coercion model of “mental health treatment.” People usually act as they do because they benefit from doing so. This whole “movement” toward using drugs is clearly driven by unimaginable profits. Take the profits away and the incentive is gone.
Very well said! If we’re concerned for people’s safety, we should help them be safe, but how is that in any way related to forcing them to take drugs for subjective conditions when the drugs may or may not have a positive effect even in the short term, and may have devastating effects in the long term? Those two concepts need to be COMPLETELY DIVORCED! Concern for someone’s safety is NEVER a reason to forcibly drug or shock them, or even to force them into some kind of talk therapy. If safety is the issue, then that’s what we should focus on resolving, not on “treating” spurious “mental health” conditions that are voted in and out of existence by a bunch of well-off elitists with massive financial conflicts of interest.
Ah, but do they have a word for “arrogant, imperialistic, condescending pseudo-professional asshole” yet? Perhaps we need to help them develop that term…
Honestly, this is cultural arrogance in the extreme. It sounds like they have words to describe the emotional states that they experience, but haven’t lumped them all together into a “disease” and see them as natural responses to the challenges of life.
I wish we were so fortunate as to not have a word for depression! Perhaps they have a thing or two to teach our “modern” society.
Can’t get the link to work, so I’m not sure what the author is talking about, but I’m having a hard time wrapping my head around why this would be a good idea.
I agree, this should be a no-brainer. Telling people their own life experiences don’t matter and that there is nothing they can personally do to alter their own emotional experiences can do nothing but depress a person further than they already are. And doctors’ beliefs clearly impact their decisions, so driving them in the direction of less connection and empathy for the patient seems so obviously counterproductive.
A corollary to this: doctors who choose to adopt the biological model of “mental illness” may already be prone to lacking empathy, and this explanation may provide them more justification for their pre-existing blamefulness or insensitivity toward their own patients. I wonder if psychiatry may attract more practitioners with this attitude on the average, because the philosophy may appeal to people who have their own issues with empathy which they are unwilling to face?
Note that “medication compliance” is a condition of returning to the school. Of course, the possibility that “medication compliance” may lead to worsening “symptoms” or may have even created the “mental health crisis” in the first place is never considered. And of course, the self-limiting nature of depression is never considered, nor is the possibility that the very environment at Princeton may be contributing to the suicidal thoughts or behavior ever a point of discussion.
Scratch Princeton off anyone’s list of desirable universities. I hope this is not the norm nationwide!
I have to agree with Bob that Alan Frances is working pretty hard to absolve the APA of responsibility for creating the DSM III et. al. in support of the pro-biological agenda. Admittedly, it is the pharmaceutical companies who have the funds to drive the point home so effectively in the public mind, but without the tacit or explicit support of the APA, their arguments would be much easier to see as the hucksterism that they are. A great example is “Social Anxiety Disorder.” This “disorder” was clearly targeted for creation and marketing by the pharmaceutical companies (most notably GlaxoSmithKline, makers of Paxil, if I recall correctly), but despite it’s non-scientific and tainted origins, it still made it into the DSM IV under Frances’s leadership. Frances makes good arguments to remove the DSM from APA control and to stop DTC drug marketing, but he’d be more credible if he would acknowledge the role the APA has had in creating this disaster.
I was actually struck by the degree of agreement that does exist between the two, and would hope that these overlaps could form the basis for some more positive conversations regarding shared goals, but I don’t think it can happen without substantial acknowledgement of the corruption that exists in the psychiatric community. Admittedly, most of the local on-the-ground doctors are as much dupes as the rest of society, but they are supposed to be the ones protecting us from this kind of danger. If the APA changed its tune and started making more rational and nuanced recommendations regarding the limitations of drug “treatment” and the variety of other approaches that have been found to be effective, and also supported the honest dissemination of literature on the down side of psychiatric drugs, instead of always standing up to defend against the “unscientific and irrational antipsychiatry element,” there might be some hope for progress. But I’m not holding my breath….
I agree the absence of any kind of analysis of race, ethnicity, and experience of prejudice is a glaring absence from the report and analysis, and I really appreciate you bringing that issue forward. I don’t think it’s necessary to throw out the baby with the bathwater, however. The report makes a big emphasis on building from the personal experiential viewpoint of the person seeking help. I see no reason why racial/ethnic identity, sexual orientation/identity, immigrant status, historical group trauma, and social prejudice can’t become an integral part of the model. Perhaps rather than withdrawing this report, which is very timely in a lot of ways, an amended report can be written that incorporates these issues into what seems a very sound framework of focus on individual needs rather than the pathologization of normal reactions to adverse social and personal circumstances.
Gee, you seem to have a bit of an agenda of your own, Tusu. “People who live in glass houses shouldn’t throw stones.” I’d find it more helpful to read the research you shared without the snide anti-MIA comments. It’s kind of odd that you’d choose this article to pick on, however, since the article’s premise directly challenges the “agenda” you appear to be critiquing. If congenital blindness really does reduce the likelihood of a schizophrenia diagnosis, doesn’t that suggest a more physiological underpinning, which is just what you’re saying MIA is biased against?
Anyway, I’d appreciate it if you’d keep your comments to direct responses to the article and any data you have that contradicts or fleshes out the picture. You already know that the basic agenda here, such as it is, would be to critically explore the current assumptions of psychiatry and to look at alternative viewpoints and approaches. If you don’t like that agenda, feel free to read some bloggers that support your views. There are plenty out there. Your need to make constant comments on the “agenda” at MIA is nothing but unhelpful trolling behavior, and it discredits your otherwise interesting information which you shared below.
Vivek, your posts are more incisive and more impactful every time. What an impressive deconstruction of the DSM and the forces behind it! This melds very well with Sera’s comments on the connection of this movement with other human rights movements, as social oppression appears to be the centerpiece of the DSM and all of its various institutional offspring. I’m glad to hear that France and Italy may have preserved some different energy in the psychiatric profession.
This is an amazing set of articles. Make sure to read Part 2 (see tabs at the top) in particular. Prize-winning journalism, or it should be. Does an incredible job of bringing the plight of foster youth to light.
I’ve been saying this for a long time. Even if there was clear evidence of some kind of correlation with genetics as a predictive factor, which there to date is not, and I doubt there will be, the impact of environment is obvious and so much larger than any genetic effect might turn out to be. The same is observed for things like heart disease and cancer, which have identified physiological markers – the association with genetics is tiny compared with the contribution of stress, lifestyle, and early-life trauma. Since we know for absolute certain that environment accounts for most of the variation in physiological disease states, how much more certain is it that environment is by far the more important variable in a “mental health” condition? Not to mention the fact that genes can’t be changed anyway, while environment can be. Corruption, fear, and egotistical hubris are the only explanations why people continue to seek these genetic explanations when it is clear they will never begin to explain the phenomena that have come to be known as “mental illness.”
We at Rethinking Psychiatry in Portland put on a symposium last year that was more focused on getting alternative service providers on board than what we’d attempted in the past. It was very interesting to note that some of the same issues came up that reflected survivor experiences with the standard mental health system, though clearly with much less intensity. The issue of labels, in particular, was very challenging – if we’re not using DHS labels, then are we using alternative labels or no labels or what? And if we’re not using labels, what exactly are we “treating?” We got feedback from some (not all) of the survivors who attended that even though it was great to see alternatives offered, there was still a sense that “we are the providers” and “you are the clients” that supported the existing biases and power structure that they’d encountered elsewhere, and left them feeling like the survivor’s voice had been muted or even eliminated from the conference.
I think this is a very tricky challenge, as our language has been so totally coopted and controlled by the DSM-aligned forces that alternative providers are still warped in their thinking by this language. (Just consider the fact that I called them “alternative providers” – kinda assumes they’re some kind of extra, and will never be part of the mainstream, doesn’t it?) For instance, providing an alternative herbal remedy for “ADHD” both legitimizes the idea that “ADHD” is something to be “treated” and avoids looking at the social/structural issues around schools and our weird modern society that make this kind of behavior seem like a “disorder.” It also avoids having to parse out whether there are some people who fit this somewhat arbitrary description who actually DO have something physiologically wrong with them (iron deficiency, sleep apnea, etc.) that is causing them difficulties, as it continues to lump all people into the same category based solely on this random construct of behavioral “symptoms.”
I am generally supportive of efforts like ISEPP to look at providing a range of alternatives for people experiencing distress. However, unless this movement is deeply informed by those supposedly benefiting from these alternatives, it’s pretty easy to fall back into the same game with slightly different rules about who is allowed to be a “client” and who is allowed to be a “treatment provider” and what a “treatment provider” has the authority to do to the “client.” Rather than doing away with ISEPP, I would love to see a more direct engagement with the survivor community and a full-on discussion of social oppression and its role in creating “mental illness” from the point of view of those who end up getting diagnosed, as well as a very survivor-centered agenda when it comes to defining what is and is not helpful. A large dose of humility is an absolute necessity for anyone purporting to help others “professionally.” There are times when I’m with Frank in thinking it may not really be possible, that defining the roles of “professional” and “client” sets up such a significant power imbalance that is too easy for the so-called “professional” to take advantage of.
Not sure what the answer is, but I do know that the biggest question I get when I suggest that psychiatry is doing more harm than good is, “What is the alternative?” I really do think that question needs to be answered, and I do believe that ISEPP and its ilk are genuinely trying to solve it. I’d just think the solution, if there is one, is going to come from the grassroots rather than from academia, for the reasons stated above.
Fascinating that they are talking about associations with childhood trauma and social isolation, and that in the last sentence, he seems to imply that psychotic individuals are “withdrawing from life,” indicating an intentional (if perhaps unconscious) decision-making process involved in the eventual development of “schizophrenia” (whatever that really means). Sounds like the evidence is suggesting a pretty different narrative than that given to those so diagnosed by the system, who are told their brains aren’t working right and that it’s all genetic and their family and other early life experiences have nothing to do with it (“Let’s not blame the parents!”) and that they have no control over what happens next. Doubtful that anyone at NIMH or in the field will notice the contradictions, though…
Well, Jill, as much as any of these theories and practices may work very well, there’s not a one that can be patented and sold for a huge profit. Not to mention, if you start actually making people BETTER, well, there goes your client base…
I read the negative comment you quoted and correctly predicted that it was made by one Gina Pera, who is a pro-psychiatry troll of the highest degree. She substitutes ad hominem attacks for reasoning and is unable to accept any point of view not 100% in accord with her own. She relies on “expert opinion” (but only of HER experts) and is willing to explain away any research finding that she finds inconvenient. An insult by Gina should be considered a compliment. When you’re able to win someone like her over to a more reasonable point of view, I’ll know we’ve won the war!
Giving advice in general seems to be ineffective and counterproductive. I think the more fundamental mistake is grouping all depressed people together and assuming that one intervention is supposed to help everyone. Since there are so many reasons and contexts for people’s emotional reaction, it should be obvious that you have to approach each person as a unique individual with different needs, goals, and experiences. By even grouping such people together in a study, you defeat the whole purpose of the study.
The only fairly universal principle I’ve found is that listening to, understanding, validating and normalizing a person’s emotional response to their life circumstances tends to help most people moving in the direction of thinking about possible solutions, regardless of their “diagnosis.” But sometimes there aren’t any large-scale solutions and sometimes someone’s circumstances simply suck. Suggesting that they “count their blessings” is so counter-intuitive to me that I doubt I could ever get the words out of my mouth if forced at gunpoint.
Kinda tired of people selling viewpoints on the “right answer” to “mental health problems.” Sometimes the best you can do is to sit with a person in their pain and let them know you empathize. Trying to “fix it” for them usually leaves people feeling invalidated and pissed.
Well, this certainly can’t be tolerated! They are teaching lay people to actually make things better with minimal professional intervention and cost! Will probably be relegated to back-page news in alternative journals and then forgotten about quickly. Too threatening to the Industry!
Thanks so much for this brutal deconstruction of the current psychiatric mythology. I appreciate the multiple references to research in multiple fields that all impact on what we call “mental illness.” I wish all psychiatrists were as well-educated and honest as you appear to be. Can we run you for APA president next year?
Actually, psychiatry’s not broken at all – it does exactly what it is designed to do. The problem is that what it is designed to do doesn’t actually bring about positive results for the patient!
And bummer about the reaction to the drugs. Sadly, I’ve heard that all too often. It’s compounded when they try to tell you that your suicidal reaction is “a result of your disease” instead of stopping the offending drug.
I agree 100%. The double standard is pretty blatant and obvious to anyone not invested in the current system financially or professionally. I’d have no problem with them doing experiments with drugs if they were actually scientific about it, but they totally aren’t. If the standards described in this article were applied to the literature on psych drugs, we’d see a 95% reduction in their use immediately. The only support for any of them is for short-term symptom reduction, and even then it only works for a limited part of the population and exposes the user to huge possible side effects beyond anything the worst results from meditation could conceivably cause. But we need to be careful about overreaching regarding meditation, while we can give out these drugs like candy, in the absence of any scientific evidence to support their extensive long-term use. I think the comparison says a lot about where the psych community is regarding scientific honesty.
The other weird take I have gotten from mainstream psychiatrists when I bring up the point that stress and trauma are deeply involved in almost every case of “mental illness” is, “Yes, but not EVERYONE who is stress has these symptoms!” Implying that the person should NOT react to being raped by developing flashbacks or intrusive memories or high anxiety, and these manifestations are therefore proof of a “bad brain.”
Yep, it’s bio-bio-bio right down the line for most of them, and now a lot of social workers and psychologists, too. Social and psychological issues get lip service at best.
In the end, blaming the brain IS blaming the person. Not only is it blaming the person, it also communicates to them that they can’t do anything about it if they wanted to. So you are the only reason you’re messed up, but you actually have no power to have prevented it. Talk about a depressing message!!!
Here is my comment I made on the article, which probably no one will ever read:
Steve McCrea · Top Commenter · CASA Supervisor at Casa
It’s interesting to hear this appropriately skeptical approach taken with regard to meditation studies. It makes me wonder why the exact same provisos and cautions aren’t applied to studies involving medication use for mental illness symptoms? In particular, observations that this science is in its infancy, that the effect sizes are often small, that initial studies often favor the intervention but are not later replicated, and that not all members in the group benefit, and some may in fact deteriorate, all of these would apply 100% to any medication study you could mention. Yet we let it slide that the average change for significance with antidepressants is a mere 3 points on the HAM-D scale, and that placebos do almost as well as antidepressants, and that a small but significant subset of antidepressant users experience some rather intense and extremely uncomfortable and even dangerous side effects, such as akathesia, manic reactions, depersonalization and increased suicidal thinking. Pointing out these very reasonable concerns often gets one attacked as “pill-shaming” or “discouraging people from taking their medication.” In fact, the very appropriate “black box” warning on antidepressants has been criticized because it slowed the long-term increase in antidepressant use among teens, which is exactly what it should have done, base on the assumption that somehow these people who stopped “taking their meds” were at more danger, when they may actually have been at LESS danger due to recognizing they were responding badly to treatment.
It feels like there’s a bit of a double standard in operation here. The writing of this article correctly frames the skeptical attitude necessary for real science to operate. It is puzzling to me why this same scientific honesty does not appear to be applied to research or publications regarding psychiatric medications.
I really appreciate your historical information and perspective, which I was largely unaware of. I would only add that the entire discipline of psychology as you describe it clearly has roots in Western European culture. I’d suggest that the issue of the “soul” as opposed to the “mind” and the “brain” encompasses a wide range of spiritual traditions worldwide, and that psychiatry as currently conceived is interested in wiping out the validity of any of those traditions, regardless of their cultural origins, as providing any kind of explanation or solution for “mental illnesses.” The denial of the spiritual nature of human beings has been relegated to the realm of delusion and/or superstition, with dire results, at least from the point of view of anyone who cares about human beings more than making a lot of money and maintaining control over the masses. I hope that any future conception of “psychology” as the study of the human spirit will include the incredible array of possible spiritual philosophies, as well as acknowledging that this is an area requiring great humility in the face of the mystery of life. Such humility is almost unknown in psychiatric circles, and the lack of it is the ultimate downfall of psychiatry as a profession and a field of study.
Or it could reflect a tendency to view less and less significant issues as constituting “mental health disorders,” fueled by successful advertising and drug/disease marketing efforts by Pharma and the psychiatric profession.
Of course, abusive people have an interest in denying and ridiculing any possibility of repressed memory. It sounds like your therapist did it the right way, allowing you to lead the discussion to where it needed to go rather than telling you the kind of things you should find or recall. I have found this to be very valid and healing, both for me and for clients I’ve worked with. It obviously worked for you. Thanks for sharing your story. I’m sorry it happened to you, but it’s great that you found a path to healing!
My thoughts exactly. At least the earlier narrative provides some sense of potential meaning to the “symptoms” and perhaps a context for taking some kind of action to resolve it. Even a misguided action is potentially empowering to the client, as they might start to brainstorm other possibilities. The current narrative postulates incapacity and helplessness and permanent disability, and not surprisingly, generates results that reflect those key elements of the so-called explanation. And it denies the obvious contribution of family dysfunction and enforced trauma to the situation, in a way that reinforces the very sense of unreality and powerlessness that the parents have helped to create.
I agree with you. I think the author of the article does not distinguish between therapy designed to uncover purportedly repressed memories, which appears to be fraught with deeply troubling ethical considerations, and the possibility that memories could be repressed, which I think there is good reason to believe happens, based on both clinical and personal experience.
As an example, I always carried around with me a vague recollection of being in second grade with my scary teacher, Ms. Vaughn. I remembered her shaking her hand while holding a book in it, and then flinging the book across the heads of the students to hit some tables in the rear of the classroom. I remembered standing up in my desk and saying something, and next thing I recalled, I was out in the hallway with another kid. I remembered going down to the office with him, talking to the secretary, having her go to talk to the principle, and being sent back to class. None of this was “recovered memory,” but I didn’t recall all of the details.
I was at my 30th high school reunion, and encountered someone who had been in the same class. I told her the story as I remembered it, and she said, “I remember that, too!” When I got to the part about standing up, she said, “She hit you!” She also recalled what I had said (“Miss Vaughn!” apparently intoned in a voice of incredulity), as well as the name of the other kid, who was a friend of mine, and that explained the other kid I remembered being thrown into the hallway with. But the moments between standing up and being in the hallway, I had no recollection of at all.
After replaying this memory to myself, I did recall that I had been sent down the hallway in the principal’s office to see the nurse (the only clear and uninfluenced “recovered memory” I experienced), who appeared to be examining my left ear, which would have been consistent with being whacked in the head by a right-handed person. So Susan’s recollection and mine fit together perfectly, except that I did not recall the part about being hit in the head or it’s immediate aftermath.
Yes, memories can be repressed. Whether they can be recovered accurately or not remains an open question. Whether it’s therapeutic to allow a person to process what they believe to be the truth about what happened, without telling them what is true or not, seems likely to be therapeutic.
I think it’s a whole different question when it’s the therapist who wants/needs the client to bring up repressed memories. That is clinical malpractice and should be treated as such. I believe the client always has the right to decide what is true and isn’t in his/her own life, and therapists who subvert that right, either by enforced diagnostic labels or suggestions or pressure of any kind to believe or recall things that aren’t coming from the client, are doing damage to their clients.
I become incensed when foster kids I work with blimp up on antipsychotics, and then the doctors put them on a diet! I’m beginning to see a few being put on antidiabetic drugs, which is at least more of an acknowledgment that there is a problem, but once again, we get one drug to address the side effects of another drug given to address the side effects of a third drug, etc. Good for pharmaceutical company profits, but it doesn’t do much for the poor client!
This is not surprising, but it is appalling. When we know that stimulants provide at best short term relief from the “symptoms” of “ADHD,” the lack of additional psychosocial supports (10%) is gravely disappointing, or would be if I had any belief that the doctors involved even know or care about the long-term study results. But even in the short term, they aren’t even bothering to check and see if their drug is ameliorating the so-called symptoms!!! As if making the diagnosis and dispensing the drug ends their responsibility as a doctor. They really have become more and more like pushers. Disgusting!
True enough, but as I commented on the article, I wish they’d be as concerned about the drugs they use but don’t know how they work, either. It’s interesting that this is approached with such caution when experimenting with legalized psychotropic drugs is considered so casually.
Noel, you always blow me away with your intelligent and honest critiques that get right to the heart of the matter. I’ve seen and experienced this exact same “let’s ignore the pink elephant in the living room” phenomenon. In the clearest example, I was at a committee meeting talking about setting some boundaries for the use of medication on foster youth statewide in Oregon. The topic was when we should trip a “red flag” mechanism for an outside review, based on age and type of prescription. Others were talking about whether the red flag age for kids on antidepressant should be any kid under 5 or under 6. I said, “There is no clinical indication for the use of antidepressants in kids under 6.” I was completely ignored, as if I had not spoken, though there was a brief pause that showed me they’d heard. I restated this louder, and was still ignored. When I later talked to the psychiatrist heading the effort (who really is a good guy and often advocates for less or no medication for kids in foster care), and he really had no justification or explanation for why that happened. It seems that there are “taboo” topics that you don’t find out about until you say something “wrong” and encounter the silence of denial.
I don’t really know why it happens, but it is amazing that a conference on trauma would not be willing to even talk about this issue. It’s not rare in my experience that “PTSD” sufferers are diagnosed with schizophrenia or “bipolar” based on “hearing voices” that are directly related to their abuse (aka FLASHBACKS). If we broaden to other forms of dissociation, the boundary between trauma reaction and “schizophrenia” seems to become pretty porous.
I wonder if they are worried about being attacked from the psychiatric profession is at the core of their unwillingness to talk about this connection? Perhaps they are dealing with their own professional traumas?
On the other hand, his psychiatric treatment doesn’t seem to have helped very much, does it?
I’m sick and tired of hearing people blame “the disease” (secret code for blaming the “patient”) for bad outcomes. We’re paying psychiatrists to help people with these ostensible “diseases.” If their “help” leads to misery and suicide, then they need to find another way to help. It’s the only profession where you can blame the subject of your profession for not cooperating in allowing itself to be fixed. If I take my car to a mechanic, and he can’t fix it, he doesn’t blame the car and charge me to come in for weekly “treatments” for the rest of my life. He says, “I am sorry – I can’t help you with this. I don’t know how to fix it.” It’s past time for psychiatrists to learn a little humility and start admitting when they don’t know how to help someone. The antidepressants don’t have to have been the cause of death for this to represent a colossal failure of psychiatric intervention. He was receiving the best psychiatric help money could buy, was compliant with “treatment,” and yet was still so miserable he ended his life. That’s a failure by any estimation.
Kupfer’s comments are appalling. A quarter of all researchers report intentionally falsifying their results. That’s more than “a few bad apples!” But of course, I expect no more from the chair of the DSM-5 task force, as he presided over a veritable carnival of intentional falsification and lies.
And they actually seem to notice and care what is going on with you. A little eye contact and a touch on the arm can go a long way to reminding someone that someone else still cares about them. But I guess the psychiatrist would have to allow him/herself to genuinely care first, which seems to be a challenge for many.
I was impressed that the kitty seemed to be capable of a more effective mental health intervention than the psychiatrist. I hope you had a therapeutic cat, too – cheaper than antidepressants, with no side effects, except for hairballs and litterboxes!
I don’t think he was saying that the behaviors were caused by drugs, but that the brain anomalies noticed in some kids were the result of those kids taking drugs. I had the same thought – they noted that the enlarged areas were the same ones seen in schizophrenia, and both are often treated with atypical antipsychotics.
My brother’s son has an “aspergers” diagnosis, and it’s clear there is something definitely not quite right with him that is not a result of their parenting approach (though they may have made it better or worse by their approach). I’m not opposed to the concept that there might be some physiological reason that at least some cases of what is called autism occur. I just don’t buy that anyone knows what, if anything, is wrong in a particular case, nor do they appear to know what to do to make it better. It’s quite likely that what is called “autism” could have multiple causes that all manifest similar symptoms. My objection is to the hubris of the psychiatric profession in asserting they know far more than they actually do. And I’m confident you agree with me on that point!
“A question that arises out of all this is whether psychiatric diagnosis came out of the loss of the art of listening. If we are diagnosing, we aren’t listening. Is psychiatry, as it has developed, a way to bypass listening and instead give a pill?”
Yes, it most definitely is! That is brilliantly stated. It reminds me greatly of the works of Alice Miller, whose primary thesis is that we suppress our own pain as children because we have to, and if we don’t become aware of that process, we inflict the same pain on our own children. Psychiatry provides an effective mechanism to do exactly that. “My son isn’t depressed because of his environment or upbringing or the school he has to attend – it’s because his brain doesn’t work!” The adults are absolved of responsibility and the children get to carry the “bad person” label. And into adulthood, the person in power is always protected by the ability to define anyone protesting their decisions as “mentally ill” and absolve themselves of the need to use their power more responsibly.
Listening is the key – when people listen and hear where the suffering comes from, it’s a lot harder to dehumanize the victim. Which is why it is SO terribly upsetting to the elite when survivors try to have their voices heard. Somewhere deep down, they know they are missing the boat and causing more pain and will be called to account for it some day. The only way to defend against hearing that deep voice in their own psyche is to cling more tightly to their defensive “theories” that put the blame on the victim instead of empowering their client to find new ways to be heard.
My housemate is a former foster youth. I was talking to her about the correlation between psychiatric attention and suicide, and she shared with me last night that the only time she was ever suicidal was when they forced her to take Zyprexa. She reports what clearly sounded like akathesia for a few weeks at least, and says she had the knife in her hand, and only stopped because her cat bit her on the arm just before she went through with it and it brought her back to reality. She stopped taking Zyprexa, and has never been suicidal since.
I think the number of suicides in the US is huge and largely preventable, but not by the current approach, which in fact seems to make suicide more likely to occur. Without a new paradigm, it’s hard to imagine what a suicide prevention effort that actually works would look like. I’d love to hear your ideas about that, Doug.
For the most part, we’ve only heard about what you feel or believe, and gotten some assurances from you that these articles/references do exist but no links to them. It’s hard to take you seriously when you come in with such an attacking attitude and yet provide no independent data to back up your views which any of us can read and digest.
The only real “party line” here at MIA seems to be “don’t expect us to believe you just because you said something.” In areas of controversy, it is important to name your sources so that others can verify what you are saying and potentially offer alternative analysis. This is a core value of scientists everywhere (or at least anyone who can legitimately claim to be scientific): data is the touchpoint that we all have to start from. So far, you provide a lot of rhetoric and not much data. I’m going to ignore accusations and be interested if you provide studies that we can read.
I would also add that if you have such issues with MIA, I’m puzzled why you would want to read/post here. There are plenty of websites who post articles that agree with your opinions and beliefs 100%. Perhaps you should post there instead? Is your effort because you’re so interested in giving us the right information, or simply because an alternative viewpoint makes you uncomfortable?
Another Portlander on MIA! I’d love to meet you some time.
I think the point isn’t that people so labeled don’t exist – it is that referring to such people as if they are a group with some common characteristic simply invites and reinforces prejudice and discrimination. I recall a discussion at a presentation by two Native American social workers about whether the term “Indian” was insulting and whether “Native American” should be generally adopted. They said that neither was really more insulting than the other, and both were used in Native communities, but the real identity of the people was their tribe. They felt that the entire effort to find a word to refer to them as a group was counterproductive, and that we should see different tribes as different cultures and different individuals within these tribes as unique individuals with their own lives and values and priorities. I think this applies here as well – how can anyone make generalizations about “the mentally ill” when the concept now embraces everything from talking to disembodied spirits to being uncomfortable with the sexual identity of your body to being unable to do math problems? What do all these people have in common, other than the fact that someone chose to label them? Not a whole lot, other than being human.
Maybe when we see the word “Mentally ill,” we should just substitute “Human Being.” Let’s face it, with the DSM 5, pretty much everyone is represented in there somewhere!
Agree 100%! And for a ton of other stuff, too. Psych drugs should be a last resort – they’re an admission we don’t really know what’s going on. But they’ve become an excuse for not even bothering to find out anything else.
I also found that phrase chilling! No toddler should EVER be diagnosed with a “psychiatric disorder!” Well, really no PERSON should, but it is especially egregious with toddlers, who haven’t even had time to solidify their basic personality. It’s bizarre!
I found this quote from Frances quite illuminating:
“…conflict between professionally run mental-health programs and those based on recovery.”
So he is admitting that “professionally-run mental health programs” are not based on recovery, and in the same sentence, he is asserting that programs based on recovery aren’t run professionally. I think he lets his real beliefs leak through here – REAL professionals aren’t concerned with recovery, and those with “lived experience” don’t really have anything to contribute to the world of those “professionals.”
I think the analysis of Frances’s real vision relating to expanding psychiatry’s influence through diverting money from the prison system is quite brilliant, really. And the analogy of enforced treatment to slavery is, of course, quite apt. Thanks for an engaging and thought-provoking article.
Au Contraire, tusu, I hear a great deal of dialogue on the MIA boards. There is such a range of opinions here that threads sometimes degenerate into attacking one another’s conflicting views on a particular subject.
And I definitely don’t see an “anti-treatment” bias here, unless you mean to define medication as the only “treatment” and try to force it on people. There are extensive discussions of alternative forms of treatment, including for psychosis and “bipolar disorder,” as well as frequent comments reminding us all that some people find medication helpful and that we need to respect their individual experiences. The main difference is that we also respect the individual experiences of people who DON’T find medical treatment helpful, regardless of their “diagnosis,” which is a viewpoint Dr. Frances (and I gather you agree with him) does not appear to support.
Where I don’t hear dialog is on the NAMI or the CHADD sites or in most mainstream discussions about psychiatry. Everyone is supposed to sing the “mental illnesses are brain diseases” song, and anyone who is off-key is shouted down very quickly.
As to death sentences, please recall that the average life expectancy for those receiving “medical treatment” for these “severe mental illnesses” is 25 YEARS LESS than the general population. So it does not appear that not receiving this treatment is likely to lead to loss of life in the collective, though there may be individuals who may want or benefit from medical interventions and decide the risk of a shorter life is worth the reduction in symptoms they experience. And they won’t get any argument from me or the vast majority of our community members. What will get an argument is if you pretend that the shortening of lifespan is not an issue, or that everyone who doesn’t embrace this form of “treatment” is a moron or a dangerous extremist.
Aside from which, I think you totally missed Rossa’s point if you claim to agree with her. I believe she’d agree with almost everything I just said, though of course, she’s welcome to correct me if I’m wrong.
B, once again, you’ve taken the words right out of my mouth. We spend far more tax dollars subsidizing rich scoundrels than the relatively small number of dishonest SSI recipients vets and welfare cheats and illegal immigrants combined, by a very long shot. In fact, it’s been effectively argued that illegal immigrants contribute far more to our economy than they take out of it. It’s the Captains of Industry who are robbing us blind! I hope the day is not far off when the average American (or whatever country you’re in, but the USA seems the most obtuse about this) starts to realize who the real enemy is.
Thanks so much for this awesome summary of the evidence regarding ECT. It makes advocacy so much easier to have a comprehensive list of references to support an alternative viewpoint. That this even needs to be said is in itself disturbing, and of course, many in the field really don’t care about or don’t want to hear any actual data that contradicts their favored (and most profitable) worldview. But for those on the fence, this kind of info is critical. Thanks again!
I haven’t lived in Philly for a long time, and don’t have any media connections, but it just seemed to me that they’d be more likely to grab at this kind of a story. But there does seem to be weird resistance to airing this stuff publicly. Perhaps the papers don’t want to “bite the hand that feeds them” and offend the pharmaceutical industry?
I think you allude to another issue in the article – it FEELS GOOD for people to believe that psychiatry’s power is being used for good. It’s the ultimate opportunity for projection – our son’s problem isn’t because we were bad parents or because his school was oppressive and abusive or that we live in a crazy society that makes people feel awful and come up with strange ways to cope with its insanities – it’s his BRAIN that is broken, and THEY CAN FIX IT! Even if they don’t really fix anything, it still fixes the problem of who is at fault, and preserves the idea that given sufficient time and technological know-how, whatever is bothering him can be erased or suppressed or removed from consciousness and we can avoid having to deal with the issues that led to his distress. It is a very comfortable belief system for those in power, and it’s kind of jarring and disturbing when people like us start asking questions about the actual validity of these supposed guardian angels who are going to use technology to make us all feel OK.
Nobody gets rewarded for saying the Emperor is naked. There are way too many people invested in this viewpoint for a few scientific facts to disturb the social trend.
It is likely that the increased placebo effect has resulted from increased social expectation that drugs will be effective against “mental health problems,” which is exactly what we should expect to happen. I guess it’s the downside of the impressive (if almost completely dishonest) marketing effort that’s pushed these drugs to the top of the sales charts. But I’m with AxqYi – any real scientist would see this trend as a result. And I also agree with Frank (as I usually do) – the decreasing impact of neuroleptics probably is a result of exactly what Bob is outlining in his book – more people have used them for longer periods of time, so they become less effective.
The recommendation to shorten trial times in order to eliminate placebo effects is particularly troubling to me. These people are not scientists!!!!
As baseball announcer Tim McCarver once said, “I don’t know why the call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it was so common, more people would have it!”
Of course, you make perfect sense, as always, and it seems any rational person would have to agree with you. Unfortunately, I must conclude that most of the mental health system today is peopled with irrational people for whom “common sense” is not all that common. Sure, a lot of them have been conned, but you’d think that simply observing the results (or lack of results) would be enough to get folks to question these assumptions. Sadly, it often is not.
Thanks for your clear, gentle and firm writing. I only wish I could find a way for those lacking common sense to hear what you are saying!
I have always said that the main cause of ADHD is SCHOOL! There was a great study back in the 70s that showed that “ADHD” kids were virtually indistinguishable from “normal” kids if they were in a classroom that allowed more spontaneous movement and decision-making by the kids. It is primarily the rigidity of the educational environment that drives most of these kids around the bend. Some kids (I was one) are able to suppress their inherent sense of boredom and injustice and put their nose to the proverbial grindstone, no matter how stupid or inane the assignment. Some are not able to do that, and these kids get diagnosed with a “disease,” rather than looking at how or why the teaching they receive is so incredibly dull and rigid that they are unable to tolerate it.
Have you tried the Philadelphia media? Trenton is kind of a suburb of Philly and your story might get more play in that region.
Thanks for taking up for her. This is disgusting. I only wish it were more shocking than it was. Can you let us know if there is someone we can contact to encourage a reporter to run a story, or an attorney to take up the case?
I just want to add that I did a brief and very painful stint as the mental health professional who made the final call in the ER as to whether someone was held against their will or not. This has deeply colored my views on this issue, because my experience is that depressed/suicidal people (an anyone else who was involuntarily detained) were ABSOLUTELY required to take antidepressants and other drugs against their wills, and were provided essentially NO other kind of service worth talking about, unless you count the basket-weaving type “activities” they forced the inmates to engage in. I suppose you could say they had the right to refuse, if they were educated enough to realize that, but of course, no one every told them that, and even if they did refuse, they would be very unlikely to get out until they changed their minds, and the pressure to comply (as well as the rate of lies told to justify this) was incredible.
This particular hospital ward stated their role was only “Stabilization,” which is essentially code for giving the clients drugs until they stopped feeling or acting bad in the view of the staff. There was not much going on that could be construed as healing, other than the attempts of the odd extra-compassionate staff member who bothered talking with the patients. Believe me, I did everything I could, including some impressive therapy in the ER, to keep anyone from having to spend a minute on that ward. And my impression is that that was standard issue at the time, and don’t see any reason to believe that it’s any different now, 20 years later on. There may be outliers, but most psych wards exist solely to convince/cajole/force their patients onto some kind of drug. I know you don’t believe that’s what should happen, but the sad reality is that it does happen and is not questioned by most of the mental health “professionals” who participate.
Thank you, Meaghan, for such a beautiful, heartfelt, and honest rendition of your experience! I am so sorry you have had to suffer as you have, and am also just plain impressed by your ability to find the good in yourself despite all of that. Yes, I can agree from experience, this is a lifelong challenge, but feelings are what life is largely made of, and feeling less isn’t the same as feeling better. I really hope this woman and many like her are able to hear your message through the rhetoric and mythology and marketing hype that’s created this antidepressant disaster.
I’m glad you’re writing for MIA and I hope you find as many ways as possible to get your message across to as many people as possible. You articulate this with the kind of credibility that the most entrenched psychiatric true believer would find hard to ignore!
It is my understanding that there are a number of states that do not have civil commitment laws for “mental illness.” Does anyone know how they manage the kind of situations Jonathan is talking about?
I agree that these cases are a dilemma, because people do need to be protected from harm and violence, and the jail system is pretty brutal. But the psych system is pretty brutal as well, and I agree with Richard that there is a benefit to acknowledging the reality that being locked up isn’t likely to be perceived as “treatment” by the vast majority of those experiencing it.
I’ll say as I have before that there is no reason that detention of a person for acts or threats of violence has to be coupled with enforced treatment. Perhaps there is a place for detention of people who have violated the law in some way but have extenuating circumstances in a separate place that is not so brutal, or perhaps we need to reform our prison system so that being detained there isn’t an invitation to further abuse by the guards and other inmates. But none of that suggests that forcing “treatment” on a person based on their purported “mental illness” is a viable idea. I think it’s a very legitimate position to be opposed to enforced treatment under ANY conditions, and yet still support using force when necessary to protect others from harm.
Of course, the question of “protecting” someone who is suicidal from him/herself is a much thornier issue. But even so, the same thinking applies: even if you decide it is OK to detain a person for self protection, it should not take away their right to consent or refuse medical treatment, in particular, the drug-based pseudo-“treatments” that are usually enforced on every detained person in the psych ward.
“Honestly, I find this article incredibly creepy. Reminds me of efforts to “help” soldiers with PTSD symptoms to “recover” so they can be thrown back into battle to be exposed to yet further trauma.
There are good reasons why depression has become more common and more chronic over time, and it doesn’t have to do with bad brains. The way we run our businesses and our society is the biggest contributor, as we encourage people to disconnect from families and community and work long hours at meaningless positions in order not to starve to death. Meanwhile, we incentivize businesses to minimize labor costs, maximize profits, and invest in machines instead of people, and we intentionally assure that there is always a certain percentage of unemployed people in order to keep competition in the labor market sharp and keep wages and prices down. And that’s not counting the effects of pollution, global warming, warfare, and economic oppression in almost every country throughout the world. Depression seems a pretty normal and understandable response to such a bizarre way of living, especially when it seems there is little to nothing any one individual can do to stop this juggernaut from continuing to move forward on its destructive pathway.
Maybe instead of teaming with neuroscientists to try and come up with new pills to make everyone OK with the crappy conditions we live in, they could start by working on improving wages and working conditions for their employees. There are many steps that could be taken, including on-site daycare, paid parental leave, living wages for low-level employees, employee democracy and profit sharing, and universal healthcare and education for cheap or free (something on which the USA has to catch up to the rest of the industrialized world).
Depression is a natural response to bad conditions. Trying to “cure” depression with pills is like trying to banish physical pain. Sure, it hurts, but it’s warning you to get your hand off the damned stove! Numbness to bad social conditions is not a worthy goal, in my mind.”
The evidence base for Benzos is only in the 6-8 week range, and the product information itself says that it is not intended for long-term use. The best analog to benzos in terms of effects on the brain and body is alcohol. Taking a shot definitely does help you sleep in the short term, but anyone using a significant dose of alcohol to sleep every night is going to be in for trouble in the long run. It is noteworthy that long-term alcohol abuse does lead to a form of dementia in many people. Why any doctor would prescribe benzos long-term is baffling, and in my mind, it is criminal behavior.
So what is the effect on later attempts at “treatment” if your first experience is being hauled off by police to the ER, put in restraints, held against your will in a hospital ward with other people there against their wills, some of whom seem kind of scary, and forcibly injected with drugs that massively alter your perception of reality, often in a negative way? Think that maybe such treatment might lead to a psychological “bias” that these people’s “treatments” aren’t anything you want to try again?
I thought the Hunger Games books and movie captured this idea very well. We may not be able to control much about our lives, but we don’t have to let “them” own us. The sad thing is, most of “them” are feeling just as powerless as we are. There are a very few evil folks who do most of the damage, but it’s perpetuated by people not speaking up. Which is why I think we “sensitive” folks are needed – we’re the alarm bells for the rest of the snoozing population!
All I can say is LAWSUIT! It is so rare that these mental health hearings result in a release, you KNOW there was no grounds to hold that person. To act with such impunity is absolutely criminal, but the evidence required for criminal conviction is quite a bit higher. So I say sue their asses. Class action would be better if they could find a handful of folks who had the same thing happen to them. It’s a gross violation of civil liberties and needs to be appropriately sanctioned by the Courts.
I notice that they don’t comment on the corollary: there are no drug treatments that are effective in reducing teen suicide, either, and there is a lot more evidence that drug treatments are more likely to INCREASE the suicide rate in teens.
As a fellow counselor, I would also encourage you to speak up loudly every time you hear this hypocritical approach being promoted. There are no doubt others in your classes who are similarly detecting that something smells wrong about this, but may not be able to articulate it, or may be too afraid to speak up. Research into bullying suggests that it only thrives in an environment where bystanders laugh along or keep quiet. And that’s what this is – bullying, with a soft, social-work-y coating laid on the outside to make it seem less harsh.
Follow your heart and speak your truth. We need more therapists like you out there!
Thanks for sharing your story. It really struck me hard that it felt easier to be a gay teen in Texas than to be a “mentally ill person” in the system! The word “stigma” hardly begins to describe it – this is blatant prejudice and discrimination. And it is always fascinating (when it’s not personally directed!) to see how quick those doing the discriminating are to defend their own behavior as beyond reproach and to blame the victim for not sufficiently appreciating their “helpful” interventions.
Because they mostly don’t give a crap. It does not surprise me that no one has done this kind of study before. They just plain don’t want to know, because the knowledge is inconvenient, and they’re all about what is convenient for them, and profitable, of course.
In a similar place myself right now. I am not sure it is about chemicals cycling for me, as much as it is about my life focus changing since my youngest son has left home for college this summer. I am questioning why I am here and what I’m doing with my life. It seems appropriate to me to be going through this somehow, even though I am hating and resisting it most of the time. I think it’s time for me to make a big change in how I’m living, and that’s why I’m feeling this way. Not sure what it looks like yet, but change is coming whether I want it to or not, so I have to work myself around into embracing the idea of a new way of living my life. Meanwhile, I am pretty miserable every single day.
I think depression for me is often the result of stagnation and feeling trapped. There are so many problems of a huge scale confronting us right now, it’s difficult not to lapse into despair. I am discouraged by the venality and thoughtlessness of my fellow humans and my own inability to impact them on a large scale. Underneath the depression for me is a towering RAGE that my life doesn’t feel like it’s my own, that I’m trapped in the capitalist treadmill of going to work to earn money, and coming home to “relax” in the evening, and looking forward anxiously to the weekend but then finding little to do on that weekend that is truly rewarding, and meanwhile waiting for the populace to wake up to the impending disasters our way of life is creating, not knowing what destruction will happen in the interim. It’s not a happy way to live, even though that’s what we’re all taught to do.
Someone once said that suicide is a political comment, not on the person committing the act, but on the society in which s/he lives. I kinda feel the same way about depression. If I were unconscious enough not to understand what is going on, I might be able to feel OK about all of this through denial and ignorance. But I am not and I can’t do it. So I am going to have to change the rules of the game somehow. We’ll see what I come up with.
Hang in there, and know that you are not alone. Perhaps your depression has a meaning you have not yet fathomed?
Would be interesting to correlate this with antidepressant usage during the same timeframes. It seems pretty obvious that we have tons more antidepressants being prescribed and people are more unhappy than ever. Fits in with Whitaker’s thesis perfectly.
The authors leave off the most salient reason for the ad hominem attacks. The clue is that they came from America even if the published results are in New Zealand. What that suggests is that there are people in the psychiatric world LOOKING for anything that might affect their bottom line, and that they have an intentional strategy of suppression via ad hominem attacks and other tried-and-true methods of discrediting of opponents in what is really an economic war. The more serious the threat to their dominance, the more vicious their response will be. It is not accidental or the result of bruised egos – this is mob warfare, where the boss has any competition in the area wiped out by whatever means are necessary.
You must be doing good work if they are threatened enough to go on the attack!
Aubrey, I am just stunned by the clarity and horror of your story, even though I am well aware of psychiatric abuse and child abuse and Munchhausen’s by Proxy. You are an amazingly courageous person not to have succumbed to this absolute Kafkaesque bizarreness. I will write to the Chief of Staff as you request, and I wish you very well in your efforts to finally find some sort of justice in all of this. Thank you for sharing your story with us.
At last, the acknowledgement of the obvious truth: psychiatrists believe in magic! Perhaps the more appropriate title to the article would be, “The Magic of Intentionally-Induced Brain Damage!”
I am with you, John. We need to find areas we agree on in order to be effective. Trying to appease or align the whole range of political opinions leads to the kind of chaos we see on this thread.
One point of agreement that seems to be repeated by both “sides” of this debate is that corporations have too much control of government apparatus, or to put it another way, that government does not serve the needs of individuals but rather of elites who have an interest in controlling the rest of us. This might be framed differently by “conservatives” vs. “progressives,” but it’s an area I’ve found agreement on across the political spectrum. I think finding issues like that which have leverage across party or political lines is a lot more important than arguing out the finer details of climate science, which is a pretty new science that undoubtedly allows many valid critiques, and which probably none or almost none of us here know enough about to really draw any definitive conclusions about. I’d rather look through the “sides” of this debate and find out where we agree, and move forward from there, rather than spending so much time hashing out the two sides of an argument that will not be resolved in this forum.
Drug companies are self-serving and greedy entities willing to lie, cheat, and bribe their way into control. They are in cahoots with the psychiatric profession, and to a large degree with big portions of our government apparatus, and have been very successful in using marketing tactics to promote the existence of metaphorical “diseases” that their drugs purport to “treat.” That’s what I think pretty much everyone here agrees to, and that’s where I think we should build from. I am of the mind that this kind of oppression is, indeed, linked to a wide range of other oppressive activities supported by our society, but it is not a requirement that others see it that way for them to oppose the Pharma-psychiatric-government effort to drug the so-called “mentally ill” into submission for a profit.
I was thinking the same thing, although that clearly doesn’t explain all of it. There are so many kids who take stimulants and become aggressive, and then get “bipolar” diagnoses! I see it all the time in my work. No one ever seems to stop and ask if stimulants could be the cause, even though increased aggression and mania are noted side effects of stimulants. Even more bizarre, we know that stimulants increase dopamine levels, and antipsychotics, which are the most common drug given for “bipolar” in children, decrease dopamine levels. So we’re increasing them with one drug and decreasing them with another.
How does the public let these people get away with it????
Which goes to show that most people’s decisions are not made with scientific data in mind, but on the basis of emotion. That is an important lesson for our movement.
“We need to give providers good guidance on how to use brief symptom measures in evaluating patients and making treatment decisions.”
I have some good guidance – toss them in the trash can! Anything that can give that many “false positives” is worse than useless. As an alternative, I suggest a radical concept – instead of giving them a questionnaire, why not try TALKING with them and taking some time to understand their lives?
I really agree with you that a huge part of “good treatment” (if that’s even the right term) is helping people deal with conflict situations effectively. I am very familiar with that fear of public humiliation, and agree that this is behind so much of what is called “mental illness.” Radical self-acceptance seems to be step one of any plan to become more effective in life – reasoning by fear is what gets us into these problems in the first place! Unfortunately, the privileged class can get away with their fear-based reasoning by attacking and “othering” those who challenge their dominance and ability to control the dialog. Even more unfortunately, a lot of psychiatrists, maybe most psychiatrists, seem to fit into that category of people who need to protect themselves by projecting their power over others, whether consciously or not. It’s dangerous when the person responsible for providing healing energy is so damaged that they can’t even conceive of healing energy, especially when they have the power to compel their “healing” concepts on unsuspecting victims.
The alternative is very clear. A really good study done in the late 70s had professionals try to identify matched sets of “ADHD” children in regular classrooms and in an “open classroom” (think Montessouri) with work stations that kids could choose between and move between when they felt they were ready to transition. The professionals were 90+% accurate in the standard classroom, but could not consistently distinguish the diagnosed kids in the open classroom setting. This is a dramatically clear result, and suggests that we should be putting these so-called “ADHD” kids into open classroom settings where they have more control over the focus and timing of their education. We did this with both of our active, oppositional boys, and both did well in this kind of setting, though they’d assuredly have been disastrous train wrecks in a standard elementary school.
Unfortunately, open classrooms were opposed and beaten into submission in the 80s as the “accountability movement” (think standardized high-stakes tests) took over in the USA. I have always believed that those behind the “accountability movement” actually hate children and believe they need to “have the devil beaten out of them” in order to make them into orderly, compliant adult consumers. There is a small resurgent effort in the “unschooling” and the liberal end of the charter school movement, but such classrooms are not readily available to the general public, at least in the US. We actually had to help invent one for our youngest, who thoroughly defied all the predictions regarding drug abuse, school failure, low self-esteem and delinquency, as he is now a freshman at Evergreen State College after finishing high school with a 4.0 average. So much for “untreated ‘ADHD’…”
Open classrooms are the alternative. We know they work, but we have to create them and make them available to our “non-standard learners.”
Can we appoint you to lead the FDA into the next millennium? Your plan makes excellent scientific sense, even though it would drive the politicians and corporate fascists around the bend!
Wow, Meaghan, you have shared both the worst and the best of what psychiatry can be! I wish we could clone your latest psychiatrist – I don’t know that I’ve ever met another one who exhibited that ability to be real and human with his client and yet maintain professionalism throughout. You are indeed fortunate to have found him, and to have discovered that you are, in fact, not ill at all, simply responding in the best way you could to an intolerable situation.
Despite which, you appear to be amazingly accomplished, creative, and persistent! Thanks so much for sharing your story with us, and I hope you’re able and willing to write more about your impressions of what works and doesn’t work in helping someone overcome a traumatic and difficult upbringing in a traumatic and difficult society.
Any real scientist knows that negative results are far more important than positive results. Science is actually really bad a proving anything, because there are almost always multiple ways to explain a “positive” finding, as well as many ways to manipulate data to make a finding look more positive than it really is.
The real test of science is trying hard to DISPROVE a hypothesis in any conceivable way and still having it hold up. Science is very good at absolutely disproving a hypothesis when the results contradict what is predicted to occur, so any events that contradict a given hypothesis are of the utmost importance, because their presence, or the lack of them after multiple efforts to replicate or disprove an idea, are really the bottom-line determinant of scientific truth.
Null findings should systematically be published, and should be required to be submitted along with any “positive” findings before a drug is ever allowed to reach the market. If this were done, a lot of bad drugs would be stopped in the pipeline, instead of 10 years later after hundreds are killed and the patents finally expire.
Thanks as always, Michael, for your passionate advocacy against one of the most heinous crimes of psychiatry – the drugging of innocent children for their normal childlike exuberance!
The only thing I’d add to this is that our schools themselves cause “ADHD” to even be an issue in a huge majority of cases. A couple of points on that: 1) there was a recent study showing that waiting a year for Kindergarten admission reduced the rate of ADHD diagnosis by 30%. 2) A great study back in the 70s showed that professionals were unable to identify “ADHD” children in an “open classroom” (think Montessouri style), while they easily identified a matched group of “ADHD” children in a standard classroom setting. So moving the kids to an open classroom essentially eliminated the vast majority of difficulties they exhibited, even though those with the ADHD diagnosis probably suffered from disproportionate levels of abuse, neglect, and trauma outside the home, as well as probably having more sleep difficulties or dietary issues or whatever else is associated with “ADHD.”
We could “cure” 90% of our “ADHD” population by simply putting them in open classrooms, and having anyone having difficulty in that setting wait a year and restarting school. Knowing this makes the drugging seem all the more horrific by comparison to what might actually be done to help the situation.
I have an even more effective screening tool that “adjusts its line of questioning depending on responses to previous questions” – it’s called TALKING TO AND LISTENING TO THE FREAKIN’ KID! I know this is a radical concept in today’s highly technological world, but I am promoting the idea that a human being may be better able to connect with a young person in distress than a computer terminal. On the other hand, given what many so-called “mental health professionals” provide today, maybe their odds are better with the computer…
I think she is preparing people for what may be a grim reality, as well as helping people who don’t want to face such a grim reality perhaps decide not to start using these drugs. Of course, not everyone has this level of difficulty, but for those who do, I imagine it must feel like a big relief to hear they are not alone, that this can be a very difficult process, and that despite those difficulties, Monica has continued to move forward and ultimately succeed in getting herself off of these drugs.
We each have something to contribute, and I think Monica’s contributions are extremely valuable, and I always have.
This is an excellent and thought-provoking comment! I really do believe and have observed that the lack of a positive social role for creative and deep thinkers and feelers in our society is part of the reason that outcomes for people experiencing “altered states” are so bad here. I think it would be a very different experience if a person heard voices and instead of others being worried about it, someone said, “Hey, you can speak with the spirit world! What are they saying? Let’s get the shaman over here – you need some training!”
As always, I appreciate both your honesty and humility. It is the lack of both that I believe contributes to the damage done in the name of “mental health treatment.” I am the last to suggest that tapering is going to work for everyone, or that CBT is going to work for everyone, or that everyone even needs to do some kind of “therapy” that can be judged to work or not work.
I have to acknowledge that I had the biggest challenges with people experiencing what would generally be termed “psychosis” when I was working with adults sent to the hospital for possible commitment. I believed and still believed it was due to a lack of understanding and skill on my part. It was very difficult to accomplish what I usually do, which is to develop a strong sense of shared reality and agreement with the client. I have been able to do this many times with people experiencing “psychotic symptoms,” but more often than not, it was difficult and I was often completely unable to accomplish it. But that doesn’t mean it couldn’t have been done by someone more skilled than myself at it.
Even Open Dialog uses medication on something like 20% of clients long-term, so I am guessing there is no one way that is going to suddenly resolve all issues of psychotic experiences. But I think Nijinsky is correct in saying that the problem may relate to “consensus reality” itself. My biggest problem with psychiatry as practiced is not that it fails to help everyone it tries to help, but that it fails to recognize the possibility that eliminating symptoms may not be the ultimate goal. Perhaps it is more important to start with respect for the fact that all individuals have their own particular perception of reality, some aspects of which could be called “delusional” by others who disagree. Trying to force one “consensus” view of what is “normal” seems to be the central problem of the DSM and the mental health industry as a whole. Being able to acknowledge, as you do, that you don’t really have all the answers, and maybe aren’t even sure of the right questions, is increasingly a rarity in the field, in my experience. Until that kind of humility and openness becomes pervasive in the field, I believe the use of medications will continue to be extremely dangerous and lead to bad outcomes, because it will not be tempered by a proper understanding that medications/drugs are just a tool, one of many, many tools, and that it is pretty much a blunt instrument whose short- and long-term effects can be devastating if used in a careless or egotistical manner, as they most often seem to be used today.
Could be. But I think it more likely reflects that the real purpose of the drugs is to make kids more manageable. Their “behavior improved” means they were less annoying. Apparently for some adults, that is more important than having the child sleep well.
Interesting that Stoessel claims that there is no evidence to support claims of bias and corruption. In addition to Phillips observation, which has been replicated many times, that pharma-funded research always tends in the direction of approving or preferring the product of the person doing the research, there has been significant replicated research on doctors believing they are uninfluenced by pharma reps talking to them about products, and yet clear evidence that they are dramatically influenced by such visits.
It is not bias to recognize the facts. It is bias to pretend they are not true when they are clearly proven to be valid. It’s kind of rich for anyone deeply inbedded in the psychiatric profession to be claiming someone else is biased. People who live in glass houses…
I completely agree – we would be more correct to say that “drugs mimic the effects of naturally-occurring bacteria” than that “bacteria produce drugs.” And the conclusion should not be that we can use bacteria to create new drugs or as a biological drug factory, but that we should be looking to naturally-occurring bacterial symbiosis as a possible solution to many health problems we experience.
But some people have no respect for life or nature…
This is a REALLY workable idea! There are a lot more readers than editors and it shouldn’t be too hard to establish credibility with sufficient references. The interesting question will be whether there is a reaction from the establishment to try and “correct” our authenticated version of reality where it clashes from the fantasy version preferred by the psychiatric elite.
What a useless hotline service! I used to run a shift on a citizen volunteer based crisis line, and no one would ever have been treated that way. Unfortunately, many hotlines are now run by “professionals,” which means they are more expensive, have less people answering calls, and treat people with a distressing degree of condescension and disrespect. I’d be interested to know if this was a purportedly “professional” hotline. It certainly failed this caller in multiple ways.
My thoughts exactly. If “symptoms” are the problem, then being dead is a solution because it removes all symptoms. This is the kind of “reasoning” that led to lobotomies. It really would be kinder to just kill the person outright rather than poisoning them to make them forget why they should be afraid.
The authors fail to follow up with the corollary of their conclusion: If telling adolescents that their brain is flexible and can be changed decreases depressive symptoms, does it not follow that telling them their brains are INFLEXIBLE and can’t be changed (i.e. “you have a chemical imbalance,” “you have a biological brain disease, like diabetes” or “you need to take your medication for life”) would INCREASE the likelihood of depressive symptoms? Since what you tell people makes a difference, why aren’t we looking at whether telling people what we tell them now is helpful or unhelpful? I’d love to see someone do a survey of people’s symptoms vs. the message they got from their provider when they complained of feeling depressed. I’d bet my mortgage that telling someone they have a “brain disease” that is “incurable” but can be “managed” with “medication” (notwithstanding the actual effects of the “medication” itself) would make people more depressed. It’s depressing to me just to write it down!
Kind of disrespectful, but still, it’s a sign of progress to be raised up to “vocal contingent” status. Definitely above “radical cult member” or “disaffected anti-scientific maniac!”
I am blown away every time you write, Sharon! Your passion is intense and focused on the right issues. I agree 100%, what we need is a survivor-led movement, with professionals only engaged as 100% supporters of the goals of the survivors. And issues of gender, race, and other social oppression need to be a central focus. Psychiatry is the ugly face of our oppressive, authoritarian society – the ultimate in victim-blaming. Power to the disempowered is the path forward. I would love to see you as a leader in such a movement.
This is extremely well described in “Zen and the Art of Motorcycle Maintenance.” It is written by a scientist-turned-teacher-turned-philosopher who eventually becomes psychotic and is “treated” with electroshock that essentially deletes his entire prior personality. The author takes us back through his road to rediscovering who he was and is, and meanwhile does an amazing job of pointing out how and why we have divorced science/technology from art, why it’s destroying our culture, and what we might do to help reintegrate them. It is one of the best books I’ve ever read on any subject, but he attacks this issue head on and with tremendous impact, at least for me.
I told my wife to push me off a cliff before she puts me in an Alzheimer’s unit. I used to work as an advocate in the ombudsman program. I would never want to be in one of these place.
Good to see this information getting out in a left-leaning media outlet. The Left in general has abandoned the psychiatric survivor’s movement in favor of advocating for more “access to services.” Reframing this as corporate malfeasance (which is exactly what it is) may bring a lot more advocates to our side.
“Normalization” of difficult or confusing experiences is a critical element of psychological healing in my experience. Psychiatry does the opposite – it takes normal experiences and makes them seem wrong, and takes difficult experiences and makes them seem terrifying. It is the opposite of what is actually helpful, without even considering the drug aspect.
I agree absolutely. What I object to his characterizing him as “mentally ill” and assuming that some kind of medical intervention would magically make him not be an abusive creep. I know I’m preaching to the choir on that one. I work with foster kids and am very well aware of the impact of early life experience on everything that one thinks, says and does as an adult. I think that’s where most of the answers to “mental health problems” lie.
There was actually an article posted the other day on MIA that says the opposite. The more intense psychiatric services someone receives, the more likely they are to commit suicide. I’d be interested to hear any data to the contrary, but it has not been in anything I’ve read.
I agree 100%. The problem with that guy was that he was a mysogynistic abusive creep. He may or may not have had a diagnosable “mental illness,” but that could not be the cause of his obsessive and disrespectful treatment of women, which started long before that event, because there are tons of obsessive and disrespectful men who treat women that way, but are fine with everyone else, and the vast majority of people who have any diagnosed mental illness would never behave in the way he did.
Additionally, you (Vegwellian) are assuming that some kind of “treatment” with a drug would stop him from this kind of violent act. There is no evidence that any drug treatment consistently stops violence, and plenty of evidence that any number of them make violence more likely in a small but significant number of cases. Read ssristories.org for a LOT of examples. Even if not all of them show causal connections, it should be clear to even a pretty pro-drug reader after reading the 40th entry or so that taking psychiatric drugs does not appear to have any limiting effect on the likelihood of serious violence.
There are a number of studies showing that AOT doesn’t even improve compliance significantly, and that it is the provision of additional supportive services, like housing, employment, etc., that actually reduces the likelihood of serious adverse consequences. The thought of demolishing millions of people’s civil rights in order to somehow stop the one in ten million who may engage in a mass shooting, using drugs that aren’t even shown to reduce such behaviors, but in fact, may very well increase them, is nothing short of abject stupidity. It is only promoted by those who either stand to profit from the endeavor, or who feel a need to control the ‘mentally ill’ for reasons that relate to their own personal issues. A rational person looking at the real data would easily conclude that this is absolute idiocy.
It is never helpful to invalidate the perspective of the client! CBT can be used to support a client’s goals, or it can be used to impose the clinician’s perspective on their client. It sounds like you got a lot of the latter. It makes no sense to even use a CBT approach if someone is in an unsafe situation or being currently traumatized. It’s also quite an invalidation to have such experiences in your past and have someone say, “You only feel bad because of your own thoughts about the events.” While such a statement may be technically true, it makes it sound as if a) feeling bad about being abused is abnormal, and b) changing one’s thoughts about an incident of abuse is a simple matter, like repeating a positive affirmation ten times and you’re OK. And that crap about being “treatment resistant” always sends me around the bend! You don’t keep taking your car to a mechanic who says your car is “repair resistant!” “Treatment resistant” should be replaced with “I have failed to be of help to you” or “I guess we have not found the right approach yet.” “Treatment resistant” is just another way to blame the victim of the clinician’s failure to help.
To me, any formulaic approach to helping someone in distress is bound to create problems. I think I agree most with Milton Erickson, who said “you have to re-invent therapy for each client.” It’s about being human and connecting and observing honestly if you’re actually helping and changing your approach if things aren’t improving. There is no magic school of thinking that leads to good results. It requires being a good communicator and being willing to BE with a person in their pain, no matter where that person may be.
Sorry, not buying the “people who are more likely to develop dementia are more likely to use Benzos.” The direct dose-dependent relationship makes that much more unlikely to be true. There is a dramatic difference between those taking them intermittently or briefly and those taking them chronically over time. Any good scientist’s first hypothesis here is that the drugs are the cause. Sure. this is not definitive and more study is needed, but this should mean an immediate halt to long-term use of benzos for sleep problems until this is proven NOT to be a problem.
There are also tons of other options for sleep issues that are rarely explored. Benzos for sleep should be an absolute last resort, and then only short-term. They are very similar in effect to alcohol. Drinking a sixpack before bed will definitely put you out, and if used occasionally won’t have too much of an adverse impact, but doing it every night is probably not advisable. Now that I think of it, long-term alcohol abuse leads to dementia, so why should we be surprised if long-term benzo use did something similar?
I didn’t find the debate in the original article to be particularly bitter or acrimonious. It appeared to be an attempt to put the findings in historical (Pilgrim) and scientific (Moncreif) as well as personal perspective. It is passing strange that we have something that is an associated risk factor at the 85% or so level (childhood trauma) which can actually be addressed both preventively and therapeutically, and yet we spend huge amounts of money on something that has an associated risk factor at the 3-4% level and which is completely immutable to human intervention (inherited genes). Assuming “the best intentions” does nothing to address that issue. I am sure the author really believes he’s acting in the best interests of his clients, but he is apparently blind to the wasted energy and effort he is engaged in which will likely supply absolutely nothing of consequence.
Perhaps the real starting point is for the mainstream psychiatrists to assume the best of intentions on the part of its critics, instead of labeling rational dissent and information as “bitter” and “acrimonious.”
I am not from Spokane, but live in Portland. I have done a few internet searches today regarding peer services or drug-free alternative services in Spokane, to no avail. You might want to connect with Mind Freedom International out of Eugene, OR, and find out from them if they have any affiliates or members in your area. What you really want to do is to connect with a mental health alternatives/psychiatric survivors group in the Spokane area, but my searches have not revealed any group in your area. Maybe you can find a renegade mental health professional who can clue you in to the “underground?” In a town of that size, there almost has to be some kind of group having the same kind of experiences. If there isn’t, maybe you should create one! But steer clear of NAMI – I read the NAMI Spokane website, and while they claim to be “peers”, they are actually mostly family members who have been indoctrinated to believe in the “biological brain disease” model of “mental illness” and work hard to indoctrinate others. They’re heavily funded by the pharmaceutical industry.
In the end, what your son and your family needs is hope. You won’t get it from the psychiatric system, but you might get it from someone who has survived it and made it out the other side. Connecting your son with such a person might be the best you can do right now to help him find another pathway.
I hope that is helpful. I’ll be thinking of you and sending good energy your way!
Sounds like the only thing they showed is that Ritalin has a direct impact on these eye movements. Of course, it can’t be a foolproof method for diagnosing “ADHD,” because there is no way to identify who has “ADHD” in the first place. So how can you know that this is “right?”
I know your dilemma. The real answer is to find an alternative placement where he can be safe and people know how to deal with him, but where the drugs aren’t the primary intervention. I don’t know where you are right now, but maybe if you can share the general area you are in, someone here might be able to make a recommendation.
The other thing that can help is to find some sort of peer-centered service where he might find other people who can understand what he’s going through and perhaps assist him in figuring out the medication picture. It can be a lot less threatening to hear this kind of information from a person who has been where you are, as it doesn’t come across as condescending or controlling.
Bottom line, it’s a very difficult spot to be in. You care about him, but he is an adult and he has to make his own decisions and live with the consequences of them. Sometimes that means he ends up in the hospital, until he becomes motivated enough to want to come up with a way to avoid that. Sometimes it means he experiments with the medications/drugs and goes on and off until he figures out that quick changes are a bad idea. Sometimes he never figures it out. You definitely have to protect yourselves, and it can happen that you have to have faith and leave it to God or the School of Hard Knocks to provide the necessary lessons. It is very, very painful to watch and not feel you can do anything. But that is the reality of an adult who is your child. They make their own decisions and we hope they learn from their mistakes. We can provide resources and suggestions, but we can’t really tell our kids how to live their lives.
My heart goes out to you. Hang in there, and let us know if there’s anything more specific we can do to help.
You are so right. Alice Miller has written eloquently on this topic for years. Either we deal with what our parents did to us, or we pass it on. Unfortunately, the 80s and the DSM/biological brain disease movement completely undermined Miller and her ilk in favor of protecting those in power from criticism. It happened in the larger society as well – the rich, corporations, the powerful all became immune to criticism, whereas in the 60s, there was a hell of a lot more accountability. We need a revolution back in that direction. We need to recognize that the person with more power ALWAYS has the primary responsibility for creating safety and a sense of value, especially when children’s fragile egos are involved. Adults need to be held responsible for what they do to kids, or else the kids become adults and continue the cycle. It’s really about that simple.
And what are the non-medical psych services? A lot of what passes for “counseling” these days is nothing more than checking in and making sure they keep on their “medication.” Especially in the school setting, I’m betting most of them aren’t getting anything that I’d call counseling.
There are also lots of families who trusted the system initially but discovered to their loss that they’d been deceived. These people are our allies. Lots of them post here. A number of them are part of the core of the Rethinking Psychiatry group I’m a part of in Portland, OR. We should not dismiss their contributions. Not every parent is a NAMI parent!
I find this fascinating! Did you publish your results? It really supports my long-time contention that 90% of what kids do as “misbehavior” is intentional and goal-directed behavior that meets the child’s needs for attention, autonomy, power, or whatever. One of my biggest beefs with the DSM is that it discounts the intentionality of behavior and assumes that someone acts a certain way because s/he can’t help it. This is often extrapolated into the idea that the brain somehow causes the misbehavior, removing the concept of the child as a causal agent. This, of course, is extremely destructive, as we’re giving the child an “out” any time they misbehave. As a friend’s son diagnoses with ADHD learned to say, “I can’t help it, I have a disability.” Not a great message for kids having to learn about morality, responsibility and ethical decision-making. I find it far more effective to give the kid credit for having developed a strategy, to find out what the strategy is for, and help them develop some new strategies that might accomplish their goal without irritating the adults or getting them into trouble quite so often.
Good article! I am interested to know that there are 5 states without civil commitment laws. Apparently, these states have not been overrun with rampant, crazed, homicidal maniacs who need to be forcibly medicated. I’d be very, very interested in reading some comparison data on suicide, homicide and other serious outcome measures between the states with no civil commitment laws and those that have them. I’m going to bet that there is no difference whatsoever.
1) Mental illness has not been determined to be a biological condition. There is no single mental illness where a definitive biological cause has ever been identified. Even the head of the NIMH, Tom Insel, acknowledges this fact. Show me any science that convincingly proves this claim and I will be very surprised. It doesn’t exist.
2) You fall victim to the assumption that the California shooter would likely not have been violent if he were taking medication. This association (between medication usage and community violence reduction) has never been established. In actual point of fact, the young man appeared to have many of the characteristics of a domestic abuser, including a sense of personal entitlement and a very downgrading view of women as sexual objects who were supposed to respond to his commands and were targets for punishment if they did not comply. While some domestic abusers have “mental illnesses,” most do not, it has been long established that there is no direct correlation between mental illness and domestic abuse – they are two separate issues that simply occur together sometimes. And there is no medical treatment for domestic abuse – it is a behavioral choice that people make, whether mentally ill or not, and whether medicated or not. The vast majority of “mentally ill” people do not make that choice.
3) You mention Laughner and Lanza as examples. Laughner may not have been taking psych drugs, but he was abusing other substances, including psychedelics, and his behavior reportedly changed after starting them. The link between mental illness and violence is very weak to nonexistent after controlling for substance abuse. Laughner is more likely to have been violent as a result of his substance abuse issues. As for Lanza, nobody knows if he was using psych drugs or not, though there are reports from relatives that he was. His medical records were apparently not released, according to Sheila Matthews of AbleChild, because officials were worried the info might encourage people not to take their prescribed psych drugs. So I think there is a likelihood he was on them when he attacked. Of course, there are many stories of those who were on psych drugs when going on killing rampages, including Kip Kinkel, the Red Lake, MN killer, and of course, Erik Harris of Columbine fame. More stories are available on SSRIstories.org.
The idea that these violent incidents occur due to lack of appropriate treatment, or that drug treatment can prevent them, is a fantasy supported by the media but not by any kind of scientific information.
4) I don’t know where you came by the narrative that people who didn’t make themselves better were lazy malingerers, but I grew up in the 60s, and started mental health work in the 80s, and I seldom if ever heard that kind of talk. The thinking of the time was that mental health issues were primarily caused by early childhood abuse or neglect, including emotional abuse and neglect, usually in the family system. While our understanding of abuse and neglect has expanded and we’ve come to recognize that other traumatic events can have an equally important role, it is only recently that the mental health world has begun to come back around to realizing that we (then proponents of the trauma model) were essentially correct all along. Even the best genetic prediction models to date (and these are pretty strained sometimes) can only find predictions in the range of 1-3% for a specific mental health issue, or maybe up to 10% for a range of issues combined. (This disappointing lack of correlation with genetics is apparent in physical illnesses as well.) Whereas trauma predicts mental health problems at something closer to an 85% rate. (And according to the ACE study, which you really must read, physical health issues are also much more highly associated with trauma than with genetics.) Don’t know about you, but I don’t think that the trauma model “rejects science-based medicine” – it seems to me that those arguing for the genetic/biological cause model are the ones rejecting science “for something that can’t really be qualified or quantified.”
Long answer, but I was really struck by the number of assumptions and mythological statements your post contained, and I wanted to present the actual data that I am aware of that refutes those claims. I am a scientist by training and am a big supporter of empirical testing of all of our hypotheses. Unfortunately, the psychiatric profession as a whole does not appear to share my passion for objectivity. You sounded like you might be more inclined to be influenced by actual facts. I hope that what I’ve shared is taken in that spirit, and not as a criticism. Many if not most mental health folks would repeat the same “facts” as you shared, and unfortunately, Goebbels was correct in saying that if you repeat a falsehood frequently enough, it becomes true. I and most of the people here are trying to undo some of those falsehoods by presenting some factual information that the psychiatric leaders choose to ignore.
I am waiting to hear how the biologically-oriented are going to spin that “forgiveness” is somehow an inborn biological trait that can’t be learned.
I agree, a pretty big jump from this correlation to the conclusion. Still, at least they’re recommending teaching something instead of drugging us into “forgiveness!”
Of course, I agree with you 100%. That’s why I used the term “Schizophrenia-diagnosed” rather than “schizophrenic.” I use that term only because that’s what they purport to be studying in their efforts to prove a genetic underpinning to this pseudo-disease. My point is that their efforts are a dismal failure, and that looking at what happened to people and how they are experiencing the world is the best approach, rather than “diagnosing” them with a “disease” that has no physiological reality whatsoever. In other words, your psychotherapists’ view is in accord with my own.
I agree that respite beds with a non-psychiatric focus would be essential if we’re to undermine and replace the current paradigm. People do need help in crisis situations, and we already have models (Soteria, Open Dialog, and many more) that show how that can be done with para-professionals and without force. The big question to me is how to deal with the politics? Such efforts are almost always opposed by the establishment as cutting into their slice of the economic pie. Where are the forces to oppose this politically-motivated defunding/coopting effort? Do you think the psychiatric system would ever embrace such alternatives to the point of diverting funds in that direction on a permanent basis? Maybe I’m being cynical, but I can’t see that happening without a major revolt from both “consumers” and “providers.”
I think the question is answered by reading the article in the “In The News” section of MIA today, showing that there is a dose-dependent relationship between increasing psychiatric care and increasing suicide rates. Sounds like the only reason to pay for more psychiatric beds is if we want more people to kill themselves!
Seems pretty clear to me. Psychiatric help provides three important things that I believe would increase the suicide rate: 1) they invalidate the genuine concerns that may have caused or exacerbated a persons’ suffering, and blame the patient for having a “disorder of the brain.” This creates a loss of agency and a feeling of being out of control. 2) they communicate that the situation is life-long and can’t be fixed by either the psychiatrist of the patient. This deepens a person’s sense of despair and hopelessness, and reinforces the lesson in #1) that the patient him/herself is unable to take any step or action to reduce their own suffering. 3) They provide “treatment” in the form of drugs that are at best temporary numbing agents that lessen the overall intensity of their experience, but don’t address whatever underlying physical or psychological issues might have caused the problem, and which at worst are independently responsible for increasing the suicide rate regardless of any other variable.
This should be viewed as a total repudiation of the current paradigm. Has someone forwarded this to the NYT or other news outlets in the form of a press release? I’d love it if someone with sufficient credentials would put this forward and offer to be interviewed about it. The best interpretation that can be put on it is that sicker people seek out psychiatric care, and it doesn’t have any positive effect at all – they are just as sick as they were when they arrived. That is the only viable conclusion from the idea that this distribution is caused by ‘selection bias’ alone – sure, suicidal people are more likely to seek psychiatric help, but getting more “help” doesn’t seem to make them better. The more likely and more sinister conclusion is that psychiatric help CAUSES an increase in suicidal behavior in the aggregate. This explanation definitely fits the data better, but even those not inclined to believe that have a lot of explaining to do.
Wow. I started reading and could not stop. This is a mesmerizing account (excuse my accidental reference to Dr. Mesmer!) and should be mandatory reading for anyone working in a psych ward or inpatient facility of any kind.
I think the most telling part is identifying the secrets as the central thing that folks in the psych ward had in common. Sadly, it appears that getting out requires keeping those secrets and creating yet more. Rather than safety and trust, it seems the ward creates the need for barriers, emotional isolation, and dissembling, and when you become good at those, you’re declared safe to be released.
Thanks for sharing this dark and yet strangely hopeful vision with us.
As baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
All the more true in the mental health field than other places, apparently.
Frank, you are so right about violent and assaultive behavior by “professionals!” In addition to the inherent violence you mention in being arrested and locked up, and often held down and forced to take drugs against one’s will, which is clearly a violent and intrusive violation of a person’s integrity and body, I see way too frequently that a patient “assaulted” a staff person, and then read the incident report, and it’s clear that the staff person assaulted the patient and the patient was not allowed to defend him/herself. I’ve seen kids have criminal charges filed because they fought back when a staff person put hands on them unnecessarily after an escalation of a power struggle started by the staff person. There are institutionalized excuses for staff assault that are almost universally accepted in residential settings, and clients are almost always blamed when any kind of violence occurs, even if the staff initiate it.
There are plenty of instances of violent and predatory behavior by staff. I’m not saying this is the norm, but it’s easy to get away with, and there are sociopathic types who go into this work just so they can exert that kind of arbitrary power over helpless victims. Another reason why enforced treatment has got to go!
I was struck by the statement that AT BEST, the genetic markers they discovered could possibly account for 3.8% of the tens of thousands of diagnosed individuals. I read in an article just a few minutes earlier that well over 80% of schizophrenia-diagnosed individuals were traumatized in their youth. Which of these appears to be the better predictor of psychotic symptoms developing? Is it even close? Wouldn’t it make more sense to work on the area that is so well correlated, and over which we also have a much greater degree of control?
It is amazing how the delusion about genetic causality continues, despite complete and colossal failures all along the road, and despite the much more obvious and clear correlations with environmental conditions. It is very much reminiscent of the eugenics movement – the “science” is driven by the ideology, and any evidence to the contrary is simply ignored as irrelevant.
Except that as I recall the findings, they had four groups: schizophrenia on drugs, schizophrenia off drugs, less serious psychotic disorder on drugs, and less serious psychotic disorder on drugs. The schizophrenia-off-drugs group did better in the long term than the less-serious-psychotic-disorder-on-drugs group. One would assume that those with the less serious psychotic disorder had a better prognosis and a greater likelihood of recovery without drugs; still, giving them drugs provided a worse outcome profile than those with schizophrenia diagnoses who avoided or weaned off of medication.
I think that pretty much kills off the “they were worse off so they needed drugs” argument. Adding to that, when the long-term outcomes differ so widely (68% to 8% at 20 years), random differences can’t rationally be the causal factor, because you have a bimodal distribution. How would it be possible that there is this HUGE gap between those who naturally recover (92% rate) and those who “need medication” (32% rate) without some kind of artificial intervention? Unless we’re somehow talking about two distinctly different conditions, which of course there was no reason to believe was the case (these people were self-selecting), the only variable that could possibly account for the discrepancy is the drug “treatment.”
But apparently ALL of those restraint uses prior to the protocols, and ALL of the restraints used in other similar venues, were/are justified and unavoidable for safety reasons…
It’s lovely that they’ve done this, but this kind of thing is often looked on as a “nice program they’ve got going over there,” instead of drawing the proper conclusion, namely, that they and most other psych wards are using restraints unnecessarily on an almost daily basis, and harming patients in the process.
Stephen, you said a lot. Anyone can be harmful if s/he has not dealt with his/her personal issues to the point where s/he can distinguish between what FEELS GOOD to do (the psychiatrist feels better because the client is now in the hospital and can’t kill himself) and what ACTUALLY HELPS THE CLIENT (the client feels worse than before because he was actually trying to solve a problem and felt hopeless, but needed to talk, but now he’s got three more problems to solve and feels brutalized and abused into the bargain.)
Good therapy or help of any kind has to start from a place of humility. One advantage of a person with “lived experience” could be that they already have the experience of being mistreated and so approach the helping relationship with more humility. But it is also possible that the person hasn’t processed the trauma and instead acts it out on the new client in order to push away his/her uncomfortable feelings. I think this happens a lot when a person who feels they were helped by medication encounters a person who doesn’t find medication helpful. And of course, the staff pressures them to adopt the “conventional wisdom” and supports them in invalidating their client’s concerns.
There is nothing magical about a “peer” providing the service. The problem is one of empowerment and oppression. As long as the “authority” has the right to tell people what is wrong with them and what they have to do to fix it, the authority will be in a position to abuse, whether s/he is a “peer” or not.
Allow me to reiterate my point: there is a difference between promoting Scientology or being a Scientologist, which as you say each person must decide about, and about which of course your own experience is a very valid source of information, and accusing someone of being a cult member or “front group” because they happen to disagree with the psychiatric mainstream. I don’t hear anyone on this website promoting Scientology as a religion. But I do sometimes hear people trying to tarnish the reputation of others who have been big contributors to our movement, including Sheila Matthews, Thomas Szaz, and William Glasser, by suggesting that they are somehow associated with Scientology or CCHR. That, I find reprehensible. I make no apologies or defense of the CoS itself – that is not my job or my purpose. But I want to make sure that we don’t get caught up into pointless arguments about who is or is not influenced/members/associated/front groups, because it detracts from our efforts and energy and feeds ammunition to those who would like to discredit us.
I hope you are able to see the difference. Scientology is whatever it is. Ad hominem attacks are ad hominem attacks, regardless of the “truth” about the group(s) to which our detractors would like to associate us all. The attackers need to be called out for using that tactic, because it harms our movement, regardless of what you or anyone else thinks about those groups.
—- Steve
P.S. I think invalidation is a very useful word, regardless of whatever “buzzword” status it may have in Scientology. I don’t like to have people feeling that I am judging their perception of the world as being wrong, because we’re all entitled to our perceptions. It’s only when perception collides with proven data that we move into a different territory. One of my biggest beefs with Psychiatry is that it tells people that their own personal experiences, and even their own perception of reality, is wrong, based no nothing but the psychiatrists’ personal biases, which of course are always assumed to be correct. There is nothing I know if that is more damaging to another person than having someone tell them that what they know to be true is false. As a counselor, I avoid creating that experience like the plague. I find that “invalidation” is a good short-cut word to describe it.
And I want to distinguish, and would like you, Ann, to distinguish, between being a Scientologist, seeing Scientology as an “ally”, seeing CCHR (which is not the same as Scientology, though they are closely linked) as an “ally,” and opposing the tactic of attacking people’s character by accusing them of being Scientologists. It is the latter that I think David (and I) are most concerned with, especially when people within the movement fall into using this tactic (as happened in the RTP debacle) to attack others who are ostensibly pursuing the same goals. To do so feeds the fires of those in the psychiatric profession or elsewhere who enjoy conflating being against psychiatry to being a Scientologist.
To me, calling someone contesting psychiatry’s preeminence a Scientologist has become the equivalent of calling an African-American the “n” word. It doesn’t even matter if the “allegation” is true or false – the word has become so emotionally loaded that it precludes any further rational communication. And it is intended as an insult, a provocation, and a distraction, and should be labeled exactly for what it is, regardless of ones’ views on the organization.
I know you have had bad experiences with Scientology, and you are certainly not alone in reporting that experience. But that’s a totally different subject than smearing our own ranks, or allowing them to be smeared, by using what has become the ultimate “swear word” of the psychiatrists working to discredit us. It needs to be confronted for the evil tactic that it is, regardless of one’s feelings about the religion in question. As soon as we even take up the discussion, psychiatry wins.
I hope I’ve made myself clear. I am not intending to invalidate your experience. I just want to clarify the difference between the qualities and policies and dogma of a religious organization, which any person may or may not agree with, and the tactic of using religious bigotry and innuendo to try and malign and discredit those speaking out against psychiatric abuse, which I believe should NEVER be tolerated for a moment.
Thanks for this article – I learned a lot! I find myself being sympathetic to the Epicurian viewpoint overall, though I had no idea of the history. I now understand why “epicurian” has been diverted to mean something much smaller – the “psychiatrists” of the time needed to demonize the movement in order to snuff it out, much as modern psychiatry has had to demonize Szaz.
I have to say, though, I think you missed the main reason why Szaz’s influence waned as he got older. It’s very clear that Psychiatry (the religion) made a monumental effort to re-define “mental illness” starting in the late 70s and early 80s with the development of the DSM-III. This effort was massively funded by the pharmaceutical industry, but also fit very nicely into the Reagan-Thatcher era push toward “individual responsibility,” meaning an increasing desire to deny the impact of social forces on individuals and free reign toward blaming all individuals for their own circumstances or conditions, including poverty, unemployment, racial discrimination, and so forth.
So there was a HUGE push toward denying that mental illness could be caused by circumstances a person is confronted with, not because it was philosophically believed to be so, but because it was economically and socially beneficial to those in positions of power to forward this belief.
Sadly, Szaz was indeed correct in his assumption that too many individuals will do almost anything imaginable to avoid real responsibility and instead cast blame somewhere else. This also leads to the desire for magical cures, and psychiatry has been all too happy to provide them, for a considerable fee, of course. The DSM and pills let EVERYONE off the hook – parents aren’t responsible for their kids’ behavior problems or emotional states, teachers don’t need to think about creating better structures or learning environments (after all, it’s the CHILD that has the problem!), therapist don’t have to actually listen to or feel what their client is experiencing, social institutions don’t have to examine their role in perpetuating prejudice and oppression – nobody’s done anything wrong, and nobody has to change anything, it’s all genetics. Even the client is off the hook – you’re emotions have nothing to do with you, it’s all your brain’s fault. So kids don’t need to learn to behave better, adults don’t need to learn to manage their lives better, teachers don’t need to learn how to teach better – we put a label on and give a drug and the problem is solved! And even if it isn’t, we blame the “disease” – if my efforts don’t work, he has “treatment-resistant depression.” It’s not because I am a crappy therapist. It’s that darned “depression” that just refuses to yield!
This viewpoint, however unsupported by actual facts, had great appeal to the masses, as well as to the monied elites who create policy and control the media. So Szaz and Laing and Mosher and Breggin and Paolo Friere and anyone who had the temerity to disagree with the “new world order” were systematically and rather easily dismissed as a crank or “antiscientific” or a “Scientologist” or whatever ad hominem attacks were effective, because these people (the psychiatric big brass and their allies) were never interested in the truth or in helping people, they were interested in dominating and making money. And they have done a great job of it, much to the detriment of those they claim to want to help.
This is the reality we’re up against, but Szaz was no politician. He was just stating what he saw. I have the greatest respect for the guy, who put his reputation on the line for the truth. If we had more like him, even if I disagreed with them, we’d be in a better place. The problem isn’t that psychiatry (the Church of Psychiatry, not all the individuals who may practice it) is wrong, its that it doesn’t care if it’s right or wrong, as long as it can hold onto it’s position of domination.
You are so right! This is all about power, and creating a cover so that the consequences of the abuse of power by those in control of our society can conveniently be blamed on the victims’ brains. I’m glad that radicals in the UK can get their arms around that. We seem to have some real challenges with left-leaning folks in the US, who seem to take the “these poor people need mental health coverage” position, and don’t seem to look at what happens when people actually receive the “treatment” they’re so anxious to have paid for. I think David is right that we need to ally ourselves with other pro-social anti-corporate anti-oppression movements and create a unified human rights agenda that recognizes the role that psychiatry plays in dehumanizing and oppressing women, gays, racial minorities, disabled people, children, the elderly, the poor, and anyone else who is “deviant” enough that they can get their greedy hands on.
Wow, David – what an epic post! As a core RTP member, I can only say thank you for so eloquently articulating the “gray-matter scare” and why it insidiously undermines our efforts to allow it any credence. I also appreciate your focus on what we CAN do to make things better, including PULLING TOGETHER, regardless of our diversity in religion, philosophy, or other matters. Psychiatry has managed to get where they are by agreeing on a message and sticking to it (regardless of the facts, in their case). We can do that, too, but we’ve got to stop picking at each other and undermining our own allies!
Thanks for everything you do and have done for our movement!
I totally agree about the checklists, and about others besides family being the potential cause of trauma. Personally, elementary school was by far the most traumatic experience I ever had. Especially second grade – Ms. Vaughn was SCARY AS CRAP!!! Threw a book across the room in a rage, destroyed my friend’s art project, then whacked me on the back of the head and threw both me and him (for crying, apparently) out in the hallway when I tried to object to her behavior. Being in her class should have given me at least 3 ACE points on any checklist!
Still, it is the CONCEPT that being mistreated is a much more important factor than genetics which we have to get out there to the public, and crude as these measures are, it does communicate that very clearly. My biggest beef with psychiatry isn’t the drugs – it’s the marketing of the concept that there are “mental diseases” that they can identify from someone’s behavior alone, and that these diseases are completely centered in the person and have no relationship whatsoever to their environment or experience. There has never been a more vile “snake oil” sold more disingenuously to the public in the history of medical fraud! And the evidence to the contrary is right there, in plain sight, all the time. It speaks to our mesmerization and deification of doctors that this chicanery has been sustained for so many years! So I’m glad we are finally talking about it, and I’d rather deal with the unscientific nature of the ACE checklist than the unscientific nature of the “ADHD” checklist any day!
I am sure this is true. I have read some recent stuff demonstrating that socioeconomic factors are more important for physical health than genetics, too. I think we all know the conclusion – we just need some highly credible person to pull the findings together and do some good PR to make sure the press gets the issue in the front pages of our not-so-trusty news media.
Good to know, Wayne! We need a “white paper” or something of the sort that pulls all this stuff together. It is simply ludicrous to spend all of this time and money determining the “genetic basis” of “mental illness” when we have an awesome predictive model with ACEs. Besides which, you can’t change someone’s genetic inheritance, but we’ve got a LOT more control over how many ACEs s/he might experience in early childhood!
He concludes that “improvement in parental behavior accounted for 60.9%” of the improvements in the children’s behavior. So thinking that their child was taking supplements to improve behavior impelled the PARENTS to do a better job, but they attributed the benefits to the omega-3 supplements.
Pretty fascinating. I guess it suggests to me that parental attitude toward a child is the most important variable in the child’s behavior, which is something I’ve always believed to be the case. Doesn’t fit very well with the bio-centric view of “mental health problems,” though, does it?
It occurs to me that it may be interesting and useful for someone with the proper credentials to compare the predictive value of genetics to the predictive value of the ACEs when it comes to “mental health problems.” The best they’ve come up with so far is that a collection of 20 or 30 or so genes occurring together create a tiny increase in the chance of developing any of a range of “mental health diagnoses.” Whereas ACEs predict drinking, drug use, depression, anxiety, probably psychosis, cancer, diabetes, and early death. It would be lovely to see a side-by-side comparison.
“…the meaning attributed to [the anxiety] and the belief that one has the power to cope with it [are] the differentiating factor between clinical and nonclinical groups.”
I think this is the most significant finding from this study. It reinforces what I have always believed – the best approach to any “mental health problem” is to assist the person suffering in coming to the conclusion that their suffering is not abnormal given their situation, and that there are ways they can cope with or overcome the situation they are struggling with. Labeling someone with a “disability” and telling them their brain is broken and can’t be fixed to the exact opposite of this. It doesn’t entirely surprise me that even using CBT approaches, especially with kids, could reinforce the idea that there is something wrong with them and that they can’t handle it without “special help.” CBT, especially when done poorly, can often convey to the person that they are “causing their own distress” by thinking the wrong things, and can easily invalidate the real challenges a person may be facing.
I also agree with the criticism that we would need to know how many in each group were taking psych drugs, because that would be expected to skew the results in the direction of worse outcomes, per Bob’s well-documented thesis regarding drugs increasing the chronicity of “mental health” symptoms.
This is genius, and yet very simple and obvious. With this kind of success, this should be replicated everywhere. Imagine if we start incorporating personalized aromas, artwork, color schemes, and activity plans into these people’s lives? There is so much we can do with the environment to help with emotions and behavior, and yet the “system” continues to focus on directly manipulating the physical body’s chemistry, which is the thing we have the least control over!
It is disturbing that in the article, he talks about barbiturates being addictive, then immediately talks about benzodiazepines as if they are not, making it sound like this is some kind of improvement. I am quite sure that this one will turn out to be addictive and have scary side effects – some are already outlined in the article.
We live in a world of marketing – the truth is only limited by what you can convince people of. What is actually true seem to be of very little interest, especially when there are potential profits involved.
Forgiveness is very difficult when the perpetrator continues to commit his/her crimes unabated. I agree that some degree of justice is extremely helpful in finding forgiveness. At the same time, I do believe I am better off if I can recognize the humanity of individual psychiatrists, while continuing to battle against the institution of psychiatry and its accepted practices. I am not sure where I come down on the psychopathic ones, who seem to have little of what I call humanity in their hearts. But the vast majority are misguided humans who thought they were trying to help, and have a hard, hard time acknowledging they might be wrong about that. It must be a horrific experience to discover that what you’ve been doing for a lifetime to “help” may be severely damaging those you thought you were helping. I do not for a minute see that as an excuse for not facing that fact, but it makes it more understandable that individuals may be defensive when confronted with the hard truth. This is doubly true when someone’s financial well-being is connected with this fraud.
I appreciate you bringing up this topic. I do think it is very important. It also applies to our ability to find and create alliances with those who don’t completely agree with our views. Systemic change is very slow and hard and there are many forces that would oppose it, often for the worst of reasons. It is way too easy to slip into rage and forget that human beings are involved, and that our best bet is to lovingly confront the bad behavior while continuing to accept the human being as a potentially valuable contributor to our long-term objectives.
We could start with a PR campaign publicizing the fact that “ADHD”-diagnosed kids don’t do better on any significant long-term outcome measure than unmedicated kids, including academic test scores, high school completion, college enrollment, delinquency, drug use, teen pregnancy, social skills, or self-esteem. The biggest selling point used to coerce and manipulate parents into using these drugs is the mythology that “untreated ADHD leads to school failure, dropping out, delinquency” and so forth. If we can help the world see that “medication” positively effects NONE of these areas, a lot of people will make a different choice.
Not sure what the means to accomplish that is, though. We need some kind of a funded, grassroots organization that can do PR and lobbying for this cause. Not my particular strong suit, unfortunately.
So much for psychiatric drugs “emptying the institutions,” eh? This is more evidence that Whitaker’s analysis is right on. Of course, if you’re making your living selling psychiatric services or drugs, I guess this is good news, isn’t it?
I have to agree with you – that was my first hit on this: perhaps slightly exaggerated but pretty much on target – you are a captive and they experiment on you until you’re allowed to leave or manage to escape.
It is interesting that those images were seen as viable selling points. Shows that maybe the public on some level recognizes the truth.
Anyone with half a brain would predict this, but psychiatric practice is so fragmented and mechanical for the most part that such connections are rarely even considered. For starters, lack of sleep is a “symptom” of depression, so depression “treatments” are supposed to improve sleep. I think many psychiatric manistreamers would have a lot of cognitive dissonance at the idea that the sleep loss actually creates the depression.
Thanks so much for this! I have written at least a half a dozen posts in the last couple of days trying to say exactly the same things – that it’s arrogant to presume we know the reason for Robin’s decisions, that we trivialize his suffering by calling it a “disease,” and that most people who are depressed have damned good reasons for being depressed. The world is a pretty depressing place right about now, and I kind of think that anyone who isn’t at least a little worried is either incredibly enlightened or willfully ignorant.
I also appreciate your articulate description of exactly what does help. It is, indeed, that willingness to live in the grey area, to not try and “make it all better,” to neither distance ourselves nor join in the misery, but to simply be there and provide a listening ear and compassionate perspective, that truly helps. Normalizing depression as a response to a crazy world is a much more healing response than labeling the sufferer as “diseased” and stamping out his/her “symptoms” in order to make ourselves feel less uncomfortable.
Your posts are always filled with warmth, wisdom, and hard truths. I hope I have the opportunity to meet you in person one day, meanwhile, keep on keeping the “mental health” world honest!
Weird that I find myself agreeing with the APA on this one… I guess it fits in with anti-stigma campaigning. But of course, it doesn’t address the drugs’ culpability in causing much of the violence that is seen from the “mentally ill.”
Wow, they actually got PAID to do this study? Morons! And they talk of “bereavement-related pathology,” as if someone’s supposed to just stay cheery as hell after a loss and any “negative emotions” are to be considered pathological.
And the more relevant question: WHO THE F*&K CARES? I recommend ignoring any attempts to downgrade our posters or commenters by this or any other tactic and reporting the offender to the moderators. I am hoping that the removal of the comment by Ken is the beginning of a new policy of removing these posts immediately. The above article is about sleeping pills as an entry path to psychiatric addiction and control. It has about as much to do with Scientology as it does with underwater farming. The reference to Scientology was brought up apropos to nothing, and is clearly a common trolling tactic, whether the poster(s) are associated with Big Pharma, the APA, or acting on their own accord. I, for one, am done responding to this idiocy, other than labeling it for what it is – trolling, and attempt to derail and distract the conversation from what we need to be talking about. The answer is to not be derailed or distracted, and hopefully to get the moderators to remove such posts ASAP.
I essentially agree with you on most points, Richard, but there are a couple of caveats I’d add. First off, talking therapies may not need to be held to the same standard of proof as drug interventions, because the drugs are so much more dangerous. Sure, there are a lot of incompetent boobs out there doing “therapy,” and sometimes the results can be quite disastrous, but most of the time, the worst outcome of talking therapy is someone deciding “he’s a quack” and looking for another practitioner, or maybe deciding to give up on the effort entirely. No one comes out with permanent brain damage, involuntary movements, or diabetes. True, there are situations where bad therapy has caused violence or suicide, but certainly at a tiny fraction of the rates seen with SSRIs or stimulant drugs.
Second, and perhaps more important, saying we need double blind studies implies that we know ahead of time who fits into the category of “needing therapy,” hence, a legitimate diagnosis. Since most of us here (and the DSM itself) have observed and agree that the DSM categories of “major depressive disorder” or “bipolar disorder” don’t represent homogeneous groups of patients who all have the same problem or need the same approach. So how are we to do a controlled study of these alternatives, since we can’t identify a homogeneous comparison group? Maybe something works for some depressed people and not for others because they have differing needs. It sounds like characteristics of helpful practitioners have been identified, and perhaps that’s where we should put our energy, since the particular school of therapy a person belongs to seems to have little to no impact on the outcome.
Finally, it is perhaps legitimate to question whether “therapy” as a practice isn’t more closely related to religion or philosophy than to medicine. If this is the case, perhaps the concept of “double blind studies” doesn’t really apply – maybe people should be able to seek out the kind of support they find helpful, without some veneer of scientific-ness that has been laid over the mystery of being human?
None of this is meant to deny the possibility of actual physiological diseases or injuries causing mental/emotional distress. These should be investigated using the scientific method and should be carefully distinguished from psychological states. But I am not sure there can be or will ever be a scientific approach that encompasses mental/emotional distress, because I don’t think it’s usually the result of a disease state of the body. And if I”m right, it puts us in a whole new realm where the science of the physical universe is not of much if any use.
Actually, “What About Bob,” while not directly attacking psychiatry per se, certainly portrays that Bob’s mental health is not improved by “services” or “treatment,” but by genuine connections with real people, as well as making it really clear that Leo, his psychiatrist, has more than a few issues of his own!
I am so sorry to hear the difficulties you are having! It sucks to have to go to an internet chat room or message board to get information you should have known before you even started taking that stuff. It infuriates me that we are lied to, including many lies of omission, and that when we do bring forward such concerns, the docs are more likely to diagnose something new than to conclude the obvious: the drugs are the cause.
Wish I had something more helpful to say, but it sounds like you’ve connected to others who have made it through, and they are most likely your best resource. Good luck, and I hope you keep posting!
And if we actually held Psychiatry to these high standards of scientific validity and scrutiny, what would we have left? IMHO, we have almost nothing, because the DSM has not the slightest shred of scientific validity behind it, as even Tom Insel admits.
It seems like the real conflict here, and it is NOT a minor quibble, is that while we work on ‘reforming’ things, millions of people are being harmed and sometimes killed. I am not objecting to reform efforts, but I had a very hard time when I was doing involuntary detention evaluations, not because I had a problem with protecting a person from immediate harm, but because the only place I could send them was the psych hospital, and I saw very quickly that what went on there was anything but healing. I spent most of my energy doing brief therapy interventions in the ER to try and get a person NOT to be committed and to find other alternatives that could work, because I knew that going up to the psych ward meant being locked into a depressingly dark and dingy space, exposed to a lot of other miserable people who were not being listened to or helped, and being tried out (without any meaningful participation on your part) on various drugs until you “stabilized,” which essentially meant you had reduced your level of annoying behavior to the point that they could figure you wouldn’t be back in the ER for at least a month or two. Then they sent you to “case management,” which meant someone checking in to make sure you weren’t going off your meds or “decompensating,” which is a fancy word for “going nuts and making trouble again.” There was little to no compassion from the system, though there were individual workers who provided some light in the generally dark tunnel these people were being sent down.
I left that job in 9 months, only because it took me that long to get another job. I got into advocacy and haven’t looked back. I don’t think I could work a job in the mental health industry, unless it was a radical agency committed to undoing the damage that the system is doing to people. It feels like collaboration with the occupying forces to me. It is an ethical dilemma, because the people who ran into me in the ER were in fact very fortunate, because I was dedicated to helping them get better RIGHT NOW so they wouldn’t have to be detained. And I was pretty good at it – I had the lowest percentage detention rate in the county. But I couldn’t stop every detention, and every one felt like I was participating in hurting someone. I had to get out.
So I get it when someone is a total abolitionist, and even when someone draws analogies with NAZI Germany. People are being systematically harmed, and participating in the system feels like tacitly supporting the damage being done. At the same time, I appreciate the reformer viewpoint, because abolition seems an unlikely goal, and because people who are sucked into the system need someone like Jonathan to give them some glimmer of compassion and hope.
Perhaps we can come together better if we talk about tactics rather than the ultimate goal. I think most people can get behind taking the force out of the equation, as long as there are some provisions for people who are dangerous in the present moment. Maybe we should try to focus on finding the things we DO want to get done, and coordinate our energies toward those things. I don’t think we can ever resolve the reform/replace/eliminate debate, because it comes from a place of ethics, and I think ethics is a very personal thing. I do think we can at least agree that individualization, empowerment and choice have to be at the center if things are to improve for those labeled by the system as “mentally ill.”
That is so helpful to know! It makes so much sense to me. People are trying to find meaning and purpose in their lives and in the universe. That’s the first touch point of any intervention, even if there are physiological health issues involved. I will remember this point and keep it in mind when needing to creatively engage someone whose perceptions of reality are hard for me to join with. It seems like it provides a great way to establish some common ground and start looking toward the future.
CPU, that’s actually not conflicting with what I said. A syndrome is something that is not understood. There MAY be a biological injury/illness underpinning for a syndrome, or for some part of the people with the syndrome, or it may just be a normal variant of behavior that some people find difficult to deal with. I am not saying that there are no mental conditions that occur due to biological factors – side effects of medication is a perfect example of a biologically-caused mental/emotional condition where we do understand at least the rudiments of the cause and can intervene medically to resolve the situation. Parkinsons is clearly biological, and Alzheimers appears to be largely biological (though its expression is highly variable, possibly depending on psychological variables).
The problem is when we take a syndrome (like severe depression) and assume that ALL people who exhibit this syndrome have something biologically wrong with them, and therefore ALL people with the syndrome require a particular “treatment.” To go back to migraines, there is a wide variety of approaches that people have to dealing with a migraine. Some find massage incredibly helpful, others feel it makes things incalculably worse, while some find it has little to no effect. Without really understanding the cause, we can’t prescribe a treatment. Sure, we can prescribe pain relievers to deal with the symptoms, but that is not the same as treating a known disease state that reliably responds to a known remedy. At that point, people just do whatever works to make it better, but we all know we’re dealing with effects rather than causes.
It’s even worse when you get into behavioral issues like “ADHD” or “Oppositional Defiant Disorder.” Here, we are merely identifying behavior that we find objectionable or annoying or inconvenient and giving it a label. I’m absolutely sure that there are some kids who are biologically wired to be more active and less willing to sit in a seat for extended periods. So freakin’ what? Who gets to declare impatience with tedium a disease? And when 10% or more of our population is afflicted with this particular set of characteristics, it’s pretty obvious that this personality type has high survival value for our species and that far from being a disease state, it’s more likely an essential genetic variant that improves our society’s functioning if allowed appropriate expression.
I am probably preaching to the choir here, but I wanted to make myself clear. Creating psychiatric labels out of syndromes actually obscures the search for actual psychic or physical injuries or malfunctions that may be causing a small or large proportion of a particular behavioral or emotional syndrome. Neurologists understand this well. The fact that someone can’t move their right arm isn’t a disease – it’s an indication that something is going on, and you don’t get a diagnosis until you find out the cause. Saying someone has “immobile left arm disorder” and leaving it at that is not only not informative, it actually deters anyone interested in seeking the variety of possible reasons why someone’s arm may be immobilized.
You haven’t heard that term because I just invented it. But since we both are using it, I think it now officially counts as a word.
My best idea to reform psychiatry would be to put you in charge. But I don’t think you’ll be president of the APA any time soon!
I think we need people in all parts of the spectrum to make things change for the better, and for my part, I appreciate your energy and your efforts. You have gotten more done than a lot of people who might criticize you from both sides. Keep up the good work!
Finally, a real scientist who is willing to admit when his hypothesis is disproven by experiment! This is very important news for those fighting the Murphy bill – one of psychiatry’s own inside researchers admits that AOT does not improve outcomes.
Interesting that they talk about access to treatment, while conveniently forgetting that the countries with the LEAST treatment (Columbia, India, Nigeria) had the BEST outcomes in the WHO studies. But at least they admit that forcing treatment yields no benefit. That’s a big acknowledgement.
Trillium Charter School is alive and well, 12 years later. It’s a public school so costs no additional money, as long as you live in the Portland Public School District. I just disconnected from their e-mail list, as Kevin’s graduated and we’ve been gradually moving on, but the community is strong and I think will be functioning 12 or 20 years into the future. The thing I love about it is the shift of emphasis away from trying to achieve approval from the authorities through good grades toward achieving self-worth through accomplishing one’s own goals. Additionally, the power dynamic is so different, with the all-school meetings and the ability to request student-assisted mediation with even a teacher who you feel has treated you unfairly or disrespectfully. He has little to no tolerance for arbitrary injustice, because he hasn’t had to put up with it, and he is therefore still in touch with his outrage when outrageous things happen.
I really think school is where most of us learn to accept oppression as an unavoidable part of the system. It’s great training to be a passive consumer. Education reform should be a part of reforming the mental health system, because it really does drive some of us around the bend!
— Steve
P.S. I only applied to Oberlin, but thought about applying to Harvard as my “back-up school.” I fantasized about sending them a rejection letter: “Thanks for your interest in my attending Harvard University. There were many well qualified schools. I have selected one whose offerings more closely match my personal and academic needs…”
No, it would mean that migraine headaches aren’t a disease, not that they don’t exist. Migraine headaches are, in actual point of fact, a syndrome – a set of symptoms that occur together but don’t have a known cause and may or may not have a variety of causes. Pretty much every psychiatric diagnosis is either a syndrome or a redefinition of normal behavior that some people find annoying or difficult to deal with. For instance, “Intermittent Explosive Disorder” is a description of people who lose their temper a lot. This really does exist – there are such people and we have all experienced them at times. But does the fact that someone has a temper mean they are medically ill? Or that they have a different personality? Or that they were poorly raised and never taught emotional self-control? Or that they were abused and traumatized and react violently to certain stimuli? Or that they were put on antidepressants recently and are having an adverse reaction? It could mean any one or more than one or none of the above things. A real disease state would have a coherent explanation and the treatment would follow rationally from the cause. We can use pain relievers to make the migraine less painful, but that doesn’t mean we understand what caused it, or what would make it so that you stopped having migraines altogether. We’re treating signs and symptoms, not diseases.
We don’t have to deny the existence of the person with temper control problems to refuse to agree that temper control is a disease state per se. It is, at best, a syndrome, something observed to occur that doesn’t necessarily have a coherent explanation. Calling it “Intermittent Explosive Disorder” makes it sound more “clinical,” but I could diagnose “Excessive digital-nasal intrusion disorder” to describe someone picking his nose and have about as much scientific validity. Yes, people pick their noses. No, it’s not a disease state, just because it makes people uncomfortable due to social rules being violated, or just because I made up a semi-scientific-sounding name and set out some “criteria” in an official guide book.
Sandy, I do agree with your basic point – medicine as a whole has been corrupted and continues to be corrupted by big money incentives and convenient lies that allow, for instance, massive sales of statins to perfectly healthy people when statins don’t actually even address the underlying issue that it is supposedly protecting against.
Unfortunately, it appears that the vast bulk of psychiatric prescribing falls into that very same category – medicating a physiologically healthy populations with drugs that don’t address whatever underlying issues they are supposed to address, and actually making people less physically healthy and less likely to “recover” into the bargain. I really do appreciate that you personally appear to recognize this and to be trying to do something about it. I’m assuming from your writing that you would adopt a more “Moncriefian” approach to drugs in mental health, using them when they seem helpful but not assuming or asserting that they are treating a disease per se, and not assuming that they would be first-line or primary interventions. But how do you see the profession as a whole moving away from this disease/drug model, when the DSM provides cover and justification for doing so, and the drug company money provides the huge incentive for continued lying to the public about the lack of a genuine understanding that lies behind the DSM and the attendant “treatments?”
Personally, I believe a move away from using DSM diagnoses is essential for any big changes to happen, and I don’t really see that happening any time soon. When so many people (not just doctors) are intellectually, emotionally, and financially invested in this cultural artifact, it seems very challenging to imagine such support flagging except by an absolute rebellion among the recipients of psychiatric care. Do you think there is another path that does not require wresting power away from those whose lack of intellectual depth and/or corruptibility prevents them from seeing or acknowledging the truth that you have come to recognize?
It’s a big problem. I’m interested to hear your thoughts on how we get to a new place.
I thought she was saying we shouldn’t get distracted. Now upon rereading, I can’t say that I 100% agree after all. I do agree that criticism of the author ought to be made based on the points in the article, not on disliking the author.
I find many of ELS’s remarks to be off-topic and often containing unprovoked hostility, and the presence of an underlying personal agenda is apparent. You can be intense, but I don’t generally find you to be mean-spirited or distracting, and your agenda is very clearly in line with mine and my perception of the purpose of this website. I just think that allowing off-topic comments to distract us is unwise. I’m trying hard to practice that myself, although it is sometimes difficult, especially if inappropriate attacking is occurring. I have asked for some people’s comments to be removed (not mentioning any names), but I have never asked for anything you said to be removed.
I don’t know if it’s reasonable to criticize Mark for not responding to posts. David Healy almost never responds to any post, and I don’t like his views on ECT at all, but he’s been a bear on the issue of SSRI side effects, and I value what he has to offer. I guess I just take what I can that’s positive and try to make productive comments, and am happy when occasionally an author responds. Mark’s got a life, too. But your comments did have some relationship to the blog, and I was not meaning to critique either them or Mark’s lack of responding in any way. I just think we should stay on the topic of reforming/replacing/ eliminating the current damaging system and not get off into other personal agendas. And again, I am not referring to you in that last sentence at all.
Hope that clarifies things. I find you to be a very valuable poster and had not the slightest intent to criticize you or your prior posts.
It is important to remember that scientifically, it is not the patient’s job to prove to the psychiatrist that the drug they are administering is unsafe, it is the psychiatrist’s job to prove that it IS safe. So any evidence that brain shrinkage and cognitive decline might be caused by neuroleptics ought to be of extreme concern, and the fact that it MIGHT be a result of the disease should not mitigate that concern one iota!
Moreover, your comment about the possibility of it being “unethical” to not provide drug treatment flies in the face of emerging evidence, to the point that the APA recently published guidelines stating that trials off medication should be attempted if possible, and that if medication is used, it should be used at the lowest dosage and for the shortest period of time. Studies by Martin Harrow and Wunderlink, as well as the WHO study, have clearly shown that many, probably the majority, of those suffering from what is labeled “schizophrenia,” are able to recover in time, and that medication in fact impedes the likelihood of recovery, probably in part due to the brain shrinkage that has been documented to be a direct and dose-dependent consequence of long-term antipsychotic use. This, again, is science, and is not really in significant dispute. There are some claims around that a different kind of brain damage may happen with repeated psychotic episodes, but I am not seeing a lot of evidence to support this claim, either. In any case, there is no longer a question about brain shrinkage caused by neuroleptics – mainstream psychiatry itself has acknowledged this as a problem.
Finally, it does appear from the comments of the researchers that they did control for cognitive decline, symptom severity, and overall level of functioning, and none of these correlated directly with brain shrinkage. If schizophrenia itself were responsible, it would seem that those with the highest symptoms and the lowest functioning would be the ones showing the most damage, but that is not the case. This is additional evidence that the theory that the brain shrinkage is caused by the “disease” is not viable.
You might want to read “Anatomy of an Epidemic” and take a look at the science backing up this concern. It is not something psychiatry wants to admit, but there is a long history of evidence that shows that neuroleptics do, in fact, cause brain damage over time.
Gosh, they claimed that Prozac drove some people to murder or suicide? How could they SAY such irresponsible things! Not only that, they hurt Lilly’s drug sales and brought on these totally unwarranted lawsuits (many of which Lilly settled out of court with “gag orders” so no one could see the actual evidence against them). The NERVE of these people!
Who might the real evildoers be in this scenario? The ones who are marketing a drug that they know sometimes leads to murder and suicide but are trying to cover it up with media attack articles? Or the ones who are calling BS and holding them to account?
Criminals don’t like watchdogs much, but those being burglarized like to have them around…
I don’t think any of those three would post here. Not because we would be too hostile (which we might very well be), but because they know on some level that their arguments don’t hold water. Torrey, for instance, knows he has intentionally conflated violence with untreated mental illness, because that forwards his agenda of more enforced treatment, apparently because he feels a family member would have benefited from this. Biederman, of course, was chastised for intentionally manipulating research data to get the “results” he wanted. These guys would be shot down very quickly if required to restrict themselves to a data-focused argument in favor of their viewpoints. They appear more interested in marketing than in truth, and would also not want to give MIA any credibility by choosing to appear here. I could be wrong, but I think they’d find the environment extremely threatening even if we were civil as could be, because they (unlike folks like Mark) don’t really have any interest in finding a better way – they already think they know the way, and are religiously committed to their viewpoints, and the facts be damned. I am sure they see us as dangerous antiscientific zealots out to destroy the tremendous scientific progress that psychiatry has made in the 21st century. The fact that this progress hasn’t actually improved the lives of their clients does not seem to register on these folks’ radar.
If they want to post, I’d say bring ’em on. But I would not expect them to have a very pleasant experience, even if we are all as diplomatic as we can possibly be.
If you didn’t know that Scientology and Big Pharma had a big blowup in the 90s, you were either too young to notice or not paying attention. Whitaker writes about it in his book. It is when the psychiatric community went whole hog into the “antipsychiatry=scientology=antiscientific
=evil” PR campaign. There was a front-page attack piece in Time around 1991 or so, which it appears likely to have been coordinated with this PR effort. It was quite intense, but of course, big pharma and the APA had the bucks and media on their side, and the outcome was the successful “Scientology Smear” campaign that you either inadvertently or intentionally seem driven to employ on our allies. CCHR would be a lot less of a pain in the ass if y’all would follow my simple advice and stop giving the tactic energy on this site.
Glasser is a long-time opponent of psychiatric drugging and has always made a lot of sense to me. He’s very practical and empowering, believing that kids have the ability to overcome challenges by their own actions, and that parents can assist kids in doing so by learning and teaching new skills in a step-by-step manner. It is difficult to imagine his views being more diametrically opposed to the idea that people have “diseases of the brain” that can’t be “cured” but can be “managed” with drugs. The absurdity of attacking such an obvious ally should be clear to anyone who has actually read his work.
I would point out, however, that tobacco consumption is always voluntary. Until we address the social mythology supporting these “illnesses” and take away the power to force or indirectly coerce people into taking these drugs, including through criminal courts, family courts, child protective services, schools, and other means of enforcing “voluntary” compliance, it becomes a little unclear to me how shaming the victims of these practices is helpful. I see it kind of like dealing with a domestic abuse victim who is still in the throes of Stockholm Syndrome. They will defend their abuser to the death, because they are under his control and don’t see any other way out. Yes, they do have a responsibility for the impact of their actions, but the person we should be shaming is THE ABUSER, in this case, the medical/psychiatric/pharmaceutical industry.
See my earlier post on how to discredit/disengage the religiously committed “proud user” without resorting to shaming tactics. Unless they’re actually on the payroll of the pharma industry, I view the vast majority of users as victims of a major societal con. Doesn’t mean their statements shouldn’t be challenged, but I don’t see that shaming is an appropriate path, at least until it becomes socially clear and accepted (as it did with cigarettes) that these drugs are genuinely and seriously damaging to the vast majority of users.
Judith Rapoport studied this back in 1980, and pretty definitively showed that her “normal” test subjects responded just the same to stimulants as her “ADHD” diagnosed subjects. The apparent observed difference she called “an artifact of observation,” meaning that people saw this “improvement” in the ADHD-diagnosed kids because they were looking for it, but the same changes were not noticed in “normal” subjects because they weren’t standing out for being particularly hyper or distractible, so the changes were not as obvious.
RAPOPORT, J., BUCHSBAUM, M., WEINGARTNER, H., et al (1980) Dextroamphetamine. Its cognitive and behavioral effects in normal and hyperactive boys and normal men. Archives of General Psychiatry, 37, 933 -941.
This is cited in http://pb.rcpsych.org/content/29/8/284, which is actually a great summary of the lack of scientific data supporting the ADHD diagnosis.
So this mythology was disproven over 30 years ago. Yet people (including professionals) still spout it all the time. I hope that reference helps you kill off any discussions along these lines in the future. I find it stops such conversations dead in their tracks every time.
I don’t think it requires “shaming” to counter the effects of “proud users.” I think that Moncrief’s approach is pretty easily adaptable to this situation. “I hold nothing against you for finding something that helps you get through the day. We all have our coping measures, and yours is as legitimate as mine. What I object to is classifying suffering as a “disorder” and assuming that all people who are suffering in a particular way need to follow your path. Drugs do have effects, and if you like the effects, more power to you. It doesn’t mean that others will have the same experiences as you.”
If that’s experienced as “shaming,” then I am not sure what else can be said. We can give people the latitude to do whatever works for them, but when they start becoming marketing agents for the pharmaceutical industry, I think we’re within our rights to object. It’s the difference between describing my own experience and extrapolating to assume that all people share my experience.
Another approach would be this: “Suppose someone had a horrible experience with psychiatric drugs and swore they’d never take them again. Would that person be ‘shaming’ you by letting you know that your solution wouldn’t work for them? Does everyone have to agree with your viewpoint to avoid being labeled as ‘shaming?’ Might you be ‘shaming’ this other person if you told them that psychiatric drugs were good and that anyone saying otherwise was harming people who might benefit?”
I don’t think we need to stand by while others sing the praises of psych drugs. They’re entitled to their experience, but so am I, and so is anyone else. If ‘shaming’ is brought up, I think it can be deflected by stating, “I’m just sharing my experience just like you are. Do you have a problem with me sharing what I experienced, even if it may differ from what happened to you?”
I think so. It is much too easy to go along with media representations of “mentally ill” as being brain-damaged and probably dangerous, chemically “different” than “you and me,” rather than acknowledging that a sick society is at the core of much of what passes for “mental illness.” I can certainly assert with confidence that the school system exacerbated whatever anxiety and self-hatred I had already absorbed from my “scapegoat” status in my family, and my mental health would have been dramatically improved by having even one person say, “You know, you’re right. This place really sucks for kids. Let’s try and find something you like better.” Hence, I became an education reformer, and have tried to be that one person for other kids stuck in the current oppressive paradigm. It is always reassuring to hear that others are doing the same, but I think it’s always going to be an uphill battle, and most people choose the path of least resistance.
In the end, we’ll probably get alternatives only when the psychiatric system gets sued and ends up spewing out enough money to make it no longer worth the effort to con people. As my old history teacher used to say, “Man is basically greedy.” Or maybe “man is basically lazy” is a better description, but it ends up being the same result. People follow the path that gives them the most payoff for the least amount of labor, unless they have a very well-developed conscience.
When one considers the wide range of difficulties observed in the current “standard practice” by psychiatrists, including incomplete histories, dismissing of trauma symptoms, overlooking of family dynamics, minimization or “treatment” of iatrogneic side effects, undue influence by pharma front men and “education,” and many more, it is hard to see how psychologists prescribing will do anything but worse in controlling this already out of control train. Based on what I see and hear from clients themselves, the last thing we need is more prescribers. We need more listeners. I thought that’s what psychologists are supposed to do.
This effort is disgusting, and that the American Psychological Association promotes it with such blithe ease makes it clear that they are being bought off by the same PharmA reps that already own the other APA.
A well-written post that should not have to be written. But logic is not at issue here – money and power are, and that’s the root of the problem.
I appreciate the reply, Mark. I am glad you acknowledge that the process of obtaining treatment does have potential adverse effects in terms of isolation and stigmatization.
The part I was referring to about diagnosis follows:
“Often they seem psychotic, probably from schizophrenia. Sometimes they seem socially impaired from childhood, even dramatically so, perhaps with some variant of autism. Occasionally PTSD seems to be part of the problem.”
I’d still be interested in your thoughts on the fact that many of the shooters were receiving or had received psychiatric treatment before engaging in their shooting rampages. At the least, I think this makes a good argument against enforcing more treatment as a means of reducing mass shootings, even if many people will balk at examining the possible role medication side effects may have played in many of the shootings.
Thanks for taking the time from your busy day to respond. I do plan to take this forward in other places to help re-focus us away from the fact that a person may have had a diagnosis (which is very common) toward the fact that the person was socially extremely isolated (which is a lot less common and more closely associated with the characteristics of most of the shooters).
I have been an education reformer my whole life, and we did several years of “unschooling” with all of our kids, as well as helping develop an alternative charter school with a child-based, democratic philosophy. I don’t think it will ever “catch on,” because that kind of philosophy is too threatening to the elite, who really need smart and well-trained but confused drones to run their social machinery for them.
My wife’s brother went to Harvard, as did his father and grandfather and who knows how far back. He didn’t really have a choice about it – his “privilege” as a white male depended on his kowtowing to the party line. He is working on his third marriage and has developed abusive characteristics and struggled at times with substance abuse. His sister (my wife), by contrast, went to Oberlin (where we met) and got a real liberal arts education, and we have traveled a very different road.
My youngest is about to head off to Evergreen State in Olympia this fall – a “progressive [school] with no tests and narrative evaluations” – not a particularly selective school, but one that really promotes interdisciplinary thinking and creative application of knowledge to the real world. I’d never consider Harvard as an option for him, and neither would he.
Abuse by Scientology is a separate subject that distracts from our purpose. There are other websites for that purpose. And the main reason CCHR is a problem for the antipsychiatry movement is because the psychiatric community embarked on an intentional PR campaign to discredit critics with the “Scientology smear” tactic. (Admittedly, CCHR did make themselves an easy target.) Perhaps you think it’s helpful for us to protect ourselves by saying “We hate Scientology, too, so we’re not bad like you say we are.” I most certainly do not think so. I think it helps them continue to divert attention from the real issues.
So as AA alludes to, my recommendation is very simple. If it’s ever brought up, we say, “What does religion have to do with the effectiveness or ineffectiveness of the current psychiatric model? I thought we were talking about science here? Why are you trying to distract us from the topic by bringing up religion? Is it because you don’t have any facts that are relevant to the discussion?”
Or words to that effect. That shuts down any discussion of Scientology or any other off-topic distraction and labels the tactics for what they are. Any intelligent person watching the conversation will easily see that one person is using facts, and the other is using rhetorical tactics.
We should work to kill off the effectiveness of this tactic, not build it up by agreeing with the APA’s marketing tactics. In fact, ANY agreement with APA marketing tactics should be avoided like the plague, IMHO.
Emergency ECT? Who the hell came up with that one? How about “Emergency head battering with a baseball bat?” Or “Emergency pushing in front of a Mack Truck?”
There’s an emergency – a person is feeling distressed. I know! I’ll electrocute him! That’s always helpful!
I thought it interesting that she did not consider the possibility that the voices for Americans diagnosed with schizophrenia are more negative and battling may be because of how our culture, and specifically, how psychiatric practitioners, define our relationship to these voices. If you are told by your doctor that these voices are bad, the content of their statements is meaningless, and your main goal is to get rid of them, it seems you’ve set up a state of warfare with the voices, which in some psychological schools of thought suggests a state of warfare with oneself. It makes sense to me that a culture which accepts that voice-hearing is OK or maybe even views it as a gift is more likely to have positive experiences with those voices, as they are not fighting them off but listening to what they have to say.
Would be interested to hear if this makes any kind of sense to those who have had this experience themselves?
I think you’re right about focusing on relieving isolation. It is interesting that the focus is always on the “mental illness” that the person is suffering, and not on the isolation, which appears to be a much more defining characteristic.
It was interesting how I experienced this article while reading it. I found myself already resisting your message early on as you outlined the various diagnoses these people might qualify for, and then talking about the difficulties of isolation and stigma. Do you think that the very process of calling these things “mental disorders” contributes to the stigma and isolation you want to avoid? I believe there is scientific evidence that this is, indeed, the case – placing these labels on people not only appears to create reluctance to deal with that particular labeled person, but also reinforces the isolation of those who are “different” by defining more rigidly and narrowly what is acceptable. I actually see this labeling process as a part of what creates these isolated and disconnected young people in the first place.
You also mention that “some” of these young people had received mental health treatment in the past. I’d correct “some” to “most.” Adam Lanza, Kip Kinkel, Scott Harris, Jeffry Weise (Red Lake, MN), the kid from Paducah, KY… the list goes on and on. Many of these were receiving medication at the time they committed these acts, and many others were withdrawing from medication at the time. Others (like Lanza), we don’t have the information on their treatment status at the time of the event, but there is evidence suggesting they may have been taking medication at the time. We know from simply reading the product label that SSRIs and stimulants both can cause aggression and “manic” episodes. I am interested how this fits into your analysis – you seem to have sidestepped that issue for the most part. But regardless of that point, I think it should be pretty clear from the evidence that intervention by the “mental health system” does not appear to have prevented the majority of these incidents, so we have no reason to believe that further such treatment will do so.
It is in the interests of the psychiatric profession as a whole to minimize such effects as I mention above, but as a change agent, I think it would be extremely valuable if you and folks like you inside the profession would be more direct in addressing these issues. Labeling creates and exacerbates stigma, according to psychiatry’s own researchers. Some of these drugs cause or exacerbate aggression, according to the drugs’ own labels. Receiving diagnosis or treatment does not appear to be reducing these incidents of violence, and may be contributing to it. These are not small issues. How would you respond to this information? Why isn’t there more commentary from the psychiatric community about these things when we hear a national call for more enforced treatment? Shouldn’t the needs of clients and society at large trump the commercial interests of the mental health industry?
I do appreciate your courage in writing here and standing up to your peers by encouraging some alternative thinking. I hope I am helping prod you to take it to the next level by honestly examining the data on the effects of treatment on violence and speaking truth to power about what I see as the big elephant in the room.
I agree – ECT can be compared to cutting on oneself, except that it does far more fundamental damage. Self-cutting creates temporary bleeding and scars on the skin, which ultimately is able to heal itself. There can be long-term issues with skin flexibility and maybe some minor damage to nerve endings, but it is unlikely to have any more severe impacts. Whereas ECT induces a grand mal seizure, causes temporary and often permanent memory loss, damages brain cells that can’t be repaired or replaced, and can and does sometimes lead to death, either directly through brain damage, or indirectly through severe despondency that sometimes follows ECT by report, leading to suicide in some cases.
Moreover, the choice to cut is completely personal and something in the control of the cutter, whereas ECT is something someone else is doing to you over which you have no control.
Now that I think of it, I’ve changed my mind. You can’t compare them, because ECT is orders of magnitude more damaging and less in the control of the “recipient.” Given the choice between cutting on my arm and getting ECT, I’d cut for 10 years rather than accept one “session” of brain damage in the name of “treatment.”
Yup. This is what success looks like from the psychiatric viewpoint. Client on medication, not being jailed or hospitalized, “symptoms” less than what they were or “under control” (not necessarily relieved or resolved.) The quality of life for the patient is not something that is even measured or considered a priority.
I actually think you were lucky to have your on the ground experience before your training. I was in the same position, and it helped me learn to smell a rat and not be afraid of calling it what it was. A lot of training is indoctrination into exactly what they told you at your job (which is a lot of why they told it to you). I’m glad to see that Temple is having the sense to have RW and other more provocative presentations, but I’m not sure that’s the case everywhere. Most psych students I’ve talked to tell me they spend an inordinate amount of time on how to do DSM diagnosis, and very little on creating new alternatives.
I wonder if you were offered any other options besides medication and ECT? I recall working on a crisis line and talking to someone who had been trying different antidepressants for over a year, with no improvement. She was on the verge of panic. I asked her if she was aware that there were other things she could do. She suddenly stopped, calmed down, and said, “No…” No one had ever told her about therapy, support groups, meditation, peer support, exercise, or any other option – as far as she knew, if the medication didn’t work, she was completely screwed.
Your story sounds very similar to many positive ECT stories. There is sometimes a benefit, but always a cost. And you are very fortunate that it worked out the way it did for you. Many others pay the cost without the benefit you’ve experienced. Try to imagine losing 22 IQ points and forgetting 5 years of your life, and feeling the same or worse than you did before.
I also wonder if you were told about the trade-offs ahead of time? Were they honest with you?
Good for you for persisting and getting the nursing degree! And thanks for honestly sharing your story – it is one of the best non-sensationalized descriptions of the long-term effects of ECT that I’ve yet seen in print.
That’s just the point, E. You are presuming “infiltration” based on association. Just because Sheila doesn’t condemn Scientology as you do doesn’t suddenly make her a “front group.” It should not surprise anyone that CCHR would support others’ efforts to expose psychiatry’s destructive behavior – that is, after all, their stated mission. The fact that they approve of someone doesn’t mean they’re financially supporting or controlling that person. To suggest that is to use the same kind of innuendo and undermining tactics that psychiatry has been employing for years.
Sheila is entitled to her opinion and is not required to agree with you. There are also a number of posters on another recent thread who describe getting support from CCHR without any apparent attempt to proselytize about the CoS – are they dupes or “front groups” as well? Your implication that her positive opinion of CCHR and/or Scientologists she has known somehow means she’s a “front group” is WAY out of line.
I am glad Emmeline has chimed in here, because her opinion about what is appropriate matters more than mine. I would like you to stop attacking our allies, and if you don’t, I’m hoping Emmeline will use her authority to remove your attacking posts. You are not helping either of your purported causes.
Quite so. However, I still think it’s a very strange way to argue in favor of more funding. Kind of like saying, “This garage can’t really fix your car, but it can kind of keep it running, even though it will get worse over time, so we should help them service more cars.” If diabetics were appearing more and more often in ERs and getting limbs amputated and dying of heart failure in larger numbers, despite treatment, even the very credulous would probably suspect something was amiss with the treatment.
The story, as Bob Whitaker puts it, is that these miraculous chemicals have taken disabled people and enabled them to become functioning members of society again. This kind of narrative completely debunks that story, and yet people seem to be unable to see the obvious contradiction.
Or another way to put it: if these drugs were so helpful, why are you seeing more and more people coming to the ER with worse and worse problems? Shouldn’t our wonderful scientific technology be making people more functional and less severe?
I just don’t get why people can’t see that the vignette they share doesn’t merit the conclusion they always seem to draw.
My point is not to attack or defend CCHR or Scientology. It is to focus on our mission. Attacking Sheila Matthews is simply an outrageous action. I don’t give a crap about Scientology or CCHR, to be frank. I believe every person has a right to make up their own mind about those groups on their own, and there is plenty of info out there about them if people care to look. If you want to critique them, please find one of the many websites that do so. I see no point in wasting our energy on this divisive crap, when there is so much to be done. And I will reiterate that any statements that conflate antipsychiatry/psychiatric reform groups with CCHR/Scientology, especially in the critical way you have done, plays into psychiatry’s hands.
If you have issues with Sheila, take them up with Sheila. If you have issues with Scientology, take them up with Scientology. If you have issues with psychiatry, that’s what we’re here to talk about. It is foolish to validate the “scientology smear” in any way on this site. It undermines our purpose and aids and assists the very people we are trying to oppose.
“At one point, Peter spent two weeks as an inpatient at the Institute of Living. He saw a therapist he liked. The prescriber there worked well with the family. Peter began attending groups. His medication was changed.
But when he got discharged, all that fell away. He returned to his old psychiatrist, who didn’t have any discharge notes that would explain what happened during the hospitalization, and who put him on the old medications.
Transitions between services are particularly problematic. Peter now receives services in the family’s home.
“By the time anything gets started, we have now had a week where basically we’re on our own because he hasn’t been to the psychiatrist, his medications aren’t working, this new in-home service hasn’t started seeing him yet, and so we’re back in the ER again,” Harding-Wheeler said.
And there’s no one professional following Peter’s care. The psychiatrist only sees him for 15 minutes at a time.
Harding-Wheeler worries the system is giving up on her son.”
This sounds like someone who has been in the system and receiving “help” for years. But the “help” isn’t helping. I do agree, the family may be and often is part of the problem. But of course, given the biological paradigm, any family issues are largely ignored unless it qualifies as child abuse, and programs to help parents improve their parenting skills or develop specialized approaches to their particular child’s needs are relegated to third-rank “nice if we can do them” status.
I’ve seen it too many times in my job. I recognize it in a second. A kid who is making that many visits to the ER is almost always involved in the psychiatric system and almost always is continuing to receive ineffective treatments, or receiving treatment to deal with the ill effects of earlier treatment. But rather than talking about the ineffectiveness of the treatment being provided, we’re all supposed to cheer for more funding for a continuation of the same stupidity that the case study shows has not only not worked, but probably made the poor kid worse than he would have been. Just as Whitaker’s thesis would support.
Can we cut this crap about Scientology? I’m starting to wonder if some posters are working for Big Pharma and trying to distract us from our objectives. I’ve known Sheila via e-mail for about 15 years. There is NO ONE in this country who has worked harder for ending psychiatric abuse than Sheila. She does NOT deserve to be attacked in this way! She is definitely “one of us,” and anyone who attacks her after all she’s done, I am prepared to consider an enemy of this cause.
As I’ve stated in another thread, this is not the place to talk about Scientology. There are plenty of anti-Scientology boards where this discussion is going on. It HARMS OUR CAUSE to give even a line of space to the idea that our allies are aligned with Scientology or are “front groups.”
I am very suspicious that this is an outside attack. If it is not, it is an ill-conceived personal mission of someone who is very mixed up about what we’re trying to accomplish here.
At this point, I am going to ask that the moderators remove any comment that accuses any person or group of being a “front group” or associating anyone with the putative evils of Scientology. Not only do these comments violate the posting guidelines, they devalue and insult valuable allies like Sheila, and encourage the kind of sniping and backbiting that the APA would absolutely love us to engage in.
Sheila Matthews is, in my view, and American heroine. She does NOT deserve this kind of crappy treatment!
The original link is having some problems, but if you scroll down the page, the whole article appears below the link, under the title, “The Shamanic View of Mental Illness.”
Gotta agree with you on that point! One article in Canadian J Psych showed that 6-7% of kids taking stimulants at normal dosages had psychotic symptoms noted in their charts (retrospectively). That’s hardly rare – if someone medicates a hundred “ADHD” cases in a year, they’d have made 6 or 7 of them at least somewhat psychotic. But how often do you ever hear anyone talk about amphetamine psychosis as a result of stimulant “treatment?” Never! Plus the drugs they use for “ADHD” increase dopamine, and the ones they use for “psychosis” decrease dopamine. So they give the kid stimulants, crank up his dopamine, he becomes psychotic, so they give him Risperdal to DECREASE his dopamine, which they are increasing with the stimulants? How stupid is that!
Actually, JAMA has published articles on medication damage before, including the big one about medical care being the third leading cause of death in the USA, as well as (I believe) the one about “seriously mentally ill” people dying 25 years earlier than the general population. Maybe it’s because it’s not specifically a psych journal? And Hopkins is the home of Julie Zito, at the School of Pharmacy, who has done a great job using epidemiological data to show the ridiculous rise in psych prescriptions for kids (including INFANTS) on Medicaid.
Not everyone in the research world is evil, even though a lot of research is biased. The information we need has been out there a long time. I think it’s more a problem of the psychiatric aristocracy and the media choosing to publish only those things that make money for them and Big Pharma.
It always amazes me that they use an example of a kid who has received psychiatric “treatment” his whole life and is doing horribly as an advertisement for why we need more mental health treatment. And people fall for it! How dumb are we? This kid is proof positive that the problem is not a lack of available treatment, it is that the treatments we use DO NOT WORK!!!! Why is that not obvious to those reading the article?
Two additional points: first, even if “ADHD” is correlated with a genetic or biological “cause” still does not mean it is a dysfunction or disorder. Being tall or overweight or having blue eyes are all genetically moderated to one degree or another. Short or fat people are treated differently in society and sometimes suffer “symptoms” as result. There is nothing wrong with a short or genetically heavy person – their “symptoms” are a result of the expectations of society and the punishment meted out for not meeting those expectations.
Second, these so-called “ADHD” kids have been shown to be indistinguishable from “normal” kids in an open classroom where they aren’t being bossed around all the time. The “ADHD” labeling process frees the adults from having to examine the structure of their school institution as a potential causal factor, and also eliminates any real motivation for coming up with structural solutions, even though science has already provided one possible answer. The label serves the adults, not the kids.
OK, I lied: three points. The last is that the so-called “treatment” has never been shown to improve long-term outcomes for kids with this label. So what’s the point of “treating” them if they’re going to turn out just the same or worse?
I hope you will discuss social structures and expectations as “causal” factors for ADHD in your coming blogs.
Thanks for continuing to challenge the conventional “wisdom” on this issue.
I will try to find a link and post it. It was pretty fascinating! And I agree with you – there is so much that we control about our physiology and emotions, it is stupid to assign us as being somehow created by our bodies. We appear to be the creators, not the created. That we sometimes become sort of victims of our own creations doesn’t make that less true. And healing, in my experience, almost always results from increasing our awareness of the degree to which we are creators of our universe.
I do agree that sometimes changes in brain chemicals can cause genuine distress. But for me, until we can specifically demonstrate a causal connection (like with Parkinsons, for instance) between a certain condition and a certain chemical deficiency and attendant physiological damage, we can’t ever claim to be curing, treating or healing anything.
I’d also add that biochemistry is massively modifiable by each of us. I’m sure I’m preaching to the choir here, but hugs, fresh air, walks in the forest sex, sleep, eating, changing scenery, meditation, getting a massage, smiling, laughing, smelling something nice – all of these things modify our biochemistry all the time. In fact, there are a number of studies showing that simply thinking of something changes our “PET scan” dramatically.
Bottom line, I’m sure there is a small percentage of “depressed” people who have something actually wrong with them. The vast majority of the time, whatever it is can be addressed in myriad ways without drugs, and should be. I have no problem with prescribing something for a real physiological problem, but we all have different brain chemistries all the time throughout the day, and we are a far, far way from even a rudimentary understanding of what is going on.
Of course, there is also the possibility that we are spiritual entities occupying and influencing our bodies, which opens up a whole different realm of possible ways to intervene. But whether you believe that or not, I think the whole chemical imbalance concept is so crude and destructive that we ought to scrap it, even if there is some tiny percentage of people where it might actually reflect reality in some way.
Which is precisely the point I am trying to make. The agenda should be to reform psychiatry. Part of that is not participating in their favorite tactic of ad hominem attacks. Having a distracting discussion of why the 1st Unitarian Church decided to stop hosting RTP and who received money from whom and why the CoS is really a bad organization does not forward our cause – it plays into psychiatry’s hands. My sense is that it is your agenda that was off topic and distracting – you seemed more interested in defending the UU Church and attacking Scientology than doing anything to advance our movement’s cause. My effort throughout has been to get us back onto the much more important topic of how to handle ad hominem attacks and the “Scientology Smear” tactic. Casting aspersions on RTP or anyone else working toward reform is at best in very bad form.
Or to put it another way: just because you think something is true doesn’t mean it is helpful to share it. Besides which, I believe it would be much more appropriate for you to put your “facts” in context of where you heard them, and not invalidate other people’s facts, especially when they are much closer to the situation than you are. For instance, I believe your “fact” that RTP is a Scientology front group has been thoroughly discredited by both MadMom’s and my counter-facts. Don’t you think you were a little out of line making such an accusation based on such limited evidence?
I think you should check your facts more thoroughly, or at least state them more tentatively with provisos on where you got them, rather than assuming that somehow you got the whole story from a brief conversation two years back and from third-hand rumors you heard through the grapevine. You can hurt people and our movement by speaking too freely about things you are not fully informed about. To paraphrase your own earlier comment, if you weren’t a part of RTP, “you can’t say anything about it without being in error.”
How would we ever know if an SSRI caused a “serotonin balance” if we don’t know what a proper serotonin balance is and can’t in any way measure it? Besides which, these drugs are not fine surgical instruments, they are crude tools which disrupt many systems within the body (did you know there are a ton of serotonin receptors in the gut, for instance?) It’s like trying to fix a watch with a sledge hammer, without even bothering to see what is wrong with the watch. Regardless of what you do, you’re going to cause damage, because you don’t know what you’re doing, and you’re using the wrong tools. Aside from which, there may be nothing wrong with the watch at all.
Of course, you’re right, you can make someone mentally or emotionally unbalanced by screwing with his/her brain chemistry, but that doesn’t mean that anyone with emotional issues is in some way biochemically “off.”
And as I said, I am in agreement with Bob’s decision to keep things politically clear by choosing not to allow CCHR or a Scientologist as a blogger, and have never said otherwise. I am glad you agree with my larger point.
I believe you misunderstood what you were told, or else he misstated the situation. As far as I know, and I am quite certain I know more than you do about it, there is no connection between the Church of Scientology and RTP. There is a member of CCHR Oregon who has been a faithful and hard-working volunteer from the beginning, but at no time have I heard any promotion of Scientology as a religion from him or anyone else. Of course, he has shared CCHR materials at times, including the film I mentioned, but so has NAMI and the Cedar Hills psychiatric hospital. Beyond the tabling fees, we have received no money from CCHR or the CoS.
You assert personal experience with Scientology, which I have no reason to doubt, but your comments are still out of order in my book. You appear to believe you know more than people who are actual members of the RTP group about our own activities, and despite MadMom letting you know she keeps the accounts and that we are getting no money from Scientology, you continue to assert that because of a comment you heard in 2012, you know more than she does.
It is my concern and belief that by continuing to try and use the “Scientology Smear” to denigrate RTP, you not only perpetuate untruth and injustice, but you support the very organization, namely organized psychiatry, that we come here to debunk and combat. You lend credence to their assertion that that being associated with the CoS even by rumor or happenstance is de facto proof that anything you say is to be discounted, no matter how well-founded in fact your position may be. I ask you to stop now. You’ve spoken your piece, but it appears to me that your personal feelings about the CoS are allowing you to do harm to people (RTP) who have done nothing to harm you, for no reason that has anything to do with the mission of this website, and inadvertently aiding and assisting those you appear to be opposed to. I ask you to refocus your energy on not allowing psychiatry to use ad hominem attacks to distract people from the real issues at stake, rather than validating psychiatry’s patented tactic by using it against people who you should see as your allies in this struggle.
Good post, Seth. The issue of the potential utility of “psychosis” to a culture and the impact on the healer (vs. patient) of embracing this “gift” rather than trying to stomp out any manifestation of it is something I often talk about. I recently read an article (maybe on MIA) about a “schizophrenic” guy who was taken from the USA to an African tribal community and trained as a shaman, and he came back calm and focused and able to complete an advanced degree and put his healing wisdom to work. Culture is a HUGE part of how these manifestations are perceived, as well as the consequences of how they are handled.
I will point out, however, that there are some on MIA who embrace the Antipsychiatry identity, including Ted C., among others. After reading this, I have to say that with Burstow’s explanation, I have to agree that I am antipsychiatry according to her definition. It is unfortunate that the psychiatric “profession” has misappropriated the word and redefined it as “pretending that people don’t suffer” or “refusing help to those in need.” I am not sure what will remedy this situation, though I think it might be helpful if the media stopped portraying psychiatrists as benign therapists who spend most of their time listening to people “on the couch” and started reflecting the true reality of what psychiatry is, so that being “anti” that does not have the connotation of being against helping people who are suffering distress, but instead indicates opposing the minimization and trivialization of the traumatic events and genuine social and emotional challenges that living in today’s “modern world” encompasses, and often blaming the victims of such events for not responding “properly” to being horrendously mistreated.
It’s a pretty monumental task to reclaim a word, though it’s been done before. I’d love to hear some thoughts on how best to go about it without creating more opportunities for psychiatry and Big Pharma to marginalize the movement.
I was sure this was a farcical article! I can’t believe these guys are serious! They are now trying to post-hoc diagnose Moses, Jesus, etc. with psychotic disorders! Unbelievable! But then again, maybe not. It shows how totally “delusional” the entire profession has become.
With all due respect, I believe you miss my point entirely. I have stated below that I understand the political reasoning behind MIA distancing itself from Scientology and/or CCHR as a matter of maintaining credibility. It is simply not worth the time and energy to fend off such attacks, and as this thread clearly demonstrates, it can provide a tremendous distraction from the real issues at hand.
My point is that it is neither necessary nor prudent to respond to any ad hominem attacks regarding Scientology (or anything else) with attempts to expose the ‘”real truth about Scientology” or to waste any time saying, “No, I’m not, you’r wrong!” or “See, those other guys supported Scientology and now everyone hates them!”
If we wish to be effective, we need to label these tactics for just what they are – attempt to distract the public from the real debate. It is never helpful to buy into these tactics by denying such association nor by agreeing with the attacker regarding the bad character of the attacked party. The proper response is ALWAYS to confront the attacker with the attempt to change the subject and avoid the issue at hand. It is obvious from the reactions to this thread that Jason’s presentation was divisive and distracting and has wasted a huge amount of energy talking about something that really does not matter one iota in terms of our overall goal. That’s what Psychiatry wants us to do – to splinter, to bicker, and to waste our energy on trivial issues while they continue to dominate the landscape.
It is interesting that we are very careful here to distinguish between “Psychiatry” as an institution, while at the same time making sure we state that individual psychiatrists don’t all necessarily fall under that rubric. Why would that not apply to Scientologists? Is every one of them evil? Why would we allow psychiatry or anyone else to paint a group of people as all being the same because of their belonging to a particular group? Isn’t that what psychiatry does anyway? Group people together and condemn them?
We have no responsibility here to defend or explain away concerns about Scientology or CCHR as organizations, nor do we have an obligation to join forces with them politically. But we do have an obligation to point out the vicious tactics being used to reorient the debate using slander and bigotry and ad hominem attacks, because those tactics are broadly used by Psychiatry to condemn all critics. We don’t benefit anyone by saying, “Don’t worry, we’re not like them” or “We think they’re bad, too.” We do ourselves and anyone else in the field of resisting the current biopsych paradigm a big favor by calling out these tactics for what they are, each and every time we see them, and not letting those using them get away with it for one second, no matter what group or characterization they choose to use as the distraction.
Oh, and by the way – we also had a table from Cedar Hills Hospital, a nearby private psych hospital that is getting interested in looking into alternatives to their traditional diagnose-and-drug paradigm. If we were a CCHR front group, would you really imagine Cedar Hills Hospital would be allowed to run a table, or that a NAMI-sponsored film would ever be shown?
We really have no agenda other than helping anyone interested in alternatives see what they are. I think it’s pretty damned impressive that we have a group that could encompass the views from CCHR to NAMI to Cedar Hills Hospital without coming apart at the seams. We may have our failings, but we’ve done pretty damned well in the inclusiveness and open-mindedness domain. I hope that puts any “front group’ discussions utterly to rest.
Well said! We need to attack the change of subject, not validate it by trying to deny our association with their chosen scapegoat. We need to bring it back around to the question; why ARE you changing the subject? Why DOES it bother you so much to talk about this? If you are so scientific, where are your data? Why are you reduced to trying to discredit the messenger with sophomoric rhetorical tricks?
It is amusing in a way that psychiatry is so upset by “competition” from a religious group that they are so anxious to denigrate as superstitious quacks. If they’re that foolish and easily misled, why are the psychs afraid of them? I agree with SomeoneElse’s comment – I think that psychiatry unconsciously KNOWS it is a religion and can’t allow there to be competing dogma, since there is no actual scientific or rational basis for their belief system. I always thought it particularly telling that the term “diagnostic Bible” somehow spontaneously emerged to describe the DSM and has been readily embraced by our culture, and that psychiatry has done nothing to combat that appellation. Maybe everyone knows it’s really a religion deep down.
On a more practical note, it’s possible that they know their drugs work largely through the placebo effect, so warding off alternative beliefs is essential to their technical “success.” In any case, I am glad so many are seeing this for the distraction that it is. We should close this down and get back to talking about psychiatry!
This is actually a very important finding! I always hear from psychiatrists that “we all know there are situations where polypharmacy makes sense” and “we don’t know that Practitioner A isn’t working with a very difficult population…” as explanations for why certain doctors “overprescribe.” It sounds here like it’s simply a matter of their attitude – some doctors don’t really care about the impact of drugging their patients into submission, and those are the ones who use the drugs most ruthlessly, regardless of the difficulties their patients are having. It will make it easier to de-bunk these arguments when I next hear them put forth.
Ann, you are again speaking of what you don’t know. I addressed this in another post. RTP has a tiny budget that is entirely from donations from members and visitors to symposia and other events. We never took a dime from anyone. I don’t know why you insist on spreading this disinformation?
My point again is that this forum is not about what is wrong with Scientology. It is about what is wrong with what passes for “mental health treatment.” We could talk about how the Catholic Church allowed its priests to molest young children for years without consequence, or how the US government helped overthrow the democratically elected government of Iran in the 50s, or how Nestle Corporation continues to market infant formula in third world nations, leading to millions of deaths of babies from mixing the formula with polluted water and meanwhile increasing the birth rate by suppressing nursing. But none of those things are RELEVANT to this discussion, and by even entertaining this topic, I believe we harm our own cause.
Please stop acting as if you know what happened in Portland. You do not. I don’t want to have to keep responding to your distortions of fact. Let’s get back onto the topic of stopping the psychiatric juggernaut.
As a practical matter, I totally understand and agree with your political decision. I believe it is legitimate to make political decisions with the long-term goal of change in mind. I am certain from your writings that you understand the tactics described in my post above.
I believe Jason’s commentary goes way beyond that and buys into slandering Scientologists as a means of clearing himself and/or his organization from that artificial “taint,” in essence buying into that taint rather than simply choosing politically to avoid the conflict. He actually supports psychiatry’s tactic and uses it to slander RTP and Marcia in a public forum. That, I cannot support.
It is always great to hear your voice on these forums!
I agree 100% with Cannotsay, Ted, Barrab and the general tone of these comments. The “Scientology Smear” has been a tactic of the psychiatric community from the early 1990s. It is an evil strategy that involves 1) intentionally demonizing believers in a particular faith community, and 2) associating anyone who disagrees with them with this group. It was and continues to be an intentional marketing ploy by the psych industry that Goebbels himself would be proud of. While I understand the politics of keeping distance from such a group as a means of maintaining credibility, Jason’s statement above actually aids and assists the psychiatric marketing team by reinforcing their message that Scientologists are all ignorant fools or devil’s spawn and that none of them could have independently come to the conclusion that psychiatry as practiced is a dangerous undertaking that needs to be reformed or abolished.
I will remind everyone that the film festival showed a film from NAMI as well as one from CCHR. And in truth, the CCHR film got critiqued a lot more strenuously than the NAMI film did. The representative running that film appreciated the feedback and provided it to those who produced the film. There is absolutely no way that their film, any more than any other film, was promoted as the absolute truth, nor were the doors closed to an open-ended discussion of any issue raised by any of the films in the Festival. RTP is a very open-minded group that welcomes participation from anyone who supports its mission. To exclude someone because they believed in Scientology would be as unlikely and as inappropriate as excluding someone for being Catholic or Jewish.
It is high time we all identified the elephant in the room. We can’t continue to allow the “Scientology Smear” to succeed, regardless of anyone’s personal experiences (haven’t actually heard any of those so far) or beliefs about Scientology. It is simply UNACCEPTABLE to tarnish all people of any religious faith with the same brush – it is the kind of bigotry that we all so strenuously oppose in the “mental health” system.
I reiterate from earlier posts: any attempt to blackball or discredit someone for being or being associated with Scientology should be met with a strong retort along the lines of:
“What on Earth does a person’s religious beliefs have to do with the lack of scientific support for the current system of psychiatric treatment?” Or, “I am not going to allow you to distract us from the important questions at hand by using an ‘ad hominem’ attack on some other group that has no impact whatsoever on your practice.”
We cannot afford to allow this practice of “guilt by association with someone who has guilt by association with someone else” to go forward unchallenged!
The baffling part of this for me is that these youngsters were deeply embedded in the mental health system, and in the case of the first, there is a direct and observable link between her “treatment” and her death, and yet somehow, this leads to a call for “more treatment!”
Not sure I can even come up with an analogy. Why are people who read these news articles so impervious to the obvious failings of the “treatment” these young people were receiving?
Psychiatry and medicine in general have often been inadvertent supporters of domestic abuse, especially when the abuser is rich and/or powerful. One of the great dangers of the “no fault” DSM diagnostic system is that it allows a victim of abuse to be identified and labeled by the abuser and to become an instantly non-credible witness. Psychiatric coercion, of course, also allows the abuser to induce the constant fear of being committed into the victim’s life. I was conned in this way once by a very smooth abuser, who had slipped his wife some meth and hauled her into the hospital, created a conflict in the parking lot where she “attacked” him, and of course, her head was spinning so badly between the drugs and being forcibly hauled into the ER that she was incoherent. I knew something was wrong but didn’t pinpoint it until later – he was not the least bit upset about her “attacking” him or being “forced” to commit her – it was all strategy. She verified this later by saying, “He did it. He said he would do it and he did it.” Unfortunately, she refused to accept my attempts to get her into a DV shelter. I’ve learned a lot since then.
It is very, very dangerous to “diagnose” someone without an identified cause, especially in the “mental health” arena. I am sorry to hear what happened to you, and I wish it were an isolated incident, but unfortunately, it is not.
As a member of RTP, I must respectfully take issue with the accuracy and tone of your post:
1) RTP did not take any money from Scientology or any other organized group. I don’t know where you got that idea, but it is absolutely false. RTP survived ONLY on the voluntary contributions of members and participants in activities, as well as in-kind donations from the Unitarian Church in the form of space and logistical support. Naturally, this kind of effort might be of interest to people of a variety of faiths, and we would not turn away a supporter based on their religious affiliations, but the group itself has and had no allegiance or financial connections to anyone but our membership.
2) I am really, really tired of having folks in our movement buy into the use of the “Scientology smear” as a means of discrediting psychiatric reform/protest/revolt. It is clearly a tactic created and imposed by the psychiatrists themselves, and every time we bite on it, we reinforce their ability to distract others with their meaningless cant and lies. While Scientology as a religion may have many flaws (and I am personally quite aware of what those are from direct experience), it is a religious persuasion, not a scientific or professional source of information. The fact that someone in this movement is or is not a Scientologist is as irrelevant to the issue of psychiatric abuse as the fact of them being a Catholic or a vegan or having a California drivers’ license.
We need to stop buying into this crap and state right out loud to anyone bringing this up: WHAT THE HELL DOES RELIGION HAVE TO DO WITH THE EFFECTIVENESS AND INTEGRITY OF THE CURRENT PSYCHIATRIC CARE MODEL???? The obvious answer is NOTHING! (Unless Psychiatry itself is willing to admit it is a religion and is threatened by the competition…) There are sound, scientific, factual reasons why psychiatric care as practiced today is often invalidative and destructive and leads to an increase in chronic disability. The professed religious persuasion of the person stating these facts has no bearing on the truth of them.
So please, let’s not blame Scientology for the Unitarian Church’s decision. As I said, I have on the ground information that suggests a very small number of individuals, for personal emotional reasons, worked hard to have this stopped, and it had nothing to do with Scientology or the aims of the Unitarian Church, though of course, it is quite possible that those excuses were dredged up and used by the individuals behind this. It was all about personal discomfort with any message that contradicted psychiatric dogma, and it would not have mattered who delivered it.
I hope that clarifies things a bit. It would really help if people didn’t make assumptions or listen to rumors about a situation that they are not personally familiar with, especially when you have more than one person available to do fact checking and rumor control.
Thank you for this article. It includes the science necessary to debunk the idea that enforcing “treatment” will somehow magically reduce violence in the community. It will be very useful to me and I am sure to others as we advocate for our congresspersons to oppose this dangerous bill.
And BTW, I love your author photo! You don’t look scary, just kind of intense, and that, in my world, is a good thing.
Great article, Mark! You have hit in the black on exactly what does not work about the current paradigm. The WHO studies showing much better results in developing countries for schizophrenia probably reflect the long-term adverse effects of drug treatment, but I am betting they also reflect how people in those cultures react to “delusions” and “hallucinations.” In so-called “primitive” cultures, those manifestations get you some special training as a shaman. In our “modern” world, it gets you shame, isolation, and humiliation, to the point that no one is even allowed to talk to you about your personal reality. How can that be helpful?
Milton Erickson and many others did great work helping people suffering from “psychosis” by talking to them. Apparently, Erickson and his ilk would be sued for malpractice today. It is appalling. I’m glad there are a few like yourself willing to recognize that not talking to people about what is real to them is about as smart as improving your car engine’s functioning by adjusting the tuning on the radio. It is idiotic, but it is standard practice. It makes me ill to see this stupidity as the standard of care!
My heart goes out to you and your daughter! I can’t refute a word that you said. What passes for help these days is outright abuse, and docility seems to be the gold standard of treatment “success.” Your daughter is lucky to have you to provide a contrast. She sounds like a perfect candidate for an “open dialog” intervention, if only we could break out of our pharma chains and develop such options here in the USA.
Thanks for sharing your story – it was very moving and sad to me, having seen similar events happen many times over my career. It is a very common thing for PTSD sufferers, including those currently still suffering abuse from parents or abusive partners, to be labeled with psychiatric “disorders” (especially “bipolar) and given drugs to suppress their symptoms. This definitely relates back to what Mark is saying in the piece above – no one really bothers to ask why you might be feeling, thinking or acting the way you are. The assumption that mental/emotional “symptoms” have no meaning is completely wrong and destructive, and you were massively disserved by the system not bothering to find out what was really prompting your symptoms. You showed great strength in persisting despite the barriers, and I have confidence you will continue to heal.
Thanks again for sharing, and I hope you continue to post. You have a lot of good and important things to say.
Yeah, great time to quit smoking by force, right after an emotional crisis leading to involuntary hospitalization and possibly restraint and/or enforced drugging. I always found that policy bizarre! Wonder if they even bother with a patch or anything to help them out.
You’re so right, if you weren’t paranoid and depressed before you got in there, you would be pretty soon after the door locked behind you!
Thanks for your kind words. It is always great to hear from a foster care survivor who has been able to create a positive life plan for herself. It means all that much more to me to hear from someone with your lived experience in the system.
I am currently working as an advocate for foster youth with the local CASA/GAL program here in Portland, OR. I have heard only too many stories like your own, kids who have suffered endless trauma and who have little to no social support, who are somehow counseled that they ought to feel good about themselves and their lives and that their suffering is somehow the result of some biological flaw in their physiological makeup. They don’t exactly blame you for feeling bad, but that ends up being the message – if you were a really together person, you’d be OK with all this and just happily attending school and going to whatever counseling they sent you to and living with whatever random person they found willing to take you in for a price and who could kick you out at the first indication of any slight disturbance or disagreement with the management. Don’t know WHY anyone would find such an arrangement depressing, angering, or anxiety-provoking…
I have only seen a few of your posts but they’ve all been right on target. I’m interested to know more about your story, but most of all, keep on posting – your voice is very much needed!
Unfortunately, this misses the point by a good margin. It is not just the experimental treatments that are dangerous to foster youth. It is the generally accepted treatments, like “treating” a 4-year-old for “bipolar disorder” with atypical antipsychotics, or “treating” a 1-year-old with stimulants for “ADHD symptoms.” Yes, these things do occur regularly, and no, they aren’t experimental. Justina’s treatment did not qualify as experimental, either, as far as I can tell. They simply decided that she wasn’t really ill and had a psychiatric disorder causing her to think she is ill. There is something particularly ironic about them forcing treatment on her because she believed she was ill when they thought she wasn’t. If she wasn’t ill, then what were they treating???
I hope they go a lot farther than the article suggests. This won’t even scratch the surface of the disservice done to foster youth by medicalizing their understandable reactions to horrific situations.
I have to say, Walt, I find the old “Endogenous/Exogenous” or “the blues” vs. “clinical depression” argument a bit tired. There is, as far as I am aware, still no way to make any determination as to whose depression is “endogenous” or “clinical,” other than the DSM fiction of how long it lasts or how bad it feels, which is, of course utter and complete nonsense. I am sure you have met people who were abused and/or neglected as young children, and you can clearly observe that the “exogenous” depression experienced by many of them is long-lasting and severe. Did this happen because they were “genetically vulnerable?” Does this imply that young children SHOULD be able to tolerate abuse and neglect, and that those who have long-term adverse reactions are in some way malfunctioning? Or does it suggest that we should treat our kids better so that we don’t create an unnecessary lifetime of misery for them?
I am glad you are able to see the absurdity of labeling 20% of the population genetically defective, and I am particularly happy to hear your concern about kids who have been through hell being hospitalized and drugged into lethargy for the convenience of their adult caretakers. I work as an advocate in the foster care system and see this every day. I agree 100% that these are issues that we can and should unify about.
Unfortunately, the issues I mentioned in part 1 of this post directly impact the ability of the system to execute part 2 on these unsuspecting youth. If we admitted that, in the absence of any physical indications (which I HIGHLY commend you for attending to in your practice), we really have no idea how or why kids’ behavior deteriorates, and that we have no reason to assume it is biological, and every reason to believe it is a result of their ongoing mistreatment, where is the justification for drugging them into submission?
I have some hope that you are open to hearing what I am saying or I would not bother. The justification for the massive drugging of our abused and neglected young people (and a lot of abused and neglected adults as well!) is the “chemical imbalance” theory or one of its biological cousins. The dogmatic belief that some people have “SMI/Bad Biology” is at the core of what is wrong with the mental health system today, because it allows those in power to ignore oppression, poverty, violence, racism, bullying, and professional hubris as causal factors. And as Alice Miller so eloquently writes about, those with the least power are always left holding the emotional bag, as it were.
Until we see objective methods to tell who has “bad biology” and who does not, I think we need to absolutely avoid using that construct at all. It doesn’t mean we can’t utilize drugs in some cases – Johanna Moncrief’s approach is certainly much more valid, admitting that we are using the drugs for their noted effects rather than pretending we’re “treating” something “biological.” But continuing to pretend that we can distinguish between those who are really “ill” and those who are suffering as a result of life experience is a fiction we can no longer afford to maintain.
But it would certainly also be premature for us to assume that they were legitimate. And given the nature of what we’re dealing with, emotional reactivity to the essence of the effort is a very likely component. It’s an old story that has happened to many before who had the courage to speak up about oppression.
As it happens, I do know a bit about the expressed concerns and who expressed them, and I am comfortable with my statement above, as it is based on knowledge, not pure speculation. It’s impossible to know what people’s motivations are, but the information I have suggests this was a political move based on emotional reaction and defensiveness from one or two people, not a principled decision based on thought and discussion among the group. Of course, you’re entitled to assume whatever you want, but I hope you would respect the fact that I have direct knowledge that you are not able to incorporate into your viewpoint, and I hope you would trust that I am communicating that information honestly to help others understand what happened.
As an almost charter member of RTP, I appreciate the outpouring of support for the difficult position we are in, and the effort to look at the reason. Francesca, I can assure you that the reason this happened was not because of a strong anti-medication or anti-psychiatry message, and frankly, I felt a bit of resentment that you would assume this is the case without knowing anything about the situation on the ground. The name “Rethinking Psychiatry” was chosen with this in mind – the group’s purpose is not to ban or destroy psychiatry, but to help re-focus the profession on the experiences of the consumer/survivor/user of services and on the range of viable options that exist beyond the scope of the brain disease/chemical imbalance viewpoint. It is expansive and inclusive in nature, and definitely pro-choice for medication (many of our regular attendees use medication regularly), to the point that we even had NAMI present a film at last year’s film festival. They were very politely received and a rich and healthy conversation ensued after the film, which I hope left everyone feeling a little more enlightened.
In truth, I believe WileyWitch is closest to the truth: it seems to be hard for people to get their heads around “mental illness” being something that could happen to almost anyone, or that oppressive surroundings, including in the family, our communities, and our society as a whole, can cause almost anyone to “lose their minds” and act in ways that are uncomfortable for us to see. In particular, it is very painful for family members to realize that they may have contributed in some unknown way to their children’s suffering, or that they might have been able to make their child’s path easier if they’d behaved differently. It seems to be “human nature” to avoid such uncomfortable realizations and project “the problem” onto a particular family member or social group who lacks the power to defend him/herself. Alice Miller writes very powerfully about this phenomenon. Of course, when the “scapegoat” starts complaining about being singled out in this way, it is in the common interest of those in power to minimize or distort his/her voice so that the social delusion of calm and order can be maintained.
It is clear that there are a certain, very small number of INDIVIDUALS within the local church structure (or perhaps attached to people who attend but not members themselves) who were disturbed by our message, and would have been uncomfortable with any message that questioned the mainstream view of psychiatry, and those individuals acted to make themselves feel more comfortable by getting rid of the “dangerous group” who was disturbing their sense of reality. And they made enough noise to make enough other people uncomfortable that the church executives felt they had to choose one or the other, and sadly, chose to support the status quo and comfort over challenging the dominant paradigm. It is pretty much that simple.
It almost makes sense to me that this would be the last form of oppression that even those battling oppression on other fronts would be able to embrace. There is so much fear of being labeled “crazy” as a means of marginalizing dissent, that those who have another agenda are probably worried that allying with the RTP movement will tarnish them in some way, much as the antipsychiatry movement has been intentionally tarnished with the “Scientology” brush (and of course, Scientology itself has been severely attacked for having the temerity to suggest an alternative to psychiatric treatment in the first place).
That being said, it is a sad moment. I very much appreciate Jonathan bringing it to national attention. I have heard great things about the Vancouver BC Unitarians and am glad they’re still on board, and other Unitarian congregations around the country continue to be supportive of this work, so please don’t overgeneralize about Unitarians based on this one incident. It is political, but it is local, and has its own backstory that has nothing to do with Francesca’s formulation that if we’d just been nicer or less strident, things would have turned out differently. We made some people uncomfortable and they acted out to make themselves feel better. It is an almost inevitable result of challenging the status quo.
I am sure we will reconstitute in some form or another. I hope that people are also considering that this kind of reaction suggest that we are, in fact, having an impact, because no one would bother trying to get rid of an organization that was easier to ignore. Let’s keep on that path and not apologize for our message making people uncomfortable. Comfortable people don’t change.
—- Steve
P.S. Thanks to Oldhead for the Phil Ochs reprise. There was a guy who didn’t mind stirring up a bit of controversy!
It is only associated with Scientology because the psychiatric industry chose to use that association as a PR tactic. As I have said before, I meet any such implications with a clear statement: What on earth does religion have to do with whether or not your treatments have been shown to work?
I agree, this is actually the real core of the problem. The drugs can’t be justified without this spurious DSM “diagnostic” flim-flam. That’s what I’m most opposed to!
But by no means do I think we should alter our language to appease the psychiatric industry. I don’t really care what the mainstream of psychiatry thinks. I do care about helping human beings of whatever profession who are in doubt about this area decide to start looking at the rest of the evidence.
Definitely important to distinguish between psychiatrists, who cover a range of beliefs and interests and openness to learn from new data, and psychiatry, an institution with a grim and horrific history of morally and criminally destructive acts, including extreme (and some would say ultimate) responsibility for generating the Holocaust in Germany in the 1930s-45. I am definitely in support of positive psychiatrists working to make changes, and am definitely against the institution as it has come down to us through the years of lying, force, and abuse.
Unfortunately, the media image that most people have of psychiatrists is as therapists who try to help their clients re-think their world views (as seen in Good Will Hunting, Ordinary People, What About Bob, and many more films and TV shows). As a result, the moniker “antipsychiatry” can cause some who are unfamiliar with the field to conjure up images of people who don’t care about mental/ emotional/spiritual distress and think that people should just “pull themselves up by their bootstraps” and “get over it.” Which is why psychiatrists use that word as a smear tactic, along with their self-serving “anti-stigma” campaigns designed to make anyone critical of their ineffective and destructive interventions seem like an insensitive heel.
I find myself in the odd position of agreeing with Richard that “Anti-biological psychiatry” or “Anti-f0rced-treatment” might be terms that the general public can more easily process, while at the same time agreeing that if you eliminate force and drugs, 98% of the current practice of psychiatry would immediately come to an end, and the remaining 2% could easily be incorporated into neurology or psychology, based on the presence or absence of an actual physical health issue. For those who would argue that the temporary use of psychotropic agents might still have some therapeutic value, there will still be medical doctors who could prescribe them, but they’d have to be viewed more along the lines of pain killers, appropriate for temporary relief of acute symptoms, but not appropriate for treatment of anything that requires actual healing.
I don’t really see that psychiatry as a profession serves any useful purpose, and its history will always weigh it down with the likelihood of evil intentions asserting themselves. But I do see a point in approaching our language strategically, for as much as it can be frustrating, most people make decisions mostly based on emotions, even when you have the facts on your side. It is this fact that psychiatry as an industry counts on, and if we are to counter it, I think we need to have a counter-message for the general public that generates the right emotional response, even if it isn’t strictly “true” in the scientific sense.
It was not my intent to be in any way condescending – I am genuinely impressed with Andrew’s ability to balance his obvious passion with an understanding of the potential limitations of his audience. It is a very difficult balance to strike and requires considerable skill to accomplish. I can easily see a person who has been browbeaten by the system but is still suffering some “Stockholm Syndrome” effects being open to hearing this letter when they might balk at a more intense approach.
I was also fortunate to have found a competent therapist, back in the days when therapy was the first-line intervention, and I’ve been a therapist myself, but unfortunately, my more recent experience is that most therapist either shy away from any deep healing because it is frightening to them to go there, or they try but lack the skills to do so effectively, and leave people in a bad place.
I also very much agree with Andrew about polemics having their place, especially from the mouths of those victimized by the system, as I’ve written about elsewhere. The Yin/Yang viewpoint makes a lot of sense to me. But this “yin” message is also vital for those who are having a hard time dealing with the possibility that their educated, trusted professional advisers may not be giving them the straight story. It can be a painful jolt to come to that conclusion, and I find Andrew’s style a perfect blend of the hard truth with a truly compassionate understanding of how best to couch that truth so that it can be heard and considered by the recipient.
That is pretty disheartening! Disgusting, really. I suppose they choose not to recall that outcomes for these “mental illnesses” are actually better in those countries not exposed to our helpful “treatments.” I hope Africa can resist!
Live, healthy babies are the most likely outcome of ANY birth! They are basically saying, “We aren’t killing them, and only causing serious problems in what we hope is a pretty small number. Or at least that’s what we think, but nobody really knows for sure.” Not very reassuring!
I will reiterate, I think there is an important distinction between professional voices, who I believe have a responsibility to be fact-based and fair and honest about admitting to possible counterarguments or new data, and survivors, whose rage is 100% appropriate and should not be edited in any way. It is not the survivor’s job to make the perpetrator feel more comfortable. Imagine if we said that a child abuse survivor needed to curb his rage so we could have a more rational discussion with those who believe that some child abuse is not so bad, or a rape survivor who was cautioned not to be too confrontational so that those in political positions to make changes to rape laws aren’t offended or scared off.
Survivors have every right to their feelings and to have them be heard. It is the job of those of us within the system or professionally advocating for change to choose our tactics and strategies based on political necessity. It is important to do that work, but not at the expense of silencing or muting the voices of those who have been harmed. If the psychiatric profession can’t handle hearing the direct impact of its own actions, then dialog is unlikely to be productive in any case. It is only through conveying the honest voices of those who have been damaged that we can enforce any kind of change with those who don’t want to hear the truth. It will require others outside of the mental health profession, along with the few but hopefully growing number of courageous “insiders,” to really bring about the change that we want. And those outsiders are moved to action by stories like Justina Pelletier, not by statistics or science. We need rage and honesty as the motivating energy to alter the status quo. It won’t happen by peaceful negotiations, even if dialog does eventually become a viable part of the picture.
So I say, let the rage fly! It will be up to Jonathan and me and others like us to put those feelings into more digestible portions for the weak-hearted “insiders,” many of whom know the truth but are afraid to speak up. My hope is that your stories will inspire them to greater courage.
The beauty of the psychiatric model is that we can argue endlessly about whether kids are “overmedicated” or “underdiagnosed” or whatever until the cows come home, but no one can ever establish the truth of the matter, because there is no way to actually tell if someone “has” or “does not have” a particular diagnosis. Dr. Whasisname can blame whomever he wants, but it is the psychiatric profession that invents the labels and lends medical credence to this preposterous process of labeling and drugging. It is characteristic of the profession to place the blame everywhere but on themselves, but bottom line, regardless of the “pressures” the poor, suffering psychiatrist has to put up with, it is he and he alone who has the authority to write the prescription. Nobody is forcing him to put his name on it. If he’s so concerned, why isn’t he starting up a re-education campaign for these parents and “groups” so they get the data correct? Such an abdication of responsibility is amazing, and yet is the common currency of the current “mental health” system. It is they, the ones with the most power, who are the helpless victims in every scenario.
It is the lack of listening, and the invalidation of people’s experiences, that is at the core of what is wrong with psychiatry. I’m with Dr. Joanna Moncrief – if we are honest about what psych drugs are and adults make an informed decision to use them, that’s up to them. The problem is lying to people that something is physiologically or even psychologically wrong with them because they ave having feelings or experiences that make us uncomfortable.
What really seems to help most is to have someone really care about you. Physical aliments even heal more quickly when the doctor has a good “bedside manner.” Respect is, indeed, the key, and any system that approaches people without that respect is dangerous and needs to be dismantled.
It is fascinating when I hear these analogies with prejudice against black people or gay people or disabled people being used to explain away critiques of psychiatry. The obvious failure of any such argument is that black people, gay people, and disabled people were and are groups with diminished power in society. Whereas psychiatry appears to have way TOO much power and is hurting people, who are complaining about their treatment. A young black man can’t do much if anything about others choosing to arbitrarily view him as dangerous, but the psychiatric community has plenty of control over how it treats its patients/clients. If they are so worried about being criticized, maybe they ought to figure out what they are doing to piss people off and CHANGE IT!
It is utterly narcissistic to palm off criticisms against a well-paid and socially-entrenched profession as “prejudice.” Its very much like the bully complaining when he ends up with a broken nose because someone finally decides to hit back!
I appreciate the feedback, but I am pretty confident that I have stopped many instances of potential psych drugging, both directly through my work and indirectly through policy and law changes in Oregon and through many trainings I’ve done. In truth, though, I don’t see drugging as the biggest problem – I see it as a consequence of allowing DSM “diagnoses” to stand as genuine medical entities when they’re actually social constructs that in some cases are fabricated from almost no evidence whatsoever (i.e. “Intermittent Explosive Disorder” and Oppositional Defiant Disorder). When we can stop legitimizing these diagnostic manipulations, the justification for forced drugging will be gone. I think that’s the goal we really ought to pursue. But in the meanwhile, I give no credence to drug “treatment” of “mental diseases,” because I know they aren’t really diseases at all.
Hey, I’m the last guy in the world to support bipolar disorder as a diagnosis or lithium as a “good drug.” Lithium is essentially a poison to the system, and its main claim to fame in my book is that the difference between the “therapeutic” dose and the lethal dose is so small that they have to constantly check your levels so they don’t accidentally kill you.
My comment was mostly meant to summarize that there is no literature support for SSRIs reducing suicide attempts or ideation, rather the opposite. I am a scientist and have to acknowledge the evidence that exists, and having done a lot of research on suicide rates and psych drugs, I have become aware that there is research showing that lithium does reduce the suicidal thinking rate. It may do so by poisoning the brain so badly that thoughts of suicide are impossible to formulate, but that’s what the research has shown. I don’t for a minute consider it a recommendation to supply lithium to suicidal people. The point was more that the idea that an increase in suicide rates is not likely to be in any way connected with the rates of SSRI prescription, except if it goes up.
I am still waiting for someone to show me any research to the contrary, but having presented this many times as a question and gotten no response, I think we are safe to assume that such evidence does not exist, even in the pharma-distorted published literature most likely to favor such “research findings.”
Hope that clarifies things. I am no apologist for lithium or bipolar disorder or really anything in the DSM, except possibly for PTSD. Except I don’t think of that as a disorder, but more a normal response to being abused. I don’t believe “mental illnesses” as defined in the DSM even exist, let alone justify medical “treatment” with drugs that are really poisons.
We can and we should, and we both do. I just think it’s important to recognize that while I’ve helped make things better for foster youth, they are still in an extremely vulnerable position with little protection, and unless the current paradigm of THOUGHT is changed, there will still be atrocities committed to foster kids in the name of healthcare. Until all or most of us in social services get away from the ‘we know best’ mentality and start with a much more humble approach, clients will continue to be harmed.
As I think I’ve said before, I am not opposed to options. I’m opposed to lying, arrogance, and enforcement of “treatment” on the uninformed or powerless. We have to address the power dynamics before real informed choice is a possibility. But we do need advocates on the “inside” in the meanwhile, because people are suffering and need our support. I just don’t think it will be enough until the general public sees that the psychiatric emperor has no clothes.
My own experience fighting for reform of the use of psychiatric drugs on foster youth reinforces your comments, Richard. We spent 5 years working collaboratively with a lot of people, including the news media and the state legislature, as well as various social service and mental health types, and attorneys and judges, and got a law passed that increased oversight levels. This improved the conversation, increased advocacy for kids in this area, raised public awareness, and did reduce the use of psychiatric drugs to a noticeable degree.
But foster youth are still being drugged up at 3-4 times the rate of the general population, and are still being told they have “chemical imbalances” to explain why they are depressed about the deplorable treatment they have received, both before and during their stays in foster care. They still don’t get listened to, still are blamed for getting upset about being mistreated, still get the message that they should be happy about their conditions and just get on with their lives, rather than being allowed and encouraged to express and work through their appropriate pain, grief, and anger. Why? Because they have no power. Because the DSM and the current model of treatment allow and encourage clinicians to distance themselves from their clients. Because our society at large is unwilling to acknowledge the oppression that is embedded in so many aspects of day-t0-day life.
Reform is important, but we need to get beyond taping on severed limbs with band-aids. We need to really deal with the realities of social oppression, both within and beyond psychiatric “treatment,” for real change to happen. It is not a matter of policy changes, it’s a real change in culture that needs to happen, where people no longer look to doctors for help with psychosocial problems, and where the idea of medicating away someone’s emotional experience, rather than sounding reasonable as it does to most people today, starts to sound to most people like the invalidative and intentional misdirection that it really is.
Thanks for a beautiful letter! You did a tremendously job of compassionately understanding the need/desire for a name/solution that is so often exploited by the current system in the name of healing, while providing the contrasting path to healing without a label. Your counselor sounds like a truly capable and compassionate person who knew what s/he was doing. I only wish there were more such people in the profession who could really focus on the kind of “deep healing” you have found.
I am glad to know you are now dedicated to passing on what you’ve received in terms of healing. Thanks for such a gentle and wise perspective – it provides such an excellent contrast to the polemics that often are heard in this and other politicized debates, and refocuses the energy where it belongs – on the needs of the person who is suffering.
I don’t know why I continue to be shocked by the absolute lack of compunction the “helpers” in the mental health system are capable of, but this one got to me. To think they would consider the belief in reincarnation as a psychotic symptom is beyond the pale. According to this standard, three quarters of the world’s population is probably subject to enforced psychiatric hospitalization.
Thanks so much for sharing your story. I hope it and others like it reach the right eyes and ears. And “brain rape” certainly sounds like an apt description of what you’ve gone through. Your strength in surviving it all and being willing to tell the world what happened is admirable and appreciated.
As far as I am aware, there is no evidence anywhere that antidepressants have an impact on reducing the suicide rate. The only data we do know of suggests that they most likely increase it. The only drug I know of that has been shown to reduce the suicide rate scientifically is Lithium, and it wasn’t by a lot. Somebody tell me if I’m missing something here.
I would argue that equating antipsychiatry with Scientology should be met with a demand to return to the issues at hand. I would observe that anyone stating this is engaging in an ad hominem attack in order to avoid dealing with the data. A simple response: “What does religion have to do with the effectiveness of antipsychotic drugs over time? I’ve presented data to show that those receiving antipsychotic drugs do worse in the long term. Why are you avoiding answering that question? What are your data to refute that? Is it possible you are resorting to this kind of attack because you don’t have a scientific response to my query?”
This will probably not convince the person trying to distract the reader with their smear tactics, but an alert reader will easily see who is talking facts and who is trying to distract.
I do agree that people have every right to give their own experience the framing they believe it deserves, and we should not have to protect psychiatrists from hearing the emotional impact of psychiatry’s “helpful” interventions. At the same time, I agree with Francesca that sometimes we do have to be careful of how we frame things with people who are “uncommitted” in the debate, so that it is difficult to view the critique of psychiatry as anything but rational and well-grounded. I suppose I hold the professionals (like myself) most responsible for getting this message out. Survivors’ views should really be considered valuable regardless of the style of presentation, because after all, they are the ones who had the experience.
Bottom line, I don’t think “playing nice” with psychiatry as a profession is worth wasting time on, but I do think there are possible allies who should be approached with a more diplomatic message. It’s important to consider the audience.
I would love to see a study on the “placebo/nocebo effects” of telling a client/patient that they have a chemical problem in their brain that they have no control over, vs. telling them that depression is a pretty common phenomenon, happens to lots of people for very good reasons, and that most people recover pretty quickly with some help. I’d bet anything that what the doctor says is wrong with you and what your prognosis is has a direct impact on the outcome.
Psychiatrists have the power of the state backing them, whereas Jews had the power of the state opposing them. Psychiatrists are a professional organization, Jews were ordinary citizens. Nazis were a political entity attacking a cultural group. Psychiarists are the political entity, and they are both defining and attacking a cultural group. There is a huge difference in power between a group of people trying to live their lives and a group of people backed by political and social power trying to tell other people how to live their lives.
I am not down with hate speech or overgeneralizations against psychiatrists or anyone else, but the analogy between people protesting psychiatric abuse and people plotting the extinction of a cultural/ethnic group based on an ideology of superiority does not hold up.
Joel, I do appreciate your comments and agree that clients demanding drugs is a very significant reality. However, I can’t agree that this client action happens in a vacuum, as your comments seem to suggest. Our culture has undergone significant changes in how we conceptualize what a “mental illness” is and how to treat it. This is especially true since the DSM III came out in 1980, and it did not happen because patients suddenly started deciding to demand drugs. It appears from the history I am familiar with to have been an intentional move directed from the heads of the psychiatric profession to position themselves for a greater market share and to aspire to a more “scientific” approach to mental health. Which was not entirely ill-intended, I have to say – the approach to mental health in the 60s and 70s was anything but scientific. Unfortunately, however, scientific started to mean physiological, for a lot of reasons that don’t have a lot to do with the actual health and welfare of patients. Loren Mosher’s experience with the Soteria House project is proof enough of that – Soteria patients clearly did just as well over the medium range as anyone receiving hospital/drug treatment as far as symptoms, but did better in terms of social variables, and cost less to care for, but somehow, the project was de-funded and Mosher was persona non grata. This is not science, it’s politics, and I think it is important to recognize that fact.
Another huge factor you are ignoring in your comments is the effect of DCT drug advertising, which is banned in most industrialized countries, for very good reasons. One look at the Zoloft commercial with the sad little circle guy and the dramatization of serotonin nerve transmission should quickly answer the question of why consumers sometimes come demanding drugs: they have been lied to and have believed that the “scientists” at Astro-Zeneca and so forth have their best interests at heart. This has happened in medicine in general, not just in psychiatry, and it is a very predictable result of the use of the magic brainwashing device called television to promote propaganda about the ostensible causes of mental illness. A recent survey showed over 80% of respondents believed that depression is caused by a lack of serotonin in the brain, despite that theory being pretty much discredited in the mid-80s. This is the result of effective propaganda campaign of which Goebbels himself would be proud.
That being said, is it not the physician’s responsibility in the end to correct any misimpressions that the patient may have about treatment? Isn’t it really your job to tell someone, “Drugs can lead to a temporary reduction in symptoms, but will most likely impact your health in a negative direction the longer you take them. The first line of defense against depression is to make lifestyle changes. Here is a list of effective options.”
Yes, US culture is degrading and more and more people are relying on drugs to solve their problems. Some of them show up in your office. I don’t think that absolves you or any other doctor from being honest and prescribing only those things that are likely to help. You can’t personally defeat the entire onslaught of DCT advertising personally, but if you and others like you are honest with patients, we can start moving the culture back into a more sane assessment of the real risks and benefits of drug treatment. It is not your fault the public has been duped, but it is your responsibility to un-dupe as many people as you possibly can, and not simply blame them for being gullible to forces that are way bigger than them as well as you.
I absolutely agree, as we will be unable to successfully engage professionals if we’re unable to have compassion for their experience, even if we aren’t able to support their methods of dealing with it. Healing begins with compassion!
James, I think you are using the term “normalize” in a very different way than I would use it in practice. There is a difference between oldhead’s previous example of saying it’s “normal” to commit atrocities because it’s been done before by lots of people, and communicating that someone’s anxiety is, for instance, a normal reaction to being raped or beaten up by parents or a spouse/partner. The latter does not assert that it’s OK to beat people up or rape them, nor does it deny the suffering of the person reporting the assault, but it puts the responsibility for the distress where it belongs: on the distressing events that generated it. I’ve heard way too many disingenuous arguments that “not everyone reacts that way” as proof that there’s something wrong with the person who experiences intense anxiety following trauma, and I frankly don’t buy it for a moment. There is no “right way” to respond and it makes no sense to pathologize someone for having a challenge in dealing with human atrocities being committed.
The biggest problem with diagnosis is that it puts the blame for the person’s emotional experience entirely on them, and, in fact, normalizes the external conditions they have to contend with. My experience as a therapist tells me that this is the exact opposite of what really promotes healing. Much of my work with trauma survivors centers around helping victims see that they did NOT cause their own victimization, that their reaction IS a reasonable reaction to a very unreasonable set of circumstances, and that it is OK for them to feel anxious, angry, or whatever they feel and it’s not OK for anyone else or society as a whole to minimize their experience or tell them not to feel as they do. Diagnosis, by contrast, creates the impression in many if not most recipients that I SHOULD NOT be feeling the way I do, that my depression/anxiety/delusional thoughts are THE PROBLEM, rather than clues to a problem of an entirely different nature. I work a lot with foster youth, and many have shared with me how tremendously insulting it is when they report being depressed about their dire situations or histories, and the system responds by telling them they have a “mental disorder” and that they need to “rebalance their brain chemistry” with psychiatric drugs. As one kid once sagely said, “Maybe it’s OK for different people to have different brain chemistries!”
Additionally, this process of diagnosing without verifiable underlying causal factors creates great problems with research. Let’s say, for the sake of argument, that 20% of kids with “ADHD” diagnoses have low iron, 15% suffer from sleep apnea, 12 % have vitamin B deficiencies, 22% are suffering from PTSD, and 26% are bored to death because they are unchallenged in school. Any research done on any of these areas will show that interventions are “ineffective” against “ADHD”, because they don’t affect a large enough percentage. If we measure iron supplementation vs. stimulant drugs, stimulants will “win” because they’ll improve symptoms on 70% of the cohort, while iron will only help 15%. But those 15% will actually be cured of a real condition!!!! The other 85% will need more work to establish a real and meaningful diagnosis, but it’s clear that the “ADHD” label will prevent this kind of genuine differential diagnosis work ever happening. And we will spend billions of dollars researching the wrong things and paying for the wrong treatments, and projecting hostility toward the people who are rightly pointing out that the Emperor has no clothes on.
It is a lot more than semantics. Choosing diagnostic labels has profound social and psychological and practical effects on both the clients and the professions trying to help them. I don’t think anyone is arguing that people suffering emotional distress should be ignored or should not be helped. What I am saying is that “diagnosing” them based solely on subjective measurements of distress, without actually identifying a real cause, is extremely destructive. It mostly serves the interests of the professionals who are having a hard time admitting that they don’t really understand what is happening. But admitting to not understanding is essential to improving one’s knowledge. Eliminating spurious “diagnoses” based on social convention and subjective assessments can only help improve the treatment of mental distress, whatever the cause.
There are plenty of stories and there is plenty of evidence that stimulants and SSRI antidepressants can cause “manic episodes.” It even says so on the product information for most of them. I work with kids in foster care and see this effect all the time. Kids are diagnosed with “ADHD,” put on stimulants, become aggressive as a result, and are diagnosed with “bipolar disorder” and put on antipsychotics. Ironically, the stimulants increase dopamine supplies, while antipsychotics decrease dopamine supplies. So they increase dopamine with the stimulants, then see evidence of excessive dopamine transmission, which they view as a new “disorder” and “treat” with a new drug, rather than doing the obvious and stop overstimulating the dopamine system.
It definitely does happen to kids and adults who have never had these symptoms before. Some doctors have even been so disingenuous to say that the drug treatment “unmasked an underlying bipolar disorder!” For some reason, it seems difficult for many psychiatrists to accept the possibility that their drugs do sometimes make things worse.
This is actually not new – a similar experiment was done in the 70s for “ADHD” diagnosed kids, and they did noticeably better with in-school exercise. Too bad the “powers that be” don’t seem to want to incorporate that information into their handling of kids in school.
I seem to remember something about Torrey having a relative, maybe a sister, who was diagnosed with “schizophrenia” and had a bad time of it. I could be wrong, but I have some memory of this.
In any case, Sera, I believe you are mostly correct, though there are a few folks near the top who have no such excuse and are just in it for the profit. I think a lot of medical decision-making in all spheres is highly influenced by professional “trauma”, as it were.
The problem, however, is that when the patient is traumatized, s/he is genuinely powerless to stop the system from doing its thing, whereas when the doctor/clinician is traumatized, because of his/her privileged position, s/he has the option of taking it out on his/her client. While the reaction (such as yours) is very understandable, the core of professionalism, in my view, is the ability to differentiate between what I need as a professional and what the client needs from me. It is never appropriate or ethical for me to take action to make myself feel better that might be harmful to the client. I am responsible for taking care of my professional needs by consultation, supervision, training, and just plain gut-wrenching and brutal self-honesty. Which is what you appear to be doing at your facility, rather than reacting by backing away from your mission.
So I can feel compassion for Torrey only as long as he isn’t taking out his fears and sadness and anger regarding his lost relative out on innocent victims who have nothing to do with his personal losses. It’s fine for his experience to drive him toward creating better treatment for those suffering similar conditions, but not to try to capture and forcibly drug anyone who remotely reminds him of his own personal situation, just so that he’ll feel safe and in more control.
And of course, as Francesca points out, he is now profiting from his projection of his bad experience onto others, which raises the unethical needle up to another level. No, I can’t feel bad for him until he comes clean about his personal life affecting what were once much more compassionate views on what genuinely helps people do and feel better.
I remember reading a bit about your history, and it suggested to me that you’ve always been open minded and willing to challenge “sacred cows” from the start. Don’t remember why I thought that, but I remember thinking it. I am sure there are any number of folks like you out there who are people with whom a productive dialog is possible – I have met a few in my years as a mental health worker and children’s advocate. The problem is that even such people (myself included) appear to be in the minority, and are under tremendous pressure from the larger culture to accept these “truths” that aren’t true. I’m interested to know how that can be changed from the inside out?
I have had my successes over the years, including helping get a law passed in Oregon to increase administrative oversight of psychiatric drugs for foster youth, which has had a definite impact in the number of kids drugged or overdrugged, and made it easier for advocates to speak up when they have concerns. But the law did not change the fundamental reality – kids who have been traumatized, sometimes brutally, often repeatedly, both before and after entering foster care, continue to be treated as if their brains are malfunctioning when they object in some way to the process, or try to adapt to the insanity of their lives.
It took a lot of work to get the small changes we did get into law. What will it take to convince an entire community that abused kids acting angry or depressed is NORMAL? That it’s hard to concentrate in school when you’re wondering if your homeless mother has attempted suicide again this week? That it is normal to be highly anxious when you don’t know if the next time your carefully-repressed anger at your parents surfaces, you may lose your foster home, school, counselor, friends, and almost everyone you know?
Or to take another issue: why is it not obvious that when you give someone a drug to make them better, and they don’t get better or get worse, you should discontinue it? I make this observation all the time, as a professional, and 8 times out of 10 (0r worse), my input is ignored or denigrated. How can I have a dialog with people who don’t want to listen?
I really do hear what you’re saying, but I don’t know the answer. It is safe now for the “powers that be” to ignore anything that’s inconvenient. The normal reaction of most people to being ignored is to shout louder or make a scene. Which, of course, is regarded as more proof that they are “mentally ill” and should not be listened to.
It’s a real dilemma. I’m interested to hear what you think will work. ‘Cause I’m kinda getting burned out being the “light in the wilderness” these days.
Thanks for any thoughts you may have about this. I hope you take time to read the link I attached above, because I think it reflects that no one is really wrong in this equation – both perspectives are really needed.
I just read an article that talks about this particular conflict in a historical context. Apparently, it is an inherent conflict that takes place in most social movements, the conflict between working with the system to make a change and working to create a new system parallel to the old and oppressive one. It seemed very relevant to this conversation. Link is below:
It seems the obvious missing factor here is that we have more people being treated for these “disorders” and yet the rate of violence, suicide and early death have increased. If these “treatments” were effective, wouldn’t we expect to see the reverse effect? They do call for “improved treatments,” but don’t seem to acknowledge the rather obvious conclusion that the current “treatments” aren’t working very well, at least for a big proportion of the population they’re looking at. It seems like folks were better off before they got these modern “treatments.”
Important to note also that the correlation was not with frequency of hospitalization, but with length of stay in the hospital. People who are hospitalized are spending less time there, and in my view, this is largely because we’re relying almost solely on drug treatment to “stablilize” and release folks before anyone really has a chance to find out what is going on. And now no one even really bothers to ask most of the time – causes are irrelevant, life stressors are irrelevant, it’s all about messing with brain chemistry.
The further we move into the purely mechanical view of “mental illness,” the poorer our outcomes become. It is a shame, though predictable, that the authors aren’t able to make the leap to see that poorer outcomes mean that the current treatment modality is not working.
I am not sure exactly where to go with this issue. There is clearly a lot of strong emotion expressed in this piece and many comments seem to relate strongly with the sentiments expressed. While I agree that dialog involves listening in a two-directional manner, I guess my first thought is that there is a lot being said here that psychiatrists as a whole profession absolutely need to hear, unedited and blunt and to the point as it is. I don’t think Daniel needs to make any apologies for laying this out.
I also agree with Bob that we want to encourage dialog with sensible and rational psychiatrists such as Sandy who are trying to make changes from within the profession. She has shown tremendous courage, both by listening to these sentiments openly and by challenging her colleagues and making real changes happen in the great state of Vermont. Her commitment to exploring Open Dialog as a viable alternative to the current paradigm is particularly admirable, as I am sure she has experienced a great deal of professional resistance and criticism for trying to replicate a psychosocial approach to psychotic experiences that relies only minimally on drug-based interventions.
I guess my bottom line is this: Psychiatrists are the ones with the power. They are the providers of the ostensible treatments and need to be open to hearing the results of their activities. I am sorry if it is hurtful to those who are working to make changes, and it is probably unfair to paint the profession with such a broad brush. But I don’t think it’s the job of the client/recipient/patient to be fair to the therapist/operator/doctor about their feedback. I think it’s the job of the professional person to be open to hearing feedback from his/her clients, even if is put in terms difficult to digest, because a true professional is interested in finding the best pathway to healing, and WANTS to know what his/her clients are experiencing.
I believe expressive pieces like Daniels only occur because the profession AS A WHOLE has been so completely impervious to more direct dialog. It feels a bit like the profession is projecting its own anxieties onto the clients and accusing them of not listening, when in fact, it has been the psychiatric profession as a whole who has been in denial and actively working NOT to hear the loud and clear feedback from its clients, or indeed from its own research and membership. Sandy is experiencing this oppression as well, and I am sorry for it, but don’t know what else to say but “We aren’t talking about you.” If the entire field of psychiatry were half as open to feedback and observation as you are, we would not have a need for the intense emotional outpouring that Daniel’s writing and the many comments express.
It is not the clients’ fault when the treatment they are prescribed doesn’t work or makes things worse. And it is understandable that the client is angry and disillusioned and may even make generalizations about the profession as a result. I am a mental health professional myself, and I hear loud and clear the damage that is being done, and I have no problem with people expressing their outrage. I guess my hope is that those psychiatrists and therapists and social workers who really care, rather than being offended or put off, will take a deep breath and say, “Wow! This is a really important message, and I need to figure out what it means.”
As an old Chinese (I think) saying goes, “instead of breaking off my finger, look at where it is pointing.” There is no “anti-cardiology” or “anti-dermatology” movement out there. There is a reason why these feelings exist. I think it is time for those of us in the mental health professions to thicken up our skins and hear what is being said without criticizing the messenger for somehow not saying it in a way that makes us comfortable.
Right you are. And Barclay and Cunningham’s work was done back in 1978 or so, and nothing has changed since that time. It is the responsibility of the DOCTORS to convey this information to patients, just like they finally have started to do about antibiotics being useless against colds and most ear infections. This was known for years, but the docs kept prescribing antibiotics to keep their patients happy, which, of course, keeps the drug companies happy, too.
Instead, the doctors should be EDUCATING their clients – “This drug may temporarily make your child easier to manage in class, but there is no evidence that they will learn anything more or become a better or more successful adult as a result of being more manageable.” Instead, they are WARNED that failure to medicate them will have “dire consequences” in half a dozen or more areas that stimulants have no effect on at all! That is malpractice, in my book. I understand that patients are susceptible to the placebo effect, but doctors should know better than to lie to their patients. The doctors’ confidence in the “treatment” is a huge part of the placebo effect anyway. They are extremely reprehensible for not conveying this information that has been known since before the DSM-III was even published.
“… lists the dire consequences if “ADHD is left untreated”:
“Increased risk for school failure and dropout in both high school and college
Behavior and discipline problems
Social difficulties and family strife
Accidental injury
Alcohol and drug abuse
Depression, anxiety and other mental health disorders
Employment problems
Driving accidents
Unplanned pregnancy and sexually transmitted diseases
Delinquency, criminality, and arrest”
As always, the authors of this paper neglect to mention that NONE OF THESE OUTCOMES ARE ALTERED IN ANY WAY BY STIMULANT TREATMENT!!!! The only one that there is any suggestion is improved by stimulants is driving accidents. The rest have been shown to be completely unaffected by long-term stimulant treatment.
I think we need to be broadcasting this fact loud and clear. There were reviews of the literature in 1978, 1993, 2001, as well as two long-term studies (the MTA in the US and the Raine Study in Australia) that compared “treated” and “untreated” ADHD-diagnosed students, and there is no consistent difference in outcomes. Actually, the Raine study showed the “treated” cohort to drop out of school at a rate over 9 times that of the “untreated” group.
This is a far more relevant point than how to define “ADHD” or whether or not it is a brain disease. The “treatment” does nothing to improve the lives of the “treated,” except for short-term symptom reduction (which does more for the “treaters” than the “treated.”) To give toddlers a drug to control behavior is reprehensible. To tell people they need to give them a drug to prevent outcomes that the “treatment” has no impact on is criminal.
The other problem is that they act as if there is some way to differentiate between “healthy brains” and those who “need treatment,” which, of course, is impossible to do. Additionally, the statement implies that stimulants have some kind of differential effect on those with “ADHD,” a premise which was disproven way back in the 70s and which only an extremely ignorant or intentionally deceptive doctor would put forth in 2014.
I actually wrote a book myself on this topic, based on years of work with domestic abuse victims. It’s called “Jerk Radar: How to Stop a Bad Relationship Before It Starts” and is basically a manual for detecting narcissists when they’re in their charm/grooming phase.
I definitely agree, abusers are the ones who seek out people who have never had their boundaries respected or learned it’s OK to say NO and stick to it. Most of the victims are not seeking anything but someone who genuinely cares about them, and these sickos pretend to be everything the victim’s always been looking for, and then pull the rug out once they’ve got them under control. It’s pretty disturbing, but there are some ways to turn the alarms back on, and that’s what the book is about.
Just thought I’d mention it, as it seemed very relevant to your observations.
Phil, this is truly a brilliant analysis that is devastating to the basic premises of the article. Essentially, the study at best suggests that we should teach social skills to kids in their school years, which, as you note, should be obvious to anyone with half a brain.
I have made similar arguments about ‘ADHD.’ It is commonly bandied about that ‘ADHD’ children are more likely to commit delinquent offenses as teens and drop out of school early. Well, we’ve pre-screened these kids for impulsivity. Most criminal activity in teens is impulsive in nature, so should it surprise us that kids who are impulsive as kindergarteners are more likely to be impulsive as teens? We’re also pre-screening for every behavioral variable that make kids less likely to be successful in school. And then we are impressed when it is announced that the kids who we know don’t fit in well in school are more likely to drop out? Of course, it adds insult to injury that the so-called ‘treatment’ for ‘ADHD’ does nothing to change either of these variables.
Also similar to this report, the vast majority of ‘ADHD’ kids don’t become delinquents and do graduate from high school, just not as big a percentage as the mean. And plenty of non-diagnosed kids drop out and commit crimes as well. Having an ‘ADHD’ diagnosis is actaully a very poor predictor of whether someone succeeds in school, even when we have pre-screened to include only those who are bound to find school more difficult to tolerate. And of course, at no time do we spend the slightest energy figuring out what environments might work better for these kids, or teaching them the skills to survive in a standard classroom environment.
You’ve done a great job of highlighting how the scam is conducted. Unfortunately, it’s subtle enough that it’s hard for the layperson to detect, and when enough letters are attached to the author’s name, sufficient complexity causes the average person to shut down and simply assume that these guys must be smarter than me and therefore must know what they’re talking about.
Wow, I am so glad to hear that guy got arrested! Can you find an article about him in the newspaper? It is so rare that one of these criminals gets punished.
Your ordeal seems surreal, but unfortunately it is all too believable. You must be an incredibly tough person to still be pushing forward to hold these people accountable! Thanks for sharing your story, and way to hang in there and not give up!
Here’s my theory on why research finds that ECT “works.” After a client has had three or four sessions, they figure out the right thing to say:
“Wow, doc, I feel SO much better now! I’m totally cured! Thank you SO much for that incredibly helpful treatment… now, can you unlock the door so I can run as far away from here as I can get!!!!!”
Wow, that’s brilliant. Exchanging marijuana use for highly addictive sleeping pills, because we’re worried about possible substance abuse and addiction???? Definitely got some people on the wrong side of the crazy/healthy line in THAT facility!
What is kind of astounding is that psychiatrists are all too ready to claim subtle and as yet undetected brain anomalies causing all sorts of psychiatric disorders, but they deny that any such damage could occur in the case of ECT, despite the obvious fact of memory loss and a lot more subtle changes in cognition that are reported. Why would the person have memory loss if their brain was not damaged? There is also a report of a “reduction in connectivity” between the frontal lobes and the rest of the brain – how would you get a “reduction in connectivity” without damaging brain tissue?
It is readily acknowledged that seizures of sufficient strength and duration can and do cause brain damage. It’s also acknowledged that ECT causes a seizure. Ergo, ECT can cause brain damage. Don’t know how anyone can deny this connection, and yet they do so again and again.
As the Nazi propagandist Goebbels said, if you repeat a lie often enough, it becomes the truth.
Another well-established but poorly-advertised fact is that domestic abuse frequently starts or increases during pregnancy or right after birth. Whether because of jealousy of the new competitor for “his” woman, or the knowledge that she is now much more dependent and unable to escapte, abuse often escalates just at the time the new mom needs more support. But this is almost never mentioned in any of the literature about “postpartum depression.” With a quarter or more of women reporting domestic abuse in the course of their lives, this cannot be a negligible variable, but it is systematically neglected nonetheless.
I have always maintained that being depressed is a pretty normal and common occurrence after having a baby, at least in our disjointed Western society. Interestingly, I have recently learned that in “primitive” cultures, the new mother is generally surrounded by other mothers and tribal elders and various caretakers for some time after a birth, and they often have no other responsibilities than taking care of the baby for weeks afterward. In cultures where this is the case, I understand that “postpartum depression” is essentially nonexistent. In any case, there are a ton of very good reasons why a new mom might feel very depressed that have little or nothing to do with biological predispositions:
I worked at a mental health center for a while with a pretty decent psychiatrist. He described a client who was Native American who was hearing voices. He respectfully offered that he had some medication that might make the voices go away.
The response: “You white people are all the same. You hear voices in your head, you want to make them go away. When we hear voices, we go sit down someplace quiet and see if they have anything interesting to say!”
It is saying that specifically removing guns from “mentally ill” individuals will not have a significant effect on the homicide rate, as the number of such crimes committed by the “mentally ill” is so tiny. It is not an argument against gun control, just against singling out the “mentally ill” as being more dangerous than the rest of the population.
You are fortunate they did not kill him with the stimulants – they really should not be used for kids with heart problems!
I think the much more interesting question is not what to do with kids who have a hard time paying attention to the teacher, but why does school have to be so darned BORING!!! Most classrooms would send the average adult running screaming from the room after half an hour. The only reason the kids put up with it is because they can’t escape.
We avoided all that by homeschooling or enrolling our kids in alternative schools with a child-centered approach that allowed flexibility and maximum self-direction. Two of them were classic “ADHD” kids, but no one at their alternative schools ever mentioned it to us. They just worked with them as they were, and adapted to what worked for them. That’s how schools should be.
There is no excuse for the “SCT” crap. Honestly, if I hadn’t been allowed to daydream in school, I would have slit my wrists. There was literally nothing else to do, and I was bored to tears. Thank the Lord they let me doodle on my notebook!
Learning should not be boring. If it is, it’s the school’s and the teacher’s fault. I’m tired of kids getting blamed because the schools are too inflexible and insensitive to notice when the kids are bored out of their minds. Stimulants aren’t the answer – a more stimulating educational environment is the answer.
It is very encouraging to read this kind of document in a mainstream media outlet. Admittedly, it’s the UK, but still, I’m glad that the issue is getting this kind of very direct and honest treatment somewhere in the industrialized world.
Yup. But that only works if we don’t rise to the bait and try to argue on their turf. The key is to change the context of the conversation and make it about their tactics, rather than about whether or not we care about those who choose to take pills to manage their emotions.
Accusing someone of “pill shaming” is a classic “ad hominem” attack, focusing on the purported characteristics of the person making the comment rather than the substance of the argument s/he makes. This is chronically employed by the industry and their psycho-phants in their so-called “anti-stigma campaigns,” whose real focus is to undermine any opposition to the psychiatric agenda by making anyone who brings up contrary facts appear to be thoughtless and insensitive and in favor of stigmatizing the so-called “mentally ill.”
I believe such attacks need to be labeled head on as what they are. It is almost a requirement to say, “I know for some people these drugs seem to be effective” as a means of taking the wind out of the sails of those who are committed to their drug approach, but if this isn’t effective, I think the answer is to attack the approach and the person using it. THEY are in fact shaming YOU for disagreeing with them.
If you consider that Irving Kirsh’s work correctly summarizes the literature (and I do), then the bulk of those who are “helped by medication” are experiencing the placebo effect, and their improvement depends on continuing to believe that the antidepressants are working for them. Such people will always have to vociferously and irrationally defend their views, much as those who believe in a very rigid set of religious dogma can’t allow that other religious dogma might have validity, or indeed that their dogma are dogma at all. They view such dogma as the absolute and unalterable truth, and will not tolerate anyone who speaks otherwise.
So I think the proper approach is not to try and understand or moderate one’s statements to accommodate those who would accuse you of being a “pill shamer.” I think the appropriate approach is to name and attack the tactics for what they are, and to make sure that anyone else reading your response sees what is going on. It is pointless to try and convince such people to hear you. All you can really do is call them out publicly and make sure you do NOT apologize for your views. Eventually, you can turn the tables on them and make it clear to any reader that it is in fact the accuser who is really the one using shaming tactics and avoiding the facts you are presenting.
There is a difference between “not understanding they are sick” and “not agreeing they are sick.” Given the sketchy and subjective nature of these “diagnoses”, it’s hard to argue with giving someone the right to disagree with their “diagnosis.” And even if they were “sick,” that does not automatically convey the right to decide what kind of treatment is helpful.
“These results suggest that care settings affect the course of cognition..” or to rephrase, “these results suggest that psychiatric institutionalization makes people worse!”
You are 100% right about the housing. There is a program called “Housing First” or something like that in New York that gets people into safe housing before even beginning to address issues of substance abuse or mental illness. Not so amazingly, these people do a lot better than those who are detained, medicated, and released within a week or 10 days, as almost always happened where I was working. That is one of the alternatives Leah is talking about. Seems we could agree on that point at least.
The problem is that the government are the only entities that can take one’s civil rights away, and that’s what is happening when someone is detained. There are a few states that don’t have involuntary commitment laws, and I am sure there are consequences of that, though I have not seen any hard data to suggest that they have worse outcomes. Remember, the WHO studies in the 90s showed that the countries with the LEAST Westernized medical systems had the BEST outcomes, so there is no guarantee that enforcing treatment on someone will make them better off in the end (though obviously there are cases where the person is appreciative or ends up with better outcomes through enforced treatment.)
The real challenge is where to draw that line, and the Supreme Court made the ruling they did because they saw evidence that psychiatrists and other doctors readily and systematically abused the civil rights of citizens when given authority to use their own judgment. This is exactly what you oppose, and I oppose it for the same reasons you do. The Supreme Court drew the best line they could – a person has to be a risk of harm to him/herself or someone else, including being unable to care for oneself safely (which sounds like it would apply to your daughter). The Murphy bill goes way beyond that, and that is why I object to it. It seeks to enforce treatment on anyone deemed “likely to deteriorate,” and that is going to allow our government, which you and I and the Supreme Court appropriately don’t trust with this kind of decision, to empower psychiatrists to set whatever standard they want for determining who is “likely to deteriorate.” It also appears to remove due process rights of those so detained, and allow access to records that it may or may not be safe for this person to reveal. These are all government intrusions into private individuals’ lives, and it seems you are against that kind of meddling. Perhaps you need to re-read the bill. It is a Pandora’s Box for the government and the psychiatric industry to determine what is “normal” for you and me, and there is nothing to keep them from deciding you are “likely to deteriorate without treatment” simply based on the fact that they don’t like how you are acting.
And by what possible objective criterion would you determine that someone “needs stimulants” in order to drive? Since there is no objective way to assess this, I am not sure on what basis they’d be able to make this decision legally. I can smell the lawsuits from here…
That nonsense about the “paradoxical effect” is still around, but was thoroughly disproven back in the 70s by Judith Rappoport, who was incidentally a big supporter of medication for ADHD. Barclay and his ilk stay away from talking about it, because they know it’s not true, but they also know the myth is still around, just like the “chemical imbalance” story. I think they try to get the concept into the popular culture and then just don’t talk about it, and pretend they never said it, or that it is “outdated information” if someone brings it up. It’s a pretty slick system.
As I have already said, there is ALREADY LEGISLATION IN PLACE to enforce treatment on those who pose an immediate risk of harm to self or others. This standard was set by the US Supreme Court in response to lawsuits by multiple people who were detained without just cause, in violation of their constitutional rights. Your daughter clearly received involuntary services and says she benefited from them. If this already can occur, why on earth do we need Murphy’s bill to add more involuntary detentions of people who are not endangering themselves or others?
I did involuntary detentions in Vancouver, WA. Washington has one of the most restrictive statutes, and it was still not at all difficult to detain someone who was deteriorating due to psychosis. There is no need for a more lax definition as advocated in Murphy’s bill.
But at this point, it seems you are “trolling” and not really willing to have a conversation. You already know we’re all wrong, so why are you bothering if you aren’t willing to respond to legitimate criticisms of the bill such as the one I just offered?
Let me hear you explain why the current law did not allow your daughter to get the treatment she needed, even if she was unwilling. If you can’t explain that, you have no argument.
I am suggesting that you specifically did not want to be treated, because perhaps the treatment you had received in the past was insensitive or abusive. You do not know that you would want to be treated. You have not put yourself in the position of those harmed by the system. Many folks say they were helped by involuntary hospitalization. Many others liken it to being raped. Is it not possible that people might rationally experience this intervention as genuinely offensive? If they are rational enough to make this choice and don’t pose a risk of harm to self or others, why should they be forced into a treatment they find horrific?
One reason they may be emphasizing this is because reduced accident is the only, and I emphasize ONLY, long-term outcome area where stimulant treatment has shown any advantage. Of course, if they did a study of “normal” people on stimulants at lower dosages, they’d find improved attention and fewer errors, too, so it’s not an impressive finding. But given that school grades, academic achievement test scores, dropout rates, college enrollment, delinquency rates, teen pregnancy rates, addiction rates, social skills, and self esteem are ALL at best unaffected by long-term stimulant treatment (and the Raine study in Australia showed dropout rates to be much WORSE for stimulant users), they have to grab onto the only straw they’ve got.
The figure of 100,000 injuries and deaths presented seems absurd on the face of it, and I wonder where that figure comes from. The TOTAL deaths from MVAs in the US in 2009 was just under 36,000. It stretches credulity to think that enforcing stimulants on the <10% of drivers who might be diagnosed with ADHD would make even a tiny dent in that figure (pun accidental!)
Bottom line, more propaganda. If this is the only area of improvement they can point to, their model of treatment is pretty lame.
Well it is obvious, Kate, that your daughter did receive enforced psychiatric treatment. So why would we need the Murphy bill? Those who are dangerous can be detained against their will if needed, and the criteria are pretty loose. I don’t know why we’d need to expand the criteria to include anyone who is “at risk of deteriorating” when that can be quickly reduced to “not taking one’s medication” when that medication, as you’ll know if you have read the posts on this site, does not help everyone as it appears to have benefitted your daughter.
The current laws allow involuntary hospitalization when a person is a danger to self or others. Those criteria were established because the psychiatric profession proved itself willing to detain mass numbers of people who were not bothering anyone but simply were acting in ways that were unusual. There is no benefit to changing those criteria, but there is a very large danger of increasing civil rights violations How do you address those who are not dangerous but are forcibly treated against their will? How would you feel if you were in that position?
Leah’s links show that IOT does not reduce re-hospitalizations, and is inordinately expensive. There are already plenty of ways to have someone involuntarily committed. I used to do involuntary commitments myself, and I can tell you that there was very little that went on in the psych ward that would lead to any kind of healing or change. If enforcing drugs were the answer, we’d long ago have solved this problem.
Additionally, you clearly can not have used all of the alternatives that you claim don’t work, because most of them are not readily available in the US. For instance, I KNOW for a fact that you’ve never had your family member in a Soteria-like placement or an Open Dialog program, unless you are very fortunate and happen to live in Alaska, Switzerland, or northern Finland. How can you say they don’t work when you haven’t tried them?
Consider also the WHO studies in the 90s which showed that the best outcomes for schizophrenia diagnosis happened in the countries that used the LEAST psych drugs, and where involuntary commitment was very infrequent, but community engagement was high. Some of the things Leah is advocating for are the kinds of things that happen in those “less developed” countries like Brazil and India and Venezuela but are not readily available in the US.
I know it seems like involuntary commitment and enforced treatment is the best answer, and I might agree with you if the treatments actually led to long-term improvement. But they clearly have been shown not to, and in fact, there is emerging evidence that long-term use of these drugs leads to an INCREASE in psychotic episodes over time. HR 3717 is based on a hopeful belief in current psychiatric technology, but unfortunately, that technology is not up to the job.
We don’t need HR 3717. It is an emotional response to the issue of violence by those diagnosed with “mental illness,” but the “solution” unfortunately has been shown to make the problem worse.
Shying away from processing combined with the psychiatric brain-altering approach is a very bad combination. Perhaps you can encourage her to ask if her current approach is working for her. Perhaps you can ask what makes her resistant to processing? Usually, people make progress by processing their experience in some way or another. Doesn’t have to be therapy per se, but telling one’s story and re-creating the narrative in a more self-enhancing way seems to be central to most people’s recovery. If she won’t do that, she may be condemned to the drug-and-pray approach.
Prozac does cause psychosis in a small number of cases, BTW.
How do they know that an increased estimation of the likelihood of future misfortune is more accurate? Besides which, don’t we need both optimists and pessimists as a part of our social structure for the sake of species survival?
Seems like kind of a no-brainer here (sorry, bad pun), but I am glad that neuroscience is finally being used to demonstrate the impact of social conditions on the brain. Of course, it’s probably hard to get funding for that kind of study, since it undermines the brain-disease-drug paradigm that has made billions for so many undeserving sociopaths. Does not surprise me it comes from Germany rather than the USA. I hope we see more of it.
Fascinating that the male fish are more aggressive when exposed to an SSRI. I think this provides some support for the SSRI-violence connection that psychiatry is so anxious to deny exists.
Eric, you have struck at the core of what is wrong with the current model. It is not merely the minimization of dangers and the overstatement of benefits of drugs; it is not merely the promotion of drugs and suppression of alternatives; it is not merely insurance companies trying to increase profits by decreasing services. It is a fundamental misapprehension of the human condition, predicated on the idea that we all should be OK with the status quo, whatever that is. If the status quo is perfect, then it follows that any distress is not caused by current social conditions, but by an inability of the distressed person to appreciate the wonderful world s/he lives in. It is a philosophy that is designed to protect the powerful from scrutiny and to punish the little child in all of us that’s willing to say, “Hey, why is the emporer riding through the town buck naked?” Naturally, those in power want to stay in power and the psychiatric worldview is perfect for suppressing dissent. But it is also necessary for those in power to deny their own personal vulnerability and distress, and this system is the perfect way for them to transfer their own discomfort with the current state of affairs onto their clients, and then “wipe out” those projected feelings with drugs.
I like your vision, and agree with Andrew that there are many who are already doing this kind of work, even if they are not supported in doing so. I wish there was a simple way to get this idea across, but the medical model is so embedded in our social fabric that it will take many years of hard work to change, even if we were not opposed by a multi-billion dollar industry filled with sociopaths.
And it is important to remember that in the clinical trials that found antidepressants to increase suicidal feelings and impulses, they systematically screen out anyone who is overtly suicidal before the study starts. So the actual suicidality figures in the studies should be expected to be LOWER than the general population of people diagnosed with “Major Depressive Disorder.” We certainly can’t “blame the disease” or say they were already suicidal but the drugs “gave them the energy to act on it,” because those who acknowledged they were already suicidal were not a part of the study.
Exactly!! We need to get over this “liberal-conservative” split that we’re being fed by the vote-buying corporate greed-mongers and corrupt politicos who are running the show. I think that genuine liberal and conservative people can come together on issues involving corporate malfeasance and influence peddling as well as violation of civil rights by the government and other groups.
I think the real divide is between those who support the power of the exploiters over the exploited vs. those who are fighting for the rights of individuals against those who would exploit them. There are “liberals” and “conservatives” in both groups – some liberals believe the government is helping by enforcing treatment, and some conservatives believe that drug companies should be able to market and sell whatever they want with no regulation by the government at all. But a good number of either political persuasion would agree that this action is a horrible travesty of injustice and institutionalized insanity.
I want us to join together with those who believe human rights come first, regardless of their political party or affiliation. Situations like Justina Pelletier should transcend any such differences and clarify the moral imperatives that can help us move forward as a country despite differences in philosophical viewpoint.
I worked as an advocate in long term care homes back in 1995, and it was a problem even then. Especially in dementia patients, any sign of aggression was generally met with antipsychotics. One guy I saw was unable to walk through a doorway without running into the door jamb, he was so drugged. The activities director said she’d been hitting a volleyball back and forth with him a week before.
Basically, anyone who can’t defend him/herself is at a very high risk of being drugged for any behavior that is inconvenient for the authorities. Foster kids have the highest rates because they are the least empowered to fight back of any population in the country. But elderly, physically disabled, developmentally delayed, school children, those in residential treatment, prisoners, soldiers – these people have become our Guinea pigs, but we’re not even bothering to look at the actual results of the experiment. What’s happening to foster kids is happening everywhere. It just happens more to them because they can’t fight back.
I always say it would be really strange if your car mechanic failed to fix your car, but insisted on charging you anyway and claiming that you car has “repair-resistant fuel injectors,” but you should still come back next week for another expensive “treatment.” But if you don’t get better with whatever they prescribe, you have “treatment-resistant depression” and it’s not their fault, it’s yours. Why don’t they just admit when they can’t help? It is pitiful when clinicians lack the moral courage to simply be honest with their clients. Sometimes the most healing thing I did was to acknowledge, “Wow, that’s a really tough situation. I don’t know exactly what to do right here. I think depression is a pretty understandable response.” It can help for people to hear that it is NOT them, and that their circumstances ARE inherently depressing and would be for anybody, even if no one has a solution. Just to know it is not because you’re nuts can be a big relief. Unfortunately, psychiatry provides the opposite energy. No matter what happens, you’re supposed to buck up and be at least mildly cheerful, or else there is something wrong with YOU! It is sick and bizarre.
How about “EYD” – “Excessive Youth Disorder,” unequivocally caused by not being old enough to have matured yet. The market is almost endless…
Or we could also have “BWSD” – “Bored with School Disorder” – I know I would have qualified! If daydreaming had been outlawed, I probably would have slashed my wrists – it was the only thing that kept me sane through 7 years of elementary school torture.
Next thing you know, they’ll diagnose doodling as a mental disorder.
I have talked to hundreds of suicidal people (used to supervise volunteers on a suicide crisis line), and have not found one who didn’t have good reasons to feel like ending his/her life. Validating their emotions and experience while helping them come up with alternative approaches was almost always a simple and effective approach. But it required a fearless willingness to allow the person to feel suicidal if s/he wanted to. It seems the current paradigm does the opposite of what I found helpful. It invalidates the very real reasons behind the suicidal feelings, blames the victim, and offers one and only one option, which is literally forced down the client’s throat if s/he resists. I think the main purpose of this, and the main reason they don’t want their clients talking about it, is because they, the providers, really don’t know what to do about it and are terrified. It brings up their own vulnerability and humanity, and many have spent their careers trying to “be professional” by distancing themselves from their feelings, and ergo, from their clients.
There is nothing helpful about the current paradigm. It exists to protect the clinician, and when it fails to help, it provides a ready justification for blaming the client instead of looking at their own behavior as the key element in the failure to help.
It is idiotic to suggest that the human brain, the most complex organ in the biosphere, could evolve in a couple of generations. Idiotic. The time from the start of human history today is a blink of the eye in evolutionary time.
My guess is that there are multiple contributing factors, mostly a combination of various ways we our poisoning ourselves and our children with an increasing willingness for us as a society to label anything inconvenient or unusual in our kids as a disease or disorder.
One emerging potential cause merits attention. There is emerging evidence that antidepressant use during pregnancy may increase the odds of autism developing later on. There are, of course, people disputing this, and it is not a settled issue, but consider that the autism epidemic in the US did not start until after antidepressants became popular, and that antidepressants are more popular here than elsewhere in the world. I am not saying it is the only factor, but it is a lot more likely to be a contributing factor than “rapid evolution” as suggested in the article. See link below for more:
I must say, it warms my heart to know that Eli Lily is so concerned with “helping satisfy unmet medical needs around the world.” They are so sweet to be so concerned about our children! But perhaps we would better phrase it “helping satisfy unmet financial needs around the world, by creating new ‘medical needs’ they can pretend to satisfy.”
This one takes the cake! But we can’t assume everyone will laugh it off. After all, people have accepted “Oppositional Defiant Disorder” and “Intermittent Explosive Disorder,” so people will believe almost anything if spoken in somber terms by a person of sufficient “authority” to convince them they should listen.
Bottom line (ha, ha) , they will continue to pull this crap as long as we (the people of the world) allow them to get away with it.
With all due respect, Sharon, my recollection of my own education suggests that schools have ALWAYS been institutions of coercion and indoctrination – that appears to be their fundamental purpose in our society, and if education happens by the wayside, that’s just a nice little bonus. But we don’t want our kids TOO educated – they might start to notice some things and ask some uncomfortable questions and maybe create some difficult resistance to the rule of the current elite. If you never have, I’d suggest reading “The 7-Lesson Schoolteacher” by former NY Teacher of the Year John Taylor Gatto: http://www.informationliberation.com/?id=11375.
Of course, this is all quite consistent with the psychiatric worldview that everyone should adjust to the status quo and that anyone who is in any way unhappy or behaves in inconvenient ways is “ill” and should be “fixed.” There is no intent to ever look at the social structure as a causative factor in a child’s unhappiness or acting-out behavior.
Sera, another incredibly on-point and moving article. I work with kids like Kelsey all the time (I work with foster kids) and find that they are almost always labeled when they have predictable reactions to their inadequate or abusive upbrinings (including poor parenting and abuse while in foster care). And they perceive it much the way you state it: they feel they are being blamed for being upset about things that anyone would find upsetting. They crave adults who are willing to listen and feel with them so they can feel safe processing what has happened and start to see that not everyone sees them as a “problem.” This is why I am more adamant about the DSM labeling process than the drug “treatments.” It is the DSM that allows us to distance ourselves from kids like Kelsey, to view their suffering as something “other” than us, something we can feel sorry for her about but don’t really have to face up to or deal with. And in taking this position, we side with the abusers and against the child.
I am also a parent with a voice, but we used ours to help create a democratic, child-centered public charter school where kids have a voice and teachers can’t get away with treating kids like herd animals. This is one way that we can start the process toward creating a new world – create schools where kids are encouraged to be themselves and are supported in exploring their world.
And BTW, for RISN, our son’s high school history teacher used Zinn’s “People’s History…” in his class. So it can be done!
The purpose of the law appears to be to broaden the already ambiguous standards for enforced treatment. This raises two issues: one, the reason for the current regulations requiring an imminent threat to self or others is because back in the 60s, doctors were locking people up left and right for no genuine reason, and there was no kind of standard. It is extremely dangerous to entrust this kind of decision to any professional without checks and balances, because, as the saying goes, “power corrupts,” and even if most of the profession uses these powers appropriately (which history suggests will not be the case), there will always be those who consciously or unconsciously use this power to oppress those who are vulnerable.
Second, it is not necessary to allow for civil rights of parents or adults to be violated in order to oppose this kind of enforced treatment. I very much doubt that anyone here would object to someone being taken into custody for threatening a person’s life. But detaining someone to protect someone else’s rights and safety does not translate into enforcing a “treatment” of questionable effectiveness for “diseases” of questionable validity.
As you yourself can testify, “treatment” does not always help as it is supposed to, and can make things significantly worse in some cases. Once we take away a person’s right to decide for him/herself what is helpful, it again puts all the power in the hands of the professionals, who usually don’t know the person well enough to understand what is going to help, and are frequently so emotionally invested in being “right” about their own “treatments” that they don’t even recognize simple, common side effects from the medications they prescribe, and continue people on cocktails of 5 or more drugs when none of them have been effective in resolving the initial problem.
Finally, mandating a person to go to outpatient treatment is not possible without the threat of being taken and locked in an inpatient ward. That is the reality of AOT – the “Assistance” is the threat of incarceration in a psych ward and enforced treatment against your will. Especially when you consider that most of the time, enforced drug treatment is not particularly effective, and even more, the increasing evidence that long-term use of psychotropic drugs can actually make it less likely that a person will recover, the idea that enforcing treatment will somehow decrease violence is a pipe dream. In fact, the vast majority of those going on these shooting sprees, most likely including Adam Lanza, have been receiving psychiatric treatment or are in withdrawal from psychiatric treatment at the time of the event. There is good evidence that SSRIs, in particular, can create or exacerbate violent tendencies in a small but significant proportion of those receiving them. Prozac was initially banned in Germany for just this reason. Not saying that all the killings were caused by psych drugs, but there are such a high number where psych drugs were involved that we can at a minimum say that forcing people to take them does NOT prevent or reduce violence in any way.
The Murphy bill is misguided and will not create the effect it supposedly intends. And it will take money away from other initiatives that are much more promising. It is an emotional overreaction to a complex issue that no one in power cares to take the time to analyze. If it is passed, it will result in more and more civil rights violations over time. It is not something you want to support.
I’m sorry you’re having a tough time with your 13 year old. It sounds VERY frustrating and downright scary. No one is suggesting that you don’t need or deserve support with helping him find a way to survive safely. It’s just that this bill won’t really help him or you, and may make it harder to get the kind of services that he might really benefit from.
I am glad this is being addressed, especially the huge evidence favoring environmental explanations vs. the complete absence of any evidence of genetic causality.
Unfortunately, taking kids into foster care does not guarantee them that love that may be missing in the home. Emotional abuse is frighteningly common in foster homes, and physical and sexual abuse are far from rare. I think the most promise has been shown in programs that support a new parent as they bring their first baby into the world. A lot can be taught in those early months that has a huge impact on both the child and the parent’s relationship to the child over time. This is where I think we should be spending our money, rather than wasting it on expensive experiments into genetic research that will, as the author suggests, always come up empty.
I want to clarify, Leah, that I loved your article and the following is in no way a critique of you or your approach. I always love what you write and appreciate your courage and creativity in working to end this misguided path we’re on.
But your last comment made me think about something that has always bothered me. It is interesting how the idea of trauma causing mental injury seems to be resisted because of the idea that families are being demonized somehow. I don’t see it that way. I know I have not been perfect in raising my kids, and I welcome their feedback about how I might have done a better job, even if it may be painful for me to hear it. I had to go through quite a difficult time with my middle son, who went off the rails on drugs for a while and struggled with anxiety and suicidal depression. And of course, I felt responsible – because in part, I AM responsible! And I spent quite some time making myself available to him so he could let me know the many things that had been going on in his mind that I was not aware of at the time. I know this was healing for him, as it was for me. Part of being a parent is recognizing that our choices affect our children, and being willing to help ameliorate the consequences of our errors, even if those consequences were unintended.
I am certainly not interested in going back to parent-blaming as a means of absolving society as a whole, either. I don’t want parents to feel that how their kids turn out is 100% within their control, because it clearly is not. In my case, elementary school was a daily compound trauma from day 1, and shaped a lot of how I deal with the world and who I became, and my mom and dad had no real control over that aspect of my life (homeschooling wasn’t a thing back then, and there were no alternative schools I could have attended). So it isn’t about BLAMING parents. It is about recognizing that the source of many of our bad feelings and unproductive behavior lies in how we adapted to our early life experiences. I don’t believe we should deny this just to help parents (or our school teachers or our psychologists) feel better. It’s become one of the main justifications for utilizing the medical model – it absolves parents of blame. Heck, it absolves EVERYONE of blame, including the kid! It’s not the parents’ fault, not the teachers’ fault, not our social system’s fault, not the kid’s fault – it’s your nasty brain that is not cooperating.
But that is just plain not true! Sometimes mental health problems ARE caused by insensitive or thoughtless or downright abusive parenting. Sometimes they are caused or exacerbated by poor teachers or an overly rigid educational environment. Sometimes bullies or sexually abusive uncles or mean older sisters or domestically violent parents are a big part of it. Sometimes placement in foster care causes more harm than the abuse it was meant to prevent.
I think we have to stop protecting the powerful and acknowledge that parental behavior, among many other things done by the adults in a child’s world, IS a causal factor in mental illness. That way, we can actually DO something about it, instead of pretending that we can manipulate brain chemicals and make everyone feel OK and act OK no matter how stupid, dangerous, or neglectful the environment may be.
I know, I know – now I am preaching to the choir! But I had to say that. I really have a hard time with the idea that letting parents know that their behavior impacts their kids’ mental health is somehow the same as demonizing them. It isn’t. It’s just being honest and giving them a shot at fixing those things that might be in their control to fix.
And I don’t buy that “mentally ill” labeled people are hospitalized or jailed more frequently in the absence of AOT – I don’t think the stats show any difference. Look at Wunderlink or Harrow. It’s a lot of money spent to humiliate and traumatize people that doesn’t even accomplish the questionable social control goals that it is supposed to meet.
Daisy, you are so right about ADHD and sleep apnea. It is also true that foster youth (with whom I work extensively) often have other sleep issues based on nightmares and other trauma-related manifestations. They are diagnosed with “ADHD” at much higher levels than the general population, and often with less justification (if there really is ever a justification for such a vague and subjective diagnostic category).
Additionally, it is common that foster youth react to stimulants with increased levels of aggression. This is a known adverse effect of stimulants, but it is almost always attributed to the child’s “disorder” and atypicals are often used to reduce aggression that is most likely being caused by the stimulants. Sometimes these kids are diagnosed with “bipolar disorder,” and those kids would not be included in Julie Zito’s stats, so the problem is actually much bigger than her estimates (though I know she eliminated them to make sure that “bipolar” wasn’t presented as an additional justification for the atypicals).
This approach is particularly bizarre if you consider the brain chemistry involved. Stimulants increase dopamine levels in the brain (as well as norepinephrine), and this is probably what leads to the increased aggression (as one often sees with meth users). But rather than decreasing or eliminating the stimulants, they add “antipsychotics,” whose main action is to DECREASE dopamine levels, which you have artificially INCREASED with the stimulants!
How this is not malpractice is beyond my comprehension. It can only be rationalized by viewing the “patient” as an object you are playing around with to see what happens. There is not even a warped and strained scientific argument that could be made for doing so. But it is happening a lot, all over the country, to millions of foster kids. It is a crime.
Was the battle to end slavery in the US “contentious?” How about the women’s rights movement? Or Ghandi’s effective effort to achieve Indian independence? Just because those in power agree to do something doesn’t mean we have to collaborate or cooperate. Contention is necessary when intended or expected evil and bad outcomes are likely to result from some action taken by those in power.
You suggest that one of the “pro” arguments is that AOT results in a decrease in imprisonment or re-hospitalization. First off, I don’t have any stats or studies showing this to be the case. Second, even if this is true, this is a pure and simple social control argument that has NOTHING to do with the mental health of the “recipients” of enforced treatment. Locking everyone in a dark basement or dropping them to the bottom of the river in “cement overshoes” would reduce the incarceration and hospitalization rates, and be a much cheaper intervention. Point being, medical treatment, as this claims to be, should not be aimed at reducing social costs, but at enhancing the health of the individuals being treated. It is notable that none of the listed arguments in favor address the long-term health and well-being of the individuals being forced into “treatment” against their will.
Additionally, the controls you suggest over the system are inadequate, not to mention they are unlikely to occur. I don’t know who you intend to have on your oversight committees, but unless they are packed with a majority of mental health consumers/survivors, such committees will become just as much a rubber stamp as the Courts are now. Plus, they cost money, and since most of our money will now go to enforcement rather than to engagement, these ideas will never be funded for more than at most an initial “show” period to shut up critics.
The “immediate risk of harm to self and others” standard was developed only after years of intentional and widespread human rights violations among those identified as “mentally ill” and some very “contentious” advocacy by the consumer/survivor movement in its infancy. It represents an absolute minimum standard to even think about justifying taking away someone’s constitutional and civil rights, and even with that standard, rights violations are rampant (look at the Pelletier case). To loosen the hard-won protections (however inadequate) that do currently exist is extremely dangerous, and not just to the so-called “mentally ill,” since the ever-expanding and increasingly subjective DSM definitions will soon allow almost anyone to be forced into “treatment” for offenses like grieving too long or being “too disturbed” about even a genuine medical condition. We need to resist this concept with every fiber of our beings, and it would really help if inside people like you, Mark, would join in condemning any loosening of the current already-too-vague standards for involuntary commitment and enforced treatment, rather than providing an “out” for proponents by proposing safeguards that won’t work and probably won’t ever be enacted.
As a professional advocate working in the child welfare system, I can say that in Oregon, the standard is not that the child may or may not have a particular disorder, but that his/her physical safety is directly and immediately endangered. A parent could believe that Martians are outside the home looking in the windows, and have convinced the child that this is true, but if the child is able to eat, sleep, attend school, and is otherwise safe and healthy, having a shared delusion is not grounds for CPS to intervene (though they might well attempt to). Any parent has a right to seek out medical care for his/her child, and make medical decisions based on informed consent, without any interference from the government, unless the child is in immediate danger. The question should not be “does this child have ‘Somatic Symptom Disorder’ (gags me even to write that down!), but whether she is in immediate danger from her parents. Which she obviously is not. So WTF, Massachusetts? I hope they appeal this to the Supreme Court of Mass, and if necessary, of the US. There are some fundamental liberty rights being freely trampled here, and some judge somewhere is going to call them on this crap. And then I hope they sue the pants off of MGH and the State of Massachusetts.
If violence begets violence, and mental health “treatment,” especially when enforced by police and incarceration, is violent, then we can expect that mental health “treatment” will beget more violence, not less. That is what we are seeing.
There were almost never mass shootings when I was a kid. Now there are many. What has changed since then? A lot more people are taking psych drugs. And yet every time one person so drugged commits a violent crime, it is blamed on the “mental illness.” If “treatment” will reduce violence, how come so many of the extremely violent people are already receiving “treatment?”
This one requires massive, organized resistance. If you’ve never contacted your legislator before, now is the time to start. And get all of your friends and relations to do so as well. This is very bad policy, developed by some very narrow-minded people and supported by some evilly-motivated and greedy folks who stand to make big bucks off of more enforced treatment.
One argument to put forth in speaking with legislators is that the vast majority of those who committed these acts of extreme violent had recently received or were still receiving “treatment” for “mental health issues” at the time of their attacks. in Lanza’s case in particular, the medical records are suspiciously being suppressed for the last 5 years, most likely because he was in “treatment” at the time of the event. How would it change the outcomes of these situations to enforce “treatment” that had already failed them?
Good to see you blogging for MIA! I remember communicating with you years ago on the “Ritalin Death” website – you have been a great advocate and helped a lot of people come to grips with this huge mass of corruption and propaganda.
I’ve had very similar thoughts about Adam and many of the shooters – the call is always for more “mental health care,” and yet almost all of them have had extensive mental health care prior to the event. What’s that definition of insanity: repeating the same action and expecting a different result? But our culture has been so mesmerized with this mythology of magical cures for “mental illness” (whatever THAT means!) that even the most obvious manifestations of this “treatment’s” ineffectiveness (and at times dangerousness) is instantly and instinctively suppressed. It really is more like a religion than a medical specialty.
Great article – I hope your viewpoint gets the public airing it deserves.
I get the RTP newsletter, and a lot of the stuff they talk about is very good. They even talk about avoiding coercion and working with the client on making their own choices. But they seem to simply avoid the question of harm through psychiatric drugs. (A lot of the stuff from SAMSHA is similarly avoidant of the rather large elephant in the living room.) My sense is a lot of the people writing in the newsletter would like to go there, but there is political pressure not to take on that issue directly. Which makes sense considering their connections to psychiatry and NAMI. Keris is great but is operating behind the lines in a hostile environment. I admire her courage for stepping into that role, but we’re a long way from NAMI really starting to focus on the evidence base instead of protecting parents’ and their funders’ feelings with their adherence to the bio-psychiatric line.
How very bizarre! It sounds like you were a tremendously successful counselor, precisely because you were in touch with your emotions and didn’t judge or stigmatize those coming to talk with you. It sounds like the hypocrites could not tolerate the idea that a person could both be a recipient and provider of counseling or other mental health services. Which is a bizarre position to take, but also a common one, because so much of what passes for “mental health treatment” is about creating an “us vs. them” mentality where we are able to distance ourselves from the “mentally ill” whom we supposedly are helping but whom we secretly or not-so-secretly believe to be beneath us. Of course, you NOT doing that is what made you successful. But if that was true, then it meant they were all doing it wrong and they might be no different from their clients and their own issues might be affecting their counseling success! Egads! That can’t be allowed! So you had to carry all the pain they were denying and be judged wanting because you had the courage to be a genuine human being.
Disgusting!!! And what a waste for the profession. You’re the kind of person we NEED as a counselor. The rest of them need to get some counseling themselves.
Thanks for sharing – while our personalities are different, it appears our values are very similar!
Scapegoating was indeed the proper word for it. I was the family scapegoat for years, until I got really sick and had another sibling born, at which point, my next younger brother got the job. I was less of a scapegoat in school, but I just hated being forced to be there and do everything the teacher said, as well as being forced to spend time with kids I didn’t really have much in common with. I have read that this is a very common experience for kids with higher IQs who are forced to hang around only with kids their own age. They tend to get along better with kids older or younger than themselves. This was very true for two of my three boys as well.
I think people feel uncomfortable with me or find me “odd” mostly because I am quite honest about what I’m seeing when people ask me (and sometimes when they don’t), and I don’t play a lot of games. I’ve never been very good at disguising my feelings, though I am quite diplomatic in expressing them. People who are suffering find me very agreeable to talk with, but people who want to maintain their “bubble” of ignorance or their entitlement to freely bully and humiliate others don’t enjoy my company quite as much. I used to get down on myself for being unable to “fit in” to certain social circles that were considered “cool.” I now consider such people as mostly a mixture of dull, anxious, and evil, and don’t bother with them any more. My own way of dealing with judgment, I suppose, but I guess hypocrisy was more my button. I have a hard time being in the room with hypocrisy without commenting. Which makes me very unpopular among hypocrites!
Ugh! It does not sound to me like whatever treatment you are receiving has been very effective! Let me know if there is any way I can help.
There are a lot of “off the grid” approaches that can provide some relief to some people. Honestly, my biggest problem with the system is situations just like yours, where they appear to be applying the best technology and know-how that their particular world-view has to offer, and it isn’t taking care of the problem. They have literally nothing else to offer you! It makes me both sad and very angry. I wish you were in Portland and we could meet for coffee and look at options. It’s all about maximum options and getting to know each person’s story. That’s what’s missing in the current approach. It’s not the drugs, it is the lack of caring and the lack of creative flexibility that pisses me off!
My first question when I had a suicidal caller, once I figured out if they were on the verge of doing something drastic, was to ask what was going on in their lives that made suicide seem like an option they would consider. It always led to a very productive conversation. It is a shame they wouldn’t do what made sense to you as one human to another.
I am sorry you are getting that vibe – it is understandable, as some folks express some very strong feelings about their bad experiences on medication, but I don’t think most of the folks here oppose medication as one option in the toolbox. I think it is the enforcement of the viewpoint that medication is the ONLY thing that will help, and that biology is the ONLY explanation for your suffering, that leads to the vitriol. In the end, people are objecting to being harmed by the rigidity of the system, as well as by the intellectual dishonesty and downright greed of those perpetuating these misguided fake-science dogma. And medication is often the means by which this harm is inflicted.
Try to imagine if you had become MORE suicidal after starting on some recommended medication. Then imagine how it would feel if you told someone this was the case and they didn’t believe you. Then imagine how it would feel if you decided to stop taking the offending medication, and they locked you in the hospital and forced you to take it. Or imagine if they did this to your child and s/he committed suicide as a result of the side effects, and nobody listened to you when you said something was wrong. You’d probably express some vitriol, too.
If you look at Leah’s suggestions for improvement, no where in there does she say not to take medication or to stay away from doctors. She is talking about speaking up, about listening to those who have been suicidal, about connecting up with others who have had similar experiences. I am sure if you did so, you’d find that some people swear by their medications and say they could not do without them, while others want to sue their psychiatrists and the drug companies for ruining their lives. Both positions are very real and very welcome. I think you get more medication horror stories on this site because it’s one place a person can go to speak from the heart about their experience and not feel invalidated. I don’t think it’s meant to invalidate your experience if it has been different. My personal view is very pragmatic: we should work individually with each person and find out what works for him/her. It is only when we decide that there is a “right way” to “treat” suicidal people that we get into big trouble, especially when we don’t even bother to ask the suicidal people what they think about our supposedly helpful interventions.
Thanks for sharing your story. Reading the article made me wonder: do you believe your feelings of depression are in any way related to your parents’ rigid expectations about what you should become as an adult?
I have often struggled with depression and anxiety in my life, and much of it I attribute to being expected to “fit in” to a world that I didn’t ever really feel comfortable in, both at home and especially in school. I am very smart and very emotionally sensitive, and I think saw a lot of hypocrisy around me but had no way to process it, which led me to feel very isolated and alone, and unsafe letting anyone know what I was thinking or feeling.
Healing for me has meant (much like Alex said) learning to just be me and stop worrying about what others thought of my behavior. I may be regarded as odd by some, but I live with integrity and have a lot in my life that others wish they had. And I’ve learned to speak my mind when it is needed, even if others may find what I say uncomfortable. I still find the world depressing as hell at times, but I have come to believe that my feelings are a very reasonable reaction to a very dysfunctional society. Does that resonate with you in any way?
Your point is well taken. If you take away the “mental health” justification, there is really nothing to justify intervention other than wanting to stop a person from doing what they are doing. And it is absolutely true that much of “voluntary treatment” is taken on under coercion, as the person wants to avoid the inevitable detention if they refuse.
You’ve obviously given this issue some very deep thought. I am very interested in hearing what processes you and those you are working with come up with. It is often hard to tell people I don’t believe in involuntary detention without having an alternative process in mind, so the work you are doing I see as vitally important.
Thanks for the interesting conversation! I hope I get to meet you in person one day.
That absolutely makes sense, and I agree with the principles you put forth. And I have been one of those people who believes in and does the work of deescalating violent or self-destructive people, and I know it can be done respectfully, effectively and intentionally without the use of force. It does require some courage and a willingness to sit with some very uncomfortable feelings, and unfortunately, a lot of people don’t have the skills or emotional wherewithal to pull it off. I think the involuntary detention statues let us off the hook for learning those important skills and make it way too easy to victimize anyone we find making us uncomfortable.
I guess my reason for raising this is that I observe that it is harder for some people to get their head around not “protecting” someone who is suicidal or hallucinating from harming him/herself. What I am advocating for is separating these discussions, aka: “We believe it is a violation of a person’s most fundamental rights to freedom of action to forcibly detain them for preventative reasons. Additionally, even in places where such detentions remain legal,we also believe it is an egregious violation of their human rights to enforce any kind of treatment on the victims of such detention, even if there is agreement they may pose a safety threat.”
To me, they are two separate rights issues: the right to be free from arbitrary detention in the absence of due process of law, and the right to be free from enforced treatment regardless of any law violations that a person may have engaged in. In most cases, it is assumed that “protective detention” automatically confers the right to enforced treatment. I want to see that assumption overtly questioned, so that even folks who support involuntary detention will be able to see the possibility of a person retaining sufficient dignity and rights to decide whether or not they want the “help” that is being forcibly “offered” to them under coercive conditions.
I hope that makes my position a little clearer. I appreciate your thoughtful response.
As I have said before, it is possible to have detention for people who are demonstrating dangerous behavior without allowing any forced treatment at all. I really think these two issues need to be separated, and I hope that issue can be raised with this commission.
Thanks, Tina, for your exceptional courage and hard work in championing this issue on an international level. You are heroic!
As a person with a scientific background (BS in Chemistry, plus lots of familiarity with social science research), it really isn’t that hard to interpret, once you sift through the BS. The main reason you are having a hard time understanding it, besides the use of intentionally technical language to make it look like they know what they’re talking about, is because most of it really doesn’t make sense.
The following lines sum it up:
“After all, common variants explain only a very small percentage of the genetic risk, and functional consequences of the discovered SNPs are inconclusive. Furthermore, the associated SNPs are not disease specific, and the majority of individuals with a “risk” allele are healthy.”
Translation: most of the people who have “bipolar disorder” don’t have these genetic markers (“very small part of the genetic risk”), even for those who do have the markers, we don’t really know if “bipolar disorder” or anything specific will result (“functional consequences of the discovered SNPs are inconclusive”), some people with other “mental health disorders” have exactly the same markers (“not disease specific”), and most people who have these “risk” markers don’t have anything wrong with them at all (“the majority of individuals with a risk allele are healthy).
Or to sum up: We’ve discovered a genetic marker that is more likely to be present in “bipolar” clients than in healthy ones. However, the vast majority of people who have a “bipolar” diagnosis don’t have the marker, lots of people who have the marker have something else wrong with them besides “bipolar,” and most of the people with the marker have nothing wrong with them at all.
It’s a pretty lame effort – “grasping at straws” doesn’t even sum it up. They are desperate to find some correlations with genes, but if this were of significance, we’d find that 1) most people with “bipolar” diagnoses have this variant; 2) most people who have the variant have a “bipolar” diagnosis, and 3) the vast majority of healthy people don’t have this variant at all. They’re 0 for 3 in my book.
Leah, I always get a little worried when I read an article about suicide prevention, because I used to supervise at a volunteer suicide hotline and watched the changes over time as we got farther and farther away from a trauma-based, human-interaction focused model to the dominant medical model we see today. Most of the writing, including from the AAS, are about knowing the signs and getting “treatment.” And you are right, there are almost no voices from survivors of suicide attempts, or of the ham-handed interventions that are supposed to help.
I was so impressed by what you had to say, as it completely reflects my own experience as a counselor and a person who has at times struggled with suicidal feelings. Your emphasis on being present for the person and not judging him/her for having his/her feelings, which in my experience are almost always very understandable given their experiences, is exactly what the mental health world as a whole needs to hear. I am so glad you’ve found your voice and helped others find theirs. I really do believe this is the only way the mental health world will reform – when those who have to suffer through its “helpful” interventions stand up and say NO MORE!
It is kind of amazing how they feel OK to make all of these claims without any literature references or footnotes whatsoever. I wish we’d have “scientific literacy” courses for teens and young adults so that people could learn to sift through this crap. I don’t know what the answer is, but this kind of posting is totally reprehensible and possibly qualifies as downright evil!
I hear you, and don’t really disagree that it is impossible to pull mind and body apart as Aristotle attempted to do. But again, you are speaking out of your personal beliefs, which I am, too, but that is not science.
I suppose the next scientific question I’d have for you is this: while it is a given that mind and body are interrelated and in a sense inseparable, how is it that we control our brains? And who is it that is controlling the brain (as in my examples of neurofeedback and the placebo effect, or the known impact of meditation in actually changing the size and structure of the brain)? I suppose we could postulate that some higher part of the brain is generating these controlling impulses, but that leads to an endless chicken-and-egg dilemma: What or who controls those higher functions?
I am not saying I know the answer to that, or that it is necessarily a function outside the brain. I am saying WE DON’T KNOW. I’m saying it is a mystery, and simply saying “we think it’s all happening in the brain” is a total punt and abdication of responsibility, which allows professionals to continue to engage in ineffective practices with impunity. An honest professional acknowledges the limitations of his/her knowledge, because s/he knows others are depending on him/her and s/he does not want to mislead those who have placed their trust in him/her. That’s my view, anyway. I think we’d all be served a lot better by admitting what we don’t know, and the nature of the mind remains a pretty damned big mystery, which is not likely to be solved, IMHO, by spending all of our energy studying and manipulating the brain when we don’t actually understand or even know what is happening up there.
And just to throw another monkey wrench into the works, what about the “second brain” in the gut?
I think the point is very well taken. “Science” (in my view) has in many ways taken over the role that religion once held in society. I still recall the visions of endless scientific/technological progress were ubiquitous in my childhood. I remember the depictions of the year 2000 involving self-driving cars and moving sidewalks outside every downtown building, and presentations on the incredible promise of clean energy presented by nuclear power.
There is a very deep-seated belief in many that technology is the answer, and that belief does result in large degree from the position of scientific materialism. I would submit, however, that the Age of Enlightenment thinkers did not as a whole dismiss the idea of a creator or of the possibility of spiritual realities that transcend the physical.
But I digress. I was not making arguments against materialism per se, but arguing that accepting a particular philosophical viewpoint as “inherently obvious” and therefore not subject to falsification does not allow the science we all want to believe in to do its job.
And I agree, psychiatry has been granted the authority it has by a society that believes psychiatry to be a scientific enterprise that is interested in coming up with a workable model that will help us understand and solve problems of the mind. Which is all the more reason many folks feel so dramatically betrayed when they discover the lack of actual scientific rigor in the theories underlying psychiatric practice. And it also speaks to the very much higher level of responsibility the profession has to be scientifically sound and thorough and not to deny inconvenient facts – if people have entrusted you with this kind of authority, integrity demands a much higher level of rigor to merit the trust the profession has been granted.
My argument is that we need to apply scientific thought rigorously, and not allow our assumptions regarding the nature of the mind, which may widely vary, interfere with our honest assessment of the facts we’re presented with, which vary a whole lot less.
Where, indeed? And why is it so important for them to invalidate these experiences? Is it threatening to the psychiatric hierarchy to allow that there are huge unknowns in the world of the mind? Is the whole materialistic approach simply a way of reducing anxiety in the face of the mystery of life?
Where, indeed? And why is it so important for them to invalidate these experiences? Is it threatening to the psychiatric hierarchy to allow that there are huge unknowns in the world of the mind? Is the whole materialistic approach simply a way of reducing anxiety in the face of the mystery of life?
I agree 100%. When I object is when so many of your colleagues assume and assert that their perspective – which to me sounds very much like I am an illusory effect of neural firing and that I have no free will or control over my own brain chemistry – is the only perspective worth having, and that anyone who disagrees is anti-scientific or superstitious. You obviously don’t take the perspective to that extreme, and appear willing to acknowledge that it is a philosophical position that others don’t need to agree with. This is absolutely not my experience with the bulk of the psychiatrists I’ve known, and increasing numbers of psychologists and counselors of various stripes are beginning to act similarly.
I think what we do agree upon is that we should focus on what actually WORKS, and that “WORKS” should be defined from the point of view of the person being acted upon by our purportedly helpful interventions. I am essentially a pragmatist at heart – if someone does a spirit dispossession, and the “client” gets better (and I know this does really happen), well, let’s find out what was done that worked and see if it works on someone else. Real science doesn’t exclude possibilities because they conflict with our basic assumptions about reality. Science is designed to cut through those philosophical assumptions and show us what is actually KNOWN.
Anyone who attacks someone else’s integrity for not being a materialist or a spiritualist or a populist or whatever “ism” they favor is not being a scientist at all. What bothers me is that the psychiatric community as a whole (present company excepted) gets away with claiming it is the “true science” while pointedly ignoring scientific data such as Harrow and Wunderlink.
Nobody needs to agree with my philosophy. They do need to show me the data to back up the idea that their philosophy leads to a workable solution. But I don’t think we disagree on that point.
Great stuff, as usual, Joanna. (Though I would not necessarily agree that “People living in western societies may no longer suffer from the desperate material deprivations of the likes of John Barton” – there are fewer but such suffering continues to exist, even in industrialized nations.) I have often said exactly what you do here – there is nothing particularly new or scientific about discovering that ingesting substances can change one’s mood or thinking. I often refer to alcohol as “the poor man’s Prozac.” But the medicalization process is clearly one of blaming the victim and sparing the oppressor, much as Alice Miller so eloquently outlines in her writing (in particular, her book, “For Your Own Good,” appears particularly applicable to this strategy of emotional suppression.)
John, I have many times experienced the same thing. I once spoke with a developmentally delayed 17-year-old (mentally about 6) who had been raped. She was depressed for about a year before disclosing her abuse, and almost immediately after telling what happened, started to act out physically. The diagnosis? “Bipolar disorder.” Another psychiatrist was treating a woman for 15 years with every drug he could think of, said he’d “tried everything,” but never bothered to ask her what had happened in her life that she was depressed about. My own son went through a difficult time as a teen, involving a short stint of drug abuse and a sexual assault by a roommate, leading to some serious depression and suicidal thoughts. A doctor tried to prescribe him antidepressants without even bothering to ask him why he’d thought about killing himself. Didn’t even bother to find out he was in withdrawal from abusing substances, not to mention having to disconnect from all of his “friends” whom he realized were only interested in using drugs and who abandoned him the moment he quit.
I could go on. It amazes me how incredibly stupid this medical paradigm allows people to be. Even an untrained 6 year old who saw someone crying would at least know enough to ask them, “Why are you so sad?”
You probably are a brilliant counselor, for the simple reason that you actually are interested in the perspective and experiences of the person you’re trying to help. And yet these morons get paid hundreds of dollars an hour to invalidate and suppress people’s normal reactions to adverse circumstances. It is disgusting!
Ah, but I think you have made my point for me – you guess that most psychiatrists, you included, don’t agree that there is some other agency involved. You would SAY that there is some neural process that would account for belief. But WHY would you say that? What evidence is there to support your claim? Is that claim not just as much reflecting a philosophical/religious viewpoint as the claim that the spirit is a separate entity that occupies and manages the body? Unless you can provide evidence for your belief, it amounts to nothing more than a generally-held belief within the psychiatric community, no more scientific than someone’s belief in angels or the afterlife.
I do think this point is vital – not that you agree with me about the nature of or even the existence of a transcendent agency capable of controlling the brain (for which I acknowledge there is no direct evidence, but whose presence I infer from other events), but that your belief is not somehow more important or accurate or scientific than mine because a bunch of other psychiatrists agree with you.
I absolutely respect you and your important work, or I would not bother having this conversation with you. I want to challenge you to ask on what basis you and your psychiatric colleagues hold that belief. Is there one shred of science telling you that the placebo effect is accounted for by a “neural process?” If so what is it? Is it anything other than pure speculation that such a process exists?
It is my observation that this absolute and unfettered need to believe that everything about human behavior can and must be explained by a neural process is central to psychiatry’s absolute blindness to other options besides chemical manipulation of the brain. And for me, as a scientist (a chemist by training), it has not the slightest degree of scientific validity. It is an assumption that is so accepted that anyone who questions it is automatically considered “not scientific,” but it is an untested assumption.
Biological psychiatry has on occasion been compared to a church or religious community (and interestingly, the DSM has been dubbed the psychiatric “bible” spontaneously by many in the mental health community!), and I find that the dedication to this particular belief is what gives it that churchlike quality. I am very interested to hear if you are able to consider the possibility that it is nothing more than a belief that is unsupported by known evidence, or if you in fact have evidence that I am unaware of to share.
Again, I have the utmost respect for you and your work, and really appreciate your posts. I hope you will take this in the spirit (forgive the pun!) in which it is given. I really want to hear your response.
Thanks for the thoughtful article. I have to say, I think Insel’s observation of the truth regarding the DSM is quite on target, but his solution continues to be based on an unproven assumption, namely, that out mind and our brain are synonymous. (I think Rossa said something similar above). It denies the obvious impact of what for lack of a better word I will call the spiritual being on the body and specifically the brain. I am not going to indulge in speculation on the nature of this apparent being, but merely point out that whatever it is, it appears to have a profound influence on our health and well-being. Or perhaps it is more correct to say that it is the agency that DETERMINES what health or well-being even means to us.
To be more explicit, let’s take the “placebo effect.” Apparently, believing that something can help us can actually help us. So a BELIEF is healing. It should be obvious, and has been shown also, that beliefs can also be harmful or debilitating. How would any of this be “measured” in the brain? What is the target area for “trust” or “confidence” or “sense of purpose?” These things have no apparent correlates in the brain. And yet they obviously impact how we think, feel and behave, every bit as much and moreso than the profession’s sacred psychiatric pills.
Another example is neurofeedback – apparently, a person can intentionally alter his/her own brainwaves to fit a particular pattern if they get feedback about when they’re being successful in approximating that pattern. And a person can be trained to do this eventually without any further feedback. So WHO IS ALTERING THE BRAINWAVES? If the brain is all, how can the brainwaves alter themselves? Obviously, there is an agent external to the brain, or superior to it, that can tell the brain what to do.
Again, I don’t pretend to know what this agency is, but it is apparent that human beings have an agency that is able to dramatically influence brain function, both intentionally and unintentionally. If we only study the brain, we miss that boat completely before we even start. Which is why no one will every get money to study why “Disney Therapy” worked for that family. There is something at work in that example that transcends brain function. Something to do with meaning and dedication and purpose and unbending intention to solve the problem. There is no measurement of such things and no “genetic or molecular target” for them, either. They are aspects of the human spirit, whatever that is. And the human spirit, in my view, is something that measures, not something to be measured, and it will always transcend any efforts to quantify it. Until we admit that simple and obvious fact, our “research” efforts are doomed to failure.
Sometimes it has nothing to do with the box at all. It has to do with who is controlling what goes in the box.
Sera, you are awesomely on target as usual. But I have to admit, this article almost made me physically ill. Especially the “game.” I am glad you were there to throw a monkey wrench in the works, but you should have been on the panel with half a dozen other survivors who genuinely know what you are talking about. I can’t believe this drivel is being passed off as “education.” It really does make me sick!
I like to add Thomas Edison, who was apparently thrown out of school at an early age and his mother was told he was “incorrigible” and could never be taught anything. He was homeschooled from there forward and apparently learned a thing or two that he passed along. I am sure he did not suffer from a lack of Ritalin in his experimentation and marketing genius.
All these great people managed to be great in an age before “treatment” or labels were invented. I have always failed to see how their success does anything but undermine the notion that “psychiatric disorders” are “lifetime brain disabilities” that require “lifelong ‘treatment.'” These people didn’t have lifelong “treatment,” did they? How did they manage to be great anyway? Seems like a great argument AGAINST ‘treatment.’
Weird that they say community based care should be emphasized in areas where other services are less available – it sounds like they should be emphasized everywhere!
Rossa, I am afraid that it’s not the professionals keeping the knowledge of helping distressed individuals to themselves – they genuinely don’t have that knowledge or those skills. There is no requirement that those entering psychiatry have any education in therapy or even advanced communication skills, and it is obvious that many of them don’t seem to be to worried or even notice that those skills are lacking. The most common attitude I’ve encountered (and I’ve worked in the field for years) is, “I’m the doctor, I’ve studied about brains and drugs, I know what I’m talking about, so you shouldn’t worry your pretty little head about it – just do what I tell you.” I have seen very destructive communication from professionals who should know better, and more commonly, a simple lack of skills leading to an impasse, where the client has bared his/her soul and the clinician can’t do anything more than say “I’m sorry” or “I think you need antidepressants.”
It is a very sad state of affairs. I think the biggest reason that peer-directed services work so much better is that the peers are better communicators – they empathize and listen well and have ideas on what the client might do to help him/herself. The combination of ignorance and arrogance presented by the average psychiatrist precludes them learning anything of importance from the client, or even admitting they have something to learn. So they’re not hiding their advanced skills – for the most part, they simply don’t have them. And in most cases, they wouldn’t care to learn them if they were offered.
—- Steve
PS I know Cindy personally, and she is a remarkable woman!
A very valid question. Unfortunately, the medical treatment model is so completely dominant in the US that very few treatment alternatives exist currently. You might want to read Robert Whitaker’s book, “Anatomy of an Epidemic,” which prompted the development of this community. There are alternatives, such as the Open Dialog approach (80% recovery rates with minimal to no medication use), the Soteria House model, and various peer-directed services. There is new research supporting “Cognitive Behavioral Therapy” for psychotic symptoms. There are also reported successes with nutritional approaches, meditation/mindfulness, vitamin therapy, and others. The biggest problem with the diagnosis of “schizophrenia” is that it probably encompasses a lot of different things that might cause the same kind of symptoms or reactions. I think the most important thing is to figure out a way to help the sufferer define the situation in a way that he can embrace. This requires a lot of skills that most mental health professionals don’t have, and honestly, I have not always been successful with it. And honestly, short-term use of antipsychotics can help get there in some cases. But the research is in, and long-term maintenance on antipsychotics clearly does not lead to good outcomes in life. Whether they are used short term or not, it’s vital to look for alternatives that the person suffering the symptoms can get his/her head around.
Hope that helps a little. It is an awful situation, and I feel for you. Wish I and/or the mental health system had more to offer.
It is also illegal. The family must be proven to pose a threat of imminent harm to the child. It seems pretty obvious that these parents were loving, concerned, informed parents trying to do the right thing. They were neither intentionally harmful nor neglectful of her needs. She appeared to be functioning well despite her medical issues. It seems it is more about the doctors fighting over their turf than the parents posing any danger. Even if the doctors they consulted with were wrong, the doctors should be held accountable, not the family for seeking out and following the medical advice of a licensed practitioner.
It’s just bizarre and shows how distorted our “mental health” system has become. The bigger shame is that the judge didn’t throw this out at the first hearing. There is no legal grounds for her to be held.
That is the hidden conclusion that was drawn from the Decade of the Brain – not only do bad relationships damage brain development, damaged brains can and do heal, and the most healing thing for a tramatized brain was shown to be a meaningful relationship with a healthy adult who cares about you! Psychiatry is always fond of telling half the story. They leave out the part about how whatever damage trauma may do the brain, psychiatric drugs not only don’t heal it, but the appear to make it worse and worse. That’s the biggest message from Anatomy – you can’t heal brains with chemicals. You can only damage them further.
I would assume from my short stint as a nursing home ombudsman that the rate of “antidepressant” drugs given to seniors has climbed steadily over time. It is important to take that into account when looking at increasing suicide rates, as the drugs themselves may be contributing.
Additionally, the drug approach that is so common and so accepted really invalidates the reasons you mention above for so much of the depression we see in the aging population – loss of community, loss of purpose, loss of housing and possessions, loss of friends and connections, loss of status, loss of control over our bodies, and in the case of nursing home residents, loss of control over most aspects of our lives. All these things make a sense of sadness or loss or even hopelessness or despair a pretty normal and common experience, but instead of being listened to, understood and supported, most elderly folks continue to get the “drug ’em and forget ’em” message that essentially says, “You should feel good, and if you don’t, it’s because your brain is messed up.” It is the opposite of the holistic approach you are recommending, and yet it is standard practice in the care of aging Americans.
And the data shows that you aren’t missing anything by not paying attention, because the kids who are artificially “interested” in it through stimulants apparently don’t learn any more than the kids watching the squirrels!
I think you make a very good point. The field of psychology doesn’t have to be a science, and really isn’t, because we’re dealing with values and priorities and motivation and emotion, things which don’t lend themselves to measurement. In fact, I think it lends confusion to what is otherwise a much easier subject to understand when we approach it more philosophically. The very fact of choosing to believe that depression or psychosis is a problem that needs solving (for instance) is a value-laden decision that belongs entirely to the field of philosophy. Which is kinda what Jonathan is saying in his article, I think.
However, I am a scientist by training (a chemist) and find my scientific way of thinking greatly enhances my ability to help people. I treat each interaction with a person as a unique experience (because they are), but I can still hypothesize what might be happening, test out my hypothesis with careful questions, and alter my theory if the facts no longer bear it out. Of course, this is all in the context of helping the person I’m helping achieve his/her goals, rather than my own.
If all psychiatrists and psychologists approached it this way, the drugs would be minimally used, if at all, because if you really look scientifically at people’s experience with the drugs, on the balance, it’s pretty dismal. I think the biggest problem is that they don’t really think scientifically at all. They have religious faith and pretend it’s science. A more scientific attitude, as well as one more humble and respectful of the person coming to them for help, would actually improve things a whole lot!
I wish everyone would read this article who keeps recommending medication for “ADHD.” All the lines about “untreated ADHD” leading to delinquency, school failure, etc., are clearly not relevant, as “treatment” changes none of these variables in the slightest. And their argument that community treatment is of low quality also holds no water – that’s the treatment the community is receiving, and the data says it DOES NOT HELP!
Science is pretty mainstream. I hope the word starts to spread. It is hard to comprehend the magical belief system that underlies this practice. Of course, it’s easy to understand the financial motivations of the purveyors of the concept, but this science is not new and this “treatment” should have been tossed out as useless over longer than 12 months back in the 70s.
Actually, the cooptation of government by business interests, I discovered recently, is the essential definition of fascism. I am not claiming benefits of socialism here – I am merely stating that our enemy is not socialism, but FASCISM, which is not going to stop until our representatives represent us rather than the large corporate interests like the pharmaceutical companies.
As further evidence, I will remark that the more socialist countries in Europe have been more resistant to the psychiatric drug craze than our own pseudo “free-market” economy, which is not free at all but highly controlled by the fascistic forces that have been running our government, and I include the Clinton and Obama administrations in that group 100%.
I think the liberal/conservative split is being promoted so that each “side” thinks the other “side” is responsible for the horrific politics in Washington, so that the “conservatives” call for less government and the “liberals” lapse into apathy, and the corporations run the show. I think we need to stop buying into this sales job, and realize that both liberal and conservative views have been and will continue to be relevant and important, but historically never led to the kind of hostility and gridlock we see today. It’s not about liberal vs. conservative – it’s about BIG CORPORATIONS vs. THE REST OF US!
Good for you! I have to say, it occurred to me that part of the picture may be that quitting gives one a sense of accomplishment, of being successful in getting out from under the “control” of this particular substance. My experience as a counselor and advocate tells me that people feel better when more in control of their lives. (Which the biggest reason I find psychiatry so abhorrent – it does the opposite!) What do you think of that possibility?
It is astounding that something having such a tiny correlation relative to the sample size could possibly be considered causal, when something like .01% of the “normal” sample have this particular anomaly. From the data, it’s obvious that this anomaly is neither required nor sufficient to prevent developing “schizophrenia,” since 99.99% of the non-diagnosed population didn’t have the anomaly.
But that’s what Loren Mosher did back in the early 70s, and they didn’t want to believe it and fired him as head of schizophrenia research and defunded the program! These people aren’t interested in science, they want to be RIGHT so they can keep making MONEY. Anything that challenges their religious worldview will be thoroughly trashed and anyone supporting these views will be personally attacked or ignored. That’s how they work. They’ll never be convinced by evidence, because they aren’t interested in evidence. Our only hope will be that new practitioners will be educated as the older “key opinion leaders” die off, while patients continue to demand more options. Psychiatry will be dragged kicking and screaming from their dogma, regardless of the facts.
I think it depends completely on how it is approached. And that’s true of any kind of talking therapy. The practitioner can be authoritarian, bossing the client around and telling him/her what to think and do, or empowering, and work with the client to identify and achieve his/her own goals.
As to CBT, I don’t see it as a technology as much as a tactical option. It is one of several approaches a client can choose to take toward making some wanted changes, but it’s not the only one. I do get exercised about folks who insist that CBT is the only way to go, and especially those who insist that reviewing past events and experiences as they relate to current thoughts and feelings can’t be a part of therapy. My approach has always been to do what works for the client, and if it doesn’t work for the client, to do something else. The only one who knows the path forward is the client him/herself, and as long as a therapist is aware of and focused on that fact, s/he can’t go too far wrong. The problem comes in when the therapist starts thinking s/he knows better than the client what the client should do. So to me it’s not CBT that’s the problem, it’s arrogant therapists, regardless of what approach they use.
In fact, my biggest objection to psychiatry isn’t the drugs. Its that the psychiatrist presumes the right to define both the problem and the solution for the patient, taking away any agency or initiative the client may have. This is counterproductive always, regardless of whether you’re a psychiatrist or a volunteer helpline counselor. Nobody needs to be bossed around and told what’s wrong with them. But I think you’re off base in identifying CBT itself as the issue. I think it can be used in an empowering way, if the therapist is sensitive and focused on the needs and reactions of the client, rather than his/her own need to feel smart and superior.
The question is not just, “How does the brain give rise to consciousness,” but also, “DOES the brain actually give rise to consciousness?” Or to put it another way – does the activity in the brain CREATE our thoughts and intentions, or do our thoughts and intentions create the activity in our brains?
Ultimately, the unanswered question that neuroscience will never answer is the most fundamental of all: What is life? How and why are we alive, and what does it mean to be alive?
Psychiatry’s biggest crime is to remove meaning from our experience. It all starts with the assumption that we’re just a product of our brains. If we’re instead the operators of our brains, the picture is completely changed.
Ah, but sometimes what is diagnosed as “ADHD” CAN be cured with love, if you add some wisdom. For one thing, the symptoms of “ADHD” can be caused by dozens of other things, like iron deficiency, sleep apnea, witnessing domestic abuse at home, lacking sufficient structure, or being forced to do developmentally inappropriate things by your school or teacher. One well designed study showed that waiting a year to enroll your child in Kindergarten reduces the likelihood of an ADHD diagnosis by almost a third. Another showed that “ADHD” kids in an open classroom setting were virtually indistinguishable from “normal” kids, even by professionals, while they stuck out like the proverbial sore thumb in a standard classroom.
We raised two “ADHD” boys without medication, and while the oldest still has some manifestations as an adult, he’s been quite successful in his employment, and the youngest is virtually “cured” in that no one who looks at him would ever identify him as “having ADHD” despite his being a classic case as a kindergartner.
Additionally, the rate of “ADHD” diagnosis for foster children is many times higher than the general population. Unless you’re claiming that “ADHD” kids are abused at 4-5 times the rate of “normal” children, it appears that a LACK of loving interaction does in fact lead to “ADHD” symptoms. Which suggests that increasing the love available in the environment might, in fact, cure them. The overlap between “ADHD” and “PTSD” and other “anxiety disorders” is large and well known.
So sure, some kids act in the way described as “ADHD.” Just like some people feel depressed. But the fact that kids act that way or adults feel that way does not, ipso facto, prove that they are “disordered” in any way. If moving a kid to a different type of classroom makes his/her “symptoms” go away, doesn’t it make sense to ask whether it is the classroom that is “disordered?”
As I think we’ve discussed before, I’m not denying there is a wide range of genetic propensities in human beings, and it’s probable that some of us are programmed to have a hard time sitting still and doing as we’re told. I think we need those people. Genetic diversity is part of species survival. Just because people are different and don’t fit in well with our social institutions doesn’t mean they have a disease. Often, it is the social institution that really needs to be changed. Calling it “ADHD” removes any responsibility from those in power to take a look at the institutions they’ve created and honestly assess whether they’re working for those they’re supposedly designed to serve. In the case of our standard school classrooms, for most kids, I think the answer is a big NO. I’d rather fix the school than punish kids (like you were) for pointing out to us that they aren’t working.
You are right, of course. However, this kind of research is essential to peeling off some of the folks who are married to the paradigm that “everything is caused by the brain.” If it’s shown that supportive relationships change the brain in a positive direction, this supports those arguing for relationship-based interactions as the primary healing modality. And it also validates those who have experienced these heightened states that it’s not just because their brains are messed up – it’s because of what happened to them.
Admittedly, there is a lot more that could have been said, but I am glad this has been published, because it really undermines the idea that “schizophrenia” is a “disease of the brain,” especially when those who are not so labeled appear to have undergone a similar process as those who are.
I long for the day when we start talking about the steamroller instead of the pea. But at least this acknowledges that there was a steamroller involved!
This is, indeed, a very sensitive area. I think we do need to acknowledge (and I think Philip clearly does so early in this article) that lack of nurturance is not the ONLY cause of what has come to be called “mental illness.” But it is a factor that needs to be considered.
It’s clear there ARE physiological causes of psychosis and other phenomena labeled as “mental illness,” with drug intoxication being only the most obvious one. My objection is not to the idea that there could be physiological causes of psychosis (or other “mental illness” manifestations), only to the idea that the ONLY possible causal factor is physiological.
Moreover, there are many other environmental factors that impact “mental health,” including living in an urban area, certain kinds of pollution (heavy metals are particularly implicated), unemployment, poverty, racism, sexism, various traumas, etc. Siblings play a role, too, as does neighborhood violence and cultural trends and expectations. To try and reduce all of this either to “you had a bad mom” or “you have bad genes” is reductionistic in the most extreme degree.
If we were really serious about finding causal factors for what is termed “mental illness,” we would stop grouping people together based on symptoms and start looking for differential causes that might underlie similar presentations. For instance, some “ADHD” symptoms may be a result of lack of structure at home. Some may be a result of prenatal drug and alcohol exposure. Some may be a result of inappropriate classroom expectations, the child being bored, the child being asked to do things that are over his/her head, the child being too young to be in school at all, the child having low iron, the child having a sleep apnea problem, the child being exposed to domestic abuse at home, or the child suffering the side effects of some other drug s/he is taking. That’s a very incomplete list of possibilities, all of which have evidence to support their potential to cause these “symptoms.” And of course, more than one of these can be going on at the same time. If “ADHD” symptoms can be caused by all these disperate things, what is the point of calling it ADHD? Wouldn’t it make more sense to find out what is behind it?
The last thing I’ll add is that psychiatry has been materially aided by NAMI in putting out this message. NAMI is mostly a creation of parents whose kids have developed “bipolar” or “schizophrenic” symptoms (which, of course, can have just as many causes as “ADHD” symptoms), and who wanted to stop being blamed for their kids developing these problems. As such, they have been very willing to accept psychiatric mantras and money, and have fully embraced the “biological brain disease” theory because it absolves them of any blame. Unfortunately, they have become a bit part of the problem, and have intensely promoted this idea that any discussion of parental responsibility is “parent bashing” and must be immediately hushed up.
Bottom line is, parents do make mistakes, almost always with the very best of intentions, and children suffer. Parents were children once, and their parents made mistakes with them, too, which they often repeat unless there is some kind of crisis or intervention to disrupt the pattern. It is not blameful to recognize this simple fact, and attempt to deal with the harmful impact of their behavior also opens the door to them healing from their own childhood traumas, and the opportunity to establish more trusting and intimate relationships with their children as adults. As Alex rightly says, not all parents will want to engage in this process, and that’s sad, but it doesn’t really help to support them in denying that they have caused some pain to their kids, because it’s their pain, too, and they also deserve a chance to heal, even if they choose not to take advantage of it.
Responsibility is not the same as blame. Responsibility means a willingness to look at the facts and to do something to solve the problem. More responsibility leads to more healing. While there are many, many reasons why adults and children suffer emotionally, we do parents no favors by letting them off the hook. After all, who is better placed to help a child who is suffering than his/her parent?
That is the truth. This is why rational arguments based on science don’t have any impact. They are, as a whole, not interested in the truth, they’re interested in power and money and being “right.” And some are even into making people suffer because they feel they deserve to suffer or just because they like watching people squirm because of what they do. They like having folks under their thumbs. While there are notable exceptions, the complete lack of empathy displayed by so many in this “profession” is truly scary.
I don’t think we disagree, except for my definition of “liberal” being a little different. The “conservatives” of today (who aren’t really conservative at all, because if they were, they’d be avoiding unnecssary foreign entanglements, allowing criminal banks to fail, and letting people do what they need to do to survive instead of locking them up) are really less “liberals” than they are FACISTS. They don’t believe in a minimally intrusive State, they believe in merging the interests of corporations and government. So rather than getting a “free market”, we get a very warped and manipulated market that favors those who already have power, and they conspire to use fear and military force to keep us peons in tow. Including psych hospitalization, of course. The Nazis were very big on psychiatrists. They were also very big on spying. But so is the Obama administration, apparently, so perhaps they’re all just facists pretending to be “liberals” and “conservatives” in order to provide an illusion of choice. Bottom line, most of them support the current psychiatric-big pharma hierarchy 100%, regardless of which side of the aisle they sit on. Perhaps it’s best if I avoid the terms “liberal” and “conservative” entirely, as it plays into the little game our Corporate Masters want us to play.
Thanks for the exchange. You’re clearly a man of some intelligence. If you were running for office, I’d probably vote for you in a second!
And actually, that 40% figure you cite supports Bob’s viewpoint on this. If 40% are diagnosed initially with depression, and the vast majority of those are “treated” with antidepressants, does it not seem likely that a good proportion of those became “bipolar” after the administration of the antidepressants? It begs the question we’re asking her to simply assume that these people were wrongly diagnosed. I think this is actually some good proof that receiving psychiatric treatment for depression increases one’s odds of eventually being diagnosed bipiolar. The reasons are, as usual, not even examined.
“The challenge lies in showing beyond reasonable doubt that these antidepressant triggered episodes were not something that would have just popped up without anti-depressants triggering them in the first place.”
Actually, from a truly scientific viewpoint, this statement is not correct. For a real scientists (and I do acknowledge that most psychiatrists don’t come anywhere close to fitting that description), the assumption would be that the drug DOES cause the reaction that occurs after its administration until proven otherwise. The concept of “Occam’s Razor” suggests that when two competing explanations could both explain the same phenomenon, the simpler explanation is the most likely one. In this case, it’s pretty obvious that a person becoming bipolar after the administration of a drug is most likely being provoked by the drug itself. The first thing a real scientist would do is to stop the drug and see if the manic symptoms subsided. If they really wanted to be thorough, they might then administer the drug again to see if they returned, though in this case, that is probably not ethical. They would then look for other cases where this has happened and look for a pattern. And then they’d do a study like the one Bob cites. If all the data support that people are becoming manic after taking the drug, it becomes the job of the people with the alternate theory to prove the more obvious and factually supported theory wrong.
Or to put it another way: the person claiming the drug is safe and does not cause these reactions has the burden of proof. The claim that these people “would have become bipolar anyway” is the questionable claim that needs to be proven. Common sense and the data provided suggest that the drug is a causal agent, and anyone wanting to refute that needs to make their own case, not simply say “You can’t prove they wouldn’t have turned bipolar anyway.” That’s an argument for a junior high recess or an internet chat room, not for a serious scientific discussion.
Of course, they always blame the patient for their reaction to the drug. But this is a very real problem, and it happens when healthy people are given the drugs. Mania and hypomania are side effects listed on the label of all the SSRIs. Dr. Ghaemi’s opinion is typical of those in the profession with a conflict of interest – if antidepressants caused mania, they’d have to change their practice and their understanding of reality. So instead, it’s the patient’s fault – the drug “uncovered an underlying bipolar disorder” and we’re now lucky because now we can “treat” it with even more drugs. I have worked in the field for many years, and I have seen this more times than I can count. And yet probably at least half the time these kids go off the drugs, they are just the same or better than when they were on them.
There is no question in my mind that SSRIs and to a lesser extent stimulants can cause “bipolar” symptoms. It is quite disingenuous to blame the patient when your treatment makes them worse.
I am sure Peter has some literature references he’d love to share. But if you read Anatomy of and Epidemic, you’ll find plenty of supporting evidence in there showing that it is the drugs that are to blame, not the patients.
Yeah, jeez, she’s dead already, why don’t you just move on? Ugh! Such callousness is incredible! I knew a psychiatrist who had seen a depressed woman for 15 years and never even bothered to ask her what she was depressed about. Another (developmentally delayed) teen woman was hospitalized with ‘bipolar’ when she hadn’t acted out in any way until she disclosed being raped a year before. Took me 10 minutes conversation with her mom to find out what had happened. Obviously, they simply didn’t care enough to have asked. It is disgusting beyond belief. So sorry you had to learn that the hard way. For the most part, they really don’t care.
Gosh, maybe we can create a computer program that uses this kind of assessment tool, and once the computer comes up with a diagnosis, we put in our VISA card and out comes a prescription!
We have sunk to a pretty low place when psychiatrists are even able to THINK about using a computer to “diagnose” a human being who is suffering. It simply underscores the complete moral bankruptcy of this profession and its approach to mental/emotional/spiritual distress. The answer does NOT lie in being more “objective” about “symptoms,” as in treating people like both you and they are machines!
Yes, I know there are far worse crimes being committed, but somehow, this just underscores how hopeless it is to try and “reform” an effort that is this corrupt and out of touch with reality. Thanks for the info, Sandra, but I came out of this feeling exceedingly disheartened.
The guy uses a lot of pictures and big words to obscure a couple of very important facts. First off, the neuroimaging studies are averaged over groups of children. There is no specific pattern of activity that is shared by all “ADHD” children, or they’d use it for diagnosis. Smoke and mirrors. Also, the PET and SPECT scans measure glucose uptake, which is assumed to associate with activity levels. This only shows how the brain is being USED at a particular time, not what it is capable of or what structural defects may be present. As to the “smaller brain” arguments, these studies don’t control for stimulant use, which is known to reduce brain volume over time.
Beyond that, the author fails to demonstrate any REASON why the “ADHD” child’s activities are behind the developmental curve. We know from many years of research that kids’ normal development can look very different from person to person, and that these developmental targets are only averages with a large range of variation. For instance, it can be normal to walk anywhere from 10 months to 18 months of age. Speech can develop anywhere from 9 months to 2 years and still be normal. These are huge percentages of a young child’s life! Why do we expect all children to develop the same level of executive functioning at the same age? It’s also well documented that boys’ executive functioning develops later than girls, on the average. You’ll notice there is no way that this person offers to determine what is “normal” and “minimially functional” for any child at any age. He simply states that some kids are behind in that area of development. This is obvious and would apply to any area of development. It doesn’t make it a disease.
Finally, he completely fails to answer the vitally important question: does your intervention actually improve the long-term development in the areas you claim are deficient? As I explained above, the answer to this question is a resounding NO! Stimulant treatment doesn’t appear to improve any long-term outcome area of significance on the average when compared to non-treated ADHD-diagnosed peers.
A fancy presentation that proves exactly nothing. “Pay no attention to that man behind the curtain. The Great Oz has spoken!”
As a dad of two boys who fit all the “ADHD” criteria when young, I have to agree with what you have to say. Just because these kids act differently, and even if some subset may be genetically different in some observable way, the “disease” itself is defined by an inability to function as the adults wish in a very artificial setting that has developmentally inappropriate expectations which some kids that age will simply be unable to meet. Strong evidence of this is the study where they found that waiting one year before starting Kindergarten reduced the likelihood of being diagnosed with ADHD by a third. Additionally, there was a great study in the 70s showing that “ADHD”-diagnosed kids were indistinguishable from “normal” kids in an open classroom setting. So it’s clear to me that in most cases, the inappropriate expectations are what cause the “disorder” to even exist.
I would only add that I hope your book also looks at the long-term outcome studies that have been done over the last 40-50 years. Despite plenty of research done by people who really wanted and expected to find a positive treatment effect, there is no evidence at this point that “treating” ADHD with stimulants has a positive impact on any major outcome area, including academic test scores, high school completion, college enrollment, delinquency rates, social skills, or even self-esteem measurements. This is hard for some folks to believe, because the short-term effects of the stimulants can be quite dramatic in improving immediate attention to task, but apparently, paying attention in school to things that you find inherently boring doesn’t actually lead to learning anything new. Go figure.
Add to that the risk profile, including the not infrequent psychiatric consequences, including manic episodes and psychosis, and it seems quite baffling that anyone would advocate for this treatment for any child where any other method could possibly serve. It is a dangerous and ineffective approach to what is mostly a social problem.
I am interested to hear how you see us addressing what I see as the underlying basis for most of this chicanery and corruption: the DSM diagnostic system. You sound like a person who understands that labeling a person is the first step to dehumanizing them and their distress, and we can all see the results. But anyone who wants insurance payments for providing service has to diagnose.
What do you think of these DSM categories, and what can be done to remove this flimsy justification that underlies all of the drugging we are so uncomfortable with? I’d love to know what action we can take to change this pattern, because in my view, as long as we can label a child or adult with a “mental disorder” based on whatever subjective criteria we as a society decide constitutes such a disorder, we can continue to blame the victims and will continue to hurt those we purport to help.
If the field can be reformed, how do you think we can do it?
I’m just saying that Conservatism is no better. The “conservatives” are the ones who are always in favor or reducing or eliminating any regulation that stops businesses from doing whatever they want, and supports allowing corporations and rich folks being able to buy elections. If we’re going to rein in Big Pharma, we aren’t going to do it by letting the so-called “free market” do the job. We’re seeing the results of the “free market” right now in the “mental health” world and it SUCKS!
I don’t think the split should be between Liberals and Conservatives. It should be between those who believe in empowering those who have to live with the oppressive society we’ve created, or empowering those who already have power to continue to oppress more easily. There are folks at both ends of the political spectrum supporting either of those viewpoints. Unfortunately, most, whether “liberal” or “conservative,” are better described as “sold out to our corporate masters.”
I frankly don’t have respect for almost any of them.
You’re in Portland?!! Me, too! We should get together some time and chat – I sense we’d have a lot to talk about.
As to this skepticism about acupuncture – in Asia, they have done operations using acupuncture as a pain relieving treatment for centuries. I think we’d know from the patient pretty quick if the pain relief was imaginary! Aside from which, even if it’s “only placebo,” apparently, that’s true for the SSRI antidepressants, too, and people sell them for billions of dollars. The placebo effect is important and not to be disregarded as “not real.” If we can get the same effect with a few needles, a lot less money, and almost zero side effects, why wouldn’t we do it?
— Steve
PS My wife is a doula and has seen acupuncture be used on more than one occasion to induce labor. Can’t tell me it has no effect!
I know what you mean, though. Most people have a gut-level suspicion of the idea that their brains are broken and they need drugs to fix them. They can be persuaded by the authority of psychiatrists and the primacy of “science” or more properly of “scientism” (the believe that “science” is the all-powerful supreme being that should guide our lives, and that questioning the dictates of its “priesthood” is akin to blasphemy), but deep down, there is still this little voice that says, “Yeah, but my life IS depressing. I SHOULD be depressed! There is really nothing wrong with my brain.” Most of the “true believers” act more like they are hypnotized or indoctrinated and haven’t really thought about whether they believe what they’re saying or not. And of course, there are a number of the big psychiatry bosses who are well aware that they are spewing nonsense with the purpose of controlling market share. But I’d say most people’s belief in biopsychiatry, while it may be fervent, has very shallow roots.
This supports the fairly obvious notion that different personality traits have different social survival value and that we need a range of such personalities for a successful society and a successful species. The problem is more that creativity and “loose associations” are less accepted and more criticized in our society than any time in the history of the world. Drones aren’t allowed to be creative. So we pathologize divergent thinking and drug our most creative folks into submission. And some escape by becoming writers or comedians. Lucky for them!
Just a reminder: NCLB was a CONSERVATIVE (or I should say “neoconservative” – no real conservative could approve of the waste of money) program championed by George W. Bush, but pushed for years by his neocon colleagues. I remember talking about it way back in 1982, when I was getting my MS in education – it was stupid back then, and it’s stupid today, but it was always a big draw for those ideologues who wanted to see “accountability” without any understanding of the vast number of variables that would affect testing outcomes, socioeconomics being the most prominent. It’s been said by competent social scientists that you could substitute socioeconomics for test scores and get almost exactly the same proportionate results.
Why are you so down on liberals and blame them for everything when most “conservatives” are just as rigid in their own views? Isn’t the problem ideological rigidity, rather than a liberal vs. conservative split?
I notice you didn’t answer my last question, either…
And you SERIOUSLY don’t think that same exact statement applies to a large percentage of conservatives?
Most people, regardless of political persuasion, are too afraid to be wrong to accept genuine feedback or to acknowledge when the facts undermine their cherished belief system. Real scientists are few and far between.
The fact that Psychiatry’s ugliness is paralleled by general medicine does not make me feel more forgiving. Allopathic medicine was absolutely BRUTAL in the late 19th and the 20th century (and continues at a more subtle level to the present day) in framing any other practice as ‘quackery’ and assuring that midwives, chiropractors, homeopaths, naturopaths, and any other medical specialty was either subordinate to the MD or was eliminated from competition completely. The results were particularly ugly in the field of childbirth, where ineffective and dangerous methods were instituted and the death rate for women and children rose after birth was moved from home to the hospital, mostly due to uterine infections caused by physicians who did not wash their hands, even after having come directly from working on a cadaver. While maternal and infant deaths have decreased dramatically since, it appears to me mostly due to an increase in antiseptic procedures plus the introduction of antibiotics. Home birth still comes out as a safer option, and doctors still make things worse in the hospital with dozens of unnecessary and often counterproductive interventions.
And that’s just childbirth. From dropping the recommended cholesterol levels based on industry-inspired “studies” that supported more drug sales through the impressive “Vioxx scandal,” allopathic medicine has a pathetic record when it comes to recognizing the need to change its practices or recognizing the potential contributions of other healthcare professionals. Psychiatry fits very nicely under the AMA’s mantle.
They don’t even tell us how predictive the ‘improved’ predictiveness of the “stress scale” is. It may be the predictive power went up from one out of 50 to one out of 35. It seems like BS to me.
I agree 100%, but we should not forget that increased psychiatric treatment also means increased drug use, and some of those drugs by themselves increase suicidal feelings and actions in otherwise healthy individuals. So I think it’s a one-two-three punch of invalidating one’s personal experience (your feelings or the reason they arise is irrelevant), conveying hopelessness (you’ll never recover from this, you are now officially disabled for life), and giving drugs that exacerbate or even help create feelings of suicidal or homicidal intent. If you tried to increase the suicide rate, you’d be hard pressed to come up with a better plan.
And I think the reason they can’t follow the results of their own investigation relates to the religious nature of the psychiatric profession. Since the diagnoses themselves are only held up by general agreement, and nobody really knows or understands what’s really going on in any of these “diagnoses,” anything that questions this structure is deeply disturbing, as if you’d told a dedicated fundamentalist that his/her god or holy figure was not real. The reaction is visceral and irrational, and the easy solution is to somehow blame the victim, who has less power, for failing to respond as they should have to your “helpful” intervention. Same thing happened when the WHO study in the 90s showed dramatically better schizophrenia outcomes in developing countries – they didn’t believe it, so they re-did the research. When it showed exactly the same thing, they attributed it to cultural differences and inadequate or incorrect diagnostics in the offending countries who had dared to show up Western medicine.
The narcissist can never be wrong, and anyone who threatens him/her must be eliminated, even if it’s their own studies. The truth almost always takes a back seat to preserving the ego when psychiatry (or medicine in general) is involved. Not to mention the threat to a lot of people’s bank accounts…
I think the idea of “sectioning” and the idea of forced treatment need to be completely divorced from each other. Someone can be temporarily held for his/her own safety without having to DO something to him/her! How’s about we create a safe space where they can relax, take a bath, get some food, get some sleep, and talk to someone about what is up if they want to? Add some good social service support to address issues of poverty, victimization by parents or partners or other adults, general disempowerment, and so forth, and you might be able to turn things around pretty fast for a good proportion of these folks.
I worked at a suicide hotline for years, and did involuntary detention evals for a bit after that. I hated the latter job, because I felt awful sending anyone into the hands of those monsters who ran the psych wards, but I helped many dozens avoid that trauma. I never found a depressed person who would talk to me whom I could not help feel a little better, at least temporarily. Listening and asking good questions really DOES help, especially if you really care about the answers. And empowering folks to find some way to regain a little control over their environments without ordering them around really helps as well. Unfortunately, most of the time the MH industry sees DEPRESSION as the problem, where as I see depression as an indication of another problem the person can’t find a way to solve.
Point being, setting up a safe place for suicidal people to hang out and talk to staff if they want to is a very realistic plan. Nobody is endangered, and the odds of at least partial resolution will go up dramatically. Why is being held equivalent with needing forced treatment? It should not be.
I am not judging the parents in this situation at all, nor do I think Faith is judging them. It’s the police response that is disturbing. And I believe that police response reflects our ongoing belief that people with “mental illnesses” are dangerous and can’t be talked to or reasoned with. I was involved with a friend whose father called the police on him because he was being threatening. The police did an excellent job of talking to him and encouraging him to find some other place to stay for the night and did not detain him. I can tell you, he was detained before and had treatment enforced on him and he was terrified of being detained again.
And I think that’s the other issue, and the place where I take issue with where NAMI has traditionally come from – I think we need to recognize that there are VERY GOOD REASONS why people resist “treatment” with drugs, and why people fight like hell to avoid being forced into more treatment. It’s not because they don’t know they’re having problems, it’s because the “treatment” is worse than the disease! And involuntary trips to the psych ward can be incredibly traumatizing, with violence and being strapped to a table and forcibly injected with drugs that numb the mind and subdue the spirit, and being held in locked rooms and “examined” by people who don’t seem to give a crap about who you are or why you are feeling or acting as you are, and having to act a certain way to be allowed to escape. It is often a horrific experience that no one would want to have to go through. It is anything but therapeutic.
So the first thing we can do to is to raise awareness of the fact that “mental health treatment” as generally delivered doesn’t seem to work for a lot of people, and stop trying to force them to “comply” with something that they know to be destructive to their life. The second is to start supporting the development of alternative approaches that involve voluntary placement in a place where people LISTEN to you and CARE about what is happening. And the third is to stop talking about “chemical imbalances” and start talking about trauma and the confusion of roles and expectations that characterize our modern society, and drive much of what passes for “mental illness.”
A tall order, I know. I would love to see more leadership from NAMI in this direction, but there is a lot of resistance within and outside NAMI to revising the “neurobiological brain disease” view of mental/emotional struggles. This view is very convenient for those who would like to suppress dissent, but does great harm to any efforts to create improved response from police and other first responders.
How about we start with a training for police, designed and delivered by consumer/survivors and their friends and families? I think that would be a great place to get a serious conversation going that respects all sides of the issue.
I also wonder how much substance abuse among the “mentally ill” is an effort to reduce side effects from the helpful “medications” they’re taking for their “mental illness.” I agree with Nijinsky (as I almost always do) that it seems obvious that traumatized people are both more likely to use drugs and more likely to have “mental health symptoms” as defined by the system. But I think Copy Cat is also right that some people do become psychotic or depressed or anxious as a result of substance abuse. Of course, the researchers also neglect to examine the number of people who become psychotic or depressed or anxious as a result of their “treatment,” but that’s another issue…
Awesome post, as always. The horse analogy immediately put me in contact with my feelings about school as a kid, feeling like I didn’t fit there, and yet knowing with a deep part of me that NOT fitting there was a good thing, that if I ever let myself “fit in” I’d lose who I was completely. I was always baffled by those who were able to be comfortably in that environment – it was pretty clear to me that, nice as some of my teachers were, the system they were participating in was intended, to a large degree, to “break” me in the same way a horse is broken.
As to people in the field, so much of what they think and do is guided by projection. Don’t know if you’ve ever read Alice Miller, but she does a great job of describing how we take what was done to us and project it onto others, putting ourselves in the role of the person who harmed us and justifying our harmful actions as “for their own good” (which is the title of one of her books). It seems to me that facing up to the fact that they either don’t know what they’re doing or that they are doing harm brings up the pain of prior experiences when the clinicians themselves were mistreated and disempowered, and unless they’ve had some seriously good therapy themselves, they can’t tolerate this bad feeling. So they project it onto their clients and try to rub it out in them so that they don’t have to feel it in themselves. It’s a theory that goes a long way to explaining why good people can do some very terrible things. The only piece I’d add is that the clinical folks themselves are expected to comply, and rebels (like me) who speak their minds are quickly marginalized or labeled as troublemakers, because they threaten the fabric of everyone else’s defense mechanisms.
It is sometimes very hard to know if I’m making any difference, but what difference I think we do make as insider rebels is very, very gradual and incremental over time. I have definitely seen the impact of empowering clients to say NO loudly and clearly, and truly believe that is the quickest and most effective way to reform the system.
Thanks again for the blog and for all you do for your clients and for all of us working in or living with “the system.”
AH, but we don’t work for the State. We’re a private nonprofit, and are watchdogs of the state.
They made your parenting contingent on taking psych drugs? That is just awful. I can truly say that I would not put up with that, and the judges here would not, either. Perhaps I do not appreciate how lucky I am to be in Oregon. Bad as it is, it sounds like our system is one of the best. Which is VERY scary…
CASA stands for “Court Appointed Special Advocates.” They are volunteers who advocate in child abuse/neglect cases where the State has assumed custody of children for their own protection (theoretically). You can bet that my CASAs are very well trained about psychiatric drugs and labels! And I’ve gotten a number of kids off psych drugs or kept them from getting on, and also helped create some scrutiny that did not exist back in the 90s when I started, including a new law and state policy. It’s a good place to do good work. Sometimes they’re called “Guardians Ad Litem.” I can see what they have in your area and get someone to call you if you’d like. We’ve also gotten kids back to moms when the State wanted to terminate their rights or keep them in foster care perpetually. I’m not guaranteeing anything, but a CASA can really help bring rationality back to a crazy situation.
Counting one’s blessings is always good, but not always easy. You clearly have some gift for determination and toughness, which is a great survival tactic! I bet your kids know you’re still out there fighting and they still love you and always will.
Julie, I am horrified and wish I were surprised by your revelations. It is always dangerous to put anyone in the total charge of another group of human beings. It is so much worse when there are no real criteria for determining who or why or what can be done to “help” someone. To invalidate someone’s traumatic experiences in that way, not to mention continuing to traumatize the person year after year, is in some ways a worse crime than the original trauma, because these people are supposed to HELP! It is a total betrayal. I’m glad you’re still fighting and I’m glad you’re on the right side, because they will one day regret what they did.
mjk, I wish you were in Oregon and I could set one of my CASAs onto your case. I don’t know if we’d win, but we’d give them something to think about. I am impressed that you’re continuing to courageously fight despite the awful things that have happened to you! Let me know if there’s any way I can help.
Hard to say on both counts. Some of these attorneys are awesome and some are just cashing a paycheck. Getting her a good one could really help. She could also benefit from a CASA volunteer or Guardian ad Litem, which is what I do. They are responsible for advocating for the best interests of the child, but are lay people and in the main are pretty skeptical about psychiatry.
As for petitions, some of them seem to be very effective and some are not. I think it not only puts pressure on the authorities, it also raises awareness of the issue among people who don’t know about it. It certainly can’t hurt, and might make a difference.
Big changes are happening these days through State legislatures. It might be a good place to start with this kind of legislation. If I’m not mistaken, the prior movement to protect the civil rights of the “mentally ill” started with state statutes preventing the willy-nilly detention of anyone a psychiatrist declared insane. I think that’s the way we get this going. Congress is simply too much in the pockets of the pharmaceutical industry, and won’t bite the hand that feeds them.
I am interested if Justina has an attorney in all this, and if so, where that attorney’s voice is. In Portland, all kids in the child welfare system get their own attorneys, and their job is to advocate for what the CHILD wants. And I’d bet my mortgage that Justina wants to go home.
This is one of the worst cases I’ve ever seen, and I have worked as an advocate for kids in the child welfare system for 17 years. Have you considered starting a “change.org” petition on this one? I’ve seen it work on outrageous situations like this one. Just a thought…
Thanks for all your advocacy, and for giving us the real data. This case is a superb advertisement for why enforced treatment is SO dangerous and should never be allowed.
It is not a left-right issue. Most of our congress is sold out to the moneyed interests. It’s about corporatists vs. those who believe that human beings are more important than dollars. There are plenty on both sides of the aisle who believe anything that will get them a campaign contribution, and the pharmaceutical companies are as ruthless as they can be in spreading their dollars around to all of the Repiblicrats who bow down to them, regardless of their “liberal” or “conservative” labels.
I agree about “right bashing,” but “left bashing” is just as unproductive. I’m more liberal than most who call themselves liberal (I actually BELIEVE in helping the poor and the downtrodden!) but I’ve been fighting this issue since the 90s, when everyone thought I was out of my mind for not supporting the “new science” of “brain disorders.”
It is not a left-right issue. Most of our congress is sold out to the moneyed interests. It’s about corporatists vs. those who believe that human beings are more important than dollars. There are plenty on both sides of the aisle who believe anything that will get them a campaign contribution, and the pharmaceutical companies are as ruthless as they can be in spreading their dollars around to all of the Repiblicrats who bow down to them, regardless of their “liberal” or “conservative” labels.
I agree about “right bashing,” but “left bashing” is just as unproductive. I’m more liberal than most who call themselves liberal (I actually BELIEVE in helping the poor and the downtrodden!) but I’ve been fighting this issue since the 90s, when everyone thought I was out of my mind for not supporting the “new science” of “brain disorders.”
I am so sorry to hear of that awful story! The most amazing and disgusting thing to me about psychiatry is that they don’t even bother to ask about what happened to you. I had a developmentally delayed girl who was 17 but mentally about 6 who was hospitalized with “bipolar disorder” and “treated” with Lithium, despite the fact that she had only started acting out after she’d been raped two years before. Another psychiatrist had been seeing a client for 15 years, said she was an “intractable case of depression” in which he’d “tried everything,” and when I asked him what had caused her to be depressed, he had no idea and wondered why I’d even bother to ask such a silly question.
They take away our power by taking away our stories and treating US like the ones who did something wrong. Well done for keeping up the fight despite it all, and thanks again for having the courage to tell your story. Are you getting any help with the situation with your girls?
Good clarification, Wayne. Which I guess goes to reinforce the finding that the system or school of thought applied by the counselor is much less important than the practitioner’s ability to communicate effectively with the client. My belief is that ALL good communication involves choice and empowerment. I spent years using my own approach to counseling for years before reading about motivational interviewing. I then discovered that I was doing “motivational interviewing” the whole time. I’d essentially re-invented motivational interviewing by observing what did and didn’t work and focusing on empowering the client. You can call it whatever you want, but if your purpose is to enforce your views and your will on your client, you will hurt your client. It’s kinda that simple.
It is fascinating for Pies to talk like this about the client “wanting to hang onto his/her symptoms” because they receive some secondary gain from them. This is right out of the world of Freud and psychotherapy/psychoanalysis! It seems like the ultimate irony that a biopsychiatrist like Pies, whose ilk have been committed since the 80s to eliminating the influence of psychotherapy or at least dramatically limiting its scope, should resort to psychodynamic explanations or techniques as a means of manipulating his clients into “taking their meds.” In a weird way, it approaches an admission that the symptoms themselves have nothing to do with biology. Though I doubt he’d ever admit that.
Weird!
— Steve
P.S. Love the new picture, Marcia! Thanks for another enlightening article!
I don’t think it’s entirely imaginary. I do trainings for new volunteers for the CASA (Court Appointed Special Advocate) program here in Portland, OR, and of course, I go into the DSM and its subjective diagnoses and the damage that drug use has done to foster kids and others in society. 5 years ago, I used to get a good deal of discomfort from some of the trainees about questioning the “professionals” who “must know what they’re doing.” The last few years, it’s gotten easier and easier, and lately, the bulk of the people in the group are already aware of what I’m saying, have big concerns about Big Pharma, and understand that there is a lot of politics behind the “medication movement.” Culture change takes time, but it is happening. There are so many more articles in the NYT, on NPR, in the Washington Post, that are critical or at least questioning of the current paradigm than there ever used to be, and this is having a big impact.
That being said, I also agree that writing back and forth on MIA makes only tiny scratches in the surface of the issue. It actually is much broader than the use of psych meds – it has to do with our society’s belief that “the authorities” should be able to decide what is what, and those authorities being bought off by corporate interests from one end of the government to the other. It is going to require a BIG shift in our approach as a country to take this movement down. Psychiatry is just one part of it, and they’re not going to go down without a fight. I am just not sure how to rouse the public sufficiently to fight back. We need a critical mass of angry people, and I am not sure we have it yet.
I meant Milton Erickson, not Erik, though Erik was quite a fascinating and competent practitioner as well and certainly focused on communication rather than enforced brain chemistry manipulation.
I can see it would be very uncomfortable for most psychiatrists to post here, though Mark and Sandra seem to be managing it OK. Perhaps the perspective to consider is why there is so much anger in the consumer world toward psychiatry. As you just commented, psychiatrists used to talk to patients but don’t seem to take the time any more. This, combined with the dishonesty about causes (pretending to believe in “chemical imbalnaces” when they’re not known to exist) and denying or minimizing adverse effects (can’t tell you how many kids I know from my profession who got “bipolar” diagnoses after adverse responses to Ritalin or SSRIs) leads to anger and resentment and distrust. And amazingly, the best cure for anger, resentment and mistrust is – ta daaaaa! – LISTENING TO THE CLIENT. This just seems so obvious to me that I just can’t even fathom that idiot I described above being paid $200 an hour to throw drugs at a person he does’t even bother to get to know. How can that be permitted to ever happen, Steve? But he is being empowered by the psychiatric system to continue to practice that way.
I hope that the younger psychiatrists really are interested in figuring out where the profession left the path of wisdom. But I think the most important point is for the profession or the professionals to ADMIT that the path of wisdom was, in fact, left behind many years back, for reasons that appear to be more economic and egotistical than scientific. Perhaps we will see a resurgence in young psychiatrists reading Erik Erickson and trying to construct imitative “word salad” as a means of reaching a person who is deep in a psychotic state. Or maybe they will read the literature on Soteria House or Open Dialog and start some new initiatives. But I’m not holding my breath. I believe you dramatically underrate the powerful interests behind this movement away from talk therapy and toward drugging. There is too much money being made for the paradigm to peacefully change with a new generation of psychiatrists. It’s gonna be a fight. Look what happened to Loren Mosher, an insider who dared to challenge the dominant paradigm, and was excoriated and shunned, even though he was absolutely correct in his conclusions.
I do think you’re right about one thing. What is funded is what practiced. Perhaps an emeritus psychiatrist like yourself can put some serious energy into convincing the profession to advocate for funding things that have long term benefits, rather than continuing to focus on short-term symptom reduction and short-term profits.
I agree that there was a time when talking to clients was the primary intervention for psychiatrists. There are some amazing stories from Laing and Erickson and others about how to accomplish this. So why, in your opinion, did the psychiatric profession stop talking to their clients? How did we get to this weird place where (and this is really true) a psychiatrist I knew said he was “treating” a woman for 15 years for depression, and had “tried everything,” but had never even once in 15 years asked her what she was feeling depressed about? And I am not buying the “insurance companies just don’t pay for it” argument – good psychiatry is not a function of how much money you get paid. It doesn’t take long to ask that question, and he had 15 years to do it in. Besides which, when I asked him what she’d been depressed about, he acted as if it was an irrelevant question. How did a person’s psychological understanding of their own emotional state become irrelevant?
I’d really like to know what you think, as you appear to have been present throughout the long transition away from talking into becoming brain mechanics. How did it happen? And more importantly, do you see how the profession can ever move back in that direction again?
I am sure this must be due to an increased genetic vulnerability to becoming a bully if you’re genetically predisposed to being psychotic. Except that it extends to victims of bullying, too, so somehow the genetic vulnerability for psychosis must somehow make you more vulnerable to both becoming a bully and being bullied. I realize this may seem far-fetched to some, but since the brain is everything and everything is in the brain, we have to somehow make these results fit into our brain-chemistry dogma.
I suppose there is an outside possibility that both being bullied and bullying are associated with trauma and high stress, but not EVERYONE who is bullied becomes psychotic, so it must somehow be the fault of the bully. Or the victim. Or both of their brains. Or something like that.
For Keith Connors to say this publicly is pretty huge. Connors was the creator of one of the more famous rating scales that teachers and parents used to rate a kid for “ADHD” and other “symptoms.” He was 100% mainstream. Nobody’s going to get away with calling him an “antipsychiatrist.” I’m pretty jazzed to hear that he made these kinds of statements to the NYT. When the insiders start calling it a disaster, it is hard for even the most hard-line psychiatric adherents to pretend that it’s all OK.
Clearly, there would need to be discussion of what the conditions would be, and clearly (in my view), it would be for some action and not some postulated risk, and clearly, it would not be predicated on the assumption or assessment of some form of “mental illness.” My point is more that this discussion, of what constitutes a danger to others and how overt and immediate that danger has to be and so forth, and separate it 100% from any discussion of enforced “treatment” for an assumed “mental disorder.” At this point, it is assumed that when someone is detained for “mental health” reasons, they can then have “treatment” literally forced down their throats. I’m saying it would be easier to stop forced “treatment” than to completely eliminate the use of force to stop harmful actions, wherever one might choose to draw that line. So we might have people being held against their will because they threatened to kill their neighbor or lit someone’s toolshed on fire, but that would NOT give the authorities any right to DO anything to them – they would still retain their right to refuse treatment regardless.
Or to put it another way, we argue to stop forced “treatment” in any setting, and have a separate discussion about how to protect ourselves and each other from people choosing to hurt us.
And you’re right, it’s not simple, but it does kind of make the point that being dangerous and needing “treatment” are not synonymous, and that even though a person may be struggling emotionally, they still retain their basic human rights.
What a crock! Almost every one of these shooters was receiving or had recently received “mental health treatment.” A lack of treatment was certainly NOT the problem! Treatment that doesn’t work or makes you more violent is the problem.
I’d put it another way – “Mental illness” (which I don’t regard as an illness per se) is not the cause of violence, it is generally the result of violence. And yes, violence can be passed on from those who are victimized to a new generation. So what we should be working toward is ending violence and abuse.
I will point out, however, that despite the violence you’ve been subjected to, you are here protesting violence rather than carrying it on. It takes a lot of courage to do that, but people do make that decision all the time. So the second thing we need to do is help those victimized by violence to heal so they don’t continue to perpetrate it on another generation. As you well know, this is NOT accomplished by locking people up and shooting them full of Haldol!
I wrote this on another thread but it didn’t seem to post. It occurred to me that there is an interesting comingling of the idea of detaining someone for being violent or threatening, and forcing “treatment” on them. I wonder if there is a way to separate these two issues? For instance, if one of the TAC types points out that some people with “mental illness” labels become violent, we can agree that violent people need to be detained for the protection of others. But why does it follow that they need “treatment?” Can we not agree that force is necessary for protection but does not take away a person’s right to accept or refuse medical treatment? If we can make this distinction, we’re no longer in the place of saying, “Well, force is never justified” and sounding naive. We’re simply saying that enforcing “treatment” is never justified, even if force may be needed for protection. This also leaves more room for entertaining the question of whether “treatment” actually reduces or in fact increases violence, as you documented in your article.
I am also glad you brought up the point about assaulting “mental health workers.” I agree 100% – I am sick of reading incident reports about how a kid “assaulted staff” after the staff person laid hands on him/her. It’s not assault if someone is trying to grab or force you or physically handle you in some way. It’s self defense.
Thanks for another great article. I’d be interested to hear if anyone else sees value in separating the issues of using force to protect vs. the use of forced “treatment” in our more public discussions of this issue.
Yeah, they did kind of give the doctors a pass, didn’t they? The reason we have to have prescriptions for these drugs is because the doctors are presumed to know more about them than we do and are able to filter the truth from the marketing and give us good advice. The abdication of this responsibility is central to the current scene developing. No amount of marketing can force a doctor to prescribe something. Only professional laziness or unethical acceptance of kickbacks can lead to this level of bad prescribing. The doctors as a group could change all this more easily than any other group. But they don’t, do they?
I actually agree that psychiatry itself will not be changed by science, because it’s not a scientific endeavor. It’s more a cross between a religion and a multinational corporate conglomerate. Where I agree with “registered…” is that those who are NOT embedded in psychiatry will need data to convince them that psychiatry’s barking up the wrong tree.
I also agree with you that most people don’t want to believe that evil motivations exist – they want to believe that psychiatry as a profession is at worst misguided, and that giving them a chance to review the data will lead them to enlightenment. It is hard for people to accept that the top dogs of psychiatry are operating on a pure business model that is interested in capturing and controlling market share and aren’t really too upset by the fact that a certain number of their clients are permanently disabled or die as a result of their “treatment.” But again, saying this to most people does result in alienation, precisely because they don’t want to believe it.
I’m not sure what the answer is, but telling everyone that psychiatry is evil is not the first step, and may never even be necessary. If WE know the ill intents of the profession, we can strategize how to defeat them without needing everyone to agree with us. I think it’s more a matter of collecting those who are not ill intended and banding us all together around the idea of making things better for those who are looking for help. Those who believe in that will rally to the cause, and those who don’t will identify themselves for who they really are.
Of course, in the end, it’s about power, and taking back power from the powerful is scary and leads to retaliation inevitably. But 7 billion people can generate a lot of power, if we’re all pulling in the same direction. How to get that coordination of effort is the real question. Whether or not the psychiatric profession, or at least its top leaders, have evil intentions is not something that anyone in the know should doubt, but announcing that publicly probably isn’t our best marketing tool.
I am impressed that the comments are so supportive. I think it makes a HUGE impact for a psychiatrist to be publishing these comments in a national news outlet. I also think you have a gift for stating these things in a way that doesn’t feel attacking or humiliating to the current practitioners (at least those with enough ethics to actually care about whether they’re harming their patients or not). Thanks for having the courage to put your voice out there in public. It is a critical part of this movement to get professionals to take these concerns seriously, and both the content and the intent of this article will make it easier for other professionals to “come out” and acknowledge these very real concerns.
My thought is to talk to others who have “been there,” both those who have provided family support, and more importantly, those who have found their own pathway to a better place despite suffering from psychosis.
If you have read Robert’s book, you’ll know that it is not uncommon for these drugs to “work” at first and then stop working, due to the physiological changes that happen in the brain as a result of long-term use of these drugs. So he really is physiologically impaired at this point, even though he may not have been at the start. So just stopping the drugs cold turkey is probably a recipie for disaster. But I do think if he says he wants to stop taking the drugs, the place to start is to understand and accept that this is his goal and help him start working towards that goal.
I know that sounds impossible, and maybe it is, but there is a lot of expertise in the “survivor” community on how to do this. Will Hall’s book, “The Harm Reduction Guide to Coming Off Psychiatric Drugs (see http://www.madinamerica.com/2012/07/coming-off-medications-guide-second-edition-free-download/ for a downloadable copy) might be a good place to start. I also suggest you find a “hearing voices” group or similar support group for “voice hearers” in your community, as well as any kind of cafe or other social meeting site where folks who can relate to your son’s struggles might hang out.
The starting point to helping anyone with any situation is empathy. You seem to have a lot of it. Try to put yourself in his situation and not invalidate his observations or concerns, but see how things look from where he sits. That may lead you to some further insights on what to do. But the truth is, there is no magic bullet or golden pathway to health or sanity or “adjustment” – these are things that he will have to struggle to determine for himself – where does he want to go, what does he think is important, what kind of life does he want to live. And he may decide things you disagree with. Accept that and see if you can help him figure out what he wants and how to get there, with the help of others who have traveled the path before him. That’s my best thinking.
I just had a thought that I’d like to hear others’ feedback about. The reason always given for involuntary detention is protection of the person or others whom that person might harm. It’s difficult to argue that this should NEVER occur, no matter what, though different arguments exist as to how and why and where such a person might be held. (BTW, I am NOT a proponent of involuntary detention in a “hospital” whose job is not to help you but is more to keep you under control!) But the biggest problem I have with involuntary detention is that it de facto authorizes involuntary DRUGGING of those so detained.
What if we changed the discussion? What if our argument became, “OK, we acknowledge that there may be times when a person needs to be protected by holding him/her against his/her will in some kind of facility, be it jail or a hospital or a halfway house or whatever. But that does NOT give anyone the right to force treatment on that person under any circumstances.” If we could decouple the need for detention (which can be argued separately in a different venue) from what should be the absolute right to refuse treatment in whatever form, we’ve taken away the argument that “well, there are those dangerous people who might hurt someone out there and have to be detained for everyone’s safety” and put the focus back on the enforcement of DRUGS as “treatment” as a separate and critical conversation.
Involuntary detention should not be synonymous with involuntary drugging. Anyone think there is value in talking about them as separate issues?
My objection is not that this isn’t a real phenomenon, but that it is caused by being required to do shift work, not by something wrong with the person who has to mess with his/her sleep schedule in this way. Just like all pharma/psychiatric ploys, we take a condition that is a likely result of a stressful environment, and instead of modifying the environment or acknowledging its impact, we blame the person who is suffering for not adapting properly to the environmental expectations. It’s like they’re saying, “Everything is perfect as it is, and if you don’t like it or can’t adjust to it, there is something wrong with YOU.” This idea that the status quo is holy and unchangable and that humans have to adapt to whatever is thrown at them is a very nihilistic approach to life. Humans are inherently creative and want to adapt their environment to their needs, and get depressed and disturbed and upset when they have to just put up with adverse conditions. But those who want to change the status quo are demonized and pathologized, while those benefiting from it laugh all the way to the bank. It’s an evil system, and I feel bad for the shift worker, and don’t begrudge them a sleep aid if that what they feel they need, but let’s be honest about the real cause – it’s caused by the abnormal schedule they’re required to keep, not by a “disease” or “disorder” in the person who has trouble adapting to these abnormal requirements of our society.
I agree, Ted. The other issue is that most of our politicians are bought off by these same criminal corporations. So it’s hard to get any attention in the legislature, unless you’re talking about someone like foster kids or the elderly with Alzheimers, and even then, the only action is a warning label on the box, and not a real change in practice.
I really think we need to work on getting legislators out of the influence of the corporations. We need to elect people of integrity, and to do something about campaign laws to prevent corporations from owning our legislators. Psychiatrists aren’t the ultimate powers in this situation – it’s the corporations that are calling the shots, and the psychiatrists are their compliant minions.
I don’t know why this surprises anyone. But as always, the authors soft soap the real implications – namely, that the concept that there are certain people who will inevitably develop “psychiatric disorder” based on biological and genetic variables is a complete and utter lie. Stress is the most important factor in any “disorder,” and reducing childhood victimization is the most effective tool there is for reducing adult “mental health problems.” But to recognize this would require the adults to take responsibility for screwing up our children, and we’d perhaps have to consider making some big changes in our approach to childhood. It’s much easier to blame the kids and their brains, plus it makes a lot more money. Reducing early childhood risk and harm is not a profitable enterprise.
This sounds very much like the writings of Robert Pirsig in “Zen and the Art of Motorcycle Maintenance.” He spent a lot of time in the high country in or around Yellowstone and analogized it with the “high country of the mind” that he explored there. He did eventually have a psychotic break, and received massive electric shock treatments and one day came to consciousness with no recollection of who he had been. The book is partly a story of his recovery of himself. If folks have never read it, I’d recommend it. It’s one of the best books I’ve ever read, and has great applicability to this theme of the safe and bland vs. the wild and mysterious.
Well, if he’s saying an approach should not be driven by ideology, he’s the pot calling the kettle black! I don’t know if I can think of a single person who is more ideologically driven than Torrey, and more unwilling to examine any data that contradicts his dearly-held beliefs.
I admire your ability to be fair-minded in your critique. I do understand that some of his early writings were quite rational, but as of today, I find the man and his “views” utterly contemptible.
Well, if treatability is the real criterion for “mental illness,” I’d have to say that Whitaker’s book shows that it fails the test miserably.
Of course, the author never addresses whom the treatment is supposed to benefit. Lobotomy was very effective in making patients more docile, which the doctors and a lot of the staff felt was very beneficial. I’m not sure their “patients” would have agreed with them, had they retained the ability to actually decide and communicate their agreement or disagreement after the brutal procedure.
The author also does not address the possibility that what is called “mental illness” is actually a spiritual issue relating to the meaning of the person’s experience and their purposes as a human being on planet earth. I was surprised he never addressed this, as most of the religious arguments against psychiatric labeling and treatment (including the Dalai Lama, I’ve recently learned) focus on the presence of a spiritual entity whose experiences and decisions have a fundamental impact on things like suffering, orientation to reality, and happiness/satisfaction.
In the end, it was a lot of words to reach a very mundane conclusion.
The article is completely devoid of any concrete scientific observations. The use of terms “connectivity” and “dysfunction” make it sound scientific, but they haven’t presented any repeatable or measurable observation that would distinguish these people from “normal” people. The best we can surmise is that somehow the brains of people who are hallucinating or are intensely fearful are doing different things that people who are calm. But that’s kind of axiomatic, like saying that sleeping people have different brain activity than people who are awake.
Another scam article trying to spin the fact that people with “bipolar” diagnoses have nothing in common with each other into the idea that “something else is going on” rather than accepting the real conclusion that “bipolar disorder” is simply an unscientific description of a state of mind that some people experience, and has zero validity as a medical diagnosis.
This is a very important article, because this kind of suicidal behavior clearly cannot be blamed on the “underlying mental illness,” as people who are quitting smoking are not as a group suffering from any particular set of symptoms other than being addicted to nicotine. So it’s very clear in these cases that the violence, agitation, depression, and suicidal thoughts and actions are caused by exposure to the drug itself. By extension, this proves that such causal impacts on behavior can be created by drugs that impact the brain, including “antidepressants” and “antipsychotics.”
Well, THAT is certainly a sobering finding! Very similar to the WHO findings about psychosis outcomes in developing countries being much better. Sounds to me like the technological approach to mental health strikes out yet again!
What I find really depressing about this story is that this kid, who was on all these drugs, was obviously suffering tremendously, and acting out on a regular basis, and yet somehow it was essential to the adults that he remain on all the drugs. It is pretty obvious that they weren’t making his condition any better, and easy to infer that they were making it worse. Why on earth would they continue a treatment that doesn’t improve the condition it is intended to treat????
And yet I see this all the time – kids are given drugs to improve condition A, which brings on condition B, and another drug to “treat” that, which leads to condition C, and pretty soon they’re on 5 drugs and condition A still persists, and condition B is worse than it even was when they had only two drugs (and of course never existed before the first drug), and the kid is in residential treatment because no foster home can handle him and he breaks windows and attacks the staff and THEY STILL THINK THESE DRUGS ARE HELPING!!!!
Good for him for getting off, and thanks to him for the awesome advice. This is such an excellent description of how and why kids get whacked out on 5 drugs at a time, and how parents and treatment providers get off the hook for their failures. Disgusting and yet inspiring.
Thanks as always for your insightful and engaging post!
There is a study in Canadian J Psych from the early 2000s where they retrospectively looked at records of kids who had been prescribed stimulants, and something like 6.8 % of the records showed some level of psychotic symptoms. It is not rare. It is reflected on the label of Ritalin at the least, and I think Adderall as well, so I have to think there is more evidence of this. Of course, it should be a no brainer that stimulants can cause psychosis, since that’s part of how the dopamine hypothisis got its start, based on meth or cocaine users becoming psychotic on high dosages.
I am sure I can dredge up the reference if anyone is interested in looking it over.
For someone criticizing you for not referring to scientific studies, his review was glaringly free of any references of his own. If this is the best that Danish psychiatry can do, they’re probably helping market your book by putting up such an incredibly lame rhetorical defense without so much as a single footnote.
The paradox is how we can call it treatment when at best it has no long-term benefits in the aggregate, and can cause the very things it’s supposed to address for many receiving “treatment.” But perhaps that’s not really a paradox. Perhaps it’s widespread delusion followed by widespread malpractice.
This is SO true! I saw an article recently about doctors having a high suicide rate. They did not talk about how many had seen a psychiatrist or what percentage were compliant with their meds or were resistant to treatment. They talked about the incredible stresses of being a doctor and how to create supportive networks so that depressed and hopeless doctors could talk to each other, as well as recommending changes in how we approach medical training. No “brain disease” talk when we’re talking about the privileged members of society. It’s understandable that DOCTORS feel depressed. But the rest of us need to buck up or drug up.
It is ironic that those seeking substance abuse treatment are excluded, since the data I’m aware of suggest that when we control for substance abuse, “mentally ill” people aren’t any more dangerous as a group than anyone else. But people who use substances ARE more dangerous as a group! If we were to select a group whose second amendment rights were to be rescinded (not that I’d agree with such a blanket action in any case), it seems we ought to exempt the “mentally ill” who DON’T have a substance abuse problem, and focus on the substance abusers as the most likely to cause violence.
Of course, there’s also the use, sometimes enforced, of LEGAL substances that might push a person to violent action, but we don’t want to talk about THAT, do we?
Perhaps there are too many politicians and rich folks that have reported for substance abuse treatment and they can’t allow this “stigma” (aka prejudice) about violence be applied to them.
I agree 100% with your comments. No society in the history of the world that I am aware of, other than our own, has ever entertained the idea that humans are just bodies and that there is no spiritual reality or entity involved. What that entity might be is and will probably remain a mystery, but that doesn’t mean it doesn’t exist. Your hardware/software analogy is excellent, but I’d add also that there needs to be someone operating the software, someone who decides which programs to run and what data to enter and what a desirable outcome is. None of this is addressed by the “human as brain” viewpoint.
Science is in truth a sub-study of philosophy. That’s why people get a “Ph.D.” even if they’re studying science. Psychiatry is based on some hard philosophical assumptions, such as “brain=Mind,” but tries to pretend that they are “obvious” or “unavoidable conclusions,” which is one of the classic sophistries used to slip unverified assumptions into an argument. In essence, they assume a conclusion and then reason from that assumption as if it is fact. And that, specifically, is what leads to the muddled confusion described in the article. Real science clarifies things. “Science” that creates more confusion is false science that rests on an incorrect assumption that the “scientist” is unwilling to let go of. That describes psychiatry to a tee!
Can’t argue with you – the study is almost meaningless without drug use profiles (licit and illicit) included in the data. However, I do find it amusingly ironic that their “predictor” genes predict the opposite of what they’re supposed to predict. Love to see them explain this one!
I see a different spin being put on this. The kids are poor BECAUSE THEY HAVE SMALLER BRAINS!!! They are born to poor parents, who undoubtedly also have smaller brains, which proves that poverty is a genetic condition and we don’t have to worry about fighting poverty, because it’s really their brains’ fault after all. What an awesome discovery!
(Just in case anyone misinterprets, the above is to be read with dripping sarcasm and irony. But it wouldn’t shock me if some biopsych proponent came up with that interpretation for real.)
This is super creepy. What I see in the future is that it becomes a condition of being released from involuntary detention – the equivalent of the yellow stars worn by the Jews in Europe during the Nazi occupation. It shows where NAMI is coming from, too, if we needed more evidence. So much for “person-centered care” and “recovery-based services.” If you are identified by your diagnosis and medication, it sure doesn’t sound like recovery is envisioned ever in your future.
Brilliant as usual. It seems to me that disclosure actually legitimizes the conflict of interest, which would explain why disclosed conflicts are associated with higher degrees of bias. Your analogies are quite powerful and hit the nail on the head. A scientist with a financial conflict of interest is no longer a scientist – s/he is a business person working to make a profit. S/he should not be allowed to define such a vague thing as “mental illness” in a way that will benefit his/her personal bottom line!
I hope some attorney can find a place/time to file criminal charges against a conflicted psychiatrist. Even if it doesn’t work, it would sure be fun to watch!
I hope you do come to the USA – we need folks like you! And BTW, in my experience, most Americans view any British-sounding accent as being a sign of sophistication and educated wisdom. So it’s all good.
People feel they are being experimented on because they ARE being experimented on! I’m glad you seem to acknowledge this fact, but I think it is best to be honest about this to the clients. That’s kind of what I think Moncrief is saying – rather than “I’m treating you for X disease or condition,” it’s more, “This drug sometimes makes people feel who feel like you do feel a little better, though it can also make you feel worse in the following ways.” Of course, the same could be said about marijuana or alcohol, which makes me seriously wonder if this kind of experimenting is very different from going down to the bar after work to toss back a couple before having to go home and face your family, or taking a couple of hits in the morning before heading off to deal with your crazy boss, because you won’t react as much if you’re high.
Taking substances can sometimes make people feel better, but I don’t think that’s a new discovery. It doesn’t seem much like medical practice to me.
All I can say is, WOW! What great courage you, the counselor, and these kids showed to have this discussion in a public school setting. I can barely imagine this being allowed, and I have to wonder what repercussions you and/or the counselor may experience once the psychiatrist gets wind of your discussion. But it sounds like an incredibly healing discussion! For those kids to hear that you and most of the kids in the class had all suffered and considered suicide at times must be very healing – I hope they came away realizing that life is hard and that thoughts of suicide are common and, dare I say it, pretty NORMAL for teens in this crazy society we’re in. I wish discussions like this could happen all across the country. You’ve done a beautiful thing, and I really want to see and hear the video. Thanks for making my day!
Glad to have some of this pseudoscientific nonsense debunked, though the idea that this is a recent discovery is wrong – the scientific world knew that depressed people weren’t suffering a serotonin deficiency as far back as the mid 1980s, BEFORE Prozac even hit the market.
It is interesting to note that all of the comments regarding neuroplasticity focused on finding drug-based ways to regrow neural connections, which predictably lead to other disastrous side effects like cancer. This ignores the fairly robust research that suggests human relationships and other environmental impacts can and do cause changes in the brain, even late in life, and that the best way to heal a damaged brain is a healthy relationship with a healthy adult. Bruce Perry’s work is a great place to find out more about this. But this would explain why talking to a friend, joining a support groups, or seeing a counselor is helpful – we CAN modify our brains by how we act and whom we interact with.
A very interesting piece of satire – at times, I wasn’t quite sure whether to laugh or lapse into hopeless apathy. Unfortunately, it is all too accurate, both in the portrayal of the DSM as a novel and in the dystopian view of humanity that it encourages. His stabs at the possible DSM disorders afflicting those who felt the need to create the tome were particularly ironic and insightful.
Great discussion! There is definitely a place for both “outside” and “inside” movements, and both are vital to success. We need people with credentials and insider credibility to challenge the dominant paradigm, and we need tons of active survivors telling their stories and demanding change. And we need writers like Bob and many others laying out the science and the sociology and the economics of change.
What I think is MOST needed is to create a system where getting people more capable and independent and empowered is the goal, and where the incentives encourage instead of discouraging this. That won’t happen without some “system change” work from the inside. It will be slow, it will be awkward, it will never look exactly like we want it to, but change does happen, even in giant bureaucracies, if there is enough weight to overcome the internal momentum. Meanwhile, we keep educating, one person at a time, and each of us uses our weight and expertise where it can help the most. There is no magic – we just have to keep pushing and not give up until it’s done!
I can’t argue with you. He sounds sociopathic for sure. He may have gotten the Adderall prescription just for kicks. As to the DC mom, she didn’t appear to have these weird beliefs before she started treatment for “postpartum depression.” I know people can get psychotic after a birth, but it sure doesn’t sound like whatever treatment they gave her helped, does it? Sounds like it made it a lot worse, to the point that she ended up dead!
I agree, the drug does not absolve him of responsibility, and I absolutely agree his belief system allowed him to absolve himself of responsibility, and it’s also really easy for him to blame the drug. The only difference between this and a drug like Heroin or alcohol is that he was prescribed the drug by a physician, who should have done a better screening and probably not prescribed an addictive and aggression-inducing drug to an aggressive person with an addiction problem. I don’t buy the “insanity defense” in this case. My guess is that he knew what he was doing when he went to get the stimulants in the first place. But that still doesn’t get the doctor off the hook.
Of course, he could be lying the whole time. He’s got a sociopathic kind of presentation. It’s not ALWAYS the drug that induces the final act. But it can be and might have contributed in this case.
I’d contrast this with the woman in DC who was shot after driving her car at the White House fence. She was being “treated” for “postpartum depression” and had no history of violence, being in fact a solid, taxpaying citizen with no criminal record prior to receiving the “help” of these drugs. In that case, I’d say the drugs are highly culpable, and she may in fact have been “insane” for legal purposes not knowing ‘right from wrong’) when she drove her care into the fence.
This guy probably needs to be in jail. He sounds dangerous, on Adderall or off it.
As I said, I think there’s plenty to indicate he was a violent and controlling guy before taking anything. The question is, did the Adderall put him over the edge? Did it make him willing to follow through with something he was only fantasizing about? We know that people are more likely to be violent and to be more severely violent when they’ve been drinking. Not everyone gets violent when drinking – I never did. But if a person is already thinking violent thoughts, drinking may drop their inhibitions and make them more willing to follow through. I think the same thing can happen with Adderall or SSRIs. In which case, I can’t absolve the makers or prescribers of responsibility, any more than I can this guy who did it. If they know that Adderall can make people violent or more violent, and they knew this guy was potentially violent, they shouldn’t have prescribed it.
Two more points: first, there are tons of gun owners who aren’t the least bit violent. They shoot animals for sport or for food, or use them for defense against wild animals, or against violent neighbors if they live in that kind of a neighborhood.
Second, there do appear to be people who aren’t at all violent but do become so while taking psych drugs. This guy doesn’t sound like he fits that profile, but such cases have been documented.
My understanding of many of these psych-drug-induced violent incidents is that the person may or may not be acting bizarrely. They usually seem to be able to think and plan and communicate normally, but do things that are completely out of character. My personal theory, based on observations and discussions with a number of people on SSRIs and stimulants, is that it’s more a distancing from the consequences or implications of their actions. Things seem reasonable that wouldn’t normally. A friend of mine was taking Zoloft as prescribed for migraine headaches. Some normal kind of problem arose, and as she went though her array of possible solutions, she thought, “I could just kill myself.” She realized this was a very abnormal thought for her to have, and was astounded it would occur to her as a solution to such a simple problem. I think a less self-aware person might readily be prompted to act on impulses s/he would normally find outlandish or dangerous.
This guy sounds pretty irresponsible and potentially dangerous in his normal mode of behavior. But I believe it is entirely possible that his ability to ACT on his violent impulses might have been enhanced by his drug-induced state. I don’t think it fully explains and definitely doesn’t excuse the behavior in a functioning adult. But I think it’s quite possible that absent the Adderall, no murder would have occurred.
I loved the article, and I think I get your point: you would be foolish to enter into a therapeutic relationship with a guy like this! He can’t be trusted, he doesn’t like you or care about your goals, he wants to push you around and have you think like he does. I totally respect you for telling him to stick his head “where the sun don’t shine!”
I would absolutely agree: folks should expect results from a therapist, and trust should only grow over time when it is earned by the therapist as a human being. The NORMAL position one should take in a new relationship is one of caution. Many people are hurt over and over again because they can’t set this kind of boundary early in a relationship, and so are unable to objectively observe whether or not trust is merited in this particular person’s case.
When I am working with clients with abuse/trauma backgrounds, I often start off by saying that I don’t expect them to trust me, that I wouldn’t trust me either, and that I hope over time to EARN their trust by my behavior. It may well be that the process of effective therapy itself leads to the trust that the therapist earns, and that this trust is only earned after results are seen by the client. This seems very healthy to me, and something we should encourage. The idea that you should open up to a total stranger just because they have a degree or assigned role in your life is foolishness. Trust is something you earn over time, and clearly your psychiatrist didn’t earn a shred of it. He earned, and appropriately received, your contempt.
I am always amazed at the amount of money being spent studying the one and only thing about a person that we have no capacity to change: his or her DNA! Especially when it comes to “mental health” problems, there are SO many other variables that we CAN change! Even in the physical realm, you have sleep, food, toxins, pain, physical injury to the brain, drugs, deep breathing… Then there are the stress-related variables (abuse, neglect, grinding poverty, dead-end jobs), and social/environmental variables (noise, pollution, racism, sexism, family relationships, loneliness), and there are spiritual variables, too. Apparently, the ongoing practice of meditation can change your brain structure. And biofeedback allows us to alter our brainwave patterns intentionally. All of these things are 100% within human control, and yet we waste billions of dollars and huge amounts of time studying stuff that is unavoidably fixed at birth.
And even those billions have yielded pitiful results!! When the best you can claim is that a third of “mental disorders” MAY be associated with a range of thousands of alleles, the chances that you’re going to come up with a genetic explanation for anything are obviously beyond remote.
One more thing: Just because something is shown to have genetic underpinnings doesn’t make it a disease. I am quite sure that some of those labeled “ADHD” by the system are programmed genetically to be more active and less tolerant of boredom. As Brett says, “So what?” Any trait that occurs in 6-10% of the population obviously has some survival value. I would suggest that we NEED some people who are more active and less tolerant of boredom. Those are the ones who push the stodgy and controlling members of society outside of their comfort zones to consider things that might otherwise never be considered.
Species survival depends on genetic diversity. We all have different genetic substrates, and that’s how it’s supposed to be. Time to stop wasting our energy on discovering the obvious fact that we’re all genetically different, and time to put in a lot more energy into figuring how we can value our differences and make a society where being different isn’t considered a disease.
I find it encouraging that these discussions are happening at a more mainstream level. It does not surprise me that psychiatrists have to “save face” by hanging onto some threads of their old thinking. It is, of course, scientifically wrong, but we should not delude ourselves into thinking this is a scientific process. This is sociology and culture change, and it is slow and incremental. Nobody every just says, “You know, our entire approach was entirely wrong and we’re scrapping it.”
I’m glad the guy is talking about humility, about the evidence that brains are harmed by the drugs, and about the now established fact that many folks do well with minimal or no drug intervention. I also like that he calls out his own training and lets us know that a lot of it was just plain wrong. That takes some courage, and we need folks like this to help turn the discussion in a more sane direction. Not that I think this moderates the need to take psychiatry out as a medical specialty, but an acknowledgement of at least a large subset of the actual facts is refreshing to me.
And of course, they neglect to mention that the “treatment” for these supposed “neurotoxic effects” of psychosis is clearly and unambiguously shown to be neurotoxic, even by psychiatric apologist Nancy Andreasen. It is hard to understand how this isn’t obvious to theses oh-so-smart researchers. But I’m glad they at least mentioned that the neurotoxic theory of psychosis is pretty sketchy even with the biased research that has been done to try and support it. Take the drugs into account, and there is no theory. It’s crap.
What a load of crap that article is! I tried to post a reply, but I had to register and I think I have to be a psychiatrist to do so. Probably spitting in the ocean, but it pisses me off how they get away with spouting this bullshit (“60-80% of the cause of schizophrenia is genetic” without any reference,and in the next sentence admitting that there is no known genetic correlation with schizophrenia!) and no one in the profession calls them on it.
Stephen, you are so awesome! I admire you for standing up to those bastards. It must be very hard to work behind enemy lines, but the folks you work with are so lucky to have you!
Which is why PloS One is the most reliable journal around. It just goes to show how shabby the “peer review” process is and how questionable the ethics of these journals really are. The state of medical science in these days is pretty pathetic.
I totally called this one as soon as I read about it. It looks like a very clear case of antidepressant-induced mania, though I did not know about the head injury, which of course adds even more of a complication and should have been carefully evaluated before someone decided to give her SSRIs.
Who in the media will point out the obvious conclusion?
I tend to think that “biological psychiatry” is a philosophical/religious viewpoint purporting that the ONLY cause of psychological distress is malfunctioning biology, and that social/emotional/spiritual context is more or less meaningless. Getting away from the biological psychiatry paradigm doesn’t mean eliminating biological causality as a possibility – it simply means seeing it as only ONE possible cause that should be objectively tested for and addressed appropriately when detected. This could include testing for iron deficiency in cases of hyperactive or oppositional children, checking for thyroid issues if someone is chronically depressed, and of course, considering the possibility that pharmaceuticals themselves might be causing mental/emotional/behavioral problems that might improve with a change or elimination of the offending medical treatment.
To me, it would also mean eliminating the DSM as the standard for “diagnosis,” since the DSM is admittedly “atheoretical” and essentially ignores the question of causality and makes it possible to diagnose a disease based only on symptoms without any attention to causal factors whatsoever.
There is no question that biological conditions CAN cause the kind of problems labeled as “mental health” diagnoses. It’s also possible that biology is only secondarily involved, and it’s further possible that the so-called disorder is entirely normal behavior for that particular person in that particular place. It is the elimination of these other possibilities that makes it “biological psychiatry” to me.
On the other hand, there’s not a lot of other “psychiatry” being practiced these days. I agree with Richard, we really ought to support those fomenting rebellion from within, but I sure wish there were more of them around!
Too true, Peter. It seems that foster kids are somehow supposed to be happy that we’ve removed them from their awful parents, and any manifestations of grief, confusion, anxiety or anger at us for “helping” them in ways they did not ask for are signs of their personal dysfunction. Sadly, the DSM invites and encourages this kind of “diagnosis” without any consideration for context. And of course, it happens just the same with adults, although the kids have less power and I think need even more protection. It’s such a horrific scam, it’s hard to even know where to begin to unravel it. But I think it starts with challenging the concept that we should all be “well adjusted” regardless of what happens to us. Which in the case of foster kids is patently ridiculous, yet it happens every day.
Ted, sorry if I was confusing – I was by no means suggesting you have engaged in ad hominem attacks on psychiatry. You have been very specific, detailed, and factual in your systematic attack on their pseudo-rational framework that excuses their abuses. As far from ad hominem as I can imagine.
I was saying that we can diminish the effects of the ad hominem attacks of the pro-psych propagandists by making sure we label them for what they are, instead of getting into a discussion of what the label “anti-psychiatry” means and whether it applies to us. I don’t like to label myself anything, especially if it gives my antagonist a hand up. I am all for reclaiming terms, but I am just not sure that proclaiming myself as “antipsychiatry” doesn’t play into their hands. Makes it too easy to dismiss me when I can be made part of a group of “anti” activists. Maybe it’s too much training in pro-social communication skills, but I prefer to label their objectionable behavior rather talk about being opposed to the group per se. It just seems to get down to brass tacks, in my view. And I don’t want to pre-label myself for their convenience, either. They have to deal with my data and not dismiss me with a term.
On the other hand, retrieving discredited terms can be very powerful in combating oppression and delineating what is really going on. I don’t think we really disagree about that. I suppose it’s more a point of tactics for me. Truth is, there is nothing to salvage in psychiatry that I can think of. It really ought to be demolished, especially their ability to define “normal” and to remove people’s civil rights based on their spurious definitions. So I am anti-psychiatry, whether I’d say it to a psychiatric apologist or not. And I am proud of it, and find it something folks should be proud of. I just like to be clear that if psychiatry made the slightest bit of sense, I wouldn’t be categorically opposed to it just because it’s called psychiatry. After all, “psychiatrist” is supposed to mean “Doctor of the Spirit.” That would sound good if they didn’t start by denying that any spiritual reality exists!
Truth to tell, we are about this close to total agreement. Sorry if my comments were confusing. I hope the context I provided makes them make more sense to you.
I guarantee, the numbers are huge. I see it every day in the foster care population. And it’s not just antidepressants. A lot of kids start on stimulants, get aggressive, lose sleep, may even get a bit delusional, and whack! They’re bipolar and get antipsychotics. Which is really bizarre, because stimulants increase dopamine while antipsychotics reduce it. So if you think the kids’ got too much dopamine going on, why not stop increasing it with drug A instead of decreasing it with drug B? But that would be rational, wouldn’t it.
The bipolar epidemic is only partly due to Joseph Biedermann’s arbitrary retooling of the criteria for “juvenile bipolar disorder.” I believe the bulk of it is fueled by adverse reactions to “antidepressants” and stimulant drugs.
It sounds like we’re of one mind on this one, Ron. I don’t like being labeled, and I don’t like to label anyone else, either. I think it plays into their game. And I don’t think we should let them throw around “Scientologist” as a bad label, either. Why should a person’s religious beliefs be a relevant issue in a discussion of the scientific utility of a supposedly medical intervention?
I think the best approach to the antipsychiatry label is to point out that this is exactly the kind of thinking that we have come to expect from the psychiatric profession – trying to discredit their critics with labeling and name calling rather than dealing with the very real issues that their preferred treatments bring to the fore.
If someone tries to label me with any label at all, I’m inclined to reply that what I am is an intelligent person who has done a lot of reading and research in this area, and who finds that research does not support what is commonly done in the field. And I provide examples.
Labeling and ad hominem attacks have always been the last refuge of scoundrels and hacks over time. I think we take that away by refusing to employ that tactic, and instead point out when and why it’s being used, and return the attacker to a discussion of the real issues at hand.
Though I am comfortable with Tina’s framing – I am anti-psychiatric oppression! Of course, that is kind of an oxymoron for most psychiatrists…
Quote from the article: “But it’s counterintuitive to ask people to raise their hands and say, ‘I’m not going to follow the conventional thought about mental illness, and I’m going to be open to the people who need support.’ ”
How did it become the conventional thought NOT to listen? NAMI has been central in helping the psychiatric profession convince everyone that it’s all a brain chemistry problem and that listening doesn’t matter. Kind of ironic for them to start on this kind of campaign. Perhaps they should apologize for misleading people earlier. Might make their campaign a little more believable.
I like to say that I’m anti-stupidity, anti-abuse, anti-lying, anti-greed and anti-coercion. It’s not my fault that psychiatry has positioned itself to be stupid, abusive, dishonest, greedy and coercive. I’m not against psychiatry for the name – I’m against what they DO! Stop hurting people, admit you don’t know what you’re talking about most of the time, acknowledge the real scientific data, and start listening to your clients and my feelings might change.
As a Buddhist teacher once said, “Don’t break off my finger, look at where it’s pointing.” But psychiatry as a profession is not interested in looking anywhere but at its own self-interest, and as long as that’s the case, I will be against them as a group.
Appreciate the perspective, and I’ve heard the same from many individuals. But I’m with John on this one – just because a drug helps you with a situation or condition doesn’t mean you’re ill. I raised two “ADHD” type boys and used alternative schooling and some creative discipline to help them succeed drug-free. It can definitely be done, but trying to force “square pegs into round holes” is a specialty of our school system, and is IMHO the main reason for the “ADHD” epidemic.
You might also want to note that a good percentage of those preschoolers and school-aged kids started out on stimulants before they were diagnosed with “bipolar disorder.” Stimulants make a lot of kids agitated and/or aggressive by boosting their dopamine levels up too high. Rather than realizing they’ve created a monster, most psychiatrists will respond by using “atypical antipsychotics,” which bizarrely enough LOWER the dopamine levels that they’ve provided the stimulants to increase. So we raise dopamine with one hand, lower it with the other, and blame the kid if it doesn’t work out as we’d hoped. Not a formula for success!
My personal belief is that we need to have a range of classrooms so those who can’t do it “your way” have another way that they can learn and be successful. It worked for my kids. I wish you’d had the chance to be in such an environment yourself, so your real strengths could have been valued instead of diagnosed as a “disorder.”
So if I strangle my psychiatrist, does he then suffer a “patient-related psychiatric asphyxiation event?”
Language has great power and is used in psychiatry to avoid responsibility and cast blame on the clients they are supposedly trying to help.
I think my favorite is “you have treatment-resistant depression.” Now, if I took my car to the mechanic, and he couldn’t make it work properly, I wonder what I’d say if he told me I had “repair-resistant fuel injectors,” but that I still had to pay him $200 and bring it back next week for another “treatment?” We’d expect him to say, “I don’t know how to fix it” and we’d take it somewhere else or live with it or do our own research and fix it ourselves.
So how to psychiatrists get away with not knowing how to help? They blame the client. No, they blame the “DISEASE” – it is the DEPRESSION that is resisting treatment, not you personally. If only that darned depression would get it together and stop resisting, things would be peachy around here. So of course, if the depression resists, and you “have” depression, there’s nothing you can do about it except come back for another round of “treatments” and hope for the best. I hope I live to see the day when a psychiatrist says, “I really don’t know how to help with this situation. I suggest you talk to someone else who has more tools at their disposal. I’ve obviously been of no help to you.” Haven’t heard it yet, and I’m not holding my breath…
I found lots of comments, the vast majority of them reflecting disappointment/disgust with the lack of objective reporting. Four pages all together, and 90% were negative. I didn’t even feel compelled to comment, because all I’d wanted to say was covered more than once by others. Well done!
That is remarkably good news from the front lines! I guess I never thought the Berlin Wall was going to come down, either – maybe psychiatry is about to make a substantive change? Dare I hope?
Good for you, though – I’m glad you’re finally going to get some help in moving in a different direction!
I agree, this might not be the best example where the drugs are clearly implicated. I’d rather have seen them investigate Adam Lanza’s case, or the Batman shooter in Colorado, or the V Tech shooting, among many others. Still, it’s good to see someone looking into it. Maybe a one of us with some “authority” (namely the right letters after his/her name) can suggest to the good congressman that this is not an isolated incident, and he ought to broaden his investigation.
Still, we don’t know that he wasn’t taking other stuff, nor do we know if he was taking more of the Trazadone than recommended for sleep. The tricyclics have been known to cause manic episodes, as they do mess with serotonin, just not as much as the SSRIs.
Clinical detachment is a myth, and not a very helpful one at that. It’s kind of like saying, “I’m not biased against black people.” There’s no way to be real without being vulnerable and open on some level. Doesn’t mean you bring all your crap and dump it on your client, but genuinely experiencing and at times expressing your emotional responses to the client’s situation seems to me to be critical to real progress being made. Perhaps I had an advantage – I never received any real clinical training until after I became a counselor. (For some reason, people seemed to think an MS in Education qualified me to be a counselor – go figure!) But I was never deluded into thinking I could be fully objective about my “clients,” nor did I try to be. If I was baffled by their behavior, I’d let them know, in a supportive way, that I was struggling to figure out why they were acting the way they were, and could use their help figuring it out. This almost always led to some very interesting and beneficial lines of conversation. Usually, it was the things that baffled and frustrated me that led me and the client to discover what was really going on. If I had not been able to admit being confused or frustrated, and tried to fit the client’s behavior into some preconceived “rational” framework, I doubt I would have been of the slightest help, and would probably have messed them up even worse.
Thanks for this rational picture of what therapy can be, the good, the bad and the ugly. I hate to throw out the baby with the bathwater, because there are some very competent and helpful folks out there doing therapy, but I’d say most are at best marginally clueless, and some are downright dangerous. The best of them seem like secret rebels in the enemy camp. My hat’s off to them, but you have to look pretty hard to find them in the mass of mediocrity that passes for therapy these days, or maybe in any days, past, present or future.
And a lot of them aren’t officially therapists, either.
Are you saying that having a sense that you are a valuable and contributing member of society with some purpose to your life has an impact on your mental health, too? Wow, now THAT’S a radical concept!
Imagine, anxiety being caused by actual life events! What a concept!
But not EVERYONE gets anxious about losing their job or being unemployed. So those who get anxious about it must have a CHEMICAL IMBALANCE that makes them unnecessarily worried about the possibility that they may become homeless or starve to death. NORMAL people don’t worry about these things. They just roll with the business cycle and starve quietly off the road somewhere where they won’t bother anyone.
“…digital smiley-faces were superimposed over the windows of his psychiatric hospital, with the title “Patients’ experience vs. meta-analytical evidence: My patients believe in the efficacy of antidepressants.” … The president of the EPA, a scientist who has co-authored more than 1,000 publications, was arguing that in the matter of antidepressant efficacy, clinical judgment trumps scientific evidence.”
Actually, he was doing more: He was postulating that the placebo effect is all that matters. Or to put it another way: he was arguing that faith is the underpinning of psychiatry, regardless of fact.
As many others have observed, Psychiatry had more in common with a religious order than it does with science. It’s not by chance that the DSM is referred to as the “bible” of the psychiatric profession. What other “medical” specialty has holy scriptures? Is there a “bible” of metabolic medicine or cardiology?
You give them way too much credit in suggesting their presentation relies on clinical opinion. It relies on personal faith that speaking the right magical words and using the right magical formulas is what creates the magical result. The truth is not relevant to their undertaking. They are upset because you’re breaking the spell.
You know the reason Benzos went out of favor is because the pharma companies and doctors could make more money on the SSRIs. Besides which, SSRIs favored the “chemical imbalance” theory much better, being “targeted” at a specific neurotransmitter, even though nobody had or has a clue as to why they even have an impact on depression or anxiety.
Personally, I find a glass of beer to be an excellent antianxiety agent. It’s cheap and readily available without prescription, and fast-acting like the benzos. Sure, there’s the problem of dosage control, but people get addicted to benzos as well. I’d love to see controlled dosages of alcohol go up against benzos and SSRIs. I bet alcohol would win out, both for effectiveness and lower side effects. Marijuana in low doses is probably also better than either benzos or SSRIs, and probably even better than alcohol on the side effect profile. But as long as no one can control the supply and make big enough bucks for their corporation off of them, alcohol and marijuana will remain “drugs” rather than “medications.” In the end, there isn’t much difference, except for who profits.
Nonetheless, I am going to find this very helpful in advocating for foster kids, who seem to get antipsychotics for any kind of distress they experience. I always get the “you’re not a doctor” routine, even though I know more about the effects and outcome literature of psych drugs than a lot of the docs. But this will be hard to refute.
That is such a disgusting story! Good for you for resisting their indoctrination into disability. It revolts me that a “professional” would herd a bunch of people together for the purpose of teaching them they can’t do things. What the hell do they think they are accomplishing? Saving you from “disappointment” when you “inevitably fail?” Sounds like projection of their own failure to ever understand how to help another human being.
Keep telling your story. It’s a much better story than the one they’re selling, and all the more important for actually being the truth!
Which reinforces my point – even the function of the genes themselves is changed by changes in the environment and our own decisions! We inherit whatever genetic material we inherit, and there’s not a damned thing we can do about it, but how those genes are EXPRESSED is something we have a massive amount of control over. Which means we also control our brain chemistry to a huge extent, and apparently can even cause new neurons to grow through meditation!
So why is all the money being spent on studying genes and brain chemistry? Why not spend the money on preventing trauma, learning good living habits, and finding techniques to assist those who have been traumatized to re-establish control over their own bodies and brains?
Rhetorical question. We know the answers, of course. There is no money in helping people become independent and highly functioning, and acknowledging the role of trauma, poverty and abuse in mental illness means those in power have to take some accountability for their own behavior. Much easier and more comfortable to blame the brain!
Great post! I would add that it is fascinating that psychiatry focuses vast amounts of energy on genetics, which is the one variable we CAN’T change. Why not focus on the environment, which is a variable under our control? The 1:76 ratio of scientific studies really reinforces the intentional blindness of the “profession” to this weird bias. In underscores my view (and many others’) that psychiatry is a religion, not a scientific medical practice.
And maybe I’m being overly optimistic – I think this particular iteration of psychiatric oppression may end, if only because the profits in it are evaporating very quickly, and the hard truth of the long-term impact of psych drugs is finally getting the press it deserves. But I have no doubt that the shadow (as JRR Tolkien put it) will reform and grow in another manifestation. It’s the basic good vs. evil battle, and probably never will end. But I do think the idea that mental illness is a purely physiological issue that can be treated with drugs is on the way out. Slowly but surely, the pendulum swings back again…
I am so tired of hearing that “schizophrenics can now live in the community because of our drugs.” It’s such a lie, but Andreasen continues to publish this nonsensical myth. It was a social policy change that had nothing to do with drugs, as Bob so amply demonstrates in his book.
That being said, she is pretty mainstream, and for her to admit that there really is brain shrinkage due to neuroleptic use is very helpful.
It’s also important to remember that any links between “mental illness” and brain volume are based on average measurements. There is no direct correlation where you can say that “this person has schizophrenia and therefore will have a smaller cranial capacity.”
They continue to grasp at straws to hold up their unsupportable brain-damage theories of mental illness. But the data is now becoming clearer and clearer, and sooner or later, they will lose.
Guess I’m glad there’s research to support this, but anyone with a half a brain and one eye to observe with would see that “antipsychotics” impair cognitive functioning. It would be like an experiment to see if leaving food on the floor attracts ants. The result is obvious without the experiment.
Laura, what a beautiful and moving essay! You really have a great gift, and your story is so characteristic of so many people I’ve seen, both those subsumed into the psych system and those committed to escaping it.
Your reminded me starkly of my days as a counselor and volunteer supervisor at a suicide hotline. For one thing, I learned that lay volunteers often made much better counselors than the professionals, because they knew they didn’t know anything much, but were there to LISTEN to the caller and help him/her figure out what to do, rather than labeling or judging or ordering them about.
Second, I remember that the main thing I advised and applied to suicidal callers was to ask what was going on in their lives that made suicide seem an appealing option to them. I assumed based on the fact that they’d called us that on some level, they really did want to live. So something pretty painful must be going on to lead them to think of killing themselves. This almost always led to very deep and meaningful conversations that were appreciated by the callers. It was what they wanted and needed – someone to care and listen.
As soon as suicide or other “symptoms” become the problem rather than an indicator of distress, we lose the ability to intervene in a helpful way. That’s what the DSM does for us – it takes the meaning away from our suffering and leaves us as a list of symptoms to be controlled or “managed.” I don’t know that I’ve ever read a more effective personal description of the vast difference between being a set of symptoms and being a human being seeking meaning in the world. I rejoice that you’ve found yours, and may you be a beacon to others who are where you once were!
He sounds like a special person who was failed again and again by the psychiatric system. It is interesting in a sickening way how the system is able to spin his story to being about how he shouldn’t have tapered off his antidepressants, when clearly 1) his antidepressants were making him physically ill, 2) his antidepressants were not working to enhance his life anyway, and 3) he continued to receive psychiatric treatment right up to the day he killed himself.
As I understand it, suicide is a pretty common outcome from multiple ECT “treatments.” It is entirely possible that he suffered not only from brain damage from long-term psych drug usage, but further brain damage from the ECT that contributed to his suicidality. Not to mention the hopelessness that comes along with the message that your brain is broken, and our ‘fixes’ aren’t fixing it.
Thanks for sharing this very sad and yet beautiful story. I’m glad you can be there with your friend when he needs you. I am sure that you have done more for him than anyone in the hospital will be able to contribute. Your willingness to feel his pain is your strength – revel in it and rejoice that you have it. It is a much rarer skill than perhaps you are aware.
I recall talking to a psychiatrist who had been working with a seriously depressed woman for 15 years. He’d never even asked her what she was depressed about. When I asked him about it, he acted as if it was an irrelevant question. He “tried everything” in his medical repertoire, but hadn’t bothered to ask the most obvious question that your average 8 year old would have instantly known to ask: “Why are you sad?” I guess if your chemicals are imbalanced, it’s your problem, and it doesn’t matter why it happened. Very handy for the practitioner, because it doesn’t require them to think too much, but for the client, a bit of a different story.
This makes sense to me, based on what people have reported to me and in the literature about the numbing effects of SSRIs. It appears to make a person less sensitive to any input from the environment, positive or negative. This may seem like a relief if you’re chronically anxious (as now you no longer care what Aunt Mable thinks of your new dress), but it also may mean failing to care about the consequences of your actions (So, I’m breaking the law – big deal). I think this is where a lot of the increased suicide/violence/homicide comes in – people may have had an impulse in this direction before, but would never have considered acting on it, because the consequences were too serious. But with SSRIs, the consequences have much less significance, so killing someone else or oneself doesn’t seem so bad any more.
I am never opposed to hearing research data that may contradict the research referenced in Anatomy of an Epidemic. Unfortunately, I haven’t seen much that has done that. Mostly, I hear criticisms that MiA supporters are “anti-intellectual” or “antipsychiatry,” without any evidence countering the book’s thesis.
So pick one area, and let us know what the counterevidence is. Present it without critical commentary about other posters, and see what happens.
I’m pretty well versed in the latest research, and I have yet to see any convincing evidence that long-term use of psych drugs leads to better outcomes. I’ve heard lots of anecdotes, which have some value, but when we look at the long-term research, there’s just nothing to support the GENERAL assertion that people staying on medication leads to better outcomes. I’d be happy to see any literature you can produce that supports people being better off in the collective sense though the use of brain-altering chemicals.
The other big point is the DSM diagnoses. I would have to toss the label of “Anti-intellectual” at you if you are not willing to acknowledge the obvious fact that the DSM diagnoses are descriptions of behavioral/thinking/emotional states that do not necessarily associate with ANY physiological problem. There have been decades of dedicated research looking at this question, and we have a few faded scraps of genetic association, not even with a specific “disorder,” but with a range of mental health issues that this set of genes may make someone more vulnerable to. That’s pretty weak evidence for physiological causation of mental illness.
So we have almost no evidence supporting the DSM diagnoses, and almost no evidence supporting long-term efficacy. Why all the argument with the selective use concept? How is it anti-intellectual to acknowledge the research that has been done?
I think the value in writing to counter idiot posts by unredeemable true believers is not to convince the person you’re writing to, but to give those reading that person’s post an opportunity to hear the counterargument and compare. If you consider your exchange as posted above, any sensible person reading the posts can see that you are coming from a place of openness and reason, and that s/he is coming from a place of insecurity and immaturity. Don’t discount the value of that. While the poster may never be convinced, you may have helped a dozen or a hundred other readers open their mind or solidify their thoughts with some rational backing. It’s definitely not a valueless activity, even if the moron writing the initial post is driven into childish retorts.
This is a very important finding! It really calls the entire DSM enterprise into question – if a diagnosis doesn’t predict need for treatment, and if receiving treatment doesn’t impact the outcome, what is the point of diagnosing someone in the first place???
All I can say is, “Another psychiatric success story.” It’s amazing the percentage of these shooters who have been “helped” by the mental health system and are either on or are withdrawing from psych drugs. If the system were so helpful, how are these people acting out so badly in ways we never, ever saw when I was a kid?
It is apparent that this woman knows more about mental health treatment than those who were trying to help this young man. She talked to him, she listened to him, she cared about him, and she had the courage to do the right thing even though she was scared. She is the kind of person we need providing care for people with mental/emotional/spiritual challenges to face. Why can’t the MH profession learn from this kind of scenario?
Peter, you summed it up so well. When I was starting out in the world of “mental health” in the 80s, we still talked about unconscious motivations and the impact of parenting and even society as a whole on development. Now it’s 100% “blame the victim.” If you can’t hack it in today’s insane world, then you’re insane, because by definition, the status quo is always wonderful to those who are in control of it.
I’m reminded of Jung’s concept of the “shadow self.” I think society as a whole has a “shadow self” that is represented by those who object to it, consciously or not. And the larger society feels compelled to snuff out any emergence of this ugly underbelly by whatever means possible, because it reminds them that all is not as well as they want to believe. And the APA and the pharmaceutical companies have all been too happy to play into that need, as they make plenty of good bucks at it. Of course, anyone who actually looks at the data is to be shot on sight.
As a friend of mine once said, “Never let the facts stand in the way of a good theory!”
Well, yeah! That’s what I was saying – given the very weak evidence of anything positive happening, and the strong likelihood of something negative happening, I’d say we’ve got a great argument for banning this drug for ANY indication.
I have talked to any number of SSRI users who describe almost a depersonalization experience, an emotional disconnection not only from their own emotions, but from how anyone else feels as well. I believe this is part of what lies behind the less common but sometimes severe violence that occurs with some SSRI users – they would normally be restrained from killing themselves or someone else by empathy for the impact on others, or at least fear of the consequences, but these barriers are kindly removed by the SSRI experience, and killing oneself or someone else suddenly seems like a reasonable solution.
It is amazing to me that anyone who knows that we could be causing permanent damage to someone’s brain with a very small chance of any positive impact, and when any such impact is at best temporary, would ever feel OK about prescribing such a drug.
I’d be interesting to hear Dr. Shipko’s rationale for continuing to prescribe them.
Not only do we need to show that “creatively maladjusted” people can survive and thrive without having their brains modified, but we also need to show that drugging people does NOT make people well adjusted mentally and emotionally, and that talking and listening to them is much more likely to lead to that supposedly desired outcome. Which is what Bob’s work is really trying to do.
The problem is, I’m not sure the psychiatric profession as a whole really wants people to recover. Their profession’s survival depends on people “needing drugs” on a semi-permanent basis. If you take that away, what has psychiatry got left to offer? The DSM? The occasional drug to deal with an immediate crisis? They lose all their power and authority, and they’re not going to let that happen. Whether they’re willing to admit it or not, psychiatry as a profession is invested in keeping people dependent and “ill.” If their mythology is no longer accepted, they become the worthless fifth wheels that they already really are.
Right you are! You reinforced my point even more dramatically. I guess it was OK for slaves to be as depressed as they wanted to, as long as they did as they were told and didn’t complain. But running away, that caused trouble! Obviously something must be wrong with them for objecting to the status quo and making things difficult for the Masters.
Sounds like a very sound analogy for today’s “mental health” industry. If you’re not completely happy with today’s industrial-corporate-capitalist-government bureaucracy, you’d better keep it to yourself. If you act out in any way that interferes with the ongoing efficiency of the money-making, soul-draining machine, you will be dealt with by disabling your brain. “Successful treatment” will return you to an appropriate state of docility such that while you may not be contributing to the machine, at least you’re not in the way.
There is “nothing better” out there. Correct. “Nothing” is better than the DSM! We’re far better off admitting our ignorance than pretending to know what we don’t, and let’s be honest, intentionally deceiving others into thinking we do.
When I had to do psych diagnosis, I chose the one that would get the client the service I thought they needed and wanted. If they asked me about it, I’d say, “I just put that down there so the insurance company will pay. It doesn’t really mean anything at all.”
That’s about the only thing the DSM is useful for – getting money from insurance companies. If clinicians were at least that honest, we might be able to get somewhere else than where we are today.
Thanks for this wonderful post! I agree with you 100%, the message from the psych community is “there’s nothing to be depressed about!” The idea that we can somehow differentiate “depression” from “simple unhappiness” is a delusion that has been promoted for many years, and is stated with such fervor and passion by many, despite the complete lack of any scientific or factual basis to make such a distinction. The author’s description of the difference appears to be more in terms of how a person is reacting to his/her sadness/despair, rather than what is driving it. In other words, some people are sad, and some people are REALLY sad and driven to do things that sad people do, like sleeping a long time or thinking about suicide. But obviously, there is a continuum from being sad to being REALLY sad, and no clear or easy way to draw a line between them.
I also agree with “feelbettercounseling” that there can be a lot of factors that come into play, some of which are purely physiological. For me, losing sleep almost always leads to a more depressed outlook, and if combined with a negative incident, can throw me into a full-fledged episode of self-hatred. Fortunately, I can recognize this now and pull myself out of it by reminding myself, “You’re tired. This will look very different once you’ve gotten some rest.” Food, exercise, physical pain/health, fresh air, sunshine, hugs, all of these have an effect on mood. But I think the most important point is to understand that depression is a human reaction that is part of our biological repertoire of survival tools. To re-define it as a disease, and to distance it completely from the experience of sadness and loss, is to diminish the experience of the sufferer and to communicate that there is something wrong with them for feeling the way that they do. Simply acknowledging that a person’s emotional response is a normal reaction to whatever difficult circumstances they are experiencing seem in my experience to be the first and most important tool in helping them come to terms with how they might move in a new direction. And yet psychiatry’s message is exactly the opposite of what I know to be helpful.
I have noticed that my belief that the world should be improved and made more just and equitable definitely associates with me feeling more depressed. However, I don’t take that as a problem with me – I view it as a sense that I am not OK with the world being the way it is! I’m sure a lot of enslaved Africans felt pretty damned depressed living on plantations and being ordered about and beaten and raped and separated from their families and their homes and their culture. Were they “mentally ill” for feeling that way?
I believe a craving for justice is fundamental to healthy human life. It is the very fact that we have lost so much control over the injustices that are happening all over our country and the world which I believe drives many to despair and other extreme emotional states. Absent this drive for justice, we end up with a lot of sociopaths and the remainder of society living a dull and apathetic existence. It is HEALTHY to be displeased about injustice, and it is UNHEALTHY to feel OK about others being mistreated. Only the twisted nature of our society leads us to feel better when we stop caring about our fellow man/woman.
It seems to me hard to believe anyone could recommend these drugs knowing this information, especially in light of Kirsch’s work suggesting that the drugs are generally acting as active placebos and have little to no actual clinical effect, except in the most severe cases. I found this article extremely distressing, as Ted did – I knew it was bad, but I’d assumed and believed that time did allow this kind of brain damage to heal.
And Stuart is right to distinguish that this is NOT a withdrawal effect. This is the effect of ongoing damage to the brain, which may or may not heal. It goes right back to Peter Breggin’s and Whitaker’s description of the neurological up- and down-regulation in response to enormous, enforced changes in neurotransmitter availability in the brain. There is NO excuse for even considering doing this to a patient, especially to a person suffering from mild to moderate depression, when there are so many other options available.
You’d think they’d have “serious concern” about the legitimacy of their predictive model, and perhaps some “serious concern” that they didn’t know their butt from a hole in the ground. I have “serious concern” that anyone takes a thing they say seriously.
Remember, though, that most of the deaths due to medical intervention are NOT due to “mistakes.” They are mostly due to the adverse effects of properly prescribed and properly administered medication.
“The findings by Barbara Starfield, MD, of Johns Hopkins School of Public Health:
12,000 deaths from unnecessary surgeries;
7,000 deaths from medication errors in hospitals;
20,000 deaths from other errors in hospitals;
80,000 deaths from infections acquired in hospitals;
106,000 deaths from FDA-approved correctly prescribed medicines.
The total estimated number of deaths caused by medical treatment in the US every year is 225,000.
Thus, the US medical system is the third leading cause of death, after heart disease and cancer.”
As I said, biopsychiatry is the philosophical descendant of eugenics. It’s part and parcel of the entire viewpoint – mentally ill people are genetically defective. And reasoned argument does not work against these people, because they are not even vaguely interested in what science has to say – they are dogmatic ideologues who only use the veneer of “science” to cover up their more nefarious undertakings.
I do agree, we do well to be very factual in our statements, as it leaves us open to attack if we’re not, but at the same time, we have to attack the power base of those who are promoting this campaign and not be too worried at the expected drama in response.
While Big Tobacco did not invent behavioral genetics, it seems to me that they did an excellent job of using public media to shift the focus away from their product and toward the individual who used it, using behavioral genetics as a foil, a tactic which is almost universally employed in the marketing of “mental health” drugs today. For example, there is now talk that PTSD is a biological problem, because not everyone reacts that way to a traumatic event, implying that the PROPER way to respond to a traumatic event is to NOT have flashbacks and intrusive memories, etc., and that those who do react that way are personally deficient in some way. This takes the focus completely off of the traumatic event and its progenitor, letting rapists, domestic abuse perpetrators and child abusers off the hook. A page right out of Big Tobacco’s playbook.
I do agree with the author that the tobacco industry honed this tactic to a fine point during my childhood years, though they were eventually busted by the overwhelming bulk of the evidence. My hope is that this will eventually happen to the psychiatric drug industry as well. Of course, it does make a difference that nobody was ever forcibly hospitalizing people and insisting that they smoke, or injecting them with nicotine as a means of “helping”…
Jay Joseph is amazing and very research-focused, which this particular author fails at. But I still think his point is well taken.
Thanks for this viewpoint, Matt. It is interesting that as a person who has done therapy with many people who have been traumatized (especially domestic abuse victims), that bluntness and the willingness to drum up some righteous indignation are actually things I try to encourage people to develop! I fully believe that learning to feel and act on anger when it arises is one of the most important recovery tools for victims of abuse and violence. I also believe that being cautious about similar future events is SMART and can often be quite enlightening for those who suffered abuse, as this rational caution often helps the survivor identify how they allowed themselves to be sucked in by the abuser and how to avoid it in the future.
I even wrote a book about it – entitled Jerk Radar. I have taken stories from victims of domestic abuse and created a manual on how to detect potentially abusive partners up front, when they’re still pretending to care about you. So I am actually advising “hypervigilance!” Many of the same principles in the book would readily be applied to receiving medical care, especially from psychiatrists.
I think seeing “PTSD” or other reactions to trauma as adaptive responses to bad situations is an awesome way for those who have been hurt to regain their power, and realize that their behavior is not a “disorder,” it is simply a matter of trying to plan a way to avoid being harmed in the same way again.
Biopsychiatry is a descendant of eugenics. It continues the search for proof that some of our population is genetically inferior and can therefore justifiably be treated poorly or eliminated. And with death rates so much higher for recipients of psychiatric “treatments,” the results aren’t so different from the early 20th-century eugenicists, except that it takes longer to kill off the “undesirables.” Reframing it as “medical treatment” allows the effort to become more palatable for the masses. But the underlying assumptions are the same: those in power deserve to be in power, those who don’t “fit in” to the schemes of the powerful are labeled as genetically deficient and are physically, psychologically and socially restrained or attacked, with justification provided by their “inferior” status.
Yes, I understand that Pharma doesn’t see psych drugs as the cash cow they were in the 90’s and the 2000’s, as they’ve played out all the “new delivery forms” and other sleazy tactics to get new patents, and are getting hit up with a lot of damaging lawsuits. Not sure what Lieberman or the APA would have to offer them that would change this viewpoint. It’s same-old, same-old at the APA!
I felt very sad to read this. I have also felt despairing at times and wanted to end my life. Many times. I never did do so, and I am glad I didn’t now, but it seemed hopeless at the time. I’ve also worked at a suicide hotline and talked to hundreds and hundreds of suicidal people. I can’t judge anyone for being there. Sometimes it’s good to know you have a backup plan if it gets beyond reckoning.
What is keeping you going at this point? You must be pretty damned tough, to hang in through such daily adversity. I’m interested to know what weighs on the other side?
Wish I could be there to help. I’ve seen a number of your posts and you are always compassionate and smart and insightful. I hope you can continue to hang in there and share your wisdom with us and anyone who will listen.
The APA appears to be a branch of organized crime at this point. It is astounding that it never seems to occur to them that the reason they are “perceived” as having a conflict of interest is because they DO have a conflict of interest. And that the reason their profession isn’t trusted is because it has proven untrustworthy over time. After all, how much can you trust someone who thinks an electric-shock-induced seizure is a “treatment” for depression?
They are criminals, plain and simple. They want your money without providing a product of value, and they know that is the case. They can justify it all they want, but that’s criminal behavior.
You’re right about corporations, especially in the USA – one of the biggest problems is that they’re viewed as “people” based on past court rulings, and as such, have “free speech” rights that include bribing, oops, I mean contributing to politicians’ political campaigns in a completely unrestricted manner. This is part of how the government has been increasingly sold off to those monied interests.
Trade is the foundation of civilization, and money is supposed to represent the labor underlying the efforts at developing and trading goods, as well as the risks assumed in bringing goods from where they are plentiful to where they are scarce, etc. What is so unfortunate is that there are so many making many billions off of products (like psych drugs) which don’t actually benefit the recipients, or who “make money” while producing nothing at all, which takes money away from the honest traders.
Hey, I like that last one. Inside each cynic is a romantic utopian at heart. I’d be happy to live on the same platform with you!
You might be right if businesses were answerable to the communities they serve, but they aren’t. The levels of pollution are just one excellent example – industry has traditionally polluted the environment with impunity. They have no incentive to do otherwise, except for small businesses that have to be accountable to their constituency and drink the same water as their customers. If there were no government to tell the big corporations to stop polluting, it would be up to each individual consumer to investigate and understand the nature of that company and decide to purchase the product of someone who doesn’t pollute. Not realistic, especially with the media picking and choosing the stories they cover under the influence of advertising dollars from those self-same industries they’d have to rat out.
There are no “free markets” in this world economy. My biggest objection to government these days is that they are owned by these very corporations who supposedly are so interested in making our lives better, and the governments take money from those who can least afford it and spend making laws and regulations to support and empower those who need it least.
I’m not a big fan of the welfare state, but things are so screwy at this point that the average person in the USA can’t afford healthcare without insurance coverage. (Naturally, this situation was created in the USA at the behest of the insurance industry, and they’re making lots of money while US healthcare outcomes are the worst in the industrialized world.) Whatever you may feel about the NHS, and I understand they’re a bureaucratic mess, I guarantee it is better than the multiple bureaucratic messes that comprise the US system that costs far more and delivers far less than the NHS users can probably imagine.
Simply removing government and letting the corporations have their way is not the answer. It’s actually part of how we got the mental health system we’re all so upset with – the pharmaceutical industry got control of the psychiatric profession, and now profits are more important than patients. I wish trusting the capitalist system were an answer, but I’m pretty clear that the current low-accountability high-profit business system is more the problem than the solution.
If I might venture a thought on this point, I believe we all have an inherent desire to be creative, to experiment with life, and to rebel against those who would restrict us from doing so. Unfortunately, when the entire society appears to conspire to restrict us from living and creating and making our own decisions, the conflict can be overwhelming and lead to what are now termed “mental health issues.”
I certainly experienced this in the school environment. I had my own world of thoughts and wishes and fantasies and emotions, all of which was clearly not welcome in the school environment, and I felt I would quickly be punished by both the teachers and my classmates for letting any of that out. So I was very shy and anxious and pretty depressed throughout my elementary years, leading to a brief “outburst” in 5th grade at Valentine’s day, where I put a “fuck you” message inside a classmate’s valentine and was busted for it. (Interesting that I chose Valentine’s Day as a time to give my rebellion voice, as to me it seemed to represent both a need to pretend to like people that I didn’t, and a competition for social attention at which I did not excel and didn’t really want to participate. This was before the days where kids had to make valentines for everyone, and my box was always one of the emptier ones.)
I ended up seeing a psychologist for an evaluation and getting “special attention” for what today would certainly have been diagnosed as a “mental disorder” of some kind or another, and would surely have resulted in some kind of recommendation for “treatment.” But it’s clear to me that my internalized anxiety was a result of an resolvable conflict between who I was vs. how I was expected to behave by the authorities. I was clearly in passive rebellion from the first day I arrived at school in Kindergarten, and would have done almost anything to escape from that oppressive environment, where I was expected to kowtow all day to the arbitrary demands of teachers who didn’t know me nor seem to care to know me and simply seemed to care about making me do as I was told, and where I was forced to associate with kids that I’d mostly never have even talked to if left to my own devices. But I was impotent to make any kind of change to that environment, and simply had to go, day after day, week after week, year after year, suppressing any outward expression of what was really going on internally and acting as if nothing was amiss. It is a small wonder and a credit to my internal self-discipline that I didn’t act out more violently much sooner. But of course, no one would ever have given me credit for 5 years of self-restraint. My one small act of rebellion was the focus, rather than the years of suffering that led up to it.
I think this mechanism leads to a ton of anxiety and depression that is not necessarily linked to another obvious cause. Naturally, other traumatic events that may have happened in someone’s earlier childhood contribute to how a person might choose to act in such a situation, and I had a few of those, but nothing too severe compared to what a lot of folks have tolerated. Yet the school experience welded into place a style of responding to the world by suppressing my true impulses, feelings and thoughts in ways that affect me to this day, and that transcended any personal issues I might have had prior to entering the walls of that institution. It literally made me nuts!
This fits into Bruce’s “internal rebellion” theory very nicely, and takes the explanation of “mental illness” beyond the realm of personal trauma and adds the impact of an oppressive and sometimes seriously abusive social structure as a huge contributing factor.
Bruce, I loved the article! A very timely reminder that rebellion against an oppressive society will always be attacked, but when “mental health” means submitting to an insane system, then the only sanity is to rebel!
Without even addressing the subjective and speculative nature of the “ADHD diagnosis,” even if we accept uncritically that some people have this “disease,” the “treatment” has been shown at best to be helpful in suppressing symptoms for the short term. There have been hundreds of articles and at least half a dozen thorough reviews of the literature, starting with Barclay’s own review in 1978, and none of them have ever shown any long-term outcome being positively affected by long-term stimulant use.
I raised two classically “ADHD” kids without any thought of drugging either one of them, and both ended up honors students in high school, highly successful athletes, and the youngest has developed into quite the social butterfly, while the oldest has been steadily employed for over 10 years by the same agency. No drug abuse, never fired from jobs, no high-school dropout or delinquent behavior from either one. The youngest is poised to start into college next year.
ADHD is not a disease, and stimulants are not a treatment. They are a way to suppress annoying behavior that many boys exhibit when forced to sit in a chair all day and do boring things. ADHD kids who are placed in open classrooms were indistinguishable from “normal” kids, so naturally, we put our kids in open classroom settings in elementary school, and their “ADHD” magically disappeared.
It is amazing that we have such broad participation in such an amazingly unscientific sham!
Sounds like you’ve got plenty of insight to me, into the total conflicts of interest that drive most of this field. The system is really more invested in you having LESS insight. Their definition of insight is “the wisdom to realize that you’re better off doing things my way because I can punish you if you don’t.” I suppose that’s insight of a sort, but doesn’t have much to do with “mental health!”
Wow, this is just fascinating! Weight gain is indicative of improvement (more weight gain is better), and cognitive impairment, which is clearly caused and/or exacerbated by SGA “treatment,” is the biggest problem he wants to solve by more SGA “treatment.”
When 70-80% of your treatment recipients discontinue treatment, it’s time to reconsider if your treatment is all that helpful.
I think he has a delusional disorder, and needs a depot injection himself!
Bob, thanks for hanging in there and having the courage to continue speaking despite the crap you’re being unfairly given. I posted on the website to register my dismay with the characterization of affairs as somehow being “your fault.” Notably, there is no blood, but there is a lot of fear and drama. On one level, I understand the tremendous anxiety these parents feel as they are unable to control what they feel are bad decisions by their own offspring. On the other, that need to control is part of what is wrong with the system and is most likely contributing to their children’s ongoing distress. They have been heavily brainwashed and don’t really see other options, and are so invested in their views that even the idea there might BE other options creates immediate defensiveness, perhaps because of their own guilt that they really do know they and the system may be failing their adult child.
It is somewhat ironic to hear this “blood on your hands” rhetoric when the treatment these folks so fervently defend is killing off its recipients many years prematurely. It seems very reasonable that a person receiving such “treatment,” especially for such subjective and potentially spurious “disorders,” might consider dying early and being miserable in the present a pretty poor tradeoff.
Bottom line, speaking the truth has gotten lots of people in trouble throughout the millenia, especially when the truth threatens the power base of the status quo. The fact that people are attacking you means you’re having an impact. Keep up the good work – you are making a BIG difference!!!
Thanks, Donna! I always enjoy your replies as well, factual with a good dose of passion and personal experience. I consider your stamp of approval to be a very high compliment, as I know you wouldn’t hesitate to tell me if I had my head in a dark and smelly place!
And again, I have to point out that these people are dispassionately talking about killing people, and arguing more about the mechanism than about whether they ought to just stop doing it. How do you do a risk/benefit analysis when 1/20 of your patients will die earlier as a result of your “treatment?” It seems very unlikely that the patient is conferred any benefit, unless they are already terminal and you’re providing palliative care. But anybody that considers an atypical antipsychotic as “palliative care” is delusional.
It disgusts me that these people can be so cold about the fact that they’re ending people’s lives prematurely!
Not to mention that there is a Black Box warning on the atypicals that it can cause early death in elderly dementia patients. So he’s mad at Haldol because it kills patients more quickly than the atypicals kill them? I suppose you wouldn’t get as much profit if they died sooner…
Which seems to be the exact opposite of what the current practices are attempting – instead, we’re being encouraged to “split off” anything uncomfortable, and if we can’t, to drug it into submission. There will be NO shadow selves in THIS society!
I remember reading about a culture, I think in the Pacific islands, where the first activity at breakfast in the morning was each person relating what they’d dreamed about the night before, in a very accepting atmosphere of interest. It did not surprise me that the article went on to say that these folks were among the most peaceful cultures on the planet.
Dreams are fascinating and informative, and it’s disturbing and indicative of where we’re at as a culture that sharing of dreams has dropped out of therapeutic practice. I definitely shared dreams with my very competent therapist as a young man, and if nothing else, they gave me a clear indication of my progress in therapy. I remember one in particular, later in therapy, where I dreamed of meeting a very ugly, stupid, diseased-looking person who looked something like me. I remember seeing him and wanting to turn away, but instead, deciding to greet and embrace this “unacceptable” version of myself. It was a very powerful moment – brought Jung’s “shadow self” right to mind. I knew at that point that my therapy was drawing to a successful close.
Thanks for reminding us of the power of our dreams. It’s interesting that “dream” is also synonymous for imagining a better future for ourselves.
Marijuana in larger doses did eventually start making me paranoid (though it only started after an incident where someone had slipped me another hallucinogenic drug). I have heard this from other users as well. I think it is very possible marijuana can trigger psychosis, especially if used long-term or with other drugs (including legal psych drugs).
That being said, I agree with you, the legal drugs are far more likely to cause psychosis and other problems than marijuana ever could. In fact, marijuana in low dosages is probably a more effective “antidepressant” or “anti-anxiety” drug than anything on the market, and it certainly has a much milder side effect profile! The problem, of course, is dosage control, but as we see with the incredible rise in prescription drug abuse, that problem exists with almost any psychoactive drug.
So I agree, it makes no sense to give kids amphetamines and then be worried when some of them smoke pot. I’m a lot more worried about the speed!
Wow, thanks for that moving story of growth! I related on so many levels. While I did not experience much in the way of overt abuse, I was definitely the secret-keeper and confidante and caretaker in the family, and learned early to be “not very demanding” in order to feel safe and feel liked and valuable. I was the “good kid” and made my parents happy that I didn’t make a lot of trouble for them, and I bought into that role.
I agree 100% that most of what passes for “mental illness” is the result of children needing to play adult-like roles and in some way care for their own parents’ emotional well being. This goes well beyond “trauma-informed” practice – it is about the day-to-day strain of having to be a certain way in order to feel safe or accepted. Have you ever read anything by Alice Miller? She articulates this idea so very effectively, she’s definitely worth reading.
I have also seen the healing power of people speaking out about their experiences. I work a lot with foster kids, who have generally been through hair-raising experiences beyond most people’s comprehension, both before and after entering foster care. I’ve seen real transformations when these kids are put on a panel to talk to adults about what it’s like to be in foster care and how the grown ups can do a better job. Finding their voices and having people actually listen and want to hear what they have to say is tremendously powerful and healing for many of them.
My biggest complaint about the psychiatric system isn’t the drugs per se – it’s the constant message that we need to shut up about our uncomfortable feelings and experiences. Being labeled and drugged reinforces earlier experiences that say, “These are the authorities and they must be right, I must not upset or disagree with them, I must not anger them or I will be hurt.” The psychiatric industry appears to be bent on getting people to be quiet and act “nice,” whereas the real path to healing helps people get a whole lot louder and, if not less nice, more willing to let other people be upset if they so choose. It’s a long road and can be lonely but leads to a better kind of life, in my view.
So thanks for sharing, and keep walking that path. So glad you’ve found your voice and are letting it be heard!
I would say that a lot of good counselors don’t get funding, and a lot of really bad counselors continue to work for agencies for a long time, especially when involuntary “clients” are involved. I’ve worked with a lot of these agencies, and most don’t know a good counselor from a bad one. Also, the training for counselors these days is really limited, with way too much emphasis on diagnosis and “techniques” of “evidence-based medicine” instead of a proper focus on relationship-building, empowerment, and sensitive and intelligent exploration of current needs as well as of traumatic events that may contribute to the current situation. Good counselors also recognize multiple factors that impact mood and behavior, including basics like food, sleep, and exercise.
In short, there are good counselors out there, but there’s no guarantee they will be funded or promoted or even allowed to continue to work at a place where they may be too threatening. I’d say that mediocre to poor counselors abound and are probably much safer in their positions than the really good ones, because any really good counselor would find the current practice parameters ridiculously restrictive and often quite destructive and would try to change them, which naturally would upset his/her bosses or someone up the food chain who is invested in the status quo.
Bottom line, I believe a really effective counselor is bound to have a subversive impact on entrenched bureaucracies, because they’d be focused on the needs of the client vs. the needs of the institution. Such behavior is rarely rewarded in the system.
“Psychiatrists may be unaware that abuse can precipitate a patient’s psychiatric symptoms. “We are trained to diagnose psychiatric disorders without looking at the social context that might have generated the patient’s symptoms,” said Warshaw.
Psychiatrists fail to ask about abuse because they don’t think it is prevalent among their patients, don’t have the time, and don’t know what to do if they identify it. They may also find it difficult to tolerate the pain and helplessness they feel when patients talk about their experiences of abuse or when their own traumatic experiences are evoked, said Warshaw.”
Is that not pitiful? But I find it 100% true. It’s all about the “doctor” being uncomfortable asking the question, or genuinely being so incredibly ignorant as to believe that trauma has nothing to do with a patient’s symptoms, or somehow idiotically believing that abuse is rare among their patients. Do they read ANY research? Do they not know that 1/3 of all women are sexually molested or abused at some time in their lives? The first question to ask any client in emotional distress, beyond the details of their current situation, should be about what has happened to them historically.
I’ve seen this hundreds of times, too, so I know it’s not idle speculation. When I did evaluations for involuntary detention, I found that probably 3 out of 4 women diagnosed with bipolar disorder had obvious, easily accessible trauma histories that they were happy to reveal with a couple simple questions and some good listening skills. This included childhood sexual abuse, rape, and current or very recent domestic abuse. But the psychs were much more COMFORTABLE diagnosing “bipolar disorder”, probably because they could “treat” it without having to actually get to know the patient.
It is disgusting to me that this kind of article would ever need to be written. How can someone be a psychiatrist and not know that trauma is incredibly prevalent and that it has a direct, causal relationship with “mental illness” symptoms???!!!
Thanks for this refreshing counterpoint to some uncomfortable discussion regarding NAMI posted recently. I love what you’re doing and think it is truly the way to move toward a new paradigm. Institutions can’t answer these questions – people need to answer them together and tell the institutions what is needed. I find myself feeling much more hopeful after reading your blog. We can do this! All of us who care can do it together.
I have certainly seen local NAMI chapters who are very supportive of real change, and others (probably most) that are very married to the current paradigm. NAMI as a national group has been quite reprehensible, and I would really want to see some evidence that they are really distancing themselves from their pro-pharma propaganda that has characterized them over the years. That being said, I’m not opposed to a rapprochement with NAMI if there is a genuine desire to explore alternatives. But it would require some acknowledgment of the damage done and some effort to make amends to those who were harmed by NAMI’s historical rhetoric. I admit, I’m skeptical that such a thing could happen, and I also agree 100% that a “forgive and forget” attitude isn’t realistic, given the real harm that NAMI has done to those it has purported to help.
Having Ms. Myrick chairing the board does help me believe that some change is possible. And I don’t want to write off the entire rank-and-file of NAMI based on its historically misguided leadership. As the stories in the article clearly indicate, there are some allies in the NAMI ranks. But the leadership has got to move off their pro-drug, pro-incarceration, E. Fuller Torey “Anosognosia” kick for any real collaboration to happen.
Well said, Sandy! There are tons of ways to improve brain functioning or make it worse. Antipsychotics are a crude tool used to attack a crudely-defined problem in a very crude way. They appear to make brain functioning worse rather than better. I was just reading another blog about how the Quaker “asylums” that involved fresh air, exercise, calm companionship, and a calm environment were more effective by far than anything we see today. Were the Quakers improving people’s brain chemistry by love and support? You bet they were!
The idea that the psychological impact of the environment can somehow be extracted from a person’s life and that we can work on brain chemistry physically without regard for that psychological environment is the primary fallacy that has led us down this destructive path.
I don’t know that their position is all that hard. I think they put themselves in a hard position as a profession by asserting things that aren’t true. It seems to me the research is pretty clear about what it suggests, even if the reasons are unclear: the less medication is prescribed (on the average), the more likely it is that the client will be able to maintain a functional social life, and the level of “symptoms” will be relatively unaffected. This is what the Soteria House experiment demonstrated rather conclusively back in the early 1970s. The results haven’t changed since then. If you care about the client’s ability to function in society, the results are fairly clear.
If psychiatrists are honest about what the research says, it seems clear that they will need to be much more conservative about prescribing antipsychotics, even if they believe 100% in the “chemical imbalance” theory. It appears that “antipsychotics” don’t rebalance dopamine, they appear to throw the balance off. So if antipsychotics are used, they should not be first line interventions, they should be used at as low a dose as possible, and clients should be weaned off as soon as is practical to do so. Much as they do in the Open Dialog program, which has the world’s best success rate with “psychotic” clients.
Most people spend most of their time on an unconscious level, unfortunately. By the end, if something like real peer work does become a part of the system, there will be hundreds of people who will believe it was their idea in the first place or that they worked hard to make it happen, even though they vigorously opposed it in reality. I’ve learned long ago as an advocate to stop caring if those in power understand what I’m talking about, as long as they do the right thing. If they want to believe it was their idea or that they somehow made it happen, I’m happy to let them save face.
Though in this case, the concept that clients actually have experiences that may be different from what the MH “professionals” expect is one that perhaps does need to reach some level of conscious awareness. The main reason most people stop “taking their meds” isn’t resistance or “anosognosia” or “thinking they’re better and don’t need it any more” – it’s because the damned things make them feel like crap and often don’t work or make them worse! Not sure how many peer specialists it would take to make that point. It should be obvious by talking to the clients and asking them why they stop, but that would require we view clients as human beings capable of making rational decisions. Which would be a TOTALLY radical concept!
I think it’s important to distinguish between blame, which I find tends to keep us stuck, and correct assignment of responsibility, which I find tends to free us. To blame someone else for how you feel tends to make it difficult to escape the fact that you can’t change what they did to you. It can become a long-term bitterness from which it is hard to escape.
However, appropriate anger at someone for acting destructively can energize us to defend ourselves or attack the correct target to assure that we or others are not abused further. In my experience, it can sometimes be critical for someone with a history of abusive relationships and interactions to learn how and when to contact and use their anger for purposes of self-protection and the promotion of justice. Often, it has not been safe to feel or act on their anger due to the dangers of the abusive environment, and they have learned to suppress anger in exchange for self-blame. Undoing this suppression can be the most important aspect of learning a new way of being in the world.
Blaming others for our anger is seldom helpful. Choosing righteous indignation at abuse or injustice that we have experienced can be incredibly powerful and effective in helping us be motivated to take action against those who are willing to abuse us for their own gain, or simply out of their own ignorance.
As usual, you hit the nail on the head. And no, I didn’t roll my eyes, and don’t think others will, either. Co-optation is a time-honored strategy of those in power to de-fang a protest movement, often employed when direct oppression has been unsuccessful. So perhaps attempts to co-opt should be considered a good sign, as it suggests they’ve given up on y’all going away. But giving in to co-optation is not an option. As Steven says, it’s all about POWER. What real peer support does is empowers clients to make decisions for themselves, which is exactly the concept that the MH authorities want to snuff out. So they hire “peers” and re-define the role into one of coaching their less-powerful “peers” into toeing the party line, taking their meds and “accepting their disability” like a good slave, oops, I mean patient, oops, I mean CONSUMER ought to. Kinda like the inmate prison warden who gains privileges by enforcing the prison rules on his/her “peers” in the jail. You stop being a “peer” the moment you have and are willing to exercise institutional power toward those who don’t have it.
Thanks as always for an insightful and memorable piece.
I have seen first hand in my work (with the CASA program) how many foster kids have “bipolar disorder” diagnosed following “treatment” of “ADHD” with stimulants, and sometimes following SSRI prescriptions. I’ve also seen many “recover” when they stopped these drugs on their own. It is a common occurrence.
I agree, it is criminal, and Biederman and others who knowingly perpetrate this nonsense for personal financial gain should be jailed.
You are right, of course. I should have put “cure” in quotes. I was using her words, but should be more careful to be clear that I don’t see any “mental illness” as a disease, and hence don’t see them being “curable” any more than playing with one’s mustache or eating vanilla ice cream is curable. Thanks as always for reminding us of the power of language to shape how we think.
At first, I thought this was an attempt at humor regarding the “diagnosers,” suggesting that they were “dependent on diagnoses” and that such dependence had a neurological underpinning. Might yet make a great article for The Onion or some such farcical publication.
I’ve seen this phenomenon too many times to catalog. My favorite is a kid in residential treatment who was said to be “sexually acting out.” His crime? He drew pictures with large penises on them, and he engaged in “sexualized talk with his peers.” His age? He was 12 years old! Ever know a 12-year-old boy who wasn’t fascinated with penises, or didn’t have sexualized talk with his peers? But because he was in a “mental health facility,” this normal behavior was labeled as aberrant.
Glad someone is reporting on this, but it’s kind of obvious that it happens, which is why an objective measure of health/illness is critical before we “diagnose” people. Otherwise, any prejudice we entertain can become a “disorder.” Which is pretty much what the DSM is all about.
Well, and how about Open Dialog? Sounds like a lot of “schizophrenia” (whatever THAT really is) has been cured by human support. Soteria House is another example. In fact, simply living in Brazil seems to be helpful, as they don’t use many drugs, and may possibly be less judgmental of those who are hearing voices, etc.
And I think there’s been some data supporting that even cancer is impacted by levels of social support.
Just because our experiences have biological correlates, doesn’t mean that these correlates are casuative of our experiences. Jill is sounding like a reductionist, which she’s entitled to be, but that’s a philosophical viewpoint, not a scientific one. She would have to explain in biological terms exactly how and why talking to or listening to someone in a calm environment reduces these supposedly biological symptoms.
One last comment – I’ve talked to lots of very agitated “schizophrenics” in delusional or hallucinatory states. I have found that the vast majority were very capable of communicating me if I was willing to listen to what they had to say first. Not that it was always easy to sort out what they meant, but making the effort almost always created a calmer situation. And sometimes, they made a whole lot more sense than they were being given credit for. They mostly needed to know that I cared about trying to figure out what they were trying to communicate. Which seems pretty normal to me.
That’s exactly what I was saying, Cataract. The other staff who are there need to intervene whenever something inappropriate or dangerous happens. If they don’t, they’re complicit. It’s that simple. I understand why the clients/inmates don’t feel safe to intervene, especially if the other staff stand by mutely, but if the staff intervened strongly, the inmates might feel there is some chance that adding their voices to the effort to stop the abuse might have an impact.
It is very challenging to talk about these things, especially if you’ve been a victim of this kind of abuse, and I very much appreciate you taking the time and energy to reply.
What an amazingly narcissistic quote! Because the patients don’t want to hear that the psychiatrist has no idea how the medications work, the psychiatrist pretends that he does, even though the truth is that he doesn’t. Sounds like lying to me, and lying not for the patient’s best interest, but lying to avoid the patient discovering that the doctor is not all-knowing and wise. Lying to meet the needs of the doctor.
So many better things happen for the patient when the doctor can admit his lack of a solution! They can work together to think over some options. The patient and doctor can both do some “homework” and come back together later to discuss what they discovered. The patient can come to the realization that s/he may have more power than the doctor to address the issues. The doctor can learn some humility and maybe discover a new approach that no one has thought of before. But we avoid these possible benefits, all to preserve the doctor’s false narcissistic image of perfection and elevated knowledge. The patient takes drugs the doctor knows don’t really help and can harm, all so the patient’s faith in the doctor is preserved. But what happens to that faith when the patient discovers that the doctor is full of crap?
I agree that most of those who tell this story are religious “scientism” true believers who are able to explain away or ignore research that is contrary to their epistimelogical mythology. But we also should remember that there are some, mostly in the higher echelons of power, who actually are quite aware of the deception and are actively promoting it because they are profiting from it. Those are the ones who have to be found and attacked. The drug companies are, of course, where many are located, but there are those in the psychiatric hierarchy who see this as an effort to gain “market share” and have no concern whatsoever for truth or patient safety or informed consent, as long as they are gaining power, prestige and money.
The bullying literature also emphasizes the importance of engaging the bystanders in taking a stand. There is no such thing as an “innocent bystander” – silence is interpreted by the bully and other bystanders as support or at least acquiescence. We really need to get those who see the brutality of this kind of behavior to speak up, including those IN the facilities who feel afraid to speak up because they will be the next ones bullied if they do. Not sure how we do that, but your comment made me think of that point.
Indeed. I was such a worker for 9 very long and difficult months, and did everything I legally could to spare or release the inmates, and was actually quite successful in doing so. But it weight heavily on my conscience to commit even one person to that horrendous institution. It sometimes seemed it would be kinder to just go ahead and let them kill themselves. The psych ward is a sick place, and the analogy with a concentration camp is apt.
Actually, whatever else one might say about L. Ron Hubbard, he’d have agreed with everything said in this blog. He considered psychiatry to be the most barbaric practice on the planet, and viewed psychiatrists as a long-standing group of evildoers behind most of the ills on the planet. I always felt that last was rather extreme hyperbole, but there are times I wonder whether he was right after all.
Anonymous, thanks for your passion for this issue. You are right, as the saying goes, you can’t negotiate with terrorists. While there are many individuals within the profession that have a heart, the core of the profession is invalidation, power, and coercion, and it does untold damage to millions planet-wide, and is in my view irredeemable.
I agree, “meds” seems to somehow make the dangers and side effects seem benign. It’s especially obnoxious when applied to kids. Makes my skin crawl, too.
Quite so. Most of the movies that show psychiatrists show them doing supportive therapy work (take “Good Will Hunting” or “Ordinary People” or even “What About Bob?” as examples.) I am sure many are quite surprised to learn how they are encouraged to distance themselves from the actual people involved and to view the client through the lens of their “symptoms.” I am encouraged to know that you and others are questioning this paradigm rather than accepting that the adult authorities must know what they’re talking about.
I just hope you and your colleagues can do some “inside work” to support what others on the “outside” are doing. Glad to know also that other docs are looking for alternatives as well. It seems your challenge is to overcome your training, rather than to implement it!
Thanks for having the courage to speak about this issue. It is not surprising to learn that you get no training in withdrawal, and it reflects the reality I see in foster care: children are almost never taken off of any psych drug without vigorous advocacy, even if the drug is clearly having no positive effect or doing damage.
I was surprised at your reports of increasing skepticism in the ranks of new practitioners, as well as a resurgence of the radical concept of actually talking to clients in a supportive way about their needs and concerns. I 100% support your belief that the recovery of a sense of personal agency is critical to survival and recovery from any mental/emotional distress.
I hope you can be a “virus” in the machinery of psychiatry, and encourage your colleagues to do so as well. The idea of listening to the experiences of those victimized by psychiatry is the beginning of learning a new path. Again, I appreciate your courage and humility. Keep your ears and eyes open and your mouth shut as often as possible, and you can be a huge agent of change.
Not saying he’s a “victim,” I’m just getting tired of reading about it. I usually skip most of his stuff, because a lot of it is written by someone else, and frankly, it just takes too long to read. But now I have to read more about how long his posts are, which is more I have to not read. It gets dull.
Can you guys please stop beating up on David? I think we get the picture. I’m getting tired of it. I think David gets that if he writes less per post, more people will be likely to read it.
I might start counting the number of posts about the number of words in David’s posts…
That is an awesome point! If someone using antipsychotics as an “adjunct for depression” and their brain volume also decreases, you can’t very well blame it on schizophrenia, can you?
Wow, that is a major study! I’m sorry the Vatican conference didn’t provide what you expected, but politics reigns, even at the Vatican. Studies like the one you just mention are so important in countering these political/economic messages that are so self-serving to the ruling class. THANK YOU for continuing to fight the good fight. I know you get discouraged, but you continue to inspire me and others to keep going when we get discouraged ourselves.
Thanks also for this new study – I have every intention of making full use of it. I’ve been saying for many years that there is no evidence of long-term benefit for stimulants, but this is the first time I can say there is definitive evidence of long-term damage. Let’s get this study as broadly distributed as possible! Given the new DSM controversy craze, would someone from the NYT be interested in this latest research?
I am not saying that nobody fits the criteria that define ADHD. I am saying that calling it a DISEASE or MENTAL DISORDER is not legitimate. I am saying that genetic diversity is the core of species survival, and that many of those who get the ADHD label are simply one variant (or probably a huge range of variants with this behavioral overlap) of the genetic options available. My kids struggled in many ways, but they were also incredibly gifted in many ways. There may be a very unusual case here or there that involves actual damage to the brain, but for my money, “unable to focus” is not necessarily a disease or disability, it’s just a fact of life some people have to deal with, like running more slowly than others or having a genetic propensity to carry more fat. We all have our challenges, but this particular one is 95% created by our classroom expectations.
There was a great study done back in the 70s where they put matched “ADHD” kids in an open classroom vs. a standard classroom, and asked professionals to identify which children had the label. In the standard classroom, they hit over 90% correctly. In the open classroom, they essentially could not tell the difference. Pretty dramatic results, eh? So ADHD appears to disappear when we change the classroom structure.
Of course, there are some kids who don’t do well in an open classroom. You’re right, there is no “one size fits all” school. But I wouldn’t take the kid who couldn’t function in the open classroom setting and call them “overstructured” and put them on a drug to make them better able to tolerate the classroom. I’d put them in a more structured classroom. It’s not their fault they don’t do well in that setting, and it’s not the “ADHD” kids’ fault he doesn’t do well in the standard classroom. It’s high time the adults realized that it’s our job to adjust the environment to meet the needs of the kids, not the other way around.
By the way, I’m really sorry you didn’t get the opportunity to learn in an environment like our youngest son has had. I know it would have made a huge difference to you. It’s very child-centered and adapts a learning plan for each kid, plus you get to sign up for what you want to or create your own projects, and you get to work in groups or even create your own classes. It’s the perfect environment for the active and intense kind of kids that usually get whacked with that label.
Anyway, I appreciate your respectful response, and absolutely accept that you have your own framing of your situation and would not want to take that away from you. What I hate is when someone foists their own view of “normal” on someone else, just because they don’t fit the other’s expectation. It’s particularly irksome when that person has power over the victim and chooses to use it to degrade and diminish rather than to understand and create. So I get passionate about it.
You sound like an awesome human being. Well done for surviving your “education!”
It made me very sad to read your post! I have always valued your posts and found them very rich, direct, and real. I think you have a great deal of understanding and compassion for those who have to actually experience the system, rather than talk about it and speculate about theoretical perspectives.
If I have said or done anything that contributed to your feeling drained of energy, I apologize for doing so. I hope you’ll still hang around and drop in your comments sometimes. You will know that I appreciate them.
I would not argue with your general observations. Obviously not ALL “ADHD” kids are anti-authoritarian, nor are all who are labeled “mentally ill” anti-authoritarian, either. However, I would dispute the idea that because someone “cannot focus one moment to the next” they are “legitimately ADHD.” There is no legitimacy to a “disorder” that is diagnosed with a checklist invented by clinicians sitting around a table voting on how many criteria are needed to justify a “diagnosis.” There are all kinds of people in the world, some of whom are happy to and capable of focusing on whatever you ask them to, some of whom can’t or won’t focus on things that are not of intense personal interest to them. Why are the latter classified as “disordered?” For the simple reason that they are INCONVENIENT for the authorities. Which goes back to the author’s point.
I raised two kids who had a very hard time focusing when they were in early elementary school. We wisely avoided standard classrooms and used homeschooling and open classroom alternatives. Both became very successful academically and athletically, and the younger is very socially popular at his high school, while the older is a hard-working and successful employee of a community helping organization. I never believed there was anything wrong with them because they could not/would not sit in a desk at the age of 6 and fill out worksheets handed to them by harried and overworked teachers.
Interestingly, the oldest is pretty authoritarian in some ways, while the youngest is extremely anti-authoritarian. But both fit the ADHD criteria to a tee at 5 or 6, neither received any “treatment” besides some very creative parenting, and both turned out to be good and successful citizens of the realm. Doesn’t sound like there was anything wrong with either of them, except that they didn’t fit into societal expectations of what makes a “good student.” Which is pretty much the definition of “ADHD” – “Annoying in a standard classroom” and “impatient with the dull and the arbitrary.”
I can completely relate to your comments, as an ongoing participant in “the system.” To hear the words “Positive Peer Culture” was a balm to my soul! I worked residential/day treatment in the 80s, and we also used to have the (these days) radical belief that children made decisions and that their behavior met a need and that they were responsible for their own decision making. I actually avoided any training in the MH area until AFTER I started working in the field (for some odd reason, they felt a Masters in Education qualified me for working with the “emotionally disturbed” teen moms in our residential treatment center), so I was primarily self-trained, and based most of my principles on what I observed. It was many years later before I discovered I was an Ericksonian.
Anyway, I also watched the deterioration of responsibility and the dramatic increase in the use of “meds” and the increasing chronicity of the population. I remember in the 90’s people starting to say, “We’re seeing much more serious situations than we used to” or “These kids have much bigger issues (usually more violence) that the ones we used to see.” I did not at that time understand the likely connection with the increasing use of drugs to “treat” these kids. But I think its clear looking back that these trends were intimately connected.
Today, I work as an advocate for foster kids (my last job in the MH industry was back in 1995). When I see the res units today, I see a lot of people who have no real idea what they are doing. They still have level systems everywhere, which are mostly based on compliance and punishment. There is little to no creativity. Kids that don’t respond to this structure are either put on meds, or their meds are increased, or they get put on new meds in addition to the old ones. Kids are on 4, 5, or more “medications” and are still attacking staff and peers and breaking windows and self-harming and threatening or completing suicide. No matter how bad their behavior gets, no one ever seems to observe the obvious: if these “meds” were working, they should be getting better, not worse!
How anyone could say the benzos are not addictive is baffling, but I do hear that sometimes, and I see people (mostly adults) prescribed Klonapin or Ativan or Xanax for many years, even though the product information itself says that use for more than a few weeks at a time can be dangerous. So they don’t even follow their own “medical” information!
I find it most discouraging. It is particularly ironic when these folks who deny reality in order to maintain their “system” accuse folks like you or me of “black and white thinking!”
But it’s good to talk to someone who remembers the “old days” when we still had a focus on helping kids manage their own perceptions of the world and the effectiveness of their own decisions, and where behavior still had meaning beyond the chemicals involved. Thanks for sharing your perspective and reminding me of brighter days. I know we weren’t amazingly helpful, but at least we didn’t (for the most part) make people worse or create addicts out of distressed individuals who needed love and guidance!
Don’t know if the pancakes turned out to be any good, but it sure looks therapeutic! I particularly enjoyed him/her stirring with the telephone. That would SURELY get you an injectable dose of Prolixin on most psych wards!
OMG, a GUITAR on the ward? What is wrong with that guy, to think that something as mundane as SINGING could make people feel better… Oh, oops, it seems to be working… OK, now we need to get rid of him, he’s making us look bad!!
There ought to be orchestras in the psych ward, choruses and solo performers and art shows and story reading and baseball games. They are just grim, dead places that would depress anyone. Too bad guys like Steve are so threatening, but I guess that tells us all where most of the system is coming from.
Yeah, it’s too scary for most of them, because they haven’t faced their own demons. That’s why the DSM is so destructive – it enables the labeler to distance him/herself from the labelee and decide that the client’s behavior/emotion/experience is just WRONG and needs to be stopped. Which, of course, is the primary justification for enforced and/or manipulated drug prescriptions. If the “bad behavior” can be stamped out, then the clinician feels better, regardless of the impact on the client. To me, the opposite of real therapy.
Giving someone credit for having come up with good survival techniques is very powerful and helps connect being-to-being, as you so eloquently say. But the therapist has to be able to tolerate a lot of uncertainty and discomfort and be OK not knowing what to do for a while if they want to really connect on that level. And most are not capable of it, even if they wanted to. Which is sad, because they really miss out on the beauty of seeing someone REALLY improve instead of just suppressing their “symptoms” (aka normal reactions to abnormal circumstances).
You had me rolling out of my chair with this one! The Nurse Abuse Line, Self-Harm Sindy! And I loved developing your own phrases for the group! Not only amusing, but it would definitely be helpful to break out of the mold like that and see some HUMOR in the situation. I remember being on the psych ward one time in the day (I did involuntary detention evaluations, and tried to let everyone go by providing them brief therapy in the ER, but I usually worked nights), and I was immediately struck by how damned SERIOUS it was! All the psychiatrists had grim looks on their faces, and the nurses seemed to be very cautious not to be loud or say anything “inappropriate”, most likely for fear of provoking an attack from one of the psychs. It was kind of scary! Can’t imagine how anyone could heal in that environment. I had to quit that job pretty quickly.
Anyway, it feels like you’re a kindred spirit, and I hope I have the pleasure of meeting you one day. I’m glad you found your voice and let your anger guide you to fighting off the real enemy, namely, anyone who tries to define who you are and how you should behave for you, regardless of their degree. I think real healing has to involve recognizing the oppressive nature of the entire social system we’re living in. A lot of “insanity” happens because people see what’s really happening and everyone around them is pretending it isn’t real. Those of us who see what’s really happening have to stick together.
As the saying goes, “You’re not paranoid if they really are out to get you!”
I actually don’t view any emotions as “negative.” I think all emotions have survival value. They contain important messages regarding our safety and need to take action to protect/defend/support ourselves. Admittedly, our emotions haven’t really adapted to the realities of our bizarre modern world, so they can be pretty confusing, but they are there for a reason. Anxiety helps us avoid dangerous situations. Anger helps us win when we have to fight for our safety or to feed ourselves. Depression helps us conserve energy when trapped in a difficult situation without an immediate solution. In fact, thinking of them as “negative emotions” probably helps reinforce their inappropriate continuation after they are no longer useful.
I can’t tell you how many people I’ve had to encourage to feel ANGRY about abusive behavior that’s happened to them, so they’ll feel enough energy to do something about it! All this Pollyanna crap about feeling happy all the time (but not too happy, that would be manic!) is just plain sick to me.
I think it all goes back to the mainstream people wanting to deny that anything bad ever happens, just like they denied in Freud’s day that the sexual abuse his female clients described had really happened. Freud did believe them at first, but was so roundly attacked by his peers and the general society at the time that he backed away from his observations and decided they were fantasies. But as it turns out, they were telling the truth all along.
Those in power would always like us to be happy or at least well-adjusted to our lower power status and dependency on their largess and magnanimity. Nobody wants the masses getting ANGRY!!! So Anger is a “negative emotion” that must be purged.
I say, embrace those homicidal feelings! You don’t have to act on them, but they’re telling you something is amiss with trying to delete “negative emotions.” Fake positiveness doesn’t help anyone but those who are already on top of the economic heap!
Sounds like she’s attempting to salvage the old dogma that “you need to stay on your meds,” even though they’re shrinking your brain. Naturally, she avoids any reference to non-toxic, non-drug ways to avoid “relapse,” which would provide the desired protection without any long-term brain damage. Someone should send her some of the stuff from Open Dialog…
I am honored that you would find my statement about therapy worthy of re-quoting, given the crappy experiences you have had. Perhaps my strength as a therapist was that I had almost no training when I started, so I had little to go on beyond my own simple sense of what I might feel like if my therapist did this or that. Of course, I did have some very good therapy before I started. Maybe that’s more important than one’s theoretical orientation – to have done enough work to keep one’s own crap out of the equation.
This is a very important discussion, as I have seen and personally experienced quality therapy and seen what it can do, and I’ve witnessed plenty of crappy therapy and seen the damage it can do, as well.
I guess what all of this made me think of is that traumatic events involve a loss of power and control. Sometimes, it is a one-time event, which, while terrifying, does not represent the entirety of a person’s life. It seems a lot easier to recover from that kind of situation. But the people I’ve encountered who are seeking help for trauma have usually experienced multiple traumas over time, reaching back to their childhoods.
I certainly don’t practice or advocate forcing a person to revisit trauma randomly, nor do I believe that a person “must” relive their traumatic events in therapy to recover properly. What I have discovered is that kids who grew up in abusive environments were forced to find ways to cope with those environments, because they generally were unable to escape or control the events in any way.
As an example, I personally regarded school as an abusive environment where I had no control over anything, and I spent a lot of energy protecting myself from the random verbal and occasional physical abuse of teachers and peers (that from teachers was far worse), including keeping a very low profile (I was very “shy” and would undoubtedly be considered to have had “social anxiety disorder” these days.) The “coping measures” I developed were necessary to survive school. Unfortunately, they made it harder for me to behave “normally” when I finally did escape. For instance, I learned never to speak up or raise my hand in a setting where I might actually get called on. I learned not to be vulnerable in any way, such as revealing my emotions or discussing an error I’d made, in front of my peers, in order to avoid bullying or humiliation. I learned to believe that my peers disliked me and that acting as if I were someone different than myself was critical to my survival. As an adult I had to “unlearn” many of those coping techniques. Of course, my quality therapist was able to help me connect those choices back to earlier trauma in my childhood (mostly neglect, with very intermittent outbursts of verbal and physical abuse) that led me to believe that keeping a low profile would help protect me. I doubt very much that I could have re-considered those coping measures without that therapy work, because they were deeply embedded in what I believed to be my personality.
So when I do therapy, what I’m looking for is something IN THE PRESENT that the person does or doesn’t do that bothers that person him/herself. I in no way evaluate for them what they should or should not believe about that behavior, but generally engage in an honest and safe exploration of what benefit they see in that behavior that makes it seem worth continuing it, despite their own assessment of the ineffectiveness or frustration the behavior creates for them. This often leads to a trip back into history to discover how and why this behavior made sense at one time in their past. In other words, this behavior that they dislike today may well have served a vital purpose for their own survival and been a perfectly rational response to a disempowered situation where they were unable to control events around them.
What seems to be most healing is for me to help the person safely explore why they themselves need or needed this behavior, from their own point of view, and to help them reassess if they still need it now. Validation, normalization, and taking an honest but supportive view of the behavior/emotion/thinking pattern is central to making this work. Telling the client that the problem is all in his/her thoughts or is caused by past abuse or is irrational or reflects diagnosis X all puts the client back in the place of no power again, which is exactly what brought them to you in the first place! Only the client knows the value and purpose of his/her behavior, and only the client can decide when and if to let go of it.
For some people, I don’t even try to find out why or explore history at all. Sometimes, they just want to try out new behaviors and see what works. So I help identify what they want to do differently and help them practice doing it, and deal with whatever emotions or thoughts that brought up. And sometimes I help people come up with ways to deal with the emotions they have in the present, without any attempt to change anything. It all depends on what they are ready to do and what they feel will be helpful.
As another example, I heard a former foster youth (age 20 or so) speaking of her time in foster care. One of the audience asked her how she’d managed to survive being in 15 or more placements after years of abuse at the hands of her parents, and suffering more abuse at the hands of the foster care system. She stated, “Well, I have this ornery streak. When something doesn’t seem right, I just fight and fight and fight and I never give up, no matter what the consequences.” Predictably, she was diagnosed with ADHD, then Oppositional Defiant Disorder, then Bipolar Disorder, and was confined to residential treatment homes and given armloads of drugs to stop her “oppositional behavior.” Why didn’t anyone ever sit down with her and say, “Gee, you’re pretty damned tough! You will tolerate a lot of consequences to stick to your point. Help me understand why it’s so important to you to fight these things. Tell me about one of those times you decided to take a stand, and help me understand what made it worth putting up with those consequences. I’m really interested in seeing how you think about these things.” She had damned good reasons for fighting, and her fighting was actually a valuable skill she learned that she viewed as central to her survival. Instead of helping her value this skill and helping HER decide when in the present and future it might or might not be helpful, the system went out of its way to define the very thing she knew she needed to do as a disease, and tried to wipe it out.
CBT can have its applications. I do believe and understand that we are ultimately the authors of our own thinking and feeling and beliefs. But telling someone that isn’t usually super helpful, especially right at the start of your helping relationship. I certainly ask them about what they’re thinking when they choose to do X, but I don’t tell them their thinking or behavior is wrong. Helping them answer the question of WHY they need a particular belief or feeling or thought seems to help a whole lot more. And anything that takes away their power to decide what is and is not helpful is, to me, harmful by definition, because it puts the person in a position where they have to protect themselves from the therapist, and re-traumatizes them yet again.
I hope that’s clear enough. Bottom line: every person is different, and I do what seems to work for that person. It requires humility, flexibility, and compassion, as well as patience and confidence that the client has all the information that you need to provide them the support that will help them move forward. Inserting your own theoretical beliefs or allowing your own needs to enter into the discussion is destructive in every case, regardless of what those beliefs may be.
Ultimately, I think you are technically correct in your statement, but it seems highly simplistic, especially when the person making the verbally insulting remarks about you is a person you need to rely on for basic survival needs, including the need for love and affection. Most clients can’t simply decide, “Oh, I’m not going to choose to believe his words any more.” It is a far more complicated situation, as the person’s identity often becomes enmeshed with the abuse and the abuser.
As you say, the child doesn’t necessarily see the sexual part as frightening at the time, but the idea that they have to not tell others about it, or that it makes their relationship “special” (later leading to confusion about the goodness/badness of the sexualized relationship), or comments made about the child during the event, and many other things that can happen create confusion, anxiety, and anger.
I agree with Joanna 100%, the words and other actions surrounding sexual abuse are often much more damaging than the abuse itself. While some people take the attitude of “I’m not going to give the assaulter any more of my energy,” others are not able to do that, and I would not label them “unhealthy” for not doing so. Responses to sexual abuse are wildly varied, and I agree also that the amount of force is only one of many factors (I alluded to it only to respond to Jill’s assertion that fear is not always part of the picture.) And while the research does show that a positive parental response has a pretty dramatic effect on minimizing the trauma in general, individual cases are always different, and sometimes the events are devastating regardless of force or parental response.
Which is why I said I take each case individually. Sometimes returning to the past is necessary – the client’s behavior makes that clear to me. Sometimes it’s destructive, and the client also lets me know that by his/her response to my questioning. Sometimes some stabilizing activities in the present are necessary to help the person be prepared to confront the past. Sometimes they are the answer in and of themselves. Everybody is different. I think that’s the biggest lesson of all, and the one that makes the DSM/Psychiatric worldview so dangerous: there is NO “right way” to help someone with an emotional/ spiritual issue. It is impossible to generalize, because for each of us, an event takes on a meaning that only we as an individual understand. Psychiatry, as well as a rote/programmatic approach to therapy, strips away the meaning of the events to the client and gives the therapist/psychiatrist/doctor the power to define the meaning for them. And regardless of the spiritual trauma encountered, that is always damaging, in my view.
People can be tough, but we all heal in our own ways. Therapists should be there to help each person discover their path, not to dictate for them what that path looks like for them.
That makes sense to me. The past doesn’t determine today, but it sometimes informs the context of what today’s choices are about. I tended to take visits to the past only in context of how beliefs based on past experience seemed to be affecting the present. It should always be clear in therapy that the purpose is to help the client improve decision making processes TODAY, not to try to fix that which is long since over.
Good point about the sexual abuse – it is more often the reaction of those around the client that has been traumatic, in my experience. I remember some good research that suggested if the protective adult(s) reacted calmly, believed the child, and took action to assure it did not recur, sexual abuse was not especially traumatic in most situations. It seems to feel more weird and uncomfortable than terrorizing, unless a lot of force was employed. The question of “what does it mean about me” seems to be a lot more salient for survivors.
Although another interesting way to visit the past productively is to talk about when the person HAS been successful or felt good, and help them re-create some of those same conditions today.
I suppose the place where most therapists go off the track is when they allow their theoretical perspective to blind them to the client’s actual progress or lack thereof. I tended to do things that worked and discard those that did not. I suppose I agreed more with Milton Erickson that “therapy needs to be recreated for each client.” The client him/herself was always my best source of information on what was going to work. That kind of thinking never let me far astray.
Perhaps I’m not understanding “catharsis” as you mean it, but I have found that in situations where a person is experiencing recurrent flashbacks and intense intrusive thoughts about an event, it is often helpful and sometimes essential to have them review the traumatic events (which they are compulsively reviewing in any case), and to help the client create a narrative of the events that are causing the anxiety. This is perhaps more akin to “flooding,” but is done differently, where the person is being asked to review the past event with the benefit of a therapist to keep their focus on the description of what happened, rather than losing themselves in the emotion of the moment. The client certainly emotes plenty during this process, but the effect in the end is very calming if the incident is reviewed several times over (sometimes many times) to the point that it no longer seems frightening to the person. The rest of your article makes total sense to me, and I appreciate the summary of the newer research, but I wanted to share that in my experience, some level of release of emotion from past traumatic experiences appears to be quite helpful and brings lasting relief, if correctly approached and used selectively. And it is certainly applicable to many terrorizing situations, such as child abuse, rape, or domestic battery, which transcend warfare. It is clear that the basis of this isn’t just re-experiencing the emotion, but re-evaluating the past experience in terms of present knowledge, rather than compulsively avoiding/re-experiencing the terror of the past. I believe EMDR utilizes some of this thinking and I’ve also seen that be very effective.
Thanks for the article – you are absolutely right, therapy can be quite damaging, and bad therapy also sets the person up to distrust the next person who offers to help, so it’s a double whammy. We need to be prepared to acknowledge when we don’t have the skills or insight to help a client and refer them on to someone/something that perhaps might, and keeping up with the latest information on what does and does not work is a big part of that.
And yet despite their biases, they still found that the main reasons for “non-adherence” (glad they used that term, rather than “noncompliance”) were dissatisfaction with results or intolerability of adverse effects. Not “Anosognosia” or thinking they’re better so they don’t need them any more. They are interested in QUALITY OF LIFE, and if the drugs don’t improve or reduce their overall quality of life, people are likely to discontinue. That over half of those so treated find their quality of life the same or made worse by the drugs should give the prescribers pause. Instead of trying to force them into agreeing with their treatment, maybe they ought to ask them why they stopped? Radical thought, I know…
And there is something quite disturbing about the title, “The neurobiology of child abuse.” What is he saying – only kids with “neurological vulnerability” develop adverse reactions to being abused? And those kids are somehow neurologically unfit because they can’t tolerate being burned with cigarettes or locked in closets?
I have decided that I’m “anti-stupidity” and “anti-corruption.” It’s not my fault the field is generally both stupid and corrupt. If they can come up with an intelligent and ethical version of psychiatry, I’ll back them 100%. But I’m not holding my breath…
The reason I don’t use the term “antipsychiatry” is solely because that term has been corrupted by the psychiatric profession into a derogatory term that implies a knee-jerk reaction against anything any psychiatrist thinks of. It suggests irrationality and a lack of supporting data, neither of which is true from my perspective. In actual point of fact, it is mainstream psychiatry itself that is irrational and lacks supporting data. This general movement could be called pro-empowerment or anti-enforced treatment or pro-choice or pro-client or a number of things, but anti-psychiatry is now a polluted term that can too easily be used to make us into caricatures and marginalize our views. I get that individuals may want to re-claim that title, much as the word “mad” is being reclaimed, or “gay” or “queer” have been reclaimed by the gay rights movement. I have no issue with individuals taking this stand, but my point in my response was that Dr. Lieberman was using it as a pejorative term to broad-brush any opposition as being irrational and irrelevant.
I posted a response to Dr. Pies’ comment which just showed up today. I doubt he’ll have the courage or decency to reply.
Thanks for that additional clarification. That is even more offensive than making someone take drugs, in a way. But you make my point for me – no matter what “helpful intervention” is used, it’s not helpful when it’s forced down your throat (literally or figuratively). I’m in the US, and there are fewer and fewer alternatives to drugs available over the course of my lifetime. I personally lucked out and found an awesome therapist who really helped me start on a new path, but it would have been a way different deal if someone told me that I HAD to see her as well as telling me what I had to do/say/think/feel in order to prove I was “recovered!” I have no truck with anyone who feels they can “prescribe” a particular service and expect a particular outcome.
It sounds like “recovery” has taken a bit of a different path in the UK, but it still sounds riddled with authoritarianism and force, as well as shame and humiliation for those who don’t “go along with the program.” That helps no one but the people getting their pay at the survivor’s expense.
Again, I think it all goes back to the initial act of diagnosing someone with a disease just because they don’t think/act/feel the way we want them to. That’s the first act of bullying, defining another person’s reality for them. Once you’ve done that, the recipient/victim of your actions has been sufficiently dehumanized that these other actions become possible to contemplate, when anyone giving it a moment’s thought would realize that they as an individual would never want to be treated that way.
Thanks for your passionate advocacy, Joanna! I hope I get to meet you one day.
This is an excellent point. Domestic abusers often engage in behaviors that have unconscious motivations to maintain control at all costs. Their behavior is still criminal, and their victims are still devastated. Unconscious evil motivations are still evil and people are still responsible for their decisions, regardless of how aware they may be of their intentions.
I agree. The message is always “Recovery is possible – IF you are a good patent and accept your diagnosis and take your drugs and don’t expect to live a normal life ever again.” The focus is still compliance and drugs. The clients are still treated like poorly-behaved children who need to be watched to make sure they don’t get in trouble.
What I think of as “recovery” means EMPOWERMENT – finding your voice and exercising your rights and telling anyone who tries to stop you to “stick it where the sun don’t shine.” This appears to be the very last thing the bulk of the system personnel ever want to see. As Sean Donovan’s piece clearly shows, they’re actually terrified and confused by anything that looks like a real recovery. It blows away their religious belief system. It makes them look and feel like incompetents. Which, unfortunately, is mostly the case.
Anyone who is really interested in recovery is interested in empowerment. And the issue of forced/manipulated psych drug use has to be addressed head on. Anything else is lip service.
Good questions, Sandy. What I tend to do is simply describe what I’m seeing, or better yet, have them do it from their viewpoint. Rather than saying, “You have symptoms of borderline personality disorder,” I might say, “You’ve told me you cut on yourself. Can you tell me what it is about cutting on yourself that is appealing to you? What do you think it does for you?” Most “symptoms” have a purpose, and I consider finding that purpose the key to making progress. Sometimes good therapy even makes the “symptoms” worse. I think focusing on the “symptoms” leads down the wrong path. The repeated behaviors of the client tell you something. The DSM/Medical Model approach says that the behavior has no meaning, it’s just brain chemicals. I say that the meaning is way more important than the behavior itself.
One of the first things I learned in the world of social work was the saying, “All behavior meets a need.” Help the client find the need the behavior meets, and you can start working with them on alternatives. But stopping the behavior stops the need being met and leads to more distress. Psychiatrists need to shift their focus away from the distressing behavior to the distress that is behind it.
I think the best way to become a good therapist is to experience good therapy yourself. It helps clear your own issues out of the way, and also helps you realize what it’s like to be on the “other side of the couch.” I was very fortunate to have an awesome therapist and so came to understand that good therapy really can change your life. Once I knew what real therapy can do, it was impossible to accept the ersatz kind that you outline so eloquently with this piece.
Great piece, Jay. As a former mental health counselor, I can totally relate to what you’re saying. I had the privilege of becoming a mental health counselor with almost no training at all (for some reason, they all thought an MS in Education qualified me as a counselor – go figure!) and learned most of what I know about therapy from my clients. The most fundamental truths I learned were that 1) me being real and genuine and vulnerable and willing to “sit” with their discomfort when they told their stories was far more important than any “technique” I ever learned, and 2) that no matter how crazy someone’s behavior seemed to me, if I listened well enough, there was some reason why that behavior made sense.
The main reason the DSM drives me around the bend is that it interferes with both of those two points I learned to be so important. Having a diagnosis allows the clinician to distance him/herself from the patient and avoid having to deal with the feelings evoked from real empathy. It also allows them to avoid working with the client to seek a context to explain the behavior or emotion, as the behavior or emotion are identified as the problem rather than the indicator of something more fundamental.
I bet you’re an awesome therapist and your clients are lucky to have you. But of course, what you do should be the actual minimum standard for therapists. We have to have our own shit together well enough that we don’t dump it on our clients. The rest becomes kind of obvious once we get rid of the need to have “clinical distance” and “evaluate our patient’s symptoms” and start dealing with them as one vulnerable, emotion-laden, spiritually seeking human being to another.
I don’t agree that this kind of effort is pointless, because not everyone in “the system” is ill intended. Some are misinformed, and others are trying to help change things from within and will really appreciate the hard-hitting emotional proof that their “radical” views might actually lead to more effective outcomes. What I’m hearing is that these people were SURPRISED that the clients they served turned out to be human after all. Keeping them conscious of that fact is critical to the safety of those currently trapped in the system.
That being said, I think it took tremendous courage to take that step, and I found their deceptive approach appalling and sickening. I hope you can have a meaningful followup discussion with them regarding the impact their “intervention” had on you and what it says about their need to maintain power over those they view as either beneath them or too dangerous to deal with in a genuine manner.
I guess what I really took away from this is that these people were actually AFRAID of you and your colleagues and felt the need to use their power to protect themselves from the danger you presented. And that danger appears to simply be that you know the truth and are willing to say it. Why is that so scary to them? Get to the bottom of that and maybe you can get to some real change.
Bottom line, Ted is right – it’s about the power structure, and until the power structure changes, this kind of intervention is just a band aid on a hemorrhage. But I still think it is tremendously valuable, both to the currently incarcerated victims who need some hope, and to those brave and lonely souls who are working inside the system to foment some kind of change.
Thanks for a beautiful and moving piece, Sean. I hope they start listening to you. You have a wonderful healing energy that they all need to get in touch with!
Boy, what a great idea, Mary! But I think they need to spend two weeks on antipsychotics as well, including a week of being threatened to return to the hospital involuntarily if they don’t “take their meds.”
It’s not paranoia if they really are out to get you!
I actually believe humility is the #1 requirement for being a helping professional If you’re humble enough, wisdom will come to you through observing and learning from your clients. If you’re not, no amount of training will make you anything but dangerous. I’m glad you’re in the humble category, and I really appreciate what you bring to this discussion. Would that all psychiatrists would model after you!
I was a bit less diplomatic than you, Matthew. See below:
Wow. Where do I begin to approach this amazingly shallow collection of ad hominem attacks and unscientific rhetoric? The author does not once even mention an actual scientific study or identify and counter a coherent argument put forward by those who oppose the new DSM and its arbitrary system of identifying any form of distress as a “brain disorder.”
For starters, I don’t know of anyone who identifies their own group as “antipsychiatry.” This is a term that is mostly used by psychiatrists such as the author to try and undermine the credibility of their critics. Notice that the author doesn’t identify one single group that so identifies – he just broad-brush paints that “there are these people out there who oppose mental health treatment and they are bad.” A classic ad hominem attack.
The author compares prejudice against psychiatry to racisim, sexism and homophobia, and talks about prejudice against “mental illness and its caretakers.” This is a highly offensive comparison for a couple of reasons. First off, psychiatry was part and parcel of the prejudice against gay and lesbian people – homosexuality was designated a mental illness until the 1970s by the very DSM this guy is defending! But more importantly, racism and sexism and homophobia are efforts by those in positions of POWER to undermine groups who did not have the power to defend themselves. It is especially ironic to talk about prejudice against psychiatry in this context, as psychiatrists are, in fact, the ones with the power to detain people against their will and force “treatment” on them based on the spurious diagnoses invented and voted on at the DSM conferences. And more ironically, it has been shown that the medical view of mental illness as brain disease INCREASES the negative stigma associated with mental and emotional distress. In fact, many of those opposed to the DSM and the current treatment practices of psychiatry are patients who feel victimized by the psychiatrists who treated them. To lump psychiatrists in with patients in terms of prejudice is an extremely shallow and self-serving viewpoint.
The author also states that: “… no one can argue with one simple fact; if you or a loved one suffers from a mental illness, your ability to receive effective treatment, recover and lead a productive life is better now than ever in human history.” Actually, that is EXACTLY what the argument is about! There is plenty of evidence, starting with the WHO studies in the ’90s and continuing right on through the work of Harlow that was recently published, that psychiatric drugs are NOT associated (in the aggregate) with a more productive life – rather, people maintained on psychiatric drugs appear to be MORE likely to remain disabled and have multiple hospitalizations than those who avoid drugs or have a short-term course of medical treatment. See Robert Whitaker’s “Anatomy of an Epidemic” for more details.
One doesn’t have to be opposed to psychiatry in principle to be concerned about the enormous rise in the use of psychiatric drugs, especially when the long-term outcome studies across the board suggest that unmedicated sufferers tend to do as well or better than their medicated counterparts over time. This is not to say that no one can or does benefit from psychicatric drugs. It is more to say that the current paradigm of care does not appear to meet the needs of many of those suffering mental/emotional distress. To label such concerns as “antipsychiatry” smacks of someone trying to avoid seeing the flaws in their own argument by attacking those who have the courage to point out those flaws.
There are a lot of fairly mainstream psychiatrists and mental health professionals who have had concerns for years about the DSM, and who have even more concerns about the oddities and excesses of the newest version (such as labeling a person who is depressed at the loss of a loved one as mentally ill if they haven’t recovered two WEEKS after the fact!) It’s clear the author is committed to his philosophical view, but if he really wants to convince anyone, he’d do better to address the scientific facts that are aligned against the “brain disease” theory, rather than attacking those who have read the research and have legitimate concerns about the DSM and the current treatment paradigm in psychiatry. You don’t have to believe that mental illness isn’t real to believe that the DSM is of questionable validity. Ask Thomas Insel, head of the NIMH. Is he “antipsychiatry,” too?
Actually, the Decade of the Brain did reveal some very clear answers, which I think the works of Bruce Perry capture very well. First, it showed that the brain is dramatically modified by the environment – we are NOT given a genetic substrate that determines our ultimate mental health. This in and of itself undermines many of the biological model’s underpinnings. Second, it showed that the brain can be healed even if injured early in life, and that the most healing factor is – wait for it – healthy relationships with other healthy human adults! Which is 100% contrary to the psychiatric worldview that we’re being sold, namely, that biology is destiny and that medical interventions are the only way to help someone who is biologically compromised.
It also showed that there are specific physical exercises that can address specific areas of physiological dysfunction in the brain.
Not surprisingly, this seminal research spanning 10 years has been almost entirely ignored in the psychiatric community, because it wasn’t what was desired or expected. But anyone who takes an honest look at what is and is not successful in the human services realm can see that good relationships are critical to healing, whatever else may be going on, and that the vast majority of the time, human relationships are the PRIMARY means by which mental and emotional distress are recovered from or understood or embraced by the sufferer.
I have no objection to neuroscience. But to be scientific is to be honest and to be skeptical and to be prepared to alter one’s theory based on the results of real experiments. Instead, we have rigged experiments and a slavish adherence to a set of quasi-religious dogma that actual science seems to be completely unable to make a dent in.
The public’s big confusion is to believe that psychiatry has the slightest thing to do with neuroscience. The new information on the DSM controversy may help to clarify this gross misunderstanding. I’m all about science, but organized psychiatry left science behind many years ago and is doing all it can right now to fight off what it knows to be the actual truth.
I agree, unlikely to be an organized conspiracy. It’s more like a religious faith under attack – the members know they have to defend themselves or their faith will go under.
I’m not putting you in that category at all. If all psychiatrists were like you, we’d long ago have been looking at a different paradigm. But I don’t think your colleagues, especially those at the highest levels of the APA, are as willing to hear the truth. Look at what happened to Open Dialog. Even in Finland, it came under attack, despite the best outcomes in the history of psychiatry.
Clearly, in psychiatry, politics and money trump science every time.
I absolutely and completely related to what you’re saying in this piece! I can’t say I’ve suffered a tremendous array of trauma in my life, but I have grown up feeling unwanted and “different” from others, and still feel that way a lot. I am also a person of integrity and person (at least I like to think so!) and I tend to relate a lot better in general to people who have been through tough times or who have fought to resist the “status quo” than those who accept “consensus reality” as the absolute truth that we must adhere and adapt to. In fact, those other people scare me!
I think the biggest flaw in the current system isn’t the drugs, it’s the idea that people’s suffering has no meaning. This relates back to that idea of purpose. If we have no purpose, what’s the point of all this suffering? If we’re just a bunch of cells and our feelings are “imbalances” that can be “fixed” with the right chemicals, it suggests that our struggles are for nothing and our feelings mean nothing. I can’t accept that viewpoint! It’s too damned depressing!
We have a quote on our refrigerator, from a Melissa Chen, age 10 or so: “Always remember, no one is normal. Everyone is weird.” Truer words were never spoken. It gives me comfort to think that those who are “normal” are essentially very good at acting the way they’re “supposed to.” I can’t, but I don’t think that’s a bad thing at all. We just need to hang together with others who can see “consensus reality” for the sham that it is.
If you do get fired, I wonder if a wrongful termination lawsuit would be possible? It sounds like you’re providing excellent treatment with very positive responses from the clients. What exactly are their grounds for firing you? Making them look bad by comparison?
Well done “coming out” on MIA! I am sure you’ll find a good use for your passions. I’ve been out of the mental health field for about 17 years now, for similar reasons – I was just sick about what passed for “mental health treatment.” And I think it’s worse today than it was in the 90s. I am an advocate for foster kids and work to get them off psych meds and away from labels and into things that really help. Maybe advocacy is a path for you, too.
Thanks for sharing and for fighting for those who can’t fight for themselves!
Thanks for that clarification. You were, indeed, lucky. You found an empowering clinician, which I find to be an increasingly rare commodity. And you have had other privileges that made it possible for you to move in and out of “the system” with some capacity for survival, something many psychiatric victims lack.
I’m glad to hear you talk about the abuse of power, because that’s what this comes down to and that’s where our interests overlap. Lies are not science, even when they’re put out by doctors. We need to take the power back to define our own experiences, and I’m glad you’re on board for that fight!
I was writing my response as you were writing yours, apparently. See below. I’ll just comment that you are operating on assumptions regarding the nature of human beings that are entirely philosophical, not scientific. You keep repeating these assumptions, namely that all experience is explainable in molecules, as if this were indisputable and obvious scientific fact.
The vast majority of humanity has believed in the presence of the human spirit, mysterious as it is, since before the beginning of recorded history. That belief is also philosophical, but can’t be refuted simply by saying it’s not true. You may choose to believe that we’re nothing but brain, but that doesn’t make it true.
In the end, I think the proof is in the pudding. We’ve been “studying the brain” for over 60 years and proposing various theories and chemical cures. The results are depressingly clear, as outlined in Anatomy of an Epidemic (Have you read it yet? You had not last time we talked. YOU MUST READ IT if you want to get where this group is coming from!) Whereas it’s equally clear that non-biological, spiritual interventions (for lack of a better word) like various schools of therapy, meditation, and the like, are able to create significant changes in both the spiritual and physiological condition of human beings. That’s not even getting into the various dietary, homeopathic, exercise-based, and other physiological interventions that have been shown to be helpful, but continue to be denied by the Big Labelers of Psychiatry.
Did you read the recent comments by Tom Insel of the NIMH about the DSM? Even he agrees the labels are crap and do damage, and he’s a psychiatric true believer!
There is a point where science can’t take us and we have to resort to philosophy. You are now at that edge. You can’t argue people into submission by restating your hypothesis over and over. Maybe it’s time you took a look at your own hypotheses and see if maybe altering them might lead you to a better understanding of the situation you’re hearing described by those who feel victimized by the DSM-based view of mental/emotional/spiritual distress?
I would have to say that I don’t think Laura is identifying a label as the cause of her distress per se – I would say it is more the use of power and deception to “sell” such a label and thus invalidate the beingness of the person being labeled in this manner which increases rather than diminishes whatever distress a person may already be feeling.
To reduce someone’s lived experience to a “chemical imbalance” is to eliminate significance and meaning from the person’s response. I would suggest that a “neuro-reductionist” view is one that suggest there is nothing beyond our neurons that defines us as human beings. The natural extension of this hypothesis (and it is only a hypothesis, not a proven law of science) is that the brain causes all behavior and therefore the only thing we can do to change behavior is change the brain.
The fact that CBT or meditation do result in changes in the brain doesn’t necessarily mean that those changes are the cause of changes in the person. The fact that choosing to meditate can actually alter the brain should be enough right there to suggest SCIENTIFICALLY that there is something more than the brain at work. After all, who decided to meditate? How did that person maintain their commitment/motivation to meditate? What were they trying to accomplish through meditating?
These are questions of what I can only call a spiritual nature, that regard the meaning and purpose of behavior. These issues of purpose are assumed by the psychiatric model to be irrelevant. You have “symptoms” because your brain is broken. The symptoms have no meaning. Hence, your decisions and reactions have no meaning. The only thing we can do is try to fix your broken brain. That’s a depressing viewpoint!!! And NOT a viewpoint that is a necessary conclusion from being “scientific.”
I sense that you don’t believe in the possibility of an extra-physical existence beyond the body. You’re certainly entitled to that belief, but it’s not one that is axiomatic. But even if you do, it’s hard to deny that the issue of intentionality and purpose is not adequately explained by any neurological model you can suggest. Perhaps it’s a matter of the whole being greater than the sum of its parts, but it seems very clear that a person’s sense of meaning and purpose dramatically effects his/her behavior and mood and thinking. And since it is the brain, in your view that is doing the thinking, feeling and behaving, SOMETHING is affecting that brain that is outside of or beyond its scope. Otherwise, the brain is opposing its own neurochemical imperative, and that makes no sense to me.
So I don’t think it’s that a label causes distress. I think it is the process of a person in a position of power using that power to invalidate the meaning and purpose in an individual’s experience and hence reducing or eliminating their sense of individual identity and power. I’ve been a counselor over many years, and I can tell you from my own direct experience that people improve generally in direct proportion that they are able to act effectively to control and direct their own lives. To have someone come and tell you that 1) you don’t really direct your own life, it’s your messed up brain that does it, 2) there isn’t anything you can do about it except take my drugs and hope it gets better, and 3) you can look forward to a life of dependency and disability and need to give up on your life goals – well, it would be extremely disheartening to the staunchest of souls.
The only real defense against such a system is to rebel and refuse to participate. It doesn’t mean science or brain study is out the window. It means that each of us gets to decide for ourselves what our lives mean and what we believe is helpful to us. And it also means that nobody can force or manipulate us into doing something that benefits them more than us in the long run. If brain study leads to something helpful, it can certainly be made available for anyone to see, think about, and use. But seeing people through a distorted lens of assumptions that convey the message that we are not the authors and evaluators of our own lives is inherently destructive and needs to end.
I agree that a huge proportion of “mental illness” is simply a result of exposure to injustice due to an imbalance of power in relationships and society. It is amazing to me that sexism, racism, classism, domestic abuse, economic injustice, and related issues are not even mentioned when it comes to “mental illness.” Sometimes trauma gets a background mention, but only because “trauma changes the brain,” not because trauma contains elements of disempowerment and spiritual distress that are a NORMAL reaction to circumstances of being out of control of one’s experience. The idea that social systems themselves could cause mental illness seems so far off the radar as to be considered absurd by many. Yet we see that in three generations, immigrants to the USA have been shown to deteriorate in their physical and mental health to levels of the ambient population.
There is no question that social and economic variables are the most ignored factors in mental/emotional distress. In my view, they are probably the most important. And the power imbalances you mention are deeply embedded in the system, from DSM diagnoses through involuntary detention. Until a shift in perspective is made and the need to address power differentials is brought to the front, our ‘mental health’ system will continue to harm those it presumes to help.
Considering the lame outcomes for antidepressants, even “modest” gains by single nutrient interventions should be of interest to real scientists. And let’s say 20% of “ADHD” kids improve with Nutrient A – well, that’s 20% fewer that “need meds” to function!
Of course, the other errant assumption underlying all of this magic bullet research is the idea that “ADHD” is a single entity that must be the result of a single nutritional deficiency. This is an absurd assumption that leads to absurd results. It is quite possible that this behavioral constellation could be caused by abuse, iron deficiency, lack of sleep, boring classrooms, fetal alcohol syndrome, sleep apnea, and probably dozens of other causes. Nutritional treatment, and treatment in general, needs to look at all the variables and treat each case individually. While it’s helpful to know that a certain percentage of cases can be helped by iron supplementation or EFAs, others may need totally different approaches. So of course, a “magic bullet” is impossible. I am sure it’s not by chance that this strategy is demanded, because it gives a big advantage to pharmaceuticals. A more holistic approach is called for, but will not likely occur while the pharmaceutical industry has all the researchers hog tied and bought off.
I would submit that studies have not shown A basis for depression in the body, they have shown LOTS of possible correlations for depression, because, as Dr. Insel himself just said, “depression” isn’t a thing that has a cause. It’s a set of symptoms that could have dozens or hundreds of causes, some of which aren’t “illnesses” or “disorders” or pathological in the least.
To try to reduce depression, which is clearly a biologically appropriate state with important survival value to the species, to a “mental disorder,” without consideration of how, why or when this “depression” occurs is quite irrational and of course, will never lead to any meaningful results.
I’m glad Dr. Insel has made this observation publicly. Unfortunately, his new path is still based on the assumption that genetic causes are primary and will be found. Common sense should direct us to look at a much more subtle and complex interaction of genetics, experience, and environment to understand each individual’s emotional responses in a much more nuanced way.
Psychiatry is like doing surgery with a claw hammer. The instruments are so crude, they can do nothing but make the situation worse.
I agree 100% that both the “left” and the “right” have been dismissive of the rights of the so-called “mentally ill” and have for the most part fully embraced the medicalized view of “mental illness” as scientific entities caused by “chemical imbalances” and “managed” by “medication.” Most of our representatives these days are deeply indebted to corporate interests, and both the APA and the drug companies give copiously to both sides of the aisle. Anyone taking a stand against forced drugging and in favor of empowerment and compassion for those who are experiencing mental and emotional challenges will quickly be branded by either political party as a quack or a kook or a fool.
Opposing the current status quo, whether in the world of “mental health treatment” or anywhere else in the medical industry, is a radical stance that has little political support. It’s only the people themselves (or should I say “ourselves”) joining together that can create the kind of political momentum to change the current dismal state of affairs. Which I think is what Jack is really getting at.
Sera, Great blog, as usual! Most of the time, most people are unable to really acknowledge the power of words and the implications behind them. I agree that for many folks (both professionals and their clientele), using the word “recovery” implies a previous illness to recover from, which can insidiously undermine a more thorough critique of the process that led to “diagnosis” and “treatment” in the first place. That critique can be critical in finding a more liberating way to view what has been happening, but such an analysis is generally not in the interests of those in power. So they discourage it by using terms like “consumer” and “recovery” to make it sound like something super helpful is happening. Sometimes words like “unwitting victim” and “escape” are more accurate and more empowering.
Don’t get me wrong – I am glad professionals are now talking about “recovery” instead of “lifetime disability” – it’s definitely a shift in the right direction. But true empowerment involves taking back the right to define our own experiences from our own point of view, and a lack of this ability or of feeling the right to exercise it is very often at the core of what the system sees as “wrong” with the individual. Being empowered has a tremendous positive impact on anxiety, depression, and hostility. But since it can’t be patented or controlled, it must not be of interest to the “service providers” (aka labelers).
I have similar feelings about terms like “self-medicating” (implies that the person using drugs “needs medication” and is using drugs as a substitute) and “misdiagnosed” (implying that the reason the person “recovered” is because the doctor picked the wrong diagnosis, rather than that there was nothing wrong with them in the first place) or “overmedicated” (implying there is a “correct level” of medication that was missed, rather than accepting that the medication was doing damage at any dosage.) I think we have to be very careful of the euphamistic use of these words to avoid the real conflicts inherent in trying to force everyone into the disease model.
I get where Kevin’s coming from, and I don’t want to take away an individual’s word for describing his/her own experiences. The problem is when those in power start using those words to cover up their misdeeds and to retain their power to define the experience of those lower than them in the social pecking order.
Kelly, I am so glad you brought this up! The analogy between psychiatry and childbirth is one I’ve observed a lot, being deeply involved in both areas in one way or another, but it’s not so obvious to those who haven’t seen both in action.
I think the main thing these areas have in common is that healthy people are identified as ill. In childbirth, the expectant mother is dealt with as if she has a serious disease that puts her life in danger and requires dramatic and intense medical interventions. The same thing happens to “psychiatric patients” – a person is experiencing distress regarding his/her life, and instead of getting support, they are pathologized as having a medical problem requiring emergency and intense intervention. And both areas have a set of “required” interventions that are ineffective or destructive, and yet receive uncritical and almost universal support from the medical personnel who believe in them. Both approximate religious movements, where loyalty to the faith appears to be more important than factual accuracy, and where those who criticize the status quo are labeled as fanatics or lunatics who don’t care about the welfare of their clients.
Birth is also the place where a lot of so-called “mental illness” gets its start. The parent-infant bond has been shown repeatedly to be hugely important in the development of the infant over time, as well as in the development of empathy and attachment on the part of the parent that is critical to the parent’s development of good parenting skills and practices. Denial of the infant’s need for dependency on a reliable caregiver is the core of many later emotional and developmental and even spiritual challenges. It’s connection to psychiatry can’t be overemphasized.
Thank you, Will. I used to work at a suicide hotline in Portland, and found the exact things you state – that everyone who wanted to kill him/herself had a solid reason for doing so, and it almost always had to do with solving a problem they couldn’t find another way to solve. It was often the result of living in unrelenting pain for long periods of time and seeing no other way out. The key to helping them was to listen, acknowledge, and help them find some small thing they could do right now to regain some measure of control over the situation they found so objectionable. Anyone who would talk to me, I would almost always find a way to help them feel better in less than an hour of supportive conversation.
Suicidality is not a disease. It’s a state of mind that deserves gentle and supportive exploration. I can’t imagine how what happened to you in the hospital could have done anything but make it worse. When you do know what is really possible in helping someone in distress, watching what happens to people in need of that kind of support be abused is all that much more painful.
Thanks from a fellow Portlander for all the awesome work you’ve done, both personally and professionally, to humanize what is currently a very inhuman profession.
I want to be clear that I don’t consider any drug likely to be 100% to blame for acts of aggression, just as I don’t blame alcohol for domestic abuse incidents, for example. The reduction of inhibitions tends to reveal what was being inhibited, and that’s different from person to person.
But the HUGE difference in these scenarios is that in the domestic abuser’s case, the abuser knows very well that alcohol will reduce his inhibitions and that he has a tendency to violence. Some will even drink specifically so they’ll have a justification for what they’re already planning.
In contrast, in this grandmother’s case, I doubt she had the slightest idea that this drug could cause her to become so detached from her friend’s experience and emotions that she could somehow feel OK about carrying out something that under normal circumstances might have only been the most remote of fantasies in her subconscious mind.
I think it is vitally important that this information be gotten out to people, not so criminal thinkers can use it to avoid responsibility for their crimes, but so that people who are taking these drugs can be honestly informed of the true effects they might experience. If this grandmother and her doctor (most doctors don’t know or deny this possible effect) knew to watch out for this, there may well have been early signs that she was reacting badly to the drug and she could have been discontinued.
I hope you will agree with me that by the description of this woman and how she lived her life, it seems extremely unlikely that she would have committed this act without the presence of the SSRI drug in her system. Her description of her disoriented state of mind at the time fully supports this contention, and the judge’s ruling confirms that s/he saw it the same way. So whether or not Celexa can be held 100% responsible for this murder, it appears clear to me that this woman’s friend would almost certainly be alive and she would almost certainly not be in jail if she had not been taking this prescription.
I know you don’t want to let the perpetrators off the hook. But I don’t want to let the SSRIs off the hook, either. At a minimum, they are guilty of being accessories to the crime.
That’s what I’ve heard from those directly experiencing. A former colleague called it “Zolofting” when she just didn’t give a crap what anyone thought about what she was doing. For a person who is chronically over-worried about others’ opinions, I can imagine this is quite a relief. But for those who are suppressing the urge to be violent because they’re worried how others would view it, creating this “Zolofting” experience could be quite dangerous!
I don’t think this is the forum to decide whether global climate change is real or not. Whatever one believes on the climate change issue, humans are polluting the planet, destroying ecosystems, screwing with the soil and creating runoff problems, creating artificial species while killing off genuine genetic diversity, and otherwise creating ecological havoc. Everything that Ron has said applies to all of these other situations as well. We need to resist the idea that mega-corporate growth is synonymous with progress, and that creative resistance is synonymous with insanity. It’s a short stride from deciding that psychotic people need to be locked up to deciding that anyone who makes too much trouble for the powers that be in society needs to be locked up with them.
I love the essay and the concept. Thanks for putting it out there, Ron.
Amazing that they could try to blame this on “depression” rather than the drug. This sounds like very uncharacteristic behavior on the part of this woman, and her description seems to suggest she was dissociated at the time of the event. This kind of dissociation seems very common in SSRI users I have spoken with and read about in stories of similar situations. It seems clear that the drug has to be extremely suspect, rather than “her depression.” She seems VERY unlikely to have done such a thing under normal circumstances.
Has anyone thought of sending this as a “press release” to the NYT? Seems they ought to be interested, given the recent amount of material they’ve published on this issue. I’d love some organization with some street cred to put this article out to a range of newspapers and TV news outlets and see what happens. Many times, newspapers only publish stuff they’re spoon fed, and the psychiatrists are better at feeding them than we are.
Ironically, the last “decade of the brain” was promised to provide these same physiological signs and proofs of mental illness’s location and etiology in the brain. In the actual event, ten years of research proved the opposite: that the human brain is not pre-programmed genetically, that it responds dramatically to environmental stressors or enhancements, and that even later in life, injuries to the brain can be addressed and the brain can heal. Most fascinating of all, the one thing that had the most healing impact on a traumatized brain was: a caring relationship with a healthy adult individual.
In essence, this decade of intense research completely undermined any expectation that studying the brain would lead to discrete “mental disorders” that are located in certain places in the brain, and emphasized instead the important of environment and relationships in creating healthy adults. But none of this deters the biological “true believers,” because the “cult of psychiatry” is based on certain inalienable beliefs that must continue to be believed, regardless of the evidence.
Great letters from both of you, and thanks for sharing them.
Don’t forget that “postpartum depression,” like all of the invented DSM “disorders,” is not a single entity – it is an effect that could have a large number of causes, not just one. Omega-3 deficits are probably involved in some cases, and completely absent in others.
Psychosocial factors also play a huge role in this phenomenon, and are almost always given short shrift. For instance, such changes as loss of income, loss of employment, need to return to employment prematurely, shifts in expectations from partner, changes in sexual activity, loss of sleep, nutritional demands of nursing, and re-emergence of childhood abuse issues are extremely common, and all can be very significant contributing factors to depression or anxiety following birth. That list could be expanded.
Additionally, it is a well-known but massively underpublicized fact that domestic abuse frequently begins or escalates during or after a pregnancy, either because the new mother is now more dependent and more vulnerable and hence safer to attack, or because having to “share” a partner’s attentions with the new baby leads to a narcissistic partner becoming jealous and hostile toward the new mother. In any case, screening for domestic abuse should be an automatic part of any assessment of “postpartum depression” before a physiological cause is assumed to be primary, because it is a VERY common phenomenon in our culture, affecting over 1/10 of all women at any given time, and up to 1/3 over the course of a lifetime.
Depression is very complex and not reducible to either simple brain chemistry or simple nutritional causes or treatments. It requires an individualized and thorough assessment of the person who is having the experience, including a wide range of both physiological and psychosocial factors.
Irene, I found your post inspiring! Perhaps what we need to do is start using the “stigma” language to insist on real dialog with the oppressive elements in the monologue, by stating that not to consider the point of view of the recipient of your ‘services’ is perhaps the essence of stigma. The “clients” or “consumers” or whatever word they want to use are categorically viewed as “different” in the sense that somehow “they” are defacto assumed to be unable to provide any legitimate feedback on the “treatment” that they are receiving. If the psychiatric labeling process isn’t inherently stigmatizing, then why are the views of this group of people, who have in common only their having been labeled by the profession, considered inherently invalid?
Thanks for providing that point of view – we have to choose not to stoop to the level of assuming ill will, but instead model what we want to experience, namely being treated as individuals of value, regardless of our views and experiences. I will definitely take this viewpoint into my next discussion with those who appear to be married to the current paradigm as a means of “reducing stigma.”
Great piece, Matt! You hit it when you talk about the victim-blaming that always lets the “profession” and the drugs off the hook.
The initial studies on Xanax apparently resulted in dramatic INCREASES in anxiety upon withdrawal, even after 6-8 weeks, which were conveniently not included in the results when evaluating effectiveness. It’s long been known that Benzos are highly addictive, way back in the late 60s when Valium was king. For anyone to suggest they’re only addictive for those who increase dosage without medical advice is arrogant in the extreme and approaches criminal fraud in my view.
I also get tired of having to accommodate the “other side of the story.” Sometimes one side of the story is based on lies and the other on the truth. Time was, reporters and news agencies took stands on these things instead of promoting this false “objectivity” where every story has to be “balanced” by comments on “both sides” even if one side is obviously outrageously in the wrong.
Thanks for your writing and telling your story. Bit by bit, person by person, I do think we’re turning the tide.
This is one of the scariest articles I’ve read in a long time. I keep up with the research in general but have never heard this information. It seems likely it is being intentionally suppressed. If folks really knew the data on this, most pregnant moms or women intending to become pregnant would stop antidepressants immediately!
Which also gives another reason why alternative approaches, which as you say are known to be as effective or moreso without the damaging adverse effects, should be the first line of approach for anyone who is feeling depressed.
I almost commented, but couldn’t bring myself to become a “member” of the Psychiatric Times. Of course, he resorts to the usual approach of stating his conclusions with no evidence, and engaging in ad hominem attacks on his detractors. He didn’t even address Moffic’s comment, which hardly even qualifies as critical. And his view of what the “average psychiatrist” does in his office is tremendously distorted! I am always stunned when a psychiatrist shows the slightest interest in the context of a person’s “symptoms,” and more so if they show any inclination to explore the client’s worldview, because the first is very rare, and the second almost never happens.
Along this line, Sandy, I’d love for your comments on the dramatically increased use of neuroleptics for “aggression” in children and the elderly. These people don’t even meet the questionable and subjective criteria for a psychiatric diagnostic label, and yet they are given drugs simply for their behavior. Where does this kind of thing stop? Can we drug someone for excessive political protest, or for being too upset about the state of the economy?
I consider this behavior not only unethical, but criminal. Do we give someone antibiotics without evidence of an infection, or blood pressure medication when their blood pressure is normal?
What do you think of this trend? Should it be stopped, and if so, how? I work with foster kids and this is done all the time, without the slightest consideration for the long-term impact on the children involved. It makes me ill, but I’d love to know how you view it.
Donna, thanks for the awesome post! The quotes from the “encyclopedia of domestic violence” were particularly good. I had never heard of that book, despite my working in the field of social work. And it’s good to know that this stuff does get published in mainstream journals, even though I don’t see anyone in the psychiatric field paying much attention to it.
Exactly! In actual point of fact, severely angry people tend to be a tad delusional anyway…
Or maybe even better, we take violent non-delusional people and put them on neuroleptics, and see if they get MORE violent. Of course, that would be considered unethical, but somehow giving them to “delusional” people isn’t.
It’s hard to be scientific when blinded by dogma, fear and incompetence. Though as a wise man once said, “Never attribute to ill will that which can easily be explained by stupidity.”
Can’t disagree with you. I just think it’s important not to paint all “alternative medicine” with the same brush. The more fundamental problem is, as you suggest, the dishonest marketing which pervades our culture. Lying to make a buck is fraud and should be criminal, especially if physical or psychological harm can come to someone as a result of your fraud. Informed consent is the issue of the century, or should be.
While some “alternative medicine” has significant side effect risks, as a rule, most are less than those of conventional medicine, which is used with so little consideration. The concern for the use of any “unproven” remedy should be proportionate to the risk. For instance, certain herbs can have significant and even deadly side effects if used in high dosages. Folic acid, however, has almost no risk, as excess B vitamins are excreted in the urine easily. As another example, homeopathy may be seen by many as hokey and unscientific, but the side effects are essentially nothing more than a very temporary discomfort at the very worst, and the costs are minimal. If someone wants to try it out, why not?
We ought not to be viewing “alternative medicine” as a monolith, but should look at each intervention with an eye to cost-benefit analysis, just as we ought to be doing with conventional medicine. Most of the time, doing that analysis honestly brings “alternative medicine” out on top, mostly because the risks, as a general rule, tend to be so much smaller, even if the benefits may be inconsistent or difficult to determine.
Well gosh, Fred, they can’t be making people BETTER! Then they’d have to get more clients, and that takes SO much time… Far better to create chronic, lifetime disability so they can charge $100+ a session for a 7 minute visit and get lots of extra payola from their drug company buddies!
I think the best bet for you is to find a “peer support” network in your area. Where are you located? There are a lot of “hearing voices” support groups and such around in most major cities that I’ve lived in. These folks won’t judge and have been there and know how to help someone, and also generally don’t charge for their services, more than some nominal fees for space and snacks and such. It might be worth looking into.
I only know one therapist in Eugene and one in Portland who does therapy work with people with psychotic issues. It’s a rare specialty, and such people are often attacked by mainstream psychiatry. It is very discouraging, but don’t give up – there are a lot of others who have experienced the same and come out the other side. See if you can find them.
So you mean angry people are more likely to be violent than non-angry people? Who would have guessed?
Reminds me of a study done years ago where they divided “ADHD” diagnosed kids into “hyperactive-aggressive” kids and “hyperactive-not aggressive” kids and followed them through adolescent. Shockingly, the “HA” kids were more likely to commit crimes than the average child, while the “HNA” kids were no more likely to commit crimes. So basically, they discovered that aggressive kids are more likely than non-aggressive kids to grow up into aggressive adolescents. It had nothing to do with “ADHD” diagnosis, but somehow they weren’t able to see the obviousness of their conclusion.
Oh, and “diagnosis” doesn’t really mean just distinguishing one condition from another. It should be a means of accomplishing a plan of treatment. But in truth, psych diagnosis doesn’t even accomplish his stated goal, as people with wildly different situations are lumped together with the same “disorder”. It would be like diagnosing someone with “a rash” without determining the cause and possible treatments for the rash. Could be they have poison ivy, in which case, Calomine lotion is appropriate. Could be they have syphilis, in which case, they’d better get antibiotics.
And there is research showing that psychiatric labels and the concept of “chemical imbalances” actually encourages people to indulge in their biases to a greater degree.
This is a typical “I’m a psychiatrist and I say it’s so” argument, without any scientific or evidentiary basis. I hope someone else will write in a rebuttal using the research. I would do it, but I got mine published the last time they brought up the subject, and I doubt they’d publish me again so soon.
“Yvonne Woodley was a 42 year old woman who was having marital difficulties. She presented to her doctor with sleep problems. The doctor viewed her as being under stress, and as posing absolutely no suicide risk. She gave Yvonne citalopram. A week later the doctor noted that Yvonne was more agitated and there were fleeting thoughts of suicide – so she doubled the dose of citalopram. After a suicide attempt, she doubled it further and a short while afterwards Yvonne hung herself.”
This is the kind of brilliant medical practice that makes me want to tear my hair out. A person presents with virtually no risk of suicide. They are prescribed a drug and became more agitated and had suicidal thoughts. First thought: could the drugs be causing agitation and suicidal thoughts, since she didn’t have them before? But no, we now increase the dosage instead. Then she actually ATTEMPTS suicide, despite being not the least bit suicidal before taking the drug. Stunningly, the idiot doctor AGAIN increases the dosage, ending up in a completed suicide.
This doctor should be stripped of his/her license and never allowed to practice again! This is gross malpractice, even within the confines of believing 100% in the “chemical imbalance theory.” A person who becomes worse during treatment should discontinue the treatment, to see if the treatment is causing the problem. Doesn’t take a trip to med school to learn that one.
As long as idiots like this are practicing medicine, we’re doomed to increasingly bad outcomes.
Can’t really argue with you, Nathan! Each of us deserves to decide what works for us, and to be fully informed of what is and is not known about the process we’re embarking on. And the range of consequences just for being “diagnosed”, let alone receiving “treatment,” are quite vast. As I said, it’s not an easy question to answer.
I hadn’t read before what you said about the therapeutic alliance building after the person feels better, but that makes a whole lot of sense to me. Essentially, I think most of us who are suffering need a person to trust so we can sort through what we’re thinking and feeling safely. The act of establishing trust with someone may in itself be the most important part of the process. I think there are lots and lots of ways to do that, and they don’t have to be “evidence based” or professionally driven or provided by someone with a degree to be effective. The final arbiter of “effectiveness” is the judgment of the person seeking support.
I think that’s truly where we go off the rails – as soon as someone else thinks they’re smart enough to know what’s good for me and feel OK forcing me to accept it, whatever “science” is behind their opinion, we’ve left any semblance of helping behind.
This is a tough argument. I am totally in agreement that the DSM is the source of almost all the evil we are fighting, and that when psychotherapists have to buy into DSM diagnosis to be paid, they are making a pact with the devil and end up colluding. I say this having been such a person for a while. It is also very true that many, I’d have to say a majority, of those purporting to provide psychotherapy either don’t know what they are doing (despite or perhaps as a result of whatever training they received), or have so many emotional issues that prevent their effectiveness, that they can either waste a lot of money or screw people up pretty badly. I was fortunate to have received almost no training prior to learning how to be a therapeutic agent, and so fell back on my own sensitivity and creating a safe space for good, solid communication, in addition to considering my clients to be the primary source of information on what does and does not work. And I had some quality psychotherapy before I ever started, which was probably more important than any training I could have had.
At the same time, I see people being drugged partly because doctors and even “therapists” see no other options. There HAVE to be other ways available to help people who are in distress, or the psychiatrists and the drug companies will own the field. Self-help and peer-delivered services can fill a lot of this gap. But in truth, this world we live in is exceedingly complicated and painful to experience, and I have found that nothing truly exceeds communication with a safe terminal who is willing to ask some tough questions in a caring way in its ability to help me create lasting change. That a lot of therapy fails to meet those criteria does not mean that quality therapy should be discarded as an option.
Interestingly, I recall a study that showed the process or school of thought employed by the therapist was relatively irrelevant to whether the client got better in the end. The client’s sense of “therapeutic alliance” with the therapist, such as feeling safe an unjudged, and being supported in trying out new things, and feeling validated for efforts they had historically made, were far more important than the therapists theoretical orientation.
I would much rather send someone who is in distress to talk to someone than to get drugs. Even if the talking is overly expensive and doesn’t always work, it at least has a chance of success. Whereas the drugs are clearly a dead-end street. Sometimes literally.
Again, a very hard topic. I don’t know what the answer really is. People do need support, and therapy can be very powerful, but the critiques raised are quite valid. In particular, I have to agree, the war is not on therapists, it’s on individuals who are suffering. But one tactic in that war is to make legitimate social and emotional support unavailable to those individuals, and cutting out the option of therapy seems to forward that goal effectively.
From the article and your post: ”Given that these medications have substantially improved the long-term prognosis of schizophrenia and that schizophrenia is a disease with significant morbidity, continued use of antipsychotics is clearly still necessary. However, our findings point toward the importance of prescribing the lowest doses necessary to control symptoms.”
This statement above is the one that we as a society and mental health system keep getting caught up on. When you read “Anatomy of an Epidemic,” you will see that the evidence does not support this claim, as often as you see it bandied about. The evidence suggests that, to the contrary, the “long-term prognosis” for schizophrenia is FAR BETTER in developing nations where psychotropic drugs are less available and less accepted. Whitaker also shows that the long-term prognosis for schizophrenia in this country was much better in the 1950s, BEFORE Thorazine and the ‘psychopharmacological revolution.’
He also shows that the BEST long-term prognosis for schizophrenia worldwide is in northern Finland, where they use an approach that considers psychotropic drugs as only an ancillary aid to a psychosocial intervention called “Open Dialog.” They are reporting functional social recovery rates (working, functional relationships, involved in normal community activities) of 80%! US rates are generally less than a 10th of that, with the huge majority of “schizophrenics” subsisting on SSI payments.
The statement I quoted above from the article is so generally accepted in the psychiatric community that to question it is akin to heresy. But the scientific evidence is mounting that it is not only false, but the opposite is true – long-term prognosis may actually be worsened by antipsychotics, even when they work to reduce symptoms in the short run.
Peter, thanks for mentioning the foster care horrors. I live with that every day. I can’t say I’m having no effect, but it does feel like we’re swimming upstream and nobody seems to be willing to risk their livelihood by speaking the truth. Or very few are, not enough to really stem the tide. I’ve also gotten the “silent treatment” for mentioning unethical behavior by prescribers. No one wants to admit it, even when they know it’s true.
And sometimes the pills cost more serious and more expensive problems. I was reading recently that a huge percentage of the increase in healthcare costs is for treating diabetes. It didn’t mention in the article that the medical profession is creating tens of thousands of cases of diabetes annually with their own “treatments” for “schizophrenia,” “bipolar disorder,” and increasingly, for “aggression” in youth or the elderly that they don’t even bother to label with a “diagnosis.” No, I don’t think pills are cheaper. I think they’re more profitable.
This actually supports just what I was saying above – if a “disorder”, and what you said, too. If there are 273 biomarkers for a “disorder,” and other “disorders” have some of the same biomarkers, how can we even call anything that heterogeneous a disorder at all? Or even identify it as an entity? There may be some percentage of these cases where there’s something actually wrong, but it’s not always the same thing, and many of the “cases” will not actually be disease states at all – simply normal genetic variations.
When a scientific theory leads to more complexity, it is generally very quickly discarded. Science should make things easier and simpler to understand. Schizophrenia is simply not a scientific concept. It’s a social construct, and the more we try to force it to be a “physiological” phenomenon, the more time we will waste and the more confusion we will generate.
Wow, thanks for taking the time for these thoughtful answers. It really helps me see where you’re coming from and where we agree, as well as why we might disagree.
You appear to be operating on a philosophical assumption that you believe to be obvious and unavoidable, namely, that “Everything has a physiological etiology, unless it is magic. Brain states give rise to feelings and behaviors.” I don’t buy that assumption myself. But I want you to see that it is an assumption and not a scientifically proven fact. All we know for sure is that biological changes correlate with changes in emotional state, but correlation is not causation.
Personally, I believe (and this is my assumption, not science) that thoughts and intentions give rise to brain states. I believe the brain and body give feedback to the entity running the show, and the physiological substrate of the body clearly determines a lot of what seems desirable/undesirable to the organism as a whole. But it’s pretty clear that we as beings can override even horribly negative feedback from the body if we have some overriding purpose that drives us hard enough. Many of these purposes seem to have no apparent survival value for the biological organism, but seem to have a lot of value for what I will call the spiritual being, whom I believe to be in charge, at least most of the time.
But that’s just me. There are lots of philosophies of causality out there. My objection to psychiatry is that it posits the primacy of physiological cause as an unavoidable truth, and castigates anyone who has another viable explanation, even when they don’t have any proof of their assertions as all.
As to “measurable differences” for those who do and don’t “have schizophrenia,” I have yet to see anything convincing on that ground. There was some big flap about loss of brain tissue, but more recent studies (Nancy Andreasen, for instance – see http://archpsyc.jamanetwork.com/article.aspx?articleid=211084) have shown that this appears to be a result of neuroleptic treatment rather than a characteristic of the “disease.” Besides which, why should we buy into the assumption, which you kind of agreed isn’t really true, that just because two people fit the subjective description of “schizophrenia,” they have the same thing “wrong” with them? If they don’t, then how is it possible or likely that “schizophrenics” will be biologically distinguishable from each other?
There are trained research psychiatrists who have opined that schizophrenia as a category should be done away with, because those who fit the criteria are too heterogeneous to study as a group. But that’s opinion again. There is no science that I know of that shows what “schizophrenics” have in common, besides hallucinations and delusions. If you have some studies, please share – I’d be interested.
Overall, I think we agree about a lot of things. I just want you to be careful not to make your assumptions into facts. What we KNOW is very limited, and to me, suggests that schizophrenia, or mental illness in general, is a pretty unhelpful concept. Between hazy and subjective definitions, and political and marketing forces, and the money to be made from choosing to believe certain things, the actual facts have long since been lost in the forest of bullshit. Whitaker really does bring us back to what is known. I think you should re-read his book. When it comes down to it, the most important result of good science is increased predicting ability and simplicity of your model. The fact that we’re killing people we’re trying to help, and making disabled people out of those who might otherwise recover, suggests that the current model is false and should be trashed. Not to say we shouldn’t ever do genetic research, or that no one should ever use psych drugs, but we need to spend our dollars on things that pay off. Pursuing a genetic cause of mental illness has not paid off, and never will. That last part’s my opinion, not a scientific fact, but the lack of effectiveness to date is pretty darned factual, as Jay has clearly demonstrated in his article.
Thanks again for your thoughtful and serious responses.
I have found plenty who say just that. As to my son, of course, he was depressed. He would have qualified for “major depressive disorder” if you wanted to diagnose him with something. But he was insulted that the person “offered” him antidepressants without even asking what was wrong. I hear from many who experience exactly the same from psychiatrists, to the point that I consider it the rule rather than the exception.
As to “brain disorders,” you continue to assume that a “disorder” such as “schizophrenia” exists as a distinguishable entity that has a physiological etiology of some sort. What evidence is there to support that? Every theory that’s been put forward so far has been shot full of holes by psychiatry’s own researchers who were dedicated trying to prove the theory correct. How do you know “schizophrenia” isn’t just a reaction, like a rash, to a variety of causes, some physical, some psychological, some existential? If there’s no physical way to distinguish those who “have” and “don’t have” schizophrenia, how do we know the sufferers have anything physiological in common? So far, the research suggests that what genes they may SOMETIMES have in common are just as common in different “disorders,” while many sufferers don’t have these genes at all.
And there are plenty of people diagnosed with “severe disorders” who would take strong exception to trying to say their conditions aren’t caused or triggered by “existential suffering” or trauma or childhood neglect or simply being sensitive to the horrid social conditions in the world they live in. Take the well-known but poorly-publicized fact that “schizophrenia” is far more common in urban areas than rural ones. Explain that in your “brain chemistry” model. Oh, right, the city badly affects their brain chemistry, triggering vulnerability to psychosis. Which means we treat their psychosis medically, rather than asking why cities make people mentally ill who would otherwise be healthy.
You also need to read about the “Open Dialog” approach, and about “Soteria House.” It should help you see that social support and caring can be incredibly effective in treating the most severe “mental illnesses,” far more effective than the crappy chemical treatment that’s helping kill people off 25 years earlier than their untreated peers.
If you haven’t read Whitaker’s book, read it. If you have, read it again with your mind open. He addresses almost everything you say here.
I stand by my contention. So far, genetic research has contributed almost nothing to the understanding and treatment of so-called “mental disorders.” I doubt it ever will. There may be a small segment of people who suffer depression or psychosis for a physiological reason. These should certainly be identified if they can, though genetics is a tiny fraction of the area of physiological causes to be studying. Given the results so far, I’d say the effort doesn’t merit the costs. Meanwhile, there are plenty of “experimental” treatments that are already proven to work better than drugs, which deserve lots of further research, but remain “experimental” because of lack of funding for research, and outright bias and prejudice by a system making billions off of drug sales.
There is much more benefit in changing the external environment. Messing with someone’s brain has so far proven ineffective, dangerous and often deadly. It’s time to invest in a different strategy.
Oh, you’d be surprised how many “unreasonable” psychiatrists and doctors tell their clients that their disorder is entirely genetics and that nothing else but drugs will help (see Engineer’s post below). My son had experienced a severe emotional trauma a couple weeks before a routine doctor’s visit. On finding he had been briefly suicidal, she was prepared to prescribe antidepressants without once asking him what he was depressed about! I’ve seen it happen so often, I have come to believe that it’s a rare psychiatrist who even considers environmental stress relevant – mostly, they just hear the symptoms and prescribe.
This is fascinating to me, because if you think about it, which do we have more control over, our genetics or our environment? Obviously, the latter is much more readily changed, but we seem to be spending all of our time trying to change the one thing that we have the least influence over.
The search for genetic causes of psychiatric disorders is a complete waste of time. As you state, all this shows is that a certain genetic substrate may make a person more vulnerable to life stressors, which could lead to a wide variety of conditions. This substrate isn’t even identified as faulty genetically – it may well be an important set of survival traits that are simply not as compatible with the insane modern world we have to negotiate. If that’s the best they can come up with, they should hang up their test tubes and go home. Because while they are wasting their time, there are a ton of social issues, like poverty, warfare, gang violence, child abuse, domestic violence, authoritarian and abusive school settings, and on and on, that all could be changed if we worked on them together.
Let’s do research on things we can actually change!!!!
I agree with you, Ron. It’s still pretty quiet out here in Mental Health Land. Getting better, but I still feel like the guy in Bermuda shorts at the black tie dinner most of the time.
I was recently at a meeting discussing the lower age limit for an automatic review if a foster kid was prescribed certain drug categories. When they asked if 6 made sense as a lowest age for antidepressants, I said, “There is no evidence base for the use of antidepressants in a child under 6.” No response. I said it again, louder. Again, no response. They’d given me studies on earlier points when I’d raised them, but not a word here. My read is they all knew I was 100% correct, but nobody wanted to talk about it. Too uncomfortable, I guess.
But that’s what we’re up against. Denial, plain and simple. People know what’s happening isn’t right, but we’re not supposed to talk about it. Most people, having received this treatment, will never mention it again. Of course, I’m not most people…
Fred, I’ve heard some horror stories before, but this one really got to me in a new way. I hope you can continue to “go public” with what happened to you. I find it particularly painful to contrast the way you were treated and their expectations for you to what actually happened when you were able to escape their clutches. Thanks for having the courage to share this story with us and the world. It reminds me again that this isn’t just a matter of “philosophical differences” – lives are systematically destroyed in the name of “helping” every day and we need to stop it!
Hey, thanks, Richard! Good to know another rabble rouser is out there. I agree, there are times I can barely live with myself for not speaking up louder. But there are limits what one person can do without completely destroying his/her credibility. I work on trying to get facts out and get people to think. Not everyone sees that as a noble effort, but I guess if we don’t, we’re yielding the field to the enemy.
Keep up the good fight! If enough of us join together, they can’t fire us all!
I think they are in danger of losing their jobs if they speak out. Look at Loren Mosher’s experience. There is definitely a “code” amongst even fairly radical critics that must always be followed: we have to say, “We acknowledge that many people are helped by psychiatric medications…” Anyone who comes out and says, “This whole system makes no sense, and appears to be damaging clients far more often than it helps” is quickly ostracized, and if s/he has enough power to be of influence, s/he is attacked as an “antipsychiatrist” or “Scientologist” and loses any position or authority s/he had.
The rulers of the profession don’t tolerate dissent.
You are too right. It’s the insurance companies and the drug manufacturers who get the big bucks. I’m sorry to hear the “Adjustment Disorder” strategy doesn’t work any more. Just goes to prove my point about greed being the driving factor.
And I believe you 100% about public vs. private healthcare – the docs aren’t making much, and neither are the therapists. A licensed MS or MSW counselor in Portland, OR often makes $30,000 or less, even in a clinical supervisor position. No wonder no one sticks around. Foster kids, in particular, get the short end of the stick, with the most inexperienced and unstable counselors handling the most complicated situations. And we wonder why a quarter or more of all foster kids are on psych drugs.
And as for the patient being on disability, that’s a benefit in a way, but it also penalizes clients who want to get a job. So we’re encouraging disability financially.
Thanks for providing the doc’s perspective. It’s a grim read all around.
That’s why all of my clients got an “Adjustment Disorder” if I could in any way justify it. Almost anyone has current or recent stressors they are having a hard time dealing with, and “Adjustment Disorder” implies the need for therapy rather than drugs.
But it really does emphasize how ridiculous DSM diagnosis is. The truth is, the doctor probably doesn’t have to worry about it, since no one on earth can ever prove you’re right or wrong about a psychiatric diagnosis. It’s really a beautiful scheme, if your desire is to make money without the slightest accountability.
The DSM’s a sham, and anyone not religiously committed to psychiatric precepts knows it. The shame is that we continue to go along with it, mostly for the reasons you mention. The only real answer is to scrap the whole idea of “medical” diagnoses for mental/emotional/spiritual issues. But I’m not holding my breath on that one…
I am a subversive professional in the mental health field, and have been pretty successful in getting people to look more critically at the use of psych drugs, especially in kids. It’s a slow process, but it is essential to have professionals in the field who voice their opposition, otherwise, the psychiatrists just have their way.
Good for you for keeping your critical thinking skills intact and maintaining your integrity despite the onslaught of psychiatric indoctrination!
I don’t mean to paint Healy as a paragon of scientific virtue. I selected him as an example precisely because he’s right in the middle of the psychiatric heirarchy, and yet still has been castigated because he doesn’t support the party line on antidepressants. (And he truly was, he lost a job in Canada because he published something negative about antidepressants.) He’s clearly not an “antipsychiatry” figure, he’s actually quite mainstream, and yet still can’t speak to his own profession about the actual data in the field.
I am no apologist for Healy’s views on ECT. It takes a pretty warped view of a human being to think that passing electricity through his/her brain will be anything but profoundly damaging. He’s no hero – it is more an example of how the profession is willing to shun its own members if they don’t toe the party line.
I don’t mean to argue with you, Layla, because your description of the current reality is actually quite accurate. But you actually reinforced exactly what I said: there is no objective way to define ANY “mental illness”.
I don’t think we should abandon the study of the mind, but I do think we should abandon the idea that a psychiatrist can look at my behavior or emotional experiences and “diagnose” a “disorder” that requires “medical treatment” due to a “chemical imbalance in the brain.” Surely, you see the difference between saying, “We’re studying people who experience the phenomenon depression to see if we can figure out what is going on” and “We can tell that you have a disorder of the brain and you need to take this drug to treat it.” I have no problem with the first approach. The second is extremely dangerous, especially when you look at the outcomes.
So my opposition to psychiatry has nothing to do with being opposed to research. It has to do with being opposed to lying to people in order to make a whole lot of money. Again, I refer you to Loren Mosher. This is not a neutral scientific enterprise. The DSM-III was an intentional business decision by the psychiatric establishment in order to reclaim their share of the market. The whole idea of “chemical imbalances” was promoted intentionally, because psychiatrists can prescribe and that was their market advantage. And of course, the pharmaceutical companies were happy to fund the effort.
Again, not saying that psych drugs can’t play a part in recovery. I’m saying that the psychiatric profession is unethical at its very core, is not interested in science, and their DSM is a tool to capture market share, not a genuine effort to understand the mind or the brain. To me, supporting scientific research DEMANDS that we oppose psychiatry, because psychiatry does not want the actual scientific data getting out. Look at how Whitaker’s book has been received, or Irving Kirsh’s work, or David Healy, or even Marcia Angell, who used to be the editor in chief of the New England Journal of Medicine. Even mainstream psychiatrists who stop spouting the party line are cut off at the knees.
There is no respect for truth at the higher levels of the psychiatric profession. “Cult” may be too kind of a term to even describe them. They are engaged in an evil enterprise, and they are doing tremendous damage in the name of helping. Don’t allow yourself to confuse them with scientists. They are capitalists plying their trade, with no concern for the consequences beyond their own bottom line.
I can’t remember who said it, but I’m reminded of the quote, “Well-behaved women rarely make history.” I’m glad your not afraid to shake them up!
It is interesting that our biology and genetics is the one thing that we have almost no control over, and yet that’s where all the energy goes. The environment is what we DO control, and yet we act as if it has no impact. There are SO many things that can be done to help someone with feeling depressed, anxious, suicidal that have nothing to do with their bodies. And there are even physiological things we can do, like sleep, exercise, nutrition, etc. that have an impact. Drugs seem like the very last thing you would do when all else has failed. I find it hopeful that you are working effectively to change that focus to the things we actually can control!
I love the graphics! Makes too much sense. Have the “authorities” in the mental health system gotten upset with you yet for grouping their wonderful magic pills in there with the illegal drugs? I have to imagine there are some who would find your presentation extremely threatening.
Well done! I’m so impressed that you have the motivation and skills to accomplish so much with so little resources. Thanks for sharing your success, and I hope your organization continues to thrive.
My take: first off, they found correlations, which are large-scale statistical probability findings. This is very far from saying that every case of these 5 “disorders” involves this gene alteration, and it’s even further from saying that this genetic pattern plays a causal role.
Second, they have lumped together 5 different “disorders” to get these results! This would suggest that either the “disorder” definitions are close to meaningless (which, of course, is absolutely true), or that they had to pool all this data from different disorders to get a statistically significant result (which could certainly be true), or it simply means that this genetic array is associated more commonly with certain personality types who are somehow more vulnerable to the stresses of our current, insane social system. There could be other explanations. It certainly doesn’t convince me of anything. It seems like almost meaningless research to me.
Glad you are interested in Mosher – it’s a thread that leads to quite a big ball of yarn. Unfortunately for all of our ideals, politics reigns supreme, even in the medical fields, and perhaps especially in psychiatry. I appreciate your willingness to explore the potential ugliness, and encourage you to continue your journey.
It is easy to confuse a refusal to accept “mental illness” as a concept and the idea that suffering is not real or can’t be caused by an illness. My objection is not against the idea that illnesses can cause mental system. It’s against clumping all people with a set of behaviors, thoughts or feelings together and ASSUMING they have an “illness” based on their “symptoms,” which are mostly a list of annoying or disturbing behaviors that we don’t like.
There could be many things your son is struggling with, some psychological, some spiritual, and some physiological. There are definitely diseases (like syphillis, for instance) that cause psychotic symptoms. They can also be caused by lack of sleep, drug side effects, or exposure to traumatic events. Wouldn’t it make sense to figure out which of these things were involved before the doctors “diagnosed” you with a “disease” just based on the outward appearance? As an analogy, if you had a rash, would you want the doctor to treat the rash without looking for the cause of the rash, whether it was allergies, measles, poison ivy, or syphilis?
If your son says the drugs aren’t helping, it’s probably because they aren’t helping. Perhaps someone needs to sit with him and help him come up with his own ideas of what he is seeking and why these events are happening, and what he thinks might be helpful? I know it’s painful to watch this happen and feel helpless to change it, but whatever’s happening, he has to be the one to figure it out. You can’t do it for him, and as you can see, the drug solution doesn’t really solve the underlying problem, even if it may temporarily arrest the “symptoms.”
As for Laura, it sounds to me like she was going through some intense but fairly normal teenage stuff, and was re-routed to a very crazy pathway that did a lot of emotional damage. I see this happen all the time. Nobody seemed to sit down and ask her what was going on – instead, they tried to snuff our her feelings and experience and used labels and drugs to try to force her to be “normal” rather than helping her find her way. I see this happen all the time.
To live is to experience distress. Distress is real, but it doesn’t work to label forms of distress as “diseases.” Sure, people recover from states of distress, but that’s the process of life. Helping people find ways to make their lives meaningful and productive in ways they care about is much more effective than drugging them into submission when they don’t fit into the status quo.
Again, I feel for your challenges with your son. Don’t give up, but see if you can focus on seeing things from his point of view. You might want to look into the Open Dialog and Soteria House approaches to get a different view on what psychosis may represent and other ways to think about helping.
I have to say, it is mostly the psychiatrists themselves who have carved out the “us vs. them” terrain. Read up on what happened to Loren Mosher when he challenged the establishment to recognize that his Soteria House non-medical approach was as or more effective than drugs with none of the side effects. Believe me, he quickly became an enemy and was summarily removed from any position of power. You are deluding yourself if you think psychiatry as a profession is interested in a middle ground. That’s why I agree with Laura that “cult” describes the overall experience quite well. Not that every member is blind, but the leadership expects blind adherence to a dogmatic and inflexible doctrine and shuns anyone who challenges it. There is no “middle ground” with such an institution. It’s either fight or be oppressed. They have the power and won’t give it up, and no rational discussion or scientific discourse is going to change that. Otherwise, we’d have Soteria Houses and Open Dialog centers in every major city in the country. But we don’t, do we?
So to reply to your reply: your philosophy drives your beliefs, and makes you more willing to believe in the psychiatrists’ story about what makes “mental illness” happen. I’m not criticizing you for this, merely pointing out that this discussions stopped being about science the moment you chose to put that philosophical assumption into place. We all do this, of course, to some extent. But to be fully scientific, we have to be aware of these biases and recognize they are biases and not facts. Doesn’t make them WRONG, only, as you admit, unprovable.
So we move to the world of psychiatry. The writers of the DSM operate on a similar and maybe even more reductionistic model, truly eliminating any possibility of spiritual influence on the body. So they’re left with brain chemicals, and all of their experiments and treatments have to do with brain chemicals and all of their conclusions are about brain chemicals. These people make sense to you because you have the same assumptions as them. But their beliefs (like yours) are NOT scientifically verifiable. There is no scientific basis for ANY of these so-called mental illnesses, not one. They are literally decided and voted on by COMMITTEE. There is not one test for any mental disorder – there can’t be, because they’re not defined by pathology. They’re defined by committee and then the assumed “cause” is sought after the fact. Surely, you can see that this is not a scientific process.
More significantly, the treatments used by psychiatry HAVE been shown scientifically to cause damage. These supposed scientists know all about Open Dialog and Soteria House and other non-drug interventions, none of which has any risk of physiological harm. If they are so enlightened and scientific, why do they avoid even talking about these treatments, and why do they find them so threatening? It’s because they know on some level that their philosophy and treatment approach is deeply flawed, but admitting it means admitting they are doing harm, and also giving up on a lot of income.
You were fortunate. You had rational providers who did pretty much what Bob Whitaker recommends – used drugs judiciously, on a temporary basis, while adding psychosocial interventions to obviate the need for ongoing symptom relief. Believe me, after working for 20+ years in the field, I can tell you, this is not how most people do it. In fact, it’s a rare exception.
My last comment. You say that we can rewire our brains. If we’re all chemicals, who is doing the rewiring? Someone’s WRITING the program, folks. That someone is who we really are, and it appears to be that we USE the brain to run the body. But who WE are remains a very large mystery, one that the reductionistic model used by psychiatry avoids, because they have no explanation for it.
There is such a thing as “mental illness” because we have defined it as such. Look at the DSM. Any one of those diagnoses is rife with subjectivity and potential bias. There is no objective way to diagnose any mental disorder in the book. A person has a “mathematics disorder” because he can’t do math. Is it possible that he was taught in the wrong way? That he wasn’t exposed to sufficient concrete stimulation to form the basis of math? That he simply doesn’t give a crap about math because he’s more interested in skateboarding or the girl sitting in front of him? The exact same argument can be made for ANY mental disorder in the book. There is not one that can be verified.
Accordingly, it is, of course, ridiculous to suggest that “mental illness” has to do with “brain processing gone awry,” as we can’t even tell what a mental illness is or who has one. This leads to stories like Laura’s. Instead of getting to the bottom of her “bipolar disorder” (namely, normal teenage developmental angst, combined with an inquisitive, non-authoritarian personality and some serious drug side effects that were ignored), she spent years suffering unnecessarily and believing her life was a hopeless disaster. A competent therapist, or even a sensitive adult supporter, could easily have helped her manager her existential conflict with sufficient time and patience, and helped her re-organize her worldview to support her success. Instead, the psychiatric profession labeled her and negated the importance of her own beliefs and experience. The results were disastrous!
If nothing else, the proof of the weakness of the “brain processing” theory is that the treatments don’t consistently lead to improvement. If you believe Whitaker’s extensive research into the scientific data on long-term outcomes (do you?), it appears we’re making a lot of people worse over time, even if a few may benefit. It all starts from the subjective and biased definition of mental disorders, which is based almost entirely on social norms and biases, with no genuine scientific means of distinguishing between one biological condition and another.
But you appear to be a ‘true believer’ in the biological model, and I doubt the lack of scientific legitimacy to any of these labels is something you can accept. How about the new proposal to limit intense grieving to two weeks (in the DSM 5)? Where’s the science behind that? If they can make that kind of idiotic and arbitrary assertion, how can you believe the rest of it is any less arbitrary?
You’re admitting to operating on a reductionist assumption that “everything arises from chemicals.” You have presented no evidence of that. And you haven’t countered my evidence that large percentages of so-called “schizophrenics,” including many who are posting here on MIA, have recovered without or in spite of chemical treatment. How does Open Dialog work at all if these folks are experiencing solely chemical/biological problems? The emphasis of Open Dialog is on the meaning of experiences and relationships between people in the client’s life. How can that be effective against a chemical problem? And why is it 10 times more effective than the chemical approach, which appears FROM THE DATA to impede recovery far more often than it assists?
You just have to look at the “Open Dialog” approach to disprove the theory that you can’t talk your way through a psychotic episode and to healing. 80% of those having psychotic experiences are able to heal through the use of communication and social interventions. The vast majority maintain without any medication, or were given medication only briefly. If this is all a brain-based phenomenon, how on earth does such a large percentage of the Finnish population recover with Open Dialog, which is primarily a “talking cure,” when US full recovery rates hover in the single digits? If nothing else, the proof lies in the almost complete ineffectiveness of the medication interventions over time. Not one medical intervention for anxiety, depression, ADHD, or psychosis, has been shown to create positive long-term outcomes for patients, whether talking about education levels, employment, relationships, or community involvement. The drugs may help people with short-term symptom management, but if you read Whitaker with an open mind, it should be clear that many of those who would spontaneously recover are sucked into a world of psychiatric insanity, just as Laura describes. The fact that some individuals can receive this kind of care and still recover doesn’t mean the care led them to recovery. The overall evidence is that we’re making people worse as a big group, even if some individuals do better or feel they do better with the drugs.
I don’t think anyone is trying to take away drugs as an option. We’re trying to look at what the institutional practice of psychiatry is doing to its own patients and to our society as a whole. The training you are receiving is just another reflection of that insidious influence. You’re already being indoctrinated to believe the “chemical imbalance” story before you’ve even had enough clinical experience to make up your own mind. Your education should be enabling you to make your own observations about what is helpful to your clients. Instead, it wants to convince you of a mythology that science has already refuted. Please, keep your mind open – Laura’s experience is far from unique.
I only wish that SSRI-induced manic episodes were rare. They are sadly very common. I find it particularly egregious when you had no mania ever in your life before the pill, and they somehow manage to blame you for the reaction. I’ve heard this all too often – “We’ve uncovered an underlying bipolar disorder!” Or “Only people with bipolar react this way to antidepressants.” What they should say is, “Oh, my God, this pill is driving him crazy – we need to stop!”
Well done for hanging in and sorting this out. Glad you’re joining the fight and making some meaning out of your Kafkaesque experience!
Great post! I agree very much with your line of thinking, that the origins of these mind states are very complex and attempts to reduce them to simple genetic or biological causes is very unlikely to be the case. And the twin studies aren’t even convincing without the methodological flaws – supposing even 50% of identical twins with “schizophrenia” (and also ignoring the impossibility of 100% accurate “diagnosis” of this rather vaguely defined malady), what happened to the other 50%? If it’s genetic, and identical twins have the same genetic material, shouldn’t we see more like 98% concordance? Clearly, genetics can’t provide the entire answer of causality, even in the most optimistic interpretation of the known data.
I’d disagree on one point, though – I don’t think there is evidence that brain and thought are an identity. It appears to me more that emotion and brain activity track together, i.e. a state of anxiety is experienced and expressed physiologically in response to a thought. For instance, a person who believes they are in danger will generally experience heightened cortisol, which is associated with anxiety and fear. But this fear may be based on a real danger (a charging bear) or a belief (my mom is probably going to yell at me) or a fantasy (the CIA is trying to track me down.)
What actually generates a thought, as well as where a thought resides and what impact it has on the body/brain, remains a very large mystery scientifically. I think we move into the area of philosophy when we start talking about thought, and as you say, it’s way too big a topic for this forum. But so much of psychiatry’s false underpinning is bad philosophy (unstated assumptions taken as proof) that I think it’s important for us to draw the line pretty firmly between what we know and what we believe or assume to be true.
Ah, but it is not necessary scientifically to prove that the cause is not disordered brain function. Otherwise, we can put out any hypothesis and say, “You haven’t proven this is wrong yet, so it is true.”
It is the responsibility of the person postulating the theory to provide the proof. If there is no proof that brain function is disordered in a psychotic person, then from a scientific perspective, we have to assume that disordered brain function is not a cause. Even if there are brain differences in a psychotic person, those putting forth the chemical imbalance theory would have to prove that these differences are the pre-existing cause of the hallucinations, rather than the result of them or something that just happens at the same time as them.
For instance, let’s assume that depression is associated with a certain chemical condition in the brain (which has not been proven, not even close). It is possible that a person’s thoughts lead to feelings of depression which are accompanied by certain changes in brain chemistry. The thought could cause the change, but the change and the depressed feelings occur together. The chemistry difference doesn’t cause the depression, they just happen to be associated.
As an example, there was a PET-scan study done where people thought of depressing things while hooked up to the device, and their brains changed to a pattern that was associated with depression. When they thought of happy things, their brains changed back to a different state. The person apparently controlled his/her brain utilization patterns based on what s/he thought.
I don’t think that anyone here would suggest that there is no such thing as mental/emotional/spiritual distress. And it’s feasible that some part of that may be the result of inherent biological characteristics, but that proposition has not been proven, despite a hell of a lot of research trying to prove it is true.
I think the objection here is to taking a set of behaviors that have been arbitrarily determined to be a “problem” based on cultural and social norms, and decide that the person with this “problem” has a medical disease. If there is an underlying pathology of some kind that made EVERYONE depressed, and we could identify that and reliably alter it in a safe fashion, then depression as an illness makes sense. But it should be clear that there are many, many reasons why a person is depressed, and many, many approaches they can take to move forward and heal or recover or whatever word we want to use, most of which have no relationship to the field of medicine.
It’s not that there is no such thing as the distressing states described in the DSM as “mental illness” – it’s that calling it “mental illness” makes one think that it’s a “disease like diabetes” that can be “treated” with “medicine.” There is at this point little to no evidence that this last statement is remotely true, and as I stated above, in the realm of science, a hypothesis is properly considered false until proven otherwise, and is then true only as long as further evidence continues to support it. “Mental illness” as a physiological disease just doesn’t meet the scientific criteria for truth.
The penny doesn’t drop because there are too many gold doubloons on the other side of the scale. The trauma theory of depression may be kind of obvious to the lay person, but to the psychiatric professional, it presents an awful dilemma, because you can’t use 15 minutes and a prescription pad to make a couple hundred thousand dollars a year. And the pharmaceutical companies stand to lose billions if they admit that bullying is a much more consistent cause of depression than any genetic vulnerability.
It’s not that the bigwigs don’t know this data. It’s an “inconvenient truth” that they want to keep quiet. Denial is a lot stronger when backed by a financial conflict of interest!
You are so right about the education system. If you haven’t, you should also read John Taylor Gatto’s “The Seven Lesson Schoolroom” (or something like that), where he talks about the implicit curriculum in schools. He was an award-winning elementary school teacher who eventually rebelled, as he found that the secret lessons of compliance, undermining confidence in our own observations, and seeking reassurance through approval by the authorities were dominating any real educating he was trying to accomplish.
It’s kind of amazing when you read some of those old documents from the 1800s in the USA – they were remarkably open and clear about their intentions, and they had nothing to do with making kids smarter or more able to think for themselves. They were all about creating “good citizens” through universal propaganda and compliance training, in order to keep new immigrants and freed black slaves from rebelling. It’s not even laid between the lines. They knew what they were doing and why.
Thanks for your response – it’s good to know you’ll always read and value what folks write to you.
That’s what the Luddites were saying. They were not anti-technology. They were opposed to the family and community being torn apart by industrialization’s requirement to have a mobile and docile population to manipulate. And they were right.
Weird that the Kirsh work has come out and research psychiatrists are agreeing that the overall effectiveness of antidepressants is very mild at best, and yet we’re trying to correlate reduction in suicide rates with antidepressant use. A competent scientist would have to compare those taking and not taking antidepressants, and when that’s been done, suicide rates have increased in the drugged samples, hence the Black Box Warning.
I plan to see the movie so didn’t read the article, but I’m glad a mainstream movie is taking on this issue, however sensationally it is presented. I hope it can promote the conversation about the connection between violence and psych drugs, because that conversation is long overdue.
I don’t know why anyone capable of the slightest degree of intellectual vigor would assume a genetic cause for a “disease” that is “diagnosed” by a behavioral checklist. Normally, one finds the gene and then defines the disease based on the cause. Anyone with half a brain would realize that just because two people are depressed doesn’t mean they’re suffering for the same reason. Real science would start to break down these situations and look for possible root causes of the “syndrome”, and only when the causes are found would the “diseases” be established.
It’s like calling a rash a disease. A rash could be caused by poison ivy, measles, or syphillus. The treatments and possible outcomes would be radically different. Yet each condition causes a rash. The rash is not the disease – the thing that causes the rash is what needs to be treated. That’s just elementary scientific logic, of which the psychiatric profession is apparently incapable.
The psychiatric establishment is remarkably deluded. Thanks for giving us this kind of hard data to help spread the new concept that DSM diagnoses are not disease states. 40 years of trying to prove something and failing at every attempt is pretty darned good proof that your original hypothesis is false.
I’m just glad this is even being discussed in the mainstream media. Breggin can be annoying, but he does have excellent research backing up his claims. I hope this heralds other interviews with this topic in mind. Maybe they’ll interview Bob Whitaker!
Thanks, but that did not quite answer my question. I asked whether it is possible that the client is making decisions based on distorted information, based on either media reports or actual discussion with his/her physician who is similarly misinformed? And if so, do you see it as your obligation as a physician to correct this information, for example, by informing him that 1) the idea of a chemical imbalance is speculative and that antidepressants fix such an imbalance simply a fantasy, and 2) that CBT gives the same benefits without the risks and side effects, and probably maintains these benefits over time in a way that drugs can’t.
Even further, do you inform them of the possibility that antidepressants, even when they work in the short term by moderating depressive symptoms, may actually alter their brain chemistry for the worse over the long run, as Whitaker outlines in his book? Or that depression often “runs its course” with no therapeutic intervention whatsoever?
This would be true informed consent. I’m a mental health counselor, and I haven’t seen anybody in the field doing it, except for client/peer counselors who have survived the system and done their own research. I’d be astounded and impressed if you did. If you don’t, maybe it’s time to start?
Gosh, you think they might find this stuff is addictive? Since it’s already used as a recreational drug? Oh, wait, it’s probably only addictive for people who AREN’T depressed. For depressed people, it’s just what they need.
That they’d even consider such an idea just shows how desperate and misguided and unethical they all are. It’s a bogus profession.
So if he had the deportment of a person headed for medical school, why the hell did he need psychiatric treatment? And what the hell does a “drug person” look like? Does he not know that addiction rates among MDs are very high?
The guy is an idiot with a degree and a prescription pad. Unfortunately, such people appear to be par for the course in psychiatry. You’d probably get better mental health care from a cab driver or a bartender or a healthy 12 year old.
And what if the patient’s decision to ACCEPT treatment is based primarily on media-delivered (or PHYSICIAN-delivered) misinformation? Isn’t that just as bad? Or worse? Shouldn’t patients be told that far from “balancing” their “chemical imbalance,” these drugs CREATE huge chemical disruptions in the brain’s equilibrium, and that the brain may respond by creating the kind of changes that may make their situation worse in the long run?
Do you ever tell your clients this kind of information? Do you even tell them what the actual side effects are, or that CBT is just as effective with a dramatically less dangerous side effect profile?
Well said. Admitting to this means we can’t distance ourselves from our clients so effectively, because we also have suffered and have our own dysfunction and pain. To truly be conscious of the impact of abuse and neglect, we have to face our own demons, and that is painful. Alice Miller totally got it right. If we are unable or unwilling to face our own losses, we act out our pain on our clients as a means of distancing it from ourselves. That seems to be what psychiatry and much of psychology has descended to – a big, complex psychological defense mechanism against recognizing that “they” are no different than “us.” Which is the exact opposite of what really helps those who come to us seeking help.
This should be kind of a no-brainer, but it isn’t for some reason. Kids who grow up abused and neglected in any way are more likely to be diagnosed ADHD and depressed and anxious and psychotic. But the current model divorces symptoms from causes, so we try to make the symptoms go away.
In a way, this should be big news, because it belies the “ADHD is purely biological” argument. But in another way, it’s so obvious that it shouldn’t have to be news. Anyone using their brain can see it if they simply look. Unfortunately, most of the mental health community continues to have their eyes shut.
Thanks for this timely and well-written essay. I agree with your three points, 100%, especially regarding the dramatic negative impact of labeling kids and adults as a means of isolating ourselves from discomfort.
The only thing I’d add in the area of bullying is that one reason kids bully other kids is that adults bully kids all the time, especially in school. If we want kids to treat each other with respect, adults have to start holding themselves to the same standards they want to see from kids. They need to listen when kids have complaints or concerns, notice when their behavior is hurtful and apologize, and be willing to negotiate and mediate as needed to resolve issues.
The labeling of kids is just one manifestation of adults taking advantage of their privilege and power and dumping their emotional issues on those least able to defend themselves. As you rightly say, it’s a very sophisticated form of name-calling, and we need to stop doing it!
It’s on the product label, for one thing. There was something in the Canadian Journal of Psychiatry in the early 2000’s where a guy went back and checked records of kids who’d been given stimulants, 100 records, and found that, as I recall, over 6% of the kids reported psychotic symptoms. I’ve heard research estimates of anything from 2-8%. I think it depends what they define as psychotic symptoms. Anyway, I found that one just by typing “stimulants cause psychosis research studies” or some such thing into my browser. There were multiple hits, but that was the best one. Totally legitimate, mainstream journal. I don’t think there’s any doubt that it can cause psychosis.
What a horrible tale! I admire your gumption in trying to turn your own trauma into a benefit for others who are similarly at the mercy of these “professionals” who often lack mercy and empathy altogether, at least toward their “patients.” Thanks for sharing your story. I’m glad you’re still fighting – we’re with you!
My comments were included, if somewhat reduced in detail. I think mine was the only one to connect the shootings to actually RECEIVING psychiatric care. The original author chose not to comment on that particular point.
I also wrote a letter to the editor, referencing the many shooters who had received psychiatric “help” BEFORE going on their shooting sprees. I encourage anyone with experiences to share or data to impart to write a letter. I’d love to see them bombarded with rational letters supporting the author’s viewpoint.
I think you are missing the point. Jackie was “clearly schizophrenic” (as you put it) because her clinician chose to VIEW her that way, and the data he reported reflect his assumptions about the situation. It is quite possible and maybe even likely that if the second clinician had talked to Jackie, s/he would have discovered a similarly compelling story. But #1 never bothered to ask her about the reason for or meaning of her voices, while #2 was interested in Jill’s story rather than telling her his view of what was wrong.
It’s also almost certain that if Jill had gone to clinician #1, she would have been diagnosed with schizophrenia and “treated” accordingly, without #1 finding out anything about her history or the possible reasons/meanings behind her symptoms. #1 would never have asked about her story.
The point is, the conclusion that is reached is dramatically impacted by the questions that are asked, and those questions are a function of the professional biases of the clinician – they don’t necessarily have anything at all to do with the client.
Case in point: I was called to the hospital to do an involuntary treatment evaluation on a 17 year old, developmentally delayed girl. She was intellectually about 6 years old. She was diagnosed with bipolar disorder, based on mood swings and aggression, which she clearly did demonstrate. However, a 20-minute phone call with her mom revealed that she has been relatively well behaved and happy until a couple years ago, at which point she was raped. She reported that the girl became withdrawn and depressed for about a year, at which point, she disclosed the rape. It was only after this disclosure that she began to be aggressive and “moody.”
She did fit the criteria for “bipolar disorder.” But I had her diagnosis changed to “PTSD,” since the “bipolar” symptoms clearly only arose in the context of a severe traumatic event. Was the first clinician wrong, or was I? There’s no way to say. The first clinician used a very narrow set of questions focused on symptoms, and told the story that this girl’s brain was malfunctioning, because that’s what s/he was looking for. I asked broader questions based on the idea that her behavior had a cause and a meaning, because that’s what I believe is important. You could say I was as biased as the first clinician, but my bias was to support more of a sense of agency for the client, because that’s what I observe to be the most helpful way to intervene.
To me, diagnoses are not right or wrong. They are either helpful or unhelpful. Mostly, I think they are unhelpful, because they take power away from the client. I used them because I had to, and I tried to use the ones I felt were the most helpful in getting them the support they needed, and if not that, the ones that did the least harm. I think you and your clients might benefit from thinking about diagnoses in that way. The client’s story is much more important and relevant than the label we choose put on them ever can be.
It’s hard to credit a diagnosis that is so vague in its criteria. Autism is probably one of the few semi-legitimate DSM diagnoses, but it’s still impossible to say who “has it” vs. who does not, let alone predict the long-term outcome. It is one more example of shoddy science leading to dire, self-serving predictions of lifetime disability that aren’t necessarily true at all.
This is simply AWESOME! Thanks so much to Sandra and her team for putting their beliefs into action. I am hopeful for the first time that something new may be going on in psychiatry, at least in one state!
I doubt that was the only reason. My bet is one of their advertisers read the piece and threatened to pull their support if they didn’t retract. Or maybe more than one. Pharma companies pay a huge amount in advertising, and money is definitely power. Or perhaps they simply threatened to put a contract out on the CEO…
Wow, what an excellent piece! It reminds me of the discussions of what word to use for the people descended from the people who lived here in the Americas before Europeans arrived to steal their land and livelihoods. Members of the dominant culture make themselves feel better by saying “Native Americans,” but when you talk to those people they are referring to, most would prefer to be identified by their tribe or locality or family name. Lumping them all together and giving them one name is, in itself, a part of the oppression. Might as well stick with “Indians.”
The need for “providers” to distance themselves from “consumers” of “mental health services” is deeply embedded in our culture. Ironically, I have found that the ability to erase or transcend that distance, to create a sense of commonality and mutual experience with those I am trying to help, is the core of what actually leads to a reduction in the person’s suffering, regardless of their “symptoms.”
The one thing the people you are referencing have in common is, perhaps, their experiences in the mental health system. Sometimes I have referred to the group as “those people who have been labeled by the mental health system as having a ‘mental disorder.'” A bit wordy, but a lot more specific. A slightly different group might be “those who are currently experiencing significant mental or emotional distress.” But that pretty much covers everyone at one time or another, doesn’t it? Maybe we should just refer to people as human beings, and recognize that distress and emotional pain is simply part of the human experience.
Thanks for the excellent blog – I am really looking forward to Part 2.
I definitely can support the idea of “formulation,” IF it is a formulation that is created by the CLIENT in collaboration with a supportive professional, who is not invested in their own explanation of their client’s reality. I would stay away from clinical language altogether, and put it in the client’s words (i.e. “The client says he hears people talking to him that others don’t appear to be able to hear, one of whom is rather rude and scary, and he would like this voice to be quiet or at least be nicer. He says the voice reminds him of his mother’s and he wonders if it may be related to how he used to treat her as a child.”), and I would require that the clinician check back at every juncture with the client to make sure their version of reality continued to reflect the client’s formulation of the problem.
Unfortunately, it would be way too easy to take “formulation” and make it into a disguise for “diagnosis” if the clinician decides to substitute his/her voice for the client’s, whom the clinician may easily decide “lacks the insight” to be able to do his/her own formulation. The element of the clinician’s humility is the critical factor, regardless of what you call the final product.
I really appreciate your efforts to create an alternative view. I do agree also with the concerns raised regarding reimbursement – it’s hard to see how insurance companies will pay for something without their little diagnostic codes to make them feel secure. Perhaps the idea of subsuming mental/spiritual/emotional well being under the rubric of medical care/insurance has to change before we see real progress.
Sounds like a lot of blaming going on. Maybe the reason is a lack of skill in understanding youth’s behavior, or even a lack of genuine empathy for the youth in their care. A careful reading of just this abstract should tell any parent to stay far away from psychiatrists in seeking help for their kids – they seem very willing to ignore scientific evidence in favor of “clinical and cultural norms” that are useless or harmful to their own clients.
I have also read that the therapist’s relationship with the client may have as much or more to do with success than the particular modality of therapy used. As I recall, it appeared that creating a safe space for sharing experiences in a non-judgmental and empowering way was the core of what made any therapy more effective. If the clients felt safe and respected, they tended to get better, whatever you called the therapy.
Bottom line, I agree with Milton Erickson’s sentiment that good therapy has to be re-invented for every client. I think we do what helps the client move forward toward the kind of life they are seeking, whatever that is. I don’t think there will ever be a “modality” that can account for all the wonderful variations and nuances in human behavior and experience.
And I agree, we should not attack anyone who is genuinely trying to help, even if our own experiences differ. I’m not in a position to say if Belinda is or is not attacking you (I haven’t read her posts, to be honest), but I value anyone who is really trying to make a difference and believe there are many paths to that particular goal.
We homeschooled, too, and I felt it was the best decision. Kids will eventually have to deal with the “real world,” but there is plenty of opportunity for that as they get older. When they have a strong base and believe in their own judgments, as tempered by facts and observations, it’s much easier for them to deal with the charlatans of the “real world” and maintain their integrity. But I agree, the parents have to have the right temperament, and it doesn’t work for all kids.
I did fine in school, in fact, I was a “good kid” and got good grades, never got in trouble, but I was depressed and anxious my whole school career. I absolutely remember being left in Kindergarten at age 5 and feeling abandoned to strangers. It seems a very bizarre thing for us to do, and I believe contributes to our community burden of mental/emotional/spiritual distress.
I am glad you are out there, doing good recovery work. But I am afraid you are more in the minority than you may believe. I have been a mental health practitioner and advocate in the field for over 25 years. It did not surprise me one bit to read that three quarters of the time, a mental health professional is responsible for telling their client that recovery is unlikely or impossible. That may be changing a bit today, but if it is, that movement is in its infancy and it remains to be seen if it becomes “mainstream.” I just know that when I talk real recovery talk in mental health planning meetings, the room often becomes quiet and the subject is quickly changed in most settings. Client empowerment makes most clinicians very uncomfortable.
I have also heard the message repeatedly that “recovery is possible IF you follow your medication regime.” I do not consider that a recovery message at all. It is an implied message of hopelessness – you can only recover if you accept that your brain is broken and that your distress is a meaningless expression of genetic inadequacy.
Recovery, in my view, has to be defined by the client. Medication may or may not play a part in it, at the client’s discretion. Defining the issue as a “mental illness” or a normal response to life’s difficult circumstances should also be at the client’s discretion.
Most mental health clinicians I have known do not subscribe to these principles, even when they talk about “recovery” and sincerely mean it. The majority seem to believe the client’s brain is broken, and they convey that to the client, directly or through their behavior.
I believe the statistics are an accurate reflection of most people’s experience with the mental health system. It is not an overly negative spin – it is the truth.
I used to work on a suicide hotline, staffed almost entirely by volunteers, and it was amazing how helpful it was for the suicidal person just to have someone listen to what they were struggling with that made life not seem worth continuing. Validating that life can be awful and that many of us (including me) may contemplate suicide as a potential solution to the dismal appearance of our lives seemed to be the thing that helped the most.
I do think suicidal feelings are a very normal reaction to the stresses of modern society. That the folks on a psych ward would try to stop patients from discussing their suicidal feelings with each other just shows how very far psychiatry has come from even understanding the problem they think they are working on.
I totally agree, any discussion of suicidal behavior and feelings needs to start with the person experiencing those feelings. That’s how I always approached it and it worked very well for me and the callers.
Thanks so much for this piece! I have been speaking these same words to my fellow professionals and even fellow critics in the US for years, but have often felt like the lone voice in the wilderness.
Many people protest the treatments of psychiatry without recognizing that the diagnostic system is the greater evil, the evil that makes is possible to continue to justify ineffective and destructive and even deadly interventions. Having a label allows us to blame the patient for their own distress and deny any form of social causation, allows us to invalidate their reality with impunity, and also allows us to excuse ourselves when our interventions don’t work or make things worse (you have “treatment resistant depression”). Not to mention allowing a lot of “professionals” and corporations to make obscene amounts of cash off a set of permanent “clients” who are unable to defend themselves or seek an alternative pathway.
Remove the DSM diagnosis, and the entire edifice of thought comes tumbling down. I’m so looking forward to your next post!
I am so glad to hear you comment on the irrational, evidence-avoidant standard of care in the obstetrical care community, which mirrors the area of psychiatry in many ways. In both arenas, we enforce interventions on entirely healthy people who are experiencing distress around big events in their lives. We can’t leave well enough alone, can’t seem to validate the difficulty of life experiences without trying to make it go away, and arrogantly assume that “doctor knows best” and that true informed consent would only cause the ignorant and naive patient to make bad decisions, because they are too stupid to understand that our disempowering interventions are really incredibly helpful, despite their personal experiences of pain and disability that result.
I am glad you are out there informing people of what is and is not known about these interventions in an honest way, and looking at empowering patients through presenting viable alternatives, which is a much-overlooked aspect to informed consent. I wish your approach were not so unusual – it is what all doctors should be trained to do as a matter of course, but in practice, I find your attitude vanishingly rare.
And remember that relapse after discontinuation does not mean the drug was working. It may well mean that the brain has adapted to the drug’s presence by becoming dysregulated in the opposite direction, and that withdrawing medication simply brings that dysregulation to the fore. It might prove that the drugs themselves are causing harm to the patients’ brains, as Whitaker so eloquently argues in his book.
It seems the real comparison group is those who never took the neuroleptics in the first place or who discontinued relatively quickly. If those people are doing no worse than those who took the drugs, we can conclude that the drugs are probably ineffective. I know there is a potential selection bias of the less affected being more likely to refuse or discontinue medical treatment, but I don’t know that that point has ever been effectively established. But regardless, treatment ought to have a significant positive effect. If we’re reduced to arguing about whether the untreated group might not have been as bad as the treated group, we’re already talking about treatment effects that are probably pretty negligible, otherwise, the difference would still be observable.
It sounds like we need a change in the law that makes such prosecutions viable. It’s related to the “corporations as persons” concept that we saw in the Citizens United ruling allowing unrestricted funding of political campaigns. We need a constitutional amendment clarifying that corporations do not enjoy the same constitutional free speech protections as individuals. A Corporation is NOT a person!
Alice, your post is moving and informative as always. I totally agree with the parallels between the psych world and regular doctors – all have moved away from history and causation into a focus on immediate symptom reduction through prescriptions, and it serves us poorly. It was noted in the JAMA in the last several years that receiving medical care was the third leading cause of death in the USA, mostly from prescription side effects.
But I do think there is something more heinous about psychiatric diagnosis. Because of its subjectivity, there’s no way to dispute someone’s “professional opinion” by seeing the x-ray or test results. Additionally, the “treatment” is in most cases the very opposite of what might actually be helpful. I am actually less concerned about the drug effects (which are VERY concerning!) than I am about the message that people get when we dispense the label.
First, it tells them that their emotional response to the world is WRONG. They SHOULD apparently be feeling happy and contented with things as they are, even if they’re in foster care or in a domestic abuse relationship or have recently lost their mom or can’t make enough money to pay the bills. (But don’t get TOO happy – then you’re MANIC!)
The second message is that YOU CAN’T DO ANYTHING ABOUT IT. If you know you are feeling depressed because your relationship with your husband is destructive, that gives you options. But if you’re depressed because your brain is broken, you are powerless. In my experience, depression is often a result of a loss of a sense of agency or control over life’s experiences – feeling trapped or hopelessly committed to a destructive course of action. Telling a person they have no power to change their emotional state by changing their views or their relationships or their world in some way reinforces the depressing thoughts they already have.
Finally, the medical model holds out hope that their magical pills will make everything all better. As all of us know, this is at best misleading and can be deadly in the long run, or sometimes even the short run. People will wait months and years for their doctor to come up with the right combination of drugs to make everything OK, and meanwhile, their lives pass them by and they feel more and more hopeless about their existence.
Healing (in my experience) has generally come from three things: VALIDATION of the depressing/confusing/scary/infuriating contditons; EMPOWERMENT of the suffering person to do something about it; and SUPPORT for creative approaches that the person decides to try, whether those are physiological (improved sleep, exercise, thyroid treatment, energy medicine), psychological (therapy, self-help, support groups, role-playing, etc.), social (new activities, friendships, ending destructive relationships, renewing past successful endeavors), or spiritual (meditation, religious practices, exploration of the meaning of “hallucinations,” protest movements, writing, art, and many more).
All of these things help the person feel more in control of their lives. Psychiatry as generally practiced helps people feel less in control. It also denies the social realities that cause emotional distress, including poverty, racisim, sexism, warfare, global corporate domination, and the general commercial stupidity of our current way of living. The labels place all the cause of distress on the person’s malfunctioning brain. It’s not just destructive – it is absolutely the WORST thing you could do to a person who is suffering mental or emotional distress!
But I guess it makes money for people, so we should just be OK with it. I’m getting depressed and angry just writing this…
REAL science takes into account all of the variables involved. Psychiatry has long since divorced itself from science by arbitrarily limiting their research to neurology, not even honestly looking at that area, and denying that other variables exist. The idea that psychiatry would “disavow science” by taking these social, emotional, and spiritual variables into account highlights the incredible biases that have prevented psychiatry from even looking at the real data in the neurological areas they claim to be scientifically interested in.
Anyone who is interested in a truly scientific viewpoint would be horrified by the dismal outcome data for psychiatric interventions, much of which has been available for decades but is only now coming to light, due to the intentional SUPPRESSION of this data by the psychiatric establishment.
To suggest that psychiatry has in any way been seriously involved in a scientific endeavor in the last 30 years is laughable. At least since the DSM-III, psychiatry has insisted that science take a back seat to marketing. Take the serotonin theory of depression, for instance: disproven convincingly in the mid ’80s, propagated for marketing purposes to the present day. That ain’t science, folks!
The sooner we stop pretending that psychiatry has been focused on neuroscience, or on any science at all, the sooner we can get back to genuinely scientific endeavors that objectively look at all the variables, and that value real patient outcomes over profit margins.
This disgusts but does not surprise me. I used to work at a suicide hotline, and the AFSP was a legitimate grass-roots organization. It apparently has been thoroughly co-opted by drug company interests at this point.
Similar things are happening in the area of “postpartum depression.” There have been historical grassroots efforts to provide real support to moms who are struggling emotionally after the birth of a child, and the many reasons for such struggles were identified and acknowledged. Now those groups have also been co-opted and the talk is all of “treatment” for the “disease” of “postpartum depression” rather than the frequent natural reaction of depression and anxiety that often accompanies the transition to motherhood, especially in a society that does such a poor job of supporting new parents.
Good for her for speaking up about it at the meeting. I’m sad to see good, solid, grassroots support networks being targeted by these evil corporate slimeballs. There are no limits to how low these scumbags will go to get a buck into their coffers.
My immediate thought was, maybe her symptoms reduced when she was in the hospital because she was able to escape from whatever abuse or oppression she was experiencing at home. Why this thought does not seem to occur to the mainstream psychiatrist is puzzling at best.
I once talked to a psychiatrist to get some history about his patient. He told me she was an intractable case of depression, been seeing her 15 years, tried everything (listed a bunch of drugs they’d used), nothing seemed to work. I asked him what had brought her to his attention initially. He said, “Huh?” I asked, “What was she originally depressed about that brought her to your care?” His rely, “Gosh, I don’t know!” Stated in a mildly incredulous tone that suggested, “Why would THAT be relevant?” He’d tried everything except asking her why she felt bad. She would have been better off talking to an average 8-year-old, who would at least have had the sense to ask her, “Why are you crying?”
Part of seeing what they want to see is seeing things from the perspective only of what benefits them, and yet being able to rationalize it as for the patient’s own good. We’re all susceptible to this, but a true professional knows s/he has this vulnerability and is constantly checking him/herself for losing focus on the client. Humility is, indeed, the word. Medical decisions shouldn’t be made for personal profit or ego enhancement; moreover, decisions about people’s emotional/spiritual life shouldn’t be considered medical decisions in the first place.
Sandy, it sounds like you have been a bit of a radical all along, although it’s disturbing that the idea of taking the time to understand your patient is actually a radical one in psychiatry today. I don’t know that I could have tolerated working in those circles as long as you have, but I admire your courage AND your humility and am glad you’re there to help open they eyes of those that are willing to see beyond what makes them personally comfortable.
I agree it’s a very positive sign that the psychiatric establishment is saying such things – it brings me some level of hope. But the glass is definitely only half full, or maybe only an eighth, as long as they are avoiding the hard facts about the adverse effects of their supposedly helpful medications. Both the long-term impact on mental health (increased chronicity due to messing with the dopamine system) and the long-term impact on physical health (acknowledging that these drugs ACTUALLY KILL PEOPLE who would otherwise live, which partly explains the early deaths) need to be overtly acknowledged before we make real progress.
Still, it’s an acknowledgement that the current paradigm sucks big time, and for that we have to be appreciative. Gives us something to build on. Thanks for sharing it, and good for jolly old England!
I think a better question is “how do you benefit from this behavior?” or “What do you get out of doing that?” I agree that asking a child “why” ends up being an inadvertent reinforcement, as well as pretty fruitless, because many times, the child’s motivation isn’t something they are aware of. But in doing therapy with adults, I have found that discovering the purpose of a “negative behavior” enables the client to figure out what need s/he is meeting with the behavior, which makes it easier to find a different behavior to meet the same need. Many times, I am undoing some of that childhood reinforcement of negativity that Howard is talking about.
That being said, the biggest unused technique in therapy is asking the person when the problem DIDN’T happen. I often asked clients who were, say, depressed, “When was the last time you didn’t feel depressed?” If you follow up on what was going on at the times s/he felt good, you can discover some things s/he may already know that work to alleviate his/her suffering.
It seems to me that, when working with adults, a combination of “solution focused” therapy (what works rather than what doesn’t) and a very change-oriented examination of reinforcements for the client’s undesired (by them) behavior (which often leads to an examination of “reasons” from the past) is a very fruitful approach.
Howard, you’re awesome, but you forgot one important point: the “medications” aka drugs given for these childhood behavioral problems have never been shown to improve long term outcomes in any meaningful category, including self-concept, academic achievement, high school graduation rates, delinquency rates, or rates of employment as an adult. If parents understood that these drugs did NOTHING to improve their child’s life in the long run, while exposing them to serious risks in the short and long term, I have to believe that the vast majority would look for other options. The main reason people continue to participate in this fraud is that they are assured that “untreated ADHD” leads to all of these awful outcomes, but are never told that the “treatment” doesn’t affect the mentioned outcomes in the slightest, except possibly to make some of them even worse.
Glad you’re still out there pitching after all these years – you’ve always been an inspiration to me. Thanks for your post!
Jack, you’re doing something awesome here, and I’m so glad that you’ve gotten some people in the hierarchy of the MSW world to listen. I have found myself in that same dilemma described by the social workers, and resolved it by putting the necessary code on the paper, and explaining to the person I was helping that I was required to do so in order to be paid, but that I considered the “diagnosis” merely an oversimplified description of the external situation that meant absolutely nothing about what was really going on with them or how I would try to assist. Still, I found this an inadequate response, as the label still hung around them even when I told them it had no real significance, as I knew that others would later “treat” them based on the diagnosis I’d given. So I always tried to diagnose everyone with either and “Adjustment Disorder” or with “PTSD,” since those were the two that most closely conformed with my actual view of the causes of “mental illness” as currently defined (i.e. trauma and social circumstances), and were the ones most likely to end the client up with therapy rather than drugs. I assiduously avoided “bipolar disorder” or “schizophrenia” for anyone not already so diagnosed, and got a number of trauma victims de-labeled (an inordinate percentage of trauma victims were labeled “bipolar” in the clients that I ended up seeing in the ER).
I particularly liked you raising the question of PTSD as an injury rather than a “disorder,” and the connection of this question to the one of transferring blame for their condition from the war we sent them to back to something wrong with their internal functioning. Of course, the same applies to ADHD and the schools, and applies in spades to the new effort to reduce the time that the “Bereavement exception” applies in the DSM-5 to a matter of two weeks! The DSM 5 takes reductionism to a new level of absurdity, and I love the idea of a boycott!
Thanks for your great work, and let me know if you’re ever out in Portland, OR – I’d love to help get folks in Oregon interested in the kind of paradigm you’re promoting.
I would love to see a brain scan trial on people who are indoors and then outdoors in different environments. I guarantee the brain scans would differ significantly depending on the environment. Anybody with an ounce of common sense (although we have to question how “common” it is, at least in psychiatry!) knows that a person who is feeling grim, depressed, frustrated, or out of sorts is likely to gain some relief from going for a walk out of doors. Why would we take depressed people (or anybody else) and put them in an environment with limited light and fresh air and lock the doors and not let them out? The environment itself would depress almost anybody! Especially when there are lovely locked rooms with beds that have leather straps to hold you down and a herd of grim-looking psychiatrists making notes and writing prescriptions but not bothering to talk to anyone on the ward. The whole setup in the average psych ward is frightening and depressing (I’ve visited more a few). The least we can do is let the poor inmates go for a walk. Even prisoners in the criminal justice system are afforded that right!
Wow, that is pitiful! I meant it when I said, “Depending on what kind of training they get.” I was assuming they were thinking of something along the lines of “trauma informed care,” i.e. how to approach a person who may have been historically traumatized (often by other police officers) and may automatically view a police officer as a threat. But of course, you’re right – this same thinking should be applied to pretty much anyone who is in distress, even if it’s just the fear of being caught for a crime they just committed. Training in “brain disease” thinking may make it MORE likely that they’ll taze somebody, because they will find it easier to distance themselves from the victim. EMPATHY is the key element in any effective training along these lines. If that’s absent, it’s worse than a waste of resources.
Anonymous, you’ve said (correctly) many times that nobody can know for sure whether drugs caused or added to a situation where someone commits a violent act or criminal act. I don’t think there’s a lot of disagreement there. You also say correctly that a drunk person is still responsible for their behavior when drunk. Also a given, which I don’t think anyone’s going to argue with.
I think there are a couple key points that go beyond what you’re saying, though. This is not just about people trying to evade criminal responsibility through drug blaming (though of course, there will be folks who will jump on that bandwagon if they think it will get them off – remember the “Twinkie Defense?). It’s about establishing some honesty about the true side effect profile of these drugs so that people can truly make informed decisions BEFORE taking these drugs.
Take your alcohol example: most people are well aware that alcohol reduces inhibitions, that people sometimes do really stupid things when drunk, and that alcohol does not do anything to heal your brain or address any physical or mental illness (except to the extent that a small amount seems to have a positive impact on circulatory health). They aren’t given a prescription and told they need to drink every day to maintain their mental stability. So the person who drinks is making an informed decision to poison his/her body with something s/he knows could cause trouble.
The difference with the antidepressants is that people are lied to. They are told that these are helpful drugs that are needed to heal their brains from chemical deficiencies. They are told that the side effects are “generally mild and usually go away after two or three weeks.” They are told that the drugs DON’T decrease the recipient’s inhibitions and that the stories about suicide/homicide/violence resulting from antidepressant use are either made up or are “a consequence of the condition,” as you yourself show in the article you quote.
I don’t think people here are trying to say that antidepressants can be definitively shown to make a particular person kill who otherwise would not have, or that there is any way to even make that determination. I think what folks want to say, and the reason these articles appear, is that antidepressants ARE associated with increased violence and aggression and suicidal acts, that they DO, in fact, decrease SOME people’s inhibitions, and that it is LIKELY that SOME PEOPLE commit crimes that they otherwise would not have if not on the antidepressants, just like SOME BAR FIGHTS would not have occurred if the participants were sober.
The people who were drinking at the bar knew the dangers when they started drinking. They knew they were poisoning their brains and continued to do so of their own free will. The same cannot be said for the vast majority of people who take antidepressants. They are intentionally deceived, and often don’t find out the truth until after someone is already dead. I think it is very legitimate to show examples of where antidepressants MIGHT have been a contributing factor as a means of establishing some social agreement and awareness that these drugs are not benign “chemical balancers,” but can in fact create extreme reactions in some people that can result in tragedy.
I have to believe that you’d agree with that general message.
As a Portland resident, I can tell you that the main reason they’re doing this is because there have been a number of incidents where people having mental/emotional crises have been shot and sometimes killed, not to mention tazed, maced, or otherwise traumatized. I think it’s probably a good idea to have a unit that is better trained to deal with traumatized or emotionally upset individuals, depending on what kind of training they get. I’m assuming the goal will be to communicate before shooting, which I have to imagine will be a step in the right direction.
It did mention that some people do fine without antipsychotics, but it was rather tepid support. The general thrust is that we should get people on antipsychotics if we can, though they do support low dosages. Trauma goes almost unmentioned. The part on CBT is probably the best, but isn’t really coherently connected to the rest – if hearing voices is a common phenomenon, and people we diagnose as “schizophrenic” are just at the far end of that spectrum, why are we treating people who hear voices as diseased individuals instead of having the primary goal be to help them make sense of their experience? Shouldn’t drugs be an ADJUNCT to these efforts, rather than the primary form of care? These guidelines don’t appear to challenge the medical paradigm, though they do expand on it significantly. I’d say it’s an improvement, but a very minor one.
Wow, what an awesome and courageous experience! Will, you have absolutely embodied what we all need to be doing in our discussions with psychiatrists, NAMI, and the rest of the “mainstream” world. I am so happy to hear of the support you received from within the rank and file of the APA – it’s encouraging to know that such people are there and willing to speak up.
I would encourage us to take a different approach re: the “Scientologist” accusation. It is the APA who has worked hard to discredit Scientology and to associate anyone who disagrees with them with that religion. In doing so, it is PSYCHIATRY, not Scientology, that is intentionally discrediting genuine efforts at mental health reform, using the “Scientology attack” as their foil.
My response to such attacks is simple: “What does religion have to do with whether or not the current psychiatric paradigm’s effectiveness is supported by scientific evidence?” Or “Why are you talking about religion? I thought we were talking about science here?” We don’t have to defend ourselves or defend Scientology – we can simply label the ad hominem attack for what it is – an intentional distraction from the issues at hand.
I think we really need to take that bludgeon out of their hands – the fact that the Catholic Church opposes abortion is neither here nor there in arguing the pro-life/pro-choice issue, and the fact that Scientology is opposed to psychiatry has no bearing whatsoever on whether psychiatry is scientifically supportable in its current form. This kind of blunt turning of the tables also exposes the attacker’s strategy and makes it less likely that others will try the same tactic in the future.
That aside, I am totally impressed by your efforts and delighted at the response you got. Maybe you can get them to start a “psychiatrists for reforming psychiatry” support group, starting with the attendee list for your lecture! It was also fascinating to hear your account of the insider politics at NAMI. I think it’s a great reminder that almost any organization can be amenable to reform – there are always rational people in ANY organization whose better sense can be appealed to. Sometimes it’s not even necessary to convince the leaders to change direction – sometimes, the rank and file changes direction and the leadership has to change or will be changed by its constituents.
I will share another bit of hope. I did a “mental health” training recently for CASA volunteers, none of whom are trained in mental health care – they are volunteers off the street. When I asked them about their belief in “chemical imbalances,” one of the audience commented, “Isn’t that kind of a discredited theory these days?” The word IS getting out and public perception IS changing, if slower than we’d like.
Thanks for this wonderful message of hope, and for the awesome work you do in Portland and around the country!
Not to mention teachers, school bullies, sleazy uncles, babysitters, coaches, Sunday School (I had some great Sunday School trauma!), and anyone the child has to depend on for their care or is forced to interact with despite their own judgment.
There are a lot of stressful situations out there, and abusive fathers (including those who abuse the parent and don’t directly abuse the child) are high on the list of mind-screwing experiences that would mess with anyone’s life. Oh, and let’s not forget stepfathers and unrelated boyfriends, who are the most likely people to abuse or kill children they happen to live with, beyond the child’s bio parents (who obviously are the most likely, if only due to average exposure times and numbers).
I also don’t get why it’s “blaming” the parent if you simply observe that they hit the child or sexually abused them and it had a bad effect on the child’s emotional condition. That’s not blame, it’s just observing the facts. Those who are reactive to possible “blame” are often guilty of things they feel bad about and that makes them more sensitive, in my view. It’s hard to acknowledge when you’ve let your kids down in some way, but we all do as parents, and if we have the courage to admit it, then our kids can start healing from it as needed. But pretending we had nothing to do with their adult behavior and emotional condition prevents even discussing the issues that might lead them to a healthier future.
Parents shouldn’t worry about being “blamed.” They are the parents. They are responsible for creating the best environment they can, and for helping their kids adapt to life. No one does it perfectly, but by being humble, we do a much better job than if we’re worried about being “at fault” when our kids don’t turn out to be perfect.
Maybe the drug companies have realized that there will be no new breakthroughs because their basic approach was deceptive and morally bankrupt to begin with, and people are finally catching on. If I were a drug company CEO and read Whitaker’s book, I’d certainly be thinking about alternate areas for research! I wonder if they’re just leaving town before they’re tarred and feathered and run out of town on a rail.
I’d be interested in comparing rehospitalization rates for people who continued on their prior dosage. This certainly supports Whitaker’s conclusion that “relapse” is often the result of withdrawal reactions to the medication.
I’d also be interested in hearing how your colleagues responded to your presentation.
I agree with Sandy – in order to get real change happening, we have to start using at least some of the language that is used by the people we’re talking to, or we’ll have no common basis for discussion. At the same time, Mary Boyles’ essay shows us how we can use those terms to explain what we’re talking about while still making it clear we don’t buy into the concept being implied by the label. In this way, we can start to get behind the label and look at the labeling process itself, which I and others have pointed out is what really provides the cover/impetus/ rationalization for all the rest of the dangerous nonsense about brain diseases.
I often resort to using things like quotation marks around diagnostic labels or saying, “people who have been labeled with the schizophrenia diagnosis” or “people who have been viewed by the current system as qualifying for an ADHD diagnosis.” This is usually digestible by people who need to believe in the labels, but allows a broader discussion to occur about whether those labels really have any legitimacy at all.
I do think this kind of work is essential, even though it feels a bit like an unacceptable compromise to even ask questions in the form they are asked. People are going to do research on “schizophrenia” whether we like it or not. I think it’s awesome that some funding will go to asking the question of whether treatments for so-called “schizophrenia” might be worse than the purported “disease,” even when I don’t agree that the “disease” is really a disease at all.
Just to clarify, I know your work well enough by now to know that you were not saying they were safe and effective, just quoting Friedman’s statements. You’ve been one of the courageous pioneers in stating the truth about these drugs when it was politically unsafe to do so, and I’ve followed your quality scientific work for many years as the world has slowly caught up to what you already knew 10+ years ago. You’re one of my heroes, and I have tremendous respect for your work, as you have always done a great job of letting the research to the talking and keeping the rhetoric to a minimum. Thanks for this and all of your excellent work!
Psychosis IS a well-established side effect of stimulants, even at prescribed dosages. A retrospective study published in the Canadian Journal of Psychiatry (about as mainstream a journal as there is) stated that over 6% of stimulant-treated kids he looked at retrospectively had evidence of psychotic symptoms in their file. I would hardly call 6% rare. This does not include the larger number who have aggressive incidents related to stimulant use, which is also covered in the story, though blamed on adolescence rather than the stimulant drugs. What REALLY dismays me, though it hardly surprises me any more, is that the doctor, KNOWING that psychosis is a potential side effect of stimulant treatment, switches to Risperdal, rather than just discontinuing the stimulant and seeing if the symptoms go away. And the poor kid is now left spouting psychiatric dogma: If I didn’t take Risperdal, I’d be too bad of a kid for my parents and teacher to handle.
It disgusts me no end that we know the school environment itself is causing the biggest proportion of these “disorders”, but the kids continue to take the blame and have their brains screwed with because they don’t fit into the environment. And I find this doctor highly reprehensible for going along with it. If he is so certain that the school itself is the major cause of these kids’ suffering, why isn’t he speaking out and meeting with the school principals and superintendents and PTSAs and letting them know what’s going on? Doctors have a natural authority that would make people take notice if they started sending this message. Why isn’t he refusing to medicate and offering these parents alternatives, like seeking an alternative school environment or home schooling or getting their kids on IEPs or encouraging them to take political action?
“I’m their doctor, not the doctor for society” is a total cop-out. Time to speak up, Doc!
I absolutely agree with Jeffrey. I see this happening all the time in my work with foster children, and yet it is rare that anyone in the mental health field connects the dots. It’s usually up to my volunteer advocates to sound the alarm, and they are then usually subjected to a level of condescension that is often quite discouraging. The only answer seems to be to get a second opinion from another psychiatrist that contradicts the first, but most psychs aren’t willing to criticize their peers. Meanwhile, these kids are being diagnosed “bipolar” in huge numbers and given antipsychotics, when the problem originated in an adverse reaction to an SSRI.
“There’s the likelihood,” said a lead researcher, “that by virtue of the fact that our clinical diagnosis is not based in neurobiology, but rather in symptomology, that we may be giving kids a serotonin drug inappropriately.”
This quote gets my vote for understatement of the year.
“Antipsychiatry” is an ad hominem attack on a person whom the psychiatric authority (or authorities) don’t want to respond to. It’s a perfectly legitimate observation to state that the DSM diagnostic criteria are observably, objectively, undeniably subjective. They are clearly based on social criteria, such as “interferes with normal functioning,” or “creates clinically significant distress.” They are also based on the assumption that “clinically significant distress” is in itself the problem, rather than being a possibly appropriate response to a stressful environment.
It’s one of those things like being “pro-life” vs. “pro-choice.” It’s really an ethical/philosophical issue, not a scientific one. We’re all operating here on the idea that psychiatric diagnostic labels should be objectively distinguishable and should suggest interventions that lead to positive outcomes. The “true believers” in the Church of Psychiatry don’t subscribe to those same values. So when confronted with the scientific reality of their failed treatments, they sink to ad hominem attacks, having no rational arguments to fall back on.
As to this movement, I agree that a civil rights framework is the most encompassing and most difficult to argue with. People have the right to good information and have the right to decide for themselves what is and is not helpful. This is held to be true in every other area of medicine – the right to refuse treatment or a particular treatment is so fundamental, it’s been argued in front of the Supreme Court. Why should the same not apply to “mental health treatments,” which are based on a much more subjective and often outright spurious basis in comparison with objectively observable disease?
We also need a comeback for the accusation that everyone opposed to psychiatry is a “Scientologist” that doesn’t buy into the idea that being a Scientologist would make someone’s argument automatically weaker. Mine would be, “What on earth does a person’s religion have to do with the lack of a scientific basis for your claims? Either they have a scientific basis or they don’t. I don’t care if your detractors are Catholic or Muslim or Zoroastrians or followers of the Reverend Sun Myung Moon – I want to hear what the scientific basis of these DSM diagnoses are, or proof of your proposed ‘chemical imbalances.’ If you don’t have it, admit it and stop trying to distract us from the hard facts of the situation by bringing in irrelevant factors.” That ought to stop them in their tracks.
“Effective and safe?” Effective for what? The only thing they’ve been found effective for is psychosis. And they are NOT safe – they cause diabetes, obesity, and other metabolic problems, extrapyramidal symptoms, akathesia and Tardive Dyskinesia, and have a black-box warning for early death in the elderly. The atypicals and their earlier cousins are largely responsible for the 25-year-shorter average lifespan of a person diagnosed with a “serious mental illness.” What would they have to do to be “unsafe?”
We do need to fight, but we also need something to fight FOR and people who will fight along side of us. Most of what has been said here is true in one way or another. It seems what we need to do is to work to create and fund alternatives and demonstrate their effectiveness, as Mosher did, but then be prepared to take on the inevitable backlash of the swine who will object to having their snouts removed from the trough. In doing this, we need every person who is committed to the rights of those receiving “care” in any form to decide what is right/wrong with them, what they need and want, and what is actually helpful in getting them closer to meeting those needs. Some will be in the system, some outside. Some will be part of the government, churches, the military, even inside psychiatry itself. We need all of them.
The other thing I know is that changing systems takes time, because we’re actually changing culture. The Church of Psychiatry has spread its gospel message far and wide in our society, and many special interests are bound up with it in one way or another. As Ted correctly states, those with power will not give it up voluntarily. But part of that power comes from the beliefs of the large group of “true believers” who are not aware of the actual truth. Prying away as many of these people as possible with effective public relations campaigns will also be essential to this plan working. And remember that many of the believers who can be “turned” work within the Church of Psychiatry itself. I’m an insider rebel and know many others who would join up if a movement emerged, but they don’t feel they can for fear of their careers. We can say that’s gutless, but that’s realty. We need to create a NEW reality where it’s OK to question the psychiatric paradigm and where the priests are disrobed and shown for the charlatans they are.
It’s hard to believe in the Wizard of Oz once you’ve seen the man behind the curtain!
So let’s create, let’s inform, let’s find allies, and let’s take the power back, and let them know we won’t stop!
Duane, you are absolutely right! We have to find common ground with people who may not agree with everything we say and do. I’d add to your list: GOVERNMENT. While lots of government workers are frustrating and bureaucratic, and government leaders are often in bed with Pharma and the psychiatrists, there ARE people in government who are genuinely trying to do a good job and are as frustrated as we are with “the system.” And in the end, our government (which is, after all, put in place by US) will have to participate in bringing and end to the madness that is psychiatry.
I still think we miss the biggest problem: not all people are depressed/anxious, etc, for the same reason. I agree that lots of people (including me) experience anxiety and depression as a result of untenable conflicts between unreasonable or unethical social expectations and the dictates of their own consciences or personal integrity. But there are plenty of authoritarian folks who are depressed (usually for some good reason, like being abused or neglected or bullied, etc.) who simply accept the doctor’s recommendation of “medication” based on “chemical imbalance” as entirely plausible based on the assumption that the doctor knows more about these things than they do.
I agree that “antiauthoritarians” are more likely to be diagnosed, and more likely to be diagnosed with more severe “illnesses”, and are probably more likely to be coereced into treatment, because they don’t “go along with the program.” And I totally agree that the profession of “psychologist” has completely sold out to the current power elite, to the point that psychologists in many states are now demanding prescribing rights (Yikes!)
But plenty of authoritarian-oriented people are victimized as well, and the results are still disastrous. I have frequently met such people at survivor meetings, and their whole worlds have often been shattered by being forced to come to the realization that the “authorities” lied to them and did not have their best interests at heart. And some of the most vehement opponents of change in the psychiatric world are authoritarian-oriented people who are religiously committed to the idea that “these drugs saved my life.”
It’s a complicated world, but I think the first mistake is to try and classify people who are behaving, thinking, or feeling a certain way as all being the same. Even calling some people “authoritarian” and “antiauthoritarian” risks us going down the same path. I think the more salient point is that allowing the current power elite to define the status quo as “normal” and to label anyone not satisfied with that “normal” as “diseased” is the core of what needs to change. And we’ll need all the people we can, no matter where they fit on the “authoritarian” scale, to support us in challenging that enforced reality.
Bummer for you, but well done on taking a stand. Sounds like you’ve been moving in this direction for a good long while. Thanks for your support for the victims of this horrible power play.
I agree with you, but part of the problem of uneducated or mis-educated consumers is that the pharma companies are allowed to do direct to consumer advertising, as well as being allowed to market illegally to doctors, who also seem to believe their lies. Additionally, the APA, NAMI, and other groups who support pharmaceutical interventions need to be restricted in their ability to lie for Big Pharma. Lawsuits don’t seem to be enough – I think criminal penalties for illegal marketing would be a great place to start. Additionally, I agree that written informed consent should be required, including written statements to the effect that this drug is being administered in the absence of clear evidence that there is anything physiologically wrong with you, and that the long-term effects of this drug are not fully known but appear to increase in riskiness the longer you take the drug.
Which brings me back to my earlier point: we need politicians who aren’t bought off by corporations, which means we need to arrange it so corporations are not able to contribute any money to political campaigns. It’s a long road, but I hope places like MiA can help educate people in the meanwhile and build some momentum.
Sandy, would love to hear you getting involved with some advocacy at the APA!
Long-term outcome studies are critical, but I agree, there are many already extant that simply need broader publication (or maybe not so simply, as the media bias toward supporting drug company propaganda is clear).
For instance, we have been studying stimulants in “ADHD” kids for over 50 years now. All of the summary reviews have shown the same thing: kids exposed to stimulants long-term do no better than those who have no such treatment or take stimulants only briefly. These include the MTA study and the Oregon State University Medication Effectiveness Study, the latter of which reviewed every piece of extant literature on stimulant research, and found no evidence for any improvement in any long-term outcome, except for a slight reduction in the likelihood of a motor vehicle accident. Delinquency, school completion, test scores, college admission rates, self-esteem, social skills, and eventual employer satisfaction with their ADHD employees were all unaffected by stimulant treatment.
This kind of research already exists for “depression” and “schizophrenia” as well, as Bob documents in the book. I think the big question is how we get this information to be published broadly enough to undermine the Joseph Goebbels strategy (the Nazi propragandist who famously stated that “if you repeat a lie often enough, it becomes the truth) pursued by the pharmaceutical companies and their allies in the psychiatric profession.
Glad to hear a mainstream psychiatrist finally say this out loud. I’ve been saying it since 1990 when I first researched the long-term outcomes. Kids taking stimulants don’t do better than kids who don’t on any long-term outcome that we generally care about. It just doesn’t work.
Yeah, I remember those breasts developing in my teen years… I hope we see another record-setting fine. But really, these guys need to go to jail. They are criminals, as well as being really bad liars.
This speaks to the larger social issue of our current form of government-by-marketing. As long as political campaigns can be funded and supported by corporate marketing interests, market benefits will be the primary value our government promotes. The “free market” (and I use quotes, because it’s clearly no such thing) will never promote something like Open Dialog – it will have to be the general community, in the form of government representation by people who actually give a crap about THE CITIZENS rather than their corporate masters, who promotes this healthy and money-saving alternative to a lifetime of dangerous and ineffective drugging.
Sorry if I was a bit obtuse, there – reading it again, it does sound rather tongue-in-cheek. But my post can be considered a preemptive effort to respond to the anticipated reply of said poster, not to mention to the usual arguments of the psychiatric community, who would blame the “underlying condition” rather than the drug.
Glad I was able to re-read your post with the appropriate level of humor!
I can’t agree with you, Jeffrey. While I don’t know how a drug might or might not cause intent to harm, it is obvious that many drugs reduce inhibitions and increase a willingness to take risks or transcend social norms. (Why are drunk people more likely to get into fistfights?) It is also well known that multi-day loss of sleep does cause psychosis eventually, and drugs can certainly cause insomnia (know any meth users?) that can lead to psychotic episodes. I don’t know that this absolves the person committing the crime of their criminal act in all cases, but there is another crime being committed if the doctor involved knows or should know of these added risks and does not discuss them with their client.
Prozac was initially banned in Germany because of a noted increase in suicides and violent aggression. There is no question that this information should be shared and believed. It’s not a conspiracy to blame drugs – they really do have this kind of effect, and people are dying as a result. We don’t have to let the perpetrator off the hook in order to demand that unsafe drugs are kept off the market, or at least that the safety issues are honestly discussed with patients and monitored for, instead of leaving a guy like the one in the picture to assure our safety.
Don’t forget Marijuana – definitely has antidepressant effects at lower dosages, and certainly has a much better side effect profile than SSRIs. I’d rather have the munchies and feel lethargic than want to kill myself or my family!
You are right about the “underlying condition,” which in a way seems even worse than blaming the patient. At least if s/he was at fault, s/he could try to fix it. The “patient” (who is disempowered by even being called that) is the victim of the “underlying condition” and has no power to do anything about it. The doctor and the drug are working on the “underlying condition” which may “resist” their treatment or may yield. It’s as if the patient/recipient is a passive observer of the whole thing. No one ever seems interested in hearing what s/he experiences, and if s/he does speak up, his/her suffering is attributed to the “underlying condition” (see “nervousness” in my post above) and the drug and the doctor are absolved. The patient/recipient/victim has no control over anything, and can’t object to or even describe his/her reaction to treatment in any effective way.
Delusion that they are being poisoned? Maybe it’s not such a delusion after all…
I have to say, this study did not surprise me in the slightest, because it’s completely consistent with my own experience in the field.
Sandy, I appreciate your giving the doctors the benefit of a doubt, but I think it’s important not to overlook another important reason doctors don’t get the full picture: many of them don’t want to see that picture if it conflicts with their own biases and training. I knew a 14-year-old whose hand shook 24-7 and who spent hours every day trying to reduce the tremor, and who was taking four drugs that caused involuntary movements, two of which specifically mentioned hand tremors as a side effect. I spoke to the doctor and said we had concerns about the side effects she was experiencing. His response: “We haven’t noticed any side effects.” They told her that her hand was shaking because she was nervous!
They didn’t notice any side effects only because they didn’t want to see what was right in front of their faces. There was no protocol for side effect screening, and the staff at the facility seemed to have no idea what she was taking or what side effects to look for. Not only did they not ask the right questions, they specifically went out of their way NOT to ask any questions or make any observations that would lead to noticing side effects.
And I don’t regard this as an outlier. It is almost impossible to get most psychiatrists to acknowledge that any adverse effect is happening, and even if they do, they tend minimize the effect or say it will go away. It seems to be a part of the culture of the psychiatric world: anything good that happens is attributed to the drug, anything bad that happens is attributed to the patient. Which is how we got 15+ years of denial that SSRIs cause suicidal thinking, despite Prozac being banned initially in Germany for suicidal thinking being evoked, just to give one example of many.
I’d be interested in whether you see this overt denial that I’m talking about and if you have any sense of how to deal with this on a large-scale level. I think this is job one in changing the paradigm – being honest about what is really happening.
And the journals and newspapers and TV stations are owned by corporate magnates that have shared interests with the pharmaceutical companies. For instance, if Big Pharma can make more money with advertising blockbuster drugs, it stands to reason that TV stations, magazines and newspapers can make more money selling those advertisements. Why would they want to kill their own cash cow? The commercialization of the media over time plays right into PharmA’s slimy hands.
Legal action is needed, but the fines aren’t enough to discourage their evil marketing actions – they still make way more money than any fines they’re assessed, and probably see lawsuits as a cost of doing business. I think we need some criminal prosecutions of CEOs and medical advisors who are lying to the public to create more profits for their firms.
It might also help to have an FDA that isn’t laced with people that have pharmaceutical company backgrounds. How about a citizen board to review these drugs, with “distribution requirements” that say you need to have people from a range of backgrounds and interests on the panel, including (of course) a minimum number of psychiatric abuse survivors, oh, whoops, I mean “peer advisers” to give real feedback about what happens and who will take such feedback seriously from others.
Other possibilities include changing the FDA rules so that all studies must be submitted for a drug’s consideration, and that the studies as a whole have to prove the drug’s efficacy rather than just having two “positive” studies, or changing the standards of what qualifies as “efficacious” to be more specific and more demanding than a 10% improvement over placebo. And how about setting a standard of maximum morbidity allowable before a drug is pulled from the market, graded based on the seriousness of the disease involved (if you’re going to die of cancer, you might be willing to take a few risks, but if your kid’s not completing his homework, a risk of psychosis or death might be a lot to be willing to assume).
We could also hold doctors accountable for failure to provide real informed consent, including failure to inform of alternatives. We could engage in media campaigns, if we could get the funding. There are a lot of things that could be done, but most require money and/or legislative or judicial support. I think the problem is that so many people have their snoots in this particular trough, the challenges in funding and political support are severe.
Maybe we start by campaigning to eliminate corporate personhood status for our legislators so that the Pharma folks can’t buy them off in the first place…
Wow, what a powerful testimony to the promise and betrayal of these drugs, both for you personally and for our society as a whole! I did not know the coda to Wurtzel’s story, which of course, received no press while her original thesis was broadcast around the world. This should serve to remind us all that these are aggressive, vested interests in operation and being “nice” and “understanding” and sharing data aren’t going to change the dynamic we’re seeing. Your personal struggle is so touching, and so reflective of the many others I’ve seen, especially the drug-induced move from depressed to “bipolar” without any attention to the real issues at hand, such as historical trauma, identity, and purpose in life.
I hope your painful experience has helped you to find a new direction. I am sure that your writing will do that for some who really need it. Maybe it’s time for you to do a book!
I generally try to get interested in how they came to their conclusions, and tailor my response appropriately. I’ve long ago learned that most people are not swayed by science per se. A lot of people tend to be swayed by “authorities” whom they believe to be “scientific” and would like to rely on those people for information without having to figure it out themselves. So I have to address the question of “could the authorities be telling you incorrect information?” before getting to any meaningful discussion of psych drugs. Of course, this discussion is positively TERRIFYING for some people, and there are many who simply can’t process the possibility, even when I share with them that receiving medical care is the third leading cause of death in the USA, primarily due to death from properly prescribed and administered prescription drugs.
Then there are those with a vested interest in believing in the “disease model” hypotheses, such as people in the field who have built their practice on this assumption, or parents who need to feel protected from guilt feelings for having possibly failed their children in some way. This is a very different discussion, and also often leads to barriers that can’t be overcome.
Bottom line, people believe what they believe for a whole lot of reasons that have nothing to do with science. Finding out how they make the decision what to believe is an essential first step in either understanding how best to approach them, or realizing that they will simply not be receptive for reasons we can’t control.
You provocative dog, you! Just so you know, I am a “credentialed intellectual” (Masters in Education, BA in Chemistry, history as a counselor/therapist, MH professional, including 9 horrible months doing evaluations for “involuntary detention”), and love the ‘real’ conversations. But I do agree, there are actually a lot more professionals out there who are sympathetic to these ideas but are afraid to speak up for fear of being attacked. I was never one, but I have been attacked or ostracized or simply marginalized for my views. The oppression does not only exist for the recipients of “mental health treatment.” There is plenty of oppression for any provider who strays from the prescribed path!
I will add that the dopamine hypothesis has been fairly well discredited (if you haven’t read Anatomy of an Epidemic yet, you need to – the studies are there), and even some mainstream psychiatrists have recently come out in the national media and acknowledged that “things just aren’t that simple.”
As to the increase in dopamine receptors with antipsychotic use, yes, that is also a theory, but a theory with a lot more science to back it up. Starting with animal models, the observed response is well documented. It is also very well studied in the field of addiction medicine, where changes in receptor densities have been found to correlate with the development of tolerance as well as with extended withdrawal processes that last many weeks or months longer than the actual removal of the drug from the person’s body. It’s been particularly clear in studies of withdrawal from benzodiazepines that anxiety attacks became MUCH WORSE than baseline during the withdrawal process on the average.
Given this, I don’t see why it’s far fetched to say that withdrawal from antipsychotics can cause a temporary increase in psychotic symptoms, even if you do believe the dopamine theory. It seems just as well supported as the idea that going off medication brings back the original symptoms, which is also, in your own words, just a theory.
As a fellow scientist by training, I am sure you would agree with me that a theory is only as good as it is able to predict future events and allow us to predictably influence them. The litmus test of the “dopamine theory” does not really rest on whether or not dopamine imbalance is involved in psychosis, or whether there is an increase in dopamine receptors with long term use. The test is whether or not intervening with antipsychotics produces the expected results. In the short term, there is no denying that it can reduce psychotic symptoms dramatically. But long-term outcomes, from Soteria House to the Harrow study to Open Dialog, appear to suggest that this short-term benefit can be deceptive, and that other non-medical or limited-use approaches result in much better long-term outcomes. That should be enough to convince anyone that the idea of using lifetime antipsychotic prescriptions as the preferred “treatment” for “schizophrenia” is not scientifically supported.
Add in the radical concept that it may, in fact, be the patients themselves that are being “demonized” and that their resistance to medication may be, in many or even most cases, very well-founded and rational, and the idea of forcibly medicating someone beyond anything but the most severe immediate crisis situation (and even then, only after everything else has been attempted) seems pretty oppressive.
“Radical humility” is it! It appears you are on the way there, Sandra, and I so appreciate your courage and willingness to take that humble approach. And you are right that the labeling process itself prevents the necessary attitude – as soon as that process is started, we’ve already lost the humble perspective.
I think Erik Erickson said something to the effect that therapy needs to be reinvented for every person. It sounds like that’s what the Open Dialog folks are all about. I’m very interested to hear both of your experiences and of the reception these ideas receive in your professional community.
Thanks for being willing to “keep your mouth shut and your mind open,” as the saying goes, and sharing your experiences with us. I wish there were more psychiatrists like you – it might give me some hope for the profession yet!
“…the biggest change I believe I can create in my work as a peer specialist (a title I take numerous ethical issues with, and that my heart really struggles with having, although that’s a conversation for another time…) is to help a person connect to a sense of inner-agency and hope that he/she has forgotten exists inside of him/her.”
It is sad to me to read this comment, because I have been a counselor/therapist in the community in the past and this is exactly what I always have done. Of course, I didn’t actually receive any training in counseling before I became one (undergrad degree in Chemistry, grad degree in Education, but somehow the MS convinced people I was a counselor!), and maybe that was a huge advantage. But I recall a lot of folks back in the 80s who thought similarly, and we got some really great results. Empowerment was the watchword – helping the “client” (whether self-identified or forcibly labeled as such) realize that it was the “client” who defined both whatever problem we were working on and what the solution was.
We have come so far from that paradigm that it is apparently almost unrecognizable as “mental health treatment,” and only “peers” (as in survivors of the system’s abuse!) seem able to recognize that this is what really helps people thrive. That paradigm came from the place of believing that everyone had a REASON or PURPOSE for their behavior, and that critical to helping was to assist the person in identifying what they were trying to accomplish and then have HIM/HER decide if their behavior met his/her own goals or if change was in order.
I concur 100% that it is the definition of “mental disorders” as medical entities needing “treatment” that is at the core of why the current system is so destructive. And despite Stevie’s protests, it is the APA that publishes and supports these definitions, and adds the social validation required to obfuscate the obvious lack of scientific validity or even scientific approach involved in developing them.
I am looking forward to the new forum. I’ve been involved in working to change the system “from the inside” for years, including helping pass a law in Oregon that has reduced the rate of psych meds in foster care from 24% to 14% in 5 years. I can tell you that it only happened when we were able to join together a group of people who had some social clout (judges, advocates, attorneys, foster youth, government officials, the news media, and the legislature), and it took a long time to make what still amounts to a significant but not sufficient impact on the system. System change takes time, and it does require an alliance of “insiders” in addition to critics from outside the system. Political power is very real, and in this country, as corrupt as the process has become, the power can and ultimately does belong to us, if only we will step up and take it back from the people who have bought it, including (sorry, Stevie) the profession of psychiatry.
Thanks again for your inspirational blogs. Let’s shake psychiatry to its foundations. The good ones (Sandra Steingard and her ilk) will come along for the ride, where as the rotten ones will fight like cornered badgers, but in the end, have nothing but their status and their illicit financial motivations to protect themselves. If we all band together, including those IN the system who want to change it, we can bring this edifice to its knees!
I do appreciate your courage and commitment in coming here and posting, despite some very hostile responses at times. I am sure you are on the “right intentions” side of the ledger in the psychiatric community, and I do appreciate as well your willingness to take some heat in that community by standing up for alternative viewpoints.
What I’d really like to see from some of the groups you mention is some concrete positions on important issues of the day. Maybe they have done so, but I’m not aware of it. For instance, it would be awesome to have a group of psychiatrists go public with the position that Joseph Biederman’s alternate view of “childhood bipolar disorder” was not scientifically based, and turned out to be dead wrong and has hurt lots of kids. An extra bonus kicker would be a statement of concern that Dr. Biederman’s position and advocacy for this new definition appeared to be motivated by a conflict of interest, due to his Big Pharma connections, but that would just be icing on the cake.
An article on criticism and change movements within the psychiatric community would be most welcome. I think the psychiatric community can no longer pretend to be unaware of the lack of scientific support for many of the positions the APA has taken or supported over the years, and they could be very helpful in spearheading some real change, just as a few selected heroes have done. But so far, those heroes get attacked by the psychiatric community in general, and they need some “insiders” to speak up and support them. This would be a great role for people like you to play in supporting this movement of change.
You’re right about revolutions, but corruption is everywhere. While I don’t want to trade an old corruption for a new one, I would love it if some people currently in power were willing to point out the current level of corruption in some concrete and public ways, as the example above outlines.
Honestly, I found your response kind of insulting. I know more than a bit about Scientology and about what are termed “cults,” and it’s very clear to me that the line between religion and “cult” is often a very vague and hazy one, much like the line between being “mentally ill” and normal. There are plenty of “cult” behaviors (such as isolation from non-members, subservience to an unassailable human authority, being expected to make unreasonable contributions of time and energy to the group, and punishment by exclusion, to name a few) that are VERY common in a wide variety of “accepted” religious sects, as I am sure you are aware.
My point, however, is that a discussion of religion, or cults if you prefer, is out of place here, in that it actually adds fuel to the fire of those who subscribe to the psychiatric cult itself. (And if we’re going to use the word cult, psychiatry may be the ultimate example of one!)
I think the point of this blog is to enhance our understanding of the real science that applies to the arena of mental distress, and the philosophical conflicts around defining what is “mental illness,” if such a thing even exists, and what might distinguish such a condition from what is called “normal.” Badmouthing a religion or religiously-affiliated group like CCHR simply reinforces the psychiatric accusation that we’re “all Scientologists” and can therefore be dismissed as cranks. So let’s focus on the FACTS, and let CCHR and the COS do what they do without wasting our energy criticising them here.
I am tired of Scientology being the whipping boy of the psychiatric profession. Its shortcomings are very similar to the average evangelical church of whatever persuasion. The “true believers” believe they are right and want everyone else to agree and join them. Sound familiar? To say they are as vicious and dangerous as the gigantic psycho/pharmaceutical junta is a ridiculous comparison, and in my view diminishes the legitimacy of what we’re trying to do.
CCHR has not always been factually accurate (though they’re getting much better in recent years), and their rhetoric often gets in the way of their message, but they were fighting the psychiatric takeover back when everyone thought Prozac was Manna from Heaven and anyone who disagreed about the biological nature of depression and psychosis was considered nuts themselves.
Psychiatry has used the “Scientology attack” as a means of deflecting legitimate criticism for as long as they have had the opportunity. Let’s not feed them more energy by dissing Scientology or any other religious practice on these blogs. There are plenty of other blogs focused on that subject. This is NOT about someone’s religion – it’s about the domination, corruption, and greed in the psychiatric profession that contaminates everything they say and do.
If someone “accuses” you of being a Scientologist based on your views on psychiatry, I’d suggest you reply, “What on earth does a person’s religion have to do with whether psychiatric practice helps or harms its patients?” It just isn’t a related topic, except to the extent that the use of the “accusation” as an ad hominem attack on opponents needs to be stopped cold, and the accusers need to get back to talking about the hard, scientific facts of the situation.
Scientology only affects those who choose to get involved. It does not scare me. Psychiatry involves people against their will and uses its financial and professional domination to spread lies and sell drugs that disable and kill people, and then blames the victims for their own demise. It scares me a whole lot!
The PET scans measure ACTIVITY rather than structure. The cause of an increase or decrease in activity is never known or even sought out. Of course, the testing is also based on our set of “known diagnoses” out of the DSM, and those with these “diagnoses” *(by the DSM’s own admission) may have little or nothing in common with each other, physiologically or otherwise. Additionally, a lot of the “results” for a particular diagnosis are obtained from averages of many scans. Any individual with an “ADHD” diagnosis may or may not have a scan remotely similar to the average scans.
On the whole, phrenology is an excellent analogy. We’re probably better off with horoscopes.
Not to mention that the risks of drugs are far greater than the risks of therapy.
But the real implication of the study, in my mind, is that people who are depressed need someone to care. It may be a giant placebo effect for any treatment – the thing that makes the difference may well be only that someone recognizes and acknowledges that you are struggling and gives you some hope. And if that’s the case, giving hope without damaging someone’s brain is certainly the preferable option!
Too bad they don’t include peer support groups in their study – I am sure they’d be at least as effective, probably more so, and are certainly the cheapest and probably the safest option to boot.
Well, as reprehensible as he is, at least Amen is TRYING to find some test – these guys who are criticizing him are using paper-and-pencil CHECKLISTS to diagnose people! They have a lot of nerve criticizing ANYONE for a lack of scientific rigor!
As long as everyone plays along, no one gets in trouble. Oh, except the “patient.” But since the ‘patient’ is “mentally ill,” it’s easy to blame any negative results on “the disease” instead of the doctors’ own insensitivity and stupidity and corruption. Anyone who commits suicide on an antidepressant: “Well, depression is a serious disease, and sometimes people take their lives despite our best efforts. Sigh…” Of course, the fact that the victim was never suicidal until they took your drug does not get mentioned.
Until both patients and our government representatives (go, Chuck Grassley!) call them on this and make them PAY in both monetary and criminal penalties, these criminals will continue to bilk us all and maim and kill their own patients with impunity.
“What was shocking to me, however, was when this psychiatrist off-handedly stated that child psychiatrists don’t medicate diseases, they medicate symptoms. I asked whether this means that if a child is obstreperous, then the doctor puts the child in a chemical straight-jacket. The psychiatrist did not respond.”
This is the ugly secret of psychiatry: they don’t even bother with diagnoses anymore, at least when kids are concerned. They KNOW they aren’t medicating a disease – they KNOW they are drugging “symptoms” without ever asking why those symptoms might exist or whether they are even an indication of anything wrong at all. Kid is “too active,” kid gets drugs, kid is less active. That’s the whole process. They are trying to make bad thoughts/behaviors/feelings go away, and “bad” is defined by them or whomever is in charge of the “patient.” The idea that diseases are involved is only window dressing. Not even the psychiatrists themselves really believe that.
You said it, John. If a mechanic ruined my car, he’d have to pay to have it replaced. If he knowingly did something to ruin my car, he’d be committing a crime and susceptible to criminal penalties. How much more should a person be accountable for ruining a life? Why do these guys get off without even a bad news story? The best way to end biological psychiatry is to make sure that this particular crime no longer pays. Fines in excess of profits made, and jail time for knowing perpetrators, those are the tools to drive the drug dealers out of business.
Criminal is right. There was also a great ABC 20/20 show on the use of these drugs in foster kids (which is the world I work in) – it is definitely worth watching, because it not only shows the awful condition two of these kids were in while taking the drugs, it also shows how well they recovered when they stopped taking the drugs, got some quality therapy, and were adopted by loving families.
It is shocking that these practices are legal. Perhaps we need to do something to change that.
If I recall correctly, the affected person is the one to identify whom s/he wants to involve in the dialogue. It definitely occurred to me that having the wrong person there could be hugely detrimental, but Will Hall did an excellent demonstration (I got to be his “co-facilitator!) which put my concerns mostly to rest.
I encourage you all to send these comments to the authors if you haven’t already done so. They said they wanted to hear feedback – let them have their wish!
I agree that the drugs by themselves are not likely to cause a person to plot such detailed violence. What I believe these drugs do, based on reading research and also on many personal anecdotes that others who did not kill people have shared with me, is to reduce social inhibition against doing things like killing oneself or others. We all have impulses to do destructive things from time to time, which we almost always are able to redirect, because we have an internal sense of ethics, or we’re afraid of being embarrassed, or we fear social consequences like arrest and jail time. What I believe these things do, based on observation and research, is create a situation where the person is no longer concerned about these consequences and is willing to act on what they’re thinking about.
There are many stories of these drugs also inducing destructive impulses in those who didn’t experience them before, but again, most people are able to say, “OK, suicide is not the answer” or “I didn’t start feeling this hostile until I took the drugs – maybe I should stop.” But a person who is already kind of unstable appears to be able to do things that they might previously only have thought of – to “Cross the line,” as you put it.
It sounds like you have an axe to grind with Healy, which I do, too, based on his historical support for ECT, which I consider barbaric and incredibly destructive. However, this issue goes far beyond Healy’s opinions. There is good evidence in many places that this phenomenon is very real, and that people die as a result of this information being suppressed.
I hope you can get by the specifics of this particular case, where this SSRI phenomenon may or may not be involved, and look at the bigger picture.
Just so you know, I’m a different Steve, not the author, but I wrote the quote about males being more genetically prone to “ADHD” symptoms.
I have no doubt that socialization plays a huge role in how boys and girls act. My point was only to say that just because someone acts differently, even if it is for sure based on genetic propensities, doesn’t mean they are “diseased.” I thought males and “ADHD” was the best example, because we have a huge disparity in behavior that is very likely rooted, at least to some degree, in the 7X higher testosterone levels experienced by males. So assuming that at least a part of the “hyperactivity” of boys is due to being male, how is that a disease? What if males are SUPPOSED to be more active and less tolerant of boredom? And what if a selection of females are also genetically programmed to be that way? So what? Does that make them DISEASED or DISORDERED, just because their behavior (assumed for the sake of argument to be genetically influenced) is inconvenient for teachers?
An interesting study was done in the 70s that illustrated this point very well. Demographically matched groups of “ADHD” diagnosed kids were put into two separate classrooms, one a standard classroom, and the other an open classroom setting where the kids had control over which station they went to and how long they stayed. They had professionals try to tell which kids had the diagnosis. In the regular classroom, the pros had an easy time picking out the ‘disorderd’ kids, but in the open classroom, they could not distinguish those diagnosed from their ‘normal’ peers.
You’d think that would have caused a revolution in how we treat “ADHD” kids, but of course, it did not. Few people are even aware of that study, but it really goes to show that a kid’s inherent “negative” propensities can be neutral or beneficial in a different environment. How can “ADHD” be a disease if you only see it in certain environments? Wouldn’t it make more sense to create an environment where those deficits become assets? But that only happens when we stop viewing “difference” as “disorder.”
Kids are all different. It’s OK for them to be different. It’s our job as adults to work with these differences to bring out kids’ strengths and help them work on areas where they need help. Drugs do none of those things, but they are convenient for those too lazy to want to spend the energy to work out what will actually work for the kids they have to deal with.
This is not an issue of whether or not Holmes’ actions were caused or accelerated by antidepressants. (He says in the article that he doesn’t know if it was a factor or not.) It’s about whether or not antidepressants can cause violence, and whether an investigation of violent acts should include this possibility as a factor. People are sometimes violent, whether on antidepressants or not. But there is plenty of evidence supporting the idea that people can become violent or more violent when taking antidepressants, and also plenty of evidence that these facts are being suppressed. That is true no matter whether the Holmes shooting was antidepressant-involved or not.
And I will point out that it is POSSIBLE that Holmes may have been taking antidepressants the whole time he was plotting. The point is, the question needs to be asked.
I noticed that the problem he is addressing is the lack of investment in new pharmaceuticals for psychiatric conditions. I didn’t notice any concern whatsoever about the millions and millions of “patients” who have been labeled, railroaded, drugged and forgotten by the helpful psychiatrists who have been so married to their misconceptions. I’m glad he’s identified the DSM system as being problematic, in that it is based primarily on fantasy and social bias, and I’m glad he wants to look for the causes rather than just the symptoms. However, he’s still laboring under the unscientific assumption that whatever is “wrong” with us can be defined by neurological findings, without any reference to the cultural subtext of these decisions on what “normal” looks like. It seems like an effort doomed to failure. It’s amazing the level of commitment that exists for an effort that he admits to have been almost completely fruitless 50 years down the line.
I agree with you, Jeffrey, but in essence, you’ve captured the basic philosophical flaw in these “scientists'” arguments. They are ASSUMING that mind=brain and discount any possibility that the mind is something more. I think there’s plenty of good evidence to suggest that the mind transcends the brain and body altogether, and some to suggest that the brain is simply the “control center” whereby the mind runs the body. But many people who are devoted to “scientism” (as a religion) as opposed to true science (as the pursuit of knowledge, being open to information that may negate your initial assumptions) are unwilling to admit that the mind is much more mysterious a thing than the brain can really explain.
Of course, even if the brain is all there is, they also are expecting us to subscribe to the idea that any deviation from “normal” is a de facto disease. Let’s take ADHD as a great example. I have no doubt that some kids are genetically programmed to be more active and less tolerant of boredom and repetition than others. (We know for sure that males are genetically more that way than females, based on the prevalence data on ADHD). But why is that a “disorder”? Why can’t it be viewed as simply a normal genetic variation, part of the survival needs of the species? These “ADHD” kids, if they grew up in a tribal society, would be extremely valuable in the aggregate – they tend to be very active, athletic, creative, willing to take risks – they are ideal hunters and would help assure the tribe has food for the winter. Just because we don’t allow them to hunt and expect them to sit for hours in a chair doing boring things, and find they rebel, does not mean there’s something wrong with them. I think it suggests something wrong with our expectations.
So I think we have to challenge the “scientism” adherents to defend their assumptions and we have to identify them as assumptions. Sure, they won’t like it, but if they are REAL scientists, they’ll be willing to put their theories to the test. Anyone dismissing objections out of hand is not a scientist at all.
I guess for me, the idea of using psychotropics for an eating disorder doesn’t really seem to get to the basic issue. Is the person’s body image or set of beliefs about food really a simple matter of brain chemistry? Is the solution to create a situation where the client feels a strong sense of hunger, even if they still feel that their body is overweight?
It seems to me that anorexia/bulimia (and I do have some direct clinical experience working with these issues) are more a matter of using food to meet other needs, and most commonly, a need to feel in control. There is a really high overlap with childhood abuse and neglect, especially sexual abuse. And of course, it’s MUCH more common in women, who are taught by our media and other social messages that being fat is the same as being bad and worthless.
To try and handle this with chemical means seems to me even more misguided than for depression, anxiety or psychosis.
Jean, I’d be very interested in hearing your perspective on these observations – have you had the opportunity to work though the issues that contribute to the eating disorder behavior? Or do you view it as a medical problem that therapy can’t help with?
The idea that mental problems are biochemical in nature robs us of any sense of personal agency, the idea that we have some level of control over how we feel, what we think, and what we do in the world. It is very interesting that in the 2008 study on schizophrenia that Bob quotes, the author finds that one of the key factors in common with people who recovered from schizophrenia in his study was, in fact, a sense of agency, of control over his/her world and in the possibility of self-generated improvement in his/her condition.
This is the one inadmissible point in the bio-psychiatric paradigm of care, and is interestingly the one most likely to lead to recovery. My experience in providing crisis counseling and brief therapy is completely consistent with this. The thing that helped most was 1) identifying what was troubling the person, 2) NORMALIZING the emotional reaction (letting them know that it was COMPLETELY UNDERSTANDABLE that they’d experience fear, anxiety, depression, anger, or whatever as a result of their experience), and 3) helping them find at least one small thing they could do that could make the situation even slightly better.
The biological paradigm does the opposite: 1) ignore any potential outside causes and focus only on the symptoms, 2) make sure the patient knows that the “symptoms” are both inexplicable and abnormal, and 3) inform the patient that there is not the least thing they could do to improve their situation, that they will be condemned for life to a broken brain, and only the magic pills of psychiatry can give them any hope of relief.
This is not just “another good point” – this is the CENTRAL PROBLEM with the biological paradigm. It’s not just that it’s subjective or untrue or leads to unnecessary drugging and danger (all of which are true); it’s because the biological explanation does EXACTLY THE OPPOSITE of what would be helpful. It undermines any thought or belief in the patients’ ability to regain control of their lives, which is the core of recovery.
Not only are they not different from the Nazis, psychiatrists were central to the Nazi regime. They were 100% behind experiments on the mentally ill and the eugenics concepts that drove Hitler’s regime. In a sense, Hitler was a front man for a movement that psychiatry not only embraced, but actively forwarded and championed at the time.
Psychiatrists and Nazis have an awful lot in common, including some very disturbing common history.
I love that idea – “Treatment resistant depression.” In what other profession can you completely fail to help, actually make things worse, and blame the condition you’re supposed to be helping for your failure? What a great deal! What would we say to the mechanic who charged us $500 for not fixing our fuel injection system, and when we asked why the car didn’t work any better, were told that we had “repair resistant fuel injectors?”
What a racket it is! Belinda, I am so sorry you didn’t have the support you needed to recover, and I admire you for the incredible strength and courage you have shown in getting away despite the lack of support. That they would BAN you from receiving any kind of support just because you didn’t do what they wanted is quite beyond the pale. I am so happy for you that you’ve found a different way forward. Remember that there are lots of us out here who believe in you and you can find us if you look. It’s so tough to get over childhood abuse – I work with abuse victims every day and I know from experience! But it can be done, and you sound like a very tough survivor and I am sure you will make it.
It has always astounded me that a person could be receiving “treatment” for so long, be clearly deteriorating, and yet have the “professionals” continue to be somehow fully convinced that the “treatment” was helpful in some mysterious way. I’ve heard someone say, “She’s like this on the meds – think of what she’d look like OFF them!” But I’ve seen dozens of situations, maybe in the hundreds, where the person was no worse off and often far better off when they stopped.
If we went to a doctor with a sore knee, and a month or two later, despite treatment, the knee still hurt, was now swollen, back pain had developed, we’re now using crutches, have severe headaches, and are seriously depressed, even the most credulous among us would quickly conclude that THIS TREATMENT IS NOT WORKING! And yet somehow, psychiatric treatment is allowed to fail without blame. Anything good that happens is because of the drug. Anything bad that happens is because of the “disease.”
Laura, it was such a pleasure to meet you in Philadelphia and hear you speak, and I so appreciate you sharing your story. I totally agree with you and Emily’s Indian holy man – “There is nothing wrong with you.” There’s a lot wrong with a system that identifies any distress as being a disease. But even within the confines of its own warped belief system, shouldn’t psychiatry be able to acknowledge when a treatment isn’t helping? Apparently, such a thing never happens.
Thanks to you for sharing and to Bob’s book for helping make that possible!
If physical abuse doubles the probability of these “disorders” arising, what does that say about the supposedly “biological” nature of ADHD or Bipolar disorder. All the NAMI/CHADD/NIMH literature repeats over and over that “bad parenting does not cause ADHD.” Well, apparently it can, and “Bipolar” as well. Could it perhaps be because “ADHD” and “Bipolar” and all of these labels are simply descriptions of sets of behavioral symptoms that could be caused by just about anything?
I agree, children aren’t bipolar. I don’t think adults are, either. These labels are absolute nonsense!
I totally agree! Real science not only allows but insists on alternative viewpoints and explanations – it’s part of the process of sifting out the truth. And even greedy and ill-intended people change their behavior when the incentives are changed, because after all, they’re out for their own benefit. So make sure they don’t benefit from doing wrong, and we’ll see a lot less people doing the wrong things.
Most people don’t do bad things knowingly, but unfortunately, a small minority of people knowingly do bad things on purpose, usually because they can make money or gain power by doing so, sometimes just because they seem to get satisfaction from being deceptive. I would term these people criminals, but many of them never go to jail, because their crimes are actually legal.
We should not assume that Gibbon or anybody else has good intentions. He may, in fact, know all the facts and be strategically working to keep them a secret. There are written memos from drug company personnel that have been released, clearly stating that their objective is to “manage the drug’s image” by minimizing the dangers or presenting alternative explanations they know to be untrue. This is very different from believing in a false theory because of insufficient or incorrect information being provided. This comes down to intentionally providing false or misleading information in order to promote a believe known to be false and potentially very dangerous.
Evil intentions do exist, and they exist, in my opinion, in much larger than average numbers in the psychiatric profession, as well as in the pharmaceutical corporations who supply them with their products. One reason the psycho-pharmaceutical industry has been able to succeed so thoroughly is because no one wants to believe doctors will knowingly act in ways that will hurt their own patients. While in most cases this is true, and the doctors are acting on what they’ve been told by someone they consider a “higher authority,” a goodly percentage of those “higher authorities” know very well that they are advocating for harmful interventions in order to maintain control of their market share. Unless we understand and accept this reality, and make it well known, I believe it’s going to be very difficult to move forward with real alternative thinking.
Perhaps it’s the triumph of marketing OVER science. We’re way beyond “misunderstandings” and into the realm of overt corruption.
No one can really claim they don’t know any better today. He does know better and is trying to refute what he knows to be true, just as tobacco companies knew cigarettes caused cancer but did all they could to prevent this truth from becoming commonly accepted.
This guy is clearly out to promote a viewpoint, and the truth is simply not relevant as long as he gets paid.
I do find this kind of startling – I am hoping a sign of a change of attitude as the hard facts about DSM diagnosis and poor long-term outcomes for those exposed to drugs even makes the mainstream media. Could this be a sign that psychiatry’s stranglehold on the mental health world is beginning to loosen?
Maybe the fact that African-Americans are “undertreated” for depression is exactly the reason that they have lower levels of depression overall! Less treatment = less drugs = less chronic depression.
It is a confusing term as they use it, but when I read the article, they seem to be talking about criticism and intense reactions to negative behavior, not verbal or non-verbal expression of emotion. “Emotional reactivity” might be a better term to describe it. Basically, it sounds like they are saying that hostility and criticism lead to more emotional problems, which should surprise nobody. Maybe they’ll argue that being criticized “imbalances your brain chemistry” to get around this one.
Pretty obvious stuff, but I guess I’m glad someone is saying it.
I agree – the most fundamental problem is the standard. If you’re looking for a reduction in symptoms according to some checklist created by clinicians with no input from the recipients of the “treatment” about what is important to them, you can delude yourself into thinking you’re being successful, because the person is temporarily “less depressed” or “less psychotic” than they were. The fact that the person is physiologically, psychologically or spiritually suffering, has a shaking hand, can’t sit still, wants to vomit, still hears aggressive voices but just less loudly than before, can’t hold down a job, is unable to engage in meaningful relationships – not one of those factors I mentioned is even vaguely considered important by the “symptom management” approach.
We need to start by resetting the goal – it can’t be about “symptoms”, it must be about improving life outcomes as defined BY THE PERSON SEEKING TREATMENT! And that includes accepting that the person may not seek treatment and be OK having his/her symptoms and working out a plan on his/her own to manage. Until we look at the person’s own intentions and values as the ultimate goal for intervention, arguing about whether a 5- or 10-point reduction on Dr. X’s scale of anxiety/depression/ psychosis will continue to waste everyone’s time.
Thanks to Dr. Steingard for acknowledging the realities of the situation. As for the intuition question, I agree that intuition is part of any problem-solving approach, and leaving it out is part of the problem. However, it’s also very easy to mistake bias for intuition. The way to counteract that is to check out each and every intuition ruthlessly against both an internal bias checklist and by external measures and values that are effective in questioning your basic assumptions. A real scientist is always skeptical, and the more skeptical the more certain they feel they are right. Intuition only becomes effective when you’re brutally honest with yourself about your own biases, something psychiatry has not even begun to entertain as a profession.
My intuition says, don’t trust anyone who says they can fix your mental problems with a pill. I think most people’s intuition would agree, including a lot of doctors, but we’ve been systematically instructed to ignore that basic knowledge. If that intuition is allowed to surface, most of the field of psychiatry would quickly dissolve out of existence, because it is based on fundamentally flawed logic that the average elementary age child finds offensive. (If you doubt me, you should ask a few non-brainwashed 8-year-olds about it.) I am not hopeful that psychiatry will ever be able to examine itself in that way.
I think she’s also commenting on the negative message that the “chemical imbalance” talk has on kids: it says “your emotions are meaningless. You’re a bunch of chemical reactions, and nothing you say or do can impact those reactions. You don’t control your emotions and they are unrelated to your life.” I suppose the other message is that emotions are annoyances that prevent us from doing what we’re supposed to do. In reality, emotions are survival mechanisms that we all need in order to navigate our world. In many ways, emotions are what drive us to survive and thrive in the world. Trying to delete those that are inconvenient sends kids a very odd message, indeed.
Your daughter’s story sounds horrible! I work with foster kids all the time and see things like this every day, unfortunately. Does your daughter have a CASA/GAL volunteer? They are not always in alignment with what we’re talking about here, but they can be amazingly effective in amplifying the child’s voice. She should also have an attorney who is fighting for what SHE says she wants, and if she doesn’t want drugs, she can tell her attorney that and the attorney should fight for her. If the attorney doesn’t, she should fire them and get a new one who does his/her job.
It is too true – when we don’t value kids, we don’t value people, and our society goes down the tubes quickly.
I work with foster kids and see this all the time. SSRIs and/or stimulants evoke aggressive incidents, which are interpreted as “bipolar disorder” and lead to atypical antipsychotic “treatment” of their own drugs’ side effects. Which are never acknowledged as such, of course.
I’m so sorry you had to go through that – well done for hanging in there and helping fight for sanity for others in a similar situation. Sometimes being really, really pissed is a NORMAL reaction to a very abnormal situation. And sometimes it’s a reaction to the drugs they give you to try and shut you up.
This has to be the silliest and most unsupportable diagnosis in the DSM. This, I must say, is a very high bar to overtake, as it’s filled with silly and unsupportable diagnoses (like Oppositional Defiant Disorder, diagnosed when a child is, surprisingly, oppositional and defiant. Pretty creative, eh?) But IED certainly tops all. The whole basis of this disorder is that the person sometimes gets really pissed off, hence, they “explode.” There are, of course, listings of manifestations of adult temper tantrums to make it all look “scientific,” but basically, they’re diagnosing anger outbursts and calling it a “disorder.” No attempt to understand context, of course. Nothing to distinguish one’s righteous indignation from another’s selfish and intimidating rant. No attempt to ferret out what other issues may be contributing to the “explosions.” If you get pissed off a lot, you have it.
We used to have a different name for people who get hostile and intimidating for no reason. We called them “assholes.” I personally prefer the traditional term, as I find it far more descriptive.
Whatever you think of his personal choices (which were pretty disgusting to me), Spitzer and his office did lead the charge and set the stage not only for a lot of states questioning and suing big drug companies for their lies, but also for the news media finally providing coverage that counters the propaganda about the “Brave New World” of psych meds. It’s possible a person can do good things and also do evil things in another context.
I’m also glad the attorney who sparked the efforts got appropriate credit for her inspiration and hard work.
The MYMOP was new to me and sounds of interest, as it could be used for clients to determine what outcomes they’re interested in and track on them. Otherwise, the screening tools you mention seem to continue the effort to label and categorize people according to “symptoms” rather than engaging the client in the process of self-discovery that leads to real healing. Your comments on Bipolar Disorder I found particularly disturbing, in that, in my direct clinical experience, huge percentages of people so diagnosed are either 1) suffering from trauma that results in “mood swings” and “psychotic symptoms” based on triggers, nightmares, and flashbacks they may be having throughout the day, or 2) suffering from the side effects of such “helpful” drugs as SSRI/SNRI antidepressants or stimulants. That’s not counting the ones who get the diagnosis secondary to recreational drug use.
Of course, the whole concept of “Bipolar Disorder” is an invention with no scientific grounding and incredibly vague descriptions and boundaries, such that many very normal people could be described that way if one believed in looking for this “disorder.” Not to say that some people don’t meet the description rather well – it’s that the description itself is scientifically meaningless, as are pretty much all the DSM categories.
You seem to be promoting an alternative “treatment” for the same “disorders” that psychiatry has already defined for us. While herbal approaches are generally less harmful than drugs, I think you’re doing a disservice to your clients and to the profession by buying into the deceptive and greed-motivated DSM diagnostic process. I strongly suggest you work toward creating a more client-friendly and empowering paradigm that is more consistent with the general holistic philosophy that I understand to underlie naturopathic medicine.
Yes, it would be very interesting to run a comparison of drug-exposed vs. drug-naive schizophrenia-diagnosed people for cognitive impairment. I thought it amusingly ironic that they found that none of the drugs have been FDA approved for this “indication,” where there’s good reason to suspect that the drugs themselves cause the impairment.
I work in the child welfare field, and I find doctors, including psychiatrists, recommending and prescribing antidepressants for common, situational depression all the time. I’ve seen them prescribed for normal grief and loss, for women in ongoing domestic abuse situations, for the aftermath of a rape of a 17-year-old developmentally delayed girl (she was diagnosed “bipolar” because of her “mood swings” following disclosing the incident), and many, many times for foster kids who have every reason to be depressed, anxious and angry about the way their lives have treated them.
I do agree that medical doctors are a huge part of the problem, but psychiatry has led the way by proposing and insisting on inane and subjective definitions of new “disorders,” by providing convenient “explanations” like “chemical imbalances” when they know these things not to be true, and by ignoring strong evidence of other effective approaches to assisting people with the moral, situational and spiritual crises that they encounter in the course of a normal or not-so-normal life.
That being said, I agree with your basic premise: modern life is inherently stressful, and a depressed reaction to it is very understandable. When we reach a point where over half of the members of a group manifest a certain response, it’s time to stop defining it as abnormal and to start looking at the structures that they are reacting to.
Take school as an example: it is axiomatic that the large majority of kids find the academic part of school dull, irrelevant, frightening, or depressing. If you doubt me, ask a hundred kids how they enjoy school. I’d bet 90 would say they’d avoid it if they possibly could (other than their enjoyment of their friends, and possibly a specific subject, usually PE, art or music classes). So are all of those kids mentally deranged? Or do we need to look at how we educate kids and stop forcing them to do things that are dull, irrelevant, frightening or depressing?
War, global warming, rampant consumerism, racism, sexism, dead-end jobs, poverty, domestic abuse – these are huge social issues that are overwhelming and depressing for most of us to confront. I don’t think there’s anything abnormal about feeling depressed or anxious or angry looking at the world we live in. Thanks for reminding us that “mental illness” as defined by the DSM can just as easily reside in the culture we’re a part of as in the individual responding to that culture.
It’s not just that they’re looking for sensational articles to publish. They also choose to emphasize “negative” findings for non-drug interventions, and “positive” findings for drug interventions. Why didn’t it make big news when the outcomes on the MTA study on ADHD and medications showed that stimulants don’t work or may make things worse after two-three years? It sure did make news when the drugs beat the alternatives at 14 months! Somehow, it’s big news that one study says that exercise supposedly doesn’t help depression, but not big news that drugs don’t help ADHD in the long term. Talk about publication bias!
I would add that failure to comply with medical advice should NEVER be a cause for forced admission, and this threat needs to be 100% removed. Even if there is a “harm to self or others” clause, it should have to be invoked each and every time a person is considered for an involuntary hold. Failing to comply with a “release agreement” to take drugs is often used as a pretext for re-hospitalization or is held over patients’ heads as a threat for noncompliance. No enforced treatment is best, but this is essential if we can’t get to the ideal.
The other aspect of informed consent is an honest reporting of alternatives. This should include a wide range of medical and non-medical services, including a Soteria-like option, talk therapy, Open Dialog, homeopathy, naturopathy, nutritional advice, meditation, spiritual counseling – anything that has been shown to be potentially helpful. These options also need to be made available to sufferers through realistic funding mechanisms, because simply mentioning options the client can’t use isn’t very helpful, either. But at this point, no other options besides medication and “case management” (a big part of which is policing medication compliance) is ever even mentioned in most acute care settings.
We have a LONG way to go to meet this UN standard!
Oh, but they are good for EVERYTHING! Maybe they should just be called “feel good pills.” Although from what I’ve heard, “Feel less pills” is nearer to the mark. As Robin Williams once quipped, a great “antidepressant” name would be “Fuckitall!”
It does not even slightly surprise me that this was observed, as I’ve seen it often myself (and I think it’s even in the warnings on the package inserts). What amazes me is that the clinicians still try to attribute it to other causes (like “subtle bipolar disorder”) rather than just admitting that the pills can make people worse.
It does sound suspicious, in that he had not engaged in this kind of behavior previously, and in that his behavior was quite blatant and erratic, as if he had no concerns about being observed or caught. There is no question that Zoloft can interfere with someone’s ability to empathize with others, and in some situations, can create frank manic episodes. Combine this with drinking, and it seems very conceivable that this could happen. I do have to say, though, that he is culpable for drinking while using Zoloft, as it does tell you not to do that on the label, as far as I understand.
I am all about considering ADHD as a developmental phenomenon. A recent study showed that kids who entered Kindergarten early were something like 30% more likely to be diagnosed with ADHD. That’s not even getting into developmental trauma. But there are also many other potential reasons for the described list of behaviors.
Which is why I doubt anybody will ever come up with evidence that the “ADHD” brain is somehow defective. It is going to be different for each child. We all know that both genetics and environment affect brain chemistry and behavior, but we also know there are many reasons why a kid may act in the manner described as “ADHD,” including the simple concept that it’s a genetic variation that is important to species survival.
So it would make no sense that “ADHD” kids would respond differently to stimulants than “normal” kids, because “ADHD” kids aren’t a homogeneous group. Some have been traumatized, some have low iron, some have sleep apnea, some were entered into Kindergarten too young, some are “active learners” in an inactive environment, some are smart and bored to death with their insipid “education,” and some just don’t like sitting still and being told what to do. ADHD is not a disease phenomenon. “ADHD” kids are simply kids seeking more stimulation. If we really want to help them, we need to either figure out why they need this, or arrange an environment that provides it. The latter worked great for my two “ADHD”-type boys. They turned out fine, drug free, but we sure didn’t put them into a regular education classroom in Kindergarten!
It’s all about development – helping kids build on the strengths they have to overcome the challenges they face. No drug has yet been shown to help with that process.
David (Bates), I am pretty familiar with the literature on ADHD and see nothing that suggests these agents act any differently on ADHD vs. non-ADHD kids. Why would they?
Judith Rappoport et al thoroughly discredited the “paradoxical effect” theory way back in 1978. She gave stimulants to “normal” kids and saw the same effects as we see in “ADHD” kids: narrowing of focus, increased willingness to continue with activities normally found dull, reduced motor activity, etc. She called the idea that they worked differently an “artifact of observation” – in essence, we are LOOKING for these effects in those diagnosed “ADHD” and so we notice them when they happen.
Of course, the idea that “ADHD” kids don’t experience side effects is ludicrous on the face of it. There is no question that they suffer in great numbers from loss of appetite, sleep disruption, and reduction in growth. Less common side effects include increased anxiety or depression, agitation, aggression, “manic” episodes, psychotic symptoms (as high as 6+% in one study in the Canadian Journal of Psychiatry), increased heart rate and blood pressure, and many more. In that last case, actual harm to the heart muscle has been noted, and in rare cases, death has occurred that has been medically determined to be caused by long-term stimulant use.
Combine that with the clear data that there is no long-term positive impact on any important outcomes, despite 50 years of research, and it really is time to question why we promote this questionable practice. Oh, I forgot – we do know why. It keeps kids quiet and makes money for doctors and pharmaceutical companies. There is no other reason.
This is TREMENDOUSLY common in trauma victims! I can’t tell you how many PTSD sufferers (mostly female) I’ve seen diagnosed with Bipolar. It’s a huge issue!
It sounds to me like the brain is able to recognize a neurotoxin when it sees one, and tries to remove it from the synapse as much as possible until it can’t do so anymore. It’s a great argument for not using antipsychotics, because the brain is clearly smart enough to know they are not good for it.
At least AI won’t have preexisting biases!
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Thanks for the laugh! I only wish it were not so close to the actual reality of these “diagnoses!”
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It sounds like those who did NOT take ADHD drugs had better heart conditions, regardless of whatever caffeine, cigarettes or whatever else they use. It is apparent that the effect is due to stimulant drugs, not other lifestyle issues of non-stimulant users, as these ought to push the needle in the other direction than what they found.
I would also remind you that “people who have ADHD” is not a scientifically definable variable. If you mean people DIAGNOSED with ADHD, it might be a good habit to clarify that. Folks are diagnosed for all kinds of reasons, and again, there is no scientific way to differentiate them from each other as “having” or “not having” ADHD or any of the other DSM “diagnoses.” It is difficult to really evaluate the scientific studies without keeping this important fact in mind. We are not working with a well-defined homogeneous group here, and the only clear variable is drug usage.
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Hard to come up with anything “right” about it, from my perspective. Pretty much like fixing a computer with a ball peen hammer.
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And financial conflicts of interest of the most powerful sort.
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Right!!!!
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I recall some interviews done with working class folks about why they did not relate to therapy. A lot of them said that they’d feel a lot less depressed if they could pay their bills every month and didn’t have to worry about getting food on the table. Talking about how they felt about being poor didn’t really help much!
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Are you suggesting that long-term use of psych drugs can cause dependence and that withdrawal can be dangerous as the client’s brain is adapted to having the drug and has a very hard time adjusting to a withdrawal period? I’ve heard from many folks that very slow withdrawal is essential for them as individuals, and also known of a few who really could not get off because the withdrawals were so bad. It’s another great argument to avoid long-term use of these drugs if at all possible, as Whitaker’s research suggests.
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I remember reading that the vast majority of doctors don’t believe they are affected by drug company advertising, while the reality is the vast majority are strongly influenced. Believing that one is NOT susceptible to manipulation makes one much MORE susceptible to manipulation!
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OK, I’ll give it a try.
First off, I am the last to deny there is real SUFFERING out there. That is not in question. The question comes down to how one views and deals with this kind of “mental” suffering.
ALL of the labels in the DSM are voted on. They are not scientifically verifiable entities, they are the results of clinicians “agreeing” on a particular set of “criteria,” which is generally a very subjective list of behaviors or thoughts or emotions that have no necessary connection to one another or any kind of “illness.” So they have no more legitimacy than “Seriously Emotionally Disturbed,” which basically means the person (usually child) says or does things that we find upsetting, confusing or inconvenient as adults. Take “ADHD” for example – one of the criteria is “acts as if driven by a motor.” Another is “Incapable of staying seated in class.” Another is “squirms when seated or fidgets with hands/feet.” Another one is “Sidetracked by external or unimportant stimuli.” Can you see that these are all simply judgments passed by an adult on a kid’s behavior? How many kids squirm or fidget? Who gets to decide what are unimportant stimuli?
But kids get this label and they are looked down upon, told they have dysfunctional brains, told they CAN’T pay attention, given controlled substances (essentially speed-like drugs) to “control their impulses,” etc. Note that there is NO attempt to ascertain WHY the child might fidgit – bored, uncomfortable chairs, dealing with trauma at home (foster kids get labeled at a MUCH higher rate), simply not a good fit with the teacher’s style? NO, it is all blamed on the kid for being inconvenient.
A similar analysis can be done for any of the labels. Scientific studies show that attributing “mental health problems” to disorders of the brain increases “stigma” (a euphemistic way of saying bias and prejudice and discrimination) and that teachers and other adults treat these kids differently once they know they “have a disorder.” Consider alone the shame of being asked in public by a teacher or parent, “Did you take your meds today?” There is a lot of shaming involved in the process, and since it has no scientific basis, I consider this kind of label just as irrelevant and damaging as saying a person is “Seriously Emotionally Disturbed.” It’s a pejorative disguised as a “diagnosis”. Look at some of the writing about “Borderline Personality Disorder” to see just how bad the discrimination can get.
Again, not saying that these behaviors and emotions don’t exist, or that people don’t need help dealing with difficulties. But the DSM labels are pseudoscientific crap voted on in committees, totally lacking in any scientific validity. Even the one-time head of the NIMH admitted this was true.
So see if that makes sense to you.
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You miss the point, by a long ways. I don’t think I can explain it to you.
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The product insert says no more than two WEEKS consecutive use of benzos, as I recall.
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Sure, “Bipolar disorder,” “ADHD,” “Major Depressive Disorder,” “Borderline Personality Disorder,” pretty much anything in the DSM is simply a made-up label for a condition that psychiatrists and others don’t actually have the slightest understanding of. These “diagnoses” are arrived at through subjective behavioral checklists that bear no scientific relationship to any bodily process, but are simply behaviors that we find annoying, unpleasant, or difficult to deal with. Not saying that a person labeled “schizophrenic” has nothing wrong with them or doesn’t need our help, but calling them “schizophrenic” provides no additional useful information and makes it easier to dismiss them as having no value or rights to autonomy.
There are several “diagnoses” where two people can have ZERO “symptoms” in common and yet both qualify for the label! The whole thing is a scam in my mind, and is far worse than the dangerous medications these labels are used to justify forcing on an unsuspecting public.
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But if it is that common, why don’t more people have it?
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I always find it fascinating how they claim that brain chemistry faults cause “depression,” but when they want to induce depression in rats or other animals, they always put them under stress and fear for their lives! It’s almost as if traumatic experiences cause the animals to be depressed…
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You do realize The Onion is satire?
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I am surprised not to hear your agreement about other labels besides “emotionally disturbed.”
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Did you read the rest of my comment? You seem to have ignored it.
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Honestly, I agree with you, but “EDP” is in the end no worse than many of the other labels that are considered more “politically correct.” Labeling other people as a means of “understanding” them is always offensive.
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I totally get this. It irks me no end when someone who has had PLENTY of the “best psychiatric care” has some disastrous outcome, and they call for more funding for psychiatric care. Robing Williams is a great example. If it worked so well, why did the person choose to end their life? Either it didn’t work, or it CAUSED the damage! More “mental health care” seems the last thing that is indicated!
So sorry you had to go through all that. I hope you’re doing better!
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Maybe. Or “Scientism” is one of my favorites – the belief that anything “sciency” must be true, regardless of the facts. If there are a few brain scans in an article, people are apparently more likely to believe it, even if the scans have no connection to the article!
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I just want to add that “bad science” is NOT actually science at all. It’s pretending to use science to explain why a person’s viewpoint is true even when the actual science says otherwise. In other words, it’s fraud!
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I think “Biological Psychiatry” is much more than that. It is the ASSUMPTION that ALL “psychiatric disorders” as defined by the DSM are CAUSED by biological malfunctions and can only be “treated” biologically. An example is the insistence that “major depression” is caused by a “chemical imbalance” despite decades of evidence to the contrary, an insistence broken only very recently and now replaced with some concept of “circuitry” which again is not actually supported by science. It is the insistence that “broken brains” are the reason for all “disorders,” regardless of social conditions or traumatic history. And yes, there are plenty of psychiatrists who practice exactly in this manner.
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Wow, good job AI!
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I am afraid I have never been in that situation. Maybe some of our other experienced folks can contribute some ideas? I just know it’s often a lose-lose situation without getting some kind of outside advocacy. I have no idea if such advocacy is available to you, though.
I suppose getting an independent doctor who disagrees with the prescriptions or supports your autonomy might also be helpful, but again, I don’t know how possible that is.
I’m so sorry you have to go through this crap!!!!
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The title actually says the “restless legs syndrome DRUG [emphasis mine].”
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Nobody asks if their cancer diagnosis is “beneficial.” It is what it is and is objectively diagnosed and you can’t decide you like or don’t like your diagnosis. (Well, you can, but it doesn’t change it!) The concept that “receiving a diagnosis may be beneficial” shows how far these folks are from an objective understanding of what is going on. But yeah, you often need a “diagnosis” to get help. It’s a very strange phenomenon to me.
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Might as well try to predict Santa’s arrival with the toys. Makes exactly that much sense to me.
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But as long as AI is fed “data” from corrupt sources, it will turn out corrupt answers. It will never be in a position to say, “Wait, this asshole is lying to me for his own profit!”
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The problem I see is the idea that “peers” should “be included” by… well, by those with the power in the system to decide to include them or not. Peers should not be “included” – the “peer perspective” should be the CENTRAL one that drives what we do. Doctors’ or professionals’ views can be “included” if merited, but only if the clients believe they have value. The basic institutional change we need is to stop giving doctors and other “professionals” the right and the power to decide if the “peer perspective” is worth their time. Peers don’t need to be RECOGNIZED, they need to be EMPOWERED and there needs to be no discussion of whether to “involve them” in decision making. Clients need to BE the decision-makers, or we will continue to have the power-hungry and arrogant “opinion leaders” assuring us with little pats on the head that they’ve “included the peer perspective” while they continue to do whatever they want, however misguided, damaging or corrupt.
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Me, too!
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I felt I was doing good things. When the bad outweighed the good, I had to stop. But I really respect those who are in the trenches or behind “enemy lines” because people need help NOW and it’s the only way I know those in the system can get support.
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I am talking from experience here. I was inside the system with a totally different philosophy than those who were running the show. I was not confused particularly, but I was certainly disheartened by the kind of pressure and discrimination I experienced when I failed to “get with the program.” A lot of it was simply isolation – folks were “He’s an anti-med guy” and ignored many of my comments and observations. I was able to fight for clients in specific situations and provide something that others did not, but it was pretty exhausting. At a certain point, I realized I was supporting an oppressive system by even participating, even if I was doing some effective damage control, and decided I had to get out of there. But I would not say I was confused. Just annoyed, disheartened and infuriated!
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I don’t agree. I think the system is organized to create confusion, and a lot of folks are simply confused. There are a small but powerful number who DO enjoy creating confusion – otherwise known as “narcissists” in their own parlance. These folks are in charge of the big decisions (opinion leaders) and support and create the system as it is. They are the ones who put out the propaganda and attack those who dare to challenge the “status quo.” Such people do absolutely exist at the lower levels of organization (the system itself attracts such people), but there are plenty who want to do the right thing and are simply confused by the propaganda and peer pressure within these organizations. There are also rebels “behind enemy lines” who do really good work and deserve credit for doing so despite the pressures and discrimination they face.
It is simplistic to assume ALL “mental health” workers have anything in common. It is absolutely not supportable to assume that creating confusion is a goal of all or even most “mental health” workers. I think most of them are more confused than we are!
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I agree wholeheartedly. There is no such thing as “involuntary treatment.” It’s an oxymoron.
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The best solutions make things feel simpler, not more complex. One of the sure signs that the DSM is off base is the ever-increasing complexity of the system over time. Not to mention the ever-increasing numbers of “mentally ill” according to this system.
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Just to be clear, there is no evidence that anyone’s depression is caused by a “serotonin deficit.” Why SSRIs work as antidepressants for some people is not scientifically understood, but it’s not because of a “chemical deficit” in the brain, that much has become clear.
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Sadly, you again are quoting propaganda. The Black Box warnings did NOT increase the suicide rate. Read the following:
https://www.madinamerica.com/2018/08/adolescent-suicide-and-the-black-box-warning-stat-gets-it-all-wrong/
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Because you say so.
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It is an attack to pretend someone is proposing something they are not and criticize them for it. Strawman argument. Study logic sometime. And read the damned book!
It is childish at best to respond to the question, “Why did people with worse prognoses do better on less APs than those with worse prognoses on more APs” with “Longitudinal studies aren’t worth much.” That is an emotional argument not a logical one, which is why I’ve decided there’s no point in trying to have a rational conversation on this subject with you. As a wise man once said, “The first barrier to learning is thinking you know all about the subject.”
Steve out.
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See how you attack anyone and anything that you don’t agree with, and use emotional arguments? Did I say to take everyone off their antipsychotics? Why raise these pointless straw man arguments if your case is so strong? Why not just present your evidence?
Of course it’s longitudinal, how else do you look at long term outcomes?????
The facts are there. You don’t care to learn. That’s your choice, but don’t claim I said things I did not.
Done wasting time on you.
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You clearly didn’t really read Harrow. Whitaker has a fantastic analysis which sinks your argument fully, though clearly the psychiatric establishment grasped at that straw, and I’m guessing that’s what you are responding with rather than your own analysis.
Harrow identified 4 groups: bad prognosis on aps, bad prognosis off aps, better prognosis on aps, and better prognosis off aps. The outcomes sorted this way: better prognosis off aps, bad prognosis OFF aps, better prognosis ON aps, worse prognosis on aps.
If the worse prognosis clients off aps do BETTER than the better prognosis ON aps, that’s the opposite of selection bias.
But I doubt you will bother to revise your statement. So far, you only take positions that support your narrative. If we can’t have a rational exchange about this, I’m done with this conversation. Your position has been thoroughly undermined for anyone who actually cares about science.
Seriously, Corey. Read the book!!!
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Harrow is the best example of how long-term antipsychotic use leads to worse long-term outcomes. Take some time and look it up!
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They still SOMETIMES work for SOME PEOPLE. And it kind of depends what you mean by “work.” Read up on long-term studies, the folks who manage to avoid antipsychotics or use them sparingly do significantly better in the long run. This is shown in more than one long-term study. Again, your tendency to generalize make a lot of what you say of lesser value than it would be. It’s not so black and white as you want to believe.
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I had a client in foster care (we were her CASA advocates) who was diagnosed with diabetes. Here CASA volunteer got them to discontinue her Seroquel (antipsychotic). Next visit, her diabetes was gone. Thank God for the CASA!
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From your own study (emphasis added):
In contrast, studies on instances of suicidal behavior from weeks 1 to 10 found no significant difference in efficacy between SSRIs, non-SSRIs, and placebo. These results indicate that SSRIs MAY offer short-term protection against suicidal ideation. However, their long-term effectiveness in mitigating suicidal ideation and preventing suicidal behaviors is limited.
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So this is one meta-analysis claiming no INCREASE in suicidal effects on children or young adults. It certainly doesn’t suggest that SSRIs reduce suicide attempts or thinking. Of course, there are other meta-analyses that show that there IS an increase in suicidal thinking, or there never would have been a Black Box Warning in the first place. So your one meta-analysis is evidence, but not much, and certainly does not address your initial claim of decreased suicide attempts/thoughts resulting from SSRI use overall.
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“Everyone here” is an all-or-nothing blanket statement, Corey, so it seems you are displaying a bit of hypocrisy yourself here. Plenty of folks, including the Author, Robert Whitaker, (and me) take a much more nuanced approach. Read some of the articles by Johanna Moncrief, for instance.
“Fact SSRIs lower suicidal thoughts reducing suicides.” You believe this, but it is NOT a fact. Look at the work of Irving Kirsh and others. Prozac was initially not approved for sale in Germany due to increases in suicidal and violent thoughts/actions in some people. I am aware of no literature review that concludes “SSRIs lower suicidal thoughts reducing suicides.” (In fact, the best reviews I have seen suggest that only about 30% of users benefit significantly from taking antidepressants.) There is a black box warning about increased suicidal thinking in youth and young adults, hardly evidence of reduced suicides.
Do you have something to share along those lines to prove your claim? Or is that just what you believe to be the case? Have you ever read Whitaker’s work? Maybe you should have a good read before you draw unwarranted conclusions!
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It sounds like you are making a lot of assumptions yourself. Why do you feel such an urge to defend these drugs? Why not read and listen for a while and maybe learn that the situation is more complicated than you want to believe it to be?
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THAT feels creepy to me! Thanks for sharing your story. If she doesn’t want to take notes, she should use a Dictaphone like doctors always have. AI is NOT appropriate for this!!!!
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That one should have to SUGGEST “shared decision making” as if the PRACTITIONER gets to decide whether or not to “share” their power says a hell of a lot about the “diagnostic” and “treatment” process!
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The problem with “recovered memories” is when the THERAPIST tells the person they have such memories but doesn’t remember them. People come across incomplete fragments of real memory all the time that can be fleshed out by good listening in the right venue. I had this happen to me – I was hit in the head by a teacher in second grade. I always remembered the incident vaguely until right before the hitting part (including her tossing a book across the room), then blanked out until I was in the hallway. I shared this with another student in the class at my 30th reunion, and she remembered the whole incident, including my being hit by the teacher! After hearing this, I recalled the kid who was tossed in the hallway with me, I recalled being sent to the nurse by the secretary, I recalled being outside the principal’s office hearing him and the secretary chatting, with Freddy sitting next to me. I have no doubt these are real memories I recovered because someone validated MY story. But no one told me they happened, I had to recall them myself.
No one should evaluate someone else’s experience or tell them memories exist that they don’t recall. But it is very much possible to recover memories of things that a person has forgotten. It happens all the time.
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You are talking about prejudice. That’s why I hate the word “stigma,” it minimizes the intent and the damage done to people.
You should know that viewing “mental illness” as a biological condition has been shown in multiple studies to INCREASE prejudice and decrease empathy for the “mentally ill” persons.
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The problem, Renate, is that not everyone experiences antidepressants the way you do. As I said before, everyone should do what works for them. But because it works for you does NOT mean it works for others, and you should be careful not to state or imply that. If “Depression” were a clear-cut, identifiable disease state, we’d be able to predict who would and would not respond to antidepressants in a positive manner. But we can’t, because “Depression” is a vague and subjective concept that does not describe a group of people who necessarily have ANYTHING in common besides how they are feeling. Just to clarify – you were seriously depressed starting at a young age and have not identified any trigger or event that changed that for better or worse. Do you think that is the same as a kid in foster care being seriously depressed because his mother abandoned him at a young age, or an aging adult who is depressed about his/her life deteriorating and losing abilities, or someone who is in chronic, unresolvable pain and does not want to get out of bed every day because their life seems so hopeless? I’ve seen kids in foster care who are far WORSE after taking antidepressants, including being aggressive, suicidal or psychotic. I’ve seen doctors not listen to them or their advocates because they believed that antidepressants are “the answer” for all forms of “Depression,” regardless of the cause.
You seem an intelligent and rational person. Surely, you can see that “Depression” is far to vague to be viewed as a single entity, and that there can be many reasons for being severely depressed, and as many possible solutions as there are people suffering?
I would never want to take away something that works for you. I just want you to see that other people don’t have the same experience and for good reasons are very suspicious about antidepressants as a solution for ALL cases of “Depression.”
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I sort of agree, but I think the process is more one of removing inhibitions based on talking to lots of ‘users.’ I remember one in particular who took Zoloft for migraine headaches, not depressed at all, saying that she’d run into situations and be going over possible solutions and would think, “I could kill myself!” She was shocked at herself for even thinking such a thing, and totally attributed it to the Zoloft.
So if a person is feeling inhibited, as in I can’t stand up to my mom or I feel I have to act a certain way to keep others happy, taking SSRIs might seem like a relief – who cares what mom thinks, those others can shove it! But what if the person is inhibiting wanting to kill themselves, but is staying together by saying, “I can’t do that to my kids” or “I don’t want to leave a mess for others to sort out, it would be selfish?” Removing those inhibitions could result in, “Ah my kids are better off without me” or “It won’t be my problem, I’ll be dead” or similar justifications. And Lord help us in the rare cases where the person is inhibiting the thought of hurting or killing others by thinking it would be too horrible a result. That kind of inhibition, we WANT people to keep!
That’s how I see it working for some people but being a total disaster for others. It depends if removing inhibitions works in your favor or against you. And I have personally seen both happen.
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When working with foster youth, I saw a large number of cases where prescribing stimulants led to aggressive behavior. I saw one VERY clear example of psychosis being induced by stimulants. A study I’m familiar with showed 6% or so of kids who were prescribed stimulants had psychotic behavior or thoughts recorded in their files. This is a very real phenomenon.
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The conclusion is not that all psychiatric drugs are bad for you, it’s that “information” coming from drug companies regarding their drugs can not be trusted based on long experience. Benefits are overplayed, adverse effects are buried or minimized, and outright propaganda is put out as if it were fact. Everyone has to make their own decision about a particular treatment, and drugs are not “good” or “bad” in the absolute sense of those words. They work or don’t work for a particular person. There is no special way to “diagnose” people and thereby determine who will “benefit” – it is simply a matter of trial and error, and we’d all be better off if doctors were honest about this instead of pitching drug company propaganda (such as the “chemical imbalance” concept) as if it were factual.
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You make the simplistic mistake of assuming that all “psych patients” are “mentally disturbed” and do “insane disturbing things.” This is rank bigotry, Andy. The vast majority of “psych patients,” in particular depressed individuals, do NOT engage in doing “insane, disturbing things.” Most in my experience AND in statistical studies are actually quite safe, and are much more likely to be victims than perpetrators of violent incidents. This is particularly true for female patients. School shooters tend to be young and male. There isn’t a lot more that they have in common with each other statistically.
As for SSRIs and violence, this is not new information. SSRIs were initially banned in Germany for inducing violence and aggressive behavior back in the late 80s, in people who did NOT have that kind of problem to start with. I don’t think it’s appropriate to ever pin a particular crime on SSRIs, but the correlation is not made up. It’s a very small number, but it does happen. Look at the Germanwings plane crash for a good example.
I am not a fan of RFK, Jr, but again, “explaining” things by blaming the patients is an immature and cowardly approach to the problem. I think we’d do better to do some honest research and to add appropriate warnings if need be.
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Pure speculation. This is not helpful to those who are truly suffering. Blaming the victim is never a good plan in my view.
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Doctors can prescribe any FDA approved drug for any indication they can find. The only way to “take away” a drug is to have the FDA withdraw their approval for that particular drug. Since drug companies contribute to both sides of the aisle heavily, it is very unlikely that any such drugs will be withdrawn from the market. Think how hard it was to even get a well-researched warning put on antidepressants. Banning them? Nothing to worry about, IMHO.
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“When someone is treated with a medication there is a reason.” False premise!
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Your premise sounds more like “being male contributes to violence,” not “depression. If young women are equally depressed but NOT committing school shootings, than “depression” per se is not a variable. Being young and male most definitely is.
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For the record, #1 is a completely false premise. But I tend to agree with you overall. I’d say that SSRIs play a role in a very small number of cases, and many other factors are involved even if SSRIs do contribute in some way. It’s certainly no argument for banning ADs, but it may be one for adding some informed consent. See the Germanwings plane crash for a fairly clear case of probable SSRI contribution to a disaster.
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Three issues with these fMRI studies:
1) The observed differences are AVERAGES, they are essentially correlations. There are plenty of people diagnosed with “ADHD” who do NOT have the expected differences, and there are people who have the differences who do not display “ADHD” behaviors.
2) These studies rarely if ever take prior medication use into account, which is a confounding factor in a huge percentage of anyone in the diagnosed group. Stimulants have been associated with changes in brain volume and functioning, which have often been attributed to “ADHD.”
3) Many fMRI studies are measuring brain ACTIVITY, not structure. Variations in activity in certain areas may be an artifact of environment and not differences in the brain at all.
Additionally, the fact that some genes may code for more active and less sedentary personality styles does not automatically make such genes “malfunctioning.” Having raised two kids (out of three) who would qualify easily as “ADHD,” I can say with confidence that both have great strengths which the non-“ADHD” population lacks in general. Both ended up being successful in school by using alternative classrooms that allowed a lot more exploration and movement. Both graduated with honors from high school, the youngest graduated with honors from Evergreen State College!
I ran across a VERY interesting study a while back. They set up groups of three kids (elementary age) with one kid diagnosed with “ADHD” in each. Control groups had three kids, too, but no “ADHD” kids. They gave them three problems to solve in a given time. They measured on-task time and successful completion. The control groups scored significantly higher on “on-task” percentage – they kept their figurative noses to the grindstone and worked hard. But none of them solved any of the three problems. Whereas ALL of the study (“ADHD”-including) groups completed at least one problem, and at least one completed all three, even though these groups goofed off a lot more than the control groups!
Of course, if the groups had three “ADHD” kids each in them, they’d have probably got nothing done at all on the problems! But I think the study showed what I believe to be true – we need these active, creative, fun-loving, goof-off moments to have healthy groups of people, and there is nothing wrong with someone who tends to play that role in society. After all, if 10% of people have a particular trait, it must have some survival value, mustn’t it?
None of which argues against your using stimulants, or anyone else, if they feel it is helpful. I think it’s just important to know that there is more than one way to look at this set of traits than to view it as an aberration or disease state.
I hope that was at least an interesting read for you.
Steve
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Very well said!
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It does not. But saying “Correlation is not causation” does not mean the correlated events are NOT causally related, merely that you have not proved it. In my world, it’s the job of the drug manufacturer and the prescribing doctor to ENSURE the drug is safe. If it is not, or is even SUSPECTED not to be, it becomes a matter for informed consent immediately. Something as simple as, “A very small number of people don’t seem to react well to this drug. If you find yourself suddenly thinking about hurting yourself or someone else, please call IMMEDIATELY and we will address it.”
Then, of course, when you DO get that call (like the Germanwings pilot), you have to not pretend “it’s part of the disease” and DO something about it. “Wow, it sounds like you are finding this drug is not working for you! Let’s come up with another plan!”
It’s really not that hard. But it starts with being honest.
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I agree, however, we should not be killing people while looking for root causes!
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I agree 100%. “Wellness camps” sound bad enough if you went voluntarily!
I am opposed to involuntary “treatment” in any circumstance, as I don’t regard it as “treatment” if the client is not a willing participant. I realize that sometimes people have to be prevented from harming others or endangering society (wandering into traffic, etc.) but that does not justify forcing drugs or “wellness camps” on people who are unwilling or uninterested in such “treatment.”
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There is nothing wrong with taking pills. MIA’s mission includes scientifically-supported use of medications. Of course, individuals are entitled to express whatever opinions they see fit, including plenty reporting positive results of taking medications. MIA is intended to be judgment free in that regard.
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I said nothing of the sort. I said that you can’t extrapolate from your own experience to that of others (which clearly you can not), and I said that no one is coming to take your ADs away from you (which clearly no one is). These are statements of fact. I certainly have no thought that sending you to a “camp” of some sort being advisable, in fact, if you are satisfied with what is happening with your current treatment, why would they want to send you anywhere? They are sounding like the ones with the issues. I fully support you in doing whatever works for you. I just can’t agree to blame violence likely caused or exacerbated in rare cases by antidepressants on those unknowingly taking pills with such adverse effects.
Look into the Germanwings plane crash if you want a really solid example. The pilot TOLD his psychiatrist he didn’t feel right taking these drugs, but the psychiatrist ignored him, didn’t change his regime and continued to allow him to fly. The results were devastating.
That’s what happens when we pretend an adverse effect doesn’t happen when the evidence says it does. It has nothing to do with individual experiences or banning of drugs. It’s just about being honest about the data.
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Or, people with ACEs may be more likely to react adversely to SSRI antidepressants and other drugs. I will repeat that the experience of “depression” in particular is RARELY associated with violence of any sort. It is usually associated with withdrawal and passivity. There is absolutely no reason to expect a rash of mass murders from depressed people. SSRIs appear to be a strong variable. They clearly don’t affect the majority this way, but as I noted earlier, Prozac was initially banned in Germany due to causing violent episodes. This is not being made up, and let’s not let SSRIs off the hook for their role in creating a more violent world! Blaming it on the victim once again is not an acceptable explanation.
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Just because you love them doesn’t mean others aren’t adversely affected. The percentage who become violent is apparently small but does exist. Prozac was initially banned in Germany because of data suggesting a small but significant number of people who became quite deranged taking them.
Besides which, depression has NEVER been highly associated with aggression and violence. Depressed people tend to be withdrawn and more passive than the average human. You can’t blame “depression” for this result, even if it makes you really uncomfortable.
And BTW, no one is coming to take your SSRIs. So let’s relax and look at the data instead of our emotions!
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It’s not “broken” if it’s working the way it is designed. I think we all get confused re: the purpose of these “systems.”
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I agree with you. A reduction in suicide compared to other methods (and how has he measured this? I don’t think he says…) might just as easily mean that fewer people are driven to suicide by this method vs. the standard. No “treatment” could very well still be superior. Since most people spontaneously recover from depressive episodes, our baseline ought to always be “untreated.” But hey, who can make money by NOT treating people? Maybe we should make it like farm subsidies – you get paid for NOT treating patients and leaving them alone!
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That’s what is so great about Rat Park! Instead of seeing how they act when abused or neglected, they look at how rats act when treated well in a super supportive, rat-friendly environment!
https://www.psychiatrictimes.com/view/what-does-rat-park-teach-us-about-addiction
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The Rat Park experiment shows the truth of what you are saying!
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All pending comments I see of yours have been approved. If I am missing something, please contact me by email NOT via a comment like this one, with date, time and partial text so I can identify the post in question. Asking here why it’s not been approved is a violation of our posting guidelines. Please stop doing this!
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Their answer will be “more funding for mental health services,” even though it sounds like she was receiving such services for years!
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That makes a lot of sense.
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I think Robin Williams did an ad for that stuff!
https://www.youtube.com/watch?v=XBb5v1sJhuU
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Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
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Then there are those who go into the field just so they can have power over others. I diagnose them with “BAD” – Basic A**hole Disorder!
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What an awful story!!! Sounds like they were trying to kill you!
You are correct IMHO – Humility is the basic building block of being a helpful person. Without it, practitioners (medical, too) are lost.
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Neither necessary nor sufficient!
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Excellent point!
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I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
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It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
Don’t hold your breath!
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I am SOOOO sorry! What a sad story. I only wish it were the only time I’ve heard that. We’re here to listen if you want to share!
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I agree 100%!
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No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
Does that clarify my position?
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There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
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“Behavioral health” always seemed like a bizarre term to me. Behavior doesn’t have health. Beings have health, not actions!
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So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
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Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
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Posting as moderator:
I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
[email protected].
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It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
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But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
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Dang, how can a guy make money selling cures when people keep getting better on their own?
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“High rate,” “associated,” “potentially,” “often linked,” “may impact…”
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
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Posting as moderator:
OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
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I’m not sure the system is “broken” so much as that it doesn’t really have the same objectives as it claims to have. Keeping folks under control is a big part of the agenda, and “healing” is something they gave up on a long time ago, if they ever really had that as a goal at all. Someone who thinks electrocuting people into having a grand mal seizure is good “treatment” for anything is not really interested in helping you get better!
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🙂
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I guess I was correct.
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The duty to inform is very often disregarded, especially in the “mental health” fields.
When did I advise a person who is depressed to study holy scriptures? I’m afraid you have literally no idea what I’m talking about. I understand you are a “physicalist” as you put it, and I believe that blinds you to the ability to understand that the CAUSES of any “mental disorder” are actually unknown, no matter how many scans you want to do. You are ASSUMING the cause is in the brain, and therefor the consequence is diddling with the brain. The results of such reasoning have so far been fairly disastrous, if you believe the literature (including Anatomy of an Epidemic). A true “duty of disclosure” would mean admitting “we are treating an entity we don’t really understand.” I doubt very much anyone hears this from their doctor.
You are, of course, welcome to express your own philosophy, however, scientific proof of such ideas remains a long way off, if we go by the literature on success rates and damage rates and even diagnostic consistency and so on. (If these scans are so great, why aren’t they being used for “diagnosis?”) You’re not going to convince me by repeating your beliefs over and over again without bothering to try and understand where I am coming from. Probably not worth further discussion, as you seem quite certain of your ‘rightness’ and I doubt will hear me, and I am certainly not going to be convinced by your kind of arguments.
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You again conflate function with structure here: “This doesn’t change the fact that a depression is not a mental state you can invoke within a blink of an eye but structural or functional deficits of your brain and such malfunctioning parts of your brain can be exposed by imaging methods.” The fact that SPECT images of “depressed” brains are similar in some respects does not imply structural differences, nor does it imply malfunction. I certainly never would suggest that depression can be overcome by thinking of different events, but that’s not what I said. Depression is a very complicated condition. The brain is clearly involved but to imagine people only get depressed because of “bad brains” is not consistent with observation, otherwise, why would it be so much more common in people with abuse histories?
And you are right, avoiding psychiatry seems like the smart path to me. I don’t think being a “physicalist” is necessarily a more rational position, though you seem to imply those who aren’t are being foolish. Being a “physicalist” is a belief system or philosophy. You are welcome to your own philosophy, of course, but that doesn’t make it any less a belief system than any other philosophy. I would prefer working with people who recognize my agency as a human being rather than seeing me as some sort of chemical machine.
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It sounds like we generally agree on all that. My only objection is that I don’t believe that “mental illness” as currently understood (or misunderstood and labeled) generally requires “treatment” of the brain per se. A person who is suffering can have a perfectly sound and functioning brain. Spiritual/emotional pain is something that I believe extends well beyond the brain, and “treating the brain” to handle most of it is like replacing memory chips to fix a computer programming error. Until we get away from seeing the brain as the problem, and start looking at social conditions, we aren’t going to get far with even the best technology, because I think we’re barking up the wrong tree!
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Brain ACTIVITY is not the same as brain STRUCTURE. A brain may be DOING certain things while depressed and those ACTIONS may be reflected in measurements of activity (PET and SPECT scans, for instance). However, a) these scans say ABSOLUTELY NOTHING about the reason the brain is behaving in a certain way, only that it is and b) it has been shown that changing what one is thinking can change the PET scan, hence, thinking of a depressing topic creates a certain pattern, while the same person thinking of something cheerful changes the pattern instantly to something else.
All that being said, there is NO CONSISTENT PATTERN that is associated with all cases of depression, or even most. Same with ADHD or other “disorders.” This is why these are never used in diagnosis, except by charlatans who take advantage of people’s vulnerability. They simply fail completely in being able to understand or predict the CAUSE of any psychiatric “condition,” and this will not change, as they measure ACTIVITY alone.
Of course, these “disorders” are defined by social expectations and judgments in the first place, not scientific criteria, so why anyone would expect any brain measurement to “diagnose” them is puzzling. Clearly, we have the cart before the horse here – we are supposed to find the proximal cause of a condition before assuming we can “diagnose” it concretely. For all we know, there could be 25 different reasons people become depressed, all of which result in similar brain scans. As long as that’s the case, the idea of diagnosing by scans will remain a pipe dream, IMHO.
Please try to keep the condescension out of any response, it is not appropriate.
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You are assuming that all “depression” comes from some biological failure of the brain. There is, of course, absolutely no evidence to show that claim to have any validity.
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I’m going to let one more post stand on this topic. Larry, if you have any validated links or literature to share that Mark can read, please help us out and do so. If not, it sounds like you’ve answered Mark’s questions and I’d like to leave off with one more post. The discussion is really quite far off the original topic.
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Any therapist who thinks it his/her job to “keep the conversation going” is an idiot. Silence is really important in a good, supportive conversation. It allows important things to surface!
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Does knowledge of the brain even have a primary place in this discussion? Are we really talking about “illnesses” if these “illnesses” are socially defined?
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They seem to mean that they expect people to get better but they get worse instead. A paradox only if there is a rational expectation that the initial “treatment” should work. That seems to be a large part of the “trick” of selling psych drugs. Make an open claim that they “work” and then call failures “resistance” or “paradoxical” instead of just admitting they were wrong!
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Walter, if you read carefully, you will see I am not generalizing, merely pointing out that the Deaf community IN MY EXPERIENCE is not monolithic in its views on “normalcy.” I am advocating for listening TO the Deaf community and its individual members to understand, rather than using “ableist assumptions” (including assuming that a member does or does not view him/herself as disabled) to characterize its members. Some do and some don’t view themselves as disabled. I’m not even disagreeing with the prior poster. This is true whether or not the prior poster identifies as part of the Deaf community.
Not sure what your point is.
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Agreed!
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How can the author state there have been “advances in treatment options” when it is clear that the “treatment options” are not resolving the problem? Wouldn’t an “advance” in treatment mean a DECREASE in the number of sufferers??? I think the authors miss the point. As Robert’s research demonstrates, the ADs tend to be COUNTERPRODUCTIVE, a form of ANTI-TREATMENT for many people. When the best estimates of “success” show rates of 30%, and even then with very small improvements that may not even be clinically significant, it’s hardly appropriate to call “treatment failures” a “paradox.” They are evidence that the treatment doesn’t work!
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It’s not a “paradox” unless there is reason to expect the “treatments” to be effective. In this case, it’s simply evidence of either treatment failure, or a hidden agenda to create more customers!
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That was intended to be a humorous remark! But the engineering team (if there was one) still missed the boat on that one.
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Any deity who came up with the human childbirth process can hardly be accused of “intelligent” design!!!
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I actually just found this comment, I think. I published an identical comment one minute later.
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Please email me at [email protected] and let me know the details. A delay of one day is normal, as there is only one of me and I don’t always get to this more than once a day. If I said something was duplication, it means you made another comment saying something the same or very similar. If that’s not the case, I can fix it, but I need to know the thread, preferably the date, and the first sentence or so, so I can make sure I identify the correct comments.
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Completely agree.
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Unfortunately for your theory, it appears that these drugs “sculpt” the brain in most unfortunate ways that are not always repairable. We also know from experiment that activities we engage in, such as meditation, do literally alter the structure of the brain, possibly in just the ways needed. Buddhist monks, for instance, have been shown to have certain parts of the brain associated with calmness and focus are more active than the average person.
https://www.reddit.com/r/Buddhism/comments/11105s/scans_of_monks_brains_show_meditation_alters/
Neuroplasticity has been shown throughout the brain, namely that brains are altered by experience, both in the negative AND in the positive. And as I recall, the most healing thing for a child damaged by abuse/neglect is not a drug, but a healthy relationship with caring adults. It literally heals the brain.
So the idea that those damaged in their brain region by abuse/neglect are not capable of healing and need drugs to survive is not supported by science. Whitaker’s work demonstrates that in the long run, psych drug use does more damage than good. Have you read Anatomy of an Epidemic?
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I have worked with foster kids, and many of them are remarkably calm in a crisis. I think it’s something you learn if you live in a chaotic environment as a survival technique. But of course, not everyone has that skill. It amazes me how clinical people with experience still believe you can predict someone’s behavior reliably based solely on their “diagnosis.” There are LOTS of differing reaction to stressful events, and no one should get to tell another person, “Your event isn’t stressful enough to be called a trauma.” The client is the one who knows what is bothering him/her and ultimately holds any solutions to problems that exist.
BTW, I was also a social worker, very calm in a crisis, but I sort of thrive when crisis comes compared to regular life. Used to manage a crisis line – go figure!
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After reading over the article in full, my sense is that the author puts a lot of time into “differential diagnosis” despite recognizing that it is objectively not possible with the subjective DSM criteria. For me, the key to success is adapting therapy to the person in front of me, and “diagnosis” per se had very little to do with that. If someone works well with a CBT (change your thinking to change your emotions and behavior) kind of approach, I’d use that approach, whether they had a “PTSD” or “BPD” or “ADHD” or no diagnosis at all. If it didn’t work, I’d use something else. I certainly wouldn’t waste my time convincing my client we needed a new “diagnosis.” I’d simply say, “Let’s try something different. Sometimes practicing skills can be more effective than going over past events. Are you OK giving that a try?” Or, God help us, I might ask the client what they’ve found to be helpful or not. After all, they are the ones who are defining “helpful” for us! If we think we’re helping and they don’t, we’re not.
So maybe the cultural references have some validity, though I see little to no scientific data to indicate that one way or the other, just anecdotes, really. But when it comes to providing therapy to a specific client, I think we do well not to call their recollections into question (particularly by asking their parents right in front of them!) but instead to apply the widest range of skills based on what actually works for the client, regardless of their ‘diagnosis.’ After all, even if CBT worked on 90% of depressed clients, there are still 10% who will fail unless you do something different. Forget “differential diagnosis” and do what works.
Milton Erickson reportedly said we have to re-invent therapy for every client. I think he got it right!
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“May cause?” How much evidence is needed to move to “DO cause!?!”
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I can’t imagine a more incompetent attempt to verify developmental trauma than asking the parents! They OF COURSE will almost always deny or minimize any harm done, and are happy to blame the child if they HAVE done some damage, as it lets them off the hook. Moreover, parents can be perfectly well intended and still do a lot of harm, of which they will not be consciously aware. They are the last people in the world to ask, “Was your child traumatized in your care?” Very often, the parents have contributed or facilitated the trauma themselves.
Beyond this, “Borderline Personality” diagnosis is HIGHLY associated with developmental trauma. I don’t think I ever encountered a person diagnosed with “BPD”(which I consider to be a diagnosis of little use except as a means of distancing oneself as a clinician from his/her client) who did NOT experience significant trauma as a child, especially when intermittent EMOTIONAL abuse is included. To diagnose BPD as an EXCLUSION for people whose parents deny they were traumatized is truly a bizarre choice, even within the confines of accepted psychiatric “differential diagnosis.”
Very odd thinking behind this kind of analysis, IMHO.
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I agree 100%. Techniques are secondary, handy “tricks” that can help smooth the path sometimes. But what is really healing is having someone care enough to be open to hearing and listening deeply to what is happening for another person. It requires courage, empathy, and an ability to hold others’ pain without reaction or withdrawing or advising. These things can be learned but not “trained” in the sense of classroom instruction. And a person can spend decades “studying” human psychology and yet be completely clueless as a therapist.
I used to work managing a volunteer crisis line. Some of my best counselors were computer programmers. Some of the worst had doctorates in psychology. I can find literally no correlation between “training” and competence as a therapist.
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I recall reading a study of kids in a residential program. Over 80% reported overt trauma. Less than 20% had it noted in their charts. So either the clinicians didn’t bother asking about trauma, or they didn’t consider it important enough to write down! This in a residential program for teens with behavior problems. How they can be sooo off base is beyond my comprehension.
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It’s hard for me to imagine how they can see case after case, like yours, where the person remains “ill” despite or even because of their “treatments,” never really gets “better” or actually gets worse, and yet somehow continue to believe their approach works! It is somehow always the patient/client’s fault when THEIR “treatment” fails, always their own doing if they get better somehow despite their “treatment.” How can they believe this themselves, let alone perpetrate it on their victims aka “patients?”
Well done to you for finding your way out!
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As I suspected, your references are only talking about probabilities and associations. There is no inkling of a biological CAUSE that would apply to all situations. Valuable information, to be sure, but nothing to do with validating “depression” as a legitimate diagnosis with a unitary cause. So for sure, Vitamin D and folate should be considered viable interventions for people experiencing mood problems, but this certainly allows for a HUGE range of possible causes, and also doesn’t eliminate the possibility of low folate or low Vitamin D cases NOT being depressed or suicidal, which would also kill off any fantasies about a causal role for any one biological condition in depression or suicidality.
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Makes sense to me!
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I have no specific objection to therapy at a distance. I used to be very successful with phone counseling at a crisis line many years back. There are some advantages to NOT being able to see one’s client – visual biases are virtually eliminated, for instance – I have no idea if I’m counseling a fat person or a black person or an old or young person.
The real question is, of course, effectiveness. I’m betting that has a lot more to do with WHO is the counselor and HOW they relate to their clients than it does with WHERE the counselor or client are during the process. In-person therapy certainly hasn’t got a fantastic record to beat!
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I’m not sure we can talk about “misdiagnosis” when there is no actual way to determine objectively who does or doesn’t have a given “diagnosis.” How would anyone know they were “misdiagnosed?” More proper to say you were misunderstood and mistreated!
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What exactly does that mean – a “neurometabolic condition?” Sounds like something he CONCLUDED rather than proved scientifically. I’d be willing to bet that he is talking about averages rather than finding a cause of all or most “depression.” He no doubt found that changes in neurons and metabolism are involved when people are depressed, and that certain changes are more common. Not a big revelation. But I’m willing to be enlightened. What does he imagine CAUSES most or all cases of depression, regardless of experience? What do all or most “depressed” people have in common that almost no one not “depressed” experiences? I am interested in this research. Let me know what you’ve got.
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Labels certainly meet a lot of societal needs, especially related to avoidance of discomfort. Of course, those who are “loyal” to parents despite abuse are presenting a competent therapist with the very thing they need to start working on, rather than promoting avoiding it by blaming one’s brain. Additionally, while the CLIENT may initially “feel better” because they’ve been blaming themselves, the studies I referred to show that OTHERS actually are more likely to stigmatize the client, including their own therapists and “mental health professionals.” Finally, it’s not the job of a diagnosis to make the person feel better, it’s to get them on the road to healing. What if we didn’t tell people they have cancer or heart disease because it made them uncomfortable? This is what happens when “diagnoses” are tossed about without regard to scientific validity. No one should be told they have a “brain dysfunction” unless the doctor KNOWS they have one, regardless of how it “feels” to get diagnosed. It is this kind of shady “reasoning” that proves psychiatry to be based on a fraudulent premise. For REAL diseases, no one gets to pick out the diagnosis that makes them feel best!
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Perhaps surprisingly, research has shown that people judge others MORE HARSHLY when their problems are attributed to “brain chemistry.” Talking about trauma and life difficulties creates empathy. If someone’s brain is blamed, it appears it’s easier for others to distance themselves, to say, “Oh, he’s ‘mentally ill,’ he’s got a brain problem, he’s not like me!”
“Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC4273344/
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I guess my sense is that anyone who was genuinely focused on making their clients’ lives better would notice if their interventions made them worse. Sure they WANT their clients to “get better,” but most seem to not deeply believe that is possible, and view “better” as meaning “less” x or y or z. Reducing one’s depressed feelings is not the same to me as improving quality or life, and even less the same as actually improving their sense of control of their lives. And if evidence came in that my approach didn’t work or was based on false premises, I would chance my approach rather than blaming my clients or insisting I was right regardless of the evidence.
But incompetent or ill-intended, it doesn’t much matter to the clients. There needs to be a real intent to find the best path. Some exceptional practitioners do have that, and get results. But I find them very much in the minority, especially in the psychiatric industry. The proof is in the pudding. And some really crappy pudding is being handed out!
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Wow, that person hasn’t got a clue if he thinks his job in therapy is to come up with things to talk about! Shocking that any insurance company would pay good money for such crappy treatment!
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Nothing wrong with an emotional response in my mind. Besides, you’ve got plenty of factual backup for your points!
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Very well said!
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I always wonder how the “brain dysfunction” advocates account for that.
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Excellent summary about what therapists do to protect themselves at their clients’ expense. C) is particularly damaging – to state or imply that you should NOT feel depressed/anxious/etc. and that YOU are the one with the problem for feeling that way. And I agree, therapists being uncomfortable with their clients’ feelings and experiences provide the OPPOSITE of therapy, and are very hurtful!
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So you are not engaged in the practice of medical science, you’re involved in the practice of perpetuating your and your colleagues’ psychiatric belief system. That’s my point. Psychiatry depends heavily on the belief systems of the mental health professionals involved, and what kind of treatment one receives is very dependent on their “philosophy.”
Of course, most people have no clue that is what is going on. They don’t think psychiatry (or alternative medicine or whatever) is something you BELIEVE IN, they think it’s some kind of scientific study that can specifically identify what is “wrong” with their brains and fix it with drugs. This despite recent reviews showing that serotonin deficits are not associated with depression, nor is excess dopamine a causal agent in “schizophrenia.” You should also keep in mind that some “clients” of psychiatry have no choice about it, whether they believe in it or not.
To compare Whitaker’s well-researched reporting to Samuel Butler or Shostakovich is an extremely weak analogy to say the least. But you don’t appear to be interested in expanding your viewpoint based on such research, so there is probably no point.
However, that still does not excuse blaming your patients for responding in predictable ways to the propaganda they’ve been exposed to. They are patients. If you don’t want to treat them, I’d say you need to get yourself a new profession. I don’t believe “psychiatrists are brainwashed,” and of course, I never said any such thing, so such strawman arguments are merely distractions. I’m not hostile toward psychiatrists, I simply don’t respect professionals who blame their clients for annoying them. They’re clients. They’re not there to make you feel good or to validate your belief systems. They are looking for help. If they don’t find your “help” helpful, it’s not their fault. You’re the professional and it’s your job to care for them. Why would you take on clients if they annoy you so much? I’ve worked with plenty of psychiatrists whom I respect, even when we disagreed about how to approach most of our clientele. I only ask for basic respect for and compassion for the client. That is what seems absent in your case. And that’s an observation, not an attack.
Why not do what one psychiatrist I respected greatly did: Say, “I know you are hearing voices that you are not happy about. I have a drug that can help you not hear them as much. They don’t work for everyone, and they can have really intense side effects, but many of my clients find it’s well worth the exchange. If the first effort doesn’t work for you, we have several options available to try. Does this sound like something you would like to try?” Or words to that effect. Of course, he did get some interesting responses. One Native American guy said, “You white folk are all the same. You hear voices, you try to make them go away. We hear voices, we go someplace quiet and listen and see if they have anything interesting to say!”
I’m sure you’d have found that client quite annoying. I find him amusingly insightful.
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Do you want us to feel sorry for you that you have to deal with actual patients? You do understand that these “diagnoses” are all “clinical opinions,” that there is no way to say for sure that someone “has schizophrenia” in the same sense that they “Have a broken leg?” Is it any surprise given the sketchy marketing techniques out there (selling “disorders” rather than treatments) that people self-diagnose in massive numbers? How do you let the pharmaceutical industry and the psychiatric industry itself off the hook for convincing people they “have” diagnoses that don’t have any concrete or objective definitions?
Have you ever read “Anatomy of an Epidemic?” I very much doubt you have. If you did, you’d have a much better understanding why people behave the way they do regarding “diagnoses.” I will simply end by saying its hard to respect someone who bears such hostility and disrespect for his own clients. You are laying in a bed that your profession has made for you, and blaming the patient is not a mature reaction, IMHO. The phenomenon is the natural outgrowth of the basic (IMHO faulty) assumptions of your system combined with an essential disrespect for the experiences of your clients, which your comments very much demonstrate to me.
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They seem to be suggesting that “mental illness” creates itself somehow. It’s totally illogical.
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How and why would psychiatrists do any of the recommended things in the essay? There is no financial or professional incentives to do any of them, and in fact involves massive incentives to maintain the status quo, which meets most of the needs of most of the psychiatric workers with no change whatsoever. Those who DO challenge the status quo are generally attacked and humiliated and threatened with loss of status or income or both if they continue their sacrilegious ways.
Psychiatry will continue to oppose any sane efforts at reform. I don’t believe it is reformable, as it is at its core based on faulty assumptions that are self-serving and self-perpetuating, and no one will be able to change its basic purpose, which is NOT to help its clients have better lives!
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Remember that these “diagnoses” are almost entirely invented and mean next to nothing. They are mostly just descriptions of annoying behavior and difficult emotion that tend to occur together. Saying he “has bipolar disorder” is not a scientific fact – it’s just someone’s “clinical impression,” AKA someone’s opinion based on their own biases and social values. There is no science to it whatsoever. So don’t let them convince you they know what they are talking about. Do what makes sense and what seems to work, even if they don’t agree with you. Your husband and you know far better what is going on than any psychiatrist!
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Stimulants can also induce OCD behavior. It often leads to other diagnoses when folks have adverse reactions to stimulants. Especially Bipolar Disorder. It can be dead obvious what happened, but try to get them to quit giving the kid Ritalin and they freak out. Once had a kid I advocated for who had an eating disorder diagnosis. They gave her stimulants, and lo and behold, her appetite was reduced! They of course attributed it to a “relapse” in her “eating disorder” rather than realizing that stimulants were a bad idea for someone with that condition!
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I think Plato nailed THAT one!
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Actually, Irving Kirsch’s work fully supports Peter’s statements. There is more, and I do agree he would do well to include such proof.
But that doesn’t change what I said. The manufacturers can’t claim that ADs reduce suicide rates unless they have evidence that they do. No one has to “disprove” an unsupported claim. The “null hypothesis” is assumed to be true unless proven otherwise!
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Just for the record, it is the job of those claiming an effect to prove it. No one has to “disprove” that ADs decrease suicide. If that claim is not supported by evidence, it is considered FALSE regardless of counter-evidence. In other words, I don’t have to prove that something doesn’t happen just because someone claims it does. The burden of proof is on the person claiming it works.
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Yes, but we also have to consider that the response of the clients is the only valid measure of success. But remember, it is the quality of the relationship with the therapist/counselor which appears to be the most important variable. How can we measure that, other than by how they are perceived by the client?
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While DBT has some useful skills that can be learned by anyone who wants to use them, to suggest it is a “treatment for BPD” is problematic, as there is absolutely no objective way to say who “has BPD” or “doesn’t have BPD.” As such, all we can really say is that some people find it useful and some do not, just like any other set of “therapy skills.” Until it is possible to actually define these “disorders” objectively, there is no way that “clinical research” can prove anything relating to a “disorder” that is defined by social biases rather than scientific measures.
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I can’t really agree with you here. It seems to me that providing therapy is more of an art, though it should be informed by science. There is no way to train someone reliably to be a “good therapist,” and I have seen many competent counselors who have little to no formal training. There is an element of having “Done one’s own work” to be emotionally available to a client which is simply not a factor of hours of training or scientific findings. The proof is in the pudding, and many therapists with advanced degrees are mediocre to poor therapists, and many of the best therapists have come to it via alternative routes (I had an undergrad in Chemistry and a MS in Education, as an example). It is not such a black and white “scientific” question!
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Thank you for taking such time giving me feedback and sharing your perception of my comments. All I can say is that you’ve given me a lot to think about. Or FEEL about?
You may be taking my comments re: euthanasia a bit too far, though. I was really just trying to get an agreed-upon definition. Whether it SEEMS like suicide or not must certainly be an individual decision!
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Sounds like a much safe option than SSRIs!
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You may be missing the point here. If there IS science to be debated, it ought to be respected. Using name calling (like “climate change deniers”) does not mean that’s true, but is a great way to distract from the fact they are avoiding talking about the real issues. The fact that antidepressants do NOT decrease suicide attempts or thinking is very well established by mainstream scientific studies. There is no evidence that any drug decreases suicide attempts except for a very thin support for Lithium which has been called into doubt. If the reviewers can’t provide any science demonstrating a reduction in suicidal thinking or attempts, it is they who have more in common with “climate change deniers.”
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Yup! You can always get some tramadol paid for, but a massage comes out of your own pocket! How much in Tramadol sales could be saved by prescribing a lot more massages?
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I found the idea of intentionally inducing anxiety, depression, etc. to be somewhat disturbing. Is there no sense of possible long-term damage from this process? Doesn’t life already teach us that difficult situations bring on difficult feelings? Why does that need to be “proven” by potentially harming people?
That being said, I agree completely that normalizing anxiety, depression, even delusions and hallucinations is the best path forward, along with some REAL medical care for real, objectively observable conditions (like drug adverse effects). There is no benefit to lying to people to stop them from blaming themselves. In fact, normalizing blaming yourself may be the very first step to moving beyond it!
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This is a HUGE problem, for psychologists/therapists as well as psychiatrists and psych nurses. They may often feel uncomfortable and want their own discomfort to go away, so they project it onto the client and either try to drug the feelings into submission or talk the person out of it, sometimes resulting in involuntary holds (aka incarceration) in hospital wards. I can’t tell you how many times I saw foster kids or others sent to the hospital for cutting on themselves (not suicidal) or for talking about suicide. One person said she called the suicide hotline because it was not safe to talk to her therapist when she felt like cutting, because she would always send her to the hospital. The are many smaller cases where the therapist wants the client to do something in order to reduce their own discomfort.
One of my basic principles of “therapy” such as I did was that when I felt uncomfortable, I assumed the client was probably getting to something really important, and the most important thing for me was to sit with that discomfort as they had to and see what was behind it. It requires a lot of courage and willingness to experience the pain of others to be of any use to another person in distress. You have to have “done your own work,” and the vast majority of “mental health professionals” have not done that, and are therefore useless or dangerous to their own clients, IMHO. It really isn’t something you can train for – it’s an attitude one has to adopt, and most don’t even realize they need to let alone have the capability of sitting with another’s pain.
There are also plenty of untrained “amateurs” who DO have that skill, as I found out running a volunteer crisis line shift. You are often better off with a well-supervised computer programmer than a trained “mental health professional!”
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Ah, but they rarely do fund this sort of study! The heavily moneyed biopsych advocates have a lot of sayso about what is studied, and protest when their pet drugs and companies get short shrift. Besides which, most studies theses days are funded by drug companies, not government entities. There’s little chance non-drug interventions will ever establish a sufficient “evidence base” to match those the drug companies can muster up!
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And of course the “evidence base” depends on what gets researched, and drug company money determines what gets researched. So there is never an “evidence base” for anything but drugs!!
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Research into what? How to create “diseases” from social bias and behavioral checklists?
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How could anyone ever tell if someone “legitimately has BiPolar Disorder” when the only criteria are a list of behaviors and emotions?
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Hey, Laura, great to hear your voice and know you’re still around and doing your thing! Hope all is well with you!
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Shhhh! You’re going to hurt sales with such research!
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I read Pies and Ruffalo’s response. It is as nonsensical as I expected. They compare “schizophrenia” causing hallucinations to a volcano destroying Pompeii. Well hey, guys, a volcano is obviously THERE and concrete and erupts lava that can level a town. How is that in any way like “schizophrenia,” which cannot be seen, felt, or otherwise observed except by its purported effects? The analogy would be more like Pompeii was destroyed by a “City destroyer.” The proof is that the city was destroyed.
That trained academics engage in such childish arguments to defend an indefensible concept is beyond my comprehension!
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Here is the Mirriam-Webster dictionary definition of “euthanasia:”
“the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy”
I’d say that whether it constitutes murder or not depends on the desires of the subject and the intentions of the one helping them die. To put it another way, is the person truly helping the subject accomplish his/her goals or simply helping themselves at the subject’s expense. In the latter case, I’d call it murder.
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Makes total sense. I was not disagreeing with you, I was trying to emphasize your point!
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Well done cK!
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There is, of course, no possible way to objectively establish “the truth” in “mental health” diagnoses, as there is no way to determine ANY diagnosis beyond simply describing it. If there is ever even ONE test to determine ANY “mental health” diagnosis, I will be shocked.
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Wow, they really do talk like that, don’t they? “Should we consider” is already a tacit admission that they don’t know what they are talking about!
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A slight increase in probability of some event or condition on average is no way to “diagnose” anything.
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“Reduce the core symptoms” is code for “doesn’t make any difference in long-term outcomes.” In “ADHD”, “reducing the core symptoms” simply means making the person less fidgety and more willing to sit through dull or unmotivating exercises. Stimulants, of course, will do this for anyone who takes them. While this might be viewed as helpful for some who take the stimulants, the idea that this is somehow a “treatment” for a “disorder” is delusional.
There is some evidence that accidents may be reduced, but crime involvement is not reduced by stimulants according to my research. They CERTAINLY do not die 5 years earlier on the average!!!
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Good article! Nice work, Bob!!!
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Commenting as moderator:
I will no longer be approving any comments on this article. The topic has been well aired and the comments are repetitive and not moving forward as a conversation. Please don’t add any further comments to this thread!
—- Steve
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What’s really awful is that none of those things that “untreated ADHD” supposedly leads to are changed by stimulant “treatment!”
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I agree that we agree!
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All very well said!
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I’m not sure where you got the idea I disagree with you. I used to be a therapist myself, and 99% of what I did was to have people describe their experiences and what those experiences mean to them. I’m simply disagreeing with you on the definition of “taking responsibility”. I don’t think you are understanding it the same way I am. The more we know about ourselves and our emotional history, the more we understand the REASONS for our “irrational behavior” (as others choose to see it, or as we choose to see it), the more we can take responsibility for deciding whether or not we are going to continue to react/respond in the same way we did before or try something new. Mostly we develop habits of thought and behavior based on what happened to us, and I saw counseling as primarily the opportunity to question whether or not those habits continued to serve us, and if not, find out what needs they are serving and find another, better way to meet those needs. So there is no blaming oneself for what happened – only responsibility for deciding how to act NOW and in the future.
That’s MY lived experience, both as a client and as a therapist. I don’t think I’m really disagreeing with you about much here. Let me know if that raises more questions/issues.
And no, I did not read the blog. I did read your comments. I’m speaking from my own direct experiences.
Steve
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I’m with Bill on this one – taking responsibility means recognizing that one’s own behavior is a choice despite past traumatic events. It’s not the same as taking the blame, which is very damaging. One can take responsibility AND be aware of and process emotion, in fact, one almost HAS to be aware to really take full responsibility.
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There are also group cultural insults that are traumatic, such as the generation of Jews whose parents were in concentration camps. There are also lots of ways that parents and other adults can hurt their kids without realizing they are doing so. School was a great example for me – daily torture, but no one seemed to notice or care, I kept having to go back every day for 13 years. There are lots of ways people get hurt and traumatized as children.
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Not surprising!
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We know at least that the AI does not dislike or judge us for our name, gender, sex, race, beliefs, etc. AI doesn’t have a subconscious, as far as I can tell!
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I remember a study where they let students log into an AI program, this was decades ago, and it was programmed to listen and ask pertinent open-ended questions. Students reported feeling better after talking to the AI!
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I would not call it “tenuous.” I would call it completely speculative!
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Thx!
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I think it goes back to “male privilege,” the broad teaching that men deserve more than women and that women’s job is to keep men happy. We are taught this all the time in our media and other parts of society. It seems it’s women’s job to make sure everything works out for men, and when it doesn’t, women are to blame!
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Well done!
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Sorry, I wasn’t suggesting YOU believe those things, I was just pointing out the failure of those arguments you alluded to made by others. I understand you are NOT a supporter of the DSM or the Medical Model. Sorry if there was some confusion there!
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I mean this idea that telling people “it’s a chemical imbalance” is somehow good for clients, which you refer to in your comment. Many say, “people like their diagnoses” or “the biological explanation reduces stigma.” Very tiring arguments, indeed!
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I agree. Blaming women for being unwilling to be your partner is childish and unproductive. Blaming feminism for women being unwilling to be your partner is childish, unproductive AND bigoted!
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There are scientific studies showing that blaming a “chemical imbalance” or brain problem leads to LESS empathy for the “mentally ill.” People relate better and are more compassionate when their issues are framed as a result of trauma or difficult life circumstances. This is science, not my opinion. I’d also suggest that lying to patients for some social reason is not the doctor’s job. You should not try and alter attitudes by lying about the science behind a “disorder.”
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I think the author would be wise to avoid the word “incel.” It has taken on some other connotations than an inability to engage in sexual activities, and is associated with misogyny and violence.
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I’m amazed anyone gets away with making that argument. They systematically RULE OUT suicidal people before doing these studies. Anyone who is suicidal during the study period became that way AFTER starting the study. If more on antidepressants are suicidal, it’s caused by antidepressants. That’s what double blind studies are for!
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Which suggests we should be looking at nutritional/macronutritional solutions, which should help SOME people, but certainly not ALL people. Depression is a VERY complicated experience that is generally more than just physiology, at least in many, many cases.
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I’m not sure I got it. What would I be looking for?
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No, I didn’t miss that part. I’m pointing out that if 55% of females have lipid abnormalities, it means 45% of them do not and are yet still depressed. Depression has multiple causes, and to try and establish ONE cause, biological or otherwise, is a fool’s errands. It’s like trying to say, “What causes a rash?” A LOT of things can cause a rash, and they require different responses. Treating all rashes with one treatment will never work. Same with depression. There will never be one “treatment” because there is never one cause. If addressing lipid abnormalities helps a good percentage, that’s wonderful, but don’t expect it to work for everyone.
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A couple of questions:
1) What do you mean “a real illness like any other?” How do you define “illness?”
2) If you are “ill” both on and off “meds,” and experienced “no success,” why are you so sure that “without meds patients are worse off?”
3) Is it possible in your mind for some people to be better “on meds” and others to be better “off meds?”
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You hit the nail on the head. Unfortunately, there is ABSOLUTELY NO WAY to distinguish “real ADHD” from any of these other conditions or no condition at all, and the DSM itself admits this quite bluntly in its introduction. That you feel you BENEFITTED from stimulants is not a reflection that you have “real ADHD,” it’s a reflection that stimulants work for YOU personally. While I never want to take this away from you, it’s a very large leap from saying that “stimulants makes it so I can complete tasks, etc.” and “I have a diagnosable neurological condition that is objectively distinguishable from normal or other such conditions in me and any other person.” Unless you can reflect an objective way to do that, all you’re really saying is that stimulants have worked well for you. And more power to you for that. Just don’t assume others who act or feel similarly will have the same results, because experience and science says that most kids who take stimulants do no better in the long run than those that don’t.
“They work for me” is about all we can say for sure.
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Remember when tey say that these receptors were “chronically decreased,” they are talking about AVERAGES. I am sure you will find many who are suicidal that do not have this condition, and many who have it who never become suicidal. If there were a way to isolate this SUBGROUP of people who happen to have this issue AND are “depressed”, by all means, we should do so, but to suggest that ALL cases of suicidal ideation or action are attributable to this is not even vaguely supported by the data presented.
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Clients are the only really valid source of feedback re: therapy. There is no “clinical measure” of how you’re feeling or what your life means to you!
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A) Szaz was not a Scientologist. He just worked with them.
B) If he is, why does that matter to you, Marcus? Why not judge a person by their evidence rather than bringing in irrelevant points like religion? A person’s argument for or against abortion, for instance, should be considered independently of whether they are Catholic, don’t you think?
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So who gets to decide what emotions are “maladaptive and pathological,” Mich? And based on what?
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With all due respect, there is not one single “mental disorder” that has a recognized “underlying brain pathology.” You should read Anatomy of an Epidemic so you will better understand why people feel they have been fooled. And people are STILL deemed “abnormal” for any negative or strong emotion they may experience. I don’t see the current system as any improvement from the viewpoint of pathologization. They are still calling you “crazy” but now have broken it down into brands of “crazy.”
There is also now evidence that making the BRAIN the focus of the “disorder” actually increases stigma and decreases empathy for the so-called “mentally ill.” Especially when you consider that the DSM “disorders” are all entirely invented in committees and have no scientific basis in brain pathology, they can keep their labels and stuff them someplace dark and stinky!
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That seems to be how they work – by down-regulating serotonin!
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It is true that antipsychotics can be useful in the short run to help people get under control. I’m just saying that calling it a “treatment” is a lot like saying morphine is a “treatment” for a broken bone. Might make you feel better and be helpful, but it’s not going to help to simply prescribe morphine without finding out what’s really going on.
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I can’t consider electrocuting someone into a seizure a “treatment,” last resort or not. And who gave the doctors the right to “see fit” when electrocuting someone is “therapeutic?”
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Actually, that’s NOT the question, with all due respect. It makes the assumption that A. these drugs are “medicines” for “diseases,” and B. that it’s always better to do something than nothing. If doing something wastes money and has no positive benefit, we are better off doing nothing than pretending we are “treating” a “disease” that we clearly do not understand!
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You should put “medicines” in quotes! The idea there is such a “medicine” is a deception!
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I know! That’s why it’s not really funny! How can these people take each other seriously?
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You are so right! The “Depression” can’t “resist treatment.” It just means their treatment didn’t work or made things worse. No other profession gets this kind of latitude! What if your mechanic said that you had “repair-resistant fuel injectors?” Would you bring your car back for another “treatment?” No, you’d know it did not work and your car was better off in the care of someone who knows what the f*&k they’re doing!
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Of course, I was being totally facetious. There is no benefit from electrocuting someone into a seizure!
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“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
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I wish I had a plan!
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Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
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And GO, ALEW!!!!
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I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
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David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
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Exactly!
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That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
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Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
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I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
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Nice!
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I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
‘
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They were actually initially banned in Germany for these very reasons. It’s a very real problem.
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Sure thing!
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
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It sounds like you’ve had a lot who are that way. No therapist should believe they know more than the patient about their own situation!
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So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
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POSTING AS MODERATOR: I honestly don’t have any idea how to unsubscribe you. Perhaps one of our tech staff can help? You can find them in the “About” section under “Staff.”
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Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
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How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
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Posting as Moderator:
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
My email is [email protected] or [email protected]. Please contact me TODAY.
Thanks.
— Steve
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I think you mean the one I wrote to Mark about his email not functioning?
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Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
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You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
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Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
Thanks!
—- Steve
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Posting as moderator:
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
Thanks in advance.
Steve McCrea, Moderator
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You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
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They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
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Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
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But that would require a level of honesty the industry does not appear willing to exercise.
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When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
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Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
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How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
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The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
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I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
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Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
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Excellent advice!
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There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
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These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
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I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
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How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
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I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
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What is “scientific” about the DSM? Perhaps the author needs to look up what “scientific” really means.
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I agree 100%!
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Actually, they provide a LOT of “education,” even at official institutions. It’s kind of sick!
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I had a lot of clients blaming their parents for their issues. Often, they were at least largely correct.
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It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
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I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
And am I wrong that you never read the book?
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I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
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I agree 100%.
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🙂
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It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
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I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
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Posting as moderator:
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
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POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
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I think I just approved your post earlier this morning. It was just waiting for moderation.
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Posting as moderator
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
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Actually, very few even bother with brain scans.
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The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
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Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
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Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
https://www.mentalhealthforum.net/forum/threads/john-nash-healing-from-schizophrenia-the-real-story.34784/
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That all makes sense. There will never be one “cause” because it’s not one thing that is happening for the same reason. People need to think!
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Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
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Can you identify the comment by the first line of text? I don’t want to remove the wrong comment!
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You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
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It may not be damaging, but it is certainly not scientific.
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Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
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The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
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The fact that sharing decision making is even a point of discussion says a lot. Why would you NOT share decisions with the person making them?
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Posting as moderator:
There’s no function to edit approved posts. The only solution I can propose is to submit your new post as a new post.
Hope that helps!
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See my emails to you.
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
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Not a problem. All part of my day.
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Please let me know if I did this wrong, Tom.
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Well said!
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You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
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“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
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It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
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Depression most often involves having a shitty life. What is used to measure that, Scott?
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There is not “line blurring” going on. The lines ARE BLURRY and what most object to is trying to make them seem like they are not.
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I think you are missing the point.
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If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
Steve
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As in we have to talk.
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POSTING AS MODERATOR:
Hi, 27/2017,
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Steve
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Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
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15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
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Wow, you can make up a lot of stuff in one paragraph. Do you have even one citation for any of your claims?
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Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
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At best, results are mixed. Read Irving Kirsch some time if you want to know the truth.
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The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
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Nobody is trying to take your medication away.
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You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
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111 days – WELL DONE!
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POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
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Way to go!!!!
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That sounds like your brother being put in danger by prejudice, not his own dangerous behavior.
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How would you know who genuinely “has” BPD?
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I “unapproved” the first one I could find. Is that the one you wanted?
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Posting as moderator: Which post, Beth? How does it start? I can delete it if you can help me identify it.
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The use of the term “resistance” these days doesn’t mean the same as Freud’s concept. It just means “didn’t get better with our ‘treatment.'” It’s basically a way to blame the client for the failure of the “treatment.” That’s how I read it.
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Electrocuting someone into a grand mal seizure sounds like malpractice to me. How can you “do it incorrectly?” What the heck is the correct way to induce a seizure that might potentially cause brain damage?
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I thought similarly – AI at least can’t work out its childhood issues in your sessions!
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Whether or not someone receives treatment is not an “outcome.” An outcome is a result of the treatment approach. The study does not state or claim or suggest or imply that no one has a good outcome using antipsychotic drugs. It suggests that ON THE AVERAGE, those who receive light or no intervention are more likely to have a better outcome at two years onward. A better outcome ON THE AVERAGE. There can be plenty who got a better outcome with drugs or a worse one with drugs as well. Your story is one story of millions. Yours can be 100% true and yet the average person can still be worse off in the long run on antipsychotics. You are one data point. A scientific study is made up of hundreds or thousands of data points. It’s not the same.
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Stick to the facts and the scientific studies as much as you can. No one can sue you for reporting your own experiences honestly.
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Most of these people have HAD ECT themselves or know someone who does. Many also know the ECT research literature better than the average clinician.
It’s insulting to suggest that anyone here is making up their minds on fictional accounts. I’m glad you had a positive experience to report, but don’t assume others experienced the same or similar things!
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Traumatizing experiences are also normalized and kids are expected to not complain about it. How many kids say things like, “Oh, that’s not abuse, I totally had it coming!”
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Gotta love it. THEIR “treatment” doesn’t work, but it’s because YOU are resistant. Or your “schizophrenia” is. Apparently resists without consulting you. Insanity!!!!
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Please explain how any one DSM “diagnosis” is derived from scientific observation and research. Specifically, please describe how exactly one can distinguish who “has” the “disorder” from who does not ‘have it.’
This is not to say that people don’t like or benefit from biological interventions. But that’s nothing new – folks have taken substances to alter their mental/spiritual reality since the beginning of human history. That’s very, very different from claiming that something as vague and amorphous and subjective as “major depressive disorder” or “adjustment disorder” or “ADHD” is derived from the scientific method. In fact, the DSM admits they are not in its introduction, in no uncertain terms. You ought to read it some time.
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The fact that you feel you can “diagnose” that based on an internet comment proves how completely subjective and unscientific these “diagnoses” really are.
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Always wondered why fathers got off the hook, just for starters.
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Your comments reflect not having read the many testimonies of people here who were diagnosed with “major depression” or “bipolar disorder” or even “schizophrenia” and were treated with drugs for years or decades with really poor outcomes, including a significant number who did far better after they came off the drugs and did other things.
There are most definitely big medication success stories. There are also disaster stories. Same drugs, same “diagnoses,” very different outcomes. If you really want to understand a site like this, that has to be your starting point. You can’t decide people are ignorant simply because they had different experiences than you. Maybe you should stop and read some of the stories before you assume that no one here has suffered any “mental illnesses” just because they had very different outcomes than you expected to hear?
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Confirmation bias is generally rooted in anecdotal evidence, aka testimonies of those helped/not helped by an intervention. Citing testimonies as proof of confirmation bias seems a bit ironic.
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It might be interesting to hear a specific objection you have to a specific claim or study.
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Here are the references I quoted. Barkley and Cunningham 1978. Swanson et al 2003. Oregon Medication Effectiveness Study 2002. Montreal ADHD Study. Raine study from Australia. Finnish comparison study to USA cohort. Not to mention Whitaker himself, who summarizes the extant literature.
How are these not citations of clinical studies? Barkley in particular is a super pro-ADHD researcher. It seems you didn’t read my earlier posts yourself. My comments are firmly rooted in years of long-term research, which you’d know if you’d bothered to read Whitaker’s work before deciding you already know all about the subject. It’s not too late to educate yourself, but I get tired of repeating the same lessons for folks who don’t seem interested in seeing another viewpoint.
And the author mentioned his “clinical experience” including a specific case, as I recall, which is 100% anecdotal. I am very clear what anecdotal evidence looks like.
I think it would be nice if you would learn to respond without putting down the person you are disagreeing with.
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Is it an illness if the responses are reasonable and understandable to the conditions bringing them about? Why aren’t the people COMMITTING the traumatic acts against their loved ones or employees or patients considered the ones who have an “illness?”
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ADHD being “more recognized” would in no way make it more likely that people taking stimulants being more likely to develop heart problems. It’s not a new suggestion. Probably not a common event but it sounds like more common if you take stimulants. Knowing what we know about stimulants, the increased risk of heart disease associated with them should not be surprising.
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Hearing about “numerous studies” but no names or links. Might be interesting to get out of the realm of “rhetoric” and into actual science.
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None of the studies I referred to were funded by pharmaceutical companies. Government studies, especially when longitudinal, are generally more reliable.
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The average “seriously mentally ill” person, most of whom have received years of drug “treatment”, die 15-20 years younger than the general population. There are, of course, multiple reasons, but psychiatric drugs and ECT are high on the list.
The antipsychotics are known to induce diabetes and other metabolic issues, and to increase heart disease. If you think inducing diabetes doesn’t kill people, you are confused.
Sometimes, psychiatry does kill.
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Anecdotes are not scientific evidence except in the crudest sense. I’m not saying the drugs have no effects or that “ADHD” is trivial or that people so diagnosed don’t do worse than the general population in a number of significant ways. I’m saying that, for instance, the claim that “untreated ADHD leads to delinquency” is false, because “treated” ADHD kid aren’t less likely to become delinquent. BOTH groups are more likely to commit criminal acts, though interestingly, I recall reading a study where those identified early on as non-aggressive “ADHD” types did not commit more criminal acts later. But it makes sense, impulsive people are more likely to do impulsive things, and committing crimes is often impulsive. The point is, IN THE COLLECTIVE, we do not reduce the delinquency rates by “medicating” the subjects. This does not mean a particular individual wouldn’t, say, feel better about school, improve their grades, or even say, “This stuff saved my life!” But those are anecdotes. Scientifically, we have to look at the overall effect, and overall, the effect of widespread stimulant use on the population is not large, if we look at the data rather than stories.
I would submit to you that there are plenty of people whom you don’t know whose situations might have gotten worse to the same degree your client base got better. I don’t know what kind of selection bias you have in your population, but I worked with foster youth and saw plenty whose lives deteriorated after starting stimulants, particularly due to aggression toward others. Many ended up with more drugs and worse “diagnoses,” one ended up psychotic until she herself stopped the drugs and went back to her old “normal.” So anecdotes can tell many stories. Collective data is more reliable.
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Multiple long-term studies show no significant advantages to those taking stimulants vs. those who don’t when diagnosed with “ADHD” in childhood, other than the accidents you mention, and I believe clearly overstate in your comments. Delinquency rates, HS graduation, college enrollment, social skills, not even self-esteem scores were better for those taking stimulants. This has been confirmed since Barkley and Cunningham’s first review in 1978, confirmed by Swanson’s “Review of Reviews” in 1993, and in the OSU medication effectiveness study back in 2002 or so. Also confirmed by the Raine study in Australia, the Quebec study, a comparison study between Finnish and US kids who had very different medication rates but similar outcomes, and more.
Read Whitaker’s works if you want to fully understand what’s going on at MIA. Not everything is the way the professionals have told you it is.
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You speak wisely. Unfortunately, the privileged are generally protected sufficiently to prevent them from hearing you!
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It’s not really a legitimate approach to say, “What else should they have done?” It assumes that doing SOMETHING is essential and that NOT doing what they propose is foolish unless you have something “better” to replace it. It is possible that antidepressants were destructive AND there was not a “better treatment” available. We should not assume “antidepressants” as some sort of minimum standard of treatment that is the default unless we have something “better” to propose. Sometimes nothing is better than doing things that are destructive.
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You’ll have to ask Justin about this. If you send me an email at [email protected] I’ll see if I can forward it to him.
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Please hit the “report” link/button for anything that shows evidence of being spam/automatically generated.
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If it were so safe, they would not have to do toxicity tests every two weeks. Lithium can do serious kidney damage among other things. It’s therapeutic dose is as close to the toxic dose as almost any other drug you can name.
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Not necessarily:
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2786428
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I think you are missing the larger point, Donna. You say our “knowledge” of these things is in its infancy. But the “diagnoses” themselves are not explanatory of anything, regardless of the education and experience of the person involved. How is saying, “Joe feels really hopeless and sees no point in his life” any different than saying “Joe has major depression?” Is there some way to distinguish Joe’s “Major Depression” from Mary’s “Anxiety disorder with depressive features?” They are simply descriptions of what is observed, and clinicians will make a lot of noise about “clinical depression” vs. “reactive depression” but look in the DSM, there is simply NOTHING there to make a distinction. You meet 5 out of 8 criteria, you “have major depression.” Only meet 4, you don’t. Nothing about cause, nothing about ongoing stressors, nothing about culture – just a description. That’s not a “knowledge in its infancy.” That’s just making stuff up, plain and simple. There is no way any “knowledge” can advance from that kind of basis. The DSM is not knowledge. It’s a fantasy that makes people believe “knowledge” is behind it.
Not sure what the answer is, but calling people names based on arbitrary checklists isn’t it.
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I agree 100%. But everyone still insists he’s wearing beautiful robes!
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Invasion of the Body Snatchers. Or The Stepford Wives.
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Replying as moderator:
I really don’t want to get into debating COVID or the WHO response. It is off topic (not about the article or about the “mental health” system) and has become highly divisive. We’ve now heard both sides well expounded. Let’s get back to our mission!
—-Steve
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The DSM makes a good doorstop! Maybe in the bathroom, so it can double as backup toilet paper!
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It’s my understanding that suicide rates have always fluctuated along with unemployment.
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I think the answer is no. No one is paid a fee for writing for MIA, as far as I am aware.
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Science is not created by consensus, and does not have any consideration for a “middle ground.” Are we going to start saying that gravity is inconvenient for some people, so we’re entertaining some small modifications to help people adapt?????
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You mean we should consult long-term outcome measures to see if something works? Wow, radical concept!
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I think you can just comment on the article and if the author is reading comments, they will consider your comment as intended for the author.
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He won’t even try. He’ll just go somewhere else and keep repeating the lie.
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The hummingbird house was a new experiment at the time with an open environment rather than cages. It felt like they were pretty good with the environment or it would not have felt good to be there. I felt like I was in their world.
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True! You should get funding for a study!
I used to go to the hummingbird house at the Philadelphia Zoo during the week when nobody was there. I would sit for 10 minutes making no noise, and soon I was surrounded by birds doing their thing. It was very soothing, and I didn’t need someone to tell me it “worked!”
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Exactly! They hire “nature therapists” and pay them to go hiking with you!
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We know this. He can’t answer my challenge and will probably ignore my response. Otherwise, he’ll say it’s “well known” and present no evidence or else attack my credibility. That’s how it seems to be done.
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Easy to say that. Please provide us with the definitive proof of shared biological pathology for all forms of “schizophrenia.” Not correlations, not candidate genes – let’s hear the exact “pathology”(to use your own words) that distinguishes these conditions. I will assume failure to answer means you have no answer.
Here’s your chance to prove us all wrong!
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I know, it’s like when they “discover” that hiking in the woods makes people feel calmer, and instead of saying, “hey, try hiking!” they decide to call it “Nature Therapy!”
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Posting as moderator:
If you want to connect via email, please let me know.
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Thanks!
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Strange things happen in Cyberworld! Including whole posts disappearing on occasion. Just check in with me next time.
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POSTING AS MODERATOR:
For the record, I can’t find any moderated posts from you. Next time, I’d ask that you email me and check before publishing the assumption you’ve been moderated. I almost always leave a note.
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Superstition comes into play in all forms of medical treatment. Placebo effect is acknowledged to deliver half the benefits of any treatment. Drugs become less effective the longer they’re around because people start to hear issues and concerns that were not talked about before. What people believe has a lot to do with what works.
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“Maybe you’re not DEPRESSED… maybe you are being OPPRESSED!”
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Very well done, Amber!!!! Take a bow!
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You sound very committed to the idea that “there is only one reality” that is unaffected by any of our personal narratives. Can you submit some scientific studies that prove your contention to be true? Or is it simply a matter of faith, based on… your personal narrative?
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I think the real lesson is: Kids are not all nails, even if you only have a hammer. Use the hammer when the job calls for it, otherwise, quit hammering our kids!
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The fact that you worked through it yourself and found out what worked and did not work for you has to be a big plus for you. Additionally, I hope you learned that not everyone responds to the same things and that a therapist has to be creative and responsive to the individual needs of their client. It’s been proven again and again that these therapist characteristics are far more important than the modality used, in fact, in many studies the modality was not a contributing factor to positive outcomes.
Bottom line, it seems you learned empathy for your clients and haven’t forgotten that lesson.
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Can’t argue with you there! Of course, if all psych studies were held to standard, there’s be a LOT less papers being published on all subjects!
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Yeah, it’s sort of rude when patients don’t comply with the doctors’ preexisting biases and expectations, isn’t it? Maybe the doctors just need to work on robots, then you get almost total predictability!
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Wow, that’s kind of stunning! Do you have a link to the articles?
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Individuals don’t need to prove the effectiveness of anything they sense is working for them. It is those claiming someone ELSE will benefit from an intervention they are offering/forcing on that person who need to show the proof.
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Or NEEDED too believe…
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One size NEVER fits all in the world of mental/emotional challenges.
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I think it showed that administering group DBT training doesn’t lead to improved outcomes. If I’m a school administrator, that should be enough for me to think, “Well, we’ve got only so much time in the day, why waste time on something that doesn’t have a significantly positive effect?” An intervention doesn’t have to be proven harmful to be avoided. It just needs to be shown not to be significantly helpful.
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These “differences” are AVERAGES – They can never be used to determine if person A “has schizophrenia” or person B does not. There are tons of “schizophrenic”-diagnosed people who do NOT have frontal cortex atrophy. It’s also well known that frontal cortex atrophy and other brain shrinkage can be caused by the antipsychotics themselves. PET and f-MRI studies are absolutely useless in “diagnosis.” And of course, this must be the case, because there is no reason to believe any 5 people with the same “diagnosis” have the same kind of problem or need the same kind of help.
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I would add that psych ward staff also need to learn and practice these things. Some do this well, but some don’t. The real problem is POWER. The people with power are telling the kids how to “manage their emotions” and whatnot, but they are still free to be as abusive, neglectful, and thoughtless as they wish and suffer no consequences. Whether its parents, teachers, staff, doctors, pastoral leaders, or even just adults who are comfortable exercising power over those they feel are beneath them, as long as the person in the one-up power position is unwilling to step down, no amount of “emotional management” will make things any better.
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I would add that the teachers need to learn and practice any skills they want the kids to have.
I had a neighbor kid who was in middle school. He explained to me they spent a one-hour assembly working on Carl Rogers’ reflective listening skills, including “I statements.”
He was sitting on the stage after the session and a teacher came up and said, “You, get off the stage!” in a very loud and aggressive manner. He said, “I don’t like it when you yell at me. I’d prefer we speak in calmer tones.”
He got sent to the Principal’s office immediately. What was the real lesson here?
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But we want him to feel OK about being in debt! Don’t want them WORRIED about it!
The goal seems to be Stepford Wives!
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I would add that being told over and over that their emotional struggles are a “mental disorder” has contributed to younger peoples’ lack of ability to cope. Used to be parents, teachers, and the kids themselves got the message, “Hey, you’re good at x, but not so great at y. Let’s work on your Y skills.” No excuses, you just were how you were and everyone dealt with it, admittedly poorly much of the time, but at least the message was, “Don’t feel sorry for yourself – you can figure this out.
I also remember the crazed maniacs who sometimes passed for school teachers back in my day. I’d hardly say the school environment has gotten more stressful!
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I must have a well-developed hippocampus, then! Spent a lot of hours with Mario when I was younger! I still play Tetris to this day!
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Fear and outrage are not scientific arguments!
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When I was a counselor and sometimes had to do these “diagnoses,” I viewed them the same way, and told my clients as much. I said they’re just descriptions of behavior/emotion/thoughts that are used to bill insurance companies. I told them I’d select the one most likely to get them the kind of help they needed. I always favored PTSD or Adjustment Disorder because they would incline toward talking solutions rather than drugs.
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Unfortunately, there are an unfortunately large number of terrible or mediocre counselors. I don’t think they “need to keep you sick” as much as not really understand what “better” means to the client and how to get there.
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Are you saying anything is better than telling someone they have an incurable brain disease and there’s nothing they can do about it except hope that the doctors have a magic pill that never seems to develop?
A sensitive 8 year old can do better than a standard psychiatric intervention. On the average, listening to someone is going to help, but who needs to be a therapist to listen? And what guarantee is there that a therapist can and will listen anyway?
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That is a GREAT reframe!
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Not to mention profits!
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It is also possible that some are NOT there to make you feel better.
On the other hand, the bartender and the heroin peddle are there to make you feel better, too.
Making someone “feel better” is generally only effective as a short-term objective. People who set their long-term goals at “making myself feel better” generally don’t have very livable lives.
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Wow, that is an incredibly sad story! It makes me angry just to read about it!
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That does seem to be the message. At least from the incompetents. Just “think different thoughts” and your emotions will change! A bit of magical thinking, there. I mean, in the LONG RUN, it’s probably true, but to make out that a person can just “change thoughts” on command, especially after years of trauma or living in current danger, chronic or acute, is patently ridiculous. There’s a lot of trust building and examining patterns and detecting the purpose of certain behavior/thinking from the client’s viewpoint and a lot of “what ifs” and “Let’s imagines” before anyone gets around to saying something as monumental as “I’ve changed my viewpoint. I don’t need my mother’s constant involvement to survive.” People believe what they believe for a reason. It doesn’t work for a therapist to say, “That’s a bad belief, you need to change it!”
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Hard to argue with you there. There are probably a few rare exceptions here and there, most of whom will probably quit early or be driven out by their colleagues.
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Nobody is saying the medications are not valid. We’re saying PSYCHIATRY is not valid! The idea of taking a substance to make yourself feel better is as ancient as human history, maybe even older. It’s not an amazing 21st century discovery of the psychiatric profession. The biggest problem is these damned DIAGNOSES, which have no scientific reality but are used to promote certain products and discourage people from exploring their own solutions.
If the drugs work for you, more power to you! This website is not about that. It’s about bringing some kind of sanity back to the world of “mental health treatment,” including stopping psychiatrists from involuntarily forcing people to take these drugs when they do NOT work for the recipient!
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CBT as practiced by many often does encourage clients to ignore or minimize or intellectualize social causes of distress. I find it useful in certain contexts, but see it as a tool, not a therapeutic school. It works fantastic for some people in some situations (I use it all the time myself), but there are times when “empowering oneself” has to take a back seat to taking an honest look at what’s going on or has happened in the past. For instance, a domestic abuse victim might learn to “think different thoughts” so they find their abuser’s comments less upsetting. This might be a useful skill, but it does not BEGIN to address the needs of the client. If all we gave our DV victims was CBT, we’d be doing them a gross disservice. Same with folks with big tramua histories. Telling them to “think different thoughts” is a short step from “get over it, you wimp!” And lest you think I’m exaggerating or making this up, several people have reported on MIA that they are told by their therapists that they should “not think of the past” and that processing historical emotions is a waste of time and they need to “Be mindful” and “focus on the present.”
A good therapist can use CBT to get good results when it is appropriate. A bad therapist can use CBT to create an emotionally unsafe environment for their clients and effectively make their “mental health” status worse.
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Hi, Molly,
I certainly have no intention of attacking psychiatrists. But you are saying things that are said by psychiatrists but not scientifically accurate. Antipsychotic drugs HAVE been shown to do brain damage, including reduction in grey matter volume, altering the size of the Corpus Collosum, and inducing neurological problems like Parkinsonism and Tardive Dyskinesia. No psychiatrist worth talking to will deny these things are known facts. There are now ads on TV to fight off TD, which is directly stated in the ads to be caused by their “mental health meds.” The idea that antipsychotics offer some protection from brain damage caused by schizophrenia or other “mental illnesses” is a nice concept, but again, I know of no evidence that this is actually true. Can you attach a link to a study or two to show where you’re getting this information?
It is hard sometimes for people who have used the MH system and feel they have benefitted from it to hear from others who feel it has harmed them. I don’t think anyone here wants to upset you about this stuff, but they’re mostly just telling their stories, and I believe they have a right to do that, even if these stories don’t jibe with what you’ve read or heard or been told. And if it causes others to be a little more careful how they engage with the system, I think that’s all to the good. An informed patient has the best outcomes, but our practitioners mostly have conflicts of interest that prevent them from giving out the honest information that everyone needs. A lot of that information is available here, albeit often in anecdotal form, but still, don’t you think folks have a right to tell their stories? If you came on and told YOUR story and someone told you it was “wrong” or was damaging people, how do you think you would feel about it?
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It’s worse than that, Molly. They don’t know what they should be aiming at. The drugs hit parts of the brain they ARE intended to hit as well, and THOSE parts of the brain get broken down and stop working properly, too. They’re not quite shooting at random, but the targeted parts of the brain do not heal under their attack. And destroying them isn’t good for the brain, either. It is a poor solution.
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I don’t consider this obvious. A person may need PROTECTION, yes, and others may need protection from THEM, but why does “treatment” in the form of enforced drugging necessarily emerge from feeling angry or confused or despairing? How about giving folks a safe place to calm down and some sane people to talk with if they want, plus some food and sleep and the like? Why start with forced drugging as the only “answer,” especially when we see how poor the outcomes are for those experiencing such “treatment” in the long term?
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I learned early on that “intellectualization” is just one more coping measure, having its value and its drawbacks, just like every other coping measure. We all need coping measures, including denial, splitting, minimization, and intellectualization, in order to survive. There is nothing wrong with using any of them if they are working for you. The times we have problems is when we learn these measures early in life and come to believe they are our only options in certain situations. Becoming aware of the coping measures we choose and getting a broader range of options in any given situation is a valuable set of lessons. A lot of times, using intellectualization to “block childhood trauma” is the smartest thing to do. There are also times it can get in the way of moving forward. Just like any other coping measure. It is not good or bad in itself, it’s about how/when these coping measures are used that matters. And who is really in a position to judge that other than the person deciding how to “cope?”
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Thank you for a beautiful post!
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The answer is simpler and more grim – they prescribe it to keep them quiet. “Antipsychotics” reduce aggression, so any sign of violence or aggression from an “autistic” kid and out comes the Risperdal or Abilify prescription. Also often used to calm down aggression that’s actually CAUSED by stimulants for “ADHD”. Doesn’t even require a “psychosis diagnosis.” If they’re annoying enough and have a label, they are fair game for antipsychotics.
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One can survive on a bit less than half a liver. The liver is the one organ of the body that regrows itself. Thank the Lord in our case!
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Yeah, but who would want them if they actually told the truth about the drugs?
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There is always an excuse, no matter how much damage they manage to do. Zero responsibility!
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Well, but the liver GROWS BACK! So really, no harm no foul!
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But don’t worry, you don’t need both kidneys to live…
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Not to mention the possible damage to the fetus of continuing SSRIs. There are fairly consistent correlations with birth defects, as well as with “ADHD” behavior later in life, if I remember my research correctly.
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Exactly. You see it all the time – an article proves that antidepressants are completely useless for kids and meanwhile increase the suicide rates, but the conclusion is, “We should be careful to make sure that antidepressants are only prescribed when indicated in children.” And they get away with it, because they’re saying what those in power want to hear!
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Labeling terms is a very human practice. People come up with words to describe what they observe, and I have no problem with that. It’s the fetishizing of these words into “diagnoses” and “disorders” that upsets me, when the “diagnoses” have no more meaning or validity that saying someone who picks his nose has “excessive digital-nasal insertion disorder.”
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I think the interesting question that never gets asked is, why do the “standard mental health” programs continue to get funded despite mountains of evidence that they not only don’t work in the long run, but in many cases cause damage? Kind of a double standard, isn’t there?
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Even the Zen Masters sometimes have to resort to a slap in the face!
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There is a difference between using a term to describe something (My husband is an ABUSER) and being DIAGNOSED with something (My husband beats me up because he has “Bipolar Disorder”). One is simply a linguistic means of describing people who have certain traits in common, the other implies some kind of deeper “causal” relationship between these people such that some sort of “treatment” will generally be helpful to all of them. Psychiatry blurs these lines badly, and I believe intentionally, such that people are confused between a description (These children all have trouble paying attention in school and get into trouble) and a diagnosis (all children who have trouble paying attention are suffering from a ‘disorder’ called ‘ADHD’ and there is a ‘treatment’ for this condition). Of course, this sells a lot of drugs, but the confusion does a great deal of damage to our society, as it prevents any real attempts to identify the actual causes in individuals, as well as taking perfectly normal behavior (being distracted when bored to death by the school curriculum or process) and making it into a disease state. But when we get as silly as calling something “Oppositional Defiant Disorder” because a person is oppositional and defiant, it should be obvious to any rational person that these “disorders” are absolute irrational nonsense! Might as well say someone picks their nose because they have “Nose Picking Disorder.” It wouldn’t be any less ridiculous.
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What they mean by “stigma” is “any comment suggesting people shouldn’t take all the drugs they are prescribed without question.” The industry creates and exacerbates stigma as a marketing tool. The furthest thing from their minds is to “reduce stigma!”
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As long as the peer respite concept is dependent on the larger “mental health system” for approval and monitoring, we will see power being used by those uncomfortable with the idea of peer empowerment to undermine this kind of effort or kill it off. I wish I knew the answer.
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I do agree with you there!
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What, you’re arguing to be objective and scientifically honest about these things? Radical concept!
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It also always seems hypocritical when they expect someone ELSE to prove their drugs cause dependency, assuming safety, while normally we expect drug trials to assume non-safety until proven otherwise. How many drugs have we been told are “not habit forming” and yet later turned out to have horrible addiction profiles? Benzedrine, Valium, Xanax, Oxy, Ativan, SSRIs… the list is pretty long at this point. Why aren’t we making the drug companies prove their drugs are NOT addictive/dependence-forming before they’re allowed to market?
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It did seem odd to me that after dismissing the claim that science understands the mind, the IFS approach still “diagnoses” people with “conditions” based on their “understanding” of the mind. Better to just admit it’s a mystery and work with the person in front of us and stop trying to “understand” them separately from their own conceptualization of their own situation.
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Despite there being scant evidence that antidepressants are of any use in the teen population, and ZERO evidence they are helpful to younger children.
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I would not just say that “patient voices” should be reported on, they should be CENTRAL to any analysis, while doctors’ opinions should be considered secondary. As long as “patient experiences” are of secondary concern, we will continue to have a system that oppresses those it’s supposed to help!
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An excellent and concise argument against the very concept of “mental illness,” let alone a “professional” approach to “treating it!”
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A really fun exercise is to pick a diagnosis and see how many different ways you can “diagnose” someone with the same “disorder” despite having no “symptoms” in common with each other. It’s not very hard, but it’s kind of amusing. Except when you realize people take this nonsense seriously!
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Of course, the fact that “treated” people die one to two decades earlier than expected IS a bit of a clue…
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There is literally almost no accountability for psychiatric or “mental health” professionals.
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If media was giving out wrong information, where was psychiatry telling everyone they got the wrong idea? Can you say “Collusion,” kids?
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ABSOLUTELY!!!!
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OMG, that TRULY sounds like torture! How can anyone see that as “treatment” or the outcome as “positive!”
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Translation: “Quit annoying us!”
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From what I understand of recent studies, the scientific consensus is about 30% of people taking antidepressants express finding improvement. When you take the placebo effect into account, that number drops even lower, and if you talk about an ACTIVE placebo, Kirsch puts the effectiveness rating near zero, at least in terms of any kind of significant clinical benefit.
The drugs do DO something (mostly a stimulation effect, with a dampening of emotional reactivity), and some people find that SOMETHING positive for them. And more power to them. But we should remember that some people find marijuana or controlled doses of alcohol or taking DSMO or St. John’s Wort helpful, too. The problem isn’t that some people don’t report benefitting, it’s selling the idea that there are NO harms and that EVERYONE who is feeling depressed needs some, and even worse, that people who have adverse reactions or simply don’t improve are “treatment resistant” or are being dishonest!!!! Just because a person or persons report they like this and it helps them feel better is no reason to create a false narrative and make people who don’t feel such a benefit into some kind of monsters for “preventing effective treatment”!
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I’ll just remind everyone here that “bad science” isn’t really science at all. It is mostly attempts to use a scientific veneer to justify things that REAL science doesn’t support. The way to tell the difference is what happens when real science comes out with data that contradict the “opinion leaders.” If they attack the data or those who promote or share it, they’re not involved with “bad science.” They’re involved in marketing!
But you ARE right, we do have to engage with anyone who is a real ally and not expect total agreement, except on the point that psychiatry as currently imagined needs to GO!
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Don’t sweat it! I get what you’re saying!
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To be clear, I as moderator am not in the business of deciding what content or claims are accurate or inaccurate, thank the Lord! All I do is make sure that the comments fit the Posting Guidelines. There is no censorship on any kind of content-based grounds, and people are welcome to say more or less whatever they want, with very few exceptions regarding taking over the site with off-topic conversations that don’t advance the purpose of the website. It is the job of the Community at large to add their feedback and “correct” anything that seems exaggerated or unproven, just as you are attempting to do.
MIA needs to be judged on the articles. No website anywhere I know of is judged by the comments people make on the articles. I assume “professional” people understand this and act accordingly.
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While I agree with your sentiments, having been “behind enemy lines” for a number of years, the problem is that the workers, while some struggle with the ethics of their situation, also have the power to easily pass on their frustrations and “moral injuries” to the very people they’re supposed to be caring for. The “consumers” or recipients or victims of their care have no such luxury. It is imperative that those working in the system who DO recognize what’s happening fight to change it, even if it means losing their jobs. Saying, “I had to harm them, I would have lost my job otherwise” is very similar to saying “I was only following orders.” Not a valid ethical “out” for someone who really understands the harm being done.
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I always found “Behavioral Health” to be a bizarre term. How does behavior have “health?” Though I guess it provides a somewhat more honest glimpse into where these industries are really coming from. If we were healing “brain disorders,” wouldn’t it be “brain health?” No, it’s about controlling BEHAVIOR based on what Those In Charge think is “appropriate!” Not much science involved, but a lot of force and lies and manipulation!
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Absolutely. No kid would voluntarily agree to do what is expected of kids in school. Or very few. It is absolutely bizarre to expect them to do so. The ones who act out just have more courage than I did!
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Makes perfect sense, actually. Want objectivity? Talk to a robot! Healing comes from real interactions with real humans who are being honest and straight and care about each other.
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I think he’s saying that the people RUNNING the system exhibit “psychopathic” tendencies, which include lack of empathy, willingness to commit crimes to accomplish desired goals, willingness to lie, cheat or steal to get what they want, sometimes even a certain perverse enjoyment in watching others suffer. Overall, it speaks to a massive need to control others’ lives at their expense, and a lack of any concern for the welfare of anyone but themselves. This is a very rough and incomplete description, but such people are only rarely ever “diagnosed” with any kind of “Mental illness,” but rather tend to skate through life making trouble for others and getting others blamed for things they themselves have arranged. Those who are “caught” are more likely to be in jail than the “mental health” system, but plenty such people get into positions of power in businesses or government agencies where they have enough control to harm people while being protected from any kind of consequences. Of course, the world of psychiatry provides many such opportunities, and it would hardly be surprising if that field attracted a disproportionate number of psychopathic individuals, some of whom may be actually directing the course of the organization/profession.
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I was agonizingly bored in school! Wanted to poke my eyes out with a fork! I understand why kids act out, just to have SOMETHING interesting going on! Unfortunately, I was too scared to take those risks, but I sure thought about it!
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And yet so not surprising!
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I agree. The only therapists of any value are the ones who recognize that there is no such thing as “professional objectivity.” In order to be truly helpful, we have to understand that everything we do is at all times influenced by our own desires and motivations, and that we are only aware of a small percentage of them. It requires “constant vigilance,” not some fantasy belief that professional training somehow cancels out subjectivity!
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I think you hit on something EXTREMELY important! It is those wounded by the abusers in society who are “diagnosed” and sent to “therapy,” while the perpetrators walk around harming others. Therapy at its best is about helping those harmed cope with the damage and the horrible awareness that abusers are running the show. I was fortunate to have a caring and competent therapist, so it’s very hard for me to even imagine what would happen to me if my therapist had joined forces with those authority figures responsible for the damage!!!!
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Disgusting!!!! I wish I were surprised!
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Any measure that could help the CAREGIVERS, in most cases. Most of it does not help the clients/patients.
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And GOOD FOR YOU for standing up for yourself! Your last sentence it to me the true key to sanity!
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Apparently, it’s OK with the prescriber that you die, as long as you are “compliant” with your regimen!
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Thanks!
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Quite so. Trust is earned, it is given entirely at the discretion of the “truster.” Expecting someone to trust you because of your position is pretty massive authoritarianism.
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I will suggest here that per the scientific method, we assume something is NOT effective until it is proven to be effective. The “null hypothesis” in this case is that antidepressants do not reduce suicidal thoughts or behavior. If such controversy and conflicting studies continue to exist 30-40 years after ADs were introduced, I think we can conclude at this point that they DO NOT reduce suicidal thoughts and behavior.
Of course, in the “antidepressants cause suicidal thoughts and behaviors,” the “null hypothesis is that they don’t. However, the fact there is a Black Box warning on all drugs impacting serotonin suggests there is enough evidence to concern people about their safety, especially in the young. Since there is almost zero evidence of any AD effectiveness in youth, and literally none in young children, even a chance of increasing suicide rates ought to be enough to eliminate these completely from the psychiatrist’s toolbox, at least for children.
At a minimum, the evidence to date is more than sufficient to conclude that antidepressants do not decrease the suicide rate for any subgroup of identified “depressed” people. The fact that certain “researchers” and “thought leaders” choose to cherrypick the studies they like should not divert us from this conclusion. Any decent review of the literature shows no positive effect, and many show possible increases in suicide rates, even in studies involving people who were screened for suicidality before starting. It’s not really that much in dispute, except for people who want to believe otherwise.
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It has always infuriated me when therapists expect their clients to automatically trust them! Don’t they get that this is Step One of any decent helping process? I used to work with foster kids, and I’d often say to them, “I suspect you don’t trust me. That’s pretty smart. I wouldn’t trust me, either – you have no idea who I am or what my agenda is! And I don’t automatically trust you, either. I’m hoping as we get to know each other, we could develop some trust.” Or words to that effect. Oddly enough, I managed to earn the trust of many of them. I wonder why?
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I agree with you for the most part. I would never have gotten where I am from psychotherapy. I did have a very good therapist and it was important in getting me started in seeing the limitations of my upbringing. But without Buddhism, meditation, exercise, a job that challenged me to overcome some of my anxieties, the support of important people (including my wife), an exploration of a wide range of spiritual practices, self-help books, and some good old fashioned hard work, I’d have never gotten anywhere. And from what I understand, the training for therapists these days has deteriorated, and they spend time studying the DSM diagnoses but don’t bother with little things like unconscious motivations or the long-term impact of trauma or domestic abuse dynamics. So I don’t want to deny that psychotherapy can play a role for some folks, but it needs to be one who really GETS what s/he is doing, and is empowering of the client to pursue his/her goals. My therapist told me her goal was for ME to become my own therapist and not need her any more. Not every therapist has such goals!
Anyway, I think you’re right, the best even the best therapist can offer (and as I see it, most of them aren’t very good!) is to help you set your feet on a different path. Where you end up going is TOTALLY up to you, and there are as many ways to find the path as there are humans on the Earth!
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Good thing for him you were around!
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Forget about “borderline personality disorder” or any other of their anti-scientific labels. What does she really need? What behavior or issues does SHE think are creating problems for her? What does SHE want to be different? What does SHE think would be a good approach?
Usually, people who get branded with the “Borderline” label are those who have difficulty trusting others in relationships. See if you can talk to her about trust. Most are also people who have had traumatic experiences early in their lives. What kind of historical trauma is she still dealing with?
She needs support and understanding, not more labels. Psychotherapy CAN be helpful but only if you find the right person who can create a safe place for her to explore her life and what she wants to do with it. Another person bullying her around and telling her “what’s wrong with you” and what she needs to do will not be helpful. I don’t know what the best way to go about it is, but it starts with NOT accepting the labeling process and find some other people, professionals or not, who agree with you and are willing to help.
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🙂
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Nah. Psychiatry is a religion of greed selectively cherrypicking science to further its own economic ends. Science doesn’t enter into it, except as a red herring to distract from what’s actually happening. Proof is, any science contradicting their narrative is attacked and/or buried. There’s exactly nothing scientific about psychiatry.
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Is the veiled reference to Big Pharma intentional or accidental? “Patently!” It’s the patents that have made it so absurd!
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Sorry, but psychiatry does NOT rely on “common sense.” Common sense dictates that people who have been emotionally distraught need to talk to someone. Anyone who has witnessed a car accident or experienced an upsetting incident has an immediate urge to tell their story to another human being, who helps best by listening. There is nothing common sensical about the idea that “mental disorders are caused by faulty brains.” That is a very non-intuitive idea that has been sold and sold HARD to the public through massive PR campaigns and through TV and movies and other media methods.
Common sense says that psychiatry is BS. It is only the pretense of “science” coming from the mouths of pseudo-“doctors” claiming “special knowledge” that allows people to actually invalidate their common sense and believe this unscientific and intuitively offensive nonsense!
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Say “ADHD” and EVERYONE is off the hook! Except the poor child’s body…
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Yeah, but there’s not a lot of money in spiritual enlightenment!
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And if you disagree, it’s more proof of their “diagnosis!”
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I would also say that the training for “talk therapy” has deteriorated massively while classes on “diagnosing” with the DSM are hugely on the rise. I often wonder from talking to them whether today’s clinicians have ever even been introduced to the idea of subconscious motivation? They get trained that PTSD exists but to they get any kind of training on what to DO that might be helpful to a traumatized person (or what NOT to do?) Once one’s had “therapy” with a person who doesn’t know what they’re doing and makes things worse, the idea that “therapy” could work is canceled pretty much forever. Which leaves people with very few options!
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Only as long as the “data” in question supports the dominant narrative. Plenty of data is ignored when it is inconvenient or might cost profits!
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Actually, there are increasing numbers of shelters for men abused by their partners, both male and female. They are rare, but a growing phenomenon.
https://nypost.com/2017/10/29/these-shelters-help-male-victims-of-domestic-violence/
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Quite so. When the experimenters have no objective means to separate those “in” the group from those “not in” the group, the experiment is DOA. Which applies to pretty much all “mental health” studies, except perhaps those measuring adverse effects of the “treatments!”
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You are confusing an observable problem and a workable solution.
Of course, no one here denies that people live on the street and talk to themselves. Believe it or not, A LOT of those people are “taking their meds” and still doing that, or have tried the “psychiatric treatment” path and it has failed miserably for them. Did you realize that the likelihood of recovering from “schizophrenia” is now a LOT WORSE than it was in the 1950s, before the “drug era” began? Did you realize that the likelihood of recovering is MUCH HIGHER in countries like Nigeria, Columbia, and other “developing countries” where “medication” is used far less frequently? Were you aware of the fact that a lot of people having first episode psychosis don’t have another, but that the likelihood of spontaneous improvement has REDUCED since psychiatric drugs are in regular use? Have you learned yet that the average “seriously mentally ill” person dies an average of 20-25 years YOUNGER than the rest of the population, and that the drugs used to “treat” these “illnesses” are largely responsible for many of these early deaths?
The social myth is that there are magic drugs that make everyone all better, and if only the “homeless” and the “mentally ill” would follow their doctors’ instructions, they’d be “normal” people working jobs and going to college and raising families, just like on the ads on TV or the movies and TV shows where someone goes “off their meds” and crashes and burns, but as soon as they’re back “on their meds,” they’re totally fine again. The industries have worked hard to create this impression, but if you can put this myth aside for a moment and actually READ some of the stories presented below, you might start to realize that it’s not such a pretty picture.
Psych drugs do seem to be helpful to a certain percentage of the population without serious damage to their quality of life, and more power to them. But the idea that doctors have some great “treatments” that make MOST people “normal” again if only they do as they’re told is completely false. The bulk of “seriously mentally ill” people who are in “compliance” with their treatment plans are poor, unemployed (on disability), and living lives that most of us would consider extremely low in quality. Those who do better often do so despite their “treatment plans” and “providers” rather than because of them, or at least have little to no support for improving their life quality from those supposedly “treating” them besides the drugs they are prescribed. Considering the massive adverse effects most experience, ranging from involuntary movements to severely blunted emotions and motivation to loss of sexual function to enormous weight gain to diabetes and heart disease, it might seem that living on the streets is hardly any worse to some recipients. And that’s not even mentioning the tremendous loss of autonomy most experience, being constantly monitored and told what to do and threatened with incarceration, framed as “hospitalization,” if they step out of line or their “symptoms” increase.
It is very easy to judge if you’re not someone who has had these experiences yourself. Why don’t you suspend the judgment for a while and try reading some of the many stories here about what has happened to people here who “complied” with their “treatment plans” and ended up devastated? There’s a LOT more to the story than you seem to have heard to this point!
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The key question would be whether one could distinguish in some objective way between “biological” and “situational depression.” Of course, no one has come close to doing that, and they don’t even bother trying any longer. It’s just “let’s try these drugs out and see what happens.” No pretension in reality of any kind of scientific diagnostic process. But as long as the big money keeps coming in, no one has an incentive to look deeper.
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You are assuming that treatment plans mandated by “healthcare professionals” are going to be helpful. Read some of the stories below and you may begin to question that assumption. Saying something “must be dealt with one way or another” does not mean that the one way currently being used is the best approach.
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It’s hard to see why anyone needs to do a study to “prove” this. Shouldn’t it be the job of those claiming this “disorder” has validity to prove it does, rather than the other way around???
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So apparently, there are a lot of “professional” participants in the “system” who are not in their right minds!!!!
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Maybe just start with the person where they are at, and stop worrying about whether they “fit” the PTSD “diagnosis,” and instead start asking questions and getting to know them on a real level and finding out where they’re at and what they really need?
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They are only “curative” when someone can make a profit on them!
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Then there is the “placebo washout,” to remove placebo responders and make the drugs look better than they are.
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Picky, picky, picky!
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But many Deaf people in my observation also DON’T view themselves as disabled. In my experience, there is a wide range of ways people view their Deafness, and it would be wise for those not a part of that community not to speak for “them.”
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Where can you have come up with such statistics? As far as I know, there is no objective description or measurement of a “neurotypical” brain that is possible. So a “neurodivergent” brain, while I think can be a legitimate identity to choose, is not a scientifically observable phenomenon, and as a result, its frequency of occurrence is not something we can claim to know.
I personally find the term “neurotypical” to be to some extent demeaning, as it seems to imply that I have somehow gotten a “normal” brain and that therefore any struggles I may have are of less significance than the “neurodiverse” brain. I can tell you with absolute certainty there is nothing “typical” about how I have experienced life and I had plenty of struggles in school and elsewhere, even though my particular “brain” (if that is indeed the variable in question) allowed me to be quite successful in the educational environment and to scrape by socially, “it” has provided plenty of challenges in non-academic arenas. Of course, you could now decide (or I could) that I really am NOT neurotypical, that I’m “neurodiverse,” but again, that would be a decision of identity that I (or someone else) made, and not one that can be verified in any scientific manner.
I don’t believe there are “neurotypical” brains out there – my observation is that everyone’s brain is different and everyone has certain things in common, and our society is highly intolerant of certain personality characteristics or behavior, which leads to bigotry and discrimination against certain people who don’t BEHAVIORALLY fit what is expected, whether because of their brains or some other reason. Does neurology factor into that? No doubt. But until there is a means of drawing some kind of objective line between the “neurotypical” and the “neurodiverse,” I’m afraid these terms remain social constructs without any objective meanings. Like I said, everyone should feel free to identify themselves as they wish, but I’d appreciate you and others not choosing MY identity for me!
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The most optimistic I’ve ever heard is 30% EFFECTIVENESS, not 30% REMISSION. It’s bull if anyone tells you there’s a 50% remission rate.
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Quite so. It is never the fault of the practitioners – the client or the “disorder” is resisting! So how is success ever to be defined, if you can’t fail except as a result of something they have no control over!
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Yeah, you don’t want to start upsetting people by speaking the truth!!! Very rude of you! /s
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Posting as moderator: Just to be clear, the above is indicated to be sarcasm.
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There are most likely some in Turkey who know the truth. But it may be hard to find each other. Most countries are dominated by people who are “true believers” in psychiatry and tend to attack and humiliate those who don’t agree with them.
It may be that you are the one who will have to educate others about what you’ve learned. We are all in the minority!
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Exactly! Besides, he’s threatening their client base!
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Quite so.
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It would indeed be interesting!
My point is that having a goal over which you have no direct control is a setup for failure, in my experience. Empathy in particular is VERY difficult to teach, especially to an adult. Not saying it could not happen, but I’d be more likely to look at something more along the lines of not engaging when negative stuff is coming from her, drilling how to convey the necessary message most effectively, and how to set good boundaries when she becomes abusive. All things the person himself can control. I’ve seen way too many people spend way too much time trying to “get their viewpoint across” or “help him see how he’s hurting me,” etc., with absolutely no success and enormous frustration. I recommend setting goals that a person can accomplish, regardless of whether someone else chooses to “understand” or not!
Hope that makes some sense.
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That DOES make a lot of sense. My only caution is that “depression” is not caused by any one thing. But testing for THIS particular thing could save a LOT of trouble and suffering for a certain identifiable subset of the population!
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If the patients got along but the staff shunned you, you must have been doing something right!
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I agree with you completely. I’m not sure I didn’t know you agreed with me already!
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A goal of making one’s WIFE more compassionate is a pretty inappropriate therapy goal! You can’t make other people compassionate! That seems like his first problem!
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I believe the link goes both ways – psychological trauma is associated with increasing inflammation and immune response. Autoimmune diseases are more common with people who have been abused, in a dose-dependent manner, as I recall.
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The question is, how can anyone POSSIBLY determine where such a “line” lies, or if it even exists? And if we DON’T objectively define what it is, then we get arbitrary and subjective rules, leading to “diagnostic drift” toward whatever makes more money for the providers and less trouble for those in control of society’s institutions.
And why do we need to define such a line anyway? Why can’t we simply say that “those who suffer need and deserve support” and provide it without pretending there is something physiological going on? Now, if there IS something physical that is off, like low thyroid, anemia, sleep problems leading to depression or hyperactivity, or whatever, then THAT is what should be treated, not “depression” or “anxiety.”
I’d really be interested in knowing why you think such a line can be and/or needs to be drawn to be able to provide full support to those who are suffering?
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That sounds very intentional and very oppressive!
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Somebody decided to go after Kratom and started making it into a “story.” That’s how a lot of news happens, someone with a lot of money and/or power decides to make it a “story” and then tells the papers what to write!
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I hope that you found people with this label were a lot more different than they were similar to each other. That was my experience. The main thing they mostly had in common is that their early lives were shitty. Other than that, I saw a huge range of human interests, abilities, and personalities carelessly lumped together simply because traumatization had made it more challenging for the poor professionals to figure out what was going on.
I actually have no patience for this “diagnosis.” Why not just say, “Mary was abused as a kid and has trouble trusting people” or whatever else is going on? Why talk about this group as if they had anything in common besides being labeled and discriminated against by the “system” personnel?
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Which is a pretty low bar, I have to point out!
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Well, there are no profits to be made from fixing society! Far better to blame and drug the patient and protect the status quo, which provides so many “customers!”
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Actually, the “comorbidity” is, in my view, not because these “conditions” share things, but because they are not actual medical “conditions” at all. What should be diagnosed is neuroinflammation, histamine intolerance, vitamin D deficiency, etc, rather than wasting time on these meaningless DSM “diagnoses” that don’t tell us anything about the actual problem at hand.
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That’s one of the most insidious dangers of the “label and drug” approach. It gives the impression that your environment is harmless and YOU have the problem. If only your brain worked better, you wouldn’t MIND being worked 60 hours a week at a mindless job that challenges your personal ethics on a daily basis! It’s all about Bad Brains, never about fixing the environment and expectations that lead to burnout!
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There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
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When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
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And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
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I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
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I wish I were surprised.
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“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
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I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
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I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
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Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
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I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
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The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
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“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
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I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
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I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
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It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
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Love the name! You’re all “in cahoots” with each other!
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ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
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It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
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Yup!
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You should give it a try! I bet the results would be quite telling.
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That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
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Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
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I really don’t know. I’ve never done it. I don’t have much interest in chatGBT myself.
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Brilliant post!
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Who’da guessed it?
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I like that one, too!
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That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
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My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
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It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
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I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
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This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
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I loved “a la carte menu” as a description of the DSM. Kinda sums it up!
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Maybe this article can inspire you to do so?
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I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
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Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
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I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
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In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
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When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
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Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Chemical stun gun is a great description!
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Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
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Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
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Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
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I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
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I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
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I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
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That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
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And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
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🙂
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Much like “ECT” aka shock therapy. If you kill off the RIGHT brain cells, things just get better and better!
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You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
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I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
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Hi, Donna!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
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I love the astrology analogy! If it helps to believe you have Taurus traits, go for it, but let’s not pretend we’re practicing medicine!
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Well, they always accuse “BPD”-labeled clients of “splitting.”
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I particularly like the term “splitting” in the title. Nice touch!
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I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
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Excellent questions! I wish I had the answer!
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Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
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Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
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That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
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Gotta wonder what the “objections” were that were raised by “other professionals?” “This might work and we’d have to give up our absolute power?”
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This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
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Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
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But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
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Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
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Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
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Sounds safer and more reliable than any of the drugs on offer!
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I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
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Their constant failure to provide true informed consent ought to make almost all of them vulnerable to malpractice charges!
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Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
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Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
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This is what Alice Miller talks about in her books. You might be interested in reading some of her works!
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I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
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Exactly!!!!
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I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
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Being a good person in a destructive system still contributes to supporting the destructive system. That’s why I’m not a counselor any more!
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It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
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Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
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There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
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I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
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I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
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It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
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My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
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“I find them really annoying, so they must be ‘mentally ill.’ Otherwise, it might mean I’m just impatient and judgmental!”
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That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
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This is all very well said!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
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Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
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Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
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I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
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The whole sham depends on the DSM for its foundation.
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It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
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So do I! It was decades later before I realized how fortunate I had been to draw the good therapy hand I did!
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That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
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Apparently, regular trips to the gym or outdoor walks already meet that standard!
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And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
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Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
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Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
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My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
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I am shocked, SHOCKED to find that GAMBLING has been going on in this establishment!
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As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
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I don’t believe that is completely true. They can apparently test for people who are “slow metabolizers” of different drugs and so perhaps avoid creating homicidal/suicidal ideation by SOME people taking SSRIs, but these tests appear to be far from foolproof, and just as importantly, almost no physicians regularly use such testing in their practice, despite your assertion that “ANY WISE PHYSICIAN” will do so. I’d be happy to be proven wrong about this, but that’s my understanding of the current situation. I have yet to meet a person currently engaged in the MH system who was offered such testing by their doctor, though I’ve heard of a few who demanded it themselves. Do you have any links to recent studies showing anything more promising than what I’ve identified above?
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Unfortunately, a great deal of what passes for “psychotherapy” these days does not incorporate any of the important philosophical underpinnings you mention above. A lot seems to now be focused on “neurobiology,” on DSM “diagnoses,” and on compliance with “medication” and other “treatment plans” like DBT or CBT. I did therapy for a number of years in various settings, some formal and some informal, and saw and heard what others were exposed to by their “therapists,” who in my view did not deserve the name. I’m not sure they are even taught about unconscious motivations or ideas of consciousness or striving or attachment or awareness of one’s own process, let alone touching on the existential issues of the bizarre expectations and abuses of modern society. The focus seems to be on making “symptoms” go away, as if “depression” or “anxiety” were the problem rather than the observable manifestation of the actual issues causing distress. This is the inevitable result of “DSM” thinking – reducing the complexity and spiritual richness of human experience to “desirable” and “undesirable” emotions or behavior, which the therapist and/or psychiatrist is tasked to change, by force or manipulation if needed. It is small wonder that folks faith in psychotherapy as you describe it is very low – very few people seem to ever experience it these days!
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I’m glad Ketamine therapy works so well for you! But I do want to remind you that this doesn’t mean it works for everyone. The idea that all people who are depressed have the same problem or need the same solution is not scientifically valid. I rejoice that people find Ketamine or any other approach workable for them. I just want to be cautious about using anecdotal data to extrapolate for others who may have very different circumstances and very different results than you had.
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Clearly, the most fundamental fallacy with the entire psychiatric edifice is the assumption that all people who “have depression” or whatever “mental illness” is under discussion are all ILL and have the SAME PROBLEM and need the SAME INTERVENTION. The DSM itself invalidates this assumption in its introduction, but this apparently has no impact on people’s viewing these “diagnoses” as some kind of valid scientific entity that can somehow be “researched” as such, even though the people in the study group often have little to nothing in common with each other. In fact, it’s been shown that multiple people can “qualify” for the same “diagnosis” and have not a single “symptom” in common! How it’s not obvious to anyone of a slightly scientific bent that this whole system is a house of cards built on nothing but opinion and bias is beyond my comprehension.
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Which once again reinforces the idea that the person one is interacting with, their maturity, skills, openness to experience, ability to create a safe environment, ability to help a client focus on their own goals and purposes, is what really matters in any kind of “therapy” or healing practice. I find calling MDMA “medicine” in itself to be an absurdity. It is not a “medical” process you are describing, it is a spiritual/emotional/intellectual journey that is very personal to each individual, and there is no way to create a repetitive “treatment” that can obtain any kind of consistent and predictable results for all people. The key is who is helping “guide” you and what kind of “guidance” they tend to provide (empowering vs authoritarian) rather than the particular drug or other method used. This is not to say that MDMA or any other drug may not be able to contribute to increased spiritual awareness or skills in life, but it’s not “medicine,” any more than alcohol or marijuana are “medicine” because they have certain effects that a person may or may not desire or benefit from.
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I do think it is of great concern that the number of contacts appears to have a direct relationship to the number of detentions. This would imply that the increase in contacts would have the same demographic distribution of seriousness as the ones already contacting crisis lines previously. Unless this is simply a redistribution of people who would have contacted another crisis line if 988 did not exist (which of course means there is NOT really an increase in contacts at all), one would expect that the new callers would have a LESS serious distribution of issues, because we should be courting new contacts who otherwise might not have called (the purpose of the 988 easier access).
So there are two likely conclusions: first, that these callers are the same people who already used local crisis lines, and we have spent millions and millions of dollars to accomplish essentially nothing at all, or second, that calling a crisis line gives a particular probability of having the police dispatched, regardless of the average severity of the call. Neither one is a happy conclusion!
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We shouldn’t have to prove they are dangerous. The standard is that the doctors/pharma need to prove they are safe. I think the biggest problem is we have hired a lot of foxes guarding the henhouse of drug safety. If we had a REAL set of standards with honest, non-corrupt people applying them, we’d all be a lot safer and it would be a lot easier to get complaints heard and acted upon!
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Why is it sad? Science is about facts, not feelings. It is GOOD that Ketamine’s rah-rah propaganda has been served a well-deserved challenge. We need to know the truth.
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It is easy to confuse “These categories are not scientifically valid diagnoses” with “debilitating anxiety doesn’t exist.” They are VERY different statements. I doubt anyone here would state that debilitating social fear and apprehension don’t exist or are not painful and difficult. The argument would be that just because you feel anxious in social situations, no matter how severe, it doesn’t mean you are “ill” in a medical sense.
I say this as a person who suffered debilitating anxiety and depression in my youth, and now at 65 rarely experience anything similar. I did get therapy for a while and do a lot of self-help stuff but never was “diagnosed” with anything at all by my therapist. It is not necessary to validate these “diagnoses” in order to agree that someone needs help and support and to assist them in getting to a better place. I’m also not invalidating the potential usefulness of psychiatric drugs, just saying that the “diagnoses” themselves are not valid medical/scientific entities, and that saying so doesn’t invalidate ANYONE’S suffering!
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The only legitimate “outcome measure” in something so subjective as “therapy” is whether the client feels they’ve gotten something out of it!
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I wouldn’t call it easy, but it’s definitely do-able. I have a little preamble I give to any new doctor I see about how I’m going to be the one making the final decisions, and if that’s a problem for them, let me know now so I can find another provider. And I have had to do that on occasion, but it almost always puts them in their place.
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So noted.
In the future, could you please report any comments you feel don’t pass the moderation standards? Or write me an email? Thanks!
Steve
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That’s the sad part about these labels. Folks can dismiss what are most likely very valid complaints by blaming the victim.
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Wow, now THAT’S therapeutic! “You’d best get better or I’ll have you locked up!” Reminds me of “Don’t cry or I’ll give you something to cry about!”
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I am agreeing with you.
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Right. So it increased to 220% of previous values.
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That is exactly my point. How is “standardization” even possible when there are no objective standards possible regarding what diagnosis to give, how to do a danger assessment, optimum “treatment,” what “good outcomes” are, how to measure them, etc.? It’s all so completely arbitrary! How can “imminent risk” ever be anything but haphazard and varied?
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I am sure this is an accurate summary of what is happening today. One of the main reasons I left the crisis line was the “professionalization,” which meant more fear of lawsuits, more rules and expectations and rigidity, and a greater likelihood of sending the police out on calls that did not really pose any danger at all. And the lack of any kind of objective standards for police dispatching or diagnosing or anything at all in the “mental health” world makes “quality control” almost impossible.
But it does encourage me to know that crisis lines do still exist where dispatching is not an option, and I wanted to make sure I shared that fact. Of course, it’s a volunteer crisis line, not a “professional” one!
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My experience (and I have a lot) is that crisis lines I’ve worked at or volunteered at had a wide range of different views on what to do about suicidal callers. I was a supervisor for a volunteer crisis line in Portland, OR, and we tried only to talk unless a person had a specific plan and intent to carry it out. The line contract was taken over by a “professional” service and the likelihood of a dispatch went up quite significantly, though they did eventually develop a “crisis team” who would see some of the people without police being involved. I later volunteered at a crisis line that never traced or dispatched under any circumstances. So it’s not legitimate to overgeneralize – different crisis lines have different philosophies, and it may also depend very much on whom you reach when you call. I can see people being VERY cautious about sharing that they are suicidal with such a crisis line, without knowing what their general philosophy about such calls is and how frequently they tend to dispatch the police!
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I’m not sure I’d say the act of a stimulant improving concentration temporarily represents “healing” per se. Smoking marijuana or drinking alcohol reduces anxiety for many, but I’d not suggest they are “healed” by the process. There are no doubt some healing processes that are mediated by drugs, but I consider this to be more or less incidental to psychiatry’s intent. For instance, I know of a guy who took stimulants for a little while and said he discovered a mental state he could get to that way, then he STOPPED taking the stimulants and found other ways to achieve that same kind of mental state. I’d call that a kind of healing, and the stimulants were a part of it, but no psychiatrist would recommend or approve of the real healing part of that action.
Anyway, that’s just my personal view on it. Some people find psychiatric drugs beneficial for whatever reason, and more power to them, but I don’t think it’s a form of “healing” to take a drug that makes you feel better temporarily. It might be the first step in healing, but psychiatry as a rule discourages any attempt at any further “steps,” in my experience. Healing tends to happen despite their interventions, not because of them.
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“Pre-dying!” I love it! It’s a condition we can ALL claim!
The same happened with cholesterol, BTW. At one point, you had to be 160 or so before anyone got worried. Then for no real reason, they changed it to 120. Actually, there was a reason – to sell more cholesterol-lowering drugs!
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It is not “demonizing medications” to observe what the research really shows and to share people’s individual experiences. It’s called sharing reality. If “medications” need to be protected from the actual facts about them, it says a lot about who is demonizing whom.
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And is in fact contrary to research showing that long-term use of antipsychotics REDUCES the average lifespan of the recipient! The odds are that she’d have lived longer if she’s avoided psychiatry altogether!
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It does feel more than a little ironic to hear that she was attacked for questioning the efficacy of antidepressants, and yet failure to take antidepressants is assumed to be the cause of her suicide. As I said earlier, wherever you come down on the “cause” of her suicide, which of course, we will never really know, it is VERY clear to me that psychiatry did NOT get her to a place where she achieved “good mental health.” She clearly eventually gave up on psychiatry because it failed her. It is more than a little disingenuous to imply that her abandoning a practice that never really worked for her is somehow responsible for her despair.
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My reality is that therapists who can create a kind and secure environment for a client to share and to some extent be challenged to seek new perspectives have success, regardless of the model they use. “DBT” will work well in the hands of a highly competent therapist, and will be a disaster in the hands of an incompetent one. CBT will similarly be successful to the degree the therapist can create a safe and connected environment where a person can share their fears and explore new options without feeling judged or threatened by the therapist. Whereas an insensitive or self-involved or “rote” therapist will have no success with CBT or any other approach.
There is no way any person can become a “good therapist” by studying a manual and following instructions without truly understanding the nature of the delicate and emotionally sensitive interactions they need to become a part of. There is solid research supporting this viewpoint. I don’t think DBT is good or bad in and of itself, I just think it’s a bunch of possible tools that a competent therapist can use to build up their client’s feelings of success and control, or a bunch of possible tools an incompetent therapist can use to make their clients feel worse and then blame the clients for the therapists’ own failure.
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Here is one study showing how stigma is INCREASED by explaining “mental disorders” as biological problems.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842491/
Here is another:
https://www.goodtherapy.org/blog/biological-explanations-may-not-reduce-mental-health-stigma-0124181
Considering there is absolutely NO evidence that any of the DSM “mental disorders” are fully or primarily caused by biological problems or issues, it’s mystifying why “anti-stigma” campaigns focus so much on convincing people that “mental disorders” are “illnesses like any other.” Unless the intent is not, in fact, to fight stigma, but to fight resistance to accepting drug therapy as the first line intervention for these ostensible “disorders.” Then and only then does this focus make any kind of sense. But then calling these “anti-stigma campaigns” isn’t very honest, is it?
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A wise person once said, “All that is not love, is fear!” Fearing our emotions prevents us from feeling the love and connection that for most of us makes life feel like it’s worth living.
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“CLD” – let’s propose it for the DSM 6!
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They also screen out suicidal people from the vast majority of these clinical trials, so these are not “suicidal people getting the energy to do it.” These are people who, for the most part, were not suicidal until they took the drugs. They most definitely can and do cause suicidal thinking. Hence, the black box warning. That warning ought to be enough for anyone to acknowledge the possibility.
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You clearly suffer from “Disliking Steve’s Analogy Disorder!”
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My favorite analogy is “You have pain in your knee because you suffer from knee pain disorder. You know you have knee pain disorder when your knees hurt, but knee pain disorder also CAUSES your knees to hurt.” Very informative!
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As extreme and simplistic as the idea that “schizophrenia” is in all cases caused by genetic or biological malfunctions which no one has ever been able to detect but we KNOW must be there?
I’m always the enemy of extreme and simplistic. I just want to make sure that everyone is fully aware of the extreme simplistic basis for these ridiculous psychiatric “diagnoses” and the insistence on “treatments” being determined by such laughably unscientific claims. The proper attitude toward any case of “schizophrenia” is that we have a NAME but very little knowledge of what is going on IN THIS CASE and need to explore what’s happening IN THIS CASE and what might work IN THIS CASE. Trying to generalize based on these laughable “syndromes” where two people can both be “diagnosed” and literally have no symptoms in common (try it some time, it’s quite possible in at least schizophrenia and major depression by my direct observation) is almost as far away from scientific as one can get.
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I don’t know about the “subscription” button. I’ll look into that for you.
Dismissing trauma as a causal factor in “mental illness” displays either ignorance or a willful attempt to redirect people away from exploring this very real issue.
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Part of “informed consent” is also presenting alternatives. This almost never happens in my experience.
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I always find it odd that defenders of the current psychiatric paradigm so frequently conflate criticisms of that paradigm with ‘stigma concerning mental health.’ The two have literally nothing to do with each other. There is, in fact, HUGE “stigma” for people suffering emotional pain who DON’T use psychiatric drugs as part of their treatment, and those who choose to discontinue such treatment are often attacked relentlessly by the very people who are supposed to be helping them.
There is certainly general discrimination in the public sphere against people who qualify for or identify with a “mental health diagnosis.” On that point, I’m sure you will find no disagreement on this site whatsoever. However, it is actually shown by scientific research that teaching people to view “mental illness” as a brain disorder of some sort INCREASES “stigma” and discrimination by making it easier for people to emotionally distance themselves from those who are suffering, while a “trauma-based” framing increases empathy and DECREASES stigma.
So please don’t blame “stigma” on those who question the accepted psychiatric paradigm. It is the accepted paradigm itself which is responsible for most of the stigma, according to their own research. There is nothing wrong with questioning the scientific validity of psychiatry’s unproven assumptions, nor does questioning those assumptions mean or imply that those finding psychiatric drugs helpful are wrong or need to be forbidden from using them. Again, the two issues have literally not a thing in common.
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There is a VERY high correlation between childhood sexual trauma and psychosis.
https://www.medpagetoday.com/psychiatry/schizophrenia/23087
It is not at all far fetched to suppose that childhood abuse can contribute to the eventual development of psychotic states. There is also strong correlation with being an immigrant and living in an urban environment.
As in all of the so-called “mental disorders,” the situation is FAR more complex than the “mental health” world would like us to believe. There is “no proof” (to use your words) that ANY “mental illness” as defined by the DSM is caused by any measurable biological/genetic factor either. I’d agree that current drug use and current trauma are often overlooked as contributing factors in psychosis. Maybe the problem is regarding “psychosis” as if it must always be caused by the same things or “treated” in the same fashion. Maybe there are many “causes” that work differently in many different people, and we ought to scrap the idea that “schizophrenia” is a “thing” that has a specific cause.
Steve
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Additionally, a very significant percentage of studies use a “placebo washout” design, where they screen people who DO respond to the placebo out of the trials! This is obviously designed to minimize the placebo response and make it more likely that the drug will meet “statistical significance” vs. placebo. So far from using active placeboes, most studies actually try to weed out those who will respond to an INACTIVE placebo in order to bias the study in the direction of their drug. And somehow, this is not considered a violation of the scientific method!
Here is a published article in a solid, scientific journal for the original poster to read. It goes over why the author concludes that more than half of all published scientific studies can’t be replicated, and hence are not valid. It ought to make him/her more cautious in assuming that anything published in a scientific journal is de facto proven truth!
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
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One article in an online publication has “done society a disservice!” Why refer back to Freud or Szasz to try and discredit the arguments of the author through the reverse “argument by authority” approach? Don’t you have your own arguments to make?
It would appear to me you might want to re-read Szasz again, as he never claimed that the phenomena describes as “mental illness” did not exist, but that the idea that these were discrete and identifiable “disease states” of the body was mythological, as this concept is not supported by scientific facts.
There is nothing “unqualified” about the argument that traumatic events alter people’s concept of who they are and how the world operates and what relationships are about. In fact, the entire movement toward “trauma informed care” is based on scientific proof that not only their behavior, but that people’s actual brain structures and activities can be dramatically altered both by early life trauma AND improved by healthy relationships later on in life. It is pretty regressive at this point for anyone to claim that traumatic events do NOT impact all of the so-called “mental illnesses” as defined by the DSM, however fuzzy and arbitrary those definitions may be. Even the most medicalized psychiatric supporters at this point know that the idea of a “chemical imbalance” or other purely physiological problem creating any “mental illness” being detectable by tests and repairable by drugs is completely unsupportable by scientific studies.
Ironically, there is far MORE support for the remnants of Freud’s “trauma theory” through the “trauma informed care” movement than for the idea that any discrete “mental illness” described by the DSM is a scientifically valid description of reality. Even more ironically, the DSM itself admits these things in its introduction, where it says that:
“In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi).”
And even more tellingly: “There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.” (APA, 2000, p. xxxi).”
So not only can the DSM criteria NOT distinguish between having one “disorder” or another “disorder,” or between having a “disorder” or having “no disorder.” Worse, two people who both CLEARLY QUALIFY for a given disorder may not have the same problems, needs, or possible solutions! What is the point of having “diagnoses” where the people who are so diagnosed are NOT “alike in all important ways?” Isn’t the point of a “diagnosis” to group together people who have similar needs and issues and distinguish people who have similar presentations but different underlying causes? These two clauses admit outright that these “diagnoses” are scientifically and practically meaningless!
So before you go about accusing others of “unqualified arguments,” it might be wise to spend some time to qualify your own arguments. No one arguing in favor of the DSM “diagnoses” being taken seriously in any scientific manner is in a position to criticize anyone else for being “unscientific!”
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It is easy to move from “she wasn’t taking her meds” or “she engaged in recreational drug use” to “she killed herself because she stopped her meds” and/or “she killed herself because she’s an addict.” Neither of those premises has any more evidence backing them up than the “psychiatry killed her” idea. Any of those are possible, none are provable. But one thing we DO know for sure – this person had the best of available psychiatric care for decades, did not “resist” or “rebel” but in fact embraced the system for most of that time, and all of that “help” did not prevent her eventual suicide. It is certainly NOT valid to suggest that everything was going just fine before she “quit her meds!” It sounds from her blogs like she struggled the entire time she was “in treatment” and went another direction for whatever reason she chose. It would be EXTREMELY naïve to look at her situation and say, “if only she’d stayed on her meds…” Whether her suicide was caused by her engagement or disengagement with “the system” is not something we can determine, but I think it is more than fair to say that psychiatry failed her in many ways, and it’s never appropriate in my mind to blame the client for quitting services when the services have not been successful. If psychiatry were the answer for her, 20 or more years of committed engagement with the psychiatric system would have led to a different outcome. I think it’s more than fair to suggest that psychiatry AT BEST did not help the situation, despite her being fully committed to following their instructions for many years. Let’s not blame “not taking her meds” so easily, since we’re hearing we’re not supposed to be so “black and white” in our thinking as the author supposedly is.
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It is true that we don’t ever know what prompted a particular person’s suicide. What we DO know in this case is that decades of psychiatric treatment did not prevent it. Whether it contributed substantially to the event or not will always be speculative, but it’s equally speculative to say, “Antidepressants save lives,” when we don’t know how people would have acted under differing circumstances.
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It sounds like you might need some help getting away from an abusive partner! Are there any domestic abuse hotlines or programs in your area? There is hope, but you will have to figure out a way of putting at least some emotional distance between you and your husband. No one should be forced to live with someone who hates them so much they intentionally make an addict out of her!
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I would add that the presence of psychiatric drugs not only can do damage itself, but it also diverts young people (and older people) from other approaches that have been successful over time, both formally and informally. It may be the lack of developing support networks as much as drug side effects that are helping cause the deterioration of youth “mental health” today.
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Please recall that there is also a POWERFUL stigma AGAINST those who choose NOT to accept the standard “treatment” offered by psychiatry, even when it is demonstrably doing serious harm.
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There are actually plenty of hard scientific studies showing that psychotropic medications IN GENERAL tend to create worse clinical outcomes. Harrow et al for instance showed that people with poorer prognoses that took antipsychotics only briefly or not at all did BETTER than those who had better prognoses and took antipsychotics long term. So on the average, they were worse off taking psychotropic drugs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661946/
Studies on antidepressants and “ADHD” also show no average benefit or worse outcomes for those taking drugs over the long term.
Multiple studies show an increase in suicidal thinking and acts in those taking antidepressants, especially when younger.
Many studies show the “severely mentally ill” have shorter life spans than the average person, much of it due to heart and metabolic problems that are known to be caused by antipsychotic drugs (clearly, there are other contributing factors as well, but treatment is associated with reduced life span).
Your analogies are completely inappropriate. Taking diabetic treatment does not INCREASE the number of amputations, it decreases them. The same can’t be said for psychosis and antipsychotics or suicide and antidepressants. Not to mention, diabetes is known to be caused by a lack of insulin in all cases. No one suffers from psychosis for a lack of antipsychotics.
Perhaps a more open mind and some honest research will help you see that the situation is not as black and white as you currently believe. You might start by reading Whitaker’s book, “Anatomy of an Epidemic.” It could be quite enlightening.
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…..
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MIA is mostly interested in looking at alternatives to the “medical model.” It is unlikely we will want to promote any “antipsychotic” drugs given the history of failure and worsening of “symptoms” and in fact the shortening of lives resulting from the “antipsychotics” currently in use. It seems very unlikely that the “new” drugs will be doing anything beyond trying to suppress dopamine and maybe suppress the uptake of Serotonin like Risperdal and Seroquel and the other current drugs.
It is truly a problem to be unable to continue. I’m betting no one warned you this could be an outcome of taking them in the first place! Have you talked to anyone who specializes in getting off drugs? There are such people around, but most psychiatrists either don’t know or actively try to prevent any effort for people to get off.
Anyone else have thoughts?
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The use of the term “inclusion” already marginalizes the peer support workers. Who gets to decide if they are “included” or not? Obviously the REAL workers, who are by definition more important than the “peer workers” because they can “include” them or not at their whim.
Reminds me of the concept of “shared decision making,” where clinicians are “encouraged” to “take the views of their clients into account” before making decisions. Obviously, the people being asked to “allow” their clients to have a “voice” are already trampling the rights of clients to true informed consent, and asking them nicely to please ask my opinion before you decide what to do to me is hardly a viable solution.
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It is very odd that in most cases, we assume that the device provider is responsible for proving the safety of its products, but in this case, it appears that the “clients” (including forced, involuntary victims) have to prove that it’s NOT safe!
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Thanks, Ted! Good to know you’re still out there fighting the good fight!
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To be clear, I am not against systematic interventions to help people who are struggling, as you seem to suggest. I just want to focus on things that actually work FROM THE POINT OF VIEW OF THE CLIENT. There are some people I know who have used the drugs as a means to help themselves, and have suffered minimal adverse effects. I’ve also known others whose lives were destroyed following that path. I used to be a counselor/therapist and I believe helped lots of people find their way to a new path or direction for their lives. My approach helped a lot of folks, but I know it didn’t help everyone I came in contact with. I had a philosophy that allowed me to connect more directly with people about what their concerns and needs were, and I’ve taken people who had all kinds of different labels and been successful when they experienced failure in “the system.” I could share some pretty impressive stories of monumental changes in people who the “Mental health professionals” had decided were intractable.
Others needed things I couldn’t provide. I tried to help them find some other pathway. I have never had or expressed the viewpoint that there is no such thing as suffering that requires some sort of advanced intervention. I am not sure where you ever got that idea, but I would appreciate it if you drop that as it applies to me. As you are against “bullying” as you so aptly put it, I’d really appreciate you not deciding for me what I believe and drawing conclusions on the basis of those assumptions.
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I agree 100%!
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I don’t think mapping the brain will create an understanding of “mental health.” But I do think that real brain research shows and will continue to show that the idea of “mental illness” is a “brain disease” is, scientifically speaking, complete nonsense.
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The problem is not that people don’t fully use the criteria (even though they almost never do), it’s that the criteria themselves are subjective, speculative, and completely unscientific in nature. You can’t judge “overdiagnosis” if there is no objective way to tell who “has” or “does not have” a particular “disorder.” The DSM itself admits in its introduction that 1) you can’t really tell who has which “disorder,” or where the line between “disorder” and “no disorder” can be drawn, and 2) any two people who COMPLETELY FIT the criteria at a given moment may not have the same problem or need the same kind of help. Of course, almost no one ever READS the introduction, and it’s couched in very squirmy language that requires interpretation, but it’s a pretty damning admission, don’t you think? We have no way of objectively determining which diagnosis you have, and even if you and another person are right in the center of the target, your diagnosis means nothing about the cause or your needs or what treatment to recommend. What is the value of such a “diagnosis?”
When I did clinical work in the past, I simply talked to the client about his/her own conception of the problem and what they thought might have helped. While of course I asked good questions and made observations and brainstormed options with the client, in the end, the client was responsible for defining the problem and whether or not a particular intervention was “working.” It is arrogant in the extreme in my view for a clinician to enforce his/her views on what is “wrong” or what “should be done” on a client, as the main reason people suffer from “mental health issues” in the first place, ESPECIALLY when we’re talking about depression and/or anxiety, is because OTHER PEOPLE have taken over their lives and told them what to think, say or do and what was “right” in opposition to allowing the to follow their own personal “voice.” I consider it more abuse for a “professional” to boss a client around and disempower them the way they were disempowered by others in their pasts. Empowerment is the answer, not more powerful people exerting their control over the clients’ lives.
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Which is how research ought to be done! The actual data should be reported and acted upon, even if the knee surgeons might lose some money in the process!
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Exactly. If the current model were working, people who USED TO BE disabled would now be OFF disability and working again! If someone’s disabled with, say, a bad knee, and gets knee surgery, we would expect that the corhort of such people would be LESS disabled than before the surgery! There may be a few for whom it did not work and they didn’t get better or got worse, but overall, the average disability level would have to go DOWN for this intervention to be considered effective! If people are MORE likely to be unable to work and participate in society AFTER receiving psychiatric “treatment” than before – well, there isn’t a much better definition of “ineffective” or indeed “counterproductive” available than having a “treatment” actually INCREASE the disability rate of its recipients!
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They say that 78.54% of internet statistics are made up on the spot!
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Another excellent example!
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Unless you’re TRYING to disable people, in which case, they are pretty effective.
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Again, I think you are confusing efforts to help with effectiveness. Stating things like “ECT is effective and safe” is just as dangerous or moreso than saying, “ECT can have serious adverse effects which should be considered before undertaking such a course of action.” Are you seriously claiming that there are NO or MINIMAL adverse reactions to “ECT” despite all of the hard and soft data showing that the results for some people are devastating? You do realize that “ECT” is the intentional induction of a convulsive seizure (hence the name) and that under normal circumstances, such seizures are considered dangerous and people take drugs to avoid them because of potential brain damage? Why would an intentionally induced seizure NOT be likely to produce brain damage when a spontaneous one IS likely to produce such damage?
My beef with psychiatry is mostly the blithe dismissal of very real concerns that exist, as you demonstrate in your comment. It is not HATEFUL toward psychiatry to report on actual events and studies that challenge the conventional wisdom. “Trust me” is a dangerous comment for ANY physician to make, but more particularly those working in psychiatry, where knowledge is scarce and speculative on the ground and no one really understands the exact cause of ANY “disorder,” or even if such a “disorder” syndrome is a legitimate entity for study rather than a broad collection of phenomena which have been cast together into a syndrome because we don’t understand them, purporting to “know all about it” is just a blatant deception.
Psychiatry would be a lot better off as a medical specialty if it took a big dose of humility and started to understand that these bad results are very often NOT random or made up or the result of “lifestyle issues,” but are very real and potentially dangerous side effects of the “treatments” they are handing out. That way, at least some measure of “informed consent” can be practiced, rather than providing bland and scientifically empty reassurances such as “ECT is safe and effective.”
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I worked for 20 years in the foster care system and the stories are all too familiar. I helped get a law passed to require such evaluations of kids before they were ever put on psych drugs, and with the help of a state-level nurse, we also managed to implement a triggered review of any case involving certain polypharmacy criteria. The drugging rate HAS dropped since then in Oregon, but it’s still way too high. It is the inevitable result of inventing “diseases” that can’t be objectively determined and giving people drugs for them. There will always be “diagnostic creep” if there is no hard line to decide when intervention is needed, as is the case with essentially every psychiatric “disorder.”
Another interesting fact was that those kids cared for by relatives had a MUCH lower rate of psych drugging than those being fostered by strangers. I have the greatest respect for the many excellent foster parents out there, but think it really helps to have someone in the room with the doctor who feels a familial obligation to care for the child’s needs. It’s way too easy in the current system to believe we are acting in the child’s interests when we’re actually acting to make the adults’ lives easier. That won’t change until we get rid of these bullshit subjective “diagnoses” as excuses to drug kids into compliance or docility.
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It depends on how frequent the adverse effects are and how seriously they damage people. There are plenty of banned therapies for various physiological problems that are considered too risky, even if they work for some people. I agree some people seem to report positive results, and I don’t particularly want to take that away from them, but it’s a cost/benefit analysis that transcends the needs of individuals.
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I also think we should remember that Vioxx, for instance, did provide pain relief for a lot of people. It also killed a certain small percentage of them, far from a majority, actually a very small minority. It was taken off the market. Because it killed people. But some people found it very helpful. The FDA decided it wasn’t OK to risk people dying, even a small percentage, in exchange for pain relief.
It isn’t always OK to allow a potentially unsafe intervention even if some people do fine on it, especially when you have no way to determine a head of time whom you might accidentally kill or whose life you may accidentally ruin.
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Seriously, what is that supposed to mean?
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Can you please provide evidence for your claims? It’s easy to say things without providing the actual backup. I’ve heard and read statistics that are WILDLY different from what you are claiming, so I need to see where you’re getting this info to put it into any kind of perspective.
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Saying that these folks need help does NOT translate into we should assume and accept that what the psychiatric profession has to offer is the kind of “help” that they need. It is absolutely wrong to postulate that needing attention means needing the kind of abusive and destructive behavior that is often accepted and even encouraged in the name of “psychiatric care.”
Those “helped” by psychiatry with psychotic disorders die on the average 20-25 years YOUNGER than those who don’t receive such treatment. While it’s obvious that there are many variables involved, I challenge you to name another profession where receiving treatment REDUCES average lifespan. Something is not right here. The problem is not that these individuals need attention, it’s that the kind of attention they receive is not the kind of attention then need in a large proportion of cases.
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Another psychiatric success story!
I’m so sorry you had to go through all of this. It sounds like a total nightmare. How people get PAID to do this kind of damage is beyond comprehension.
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They never want to admit the significance of the placebo effect. BELIEF can be more powerful than actual physical phenomena in the body! How much MORE causative can belief be over mental phenomena?
You’re right, they can’t really study it honestly. They can’t afford to let the results get out!
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Sadly, I can validate all of your observations in the people I’ve seen have to go through the system. Professionals who are prepared to be vulnerable and really care are rare and are themselves often attacked for doing so. I apparently had “bad boundaries,” according to those who wanted me to toe the line and stop giving my time and energy to actually trying to help people get OUT of the system and manage their own affairs. Eventually, I had to give it up because it was clear that the intention of “the system” was VERY different than my intention!
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Best Christian rock song in the history of Rock and Roll!
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The idea of the “paradoxical effect” was disproven in about 1978 by Judith Rappoport, et. al. They gave stimulants to non-ADHD teens after doing a baseline behavior check. They found the same effects – better focus, less easily distracted, less movement of extremities. Rappoport said that the idea this was different for “ADHD” kids was because people were looking for that change and therefore found it, while the “Normal” kids weren’t particularly hyperactive so no one would notice if their activity levels dropped. She called it an “artifact of observation.”
“In the 1990’s, it was thought that stimulants worked “paradoxically” in those with ADHD. That is, in people without ADHD, stimulants would cause agitation and over stimulation but in those with ADHD, they would act paradoxically and calm them down. In fact, it was considered by some to be a kind of diagnostic test- if the medication helped, then by default the person must have ADHD.
This is actually not the case.
We know today that stimulants stimulate the whole brain- in everybody. Those that have ADHD and those that don’t respond in kind. Stimulants can help everyone to focus, regardless of meeting criteria for a diagnosis of ADHD or not.”
https://www.adhd.nyc/single-post/2018/03/28/the-paradoxical-effect-from-misunderstanding-how-stimulants-worked-to-understanding-whe
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My understanding is that it’s far worse than most who haven’t experienced can imagine. I went through a VERY brief period after taking too much caffiene and being up all night. I couldn’t stand up, sit down, lay down, close my eyes, walk around – it didn’t matter what I did, it felt wrong. I’m sure this is a tiny fraction of what it would be like to have full-on akathesia, all day, every day, especially if your doctors didn’t warn you of it, or deny or minimize the effects on you. It sounds perfectly horrible!
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And all along, these people thought they were HELPING you? I’m so glad you escaped!!!
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Or to sum it up more succinctly, they have no idea how to separate “delusions” from people’s “normal” beliefs, but that doesn’t stop them from pretending they can tell the difference and charge insurance companies for the service.
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Uncontrolled sense of restlessness and discomfort in remaining in one place, induced by many different psychiatric drugs. The name literally means “Can’t stay still.” It is mostly a subjective internal experience that most folks would not notice unless they asked about it. It is reportedly very uncomfortable! I’d love it if someone who’s had this experience can add some to this description, as it seems very clinical to me and I don’t think conveys how awful it is to have to put up with.
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It sucks that they invalidated you like that! Seems like one of the worst things that happens as a result of the labelling process – soon nothing you say can be believed, they can dismiss anything you say as “symptoms.” It’s dehumanizing!
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Very well put indeed!
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“Some promise” is pretty high praise from a profession whose main intervention for psychosis causes neurological damage that can be permanent and cuts the average lifespan of the “patient” by 20 years or more!
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I find a balance of both to be optimum. I consult my emotions directly, and then use my reasoning to figure out where they’re coming from and what they’re telling me to do. I try not to act on emotion alone, but I also find that acting on intellect without consulting emotion can lead me to bad decisions!
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“I’ve met no clinician dedicated to the care of those with neurobehavioral disorders whose repertoire of treatment possibilities didn’t span the entire biopsychosocial spectrum.”
Well, I have. Plenty of them. Not all of them, but I’d say 50-50 would be optimistic in the psychiatry world.
This sentence also subscribes to a certain viewpoint, calling people “those with neurobehavioral disorders,” and assuming that “treatment possibilities” are the answer. This lens in and of itself can blind you and others who see people this way to the many options available for approaching people who are finding the world difficult to sort out at a particular moment. You are assuming you can identify these “disorders” and can assign them to people, which is in and of itself a dehumanizing process. Additionally, seeing these issues as “neurobehavioral disorders” has been shown to DECREASE empathy and INCREASE bias and “stigma” against them. So it is possible that you and many others who see things this way may fully believe you are being open minded and humble, yet still believe you can “know” what is “wrong” with another person and can “tell them” what “treatment” they need. This disconnect can prevent trust from your clients, and can allow you to unconsciously judge people who don’t meet with your expectations.
This is not casting aspersions – this is a simple truth that has been supported by scientific investigation. NONE of the DSM “disorders” have a consistent and testable biological basis, and so none of them are objectively “diagnosable.” Why not simply talk to each person about what THEY think is needed and what they want to change about their lives, and help them based on their framing of reality rather than forcing a “neurobehavioral” frame on what is often simply normal reactions to difficult circumstances?
I hope that makes some sense to you.
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Posting as moderator:
It sounds like we’re getting into different interpretations of the same statements here. My read of the comment was that the commenter was criticizing the labels as not being helpful in general, not saying that the poster/blogger for choosing that label for him/herself. It’s a very touchy area, and I can understand Lisa taking it the other way. I think I understand both viewpoints, and I think both have legitimacy, and I’m hoping we can respect that there are differences of viewpoint expressed at MIA and that they are generally not aimed at a person just because they disagree with that person. I’m glad both of you got to say what you needed to say, but I’m hoping we can move on from this discussion soon, as I don’t see any way to really resolve such a value-based disagreement. I leave it to you to decide if another comment or two is needed to come to some sort of closure.
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Well, EVERYONE’S brain is different! Having a “different brain” is not detectable, because there is no “normal brain” to compare it to. The entire concept has no real scientific underpinnings at all.
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Psychiatry has certainly NOT been standardized – they don’t even have a legitimate definition of what “success” looks like, let alone a standardized way of detecting their “disorders,” nor a standardized form of “treatment” that is even marginally effective in the broadest possible sense.
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It is odd that he says no one’s heard of it but they all think it’s garbage! How can “they” think such things if “they” never heard of it?
Sure sign that someone’s afraid to be found out when they start coming up with irrational attacks! Of course, a lot of his friends probably DO think it’s garbage, but I think the same thing about their “model!” Depends who you hang with, I guess!
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I’d add, “We don’t quite know what it is but we don’t like it so you’d better stop or we’ll punish you.”
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It’s all very understandable when you think about it.
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It’s whichever power gets the job done, I think.
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Very well put. The biggest difference in psychiatry is that psychiatrists can seriously make things up out of whole cloth and use “reference to authority” to “prove” they are right, since there are no actual criteria for success. As much as it may not be proven that reducing cholesterol levels has any positive effect on frequency or heart attacks or life expectancy, at least the “treatments” DO have to reduce cholesterol numbers. There’s no such measurement in psychiatry, so they can REALLY go wild with their claims, as soon as anyone believes their bogus “diagnoses” are real.
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For a REAL scientist, failure to prove efficacy leads to the conclusion of “no efficacy.” The “null hypothesis” is assumed true until proven false. So Atfab is talking through his hat, but it seems that’s the only way to justify continuing to prescribe these “treatments” to innocent patients who don’t know any better.
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We’d probably be better off with robots prescribing. At least they can be programmed not to be prejudiced and give the same crappy care to everyone. Less prone to power struggles, too. And that’s not an advertisement for prescription robots, either. It shows how far below the robot standards the current professions really are.
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We live in a world of marketing. Everyone seems to have an agenda that involves taking my money or power away!
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True enough! It’s just not an “antidepressant.” It’s a “manic induction agent!”
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Did we need to do a study to “discover” this rather obvious fact?
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Indeed!
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It shouldn’t be the patients’ job to act on outcomes, it should be the doctors’ jobs. It is clear they have totally abdicated that responsibility, and that they insist on using the same “treatments” despite actual WORSENING outcomes for the clients.
Though as someone else pointed out, if the desired “outcome” is to make money for the practitioners, they’re doing a fine job of it.
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Of course, no real analysis has been done on causes, because they’re afraid to find out the truth because they suspect it’s their wonderful drugs.
Of course, life survival strategies and poverty and other stresses would contribute to this, but some of those strategies are actually a result of “treatment” in many cases. For instance, smoking is incredibly common in the “chronically mentally ill” and is often blamed for these dramatic statistics. But it is well known that cigarettes increase dopamine, and a discussion with the “patients” shows that many of them smoke to reduce the adverse effects of their “medications” that dramatically reduce their dopamine levels. And of course, being a “mental patient” almost ensures that poverty will result from long-term “treatment.” Drug abuse is also common among the “CMI” population, but I’d still maintain that this is another failure of the “mental heath” system, as an effective system would make people less likely rather than more likely to use street drugs.
It’s all fine and good to blame the patients, but the hard reality is, more treatment leads to shorter lives, and there is no “explanation” that absolves the “doctors” from this horrible statistical result. No other “treatment” modality for any other disease state would allow this kind of statistic stand.
There MIGHT be subgroups whose lives are extended by psychiatric intervention, but I have seen no study that has even looked at this question. If there were such findings, I’m pretty sure we’d see huge headlines saying “Psychiatric treatments increase longevity!” even if it applied to only 3% of the population!
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Or it takes away extra time to live. The average “Seriously Mentally Ill” American still dies 20-25 years earlier than the average American. Psychiatry is the only “medical” specialty where treatment has been proven to SHORTEN the patients’ lives!
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The mistake is the assuming that a “good outcome” means the patient actually improves!
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Just for the record, I’ve never studied psychology in any depth. My specialty is actually education, in which I have an MS. I sort of snuck into the “mental health” field through the back door, which may be part of why I never really bought into the “DSM worldview” or the psychiatric dogma. I agree with you 100% that the DSM is a complete scientific fraud.
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The placebo effect is intentionally minimized in “randomized” trials. Kirsch’s findings indicate that the huge majority of “positive” impact from “antidepressants” is, in fact, due to the placebo effect.
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Especially if the benzos were taken over a long period of time.
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It seems the “Invasion of the Body Snatchers” or “The Stepford Wives” is the psychiatric definition of “mentally healthy!”
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Actually, if they’d even really rely on data, the DSM and the label-and-drug model would be long since dead. There is no “data” that suggests this approach is anything but destructive in the general analysis, regardless of some individuals possibly benefiting in their own views.
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Yeah, antipsychotics are “incredibly helpful” yet Vitamin B3 is going to do us all in! Talk about lack of credibility!
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In fact, they will tell us over and over again that there IS no cure and taking their drugs will be our only hope of “managing the illness.” The choice of “Insulin for diabetes” was not one made by chance. That’s the reality they have always wanted to create, because it justifies endless drug prescriptions and the denial of other approaches meant to actually eliminate the problems they need to sell their products.
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Computer chips in the brain – what could go wrong?
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Dignified and respectful treatment is just not marketable!
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Wow, sounds like they all resisted you at every turn! Did you get any kind of support from anyone?
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I have to say, putting the testicles on the OUTSIDE in a little skin sack is pretty good proof that “intelligent design” is nonsense! I mean, it could be “designed” that way, but is it really “intelligent?”
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I do believe in penis envy. It happens when a man and a woman are outside and it’s cold and rainy and there is no bathroom available and both of them have to take a leak!
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I appreciate you sharing your experience, and I agree that lived experience should include everyone who has such experience, regardless of what that experience is.
I do wonder, however, where you get the idea that if alternative approaches were identified, they would have been identified by psychiatry and adopted. I just finished posting on the article about Martin Harrow, who was apparently castigated and attacked for publishing research that did not agree with the psychiatric mainstream position that all “schizophrenic” diagnosed people must be maintained on antipsychotics for the rest of their lives. Harrow was no radical, he was a mainstream researcher who simply reported his findings of a very well-designed study. They attacked him simply because he challenged the status quo belief system and threatened the hierarchy’s control of the narrative. It seems very likely that the very best evidence of any alternative approach would be attacked and buried, rather than identified and accepted. That’s my view of it anyway, and I think that’s what the evidence tells us. Mainstream psychiatry is not particularly interested in alternative viewpoints.
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It says a lot that Harrow, who before his research was very much a mainstream researcher, was vilified for simply presenting the results of his research. It goes to show the lack of integrity pervading the psychiatric industry, and the lengths to which their leaders will go to stifle any attempt to undermine their cash flow, regardless of the truth of the data presented.
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Maybe more like the guy who pointed out the Emperor was, in fact, completely naked.
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Sounds like my kind of book!
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“Relapse” is not even an appropriate term to employ. It originally came from the substance abuse world, and reflected a decision to start using again, “falling off the wagon,” as it were.
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Wow, that’s a great quote!
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All very well said.
RE: iron deficiency and “ADHD”:
“The lower the levels of ferritin — a protein found inside cells that store iron — the more severe the symptoms. A small study, published in Pediatric Neurology, showed that symptoms improved when iron-deficient children with ADHD took an iron supplement.”
https://www.additudemag.com/adhd-mineral-iron-supplement/#:~:text=Low%20Iron%20and%20ADHD&text=The%20lower%20the%20levels%20of,the%20more%20severe%20the%20symptoms.&text=A%20small%20study%2C%20published%20in,ADHD%20took%20an%20iron%20supplement.
This is from ADDitude Magazine, hardly a bunch of antipsychiatry rebels!
Of course, some “true believers” try to claim that “ADHD reduces iron levels!” No accounting for human stupidity, I guess.
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I have not. Do you have a suggestion?
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Not to mention the degree to which psychiatric “treatment” leads to an INABILITY to move one’s body in a normal fashion, tardive dyskinesia, EPS, akathisia, etc.
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“Well, but, you see, it’s because the people in areas with high commitment rates are SICKER, that’s WHY they have higher commitment rates, I mean obviously, it’s not OUR fault, and it CERTAINLY doesn’t mean that commitment isn’t REALLY IMPORTANT as a tool in… oh, fuck, let’s just pretend we didn’t read that…”
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POSTING AS MODERATOR: I just want to be clear in approving the above comment that I am assuming the author means the abusive families of those “Mad people” who HAVE abusive families, as there are plenty of “Mad people’ who don’t have abusive families, though there are also plenty who do.
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Low iron and sleep apnea or other sleep problems are also frequently implicated but almost never mentioned.
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That’s exactly my reaction! If you have two options, one of which is completely safe and without notable adverse effects, while the other has all sorts of possible damage AND stops working as soon as you stop it, and both are “equally effective,” clearly, the first is FAR preferable! But the researchers never seem to say this. Maybe they’re not “allowed” to!
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You hit him where he lives, dogworld! There is no way to tell who is and is not “ill” or “disordered,” so the whole thing breaks down, and on some level, they all know this. You pointed out the emptiness of their philosophy, and of course, were attacked for doing so!
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My point is that “mad” and “crazy” have both been used historically as more or less synonymous. There is nothing about “mad” that implies “mentally ill” in the modern sense. In fact, it is also synonymous for kind of wildly creative and spontaneous. There is also the usage of “mad skills,” meaning incredibly fantastic. And of course, “mad” also has the meaning of “angry,” which makes the choice of the word “mad” kind of interesting for a website like “Mad in America” – it can reflect any of the above meanings, including having difficulty with the weird expectations of modern society AND pissed off that we are expected to “be OK” with all that AND angry at the “system” for driving us all “mad!”
So I think it’s a very rich word with a lot of nuances, very, very different from the extremely specific word, “Mentally ill,” which was created for the very purpose of “othering” folks by the “professionals” or “experts” claiming they have some authority to determine who is or is not “normal.”
Anyway, that’s my take on it. And I’m not making comments as moderator here, just me as a person expressing my views on the point. I see no reason not to have “Mad Camp” as long as the more empowered uses of the term “mad” are intended and understood. The problem to me is not the word, it’s the intention behind the word, and I don’t see “mad” as necessarily having the the intent to disempower or other a person, especially if that person chooses to identify with “madness” as a means of empowering him/herself.
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As I think I’ve said before, we’ve kind of aired this out pretty thoroughly. There are people who want to “reclaim” the word “mad” from the psychiatric profession, and those who consider it unredeemably contaminated. I think everyone is entitled to their own view on that point. “Peer” is a different issue to me, as I believe it’s fair to say the term was invented BY the psychiatric profession for the purpose of “defanging” the antipsychiatry movement, and has some associations that are hard to shake. But the term “mad” (like the word “crazy”) has a long and varied history of use over centuries. In fact, I have seldom if ever heard psychiatrists or psychologists using the term “mad” at all. They usually eschew it for terms like “mentally ill” or “mentally disordered” or even “consumers.”
But in any case, I think “mad” is going to remain an interesting and ambiguous term, and I can’t see these ambiguities being resolved in the MIA comments section any time soon!
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POSTING AS MODERATOR:
To have something taken down, just email me at [email protected] and let me know what you want removed.
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Once again, the authors bypass the obvious conclusion that using “ECT” as a “treatment” for severely depressed people should be discontinued, as it does not work and can potentially do tremendous harm to the “patients” exposed to it.
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I agree. The drive to define things as “psychiatric” is as far from scientific as it could be. It’s a big-time marketing scheme, as the inventors of the DSM III have admitted out loud. And it of course is an effort to protect the status quo social dominance system from criticism by attacking anyone who isn’t “loving it” or at least keeping quiet about their objections as being “ill” rather than “damaged” or “oppressed” or simply “dissatisfied” with the current state of affairs. As in any “dysfunctional family,” those with the power are protected and those without power are blamed. The last thing anyone suffering from emotional stress and difficulties needs is to be blamed by those in power for their own distress!
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I agree absolutely. The framing of these problems as “disorders” and the semi-arbitrary division of such issues as being some sort of unitary problems is in itself hugely problematic, and accepting that framing means we’ve lost 3/4 of the battle already. The DSM is the key to psychiatry’s claims of legitimacy, and I don’t think we can undermine psychiatry’s hegemony until we challenge the legitimacy of their bogus “nomenclature” and pretense of knowledge about things they have no real understanding of.
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I will once again point out that fearing retaliation from one’s peers or superiors for reporting abuse is not STIGMA. It is DISCRIMINATION, plain and simple. The person is not ashamed of reporting, s/he is AFRAID of the consequences of reporting the event, and for very concrete and real reasons. They are being treated in a violent and threatening manner for seeking justice. VERY different from the concept of “stigma,” if it ever actually does apply to any kind of violent victimization such as rape or sexual assault.
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Yup. You can’t diagnose a “disorder” from averages. Just because something is more common in a particular population doesn’t make it a causal factor, as many in the non-identified population still have the same “something,” just in somewhat smaller numbers. This is the big problem with both brain scans and “genomic” studies – they rely heavily on correlations, but as any beginning scientist knows, “Correlation is not causation.”
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I do get that. But most of that is in the context of “diagnosis.” I’ve heard lots of arguments about whether someone qualifies for a “PTSD diagnosis” based on whether or not their experience could really be called “traumatic.” I think this is very damaging. Traumatic experiences are at the discretion of the person feeling traumatized. Minimization is another act of discrimination that is unfortunately encouraged by the whole idea of dividing people into the “mentally ill” and the “sane,” which as we both know is not a scientifically valid distinction.
That’s my take on it anyway. Everyone on Earth has experienced trauma of one sort or another. Who is to say that being abandoned temporarily by one’s parents at the age of 6 is more or less of a trauma than being sexually molested by the babysitter or being told day after day that you’re too stupid to succeed? Something is as traumatic as the effect it has on the person being affected. No one else is really in a position to judge.
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Somehow the word “creep” being in there is kind of… well… creepy!
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Or to put it another way: Society as a whole has become less tolerant of abusive behavior towards children, and is redefining these concepts in the favor of protecting children from abuse.
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Psychiatric drugs and demon dispossession have some common roots back there historically. Both identify a vague and unidentifiable “something” that has “taken over” the victim and needs to be “driven out” by physical and or psychological means, even when the ‘exorcists’ have no actual comprehension of what the entity that has “taken over” actually might be. On the whole, I’d be more in favor of demon dispossession, though – fewer ill effects on the body in general!
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I would add that kids are almost always the targets for bullying interventions in schools, but teachers and administrators most definitely engage in bullying behavior, often without consequence. I see kids referred for “behavioral problems” that originate with objecting to being mistreated by their teachers!
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I would agree, attachment in the Buddhist sense is a much more ineffable quality than a sense of “attachment” to one’s caretakers. The latter has less to do with managing one’s desires and expectations and more to do with needing someone to keep us safe and feeling cared for when we are vulnerable and incapable of caring for our own bodies.
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POSTING AS MODERATOR:
The use and meaning of the word “Mad” has been a constant controversy here for years. I totally understand the conflict from both sides. I hope we can all accept and understand that others’ use of the word is for their intended meaning, even if it means something else to us as individuals. I find “all or nothing” statements about this unproductive, and hope we can own our own beliefs and meanings without having to accuse everyone who doesn’t agree with us of some sort of misbehavior. As the prior poster says, “language is a tricky beast,” and I think we are best served by discussing how we find the word “mad” affects us or how we might seeing it affect others without the assumption that everyone has to see it the same way.
Hope that makes sense. I don’t think we’re going to come up with a black and white answer to this nuanced question!
P.S. I just came across this from Laura O posting earlier on this same thread. I hope she doesn’t mind my using it as a model. It is a perfect example of how to critique the use of this word without attacking others who see it differently:
“I, too, would never label myself or others as “Mad”. For me, it’s a condescending, disparaging word that minimizes the very real suffering survivors experience in their lives.”
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Thanks for that. I still see the old email under your name. Maybe you can send the new one to me at [email protected]?
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Alice Miller would agree with you!
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The biggest problem with Freud is that he chickened out. He had it right at first, that many young women were being sexually abused by their relatives or others, and that their “Mental health issues” were largely caused by this. But his colleagues attacked him and he backed down, deciding that these recollections were “fantasies” in order to protect the men of the day from scrutiny. It took another hundred years before we finally came back to the point, and there is still a TON of resistance to the idea to this day. A large part of the effort to blame “mental illness” on the victim’s brain is that it deflects attention from the real causes, which are generally abuse/neglect, poverty and social dysfunction.
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I agree 100%. I had a dog who was neglected in her early life – she was constantly anxious and needed to be petted all the time to keep from freaking out. She also used to compulsively run away, much like abused/neglected teens in foster care often do. My friend also had a parrot who behaved quite “normally” most of the time, but whenever a wooden stick or rod was brought near him, he totally freaked out, going back and forth between attacking the stick and trying to hide from it. Sounds a lot like “PTSD” to me! (I mean the parrot, not my friend!)
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LOL!!
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To yinyang: I have revised this comment slightly so it will pass our Posting Guidelines. I was unable to send you an email to discuss it, not sure exactly why, . If you want to be informed of or have feedback into moderation decisions, I’ll need a functioning email address from you. Thanks!
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Hey, Diaphanous,
Great to hear from you again! I’m glad you have a plan going forward. Sometimes there are no easy answers, but I think taking as much control and responsibility as you can is most likely to give the best results!
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What a sad and infuriating story! Somehow we have to get this information out there to those who are vulnerable or who care for the vulnerable!
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Seriously, these folks are reaching pretty hard if they’re claiming that low birth weight is somehow a genetic factor!
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Agree 100%!
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I agree completely. It’s easy to forget why those laws were put on the books. It was because of serious and repetitive and unapologetic abuse. It is always very dangerous to afford one person power over another, especially with the façade of “helping” the person we have the power to control.
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Wow, great to hear from Alice Miller again! Her wisdom never grows old. And now we have “neurological findings” to support what we’ve all known to be true all along!
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It has always been my belief from observation that the main action of “antidepressants” was a general blunting of emotion. That result is described by many who take the SSRIs in particular, and fits with both the “positive” and “negative” reported effects. If one is very anxious all the time, a blunting of emotions can be associated with reduces anxiety, which might seem positive. If one is being held back from doing impulsive things (including killing oneself or harming others) by fear of the consequences, blunting may result in manic episodes, increase in suicidality, or increase in impulsive violence, including those occasional murderous acts we all have heard about. Loss of sexual function is also consistent with blunting of physiological sensations and with impairment of the motivational system to rewards (rewards are less rewarding, hence not as much worth pursuing, or sometimes not even physiologically feasible). There isn’t much that the SSRIs do that isn’t explained by emotional blunting. I think that is their main mechanism of action. And I think it is well worth recognizing that these are not “antidepressants” but “antiemotion” pills, and to ask whether this is really something that society as a whole really wants to be promoting as a benefit.
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Precisely!
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That is exactly how I used to work. I always used the client’s exact words or as close as I could get in framing the problem. The only purpose for DSM “diagnoses” was to obtain reimbursement, and if the topic of “diagnosis” ever came up in discussion (and it usually did not), I would tell them exactly that. I’d say I gave them the best “diagnosis” I could to get them the kind of help they were needing/asking for, and that the “diagnosis” meant nothing else but that. I always told folks that they were the only ones who knew what, if anything, was “wrong” and what would work. I was just helping them to sort that out for themselves.
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Or perhaps they should admit that the “mental illnesses” they are studying are actually in most cases the effect of chronic stress and stop pretending they are studying genetics of behavior at all.
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You are not taking responsibility for the impact of your invalidation of others. You have not demystified anything that I can see, it comes across that you have simply told another poster they were too stupid to figure out how to get EMDR paid for. It came across as condescending and had a hurtful effect. I would hope that you as a professional carer would want to know that so as to avoid doing similar harm in the future. At a minimum, you could own your own experience (“I personally haven’t had that problem” or “It’s my understanding that most insurance will pay for EMDR”) without telling the other person they were wrong for saying otherwise. You don’t know enough about their situation to presume to tell them what can and can’t be covered in their context, and I think you’d be well served to remember that next time you comment on another person’s experience.
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Rachel, I’m baffled how many times you seem to have taken the exact opposite from my words that I am intending to communicate! I am a HUGE believer in the impact of environment and family upbringing as the MAJOR CAUSE of most of the DSM “diagnoses,” and science backs me up on this point. Where on earth did you get the idea I thought otherwise? I need to figure out what I’m saying that is not getting across to you. It’s really confusing to me how you are mistaking my meaning so frequently, even though I sense that you are doing your best to make sense of it!
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I do not. Nor was I saying he was saying that, in fact, I was lauding him for saying it was not an either/or thing. I’ve known WAY too many in the psychiatric world who DO insist it is an either/or thing and have had many a frustrating conversation about it with “professionals” who ought to know better.
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Touche! It is fascinating that the psychiatric mainstream claims that these “mental illnesses” are all or mostly genetic, yet they have to use torture of animals to create similar circumstances. Wasn’t the “wire monkey” set of experiments sufficient to establish that early childhood mistreatment/neglect leads to a host of “mental illnesses” for adults? How many times do we have to do the same experiments and still fail to see the real results?
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I am glad to hear that. Anyone claiming that either nature or nurture is the sole cause of aberrations in human behavior is selling something!
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Quite so. But you and I are in no position to judge how easy or difficult it may be to find a provider willing to support/justify the treatment the client wants. I’m saying it’s important that folks with professional backgrounds, like you and I, learn to step down from our one-up power positions and listen to the people actually in the trenches seeking services. If someone says, “I can’t get a therapist who will provide EMDR because I have a BPD diagnosis,” it is our job to listen to and believe them, because we are not in their position. A more respectful approach would be to ask some questions, like, “What state are you in? What have the therapists said to you when you asked? Is it the therapist refusing to ask or the insurance company refusing to cover it? What kind of “reasons” are you getting from the insurance company?” Then maybe we can help that person find a path toward getting it covered. Just saying, “No, you’re wrong, it’s covered by your insurance” comes across as both condescending and invalidative of the very real experience of the poster. It is, for lack of a better word, a rather unprofessional approach, IMHO.
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As I have always maintained, people act a certain way because on some level it seems necessary or wise for their own survival. To think that folks can simply “think away” their own history and the reasons for their fears and their insistence on or avoidance of certain situations is actually quite invalidative of their experience. And suggests simplistic answers, such as “Just think the right thoughts and you’ll feel better soon!” which are hardly realistic for people struggling with past and often current abuse, often by the very system that’s claiming to help them. And it provides cover for blaming the victim for “failing to think the right thoughts” or “failing to take the program seriously” when it doesn’t work for them.
I’ve been told by several people that DBT practitioners sometimes FORCE people to engage in “mindfulness” activities. Nothing could show more ignorance of how mindfulness really works than thinking you can force someone to do it and expect any kind of results. These manualized “therapy programs” are of very little use in most cases, as what the person really needs is someone to LISTEN and UNDERSTAND them, and help THEM make their own minds up about what they want to be different and whether or not a certain approach is working for them.
And your last comment is most important. There is no way to completely set one’s issues aside as a therapist. The best one can do is to be aware that you DO have issues and you WILL bring them to the session, and to be aware enough of them to distinguish between your own needs and the client’s needs. The number of people who can actually do this is incredibly small!
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Not saying that at all. I’m saying to do legitimate scientific research, you need a legitimate research group of people who have something that makes them the same. Murderers don’t qualify as such a group, as they are selected by a specific kind of behavior AND by the fact that they got convicted. It could be an interesting subject that might LEAD to some scientific hypotheses, which could then be tested, but simply comparing brains of convicted murderers smacks of “phrenology,” where the head shapes of criminals were compared to conclude what commonalities criminals shared in order to predict criminality. It was, of course, a complete bust, but it all sounded very “scientific.” So far, brain scan research has been used to “explain” a lot of things that it doesn’t explain at all. I’m very skeptical based on the sketchy history of brain scan research as well as the obvious heterogeneity of the group of “convicted murderers” and would have to see the basis for the research to judge.
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It’s one thing to say it is “covered” as in “it is reimbursable.” Whether a person can actually GET coverage is much more complicated, as they require the insurance company to decide the treatment is “medically necessary,” which is hardly a black and white decision, and biases and financial conflicts of interest often enter into the equation.
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It’s always interesting to listen to these ideas, but they are mostly very unscientific, relying on the assumption that correlation = causation. The fact that there may be some similarities between brain scans of two people who happen to be murderers proves absolutely nothing at all. Until we can see that most or all murderers have the same brain activity/structures and that no one or almost no one who doesn’t murder doesn’t have them, we have nothing of use scientifically. Murder, like all human behavior, is extremely complex, and there is no reason to believe that it is “caused” by a particular physiological state.
I just wanted to clarify where I was coming from. My main point is that you can’t vote diseases in and out of existence. There needs to be some sort of objective means of distinguishing between who does and does not “have” a particular “diagnosis,” and such means simply do not exist for ANY “DSM diagnosis.”
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Agree on all points.
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I think you are speaking in technical terms of what is theoretically possible, while the other posters are speaking in terms of what ACTUALLY HAPPENS in the real world. It’s probably neither possible nor appropriate for those of us who haven’t been in the position of seeking “treatment.” I defer to those who have been on that side of the table.
That being said, I really do appreciate your efforts to destigmatize the BPD “diagnosis.” I think your framing of these “diagnoses” is about as sane as anyone working within the system can make it. But I do think it’s important to remember that you (and I) are/were outliers and that most clients of the “mental health system” are not treated with anything close to the degree of respect for their context than what you are describing.
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I refer to it only as a way that some people identify themselves. Of course, I don’t see psychiatry as a “product” in the same sense as a tube of toothpaste. First off, toothpaste doesn’t pretend to be more than it is. Second, no one can legally force you to accept their “toothpaste” as a “product” that they can force down your throat! I suppose the person is a “consumer” in the sense that they are forced to “consume” the drugs that are selected for them, but the social meaning of “consumer” suggests a person who can use their buying power to influence what products are available. That certainly does not apply to the bulk of psychiatric “participants,” willing or not.
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MUCH better outcomes, when you removed the syphilitic and dementia cases from the cohort.
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It is extremely easy to describe a behavior without a label. Some examples: “I feel worried every time I go out of the house. I’m not afraid of anything specific, just have this big surge of anxiety.”
“When Mary visits her mother, she sees things in the house that remind her of her sexual abuse as a child by her father, and she often experiences flashbacks of the event.”
“Monique has never left her children with another caregiver in 5 years. She states that she is afraid that her children will be sexually abused. When asked, she relates that she was also sexually abused as a child.”
These describe what is happening far more accurately than “I have agoraphobia” or “She suffers from PTSD” or “She’s got an adjustment disorder.” And they invite an exploration of why these things are happening, and what might be done about them. In the latter case, a very short intervention inviting her to find someone she knew would NOT sexually abuse her child and make a plan to get a break led to a COMPLETE TURNAROUND in her life, from suicidal to passionately pursuing a sexual abuse recovery program. I met her two weeks later and she was virtually unrecognizable, she was so pumped. So why did she need a “diagnosis?” She did not. She needed someone to be interested in her situation and to drill down as to her motivations and to help her take some sort of effective ACTION to challenge her unproductive but understandable fears.
Some doctors THINK “mental illness” is a ‘misfiring of the brain,’ but no one really knows what that really means, even though they say that. There is no evidence of “proper firing” or “misfiring” that they can point to, no measurement of correct “chemical balances” that they can perform, no “normal brain” they can compare yours to and show some sort of abnormality. I find (and science supports me in this) that this kind of explanation leads many folks to feeling hopeless and disempowered, and deflects attention from the causes and possible interventions that might let the person herself take more control of her life.
I am certain that different people have variations in their genetic makeup, and I don’t exclude the possibility that in SOME cases, this may create some kind of vulnerability. But that does NOT make the genetic differences a “disease” marker. First off, there is absolutely no reliable evidence that any “mental disorder” associates with any “genetic abnormality” in the brain. The best correlations are in the single digits for large groups of genes considered together, but none is even close to being able to predict ANY “mental disorder” in the entire manual. Whereas most “mental disorders” correlate at over 80% levels with childhood adversity and mistreatment. Since genes are the one thing in the entire equation we can NOT change, it seems pretty silly to spend billions researching genetic causes when we know that childhood adversity is a very ADDRESSABLE reason for these “disorders” occurring.
In your case, you yourself identify that others with similar genetics have some similar behavioral tendencies, but your case became more severe because of the abuse you suffered. It seems if you need a “diagnosis” it ought to be “Victim of childhood violence,” which is at least observably true. Saying someone “has OCD” and trying to blame it on your brain is very typical psychiatric narrative, but it is pure speculation on their part, they know NOTHING about the actual causes of these behaviors and emotions.
If their approach works for you, more power to you. I would never want to take that away from you. But your personally benefiting from what they did with you does not legitimize the DSM, which the head of the NIMH himself said “lacked validity” a few years back. The NIMH even stopped using the DSM diagnoses for research after that time. It is VERY legitimate to question the DSM categories scientifically, and it has nothing to do with believing or not believing that people in distress need assistance. I think everyone should do what works for them, but I am opposed to lying to people about what is known just so they’ll be more comfortable accepting whatever treatment is offered.
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I am not calling you “brainwashed,” and I have never suggested eliminating all treatment, and I don’t know how you would draw that conclusion from what I wrote. My comments clearly criticize not TREATMENT but the idea that the DSM can “diagnose” people accurately of some kind of medical problem using checklists of problematic behaviors, thoughts, and emotions.
Perhaps you are thinking that DSM “diagnoses” are the same as treatment? I understand that people benefit from getting outside help, and professional assistance CAN be quite useful to some folks if you have the right professional and the right approach.
But pretending that somehow professionals can distinguish between “obsessive thoughts” and “intrusive thoughts” and normal thoughts is not scientific, and the DSM itself says it is unable to do that. I’ve helped lots of people over the years improve the condition of their lives, and never once did a “diagnosis” play any role in helping bring it about.
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Most psych survivors were psych consumers at one time. I’d say it depends on the “consumer.” Those who are invested in promoting the current system need to be left alone, but there are many “consumers” who are confused, angry, frustrated, and beginning to doubt the veracity of the psychiatric narrative. Such people need to hear from survivors rather than those other promotors of the status quo referred to above.
I consider it bigoted to assume that all “consumers” are the same.
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I understand that you believe these “disorders” have some real scientific meaning. I do not. Being very familiar with the DSM, these “disorders” are very simply descriptions of behavior or thoughts or emotions a person might have which tend for whatever reason to occur together.
Intrusive thoughts are VERY common with people recovering from traumatic experiences, and seem to actually be part of the DSM description for PTSD. So how can you tell if you have “covert OCD” or “PTSD” or simply have thoughts you don’t want to have that seem to come from the outside? I’m not against DESCRIBING things I just think putting a name on something one observes is not the same as “diagnosing.” A diagnosis ought to be aimed at establishing cause, distinguishing between seemingly similar presentations based on cause, and distinguishing between effective treatments/interventions for the situation. As a former counselor/therapist, I found little to no value in labeling a person’s experience based on the DSM. I simply went directly to “What are you experiencing?” and then looked for the underlying reasons the person may be experiencing these things. “Intrusive thoughts” can have many different origins, and I’d start by asking what the thoughts were and when they arose and go from there. No “diagnosis” is needed – all I needed to know was that the client was willing to share their experiences with me and help me understand what was happening to them. The only reason I ever gave a DSM diagnosis was for insurance reimbursement, and that’s about all they are good for, IMHO.
I’m sorry if that clashes with your beliefs, and I don’t expect you to agree with me or think less of you if you don’t. But my opinion is based on decades of experience and I’m not likely to change it, as I feel I have a very good handle on exactly what these “diagnoses” really represent.
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I don’t care how the DSM 5 “organizes” their fictional definitions of “disorders.” As I noted, the DSM itself admits it can’t clearly distinguish between someone who has Disorder A or Disorder B or Disorder A and nothing at all wrong with them. It goes on further to say that “There is also no assumption that two people with the same disorder are alike in all important ways.” In other words, two people with the same “disorder” may have very different needs and very different causes and very different approaches may be needed to help them, even though they have the same “diagnosis.”
What is the point of “diagnosing” people with something that they may or may not have, when even those who fit the same “diagnosis” may have totally different problems requiring totally different solutions? It makes the concept of “comorbidity” more than a bit of a joke. Do I have “excessive digital-nasal insertion disorder” or do I have “itchy nasal passage disorder?” Maybe it’s comorbid, because my nose itches AND I pick my nose to relieve it? Or is the latter simply a consequence of the former diagnosis?
The real question is, why should anyone care what label you put on my behavior? Why not just let me pick my nose, or help me with the itchiness or find something useful to do besides “diagnosing” something you have absolutely no understanding of?
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It is so obvious how biased they are toward the evidence by how they talk about it. For abuse to have CAUSED “schizophrenia,” apparently we need proof beyond a reasonable doubt that EVERY case of “schizophrenia” is caused by abuse, despite there being no reason to assume all cases of “schizophrenia” are caused by any one thing, it being a behavioral syndrome that could have many causes. But for biological causation, a tiny correlation of hundreds of genes associated with less than a tenth of cases is evidence that “schizophrenia has a biological cause,” even though correlations with childhood abuse are ten or a hundred times stronger. How is it that the world of science and medicine is still willing to entertain and publish such obviously biased nonsense?
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The very concept of “Comorbid disorders” presumes that the DSM is able to distinguish between one “disorder” and another, while the DSM itself asserts its own inability to do so.
“In DSM, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no disorder.”
In other words, there is no clear line between “disorders,” so the concept of “comorbid disorders” is totally invalid.
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I would also ask why we would assume that the woman would NOT have lay down on the bridge just because she was “medicated.” And the term “leaving [her] unmedicated” reflects a very paternalistic attitude, as if we have a right to “leave” or “not leave” her in a particular degree of “medicatedness.” As if she herself has no particular rights to decide her own course of action.
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It is often NOT covered by insurance.
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“Nature therapy” is the one that irks me most. A walk in the woods has now been turned into an “intervention!”
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Are they now going to call for “compassion therapy,” doing “nice” things for others to improve one’s “mental health?”
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Do they also vote on a ‘consensus definition’ of recovery from the flu, or a heart attack, or a broken leg? What kind of a medical “disorder” requires people to VOTE on whether or not you’re recovered?
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Meth is quite literally a drug used to “treat ADHD.” They call it Desoxyn. I kid you not!
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I think any medical diagnosis needs to be able to differentiate between a “normal” and a “diseased” state, objectively and consistently. Medicine is to treat the BODY. “Psychiatry” and “Psychology” are supposed to deal with the “psyche,” aka the Human Spirit. Attempts to treat spiritual issues with drugs and surgery and electric-shock-induced seizures are doomed for failure. So I think the “treatment” of any spiritual/emotional condition does not belong in the realm of medicine, and therefore the idea of “diagnosis” in the medical sense is irrelevant, and likely unavoidably destructive.
I much prefer the use of descriptive language. “Mary hears voices speaking to her that others can’t hear. She is feeling very anxious and worried that the voices are going to tell her to kill herself, as they have done in the past. She feels safest at her sister’s house, who is good at calming her down.” That sort of thing is a LOT more helpful than saying, “She’s got schizophrenia!”
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That is EXACTLY how I look at it. Why the labels? Why not just describe what is going on, unless you REALLY understand what’s behind it?
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I never have agreed with almost anything Dr. Pies has said. He’s a marketing agent for psychiatry.
What he’s saying in the article is technically true, but he is not taking into account HOW the DSM is used. The fact that someone has a “medical diagnosis” opens the door to stigmatization, which has been proven over and over again to be greater the more medically the causes of these “diagnoses” are viewed. A lot of the text he includes are from the introduction and clinical guidelines, which I’m sorry to say most clinicians don’t bother to read, or if they do, fail to put into practice. Pies also fails to give any reason, and in facts argues AGAINST it, for putting people into these “fuzzy categories” in the first place. Any reasoning he uses is more sociology/anthropology than medical in nature. By admitting there is no clear boundary between one “disorder” and another, and between having a “disorder” and having “no disorder,” he acknowledges that the whole house of cards blows down with the slightest puff of air.
Here is an example in his own words: “When a patient presents with the complaint, “I hear threatening voices in my head,” we simply must diagnose—a word whose etymology means, “knowing the difference between.” For example, we must know the difference between “threatening voices” stemming from combat-related trauma, on the one hand, versus schizophrenia or anti-NMDA receptor encephalitis15 on the other. Otherwise, our treatment is likely to be misguided.”
Note he gives NO real reason why he “MUST DIAGNOSE,” and defines diagnosis as “knowing the difference between.” But he just admitted above that the DSM itself asserts no ability to “know the difference” between being disordered or not, or between having one diagnosis or another! So giving a DSM diagnosis does NOT provide “the difference between,” it actually confuses such efforts by lumping people with widely differing problems into the same “diagnosis!”
Notice also in his example that he is NOT talking about differentiating between “mental disorders,” but between causes (Combat trauma, encephalitis, or the mysterious and undefined “schizophrenia,” which is such a vague “diagnosis” that the Japanese are not even using it any longer.)
In short, Pies and company talk a good game, but when you look at what he’s REALLY saying, it’s simply more marketing of ideas that don’t have any scientific basis at all.
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Again, this would not be a “cause” of “ADHD,” as the large majority of those so diagnosed do NOT have this mutation, and there are apparently lots of people who have the mutation who DON’T get diagnosed with “ADHD.” There may be a VERY small subset of those diagnosed who have this problem, and I have no objection to folks testing for this anomaly and doing some sort of research on the tiny subgroup. But at that point, they are no longer diagnosed with “ADHD,” they are diagnosed with CDH2 mutation, which has to be made very clear in order to get any useful outcome.
As to stimulant “treatment,” as I indicated earlier, there is little to no evidence that using stimulants in the long term improves overall outcomes for the “ADHD” cohort, and there are notable adverse effects, including growth retardation, loss of appetite, and psychotic symptoms in up to 10% or more of users at “therapeutic” dosages. But one would have to look at the CDH2 subgroup and look at them separately to really answer that question. In my book, if there are risks and no real long-term benefits, I don’t care if there IS a biological cause, there is nothing to recommend assuming the risk of drugging kids without a clear and substantial benefit.
The other problem is who gets to define what is beneficial? If the teachers are telling the story, they might decide that being relatively inert and sitting quietly in a chair all day is a beneficial outcome. But what about from the kid’s point of view? Nobody bothers to ask what THEY find helpful in most cases. It’s an intervention for the benefit of the adults. As I said, why is there no “hypoactivity disorder?”
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I agree, to be scientific, one must be skeptical and always open to new data that disconfirms your hypothesis. To the exact contrary, the psychiatric/psychological industries have a marketing approach, searching for and emphasizing every tiny snippet of data that supports their contentions, and going far out of the way to bury or discredit even bury data that disagrees with their preferred narrative. As soon as you start selecting which data you want to pay attention to, you’ve left the ship of science!
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Exactly. It seems a gradual narrowing of “normal” is happening, and instead of “normal” we now have “acceptable” or “appropriate.” Which is of course defined by the authorities in charge. I think it crosses the line from puzzling into evil.
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They most definitely had the right idea!
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I would submit that Buddhism, for instance, does not require or teach conformity, except to the extent that certain practices are recommended to improve one’s understanding of one’s own spiritual nature. I’ve also been to Quaker meetings, where there is no preacher or designed program, but the attendees are encouraged to get in touch with their “intuition” and speak as they feel moved to speak. I don’t see much conformity there, except that you need to be quiet while others are speaking and not invalidate or criticize what they share.
I definitely see that organized religion tends very strongly toward enforcing conformity of both belief and actions, and often uses fear to create compliance. I have never had any patience with such practices. I think we should all be in touch with our own inner sense of what is “right” and true, rather than following some outside interpretation of reality. That’s one of the reasons I love the Quaker approach. Nobody gets to tell you what God (or whatever spiritual reality a person might believe in) has to say to you. You get to seek those answers for yourself.
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That’s the other good point – we know that healthy relationships can “heal” whatever changes to the brain occur as a result of trauma, at least to an extent. Why we waste time on all these biological cause studies when we KNOW that social conditions can be improved and result in improved outcomes is quite puzzling. Unless we postulate that those providing “treatment” aren’t really that concerned with people’s outcomes being improved?
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I think we’re overgeneralizing a bit, though. Not ALL religious are about conformity. There are lots of brands of religions, and the same nominal religion can have sect with WILDLY different approaches! But I do agree that humans tend to turn any religious practice in the direction of conformity, and the more “organized” it is, the more authoritarian it seems to get. But that’s just my observation.
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So are you saying that large pharmaceutical companies DON’T frequently promote their products by hiding data and lying to the public and overstating the benefits and downplaying the adverse effects of their product? Do you remember Vioxx? The lawsuits they “settle” out of court, like the one for falsely advertising antipsychotics for children? You don’t think that PharmA lobbyists are buying influence in Congress? And I’m not just talking about checking labeling – I’m talking about assuming that doctors are always telling the truth and have your best interests in mind.
Take the antidepressants as an example. It was a known fact that they caused aggression and suicidality in a small but significant number of recipients, way back in 1987. Prozac was initially banned in Germany for that very reason. But it took until something like 2003 for that warning to get onto the label. Why do you think that happened? Do you think no one NOTICED? Or perhaps they suppressed this information in the interests of making profits? Do you really think they are beyond this? Or that doctors are all above board and honest and well educated when they get a ton of their information from drug reps?
I don’t think the regulation of the drug industry is any better than it was 40 years ago – in some ways it’s worse! Did you know that you can get a drug approved with just TWO studies that show it’s even marginally better than a placebo, even if there are 80 studies saying it doesn’t work or makes things worse? It used to be three were required. Hardly an improvement in the regulatory system.
I’m really not sure why you seem to be making this into a black and white issue. The world isn’t divided into those who qualified to interpret medical information and those who are doomed to accept their judgment. I notice you have not acknowledged that an intelligent person CAN personally read scientific research and draw his/her own conclusions without the intervention of a “medical professional.” Do you think that is impossible? Are doctors automatically smarter than I am? Are there no incompetent or corrupt doctors out there who can’t be trusted with my body and my life? If I can’t decide that, who can? And how would I decide if I’m too dumb to do my own research?
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Who said only trusting oneself? Clearly, I’m advising doing scientific research, speaking to other doctors and medical professionals for second opinions, looking at proven alternatives, etc. I’m saying that AUTOMATICALLY trusting that what a doctor is telling you is the truth just because they are a doctor is foolish and dangerous. It’s also bullshit that no one is smart enough to learn on their own a good bit of important information that doctors may or may not share with you. You don’t need qualifications to read scientific studies in many cases, or to simply read the patient handout for any drugs you are prescribed, especially when we’re talking about psychiatry/psychology. Not saying I would determine for myself what drugs (if any) to prescribe, but it’s not that hard to discover that your physician is talking through his/her hat with a little research.
My dad was taking blood thinners after a heart attack. He went to a doctor, told him all about every drug he was taking, and was given a second prescription. Within a day or two, he was having instant bruising when he put his elbow on the table or pressed his finger into his arm. He looked up the second drug he was prescribed, and it said in BOLD LETTERS: CONTRAINDICATED WITH BLOOD THINNER X. DEATH COULD RESULT. He was hemorrhaging at the slightest touch. A minor car accident or a fall off a chair or small ladder would have certainly killed him on the spot. Yet the doctor knew all his medications and still prescribed this deadly combination. Are you suggesting he wasn’t “qualified” to look up the drug and discover it is contraindicated with the blood thinner he was prescribed, nor to conclude quickly that his subcutaneous bruising was almost certainly caused by the noted negative interaction between these two drugs?
Every since that time, I NEVER take any drug until I’ve looked it up and examined side effects and contraindications. If my dad had fully trusted that doctor without question, he’d almost certainly have been dead at 40, instead of living until he was 85. Unquestioning trust in doctors is as dangerous as going it alone with no advice. In psychiatry in particular, going it alone may in fact be safer in many cases.
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It is saying that you can’t trust that the doctors or Big Pharma are going to give you honest information. I don’t think it’s promoting the “untrained public” to “self medicate,” it’s promoting asking questions and doing one’s own research and getting multiple opinions before assuming that the “information” you have been given by the professionals is automatically to be trusted.
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You are right, of course, I should have put “medication” in quotes, or used the term “drugs.” “Medication” is a euphemism, especially when the drug is given for no discernible medical indication.
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Yes, animals do appear to commit suicide:
https://qrius.com/humans-commit-suicide-animals/
I think it is EXTREMELY damaging to “put thinking suicidal back in the closet.” This will make it MORE likely that people will kill themselves because they can’t talk about it! I used to work a suicide hotline and have talked to hundreds of people who said they were considering suicide. The vast majority were not “threatening,” they were simply desperate to end the pain they were experiencing and wanted some kind of help.
I have heard of people, especially domestic abuse perpetrators or child molesters, threaten suicide when consequences ensue for their bad behavior. This is a different matter and should be dealt with much more harshly, I believe, as it is an attempt to use the threat of suicide to manipulate or control others and avoid accountability. But the vast majority of suicidal people are looking for someone to talk to and connect with.
Of course, there are also those who rationally decide that suicide is the best next step in their lives, based on health conditions or something of that nature that has a very grim future prognosis. It would seem cruel to deny such people the right to talk over the pros and cons of their options, including suicide, so they can make the best decision they can.
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I am saying all of those things. When “ADHD” is defined by a set of behaviors, most of which are based on school behavior, and none of which are even slightly objective observations, you’re going to get a group that has little to nothing in common with each other except the behavior. It could be totally normal for that child at that age and stage of development. It could be the result of nutritional deficiencies, particularly iron, or sleep problems. It could be an indicator of problems in the home that are not addressed, particularly domestic abuse. It could be an indicator of prior trauma and possible “PTSD” symptoms, where there is a huge overlap with “ADHD.” It could be an incompetent teacher who doesn’t know how to manage a class and provokes resistance from the more sensitive or the bolder kids. It could be the child is bored to death because s/he is way ahead of the class and isn’t being challenged at all. All of the above considerations could cause the “symptoms” described as “ADHD.”
Here are a few of these “symptoms:”
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick to tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
Not one of the above is in any way objectively measurable, and none require any kind of medical “explanation.” Most are just ways that kids act when they are young and less mature. Ever know a kid who acts without thinking, or interrupts conversations, or had a hard time waiting their turn? More importantly, how many kids do you know who do NOT engage in these behaviors at least some of the time? How could you possibly tell when a kid “interrupting conversations” reached some critical level that it becomes a “symptom?” And why would we assume that any of this is caused by some sort of “brain problem?”
A very interesting study shed some light on the advantages this “ADHD” behavior actually conveys on kids and on society. They took groups of three kids and gave them a set of three problems to solve. One bunch had two “normal” and one “ADHD” kid in each group. The control groups had three “normal” kids in each group, no “ADHD” kids. They measured how often the group was “on task,” working on solving the problems. The control groups did significantly better on this measure, while the “ADHD” groups goofed off or screwed around more and spend a good deal less time working on the problems. But NONE of the control groups solved any of the problems, while all of the “ADHD” groups solved at least one and I believe a couple solved all three! So their goofiness and off-task behavior allowed for more creativity and outside the box thinking and meant these problems got solved.
Now if they’d had groups with THREE “ADHD” kids, it’s quite possible nothing would have gotten done at all! But it shows that we NEED these “ADHD” types to help us solve problems, and that having ALL conventional thinkers in our society will most likely lead to stagnation and failure.
It takes all kinds to make a world, as they say, but apparently psychiatry has no idea what that means, as they want to make all kids act in ways that keep the adults happy. And that’s what I believe “ADHD” is really all about.
Notice there is no “Hypoactivity” disorder? I think that says a lot!
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Some have claimed that “ADHD” brains are smaller on the average, but those studies did not take into account medication use, which shrinks the very parts of the brain they say are smaller, particularly the cingulate gyrus. Additionally, even if these studies were accurate, they are AVERAGES, which means that lots of people WITHOUT “ADHD” diagnoses have smaller brains and lots of people WITH “ADHD” diagnoses have larger brains. It is obvious that if these were “causes,” it would apply to all of them. There is no evidence that everyone with “ADHD” has any kind of similarity in brain structures, so that claim is BS.
Of course, a lot of psychiatrists will tell you that your kid needs “treatment.” That’s just what they do. Until and unless they have some evidence that this “disorder” is actually a disease state, you are safe ignoring them. It’s also VERY important to note that kids who are “treated” with “ADHD” drugs do not do any better in the long run, academically, socially, or physically, than those who are “diagnosed” but don’t receive any stimulants. So the “treatment” is not worth anything much in the long run on the average, even if some seem to do better taking the drugs.
My final point is that even if the “ADHD” child is in some way biologically different, difference is not the same as disease. Species survival depends on genetic diversity. There is no reason to think that being less patient with boring stuff and wanting to move around and not follow rules is evidence of anything “wrong” with the child. I think the main problem is that we try to expect kids to do things that are abnormal to expect kids to do. The strong evidence of this is that fully a THIRD of kids diagnosed “ADHD” in Kindergarten prove NOT to get that “diagnosis” if they wait a year later to enroll in school. A third grow out of it in one year. That’s not a “disease,” that’s a problem of inappropriate developmental expectations.
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I’d love to see that experiment!
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Who is trying to take away your Adderall? Certainly nobody here. If it works for you, that’s your decision. The problem is not with people taking Adderall if they feel it’s helpful, the problem is telling everyone that these difficulties are the result of a “disease state” despite having little to no evidence that such a “disease state” is valid and verifiable.
It’s not about the drugs. It’s about the “diagnoses.”
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Amen!
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That really sucks!!!
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I don’t think it’s broken. I think it serves a different purpose than it pretends to. It does quite well in making money for certain people and keeping other people under control or sufficiently diminished in capacity to not be threatening to the status quo.
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It sounds awful! I don’t understand how psychiatry can look at this kind of result and feel “successful.” It is criminal what they’ve done to you!
Do you have anyone you can talk to who would understand and provide some support to you? I mean real PEOPLE, not “professionals” pretending to “be there to help.”
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That is disgusting! The discrimination against anyone with a “mental health” label is bad enough, but these folks have used that to leapfrog their anti-gay biases into the forefront! Thanks for sharing your story!
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Excellent counterexamples of the “need for forced treatment!” I’m so sorry you had to go through this kind of crap. And I think you are right, it remains invisible to most “insiders,” because those who have been essentially arrested and held against their wills are totally willing to say whatever they need to say to get the hell out of there. So if you ask a forcibly incarcerated person in a “mental” ward if they were OK with being detained, the smart ones will say, “Oh, yes, BLESS you, I’m SOOO lucky you put me in here, I’m SOOO much better now, can you please unlock the door and let me go home?” This is not even taking into account the phenomenon of “internalized oppression,” where some of the victims spend a lot of energy trying to explain why their abuse is “understandable” and somehow deserved, as a means of avoiding the conflict of being the adverse effect of an overwhelming power that they can’t possibly match. I’m usually all for asking the client to let us know the truth, but asking people in the hospital psych ward involuntarily if they agree they ought to have been detained is going to give you a very distorted picture of reality.
Thanks for sharing your stories. I hope some of those “insiders” take a good look at the utter randomness of these events!
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REAL science DOES show psychiatry and the DSM to be fraudulent. The problem is, psychiatry pretends to be “scientific” when it is actually opposed to real science, which shows it up as a flop every time.
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Not only do they “report” data, they distort it, hide it, or sometimes make it up from whole cloth. If they were real scientists, they’d have given up on the “bio-medical model” decades ago. These professions are more like marketing agents, only putting forward such “data” as promotes the products they are selling, and hiding or minimizing or distorting anything that might harm their bottom line.
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I prefer a chain saw, myself. Or maybe a band saw. Gets it nice and even!
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Certainly not in the Halls of Psychiatry!
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Isn’t Lunesta one of those drugs where you can drive around and do things as if conscious but not remember any of it?
Sounds like a freakin’ nightmare!
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I agree – noise is everywhere, both auditory noise and visual “noise,” constantly bombarding us with messages we don’t have a choice whether or not to receive.
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It is quite clearly and obviously a violation of the concept of “informed consent,” which is supposed to be central to medical practice in any form. To simply justify lying as “It gets more people to accept our drugs” is not practicing medicine, it’s practicing marketing!
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I would say that psychiatry shares many similar aspects with religion, but is not itself a “religion” per se. I’d say it’s more of an anti-religion, deleting any kind of theology but instead “preaching” that the spirit does not exist and that all of our behavior is the result of chemical interactions and that human beings lack any of the essential qualities of will, intent, values, priorities, and also lack the ability to have an impact on their own psychological/emotional welfare.
I would have no objection with psychiatry being a competing “philosophy of being”. The problem is, it is claiming to be a scientific endeavor and part of the field of medicine! This tends to give this nihilistic philosophy FAR too much influence far beyond what its arguments have merited. Additionally, Spinoza and Kant and Hegel did not have the power to forcibly detain people based on their philosophies.
So psychiatry can make all the claims it likes about “useful fictions,” but in the end, it’s not OK for “doctors” to use “fictions” of any sort to manipulate people into using drugs they don’t need or want, and particularly to use such fictions to forcibly detain and drug people whose only crime is having a hard time fitting into our strange and challenging social expectations.
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Bill aka Thomas Schnell,
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The lack of improvement in outcome measures is one of the most important open secrets in the whole field of psychiatry. What is the point of exposing kids to powerful drugs like these when there is no evidence it helps them in the long run?
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As I’ve said before, in what other area of “medicine” do we have to have a discussion of “shared decision making,” with some doctors OPPOSING the idea of sharing with the very person being “decided” about? It is the CLIENT who should be deciding how much decision-making to share! What happened to “informed consent?” We shouldn’t have to be talking doctors into SHARING the decision making with patients. Patients should ALWAYS be the decision-makers if they are in any way capable of communicating their intentions, and doctors should be ADVISING them. The fact that patients have to ASK to be a part of the decision-making process shows how screwed up the power dynamics really are.
The only barrier to “shared decision making” is prejudice and discrimination by the practitioners.
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The big error that the DSM perpetuates is the idea that a particular “diagnosis” has a specific cause in all cases. The DSM itself disclaims that they mean this, but that’s how people interpret it, and I don’t think it’s by accident that it works out that way.
It should be obvious that at least SOME of the time, crappy parenting IS the cause of a person’s “mental disorder,” and addressing that early life trauma is an essential part of their healing from the resulting injuries to their spirit (speaking metaphorically, of course). The idea that exploring parents’ behavior as a possible causal factor is “blaming parents” is downright childish, and plays into the hands of those parents (and they are NOT rare) who will use a “mental disorder” as a cover for their own abusive or neglectful behavior.
It’s also important to note that parents can do damage without intending to. They don’t have to be “bad parents” or be overtly abusive to simply not understand the child’s needs and make mistakes that contribute to their anxiety, depression, or inability to exert control over their behavior at times. So it isn’t a matter of “blaming parents,” it’s more a matter of helping the child/adult come to terms with ways in which their parents may not have been able to meet their needs fully.
It’s not a “black and white” thing. It’s just as bad (or maybe even worse) to let all parents off the hook as it is to blame parents for everything that goes wrong with a child’s life.
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Honestly, how can anyone take them seriously when they come up with this kind of obvious nonsense?
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I think they are pretty much ALL the same. A list of symptoms or effects with no effort to deduce a cause, despite an assumption that all people having this “diagnosis” have the same problem. It’s quite destructive!
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You and our society are combining two separate issues. Society needs to be protected from people who are behaving dangerously or disrupting the ability for society to function. That does not automatically mean they need “treatment” in the form of drugs, or that the drugs will automatically make it better, or that the full civil rights of a person need to be eliminated in order for society to be protected. There are people who have experienced both jail and forced psych hospitalization who prefer jail. Not saying that’s the answer, either, but forcing drugs on someone isn’t necessarily the answer, either. Maybe we need to be creative and start coming up with some new answers that nobody’s thought of yet.
A reminder that shooters at Springfield High School, Columbine, Red Lake MN, and many other places were taking psychiatric drugs at the time of their shooting sprees, not to mention the Germanwings guy who flew a plane into a mountainside on purpose. The media makes it appear that the drugs somehow magically make a person fine and stop any possible threat they may pose, but the hard facts of reality don’t fit that rosy picture. And the damage done by enforced psych hospitalization can be substantial.
How do YOU propose balancing the safety concerns you mention with the high rates of damaging adverse effects of both the drugs and the process of being essentially arrested without committing a crime and forced to take a drug that may not only not help but make a person’s situation worse, and take away any right of that person to place a rational objection to the force being applied?
My personal view is that once force is involved, you can no longer call what you are doing “treatment.” It becomes enforcement of social norms via drugs, and that is absolutely NOT the same thing as trying to help someone get better.
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“The incidence rate of bipolar disorder was 30 times higher in people with a prior diagnosis of ADHD and anxiety than people who weren’t diagnosed with either.”
https://www.healthline.com/health/adhd/adhd-and-bipolar
Stimulants can cause “bipolar” symptoms:
https://ajp.psychiatryonline.org/doi/10.1176/ajp.2006.163.7.1149
“The FDA notes that usual doses of stimulants like Adderall can cause psychotic or manic symptoms, like hallucinations, delusional thinking, or mania, in children. They also note aggressive behavior or hostility in children and adolescents with ADHD.”
https://cliffordsegil.com/this-is-how-adderall-really-affects-your-brain/
“Emergence of New Psychotic or Manic Symptoms
Treatment emergent psychotic or manic symptoms, e.g., hallucinations, delusional thinking, or mania in children
and adolescents without prior history of psychotic illness or mania can be caused by stimulants at usual doses. If
such symptoms occur, consideration should be given to a possible causal role of the stimulant, and
discontinuation of treatment may be appropriate. In a pooled analysis of multiple short-term, placebo-controlled
studies, such symptoms occurred in about 0.1% (4 patients with events out of 3482 exposed to methylphenidate
or amphetamine for several weeks at usual doses) of stimulant-treated patients compared to 0 in placebo-treated
patients. ”
https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
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Here is the one that got me initially looking into this many years back:
https://www.ablechild.org/learn/50-conditions-that-mimic-adhd/
Hope it helps!
Steve
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Very true. There can be good information in actual research which is not available to the public due to obfuscation or inappropriate framing of issues. One of the worst things about the DSM is that it prevents any real research on subgroups of any “diagnostic category” because it’s assumed that research has to be done on the entire cohort, heterogeneous as they all are. If 10% of “ADHD” diagnosed kids are improved by addressing low iron, this is viewed as a failure, because only 10% of the cohort is “helped,” while supposedly 70% are “helped” by stimulants. But this 10% can be COMPLETELY CURED by this approach and removed from the cohort! No one knows of this because such research is buried in drug company-supported study manuscripts intended to bury it. It’s not really science to corrupt findings in this way!
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If only we could electrocute people more gently…
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If only “following the science” led to big profits, they’d be all over it! But when science costs people money, they tend to cover it up rather than following it anywhere.
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I hate the concept of “unmasking.” It’s more like CREATING psychosis by randomly drugging people without having the vaguest understanding of what is actually going on.
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It sounds like you worked VERY hard to find the right practitioner! Not everyone has the resources, time, or freedom to do such a search, unfortunately. It is true, most of the people here had bad to horrible experiences, and in a way that’s a bias. But there are SOOOO many places folks can go to talk about their positive experiences, it’s super helpful to have a place where ALL experiences are welcome to be shared. I know of a person who got kicked off of a “bipolar support group” because she questioned psychiatry’s approach to her case. I’ve gotten ‘feedback’ on an “ADHD” site for using the term “Drug” – I’m supposed to say “medication” so as not to suggest any connection with street drugs, even though all the “ADHD” drugs are, in fact, sold on the street. There are many practitioners who view any skepticism toward “medication” as a sign of “lacking insight.” It is a lot of hard work to find the kind of help you need, and it shouldn’t be. That’s what MIA is about, IMHO.
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Certainly doesn’t seem like the way someone would act who wants to help “heal” one from one’s mental/emotional distress!
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Do we REALLY have to do a study to determine that inducing grand mal seizures by electrocution is NOT a healthy thing for children (or anyone else, for that matter)?
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I can read the list of “criteria” as well as anyone. They’re not exactly complicated. And I have an MS and experience as a counselor, and used to diagnose lots of people using the DSM (though I saw it only as a means of getting their insurance to pay, not any kind of scientific “truth” about their condition). It was pretty obvious that if I sent my oldest to a standard school classroom, it would be days before I got “the note” telling us to take him in for an “evaluation”.
Here are my responses for Patrick, our oldest:
Displays poor listening skills (yes)
• Loses and/or misplaces items needed to complete activities or tasks (frequently)
• Sidetracked by external or unimportant stimuli (frequently)
• Forgets daily activities (yes)
• Diminished attention span (Compared to whom? But less than most kids his age)
• Lacks ability to complete schoolwork and other assignments or to follow
instructions (not sure if it was ability or motivation)
• Avoids or is disinclined to begin homework or activities requiring concentration (Absolutely!)
• Fails to focus on details and/or makes thoughtless mistakes in schoolwork or
assignments (yes)
• Squirms when seated or fidgets with feet/hands (yes)
• Marked restlessness that is difficult to control (yes)
• Appears to be driven by “a motor” or is often “on the go” (dumb criterion, but if they mean he didn’t like to sit in one place, absolutely)
• Lacks ability to play and engage in leisure activities in a quiet manner (Are you kidding? No volume control!)
• Incapable of staying seated in class (maybe not incapable, but had a hard time with it)
• Overly talkative (not really – this is the only criterion that did not apply to our oldest)
Symptoms present prior to age 12 years (from birth, more or less)
• Symptoms not better accounted for by a different psychiatric disorder (e.g., mood
disorder, anxiety disorder) and do not occur exclusively during a psychotic disorder
(e.g., schizophrenia) (This is a fascinating criterion, meaning even if ALL the criteria are met, you might NOT have “ADHD” if, in someone’s OPINION, you might have something else. VERY scientific! But no, it wasn’t)
• Symptoms not exclusively a manifestation of oppositional behavior (Again, very silly. How would anyone ever make this determination?)
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Well, good! We agree on that point. I’ve never, ever criticized someone for making an informed decision to use stimulants. I am only objecting to representations by doctors that that things are true which really are not.
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Correct.
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Sorry, Thomas, but even the most mainstream of psychiatrists will tell you that there is NO brain measurement, PET scan, SPECT scan, MRI, or other objective measure that is diagnostic of ADHD or any other “psychiatric disorder.” The DSM itself admits that these “diagnoses” group together people who may have little to nothing in common physiologically – they are grouped based entirely upon subjective and unmeasurable criteria like “Acts like driven by a motor.” How would you measure THAT?
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Your premise is contrary to research data. I’m not going to go into agreement with you that everything has been tried when it has not. If an open classroom has not been tried, it should be.
The other thing I’d look into is what kind of family life or conditions the child is experiencing. There is hard data showing that kids in foster care have MUCH higher diagnosis rates, and that the overlapping symptoms between “ADHD” and “PTSD” quite commonly lead to PTSD sufferers being “diagnosed” with ADHD without looking at the underlying trauma, which is often ongoing.
However, it is appears to me that you are not really interested in having this discussion, as I gave you a very legitimate answer to your question, which you intentionally dismissed on speculation without considering it at all. Two of my three kids went to “open classrooms” and did absolutely fine despite moderate to severe “ADHD” symptoms in elementary school. You make no comment and give no credence to the fact that similar results have been observed with many who fit the “ADHD” criteria. It appears to me by this behavior that you are simply selling your viewpoint and trying to invalidate others who have given perfectly rational responses. This is not productive and I frankly find it extremely irritating. I could be wrong, but it appears to me at this point that the only answer you will accept is, “You’re right, Thomas, I’d totally put my kids on Ritalin.” I’ve already faced EXACTLY the situation you described and HAVE come up with an effective plan to handle it without any stimulants at all. So no, I would NOT put my kids on stimulants, because I did not need to, as we came up with a more effective plan.
See my remarks on Thomas Edison. There are other examples (like Einstein) of kids who didn’t do so well in school yet contributed mightily to our society. The ability to apply oneself to concentrating on schoolwork is a massively overrated skill. And you’d have a lot more influence on the people you are so passionately trying to convince of your viewpoint if you’d start by acknowledging the multiple successes of “ADHD” people who have succeeded without “treatment.”
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A person with diabetes has a measurable deficiency in insulin, and giving insulin directly repairs that deficiency and leads to physiologically measurable results.
No child or adult has ever been shown to have a measurable deficiency of Ritalin or Adderall, and giving Ritalin or Adderall is not repairing any such deficiency.
The situations are not in the least comparable, as anyone who looks beyond the surface arguments should easily be able to comprehend.
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Funny how Edison is often referred to as a sufferer of “ADHD.” He did horribly in school and was kicked out of elementary school with the comment he was “incorrigible.” Educated at home by his mother. No stimulants. Yet he appeared to turn out quite well in the end, didn’t he? Why didn’t he become a criminal or a drug addict? How was he able to learn so well without the benefits of a standard classroom? Is it possible that he always had the capacity to learn, yet could not do so in the sterile and rigid environment of a school classroom?
“Edison had strong opinions about education. Most schools, he believed, taught children to memorize facts, when they ought to have students observe nature and to make things with their hands. “I like the Montessori method,” he said. “It teaches through play. It makes learning a pleasure. It follows the natural instincts of the human being . . . The present system casts the brain into a mold. It does not encourage original thought or reasoning.”
Frequently Asked Questions – Thomas Edison National Historical Park (U.S. National Park Service)
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An open classroom, as I’ve already stated more than once. You are making the assumption that paying attention to schoolwork is necessary to succeed in life. The long-term studies on stimulant treatment belie this assumption. Kids taking stimulants complete more homework, pay more attention to the tasks at hand, yet don’t learn more as a result. This should raise questions as to whether they may be daydreaming simply because the “work” they are presented with is inherently dull and ineffective as an educational tool.
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“Candidate gene…” “association/linkage…” These are speculative ideas, probabilities, not causal factors. A causal factor will be present when the situation is occurring and absent when it is not. In these GWAS tests, the “candidate gene” is present in the unaffected population in large numbers, just somewhat larger numbers in the “test” population. It doesn’t really explain anything at all.
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And another 24 million who may have been told that “this is the answer” and remain in despair, and are prevented from seeking other solutions by the faith they put in their doctor’s promises.
I would love to see what percentage of doctors tell their clients there is about a one in five chance you will get a significant benefit, let alone how many inform their clients of the wide range of other options available. I talked to a woman on the crisis line I worked one time, and she’d been seeing a psychiatrist for well over a year and seen no benefits. She was frantic, telling me she thought nothing would ever work and she’d feel that way for the rest of her life! I asked her if anyone had told her there were other things she could do for depression besides drugs? She was silent for a moment, suddenly calm. “No,” she said. “Well, there are,” I told her. “Oh!” she said. “Well, THAT’S good!” Her despair was gone in a moment as soon as she learned there were other options, but NO ONE had discussed these options with her!
There is a very great harm in telling people that you know the cause of their suffering when you don’t, and even greater harm when you tell the person you have a solution when that solution has a 4/5 chance of failure.
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“…may eventually have implications…” Hope springs eternal!
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I mostly agree, but I can’t really agree that science has resisted the colonization of its methodology and discoveries against the forces of greed and capitalism. The very existence of “biopsychiatry,” which is the only real psychiatry that exists today, is proof that greed and corporate control can take over a supposedly scientific endeavor and turn it into a gigantic marketing campaign. When we are hearing that more than half of today’s “discoveries” are false due to corruptions in the scientific method and in some cases outright fraud, it’s hard to see how science has been able to avoid being coopted by the forces of capitalism and greed. True scientific method is value-neutral, but how many scientists have the courage and integrity to continue to do real science when the results they discover are covered up or they are attacked for coming up with the “wrong” findings for those looking to make more money?
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It really sounds like the medication was a life saver for you. I have also heard other stories of this nature, and I have no doubt they were true. Where I object is when you assume that “we” (meaning all students suffering from attentional issues for whatever reasons) will all benefit in the same way as you did. As you say above, many factors impact learning. Stimulants are only one factor, and according to the literature, not the determinative factor for most kids. Again, that doesn’t mean it wasn’t determinative for YOU and for others who had such a favorable response. It just means we can’t generalize from personal experience to scientific conclusions on a population level. I believe you, 100%. I also believe the statistics. I also believe the stories of people whose lives were made just as much worse by stimulants as yours was made better.
So I hear your personal experience, and your understandable passion for this subject. I’m just not down with the assumption that because you had this experience, everyone who is diagnosed with “ADHD” will have a similar one.
I’d still be very interested in hearing your response to the established fact that “ADHD” kids do far better in open classrooms than in standard ones. I have two kids who both qualified for “ADHD” diagnoses, and we used homeschooling and alternative child-centered schools, no medication or other “treatments,” and both graduated from HS with honors, and the youngest graduated from a university with honors. Both are gainfully employed, have never gotten into drugs or delinquent behavior, and appear to feel pretty good about themselves and their lives. I really think it is a possible answer for a lot of kids who get this label. What do you think?
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https://news.fiu.edu/2022/adhd-medication-alone-doesnt-improve-classroom-learning-for-children-newresearch
From James Swanson, et al, who is a proponent of the use of stimulants for “ADHD.” This is a review of ALL reviews to date (in 1993) and so is a compilation of ALL research to that date, not just one study:
What Should Not Be Expected
1. Paradoxical Response
a. Responses of normal children are in same directions
b. Responses of normal adults are in same directions
c. Responses of affected adults and children are similar
2. Prediction of Response
a. Not by neurological signs
b. Not by physiological measures
c. Not by biochemical markers
3. Absence of Side Effects
a. Infrequent appearance or increase in tics
b. Frequent problems with eating and sleeping
c. Possible psychological effects on cognition and attribution
4. Large Effects on Skills or Higher Order Processes
a. No significant improvement of reading skills
b. No significant improvement of athletic or game skills
c. No significant improvement of positive social skills
d. Improvement on learning/achievement less than improvement in behavior/attention
5. Improvement in Long-Term Adjustment
a. No improvement in academic achievement
b. No reduction in antisocial behavior or arrest rate
https://escholarship.org/content/qt4jr2777t/qt4jr2777t.pdf
“In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
https://pubmed.ncbi.nlm.nih.gov/16623654/
There are also the RAINE study in Australia, the Quebec ADHD study, the long-term data from the MTA study in the US, and a comparison study between Finnish and US “ADHD”-diagnosed children showing that there were little to no differences between groups, despite the Finnish group using far less stimulant treatment. And the OSU medication effectiveness study, though somehow the original reports on long-term outcomes don’t seem to be available any longer.
I’m afraid the jury is in on this point – there is no general long-term benefit to stimulant treatment of any significance. One can certainly find individual studies that claim these effects, but large reviews of huge amounts of data show no real benefit of mass treatment of “ADHD” with stimulants. This of course doesn’t mean that some individuals are not positively affected, perhaps in very significant ways, but as a group, stimulants have not proven to improve long-term outcomes for “ADHD.”
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Wow, even I am shocked and disgusted that “mental health” personnel would ever talk in such a fashion to clients! That is absolutely disgusting! Though I definitely have gotten the “let’s put you on a diet after making you fat with antipsychotics” energy a lot. Seriously, are these folks incapable of basic cause-and-effect reasoning?
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I have responded many times directly to comments you have made, and asked you questions to clarify your position. If you ask me a question, I will always respond to it if we are engaged in a discussion. I have acknowledged points that you have made that seem to be supported by the literature. I simply have a different set of experiences than you. So far, I have not seen any interest from you in finding out why I hold the beliefs I do, nor have I gotten responses to clarifying questions I have asked you, nor do I recall having gotten any response to the research data I have provided regarding ADHD kids doing better in open classrooms or outcome measures not being improved in the long term by stimulant treatment alone. I don’t think it is at all true that I have not listened and responded to your comments. I don’t see you listening to or responding to mine. I don’t expect agreement from you, but I would hope some kind of acknowledgement would be forthcoming when I take the time to respond to your comment. If you don’t want to, that’s up to you, but I don’t appreciate being judged as unresponsive when the facts say otherwise.
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I am sorry that you personally experienced such devastation and destruction.
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Posting as moderator:
It is. If you feel any specific post has been allowed that has personally attacked you or your character, please either hit the “report” button or better yet, email me and explain what you are seeing.
However, as I have said before many times, disagreeing passionately with a person’s viewpoint is not considered a personal attack, it is simply disagreement. It is important for folks to keep this in mind when evaluating whether a comment constitutes a “personal attack.”
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It sounds very much like your parents were emotionally abusive, simply because you didn’t fit their expectations of you. I consider that horrible on their part, and I empathize with having to put up with that kind of horrible behavior. I would be very angry and disappointed by them, but I’d imagine I might always feel somewhat like I could “never be good enough” to satisfy them. Their behavior was cruel!
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Consensus of “experts” has absolutely nothing to do with science, Thomas. Scientists agreed at one time that formula feeding was as good or better than nursing, that Thalidomide was safe and effective, that DDT had no harmful side effects, that Valium was not addictive, that Xanax was not addictive, that Benzedrine was not addictive, that Tardive Dyskinesia was a consequence of “schizophrenia” rather than the drugs given to “treat” it, that Viiox was safe and effective, and that SSRIs had a mild side effect profile and no withdrawal effects at all. None of these things that “experts” agreed to proved to be true in the long run. “Experts” have lots of conflicts of interest these days, making the problem even worse. You can hire an “expert” to claim almost anything these days.
And we already have a means to help these children that is drug free and proven by actual scientific research. It’s called an OPEN CLASSROOM. “ADHD” kids are indistinguishable from “normal” kids in such an environment. The only thing stopping us is laziness, narrow vision, and the financial conflicts of interest mentioned above.
I continue to notice that you tell other people what you think they should believe but do not respond to my comments relating to your assertions. Again, I ask you, are you here to have a conversation or to try to get others to agree with your pre-determined viewpoint? A failure to answer this will indicate the latter, and I will no longer bother trying to have a conversation with you, though I may still post scientific evidence to counter any claims about “experts” agreeing as some sort of proof of anything.
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I do agree with you, 100%! But I guess I’d put it another way: people who have physical brain lesions resulting from accidents or actual diseases are NOT diagnosed because someone labels them with a psych disorder instead of actually finding out what’s wrong with them! I guess I have a big problem calling these labels “diagnoses” instead of recognizing they are meaningless labels, no different than saying, “He’s socially awkward” or “she’s pretty aggressive in conversations.” They are opinions based largely on biases and stereotypes and tell us NOTHING about what is really going on for that person. And as you point out, they also deflect attention from searching for ACTUAL medical diagnoses that we CAN do something about!
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I am surprised that “placebo washout” is not seen as a biasing factor. Removing people who respond to placeboes is clearly not a scientifically justifiable action, as it biases the studies in favor of the drug (treatment) and against the placebo.
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I would submit that there is no way to “misdiagnose” “bipolar disorder,” as there is no legitimate, objective way to “diagnose” it correctly. If we can’t objectively distinguish between those who “have bipolar disorder” and those who do not, the idea of a “diagnosis” loses all value except as simply a discussion term. If you can’t know you are “right,” how can you know if your “diagnosis” is “wrong?”
But I agree with you completely – the lion’s share of “mental illness” is simply each person’s response to trauma and difficulties in survival which we all face in one way or another.
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“The findings suggest that the serotonin theory was endorsed by the professional and academic community,” the authors write. “The analysis suggests that, despite protestations to the contrary, the profession bears some responsibility for the propagation of a theory that is not empirically supported and the mass antidepressant prescribing it has inspired.”
https://www.madinamerica.com/2022/04/psychiatry-ever-endorse-chemical-imbalance-theory-depression/
https://www.sciencedirect.com/science/article/pii/S266656032200038X
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Yet oddly, these behavioral changes contributed nothing to long-term outcomes, as multiple studies have shown no academic advantage for taking stimulants over the long term. Kids who took stimulants and kids who did not had very similar academic outcomes, including test scores, HS graduation rates, college enrollment, or even other measures of social outcomes like delinquency scores and self-esteem. So apparently, doing more problems more quickly might get approval in the classroom, but has no actual impact on learning.
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Exactly.
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I see no harm in looking at scientific data. The problem is when the “scientists” choose not to believe what that data is telling them, or to cover up what they know the data says because it undermines their self-interests. At that point, they are no longer scientists, but either cult members or marketing agents.
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Staff emails are available under the “Staff” subtab, which is under the “About” tab at the top of the front page.
My email is [email protected]
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A wise man once observed that scientific explanations should make things simpler. When your theory makes things more and more complex over time, the theory is wrong! And the DSM and the “biological” explanations for “mental illness” certainly qualify as making things far more complex than they really are.
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And my observation is that the most helpful professionals are the ones who simply back down from the “expert-user” dynamic and talk to the person like one person to another. Which is what they are!!! The most important lesson I learned as a counselor is that I never had the answers, the client did. Sometimes I had the right questions, that was about it. The rest was all an exercise in giving a shit about the other person’s life.
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I would not say less expensive. I’d say more REMUNERATIVE to the doctors and the pharmaceutical companies!
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I have as well. I’ve also known insensitive, thoughtless, means-spirited psychiatrists. And I’ve known compassionate and intelligent psychiatrists who have done a lot of harm by following “protocols” instead of getting to know the patient. I’ve seen psychiatrists who insist on increasing the dosage of something that has harmed their patient or not been helpful.
I have also noticed something about you, Thomas. I notice that when I ask a challenging question, you don’t answer it.
Why is it so important for you to convince everyone here that your viewpoint is correct? At least, that’s how it seems to me. I see little to no effort to understand others’ feelings, experiences, and logical objections, and a lot of effort to promote your own viewpoint. Is that why you came here?
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Talk about adding insult to injury!
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No problem!
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Commenting as Moderator:
Just so everyone is aware, ALL comments are “held in moderation” initially until I or someone else can approve them. Since I am doing 5-8 hours a week in this role, it can sometimes take hours, or even up to one calendar day, for comments to be approved. There is no meaning to having a comment “held in moderation” unless it’s been more than a day, in which case folks should contact me to make sure the comment isn’t lost and to discuss any concerns the comment might have raised. But this one was approved as soon as I read it.
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I have always wanted to see “Basic Asshole Disorder” in there: “BAD!” Or Chronic Asshole Disorder: “CAD!”
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See my later post for examples.
At this point, Thomas, I’m not sure you’re really willing to engage in a meaningful conversation. Are you here to discuss different people’s realities and to learn from each other, or to promote your own viewpoint? I’m not sure I want to waste more time trying to present an alternative viewpoint if you’re seriously not open to hearing alternative viewpoints. Are you?
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Actually, stimulant treatment has not been shown to increase self-esteem in the longer term in “ADHD”-diagnosed children.
https://www.additudemag.com/impostor-syndrome-adhd-treatment/
“However, they also found a negative effect on the youth’s sense of self with youth reporting that they no longer felt like themselves, were happier off the medication and noticed a change in their personalities.”
https://link.springer.com/article/10.1007/s40474-015-0039-5
“Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
https://pubmed.ncbi.nlm.nih.gov/16623654/
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Of course, the theory that “ADHD” is caused by a genetic malfunction is also not based on double-blind, controlled studies, despite what we’ve been told. Let’s not set a double standard. Of course, the idea that something so nebulous as “having difficulty paying attention” or “being overly active” is ALWAYS caused by the same thing is absurd. But here is one article supporting that poor parenting DOES have an effect on attention span and hyperactivity in some kids:
https://www.chicagotribune.com/lifestyles/health/sc-adhd-critical-parents-health-0224-20160211-story.html
Other causal factors that have been identified include poor diet, low iron levels, high lead/heavy metal concentrations, and sleep apnea. And trauma has also been implicated, particularly kids who have “PTSD” symptoms have a huge overlap with “ADHD,” and a study I recall said that family doctors in particular are more reluctant to diagnose “PTSD” over “ADHD” even when children clearly meet the criteria for the former.
https://life-care-wellness.com/how-childhood-trauma-could-be-mistaken-for-adhd/
This in my mind is the inevitable result of having such sketchy, subjective criteria for “diagnoses.” Kids can meet the criteria for both “ADHD” and “PTSD,” and there is not a clinician in the world who can objectively tell the difference. All we have is their opinion on the matter, because the “criteria” don’t make the distinction for us, do they?
We all know there is no definitive cause of “ADHD”, despite decades of research. I’m not holding my breath that there ever will be, because it’s obviously caused by a whole lot of different things, since the only thing these kids have in common is that they have a hard time paying attention to things they aren’t very interested in, and similar subjective “criteria,” not all of which they have to even share with others with the same “diagnosis.”
From the DSM: “[In DSM]… There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.”
So we can’t assume that all “cases of ADHD” are “alike in all important ways.” This strongly suggests that the assumption all such cases are CAUSED by the same phenomenon is completely inappropriate.
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We always seem to be “on the cusp,” yet those razor-sharp understandings and interventions never seem to have developed. I’m glad at least that you recognize that we’re trimming hair with a scythe right now. It is difficult to understand, though, why you don’t consider giving someone a shave with a scythe is a pretty dangerous undertaking, especially when there are less dangerous options, including letting one’s beard simply grow out!
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The “proper diagnosis” of ADHD requires the subjective evaluation of “traits” with pseudo-scientific foundations. Such concrete and measurable things as “loses and/or misplaces items needed to complete activities or tasks” and “Appears to be ‘driven by a motor’ or is often ‘on the go'” or “is overly talkative.” You know, the kind of things that a Scientist can Measure with his “Talk-o-meter” and such.
It is also very obvious from my own observation that these criteria are almost never consulted. Most doctors simply go with what their “impressions” are, usually based on parent and/or teacher report. The main reason more and more kids are “diagnosed” is not because we’re looking better or there are more kids developing this “disorder.” It’s called “diagnostic drift” – when subjective criteria are used to establish a boundary, over time, that boundary gets pushed so that more and more people “meet the criteria” due to pressure from parents and/or teachers to “diagnose.” This was very clearly seen in autism as well as “ADHD.” I have also NEVER in my entire career seen a doctor document “more than one person” providing evidence in “more than one setting.” To the contrary, I’ve seen dozens, probably more like a couple of hundred cases where the school was the only source of “information” and where parents agreed to the stimulants under pressure from the school. I’ve also seen some where one parent decides to “get him/her diagnosed” when another (usually non-custodial) parent disagrees completely. I’ve seen kids who ONLY take stimulants for school time because they “don’t need it” at home. According to you, these kids should not be “diagnosed.” Yet they are, by the wonderful, caring, competent medical professionals you speak so highly of in your next post.
I get the impression that you really want us to believe that all or most mental health professionals are competent, caring and thorough, and track closely on family history and the success of their interventions as well as the potential side effects. I would bet big money I’ve seen a hundred times as many “ADHD” cases as you have in my career, and I can tell you that those assumptions are very, very wrong.
I recall one girl who had graduated from an eating disorder clinic. Shortly afterwards, she was put on Ritalin for “ADHD” by her caring and competent medical professionals. Oddly enough, she started eating less, an obvious and very well documented side effect of the stimulants which started almost immediately after their administration. They started talking about her “relapsing” in her “eating disorder!” It took my VOLUNTEER, LAY-PERSON advocate, about 5 minutes to figure out what was going on, and we eventually convinced them to stop the stimulants. Lo and behold, the “eating disorder” went away! Her argument was, “What’s more important, eating or finishing homework?” But the professionals were apparently unable to make that value judgment.
I also saw many cases where kids became aggressive when taking Ritalin or other stimulants, a fairly common adverse effect that is noted on the patient handout for every one of the stimulant drugs. Very frequently, instead of stopping the stimulant, such kids were put on antipsychotics, like Risperdal. Now antipsychotics, as you may or may not know, have the primary action of increasing dopamine uptake to lower the amount of dopamine between the brain cells. While stimulants have the effect of reducing dopamine reuptake and increasing the amount of dopamine floating around in the brain. It doesn’t take a neuroscientist to figure out that if giving something to INCREASE dopamine leads to aggression due to TOO MUCH DOPAMINE, the right thing to do would be to STOP INCREASING THE DOPAMINE SO MUCH! Why would it occur to ANYONE to give ANOTHER drug to decrease the dopamine you’re increasing with the stimulants???? Again, these are the same competent, caring mental health professionals who are trying their best to provide good service. But a high school student could figure out what’s going on in a 15-minute internet search. And this was not an outlier, Thomas. This happened ALL THE TIME. Probably seen a hundred or more such cases over 20 years, maybe a lot more than that.
I could give you a lot more stories, but you get the drift. I’m not saying the medical professionals are all incompetent or don’t care, I’m saying they are operating on FALSE INFORMATION which warps their decision making in very bad ways. It’s not a matter of incompetence – the basic assumptions of the system are faulty, and unless you luck out and get a maverick who does his/her own thinking, the training in those basic assumptions turns potentially good clinicians into feckless authoritarians copying behavior they don’t really understand but feel compelled to repeat because their boss/trainer/insurance company says that’s what they’re supposed to do.
I will allow that I did run into some really competent clinicians in my 20 years working with foster youth, some of them quite impressive. But they were very much in the minority. The majority, as anyone would expect, followed their training and pretty much locked up and stopped thinking when their training let them to poor results.
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You are absolutely right, there are a lot of honest, hard-working individuals in the medical industry (though I hope you will concede that like any profession, there are also plenty of dishonest, lazy ones as well). The problem is, when you work in a SYSTEM that is designed poorly around false assumptions and is corrupted massively by financial conflicts of interest, even the best people will end up mostly doing damage control, and the bad ones will do massive destruction.
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Fantastic post! I’m sorry about the abuse you experienced, but it’s awesome how you figured out how to heal, despite rather than because of the “help” you received from the psychiatric profession!
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This is straight out of Irving Goffman (The Total Institution). The needs of the institution ultimately trump the needs of the individual, and the emphasis on “safety” in the short-term, physical sense is primarily a means of keeping the staff and institution out of legal trouble. To really change this would require a reconsideration of priorities that a large institution is rarely interested in or capable of, as it goes against their own interests, and the patients have no power to prioritize their own needs and have to simply put up with whatever the institution decides to do. Hence, the institution has no real incentive to do other than what they do – protect themselves first, whatever the cost to the patients’ emotional safety.
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I do agree with you here – who cares what the “neurology of politics” is? The only reason I can see for it would be to select out people with the “proper” neurology to follow some pre-determined agenda.
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Certainly, the correlations between childhood abuse and “schizophrenia” labels being assigned is orders of magnitude higher than the most optimistic estimate of “genetic contribution.” We’re talking over 80% vs. at best single digits, and that’s not even allowing for the biased research and reporting you properly identify. Plus, childhood abuse is something we CAN do something about!!!!
Someone simply doesn’t want that information to be discussed! I wonder who?
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Posting as moderator:
It seems I made an error in approving the initial comment in this thread. Now I’m feeling like having to allow each person respond to the last person’s assertions, but it has become increasingly non-productive as time has gone by.
At this point, I’m going to ask folks to swallow up whatever hurt feelings and misunderstandings and move on to other posts. I’m no longer going to publish the back-and-forth discussion about who said what. It’s clear there are some disagreements, and that’s OK, but let’s move away from the subtle personal slights that have started to emerge in this conversation.
Thanks!
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Excellent analysis, Patrick!
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Very well said, Richard!
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Who here has said that chemicals can’t change one’s cognition? Nobody here would believe such a silly, obviously incorrect thing. It’s just that altering cognition does not constitute medical treatment per se. People have taken drugs to alter consciousness since the beginning of time. Tons of people drink coffee to increase alertness, a lot of anxious folks (like me) have used alcohol to moderate social anxiety, people use hallucinogens to have altered perceptions of reality. Sure, people can take stimulants to help them concentrate, or antidepressants to help them focus less on what is worrying them and more on what is happening now. Why the hell not? But it’s not like it’s some great technological discovery that drugs alter consciousness. The concept has been around for millennia, undoubtedly from before recorded history. They’ve invented some newer drugs recently, and MAYBE they are better in some ways for some things. But they have no idea what they are “treating” with these drugs, and they can’t predict ahead of time whether or not the drugs will “work,” they don’t really understand WHY they have the effects they do, nor is there any kind of broad agreement on what “works” even means (Is it better NOT to be anxious about the fact that your husband might come home drunk and possibly kill you and the children? Is it a positive to take a drug to be OK with your dead-end job and your crappy boss? Is it an improvement to be able to “stay on task” in school when the long-term studies show that those kids who “pay attention” don’t learn any more than the ones who are goofing off?)
And there are ALWAYS costs for taking any mind-altering substance, and almost every one of them leads to tolerance over time. One of the very worst failings of psychiatry is their unwillingness to be honest about the real costs vs. long-term benefits so clients can make an honest cost/benefit analysis.
You may not be a scientist, but I am by training (a chemist). And I’m telling you, the fact that a drug temporarily ameliorates a particular condition or state of mind is no big discovery in medicine. If someone could actually discover WHY a certain 20-30% of people responded to Drug X, that might be the BEGINNING of something of significance. But a pretty decent percentage of people respond to mega-vitamin therapy or changes in diet or improved exercise plans or meditation, too. So which is the real “treatment?” Or is the “disorder” not really a medical condition at all, but simply an inconvenient mismatch between one’s personality and the expectations of the society one lives in? And as such, would there not be multiple possible “solutions” to the problems so created, including the solution of simply not playing by the rules one is expected to comply with?
“It works for me” is not a scientific argument. It’s a personal testimonial, which is great, but there are a lot of varying testimonials out there that have to be taken into consideration, and some of them are VERY different than yours.
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Glad we’re on the same page there! Just wanted to clarify!
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So why not simply have kids who struggle with Kindergarten wait another year to enroll, and have kids who don’t do well in standard classrooms assigned to open classroom environments where “ADHD” kids do so very much better? These are two things that we KNOW help and do absolutely ZERO damage.
Perhaps the need to “pay attention” to what other people think is important is very much overrated in our society. Maybe we need to help these kids build on their strengths rather than making them feel ashamed of not being able to or interested in doing what the adults have decided is “essential” for kids to do.
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I pretty much agree with all you said, except that I don’t think “social defeat” is caused by the genetic phenotype, it’s caused by the society’s unwillingness/inability to be flexible enough to deal with the wide range of “phenotypes” that are around. “ADHD” is the best example. It is caused almost entirely by inflexible social expectations in schools. Kids who go to school a year later have a 30% lower chance of being “diagnosed.” Kids with an “ADHD” diagnosis in open classrooms are virtually indistinguishable from their “normal” peers. A great study showed that groups of 3 with an “ADHD” kid in the group did FAR better solving problems than groups of 3 “normal” kids. If we didn’t expect young people to sit still for extended periods of time “studying” subjects they have no interest in or have already mastered, “ADHD” would mostly disappear, regardless of the fact that some kids will always be ‘more active’ than others in any group.
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I’m glad it was helpful!
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Many people do better when they STOP taking their psychiatric drugs. Not everyone benefits, in fact, the latest solid review of decades of data suggest that perhaps 30% of users have a substantial improvement on psych drugs. You just happen to be one of those who benefited, and more power to you. It doesn’t mean that these people will deteriorate if they go off the drugs. Many have had no benefit or have been harmed by the drugs, and are pleased to get back to a more “normal” state, even if it is not optimum.
You are not doing anything wrong at all. You believe based on your experience that the antidepressants are essential for your survival. Not everyone believes or experiences that.
If you were made psychotic by your antidepressants, your feelings about them might be very different. If you were essentially arrested for saying you were suicidal, handcuffed, taken in a police car to the hospital, “evaluated” by a person who didn’t seem to care, locked in a ward with a lot of other people who are struggling and possibly acting out in a frightening fashion, given drugs you did not choose to take without any semblance of informed consent, and told when released that you HAD to take these drugs or you’d be hospitalized again against your will, your feelings about antidepressants might be very different.
There is nothing wrong with taking psychiatric drugs. There is also nothing wrong with NOT taking psychiatric drugs. Each person has to decide for him/herself, and we should not criticize them for making their decisions on their own best data. We SHOULD criticize the psychiatric industry for being dishonest with their patients, though, because they owe folks an honest rendition of what they do and don’t know, including that chemical imbalances are NOT implicated in depression and that only 30% of people taking antidepressants experience significant relief, as well as the common side effect and withdrawal effects of the drugs they are prescribing.
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It may be optimistic to think so, but it is essential that these facts be expressed and publicized, as the current “it’s all in your brain” narrative will otherwise dominate, regardless of the scientific evidence to the contrary.
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Though that last point seems to be contradicted in practice by the inappropriate use of “twin studies” to prove “heritability” and thereby infer genetic causation.
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Probably true!
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Science has been contaminated by the profit motive. There have always been concerns regarding authoritarian approaches to science, which is why a lot of new discoveries come from people not in the field of the discovery. But since they started allowing professors to profit from their work, and allow drug companies and others to fund fellowships and chairmanships, the situation has become far, far worse, to the point that someone estimated over half of recent scientific “discoveries” are actually false. The news media also contribute to this by blasting the commercially favorable results they are given in a press release when some new “discovery” is made, but never bothering to publish a correction or retraction when the original researcher had to “eat crow.”
Science is at this point highly corrupted, especially where pharmaceuticals are concerned.
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Speaking Spanish also runs in families. I wonder if it’s genetic?
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I would add to that cultural dislocation and living in an urban environment.
The example I use is that not ALL kids who get hit by cars at a crossing near a school have their legs broken. Should we do research into why certain kids have “weak bone disorder” and try and come up with some “treatment” to make their bones tougher? Or should be maybe put in a traffic light and a crosswalk?
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Well, since until recently the industry has DENIED that there are any withdrawal effects, they certainly wouldn’t bother HELPING you deal with the effects they are trying to pretend don’t exist!
It is criminal to let someone deal with that kind of crap without support, especially if you’re the one who created the dependency in the first place. But unfortunately, the industry appears to have no sense of shame.
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Per Alice Miller, the only thing that would distinguish a “good therapist” from a “bad therapist” would be the degree to which they are aware of and have processed their own childhood trauma, so that they would not act those needs out on the client. The “school” of therapy or the degree of the therapist would have essentially no impact on the outcome. Which I think is why they found that talking to a friend is just as likely to be helpful as talking to a professional. Not all friends will be helpful, only the ones who have dealt with their childhood trauma, but the odds of finding someone who has are not improved by seeing a “professional.”
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Truly. They find a SET of genes that has a 1.065% correlation with the “condition” in question (not even dealing with the impossibility of locating a legitimate study group with the subjective criteria used for “diagnosis”) and say, “We’ve proven that “ADHD” is genetic!!!” You look at the article and find that only 5% of the study group has this combination, while 4.7% of the control group has the exact same set of genes! How is that causation? But people lap it up. I guess if you WANT to believe something badly enough, you find a way to justify it.
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Wow, unbelievable! So you’re not able to take in any food orally, but they won’t give you sustenance? Because they are claiming you are making it up?
Holy crap!
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Or maybe some “Fuck’emall” instead!
Are you in the clutches of the doctors right now?
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And yet adults diagnosed with “ADHD” report on the average lower quality of life. Which means for every success story, there is someone made at least that much worse. Decades of research show no improvements in long-term outcome for ADHD kids treated with stimulants over those who are not. So whether it has a “biological etiology” or not, stimulant treatment by itself does nothing to make life better on the average for those so treated.
I do rejoice for your personal success, and hope it continues to go well for you. But the idea that we are “nearing an understanding” of “ADHD” is not supported by the literature. In fact, the BEST “treatment” for ADHD seems to be to put kids in a non-traditional classroom where they get more control of their activities. No “medications” needed. On the average, of course.
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“I can come back weekly and charge another $200 for weekly “treatments” that will keep your entire bathroom from collapsing into your basement.”
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A plumber would probably be a better bet in most cases. At least s/he won’t be deluded into believing s/he has some great “treatment” to force on us!
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My favorite is “Treatment resistant depression.” Not, “We failed” or “we don’t know what we’re doing,” but “Your depression RESISTED my efforts to treat it!” What would we do if we had a plumber come by and we paid him $200 dollars and he said we had a “repair resistant toilet?” We’d fire him and get a new plumber! What kind of professional blames his/her client for his/her failures?
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This community consists of a huge majority of “affected people,” Tmason. They just weren’t affected in the same way as you were. I find it disappointing to see how easily you seem to dismiss other “affected people’s” experiences while wanting others to value yours. It is not “at your expense” that people share their stories, even if you find these stories confusing or contradictory to your own experience. It is for their own benefit. If you want to be respected, you need to start with respecting the fact that not everyone experiences the “system” the same way you do. If you’re not interested in that kind of discussion, where each person is entitled to share their own story and experiences and no one is entitled to invalidate them for doing so, then I think you may have come to the wrong place.
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Exactly! The DSM appears to be designed to blame the victim and let anyone with power off the hook!
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I agree that “treatment” and involuntary detention need to be seen as COMPLETELY separate issues. It does not follow that because Person A is having a hard time managing in society without worrying or annoying people, that person needs “treatment” forced on them, or needs “treatment” at all. It makes sense that society might need to protect its members from someone who is out of control of his/her behavior, but as soon as a person is arrested (and let’s be honest and call a spade a spade, that’s almost always what happens, they are arrested and handcuffed and put into a police car), it stops being “treatment.”
I don’t see why there can’t be “calming centers” where people go to be away from chaos so they can regain their perspective without having to label that person as “mentally ill” or force drugs on them. Maybe there can be things on offer if people want them, but literally forcing pills down a person’s throat can’t really be seen as therapeutic, IMHO.
I also think Miranda rights are appropriate before every “mental health” detention evaluation, including the right to not answer and the right to legal representation.
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I would add that there is no real way to TRAIN someone to listen respectfully in all cases. There are “techniques” that can be taught to a person who is really open to experiencing how others feel, think and behave and their motivations for doing so. But there is no way to guarantee that any individual is capable of or interested in having that experience, and if they are not, no amount of training can get them there. So someone having a degree in psychology or counseling is no guarantee that this person is any better than a random person on the street at listening and caring about another person. And research reflects this, as I recall. But for some reason, I can’t find the study that applies on the internet – it is drowned out by dozens and dozens of articles on “why therapy is different than friendship” and the like.
What people need is a non-judgmental listener who will support them in figuring out their own path. What they are offered is often VERY different from that, unfortunately.
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Who said “talk is cheap?”
I never thought of the idea of “price per word!” It’s a very interesting and applicable concept!
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I don’t think it’s fair to say everyone thinks anything in particular. There are plenty of people here who are still involved in the psych system, voluntarily or not, and who use psych drugs, voluntarily or not, and some who have found therapy helpful, while some have not. Some give credence to mental health labels from the DSM, some (perhaps most) do not, but no one is required to disbelieve in them or to believe anything in particular. There are people who post here who are supportive of the current mental health system and who report research findings in support of the status quo paradigm.
I think what most people have in common at MIA is that they have either been harmed or seen people harmed by the “mental health” system as it is. I doubt that ANYONE would question that the phenomena listed in the DSM as “mental health disorders” occur and exist and are troublesome or even extremely distressing to many people who experience them. From my own point of view, I think the question to be posed is, just because a set of phenomena happen and can be identified as happening, does that lead to the conclusion that the person experiencing them is medically ILL, or requires medical intervention? Does it automatically imply, as many doctors claim, that one’s brain is malfunctioning, and even further, that there is nothing that YOU as an agent in the world can do about such phenomena?
The second, and extremely closely related, question is this: Are psychiatrists, psychologists, the news media, entertainment media, the internet, telling us a true story of what science really says about these phenomena? For instance, if schizophrenia is a purely biological phenomenon, why is it so much more common among immigrants and urban populations? Why do sufferers in third world countries have so much better recovery rates if the don’t use our “state of the art” drugs to manage their condition? Why is it that people in countries that accept “hearing voices” as a culturally appropriate phenomenon tend to have “nicer” voices compared to those in cultures where hearing voices is shamed and looked on as a “disease?”
Also, the history of pharmaceutical research is rife with manipulation of results and downright dishonesty. This is not confined to the psychiatric field, but it seems to be far, far worse when dealing with phenomena that can not be objectively distinguished from “normal” situations. We’ve been told that antipsychotics were responsible for “emptying out the psych wards,” only to find that it was a policy decision having nothing to do with antipsychotics, and that people diagnosed with “schizophrenia” are much less likely to recover today in the age of pharmaceuticals than they were in 1955. We’re told that Prozac and other SSRIs have a very mild side-effect profile, only to find out that they can cause some people to become suicidal or homicidal, and can have devastating withdrawal effects that were swept under the rug for decades. We hear that “depression” is caused by low serotonin, only to find out that this theory was debunked back in 1985 or so, and psychiatrists now tell us that “no competent psychiatrist has believed this for decades.” There is a fundamental DISHONESTY about the system and how it “works.” A skepticism about the intentions of the system may be the thing most of us here have in common.
I appreciate your asking that question. I take it to indicate you are concerned with understanding the community you are entering.
You are welcome here to have your own views and share them, as long as you are respectful about it. Others may disagree with you, as long as they are respectful about it.
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Exactly!
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It will be called “Befriending therapy” and someone will write a manual and then copywrite it so that no one’s allowed to befriend children unless they have the proper license and certificate from “befriending therapy” training!
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Gosh, what a radical concept! But do you think this will change the status quo one iota? Not a chance!
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So what’s your take on putting kids with these personality characteristics into classrooms where they naturally do better and have a lot less stress, since we know that open classrooms can provide this kind of experience?
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I’d file this under “Studying the Obvious,” or “Did they really pay someone to do this study?”
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Judith Rappoport et al proved this back in the late 1970s. She and her colleagues gave stimulants in therapeutic dosages to teens who were not diagnosed with “ADHD”. They measured things like movement levels and activity levels and ability to concentrate. All were improved in a similar manner to those who were diagnosed with “ADHD” (or whatever they called it back then – hyperkinetic reaction of early childhood or MBD or the equivalent). She called the “paradoxical effect” a myth which was “an artifact of observation,” meaning that people noticed that the “ADHD” kid concentrated better because they were LOOKING for that, but did not notice the same effect in non-diagnosed people because they weren’t looking for that result.
https://www.science.org/doi/10.1126/science.341313
Note that Rapoport has been a supporter of stimulant treatment for “ADHD” for her entire career. This study has been considered conclusive (in 1978) and the idea of the “paradoxical effect” was dropped afterwards by researchers, though the popular myth of the “paradoxical effect” survives in some communities to this day.
More recent scientific commentary on the subject:
https://www.adhd.nyc/single-post/2018/03/28/the-paradoxical-effect-from-misunderstanding-how-stimulants-worked-to-understanding-whe
The idea that “ADHD” kids react differently to stimulants has long since been discredited.
As to WHY they increase concentration, we’d have to get into talking about the role of dopamine in concentration, an area where I have not studied extensively at all. But it is VERY clear that all kids (and by extension adults) taking stimulants will react in a very similar manner.
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The idea of “using one’s voice” as a means to combat insensitive or bullying people is that it doesn’t work very well if you don’t have the power to make your own voice heard. Speaking up when involuntarily committed to a psych ward or living with an abusive partner or abusive parents can be extremely dangerous! Certain bosses specialize in firing anyone who “uses their voice” in any way that challenges the boss’s power and control. I do think we should trust our intuition, but we need to be selective where we “use our voices” if we don’t want to get injured!
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Clearly, being “highly sensitive” is caused by a chemical imbalance in the brain. Research has proven that insensitive and thoughtless people fare better in society, experiencing less anxiety and depression and being more successful in certain professions like sales, law, or politics. There are special drugs now to help people care less, the most popular being “Fuckidall,” promoted by famous comedian, Robin Williams. Our next efforts will be to create psychoeducational presentations in schools and other places teaching people the importance of insensitivity and teaching them specific “Fuckidall” skills that can be practiced even without medical intervention.
Stop worrying! Stop caring! Buy some “Fuckidall” today!
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If NAMI is opposed, you KNOW you’re around the bend!
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There is certainly no denying that physiological damage CAN cause psychological phenomena. The problem, as you intimate, is the assumption that physiological damage is the ONLY thing that can cause psychological phenomena, or worse, that physiological DAMAGE (and let’s be honest, that’s what every drug intervention AND so-called ECT does to the brain, and usually to other parts of the body as well: physiological damage) is the only way to address psychological phenomena. It’s like saying insufficient memory can cause a computer to slow down, so the answer to any computer slowing down is adding more memory chips. Illogical. Except adding memory chips at least enhances the machine’s capacity, while psychiatric drugs without exception decrease the body’s capacity to do something, whether the reuptake of serotonin (SSRIs), the reuptake of dopamine (stimulants), or whatever process these drugs disrupt.
So if some observable physical defect can be detected, it should be addressed as best we can. But ASSUMING that we’re addressing a physiological deficit that no one can actually identify is a very dangerous pathway.
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I have to disagree with you that “we” (meaning all ADHD-type personalities) “function at a level so far below our potential.” This is only true to the extent that you accept the normal capitalistic go-to-work-and-do-what-your-boss-says-for-a-paycheck kind of standards as one’s “potential.”
A fascinating study was done not too long ago where they took kids and put them into groups of three. The study groups had two “normal” kids and one diagnosed with “ADHD.” The control groups had three “normal” (non-ADHD) kids in each group. They gave them a set of three problems to figure out the solution to. I can’t remember the age level, but I think they were elementary, something like 8-10 years old.
They measured “on-task” behavior, and the non-ADHD groups did far better. The groups with the “ADHD” kid in them screwed around more, focused less on the problems and more on just hanging out together. But when it came to solving the problems, NONE of the so-called “normal” groups solved ANY of the problems, while each of the ADHD-inclusive groups solved at least one, and if I am recalling correctly, a couple solved all three.
Now if you’d run groups where ALL THREE kids had an “ADHD” diagnosis, it’s quite possible nothing would have been accomplished at all in terms of the problems at hand. But it’s clear from the results that the off-task, goofy, creative, “what about this” kind of behavior from the supposedly “mentally ill” child played a very important role in getting the task at hand done, even if less time was spent at the task itself.
I think the implications of this study are quite huge. Perhaps instead of trying to FORCE the “ADHD” kids into becoming more willing to do as they are told and focus rotely on the “task at hand,” we ought to be looking at figuring out how to make the most of this skill set that clearly our society needs to survive! I think that’s why the “ADHD” kids in the open classroom settings were almost impossible to detect – they weren’t being expected to be rigidly “on task” doing something they found dull or pointless, so they had far fewer problems than their counterparts in “regular” classrooms.
Another interesting study looked at employer satisfaction with their “ADHD” – diagnosed employees. One might expect they’d be less satisfied because these employees would come late, be disorganized, say offensive things to other workers, etc. But as it turned out, their satisfaction levels were quite similar to “normal” employees. The experimenter observed that the “ADHD” employees tended to CHOOSE jobs where promptness and adherence to assigned tasks were not as important. They became ski instructors, computer programmers, entrepreneurs, salespeople, whatever suited their personality best.
Which goes back to my original thesis: “ADHD” is a real phenomenon, but it is mostly a problem only because we expect these kids to do things that they are not ready or able to do, and then punish them for failing to do so. When they have more control of their environment, deciding what to do and when to do it and when to shift to the next task, as in an open classroom, on the whole, they do MUCH better than if they are being constantly directed by authority figures on what to do next and when to start and stop their activities. So much better that they look “normal” to professional observers who are looking to pick them out.
This does not even take into account the HUGE percentage of kids “diagnosed with ADHD” when something else is really the problem. 20 years working in the foster care system showed me how frequently kids with horrible home lives and super high anxiety levels or even frank PTSD symptoms are labeled “ADHD” because they “have trouble concentrating on their work!” Well, if YOU were removed from everyone you ever knew after years of being abused and neglected and were forced to live with a family who had to be PAID to take care of you and could dump you at a moment’s notice, you might find concentrating on schoolwork a bit difficult, too!
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No one can be totally “nonjudgmental.” The best we can do is be AWARE of our judgments and decide not to act on them, but take them into account when evaluating what is the best thing to do. A person who pretends to be “nonjudgmental” is usually not being honest with him/herself and will have to rationalize any decisions as being “for the good of the client.” I always knew there was a danger I was acting to meet my own needs rather than the clients,’ making it a lot more likely I could avoid that danger. At least, that’s how I saw it.
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Oh, absolutely, for me, any therapist who thinks s/he can be “above” countertransferrence (aka an emotional reaction to a relationship with another human being!) is highly dangerous!
In my relatively brief stint as a counselor, I viewed my reaction to the client as a) my responsibility completely, b) something that told me about how I might potentially make this situation worse by making it about me instead of them, and c) information about how the client is affecting me that may give me some insight into what’s going on with them. It is completely NORMAL to have an emotional reaction to an interaction with a client or any other person for that matter. The only thing that SHOULD distinguish the counselor from anyone else is that they understand how to use that information to get their own issues out of the way and make sure they are responding to the person asking for help. Anyone pretending they DON’T have an emotional reaction to their client is just plain lying to him/herself.
The only way I see to be able to be successful as a “counselor” or “therapist” is to have your own shit together enough that you don’t end up acting it out on the client. That means that far from being “above” your emotional reactions, you are 100% aware of those reactions AT ALL TIMES and are humble enough to know they are there and respect them, both as an expression of your own needs and as a conduit to information that might be of help to the client. There is no training for this ability. It means you have to have done your own “work” on yourself by whatever means you can. I found clients respected me because I was genuine and in touch with my emotions and was honest with them about what was going on for me without putting responsibility on them for my reactions. They liked it that I was human and real with them, and that I think was what worked when it did work – nothing to do with any training or “method,” just being one human honestly there with another and willing to share their pain without trying to “fix” it to make myself feel better.
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You start curing people, then you have to go look for new clients! Easier to just keep the ones you have sick!
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It should be noted that EVERY person can experience “psychosis” if they go long enough without REM sleep. It is not an “abnormal condition,” it’s something everyone can experience under the right (or wrong) circumstances.
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They used to call it a “chemical lobotomy,” before the marketers got a hold of the concept and saw the income potential!
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A few good studies back in the 1970s showed that “ADHD” diagnosed kids placed in open classroom environments were indistinguishable from “normal” children. Additionally, a bunch of studies in very different places ALL showed that if you wait a year to enroll kids in Kindergarten, the rate of “ADHD” diagnosis goes down by 30%! A very odd “disease” indeed that is reduced by 1/3 if you just let kids develop for another year before enforcing your expectations on them, and pretty much disappears completely when you stop enforcing those expectations entirely!
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I was trying for some ironic humor. If they really did have the intention of helping, those committed to the system would NOTICE when what they did was not helping or making things worse, and then would try to DO something about it, instead of blaming the “patients” for their own failures.
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My point was that the horse isn’t going to reply to you out of his own psychological issues or history or be hurt or angry that you don’t agree s/he’s “helping” you. They are just going to be a horse.
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Maybe we should cut out the middle man and just hire horses to do therapy with us. A lot less “countertransference” to deal with that way, as we know the horse has no hidden agendas!
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Isn’t it weird that childhood abuse, physical, verbal and/or emotional, is ubiquitous in psych wards, yet they continue to insist on “treating the brain” with continued crappy results? You almost get the idea that the system wasn’t created to help people get better…
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Based on the title, I’m guessing we’d agree about a lot of things!
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It sounds like literal torture! I have also noticed that whatever “treatment” is being provided, there is no requirement that it actually improve the client’s condition, either by the client’s report or any of their subjective “screenings” that are supposed to be objective. If things get worse, it’s raise the dosage or try a new “treatment.” And then they say you are “treatment resistant” if their shit doesn’t work, rather than saying, “Well, I guess our shit didn’t work this time.” And if you somehow get better in some way despite all of this nonsense, they are the first to step up and give their wonderful drugs all the credit. No, logical reasoning doesn’t seem to be in much supply.
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“You thought it was dead and buried…
But you were WRONG!
It’s BACK and it’s COMING FOR YOU!
The LOW SEROTONIN THEORY! It’s killed before, it’s died and come back to life, and now it’s dead and can no longer be killed!
THE SEROTONIN ZOMBIE! Coming soon to a psychiatric office near you!”
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Aw, you got my hopes up for a minute that some radical psychiatrist group was actually fighting for patients! Knew that was too good to be true!
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Doesn’t NOT telling the patient of the risks of suicidal behavior from antidepressants put them at risk of death?
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The amount of lithium used as “treatment” for “bipolar disorder” is many, many times the daily required dosage for nutrition. One estimate I just read suggests that one mg of Lithium a day is sufficient. Another measured the amount in micrograms (thousandths of a gram). A “therapeutic dose” is defined as 300-600 mg three times daily, or 900-1800 mg, one to two THOUSAND times the needed amounts. No one will specify what actual daily dosage of Lithium will kill you, but it is recognized that the “therapeutic” dosage and the toxic dosage of lithium are so close together that regular blood tests (once a week or so to start with) have to be done to ensure you are not receiving a toxic dosage.
Lithium at high dosages is most definitely a drug. And a potentially deadly one. For those who don’t happen to die as a result of overt toxicity, Lithium at “therapeutic dosages” is known to be very hard on the kidneys, and can lead to kidney failure.
https://www.kidney.org/atoz/content/lithium#:~:text=Lithium%20may%20cause%20problems%20with,you%20have%20been%20taking%20lithium.
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LOL!
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They also seem to be drawing the subtle conclusion that “rats who are more active are more likely to be more active than rats who are less active.” Very deep!
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There is more than a “dearth of long-term data on impact and safety.” There is PLENTY of long-term data saying that the impact and safety profile of these drugs is questionable at the VERY most optimistic. I’m not OK buying into this “more long-term studies are needed.” The studies we have are more than sufficient to call the use of these agents into question, particularly the blithe way they are prescribed so broadly with little to no standards of care. It is the job of the doctors and the medical community to prove they ARE safe, and they have failed to do so. No one should have to prove “beyond a reasonable doubt” that they are dangerous!
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In other words, you know of no such stories you can share. Your are unwilling to support your claim with data, yet expect others to accept your claim or else they are “not hearing your voice?”
This is not a matter of viewpoint. Either the media is slanted toward success stories or it is not. I’ve given a long list of examples of that slant. You claim I am wrong. Where’s your data?
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Consensus is not science. Scientists have had “consensus” on all sorts of things that were stupid or dangerous in the very recent past. Thalidomide was safe, bottle feeding was as good as or better than nursing, Benzedrine was not addictive, Valium was not addictive, Prozac had a only few mild side effects, Viiox was safe and effective, schizophrenia was caused by overproduction of dopamine, depression was caused by low serotonin, Tardive Dyskinesia was a consequence of being schizophrenic and was NOT caused by antipsychotic drugs… all of these things were agreed upon by “consensus” and turned out to be totally wrong. So scientific consensus is not worth wasting our time on. People agree to false ideas all the time and swear by them, even in the world of science.
You seem to have spent a great deal of time reading research on these genetic factors, which is great! I’m interested to know what PERCENTAGE of those “diagnosed” with ADHD have the specific CDH2 mutation you mention, and how many have that mutation who do not have an “ADHD” diagnosis? This information is essential if one is going to assume causality of a particular gene. Most of the genetic studies I have seen have found only probability correlations, and I seem to remember someone talking about this one and it was also a correlation – more people diagnosed with “ADHD” had this variation, but most did not, and a lot of folks having the variation did NOT get diagnosed with “ADHD.” Which suggests it could be A causal factor in SOME subset of those diagnosed with “ADHD”, but does not explain the phenomenon overall. Which might be good if that subset is in some way able to be identified and “treated” in some specific way. But it would not be proof that “ADHD is genetic.”
But I could be wrong. Please share.
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He has already made it clear he is not a millionaire, if you read prior posts. It is also completely irrelevant to the questions of science that are posed in his book. Are you implying that rich people have no right to comment on the condition of psychiatry and its impact on society today?
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Lovely hypotheses. No actual facts presented. Who cares who yawns, seriously?
These presentations are 100% relying on emotional arguments. It is factual that people have been told for decades and still are told by some practitioners that they have a “chemical imbalance” that is “corrected” by psychiatric drugs. What you share is a bunch of professionals using plausible deniability to say, “Oh, we never really SAID that. Or at least none of us actually BELIEVED that, even if we did say it. So who cares if everyone still believes it’s true?”
The “black bile” comment is particularly egregious. No one has every told anyone in recent times that their depression was caused by “black bile.” While fully 80% of Americans in a semi-recent survey said they believed that depression was caused by a “chemical imbalance.” The latter circumstance did not occur in a vacuum. Whether they themselves believed it or not, psychiatrists sold this idea of “chemical imbalances” hard, along with the pharmaceutical companies, because it was good for business. They only backed away from it when forced to by hard scientific research, and many still promote it in their literature or their practices. These after-the-fact disclaimers are in no way convincing. If they thought this such a silly, simplistic theory, why have they not spoken to discredit it publicly until Moncrieff’s study finally shone some public attention on the subject?
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I completely disagree with you. My experience is that the “success stories” are the only thing you ever hear in the media, and that those who have problems with this approach are silenced. Sure, there is the odd “horror story” that is sensational enough to make the news, but the idea that “ADHD” is a “neurodevelopmental disorder” that affects millions of children and can be specifically diagnosed (usually implied that “brain scans” or a response to stimulants are diagnostic) is almost never, ever questioned in the mainstream media. There are plenty of “celebrity stories” (Ty Pennington, Simone Biles, Michael Phelps, Justin Timberlake, Jim Carey, Howie Mandel) where the message is “Stimulant treatment saved my life.” I can’t think of one celebrity who has come out saying, “I tried this stuff but it really didn’t work for me” or “They tried to say my kid had ADHD but he moved to a new school and things went much better.” You’re welcome to prove me wrong by getting me some of these stories about how stimulants don’t work or made things worse or weren’t needed because X was really the problem, but that’s not what I see in the media at all. Seriously, I can’t think of a single story off the top of my head where such a story is told. I’m open to hearing evidence to the contrary.
But my point was not about Big Media, it is about each of us being willing to accept it when other people have different experiences and don’t agree with our own viewpoint. My initial impression left me wondering if you’d be open to hearing things that don’t fit with your own narrative experience. But I could be wrong. Everyone’s entitled to their opinion here, and we all have to respect each others’ views, even when they disagree with us, as long as it is done civilly and with respect for the diversity of experience that exists in the field.
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You are absolutely welcome to tell your story here. We value all voices of anyone who has been through the system and want to hear how things look to you. At the same time, it’s very important to remember that others have had different experiences than you have had, and that you owe them the same level of respect that you are asking. Different people have different experiences, and hearing that one or two or ten or a hundred people feel their lives are turned around by by stimulants doesn’t alter that one or two or ten, or a hundred people share having experienced harm or confusion with the same approach. It also doesn’t alter the statistics and scientific studies about the overall results of stimulant treatment on the whole group of people diagnosed with “ADHD.” You may learn a thing or three from them as well, and it might help you not take it personally when other people’s description of their experience is quite divergent from your own.
I hope that makes sense to you.
BTW, I HAVE seen objective interviews of people diagnosed with ADHD and treated with stimulants or some other approach, and have spoken personally to a large number of such kids. I can assure you that there is a very wide range of responses, some of which reflect your own, some of which are more lukewarm, and some of which reflect feelings of resentment and betrayal. For instance, I worked with a ten-year-old foster kid who was put on stimulants while in foster care, and I asked her how she felt about it a year and a half or so after she was put on the drugs. She said, “Well, I guess it did help me focus better… but on the other hand, maybe I was just going through a lot of stuff at that time.” I would ask you to reflect on why she might not have been as enthusiastic about stimulants as you are. Food for thought.
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I agree. Folks who are looking for help don’t need another person whose ego they need to protect. Most of the time, that’s what got them into the trouble they are in, having to take care of people who were supposed to be taking care of them. It is ridiculous for a professional to create this kind of expectation, consciously or not. It’s not the client’s job to make them feel good about their work.
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If you would actually read Whitaker’s work, he was originally fully supportive of the status quo system. He only reduced his support as he observed SCIENTIFIC STUDIES showing that people AS A WHOLE were getting worse, not better. As far as I know, Bob Whitaker has never said that psychiatric drugs are worthless, that all psychiatrists are evil, or that no one has benefitted from psychiatric drugs. In fact, he has spoken out in favor of a targeted use protocol for psychiatric drugs, to use them for what scientific study says they are useful for, primarily for short-term symptom reduction, while seeking to look at other approaches which COULD be used by psychiatrists or anyone else to try to get past “symptom management” and create some viable long-term change. He even gives a couple of examples of how this mixed-use protocol would work, including real world examples of where it has been effective. Given the disastrous “recidivism” rate among users of psychiatric drugs and repeated studies showing that long-term use can make things worse for many users, indeed perhaps the majority, this seems a VERY rational viewpoint to take.
You seem to be making this a personal thing, as if critiquing psychiatry as a SYSTEM is the same as saying psychiatrists AS INDIVIDUALS are no good. This is simply not the case. You are arguing for a chance to have a civil exchange about these questions. It seems to me that would start with you as an individual dropping the assumption that people at MIA are out to destroy people’s “mental health,” which VERY clearly seemed to be your assumption from the first words you put down in your first comment. If you come into a web community and start off insulting everyone here, it should hardly be surprising if you don’t get a warm welcome. If, perhaps, you REALLY want to have a meaningful discussion as you claim, it would seem to me the most sensible thing would be to start by saying, “Wow, I have a really different experience of psychiatry from y’all. Can you help me understand how you came to these conclusions, and maybe I can tell you how I reached mine?” But I don’t hear you expressing any interest whatsoever in the people who have experienced psychiatry as something unhelpful, insulting, demeaning, or downright dangerous in a very physiological way. I am hearing in you a desire to tell such people their experiences are wrong, or their conclusions are wrong, but wanting them to listen to YOUR viewpoint “nonjudgmentally.” I don’t think that is a realistic plan.
Have you actually read “Anatomy of an Epidemic?” That might be a really good starting point before you start forming conclusions about Bob Whitaker and the entire community simply because they see things differently from you.
And I absolutely respect your right to have your opinion, and you are welcome to post it here. But others are also welcome to theirs, and I kinda want to see you find the same respect for them you are asking for yourself.
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How can such a thing ever be ensured? I don’t think it can. Way too much depends on the personal needs of the counselor/therapist rather than what they are trained to do.
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I think it’s a scientific fallacy for them to suggest that success of “pharmacological treatment” with a particular drug equates to some “pathology” of a “disorder.” They made that assumption for “ADHD” (that insufficient dopamine was indicated because increasing dopamine “helped”) and this was found to be false. They assumed low serotonin caused depression based on response to SSRIS/trycyclics affecting serotonin. Recent publications have finally put this idea to bed. They assumed that psychosis is caused by TOO MUCH dopamine, because of the response to dopamine inhibitors. Again, they have been proven completely wrong on this. I’m sure the same would be true of OCD. It’s undoubtedly FAR more complex than such simplistic answers want us to believe.
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LOL!
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You are preaching to the choir. I disagree with people who say “The system is broken.” No, the system is doing just what it’s supposed to do. It’s just not ACTUALLY supposed to do what we are told it’s supposed to do.
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Why is it a criticism of “antipsychiatry?” Sounded like a fantastic critique of psychiatry itself! And I agree with you, which is why I argue that the only person qualified to tell if something “works” is the client comparing what they got to what they wanted to get out of the deal.
No one has to tell you if your shoes fit or if you liked the meal you were served.
Thanks for sharing!
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The challenge comes when someone is walking behind you, undermining the incremental changes you have gotten implemented before. That’s what drove me out of the profession eventually. I realized there are some people whose idea of “positive change” was very different than mine, and in fact, MY ideas of “positive change” were threatening and destabilizing to their safe (if utterly ineffective) worldview. And a lot of those people seemed to be the ones running the show.
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I agree if you’re going to do therapy, the client has to be the one to decide on what a “good outcome” looks like! No one else can do it but them and have them feel self-determined about their successes. “Therapy” or any other intervention done “for the client’s own good” is almost always the opposite of “therapeutic.”
The biggest problem with THAT idea is that at the beginning, many of the clients I had did not know what they thought a “good outcome” would be for them. The first part of my approach for such people is to help them get to the point where they could make a decision as to what they wanted their life to look like, or what they wanted to change about their lives. Sometimes that’s 90% of the problem – the client has had so many people telling them what to do, think, or feel that they have lost any sense of their own purpose and intentions in life. They do NOT need a therapist or psychiatrist or anyone else piling on more “shoulds” and “should nots” to their already burgeoning heap of them!
But of course, every client is different. Those who already know what they’re trying to achieve have been the easiest to work with, as a few questions helps them identify such barriers as they are encountering (or putting up themselves) and they’re off to the races! But such folks are rare in my experience.
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I think it was Hemmingway who said of psychiatry, “The operation was a success, but we lost the patient.” And for every fatality, there are a hundred or a thousand more damaged in various ways that are often not even noticed. It is baffling to me that they continue to get away with it.
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We know psychiatry is responsible for a lot of early deaths, none more tragic than Jay. What other specialty would be able to get away with having its treatment “successes” dying 20 years earlier than those who manage to avoid their “treatment?”
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Have you ever watched “What About Bob?”
“Death therapy, Bob! It’s a sure cure!”
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I do agree that social indicators are a legitimate way to measure success – is the person working or involved in activities of some sort, do they have any kind of social interactions, are they sleeping better, are they off of disability payments, are they exercising, etc. But even there, we can’t assume one set of outcomes for everyone. For some, disability is an unavoidable reality. For some, working in a capitalistic 9-5 job is not going to be realistic, regardless of “therapy.” So again, there does need to be some sense of what “success” looks like, but I think we agree it needs to be very much individualized to the person in question, even if some kind of generalized guidelines are agreed to. And it seems we both agree that “symptom reduction” is not a very useful “outcome measure!”
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Lithium has the closest range between “therapeutic” dosage and toxic dosage of any drug in use today. My belief has always been that the basic action of Lithium is to poison you, JUST A LITTLE, but not too much. The long-term kidney damage alone belies their claim that lithium will do no harm at “therapeutic” levels.
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The brain imaging stuff is almost all smoke and mirrors anyway. They find that on the AVERAGE, people who “have major depression” have lower activity in X area. They DON’T tell you that not all people labeled with “MDD” have lower activity in the area, some have HIGHER activity, some “normal” people have lower activity and are NOT depressed. So their findings are meaningless.
Add to that the fact that the brain is constantly changing and that PET scans and SPECT scans measure activity levels, and the whole thing really comes apart. I recall an experiment where they had people think about something sad that happened. Their brain scans changed. Then they had them think about something happy that happened. Their brain scans changed back. So thinking a THOUGHT changes your brain activity levels, and the whole idea that higher or lower activity in a certain area means something chemically or structurally wrong is completely debunked.
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They still “treat” these “disorders” with drugs, so I’d say they DO consider them “diseases,” at least from the point of view of “disease as opportunity to make a profit.”
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You are making generalizations about therapists. Some of them very much DO tell you what to do. There are also plenty of inadequately trained therapists out there, or therapists whose own issues make them dangerous no matter how much training you provide. Since there is no agree-upon means of helping clients in the first place, it’s pretty presumptuous to assume all have “adequate training” and know what they are doing. There are competent and incompetent people in every profession. Why would therapists be an exception?
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The problem I’ve seen over the years is that reform efforts are only funded initially, but once the “testing” period is over, they are either discontinued or left to scrabble for grant money every year, because the system “can’t afford them.” The reason we “can’t afford” the reform efforts is because all the MONEY is going toward paying for overpaid psychiatrists and overpriced drugs for overhyped ‘conditions,’ and no one is willing to get their snoots out of the trough so the money can go to something workable.
That’s my experience, anyway.
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I’d also submit that if they have the same “outcome measures,” whatever that means, then mindfulness is MUCH more “effective” because no one has to tolerate the potentially horrific and even dangerous “side effects” of the drug. Any non-drug alternative that is judges to have similar effects should be considered a HUGE improvement over any drug option for that reason, even within their own strained structure of “reasoning.”
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I always say the “Mental health” system is not broken, it’s just doing what it’s intended to do, quite well, in fact. The biggest problem is that they pretend they’re doing something else having to do with “helping the mentally ill,” and people believe them.
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I think authoritarianism is the real enemy, the belief that those higher in the hierarchy have the right to order about those below them at will. It can happen in communism, capitalism, or any other system of economic power distribution.
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I have observed enormous, open and unapologetic abuse and discrimination against folks with “BPD” diagnoses. At this point, I consider the label nothing more than an insult.
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Touche!
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I’ll have to read that one right away!
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The importance of self-determination in any kind of “therapeutic” intervention cannot be overstated. I can see how the “home version” might have some real advantages in that the variable of whether the therapist feels safe to talk to is removed, as are the therapist’s own emotional reactions which so often interfere with that sense of safety.
I’d be interested to know if there is any data on the experiences of people who did this in the office, particularly as to whether certain therapists worked or didn’t work for people.
But anything that gives people more ability to chart their own course seems very much worth exploring. Not to mention the price!
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It sounds VERY interesting, actually. Have you considered submitting a blog?
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All true. The problem is, the psychiatric profession, far from fighting “stigma,” has demonstrably increased it, and the psych diagnoses are actually BUILT on pre-existing social stigma and discrimination. And when we start talking about PSYCHIATRISTS being somehow “stigmatized,” we’re really leaving the original meanings far behind!
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Hell, it sounds like they’re not even treated as well as dogs!
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Well, I don’t know if this is true for her, but I associate the term “stigma” with sleazy psychiatric propaganda efforts to make it OK for everyone to be on psych drugs. So I don’t like to use it, either. Maybe that’s her take on it, too. I think we should not say “stigma,” I think we should say “discrimination,” and NO, that does not apply to the poor psychiatrists! They are the “discriminators!”
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True enough! And the punishment for not adhering to the status quo can be quite severe, too, so anyone better be prepared for a battle if they want to go that direction! And I think that’s the problem – many people in the system SEE what we’re seeing, but very very few have the courage to act on that knowledge.
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I can’t really argue with you. The power imbalance is ubiquitous, and no doubt plays out here at MIA as well.
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Wow, that is a grim but very feasible explanation for how “personality disorders” came to be what they are. So people are not human normally, but those who INSIST on being human are therefore BAD!
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The idea that “all behaviors are purposeful” has been central to all of my work as a counselor and/or social worker, but it seems an utterly foreign concept to those steeped in the DSM/psychiatric worldview. If all “mental illness” is a result of “brain dysfunction,” then NO behavior has any meaning or purpose at all. Could not be a more opposite approach to what I know to work!
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I know I’m not Dr. Murphy, but I think you have put your finger on a most important issue: how CAN one measure success when the “diagnoses” themselves aren’t even based on any kind of objective test, let alone the outcomes! But insurance companies have become accustomed to accepting DSM “diagnoses” for purposes of reimbursement. In fact, that is what the DSM was invented for and the only actual legitimate use for the manual. It is psychiatry itself that has tried to parlay a very subjective billing document into some kind of pseudo-scientific diagnostic tool for “disorders” that can’t be objectively defined, let alone tested for.
What, indeed, is success in such a scenario? And who gets to decide?
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They probably wouldn’t phrase it quite that way, but I have certainly known psychiatrists, mainstream and considered competent, who had exactly this attitude. They express seeing the mind as some sort of mechanical device, and that they are simply tinkering with the parts like a mechanic with a car, to get it “running smoothly.” There seems from some to be no recognition that there is a person in there taking in information and making decisions and having emotional reactions to what’s happening to them, including what the psychiatrists themselves are doing. They seem to view people as bodies, and to discount any sense of agency that an individual may have. It’s not hard for me to see them discussing whether or not treating the “patient” as a human being is a good idea.
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David Healy is certainly one example of a person who lost prestige and position for questioning the status quo paradigm. He was denied a position he had already been hired for in Canada because of his views. I’m sure there are lots more. How tenure comes into play is something I don’t really know enough about to comment on.
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And every year, our “mental health” outcomes get worse and worse. Could there be a connection here?
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OCD is a description of a way of behaving. No one has ever said that such behavior doesn’t exist, only that it is not a valid medical “diagnosis” of a “disease state” or “disorder,” as labeling a set of behavior “OCD” does nothing to identify either cause or appropriate “treatment,” as any good diagnosis must do, of course. You seem like a bright fellow and that difference should be VERY easy for a bright fellow like you to understand. And the idea that drugs can induce or exacerbate a particular kind of behavior should also not be surprising to anyone with the slightest education in the area. I’m sure you can think of some examples.
I get the distinct impression that you are not really interested in understanding the answers to your questions. It seems you are trying to provoke people or prove “us” or Whitaker wrong. Am I wrong?
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Understandable!
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You are missing nothing. There is no objective means to assess “success” in any “mental health treatment” modality. This is why psychiatry/psychology are not actually scientific endeavors. There is no way to even select out a legitimate group for experimentation, let alone obtain an objective measure of pathology or success, for ANY DSM “diagnosis.” Perhaps it’s the last point you are missing after all!
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I would suggest the same question applying to psychiatric drugs and to electroshock “therapy,” and see no actual answers to any of these questions.
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Those are all assumptions on your part, which could be true or not be true. It does reflect where folks choose to spend their time, but I have no idea why someone chooses not to respond to comments. I am sure there are lots of reasons, and for some, your assumptions are probably true. But I’m not really in a position to know that. That’s my take on it, anyway.
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And now the drug companies can create Tardive Dyskinesia and then sell you a “treatment” for it! TD was a big secret no one talked about, until they were able to make money off of it, now it’s on national TV!
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Hey, don’t give them any ideas! I’m surprised they haven’t come up with that one yet themselves!
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Replying as me, this time: I don’t think we know whether or not she’s read the comments. I hope she has and that it informs her further work. I am glad she is challenging some of the psychiatric shibboleths with her work, but I also hear a someone apologetic tone in her critique, which I find inappropriate when critiquing those with great power vis a vis their “patients.” The fact that her colleagues are even having a discussion as to whether or not “patients” ought to be treated as human beings suggests that there is a lot worse going on here than a few people being misguided or not quite understanding the experience of their “patient” cohort. It seems there is a built-in dehumanization process going on which can’t be explained by individuals being “misguided” nor altered by a bit of “sensitivity training.” This is ingrained, systematic behavior that is encouraged and enforced by those in charge of the system, and needs to be recognized as being intentional and enforced, such that any (such as her) who challenge the dominant narrative will be punished. Given her own experiences and sensitivities, I’m betting the author will gradually come to that conclusion (as I did), but in the meanwhile, I see no reason not to point out this inconsistency, as long as we do it as respectfully as we can. I value her work and have hope for her in the future, but I do see a need for a more blunt assessment as to why her colleagues are not receptive to her observations.
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I agree completely. Except that I also believe oncologists and other doctors of actual medical conditions damage their patients’ care by treating them as objects rather than people. It is well established that assertive, empowered patients actually live longer and have fewer ongoing issues than those who simply passively accept whatever “care” is doled out for them. So even oncologists ought to be engaging with their patients as human beings, for their own health and the success of their interventions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005070/
https://www.patientbond.com/blog/patient-empowerment-impact-health-outcomes
https://www.acc.org/latest-in-cardiology/articles/2019/02/01/12/42/the-patients-voice
If PHYSICAL health outcomes are significantly affected, how much MORE would mental/emotional outcomes be impacted by how the “patient” is treated? This is one more reason why the idea of providing “medical treatment” to those with mental/emotional/spiritual issues is so destructive – the transfer of the “patient as object” attitude so common (yet still ineffective) in medical care is transferred to an area where it does a tremendous amount of damage, being essentially the exact OPPOSITE of what is required for actual improvements in “mental health,” though that term itself reinforces the idea of illness that is not appropriate to the situation 99% of the time. It boggles the mind that anyone who actually has the vaguest comprehension of what people are suffering from and what they need would have to have a discussion, let alone an argument, about whether treating their patients “like a human being” was a good idea!!!!
It is bizarre that the world of physical healthcare is making more effort to alter this attitude while our “mental health professionals” seem to be arguing to continue it!
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Yeah, really seems to have missed the boat on THAT one!
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Well, in the end, action does result in results, but sometimes it just takes a hell of a lot longer than I want to!
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POSTING AS MODERATOR:
Many authors don’t read the comments, or choose not to engage in the commenting community. It can take more than a bit of courage to dip into the comments section! And it is by no means a requirement that authors respond to comments, and can’t be assumed to mean anything other than that they choose not to engage.
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Sadly, that was my experience working “Behind enemy lines!”
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It is just an unsupportable claim, the sort the industry makes all the time. There are plenty of people who have no history of “bipolar” diagnosis who get manic on ADs, and it’s even worse for SSRIs or SNRIs. Aside from which, there is no way to actually determine if someone does or doesn’t “have” “bipolar disorder.” So they can (and often do) claim after the fact that the REASON the person became manic on their drugs is because they WERE ‘bipolar’ but didn’t know it. I recall specifically the rhetoric that “the drugs uncovered a latent underlying ‘bipolar disorder!'”
The fact is, these drugs can make ANYONE act in a manic manner, it’s simply an adverse effect, and no one has EVER drawn a connection between such a reaction and “bipolar disorder,” except anecdotally and after the fact. In other words, it’s bullshit!
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POSTING AS MODERATOR:
Why would you think “this comment won’t survive long?” You haven’t violated any of the posting guidelines, have you? We don’t moderate for content here. You can say whatever you want, as long as you are civil and respectful about it. I hope the continuing presence of your comment makes this very clear.
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We eventually had to invent an alternative school that was child centered. Our youngest went through this school from K-12 and was very successful in college and is now a very powerful, intelligent, and capable adult, despite his “ADHD” tendencies that might well have gotten him “diagnosed” if we weren’t well enough educated to avoid it. The school didn’t last long after we left, but a lot of kids did have a different kind of school experience, one where the kids actually had RECOURSE if they were being abused or mistreated by the adults or other kids. It was a beautiful thing while it lasted, but eventually it knuckled under to the forces of “human nature.”
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And I am glad she’s on the side of treating patients as if they were human beings!
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POSTING AS MODERATOR:
It occurs to me that posters in the MIA community are ALSO a group, and I have unintentionally allowed slanderous generalizations about that group, as Nijinsky so powerfully reminds me. In the future, any comments about the MIA community of commenters will be moderated as generalizations about a group based on their membership in the group.
Nijinsky is also correct that any allegation of an inappropriate comment should be specific, and actually needs to be referred to me as moderator, rather than to the community as a whole. In an effort to be fair, I have allowed violations of the Guidelines, and will be correcting that mistake in the future.
Any criticisms need to be of specific ideas, not of the MIA community as a whole. It is acceptable to critique MIA as an organization, but not groups of individuals who contribute to it, especially in such a generalized manner.
Thanks to Nijinsky for reminding me of this requirement.
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I thought about this very point last night. The Posting Guidelines forbid attacking a person or making attacking generalizations about a group. But there is nothing saying we can’t attack IDEAS. Perhaps some folks find that confusing. You are all welcome to visit and share your ideas, but your ideas are going to be vulnerable to attack and may need to be defended with logic and data. There is nothing mean about letting someone know you disagree with them, especially if you provide legitimate data, either research data or personal experiences or both. It’s part of the price of coming here. If a person wants to challenge the ideas of others, they should expect that they may be challenged in the same manner. That’s how this community works.
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Have you ever read John Taylor Gatto? He was an award-winning elementary school teacher who wrote “The Seven Lesson Schoolroom.” He gets down to the actual meta-lessons that lie behind all of the supposed educational activities, and breaks them down into specific “lessons,” including “Never trust your own observations” and “Always ask permission from the authorities.” It is quite on the point of what you’re talking about. And sadly, though individual teachers challenge this thinking “under the table,” I would posit that it is essentially impossible NOT to reinforce these “lessons” when you participate in the system. I was a teacher for three years, and approached it with a growth and reform concept, and found it quite impossible to make more than a tiny scratch on the bigger system. It is a very unhealthy place!
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The fact that this is even a question, whether or not to treat patients as “human beings,” says about all one needs to know about the industry!
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I am TOTALLY down with rejecting capitalism AND psychiatry! I just don’t yet know what the better plan is. I think we’ll have to invent it as we go along.
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Ha! Love it! Bob Marley was a man of great wisdom!
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I accused you of nothing. I simply disclosed my intentions. It appeared to me that you came her with a pre-existing viewpoint and have “attacked” others who don’t agree with you in exactly the way you are claiming others are “attacking” you. I consider it valid for people to express an opinion and to have an intention, and it is not an “attack” to me if someone expresses an opinion I don’t automatically agree with. Of course, you don’t need to justify being here. But in my experience, if one wants to actually relate to people, rather than merely irritating them, it might work better to spend more time listening and less time telling others what you think of their ideas. But of course, that’s just my viewpoint. If you want to disagree with people, you’re going to get a lot of arguments, that’s just how people are. If that’s how you want to conduct yourself, you have every right to do so. But you don’t have a right to have everyone respond supportively, especially when you don’t show them the same courtesy, IMHO. I prefer to have honest but civil exchanges of viewpoints, with each side presenting the evidence to support their views. It doesn’t have to be viewed as a “win/lose” “right/wrong” kind of thing. Maybe people just have different experiences and are sharing them with each other? Maybe no one means to “attack” you at all, but just want you to understand what has happened to them without you judging them for sharing it? Maybe you can share YOUR experience and let others know how you came to the beliefs you have? And they can do the same, and each of you will be a bit wiser for understanding the universe isn’t always the way we ourselves experience it?
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Posting as moderator:
If you are feeling abused by a specific post, please inform the moderator by emailing me or hitting the “report” button. It is unfair to community members to make blanket assertions that you are being “discounted, insulted or abused” without citing specific instances, not in the comments, but to the moderator to be handled, edited or removed. Everyone is welcome to their own viewpoint, and passionate disagreements to occur and are welcome, but only as long as they remain civil, which means no personal attacks and no generalizations about groups of people based on their belonging to a particular group.
Please contact me at my email address if you need further clarification. Respectful disagreement is not the same as insults or abuse, and I am here to make sure that we allow the former but not the latter.
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“Rethinking” does not mean what you said here at all. It means having an open mind. I personally would appreciate you not intentionally interpreting what is going on here. If you want others to welcome your viewpoint, you need to allow that others’ viewpoints might also have validity. Otherwise you are asking of others something you are not willing to grant.
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POSTING AS MODERATOR: Brenda, I want to clarify that EVERY viewpoint is welcome here, and we NEVER moderate anything based on the content. Clearly, anyone claiming that the medical model is “correct” is going to have to deal with a range of varying opinions, some expressed with more passion than others. But that is hardly different than what you have offered above. So everyone is always welcome to offer differing points of view, but everyone else is also entitled to respond with theirs, and there is no rule against disagreeing or challenging folks to come up with data to support their viewpoints. As long as those disagreeing with you are civil in their replies, they have the same rights as you do to express whatever opinions or viewpoints they have.
I hope that makes things clearer.
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I’m afraid there is no science behind the medical model, either. Not one of the DSM “diagnoses” has a legitimate, objective way to differentiate it from a “normal” person, let alone differentiate those WITHIN the “diagnosed” group on the basis of what is CAUSING the problems.
The DSM itself says this: “In DSM, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” It also says that, “There is also no assumption that all individuals described as having the same. mental disorder are alike in all important ways.”
What do these two admissions mean? First, they are saying that they can’t tell which category a person fits into, they could fit into more than one category, and there is also no way to tell with any certainty if a person even has a disorder or not.
Second, and perhaps more important, the second comment says that even if two people fit the same diagnosis, center of the target, same symptoms etc., it doesn’t mean they necessarily have anything of significance in common with each other.
So in other words, any person “diagnosed” with a “mental disorder” is so diagnosed subjectively, with vague and undefinable boundaries deciding whether they do or don’t “fit the criteria.” AND any person diagnosed with a particular “disorder” may have nothing in common with another person having the same “disorder” diagnosed, meaning the “diagnosis” doesn’t even tell you what kind of “treatment” they would need.
Of course, everyone ignores this and pretends we somehow “know” that all “mental disorders” are caused by “biochemical/neurobiological” problems with the brain. Does that sound scientific to you?
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It seemed to me you were selecting your examples with a bias toward making your point, and by selecting and mentioning them, you seem to be suggesting they are more valid. I showed that by creating a similar list of psychiatric disaster stories from people just as famous. Why did you select those and not others? Your comments also seem to imply that having a “diagnosis” means needing “treatment” and that the “treatment” in question will generally work. Have you take the time to read Whitaker’s book yet? Have you taken the time to read some of the comments and articles from survivors of the psych system? Try reading the recent podcast regarding a psychologist studying what happens to people who are exposed to “involuntary treatment.” Her commentary on her OWN forced “treatment” as a teen and a young adult is CHILLING. I only wish it surprised me.
I’m trying to get you to open your mind here. If you want validation that “treatment works,” there are plenty of places you can go. I assume you came here to look at things more broadly. There are very FEW sites where survivors can share their stories of what DOESN’T work about the system without being attacked or censored. This is such a place.
The “Reply” button sometimes disappears when you get too many comments in the same thread. You just go back to the last one that has a “reply” button and it will appear at the bottom of the comments currently approved.
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So what? Who says he’d have been better off seeing the psychiatrist? Marilyn Monroe, Del Shannon, Stevie Nicks, Jordan Peterson, and Ernest Hemmingway, among others, certainly were not.
And Edison was a classic “ADHD” kid who was kicked out of school and his mom told he was “incorrigible.” Mom knew better and educated him at home and he became one of our greatest inventors and marketers of new ideas. Would he have been better off being “diagnosed” and “treated” in his youth?
Depression exists. People get depressed. Nothing new. Drugs can be used to alter people’s emotional reality. Also nothing new. Giving drugs to people without having a clue what is wrong with them and hoping that some of the spaghetti sticks to the wall when tossed is hardly an impressive medical approach. Proving that people have issues doesn’t prove they are medical problems, and CERTAINLY doesn’t prove that drugs are the answer.
Actually, long-term studies on antidepressants, stimulants, and antipsychotics have shown that NONE of these drugs improve long-term outcomes on the average, and that’s from studies mostly TRYING to prove they work. Read Whitaker’s work and see what you think afterwards.
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You are operating at a level of privilege that allows you to ignore the fact that others don’t always “have a choice” like you do. “I don’t have to allow myself to be oppressed” sounds very New Age, but being born black or female or poor or in a third-world nation where multinational companies extract all of our resources and pay people pennies a day to work and there are no other employment options available is not a choice for those people. I’m guessing you’re privileged enough to insist on the ultimate privilege, the privilege of pretending you don’t have privilege and that others are suffering simply because they are too lazy to “insist” on becoming “unoppressed.” I hope you are able to open your mind and realize how incredibly FORTUNATE you are to be able to believe you “don’t have to allow yourself to be oppressed.” A lot of the world doesn’t have that option.
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Here’s a hint: there are cultures where “postpartum depression” essentially does not occur. These cultures are characterized by providing instant and ongoing support to new mothers, surrounding them with folks to cook, clean, sew, heat the home, etc. so the mother has only to care for the child. In our “enlightened” culture, we give moms next to zero support and six weeks of “parental leave,” often unpaid, and threaten the mother and family with poverty if she decides not to come back to “work” soon enough.
I wonder why we have more “postpartum depression?” Must be genetic…
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I do have a lot of respect for Marx. But I also think there are lessons to be learned from the Russian experiment and other efforts at collective living and governing. Clearly, something went awry between the Proletarian Revolution and the melting away of the ruling class. What happened? Why? Was it inevitable? What can be learned from the collective farming efforts? What is worth keeping and what part of it was problematic?
I think it’s fair to say that communism AS PRACTICED in the USSR and in China most definitely devolved into something pretty oppressive, which was what the joke was really about. And sure, you can say “That’s not really communism,” but you know what I’m talking about.
The Israeli kibbutz might have come the best to emulating what Marx had in mind. What worked about that? What did not? How did they come to be slowly undermined? How can that be altered?
Communism has yet to prove itself functional in the real world. Doesn’t mean it won’t. Capitalism has certainly proven to have some very serious adverse effects on a worldwide basis. I find these effects horrifying. I’d love to find a viable solution. Just not committed to the idea that Marx has the solution. We should keep working on it!
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Oh, I forgot about Del Shannon:
https://www.latimes.com/archives/la-xpm-1991-01-29-me-77-story.html
A shame that “stigma” kept him from getting the help he needed! Oh, wait! He DID get the highest quality psychiatric care available. And killed himself a few weeks later. Now THAT’S a psychiatric treatment success story!
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The DSM III was specifically and intentionally designed to make psychiatry seem more “scientific” and claims of “biological causation” were intended to do the same. Its own creators admit this.
“While the successive framers of the DSM have attempted to base it on scientific evidence, political and economic factors have also shaped the conceptualization of mental illness. These economic and institutional forces have reinforced the DSM’s use of a medical model in understanding psychopathology. Though the scientific evidence for a medical model is mixed and evidence for other types of conceptualizations have been given less attention, the medical model provides for reliable diagnoses that allot diverse benefits to treatment providers and researchers, as well as to the pharmaceutical and healthcare industries.”
https://www.cambridge.org/core/journals/european-psychiatry/article/abs/influence-of-corporate-and-political-interests-on-models-of-illness-in-the-evolution-of-the-dsm/EBDA0C7701E89B6C85B28FA4A34EE4F8
“During our interview, Spitzer mentioned openly, almost proudly, that one of the reasons he pushed for adoption of the term “disorder” for conditions such as anxiety was that it eliminated psychotherapy and psychoanalysis as treatment options. He added that opponents of the change could have mounted a legitimate defense if they’d spotted a key discrepancy with the ICD system, where the term “anxiety neurosis” was still included, in ways that made the DSM change look arbitrary and loaded. And he openly acknowledged that the addition of new conditions to the DSM was in part “a function of ‘Do you have a treatment’? If you have a treatment, you’re more interested in getting the category in” (qtd. in Shyness 75). Such pressure from drug-makers and their academic sponsors highlights a cart-before-the-horse dynamic often borne out by the DSM-III papers, as in the above linking of Panic Disorder to Upjohn Pharmaceuticals.”
https://www.psychologytoday.com/us/blog/side-effects/201601/the-problem-heroizing-robert-spitzer
It was about competition for market share with various therapists/counselors/support groups, and psychiatry could only claim primacy if they promoted the one product they could offer that others could not, which was drug prescriptions. So they designed the DSM to be “atheoretical” (meaning none of the “diagnoses” were concerned with WHY that person acted/felt/thought that way) and left the “theory” to be filled in by those applying the “diagnoses.” This left the door wide open for unscientific claims that because drugs affected people’s moods and behavior, these “disorders” must be caused by brain abnormalities, even though the DSM specifically avoided saying any such thing (knowing there was and continues to be scant scientific evidence to even suggest such a thing might be true). It worked a treat, especially with the massive marketing assistance they received from the drug companies, who could see a bonanza coming their way. What is better than a chronic condition which has no identifiable cause but which can be “treated” with drugs for the rest of a person’s life?
So it doesn’t have to be a “conspiracy,” merely a capitalistic coming together of financial and guild interests, which neatly dovetailed with a society who was anxious for an “explanation” for the vast emotional distress that citizens of more industrialized countries seemed to be experiencing, without having to question the basic assumptions of such a society’s status quo.
The DSM was not and will never be a scientific document. It was at first a list of billing codes, but Spitzer and the DSM-III committee turned it into a political document that intentionally redefined “mental illness” as a medical problem treatable by doctors and drugs. That decision was made intentionally and had nothing to do with the eventual well being of the clients. It had to do with psychiatry’s bid for domination over the less expensive and frankly more effective (though the bar is VERY low) therapeutic approaches that were threatening to take away their client base.
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I’ll repeat my answer, in simpler terms this time around so you can’t miss it: NO.
And yes, we do need to find an alternative.
Time to move on.
Steve
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So noted.
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Ah, rehab centers are for drug and alcohol use, I believe.
I see your Dwayne Johnson, and I raise you Ernest Hemmingway, Marilyn Monroe, Stevie Nix, Jordan Peterson, Robin Williams, Michael Jackson. I could go on. All of the above were massively failed by psychiatry and report being damaged by their “help”. Some even died. Hemmingway’s famous line, “The operation was a success, but we lost the patient!” was in reference to receiving electroshock therapy. He committed suicide.
There are lots of people (including me) who have struggled with difficult emotional experiences, including feeling suicidal. That doesn’t mean the system will be of help to them. Perhaps it’s time to stop writing and start reading some of the many testimonials available here. Admittedly, it’s a skewed sample, but to claim that psychiatry is “there to help” seems a bit of a stretch, especially after reading the recent article referring to a study of psychiatric inpatient “treatment!”
Try to open your mind to others’ experiences. This website exists for a very good reason, and it’s not to make people like you feel uncomfortable. There are a lot of stories out there that you may not want to hear, but perhaps you NEED to hear them anyway.
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Very well said!
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You could also look at the illegal drug industry and say exactly the same thing. But we at MIA decide medical efficacy by science, not popularity. And BTW, there are PLENTY of “customers” of these drugs who are not voluntary in the least degree.
I think we can look at the amazing success of these companies, including their ability again and again to absorb multi-million dollar lawsuits, as a sign that marketing far outreaches science in terms of selling products.
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Nor do we know if such processes are even located in the brain.
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My humor reflects the reality that people in any political/economic system will to a significant extent be tempted toward greed and the desire for personal power. This is what has happened throughout human history, and I’m not holding my breath for it to change anytime soon. I think Marx’s analysis of capitalism was absolutely brilliant, genius, unparalleled in any other writings before or since. I am not sure his solution is workable based on the fundamentals of human nature. And to date, history has proven my observations to be accurate.
You’re welcome to disagree with me, of course, but the real point of my comment is that psychiatry doesn’t really care who is in control, they simply want power. Or to put it another way, the problem isn’t which form of government or economic system we endorse, the problem is that we allow the exploitation of other human beings.
It is hard to see how you would twist that bit of humor into accusing me of suggesting that capitalism is the pinnacle of human achievement. The joke says that the essence of capitalism is that “man exploits man.” Do you see that as some sort of recommendation of capitalism as a superior form of economic system? That’s a pretty bizarre spin to put on a joke that clearly indicates both Capitalism and Communism (as practiced in the real world so far) to be flawed in their exploitation of human beings for power and profit. Perhaps it’s time to reconsider your political analysis of my joke. Or maybe simply file it away as a momentary attempt at humor in a very grim world.
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Correction: there is no scientific test for ANY DSM classification!
Otherwise, I agree with your comments 100%!
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Your psychiatrist is simply telling you what they believe. I know of no data suggesting that “untreated” anxiety is any worse than “treated” anxiety, and the same for every other “mental health condition” in the DSM.
As to whether or not it’s worth it for the “benefits,” that’s something each individual has to decide. My personal view, though, is that the less drugs I take, the better. ALL of them have adverse effects, and the list for antidepressants is quite long. Read up on the issue and see what you think. And remember, recovery rates were MUCH higher before antidepressants existed, and there are LOTS of other things you can do instead that DON’T have these bad effects on your body!
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You are so right, there is no prevailing “scientific” paradigm! The current paradigm is the farthest thing from scientific, it is arbitrary, rigid, dishonest, and authoritarian, and denies any real science that speaks against it. It has much more in common with a religious practice than science. Maybe we should call it the “current propagandistic dogma?”
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You are right, it is essential to find solidarity with people with similar realities! But that is VERY different than someone else deciding FOR you what group you belong with on some arbitrary criteria, and particularly telling us what we have to DO about our supposed “condition!” We should be the ones deciding for ourselves what group we belong to and who are our “people” and what it means to be part of that community!
I’m sure I’m preaching to the choir, but I just wanted to emphasize that point!
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This reminds me of a joke from Mad Magazine in my youth:
What’s the difference between Capitalism and Communism?
In Communism, Man exploits Man.
While in Capitalism, it’s the other way around!
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Not at all. Drugs work for all sorts of reasons. All it means is that that particular 15% responds positively to antidepressants. There is no other conclusion that can be drawn.
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With all due respect, many businesses profited mightily from the Third Reich, and Hitler’s rise to power would never have happened without the huge support of capitalists in Germany and around the world:
https://www.adl.org/news/op-ed/german-businesses-and-nazis
https://www.brennancenter.org/our-work/analysis-opinion/how-big-business-bailed-out-nazis
Many US industrialists supported Hitler as a bulwark against Communism:
https://therealnews.com/d-day-how-the-us-supported-hitlers-rise-to-power
https://www.truehoop.com/p/hitlers-american-business-friends
So the evidence is not that Capitalism saved us from the Nazis. Rather, the Nazis and Capitalism were rather friendly. It was the courageous nations whose people sacrificed by going to battle on the air, sea, and ground and were willing to sacrifice their lives who ended Hitler’s power. And let’s not forget that this effort would never have succeeded without the enormous Russian army, from a Communist country at the time.
Hitler’s demise occurred because a number of countries agreed that they needed to stop him. Regular citizens of both Democratic and Communist countries battled Hitler while most of the Capitalists sat back and sold goods to one side or the other or both.
As to rebuilding Europe, perhaps you are forgetting the Marshall Plan, one of the most “socialistic” efforts ever put out by the USA, not to mention the GI Bill, where formerly poor kids were given college educations and cheap housing loans and started the biggest expansion in the middle class in the history of the world? Hardly the work of capitalism! More the result of smart investment of tax dollars leading to great results.
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So very true! A lack of philosophical clarity about meanings and values and intent and language dooms any “scientific” effort to failure. In this case, the most basic tenets of science are violated from day one: You can’t do a scientific experiment by assuming a heterogeneous group has something in common with each other. Lacking a clear distinction of an “in” and an “out” classification, no further experiment can be done. Of course, there are tons of other problems with psychiatry, such as whom is it intended to serve, what the purpose of the enterprise is, who gets to decide what “works” means, and on and on. It astounds me that any thinking person can take psychiatry’s pretense seriously!
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But the real problem is not having an objective way to “diagnose.” It is human nature to allow “drift” in any non-objective line that is drawn, and that drift will always tend toward what makes the powerful more comfortable and the less powerful even less powerful than before. When it was first proposed, “ADHD” (or MBD as it was called at the time) was supposed to affect a tiny proportion of the population, kids who’d had some kind of trauma or disease that made them unusual. By 1980, suddenly 3-5 % of the population “had it,” and they were 90% boys. Not long after, it was “discovered” that girls got it, too, and that kids don’t grow out of it, and that adults also had “ADHD.” The requirement that the child showed signs of “it” before 6 was removed, and now we’re seeing rates of 10-15%, and some places 20% of boys in a particular school or area are “diagnosed” with this “disorder.”
I don’t see any way to stop this slide without hammering away at the utter spuriousness and subjectivity of these “diagnostic criteria.” I really don’t see “better diagnosis” as a way out of the mess. You can set up the best “standard diagnostic interview” in the world, but people will use it in ways that fit their worldview, and the industry will continue to chip away at these soft boundaries until more and more and more of the population will be seen as “mentally ill.” Because that is the INTENT of the system. At best, a standard interview format can slow the drift, but it will not stop it, because the force is pushing in that direction, and there is no objective standard one can point to and say, “No, you’ve really gone too far on this one.” The “diagnosis” is, in the end, a matter of opinion, and that opinion quickly deteriorates into “whatever the clinician wants to see.” That’s the problem I see as unsolved by the diagnostic interview. Not that I want to minimize the thought and good work that’s gone into this for you. I’m sure if we had honest clinicians and an industry truly focused on helping people, such an interview could be conducted in the knowledge that these “diagnoses” are indeed only ways of describing situations and don’t actually tell us what (if anything) is wrong or how to “treat” the patient. Of course, that begs the question, what use is a diagnosis that doesn’t tell you what is wrong or how you should treat the patient? But that’s for another post.
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Well, that’s not a bad standard if you want to set one. I get that you’re using this to battle the status quo. I’m just saying that the fundamental of the status quo that needs to be changed is not going to change by better outcome measures. I do care about the people who have to put up with the system as it is, and I used to be the clinician “behind the lines” and feel like I made a huge difference for some folks I encountered. But I got worn down by the general acceptance of the DSM diagnoses and the abusive treatment of clients that resulted. It’s hard to see what can really alter the deep issues with the current disingenuous “philosophy” of the system.
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Of course not. But most people haven’t the first beginnings of a clue about what happens in the “mental health” system. Most still believe in the TV “psychiatrists” who are wise and compassionate and good listeners who do therapy. They see the MH system as protecting them from dangerous “schizophrenics” and dispensing magical pills, and the only reason a “mentally ill” person is suffering is because “they’re off their meds.” I’d love to see psychiatrists held accountable to some sort of client-based outcome measure, but they’ll fight anything sane and if it did happen, they’ll find a way to doctor the results (sorry for the pun!)
Sorry for being so cynical, but it seems we have an entire profession run on false assumptions and secret ill intent, and it’s hard to see any measures to create honest accountability being successful even if such a measure could be found and validated.
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Utility in accomplishing what, though. That’s a very problematic question!
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The fundamental error of the whole “DSM” model is the assumption that you can group people together based on how they feel, think or behave and that somehow all those people not only have something “wrong” with them but that they all have the SAME THING “wrong” with them. It is an absurd proposition, but I don’t think it’s by chance that they came up with it. It’s a great strategy for selling drugs!
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You mean some kind of quasi-objective outcome measure.
I do agree that the status quo is able to CONTINUE because there is no “yardstick” of success that psychiatry has to adhere to. My problem is that any such yardstick is ultimately not really objective, largely for the reasons you enumerated earlier. Cancer can be tested for reduction in tumor size or in certain chemicals present in the bloodstream. Heart disease can show better outcomes through increased QT intervals or other such electrical measurements, as well as blood flow measurements. If a drug REDUCED blood flow through the coronary arteries, no amount of flim-flam could be used to say that this led to “improved outcomes.”
But there literally is no such measurement possible for matters of the mind/spirit. It is only when such testing and measurement fails that we should even be considering something a “mental health” problem. It’s not a body thing, and trying to pretend it is is just misleading. The real truth is, “mental health” intervention should not be considered part of the medical system, and demanding “outcome measures” is simply allowing the ruse to continue that any such objective measure is even possible. So I have a problem with the idea of “outcome measures” in the sense of “treating” some kind of physiological illness. Hell, they can’t even define WHAT they are “treating,” let alone what a good outcome would be! And of course, they always fall back on “symptom reduction” as their “outcome measure,” even when that may have nothing to do with the goals and purposes of the client. And “symptom reduction” is, of course, the area where the drugs are most likely to look “successful,” and I don’t think the choice of these “measures” is in any way disconnected from that fact.
Bottom line, the whole idea of “treating” “mental illness” as a disease state is wrongheaded and destructive. I can’t see any way to get around that, and I think we’ll be a lot better off simply stating that fact than trying to come up with quasi-objective measurements to keep the insurance industry happy. Impractical, yes, but at some point, I think we have to stop pretending!
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I’m really talking about simply asking the person to tell you what did and did not work about their experience. Clearly, a third party not associated with the therapist or his/her agency would be ideal. But I’m not advocating for any kind of “outcome measures.” We don’t have a homogeneous group of people to apply this concept to anyway. We just have to give a shit enough to listen to the client, whatever s/he said. I do think that a person who REALLY cares and wants to know will be honest in their response, but there’s no guarantee. It’s more of an integrity thing to me. There is no mathematical way to evaluate the success of any “mental health” intervention.
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Your explanation makes sense, and I’m glad we agree that the client is the only viable source of this information. It’s apparent you’ve studied this question much more in depth than I have!
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Or an opportunity for abusive people to make it so their victims don’t care about or don’t remember what happened to them?
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I have always thought that the only one in any position to evaluate our “outcomes” is the person receiving the “help.” No “independent assessor” will be in a position to truly judge what is helpful, unless they are looking at therapy as a way to improve the behavior of the client for the benefit of society at large. Which is a VERY slippery slope!
The client is the one who knows IF something is wrong, WHAT exactly is wrong, and what an improvement would look like. The therapist’s job, in my view, is to help the client come to understand their OWN view of what they want and what the barriers are to accomplishing it, and to help them circumvent or remove such barriers so they can succeed. It is not the therapist’s job to tell the client what is wrong or what they “should” do or not do. Most people are messed up specifically BECAUSE other people told them what was wrong with them and/or what they “should” do or not do. As such, the therapist is not in a position to decide for the client if therapy “worked” for them. If I think therapy was great and the client said it was worthless, it was worthless. All the more so with drug interventions. There is a balance between “reduced symptoms” and reduced quality of life that only the client can assess.
So skip the outside assessor. Ask the client. They are the only ones who can define ‘success!’
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Ways to help people get a grip on their own moments of “irrationality” and the reasons behind them, to manage to set boundaries on those who would harm us regardless of how they try to resist, as well as means to address ACTUAL health problems that are observable and can be addressed by physiological means, are all very welcome and needed. I do think it naïve to imagine that the death of psychiatry would lead to a sudden move to sanity and peace and good communication and respect in the world. But it sure would help NOT to have them around trying to make it worse by creating pretend “solutions” based on a complete misunderstanding (often an intentional one) of what a human being and a mind actually might be. We most definitely need to be working on real ways for people to learn to respect each other, to not react out of fear and hatred, to detect and avoid people who are dangerous to them, etc. But I don’t see physiological interventions being more than a tiny part of that approach. I don’t think we disagree on that point.
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I think that’s even worse! When we are suffering from “mental health,” the syntactical and semantic world has really been stood on its head!
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I always loved that one. It’s NOT that we failed the client, their DEPRESSION resisted us! It’s not our fault, not even the CLIENT’S fault, it’s DEPRESSION’S fault! As if it is a separate entity with an ability to resist despite everyone’s best efforts. Why not just say, “We haven’t been able to find a way to help her so far.” But that would mean admitting that their wonderful “treatments” may not be quite so wonderful! We can’t have THAT, so let’s “blame the disorder!” It’s a win-win! Oh, except for the client, who remains depressed and looses all hope, but hey, it’s not OUR fault that Depression is so mean to her!
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“The Stepford Wives” or “Invasion of the Body Snatchers” seem to be the ideal from a psychiatric point of view. Mildly positive attitude toward everything, no matter how bad, never very excited or upset or afraid or hostile, just dull, socially accepted blather. Anything else is a “disorder.”
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If we’re going to talk spiritual, I’d consider the mind to be more of a relationship or interface between body and spirit. I would still maintain “Mind” is not something that has a location in space or in the brain as psychiatry and related disciplines assume. What’s going on at a micro-microscopic level (electrons and fields and so forth) is beyond my current understanding, but it’s absolutely certain that “treating” the body per se is not going to be effective at this level.
It is silly, of course, to pretend that people don’t feel depressed or anxious, or behave in irrational ways that are not productive based on past experiences. I just don’t consider such things to be “illness” in the sense that a specific and measurable part of the BODY is somehow out of whack! The definition of “illness” is very problematic if we’re talking about disturbances in an electrical field around the body, let alone the damage to the “spirit” (whatever one considers that to be), which to me seems to be the main reason for the kinds of emotions and behavior that are currently identified as “mental illness” by the crackpots who created the DSM. I seriously think we need to get far away from that term, as it’s been claimed completely by the DSM propagandists, and doesn’t really describe the situation in terms that the average person can wrap their heads around.
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In this case, I’m using the term “improvement” exactly as those claiming the “benefits” of psych interventions are using it. By their very own measurements, they are incapable of “improving” any situation, and their approach is about as “effective” as going to the bar after work to get a buzz on. They can’t even “succeed” in their own paradigm, let alone address the fact that the entire paradigm is based on a fantasy “model” with no connection to physical reality.
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I think we’re talking about semantics here. Obviously, mental DISTRESS exists, difficult EMOTIONS exist, dysfunctional BEHAVIOR exists. But to call a mind “ill” in the same sense as a body is “ill” is a logical fallacy, which is what Szaz was talking about. If there are ways of helping with mental/emotional distress that folks are aware of, we absolutely need to engage with these approaches. But it’s not a MEDICAL problem. The mind can’t be “ill,” as it is not a thing of the physical universe. The term “illness” is an analogy or metaphor that can’t literally be true.
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It’s only a “paradox” if one insists that “treatment” MUST a priori be effective. If one instead simply asks the question, “Does ‘treatment’ improve the ‘symptoms’ of ‘major depressive disorder’ over time?” there is no paradox. The answer is quite simply, “NO!”
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It is fascinating how psychiatric apologists are allowed to distract from the topic with irrelevant associations of religion or politics. Science is science, and when there is no science behind your position, it doesn’t matter the political or religious affiliations of the person pointing that out, any more than the race or sex or country of origin has anything to do with it.
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Well said, ESPECIALLY #8!
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Lots and lots of people have questioned it, but they are shot down by the orthodoxy and massive “group agreement.” It eventually became so bad for me that I realized I could not ethically continue in the “mental health” field, as the purpose had shifted away from trying to find ways for people to live better to trying to find ways for people to “stop feeling bad,” and that drugs had taken the center stage despite all the very rational arguments against them. It became clear, I suppose, that rational arguments would never win the day, because the field had become predominantly irrational, and rational critiques led to shame, punishment, and shunning.
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“Diagnostic Drift” refers to when a soft line is drawn with no objective determination of who “has” or “doesn’t have” a particular condition, the line tends to move to include more and more people over time. This has been proven over and over again, particularly when there are incentives in place to “diagnose.” For “ADHD”, the incentives include explaining failure to be able to teach children or manage a classroom, justification for failing to learn sufficient parenting procedures, finding an “identified problem child” to maintain a dysfunctional family unit, creating a cadre of “specialist” who can make money off of making these “challenging diagnoses,” writing books and giving lectures, and of course, the financial remuneration for psychiatrists, doctors, and pharmaceutical companies.
And of course, you are correct, when “treating” something that hasn’t been actually established as a bona fide physiological problem and includes an incredibly heterogeneous group of “diagnosees,” one will certainly see “treatment failures” over and over again. And the soft “diagnostic criteria” of course make it easier to put the blame for any failures on the client instead of the person administering “treatment.” Instead of saying, “My treatment failed,” you can say “X is ‘treatment resistant,'” or “It’s really Bipolar Disorder” and off you go down another “treatment” path. I suppose that’s “reification” in action. We’re “treating” a metaphorical concept that is indistinguishable from “normalcy,” so the entire “treatment” process is by definition fantastical, having no concrete connection to reality. Except the damage done to the victims, oops, I mean “patients”, of course. That is very real and concrete, unfortunately.
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I would say that there was plenty of “depression” but it was transitory, and understood to be in most cases a normal reaction to adverse circumstances. It seems clear that “antidepressants” are quite capable of taking temporary “depression” and making it permanent. Another psychiatric success story!
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Well, they will never be able to help the 1% until they start admitting that the 20% that are diagnosed are 19% having a hard time with a traumatic existence. And I agree, the severity is not related to whether or not it’s a “biochemical depression,” if such a thing is proven to exist. Many, many cases of experiential depression are incredibly severe! And as you say, there are some people who have depressive tendencies that are mild but chronic who may very well fit into the same category with someone who is genuinely “seriously depressed for no reason.” Until there is some effort to actually make this distinction, any case of ACTUAL biological depression will be totally submerged in the flood of experiential depression cases and will never be identified or detected as a valid group for study. And I don’t see psychiatry being willing to go there any time soon. There is WAAAY too much money being made under the current model, even when they themselves know it’s not a valid model at all.
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But they have not yet realized what you said, that “depression” is not a “homogeneous disorder.” They continue to comment on and “diagnose” “major depression” based on subjective criteria, and studies are done over and over on groups of people “diagnosed with major depressive disorder.” The only way anyone will make ANY kind of progress on if there is a subgroup who actually DO have something physiologically wrong with them is to STOP grouping heterogeneous people together as if they all had one “disorder,” and instead start breaking down the subgroups and try to find some who actually DO have something in common with each other.
And I have no faith that brain scans are the way to do this. But even the link you mention still talks about “different types of depression” rather than “some depressive symptoms may have a biological cause.” They are still running on the assumption that ALL cases of depression are “medical,” that ALL of them are caused in some way by biological anomalies, and that sorting these “depressed people” into categories will solve the problem. Until and unless they begin to recognize that MOST cases of “depression” are NOT caused by biological problems, but by a wide variety of social, interpersonal, and individual psychological needs, and that even those cases which DO have biological causes need to be checked for things like sleep deprivation, nutritional deficiencies, anemia, and so forth before jumping to the unwarranted conclusion that something is wrong with their brains and that brain scans will somehow answer this very complex question.
And finally, if “they are not there yet,” why do “they” pretend that they ARE there and claim things are true that they don’t know about? Why do “they” get so threatened when people point out there are 80% or higher associations between MDD and childhood adversity/trauma and that attacking THAT problem will probably be a lot more fruitful than experimenting on people’s brains when you don’t really know what you’re doing?
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I would frame it more as a lack of any concrete means to MAKE a “diagnosis” from the DSM. As soon as you create “diagnoses” based on totally subjective “criteria,” the process of “diagnostic drift” will almost immediately take place. First, only the “really severe cases” are “diagnosed,” then the “benefits” to a less serious level of “dysfunction” are touted, and pretty soon, any kid who doesn’t want to sit still for yet ANOTHER round of math instruction on a point he already understood 3 months back is now “disordered” and “needs medication” for his “attentional difficulties.”
It also lets the adults off for creating poor environments for kids. I’d have had a lot less “attentional difficulties” if I weren’t bored to death all day every day throughout my entire tortured elementary school years. Why should the kids have to “pay attention” to whatever drivel the adults turn out? Maybe the adults suffer from “Boring Teacher Disorder!” It is exactly as logical and scientific!
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Dangerous to the psychiatric profession, because they might expose the truth that they know nothing about helping the “mentally ill,” and actually seem in most cases not to actually WANT to!
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Indeed. Not sure how anyone could expect giving a street drug to little kids would be helpful to anyone but perhaps the adults handing the drugs to them.
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Not only are academic measures not improved, but not one significant outcome measure is better for those “treated” with stimulants vs. those diagnosed but not “treated.” This study shows that not only is there no benefit of long-term labeling and “treatment,” it actually makes kids’ lives measurably worse! Yet MILLIONS and MILLIONS of kids are getting labeled and “treated” every day. More proof that psychiatry not only doesn’t improve lives, it makes them worse, and despite doing so and KNOWING it is doing so, it makes no effort to change its theories or approaches.
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I agree completely. It is presumptuous to assume the right to assign cause to something that one doesn’t even know how to define!
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He is correct. They have worsened. Yet still, he remains committed to the drug approach!
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Interestingly, during my brief stint as an official “therapist,” my goal was always to have the person NOT need me as quickly as possible. I didn’t WANT them to keep being my “clients!” Of course, I got paid by an agency regardless of who I saw, and there were always more “clients,” so the financial conflict of interest really wasn’t there in that role. So we’d get down to business, almost from the first words out of their mouths. But when it comes to GOOD therapy, the least necessary to get the client functioning on his/her own should be the goal! Yet I know it often is not.
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And they admit freely on the one hand that the conditions around the pandemic caused anxiety, yet on the other hand, they place the cause in the child who is feeling anxious. Contradiction much?
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Thanks for that clarification. I totally get what you’re saying now.
But I still think Psychiatry has a hell of a lot in common with religion!
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“Mental state” is also proven to dramatically affect biology, and the brain can be restructured to a significant degree by experiences. If we’re all brain, how does THAT work?
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I am not arguing against anyone using Ketamine as a means of relieving their suffering. It is apparent that this works for some people. But to try and codify what appears to me to be essentially a spiritual experience, to market it and sell it at huge cost to people while representing it as “the latest breakthrough” without mentioning that it won’t help everyone and can be harmful and that similar or better processes are quite possibly available through religious/spiritual practitioners is very damaging. There are lots of ways for people to get help for their situations, and everyone responds differently to whatever approaches are taken. The sooner the psychiatric world cottons on to this fact, the more likely it is they might actually be helpful to people. There’s a big difference in my mind between trying something and seeing if it works and selling a supposedly scientific “treatment” based on flimsy evidence and a lot of marketing.
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And from the people who use such categorizations as means to promote prejudice against abuse victims and others who are not happy with the status quo.
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There are any number of critiques of psychiatry, and even medicine in general, identifying similarities to religious practices. Please don’t minimize this as related to Catholicism. Here are a few examples:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625374/#:~:text=Psychiatrists%20have%20reserved%20powers%20to,prized%20virtues%20within%20mainstream%20psychiatry.
https://www.jstor.org/stable/27506042
https://www.drugtopics.com/view/opinion-modern-medicine-religion
It’s not a new idea of Gina’s. Heck, folks refer to the DSM as “psychiatry’s Bible!” Do you think there may be a reason for that comparison?
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Wow, great article, Patrick! I’m kind of surprised they published it. Your analysis of the actual trial data is very informative. I only wish that more people would think with that kind of information. If you did a hundred trials, and 80 were negative, 18 were neutral, and two supported the “treatment,” you could still apparently get it through the FDA???? And they didn’t even manage to get TWO positive trials! I’d bet Jack Daniels would meet statistical significance in a four-week, controlled dosage trial. Why do we allow this antiscientific nonsense?
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I really think that’s the core of it. We are taught not to trust ourselves and our internal intuitions, starting VERY young! We are taught to “trust the adults, they know what’s going on” and to dismiss our own valid observations over and over again. Then, as adults, if we find we’re having difficulties, once again, we are taught to ignore our own instincts and just do as we’re told. Well, that’s how we got INTO this mess in the first place! I have no objection to true collaboration and agreed restrictions based on the needs of a group or community, but simply dismissing a large proportion of the populace’s observations as invalid or unimportant is certainly not going to lead to a better world, or even better “mental health” for the individuals involved. It’s kind of like saying I slammed my finger in a door, and the “treatment” is to now hit it with a hammer! Doing more of what made us “crazy” in the first place is not a solution!
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What happens when the “client” starts applying these skills to the staff that are teaching them how to do so successfully?
I had a young friend who was in 5th or 6th grade. The school had a training on Carl Rogers’ “reflective listening” skills. During the assembly, they even did role plays. Afterwards, Jeremy sat on the edge of the stage, and a teacher came up with a raised voice and told him he’d better get off the stage. Jeremy said, “I feel uncomfortable when you yell at me. I’d like it if you could talk in a quieter voice.”
He was immediately sent to the Principal’s Office for “talking back” to the teacher.
I think the lesson is clear enough.
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I am so sad to hear that! But glad that you’ve made it through. I can’t imagine how difficult it would be!
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DISEASE: a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms : SICKNESS, MALADY
https://www.merriam-webster.com/dictionary/disease
Clearly, the boundaries between medical disease and social “disorder” have become very fuzzy. But to me, a social disorder is something CAUSED by social conditions. As you can see, the definition of “disease” above reflects something wrong with the BODY, and because medicine (at least in the Western countries) consists primarily of prescribing drugs and surgery, as well as lifestyle recommendations (which are not considered “treatments”), the idea of “treating” a “social disorder” by medical means seems stupid, kind of like drinking alcohol to deal with having a dead-end job and an unsatisfying relationship.
Here’s a decent description of a “social disorder:”
“When disorder and immoral events occur in society, it is called social disorder. From the beginning of the world’s existence, there has been chaos, heartache, catastrophe, and disorganization all of which can mostly be attributed to corrupt human behavior. Societies, countries, cities, communities, and families all experience this disorder in different ways, depending on their environment, population, and circumstances. This lesson will review some of the immoral dilemmas and misconduct that influences social disorder.”
As you can see, this definition involves issues of morality, order, corruption, environmental circumstances, social expectations, and even geography. Why would medical “treatment” be appropriate to deal with immorality? Or geographic trends (did you know that schizophrenia rates are MUCH higher in urban environments?) Or environmental problems? Medicine addresses the body. The major error that psychiatry makes is assuming that physical “treatments” can be used to address social/emotional problems. That assumption is 100% wrong. The only thing medicine can do for “mental illness” or “social disorders” is to “medicate” away the emotions involved with feeling oppressed or alienated or angry about the social conditions that prevail. Unless you are more going down the line of eugenics, and want to use “medical” interventions to reduce the ability of rebels to take action, or in fact incarcerate or sterilize or even kill them, as psychiatry has done in Nazi Germany and in the USSR, among other places.
Social disorders are social problems and need social solutions. I’m not opposed to thinking differently about that, but I am having a very hard time seeing what doctors are able and willing to do about a social problem like boring classrooms or domestic abuse in the home.
Using your example, how is “ditention” caused socially, and what medical intervention would stop it from happening? Or are you just talking about ameliorating the consequences and allowing the cause to go “untreated?” Which I think puts us back in the Jack Daniels category of “treatment.”
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BPD isn’t just dubious, it’s entirely subjective. So the only thing they CAN measure is “people who have been diagnosed with BPD.” Which is an extremely heterogeneous group, so the assumption that all will respond to the same or similar “treatment” is absurd.
I think you are correct, good therapists use what seems to work and discard approaches that are ineffective. It’s very intuitive, and the diagnosis is essentially completely irrelevant to good therapy. It’s also increasingly rare, as the DSM approach has dominated trainings and courses nationwide. So you’re right, measuring “effective therapy” for “DBT” is a fool’s errand.
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Well, a “cultural disorder” is by definition not medical. So I actually agree with you there. The question is why we want doctors “treating” social disorders with drugs, when the obvious answer is to alter social conditions that are causing the “disorders.” Schools are a fantastic example. “ADHD” is actually DEFINED to a large extent by behaviors in school that teachers find inconvenient or annoying. The same kids who are “diagnosed” with “ADHD,” when served in an open classroom environment, where they have more choices about how to spend their time and when to switch activities, are literally indistinguishable from “normal” children by trained professionals, per controlled scientific studies! So why give them drugs, when transporting them to an open classroom alleviates most of the “symptoms” without any of the risks of drug “treatment?”
One could even build on your comments and suggest that the actual purpose of psychiatry is to deflect any attention from the social causes of these “disorders” and instead blame people’s biochemistry so that no changes will happen to the social status quo.
What are you recommending I read that I have not responded to? I don’t remember that. I’m almost always willing to look at anything that provides new perspectives. I’m not willing to spend much time rehashing psychiatry’s spurious arguments about “mental disorders” being caused by biological problems in all cases (even their own DSM says otherwise), but if you’ve got something refreshing to share, I’m all ears!
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It remains a legitimate question as to whether this difference is a “disorder” or “medical condition,” which is a philosophical problem of great magnitude that psychiatry has always dodged. Difference is not disease. And there is still no clear line of demarcation as to who “has” or “doesn’t have” ditention or what causes the condition or situation.
Thanks for the interesting information. I’d also suggest that if the DSM were organized around things that could actually be distinguished from each other and from so-called “normal,” there might be SOME outside chance of finding a small subgroup of people who actually DO have something wrong with them. But this would require psychiatry to give up on their fictional DSM “bible” and start being a hell of a lot more humble about what they do and do not know. I’m not going to hold my breath.
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Disgusting, but not surprising. I’m sorry you have been victimized by this dishonest nonsense!
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Who woulda guessed?
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I have to say, that particular course of events is VERY rare, in my experience. In fact, I can’t think of one person who ever went in and asked for ECT. It generally occurs when someone is told they have “major depression” and is told it is a “neurobiological disorder of the brain” and that there is no cure, but that antidepressants can make it so you can live with it, yet antidepressants don’t seem to work despite multiple attempts of different drugs and combinations, and the doctor tells the desperate sufferer that ECT is the only “treatment” left and in desperation, they agree with it. That’s my experience, having talked to at least a few dozen “voluntary” ECT clients.
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As far as I recall, “ditention” is not a current DSM diagnosis. And I’d need to see how this “ditention” is objectively distinguished from “normalcy” in a consistent way.
That being said, if we have one example of a “biological cause” (though it sounds more like a correlation in any case), that’s not a very good advertisement for the idea that “mental illnesses” are biological “diseases.”
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Reading the DSM would not have helped. Believing in the DSM was the doctor’s first error. Once you start down the path of “diagnosing” your clients based on prejudice and subjective checklists of behavior, any “intelligence” one might have will have to be suspended. It’s not a matter of “misdiagnosis,” it’s a matter of not having a clue to start with what the significance of anyone’s mental/emotional suffering is, and not caring enough to find out.
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I believe the latest research says about 15% have significant improvements with antidepressants. And I’m very glad you managed to be in that group!
I think you might be missing the point a bit, though. The drugs are drugs, and they work for some people and they don’t for others. That’s not the sham. The sham is the PRETENSE that there is some way to “diagnose” people with the highly subjective DSM, and that these drugs “rebalance chemicals” in the brain that are associated with these subjective “diagnoses,” and that all ‘mental illness’ so defined is caused by faulty brain chemistry.
There is nothing wrong with finding that a particular substance works for you to enhance your life. But there’s no new “science” of the brain involved here. People have been experimenting with substances since the beginning of human history, from alcohol and inhalants to herbal medicine, not to mention any number of spiritual interventions from many different cultures. I object to none of these, as long as they don’t damage more than they help. What I do object to is people pretending to know things they don’t know, and using that pretend knowledge to sell things, despite data that belies their own assumptions. That’s the sham, not the drugs. It’s what they TELL you about the drugs and diagnoses that is fraudulent.
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What did your psychiatrist say?
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Looks like absolute proof that “stigma” is caused by the diagnoses, or the person applying them, rather than some pre-existing social biases. If it matters which “diagnosis” you have, it’s clear the discrimination experienced is applied to the diagnosis itself and what we have been “taught” about these “diagnoses” by our wonderful Mental Health System and drug industry. In other words, no “diagnoses,” and the “stigma” doesn’t happen.
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I always found the best “screening” to be: “How are you doing?” Then ask questions depending on the answer and figure out what the person is worried about or frustrated about or angry about or whatever. Then try to help them come up with a plan. It ain’t rocket science, folks.
Of course, the PURPOSE of “routine anxiety screenings” IS to create “overdiagnosis and overprescription.” That’s the whole idea. That’s also not rocket science. Screenings exist to get new “customers” and sell more product. They are marketing tools, not medical screening processes.
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A very interesting study was done a number of years ago. The experimenter created groups of three children who were assigned three problems to solve. One set of threes had an “ADHD-diagnosed” child and two non-diagnosed children, and the control groups had three non-diagnosed children in the group.
They measured “on task” behavior, meaning how much time did the kids spend trying to solve the problems rather than goofing off or doing something else. The “ADHD” inclusive groups did far worse on this measure, much more joking around and goofing off than the control groups. However, the primary outcome was which groups solved the problems more effectively. All of the “ADHD” groups solved one or more of the problems presented and as I recall, a few completed ALL the problems. NONE of the control groups solved any of the problems presented.
“ADHD” behavior still has survival value. Sure, if you put three “ADHD-diagnosed” kids in the same group, they’d probably have been very unproductive. But hard work from the “conventional” thinkers did not lead to solutions. We need ALL types in our society, and discriminating against certain children because they make life a little (or a lot) more difficult for adults to manage is both short-sighted and overtly destructive to our success as a society.
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Not merely “not required,” but not CAPABLE of “diagnosing mental illness.” Of course, why would we expect they would be when “mental illness” is defined by a somewhat arbitrary collection of thoughts/feelings/behavior as “criteria” and set at TOTALLY arbitrary levels of how many “criteria” are required for a “diagnosis,” such that in many if not most “diagnoses,” two people can be “diagnosed” when they have not one single symptom in common with each other. The very idea that such a wide range of heterogeneous behavior/emotion/thought could ALL be caused by some specific genetic anomaly is absurd on the face of it. But logic is not the basis for “mental health treatment.”
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With all due respect, this seems to shed more heat than light on the matter. Finding partial correlations doesn’t give us any real sense of cause, because most of the people diagnosed “ADHD” or “bipolar” or whatever don’t share these genes in common.
More importantly, these genetic findings provide absolutely NO guidance as to what, if anything, one can do to assist those having this highly subjective and heterogeneous “diagnosis.” What good is it to know that 10% of “ADHD-diagnosed” individuals have “altered dopaminergic firing patterns” if this doesn’t lead to any understanding of how to help even this minority of such individuals.
Finally, the fact that there are genetic variations between people that express themselves behaviorally means absolutely nothing about whether or not such states are, in fact, pathological. The assumption that kids who struggle in a standard classroom setting are ipso facto “disordered” deserves extreme scrutiny, which seems to be avoided by most advocates for the idea that “ADHD” is some kind of biological dysfunction rather than simply a common variant of behavior with survival value that teachers and parents tend to find inconvenient.
So again, not much light shed here. No one should be surprised that different behavior might be associated with different genetic makeup. Genetic diversity is the key to species survival. Different is not “disordered.” When THAT question gets addressed, maybe we can talk about some “light” being shed on the subject.
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For sure!
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I think you are still making unfounded generalizations, as if you can read the mind of all therapists, and as if all therapists have the same thoughts and intentions. This is obviously untrue. I think it’s possible to make generalizations about psychology/therapy as an industry, but individuals have different experiences and individual therapists are a VERY diverse group.
I’m not making apologies for the horrible state of affairs that exists today. I’m just saying that you can’t know what every therapist is thinking or intending, nor can you judge the experiences of those who employ them as being invalid or unhelpful based only on your own subjective opinions.
I am wondering – do YOU personally have experience with therapy?
I’m also with you on political action being necessary, and I hope we can get organized enough to make it happen.
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Wow, they don’t see the irony in that one?
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Because they very often ARE dangerous!
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Peter Kramer: “Listening to Prozac.” I think Breggin wrote a critique of that book called, “Talking Back to Prozac!”
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Good plan! Stay below the radar. But you shouldn’t HAVE to do that!
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I generally agree with your sentiments, however, I have noted there are times in one’s life where the other party is simply not interested in collaboration. This is particularly the case when there are substantial power differentials and/or when there are financial conflicts of interest. I am afraid to me that psychiatry has reached the point where both of those issues have made them impervious to logic and compassion as a profession, even if individuals are capable of seeing the damage psychiatry has done and want to change it. The latter deserve to be reached out to and asked for specific actions that would be supportive, but the former are safe enough with their power to simply deny reality and keep on with the “theories” that have made them so much money and given them so much control over the industry and their “mentally ill” charges. Bob Whitaker himself has always been open to discussion regarding his findings, and has appeared with psychiatric industry luminaries to “debate” the issues at hand. The result is almost always the same – they don’t debate, but they attack and undermine and lie and manipulate their way into defending psychiatry’s entrenched position. They can’t AFFORD to face reality. How is one supposed to collaborate with that?
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A psychotherapist, whatever their value, is not an attorney and is not required or expected to follow case law. It does not follow that a psychotherapist is conning anyone, though clearly some of them are doing so. Many people report improvements in their lives following therapy. How do you account for such people? Are you simply dismissing them as dupes because they don’t fit into your preferred narrative of reality?
I’m not a big fan of psychotherapy, especially when it serves as a handmaiden to the DSM and the psychiatric “mental health” drug-and-pray paradigm, which much of it does these days. But there have always been people with a particular ability to listen and be present for others who are seeking to make sense of their lives. Not too many attorneys are any good at this, but some of them are, too. So are some friends and acquaintances, doctors, dress makers, etc. Just by the odds, I’d say more than a few therapists must fall into the category of people who are good at listening and can help people sort out what direction they want to go with their lives. Just because YOU don’t value that kind of assistance doesn’t mean it’s not helpful to anyone.
I think it’s important we not fall into the trap of deciding what is right for other people. That’s the biggest problem with psychiatry, when it comes right down to it. It tries to force its views and actions onto other people without any concern for whether or not these things are actually of any assistance. I hope you will see that viewpoint and stop trying to tell everyone else what their experiences are supposed to be, instead of letting them decide for themselves.
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You’d think, wouldn’t you?
Thanks for your support!
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A lot of them don’t even consider psychotherapy. It’s drugs and ECT, and if that doesn’t work, blame the patient for being “treatment resistant.”
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That’s about right! My wife just got a note about “splitting” in her chart for SURGERY because she got in a conflict with a nurse who was being condescending. Her response would have made any competent DBT leader proud (if there is such a thing), she simply stated how she felt and asked for a change in the nurse’s behavior, but somehow, she had “Cluster B personality traits” because she complained about this person’s treatment of her. It’s a sleazy cover for saying, “This person’s a jerk and I don’t want to deal with them!” And it prevents any analysis of what the STAFF PERSON may have done to induce the supposed “cluster B personality traits” in their charge.
What ever happened to “The customer is always right?”
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Quite so! Biological causes are popular because “no one’s to blame!” (Except the poor client, but really not, because it’s not YOU, it’s your DISORDER that’s at fault!) The idea of social causation might mean someone has to DO something, to alter their own behavior or the structure of our institutions, and that is just TOO HARD! So let’s all blame the brain, whether or not it makes sense, because it makes us all FEEL less responsible! (Except the client, of course…)
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Wow, what a bunch of f-ers!
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Wow, those are really excellent examples!
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Something that occurs to 20% of the population isn’t abnormal.
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Weird how many people report things that “never happen!” Anyone who says something “never happens” is obviously either deluded or intentionally covering up. Humans are capable of all sorts of heinous behavior, and it’s naïve at best to imagine that nothing of this sort happens just because people belong to a particular profession. Reminds me of when a colleague who contacted a suburban school to offer a talk on sexual abuse, and the principal said, “We don’t have that sort of problem here.” RIIIIGHT.
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And I bet they didn’t warn you of these side effect when they gave you the drug.
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It was actually apparent if you listened carefully to the ads that they were not supported by the literature. They always would say, “Some scientists BELIEVE that depression is caused by an imbalance in chemicals…” but then would say, “Zoloft can correct these imbalances…” So they admit in part one that this is NOT established fact, only something “some scientists believe,” but they follow it up with a sentence that assumes these “beliefs” are correct. Very sleazy advertising, should not have been allowed, but that’s how they got by the rules about “false claims.”
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Do you mean coerced? I agree with you 100%. Actually, there can be no such thing as “involuntary treatment.” If the person has not genuinely consented, it’s at best “management,” and more likely punishment. Force is not and can not be part of any “mental health treatment.”
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I am sure the Big Cheese of psychiatry are well aware that these drugs impair normal functioning in the brain. The problem is, they are not there to find the best solutions for their patients, but to assure their continued dominance and high incomes. So no amount of studies and proof will change their minds. Their intentions are not the same as yours and mine.
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They’re already making money “curing” Tardive Dyskinesia that they CAUSED with their “antipsychotic” drugs.
Steve
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Yeah, so much for the “anti-stigma” campaign, eh?
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I like to say that the system is successful, it’s just successful in doing things that have nothing to do with improving anyone’s “mental health,” whatever that even means. If you go by making money, creating dominance for the psychiatric profession, selling concepts that have become part of society’s fabric despite their veracity or lack of same, it’s been wonderfully successful!
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Loneliness is chronic in our weird society and is of course causal in many “mental disorders” as described in the DSM. But if they admitted that, they might have to DO something about the situation! Instead, it’s easier to assume that everyone should love our society just the way it is, and that anyone who doesn’t is deviant, oops, I mean “mentally ill” and must be “helped” to stop those “bad feelings” that are making the so-called “normal” people feel bad, because it reminds them that THEY are lonely and confused and hopeless as well.
It’s quite a conundrum!
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One thing I don’t get is this: if they think you’re a hopeless case, why do they keep accepting payment for “helping” you, and indeed forcing you to be “helped” even though they themselves have admitted they don’t know anything that will help?
I’m glad you got away from such irrationality!
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And as I have pointed out elsewhere, by this definition, alcohol, marijuana, and heroin also “work” in that they have discernible effects on the mind and on the brain, which some people find desirable or relieving to take. I would hope that a medical specialty would aspire to a higher goal that, “Here, take some of these, you’ll feel better.” Anyone with a drug-seeking auntie can get as good service from her: “I’ve got valium, Percocet, klonapin, oxy, what do you need?”
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One cannot allow a fear of being accused of something deter one from doing the right thing. However, Bob Whitaker has of course been accused of being a Scientologist and all sorts of other things despite his determination to maintain a hard, factual stance. I actually don’t know that you or I or anyone else are in a position to criticize his approach, as he has had an enormous impact on exposing the truth about psychiatry, as much as anyone I can think of. So I say, WELL DONE, BOB WHITAKER! We need an antipsychiatry movement, but having a source of reliable information as well as a forum for discussing issues that aren’t discussed anywhere else on the Internet in these kinds of numbers is invaluable.
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Rachel, so nice to hear from you!!! I’ve missed you!
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Who could have guessed?
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Hmmm… 2% vs. 70%… which seems to have more effect, neurology or life experience… tough one…
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To translate into English: It’s more helpful to talk to someone who seems to like you and care about you than to someone who is treating you more or less like an object.
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If that is their plan, why don’t they just give people niacin pills, and say the flush is proof that it’s working? Why make billions for pharmaceutical companies with super expensive placebo pills? Sorry, that argument does not hold any water!
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It may also cause a decrease in distressing thoughts like, “If I killed myself, my mother would be so upset, maybe I’d better try something else” or “If I shoot these people, I’d go to jail and I’m really scared of that!” So instead we get a suicide or a homicide.
“Decreasing distressing thoughts” is not always a great thing. And even if it were, I can go down to the bar and suck down a couple of ales and a few shots of Jack Daniels and decrease my “distressing thoughts” without medical pre-approval, and with similar results.
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The first day I met my (very competent) therapist, she told me the goal was for me to develop my own internal therapist so I would not need her or anyone else to help. The first day.
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As soon as they bring out the ad hominem attacks, you know they have no ethical leg to stand on!
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Exactly. A “true” finding should prompt a forceful attempt to disprove it. Only after vigorous efforts to come up with any and all reasonable alternative explanations and finding them wanting is something “true,” and then only until any further data that brings the “true” datum into question. Psychiatry certainly does not operate that way, never has, and most of Medicine is similarly plagued with favorite theories and beliefs that are untested or are believed because that’s what everyone believes, not because of any intent to find the actual truth.
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And often results to which they never willingly agreed to aspire, and continue to protest even when “in compliance.”
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It sure isn’t science!!!
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When I say “ended his life,” I meant he died in a mental institution, not that he intentionally killed himself. It was a horrific tragedy, and possibly not an accidental one.
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When half of the population is “abnormal,” how can you any longer call it “abnormal?” Isn’t it “normal” by definition when close to half of a population experiences it?
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That’s a bloody understatement! He was fired from his job and treated with such derision that he eventually went mad with frustration – he had proven his point beyond all doubt, and yet was punished for it! I believe he ended his life in a mental institution. There is some question of whether he belonged there or was put there by his enemies. It is a story of arrogance, bias and mutual backscratching allowing the death of thousands and thousands of women in the face of absolute proof of the medical profession’s wrongheadedness.
Does that sound familiar to any of us?
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ECT actually erases memories, which would make it very hard to complain!
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Anaphalaxis as curative… makes just as much sense as electrocuting someone to induce a seizure to “help” them.
Sometimes a bad thing can end up making good things happen. I’m glad you escaped from their malign influence!
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Numbing seems to be the most common experience for ANY “antidepressant.” I think it’s the main “therapeutic effect.” If you’re too worried about everything, not giving a crap might feel like “relief.” Of course, if you were not murdering someone because you were worried about the consequences, not giving a crap might turn you into a murderer. It’s a very dangerous game.
Exercise is probably the #1 best health treatment for almost anything, but particularly good for depression/anxiety!
Remember there WILL be withdrawal effects, so be prepared for them and don’t give up just because it happens. You can do this!!!
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It is my observation over time that “bipolar” is much more frequently diagnosed in women than men. There is some support for this, but not from a very critical viewpoint:
https://pubmed.ncbi.nlm.nih.gov/14563100/#:~:text=Bipolar%20II%20disorder%2C%20which%20is,disorder%20more%20often%20in%20women.
https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-020-00207-z
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I’m all for voting in as many sane people as we can find. But you described it all too well – the best marketing campaign wins!
Outlawing corporate campaign contributions might be a good starting point, though. No one wants to bite the hand that feeds them.
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Yeah, that’s a very subtle point. People are distressed because distressing things happened to them? NAH, couldn’t be!
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I agree 100%! The new axis should be “Big Corporate supporters” vs. “Representatives of actual voting constituents.” Of course, there may not be enough of the latter to actually form a party!
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The reviews on antidepressants of all types are very similar. The fact that something that works on dopamine instead of serotonin is still considered an “antidepressant” shows that they doctors haven’t the slightest idea what is causing “depression” nor whether “depression” has anything to do with “disordered brain chemistry” at all. Any drug you use is an experiment on your own brain, which you’re entitled to do, of course, but it’s not based on any good literature support for Wellbutrin over any other kind of drug. I am of the opinion that it’s similar to trying alcohol or marijuana to deal with your issues. Some people find it helpful to have a few drinks, while others lose control of their lives. But alcohol is not “treating” anything, it’s just a way to temporary feel better. Same with Wellbutrin or SSRIs or any other psych drug. Until and unless someone really finds a subgroup of “depressed” people who actually have some specific, testable issue with brain chemistry, drug “treatment” is similar to taking aspirin for leg pain. It might make the pain go away temporarily, but it’s not going to fix what’s causing the problem.
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It’s kind of a weird reversal to me when those who are in charge want their charges to be empathetic, curious, and respectful. Isn’t it a basic of “mental health” treatment that the clients shouldn’t have to take care of the clinicians? How about psychiatrists start by being empathetic, curious, and respectful toward their clients who are criticizing them? Maybe that mutual respect could be created on the impetus of the professionals instead of expecting the clients to set the tone?
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I’d say screening works, in this case doing exactly what it was intended to do: create more customers for the psychiatric profession and the drug industry. The problem is the INTENTION of those doing the screening. If they actually wanted to help, the screening itself would look VERY different, and the range of responses would be much larger. So I agree with you, the screening itself is not the problem, it is the lack of intention of those providing “mental health treatment” to actually improve the situation that is at the core of the difficulties.
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“Vowel movement!” That is hilarious!
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These claims of multi-gene associations are really just window dressing. It means absolutely nothing that 4% of those “diagnosed” with “ADHD” have a set of certain genes in problem, when only 2% of “normal” people have such an association. There are still 96% of the affected population who don’t even have the genes in question! Why does anyone take this crap seriously?
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I know that. I was joking that their “treatment” doesn’t diverge much from saying to go get a drink at the bar. Alcohol can be incredibly destructive and is not a solution for anything. But the same can be said for the psych drugs as a general rule.
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Thanks for the clarification. I am aware that the so-called “mentally ill” have few friends either side of the aisle. It is one form of prejudice and discrimination that all but the most enlightened “social justice warriors” seem to find AOK, and one area where “government overreach” is totally fine with the Right.
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I find it interesting that the no votes ended up coming from Democrats, per your description. I remember you talking about several GOP members being opposed to this and speaking against it. What happened to them?
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Well, at least the “involuntary clients” aka prisoners would have some lovely artwork to look at!
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How about we call it “malpractice” and punish those employing it by large fines and imprisonment and loss of their medical licenses?
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I can say no more to expound upon this enlightening theory! Thanks for the laughs!
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You are right, of course. If 16% are significantly helped and the overall benefit is barely noticeable, there must be a significant number who are harmed to balance out that 16%. That number rarely seems of interest to psychiatry. They don’t seem to be interested in finding out who the 16% are who DO benefit from these drugs and letting the rest look for other help. It would destroy their and the drug companies’ bottom line.
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Excellent example! But since not ALL people appreciate French impressionists, there must be SOMETHING wrong in the brains of those who fail to recognize their beauty!
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It’s actually even worse than that. What scientific information is discovered is intentionally denied by psychiatry when it contradicts their preferred narrative!
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A wise therapist knows s/he can never “fix” anything about another human being.
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My pleasure!
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Having no measure of “success” dooms any of these interventions. If you don’t know what “improvement” means, you have no means to tell if your intervention is “working.”
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Really, in my view, nobody can “have” “bipolar disorder.” They can be labeled with BPD, they can identify with BPD, they can “fit the DSM criteria” for BPD, but there is no way to distinguish who “has it.” It is completely subjective and almost totally arbitrary, having almost no coherent meaning except that someone acts in certain ways that other people don’t like.
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I agree. The intent is pretty much sociopathic. Whatever gets the power and money is what they’ll do. They will serve communism, fascism, corporate capitalism, state-controlled capitalism, even anarchism, as long as they can gain the power and money they wish to compile. This is true of most industries, of course, but in this case, the scope of the damage done is so vast, and the insult to human self-determinism so blatant, and the lack of accountability so complete, I think it is a special case of extreme danger to the survival of any system which allows its participation.
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I object to the statement that the “prevailing view” is that nothing can be wrong with a brain. I haven’t heard anyone say that at all. Just for the record.
But I do get what you are saying, and it ought to be carefully considered, whatever “treatment” is being administered. The mind affects the whole body (including the brain), and the body affects the mind. The idea that some little spot in a brain can be “treated” and have no effect on the rest of the body is a very dangerous idea. But it’s also true that imagining the body can be ignored when working on the mind can lead to a lot of errors and potential damage. Psychotherapy for Lyme Disease is not going to help any more than giving antidepressants to a mother in a domestic abuse situation. Everyone is different and deserves an individualized approach not based on dogmatic insistence of the “helper” that their approach is the RIGHT way regardless of how the poor client feels or reacts!
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Well, I am sure that most on the front lines psychiatrists do their best and probably believe sincerely they are being helpful. What I don’t understand is why the thought leaders are so committed to biological explanations. It can not be a result of not having enough time. People in high places continue to alter the known research in order to continue to justify biological treatments.
A very simple example: Stimulants are claimed to be effective in “reducing the core symptoms of ADHD.” However, decades of long-term research have shown little to no benefit in ANY long-term outcome. This was first observed in 1978 by none other than Russell Barkley. It has been the same result in 1993 (Swanson) and 2003 (OSU medication effectiveness study). Several long-term naturalistic studies (Quebec, Raine, MTA, Finnish/USA comparison) have supported these findings. It was demonstrated in the 1970s that open classrooms work very well for these kids, to the extent that professionals can’t even tell them apart from “normals” in this kind of setting. It has also repeatedly and undeniably been demonstrated that fully a third of “ADHD” cases go away if you simply wait a year before enrolling a child in kindergarten.
So why are we still insisting that ‘untreated ADHD’ leads to negative outcomes, when “treatment” does not improve them? Why is it insisted that ADHD is a biological problem that requires a biological solution, when it appears that a change of setting resolves most of the “symptoms”? Why is most of the research money still invested in “medication?” It’s not because clinicians don’t have enough time in the field. It is because the profession supports biological research even when the data does not support it.
This is most definitely not about “serotonin.” It is about psychiatry as a profession/industry needing to continue to support “medication” as a primary intervention, because that’s where they make their money. As an INDUSTRY, not as individuals. So sure, the system is designed so that doing therapy is not remunerative, that “med checks” make more money in less time, and so that people who question the biological paradigm (like Moncrieff) are attacked for doing so. It is easier to follow the path of least resistance. But what that means is providing “services” that are either ineffective or sometimes destructive over time, meanwhile making any other approach unable to be researched and so criticized as “not evidence based.” All the while spreading misinformation about the nature of these “disorders,” which are in actual point of fact simply descriptions of sets of “symptoms” that tend to occur together. Perhaps the most egregious damage is the prevention of research into ACTUAL causes of these “syndromes,” because we spend our money researching the DSM categories which embrace totally heterogeneous groups.
I’m not asking you to fix all of this, or even explain it. I’m asking you to acknowledge that psychiatry AS AN INSTITUTION is committed to following the biological track, regardless of whether it leads to results or not, and are frequently quite hostile to folks like Bob and Joanna who have the temerity to point out the facts that diverge from their desired narrative. Why else would Joanna be so roundly attacked for presenting information that supposedly “psychiatrists have known for years?” If psychiatry has known this for years, why else would official sites and training literature and even textbooks continue to portray this falsehood as truth? And why is the search for some “deeper biological reality” instead of being willing to question whether the quest for biological explanations is simply misguided and should be dropped for some more fruitful path? It is hard to deny that psychiatry is not on this path by accident, and that it is committed to biological explanations in a way that a scientific enterprise can not be allowed to be.
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I’m glad we are on the same page. Then I challenge you in this way: are you suggesting that most of your colleagues are NOT using the idea that drugs are the solution because these issues are primarily biological in nature? Does the evidence not suggest that such colleagues (and reading the comments here should disabuse you of any notion that your views are in the majority) continue to spend most of their time and energy trying to promote or prove that biological solutions are the best solutions? What else does the average psychiatrist have to offer besides the drugs?
Whether or not it is stated overtly, in practice, the basic business of psychiatry appears to be to get people taking pills. And what about the hostility that Dr. Moncrieff has received for simply stating the scientific conclusion that 50-60 years of research has provided: that a serotonin imbalance is NOT associated with major depression. If the psychiatric profession is NOT invested in promoting primary biological explanations for “mental illness,” why is it so upsetting to have the actual science on that question reported?
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Very well said. It appears we agree once again wholeheartedly!
In my time as a therapist, I always assumed I knew NOTHING about a person I met, regardless of what I might have read in the file. I always knew that if anyone had the answer, it was the person in front of me, and it was my job to help them tell me about it, verbally or nonverbally. And every single situation had different contexts and reasons and possible solutions. Sometimes I had to be very quick on my feet and try something totally off the wall! And the most off the wall strategies almost always worked!
The fact that the person was “depressed” told me exactly NOTHING about what I had to do. I considered “diagnoses” mostly a waste of time, if not a detriment to progress. Every single case is different!
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They’d never do something like… oops, never mind.
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There is nothing scientific about it. It is all a very complex form of marketing.
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I love it!
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Sorry, I had to chuckle when you used the term “outweighs” in reference to Zyprexa! I think in this case the risks LITERALLY outweigh the benefits!
Not meaning to minimize the incredible harm done to folks by the massive weight loss and other health insults caused by these horrible “atypical” antipsychotics. There’s really nothing funny about it – it’s a systematic criminal act!
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Sounds like another money-making scheme to me. As one commenter points out, why not take some wellbutrin and a few cold pills? A lot cheaper and more accessible!
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With all due respect, is it possible that the reason we “don’t know what’s going on in the brain in the deepest and most important ways with depression” is because we’re making an errant assumption that all depression is related to something “going on in the brain?” If that assumption is wrong, every attempt to discover “the answer” will fail to provide an answer, because we are barking up the wrong tree. That seems to be what the research is showing. Sixty years later, we still don’t know of a biological ’cause’ for depression, despite billions of dollars and millions of person-hours dedicated to the project. At what point do we admit that this is most likely because there IS no biological cause? What if “depression” is simply a description of a very complex state that organisms go into when exposed to a threat they can’t immediately manage? Would not then each case of “depression” result from potentially completely different “causes,” with the only thing shared in common being the depressive experience? Pain is a great analogy. What is the biological cause of pain? Is it certain neurons firing in a certain pattern? Or is it putting one’s hand on the stove or getting one’s foot run over by a car or being unable to digest X or Y or having a cancerous growth on an organ or experiencing extreme emotional distress that is expressed as physical pain or just not getting enough sleep for 5 nights in a row?
Why is the psychiatric profession so dedicated to proving a proposition that has yielded no deep understanding of the situation despite over 60 years of intensive research? When is it time to admit that the theory you’re investigating simply is incorrect, and start on a new hypothesis?
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I love that idea! Need to get some funding!
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There is another option to deal with “cognitive dissonance:” Accepting the fact that facts don’t fit with your conclusions to date, no matter how uncomfortable that process may be, and reconsidering those conclusions based on the new data. This is what we expect of actual SCIENTISTS, 100% of the time. Anyone who can’t deal with facts contrary to theory needs to stay far away from any scientific field!
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“Treatment resistant” is a handy “explanation” for their chronic failures. There is no other industry where shortening your clients’ lifespan can be blamed on your clients!
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These are some excellent calculations!
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We do seem too be on the same wavelenth! If you’re every in the West Coast USA, we should get lunch! I bet we’d have an AMAZING conversation!
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POSTING AS MODERATOR:
Let’s recall that this thread is on “psychiatry, fraud that the case for a class action lawsuit.” I am not allowing further discussion of COVID on this thread, as it is far off topic. We all know it is controversial, and both sides have now been stated, so I’m calling a stop to further back and forth on this, because experience says that this will be unproductive and will escalate to hostility.
Thanks to both of you for your viewpoints.
Steve
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Wow, THAT is scary as hell! How can they experiment on people without telling them they were participants? Holy Tuskegee Institute, Batman!
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Who you callin’ a barbarian, buddy? GET HIM!
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Well, there is is in black and white.
I think anyone with a truly therapeutic orientation would find this prioritization horrifying. To prioritize the needs of the therapist and/or program over the needs of the client simply reinforces all the bad “lessons” these folks have learned from teachers, parents, clergymen/women, and abusive partners or caretakers prior to showing up for DBT. It quite frankly is going to make the DBT provider into another abuser, and reinforce the very “coping mechanisms” DBT supposedly is there to help us learn how to circumvent.
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I really related to what you said about “postpartum depression.” My wife did some cross-cultural research on “postpartum depression,” and discovered that there are several more “primitive” cultures where “PPD” simply does not occur. If it were hormones, wouldn’t the rate be pretty much the same across cultures? And guess what characterized the cultures with low or completely absent “ppd” rates? They provided excellent support for the new mothers, freeing them up from any other job besides raising the baby. Friends and neighbors cooked, cleaned, took care of the other kids, hauled water, whatever was needed so the mama could just focus on taking care of baby.
But sure, it’s all chemicals!
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The unasked question: what are the odds of “remission/cure” if they receive no “treatment” at all?
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The idea that ingesting substances to alter consciousness is neither new nor particularly scientific. Pretending that a response to a drug means anything about cause or constitutes “treatment” is the central sophistry used by psychiatry to “explain” its outrageous corrupt actions. I have NO trouble with people ingesting substances to alter their consciousness, and I’m sure in some cases something good can come out of it. I have BIG trouble with calling such ingestions “medical treatment” and charging people and governments ridiculous amounts of money to run an uncontrolled experiment on our brains.
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Well, you know that CAN’T work, because no one can patent it and make money out of it! So it must be a deception. REAL medicine makes millions for pharmaceutical companies! That’s the first criterion!
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You are right, re-learning who can be trusted does require trusting someone for at least a period of time to find out if it will work. The key is figuring out WHOM to try it with. There are ways to gauge trustworthiness with some level of accuracy, and this CAN be taught to a willing student. But of course, the person playing the “helper” role has to be the first one trusted, and that can take some time and mean dealing with some hostility and other emotions. At least that’s my experience. But to keep in mind who is behind this and that it’s all about trust to start with can help me be patient with the process. Sometimes the FIRST level of trust is to say out loud, “I know you probably don’t trust me, and I don’t blame you for that.”
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Wow, so it is worse to have criticisms or just a general dislike of your therapist than to be bulimic or massively depressed or be unable to go out of your house? Though I suppose the last might be “treatment interfering,” because you’d be inconveniencing someone who might have to come and get you.
This is sounding more and more insane. From what little I do know of DBT, this certainly sounds like some “interpretations” that were willfully entered into by people who just didn’t like the clients and wanted to whip them into line! How can anyone consider any of that “therapeutic?”
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Well said! Most “mental illness” is in my view CAUSED by more powerful people deciding they know best and imposing their rules on those who have less power than them. I see no way that using power to enforce/attack/undermine/invalidate people can possible help them become more “mentally healthy!”
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I absolutely agree!
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An interesting way to put it! Can’t say I can argue with you. We have center-right and right-right and crazy-right in this country for the most part. What would be a soft left-center in Germany is considered a wide-eyed radical in the USA!
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You have an amazing DBT THERAPIST. There is excellent evidence that the quality of the relationship between client and therapist is more important than the school of therapy practiced. It is great that you found the right therapist taking the right approach with you. But I can tell you, after years of experience as a professional in the mental health industry, that not all therapists are capable of doing what needs to be done for people with traumatic pasts, and reading these stories should give you an idea that simply saying “I do DBT” does nothing to guarantee a positive experience, or even a neutral one.
The therapist’s ability to connect and create a safe space is more an art than a science, and you simply can not learn that ability by reading and abiding by a workbook. It’s MUCH more complicated than that, but the therapist/client relationship is at the core of quality therapy, regardless of the “brand” of therapy practiced.
Good for you for finding the right fit and getting yourself on a new path!
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As I’ve said many times, the “right” isn’t friends to anyone who feels psychiatry has harmed them, either. They get money from the same pharmaceutical and insurance industries, who are happy to paper both sides of the aisle with warbucks. Looking to the current political parties to support this movement will lead to nothing much worth discussing. They will both be dragged kicking and screaming to any real resolution, because it will mean tweaking the noses of people who have lots of money and power and make big campaign contributions!
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Gotta love it! Maybe he should start a new political party, the “It’s For the Beer” party? Probably get a lot of followers!
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Wow, they SERIOUSLY tell you this nonsense? I’d think they’d maybe teach you the skill of “how to tell whom you can really trust” rather than “give everyone the benefit of the doubt.” How many abuse victims got that way partly BECAUSE they gave someone the benefit of a doubt whom they should not have?
I am finding that particular “skill” kind of disturbing!!
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You got it right. This is NOT a left/right issue, it’s an issue of economic power and investment. Neither party will sign off on something that their contributors will freak out about because it loses them big, big bucks! Carlson is willing to put this on because he is famous for spitting in the face of anyone he wants to, and he’s tolerated because his comments are considered so biased as to not be believable. Mainstream media will not cover this kind of thing or will minimize or spin it somehow, because they depend on the same contributors who own our representatives.
We need to ditch the left-right axis. We need to replace it with the greed – integrity axis. People on the greed end of the axis should not be supported by anyone, regardless of party. Unfortunately, that doesn’t leave a whole lot of representatives left on the integrity end!
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It is always a requirement to say “We know psychiatric medications can be life-saving for some” or something of that nature. Otherwise, your comments are instantly dismissed.
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What would that organized resistance look like?
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Never heard that one! Thanks!
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I am thinking you have missed the point of this article. Johanna did not say that SSRIs can’t work nor that all psychiatrists are telling their clients that they have a “chemical imbalance” or something wrong with their brains. She is saying that the claim that “depression” is caused by low serotonin is FALSE. It has been shown that over 80% of US citizens polled believed that depression is caused by low serotonin. Someone is telling this story, and if you read others’ posts, you can see that this story is indeed told to many by their doctors. The reactions she has received also seem to indicate that some of the psychiatric establishment is quite upset at her for stating this fact out loud.
Science is not built on individual experiences. Nor is culture. I am glad that you have had such a positive experience yourself. But that does nothing to invalidate Johanna’s summary of the research. Depression is not caused by low serotonin. That is all she is saying. She is saying nothing about what works for you. I hope I have made this distinction clear enough.
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Very well said. The comment “Depression causes hopelessness” is an absolute meaningless sophistry. It’s akin with saying “A sore knee can cause your knee to hurt.” The attempt to make “depression” into some kind of an active, evil entity that “does things” to us is the most destructive and disempowering way one could possibly view the situation. It is the opposite of the kind of thinking that can actually help us move past feeling hopeless. It is hard to fathom how they continue to get away with these syntactical idiocies!
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All too true, Rogier. The hard question is why their shenanigans and dishonesty are still not obvious to those in society at large. It’s not even a very good con. I think it’s only our culture’s faith in “science” and “medicine” that allows them to get away with it, that and a massive dose of pharmaceutical company marketing. Hard to know what to do with such irrationality!
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I think it is less about holistic programs and more about having therapists who have done their own work and are actually emotionally available to their clients. There is no workbook for caring about another person.
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And with it, it has been shown that school or type of therapy practiced is not a significant variable!
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It may be of interest to know that lots of good research has shown that the relationship with the therapist is much more important than what school of therapy is being followed. I am guessing that the reason it “worked” for you and “didn’t work” for others is because your therapist extended genuine caring to you while theirs followed a “cook book” approach to DBT without recognizing the damage their lack of engagement did to their clients.
It is easy to assume that “DBT” is the same for each person who experiences it. That assumption is absolutely wrong, as the evidence here suggests.
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It also shift the blame to the “client/patient,” so the actual powers that be can pretend everything is OK and that anyone having a hard time with the status quo is themselves to blame for not “adjusting properly to reality.” It can be a seductive idea for troubled individuals as well, as it promises path to feel better without having to examine any of one’s own beliefs or behavior. Of course, this leads to further troubles, because no one is looking for root causes, but it does keep the Benjamins coming in to psychiatry and their close cousins in the pharmaceutical industry.
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You sound like the kind of therapist someone would be more likely to benefit from seeing, and you clearly travel in such circles. I had a great therapist way back in my 20s. I know it can really help. But you can also see that many people do not have that experience. I believe the newest crop of therapists are trained much less in meeting the client where they’re at and much more in DSM diagnosis and brain chemistry and brain scans and a lot of pseudoscientific “facts” that get in the way of the real deal in therapy, which is getting to know and respond to your client as a unique individual rather than a collection of brain cells.
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Ha! I like that one!
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Some of the PATIENTS have expired, too, sadly!
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I am sorry, but the DSM is really a bunch of gibberish to me. And not because I’m not smart enough to understand it. It’s because I am smart enough to recognize gibberish when I see it. How, for instance, would one determine if a client is having an ‘untreated mood episode?’ It would be entirely a matter of the opinion of the clinician, and 50 clinicians might come up with 50 different answers. It also presumes that ‘treating’ the ‘mood episode’ would resolve it, and if it does not, the personality disorder should be applied, even though there is a ton of information suggesting that the ‘treatment’ of ‘mood episodes’ is extremely unpredictable and can make things worse. It also presumes that the ‘mood episode’ is not caused by another psychiatric drug, even though stimulants and antidepressants are well known to create manic episodes in some of their recipients. So we have an undefinable criterion (mood episode) ‘diagnosed’ by pure clinical opinion, being ‘treated’ with something that may or may not help, and assume that the failure for ‘treatment’ to help means the person has a ‘personality disorder,’ without considering that lack of treatment effect, or even the ‘treatment’ itself, may be responsible for the subjectively ‘diagnosed’ ‘mood episode’ which failed to be ‘treated’ successfully. Not to mention that the ‘personality disorder’ diagnoses themselves are even MORE subjective and vague than the ‘mood episodes’ whose ‘failure to respond’ to ‘treatment’ can apparently lead to such a diagnosis by default.
From a scientific viewpoint: gibberish! Science should make things clearer, simpler, more successful. These ‘diagnoses’ clearly make things vaguer, more complex, and impossible to even define let alone improve success measures. How on earth can anyone make sense of this bizarre and unhelpful array of subjective ‘diagnoses’ all of which lack any legitimate scientific underpinnings to speak of, and are essentially constructed by committee and most commonly voted in or out of existence by a bunch of ‘professionals’ without any resort to any kind of scientific verification?
Gibberish!
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Here’s the thing. In science, the hypothesis is considered FALSE until proven otherwise. It is not anyone’s job to ‘disprove’ the ‘chemical imbalance’ theory, it is the claimant’s job to prove that there IS such an imbalance present. Moncrieff is quite specific in stating that there is no proof of a ‘chemical imbalance’ in serotonin in depressed patients. That’s her conclusion, and her only conclusion. And that is sufficient. The claim has been out there since the 1960s, it is now 60 years later and there is no evidence that it is true. In the world of science, this means it is considered FALSE. Especially given how many billions of dollars have been invested in unapologetic attempts to prove it is true. At some point, we have to accept that failure to prove truth is ultimately proof of falsehood, and Moncrieff is saying we have reached that point.
Of course, it does not mean no one has a ‘chemical imbalance’ or that some other chemical might or might not be ‘imbalanced’ or that no one experiences relief from feeling depressed via taking antidepressants or other psychoactive drugs. It simply proves that what is currently defined in the DSM as ‘depression’ is not CAUSED by low serotonin. This truth was actually known as far back as 1985, before Prozac was even brought to market. The main reason people believe in this idea is pharmaceutical marketing, product placement and script alteration in TV shows and movies, and the support of the psychiatric industry for this fiction. There was never a time when the serotonin theory was supported by hard data.
Finally, the argument that the drugs make people feel better by mysterious means does not suggest that these drugs are correcting chemical imbalances. Alcohol is possibly the world’s best short-acting anti-anxiety agent. Are you arguing that getting mildly intoxicated corrects a chemical imbalance? Humans have taken in various substances to alter their mood since the beginning of history. Saying that ‘psychiatric drugs make people feel better’ is a trivial result. So do non-psychiatric drugs. Discovering that ingesting substances can alter moods is hardly new news. What would have to be in place to prove something of this nature is that people lacking a particular chemical ALWAYS or ALMOST ALWAYS feel a certain way, and that altering that chemical ALWAYS or ALMOST ALWAYS makes them feel OK again. People lacking in iodine have certain characteristic symptoms. Most have some or all of the same symptoms. Taking iodine almost always resolves the situation. This shows a lack of iodine is the cause of the symptoms. Nothing of this nature exists for any psychiatric ‘disorder’ or drug. That is what Moncrieff is saying. No evidence means no evidence. Depression is NOT caused by low serotonin, regardless of how people feel when they take serotonin-enhancing drugs. That is science, not opinion.
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Imagine that! Who would have guessed that bad things happening to you could make you feel bad?
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But we do know that telling someone they have a ‘brain disorder’ that will be lifelong CAN and DOES cause depression!
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Masson was for the abolishment of psychiatry before the DSM III even came out. He’s way ahead of us!
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I agree with your general premise. But what if psychosis isn’t caused by one thing? What if different episodes of psychosis are caused sometimes by emotional stress, sometimes by reactions to other drugs, sometimes by Lyme Disease or syphilis, sometimes by nutritional deficiencies, sometimes by opening oneself up to a higher level of spiritual awareness? What if there is more than one ‘spectrum’ involved? What if the idea that finding THE cause of psychosis is like trying to find one cause for ‘pain?’
‘
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‘Stigma’ is code for ‘prejudice and discrimination.’ It is rare that anyone in the system recognizes that they are facilitating and in some cases causing or perpetuating such discrimination by their own behavior.
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In other words, our society forces us to adapt to circumstances that we are not adapted to genetically. Reminds me of the book ‘A Hunter in a Farmer’s World,’ by Thomm Hartmann, which critiques how we blame and devalue kids with so-called ‘ADHD’ characteristics for not fitting into a world they were not designed to fit.
Notwithstanding this important point, genetics are still the part we can’t change. Why not work on helping people figure out how to adapt better, or even work on creating a more flexible society where we appreciate and value differences and create niches where everyone can find a place to fit? Open classrooms for ‘ADHD’ sufferers is one very good example. The idea that all kids must ‘learn’ in a standard classroom and that those who don’t are ‘ill’ is simply nonsense. We force them to attend classrooms that are specifically designed to frustrate and defeat them and are surprised when they end up feeling frustrated and defeated?
Genetics may help explain certain problems raised by modern society, but it doesn’t do much to help us solve them, except by perhaps reminding us that rigidity of expectations is bound to reduce the quality of life for all of us in the long run.
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Plus genes are the one thing in the equation that we can’t ever change! Why spend billions studying genetics and getting tiny little ‘correlations’ from sets of hundred of genes, when we KNOW that certain environmental conditions will cause or exacerbate these problems and those CAN actually be changed?
A great example is the so-called ‘ADHD’ child. It was shown in the 1970s that such children to incredibly much better in an open classroom, to the point that professionals can’t tell them apart from ‘normal’ children in that setting. Yet we spend tons of money promoting ‘genetic’ explanations that can never seem to be proven, instead of spending a lot less creating open classrooms as an option for kids who struggle in standard classroom settings.
Sometimes I think the only reason they are so married to genetic explanations is because it lets the adults off the hook for trying to fix anything. ‘Oh, well, it’s just genetics, nothing we can do about it.’ Highly irrational!
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Psychosis is a definable phenomenon. It can be seen, felt, observed, verified by discussion.
Schizophrenia is a concept, and idea, that idea being that people who experience a very real psychotic phenomenon are ‘ill’ with a specific ‘disease’ or ‘disorder’ which is caused by a purported ‘chemical imbalance’ that can’t be seen or measured in any way and is now being denied by psychiatrists they ever claimed was true. Clearly, something is happening when a person is experiencing psychosis, and no one can rationally deny that. But for medical doctors to claim that they know this phenomenon is caused by a ‘disease state’ in the brain is reaching far beyond what any kind of scientific or observable data can tell us. It also gives power to the psychiatric system to claim the need to force ‘treatment’ on those who don’t want it or have observed already that it doesn’t help them or makes their situation worse.
So in my view, anyone claiming psychotic experiences don’t exist is full of crap. But it does not follow that those experiences are definable as ‘schizophrenia’ as described in the DSM, nor that they are caused by faulty brain chemistry, nor that drug ‘treatments’ will automatically help the person experiencing psychosis.
Again, I’d go to the mat to protect YOUR right to call the phenomenon whatever it is you believe best explains it. I do NOT support the idea that someone else can tell YOU that something is wrong with you called ‘schizophrenia’ until and unless they can objectively define this condition in ways that can be validated and verified objectively.
Perhaps an easier analogy is the term ‘ADHD.’ Do kids act in the ways described as ‘ADHD’ in the real world? Of course, they do. It is a very common set of behaviors, especially in boys. Does the fact that they wrote down descriptions in the DSM and voted on how many ‘criteria’ are needed for a ‘diagnosis’ mean there is anything at all ‘wrong’ with kids who happen to fit that description? Absolutely not. It doesn’t even mean that kids who act that way have anything in common at all – they may each act that way for totally different reasons, and assuming that just because they act that way means they are ‘mentally ill’ is ridiculous.
Same holds true in my mind for ‘psychosis.’ There may be one or ten or a hundred reasons why this phenomenon occurs. Maybe SOME such people really DO have a chemical or structural problem in their brains – but we don’t know if they do or which ones do. They may in fact be reacting to stress, but assuming ALL are that way because of stress is, as you correctly observe, not close to a valid inference. There may be thyroid problems, brain tumors, head injuries, huge anxiety, nutritional deficiencies – who knows? Because all they have done is collect a bunch of thoughts/emotions/behaviors that tend to occur together, described the behaviors and claimed it is an ‘illness.’
So no, saying that the DSM-invented description of ‘schizophrenia’ is not an illness does NOT mean someone is saying that people who have psychotic symptoms are making it up or should just get over it or are all victims of trauma or any such thing. It is simply saying that there is no scientific proof that all or most people fitting that description can be claimed to have something specific in common that is ‘wrong’ with them that can be measured, identified, and ‘treated’ by a doctor.
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Treatment by definition CAN’T be faulty. Therefore, the problem MUST be with the ‘client.’ There is no other option.
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Thanks for a genuinely honest and insightful post. I really loved it.
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Great list.
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It has been established that the quality of relationship with the therapist is more important than their training or school of therapy
https://www.family-institute.org/behavioral-health-resources/importance-relationship-therapist
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Ha – or ‘excessive keystroke pressure disorder.’ No one’s responsible – the ‘disorder’ caused it all.
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Do you think ‘mainstream physics’ is pretty much the same in all countries, or ‘mainstream biology’ [Q] [sorry my question mark isn’t working] If psychiatry is a scientific endeavor, as it claims, it is fair to assume that variance from country to country would be cultural, not in the mechanics or philosophy of psychiatry itself. Psychiatry portrays itself as the ‘scientific’ approach to ‘mental health’ and promotes very much the same messages around the world. How that is applied, of course, varies by country and community and even by facility to facility. But it is most definitely fair to say that ‘mainstream psychiatry’ is pretty much the same in all countries, as to its objectives and fundamental beliefs. Or all ‘developed’ countries anyway. It is interesting to note that recovery rates for schizophrenia in ‘less developed’ countries are far better than those getting the ‘full benefit’ of ‘mainstream’ psychiatry. When it comes to psychiatry, it seems that the dictum ‘less is more’ is supported by the data.
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Seriously, when their ‘treatments’ don’t work, they get to blame the ‘patient.’ No other profession gets away with saying that their failures are their ‘customers” fault.
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I agree with your sentiments in a lot of ways – insurance companies do drive what ‘services’ are available and reimbursable. However, if we really want to ‘just be friends,’ it is going to require an acknowledgement of psychiatry’s role in perpetuating a lot of dishonest nonsense. There is good quality evidence, not even disputed among research psychiatrists, that antipsychotics don’t have long-term benefits and probably decrease chances of survival over time, that the ‘seriously mentally ill’ die 20-25 years younger than their non-diagnosed counterparts, and that the drugs play a role in shortening lives, that antidepressants’ effectiveness is pretty limited and fades with time, that some who take antidepressants become manic and often end up with ‘bipolar’ diagnoses, that there are no long-term outcomes that are improved by long term use of stimulants, and on and on. When these studies and reviews are brought to light, just as with Johanna’s honest hard work, the authors are attacked with accusations of connections with unsavory or dishonest people, their motivations are impugned, their characters are attacked, their observations are minimized, and they are ridiculed and often shunned for speaking the truth.
Having any kind of respectful relations begins with psychiatry’s leaders agreeing to acknowledge and abide by honest research findings instead of trying to spin everything to make psychiatry look right and anyone questioning their absolute authority to declare what is ‘true’ as insane or ill-intended. And I don’t see that happening any time soon. Psychiatry in the institutional sense has cast their lots in with the pharmaceutical industry, and many people’s reputations and standing in the medical community depend on maintaining the fiction of the DSM and the fictionalized ‘research’ that is used to back it up. I’m not opposed to folks on the front lines who are trying to do the best they can. I am opposed to the massive amounts of false information that is forwarded and enforced on those who do have to do that hard work up front.
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Or what their advertisers WANT the public to hear or read.
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Still sounds like straight up philosophy to me. I have never doubted the value of instincts, but while they are an excellent guide to personal action, they don’t provide a structure to build a mutual understanding upon. To claim a scientific explanation for emotions, we need some kind of verifiable agreement, whether by measurement or by predictive ability or elegance of explanatory power – like the sun-centered view of the planets – which is clearly simpler and more useful in predicting future events. It seems you have an interesting hypothesis and some possible theories on how it might apply, but I don’t see a useful explanation of the origins and location of emotions that helps understand and predict emotional events and outcomes in the future.
Best to you in your future.
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OK, I did a quick search for concrete evidence of 4e cognition and found exactly nothing. I found a LOT of philosophizing on the ASSUMPTION that cognition is a full-body process, but there is nothing I’ve seen so far that even slightly approaches a falsifiable premise, let alone an actual experiment. To suggest that this very arcane theory is a scientific explanation of emotion doesn’t appear to be close to a valid claim, from what I’ve read so far. Perhaps you can direct us to an article that exemplifies an actual scientific experiment demonstrating the validity of 4e cognition and its applicability to emotions.
Sorry, my question mark doesn’t work. I urgently need a new keyboard.
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There have been plenty of groups of ‘scientists’ who have been dead sure and published lots of papers and so on. Sorry, but if this makes any kind of sense, it ought to be readily explainable to the lay person. Einstein’s theory of relativity is as complex mathematically as any theory known to man, but it can be explained in terms of bending space and the effects of travel as the speed of light is approached, etc.
I have yet to hear anything from you that suggests any kind of grasp on the practical implications of this philosophy. Surely, you can come up with a simple example showing how this approach works out in the real world. But I am skeptical that such a thing can really be done, as we simply haven’t the vaguest idea what a ‘mind’ is or how it ‘arises’ or where it resides. Nothing, not a clue.
I will give this a quick look, but it sounds like a very complex and difficult theory to explain, and in the end, good science tends to provide simpler solutions, not more complex ones. In any case, we really need to see a falsifiable premise that is vigorously tested before admitting something to be scientifically valid. I see no such premise here. The idea that the mind is distributed throughout the body is not one I can see being testable. Though I’ve been wrong before, I’ll have to see the actual hard testing before I get too excited about a particular philosophical viewpoint.
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I am not saying you are wrong. I’m just saying we’re not talking science any longer. When you have to talk about moving away from Cartesian dualism and ‘centering’ the mind in the body, not to mention declaring that something is ‘all the rage,’ we are definitely not talking about straight science anymore. We are talking about philosophy. Nothing wrong with talking philosophy, in fact, one of psychiatry’s most fundamental weaknesses is its lack of any coherent philosophical agreements and structure, but a possible viewpoint on what the mind or a thought or an emotion might be is a very far cry from a scientific understanding of it. I defy you or anyone else to design a scientific experiment to prove where the mind is located. I guarantee you can’t do it. So whether the mind is in the brain, in the body as a whole, or impinging on the body/brain from some exterior viewpoint, is simply not a question science can answer at the moment, and may never be able to answer.
But I am still interested in hearing the ideas involved. I love philosophy, actually.
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COMMENTING AS MODERATOR – I appreciate the exchange here, but let’s not get too far off of the focus on mental/emotional wellbeing. We all know this is a hotly contested topic and that there is little chance that a lengthy discussion will lead to anything but a lot of conflict and disagreement. Everyone’s entitled to his/her opinions and views, but I don’t want to get into the kind of back-and-forth where one person’s opinion has to dominate and the other person has to be ‘wrong.’
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‘Black propaganda,’ as I think it’s called. No interest in actually conveying information, just trying to make a particular person look bad. It’s appalling, yet surprisingly effective, as critical thinking seems to be fading into the land of never-never as a commonly held skill in the world.
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You clearly get what I’m saying. Irony is a lost art.
Obviously, the only people benefitting from the most recent ‘improvement’ in ‘schizophrenia’ injections are the ones who save their monthly trip to have to visit their clients and inject them and only have to do it twice a year.
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I love what you had to say about schools. When I was a teacher, I used to use a GREEN pen, and marked the questions the kids got CORRECT.
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Hey, Nick,
I really appreciated the first part of your comment – I agree that psychiatry has relied on ‘naming’ and ‘categorizing’ to the detriment of understanding and using actual relationships between two human beings as the primary ‘healing’ agent. But of course, it should be understood that relationships are not really within the aegis of medical practice in the first place, so perhaps the first error is for medical folks to try and ‘heal’ emotional/spiritual/relationship concerns.
As to your second statement, your explanation of emotions seems extremely shallow and limited, and not particularly scientific. ‘Seeing’ ‘mind’ as located in the body sounds a lot more like philosophy, as does ‘describing’ emotions in terms of ‘subtle neurological-muscular movements.’ I don’t think it’s fair to claim an irrefutable or even generally agreed-upon scientific understanding of emotions. Sure, there are lots of theories, but all that I’ve seen doesn’t come close to a fully tested falsifiable understanding of what emotions really ARE.
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The ‘conservative media’ is honestly not much better. Both ‘sides’ are owned by their big corporate supporters, and greed and graft knows no political affiliation. I know of no nationally recognized leader who has a clue or gives a crap about the plight of the ‘mentally ill,’ on either side of the aisle, beyond the idea of giving more money to the ‘mental health’ authorities or refusing to do so.
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If this is such ‘old news,’ why is it that so many clients are being told that they have a ‘chemical imbalance’ – I’m not surprised but I am disappointed. It didn’t take long for the propaganda machine to get started, did it.
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Such a mass action would require the current beneficiaries of SSRI sales to agree that such a mass action would be beneficial, or for society at large to strip such people of their power to insist that we use “antidepressants” widely regardless of their actual utility and risks. That is the reason that “logic” becomes important in such cases, though it must be admitted that logic and facts don’t seem to have much effects on the beneficiaries mentioned above.
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Your answer is disrespectful and invalidative of my personal experience, and that of anyone else who has had a positive experience. How is it possible for you to know if my therapy experience was or was not helpful to me? You have decided what you believe to be true and insist that the world conform to your belief, even if the evidence suggests a more nuanced approach would be closer to the truth.
Your contention is: “What the psychotherapist does is make you afraid of your feelings and instincts. It is very much like the religious doctrine of original sin. You are to believe that there is something innately wrong with you.” My therapist did none of those things. In fact, she encouraged me to believe in and respect my own experience and emotions and instincts, and to discard all kinds of crappy ideas I’d amassed to protect myself from those emotions and instincts. So she actually did the exact opposite of what you claim “the psychotherapist” does. By the end of our association, I felt a lot more “right” about myself than I ever had. It was the adults around me who wanted me to believe there was something innately wrong with me, and my psychotherapist who supported me in discovering that there was nothing “wrong” with me at all.
And ironically, with these comments, you are the one telling me there is something “wrong” with me for following my own instincts in evaluating my own experience, telling me that I should disrespect my own feelings and instincts.
I don’t think we help anyone by being as rigid and judgmental and bigoted as those we are criticizing. If we are going to defeat psychiatry as you say you want to, we can’t dismiss the experiences of its users as “you can’t have benefited, because it ruins my thesis.”
As I like to say, “Generalizations are always wrong.”
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It should not surprise us that benzos, at least, will of course increase the rate of traffic accidents, as the effects and mechanism of action are very similar to alcohol. But this seems to be a very general increase, suggesting that at least in a fairly high proportion of users, a level of intoxication and impairment results from ‘therapeutic’ doses of these drugs. Of course, leaders in the psychiatric world would want this to come out. But I have long had concerns that many long-term benzo users are on the roads under the influence. Now there is even more to worry about!
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I think the more relevant fact is that a century ago, most “depressed” people recovered without any help from the “authorities.” Depression as a “chronic condition” was very, VERY rare back in the day. The frequency of chronic “depression,” however defined, has only increased since the helpful insistence of giving everyone who feels bad a ‘diagnosis’ and prescribing drugs that can be harmful and giving up on the idea that a person has the resources to address their own emotional condition, even if they may need some assistance with that. Trying to redefine episodes as really ‘mixed’ vs. ‘manic’ vs. ‘depressed’ is very much an act of rearranging deck chairs on the Titanic. The iceberg has long since been hit and we should be trying to help people escape rather than sorting them out into which room they are to go down in.
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I’m afraid I can’t agree with you. I had a very good psychotherapist. I would not be who I am today without her support and intervention. Sure, most of them these days are dogs, but it’s not right that there is no such thing. I think that is a bias you hold, but the evidence speaks to the contrary. I’m sure others here will agree with me that such people DO exist, however rare they may be today.
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Wow, LESS brain damage when electrocuted! THAT’S what I call progress!
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I agree 100 %!
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I’d more refer to that as “social problems that have medical consequences.” Defining the problem as “medical” is the first mistake. Feeling bad is not a medical problem. It could be the result of a medical problem in some cases, but emotions themselves are not medical problems. If it’s a social problem, no amount of “medical treatment” will solve it, and their pretense to the contrary is making things worse.
On the other hand, it’s also possible (and I think likely) that the “treatments” that have “improved so much” are actually making the situation worse, above and beyond any social problems that do exist. At least treatment for resperatory conditions improves those who are treated. In psychiatry, it may mean you die 25 years sooner with “successful” treatment.
I know you’re not arguing with me about these things, I’m just responding to the “Devil’s advocate” position you put out there.
Maybe I’m just not feeling too inclined to be “fair” to the psychiatric profession today!
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Exactly! How can you hear, “Our treatments have improved, but people are getting worse” and not be stopped by the irrationality of it all? How CAN a medical problem require a social solution? Makes zero sense, but people just not their heads and “agree” to something they can’t possibly understand, because it literally makes no logical sense.
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How does a rational person believe that “treatments have gotten better and better” at the same time as outcomes have gotten worse and worse? How can better “treatments” lead to worse outcomes??? Why is this contradiction not totally obvious to readers of his commentary?
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My guess would be that it depends on the person/people you get to talk to, as well as the general philosophy of the hotline. The more “professionally staffed” the hotline is, the less likely I think it would be helpful.
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I think that is a very insightful comment. It is the judgment about a particular mechanism adding emotion that seems to make it “automatic” and unable to be rationally processed. There is nothing wrong with having mechanisms to deal with reality. Feeling we HAVE TO or CAN’T or “SHOULD” or “SHOULDN’T” with intense emotion is what gets us stuck, I think. I can say in my own case that learning to view such mechanisms more dispassionately (“What was I trying to accomplish with that approach? Why did I choose to handle it that way? Did it work? If so, what makes me keep trying to use that approach?”) has been what has helped me gain more control of my life.
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So what happens to all of the “problem therapists” who appear to be getting such poor results with DBT?
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Alice Miller and I would both agree with you on that last point! In fact, I think one of the very worst aspects of the DSM is that it enables the “professionals” to blame the “clients” for their own (the professionals’) discomfort with the helping process. It is not only not helpful, it seems to me that the very WORST thing one can do in such a situation is to put the client at a distance by providing a label and to call his/her experience “symptoms” caused by a “faulty brain” that need to be suppressed! In actual point of fact, it is almost always the SUPPRESSION of their own emotions and experience that CAUSES their “mental illness” in the first place! Other than “surgery” on the brain, it’s hard to think of anything worse that one could do than the label/blame/drug model that the DSM was constructed to encourage and justify.
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You are far from alone. I used to work at a crisis line (a volunteer-based one), and people would report calling us because they knew they couldn’t talk to their therapist or else they’d be sent to the “hospital.” This was especially true for people who cut on themselves and were not in any way suicidal. We never would send out police on those calls, but we did sometimes trace suicidal calls on those who appeared to be about to act on a plan to kill themselves. I know that this and other hotlines have been “professionalized” (no longer volunteer based) and are much more likely to send the police on callers than we were. I volunteered for a hotline here in Olympia, WA, who did not ever trace or dispatch on anyone unless they asked us to do so. But such hotlines seem to be disappearing. I also have known many who found being hospitalized so traumatizing that they’d rather suffer their “symptoms” forever rather than risk being sent there. It is a sad commentary on the level of “help” that is currently available.
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Exactly! Every “mechanism” has a motivation behind it. Most of them made some sort of sense when we invented them, but aren’t very useful today, or we use them when they aren’t helpful. I think that’s most of what is classified as “crazy” in the DSM, people using coping mechanisms they once found helpful in places where they’re not helpful any longer.
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I’m quite sure you’re right – the desire to somehow “rewire” people to be the way others want them to be is at the center of psychiatry’s motivations. And it will always lead to destruction!
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Well, to me, it’s just a habitual thing we do with our minds to accomplish something. ‘Survival’ and ‘coping mechanisms’ that you mention would qualify in my view. In my analogy, it would be the equivalent of the “program.” I think there are mechanisms that are conscious and intentional (like how do you drive a clutch car, or how do you make a curried chicken dish). And some are unconscious (like how to deal with someone who tries to make you feel small, or how do you deal with your sister tattling to your mom). I think we get fucked up most by the unconscious kind, because we don’t remember why we feel like we have to “run the program,” but we just know we HAVE to. Conscious ones we can change if circumstances require it (like I buy an automatic!)
That’s how I think of it, anyway. Don’t mean to speak for lecox or anyone else. It’s definitely NOT a physical universe thing to me!
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I guess it depends how one defines “mental mechanisms.”
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The DSM committees have never been overly concerned with scientific veracity. They are telling a story. Fact that get in the way are discarded without a second thought.
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I don’t think that’s necessarily true. “Mental mechanisms” may have zero to do with the body. The “mind=body” equation is central to psychiatry’s worldview, but there is no reason to believe that “mental mechanisms” don’t exist entirely independent from biochemical operations. To use the hackneyed computer analogy, there can be lots of mechanisms in a computer program that are completely undetectable in the physical operation of the machine. From the outside, the computer looks the same no matter what program or calculation is going on. Just ones and zeros and switches and connections. But the code that is run is vastly, perhaps infinitely flexible. I don’t at all believe the mind is a computer or even like one, but I think the analogy is apt. Messing with the “hardware” is a dumb way to solve a “software” problem, let alone a problem with the programmer him/herself!
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No specific “thing” causes “depression.” Depression is a state of mind, not a medical entity that can be “caused.” Many things may “lead to” depression, but this research thoroughly disproves that any commonality in serotonin processing or levels has the slightest thing to do with it in a general sense. Researchers need to get a clue and start looking for subgroups who might actually have things in common with each other.
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It is sounding like your voice is being dismissed and they are treating you as if you have no understanding of what is going on and need them to make decisions for you. I’m so sorry you are experiencing this kind of behavior!
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So their final recommendation is, “We have to do something, so let’s do something stupid that makes things worse, because otherwise we’d be ‘turning a blind eye.'” How does that make sense?
I also noticed that the study doesn’t mention the very high possibility that screening led to SSRI “treatment,” which is associated with INCREASING suicide rates, especially in youth. This seems a likely explanation for at least some of the increase in ED visits.
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It is beyond silly to “screen” for something that you can’t objectively detect, and for which you have no effective “treatment” or intervention to offer. Such “screenings” are clearly an effort to increase their client base, and fit better into the rubric of marketing than they do of medicine. I recall a doctor once saying, “So I got a positive screen for depression. Now what am I supposed to do about it?”
Depression screenings are a scam and should be illegal.
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Very well said!
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I think it is unconscionable that they would increase your medication levels without so much as a “by your leave.” I wish I found it shocking. What is your best response to this? If you let them know your strenuous objections, are they responsive in backing off to where you were most comfortable? You are a voluntary patient – they ought to be consulting you at every turn in the road.
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I agree 100 percent! People need HELP, but not because they are BROKEN and need some sort of “repairs.” They need compassion and interest and maybe a few ideas for new perspectives. And they need some HOPE for a better future. Some people can be helpful, but a big part of being helpful is NOT thinking that you know better than the person needing the assistance. The person him/herself is the only one who knows what is going on or what will end up being helpful. The best we can do is facilitate the process.
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It has to be OK for people to experience suffering without having it “fixed.” Psychiatry’s main thrust is to STOP people from feeling x or doing y. Good therapy should rather make it safe for people to experience whatever they are experiencing without judgment or a need to “fix it.” A person isn’t broken because they are suffering. They are just suffering. It’s part of the human experience.
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That is also my general experience. Once someone is labeled “borderline,” they are sometimes the butt of denigrating “jokes,” and are often spoken of in condescending terms, and regarded as “problem clients” who can’t really be helped. Not everyone behaves this way, but such behavior occurs without sanction or challenge, it is accepted to trash talk “borderlines” in a most dehumanizing manner.
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It seems you will not be able to understand and/or accept what I am saying, as your response appears to again criticize without specifics, and does not seem to address what I see as the central conflict we are having. So I will choose to back out of this conversation. I would just appreciate it in the future if you do not accuse me of offensive behavior without giving a specific example and a specific reason, but if you do continue to make such nonspecific accusations, I will choose to ignore them.
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I am concerned that you are making assumptions about the meaning of my comment that are not my intentions.
I have never stated or implied that TREATMENT BY SOCIETY is better/kinder/not abusive in every tribal culture. What I said was ONLY that the content of voices is affected by culture, per the studies I have read:
“https://news.stanford.edu/2014/07/16/voices-culture-luhrmann-071614/”
I find that fact very interesting. I think it adds some complexity to the picture of how one might best approach someone who hears voices to get a better idea of what might be helpful. It is not meant to disrespect your views of your own situation.
I have also not heard people here “denigrating your schizophrenia” in general, and I certainly have never meant to do so. There is general disagreement about whether “schizophrenia” is the name of a “disease” or “disorder” or merely a description of phenomena which really do occur but are not attributable to one, concrete, biological “disorder” or possibly a wide range of causes, such that one case may have little or nothing to do with another. This is very different from specifically attacking or “denigrating” you for your view of your own situation.
With all due respect, we all have a right to disagree about things that are not determined to be “factually true” in a general sense. I have never once disrespected your right to label yourself with “schizophrenia” and to believe that you personally have a problem with your brain that causes your voices and other symptoms to occur, and in fact have state repeatedly that you absolutely have that right and that I do not question it. I also agree with you 100 percent that bullying others into agreeing to comply with someone else’s belief system is a huge problem. I would like you to grant me and others the same right to believe differently than you about THE CONCEPT OF SCHIZOPHRENIA IN GENERAL, without taking it to mean I intend some criticism of you individually and your beliefs. In truth, I find it likely that some people do, in fact, have difficulties with brain functioning that lead to some cases of “mental illness” as described in the DSM. I just don’t believe that we can define a “disease” for OTHER PEOPLE by looking at their thoughts, emotions and behaviors. Until there is some way to distinguish which people have or do not have a biological problem, and what exactly that problem may be, I’m afraid the final assessment will remain up to the individual client, not to the psychiatric “thought leaders” or individual mental health professionals.
My objection is not YOU believing in schizophrenia and biological causation for you, and I have no criticism of you for choosing to approach the situation in ANY way you feel would be helpful. My objection is to DOCTORS and other MENTAL HEALTH PROFESSIONALS telling their CLIENTS that they “have a chemical imbalance” and “need drugs” when they have no real idea what is going on with that particular person. I have NO problem with the CLIENT identifying as “ADHD” or “Autistic” or having an “anxiety disorder.” I just don’t think it’s someone else’s job to pretend that they know things about the client that they do not.
If you believe I have in some way “denigrated your schizophrenia,” I would appreciate you directly stating exactly what I (or someone else) might have said that you find denigrating. That way, we might be able to come to some kind of an understanding. But I really don’t like being treated as if I’ve done something wrong without knowing specifically what it is that you are objecting to and why.
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Wait, are you saying that HOMELESSNESS could be caused by LACK OF AFFORDABLE HOMES? Woah, dude, that’s CRAZY TALK!
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There is no way to be a failure at being a psychiatric survivor. All you have to do is survive. And if you can tell your story, so much the better. You deserve admiration for your courage!
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An interesting fact you might want to know is that studies of voice-hearing people in cultures where hearing voices is accepted or viewed as a gift have their voices say a lot more positive things. There is excellent evidence from the WHO studies that people in developing countries have MUCH better long term outcomes, despite (or because of) using a lot less psychiatric drugs in the process. Culture and expectations apparently DO have a very significant impact on how “schizophrenia” is experienced.
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The comment makes it sound as if stigma “rubs off” on the providers, when in actual point of fact, the providers themselves create the stigma they are complaining of. The main reason psychiatry is viewed as a sketchy, unscientific, unprofessional branch of medicine is because psychiatry IS sketchy, unscientific, and generally unprofessional. Psychiatry has earned and deserved the reputation is has. Its patients have not earned or deserved the prejudice and discrimination that the psychiatric “profession” has brought upon them by their own unscientific and unprofessional behavior.
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I would have to disagree that these drugs are not coerced or that there is no visible violence, except to the extent that folks who have never seen the inside of a psych ward have not witnessed such violence being applied. There are tables in there with wrist and ankle and waist restraints, and people get wrestled into them, or held down and injected with psych drugs (as “masculine” an act as I could ever imagine.) Additionally, mothers do not own the market on telling people they aren’t responsible for their actions.
Perhaps more importantly, history shows us that women are, in fact, the targets for certain interventions, in particular ECT, and for certain diagnoses, in particular, “Borderline Personality Disorder,” among others. Phyllis Chesler has written extensively about this in “Women and Madness,” but she is certainly not the only one.
Finally, psychiatry is fully the invention of white European males, with very little contribution from other sources. While it has become more “diverse” as the decades have passed, the basic assumptions, particularly the idea that a “sane” practitioner can determine the “insane” patients by observation and can use force or coercion to get them to behave “properly,” have never actually changed. The more recent marriage to the pharmaceutical industry to use drugs and ECT to alter someone’s brain to stop them from feeling the “wrong” things and/or behaving the “wrong” way certainly fits with a historically “patriarchal” worldview, namely that the “authorities” get to decide what YOU ought to do, and dissenters are to be punished. It’s true that the “punishment” has taken on a different color, mostly due to the presence of mass media and drug company marketing of “diseases,” but when push comes to shove (sorry for the ironic analogy there!), psychiatry is a top-down, fully authoritarian effort to “make people behave,” and it is very much backed up with the full use of government and social force to make its pronouncements stick OR ELSE.
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That is pretty damned offensive – makes “the seriously mentally ill” (who of course could be anyone “the authorities” so deem, given there is no objective way to assign such a label) sound like the enemy and psychiatry frustrated to be unable to defeat them and their “unattractiveness.” This kind of comment reveals a lot about the contempt in which such people are commonly held by those running “the system” that is supposed to be there to help them.
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I agree 100 percent!
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I agree, it’s worse in a way. Kind of like how the culture of Nazism in WWII allowed more “normal” Germans to feel OK about committing atrocities against Jews and Gypsies and so on. An individual narcissist can be dealt with once you know who and what s/he is. A culture set up with discriminatory rules is much harder to fight!!
And of course, it does make it easier for true narcissists to find a spot to do their dirty work!
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It kinda does encapsulate all wisdom, I think!
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I think you hit the crucial point here: the person has REASONS they choose to ignore the evidence, and WE DON’T KNNOW WHAT THEY ARE! Calling something “delusional” is a judgment placed on them by the “experimenter,” and as soon as that is done, we stop being scientific.
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Isn’t it a shame that the title can’t just read, “Exercise makes people feel better!” Why do we have to talk about “lower risk for depression?” How about “Better chance of enjoying your life?”
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Well, that’s what I eventually had to decide. I realized that it wasn’t because they “didn’t understand” that their interventions were harmful. The people in charge actually believed that “stopping symptoms” was the actual GOAL and that quality of life issues or trauma history or WHY people had the feelings they had were actually not relevant. I remember talking to one psychiatrist about the “medical model” and drug “solutions,” seemed like a perfectly nice person, and I asked him about PTSD. I said, “Well, at least for PTSD, we can say with certainty that it is caused by traumatic events, not malfunctioning brain chemistry.” And he said, “But not EVERYONE who is traumatized gets PTSD! So there must be SOMETHING different about their brains that makes them vulnerable!” I gave up on the conversation at this point.
But this guy was not “narcissistic” in his presentation in any way. I think he was just trained by and believed in a system that treats ‘the mentally ill’ as objects or lesser humans. As I’m writing this, I think that’s the basic problem. There are plenty of non-narcissistic people who believe that black people “should get over slavery,” that feminism means hating men, that gay people are dangerous pedophiles, and all sorts of stupid things, because cultural prejudices allow them to entertain these beliefs without challenge. Bottom line, the system trains people to DISCRIMINATE against “the mentally ill,” and those who resist are themselves ostracized, ignored, or attacked for challenging the system. It’s not a matter of individual narcissism in most cases. It’s a culture of bias and disrespect and prejudice that these individuals are participating in that makes them feel OK about treating “the mentally ill” as “less than” without any pangs of conscience disturbing them. And of course, Alice Miller’s considerations play strongly into this, as the culture provides ample cover for the “professionals'” need to punish or silence their clients for making them feel uncomfortable with their drama.
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When you get better, it’s always because of the drugs. When you get worse, it’s always because of you or “your disorder.” The drugs always get a free pass, every time.
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In fairness, I started out in the “mental health” system because I wanted to help people, as I had been helped by my therapist, who frankly did a great job in many ways and really helped me get onto a new path in my life.
Of course, I was never a “follower” and always was suspicious of the “medication” advocates and the DSM never made sense to me, and was viewed as a rebel and often tossed monkey wrenches in the system, but still I had opportunities to be helpful in a genuine way, and people seemed to appreciate what I could do, so I continued for over 10 years in the profession. It wasn’t until I worked doing “involuntary detentions” and saw what happened to people in psych wards and how many “mentally ill” people were labeled, drugged and forgotten, their quality of life total shit but their caseworkers interested only in whether they were “on their meds” and what their “symptoms” were, that I felt I had to get out for ethical reasons. Don’t get me wrong, the people who got me for their “evaluations” were quite fortunate, I had by far the lowest rate of detentions in our agency, and I sprung some inmates from the joint as well, but I could not ethically hold people against their will in such horrid conditions as prevailed in the psych wards.
So people do learn and grow and sometimes grow out of their excuses or explanations for overlooking the real horrors of the “mh” system. Of course, the system is far worse today, and I doubt I’d have lasted 3 months, but there are people in the “system” who don’t really believe in it fully, and we ought to give them some credit for operating behind enemy lines. It’s not a fun role to play!
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CERTAIN people. Other people are pretty depressing!
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I’m not totally sure about that. I think it may be that a certain “brand” of narcissist is attracted to the field, kind of like police and the military. There are also lots of people approaching it with good intentions, but the DSM does make it easy to indulge in narcissistic fantasies. It’s also true that when things get difficult in a “therapeutic relationship,” there is, in my experience, a very strong drive to “fix it” because it is VERY uncomfortable to have to sit with someone else’s pain right in front of you. But I’ve found the key to success is being WILLING to tolerate that pain being there and NOT knowing what to do about it and letting that be true while looking around and exploring what that pain is looking like. The DSM/drug model unfortunately allows someone looking for an “out” to simply say, “Wow, you must have ‘major depression'” or “I think you need antidepressants” instead of hanging in there and believing that a good direction will emerge if we are patient and willing to sit with that discomfort for a while.
So I think the major challenge is that therapists enter in totally unprepared, have NOT done the work to deal with their own pain, have that pain brought back to the surface by their client, and then feel they have to stop the client from having those feelings because they want to feel better themselves. And the label-and-drug model makes it all too easy to act out those “savior” fantasies within the expectations of your supervisor or “the system.” It’s pretty much a setup for failure. I admire those who are able to work within that system and still help people. I finally gave it up and decided advocacy was the better path for me to go.
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The main qualification for a therapist is not degree or training or years of experience. It’s the degree to which they have dealt with their own childhood trauma and disappointments and enforced roles. Alice Miller got it right!
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I agree. Embracing disagreement teaches us to be bigger people. Fighting to be “right” makes us smaller. My biggest challenge comes when I’m trying to be big and encounter those who want me to be small again. It is tricky to handle that without lowering oneself to the “make them wrong” viewpoint.
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I think these are important insights. It took me a long time to realize that someone else disagreeing with me had to do with them, not with me. I mean, I understood that intellectually, but to get so I accepted that fact emotionally took a long time.
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I am sure I’m not totally consistent, and you’re right, it depends a bit to whom I am talking. For some, they will be less able to hear what I’m saying if I use the term “drugs.” I try to use quotes whenever I use the term, but sometimes, I do get on a roll and get sloppy!
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I think he meant he’d use quotation marks to show disbelief or contempt for the word usage, to indicate irony. But I’m with you, why not call a spade a spade and just say “drugs,” unless you’re referring to someone else’s use of the term? The truth is generally better than beating around the bush.
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So if we know they are not even “approximately true,” why would anyone of a scientific bent even bother to consider them of the slightest value?
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The term “overdiagnosis” itself is a euphemism for malpractice, drugging people for no known cause. Let’s not mince words here! It’s not “overdiagnosis,” it is FRAUD, and it is financially incentivized instead of penalized as it ought to be!
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LISTENING to clients? No wonder you were blackballed! That’s radical crazy talk, that is! Next thing you know, you’ll be CURING people, and then where would the psych professions get their clients?
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I’m with Einstein on this one!
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All I can say is, I totally shared your concerns and experience. What the kids said counted for nothing, parents or foster parents were snowed under with technical terminology and fear mongering, and anyone calling out the ill effects of a particular case of psychiatric drugging was in for an attack.
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I don’t think that diagnosis is a priori wrong in the “mental health” area. I just think that such diagnoses should represent something actually distinguishable from a different “diagnosis.” The DSM itself admits it fails to do this (actually that it doesn’t even ATTEMPT to do this) in its introduction. CBT is just a way of engaging a person’s thinking process in interfering with their habitual behavior. It’s possible it may be more effective in disrupting anxious thoughts than in stopping, say, hyperactive behavior, but that’s just a percentage based on the kind of “symptom” we are dealing with. The fact that CBT may be more useful for someone feeling anxious does nothing to confirm that anxious people are anxious for the same reason, that anxiety is de facto a “disorder” or “disease” state in all or in fact in ANY case, and studying “anxiety disorders” means studying people who most likely are quite diverse and heterogeneous, meaning that even if 80 percent of people can apply the list of definitions and come up with the same “diagnosis,” there is no reason to believe that these people have anything in common other than the fact that they happen to fit the list. It’s sort of like saying that if 80 percent of people can be identified as suffering from “knee pain,” it means that “knee pain” is a valid diagnosis. Of course, it’s nothing of the sort. Knee pain can be caused by a score or two of different actual diagnoses, including a bruise, water on the knee, arthritis, a torn ACL, MCL, or other ligament, a torn cartilage, etc, etc, etc. “Knee Pain” is simply not a useful diagnosis. Pretty much every psych diagnosis is similarly useless. What if one person is depressed because of thyroid issues, one because of childhood abuse/neglect, one because he’s in a dead end job, another because she’s suffering from domestic abuse, another because he can’t figure out the meaning of his life, another because he just got diagnosed with cancer, and another because she’s got severe anemia. Feeling depressed, losing sleep, losing joy in things we used to like, these are subjective, almost arbitrary items that could all be caused by dozens of reasons. It’s scientifically incredibly weak to try and do “research” on these so-called “diagnoses,” not because diagnosis is wrong but because these diagnoses don’t provide any explanatory model for what is wrong and what might be done about it, except on the most superficial level. It’s very much like diagnosing “knee pain disorder.” If we accepted that as a diagnosis, guess what would always be the most effective “treatment?” That’s right, drugs. Do you think the “atheoretical” diagnostic plan was created by accident? Or is it perhaps intentionally done to make marketing biological “solutions” a lot easier.
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Actually, advanced imaging has contributed to proving that the DSM concept of “mental illnesses” is complete bunk for almost all so “diagnosed.” It is showing that folks with the same diagnosis have almost nothing in common, except for common damage from the drugs they may be taking.
And my retort to your neurologist relative is this: I’m a very smart person. If you can’t explain it to me, it’s probably not because I can’t understand it. It’s because either you don’t want me to know, or you don’t understand it yourself.
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By the way, I do support doing research on “diagnoses,” but only for the purpose of demonstrating the fecklessness of “diagnosing” people in this slipshod manner, or the lack of effectiveness of a given “treatment” for such “disorders.” I consider any research done using the DSM categories to be prima facia false, as the groupings of people on that basis have no scientific validity (they are heterogeneous groups having no known, measurable qualities in common). The main error in the DSM is assuming that people who have the same “diagnosis” have something wrong with them, or the SAME thing wrong with them all. The DSM itself even admits to this failing. But what is the use of a “diagnosis” that groups together people who have nothing in common? It is literally possible for two people to have “Major Depressive Disorder” or “Generalized Anxiety Disorder” and have not one single trait in common with each other! From a scientific viewpoint, the DSM is utter garbage!
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How can a “diagnosis” be reliably made when the criteria are totally subjective in almost every case? What is the standard for reliability, merely that other people’s opinions agree with yours? And if that’s the case, shouldn’t we be using language such as “people typically labeled as ‘bipolar'” or “people typically labeled with ‘major depressive disorder?'”
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I found the same thing with foster youth or their parents or foster parents. No one was really given informed consent. One facility had a “clients’ rights” sign on every wall that said they had the right to know the intended benefits and potential adverse effects of any medications they were given. When my CASA volunteer asked the therapist when that had happened for her charge, the therapist said, “No, we never do THAT! They might pretend they had the side effects or decide not to take the medication!” Which is kind of the point of “informed consent,” isn’t it? That was the attitude I met every day. Doctors knew best, people needed to do as they were told or horrible consequences would ensue, and anyone who said otherwise was brainwashed or “anti-science” or just didn’t understand how important these “meds” were. Yet 9 out of 10 kids stopped their “meds” or cut down to one almost immediately after they escaped foster care, and very few that I knew of suffered any adverse effects in the long run. And when asked at multiple “foster youth panels” what kind of intervention they found most helpful, not one of them ever mentioned “medication” as a key to their success. It was always a person or a relationship that they identified as what helped them through. Sometimes a therapist, but never once a psychiatrist or his/her “medications.”
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Part of the problem is that “overdiagnosis” and “overmedication” are not concepts that can be applied to psychiatric “treatment,” because there is no objective way to determine who does and does not qualify for a “diagnosis” made from a checklist of behaviors. So we decry “overmedication,” but the next person who comes in “depressed” for whatever reason can be reasoned to “qualify” for “major depressive disorder” and thereby be drugged once again. Add in the strong financial incentives to drug anyone who comes in the door, and you get the disaster that is “mental health treatment” today.
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I notice that you seem to continue to view clients from a viewpoint of “diagnosis” and “treatment.” CBT to me is simply one of many techniques that can help certain people get a perspective on what THEY can to do improve their lives in ways that they find helpful. I never cared one whit what “diagnosis” they had. All I cared about was what THEY saw as the problem (often requiring some pretty good interviewing skills to help them figure out) and what THEY felt was helpful in moving forward. Sometimes CBT was perfect, sometimes it was useless, not depending on the “diagnosis” but on the person’s personality and goals and viewpoint on what they are trying to accomplish. Similarly, some people did REALLY well with regressive techniques, others wouldn’t consider it or it wasn’t really realistic given the circumstances or timeline or it just plain didn’t work. Some do well “brief therapy” techniques (what did you do the last time this happened?), while some find them insulting. Sometimes I made stuff up on the spot specific to that particular person. My primary rule was, “Gather information. Try something that seems to make sense. If it works, do it more! If it doesn’t, stop doing it, gather more information, and and do something else!”
Milton Erickson said that therapy needed to be “reinvented” for every client/case. He was correct. I tried to approach each case with a “Beginner’s Mind,” as they say in Buddhist teachings, open to experiencing what is before me, no preconceptions or judgments or plans. I found that “diagnoses” did nothing but confuse and distract me from getting to know the PERSON in front of me, which was the key to my success in the field. The question to me was never, “What is his diagnosis” or “what is wrong with her?” or “what school of therapy should I follow?” It was more like, “Who is this person? What’s important to them? What are their goals and what do they see as barriers to those goals? What kind of fixed beliefs or behavior do they seem committed to that don’t make sense to me, and why do they make sense to them? How can I assist them in stepping out of their normal ‘scripts’ and see what alternatives might exist?” There is no formula for doing this – one has to simply roll up one’s sleeves and be humble enough NOT to “know” things about this client that you really don’t know at all.
People are mysterious. Psych “diagnoses” don’t help us understand the mystery, they trivialize and confuse the real issues that we ought to be looking at. If I were you, I’d consider dropping them from your vocabulary.
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Fantastic and powerful post! Thank you!
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I will write an email to Boans and make sure he’s OK with it, and then get back to you.
Do you have a link to the Maradona trial?
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It certainly applies!
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Commenting as moderator: I can contact each party and get their agreement to exchange contact info, then send you both an email so you can communicate.
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I prefer to look at it as most people going through a series of learning experiences and coming up with a more effective way to conduct their lives. Psychiatric “diagnosis” and “treatment” interferes with that natural learning process, both biologically and psychologically.
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Awesome plan! The Long Term Care Ombudsman program in long term care facilities provides an excellent and replicable model. It is LONG overdue!
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And a bit more honest, actually.
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We definitely agree on that, and that’s a good start to a deeper conversationn. It’s very important to understand not everyone has your kind of experience. I have thankfully never been held against my will, partly because I’m older and grew up in an era where “mental health professionals” were more interested in relationships and experience and less in proving biological causation, and because I lucked out and got a really good therapist on the first shot. Plus I am a white male with a college education, privileges the majority of those held against their wills don’t have. But in today’s environment, it’s quite possible I would have been “hospitalized,” because I definitely did express feelings of suicidal ideation during my therapy. I’m happy to have dodged that bullet. Others are not so fortunate.
My distrust/disdain for psychiatry is not based on my personal direct experience as a client, it is actually based on comparing the conclusions of real scientific research to what front-line psychiatrists and “thought leaders” tell us is true. It started with “ADHD.” My son clearly fit the criteria, and I was concerned it would come up when he got to school age, so I did some research on long term outcomes. I was STUNNED to find that there was no long-term research suggesting that ANY long-term outcome, including academics, school completion, college enrollment, delinquency rates, teen pregnancy rates, social skills, or even self-esteem, was improved for “ADHD” kids taking stimulants vs. those who don’t or who take them only short term. I’ve tracked on the research since then, and that continues to be the case. Yet I heard psychiatrists and school personnel saying things like, “Untreated ADHD leads to school failure and higher delinquency rates,” when “treatment” did nothing to improve those outcomes!
I have since tracked research on antidepressants, anti-anxiety drugs, antipsychotics, and to a lesser extent, “mood stabilizers,” and the exact same pattern emerges. Antidepressants are insisted on as “life-saving” for suicidal people, yet there is no evidence they reduce the suicide rate, and suggestion that they may actually increase it. Antipsychotics are supposed to be essential long term to prevent “relapses,” yet those who take them long-term are MORE likely to be re-hospitalized or otherwise deteriorate than those who use them short term or not at all (see Harrow’s work, referenced in Anatomy of an Epidemic). These are large scale studies of many people, and don’t imply that no one is helped by these interventions. It means that on the average, people are better off not taking any of these drugs for the long term. And people are not told this, and ought to be.
So the reason I distrust psychiatry as a profession is because they’ve been dishonest. They’ve claimed that all their DSM diagnoses are entirely or primarily biological in origin, despite a lack of research suggesting this is true, and a commonsense critique that claiming the same cause for everyone’s “depression” or “anxiety” flies in the face of reason. They’ve lied about the research that IS done, and have attempted to suppress real data that comes out which contradicts their desired narrative (Harrow, Kirsch, the WHO intercultural studies, etc.) They accuse people like Robert of being antiscientific or cultists just because their findings challenge that narrative. So no, I don’t trust them, and it’s not for emotional reasons, though I consider a person having been personally brutalized an excellent reason to distrust them anyway. But I’m not one of those. I worked IN the system for years, and I saw what really happened as a result of this system. Not saying that all psychiatrists are evil or stupid, nor that people for whom these treatments work should be denied access to them. But I don’t think medical professionals should lie to people about what they “know” in order to get them to agree to a particular approach. Do you think it’s OK for an entire “medical” industry to misrepresent the facts in order to increase their market share? I don’t, and that’s why I have no trust or respect for psychiatry as a profession, regardless of my positive interactions with some psychiatrists and the reported successes of some percentage of patients.
I hope that makes things clearer on where I’m coming from. If you haven’t read Anatomy of an Epidemic, you really ought to. It is very well researched and non-emotional in presentation, and might help you understand the “rest of the story” for people who have not been as fortunate as you and I have.
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I probably don’t qualify as a “MH guy” any more, by most “MH people’s” standards!
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You are fortunate to have had that experience. In my long experience, it is not typical. Having money does give a person a lot of options that those with limited funds can’t afford. Not to mention those who are held against their wills. There are a lot of different experiences shared here, and I hope we can all respect that fact.
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You are by far not the first I’ve heard to have this happen, and I find it horrifying how much it is minimized and denied.
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There is a LOT of effort to try and prove that it’s all biological, despite decades of failure. But as to actually trying to UNDERSTAND why these things happen, there is almost no research at all. And research that assumes a conclusion before it begins is not really scientific research at all.
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That would be a lot better!
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I challenge you to show me hard evidence that there is “some kind of chemical disruption in the brain” of all or most people who fit the criteria for “MDD.” The idea of the “chemical imbalance” theory was disproven back in the ’80s, before Proac even came to market. Even mainstream psychiatrists are disavowing this theory and claiming that they never supported it. They’ve moved on to the idea of “circuits” and of “genomic analysis” because their original theories on cause have never panned out.
Of course, nobody knows if it’s nature or nurture, and as in pretty much everything, including hard biological illnesses like cancer, diabetes, and heart disease, it’s no doubt a combination of both. The “diagnosis” is not made by any kind of brain scan or measurement of brain chemicals or EEG or any kind of measurement – it’s just a list of “symptoms,” and most doctors don’t even bother using those. How would it be possible to distinguish “clinical depression” (supposedly caused by biology) from any other kind of depression just using a checklist of symptoms?
Your case may be particular, you may have some biological vulnerability, but I would bet that no one has shown you what exactly is wrong with your family inheritance. In any case, just because your case may be biological doesn’t lead to the conclusion that any other case is biological. The psychiatric profession makes a common but serious scientific error in assuming that all subjects with similar presentations have the same problem. This is, of course, nonsense scientifically, as something like a rash can be caused by dozens of things, including poison ivy, prickly heat, the measles, or syphilis. I’d sure want my doctor to be able to tell the difference before they started ‘treating’ my rash!
The other interesting scientific question is: If there is no objective way to tell who “has” “clinical depression” caused by a “chemical problem,” how would anyone be able to determine what “overprescription” would mean? What’s an appropriate level of prescription look like for a disease that has no reliable physical markers whatsoever? That’s one of the biggest problems with the DSM approach – no one can really tell if the doctor is right or wrong, because it’s all a matter of “clinical opinion.”
Again, I support anyone who finds antidepressants useful, or anything else that helps them. I don’t deny that depression can be a HUGE problem in a person’s life – been there, done that. But that doesn’t make it a medical problem. The burden of proof should be on those claiming it is, and they haven’t met the standard.
Additionally, the article itself makes it clear that most people do NOT benefit from antidepressants. Why do you think that is, if it’s a biological problem? Or how can you distinguish the bio-depressed from the psycho-spiritually depressed? Or those depressed because their lives are depressing? How can you tell?
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I mean leaving these poor people alone instead of “treating” them for a “disorder” that no one can say actually exists.
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That’s awesome!!!
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Probably so. It can be stated to a certainty that “treating” his “chemical imbalance” did not lead to a successful outcome!
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Wow, THAT would be REALLY dangerous!!! Where would they get clients if THAT news got out?
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Just to be clear, Maggie, I don’t think anyone here thinks a person should “just get over it.” That’s a trope that is tossed out by the psychiatric industry to try and discredit their critics, pretending critics are saying, “There’s nothing wrong, just quit whining.” But that’s not the critique here. The proble is the CLAIM that “depression” is a DISEASE STATE without providing any evidence that this is the case, and then pretending they can somehow TELL who “has clinical depression” and “needs medication” while in practice recommending drugs for pretty much every single case they run across.
I have suffered a lot from chronic depression and it took years, decades really, to truly get a handle on it, and it still is a problem sometimes for me. But I don’t hold that I have a “disease” that can be somehow cured by messing with my brain functioning, because there is no evidence that either of those things are true. I also know that some people find antidepressants helpful on a personal level, and I have no concern about that. But I do have a concern about professionals making claims of scientific support for something they have no actual understanding of, particularly when they approach it in a completely biased manner and deny evidence that really IS scientific, such as the fact that most people do NOT get better on antidepressants, as this article shows us.
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That is an EXCELLENT point! They should not just compare to placebo, they should compare to doing nothing at all!
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See, you’re dangerous! You keep actually healing people, next thing you know, they’ll have to go looking for clients! And they’ll be expected to actually HELP the clients, too! Which means having to find even MORE clients! There is SOOO much more work that way!
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The most obvious one was the Germanwings aircraft murder/suicide. The guy TOLD his psychiatrist he was having trouble with his “meds” and asked for her help. I don’t think she did anything but continue him on the same drugs. And 150 people died needlessly. But his “mental disorder” was blamed instead of the psychiatrist’s mapractice and neglect.
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POSTING AS MODERATOR: It sounds like you two are not going to see eye to eye on this issue. How about we leave it at that? Just a suggestion. I don’t see either one of you attacking the other, but I don’t see you approaching an understanding, either. Just restating positions, which is OK, I guess, but where is the discussion heading?
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“Treatment resistant” is such a ridiculous term! It implies that EVERYONE should respond to “treatment,” and that anyone who doesn’t is either personally resisting, or their “disorder” (a mental construct!) is resisting! Why not just say, “Our treatment failed” and leave it at that?
What would you think if you took your car into the garage, the guy worked on it for two weeks and then gave it back and said, “The problem is, you have repair-resistent fuel injectors! I can’t fix them, but if you come back once a week we can treat the symptoms…” You’d get a new mechanic double quick!!!
“Treatment resistance” is a loaded term meant to blame the client for the doctor/therapist’s failures.
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Subtract out placebo responders and those who would have gotten better regardless, and Irving Kirsch’s work seems pretty spot on.
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I am so sorry to hear how distressed you are feeling! It sounds like you have a great love of life. I hope that will sustain you. While I don’t know what it’s like to have your condition, I do know what it feels like to wonder if life is worth living. I will be thinking of you today.
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You mean if something doesn’t work, you should stop doing it and try something else?
You’re a dangerous radical!
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Maybe so, in most cases. As a wise person once said, “Never attribute to malice that which is easily explained by stupidity.”
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Too true!
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As Hemmingway sagely stated, “The operation was successful but the patient died!”
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I actually think Richard has done quite a bit, but I’ll let him answer this for himself.
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I agree. I think in the end we don’t even disagree that much. I just think we are missing each others’ meanings. Though our latest exchange has helped me with that.
If you’re ever in the Great State of Washington, there’s some great hiking just outside my door!
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And you managed all this change without drugging the dogs? I guess it wasn’t a “chemical imbalance” then!
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Well, some of them are. I’m afraid way too many know the truth and are just protecting their “gravy train” with their lies.
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I think it makes it worse, because if Jim is right, it means the doctors are intentionally and knowingly lying to their patients in order to obtain compliance with their “treatment plan.”
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I agree with your revised title.
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No, that is NOT what I want. I simply want you not to classify people who experience hallucinations/delusions as “schizophrenics who believe they have that” or “schizophrenics who believe they don’t have that.” You are ‘diagosing’ that person against his/her will, even if you accept that they “don’t believe they have that.” Why not call it “people with delusions/hallucinations who call it an illness, and people with delusions/hallucintions who don’t call it an illness?”
It is more like a Muslim trying to convince ME that I have to do Ramadan, because she’s a Muslim and that’s her lens. I hope we are capable of rising above that.
But thanks for the clarification. I believe I understand your views much better now, and my prior confusion is quite fully cleared up.
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You are clearly empowered to believe in your doctor – s/he may even be right! What I am saying has absolutely nothing about you or your diagnosis or your belief in your psychotic experiences as an illness or agreeing with your doctor. The objection I have is to you saying that because YOU believe your doctor and his/her diagnosis, it means other people who view it differently are “choosing to believe” something you regard essentially to be wrong. And you’re entitled to believe that, just as others are entitled to believe you are “wrong,” but most of your comments reflect an “open minded” attitude, live and let live, believe as you see fit, which I agree with. I was just pointing out that others should have the same right as you, not to be talked to as if their belief that their situation is NOT caused by biochemistry or is NOT called “schizophrenia” just because the doctor says so is irrational, which is what I was getting from your post. People don’t just have the right “believe their schizophrenia is something else,” they have every right to believe that they don’t have schizophrenia or that doctors’ “diagnosis” of schizophrenia doesn’t meet minimum scientific standards as a “diagnosis,” even if the condition described does exist.
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With respect, DW, I have to note that you said:
“IF…
anyone has schizophrenia and prefers to regard it as not schizophrenia but some other ailment or stress or trauma or government plot or even extra terrestial indoctrination…
I will be encouraging of this YOUR CHOICE of way you know YOU”
It seems you are saying that others DO HAVE schizophrenia but are REGARDING it as “not schizophrenia.” This seems to violate your own principle – you are telling them that they DO have schizophrenia even when they don’t regard it that way. You want others to allow you to BELIEVE or ASSERT you have a disease called “schizophrenia.” Why do you not respect others rights to BELIEVE or ASSERT they do NOT have schizophrenia? If you respect that right, how can you say that they “have schizophrenia” by your own or the doctor’s definition and are REGARDING it as “not schizophrenia?” It sounds as if you are saying that you know they DO have it but are willing to tolerate them claiming otherwise. Is that how you see it?
Or does the other person have a right to DEFINE their experience as they please, since there is no objective way to “diagnose” schizophrenia beyond a list of thoughts and behaviors made up by a committee of psychiatrists? If everyone has a right to their own interpretation of reality, why would you or the doctor be in any position to define their condition as “schizophrenia” and then magnanimously grant them the right to “regard it” as something else?
Perhaps your concern is not that others won’t allow you to define your own condition, but that others choose to define it differently than you do?
I ask this with the utmost respect. I have had a hard time understanding where you’re coming from, and I sometimes think I do, and yet you sometimes talk as if you think I don’t. Maybe I didn’t really understand you in the first place? Some clarification would be appreciated!
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I certainly never said any of those things. What I DID say is that DOCTORS should not be able to tell YOU or ME or ANYONE ELSE what is “wrong” with them when they have no idea or scientific or even intuitive basis for their claims. I get frustrated when you claim I am saying that you have no right to choose your label. I have literally NEVER said that. I have said that no one ELSE has the right to label YOU (or anyone else) without your (or their) agreement. I hope the distinction is now clear.
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As usual, I agree with you almost completely. The one exception is your comment that you are sure the “mental health” meme was entered into with “good intentions.” Nothing expands that quickly without funding behind it, and that funding comes from our friends in the Pharmaceutical Industry. I am certain this phrase was chosen specifically because it had the effect that was wanted, and it was spread as propaganda through the usual “advocacy” groups and social media sites with the intention of making it ‘popular,’ as a means of marketing their wares. The more “mental health” is normalized, the less people look for other explanations, and the more drugs and “services” are sold. The intentions are NOT good!
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Kinda goes to show that they DO know what’s going on. It’s not ignorance or gullibility, it’s straigt up corruption, at least at the higher levels of the hierarchy.
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People who don’t want to change anything should be left alone. I was assuming we were talking about a person seeking assistance. I see no need for an outside “professional” to label their experiences as “mental disorders.” I think it should be up to the person seeking help to define what they want to change and whether or not a particular approach is of interest or appears to be “working.” I hope that is clearer. No one should be forced to entertain “help” for something they don’t want help with, nor should someone else be able to define what “help” looks like for a particular person.
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Parents don’t have to be monsters to cause harm to their children’s psyches.
No one is all good or all bad. We are all human and make errors and do good things and mess up and recover. It’s not about good or bad parents. It’s a lot about what adults went through when they were kids and pass on, and about what adults/parents are expected to do in our society and what they are supposed to do with their kids.
Most people would say my parents were fine people. They did a lot of things right. But they did some things wrong, too. Additionally, schools were full of well-meaning folks who often did a lot of harm because “that’s how we do it.”
An example: Good parents were expected to leave their kids to “cry it out” in their cribs when I was a baby. They were expected NOT to nurse their babies and to feed them solid food at way too young an age. Some were told that taking Thalidomide was safe and ended up with hydrocephalic babies or other birth defects. All were expected to send their kids to schools without question, even though some of my teachers were absolutely crazy and dangerous. One hit me in the head after she tossed a book across the classroom in second grade and I protested. Was that my parents’ fault? The teacher’s fault? The school’s fault? Society’s fault? It doesn’t matter whose “fault” it was or whether the teacher was a monster or just a sad old lady who never was loved. What matters is that I had experiences that were not healthy for me. They hurt me, whether they were intended to or not. It was helpful to recall those hurts and what decisions I made at the time, so I could learn to make different decisions today. There were no monsters. Just adults trying to do their best. But I still got hurt, and I don’t have to make excuses for them. I can take care of my own needs and let them be upset about it if they want to. Which my parents were, but we healed some as I grew up and was better able to express myself. I loved them, they loved me, and we were better off facing up to the painful moments where things didn’t go so well.
No blame or monsters or heroes required.
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I’m not sure they were ever “bedazzled.” If you listen to the discussions around the time of the creation of the DSM III, they were quite blatant about their political goal of establishing psychiatry as a “real science” by pushing claims of biological causation and treatment. Of course, Big Pharma was happy to help out for a price, and they developed a symbiotic economic relationship that continues today. Many lower-level “mental health professionals” are, in fact, bedazzled, but the leadership premeditatedly planned to sell this concept to the public, whether or not it was true, and they have succeeded.
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Maybe that’s why they are called “shrinks!”
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I loved that: WHOSE problem did it solve? The most critical question, almost NEVER asked by “mental health professionals!”
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How does he rationalize these as “valid illnesses” when there is no objective means to determine who “has” such “illnesses?” And by extension, how can these be “treated” when we are unable to distinguish those with the “illness” from those who have other problems or no problems going on?
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Or they were flat out trying to pretend they had a model to disguise their real intentions.
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Why bother forming a model of a “mental disorder?” The term is already so biased and polluted it’s not worth trying to rescue. Why not simply help people identify what they want to change about themselves and help them find a way to do it? Or work to alter the known social conditions which create such emotional distress in the first place? Why not work on building a world that respects people’s mental/emotional condition instead of making diseases out of them?
Humans’ biases will not ever allow for a rational “model of the mind,” let alone of “mental disorders,” in my humble opinion. It’s a case of Heisenberg’s Uncertainty Principle brought to life: as soon as a mind starts studying “the mind,” the mind itself is altered by the process.
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Posting as moderator: After a certain number of layers of comments, the “reply” button disappears, so Mr. Cox has no control over this. What you have to do to comment is go back up the thread to the first one that still has a “reply” button and hit it. Your comment will appear next in line.
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I think you have hit the most fundamental problem with the “helping” professions. Anyone who thinks they can tell another person what is wrong with them, what they need, and/or what they need to do about it is inherently dangerous. People don’t need someone to define things for them, they need someone to help them figure out what they need and how to get their needs met. Humility and empathetic listening, along with a few carefully-selected pointed questions, is what most people find most helpful, whether it’s from a professional, friend, family member, or a stranger on the street. As soon as a person forgets that the only one who knows the ‘right answer’ is the person seeking assistance, they become a hindrance rather than a help. And when they expect the person seeking support to “appreciate” whatever “help” they choose to provide, they become inevitably damaging to the person they are claiming to “help.”
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To clarify, I looked in our database of users and did not find “Richard Sears” there. I do know who Richard Sears is.
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I would have to opine that a big reason why “men hate women” is because they are told to and allowed/encouraged to by the society we live in.
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It is also very possible that the best of parents make errors and their kids end up hurt. It is very important that parents are willing to take responsibility for their contribution to thhe problem, and the best parents are willing to do that, and make it OK for their kids to give them feedback about their experience as children. You don’t have to be a “bad parent” to contribute to your child’s emotional struggles!
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I agree, that is exactly what happens, even to other health professionals. We’ve all been taught that “mental illness,” and suicide in particular, is very, very DANGEROUS and that anyone NOT a professional will no doubt mess it up, with the corrolary being of course that you’ll get sued if you don’t get it right. I remember a kid in residential treatment who would claim he was “suicidal” because he knew it meant a trip to the ER and he could get out of a day of school. The res staff were too afraid to handle it until they got approval from the psychiatrist to do a “planned ignore” and not automatically transport him every time he said the “s” word. It really is quite ridiculous – we are removing what is probably the BEST assistance a person thinking of ending his/her life can get – support from friends and loved ones – in favor of forced hospitalization and drugs that present no evidence of doing anything to reduce suicides, and may actually increase them. Who is insane, now?
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Precisely. We must identify the real problem here. People often need help recovering from bad events, but they aren’t “diseased,” nor are the social conditions we allow and encourage something we should all feel OK about and be subject to “diagnosis” if we try to fight them!
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The term “recover” is often used in terms of injuries or illnesses. It is the assumption that a mental/emotional challenge is an “illness” of some sort in the individual that needs to be challeneged. And I would submit that many people need help “recovering” or “recuperating” from the assault on their lives and their integrity that psychiatry itself has perpetrated!
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No one has ever seen a “brain circuit.” But the “brain circus” is on wide display for anyone with his/her eyes open!
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Why do they need a “mental health partner?” They should just do it!
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Well, I suppose someone might need to recover from an assault or a hurricane…
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Which is all quite ridiculous. I have met a LOT of people with “borderline” diagnoses, and never met one who didn’t have a massive trauma history!
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Precisely! An hour on the internet every day would have taught me WAY more than I learned in my entire elementary school years, I think!
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How can we talk of “false positives” when there is no objective way to “diagnose ADHD” in the first place?
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Otherwise known as “GREED!”
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Plus I figured out what they were talking about in minutes, or already knew about it, and yet we continued to ‘study’ the material for months!!! There was nothing to pay attention to. It was about as exciting as watching rocks eroding or paint drying. If it hadn’t been for daydreaming and doodling, I’d have probably done myself in by third grade!
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And shortened lifespans!
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You are quite right. There was a quite open discussion of this back in the 90s. They chose the term ‘medication’ instead of ‘drug,’ and substituted ‘discontinuation syndrome’ for ‘withdrawal,’ to differentiate as much as possible their psychiatric “medications” from their close cousins, street drugs (and sometimes they actually USED street drugs and called them “medications” instead.) There is no doubt what you say is absolutely and intentionally true.
“Severe and persistent withdrawal syndromes from antidepressants have long been neglected or minimised. Obscuring a potentially serious risk, the pharmaceutical industry coined the term “discontinuation syndrome” to avoid association of antidepressants with psychotropic dependence. This term is unnecessary and misleading, suggesting antidepressants cannot cause dependence and withdrawal.11,16 Thus, patients and prescribers may misattribute withdrawal symptoms as relapse or emergence of new mental disorders.11,16,21”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768871/
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I think for some people, “recovery” means “accepting of diagnosis and taking all drugs prescribed by doctor.” The idea of recovery WITHOUT or IN SPITE OF medical intervention seems to be heretical in some circles. It’s almost like you’re saying it’s not a medical problem at all! Which might suggest that maybe THEIR acceptance of their diagnosis and medical intervention could be called into question. EEEK!!!
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“You were misdiagnose.” What a classic line! Because our “diagnoses” are “incurable,” anyone who gets better must by definition be “misdiagnosed!” That way, they can never be wrong, just by redefining their terms whenever their assumptions are proven false. You can’t lose that way!
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https://connect.springerpub.com/content/sgrehpp/19/1/24#:~:text=Despite%20many%20scientific%20and%20governmental,or%20degree%20of%20brain%20damage.
I’m afraid that the literature shows brain damage to be quite common in ECT. In this review, they suggest some level of damage is always present. ECT “works” by inducing a grand mal seizure in the individual receiving it. When people have seizure disorders, we do everything we can to STOP them having seizures, specifically BECAUSE there is damage to the brain when uncontrolled seizures occur.
I’m not trying to invalidate your personal reality, because what works for you is what works for you. But it is not accurate to suggest that loads of studies show no brain damage from ECT. It is most likely that any therapeutic effect for ECT is the result of minor brain damage. But sadly, it is not always “minor,” as many survivors of ECT can attest. It is, at best, a very risky procedure whose benefits are unpredictable and generally very short lived. That doesn’t mean that no one finds it beneficial, but it does mean that claims of “safety” are not supported by the scientific literature.
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But wait, I thought it was all biological and genetic! You mean what KIND of life you’re living affects your emotional well being? Gosh, who would have GUESSED?
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Yeah, but they are stigmatized by the psychiatric “profession” itself, and they don’t want to talk about THAT!
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I agree with you for the most part. The only objection I’d make here is that psychiatry is not to me “science done badly.” It is pretend “science” used in the service of marketing drugs. You and I both agree that enforcing drugs on people as “the only solution” is oppressive, especially when done so without the consent of the “drugged.” I am adding that pretending that “science” supports such an action, that the reason you should “go along with the program” is because “you have X disorder” or “you have a chemical imbalance in your brain” is not science, but pure marketing, promoting something they know is NOT supported by science as if it were, because it sells drugs.
If psychiatrists said, “These phenomena happen to people. We don’t know why, but we have discovered some drugs that may stop some of these phenomena temporarily, with x and y adverse effects,” then they’d be a lot closer to being scientific.
So a person can believe fully in science as a means of determining the truth (or I should probably say, a means of determining what is NOT the truth, as science is a lot better at that) without having a minute to give for psychiatry’s effort to use people’s vulnerability to sell them drugs. I will add that I don’t worship science and recognize its limitations, and have a full spiritual life and believe in lots of things that Science can’t explain. But psychiatry has nothing to do with science, except to the extent that they can study what effects these drugs actually have on people, and they’re not even honest about that.
I never confuse psychiatry with science. It’s a marketing scheme, plain and simple. You or anyone else can certainly use the psychiatrists’ framing of disorders or diseases if you choose to, and more power to you for it. I even use some of them on occasion. But I don’t view such “disorders” as scientific entities, any more than describing someone as “courageous” or “a slow runner” or “has lovely hair” as scientific descriptions.
I don’t mind you viewing yourself as “ill” and describing yourself that way. I do mind a doctor pretending that they have proof that I am “ill” and therefore need to accept their “treatment” of me as a legitimate medical practice, especially in the absence of any evidence that they can identify a definitive cause and test me for it in some objective manner. Just as someone is free to be a Christian or a Muslim or a Hari Krishna if they want to, but I object when they start telling me I have to agree with them, especially if they try to claim that “Science proves that Christianity is the ‘right’ religion.”
I hope that clarifies the point.
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The thing is, you just can’t make that much money off of helping people have better lives. Better income from keeping people “disabled” by the very “treatments” you provide, so they think they have to come back for the rest of their lives. Kind of like being a drug dealer, except with the power of an MD behind your name.
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I think there is a big difference between one citizen telling another one what to think/not to think about their condition, whatever it may be, which I think would be a bad thing, and a person with big social power, like a doctor or psychologist, telling people that “science” says that you have “X disorder” and that it is biological in nature, and that drugs are the solution, especially when there is no scientific evidence that is the case. So I think the two of you may be talking about different subjects. It seems like DW is not liking it if people tell HER that she “is not ill” or that “schizophrenia is not an illness,” which I completely understand and agree with. What I understand YOU to be saying (and I agree with you 100 percent) is that the PROFESSIONS of psychiatry and psychology have intentionally perpetrated misleading or downright dishonest representations of the truth, and that these misrepresentations have damaged those they claim to help. To me, these are completely different subjects, and I hope we can all be careful to make sure we make that distinction. If DS or anyone else wants to frame their experience as an illness or attribute a biological cause, they are free to do so. When a psychiatrist or psychologist or an MD makes that claim about someone ELSE, then it is THEY who are bullying and telling others what to believe about their own condition, without scientific backup for their position.
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As I like to say, “Generalizations are always wrong!”
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In fact, the data suggest that antidepressants, far from saving lives, actually INCREASE the odds of someone committing suicide. And the fact that the suicide rate for folks leaving a psych hospitalization is so amazingly high does not speak well of the “treatment” they are receiving.
There is no drug on the market today that can legitimately claim to reduce the suicide rate. Even the drug companies don’t claim that in their advertisements. They count on psychiatrists to do that bit of marketing for them.
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I guess we’ll have to agree to disagree. To me, the idea of talking to a “professional” who pretends to some “superior knowledge” in order to “diagnose” me with a “disease or disorder” is VERY different from sharing my experiences with someone who has been there and understands how it feels to be in a similar situation. Human beings have communicated and shared with each other in times of trouble or to mitigate traumatic experiences since the beginning of human language. It is a natural and healthy thing to do. The problem I see is that this natural, human process has been coopted by those claiming special skills or knowledge in the area of “helping,” while presenting no evidence that a degree or professional position confers any kind of advantage in doing so. Folks need to recognize when they’re being scammed. But to suggest that sharing one’s experiences with another human being is ipso facto proof of being a fool or a sucker is just plain nonsense to me. I’m all for fighting back against the system and have done my share over the decades, but I also know that without other caring individuals to listen and help me through life’s challenges, including one very helpful therapist in my 20s, I would not be in the excellent place I am today, and in fact, would never even have fully realized that I needed to fight, and whom I needed to fight against. Dismissing the need for human sharing of experience is simply not a workable theory, no matter how many barriers are manned. But people DO need to learn, or re-learn, since we all once knew how to do this intuitively, how to discern those who we can trust from those who are not really there for us. Many revolutions were brought to a standstill by people’s inability to realize which leader ought to be trusted and which should not, so it doesn’t just apply to therapists or “peer supporters,” either.
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Actually, I respect people’s inherent ability to discern who are and are not their allies. Unfortunately, that ability has been messed with starting at a very young age, and it is the lack of that ability that allows people to be taken advantage of, including by “professionals.” If people need anything in terms of “help,” the thing they need most is the ability to learn whom they can and cannot trust. If you ask me which is more likely to be trustworthy, a psychiatrist, a therapist, or another person who has “been through the system,” I’d bet on the third by a mile. It’s true many such have been coopted, but that should become obvious in 5-10 minutes of conversation.
And I’d ask you this: if people are to join in some kind of resistance movement, would that not involve disclosing their affairs to people who may or may not be their actual allies?
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“Y’all” meaning peer supporters and those who try to help without claiming some kind of superiority of station or knowledge. In other words, “real folks!”
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No we don’t. We want real Peer Support to be paid for by all the money that we save when we fire all the psychiatrists and stop wasting so much money on non-working “Treatments.” I think the objection to referring to “mental health conditions” is mostly that it makes “peers” into automatic subordinates to the “mental health” system. I’d love it if the “system” were subordinate to y’all and especially the clients themselves, but that’s going to require a total re-do of the model where peer support is an “adjunct” or an “alternative” or “supporter” rather than the main deal.
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I know how ETC “works.” After the “patient” gets 3-4 “sessions, they assure the doctor, “I feel SOOO much better now. THANK YOU for this wonderful experience! I don’t feel even a TINY bit depressed! Now, can you unlock that door so I can get far, far away from you and your ‘help?'”
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I think it is also important to remember that not all “logic” is logical! But I agree completely, it is the suppression of feelings, not the feelings themselves, that lead to real trouble. Not all feelings need or deserve to be acted upon, but all of them can be safely EXPERIENCED, and in fact, feeling “negative feelings,” as people call them, generally leads to them being LESS likely to be acted upon in a destructive way.
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I wonder if there is a blood test for gullibility, or dishonesty?
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Seriously, a blood test for suicide? Who is dumb enough to believe this kind of nonsense?
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You should keep in mind, though, that how a country is RULED (monarchy, etc.) is not the same as how the economy works. Capitalism is an economic model. We kind of know at this point that uncontrolled capitalism leads to monopolies, price-fixing, decreasing wages, and an increasing gap between the “haves” and the “have nots.” At the same time, we know that a fully government-controlled economy does not allow for sufficient freedom and motivation to create solutions to problems. Both are susceptible to corruption, of course. So it’s not a simple question of how the government is organized. Private enterprise has its own set of rules. There are plenty of capitalistic countries that have despotic governments or monarchies or even ostensibly “communist” governments like China or Viet Nam. It’s a very complex problem!
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Actually, the best “treatment” for childhood trauma has been shown to be a healthy relationship with a caring adult or adults. Dr. Bruce Perry has written extensively on this point, as have others. The psychiatric community, as usual, has focused on the ostensible “brain damage” caused by childhood trauma, but have bypassed (or intentionally ignored) the brain-science solution, namely a safe environment with caring parents, which is shown to heal a good part of the damage you describe.
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It is also “surprising” because doctors and other “wise ones” have blamed “hormones” for all cases of “postpartum depression,” in the interest of promoting their biological solutions to women’s “hormone problems.” This, of course, is an ancient trope used in service of oppressing women through asserting that their “hormone swings” make them incapable of thinking, voting, holding political office, owning land, etc. The idea that MEN might suffer from “postpartum depression” shoots a gigantic, cannonball sized hole in the side of the “it’s women’s hormones” ship, and so of course must never be considered. If MEN can become depressed after a birth, well gosh, that means it might have something to do with the CONDITIONS new parents have to tolerate rather than some random “hormone imbalances” caused by God’s poor design of women’s bodies.
Of course, the industry will now embark upon an effort to prove that MEN’S hormones are somehow altered after their partner gives birth, spending millions of dollars and assuring us that “the solution will be right around the corner” instead of observing the obvious and trying to work on improving post-birth support for both men AND women.
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Good post, Jessica. It might be of interest for you to know that a number of studies in different places in the US and Canada show that simply waiting one year to enroll kids in Kindergarten reduces the “ADHD diagnosis” rate by a third! It should be obvious to anyone that this has more to do with developmental levels and adult expectations not matching, not a “disorder” centered in the child because they can’t do what the adults arbitrarily expect of them. And the worst of it is, “medication” over the long term does not improve ANY outcome that we care about vs. kids who were not “medicated” for the same “disorder.” The whole thing would be funny if kids weren’t getting hurt by it!
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We should not have to do research to show that maintaining meaning in our lives helps us function better! Kind of obvious, dontcha think?
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Not everyone has a choice whether to participate in the system. But I agree, the analogy to slavery is a bit strained. It’s more like incarceration without cause and without recourse. Which is pretty freakin’ bad!
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I appreciate your scientific mindset in not ruling things out when you really don’t have data to draw a conclusion. I wish more folks had that attitude.
I will add here that it is in my experience very difficult, in fact often next to impossible, to detect “signs of akathesia” beyond a person telling you what is going on. There are sometimes external signs, like being unable to stay in one place for long, or restless legs and that sort of thing, but it is described as an INTERNAL sense of restlessness and agitation. It may or may not be accompanied by obvious externals symptoms, and a meaningful discussion with the subject would be necessary to make a definitive diagnosis. It is also easily overlooked or seen as symptoms of “the disorder” rather than recognized for what it is.
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I think 3/4 is a very optimistic estimate. More like a few drops left in the bottom!
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I am inclined to ask, “If you agree with so many of Bob’s scientific critiques, where exactly IS the baby that we don’t want to throw out?” Looks like a hell of a lot of bathwater to me!
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Besides, this is not anything new. Been known for a couple of decades. Facts don’t seem to have much impact on “standard psychiatric practice” in my observation.
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OMG, what a horrific experience!!! This sounds like malpractice even by their own standards. The doctor was warned by a pharmacist and the drug company but continued anyway. I’m SO sorry you have to go through all this! And I hope you find some sense of peace and justice in the future.
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I agree absolutely. The veneer of “medical treatment” allow the adults to pretend they don’t really know what’s going on. But the kids pretty much always know, and will tell you if you ask them in the right way. They’ll tell you “I have to take drugs because I can’t control myself” or “They give me these because I get in trouble too much.” They have no illusions about “mental disorders.” Which tells me the adults know this on some level, too, but they’ve learned to suppress their awareness.
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But stimulants for “ADHD” is not a question of whether you get caught. It’s all right out in the open. It is justified by the “medical diagnosis” of “ADHD.” But the idea of “treating” a young kid for “athletic deficiency disorder” would horrify most parents. Why doesn’t doing the same for school performance horrify most of us?
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Oh, steroids are a different question, not pretending to be “medical treatment,” and all done under the radar. I’m talking about creating a “medical diagnosis” that X person has “athletic deficiency disorder” that is caused by “genetic abnormalities” and is “treated” by giving them stimulants. The reason I bring it up is because most people would find such an idea disturbing, but when it is for academic performance, they’re OK with it. They don’t get that it’s the exact same kind of activity, just with a different focus.
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They would do it if they could get away with it, I’m sure. I think there is a visceral cultural taboo on “performance enhancing drugs,” and I think trying to “sell” that concept would make their intentions and their “treatments” too obviously counterintuitive for the general public, and start some unwanted scrutiny. I think they know this on an intuitive level and so they don’t try that play. Drug-enhanced school performance is OK. Drug-enhanced athletic performance is a no-no. So they go for what sells.
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Extremely well said, Registered!
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The analogy of athletics is a good one. I wonder how people would react if non-athletic kids were diagnosed as having “athletic deficiency disorder” and given stimulants to improve their performance?
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It also stops people from looking for better answers. “If my brain’s not working right, there isn’t much I can do about it, is there? Might as well hope the drugs work, because otherwise, I’m screwed.”
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Of course, brain imaging has its place and can be valuable. It’s just not valuable when looking at behavioral/mental/emotional/spiritual challenges. Finding that a particular area of the brain is “more active” or “less active” when someone is feeling depressed tells us practically nothing about causality.
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Seriously, if that’s the problem, why aren’t they working on this with their clients, instead of drugging them into an apathetic state so that they’re less bothered by having their needs go unmet?
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I do hear what you are saying. It sounds like you are operating at a very high spiritual level!
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I particularly agree with your point that everyone’s “cause” is unique to their own life situation, both physiologically and psychologically/spiritually. Trying to come up with one answer for everyone denies this obvious fact. “Depression” is a false category of “disorder.” It is an effect, not a cause. If we want to handle the situation, we have to find the cause, and calling “depression” the problem implies that all “depressions” are caused by the exact same circumstances, which is a silly thing to think.
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Bigotry AND prejudice AND discrimination!
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But pretending that we “know” the cause and providing “treatment” on those assumptions clearly leads to destruction. You can provide aspirin or morphine for a broken leg, but you’re not treating “leg pain disorder.” On that basis, getting drunk can be called a “treatment” for “anxiety disorders.”
And of course, in many, many cases, we DO know the actual cause of a particular case of “depression,” and it is usually NOT due to a physiological event, though sometimes it IS and we know it and we should “treat” the actual problem rather than the “symptoms” (low thyroid would be one example). We certainly know enough to know that “depression” is itself a “symptom” rather than a “disorder” that “causes symptoms.” It would be best for the clients involved if we dropped the whole notion of “depression” as a disorder and started viewing it a symptomatic of something else.
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If he were a real scientist, he would never view finding out the truth as “defeat!”
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Well, I think the first mistake is thinking “depression” is a thing that is always caused by the same factors. But I agree, there are certainly many understandable causes for depression that are addressable, once psychiatry’s false categorizations are set aside. And there are many, many things that can be done to help, regardless of the underlying reasons.
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“Poverty” has always been a concept psychiatry and other “mental health” disciplines have avoided talking about. It challenges their basic assumptions too directly and effectively.
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I would define it a bit differently – I see “scientism” as being the believe that Scientists are Authorities and that we peons are too stupid to understand their deep wisdom, so we have to simply believe what Scientists tell us and do as they tell us, even if it makes no sense to us at all. Because Scientists are All Wise, and we mere mortals couldn’t hope to understand the depths of what they are telling us about.
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This was another trope of the psychiatric/psychological community to justify their drug interventions. There was never any means to distinguish “endogenous” from “exogenous depression.” It’s kind of dropped out of use, since it has served its purpose and allowed the drugging paradigm to take full hold. Now most psychiatrists assume that all “depression” is biologically caused, despite still having no evidence to prove or even suggest that is the case. Note at the end it states “The exact cause of depression is still unknown.” Which really means, “We have NO CLUE of the cause of depression, and we’re making this up!”
https://psychcentral.com/depression/endogenous-depression#history
“According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), anyone experiencing endogenous or exogenous depression will likely receive a diagnosis of major depressive disorder (MDD).
Medical professionals no longer give endogenous depression as an official diagnosis, and the DSM-5 no longer lists endogenous depression as a diagnostic category. Still, some researchers and mental health professionals find that locating the sources of depression — internal or external — could help you with finding treatment that best suits the specific needs.
The exact cause of depression is still unknown.”
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Don’t think I ever claimed that “liberals” and Democrats have done anything but support psychiatry’s agenda 100 per cent. Most “conservatives” support it just as much, of course, but any of the rare moments of resistance I have seen has come from the political Right, based on the idea of “government overreach” or protecting the rights of individuals. Still, their numbers are tiny, tiny, tiny, and the overwhelming majority of both parties are fully bought off and supportive of the pharma-psychiatric industry.
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I am surprised your psych professionals said that to you. I’ve almost never seen it. I actually got severely criticized for training our CASA volunteers in exactly this point, by a training coordinator who bought into the medical model.
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You once again assume the condescending attitude that I somehow “misunderstood” when I have explained myself very carefully. I have misrepresented nothing. I have used quotations from the paper itself. Those who understand the demanding, rigorous logic of the scientific method will know what I’m talking about. And I notice that you did not even bother to try and refute my arguments logically, but resort to ad hominem attacks to try and make your point.
Meanwhile, it’s clear that you have already decided that you are “right” and are unwilling to accept the most rational possible feedback from me (did you even bother to read and digest my arguments?), so I am not intending to get into further discussion with you about it. The article says what it says, and I have directly responded to the logical flaws and the actual data presented. If that’s not good enough for you, please at least refrain from your condescending swipes at my intelligence and/or integrity. It is not a becoming look on you.
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How about “America’s Phrenologist?”
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I agree completely with you. These attempts to “prove genetic causation” by finding some tiny correlation involving dozens or even hundreds of genetic markers really are a joke and can never prove anything close to what they’re claiming. Especially when we have massive correlations with traumatic events that vastly outstrip the most optimistic (aka delusional) interpretations of the genetics data. Basically, they REALLY REALLY want there to be a genetic basis, they REALLY want it to be true, so maybe if they close their eyes and click their heels together three times and say, “There’s no cause but genes… there’s no cause but genes… there’s no cause but genes…”
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I have used the analogy, “If children are being hit by cars outside of a school, and 20 percent break their legs and 80 percent don’t, do we do genetic testing to see why some of them have ‘weak leg disorder’ because they can’t stand up to being hit by a car? Or do we figure out how to stop cars from hitting kids on their way home from school?”
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Just to be clear, “white male authoritarianism” can be and is enforced or enacted by non-white people and/or by women. It is the “thinking” or the philosophy or the “system” behind the actions that is authoritarian, and that system was most definitely constructed by white, male authoritarians over many decades or even centuries. The question isn’t who is doing it, it’s more who is impacted, and history shows us that women are regarded “by the system” as being more “sick” or “disturbed” or “mentally ill.”
Consider the idea of “hypersexuality.” That concept is almost NEVER applied to men, but is a big “problem” for women, according to psychiatry. This reflects male privilege in our culture, in that men who sleep around are considered “players” or “studs” or “Ladies’ men,” whereas women who do the exact same thing are considered “sluts” or “whores” or “slags” or any number of unflattering things. No man was ever diagnosed with anything because he slept around.
That’s just one example, and it’s very clear that women have long been a part of enforcing this condemnation of women who are “promiscuous.” The term I think that applies is “internalized oppression,” where members of an oppressed group are expected to enforce “norms” that come from the group in control in order to avoid punishment themselves.
So in my view, psychiatry incorporates many biases and prejudices about women from the general society, and as a result, is even more likely to attack women than men for being “different.” It is also clear that racism is part of the underlying structure of psychiatry, as the disproportion of black people being diagnosed “schizophrenic” is way higher than the general population. The fact that black psychiatrists may participate in this set of discriminatory practices does not make it any less racist.
I hope that makes some sense.
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Just to be clear, Joshua, with almost no exceptions, “conservative” representatives are just as supportive of incarcerating the “mentally ill” as the “liberal” ones. Big Pharma donates big money to both sides of the aisle. I agree that the rare politician who opposes such efforts will likely be on the conservative side, but the vast majority believe strongly that the “mentally ill” are dangerous and need to be locked up. In fact, one of the most common arguments against increased gun control based on mass shootings is that the “shooters” are “mentally ill” and should not be out on the street, hence blaming the shooter’s “mental illness” to redirect attention away from gun availability as a possible cause. I’m not meaning to hash out the gun control debate here, just pointing out that “conservatives” in general don’t give a half a hoot about the plight of the unlawfully incarcerated “mentally ill,” an even less so about the damaging scourge of mindless labeling and “medication” of millions of their constituents.
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Oh, believe me, I understand only too well how this kind of study is misinterpreted to indicate causation.
Here is the operative statement:
“…which damage functioning are found more often in people with schizophrenia than in controls.”
Clearly, if these genes are only “found more often” in those diagnosed with “schizophrenia,” there are large numbers of controls who have the same genes, and there are large numbers of people labeled with “schizophrenia” who do not have such genes.
Further, they state: “… here pathological changes in DNA sequence, can at least sometimes result in a severe illness characterised entirely by abnormalities in mental functioning.”
Of course, this statement is not a legitimate conclusion from the data presented. All that we know is that a certain genetic pattern is associated to some degree with the probability of developing the subjective set of symptoms that are called “schizophrenia” by the DSM’s authors. Since 1) that set of symptoms does not objectively define any specific “condition” that can be tested for and verified, and 2) the pattern is only ASSOCIATED with increased probability, with a huge percentage of the people having this set of genes NOT developing said “condition,” and a similarly large proportion of those “diagnosed” with this “condition” NOT having the set of genes in question, there is no way to conclude that this genetic pattern is causal.
There is also no specific evidence that the genes in question are “pathological changes,” since they don’t create any kind of “pathology” in the majority of people who have it. The comparison with smoking is, of course, odious, since we are talking about a carcinogenic agent being ingested vs. a genetic pattern possessed by many “normal” people. To claim genetic causality of “schizophrenia,” either all or most cases of “schizophrenia” must have this genetic pattern present, or an objectively verifiable subset of such cases, which can be unequivocally distinguished from those not so affected, would have to all have this same genetic pattern. It is not proper to assign causality to genes which neither cause most cases of the “condition,” nor which are present in large numbers of people without the condition applying.
Note that I predicted this would be the case before I even read the article. All recent claims of such “causality” are based on the same flawed “logic,” confusing correlation with causation, I would at this point say intentionally.
Do you always assume that someone disagreeing with your viewpoint can only do so because they “don’t understand?” I personally found that assumption both condescending and insulting, and I strongly suggest you avoid making such assumptions in the future. I am correctly interpreting the data presented in the study, and comparing it to prior efforts to make the same arguments, all of which fail for the reasons identified above. You may choose to disagree with my evaluation, but I think my reasoning is quite solid and disagreement would be difficult to rationally accomplish given the barriers cited above. You’re welcome to give it a try, but trying to deny the premise that causal conclusions can only be drawn when all or the vast majority of such cases have the specific genetic variations in question seems to be an unconquerable flaw in this and other such claims’ reasoning.
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“There is no shame in being a permanently brain-damaged second class citizen!”
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Honestly, I do think there is such a thing as “good therapy.” The problem is, there is no guarantee nor even probability that anyone advertising as a “therapist” has any clue how to do it. And there are any number of non-licensed, non-trained people who are quite capable of assuming an effective helping role. I think we need to respect folks who say they had a good experience (I did, 40 years ago, and I can still see how it was very important to my growth), but it appears that such experiences may be the exception rather than the rule. And it’s certainly not wrong to say that being randomly assigned to “a therapist” is potentially quite dangerous!
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First off, there have always been claims of “causes” for schizophrenia and other DSM-identified “conditions,” and none so far have panned out. These “genes that contribute” will undoubtedly contribute in a small way to a limited number of cases, and such genes will no doubt appear in many in the general population who do NOT “have schizophrenia,” and will NOT be present in many cases who “have schizophrenia.” This is not to say there may be a small subset of people so diagnosed who will have a large genetic contribution to their situation, but so far, we have at best tiny correlations with large sets of genes, all of which overlap to a huge degree with the “normal” population.
Whereas correlations with events like sexual abuse, early childhood neglect, domestic violence, head injuries, sleep loss and others are much, much higher than any genetic correlation to date. So why are we spending so much time finding tiny correlations with genes when we have HUGE correlations with traumatic events?
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Seriously! I always find it oddly hypocritical for the psych professions to claim that all of our “mental illness” is biologically based, and yet create their model animal subjects by scaring the shit out of them! Why don’t they just find some “genetically ill” mice to test their drugs on? Oh, wait, is it because they actually realize that the main cause of “mental illness” is being terrorized, tortured, or ignored or mistreated, and know that there are no “biologically ill” mice (or humans) in the real world?
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And the correlations are usually dozens of times greater than the miniature “correlations” found in genome-wide studies looking for genetic causes. Yet where does all the money go?
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He didn’t so much moderate this view as recant his earlier theory, which was of course very much on the right track, but made Victorian male society VERY uncomfortable (especially as so many of them had themselves engaged in sexually abusing girls and young women). He was roundly attacked by his colleagues and society at large for putting forward a theory that put the blame on the more powerful members of society, and under this pressure, he backed out and came up with a theory that was less threatening to the status quo. It was almost 100 years later before the incredible frequency of childhood sexual abuse and its connection to what is now called “mental illness” was finally revealed. Even today, there is great resistance in many quarters of the psychiatric world to understanding and attributing causality to childhood abuse and neglect when discussing ‘mental illness.’ It’s always easier to blame the victim.
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To be clear, I never meant to suggest that YOU said anything about charlatans’ use of diagnosis. I am merely pointing out that there is a difference between YOU selecting the descriptor(s) or terms that YOU want or relate to, and other people (like the psychiatric hegemony) pushing diagnostic labels on people and NOT giving them the opportunity to choose. Based on what you have said many times, I think we agree wholeheartedly on this point.
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Actually, I think psychiatry DID move the needle on suicide. Unfortunately, the moved it in the direction of increasing it!
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I am kind of appalled by the invalidative attitude you take toward those youth who happen to reside in residential treatment facilities. I have known dozens and dozens of such youth, and have found them no less reliable in general than the staff who report on them. They have no particular motivation to lie to perfect strangers, and I’m quite confident that the collective statistics are indicative of a very real phenomenon. Their comments are also quite consistent with my own experiences that show psychiatrists in particular to overlook or minimize the importance of traumatic phenomena and cast blame upon the patient/client and/or their “disorder” or their brain for otherwise obvious connections between a child’s behavior and events in their lives.
I agree that these kids are often coerced into agreeing with statements their caretakers/doctors are forcing upon them, but that argues 100% in favor of the above observation, as the “mental health” personnel are usually very invested in proving their “diagnoses” are correct and explain everything, and that their “medications” are 100% justified, even if the kid is deteriorating in front of their eyes. The days of therapists coercing their clients into admitting to “abuse” are long gone. They are much more likely to coerce them into the idea that they have “bipolar disorder” and that the fact their father sexually abused them (or continues to do so) isn’t really that important.
And while I am not sure the 80% figure is verifiable (though SomeoneElse provided a link supporting that claim), there is no doubt in my mind that a large majority of those diagnosed with “mental illnesses” have experienced multiple “ACEs,” as the current parlance calls it, which contribute massively or actually are the primary cause of their distress. This is based not only on research, but on decades of personal and professional experience. The percentage of women I interviewed diagnosed with “bipolar disorder” who had enormous histories (and sometimes current experiences) of abuse as a child or young adult is probably at least into the 80s. Even higher for people diagnosed with “Major depression” or “anxiety disorders.” And there is plenty of evidence that the likelihood of childhood abuse (especially sexual) in diagnosed “schizophrenia” cases is many times the population average.
What you seem concerned about was common in the 80s, when everyone’s problems were attributed to bad mothering. Now parents are totally off the hook – it’s all the fault of the brain or the “disorder.” As you say, no one knows what a “disorder” really is, and yet these vague, spurious “disorders” seem to have amazing powers! In the 80s, a kid who never was sexually abused was convinced that s/he was in order to feed the egos of the psychologists/psychiatrists. Nowadays, a kid who WAS sexually abused is “diagnosed” with “ADHD” or “bipolar disorder” and no one bothers to look any further. That’s the current reality, at least in my very broad (25+ years) experience. Things are VERY different today than they were in the days of the McMartin Preschool!
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Missing my point. I am not arguing that charlatans don’t use DSM “diagnoses” or generally accepted social concepts to fleece people – they most definitely do, in fact, that’s psychiatry’s stock in trade! I’m saying that phenomena do exist absent the approval or disapproval of a bunch of corrupt old mostly white farts, and the ridiculous behavior of many “modern” “mental health” personnel doesn’t preclude the existence of phenomena they have made such powerful efforts to misunderstand and abuse.
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Yes it is!
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Well, I can tell you that “Penis Envy” is a verifiable phenomenon. It happens every time a man and a woman are out hiking together in the cold rain and they have to take a leak in the woods!
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Sybil was not by any means the original case of “MPD.” The phenomenon has been reported since ancient times:
“The amazing history of dissociative identity (DID), some say, dates back to Paleolithic cave paintings in the images of shamans. Others suggest that the history of dissociative identity disorder dates back to reports of demonic possession that are now thought to be incidences of dissociative identity disorder. Either way, it’s clear that dissociative identity disorder has a long history and is not a new concept (while the terminology now used may be new).”
https://www.healthyplace.com/abuse/dissociative-identity-disorder/the-amazing-history-of-dissociative-identity-disorder-did
Of course, like any so-called “psychiatric disorder,” there is no objective way to determine if someone “has DID” or “is faking” or to do anything but express opinions. It is a phenomenon that appears to occur rarely, it has been sensationalized and abused as a concept, and I don’t trust psychiatry’s ability to define or evaluate the phenomenon or any other phenomenon in any meaningful way.
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Perhaps a little exaggerated, but not by much:
https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-019-0239-1
And we don’t know how the presence of childhood abuse was determined. There are plenty of people who experience childhood abuse and neglect who don’t realize that they have – they view their treatment as “normal” based on their experience. There is also the question of screening. I recall a research study where volunteers went into a children’s psychiatric residential facility and asked questions of the residents. As I recall, about 80% of the residents reported childhood trauma to the volunteers (total strangers to them), and yet less than 25% had this documented in their charts! So either the residents were more comfortable sharing their childhood trauma with total strangers than the staff they see every day, or the staff never bothered to ask, or the staff considered the presence of childhood abuse not to be of sufficient significance to write into the log.
I worked doing involuntary hospitalization evaluations in Vancouver, WA for a while. I spoke to at least a few dozen women diagnosed as “bipolar disorder” during that time. I’d estimate that 90% of them had significant trauma, right on the surface, which was ignored or never considered by their prior care providers. One girl was a MR/DD kid of 17 whose intellectual level was estimated at age 6. She had been raped a couple years before. For a year or so, she was very depressed and withdrawn, which was very different from her previous personality. After a year, she disclosed her rape to her mom. After this point, she became randomly aggressive at times. Her diagnosis? BIPOLAR DISORDER! I gathered all this information in a 20-minute interview with her mom. I actually got them to change her dx to PTSD, but seriously, how OBVIOUS was it that the rape was the event that caused the distress, as there was no distress before, and as she shifted from depressed to angry after disclosure?
It is important to be objective, but that also means being honest about the limitations and massive conflicts of interest that are part and parcel of the field. Underestimation of the impact of environmental impacts is absolutely a basic assumption of the current diagnostic system. It claims to be cause-neutral, but in practice, it is extremely biased toward prioritizing biology FAR over any other potential cause.
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Given what you said about Aristotle and his impact on philosophy, I’m sure you’ll find it engaging on many levels. Truly one of the top three books I’ve ever read!
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She is talking about the assumption that children exist to meet the needs of adults. Pedagogy is simply a way of codifying the expectation that children will do as they are told “for their own good” (another title of one of her books). Putting adults in the role of helping kids (or other adults, for that matter) figure out what THEIR needs are is a radical action, and people who do so are generally attacked by the society at large.
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Or they were (and still are) designed to provide convenience and practical utility to adults who are responsible for caring for people with difficulties. I worked with a kid in a group home who refused to brush his teeth and so forth, and they asked the doctor to increase his Risperdal dosage. It is often very simply about compliance and control.
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“Works” is the operative term often used by the psychiatry/psychology to justify their “treatments.” They often say, “The drugs work” or “treatment works” without any real criteria for what that’s supposed to mean. If a foster parent says that stimulants are “working” for their foster child, do they mean that the child feels better, the child is being more compliant, the child is feeling more successful, the teacher SAYS the child is “doing better,” the child is less annoying than previously, the child is completing more busywork while not learning anything new, the child is more willing to do things that are boring without complaining… the list of possible definitions is almost limitless. If we don’t ask what “works” means and for whom the intervention is supposed to “work,” we get kids/adults who are nearly catatonic being identified as “treatment successes.”
I can’t read my prior comment, but I’m guessing by “plays” I meant “participates in the agreed upon social processes/procedures.”
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Hey, you’re right about Aristotle! Have you read “Zen and the Art of Motorcycle Maintenance?” He totally takes Aristotle down!
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“Neither Conor nor Maeve have the capacity to decline treatment, yet with treatment, both are highly likely to recover and lead full lives.”
Yeah, kinda need a reference on THAT one!
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Well, I completely agree with you, of course. The overwhelming problem with the whole idea of “what works” is that we’re not talking about something concrete and measurable here. “What works” can be defined in many different ways, and there is no way to determine who is “right” about the answer to that complex, highly philosophical question. And absent agreement on that point, there is really no sense it trying to “scientifically” determine anything about this whole area! “Mind” is a mysterious thing, and “science” hasn’t even begun to touch on the vaguest understanding of “Mind.” Of course, they want to CLAIM that mind=brain, because it feels more “scientific” and less “superstitious,” but that’s really just a philosophical position, not a scientific one.
The first barrier to understanding anything is deciding that you already know all about it! Humility is in very short supply in the psychiatric “professions!”
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Address emotions by improving quality of life? That’s CRAZY talk!!!
/s
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I think her main thrust was for adults to realize they are dangerous to young people and to stay the hell out of their way!
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Most movies and TV shows portray psychiatrists as therapists. I’m sure that’s not by accident. The confusion between psychiatrist, psychologist, and therapist counselor is important to protect psychiatry from people understanding that psychiatry is akin to drug pushing.
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Is this supposed to be news? Peter Breggin wrote about this in 1993. I’ve heard many users describe this exact phenomenon, not as a “side effect,” but as the primary effect of SSRIs. Anyone who has actually listened to a dozen SSRI users will have heard this at least once or more. How is this only being “discovered” now, thirty years later?
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Mind definitely does affect brain. There was a great study out of the University of Chicago where they did brain imaging on a number of Buddhist monks who mediated many hours a day. The part of their brain associated with calm and focus was significantly larger than those of “control” subjects. WE also know that taxi drivers, for instance, have a bigger part of their brain committed to geographical and spatial reasoning. Also, the folks studying the brain in the “Decade of the Brain” research found that damage can be done to the brain by early trauma, but also that healthy relationships with caring adults can actually heal the physiological damage done by early abuse or neglect (for some reason, that second part of the research always seems to get buried. I wonder why?)
What we think about and how we behave most definitely affect the brain. I don’t think it’s a “maybe.” There is solid evidence that it’s a “yes!”
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Actually, I think Freud got it mostly right to start with (Trauma Theory) but then recanted under pressure from his colleagues, many of whom probably sexually abused young ladies in Vienna themselves.
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That study sounds like a bit of semantic hocus-pocus. Of course, “benzodiazepine use disorders” is another loosely-defined, subjective description of behavior that no one can objectively verify. But be that as it may, 17.1 percent acknowledging “misuse” is pretty damned significant. I’d also submit that most who ARE dependent on these drugs are probably not aware of it, and would not be until they tried to come off the drugs. All in all, this article doesn’t seem to contribute much to my understanding of either abuse of or unintentional dependence on Benzos as a social/medical/philosophical problem.
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Seems to suggest that our personalities derive from more than simple genetics!
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It is important not to misinterpret Miller. She’s not saying that our parents are abusive assholes, she’s saying they are suffering from THEIR parents’ shortcomings, who were suffering from THEIR parents’ shortcomings, etc., and that unless the parents are able to face and feel the pain of their own childhoods, they will repeat what happened to them and pass it on to another generation. Blaming parents is NOT what she’s about – the idea is to learn where your parents went off the tracks and EXPERIENCE the pain you were avoiding, so that you have a chance NOT to pass this pain on to others. But if the therapist him/herself has not does their own work, they pass on THEIR parents’ pain and shortcomings (and maybe their therapists’) on to their clients.
So in the end, it is kind of dangerous to go see any therapist, as they may be working out their shit on you. You’d have to carefully screen for self-awareness, humility, and ability NOT to put their shit onto others before you ever consider a therapy relationship. That’s what I see, anyway.
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Well, you were better beforehand and worse afterwards. The doctor says that couldn’t happen, but it did. What is the most likely explanation?
I’d say tell the doctor to take a long walk off a short pier.
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Besides, we can’t be curing people, or we’ll have to find more patients to bilk!
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“We don’t know how it works” is quite an admission. I’d challenge the “but it works” part with, “Works for whom?” or “Who gets to decide what ‘works'” means?
I was an advocate for nursing home residents at one time in my career. I visited one facility because a family member said her dad was overdrugged on Abilify or some other “antipsychotic”. I went to talk to the guy, and he could barely keep his eyes open, couldn’t even stand up without assistance. He had bruises on his forehead from running into the door jamb on the way to dinner. I talked to the activities director, who said a week ago, she’d been hitting a volleyball back and forth in the courtyard with this same guy.
Did the Abilify “work?” Well, if your intent was to induce a near coma so the guy was incapable of doing anything at all, I’d say it worked great. If the goal was to enhance his quality of life, I’d say it did the opposite. Those who claim it “worked” clearly consider his quality of life to be a secondary concern, or of no particular relevance. So it “works” for them, even though it destroys the client’s life.
Beware of anyone claiming something “works” on someone else!
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You sound a lot like Alice Miller’s work!
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The problem with this “reasoning” is that there is no evidence that “treatment” makes things any better. In fact, the more “treatment” is passed around, the more chronically “mentally ill” people seem to be appearing. So more and more of what doesn’t work is the answer?
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I also know a person of privilege who had a hallucinatory experience, and was “diagnosed” as “bipolar” and discriminated against in their work and other settings for this label. It was interesting to note that this person claimed that they were “misdiagnosed” and were having a “spiritual awakening,” but continued to believe there were “real” bipolar people out there, only she wasn’t one of them. This person’s emphasis was on proving she was not “one of them” instead of identifying the labeling process itself as opening the door to very real and serious discrimination and abuse, which of course anyone labeled “bipolar” would likely experience, regardless of the reason for their label being attached. I understand why this happens, but I think it shows how hard it is to arrange a sense of “comradeship” when the entire process is so fraught with danger for anyone participating as a “client” or “patient.” When people are scared and isolated, they tend to search for a way to save themselves, and the plight of others may not occur to them until well after the incident, or in many cases, it may not occur to them at all.
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I like your thinking here. Options without domination seems to be the best way to help people. Domination is often what created “mental illnesses” in the first place, so it’s not likely to make us better!
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I think the biggest problems with screenings are a) screeners who don’t care (employed in a cold way is a great way to put it) and b) the person or organization doing the screening has no idea what to do about the situation. I read a doctor one time saying, “So we screen for suicide and the answer is positive. Now what the hell am I supposed to do about it?” Of course, the “right answer” is to refer them to a psychiatrist, but we know that doesn’t generally do much to solve the problem.
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The problem I see is that there is no way to ever prove them wrong. If they claimed you had high blood pressure, you could have someone measure your blood pressure and say, “See, it’s in normal range.” But with psych “disorders,” it is always a matter of someone’s opinion, and anyone with an MD gets more autotmatic credence than the average Joe, and a LOT more than someone they’ve labeled with a “mental illness.” As long as there are no concrete criteria for deciding who “has” and “doesn’t have” a “mental illness,” the psychiatrists/psychologists/doctors will always be in control!
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Quite so. It is an endless loop. Heller captured this idea so well with Catch-22!
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If they can. Too many psychiatric “users” have literally no choice about it at all.
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Yeah, I love it when telling them you don’t want their “help” is an indication that you NEED their “help” because if you were “mentally healthy,” you’d automatically agree with them about everything! Talk about “crazy!”
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Agreed on all points!
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Gosh, I keep forgetting!
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In my experience, the act of invalidating someone’s ability to decide what is happening and what to do is the very SOURCE of most instances of what the DSM calls “mental illness.” To provide “treatment” that involves further invalidation and “I know what’s best for you” energy is like putting out a fire with gasoline. It is literally the LEAST helpful thing you can do, besides overtly abusing the body of your patient. Yet people get paid to make other people’s lives worse.
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If “psychiatric treatment” helps people overcome “mental illness,” why aren’t there fewer people suffering from “mental illness?” Seems like the more “treatment” is provided, the MORE “mentally ill” people turn up!
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Isn’t the fact that there is no way to measure the quality of psychiatric care kind of proof that we’re not dealing with medical issues? What if heart surgeons said that there was no way to tell if they did a good job or not, so that everyone should just let them do whatever they want to? I don’t get why they get away with that kind of nonsense.
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Because the “depression” was rude enough to refuse to get better with the drugs. Though no one bothers to ask the nice old lady why she might be feeling sad or hopeless.
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I tend to laugh at the idea of “treatment-resistant depression!” As if “depression” is a sentient being that can “resist!” What they mean is, “My approach to helping you failed completely,” but instead of admitting this, they blame the patient. It’s like the car mechanic saying, “Your car has repair-resistant fuel injectors” instead of admitting he doesn’t know how to fix the car. That way, he gets to charge you for it and offer to charge you for another “treatment” next week, even though he hasn’t the first clue what he’s “fixing!”
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What other profession REDUCES the average lifespan of its patients and then blames the patients for their failure?
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Commenting as moderator: The phrase used in the last comment is not intended as an insult to Catholics or Christians, but as a metaphor for how the poster felt being abused at a Catholic institution for many years. No offense is intended to Christian believers.
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So you don’t think it costs $1630 more to make digital Abilify?
I guess that’s why they call them “smart pills” – the manufacturers have found smart ways to rake in more obscene profits!
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This is a fantastic concept that has a proven track record. Yet it is not embraced by either party. I wonder why?
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True enough – horseshit at least can serve a purpose, while the DSM is useful only as a doorstop or extra TP or to start a wood fire in your fireplace. Maybe as a defensive weapon if attacked. It really has no productive purpose at all, and in fact is destructive in the extreme.
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Some patients want someone else to tell them what’s wrong with them, even if doing so is the opposite of helpful. But some most definitely are looking for someone to help them explore their own needs and thinking and emotions to find a better way to live. There is also a group in the middle who are willing to believe the psychiatric story because “they’re doctors” and it sounds very “sciency,” but are to one degree or another disappointed that the promises they were given don’t come to fruition, and eventually, these people rebel, either quietly or loudly, but sometimes it takes years or even decades for them to really “get” what happened.
I remember when I worked on a suicide hotline, I got a call from a woman who said she’d been trying different antidepressants for over a year. She was quite frantic, saying she was working on her 5th antidepressant and none of them worked, and she told her doctor that it wasn’t working and all he would say was, “You have to give it time” or “let’s try another one.” She was panicked that she’d always feel depressed and be waiting for something that would never happen. I acknowledged that this was very difficult, then asked her a simple question: Had anyone ever told her that there were other things she could do besides taking drugs for depression? She was suddenly calm. She said, “No.” I said, “Well, there are.” She said, “Oh. Well, that’s good!” and then we got to talking about what else she could do.
I don’t think she “wanted” a diagnosis. She wanted help with a situation she didn’t understand, and the doctor told her what to do, and she tried it, having no other frame of reference. If the doctor had told her something more sane, she would have taken it up in a moment. Her only fault was trusting the doctor, not wanting to avoid responsibility for her condition.
It is easy to make generalizations, but as I like to say, “All generalizations are always wrong.” People are different, and we ought to consider that when making our analyses.
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Well, you know yourself better than I do, and you should act in accordance with what works for you. As I said above, I tend to avoid doctors whenever I can, too. Even the nice ones have a lot of false information they’re working on.
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I actually screen my doctors ahead of time. I let them know that I’m in charge of decisions, they’ll advise me but I may or may not take their advice, and if that’s not OK with them, they should let me know right away and I’ll find another provider.
Though I prefer to avoid doctors altogether. I usually get a nurse practitioner or a physician’s assistant to be my PCP. I actually now have a naturopath as my PCP. The less I see of doctors, the happier I am, generally speaking.
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A doctor almost killed my father when I was 8, as he was taking blood thinners (which he reported to the doctor) and was prescribed something that created uncontrollable bleeding when combined with blood thinners! His arm bruised if he just set it on the table. If he’d fallen off a ladder or been in a minor car accident, he’d have bled to death in minutes. I learned at that young age never to take ANYTHING I hadn’t personally looked up for adverse effects, no matter what the doctor told me.
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I think the word you are looking for is “horseshit!”
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Ignorance or malfeasance or a combination of both, it doesn’t matter much to the client/patient/victim, they’re still harmed just the same. If they don’t actually know the adverse effects, they should not be prescribing it. It’s like saying, “I didn’t know guns shot bullets.” PUH-LEASE, take a little responsibility, medical folks!!!
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Nothing irrational about being afraid of people who are dangerous to you!
As for depression screenings, my understanding is that it’s totally OK to refuse to do them. It is also completely legit to just answer in the way that reflects best on you – they have no right to know your inner thoughts and feelings!!! So if they ask me, “Have you felt depressed in the last three weeks?” of course, I always say, “No” no matter what I’m feeling. I’m sleeping fine, my appetite is fine, etc, etc. until they are done. But the more I think about it, the next time I hear them starting in on this, I’m going to say, “Is this a ‘depression screening?’ If so, I decline to participate and will not answer any questions on the screening.”
That may or may not be realistic for you. I find it obnoxious that they have the temerity to do such a screening when they have no idea what to do with a “positive” outcome (and of course are screening in the first place for something so vague and subjective that no one can tell if you “have it!”) But I do know I’m in charge of my own medical care, and the more I assert that right, the better I feel about my interactions.
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“Unaware of adverse effects” is absolutely no excuse – if they don’t know the adverse effects, they have no business prescribing them! And the truth is, most know enough about the adverse effects to know they’re not being honest when they prescribe. I believe point #2 is the main reason – they don’t want the truth to get out because many of their clients would then refuse to take what they prescribe, and that will cost them in some way or another. It’s quite intentionally dishonest.
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Psychiatry proved quite comfortable with both Stalin and Hitler, as well as modern western democracies. Like cockroaches, they adapt to whatever environment is provided.
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Irony alert! It is painful to watch someone laud the very industry that shortened her lifespan without even resolving her so-called “symptoms.”
But really, a giant Prozac urn? That’s taking “destigmatization” to a new level!
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It is clear that the DSM diagnostic process is DESIGNED to create “stigma” and justify discrimination against those who are perceived as “different” or danagerous.
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One could almost say there is an effort NOT to understand the cause of severe emotional pain. My experience as a provider was that it was rare that most “clinicians” asked such questions, or if they did, they’d simply “catalog” them along with other “symptoms” in order to claim a “diagnosis.” Very few seemed to understand the significance of such events, and of those who did, most didn’t really know what to do about it. I used to say there’s a one in five chance of getting a competent therapist. Nowadays, I think that would be a gross overestimate!
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The basic approach of psychiatry is to suppress the brain’s abilities and to impair normal functioning. Kind of like, if your hand hurts, numb your hand. If that doesn’t work, remove it. There is no effort to actually determine WHY your hand hurts or what else might be done. If “depression” is the problem, then the “answer” is to make the person less depressed. So “antidepressants” are the way to go. The idea that a person may have a good REASON to be depressed, or that some other physiological problem is causing it, doesn’t appear to be a relevant concern of theirs.
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He no doubt overlooks the most obvious reason: more “treatment” CAUSES more suicides and mental distress! The BEST spin you could put on it is that “treatment” is completely ineffective, but there is plenty of evidence to suggest it is more dire than that. Plus the widespread false propaganda that “mental illness” is caused by and helped by physiological processes prevents people from doing things that actually DO work.
It is my belief and observation that the very act of labeling someone’s problems as an “anxiety disorder” or “major depression” is demoralizing from the get go, and even without the adverse effects of the drugs (which clearly DO make some people worse!), the labeling process most likely contributes both to mental distress AND suicides.
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My impression was that she died early due to years of “treatment” for “bipolar disorder.” She did some PSAs for “recognizing bipolar disorder” or some such “anti-stigma” memes. She is not alone, as the average lifespan of those diagnosed with “bipolar” or “schizophrenia” is literally 20-25 years shorter than the average person. I wonder why?
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There is also the question of grouping. If one treatment cures 10 percent of the “ADHD” population, but drugs “reduce symptoms” in 70 percent of the population, the 10 percent treatment will be regarded as “ineffective,” even though it cured one out of 10 people completely. If you have arbitrary and/or purely subjective groupings of subjects, you’re not going to get any meaningful information. A REAL scientist would look at that 10 that WERE cured, and say, “Wow, what is different about these people that treatment X worked so well?” Then they might actually be able to identify a true group that has something in common with each other, and THEN (and only then) can they actually look for causes.
But too many people are hypnotized by the “Gold Standard” argument and think that anything producing a p value under .05 is “evidence based,” regardless of the triviality of the result or the heterogeneity of the group. It is a setup for drugs to “win” every contest, and I doubt very much if that fact is accidental.
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Precisely!
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“Stigma” really is a euphemism for intentional discrimination. And of course, the ones complaining MOST about “stigma” are the ones who are most committed to this kind of discrimination themselves!
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And when they DO come up with a needle, they’re claim that this is proof that NEEDLES cause HAYSTACKS or that HAYSTACKS are made of NEEDLES!
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“Negatively influencing outcomes?” Don’t they mean “Negatively influencing profit margins?” As far as I can tell, outcomes for most any “mental illness” you define either remain the same or get worse with long-term “medication” (aka drugging). Stimulants, antidepressants, antipsychotics, all are associated with either no change or deterioration over time when used long term. Not to mention killing people off 20-25 years younger with the antipsychotics, hardly an “improved outcome!” How do the doctors get away with this nonsense?
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Absolutely!
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That would be awesome!
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I agree. It’s also true that correlation can be “significant” in terms of P values, yet there can be enormous overlap between those “having” and “not having” the anomaly in question. To be diagnostic, a particular “anomaly” has to occur in all or almost all of the test subjects, and in none or almost none of the control group. The fact that “ADHD” diagnosed kids have a 5 percent smaller brain volume (notwithstanding the issue of drug effects on brain size) means almost nothing, because 95 percent of the kids will have brain volumes that overlap with the “normals.” So the smaller brain size, whatever the reason, doesn’t indicate “ADHD,” because too many non-ADHD people have the same brain volumes as “ADHD” people. Of course, there is absolutely NO reason to expect that a random-ish list of behavior that adults tend to find annoying would somehow translate into a measurable “brain dysfunction.” So the whole effort is pretty much a waste of time.
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The problem with this kind of research is that lumping all people diagnosed with “Major Depressive Disorder” together for study is kind of like grouping people by “pain tolerance” or “tendency to breathe deeply” or “having a poor appetite.” The “criteria” for “Major Depressive Disorder” do not distinguish valid groups of people likely to have something neurological in common. The very idea is based on a logical fallacy, and can’t lead to any kind of valid scientific answers.
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There are lots and lots of citations re: long term outcomes not differing.
Just a few:
https://academic.oup.com/jpepsy/article/32/6/643/1021192 (Just ran across this by chance last night)
The RAINE study in Australia: read the executive summary:
https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports-and-publications/PDF/MICADHD_Raine_ADHD_Study_report_022010.pdf
The Quebec study:
“We examine the effects of a policy change in the province of Quebec, Canada which greatly expanded
insurance coverage for prescription medications. We show that the change was associated with a sharp
increase in the use of stimulant medications commonly prescribed for ADHD in Quebec relative to
the rest of Canada. We ask whether this increase in medication use was associated with improvements
in emotional functioning or academic outcomes among children with ADHD. We find little evidence
of improvement in either the medium or the long run. Our results are silent on the effects on optimal
use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the
community.”
https://www.nber.org/system/files/working_papers/w19105/w19105.pdf
Swanson’s “Review of Reviews” in 1993: https://escholarship.org/content/qt4jr2777t/qt4jr2777t.pdf
Russel Barkley’s 1978 review: no academic benefits of long-term stimulant treatment – https://pubmed.ncbi.nlm.nih.gov/22418/
The long-term MTA study results show no advantage to stimulant use over time:
“The latest follow-up, released in March 2017, further confirmed the association between stimulant medications and reduced height; patients who took stimulant medications consistently were an average of 2.36 centimeters shorter than their peers who had stopped taking medication or who took it only sporadically. But, in a confounding twist, the two groups (those who took medication consistently and those who didn’t) showed no difference in symptom severity — though members of the former had, on average, taken more than 100,000 mg. of stimulant medication over the course of their lifetimes.”
The researchers do some pretty good pretzel twists to try and minimize these results, but it certainly suggests strongly that there are no long-term benefits to stimulant use.
https://www.additudemag.com/latest-mta-results-putting-adhd-treatment-data-in-context/#:~:text=The%20Multimodal%20Treatment%20of%20Attention,adulthood%2C%20have%20no%20effect%20on
Another one I just found:
https://pubmed.ncbi.nlm.nih.gov/29530108/
There is also a comparison study of Finnish vs. US students. Far more US “ADHD” students took stimulants, but there were no differences in outcomes. I can’t seem to find a link to this study.
So the jury is long since in on this question. There are no long-term benefits of stimulant use for “ADHD” diagnosed kids.
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The power imbalance is the central conflict in any kind of “therapy.” In my experience, those who can step down from their power advantage are the only ones who are ever successful in helping their clients. People generally don’t need another boss – they need a human being they can feel safe with!
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The problem is the “honest” part – those benefitting from these “diagnoses” are not interested in having an honest debate, because they know they have no solid data underpinning their approach. But they have the power to deny any other view through use of their “authority” to suppress actual debate and known research.
It’s not about debate or facts, it’s about power.
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Pretending to “help” people for pay when you have no actual idea what is helpful or even what you’re supposedly helping with is a very shallow approach.
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This has always seemed true to me, but everyone seems to think they are very “sciency.” I remember a study showing that including brain imaging pictures in an article, even if it had nothing to do with the content of the article, made people more likely to find it credible.
Humans are unfortunately too gullible in many cases.
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But only if the adults took responsibility for creating the best environment for the kids, instead of expecting the kids to “adapt” to whatever the adults decide is “normal.”
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I can’t seem to find it – not sure what I did with my old “ADHD” article copies! I think it might have been done by Dr. Sydney Zentall, because she’s been talking for decades about how changing the environment to create optimal stimulation is best for “ADHD” kids, rather than trying to artificially stimulate them with drugs. But I’m not sure. I’m sad I can’t find those documents! But I assure you, that was the result.
The other important result, and I can get citations on this one, is that “ADHD” kids taking stimulants don’t do better academically (or on any other outcome measure) than kids who don’t in the long term. So why are we doing this to kids, if it doesn’t even help their long-term academic outcomes????
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It is somewhat stunning that people can’t see the utter shallowness of the psychiatric/DSM worldview. Just reading the names of the “disorders” is enough to make a rational person laugh out loud! “Oppositional Defiant Disorder?” How do you know you have it? Because you won’t do as you’re told!!! “Intermittent Explosive Disorder?” “Disorder of Written Expression?” How is any of this taken seriously???
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I think you make an excellent point. “Crazy” behavior is almost always a result of someone feeling trapped or used or as if they failed based on someone else’s judgment of what they ought to be doing. It would have been interesting if you and the teacher could have sat down years later and talked about what happened, and maybe understand what was going on for each of you. But I do hold people in positions of responsibility to a higher standard of controllinng their behavior when vulnerable young people are in their charge.
I apologize for my use of that language and appreciate your feedback.
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I have often used the “canary in a coal mine” analogy for the “ADHD” kids. If these kids are having a hard time paying attention, it means that 9 out of 10 of the rest of the class feels the same way, but they are restraining themselves to stay out of trouble. The only “problem” with the “ADHD” diagnosed kid is that they aren’t as skilled at repressing their boredom or sense of frustration or outrage as the rest of us. Hardly a “disease state!”
I also agree that we do try to change the kids instead of the environment. Some seminal research was done on “ADHD” kids back in the 70s, where two well-matched groups of “ADHD”-diagnosed kids were put half in a standard classroom and half in an open classroom. They then had teachers come in and try to identify the “ADHD” children. In the standard classroom, they were over 90 percent successful. In the open classroom, there was a very slight but not significant trend toward the “ADHD” being picked. In other words, put these kids in an open classroom, and you can’t tell them apart from “normal” children! Now this was done way back in 1978 or so. So why haven’t we created open classrooms for our “ADHD” children? I guess no one profits from open classrooms, while selling stimulants is a lot more profitable. Plus changing the environment means the ADULTS have to take responsibility, while “ADHD” means we can blame the kids and keep doing whatever we want as adults. It’s disgusting to me.
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Thank you for this! You made my day!
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Except that “removing evil spirits” can’t actually harm you! Much preferable to the “active placebo effects” of SSRI antidepressants, for example. If someone can get better by an exorcism, so much the better for them, because they can dispense with the psychiatric system, which can really do some damage!
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I actually prefer the idea of tying kids to a chair. At least they’re being honest about what they’re doing and can’t pretend it’s “for the good of the child” or some “educational intervention!” But well done for you for defeating that crazy teacher!
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I am very much in favor of reading Miranda-style rights to anyone subjected to an “evaluation.” The right to remain silent and the right to consult with an attorney should be afforded to the “mentally ill” if an alleged criminal has those rights.
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Yet somehow, Psychiatry pretends that all these people have the same “condition,” the same problem, and need the same “solution!” And 99 percent of people believe they know what they’re talking about!
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Too true!
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Thank you for this – you put a lot of my feelings into better words than I could have come up with.
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Thanks for a great post!
I’d just add that is possible medical doctors don’t go for “mental health treatment” because they know better than most people how dangerous some of the “treatments” are. If you ever read the entire label for Abilify or Seroquel, or even an SSRI antidepressant, you’d be a lot more careful about ever being “treated” with one of them!
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Very rude of you, getting rid of reliable clients that way! We can’t be curing people, it cuts into profits!!
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I am aware of a case from near the Mexican border, where all angles of “western” psychiatry had been tried on a so-called “schizophrenic” in a hospital there. They brought a shaman from Mexico over the border to do a spiritual exorcism. The person got better.
There are also shamans involved in the hospital system in Brazil, from what I understand. I don’t have any idea if “spirit possession” is a real thing or not, but spiritual cleansing of various sorts has been arguably more effective than anything psychiatry has to offer. And the side effects appear to be WAY less!
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I am not sure if the title is meant to be sardonic, but of course, psychiatry’s real failure lies in the last part of the title. If your goal is to “stop” self-harming behavior, you’ve already missed the boat. Self-harming behavior meets a need, and the key is understanding the goal/purpose of self harm and to help the person evaluate for him/her own self whether or not s/he wants to change that behavior. Attempting to force someone to “stop” self harming has been demonstrably destructive any time I’ve seen it attempted. If self harming is about having control of one’s pain, how can trying to force a person to stop be a good idea?
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Sure. A farmers’ market. People bring their goods, put a price on them, other people decide if they want to buy or not. No fakeo marketing, responsibility to the community putting up the farmers’ market not to violate basic rules, real competition for prices (no monopolies), consumers determine what is too high a price or what is popular enough to bring more of or charge more for. Workers have basic control of their workplace (most work for themselves or family). No money leaves the local community. If you’re mean or pollute the environment or are unsafe, you’re not asked to come back, or no one is willing to buy from you. It’s a nice model of what a free market COULD look like without billionaires and mass marketing and monopolization.
Hope that clarifies!
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Right. It appears the only “normal” people are the mildly sociopathic, because they never get too excited or too upset about anything. Looking at the DSM, it appears that having any kind of emotional reaction to anything is the sign of “mental illness.” Even annoying OTHER people makes you ill! Those people with no personalities in “Invasion of the Body Snatchers” or “The Stepford Wives” are the epitome of “good mental health” by DSM standards!
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“Billing fodder!” I like that one!
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Having worked at a number of “mental health” facilities in my younger days, I can tell you there is ALWAYS at least one psychopathic/sociopathic person on staff. Never worked at a place that didn’t have one. Half my time was spent undoing the damage of these one or two people who either had no clue or didn’t care or actually enjoyed messing with people’s lives.
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The other thing they fail to mention is that these differences are AVERAGES. There are TONS of “depressed” people with higher IQs or larger hippocampi and non-depressed people with smaller ones. If there really WERE some kind of neuropathology, we’d see more like 90% of depressed people having smaller hippocampi, or 85% having much lower IQs. This kind of research is horseshit, but it passes for “scientific” because they can tease out a P value of .05 on an average of hundreds or thousands of subjects. Any meaningful finding would have to clearly distinguish the “haves” from the “have nots.” This doesn’t even come close. It’s a joke.
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Not to mention having a depressing life: dead end job, stuck in an unhappy or literally dangerous relationship, dealing with childhood abuse and abandonment, or just dealing with the inherently stressful lifestyle that we’re all expected to “love” today, and if we don’t, we’re considered “disordered” for wanting to make major changes in our current reality.
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Most providers don’t have the first clue of what “worked” for the client, or even what the client regarded as “working.”
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The detriment of all except those profiting from the creation of a permanent underclass of “mentally ill” enforced “customers.”
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Of course, such a project is a failure scientifically before it starts. Because it starts assuming that “Major Depressive Disorder” is a unitary THING that has a unitary CAUSE. Why would we assume that ALL people who fit a subjective list of “criteria” that have little to nothing to do with the body itself would have a “neuropathology” that causes them to fit this subjective list? It would be like asking, “What is the neuropathology of cowardice?” or “What is the neuropathology of spontaneity?” Why would we assume that all depressed people even HAVE a “neuropathology” without evidence that this is the case. It might be viable to ask if SOME cases of “major depressive disorder” might have neurological underpinnings, but we can’t assume the conclusion, as these “researchers” appear to have done. In order to do a REAL scientific inquiry, it would first have to be identified WHICH cases have some kind of neurological problems, how to distinguish them from people who just happen to feel really bad for a long time, and to create a group of people who actually DO have some kind of evidence of neurological “causes” as a study group.
But instead, these folks just assume that there IS a “neuropathology” and their “research” is to find evidence to support the conclusion they want to find. That’s not science!
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I know. It’s not really capitalism when it’s part of a local community. The local community asserts its values and requires social behavior of local producers. It’s kind of like unspoken socialism – you have to behave or you are shunned. But that stops working pretty fast when the person doing the production is no longer invested in the community they produce in. As soon as people become expendable, things spiral very quickly out of control.
To be clear, I’m saying I have no problem with the local farmer bringing in food to sell, and using his money to buy shoes at the shoe store, with farmer, shoemaker, and whomever profiting from their honest labor. That’s the level where I see the “free market” working. As soon as the rich guy can move out of town and pollute the river or undercut local businesses to create a monopoly without any fear of community consequences, we are in trouble.
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A good point, Yinyang. However, I would posit that one can actively oppose psychiatry in a most vigorous manner without having to give psychiatry the “respect” of granting it any kind of professional status.
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I like your comment that no one needs to claim to be “anti-astrology” or “anti-phrenology.” All we have to be is “pro-truth” and “pro-rationality.” Psychiatry embraces neither of the above.
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I don’t disagree with you, but I am quite sure that psychiatrists in both the Soviet Union and Nazi Germany made plenty of money. It is true, their malfeasance and ill intent appears to go well beyond that simple motivation, but my original point was that the psychiatric profession has absolutely no intellectual or philosophical connection to Marxism. It seems to be quite adaptable to whatever form of government is present, which I suppose provides more evidence that the intent goes beyond cupidity. But there is no question that greed plays a very large role in the current application of psychiatry, and the “profession” (if we may use that term VERY loosely) would be quite upset if a Marxist revolt took away their gravy train.
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Do you not see pharmaceutical corporations as fully complicit in the structure and marketing of psychiatry in the 21st century? Or the 20th for that matter? How could psychiatry sell its wares without Big Pharma? And is not Big Pharma the ultimate end game for corporations – almost unlimited profits with almost no accountability? Isn’t this where unfettered capitalism inevitably leads? What forces oppose this natural tendency of corporations to get bigger and richer and to eliminate the competition? Isn’t that what international Corporate Capitalism has always brought us?
I think capitalism can work on a very localized scale, but only because there is a natural set of checks and balances whereby the local population can call the capitalists to account. If the local mill is dumping waste into the river, the citizens downriver can get together and say, “Hey, knock that shit off” and they have to listen, because they are neighbors and if people get pissed at them, they will stop buying from them. But if someone in Taiwan or Chicago or London is polluting my local river in Washington, what the hell can I do about it? There is no one to complain to, and the big company doesn’t give a crap if I live or die, as long as the money keeps coming in.
That’s why I see psychiatry as a fully capitalist enterprise they exist to make PROFITS, they collude with others making even BIGGER profits, and they are utterly unaccountable to the population they claim to serve. That’s as capitalist as it gets in my book.
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Nobody’s saying the current system is working, Richard, or I’ve certainly NEVER said anything remotely like that. I told you I agree with Marx’s analysis of capitalism, which was and is indeed genius. I just don’t see him providing a workable alternative system, that’s all. Maybe more practice is needed, maybe I’m too cynical about “human nature,” maybe I can’t envision enough people being educated (or even interested) enough to learn the reasons why cooperation matters. My observation is that current society requires a HELL of a lot of cooperation, yet this is all very much taken for granted and people are easily manipulated and taken advantage of by posing “us vs. them” scenarios. I would love to see the “workers unite” and create some better conditions. I just don’t see Marx as providing us a pathway there. I get stuck in how the “Dictatorship of the Proletariat” leads to the classless society. It has not yet happened in reality. Israeli Kibbutzes are probably the very best example to date, but my understanding is that they are now a very tiny part of Israeli society.
You’re free to disagree, but I think you could ease off the suggestion that I think “capitalisms is the highest pinnacle of human organization.” You know very well I never said that, so please refrain from “strawman” arguments in the future.
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Marxism as practiced has been a disaster. I think Marx’s analysis of what was wrong with capitalism was quite accurate, but his solution fails to take human nature into account. Humans need to feel like they are competing in some way, that their individual efforts make a difference. They don’t do very well working for “the good of the collective,” much as many like to think they do. Collective farming was the best example – production was very low, until they gave everyone their own 10 acres or whatever to farm. The productivity on the private land was many times that of the collective farms. I suppose you could say that people need a game of some sort, a way to “win” or “lose,” and collectivist farming doesn’t seem to provide it.
But of course, the other verity of humans is that “power corrupts,” and it was ironic to see the Communist Party leaders hanging out in the same dachas of the aristocracy they claimed to want to get rid of.
So sure, communism in practice was a total failure, and led to dictatorship in seemingly ever case. But that doesn’t make psychiatry communistic. It’s just plain authoritarian, and so naturally will do well in either fascist or communist or any other authoritarian state where the need to control other people is prominent. However, it should be observed that while the communists USED psychiatry to keep their rebels under control, psychiatry was part and parcel of the planning and implementation of Nazism in Germany, up to and including mass murder. So I’d still say psychiatry proved a better “fit” with fascism overall.
Regardless, it appears to me that psychiatry is less interested in economic theory and primarily concerned with making money and establishing power over others. They will do so in whatever economic system is in use. They are very, very comfortable with capitalism, as drug company profit margins on psych drugs should make very clear. Communists are anti-capitalists. Psychiatry, simply put, is not.
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It is always ironic when they go on and on about the dangers of Vitamin B3 or others because they “haven’t been fully tested,” while they give out drugs that they KNOW reduce people’s lifespans by 20-25 years. Hey, I think I’ll take my chances with the “untested” vitamin B3!
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I have a hard time seeing anything “Marxist” about the “mental health” system. There is no effort or intention to create equality between workers and the wealthy, nor any effort to redistribute control of the means of production to the masses. If psychiatry had “Marxist” roots, it would create collective wards where no one had any economic incentives to push drugs on another person.
Psychiatry is a strictly capitalist enterprise. It is about making profits, regardless of the effect on the “consumers.” It is about projection of the power of the wealthy over the rest of us. Nothing Marxist about it, in my view.
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I agree 100 percent! And I don’t even consider them Western European and North American accounts. I consider them medicalized accounts of psychosis and mental illness, which work primarily for those providing “services” and selling drugs, and which work for almost no one of any culture otherwise.
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Posting as moderator:
We are now getting off the topic pretty far. I will allow this statement, but I do not want to deteriorate into a hostile exchange about COVID or about Gavin Newsome, and I see this as a very real possibility, based on past experience. The article is on “The Danger of Marginalizing People,” and comments need to be focused on that topic, specifically as it regards the “mental health” system. If we get into political discussions of other topics, I will intervene to keep the discussion on topic.
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Well, of course, I agree 100%, a “personality” can’t have a “disorder,” it is not a thing of the physical universe, it’s a consequence of thought and decisions made by a person. And I’d say that of course, a personality CAN be changed – I see it more or less as an invention a person creates to deal with the decisions they need to make to survive in the physical universe. I like the question of “genetically inherent” or “culturally inherent.” I might also add “spiritually inherent,” because I see it as entirely possible we bring some history with us when we arrive on the planet. But that’s getting deeper than we need to here. The very idea that a “personality” is something that can be “ill” or “disordered” is pretty outrageous, and yes, obviously has to come from someone else judging a person’s “personality” as being good or bad or inadequate. It is observable, but I don’t think anyone but the person him/herself is in a place to judge the quality or usefulness or need for change of the personality. It’s something we own completely ourselves. Criticisms of a set of “personality disorders” is rank prejudice and nothing more.
So I’m totally with you – psychiatry is utter bullshit, because it starts from a false premise that there is a “right” personality or “right” mind that only THEY can determine, even when they have no idea how they possibly could begin to make such judgments. Such is the hubris of psychiatry!
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Yes, I most definitely have considered that question in detail. I think you ask an excellent question, and one to which I nor anyone else I know of has a real answer. It could be viewed as a metaphor, certainly. I think it is one of those things that we only observe by seeing the results of it, kind of like magnetic force or gravity – you only know it’s there because of what effects it has on objects within its sphere of influence. That being said, the “mind” is a similarly problematic force. Assuming that the “mind” is simply an effect of the brain leads us to psychiatry or other empty conclusions. It appears there is something that is able to INFLUENCE the brain, to the point of actually altering its STRUCTURE (look at the studies on altered brain structure in meditating Buddhist monks, for instance), yet no one can really say what it is?
But I’m not one to say something is “bullshit” just because I can’t explain it. That’s not really scientific, either. I am much more inclined to simply say that personality is a pattern of behavior that a person tends to engage in, sort of the interaction between his/her mind and the environment s/he encounters, that some of it appears to be “inherent” and some learned, but that we don’t really know what it is or how it comes to exist, any more than we know what the mind is or how it comes to be. It’s a mystery, and I’m OK with that.
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Eh, I still think you’re talking about rearranging deck chairs on the Titanic. “Effectiveness” is a very problematic term when your “diagnoses” are voted on by committees and there is no objective way to create any kind of legitimate study groupings. Beyond that, the concept of a treatment “working” requires some agreement on desired outcomes, and no such agreement exists in psychiatry/psychology, nor probably ever can or will. For instance, is the goal of working with an “ADHD” child to make them “less hyperactive, distractible, impulsive?” If so, then stimulants seem to “work” pretty well. But if the goal is to have them become more academically competent, stimulants are a complete bust, may actually make things worse in some cases. So what’s the goal? We all know that in practice, the goal is to make the kids more compliant (dosing studies bear this out in every case). Is that really a legitimate measure of “working?” If it is, gagging and tying someone to a chair would also be judged to “work.”
Psychiatry has massive philosophical conflicts preventing it from successfully studying anything it its realm of interest. I don’t see that changing any time soon.
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HiTop still doesn’t bother to look at the causal factors in whatever presentation is seen. Ten people could all exhibit “OCD” symptoms for 10 different reasons and need 10 different interventions. Until a “diagnostic” system is based on finding the actual CAUSE of something, it is worse than useless. And since the causes of so-called “mental disorders” primarily exist in a realm called the “mind” which psychiatry has not the vaguest understanding of (still confusing “mind” and “brain” and insisting they are the same), the odds that they will somehow sort this all out are about zero.
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I have talked to plenty of adults and kids before and after stimulants. Some do talk like you do about it. Of course, these are the success stories. Most in my experience appear to view it as a somewhat helpful intervention in the short term, but complain a lot about the costs. A small number complain that it nearly destroyed their lives. You appear to communicate mostly with people who found it worked for them, so you have clearly decided that this is “reality” and other people who have different experiences are “wrong.” That’s what I’m objecting to. I’ve never said that you or others like you did not have positive experiences. I have said that these experiences are not uniformly positive. I’ve also said that other people have managed to have very positive experiences without drugs. What is wrong with that? Why are you unwilling to hear that viewpoint, if this stuff makes you “listen better?” Not everyone has your experiences.
I’ve also shared hard research with you backing up my viewpoint that a) not everyone benefits, b) most benefits are short term, and long-term outcomes have been shown over and over again not to be altered by stimulants or the lack of stimulants, and c) there are other things that you can do besides/in addition to stimulants that really do help.
Again, what is your problem with any of that? Do you NOT want there to be other ways to help? If some kids can do well without stimulants, why do you begrudge them that opportunity? Why not keep a child back a year and see if they do better after a year of maturity? Why not put your kid in an open classroom if kids like him/her do well in that kind of classroom? Why take the viewpoint that a person (me) who has raised his kids successfully without stimulants has somehow deprived his kids of “clear vision” when it’s obvious they are none the worse for wear? Why can’t you simply allow that what you did worked for you, but others may take different approaches? I have NEVER told you that your approach was wrong, or that people who medicate their kids with stimulants are abusing them or doing them harm. Why am I and others like me not afforded the same decency from you?
Please don’t respond with more insults. I need an acknowledgement that your way is not the only way, and that people who use other approaches are not wrong for doing so. If you can’t manage that, please don’t say anything at all.
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Drinking makes some people feel less depressed. Good for them. Doesn’t make alcohol a “treatment” for anything.
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I think that comment is very telling, and it supports my contention that most of the suffering that occurs to the “ADHD” child is due to the unrealistic expectations adults put on them in order to attend school, as I stated above. This comports 100% with the observation that ADHD-diagnosed kids are found to be essentially “normal” in open classroom settings where they are encouraged to move around and have more control of their environment (fewer unreasonable expectations). That approach certainly worked wonders for our kids.
It also helps explain why a third of the ADHD diagnoses go away if kids go to school a year later – they are older and more developed and it’s easier for them to follow the expectations set for them by the school. It also helps explain why so many kids “grow out of it” in their teen years – they are developmentally older and more ready to adjust to outside expectations of the school and others (this was certainly true for my oldest).
More importantly, it also explains why kids who take stimulants over the longer term don’t actually end up with better outcomes, even though their grades and adult approval ratings are better on stimulants. The stimulants make the adults happier and less concerned with the kid. The child’s learning environment is not improved, he is not doing anything different than his non-stimulated ADHD classmates, but “everybody else is being a lot nicer.”
So effectively, stimulants create an environment where the adults are more willing to leave the poor kid alone!
I know this is a perspective that you, Donovan, may disagree with, but I think the logic presented here is very consistent with Insel’s report from his son. The main benefit to his son was not being able to concentrate or learn more, it was that others were nicer to him! I hope you are able to listen and hear this perspective as I have listened to and heard yours.
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I agree with you. It is pure “cultural bias” to believe something like “borderline personality disorder” even exists at all. It is clearly skewed against women for starters. And how can you “overdiagnose” something that is not objectively diagnosable by any known standard? It’s like saying that beauty or cowardice or kindness is “overdiagnosed.” If there is no objective standard, there is no meaning to “over-” and “underdiagnosis.” We’re just making shit up, and no one’s “diagnosis” should be invented arbitrarily. But if it IS invented arbitrarily, it’s nonsense to talk about “overdiagnosis!”
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Yup, that’s the guy. I mixed him up with Liebermann. It’s hard to keep the scummy bastards straight sometimes.
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I also find it fascinating that the Industry wants us to believe all these conditions are “biologically based,” yet when they do animal tests, they have to terrorize and traumatize the animals to induce the proper “mental state.” One might get the idea that these “mental illnesses” they are testing are, in fact, the result of terror and traumatization!
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People should receive the kind of help/support they need without having to prove themselves “disabled” enough to “deserve” that help.
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I am glad that you found stimulants helpful to you. But you continue to argue a point no one is making. And you are now getting insulting implying that those making these arguments don’t give a crap about the children involved. I can tell you that I spent over 30 years in the field of helping children and saw and talked to hundreds and hundreds of kids diagnosed with “ADHD,” as well as their parents, their teachers, their counselors, their siblings and others involved with them on a daily basis. So I am not basing my opinions on some intellectual exercise. They are informed by much direct experience, including with my own kids, and calling me “criminal” for drawing the conclusions I have made after decades of research and direct personal experience is most definitely beneath you.
Additionally, your personal experience is important, but does not mean that your own experiences are “average” or “expected” from all or most “ADHD” diagnosed people. In fact, decades of evidence show that there are no reliable improvements in ANY long term outcome areas for long-term stimulant use, including academic test scores, high school graduation rates, college enrollment, delinquency scores, social skills, employer satisfaction, or even self-esteem. However YOU may feel about YOUR treatment, or others you know, you can’t claim that children are being cheated out of this special advantage that science says does NOT happen for the large majority of recipients.
I’d really appreciate it if you can constrain yourself to presenting your personal experiences and such scientific data as you feel you’d like to share, as well as directly addressing the science and experiential data that has been presented to you in good faith, and leave off on the disparaging comments on individuals who happen to disagree with you, especially when those objecting have presented their own data to which you could choose to directly respond.
Bottom line, you have your experiences, others have their experiences, they aren’t going to be the same, and all such experiences are welcome to be shared. Please be respectful that not everyone is going to see things your way, and that disagreeing on science is not a personal thing.
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I have never said that stimulants can’t be effective for people in the short term. My premise, if you will read more carefully, is that the appearance of stimulants “working” doesn’t mean there is something biologically wrong with the subject. Alcohol is an excellent “antianxiety” agent – used to calm me right down in social situations. Why? Because that’s what alcohol does. Not because I had some “diagnosis” that alcohol “treats.”
No one is arguing that psychotropic drugs don’t affect people in certain ways that some people will find helpful. I am trying to separate that easily observable fact from the scientifically tortured concept that we can somehow “diagnose” someone with a “medical disorder” based on a subjective list of behavior, or from their response to certain drugs, as you seem to be claiming is true.
As for humiliation, I want you to consider carefully how much of the “humiliation” that kids experience is based on how others treat them for not ‘fitting in’ with the schools’ expectations rather than because they “cannot concentrate as they need to.” There are kids younger than TWO YEARS OLD being “diagnosed” and “treated.” How on Earth can this serve the needs of the toddler to “concentrate as they need to?” Aren’t we talking about inappropriate developmental expectations at some point? Also, did you know that a couple of good experiments with open classrooms have shown that “ADHD” kids who are put into such an environment are almost impossible to distinguish from “normal” children? Or that a number of good studies in various locations have found that comparing kindergarteners who are 5 vs. almost 6 when entering Kindergarten consistently shows a 30% reduction in ADHD diagnosis rates SIMPLY BY WAITING A YEAR LONGER BEFORE ENTERING SCHOOL! And this finding has been replicated in a range of different geographic settings in different states and countries. That’s what I call a robust finding! Why aren’t we simply delaying the entry of kids diagnosed with “ADHD” for a year, or sending them to open classrooms, when that would give us a 30% cure rate?
If “ADHD” were a detectable biological problem, why would it matter what kind of classroom the kids are in? Why would waiting a year to enter school suddenly eliminate a third of these “biologically deficient” children? Isn’t this proof that maturation and developmental expectations play a huge role in who gets labeled “ADHD?”
Now, if you’re just going for the idea that, “We should be able to give kids stimulants if it makes it easier for them to fit into the classroom, and if they and their parents don’t mind,” that’s a very different argument. But the fact that some kids/adults happen to find the effects of stimulants desirable means absolutely NOTHING about the condition of their brains. It just means they like the effects, just like I like the effects of alcohol. Read some stuff from Johanna Moncrieff on the “drug model” rather than the “disease model” – she describes this WAY better than I can. You don’t have to have a “disease” for a drug to have an effect, and just because a drug HAS an effect doesn’t mean there’s something wrong with you. I hope you can agree to this rather obvious and scientifically unarguable premise.
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Yeah, I guess it depends on what you define as “works.” And for WHOM does it “work?”
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They are “suggesting” that the structure of the brain is a problem. But there is no evidence whatsoever that this suggestion is accurate in the slightest degree. When the brain is compromised, you see a neurologist. “Mental illnesses” are not “brain abnormalities,” however much the psychiatric profession continues to pretend that is true. There is not one single “mental illness” in the DSM where most or even a significant minority of people so diagnosed have any physiological problem in common. And this is not for a lack of trying. They’ve been searching for DECADES for “brain problems” that explain “mental illnesses,” and have found nothing of the sort. Absent actual PROOF, the “suggestion” you mention is as useful as the idea that there are living inhabitants on Mars.
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Great article, as usual. The one thing I might have included is the multiple studies on “ADHD” diagnosis and admission to school, showing that a one-year delay in school entry leads to a 30% reduction in “ADHD” diagnoses. This both undermines the idea that “ADHD” is something objectively diagnosable, and also extrapolates to say that if you just leave these poor kids alone, a third of them will most likely “grow out of it” in a given year. Probably even a higher percentage of preschoolers. Which anyone with “common sense” would expect. Though I guess it isn’t as “common” as it used to be!
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I agree – since most of psych drugs’ effects appear to be placebo effects, a little “snake oil” might not do any harm to try out. Worst that happens is nothing, and your body still is allowed to grow and develop.
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Again, I think you miss my point completely. It is not scientific to ASSUME that a cluster of behavior/emotion/thoughts that tend to occur together are a “diagnosis” that is caused by something biological. You are taking a PHILOSOPHICAL position, called Materialism, in assuming that there is no other possible cause. What EVIDENCE is there that any two cases of “depression” have or need to have a common cause? I already gave you a half a dozen reasons why a person might be feeling despairingly hopeless. Are you really suggesting that a person who is depressed because they feel trapped in a domestic abuse situation should have the SAME DIAGNOSIS as someone who is depressed because they are suffering from a low thyroid situation or Lyme Disease or a head injury? Do these cases have ANYTHING in common other than the similarity of emotional reaction? Would any sane person prescribe the same “treatment” for all four situations? If you gave antidepressants to a person in a DV situation, and they suddenly felt more comfortable being abused by their partner, could you consider that a good result? Are there times when feeling anxious and/or depressed is a NECESSARY, NATURAL process that helps humans decide to alter non-optimum living or social situations?
I am certainly not asserting that there are not biological correlates to the actions/experiences of the mind. For instance, we know that Buddhist monks who meditate regularly actually CHANGE THE SIZE OF PARTS OF THEIR BRAINS. But consider what that means – their CHOICE of mental activity alters the physical structure of their brains. So how can we assume that the brain is entirely causing their mind’s actions if their mind can alter the structure of the very brain it is supposed to be created by? Clearly, there is something far more complex going on here. Is the “biology” of depression (which btw has never been found to consistently exist for depressed people) the CAUSE of a person being depressed, or is it the RESULT of their framing of events as hopeless? If the mind is just a function of the brain, how is it that ASSUMING A DIFFERENT VIEWPOINT can “cure” depression or anxiety without any physiological intervention whatsoever?
It is incredibly simplistic to believe that there will EVER be a simple, scientific, objective, biological explanation for why people get depressed, because the number of variables is ENORMOUS, including the direct impact of the MIND on the BRAIN. Of course, being a materialist, you no doubt reject my premise that the mind can transcend the brain and act upon it, but that is again a philosophical and not a scientific position. You can provide no proof that people who meet the criteria for “Major Depression” have anything in common at all, and the DSM itself admits that the “diagnosis” does not lead one to that conclusion. So what’s the point of grouping those who feel depressed together at all? Wouldn’t it make a lot more sense to group together people who have domestic abuse histories with others who do, even if some are angry, some are depressed, some are anxious, and some are feeling pretty objective about the situation? But of course, being a “domestic abuse survivor” will also never be a biological “diagnosis,” because it’s not a biological condition. It’s a social one.
I hope I make myself clear.
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They work short term the same on everyone. Judith Rapoport et al showed this way back in about 1978. They gave stimulants to non-diagnosed people to test the “paradoxical effect” theory. She found that non-“ADHD” kids on stimulants had longer attention spans, were harder to distract, and lower motor activity levels, all the same things they do for “ADHD” kids. She said the reason people though the “ADHD” kids were reacting differently was because people were LOOKING for these changes and so found them, but would not notice on kids where they were not trying to “solve” attention problems. This issue was laid completely to rest scientifically at that point, and anyone being honest these days will tell you that you can’t “diagnose” someone by their reaction to stimulants, because most people react the same way, diagnosed or not.H
“However, it is now established that the focusing effects of stimulants in ADHD are not paradoxical; these agents have the same effect in ‘normal’ human subjects (albeit a more subtle response given ceiling effects) (Rapoport and Inoff-Germain, 2002).” https://www.nature.com/articles/1301164#:~:text=However%2C%20it%20is%20now%20established,Inoff%2DGermain%2C%202002).
Also, Rapoport’s original study from 1978: https://www.science.org/doi/10.1126/science.341313
It has come to my attention that this mythology is still promoted by many sites who pretend to be objective about ADHD, but the science has long since proven them wrong. There is no “paradoxical effect.”
As to longer-term effects, I think we’ve exhausted the literature on that point.
Enrico, please give it a rest. You will not convince me by repeating the same things over and over again. I heard you, I read your evidence, I acknowledged your position, I’ve established mine with the necessary evidence. I’m sure I won’t change your mind, and you won’t change mine. Let’s just stop arguing!
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Just to add a little extra evidence, I looked up “causes of depression” on Google. Here is a list of the titles that turned up:
The 4 major causes of depression
The 7 major causes of depression
3 major causes of depression
The 8 forms of depression
The #1 cause of depression (Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged work stress – are more likely to cause depression than recent life stresses.)
That’s on one search. Doesn’t sound like anyone has a grip on what “causes” depression, and there are as many theories as their are people tossing the label around. I think it’s because depression isn’t a “thing” that has one “cause.” It is an EXPERIENCE that can have hundreds of potential causes, and depending how it is handled, can lead to deterioration or to the opening of new perspectives on possible interventions that may improve one’s life. Any attempt to try and come up with one “diagnosis” for such a varied and nuanced experience is doomed to failure.
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I think you are overlooking a rather obvious point – the manifestations called “diagnoses” in the DSM, however real the suffering involved, are assumed to be (even by you) some sort of physiological experience. Hence, if the person’s brain were “right,” they would not be depressed, anxious, intense, or whatever. This is an absolutely nonsensical assumption! These “illnesses” are “intangible” because they don’t actually represent physiological illnesses at all. These diagnoses represent a potpourri of different emotions and behavior that are literally VOTED into or out of existence. The emotions and behaviors so designated are all things that occur with some frequency in “normal” people, and the “criteria” are very much arbitrary distinctions between “normal” and “abnormal,” which the DSM itself admits in the introduction are not able to distinguish groups of people having actual problems in common with each other.
https://www.psychologytoday.com/us/blog/in-control/201908/mental-health-diagnosis-just-say-no
“One of these innovations was that the new DSM was “a descriptive approach that attempted to be neutral with respect to theories of etiology” (p. xxvi). So, even though diagnosis is the identification of the nature and cause of a phenomenon, the APA somehow reconciled publishing a diagnostic manual that made no reference to the cause of that which was being diagnosed.”
[Direct quote from the DSM:] “In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi). So, the categories that DSM offers us do not have boundaries demarcating one disorder from another or, indeed, one disorder from no disorder. This is an extraordinary revelation. This means, according to the DSM, there is no assumption that the category “schizophrenia” has boundaries that separate it from other mental disorders or from not having schizophrenia.”
In other words, the distinctions in DSM diagnoses are ARBITRARY, they are not based on any legitimate grouping of people who have a problem in common.
Take “Major depression” for example: It COULD be caused by physiological events, such as drug side effects, low thyroid, anemia, Lyme disease, brain tumors, etc. It could be caused by social events: death/loss, current abusive relationship, unemployment, neighborhood violence, racism or other discrimination, being stuck in a dead-end job, poverty, etc. It could have psychological causes, such as a particular attitude toward life and events, high stress, prior abuse/trauma history… you get the idea. It is just SILLY to think that a person who is depressed because his mother died when he was 17 and he’s feeling a deep sense of loss has the same needs/problems as a person who is currently being abused by her partner, or has the same needs/problems as a person who was just diagnosed with cancer and is having side effects from chemotherapy. These people CLEARLY do not fit into the same category for either study or for planning, and yet the DSM makes absolutely no distinction between these groupings – these people, if they meet the criteria, are “diagnosed” with “major depressive disorder,” regardless of the cause or what their actual needs of the moment are.
Now I’m not saying that individual practitioners don’t make these finer distinctions. I hope that most of them do. But the DSM itself is useless as a “diagnostic” manual if it can’t distinguish between a cancer patient taking drugs that affect the mind (not to mention having a big existential problem regarding their prospective death), and a person whose mother just died and a person who has a malfunctioning thyroid.
That is what people mean when they say “mental heath diagnoses are not real.” They’re not saying that people don’t experience depression or anxiety at sometimes severe levels. They’re saying that the DSM “diagnoses” are of no value in establishing either cause or optimum “treatment” or prognosis. They are scientifically meaningless labels that are at best useless except to bill an insurance company, and at worst can be extremely destructive by papering over the real issues involved and invalidating the knowledge and experience of the client.
Given all that, I very much doubt that a “more objective diagnostic system” can ever be achieved, because the very idea that people who have difficulties emotionally or behaviorally are medically “ill” is absolutely without basis in reality. There may be a very small subset of these conditions that can be attributed to actual medical problems, and they should be, but calling everyone who finds life pointless at a particular moment “ill” as if someone whose mom just died is supposed to be cheerful is an absurdity that is not redeemable except by scrapping that concept and starting over.
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You might get the impression that they somehow don’t WANT people to successfully get off of them!
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Very well said! The psychiatric professions and the DSM seem to do the very opposite of following this wisdom in almost every case!
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Hardly surprising.
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“That’s absurd” is always the last defense of those who have no real argument in their defense.
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I wish I could find one! Doctors get a lot of cover for malfeasance, as long as it’s considered “standard of care.” It is most infuriating!
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I am certain he deserves firing, as this was hardly “one misstep.” He really should have been fired long, long ago for corruption. He is almost singlehandedly responsible for making the “juvenile bipolar” craze happen, by creating a justification for millions and millions of unnecessary and damaging prescriptions. He actually PROMISED the drug company funding one of his trials that the trial would be positive for their drug, BEFORE the trial even started.
Maybe this particular tweet could be forgiven, but his other crime can not. He ought to be in prison, IMHO.
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Gosh, who would have guessed that he’s an arrogant racist misogynist? Sounds like he hates children, too. I hope he spends some time behind bars some day.
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So you mean actually helping people meet their actual NEEDS without forcing them to do anything improves their “mental health?” Gosh, who would have guessed it?
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Thanks!
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How about providing them with every other possible source of non-drug support possible, including full physical workups, checking for ongoing abusive relationships, nutritional analysis, exercise, spiritual guidance, support groups, reading, music, art, coaching, etc, before even considering giving drugs that by their very nature disturb the normal functioning of the brain and nervous system?
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How probable is “two sigma” compared to random chance?
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Quite so!
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“Mental health diagnoses” serve a lot of social needs that have absolutely nothing to do with the health of the individuals so labeled. It has more to do with defining acceptable behavioral norms, removing blame from those in power, and silencing direct or indirect objections to the status quo. A kid gets “diagnosed” with “ADHD,” for instance, not because there is any identified medial problem, but because the child’s behavior is inconvenient for the adults involved. “Diagnosis” enables the adults to name and blame the child without the bother and the risk of finding out what is really happening. This is of course doubly beneficial to those who are guilty of abuse or neglect of the child, because they have something to cover up, and the “diagnosis” provides cover for them to continue to act out their own problems on the child without the danger of being called out or consequenced for it.
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It’s more like alchemy than anything else to me. Just keep experimenting and eventually you WILL find a way to turn lead into gold. Just because it hasn’t worked 100,000 times before is no reason to think it won’t work in the future!
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There are cases of infants under one year old being prescribed stimulants for “ADHD.” It is very disturbing that anyone could even CONSIDER such an option! Frankly, I’d rather see them use laudanum – at least they were being honest about their intentions!
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Dang, irony alert!
What a screw job!!!!
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That, of course, is the total downfall of psychiatry and the DSM – there IS no valid definition of “normal” on the psychological/spiritual/behavioral level. There is no way to extract “normal functioning” from the society and culture in which such functioning is defined. So their definitions are actually simply a collection of social biases described in some fancy language designed to obscure the fact that they’re basically saying, “Stuff that we don’t want” or “stuff that is hard for society to deal with.” And of course, completely denying that our social system itself is the proximal cause of most of the “stuff we don’t want.” The real challenge is why so many people believe this nonsense that is so easily debunked.
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Hi, Ted!
Have you ever made the legal argument that a person DOES meet the criteria for civil commitment (danger to self or others), but that this does NOT entitle the “doctors” to force “treatment” on them? It is very much taken for granted that civil commitment automatically confers this right on doctors and removes the “patient” (AKA inmate)’s right to informed consent. But why is this legally valid? It makes sense to get someone off the street if they’re walking in front of cars, but why does that confer anything more than the need to clothe and feed them and keep them warm until the crisis passes?
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Yeah, like the parents are always TOTALLY reliable sources as to stresses or trauma in the family. RIIIIIGHT!
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Dang, you got me, Bradford!
You know, sometimes people who get hit by a truck and have a near-death experience suddenly realize their life priorities have been wrong and make a big turnaround. Maybe we can start pushing people in front of trucks, testing out varying speeds of impact, to see if we can get the right force and level of shock to induce the intended reorientation. It would make as much sense.
Actually, I think I understand how “ECT” actually “works.” After two or three “treatments,” the recipient says, “Gosh, doc, I’m feeling SOOOO much better now! That ECT really did the trick. I’m TOTALLY healed! Now, can you please unlock the door so I can get the hell out of this place!”
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It is hard to see how anyone who is in their right mind could possibly imagine that electrocuting someone to induce a grand mal seizure could possibly be “therapeutic!” It take some SERIOUS bending of reality to try and make that one work, yet somehow, they manage to justify it anyway. Fraud is right!
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It is fascinating how the arrogance and corruption of these “leaders” are there right out in public for anyone to see, and yet so few see them. “Consideration” of the social determinants? As if THEY are in the position of deciding what is true, rather than observing the known facts? And their “customers’ mental health” – are we admitting here that the APA is a trade marketing organization that doesn’t give a crap about science as long as they maintain their market share? And why would a professional want to come and beg these folks to include something in their manual when it’s obvious that they don’t give a half a crap about the patients’ “social determinants” as long as they’re making sufficient profits?
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I don’t want to denigrate the scientific knowledge of doctors. It’s just a shame most psychiatrists don’t have an scientific knowledge to speak of. Pretending to know things when you don’t is most highly deserving of denigration!
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Actually, there is no way to judge “overdiagnosis,” because with the utter subjectivity of EVERY DSM “diagnosis,” there is no way to determine what the “correct” level of diagnosis really is. So how can you “overdiagnose?” That’s part of the brilliance of the DSM – you can’t tell the they’re wrong, because there’s no way to prove it!
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Not to mention the profits the “biological” worldview brings to our corporations!
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Wow, such warmth and love! I’m so sorry your mom was such a jerk! But it seems she was already looking for an excuse to disconnect anyway. I hope you’ve found some other people to fill the role of family members. Your mom sounds like she’s failed you badly!
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You upset them. You must be Borderline. Which means you must be suicidal. Which means they have to STOP YOU. Even if you aren’t really suicidal at all.
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Definition of “Borderline:” client who annoys the staff sufficiently or challenges their authority without compunction.
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Excellent!
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That is true, it should not be. Yet that is all too often what is on offer. My point is that it has to be done in the context of a bigger process of self-discovery. How to create a scenario which is “intellectually satisfying” is, indeed, the challenge. For some, it’s pretty natural, for others, it is quite a foreign concept and a lot of processing needs to happen before this is a reality to them. For others, it simply doesn’t work very well. I think a good therapist has a wide range of tools available, and CBT should just be one of them, and “tool selection” should be based on the needs of the client, not the need of the therapist to feel superior or skilled or whatever their needs may be.
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Hey, great move to get rid of them! But seriously, they dispatched someone because you got angry at them? That’s super fucked up!
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It is also often a gross oversimplification. Yes, thinking about your mother having abandoned you IS painful, and it IS over, and you are not benefiting yourself by thinking about it over and over. But there are reasons why we are attracted to events in the past that are painful – we are still looking for some compassionate person to step in and make it RIGHT. And telling a person, “Just think of something else” when there is that much emotional charge on an event, be it fear, anger, grief, apathy, confusion, or whatever, is often counterproductive, leaving the client feeling like a failure for continuing to think “wrong thoughts” and feeling blamed for having “reacted badly” to the very real trauma they experienced. It also adds insult to injury if the “counselor” tells the client which feelings/thoughts need to be changed and/or what they need to tell themselves to change them.
I certainly used CBT techniques when I used to be a counselor, but only at times when the client appeared to be able to process the past experiences attached first, or was dealing with fairly recent material. I would never try to ‘change the thinking’ of a person to the thoughts I believed they should have, nor would I ever blame their suffering on their own need to process harmful things that happened to them before being able to ‘let go’ of thoughts and feelings they may at one time have felt essential for their survival.
Nobody should do CBT as a primary therapy approach in my book. It’s a set of techniques that have their place when carefully applied, but therapy had better be a whole lot more than that if you want your client to get anywhere close to where they want to go.
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POSTING AS MODERATOR:
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Steve
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And to use science for what science is good for, but not forget that it has its limitations. Science can’t absolve us of the ethical/philosophical activities such as deciding what is good and bad in society, determining the scope of freedom when one’s activities impact another, deciding what purpose society has, whether and to what degree to enforce compliance vs. encourage creativity and free expression, and so on. Science (if used properly) is great at helping eliminate bias when determining truth. But it doesn’t help much with ethical issues where there is no absolute “True” or “False” involved. The entire area of “mental illness” is fraught with these ethical conflicts, such that no real “science” is currently possible in the field, since there isn’t even vague agreement on what a “mind” is, let alone whether a mind can have “health” and what a “healthy mind” would encompass. Not to mention the question of whether having an “unhealthy mind” would ever qualify one for involuntary imprisonment in the name of “health!”
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True enough! When you are engaged in a very unscientific enterprise, it is almost impossible to define an outcome. But I’d still maintain that under such subjective circumstances, the only one who can even formulate an “outcome” is the client. Of course, any clinician who tries to manipulate his/her client into deciding they had a “good outcome” just to make the therapist feel better deserves to spend eternity in purgatory.
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Which sadly becomes an excuse to blame the client. And the DSM makes client blaming easy.
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Well said. When you start your “research” with a group that is inherently so diverse as to have little to no significant characteristics in common, your research is of course going to turn up nothing.
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I never understood why disclosing one’s conflicts of interests somehow negated the attendant biases. Imagine a criminal case where the prosecuting attorney admits that they have been looking for a way to convict this person due to a personal grudge from 15 years ago. If they disclosed this conflict, would they still be OK to prosecute the case????
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It means they’d have to deal empathetically with the patient’s actual needs, and be willing to admit it when they didn’t know what they were doing, which is most of the time. That would be intolerable, because they’d lose their superior status and have to be a vulnerable human being, just like the client is. Ironically, my experience tells me that the key to actually BEING helpful to a client is the willingness to be a vulnerable, genuine, humble, fallible human being who is willing to meet them where they are at and not think you know more than them about their own problems.
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Wow, you ought to submit this as a blog. What a fascinating education! Thank you for that comment!
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Why would they have to SAY that patient-reported measures should be “included?” Why wouldn’t they be the MOST IMPORTANT measure in every case?
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The difference between a good therapist and a bad therapist is that the good therapist is concerned with the perspective of the client, and a bad therapist is concerned with their own perspective. The bad therapist wants to look/feel good about their work. The good therapist wants the client to regain control of their own perspective. The only valid measure of success in a therapist is the empowered client’s satisfaction with the process.
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The difference I see in your analogy is that no one is promoting cigarette smoking as a “treatment” for “ADHD” or any “educational disability.” Drugs can be useful for many things. I’d be dead today without modern medicine. But it sounds like we’d both agree that just because a drugs is perceived as helpful in a particular situation for a particular person, it doesn’t mean that person was “ill” or that the drug “cured” or “treated” a condition.
A shot of Southern Comfort definitely reduces my anxiety, but it’s hardly a medical treatment!
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Unfortunately, most people are unaware of their philosophical assumptions, and have a hard time distinguishing these assumptions from fact. I agree, our educational system really needs to make the study of philosophy and its application to practical decisions a priority again. Back in ancient Greece, ALL learning was recognized to be a subset of philosophy. That’s why the highest degree is a Ph.D. – Doctor of Philosophy.
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I think a lot of folks have been convinced that it is “unscientific” or “mystical” or superstitious” to entertain any possibility of a spiritual existence beyond our bodies. It’s odd, because most people in the world appear to believe in such a spiritual existence continuing beyond our physical existence in our bodies, yet somehow this doesn’t seem to conflict with claims that ‘science’ does not include the possibility of spiritual existence. I’m personally of the opinion that scientifically, there is no way to rule in OR rule out such spirituality to a certainty. But that means science ought to remain open to the possibility. There are certainly bits of circumstantial evidence, such as the placebo effect and neurofeedback, that suggest there is something about our existence as beings of whatever nature that allows our mental processes to control what happens to the body. How that effect occurs, no one really knows. So discounting the potential that we are spiritual beings that transcend our earthly existence on “scientific” grounds seems ungrounded in factual evidence.
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Yeah, let’s not waste our money on the things that have a 50 times greater correlation! Let’s spend more money researching stuff that is barely better than chance at distinguishing “depressives” from “normals.”
You know what my approach was for distinguishing depressed individuals from non-depressed individuals? I asked them if they felt depressed! It was a remarkably accurate “marker.” People who say they are depressed are statistically FAR more likely to be depressed than those who say they feel fine!
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It should be clear that any brain-affecting drug could cause brain shrinkage, based on your research. I’ve never found the “neurogenesis” explanation/claim for SSRIs to be particularly convincing. But you are very correct, depression is almost always a symptom of something else. In fact, I think it’s fair to say that “depression” is not the “cause” of anything. It’s an experience people have, which could mean a hundred different things. Calling it a ‘disorder’ is always euphemistic.
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“Voluntary” electric shock “therapy” (no, I won’t use the euphemism) is also an abomination, since there is absolutely no way to give “informed consent.” Anyone who really understood what this “therapy” involves would run the other way full speed! Though it seems more than a tad counterintuitive that inducing a grand mal seizure through electrocuting the “patient” would in any scenario be advisable.
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We must also remember that psychoanalysis was not accepted until after Freud disavowed his trauma theory and blamed the patients’ woes on his own “complexes” instead of focusing on the causal traumatic factors. I’d say that psychoanalysis was thoroughly defanged before it was allowed to become popular, and hence was reduced to a tiny fraction of its potential effectiveness. The removal of the right of the clinician to “interpret” seems like a critical move. But I wonder how many clinicians are fully capable of resisting the urge to foist their evaluations onto the client.
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Remember always that such studies are not always controlling for psychiatric drug use. We know at least in “schizophrenia” that brain shrinkage is causesd by the drugs themselves, and there is suggestive evidence that this happens with stimulants for “ADHD” as well. Any generalized measurements like brain volume are not valid if substance use, legal and illegal, is not accounted for.
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I’ll put it on the agenda for my next tour of England!
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I particularly find the possessive form, “My mental health” or “My depression” or “My diagnosis” a disturbing trend. As I said once, depression isn’t something you HAVE, it’s something you DO. And framing it that way means you can do something to change it. Whereas if it’s something I simply HAVE, then I no longer have agency, I’m stuck with it, as if my own decisions and beliefs and actions have no chance of altering my fate of having “mental health problems.” I don’t mean to blame anyone for feeling bad, but the idea that someone else is making all that happen and that someone else can “fix” it sells lots of drugs and keeps people dependent for life instead of teaching skills to regain control of our lives.
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We do seem to, don’t we?
If you ever come to the West Coast of the USA, I think we’d have a hell of a great lunchtime discussion! I hope we get to meet one day – there are few people who evoke that wish for me, but you’re definitely one of the top!
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I agree 100%!
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Doing nothing at all is usually a far more effective intervention than psychiatry is able to come up with on its best day.
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You know, it kind of sounds like everyone is more or less on the same page – don’t start suddenly, have a plan, adjust to individual needs, listen to your body, the person withdrawing is the best guide. Seems like good advice.
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It has always seemed to me that everyone’s body is different, and so a different approach needs to be considered for each person. Psychiatry’s biggest failing is assuming that everyone who feels “depressed” (or whatever other manifestation they identify as “illness”) has the same problem and needs the same kind of help. We should not fall into this trap! I think the advice about starting slowly and observing how much a person can tolerate is very, very important, but assuming that 10% or 5% will work for everyone means that some people who could get off a lot faster are restricted, and others who may find this rate too fast will feel hopeless. I think flexibility and respect for each person’s own sense of what works for them should be the center of any effort to wean off of dangerous drugs.
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My feelings exactly!
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Yeah, good question, isn’t it? I see this often – the experiment itself proves that there is no point giving antidepressants to teens, say, and yet the conclusion is that we should still do it. Clearly protecting guild interests over patients!
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Everything you’ve said is speculative. There is nothing you provide that shows any actual EVIDENCE that a particular chemical problem in the brain is associated with depression. In fact, this idea was disproven way back in the mid 1980s, before Prozac even came to market.
I’m not interested in opinions of people. I’m interested in EVIDENCE. And so far, you have presented anecdotes and opinions. No one is saying that some folks don’t feel better when taking antidepressants. I am contesting the idea that the primary CAUSE of depression has ever been established as being biological.
“The chemical imbalance theory as a cause for anxiety and depressive disorders never was true. In fact, no experiment has ever shown that anyone has an ‘imbalance’ of any neurotransmitters or any other brain chemicals. The entire theory was hypothetical.
Over the last ten years, independent research has continually shown the chemical imbalance theory to be false. Furthermore, independent research has shown medications used to ‘correct’ the imbalance were largely ineffective with many fairing no better than placebo.”
Please read the following for an overview of scientific challenges to the “chemical imbalance” concept.
https://www.anxietycentre.com/articles/chemical-imbalance/
https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again
You might also benefit a lot from reading Anatomy of an Epidemic. It might help you understand the scientific reasons why Bob and others question the standard psychiatric narrative. It does not come from a place of hostility, it comes from a place of wanting to get it RIGHT for people who need the kind of help that drives them to psychiatrists.
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Can you please provide citations demonstrating convincingly that, say, “Brain chemistry” or “biological differences” are “causes” of depression? I am very familiar with the research in this area, and am aware of no consistent biological difference that characterizes depression or accounts for more than a tiny fraction of cases of “depression,” even in the most optimistic interpretation. In fact, luminaries such as Dr. Ronald Pies and Thomas Insel have assured us that psychiatry never took the “chemical imbalance” theory seriously, and that it was, in fact, drug companies that made such tropes commonplace beliefs.
On the other hand, I can provide oodles of evidence that the correlation between childhood adverse events and cases of “depression” is extremely high, much, much higher than the most optimistic “biomarker” research has ever been able to accomplish.
You are welcome to your own opinion, but not your own facts. I’d like to see what scientific data you are basing your stated opinion about “causes of depression” on.
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I feel I need to add that stating the COVID epidemic contributing to isolation, feelings of hopelessness and self-harm seems to completely undermine the idea that these “mental disorders” are caused biologically. Seems the professionals are talking out of both sides of their mouths here.
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I have suggested “Math teaching disability” and the like before, too! If you’re being paid to teach me math, and you can’t do it, why is this my fault?
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Maybe they should call it “Co-corruption!”
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All too disturbingly true!
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That is an excellent point! The opioid/benzo crisis shows that doctors can not be trusted with distribution of dangerously addictive drugs.
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Thanks for sharing this! As a “therapist” who received almost no therapy training, I found exactly the same things you did. CBT is not a form of therapy, it’s a set of techniques, which have applicability to certain clients under certain conditions. It’s not something you can do with everyone, and the response easily determines the appropriateness if you’re using it poorly.
Most importantly, all therapy depends on an empathetic relationship with the client, and as you put it so well, an ability to respond dynamically to events in the therapy relationship and alter one’s course as more information comes to the therapist’s attention.
Milton Erickson said that therapy has to be reinvented for each client. I agree with him 100%. No workbook or theory or set of “skills” or homework can substitute for the hard work of legitimately gaining the trust of the client and helping him/her climb into the chaos and start sorting things out. The idea that one response will suit everyone with a particular ‘diagnosis’ is not just wrong, it’s utterly destructive.
And well done escaping that “funny farm!” Probably the greatest gift that you received from them – realizing that you are smarter than they are and can figure out what you need as far away from them as you can get!
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I wrote a book about how to avoid abusive partners early on in the dating process (“Jerk Radar”). The last chapter, and in many ways the most important chapter, is called “Trust your gut.” It goes into how abusive people give off a ‘vibe’ or engage in certain behavior that raises one’s hackles, as it were, or sets of alarms intuitively. Little kids tend to go by these “gut level” assessments consistently, but I talk about how we are trained as kids by adults to not believe ourselves, and eventually stop believing our very accurate perceptions of reality. “Uncle Eddie is just being friendly, dear, they kiss on the mouth in his family” or “Don’t say such things about your grandfather, show respect for your elders!” or “Oh, Johnnie, your teacher doesn’t HATE you, they’re just trying to teach you some DISCIPLINE!” The ‘gut level’ instinct is trained out of most of us rather systematically, and this makes us extremely vulnerable to predatory people. Almost all of us need to find ways to re-learn how to listen to and respect our intuitive warning flags.
Of course, those subjected to abuse by caretakers have this sense utterly trampled in most cases. Up is down, in is out, love is hurting, you love me means I have to take care of you, and on and on. Your perception of reality is brutally attacked at every turn in the road. Is it surprising that a person subjected to such atrocities would have some difficulty knowing whom to trust? Why would you tell them to explain away their considerations by a call to “be reasonable” or “understand the others’ point of view?”
Clearly, the most helpful thing for such a person is to a) acknowledge that their sense of trust has been systematically violated and that difficulties with trust would be totally normal under the circumstances, and b) help the person to re-learn how to trust and act on their own gut-level instinct that has so thoroughly been invalidated, so that they learn that while not everyone is untrustworthy, it makes good sense to keep one’s boundaries up and to listen to and respect our intuition.
The idea of teaching such a person to automatically “give the benefit of the doubt” is quite outrageous. It’s the very last thing in the entire world you’d want to teach them!
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Right! It would be very much like curing “pain” or curing “baldness” or “high blood pressure.” Except that at least baldness and high blood pressure can be objectively measured, but still, something that can be caused by dozens or more different causes and is in some cases normal can’t be “cured” without some kind of rational analysis as to cause!
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Calvin, it sounds like you were looking for a way to establish more control over your life, and psychiatry gave you the opposite. I found it sad hearing you decided that staying silent was your only remaining way to accomplish that. I’d say your story is far more compelling than you may think it is. I found myself thinking, “Man, if they told me what they told him, and gave me as little hope, I’d have wanted to kill myself, too.”
You were VERY badly served by psychiatry. They did less than nothing – they undermined your belief that anything COULD be done, and I find that unforgivable!
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I don’t know why this is published as if it were some kind of new news. The first review of stimuants for academic performance was done way back in 1978 by none other than Russell Barkley, the eventual advocate for putting massive numbers of kids on Ritalin. His review showed kids taking stimulants barely outperformed their non-medicated peers, and commented that the difference was so small it was “easily explained by reading the questions more carefully.” Repeated reviews by Swanson (1993) and by the OSU Medication Effectiveness Study in about 2002 or so found no significant improvement for long-term stimulant use in any academic measure. Naturalistic studies like the MTA, the Raine study in Australia, the Quebec study, the long-term MTA results, and a comparison study between Finnish and US children showed again and again that stimulants provide no improvement in any academic measure, and in fact, no improvement in ANY long-term outcome that adults would wish to see improved by “treatment.” This is just one more nail in that coffin, but the sad reality is that psychiatry has not noticed so far that the patient has been dead for decades.
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You mean to say that industry-sponsored studies are BIASED? Please, Richard, say it ain’t so! I am SO disillusioned!
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You are right! How can you “overdiagnose” something when there is no objective way to determine who “has it,” and so no way to determine what the “right” level of “diagnosis” is? Perhaps we should talk instead about sexual minorities being more likely to be subjected to the most shaming and destructive label in the DSM arsenal.
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Even if there WERE a way to make Ketamine-assisted therapy effective (which I still have very serious doubts about), it is a certainty to me that in the hands of the commercial/economic incentives of today’s system, any chance of general effectiveness will be very quickly overwhelmed by the authoritarian, disrespectful, and degrading conditions that pertain in almost all “mental health” agencies. It seems like another boondoggle for the drug companies and their minions.
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An excellent point!
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How did you pass it on? It always feels bad if we can’t stop others from getting similarly hurt.
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What you observed for decades is absolutely correct. None of this was truly intended to help, except for those low-level people who think that forcing people to do things they don’t want to “for their own good” is some form of “help.” I can see how reading this stuff can bring back the pain, but don’t ever believe anyone who says that your observations were “wrong.” Honestly, I think the first step to healing from crap happening to us is learning to trust that we were RIGHT when we knew we were being fed a line of crap!
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Posting as moderator:
To be clear, we welcome those who feel psychiatric diagnoses are “helpful” to them – all are always welcome to post at MIA as long as they follow the Guidelines. We welcome all viewpoints. However, it is important that such posters respect the fact that they will encounter alternative viewpoints here, and to own their own viewpoint as theirs and not try to force is on others or to invalidate others’ attempts to communicate their own views. We are all free to disagree, but with respect. I am getting the feeling that some folks are feeling their views are not being respected. Which is ALSO a free topic of conversation, as long as we make sure it’s not getting to personal attacks on people for disagreeing.
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So it is less the existence of these labels than the way they are USED. The DSM was originally used only as an insurance billing document, and no one took the categories as anything but vague categories used for general communication. They evolved into these pseudo-scientific labels which doctors and others can use to avoid looking at causes and to justify the use of drugs. I have never objected to an INDIVIDUAL choosing to identify with a particular diagnostic DECRIPTION. When it become untenable is when scientists pretend that “depression” is a unitary category with a unitary cause which should be “treated” by a unitary “treatment plan.” Such a viewpoint simply invites and justifies ignoring the complex causes and influences on something so universally present and natural as anxiety or depression, and the blaming of the patient as well as using drugs as a first-line intervention. None of this can happen if the DSM doesn’t serve as a means for doctors to justify condescending to their patients and subtly or not so subtly blaming them for feeling “too depressed” or “too anxious” instead of looking at what has happened in their lives (including known physical problems) that might explain one or another particular instance of “depression.”
So I have no hostility or disrespect for someone who calls himself/herself “ill” or “depressed” or “schizophrenic” or “autistic” if those labels work for someone. I do have a big problem with a doctor or other authority figure telling someone ELSE that they “have depression” or “have schizophrenia” as a means of labeling and downgrading the client’s experience without any actual scientific basis for their claims. It is very different to say that no one has the behavior labeled “ADHD” (which is NOT true) and to say that “ADHD” is not a valid scientific entity for a doctor or anyone else to assign to a person who presents to them, particularly over the client’s objection.
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That is my experience as well. Blame the client, then drug them. If that doesn’t work, label them “treatment resistant” and refer for ECT.
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Hard to imagine calling someone “paranoid” when the staff really ARE spying on them!
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“You are too complex” seems to me to translate into “I don’t have the skills to figure out how to help you.” Same facts, very different framing. If you take your car to the mechanic, and he says, “You’re engine is too complex,” you’re going to know he means, “I don’t know what the fuck is going on.” There is no difference, except that MH “Professionals” are allowed to get away with it.
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It is a very disturbing practice, surely violating the rights of the patients. They are not under arrest, after all! But it seems that almost anything can be rationalized in the name of “mental health treatment” no matter how brutal or disturbing.
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I think the goal is seldom to make people feel better. I think it is to STOP people from feeling certain things, which eventually devolves into stopping people from feeling anything at all. This is the only way that anyone could look at a semi-comatose person slumped in a chair and consider it a “treatment success.”
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Hey, not criticizing, just piling on!
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Wow, great post! I’d only add that involuntarily committed people should not ever be charged for their “care.” This would remove a big financial incentive for locking people up. Prisoners don’t pay for their imprisonment, neither should psychiatric inmates.
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Yeah, why don’t they tell you they’re “still learning” when they’re pretending they know you have a “lifetime biological brain disease” and that you have to take the drugs for the rest of your life and there is nothing you can do about it? Might be helpful to know that they might have no idea what they’re talking about!
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Trade protectionism there. Not surprising.
But yeah, the Native American Church is just the kind of approach I’m talking about. What was it they did in Saskatchewan?
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Thanks, Ed. I have read parts of the article, though it is quite long. I get the idea we’d probably agree on a lot of things. I do think it feasible that psychedelics can be used in a helpful way, but there is little to no chance that the psychiatric profession, or even the profession of psychology, will be able to use it in a helpful manner. Psychiatry in particular specifically denies the validity of the spiritual world, while those who HAVE used psychedelics historically in a helpful fashion are shamans or other spiritual leaders who are helping expand one’s viewpoint of the world, not trying to “cure mental illnesses” that don’t even exist. Without a big change in viewpoint and philosophy, I believe psychedelics will be as dangerous in the hands of psychiatry as any of their “medications.”
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True dat!
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Wow, that’s an awesome article! This guy sounds a lot like Bob Whitaker. My only objection is the use of the term “overprescription.” How can you “overprescribe” when there is no ability to determine what the “proper” amount of “prescribing” would be? But besides that, he hits on the key issues of ineffectiveness, permanent damage, long-term deterioration, and removal of personal agency. I’d love to see this guy write an article for MIA!
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Without even reading the article, I found I objected to the title. Why are we calling this “psychedelic medicine?” It is NOT medicine! It is at best “psychedelic therapy,” not a medical intervention at all, but a mental/spiritual one. I find it continuously offensive when things that are potentially helpful to our spiritual needs are coopted by the medical establishment, such that going for a hike becomes “nature therapy,” and doing fun things becomes “occupational therapy” and on and on. “Psychedelic therapy” is distorted enough – PLEASE let’s get away from calling it “medicine!”
Similarly, taking the flashback phenomenon and giving it a “medical” name does nothing to advance our understanding of what is going on. Flashbacks are pretty mysterious, there appears to be no understanding if there is any physical reason for flashbacks, let alone what it might be. People who have flashbacks aren’t “HPPD patients,” they are people who have experienced flashbacks. Why do we feel this need to dehumanize folks by grouping them together, as if experiencing flashbacks is again a failure of the “patient” to respond “properly” to “treatment?” Just as we excuse the failure of antidepressant “treatment” by calling the victim “treatment resistant” instead of just admitting that the drugs have failed to help or have harmed the recipient?
I know that “medical language” tends to get things published, but it’s an insidious slippery slope away from treating people as human beings. I’m not categorically opposed to the idea of using psychedelics to help people find some level of mental/emotional perspective, but the idea that it can become some kind of standardized “medical treatment” is a very damaging absurdity that could very well ruin any chance that the use of psychedelics can develop into something that might actually be helpful to people’s spiritual growth.
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No problem. You have been deeply traumatized by people you should have been able to trust, and it sounds like the destruction was massive in your case! I admire you for pressing on despite it all. That takes a lot of courage!
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You got it. He was blowing smoke out his ass. I’m sorry you didn’t get the right information before you encountered him. But thanks for taking up the sword for making it better!
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Are you trying to say that it is somehow arbitrary to say that amphetamine is safe when you get it from Big Pharma but not safe when you get it somewhere else? That’s CRAZY talk!
Don’t forget, Methamphetamine (under the name Desoxyn) is also sold as a “medication” for “ADHD.” So it’s also healthy only when Big Pharma is profiting from it.
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That’s a great description! A map of nowhere, with all kinds of directions to get from no-place to nowhere else.
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Western psychology can also rip Westernized families apart. For whom does the DSM model really work?
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More stunning research! This is somewhere on the level of “serious injury to the knees is associated with increased knee pain later in life!” Seriously, is anyone surprised that having major frightening experiences earlier in life might make it more likely that one is more easily frightened? “People who have been major car wrecks are shown to be more worried about getting in car wrecks.” And they get PAID to do this research???
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Let’s assume our desired conclusion and then collect data in a biased manner to try and prove it. VEEEERY scientific!
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Sociopaths working together. Ugh! Do they just like to do the opposite of what you ask for, just to prove they can?
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It does take courage, but there are many who do take that stand. They need more support for doing so!
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If such studies existed, you’d think he’d have the decency to refer to at least one of them in his retort. But of course, he does not, because such studies do not exist, or if they do are not able to be replicated. He’s using the “resort to authority” approach to prevent further investigation into what is actually going on.
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There has never been any good evidence, or even mediocre evidence, for the use of antidepressants in kids. There was one study that showed Prozac to have some positive effect on kids over 12, but that study had significant flaws and was never replicated. It seems to be pretty clear that prescribing antidepressants to kids is malpractice, plain and simple. But apparently, if enough doctors do something, no matter how stupid, it becomes “standard practice” and can’t be called malpractice for legal purposes.
The only issue I’d take with your comment is that some adults DO believe that restraining kids chemically IS “helping” them. Clearly this applies to people who don’t really like children very much. But such people do exist in significant numbers.
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This is just a comment on the comment I just read, not a critique of anyone’s arguments.
I think it is relevant to note that “placebo effects” have taken on (largely due to pharmaceutical company pressures and narratives) a negative connotation, the implication being that “placebo effect” are not real or are imaginary. Placebos of many kinds, including group rituals, can have very powerful, very real effects. The only relevance of calling it a “placebo effect” is that the effect is not caused by the drug or whatever specific intervention is being looked at. I think this can create a negative emotional reaction when people hear “X appears to be a placebo effect” about something they’ve seen be effective.
I think the placebo effect is FASCINATING and says a lot about what’s wrong with psychiatry’s narrative. If believing something can actually change outcomes, even if the “something” has no direct effect on the brain or body, it suggests that what we believe or imagine or strive for is FAR more important than the “brain=mind” theory can possibly begin to explain.
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Sounds so VERY therapeutic! Really, how can these people take themselves seriously? An 8 year old child would at least know to say, “Why are you sad?”
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Wow. Well said! I have nothing to add!
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It is interesting that clinicians are feeling the same kind of life stress and burnout that many if not most of us in late stage corporate capitalist societies are experiencing. It is a shame that the real causes are right in front of us, but that the mental health industry as a whole continues to pretend it doesn’t exist.
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I think it helps people to avoid dealing with real but semi-conscious conflicts that are really at the root of feeling hopeless about life in many cases. Certainly was true for me! It’s a lot of work to re-think one’s view of life and one’s habitual behavior. It’s easier to blame it on the brain and take the pill. At least in the short run. Especially if someone in authority is doing the hard sell on it. I did not WANT to get therapy – I NEEDED to, but it took two other people dragging me kicking and screaming to get it started. Very glad I did.
Of course, a lot of “therapists” these days don’t do what I consider therapy. Many seem to use a forced and very shallow form of “cognitive behavioral therapy” and aren’t interested in childhood trauma or internal conflicts. I was very fortunate in getting a good one on the first shot, but it still wasn’t any fun, and I felt like quitting partway through. A pill would have been a LOT easier, but of course would never have been a tenth as beneficial in the long run.
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Including “no treatment” when the “condition” is a result of normal reactions to external problems, such as child abuse, poor parenting skills, or dull and rigid classroom environments that lack the necessary stimulation for a bright and curious child.
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How can you have “overdiagnosis” or “false positives” when there is no objective means to determine who HAS and DOES NOT HAVE a particular diagnosis? Isn’t the main reason for “overdiagnosis” the fact that there is no line between the “ill” and the “normal?”
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I would say that physicians almost NEVER direct someone to discontinue ANY psychiatric drug. Additionally, “return of symptoms” is often a euphemism for “withdrawal symptoms” occurring upon withdrawal. Support is, indeed, needed, but medical providers almost never provide the kind of support that is helpful. If we all waited for a physician to “direct” their patent to withdraw, almost no one would ever get off psych drugs, no matter how bad the effects of the drug in question.
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I never knew he was so frank about his chicanery.
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Wow, some really radical thinking there! You mean that people get depressed because their lives kind of suck? NAH, COULDN’T BE! If their brain chemicals were adjusted properly, they’d be HAPPY that they were poor, homeless, raped, sexually abused, abandoned or whatever. EVERYONE knows that!
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Just to be clear, I’m not calling the article disempowering, I’m saying the concept of “shared decision making” presumes that decision making is normally NOT shared with the client, but made by the doctor without any input from the client whatsoever. And doctors are arguing as to whether they SHOULD consider “sharing” what is really the client’s decision with the client. I don’t see it as a salvageable concept, as it is tainted with the idea that sharing decision making with the client whose life is being impacted is somehow optional!
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As I’ve said before, the very framing of this as “shared decision-making” is disempowering by definition. They are talking about DOCTORS deigning to “share” THEIR decision making with the client! And the doctors are ARGUING about this! The decisions should always be the CLIENT’S decisions, unless the CLIENT wants to share it with the doctor or someone else! The fact that they even need to TALK about including the client in the decisions, and that NO ONE sees this as hypocritical, shows just how far into authoritarianism the medical establishment has sunk.
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Great paper! Reminded me of some stuff I used to know about those Prozac trials. Amazing that these “peer reviewed” studies ever saw the light of day!
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It shows intent to bias and deceive from the get-go. This is not science, it’s marketing!
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That’s always been my biggest challenge with this whole “chemical cure” mythology. If I take a pain reliever and I still have as much more more pain than before, do I have “treatment resistant pain?” Or did the drugs fail to have the advertised effect? If I take an antidepressant and am still depressed, THE ANTIDEPRESSANT DIDN’T WORK! It’s not because I’m “resistant” or “need an adjunct medicine” or whatever. It means the treatment FAILED!!! Why is this not obvious? Why do intelligent people fail to observe this rather obvious conclusion?
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Here is an article covering the issue of so-called “discontinuation syndrome” (aka withdrawal). I found this in a 10-second search. Many other articles on the topic are readily available in the mainstream psychiatric publishing world.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449237/
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Do you actually want to know the answer to that question?
I would guess that most doctors have not ever read the 35 pages of warnings and could not tell you half of it. My father was almost killed by a doctor prescribing something when he was on blood thinners after a heart attack. He told the guy exactly what he was taking, and the drug warnings included a BOLDFACE warning NOT to prescribe this second drug with blood thinners because DEATH MAY RESULT! Yet the doctor prescribed it anyway, and my father luckily noticed he was getting bruises by simply resting his elbow on the table or pressing his arm with his finger. HE looked the drugs up in the PDR (the “internet drug site” equivalent of the 1960s) and discovered that the doctor had acted incredibly irresponsibly and could very well have killed him. A minor car accident, a fall in the garden, the most minor injury could have resulted in death. I have heard stories and had direct experiences myself over time to reinforce the idea that doctors don’t, and given the volume of new drugs, really CAN’T, know and convey the actual dangers of these drugs. I will NEVER take a drug that I have not personally checked out on more than one source.
So no, it is not hard AT ALL to imagine doctors either not knowing these things, or not caring to communicate them, or intentionally NOT communicating the possible dangers because they are worried that the patient would decide not to take the drug if they knew the actual risks. I would assume it far more likely than not that the doctors would NOT communicate such things to me, based on personal experience.
I’ll leave it to others to explain what ACTUALLY happened to them on antidepressants, though of course, you can easily find that out for yourself by searching this site. Sometimes other people have different experiences than you do. Maybe you could generate some interest in listening to them instead of dismissing their experiences as “hard for you to understand.”
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How do they, Enrico? You don’t know any more than I do. Nor do you even know that cells DO create thoughts. That’s what you believe. There is no proof or evidence of what thoughts even ARE, let alone what creates them. You believe the brain creates them, because you are a MATERIALIST philosophically. Not everyone in the world is a materialist, and materialism isn’t inherently more “scientific” than any other philosophical viewpoint. There are other philosophical viewpoints that are just as valid as yours.
You are sharing your beliefs, not scientific verities. Which is fine, as long as you allow that every other person here is just as entitled to share their views and beliefs as well, and you don’t somehow entitle yourself to be the arbiter of truth when you’re sharing your personal views. I don’t see you granting others that right very often. I more commonly see you presuming to know more than those who are here, and talking down to others who don’t agree with you. It is not a very respectful way to conduct a conversation, in my personal view. I guess that’s philosophical, too – one philosophy is that conversations to be “won” by trying to overwhelm or dominate the other person until they submit. I don’t take that philosophy. I like conversations to be a sharing of information from different viewpoints so I can learn things and expand my viewpoint to include more data and observations and experiences beyond my own narrow path in life. You have a great opportunity here to open your mind and learn from others who have had different experiences than you have, to actually WANT to know why some people find the very things you consider to be miraculous advances in science to be sketchy, unscientific, and even dangerous and destructive. Do you want to know? Or are you primarily engaged in trying to convince the “misled” or “misunderstood” on this site to the “real truth,” which of course means the “truth” you’ve already decided is “right?”
The point re: Insel’s comments is a case in point. You “don’t understand” the relevance. Do you WANT to understand it? What if you actually asked the poster to HELP you understand it, and tried to put yourself in his shoes and see it from his viewpoint? I’d say the reason is quite obvious: Insel RAN the NIMH for years. He spent lots of time doing the kind of research you seem to value (at least when it fits with your narrative), and at the end of his tenure, states that the DSM approach has led to literally NOTHING of lasting value. That one of the key thought leaders in the psychiatric community would publicly announce this should be of GREAT interest to anyone with a real scientific bent. The fact that he was called on to walk back his comments by that very psychiatric community he is a part of should tell you a LOT more. My read is that the psychiatric community knows that the DSM is not worth the paper it’s written on, but they can’t admit it to themselves, or they don’t want the word to get out. Does it seem POSSIBLE to you that this explanation makes some sense? What is YOUR thought on the significance of the lead psychiatric researcher in the #1 center of psychiatric research in the USA says that the DSM actually makes it harder to make sense of “mental illness?”
I have noticed again and again that you do not respond to solid, well-argued, positions that don’t correspond to your views. Will this again be the case with this one? Will you pretend that I didn’t write this because it’s too uncomfortable to face the truth contained herein?
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Are you now denying what the entire psychiatric research world now admits? That “discontinuation syndrome” (aka WITHDRAWAL) and Tardive Dyskinesia and Neurological Up- and Down-regulation are very real? One study is enough when the study agrees with you, but massive data over decades is not enough to convince you when it disagrees with you?
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Yeah, sorry, I’m spoken for! But thanks for the chuckle!
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I am saying it is a contributing factor, and that at least SOME of the high rates of smoking among those diagnosed “schizophrenic” are due to the “treatment.” I’m also pointing out the irony of the psychiatric industry using “treatments” that are known to reduce lifespan, and yet trying to blame it on habits that their own drugs actually encourage/reinforce.
But you’re right, poverty, discrimination, and trauma are related to “poor lifestyle choices” AND to being swept up by the psychiatric industry as a “patient.” It is a very complex system. But a part of that system is a “treatment program” that doesn’t actually work in the long run in many if not most cases, and which can create or exacerbate the exact “symptoms” they claim to “treat.” And meanwhile reducing people’s quality of life and life expectancy, while trying to deny this is true.
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I certainly believe you, Gina. And I think the vast majority of MIA posters believe you, too. Many of them have experienced similar things. Psychiatry sucks!
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Writing just as me, here, not as a moderator.
Why do you continue to post here if you find the basic premise of the site to be so wrong? Do you really think you’re going to convince your audience? Why not go somewhere else where people who agree with you share their views? I don’t see much interest on your part in hearing anything anyone else says, or learning anything you don’t already believe you know. So why are you posting here? What is your purpose? I’m not being snide, I really want to know what you’re trying to accomplish?
I would bet my bottom dollar you’ve never even read Anatomy of an Epidemic or Mad in America. Am I right?
I don’t believe from my observations here that you really want to engage in a conversation about any of these topics. I assume from your behavior that you mostly want to tell us all that none of us know what we’re talking about and you know better than us. Am I correct?
I predict that you will not respond to this question.
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I understand that since cigarettes increase dopamine, and the antipsychotics massively decrease dopamine, many antipsychotic users (forced or voluntary) smoke in order to reduce the side effects of the antipsychotics. Many probably don’t even know that’s why they do it, they just feel better when they smoke. So ironically, the psychiatric industry wants to blame shortened lifespans in the “severely mentally ill” on “lifestyle issues” like smoking, while the drugs used to “treat” these “disorders” in fact dramatically INCREASE the rate of smoking among the “treated!”
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Man, that IS depressing!
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Scientifically speaking, there is no need to “prove that ADHD isn’t real.” And the existence of people who fit the description is not proof of anything. It is the responsibility of those claiming it is a disease state to prove that it IS a disease state. Anyone can describe a condition and claim it is a “disorder.” As I’ve said before, genetic diversity is the key to species survival. I’ll remind everyone of the study where groups of three kids having one “ADHD” – diagnosed child were WAY BETTER at solving problems than groups of three who did NOT have an “ADHD” child in their group.
The point is not to prove that people can be identified as “fitting the criteria” that were chosen to describe “ADHD.” The point is to prove that such people a) have significant things in common besides acting a certain way, b) that there is some means of objectively distinguishing those so identified from the general population, and c) that the variation is a malfunction rather than simply a variation in genetic inheritance.
For instance, running slowly has a very large genetic component. Failure to be able to run quickly leads to significant psychosocial distress, as any such person who has had to go to PE classes can testify. Giving stimulants to such people would improve their running speed to some degree in most cases. Is slow running a disease state? Who would need to provide proof of this? Would I have to prove that it WASN’T a disease? Or would someone claiming it was be responsible for the proof?
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Thanks for sharing this – it includes some good information that is new to me.
I would pose this question to you: if, as you show above, fluoridation of the water supply can significantly effect the rates of “ADHD” in the population, how does that jibe with your earlier researcher’s claim that it is entirely caused by a mutation in a certain gene? Does this not suggest that the environment can and does have a huge impact in the expression of one’s genetic inheritance? Does it not suggest that people who do NOT present as “ADHD” to begin with can BECOME “ADHD” cases due to environmental influences?
Taking this further, could there not be “psychologically toxic” environments that might “cause” a person to “become ADHD” when they otherwise would not have presented that way? Does it not similarly follow that there might be “psychologically healthy” environments that, if applied systematically, would REDUCE the likelihood that someone would present with “ADHD” syndromes or would reduce the severity of these “symptoms?”
Doesn’t it make more sense to suggest that a person may inherit a “vulnerability” or a “tendency” to engage in this kind of behavior, but that the expression of this tendency is strongly affected by the environment they are forced to contend with? That it is not a “nature vs. nurture” situation, but rather a combination of nature/nurture, as most behavioral syndromes (and even major physical health problems, like heart attacks and diabetes) appear to be?
If this is the case, which do we have more control over, nature or nurture? Genes or environment?
I would ask why do we spend so much of our time and money focusing on the one element in the equation, the genetics, that can’t be changed? If we really want to help these kids, why would we not focus our energies and attention on altering the environment to improve these kids’ lives?
Examples might include NOT fluoridating the water, creating open classrooms for kids who find them more workable, teaching parents how to handle these kids without accidentally reinforcing negative behavior, valuing and taking advantage of the kids’ strengths, and even holding kids out of school for an extra year to allow additional maturation?
(Did you know that there is a 30% reduction in “ADHD” diagnoses for kids who start in school one year later? THIRTY PERCENT! We could avoid a THIRD of “ADHD” diagnoses by keeping kids who aren’t ready out of school for a year! Why aren’t we doing this?)
I am not and have never been arguing that some kids don’t often “come that way.” My own kids are a good example – their personalities reflected an intensity, a need to be active and busy, an intolerance of boredom, that were certainly not a result of anything we did or did not do that we are aware of. My point here is that genetic diversity is the key to species survival, and being genetically “different” does not imply being genetically “disordered,” and genetics is in any case the one part of this equation that is completely unchangeable. Why don’t we acknowledge that both nature AND nurture are involved, and spend more time addressing environmental things (like water fluoridation and classroom structure and parent training) that CAN be changed to give these kids a better chance at survival?
I hope everyone will consider the full implications of these findings. Something that is completely genetic in origin (like, say, eye color) would not be so variable depending on environmental impacts. It’s got to be both. Let’s accept that differences most likely exist, but spend our energies on trying to control the environmental variables that we CAN control!
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Yet in the 3-, 5- and 8-year follow-ups on this very same study, kids who continued or started to use stimulants did no better (and in some ways worse) than kids who discontinued or never used stimulants. Which fits in exactly with the data I just shared in another post, and which is generally well known but kept very quiet among researchers: stimulants do work to “control the core symptoms of ADHD,” as they usually put it, but have been shown again and again not to lead to any improvement in long-term outcomes. In other words, stimulants can make it easier for you to pay attention to your schoolwork and complete your homework, but apparently, paying attention to your schoolwork and completing your homework doesn’t lead to you becoming more successful later in life.
In fairness, there are many who claim that stimulants destroy kids’ lives, and while that may be true in individual cases, in the collective, there is no evidence of stimulants doing great HARM to long-term outcomes in the collective. But they don’t really help, either, if you care about things like delinquency rates or high school graduation rates or social skills. And there are risks, outlined in my other post, that a rational parent might be well advised to consider when that risk is set against only short-term gains. It is a matter of informed consent, and it’s pretty dishonest at this point to claim that stimulants are going to magically change kids’ lives for the better in the long run. Some may choose to use stimulants for their short-term ability to “reduce the core symptoms of the disorder,” but if they’re aiming for longer-term improvements, it appears they have to look for additional interventions to help.
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Drugging a kid means giving a kid drugs for behavioral control.
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Sounds like a very idealistic picture. I guess we will see how much of it comes true.
I thought this article speaks to the idea of long-term use and loss of efficacy. Have you considered WHY tolerance develops over time? In the world of substance abuse, tolerance is related to significant brain changes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036556/
Have you ever heard of “neurological down- or up-regulation?”
“In 2013 they compared the brains of kids with ADHD before and after a year of treatment with stimulant medications. The studies showed an increase in the density of dopamine transporters—those molecules that take dopamine out of action—in the brain after treatment. This suggests that the increase of dopamine stimulated by the medication may have prompted the brain to develop more dopamine transmitters to clear it away. How long that change might last is not clear, as the level of transporters in the brain fluctuates. But it could result, researchers note in their conclusion, in the medication not working as well as it had to reduce symptoms over the long run.”
https://childmind.org/article/will-adhd-medication-change-my-childs-brain/
More on the long-term alteration of dopamine transmission with long-term use of stimulants over time:
https://www.healthline.com/health-news/mental-long-term-adhd-medications-increase-dopamine-transporters-051613
Anybody here want to share your personal experiences with stimulants?
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Oh, that is sad! I liked Seth!
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As I’ve already demonstrated, long-term studies show no difference between “treated” or “untreated” subjects on all major outcome measures, including academic test scores, high school graduation rates, delinquency rates, college enrollment rates, social skills, and even self esteem, which is the one even I would expect to be affected. I was actually quite stunned when I first discovered this fact way back in about 1989 or so, when I first started researching this topic for my own son’s needs. Stimulant treatment is simply not a major factor in long-term success in “ADHD” – diagnosed children. Other factors appear to completely overwhelm any benefits of temporarily paying more attention to or completing more school work. Stating that certain psychiatrists “believe the evidence proving it is a bio-chemical problem, is overwhelming” is absolutely irrelevant. The data speaks for itself, and saying otherwise over and over doesn’t change the science.
https://journals.sagepub.com/doi/abs/10.1177/000992287801700112 (This is Barkley and Cunningham’s study, where Barkley, one of the biggest ADHD advocates around whose income depends greatly on accepting ADHD as a valid construct, states that the VERY slight improvement in test scores for the “treated” groups was easily explainable by the subjects simply reading the questions a little more carefully than the control group. He called the long-term results “Disappointing.” But that has not stopped him claiming later on that anyone NOT putting their child on stimulants for “ADHD” is committing child abuse!)
“Jacobvitz et.al. acknowledged the short-term benefits outlined earlier but focused on the same limitations of stimulants noted by Schrag and Divoky
(1975), McGuiness (1989), and Kohn (1989). As a conclusion, Jacobvitz et al. urged “greater caution and a more restricted use of stimulant treatment” (p. 685). In contrast, Stevenson and Wolraich acknowledged the limitations outlined here but focused on the temporary suppression of symptoms.”
https://escholarship.org/content/qt4jr2777t/qt4jr2777t.pdf (Swanson et. al, 2003)
““Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors,
social achievements” and other measures.
What is absolutely fascinating is that they revised the report later to eliminate ANY MENTION of long-term outcomes, as if this conclusion were NOT drawn from the study. I think that says more than a bit about the desire of the psychiatric profession to cover up this embarrassing conclusion. (In fairness, they DID find one study of decent quality that showed a reduction in accidents for stimulant users. That was the only positive long-term outcome they found.)
https://www.iacaf.org/assets/Uploads/Documents/DERP.pdf (OSU Medication Effectiveness Study)
“Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the community.”
https://www.nber.org/system/files/working_papers/w19105/w19105.pdf (Quebec provincial study)
“No significant differences based on medication-use were noted for the following
measures taken at 14 years of age: depression, self-perception, and socialfunctioning.
• Whilst no statistically significant results were noted, a trend toward slightly higher
depression scores was noted with the use of medication.
• A trend toward slightly lower self-esteem and social functioning was also noted with
medication use at one time point or two time points. However, consistent medicationuse at all time points, including at 14 years, trended toward slightly improved selfperception and social functioning.” There was also a finding of a MUCH higher percentage of grades repeated for those taking stimulants.
https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports-and-publications/PDF/MICADHD_Raine_ADHD_Study_report_022010.pdf (Raine study from Australia)
I can’t find the USA/Finnish comparison study right now, but it showed that medication rates were MUCH lower in Finland, yet outcome measures like delinquency and school failure were no different in these comparable populations.
The studies referenced above involved MANY THOUSANDS (probably more) of “ADHD” diagnosed children in the USA, Canada, Finland, and Australia. The OSU study looked at every single reference they could get their hands on at the time that had to do with stimulants and ADHD. There is a mass of strong evidence that stimulants don’t alter long-term outcomes, and at this point, most research psychiatrists have accepted this as factual.
This Web MD article is most significant in what it does NOT say about long-term outcomes. If there really WERE known benefits in the long term, don’t you think they’d mention them right here? But they don’t, do they? I wonder why?
“Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.”
https://www.webmd.com/add-adhd/childhood-adhd/adhd-kids-med-use
The lack of long-term benefits from stimulant drugs for “ADHD” diagnosed children is an open secret. It is known but not talked about. Anyone claiming there IS some benefit for any of these long-term outcome measures has a big hill to climb. Simply stating that “I believe that” or “Dr. So-and-so says that…” is not going to come CLOSE to cutting it in this case.
For those who actually believe in unbiased scientific analysis, the jury is IN on this question. The burden of proof is now on anyone claiming some long-term benefit. Stimulants are effective in short-term suppression of “ADHD” symptoms in the majority of children so diagnosed. That’s about all that can be said. Depending on one’s philosophy of education, and to some extent, on available educational options, this may or may not be considered beneficial. But claims of long-term benefits are mythological, not scientific.
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Don’t forget the “placebo washout” strategy. They do whatever they can to reduce placebo effects and maximize the chance of a positive P value.
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In a very small number of cases. VERY small.
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You state that as if it would be wrong to believe that, no matter what the actual data. Science is not a religion. See my other post.
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The average lifespan of the “seriously mentally ill” has steadily DECREASED since the advent of psychiatric drugs. Such people now die 20+ years younger than their non-diagnosed counterparts. A significant part of that decrease in lifespan is the result of treatment with antipsychotics. As many as 14.5 years lifespan may be attributed to antipsychotic use.
https://www.hcplive.com/view/is-treating-schizophrenia-with-antipsychotics-worth-the-risk
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Well said. The only caveat, and a big one it is, is that whatever philosophical approach one takes, the results have to reflect some apparent improvement, at least within your own philosophical structure. It becomes a BIG problem when one becomes so committed to his philosophical views that actual data that doesn’t support one’s theories is ignored or minimized or denied.
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https://www.healthline.com/health/adhd/evolution
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I have seen way too many kids “flip” to bipolar in my career as an advocate for foster kids. It is not rare that a kid gets aggressive in response to stimulants, but it is unfortunately VERY rare that doctors see that for what it is, and it almost always leads to more drugs and more serious diagnoses, instead of saying, “Gosh, those stimulants seem to have made things worse! Maybe we should stop and start over!” I had one who went two years deteriorating, until she herself decided to stop all three drugs she was on. She had become psychotic and aggressive on the stimulants, but when she stopped, she was back to her old self within days. But the doctors never had a thing to say about it. Did not even acknowledge they’d done her wrong. That happens WAY too often for my comfort!
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COMMENTING AS MODERATOR:
Hi, Gina,
I have moderated the comments you reported, as I understand in context why these might have come across as offensive to you. I am sorry we didn’t catch them sooner.
In the future, please email me rather than posting complaints about posts in the text of a comment. I am very responsive to such complaints, but it doesn’t help the community at large to have to process these complaints publicly, and as such, it is stated in the Posting Guidelines to handle such complaints by talking to the moderator or simply reporting them through the “report” function at the bottom of every post.
Steve
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Let’s agree to both ignore each other, eh?
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I think another vitally important question is how/why the current “mental health” apparatus does not SEE the very obvious connection between childhood adversity and adult “mental health” diagnoses. They spend decades researching the “biological underpinnings” of these “disorders,” and come up with 2, 3, 5% correlations, when childhood abuse/neglect/abandonment has associations at 80% or higher to most “disorders.” Seems like a case of intentional blindness. We’ll never be able to teach kids sufficiently about neurodiversity and the importance of healthy child rearing when the bulk of the “mental health” industry appears committed to denying that it matters!
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One study by one person does not begin to compare to 4 long-term naturalistic outcome studies and 4 comprehensive literature reviews. The jury is IN. There is no long-term outcome that is consistently improved by stimulant treatment. It’s a fact.
Just stop now.
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Thank you, Jonathan. As I have said, there are philosophical differences that lead to different approaches. Different approaches are absolutely allowable. Claiming that all kids who present in this way “have a biological deficiency” is NOT scientifically valid at this point. It is VERY important to make the distinction between philosophy, which entertains the possibility and effects of different worldviews, and science, which attempts to discern facts and predict precise outcomes. Confusing one with the other leads to a lot of false conclusions.
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I am done with this conversation. Please leave it alone.
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Thank you!
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Your comments continue tot be insulting. I never said “no biomarkers exist.” I said that your study did not prove that all or even most cases of “ADHD” are biological. I have also proven again and again that there are other alternatives to stimulant “treatment.” You are assuming the outcome and dismissing my example of my own kids because you don’t want to accept that your viewpoint is limited by your own biases. “Misdiagnosis” is common because there ARE NO OBJECTIVE STANDARDS FOR “DIAGNOSIS.” In fact, if there is no way to know who “has it” or doesn’t “have it,” there is no way to determine if someone is “misdiagnosed.” This leaves the door open to biased advocates to decide that anyone who IS helped by non-chemical methods “must have been misdiagnosed” to preserve their preferred belief system.
My kids absolutely fit the criteria to a tee. They were helped to lead productive lives with no stimulants. You apologized earlier for minimizing that accomplishment, yet you continue to do exactly the same. You assert that I was making my blind children go around pretending to be able to see. That is incredibly insulting, and you don’t even realize it.
I don’t “strongly disagree,” I have the best possible example that your generalization, which you repeat over and over again, is not true. I also have presented excellent proof that your insistence that “treatment” with stimulants is essential is absolutely not true, since in the long run, there are no significant advantages to “treatment” over “non-treatment” or “medical treatment” over psychosocial intervention.
Seriously, PLEASE DO NOT RESPOND if you’re going to keep insisting that I’m a child abuser forcing my blind children to pretend to see! If you don’t agree with me, DON’T AGREE, but I don’t want to hear you telling me I’m wrong. If you can’t accept that the world is bigger and more complex than your data to date, you are no scientist and will fail to ever learn anything about why some people find your approach so horribly offensive.
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Nonsense. Reviews by Barkley and Cunningham (yes, the same Barkley who makes millions selling the idea that “ADHD” sufferers are being abused if not given stimulants) in 1978, Swanson in 1993 (“Review of Reviews”), and the Oregon State University Medication Effectiveness Project (which looked at EVERY piece of literature on the subject every published in about 2002) ALL concluded that there are no long-term outcomes improved by stimulant treatment when comparing those “treated” and “untreated” who were diagnosed with “ADHD”. Also, long term studies like the Quebec study, the RAINE study in Australia, and the Finnish study (compared kids in the USA with very HIGH “treatment” frequency and duration to kids in Finland with much lower treatment levels, no differences found) ALL found that there was NO long term benefit to those “medicated” vs. “unmedicated.” The highly-touted MTA study showed that the stimulant group had some advantages in reading at the end of a year, but by the three-year followup, that difference had vanished, and later followups showed that those who continued to be “medicated” had DETERIORATING outcomes in comparison.
Here is a more recent revivew:
“In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
https://www.tandfonline.com/doi/abs/10.1586/14737175.6.4.551
Have you actually READ “Anatomy of an Epidemic?” This is covered in Anatomy, though more data has come in since Anatomy to provide even more support.
Repeating quotes from some guy with a degree does not constitute evidence. The jury is in – long term “treatment” with stimulants DOES NOT improve long-term outcomes. 40 years of studies should be sufficient to prove this point. If you want to pretend it’s not true, that’s your choice, but don’t try to convince me or anyone actually familiar with the literature.
I have the data on this, Enrico. Probably best not to try and argue this point, and instead either retreat or consider the real implications of the REAL science, rather than relying on quotes from “professionals” who probably have a conflict of interest.
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My kids NEVER felt they were lazy, crazy or stupid. Unfortunately, most of the kids I knew (and I knew dozens, probably hundreds) who were “diagnosed” with “ADHD” were pretty sure they were being told they were crazy. Some rebelled against it, some accepted that they were “crazy” or at least “incapable,” none of them I can recall escaped without feeling their “diagnosis” meant they were either dumb or crazy or incapable.
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So why not dedicate yourself to creating better classrooms, rather than trying to pretend that this hypothetical kid can’t learn just because they are too bored and distracted to function well in a so-called “normal” classroom?
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992783/
https://pediatrics.aappublications.org/content/137/1/e20152486
https://www.webmd.com/add-adhd/childhood-adhd/news/20151230/adhd-meds-may-raise-risk-for-psychotic-side-effects-in-some-kids-study
https://www.addictioncenter.com/stimulants/ritalin/
Have never heard of anyone getting psychotic, having a heart attack, or getting addicted to aspirin.
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“I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration.”
I already gave you a clear and thorough demonstration of exactly how this can be done. Your latter claim is not supported by the literature. As I’ve said all along. It appears you already “know” the answers, so why are you bothering to have a “discussion?” It sounds more like you want to force anyone who disagrees with you into submission.
If you really care, do your own research. But I don’t think you’d accept it if the results were right in your face.
And talk about not answering questions – if chemical stimulation to enhance concentration in a regular classroom environment is such a great solution, why is it that study after study shows no improvements in long-term outcomes for medicated vs. non-medicated “ADHD” diagnosed cases? Answer that if you want others to ask your (possibly disingenuous) questions.
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So what’s your objection to creating open classrooms, where these “ADHD” kids seem to do so much better without any special “treatment” at all?
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Some people’s lives transform after they’re hit by a truck. Near-death experiences can be life changing! Maybe we can come up with a “treatment” that involves killing someone and bringing them back to life! Very New Age!
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That was my favorite post that I’ve ever read from you! Very well said!
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Or maybe some kids learn differently than is expected of them.
Look, we’re not going to agree on this. It’s a philosophical problem, not a scientific one. You have a set of assumptions, mostly that kids learn best by doing what they’re expected to in a regular classroom, and that being unable to do that is a problem with the child. I have a different set of assumptions – that it is the adults’ job to figure out the best setting for children to learn in and that adapting your approach to the children’s needs obviates the need to come up with ways to get them to fit into the “normal” classroom. Within our own sets of assumptions, we’re both right. And it doesn’t seem that either of us are ready to accept the other’s philosophical assumptions. And it’s starting to get personal.
Let’s just agree to disagree and have done with it. Diversity of perspective is the sign of a healthy community.
All the best to you.
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How on Earth do you know that my children were “not as limited as many?” How could you possibly know that without meeting my children, and without attempting a similar intensive behavior program based on the individual needs of other similarly “impaired” children and seeing what the results were? Your comment continues to come across as condescending, as I find quite common with people who are advocates for stimulants, rather than objective observers looking for the best approach and open to new ideas.
Where in my comments have I ever criticized you or said you should hate or disrespect psychiatry or psychiatrists? And I don’t condemn teachers, I am criticizing the SYSTEM of education that requires children to engage in behavior that meets the needs of the adults and not the children. I’ve even given you alternative educational approaches that work for “ADHD” diagnosed children, in which you have shown not the vaguest interest. What would happen to those kids who “can’t learn” in a standard classroom if they were given a different venue to learn in? What if 70% of them suddenly did not “need medication” any longer? Would you consider that a GOOD outcome? Or a BAD outcome?
And if it’s all biological as you claim, why is it that there is a full 30% reduction in kids getting diagnosed “ADHD” if they wait one year longer to enter school, as has been shown in several quality studies? The 30% figure is remarkably stable over these studies, too. What would happen if these kids were given yet another year to mature before enrolling? Could we reduce that figure by 50%? Would you view that as a good thing, or a bad thing? Especially when there is NO evidence that taking these stimulants over the long term has any positive impact compared to kids who quit early or never took them.
Your view of the situation is extremely monochromatic. I’m just trying to broaden your perspective, not tell you that stimulants are wrong or bad. I’m encouraging you to take a wider view, instead of assuming that using chemical means to enable a child to sit still and pay attention in a standard classroom is not only the best but the ONLY way to help kids who are struggling to learn in that environment.
It doesn’t suit you very well to claim you are sorry for condescending and then continue to condescend. But maybe you can’t help it.
This time I’m REALLY done. I’d appreciate it if you did not add more disrespect and condescension to the pile. Maybe best if you just stop trying to convince me of something I very well have established to be a very narrow and ineffective view of “ADHD” to my own satisfaction.
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Very well said!
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I acknowledged early on in our discussion that short-term symptoms can be improved by stimulants. I point out that long-term outcomes are NOT improved. How do you deal with that conundrum? Pretend that it doesn’t exist?
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After re-checking my post, I find your diminishment of the accomplishments described to be even more offensive. Did you even bother to read what I wrote? Do you have any comments or thoughts on the idea that using of rewards of intense stimulation to help kids learn new behavior? Do you have ANY experience in behavior change theories? Do you even understand the point I’m making, or are you just choosing to ignore it because it doesn’t fit your narrative?
BTW, I have used these same approaches professionally with lots of kids, and also with adults, with some modifications. They WORK. It’s not because “my kids didn’t need medical interventions.” It’s because these interventions are smart and on target and very, very effective. But they require analysis, creativity, and months or even YEARS of HARD WORK! Maybe most people just don’t know how or don’t want to do that kind of work, and stimulants give them an “easy answer.” But one thing you have NEVER responded to is decades of research showing that long-term outcomes are NOT improved by stimulant treatment. My way DOES appear to affect long-term outcomes, at least in my kids’ cases. No learning problems, no delinquency, no school dropouts, continued high academic test scores, academic honors, and for one, a complete college education, again with academic honors. Stimulants can make no such claims. If you’re so interested in science, why not look for better solutions? Why spend all your time railing about genetics when it’s the one thing in the equation that can’t be changed?
I assume you’re aware of the research on brain plasticity, that the environment molds and changes the brain based on how it needs to be used to survived. What if our approach altered the epigenetic conditions in the brain by teaching our kids to use their brains differently? Would that not be a great outcome, and exciting outcome? Why is that not of interest to you?
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Not only has “mental health” treatment not increased longevity, it has dramatically reduced it.
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My children functioned without medical intervention, but with a HELL of a lot of non-medical intervention. We EARNED their positive behavior through YEARS of hard work. You are trivializing it by trying to pretend that “they functioned without medical intervention,” as if what we did had NOTHING to do with their success! You are building a strawman argument to bolster your own case, rather than listening to the story and trying to find the core of meaning behind it.
What if lots of children could function without medical intervention, and nobody ever tried? What then? What if we are exposing children to years of drug side effects without really addressing their issues? What if 90% of those children COULD “function without medical intervention,” yet never had the chance to because people like you insisted it was impossible? Are we not cheating them out of an opportunity to grow and learn by telling them and their parents it is impossible?
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Poor vision is objectively measurable, and is nearly 100% correctible by lenses. “ADHD” is a social construct “diagnosed” by a list of behavioral characteristics, some of which are, frankly, pretty ridiculous. “Acts like ‘driven by a motor’?” Isn’t that just a BIT different than “Is unable to read letters of X height from a distance of 20 feet?” Additionally, there is a very significant minority of “ADHD”-diagnosed, probably 30%, who don’t even respond positively to stimulants in the short term, some of whom actually get demonstrably worse (aggression, lethargy, psychosis in over 6% – hardly rare, eating problems, growth retardation – the list is pretty long).
Your comment is clearly disrespectful to those of us who choose not to buy into drugs as the solution. And they ARE drugs. They are generally schedule II controlled substances that can be sold on the street for money. Pretending they are NOT drugs in order to preserve middle-class sensibilities is just plain dishonest.
But yes, you are being extremely condescending to anyone who disagrees with your approach. “If someone doesn’t want improved vision, fine.” That implies that I have somehow neglected my children by forcing them to go around unable to see. As you can see from the results, my kids are NOT blind or limited in their capabilities in any way. They are just as capable as you or me, absent any stimulant “treatment” in their lives. It appears you are extremely invested in your idea that stimulant drugs are the only answer for kids who have what is at best a behavioral syndrome that is “diagnosed” by utterly subjective means. It’s insulting in the extreme, and I ask you to stop doing it, to me, and to anyone else you meet. Maybe instead of telling everyone else what is “right,” you could start listening and perhaps expanding your viewpoint. Instead of an analogy that I let my kids go around with poor eyesight, perhaps you can open your mind enough to say, “Wow, that sounds like you did a good job! Maybe there are other options I haven’t considered that could work for some kids.” I am not ascribing ANY immoral motives to you or anyone else who chooses to take stimulants, and I made that point more than once in this thread. I have been arguing ONLY from the scientific perspective that one study on a very limited population does not establish a “cause” for “ADHD” nor that it is a biological phenomenon only, nor that it is even a legitimate entity for scientific study. Your comments have been and continue to be dismissive and disrespectful of other viewpoints, and I’m calling you out on it. If anyone is ascribing ill motives to those who don’t agree with them, it is you who is doing so. You might want to take a very hard look at your own behavior instead of spending all your energy criticizing those who have good reasons to disagree with your assertions.
And I have provided you a VERY concrete example of training that has had proven results. How is that “off the topic?”
If you want to learn anything, you have to open your mind to the possibility that you have not been told the whole story. So far, I don’t see much if any openness to hear anything that contradicts your own preferred narrative.
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Just to be clear, there are plenty of women who embrace “patriarchy,” and also plenty of men who don’t. Internalized oppression is a very real thing, and there is no reason that a woman can’t engage in sexist behavior or operate on sexist assumptions and values. Remember Anita Bryant? I’d have to say that even proposing the idea that PTSD is caused by women being on their periods is offensive on the face of it. Though the I agree with the rest of what you said – the lack of “common sense” in such a study is startling!
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How long to you have? I can write a book on the subject.
Just for starters: what do you know about “ADHD” kids? They need STIMULATION. They can’t stand boredom and routine. They often create behavioral issues in order to get the reward of adult engagement, even if it costs them getting in trouble. Which reinforces their negative behavior.
So why not create a situation where they get intense stimulation for DOING WHAT THEY ARE ASKED TO DO?
Example: My youngest didn’t like to lie still as we got ready for bed (reading time). He’d wiggle around, hide under the covers, smuggle in little toys to play with, and on and on. He was 5 1/2 at the time. I decided to create a program – I bet him a quarter that he couldn’t stay quiet for 1 minute without moving. Of course, he assured me he ABSOLUTELY could do that, NO PROBLEM! The first night, it probably took him 3 minutes to get settled down to the point I could even start the clock. But I waited until he was able to keep some semblance of calm for a minute, then I dramatically expressed GREAT frustration and coughed up the quarter begrudgingly. But I told him, “Tomorrow, we’re going to go for a minute and a half, and I KNOW you can’t do THAT!” We continued this process for a couple of weeks, and worked all the way up to 5 minutes. The last night, he took one deep breath, and completely relaxed, was totally still for five full minutes without a twitch. As I coughed up the last quarter, I said, “Well, I guess I was wrong. You CAN control your behavior, you just have to decide you WANT to do it!”
Several months later, he and a friend (who happened to be diagnosed ADHD and on stimulants, but I did not know this) were jumping on our trampoline. His friend was violating the safety rules (he was older, more like 7, quite bright, and knew and remembered what the rules were). I reminded him of the rules, closed the door, and a minute later saw him doing the same thing! I went outside again and asked him why he kept violating the rules? He said, “I ate red dye this morning, and it cancels my medication, so I can’t control myself.” And Kevin immediately said, “Yes, you CAN control your behavior, you just have to decide you want to!” This was a very real, very deep learning experience for him which he was now applying to his friend. And all for only
a few bucks and less than an hour of my time!
Did this mean he was never wiggly or disruptive or oppositional again? Of course not! But it gave a context to have further discussions and to face bigger challenges building from this solid base. Plus it taught ME an important lesson – he WAS capable of facing pretty significant challenges, if he could WIN at the end, and especially if I got “upset” about his “defeating” me. I used this principle again and again throughout his childhood, and even as he grew older and recognized the “game” behind it, he still was tickled pink when I got “upset” with him for “beating” me, even when he knew I WANTED him to win.
That’s just one short example of the kind of learning that can happen with a highly “ADHD” child when the adults, instead of getting angry at him for doing bad things, get “angry” at him for doing what we want!
So rather than deciding to define my kids’ behavior or actually their entire personality as “wrong” or “disordered,” we spent most of our time validating the strengths of their personalities and identifying and helping them overcome their challenges through fun and challenging reinforcement programs. We regarded every moment as a possible teaching moment, and always had a goal and a focus for what we were working on next. I don’t want to suggest this was EASY – it was a lot of work, me made a lot of mistakes, and there was plenty of yelling and tears and accidental reinforcement of bad behavior. But we had a plan and stuck to it, and it worked. Eventually, Kevin himself started to set his OWN goals and pursue them with the passion he always brings to his life. He continues to this day to challenge himself to do better and to discipline himself to make his life the best it can be.
There was never a need to pathologize their behavior, to label them as this or that, or to provide artificial stimulation through physiological means. We used what we knew about our kids and the behavioral patterns that were common, and we focused on building their strengths and using them to attack their difficulties and challenges.
Does any of that sound irrational, punitive, or harmful to our kids? I think the success we achieved together speaks for itself.
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Truly! This would be sketchy as a paper submitted to an 8th grade science class!
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You are assuming that the “ADHD” child WANTS to learn but is UNABLE to learn. If that is the case, why is it that one review after another over decades shows that stimulants create more “on-task” activity but do NOT translate into more learning/understanding in the long run? Is it possible that the child is being forced to do “work” that is not actually educational for them? That they already understand the material and are simply bored by having to “practice” over and over and over again doing something they already have down? Or that if offered a more hands-on, active, self-paced opportunity to learn, they would thrive on it, but such an opportunity is simply not made available to them?
I’d also ask you to explain why long-term outcome studies show no discernible effect on self-esteem, if these shaming experiences are theoretically reduced in number? Is it perhaps that we are replacing one shaming experience with another, telling a child he “needs his meds” in order to learn things? Singling him out as “disordered,” often in ways that are obvious to everyone in the classroom? What does it do to a kid’s self-esteem when told that his brain “doesn’t work right” and that he needs a drug to “rebalance his chemicals?” What happens later on in life when he discovers that he was actually lied to about that supposed “fact” (because as we should all know by now, the “chemical imbalance” theory is dead, even in mainstream psychiatric research circles)?
I was a shy kid in school. I had no trouble understanding anything the teachers were trying to teach us, though I did get frustrated at the ridiculously slow pace. Frankly, I was BORED TO DEATH, and no amount of increased “time on task” was going to teach me anything I didn’t already know. And trust me, I daydreamed like mad, and often completely tuned out the teacher droning on about something I already understood. I needed some NEW TASKS in order to learn more, not more time on the same boring tasks that I’d long since mastered!
I was very good at “complying,” so stayed out of trouble, but was terrified to talk because of the potential shame involved in exposing oneself to possible ridicule from the teacher or the other kids. I got embarrassed, turned red, and could not respond. I was laughed at. I avoided talking so as not to keep having that experience.
So what was the problem, Enrico? Was I “disordered,” because I was sensitive and easily embarrassed? Was my constant daydreaming an indication of me having “ADD without hyperactivity,” or a sign that I was in an incredibly dull and unstimulating environment for hours on end every day? Was I “disordered” because I didn’t want to risk getting humiliated? Or was the problem PERHAPS that the environment was a complete and total setup for a shy person like me to be exposed to? Was the fact that no one gave a shit whether or not I was shamed or embarrassed, or that the teachers themselves often PARTICIPATED in the shaming behavior perhaps a factor in why I was so reticent? Today, I would no doubt be “diagnosed” with “Social Anxiety Disorder” and efforts would be made to make me more participatory and to be able to “control my emotions” so I was “tough enough” to handle the inevitable shaming experiences that would ensue. My needs would be invalidated, and I would be accused of being a failed person because I couldn’t easily “fit in” to what I was expected to do.
Kids should not have to learn in a shaming environment. They should not have to learn in ways that risk trauma if they participate. They should be able to learn in ways that work for them, instead of having to be forced into a rigid structure that takes their normal ways of learning and makes them a source of shame and embarrassment? Instead of trying to alter the kids’ personalities, maybe we ought to teach our teachers how NOT to shame kids and how NOT to set up situations where other students can shame them as well?
Another interesting study showed that kids diagnosed with “ADHD” actually LEARNED MORE WHEN MOVING AROUND! So by forcing them to sit still and “pay attention” to the teacher talking, we are STOPPING them from learning. If giving them stimulants makes them more willing to sit there and take in all the boring “information” being tossed at them, that apparently doesn’t translate into them learning any more than they would have if they goofed off the entire lecture. In fact, they’d probably learn MORE if they were allowed a half hour of searching the internet and reading about what they’re interested in than they do sitting through a lecture in a chemically altered state.
I’ll again refer you back to the 1970s era study on “ADHD” kids in open classrooms. They stood out like sore thumbs in a “normal” classrooms, but professionals COULD NOT TELL THEM APART FROM THE “NORMALS” in an open classroom. So instead of drugging kids so they can sit still through a boring lecture and get higher points for “Stayed on task,” why not create open classrooms for anyone who needs or prefers that style of learning?
Remember also the study showing that these supposedly “disordered” kids were a critical element in groups of elementary school kids actually solving problems. They brought something to the table that three “normal” kids would have benefitted from. Why do we want to suppress that strength, just so that teachers and parents have an easier time?
The fact that teachers and other students hurt, shame and confuse other kids who don’t function well in a standard classroom is the fault of the teachers and the system they work with. As I’ve said before, my own kids had NO STIMULANTS despite pretty severe “ADHD” symptoms, but both graduated high school with honors and are paying their own way in the world and have functional relationships and goals and are functioning in every way as a contributing member of society. No one today would “diagnose” them with anything at all. What was different? We didn’t try to force our “square pegs” into the “round holes” of the school system until THEY decided they were ready for it. We loved and respected them, but of course taught them things they needed to know, including how to discipline themselves and how to get along with folks they disagreed with. Neither of them were in the tiniest degree unable to learn. In fact, they are both brilliant, fast learners! But they did not learn the way that schools expected them to learn. We never considered that their fault.
You are asking others to consider your hypothetical scenarios. What about my very REAL scenario of my two kids, and the research that supports what we did to help them mature into functional adult citizens? Does that suggest that alternative viewpoints may not only exist, but in fact be viable ways to view the situation that lead to positive results?
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This is a nice story, but does not reflect reality in the vast number of cases I see, nor does the research support the “transformed overnight” meme, except in the most mundane of aspects, namely that many kids behave more acceptably to the teacher’s (or parents’ or professionals’) eye on stimulants. Long term studies and literature reviews have repeated ad nauseum that long-term stimulant use does not improve outcomes in academic, social, behavioral, or emotional areas. I’ve listed some of these in another post. Try googling “long-term outcomes stimulants ADHD” and read through the results. There will be a few individual articles claiming positive benefits, but the reviews of the literature and the long-term outcome studies, including the Montreal, Raine, the Finnish study, and the highly touted MTA study, all show “disappointing” results.
I would also submit that your characterization of how adults treat these hypothetical “ADHD” children amounts to verbal and emotional abuse. Giving drugs to avoid verbal and emotional abuse by adults seems a little ass-backwards to me. Perhaps the parents need to learn how to treat a child who doesn’t naturally fit into the largely arbitrary social expectations foisted on them by schools and often by the parents themselves?
As I’ve said before, I speak from direct experience in this case. It is VERY possible to create a positive environment that is both nurturing and sets reasonable and attainable expectations for kids based on their personalities. It’s just that very few children ever experience these conditions, because parents are expected to send their kids to schools that are not suited to their needs.
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I’m not resisting what Birk shows. Saying that this mutation is ONE POSSIBLE CAUSE of the syndrome called “ADHD” is absolutely fine. Saying it IS THE CAUSE of ADHD is not fine. That’s what it sounded like you were saying. The big problem I’m pointing out is taking a single finding and extrapolating it to everyone, going from a subset of “ADHD”-diagnosed people have this particular anomaly to “ADHD” is a disease state that is caused by this genetic mutation. It presents an interesting template for further study. But there are many other interesting templates for examination, including low iron, sleep apnea, nutritional problems, exposure to abuse/neglect, exposure to domestic abuse in the home, inappropriate expectations set on younger children, maturity at admission to school, classroom structure, skills of parents and/or professionals managing these children, and on and on. As I explained to you earlier, I have two of my three boys who fit the “ADHD” criteria to a tee, and both were successful in high school and one in college with no drug intervention whatsoever. Should we not be grateful that at least some “ADHD” kids can be TAUGHT the skills to concentrate when they need to? Would this not be a topic for investigation? Isn’t that information that can be used to help others? Isn’t that what we are all striving for?
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The point is, response to stimulants is not diagnostic of “ADHD” or anything else except having taken stimulants. Again, if you LIKE the effects of stimulants, you’re welcome to take them. It is completely irrelevant to the question of biological causation.
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OK, I’m going to try one more thing here and then that’s it for this discussion for me. I will keep it very simple.
Let’s say we did a study and found that poison ivy causes skin rashes. We had a large sample of people and found that 90% of those exposed to poison ivy got a skin rash.
Can we now conclude that skin rashes are caused by poison ivy?
Or can we conclude that a certain subset of skin rashes are caused by poison ivy?
What would we need to do to demonstrate that ALL skin rashes are caused by poison ivy? Would this one study be sufficient to show that?
This is what you’re doing here. You are saying that people who have this mutation are likely to fit the description of “ADHD.” This is not something I’m arguing with. I’m asking you how you could possibly conclude from this one study that ALL cases of “ADHD” have this cause?
The answer is, you can’t. If you can’t see that, you can’t try talking science to me. It’s a fundamental tenet of science – correlation does not imply causation. There could be 500 different, distinct causes of the syndrome called “ADHD,” and this could be one of them. We could do the same with abused children – take 100 abused children and 25 of them are diagnosed with “ADHD.” Does this mean child abuse causes “ADHD?” No. It means at most that SOME “ADHD” behaviors are caused or increased by child abuse. It could even mean that abused kids are more likely to be taken to a psychiatrist for a diagnosis. Or that foster care placement makes kids more anxious and that this creates more “ADHD” symptomology. And there are many people who are diagnosed with “ADHD” that have no child abuse in their background. But it is a factor that contributes. That’s all we can say.
Like I said, you could be right, maybe every single case of “ADHD” has this mutation. But this study certainly doesn’t come anywhere CLOSE to proving such a thing. It shows that people who have this genetic mutation are likely to show “ADHD” symptoms. And that is ALL it shows. The rest will require further study.
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An excellent perspective! I doubt that hunter-gatherer societies spent a lot of time talking about “egalitarianism.” They just lived in the ways that worked for them, which included a level of collaboration and respect for differences, just because that was what worked best over their history.
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Sorry, can’t agree with you here. I can’t argue with the result that a certain very small subset of people diagnosed with “ADHD” had the genetic mutation that Birk has located. I don’t want to argue with that. But science is limited to answering the question asked. This study showed that a small sample of humans diagnosed with “ADHD” had a certain genetic anomaly. That is ALL that it proved, whatever the researchers theorize it means. Science is inherently SKEPTICAL. It is supposed to doubt its own conclusions and try to come up with alternative explanations and to DISPROVE anything that it wants to prove. No real scientist has the attitude that one study, particularly with the small sample size involved, can “prove” that “ADHD” is biological! It’s an outrageous assertion scientifically. Consider that we all “knew” for a certainty the formulas for acceleration and force and the gravitational constant and so forth for CENTURIES before Einstein showed them to be an approximation rather than a precise description of reality. Science is always working to improve itself, and that means questioning assumptions and conclusions that are not established beyond a reasonable doubt, and even those that ARE established as “laws” are STILL subject to revision when contradictory data arrives on the scene.
Replication is the core of scientific verity, moreover, replication in the face of efforts to establish alternative explanations. You can’t take one study and extrapolate it to apply to the entire population in question, ESEPCIALLY when this population is defined by ridiculously subjective criteria like “displays poor listening skills” or “appears to be ‘driven by a motor’ or is often on the go.” Seriously, “Often on the go?” You think that every child who is “often on the go” would not be “on the go” except for some genetic anomaly? It is absurd to so readily believe that one study, which establishes nothing more than an ASSOCIATION with these “ADHD” traits, proves causality.
Anyway, you seem to have convinced yourself and are not really interested in discussion. I’m not sure why it is so important to you to make more of this study than it offers, but maybe you’ll be right and I’ll be wrong in the long run. But I certainly will not concede that a single study on a tiny subsection of this population proves “causality” of “ADHD.” Come back to me when you have at least three studies from different, non-biased sources that indicate that over 90% of those “diagnosed” with “ADHD” have this anomaly, and that less than 10% of the general population have the same anomaly, then maybe we can talk.
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Your comment comes across as extremely arrogant. Neither you nor Dr. Birk has come anything close to explaining why a subjective list of behavior that adults and especially school personnel find annoying is 100% “caused” by a genetic anomaly that is seen in mice.
I am the first to say that kids (and adults) who have a hard time concentrating on the daily drudgery of the average school classroom should not be abused, neglected or treated as second-class citizens. But the problem in my mind is not the kids, it is the school structure itself and the ongoing justification of mistreating children who don’t do well in that structure that is to blame here. I totally allow that there are some kids who are born not being tolerant of boredom and repetition, not liking to sit still, etc. just because they came that way. Two of my three boys who fit that description. Both of them graduated high school with honors and have social lives and have successful jobs and are no less happy and productive than the average person, despite neither of them ever having had a milligram of stimulants in their lives. We did have lots of frustrations, especially with the older one (we learned so much from him that the younger was MUCH easier!) and I’m certain if we’d sent them to “normal” schools with “normal” classrooms, they’d have struggled and probably learned to hate school. So we didn’t do that. We sent them to alternative schools and homeschooled for several years, and spent a lot of time learning creative ways to approach discipline that worked better for their particular personalities. And yes, they COULD and they DID learn how to concentrate when they needed to, how to alter their approach to relationships, to accept losing and failure as learning opportunities, and even how to accommodate arbitrary restrictions an expectations in order to get what they wanted/needed out of life.
I would also add that if YOU find stimulants helpful to YOUR life, I certainly have no objection to your choosing to use them in whatever way seems helpful to you. I do object to your attempts to narrow the discussion to Dr. Birk’s single, small-sample, narrow and unreplicated study as some kind of proof that you have all the answers and that everyone else’s conception of “ADHD” is wrong and that it’s 100% biologically caused and that anyone who acts that way has a “disorder” and that anyone who thinks otherwise is sadly ignorant. There is PLENTY to talk about both philosophically and scientifically that is unresolved, and I am extremely well versed in a wide range of research on this topic, in addition to having personal and professional experience over many years in the area. So please, do not condescend to me and pretend that your single study has proven anything. I hear and understand and agree that there are most likely biological conditions that are ASSOCIATED with “ADHD” symptoms. But that is a tiny, tiny piece of a very large and complex puzzle that involves not only biology, but culture, history, sociology, philosophy, and education, among other variables.
I have not even touched on the very important question of long-term outcomes. There is at this point a pretty solid range of literature showing that stimulant “treatment” alone does nothing overall to improve long-term outcomes like high school graduation rates, college enrollment, academic test scores, delinquency rates, teen pregnancy rates, drug abuse rates, social skills, or even self-esteem (even if they may help one or more of these things in a PARTICULAR person at a particular time). Even if it is absolutely proven that EVERY person who fits the subjective “ADHD” profile has this genetic anomaly, which I hope you are able to acknowledge is NOT claimed nor proven by your Birk study, there is scant evidence that taking stimulants does anything more than temporarily make it a little easier to concentrate (just like it does for most adults, “ADHD”-diagnosed or not – see my other post), which doesn’t even lead to better educational outcomes on more than a short-term basis. So why spend all this time arguing about whether or not “ADHD” is caused by a genetic anomaly while not addressing the major concern that taking or not taking stimulants doesn’t seem to make a big difference in the long term for the “ADHD” sufferer? Maybe we should spend less time on arguing about genetic causation and more on figuring out how to make the school environment more workable for these kids (and for other kids who also find it oppressive but are “genetically” more able to pretend they’re OK with it)? After all, genetic diversity is the key to species survival. Why are we picking on these “ADHD” kids when we know that, for example, putting them in an open classroom environment (that’s what we did for our boys and it worked!) makes such kids virtually indistinguishable from “normal” kids?
I am sorry you have suffered at the hands of the system. It didn’t have to be that way. But I don’t think the evidence suggests a simplistic, biological answer to what is a complex sociological problem.
I’ll leave you with this: a recent experiment took groups of three elementary school kids and gave them three problems to solve in a specified period of time. The experimental group had one “ADHD” diagnosed kid and two “normal” kids, while the control group consisted of three “normals.” They were rated on percentage of time on task as well as on how many problems they were able to solve. Not surprisingly, the groups with the “ADHD” kid in them spent considerably more time “off task” doing and saying things that had nothing to do with solving the problems at hand. The surprising outcome (to the experimenters, though not to me) was that NONE of the groups of “normal” kids were able to solve any of the problems they were presented with, while the “ADHD” groups consistently solved one or more of the problems, despite spending less time focused on finding a solution. Of course, if they’d had groups of three “ADHD” kids vs. three “normals,” the results may have been quite different. But I think the lesson from this study is that people who are off-task, silly, have scanning rather than fixed attentional focus, are ESSENTIAL to the survival of our species. They are the ones that come up with new ideas, that “think outside the box,” the ones not constrained by convention but who can dedicate themselves to finding a way to make things work, regardless of what anyone else thinks of their approach. We need these kids and adults!
Just in case you think I’m making this up: https://www.psychologytoday.com/us/blog/freedom-learn/201603/adhd-creativity-and-the-concept-group-intelligence
It has been observed that folks like Edison and Einstein and Gauss and Lincoln and Van Gough and Leonardo Da Vinci might have been diagnosed with “ADHD.” I have to wonder what marvelous contributions to the world might have been lost if these folks had been “properly medicated” in their day? Maybe the world just needs to make more room for people who don’t like to sit at a desk and do as they’re told all day long. Maybe it IS genetic, but why would 10% of the population have this particular genetic inheritance if it didn’t have a purpose in helping our species survive?
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Could you PLEASE respond to my very valid points regarding the CDH2 mutation NOT being established to exist in all or most or even any kind of percentage of so-called “ADHD” sufferers? Or help us understand why early childhood abuse and neglect is associated with 4-5 x increase in “ADHD” diagnosis if this is all about the CDH2 mutation? I could add more, but I want to keep it simple so we can see if you have any kind of answer to these key questions. So far, you have avoided them and keep repeating the details of this rather limited study.
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Just to be clear, Judith Rappoport, et. al., showed unequivocally (back in about 1978) that non-labeled people respond exactly the same way as “ADHDers” to stimulants. She called the claim of differential response “an artifact of observation” due to the fact that people are LOOKING for a particular response from the “ADHDers” and so notice and value that response, while the same response from “normals” doesn’t get any attention because no one is trying to “fix” them. So the improved concentration you attribute to “ADHDers” responding instantly to stimulants is the same improved concentration that ANY PERSON would gain as a result of stimulants.
“Since the positive effects of stimulants on disruptive behavior were described (Bradley & Bowen, 1941), further pediatric study has been limited almost exclusively to samples of hyperkinetic school-age children. Because these agents normally were viewed as arousing in their effects on the central nervous system, but were calming in their therapeutic effects on these children, stimulant effects on Attention Deficit Disorder (ADD) were interpreted as being ‘paradoxical.’ Investigation of effects in normal children and adolescents and in those with disorders unrelated to Attention-Deficit/Hyperactivity Disorder (ADHD), as well as in young adult samples, however, indicate that stimulants appear to have similar behavioral effects in normal and in hyperactive children. This brief report is an update (as of August 2002) on studies of stimulants in ADHD and normal children, with particular focus on MPH.”
https://www.researchgate.net/publication/10812795_Responses_to_methylphenidate_in_Attention-DeficitHyperactivity_Disorder_and_normal_children_Update_2002
Since you seem to have respect for researchers in the field, I will assume that we can consider that particular topic closed.
Steve
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I have made my points, and you appear to have no response other than “Dr. Birk said so.” The fact that Dr. Birk said so is of absolutely no consequence to me or to Science as a whole.
I don’t need to contact Dr. Birk – s/he has overstated the case by any level of scientific analysis. It appears we will be unable to agree on these points. You are free to believe Dr. Birk’s analysis if you wish, but it is still important for any real scientific discussion to point out the limitations of the research presented. Since you appear to have no interest in responding to the points I have raised, it appears that no further discussion is possible.
Best to you in the future.
Steve
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Ah, now we get down to it. It is ASSOCIATED with “familial ADHD.” Associated means it occurs with a higher percentage in the “ADHD” population than in the general population. It does not mean it is a cause, as there may be many, many cases of the same mutation in people who don’t fit the “ADHD” criteria. “Correlation is not causation.”
We know for certain that familial domestic abuse is highly associated with “ADHD.” It occurs more frequently in the “ADHD” population than in the general population. Does that mean that familial domestic abuse causes “ADHD?” What about the many children who are exposed to the same kind of parental behavior who do NOT develop “ADHD” symptoms? What about the large number of “ADHD” diagnosed children who don’t have domestic abuse in their history?
Other associations are low iron, sleep apnea, younger age of starting school, being in a traditional classroom vs. an open classroom, abuse/neglect at an early age, etc. Are all of these “causes” of “ADHD” because they are “associated” with “familial” ADHD? Does a traditional classroom “cause” ADHD because more “ADHD” behavior is associated with it? Or does a traditional classroom structure simply not WORK for a certain percentage of children, for a wide variety of reasons?
Correlation is not causation. And you continue to avoid the most important question of why this particular set of subjective behaviors are automatically a “disease state” even if a consistent physiological cause were found.
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Sounds a lot like “blaming the victim” to me. Of course, people don’t want to feel marginalized. But why is it their job to carve off parts of their personality in order to “fit in?” Why is it not the job of society in general to help people feel more welcome and accepted, even if their behavior is unusual or confusing, yet does no harm to anyone? Isn’t a lot of “mental illness” simply the consequence of society’s narrow view of what is “normal” or “acceptable” behavior?
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That is more than possible, since they seem to know very little about either on the whole. But I think that would make you more of a shaman than a doctor. Of course, if I wanted to use psychedelics for any reason, I’d of course seek out a shaman and avoid anyone claiming to be a “medical practitioner” using psychedelics as “treatment” for some manufactured “disease” s/he decided I supposedly was afflicted with.
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Again, claiming “cause” requires establishing that all or almost all “ADHD” sufferers HAVE the CDH2 mutation, and that no or almost no “normal” people have this mutation. To claim this from the data presented is pretty laughable. They’ve shown that a very small sample of people/mice subjectively judged to “have ADHD” without objective measures happen to have this particular mutation. Does EVERYONE with this mutation have “ADHD?” Or is it 10%, 20%, 50%? Does EVERYONE diagnosed with “ADHD” have this mutation? Do some have the mutation and NOT develop “ADHD symptoms?” Is the presence/absence of this mutation determinative of a person’s long-term success in life? Does “treatment” for this putative problem actually do anything to improve long-term outcomes for those so “diagnosed?” Is there even an objective way to determine who “has” or “does not have ADHD?”
It is scientifically absurd to declare that this mutation “causes” ADHD when the “disorder” itself is not objectively discernible, nor is there any indication that those so “diagnosed” have any kind of physiological problem or are just a normal variation of behavior that doesn’t work so well in modern society. After all, genetic diversity is central to species survival. Why is a genetic variation, even if it is 100% associated with this behavioral syndrome, automatically a “disorder” when our species depends on a wide variation of genotypes and phenotypes to survive?
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There are no long-term outcomes that are improved by “ADHD treatment” with stimulants. This has been shown by Barkley in 1978, by Swanson’s “Review of reviews” in 1993 or so, and by the OHSU comprehensive study of long-term outcomes, which looked at essentially every study ever published on the subject up to somewhere around 2001. There were NO improvement in long-term outcomes for “treated” vs. “untreated” subjects noted in the OHSU study, including academic test scores, high school graduation rates, college enrollment, delinquency rates, teen pregnancy rates, social skills measures, employer satisfaction rates, or even self-esteem. The only variable that was improved is a slight decrease in accident rates. In Barkley’s 1978 review, he said that the improvements in academic test scores were so small that they were easily explainable by reading the questions more carefully. And yes, this is the same Russell Barkley who has become one of the keenest advocates for “treatment” for “ADHD,” so we can hardly blame researcher bias.
Additionally, long-term studies like the Quebec study, the Raine study in Australia, the Finnish comparison study, the long-term follow-ups to the MTA study in the USA, all lead us to the inevitable conclusion that long-term outcomes are not positively affected by stimulant treatment. To claim “we know there is a biochemical basis to ‘ADHD’ is, of course, utter nonsense scientifically. But we are not even at the point where we can say that “treatment” leads to any significant long-term improvements in any significant outcomes.
The small study that is referenced doesn’t even come close to touching any of these long-term effectiveness questions. It ignores the obvious environmental impacts on “ADHD” behavior, including later entry to school, having open classrooms, and the impact of psychosocial stressors on the “diagnosis” (studies have shown “diagnosis” rates of 5-10 times higher in children who have experienced serious abuse or neglect). Nor does it address finding some objective way of even determining who “has” or “does not have” “ADHD.”
Repeating something over and over again doesn’t make it true. From a purely scientific viewpoint, “ADHD” isn’t even something that can be objectively determined to exist, let alone to be a “disorder” or divergence from “normal.” This study barely scratches the surface on questions of etiology, differential “diagnosis,” and long-term effectiveness of proposed “treatments.” It is ridiculous to claim that this proves any kind of “biological basis,” when the condition you have identified hasn’t even been established to exist in all or most or who knows what percentage of “ADHD” diagnosed people, nor the percentage of the people having this variation who may NOT have any “ADHD” symptoms to speak of. And of course, the entire enterprise is called completely into question by an inability to objectively even define who does or does not qualify for the “diagnosis” of “ADHD” in the first place.
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Nonsense. We would need to see that all or almost all cases of “ADHD” have this same mutation, and that no or almost no person with this mutation does NOT have the “ADHD” features. Given that “ADHD” is defined by subjective behavior and sociological variables, the odds that EVERY case of “ADHD” so “diagnosed” is caused by this mutation is exceedingly questionable. In any case, this question does not begin to be answered by a handful of mice, or even a very small number of “ADHD” cases studied. We also know that, for instance, waiting one year before enrolling a child in school leads to a 30% reduction in “ADHD” diagnoses (a number of studies confirm this), that sociological stress such as neglect and domestic abuse increases the rate of “diagnosis,” that placing such children in “open classrooms” makes it practically impossible for professionals to distinguish them from “normal” children, and that prior comparisons of “genetic markers” have proven extremely heterogeneous, that is, that many “diagnosed” with “ADHD” did NOT have the markers, and many who were NOT “diagnosed” did in fact have the same markers.
And of course, the entire line of inquiry ignores the rather obvious question of why a particular challenge in paying attention to boring activities is considered a “disorder” in the first place. I recall an article (which I can’t seem to locate now) that showed employer satisfaction with historically “ADHD” employees did not differ from those not so diagnosed. The explanation offered was that those with this “diagnosis” simply chose employment opportunities that fit with their personalities, rather than being forced, as they are in schools, to do what they are ordered to do with no ability to choose the activities they prefer. This is strongly supported by investigations in the 70s indicating that “ADHD” children are virtually indistinguishable from “normal” children in an open classroom environment.
In short, there is a huge number of variables involved in this analysis that are ignored, most particularly the problem of “selecting” subjects based on a subjective list of behavioral characteristics that are not truly measurable in any objective manner. This particular study does nothing to answer the bulk of questions that the diagnosis itself raises, yet even within the context of the accepted nomenclature, there is no way to draw the conclusion you claim from the extremely limited study you present.
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My objections remain unanswered. This is a speculative effort to establish a correlation between “ADHD diagnosis” and a certain genetic pattern. It is performed on a very small number of MICE. It does not address questions of rearing variables, does not establish probability of the “error” being found in the “ADHD-diagnose” population, nor in the general population vs. “ADHD-diagnosed.” It does nothing to establish any kind of “abnormality” of this genetic combination to distinguish it from normal genetic variation. One more “promise” of a “biological cause” which is nothing of the sort.
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So you’re really talking about THREE cases here, all related to each other? With similar juvenile environments? No comparison subjects/control subjects?
Seems pretty weak to me.
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As usual, you are identifying an “association.” Nothing in your article speaks of a “cause,” nor does the degree of “association” appear anywhere here. There is no comparison stating what percentage of people who have this mutation who are “diagnosed” with “ADHD” vs those who are not, nor what percentage of “ADHD” sufferers actually have this particular mutation. To claim “biochemical cause” as you imply in your first sentence, we’d need to know that almost all “ADHD” sufferers had the mutation and almost no one who has the mutation is NOT diagnosed with “ADHD.”
The article also avoids the very important question of whether or not this is simply a normal genetic variation that has been pathologized because the associated behavior is annoying to adults.
It is tiresome to keep hearing of these “breakthroughs” which don’t address the most basic scientific questions yet claim “proof of biological causation.”
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I like some of what you said, but I don’t agree that the DSM would shrink in the absence of child abuse and neglect. The DSM serves a purpose that is very different than helping people recover from trauma. It enables psychiatry to justify intervening in situations where they don’t have the first idea how to help, and it also justifies blaming the victim when their “treatments” don’t work or do harm. There are WAY too many people making money off of the current system to think they’d just back off if humans suddenly became more sane. I think the greater hope would be that humans who were NOT abused in childhood would find it easier to recognize the false “authority” of psychiatrists in the area of “mental health” and that psychiatry would die a well-deserved death in the face of actual approaches that help people learn and grow spiritually rather than ones that try to “help” by disabling people’s brains with dangerous drugs.
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Dang, 2000 mg! That really is torture!
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Excellent post! You have summed it all up in a few paragraphs!
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That data was from two WHO studies in the mid-90s, which Whitaker reports on in Anatomy of an Epidemic. They re-did the same study because the mainstream psychiatrists didn’t believe the results. They still try to explain it away by saying it is due to “cultural factors,” while ignoring the most obvious difference – fewer people on fewer antipsychotics.
You are fortunate to hear Seikkula in person! I’d love to have that opportunity!
Steve
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Another conclusion that SHOULD be obvious, but somehow is not to those making the rules.
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That is a pretty MASSIVE disparity! Of course, the psychiatrists would like to blame it on “the disease,” but the almost certain culprit is the drugs they use to “treat” it.
Would love to see someone do a comparison with “untreated schizophrenia” and see the prevalence in that population compared with those “fortunate” enough to get the best of modern medical “care.”
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I do think you make a legitimate point – Occam’s Razor aside, we can see that the results of assuming a material cause of the mind has certainly not led to any kind of success. From a purely practical viewpoint, materialistic assumptions about the mind so far appear to have led to a complete dead end.
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Fair enough. Thanks for the stimulating exchange!
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I note that the blurb on the book you linked refers to “the mystery of the mind.” There are lots of opinions and explanations, but very little hard data to base those speculations on.
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I appreciate that you say you “prefer it.” As I said, we’re talking philosophy here, not science. Until we know something of how neurons “generate inner realities,” we’re speculating. We don’t KNOW a single thing about the “mind” except indirectly by its apparent effects. My opinion is that we will not ever get there, because we’re using the mind to study the mind. The Buddhists have probably come the closest to getting a handle on it, but again, they are focused on effects, not on where the mind actually comes from or what it particularly is.
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So how have these studies led you conclude that “mind” is an emergent property of neurology? What concrete observations show this to be the case?
BTW, I admire you commitment to these studies. I totally support the study of the mind/spirit or whatever you want to call “it” by individuals and groups. I just don’t see this leading to any scientific conclusions. But I’m open to new information, of course.
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But why does the mind as a virtual extension of neurological activity “stand on its own?” It only does if we adopt a “materialist” philosophical viewpoint. Science can tell us that we have a brain and what the brain is doing and how it happens, but so far, it can’t really identify what “mind” really is. So how can we conclude that it’s a neurological phenomenon? That only holds if we pre-judge that it can’t be anything else. Which is not a scientific position, it’s a philosophical one. There are plenty who would say that the world doesn’t make sense without a “creator” on a spiritual level. They don’t have “proof” either but are just as convinced of their viewpoint.
Psychiatry, in fact, relies on a “materialist” interpretation of the world to conclude that “Mind must derive from brain, therefore Mind can be altered only by altering the brain.” I think it’s important to take a stand that psychiatry has NO IDEA WHATSOEVER what “mind” is. And my observation is that as soon as we concede that a materialist worldview is the ONLY worldview that is “rational,” we spiral very quickly down the slippery slope into pseudoscience and violent acts on the body to affect the mind. So I think it’s essential NOT to accept that we “know” that the mind is a function of the brain, and that it is, in fact, a mystery. I’m not claiming I know any more about it than anyone else, but the truth is, any speculation about the mind is not based on scientific knowledge, because we don’t really know what it is we’re talking about.
”
Until you get me a spoonful of “mind” or in some other way demonstrate what it is in a replicable manner, it remains beyond the scope of science to study.
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Worse yet! They only need ONE? It used to be three back in the 90s, then the lowered it to two. One is RIDICULOUS!!!! And how can 81% of applications be “critical” enough to qualify for an accelerated application? Corruption is rampant!
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Done.
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Well said, Brett! I think this is the highest quality post I’ve ever read from you! You are on fire!
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There is also nothing to prove that it is an emergent property, nor anything to prove it is NOT of a spiritual nature. The mind remains a mystery which Science has so far not made a dent in. Questions of philosophy must be answered (such as what IS a mind? or Do non-material things potentially exist?) before any claims can be made about the nature of the mind.
You write as if failure to prove a spiritual reality exists means that it doesn’t. It does not. Most people don’t realize that there are THREE conditions for any scientific question: True, False, and Insufficient Data to Determine. The Mind belongs to the latter designation.
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They apparently need two “statistically significant” results from two separate studies. Unfortunately, there can be 150 studies showing no response or negative response, and it doesn’t matter. It also doesn’t matter if “statistically significant” changes are meaningful to the patient/client, nor whether the client regards the benefit as not worth the cost. Study dropouts are often not counted as failures in the results, placebo responders are often filtered out at the beginning to give the drug a better chance of “success,” and still the “improvements” are often tiny and not of clinical significance.
It’s a racket!
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Reading this has led me to look at my own eating behavior and attitude towards food, and how pervasive this idea of controlling food and weight has become in our culture. It seems to happen without thinking. It seems “normal” for us to be anxious and compulsive about weight gain and about food!
It seems to me that we ought to be collectively attacking those attitudes, which it appears that many if not most of us share, rather than labeling those at the more extreme end of the spectrum as somehow “deficient” or “wrong” because their particular adaptation to these bizarre expectations and attitude about food and bodies happens to fall into a certain range. I will be thinking differently about my own relationship to food after this. Thanks, Shira!
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I honestly don’t think they know how to help. They are so busy pretending they do, they somehow don’t notice that they’re making people worse!
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That is so awfully sad!
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Unfortunately, open-mindedness doesn’t pay nearly so well as authoritarianism and good marketing!
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It’s like trying to find the “cause” of abdominal pain. If you try to find one cause, you’ll be completely baffled and decide it is “incurable,” and spend a lot of money on pain relievers and Ex-Lax. There is no reason to believe that “schizophrenia,” itself definable in so many different ways even within the DSM paradigm, is a “thing” that is caused by another “thing.” It is, at best, a syndrome that could have a wide variety of causes and potential solutions. Should be obvious to anyone who understands science, but apparently a hell of a lot of “mental health professionals” aren’t in that group!
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Yeah, I know, shocking conclusions, aren’t they?
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What if getting help from the medical field is not going to be that person? Is it possible that someone from a very different background could provide the listening and support you need?
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I would submit that there is plenty of evidence from many sources indicating that doctors/psychologists/therapists, having an inordinate power balance vis-a-vis their clients, will not infrequently abuse that power imbalance to their advantage, consciously or unconsciously. Why this would somehow NOT apply to therapy using psychedelics would be a big mystery to me. There are capable therapy practitioners out there, for sure, but there is little to no accountability or quality control. Once you have your degree, you can do just about anything that can be framed as “for the client’s good” and get away with it. I am glad you’ve had good experiences, but I don’t think we can assume from either your or Will’s experience that any particular practitioner will not take advantage of his/her position. They may do so without even realizing it, and the client then has no recourse, and often lacks the sophistication to even know they’re being misled or taken advantage of.
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First off, much of Western medicine is in fact based on fantasy, psychiatric care being the most prominent example. It is a TOTAL FANTASY that we can “diagnose” someone with a “medical disorder” by observing their behavior and comparing to some semi-arbitrary checklist created by someone laden with personal/cultural biases against some of the behaviors on the list. The clearest example is “ADHD.” We take a set of behavior that adults find annoying and put it in a list, and then “diagnose” kids who meet these “criteria,” which were created from whole cloth from the fantasy of the “acceptable student” that the creators have imagined. There is no possible way to prove you DON’T have “ADHD,” because there is no test – it is 100% “clinical opinion.” Moreover, there are studies showing that “ADHD” kids are indistinguishable from “normal” kids in an open classroom, that 30% of “ADHD” kids become “normal” if they just wait a year before starting school, or that groups who include an “ADHD” child in them are greatly improved in solving concrete problems. Yet they are “disordered” because someone didn’t like how they behaved, because they were inconvenient to adults.
Can’t get much more fantasy-based than that! There is nothing “scientific” about psychiatry when the “diagnoses” are meaningless fantasies from the powerful projected on the powerless. Basically, they have drugs, they hit you with them, they see what happens. Half the time, when it doesn’t work, or makes things worse, they raise the dosage or add more rather than removing the offending drug. There are no real standards and no clear accountability for errors or abuse. No science involved.
Second, there is plenty of evidence that many folk practices work just fine. In fact, the entire idea of drugs and pharmacies came from the use of herbal medicine, many of which have been in use for tens of thousands of years. I trust 10,000 years of human experience over a couple of biased 6-week trials from drug companies.
It is simplistic to dismiss 10,000 years of folk medicine and pretend that Western medicine has all the answers.
Oh, just to add, full operations have been done using acupuncture as anesthesia. Very unscientific? I don’t think so.
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Wow, that is a horrible story! I am so sorry you have had to deal with this level of abuse and idiocy!
I really believe the only way any of this will change is when it starts costing them more money than they are making. We need some kind of class action lawsuit where psychiatrists and drug companies and hospitals and insurance companies (especially insurance companies!) have to pay for their errors in big money.
My sincerest condolences on your loss.
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In truth, Northern Theories don’t even work well for us Northerners!
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There are many who believe that drug residues are stored in our fat cells, and can be released at later time by activities of normal living.
But half lives have a lot to do with withdrawal symptoms. Short acting drugs like amphetamines act quickly, but also leave the system quickly. The withdrawals can be extreme but the half lives are short, so the recovery is quicker. Long-acting drugs, like “antidepressants” and “antipsychotics,” take a while to build up but have very, very long half-lives. So withdrawal can last a long time.
This is not even taking into account the brain changes that happen with psychoactive drugs. It can take a much longer time for a brain to fully heal, long after the drugs have mostly left the system entirely.
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That would be part of the “pros and cons” discussion. Almost anyone who is considering suicide has some “cons,” and loved ones’ grief and anger is very often one of them. But I let the suicidal person make the list. Sometimes it is a bit surprising – not always what you expect it to be.
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I wouldn’t rule it out – they can make up anything and call it a “disorder” and no one bats an eyelash, no matter how stupid or insipid. Consider that “Intermittent Explosive Disorder” and “Oppositional Defiant Disorder” are assigned with all seriousness by “mental health professionals” despite the ridiculousness of such “disorders.” The DSM is an absurdity, so one more absurd “disorder” won’t make it any worse.
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Why should being “marginalized” be of the slightest relevance in a supposedly scientific field? Doctors don’t exist to feed their own egos! If you are not effective, you SHOULD be marginalized! It shows how invested psychiatry is in marketing over substance!
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It depends on the drug. The best you can do is use the drug’s half-life (the time it takes for half the drug to be eliminated) to make an estimate of how long it’s been in the body. Every drug has its own half life, and if you don’t know the dosage, it may be impossible to tell anything about how long the drug has been in the body at all.
Is there some reason you need to know this?
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Interesting choice to remove that article. Kinda says a lot about where NIMH and the industry is coming from!
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It seems to me like trying to tell someone it is NOT their decision to end their lives is counterproductive. What is the clinician going to do if they say they want to? The only option is to use force to stop them, which clearly is NOT their decision. So obviously, it IS the person’s decision whether they want to end their lives. When I was a counselor myself, I never told anyone that they should or should not end their lives. I simply asked them what was going on that made suicide seem desirable, or what problem was killing him/herself going to solve? Then we talked, with my effort being simply to understand and explore the pros and cons with the client. It actually was a very effective approach to help people consider other options. Whereas when I saw others take a more authoritarian approach, it tended to escalate the situation. I see no downside to acknowledging reality – it really IS their decision and it’s not the therapist/counselor’s job to “talk them out of it” or stop them.
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Posting as moderator:
OK, so is it fair to say that “There are a wide variety of observations and opinions about COVID and vaccines, and we all have to come to our own conclusions. We all hope that folks draw those conclusions from observable data rather than rumor and fear.”
I think this is as far as I want this discussion to go. It really is off the topic and is starting to move toward that “Right/Wrong” energy that I want to avoid.
Can we leave it here?
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I’d be OK with this idea, if the title were changed. It’s not “mentally unhealthy” to be worried about climate change.
It would be better to entitle it something like, “Climate Change is an Inherently Depressing Concept.” Or “People Feel Bad About the Idea that the Climate Is Deteriorating and there Is Nothing They Can Do About It.” Or “Climate Change is Pretty Fucking Scary!” Something that validates that it is not “unhealthy” to have real feelings about real events.
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It is very possible to be clear about one’s relationship and still be warm and friendly and caring. You simply have to say what you are and are not willing to do. The fact that a lot of therapists are not good at this doesn’t make it not possible. People are looking for authenticity and genuine caring. They don’t want an artificial relationship with a semi-robot, who asks questions but doesn’t care about the answers. Caring is the essence of being a good helper to anyone else. A person who can’t muster up some genuine caring should do his/her clients a favor and go into some line of work where they don’t have to deal with people in vulnerable situations.
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Can’t disagree with a word. They are criminal organization, and should no longer be allowed to sell ANYTHING.
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I agree. Any company who has sold drugs that create TD should provide palliative or corrective care FOR FREE as a condition of being allowed to continue as a company. Double if they denied or hid that their drugs created TD. It pains me deeply to see the ads now for TD drugs, yet further profits for companies to “treat” the very disease they CAUSED!
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POSTING AS MODERATOR:
I appreciate the ongoing interest in this topic, but again, this is not the forum to argue about COVID. People have stated their positions, which I absolutely support, but I don’t want to see us getting deeper into claims/counterclaims on this subject. I will begin disallowing posts as “off topic” if it gets into that kind of exchange.
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COMMENTING AS MODERATOR:
Thanks as always for everyone contributing their views to this discussion. As I’ve noted before, COVID and vaccines are a complex and controversial issue involving science and sociology and politics, and people have strong and sometimes passionately divergent views on the subject. I want to let people say what they need to say, but this discussion in the past has deteriorated into a very personalized and unproductive discussion. I’d like to make sure that does not happen, and I ask folks to own their own viewpoints and be very careful not to condescend or insult others who disagree with your views. If such a deterioration does occur, I will very quickly stop any further COVID postings as off topic. Though I know there is a relationship via Big Pharma, I’d prefer if we stick to talking about psychiatry!
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If that is the case, then psychiatry as a whole is provably and undeniably bad. It is well established that those in psychiatric “treatment” for “serious mental disorders” (read “bipolar” and/or “schizophrenia) die an average of 20-30 YEARS earlier than the “untreated” person. I’m sure similar outcomes are observable for “anxiety disorders” and “major depression.” It is the only profession where treatment measurably DECREASES life expectancy!
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We have dropped to a pretty low point if we have “doctors” telling us we are “too happy!”
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It is odd that they are so afraid of “peer relapsing” while the professionals get off the hook for all kinds of mental/emotional lapses. Discrimination, at the least.
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It seems to me that you’re saying a person has a right to view him/herself as ill if he/she sees it that way. I don’t hear anyone arguing with you on this point. I think you may misunderstand that when someone says, “ADHD” is a bogus diagnosis, they don’t mean that no one acts or feels that way, just that labeling that set of behavior and calling it an “illness” is not a scientifically valid undertaking. I’m all for people identifying as they see fit, as long as they don’t do it for someone else. So for you to say you have an illness called schizophrenia is your right. For Doctor So-And-So to tell Mary that SHE has an illness called schizophrenia, despite his complete lack of ability to objectively tell her what that means, THAT is where the problem arises. Some (like you, apparently) don’t mind that label, and that’s all fine for them. But what of the person who doesn’t agree that s/he is “ill” by the DOCTOR’S definition? Where are their rights? By your philosophy, don’t they have a right to refuse that label put on them by a doctor without consultation or agreement?
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When there is no objective way to distinguish who “has schizophrenia” from who doesn’t, there is no way to actually DO a study, let alone draw legitimate conclusions from one. I agree with you, distinguishing what a person has DONE is much more useful that trying to tell them what the ARE, especially when the definition groups together people who have little to nothing in common other than certain arbitrary “symptom clusters” that are not subject to anything but the opinion of someone with letters after his/her name.
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Good move!
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Another psychiatric “success story!” It is always stunning to me how absolute proof that the drugs were doing DAMAGE, let alone not helping, does nothing to move them from believing you are crazy for stopping their wonderful drugs!
Thanks for sharing your story, and well done for getting out of their clutches!
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More like “pathetic abilities!”
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Higher standards would be an improvement, in that fewer truly useless drugs will get to market. But it doesn’t really address the fundamental problem in psychiatry, namely that we are dealing with subjective phenomena and pretending that we can objectively “diagnose” something that has no objective reality in the physical universe. So if we say the HAM-D scores need to be a 50% decrease from baseline, there is nothing to stop investigators from diddling with the data to create the apparency that there is such an improvement. There is also the problem of “negative” studies being buried and only the “positive” studies being published. This is, of course, anti-scientific in so many ways, including the idea that a study that proves a drug ineffective is “negative.” We SHOULD be after objective evidence, not a particular “positive” outcome. But that’s just the starter. The whole system is so corrupted, it’s hard to know what can be done to fix it.
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Agree 100%. All these “awareness months” are is taxpayer-subsidized marketing opportunities!
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Honestly, the attitude is worse than the worst of the drugs! You come in and they tell you, “Well, your brain is broken, this has nothing to do with your decisions and/or experiences, and there’s nothing you can do about it except take drugs and hope they work for you.” Talk about discouraging!!!! And then to tell you that “there are no good treatments” to your permanent brain disease? If you wanted to induce suicidal thinking, that would be a good way to get there. Very disturbing to think that is how far our “mental health” system has sunk!
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It is hard to see what ethical standards can be applied to making a totally subjective “diagnosis” based on somewhat random, subjective criteria and “clinical judgment.” I tend to agree that the truly ethical approach to such assessments would be to simply not do them, or at a minimum, make sure everyone knows that the results are utterly subjective and only as useful as the person receiving the “assessment” chooses to find it.
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All I can say is, VERY well done for finding your path!
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It’s not about “assessments,” it’s about conflicts of interest. Unless those doing the “assessments” are completely free from any financial conflicts of interest, there will be both conscious and unconscious efforts to slant the data toward increased profitability. It’s not realistic to expect people to be objective when their financial well being and status are tied up in a “positive” assessment.
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A sociopath’s dream, for sure!
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Or grasping at money!
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I think the real point of The Emperor’s New Clothes is not that the Emperor will become enlightened, but that those in the crowd who were afraid to say what they saw were now free to make that observation, because someone spoke up and validated what they all knew. I think that’s our role here – we have to keep pointing out that there ARE no clothes to new people who feel like something is wrong but haven’t gotten to the point where they feel OK saying it out loud. People will arrive at that point at different times and different ways, but at least when they do get there, they’ll hear someone else saying, “No, you’re not crazy. They really ARE completely clueless AND dangerous, and they ARE making your life harder instead of easier!”
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OK, good to know. The reason I ask is that I’ve seen some excellent plans and projects funded initially and have great potential, but as soon as they have to compete with “mental health services” for actual dollars, they get defunded pretty quickly. The “mental health” industry is OK with things like this operating as a fringe or “alternative” approach, but as soon as they see their own funding threatened, the gloves tend to come off!
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To what degree are these trauma centers funded by the “mental health” system, and to what extent by outside agencies, such as government grants, domestic abuse agencies, child abuse prevention programs, etc.? I do find this encouraging but want to put it in perspective.
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VERY well said!
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“Could have been misdiagnosed?” What a ridiculous argument they make! If you STOP the drugs and you GET INSTANTLY BETTER, they OBIVOUSLY “misdiagnosed” you, because the DRUGS WERE CAUSING THE PROBLEMS! It is well known (and is on the consumer handout) that stimulants can cause mania and/or psychosis at typical, prescribed doses in children. What’s even more stupid is that anyone with the slightest background in brain biochemistry knows that stimulants increase levels of dopamine. Psychiatry’s own self-appointed gurus have long claimed that psychosis is a result of high levels of dopamine in the brain. So they “antipsychotics,” which you were no doubt prescribed, LOWER the amount of dopamine. So you were given one drug to RAISE dopamine levels, then another to REDUCE the artificially high levels caused by the stimulants. And they say you are “in remission?” The lack of responsibility is staggering! But unfortunately, not at all rare.
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This is what happens when you “diagnose” people with purely subjective criteria. Someone’s opinion becomes “your diagnosis,” and you have nothing to argue against them except for common sense. Yet, as we see here, common sense is NOT particularly common amongst the supposed “experts” in the “mental health” system. The most obvious things in the world, such as the induction of psychotic behavior by a drug that is known to induce psychotic behavior, can be completely denied despite an again obvious “recovery” immediately following withdrawal of the offending drug.
I’m so sorry you’ve been through this. I hope you and your family have drawn the proper conclusion that these people can’t be trusted to have your best interests or even basic logic at heart, and will stay as far away from anyone who tells you “you have X disorder” as you can possibly get.
Humans survived for hundreds of thousands of years without brain drugs. You can, too.
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I think it’s a little presumptuous to state that they are “effective regardless of some minor unwanted side effects.” First off, they may be effective for you, but that doesn’t mean they are effective for everyone else, and it feels like it invalidates others’ experience to say otherwise. You wouldn’t want others to tell you they don’t work at all, so I think it’s fair not to tell others that they “work” as if your experience is true for everyone.
Second, let’s not pretend that the side effects are always “minor!” There are many people on this site who have had awful “side effects,” including loss of sexual functioning, loss of feelings of pleasure, psychotic symptoms, suicidal and/or homicidal feelings, loss of appetite, and many more. Again, you are assuming that other people have experiences similar to yours, and I can assure you that this is by no means always or even most often the case.
With all due respect, we work to be accepting of everyone’s experiences here. It would be appreciated if you would do the same.
Additionally, I am not aware of ANY research ANYWHERE that identifies a particular “pathway” or “circuits” (or that even is able to objectively identify a physical “pathway” or “circuit” in any manner) that is associated with ANY DSM disorder. The psychiatric profession has finally disclaimed the “chemical imbalance” theory, only after decades of pressure from many quarters, including researchers themselves. The idea of “circuits” being involved is just another theoretical explanation that lacks supporting evidence. When I see research where a “pathway” in the brain is objectively defined and where some objective measurement of “flow” through the “pathway” is obtainable, I’ll start listening to talk about “pathways.” The psychiatric profession has spent decades manufacturing and falsifying and exaggerating or minimizing research to suit its own agenda. I don’t really care what “the experts” have to say, I want to see the research myself before I believe it.
Finally, I will submit that, however well antidepressants or any other drug in question work for a particular person or group of people, the very idea that “mental illnesses” are purely physiological phenomena that will admit to a purely physiological cause in all or even most cases is, again, pure speculation, and indeed ignores obvious evidence to the contrary. If it’s all biology, why is it that immigrants and urban populations and people sexually abused as kids have much higher rates of schizophrenia diagnoses than the general population? Why is adult depression and anxiety associated at a 90% or better rate with childhood abuse and neglect? How do people get better without drugs or medical interventions at all? How did I overcome serious depression and anxiety with therapy, reading, and facing life’s challenges with support from friends and family and community? Do you wish to invalidate my experience by claiming that I “didn’t have depression, really” or that “it wasn’t that bad,” or is it that my brain chemistry somehow changed through my own thoughts and relationships and interactions with life? And if my brain chemistry can change (and there’s plenty of evidence that it can) through social experiences and alterations of thought and behavior patterns, why would you insist that drugs are the answer for everyone?
How do you explain the actual PHYSICAL changes in the brain that happen with meditation or other processes that don’t involve any kind of physical intervention at all if it’s all biological?
I am glad the drugs have worked for you. You are certainly not alone in saying that. But please, don’t try to talk down to people who have had different experiences. My belief is that “depression” isn’t even a legitimate category of “disorder” – people are depressed for a myriad of reasons, some physical, some psychological, some spiritual, some social. What works for one person doesn’t work for every other person. We all need to find our own paths. You have found yours – let other people find their own and explain to YOU how it is for them, instead of assuming you are in a position to tell the rest of us “what is true.”
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I’m confused – you said Prozac was a wonder drug, but you would “still take it now if it worked?” Did you stop before you did the TMS?
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Out of control children have been managed without a “diagnosis” or drugs since the beginning of human history. I think the problem is not so much one of “out of control children” as isolated parents lacking support. We were not willing to consider any kind of drug intervention for our boys, so we had to figure it out. Much as you did, we used dietary changes, good parenting skills, and a lot of patience. And we read a LOT about how to manage challenging children. They both turned out OK without a milligram of “treatment.” The one who had the most problems was the one who was NOT difficult as a young child! So you’re right, every child is different!
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Beautiful post, JanCarol! This reflects my experience completely!
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“True clinical depression” is completely subjective and indistinguishable from “mere sadness.” Not even the DSM has “criteria” for “clinical depression.” It sounds like a technical term, but it is literally meaningless in terms of any kind of research or statistical purposes, even within the sketchy confines of psychiatry’s own subjective “model” for understanding “mental illness.”
I also don’t find it convincing that we ought to prescribe drugs “until something better comes along.” There are lots of people (including me) who find their own pathway out of feeling severely depressed. It is an error to assume that all “depressed” people have something wrong with them, or that all who DO have something wrong have the SAME thing wrong and need the same kind of help. “Depression” is a catch-all category that says absolutely nothing about what the person is depressed about or what can or should be done about it. When someone says “depression is a fake illness,” they don’t mean that depression doesn’t happen, they mean that “depression” is not a real entity that is valid for study and conclusions. It is not helpful to group all “depressed” or “clinically depressed” people into the same category when any two “depressed” people may have little to nothing in common with each other beyond how they happen to be feeling.
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I would say that there IS a consensual psychiatric model. That model assumes that 1) there are such things as “mental illnesses” which are distinguishable from “normal” conditions. 2) these “illnesses” can be “diagnosed” by “professionals” with sufficient training. 3) there are “treatments” available for these “illnesses” that can “reduce the symptoms” of the “illnesses.” 4) These “illnesses” are essentially physiological in nature and inhere in the person experiencing them rather than in the environment/culture or in the relationship between the environment/culture and the person. 5) That these “disorders” can be described and “diagnosed” using the DSM or the ICD or some other “diagnostic system.” 6) That these are “medical” problems that need to be handled by “services” provided by “medical providers” and paid for by insurance. 7) That sometimes, these “disorders” become so unmanageable that “treatment” must be forced on unwilling participants “for their own good.”
Admittedly, there are plenty of free-floating and irrational interpretations that are pulled out when necessary, but I’d say all of these interpretations are expected to fit into the above. As a former “mental health” professional, I can attest that violating these tenets results in hostility and in some cases even shunning by the system insiders. Not sure how “consensual” it is, but it certainly seems to be expected that people will agree to these basic tenets, and in fact, clients/patients are “diagnosed” as more serious to the degree that they deny the “validity of their diagnosis.” It’s pretty solid in my view.
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Placebo effects are very real and very powerful. It is upsetting to take away someone’s belief in something they believe is magically helping them feel better. The fault lies with those who have perpetrated the lies their upset is built upon.
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A model is useful only to the degree that it correctly explains predicts the effects of actions we take into the future. The psychiatric model explains nothing, obscures real causes, and fails to predict even the success or failure of its own interventions. Therapy models to date similarly fail to account for observable facts nor are they able to predict the outcomes of their own interventions. I’ve got nothing against models, but they need to work!
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The other big question that is almost always avoided is, WHAT should the endpoint be? Is a “reduction in symptoms” really the result that is wanted? Is making a person “Less depressed” a legitimate outcome? Would we not want to look at “quality of life” variables as being more important to the client?
Plus, Irving Kirsch’s work has showed clearly that the FDA rule of submitting two positive studies out of ALL studies being done totally skews the results. How much research is never even released because it doesn’t say what the manufacturer wants it to say? How many drugs are on the market as “safe and effective” when the TOTALITY of the data says that it doesn’t really work or is far more dangerous than claimed (Viiox being a great example)?
There is much to be answered for in the area of “scientific” research, especially when it comes to psych drugs.
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I think 20% is VERY generous. We know that half or more of all medical research is not replicable. I think we can extrapolate that much of the research that isn’t replicable is also lacking in integrity.
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It cuts into profits if you start making people better!
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Harrow’s study showed that “psychotic” patients with WORSE prognoses did BETTER off drugs than the people with BETTER prognoses did ON drugs. So the idea that those with “less illness” go off the drugs is a marketing scheme. It’s not true.
I think the answer to the question is either 1) because it doesn’t work, or 2) because the “cure” is worse than the “disease.” As Hemmingway quipped, “It was a brilliant cure but we lost the patient.”
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As I’ve stated before, the whole idea of “shared decision making” suggests that the CURRENT model is “non-shared decision making,” which equates to THE DOCTOR GETS TO DECIDE! In other words, “Shared decision making” means the DOCTOR deigns to “allow” the patient to “have a voice” in deciding what will happen to his/her OWN BODY! Something is VERY wrong with this whole idea!
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I am quite certain that taking enough of any mind-altering drug for long enough will cause some level of brain damage.
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Wait, you mean encouraging people to KEEP using drugs instead of quitting led to more overdose deaths? How can that BE, Patrick? It is SO counterintuitive! /s
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Very well said!
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I’m not sure the system is “broken,” I think it just has hidden objectives that most of us find abhorrent!
I had the same experience as you back in the 70s. I had a therapist, we met once a week, we talked about my motivations and barriers to my success, we reviewed some traumatic history, I practiced new ways of thinking and acting – no drugs were considered or needed! And I never got an official “diagnosis” from my therapist, though I’m sure she had to submit one to get reimbursed. It just wasn’t important. I wasn’t considered “ill,” I was considered one of the smart ones who realized that he could make his life better. My therapist and I both agreed that it is a lot saner to seek support than to continue pretending things are OK. It was a very supportive relationship – no “stigma” involved, and no drugs needed or wanted.
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I agree. The news and entertainment media are also a HUGE part of why “everyone believes” in chemical imbalances, while even the most cynical psychiatrists nowadays have to admit it’s kind of a crock of horseshit. The message is out there in many forms, and I think a lot of people get their “Truth” from movies and TV shows. It is a lot to battle!
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How about “Fight the stigmatizers – AKA your psychiatrist!”
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An “incurable disease” is cured by NOT engaging in “treatment!” It’s a miracle!!!
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Just to be clear, all of the evidence suggests that Williams did receive what would be considered the top of the line in psychiatric/substance abuse treatment and therapy. This is not a case of someone “unwilling to seek treatment due to stigma.” This is a case of treatment failing him over and over again over many years.
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“Froward” is a word. It means difficult or contrary or rebellious. It’s never used any more, but I know it from Lord of the Rings. “Oft faithful heart man have froward tongue.”
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Well, at least the FDA caught on that time. Too many times, the FDA itself colludes in passing through questionable drugs.
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I don’t see this so much as a dilemma. The simple expedient is to treat people who present as dangerous based only on the dangerousness of their behavior, not on any presumed “mental illness.” The truth is, one could say that any person committing a crime is on some level “crazy” because they are risking prison for some drama they want/need to act out. What is to distinguish someone who is willing to hold up a convenience store from the lady who tossed the baby out the window? The only real criterion that makes sense is to say that they did harm or threatened harm to others, and are therefore held in custody until that situation is resolved. “Mental illness” doesn’t have to enter into it at all. And even if we do decide we can “hold” someone for these subjective and legally vague and rhetorically nonsensical “illnesses,” it does not follow that they can/should be forced into “treatment” against their will. Their job is to demonstrate that they are no longer dangerous.
Of course, help of many kinds can be offered, and people who don’t find a way to alter their circumstances might be incarcerated for some period of time, but that’s the same for any kind of criminal behavior. I’m all for completely decoupling the idea of holding someone for being “a danger to self or others” and the idea of them needing “treatment” of some kind. There is simply no way to figure out who is/isn’t “mentally ill,” let alone who will “benefit from treatment.” That being the case, it seems beyond unethical to force “treatment” on someone based on these totally subjective labels, especially when it’s entirely possible that the “treatment” you’re forcing on them may kill them before their time!
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I have had similar epiphanies many times in my life. When “everyone knows” that something is “accepted practice” and no one ever provides another perspective, sometimes some very weird or dangerous or just plain oppressive things seem “normal” and people who don’t adapt “abnormal.” Sometimes it’s very odd looking back on it that I’d ever accepted that viewpoint, that the obvious injustice or irrationality of it did not just smack me in the head before the scales fell from my eyes!
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I found 9.
https://journalofethics.ama-assn.org/article/antidepressants-and-fdas-black-box-warning-determining-rational-public-policy-absence-sufficient/2012-06
The others are probably “antipsychotics” like Risperdal and Seroquel that act on both the serotonin and dopamine systems. It appears that messing with serotonin is what causes the increase in suicidal thoughts/behavior in some of the people who use them. Not that this deters doctors from prescribing them by the millions, mind you. But we all knew that!
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COMMENTING AS MODERATOR:
Can we please leave the discussion of disease/not disease for this thread at this point? I think we’ve heard both sides of the issue thoroughly aired, and it’s starting to feel a little personal at this point.
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Again, why the “shared decision making?” I don’t SHARE decision making with my doctor or medical provider. S/he gives me information and advice and I MAKE THE DECISION. There is no sharing, it’s my call, every time. Why is this glaring violation of the rights and the self-respect of so-called “mental health consumers” not obvious to anyone looking at the situation? The very concept infantilizes the clients. And remember, we’re not talking about the client choosing to “share decision-making” with their doctor. We’re trying to convince the DOCTOR that s/he is not entitled to just do whatever the f*&k they want to the client without his/her approval. The argument is now, “Gosh, don’t you think you might CONSULT the client before YOU decide what you’re going to do to them?” This is totally ass-backwards in my world. I will never see a medical professional who thinks s/he gets to tell me what to do, and I’m glad that I have the privilege and the skills to carry out that intention. But many people don’t even see or understand what is being done here, let alone have the courage and ability, or even the legal right in many cases, to tell the doctor to go stick it where the sun don’t shine. That is not an acceptable situation!
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It does seem to at least create some options for a person who is being abused or taken advantage of, but sounds like it leaves a lot to be desired.
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They don’t really use a scientific “model.” They use a marketing/business model, based primarily on what will convince the “customer” that their “product” is something they should buy. No science is involved, except the “science” of how to convince people to change their minds and do what you want them to do.
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Wow, sounds like teaching apathy. “Do it this way, but if it doesn’t work, give up!” I thought therapy was about reclaiming one’s power? Silly me!
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I wouldn’t so much mind agreeing to use GIVE skills, as long as the professionals made it their priority to do the same! And they obviously were NOT practicing those when talking to you! Hypocrites!
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Response to “I’ve never heard of anything like that!”
“Well, now you have!”
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I think “therapy” deserves to be in quotation marks here! There is nothing “therapeutic” in intent or effect when hiring someone to shame and humiliate your child further than you as a parent have already managed!
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I don’t believe in “shared decision making.” I believe in the client making ALL the decisions, with the advice of their chosen medical advisors.
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Well, as I said, I agree with you in the main. People intentionally committing evil acts are rare, but I felt their presence needed to be pointed out. Most of us need MORE time in our comfort zones, not less.
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Of course, I agree with you that most such people are indeed quite uncomfortable. But there appears to me to be a small but solid cadre of folks who actually are quite comfortable believing they are “helping” even when all the evidence points the other way. They are very blithe about explaining away anything that doesn’t support their viewpoint, and seem quite comfortable as long as there are enough people around them to support their viewpoint. Admittedly, there is a lot of anxiety underlying their apparent ease, and that comes up when they are challenged, but their “comfort zone” appears to be quite compatible with people being harmed “for their own good.”
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I think it depends on what they are feeling comfortable with. I they’re comfortable harming or discriminating against or oppressing others, I’m all for making them uncomfortable!
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That is great news!
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The thing about this is, Buddhism and other spiritual approaches aren’t “treatment.” I don’t have a knee-jerk negative response to the idea of “alternatives,” but if they are “alternatives,” they should be alternatives to viewing emotional distress as “mental illness” and alternatives to pretending to provide “treatment” in the medical sense for problems that are not medical in nature.
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Hey, that sounds like good news for the Forces of Justice!
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The FDA is populated by people who are part of the drug industry. That’s what I meant by my comment. We need people who don’t have a financial interest in the outcome. There are plenty of scientists in other fields who know enough to evaluate the studies – they don’t have to be doctors or drug company investigators, in fact, we’d be better off if those evaluating drugs had zero attachment to the medical field or drug research at all.
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We need an oversight and licensing entity that is not beholden to those who profit from selling drugs that don’t work!
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Is there any way to “leave town,” as it were? What would happen if you were no longer in France? Would they stop you at the border or something?
Sounds awful!
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“Laughable” is right, or would be, if there weren’t so many casualties of the process!
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I am sure that stuff like “neural atrophy” and other physiological phenomena both result from and contribute to what the DSM refers to as “mental illness.” I’m not familiar with the concept of neural atrophy, but it seems like it suggests that trauma causes certain kinds of neurons not to grow or to die off. This would not be at all surprising. There is also literal brain damage that comes from taking neuroleptics or other “psychoactive drugs” like stimulants or “antidepressants.” There are also real diseases like an underactive thyroid or Lyme disease or other conditions that directly affect people’s mental/emotional functioning. And of course, the fact that one has a chronic or terminal disease going on affects one’s psychological well being as well. So it’s very complicated. I don’t think a person severely traumatized in childhood can ever get to a point where their childhood traumatization is not relevant or impactful in their lives, probably on a physiological as well as a psychological/spiritual level. We know that traumatized people are more likely to contract or develop physiological ills, even controlling for ineffectual pseudo-medical interventions by psychiatrists and their subordinates. So there is a physiological effect of trauma, and there is a psychological effect of physical illness. It’s all interconnected, and we’re better off just focusing on individual situations and what works for a particular person rather than trying to generalize about “illnesses” that are not objectively discernible.
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I have never said that there is no biological contribution to what is called “mental illness.” I am only opposed to ASSUMING that any one “mental illness” as defined by the DSM is CAUSED by “bad biology.” I’m not even saying that SOME cases of what is called “mental illness” are NOT caused by “bad biology.” My main point is that something defined entirely by a list of social/emotional/behavioral indicators is VERY UNLIKELY to have a biological cause in all or even most cases.
I hope you see the difference between a biological CAUSE that is consistent for all cases vs. a biological ASPECT that is present in some of the cases, which may or may not be causal. There are biological similarities between people who are feeling aggressive, as an example – elevated cortisol levels, for instance. But that doesn’t mean that elevated cortisol levels CAUSED the person to behave aggressively. It could be a cause, an effect, or simply a correlate of the body’s preparedness for fighting. It is biological, but “aggression” is not an “illness” caused by high cortisol levels.
Does that make more sense?
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I agree 100%. If a plumber promised to fix your leaky pipe, then ended up flooding your basement, and “fixed” that by burning down your house, they would owe you the cost of replacing everything they ruined, plus additional for the inconvenience and emotional turmoil you experienced as a result. Why would this NOT apply to psychiatrists? If you are paying them to improve your “mental health,” and it observably gets worse, and your physical health deteriorates as well due to their “treatments,” at what point are they responsible for damages? Seems like simple breach of contract to me for starters, with aggravating factors involved with worsening instead of improving your condition. I guess normal rules of contract don’t apply to psychiatrists?
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You mean like having facial hair?
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COMMENTING AS MODERATOR:
I enjoy the exchange of views, and I do think political parties have some bearing on decisions to enforce “treatment” on people just because they happen to be homeless. I do want to make sure this doesn’t shift off onto a philosophical argument about which political party is “better.” Let’s keep focused on the issue of the article, planning to “force homeless into ‘treatment.'”
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You’re right, of course. Psychiatry has not failed, it has succeeded admirably. People are just confused as to its aims. If it were designed to help people be more effective in managing their lives, it would be a failure. But if the purpose is to deflect attention from the real issues and blame the victims of abuse and oppression for their adverse reactions, meanwhile making boatloads of money, it has been an unqualified success.
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I can get behind that – “Sad Pride!”
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I loved this article! It really gets to the heart of these eugenic, racial superiority themes, which have been around for centuries, probably millennia. It’s a bit shocking even to me how the exact same language is used today that was used 1-200 years ago. It goes to show that the real problem with psychiatry, and our society at large, isn’t a failure of honest people to understand the issues, the real problem is certain people believing they are superior to other people and looking for “science” to justify their continuing acts of oppression.
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In fact, stopping people from pointing out such divisions is divisive in itself.
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Step One: Keep them away from anyone who thinks their brains need to be “fixed!”
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Well stated.
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I can see that. Self-desensitization seems like it’s very possible. But if someone is going to try and help someone else, listening is the starting point. I agree 100% that there is no special advantage to using “EMDR” or other “specialized” procedures. There are some tricks or techniques that can be used to help someone feel safe to share, but the basic is not trying to tell the other person what to do or think, but instead listening to their story. I’ve certainly seen writing, art, music, pets, etc. serve an equally valuable role to a “therapist,” or to a listening and caring friend. Whatever works is what works, and therapists have no corner on the market of “helpfulness.”
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It is a certainty that the action of Benzos is very, very similar to the action of alcohol on the brain. Both affect primarily the GABA system, and benzos have long been used as a controlled way to withdraw alcoholics from alcohol dependence without bringing on possible deadly withdrawal effects. I am quite certain it would work the other way if it were tried. So taking benzos is very similar to drinking. The only big difference is dosage control, and of course, lots of people increase their benzo dosage beyond what is prescribed. They are sold as street drugs, too. The one time I served on a jury, the defense tried to get his client off of a DUII by pointing out that he was taking Valium and that the effects were almost indistinguishable from alcohol. They are very close to being mimics of each other.
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I’m absolutely sure that watching Queer Eye leads to changes in PET scan or SPECT scan patterns in the brain, and leads to positive changes in a range of neurochemicals believed to be involved in mood regulation! We just need to have some people watch it in a scanning machine, and we can start selling it as “therapy!”
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Not sure what you’re saying here. What is there “more” than the fact that the therapist is listening non-judgmentally and interestedly? I know there are a few techniques tossed in there, such as the concept that if a trauma doesn’t lift, there is an earlier one of a similar nature that needs to be examined. But I’m saying the eye movement or tapping or whatever seems extraneous. Are you saying that “tapping” and that sort of thing was a staple of folk wisdom for a long time? I’d be very interested to hear what you have to share on that point.
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The best plan, I think, is generally to refuse them politely. Remind them that you have a right to refuse medical treatment, and you’re choosing to decline. This would only be a problem if you are already on their “radar” as a “crazy person” (oops, I mean “Person suffering from mental illness!”), in which case, I think a very careful lying strategy would probably be safest. “Have you had difficulty sleeping?” “No, not at all. Sleeping great!” Etc. If you read up on the so-called “symptoms” of what they’re screening you for, it’s pretty easy to stay ahead of them.
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I always thought the eye movement deal was hokey. I think telling one’s story to someone who knows how to listen and is interested is the primary source of “mental healing,” if that’s the proper term. A lot of folks really twist themselves into pretzels trying to come up with a “biological” explanation.
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You are talking individuals vs. societies. Societies can agree on pretty distorted things without needing the “leadership” of a sociopathic person. You have a very rose-colored view of society if you think that simply removing bad players will suddenly make people bright and perceptive and assertive and planful. Doesn’t Dianetics suggest that people have to deal with their own traumatic pasts before they can become rational? Do you really think everyone will suddenly become rational just because intentional oppression by individuals is removed? With respect, I don’t. People working as groups is a totally different thing than individuals getting out from under oppressive control of other individuals. At least, that’s my take on it. Surely, the concept of mis-education and distorted belief systems in the minds of people of good will is real and meaningful to you?
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Here’s the thing, though. Even if we eliminate the psychopathic types from our society, they have created ways of doing business that require sociopathic behavior in order to succeed. For instance, we could eliminate all the sociopaths from the field of psychiatry, but we have millions and millions of people who still believe that these “diagnoses” and “treatments” make sense, and these people will continue to pound this false data into those they train, and very little will change.
The sociopathic types prevent positive change, so eliminating or restricting their reach makes positive change more possible. But there needs to be a concerted effort by the pro-socially-oriented people to create systems that don’t reward sociopathic behavior.
Just as an example, I’ve always thought that “reading groups” were a horrible way to teach kids to read. It requires them to “sound out” words they don’t understand, and to pronounce words correctly that they have never said out loud before. There is little to no emphasis on actually understanding the passage being read, and those who decline to read out loud are shamed for it. I could go on.
But those who apply “reading groups” believe wholeheartedly that it is a viable approach! They would be upset if someone told them differently. “It’s how we’ve always done it.” “How would they learn to read otherwise? How would we KNOW they were learning?” It doesn’t require a sociopath to continue this process, because everyone believes it’s necessary without really thinking about it. So there is a massive re-education and re-creation that would need to happen if we wanted reading instruction to improve. It’s true, this process would be much easier without the destructive people who are interested in control and punishment rather than education. But the system they are implementing continues to be oppressive, even if none of the teachers are personally sociopathic in the least.
This same thinking can be applied to any system you’d like to think of. There are expectations, rewards, penalties, restrictions, processes, agreements, etc. that determine how the particular activity will be conducted. These systems have a “life of their own” in a sense – a complete turnover of staff can occur without the business/agency culture changing in any significant way. That’s what I’m talking about. Some people like to destroy stuff and people, and will try to twist whatever system that exists to their nefarious purposes. But that’s not the whole story. People need to learn how to communicate and work together as a group to improve or retool or trash the group agreements that exist but don’t really work very well, or to create new agreements. This takes a lot more than just getting rid of the bad players, IMHO.
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I saw kids all the time in foster care who would be given Ritalin or Adderall for “ADHD” and then get aggressive or even psychotic. Rather than stopping the stimulants (which we KNOW can cause aggression or psychosis), they’d give them a NEW diagnosis and put them on yet another drug! It was very common, and very irrational!
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I will choose to take your words as honest and not intended to hurt. But they do hurt. I think it best we abandon this discussion. It appears that we are unable to understand each others’ words, which is OK. But I can never agree to “keep women’s stuff” out of it when in my view it has been built in from the start. Obviously, you are unable to see what I am looking at, and that’s OK. But let’s not take it personally that we disagree on these points.
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I can’t agree with your conclusions from this data. The fact that women are more likely to go into psychiatry does not mean psychiatry does not discriminate against women. This is where the individual vs. group viewpoint comes into play. The women as individuals are most definitely women, but they are buying into and implementing a model which at its core is discriminatory towards women. They are participating in an oppressive SYSTEM, regardless of their individual orientation, and after being trained in this system and surrounded by this system and criticized and sometimes attacked when they stray from the expectations of the system, they eventually quit or comply with the system. And if the system is based on assumptions that are sexist or racist or whatever, that person, regardless of sex or race or whatever, will enforce these norms and internalize them without even noticing that they exist.
Let’s take the example of “Borderline Personality Disorder.” The description of this label generally encompasses typical reactions of a person who has been abused and/or neglected intermittently from early life onwards. They are describe as having difficulty trusting people, having volatile emotions, using indirect (“manipulative”) approaches to get their needs met, having a hard time maintaining relationships, anxious, distractible, etc. I worked for years with foster children, and a large number of kids fit these descriptions. So what does the system say to DO with that person? Whether male or female, younger or older, black or white, feminist or not, the system says you DIAGNOSE this person and then you TREAT them. The person is identified as having a “dysfunction” and the fact that they have been abused/neglected, placed in foster care, moved around, separated from siblings and extended family, currently in an overcrowded foster placement lacking in affection, had their schooling interrupted and had to move repeatedly and lost friends and support people every time, is of no actual interest or consequence. Since a third of women are sexually molested or sexually assaulted in their lifetimes, and a quarter experience physical abuse from a domestic or dating partner, not to mention the myriad day to day abuses and “microagressions” women have to put up with, ignoring these experiences is highly invalidating and destructive to any effort to actually be of assistance to people who get these labels. In fact, having been labeled “borderline” opens them up to an entirely new brand of oppression, with of I am confident you are quite aware.
The fact that your psychiatrist happens to be female has absolutely zero effect on this process. They are trained just the same as their male counterparts, and generally believe that “Borderline personality disorder” is a real thing that can be “diagnosed,” and that this person needs “treatment,” normally in the form of drugs and some kind of other-directed “therapy” like DBT. The person that abused her is considered “normal” and never gets identified, let alone “treated.”
So the SYSTEM is discriminating against women, whether or not the practitioner is female. Unless the practitioner him/herself becomes aware of the anti-female, anti-abuse-victim mentality built into every aspect of the system of “diagnosis” and “treatment,” the practitioner will continue to perpetuate this mentality, regardless of the sex of the practitioner. That’s how systemic bias work. It transcends the intentions and experiences of the individual.
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I appreciate the clarification, and I do understand what you’re saying – in the end, it is not helpful to identify as “oppressed” and to blame “oppressors” for your condition. What I am concerned about is not an individual’s attitude, but a recognition that oppression is a very real thing that actually happens to people, regardless of what attitude they assume. It’s a delicate balance, but oppression really does exist and needs to be called out for what it is. Otherwise, saying “don’t view yourself as oppressed” becomes another form of oppression – we are not only told how to identify, but we are blamed for not having a “positive attitude” and told our reactions to the very real oppressions that have and continue to occur to us are the problem, rather than recognizing and attacking the oppressive attitudes in those doing the oppressing! It does not help anyone to be told that you are “inviting oppression” by identifying that women, dark skinned people, or psychiatric “patients” are being victimized by those in power. As much as I believe in empowering people to take charge of their lives, the real story of how we got where we are and what forces are arrayed against us needs to be told. I don’t see it as “identifying as oppressed” to say, “Men are allowed to get away with a lot of shit in this society that women can’t.” It’s just plain facing reality.
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I agree 100%. I was using the most concrete and unrefutable examples. I have worked with domestic abuse victims for decades and it is very clear that men and women doing exactly the same thing gets a very different response. There are way too many examples to cite here.
In fact, one of the huge and appropriate criticisms of psychiatry comes from feminist writers in the 70s and later on. (Probably earlier, too, but I just haven’t read them yet.) They point out that many manifestations of surviving abuse at the hands of men, often sexual partners or husbands, are treated as “mental illnesses” by the very male-centric system. I’d suggest that anyone who wants to get rid of psychiatry needs to be aware of the deep and fundamental connections between psychiatry and the intentional oppression of women who speak up and try to have power in our society.
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Hi, Rebel,
Are you staying that you DON’T think men as a class have oppressed women throughout history, and continue to do so? I’m not talking about individual men, though many individuals do act oppressively. But do you realize that it was legal for a man to rape his wife until very recently? That there was very little legal protection for a woman being beaten prior to the 1970s? That women could not vote until 1920? These are very obvious manifestations. When one looks at more subtle forms of oppression, they are rampant, even today. Let’s look at the question of sexual activity. What do you call a woman who chooses to sleep with multiple men? Slut, whore, bitch, tramp, hooker. What do you call a man who sleeps with multiple women? Stud, player, ladies’ man, heartthrob. There are no negative words for men who sleep around. There are no positive words for women who sleep around. Why does that happen? Why are women shamed for being sexual beings, while men are applauded for it?
I could go on. There is real oppression out there. Enslavement of black people isn’t just a consideration. They were literally slaves, bought and sold human beings. I find it very hard to understand how this can not be obvious to anyone living on this planet. Women have been oppressed as a class by men as a class. It’s just a fact of life. Are you saying women should just have had a better attitude toward being treated as second class citizens (or non-citizens, as I said before, since they were not even allowed to vote)? If psychiatry is oppressive and its “patients” are targets of that oppression, why wouldn’t the same apply to other groups?
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Of course, when there is no objective way to see who “has” or “doesn’t have” your purported “diseases,” it becomes easy for those greedy for power to act without accountability.
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I’m not arguing against 1) or 2). I’m saying that Carrie Nation and Jane Addams and Emma Goldman and Emmeline Pankhurst and Elizabeth Cady Stanton were not all stooges of the Rockefellers. Like I said, attempts to coopt such movements are very common, but it seems obvious to me that such a movement is a natural outgrowth of oppression. It is exceedingly unlikely that those in control would undermine their own control by creating more rights for those they have a natural interest in continuing to oppress. It also makes zero sense that the Rockefellers would free people in order to enslave them. Why not just keep them enslaved? Though it DOES make sense that they might want to claim responsibility for something they had nothing to do with, something our “antisocial” types very typically love to do. Just because a Rockefeller said it doesn’t make it true!
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I am not arguing the merits of the women’s movement, which is a much bigger topic than I can cover here. I’m simply saying that it is diminishing to the women who sacrificed their reputations and in some cases their lives to get the right to vote and many other rights as listed above, and more, to suggest that they were somehow dupes of some other forces. Women are certainly not monolithic, and I did not even vaguely suggest that in my comments. I dispute the idea that women were not the progenitors of their own movement toward freedom and civil rights. It seems nonsensical to me.
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It seems utterly confusing to me why you would not credit women with starting and maintaining an effort to strengthen women’s rights, or darker skinned people with starting and maintaining an effort to strengthen the rights of the darker-skinned population. It’s not just “conventional wisdom,” it is plain old logic. Whether other less savory individuals or groups may have done their best to coopt such movements is an entirely different question, but I think it’s pretty insulting to women to suggest that the monumental struggle to get the right to vote, to be protected from rape and violence, to raise their children, to be able to be employed and paid as men are, to be able to dress as they wish (I just read an article how two lady motorcyclists in the 1910s were repeatedly ARRESTED as the crossed the USA for wearing pants!), to use birth control, and on and on, is the result of some sort of manipulation and control by antisocial personalities. Are we then to conclude that absent such provocation, women would have been happy with their lots as second class citizens (or actually, non-citizens who could not even vote) and never gotten together as a group to try and make things better for themselves and society as a whole?
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Great post again! Nothing to add, except BRAVO yet again!
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Ah, but where does the “antisocial personality” come from? Personalities are not completely fixed, in my view. They are affected by experience! Suppose one could RID society of most of the antisocial types, by handling their fears and historical trauma, while containing those who were simply unable/unwilling to behave in a social manner? Or do you think people are just born antisocial, nothing they or anyone can do about it?
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I agree with your views expressed here. Thanks for taking the time to put it into words.
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I agree. A truly culturally aware approach would START by trying to learn from the culture we are encountering, and being humble enough to understand that they have much to teach us. The “schizophrenia” recovery rate is 10 times better in the “developing” world. Our “thought leaders” have tried their best to explain this away, instead of finding out what they’re doing right and what we’re doing wrong. That’s the real problem. However gently it is framed, we Westerners believe our culture is superior and that these “primitive” people need to learn how to do it our way.
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Humans make decisions. They have values, priorities, fears, desires, etc. Most of the ills of society come from humans making destructive decisions due to their lack of perspective or courage or their fears or desires to dominate others. The problem with psychiatry is that they don’t recognize this fact and instead try to pretend that these ills are the result of “bad brain chemistry,” as if people will suddenly all cooperate and be productive and stop hurting each other if only their serotonin levels were fixed! Psychiatry is about forced invalidation of reality, and about blaming people’s brains instead of helping them learn how to live better.
Removing psychiatry will not stop people from being violent, racist, abusive or neglectful to their children or other charges, thoughtless, sexist, or otherwise obnoxious. It WILL stop psychiatrists and Big Pharma from making money off pretending that they have “treatments” for these social ills. It WILL stop people being incarcerated and “treated” against their will based on these pretenses.
Improving society as a whole will depend on a lot of people working together. Eliminating psychiatry will be a positive step, but there is a lot more that we need to face up to before we have a functioning society. That’s my view.
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I very much love the (to me rather obvious) idea that the client is the ultimate judge of what works or doesn’t work!
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Is it not possible that a headache is a part of the traumatic experience chain being examined? I have found that I and others I’m working with will have a pain that comes up when thinking about a certain event, which usually resolves upon relating what happened in its entirety, sometimes several times before I get it all resolved.
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Very well said! Bravo!
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Non-compliant seems to suggest that the patient is a child and the doctor is in charge of discipline if the patient doesn’t do as s/he is told. It’s a pretty disturbing concept if you think about it.
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Oh, believe me, I agree with your observation! I have to fight to have “informed consent” many times when I see any kind of mainstream medical practitioner. I avoid MD’s like the plague for that very reason! And when I am forced by circumstances to talk to one, I start them off with a preamble that I am going to listen to their advice and make my own decisions, and if that’s a problem for them, let me know right now and I’ll find another practitioner. I rarely have to do so, but I have. You have to be an advocate any time you go see an allopathic physician. Some of the younger ones seem a little better, but I assume they’re going to be arrogant and self-absorbed until proven otherwise.
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COMMENTING AS MODERATOR:
I am getting concerned that this conversation is getting off topic and entering into one of those areas where people have strong emotions and where finding agreement is very difficult. This thread is about EMDR and should remain about EMDR. We do often allow conversations to wander off into other areas, as long as it is a productive discussion where people are learning and explaining thing to each other. When it degenerates into trading positions and making generalized statements without actual information or experience to share, that’s going too far. I know different people have had very different experiences with CCHR and the Church of Scientology, but this is really not the place to have that argument. I want to respect different people’s experiences, but I expect all of us to respect each others’ experiences as well. So I am not going to allow this to degenerate into a sparring match about the merits of a particular group or organization. I would ask you to keep to your personal experiences and respect and understand that others may have had different experiences.
I hope I’m being clear. Comments need to be productive, or they will be moderated as “off topic.”
Let’s get back to talking about EMDR!
Steve
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You know, that’s a great point I never thought of! If someone is a client of a doctor or other professional, the doctor works for THEM! There is no “shared decision making,” the decisions are made BY THE CLIENT! And the interesting part is that the alternative to “shared decision making” is cutting the client out of the loop entirely! We’re supposed to be excited by the prospect that the PROFESSIONAL will deign to “share” decision making with the client. Whereas the CLIENT should be the one deciding whether s/he wants to follow the advice of the “professional” in every case.
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I think the difficulty understanding how EMDR works stems from assuming it works on the brain, as most researchers have done. There are many regressive processes that have focused on reprocessing past experiences, and results have varied, I think mostly because it’s not necessarily what everyone needs at a given time, or because people have other more pressing needs in the present moment that make regression less likely to be effective. The most fundamental error of the psychiatric/psychological professions is assuming that everyone having the same presenting issues has the same problem and needs the same solution. I’m more inclined to think of there being problems in the physiological, psychological, and spiritual realms, and the proper solution depends on the actual cause. Someone who is depressed because of his dead-end job isn’t going to get better with biological “treatments.” Someone with thyroid problems won’t improve with the best therapy imaginable. But people who really do have what I will refer to as ‘spiritual issues,’ by which I mean difficulties figuring out the meaning of things, their place in the world, or how to manage past events that have affected their thinking, will probably benefit from regressive processing like EMDR, whether you tap or roll your eyes or just lie their quietly while you relate what happened.
The other critical part is that any regressive process MUST provide absolute safety from the listener, not to evaluate the meaning of things or stop or redirect the person or tell them that what they said wasn’t true or doesn’t make sense. It’s their story to tell and the processer, whatever the process may be, must be committed to letting the person tell their story without editing or invalidating or doubting anything in the story. I am guessing that’s where a lot of practitioners fall down on the job.
Anyway, I doubt anyone looking for biological explanations for why EMDR works is going to be looking for a long time. I don’t think it’s a biological process, even if biological events are involved.
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The fact that these approaches are called “alternatives” is in and of itself a big problem. It implies that the MAIN way to do things is psychiatry, and these other “alternatives” are for either when it doesn’t work or someone wants to “try something different.” There is condescension in the very term. Same applies to “alternative medicine.” In fact, I’d prefer these approaches not be called “treatments” at all – I’d prefer they be called “approaches” or “strategies” or “opportunities” or “processes” or anything that doesn’t imply any kind of relationship to medicine or psychiatry.
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Columbia has the worst press regarding drug trade. It looks like only 3% of their GDP comes from drug production and sales, down from 7% some years back. Hardly the backbone of their economy!
https://www.sciencedirect.com/science/article/abs/pii/S0305750X9800028X
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I am sure the promotors of the various Benzos have a strong interest in making sure that Heroin or other opioids get all the blame. I’m sure “opioid epidemic” was agreed upon as the name for the problem by people in high places of power.
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I don’t know that Robert would identify MIA as a “social justice site,” but it certainly provides a safe space for survivors to have a voice, and the forums here are populated primarily by survivors, and we have discussions that center on issues that would get commenters tossed off of a lot of “mainstream” sites. And there are many articles posted by survivors, such as Christine’s this very week. I think it is exceedingly unfair to call MIA a forum for “liberal mental health professionals.” There is a hell of a lot more going on here than that. In fact, I seem to recall certain “liberal mental health professionals” either changing their tunes or stopping posting here because they could not handle the intensity of the appropriate feedback from the survivors who are the core of the commenting communities. So I respectfully and firmly disagree with your assessment.
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Wow, they seem to be worried that you “voice hearers” will compare notes! Can you ask them what evidence they have that voice hearers getting together is harmful? The evidence I am aware of says that it’s quite helpful to get together with other voice hearers. Honestly, they have no idea what they’re talking about, or they’re lying. You should do what feels right to you, and to hell with what they think!
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POSTING AS MODERATOR:
I continue to be concerned we are going too far afield, here, even though I participated myself in getting us here. My sense is that no one is disputing that a lab release is a very plausible explanation for what happened, and that this explanation was quickly and summarily dismissed without investigation at the beginning of the COVID pandemic. I’m not seeing that anything else can be inferred from this fact, and I don’t really want to see this conversation go down that pathway. The question of how to distinguish a “conspiracy theory” from a feasible explanation seems like a topic related to the
“mental health” system, but I want to make sure we do not get back into another endless loop about unprovable opinions regarding the intentions of various parties, good or bad. That is a conversation for another website.
Just trying to head this off before we end up going down that pathway.
Steve
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The doctors almost killed my dad when he was 40. He was on blood thinners from a recent heart attack, and they gave him something that was totally contraindicated with blood thinners, with a warning it might kill the patient. He had sudden bruising from barely touching his arm. He looked it up in the PDR and found out what was happening. If he had trusted them, a minor accident, a fall, a bump on the head could have killed him!
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Sounds like fascism to me!
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Me, too! It’s a ridiculous idea! I personally think patenting GMO plants is a ridiculous idea. They did not “invent” a plant! They just messed with it. Otherwise, breeding a new strain of cow would be patentable. Capitalism sucks!
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I know, it’s disgusting. And they are often even WORSE on the 4 drugs than they were before they started the first! But the answer never seems to be, “Gosh, this doesn’t seem to be helping – maybe we should do something else!”
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They are seriously trying to patent an INDIVIDUAL’S genetic data??? Do they really think they can OWN someone else’s genes??? This is bizarre, even for our bizarrely capitalistic society!
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“The road to hell…” as they say. Good intentions in a damaging system usually leads to either the person quitting or being coopted into doing things they know are wrong. The system needs to change. Changing the personnel without changing the model just leads to more of the same.
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You can tell by the intensity of the response who doesn’t have the real data behind them. Why would there be a need to put down someone sharing their own negative experience if you are SO confident that the drugs are great? Couldn’t you just listen and say, “Wow, that sucks! That didn’t happen to me, but if it happened to you, I’m really sorry to hear it. I guess they don’t work the same for everyone!” Is it that hard to be a tad empathetic? Apparently.
But there is still that one out of 10, and that’s who we have to look for, I think.
I also think it matters what site you go on. I used to post occasionally on the CHADD site (very pro-drug ADHD site, or was at the time at least, kind of like the NAMI of “ADHD” parents). Man, you had to tread lightly not to be attacked or tossed off the site! I stuck to sharing studies and alternative approaches, and my own experience with MY own kids, but still got attacked. I told them I had two “ADHD” type kids who grew up fine without drugs. I admitted it was a lot of work and required a lot of creativity and research and just trying things out. Still, they said things like, “It’s great if your kid has a mild case and you can get by without drugs.” (There was nothing MILD about Patrick, I can tell you, and Kevin would have been just as tough, except we learned from Patrick how to handle him!) Or, “I know this worked for you, but we don’t want you to discourage or shame other parents who might need the medication for their kids.” They “corrected” me when I said “drug” instead of “medication,” even when I pointed out that d-amphetamine was actually a street drug of abuse.
I may have educated a few people but most of their minds were made up. So I stopped wasting time on it and started looking for sites that were less rigid and medical-model oriented. I still toss out some corrective data in that kind of site from time to time, but I don’t expect to be welcomed there! Mostly, I try to find communities like this one where my views are a little more “mainstream,” even when the site is totally NOT mainstream!
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It matters to some people. Not all, or even most. We have to find that small cadre of people who really see beyond the surface. They are rare but they DO exist!
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Interesting how an ineffective “cocktail” of drugs leads to the conclusion that a “new cocktail” needs to be devised, rather than the more obvious but less remunerative conclusion that “cocktails” of random drugs simply don’t lead to good outcomes, at a minimum in this case at least. The answer is always more or different drugs, it seems, no matter how many times that screw just WON’T HAMMER IN PROPERLY WITH THIS HAMMER!
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They are also often used on children or the developmentally delayed or the elderly for “aggression.” As one can imagine, it’s pretty easy to conjure up some “aggression” in any of these populations by just putting hands on someone and trying to move them, and when they fight back, call them “aggressive.” Psychosis these days is the tip of a much larger iceberg when it comes to “antipsychotics.”
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I agree 100%!
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It is disturbing that the kind of stalking behavior you are talking about is laughed at and minimized. The view that he is obsessive and stalking because he “loves you so much” is a common one that is strongly supported by our media. How many “romantic” movies involve a woman turning down a man’s advances, and him engaging in “romantic” behavior like following her home, strewing her walkway with rose petals, serenading her outside her window while the neighbors look on, proposing to her in an extremely public venue, and other obnoxious behaviors that show he “loves her so much?”
I’m so sorry you were not supported by your coworkers. People who engage in that kind of behavior are almost always dangerous and need to be stopped very early in the process.
Your insight that the “voices” that people here are often them fighting with someone from the past is a very good one!
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I agree, testing for those with “extra sensitivity” could easily be used as an excuse for not facing the fact that the drugs themselves are systematically destructive and don’t actually “treat” anything, any more than drinking “treats” anxiety by interfering with a person’s inhibitions. (Someone recently shared with me a study on using laughing gas to “treat” depression! The idea of it made me laugh out loud!)
That being said, I do think it’s good for the common person to know that such genetic vulnerabilities do exist and to insist that doctors check for these before prescribing them random drugs. Apparently, the genetics affect a lot more than just psych drugs, and people who have this particular vulnerability deserve to know about it.
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That actually makes a lot of sense to me. I’ve seen kids get super aggressive on stimulants, then be put on Risperdal to “calm them down.” When someone prevailed upon them to stop double-drugging the kid, they always want to take them of Risperdal first, which of course then leads to the aggression they’d created with the stimulants, which leads to, “Oh, no, he’s having a relapse, we’d better abort!”
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I like how you use the term “executors” rather than “experimenters.” They are more like technicians carrying out a designed task with a desired outcome, and have apparently not the vaguest interest in actual science experiments!
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So sorry! Hope it goes OK for you!
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Sounds like we’re pretty similar in not trusting until we get the evidence in.
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I tend to agree with you overall, but I think we need to reserve skepticism for both directions. Choosing to believe a “theory” because it “feels right” isn’t really valid, either. We need evidence. And as you describe it, it has been very difficult to get true and honest information from anyone in this COVID mess. So sometimes all we can do is gather the information we have and make the best decision we can based on what we know and our intuition. My intuition tells me that intentionally releasing a virus to create a worldwide pandemic doesn’t really benefit anyone enough to be worth the effort to make it happen. I could be wrong, but it just seems way too far fetched for me. Whereas an accidental release seems much more believable based on history and probabilities. Others will have a different take. But if we are going to have a group discussion of what is/isn’t happening, it has to start with what is known. If the answer is “little to nothing,” I suppose intuition is all that’s left to us, but it’s not really appropriate for people (I’m not referring to you, of course) to cast aspersions on others’ characters because of personal intuition. There is a very big leap from, “I’m feeling uncomfortable with the information about the last election” to “there was massive fraud, the election was stolen and we need to break into the Capitol and stop the transfer of power by violent means if necessary.” Just as an example.
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I am not sure I can agree with you. I evaluate “conspiracy theories” like any other theory: 1) given what I know, how likely/unlikely is such a theory to be true? (Occam’s Razor, for instance – is it the simplest explanation? Does it require me to assume untestable proposals? How many times?) And 2) is there actual hard evidence to substantiate the claim?
An example would be the recent claims of a stolen election. As to 1), the simplest explanation is that Trump simply lost the election. For any other theory to hold water, it would have to have a plausible mechanism by which it occurred. The idea that millions of people “voted fraudulently” and ALL voted for Biden illegally and somehow local election officials missed it requires believing unprovable premises that contradicts many decades of experience. The idea that there was a giant conspiracy to intentionally overlook these millions of irregularities that involved life-long Republican election officials somehow joining in to get a Democrat elected requires even more unprovable and very unlikely assumptions to be true. Which moves us to 2). If I am to believe these less likely scenarios to be accurate, I will need hard evidence, and the more implausible the theory, the more hard evidence is required. Dozens and dozens of cases were brought before a wide range of judges, both Dem- and GOP-appointed, some Trump appointed, and not one case was found to have sufficient evidence to go to a full trial. So we have two unlikely scenarios requiring unprovable assumptions to be accepted, and a lack of any concrete evidence. These “theories” can be dismissed out of hand. They are simply false.
Whereas the “lab origin” theory does NOT stretch the imagination at all – historically, lab accidents have happened, if pretty rarely, including adverse consequences (remember the Killer Bees?), and safety protocols are not infrequently ignored (look at handwashing figures at hospitals for support for that premise). When it was denied initially, there was no specific evidence against it, nor was their evidence in favor of alternate theories. It was pure speculation, and I never did buy it. On the other hand, the idea that there was an international conspiracy to release COVID into the environment intentionally was a much more difficult premise to buy (WHY would “they” do this again? To sell vaccines???), and required a number of untestable assumptions, and is FAR less probable than a lab release origin. So until and unless I see specific hard evidence to show this far less likely scenario to be more feasible, I am ignoring that as a likely cause, and am putting my bets on accidental lab release.
An old medical saying goes, “When you hear hooves, think horses, not zebras.” Unless you’re on the African savannah, of course!
Steve
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I don’t see how science could ever prove or disprove the existence of a Supreme Being. Science is the study of what happens under earthly/celestial rules. The idea of a supreme being transcends the rules of earthly existence by definition. They are simply different realms. Science could totally follow exact rules that are completely knowable and still be the product of some form of creation. At the same time, the world could be filled with one mystery after another and still be the product of physical forces with no creator in sight. So to me, science is not required nor likely capable of proving or disproving the existence of a creator, and it can happily go on being scientific and reliable and helpful and viable without the question of a supreme being even being raised. Science and religion are simply two different realms that have little to do with each other. As long as religion doesn’t invalidate the facts we observe in front of us, it’s all fine by me for people to have and exercise their faith. I only object when one’s faith says that what is observed is wrong because some book or prophet says so. Otherwise, who am I to decide how we all got here?
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Of course, no one wants to look at “antidepressants” as a cause. Too much money at stake to actually care about the results!
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Ombudsmen can stand up for individuals in oppressive systems, and can collect data and stories relating to oppressive patterns that transcend individual cases. But advocates alone can’t create system change – I think it requires the “consumers” to stand up and demand different “solutions.” And some systems are simply too corrupt or ill-intended to start with and resist any effort to “reform.” Such systems need to be discarded and a new plan built from scratch.
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I have never understood why the concept of a creator is contradictory to the theory of evolution. If God is supposed to be all-powerful, wouldn’t He (or She) be capable of inventing a way for species to succeed each other?
But we are getting a bit far afield now…
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I used to serve as an Ombudsman for those living in nursing homes and other facilities for the elderly and disabled. It’s actually a great model! Unfortunately, there were never anything close to enough Ombudsmen to go around. Not a lot of funding for holding the powerful accountable!
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I think that stuff about “free will” has very little to do with science at all. It’s essentially a philosophical argument, suggesting that because there is not enough time to “think” before making certain decisions (such as a batter swinging at a ball) that therefore the person can’t have made a decision and must be compelled to be acting the way that s/he is. They pretend that this is “science” by measuring reaction times and the time required for a conscious cognition to be put into effect. The measurement of such times is scientific, but the conclusion is based on the (I believe quite errant) assumption that a conscious thought is required in order to make a decision. This is NOT a scientific, but a philosophical premise. A common fallacy these days is to measure something (like PET or SPECT scans) and then draw conclusions based on unstated philosophical assumptions, which invalidates the conclusions entirely.
Anyone who watched Mike Schmidt (Hall of Fame third baseman for the Philadelphia Phillies back in the 1970s and ’80s) foul off one pitch after another after another when he had two strikes on him, waiting until he walked or got a good one to hit (as I did many times when I lived in Philly), has to conclude that the guy was doing it on purpose, no matter whether or not he had time to consciously decide where that ball was coming into the plate!
Sorry if that’s too far down the “rabbit hole” for others. Feel free to ignore!
Steve
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Quite so!!!
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It is hardly shocking that the USA refuses too support the CRPD. Big Pharma owns way too many of our political representatives and administrators!
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It would seem to me to be the only legitimate measure. Anything else becomes someone else’s agenda.
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The “Authorities” always say that this kind of intervention is “too expensive” and doesn’t get funded. Meanwhile, they spend billions on useless and destructive “treatments” that could easily be redirected toward this kind of help. It’s more like, “We can’t afford to fund this because it will take our snoots out of our comfortable troughs!”
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A big part of the problem is that there is no actual standard on what “helping people” actually means. Of course, it can be vastly different for each person from their own perspective -forr one it’s getting married, another it’s getting out of a dead-end job, another it’s recovering from childhood abuse, another is working on serious health issues – naturally, when you lump together people who have little to nothing in common, it’s going to be hard to define any kind of “improvement.” The only thing that makes sense to me as a standard is that the person in front of you becomes more capable of handling his/her life in as self-determined a way as possible. Nothing else really can make sense for everyone at one time. Not very “measurable,” but I’d say the client/helpee will know if they are feeling more in control of their lives!
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Your statements are unfortunately very valid. People are susceptible to being sold “wish fulfillment.” I’m not sure what anyone can do about that. What I think you’re leaving out is that this model primarily serves those who wish to label and dismiss the distress of others and have them take the blame for it. Is it really likely that the average person is going to stop believing in psychiatry, or in the infallibility of doctors in general, when they are blanketed with propaganda through their own doctors, the media, the schools, their churches, their friends, and so on? We can’t expect the mass of individuals to develop this kind of insight – action needs to take place on a MUCH larger scale than hoping that educated individuals somehow acting en mass to alter the economics of selling people drugs that don’t work at a premium price.
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You are talking about internalized oppression here. No one is denying it exists. I am saying that it is still the full responsibility of the abusive “doctors” in the system to NOT “tell people what they want to hear” but instead to tell people the truth, regardless of what they want to hear. That’s the responsibility their power conveys upon them. We can and should help people NOT view themselves as helpless, by all means, but that does not for one instant relieve psychiatry’s responsibility for pitching that narrative with all they have the power and money to do. Most people would have a much harder time convincing themselves they are hopeless without the unscrupulous support of those in power who know better, but pitch that narrative only so they can make themselves rich at their patient/victims’ expense. And even those who DON’T view themselves as hopeless/powerless are relentlessly beat upon to accept that viewpoint, not only by doctors, but by friends and relatives and TV shows and movies and the evening news, not to mention DTC advertising. We need to stop the onslaught instead of wasting our energy trying to talk the victims of the onslaught into ignoring the enormous social pressure to conform!
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Or, is the sudden increase in violence attributable at least in part to the increase in antidepressant prescriptions itself?
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What else needs to be said?
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Lawrence, I am not arguing that people are not making decisions. But a lot of times they are NOT aware of doing so, while the “mental heath” industry is quite aware and intentional in their deceptive practices, and takes advantage of common cultural beliefs to manipulate those who are not as aware of their ability or need to think independently. I don’t think it is proper to invalidate all responsibility for the clients, as reassuming responsibility is critical to improving one’s emotional state. However, there is a big difference in levels of responsibility. The client has a normal human desire to seek a quick and easy solution, just like almost all human beings on earth. They are responsible for choosing to trust and believe the doctors’ pronouncements and directions, which our society totally supports and even expects of people (I can’t tell you the flak I’ve taken over the decades for questioning doctors’ opinions, and not just from the doctors!) Whereas the clinician knows (or should know) about human nature and the tendency to look for easy solutions, and intentionally tells a tale that they know to be false, taking advantage of the subconscious need to trust them on the part of the client. They are also responsible for observing whether or not their intervention is helpful, for researching the outcomes for these interventions, and for changing the intervention if it doesn’t seem to be working. Failure to do all these things is 100% on the clinician, whatever level of awareness the client may or may not possess.
Psychiatrists as a guild, in particular, are responsible for creating an utterly dishonest narrative for promoting their own financial and guild power interests and using what they know about human nature to create incentives for people to avoid their real problems and rely on the psychiatric profession for a “solution.” They spend billions and billions of dollars on this, invent new “disorders” in cahoots with the pharmaceutical industry, create or alter “practice guidelines” in the direction that increases their power, influence, and income, and intentionally ignore or misinterpret their own industry’s research that says that none of this crap really makes a difference in the long run, and in fact can be quite destructive or even deadly.
So on the one hand, we have the clients, the “marks,” as it were, who are guilty of being human and seeking an easy way out, and we have the gigantic collaborative shell game which is utterly committed to milking the “marks” for all they’re worth by lying to them and making them think such easy solutions are real, in contradiction to data they are quite well aware of. We know who is really running the show here. And that’s not even talking about directly or indirectly “involuntary” clients, which encompasses a lot more people than most of us are aware of.
Blaming the clients for being gullible feels very much like saying that domestic abuse or rape victims should just learn to make better choices and avoid abusers, thus letting the abusers completely off the hook. Yes, it would be very good for them to learn to recognize abusers earlier (I wrote a book on this very subject), but the abusers are the ones making the problem. If there were no assholes out there looking to victimize them, they would not have to look out for them. The assholery is 100% the responsibility of the assholes in the world, and blaming the victims for having normal human emotions and reactions doesn’t help change the situation at all. The real goal should be for those authorities to actually BE trustworthy and tell their clients the real truth, even if the clients don’t want to hear it or believe it.
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I have always found it utterly offensive when they give people a drug that makes them fat, and then tell them to exercise and go on a diet! It’s disgusting!
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I think it mostly works great for those in positions of power who want to evade responsibility for the results of their use of the power they have. This can be a parent who isn’t willing to figure out how they might better approach their child, or a teacher who would rather blame the student than change their educational approach, or even a whole system like foster care where it’s easier and less uncomfortable to “diagnose” their charges than to figure out what is actually going on and how to help for real.
As in any oppressive system, internalized oppression is a very real problem. There have always been women, for example, who vociferously object to any discussion of altering gender roles, or foster youth who embrace the identity of “mentally ill” because that’s what is expected of them and rewarded, or kids who believe they are “stupid” or “bad” because they can’t make themselves fit into the abnormal expectations of the school system. But such internalization, in my view, is a consequence of the system, not a causal factor. It is true that being “diagnosed” with a “mental illness” can temporarily relieve a “client” from the responsibility of having to take action to move their lives in a positive direction, but it is psychiatry who is responsible for holding out this false hope of a ‘Medical solution’ and creating a Stockholm-syndrome kind of situation where hope of the “right answer” is always right around the corner, with the next “change of meds,” while the poor client gradually deteriorates and begins to blame him/herself for not being a “good enough” mental patient.
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Training and education are a part of how any culture transmits its knowledge to another generation or to other members of the society as a whole. There is nothing wrong with someone with higher skills in a particular area teaching someone who doesn’t have all those skills how to do what they know how to do. It would be silly for an expert blacksmith to not teach others their blacksmithing skills because it somehow prevents them from a purely egalitarian relationship. And I also see no reason why the blacksmith would be wrong to charge for that service of training.
The serious problem we are really talking about is the cooptation of a movement to empower people by an institution dedicated to putting people down. The word “peer” has been so seriously coopted by the “mental health” system that it is difficult to use it in its original meaning. But KS is right, a “peer” is simply someone who is at an equal social status or standing as you are, rather than possessing some kind of power advantage. Co-workers are peers, as opposed to management. Students in the same class can be referred to as peers without any negative implications. It appears to me that it is only in the field of psychiatry/”mental health” that the term has come to mean something potentially nefarious. And of course, the “peers” who are buying into the system are no longer “peers” in the true sense, as they are granted a certain “power over” their ostensible “peers,” but only as long as they toe the party line.
So the problem isn’t “peers helping peers.” The problem is the authoritarian power distribution in the “mental health” system that pits people against each other and requires compliance with certain dogma in order to be granted “power over” those deemed beneath you in the system. In my view, there is absolutely nothing wrong with teaching certain approaches or techniques or ways of thinking about how we help each other, as long as 1) these approaches are offered in a “take what you need and leave the rest” style, rather than a “this is the right way and anyone who disagrees is wrong” approach, and 2) the training is not offered in the context of an authoritarian system where those higher in the hierarchy are permitted, nay, are EXPECTED to put those beneath them in their proper place.
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How about a “revolution AGAINST ‘mental health care?'”
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My main objection is reframing what is likely a wide range of withdrawal effects as “relapse.” I find this quite disingenuous. It assumes that the “antidepressants” are automatically helping in all cases and that the psychotherapy is needed because not having the pills to keep their “disease” under control means they’d need therapy. The idea that they feel bad because of the known and often serious withdrawal effects of stopping the pills themselves is completely discounted.
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Hey, I have a better plan: if you just take a couple teaspoons of Epsom Salts in warm water in the morning, you’ll completely lose your appetite for anything, feel nauseated at the thought of food, and have a bad case of the runs within hours! A lot cheaper than taking the drugs with the same result. People who purge have been aware of this for DECADES! But seriously, folks, what kind of an industry comes up with solutions like this? What’s next, they burn out our taste buds so nothing tastes good? At least the stomach staple is honest in its approach and doesn’t pretend to be “treating” anything. What is wrong with these people???
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He must have “anosognosia” – doesn’t realize he’s still “ill” despite having no symptoms! Or else he was “misdiagnosed.” It COULDN’T be that they just had no clue what they were doing! Or worse yet, they DID know what they were doing and thought it was a “good result.”
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I feel compelled to ask a question here, not as moderator but just as a person. It seems you feel that someone is telling you that you don’t have a right to “be ill.” You have talked at great length and quite articulately about the importance of allowing multiple definitions or understandings of what is called schizophrenia in the DSM, and have acknowledged the sketchy and subjective nature of these DSM labels. I have also seen many posters, including me, support you in being able to view yourself as schizophrenic or ill or however it is that best describes what is happening to you. I honestly don’t recall one person saying you are wrong to view yourself that way, though it is possible I have missed it.
So my question to you is – who do you feel is telling you that you don’t have a right to identify as ill or schizophrenic? And what are they saying that is giving you that message?
It seems pretty clear that you feel compelled to say this same thing many times, which makes me think you are not feeling heard, yet looking from my perspective, I don’t really understand what it is that is not being heard? Can you help me understand this, in specific and simple terms? What is it that people are saying that upsets you and gives you the sense that your right to be ill is being taken away from you?
I hope you will take this in the spirit in which it is asked. I really do want to understand.
Steve
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Generally speaking, I’d say your correct!
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“Normalization” was to me the most essential element in approaching people in distress. Letting people know that their reaction to their situation was pretty common, and that lots of other people had experienced similar struggles or engaged in similar coping strategies. Helping them see that their reactions were less the issue than the things they were reacting to. Which is pretty much the opposite of what most people experience when they encounter the “mental health” system.
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As I like to say, “Generalizations are always wrong!”
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Sleep disturbances and low iron are just two common causes of “ADHD.” And of course, exposure to various forms of trauma. Plus being enrolled in school too early. (30% fewer “diagnoses” if the child is one year older at admission to Kindergarten, in several studies.) It’s a wastebasket “diagnosis.”
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Also interesting to call it “relapse” when the person is actually in withdrawal.
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You are missing the point of the communication.
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POSTING AS MODERATOR:
Everyone is welcome to post at MIA, as you say. There are no restrictions on language, other than what is listed in the “Posting Guidelines.” This does not mean that others will always see things similarly or won’t argue or disagree. It’s OK to argue and disagree about concepts/ideas as long as you’re not attacking a person or group or people. It gets stickier when one person feels that attacking a particular concept or idea is attacking them personally. This can lead to difficult conversations, but again, that doesn’t mean anyone is not welcome, it just means that words/ideas have different meanings to different people. It is always my hope that such conversations lead to some kind of Hegelian synthesis where everyone understands each other at a higher level. But sometimes we have to agree to disagree, and that’s OK. MIA doesn’t take sides, we just try to make sure the conversation is fair and respectful.
Hope that clarifies things!
Steve
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Sometimes I am just trying to meet someone where they are and create some common reality. Not everything I say is intended as advocacy for the cause of ending psychiatry. Sometimes I’m just talking to someone. I don’t like the idea that you are hovering around waiting to pass judgment on the adequacy of my communication. It was not intended for your consumption, and frankly isn’t really your business to critique, IMHO.
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Too true! Except they are still pushing the drugs, as far as I can see. Harder than ever!
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You know, I find I agree with most of what you have said. The problem I see is, and I’m guessing you agree with me, it is (or should be) the job of the psychiatric profession to correct these misimpressions and to get people to focus on what really will improve their lives. So it’s definitely true that the residential treatment staff would often refer kids to a psychiatrist for such idiotic indications as “doesn’t want to go to school” or “stays in her room too much (isolates)” or “won’t complete their ADLs” (I kid you not, these are all three actual reasons provided by treatment programs to justify a “med increase.”) But I also think it’s true that the psychiatrists had a responsibility to say, “You know, it’s not OK to refer kids to me just because you can’t figure out how to get them to school. That’s really your job as a residential counselor.” Or “Yes, teacher, Joey can be hard to handle in class, but he’s super smart and tells me he’s bored to death. He needs to be challenged in class – what can we do to make things more interesting and challenging for Joey, instead of blaming him for being bored?”
There are a lot of “reasons” why this epidemic of labeling and drugging has occurred, DTC advertising being a very big one. However, psychiatry as a profession has paved the way for this to happen, by redefining mental/emotional problems as “probably biological” and by selling the drug solution as the first line intervention, instead of a temporary or adjunct intervention on the path to empowering the client. At least, that’s my view of it.
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I think it’s important not to overgeneralize, though – there are most definitely “peer workers” who did whatever they could to empower their “peers” in taking on the system. Stephen B. is a great example.
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I am sharing only my own experience as an advocate for foster youth and earlier as a mental health professional. I don’t recall many psychiatrists in community settings trying to taper patients from drugs they got from family physicians. Most of the time, they got referrals from physicians who had prescribed either stimulants (for “ADHD” diagnoses) and/or SSRIs (for “major depression,” which was a very common “diagnosis” for foster kids). They usually got referrals because the physicians’ initial prescriptions didn’t work or more commonly made things worse (usually made them MORE aggressive instead of less), and most of the time, they increased dosages or added new drugs, even if it was kind of obvious that the drugs were causing the problem. As advocates, we usually had to move heaven and earth to get them to EVER reduce ANY drug, let alone drop something from their regime. Every once in a while, they might do a “med wash” if things were super messed up, but that was one case in 500 probably. Most of the time the answer was more “meds” in bigger amounts. There were only two psychiatrists I ever met who even understood that stimulants could make kids aggressive, and only one who regularly did anything about it. I could count the number of med reductions on two hands, and most of them were prompted by us or by the child’s attorney not by the psychiatrists. So my experience is very different than yours!
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And furthermore, the big question that is avoided is, “Working for WHOM?”
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Very well said!
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I think the question of whether the “system is broken” depends on what we believe it was designed to accomplish. I think it is fair to say that the system works quite well for a certain kind of person, in particular, a person who is gaining money or prestige by pretending to know things about “mental illness” when they actually have little to nothing to contribute. To such people, any “improvements” in the system are seen rather as threats to their control. They don’t see the system as broken, they see those who challenge it as deluded or hostile!
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That is a good way to put it. The error that many make, especially those with conflicts of interest, is that they try to find evidence to support their preferred theory, and despite never finding evidence to reject the null hypothesis, they continue to believe that their hypothesis will eventually be proven true. At a certain point, failure to disprove the null hypothesis repeatedly proves the null hypothesis true.
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Your last line says it all for me. There is nothing “disordered” about reacting emotionally to adverse circumstances, whatever they may be. In fact, it is more likely the message from authorities NOT to be emotionally powerful, NOT to tell the story, NOT to “overreact” that creates most of what is so euphemistically referred to as “mental illness.” The label-and-treat (or -drug) method makes people worse!
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I’m not sure if the intent is specifically to marginalize and minimize, but marginalization and minimization are required to accomplish the actual goal of making money and amassing power and deflecting attention from larger social issues. Marginalization and minimization may be “means to an end,” but it doesn’t make a lot of difference to the patients. The most important, certain knowledge is that the intent is NOT to make the patients’ lives any better, whatever else may be intended.
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POSTING AS MODERATOR:
Very well said, and I thank you for taking the time to make this important point.
From a moderator’s viewpoint, an argument about whether or not “Critical Race Theory” is being taught in the schools or should be or is dangerous or not dangerous doesn’t really get to the point of the article, which is about “mental health activism.” However, comments connecting CRT to “mental health” oppression such as you have done will continue to be welcome. I hope the distinction is clear.
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I’ve long said that the DSM categories make scientific research impossible, because they group together totally heterogeneous groupings of people, particularly if you’re studying physiology. Why would anyone assume that all people who feel depressed have the same problem??? Even if we assumed there WERE some physiological cause to ‘depression,’ which of course is also a ridiculous assumption, it’s like saying everyone with a rash has the same cause, or everyone with a sore knee should be diagnosed with “knee pain disorder.” (Of course, medicine IS moving in that direction, with things like “high blood pressure” and “obesity” being now accepted as “diagnoses.”) Naturally, if you studied people with “knee pain disorder,” you’d find that most did not respond to any single treatment, with only 20% responding to arthritis treatments, 15% responding to chiropractic adjustments, 20% responding to treatment for strained ligaments, 15% to orthotic shoe inserts, etc. All of these treatments would be dismissed because they only helped a small percentage of the “KPD” patients, and the only thing that would “help” the majority of them (temporarily) would, of course, be pain killers. So we’d decide that “KPD” is a chronic, untreatable condition, but that we can “manage symptoms” with pain killers for life. Works great for Big Pharma, but not so good for the person who could function fine in a few weeks or months if they got the correct treatment for their actual underlying problem!
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I love your framing of your comment to get him to read it! Brilliant!
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POSTING AS MODERATOR:
I have posted this last comment, but “critical race theory” is a long way off of “mental health activism.” So let’s get back on topic!
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I believe you are correct.
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Oh, it IS based on a misunderstanding of their philosophy – anything that minimizes discomfort and maximizes profits for the “clinician” is good! Anything that increases discomfort or dilutes profit is “bad.” If people understood the REAL philosophy behind this “model,” they’d have a lot easier time deciding what to do with the “recommendations” it generates!
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From what you are saying, it sounds like the staff are “splitting” as much or more than the “clients!”
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POSTING AS MODERATOR:
At this point, I’d like to bring the discussion of the use of the term “schizophrenia” and the related issues to an end, at least as far as this particular thread is concerned. It seems that all the positions and viewpoints have been aired and are at this point being repeated. I think anyone reading this thread will get a very good idea of the issues and the various ways to look at it. I don’t want to have things deteriorate into a more personalized exchange that could be hurtful, and in truth, the thread has veered pretty far from the original topic of the difficulties being a “mental health professional” who is out of agreement with the status quo model of reality that is so vociferously enforced by the “authorities” in the field.
Thanks to everyone for their contributions – it has been a very interesting discussion!
Steve
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Just to clarify, I was not talking only about “critical psychiatry” people from the “professional” ranks. I know of plenty of clients/survivors/victims who totally bought into the “mental health” narrative to start with, then began moving to “Critical” as they learned and experienced more of the failures and damage that the system doles out, and eventually to a more abolitionist stance. Laura Delano is only one good example. I agree it is true that most antipsychiatry activists don’t come from the professional ranks, but “peer workers” and some fringe therapist types (like me) who never did embrace the “medical model” are certainly worth spending time educating. Stephen was another good example of someone who worked in the system but never bought into it, and came to a more radical position through observing the way he was treated in his “peer” role. Such people to me are very much worth educating, as their evolution does happen with some frequency, in my observation.
Of course, I agree that being “scientific” is a necessary but certainly not close to sufficient criterion for any kind of claim of “medical treatment.” And that there are many areas where science is not able to really provide any answers, such as the nature and function of the mind itself.
Additionally, I’m not a pure “professional” type, as you may remember.
Steve
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Yeah, how many times to you have to try and fail to prove something before you have disproven it? That’s kind of central to science – failed efforts to support a hypothesis means the hypothesis is regarded as false. Apparently, these rules don’t apply to psychiatric research?
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That makes great sense to me. It is easy to see how that could bring comfort. And as I said, I think you should do whatever it is that gets you through the day. I have no criticism for anyone who personally wants to embrace whatever label they choose. It is, indeed, the bullying aspect that I object to. I do think it’s very possible to be assertive and strong without being a bully. But it’s a skill that few truly develop.
Take care of yourself!
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I am suspicious of the trope that any “mental illness” has a unitary cause at all. Trauma, nutrition, social conditions, sleep problems, immigration, urbanization, adverse drug events, grief and loss… there are many, many potential causes for any “mental illness” that exist and are routinely ignored.
Treating people as individuals and looking for root causes instead of categorizing and discriminating against people based on social constructs seems to me more likely to lead to better outcomes, regardless of what the DSM/psychiatry wants us to call these phenomena.
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I hear and I think I understand what you’re saying, both of you. Here is where I think the conflict lies: I think that you, DS, are arguing about your right to view yourself as ill and having schizophrenia and find objections to these terms conflicting with those rights. I see you, Oldhead, saying that giving power to these words IN GENERAL means giving power to the system to label and judge people and also gives credence to the idea that psychiatry can define “mental illness” by coming up with a list of “criteria” voted on in a meeting of privileged “professionals” who are more or less arbitrarily condemning people to a label indicating that their brain is broken without any objective means of identifying what is supposedly wrong.
Oddly, I agree with both of you. I think the use of the term “schizophrenia” by an individual, and/or a reframing or believe that you as a person “have an illness” is your absolute right as a human being that no one should try to take away from you.
At the same time, I see the damage that these labels do to people, as you, DS, saw in my presentation on “ADHD.” So in general, having these labels ENFORCED on individuals who may or may not agree with these evaluations or the philosophy behind them is evil. And spreading the idea in society that psychiatrists have some inside knowledge of the causes and effective “treatments” for these “mental illnesses” that they claim to be able to identify is very destructive socially, as it reframes what are often completely normal reactions to difficult or oppressive social conditions as “diseases of the brain” or “of the mind” with no evidence that there is anything at all wrong with a person’s brain.
So it’s no big deal for YOU to believe in schizophrenia and view it as a disease, if that is what you see and believe is going on. However, it IS a very big deal when psychiatry as a profession/industry is promoting a concept of “mental illness” that is not actually supported by science, or in fact is even able to define its basic terms (like “mind”), and that has huge financial conflicts of interest driving its claims, and which claims are very destructive to our society at large.
And it is VERY difficult to engage in an honest discussion of the damage done by the current psychiatric system without directly criticizing the idea of “diagnosing” people with “mental illnesses” in the absence of any evidence that these sets of “criteria” they identify correlate with any kind of specific biological problem. This observation does not in any way suggest that you, DS, do NOT have an illness of some sort, nor does it suggest that you aren’t allowed to call it an illness or call it “schizophrenia.” What it means to me is that the PROFESSION calling EVERY situation where people have similar experiences to you “schizophrenia” is not supported by science, nor is it even philosophically sound for professionals to suggest that people have an “illness” that can’t be defined by any objective means. I hope that this difference is clarified by my remarks. This conflict is the cause of much consternation both by those identifying personally as “schizophrenic” and those who find the process of labeling BY PROFESSIONALS in general to be objectionable on the face of it. And this conflict, while understandable, is to me unnecessary. Because the first has to do with the right of an INDIVIDUAL to identify with their own terms and ideas, while the second has to do with the assumed authority of a large cohort of professionals to use their power to label a range of people as “mentally ill” without their agreement or even any objective scientific evidence supporting such claims. These are very different assertions that don’t actually conflict with each other, even though it may feel as if they do.
I hope that helps a little.
Steve
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Thank you for your kind words! I’m glad you found the training inspiring. I’m not always full of “joyous excitement,” but I do try to get there at least a few times a day!
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I think there is a more fundamental problem – your comments (and Laing’s) presume that “schizophrenia” is a unitary condition with a unitary cause, whether it’s biology or trauma or “refrigerator moms.” There is, of course, no accurate, objective way to determine who “has” or “does not have schizophrenia,” since “schizophrenia” is “diagnosed” by a list of thoughts/behaviors that allow for a broad range of “clinical opinions” to enter in, to the point where people who have literally not one single “symptom” in common can all be labeled as “schizophrenic.”
So we are left at a place where any explanation will fail, because no one explanation could possibly explain such a wide variety of experiences and behavior. So we get endless discussions of who “has it” or whether “it” really means anything specific at all, or what causes “it” if anything. And we have people like DS who perceive correctly that SOMETHING is not right, and yet the “help” she is offered is ineffectual, perhaps because they are given the idea that the psychiatrists “know” something that they don’t.
So the most sense that can be made of “schizophrenia” is that it is a name for a certain broad set of experiences, and that some people (like DS) identify with it and others don’t. It does acknowledge the idea that SOMETHING is wrong, yet it does nothing to determine what is actually wrong or what if anything should be done about it. People should be respected for the identity that makes sense to them, yet the general use of the term will never lead to any resolution or effective “treatment,” because we are expecting people who have a wide range of different issues going on to ALL respond to the same “treatment.”
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I’m not aware that the requirement to do one’s own therapy before becoming a professional therapist is still in place in the USA, at least not in most places. It used to be a requirement, and in my view, it still ought to be. The big problem being that the “outcomes” for therapy are so disparate, and in fact, even the idea of what an actual positive outcome IS (lower symptoms? Less troublesome behavior for society? Opinion of the client? Achievement of agreed-upon goals? Avoidance of hospitalization?) that it would be very difficult to get any kind of consistency in our therapy candidates’ therapeutic “success” ratings.
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I agree with this. Many who eventually become antipsychiatry activists begin (like I did) with a “critical psychiatry” stance. There is an evolution of viewpoint that takes place as people gather more information, and I don’t think it’s proper for me to judge where people need to be on that path. I don’t hesitate to lay out facts for people to hear, and I don’t for a minute buy that doing so is somehow “shaming” people who don’t want to know the information. But I don’t expect people to agree with me just because I said so, and I try to meet people where they are and help them take whatever next step seems right for them. Psychiatry takes away people’s ability to make their own decisions about things. I’m not going to do the same, even if people see things differently from me.
However, when we’re talking about systems of oppression, there is no mercy!
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I’d like to see a campaign against the “stigma” of NOT taking psych drugs or NOT allowing ourselves to be “diagnosed!”
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That is another of the bad things about the drug model – it gives psychologists and therapists an “out” so that instead of admitting they don’t know what’s going on or what to do, they can blame the client for “failing therapy.” Sorry, if you’re being paid to do therapy, and it doesn’t help, the only one failing is the therapist! You (the therapist) aren’t delivering your product and should step aside, instead of blaming the client’s brain and passing on your failure to your client.
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There are lots of programs to help people with things that are not “mental illnesses.” Why would we not be able to provide a process for people to re-integrate their lives without requiring that they have a “mental illness?” Churches, support groups, hotlines, meditation groups, Tai Chi classes or meetings, community get-togethers, all of these things happen all the time with participants able to join without subscribing or being “diagnosed” with anything. Why not Soteria House?
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Posting as moderator:
I can’t promise anything, but I do try and facilitate contact between people who might want to talk. I’ll see if I can send the author a message and see if they want to share their contact info.
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That sucks! Are you under threat of re-hospitalization if you tell them to stuff it?
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HIPAA should NOT prevent anyone from seeing their own records. It is designed to protect the CLIENT’S confidentiality. I’ve heard it interpreted in this way, but it is just plain wrong. There is no “confidentiality” of one’s on records from oneself. It is a contradiction in terms!
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Posting as moderator:
I am approving this post, as it does not specifically violate the Posting Guidelines. However, I am concerned that this will re-create the dive into off-topic interpersonal hostility, as it has done twice before. Richard has posted his view of things, others are welcome to post their view of things, but it is essential that this not deteriorate into an us-vs-them, “You are wrong and I am right” kind of discussion. I ask for your cooperation in keeping this a safe environment for all views to be expressed. I will be keeping a close eye and will intervene swiftly if I see this conversation deteriorating into personalized attacks.
Thanks for your help!
Steve
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Perhaps they mean “collaboration” in the sense of Vichy France collaborating with the Nazis? That would make more sense!
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Collaboration = corruption in this case!
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Excellent point! I would have been far LESS depressed if I was not forced to go to school every day.
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They had “anosognosia” – didn’t realize that they had no real reason they wanted to kill themselves, that it was just a brain malfunction.
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I read a study one time where they sent volunteers into a residential treatment facility for teen youth with a handful of reasonable but kind of personal questions. Over 80% of the youth revealed a trauma history to these complete strangers surveying them. Yet less than 20% had their trauma history documented in their logs! So either the youth were more willing to trust a complete stranger than one of the staff they see daily, by a factor of 4, or else the staff never bothered to ask them, or considered their revelations so irrelevant they didn’t even warrant a log entry. I thought it said a whole lot about what “treatment” constitutes today.
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The legal question would be whether he received “informed consent” as to the likely effects of the drugs. He would not have to have been forced onto them, the doctors would have to have been dishonest or have left out important information that could have prevented his death.
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And some of these “consumer advocates” are front groups for drug companies and are in their pay.
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POSTING AS MODERATOR:
At this point, this discussion seems to be moving in a more personalized direction that I don’t think is going to be productive. A couple things are clear: 1) Everyone has a right to identify as they please; 2) Everyone has a right to object to terminology they find objectionable; 3) when there is a general objection a term that an individual might find workable for him/herself, there is a very distinct possibility of feelings getting hurt.
It seems to me that the primary conflict is around whether the general discussion of the damage done by psychiatric labels is in some way disrespectful to those who identify with such a label. I’m not going to try and be the final judge on this point, but I will say that the conflict is one that is inherent in the subjectivity of the diagnostic system itself, and is unlikely to be resolved by further discussion of this nature.
So at this point, I am going to ask that we leave this discussion where it is at, with the acknowledgement that the conflict is not resolved, and that different people have different feelings about it, to which each is fully entitled. Others who want to discuss this further with each other are certainly entitled to do so by direct communication off line. If anyone needs/wants to connect with someone through email for further discussion, I am always happy to assist with making such connections.
Steve
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Now we’re not even supposed to talk about it. We’re supposed to take drugs and hope that we feel better, without even consideration of the actual source of our distress.
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That makes sense to me. You are empowering the client to evaluate his/her own ability to admit being wrong about his/her perceptions, as well as normalizing a very human tendency to fight the possibility of being “wrong” about one’s ideas or perceptions.
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Not trying to “bait” you, just wanting to clarify your position. I think you did so quite effectively. There is, sadly, more brain surgery for insomnia going on than any of us would like to admit.
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It’s a difference between a decision or direction being wrong, and a PERSON or their feelings/reactions being wrong. I agree 100% with your statement that “most ‘mental health’ problems result when people have a goal and then are doing things that actually get them going in the opposite direction without their awareness of that.” So the goal of therapy is to help THE CLIENT to gain an awareness of what direction s/he wants to be going and what barriers, internal and/or external, may be preventing that, including false beliefs that seem to force them to go in the opposite direction. Again, that is very different from saying that the person is wrong for feeling anxious or depressed or angry. Long ago, I learned that the proper approach is to validate/normalize FEELINGS, while challenging BELIEFS/THINKING that is getting in the way of the client’s success.
And I think you are mistaking me if you think this is about the word “wrong.” It is about the invalidation of a person’s knowledge of or ability to know their own mind and ethics and/or to decide for him/herself what is right/wrong, effective/ineffective, valid/invalid. And it most definitely IS imposing one’s idea of rightness/wrongness when we tell or imply that a person’s emotional reaction is somehow “wrong” or that a person suffers from a “mental illness” simply because s/he engages in behavior that seems irrational or unproductive. I find it much more helpful to help a person identify the reason why something that I think is “irrational” makes sense to them. Once the problem they are trying to solve with the “irrational” behavior becomes clear, it may be possible to consider other solutions that are more coherent with their goals.
Of course, this is more complicated when a person’s connection to what we consider “reality” is more distant. But I think the same principles apply. It is clearly very ineffective to start off telling someone who hears voices that they are imaginary, or telling someone with a “delusional” belief that their belief is wrong. It’s a question of what really works, not a particular antipathy to the word “wrong.”
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We do not withhold or approve comments based on opinion or topic. The only comments held back are those which violate the posting guidelines, which are available on the home page. You are entitled to post any opinion you have to share, as long as it’s done respectfully. Of course, others may respond in kind.
That being said, I have to ask: are you suggesting that the poster is making up this story? At least in terms of the dosages prescribed? Or are you simply shocked that your colleagues would engage in such unscrupulous and unethical behavior?
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The point is more that I have no right to decide what they are doing is “wrong,” unless it is a violation of the rights of others. I would equally not want to tell someone that their behavior is “right,” as I also believe that is their job to evaluate. So telling them that “there is nothing wrong with you” is also not a viable position. It’s just plain not my call. This also doesn’t prevent me from expressing my concern for the direction someone is going, or pointing out potentially adverse consequences of their continuing on the path they’ve chosen.
I do also agree that there are “better” or “worse” ways to do a particular task, and that we are doing no favors NOT to tell someone they’re going the “wrong way to get to the Pacific Ocean.” But that’s a different context, where the person has made their goals and intentions clear, and you have information to convey that will help them accomplish their goal. That is very different from saying to someone that feeling depressed about something is “wrong,” that it is “right” to listen to your doctor or teacher, that you are “wrong” not to want to go to school or find it dull, that your perception of the world is “wrong” and that if you agree with mine, you will be more “right.” In a therapeutic setting, it is my job to empower the person I’m helping to become more self-determined and to apply their abilities to creating their own lives. Something is only “wrong” to the degree that it fails to move them in the direction they want to go, and again, no one else is able to determine that definitively besides the client him/herself. Again, the only exception to that in my view is when the client is violating the rights of others, and even then, it is ultimately the client him/herself to decide what that means and how to handle the conflict. Therapy is about empowering the client, not enforcing my view of reality on someone else. And the proof is in the pudding – people who are told what to think and do, in my experience, tend to do worse and worse. And the vast majority of the time, the reason they present as “mentally ill” in the first place is because their sense of self-determinism has been systematically snuffed out of existence. The last thing most clients need is someone else’s needs and wishes to accommodate!
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Scorn or shame is what I want to avoid. But in truth, I don’t believe it is helpful to tell someone else what you think is “wrong” with them.
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It has become a remarkably common practice. Shows the ethical level of the average psychiatrist today, no personal disrespect intended. In fact, I respect you for posting your disagreement here. I hope you will hang around and read some stories and let it affect your practice.
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I don’t agree. I would never say “there is something wrong with the way you are looking at yourself.” I would ask the person what they were trying to accomplish, and ask them whether they believe their current approach is getting them where they are trying to go. I would also listen for things they felt they “couldn’t do” or “have to do” and ask them to explain how they came to these conclusions. If the person had beliefs I saw as irrational or even non-reality based, I’d ask them to explain how they know these things to be true. I might challenge their beliefs with contrary facts and ask them to explain these differences. I might even say I disagreed with them about certain conclusions. But at no point would I ever tell them that something is “wrong” with how they were looking at themselves. That is simply not my job. It is their job, 100%.
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Absolutely. To determine “overdiagnosis,” one would have to determine objectively the proper level of diagnosis. With the shifty, subjective, hazy criteria designed for “ADHD” or any other DSM “diagnosis,” there is no possible way to objectively diagnose even one single person. So yes, ANY “diagnosis” is overdiagnosis. Or in other words, DSM “diagnoses” are fraudulent, 100%. Not that human suffering isn’t real nor that people don’t need extra support sometimes. But calling these things “diagnoses” is, scientifically speaking, a complete joke.
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Hi, Ron!
I think there is a difference between a person deciding for him/herself that there is something “wrong” with their beliefs, assumptions, habits and someone ELSE telling us that something is “wrong” with us, or deciding exactly what it IS that is “wrong” with us. And deciding there is something “wrong” with our own belief systems is highly subjective and personal, very, VERY different than saying there is something wrong with my blood pressure or my ability to breathe or my immune system. The question of what “wrong” means and who gets to decide this is essential to having this kind of conversation make sense.
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It always bothered me a lot when institutionalized children/adults had hands laid on them by staff, and when they fought back, they were accused of “assault,” and sometimes even charged criminally! The “CLIENTS” were assaulted by the staff and were fighting back! It is stunning that this obvious fact seems to be lost not only on “mental health professionals,” but on our entire legal system. Defending oneself can’t be considered an assault!
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Couldn’t agree with you more! Detaining someone for being dangerous should NOT in any way be considered as or associated with “treatment” or “diagnosis” at all. Social control is social control. As I’ve said many times, without even arguing about the obvious failings of the destructive psychiatric model, as soon as you introduce force, it can no longer be considered in the realm of “treatment.”
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I am never one to justify violent behavior, just because someone is enraged. But I find it predictable and understandable, even if it is ineffectual and counterproductive in most cases.
Of course, there ARE cases where violence IS justified, when one’s safety or the safety of others is involved. In such cases, the minimum force should be used, but the use of force isn’t always “wrong.”
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Nothing like a prescription of “common sense!” Though as Tim McCarver once remarked, if it were all that common, more people would have it!
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Exactly. It is not aimless, it is the result of just too many days, weeks, months, or years of being invalidated and abused. Eventually, everyone reaches a limit.
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Psychiatry residents need more training in the actual root causes and effective interventions for people who are suffering emotionally and come to them for help, and more training in the fact that the current system is utterly ineffective and in fact destructive in many if not most cases. Though going into another specialty sounds like a good option, too.
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I would suggest that King was not advising or supporting violence (he was a VERY strong advocate of a nonviolent approach), but more putting the violence from the poor and disenfranchised into perspective. While he supported nonviolence, he understood that if you push people enough and deny them their voice, their frustration and anger will in many cases be translated into rage and violence. So a person wanting to reduce violence would be wise to start listening to those who are shouting but not being heard.
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I would add domestic abuse and child abuse to your list. Both are highly associated with “mental health” issues. But of course, that must be because people being abused have bad genes or something. Couldn’t be that the trauma themselves cause “mental health symptoms?”
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Ah, that is the question, isn’t it?
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There is actually no data supporting the idea that “antidepressants” reduce the likelihood of suicide. Rather, the data indicates the opposite – that people are MORE likely to kill themselves after starting “antidepressants.” Yet somehow the idea that “antidepressants save lives” still lives on.
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How about “One in three COVID 19 patients find the experience significantly depressing and anxiety-producing?”
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Wow, great essay! I love every word! “Continuum of normal” – I’m going to use that one!
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There is one explanation: their income depends on their denying the reality of withdrawal syndromes.
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Glad to hear it! That guy makes a lot of sense to me.
Steve
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All I can say is, very well said, and I agree completely. I just wonder how many other people we see “acting normal” who go home and order takeout because they are utterly exhausted from “acting normal” and who lay on their couches crying or numbing themselves out watching Netflix.
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This appears to be a very complex way of saying that DSM “disorders” are nonsense and cause great harm to people in general by making it appear that there is a black and white answer to the question “am I ‘mentally ill?'”
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Bruce Perry is a man who tells it like it is, backed by solid research. The psych mainstream really WANTS to dismiss him completely, but can’t, because he’s so solidly based in research. They have chosen to coopt and minimize his contributions, focusing on “trauma changes the brain” as a means to justify more drugging, and forgetting Bruce’s main theme, which is, “Healthy relationships can HEAL the brain, even in adulthood.” The latter message is unacceptable and has been muted by every possible means the psych professions have had at their disposal. This looks like an important read. I hope that Oprah’s stamp of approval gets it the wide viewing it most likely deserves.
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You might be surprised to learn how many “normals” are falling apart inside despite appearing “normal.” I sometimes think “normalcy” depends mostly on the ability to act.
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The whole idea that people can be divided into the “mentally ill” and the “normal” is brought into sharp relief by your analysis. A “normal” person who gets intimidated by his/her boss and starts feeling anxious and avoids him/her is considered to be “under stress.” A “mentally ill” person with the exact same reactions to the exact same situation is considered to be “having symptoms” or “decompensating.” It is nothing but rank prejudice and discrimination, not dissimilar in structure to white people engaging in violent acts being considered “lone wolves” or “troubled men” when black people doing the exact same thing are considered “thugs” and Muslim people doing the same thing are considered “terrorists.” This is perhaps the most important reason that “mental health” labels in general are ultimately destructive, even if a particular person doesn’t mind or appreciates their particular label. These labels are more or less arbitrary, and enable folks to engage in systematic discrimination without consequence against people who have them. In fact, these labels make such discrimination virtually invisible to most people who observe it happening. Instead of seeing it as condescending disrespect, the discriminators can frame it as “helpful concern” and the observers allow that framing unless they are quite enlightened.
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Same thing happens with “ADHD.” They give the kid stimulants to increase their dopamine levels. They often become aggressive, lose sleep, even hallucinate sometimes. Then they give them antipsychotic drugs to DECRASE the dopamine levels that they are INCREASING with the stimulants! Why not just STOP INCREASING the dopamine by giving them less stimulants? No, that would be too simple and not make them enough money, I guess! That is REAL insanity!
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Yeah, for some reason, a lot of people seem not to appreciate all the helpfulness involved in being arrested without charge, held against your will, and forcibly drugged “for your own good.” Ingrates!
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I don’t think it was a “mistake” – it was the usual support for their big Pharma donors at the expense of their constituents. It was effective for what it was intended for – keeping their donors happy!
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Isn’t this sort of like saying, “Baseball bats are not useful for playing ice hockey?” Even if you buy into the antidepressant mythology, why would they be of any use for back pain? Unless they make it so you feel OK about having back pain and it doesn’t bother you as much?
Weird idea!
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Amazing how the exact same behavior is seen as “recovery” when they think you are taking their drugs, and the same behavior becomes “symptoms” when they realize you’re not. Pretty logical, isn’t it?
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Of course, I was joking, too! It irks me no end that they take normal things that help us feel good and rebrand them as “therapy!”
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Are you suggesting we start a new program called “Bible Therapy?”
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Notice how the emphasis is on “helping middle schoolers cope” rather than asking why middle schoolers have to cope with so much that they “need help,” or what it is that we’re forcing them to cope with that might be modified to ease their stress?
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All too true! I’m tired of hiking being called “nature therapy,” or expressing oneself through artistic media being called “art therapy,” or meditating on the meaning and purpose of existence being called “mindfulness therapy.” Some things are just good things to do. I would hate to think they will turn Harry Potter into “fantasy fiction therapy” instead of just being a good read!
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Apparently, accurately reporting on their own research can be “shaming” if the research doesn’t line up with their “Take your meds or else!” philosophy!
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They’re not lying, they’re using “alternative facts!”
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Bullying is, indeed, the more fundamental problem. Psych labels are merely the bully’s tools.
I appreciate your clarity about why you wanted a “diagnosis.” I’m sure your feeling is shared by many, that lacking a “diagnosis” means you are not taken seriously. But I would toss out the question: why in our society is it necessary to have a “diagnosis” to be taken seriously? Maybe that is a problem even more fundamental than bullying itself!
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I agree absolutely. The word has been “polluted” by the cultural context surrounding it, at least for me. It is associated in our culture with violence, destructiveness, lack of value, and shame. It is interesting that in other cultures in which “voice hearing” is more accepted, “Voice hearers'” voices are actually more positive and helpful. How we choose to view phenomena and how we choose to name them has power. At a minimum, that power should not be usurped by the “professionals,” but I’m afraid most of these labels have already been appropriated culturally to the point that their personal meaning is difficult to untangle from their cultural meaning.
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Why are you ALWAYS diagnosing me? Besides, I don’t agree – I have Oppositional Defiant Disorder, not Borderline, and you can’t tell me otherwise!
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Another of those weird “Medicalized” headlines. Why not just say, “Financial debt is depressing and anxiety-provoking?” Why the resort to “mental health outcomes,” as if getting upset about financial problems is some sort of disease or “disorder” or failing of the person in debt? Why not just admit that being in debt sucks?
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You write very powerfully! And I appreciate your comments very much, and your kind words for me as well.
I think the only REAL way to be non-judgmental is to understand that we are ALL judging all the time, and to become AWARE of and acknowledge one’s judgment, to the degree that one is able to view those very judgments themselves objectively enough to set them aside and not put them onto the other person. It is difficult to describe, but I do believe it is most definitely possible to accomplish, at least enough that the person we are dealing with doesn’t feel they are being judged and sees that you are able to hear what they really are saying instead of what you think they ought to say or mean.
I am reminded of a quote from the Princess Bride by your closing paragraph: “Live IS pain, Highness. Anyone who tells you different is selling something.”
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I think the person suffering has every right to identify their “problem” or “issues” however they would like to view them. My objection is when another person tries to take that right away by deciding for you what your “problem” is. It would be one thing if they are saying, “You have a brain tumor” or “Your blood pressure is higher than normal.” But instead, they are judging their clients/patients/whatever based on some set of arbitrary rules and pretending they know what they’re talking about.
I respect YOUR views on your condition/situation WAY more than any “professional” who might come along and condescend to “diagnose” you!
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Excellent analysis!
I always figured the best assessment tool was to ask the client what s/he felt was troubling them, and then ask what they would like to see be different in their lives. Then ask them what barriers they saw to making that happen. Depending on what they said, there would be a whole lot of different things they could do to move in the direction they wanted to. No “clinical judgment” or “diagnosis” or “spectrum disorders” required!
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Waste of time. The “model” fails to alter the most basic and incorrect assumptions of the DSM, namely, that a “clinician,” by virtue of some level of training and education, can look at someone’s behavior, mood, or thinking and objectively determine if there is something “wrong” with them. It doesn’t matter how you slice it, we’re substituting human judgment for actual scientific observation and attributing “medical” legitimacy to someone’s biases and opinions based solely on what kind of degree or training they have. As long as we pretend that we are “diagnosing” a “mental illness,” it doesn’t matter if we use HiTop or the DSM or the ICD or a dart board, we’re wasting a lot of energy categorizing what kind of iceberg hit the Titanic instead of trying to keep the ship from sinking or getting the passengers to the lifeboats!
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Gosh, I’m SO surprised!
But will this lead to a reduction in the use of “suicide screening tools” or the substitution of “clinical judgment” for actual communication with the client in front of the “clinician?” You bet it won’t!
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Well said, Krista!
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Well, no community just IS that way, it has to be CREATED that way and continue to be created that way over time. I have experienced that from time to time in my life, but only for a little while. It is difficult to get everyone on board with that kind of ongoing creation. We’ve all grown up in an oppressive society and we all need healing!
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Humans are social animals/beings. Most don’t do well when isolated. We seem to thrive when living in communities. The failure of psychiatry to even notice let alone try to understand this simple fact makes it impossible for psychiatry to ever be of any help to anyone. The Rat Park experiment alone puts the lie to the vast majority of psychiatric research – obviously, if community and activities can change even a rat from a cocaine addict into a “normal” community member, the idea that addiction or “mental illness” is inherent in the person seems pretty stupid.
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Usually, when a practitioner “wants to protect you,” it usually means they want to protect THEMSELVES from the feelings you evoke in them. If YOU get “treatment,” then THEY will feel better. It has little to nothing to do with your needs!
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Leave the grannies out of it, and I’d say your punishment might be a just one for a decent percentage of psychiatric practitioners today. I mean, it’s probably not their grannies’ fault they bought into the DSM.
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When you put it THAT way, it sounds like it’s a BAD thing…
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Ah, you antipsychiatry types ALWAYS exaggerate! It CAN’T be over 400,000 a year, maybe only 350,000 deaths… Well, gosh, I guess that doesn’t sound very good, either… Uh, oh…
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That sounds like an AWFUL experience! I ran into quite a few of these situations when I worked with foster youth. The easiest “disease” to attribute to your child is a “psychiatric disorder,” because there is no objective way to prove that the “diagnosis” is right or wrong. It is the “Munchhausen parent’s” paradise!
I hope you have found other adults to validate the bizarreness of this experience. I was not meaning to imply that you were validating the DSM “diagnoses,” I was just expressing my own discomfort with assigning a “disorder” that is in no way validated or validatable, rather than just describing the behavior that is of concern for what it is. You certainly did a fine job of doing the latter!
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Quite so. It also implies the ability to discern legitimately between the “properly diagnosed” and the “misdiagnosed.” Which of course is utterly absent for any of the DSM “diagnoses.”
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I have always considered “transparency” a joke. “I’m taking bribes from Big Pharma to promote their drugs. Here are the companies paying me off.” And then the get to go ahead and make “recommendations” based on who is paying them, and no one stops them. How about disqualifying anyone on the take from participating in making practice recommendations? How about forbidding researchers at colleges and universities from taking any funds from industry directly, as used to be the case when I was a kid? As soon as you can use your research grant to get a patent and make a ton of money, your scientific objectivity is shot to hell, I don’t care who you are. Publishing one’s conflicts of interest is a useless and ridiculous measure. Preventing conflicts of interest is what we need to be doing.
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Yeah, I would say “from the ground up” is no longer reform. It’s demolition and restarting from scratch, and that’s what is really needed.
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“Munchhausen’s by proxy” to me isn’t something to “diagnose,” it’s just another phenomenon that most likely has multiple causes and multiple effective interventions. Drugs obviously are not one of the effective approaches.
Rather than call it “Munchhausen’s by proxy,” why not just say, “This person likes/needs to believe that his/her children are ill to meet some personal need of their own.”
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Generally, yes. If something doesn’t show up and I haven’t sent you a note, by all means, check in with me. Sometimes I think I’ve approved things that somehow don’t get approved, and sometimes I forget to write the note to ask you to explain. It is rare that I change or remove something without connecting with you in some way, so please check back in with me if you are wondering what happened.
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Even by their own rules, these drugs don’t have any positive effects in the long run. This is not new news – Russell Barkley himself found this out way back in 1978! So why doesn’t anyone know this?
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What it means is that the doctors are not prescribing based on scientific evidence. They are motivated by different factors, including keeping parents happy, feeling like they are “doing something,” fitting in with social expectation, and/or increasing their personal income, to name a few possibilities. It is not a problem of information or knowledge. It is a problem of improper motivation.
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So very well said! You almost made me cry!
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Posting as moderator:
I am allowing this comment, despite stopping this thread earlier, because the poster relies on personal experience and research data in her comment and is presenting the evidence she has encountered in a respectful manner. I am not inviting a return to the personalized, escalating rhetoric that was occurring previously. Others who wish to present their own personal experiences with COVID vaccinations are welcome to do so, particularly as it pertains to any pressures, oppression, or neglect based on “mental health” labels. Personal experiences are always welcome. Personal attacks and invalidation are not.
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A number of people have been saying they are not receiving notifications despite being subscribed to an article’s comments section. James is aware of this and is working on figuring it out.
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I’m not sure I agree. There are power differentials that exist in almost any relationship. It is the negotiated terms of the relationship that allow or disallow connectedness. If the person in the higher power position chooses to be respectful and genuine and chooses not to use that power over the other person, I think connectedness is still possible. But if one person actually views himself as superior and is willing to disregard or condescend or otherwise use his/her “power over,” then I agree there can be no connectedness between them. To connect, there needs to be sufficient safety for both parties.
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“Misdiagnosis” can’t be applied unless there is a way to objectively make a “diagnosis.” There is no way to objectively tell who “has” or “does not have” ADHD, so the idea of “misdiagnosis” is nonsense!
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People act on incentives. If they are getting paid to do dumb and destructive stuff, they will continue to do dumb and destructive stuff. Few people have the courage to stand up to injustice or even garden variety ignorance.
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That’s for sure!
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It can never be caused by the “treatment” – it’s always the patient’s or the “disorder’s” fault, as if the “disorder” is some kind of animated being that is trying to thwart their “treatments.” It seems it is never, ever the doctor’s fault or failure, no matter the actual data.
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Why would we want to “infuse” the view of despair with “biological perspectives?” Sounds like what they already do, and with horrible results. How about they let the actual sufferers “infuse” psychiatrists’ views with human and compassionate perspectives?
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Conflicts of interest are an enormous problem in the government right now, at least in the USA. There’s a revolving door with Big Pharma. I believe more than 50% of the FDA membership should be people who have no relationship to the pharmaceutical or medical industries at all. Indeed, why would we believe the fox when he says he’ll guard the chicken coop for us?
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Quite so! The HVN should probably be analyzing the “mental health” system!
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They have not researched “deaths of despair” because they don’t recognize despair as a legitimate complaint. There should BE no despair, as far as their model is concerned. Despair is indicative of “illness,” even if it’s caused by being hung upside down in a dungeon and tortured by people who have promised you will never escape. The tortured person should apparently have a better attitude, or else the reason they’re so upset is because their brain chemistry is messed up. If they were “normal,” it would not bother them much to be tortured. They’d just accept it as another one of those crazy things that happen in life!
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That’s how REAL scientists act! Maybe we can get them to take a similar approach to psychiatry! I’m sure they’d be appalled.
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Well, they can’t TOTALLY go away, or they’ll have to find new customers. They mostly want them to be inert, except to have just enough energy to pick up their next prescription.
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We should give credit where credit is due!
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It is the only medical “treatment” where the odds of survival are DECRASED by receiving “treatment!”
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I see absolutely no proof of the mind being something separate from the body, either. There is no proof either way. It’s a mystery.
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Or to be afraid that if they DON’T go along with the abuser, they will be the next target!
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I am sure they don’t cure infections, but they have been noted to have strong effects on pain, nausea, emotional conditions, fatigue, etc. These effects are apparently measurable and observable in the brain.
https://www.mdlinx.com/article/7-potent-powers-of-the-placebo-effect/2cO3HNrMslvxpW4qQ1hZpg
More convincingly, how the brain is used has been shown to alter the function of the brain itself. Taxi drivers develop an increase in areas of the brain associated with geography; meditating monks have an increase in areas of the brain associated with calmness and relaxation, as well as alterations in brain wave activity.
https://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion/397706/
One can say, “Well, they’re using that part of the brain more, so it’s more developed.” But WHO or WHAT is using that part of the brain more? And HOW is that decided? These are things we simply do not understand.
The mind is and remains a mystery. It appears to have effects on the body, but how these effects are created is not remotely understood by any in the world of science. What “the mind” even IS is not understood by scientists. I don’t claim to have any understanding of it myself, I’m just pointing out that claims that understanding the brain means understanding the mind are similar to claims that understanding electrical circuitry is the same as understanding computer programming. They are very different things.
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I would say that the brain is an organ, while the mind appears to be an agent of controlling the body. It is certainly within the realm of possibility that the mind does somehow arise from the brain, but that is certainly not proven, nor is there even evidence to say it is so, other than materialists saying, “It must be, because what else could it be?” But regardless of that, there is tons of evidence that the mind, whatever that is, is able to control the body, including the brain, in many, many different ways. The placebo effect is a great example. How can believing that something will work help the body to heal or change? Obviously, there is some form of agency that uses beliefs and goals to move the body to do things. Perhaps the concept of a “programmer” is the best analogy. Lots of people refer to the “hardware” (the brain) and the “software” (whatever programs the brain is running), yet no one seems to remember that someone has to WRITE the programs for a computer to run! So who is the “programmer” of the human brain? That’s what I’d call the mind. And again, it is a mystery – no one really has a clue what it is or how it works, but it is clear that it DOES exist and it DOES work, and pretending that we’re just a brain is as dumb as pretending a computer is just a bunch of electronic components and wires. Try to run a computer without software and see what happens! Try to program a computer without a programmer and see how far you get.
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Quite so. Science is about establishing what is TRUE, not what is RIGHT.
You should read “Zen and the Art of Motorcycle Maintenance.” It speaks to this very issue! One of the best books I’ve ever read!
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I would say that psychiatry mistakes the BRAIN for the MIND. The mind runs the body, including the brain. Whatever the mind is. Which to me remains a mystery. But psychiatry doesn’t allow mysteries. It makes them, dare I say it – CRAZY!
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Oh, I think they know very well who Karl Rove is. I just don’t think they consider him a person they’d like to be compared to. More somebody they’d wish to NOT be like at all.
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I agree 100% on THAT point! I think I’m emphasizing more what people’s attitudes have become, and you are emphasizing more how that attitude has been used to mislead the public. There is nothing “rational” about believing some subset of humanity, with sufficient intelligence and training, can somehow determine what is “true” for the rest of us. It’s just as superstitious as believing in evil spirits. Maybe a little more so!
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Right you are! The very essence of science is skepticism, the willingness to invalidate any and all conclusions in the face of new data, and in fact, the drive to do all we can to try and invalidate a particular theory that SEEMS to be true, and only accepting it as truth when all other explanations are proven to fail. And even then to be prepared for new data to force modification. The concept of “scientific truth” is badly misused, as “scientific truth” by definition is always subject to change. Even Newton’s Laws of Motion, long held up as the ultimate in “proven fact,” ended up being approximations. Who knows what we’ll discover in the future, if we stop pretending that some “smart people” already know everything and that we can stop looking and just let them tell us what is true!
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True, but a slightly different issue from what I’m talking about. The idea of science being “value neutral” is extremely problematic, as Robert Pirsig so eloquently elucidates in “Zen and the Art of Motorcycle Maintenance.” But what I’m talking about is a form of almost religious worship of Scientists as the All Knowing, so smart and informed that us mere parishioners are too ignorant and easily misled to be able to understand their deep knowledge. Doing what the Scientists say makes us Smart and Clever free from the curses of Superstition and Blind Faith! The fact that this is another form of Blind Faith does not occur to the faithful. Science is Truth, and to question this is Sacrilege! Oops, I mean Unscientific! Psychiatry is able to use this kind of blind faith to maintain its hegemony despite the fact that their own scientific researchers (not to mention basic logic) have proven that their diagnoses are nonsense and that their “treatments” tend to make people worse rather than better, and in fact to shorten their lives. To question Psychiatry is to question Science, and who are we to question the wisdom of the Great Scientific Gurus!
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It has always both fascinated and repelled me that those oppressed by abuse and social discrimination are the ones identified for “treatment,” while those who do the abusing and oppressing are not “diagnosed” with anything at all. What’s wrong with this picture?
Your points are all very well taken.
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“Mindfulness meditation” as promoted by DBT or others is at best distantly related to actual Buddhism. If you study Buddhist teachings, you will find that the idea of “mental disorders” and “treatment” would be considered absurd, and forced treatment would be considered a horrible affront to humanity.
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It is also interesting that they admit to “neurological changes” due to antipsychotics, which is a nice euphemism for “brain damage” or “abnormal brain functioning.” They slipped that one in without admitting what it really means.
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Not really news to anyone paying attention.
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A lot of people are “pro-scientist” rather than “pro-science.” They thing science is something that other smart people in lab coats do, and they then report their findings honestly and all we need to do is follow their recommendations. The idea that scientists could be dishonest or corrupt or just plain incompetent and narrow-minded is too much for them to process. It’s more like a religion than a logical conclusion. Real science is scary to those people, because it requires them to personally sift and evaluate the evidence, instead of deferring to “the authorities.” So they get very upset at people who question their “pro-scientist” dogma!
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Speaking Chinese tends to run in families. Must be genetic, eh?
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“No result” is apparently no reason not to continue with “treatment” in the world of psychiatry. Continuing “treatment” is all that matters. If it doesn’t work, we double the dose. If that doesn’t work, we add another drug. We continue until the person either lapses into apathy or dies. That’s psychiatry in a nutshell.
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You really know how to ruin a figure of speech! So what are you “seizing” right now? How many “seizers” does it take to “seize it?” And if everyone agrees, why is there any need to “seize?”
Only fair if I ruin your figure of speech in return…
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So you’re saying it would have alienated his loyal followers to say, “Hey, these psychiatrists had no clue what they were doing!” or “I realized that I was failing to follow my own advice about fogging my feelings?”
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Getting a Masters Degree in Education disabused me of any delusion that having an advanced degree means you’ve met some much higher standard of knowledge. My grad courses were WAY easier than most of my undergrad education, and a student could easily get through the entire curriculum while having not the slightest skill or motivation toward caring about kids’ learning. I’m absolutely certain the same would apply to a psychology degree. The only truly useful part was my internship, and that was because I was lucky enough to land a good mentor teacher to work with.
An advanced degree means pretty much nothing about someone’s skill level or integrity.
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And despite all that, the ending isn’t all that “happy.” Another psychiatric success story!
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He is ABSOLUTELY a victim of psychiatry. I hope no one is disputing that fact. Again, my disappointment is only that a person with such a large platform has missed an opportunity to get the word out about his victimization, especially since his own philosophy as stated is so consistent with a critical attitude toward the kind of “solutions” psychiatry has offered.
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Sounds like he was a practicing psychologist in the past, but no longer sees clients.
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Some of those “helpers” are posing as helpers and are not anyone you should follow!
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I don’t wonder, I am certain of it!
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Oh, no, it wasn’t CAUSED by the drugs! The drugs UNCOVERED a LATENT PSYCHOTIC DISORDER! That’s what they tell people. It’s sick!
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I hope so!
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The “Treatment” for akathesia is to stop administering the drugs!!! But apparently, that’s not an acceptable plan. The answer always seems to be more drugs, not less.
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Yes, the magic of “cognitive dissonance.” Nobody likes to be wrong, even when it’s not exactly their fault. But most of what we learn comes from being “wrong” and trying to do better!
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As for me, I feel no hostility toward him at all, just a certain sadness and disappointment that such a fantastic opportunity to direct his energies toward that profession which is most strenuously opposed to his philosophy, even when he was victimized by that profession. But it is very hard to admit when you’ve been victimized, especially for those who revere doctors as being automatically more trustworthy than the general population.
I wish him well, and hope he sees soon what seems clear to us who are further down the road.
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“Indifference” and “equanimity” seem like very different things to me. The latter is being “above the fray.” The former is giving up, being “beneath the fray,” as it were.
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Surprised they don’t have “antipsychiatry disorder” in there yet. Maybe in the DSM6?
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It does seem ironic that he is telling people to face their emotions and not try to “fog” them, while taking antidepressants for years and then getting dependent on Benzos by following his doctors’ advice. Wouldn’t you think he’d see the irony here and come out and acknowledge that he’d been led down the garden path? I feel compassion for him, but he’s missing a great opportunity to promote his ideas by challenging the cultural assumption that “feelings” can be a “disorder” that needs to be “treated” rather than understood and faced as Peterson insists is necessary to get away from our overly “orderly” society.
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I needed to read that last part. I think I need to stop fighting so much and let people be where they are in their journey. Yelling at them or being disgusted with them does nothing to help, and damages my own peace of mind. Not that I’m not ready to take to the streets when the time is right, but I don’t see that happening any time too soon.
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I think the clinical approach is called either “corruption” or “stupidity.” We could give it a fancier name if you’d like.
Adderall can certainly counteract the effects of “antipsychotics,” especially the traditional ones like Haldol that act solely on dopamine. It appears that is why smoking is so very common for users of neruoleptics. (What, it’s not because they are all lazy, irresponsible addicts? But, but…) But what sense is there to raising dopamine levels with one drug while lowering them with another? Meth would absolutely work similarly. Stimulants are pretty much all the same, except perhaps for cocaine.
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My understanding is that the shrinkage is primarily in the basal ganglia, where a lot of dopamine is processed on its way to the frontal lobes. (If I recall correctly, this was the part of the brain that lobotomies attacked, leading some to call neuroleptic “treatment” a “chemical lobotomy.”) This makes sense, because dopamine is the target of the “antipsychotics” aka neuroleptic drugs. I also seem to recall something about reduction in white matter, the stuff that surrounds the neurons. Tardive dyskinesia is clearly and unarguably caused by damage to the dopamine system, only seen in people taking dopamine inhibitor drugs like the neuroleptics, and it would stand to reason that damage to the dopamine system would associate with TD, though I have not researched that question.
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Indeed it does! But apparently, they don’t even respect their own “experts” when they come up with the “wrong answer!” These are not people who are going to suddenly say, “Gosh, we seem to have gotten it wrong – maybe we should listen to our clients in the future.” They are dogmatically committed to their worldview and to taking down anyone who dares to challenge that view. I want to extend my love to such people and hope for their transformation, but we can’t allow such people to decide what is “helpful” for the people they truly don’t give a crap about!
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New drug names have to have a Z or a Q or some other rare letter in it, or some weird spelling. So maybe we can go with “Taperz” or “Nottooqik” or “EventuelyOff.” Or “Qutdownz?” “UKANQiT?”
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Of course, alcohol feels good, too, and I used to enjoy marijuana before it started making me a little paranoid. I have no objection to people using whatever drugs work for them, but it’s sure not a sign of psychiatric drugs “working” to “treat mental disorders!”
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Not to mention denying the evidence from their own researchers: that “ADHD” is 30% more likely to be “diagnosed” if a child is a year younger, that there are no long-term outcomes that are improved by stimulants for “ADHD”, that “antidepressants” increase the likelihood of aggression and/or suicide rather than decreasing them, that taking “antipsychotics” for more than a brief time dramatically DECREASES the likelihood of recovery, that countries with less “antipsychotic” use have better outcomes, that the likelihood of “psychosis” is strongly affected by social conditions, in particular, migration, urban living, and childhood sexual abuse, that genetics contributes little to nothing to the probability of any psych “diagnosis,” that “antipsychotics kill people decades earlier than the general population… I could go on.
I agree, the most fundamental evidentiary problem is ignoring the actual experiences and feedback from those they are supposed to be helping. You’d think that would be the MOST important data, and it is considered the least. But even without that vital consideration, the profession’s ability to ignore cartloads of inconvenient evidence disqualifies them for even the vaguest consideration of being “scientific!”
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I agree completely. School in its entirety was a total violation of any sense of safety or self-determination I had. I was in internal revolt for 13 years, but externally acted like things were OK, except for one or two incidents of acting out over the years. It is very damaging, and is only one of many ways in which we have to deny our intuitive sense of what is right in order to survive.
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Most have given up on the idea of “bad parents.” Any suffering is caused by a faulty brain. Because if your brain worked properly, apparently, we’d all be happy with our circumstances, no matter how grim!
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Thanks for pointing out the subtleties of your comment! Your writing borders on the poetic!
I don’t think it is inevitable that we are required to disrespect our own instincts and rhythms. It seems to relate largely to having too many people for the space we have, and having too few people with too much power to direct others’ behavior for their convenience. And we all accept it at this point, or most of us. I think a lot of ‘mental illness’ comes from internalizing these expectations.
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Very well said, John!
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It can hardly be considered coffee’s fault that our circadian rhythms are not respected. I’d view coffee as mostly an effect – an attempt by individuals whose circadian rhythms are PERFORCE disrupted by a society that does not respect them to do something to maintain their alertness in spite of the constant assault on their natural rhythms of sleep and lots of other things. This disrespect begins in the cradle (remember forced feeding schedules and intentional waking of babies who “slept too long” for their arbitrary schedules?) and continues through school (how many days were we all forced to “go to sleep on time” and get up at a ridiculous hour to spend a day of largely wasted time in a building we hated with people we were forced to associate with doing things that someone else decided were important?) and of course is brutally enforced in the workplace for most of us who have had to do a “job” to maintain survival for ourselves and our families.
Let’s not blame coffee for doing a job that our society has created for it! Remember the Rat Park experiment – rats DON’T prefer cocaine to food when their social and emotional needs are met!
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A lame excuse for “science!”
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I think you’re right. It is driven by profits, so making it no longer profitable to drug people for ostensible “mental illnesses” is the answer. But drug companies can apparently afford the fines, so going after the prescribing doctors or those creating the “practice guidelines” seems the most likely to be effective.
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It is a typical, dense, heavy-handed, insensitive, context-absent psychiatric intervention. If someone doesn’t eat enough, let’s give them a drug to make them hungry! If they eat too much, let’s give them a drug to make them LESS hungry! If they take stimulants (which increase dopamine) and become aggressive, forget DECREASING the stimulants, let’s give them antipsychotics to decrease the dopamine we’re increasing with the stimulants!
It’s like watching someone try to do sculpture with a pickaxe. They have no tool to do the job, but insist on doing it anyway, and regardless of the damage done, never seem to conclude that perhaps they ought to find a small chisel and hammer, but continue to hack away with the pickaxe and require everyone else to admire their “work.”
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And comments like that have been made for decades. Yet, no one fills the holes, the prescribers are not better educated, non-pharmacological treatments are not given attention, and patient feedback is minimized or ignored. What could possibly occur that would change this?
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But cigarettes can also uncover a latent coughing disorder. Which, of course, we can treat with an anti-coughing medication. And later on, you may develop lung cancer. We have found that lung cancer patients seem to have a penchant for cigarettes earlier in their lives. We believe a chemical imbalance in those pre-disposed to lung cancer also leads them to crave cigarettes. Of course, the cigarettes are just a meaningless correlation – the couldn’t POSSIBLY be a causal factor!
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This seems to be so difficult for some people to understand. To say “there are no ‘mental illnesses’ is not the same as saying that this kind of suffering doesn’t happen. It means that the categories they define don’t mean anything at all! You can group together people with brittle fingernails or people who clean out their ears with their pinkies or people whose hair falls out early or people who have larger breasts on the average, and any one of these can be defined by a list of “criteria” and people can be diagnosed with “Excessive Ear Cleaning Disorder” or whatever you please. But if the grouping of people has nothing in common other than the ostensible “symptoms,” what is the point of it? And to then attribute these “disorders” to “neurodevelopment” without a shred of evidence adds insult to injury! Plus, if some subset of these people really DID have a neurological problem, the psych “diagnoses” immediately become a barrier to discovering this, because they’d be grouped together with a large cohort of people who did NOT have the same problem, and no one would look at these people with an interest in finding the cause.
There is no scientific validity to any “mental disorder.” They are based on arbitrary judgments and assumptions that have no coherent meaning. This is not to say people don’t suffer these described syndromes at times. It’s saying that calling these collections “mental disorders” is worse than pointless – it actually prevents any recognition of any ACTUAL physiological problems that DO exist, while invalidating the importance of life experience as the most important contributing factor to most mental/emotional distress.
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Very true!
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Seems a very likely connection. I mean, athlete’s foot is embarrassing, causing anxiety and depression, which no doubt leads to violence, since we know all depressed people are violent. I hope you will control for the presence of clotrimazole, though. Could be a confounding factor!
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You made me laugh!
But seriously, I’d love to see a study where antidepressants take on controlled doses of chocolate or French fries. I bet there would be little to no difference. In fact, chocolate would probably win!
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Well, perhaps it’s time to recognize the antidepressant effects of fast-food French fries!
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Ah, but was the elevated histamine actually CAUSED by the psych drugs themselves?
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A lot of “witches” were midwives and herbalists. Women with power were always threatening to the patriarchal “leaders.”
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So you mean handcuffing someone and forcing them into a patrol car, dropping them in a locked “ward” and strapping them to a bed and forcibly injecting them with a drug that makes them feel half dead, discourages them from seeking out similar experiences in the future?
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An excellent argument! However, it doesn’t work so well for the drug companies!
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Exactly! If it were low lead, we’d have to start THINKING, plus, our stimulant sales might go down, and if the client is actually healed, well, I’d have to look for new clients, wouldn’t I?
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I don’t disagree at all. The point is not that acting out of anger is always OK, but that feeling anger is not a “disease” and behavioral choices are not ma “disorder.” They are choices. And choices have consequences. And if we want different consequences, we need to make different choices, and we can use our feelings in different ways rather than trying to snuff them out or feel guilty for having them.
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I certainly would not expect you to. I was only mentioning that it is not a rare thing or an abnormal one that people who have had their trust frequently violated have a tendency to be sensitive to others’ questionable behavior. Anger can be a good way to protect ourselves from danger!
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You are engaged in a noble pursuit, and the dangers are real. I hope you get some press and make them squirm!!!
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Psych “diagnoses” most definitely discourage and undermine any effort to look for any cause, even an obviously physiological one like Wilson’s Disease. Once we “know” someone “has ADHD,” any further effort to determine a cause is immediately brought to a halt.
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I don’t know if this applies to you, but I’ve known a LOT of people who have been traumatized in youth and adulthood, and it is very common that such people strike out when threatened or bossed around. I don’t think it’s “abnormal,” but it can be a problem sometimes.
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Whew, sounds GREAT! Can you make sure to link us to the letter when it gets published? I want to see how this goes. You sound like a force to reckon with!
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You are so right! It is a shame scientists don’t consult with you. They really ought to if they want to remain scientific and sane in their research!
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Well, not NOBODY… there are plenty who make plenty of money over selling hopelessness and dependency.
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Thanks for the ongoing education! Difficult reading, but it says so very much about why this “profession” has roots in very dark and destructive places, and why trying to “reform” the profession is destined to complete and utter failure.
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And of course, the psychiatrists were foursquare behind the Nazis from day one. That can not be in dispute.
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It is my impression that “scientific” eugenicists in the psychiatric world inspired the more direct and blunt efforts of the Nazis.
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That is a very generous assessment of your therapist. Too bad she could not show the same generosity of spirit to you!
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Just doin’ mah job, ma’am!
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Clearly, that is central. The need to define “normal” and to attack or demonize anything that deflects from that “normal” seems to be critical to this effort. This way, everyone is focused on whether they are “happy enough” or “good enough” or “smart enough” or “pretty enough” and so on, instead of wondering where this anxiety and frustration is coming from!
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I believe the “survivor” concept came from the world of domestic abuse/sexual assault intervention. Could be wrong there, but that is my impression. The intent as I understand it is to define someone by their strengths and accomplishments rather than by their victimization. But that’s my limited understanding.
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“Neoliberalism is contemporarily used to refer to market-oriented reform policies such as “eliminating price controls, deregulating capital markets, lowering trade barriers” and reducing, especially through privatization and austerity, state influence in the economy.”
https://www.google.com/search?q=neoliberalism+defined&rlz=1C1RLNS_enUS769US769&oq=Neolib&aqs=chrome.3.0i433j69i57j0i67j0j0i433j0j69i60l2.4527j0j7&sourceid=chrome&ie=UTF-8
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It is true that the US medical society is pretty obsessed with cutting out anything remotely related to cancer. However, at least there is an actual THING to be evaluated in that case. Psychiatry is the only profession I know that has done surgery for the sole purpose of destroying normal, healthy cells.
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“A more recent analysis estimates 128,000 Americans die each year as a result of taking medications as prescribed – or nearly five times the number of people killed by overdosing on prescription painkillers and heroin. Sep 27, 2016”
https://health.usnews.com/health-news/patient-advice/articles/2016-09-27/the-danger-in-taking-prescribed-medications#:~:text=A%20more%20recent%20analysis%20estimates,on%20prescription%20painkillers%20and%20heroin.
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https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html
Note that the now use the term “medical errors,” but over 120,000 deaths included in the original study (back in 2001 or so – more than half!) resulted from properly prescribed and properly administered drugs. So it doesn’t require an “error” for doctors to kill you. Standard medical practice does the job more than half the time.
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Too true! For every death, there are dozens of injuries that mostly go unreported. As well we all know!
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That’s for sure!
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Talk about missing the point! Her suicidal thoughts appeared to be directly related to the stresses of having to deal with the racism and classism and anti-American sentiments in the British nobility, so essentially, with social ostracism and discrimination. There is no “treatment” for abuse!
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I agree. Cancer treatment kills lots of people! But at least in that case the disease itself can kill you, so the risk of death is more understandable. Risking death because someone behaves in ways that society finds difficult to manage? Seriously?
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Receiving medical care is the third leading cause of death in the USA. But I would bet that psychiatry is at the front of the line in terms of iatrogenic deaths.
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Fair enough.
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Certainly. Evidence has to be examined objectively, or we’re no longer doing science. We’re doing marketing!
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Holy crap! How could anyone “heal” in such an environment???!!
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I think he was being facetious!
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I agree with all you say above.
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Oh, sorry, I forgot!
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OK, HIGHLY misogynistic. You get the idea.
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And let’s not forget that the staff can be dangerous, too!
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The ultimate subgroup is a single person. If you break it down far enough, you end up with individualized “treatment,” which is what should be happening anyway, if any “treatment” at all is considered appropriate.
Of course, there is “heterogeneity” in a group you put together based entirely on how they FEEL at a given moment in time. The idea that people who feel depressed are all the same is the most basic deception psychiatry is based on.
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I’m just going from stats here. Most mass shootings are perpetrated by young men who are misogynistic and have a history of drug abuse, or are on psych drugs. I am certain older men would factor in there as well, as being MALE is the most common characteristic by far of all shooters. My point is, if we’re going to create a profile, we ought to base it on actual correlations, and “mental illness” doesn’t even come close to making the cut!
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It is not UNCLEAR how it could be considered ethical. IT IS NOT ETHICAL, and should not ever be considered to be ethical. These people KNOW they are being unethical, or else they have no sense of ethics to offend. Why not call this out for what it is?
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Actually, that is a good point! If they are advertising being “evidence based medicine,” isn’t that a tacit admission that their prior “medicine” was NOT evidence based?
Of course, it is impossible to have a real evidence base for “disorders” that are not objectively distinguishable from non-“disordered” conditions, which the DSM itself admits in its introduction is the case for any and all of the DSM “diagnoses.” Kind of like collecting “evidence” to “treat” laziness or cowardice or spontaneity or joy. It is an illogical proposition from the word go.
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Reducing the placebo effect is anti-scientific. Drug companies hate the placebo effect because it shows up their drugs as mostly active placeboes. Keeps them from selling as much!
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Well said. If we were going to “profile” the dangerous person who needs to have an eye kept on them, it would be a younger male domestic abuse perpetrator with a substance abuse problem (or on certain psych drugs) and an obsession with weapons. “Mental illness,” whatever that means, would not even make it onto the board as a risk factor. Most gun owners are safe, most people labeled “mentally ill” are safe. We should be looking at the actual risk factors if we are going to try and prevent such situations from arising.
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Sounds like “refugee” applies pretty well! When you have to leave your home and avoid the “authorities” for fear of being “sent back,” you are a displaced person, in my view.
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I will do my best!
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I see it as a constant struggle. There are people who believe they “know best” and should be the authorities, and others who resist are “wrong” and need to change their viewpoints or attitudes to comply with what “we know is true.” This kind of arrogance in a “helper” is incredibly dangerous, because the “helper” has no naturally occurring reason to stop or question his/her activities, since s/he is automatically doing good by virtue of being the authority!
The other group, which I think is a lot smaller, is those whose intent is to increase the self-determination of the people they help. People in this group would be horrified by the idea of telling someone what to believe or think about their own situation, and instead are focused on helping this person gain sufficient perspective to evaluate their own lives and tell their own stories, unencumbered by any “expected” way of thinking or acting.
Of course, there are many who don’t really belong to either group and can be swayed one way or the other. Unfortunately, at this time in history at least, Group One has control of the mass media and the main messages we receive are authoritarian ones, and those working for empowerment are considered foolish or dangerous.
That’s my take, anyway!
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I don’t think we are talking about the same thing if you are saying that “repressed” memories can’t be spontaneously recalled. If “repression” per se exists, it would involve an immediate action of putting this memory out of consciousness for purposes of self-protection. There is nothing in the concept of “repression” that would say such a memory could not later be spontaneously recalled or triggered, in fact, this is exactly what PTSD researchers find happens when a person gets triggered. They may have had some vague awareness that “something bad happened during the war” or “my uncle used to creep me out when he came in my room,” but then something reminds the person of what actually occurred, and the memory comes back up in more detail.
I am certain that there are people who have chosen to distort this admittedly theoretical mechanism to explain how such events happen in order to justify “pulling out” memories that the client is “repressing,” then I say they are behaving reprehensibly. As I think I’ve made clear, there is no excuse for such a shabby form of “therapy.” It sounds like we agree on most points, and are perhaps having different meanings for the term “repression” that are causing us to think we’re disagreeing.
Thanks for working through this with me.
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I agree with you – not knowing is quite dangerous!
When I say “unethical,” I’m referring to acting on the therapist’s idea of what they “should do” rather than on the observable effects on the client. It would follow that there are a lot of unethical therapists practicing. A truly ethical therapist is humble, knowing first off that it’s better to do nothing than to do harm, and knowing secondly that anything they DO attempt needs to be filtered through the knowledge that inadvertent harm is easily done and not always readily observable. A competent therapist is one who is constantly getting feedback from the client, verbally and nonverbally, and altering one’s approach to meet the needs of the client rather than the therapist’s need to be perceived as “competent” or “insightful” or “skilled” or to prove that the therapist’s school of thought is “correct.”
In my experience, there is nothing that harms a client more than telling the client what to think about his/her own narrative. Telling them that their memories are “false” or telling them that they “have memories that they don’t recall” are equally destructive, and it should be obvious to anyone looking at the client’s reaction that such actions create confusion and uncertainty, and those are two things we should NOT be creating as therapists!
My biggest objection to the DSM is not the drugs, it is the action of the doctor/therapist telling the client what to think or believe about their “condition” or needs. Even if such an evaluation were based on facts, it is still not going to be helpful to tell the client “here’s what’s wrong with you.” When such an evaluation is based on raw speculation or invention, as the DSM “diagnoses” almost entirely are, it probably crosses over from unethical treatment to criminal fraud in my view.
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Wow, that’s a pretty bent assumption there! I know many people who believe that people could recall prior abuse that they have not recalled previously who would find the idea of “recovered memory therapy” horrific and abusive. Perhaps we travel in different circles. There is absolutely no connection between the ability to recall memories previously not available to the conscious mind and the vindication of therapy that implants “memories” that never occurred, or assumes the presence of “memories” from a vague and subjective list of “signs and symptoms” that has no scientific validation.
And I would add that the possibility of this discussion is certainly NOT foreclosed upon just because of the observations that some abusers have used the concept to discredit their accusers. Both can be valid at the same time. There is no contradiction that I can see.
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And maybe add “escapees” to the options!
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“Inmates” and “outmates” works for me!
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That’s more what I think of in terms of “False Memory Syndrome” – the therapist TELLS you that you had a traumatic experience, even if you have no reason to believe this is true. THAT is pretty scummy of a therapist to do that kind of thing.
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So we are playing semantic games now? You know no more than I do about why someone doesn’t recall something that happens, or what mechanism is involved in them being “spontaneously recalled.” I hear no science about this, just a redefinition on your part.
So we can agree that a traumatic memory could be “forgotten” and then “spontaneously recalled” based on some environmental stimulus? In that case, there isn’t much we are arguing about. We’re both saying that something could be forgotten and then recalled later, and the fact that it wasn’t recalled doesn’t mean that the spontaneous recollection is false. Seems like splitting some pretty fine hairs to me.
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You can say the same thing over and over, but it doesn’t make it true. First off, there is nothing “fantastical” about the idea that people would choose on some level not to consciously recall something that was troubling them. If they can “spontaneously recall” something they didn’t before, why could that thing they “spontaneously recall” be a traumatic event??? Your argument makes no sense at all!
My point regarding memories is that YOU are not in a position to tell ME what I recall is true or false. OF COURSE, people have inaccurate recollection that are contaminated by later experience or poor questioning or whatever. My point is that NO ONE can say if the recollection is true or false absent confirmation from objective data. As this is almost never possible, we are left with the subjective problem with memory in general.
For instance, the person who recalls what they believe was abuse may be confused or recall incorrectly. Absolutely. But why does this same reasoning not apply to the person who denies that it happens? Could the alleged abuser or other family members not have their recalls contaminated by later experience, or by their on conflict of interest in wanting to minimize the damage they have done or to avoid legal consequences? Do we require a “mechanism” to explain how people who are guilty of abuse claim to be innocent, and often BELIEVE themselves to be innocent in contradiction to actual facts?
It is very interesting how the recollections of those claiming abuse are so closely scrutinized, and frankly thoughtlessly invalidated on occasion, while the recollections of those denying the abuse are so readily accepted as true? Why do THOSE “false memories” not concern the “false memory” crowd?
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Again, these two things have nothing in common. One is a spontaneous process that occurs within a person, the other is an effort to induce or implant memories in people who have none. The latter is NOT caused by the concept of repression, it is caused by unethical therapists who are either greedy or unable to deal with their own issues and act them out on their clients. If they did not have “repression” to use as a blunt instrument, they’d come up with another one. And many do. How many professionals believe they can “detect bipolar disorder” (or whatever other “disorder du jour”) and tell people they “have it” without any objective way to say it is true, and without the slightest consideration of the viewpoint of their “client?” This is not caused by the concept of “bipolar disorder.” It is caused by unethical practitioners, and is far, far more common than the “false memory” phenomenon.
It is important not to blame a concept or idea for how people choose to use it. No one should be telling anyone what they should believe about their own experience. THAT is the problem!
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So what is the “known psychological mechanism” by which people spontaneously recall things which they have not had a conscious recollection of previously?
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The majority of experts also believe that psychiatric drugs address biological anomalies in human brains, despite the complete lack of evidence that “mental illness” of any sort is associated with biological anomalies, nor that psychiatric “diagnoses” are meaningful entities that identify homogeneous groups, nor that people so “treated” do better in the long run (and significant evidence that on the average, they do NOT do better). The majority of experts are comfortable with a 30+% Caesarian section rate. The majority of experts believe that “treating” youth with “antidepressants” is good treatment, despite overwhelming evidence that there is no benefit to such “treatment” for children and that the recipients of such “treatment” are MORE likely to kill themselves or feel like doing so. The majority of experts once believed that Thalidomide was safe, that Benzodiazepines were not addictive, that Benzedrine was not addictive, that Tardive Dyskinesia was NOT caused by antipsychotic drugs, that there were no withdrawal effects from antidepressants, and that Viiox was a safe and effective pain reliever. They believed that sexual abuse was explained by “Oedipus complexes” or frustrated sexual drives in three year olds. Experts believe a lot of things that are not true. The “resort to authority” argument doesn’t hold a lot of water in the area of “mental health.”
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I don’t agree. It is scientifically improper to assume repression can’t exist, just as it is scientifically improper to assume that it does. I agree that it is easier to prove that repression does occur than proving it doesn’t, but there is plenty of suggestive evidence that it does occur, even if it is not conclusive. The evidence that people do, in fact, recall memories that they previously did not and that these memories reflect actual events that happened is pretty powerful in the community of people who treat “PTSD” and other trauma phenomenon. It is not scientifically valid in any sense to invalidate such evidence simply because occasions occur where such memories are implanted by poor or unethical therapists or professionals. Stories of repressed memories have been recorded for over 100 years and cannot be simply discounted because someone says “prove it.” The proper scientific position on repressed memories should be, “We really don’t know for sure.” To invalidate memories of a person who recalls them can be just as damaging as trying to induce memories that don’t exist. In the end, the only real judge of the reality of a memory, absent confirmatory evidence, is the person doing the remembering.
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Of course, these are not criteria that are generally accepted in the “mental health” system, which we know has pretty low standards to start with. I would say the important missing information is that the allegations were made after influence by a professional or other adult who has encouraged the person to believe they have memories which they don’t recall. I think denials by perpetrators are completely meaningless and should not even be a consideration, and denial by family members would also extremely questionable and need to be viewed in context. Not sure why the perpetrator would have to have any kind of dependency on substances, or “bipolar disorder” (which is, of course, totally unverifiable), or a history of molestation or abuse. Many, many perpetrators do so when stone cold sober, and many, many perpetrators have no record whatsoever, especially in family situations. As to “bipolar disorder,” it is a ridiculous criterion. Are they really suggesting that being diagnosed with “bipolar disorder” is a requirement for molestation? That “bipolar disorder” predisposes people to molesting children? I find such a suggestion utterly ludicrous in my experience (and I worked for 20 years with foster youth, seen plenty of abuse victims and perpetrators). And what’s that weird point about “bestiality appears in prehistoric art?” Are they trying to normalize bestiality? Or what?
These seem like extremely questionable criteria for any “diagnosis,” and the stakes involved here are enormous. Surely, the authors could do better than this!
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Or they are dealing with a person who is overwhelmed, whose life has turned upside down and who has insufficient support or is being actively undermined. It is very common for overt domestic abuse to begin during pregnancy or shortly after the birth of a child. Additionally, the mother usually has to deal with loss of sleep, physical stress of nursing, change of body image, loss of connection through employment, loss of income, isolation, triggering of childhood memories of abuse/neglect, shock or disappointment about the realities of having a baby not matching social expectations… I could go on. There are a lot of good reasons to be depressed after a child is born that have nothing to do with the body. That said, I totally support nutritional interventions, as a lot is changing on a physiological level as well.
In short, the idea that “postpartum depression” is a medical problem is laughable for anyone who has actually become a new parent of an infant.
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I don’t agree. There are people who are still receiving “treatment” involuntarily, including those forced by law and those who are in a bad position where detoxing from these drugs is dangerous or sometimes even not feasible due to alterations to the brain caused by the drugs. Additionally, I’d say that anyone who has recognized the contradictions and dangers the system has put them through and is trying to get out is also a “survivor” by any measure. They have survived, even if they are still being abused.
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I think you summed it up very well. I have absolutely no problem with folks being careful about the details of such memories being potentially altered by mixing up with later experiences. We all know this can happen. But I take absolute exception to the idea that a vague, hazy recollection can be clarified and retrieved more completely by writing or talking to someone about what is recalled, nor that a memory can be brought to consciousness by external events that has not been held in conscious memory for very long periods of time. The phenomenon of PTSD suggests that memories being triggered by external factors similar to the unrecalled events can and does occur and has been very well documented. I have no problem saying that we don’t fully understand how memories work and how accurate such spontaneous recollections of previously unconscious memories might be. I have a BIG problem with one person telling another person such memories are false simply because they were forgotten (for whatever reason) and then later recalled. AND I have a big problem with someone telling someone they DO have a memory that they have NOT recalled as well!!! It is for the person having the recollection to judge how accurate or believable it is, absent any external proof regarding such recollections. The problem with the FMS concept is that it can very easily be used to invalidate the recollections of others that are NOT induced by bad therapists or malfeasant professionals. If a therapist is seen to have intentionally implanted or insisted on the presence of “memories” the client has never recalled, then I think “FMS” has some validity. But to say it is somehow “proven” that memory repression can’t happen is going WAY beyond where the science of memory can possibly take us today.
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Richard McNally can say whatever he wants to say. “Recovered Memory Therapy” is a sham, and we all know that. But it does not follow AT ALL that “repression” does not exist. And there are certainly many in the “false memory crowd” who suggest that ANY memory that was not recalled all along is almost certainly false. One such post was approved (with provisos) just a moment ago and is in this thread for you to read.
I still see absolutely nothing in your post to even distinguish the difference between a “spontaneous recall” of a previously unrecalled memory and a memory temporarily “repressed” under stressful circumstances that is later “spontaneously recalled,” let alone evidence that the former exists and the latter does not. It is not logical or scientific to deny that something happens in order to address unethical practitioners who choose to take advantage of their clients’ vulnerability by suggesting that they have “memories” which the clients have never originated having recalled. The latter should be handled by the criminal courts and by stripping such practitioners of their licenses. Their unethical behavior has NOTHING TO DO with whether or not a person can “repress” a memory in a moment of stress and then “spontaneously recall” such a memory at a later time.
I will also counter your statement of “providing cover” by saying that the overreach of the concept of “false memory syndrome,” which properly applies ONLY to “memories” evoked or created by poor questioning or unethical acts by a therapist to implant memories the client has never said they recalled, has provided cover for people who have committed acts of abuse against children and yet can claim that their child’s recollection is a “false memory” in order to avoid the consequences of their criminal behavior. Surely, this should be as great a concern as therapists implanting “false memories” with poor technique or unethical attitudes toward profiting from creating upset in their own clients.
https://www.rasasc.org.uk/farewell-to-false-memory-syndrome/
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POSTING AS MODERATOR:
I am allowing this post to stand, ONLY because there is already a reply posted that indicates that the case in question is not about a person who is posting here. I have already asked that people be VERY careful not to intentionally or accidentally invalidate the recollections of any person who is sharing their personal narrative. This kind of post is extremely dismissive and invalidating, and if it were in response to someone’s own story, could be extremely hurtful. PLEASE do not post anything that could call another person’s recollections into question! This is NOT a place where people should have to “prove” their personal stories are correct, and those who demand such “proof” will be moderated without exception, and may ultimately be blocked from posting if this kind of thoughtless behavior continues.
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Well, I guess she recovered those memories, didn’t she? Sounds like they were pretty accurate!
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I think you are splitting hairs here. The big question is not whether someone can introduce false memories with poor questioning techniques or intentional manipulation – we all know this happens, and there are systematic trainings on how to question kids to avoid such events happening.
The big question is whether memories can exist of which a person is not consciously aware, but which can come to awareness at a later time. If you call this “spontaneous recollection,” that’s your right, I suppose, but I fail to see any distinction between a memory a person files away to the “unconscious” file that can later be retrieved and the basic assumptions behind “repression.” Repressed memories, to me, would be memories that a person on some level becomes unaware of as a self-protection mechanism against being overwhelmed by pain or fear, or perhaps simply because they are unpleasant to recall. If those memories later become retrievable under less stressful circumstances, I think we have the full mechanism of “repression” in view, no matter what term you choose to refer to it. As long as someone isn’t “pulling” the memory out, I think “recovered memories” are a very valid phenomenon. Whether these memories contain all the information recorded with 100% accuracy remains debatable, but in the instance noted, a person is “triggered” to recall a memory of something that in all likelihood really happened. A lot of folks in the “false memory” school of thinking would question or deny that this memory could be a memory of a real thing that happened, and that I find to be a very destructive and unscientific viewpoint.
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A diabolical team indeed!
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Sounds pretty damned legit to me. No one asking “leading questions” or encouraging “disclosures” of things that didn’t happen. Just a pure, spontaneous recollection. I see absolutely no reason to doubt such a recollection is valid. In fact, I’d think it rather evil to try and invalidate it.
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I think you have it backwards. The drug companies come up with the “treatment,” then the APA invents a “diagnosis” for it to “treat.”
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POSTING AS MODERATOR:
I generally don’t remove moderated comments until the end of the month. At that time, it often occurs that a long string of “removed for moderation” comments appear at the same time. It is not the result of a change of policy, it’s just an administrative issue, based on the most efficient approach to saving copies of moderated posts before deleting them.
Hope that explains things!
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Are you suggesting that “precision psychiatry” would have to actually be focused on finding out what ACTUALLY WORKS and WHY, and applying it on a case by case basis?
You are such a radical!
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“Precision psychiatry” can start as soon as psychiatry is able to precisely distinguish between an “ill” person and a “well” person. And I won’t hold my breath that this ability will develop in my lifetime, or ever. Because there is no way anyone can establish with precision that someone’s emotional condition is specifically caused by a “mental illness” that is based on committee consensus and voting.
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POSTING AS MODERATOR:
A reminder that generalized comments about COVID-19 are going to be moderated at this point as “off topic.” The topic of the blog is whether or not those labeled “mentally ill” should be prioritized for the COVID vaccination. The wider discussion has led to deteriorating civility and increasing personalization of comments without contributing anything to the main topic, and also without much evidence that an actual exchange of information was going on. I apologize to those who are posting appropriate comments, but for the good of the community, this particular aspect of the discussion is closed.
Feel free to make comments on the basic premises of the article.
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In the USA, receiving medical care is the third leading cause of death. Over 220,000 deaths in hospital settings alone are caused by errors or unnecessary surgeries, but most of all by side effects of properly prescribed and properly administered drugs. Seeing a doctor can be very dangerous!
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Yeah, I’ve heard some people taking Seroquel or something “recreationally.” They must not have very fun lives!
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I am glad to hear that you were able to heal, and I’ve known many who have been able to, probably a majority. But I have run into a number who seem to be set up now so that stopping the “antipsychotics” leads to massive “relapses,” and despite slow tapering and support, it seems they have now become dependent on these drugs for stability. Bob goes over the mechanism in his book, and it makes perfect sense. So I agree that keeping hope alive is critical to recovering from the “help” usually doled out by the psychiatric industry, but it does seem to become harder the longer one is on these (on the average), and there does seem to be some lasting damage that some folks are not able to shake, in my experience.
The spirit, however, can always be healed!
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As in, “If you rail against abusive doctors, you must have a ‘personality disorder?'” And if the doctors are abusive, is there something wrong with railing against them?
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I do mean in terms of probabilities. The longer one takes them, the less likely they will be able to repair the damage.
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I have no problem with “madness” as a self-description of a certain act or behavior – “I went mad!” Or “I had this mad idea…” I do see what you mean about it potentially becoming a counter-identity for someone being attacked or dismissed by psychiatry. I’m not sure I find that a bad thing – certainly better than kowtowing to the “authorities” and letting oneself be dismissed as “mentally ill.” But I can also see how it could still be viewed as accepting one’s “otherness.” In the end, I tend to agree that we’re all a bit “mad” in one way or another, and the distinction seems to fade away if it is viewed that way. Though it does provide a nice double-entendre, because we’re all freakin’ pissed at the system!
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I think two years is just where the divergence becomes big enough to be obvious and undeniable. I am sure the damage is being done from Day One, but possibly it is more “healable” before the two-year mark, after which the changes become more permanent and deterioration becomes the rule of the day.
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An excellent question. I do believe that self-healing has to happen before one can truly be of help to others in their struggle. What I hope we will work towards is communities of people caring about each other, as opposed to the “winner takes all” philosophy that seems to have the world it its grip right now. But this will mean challenging those who are benefiting so extremely from the status quo, and that will take love to a higher level of seeking justice for those we don’t personally know. It’s a big hill to climb!
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COMMENTING AS MODERATOR:
OK, Richard, you get the last word here. We are now going to stop any further discussion of the generalities of COVID. Further discussion on this thread will be focused on the particular question of COVID vaccine prioritization for the so-called “mentally ill.” Any divergent comments regarding the possible causes and general approaches to COVID not specific to the article will be moderated as “off topic.”
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Does it seem completely outside the realm of possibility that the virus DID accidentally escape from the lab and that the people who run the lab didn’t want anyone to know about it? I am pretty surprised at your complete confidence in the authorities to always tell the truth, given your experiences in the world of “mental health” where the authorities lie through their teeth as a matter of course. It seems contradictory to say that you can’t say with certainty that COVID 19 was not a lab experiment gone wrong, and yet say a moment before there is “NONE, WHATSOEVER” evidence that this might have happened. I think there is plenty of circumstantial evidence that such a release is quite a strong possibility, even if is is not a proven fact.
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Does your question mean that YOU think it is a GOOD idea to create extra-infectious deadly viruses in labs, trusting that ALL the human beings in charge will ALWAYS act with complete and utter security to make sure there is NEVER an accidental release? If anyone really believes this is a good idea, I think I have some farmland near Chernobyl that they might be interested in.
It means the idea that somehow a coronavirus that is particularly virulent is coincidentally released just a few miles away from a lab doing research on making coronaviruses more virulent but that it is from bats at the local grocery stretches credulity well beyond comfortable bounds. Besides which, there is now some evidence emerging from China (via the US State Department) that some of the Wuhan Lab workers were ill with a flu-like illness just a few weeks before the huge outbreak was identified. I am by no means buying anything suggesting this is some kind of planned “plandemic” for some kind of nefarious but as yet vague plot of the Shadow Government to somehow obtain worldwide control by forcing everyone to wear masks or some such nonsense. However, history tells us that “High security” labs and the like are far from perfect, and escapes and leaks are not a rare phenomenon. Additionally, the Chinese have been quite protective of any information regarding this lab and how the pandemic got started. So while I can’t be certain of this, all the evidence leans toward the likelihood that this virus did, in fact, accidentally escape from the lab in some way. As the saying goes, “Never attribute to malice that which is easily explained by incompetence.”
Even if the virus did not escape from the lab, the possibility of such escapes is certainly more than negligible, and the idea of creating viruses that COULD cause a worldwide pandemic as a means of PREVENTING a worldwide pandemic seems quite foolish, to say the least. This research was discontinued by the Obama administration for a very good reason. It needs to be stopped, permanently.
I would appreciate it if you are a little more careful in your between-the-lines implications in your “questions” in the future.
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Advocacy skills are often learned through harsh necessity!
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Well done!!! Thanks for sharing that story – you sound like a very capable advocate!
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I agree absolutely, modeling and education is what helps other people see the possibilities. As I said above, my only concern is that we need to go beyond the individual’s experience and work on system problems. I spent a lot of years advocating for foster kids, and despite repeated successes with individuals, saw the exact same situations arising again and again, because they were only responding to my or my CASA volunteer bugging them and pressing them to do the right thing, and never really learned why it was the “right thing” in the first place.
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Very well said, as usual!
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A 0.5% risk correlation is pretty much a negligible tendency. Especially when those same genes appear very commonly in “healthy” people.
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Oh, believe me, I agree with you completely, but it just can’t stop at the individual level, and we can’t allow those running the show to reframe all of this as “individual problems.” You know as well as I that the personal melds into the family which melds into the institutions we participate in which melds into the survival of the species as a whole. Each affects the other, back and forth, and I think that needs to be recognized for us to be successful.
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And the results were measurably better, by a long ways.
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You are probably right. I know of a few cases personally where the person had zero history of suicidal or homicidal impulses before the drugs. But I know from both research and direct personal conversations that the suppression of inhibitions is one of the cardinal effects of cranking up serotonin artificially. It is too consistent a report to be chance, according to my “inner p-value test!”
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Very nicely said!
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Although I think it is important to recall that this is not all about our individual abilities to empathize, listen, etc. There is also a very widespread lack of community connections that impact the most skilled communicators among us. There is more going on than a lack of individual skills here. It is, as they say, a “system problem.”
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I am sorry if you thought I was referring to you when I said “beyond stupid.” I was referring to the authors of the DSM who make that claim, that if I’m not “over it” when my spouse dies within two weeks, I have a “mental illness.” It is the most absurd of many absurd things in the DSM.
It appears you are simply defining “illness” as “distress.” I don’t define it that way. I believe there is plenty of distress that is natural and normal and healthy and not a part of any disease process. I also believe that calling these things “disorders,” as the DSM clearly suggests we ought to, prevents research and interest in actual physiological problems that may be in play.
But it sounds like we are substantially in agreement on most points, except for that definition.
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I don’t think we’re far apart here. You are choosing to define “illness” more broadly by far.
Just for the record, I have never regarded SUFFERING as metaphorical in any sense, and I don’t believe I said anything like that. The problem with the term “mental illness” at this point is that it is used intentionally as a means of denying that suffering has any kind of meaning beyond messed up brain chemicals. The idea of the “mind” being “ill” in the same sense as the body is the metaphor we’re talking about here. Suffering is very real. Saying someone “is mentally ill” because they are suffering is metaphorical.
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Well, this certainly sounds like positive news! I can only hope it pans out as this doctor predicts.
And I also certainly hope that experiments designed to make viruses MORE dangerous are banned worldwide after this fiasco.
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Shunning is always a risk when challenging the “group think!”
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Thanks for the elucidation. Sounds like you know what you’re talking about!
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“Contempt of Forum!” That made me laugh!!!
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Dang, we need someone to try and refute it! Of course, the fact that they haven’t even tried means they know how badly they would lose if they did. They want to preserve their ability to con most people by allowing those who have the resources to fight to get away with it.
What about a class action?
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That is, in fact, an excellent question. It is also worth asking how the other members of the family incorporate this destructive behavior with their image of the parent as a compassionate person?
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Do you realize that the bulk of those “homeless mentally ill” who are talking with themselves are either taking “psych drugs” or have taken them without any real success? Do you know that some people have reported BECOMING psychotic after taking psychiatric drugs when they had none before? Have you noticed that the number of such people has dramatically INCREASED in the years since psychiatric drugs became the “treatment of choice” for such people? If these drugs are so great, why are there more and more “mentally ill” people living on the streets?
Were you aware that studies show that long-term use of antipsychotic drugs DECREASES chances of recovery? Were you aware that providing shelter for homeless people, with no other intervention, IMPROVES their “mental health” symptoms? Did you know that people are more likely to attempt suicide AFTER they leave the hospital than before?
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I still don’t get why you don’t get what I’m saying here. There ARE physical illnesses that can be DIAGNOSED based on CAUSE. These are real illnesses/injuries of the BODY. They may cause what is currently called “mental illness symptoms,” but they are PHYSIOLOGICAL PROBLEMS that can be diagnosed as such. Would you say a person with low thyroid has a “mental illness” if they become depressed as a result? Is the child who is hyperactive because of disturbed sleep (sleep apnea or other sleep disruptions) “mentally ill?” Or do they have a physical problem that makes them act hyperactive?
Compare this to someone who is depressed. Diagnosing them with “major depression” can be done without the slightest reference to cause. They could be depressed due to a head injury, due to domestic abuse victimization, due to having a dead-end job and no chance of promotion, due to feeling unable to pay one’s bills, due to the loss of a loved one or a pet, due to confronting the difficulties of aging, due to lack of sleep, due to wondering what the point of life is, due to anemia, due to Lyme Disease… you get the idea, I hope? The “mind” is not “ill” because a person feels depressed. They may be struggling with something difficult, but that does not make them ILL. Their body can be ill/injured in a way that affects their mind via their brain (which is a part of the body). But being depressed does NOT suggest any sort of “illness” that can possibly be defined! It’s kind of like saying I pick my nose because I have “nose-picking disorder.” It is completely tautological and means nothing at all. It CAN be used metaphorically (“I experienced psychic injury as a result of my abuse” or “I need to heal from my difficult childhood,”) but until someone can show me the location in the body of the “psychic injury,” it is a metaphor and not an “illness” in the medical sense.
I think that is as clear as clear can be. I understand that “mental illness” is used generically to refer to any kind of emotional upset or reaction, but it’s obviously beyond stupid to say someone is “ill” because they feel sad that their dog died, or because they are anxious about asking a girl for a date, or because they find school boring. There is a clear and distinct difference between a physical illness that has emotional effects, and an emotional situation that has no physiological cause. If that’s not enough to explain it, I’ll have to just agree to disagree. It seems obvious to me that these are very different realities.
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Of course, there is no actual way to objectively determine who “has bipolar illness,” so this provides a handy excuse to let the drug off the hook and blame the patient. I think it’s fair to say that suicidal and/or violent behavior can be caused by exposure to SSRI drugs, regardless of “diagnosis.” It may be that people with a “bipolar” diagnosis are more likely on the average to react in this way, though I have seen no scientific study ever done to prove this (and it would be difficult to prove anyway, as again “bipolar” is such a vague and subjective “diagnosis” as to defy any clear definition of who “has” or “does not have” such an ostensible “condition.”)
I am not in the least inclined to let doctors and drug manufacturers off the hook by blaming their victims as being “bipolar.” If they don’t know their craft well enough to judge who will and won’t become suicidal taking SSRIs, then they ought to admit that up front and warn everybody of this possible danger, rather than trying to hide it for decades and then complaining when the FDA forced them to put it on the label, claiming that “lives will be lost” if we tell people the truth. Well, guess what, making people suicidal and/or homicidal loses lives, too!
The hiding and denial of the adverse effects of SSRIs is one of the many heinous acts that prove psychiatry to be essentially a corrupt industry that is more interested in covering up their failure than in learning how to do their jobs better.
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Well, time for a test case, I say!
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I am not saying that at all. I am saying that the legal definition is a SOCIAL definition, and that the legal system acknowledges the uncertainty and subjectivity of such judgments, and makes no claim to scientific verity (hence the need for a jury of 12 to make final decisions). The problem with psychiatrists in the legal system is that they claim to be able to KNOW who is and is not dangerous, who is and is not responsible, who is and is not aware of right and wrong, in some sort of expert or “scientific” way, such that other people’s judgment should be subordinated to them. It gives them WAY too much power, and is based on no actual knowledge that differentiates them from anyone else’s judgment, as has been shown again and again when the question of predicting danger or recidivism is concerned. Psychiatry has no right to claim expert knowledge of danger assessment or evaluation of a person’s state of mind at the time of committing a crime, because they as a profession have proven incompetent in such assessments. We are better off by far admitting that, and giving that latitude to the judges and juries who are appointed to make difficult, subjective judgments. Having psychiatrists in this role makes it way too easy for judges and juries to pass the buck and accept their judgments, rather than those parties having to personally wrestle with the difficult questions of capacity and safety.
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Well, let’s say you brought the canon onto your third-story balcony then, and filled it up with dirt and planted petunias. I’d say it could serve that purpose, though a standard planter might be more practical!
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It is true, the SSRIs most definitely can take away someone’s inhibitions, such that something which seemed horrible (I can’t kill myself, how would my mother feel?) can now seem acceptable, (“Ah, she’ll be fine, not my problem anyway…”) I had a friend once who called it “Zolofting” – where she simply didn’t care about what anyone or society thought about anything. This might seem like a relief to someone who was always worrying, but if someone was always repressing a desire to go on a shooting spree for fear of the consequences, it might not be such a great idea…
Still, there are plenty of reports of people who had no suicidal and/or homicidal impulses beforehand contemplating these actions after being “medicated” with SSRIs. And in any case, removal of inhibitions is NOT the same as “providing the energy” to do something. It is an alteration of one’s moral compass, a muting or deletion of the sense of right and wrong. And it is pretty damned dangerous! Though I’m sure you’d agree with me on that last point.
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I would love to see someone challenge psychiatric “science” in court using the Daubert standard. The falsifiability standard as well as the discernible error rate standard would exclude any psychiatric testimony relying on DSM “diagnoses.” Has this ever been tried?
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My research into the subject supports Cabrogal’s assertions. The recidivism rate, at the least, for intrafamilial sexual abuse is dramatically lower than for extrafamilial abuse. This doesn’t of course mean for a moment that serial sexual abusers don’t abuse their own children, but I think if we’re talking statistics, this pretty dramatic differentiation should be noted.
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“Insanity” as a legal principle grew up as a completely separate concept from “mental illness” in the psychiatric world. Psychiatrists have made every possible effort to co-opt this judgment, and I find this extremely problematic. There is no objective way to determine who “has” and “does not have” a DSM diagnosis. While the concept of “diminished capacity” and “awareness of right and wrong” can be executed in the legal arena without any “help” from psychiatrists. Psychiatrists need to get out of the legal arena, because their claims of being able to determine “legal responsibility” are not grounded in science or even in legal tradition. They are grounded mostly in fantasy and in social biases that have no place in courts.
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Quite so. It is definitely a “Minority Report” kind of phenomenon.
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“Psychiatric patients’ vulnerability, combined with the coercive nature of involuntary care, could also foster outright exploitation.”
I would not say “could” here. I would say, “…will inevitably lead to outright exploitation.”
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I also want to note the subtle but damaging implication in the statement, “…you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others.” The word “enable” is the problematic term. It makes it sound as if the depressed person is lying in bed, thinking about suicide or murder, but only doesn’t kill people because s/he lacks the energy to do so. It buys into the mythological trope that the “antidepressants” are not themselves creating suicidal or homicidal impulses, but that depressed people are ticking time bombs just waiting for the burst of energy enabling them to act on their dastardly deeds.
SSRI antidepressants, at the least, have been tested on non-suicidal people and a small but significant number of those become suicidal. THey were not “lacking energy,” they BECAME suicidal after taking the drugs. Similarly, these drugs were initially banned in Germany due to an increase in aggressive behavior in those taking the drugs. This information has been known for decades. Pretending that the “activation” of the SSRIs “enables” suicidal or homicidal people to act out their impulses is a false narrative created to absolve the SSRIs and their prescribers from responsibility for their known adverse effects.
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I don’t want to seem impertinent, but I feel I need to ask one question: is it still “psychiatry” if it is focused on moving people through art and writing to change how we relate to each other’s suffering? That doesn’t sound like a “reform.” It sounds like an utter repudiation of everything psychiatry currently represents. Sort of like transforming a cannon into a flower planter. It’s not really a cannon any longer, even if it’s the same shape.
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Another difference is that at least prisoners have a defined sentence. The psychiatric “sentence” can be forever.
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Or due to fat-increasing psychiatric drugs!
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Just for the record, there are uses of the word “mad” (and I don’t just mean “angry”) that do not imply insanity. “Crazy” comes from the little cracks that appear in the patina of a glazed piece of pottery as it ages. So being “crazy” means having an interesting array of fine detail that transcends the original design.
But I do understand what you’re saying. No one has to identify as “disabled” to attack the status quo.
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POSTING AS MODERATOR:
I am getting the very strong impression that this conversation is on the verge of escalating into a more personal one. I am not really seeing an exchange of views as much as an exposition of different positions, any of which have their perspective and reasoning behind them from the viewpoint of the poster. What I’m NOT seeing as much of is 1) exchange of statistical or scientific data or studies supporting one’s position; 2) personal stories to support the viewpoint being taken; 3) attempts by one “side” to understand where the other “side” is coming from.
The original point of the article was not to debate COVID or even the safety profile of the vaccines released to date. The article is about whether or not it makes sense to prioritize/encourage/enforce vaccines for people “diagnosed” with “mental illnesses.” There are many issues that this raises, including the question of what message it sends to make this kind of “prioritization,” whether force is being contemplated, whether or not the vaccine interacts with psychiatric drugs, etc. I think we’d do better to focus our energies on those questions. I think everyone has stated their positions fully and with passion, and further discussion along these lines seems likely to deteriorate as it has in the past.
If folks have actual articles, research, statistics to share, please feel free, but we really aren’t learning much by simply restating our positions louder and with more emphasis, and stating or implying that those who disagree with us are irrational or dangerous. Let’s either start listening and focusing on known facts, or get back to the topic at hand.
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It is also because of an unwillingness to acknowledge ANY adverse effects of drugs used to “treat” the “mentally ill,” and the easy discriminatory biases toward blaming “the illness” for any escalation of “symptoms,” while of course crediting the drug “treatment” with any improvement that is noted.
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Perhaps I misread your comment. Good to know we’re on the same page.
Though I don’t agree with your last statement. You are, I believe, referring to the “governmental” meaning of authoritarian. Being “Authoritarian” in my view does not require you to be the “authority” yourself. Every authoritarian leader requires followers who are unquestioning in their loyalty and allegiance to the leader. In fact, there are generally power hierarchies where the people at the top expect compliance from those beneath them, and those in the middle have to comply with those above, but get to order about those below, and it’s only those at the absolute bottom that don’t have anyone to dump on. To me, an authoritarian is anyone who believes in and subscribes to this kind of structure. As you can see, the key is unquestioning allegiance to those above you in the chain, and the absence of independent thought at anywhere in the hierarchy. Those who say that psychiatry must work “Because they are doctors, and they know what they’re talking about, and you aren’t, so I don’t care what you think” are as authoritarian as the psychiatrists that set up the system.
“According to Adorno’s theory, the elements of the Authoritarian personality type are:
Blind allegiance to conventional beliefs about right and wrong
Respect for submission to acknowledged authority
Belief in aggression toward those who do not subscribe to conventional thinking, or who are different
A negative view of people in general – i.e. the belief that people would all lie, cheat or steal if given the opportunity
A need for strong leadership which displays uncompromising power
A belief in simple answers and polemics – i.e. The media controls us all or The source of all our problems is the loss of morals these days.
Resistance to creative, dangerous ideas. A black and white worldview.
A tendency to project one’s own feelings of inadequacy, rage and fear onto a scapegoated group
A preoccupation with violence and sex”
https://www.psychologistworld.com/influence-personality/authoritarian-personality
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Just to clarify: to assume that vaccines or any drugs are likely to present unknown dangers until proven otherwise is rational. To assume that all vaccines ARE unsafe or that the dangers out weigh the benefits REGARDLESS of actual evidence is irrational. I am not advocating for mindless acceptance of drug company or CDC assertions, as your post perhaps seems to imply. I’m arguing against automatically rejecting the possibility that something might be helpful based on past bad experiences with vaccines or drug companies or governments, or based on someone suggesting without evidence that there is some nefarious purpose behind such efforts and therefore not bothering to do one’s own research on the subject.
In other words, I’m opposed to authoritarian approaches, regardless of who is the “authority.”
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Because not all of them have proven dangerous. It is irrational to assume that even all drugs are dangerous without evidence one way or the other. I do think it’s wise to be SAFE, namely to assume it is LIKELY there are unknown risks of ANY intervention until proven otherwise. But SSRIs are of course a horrible example. They are factually known to be dangerous, and those claiming otherwise are just ignoring the facts. But it would be foolish to assume that any new drug that came to the market would automatically be dangerous just because SSRIs are dangerous. That doesn’t mean I’d take something just because it wasn’t yet PROVEN to be dangerous. It means I would be extremely cautious about taking a stand before I knew the evidence. I generally never take ANY drugs, largely because EVIDENCE suggests that drug companies don’t do safety testing and hide bad information from the public. But if I do need to take a drug for any reason, I do a thorough research of what is known about it, and have no problem whatsoever telling the doctor or pharmacist that I’m not going to do what they say I should, even if they get snide or condescending with me. In fact, I avoid doctors as much as possible, and use nurse practitioners or physician assistants instead. And I currently have the good fortune to have a naturopath as my PCP! So I’m not apologist for the drug industry, which you should know very well by this point. However, being rational means allowing that despite their history, the drug industry may develop some useful things from time to time, and I need to be open to that possibility, particularly when a whole society is being affected by this particular “viral phenomenon.” It doesn’t mean I assume they are not lying to us or pretending to know things they don’t, as I think I made VERY clear in my prior comment. It just means I don’t rule out the possibility that the vaccine may be an overall benefit without gathering actual data as to the pros and cons. Which seems to be just what you advocate for in your other post.
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But other than that, it all makes PERFECT sense!
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I like it – let’s call it the “Emotional suffering for whatever the fuck reason” model. ESWTFR. Works for me!
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So just to clarify, there is a difference between being “completely unaware” of something and “recovering” a memory of it, vs. knowing that SOMETHING happened and recovering more details and specifics at a later time. The latter is something I have observed many times.
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Exactly! There is no known “additional risk” that comes with “mental illness.” It’s mythology. The only think Brendan Kelly missed is domestic abuse as an indicator of likely violence and danger. “Mental illness” doesn’t even come into the equation!
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I want to be clear in my view that seeing all vaccinations as dangerous and ill-intended is foolish, but assuming that all vaccines are effective and benign and are intended to help is just as wrong. Each vaccine needs to be evaluated on its own merits. At this point, it does appear from what I’ve seen and read that the COVID vaccines are, in fact, generally effective in preventing infections. However, there has certainly not been enough time or research to determine what the long-term effects of these vaccines will be, and which people may have more severe reactions than the average. It also remains to be seen if those so vaccinated can still pass COVID to someone else (are they not able to be infected, or if they just become asymptomatic). It does appear that people with a history of allergic reactions may be at risk. There is also some suggestion, though this has not been studied, that older folks may be more likely to have adverse reactions.
So it’s never a black and white thing. I’d welcome people submitting actual studies or epidemiological statistics on the pros and cons of this particular vaccine, but I don’t think it’s particularly helpful to either condemn anyone supporting vaccines as a fool or a dupe, nor is it sensible attacking anyone who expresses concerns about the lack of safety testing or long-term experience. We are doing a rather uncontrolled experiment here, and folks do have a right to do their own research, and are not obligated to automatically assume that “these vaccines are safe” just because the authorities say so. But I also think we do a large disservice to assume that the vaccines are dangerous or intended to harm without gathering data to actually support or refute that position. Again, just because someone says it’s true, doesn’t make it so. Let’s allow people to do their own research and come to their own conclusions, helped by whatever data and research can be shared with each other.
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And when force IS used as a last resort, that does not excuse forcing “treatment” on someone regardless of their agreement and intentions. I believe detaining someone for a criminal act needs to be completely separated from any idea of “treatment.” “Forced treatment” by definition is no longer “treatment” at all. It is force.
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Very well said!
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Understood!
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Something being described as “metaphysical” doesn’t make it not real. It just means we are in a realm that extends outside the purview of science!
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How is “forgetting things and later remembering them” any different from “recovering memories?” My experience as a counselor who does not EVER try to tell any client what to think or believe about their own experience is that many clients have the vague notion that “something” happened to them but can not recall at all what that “something is.” Yet when a safe enough space is created, they feel OK about remembering the details, without any prompting from me. Did they “forget something and later remember it?” Did they choose not to be aware of the information that they knew had happened so they didn’t have to deal with the consequences? Should I automatically discount these recollections because they did not have them before?
I used to have a vague recollection of my second grade teacher tossing a book across the room after yelling at us and shaking that book for some reason. I seemed to recall standing up in my seat, and then being out in the hall with another kid. That was it. I wasn’t really sure it had actually happened. It had a dreamlike quality about it. At my 30th high school reunion, I told this recollection to a classmate of mine. She remembered it really happening! She remembered me standing up in my seat and saying, “Miss Vaughn!” in an incredulous voice. She recalled her marching down the aisle, hitting me on the side of the head, and tossing me and Freddy Baughman out in the hallway. She even knew the name of the kid who was out there with me, which totally validated my recollection.
After hearing this, I recalled more information about it – what Freddy said to me, going to the office, seeing the nurse who checked out my left ear (which would have been the one exposed to her right hand as she hit me). I still don’t recall being hit, but it all made sense and checked out with what she remembered, and she was completely certain about it happening. She had “forgotten” the incident as well until I mentioned it, but instantly recalled it in detail.
So was my original haziness an indication that the incident was made up? Or that I had altered recalls? Do the additional tidbits I later recalled qualify as “recovered memories?” Or did I just “forget” and then “remember?” How on earth can anyone make that distinction? Who can possibly judge the accuracy and validity of these recalls besides ME, the person who was there? Of course, I will never know for certain exactly what happened, and it is possible that the details I recalled may be somewhat of an alteration of the actual events. But I have absolutely NO DOUBT that such an incident did occur, and that I had invalidated the reality of this recollection before getting validation and additional details from my friend Susan’s perspective.
I find the act of inducing “recovered memories” based on some therapist’s idea of what “signs” they see in the client to be utterly reprehensible. If that happened to you or your family, you have all my sympathy. However, to extrapolate from “memories can be induced by unethical therapists” to “clients are not able to remember things they may in the past have chosen to forget,” is unforgivably unscientific.
You are correct that “proving a negative” is particularly challenging for science. But just because science can’t “prove a negative” doesn’t mean the phenomenon does not exist. It just means we don’t know the answer. Practically speaking, I’ve found without exception that respecting the client’s recollections and perception of reality as their own, and respecting their right to create and modify their own narrative, is essential to any kind of effective therapy. Many people are suffering specifically because they have had their narrative invalidated or manipulated by others, including by unethical therapists. Each of us has to evaluate the quality of our recollections based on our own standards of judgment.
Let’s not make the leap to invalidating someone’s recollections for our own comfort. Each of us is entitled to define our story, and it’s not you job or mine or any other person’s to tell people what is and is not true for them.
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POSTING AS MODERATOR:
I am not going to get into the semantics of what a “repressed” vs. “unconscious” vs. “forgotten” memory means. It seems like splitting of hairs to me. But I can state unequivocally that someone whose comment invalidated someone’s individual recollections/narrative would not be allowed to be published, so you would of course not read it. I trust you can read between the lines on this point.
NOT posting as moderator, I believe there is a pretty massive distinction between saying “repressed memory therapy” is nonsense and probably quite dangerous, and saying that no one can bring an unconscious memory (whatever you’d like to call it) to greater consciousness and awareness. The two factually have nothing to do with each other. One is a method of ostensibly “helping” someone recover assumed “memories” at the insistence of the “therapist,” the other is an observation of a process of how we recall (or don’t recall) things that are in our past. I think it is fair to say that scientific research has thoroughly invalidated the first, but that the second remains as much a mystery as the nature of the mind itself.
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Not in my view.
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COMMENTING AS MODERATOR:
To be clear, this is NOT a response to andersone’s comment, I just put it here because I have to put it somewhere I think it will be read.
I want to note here for everyone that this is a VERY sensitive subject, and folks need to be EXTREMELY careful what they say, in terms of how it might affect another person who is reading. There are many people posting on this site who have been abused physically, sexually, or otherwise, and it is absolutely their right to tell their own stories and have their own reactions and opinions to this essay. The main way “false memories” are implanted or altered is by a person in a power position telling the person they are working with what is/is not true and invalidating the clients’ own recollections and sense of “rightness.” Please, let us NOT do this to each other here!
My read of the data is that 1) false memories CAN be implanted by poor technique by questioners, and 2) the question of whether “recovered memories” can happen is one that remains undetermined. As such, it is NOT going to be accepted by me as moderator for anyone to tell anyone else that their own memories are false or that recovered memories don’t exist. We need to respect that each person has the right to make their own evaluation on this question, which I believe is a question that actually goes well beyond what science can tell us today, and maybe will ever be able to tell us. Additionally, there are an unknown number of posters on this site who have already been TOLD by clinicians and family members, and in some cases even the courts, that their known, certain, clear recollections are “false memories!”
So please, tell your own stories, share what research you have, but be very careful not to suggest or imply that others’ recollections and experiences are not valid!
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So you are saying the incident is recorded but “unconscious?” That’s what I always considered to be the case with “repressed memories.” They only appear to be “forgotten.” It’s more they are inaccessible, for the protection of the person who was traumatized. That really does make sense to me.
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Your comment reminds me of Alice Miller. And that is a compliment in my book!
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Agree 100%. The whole subject and industry is corrupt from top to bottom. But that’s another reason that these DSM “diagnoses” are so dangerous – they allow the industry to continue the fiction that these drugs are “treating” some sort of “medical condition,” rather than prescribing them to suppress feelings/thoughts/behavior about which they have no rational understanding, nor any intent to come up with one.
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Sounds like some censorship there. If the Powers that Be are so convinced at the correctness of their opinions, why do they have to suppress anyone’s voice who disagrees?
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Yeah, you’re right. Completely illusory.
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Oh, and just by the way, DO you tell your clients that long term use of antipsychotics can lead to permanent movement disorders, diabetes, heart disease, weight gain, and possibly an early demise? If you don’t, why don’t you?
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“ADHD” is also strongly associated with abuse/domestic violence in the home.
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I am sure that lots of people who have been forcibly psych “hospitalized” would give your approach a big thumbs up. I think you are missing the context of these comments that doing a better job of using less force and coercion and attending more to social conditions would be an IMPROVEMENT, but that it does not address fundamental issues of power and pretense of “scientific-ness” in the current model, that are both misleading and potentially dangerous.
I once worked at a nursing home ombudsman’s office for the State of Oregon. I recall a home that was shut down and put into federal receivership still received over 80% “good” or “excellent” ratings. A lot of folks are willing to go along with whatever is offered and feel like if they’re treated with some level of respect, they’re AOK. They are generally unaware of the damage that may be done to others, and sometimes even to their own potential growth, because they’re doing what they’re “supposed to do” and they don’t know of any other way.
There are any number of folks who post here who might in the past have given in-home treatment high marks, and only realized over time that the “treatment” wasn’t really helping or was making their lives worse. And like I said, it sounds WAY better (in most cases) than being locked up after being arrested by the police! I mean, who can’t see the relative advantages there! Yet the basic assumptions of the system, that people “have bipolar,” that they “need treatment,” that drugs “correct chemical imbalances” or some physiological/genetic problem, are all still there.
So the question to me isn’t what your customer satisfaction ratings are, or whether “acceptance of treatment” is higher. The real question is what COULD happen to these folks if the current paradigm were scrapped and they were approached from a standpoint of people who have experienced difficult times and need support, rather than people who “have” a “disorder” and need to be “fixed?”
I want to say that I do appreciate your efforts. But I would encourage you to listen a little more deeply to the feedback you are receiving, and don’t be so quick to dismiss it as people who “don’t understand” or “reject treatment.” I’d suggest you listen from a standpoint of saying, “These are people who report having been severely damaged by the system I essentially believe in and promote. How and when is this happening, and am I inadvertently contributing to this kind of event, even when I think I’m doing things right?”
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I would agree with the “multiple cause” theory, and that overt or specific trauma is not required to fit the “criteria” a “mental illness.” Of course, the fact that someone “fits the criteria” means essentially nothing at all if the “diagnosis” has a wide array of possible causes.
The main problem I have with these “diagnoses” (and others will raise other problems, I’m sure) is that they lump together people who have nothing else in common besides feeling, thinking or acting in a certain way and ASSUME that 1) all these people have something wrong with them, 2) they all have the SAME thing wrong with them, and 3) some form of “treatment” should help ALL of them “get better” in someone’s eyes. Of course, these “diagnoses” have absolutely no scientific validity at all, as Thomas Insel, the head of the NIMH, himself admitted years back. He said it’s like someone diagnosing “chest pain.” It is meaningless to make such a subjective and broad “diagnosis,” because it includes people who have literally nothing in common with each other besides a surface manifestation of some sort. It is not possible to conduct any meaningful research on a group of people who have no common trait. What would you be studying?
As to “innate vulnerability,” I’ll go to an analogy. If 50 people got hit by a car at a certain intersection, and 35 of them broke their legs, would we be studying that group for a diagnosis of “weak bone disorder” and find out what kind of “genetic vulnerability” they had to their leg breaking? Or would we study the intersection or crossing and find out why it is that so many people are getting hit by cars there?
Just for a little icing on the cake, the most optimistic estimate of the “genetic” contribution to any single “mental disorder” is well below 10%. Whereas people diagnosed with “schizophrenia” correlate with childhood abuse/neglect at an 80% rate or higher. Correlations between abuse and “anxiety” or “depression” are even higher. So the very idea that these “disorders” have a “genetic etiology” is over 90% mythology.
One question to leave you with is this: If there is a less than 10% genetic component and a more than 80% environmental component, and the genetic component is the one thing in the equation that can absolutely NOT be altered by any means, why are 90% of the dollars spent on studying genetics and physical interventions and a paltry sum being spent on studying environmental effects and how to ameliorate them? I think the answer says a lot about the ostensible “objectivity” of the current system leaders, don’t you?
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I agree. I’ve seen many articles on the high suicide rates among doctors, and there is not a single word about “chemical imbalances” or “genetics” or even DSM “diagnoses.” It is all about stress, burnout, loss of sleep, rough schedules, inability to maintain relationships, poor training… not a word about “mental illness” is raised. And the remedies are all about creating better working conditions, selecting for a wider range of personality traits, improving the training process, changing expectations. In short, changing the environment rather than blaming the person who has a hard time adapting to it. Why does this reasoning not apply to kids in school, or foster youth, or victims of domestic and sexual violence, or victims of racism, sexism, and other oppressive structures?
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The “symptoms” of ADHD are an adequate description of the most common frustrations adults have with younger boys.
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While there is no doubt that some people would find this approach far less oppressive, it does not reduce the power imbalance and the frequency of coercion or abuse. I’d say that a person who agrees to “voluntarily” be treated at home under fear of being forcibly “hospitalized” is in no wise voluntary. Additionally, if the recipients of these voluntary “services” are only offered biological interventions, or are forced to accept biological interventions as a part of the package, or are misinformed about the limited benefits and potential long-term costs of these interventions (including the very real possibility of a significantly reduced lifespan), or are not offered the full range of alternative options (including sending y’all away at the door), we are still dealing with degrees of coercion, and the “voluntary” nature of these services is undermined.
Just a question: does your service tell those who are recommended to take antipsychotic drugs that they are risking shortening their lives by a decade or two by accepting this “service?”
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How do you know she “had a mood disorder?” By how she acted? How do you know that how she acted was not simply a reaction to her abuse and oppression? What objective means do you have to distinguish who “has a mood disorder,” other than your own opinion or a subjective behavioral checklist?
When I used to do hospital evaluations, I ran into many women who were diagnosed with “bipolar disorder” or “anxiety disorders” who were feeling suicidal or panicky. I asked every one of them about their current relationships and abuse history, and every one (except two who would not talk to me) shared horrible abuse that occurred when they were young.
Maybe a “mood disorder” is no more or less than what happens to people when the stresses in their lives overwhelm their coping measures. In which case, do they have a “mood disorder,” or are they victims of a thoughtless and oppressive culture that continually puts people in a place where they can’t cope with the harm that they are repeatedly exposed to.
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I totally agree! I’ll talk with anyone who wants to change things, no matter what they think the “new solution” is. Even those who are “reformers” are potential recruits for a more radical analysis. Heck, I was a “reformer” once upon a time! And we can work to get agreement with “reformers” on certain goals that will help in either purpose, like getting Miranda rights read to people receiving an “evaluation.” We need to generate power, and ideological purity isn’t a requirement to get things done.
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Bright, bored, or troubled. Exactly.
At this point, I often bring up the fact that there is NO evidence, despite 50 years of biased research LOOKING for such evidence, that “ADHD” drugs improve ANY long term outcome, including delinquency rates, academic test scores, high school completion, college enrollment, mental/emotional well being, social skills ratings, teen pregnancy rates, drug abuse rates, or even self-esteem ratings. A number of long-term studies suggest diminished functioning in one or more of the above areas. So we are exposing millions of kids to the risks of stimulants, including psychosis, mania, weight/appetite loss, reduced adult height, alterations in personality, and a small but not insignificant chance of heart damage or death, to name just some. And yet there is no evidence to suggest that these risks are associated with ANY long-term benefits at all, in any area.
So WHO has the “mental illness” here?
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I think that is an important distinction. The conceptualization of emotional distress as existing in the BODY of the distressed person is the central evil that psychiatry is based on. The rest is all footnotes to blaming the patient/client for their own suffering. If it’s in their bodies, then it’s not something the powerful (or anyone) in society needs to worry or think about.
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The first “choice” should be to choose to decline any “help” that the person finds unhelpful. And that should include the “choice” to reject the framing of his/her problems as a “mental illness.” That choice is seldom if ever afforded by those in “the system.” Once that choice is denied, any further “choices” become fairly illusory.
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Our governments AND our corporations/professional guilds who pressure/manipulate/pay our governments to do the set up.
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“How can you reduce your exposure to violence in your life?” rather than “How can we work together to stop people and institutions participating in violence against citizens?” Or even more so, “What is going on in our society that creates and encourages violence and oppression, and what can we do to. change those conditions?”
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I want to post an interesting question here, David: is it “treatment” to help the victim of an extended set of violent criminal acts to avoid further victimization?
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This is my experience also. Practical considerations sometimes requires using the language of the oppressor to get one’s point across and have the desired effect. Real advocacy requires a focus on getting the product, however it has to be gotten. The finer points of philosophy can be addressed in a different forum.
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SOME correlation? The correlations with biological markers come in at single digit correlations at best, while here we’re talking 50-80%. I’d say there is a VERY STRONG correlation with “mental illnesses,” and that’s not counting the damage that does not show up at the “mental health system’s” door.
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Let’s simplify by expanding the list to include: EVERYONE! NO ONE who isn’t voluntarily asking for it is appropriate for psychiatric “hospitalization.” In fact, calling it “hospitalization” is a misnomer. “Psychiatric detention” is the most polite term I could come up with. “Incarceration” is closer to the truth.
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I am aware that “mindfulness” is part of DBT, and a significant number of commenters on MIA have stated that they were coerced into doing “mindfulness” during DBT, or else suffering some kind of consequence from the group leader. While this is completely contradictory to actual meditation practice, it is being done, and frankly gives a very bad name to what I’ve found to be an extremely powerful and helpful practice.
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Absolutely not. I’m always amazed that the same doctors who hand out drugs that demonstrably cause earlier death in recipients, and warn strenuously that taking large doses of niacin or vitamin C is dangerous, or that homeopathic stuff is a terrible hoax and waste of money.
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I have seen brain studies on Buddhist monks who have meditated for decades. It indicates that the areas of the brain associated with calmness and focus are larger. Now that doesn’t mean that people being forced to “meditate” are going to see any benefits, and I’m guessing they probably are likely to be harmful in some cases. I do have serious doubts about actual brain damage occurring, but psychological damage seems likely whenever force or coercion is involved.
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Seriously, that is CREEPY!
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The only real benefit of these spy cameras would be to catch the evil actions of the staff toward the patients. But somehow, I don’t think that’s the purpose of it.
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Interesting! I wonder also if the ability of clinicians to get paid good money for providing “DBT” has added additional appeal to the label?
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There are dupes who believe this is for the benefit of the “patient,” but these people are duped. The forces behind anti-stigma campaigns are not concerned with the welfare of the “mentally ill.” They are trying to protect and expand their markets. It’s true that NAMI feels like they are helping out, but they are funded to a very large extent by Big Pharma.
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I agree with your expansion of the purpose. The labels help the non-labeled feel better.
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I don’t see awareness campaigns as “symbolic,” I see them as marketing schemes for the psych system. They are selling the idea that people have “mental illnesses” and that the system has solutions to these “mental illnesses” and that anyone who says otherwise is “shaming” the “mentally ill.” It has no other real function than to publicize and sell the concepts above, as far as I can see.
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The “mental health” version of “mindfulness” was also appropriated from Buddhism and Hinduism, and as such, misses a lot of the substance of what “mindfulness meditation” is really about and what it is intended to accomplish. It’s not about breathing deeply to make us feel less anxious, even if it happens to have that effect. But anything spiritual seems to be anathema to the mental health industry, and in particular to most of the psychiatrists I’ve encountered.
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POSTING AS MODERATOR:
Just to be clear, there was never any kind of ban on the SUBJECT of COVID. The last conversation was shut down because of the tone of the participants, and the escalating personalization and attacking nature of the comments. Facts and experiences on any subject are always welcome to be discussed, as long as it is within the Posting Guidelines.
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My point has nothing to do with the “learning” aspect of school. I always knew from the start that school was not about “learning,” it was about COMPLIANCE and HIERARCHY. Knowing your place. Dumping the shit downhill on the person on the next lower step. Not challenging the basic assumptions. Trusting the “authorities” to have the answers and subduing any independent sense of reality.
The advantages of online school for me would have been
1) No need to be with rude and obnoxious and bullying teachers all day. Having a mute button or the ability to walk away from the screen if they were abusive. Not having to stay in at recess because I talked to someone at the end of lunch. Not having my teacher be able to throw a book across the room and hit me on the head when I objected.
2) No need to be with obnoxious and bullying peers all day. No recess sitting wondering if anyone would want to play with me. No having to stand by and watch when other kids were being abused.
3) No need to get up at the wee hours and take the bus. ‘Nuff said there.
4) Ability to proceed at my own pace on things without having to wait for the class to catch up.
5) Plus, I could have gone to the bathroom without getting their freakin’ approval!
Naturally, it is quite possible to make distance learning just as obnoxiously authoritarian as in-classroom school. But it would have made me feel a lot less anxious just to know I could be where I was and not be subject to the whims of the teacher and can turn my camera off at my discretion, even if they got mad at me. I’d have given a lot for those privileges.
Steve
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You’re SUCH a radical!
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Isn’t this kind of like saying “Spoons are superior to forks in digging traffic tunnels?”
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The lack of a means to objectively determine if something “works” is the achilles heel of psychological therapy. People argue endlessly about what “works best” without any definition of what “works” really means.
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Let’s do it! We can start our own journal, too. “The Journal of Research into Obvious Shit!” J-RIOS!
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You must have “Anosognosia” – failing to realize that they know more than you do about yourself!
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Are you suggesting we have to TALK to these people? Whatever for? Much quicker and more remunerative to just drug ’em and blame any bad results on them.
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That’s a pretty tenuous hypothesis, Oldhead. I think it would require extensive study, including multiple replication studies, to prove such a connection. Correlation is not causation, you know. I think we need to set 20 million or so aside to make certain!
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So we’re working to benefit the “mental health providers” rather than the actual clients? Kind of says a lot, doesn’t it?
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I prefer a “prebriefing” or orientation, including Miranda Rights, BEFORE an “evaluation” is allowed to occur.
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They’re just upset with you for not needing their “help!”
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POSTING AS MODERATOR:
OK, this is enough. People have had their say. I am going to end the discussion at this point. Time to move on.
Steve
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I agree. The title should read, “Antidepressants can cause manic behavior in many who take them.” Honestly, from talking to a number of people who have taken them, I kind of think that’s what they do. For people who are really withdrawn or super anxious, it probably feels good as long as it doesn’t go too far. But I’ve never taken them myself, so I really don’t know. In all likelihood, different people have totally different experiences. Which is really not a good thing if everyone who “has depression” is encouraged/forced to take them.
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Yup. Kindergarten playground stuff, and of course, the biggest bully tends to win out, unless the rest of the kids gang up on him (or her).
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POSTING AS MODERATOR:
I am going to agree here that this has most definitely veered in too personal a direction. I think everyone has had a chance to make their points, and folks can go ahead and read and make up their own minds about it. Or better yet, visit the site and see what you think.
At this point, I am not going to post any further comments along this line of discussion. It is apparent that there are personal feelings and disagreements here that are best resolved by individual conversations. I’m happy to connect people who feel the need to talk to each other via email, but for purposes of this discussion, we need to refer back to the content of the article, and any personal complaints or criticisms will no longer be published.
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Yes, you certainly did.
Though I will say on my own behalf that being IN school was what was making me feel suicidal. “Distance education” would have been an amazing gift for me.
Which goes to show that trying to do the same thing for every child is dumb.
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Good education is often humorous!
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Psych “diagnoses” are opinions, every one of them. It is ridiculous to apply such a term to a so-called “illness” that is not objectively observable or determinable. Like saying someone who doesn’t acknowledge that they’re “cowardly” is suffering from “anosognosia.” There is a proper application of the term to a known, observable neurological problem that can be tested for and verified. Saying someone has “anosognosia” because they disagree with your opinion is about as far away from scientific as you can get.
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I don’t expect him to. I don’t know of any politician, “liberal,” “conservative,” “independent,” or anything else, who has done diddly squat for the survivors/victims of the psychiatric industry. They mostly are partly owned by the pharmaceutical industry. But that’s kind of a weird question to ask in the context of my question. I just want to know if there is any initiative that I need to get my energy behind.
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Can you let us know what exactly happened under the Trump administration to help those victimized by the “mental health” industries? I have not heard anything about that, but I’m happy to learn more.
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Perhaps the challenge is to remain calm and centered when you’re torn between running from the room and beating your “therapist” to a pulp!
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Additionally, since 90% or more of the funding goes to drugs, naturally, the only “evidence base” that exists is for the drugs. So anything else, except DBT apparently, can’t be considered “evidence based,” because the lack of financial incentive means no one has bothered to study it!
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Gosh, that’s just WAAAAY too rational!
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Enforced “mindfulness” is a contradiction in terms. If you’re being forced, how can you remain “mindful?” People who choose to use it may find it helpful. And they may not. And the “mental health” authorities should do some themselves before they even think of trying to force people to do something meant to help people feel more self control in their lives!
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“Death Therapy, Bob! It’s a sure cure!”
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I’m sure that whatever bug that existed would no longer be observable after the backhoe was done with the computer!
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Right you are! What if he said, “Well, we don’t know what really causes depression, but microwave radiation from cell phone towers may play a role?” Everyone would be immediately (and appropriately) up at arms! Science doesn’t speculate, except in the formation of hypotheses. It makes zero sense to share hypotheses that are purely speculative as if they were somehow sharing some budding scientific discovery that is “just around the corner.”
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If Pies’ theories on the delicate balance of the “symphony” of chemicals are true, I’d have to say that how psychiatric drugs are used by psychiatry would be akin to tuning a fine violin with a pair of barbecue tongs and a ball peen hammer.
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“The authors emphasize that many intervention techniques currently available to relieve CMDs miss the mark. Tension exists between some orientations to intervention harbored by mental health professionals, and issues of access and effectiveness continue to compromise the impact of existing supports.”
This is impressive double-speak! To say that an intervention “misses the mark?” Doesn’t that mean that we are spending money and time and energy on things that DO NOT WORK? If an engineer “misses the mark,” his bridge falls down and he gets fired! And tension between “some orientations” and “effectiveness” seems another way of saying that practitioners continue to insist on using interventions that DO NOT WORK!
Sounds like job protectionism for the incompetent to me!
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The term “obsession” is often just a negative reframe of “passion.”
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I love me some Flip Wilson!
Do I got an AAAA-MEN!
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As Tim McCarver once said, they should call it “Uncommon sense,” because if it were that common, more people would have it!
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I think that might have been Goebbels who said that originally. But it’s a very fascistic kind of way to do business.
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There were lots of “good people” who participated in atrocities in Nazi Germany, and lots of other places around the world. The Milgram experiment ought to have taught us all that years ago. “Good people” who don’t think for themselves are always vulnerable to being manipulated or “educated” into doing horrible things.
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So are you suggesting that you’d need to know what you’re trying to prevent before you try to prevent it?
Deep thinking!
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Meaning that his behavior was pretty predictable to a person who had no particularly advanced training in “psychology” or “psychiatry” or anything beyond an ability to observe the obvious.
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His behavior is consistent with a person lacking in ethics and willing to bully and harm others in the interests of pursuing his own goals. His speeches from day one appeared to be calculated to play on peoples’ fears and prejudices and to bring out the worst in terms of hatred and division between Americans. It was also clear from the people he hired and who traveled in his circles that he had criminal connections and engaged in his own personal forms of corruption. Not to mention the constant lying about everything, and his tendency to turn violently against his “friends” as soon as they said or did something he found threatening or even disagreeable. I didn’t even consider his personal life, though of course, it is totally coherent with my observations that he is selfish and bullying and corrupt. (Paying off prostitutes to keep quiet? Cheating on his wife? Bragging about grabbing women’s private parts?)
As to the insurrection, he started telling everyone back in March or April how the election was going to be “corrupt” because of “fraud” due to voting by mail. It was obvious that this was going to be his backup strategy in the likely case that he lost the election. It became more obvious in the summer how desperate he was, as COVID raged and his popularity ratings tanked. The hiring of a postal service head who intentionally slowed the mails showed just how lacking in any kind of ethics he was. The civil suits aimed to make sure that the mail-in votes (likely to be heavily Democratic due to his previous lies about the unreliability of mail-in votes) were counted last were a pretty obvious ploy to make it look like he was ahead at the start and have Biden catch up later in the evening, leaving him free to claim “victory” before all the votes were counted and to claim “fraud” and being “cheated” out of his supposed victory by those evil mail-in ballots. The eventual end game was for him to inflame his supporters to go to bat to keep him installed as “President for Life” regardless of the electoral count.
So yes, it was utterly predictable that something of this sort was part of the plan. The “stand by” message to the right-wing militias should have made it obvious to anyone whose eyes were open.
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Actually, according to quantum mechanics, all matter has both a wave and a particle aspect. The wave aspect of large, solid objects is so small as to be negligible, but when you break it down to a molecular/atomic level, the chair you’re sitting on is a particle/wave phenomenon, and there is an infinitesimal possibility that it could suddenly become empty space and you’ll fall on the floor on your butt!
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Well said indeed!!!! Finding agreement on VALUES is what really leads to people coming together. Tossing labels creates division and fear!
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I am actually working on a comedy routine and am ready to roll it out for the public as soon as “open mic night” is back in operation. I call it, “Intelligent design.” I agree with folks that design by a Creator is a reasonable position to take. But then I ask the question, “If we were designed, I have to ask – how intelligent is it?” Of course, psychiatry is going to have a place in the routine at some point.
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That is my feeling. A person should be removed from office based on their inability/unwillingness to execute the duties of the office with integrity. Corruption, neglect, malfeasance, poor judgment, dishonesty for personal gain, these should be the things that are considered. Behavior, not “diagnosis,” is what matters.
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Or why not just stick your finger in a socket 3 times a day for a few weeks? Makes about as much sense, and it would be cheaper, plus you can stop if you don’t like it.
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I also predicted his behavior, months ago. It’s not rocket science.
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There is no data indicating that psychiatrists or psychologists are any better than anyone else at determining levels of dangerousness than the average Joe on the street. And there are plenty who are “diagnosing” him at a distance.
And BTW, I do consider him very dangerous.
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Maybe you should be the stand-up comic!
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I usually distinguish between science (an activity) and Science (a demigod). They are not even close to the same!
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I personally think “religious cult” is a much better descriptor than “conspiracy theory.” They are not operating ON a conspiracy theory, THEY are conspiring themselves to make money off of misrepresentation of truth and off of their status as “doctors.”
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Can’t argue with you there – the intention to avoid inconvenient realities is pretty widespread these days. Or to put it another way, no good discovery goes unpunished!
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I would say that true science has helped accomplish a great deal in terms of technology and knowhow. You can’t program a cell phone or create an electrical grid or fly a plan without science. However, what PASSES for science these days is often corrupted, either by money or desire for status, or the need for society to have “answers” to questions that science can’t address. Psychiatry is NOT a science in any sense of the word. It masquerades as a science and pretends knowledge that it does not have.
This doesn’t mean a true scientific approach can’t be taken toward human beings. It means that science has to be honest about what its findings are. For instance, 50 years of genetic research has failed to indicate any genetic basis for any “mental illness” identified. This ought to be considered proof that “mental illnesses” don’t have a genetic origin. But this result is not accepted. In fact, psychiatry fails from day one in being a science, in that its terms are not definable by any objective means. If you make up “diagnoses” without any reference to objective observation and measurement, any claim to being “scientific” are already out the window.
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Plus it’s not very profitable to cure people!
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But wait, not everyone’s hair gets as wet as everyone else’s! Maybe we should be more careful to study how those with wetter hair may be suffering from “wet hair disorder!” Or are the dry ones the ones with the disorder? I’m not quite sure… well, let’s just study it further anyway…
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And so what? If they actually had something worthwhile to offer, it might be worth some risk of offending people or risking some false positives to get them some information. But they offer hopelessness and dependence on life-threatening, soul-flattening drugs that may or may not even work to “reduce the symptoms” of a “disorder” (and may in fact bring about the very “disorder” they’re supposed to address) that there is a 50-50 chance they won’t even develop??? Are these people serious????
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Even geneticists don’t believe in genetic determinism any more. Except for simple one-gene traits like eye color, environment massively changes genetic expression through epigenetics. Genetic determinants are the “holy grail” of psychiatry, always on the horizon but never actually in hand.
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Wow, is this only the 100th time or so that this finding has been made? Maybe we need to spend 20 more years testing to REALLY make sure that there isn’t the SLIGHTEST correlation…
They are saying that psych research has a “replication problem.” Maybe that’s because they’re framing it wrong – they DO get replication again and again that their hypotheses and theories ARE WRONG. But since it doesn’t validate their preconceived prejudices, they consider it “failure to replicate” instead of the clear and repeated replication that their hypothesis holds no water.
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Yeah, I know – why put all this energy into the one element in the equation that can’t be changed, especially after all these years of no results? You’d almost get the idea they don’t WANT to look at abuse/neglect/stress as causal factors…
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Sounds like a great project, Paul! “Things you should know before you see a psychiatrist.”
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As I read this, I think you’re both right. The DSM is, by design, not based on understanding of “mental health” (whatever they claim it to be), nor is it intended to heal anyone. It was originally a billing manual. But the use of the DSM is determined by people who don’t really want to help. So it is evil because it enables abusive “mental health treatments,” but it enables those because it is designed by people who are actually committed to making sure no one gets better.
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It certainly does provide all the “cover” needed to do lots of disguised harm and have people believe you know what you’re doing. And the DSM III forward were designed specifically to allow psychiatrists to pretend they were doing “science.” There are no doubt many ways to screw our fellow humans over, but there can be no doubt that the DSM exists for the purpose of making the whole psychiatric worldview/deception viable.
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Human needs don’t sell drugs, and take way too long to discuss, so one can’t bill $300 for 15 minutes any more. Besides which, you might actually make your clients better, which means you have to look for more clients.
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There is every indication that the very fact of being “diagnosed” leads to stigma, particularly to the degree that such “diagnoses” are associated with biological explanations for the “diagnosed” person’s suffering. It is built into the psychiatric system – the system itself stigmatizes those it serves as a matter of course. The only way to avoid this kind of “stigma” is to develop a different system.
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That is SO true! Anxiety is almost always associated with abuse, in women especially. Yet I have seen many, many “evaluations” done and “diagnoses” reached without any attempt to even screen for abuse. It is appalling.
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The “free market” is a scam. There is no “free market” today. Even Ayn Rand agreed that “free markets” require a way to avoid monopolization. Real “Free markets” exist only in a social context, where there are rules of competition that are either agreed upon or enforceable. They seem to work well in smaller communities where there are direct and immediate consequences for mistreating community members. But to think that today’s corporate grift and corruption even vaguely approximates a “free market” is a joke. Most of those objecting to “regulations” really just want the regulations that keep them from risk-free profits to be eliminated, and love the regulations that protect their market share. There is a sociopathic drive to “profit” regardless of the social effect, or even the legitimacy of the product, as psych drugs definitively prove. The Koch Brothers, supposedly super-advocates for the “free market,” advocated for increasing taxes on rooftop solar in Oklahoma the minute it started threatening their profits. This kind of thing happens all the time.
I agree that complacency is a huge part of the problem. Unfortunately, a lot of complacency is disguised apathy by people who don’t see any way to “win” or even break even in the current economic structure. The “criminals on the planet” are running the show, whether through manipulating/corrupting government officials, controlling media messages, undercutting or buying out the competition, destroying small farms/businesses with the assistance of the government, and so forth. How much can even the most vigorous individual do against the evil of Novartis or Monsanto? To challenge this requires organized resistance, no matter how spiritually aware and capable the individuals are. Where does this organizational energy and MONEY come from?
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Well, I don’t disagree. I think Sanders said “AT LEAST” they should be able to afford to live, and the fact is, people making minimum wage and even well above minimum wage do NOT have enough income to feed and shelter themselves and their families. Clearly, that is a VERY low bar, and yet we fail to achieve it. So yes, something is drastically wrong with a system that values real work so poorly and yet rewards screwing around in the casino of Wall Street producing NOTHING of value so well. Better pay and fewer hours for everyone should be goal #1 to help create a better society. People shouldn’t have to work three jobs to make ends meet when others make $10,000/hour or more. But try to tell that to those benefiting from the status quo.
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I think you get my drift. People should be paid relative to their contributions. There is no “law” to determine this – it is a matter of personal and group ethics, a subject that sorely needs more study and commitment, obviously. So I agree, spiritual growth is at the center. We don’t need a society where some group enforces the rules on value of work, we need a society where those who are in management recognize and reward the contributions of those who contribute well, or better yet, a collective-type workplace where the group agrees on what people get paid for what work. But that takes emotional/spiritual work and courage, and that seems in short supply in our industrialized, corporatized society.
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I think the point here is not that we should just give people money. It is that the stress of economic poverty is a huge causal factor in “mental illness” as “diagnosed” by the DSM. Creating a plan to deal with poverty will improve “mental heath” more than an army of therapists ever could. To paraphrase Bernie Sanders, anyone working a full time job should be able to make enough money to pay for food, shelter and the basic necessities of life. So, people should get more money as compensation for the valuable work they are already doing. If this were the case, “mental health” would improve dramatically, as well as the economy expanding due to more people having disposable income. No “communism” necessary!
Or course, the “mental health” industry will object to any such efforts, as they will lose clients and income. But we can come up with re-education programs to train them to become more productive contributors to society. And those rich criminal types (not all rich people, but a large subset who are getting paid lots for doing little) who are skimming money off the top while producing little to nothing will, of course, object strenuously, but what do we expect from non-productive criminals?
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Isn’t it a form of stealing not to pay people wages that reflect the actual value of their work? Why do the well off get to blame it on a broken system, when those whose lives are being stolen from then via the wage slavery this broken system rewards don’t have that luxury.
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It is my understanding that the ICD codes were derived from or coordinated with the DSM.
https://www.adsc.com/blog/icd-and-dsm-coding-whats-the-difference
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Confronting the exploitative nature of the current “employment” arrangements is a critical part of addressing the “bad jobs” issue.
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Wow, great research! Thanks for sharing this – I think it is VERY important!
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Some are, some are not. It’s not possible to make generalizations about MSWs. Some work in psychiatric centers, but I’d say most do not. Some do individual therapy. A lot just work in various social services roles, like child protection, domestic abuse survivor support, working with the homeless, and so on. Social workers are a pretty diverse lot.
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In other news, death threats are noted to increase anxiety, and permanent incarceration in a dungeon without charge or hope of release has been linked to depressed mood. It is noted that not all respond to death threats with anxiety, and is postulated that this reaction is due to a chemical malfunction in the region of the amygdala which amplifies the fear response. Of course, those who don’t experience increased anxiety score high on tests of psychopathy, but hey, it seems like psychopaths are better equipped to deal with direct threats to their welfare, which is quite adaptive when confronting other psychopathic killers.
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The only point I’d disagree with is your use of the terms “contamination and degradation” in regards to psychiatry. Psychiatry was already contaminated and degraded plenty long before neoliberalism arrived. I’m sure they were absolutely thrilled to meet each other, as psychiatry as an institution was already committed to the goal of making money and maintaining the status quo, whatever the cost to its patent base, and they have proven a perfect support for Neoliberalism’s most damaging premises, without having to modify themselves in any way.
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If the car itself had a flaw which only occurred in one car in 100, but that one driver got killed, I’d care a lot about that, and the fact that you had no trouble with your car would not convince me that the car did not pose a danger to drivers. I hope that distinction is clear. The assertions here are not that someone had an accident with the car, but that there is an “intermittent” problem with the car itself that most people won’t see, but those who do see it can be seriously harmed. This is a very real problem seen frequently in psychiatry. Only one person in 20 becomes psychotic on stimulants at normal dosages, but those 1/20 can be severely impacted. Only perhaps one in 200 have a violent outburst due to being on SSRIs, but those small few include murderers. Should we not tell people that this is a risk, even if the risk is small? It is not reasonable to minimize or dismiss real risks just because they don’t happen that often. The stories being told tell me that such risks are very real and should be taken into account as a person considers this treatment, even if some people choose not to risk it as a result.
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Posting as moderator:
As I said before, I expect people to respect that others’ experiences are valid. That goes both ways. It sounds as if some are experiencing your comments as invalidating the experiences of those who have had different experiences than you. It sounds like you have felt the same way about others’ comments. That’s what I am concerned about.
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Interesting. What are these perceived “barriers to implementation,” and from whom do they come? It seems to me that almost any patient would be foursquare behind being actually told the truth and being consulted before agreeing to a treatment plan. It seems to me that the only barriers to implementation have to come from the rigidity of authoritarian practitioners who want their patients to blindly follow their dictates and are afraid that telling the actual truth will lead to pesky difficulties like the patients actually discovering that these “professionals” don’t actually know what they’re talking about.
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Posted for KindredSpirit:
MissDolittle, of course, TMS *can* help people because that’s how the placebo effect works. What hasn’t been demonstrated is that the help you believe you got from your treatment should somehow have more weight than the stories of harm from those who were not helped by this treatment. There will always be people who feel that TMS or ECT or psych drugs helped them. There will always been people for whom these treatments were neither helpful nor harmful. But we also have to sit with and reconcile the pain from those who’ve been deeply harmed by these treatments.
You seem to think “screw you, I’ve got mine” is a reasonable response to someone else sounding the alarm about the damage these treatments have and continue to cause to people who weren’t as lucky as you.
You haven’t done anything to prove the efficacy of TMS, only your lack of compassion.
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Very well said!
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I am concerned when you say you don’t care what anyone else says. TMS may have worked for you AND harmed others. Does it not concern you that others may have been harmed? Does it invalidate your success that other people may not have experienced the same thing? It is OK that you found it very helpful and other people found it unhelpful?
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Commenting as moderator:
I am not speaking to a particular poster in saying this, but I think it needs to be said.
I think this discussion will be a lot more productive if each person allows that others may have had different experiences, and not try to “explain” how other peoples’ experiences have happened. I think we need to respect that different people experience the world differently, and the fact that something “works” for one person does not mean the other person’s experiences are not due to the “something” that person one feels like works for them. Or vice-versa.
It seems to me that the science on TMS is not very well determined, and the “science” on “mental health” is almost completely absent. So we’re going to get into different opinions and experiences, and that’s OK. Especially when dealing with something as amorphous as “depression,” there is no reason to believe or expect that any two people will have the same experience just because they’re both feeling “depressed.”
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Of course, it is possible – genes play some role in everything we do. The point is, the psychiatric profession WANTS to blame the genes and distorts the research to try and force that conclusion. And despite that, genes still fail to explain anything about any psych disorder consistently, even a small percentage.
I look at it this way: we all have genes, they are pretty much fixed from birth. They are not something that can be changed. There are LOTS of other variables that CAN be changed, through epigenetics, through individual efforts, through improved social structures, through community supports, etc. Why focus our attention on the one thing that can’t be changed? Why not focus on the things we HAVE control over, especially as genetic research so far is a huge bust, despite billions of dollars having been invested in it?
The other thing about genetics is often overlooked – a particular set of genes may allow vulnerability to certain conditions, but might also make other conditions possible. A hugely disproportionate number of our poets, writers, playwrights, graphic artists, etc. have had psychotic experiences. Perhaps a certain set of genes opens us to alternative experiences of life and enables artists to flourish? And snuffing out those genetic variations snuffs out a lot of creativity and motivation to change and grow in society?
The way psychiatry approaches genetics borders on eugenics. They want to “stamp out” the “bad genes” without any real interest in understanding the purposes of those genes. Species survival depends on genetic variations. Genetic differences are not “diseases” or “disorders.” We would do best to simply understand that we have the genes we have and learn to work with them.
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Precisely!
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I fully acknowledge not knowing what these things mean, mostly because I don’t think they mean anything specific, but are simply descriptive syndromes that don’t really hang together in terms of cause.
As for politeness, I find it perfectly viable to be both polite and firm. Of course, there are people who won’t respond to politeness, but that’s no reason to toss it out in every single case. There are plenty of people who will listen better if the person speaking doesn’t start off being presumptuous and offensive. I save that for those who don’t seem to be capable of hearing things presented more rationally. Which, admittedly, is a lot more common in this particular field of endeavor.
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I have a hard time thinking there can be a unitary cause for psychosis, since we know that it can be caused by things as disparate as several days of no sleep and excessive stimulants and childhood sexual molestation and living in an urban environment. But I’m interested to hear – what does Jung say is the cause? I have read some of Jung’s work but this one has not come to my attention. And any explanation that gets away from brain-blaming seems very worth considering to me.
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If the opinions of those who say it doesn’t work for them are questionable, why aren’t the ones of the people saying they work wonderfully similarly questionable?
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The “toddler stage of science?” Is that where when someone contradicts your views, you hold your breath until you turn blue?
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The point of putting quotation marks around “psychosis” is not to deny such experience exists, but to take away the implication that “psychosis” is a “thing” that can be viewed as a unity. It’s an experience that has many potential causes, which have been lumped together into one purported entity for purposes of making money and saving the trouble of having to seek out the actual causes.
Tell you what – I won’t correct your language in the future, and you don’t correct mine. If you wonder why I’m using a particular convention, maybe you could ask instead of assuming and telling me my own reasons? It would seem a lot more polite to me.
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I think you are right – as communities deteriorate, money becomes more important, and greed more prevalent. The Luddites got it right!
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If I had a repair manual for a lawnmower and tried to apply it to an airplane engine, you’d be pretty disturbed if I said, “If somebody has something better…” you’d think that I was pretty stupid or unethical. Either the model works or it doesn’t. If it doesn’t work, you work on developing a new model. You don’t continue using the model that doesn’t work, and you especially don’t claim that the principles of this model apply to the situations where we know they do not apply.
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Did I say otherwise? I think you are interpreting. My point is that denying the cognitive damage due to antipsychotics is contrary to known facts. It seems you agree with me.
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If we are not “bound” by the DSM, and the DSM is de facto not useful to determine what we need to do, what is the freakin’ point of the DSM? Is he finally admitting that the only real purposes of the DSM are as a billing code manual and as a doorstop and back up toilet paper dispenser?
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They only make sense when we assume the objective is making money. If we assume the objective is helping people get better, of course, it all seems bizarre. But in terms of turning a profit, it’s all quite logical and effective.
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It’s bad when the truly insane are defining what “sanity” looks like!
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I agree 100%. There are the intentionally evil, a small cadre in charge, and a lot of dupes or petty tyrants who go along with the program. None of it is designed to assist those receiving the “aid.” There are many things that can be done which are not conceived or are actively suppressed by the “mental health authorities” because they disturb the larger agenda of making money and keeping people from gathering together to protest.
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You tell ’em, sister! Brilliant writing!
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And in my experience, enforcing reality on someone else or invalidating their personal reality without reason are the best ways to drive them “crazy!”
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That is kind of disturbing! Where are the tax dollars to help the patients????
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What about the insanity of the people who continue to push and enforce these drugs on people despite consistent evidence of harm and early death? There is plenty of evil that is not caused by psych drugs.
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“I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan;…”
https://www.nlm.nih.gov/hmd/greek/greek_oath.html
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I think “work” and “job” have become synonymous. “Job” used to be a term of disparagement, implying a low-level means of making a living. It is very different from “work” or “employment” or “calling.”
“job. (1) A low mean lucrative busy affair. (2) Petty, piddling work; a piece of chance work.”
https://www.etymonline.com/word/job
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Makes sense to me!
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Actually, I don’t think you get what I’m saying. I’m not suggesting that “lived experience” per se automatically gives one natural authority. It is based on one’s competence in accomplishing the tasks at hand. And you’re right, hierarchy does seem to be a natural outgrowth of human groups. I’m saying that the optimum situation is where the official “authorities” conform as best they can to natural authorities, and that such authorities that do exist in the hierarchy respect the fact that their position does not preclude someone else knowing more than they do about a subject, and that the ostensible “subordinates” don’t assume that the authorities automatically know what they’re doing.
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“Benefits exceed the harm” is a very different standard than “First, do no harm.” It seems to be what is currently adopted, but it’s not the oath they take.
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Though it is true that as I lost hair, I became less and less depressed over the years. So I think the correlation is very real!
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I think the problem is more one of designating certain people to be in power based on the number of hours they spent in the classroom or the amount of property they own or the kind of asses they have kissed. There is such a thing as legitimate authority, but it’s not based on a person’s degree.
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Sorry, Upton Sinclair.
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I think that was Sinclair Lewis, but the point is well made.
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Unfortunately, that is how sciences is taught and viewed far too often. What you describe is the opposite of science, but most people don’t seem to really understand that.
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I find the ability to temporarily step out of one’s own biases is helpful to making rational decisions. But I agree, engagement is inherently subjective, and trying to permanently remove subjectivity is a road to a dark place.
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It sounds like you may have been misdiagnosed! Or at least you’re in remission!
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The first step toward neutralizing one’s subjectivity is to notice that it exists. Most do not get that far. Those who assure you they are “objective” are usually the most dangerous of all!
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I find that the term “doctor” when applied to those focusing on mental distress reinforces the idea that there is something wrong with the distressed person, and that medical “treatment” may be needed. Does that seem true to you?
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I call that getting to the ROOT of the problem!
And I’m not ENTIRELY bald yet. So I must have a mild case!
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Hey, losing hair is definitely a social stressor. Could “uncover” an “underlying depressive disorder” when you go bald!
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It is actually a false expertise, kind of like being an expert in alchemy, but a lot more dangerous. Being an expert in “psychiatry” has no relationship to being an expert in human relations or human suffering.
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Oh, I WISH they bothered to listen and encouraged patients to talk! Most of them don’t give half a hoot what the patient says, except to convey their “symptoms” for the doctor’s guidance in prescribing something to suppress them.
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I would say that I DO respect professional expertise whenever it is demonstrated. The problem is, a doctorate is neither necessary nor sufficient proof of “professional expertise.” I’ve know PhDs and MDs who were so incompetent and/or malfeasant as to be extremely dangerous, and I’ve known volunteer crisis line counselors who were incredibly capable and successful in helping their charges consistently and effectively. I don’t really see a direct relationship between training and professional expertise, especially in the “helping professions,” and the pretense that such a relationship exists is part of why the current system fails so badly. I mean, why would someone trained as a medical doctor be expected to have ANY expertise in helping people with emotional/spiritual/behavioral problems they might identify? Let alone the expertise to “diagnose” such people according to the subjective and largely arbitrary rules of the DSM? It’s kind of like hiring a plumber to repair your car.
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I meant in a large public forum like the WSJ. I know there are plenty of people (like me) who don’t think getting an advanced degree confers some special status on you that entitles you to a special name. But purposely writing an article in a national journal saying that someone shouldn’t be called “doctor” specifically because they’re the First Lady smacks of sexism to me.
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Precisely. Asking the question gets you attacked in such institutions. It’s like living in an alcoholic home – certain things are NOT discussed, and those who mention them are punished. Kind of the definition of oppression, in some ways.
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As to whether it is “sexist” or not, I think the question to ask is, have you ever heard this kind of argument being used to tell a man not to call himself “Doctor?” And how would it fly if a high-ranking male cabinet member were called “kiddo?”
It is, at best, intentionally demeaning. Of course, I don’t call my doctors “Doctor X” anyway, so she wouldn’t be getting that honorific from me, but I wouldn’t try to rub it in by writing an article or do a TV bit about it!
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I think that was the Jesuits who said that.
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That makes sense. Of course, the 2-4 weeks statement is not based on any kind of research. It’s either wishful thinking or outright disinformation.
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This is only true for short-term usage. It can take much, much longer the longer you have been using the drug, according to well-researched drug abuse studies, which are completely analogous. In fact, with really long usage, no one really knows if the brain ever fully recovers.
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Additionally, if heavy cannabis users are also on “antipsychotics” for “psychosis,” it could be the legal drugs doing the cognitive damage.
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I guess it depends who is stating the dangers. It may be that detractors overstate the risks, but it is clear to me that the psychiatric profession understates them, to the point of violating their own ethics of “informed consent.”
Again, I’m glad that it worked well for you. But I have talked to many people whose lives were destroyed or severely damaged by ECT. My point is that it makes logical sense that since seizures can and do cause brain damage, ECT would pose a risk of brain damage. It is the responsibility of psychiatry to evaluate this risk, or else acknowledge that the risk exists. This does not appear to be happening with the people I’ve talked to or read about.
Notwithstanding that scientific reality, there is plenty of evidence that brain damage can and does occur as a regular effect of ECT. The existence of such evidence should in itself be sufficient to insist on a serious warning that this is a significant danger.
From one internet search:
https://connect.springerpub.com/content/sgrehpp/19/1/24#:~:text=Despite%20many%20scientific%20and%20governmental,or%20degree%20of%20brain%20damage.
http://www.ectresources.org/ECTscience/Templer_1992__AAA__Permanent_brain_damage___Overview___Controversy___Worse_with_pre-existing_brain_damage_.pdf (this is a very pro-ECT article which identifies long-term memory loss and brain damage in a significant number of cases)
https://www.pnas.org/content/early/2012/03/12/1117206109
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And are DOCTORS any less fallible recorders of what they tell their patients?
Sounds like a bunch of self-serving blather to me.
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So it is possible that “Autism,” whatever that is, is simply a combination of high intelligence and certain personality characteristics? Yet there are plenty of “autistic” people who have lower IQ, correct? So are those people “Austistic”? Or are they something else?
Perhaps we can just go with describing people’s behavior instead of having to slot them into “categories” that limit our ability to see the differences between them?
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Promoting acceptance of those who don’t automatically “fit in” is among the worthiest of social goals. Psychiatry, unfortunately, appears committed to doing exactly the opposite!
I knew we were in essential agreement!
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Of course, we also know that science is not a matter for consensus. People have agreed to a lot of “facts” that were scientifically proven false. And still do. Witness psychiatry as a whole.
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You should charge him/her $100 an hour for the suggestion!
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I appreciate your thoughtful reply.
I truly have no problem with social sciences, as long as they learn to limit themselves to actual observations and understand the problems of variable control that are so prominent.
Let’s take the “ADHD” diagnosis as a very simple example. We can look at a classroom and say, “Wow, there are some kids who do really well in this classroom, and others who do poorly.” That is an observation. We can say, “A certain subset of those who do poorly seem to have characteristics in common – they have difficulty sitting still, they seek out constant stimulation, they seem impatient with the process, interrupting the teacher and so on, and they don’t like to do exactly as they are told.” These are still legitimate observations.
We stop doing science when we say, “Those kids who don’t do well in the classroom have something wrong with them.” We are now in the realm of judgment and behavioral control. I suppose we could continue with the assumption that behavioral control is our goal, and then scientifically study better ways to control behavior. But that decision, that behavioral control is the goal, is in no way scientific, even in the very loose social sciences sense.
If we REALLY want to be scientific, we’d have to break down the classrooms into groups. We’d have to do backgrounds on the groups to see if the ones who hate it have anything in common, and if the ones who tolerate it have anything in common. We may find that the majority of the tolerant group ALSO hate being there, but simply have more skills to cope with feeling oppressed. But maybe that means THEY are the ones with the problem! “Over-accommodation Disorder” could be attached to them, and we could give them drugs or do behavioral training to make them LESS compliant and tolerant of oppressive environments!
Of course, the question of whether the environment is “oppressive” or not is social and political and not at all scientific, either.
And we could go on, but I think you get the idea. As soon as VALUE JUDGMENTS get involved, we are leaving the path of science. We can observe behavior and even draw conclusions based on these observations, but what we decide these conclusions mean about how we as humans should act is very much outside the realm of science, and always will be.
It is also valuable to recall that science is a subcategory of philosophy. So something can be philosophical within the boundaries of science, but if it is a “mix” of science and higher level philosophy, then it’s really no longer science, strictly speaking.
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I think we’ve both made our points. I’m guessing we’d actually agree closely on what should be done to help people with perceptual or behavioral differences, and I certainly have never claimed in anything I said that biology does NOT impact behavior or perception – I actually said the opposite several times, as I recall.
The only point I am making is that claiming neurological SAMENESS of people who don’t happen to stand out as “different” does not make scientific sense. We have close to zero idea why people act the way they do. All we know is that certain patterns to emerge, and that expecting people to simply change their perceptual or behavioral style because it’s inconvenient for others is rather oppressive. I am encouraging us to focus less on whose brain is more “different,” and more on how we can help people whose behavioral/perceptual/personality styles don’t fit our largely arbitrary social expectations can find their place in our social system. If someone has to have a “diagnosis” or a “spectrum” identity to be considered worthy of special consideration in this regard, we are leaving millions and millions of kids behind just because they happen to be better at adapting to irrational and oppressive conditions than others.
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I say “seizure” because that is exactly what ECT does. This question is not in the slightest dispute, even amongst the most fervent supporters. The very idea, as I recall, came because they found that people hospitalized for psychotic episodes were less psychotic after having a seizure. They used to induce seizures by drugs like Metroconazole (I think). The whole point of ECT is to induce a seizure.
I am not “angry” at ECT – I am angry at psychiatry for pretending they don’t know what the limitations and dangers of ECT really are. I’m glad you found it helpful. But I can’t allow the claim that no one has proven that ECT does damage to the brain stand. It is a basic tenet of science that the person making a claim is responsible for proving the claim – the “null hypothesis” (that there IS no effect) is assumed true until proven otherwise. If you’re trying to prove something has a positive effect, the assumption is that it does not, until proven otherwise. If you’re trying to prove that something which reason would suggest is unsafe is safe, the assumption is that it is NOT safe until proven otherwise by the data. Otherwise, I can claim that “cars are run by angels” or that “sleeping in the rain without a coat at 35 degrees F is safe” and you’d have to prove that cars are NOT run by angels, or that sleeping outdoors in a 35 degree rainstorm without a coat is unhealthy. In the case of ECT, reason would suggest that a grand mal seizure is dangerous, so it’s the promotor of ECT who has to prove it is not.
The smoking industry and drug manufacturers in general apply the reverse approach – they say, “No one can prove that cigarettes cause cancer. We don’t have to say it can until someone proves it does.” As you can see, this is not “science,” it’s a form of marketing, and the same kind of BS marketing has been done in favor of ECT.
The following article may illustrate my points:
https://www.nature.com/articles/35002188
As you can see, ECT induces seizures, and there IS evidence of brain damage. But again, it is not the job of critics to prove it ISN’T safe, it is psychiatry’s job to prove that, despite the logical conclusion that seizures can and do induce brain damage, the process of ECT somehow is exempt from this general expectation.
As you can see below, no one in the medical field outside of psychiatry pretends that seizures are not potentially dangerous to the brain. Why ECT should magically be different is theirs to prove, and they have not even attempted to do so. They just say it isn’t and dare others to prove them wrong, just as the cigarette manufacturers did for decades.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783429/
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I do agree. I get very upset sometimes when they take things like going for a walk and call it “Nature Therapy!” I call it, “Doing normal things that make you feel good about life.”
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I agree 100%. But for some reason, this kind of argument flies over most people’s heads. Whereas pointing out that there is no evidence of long-term benefits almost always has some “bite.” Some people get upset about it and try to tell me I’m wrong, others are shocked, but a small few are induced to explore the question further. I’m afraid the idea that “ADHD” exists is too firmly planted in the minds of at least US society that pointing out its spurious nature seems to induce too much “cognitive dissonance” for most people to handle!
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And as I said, we are now getting into philosophy, not science. While stating that “all things have a cause” is pretty solid scientifically, the assumption that cause is always biological is a philosophical one, that is often presented as “scientific” (in fact, people are often accused of being “unscientific” when proposing other philosophical positions), but actually in no way proven by any scientific means, and in all likelihood unprovable by such means. We get into a discussion now of what is the MIND vs. what is the BRAIN. The position you present is a “materialist” position, that all causes must be material in nature, and therefore changes in the mind must be caused by something in the physical universe. Yet there are traditions of thousands of years duration that place the mind as transcending the body but being in charge of running it, and would see the brain as more of a “switchboard” used by the mind/spirit to run the body. Less esoteric ideas include the idea of “emergent properties,” in other words, the physiology of the body creates an effect that then is able to act on the physiology itself. It seems pretty clear to me that humans can do a lot to control their bodies, including their brains. Biofeedback and meditation are two examples. There is also the science of epigenetics to consider, which falls within the purview of materialism, but allows that environmental changes are able to change the way the body works and what genes are expressed or muted or turned off.
So the idea that the brain is the causal factor of all phenomena of the mind is not something I would automatically accept. I have no interest in denying either the very real experience of being a “different” person in a world that ACTS as if there is some “normal” we should aspire to (I am such a person myself, as you might surmise.) I also don’t deny that biology may play a significant role in such differences. I see the problem more in society’s unwillingness to recognize or accommodate to the factual existence of such differences, whether they are obvious or subtle or disguised by the person pretending to be “normal.” I doubt you’d disagree with my last statement, given what you seem to be doing.
So you ask some excellent questions. They are just more philosophical questions than scientific.
As a closing example, let’s suppose for the sake of argument (and I suspect that there is some truth to this) that a certain percentage of the population is biologically predisposed to hate sitting still and is very intolerant of boredom and is constantly seeking stimulation. We put children with these characteristics into a standard classroom, and they act out and get into trouble and are extremely unsuccessful. Is the problem that the child is “too active” and “unable to focus” (even though they seem to focus just fine on things involving big movements and interesting experiences)? Or is the problem that the classroom is too dull and rigid and unable to accommodate the needs of these children?
Not a scientific question. It’s a philosophical one, and a very good one, especially when one makes the scientific observation that children of this personality type do quite well in an open classroom setting where they can set more of their own agenda. We can study these kids in different environments and observe what happens scientifically. But deciding what it means transcends science.
Again, I do really appreciate the work that you’re doing. I’m sure it would have been a big relief to me as a kid to know I wasn’t alone and I wasn’t so “weird” as I thought. I fully support those efforts. I just don’t want to concede that there is some “normal” neurological configuration that “normal” people have and that we need to only accommodate for those who diverge far enough from this purported “norm” to stand out. There are plenty of “normal” kids in any classroom who are in intense pain and hate every minute of their experience, yet are able to act “normal” as a performing seal might in order to keep their masters happy and less dangerous. I was one of those kids. I could pretend to “fit in” and do what was expected of me, but I was miserable for 12 1/2 years of school. Was I really neurologically “normal” because I could accommodate? Was I neurologically “abnormal” because it was painful to accommodate? Or were the adults simply unreasonable to expect children to comply with such an oppressive system?
I vote for #3! But science can’t answer that question for us.
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The question isn’t whether “being autistic” is the cause, it’s whether brain alterations are the cause of “being autistic.” It sounds like there is some evidence in a number of spheres that differences in brain operations, aka how the brain is USED by the person running it, between different groups. But we walk down a VERY slippery slope when we assume without scientific evidence that these differences are necessarily structural or causative.
The following link shows how imagination can cause changes in brain imaging that mirror real experiences. This demonstrates the power of the individual to alter his/her own brain operation, which to me tells us that there is no way to causatively link brain images to structure – they are simply different measurements that in most cases have little to nothing to do with each other.
https://www.sciencedaily.com/releases/2018/12/181210144943.htm
I don’t mean to try and refute that there are people who experience the world differently from the “average” person. I just don’t see at this point any means to objectively distinguish between them. I much prefer to look at it as a human problem – how do we as a society deal with the inevitable differences in needs and skills and preferences that will exist in even the most homogeneous group or community.
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And it is worth mentioning again that 50 years of research have yet to produce any evidence that “medicated” “ADHD” youth have any better long-term outcomes than those who don’t. So why are we exposing young children to the risks of Schedule 2 narcotics when there is no evidence they help for more than a few months at best?
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At the risk of repeating myself, it is not the responsibility of critics to present evidence that inducing a grand mal seizure through electrocution damages one’s brain. It is the responsibility of those claiming therapeutic effects to prove that inducing a grand mal seizure through electrocution does NOT damage one’s brain. We all know that seizures are dangerous and can produce brain damage, which is why people with seizure disorders are immediately put on anti-seizure drugs. Why would we imagine that an intentionally-induced seizure would somehow NOT create brain damage?
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I want a “like” button on this one!
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I get that. But your definition is philosophical, not scientific. There is no objective way to distinguish your two groups. It is a judgment call, which I think is why the term “spectrum” was introduced. I have no objection to philosophical definitions per se, I just object to them posing as scientific ones. You have proposed no specific neurological “structural differences” nor presented any evidence of such. The burden of proof falls to those claiming there is some way to distinguish these groups neurologically, and I have seen nothing that meets even a very loose standard of proof. What I hear is that certain people tend to behave in certain ways, and that some people believe these differences are neurological in nature, but no one can show what the difference is. The definition is entirely based on subjective assessments how people act, feel and think (as all psychiatric “diagnoses”) and so falls into the category of philosophy. I see no scientifically valid entity of “autism” that can be distinguished beyond someone’s opinion or assumptions.
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“Fishing therapy!” I love it!
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Thanks for that.
As I suspected, these results are based on functional brain scans, rather than structural differences. Additionally, these patterns are based on averages among participants, rather than specific, consistent differences between the groups being measured. So there very well may be many individuals in the study group who do NOT have the characteristic pattern, and many individuals who DO have the characteristic pattern, who are in the control group. The differences do not distinguish between the groups.
An illustrative quote:
“No research has uncovered a ‘characteristic’ brain structure for autism, meaning that no single pattern of changes appears in every autistic person. Studies of brain structure often turn up dissimilar results — there is great variety across individuals in general. But some trends have begun to emerge for subsets of autistic people. These differences might one day provide some insight into how some autistic people’s brains function. They may also point to bespoke treatments for particular subtypes of autism.”
So SOME people diagnosed with autism have certain characteristics in common in terms of FUNCTION. They state clearly that these findings can’t be considered causal, as they might be the result of rather than the cause of “autistic” behavior, and as they are not close to consistent for anything close to all people so labeled.
The studies are suggestive that there may be some correlates among people labeled as “autistic,” but does not establish that these are either genetic or neurological in origin. Of course, we might expect that from a group of people who are “diagnosed” based on subjective behavioral checklists and clinical judgment. In short, I would conclude from these studies, and what else I know, that “autism” is a loose connection of people who have certain behavioral/emotional/intellectual characteristics in common, but that this group is extremely heterogeneous and that the causes of these shared behaviors have not been determined, nor has it been determined that such behaviors even HAVE a shared cause.
This is the problem with “diagnosis by checklist.” I don’t mean in any way to suggest or imply that people who fit this description don’t have anything in common, nor that such people gathering together isn’t a great idea (it IS a great idea!), nor that there couldn’t be some biological similarities between a big part of such a group. I’m saying that there is no direct evidence that people so grouped have a neurological problem, have a shared neurological problem, or even have a biological problem at all.
As to “neurodiversity,” my opinion is that the idea that there is some kind of “normal” neurological configuration that can be used as a basis for “neurodiversity” to be determined. I am of the opinion that we’d be far better to consider EVERYONE “neurodiverse” and needing individual, creative interventions that respect our individual rights and needs. Which it sounds like you are making every effort to provide, so WELL DONE!
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As Whitaker outlines, there are actual physiological changes forced on the brain by these drugs, and depending how long a person’s been on them, it can take a very long time to get back to “normal.” It is exactly the same process as happens with street drugs, yet of course, the psychiatric guild continues to deny that such things even happen, despite the science.
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I do think it important to remember that something can be intentional without being fully conscious. A lot of times, the staff’s motivations go to maintaining order and avoiding emotional discomfort on their own parts. They are mostly completely unaware of these motivations, yet make decisions with these motivations in the back of their minds. The DSM contributes greatly to making this easier, because rather than admitting they feel uncomfortable because they don’t know what to do or because their own issues have been brought to the surface, they can blame the patient by saying, “Her borderline symptoms are escalating” or “He’s decompensating, we need a PRN injection stat!”
So the staff may not be aware they are intentionally oppressing their patients, and yet be intentionally oppressing their patients nonetheless, with the full support of the oppressive system.
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What kind of evidence are you aware of for consistent and objective “neurological differences” in autistic-diagnosed people? I have not seen any such evidence, and have been working with this stuff since the mid-90s. I’m always happy to be educated, but if there is any such evidence, I am not currently aware of it.
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Well said!
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Not sure how this is “news” to anyone with half a brain. It’s kind of obvious, unless you’re trying really hard to not see it.
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It depends on what you mean by “works.” If you mean, “Can I manipulate my mental and physiological states by experimenting with mind-altering drugs,” then yes, they “work.” If you are asking can such drugs improve ones’ biological well being, balance brain chemicals that are theoretically “out of balance” (with no evidence, of course), or “heal” some sort of purported “Mental illness,” the answer is a resounding NO.
As Peter Breggin pointed out almost 20 years back, these drugs don’t fix anything. Every one of them acts by disrupting normal functioning of the brain (and other parts of the body). If someone likes the way this disruption makes him/her feel or think, that’s up to the user. But it’s past time to stop pretending that these drugs “work” in any sense of healing the body, or helping the body heal. They absolutely do not.
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I prefer making fun of the intentionally obtuse!
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Not really funny. A little too close to the actual truth!
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Definitely qualifies as irony. I think satire has to be intentional!
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I’ve seen some amazing work from certain police officers, certainly worthy of the best of the best of the “mental health” industry.
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Fixed!
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Not sure where you heard that, but it sounds pretty outlandish. No one is advocating to abolish the second amendment that I’ve heard of, and even if they did, there is NO way 2/3 of the States would support it. Biden can’t change amendments even if he wanted to. I don’t think it’s something to worry about.
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Probably a technical problem. Sometimes I approve them and they don’t register as approved. I’ll get back to you on this.
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Certainly. But a very important question that is generally avoided is this: genetics contributes to behavioral decisions. SO WHAT? Genetics is not something that can be modified, except through epigenetics, which is directed by, guess what, EXPERIENCE. So why do we spend millions and millions studying genetic vulnerability when we can’t do anything about it? Wouldn’t it be more productive to direct the bulk of those dollars toward finding what kind of environment helps people succeed emotionally and mentally and toward creating such environments?
As an example, it’s likely that a certain percentage (but very far from all) of “ADHD” cases are no doubt strongly influenced by a genetic tendency to be more active than other kids. These kids don’t succeed in a regular classroom very easily. So is the answer to try and alter their brain chemistry (seeing as the genes are not changeable)? Or is the answer to create environments that allow such kids to be active and to learn in the way they learn best?
Finally, before we ascribe specific behavioral tendencies to genetics, ought we not to have evidence of what genes affect what behavior? Yet decades of research provide almost no information about this. Why do we imagine that’s going to change somehow?
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Perhaps a retreat to a Buddhist monastery can be an option in lieu of “hospitalization.”
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Hey, now you’re talking sense! They could dispense a little Buddhism or whatever their training on the spot!
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In other words, there is NO EVIDENCE that these “disorders” are in any way genetically caused. Why not just speak the truth, rather than couching it in arcane jargon? Oh, right, then people might actually get the point, and their sales would drop!
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Are you using logic again? When will you learn?
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Kickbacks, anyone?
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First off, I don’t see doctors being particularly reluctant to prescribe benzos. Xanax is the second most commonly prescribed psychiatric drug, and Ativan comes in at #7, in 2016. (https://psychcentral.com/blog/top-25-psychiatric-medications-for-2016/)
Second, restrictions on long-term use appear to be advisory at this point, and the recommendations for short-term use only are well established and long standing. There are exceptions to every rule, but it seems to me that it would be irresponsible not to give appropriate warnings regarding the difficulties of discontinuing Benzos. The guidelines seem appropriate to me, just as it is appropriate to warn adults and youth that stimulants are drugs of abuse, even though it appears that a certain percentage of users report being pleased with the results.
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Exactly!
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Yet they continue to pitch that these are “lifesaving drugs.”
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To write this article without any reference to power dynamics renders the entire effort almost meaningless.
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You may be correct in your evaluation, but my point still stands: until someone comes up with an objective standard that is based on a real-world, replicable measurement that doesn’t depend on the opinion of “experts,” the boundaries of any “diagnosis” will continue to expand and no argument regarding “overdiagnosis” can ever be made, because there is no standard for diagnosing. The rest is all philosophy, and generally not even very good philosophy at that.
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It seems scientifically sketchy at best to suggest that something is “overdiagnosed” or “underdiagosed” or “not overdiagnosed” when there is no way to measure what the correct level of “diagnosis” could possibly be. It’s like arguing whether kids need more or less recess or more or less discipline in school. There is not a “right answer,” and it is silly to talk about it as if there were. More or harsher discipline has certain consequences, which some people like and some people don’t. It’s totally subjective. Same with basically all of these psych diagnoses, including autism. There is no way to “over- or underdiagnose” because there is not correct level of “diagnosis,” mostly because these are not definable medical conditions but socially-bound, subjective definitions based on beliefs and values rather than any kind of scientific observations.
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And yet has practice changed significantly since then?
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From a medical/scientific viewpoint, it is a meaningless grouping of people who have little to nothing biologically in common. People can identify that way for themselves, but to me it has all the scientific validity of “diagnosing” people as Catholics or French or greedy or sexually promiscuous. People can be all of those things for as many reasons as their are people. People can identify however they wish to, but it doesn’t make their identification a “diagnosis.”
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Or is it just a description of certain behaviors that tend to occur together, like being an impulsive person or being conservative and cautious or being a risk-taker? Maybe it’s just a personality presentation that can have lots of reasons for occurring?
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Once again neglecting the important question of why a sweet, even tempered young man would kill himself in the context of his school experience. (Not to mention where he got the shotgun.)
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Jeez! That’s horrible!
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I don’t know that anyone here wants to prevent you from doing something you find helpful. However, it becomes different when doctors lie to people about the supposed causes of their problems and try to force “treatment” on them that is really just giving a drug and hoping it works. Not to mention the incredible levels of denial that occur when the clients themselves report that the drug is making them worse.
I’m interested by your comment that “Anxiety has been proven to be real and heredity.” Anxiety is certainly real, but I’m pretty familiar with the research on this point, and I am not aware of anything that suggest that “anxiety” IN GENERAL is hereditary. I’m not denying the possibility that some people may struggle more with anxiety (including me) for reasons that may be significantly affected by heredity. But these same anxious people may have lots of other good qualities, like empathy, commitment to bigger goals, willingness to sacrifice, sensitivity in social situations, and so on. And of course, it is obvious that anxiety is HUGELY impacted by environmental factors. It is, in fact, a survival mechanism to help us avoid dangerous situations. So to decide that anxiety is hereditary is, as far as I know, not supported by evidence (please share if you have some!), but more importantly, anxiety is not a “disease state” that needs to be “treated,” even if some people find that there are drugs or other physiological interventions that can ease anxiety.
Hope that makes sense!
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Of course, I agree. I just don’t see that much difference, except that stressed parents have to be there with their kids and try to enforce the teachers’ dictates. Virtual learning will work better for some kids, worse for others, be the same for others, but it does not begin to address the flaws within the system, which is my point. Rather than simply observing that some kids are less anxious when they aren’t forced into an unnatural setting under the control of a person they may or may not respect with kids selected at random that they can’t get away from having to do things that may or may not make any sense, maybe they should be asking why going to such a setting induces so much anxiety in so many children, and maybe stop doing those things that make the environment so utterly oppressive? But that would presume that there is a desire to empower rather than oppress the students, which is probably a highly erroneous assumption.
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Ah, I see. Similar child abuse to making kids sit in desks all day and do whatever the teachers tell them to do, I’d say.
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So you are saying that “virtual learning” on a large scale amounts to child abuse?
I’m a little surprised if that’s what you’re saying, since I’d expect you to see the school system as a primary means of keeping the unruly masses from rebelling. The whole enterprise is massively authoritarian from day one, and I believe a lot of what is not working in US society, at least, has to do with little kids being trained to invalidate their own perceptions and being forced to accommodate the “party line” on what is “right” and “wrong.” Not to mention the number of kids routed to the psychiatric system by schools.
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The improvements due to “virtual learning” were entirely accidental, and those who have made these observations are scurrying for cover, having no intention of discovering why such a large contingent of kids are less “mentally healthy” when exposed to the oppression of the school system.
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Or should the system recognize that he is a child harmed by abusive parents, and provide the appropriate supports without having to “diagnose” him with anything except being treated like crap by the people who are supposed to love him?
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Or people with the same “diagnosis” sharing nothing in common except for their behavior and/or emotions. If people with low thyroid, childhood sexual abuse, and a dead-end job all get the same “diagnosis,” something is pretty wrong!
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Good clarification. Many things exist as concepts without having a corresponding physical reality.
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It’s kind of a joke to talk about ‘differential diagnosis’ when there is no objective way to differentiate between one group and another. I think it’s fine to talk about personality characteristics and how to deal with them, but the idea that these utterly subjective categorizations somehow represent “diagnoses” is laughable, and to talk about “differential diagnosis” as if that were somehow a meaningful phrase is ludicrous to me.
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“Jerk Radar” concepts are most definitely applicable to psychiatry. They try to charm you initially with promises of a better life, try to quickly engage you with them intensely to isolate you from other help, interfere with other relationships by explaining how they have your best interests at heart and that anyone disagreeing with them is undermining the relationship. Big egos abound, with willingness to lie or manipulate to maintain control, and willingness to blame others for anything that goes wrong. Low responsibility – goes without saying. History of abuse, encouraging others to use drugs, employing denigrating labels and comments… the concordance is quite thorough.
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That is so awful! Thanks for sharing your story, and I’m so sorry this has happened to you!
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Nor do most of us pretend that we have some scientific backing for our “diagnoses!”
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This is very well spoken! I would add that what people have in common is more likely to be the stresses that CONTRIBUTED to their “symptoms” rather than the label. For instance, survivors of domestic abuse have a lot in common with each other, even though they might qualify for “PTSD,” “Major Depression,” “Bipolar Disorder,” “Borderline Personality Disorder,” “Anxiety Disorder” or many other possible labels. It would be more functional AND politically powerful to organize around experiences, rather than “reclaiming” a label that was never even relevant to most of the people who had it applied to them.
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Yeah, seriously! I’d love to see any of the “mental health professionals” live on double that a year.
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Posting as moderator:
There is no rule here that participants in comments are or are not “supposed to hate Trump.” I am concerned that this thread is about to go off topic into electoral politics or some other disrelated conversation that will end up being unproductive and hostile, as has happened recently.
The point of the article is that the White House refused to pay for “mental health care” for separated migrant families. Arguments about whether this is a good or bad thing are welcome. I don’t want to see an argument about whether this means “Trump is bad” or not.
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Too true! They are very handy in shutting up these “problem people” without bothering to find out what is going on with them.
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How does anyone distinguish what is “endogenous depression” from “exogenous depression?” If you feel the drugs were useful to you, I have no reason to doubt you. But you are extrapolating from your own experience to assumptions of physiological cause that are not supported by scientific observation.
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Yeah, better keep THAT one quiet! They’ll be coming after you for elbowing into their “turf!”
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I agree with you. I think having your own observations and conclusions invalidated without reason is the most painful of circumstances, short of physical harm. It is extremely destructive especially when engaged in by someone who is supposed to help you.
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Oh, you mean “Uncovering a latent psychotic disorder?” It is NEVER the drug’s fault!
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Which of course means that the only “evidence based treatments” are going to be drugs, because they’re the only ones with enough research to provide an “evidence base,” however corrupt or flawed or sketchy that evidence base is. For instance, they still call stimulants “evidence based treatment” for “ADHD” even though decades of research show that they do NOTHING to improve long-term outcomes for children. What good is an “evidence base” that doesn’t take long-term effects into account?
And that’s not even getting into how the grouping of the “DSM disorders” puts together heterogeneous groups who will respond differently to the same approach, so that only the heavy-handed “symptom suppression” approach will be viewed as “effective.”
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I don’t know that I have one to hand, actually. Whatever you call it, there is a power differential, and any person who is really good at it knows this is a huge part of the dynamic and knows how to step down from their power and return the power to the client, and appreciates that the “peer worker” is actually in a BETTER place to do this. But the DSM attitude/philosophy speaks directly against this, encouraging and even in some ways requiring the “clinician” to see the “Mentally ill” as below them. And by analogy, the “peer worker” is below them, too.
Maybe we can call them “coaches” or “mentors” or something that doesn’t delineate their value as being a “peer” with people who are identified as being “beneath” the “professionals.” But the real problem isn’t the name, it’s the attitude of the professionals toward their clients, and by analogy to anyone who as been on the “client” side of the relationship. Condescension is both a consequence and a cause of the disempowerment of clients, and I see that condescension clearly indicated in attitudes toward “peer workers,” who are automatically seen as less wise, less emotionally stable, less effective, and less important than the so-called “professionals,” even when the opposite may well be the truth.
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I’d say by MOST providers these days. There are exceptions, but they are most definitely in the small minority.
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The “peer” designation appears to me to be intentionally condescending, to mark these people as “not REAL professionals” so their views can be overridden when they threaten the status quo too directly.
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Maybe they mean “lived experience” of the nonsense and discrimination so many people experience at the hands of the “helpers” in the “mental health system?”
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Well, we can’t have something as cheap and accessible as manganese and Vitamin B3 as a treatment! Where’s the money in that? Sheesh!
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I honestly have not seen anyone saying that a response to life’s tragic circumstances is not absolutely needed. Perhaps you can let me know what quotes or statements lead you to this conclusion? I think there IS a sense in a lot of people that a “professional” response to human distress is condemned to failure from the get-go due to differences in power and intention between the “helper” and the “helpee.” Perhaps that is what you are referring to?
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It is oddly euphemistic, as I was trying to point out. I mean, who the f*&k else would be at the “center” of your considerations? It’s kind of an admission that the “care” they have been providing has had nothing to do with the person they are “treating!”
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The fact that anyone has to suggest that “person-centered services” should be a model of care tells us enough about the usual attitude of the “mental health” professions toward their ostensible “clients.” What other kind of help could possibly be envisioned, that is not centered on the person one is purporting to “help?”
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I think my response DOES answer your question, and quite clearly. Each person will need something different, and the first error of psychiatry is clumping people together based on how they feel or act rather than on what their experiences, life conditions and motivations are. The only way to help people in distress is to get to know each and every one of them personally and help them figure out their path. It is much more a spiritual than a physiological thing, though physiology certainly does play a role (exercise, sleep, nutrition, etc.) Psychiatry is destructive largely because it invalidates the humanity of its clients in the interests of money and power. Restoring connections and respect and caring leads to a wide range of solutions that depend on the person and his/her situation. There is no “prescription” for mental well being.
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Maybe they should just pay the “patient” the amount they WOULD have paid the drug companies and the doctors. I bet that “depression” would drop markedly as a result!
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Reminds me of the Star Trek Next Generation episode where people from one planet got everyone on another planet addicted to a substance only found on the first planet, and then said they all had a “disease” for which their drug was the only “treatment.” And of course it was VERY expensive, but what’s it worth to be protected from this horrible “disease!”
It is beyond despicable to create a “disease” with one drug and then sell another to “cure” it!
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I think I lucked out. Plus, it was a different time. I am not sure psychology/counseling students are even taught about the subconscious mind any more. But they get LOTS of “differential diagnosis” training in the DSM, sadly.
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And she was an MSW, by the way.
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I actually had a very good therapist who worked with me to meet MY goals, never once told me what to think about my life even when I asked her to do so. But this was back in the 80s before the DSM took full hold. I think such people are harder to find these days, but I do think there are times when having an objective person who is willing to listen and ask pointed questions about your thinking and decisions WITHOUT telling you what to do is extremely valuable. The problem is, most therapists seem incapable of being there for the clients without meeting their own needs at the clients’ expense. The DSM structure makes it that much easier to avoid the real issues or to work out the therapists’ issues on the client. And I’m not sure there is a way to actually train therapists to do this. It seems to have a lot more to do with the therapist’s own grasp on his/her personal issues and needs, and corresponding ability to set those needs aside and truly LISTEN to the what the client is saying instead of trying to “fix” the client’s life.
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“Manipulation” is just an indirect way of controlling one’s environment. The “Mental health” teams use it all the time.
What is it called when I give you give points or privileges for doing what I want you to do but taking them away when you don’t?
Manipulation. Case Closed.
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Isn’t “harshness” a symptom of some “disorder” or other?
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I think the problem is connecting psychiatry, which is NOT designed to help people except in the crudest sense of deadening “negative emotions,” and society responding to suffering and misery, which I agree society is responsible to do. In fact, as long as psychiatry is around, our society at large can pretend that psychiatry has the answer and that they don’t need to bother responding to your or anyone else’s emotional difficulties, as they will buy psychiatry’s story that it’s all about flawed brains and doesn’t require any social changes at all.
As to what society can and should do, I think there is a major problem assuming that there is one answer for all those now considered “mentally ill” by the DSM system. There are many different responses possible, which can be adapted to many different situations. For instance, the main “cure” for ADHD appears to be to restructure schools so that they are more adaptable to the needs of kids. Things like “anxiety” and “depression” can have many causes, and the response should be different for different situations. Does society need to respond the same way to a person in a dead-end job or an unhappy marriage, as opposed to someone abused as a small child, or a person who is being discriminated against systematically because s/he is an immigrant or a black person or a woman?
Grouping “the mentally ill” together as if “they” are some monolithic entity plays into the hands of the psychiatric community and the drug companies’ needs. It is a false grouping of heterogeneous people into pseudo groups, which obscures any real attempt to analyze and help with a person’s actual situation.
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Or perhaps psychiatry’s existence is the reason there is such limited support available.
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Well, you see, the drugs “unmasked an underlying movement disorder.” It was there all the time, the antipsychotics just allowed it to express itself.
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I do get your point. But I think we can be a LOT less concerned about the safety of a sugar pill or a dose of niacin vs. a chemical that has known adverse effect on brain chemistry as well as a wide range of known and unknown effects, some of which can be deadly.
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Acquiescing. Giving in.
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They are most DEFINITELY symbolic to the “practitioners,” especially those who have a big financial and/or status investment in the system. This symbolism is a large part of what makes them deaf in the main to the actual experience of their “clients.”
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Good point!
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How about we start a draft for our politicians? Kind of like jury duty? Hard to see how it could be any worse.
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Placebos have “symbolic meanings” and don’t do any damage. Or maybe they can start in with crystals or Tarot cards if they’re looking for symbolism. Symbols don’t have to screw with our brains!
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Yeah, Freud was a huge improvement over anything else that preceded him, because he at least started from the idea that the what the client says is the most important thing to consider. That postulate alone would invalidate the entire edifice of the DSM and all that passed for “psychiatry” throughout history. It is just a shame that he backed down from his accurate observations. But as we all are, he was a product of his time, and his revelations were just not tolerable in the society he lived in, however accurate they may have been.
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But I don’t recall Jung reviving the observation that children (especially girls) were frequently sexually molested and abused by adults in society and that many of their “mental illness” manifestations resulted from these abuses. Maybe he did and I’m just not aware of it.
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Freud’s main contributions were that he believed that listening to people’s stories was a path to healing, and that early life trauma unconsciously affected decisions and emotions on an ongoing basis. He was the first to recognize that sexual abuse of children (especially girls) was rampant, and at first he believed these stories and attributed women’s “hysterical” symptoms to the abuse they had experienced. This outraged the Viennese society of the time (one has to wonder how many of his psychiatric colleagues were suddenly worried they’d get busted!) and he came under tremendous pressure to recant. Unfortunately, he did so, and devised all the weird “drive theories” like the Oedipus complex and penis envy and whatnot and the secret of childhood sexual abuse went back under wraps for another hundred years. Most of what he is remembered for is the crap he came up with to explain away his original observations. He may have saved his career by doing so, but his betrayal of his integrity condemned another four generations of children to unrecognized sexual abuse.
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There is no question that these drugs have an EFFECT, and sometimes the effect seems positive or worth the cost. This does NOT mean there is something “wrong” with the child, or that the child is being “treated” for some “disease” or “disorder,” or that other children experiencing similar problems will be “helped” by whatever you felt worked for your child. Individual stories are valid, but scientific claims need to be made on overall data, not individual stories.
Best of luck with your continuing challenges!
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I have noticed that when something the researchers WANT to be true is proven false, “More research is needed.” Whereas when there is the slightest hint that what they want to be true MIGHT be supported, it is broadcast all over the world as if it is utterly proven true. A little bias there?
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I like that idea!
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There is also a myth that the “atypical antipsychotics” don’t cause TD. They do, at lower rates, but they most definitely do.
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Thanks!
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I’d be pretty f-ing insulted if I were called a “treatment non-responding anxiety patient.” Isn’t it clear how dehumanizing this whole idea is?
I also wonder that the model here is to only provide therapy to those whose drug “treatment” seems to have “failed.” Why not start by talking to them before you decide to mess with their brain matter?
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It sounds like we’re substantially on the same page. He has recently revealed some childhood trauma we did not know about, and he was operating with that inner secret (from himself, too), which no doubt made it difficult to make sense out of things. He also had an emotionally abusive partner he was escaping from, and I think the drugs provided escape for him, too. He was guided at first, but the person guiding him also had some serious issues and told him some very not helpful things. I think certain people just don’t do well with any kind of drug intervention. Nothing works for everyone, and we all have to find our own paths.
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I think we’re getting into the difference between individual actions, which vary widely, and the system that has been devised, which is very narrow and rigid. There are most definitely individuals who can do great things within the system, and those who fight the system itself to do better (I was one of those for a while). I had a great therapist who really helped me back in the 1980s, though in fairness the DSM-III was just taking hold and therapists were more conversant with Jung and Rogers and Hoffer and Maslow and Bowlby and the like. But the system has changed, and is now rigged to encourage labeling and drugs and a discounting of the importance of experience and personality development as well as to ignore social impacts on human experience.
I’d use the comparison of individual vs. systemic racism. There are individuals who really do choose to hate people based on their skin color or national origin or class. But the majority of people are able to manage relationships with individuals of varying backgrounds without overt hatred. Unfortunately, ALL of us are steeped in a culture of racism, and carry around images and assumptions and reactions that are “programmed” in by the society we’re a part of, to the extent that much of it, we don’t even notice. Some people are able to rise above this training to one degree or another, but most are only partially or marginally aware that such things are even happening.
That’s how I see the psychiatric system. There are individuals within the system who can rise above the system’s assumptions, but the training and the culture surrounding “mental health” is warped in the direction of believing that “the mentally ill” are a specifically identifiable population, whose value and capabilities in life are less than the “normal” person, which of course the majority practitioners believe themselves to be. So even if people within the system do challenge the system to do better, they tend to make temporary stirs in certain areas which quickly settle back down into the status quo, because the system is supported by a huge culture of discrimination and condescension and power dynamics, and most of the practitioners are comfortable enough with it to keep supporting its basic assumptions.
This is why I got out of the business myself. I decided at a certain point that continuing to participate, even as a rebel behind enemy lines, was a tacit approval of the system as it was. I saw the damage being done and realized that one person can’t change the entire culture. So I became and advocate, and earned a lot more inner peace.
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I can testify that they really screwed up my son’s life, too. Testimony is evidence only in the most limited sense. And the process you describe is not a “medical” intervention, but a spiritual/religious ritual, and so does not belong in the realm of “treatment,” even if it does work.
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Decriminalize, not legalize. But yeah.
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I am most definitely saying that psychiatry as a pseudo-scientific philosophy/religion denies or minimizes the causal role of stress and trauma in any of their “diagnostic” categories. At the same time, they also systematically overlook REAL physiological problems, like sleep apnea or low iron for so-called “ADHD,” and deprive the client of actual medical care that they may need.
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Looking again, I just thought it was an important distinction to make. It is common to use the term “illness” in a metaphorical sense, like “that is SICK!” or “she has mental illness” without any actual attempt to look for physiological illnesses, and without the consideration that stress and trauma cause physiological symptoms that can easily be interpreted as “illness.” Of course, these ostensible “symptoms” are intentionally framed as “illness” by the psychiatric community.
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And having an attorney present would keep the interrogators, oh, oops, I mean “interviewers” more honest.
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Good point! And that’s not even counting the ones who would NOT have killed themselves if they HADN’T been psychiatrically detained.
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Sometimes my comments have their on momentum. Take them for what they’re worth to you, and leave anything you don’t find useful.
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I think how things have played out suggest where Britney’s problems may have originated. Parents sound super controlling!
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Throwing up suggests “ill.” Feeling depressed suggests “stressed” or “traumatized.” There are some people who are depressed because they are ill (low thyroid, chronic pain, iron deficiency, etc.) There are some people who throw up because they’re stressed or traumatized. To assume someone’s ill because they are depressed is dangerous and unscientific. Screening for illness makes sense. Assuming illness does not.
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‘Kwanzaa’s second principle, Kujichagulia, Swahili for “self-determination,” which reflects a sense of “defining, creating, naming, and speaking for oneself.” ‘
If this second principle were put into place, the DSM and the standard of “care” in the “mental health” system would be immediately put to rest. The DSM’s purpose is to “define, create, name, and speak” for the “patient” and prevent the patient’s voice or viewpoint from being taken seriously.
The author may actually have been fortunate that her colleagues didn’t immediately call the authorities and allowed the author to exercise her own self-determinism in deciding how to proceed with the assistance of her psychiatrist. I was a bit disturbed to hear her talking about the “stigma” of “mental illness” and even moreso being “stigmatized” for being black. I think the proper word here is “discrimination”, not “stigma!”
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I think psychiatric practitioners who “treat” imprisoned “patients” are worse than the criminal justice system. At least alleged criminals have to be “Mirandized” and can have an attorney present during questioning, get a full trial and have to be convicted “beyond a reasonable doubt,” and have a specific and limited sentence. The “committed” have almost no rights, other than a “preponderance of evidence” trial in front of judges who are generally heavily biased against them. And they can be “held” indefinitely, or at least as long as their insurance holds out.
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Lies, damned lies, and statistics!
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“Needing help” is not synonymous with “being ill.” We all need help in this crazy, bizarre, heartless world we’re trying to survive in. It’s no sign of “illness” to find our modern way of life distressing.
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Actually, the village shaman is on a higher ethical plane, because at least s/he is not pretending that s/he is engaged in some kind of objective “science.”
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The other huge problem with “EBM” is that “evidence” will only accumulate when studies are done, and most studies are funded by the pharmaceutical industry. So any non-drug interventions (like peer support) will never gather enough evidence to be called “EBM,” even if the results are far superior to “treatment as usual.”
And of course, the article does not take on the more fundamental problem, namely, that helping people suffering from emotional distress is not really “medicine” in the first place. Studying “depression” will never lead to a proper “evidence base,” because the researchers are studying a heterogeneous group, where some will be helped by one intervention and others will be not helped or harmed. If people are treated as individuals, we’ll get a lot better result than by lumping together a whole bunch of people with a wide range of issues and trying to “treat” them as if they had a medical problem that no one apparently can actually identify.
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There is no “therapy” with force. It’s not Open Dialog, it’s a sham!
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Thanks for the excellent summary. While most of this has been easily knowable for decades, it is good to have it capsulated for those who have been propagandized by the “mental health” industries, including the practitioners themselves, in many if not most cases.
Looking forward to Part II!
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You take it right!
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Yeah, if owning guns reduced crime, we in the USA would have the lowest crime rates in the world!
But you are right, there is nothing to suggest that having a “mental illness diagnosis” makes one more predisposed to violent gun use. Heavy drug use (including LEGAL drugs like antidepressants and benzos) and domestic abuse are the highest associations with gun violence and have been for a long, long time. The “mentally ill” angle is just to create a scapegoat so those much larger REAL social problems can be ignored or minimized.
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Wow, you’re sad about your sister dying? No WONDER they drugged you! You’re not a complete automaton yet!
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Wow, well said! Very powerful!
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Very well said, Kindred! Not a word to add.
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I think MIA provides a degree of “informed consent” that the industry finds embarrassing and threatening. It could be “therapeutic” for people who sensed the truth but haven’t seen it in black and white before.
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Answer: NO! Next question…
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I recall an experiment where someone designed a computer program to act like a non-directive therapist. It asked basic questions like, “Tell me about your childhood,” and gave generic acknowledgements like “I see” or “Uh huh…” If someone went off on a tangent, the computer would say something like, “Let’s get back to your mother.” The users reported feeling better from using the program. I think it showed how desperate people are just to have someone listen to them, even though the “listening” was totally artificial. Perhaps the machine had an advantage, in that it was unable to give unsolicited advice or demonstrate prejudice or evaluate for the user what the computer thought their “real problem” was.
Anyway, I think we’re sinking down pretty low when we’re trying to have computers provide “therapy.” Though the computer program may have a big advantage over a psychiatrist with a prescription pad. At least it won’t make you worse.
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Very true! The problem is not that the information is not known and available, it is that there are so many people invested in the status quo who stand to lose money or status or both, that the facts are no longer relevant to their analysis. The only consideration is how to maintain power as long as possible before one is caught and held accountable. And this attitude extends very far beyond the boundaries of psychiatry.
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Weird, since so many deteriorate ON the “medication.” And of course, their answer is “they’re not taking a big enough dose!” If the “treatment” isn’t making the person better, why would we continue “treatment?”
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Why is the conclusion not that “The risks outweigh the benefits for children and they are contraindicated in children. The proposed benefits for youth are slight and do not appear to outweigh the risks, so prescription in adolescents is also inadvisable.”
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There has never been “evidence of benefit” for “antidepressants” in children. Yet still, they continue to be in widespread use in that population.
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Posting as moderator:
Is this one of those “agree to disagree” moments, perhaps?
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Correct! A “lack of direct experimental confirmation” means no support for your hypothesis, or in other words, your premise is FALSE!
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“Collaborative care” means you get to choose between two or three different toxins to attack your body with.
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It was a twitter hashtag to start with.
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I recall seeing a film of a nice, German family, small house with a garden and a white picket fence. The father was a German officer, was dressed up for work. Walked out the front door, said goodbye to the wife and kids, and turned up the street. The camera shows Buchenwald rising in the background and the father heading off for his job at the death camp.
Individual humans do not have to be evil for their behavior to be evil, or for the institution they work for to be evil. Many “good” people are able to justify bad actions in a wide range of manners, and evil institutions are very generous in providing plausible justification for the actions they want people to be able to justify. Remember the Milgram experiment!
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Posting as moderator:
Don’t sweat it! As long as you’re not calling someone names or telling them off, swear words will generally fly without attention, at least at this moment in MIA history.
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Very well put, Oldhead.
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Well said!
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Biederman and company also cherry picked their non-placebo-controlled studies. Studies in Quebec, Australia (Raine Study) and in Finland showed that taking stimulants don’t improve any outcome measured in the “meta-analysis” discussed. Additionally, the OSU Medication Effectiveness Study showed no improvements in any outcome, except for a slight reduction in accidents for “medication” users. This issue has been studied for over 60 years now. If this stuff were so awesome, why aren’t there clear and unambiguous indications of positive results? How many “no result” findings have to happen before we conclude that it simply doesn’t have any long-term benefits?
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It’s tenable if you’re trying to make money and expand your client base. If you actually care about science, it’s nonsense. But these are not scientists we’re talking about, they’re either dupes or snake oil salesmen.
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That is my observation also. “Peers” are rarely considered equal partners, but more someone who can “talk at the client’s level” and thereby explain why the system is “right.” I’ve seen plenty of “peers” who intentionally and consistently buck that trend (Stephen Gilbert/Boren, for instance), and they can sometimes get some stuff done, but they are never considered actual peers to the professionals. As long as that condition pertains, “peer support” remains mostly coopted and lacking in significant influence beyond the level of an individual person’s situation.
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Posting as moderator: It is possible that past moderators handle things differently. The Posting Guidelines do mention profanity, but in the context of being respectful to others. It could be interpreted that all profanity is banned, but I’ve read it as meaning profanity in reference to someone’s person or ideas would be out of bounds.
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Plus, who makes money out of making these kids better?
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Posting as moderator:
There is no rule against using profanity. The rule would be against using profanity toward a particular person or group. Hence, you can say “Fuckk it all” or “This is a fucking joke!” but you can’t say, “The moderator should fuck off!”
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Exactly!
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Seriously! This is a new concept?
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How can there be “digital markers” of “mental disorders” when there are no actual BIOLOGICAL markers to distinguish whether or not someone has a “disorder” or not?
This is rank idiocy!
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I liken the concept of Digital Psychiatry to proctology – it gives them the opportunity to stick a finger up their behind.
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Anyone who gets upset about anything for any reason has an “emotional regulation disorder.” Especially if you get upset at THEM!
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You’d think, wouldn’t ya?
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TWO YEARS? That’s awful! Well done for surviving it! And escaping!
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Something can’t be “overdiagnosed” if there is no objective means to determine the “proper” level of diagnosis. In essence, EVERY diagnosis is “overdiagnosis,” since there is no observable malady to diagnose in any individual.
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The difference is that I get to define what I think. is “wrong” in the mental/spiritual realm. If a doctor tests and finds I have low thyroid, s/he can then tell me what is “wrong” and we can make a plan. But no one can tell me it’s “wrong” for me to have flashbacks or feel anxious. Sometimes feeling anxious is absolutely RIGHT – it is my body warning me that I’m in danger! Sometimes it is right but not very helpful, like if I’m going for a job interview and there is a “danger” that I won’t get the job. Sometimes it was right at an earlier time but is being applied to a situation today where the application doesn’t work. So I would be “wrong” for applying it to this situation. But the anxiety isn’t in itself “wrong.”
Establishing order is what we do as humans. So “disorder” can certainly be perceived as “wrong.” But someone else telling me that my emotional state is “wrong” because it doesn’t meet their criteria for “normal” is judgmental and is frequently destructive.
As a therapist, I have no problem asking a client, “What’s wrong?” from the perspective of the client. But I would NEVER tell a client, “Your reaction to being sexually molested is ‘disordered’ (AKA WRONG!)” It’s not my job to decide, and that’s why the DSM labels are problematic. It makes people feel “wrong” for feeling the way they do, instead of helping them see the challenges they face in a new light, which is what therapy should be doing.
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And tends to kill you younger if you follow your “treatment plan.”
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“…by convincing them that their troubles are just an inevitable result of what happened to them, and there is no possibility of them changing their reaction to something else and so getting more control over their lives.”
I don’t think someone needs to believe there is something “wrong” with them to consider the possibility of changing their reactions/coping mechanisms. My emphasis has always been on how they WANT their lives to proceed as opposed to how they can be “fixed” in the sense of “returning to ‘normal’ (as defined by our social norms).
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Harrow showed that people with more favorable prognoses prior tom the study had worse outcomes on drugs than those with less favorable diagnoses had when off drugs. So “favorable prognostic factors” did not associate with better outcomes, whatever Harrow might have speculated about it. I also understand that he reconsidered his first analysis in the light of further data and critiques, and I’m wondering if you were reading his first assessment.
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Very nicely said!
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Exactly the point. It’s about self-determination, not semantics.
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Very well said!
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There is a difference between saying there is “disorder” vs. saying I “have a disorder.” One is a temporary condition of the self and surroundings, the other is a judgment of insufficiency that is inherent in me. At least that’s how it comes across to me!
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POSTING AS MODERATOR:
I don’t know of any way to make the website an active link. Have you tried copying the address into your browser?
Steve
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Disgusting!
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POSTING AS MODERATOR:
If there are specific posts that aren’t there, please let me know. Your posts are pretty much always posted without moderation, so I’m not sure what could be missing. E-mail me directly if you find something specific I need to look for.
Steve
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Well, how about they finish their research before they are allowed to prescribe these “mystery drugs” that just MIGHT make you sick or kill you, we’re just not sure…
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I agree, children are their weakest point. They can’t portray a two-year-old as a potential mass murderer needing to be “treated.” When you tell people about kids under one year old being on psych drugs, they are stunned. When you let people know that over half of foster youth over 12 are on psych drugs, people pay attention. A lot of the arguments for psych drugging and incarceration don’t sound nearly so convincing when kids are the victims.
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How about this one?
https://www.psychologytoday.com/us/blog/out-the-darkness/201603/chemical-lobotomy
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That’s why I always avoid the term “misdiagnosis” when applied to DSM labels. It implies that there are people who are “correctly diagnosed” but you’re just not one of them. I think the correct label is “malpractice!”
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It is also not known or readily forgotten that these “neurotransmitters” affect a lot more than the brain. 90% of the serotonin receptors in the body are apparently in the gut. We are doing more than messing with people’s brains here. Hence, the obesity, diabetes, and early death figures.
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Hi, Sandra,
I guess I have a little concern about the idea of “diversity of opinions” in this context. My problem with it is this: those in the psychiatric world have a MUCH greater power and privilege than those that they ostensibly “treat.” I believe that conveys a much higher responsibility on them to insist that their “opinions” are based firmly upon scientific facts and knowledge. I think one reason you don’t have an answer is because opinions or “voices” can be valued differently by different people, and it is of course very, very easy for those in power to simply ignore the voices of those they have power over. So if we REALLY want to have a conversation where “all voices are heard,” I think we have to start with amplifying the voices of those who receive the services in question, such that their EXPERIENCES (not their OPINIONS) are considered the most vital data being examined. At the same time, those who have the power to ignore such voices would have to be restricted from positing their opinions as fact – they would have to present scientific data to support their opinions, AND would have to have their positions jibe with the reports of their “patients” or else not be considered valid.
It is, indeed, difficult to manage, but not because there is a diversity of opinion, but because there is a differential of power, and those who have the power to make their opinions sound like facts are unwilling to set that power aside long enough to hear what the real effects of their “treatments” are. Present company excluded, I think.
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I agree wholeheartedly – the tendency of the “professional” is often to force the person to be “reasonable,” and to re-a. ssume the roles they are rebelling against. Which is actually the very WORST thing you can do! A “mental health” crisis generally means that whatever role a person HAS been playing is not working. Maybe they need to reconsider how they’re living their life! Forcing them back into their old roles would drive them into apathy.
Having a crisis is not an illness! And the solution is not to. force someone back to “normal,” whatever that is.
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I was pointing out that state legislators also have that power, and in fact it is state legislatures that are in charge of civil commitment laws. So both need to be addressed, and wherever one gets access is the best place to start.
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Stimulants have also been implicated in a number of mass shootings, though much less often than “antidepressants.”
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By the way, Johanna, congrats on the second edition, and thanks for all the awesome work you’ve done over the years!
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POSTING AS MODERATOR:
In fairness to Oldhead, I have posted this last response (since Richard specifically referred to him in his post).
I will be following Robert’s directive from here onward, and post things that relate to Terror Management Theory. Comments re: COVID are welcome as long as they are presented in that context. Any attempts to personalize negative responses will not be posted.
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Pretty much, yeah. They don’t have to agree with each other or with US law, though US law can supersede them depending on the issue. “State’s Rights” vs. centralized government control has been an issue since the first Continental Congress back in the 1700s. It continues to play out today, right in front of our eyes. The intensity of the conflict over “mask mandates” is a reflection of that ongoing conflict. “Let’s act together in everybody’s interests” vs. “Washington isn’t going to tell US what to do!” Our current “liberal-conservative” spectrum is closely related to that theme, IMHO. Unfortunately, I think it can blind us to bigger issues on different spectra.
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I agree, we know what we need to know about them. We know: 1) They mess with our brain chemistry, and indirectly, our brain structure, just like any “psychoactive drug,” including heroin, meth, alcohol, LSD, etc.; 2) there is no identifiable “illness” being treated, no means of distinguishing the “ill” from the “well,” so at best, these can be considered palliative drugs, similar to heroin for pain or aspirin for headaches; 3) all of these drugs have serious and in some cases deadly adverse effects, such that people taking the APs die 20-25 years earlier than the average person in society; 4) they all have withdrawal effects that generally lead to MORE of the “symptom” they are supposed to be suppressing; and 5) whatever unstudied long-term consequences exist, the evidence suggests that they are not good or helpful.
What more needs to be known? A simple cost-benefit analysis says that we’re “treating” an unknown condition (if it even is a condition) with a drug that has largely unknown long-term consequences (other than early death and diabetes) and known short-term adverse effects which can be severe, and known withdrawal effects which can be worse than the “condition” being “treated.” The only benefit appears to be a temporary lessening of uncomfortable “symptoms” for an unknown proportion of the population using them. What argument is there for their continued widespread use? What happened to “first, do no harm?”
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I totally get that these laws are often ignored or treated in a lackadaisical manner. Your situation clearly screams criminal prosecution. But once you’re labeled “mentally ill,” anything you say can be ignored or attributed to “your illness.” It’s a crazy catch-22.
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Certainly, state legislatures have done a ton of things that have forced the national government or national/international corporations to take notice. For instance, California set fuel emission standards that were higher than any other state. Because they wanted to sell cars in California, auto makers targeted making cars to meet those standards, even if other states didn’t require it.
Laws governing “involuntary commitment” are made by the states and differ from state to state. Setting a different standard in a particular state and proving that it worked better is one very legitimate approach to handling the problem. The city of Berkeley, CA banned “electroshock therapy” for a while back in the 80s, and even though a judge overturned it, it got plenty of news coverage. It’s a legit strategy.
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It seems there is some idea that someone has to “do something” about people feeling bad, instead of just being there and allowing people to feel whatever they feel.
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Posting as moderator:
That is a good idea, Sam!
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Thank you, Larry! That is very helpful.
And I agree with you – it is one of those arguments like nature/nurture that can go on forever but not be resolved. Some of it gets down to values and priorities, and some comes down to perceptions vs. reality. The second part can be addressed through research, at least in part. The first is not resolvable except through quality communication, which I find few take the time to learn or execute.
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BTW, this is not aimed at you, Larry. I’m just observing some potential escalation here and want to nip it in the bud!
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Commenting as moderator:
I have a suggestion. It is clear that we could go on and on about how this is proven or not proven or this is the right approach or that approach is really dumb and anyone who agrees with it is a fascist traitor and on and on. But I think you’re right – science does not make political decisions, and political decisions themselves can’t be altered by science. So let’s stick to the stuff that CAN be determined with more certainty!
If someone believes hydrochloroquine works, please, share the studies showing that is true! If someone believes it’s dangerous, please share the source of that information – what side effects have been shown in studies to occur, and what’s the cost-benefit analysis? If someone thinks masks are dangerous, where is the data? If you believe they’re helpful, let us know the scientific reasons why.
The last time this discussion got started, it degenerated into a rhetorical shouting match that had to be discontinued. I don’t want that happening again. Let’s debate the issue like the intelligent, mature adults we all are, and put out the pros and cons without the hype and fear. After all, we’re not going to change the minds of most people by telling them they are wrong. Let’s put the data out there and let people decide for themselves! I’d be happy to be educated, especially about the value of Zinc and Vitamin C and D.
So my suggestion here: instead of wasting time about whether Trump’s or Biden’s plans are good or bad or bad and worse, why don’t WE bring the science together and examine it? How about educating each other in a mutually respectful environment, and then we can all decide which plan(s) seems best to us? Does that sound do-able?
I very much doubt bringing psychiatry to an end will realistically occur if people on the same side can’t work out a way of communicating respectfully about things we don’t agree about. Thoughts?
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I certainly agree that it will require mass numbers of complaints to the people who make our laws. Perhaps local or state governments might be an easier starting point, as they are representing fewer people at a time. Or perhaps a candidate can be put on the slate who already understands what is going on!
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Wow, I never thought of it that way, but that really does make sense! I don’t suppose anyone could be convinced to study that point, though. The conclusions might cost people too much money and status!
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Working as an advocate for foster youth, I saw this same pattern over and over. Stimulants for “ADHD” leading to deterioration/aggression, leading to more drugs, leading to more deterioration, eventually leading to kids on 4-5 drugs who can’t maintain in a foster home and end up in residential “treatment” centers. And yet mentioning that the “treatment plan” seems to be leading to more and more deterioration is met with hurt feelings and outrage, or with complete dismissal. Isn’t “treatment” supposed to make you better?
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Yeah, there was some study way back that claimed that “combined therapy was better than either medication or therapy alone.” It became some sort of mantra such that any challenge to it was met with derision, at least in the circles I was traveling in at the time, even though many future studies showed no such thing. It’s one of those myths like the “broken brain” myth that has little to no support, and yet persists like a bad case of poison oak.
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Far too many. Most of them were voices I’d rather not hear. Maybe I need some Haldol when I’m around them…
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“because vocal biomarkers index the faulty neural circuitry of mental illness, they are agnostic to language difference…”
And yet NO ONE has EVER found any faulty “neural circuitry” to “index?” What is wrong with these people?
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Are these people freakin’ serious? What about a voice pattern could POSSIBLY be considered a “biomarker” for anything? I suppose that they will discover that “depressed” people speak in a flatter and less variable tone. Or we could just ASK the person how s/he is feeling instead of using all this technology to analyze their voices? How does this kind of idiocy pass for science?
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And a lot of people given antidepressants don’t feel better or feel worse. See Kirsch’s works for the minuscule difference between AD’s and placebo when you look at all the trials together instead of cherry picking the ones they submit to the FDA. As for antipsychotics, yes, they do tend to reduce hallucinations and in some cases delusions in the short run, though certainly not for everyone. Unfortunately, long-term followup studies suggest that this is very much a temporary phenomenon, and that over the long term, people chronically using antipsychotics have MORE episodes of psychosis than those who use them intermittently or not at all. If you would read “Anatomy of an Epidemic,” you could see this research for yourself.
I’m afraid a lot of what you’ve been led to believe about psych drugs is not actually true.
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I’d be interested in hearing your “evidence of brain pathology” for any “mental illness” you’d like to name. Of course, all such research is tainted from the beginning, since the definitions of “Schizophrenia” and “bipolar” and “Borderline Personality Disorder” are all extremely vague and subjective, leading inevitably to heterogeneous groupings who can’t possibly have significant shared biological traits. But even accepting such vague definitions, the research I am familiar with shows at best very small correlations with any biological “cause,” the most optimistic being around 15% correlation with a mess of a hundred or more genes, and using multiple “disorders” for the correlation. Whereas the correlation between traumatic events and any of the “mental disorders,” including “schizophrenia” and “bipolar,” is extremely high, usually over 80%.
And if you’re talking instead about fMRIs and PET scans, this research has long been critiqued for not being able to distinguish cause from function. What I mean is, if a “depressed brain” has a certain pattern (which has NOT been consistently shown, by the way), there is no way to know if that pattern CAUSES depression or RESULTS FROM the person feeling depressed. In fact, there is evidence that thinking depressing thoughts shifts the brain’s function in the direction associated with “depressed brains,” and thinking of something else returns to a more “normal” pattern.
The other problem is that these scans are AVERAGED. So even if there is a tendency, for instance, for people who are diagnosed with “ADHD” to have a certain pattern when confronted with difficult tasks, only SOME of those so diagnosed have this pattern – there is a wide range of individual results, some of which conform closely to the pattern and some of which vary widely. This is why PET scans can’t be used as a diagnostic tool – there is NO consistent finding across large numbers of “ADHD”-diagnosed people.
So the science I know of says that biology probably plays some role in how we react, but that there is no consistent biological pattern with any of the “mental illnesses” as defined in the DSM. The science also says that traumatic experiences are MUCH more highly correlated with any “mental illness” than any biological findings to date.
I’m happy to read any research you have that would speak to this question. But so far, I can’t agree that the science to date agrees with or even suggests the conclusions you propose.
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In other words, listening to a black young person’s experience and validating it can help them feel better? This title makes it seem like “discussing racial stress” is some kind of a special “therapeutic technique” for black youth with “mental health problems.”
Systemic change will happen when we stop talking about common experiences and reactions to our social and economic system as if they are somehow “illnesses” that need to be “treated.” And when listening to someone is considered what kind-hearted and compassionate people do when meeting someone in distress, rather than some sort of “treatment” for “mental illness.”
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And if your period ends and you stop having menstrual symptoms, you lose two points as well. Maybe Prozac stops your period!
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If you stop waking up in the middle of the night, you can get -2 points on the scale!
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Of course, they don’t really have an opinion of you. They haven’t bothered to find out who you are. They have an “opinion” of “bipolars” or “borderlines” or whatever box they want to put you in. The only “success” with such people is escaping their boxing game and finding someone who actually cares about you as a human being.
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You can’t bill for drugs administered to a dead person. Not economically viable. So it has to be keeping people alive but inert. Works for everyone, except the “patient,” of course.
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I think it is only offensive to those who don’t want anyone looking too closely.
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Trying to “explain” your behavior is often regarded as more signs of “illness.” You haven’t accepted their explanation, so you must “lack insight into your condition.” It’s a no-win situation!
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“Overtreated” suggests that there is a proper amount of “treatment.” It seems a devious term to be used in this context, as of course, having no objective way to “diagnose” “bipolar” or any of the other so-called “disorders,” it is impossible to even establish what is being “treated,” let alone what the “proper amount of treatment” would look like.
Maybe the title should be, “Overheated, then overwhelmed with attempts to define and control my life.”
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I think you’re right on that indifference is the big problem that underlies the ability of some “mental health professionals” to continue to do harm and feel OK about it, and that the public has unfortunately largely bought into this idea to a large extent.
I do want to take a moment to remind everyone that psychiatrists are human beings, like everyone else, and they come in all varieties. I don’t think we can say that all of them are “soulless” and “cynical.” Certainly, there is an attraction to the soulless and the cynical to a profession that handles pain by repression and blaming, and makes lots of money for its followers while creating permanent clients. However, my experience of rank-and-file psychiatrists is that most are more “hypnotized” and think they are doing good works. They have been trained, as it were, in a cynical system of thought, and behave in accordance with that system. And there are a handful who see the foolishness of their training and are trying to do something better, some ow whom post on MIA.
But in the end, you are correct in saying that it will require organization and resistance from the potential clients/victims of such a soulless system to bring it to an end. Connectedness is the cure to soulless cynicism, in my book.
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It is tough to fight a metaphor!
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Half-life has to do with immediate drug effects, including withdrawal. It doesn’t account for damage and changes in the brain or body resulting from the drug use. Especially after long-term use, these changes can be profound and take a LONG time to repair themselves, if it ever even happens.
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I don’t think we really disagree with each other much here. I think we’re just emphasizing different aspects of the problem. Being biased against someone for differences is certainly not something invented by psychiatry. They just tend to make it a lot worse, and then blame others for their poor outcomes.
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Wow, anthropomorphizing your “disorders” as evil entities to be battled but never defeated! This takes disempowerment to a new level!
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LOL!
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It is true, we ought not to think less of people regardless of whatever struggles, physically or psychologically or whatever, they may experience.
My point is that how a problem is framed has a lot to do with what people believe can be done to resolve it. The placebo response is a perfect example – if people are given hope that they will improve, they can often rally their internal resources and they actually DO get better without intervention. This is particularly true of so-called “mental/emotional disorders.” Telling someone they’ve “had a rough childhood but that other people have experienced the same and have overcome it, let me connect you with some of them” will give the person both validation and hope. Telling someone their “brain is genetically defective and they’ll have to take drugs for the rest of their lives to deal with the symptoms, but there is no cure” removes agency and blunts hope. Since the latter has not been shown to be true in the overwhelming majority of cases, why would we not start with a framing that provides hope and agency, rather than one that promotes hopelessness and passivity?
There is a reason psychiatry frames things the way they do, and it has not much to do with helping people achieve better control of their lives.
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Thanks for the clarification.
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I would add that suggesting Open Dialog might work is no more of a fantasy than suggesting that taking antipsychotics for the rest of one’s life is a viable solution for most people. Or more of a fantasy than NOT telling clients the known potential adverse effects of the drugs being recommended because it might make them decide not to cooperate. Or the fantasy of choosing a list of undesirable behaviors that tend to occur together and calling it a “diagnosis” and then claiming that “it” is caused by a “biological brain disease.”
The entire enterprise of psychiatry seems to be founded on fantasy. Not sure why trying Open Dialog would be any more fantastical than what is already accepted as “standard treatment.”
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“They were dysfunctional before I treated them.” I always find this a very lame line of “reasoning” and don’t understand why it seems to work to deflect so many people’s concerns. If I went in for a sore shin and came out of the doctor’s office with a broken leg, I don’t think they’d get away with saying, “Well, the leg was dysfunctional before I treated it.” Treatment, if we may even use such a term, is supposed to improve the condition. Even accepting that the person was “ill,” if they continue to act “ill” despite your “treatment,” how does that let you off the hook? If your “treatment” doesn’t work, why are you accepting money for “treating” them in the first place?
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Posting as moderator:
Anyone who wants to post here is allowed to post, as long as they follow the Posting Guidelines. We have never moderated family members who chose to participate based on their being family members or on their not having a family member embroiled in the system. It is true that some of our community distrust family members’ intentions, based on their own experiences. But family member voices have always been welcome at MIA. I’m not sure where you are getting the idea that family members are “not allowed to post” if their loved ones are not caught up in the system. What would stop such a person from posting?
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Multiple studies have indicated that the process of telling someone they have a “Brain disorder,” or telling someone else that “mental illness” results from brain malfunction, increases “stigma,” in contrast to telling people that it is the result of struggling with difficult life experiences. So a large percentage of the “stigma” is the result of the very psychiatric system that later decries it.
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Posting as moderator:
I want to be clear that voices of those who feel they are helped by psychiatric drugs have always been welcome here. It is admittedly sometimes a challenging environment, as they will hear stories and feelings which don’t comport with their experience, but attacking or downgrading people because they choose a pathway that includes psychiatric drugs is never accepted here. Now if someone starts arguing that people HERE need to accept their reality and validate the reality of DSM diagnoses or something of the sort, they’re going to be in for an argument. But civil exchange of views is the central theme of the comments section, and no one is allowed to be censored or attacked for having a contrary view.
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I made a couple of comments on the original article, which initially got published. But I just checked and the comments section appears to have magically disappeared! I wonder why…
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The other problem with “evidence based” is that the only things that get an “evidence base” are the things that are funded, and we know who pretty much decides what gets funded. Hint: it’s not the recipients of the “evidence based therapies.”
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Akathesia is often not reported and not understood by people who work with children, even the psychiatrists. I had a young lady (14) who specifically reported being “unable to sit still” (the literal meaning of “akathesia”), and was on a special program where she could raise her hand to leave class because it was so hard for her to stay in one place. They had a goal of staying in class longer. After my CASA volunteer and I got them to reduce her Risperdal and Lithium dosages, her in-class percentages went up significantly. But the psychiatrist still denied that akathesia had been an issue. A survey of the residential staff showed that none of them had been trained on what to look for as adverse effects, nor were they told that watching for adverse effects was a part of their job. The level of denial is unbelievable.
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Or perhaps, “Some people use guns to kill people.”
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“Policing by consent” is the only possible policing that would work. And of course, with the huge prejudices and power imbalances in our current society, we’re a long, long way from “policing by consent!” It seems the less power you have in your position, the less “consent” is required for you to be “policed.”
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I’m saying that not all the individuals who play the role of police are acting in defense only of the rich and powerful. I suppose the same could be said of psychiatrists, though in my observation, there are a hell of a lot more police of integrity than there are psychiatrists. The school system is very similarly messed up to me. There are a goodly percentage of teachers who care, but they work in a system that disempowers the students and they can’t really fix it themselves.
I’ll look at your links, but I was interested in YOUR answer – what do YOU think we do about bullies and aggressive people when there are no more police?
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I have to take issue with this to some degree. I have known many police/sheriffs who have done a fantastic job of “protecting and serving” the community they are in, including handling some situations involving “mental health clients” with particular aplomb. I’ve also seen unwarranted brutality, dismissiveness, and threatening behavior that would make anyone distrust the force. Both kinds of officers exist. And while accountability issues are critical, particularly with darker-skinned people, and systemic racism is very, very real, I am not sure we really want to live in a society where there is NO police function at all. We saw what happened in the CHOP zone when there was no law enforcement – people got shot and died. Every society has some form of law enforcement, formal or informal. There will always be people who threaten the community in some way. While the current system appears to have been coopted by the rich and powerful, and this has been true for a long, long time, I have to ask what means will we have to deal with people who want to harm and take advantage of others if the police are entirely “defunded?” And even if they are defunded, what’s to prevent psychiatry from coming in to take over their role by “diagnosing” people who don’t behave as society expects, for whatever reason?
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We’re ruining your life because we CARE!
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Well said!
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Ah, but the ones who are in denial are the ones deemed “mentally healthy!” If you’re too worried about it, you have an “anxiety disorder!” If you’re working hard to stop it, you’re “Manic!” If you give up and feel hopeless, you have “major depression!” The only acceptable response is to not be too worried about it and assume it will work itself out.
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P.S. I do not exempt myself from the criticism contained in the above moderating post.
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You have described the underpinnings of fascism quite articulately.
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The problem with this is that once you make it OK to use these in “extreme cases,” very quickly, it becomes OK to use in ANY case, because there is no objective standard to justify their use. And making people more tractable isn’t really a “medical” issue, anyway, it’s a social management issue.
There are also lots of ways to intervene with dementia patients that don’t involve drugging them into submission, and these are rarely even considered before going to the drug solution. Yet information on these is buried deep! I just did a search on “alternative approaches for dementia” and got only drugs and “complimentary medicine” (herbs and homeopathy, etc). I had to go for “psychosocial approaches to Dementia” to get any hits worth looking at. This is because dementia has been redefined and captured by the psychiatric industry and all other approaches have been suppressed.
My wife’s dad had Alzheimer’s and was put on Risperdal because he was grabbing the nurses arms too hard. He went from being quite interactive and gregarious within a very short time to being unable to sit up, head thrashing from side to side, trying to but unable to talk, obviously in utter misery. No one at the facility seemed to know or care that the drug had done this. Ginny got her mom to take him off the drug, and within three days, he had recovered most of his personality and communication ability. When he grabbed her arms to tightly, she said, “Dad, you’re grabbing too hard, it hurts!” And he stopped grabbing. That easy! And yet they felt it was OK to drug him into insensibility and near paralysis because he didn’t just do what they wanted without having to communicate with him respectfully.
Yes, dementia is very difficult to deal with, and yes, antipsychotics make them easier for caretakers to manage, but the dangers of abuse of power by the facilities or other caretakers are extreme, not to mention the risk of early death that they convey. I would not allow my loved ones to be put on these drugs. They are for the convenience of the caretakers, and remove any incentive for them to actually figure out a loving way to handle the difficulties such people present.
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I think we’d call that a “mole.” Sounds like a great idea!
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Posting as moderator:
OK, that’s it! Everybody out of the pool! This thread has deteriorated and has become nothing but a back and forth between people completely fixed in their positions. It is time to end it. Again, I am not “banning posts on COVID” or “censoring,” I am stopping this deteriorating thread of subtle insults, straw-man arguments, defensiveness and disrespectful analogies. EVERYONE has had their say. I will not post any more comments on this theme on this thread.
We can do a lot better than this, folks!
Steve
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And a find job they did of it, too! “We have the BEST waterboarders!”
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Richard, it is too difficult and time consuming for me to address the various assumptions and implications in your responses. You’ve made your point, people can read it, and I’ve made my point, people can read it. It is time to end this conversation, as it is not only going in circles, but going on extreme tangents at this point. We agree that COVID is real and that it needs to be taken seriously and that there are people with hidden agendas opposing taking it seriously or taking advantage of it for political gains, and that those forces need to be opposed. Let’s focus on what we agree upon and move on.
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I agree, and lets start with them!
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My answer: “Because it makes it easier for the staff to neglect them, and makes big bucks for psychiatrists and their Big Pharma masters.”
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Oh, believe me, you’re not the only one! I’m still waiting for that moment of crystallization when suddenly it becomes clear to enough people that something shady is going on. In the meanwhile, I keep trying to educate and support, educate and support. But it doesn’t feel very hopeful.
Still, I never thought the Berlin Wall would come down, and it did. So the world can surprise us sometimes. I’m hoping it will be sooner rather than later! What will it take for the masses to rise up and say “NO!”
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POSTING AS MODERATOR: So we are in agreement that black and white rules of moderation are not possible?
I tend to agree with you that using terms such as “fascist” out of context would constitute ad hominem attacks. I will continue to try and be more sensitive to this kind of language, and will appreciate people reporting posts where I have missed such statements. Of course, it is quite legitimate to say, “My therapist was a bully, because s/he would tell me I was stupid every time I questioned her.” Or to say, “This person subscribes to fascist ideology, as indicated by his references to quotes from Mussolini and his use of nationalistic slogans and identification of external threats as excuses to curtail civil liberties,” or that sort of thing. The issue would come if the person is trying to discredit an author or another poster by the use of such terms to refer to them or their writings without any such context. My preference is for folks to simply refer to the offending comment, such as “Mr. X uses the term ‘redskin,’ which I and I think most people consider racist” rather than “Mr. X is a racist because he said the word ‘redskin.'”
So there is always a degree of subjectivity. But I don’t think we want a community where someone can say, “Oldhead is a slimy bag of feces” without being called out on it. Nor do I think we want a site where someone can’t say, “I think vaccine policy is highly influenced by unethical government agents in cahoots with the drug industry” without being called names or shunned or having his/her opinion censored just because their position may be viewed by others or MIA staff as controversial. Which is why we have the posting guidelines. But again, they’re guidelines, not rigid laws, and the goal is to have a free-flowing conversation while avoiding as far as possible unnecessary personal hostility, bigotry, and hurt feelings. As long as we keep that goal in mind, I think we can all live with the uncertainty of it. And as you know, I am always willing to listen to and discuss if anyone feels they are being treated unfairly. I am not sure how we can do any better than this.
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Well, if we’re talking about whom we support politically, there are sides. I took your comments to be referring to the larger questions of knowledge/facts regarding COVID and other issues that are in conflict. I was objecting to the idea that there are “sides” when it comes to exploring the truth of a particular assertion. I don’t consider science to have “sides,” except for seeking the truth and using “science” to avoid or distort it. But using “science” to distort truth is not science at all.
I do know the song you refer to. But as I recall, it was in reference to being on the side of those who are exercising power for their own benefits, vs. on the side of those who are attempting to come together to resist them. This seems pretty different from questions regarding what the actual threat from COVID is and how best to deal with it. As I have already stated clearly, politicians from both sides have tried to engage in “information management” or “messaging” to take advantage of this world-shaking issue and benefit themselves. I’m definitely NOT on their side. But I can’t embrace the idea that there is a “side of truth” and a “side of dishonesty” in this particular case. (Well, OK, there MAY be a side of dishonesty!) The sides I see are the side of using a disaster to manipulate people to support or oppose a political agenda, and those who are trying to figure out the best thing to do to ensure the safety of our population while remembering the limitations of our knowledge, and maximizing our ability to remain engaged and productive in our lives. That’s the only side I support fully.
What I don’t support is the idea that there are those who believe and agree with everything you said above and those who don’t think COVID is real and don’t give a crap about anyone else but themselves (or those who are too foolish to avoid the deception of the Forces of Evil). I’ll provide a simple example: should one wear a mask while hiking in the woods, or at least when passing someone else on a hike? If I told you that the science suggests that outdoor mask-wearing outside of a close gathering of people is pretty much pointless, would you consider me part of the “other side?” Well, a recent tracking study in China tracked 7000 cases as to origin. Exactly ONE case out of 7000 was caught outdoors, and that one case involved a person talking to an infected person at close range for more than 15-20 minutes. So I don’t wear a mask outdoors, unless I am in a crowd. This is in violation of the CDC guidelines, which from a scientific point of view appear to be wrong. Does that make me one of those deceived by the forces of evil? Do I have to wear a mask while hiking to be considered on the “right side?”
To reiterate: Politics has sides. Science does not have sides. Things are proven true, proven false, or are uncertain. Very, very few things fit into the first category. Generally, things are scientifically false or are uncertain. Uncertain situations require judgement, and judgement is based on data, not political agendas. Mixing science with politics creates bad science.
I hope that clarifies my point. As to the Bush comment, it was just what came to mind when you said what you said. I’d certainly never compare you to Bush II, with whom I’d guess you have almost nothing in common. But I’m also not going to apologize for what thought came to mind when you said it, nor for sharing it. I hope it gives you pause to consider that you may be creating an impression that you don’t want to create.
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POSTING AS MODERATOR: I challenge you to find an objective way to decide whether someone’s comments are “shaming” or make generalizations based upon a label or are an attack on a person vs. on what that person said. Moderation is unavoidably subjective, no matter how objective I try to make it. If we are in grey areas, I tend to use consultations with others, but again, not purely objective. Sometimes I pass something through and it ends up offending others for reasons I could not have understood until explained to me, and I have to reconsider.
Sorry, but there will always be grey areas in moderation. Nature of the beast.
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You are welcome!
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POSTING AS MODERATOR: When a certain number of “levels” are reached under a particular thread, the “reply” button disappears on new comments, and you have to go back to the last one that has a “reply” button and use it, and your post will end up at the end of the thread. It’s a feature of WordPress and not something we have control over.
Hope that helps!
Steve
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Just because it seems preposterous doesn’t mean they can’t make big money making that claim! Doesn’t matter if it’s true, as long as enough people believe them.
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POSTING AS MODERATOR: Oldhead, you cut off the part of the last sentence you quoted about insisting that others agree with their personally-derived “truths.” MIA is and should continue to be a place to explore the truth, but when the discussion itself becomes increasingly authoritarian as it progresses, there is a point at which it is no longer productive of truth, as both sides are merely stating and restating their own ‘truth’ in a louder and louder voice, and things get more personal and insulting and it gets plain ugly.
Admittedly, it is hardly an objective standard, but in the thread I asked people to let go of, it was most definitely getting into that realm and very far afield from the original topic.
Sorry, there are no black and white rules in moderation! But I’m not moderating for content, except to the degree that off-topic conversations on any subject, when they become unproductive and backbiting, will be discouraged.
Your idea of a different place to have this discussion is a good one. Not sure exactly how to bring that about, though. I’ll give it some thought.
Steve
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Hi, Richard,
I appreciate your inclusion of a lot more factual material in this comment. However, I do find using language like “Which side are you on?” does contribute to divisiveness. It reminds me of GW Bush’s “You’re with us or you’re against us” rhetoric back in the Iraq Ward run-up. I do agree that these issues are serious and we need to make our decisions based on facts rather than rhetoric, and that there are political agendas behind much of the supposed “facts” that we have been provided with. But not having reliable fact sources does put us all in the position of having to educate ourselves about how to evaluate what information is true. I’m hoping MIA will run an article or blog on this point, because I think people need help sorting out what is or isn’t true, and many don’t even know they need that help. I believe that acknowledging the point that it is difficult to know whom to believe is very important if we want to help more people make better evaluations of what “information” to believe.
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Note how cleverly they say that “chemicals… MAY be unbalanced,” but then claim that the “medication” helps “restore the balance” of chemicals that they later admit they don’t know are actually “imbalanced” (which is why they say MAY). It is a clever workaround of “truth in advertising” laws, but I think it should never be allowed, because by claiming to restore the “balance,” they are essentially asserting a truth that is actually not known to be true.
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Posting as moderator: COVID is a valid point of discussion if it is relevant to the article at hand. In this case, there is a claim that COVID is somehow moderated by psychostimulants, so that would be the topic of the conversation. Clearly, comments relating to COVID would be germane to the discussion. However, if the thread gets hijacked into talking about related issues that go too far afield from the article’s topic, I might end up asking folks to end the discussion, particularly if the discussion is becoming repetitive and escalating into personal attacks, as happened in the thread I believe you are referring to.
I have never said that talking about COVID is off limits, just that we need to stay on the topic at hand and be respectful to each other in the discussion. The difficulty seems to come in when instead of sharing their perspective, folks begin to assert “truths” that are not objectively established and telling others who disagree with them that they are fools or dupes for believing it. I think we can all agree there has been a lot of disinformation about COVID coming from various people with political or personal agendas. I would just call for restraint in staying on the topic of the article and allowing for the possibility that our viewpoint may not be “right” in an absolute sense of the word.
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“… give him the result that HE wanted.” There, indeed, is the rub. The psychiatrist wasn’t concerned with the result the client wanted, only the result the psychiatrist wanted. Paternalism/authoritarianism in a nutshell. He knows better than the person he was purporting to help. If they disagree with him, they’re a “resistant client!”
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I think the first thing to remember is that things like “anhedonia” and “fatigue” happen for a hundred different reasons. Labeling these phenomena as “illness” obviates the need to look further for the actual causes and potential cures for any REAL illnesses that might exist (such as anemia, low thyroid, heavy metal poisoning, etc.), and ALSO prevents the consideration that such phenomena may in fact be NORMAL reactions to adverse circumstances. Depression, anxiety, anger, hopelessness, excitement, all are part of the human experience, and to relegate them to “malfunctions” when they are in fact essential survival factors in life is in itself depressing and discouraging to people trying to make sense of their experience.
So no, people aren’t lying about what happened to them – no one denies that suffering occurs. The problem is the simplistic reduction of suffering to a “malfunction” in a person, as if suffering were not a normal part of life, as if everyone should always be “happy” regardless of their circumstances (but not TOO happy – that might be MANIC!)
It is not a choice between denying suffering exists and calling it an illness. We can all acknowledge suffering as an unavoidable and necessary part of life, as well as recognizing that people need support when they ARE suffering. We can also acknowledge that there MAY be physiological causes for SOME psychological suffering, but that absent an actual understanding of the cause or evidence of specific physiological pathology, we should assume that psychological suffering is the simple result of living in a confusing and at times challenging world, and that compassion, not medicine, is the best place to go to help.
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I am very sorry to hear that you had such a bad experience! Apparently, you are not alone. However, I would not necessarily agree that you have nothing to lose by trying “ECT.” There are many people who have described horrific “side effects” of ECT, especially loss of memories, including the good as well as the bad. I strongly suggest you read up carefully and read some stories from people who have tried it out. I’ve never actually met someone where it “worked” for more than a very short period of time, and I’ve met a good number where it did essentially nothing or where they deeply regretted the damage it did to their brains. I don’t want you to feel like a fool yet again!
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Richard and Nijinsky,
I really see two very separate issues being argued here. One is that people can promote misleading information on the internet. It appears that both of you agree that is true and there is no real argument about it. The COVID discussion seemed more about what to DO if such information is put out by people who believe it is true. It seems the real point of disagreement is whether or not it is helpful to use pejorative language like “nonsense” and “dangerous” and “conspiracy theory.”
Clearly, people can disagree about the wisdom of using particular language. I guess the question I would ask is how it helps the discussion to use this kind of language? Does it discourage people from considering such information? Does it drive the proponents deeper into defending their positions? Does it create a meaningful discussion or does it undermine opportunities to truly examine the data that is presented?
I tend to agree with Nijinsky on this point. There really ARE conspiracies operating, and the term “conspiracy theory” has been used broadly to discredit any questioning of the status quo, no matter how rational or well supported. Antipsychiatry activists have been accused of being “conspiracy theorists” or “anti-science,” and it is a very effective way of silencing dissent. If we don’t want that kind of language used against us, I think we need to be more creative in our language rather than relying on general put-downs and characterizations that don’t involve any kind of analysis. I liked learning, for instance, the very low number of deaths claimed by the website in question. This was MUCH more influential in my assessment of this person’s claims than saying he is “promoting conspiracy theories” or “spouting nonsense.” To me, the more we stick to citing and responding to actual facts or claims, the more effective we can be in undermining inaccurate sources and theories. Calling names makes the name-caller less credible in my book, plus it legitimizes the kind of fact-free attacks that are often leveled at those who oppose psychiatry’s hegemony.
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One of the worst things about the DSM is that it immediately disempowers the labeled person. Instead of seeing your emotions, pains, fears, joys, etc. as a result of your ACTIONS, they take away your agency and tell you that you feel this way because you are broken in some way. And they give you no hope of anything YOU can do about it, except to try their drugs and hope you’re one of the lucky ones that they work for.
Thanks for sharing your story!
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“AADD”? I think it’s catchy!
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“PAD” – I love it!
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There are no clear lines – it extends into every aspect of life in our “marketing culture.”
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Most don’t even bother with the DSM any more. If they think someone is “disordered,” they declare them “disordered,” and no one has the right to argue.
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I don’t disagree with your assessment that psychologists and psychiatrists are involved with the COVID response, and not in a particularly helpful way, and discussion of this connection or similar material relating to our mission here is more than welcome. The issue becomes unclear when we are talking about whether or not COVID is a serious risk, whether or not masks help prevent infections, whether or not there is some international conspiracy to use COVID to accomplish some other political goals and so on. These are certainly legitimate areas of concern and valid for conversation, but threads have been completely hijacked and gone way off topic when I have allowed this kind of discussion to expand beyond the boundaries of the effects on behavior and emotions and the way that the psychological/psychiatric industries have tried to capitalize on COVID to convince us that a “wave of mental illness” is occurring instead of recognizing that being afraid of a pandemic virus is a normal thing, or comments of that nature. There is a moment when it stops being about the psych industries and it starts being about political issues that transcend psychiatry/psychology by a very large distance. For instance, arguing about whether or not COVID cases are overcounted or undercounted or whether or not “shutdowns” were needed or whether the Democrats are fear mongering to help their election chances or Republicans downplaying it to appeal to their base and so on have nothing to do with the psych industries. Those kind of posts are not going to be allowed without a direct connection to the material in the blog/article in question.
Hope that clarifies things.
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That will probably appear in the next DSM – “COVID anxiety disorder” or “pandemic anxiety disorder.”
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POSTING AS MODERATOR:
I have allowed a lot of off-topic remarks regarding COVID on threads that have nothing to do with COVID. I think it is time to stop this. We are not a site about COVID, and it is a very controversial subject that goes very far afield from rethinking or ending the practice of psychiatry. I am not going to allow any more COVID posts that are not directly relevant to the article at hand. There are plenty of other forums where such discussions are more appropriate to conduct.
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POSTING AS MODERATOR:
I have allowed a lot of off-topic remarks regarding COVID on threads that have nothing to do with COVID. I think it is time to stop this. We are not a site about COVID, and it is a very controversial subject that goes very far afield from rethinking or ending the practice of psychiatry. I am not going to allow any more COVID posts that are not directly relevant to the article at hand. There are plenty of other forums where such discussions are more appropriate to conduct.
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“Stopping suffering” or “controlling symptoms” are extremely nihilistic concepts that deny the reality of being human. Instead of “stopping suffering,” any real help has to focus on making SENSE of suffering and helping people assume more control of their lives, including dealing with the ongoing effects of past and current abuse. If we focus more on stopping ABUSE (including the abuse of power) than stopping the feelings of those who have been abused, we’d be getting more onto the right track.
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There is not only “not a lot of evidence,” there is NONE. The only “help” that neuroleptics provide in those with dementia is for the staff who have to deal with it. It makes the residents more “manageable”, that’s all. And of course, it kills them off early, too, per the black box warning. But that doesn’t seem to bother most of the people involved in the adult care industry.
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Agree 100%!
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It does sound very suspicious, to say the least!
I agree, the “false memory syndrome” thing was originally about implanting memories by asking questions to kids the wrong way. Somehow it got altered into the idea that recovering memory from moments of limited awareness somehow never happens. It’s bullshit, but met the needs of those who want to blame clients or their brains for what happened to them.
Steve
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It’s almost like escaping domestic abuse. You need a new identity in order to escape the abuser hunting you down. Very distressing!
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I guess they’re just not interested in playing by the rules. But it shows that on some level, people understand these are not “medical diagnoses.”
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It is difficult to live without hope. Hope means having some intention for the future to be better than the present. I hope you can find a way to connect with some kind of purpose and intention for your future, because you deserve to feel safe and well!
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Wow, I didn’t know that about “Bipolar III!” So even if psychiatry causes you to go manic, YOU have a disorder???? Bizarre!
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I think they are trained not to look.
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Funny, I felt the same way.
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Yeah, I think the 220k was just hospital deaths. I’m sure the larger number is correct. And very frightening!
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Great data! I will just take a moment to remind people that prescribing drugs within the standard of care is not a “medical error,” it is standard medical care. So the fourth leading cause of death in the USA is STANDARD MEDICAL CARE! There have been efforts to spin this as “medical errors,” so they can make it seem like these are mistakes made by “bad doctors.” But the truth is, this is not a result of “bad doctors,” the vast majority of these deaths, over 200,000 yearly, up to 400,000 in some estimates, result from standard medical care. This should be a terrifying statistic, yet somehow we are much more worried about the very rare possibility of a terrorist attack than we are about the carnage going on around us every day due to the awful outcomes of our own medical system.
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I totally feel you on the “coping strategies.” There was a recent article on “ecotherapy” that made the same impression on me. Don’t take my hikes in the woods and turn them into some form of “therapy!” They are walks in the woods, and I love them, and that’s all that needs to be said! I don’t need “coping strategies”, I need meaningful and fun activities that make my life feel worthwhile. It’s not therapy, it’s called LIFE!
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I think the first mistake of psychiatry is to assume that everyone who acts or feels a particular way should be grouped together and “treated” as if they have the same “disorder.” The evidence you report supports this. There most definitely could be biological factors that cause any sort of “psychiatric symptom.” But then we need to detect and treat the REAL problem instead of just suppressing the overt manifestations with drugs. I know I’m preaching to the choir here, but biochemistry can easily be addressed without resorting to the subjective and largely nonsensical DSM. Real science looks for causes and relationships, which I’m hearing you call for. I have no problem with that, as long as we don’t assume that “schizophrenia” is a legitimate category that groups together people who have some causal factor in common.
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Ah, I get it! But someone else had resurrected it first, I believe. I was just responding to a comment someone else made, otherwise I would never have seen it. Good to know it’s still breathing!
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That is so sad, Kate! I can say that I absolutely believe you. It is not hard at all to believe. There are others who will believe you, too. I think you can connect with those who really do understand. As for the rest, they can go ahead and take their drugs and deceive themselves. But once you’ve seen “the man behind the curtain,” you can’t believe in the Wizard any more.
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That is appalling. I only wish it were surprising.
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What’s “necro” mean?
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Nadine Lambert did some good work on this line. She also showed an increased risk of smoking relating to the use of stimulants in childhood or adolescence.
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“…clinicians often problematize the sexual needs and practices of residents.”
That’s pretty damned euphemistic! Why not say, “Clinicians tried to shut down any opportunites for sexual expression due to their own discomfort, and used their power to deny residents their civil right to meet their sexual needs without interference.” This is a matter of a violation of rights, not some philosophical discussion of “problematization!”
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“It is inarguable that mental health phenomena have a basis in biology, and that most (but not all) should be classified as biological dysfunctions.”
Why on earth is this “inarguable?” Sounds like the author assumed the conclusion without proof.
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I actually don’t consider the problem to be complicated at all. One side knows it doesn’t have the data but is making money hand over fist. The other side has the facts but extremely limited power. Power outstrips facts if it wants to.
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And the third rule is to vigorously attack anyone who has the temerity to break rules 1 and 2.
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I think the hook for me is that anyone who recognizes psychiatry is messed up and is doing damage is someone I want to engage with. Most “antipsyciatry” people have had less radical views earlier in their lives/careers. We don’t like to believe that a social institution is actually intending the opposite of what it purports to be doing. That is an awareness that occurs only after long examination of the facts, unless someone is thrown into the system and experiences it directly and undeniably, and even for the latter, it often takes a long time to come to full awareness. This group appears to have come a long way down the path to understanding what is wrong with psychiatry. My view is we should welcome such folks and try to help them see further, rather than criticizing them for not being “antipsychiatry enough” to meet our exacting standards.
That’s my take on it.
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Not to mention screwing badly with one’s appetite.
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I would CERTAINLY object to tracking people who have not been convicted of a crime. Mask use is certainly no reason to track or punish people. We should be working on getting agreement on how to help each other.
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Actually, it is the job of the researcher to prove that genetic/biological causes exist and are causative, not the job of detractors to disprove it. Scentifically speaking, lack of proof of genetic causation means it is assumed to be scentifically untrue, at least for the moment. And the fact that something “runs in families” is certainly no proof of a genetic origin! Speaking Chinese or using silverware to eat with both run in families, but are not in the least genetically related. Culture is passed on through families, and explains a great deal of similarity between parents’ and children’s behavior.
If we want to be scentific, we have to be VERY careful about what we assume to be true. 50+ years of research have failed to demonstrate a specific biological cause of ANY of the “mental health” diagnoses in the DSM. Scientifically speaking, this suggests that such causes are very unlikely to exist, at least in a general sense. Specific instances of these “diagnoses” may have biological origins, but unless ALL or almost all cases of “depression” are shown to be biologically caused, we can not say that “depression” is biologically-caused condition.
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Posting as moderator:
I am agreeing with Oldhead that this topic has been thoroughly hashed out and further argumentation is not going to add much to anyone’s understanding and may lead to hurt feelings. I’m already seeing things getting more emotional and some hurt feelings being generated, yet little to no progress toward agreement for the effort. It seems there are strong feelings on both sides of the issue, and we have seen some links to data enough that people who are reading this can hear the arguments and make up their own minds.
Besides which, this is pretty far afield from the original topic. So I’m going to ask that we wind this down quickly. There are a couple more comments that I have to consider whether to post or moderate, and that may engender a reply or two, but let’s try to bring it to a civil end. Sometimes we just need to agree to disagree.
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So what’s the beef with the masks, then? And I did not intent to imply that KS was engaging in conspiratorial thinking. There were other comments (including some comments from your source person, Berensen) that suggested required mask-wearing was part of some larger conspiracy to gain control of people through fear. I am trying to decouple the idea that people are promting fear (which they are) and the idea that wearing masks can reduce the passage of pathogens from one person to another (which they can).
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Like I said, I know there is a lot of shimmy-shammy with the statistics. I think I noted way back that the death rates from other things dropped suddenly when COVID came in, most likely due to a preference for labeling deaths COVID-related (I think there was some financial incentive involved). I also remember the stuff about how the flu killed 60,000 a year, but we discovered that this was an “estimate” based on pneumonia deaths, and did not actually count flu deaths at all!
But again, there IS a virus, it IS contagious, it is almost always spread with extended time together indoors through breathing, and it therefore makes a lot of sense to wear a mask indoors. If it doesn’t help, it doesn’t, but there is nothing irrational about the concept, nor is it a new idea invented to expand the “plandemic.” There is plenty of real conspiracy going on, and arguing about masks seems like a pretty useless distraction at this point. It makes as much sense to me as telling people not to cover their mouths when coughing because the CDC said we should.
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Are you not allowed out of your house? Where are you exactly? We’ve gone shopping and hiking and biking and gotten takeout the whole time. It’s a big jump from “try not to pass it on” to “permanent isolation.” Maybe things are different where you are?
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And I just looked at your Twitter link for Berenson and found no reference to any scientific data on the entire first page.
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I did not hear Kindred or anyone else saying this was not a political issue. I heard her specifically say that she understood there WAS politics going on but that politics does not cancel out basic precautions that are known to be effective. She pointed out the general recommendation of covering one’s mouth and nose when sneezing. Do you really think that recommendation is based on “conspiracy” to make people more anxious? Or is it based on the knowledge that people who are sneezing may be ill and possibly pass on a virus or bacterium to others? How big a leap is it from there to saying that selective mask-wearing could help protect individuals and slow the spread of the disease, regardless of how many scare tactics are in use?
I absolutely think that political entities are using COVID to grind their own political grist, as they do with almost anything that comes up. It doesn’t mean COVID isn’t real or that masks have no effect. It seems irrational to me to assume that because people may be trying to scare us, that everything they say should be resisted. The proper approach is to discount scary but unsupported “data” from ANY source, and to research from real data and draw our own conclusions. I also think there are people who want to scare us about the possibility that COVID is an intentional “plandemic” and I find them just as non-credible as those who claim that it’s all from some bat crap on a piece of fruit that just happened to be in the same town as a wet lab working on making coronaviruses more virulent.
We’re all getting lines of crap, and it’s coming from all directions. It’s time to calm ourselves down and return to “common sense” and rational discussion of actual data.
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Kindred also included a number of links to valid scientific articles.
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Of course, I don’t consider the CDC to be “scientific” – I think I made it clear I was talking about research, and that should havee been very obvious from my comments.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext
https://www.advisory.com/daily-briefing/2020/06/16/mask-covid
This is from Vox, but cites and summarizes research directly, and appears quite rational, and even goes into how false research led people to believe that running past someone put them at risk:
https://www.vox.com/future-perfect/2020/4/24/21233226/coronavirus-runners-cyclists-airborne-infectious-dose
https://www.medscape.com/viewarticle/931898
No harder to come by than Alex Berenson.
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I don’t disagree at all that the mainstream media is primarily propaganda from the current elite and is not trustable. Which is why I said I use the internet to look at actual scientific studies and data rather than trusting anyone else’s interpretation of events. There are huge exaggerations and manipulations of data from both the “left” and the “right,” but mostly from those who have an interest in keeping control of society so they can make money.
One of the things which makes me doubt that the release of COVID was planful is the fact that a lot of folks are losing money as a result. At the same time, the current surge in stock prices does suggest that some insider knowledge may exist that we don’t know about. But we will never know about that stuff for sure. What we CAN know is that there IS a virus and it IS contagious and we have some means of lessening the spread of it. That is not from the mainstream media, that is from direct research published in scientific journals. Most of the good stuff to argue against psychiatry’s insanity also comes from that kind of research. Of course, some of that is biased, but we are also capable as intelligent, rational humans to evaluate that as well.
So perhaps I didn’t make myself clear: I don’t accept anything from a media source that interprets the data for me. I look at the data as best I can. The data does exist and can be located if one is persistent enough and can filter for conflicts of interest. Far better to do the research than to assume that no truth can be found because the MSM and others with their own agendas alter the data that is easiest to find.
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I have to evaluate the information for myself. It doesn’t really matter to me if someone does or doesn’t want me to use a mask, I have to decide based on what I know about science and diseases and this particular disease. It is not a matter of “deciding who I believe.” But unfortunately, most people are not scentifically literate and don’t seem to have learned how to evaluate data. So they are depending on someone else to do their “evaluation” for them, and instead of deciding WHAT to believe based on data, they have to decide WHOM to believe, based on God knows what standard.
Hence, we get “infowars” and “left-right” unresolvable arguments, because one person believes Person X who says “all psychiatrists are helpful people who are doing all they can to help humanity, despite a few mistakes” and others believe Person Y who says, “All psychiatrists are evil and they are the cause of all that is wrong with the world.” But neither person really KNOWS what psychiatrists do, so there is no real end to the argument, and it becomes easy for the powerful to dismiss antipsychiatry activists as “anti-scientific” despite evidence that they have no interest in following any scientific principles at all. Because they are doctors, after all, and so they should be trusted. And so on.
So I revert to first principles: let me see the data. The data right now indicates that masks make little to no sense to enforce outdoors (unless you are in close proximity to someone who appears to be ill), whereas indoor mask wearing makes scientific sense, since we know that all the “superspreader” events involved indoor contact and that cumulative intake of “droplets” appears to be the means of transmission. I’ve stopped washing off surfaces unless they are already wet, I don’t wear gloves. I do wash my hands when making contact with a questionable person or surface based on my perception of what may or may not have been “shared” with me, just like I always have. I was advised to consider washing off my shoes after cleaning our bathrooms – I ignored this advice. I don’t do something because the CDC says so, I do it based on the data. I did not wear a mask initially, but have become persuaded by the data regarding how the virus is passed that masking does have a positive effect indoors. So I wear a mask while shopping, etc, and avoid being in indoor spaces with other potentially infected people for extended periods of time. That’s my analysis of the data collected so far.
There ARE real scientists out there doing real work. They DO collect actual data. Some of it is hidden, some sensationalized, but with the internet, we can get back to the real source of the data. While I have no doubt whatsoever that lots of people are trying to manipulate this set of events for political or economic gain, and that we can’t trust any source without full vetting, I also know that COVID is a real thing and I neither want to get it nor to pass it along to anyone else whose immune system is less vigorous than my own.
I think the real challenge that we have failed to meet is that this is a COMMUNITY problem, and we are an extremely selfish society. Calls to reduce selfishness and work together on finding workable solutions should be supported and not denigrated, and we should be evaluating what to do based on actual information, not on “theories” propounded by people who actually have a conflict of interest in getting power or money or attention for spreading “news” that is of a questionable nature. The fact that this encompasses a large proportion of our news media is discouraging, but should not prevent us from seeking out real data and acting on it.
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Wise words, SE!
Steve
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Just as in warfare, justification of such things depends on dehumanization of “the enemy.” The only way “decent” people can do horrific things is when they have been convinced that the person they are doing it to is not fully a person.
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I think the point, though, is whatever conspiracy might be behind it, COVID is a very real disease and can kill people. The point about masks seems to be a big stretch to associate with any conspiracy, as I hardly see how any international criminals will be served by people wearing surgical masks, besides which, they are recognized as a reliable way to reduce the spread of disease.
Personally, I think the science says that outdoor transmission is practically nil, so arguing that people should wear masks while jogging in the park seem over the top. But big transmissions have happened in indoor spaces where people are in the same place for a longer time and where the air circulation is poor or recycled. So indoor masks are of value for both the user and for others possibly vulnerable to infection by a maskless person.
There is a lot of hyperbole on both sides, but there are people doing real research, as there are on many subjects. While spreading fear certainly can be an intentional means of controlling voting behavior or preventing or encouraging certain mass activities, mask wearing seems sensible when applied to indoor spaces. I’m not sure how any “international conspiracy” could possibly be served by people wearing masks. But having people arguing about whether or not to wear them and creating political upset over this pretty minor issue most definitely COULD serve the purposes of these ostensible conspirators.
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I would also remind everyone that a great number of people who eventually become antipsychiatry activists started out as “reformers.” I am one. People evolve over time, and I think that insisting on “ideological purity” does a lot of damage to progressive and radical causes. That is not to say that people should not be firmly educated regarding the truth about psych drugs and the DSM and the history of psychiatry as a “profession” and their knee-jerk refusal to consider any research data that conflicts with their incomes. But harshly criticizing people who are beginning to understand the destructiveness of the psychiatric system for not “getting it” tends to drive away people who have a real chance of “getting it” if nurtured toward that understanding.
There are, of course, power issues involved that have nothing to do with reformism vs abolitionism, but I think these need to be dealt with as separate issues. My personal view is that anyone who thinks psychiatry as practiced is messed up, I welcome in for further discussion. And I try to find out why they think it’s a problem and what they think should be done about it before I start telling them where I want to see their thinking go. After all, we all agree that self-determination is a primary issue in any critique of psychiatry. I don’t think any movement is going to get where it needs to go if we don’t support the self-determination of adherents to the movement itself.
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The currently dominant Western culture, as represented by our many media sources, schools, churches, businesses, and other institutions.
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Well, sure, we want them to FEEL GOOD about being homeless and poor!
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Remember the Helen Keller story? Told to us to show how “if we work hard enough, we can overcome adversity?” As it turns out, Helen Keller fought her whole adult life against that message, and in fact was a passionate advocate for workplace safety and other socialist issues, as she discovered that most blindness came from preventable accidents and poverty.
“But there is much more to Helen Keller’s history than a brilliant deaf and blind woman who surmounted incredible obstacles. Helen Keller worked throughout her long life to achieve social change; she was an integral part of many important social movements in the 20th century. She was a socialist who believed she was able to overcome many of the difficulties in her life because of her class privilege—a privilege not shared by most of her blind or deaf contemporaries. “I owed my success partly to the advantages of my birth and environment,” she said. “I have learned that the power to rise is not within the reach of everyone.”
https://www.zinnedproject.org/materials/truth-about-helen-keller
Her story was intentionally turned around from the idea that she had privileges and protections that should be but are not extended to everyone, to “You can make it if you try hard – just look at poor Helen Keller.” There is active hostility toward the idea that success is largely moderated by privilege.
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We do seem very committed to the idea of winners and losers in this culture!
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So “antidepressants” are now pain killers, too? I suppose there are fewer reports of chronic pain amongst those who take their lives as a result.
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New title: “Being kind and communicating with people makes them feel less hopeless about their lives.”
Or: “Talking and listening to people makes them feel better than telling them their case is hopeless and giving them drugs for life.”
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Oh, I’ve talked to more than a few psychiatrists who are convinced they are fixing brains, or that the brain is the cause of all forms of distress. The usual argument is, “It has to be, because if it’s not the brain, what is it?” A complete denial that a mind may be something that transcends the operations of the brain. I really do believe they are taught that, a reductionistic philosophy that disguises itself as “science.” Naturally, I’d love to do all I can to support the Kelly Brogans of the world who are trying to do something different, but they’ve got a lot of money and power aligned against them. But I really think removing the idea of mind=brain has to be central to undermining the mindless drugging and surgery that is proliferating under the guise of “treatment,” because if we are not “treating” problems in the body, the idea of drugs and surgery immediately stops making any sense at all.
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Good one!
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It is true, people who get pulled into psychiatry are looking for something, some way to change or improve their lives. It is the deception and chicanery that characterizes psychiatry that is problematic. Lying to people in order to make money does not improve their mental/emotional/spiritual condition.
It does seem to me that differentiating between treatments for the BODY need to clearly be separated from efforts to help someone make sense out of his/her life and be more effective in living. I think the term “mental illness” implies a “wrongness” that is pseudo-medical in nature, which is why I think we need to strongly object to the term. Offering someone help with “life goals” or “spiritual distress” or “dealing with the effects of historical trauma” allows for some differentiation in both apparent cause and in what approach might be taken. A person who is depressed due to having a dead-end job but being too finanically strapped to quit requires a very different approach than a person who is long-term depressed due to having been abused as a child and developing some unhealthy ways of avoiding further damage, and yet a different approach from someone who feels depressed due to a thyroid condition or anemia. I also believe that allowing/encouraging the person in need to both define the nature of their problem and to fully agree with the strategy to address the problem is going to be far more helpful than having someone “diagnose” him or her (absent any actual, objectively observable illness or injury). These things will not happen as long as “mental illness” is something handled in the medical system.
There are also some major philosphical problems that are ignored or hidden by the DSM diagnostic process. The question of “what is the mind?” is one that no one really talks about. The psychiatrists assume the mind is the brain, and therefore they try to “fix the brain” by mechanical means, which makes as much sense as fixing a computer program by removing transistors or capacitors or deleting memory chips. But they are doctors (or claim to be), and doctors deal with bodies. If we are something more than a body, then we don’t need medical personnel dealing with our challenges in planning and executing our lives.
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If there is no such thing as a “mental illness,” how on earth can their be “causes for mental illnesses?”
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The term “ecotherapy” has an interesting effect on me. It feels like taking a normal activity that feels good and makes me happy and turns it into some kind of “treatment” for whatever “ailments” or “disorders” I might be having.
I can more easily wrap my head around “ecopsychology,” because it suggests more of an understanding of how poor environments lead to feeling anxious or sad, and that respecting our need for nature and growing things is important to our welfare. Perhaps it is more appropriate to identify the damage done by forcing people to live in eco-poor environments, rather than to suggest that nature is some kind of “therapy” for those who can’t tolerate the stressful living conditions we “modern” humans are forced to put up with every day.
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I learned it from hard personal experience over decades trying to “work within the system.”
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Oh, that made me laugh!!!
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The “peer movement” was mostly created to undermine the “patients’ liberation” movement that was effectively undermining psychiatry’s bottom line in the 70s or so. They never did value “peers,” but they wanted to coopt those who were objecting by allowing them a limited role and paying them a little money. They gave the idea that “peers” would have an influence on policy and practice, but in reality, they were expected to toe the party line and not do anything “radical” like suggesting that people might be better off without “taking their meds.” That’s my read on the situation.
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How about the “Let’s only do things that the client actually finds agreeable and helpful, and stop doing things that they tell us don’t help” model?
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That’s the biggest problem of all I see with “the system.” No matter what great approaches are invented, no matter what level of training is offered, no matter what written expectations are, the staff have the power over the clients, and “power tends to corrupt” is a very true statement. “Mental health professionals” will say they are doing “Trauma informed care” or whatever, but simply continue their dominating way and put a veneer of “trauma informed care” over top of it. They can’t really ever be “trauma informed” until they are aware of and deal with both their own traumatic histories and the times they have traumatized others intentionally or inadvertently. And there are no real incentives to do this. Anyone with the proper degree(s) and/or credentials can become a “mental health professional.” There is no requirement of emotional stability or emotional availability or personal insight or sensitivity whatsoever. A jerk doing “WRAP” is going to be a jerk, no matter what you try to do to “train” him otherwise.
As long as the power differential is there, any form of “therapy” can be potentially destructive.
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Great post!
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I worked with a girl who was temporarily in residential “treatment” for issues having nothing to do with “depression,” even by their own loose standards. When she would spend a lot of time in her room reading, they said she was “isolating” and tried to force her to join the group in “voluntary” activities! It was ridiculous. She was fortunate to have an assigned advocate who stood up for her and to have a fairly strong ability to assert herself respectfully. I’m sure lots of other kids were criticized for “isolating” when they were just taking care of thesmselves in various ways. It was highly disrespectful!
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Or even simpler: “Treating people like crap makes them feel like crap. People who feel like crap sometimes do crappy things, too. So let’s quit treating people like crap!”
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That is very true. I also see “marketing” of surgeries and various drug interventions like anti-cholesterol drugs and flu shots and blood thinners and “ED” drugs and even botulism toxin injections to smooth out one’s wrinkles. It isn’t always for money specifically, either. Sometimes it is a need for their training and system to be “right” and to assert control over the patient. Which is one reason that nutritional approaches and chiropractors and acupuncturists get attacked by the mainstream – they are elbowing in on the MD’s control of the market. It’s not only financial, but also prestige and power that are at stake.
The first thing I do when I meet any doctor I need something from is to explain to them that I’m an intelligent and well-educated individual and will be making my own decisions about what to do, which may or may not coincide with their expert advice. I’m paying them mostly for information and suggestions, but bottom line, it’s my body and I get to make the final call. And I let them know if they have a problem with this, I can find another practitioner. They almost always assure me that it’s my right to decide what I do, but I don’t think that happens with all of their patients. I think most doctors like to BELIEVE they are empowering or providing informed consent, but a lot of them don’t like to be questioned or contradicted by their patients and will use pressuring tactics and outright dishonesty sometimes to get the patient to do what they want. Of course, this is easiest and most pronounced in psychiatry, where there is no actual accountability for even defining the entity being “treated,” so they can say almost anything and can’t be “proven wrong.” But that kind of attitude is what makes US medicine more expensive and less effective than most other industrialized countries.
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But should marketing be a part of “medical” diagnosis? Would you want your doctor to tell you the truth, or to sell you on a concept which will make you more willing to accept his drug-based “solution?”
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Now THAT is absolutely true!
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And so you see the true intentions of the “mental health professionals” you were dealing with. There is not any real interest in making people healthy in evidence there. As soon as you started threatening their control of the situation, their interest was in fact to stop you by any means possible. One can only conclude that their real intent was to maintain these people as “disabled patients” for as long as they could get away with it.
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When I am speaking of marketing, I’m talking about the self-centered kind, where you have no concern for the truth but only for convincing the person to buy your product, regardless of the quality. This is different than couching one’s message in terms the other person can understand. But it’s a slippery slope as soon as one starts assuming one knows better than the subject what is or is not going to be helpful. Educating about real ideas can certainly require a certain about of framing or consideration of the other person’s ability to receive the message. But that is different in my mind from knowing that something is false and attempting to convince someone otherwise by manipulative means. And if you think about it, even if something IS helpful, if a person feels coerced or manipulated into doing it, they’re not usually going to be able to realize the benefits, are they? Compared to a situation where they drew their own conclusions from the honest data?
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I’d say the first problem is seeking a “treatment for depression.” This assumes that “depression” is the problem and that all people having “depression” have the same thing wrong with them and need the same “treatment.” I certainly don’t know enough about you to say what you might need or benefit from in terms of intervention, but “depression” has multiple possible causes that vary from past abuse/neglect/trauma to dietary problems to physiological issues like thyroid malfunction or Lyme Disease to current life circumstances like domestic abuse or a job you hate to existential questions about the meaning of life. Everyone is different, and the idea there is one “cause” for depression is a myth created by psychiatrists and the pharmaceutical industry in the interest of selling their wares.
This is not to say that antidepressants or any other intervention can’t be felt to be workable by a particular person. It’s more that pretending that you have a medical problem when they actually have not the slightest idea what, if anything, is wrong with you is never going to lead to any real solutions. If you think about it, drinking controlled amounts of alcohol can and does provide direct relief from intense anxiety, and frankly with fewer side effects than the benzodiazepines so readily prescribed for that “diagnosis.” But drinking alcohol would never be considered a “treatment” for anything, and benzodiazepines should not be, either. They are just a drug people take that makes them temporarily feel better. Unless you really understand what is causing the anxiety, there is no “treatment plan” that will predictably handle the problem. There are drugs that create all kinds of effects, some desirable, some undesirable, some desirable to people dealing with the “problem person” while undesirable to that person him/herself.
So I don’t think there is a simple answer to your question. Every person is different. But I think telling people that they have a “chemical imbalance” or that something is wrong with their brains is utterly irresponsible and lends to further feelings of depression and hopelessness.
I say this as a person who has struggled plenty with depression in my life, including feeling suicidal at times. I no longer feel depressed most of the time, and have learned to recognize when I’m going down that path and have things I can do to redirect my attention and behavior into a new route. For me, things that helped have been meditation, caring friends, inspiring work that forced me to face my fears, real talk therapy (none of this “evidence based practice” crap, just a real person who got interested in my life and helped me realize some things about my family and my own way of thinking about the world), self-help books, exercise, and creative activities like singing, home film making, and the like. Others will have their own approaches. You can develop one, as well. Maybe it will continue to include antidepressants. Maybe it won’t. That’s your call. But the beginning of wisdom is realizing that the psychiatric profession has nothing else to offer but their speculative “disorders” and their pharmaceuticals, and there are SO many other things that can be done! It starts by recognizing that you are not “treating an illness,” but dealing with a life circumstance that has its reasons for being there, whether they are physiological, psychological, or spiritual in nature.
Best of luck to you in finding your path!
Steve
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“Third party medicine!” You treat someone else, and I get better. What could go wrong?
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True. It would be more accurate to say, “We are trying to eliminate emotions” or “we are drugging reactions” instead of “alleviating symptoms.” Unless symptoms is used in a very broad sense to mean “effects of an underlying cause,” not implying anything medical. It seems to buy into the pseudo-medical way of thinking, doesn’t it?
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It seems you consider the facts I’ve presented as “arguments.” They are not. What I have presented are scientific conclusions arrived at by psychiatry’s own researchers, clear statements made by psychiatry’s own spokespersons, and hard facts about how the DSM is put together. None of these things are my opinions. They are all known to be true from research or from direct statements from unbiased participants. Actually, in the case of Pies, a participant highly biased in favor of psychiatry, who still admits there is no “chemical imbalance” and attributes this idea’s promotion to the pharmaceutical industry, and asserts that psychiatry has never supported this claim (though there is also plenty of evidence that they have done so vigorously).
Have you read Anatomy of an Epidemic? It sounds like you have not. I’d strongly suggest you do so if you want to undestand what is going on here. There is plenty of research supporting a view questioning the validity of the psychiatric worldview.
If you have, as you state, scientific evidence of the ability to identify and detect “chemical imbalances,” I would be very interested in reading these studies. I’ve been studying this area for decades and have found nothing but the most circumstantial “evidence” presented on this, and as I’ve stated, even the psychiatric community is now backing away from these claims as being, at best, “simplistic.”
It is true that everyone is entitled to his/her own opinion, but we’re not entitled to our own facts. I would like to discuss the actual research you’re talking about. If you choose not to, that’s your choice, but I absolutely do not accept the characterization that I am “anti-science” simply because I don’t agree with your point of view.
I wish you well.
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I agree 100%!
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I’d be interested to hear where you’re saying that people are being anti-scientific. I believe it is very much possible to feel that psychiatric drugs are USEFUL to you without accepting that you have a “chemical imbalance” or that the drugs are actually “fixing” anything wrong with your brain.
I like your comment that the environment and the brain/body are interacting all the time and affecting each other, and that early trauma does sometimes lead to alterations in the operation of the brain. What most people do NOT know is that the “decade of the brain” was also the time of discovery of “neuroplasticity”, or the idea that the brain can adapt later in life, including the idea that the brain can and does adapt in POSITIVE ways to a positive environment. Psychiatry has grabbed onto only the half of the story that suits them, and portrays that a “broken brain” from childhood can only be “fixed” with their drug interventions. This is NOT science, this is a marketing ploy. Science tells us that brains are not “broken” by trauma, but that they adapt to survive in the environment they are in, so the real key to healthy brains is healthy environments.
Additionally, the DSM “diagnoses” (I’m sure you’ve been given some of these over time) are also NOT scientifically determined, but are voted on in committees, and are based on subjective evaluations of another person which are ripe for bias and discrimination to enter in. There is no test for any “chemical imbalance” in anyone’s brain, nor even a concept of what a normal “balance” would look like. Mainstream psychiatrists like Ronald Pies and Thomas Insel have acknowledged this, and Pies called the chemical imbalance theory an “urban legend” that no well-informed psychaitrist takes seriously. Yet you have clearly been told that you have a “chemical imbalance,” even though no one knows that such a thing exists. This, again, is not scientific, and opposing it is not anti-scientific.
So while many views expressed her are not accepted by the psychiatric mainstream, my experience is that folks here are MUCH more interested and committed to science than the psychiatric industry itself, and that’s a gigantic understatement. This may be hard for you to believe, and I can certainly see how the statements made here seem shocking and out of line with what you’ve been told. But I encourage you to read some of the articles, especially the scientific research articles. There is solid scientific research showing that antidepressants increase rather than decrease the suicide rate, that people diagnosed with “schizophrenia” do better in the long run the less “antipsychotics” they take, that twin studies don’t actually prove any genetic heritability of any “mental illness,” and that labeling someone with DSM “diagnoses” increases rather than decreases the “stigma” that they experience, both from their own view and from other people’s treatment. All of these things are scientifically shown to be true. It sounds odd, but to find out what is scientific, you have to start by unlearning whatever you’ve been told about “mental illnesses” and “medication” and “diagnoses” and start over with an open mind, looking at the actual data. You may still draw the same conclusions in the end, but the psychiatric profession has some gigantic conflicts of interest that make them a very unreliable source of information.
Hope that helps a bit. I’m really interested to hear what parts you find “anti-science.” It should be an interesting discussion if we all are respectful and keep open minds.
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For me, it gets down to genuineness. A person can use a lot of different ways to express regret that they have harmed you, whether accidentally or intentionally. I have no button on “sorry” per se, but it is often used in insincere ways. Something like, “I’m sorry you feel that way,” isn’t really acknowledging any causal responsibility on the part of the speaker, whereas something like, “I’m really sorry you’re feeling hurt – it wasn’t my intention, and I want to understand what I did that hurt you,” would come off as a person who really regrets his/her action. So the term “sorry” isn’t really the issue for me, it’s whether the person is interested in understanding my experience and making sure it doesn’t happen again, or is just “apologizing” without really recognizing what happened or having any intention of doing anything differently should the same situation arise in the future.
There is also a very legitimate use of “sorry” in the sense of, “I’m so sorry to hear you had to go through all that shit!” Or “I’m sorry to hear that you were treated disrespectfully.” This works OK for me if the person has taken the time to hear and understand my story and is acknowledging the pain/frustration or whatever involved. But it can be a slippery slope. “I’m sorry that happened to you” or “I’m sorry things didn’t work out the way you wanted” can come across as dismissive or condescending.
Bottom line, to me, it’s about the sincerity of the message, not the specific words used. But others may feel differently.
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Wouldn’t this kind of be like standardizing “measures of courage” or “measures of sponaneity?” Or perhaps “measures of phlosophical insight” or “measures of esoteric-ness?” How can you measure “mental health” when it is is metaphorical in nature?
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Agreed. There is nothing more to expose, and they are not interested in “facts.” They want to keep their power and their money, and no number of studies will change that. If they cared about science, they’d have stopped doing it long, long ago.
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And what does it say about the psychiatric industry that they were NOT excited to hear that genetics is not a significant contributor to “schizophrenia?” Can you say, “Conflict of Interest?”
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OK, I like the analogy to “insular!” Makes more sense to me now.
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“Messaging” is marketing. The public should not be “given a message,” they should be given the truth, in terms they are able to understand and personally digest. “Messaging” is already a move into authoritarian thinking, that we should tell people the things that make them do what we want instead of just informing them of what we know and don’t know and allowing them to make adult decisions about how to proceed.
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I often use the car accident analogy – if people at a certain streetcorner are being hit by cars at a high rate, and only 35% of them break bones in the process, do we diagnose those people whose legs break with”brittle bone disorder” and try to find out why, or do we put in a stop sign or traffic controls to ensure fewer people get injured?
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I’d suggest that the American Psychiatric Association and their “opinion leaders” are the ones who are trying to control the narrative, along with their friends in the pharmaecutical industry. That’s an oversimplification, but what it comes down to is that there are people whose salary depends on promoting the label-and-drug model in the biggest possible way, and such people are not the least interested in learning anything about the actual needs of individuals, and in fact will argue in the most intense and irrational ways about how “wrong” anyone is who questions their paradigm. The recent Phil Hickey article critiquing Ron Pies and his associate gives a little meat to that comment.
I don’t quite get what you mean by “Unselor” still.
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I agree, it might be fun to watch them squirm. Do some role plays of real scenarios, and see how long it takes before the run from the room!
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The fact that you are able to say, “Of course I could be wrong…” puts you miles ahead of many others. I think that humility is the core of being a good helper, because it’s the only antidote to the power imbalance. We have to each realize the potential damage we can do and how possible or even likely it is that we will misapprehend things, so that we are constantly checking and re-checking things to make sure we’re on the right track and continuing to be helpful.
I am certainly not in any place to say someone is “born with” the ability to connect or if it is learned over time or more likely “unlearned” (I like your point about too MUCH training – people can get very invested in their group’s agreement as to what is going on). There are also financial incentives involved for a lot of people in the “mental health” industry that make the idea of the client having his/her own ideas about what is the right thing to do rather threatening. And there is also internal pressure from those who have such conflicts of interests upon clinicians to maintain the status quo. General education in life can be a big counter to our inappropriate concepts and training, but I have no idea how to specifically train someone to be compassionate.
A good example would be “cultural competency training.” There ARE people who benefit from such training, but these are generally people who are already oriented toward wanting to create that kind of environment. Those who are committed to NOT being culturally competent, for whatever reasons, tend to avoid such trainings like the plague. And if they are forced to go, they go under protest and generally make fun of the process. There may be one or two here or there whose eyes are opened by the process, in which case, I’d say it’s well worth it, but the bulk of people attending are going to trend they way they’ve always trended, because they’re not motivated to do differently.
Can you “train” a person with deeply-held racist views not to be racist? Most of the time, no. Can you train a person who sees “the mentally ill” as someone beneath them on the scale of life, who doesn’t understand what he needs and requires the pateralistic wisdom of his/her counselor/psychiatyrist, to see that person as a person instead of “a schizphrenic” or “having ADHD?” I’d say usually not.
So training for sure has value, but only if some preconditions are met. And if those preconditions are NOT met, training people on techniques or skills or whatever is going to have a limited effect. I wish there were a way to train people to be more sensitive. Perhaps the only real answer on that line is for the person to do his/her own healing to the point where s/he can recognize when his/her own issues are getting in the way, and can differentiate between the counselor’s needs and those of the client. But the person would have to recognize that need before such healing could even begin.
Or another way to say it: disempowered counselors are not going to be able to empower their clients. As long as we have to subordinate ourselves to some control system, whether external or internal, that tells us how we have to do or think about things, we won’t be able to be flexible and sensitive enough to know what will be helpful to the client.
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It very much sounds like the right idea (see my other post). However, you already have seen at least one person who can not process whaet you’re talking about. I don’t think it’s likely because they lack training. I think it’s likely because they lack the perspective and strength of character, or have not done sufficient work on their own issues, or come from a strongly authoritarian viewpoint, such that the idea of the client finding his/her own path seems impossible to imagine. I could be wrong, of course – maybe a round of training in IFS would open her eyes. But I would bet you a whole bunch of money that if you took 100 psychiatrists and put them through intensive IFS training, at least 95 of them would be completely unmoved in their views on what the human mind is capable of. Fixed ideas don’t yield to training very easily, and people’s vulnerability is generally their first and most important concern. Given the ability to use one’s power to protect oneself vs. opening up one’s mind and being vulnerable to feeling confused and wrong and hurt, etc., the vast majority of folks will choose protecting themselves every time. I think this is particularly true for the field of psychiatry, which pre-selects people who already see their roles as “fixing” other people’s brains. Maybe if you could get to them when they’re still undergrads, you’d catch a few more, but most of the psychiatrists I’ve known over the years would die on the hilltop of “drugs are the answer” before yielding to any counseling concept, let alone one which emphasizes empowering the patient to make his/her own choices.
That’s my experience, anyway. It sounds like IFS might be a wonderful thing to learn and develop from, but it would be profoundly threatening to the psychiatric establishment, and would be rejected out of hand by a large percentage of those in control of the industry.
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I am saying that training in and of itself is neither necessary nor sufficient to make someone a competent counselor, if that’s the term we want to use. Naturally, a person who has the gifts/understandings necessary to connect with someone else can benefit from some wisdom and experience that others have gleaned from their own efforts. But no amount of training can teach a person how to connect emotionally and safely with another person. Someone can use all the “I” statements in the world, and to do “active listening” and to follow all the precepts of DBT or CBT or whatever and still be incompetent or totally destructive as a counselor. You can actually use the skills taught in your training to give someone the idea you CAN be trusted, and after they share with you their deep secrets, you find your own issues get engaged and you get annoyed or bossy with them or turn cold or send them off for antidepressants and you have SCREWED them over. A person would be MUCH better off seeing right up front that a person doesn’t really care about them than to have the person learn “skills” that make it seem like they care more than they do.
So sure, one can train in skills. But it doesn’t make you a counselor/helper, and it can make you more dangerous. And a person who has zero training and excellent empathy can actually CREATE skills and approaches or help the CLIENT create such skills and strategies him/herself! Becuase they start with UNDERSANDING the person in front of them rather than seeing the client through some clinical “lens” or applying some “evidence-based practice” in a mechanical or robotic fashion without being able to observe the needs of the client or the effect of the intervention on him/her.
Setting up a patient/client relationship sets up a power imbalance automatically from the word go. The number of people who can operate in such a situation without taking advantage of their power is, in my experience, pretty small compared to the number of people selling “clinical services.” I recall a study telling us that a person is just as likely to experience relief/improvement talking to a good friend than to a counselor. I find this very easy to believe, because the degree and training confer no assurance that the person is competent or caring, and a caring friend is a far better resource, however untrained they may be, than a supercilious or insensitive “counselor.”
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SO true! Humility is the beginning of wisdom!
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This may be the most important truth that we have to work with!
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I have to agree with you. I don’t think anyone can be “trained” to be a counselor/advisor/mnetor in more than the most rudimentary way. There is a presence that a person can adopt with me that is healing, and that presence has mostly to do with being willing to be there and accept who I am and genuinely respond to me as one person to another without putting me in the position of having to edit or explain or justify my own thoughts and feelings. There is no “technique” involved, no “method” that one could emulate, no “treatment plan” involved – it is simply the proper mindset and attitude of being present and caring and being willing to experience whatever is coming up and in fact NOT knowing or deciding what all of it means or what the helping person should DO with it. I think this has to be experienced directly, and some people are not really able to do it for whatever reason, no matter what training they receive, and others seem to come by it naturally without any training at all. I’m not saying it can’t be learned, but it’s not something you can teach someone else, like how to repair a car or make a recipie. It’s not some kind of “program” you can put in a manual – it requires genuine outreach of one human to another and a willingness to be vulnerable and to NOT know ahead of time “what to do.” We need to ditch the idea that getting a PhD or whatever makes anyone any better than anyone else in the realm of caring!
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Commenting as moderator:
I’m only approving this because I know how much Frank and Oldhead truly love each other!
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How about we rebrand them as “psych-oil salesmen?”
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Not only weren’t you given “informed consent,” you were actually given intentional MISINFORMATION that deflected your own observations of reality. Maybe we should call it “Misinformed non-consent.”
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It is baffling to me why the smoke and mirrors show isn’t obvious to anyone. They’re not even any good at it!
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I am amazed that they can write this stuff seriously! Especially the stuff about how “anxiety disorders” are shown to CAUSE anxiety and are not mere labels, yet in the same sentence state that the anxiety could be caused by any number of very different things. It seems they disproved their own statement by the end of the paragraph, yet did not seem to notice.
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Well, if this leads to a reduction in “medication” use, I’m sure the psychiatric profession will want to oppose it in every way they can. We don’t want people getting better – how will they sell more drugs?
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Well, it sure ain’t news. I was just surprised that Frances would have talked about it in his pre-DSM-IV days.
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Disgusting! I wish I were shocked, but I no longer am. How do they get away with it?
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Reliable tests are very dangerous to the psychiatric hierarchy. They threaten to prove that psychiatry is full of crap. The last thing the psych profession wants is any kind of reliable test!
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Wow, did not know that! Credit where credit is due.
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Who would have guessed it?
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It made that model dominant, far more than it had ever been before. It was a big-time and intentional power move.
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I agree – removing the incentives for lying and minimizing adverse effects and overblowing “positive” results is the real game here. If you pay people more when they lie, a lot more people will lie. Also, taking away Big Pharma’s power to influence academic research is very “do-able” but would require a lot of piggies to remove their snouts from the trough, and we’ll hear a LOT of unpleasant squealing if we do that!
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Actually, I think it’s more like dipping the spaghetti in glue and then reporting a “positive result” when it sticks.
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I like that example and have used it myself. What if we dianosed kids who aren’t good at sports with “athletic deficit disorder.” It would be “treatable” with stimulants, too! Stimulants would improve athletic performance, speed, quickness, concentration, intensity… what would parents and teachers have to say if stimulants were recommended “treatment” to make kids better at sports?
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It’s also fascianting that they INDUCE “depression” in mice by creating high-stress situations, and then use them for subjects in their experiments. All the time claiming that “depression” is a “biological brain disease” not caused by the environment!
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Repeated failed attempts to prove something scientifically is the definition of DISPROVING that very thing. If these psychaitric “professionals” were truly scientific, they’d realize their experiment was successful – they have successfully proven that none of these “diagnoses” have a physiological cause or even correlation. Convincingly proven.
Which leaves us with the sad conclusion that they are not scientists at all. I think they are mostly either dupes or marekting agents.
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And “progress” includes reducing lifespans by 25 years on average for the “seriously mentally ill.” More “treatment” seems to lead to shorter lives. Where else in medicine would this be remotely acceptable?
Just for the record, though, the “medical model” has deep roots that go back at least to Kraepelin and probably long before. I think the DSM III just codified the ‘medical model’ and launched the most complete takeover of the “mental health” industry by doctors in history. But doctors back in the 19th century still had an investment in the idea of biological causation, which meshed very tightly with the eugenics movement, of which psychiatry was always an integral part.
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Precisely! In fact, it is not science at all. It’s prejudice.
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“Fritz et al. propose transdiagnostic interventions that can “correct” these disruptions.”
If interventions need to be “transdiagnostic,” then what is the point of having a diagnosis? Isn’t the whole point of a diagnosis to figure out what’s going on and what plan to make to address the cause? If a diagnosis doesn’t tell you how to intervene, it needs to be trashed! Which pretty much means the entire DSM.
This whole set of ideas is ridiculously complex! A good scientific theory should make things easier to understand. It seems like a very complicated effort to “explain” the DSM “diagnoses” that really don’t merit explanation. There is no need to do intense gymnastics to try and make these false concepts “work.” Just admit they don’t, and start over, preferably by ditching the whole idea of “mental illness” and “psychopathology” for starters.
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The psychiatric worldview seems to imply that we are little to nothing more than animals. In fact, the psychiatric worldview probably disrespects even higher animals’ abilities to make decisions about their lives.
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I was being ironic. If there were a success story, it wouldn’t be psychiatry’s, it would be your heroic success in healing both despite them and FROM their destructive efforts!
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But they would, of course, insist you must take “heart attack prevention” drugs forever, because you’re “at risk.”
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I might say that psychiatry is not responsible for initiating stigma, but they ARE responsible for capitalizing on and exacerbating existing stigma/prejudice in the interests of controlling their patients and making a profit.
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If I had to gamble on psychiatrist vs. library assistant on helping me with my “mental health,” I’d definitely start with the library assistant. At a minimum, they are trained to help people find what they want rather than deciding what book the peson “needs” to read and trying to force or manipulate them into reading it.
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Commenting as moderator:
I do see some importance in this line of discussion, but I also do see things getting a little personal on both sides, to the point that I was considering how best to intervene. I think we need to stick to the concepts and move away from more personalized comments that seem to accuse the other commenters of insincerity or mean-spiritedness. There is plenty of room in the general concept of “socialism” in our society for lots of confusion and different viewpoints. Perhaps if each person can simply discuss what definition they are operating from, it would be more productive than trying to state or imply that the other person’s definition is “wrong?”
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Another psychiatric success story! I’m so sorry you’ve had to go through all of this nonsense. We ought to be able to trust our docrors, but apparently, it’s “caveat emptor!”
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In other words, they CLAIM they are providing “involuntary treatment,” but in fact, they are imprisoning people and forcing them to comply with the psychiatrists’ authority, and there is nothing “therapeutic” about it in either intent or in effect.
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I’m saying if it is forced, it can’t be a form of “treatment.” It is an act of violence against the will of the victim.
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This is one of the most extreme dangers (of many) regarding the idea of DSM “diagnoses.” Once they decide on a psych label, they stop looking, as if the label somehow explains anything relating to WHY you are having these difficulties. The book itself says it makes no representations as to cause, and yet, once that label comes down, they think they “know” all about it and stop looking for anything else. It is incredibly destructive, as you unfortunately now know from direct experience!
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Sadly, and predictably, no one really ever studies the long-term effects of these drugs. So it’s hard to say. But most people I’ve talked to who take these drugs, especially if it’s not for a long period of time, report at least some significant recovery after stopping. There are exceptions to that, but most get back to some semblance of “normal functioning” over time.
What issues are you struggling with that you think may be related to the Zyprexa?
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Gotta watch the psychologists, too. Many are wannabe psychiatrists who believe fully in the “biological brain disease” concept, especially for “schizophrenia” or “bipolar” diagnoses. If you are looking for a therapist who might have a chance of being really helpful, start by finding one who firmly believes the DSM is a useless doorstop and is more interested in what YOU think you need than in slapping some label on you. Just being a psychologist is no guarantee you won’t be routed down the same label-and-drug pathway!
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“Forced” and “help” in the case of mental/emotional issues are contradictory. The presence of force belies any purported intention to “help.” At best, you are stopping someone from doing something that you don’t think they should do. But many other and worse things happen as soon as you decide that you get to decide what “help” another person should get. There is no such thing as “involuntary treatment.”
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You’d have to be in denial to take up the sword for psychiatry. The “mentally ill people commit more suicide” trope is easily debunked, because most every trial ever done removes suicidal people from the pool before starting the trials. So there should actually be FEWER suicidal people in the trial than the general population, and an increase in suicide rates is even MORE condemning of the drugs. Besides, that’s the whole point of the control group. They are “mentally ill” too, and commit suicide at a lower rate. That’s all you need to know, except if you don’t WANT to know.
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OK, it is “UP – YOURS!”
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Wow, great stats! I did not know that about veterans – do you have a link for a study on that? I’d love to add it to my arsenal!
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Undermine Psychiatry – say Yes to Outlawing Utterly Rotten Systems! (Work out the acronym on this one!)
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That’s the idea!
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“SOSEA!”
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I was hoping for it to be an acronym for an ANTIPSYCHIATRY group!
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In fact, there are many situations where the emotion involved is quite logical and necessary. If one is being chased by a bear and does NOT experience fear, absent a VERY powerful shotgun or other effective weapon, NOT feeling fear would be quite illogical!
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Not sure I agree on that last point. There have been healers as long as there have been human beings. Though I do agree it has been coopted by a certain set of commercial interests to a degree.
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So you’re suggesting that if psychiatry opposes something, it’s probably good for you? 🙂
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It helps temporarily to drink a couple of beers after work, but I don’t think we can call it “healing” quite!
You’re absolutely right – in the realm of the mind, there is no “healing” through drugs. The idea of using drugs rests on the hard materialist assumption that the only thing “wrong” with a person must be a physical thing, and the elitist assumption that anything that doesn’t indicate full agreement with the current status quo is de facto a ‘disease’ that needs “healing.” Both assumptions are extremely dangerous!
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Yeah, kind of like limiting arson to situations where the homeowners are not in the home at the time.
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“ACT OUT” – I like it! Now we have to come up with some words that spell that out as an acronym. Start off with “Anti Categorization Team for Opposing Ugly Treatment?”
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I agree. It is only a “controversy” because certain people continue to make money from this destructive and barbaric act. Seizures aren’t good for you, folks. Why should anyone have to “prove” that fact? Those proposing intentionally invoking seizures by electrocution better have some pretty AMAZING data proving what wonderful benefits exist to justify damaging someone’s brain and life in this way. And we know they don’t. So where is the “controversy?” Whether or not we should harm our patients for profit?
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Well, of course, there are medical issues that affect someone’s mind/behavior/emotions. These ARE real medical problems that a physician should deal with. Equally obvious, the system of “disorders” prevents the differentiation between actual medical issues and mental/emotional/spiritual issues which have little to nothing to do with any kind of medical problem at all.
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As Tim McCarver once said, “It it were that common, more people would have it!”
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It is aimed very much at detecting Romantic Jerks. But a lot of the principles do apply to other Jerks, particularly the tendency to blame others for one’s own shortcomings, the tendency to charm someone into agreement before altering the terms unilaterally, and the tendency to group people into those who are above or below each other in the hierarchy of life (not to mention a strong need to make up or blindly follow the rules of such a hierarchy and enforce them on those the person sees as “beneath them” on the ladder of life.) And perhaps the most important – we get a kind of a sick or uncomfortable feeling around such people, which we often try to explain away to ourselves. Lots of it is very applicable, though hopefully their sexual behavior doesn’t come into play!
Thanks for the words of support!
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An excellent question. In the Lakota tradition, it is my understanding that healers don’t charge anything, but only accept whatever gifts are given in appreciation. I think they probably do OK for themselves.
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I think the psychiatric industry is deeply threatened by anything that actually has a chance of working, and the more it humanizes the “mentally ill,” the more threatening they seem to find it. Their response to “Open Dialog” is pretty solid proof of this. 80% success without drugs should be considered a miracle, but it is relegated to a fringe approach that no serious psychiatrist can take seriously without being attacked by his/her compatriots. I think that says a lot about the actual purposes of the psychiatric “profession.”
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Well, certainly. It is not the individuals per se but the structure that is abusive. I have worked with these folks and know well that there are some sane or at least semi-sane individuals who do this work. And I’m not opposed to the concept of “healers.” I just don’t think that it has much if anything to do with medical “treatment” in most cases. But I think you’ll agree with me on that point.
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The answer to the question of “what happened to ‘radical psychiatry'” is contained in the question. It was, of course, rubbed out by “real psychiatry,” which could no more be “radical” than water can be dehydrated. Psychiatry is based on oppressive assumptions, and the only “radical psychiatry” possible would be to oppose psychiatry itself. Now that WOULD be pretty radical, but would it any longer be “psychiatry?” I would say not. Why not be a “radical empowerer of the downtrodden” instead of a “radical psychiatrist” and eliminate the inherent contradiction in the terms?
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True words. Unfortunately, we have mostly been exposed heavily to indoctrination most of our lives and are pretty used to it. Plus, stepping outside of the “normal” viewpoint can be dangerous, including being labeled “mentally ill” and being punished for diverging too far from “acceptable” emotions or behavior, even if nothing you say or do is really a danger to anyone else’s rights. The entire school system is pretty much all about indoctrination from start to finish. Why it is that I somehow escaped the worst of it remains a bit mysterious to me, but I now realize that the “problems” I had in school were mostly due to me maintaining my integrity and not going along with the crowd. It takes courage to educate and empower, because we have to have faith that the other person has the capacity to think and reason sufficiently to observe reality with reasonable acuity. Certainly, schools lack that courage in the overewhelming majority of cases.
Glad to know there are some of us working for the same goals, though!
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I tend to focus on a person by person effort to educate and empower, attempting to consolidate and group together with people of like mind. I think we’d both agree that people have a right to make their own decisions about things, as long as that right doesn’t run afoul of the rights of others. So trying to indoctrinate people into any “right way of thinking” is ultimately doomed. The only effective approach appears to be to help each person see things in a new light and to assert their own truth and follow the path that seems rationally and spiritually right for them to follow. But it’s a lot of work, and it takes time, and the opposition has no compunction about indoctrination and brainwashing! I suppose we have got to find each other and support each other in expanding people’s understanding of people and of sanity, and to build a stronger and stronger base of rational and respectful group ideals, but society is improved in a pretty gradual manner, while it can be wrecked quite precipitously. I get discouraged sometimes!
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““To this day we continue to disproportionately incarcerate black people and coerce them into treatment. Moreover, if you are black you are more likely to die under restraint whilst receiving mental health care than if you are white.”
Maybe the first action should be to look in the mirror and see how your profession is structured to maintain oppressive conditions and excuse the oppressors while “diagnosing” the oppressed. Or would that be too simple?
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This is so utterly blatant and predictable. And I don’t believe it is a choice of “easy” vs. “effective” in most cases. It is a choice of “making money” vs. “makinig a lot less or no money,” at least in the USA. Providing “no treatment” not only makes doctors feel less valuable, it means they can’t bill for their continuing “services” to their drug-dependent patients. Hence, WORSE outcomes mean MORE MONEY for the doctors, so the science has no impact, because improved outcomes (consciously or unconsciously) don’t appear to be the goal of many if not most psychiatric practitioners. Otherwise, they’d be excited to learn about this kind of thing instead of pretending it doesn’t exist.
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Yeah, it doesn’t really mean anything to be “diagnosed” with a “personality disorder.” I’m just saying that it has no more meaning than calling someone an “asshole.” I’ve actually been very fond of a lot of people who have gotten “borderline” “diagnoses” in the past. I put no weight on them. I’d be more inclined to say things like, “This person has a hard time trusting others” or “he likes to exert power over people arbitrarily.” This is a more realistic way to talk, such that others could compare notes or agree or disagree or work together to come to a better understanding of a particular person and his/her motivations. Labeling stops the discussion at the label, and I don’t like any of them, whether you say “asshole” or “narcissistic personality.” It’s all just opinion posing as fact.
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I agree that we can all do a PERSONAL evaluation by talking to someone, but obtaining agreement in a society as to who is considered “antisocial” and who is not is a more challenging process. There would have to be agreement as to specific acts which are taken that qualify someone as a danger to society, which should, of course, be enshrined in rational laws and social mores regarding behavior. The unfortunate fact is that “antisocial” people, as you describe them, are often part of creating said laws, which means that people who are genuinely productive get attacked, while those creating havoc are too often rewarded, particularly if they are privileged in the power structure. Our current national government is proof of this point. “Narcissistic” people are grossly overrepresented in US CEOs, according to my research.
Additionally, some “antisocial” people are pretty crafty, and you and I may be trained to recognize them, but others less savvy are too easily taken in by their “charming” behavior. (That’s what my book, “Jerk Radar,” is all about.) To teach everyone to recognize them is a Herculean task. I think it is more realistic to expect those who are able to detect them to work to rid the world of their influence by education and collective action and leadership. But it’s a tough row to hoe!
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Saying someone has a “personality disorder” is very similar to saying “he’s an asshole.” It has exactly that degree of scientific validity, but it’s certainly possible to look at someone and observe that s/he commits a lot of criminal acts and decide that s/he needs to be removed from society or stopped in some other way. It’s the conflation with “mental illness” and “diagnosis” that creates the problem.
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They are re-proving that which is already known, because somehow the profession of psychiatry has shifted the burden of proof such that detractors need to prove that their “treatment IS dangerous instead of them being responsible for proving it is not.
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As often happens, the authors are way too careful in their analysis. The title should not say “misleading” but “false” beliefs, and the attribution of responsibility to drug companies belies their own data that doctors who are fully aware of the science about both placebo and withdrawal effects continue to prescribe despite their knowledge. This suggests that the problem is not merely with pharmaceutical companies nor with academic interests alone, but that many individual psychiatrists are themselves corrupt, most likely receiving either direct kickbacks or gifts and perks provided for prescribing sufficient numbers of a particular drug, or else establishing some kind of prestige in their profession for supporting this kind of narrative, in contravention of the facts. It is apparent from this research that knowing the facts does not deter psychiatrists from believing whatever belief serves them best. So it is a much bigger problem than insufficient medical education. It comes down to an entire profession committed to a false narrative, and knowing on some level that backing away from full support for these beliefs that they KNOW to be false will lead to the collapse of their profession and their personal prestige and wealth.
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Quite so. The most fundamental requirement of social sciences is to select a group that is homogeneous in the specific trait to be investigated. Otherwise, any research is meaningless. But if you’re not actually concerned with facts, I guess it works pretty well.
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But don’t grin TOO hard, or you’ll be labeled manic!
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That sounds like George!
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I agree with you, stigma and discrimination do emanate from the society at large, and the society needs correction. Unfortunately, psychiatrists, on the whole, rather than helping demystify and normalize emotional distress and behavioral difficulties, appear to have doubled down on labeling and stigmatizing those who don’t “fit in” to our society. There is scientific proof that assigning biological causation to “mental illnesses,” as you are clearly promoting, INCREASES stigma and discrimination, while framing them as reactions to stressful events DECRASES stigma and increases empathy for the victims of trauma and social stresses.
GIven that there is not one “mental disorder” that has a physical cause or even a physical CORRELATION associated with all or most “cases,” and given that these “disorders” are all defined by social criteria which are based on the very social assumptions and stigma you are trying to elminiate, it seems a lot more sane to frame “mental disorders,” if we need to define them as such, as common reactions to stress and trauma.
Since we know that the current system supports and increases stigma and discrimination, what do you suggest be changed in the system to ameliorate that? Can you see ways in which psychiatry itself is contributing to the stigmatization?
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How about, “Psychiatrists show no actual understanding at all of “psychosis,” but have a lot of varied beliefs that many of them consider ‘facts.'”
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Posting as moderator:
Hi, Caroline,
I am not responsible for subscription problems. You probably want to talk to James Moore. He has helped solve this kind of issue before. Sorry!
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“When the only tool you have is a hammer, everything starts to look like a nail.”
No one here is labeling psychiatry as a “stigma.” Psychiatry is stigmatizing its own clients by labeling them based on socially sanctioned/unsanctioned behavior.
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I couldn’t make the links work.
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They actually obscure any effort to discover the actual cause of any phenomenon.
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Appalling! Very much like Kindergarten, except we didn’t have to take drugs and weren’t labeled as malfunctioning. They at least recognized that we were children, not robots.
It seems particularly ironic when they tell you on the one hand that you have no control over your symptoms, only the drugs can help, and yet they punish you for failing to participate or to control your behavior in the way they want you do. Which is it people?
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Wow, that sounds like Kindergarten but worse. And just so you know, I found Kindergarten to be daily torture. To be graded on your game performance… that’s ridiculous!
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You really think that any drug that has an effect is somehow neuroprotective???? Improvement is not a sign of neuroprotection. Look it up. Alcohol is very effective at reducing anxiety. Does that mean drinking alcohol is “neuroprotective?”
I’m not doing your research for you. You obviously don’t have any research to hand and have simply swallowed up what someone wrote or said in your training classes. I’m not interested in hearing quotations from your “abnormal psych” professor. Come up with some real data or drop it.
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“When your only tool is a hammer, everything starts to look like a nail.”
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If you’re hearing this for the first time, you’re obviously out of the loop. But I don’t see much point in talking to you, since you want to preach rather than exchanging views. So I’ll be signing off of this conversation, since I pretty much can predict whatever it is you’ll say already.
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Once again, your views are equated with scientific truth. Just saying things don’t make them true. If we want to have dueling personal experiences, I have helped people who have “severe suicidal ideations” to huge turnarounds in their lives with no assistance from any drugs whatsoever. I’ve also talked to many people who have taken drugs and become MORE suicidal, or suicidal for the first time ever in their lives, and it went away when they stopped.
The scientific evidence is strong that antidepressants DO NOT prevent or reduce suicides, and they likely increase the probability on the average. Perhaps you simply lack the skills to help these people, which is not a black mark for you, just a fact. But claiming that the fact you can’t help them means that nobody else can is very much an arrogant and self-centered viewpoint. A little humility might be a good starting point, rather than simply stating your opinions louder and louder when actual scientific data goes against your viewpoint.
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That is an interesting statement. You understand that scientific analysis of the data from multiple studies has shown that there is an increase in suicide for those on antidepressants over placebo. Perhaps you don’t understand that the people in these studies are screened for suicidality before the studies begin. So these are people who were NOT suicidal who BECAME suicidal during the study. This was so clear that the US FDA demanded that a black box warning be put onto the label. And yet you state your BELIEF that suicidality is not caused by antidepressants? How do you expect to have the slightest credibility when making such statements of faith that directly contradict scientific data? Because of your personal observations, you get to invalidate actual scientific studies?
Don’t bother responding if you’re going to continue just telling us you’re right because you say so.
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There is no such thing as “overdiagnosis” when you can’t objectively establish what the “proper” level of diagnosis really is. Lacking any way to objectively determine the presence or absence of ANY of the DSM diagnoses, the idea of “over-” or “underdiagnosis” is a scientific absurdity.
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They are also frequentely accused of assault and sometimes charged criminally, especially in institutional settings, when they react defensively to what is actually an assault by the staff. Any time a staff person lays hands on a person, any defensive reactions should be considered expected and understandable efforts to defend one’s person from attack. It is a manifestation of the power imbalance between patient and staff that the staff can assault patients with impunity and yet any attempt by a patient/resident to defend him/herself is automatically considered an assault.
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So are you suggesting that somehow facts are not relevant to their “scientific” position? Do tell!
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Have you read Anatomy of an Epidemic yet? You really ought to read it. It would enrich our conversation enormously.
You sound like a person with an open mind. Welcome, and I hope you continue the conversation.
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And I just looked over my last two comments to which you appear to be responding. I see nothing there that sounds the least bit grumpy. Not sure what you’re talking about there. Perhaps you only have hammers and I look like a nail to you?
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Your point is very well taken! There is no such thing as “rights for the mentally ill,” they are the same rights everyone else has. The question is why they are not regualrlly afforded to those labeled as “mentally ill,” and why the failure to enforce them doesn’t seem to bother people too much. It is an issue of prejudice and discriination, not of a lack of “rights” under the law.
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There is really nothing “scientific” about the idea that the mind is synonymous with the brain. It’s a philosophical position posing as a scientific one. A real scientific approach would be to postulate what would predictably result if the mind WERE inside the brain and what would predictably result if it were NOT insde the brain, and then start reasoning from your observations. But since no one can truly define WHAT the mind is, let alone WHERE it resides, the proper scientific knowledge in the sphere is simply, “We don’t know.”
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Why, you rebellious good-for-nothing, disrupting the group experience like that for no reason at all! Obviously showing clear signs of “oppositional defiant disorder.” Oh, but there’s no drug for that, so maybe we’ll roll with “Bipolar” and go from there… /s
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From the article you link:
“These results suggested a differential effect of antipsychotic agents on BDNF levels inpatients with schizophrenia. Peripheral BDNF may play a role in the disease process of a subset ofpatients, related to the use of antipsychotic agents”
The authors are talking about a “differential effect” with SOME patients, and it says it “MAY play a role,” so not clearly established. There is nothing about protection from harm to the brain in this link, so claims of “neuroprotectiveness” are not shown by this link.
Additionally, we’d need to know what kind of ostensible damage naturally happens in cases of “schizophrenia,” which is, of course, extremely problematic in that there is no objective way to diagnose who “has schizophrenia” and who does not, so any study on “schizophenia” may be and is most likely being done on heterogeneous populations, making any claims of neurological damage due to “schizophrenia” moot, let alone claims of “neuroprotectiveness.”
Such a well educated person as you must certainly be aware that even mainstream psychiatry has questioned the validity of schizophrenia as a concept: https://theconversation.com/the-concept-of-schizophrenia-is-coming-to-an-end-heres-why-82775
Of course, we DO know for certain at this point that “antipsychotic” drugs, formerly known as “major tranquilizers” and “neuroleptics,” do actually CAUSE brain damage, in that they create a loss of grey matter over time (on the average): “Viewed together with data from animal studies, our study suggests that antipsychotics have a subtle but measurable influence on brain tissue loss over time, suggesting the importance of careful risk-benefit review of dosage and duration of treatment as well as their off-label use.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/
I find it a bit hard to see the argument that something which reduces grey matter volume in the brain (the actual NEURONS are less dense!) is somehow “neuroprotective.” In fact, the mechanism of “synaptic pruning” is well known in studies of long-term street drug users, and there is plenty of evidence to suggest that the exact same process occurs when other psychiatric drugs that mess with neurotransmitter levels are used. Hardly an indication of protection of the brain from damage.
Sorry, you’ll have to do a lot better than that to have any credibility in this quarter.
As for your suggestion regarding antidepressants, I can only refer to the best insult in the history of film, from the Wizard of Oz:
Auntie Em (To Miss Gulch): “Elmira Gulch! Just because you own half the county doesn’t mean you can run the rest of us! For twenty-five years, I’ve been DYING to tell you what I really think of you. And now… well… being a Christian woman, I can’t say it!”
Hope that’s not too subtle for you to parse out.
Enjoy your evening!
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Yeah, gotta love that concept of “treatment resistant.” If our “treatment” doesn’t work, it’s not our fault, you are “treatment resistant.” Which justifies us doing MORE of the “treatment” that didn’t work or forcing a worse “treatment” on you against your will. “I KNOW this will work, if only she’d stop RESISTING…” Why do people believe this kind of obviously illogical nonsense? Hammering harder on a screw will not screw it in!
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It sounds like you are here to promote a viewpoint. It’s my expectation that a person claiming research needs to provide their own links rather than saying “do a search on Google.” Do you have anything specific? I’m pretty familiar with the literature and any study I’ve seen on “neuroprotective effects” of psychotropics has been refuted or is not replicable. Please correct me if I’m wrong, but I’m not going to search for studies that you claim exist. Please provide some links and we can talk.
As for “side effects,” sure, all drugs have side effects. The question is always whether the risks outweigh the benefits, remembering the Hippocratic Oath to “first, do no harm.” When people diagnosed with “serious mental illnesses” are dying 25 years earlier than the general population, when studies show that people NOT taking antipsychotic drugs do BETTER than those who take them in the long term, even if they had a worse prognosis to start with, when people in “developing” countries do far better in terms of recovery than those who have the “benefits” of modern psychiatry, arguments about “neuroprotectiveness” start to sound pretty foolish.
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Your assumption that a “suicidal patient” will die or kill is, of course, a ridiculous one. I have talked to hundreds of suicidal people in my role as a crisis line supervisor and doing involuntary “hospitalization” evaluations and advocating for foster youth and just being a human being encountering other human beings in our crazy culture today. I would suggest that 98% of the people I talked to felt better JUST BECAUSE THEY FOUND SOMEONE WHO WAS INTERESTED IN THEIR STORY. Not once did I ever recommend or require psychiatric drugs to “prevent suicide.” But you might be interested to know that I did encounter a significant number who were suicidal ONLY AFTER they took one of psychiatry’s magic “antidepressant” pills. I met many, many more who found the drugs marginally helpful, utterly useless, or making things worse.
The message that we are somehow taking a huge risk by NOT drugging a suicidal person flies in the face of massive evidence that a) “antidepressants” do nothing to prevent suicide, b) “antidepressants” actually CAUSE suicidal feelings or actions in a small but significant proportion of those who take them, and c) there are many ways to help a person considering suicide that have nothing to do with giving them drugs of questionable value and unquestionable risk.
I think you have come to the wrong place if you want to sell the idea that we only have a choice between drugging people and letting them die. We know better. I hope you’ll read some of the stories here and you can learn that there is another viewpoint.
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I thought psychiatrists didn’t believe in souls. This would suggest that psychiatry doesn’t have one to save. Or that psychiatric theory is based on false premises. Or both.
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I am not able to answer that question, as I don’t meet or talk to most of the authors personally. My guess would be that the percentage is considerably higher than the general population, but that’s just my educated guess.
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Good one! Except in this case, there is unfortunately no “safe word.”
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Shouldn’t it be the responsibility of the “scientists” involved to prove that antipsychotics DON’T damage the brain? It seems the evidence is sufficient to suggest strongly that they do. That should be the end of the story.
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I know what you mean. I was just being flippant, as I have a tendency to do. Naturally, if a person has experienced lots of rejection over his/her life, rejection by psychiatry will at least initially feel like other rejections. It is to be hoped that over time and with education, a person might come to understand that s/he may have “dodged a bullet,” but it is hardly reasonable to expect a client to see this up front.
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I hadn’t thought of cat litter, but that could be another application! 😉
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Most of today’s “mental health professionals” are not able to help, either from lack of humility or fear of retaliation for bucking the status quo.
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I would suggest that a doctor should not be prescribing anything with which s/he is not familiar enough to give informed consent.
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Of course, denial of services IS a reward, when you think about it.
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You could save on toilet paper…
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Well, there is a definite association between flower arrangements and funerals… Hmm….
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There was a lot of guano in that particular office!
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I fully acknowledge that the overwhelming majority of people in the “mental health” field should be doing something like flower arranging that doesn’t involve pretending to “help” people. The humility to accept feedback is a very rare commodity, and seems to be becoming rarer as the years go by.
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If you’re referring to Bradford, I don’t think he would in the slightest be able to be catetorized as one of “those white men.”
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I agree. It is the psychiatrist who should make certain that any such interactions happen in a non-threatening manner for the PATIENT! Te psychiatrist has all the power, and expecting the client to protect the psychiatrist’s ego is very much like expecting the victim of an assault not to upset his assailant too much for fear of “provoking” further attacks. The person with the most power is the most responsible for creating a safe atmosphere for discussion. If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.
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What an idiot! Anyone asking someone else to throw a chair at her deserves to have a chair thrown at her.
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I went to a counselor one time. I told him I would feel angry sometimes when I got home from work. He said, “So you get angry when you come home from work?” I said, “Yes, I just said that!” He was like a freakin’ parrot! Just repeated back what I said to him, and then invited us to join his church. At least he didn’t “diagnose” me. I’d have had to tell him what my “diagnosis” was and no doubt he’d have repeated it back to me. How can people feel OK taking money and not providing a service of any value? I mean, they have to know that they aren’t helping, don’t they?
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I wonder what she would have said if you’d asked, “And where do YOUR traits come from?”
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Wow, great post! Could not have said it better.
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How about, “You may not improve, but our investment portfolios sure will!”
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Don’t worry, I did not moderate the comment. It happens all the time!
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I don’t have any comments from you in moderation, Bradford. Email me if you are still getting this message, with the link, so I can see what’s going on.
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Perhaps instead of saying, “Opposing corruption in psychiatric science,” we could just call it “opposing psychatric corruption posing as science.” As I commented in another post, it’s a pretty big stretch to even use the term “psychiatric science.” It’s kind of an oxymoron, because if psychiatry were at all interested in science, it would have to tear down the entire structure and start over again.
Unless they mean the “science” of making lots of money through clever marketing of destructive ideas…
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It seems to me that the conclusions, as usual, were dramatically soft-pedaled compared to the actual conclusions one ought to draw from this. If the most experienced professionals in the field can’t draw a common conclusion from the same data, there are only two possible conclusions: SPECT scans or PET scans actually tell us nothing significant or meaningful about the brain or its functioning, or that the people analyzing the data are either so incompetent or so utterly biased as to remove any possibility of gaining any reliable intepretation of ANY data from these scans, at least as far as “mental health” is concerned. Or both may be equally true.
These people are taking in millions of dollars, including our tax dollars, doing worthless research and making claims that are not substantiated, otherwise known as LIES. This is a dire situation and calls for a complete reconsideration of the value of spending significant money on what is either a fraudulent field or one in such a stage of infancy that nothing of value can be expected for decades to come. Particularly given that such studies are granted such high value and yet are almost worthless, these studies are contributing confusion rather than knowledge, and should be discontinued or else relegated to a very cool back burner while somebody figures out if there is anything of scientific value that will ever come out of this kind of study.
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I see no alcohol wipes, no blood drawing equipment, no stethoscopes, not even a blood pressure cuff or thermometer or a scale. Usually just a desk, books and a filing cabinet. Pens, papers, coffee, whatever, but no sign of a medical exam being even a possibility. And clients I’ve spoken to almost never report any kind of medical workup, and most that do are sent to someone or someplace else to do it. Psychiatrists don’t do medical exams in the vast majority of cases, based on my observations and data.
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Having an open mind includes being open to the possibility that other people have experiences you have not yourself had or imagined. Remember that we’re not only dealing with withdrawal here, we’re dealing with brain changes that happen over time and take a lot longer to heal than simply removing the drug from the system. Meth, for instance, should be out of the system within a couple days at the most, but the consequences of bathing one’s brain in dopamine for years are evident in a range of difficulties that can last months or years after the last dose.
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Power dynamics really are the ultimate problem, which Mirandizing the potential victims does not resolve in any way. It might just let a few more people escape from knowing what they’re up against. But I’m sure it would only stop a very small proportion of the current batch of forcibly “hospitalized” people (inmates). At the least, giving such a warning would be an acknowledgement to the larger society that we are not talking about “treatment” when we lock someone up.
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Isn’t saying “fraud in psychiatric science” redundant? In fact, isn’t the term “psychiatric science” itself an oxymoron?
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I’d say it is an extreme rarity that any psychiatrist performs even a rudimentary medical exam. They don’t even seem generally to have the equipment to do so in their offices. It’s clearly not an expectation, which says a lot right there.
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It sounds like you found a bunch of things that helped you move forward. It also sounds very clear that “medical intervention” was not one of those things, and was in fact worse than a waste of time, it did overt harm.
People need to hear these stories. Thanks for sharing yours!
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I think it is very possible to have therapy of many kinds without a doctor/psychiatrist’s involvement. And I don’t think it’s a problem of “inadequate training.” It’s more a problem of following a completely false and destructive model, which they are very adequately trained to apply. The model they are applying is the problem, as it is based on the ideas that 1) behavior outside of the “social norm” indicates a “disorder” just because it isn’t “normal,” and 2) that any such manifestation must indicate a physiological problem with the person acting that way, since apparently everyone should be moderately satisfied to moderately dissatisfied with the current status quo, and anyone who has more extreme reactions is defacto “ill.”
I don’t think ANY positive change can be possible when operating on such a nihilistic and destructive model of the human mind and behavior. As long as no agency or decision-making capacity is assigned to the client, there is nothing that psychiatry can do but destroy lives, and it does that very well, indeed.
And “insufficient numbers of psychiatrists” would not be on my list of things to be fixed. We have far too many, and they appear for the most part to wreak destruction wherever they go. The average 12 year old has a better grip on how to help a person in distress than the average “DSM-trained” psychiatrist. At least the 12 year old would have the sense to ask a person WHY they are sad, instead of blaming it on his/her brain!
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I would say any time the “professional” is considering the possibility of “hospitalization,” it becomes an assessment. If someone asks questions that lead them to decide you need to be “hospitalized,” and they haven’t warned you they were “assessing,” none of that data is useable for petitioning the court. It’s thrown out, just like an illegal search. And no one gets to “prep” the official “assessor” with any lead-ins, like “He’s my patient and I’m really worried about him,” or anything like that. Just facts, with any self-disclosures eliminated that have not been “Mirandized.” That’s my thinking.
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Ping pong can be therapeutic, at least temporarily, but one doesn’t have to go to the psych ward to get it, just the garage or basement of a middle-American teenager’s home. It boggles my mind what they are able to pass off as “therapeutic!”
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I don’t know that it’s true, but it should be true.
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Those who are pretending but don’t have an actual grasp of their subject are always threatened by any person with real knowledge and understanding, as they know they are always vulnerable to being “outed” as the charlatans they are.
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And sometimes, they think YOU are the weed!
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I have seen this many times. A staff person puts hands on a kid in residential “care,” the kid reacts by slapping his hands away, and they say, “The patient assaulted the staff.” The reality is, the staff assaulted the patient, and the patient defended himself. But history is written by the victors, as they say.
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I think what you just said agrees wholeheartedly with the concept that “mental illness” is a metaphor (“Thus a mental “illness” might be called an “illness” just because there might be certain behaviors connected with it that mimic physical illness, like expressions of pain.”) With which I agree, but my reasons for not using the term “mental illness” still stand. It adds confusion and makes it easy for the psychiatric industry to continue to convince people that they need to see a DOCTOR, rather than a friend or spiritual guide or wise elder or another person who understands what it’s like to be in your circumstances.
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How about “dangerously irrational?”
But of course, his “illness” lies to a large extent in the society in which he practices. His behavior is sanctioned by the social mores of the time he lives in, so he is considered “sane” while his victims are considered “ill,” simply because he pronounces it is so. This “illness” would not be possible without the huge power imbalance he enjoys. So again, if the psychiatrist is “mentally ill,” what is actually ill? Him? His theories? His group (psychiatrists)? Society at large?
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Let me ask you this. From a purely personal viewpoint, what do you think a “mind” is? Is it a part of the body, a section of the brain? Is it an outgrowth of the brain, like a computer program creates images on a screen that are not understandable in terms of the structure of the computer? Is it something external that resides in the brain, a spiritual entity? Or an interface or control mechanism for running the body?
If the mind is NOT a part of the body, what would it mean for the mind to be “ill?” Can the concept of “illness” extend to a spiritual entity? Certainly, distress is obvious, as is happiness or confidence. But is lack of confidence an “illness?” Or is it a lack of an ability to believe in oneself? If we’re talking about beliefs, it’s hard for me to see beliefs or ideas or even spiritual entities as having “illnesses” in the same sense that a body has infections, cancer, broken bones, etc. How can a mind be ill if it is not a part of the physical universe? And who would decide what “ill” would mean?
The other point I made already is that the term “mental illness” has been utterly claimed at this point by the psychiatric profession and their allies, and is fully associated in the public mind with “brain disorders” or “chemical imbalances” and such. To me, it makes no sense to use a term that feeds into the hierarchy of psychiatric dogma, as it is way too easily misunderstood or misappropriated. I much prefer to speak of “mental/emotional distress” or “suffering” or “confusion” or “altered perceptions” or “sadness” or “worry.” You may think it is splitting hairs, but in terms of reclaiming power from the “mental health professions,” I believe discarding this very confusing and coopted term is essential, regardless of what other considerations exist.
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People hate to admit they’re wrong, especially when they’re making handsful of money at it!
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I agree that “mental illness” at this point is such a tainted term, it can’t even be referred to in the metaphorical sense without instant connection to the DSM and all the stupidities inherent in assuming a “real disease” is present and exists in the brain. It is a term that needs to be tossed and never used. For certain, people experience confusion, illogical urges, emotional distress, even experience seemingly unavoidable sensations, voices, etc. that other people don’t perceive. None of this implies “illness.” It might very well imply some sort of causation, which in SOME cases COULD be physiological, but the idea that we lump all “depressed” people together as having an “illness” that needs to be “treated” is reductionistic and scientifically invalid.
I very much favor the idea of simply describing what the person is experiencing and going from there. “I feel hopeless and am not sure why my life is worth living” is something I can related to. “I feel like killing myself because I’m mentally ill” is not something that I can find any shared reality with. It doesn’t really mean anything. The first one allows that a person is doing something and can potentially take action to remedy the situation by answering some of these difficult questions or refocusing his/her attention on meaningful activities. The second implies powerlessness and lack of agency, and that for me is enough reason to bag the idea of “mental illness” altogether, bad “science” notwithstanding.
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The only thing “known about mental illness” is that there is no such thing. Not saying there is no mental/emotional suffering, but it’s not because a person is “ill.”
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Well said! If you can’t convince them, drug them. If that doesn’t work, electrocute them. Sounds like a great plan if you’re tying to immobilize your “patient!”
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Failure that makes you enough money is reframed as “success!”
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I so agree. I think a “Miranda”-type warning should be given to anyone undergoing such an “assessment.” “You have the right not to say anything or answer my questions. Anything you say can be used against you to lock you in a psychiatric ward against your will. You have the right to have an attorney present during this ‘assessment.'”
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THAT is what I’m talking about!
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“Random specificity!” Nice one, Bradford – you nailed it! “Precision” and “psychiatry” don’t even belong in the same paragraph, let alone the same phrase.
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New title: “The use of induction of grand mal seizures by electrocution should no longer be allowed or justified through pretending it is some sort of ‘treamtent’ when it is actually electrically-induced brain damage.”
Or “Induction of seizures is not ‘treatment.’ It is intentional brain damage.”
There are many other options, but you get the idea.
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“How can we improve things?” How about not arresting people every time they display distress or mention feeling suicidal? Just for a start?
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Holding that cognitive dissonance at bay does bring in the bucks!
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I love this – when we use proper mathematical analysis, the findings are “no longer valid.” Meaning they were NEVER VALID in the first place! Isn’t the real conclusion, “The findings were fraudulent, as the researchers used inappropriate methods to draw the conclusion they wanted to find?” Why not call a spade a spade?
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Me, too! In fact, being rejected by the mainstream adds at least one star to a person’s review, especially in the “mental health” field!
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The Buddhists would say that acceptance of what currently is would not at all be incompatible with changing what is for the future.
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I agree with you, except that a professional degree alone doesn’t convey the privilege of being heard – that privilege quickly evaporates as soon as you challenge the necessary status quo belief system, as Peter Breggin, Fred Baughman, John Read and many others can attest.
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Laughter is, indeed, the best medicine. I heard of a program in the Eugene area where people suffering from mental/emotional distress (I don’t believe they have any “admission criteria” except that you’re feeling like you could use some help) get trained and supported in doing standup routines as a means of helping them. It sounds like a lot of fun!
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Well, by all accounts, sneaking in wouldn’t be very difficult. “Empty, hollow, thud.” (The Rosenhahn Experiment.) The challenge would be getting the phone in. Perhaps one might find a staff person who is concerned about abuse who is willing to assist. Inmates get phones and drugs and other contraband inside jails, and it’s usually with the help of the guards.
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Or screw telling them at all, and get it published by some media outlet or other, maybe in a compiliation with others who have had similar experiences. If you tell a psychiatric “professional,” they’ll most likely tell you, “Well, if you got better, you must have been misdiagnosed, since we know no one gets better from that without our drugs.”
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Yeah, the placebo effect kind of refutes the “brain disease” concept all by itself. But most psychiatric researchers view it as an annoying impediment instead of real and meaningful data. If a third of your cases can resolve based on BELIEVING that they’re going to resolve, it sounds like there is something pretty powerful about believing things that affects the entire body and all its systems! But it’s hard to make money off of that kind of data, and it keeps making their drug trials look bad!
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More like of the staff’s “right to privacy,” aka right to evade responsibility.
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Maybe we need to put up some videos of someone being “restrained” in a psych ward, or someone in four-point restraints, or someone before and after their last Haldol injection.
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And I agree, Boans is pretty darned funny, though I think half his jokes go over most people’s heads. He’s very subtle sometimes!
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I actually have a stand-up routine I’ve worked on and am about ready to try out next time “open mic” nights are a thing after COVID.
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Hi, Furies,
Not sure I said what you think I said. I have no problem with the term PC. It was objecting to it being turned into a term of hostility because it undermines what was a very legitimate effort to look at the purpose and effect of certain terms from a perspective of power in relationships. But that’s what the term has come to mean, and it is used that way, and everyone understands that. So I wasn’t criticizing you or anyone else for using the term. I was only observing that the real purpose of looking at “correcting” language wasn’t to make people wrong, it was to address issues of inequality, and it’s been coopted to another purpose by those in power who don’t want the power dynamics to change.
I’m sorry if you got the impression I was criticizing you. I was not, not at all.
Steve
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And lust is a no-no for women, too. Don’t want to be called a “slut” even in these “modern” times!
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Wow, who would have GUESSED that feeling like killing oneself could be related to unmet needs? Such radical thinking! Just when we were all convinced it was a brain disorder that had nothing whatsoever to do with the person’s place in the world and experiences!
It is sad that such research is even needed. Seems to me kind of like discovering that “based on interpersonal theories of infant communication, crying in babies is often caused by unmet needs for food and nurturance.”
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I agree. It appears to me to be a term that has been appropriated and turned into a negative. It is unfortunately true that a lot of shaming has gone on in the name of “political correctness,” but in reality, words have great power and choice of language generally frames both what people see as the problem and what solutions are to be considered.
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MIA is a news magazine. It operates on a skeleton staff and accomplishes an amazing amount with a tiny budget and a lot of volunteer work hours. There is no bandwidth to start creating other organizations, but of course, if readers see such a need, they are encouraged to come up with ways to make it better. We put the information out there for others to use in whatever way seems productive to them.
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Way to see the silver lining, O.O.! You’ll be feeling better in no time, and you can help cheer up your jailors, too! After all, they’re just caught in the capitalist system, trying to survive like anyone else. Give ’em a smile, and next time, they may smile right back at you!
OK, that humor’s getting a little too grim, even for me!
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I agree, most people go to NAMI because they need support, just like most people go to psychiatrists because they feel desperate and are looking for answers. But the organizations themselves have to answer for being corrupt and misleading people intentionally, because that’s what they do.
NAMI is a very interesting phenomenon. There are plenty of people who go to NAMI genuinely looking for support, and some even find it to some extent. There are also a good segment, by my observation, who go to NAMI to be absolved of responsibility for any contribution they may have made to their child’s distress, and these are the ones who really grab onto the “bioligical brain disorder” terminology and ideology. The people in the second group, I have found almost impossible to talk to, because their identity is very much tied up in blaming their child’s brain for everything, which means toeing the party line on the “liftime brain disorder” and “drugs for life” concepts.
I truly wish there were other places for families to go for support. I mean, there ARE, but NAMI pretty much has taken all the air out of the room so any such effort is generally small, local, and relatively unknown (sorry, bad pun there!) And it becomes a real problem when families really do need genuine support and they get a choice between NAMI and nothing. But the needs of family members are very different than those of the survivors of psychiatry, and in all too many cases, those needs conflict too strongly for both to get support in the same venue. Open Dialog appears to make an effort to bridge that gap, which I’m sure can be very helpful in many cases, but it’s also generally not available, and depending on the family members’ attitudes, might or might not provide what they needed.
It’s a problem, for real.
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I don’t disagree. It is amazing how many normal activities are coopted into “therapy” so that someone can charge you for it and still maintain the fiction that they are “treating” some “disease state.” I get apoplectic when they start talking about “mindfulness” or “exercise as therapy” and that kind of nonsense. “Therapy” appears to be anything that can be marketed to convince people that someone else has an answer to their problems.
My point in that comment is that people in the “biz” try to come up with some magical “therapeutic school” such that if everyone does this, their clients will all get happy. And of course, whenever the client does not, they are “treatment resistant,” because our “treatment” is “evidence based,” so any “failures” are the fault of the client, or the “disease.” It’s 99.9% hogwash. Deep breathing isn’t therapy. It’s breathing. Available to anyone for free.
When I was a “counselor,” I had the great advantage of having no training whatsoever to be a counselor. So I basically just listened to people and tried to understand their issues, and occasionally came up with an idea or suggestion for them to consider at their own determinism. There was no need for a “school of therapy,” I considered myself just another human being who had somehow earned the privilege of their trusting me with their thoughts and feelings, and I acted accordingly. If that’s “therapy,” then “therapy” is pretty much anything that someone finds helpful in confronting life. The idea that telling everyone to “change their thoughts” is somehow going to produce uniform results is stupid. Just be human. That’s what people need.
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Your comment is very welcome, and thanks for sharing it!
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I always thought of CBT as a technique, not a “therapy” by itself. It works great in some situations, and is awful in others. Works really well for some people, others find it intrustive and invalidative. Any therapist worthy of his/her fee would adjust his/her approach to the person in front of him/her. The best therapy is what gets the person you’re working with to where they want to go. Rigidly applying one technique as the be-all and end-all is a sure sign of incompetence.
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I think this is a great clarification. Allies can be ESSENTIAL! But only if they are supporting the survivors. And as long as the power disparities exist based on race, class, education, etc., there will always be an awkwardness in negotiating this kind of advocacy.
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Sam, I really DO think the way you describe your approach is an exception. Most family members are neither committed nor skilled enough to find a way to either elude the “helpers” who “know better” or find people who actually CAN help or develop his/her own approach. Family members most defintely CAN be incredibly helpful, but as often as not, they can also be incredibly harmful, and are sometimes the very reason the person was traumatized and overwhelmed in the first place. So it is possible, even likely, that there is some bias toward distrusting family members who claim to be “here to help.” Personally, I think each person is different and should be considered individually. But I’m in general agreement that the voice of the person ostensibly being “helped” has to be raised above that of any family member, however well intended, because in the end, that is the person who has to live with the results of any “helping” that is going on.
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Being locked in a dungeon and being fed barely enough to survive on just so they can come and torture you every day is NOT the cause of your depression. It is your INTERPRETATION of your circumstances that causes your depression.
Think of positive things: what can you be thankful for today?
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Who can argue with that logic!
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But being OK with your “symptoms” is a sign of Anosognosia, so if you’re OK or not OK, they still think you’re nuts. Oh, oops, I mean “experiencing mental health challenges.”
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Thank you, Richard! LOVELY post!
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Thank you for sharing your struggles and your success! I so agree with you about the world that we men have created!
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Somehow, the irony of banning walking in a health class seems to be lost on our good adminstrator!
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I’m not saying at all that he didn’t say that, just that I am not sure it means what you think it means. I don’t think you are casting aspersions, either. I just see the logic in the decisions he’s made, and the effect it has had.
I did check the mission statement, and it is a “reimagining” statement. So it may be you are right. But I’ll leave it to Bob to say.
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This is NOT me as moderator. I will let Bob answer for himself on this, but my view is that this is a misperception of what he has said. For sure, he wants to be seen as scientific and objective, and I think the pursuit of disseminating information and letting people draw their own conclusions from it is the most effective way to make that happen. And I certainly see that his work AND MIA has had a huge impact on causing people to question the dominant paradigm, more than any other person I can think of. I think his impact speaks for itself and I have certainly not accomplished 1/100th of what he has, so whatever approach he is taking, my hat is off to him.
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Posting as moderator: I do want to point out here that MIA is not taking any specific point of view regarding reform vs. abolition. MIA was created as an alternative news source to put out any and all information that questions the validity of the current paradigm of care. It is not intended to take a political position on an antipsychiatry vs. critical psychiatry viewpoint. It is intended to encourage discussion of a range of viewpoints that are not normally made visible, and to allow voices that are normally silenced to be heard. As such, MIA is not taking any particular viewpoint supporting or opposing the abolition of psychiatry. That is up to the readers to determine for themselves.
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Exactly. Mainstream schools are a positive for a small minority of kids, I think. Most are bored to death, feel resentful of the many restrictions on their activities, feel restless and anxious to do something of their own choosing. Bullying and shaming are generally epidemic, often due to institutionally approved bullying by school staff.
I remember very well being in 6th grade on the last day of school. The last 5 minutes, no one said a word. We had a clock on the wall that had no second hand, but which gave a buzz 4-5 seconds before moving to the next minute. As we went through the last minute, the tension was palpable. The clock buzzed, the minute hand ticked, and the bell rang. Suddenly, pretty much every kid in the room stood up cheering in joy and picked up their stuff and ran out of the school as fast as they could go! If school was such an appropriate and helpful place for kids to learn, why was everyone so elated and relieved to be allowed to escape?
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In “mainstreaming,” there is an unspoken assumption that adaptation to the “mainstream” is good, and that the “mainstream” way of “educating” kids is the ideal, and that kids who can’t manage that are “special education.” I disagree with all three of these assumptions. I think that “Mainstream” schools are actually quite damaging, both educationally and emotionally, to a majority of kids who attend. The lack of creative alternatives condemns all of our kids to this unproductive and at times destructive “mainstream.” When kids can’t manage it and fall out for one reason or another, it should be a sign that this “mainstream” is not working for these kids and that there is a need to approach them differently. But instead, we assume that the child is flawed for finally letting us know that our system doesn’t meet their needs. How many kids are in the “mainstream,” suffering every day (as I did) and yet swallowing their needs and “fitting in” to avoid punishment and humiliation?
Assuming “mainstream” schooling is healthy or appropriate allows schools the luxury of not confronting or improving on their failures. They can blame the child and keep on doing what they are doing. It is very much analogous to the assumptions of the psychiatric worldview.
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You make an excellent point!
Plus, people probably DO feel better when they take Ketamine. Until they stop taking it. Or until they become addicted and tolerance builds up. That is not a solution, even if the study WERE really double blinded, and really were positive for Ketamine.
I could do a double blind study for alcohol, and I guarantee that alcohol would show significant anti-anxiety properties. There is no doubt about it. But does that make it a “treatment” for anxiety? It is ancient history that taking substances can alter one’s mental state temporarily. Is this really all that has to be proven for a drug to become a “treatment?”
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People come out worse from psychiatric interventions all the time, and it is almost always blamed on “the disease”, aka blamed on the “patient.” Take a look at “treatment resistant depression.” All it means is “our approach failed.” But rather than take responsibility for failing and looking for another approach, they blame “depression” for “resisting” their “treatment.” It is a pervasive tactic that absolves the psychiatric “professionals” of any responsibility no matter how much worse the “patient” is upon release that at admission. It remains baffling to me that this is not obvious to more people who watch the process.
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I think you’ll find Oldhead in particular agrees with both of us that the difference between “mind” and “brain” is vast, and that psychiatry’s efforts to equate the two are at the center of the deception or idiocy, whichever we consider it to be.
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Not fringe at all in this community. You are largely preaching to the choir, I think!
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I think it means that they have given up on testing on drug-naive patients because 99% of the patients they deal with are or have been drugged, usually with multiple drugs. A pretty weak argument scientifically. Reminds me of how they used to say they can’t ethically have “control groups” with “schizophrenia”-diagnosed patients because it would be unethical to deprive half the group of their wonderful “treatments.” Even though their odds of recovery would improve as a result. Go figure!
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Your conception of my reasons for leaving the MH system was quite accurate. No need to apologize. I want people to know why.
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Yeah, we don’t want those poor pills to feel bad!
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Hey, they give us two whole weeks to get over our spouse dying. That’s pretty generous, don’t you think?
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When I worked at a crisis line, we used to get calls all the time from people who used cutting to cope. They said they could not tell their doctors or therapists because they’d be hospitalized. They were uniformly NOT interested in killing themselves, they used it as you describe, as a way to reduce tension or frustration or pain. It was clear to me that it met a need and was not specifically dangerous, so enforced “hospitalization” even by their own “danger to self and others” standards didn’t apply. I found it quite ironic that they were doing “therapy” with people who could not handle talking to a person who used cutting as a a means of coping with a difficult reality. How could any therapist be helpful if they aren’t actually safe to talk with?
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We can’t change the system? Really? We ARE the system! What an apathetic approach she is promoting!
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And that figure of 60-70% is still valid for those living in “developing” countries where they haven’t yet discovered the wonders of “modern psychiatry” and don’t hand out drugs to everyone who has any kind of difficulty.
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Posting as moderator: Just a reminder that most MIA articles are either already on the internet or are submitted by folks who are telling their own stories or summarizing their own research. MIA doesn’t decide whether the author uses quotations around certain “mental health” related terms except when it is an article published by MIA itself.
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I question the use of the obfustacory term “problemetized.” Why don’t we just say the image of ‘schizophrenia’ as a “Chronic life-long disease” was disproven? Or shown to have no scientific basis? Or exposed for the subjective and prejudicial term that it is? Or something like that.
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Yeah, I always feel like killing myself when I feel better. What kind of nonsense is that?
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I don’t mean to be disrespectful in asking this, I’m interested: What do you see as non-biological psychiatry? If there is no physiological disease state, what purpose does a medical doctor have in this area?
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They do. I used to work with foster kids and I always attended foster youth panels where the kids presented on what THEY thought should be different in the system to make it work for them. At one such meeting, I asked them what was good or not good about their “mental health” support. They talked a bunch about therapy but not a word about “medication.” When the topic came up later in the discussion, it became clear that they did not see “medication” as a “mental health treatment” but as a means for adults to manage “bad” behavior. They understood it as something that happened if you acted out and the intention was to stop you from acting that way. They knew intuitively that it had nothing to do with their health, “mental” or otherwise.
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Sounds like your fellow pupil is way ahead of many of the “mental health professionals” I have known.
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That was my immediate take – we have to STUDY to see if playing games and interacting positively with other people and eating well are going to be helpful? And yet “ECT” is considered “helpful” until proven otherwise???? Some people really have got their priorities out of whack!
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Many have still not admitted it, even though it says exactly that on the label.
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“Moving cars are a “risk factor” for broken legs, but clearly, there is a biological vulnerability for people whose legs break when hit by moving cars, because after all, not ALL people who get hit by cars break their legs, so there MUST be something different about those “weak-legged people” who just can’t take the hit and keep on walking!”
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They always were cultural categories. The kids just understand that intuitively.
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Of course, that begs the question of how any person could be determined to “have a mental illness” when these “illnesses” are clearly subjective judgments about a person’s behavior or character, without any objective way to determine who does and doesn’t “have” these spurious “disorders.”
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Ever see the movied, “What About Bob?” with Bill Murry and Richard Dreyfuss and Julie Hagarty?
“Death therapy, Bob! It’s a sure cure!”
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Most people would allow that electrocution and grand mal seizures would be things that anyone would want to avoid at any cost. It shows how utterly distorted the world of psychiatry is that opponents of “ECT” have to do anything at all to debunk the obvious harms that inducing a grand mal seizure would create. People who have near-death experiences often recover an appreciation for the fragility of life and make big changes to make their lives more meaningful. Does this suggest we should push people in front of cars as a form of “therapy?”
I also doubt the patient ratings are reliable. After 3-4 “treatments,” I’m guessing most of the “patients” are very much inclined to say, “I am feeling SO much better! I feel COMPLETELY cured! Now, can you please open that door and let me the hell out of this place?”
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I think we would have to create a bank of lawyers who were serious about enforcing the laws, not the “reasonable” lawyers generally employed in these roles today. Of course, some of these lawyers would be excited to actually be able to defend their clients and would be happy to step into the new role. But it would mean hiring lawyers who would actually be willing to challenge the system. It would also mean collecting stories and data to change the laws so that they are enforced and effective. It would be a big change from the status quo.
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Of course, they’ll feel threatened. Because they know the truth is not on their side.
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Just for clarity’s sake, there are most definitely therapists and other “mental health” workers who do not bill insurance companies.
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Fantastic link! Everyone should read this.
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Are psychiatrists really challenged by this question? It seems likely there will be no actual research into what happens or why. Perhaps the challenge they don’t want to face is why more people will suddenly qualify as “mentally ill” when it’s all supposed to be a “biological brain disease.” But we know that no one will really challenge them on that point except their “patients,” whom no one will listen to, because, after all, they are “crazy.”
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I would add that the “overreach” is driven by intentional bias in the direction of making genetic explanations stick even when there is no or only circumstantial evidence for them being true. This, in turh, is driven by both professional and financial conflicts of interest, as there is more profit to be made and more responsibility to be evaded by those in powerful positions if the “biological explanation” can be propped up enough for people to buy into it.
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An excellent point, I’m afraid.
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Not sure how I can help. I think you expressed yourself quite admirably!
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On the other hand, some people won’t make it to the doctor to get “evaluated for depression” and hence will not start on SSRIs or other such drugs, which may bring the suicide rate down. I know a person who has gotten off of antipsychotics because the doctors were unwilling to come to his/her home to administer it. This person is doing quite well in the aftermath, despite trying many times to stop in the past without success. I’m using s/he construction to obscure any guesses at the person’s identity.
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That MUST be it… I mean, he was alive in the 70s when the DSM III came out… maybe it IS his fault. But wait, NOTHING is his fault!
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How about “People who run afoul of the “mental health system” in “developed countries” are more likely to be worse off than if they were left alone.”
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So I guess I am a “danger to self and others” if I choose not to wear a mask while hiking, even when all data suggests that casual outdoor contact between individuals is essentially never going to result in transmission?
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I guess it seems like a sneaky way to suggest that somehow Covid19 and “harm to self and others” are connected. I guess as I read it again, the implication is that people with “serious mental illnesses” could be incarcerated because they are judged as too stupid or incompetent to take proper protective measure against Covid19. Which is, of course, is ridiculous, because COVID19 isn’t necessarily dangerous to everyone, and because the fact of someone “having a mental illness” is probably completely unrelated to their ability to protect themselves in the first place. Hey, people with “OCD” characteristics or who are afraid to go out of their homes would actually be at an advantage! But naturally, they can’t just come out and say what they mean, they have to raise fears by vague generalizations. That guy is a dangerous person! He is a “danger to others” with his whacky ideas!
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“• PROVIDE GUIDANCE ON INTERPRETING STATE CIVIL COMMITMENT LAWS TO RECOGNIZE THE RISK OF CONTRACTING OR SPREADING THE CORONAVIRUS AS A FORM OF “DANGER TO SELF OR OTHERS” AND A BROADER INTERPRETATION OF “GRAVELY DISABLED” THAT CONSIDERS COVID -19.”
Does that sentence even make grammatical/syntactic sense? Sounds like gobbledygook to me.
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It is hard not to “blame the field” when they have plenty of information, from research science to individual testimonials to epidemiological statistics that says their approach is failing, yet they continue to attack those who speak the truth and to promote the failed model despite these facts. Who else is to blame?
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There used to be a crisis line whose name was “Let’s talk.” It seems like such an obvious thing. What do you do when you see a car wreck? First thing you do is tell someone, go over what happened and how you felt, they ask you questions, etc. It’s what you do when something scary happens. It is only massive propaganda that has moved people away from this basic, intuitive understanding of what people need from each other. Any “therapy” that isn’t primarily based on listening should be immediately shitcanned!
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Well, there have always been suicides, but it appears that using “medications” can make people kill themselves or want to who never had that impulse before, that’s for sure. How SSRIs ever got the reputation for being helpful for suicidal people is beyond my comprehension.
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I am afraid that is the real “benefit.” It makes people less inconvenient for the status quo to control.
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A sad comparison!
“Hospitalizing” someone for suicidal thoughts or plans is one of the most counterintuitive things I can think of. And someone PRETENDING you are suicidal is far worse!!!! I can’t imagine my rage – but of course, my rage would be “evidence of my disorder” and be held against me, too.
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In fairness, there are some rational helpers scattered about in the “mental health” system, and if you’re needing someone to listen and they have the capacity and skills and proper attitude to do so, it would be a shame to blot them out by generalization. On the other hand, Muhammad Ali used the analogy that if you’ve got a hundred snakes outside you’re room and 90% of them are nice snakes and only 10% are planning to bite and kill you, are you going to go out and check and see which ones you can trust, or are you going to just keep your damned door shut?
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Sweet! I want a copy!
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Yup. Nothing says, “I care” like handcuffs, a squad car, and being forcibly injected with mind-altering and body-altering drugs. Cheers me up every time.
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Well said! I like your comment, too!
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I LOVED the graphic! I am envisioning a potential client approaching a “professional” with this in hand. “Before I agree to share my feelings and experiences with you, I have a few questions I’d like to ask. First off, do you feel you are in a better position to know what to do that some of your client? Please elaborate…”
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Maybe that’s what they mean. Prepare them for the idea that they’ll have no power and be subject to the whims of those who control our society?
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Milton Erickson used to say that therapy has to be reinvented anew for each client. I believe he was absolutely correct. Labels only distract from the fact that all people have unique needs and strengths and that nothing is going to work for everyone based on some external characteristics.
There are some educational techniques we can use with kids who have difficulty communicating, just like there are approaches that work better or worse for kids who are seeking lots of stimulation or don’t like to sit still. But these are adaptations to personalities and personal needs, not “diagnoses” of “disease states.” Any kind of “treatment” requires creativity and a willingness to communicate with the person you’re trying to help, verbally or non-verbally. The rest is all window dressing, or more often, marketing.
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Scientists are supposed to be critical of everything. Skepticism is the core of good science. If something seems right, try every way possible to prove it isn’t. Only when you have eliminated all other possible explanations can a scientific datum be considered “true.”
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Yeah, apparently the staff aren’t yet capable of using rational thinking or socialization skills, either, are they?
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In the real world of science, “spectrum” always denontes a continuous range from one extreme to another. As much as people are defined as “on the (autism) spectrum,” a real spectrum has no defined point of differentiation except at the extreme ends. If there is a spectrum involving people, then EVERYONE is on the spectrum somewhere. I know that’s not how the word is used by most people in this context, but scientifically/mathematically speaking, that’s the nature of a spectrum. It doesn’t suddenly stop at a certain arbitrary distance from “normal.” The recognition that there ARE spectra of human behavior and emotion that exist around any definable “norm” is a very good thing, but deleting the idea that there are people “ON” the spectrum and those “OFF” the spectrum is really not a sustainable concept.
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I tend to agree. We don’t know in any case even whether it’s “neuro”, that the person is somehow neurologically different, nor do we know if that difference in a particular case is a result of any kind of abnormal disease process. There are probably some people “on the spectrum” who actually do have something physiologically wrong with them, but we don’t know what it is or how to differentiate those who really do have a physiological problem from those who simply act in ways that are unusual or that make some “normal” people unconfortable for some reason.
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Excellent analogy with “sex offenders.” A sex offender has committed a CRIMINAL ACT, and his/her label is based on that act(s). This is defined by law and enforcable with known penalties. A person who “has a personality disorder” is so labeled based on a general opinion of what some people have decided is a “problem personality.” Such a label does not require ANY specific act, it is NOT defined by law, or actually by even any objective meausrement at all, and the penalty can be whatever the people in charge want to assess, including incarceration on a more or less permanent basis, enforced drug-taking, public shaming, discouragement, being discriminated against in employment or education, and on and on. It is not in any way a legitimate analogy.
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Exactly!
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He also discredits anything, including “double blind studies,” that doesn’t fit with his preconceived agenda. In a word, he cherry-picks the studies that make him “right.”
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Remove it? NO WAY! Dumbledore’s wisdom is quite well placed on MIA. Thanks for “sharing a few words” with us!
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“I’m trying to track down on the study that allegedly shows that people avoid artillery ranges for fear of being blown up.” Gotta have a study before we decide things, don’t we?
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Very well said!
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I guess Covid19 has “unmasked their underlying mental disorders.” Sorry, bad pun!
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I would add that asking people questions, per the Socratic method or something like it, is a better way to lead people into making observations that conflict with their own assumptions than telling them they are wrong. Most people hate being wrong. As Albus Dumbledore wisely stated, “Most people find it much easier to forgive you for being wrong than they do for being right.” Or something like that.
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Where, indeed?
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My concern is not with fairness or unfairness to Donald Trump per se. My concern is that allowing “professionals” of any stripe to “diagnose” public figures reinforces the idea that “mental illnesses” CAN be objectively “diagnosed” and that these professionals have some inside knowledge that makes them more capable of validly assessing the capacity of a particular person to continue in the office of President. It empowers the DSM and its adherents in a way I find unacceptable, regardless of the reasons given. Since the author acknowledges early in the piece that the DSM “diagnoses” lack any sort of validity, the labeling process he is describing is no more nor less meaningful than any lay person getting together with another lay person and saying, “I think Trump is crazy!” Or “I think people opposed to him have ‘Trump Derangement Syndrome.'” Sure, any psychiatrist or psychologist has the right to come up with a descriptive label of Trump’s or any other President’s behavior or conduct, just as any other citizen has that right. We still have freedom of speech in the USA, last I heard. The question is, why should their label carry any more weight than the guy in the machine shop or the woman serving her country in the armed forces or the teenager trying to figure out what politics is all about? Why should a Ph.D. or M.D after someone’s name privilege them to provide a “professional” opinion regarding labels which the author himself admits are essentially fraudulent?
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It shows an incredible degree of defensiveness and insecurity. What’s the big deal about admitting that you don’t know what’s going on and are trying to figure it out? Or that you’re disappointed that the drug didn’t live up to its advertising? If a doctor cares more about patients than ego or income, we wouldn’t see this kind of behavior.
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As much as I dislike government bureaucracy and corruption, it is hard to see how government-funded researchers could do any worse than the current situation. What’s your solution? I’m interested in hearing your thoughts.
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Absolutely, in which case, the owners of the coal mine can be absolved from any responsibility – after all, it’s a “biological brain disease.”
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True enough. But the strange part is that they get away with it. I mean, who would take their car back to the mechanic who told them their car was “repair resistant?” He’d be laughed out of business in a trice.
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Hear, hear! It is the responsibility of the researchers to prove their intervention is safe and effective, not the responsibility of detractors to prove them wrong. If there is no proof that “depression,” let alone “treatmeant-resistant depresssion,” actually even exists as an entity, it’s pretty rich to accuse people of being “treatment resistant” just because you don’t know how to help them or are making them worse.
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“This coal is mining-resistant.”
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Well, they must have been misdiagnosed then, because we know everyone needs their “medication” for a lifetime!
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The concept of “treatment resistance” is utterly ridiculous. If I am being paid to fix a car, I don’t get to say the car is “repair resistant” when I can’t figure out how to fix it. It irks the crap out of me that they get away with this kind of nonsense. If they need a label, why not just say, “People who are not helped by our interventions?” Or why not just admit that their whole “treatment regimen” is guesswork and there is no actual expectation that any drug will necessarily be helpful?
Fava does some really important work. We need more researchers willing to challenge the status quo. But I wish they’d been a little more blunt about calling out the nonsensical and defensive nature of this entire concept.
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I agree completely. It is most definitely NOT equal for all!
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And I would submit that we all do have SOME power, however small it may seem.
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I was talking more about perpetuating and supporting habits, ideas and institutions through our training, mostly on an unconscious level. I contrast this to the idea that somehow it’s always “those other people” who are racists, sexist, violent, abusive, etc. Naturally, there are people who are more or less aware of these tendencies and are more or less active in combatting both the internalized and external forms of oppression, such as not allowing ourselves or others to blame “the mentally ill” or black people or even gun owners as the “cause” of violence, but instead reminding everyone that violence is possible in any of us, and its more frequent emergence in our society is not caused by some external force or group of “other people,” but is actually a function of the society in which we are all participating (however voluntarily or involuntarily).
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And there are a lot of other things one can do about sleep issues besides drugs!
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Yeah, apparently you’re supposed to be HAPPY that you’re physically ill or that your life may be in danger. God help us we should find it discouraging or overwhleming to have an actual phsyical disease process going on! Apparently we’re supposed to face pain and death cheerfully (but not TOO cheerfully – that would be manic!)
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We are also encouraged to group people into “those oppressive bad people” vs. “the rest of us,” rather than recognizing that all of us participate in some ways in maintaining oppressive systems. It’s easier to maintain the status quo if we can blame “those other people” for being the cause of the “bad stuff,” so we can pretend that if only we get rid of the “bad people,” the rest of us “good people” can get on with doing good. And of course, “the mentally ill” (as conveniently defined by the status quo) are often put into that scapegoat role of the “bad people” who are causing all the problems and need to be “controlled” for “their own good” or the good of society.
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I do like a spectrum approach to these discussions – it allows for variation without discrimination, and also includes the possibility that people who aren’t near the center of the graph can still have a lot to contribute that those closer to the “average” would not be able to provide. Ironically, every population biologist knows that diversity of phenotypes is the core of species survival – adaptation is only possible if there is a range of potential responses available within the species, and those who are too adapted to a particular niche are wiped out when change becomes necessary. As long as the concept doesn’t lump people into those who ARE and ARE NOT “neurodiverse,” I think it works, but we both know there are forces who can take any reframing and smash it back into two-valued “logic” for their own nefarious purposes!
Thanks for your thougts on this!
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The only problem I have with the concept of “neurodiverse” is that it seems to imply or could be thought to imply that there is a “neuro-normal” that describes most people. I don’t think that is the case. I think we’re all “neurodiverse” to a large extent. Unfortunately, our society picks on certain “neurodiversities” and condemns them, which is pretty sad. But I do get that normalizing “different” presentations is a very sane thing to do, and I totally support that idea!
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Word!
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B complex was always part of my hangover “treatment.”
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I think the biggest problem with even quality therapy is that it is not really the proper mode to deal with current or ongoing abuse or oppression. It can be valuable for a person to discuss the pain of living with a dead-end job, and may even help motivate a person to seek a better one, but it can’t take care of the question of why so many jobs are dull and lifeless and why so many people are forced to work in them for inadequate pay in order to merely survive to face another day. Therapy can be valuable, but it is limited and can’t really handle the bigger social issues with which our current Western society is riddled.
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Don’t you think the canary needs to understand and accept his feelings regarding being killed by mine gas? /s
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Yeah, I think I’d volunteer for that one. Except if you’re a kid, they might lock you in a “residential treatment home” until you learn to knuckle under.
The best diagnosis is “don’t know what happened to that guy – he seems to have disappeared.”
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Lack of long-term outcome data means you have no idea if your “treatment” is actually effective. Which means from a purely scientific viewpoint, your “treatment” is not legitimate. We assume something doesn’t work until proven that it does, not the other way around. That’s how science is supposed to work. Anything else is marketing.
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Well, of course, the algorithm is only as good as the programmer. I’m sure someone could program a discriminatory app. But at least they won’t have to manage their emotional reactions to our statements, appearance, etc. I’m sure they’d totally suck, because they’d be made by people who have no comprehension of what is helpful, otherwise, they’d realize that a computer can’t provide what is needed.
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Hey, people do it all the time. I was just making it clear that there is a difference between people calling someone names because they don’t like their behavior vs. calling someone official names with the power of a medical degree behind it. It’s still name calling, and I am generally opposed to name calling, as it is usually very unproductive and avoids planning to overcome the problem. But there is a very important difference in quality between being called a name by someone who is no more or less powerful than you are vs. being officially sanctioned by the medical profession to call people names as “medical diagnoses.” The second is far more insidious and destructive.
Hope that makes my point clearer. At least in the colloquial situation, we KNOW it’s a matter of name calling or generalizations with no scientific basis. No one is pretending that the other person “has” some brain problem or whatever. They’re just saying the othe person is a jerk.
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Right, the DTs are evidence of “their disorder returning” or “relapsing” and obviously indicates that they “need” alcohol in order to function. I’m sure many an alcoholic has used this very “evidence” to prove they “can’t quit.”
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Perhaps we sbhould entitle it, “The DSM was created by the psychiatric industry in order to lead us far astray.”
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You’re welcome!
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Nah, they just liked high school for some inexplicable reason. I guess maybe they would miss their friends, but I didn’t have that many, and in any case, I could still be friends with them absent the authoritarian regime. And that was in the days when we had MORE freedom in high schools, right at the end of the 60s “student rights” movements. Student rights have massively deteriorated since that time, in my observation, other than that physical abuse has been MOSTLY outlawed.
My high school was in suburban Philadelphia. Supposedly one of the top 10 public high schools in the country. And there were a lot of good teachers. But it was still school.
And there were still a few, like Mr. Mims, who probably belonged in jail. Even as naive as I was back then, I suspected he was sleeping with at least one of the students.
I guess I’m impatient with injustice and authoritarianism. Probably a “mental illness” of some sort. Otherwise, I would have loved being pushed around and bored and bullied and neglected and prevented from exploring anything not on the curriculum. What was wrong with me?
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Surviving trauma tends to make people “prickly!”
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“Narcissistic” is a colloquial description of a certain kind of behavior, kind of like “cowardly” or “noble” or “conscientious.” “Narcissistic Personality Disorder” is an alleged “mental disorder” that can purportedly be “diagnosed” by people with a “professional background.” What would you think if they diagnosed someone with “Cowardly Personality Disorder?” Wouldn’t that seem pretty far out there, to take a set of personality characteristics and call it a name and then claim it is somehow a “diagnosis?”
You could replace “narcissistic” with “childish” or “selfish” or “ill tempered” or “thoughtless” or “mean-spirited” and it would still just be a description of a person’s behavior. A description of a person’s behavior can not logically be a medical “diagnosis.” That’s the difference.
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OK, we’re “flying myopically”. Bit of astigmatism, that’s all. I can see ahead, but it still looks fuzzy to me!
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I remember they had an overnight party the day of graduation, with a hypnotist and dancing and punch and the usual entertainments. I saw different clutches of kids hugging each other, some with tears in their eyes, talking about how sad they were it was all over. I was thinking, “What high school did YOU go to?” I am sure that their experiences were very real to them and I admire them for being able to emote about them publicly, but it was TOTALLY unreal to me. I felt a huge weight off of me, along with the thought, “Wow, I’m free! Now what am I going to do with my life?”
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Not sure which “original comment” you are referring to. Can you provide more details?
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I think you’re making total sense. My point is only that there are, in fact, any number of imponderables, and it is possible, even likely, that some measures in place are not particularly helpful while there are others we will later learn we ought to be doing. We’re flying blind to a large extent, as there is not much prior experience to draw on, and we don’t have time to do controlled experiments. So “playing it safe” and reducing risk is probably the best we can do. But I do think it’s important to acknowledge (not saying that you aren’t) that our knowledge is limited and to some extent we’re making educated guesses as to what will be most helpful, which explains at least in part why at first we were told no masks, then we were told to mask up. New information is coming in and best practices will change as we learn more.
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Because traditional meditation approaches are grounded in Hindu and Buddhist spirituality, I see meditation as being utterly incompatible with psychiatry. “Mindfulness” is something appropriated from Buddhism without the nasty entanglements of silly questions like “What is a person?” and “How should I conduct myself on Earth?” and “What happens when I die?” Buddhism is based on the assumption that we are spiritual beings who suffer because of our own attitudes toward life, and offers a means of attaining greater peace and satisfaction through expanded use and understanding of our minds. Psychiatry teaches us that we are bodies, that there is no spiritual existence, that the mind is just a function of the brain, and that the mind is incapable of having more than a marginal influence on a person’s “mental health.” Meditation in every way contradicts the basic tenets of psychiatry, unless you go for “McMindfulness” that says you can sit there and breathe and it can calm you down. Which can be true, but it certainly misses the point, especially when people are told they HAVE to meditate or are shamed for failing to “succeed” at it.
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Do we know that reduction of droplets extruded reduces the likelihood of infection when distancing and surface sanatiziation and hand washing are all in effect? A recent study showed that outdoor transmission almost never has been shown to occur. So maybe we should only wear masks indoors? There are lots of imponderables, which is my point.
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Not only is psychiatry not intersted in what stress from the past is affecting us, they’re not even interested in what it is in the PRESENT that we’re finding upsetting! Apparently, we’re not supposed to ever be upset by ANYTHING, or else we’re “mentally ill.”
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If you have enough cash.
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It seems that only a certain number of comments in a thread can “nest” as replies, after which they are just listed one after the other, with no “reply” button. You have to go back up the chain to the last one that had a “reply” button on it if you want to continue on this thread.
I agree that there are things which are concretely known and some which are purely speculative, but there are also partly-knowns which have to be evaluated, and that’s where a lot of conflict occurs. For instance, it is known that COVID19 virus can be found in droplets in the air 2-3 hours after they have been deposited. But what does that mean? Are they still infectious at that point? Do ACTUAL cases get passed that way or don’t they? Is this important for people who are infected to prevent spread, or people who are trying to prevent infection in themselves? These are all questions that people are willing to weigh in on heavily, either shaming people for not wearing masks or dismissing the possible risks as nothing but hype. The truth is, we don’t know if masks help or not, or how much, or on whom. A lot of this stuff is guessing.
As to how Trump is handling all this, again, I think this subject is pretty well pooped out, and I’m going to ask more directly that the two of you move on from this subject, as it is now deteriorating into a more personal “thing” that is not productive.
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Polypharmacy is the usual term, but I think polypharmacology works just fine! Or we could just call it “masses of drugs tossed together willy nilly with no idea how they’ll interact.”
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Yeah, I was going to object that most of this stuff doesn’t even work on the white, Anglo-Saxon people that the research is done on.
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Posting as moderator:
I agree that this exchange has been interesting, but has perhaps reached as far as it can go. I think we’ve seen both perspectives fleshed out pretty thoroughly, and I doubt very much if either of you will sway the other. Part of the challenge of this set of events is the inability to know what information is reliable or not. I think this exchange makes that point very clear.
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“The problem is that common approaches to deploying AI tools are not improving outcomes.”
No, the problem is that common approaches to “helping” with mental/emotional/spiritual distress don’t improve outcomes, and no amount of AI is going to change the fact that the basic model of distress and helping is fatally flawed. Well, flawed unless your “outcome” is increased profits. Maybe that’s what they mean – AI isn’t improving income, therefore, it isn’t working?
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This study should not surprise anyone, except for those who like to keep their heads in the sand. Anyone with a modicum of experience in this area, first or second or third hand, knows that these drugs interfere with your thinking processes. The disturbing part is that this viewpoint would still be in any way controversial.
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I wasn’t so much bullied by peers as by teachers (we had some mean ones!), plus very lonely and bored out of my mind. I hated taking arbitrary orders from anyone, and still do. Particularly when I was smarter than most of the teachers and was always way ahead in almost every subject, which instead of counting as a positive made me a problem for them. The kids who liked school were the ones who had lots of friends, mostly, or the ones whose home lives were so bad that school seemed like a big step up. I was neither, and I hated every minute of elementary school. Junior high was only better because they had sports and I was a good athlete, and so finally got a few friends, too. When I graduated high school, I felt like the allied troops had freed us from the POW camp!
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Well, we wouldn’t want to get in the way of commerce, now, would we? What about the danger to the individual of a poorly-programmed driverless truck? Oh, but I guess actual PEOPLE would be expendable in this futuristic world.
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Plus ditching the daily commute HAS to be a big plus. And when I was a kid, I’d have given my eye teeth to be allowed NOT to attend school for ANY reason. I LIVED for summer vacation!
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That’s been my experience, both as a helper and as a “helpee.” These “disorders” are just a way of experiencing the world, and we have to be the ones to decide what is and isn’t the best way to approach it. Most of the time, people have adapted to difficult circumstances by developing a way of thinking about the world or interacting with the world that seemed to work at the time. So accepting that these thoughts/behaviors/emotions have served a purpose, and then asking oneself what purpose they continue to serve, has been a successful path for me. Others would frame that differently. But in any case, what is helpful is NORMALIZING the experience as part of your own process, rather than externalizing it and making it seem like “OCD” or “ED” is some external agent that is attacking you! It reminds me a lot of demon possession. Not saying some people might not find it helpful, but it sure seems counterproductive to me.
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A lot of science is also rooted in what is known NOT to be true. It’s a lot easier to disprove a hypothesis than it is to prove one unequivocally. The most certain data in science are which theories are absolutley wrong. Unfortunately, these days such vital information is often buried or at least not published. Especially when conflicts of interest are involved. Peer review’s job ought to be to poke holes in the methods or conclusions of the researcher based on the data. Unfortunately, that role is not always played fully by the reviewers these days.
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Wow, that seems titanically dumb! Give your “eating disorder” it’s own personality and power and indepencence, as if it were a separate entity. How the heck is THAT supposed to help? So you can tell your “ED” voice to go f*&k itself? Seems utterly idiotic! Has anyone ever seen this idea be helpful in any way?
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Sorry, can you define “sealioning” for me?
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If there are driverless trucks careening around the roads, they might not have to work hard to keep me from driving anywhere! Sounds like a scary scene to me!
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I think calling it a “disorder” IS shaming! THe non-shaming approach is to assume that it is a normal reaction to circumstances, or else a manifestation of a legitimate and observable physiological problem (lack of sleep, thyroid problems, etc.) It is hard to think of a much more shaming approach than to say your emotions mean nothing, your brain is broken, but there’s nothing anyone can do to actually fix the problem, it’s just you have an inherently bad brain. Tough luck!
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An excellent point. Though perhaps if it were scientific, it couldn’t be what it is – it would be something entirely different, because it ISN’T sceintific at all!
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You mean you can only be “normal” when you’re the one defining “normal?”
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A point I have always shared and agreed with. Corporations are a force of their own and are often subject to no government at all, yet can do as much ore more damage than any government, and many of the problems with government (though certainly not all) are due to their being in bed with Corporations and/or Crime. And I do see an increasing crossover between Corporate and Crime that also needs to be addressed.
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I don’t think I got it, but I can pass your email on to Boans if that’s what you’d like. Just let me know here and I can get it from your profile.
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Or better. At least software apps can’t be specifically prejudiced against a particular person.
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I stand by what I said. And it does appear that you misinterpreted my comment. While it does come across as rather flippant, nothing in that comment says that JWR or beer or “antipsychotics” have no effect. All I am saying in this comment is that just because something DOES have an effect that someone likes does not make that something a “treatment” for a “disorder.” Alcohol reduces anxiety significantly. It’s a fact. Why isn’t it considered a “treatment” for “anxiety disorders?” I certainly used it as a teen and young adult to reduce my anxiety in social groups, and so do lots of other people. How is this different from taking Xanax?
You say “APs” saved your life. I have no desire or data to disagree with or refute your reality on that point. Other people say “APs” ruined their lives, including ruining their health. Neither you nor I have any data to disagree with or refute their reality, either.
The only real point here is not to confuse a drug’s effects, which may be perceived as positive, negative or neutral, as evidence of any particular “mental health” issue being present or absent. We don’t diagnose cancer based on whether people feel like cancer treatment worked. We don’t diagnose a skin rash based on whether steroid cream makes it go away or not. We look for the CAUSE.
We should not diagnose “mental disorders” based on people’s reaction to drugs. I don’t want to prevent people from using substances they find helpful. I just want to keep doctors away from “diagnosing” people with speculative “diseases” that no one can objectively observe to exist.
OK, I broke my vow. That’s really it, Martin. No more.
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I absolutely agree, Trump is NOT the problem. Which is why simply removing him is NOT the answer. He’s a symptom of a much larger, more difficult problem that besets our whole society. But it’s easier to blame Trump and imagine that somehow if Biden gets elected things will magically improve. I hope people aren’t holding their breath for that one.
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Sometimes we believe we can change things, or the pile of data doesn’t reach critical mass until a certain point. There are many of us here who had “epiphanies” at one time or another in our lives/careers. At a certain point, I think a person comes to see that it’s not just a matter of confusion or needing training, it is the intention of the SYSTEM that is wrong headed. I’d guess a DSM IV conference would make that point pretty clear to anyone who was participating.
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So you can’t see the difference between, “The majority (defined as more than half) of scientific studies can’t be replicated” and “Scientific data is not replicable?” Even when I stated clearly that TRUE scientific data IS replicable (around half of the studies I’m talking about), and that this is the only way we can tell if it is true? To put it another way, half of what is put forward in journals as “scientific data” later turns out to be false. Does that state it more clearly? Data that can be replicated are true, those which cannot are false, scientifically speaking. So SOME scientific studies can be validated, but according to the article, more than half cannot be replicated. Which leaves us with plenty of valid scientific data, it’s just a lot less than we’ve been led to believe by leaders in the medical/psychiatric industries. I refer you again to the Viiox scandal. We were told that it was safe, when there were plenty of studies saying that it wasn’t. But those studies were hidden and not published. The studies used to promote its safety could not be replicated, and the drug company promoting Viiox knew this but chose not to share. The studies they used were false. They were put forward as if they were true by people who knew they were false, but who had an interest in profiting off of Viiox’s sale and use. That seems pretty simple to me.
You never did read the article, did you? It would really help if you did.
We really need to end this. It seems we are unable to listen to or understand each other’s viewpoints. For you to suggest that I have ever said that antipsychotic medication has no effect on people shows how far we are from being able to communicate.
I am not going to respond to further comments from you on this topic. I would suggest that if you find the comments here offensive, you might do better to seek another community that is more comfortable for you and aligns more closely with your values. I certainly have no intent to frustrate you, but it is apparent from our conversation that you are not getting what I’m saying, and I’m sure you feel the same way. So let’s just stop, OK?
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There is nothing in the first statement that contradicts the second. Both say that the majority of today’s scientific research is not replicable. Majority means more than half. If you read the article, you’d perhaps understand why I’m saying that. Scientific analysis of the data says that over half of scientific studies are not replicable. I suppose that study could be wrong as well. But that’s why I read them, so I can make up my own mind. I wouldn’t believe the article unless I read and analyzed it myself. Which is the real point here.
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That sounds like FUN!
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Nah, they give you stimulants for “Binge Eating Disorder” to supppress your appetite. But if you eat TOO little, they’ll pull out the Zyprexa. Of course, there is the option of giving someone Zyprexa until they balloon up, then diagnose them with “Binge Eating Disorder” and give them stimulants as well.
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Again, I did not say that scientific data is not replicable – you are putting words in my mouth. You either did not read the article, or did not get the main points it makes. The point is that TRUE scientific data IS replicable. But data that is NOT replicable is, BY DEFINITION, not scientifically true. Just because one study shows that X drug has Y effect, that doesn’t make it scientifically factual. Other studies would have to be done testing this hypothesis, and actually working hard to look for other explanations (like the placebo effect, selection bias, statistical manipulations, etc.) to undermine the result that the original researchers may WANT to be true. Only when a theory can withstand the rigors of repeated testing with intent to DISPROVE it or provide an alternate explanation, and yet continue provide the same result, is it regarded to be scientifically “true,” and then only as long as conflicting data don’t come in to create more questions. Unfortunately, this re-testing seldom happens today, largely because it is rarely funded. And even when it does occur, such retesting results are rarely published. This is especially true when these studies clash with the preliminary results that have been shared worldwide as if they were a new and amazing breakthrough rather than just a promising lead, or when some person or corporation stands to reel in healthy profits from the preferred “truth” reported in the initial study.
So the point of the article is not that scientific studies can’t be replicated. It’s that people often have preexisting biases that make them WANT a certain result, and that they regard studies that don’t provide that result as “failure” and therefore unworthy of pubication, or in need of overt suppression. It is also a problem that many “positive” studies are only positive because of intentional design changes (like “placebo washouts” or not counting dropouts as failures or changing the primary outcome measure when a secondary measure gives you the answer you want) or sometimes outright dishonesty in reporting the data. THOSE are the studies that are not replicable, the biased studies that DON’T follow true scientific method, and they are not replicable because their underlying hypothesis IS NOT TRUE, and for no other reason.
So those area my views on the finer points of the scientific method, and I ask that you respect what I am saying as what I really mean and not try to “interpret” some other meaning that is not contained in these words.
Suffice it to say, I think we’ve had our talk, and it’s starting to deteriorate into a more negative exchange. I think we should leave it at this point, and agree to disagree. It seems unlikely that further discussion will be productive.
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Well, you were very fortunate. Bullying was common in the schools I attended. There were plenty of good teachers, but also some totally crazy ones. My second grade teacher was screaming and yelling at us one day and tossed a book over our heads against the back wall of the classroom. When I stood up to object (and I NEVER talked back or did ANYTHING to get in trouble, but this was just too much even for me), she came down the aisle and smacked me in the back of the head and took me and another kid who was crying and tossed us out in the hallway. I never even told my mom, it was so NOT surprising that such things happened. A friend of mine was shoved down onto the gravel track by Miss Cooper at the end of recess in front of 100 kids and some staff. Yelling at kids and forcing them to stand at attention for a half hour, flicking them in the head with fingers – all of these were totally normal and accepted by the school staff.
I think it is pretty biased to say that homeschooling automatically deprives kids of anything. It obviously depends on how it is done.
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No, they’re frightened of the drug companies, who have a symbiotic relationship with the profession of psychiatry.
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I agree. Fear is the main driving force. And it is not without good reason.
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I love it! “You want drugs? We say YES! Lilly, Lilly, WE’RE THE BEST!!!”
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Wow, you REALLY need to stop projecting your assumptions onto me, dude! I AM a scientist (chemist) by training and I would be DEAD at the age of 8 from a ruptured appendix and peritonitis without modern medicine. I am ABSOLUTELY a full supporter of modern medical science, and I fully understand what good and bad research looks like. Where we appear to disagree is that you believe psychiatrists are scientists. I think there is massive SCIENTIFIC evidence that the vast majority are not, and that the entire edifice of psychiatry is built on a foundation of sand and wishes. This does extend to medicine as a whole to some extent, but psychiatry is entirely based on unscientific or antiscientific premises. Look into how those DSM categories are determined, and if you have any degree of intellectual honesty, you will agree with me.
And in case you think my skepticism re: modern medical research is misplaced or based on emotion, try reading the following, which outlines why the majority of scientific research done today is not replicable, which from a REAL scientific perspective, means it is scientifically untrue:
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
Again, I am NOT saying that the drugs prescribed for “psychiatric conditions” can’t be perceived as helpful by those taking them, even life-saving by some. But you and I both know that anecdotes don’t make science, and there is a lot of good science out there that is buried because monied interests don’t want it to come to light. This is covered in the article. Please read it before you come back and try to imply that I am antiscientific again.
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Yeah, I would have felt the same way! I’d have been SOOOO happy to be at home and able to pursue what made sense to me instead of being bossed around by bullies and teacher/bullies and forced to be together with people I didn’t choose doing activities I had mostly no interest in at all. Homeschooling must be a Godsend for a good percentage of kids, at least the ones who don’t need to escape from their parents/siblings.
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Although the vast majority of “the right” also supports psychiatry, if often for different reasons. There are few of any political stripe willing to really challenge the psychiatric status quo or the drug companies who line our politicians’ pockets in a very non-partisan manner.
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Maybe they should just get the drug companies to buy them coats, and they can wear the “colors” of their sponsors, kind of like race car drivers. “And now, in the southeast corner, in the bright red coat, representing Eli Lilly, Dr. JO-seph… LIEEEEBERMAAAAAN!”
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Given the widespread agreement amongst professionals and informed laypeople that “scientific” studies are massively affected by economic and professional conflicts of interest, I’d rather trust my own ability to judge amongst the many stories that told, both by journalists and by professionals, and by those who have experienced the effects of the drugs directly. If we start with the rather obvious and undeniable facts that these drugs cause huge weight gain, diabetes, and heart problems, and knowing that any number of studies have shown extremely shortened lifespans in those diagnosed with “serious mental illnesses” since the pre-drug era, and actually KNOWING people who have died early directly as a result of taking these drugs, the prospect that they shorten lives seems by far the more believable story. Scientists who are schooled in analysis and methodology are also those most capable of abusing their abilities, and recent history is replete with examples of their having done so (Bidedermann’s “juvenile bipolar disorder,” the Viiox scandal, the lies about antidepressants and suicide, the lies about Benzedrine, then Valium, then Xanax being “non-habit forming,” the denial that Tardive Dyskinesia is caused by neruoleptic drugs – shall I go on?) So someone being a scientist does not convince me of their superior reasoning ability OR superior ethics. Maybe that’s where you and I differ here. You trust psychiatrists to be legitimate scientists. I don’t. You believe you have very good reasons for trusting them. And I have very good reasons for not doing so.
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Ha! Good one!
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Fair enough, but still there is no actual way yet established to measure that difference, let alone studies that have actually done so. How many become suicidal coming off their “meds” and becoming psychotic? How many become suicidal going ONTO antipsychotics? How many because sucidal because they are WITHDRAWING FROM antipsychotics? How many would never have been suicidal in the first place if they’d taken another path? These are things we do not know the answers to, so claiming that “lives are saved” when we also know that lives are lost is very, very premature at this point. We don’t know the cost/benefit analysis and will never really find out what it is when so-called “scientists” are dishonest and manipulate data to serve their own interests instead of the interests of the public.
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And Mother comes in a distant fourth place.
Excellent observations, though very sad. We do need to create communities that work for all of us!
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Nothing is more stunningly idiotic in recent years than the idea of giving stimulants for “Binge Eating Disorder.” The disorder itself is laughable, clearly invented solely to sell more drugs (not saying that people don’t binge eat, but the “disorder” is defined in the usual superficial, blameful manner). But to “treat” it with stimulants is ridiculous. As if the problem is appetite. And of course, there is no effort to actually look at WHY the person may be eating in this way, only an attempt to bludgeon the body into submission. I find stomach stapling more rational.
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I would submit that the moment when we are “two people talking” is when real therapy can take place. As for “countertransference,” it is totally and completely normal for therapist and client to form a bond, and for them each to have feelings about the other. The difference SHOULD be that the therapist uses his/her feelings in the service of therapy, and does not take advantage of the client’s vulnerability in even the slightest way. I often found it helpful to share my feelings of the moment with the client when it seemed likely to increase trust or open up a new perspective. After all, they’re sharing their feelings with me, shouldn’t they get to know that they are having an impact, that I’m not a block of wood trained to say, “Go on” every three sentences? People want to talk to another PERSON, a REAL PERSON who interacts with them in a meaningful way. Nobody wants to talk to a “blank slate.”
That’s my experience, anyway, but I was not a DSM-trained standard therapist. I pretty much made it up as I went along, depending on the client. Kind of Milton Ericson style. I’d probably be fired in a second from most places nowadays.
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It sounds like you agree that antipsychotics do play a role in shortening lifespan, but that poverty’s role is greater. This is possible but certainly we don’t have data to prove or disprove this hypothesis. But saying “studies show you live longer if you stay on your medication” is a misstatement of fact, and actually contradicts your earlier statements that antipsychotics do, in fact, contribute to the undeniably shortened lifespans that have been reported. The truth is, there are studies claiming one and the other, and the question as to why lifespans for the so-called “SMI” and the role that antipsychotics play is at this point is very complex and can not definitively be answered as you claim.
The point of this article is that the claims that people live longer on “APs” put forward in THIS set of studies are based on manipulation of data. I think you should be able to admit that there is a major conflict of interest when people who make their money selling drugs and drug prescriptions do such research, and that intentional manipulation of data has been shown to be extremely common in all branches of medicine. The studies in question clearly don’t prove anything, especially given the basis of “person-years” on medication, which even a layperson can see is a pretty poor substitute for the actual lifspans of actual human beings who are on/off antipsychotic drugs.
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I think there is a big difference between saying, “Corporal punishment won’t destroy kids’ psyches in and of itself” and “It’s really no problem for parents to use corporal punishment.” It’s one of those things where the truth sometimes hurts, and it feels like a criticism of the person who has used spanking, but it’s still the truth. I think it’s fine to say, “You don’t have to worry that you’ve destroyed your kids’ lives just because you spanked them now and then,” and certainly removing kids to foster care for spanking is massive overkill (given the incredible damage done by the very act of foster care placement), but I think it is important to be honest and say that spanking has been shown to be ineffective and potentially damaging, and that there are more child-friendly ways that work better in accomplishing the same goals.
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I think these institutions just assumed that psychiatrists were on the up and up and took them at their word.
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And which “antipsychotics” make you gain weight, which was the original problem you were supposedly “treating.”
Makes a WHOLE lotta sense!
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What continues to baffle me is why psychiatric practitioners continue to see things such as “catatonic mutism” as some kind of “treatment success.” What does “failure” look like to them? Is it any wonder so many people won’t “remain compliant” to their insensitive and destructive label and drug based paradigm?
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Thanks for that clarification. You won’t find many Lieberman fans on this site!
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Poverty is, of course, a factor in the lifespan differential. But even between the most rich and the most poor, the differential does not even begin to approach 20 years.
“More precisely, the study shows that in the U.S., the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.”
http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411
Why is it difficult to believe that drugs which cause obesity, diabetes, and heart disease would be responsible for shortening the lifespan of those who take them? I should think it would be almost impossible to believe they would NOT shorten lifespans, as heart disease and diabetes are very high on the list of killing diseases in the USA and around the world. I find it difficult to take anyone seriously who doesn’t see the almost certain impact of these drugs on lifespan.
Of course, we should also be asking why our “mental health” system is leaving the huge majority of its “seriously mentally ill” in lifetime poverty. Does that not convey a responsibility for decreasing lifespans, when our “treatment” fails to take into account the quality of life of those being “helped?”
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To say that one is “misdiagnosed” implies that there is some way to make a “correct” diagnosis. To me, all psychiatric “diagnoses” are “misdiagnoses” because they claim an understanding of whatever problem(s) are going on when they don’t actually have one.
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Well, of course. I was responding with the idea of “psychiatry” as “carers for the spirit,” psychiatry as it COULD be if they started off by actually believing that such a thing as a human spirit exists.
Psychiatry is worse than nonsense, or it would already be interested in all the above things I mentioned. The “ADHD” example alone proves that they will bury useful evidence that would reduce the number of diagnosed/drugged kids and promote things that will sell more stimulants. They are a bankrupt profession.
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I was not being facetious at all, John. You like to write and you write well. Why shouldn’t you write a book? I really think you should consider it. You have a lot to say that needs to be heard.
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For example, looking at indigenous healing practices and indigenous cultures and seeing what they do for “mental health problems.”
-Looking into why people diagnosed who hear voices have more positive content in countries where culture supports voice healing as a normative experience, and exploring how altering our cultural attitude toward voices might help those suffering right now.
– Looking at different classroom settings and observing that “ADHD”-diagnosed children do so much better in “open classrooms” than those who are in standard classrooms that they are indistinguishable from “normal” children, and then advocating for revisions in classroom settings instead of drugging the kids who don’t “fit in.”
– Looking at why it is that certain cultures have almost ZERO incidence of “postpartum depression” while in our culture, it is almost epidemic. Helping move our culture in a direction that emulates those who support new moms in a way that they don’t suffer, based on the evidence of the absence of this suffering in their culture.
– Studying the interesting phenomenon whereby immigrants develop Western maladies, both “mental” and “physical,” by three generations living in a Western culture. See what it is about Western culture that makes them ill and see if we can stop it.
– Look at the impact of racism on group experience in terms of emotional experience and behavior.
– Examine the connection of job satisfaction/”stuckness” to other life indicators, such as mood, marriage success, etc.
The list is endless. These are things that could be studied using social science methods and might lead to improvements in our social welfare. None of them require labeling anyone as “ill” or “bad” for diverging from what the society considers “normal.” In fact, a real “doctor of the spirit” would dbe working to redefine “normal” toward what works for people instead of what works for the institutions of society. Psychiatry appears to be doing the opposite. If you don’t “fit in,” you’re abnormal and need to be “fixed.” Those who don’t create any problems for the status quo are “normal” and don’t need fixing. “Fixed” is defined as being happy with the status quo (but not TOO happy – then you’d be manic!) It is not working in the interests of improving people’s lives, unless you count the people who are making big bucks out of the enterprise. Sure, there are a number of people who feel better taking their drugs. But people also feel better smoking dope or drinking beer every day. Drinking beer to feel better can be helpful for some, but it’s not a medical treatment.
So there’s lots to do, but drugging people unhappy with their lives is not particularly productive, IMHO. Especially if you label them as “abnormal” for feeling, thinking or behaving the way they do.
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Sounds like a great approach for being truly helpful to another person!
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Once we allow for subjective “diagnosis” based on observer opinions, there is no end to who and what may get “diagnosed.” I think that’s the clear and obvious conclusion from this observation – when there is no objectively definable line of “normal,” sooner or later, everyone is diagnosable. Which, as you say, makes “abnormal” the new normal!
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Thanks for your passionate reply.
There are a couple of things you say that I have to take issue with. First, there is plenty of evidence of significant brain changes due to trauma. This was the primary finding of the “Decade of the Brain” research, which was actually quite different than what was anticipated. More importantly, and less well known, are the findings that the brain can continue to change in a POSITIVE direction when a traumatized person is supported by a healthy adult caretaker or support system. Dr. Bruce Perry is one of the best resources for this. Easy internet searches for these items. Here is one just to get you started: https://www.psychologytoday.com/us/blog/the-mindful-self-express/201809/how-ptsd-and-trauma-affect-your-brain-functioning
You also seem to conflate “cognitive disability” with “mental illness.” You suggest that most of those severely affected by the syndrome called “schizophrenia” are affected by brain damage. I know of no evidence that this would be true in most cases – there has been a long, intense and frankly biased search for brain damage associations with “schizophrenia” and many other “mental disorders” with little to no results. There is evidence of brain matter loss in people diagnosed with “schizophrenia” over the long term, but Nancy Andreasen’s own research, which she really didn’t WANT to believe at first, showed that antipsychotic drugs cause loss of brain matter when used over the long term, so such studies are meaningless unless controlling for AP use, which is almost never done.
Finally, you also assume that the “schizophrenia syndrome” is due to different types of “brain malfunction.” As I’m sure you are aware, science proceeds from hypothesis to proof, and it doesn’t work to assume the conclusion that brain malfunction is the cause when that has not been shown to be the case. And your suggestion that the fact that certain drugs “work” to decrease these loosely defined groups of “symptoms” proves an underlying disorder is similarly flawed. Under that reasoning, alcohol must be addressing an underlying “brain malfunction” because anxious people feel better when they get mildly intoxicated. Correlation can’t be used to diagnose anything.
I very much respect your reframing of “schizophrenia” as a syndrome, something which would really help if we all operated from that assumption. Unfortunately, the current reality in “mental health” research is that these syndromes are being treated as unitary entities for investigation, and that leads to a lot of misleading, trivial and/or meaningless results. I also agree that it is easy to “throw the baby out with the bathwater” if one is too committed to dogma on either side of these questions. I’m a scientist in the end, and at this point, I see no science that really proves that “schizophrenia” is caused by any kind of a brain malfunction, and I am doubtful that continued research will prove any such thing. Partly because, as you say, it is a syndrome, and there may be (probably are) some subgroups that DO have biological causation, but these will never be discovered as long as research is done on “schizophrenia” with the assumption that all cases have the same cause and that this cause is necessarily biological in nature. It is clear from research that trauma has a very high correlation with the syndrome in question, as does urbanization and migration to a foreign culture. It’s also very clear that the manifestations of this “disorder” vary widely depending on the culture in which they occur and how the culture in question responds to such issues. It is, as you suggest, a much more nuanced picture, and until proven otherwise, I think it makes a lot of sense to assume that both nature AND nurture are involved.
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No, I don’t disagree that we can make factual observations about what people believe. My only point is that science can’t determine “what is right” by the scientific method, and it appears we agree on that point. Sorry if my post sounded dismissive – I was kind of in a hurry last night! And I do think qualitative research is a valid means of studying ethics, though it gets more into sociology/anthropology and is a far distance from medicine. I guess that’s what I’m really getting at here – we can study history and use scientific means to determine certain things about history, but using those methods to make claims about medical treatment of one’s body would be ludicrous. Medicine can be studied from an anthropological/sociological viewpoint, and it has been (“Medicine and Culture” was a great read, comparing medical practices in France, England, Germany and the USA and demonstrating how much of even non-psychiatric medical decisions are made based on cultural beliefs), but this is not a way to determine what is actually wrong with someone or what kind of treatments are effective. Psychiatry would be FAR better off if it viewed itself as a sociological/anthropological soft science and proceeded accordingly, but there’s a lot less drug company money in such an approach.
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I like it, John! You should write it!
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I love your last paragraph! I think it gets to the core of why very few within the ranks question the basic assumptions of psychiatry. I was a dissident voice in the “mental health” field and I can tell you, it is not a comfortable position!
I do take issue, though, with your assertion that “there is absolutely no possibility that eventually a psychiatrist could not come to the conclusion that it is all a lie.” There are certainly psychiatrists and other “mental health” workers who have come to this conclusion from observing the fact, though admittedly, it is a small minority by my observation. I would suggest that it is very difficult to work in this field at all after having drawing such a conclusion, and most who do so will be unable to live with themselves if they continue to practice as they have done in the past. So they mostly leave an do private work or find another profession. Very few remain in the public “mental health” system once they see what it is actually doing, and those that do, I admire for their courage.
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It is pretty common for people recovering from a traumatic experience to want to help others do the same. I’d say you’re on the right track in contacting people who have experienced similar things. I wouldn’t waste a lot of time on the “true believers” who can’t consider anything but their own rigid beliefs for fear of their world collapsing, but there are plenty of people who are “on the fence” or who haven’t been helped as promised or who have deteriorated in “psychiatric care” who need people like you to help them out. It’s just a matter of connecting with such people, which isn’t always easy. I also think it’s very important to stay connected with others who agree with your view of things so you don’t start feeling like you’re the “only one.” MIA is really good for that.
I hope someone who has been exactly where you are can chime in and share how they managed to move forward after this kind of trauma.
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I think he means “decline in the use of corporal punishment.”
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Maybe we can get our president to start consulting King’s mother. Seems she gave him some good advice!
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Ethics is a branch of philosophy. Philosophy is senior to science. Science depends upon a certain philosophy of what is true vs. not true. Ethics has to do with what is GOOD or NOT GOOD. Science can’t answer those questions, except in a mechanical way of measuring X outcome when ethic Y is agreed upon by a society. The decision of what is good or bad is both an individual and a social one and is not really subject to scientific analysis, as it does not provide measurable inputs or outcomes.
Read Zen and the Art of Motorcycle Maintenance for an incredible exploration of this very subject. It is one of my favorite books of all time.
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Consensus is completely unrelated to scientific truth. Scientific truth requires proof, usually in the form of vigorous efforts to DISPROVE a particular hypothesis repeatedly failing. The fact that “scientists agree” to something does not make it true or untrue – opinion is not science. And while “beyond a reasonable doubt” certainty is not always attainable, it should be the goal. Instead, what we see is so-called ‘scientists’ collecting evidence to support their own views and hiding things that would cause doubt. That is not science. That is marketing.
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Holding on by your fingernails, I’m sure!
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Well, sure, it comes from trees that grow in the wild, so of course, it’s “all natural” and organic and no GMOs and all that stuff, too! Zero carbs, cruelty-free, fat-free, gluten-free, etc. MUST be good for you!
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I understand that Drano and bleach together is a bad combination. Monotherapy with either is preferred.
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Hi, William,
Doctors can prescribe drugs for any indication. It is not a requirement that they have a DSM “diagnosis.” Lots of people get antipsychotic drugs prescribed with no DSM “diagnosis” at all. They prescribe them for sleep problems, for “behavioral disorders,” to “augment antidepressants,” etc.
Besides which, billing codes are not the same as actual medical diagnoses. If they need to invent a billing code, let them invent a billing code, but let’s not get confused and pretend that a billing code means anything more than that you get paid by the insurance company. The original DSM was, in fact, invented so they could bill insurance companies for “therapy.” The idea that these codes represented actual disease states is quite a distortion of their original purpose, and is utterly unscientific, as there is little to no evidence to suggest that any of these arbitrary groupings by symptom create groups who actually have anything physiologically relevant in common. It would be like billing for “stomach pain.” Sure, you can bill the insurance company for that, but is it indigestion? An ulcer? A gall stone? An intestinal blockage? Appendicitis? Bowel cancer? Each of the things I listed could cause “stomach pain.” So doctors neither diagnose nor treat “stomach pain,” not if they are in any way competent. They’d look for the CAUSE of the stomach pain and treat THAT.” Psychiatry as a profession makes no effort to differentiate between depression due to a loss vs. depression due to a bad boss vs. depression due to insomnia vs. depression due to a low thyroid condition vs. depression due to a long struggle in a dead-end, meaningless job vs. depression due to my husband beating me randomly and controlling everything I do and trying to drive me nuts on purpose. So saying someone “has depression” is pretty close to meaningless.
I believe the same is true for “schizophrenia.” Many people in the psychiatric field even agree with me on this, and there have been proposals to scrap it as a concept altogether. The fact that professionals in the field disagree as to whether it exists should be reason enough to see that it is not a real scientific concept. Nobody argues about whether cancer or broken legs or syphilis actually exist.
So if you need a “diagnosis” to get the drug that you feel is necessary, by all means, get a “diagnosis.” I just ask that you not confuse this with an actual, scientific analysis of what is happening that is causing this phenomenon, nor even what to do about it. Antipsychotics can diminish hallucinations, and to a lesser degree, delusions, at least temporarily and at least in some people. That’s about all you can say about it. It is not “treating” a known disease, because no one knows what causes “schizophrenia” or if it’s even a “thing” that has a cause, vs. a phenomenon that is associated with many different causes and possible interventions.
I hope that clarifies my position on this.
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And it is an organic solvent and will dissolve fatty tissues, so it’s perfect to attack a fat-based virus like Covid-19! Why didn’t we think of this before?
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We’ll put a team right on that!
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“Many scientists argue that turpentine, despite significant adverse effect in some cases, has potential benefits that outweigh the risks. Most users of turpentine find the adverse effects diminish over time, often quite suddenly (death generally ends all such complaints). But all drugs have side effects. It is certainly worth further study. “
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“…explain how Scientology utilised pseudo-science to seek public support.”
Talk about the pot calling the kettle black!
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I’ve seen kids put on a diet and told they need to exercise more as a response to “antipsychotic” weight gain. Of course, they almost never told the kids there was any relationship with the drugs. I saw one girl’s diabetes disappear within a week or two of discontinuing Seroquel. Crickets from the psychiatrists, of course. I saw one kind graduate from a year-plus long eating disorder program, only to be put on Adderall for “ADHD”. Strangely enough, she stopped eating again. If my CASA volunteer hadn’t intervened, no one would have noticed that the “treatment” for “ADHD” was eliminating her appetite, and would have said her “eating disorder” is “coming out of remission.”
Not much real medicine being practiced by psychiatrists, at least for the kids in the foster care system.
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I would even go so far as to say for some people, figuring out how to know what they want is the core job of therapy! So of course, such people won’t be certain what they want to start with, and a good therapist would know this. Sadly, there aren’t very many therapists out there whom I’d describe as good.
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Exactly. It is abuse, yet if you have the nerve to call it out, then you are “treatment resistant.” There is no way to win that game except not to play.
And it is totally “Caveat empor” (buyer beware) when it comes to counseling. If you don’t already know what you want, you get pot luck, and pot luck usually isn’t very lucky.
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This is a great point, too. I was a “dissident mental health professional” in my day. It was obvious how quickly marginalized I would become if I just came right out and said “I don’t believe in all this DSM/drugging nonsense.” I had to learn to couch it all in proper “scientific language” and refer to studies and make it all into a big academic discussion. And mostly keep what I did in my own sessions pretty quiet. There is a lot of force brought onto any professional who won’t toe the party line, or at least that was my experience.
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It is not always possible for people to choose to walk away from psychiatry – many are forced either by forced treatment orders, threats of hospitalization, threats of loss of children, decisions made by parents or relatives of people in nursing homes, and on and on. Additionally, the propaganda that has been spread regarding these DSM “diagnoses” has had other destructive effects, to the point that people are so confused they don’t even know they have another option.
I had a caller on the crisis line I worked for one time who had been trying antidepressants for over a year with no success. She was frantic and thought that she’d never get any kind of relief and was condemned for life to suffer this kind of emotional distress. Then I asked her, “Did you know there are other things you can do besides drugs?” She was suddenly calm and said, “No.” I said, “Well, there are.” And she said, “Oh. Well. That’s good!” She had been asking for help for over a year and had NO IDEA there was any other option besides drugs. Nobody had even discussed that with her. THAT is what is wrong with the system. If people want to take a drug because it makes them feel better, I’m totally OK with that. I am opposed to a system that lies to people and pretend to know things they don’t know. I’m opposed to a system that profits from hurting people. Yes, people do have a level of responsibility for their own decisions, but the issue with psychiatry extends far, far beyond individual choices to participate or not.
Hope that clarifies things from my viewpoint.
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I don’t disagree with your analysis. I just don’t see the path forward. Perhaps I’m just more cynical about humans changing how they are trained to behave. It does appear that our economic situation is going to be in the toilet for months at least, maybe longer, so people’s tolerance of the “status quo” may indeed reach a breaking point. It is also true that the need for socialist-oriented interventions has never been clearer. But I’ve already heard people in positions of power saying in effect that socialism is OK in a crisis but not for day to day living.
I’m ready to act, but I still don’t see the path!
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Not to mention, “I was just following orders…”
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Nor that it is back “in whack” when they are “properly administered.” No one knows what a “proper chemical balance” looks like, because it varies massively from minute to minute all day long.
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I think you are assuming a context for my comments that was not in evidence. I’m not talking about political revolution, I’m talking about whether or not someone should use his/her “professional expertise” to decide if a particular president is doing his/her job. The efforts to “diagnose” Trump do, in fact, contribute to the idea that if somehow he were removed, things would be “back to normal.” Aside from the very relevant question of whether “back to normal” is a legitimate or sane goal, focusing on Trump as the problem avoids the more salient question of how our system created a situation where such a person could even be considered as our “elected leader.” I think your analysis is a lot more relevant when we get to that more nuanced point, but it is certainly obvious that our populace is so far away from even asking that question that, in order to meet people where they are at, we have to answer less overarching questions and start with ones like, “Who gives these people the right to decide whether a particular president is fit too serve?” My bet would be that the majority of people would have a great deal of difficulty coming up with a rational answer to THAT question, let alone have the capacity to even think about the larger issue of what to do about a system that produces “column A/column B” type choices where both options lead to continued deterioration in the average person’s ability to survive with some measure of dignity.
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You mean ignored by me? I don’t always reply to comments in response to mine.
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It is a means of establishing facts. It doesn’t deal with ethics. Ever read Zen and the Art of Motorcycle Maintenance? It totally handles that exact question with eclat!
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I suppose one could manage to be evil in a more systematic and effective fashion.
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Fancy way of saying, “We know they don’t mean anything at all.” Kind of like when they say, “The effects of X are not fully understood,” which really means, “We have not the slightest idea what it does.”
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I think “Microaggression” is meant to refer to acts which are not obvious to a person who is not receiving them, but are significant and harmful to the person who does. For example, saying to a person who is in a violent relationship, “Why don’t you just leave?” might not seem like a big deal, but it comes across to the recipient as something like, “If you were any good as a human being, you would have left by now.” The person saying it might not even intend it as harmful, but it is invalidating and distressing for the person on the receiving end.
So I think “microaggression” is a pretty legitimate term that I find useful. Others are free to disagree.
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I don’t disagree with your last statement entirely. The problem is that psychiatry has coopted such definitions of “illness” and tried to intentionally warp them into the realm of physiological disease states, with little to no scientific evidence that this framing is in any way legitimate.
I don’t dispute that social sciences can be approached in a scientific manner, but I don’t see much point in trying to define a “personality disorder” as some kind of entity that can be identified, because scientifically speaking, it isn’t really possible to do that. We could theoretically choose a particular kind of behavior, like selfishness, and attempt to measure aspects of this behavior in a reliable fashion. But there is absolutely no reason to assume that the constellation of behavior that psychiatric leaders have agreed upon by committee consensus have any kind of legitimate standing as a viable object for study. A study group needs to have sufficient homogeneousness in a particular aspect in order to yield any relevant data. I’d argue that “personality disorders” do, in fact, describe behavior that people find annoying and clumps them together in a somewhat random fashion. I’ll note, for instance, that selfishness is an aspect of “narcissistic,” “Borderline,” and “sociopathic” personality disorders at a minimum. The overlap between these pseudo-entities is so great that they are essentially useless for any kind of social science research.
Hence, it really is no different than calling someone a “jerk” in my mind. And btw, I do define “jerk” in my book, but I would make no claim (and in fact, I clearly state the contrary) that there are “jerks” and “non-jerks” that can be clearly distinguished from each other. It is a spectrum of behavior which, at one end, people find offensive and unacceptable. That this distaste is related to social evolution seems likely, yet the idea that such disapproval of behavioral traits can be considered a scientific definition is belied by the wide range of what is considered acceptable behavior depending on the culture one grows up in. We are most definitely in the area of sociology and anthropology rather than psychology at this point, and certainly a long, long way from the pretense of medical precision that the psychiatric community would like us to adopt.
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Maybe we should get some bartenders onto “Meet the Press” to present their views on President Trump’s mental fitness for office?
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Except for those who decline to diagnose.
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I am trying to distinguish between scientific answers, which need to be proven beyond reasonable doubt with actual facts, and social answers, which are massively influenced by culture and social conditions in ways that transcend scientific analysis. For instance, I wrote a book called “Jerk Radar” that characterizes certain behavior as “Jerky,” and even ends with a quasi-mathematical “quiz” to see how your date measures up to the principles introduced in the text. These principles are not in the least scientific – they are based first off on certain social agreements on morality, such as that it’s not OK to promise you love someone and want to marry them when all you really want to do is get them to sleep with you. There is no scientific reason that a person should not do that – in fact, from a pure “evolutionary” (scientific) standpoint, one might say that the man (in most cases) is ensuring that his seed will be spread more widely and thus increasing his chances of his DNA’s survival to the next generation. But from a social/moral standpoint, this kind of behavior is condemned as dishonest, manipulative, and self-serving. There is no scientific test for selfishness or dishonesty – it is entirely a social judgment. It is not possible to objectively measure who is and is not a “jerk,” though it is possible to define a certain behavioral spectrum and to look for behavior that tends toward one end of that spectrum as something to avoid. But what you or I or a different person would view as “jerky” behavior is totally a matter of our personal opinions, values, and priorities. It’s not scientific.
By contrast, someone who has cancer has a very specific growth that can be identified on an x-ray or MRI, can be biopsied to test the cells for certain tendencies, can be viewed under a microscope, etc. This is science, this is medicine – the identification and treatment of observable conditions of the body. There is no moral argument about cancer – you have it or you don’t. Yes, there are boundary conditions, pre-cancerous cells, but there are still observable conditions being discussed.
As far as Trump is concerned, there is nothing in his behavior that suggests he is “ill” in the sense of having a physiological problem that could be observed, diagnosed or treated. The definition of “personality disorders,” as Lieberman himself proclaims in the article, is vague and subjective and “lacks validity,” meaning that it has no concrete meaning or value as a scientific/medical concept. It is a list of behaviors that most people don’t like very much. To say someone “has a personality disorder” is about as meaningful as saying, “He’s rude” or “He’s got a temper” or “I don’t like his attitude” or “He’s such a jerk!” It puts a pseudoscientific sound on something that is very much a moral judgment, and in this case, there really is no overlap with medical conditions at all. Unless you can show me how to distinguish “personality disordered” people from the “normal” population by some reliable, objective means, it remains a moral judgment, and in essence, a slam or put down in most cases.
I want to be clear I am not arguing against making moral judgments – I hope it is clear from my comments that I do believe in people being held to minimum moral/ethical standards by their social group, and that there ought to be significant consequences for failing to fulfill one’s social agreements, including possibly removal from one’s job. This applies even more to a President than other people, because the sweep of his responsibilities is so large. But those judgments have NOTHING to do with medicine, unless a doctor is able to come in and say, “Yes, he has a brain tumor,” or “Yes, his heart attack has left him unable to engage in the stressful duties of being President, and resuming his office will probably lead to his death,” the medical profession has no business poking their noses in and pretending to be able to evaluate his “fitness for office” based on some vague and subjective label that they are applying to a person they have not even met. It gives a veneer of ‘scientific authority’ while lacking any of the necessary conditions for any kind of scientific conclusion to be drawn.
I hope that clarifies my point.
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Wow, Brett, I missed that point entirely! This should be copied and reprinted over and over and brought before judges and legislators all over the world. I find it a bit awkward to be in agreement with Lieberman, but I guess it goes to prove that these guys are pretty much all aware of the lack of scientific credibility in their “treatment model,” but chose to “forget” these inconvenient facts as long as they are being sufficiently reimbursed for their troubles.
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Or apparently even those they HAVE met, as their odds of getting it right are apparently worse than the odds of the 10-day weather forecast in the Pacific Northwest in March being correct.
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Are you suggesting that psychiatry may be caused by a genetic anomaly? Perhaps one that blunts one’s sense of empathy or leads to an unremitting need to control other people’s lives?
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Sounds like a plan to me!
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Finding “schizophrenia” in the genome is such a joke at this point. They have to go to lists of hundreds of “markers” to get even 1-2% correlations, when the correlations between what they call “schizophrenia” and environmental stress are in the 80+% range consistently. It is such an obviously self-serving process that assumes the conclusion before doing the work, it is laughable to even consider it in the realm of science. It is more of a religious faith, and as we all know, you can’t use logic to counter religious faith. They operate on completely different rules. Which would’t bother me quite as much if they weren’t pretending to be scientists!
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Well said!
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Exactly! That’s why I don’t use “stigma” and just call it “discrimination.” Stigma refers more to an internalized oppression – I feel bad because other people don’t accept me. Discrimination puts the responsibility where it belongs – on the person mistreating you based on their perception of your “otherness.”
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Though I often prefer simpler terms, like, “He’s an asshole.”
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You provide an excellent example of a SOCIAL label. I have no problem with social labels as a shorthand way of referring to a set of characteristics, as long as one understands that it’s shorthand and doesn’t come close to fully describing the person behind the behaviors. Trying to take a SOCIAL label and turn it into a MEDICAL label is not something I support, and it is especially pernicious when the pseudo-medical label is used to “other” the person involved and enforce a worldview and possibly a “treatment plan” on him/her. I have no problem someone saying, “My ex was such a narcissist!” I have a big problem with a professional saying, “Your ex has ‘narcissistic personality disorder,’ and his bad behavior is the result of a malfunctioning brain.”
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I certainly agree that at some point in any process, a person wanting to be effective has to take a moment to ask what part of this s/he controls. Otherwise, we can waste a lot of time banging our heads against big walls rather than looking for doors or digging tunnels or climbing trees or perhaps choosing another direction to travel. In particular, we can’t directly control how other people choose to view us, and I have spent decades learning slowly how to let go of that urge. But again, to have this kind of discussion presupposes a level of trust that isn’t always present. I also get the idea that saying to “focus on what you control” out of context can very much come across as, “Don’t worry about those people with the rifles over there. You can’t decide whether they shoot you or not, so let’s look for something positive in the situation.” True, there isn’t much we can do about “the people with the rifles over there,” but it is essential to acknowledge their presence and the effect they are having on us before moving to “focusing on what we can control.”
I hope that makes sense. I most definitely ask that question frequently when I’m working with someone, but certainly not to start out with and always with a sensitivity to when the client/friend/person I’m helping is in a place where that question can be taken on board without feeling shamed or invalidated in their fears or frustrations.
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I think that is a very fair point. I’d like to pass the “McCrea Rule” that says they can’t diagnose anyone, but not sure that will get too far. The whole discussion seems rooted in the idea that they have this capacity to “diagnose,” which of course I don’t support, but at least if they have to see the person first, they will be limited to applying their social biases to those whom they have at least spoken to.
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Can’t disagree with anything you said!
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That was my sense of it as well.
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Ron, I think the objection here may be more to the idea that if you “focus on what you can control,” you will somehow magically feel better and solve whatever problems beset you. Naturally, focusing on what you can control does help a person feel more able to make decisions instead of feeling stuck, but just as naturally, advice to “focus on what you can control” when one of the things you CAN’T control is eating or having a place to live or dealing with an abusive partner can come off as just a TAD insensitive. I think it has a lot to do with the relationship between the parties and the timing of such a question. If you haven’t take the time to really understand and empathize with the difficulties of the situation to the satisfaction of the other person involved, suggesting to “stay positive” or “focus on what you can control” is going to come across as condescending or pollyanna-ish, as it feels more like a brushoff than an attempt to understand and be supportive.
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I can tell you I never blew up frog’s asses. Though my brother did some pretty nasty things to bugs and birds.
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The same would apply to any president. The problem is, with whom would we replace him?
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I like your analysis. I had not seen those last few stories from his childhood, but they don’t surprise me. The best predictor of future behavior is past behavior. Most people don’t change unless they are forced to by external circumstances. Someone born with a silver spoon in his mouth has very little external motivation to change anything. If Donald solved problems as a kid by throwing rocks or hitting kids with a bat or pushing people out of windows, there is no reason to think he’d be much different today, other than finding different means to bully people whom he finds threatening.
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I appreciate both your viewpoint and the civil tone of the discussion. I think the challenge that professionals (and I qualify as one) face here is that concern for safety of the nation can be very legitimate without invoking any kind of “mental illness” as a causal factor. There are plenty of people who are willing to kill other people who have no “mental illness” at all, even by DSM standards. They just think killing people is a good way to solve certain problems. They may even have their own internal “ethics” of when it is and isn’t OK to kill. In some cultures, it may even be required to kill someone if one’s honor is sufficiently undermined.
It is in my view utterly impossible to disentangle “personality disorders” from problems of ethics, morality, and social values. Until and unless there is an objective way to “diagnose” someone with a verifiable “mental illness,” we’re building castles in the air. I’d rather go back to philosophy and ethics to handle this kind of situation. Bringing in “mental illnesses” just adds confusion and controversy.
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I guess we’ll have to disagree on this point. Saying he is a “malignant narcissist” or combines “traits of three or more personality disorders” is to me simply a rarified way of saying he lacks ethics and empathy and is willing to hurt others to get what he wants. I’d rather call him “A person who lacks ethics and empathy and is willing to hurt others to get what he wants.” It describes him in more precise terms that are understood by most laymen and doesn’t assume any special knowledge due to my advanced degree (yes, I do have one) or my position in society. I’m actually more comfortable with “evil” than “malignant narcissist.” For one thing, the latter seems to imply that he is suffering from some sort of “health problem” when what he is really suffering from is a moral/ethical problem. There is no evidence that can identify a “personality disorder” besides a set of descriptions. Why not just be honest and give the descriptions instead of pretending we’re dealing with a medical problem? It doesn’t require any special knowledge to observe and conclude his lack of integrity. It only requires an honest and sufficiently mature person observing his dishonesty and corrupt behavior.
One of the major confusions introduced into our society by the DSM III and psychiatry’s marketing of the “chemical imbalance” concept is a confusion regarding what are medical issues vs. what are social/ethical issues. There is no scientific way to determine if someone is maintaining their oath, is dealing honestly with those whom he encounters, is playing by the rules, or any of the things that come into assessing a “personality disorder.” All these things are matters of opinion and of social expectation. The likelihood is that he is NOT suffering from any “disorder,” he is simply acting out HIS morality in a world where the majority find that morality unacceptable. Again, this is a matter for social judgment, not quasi-medical analysis or treatment.
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The problem I have with your commentary here is that “malignant narcissist” isn’t an objective medical decision, but a moral/philosophical one. I think rather than “diagnosing” Trump, what is needed is a coordinated effort to honestly evaluate his behavior in terms of whether he’s doing his job and adhering to his oath of office. It is more akin to a boss firing his/her subordinate than a psych evaluation. People are hired and fired every day without the assistance of the psychiatric profession. We have a means for removing incompetent or corrupt presidents from office. The unfortunate reality is that at this point, those responsible for making that decision are too corrupt to execute their duties of office as well. But corruption and meanness are not “mental disorders.” They are corruption and meanness. If Congress doesn’t act to remove him, the voters have a responsibility to do so. If they do not, well, as they say, people get the government they deserve.
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I’m not sure anyone is arguing in favor of the APA setting standards for anyone. I certainly am not. And I also agree that the APA should not be weighing in on such things, nor do I think the media should be giving it any kind of weight in their coverage. But these are the times we live in.
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So you think Lieberman did the right thing for the wrong reasons?
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I wish I could argue with anything you said here. The system COULD work if Congress had the interests of their constituents as their primary objective. But it is clear that they do not.
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I have found that psychotherapy CAN work, but only if you have the right kind of therapist. I was lucky.
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I think this is an excellent clarification, Bob. It demonstrates how political psychiatry is as well as their lack of coherent philosophical or scientific structure to be able to answer a basic question that is supposed to be central to their own “expertise.”
But I still think the Goldwater Rule makes a lot of sense!
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I tend to agree with Kindred here. This is NOT a time for psychiatrists to start weighing in on whether a given President is “sane” or “insane.” We should expect our presidents to follow the rule of law, and remove them when they show they are unable or unwilling to do that. Whether or not a president is fit to continue in office is an assessment that needs to be made by the people working with him/her at the time, and is ultimately a decision Congress needs to make. I think the Goldwater Rule was put in place for a good reason and should remain.
The article also tiptoes around the giant elephant in the lecture hall. The fact that people within the profession can so vehemently disagree in a public forum without any objective way to determine who or what is “right” speaks volumes about the profession itself. That lack of any objective standards alone should preclude them from weighing in on whether or not a president (or anyone else, for that matter) is “sane.” If there is no means to come to an objective answer, it begs the question of why they feel qualified to give a “professional opinion” in the first place.
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Any “diagnosis” that boasts a 75% “false positive” rate is worse than a waste of paper – it’s overtly destructive. Besides which, what does psychiatry have to offer for these “psychotic risk” patients BESIDES drugs? Is there some intervention they are touting that will lead to fewer of these people developing more serious “symptoms” and hence reduce the total number ultimately smacked with the “schizophrenia” or “bipolar” diagnoses? Or, and I think this FAR more likely, will this simply bring people to the attention of the system whose only tool is a hammer, leading such people to become another set of “nails” to be hit with psychiatry’s biological sledge hammer? (Not to mention ongoing “customers” to help pay for their yachts or their kids’ college educations?)
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An excellent question! Any takers?
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I hear what you’re saying – you were in distress and you found the diagnosis and the drugs very helpful. I don’t want to invalidate that. But I have to disagree that the DSM helped you. The DSM did nothing except provide a billing code so they could charge the insurance company for neuroleptic drugs. The drugs seemed to be very helpful to you and worth whatever side effects you have to tolerate. Reading here, I hope you understand that your experience is not shared by everyone who takes these drugs.
You might want to read some of Joanna Moncrieff’s work. She talks about the drug-centered (instead of disease-centered) approach to drugs. Drugs have effects. Some people find these effects helpful, some do not. There is no need for any “diagnosis” for them to seem helpful. And the diagnosis does not contribute to understanding why these things are happening to you or how to solve whatever problem is going on, or even to predicting which people will find them helpful or harmful. . The drug simply suppresses the manifestations you wanted to have suppressed. And that works for you, and well done. But your one personal experience does not necessarily apply to everyone who is involved. Not to mention that the DSM “diagnoses” a lot of other things besides “schizophrenia” that can be extremely damaging or can justify extremely damaging actions taken against a client, including discrimination and involuntary detention by the police, which understandably is highly traumatic to people who are forced to live through it.
I would strongly suggest you read “Anatomy of an Epidemic” and also do some research into other peoples’ experiences so you can really see both sides of the situation. I’ve seen lots of people who feel like you do. I’ve also seen lots of people who feel their lives were destroyed by psychiatry. I think it would help a whole lot if you can try to understand why so very many people find psychiatry dangerous or unhelpful rather than just dismissing their stories and their observations as misguided without really trying to hear where they’re coming from and why.
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It certainly provides the justification for everything they do. And it alters societal perception of distress in ways that are extremely harmful but difficult for the average person to notice.
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Psychiatric “thinking” led to the DSM. It is a tool, not the cause. But it has proven a very destructive tool, indeed.
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I think that’s the point here. Some people may find it helpful, some may find it harmful, some may find it does nothing. But the practitioners don’t know what, if anything, is being “treated” nor what “improvement” means. If you don’t know what the problem is, you’re just shooting craps claiming to have a “solution.”
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Definitely looks more than a bit scary to me!
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It goes right back to “beating the Devil out of them.” It is assumed you must DO something to people who are suffering, to toss out the “evil entity” that is possessing them. We have changed from “The Devil” to “Your Disorder” but the rest of the game is exactly the same. And as in the past, all kinds of barbaric activities are justifiable to eliminate the “forces of evil” from the patient/victim.
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One of the problems I see with the concept of “recovery” is that it is a co-opted term that presumes that “mental illnesses” are real, scientific entities which can be “treated.” The truth is, “depression” and “anxiety” and “psychosis” are just descriptive terms that don’t reflect any known pathology. What this means is that the “solution” may be totally different for each person, even if they have the same “diagnosis.” So when these “disorders” are studied, no “treatment” will be shown to be generally effective, because we’re not “treating” any kind of unified condition or illness. So it is that some people who “have depression” thrive in therapy, others find it useless or damaging. Some people benefit from nutritional approaches, some need thyroid treatment, some just need to get a new job. Some have to escape from violent relationships, some need time to grieve, some need to move away from their parents, some need to learn how to manage their children’s behavior more effectively. Some need more money or healthcare, some are old and their bodies are deteriorating and they need to move on to the next life. ALL of the above people could be classified as having “Major Depressive Disorder!” Do we REALLY expect each and every “depressed” person to respond to the same “treatment,” when I have just listed over a dozen possible causes/approaches that are completely unrelated to each other? Of course, lumping them all together does meet the interests of one particular group: pharmaceutical companies. Because if you only look at “symptoms,” and measure all “treatments” of these issues, pharmaceuticals will have an advantage, since they are focused only on making the symptoms go away rather than detecting fixing anything that’s actually amiss.
So I’d say, don’t wait around for the “mental health” industry to come up with answers. There are too many conflicts of interest involved. I think each of us has to find our own path, except that we ALL need to work together to reduce poverty, racism, sexism, and other social ills, and to challenge the institutions of this society to become more humane and just. Beyond that, I think what “helps” is only going to be determined by the person seeking help, and anyone claiming to be able to “fix” our problems is immediately to be distrusted.
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I would add to this that the main reason unprocessed foods are so unavailable or un-affordable to so many of us is that our government has been corrupted by big food industries and that damaging things like high fructose corn syrup, sugar, and highly processed grains are massively subsidized. We now have to pay premium prices to get food that used to be normal fare before food industrialization. I hope we can go beyond saying, “Hey, it’s OK for poor people to eat crappy food if that’s all they can afford” and toward saying, “Hey, why is it that we are subsidizing the production of crappy food at all, and why don’t we create a system so that healthier foods are available and affordable to all of our population?” And that doesn’t even get started on why there is such widespread poverty in what is held to be the richest nation on earth!
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Someone should tell a real story about what happened in a psych ward, but pretend that they are describing a stay in prison, and see how outraged people get. I bet prisoners would get more empathy and concern than “the mentally ill” do.
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I really do agree that any therapist who is stuck to a particular “school” of therapy is one to steer clear of! It suggests lack of depth and inflexibility, and, dare I say it, immaturity!
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It’s a Zen thing – there is no positive without negative. The problem is when they get out of balance, either direction.
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I actually think “Science” should be put in quotes, because REAL science uncovers what is known AND what is unknown. “Science” that is manipulated by corporations or other conflicts of interest is NOT science at all. It’s religion or it’s marketing.
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I would not call what most psychiatrists do “science.” It’s not common sense, either, of course. It’s largely parroting of pharmaceutical marketing, though I’m sure a lot are deceived into thinking it has something to do with science.
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There is no evidence that antidepressants reduce suicide, yet these claims are still made wholesale. As for Prozac, it is the ONLY “antidepressant” that has ANY support for its use in those under 18, and the one study that supports it has been harshly criticized as flawed. But there is NO study suggesting it is “safer.” Where do they get these claims????
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The main “outcome measure” used by most “mental health services” these days are whether people “have symptoms” or are “on their meds.” I have rarely seen employment used as an outcome measure by any such agency, in fact, they often seem to discourage efforts of clients to find employment, encouraging them instead to get on disability for life. As for quality of life, it doesn’t even enter into the discussion in most situations.
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An excellent and important distinction! All of us can engage in negative or destructive behavior from time to time. What I think we’re talking about here is people who are COMMITTED to negative and destructive behavior, people who genuinely believe that the best way to live is to be selfish and disingenuous and to mess with other people’s success and even their very sanity. To be raised by such a person is a nightmare and has lasting adverse consequences. But even accidental or unconscious role assignments can be extremely damaging. I also appreciate the observation that our larger society creates and exacerbates such negative flows, as they benefit capitalistic ventures. Insecure people buy deodorant, more makeup, and more insurance. Not to mention more “mental health” services!
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I think they want to “Stigmatize” anyone who disagrees with them.
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“If so, then even the DSM-5 needs to be examined as to whether it’s more of a cultural document of social moral values, reflecting the subjective moral socio-cultural opinions of those who voted the DSM-5 into existence – rather than a list of objectively tested medical diagnoses?”
I think you have described EXACTLY what the DSM manuals are, and I don’t know how anyone examining the DSM-5 honestly can’t see this obvious truth.
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I don’t call them “narcissists.” I just call them “jerks.” Or “assholes.” Less clinical, more accurate, no free justifications offered. It’s a way of acting, not caused by anything in particular except deciding to be a jerk. I can have compassion for such people, but only after they decide not to pass their pain on to others.
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Amen! If there were a “love” button, I’d push it!
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I think the real question is, what do you DO with such information once you realize what is/was going on? That’s where even the best of our “mental health” services frequently let us down.
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I suggest you re-read what I stated in my earlier comments. I have never been accused of inconsistency.
I think you’re right, we’ve aired this out as much as we can air it. We may just need to agree to disagree on the extent to which genes vs. environment are responsible for these phenomena. Since the scientists can’t prove what is going on one way or the other, I think we’re on solid ground saying that no one can say for certain at this point what causes these phenomena to occur.
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As for immigrants, it is a specific risk factor, independent of poverty. But even if poverty IS a risk factor in itself, it still supports my observations regarding the relative contributions of genes vs. environment:
https://theconversation.com/immigrants-suffer-higher-rates-of-psychosis-heres-how-to-start-helping-them-73552
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I never said that genes play no role in schizophrenia. I said that it is not a “genetic disorder” like Down Syndrome or Cystic Fibrosis. And I said that there are small correlations with certain genetic patterns, but that the correlation with childhood adversity is much higher than any genetic correlation. It sounds like we are in essential agreement that genes and environment play a role. I ask that you be more cautious not to read things into what I’m saying that I didn’t actually say.
Similarly, I didn’t say that psychiatrists shouldn’t be trusted in the present or future because they were dishonest or misinformed in the past, though I think it would be a very reasonable thing to say. (How do YOU decide if someone can be trusted? Don’t you decide based on how they acted in the past?) What I said was that psychiatrists agreeing about something is irrelevant scientifically. I pointed out that psychiatrists have agreed almost to a man/woman about some “facts” in the past and right on up into the present which are now known to be false. This simply confirms that agreement among psychiatrists does not equate to scientific reality. I am certain the same observation can be made in almost any field of study we could mention. Science does not operate by expert consensus. It operates by experimentation and study and the ruthless questioning and retesting of any theory proposed to be true. It is also important to remember that scientifically speaking, any claim is assumed to be false until proven true, so the lack of evidence for something like a genetic basis for schizophrenia means that from a scientific viewpoint, it is not a valid theory.
Bottom line, we both agree that both genes and environment are most likely involved in what is called “schizophrenia.” So what are we arguing about?
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From your article: “Rather, researchers discovered that risk for psychiatric illnesses tends to be “highly polygenic.” This means that many combinations of DNA variations— cumulatively occurring in as many as 1,000 of our 21,000 genes—contribute to risk, when viewed at the level of the entire human population.
In light of this discovery, the question for an individual becomes: Which of these many variations, if any, do I carry in my own genome? And how, if at all, might the variations that I have in my genome affect my mental health and that of my children and grandchildren? Answers to these questions involve understanding what “risk” means in the genomic context.”
Note that this research is a) in the earliest phases and b) involves “risk variations.” This does NOT represent the genetics of a “genetic disease.” A genetic disease is something like Down Syndrome or Cystic Fibrosis or Huntington’s. These diseases involve a clearly identifiable gene which leads unerringly to the same result in every single case.
So far, as have already mentioned, such research has led to groups of often hundreds of genes which are estimated to contribute very small proportions of the “risk.” How that risk is assessed remains unclear to me, but even the most optimistic efforts have never shown even a 10% contribution, meaning that even if we take all this at face value, 90% of “schizophrenia” is environmentally mediated. In fact, the very use of the concept of “risk genes” acknowledges that environmental insult is REQUIRED to create the syndrome in question.”
Your own first comment, suggesting that immigrants have higher rates of “schizophrenia” due to having harder lives due to poverty, is an acknowledgement that “schizophrenia” is NOT a “gene disorder” and is highly affected by environmental situations. If it were purely genetic in origin, it would not matter what kind of environment was involved. Poor kids with the Down Syndrome genes don’t suffer more from Down Syndrome than rich kids with the genes. Every kid who has it, gets it. No kid who doesn’t have it gets Down Syndrome, no matter how s/he is treated.
And for the record, poverty is not the risk factor for “schizophrenia.” It is being an IMMIGRANT that specifically confers the risk. And there is no gene for immigration.
As for the genome, I believe the analogy to an “operating system” that I offer is a much more appropriate one. The most superficial observation of human beings makes it very clear that most of our “programming” comes not from our genes, but from the decisions and priorities and education and training and experiences we have after birth. Ants’ “programming” is all in their genes. We have the obvious ability to reprogram ourselves (or to be reprogrammed) based on experience. Which would include adapting to childhood adversity by various means. Not suggesting that such adaptations are not INFLUENCED by our genes, but we are not pre-programmed in our responses in the way an ant or even a mouse might be.
Of course, the fact that a bunch of psychiatrists agree on something adds not one iota of confidence that it is true. Psychiatrists agreed that Benzedrine (and later Valium) was not addictive, that Thalidomide was safe, that Haldol and Thorazine did NOT cause Tardive Dyskinesia, that antidepressants did NOT increase suicidality (some are still denying this), that antidepressants do NOT create withdrawal symptoms, and on and on. Psychiatrists still deny the decades of research that show stimulants do not lead to any improvement in long-term outcomes, nor that “unmedicated” people with “psychosis” more often than not do BETTER when they are not on long-term antipsychotic drugs. Again, this is NOT to say that some people don’t find these drugs helpful in their observation, just that the idea that EVERYONE who has any kind of psychotic episode MUST be put on antipsychotics for life. You yourself acknowledged earlier that this is true, yet the majority of psychiatrists still insist that every psychotic patient be immediately and permanently put onto antipsychotics. So the agreement of psychiatrists as a group means very little in terms of what is and is not true. Science should be our guide, not “resort to authority” arguments that “most psychiatrists say it’s true, so we should believe it.”
I really am sorry that you feel you were misled and it sounds like you had an awful outcome! I also want to acknowledge and validate your experience. I certainly agree that all people should vet any and all concepts claiming to “help” people with “mental illnesses.” The fact of the matter is, nobody really knows what a human mind IS let alone how it works and what helps when it doesn’t seem to be working well. It is the arrogance of psychiatrists insisting that they KNOW things when they really don’t that rankles. I have no answers, either, but trusting psychiatrists is a risky business as well, as you should be able to observe by reading the stories on this site. You have your reality, but other people have different experiences, as I’m sure you can see if you have any empathy at all for the many people on this site who have experienced harm at the hands of the “mental health” system.
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Two viable explanations: 1) the researchers are less able to get away with hiding “negative” results with new laws/regulations regarding availability of unpublished research. 2) Placebo response is a large part of the recorded “benefits,” and as is common among drugs of any sort, decreased confidence by the public in a particular drug over time leads to an increase in placebo effects.
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So sorry to hear that! The “MH” system is a dangerous environment for disagreement and innovation, at least that was my experience.
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I do find it amusing how they say that “traditional” mental health interventions don’t work with “indigenous people.” For whom DO they work?
I was at a training regarding systemic bias against African Americans in the child welfare system some years back. Someone said that the “mental health” system didn’t work well for black people. I stated, “It doesn’t work that great for white people, either!” Got a big laugh from the crowd. I think people know this deep down.
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Well, individuals certainly report perceiving them as beneficial. But then, many people perceive a snort of Johnny Walker Red or a couple of beers after work as beneficial, too. Doesn’t make beer a “treatment” for “Work-Related Stress Disorder.”
Apparently, hospitals are reporting a dramatic decrease in admissions for heart problems and other acute incidents. Is it possible that staying home from work and not having to commute in insane traffic to keep a ridiculous schedule may be beneficial to one’s health? Or perhaps fewer visits to the local MD may result in fewer incidents of iatrogenic heart attacks?
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Your faith is again touching. But a tad naive in my view. Time will tell which of us is correct.
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There is excellent and undisputed evidence that diagnoses of “schizophrenia” are much higher in immigrant communities. How do you explain that genetically?
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No one is saying that medication/drugs can’t be beneficial. But the fact that you find them beneficial does not imply that you are being “treated” for a “disorder.” It just means that you find them beneficial. Lots of people do, but lots of other people don’t. Is that not a fact you have to consider in your analysis? What about the “schizophrenics” (who are many) whose lives are not improved or are made worse by these same drugs?
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I don’t agree at all. From Wikipedia:
“In the fields of molecular biology and genetics, a genome is the genetic material of an organism. It consists of DNA (or RNA in RNA viruses). The genome includes both the genes (the coding regions) and the noncoding DNA, as well as mitochondrial DNA and chloroplast DNA.”
Your statement is the same as saying that a computer program is the same as the computer hardware. The genes are hardware. They contain instructions, which is programming of a sort, sort of like the “operating system,” but the incredible complexity of human behavior is no more explainable by the genome than a computer’s behavior is explainable by the operating system.
Not to mention, the computer has an OPERATOR as well as a program and hardware. I challenge you to provide a genetic explanation for who/what is operating the brain?
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You make my point for me. If we don’t know how the brain works, then we can’t say that “genes cause schizophrenia,” at least not if we are being scientific. All we can say is that “genes create the brain.” We’re on safe ground there. See my other post for the requirements of a real “genetic disorder.” Being related to the brain that is created by genes doesn’t qualify as proof. Makes as much sense to say that running is genetically caused, since the leg muscles are created by genes. It is, indeed, a nonsensical argument.
I am guessing that you are what is called a “reductive materialist.” Do you believe that everything that happens must be directly explainable or measurable in terms of physical reality? And therefore that the mind must be created and run by the brain, and therefore every manifestation of the mind must be caused by the brain?
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I read the entire article. All it says is that gene expression is altered over time and that these alterations can be tracked. It does NOT place responsibility for “schizophrenia” or any other “mental disorder” in the genes. It talks about an identified “risk group” of genes, providing no information as to what level of risk is entailed by these genes, nor any correlations to a particular “disorder”. The total effect of these genes is not calculated or estimated. The article clearly mentions methylation, the core of “epigenetics,” as a big factor that they will be looking at. All indications I’ve read are that epigentics is primarily and deeply affected by the environment.
So the article you provide provides no evidence of a genetic origin of any “mental disorder,” and allows for a huge possibility of variation of outcome due to environment. The presence of “risk genes” is mentioned in passing, but risk is not causation, as I’m sure you are aware. I’d be really interested in hearing a comparison of the level of risk attributed to “risk genes” as compared to the level of risk attributable to childhood adverse events. I feel quite certain that the “risk” from environmental abuse is much higher than that from any set of “risk genes.” But your article doesn’t bother to do that comparison. It is an interesting and telling fact that the article makes no mention of non-genetic risk factors, and seems bent on finding a genetic explanation, even when such an explanation is not really viable under the huge variation of environmental factors impacting these “risk genes” that are postulated to contribute to these “disorders.”
It is also worth noting that the “risk gene” group is correlated with more than one “disorder”. A truly causal gene would be associated ALWAYS with the disorder in question. For instance, children with the Down Syndrome genes will ALL have Down Syndrome. That’s a genetic disorder. Having correlations with “risk genes” does not make any kind of argument for a “genetic disorder.” The “risk genes” could be associated with other survival traits that are essential to the species. To use the obvious example, even if they found a gene which made kids more active and intense than average, and even if that gene did so 100% of the time (which by the way has never been shown to be the case, nor have even “risk genes” been identified), it would not prove that “ADHD” is a “gene disorder,” because the genes convey a general personality tendency that could be positive or negative or neutral depending on the environment.
You are entitled to believe what you want, but I’m pretty well versed in the research and am quite certain that there is no proof that “schizophrenia” is even a distinct an definable entity, let alone a “genetic disorder.” If you claim it is such, you’ll have to come up with a lot more convincing article than that one to sway my opinion. Mind you, I can be swayed with adequate research, but this doesn’t do it for me. I certainly don’t deny that genes can be involved in mental/emotional states, but “can be” is a pretty broad statement, while claiming that a specific “disorder” IS genetic requires a lot of proof to establish.
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Just the kind of “reasoning” that got us where we are. There were days in the not too distant past when wanting to escape enslavement was considered a “disorder.” Most of the victims of this “disorder” happened to be black. Must be genetic, eh?
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I would suggest that any “therapy” that is not “trauma-informed, is based on shared-decision making and promotes personal choice in charting the direction of one’s life” does not qualify as therapy. The essence of quality therapy is enhancing one’s self-determinism and ability to exercise one’s options with confidence. “Therapy” that promotes dependence, that blames the client, or that enforces another’s worldview (especially if it is a chemically based worldview!) should instead be called by another name: ABUSE.
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Your optimism is touching, but I don’t share it.
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You miss my point, in a couple of ways. First off, there is no “genetic variant” that “causes” schizophrenia. I ask you for evidence of this and you have not presented any, so it is just as right to say “there’s a correlation but no causation” when referring to genetic claims as well. Which leads to the second point, that the correlation (which I called a correlation, not a causation, if you will review my post) is about 10 or more times higher for childhood adversity than it is for genetic markers of any type. And the relationship is dose dependent. And even the research for markers has to use something like 100 potential markers to get anything like 5-10% correlations. There is no one gene that contributes more than a tiny fraction of that, even in the most optimistic assessments that have been done. So yes, it’s ALL correlations, Martin, including the overblown claims of “heritability.” Here is just one link, found in seconds on google:
“Those that were severely traumatised as children were at a greater risk, in some cases up to 50 times increased risk, than those who experienced trauma to a lesser extent.”
https://www.sciencedaily.com/releases/2012/04/120419102440.htm
RE: multiple casues of “schizophrenia”
https://www.medicinenet.com/is_schizophrenia_a_genetic_disorder/ask.htm
The real problem, of course, is that “schizophrenia” itself is just a name given to a certain set of behaviors or experiences, and these “criteria” may exist in people who have little to nothing in common, genetically OR environmentally. The idea that behaving in a similar way means that people have the same problem and need the same “treatment” is scientifically nonsensical. It’s quite possible that SOME people who meet the criteria for “schizophrenia” have something genetically wrong with them, but to suggest that “schizophrenia” is caused by genes or by any one specific thing is absolutely not supported by science, whatever your personal feelings may be on the matter.
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Maybe their genetics somehow magically attracts abusive people to them. THAT would explain it! /s
Seriously, if there were ever a “disorder” that we KNOW the cause of, it’s PTSD. Efforts to make THAT into a “genetic brain disease” is far beyond the pale!
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If schizophrenia is a “genetic defect,” why have 50 years of genetic research fail to identify any genetic cause? Why are the correlations with childhood adversity in the 80% + range while the best specific genetic correlations are in the single digits?
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Nice job!!
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I mean has your training translated into any programs or pilot projects or individuals starting on a new way of doing things?
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One might easily feel overwhelmed and overworked if one’s efforts were constantly unsuccessful or damaging to one’s clients. I am sure many psychiatrists recognize on some level that they are not being helpful or are being destructive, and the weight of that must indeed be heavy. The denial of contradictory data is needed to maintain some semblance of being a “good person,” and few seem to have the moral courage or integrity to simply admit what is going on. Instead most seem to be avoiding their own pain and guilt by focusing on convincing others of the “rightness” of their approach or the supposed lack of any “alternatives” and blame insurance companies or short sessions or “the disease” or the client or anyone else except for the processes they are engaging in that are so obviously failing. I MIGHT feel sorry for those who recognize this, but only once they decide they can’t live with themselves doing it any longer and stop.
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Sounds like you’re doing some great work! Has anybody had the courage to go beyond hearing and to do something further?
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Sometimes recently I’ve been thinking that individual people can be forgiven and healed, but organizations and institutions don’t have their own independent “souls” and so can’t be “forgiven” in the same way. They can only be reformed or eliminated. And as someone wisely noted, the first goal of every organization is to perpetuate itself, so efforts to reform are often doomed, as the internal need to continue doing what has been accepted as “right” is very powerful, especially if rewarded with funds and/or prestige. It is only the most enlightened of organizations that is able to evolve when new data or ideas are brought forward. The “mental health” professions, at least at this time in our history, are seeming to be pretty much the opposite of enlightened. It is almost certain that they will continue to perpetuate the nonsense that their industry is built around unless they are met by some massive force that prevents them from getting rich or powerful by doing so. It has become clear that facts and research are no impediment to the continued psychiatric delusion.
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The primary “science” Big Pharma relies on is the science of marketing. Actual medical science serves only as marketing’s handmaiden, and when medical science stops serving marketing, it is quickly and unceremoniously discarded.
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Well, MOST shrinks. There are some exceptions out there, but they are rare and often under attack!
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Wow, thanks for that inspiring story! And well done for maintaining your integrity despite efforts by the system to distract and deflect your attention away from the real issues. We need leaders like YOU!
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The irony is that “clients” of the “mental health system” are exposed to the same kind of treatment that created their distress in the first place. Being forced to pretend to agree with an enforced reality is very familiar to children growing up in unloving or emotionally distorted home situations, where they have to “manage” those who are supposed to care for them in order to survive and avoid further harm. How is dealing with a rigid, authoritarian bureaucracy bent on labeling and blaming its victims any different?
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Excellent points! I often wondered why so many people identified as “SMI” smoked cigarettes, a factor many in the industry blamed for their early deaths. It was only in the last 10 years or so that I became aware that people on “antipsychotics” often use cigarettes to offset the assault on their dopamine systems, to try and slightly lift the severely depleted levels of dopamine caused by the drugs. And I always found it particularly offensive when clients, often children or teens, were told to go on a diet and to exercise more because of the huge weight gain they experienced on Zyprexa or other “antipsychotics.” Their doctors didn’t even bother to tell them that the weight gain was directly related to the drugs. How is that not malpractice? But as usual, the individual or “the disease” is responsible for anything bad that happens, while any positives are attributed to the drugs.
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And an ugly one at that!
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There is nothing inherently “aggressive” about filing a complaint. It is everyone’s right to do so. Only those afraid to deal with the consequences of their actions regard a formal complaint as an act of aggression. Unfortunately, there seem to be a lot of such people working in the “Mental health” system!
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Originally, psychotherapists were expected to go through their own therapy before taking any clients, for this very reason. I think the real difference between helpful and unhelpful therapists is their ability NOT to project their issues onto their clients. But since this is no longer a focus in training, I am afraid very few therapists these days meet this standard.
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And the machines can’t even argue or refuse their “meds!” What a perfect plan!
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I agree. Victim is in reference to an EVENT. It does not define a PERSON, it defines the action of one person or group against another that causes harm. I can be a victim of a crime without victim defining my identity as a human being. In fact, it is the confusion of events with identity that is what most characterizes the stupidity of the psychiatric worldview.
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Maybe we can just pay them NOT to “treat” us?
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Those who need to convince others to agree with their beliefs clearly are lacking real conviction in what they say they believe in. If you really feel certain something is true, the fact that someone else doesn’t agree with you is of very limited importance!
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These are great tips. The sad part is that someone has to be so careful to strategically approach those who represent that they are there to help you. Something is SERIOUSLY wrong with this picture!
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I would say from experience that condescension is the most common attitude. The “professionals” feel like they’re being helpful and want appreciation no matter what they do or how bad it is for the client. Unappreciative or difficult clients are most definitely made fun of by some, and it is difficult for those who are uncomfortable with it to speak up. (Though I used to do so a lot of the time.) The truly successful professionals were the ones who saw the clients as just other humans not very different than anyone else, except as to the particulars of their personal circumstances. But they were in the minority. Not saying that a lot of professionals didn’t care at all, it’s just that so many viewed the clients through a lens of inferiority or failure. They often viewed the clients with pity rather than true compassion. There were plenty who did not, but again, they appeared to me to be in the minority.
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I suppose that is an “effect” of a sort, though of course it is of no use to the actual “client.” Maybe they should use future financial reimbursement as their “primary endpoint?” It would eliminate a lot of confusion!
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Wow, they call it “poor results” and encourage continued investigation? A true scientific analysis would call these approaches utterly useless based on the data, and recommend giving up on these approaches entirely!
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Thank you for this, Miranda! It has really bothered me how the normal anxiety to the Coronavirus situation has been framed as “triggering mental health issues” for those with a label. You did a great job of showing the disparate and confusing coverage of this, and the intense but unspoken struggle to define what a “normal” reaction to such a situation must be. I’d only add that the fears of a sudden wave of “mental illness” sweeping the country completely puts the lie to the idea that these “mental illnesses” are somehow biologically determined. I also appreciate very much the observation late in the article that many of those already labeled “mentally ill” may actually have a lot to teach the so-called “normal” person about living in isolation or being extra safe or managing anxiety about situations we don’t control.
Glad someone is finally talking about this!
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You are so right! Corruption of “science” has led to an inability to distinguish what is true from what is profitable, which is exactly what real science is supposed to be preventing!
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Well said!
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Well, you KNOW it’s your fault no matter WHAT happens. Unless you get better, in which case it must have been the drugs!
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I’ve never heard the word “cruel” used, but they certainly believe that life will be exceedingly painful if one does not develop an awareness of reality as it is and begin living with the knowledge of constant change and impermanence. And I agree with them on that point.
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Accepting and normalizing one’s own feelings is an essential step. Looking at “positive thinking” may work for some people and be disastrous for others. The first mistake is telling the other person how to feel or what will “work.” The only one who knows what works is the person who is trying to make the changes.
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Blame is an utterly ineffective tool in any case. Reflecting on possibilities and options gives people their power back. That’s what really works.
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I personally think that’s a distortion of Buddhist thinking. They don’t teach that we should just suffer or that those who accept the Buddhist path won’t suffer. They teach that suffering is primarily caused by wishing/desiring that things be other than as they are, as well as clinging onto and trying to keep things the same that will inevitably have to change. But they also teach that compassion is central and that the easing of suffering is very realistic and something to be valued for all, whether Buddhists or not.
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In particular, “Pospartum Depression” has been massively promoted as a “disease state” when the vast majority of cases consist of very understandable reactions to difficult life circumstances and the incredible lack of support available for new moms in our culture. My wife did some research on this and found that there are cultures where there is practically zero incidence of “postpartum depression.” Not surprisingly, these cultures put a big emphasis on supporting new moms in doing their job as parents so they don’t have to do much of anything besides spending all their time and energy learning how to care for themselves and their new babies.
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They have neglected the results of their own scientific research!
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Professional consensus is the ultimate enemy of science!
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I suppose if I deny I was shouting, I will be labeled with Anosognosia and be drugged anyway!
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Lucy gets it 100% correct here. I have never seen a clearer example of the ludicrousness of claiming “mental illness” to be the cause of anxiety/depression/anger/fear relating to this huge, worldwide concern. I wince every time I hear someone say, “Mental health issue can be TRIGGERED” by the Coronavirus fears. Totally “normal” and undiagnosed people are losing sleep, hoarding toilet paper, worrying about finances and the economy, etc. It is NORMAL to be worried about something like a potentially deadly virus and the social disruption it is causing! In fact, people who are NOT worried are the ones making the problem worse!
This is proof that the MH paradigm is completely bankrupt and needs to be scrapped!
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Naturally, they neglect to mention that something neurotoxic to fetal cells is most likely toxic to adult brain cells. An inconvenient truth.
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That totally sucks! What the hell are you supposed to do? Hire an attorney?
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Good news from my home state of Washington: hospitalizations DOWN this week by about 20% over last week. Social distancing does seem to be working for us here. Keeping my fingers crossed!
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Sometimes what you have to do is do anything you can to convince them you agree 100% and are now happy and healthy due to their wonderful interventions, and then escape once they open the door and don’t ever come back! You clearly have sufficient “insight” to understand what they are about and that convincing them is impossible. So the next best thing is to escape their influence in any way you can! Easier said than done, though. WAY easier.
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Gosh, you don’t sound very APPRECIATIVE of their efforts, Boans! 😉
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Of course, a lot of the “treatments” adversely affect their “patients'” physical health, making them more vulnerable. Not to mention the impact of being given the idea that your brain is permanently broken. It has been shown that having hope and purpose improves health and resistance, too, though this is pretty much common sense. Though it appears not so common in the world of “mental health treatment.”
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I’m afraid way too much money is being made keeping people in “coping mode.” If we really taught people or helped people to become more capable of managing their own lives, a lot of people might need new jobs!
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Could not emotional state be a determinant of the vagal nerve system state?
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How could they possibly HIRE enough people to track everyone’s whereabouts???
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Gosh, that sounds kind of rational! How refreshing!
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But remember that corrupt politicians could not be bought if someone were not out there buying them. As long as taking “contributions” from big money corporations is allowed, we will have corruption. It needs to stop!
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I know, right? Instead of taking a walk, I’m engaging in “ambulatory therapy?” Surprised they haven’t tried to patent it and forbid us to take a walk without paying our therapist for it!
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I agree 100% – why all the focus on genes? Let’s just allow that some people will react differently to the same situation than others, and that genes probably play some role in it. So freakin’ what? It’s like studying people’s bones to see why some people get broken bones in a car crash instead of trying to reduce the risk of collisions. Idiocy!
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Apparently not. We end up being at the lowest end of any health outcome measurements of industrialized countries.
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At a minimum, they ought not to be allowed to take lobbying costs off on their taxes! Or maybe we should TAX lobbyists heavily for their “work?”
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WTF does that have to do with the Coronavirus?
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Of course, Major Depressive Disorder is a social construct, so how would you know if somebody “had it” or not? It would be similar to saying that someone “has courage” or “has racism.” It makes no logical sense if you can’t distinguish between those who do or do not have a particular “condition.”
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I think that is a legitimate distinction. I was talking about moving from a strong core protest to a larger mass movement. I agree we are not really at a point where that can happen yet, and building a strong intellectually/scientifically viable base is essential to any movement succeeding. It’s just that a lot of people aren’t able to process on the level that is needed to understand the viable base and need their memes and leaders in order to get with the program. It will happen one day, but again, we’re not there yet.
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There is a difference between pandering and taking the facts of human behavior into full account when planning a strategy. I would challenge you to show big changes happening against the status quo that were not created with emotional appeals to the masses. Of course, there need to be solid, real, honest ideas that have strong logical backing, because otherwise they don’t WORK. But I can’t think of a major change movement that didn’t employ emotional appeals as a big part of their strategy. I could be wrong, of course, but I’m not seeing examples of “intellectual revolution” being successful. I’m open to hearing examples if you have some. Like I said, it’s not my specialty, just going by what I’ve observed.
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So what’s the intelligent strategy? I don’t see one so far.
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I have had that very thought!
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So how does “we” get larger, then?
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One can be right all day long and get nothing done. That’s how I’ve experienced attempts to change the system from within. I have no interest in denying reality or polling anyone on what they want to hear about psychiatry, and frankly, given my history, I find that suggestion a little disrespectful. I absolutely agree that calling psychiatrists “doctors” or psychiatry “medicine” is a fraud and needs to be called out as such. The question is how you get masses of people on board with that idea. Most people don’t think with ideas, they react with emotions. That’s why a story in the paper about a poor kid living on the streets with his parents gets tons of donations, while a request for an increase in the welfare budget is met with disinterest or scorn. People have to be grabbed emotionally. Facts don’t convince most people of anything much. Most people are driven by emotional “reasoning,” which is one reason psychiatry has been as successful as it has – it appeals to people’s desire to feel like someone understands something that they don’t, and to people’s desire to blame someone/something in a way that keeps them from having to make any significant changes. It’s how people in groups tend to act. You have to get them excited or angry or worried about something or they will roll with the status quo. At least that’s my experience. Maybe I’m just too cynical!
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You say you learned schizophrenia is genetic? Who told you that, and what proof did they offer? A full review of massive research has shown a complete failure to demonstrate any specific cause for “schizophrenia,” or even significant evidence that “schizophrenia” is even a valid entity for research. Mainstream psychiatrists (including the head of the NIMH, Tom Insel) have recognized that these diagnoses “lack validity,” and some have even proposed dispensing with “schizophrenia” as a diagnosis, or saying that there are “schizphrenias” which have no necessary relationship with each other in terms of cause.
I’m sorry that OD did not work for you. The folks who invented and developed it have made it clear that 20% of clients don’t respond to OD. You may have been one of them. That doesn’t make the data wrong.
I’d also be the last to deny that biology COULD cause a person to have hallucinations and aggressive behavior. But calling all such cases “schizophrenia” and asserting that they all have genetic causes is absolutely contrary to actual science.
If anyone had an agenda, it was the person telling you this stuff.
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We are appealing to anyone who is uninformed and who needs to become educated. The world isn’t broken up into those who agree with eliminating psychiatry and those who sing its praises. Most people don’t really HAVE opinions, they make their opinions based on rhetoric they hear from those whom they assume know more than they do. There is no reason not to reframe psychiatry as a human rights abuse because it will garner more support than trying to convince everyone that psychiatry is a fraud (which it is), because we need the general public opinion to turn against psychiatry. That seems to me the most effective, practical way to do it. Any mass movement requires a mass of people to participate, by definition. It seems to me that the way to get a mass movement going is to have memes that people can get behind in large numbers. Take “MADD” for instance. They didn’t argue that no one should drink, they argued that people should not DRIVE drunk. And they came up with the meme of the “designated driver,” which resonated with big numbers of people.
I’m not a master of group dynamics or mass movements, but it seems to me that people can wrap their brains around the idea that people deserve to have their rights respected more easily than they can that their doctors are a bunch of charlatans, even if the latter is observably true.
Hope that makes some sense.
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Time for another Rosenhahn experiment!
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True compassion, in my opinion, can’t come from a place of hierarchy and authority. Authoritarians are capable of pity (hence the “anti-stigma” campaigns), but true compassion requires stepping away from the superior role, and a true authoritarian can’t ever allow that.
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I personally think the human rights approach is the broadest and would have the most general appeal, especially if combined with honest rhetoric regarding oppression of particular subgroups within the general abuse of rights that psychiatry represents. People want to believe in doctors, but they also want to believe they ave rights which can’t be violated willy-nilly. How we can connect the abuse of rights of the psychiatrized with the rights of people who haven’t yet had that experience is a bigger challenge, but one that I think eventually can be overcome.
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It’s a classic tautology. Since it’s not “normal” to do antisocial things, anyone doing something antisocial is “abnormal.” But since we’re not allowed to say things like “evil,” we say such people are “crazy” because “only a crazy person would do something like that.” So they did it because they’re crazy, and they’re crazy because they did it. Then, by analogy, anyone who is “crazy” (aka “Mentally ill) is dangerous, because by definition “crazy” things are done by “crazy” people. QED.
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“Never attribute to malice that which is easily explained by incompetence.”
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Dark magic, though.
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I do want to distinguish somewhat between you as a layperson saying this vs. a medical professional saying this. You are not purporting to be representing the latest scientific knowledge in the field, so it’s more understandable and less damaging to use analogies to explain things. That being said, I still consider it a damaging framing of the reality of “mental illness.” What you said at the end is much more relevant to understanding most people’s situations – that we have trauma, neglect, and other harm from how we grew up, whether from parents, siblings, school, church, or other institutions. Finding someone to talk to who really understands these experiences is what I’ve found helps people the most. Most folks don’t “need medication,” they need UNDERSTANDING. This is not to say that some people (like you) don’t find these drugs USEFUL. It is to say that the idea that you are “treating a brain malfunction” is simply wrong, both scientifically and sociologically. It is not a “disease” or “disorder” to feel bad, act in antisocial ways, or think unusual thoughts. Some disease states DO cause emotional distress, weird thoughts, or antisocial behavior, but those disease states have specific causes and usually specific remedies. To say that someone “has clinical depression” is totally subjective, and it is highly misleading to create an analogy with diabetes, as diabetes is objectively measurable and has a specific treatment that is effective almost 100% of the time. This is simply not true of “antidepressants” or any of these psychiatric drugs. They are very simply efforts to make someone feel better or act better temporarily. There is nothing observably wrong with the person, and there is nothing specifically being “fixed.”
I think you’d be far better off telling people that “I’ve taken these pills and they have helped me feel better. That apparently doesn’t happen for everyone. Nobody really knows if there is something biologically wrong with you, but I can tell you that I understand your plight and am very happy to listen. I find that listening and caring for each other is the best ‘medicine.'”
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Me, too!
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Most people who become suicidal as a result of taking any drug are unaware that the drug is the cause. And those who are aware or are becoming aware are roundly invalidated by their doctors and “mental health professionals” in the majority of cases.
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That is truly disgusting!
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The point about lung cancer is very well taken. The fact that some people like the effects of cigarettes and don’t suffer much long-term damage doesn’t mean that “stop smoking” campaigns are “shaming” those who continue to smoke.
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This really is the key question. “Medications” are measured intentionally only against “symptom reduction,” mainly, that a person feels LESS of the “negative” feeling or engages in less of the “undesirable behavior.” Quality of life is almost NEVER the overt measure of success. If it were, “medications” would be relegated to last-resort status or banned altogether. One of the great things Bob has done in Anatomy is to demonstrate the massive REDUCTIONS in quality of life with the current paradigm. And to me, what is the point of any “mental health” intervention if the recipient isn’t more satisfied with his/her quality of life as a result? What other measure of “mental health” (if such a thing can even be defined, let alone measured) could be identified?
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It does seem odd in the extreme that “treatments” which reduce the average lifespan of the recipients are seen as “lifesaving.” A little Newspeak if you ask me.
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I hear that you’ve had a good personal experience. It concerns me that you seem not to want to hear that not everyone experiences things the same way you do. You write a number of philosophical assumptions regarding the brain, but provide no scientific proof that the brain is the cause of “mental disorders.” If you read the article, you’ll see that the primary difference is that we KNOW that insulin is the singular causal factor in high blood sugar – it can be measured, blood sugar can be measured, and adding insulin or coming up with a way to increase insulin reduces or eliminates the problem in almost 100% of the cases. Add insulin, reduce blood sugar – it is that simple.
With psychiatric “diagnoses,” there is no known missing substance that needs to be replaced. There is no substance that can reliably replace the mystery “missing substance” and create beneficial results 90% of the time, or even 50% of the time. Compared to placebo, Kirsch’s work showed that ADs are barely better than taking a sugar pill. Compare that to the almost universal success of insulin in reducing blood sugar. Heck, we don’t even know if there IS any chemical causing ANY of these conditions, let alone are we able to MEASURE those chemicals.
SO the analogy fails completely. There is no SCIENCE saying that “depression is caused by low serotonin,” and lots of evidence saying that it is not. Doctors are GUESSING as to what drugs may or may not be perceived to “help” by reducing the experience of depressed emotions. The analogy with drinking a controlled amount of Jim Beam whiskey daily is a much more accurate one. People DO feel better when they drink alcohol, but there is no “condition” being addressed by the alcohol – it has a general numbing and elating effect on everyone. All psych drugs work similarly – they create effects that some find agreeable, and some don’t. The “diagnosis” itself is made by listening to a list of feelings and behaviors, not by measuring something concrete like blood sugar levels.
So in essence, the “insulin for diabetes” analogy is a complete deception. Vague philosophical assertions about the nature of the brain (unproven, except that the brain is of course nervous tissue 100%, not a muscle) do not count as hard science. If there is nothing to measure and no reliable approach to improving such a measurement, we’re talking about something VERY different than diabetes.
Your clients are relying on you for honest information. I don’t believe it is ethical to provide them with unscientific ideas based on your personal belief system. I believe you are responsible for telling them the facts, including the fact that we don’t know WHAT causes “mental illnesses,” or indeed whether they are “illnesses” at all.
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The irony of the “Decade of the Brain” is that they discovered that the idea of specific “mental illnesses” due to “brain disorders” was wrong. The real results were that the brain is FAR more flexible and malleable than anyone believed, and that experience can change the brain through adulthood. And the most significant brain-healing action we could take for kids is a positive relationship with a mature adult. TOTAL contradiction to what they wanted to find, and of course, these results were largely ignored, except to emphasize that early abuse/neglect “damages the brain,” which serves their narrative if looked at in isolation. If they REALLY applied the lessons from the Decade of the Brain, the DSM would be ditched and we’d be spending a lot of time would be spent improving people’s relationships with each other and creating positive environments that promoted grain health for kids and adults. Who would have guessed?
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Because there is no such proof!
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I’d love to have a link to that article posted! I’ll have to look it up, but it is amazing (and yet not surprising) how hard proof of damage is provided and yet to claim that it is “safe” to use something that induced a person to kill his child and almost kill himself! How is that “safe?”
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Beautiful writing, as usual, Noel! This is the kind of talk I recall back when I initially broke into the field of therapy. I don’t know that this kind of discussion even happens in most peoples’ training these days.
I do want to point out that one of the many reasons trauma survivors die 20 years earlier than the general population is the drugs they are given/forced to take by the “mental health” system itself. Further physiological and psychological traumatization does not appear to be particularly helpful in “treating” the effects of chronic trauma!
Thanks for all you do to bring sanity to the crazed world of “mental health treatment.” I wish that all “mental health” workers took their cues from your philosophy.
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I like the article, great history there. However, I would argue that these efforts at transformation were ultimately coopted and that the basic fundamental beliefs of the system have not changed much at all. Women are still told that their anxiety/depression the the face of childhood sexual abuse, rape, domestic violence, and general oppression by the mainstream of our society are personal problems. They are still proffered new versions of “mother’s little helpers” in the form of benzos and SSRIs. They are still blamed for not “adapting to their roles” properly, and still diagnosed for being “too emotional.” These seminal writers’ critiques are just as valid today as they were in the 70s. We are still waiting for the ensuing “transformation,” and will most likely wait forever for this utterly patriarchal and oppressive system of thought to actually become responsive to the actual needs of clients and society at large.
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It is not the inability to trust, but the inability to know WHOM to trust that is a problem. Anyone who says “trust me” without taking adequate time to earn that trust is someone who goes on the “don’t trust” list for me right away!
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Yes. It was a known concern before it was approved.
“Those who developed akathisia or who had any suicidal tendencies were excluded from the trial data on the basis that they would otherwise obscure the results of the drug’s success in treating depression. Yet the German licensing authority, the Bundes Gesundheit Amt (BGA), on scrutinising the results, expressed concerns about the drug’s safety. On May 25, 1984, according to Lilly’s internal documents, a letter from the BGA stated: “During the treatment with the preparation [Prozac], 16 suicide attempts were made, two of these with success. As patients with a risk of suicide were excluded from the studies, it is probable that this high proportion can be attributed to an action of the preparation [Prozac].”
https://www.theguardian.com/theguardian/1999/oct/30/weekend7.weekend1
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THAT made me laugh!
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I agree. It is not absolute poverty, but the power differential from income disparity that causes the greatest distress. The sense that you are somehow unable to succeed at life because the rules are rigged against you separates you from others, while working together with others struggling toward the same goals brings people together in a sense of community that is what really helps people feel good about their lives.
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But besides THAT, they’re actually pretty benign…
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Sorry, you got me!
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So being unable to provide sufficient resources to survive, being worried about losing electrical power or heat or even housing, being unable to eat sufficient food and having no recourse, all of these things could make a person more “depressed?” Golly, jeepers! These poor people must have chemical imbalances, mustn’t they? Or they need to sit and have someone understand the difficult feelings associated with having your family lose their home or slowly starve to death?
I’m glad this research has been done and is published, but how many times to we have to study the obvious? Anyone with half a brain could figure out that poverty feels like crap and will lead to more suicides. Time to DO something about it instead of continuing to blame the victims of our heartless economic system!
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I have known plenty of people who were on “maintenance antipsychotic treatement,” in fact, almost anyone who had been to an ER for “psychotic symptoms” got on one. Many were forced to take them and had no choice. A lot of foster kids are put on them daily for behavioral problems that have nothing to do with psychosis. Old folks in nursing homes are put on them to manage difficult behavior, again without any “psychotic disorder” diagnosis or even symptoms. It is no myth. It is true that many people (like mathematician John Nash) go off antipsychotics as soon as they are safely away from the authorities. But the standard recommendation I’ve seen for ‘psychosis’ or ‘bipolar disorder’ is “maintenance antipsychotic treatment.” And those who refuse to “comply” are pressured, manipulated, or incarcerated for it. There is no myth involved here.
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That is exactly what I recall reading. Thanks!
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Prozac was actually NOT approved in Germany, and I believe Italy as well, due to suicidal and aggressive impulses being aggravated or induced by the drug. This was known information from day one.
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Oppositional defiant disorder? Until they piss you off so badly you go off on them, then you have “Intermittent Explosive Disorder.”
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The main valuable expertise I’d be looking for is the ability to convey interest and compassion while I told my story. And from psychiatrists, I can count the ones I’ve see do this on one hand and still have a couple of fingers left over. Most counselors/therapists these days are also bought into the DSM and have stopped talking about unconscious motivations and life goals and sense of purpose and spend their time on “symptom reduction.” It’s a sad situation, and I would value the clients’ expertise over the “mental health professionals” at least 9 times out of 10. Most of what I learned about therapy, I learned from clients letting me know what they felt helped and did not help. There is no other standard for success. It should be the #1 most valued information there is, not relegated to third place after “research” and “clinical expertise.”
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It is interesting that they refer to “clinical expertise” but to “patient preferences.” What about “patient expertise?” or “Patient knowledge?” It seems that framing a patient’s/client’s decisions as “preferences” is disempowering, in that it implies that the patient’s information is irrational or emotionally-driven, rather than being rationally-derived information based on the patent’s own experiences and knowledge base. A normal power distribution would require the patient and the therapist to negotiate an agreement on the actual facts of the situation, assuming each one had an expertise of their own that legitimately informs the mutual understanding of both the problem and the possible solutions. “Preferences” is a very weak term for what is being expressed by the clients in these situations.
Additionally, the author neglects to observe that the “evidence base” for “EBPs” is based on the categories in the DSM, which psychiatry’s own leaders (like Tom Insel at the NIMH) and the DSM introduction itself acknowledge to be invalid, heterogeneous categories of behavior that do not necessarily indicate any commonalities between those who “qualify” for a particular diagnosis. So saying that “X treatment is more effective for major depression than Y treatment” becomes a nonsensical statement, since depending on which client with that diagnosis presents to you, the required “treatment” may vary wildly.
If you really want to do “evidence-based treatment,” you have to start with a legitimate grouping of candidates for study. Absent that, the “scientific evidence base” for these therapies is worse than useless – it is actually deceptive.
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Don’t know that I was always “eager” to see my therapist, but what was clear is that my therapist, who was wonderful, was focusing on doing whatever she could to help ME meet MY goals. She never told me what to think or believe, never told me what I should or should not do, never criticized me for making a particular decision. She was genuinely INTERESTED in finding out more about me, and even when there were some hard times going through material I would most certainly have avoided without her being there, I always knew she was on my side and would make it safe for me to say whatever was on my mind.
This was way back in 1982-3 before the DSM took over and when therapists actually listened to their patients. I know there are a lot less such people out there these days. If I were screening a therapist, my first question would be their opinion on the DSM diagnostic approach. If they showed any respect for the DSM, that would be it for me. And if they started talking about “mental illness is a disease, like any other” or “insulin for diabetes,” I’d run from the room!
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Did I not read fairly recently that receiving “more intensive psychiatric care” actually leads to an INCREASE in suicide attempts? It seems to me that psychiatric care encourages a belief that one’s situation his hopeless and intractable and that one can personally do nothing about it. At least blaming it on bad toilet training meant you had a chance to get over it. Now it’s all in your warped brain and the only “hope” is that the drugs might make you feel a little better, if they don’t kill you in the process.
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“Less congratulated and more appreciated.” Bingo!
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Absolutely! Even within their own framing of things, which of course, lacks any real scientific basis, there ought to still be the expectation that TREATMENT WILL IMPROVE THE SITUATION! It’s probably the first and easiest place to attack psychiatry, without even getting into the DSM idiocy. If I have a skin rash and take a drug for it, the skin rash NEEDS TO IMPROVE! If it doesn’t improve, WE NEED TO DO SOMETHING DIFFERENT. Why does this reasoning not apply to psychiatry?
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Great point! When working with foster youth, I often found the kids accused of “assault” by staff in institutions when a very short investigation proved that the child was fighting back against the staff assaulting THEM! But that part never got recorded in the logs, did it? “History is written by the victors.” Certainly, the residents of any kind of institution are not the “victors” and their version of history is never recorded by the institution’s staff.
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True. All authoritarianism depends on fear to be successful.
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Well, WE do – but THEY (the psych profession) don’t! Obviously.
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The article fails to mention the rather uncomfortable fact (for psychiatry, anyway) that the indigenous approaches are FAR superior to anything psychiatry has to offer, if we actually care about the quality of life of the “patients.”
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After reading the article, the answer is clearly “nothing,” unless by “adding” you mean “providing yet further distractions and justifications for avoiding looking at environmental/social/spiritual causes.” It also appears to avoid looking at ACTUAL physiological causes of emotional distress, such as poor diet, thyroid issues, anemia, sleep problems, etc.
They mention early on something about “issues of the relationship between mind and brain,” and yet the actual research seems to be all brain, all the time. Not one more word about “mind” in the entire article.
In other words, “Meet the new boss, same as the old boss.” Nothing new to see here.
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Well, I’m doubly sorry no one has told you that! It is a sad state of affairs we are in, and a lot of folks are getting harmed for no reason. Lots to be sorry for!
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It seems important to distinguish between medical ERRORS (doing the wrong thing or overlooking something) vs. medical HARM (patient has a worse outcome despite following standard medical practice) vs. MALPRACTICE (doing something that the doctor knows or should have known is harmful, or failing to inform patients of risks of medical harm prior to treatment, etc.) Most medical harm is NOT due to errors, it’s due to adverse drug effects. And of course, those drug effects are MALPRACTICE if they result from neglecting to do proper differential diagnosis, or failing to provide proper informed consent to the patient. The medical profession has tried to reframe medical HARM as medical ERROR, even though most of the harm is done by standard medical practice. This appears to be an intentional effort to downplay the dangers and inadequacies of standard medical practice and to make it seem that failures and harm are due to a few “bad apples” rather than the standards of care being inadequate and frequently dangerous and corrupt.
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But then they might CURE some of their patients, and would have to look for NEW patients, which is SUCH a hassle! Better to keep them “ill” so you can keep selling them drugs and “services.”
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Except they aren’t usually ERRORS! They are usually MALPRACTICE!
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Why should you automatically trust them? Isn’t trust earned by trustworthy behavior? Isn’t one of the “deficits” of “borderline personality disorder” (as they frame it) a difficulty deciding who can and can not be trusted?
It is clear that these people don’t really know what they’re doing, and they get very insecure when anyone starts making it clear that they don’t, they get defensive and start blaming the person telling them the truth. It’s like The Emperor’s New Clothes! Lord help anyone who points out that the King is naked!
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No point in being upset about comments from those with no credibility.
So sorry you had to deal with this hell!
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I LOVE your “underlying black eye” theory! I’m totally going to steal that.
Do you mean at the end that they are blaming YOU for being mistreated because you get under people’s skin???
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Oh, right, you have Toxin Oversensitivity Disorder. Not EVERYONE gets sick from eating our food – it must be YOU have a problem!
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It’s like a fundamentalist religion. The DSM believers have faith. They don’t need or want facts.
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I also like the idea of having a “patient” volunteer to lead the group.
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I think you start by pointing out the power differential overtly, acknowledging your power advantage and the general advantage of the other staff people and asking how they think it will affect the conversation. I would then humbly ask what YOU can do to make it more comfortable or easier for people to say what they are thinking without feeling like they might get into trouble. But I think the first discussion would be a huge one, if it gets going, and will pull you in the direction you need to go. I think the main thing is to bring it out in the open as an unavoidable fact of life, and get them talking about how it affects their experience. It will be a lot more interesting than Nietzsche, I’m thinking!
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Another psychiatric success story! How can these people not see when their “treatment” fails utterly? In what other profession are the professionals allowed to blame their failure on the person/machine/process they are supposed to be fixing? “The bridge collapsed because it was a span-resistant river.” “We couldn’t fix your breaks because they are repair-resistant.” “You were poisoned because our chef had the misfortune of serving health-resistant food.” Come on, who the hell else would ever get away with it?
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Plus they’d have to define sentences and let people out when they’d served their time, instead of when the psychiatrist decided they were “ready.” Nowadays, your sentence seems to be as long as the insurance will pay.
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Horrifying, but not surprising. I’m so sorry you had to deal with this!
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They’ve done a pretty good job with the “scientific” smoke and mirrors job so far, and I’m guessing they will continue to do so as long as it works. Pretending to be the “scientific” voice is usually a winning play these days.
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Somehow, I found the entire article alienating from the start. The language is very “clinical,” and there is a confusion between social conditions and “mental health diagnoses” that the authors never begin to address. If loneliness is caused by social conditions, then how does it even become a “mental illness?” If “mental illnesses” as defined by the DSM can be caused by loneliness, which is itself caused by adverse social conditions clearly identified in the research, how are they “illnesses” at all? Should they not instead inform the need for changes in the social structure that is increasing the difficulty people are having creating meaningful relationships?
A lot of fancy words that seem to obscure more than they illuminate.
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It seems likely that such a group would not be fully successful unless it started with a full discussion of the power dynamics entailed in you being the “professional” and organizing the group. It is apparent from your description that they patients viewed you as the “expert” regardless of any provisos you may have put out there. In fact, your ability to frame the conversation in terms of your role is already an exercise of power over the participants. Unless this set of assumptions, which may have largely been unconscious or subconscious, are fully deconstructed, the group as you envisioned it was unlikely to develop.
Of course, if you HAD conducted such a discussion, your hierarchical peers would have felt their power threatened and almost certainly would have shut you down, just as they did with the “du” vs. “Sie” issue. Why would it bother them for you to use informal pronouns, except to the extent that it threatened their role as the “experts” speaking down to the “patients?”
I have to wonder what Nietzsche himself might have said about the process.
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What evidence-based biomedical psychiatric models? Does anyone know of any evidence based biomedical psychiatric model?
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MAY add to mortality rate? Is this SERIOUSLY still in question???
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Wow, so the satisfaction ratings for these drugs are 6% approve and 60% disapprove. So the odds are 10-1 that these will make your life subjectively worse. And that’s not even counting the long-term effects like diabetes, heart disease, weight gain and early death, which may yet effect the 6% who approve. Yet this is the standard of care?
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This is why I’ve said again and again that psychiatry itself is not the enemy, it is only one manifestation of the enemy. The real enemy is AUTHORITARIANISM, the belief that people have the right to order about and take advantage of those below them in the power structure, and the belief and experience of those below that they must acquiesce to such behavior or be punished or ostracized from the group. Regardless of the name and stated purpose of a group, the ability of the group’s membership to hold the group’s leadership accountable is essential to any movement toward justice and equal rights to be successful. In other words, we have to have our own house in order before we’ll succeed at changing the external circumstances. And that is not an easy task!
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No, they don’t. Generally, the psychiatric line is that we are just a bunch of chemicals swirling around and have no free will or motivations. So the only way to intervene is to swap chemicals. There is no person there, just a body.
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Twitching wrecks make for better customers – you can sell 4-5 drugs at a time, and they don’t even have the wherewithal to object. And even if they do object, they’re “crazy” (oops, I mean “mentally ill”) and their opinion doesn’t count. It’s a win-win! Well, except for the client, I guess…
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It is also very important to note that these “differences” are AVERAGED over large numbers and are generally quite small. There is a huge overlap between the “disordered” and the “normal” population on any such measure. In other words, even if the average brain size of an “ADHD” diagnosed child is smaller, there are many “ADHD” diagnosed children who have larger brains than the average “normal,” and many “normal” kids who have brain sizes smaller than the average “ADHD” diagnosed kid. When you then take into account that the “ADHD” diagnosed population contains large numbers of kids on stimulants, which we know decreases brain size in the area of the basal ganglia, even these average differences reflect nothing at all.
SO in other words, it’s all smoke and mirrors. There is no “difference in the brains” of “ADHD”-diagnosed kids. It’s all PR.
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But there IS a point in telling parents that their kids have a “brain disorder,” even though this has been disproven decades ago: they will be more willing to accept and administer a drug to their child. That is the ONLY purpose for this deception to have continued this long, and the fact that it does continue makes the intentions of the profession eminently clear.
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Where did they ever come up with that 51% suffering from trauma statistic? The real answer is in the 80-90% range from everything I’ve ever read. Did he provide a reference or was he just spewing hot gasses from his mouth?
The “It’s not all about medication” meme is just a cover for the fact that “medication” prescriptions are 99% of a psychiatrist’s business these days. My experience (and I have a lot from advocating with foster youth) is that the vast majority of psychiatrists exist solely to prescribe and “monitor” drugs, though the term “monitor” must in most cases be used very, very loosely.
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Perhaps “How are psychiatrists being indoctrinated” would be the more appropriate question.
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I agree!!! Talk about a false dichotomy!
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STUD: Sticking it TO Unethical “Doctors”
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They need to believe in their doctors and in “Science.” It violates basic mythology for most people to question that doctors are knowledgeable scientists with their patients’ best interests at heart. We have to undermine this mythology before any real change will happen. I do feel bad that kids have to deal with parents who are deceived, but most parents are trying to do the right thing and need to be educated. Of course, there is a minority of parents who are more interested in controlling and subduing their children than in helping them live well, and such parents get very little sympathy from me.
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The 6% (I actually think it was more like 6.7%) was from a file review, and only included those reactions noted in the kids’ files. Naturally, there would be doctors who would not notice these symptoms or would not write them down, and also kids/parents who did not report them or did so in a way that the doctor did not make the connection. So if 6% of doctors both knew and recorded these reactions, clearly the actual number so reacting would be considerably larger.
That being said, even a 6% rate is large enough that it ought to be discussed at every “informed consent” conference with parents and children considering this “treatment.” Of course, many doctors don’t really do an informed consent consult in the first place, but even those who do rarely if ever mention to watch for psychotic symptoms as an adverse effect. In 20 years of experience as an advocate for foster youth, I never once heard or saw it mentioned to any of the 20% of kids in care who were diagnosed with “ADHD.”
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Too true, Boans!
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Few parents indeed are ever told that psychotic experiences are a possible adverse effect of stimulants, even though one study indicated over 6% of kids on stimulants had psychotic symptoms noted in their files. Most kids who start showing these signs are diagnoses with “bipolar disorder” or a “psychotic disorder” and put on antipsychotics. I saw this many, many times in the foster kids I advocated for.
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I do believe they can create “mental illnesses” out of almost anything!
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I think your analysis is pretty spot on. I had not heard the “postmodern Marxist” meme, but it does seem kind of ridiculous.
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Because THAT’S how we do Science – we choose our model based on what makes the “experts” feel comfortable with their delusions and never challenges their pre-determined reality.
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Especially if you can find at least one study whose data when sufficiently manipulated support your “yearnings,” at least on paper, even if there are 50 others that oppose it. I mean, THAT is science at its best, right?
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If sarcasm is a “mental illness,” I think you and I are both seriously afflicted!
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Cluelessness doesn’t cover “I don’t want to know or accept the facts.” That’s deception.
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I think what it does is help create and sustain an alternate narrative of what is going on. It helps people see that an attitude critical of psychiatry is not “nuts” and is based on actual data and research as well as lots and lots of people’s experience. This in itself doesn’t change the status quo, but it helps bring people together that are opposed and provides tools and information that will help them do so. That’s my take on it, anyway.
It also provides a space where survivors of the psychiatric system can speak their truth and not be brushed off or attacked for doing so.
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What other medical profession bases its interventions on ‘strong yearnings?’ Isn’t that a tacit admission that no science is going on here?
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“I never let my schooling interfere with my education.” Mark Twain
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You can only “overdiagnose” if there is an objective way to determine a diagnosis. If there is such a means, then it’s not “overdiagnosis,” it’s called a WRONG diagnosis! If there is no such means, then ANY diagnosis is “overdiagnosis,” otherwise known as FRAUD.
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I’m afraid your right. Commercialism has invaded every corner of our society.
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No one really understands how memories are saved or retrieved.
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It frustrates me when they call this process “overdiagnosis” or “overmedication.” They should refer to it as MALPRACTICE. Because that’s what it is. Generalized and incentivized malpractice to make money while not helping or harming patients.
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In other news, hitting people on the head is associated with bleeding and broken skulls. Though not everyone suffers from broken skull. Perhaps we should study “weak skull disorders” to figure out why certain people’s heads are too weak to withstand being hit by a big hunk of wood?
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I checked in the spam folder. I may have retrieved it. Have a look and see if it is now there.
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As I like to say, species survival depends on genetic diversity. We need a range of “phenotypes” in order to get the work of our society done. We’re in big trouble when we start deleting certain presentations because they are inconvenient or uncomfortable to confront for those in the seats of power.
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Perhaps it is the people doing the “treatment” that need to be “humanized!”
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That is true. But by definition, anyone who opposes the psychiatric mainstream is “controversial.” The fact that he used to support it and then was harmed by it might give him more credibility. Of course, I’d LOVE for a mainstream figure to take up the sword, but that seems a long shot at the moment.
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Our TV and movie media are also highly complicit in creating this impression that “meds are the answer.”
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I wouldn’t really classify him as “right wing.” He’s kind of “wingless,” says what he thinks with no real allegiance to any political viewpoint and offends both ends of the political spectrum. Though some right wing folks have attached themselves to some of the things he has said, because they can be made to fit the right-wing narrative. But in my view, he’s an equal opportunity offender.
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My apologies to you and others. I’d approved a bunch of comments last night but somehow it did not process them as approved. It’s now posted. Thanks for prompting me.
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Not sure that I got something from you – did I respond?
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Wow, a Holistic Psychiatrist! I’d have thought that was an oxymoron!
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This is a very well-spoken and well-known public figure. I hope he can be encouraged to join the ranks of the movement to discredit psychiatry and remove its unchecked power. He would be a strong ally.
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Thou shalt count three. Thou shalt not count four, nor shalt that count two, unless thou shalt immediately proceed… unto THREE.
Five is right out.
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In what other situations can these diagnoses be given out? They are ALWAYS given on in a subjective situation, because they are all utterly subjective by their very nature. A lay person is just as qualified as a psychiatrist to give a subjective opinion on someone’s “mental health condition,” which is why so many feel like the can do so.
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Do you have any such evidence to present?
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“Recovery” on their terms, though. Someone like John Nash who recovered in spite of rather than because of their interventions is an embarrassment, so much so that they had to change the movie and make it seem like they’d helped him, in order to protect their interests.
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You can just see “schizophrenia” resisting, like a stubborn donkey refusing to cooperate with their drug regime!
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Where is the Holy Hand Grenade of Antioch when you need it?
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Anyone who really has an idea to DO anything is generally regarded as “crazy.” In a weird way, it could be considered a badge of honor that “normal” people recognize that you’re not one of them!
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“Let folly be our cloak!”
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Oh, I don’t know, most would be qualified for employment in pharmaceutical marketing.
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“By their fruits shall ye know them.” Indeed, it is easy to see where they are coming from by their vicious opposition to any attempt to look at the actual consequences of their policies and “treatments.”
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Ha! LOL!!
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I should have said that HIPAA protects AMERICANS against having their medical information spread around. I can’t speak for any other country. Sounds like Australia may have some catching up to do in this area!
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The psychiatric profession are mostly not scientists at all. They are mostly marketers.
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HIPAA should protect an employer from finding out privileged information from a medical file. Theoretically.
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It is clear from the focus of the “studies” that the definition of effectiveness is “reduction in symptoms.” This may or may not be of interest to the client specifically, but it certainly makes it obvious that resolving the actual issues that created the “symptoms” is never the goal. It’s like spending a ton of money on topical rash treatments without bothering to figure out if you have poison ivy, the measles, prickly heat, or syphilis. But it certainly is “effective” for creating lifetime patients and blockbuster drug sales!
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I think you are being very unfair to little girls in making the above comparison. And maybe insulting to old farts, too.
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I’d prefer to have “regular people” running for office rather than letting the ignorant and uninformed do the voting. There was an influx of new candidates in 2018, mostly women, who were NOT career politicians but just seemed tired of “business as usual.” But of course, we have to get rid of corporate money donations as point zero in any change plan, which is one thing Bernie has been very strong about.
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Though I must ask who, besides Marianne Williamson, is even opposed to increasing forced “treatment?” The political landscape is indeed grim from the point of view of our intentions here. Sanders might at least be able to listen to those who wish to educate him further. But my hopes are slim.
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We know little about the brain, but we know next to nothing about the mind. Which are most definitely NOT the same thing!
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Such euphemisms! What we REALLY should say is, “Schools as designed are extremely stressful for a large percentage of children. We need to rethink how schools are run so we don’t keep traumatizing our young citizens.” You don’t have to be “vulnerable” for school to stress you out. In fact, schools appear to MAKE a lot of kids “vulnerable” in ways they would not be if they participated in a more child-centered, respectful institution.
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That’s rich! If Bob were interested only in making money, he’d become a psychiatrist instead of railing against them! Or invest in Big Pharma stocks. But people hear what they want to hear.
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From my observation, antidepressants essentially induce a manic-like state, where a person is more spontaneous and less concerned about consequences. A friend of mine called it “Zolofting.” It’s kind of a “who gives a f*&k” attitude that can feel really good, especially for someone who has always been worried a lot about what other people think or feel about them. But as with all drugs, messing with the neurotransmitter system, however good it might feel, has long-term consequences that are often quite destructive. Some people seem to be able to tolerate them long term, but it’s a very risk way to “feel good,” and of course, does nothing to address why you might have been feeling bad in the first place.
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The problem is, nobody has a clue what to test for. What’s SUPPOSED to happen is that a cause is postulated, and things that would be present when that cause exists would be extrapolated, and then we develop a test for those events/conditions. We haven’t even gotten to first base (identifying a cause), mostly because “schizophrenia,” like pretty much all the DSM “diagnoses,” is a very vague concept that could not possibly represent one specific malady, and may not represent any malady at all. So how to you test for something that is defined socially instead of physiologically?
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I will write to you off line.
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For some folks, “bias” means saying or doing anything that interferes with pursuing their own interests without consideration for the impact on others.
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There are any number of celebrities who had bad experiences with psychiatric “help” as well. I wonder how many of them might get on the bandwagon? Stevie Nix is one that immediately comes to mind.
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Not to mention marketing agents to do the proper “focus groups” on the impact of their preferred euphemisms. Gotta do some market testing, you know?
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“Discontinuation syndrome” was obviously an intentional euphemism for withdrawal. It was invented to keep a distinction from street drugs, as no one wanted the similarities between the two to be noticed or talked about. Another example of the disingenuousness of the psychiatric industry.
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You both have said your pieces, and I’m asking that this be the last comment along these lines. We have gotten way off the point of the article now.
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Ironically, the neuroleptic drugs they recommend CAN cause psychosis in otherwise totally healthy subjects, especially after it is withdrawn.
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Nothing makes the moral bankruptcy of the psychiatric industry clearer than the violence with which they protest and demean any effort to have a rational, fact-based discussion of their methods and philosophy. If they really knew what they were talking about, why would they have to discredit the critics instead of answering them with their “science?”
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The approaches aren’t outdated, they are corrupt!
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I did mean in the USA. I am certain that similar circumstances pertain in most other “western” countries. Our culture seems to depend on the oppression of portions of the population for its full functioning, if we can call it that.
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It is important to keep in mind that the first child abuse case was brought by the SPCA on the theory that children should be treated at least as well as dogs. Protection of women from abuse came 100 years later than children. We have always afforded pets more compassion and rights than humans, at least the humans that we have decided don’t deserve to be considered human.
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There is nothing in my statements that conflicts with the idea that certain people’s conditions might have a physiological/medical genesis. All I’m saying is that calling these “mental illnesses” obscures the fact that there are multiple possible causes and multiple possible solutions, and that in many cases, there need not be anything physiologically wrong at all. Once we say someone “has depression,” any attempt to understand the real causes, be they physical, psychological, spiritual or social in nature, come to a rapid end. This is particularly true when the system automatically assumes that every single possible divergence from complete satisfaction with the status quo is caused by a “chemical imbalance” or other physiological problem.
There are most definitely physical illnesses that manifest with psychological “symptoms.” It just doesn’t work the other way. As Socrates pointed out, if all men have facial hair, and Bob has facial hair, it doesn’t follow that Bob is a man. The logic flows from known physiological conditions to psychological effects, but not the other way.
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The problem resides in trying to come up for a “solution” to something that can not be identified or defined as a single entity. “Mental illness” is a concept, not a disease state with a defined cause. Why would we imagine for a moment that something so nebulous and subjective as “mental illness” could possibly have a unitary cause or solution?
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They must all be pretty freakin’ old!
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Maybe the word “thought” doesn’t really apply here. Maybe “Delusional greedy fantasy leaders?”
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Unfortunately, long-term statistics and models suggest that continuous “treatment” with “antipsychotics” makes any problems with the dopamine system that may theoretically exist into observably greater dysfunction.
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Thank God for small favors!
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True enough. If the facts supported the pro-psychiatry viewpoint, why would they be so bent on suppressing any kind of dissent with these sleazy tactics? The only reason people viciously “attack the messenger” instead of addressing the concerns raised is because they know they have something to hide.
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I’m glad this is coming up, and it looks very interesting! I have only one suggestion: let’s see if we can find a way to talk about “people who are suicidal” without lumping them all together and implying there is some “treatment” that is going to “help” all such people. There is a subtle but powerful subtext through most of the titles of the presentations that buys into this idea.
How about “people who are feeling despair” or “people who are wondering if their life continues to be worth living” or something like that? Or “helping people find hope when their lives seem hopeless to them?” Something that makes it feel like “feeling suicidal” is actually a pretty common experience that doesn’t necessarily reflect anything “wrong” with the person having that experience?
I think Leah’s title gets to this best: “The Way Forward: Pathways to Hope, Recovery, and Wellness with Insights From Lived Experience.” Hope, wellness, insights… no mention of ‘suicidal people’ at all.
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It is also important to remember that the “differences on brain scans” are AVERAGES, not diagnostic indicators. And you’re right, of course, they could mean anything. But even if some so-called “ADHD” kids do have a different genetic presentation, SO WHAT? Tall people have different genes than short people, red haired people have different genes than blondes or brunettes, men have VASTLY different genetics in the XY chromosome area… genetic differences are the key to species survival!
As for the heart events, this was being discussed way back in the mid 90s in antipsychiatry circles (see the “Ritalin Death” website), though it was massively denied by the mainstream. Now, once again, we find that the protesters were correct and the “professionals” were lying. Anyone see a pattern emerging here?
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Yeah, I get that. And you’re right, the title WAS quite misleading to me as well! I kept waiting for the “solutions to poverty” part to come up, but it never did. I just attributed it to the source. As the Buddhists say, misery is caused by the expectation that things will be different than they actually are. (or words to that effect).
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And they so often exclude those who drop out instead of viewing them as the “treatment failures” that they should be considered. Even within their own rules, these drugs don’t often do the job, so they change the rules to protect the concept.
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Quite so. An epic tragedy driven purely by egos and the desire to maintain control, damage to the patients be damned.
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I personally thought this was quite enlightening for anyone looking at the gap between what supporters of the DSM approach say and what is really true. I don’t expect an interview with the APA head to get into Marxist analysis, I expect it to report accurately what the APA head has to say. This can be VERY important in laying out a counterattack, as once a person is on record making specific statements, it is a lot easier to counter their position with factual research and descriptions of real events. I don’t see it as supporting the idea of “mental illness” just because MIA interviews someone who believes in it. But maybe that’s just me.
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I read the quotes from the pamphlet in the article. It seems to be pretty straightforward, and the criticisms forwarded are generalizations and don’t appear to address any of the specific claims in the pamphlet at all. Saying something is “misleading and inaccurate” without saying what is inaccurate or misleading about it is a pretty lame criticism!
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And it is a shame that the medical profession (not just psychiatry) is so willing to punish and shame those who display such bravery.
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Shocking. Not really. I think they specifically DON’T look at “medication” as a factor because they are worried what they might find out!
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Is there any other field of medicine where people “favor” certain philosophical viewpoints toward the “diagnoses” and “treatments?” Do we vote on whether or not someone has cancer or a broken leg?
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You are correct, of course, and I do apologize. Though benzos CAN be drugs of addiction as well, and are sold on the street for that purpose. My point is rather that trying to say Klonapin isn’t a major drug is incorrect. It creates a physiological effect that is more difficult to get off of the longer you take it. AND it is a drug of addiction as well.
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It is certainly the ability to force others to accept “treatment” that is the most reprehensible power of psychiatry, especially when they know their ‘disorders” lack all validity. But propaganda and status are other powers that can still be used to enforce the psychiatric worldview, even without the courts’ backing.
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No, that’s “anosognosia!” EVERYONE is mentally ill because we SAY they are mentally ill! True insight is giving up on rationality and accepting psychiatry’s nihilistic worldview. At least, that’s THEIR definition of it.
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And yet…
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In psychiatry, “insight” means “realizing you’d better go along with the plan or you’ll get punished.” That’s a valuable insight if you’re in their clutches!
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Klonopin is plenty powerful. Many people report becoming addicted. It’s a benzo. Sure, there may be worse things, like having a hand cut off is worse than just a finger. But it’s plenty dangerous.
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I LOVE it! This would be a fantastic “study!”
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That was poetically put!
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Are we surprised?
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I think you mean before “DesHorse!” Thanks for the laugh!
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I’m not entirely certain that people are looking for relief from suffering, at least not all or most. I think a lot are looking for UNDERSTANDING and CONNECTION, but they are offered “escape from suffering” as a weak alternative by the psychiatric industry, and told that’s all they can hope for. Understanding is more nebulous, requires more work, and can be scarier, but those who have genuinely experienced understanding from another person after working through some pain know it is far superior to merely escaping. Because the escape offered by the psychiatric industry is not very different than getting drunk to forget one’s pain – once one “sobers up,” the pain remains in place and needs to be avoided yet again. To reconsider that pain from a new perspective can not only ease the pain, it can provide meaning for one’s suffering and pathways to create a better life going forward, something no drug can ever begin to deliver.
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I don’t disagree with you on that point. There are certainly diseases and medical situations that cause what has come to be known as “mental illness.” My objection is only the idea that they are “mimicking a mental illness,” because there is no such thing as a “mental illness” to mimic, at least not as defined in the DSM. It is an absolute certainty that anything which is called a “mental illness” COULD be caused by real physiological problems (there are literally hundreds of examples), and one of the greatest harms done by psychiatry is to stop doctors and patients looking for actual causes and allowing the “mental illness diagnosis” stand in place of actual research into causes.
SO in essence, it seems we agree with each other, terminology notwithstanding. I appreciate the feedback.
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What are the odds they controlled for psych drug exposure? About zero. Perhaps the article should read, “Exposure to neuroleptic drugs causes reduced links between brain cells?”
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Quite so! But if you get the empty chamber, you can go on TV and tell how “psychiatric treatment saved my life!”
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I agree they have no idea of the cause, but I highly doubt further study of the brain per se is going to yield any more information. It is their primary error to believe that the brain is the causal factor in these “disorders,” in the same sense that solving a software bug or issue can not be resolved by studying the hardware. The mind runs the brain, not the other way around.
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More like Russian Roulette!
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Right! If we even acknowledge a “mimic” of a “psychiatric disorder,” we are allowing that there are non-mimic situations where there is a “real disorder” going on. It’s insidious but very powerful.
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Now, there is a thought! Kind of like stopping headaches by not allowing yourself to be hit on the head repeatedly by a hammer!
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The Rosenhahn Experiment. They’re still trying to live that down.
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It all depends what “effect” you’re trying to accomplish, I guess.
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I for one am very glad that it still bothers you, Sera!
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It is kind of amazing how they have to include an “explanation” of the third point, without any evidence, and without mentioning the obvious, likely hypothesis that the drugs themselves are increasing the suicide rate.
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Apparently, going for a walk in the woods is now a form of “treatment.”
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An excellent example. Thank you.
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Lawrence, can you please address the issue of long-term neurological damage that extends beyond the technical withdrawal period from the drug itself? This is not really a controversial issue, at least in the world of substance abuse – it can take a long time for the brain to recover from years of drug-induced altered functioning, and in some cases, there is evidence of permanent damage. Why would this not apply to psychiatric drugs?
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Isn’t “precision psychiatry” one of those oxymorons, like “Jumbo shrimp,” “civil war,” or “low-carb beer?” I can’t think of a less “precise” profession – even predicting the weather is more certain!
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I agree. It bothers me when they chant “don’t blame the parents, don’t blame the parents!” Sometimes (not always) the parents ARE partly or largely to blame!
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Well, what else did you expect him to do? It’s the only think he knows! Maybe he can give some drugs to the person doing the restraining?
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It is certainly dependence at a minimum.
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I would add that “withdrawal” may not be the proper term for this experience. It is more like “recovery from brain damage.” Most people know that the specific withdrawal period for cocaine, for instance, is pretty short – a matter of hours. But for someone taking cocaine long-term, the recovery period can literally take years. I find it pretty easy to believe that the exact same kind of mechanism would be at play for any psychoactive drug, in fact, I’d be stunned if it were not at play. There is plenty of research regarding neurological up- or down-regulation in the brain when the brain is flooded with/deprived of normal brain chemicals. Recovery from this kind of damage is going to take a hell of a lot longer than it takes the drug to exit the body, and I think it is pretty disingenuous to suggest that people suffering months or a year later are automatically suffering from some psychological problem when it is very possible they are continuing to suffer from brain damage induced by neurochemicals provided by their friendly “medical professionals.”
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Gosh, who would have considered such a thought? No it’s not radical, it’s common sense, but as Tim McCarver once quipped, “If it were that common, more people would have it!”
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Perhaps they should measure how much their drugs increase kids’ sense of belongingness? Something tells me the drugs will not perform very well with that as the outcome measure.
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Speaking Chinese also runs in families. Do you think there may be genetic roots?
They can’t even find genetic vulnerabilities for heart disease or most cancers. There are a few clearly genetic diseases, but even physiological diseases are influenced heavily by environmental impacts. To suggest that “mental health” is analogous is pretty ridiculous.
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Might as well call alcohol an antidepressant. People drink when they feel depressed, and then they feel better for a while until it wears off. What’s the diff?
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This is the fourth loss of a significant MIA contributor and antipsychiatry activist in the last month or so, and it is hitting me and others very hard. Bonnie in particular always seemed so immutable, so inexorable and so powerfully present, it is hard to imagine her succumbing even to death. Her spirit will continue to be with us as we fight on, but this is a huge loss to us and to the world. RIP, Bonnie, and keep fighting on, wherever you are!
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Being sarcastic. Sorry if that wasn’t obvious.
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This happened all the time with kids I knew in foster care. They’d give the kids stimulants for “ADHD” and then they got aggressive, so they’d give them an “antipsychotic” to calm them down. Raise the dopamine with one drug, decrease it with the other. Idiocy, but it was done ALL THE TIME. No science going on here!
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“Death Therapy, Bob. It’s a sure cure!” From the movie, “What About Bob?”
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The kneecaps disintegrating is merely a sad escalation of the disease process. If only we’d have gotten there in time…
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You mean gathering together everyone who experiences knee pain together and giving all of them the same “treatment” without any further analysis isn’t going to work? Wow, what a pessimist you are!
Though I suppose it “works” if your business is selling pain relievers.
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It’s also ridiculous to ask if “treatment” is effective for a “condition” that is utterly unmeasurable and metaphorical in nature.
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Thank you for that, Rachel! That was a wonderfully sensitive post!
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That was my thought, too! If meditation can change attitudes toward distress, doesn’t that toss the “genetic brain disease model” in the garbage bin? But expecting consistency from the psychiatric “thought leaders” is a sure way to get a headache!
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Yeah, they should say, “…divergence between commonly accepted pseudoscientic and self-serving ‘explanations’ for depression and the actual experience of those having those labels slapped upon them without any attempt to understand the context of the ‘symptoms.'”
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Maybe you can select options: “If you’d just like a prescription, press 1. If you’d like a spurious but scientific-sounding ‘diagnosis,’ press 2. If you’d like to have the context of your ‘symptoms’ specifically invalidated, press 3. If you’d like a psychobabble explanation of why you need to keep taking your drugs forever, press 4. If you’d like someone to actually listen and understand your struggles, hang up and call somewhere else!”
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Well said! It is the responsibility of those claiming to “treat the mind” to come up with a coherent definition of the “mind” they are supposedly treating. Those criticizing the approach don’t need to define “mind,” they just need to point out that those claiming to be “treating” it can’t define their terms.
You can’t treat a metaphor!
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And at least they wouldn’t invalidate you if you disagreed with them.
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“Keeping up appearances” is associated with being dishonest about what’s really going on in the family. Highly associated. Pretty much 100%.
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Yeah, kind of like saying, “Broken legs are highly associated with specific blows to the leg region. People who were not struck in the leg were far less likely to have their legs broken. Very high level of certainty on this one!”
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I like it! “Love Your Misery!” I’ll buy a copy!
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Well said! There is no excuse for any “professional” not asking every client about relationships and family history. It seems today that such professionals are the exception rather than the rule.
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Yeah, seriously. Creative work, there. Deep insights!
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I don’t disagree with anything you said. I was making the point that I do support individual people in making their own decisions and try not to make generalizations about “psychiatrists” as individual practitioners. There are many subtle points on “effectiveness” of drugs – as I’ve often pointed out, alcohol is a great “antianxiety” agent, but no one would prescribe it as a MEDICAL TREATMENT. It’s just something that makes you feel better temporarily. There are always dangers of ANY psychoactive drug, and I would certainly not recommend Ritalin as a way to make oneself fit into the capitalist mold. My point is only that individual decision making is one issue, but group-wide intentional corruption is something completely different. The first is complex, the second is not really all that complex at all. People do things that bring them money, unless they are motivated by caring first. It’s clear that psychiatry as a profession is motivated by greed and power over individual results.
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I would suggest that there are, in fact, many caring individual psychiatrists out there, and I have certainly met some of them. I think there is a distinction to be made between psychiatrists (who vary widely as individuals) and “psychiatry,” which is an institution that has its own objectives and strategies and fears and blind spots. It is the institution that I am criticizing, the APA and its group objectives to promote a biologically-centered viewpoint and a drug-centered approach and the DSM strategy of de-contextualizing people’s suffering and blaming them for their “wrong” reactions to trauma and stress in their lives, and the constant hostility and dismissiveness toward even their own research when it conflicts with their agenda. I also feel it is very appropriate to criticize the corruption coming from the pharmaceutical industry that has informed the above goals and strategies.
I also would never criticize an individual for doing whatever works for them or their families. I have stood by and watched while a friend’s husband got ECT (which didn’t work) and eventually came up with moving to another part of the country as a solution. I’ve known domestic abuse victims who used antidepressants as a means of becoming less worried about their abusers’ feelings and it helped them get away. I know people who feel that they can’t live without Prozac or who feel they’ve benefited from stimulants helping them concentrate better. I have no problem with people doing what works for them. And I have no problem with individuals, professional or not, helping other people. But I do have a big, big problem with an entire profession intentionally lying and manipulating data so that they and their drug company counterparts can increase their income and power, and I make no apologies for doing so.
I hope that makes things more clear.
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I like this post. The distinction between trying to “make the bad behaviors go away” and understanding their origins so that a person’s needs can be met in another way is huge! Once we understand the emotions driving behavior, CBT can be a useful technique to practice doing something different. But CBT alone often comes across as minimizing or invalidating the emotional components of behavior. People choose a particular action for a REASON, and without understanding the motivation, changing the behavior in isolation doesn’t work very well, in my experience.
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If only your brain worked properly, none of that would bother you at all! Stepford Wives are apparently the psychiatric ideal.
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You can contact Bob at [email protected]. I can’t speak to how available he would be at a given time – he travels a lot!
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I don’t know, maybe it would be fun to interrupt someone’s tirade and say, “You know I was considered one of ‘those people’ once. Do I seem crazy, dangerous or hopeless to you?” Might toss a monkey wrench in their works.
BUt I also get why you wouldn’t want to go there. People who are on that kind of trip really NEED to believe what they are saying, and even a big dose of “cognitive dissonance” rarely has any effect.
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Having spent half my career advocating for foster youth, this article resonates with me. Foster youth are the most disempowered group of citizens in the country, and they need all of our help. The rates of drugging tend to be around 20%, but increase by adolescence to over 50% in most states. Claims of “genetic inheritance” and “chemical imbalance” are particularly offensive and egregious in these cases, as we KNOW the main reason why these youth are suffering, yet somehow they continue to be blamed and “treated” for not being happy with their second- or third-class citizen status in life. Many are groomed for the adult “mental health” system and are told they have no chance of surviving without public assistance/disability payments for life. Yet many also rebel when they are able to escape the system and ditch their “mental patient” identities, acting on impulses and beliefs that have been subdued since they were very young in many cases.
These youth need and deserve all the support we can give them. They are the ultimate “market” for the psych industry and are almost helpless to resist.
Consider supporting your local CASA (Court Appointed Special Advocate) program, or volunteer to become a CASA in your jurisdiction, and you’ll have some direct and substantial influence upon this most undesirable course of events!
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Most of them don’t even know the adverse effects of the drugs they personally prescribed. I’d bet that 90% don’t even know there ARE withdrawal effects from Cymbalta. I just figure I have to educate them every time, but avoiding MDs whenever possible is much more effective. I only see them when I have no other choice or need something specific that only they can provide, like antibiotics. Don’t trust them as far as I can toss them.
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1 in 4 women are on antidepressants. 1 in 5 women is in an abusive relationship at any given time. What do y’all think the overlap is there? It’s gotta be huge. Has this question ever even been asked?
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Quite so. And of course, once we start “socially defining” “disorders,” anything and anyone can be targeted.
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I’ll go with Oldhead on this one, and say that a MIND is an idea, or a set of ideas and processes, and ideas can’t be “ill.” There are neurological illnesses, which should all be detectable by some physiological means. But it is a mistake to equate neurology with “mind.” No one really knows what “mind” is, and until we do, it is going to do nothing but add confusion to call a mind “ill.”
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Thanks, Gail. Most upsetting to hear about.
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Alto, it’s good to see your name up here again! I’ve missed you. Thanks for the post!
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Whether or not, the idea scares the snot out of me. It would certainly fit with the objectives of an MK ultra project.
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Belief in the suppression of the “mentally ill” is a bipartisan issue. One of the few things the current parties can easily agree upon.
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It is not lack of training, it is the ability to dehumanize the victims that leads to this kind of mass unethical behavior. It works very much similar to a gang rape. What is the likelihood that ALL members of a certain sports team are rapists? Simply not possible. So how does an entire team participate in such an atrocity, as has been documented numerous times? It happens when the victim is sufficiently dehumanized that other group members can treat the victim is a non-human so that normal rules of ethics don’t apply in this situation. Same thing with group torture like Abu Ghraib. And it is psychiatry’s own DSM labeling process that makes this mass dehumanization possible. Those people providing “treatment” have been “trained” to see the “patients” as a subgroup who don’t deserve the same rights as other humans. So, in fact, it is not a lack of training, but a training in the use of dehumanizing terms and beliefs that leads to this result.
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Right you are, Sam! Genetic diversity is the core of species survival. Even if it’s proven that genetics, for instance, affect activity levels and that some “ADHD” people have a genetic difference means NOTHING about whether or not “ADHD” is a disease state! Men and women have VASTLY different genetics in the X/Y genes, heck, men are MISSING a whole bunch of DNA that women have, and men certainly act differently overall than women. Are we prepared to call having male sex genes a “disease” based on that fact alone? (Testosterone poisoning, anyone?)
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The large associations with individual violence are drug use/abuse and domestic/family/pet violence. “Mental illness” and especially “Schizophrenia” are tiny blips in comparison. But it’s easier to blame than it is to deal with big societal problems like why so many people are using and abusing drugs and why so many feel it is OK to beat up their wives and children and dogs.
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I think the larger question, Daniel, is how do you feel about the use of psychedelics IN THE HANDS OF PSYCHIATRISTS as you know they currently practice their brand of “medicine?” Hell, we know that alcohol can be a great antianxiety agent, and has a better “side effect” profile than benzos. But it’s not a MEDICAL INTERVENTION, it’s a way of holding anxiety at bay. That’s the level psychiatry is working at right now: Anxiety BAD. Benzo make anxiety go away. GOOD. Benzo patentable. GOOD. Alcohol not patentable. BAD. WE USE BENZO! There is no sense of mission or analysis deeper than that going on at the practice level, and for those operating on the “theoretical” level, the situation is even worse! “This research disproves our theory. WE MUST BURY IT! This person speaks uncomfortable truths. WE MUST ATTACK THEM! This group opposes us. WE MUST DEMONIZE THEM!” Do you really want people in such positions promoting psychedelic drugs for traumatized people? A profession that systematically denies that traumatic events are even causal factors in their lists of “disorders?” And who can then force psychedelics against their will on anyone they decide is unable to make informed decisions for him/herself?
It is much more than a question of whether there are positive research results. It’s a question of putting trust into an utterly corrupt system of decision making and control.
Steve
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That’s what I was thinking. What psychiatrist would possibly be remotely qualified to engage in guiding someone through this kind of experience? It seems beyond ludicrous, having known some folks rather intimately who have used this drug. It is shocking that even psychiatry would be so arrogant as to think just giving someone a dose of this and “objectively” watching what happens would be anything but an invitation to disaster.
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Maybe “cult” is the appropriate term?
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Scary, yet hardly surprising.
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Wow, you are suing? Let us know how this goes. I think the only real success in undermining the psychiatric worldview and control is to hit them in the pockedbooks and in the public realm of discussion. I am sorry all this crap happened to you, but t would truly be awesome to have national news about the psych professions getting their butts sued for hurting people they are claiming to help.
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You’d have to have racked up some serious bad Karma to come back as a psychiatrist!
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There has been some amazing work showing that the best way to get people off the street is to, wait for it… provide them with housing!!! Who could have guessed it?
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I can’t quite agree with that last statement. While individual psychiatrists may have some concern over their individual clients, it would appear that psychiatry as a profession not only doesn’t care if their clients get better, they actually fear them getting better because it will cost them too many “customers.”
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Psychiatry and big pharma have ALWAYS claimed miracle cures. Remember when Benzedrine was all the rage, safe, effective and non-habit forming? When that disaster was finally admitted, we had Valium, which was, wait for it, safe, effective and non-habit forming. Except that it’s one of the most addictive drugs known to man. Later on, we have claims that Prozac and the SSRIs are effective and have virtually no side effects. Well, except for increasing the rate of suicide and the occasional outburst of homicidal rage. Oops! So forgive me if I’m a tad skeptical when a party drug/tranquilizer is suddenly claimed as the miracle cure for everything. As for “rewiring the brain,” that’s a pretty tired analogy that doesn’t really correspond to any reality at all. There are no wires in the brain, and nerve channels are not in any way remotely similar to wires other than the ability to conduct and electrical signal.
It’s important to sift through the rhetoric. EVERY drug is “safe and effective with no side effects” until the patent runs out.
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Are you trying to suggest that the DRUGS may make people violent? Well, we can’t have any of THAT kind of testing around! What will happen to our big donors’ bottom lines?
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Which shows why ghostwriting should be banned. Or the article should be credited to “Merck Pharmaceuticals, Inc.” instead of a doctor.
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There is also some discussion of how abusive the music industry was to her, and how she had one hour a day to herself and was constantly pressured to produce more and more. So Capitalism has contributed massively to her breakdown. But it’s still all blamed on genetics. Pretty baldfaced BS, but everyone sucks it up.
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I just did a little research on Britney Spears’ life. It sounds like she had a very traumatic upbringing, exposed to domestic abuse by her dad, dad was an alcoholic, and of course, her mom most likely meeting her needs through having Britney perform as a kid. There is evidence she most likely experienced domestic abuse herself. Seems she grew up very insecure, for rather obvious reasons, and was easily taken advantage of by others because she was constantly seeking approval. Of course, NONE of this is discussed in the explanation of her “disorders.” It is all blamed on her “condition,” but it is easy to see that the controlling behavior of her family members continues to the present day. Instead of acknowledging the abusive behavior by her parents, they talk about her being the victim of “very bad genetics.”
This shows the destructive nature of the DSM labeling process, even for the rich and famous.
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Waste of time. The only measure of whether or not any “therapy” is effective is whether the person receiving it thinks it’s effective. To think that one “therapeutic school” will magically be proven more effective, regardless of the therapist or the client, is simply a fantasy. Therapy is a HUMAN INTERACTION, not a mechanical undertaking that can be quantified and measured out like some weight of ground meat!
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It is true. I never saw one kid who ever needed to be restrained during my school years. Even the “special education” kids. It just was never done that I could see. What’s different? We know what’s different. Way too much “treatment” and not enough compassion.
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Mostly ignorant, I think. They are authoritarians, and the “experts” told them it was true, so they just accepted it. After all, it happens that way in the movies and on TV, so it must be real, eh?
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Does that mean I’m in?
Maybe we can shorten it to “The Church of Sanity and Common Sense.” CSCS is a workable acronym. Anyone else want to join?
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“I belong to a church called “these ideas and implementations are harmful and not working, let’s try something else that has some common sense””
I want to be a member of YOUR church!
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But of course, the answer is still more “meds.”
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An apt analogy!
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Indeed!
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Not to mention the cherrypicking of conforming data.
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The idea of finding and testing the homogeneity of a group seems to be a lost principle of science, and not just in psychiatry.
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You have summarized my views perfectly. Thanks for a great post!
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Why not? “Psych evaluation cliff notes!”
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Amazing how long they can claim that they “haven’t found the right combination” as if that is an inevitable outcome given enough time, instead of admitting that “our drugs have not been helpful to her, and stopping them makes a whole lot of sense under the circumstances.” How many times can you take your car to the mechanic and hear, “We haven’t found just the right ‘treatment’ yet for your engine…” before you fire them?
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That’s a great way to put it, Al. We have to be willing to not know and to sit with the person we’re helping and feel their discomfort and pain and despair and not run away from it. Even if we don’t know how to help, knowing that we’re willing to confront the situation with them and NOT try to “make them better” in and of itself is the core of actual helpfulness. And if a possible solution then DOES emerge, both know that it’s a real possibility rather than something you cooked up to make yourself feel better.
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I read up a bit on it, too. It sounded like the big objection was that people from the Lower 48 were going to be shipped to Alaska for “treatment.” Seemed like the article was a whitewash. Definitely see some very real concerns about THAT idea!
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If you haven’t read about the “Rat Park” experiment, you should. It kind of says all that needs to be said about addiction. Classic experiments have been done where rats in a cage are given a choice between pushing a button for water/food and one for cocaine, and the rats eventually choose the cocaine so often that they die, which is held up as proof that cocaine is “physically addictive” and that the rats have no choice once they’re addicted.
But the Rat Park people put the rats in a healthy rat environment, with dirt to dig in and tubes and wheels and stuff to play with and other rats for company and so on, everything a rat would need to live a happy rat life. And they were given the same choices, and guess what? These rats picked the food and water and left the cocaine alone.
To me, it is total proof that the “physically addicting” theory of drugs is hogwash. People, just like rats, take drugs because they’re in pain and they’re trying to alleviate it. Some of these drugs are legal, some are not, but it doesn’t matter, because if they can’t fix up their environment to meet their needs, they will instead continue to use the substance to numb out their feelings of anxiety and depression. The answer is not more drugs, but an approach to modifying the environment so it is easier for folks to meet their basic needs. We need to set up “human parks” and see how many humans choose drugs over life!
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“Remember, there is no shame in being labeled a worthless, helpless, permanently brain-damaged drain on society of whom other people are taught to be irrationally afraid and who will remain on disability for the rest of his/her medically forshortened life, no matter WHAT those other people say!”
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Great strategy! This actually comports with my theory on how “ECT” gets people rating it as improving their conditions. After several “treatments”, the patients/victims become more and more likely to say, “Wow, doc, that was GREAT! I feel SO much better, not a HINT of depression any more! What a miracle! Now, can you please unlock that door and get me the hell out of this place?”
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Well, I guess that depends on how you define “working.”
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And the irony is, they are now starting to prescribe more and more “medication” to stop people drinking. Drugs to stop taking drugs. What could go wrong?
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What’s the “Siberia Bill?” I’ve never heard of that one!
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Unfortunately, recreational drugs and psychiatric drugs are very similar in action, and attempts to convert street drugs into psych drugs are a natural progression from the “bad brain” viewpoint. After all, taking cocaine makes you feel better, doesn’t it? So it’s an antidepressant! Maybe a tad addictive, but hey, you have to deal with the side effect, right? They’ve already converted amphetamine sulfate into a “medical drug,” and tried to do so with meth, with a lot less success, luckily. Why not esketamine, or heroin? The difference between taking Xanax and drinking a prescribed amount of alcohol three times a day is essentially zero. The line between drug dealers and the average psychiatrist is a thin one, indeed.
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First they’d have to invent a special mallet, and give it a different and technical sounding name, then they’d need a name for the “therapy” that would sound “sciency,” get a patent on both the mallet and the process, and then “mallet therapy” could become a reality.
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Wow, what awesome news!!!! Way to take it to The Man!
Life’s still a journey, but at least you get to follow the path you choose. Well done!
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Well, they based their research on client feedback! No wonder no one pays attention – who cares what the CLIENTS think helps? We’d rather engage in mutual pseudoscientific banter about stuff we don’t understand, rather than actually asking the end user what s/he thinks. Then we might actually have to CHANGE what we do!
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“And if you don’t make it, just keep on faking it!”
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Though Netflix is a lot cheaper and has fewer “side effects!”
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“If you were Jello,” seriously??? That is majorly warped.
I’m glad you brought this up, especially regarding the obvious financial advantages the “mental health professionals” display. It seems like quite the slap in the face. I mean, I get someone wanting to have a nice office that doesn’t have paint peeling or sticky spills on the floor or broken blinds, but these opulent offices just scream “I’m making a boatload of money off people like you, and when push comes to shove, that’s what really matters to me.” I think it’s inherently offensive. But I guess if the “professional” really believes their clients deserve less because they are that much less important or valuable, maybe they don’t notice how insensitive and greedy they’re being.
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Of course, they don’t really even do laboratory science, either. They do experiments on heterogeneous groups, don’t identify proper outcomes half the time, if they do identify outcomes and they come out negative, they shop around for positive outcomes instead of reporting, and when their own research condemns their process, they ignore it or “explain” it away and keep on doing whatever they already decided they wanted to do. Not very scientific.
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It really shows the intense differentiation made by many or perhaps even most “professionals” between themselves (sane people) and their clients (insane people). It is this differentiation that makes it next to impossible for such professionals to be genuinely helpful to their own clients.
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I can’t disagree with a word. Anyone who is any good as a counselor/therapist that I’ve ever known is totally opposed to the DSM and the psychiatric worldview. Not all are actively antipschiatry, but they all recognize that the idea of “mental disorders” and “disorders of the brain” are crap.
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What I find fascinating is that in the entire article, getting feedback or information from the actual clients is never mentioned once. Perhaps that’s the real reason clinicians can’t get together – they’re aiming as usual at the wrong target.
Maybe we start with asking clients what or whom they find helpful, then find out what those people do that the clients find of value. Nah, too simple and effective…
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That is a beautiful post! I can absolutely relate to having to learn that my rage is essential to my survival! And you truly show how destructive idea that you are “disordered” for having your feelings can be. It destroys people’s idea of themselves and keeps them from learning how to direct their righteous indignation for the purpose it is intended.
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If even Rush has this figured out, makes you wonder what this guy is trying to accomplish. If words don’t matter, why the heck is he talking to us?
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I was fortunate enough to have such a therapist in my 20s, back before the DSM took hold. It is unfortunately much more difficult to find such a person these days. Almost impossible for some people.
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Perhaps it is the word “thought” that bothers me. Not a lot of “thought” involved, unless you mean thinking how you can pull one over on the general populace for financial gain.
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“Szazian” is just another way to discredit both Szaz and anyone else who dares to question the fact-free psychiatric dogma on which the entire system rests its ugly head.
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Plus, in the casino, no one pretends “the house” is trying to help you out.
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How about “the errant assumptions that underlie the mythology on which the psychiatric worldview is built?”
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I apologize if I seemed to minimize the incredible damage these drugs can do. I find them abominable and the lies about them and the pretense that they are so wonderful and that the “side effects” are someone’s “disorder” reasserting itself incredibly offensive. The point I am making is that the presence or absence of the drugs doesn’t address the bigger issue. I totally agree the drugs are bad news, and it’s my belief that anyone who gets TRUE informed consent about them would be VERY reluctant to use them at all. It is the framing of the problem as “biological” and the promise of FIXING the “imbalance of brain chemicals,” as well as the societal propaganda pushing all the blame for any behavioral or emotional issues that make the ‘status quo’ uncomfortable on the person with the emotions, or worse yet, on their brains, that allows these drugs to be marketed and sold. If that structure is removed, psychiatry is left with, “This might make you feel better temporarily or it might not. It has a bunch of risks and no long-term positive effects. It won’t solve any problem you have, the only thing it might do is temporarily make you feel better, and even that is not a guarantee.” If that is the marketing pitch, they’ll be right down there with the corner drug pusher, which frankly is where the bulk of psychiatrists belong.
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Anybody who would state that “Language does not matter” is not worth reading another word from.
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The question I ask is this: is psychiatry really a “school of thought?” It purports to be a MEDICAL SCIENCE, with no actual support for that claim. It ignores its own research when it conflicts with the basic dogma of the belief system. People who don’t support those dogma are attacked and/or purged from the group. It seems a lot more like a RELIGION than a school of thought. A school of thought implies a philosophical viewpoint that is open to argumentation and new data. Psychiatry is unwilling to admit that it is promoting a philosophical viewpoint with which others may honestly disagree, and relies instead on having social power to enforce its dogma regardless of the truth. Which really prevents any kind of civil discourse with those who are unwilling to recognize the speculative and frankly dishonest nature of psychiatry as a “medical” field. For that reason, having a discussion about it feels like a big waste of time.
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I think perhaps you are confusing these drugs, which people may find useful on occasion, and psychiatry, which comes up with socially-biased “labels” in committees of entitled old (mostly) men and lies consistently to people about the “biological origins” of their “disorders,” despite masses of evidence showing that 1) there are no identifiable physical indications of ANY of their so-called “disorders,” and 2) the “treatments” for these “disorders” are essentially an uncontrolled “experiment” where the experimenters declare success whenever anything good happens and blame any unexpected or undesired result on the client or the “disorder,” and 3) any and all evidence invalidating their “theories” is dismissed with unfounded “explanations” or ad hominem attacks on anyone who dares to challenge their dogmatic “reality.” I’d be happy to make drugs available (with GENUINE informed consent) to those who want them once the lies and excuses and pressures and marketing bullcrap area taken out of the equation.
The problem isn’t the drugs – it’s the lies and the abuse of power that are the real core of psychiatry. And that core is, in fact, totally rotten.
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“Therapists should have innate understandings of themselves, life, and the possibility of themselves being completely wrong.”
You said a mouthful there! Success of “therapy” of any type has a lot more to do with the qualities and attitudes of the therapist than what “school” they subscribe to. In my experience, the very best counselors have no commitment to any particular approach, and do instead whatever works for their client. But such therapists are rarer than hen’s teeth!
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Very well said. Can’t disagree with a word of it.
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I suppose if we define a “real leftist” as someone committed to actual empowerment of the masses, then I would agree with you. But there might not be a lot of “real leftists” around. There could certainly be people who are sincere but confused, or who have difficulty overcoming their authoritarian programming. The folks at the school I refer to for the most part really did believe in the model, at least to start with. They just got nervous and started panicking. It takes a lot of courage to really stick to one’s mission in the face of the training and pressure to the contrary. And there are a few people around pretty much any group who are mainly interested in gaining control of the group, and are only faking commitment. One school I helped create was destroyed by such a person.
As to legitimate authority, of course, I’d agree with you 100%. When I talk about authoritarianism, I’m talking about the acceptance of certain people as authorities regardless of legitimacy, and authorities expecting compliance with their demands without question, as well as both authorities and members attacking on those who are willing to question the dogma of the authoritarian group.
Again, I’m not trying to say this is hopeless or that we should give up. I am merely saying that one needs to be constantly vigilant about authoritarian types making their way into such an organization, as well as being vigilant that one’s own subconscious needs for control and safety don’t overshadow the goal of empowerment of the populace.
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By all means, we should never stop working toward that goal. We simply need to do it in awareness that AUTHORITARIANISM is a deadly foe that is larger than capitalism itself. Freedom and mutual respect and support are the goals we need to pursue, not a different system with different bosses and different people in powerful and oppressed roles. But I think you agree with me on that point.
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This may be my favorite of your posts ever. Nicely stated!
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And just for the record, I don’t equate efforts to maintain the status quo at all costs, which tends to be the ‘right’ leaning form of authoritarianism, with efforts to force one person or group’s vision of change on society by force, which tends to be the ‘left’ leaning form, in my view. Fascism is fascism, it’s authoritarian for sure, but not all authoritarians lean toward fascism. As you well know, there have been plenty of ‘socialist’ dictatorships and lots of human rights abuses done in the name of “socialism.” My only real point is that ONLY looking to the “right” for authoritarianism fails to take into account the internalized oppression we’ve all experienced which leaves every one of us vulnerable to either kowtow to or engage in authoritarian tactics in the service of what seems to us to be a worthy goal. It is something that must be consciously identified and resisted if we’re going to create a different kind of society.
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Dang, who can make a profit off of THAT kind of a plan?
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I think I understand you better at this point. I was simply stating that SOME authoritarianism can be found everywhere, because it is endemic to our society. By no means do I mean to suggest (or did I suggest) that it simply “human nature” – I believe, as I stated, that it is TRAINED into us from birth onwards, both explicitly by parents and churches and educational institutions and so forth, and implicitly by being the only game clearly on display, and by the hostility expressed toward those who refuse to go along with the status quo. It is a challenge to overcome that kind of training for anyone. For instance, in the “dictatorship of the proletariat” concept, the idea is that there is a temporary period during which the new ideas will become held by a majority of the people in the society, allowing this dictatorship to melt away. But during that period, there is an authority in charge of what should be taught and how it should be taught, and those doing the “teaching” ALL grew up with these authoritarian models of education. So it requires real care and attention not to replicate the same forms that we’re comfortable with, as my example of the “democratic school” shows so clearly. It is not enough to just believe in a revolution, we have to pay attention to how it will happen and what will happen afterwards. I don’t think it’s doomed to failure, but I do think these challenges are great, because a lot of the ideas and models we carry are not conscious (kind of like implicit racism or other unconscious biases). I have always found it of the greatest importance to address the dilemma of being a person of privilege and authority trying to help others to find their own freedom. How easy it is to fall into saying, “Do it my way, it works for me.” It is a challenge we must all keep at the top of our awareness any time we’re working for real empowerment of ourselves and others. That’s my experience anyway.
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Wayne Dyer was a big help to me. He’s very practical and empowering.
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I didn’t say a lot of what you think I said, Richard. I think it’s important to be careful not to read into posts things that are your assumptions. I’d prefer if you’d simply ask for clarification if what I said is confusing.
I believe that a lot of the current population is authoritarian, at both ends of the political spectrum, based solely on my own observation of people’s behavior. I believe this is mostly because of our authoritarian means of educating people and our ubiquitous authoritarian structures which seem to be “the only way” because people don’t SEE another way ever demonstrated to work. I certainly know people who are not authoritarian and believe that non-authoritarian structures can be found and/or created, and have spent a good proportion of my time on Earth working to create that possibility. However, it’s not as easy as it sounds, because we have all had this stuff hammered into us from birth, and people who are NOT authoritarian are punished for following their path. Naturally, authoritarianism occurs on a spectrum, and people are pushed back and forth based on how their efforts are perceived and reacted to by those around them. So encouraging anti-authoritarian thinking is possible and will push people in the direction of seeing things that way. But just as obviously, those who are running the current society are very invested in maintaining the current power dynamics and use authoritarian tactics to maintain them and push people to a more authoritarian view of the world. Revolutions have historically not always led to real change, because the internalized authoritarian underpinnings of the social system were not addressed, and the new rulers step into the authoritarian roles that they and the society they are part of feel comfortable with. This is a big part of why the current “liberals” in the USA have such a hard time supporting antipsychiatry as a movement – they are unable or unwilling to challenge the idea that doctors generally have their best interests at heart and should be trusted to make up rules that the rest of us should follow. That’s authoritarianism, and you see how strong it is when you try to talk to some (not all) “liberals” about the human rights concerns of those labeled “mentally ill,” with whom their stated philosophies should have great solidarity. But they don’t, because it’s not in their own structure of what is “right” and “good” and “wrong” and “bad.” They accept the authority of the doctor without questioning it. I saw a lot of this when working on creating democratic schools, where kids are mainly responsible for making up their own school rules and enforcing them. Parents and teachers SAID they believed in these principles, but when the kids’ standardized test scores started to come into play, or the District started complaining about the vagueness of the curriculum, they started getting unconsciously very nervous and bit by bit re-instituted authoritarian structures that were opposed to the mission, because they really weren’t quite comfortable themselves trusting kids to wield all that power themselves, much as they wanted to believe that they backed the mission 100%.
The world is not a black and white place. I can certainly go into examples from our current world where people on the “left” engage in authoritarian behavior and don’t recognize it as such. Examples on the “right” are perhaps more obvious and easy to identify, but the idea that all authoritarians are right-leaning politically is just plain not borne out by the facts. There are also people who identify as “conservative” who are actually quite anti-authoritarian. We need to become more aware of this if we really want to change the way we’re doing business. Because in the end, “society” exists within the people who create and participate in it, and if we want to create a new society, we have to understand our internalized oppression and deal with it, or else we will perpetrate it in our new society as well. As the Who sagely suggested, we want to avoid a “Meet the new boss, same as the old boss” situation. It is not enough to change the external structures of society. We have to change our own internalized structures, too. And that’s a lot of hard work that few are ready to take on, in my experience. That may seem jaded, and maybe it is, but it doesn’t mean I don’t think it can be done. I am saying that, as discouraging as it sounds, this reality MUST be dealt with, and pretending that it doesn’t exist will doom further revolutionary efforts to failure or limited success. We do ourselves no favors by ignoring this particular set of facts about human behavior.
I hope that clarifies things.
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WOW! That’s a big victory!!!! Thanks for letting us know!
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Authoritarianism knows no party or political persuasion.
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The trick is, they portray anyone who actually gets caught as a “bad apple” and an outlier and assure everyone that they are HORRIFIED that any doctor would act this way, and THEY certainly don’t ever do anything like that! It is a great way to distract attention from any deeper investigation or analysis.
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Very well said!
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It is always a mistake to assume that this system works in any way on logic.
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NA might not be a bad idea, I don’t know. It seems that familiarity with dealing with withdrawal might be valuable. I knew a former heroin addict who took SSRIs for a time, and she had bad withdrawals. She said she felt lucky she’d had to withdraw from heroin, because otherwise, she would not have understood what was happening or how to deal with it. Of course, the doctors never bothered to tell her that she might experience withdrawal.
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Paula Caplan, I think.
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A message from Sharon Crestinger, who has been an MIA poster in the past:
I am thinking of Julie Greene today and am very sad for her transition from this dimension. I have many comrades and friends, but few contemporaries in the world of survivor and abolitionist essayists. Julie was usually the first one I could name. This was the context of our relationship.
Writing was never a problem for Julie. She wrote and wrote, every day. It’s beyond an outrage that she was murdered by psychiatry at 62 with so much left to say. And, I am glad she said so much while she was here. Julie got discouraged and frustrated sometimes that her work didn’t find a wider audience, but she never gave up. I greatly admired how she kept going through the discrimination, marginalization, health problems, and everything else she faced as a survivor. She believed her writing and her activism made a difference and that if she and others just kept going, abolition would be a real possibility one day. Julie believed the work of abolition would eventually succeed in a very real and material way I greatly wish I could share.
Julie was my best editor. The way she lived her life inspired me.
I see a lot a grief for the end of Julie’s life. I’m trying hard to be outraged, but I am so sad and tired.
I wish more people were outraged. I wish more people used the words murder and genocide to mark our passings.
Safe travels, comrade. I’m so sorry you won’t see your writings elevated to the place of importance they will eventually occupy in our history.
Sharon Jean Cretsinger
Tijuana, December 7 2019
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Your point about the “hostile takeover” is very well taken. There appeared to be little in the way of hostility – it was more of a merger made in the interests of monopolizing the market. Both sides agreed from the start, and both sides benefited massively from the collaboration. The only hostility was toward any whistle-blower who tried to point out what was really going on.
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Very well said! More appropriate to ask how “service users” see their right respected or not respected by “mental health professionals!”
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Of course, he’s dangerous! We can’t be helping people CURE themselves! Then we’d have to find more clients, and some of them might figure out that we have no actual idea what we’re doing!
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You seem to be coming from the assumption that all people with the “ADHD” label have the same problem or need the same kind of help. “ADHD” is just a name for a certain set of behaviors that have been identified as problematic. There are all kinds of reasons why people act that way, and hence all kinds of different things that might help different people. It makes total sense that some “ADHD” labeled people would do better with meditation and some would not, because they’re all different. Acting in a certain way doesn’t make people actually similar – it’s just a surface manifestation. Unless you know why it’s happening, you can’t say they are similar at all.
Besides which, some people who act in ways that are called “ADHD” don’t believe they have any problem, just because other people have a problem with their behavior. And I tend to agree with them.
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I’m so glad you said that! Science is MUCH better at disproving things than proving them. Scientific proof really consists of vigorous attempts at DISPROVING a hypothesis failing over an extended period of time. A scientific finding that can’t be replicated isn’t scientifically true any longer, but of course, psychiatry does not hold itself to such standards.
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I agree!
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I am so sorry to hear of this! I only wish it were some anomaly, but unfortunately, she is far from alone. I am glad you guys are trying to make some sense of this by warning others of the dangers.
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Horrible! Disgusting!
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Holy, holy, holy…
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I was taught to “label behaviors, never label people.” This was obviously before the DSM took hold. It’s all about labeling the people.
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Ditching the DSM should be on the list. The DSM a highly trauma-misinformed or trauma-denying or trauma-delegitimizing document, and to attempt to provide “trauma-informed care” while working in a DSM framework is utterly impossible to accomplish. Those who really do effective trauma work either ignore the DSM entirely or use it for insurance billing. It has no place in actual therapeutic intervention for trauma survivors.
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I think what bugs me about this is that it begs the very important question of why there would be debate in the first place. I bet you can’t find 8 or even 4 different audience critiques over clinical practice guidelines for heart attacks or broken limbs. Sure, there will be different opinions on particular approaches taken, and on the possible conflicts of interest with drug companies and others which plague the entire medical profession, but no one will be arguing that heart attacks don’t really happen or that it is a medicalization of a normal human variation. The main reason there are debates of this nature is specifically BECAUSE there is no scientific basis on which these “diagnoses” are formed. So yes, it is a social document, for sure, but one that has little to nothing to do with science and a lot to do with economics and sociology.
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The problem with the label “PPD” is that it implies something you HAVE rather than something that is happening to you as the result of complex circumstances. Anyone who has had a child knows there are 50 reasons why you might be feeling depressed after the birth of a child. To mention one that never gets mentioned, domestic abuse often starts or escalates immediately after childbirth, and DV is hardly a rare occurrence. How many cases of emerging domestic abuse are papered over by the term “PPD?”
I know I’m preaching to the choir here, and we are not in disagreement, but I wanted to make it clear from my viewpoint why the term PPD is particularly offensive to me.
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Anecdotal evidence can be useful, but these studies are controlled and more intentionally screen out “false positives” and “false negatives.” The placebo effect is a HUGE part of why some people find their antidepressants effective. There are also many who find them effective to start with and then the effectiveness fades over time. There are also many who start on ADs and then have trouble coming off due to withdrawal effects, and many of these are told that this is their “depression coming back” and proof that the ADs are “working.” And of course, there are some who derive actual benefit from them in terms of feeling better, however that may be defined.
Talking about understanding the “nuances of psychiatric care” is likely to be considered pretty insulting in this particular community, as most of the posters have been exposed to those “nuances” personally and can tell you a thing or two about just how “nuanced” the approach was in their particular case. I get that you have found ADs helpful for you or your clients, but it should be clear very quickly from reading these posts that this is NOT the case for everyone, and I think it would be wise to listen a little more to what people have to say about their own experiences before leaping to the conclusions that they “don’t understand” what psychiatric care is all about.
BTW, have you read Anatomy of an Epidemic yet? You really should read it. It is the basis for this entire site and community, and might open your eyes a bit to what people here are protesting. Hint: the use of medication is not the main issue.
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I guess some kids must not be “tough enough” to deal with the abuse and need to be diagnosed because their brains just aren’t up to the task of being forcibly separated from their families and kept in overcrowded little rooms or cages without knowing if or when they’ll ever be released. I guess the “mentally healthy” ones either lapse into total apathy or “look on the bright side” because “they control their own narrative.”
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Exactly! “Enforced meditation” is an oxymoron. And only someone who doesn’t really understand it will try to force it on another, including forcing them to do it “the right way.”
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The idea of common sense suggests that a person with little to no education should be able to see the truth in it intuitively. I truly believe this is the case when it comes to understanding human beings and what we need from each other. Too much training, as you say, creates more and more confusion, because they’re making things more complicated than they really are. And then we get weird studies showing that “racism and oppression increase mental illness symptoms.” Gosh, who knew? It really isn’t that complicated, though it requires courage and willingness to experience intense feelings to fully understand, and that’s where a lot of “professionals” fail.
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At Tim McCarver once said, “They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
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All I can say is, wow, what a powerful post! Thanks for sharing your story. Your son sounds like a very special person, the kind of person more kids need to meet when they are young!
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Though Oldhead may disagree with you, I do not. While psychiatry as a “profession” may not be a legitimate “service” that actually intends to meet anyone’s needs but their own need for money and power, most people who seek out psychiatry DO have a need of some sort that our society is not meeting. While there is no real hope for reforming psychiatry, as its intentions are not actually to help (though individuals within the system may have that intention), there are people who need real support and caring which our society fails to provide (or at times actively opposes). We need a plan to help such folks (which let’s be honest has included most of us at one time or another), and I do think that having such a plan will make it easier to get rid of psychiatry, as it will remove one excuse/justification for psychiatry’s existence. Naturally, the psychiatric hierarchy will attack any such attempt with vigor, but that is to be expected, as they will see their gravy train being derailed. So we’re not talking of an “alternative to psychiatry,” but a viable way to help folks who are suffering from the oppression of our patriarchal, authoritarian and capitalistic greed-and-power based system of social control.
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Do you know of any evidence that any of these “disorders” are physical problems? I don’t. For sure, physiology can be involved, including things like sleep, diet, exercise, drug intake, physical pain, etc. And there ARE physiological conditions that can cause mental/emotional effects (like Lyme Disease). But so far as I know, there is no proof that any “mental illness” is consistently CAUSED by a physiological problem. Remember that these entities are defined by committees voting, not by any kind of scientific process. How would they even know the cause if they are defined by a list of behaviors and feelings?
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Right, they’re just effective for something different than what we assume they intend. That’s where people get confused. They think that the goal is to make people better, when it’s actually to make themselves rich.
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First rule of anarchism: there are no rules!
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“How do you FEEL about being $10,000 in debt and being unable to pay for food and rent? I know you can’t control your hunger or being evicted, but what can you focus on that you DO control?”
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I have found the same. You can’t fully trust someone until they’ve seen you let loose with your most difficult feelings and behavior and find they still want to be around you. There is no intimacy without vulnerability, but we’re taught all the time (which actually starts making it true) that sharing our true selves is foolish and dangerous and we’d better keep those masks on, or else!
I personally found school particularly awful in this way. Keeping one’s own integrity in place in a standard school environment is next to impossible for most kids.
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And our society as a whole makes it even harder, as even those women with no trauma history are taught that their value lies in sexual attractiveness and acceptability of appearance to others. But naturally, this kind of issue does not appear to carry any weight with the paternalistic psychiatric profession, which seems myopically committed to blaming the victim and letting social institutions off the hook.
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Another startling piece of research reporting on the obvious. Too bad common sense is not more common, we could save a lot of money on research.
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Well said!
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Yeah, surprising outcome, isn’t it? Who could have guessed that dehumanizing conditions caused people emotional distress and upset? Sure glad we have Scientists to figure out these difficult questions for us!
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I don’t think the hospital did the survey.
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The reason it seems arbitrary is because it IS arbitrary. The research on “antidepressants” rarely extends beyond 8 weeks. No one knows how long one would continue to “benefit” from taking these drugs. Or if a particular person would benefit at all. Or actually what “benefit” really means in this case.
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Well said. I think the title is far to gentle. It should read, “Textbooks provide known lies and disinformation about so-called “ADHD.”
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We’d be better off if the inmates actually WERE running the asylum!
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Magic spells that are reimbursed by insurance, though.
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I heard an almost exact replica of your description from a coworker who was taking Zoloft for migraine headaches, not “depression.” She was shocked with how “reasonable” the idea of suicide seemed to her, just a casual thought, like, “I could go to the store. I could kill myself.” I do think the “positive effect” of SSRIs is a lessening of empathic connection to others. For some people, this will feel like a relief. For others, it will make things seem reasonable that would have seemed outrageous before. Including suicide or murder in some cases.
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I think the argument is if they had the right genetics, they wouldn’t MIND so much that their limbs had been blown off.
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Seriously? That surprises even me. But maybe it doesn’t.
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Seems to be the logical conclusion based on their actions, doesn’t it?
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Commenting as moderator: Just so you know, I will never moderate you for including accurate descriptions of your experience, no matter how ugly it was. Moderation is only for things that attack or distract, not for things that are true but uncomfortable. Sharing the true but uncomfortable is a lot of what this site is all about!
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Oh, were you under the impression that the goal was to reduce mass shootings? I think that’s where the confusion enters in.
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I think you hit it on the head. “Mentally healthy” in these circles seems to mean not experiencing any strong emotion of any type. Like Stepford Wives or Invasion of the Body Snatchers. “Once you do the transformation, you’ll understand.” If those pea pods from Invasion of the Body Snatchers really existed, the psychiatric profession would be very excited about them.
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I agree with you on that point!
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Ah, I’ll go with the demons. At least that way, it’s not my fault.
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What, a 20% copay? $4000 maximum lifetime demonology coverage?
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Yeah, at least a demon is an external agent that you can get rid of, not something that is embedded in your faulty DNA. I’d go for demon exorcism before psychiatric labels and drugs!
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Wish they’d be a little more definitive in their conclusions: “The use of ADM for adolescent depressive symptoms is not supported, as the risks far outweigh the ostensible benefits.” Or “Doctors should not use ADM as a treatment modality for children or adolescents having depressive symptoms.”
Of course, the idea of “treating” depression is problematic in itself.
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Of course, it’s impossible to really define “relapse” when you haven’t bothered to objectively define what the “illness” is in the first place. Not to mention the huge number of “relapses” that are actually withdrawal syndromes.
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I am SO shocked and disappointed! Who could have predicted this outcome?
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My understanding is that the Fluoxetine trial was seriously flawed. I think Bob talked about that in Anatomy of an Epidemic, but I’m not totally sure.
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Not a problem. It’s easy to misunderstand communications, and I appreciate the clarification.
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Seriously, what is “friendly” about being shot in the back by your own troops??
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““Partnership-based relationships seem to promote personal recovery more than traditional expert–patient relationships. Our findings also indicate that mental health services need to be organized, more individually tailored, and “bottom-up,” starting with the needs, preferences, and goals of service users.”
This is a very euphemistic way of saying that seeing a doctor is not likely to be helpful, and that services that ARE actually helpful are ones that start from the client’s needs and preferences. Is this news to anyone? But good for them for making it explicit.
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I had not thought of that, but it makes complete sense that they’d want to subsume sexual assaults under “PTSD” so that it can be palmed off as combat trauma or something other than what it is. When will we learn?
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That was my experience as well. I remember being a safety patrol and having to keep the kids outside the building when it was 20 degrees out while the teachers walked around inside drinking coffee in their comfy sweaters. I think that was the first time it really struck me clearly just how systematically abusive the system was.
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When you addressed this to “Steve,” I hope you were not talking about me. I agree with everything you said here.
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Parkinsons is a malfunction of the dopamine system. Antipsychotics mess with the dopamine system. Most “bipolar”-diagnosed people are put on antipsychotics. The first line of inquiry should be regarding the impact of antipsychotics. Occam’s Razor.
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Messing with brain chemicals is just a bad idea!
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Well, ugh! But in addition, what does he think the chemicals in the brain are made from? Food, obviously. Even if one fully embraces the “chemical imbalance” myth (which even psychiatrists are now finally backing away from), it would still make sense that nutrition would be a viable intervention.
I wonder how much money he gets from Big Pharma every year? Sounds more like a drug salesman than a doctor.
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That story is truly disgusting. It reminds me that a century plus of “progressive educational reform” has had little real effect on the authoritarian basis for schools. Lipstick on a pig, I’m afraid.
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And I’d probably be much more interested in talking to one who did than one who simply believed in the “status quo” mythology.
It is my understanding that traditional healers are part and parcel of psychiatric care in Brazil, and they do, in fact, come in and deal with spirits. I also know of a case in Texas, I believe, where a spiritual healer came over from Mexico and cured a person deemed “severely treatment resistant” by the doctors.
Compared to “standard treatment,” I’d take spirit dispossession any day of the week.
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100% agreed!
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I would suggest that it’s not possible to be “misdiagnosed” and/or “overmedicated” when there is no objective means to determine a proper “diagnosis” nor what an effective level of “medication” actually would look like. What is the proper dose of exorcism for casting out demons? Though casting out demons is probably a more effective approach…
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The authors’ experience is not in the least bit surprising, and they properly identify the privilege and power of the academic elite who don’t want their authority challenged. I would have liked to hear more of a connection made between that power and the money flowing to institutions from psychiatry, from equipment makers, and from the pharmaceutical industry. Academia has been largely corrupted when the door was opened to big corporations essentially buying research that promotes their product, including the right to not publish research which is critical. This ethos permeates the entire academic world (not just in psychiatry) to the extent that it is almost invisible to those who swim in that particular water. We don’t bite the hand that feeds us, especially when the owner of the hand can now bite back so painfully. We have to get big corporations disconnected from academic research!
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The term “social psychiatry” appears to me to be an oxymoron. It fails to recognize the corrupt nature of the current biomedical model and suggests that it is feasible to “integrate” this model with more social/psychological views of emotional distress. This is in my view impossible, because the biomedical model is driven by profits and the interests of the APA to control the narrative, and is not in any way directed toward “health,” even in the metaphorical sense. It is directed toward profit and control, and as such, can’t be integrated into anything rationally focused on improving people’s lives. If you want a socially responsible and flexible approach to people’s emotional well being, don’t bother with the current model. You’d need to start over from scratch.
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If someone were NOT a therapist, just a friend or colleague, do you believe that that person might listen to someone else’s experience in a non-exploitative way? And that such listening could be helpful to the person telling their story? Is it possible that those “on the barricades” might tell each other stories during lulls in the fighting, and that they might benefit from sharing their stories with each other?
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This has been studied and proven, and yet…
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Well put!
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If I really wanted to reform schools to improve what they metaphorically and euphemistically refer to as the children’s “mental health,” they could start by reforming the authoritarian nature of the student-teacher relationship and give the students more control and some genuine recourse when they have been wronged by the staff or other students. There are any number of “democratic schools” around the country and the world, starting with Summerhill way back in the early 1900s. At Summerhill, students got to choose what classes they attended, including not attending any class at all. And yet the students chose to attend classes most of the time and would ask kids who were not serious about studying to leave. They made their own rules and had their own justice system for kids AND adults who might have transgressed the school’s agreed laws. The students and staff all got one vote at the meetings, and staff were frequently overruled in their suggestions. This is the kind of approach that is needed if we want our students to be “mentally healthy” – an environment where they are trusted, where they have responsibility and control, where they are able to protect themselves from abusive or coercive behavior of others, where adults are there to help the students pursue their own goals instead of forcing the students to pursue the adults’ goals. Most adults are horrified by such an arrangement and believe that students will never learn anything unless they are forced and coerced and punished into compliance. This is because our culture hates and disrespects children, and most of adult “mental illness” starts from the disrespect and mistreatment of children as they grow up.
It is laughable in my view for schools to talk about improving students’ “mental health” when the reality is that schools do a huge amount of mental/emotional damage to our kids that many never recover from.
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But I guess that would assume the therapist was assisting in some way, which could be an optimistic assumption.
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Maybe we could call it “therapy assisted dogs!”
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You seem to automatically equate healing with pity. Pity does not heal. Nor does healing remove the need for justice. In fact, justice is often critical to healing occurring, as Alex relates in his post. There is no reason why healing and justice can’t both occur together.
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I agree with you. The idea that any one intervention will help in ALL cases of “depression” or “ADHD” or whatever label psychiatry wants to toss out is the central problem. There are real, physiological problems that can affect mood and behavior, and they ought to be identified and dealt with through testing and smart interventions. I only protest when someone suggests that ALL such issues can be handled by nutrition or any other specific intervention. Everyone is different, and how they feel is a very sketchy guide for intervention. Good research and exploration is the key to finding out what is actually needed, instead of assuming that someone feeling depressed or anxious is enough information to know what to do.
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Hear, hear! Unfortunately, a degree and a license is not even close to a guarantee that a person has the ability to be a healing presence in someone else’s life. We need to select our healers very carefully!
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Exactly!
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I’m gonna guess that’s a “yes.”
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I can’t say that, and I didn’t say that. I’m saying that no doctor can tell you that your depressed moods and experiences are due to genetics, nor can they say in general (and this is more important) that depression is always or usually due to such genetics, because they don’t know that. They’d be lying to you if they claimed that they did. YOU can make your own observations and believe as you see fit, and I totally support your right to do that for your own situation. It’s when one person starts telling another what THEY should believe that things become dangerous, especially when the person (like a doctor) has a special societal role of translating what is known scientifically for lay people. For a doctor to claim that you or anyone else is suffering from a “genetic predisposition” to depression when they have no way to know if this is true or not is not only dishonest, it should be considered malpractice. Whereas your own assessment of your own situation harms no one and hopefully helps you get a better grasp on how to help yourself to move to a better place. That’s the big difference.
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Hey, I have never said that I “rule out” biology! I’ve always agreed that there are real biological problems that cause problems with moods and behavior. (One such problem is the adverse effects of drugs one is taking, for instance). What I have said and continue to say is that the fact that one FEELS a certain way or ACTS a certain way does not say ANYTHING about why they feel or act that way, and to suggest that simply because someone feels depressed it means they have a problem with their brains is absolutely ridiculous. It’s very much like a person having a pain in their leg and being diagnosed with “leg pain disorder” and to “treat” it by giving drugs to dull the sensation of pain. There could be 50 reasons why a person’s leg is hurting. Let’s suppose they were hit by a car, or stung by a bee, or have a piece of shrapnel in their leg. Is the pain in the leg the problem? Or is it information that leads us to investigate what is going on?
I don’t know why it seems to be so hard for you to see this distinction. No one is denying that physical conditions can cause changes in mood or behavior. What we’re objecting to is the idea that ALL changes in mood are behavior are ALL caused by physical conditions, especially when there is absolutely NO physiological finding to support such a ridiculous assertion.
If you want to believe that you have a genetic condition, you’re welcome to believe that. But there is no scientific evidence showing that there is any genetic basis for depression, and assuming or implying that everyone else who is depressed has a genetic or biological problem is going to be viewed as a problem by most of the people who post here.
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Wasn’t that the Hotel California?
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It is encouraging to know that professionals have resisted this effort in France. I wish this kind of thinking would catch on around the world!
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Why “reduce” coercive practices, since they are seen as human rights violations? Why not eliminate them? In fact, why call them “coercive practices?” Why not entitle this “Eliminating human rights violations from any human services agency or practice?”
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I actually do think that words define our reality. For instance, if a person is kidnapped and threatened with death, and as a result has moments of intense anxiety that this might happen again, do they have an “anxiety disorder?” Or are they responding pretty normally to a violent and terrifying experience?
I’d say it matters a lot to the victim whether you tell them that their response is a normal reaction or a “disorder” that needs to be “treated.” Having worked with a lot of traumatized people in my career, I’d say that it makes a HUGE difference to have a person think of their reaction as an understandable response to a difficult or impossible situation. The more I was able to have the person understand why they reacted the way they did, the easier it was for them to recognize that the present moment was different and that perhaps a different response in the present is a possible option. Whereas telling someone that they “have a disorder” tells them they SHOULD have reacted differently to the situation and that the fact they are upset about it is a personal failing that needs to be fixed.
Words do matter. A lot. Especially words about who you are and what your behavior and feelings mean.
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The clinical guidelines do need to be reconsidered, starting with, “Depression will no longer be diagnosed as a disorder.” The rest will be a lot easier once they get that part over with.
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Dang, these guys are really making things complex!
What’s wrong with mind-body dualism, anyway? Why would that philosophical position be outdated? I’d say the majority of the world’s cultures see the spirit and the body as being separate entities that interact with each other. This viewpoint could also have explanatory value if it is not dismissed out of hand. Without knowing what “the mind” really is, how can it be considered “disproven”?
What needs to change is demonstrated in the article – the masquerading of philosophy (such as ethics, epistemology, etc.) as scientific inquiry. Asserting materialistic philosophy as established “truth” does not do science any favors. It’s best to acknowledge when the unknown is unknown, instead of calling a viewpoint “outdated” because it isn’t currently fashionable.
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That’s the real definition of “working” from the point of view of the system. As long as sales are up, “It’s working!”
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It appears to me that most DBT practitioners don’t have the first clue about “mindfulness.” The whole thing comes across as highly authoritarian, which is totally counter to mindfulness. You can’t force someone to be “mindful.”
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This is true, of course. Medical care is the third leading cause of death in the USA. But I consider it even more egregious when the “conditions” being “treated” aren’t even objectively definable, and actually represent social assumptions and biases rather than medical conditions. It’s bad enough we have to trust doctors to treat actual illnesses. I sure don’t want them “treating” my emotions and thoughts!
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Let’s get rid of the “mental health” language here!
How about: “Survivors’ reality is badly messed with when people don’t believe them.”
Or: “Survivors of sexual abuse find it invalidating, infuriating, and depressing when people pretend that what happened to them wasn’t real.”
Or: “Denying the reality of sexual abuse survivors is another form of abuse.”
It doesn’t “affect the mental health” of abuse survivors. It attacks them directly and undermines their safety and sense of reality, and it does so intentionally. It is normal to be pissed and confused and self-blaming after someone abuses you, and even more so when those entrusted to protect you protect your abusers instead.
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I agree totally. It would be better they told no one than that they are invalidated or disbelieved or blamed in any way for what happened to them.
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How would we react if our doctor told us, “Well, I can’t say for certain what’s wrong, but we think you have a little tiredness disorder, plus a rashy skin disorder and an insomnia disorder plus a headache disorder and a right leg numbness disorder. We have a drug for each of those conditions, but it won’t cure them. It might keep the symptoms under control, but the drugs will make you gain weight and possibly raise your risk of early death through heart disease and/or diabetes. And we still don’t really know what’s causing all of this.”
I think we’d all realize we were visiting a charlatan.
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Sweet!
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Much better!
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Why would the DSM bother trying to be more “relevant for indigenous populations?” It isn’t even relevant for members of the culture which spawned it.
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How about we just oppose “people shaming?”
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The stunning part is that no matter how much worse the client becomes, the “treatment” is always exonerated.
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I’d sure call it that.
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The burden of proof is always on the person supporting the hypothesis. So one can say a hypothesis can’t ever be proven absolutely, because there is always the possibility of new data having to be incorporated into a system. Even Newtonian Mechanics, the ultimate in a set of certain laws of the universe, had to be modified eventually due to relativity and quantum mechanics.
But science is actually very capable of disproving things. All that’s needed is for the theory to predict something that doesn’t appear to be true in reality. For instance, if there is a claim that “low serotonin causes depression,” it would follow at a minimum that all people who are seriously depressed will have low levels of serotonin compared to normal. That isn’t sufficient to prove it, because of course low serotonin could be an effect rather than a cause, or simply a co-occuring phenomenon that has no relationship to depression. But if depressed people DON’T have lower serotonin on the average than non-depressed people, the theory is shown to be false, because the results conflict with the hypothesis. And in fact, this is the case. People who are depressed don’t always have low levels of serotonin, and people with low levels of serotonin aren’t always depressed. Moreover, increasing serotonin levels doesn’t consistently improve depression, and many “antidepressants” don’t even attack the serotonin system.
So yes, the theory of low serotonin causing depression has been convincingly disproven. We know it is not true. It isn’t just a lack of data – the data show that that hypothesis does not predict realty, and is therefore false. Similar arguments can be shown for the high dopamine theory of psychosis, and the low dopamine theory of ADHD. The idea that “mental illnesses” are caused by “chemical imbalances” can’t entirely be disproven, but in every case where a concrete hypothesis has been put forward, it has been disproven.
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I think perhaps you underestimate the power of multi-billion dollar worldwide marketing systems.
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I agree with you. I’m not sure whether I was responding to you or just to the topic in general. I think it’s important not to generalize about how to handle specific manifestations as if they all require the same handling. I actually think that point is quite consistent with yours, as the nature and meaning of voice hearing could also be very different depending on the person in question.
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It’s not “controversial” to rely on secondary outcomes, it’s a violation of basic scientific principles and any study relying on secondary outcomes should never be published. So much for “peer review!” And even their sketchy “Secondary outcomes” did not support their conclusions.
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I tend to agree. There are other forces not obvious to the doctor-patient relationship that act to make it more difficult to avoid psychiatric “treatment” even in the absence of overt force. For instance, doctors are pressured from insurance companies and their own organizations, as are counselors and therapists, potential patients are pressured by friends, family, workplace, schools put pressure on parents to psychiatrically “treat” their kids, the news media makes it seem like people are foolish for not “taking their meds” as prescribed, movies and TV shows dramatize again and again how those who “don’t take their meds” deteriorate and become dangerous, and yet are magically fixed when they are back “on their meds.” Maybe it’s not “force” but “social coercion,” but there are a lot of people on these drugs against their own better judgement, or lacking any kind of informed consent, who were not ordered by the courts to take them. Lying to people can be a form of coercion if the lies create fear that the person will be damaged or do something dangerous if they don’t comply with the doctor’s “suggestions.”
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Apparently we’re all supposed to be mildly bored to mildly engaged with everything. No strong emotions are “normal” per the DSM. Sounds like Invasion of the Body Snatchers would be the psychiatric ideal.
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And maybe the answer is, “It all depends on the needs of the person hearing the voices.” Maybe there is no “correct way” to handle voice hearing, because it’s an individual phenomenon and not something we can generalize about.
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Look at you, being Switzerland! You go, Oldhead!
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It seems this is where we disagree. If I want to challenge someone regarding psychiatry, it’s not the time pr place to speak out against Scientology, because I see it playing into the hands of the person trying to avoid the question.
Now if a person GENUINELY thinks that all antpsychiatry activity is started or supported by Scientologists, that’s an opportunity for education. Very different in my mind from a blatant effort to intentionally deflect attention away from a critique of psychiatry by implying that anyone taking such a stance must be irrational and unscientific.
Anyway, as I said, we can respectfully disagree on this point. I don’t see much point in continuing the discussion, as we’ve both made our positions and arguments clear. People can consider either one and do what works for them.
Another clever approach was suggested by another poster: “Actually, I’m a Buddhist. What about you? Now that we’re done with talking about religion, let’s get back to talking about psychiatry.”
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Precisely. They are only threatened by those who question their basic premises, because they know that “the emperor has no clothes” but they don’t want anyone else to notice it. If there were a mindless and dangerous cult that promoted their product, they’d be four square behind it. Oh, wait… there already is one…
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Deprogramming sounds right to me!
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BTW, do you really think that most of the psychiatric profession is asking protesters about Scientology because they are concerned it is a “dangerous cult” and don’t want to interact with it? Or do you think they
are using a preexisting social reality/fear to manipulate people into thinking that anyone who opposes psychiatry is only acting out of the dogmatic insistence of Scientology’s leadership? I personally doubt very much that any psychiatrist actually has such a concern or would be in the slightest degree reassured if you told them you were not. It seems to me that the goal is to tarnish all resistance with the brush of irrationality, and my preferred response is not to allow that goal to be put forward unchallenged. Because people are easily manipulated by innuendo.
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That’s my position as well. Social control should be named what it is. It’s not “treatment” of “mental health issues.” It’s an attempt to control “deviant” or “undesirable” behavior from the point of view of the status quo. Naturally, it’s a very slippery slope when we start reframing “He’s doing something that annoys his neighbors and should be stopped” as “He’s got a ‘mental disease’ MAKING him do something annoying and heneeds to be ‘treated.'” Again, what is “deviant” is defined socially, not medically, and it’s a pretty big scam to pretend otherwise.
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I do think that is an excellent point.
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Hence, the question of who the mysterious “programmer” of the mind actually is!
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Yes to both!
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Most of the group members are probably too drugged to realize where they are!
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I am never arguing for any kind of “broken brain” theory. I am saying that there ARE brain problems, which are handled by neurology or some other actual medical specialty. I was trying to explain within Rassel’s context of materialism why “mental illness” still does not make sense as a medical problem. I’m not a materialist by any stretch of the imagination!
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Well, that could work just fine, but it still leaves you potentially vulnerable to someone changing the topic to how bad Scientologists are or how “most” opponents “are Scientologists” even if you are not. It is an attempt at distraction, whether they are accusing you of being a Scientologist or a Zoroastrianist or a Communist or a Nazi. I think the best approach is not to take the bait. But I know we will respectfully disagree on this point.
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Or how the same “diagnosis” can be helped by different “treatments.”
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I could not agree more with your sentiments here.
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Of course, there is also the problem of who the “programmer” or operator of the mind actually is…
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I don’t think anyone here doesn’t believe that a brain can malfunction. I don’t agree that a brain malfunction is the only thing that can be behind someone being violent or depressed or whatever. It sounds like you believe the brain creates the mind and therefore HAS to be responsible for any actions that occur. I don’t see it that way – I see the mind as being the mechanism for controlling the brain, at the minimum an “emergent property” that extends beyond the mechanism that created it. I also hold the strong possibility that we are spiritual entities that are responsible for our bodies, though it is difficult to prove or disprove this kind of premise. In any case, it is pretty clear from direct observation that the mind can and does control most aspects of the brain. Even the revered PET scans show that when someone simply THINKS something different, the PET scan changes. For instance, someone can think of a sad event and their brain shifts gears into a “sad” profile, and shifts back when they think of something that isn’t sad. This belies the idea that feelings “just happen” because our brains are bad.
Even if we accept the premise that it’s all in the physical universe, there is still the “computer model” to consider. While I don’t believe that the human brain is much like a computer really, it is fair to suggest that we have “hardware” and “software” operating, in the sense that there are physiological structures that are used while thinking and making decisions and emoting, but there are also “programs” in the sense that we make MEANING out of things and we make decisions based on values that are programmed in starting early in life.
Using this metaphor/analogy, what if the problem is not in the hardware, but in the programming? You can’t solve a programming problem by replacing memory chips or rerouting the power supply. The program is contained within the chips, and really consists only of on/off switches. It is only because the programmer assigns MEANING to the switches that the computer works at all. It seems to me that what is wrong with the “mind” most of the time is faulty programming, or perhaps more accurately programming that doesn’t create the desired result from a social perspective. Of course, then we get into the question of who gets to decide what the “desired result” is, which is a whole different question. However, it is likely that those who are violent have, in most cases, grown up with and/or developed value systems in which murdering people is not wrong or is justifiable under certain circumstances. This is something that can not ever be improved by physiological intervention.
So the catch-all of “mental illness” does not necessarily imply any kind of problem in physiology, even if you take a strict materialist point of view, any more than a computer malfunction has to be a function of the hardware. The vast majority of computer problems are programming issues, and the same analogy almost certainly holds true for “mental illnesses” as identified by the committee-driven DSM.
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Wow, impressive post!
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The shrink was shouted down and ended up leaving embarrassed and silenced.
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Actually, even allowing the discussion of whether antipsychiatry and Scientology are the same or not still gives in to the tactic. When we were at the APA protest in Philadelphia, a psychiatrist said she’d talk with us, but wanted to know if we were Scientologists. We shouted her down, saying, “Oh, no, you’re not pulling that crap! We’re here to talk about psychiatry, not religion!” And various statements of that order. The topic of Scientology vs. antipsychiatry was never breached, because she understood we were not willing to play that game with her.
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Not to mention that calling most people “normal” is a disturbing concept.
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Oh, I thought you were going with, “We’re not the Judean People’s Front! We’re the People’s Front of Judea! Our greatest enemies are the Judean People’s Front.” “Well, except for the Romans…”
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Perhaps I should have said, “Does not need to be JUSTIFIED.” You are quite right, it often needs and benefits from thorough and rational explanation.
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Psychiatry claims to be helping with “mental health problems.” We are seeing a VAST increase in the use of psychiatric “treatments” (especially drugs), and yet we’re seeing a steady worsening of the “mental health problems” that these “treatments” are supposed to solve. Isn’t it psychiatry’s job to address these “worsening conditions of society” through their helpful interventions? Doesn’t seem to be working too well, does it?
And this trend is seen to happen again and again in countries where drugs and the “treatments” are introduced – more and more people on disability and unable to participate in normal social interactions and expectations. What exactly is psychiatry claiming to be doing about these societal problems? It seems at best to be drugging the brains and bodies of those harmed by these societal woes, and at the same time denying (through their claims of physical causality) that there is any connection whatsoever between the suffering experienced and the social issues that you have identified. In all likelihood, psychiatry as practiced is not helping, but in fact making those conditions worse by providing a handy way to blame and silence the victims of our post-industrial society’s insanities and adding to that insanity by its stigmatizing labels and “treatments” for “disorders” that are voted into existence by committees.
If mental health problems are caused or exacerbated by social conditions, what exactly does psychiatry propose to do about them, Stevie? Maybe start by discontinuing the blaming of people’s “malfunctioning brains” for their suffering?
Of course, the bitter irony of you blaming psychiatrists’ high suicide rates on social conditions while the profession blames their clients’ genetics is not lost on anyone reading your comment.
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It comes from a fear of how others who don’t understand may characterize you. Depending what position one is in, it might make sense not to advertise it. But I don’t think it’s something one needs to defend or explain. It’s the psychiatrists who need to do the explaining. But they are way too often let off the hook by people buying into these rhetorical tactics.
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I like it! Definitely makes the point and takes the focus off of you and puts it back on the attacker’s distracting strategy. Plus it’s kinda funny!
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I call it the Ad Homenem Attack, based on ancient Greek definitions of rhetorical techniques. The Greeks recognized that attacking the character of the person involved through generalization or implication is a tactic relied on when someone is lacking a logical argument. Ad Hominem means an attack “on the person” rather than on the subject or the argument or the data.
My usual retort to such an effort is, “Why are you talking about religion/philosophy/(whatever they’re using to distract) when I was talking about scientific facts? Is it possible that you don’t really have a counter argument and are resorting instead to trying to attack my character due to the weakness of your argument?” This immediately shifts the discussion back to the topic at hand and identifies the tactic to the listener. If the person continues the attack, it’s easy to say, “Well, I guess we know who has data to back up their argument and who doesn’t. Come back when you have some actual science to share with the audience.”
The biggest mistake people make is trying to prove they are NOT “antipsychiatry” or “a Scientologist” or whatever. As soon as you take that bait, they have won, because now the topic is your credibility instead of the data you’ve presented.
That’s my take on it, anyway. I know not everyone agrees with this.
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Surprised they didn’t take her license away, what with her actually helping people get better and all.
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I would submit that lobotomy would be evil no matter what “disorder” has been legitimately identified.
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Not only because of, but in support of the demonization of Scientologists, antipsychiatrists, or anybody who threatens their control of the market. The idea that people who oppose psychiatry are anti-scientific, biased and/or irrational is a PRODUCT that has been SOLD by the psychiatric industry in order to deflect criticism. Robert is quite clear about this in Anatomy, where he outlines how the psych profession collaborated with Time Magazine to do a cover hit piece that established and connected any resistance to psychiatric hegemony to irrationality and self-serving bias. To suggest he doesn’t understand this suggests that perhaps a person might need to reread Anatomy again, because they’re forgetting what RW has said about this very subject.
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Scientific theories are not based on “popularity,” or should not be. The general exception to psychiatry is not that one of its theories got shot down, but that the entire edifice is based on false scientific premises, namely that one can group behaviors together and define “illnesses” based on checklists of behavioral characteristics, all of which might exist in people who might have little to nothing in common except for certain aspects of their external presentation. There are actually diagnoses where people could literally have NO criteria in common and still both have the same “diagnosis.” Additionally, psychiatrists have been chronically resistant to actual data that contradicts their theories. The “chemical imbalance” theory was essentially disproven in the late 80s, and yet continues to be perpetuated to this day by many claiming “scientific basis” for these DSM “disorders.”
I would not have an objection to an honest science of the brain, as long as it adhered to basic scientific processes and assumptions and admitted to error when conflicting data shot down a theory. Oh, but there already is such a science – it’s called neurology!
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That is exactly what I meant.
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Sometimes “therapy” is a session of advice on how to “accept” your fate as a permanent psychiatric patient and psych drug user.
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I agree with that observation.
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That is FASCINATING!!! Everyone interested in REAL science should have a look at this.
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Posting as moderator:
Hi, Kitty,
I just want you to know that now ALL comments are held for moderation, so yours was not singled out as such, it just joined the moderation queue like every other comment.
— Steve
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Of course, I agree with you completely.
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Would you deny that such “inability to down regulate” is a very common and pernicious result of early childhood abuse and/or neglect?
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It sounds like you are defining “mental illness” as any condition that results in people behaving in dangerous or destructive ways. Do you really see these behaviors as “illnesses” in the medical sense? Do you believe that something is physiologically wrong with someone who does these things, and that this explains fully why they do so? Or are you simply stating that these people may meet the “criteria for mental illness” as defined by the DSM, which we all know is something decided on in committees and voted on by the APA, rather than detected by any legitimate test of “health” or “illness?”
If it is the latter, then claims that all shooters are “mentally ill” is pretty meaningless, as it seems to be defined simply as behavior that a society disapproves of.
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I agree, and that was actually my point. It’s not “fragile” to need and want safety and agency in one’s life. It’s a normal part of being human. What is abnormal and unfortunate is when humans intentionally take away other humans’ safety and agency in order to profit or dominate others. We should, indeed, be focused on stopping abusers instead of accusing their victims of “fragility.”
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You don’t have to be “fragile” to be devastated by childhood sexual abuse or rape or systematic bullying or neglect/abandonment by one’s parents, etc.
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I agree with this thinking 100%. The primary error in the DSM is the assumption that all depressed people are the same, all anxious people are the same, all hallucinating people are the same… these assumptions are absolutely not true, and there is no reason to suspect they would be. Some people who are depressed love meditation! Others find it completely useless or damaging. Same with CBT, regressive therapies, micronutrients, etc. Every person’s needs are different, and what will help is different, too. There is nothing to suggest that all depressed people will be helped by the same approach.
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That’s an awesome idea! Those most “insulted” by the thought would clearly be the ones most in need of monitoring.
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I know it’s not the article’s point, but I have to remind us that RECEIVING medical care is the third leading cause of death in the USA. More reason to separate helping people with psychic or spiritual damage from the medical profession.
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[Moved at request of Oldhead]
“Psychiatry did NOT help me fit in at all.”
Then they go to plan B, which is simply to keep you out of sight.
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Hey, if there’s a six figure antipsychiatry job, I’m getting my resume in first!
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I love it, really!
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“Work” depends a lot on what you’re trying to accomplish. If you’re going for inertia and apathy, “antipsychotics” work just great!
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There aren’t too many antipsychiatry advocates who are making six-figure salaries off of promoting corporate propaganda.
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Thanks!
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When you threaten someone if they don’t “voluntarily” do what you want, the concept of “voluntary” has been completely and permanently negated.
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I am still “agnostic” but find this concept totally feasible. It is the assumption that the “mind” or the “spirit” is a known quantity and is generated and controlled by the brain on which the entire edifice of psychiatry is based. Admitting that the mind is a mystery destroys their entire philosophical structure.
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“Working well” is the key phrase here. The vast majority of conventional systems do not “work well” for the majority of those exposed to them. The WHO cross-cultural studies bear this out. A person who hears voices is far better off (in terms of effective help) living in Brazil or Nigeria than in the USA or Great Britain.
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They are both important. You focus on getting good sleep, eating well, working with supportive providers to address any possible physiological problems. But you make sure that they have a real way to TEST for these problems, rather than just telling you that you “have a disorder” because you meet some biological checklist of criteria voted on in some meeting at the APA convention. AND you focus on environmental factors, managing stress, deciding on healthy vs. unhealthy relationships, creating the kind of life you want, staying away from destructive people, etc. AND you focus on social things – connecting with other people, making sure you are engaged in productive activity that has meaning for you, etc. They are all important. The problem with the DSM is that it ASSUMES biological cause without testing it out, and at the same time minimizes the impact of the psychological, social and spiritual issues that create most of the “mental health” issues that are “diagnosed.” I say this as a person who used to be VERY anxious much of the time, who had frequent thoughts of suicide when under stress, who was tremendously shy and isolated as a child with really limited social skills. But now I’m very easy to talk with, have excellent social skills in most situations, am willing to engage with total strangers, have learned how to have difficult conversations with hostile people – LOTS of things that I could never do before. Do I get anxious sometimes? Sure. Depressed? Absolutely. But I know what to do about it now, and I don’t get stuck there.
I managed all of this with no “treatment” except for 15 months of weekly therapy in my 20s. The rest I learned by reading and sharing with others and by challenging myself to do things I was scared of through my employment and my drive to improve myself. I have learned that lack of sleep leads me to being more depressed and anxious. That’s biological. But I don’t need a drug, I need SLEEP! And when I get it, I find it easier to deal with stress. It doesn’t cure it, but it makes it easier.
So I do believe it’s all of the above, but I don’t believe, based on research and observation and stories from others, that the psychiatrists have the slightest idea what might be “biologically” wrong with someone who is anxious or depressed or whatever, if anything. Their claims about ‘chemical imbalances’ are outright lies, and some (like Ron Pies) admit that this is the case. Yet they still try to tell you it’s all because of your “bad brain.” I see the system as being corrupt and misleading and very destructive. Each of us has to come up with our own approach that works for us. Any therapy or other help should be focused on helping YOU find YOUR path rather than telling you what they think is wrong with you and providing false explanations in order to sell drugs.
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I have no problem with that framing. The problem is that the DSM categories have nothing to do with biology – literally NOTHING AT ALL to do with biology. If you have a thyroid problem, or anemia, or syphilis, you’d better get medical treatment! But that has zero correlation with any DSM category – they are real medical problems that are treatable, unlike the DSM labels. Other issues like food, sleep, exercise, physical pain, all can contribute to feeling bad or being confused or whatever. Those are biological. “Depression” is not biological, “Anxiety disorders” are not biological. They are catchall phrases made up for lazy clinicians who don’t want to bother to actually figure out what’s going on.
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Wow, that’s a pretty big change!
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I have done this, actually. Just heard back from the guy today. He’s doing a lot, a lot better than when I started, but it’s taken years. He was in and out of “hospitalization” and on lots of drugs, now has worked for a year plus in construction, is studying, is able to communicate effectively with others, not using, has made amends to a number of people he’s hurt… still on a very low dose of “antipsychotics” to stave off withdrawal, but tapering gradually. I had no professional relationships with this guy. He was a friend of my oldest son, but everyone had disconnected from him and I was the only one who believed in him.
So yeah, it happened.
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Still don’t really see the similarity.
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I’m not sure I see the similarities you mention. As I understand it, Scientology is based on the idea that we are spiritual beings being held back by physical and emotional pain, and that the answer is reexperiencing this pain to release it. It seemed very individualistic as I have read about it. That’s my understanding, correct me if I’m wrong about that. I’m unaware of any kind of family approach, and there was no talk about “different internal voices” or a lot of talk about “different parts” of people and so on as Schwartz seems to go on about. I don’t really see what is so similar about them. Do you have any specifics?
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I agree completely. As long as the mind remains a mystery, trying to figure out how to “treat” the mind is a total waste of time.
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Bitterly ironic.
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Yeah, I know – rhetorical question, in the end. We know why.
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Wow, that is kind of bizarre! They acknowledge it’s unsafe for “normal” people, but somehow it’s not unsafe for someone with a metaphorical “illness of the brain?” Got to be a way to make some hay out of that admission!
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I so admire what you are doing. I have been there and I know how difficult it is to work “behind enemy lines” like that. Keep up your great work!
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I think you hit the key point – people can label themselves whatever they want, and more power to them. But when credentialed doctors who have the trust of their patients and the general public start promoting “theories” they know to be wrong or speculative as if they are certain and settled science, they are being extremely unethical. And when their clients are concretely harmed by such deception, they have moved from unethical to criminal behavior.
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There would be a lot more money available if we saved it by not enforcing ineffective or destructive “treatments” on people who don’t need or want them.
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Posted for Oldhead:
Be assured that Kindred “caught on” long before you even thought of this article.
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Forced mindfulness is an oxymoron. By definition, mindfulness has to be voluntary – it is a choice that one makes to be aware of one’s presence and relationship to the world. Anyone who tries to force it without full agreement is being abusive.
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OK, in order to honestly prescribe benzodiazepines for anxiety caused by chemical imbalances in the brain, would you not have to be able to establish a) what a proper “chemical balance” is, and b) how to measure deviations from that normal expectation? Would you not also be required to show that anxiety is CAUSED by such an “imbalance” rather than the “imbalance” being a natural occurrence when someone feels anxious? And if neither of these criteria are met, how could anyone be considered to be practicing medicine when they prescribe a drug based only on behavior and emotion rather than any actual measurement of normalcy/deviation?
I know that you’ve been told by many sources that “chemical imbalances” are real and that drugs “treat” them. But were you aware that mainstream psychiatrists like Ronald Pies, a great champion of the current model of “treatment,” have said that the chemical imbalance theory is false, that it is, to quote Pies, “an urban myth” that no respectable psychiatrist takes seriously? That the idea of a “chemical imbalance” was actually debunked as far back as the 1980s?
You have been lied to, XxXxXx. I’m sorry to have to say it, but it’s true. There is no evidence of a chemical imbalance even being measurable, let alone “treatable”. Benzos make people relax and not worry about things. It is the same effect on anyone. It’s a crude effect that certainly does nothing to “balance” anything, but actually pushes the brain very far past its equilibrium. This can feel good at times, but it also causes dependence and addiction. Long term use actually does damage to the brain, including damaging cognitive functioning. All of this is commonly known from psychiatry’s own mainstream researchers.
The idea of “treating” chemical imbalances is 90% drug company propaganda, supported by mainstream psychiatry from day one. There is zero scientific truth to it. Even Ronald Pies says so.
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But they don’t do that, do they?
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“All natural, hormone free, cruelty free, no GMO, gluten free, dairy free mental illnesses! Only at Whole Foods!”
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So how would anyone know if someone has an “organic problem” with their brain? Can you name any one of the DSM “Diagnoses” that can be detected objectively as an organic problem?
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True enough!
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As if there is a “right” way to respond to a traumatic event or a traumatic life!
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And then they try to put you on a diet, without even admitting that the drugs are causing the problem.
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How about “common and well documented but systematically denied?”
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It is ironic that they give a drug that makes a person sedentary and lethargic, and then recommend getting more exercise. Maybe the exercise should be tried instead of the drug in the first place?
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I certainly think the terms “involuntary” and “treatment” don’t belong in the same phrase. If it’s forced, it sure isn’t “treatment.”
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And save themselves some money, too!
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Maybe there aren’t so many smart people in the world after all.
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The connection between misogyny and mass shootings is just beginning to be recognized for what it is. But it doesn’t make good copy or help either party politically, so it’s not out there where people can read about it.
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So how would you define a “mental illness,” Milan? How would you distinguish it from “normal suffering?” That’s the part I really struggle with. Plus, if your distress is caused by abuse and oppression around you, is it an “illness” to be upset about it? Seems like a pretty strained concept, even though you’re right, there is lots and lots of agreement about it.
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Insult to injury!
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Kinda says it all, doesn’t it?
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But how would we decide who is better or worse than us? How could we survive without a hierarchy of “goodness” so we’ll know that even though we suck we’re not as bad as THAT guy over there?
The need to establish dominance hierarchies seems to be central to Western culture.
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It is fair to say that not everyone bothers to take the time to read a document before criticizing it. Thanks for this clarification!
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I don’t disagree with this at all, in fact, I’ve said the same many times. We’re living in the resurrection of Calvinism – your financial success proves that God is with you. This, however, doesn’t mean that we can’t help each other to deal with the consequences of these destructive postulates, whether in formal or informal ways. Naturally, the psychiatric/psychological industry is an industry and is driven by profits, and that’s the real problem we’re all dealing with.
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The USA exists only as a result of violence and oppression, a fact which colors every aspect of our society. We are not alone in this, of course, but the particular history of the USA, from the treatment of the native population to the use of slave labor to create wealth to the continued second-class citizenship of certain populations in the USA continues to place violent conquest and subjugation at the center of our politics. And of course, the entire business model of Western society is based on conquest and the implied violence of starvation and hopeless poverty for those who fail to comply with “the rules,” and even for many who do.
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Wow!
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e) They are ultimately corrupt and will “treat” their patients based on their own profitability rather than what is actually helpful to the client/patient.
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You know, I had not even thought of that until you just said it. I assumed that he realized he was busted and had no hope of preserving his self-absorbed and abusive lifestyle and therefore decided that death was better than living such an ignominious life. But it is quite possible this process was initiated or exacerbated by antidepressant drugs.
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I would agree that the conclusions from this study are very limited, but there doesn’t seem to be any evidence that hospitalizations the way we do them is decreasing the suicide rate. Again, it is the responsibility of those advocating for more hospitalizations to prove that they DO reduce suicidality, not the responsibility of those opposed to prove it does not. There is no evidence here that a reduction is taking place, therefore, the scientific conclusion must be that to date, we can’t say that hospitialization is an appropriate action to prevent suicide, at least as it is done. This doesn’t mean that certain individuals might not choose not to commit suicide if they are kept alive a while longer, but there is no data to suggest that the “treatment” is anything more than simply preventing a person from acting upon impulse and giving them time to consider their decision in a new light.
What I am uncomfortable with is starting from the assumption that hospitalization DOES reduce suicidal behavior and forcing someone to prove that hypothesis wrong. We should assume that it DOES NOT until those in favor of it prove otherwise, just as a drug has to be proven effective against placebo or it is assumed that it is not effective.
Hope that is clearer.
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Very well said!!!
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There is a very distinct difference between not accepting psychotherapy IN GENERAL, and I actually agree with you on this point, and invalidating the personal experience of someone whose experience in something that happened to be called “psychotherapy” who describes specific ways in which it helped that person accomplish the very things you claim to value, including feeling one’s unwanted feelings and taking political action. The first is an opinion, the second is disrespectful to someone else’s experience. The first is allowable, the second is not.
ise, you are contradicting your own premises.
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This is not about you “going along” with anything or about me “feeling better.” It’s about your chronic attempts to make gross generalizations and being disrespectful about others’ experiences. Coming back with, “Well, it sounds like your therapy experience worked well for you, but it is not consistent with my experience” might work. Suggesting that I am wrong in my assessment of my own therapy experience is a totally different act, and borders on abusive on your part. There is absolutely no inconsistency with receiving therapy and being willing to fight psychiatry, as my case and the cases of many other people on this site can attest. Your inability/unwillingness to accept that anyone else’s experience might not comport with your predigested views massively undermines your credibility. It seems impossible to have an exchange with you, as you appear to be preaching to your own choir and deleting any notes that don’t fit with your song. At a certain point, it moves beyond expressing your opinion and into the realm of suppressing others’ experiences, which is something I’d think you of all people would be against. You don’t want to be one of those that you’re fighting against, do you?
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I can testify as an advocate for foster kids for 20 years that the system often does more harm than good. There are most definitely some situations that turn out much better for the kids or the families, but there are just as many where the kids continue to be abused, neglected, or forgotten, including being abused by the “mental health” system during their time in care. Most of our advocacy was done to prevent further harm by the system itself. And statistics most definitely show bias against black people, Native Americans, Latinx people and poor people, all across the country. Child abuse is awful, but foster care is not a great answer, either. We need to look at other ways to deal with the problem.
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It certainly suggests to me that at the minimum, psych hospitalization doesn’t appear to reduce suicidal acts. And from a scientific viewpoint, it’s the responsibility of the “treaters” to prove their treatment works. Saying they are worse to start with and that’s why so many kill themselves afterwards suggests that “Treatment” has had no positive effect.
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So help me understand how someone learns to face what happened to them as Alice assures us we must do? It’s easy to say that, but as Alice would explain, our defensive symptoms make it very difficult for us to face our pain and instead we tend to pass it on to the next generation. So how does one get through this defensive system so one can feel these undesired feelings?
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Yes, but… is still an invalidation of my very real personal experience. What you need to be acknowledging, from my viewpoint, is your insensitivity toward my own experience. Repeating your philosophical mantra doesn’t really do the job here.
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Very well said, Alex!!!
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The unscrupulous and the foolish are incapable of exercising “common sense.” Let’s be honest, if it were all that common, more of us would have it.
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Again, it’s clear you argue from your own personally limited viewpoint and nothing anyone says will sway you from it. You tend to repeat the same statements over and over, but they are full of assumptions, such as the assumption that therapy itself must lead to legal redress, or that therapists are going out of their way to force people to adjust to their circumstances instead of fighting back, which is, of course, only your own assumption and in my case is directly contradicted by the facts I’ve presented.
You’re also invalidating my assertion that taking on my own parents and reclaiming my power is plenty of redress for me, as it freed me to follow my own path instead of spending all my time worrying about what they think or do. If that is not a positive outcome, I’m not sure what if anything would ever qualify. Perhaps you’d have been satisfied if I’d sued my parents for being insensitive and overwhelmed and not being able to do what they needed to for us kids?
And you yourself admit that some “stuff” IS between your ears, in the sense that “feeling your feelings” per Alice Miller is an essential part of becoming a whole person, at least if you really believe what Alice was saying. I would think you would support whatever efforts did that for a person, regardless of what it’s called. But you don’t seem to do that. You want to tell everyone else what to think and believe, even when the person him/herself tells you that your beliefs are incorrect in their case. This kind of invalidation doesn’t help anyone, and in fact reminds me of the very failings of the “mental health” system you and I both so vehemently disapprove of. You would be a lot more credible with me, and I think with a lot of people, if you stopped telling me/others what they should believe and started listening a little more and trying to incorporate what you hear from me and others into your philosophy, instead of just ignoring or arguing with me down when I don’t agree 100% with your preconceived philosophical notions.
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Again, agreed 100%. Cultivating that gut level feeling is something I talk about in my book as the ultimate tool for detecting abusive people, but our society teaches us from early on how to mute that “little voice” and talk ourselves out of believing what we have legitimately observed. A big part of healing on the spiritual level, to me, comes down to learning to listen to those intuitive messages and to take the time to figure out what they’re really about. It’s not always clear exactly why we get those messages, but they are there to be respected and listened to!
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AMEN!!!
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I agree. Most psychologists and counselors are 4 square with the DSM model and believe most of the mythology about “biological brain diseases.” Some psychologists in some states have even fought for prescribing rights! The therapists/counselors I’m talking about are generally mavericks who aren’t interested in playing along with any system, but are committed to meeting people where they’re at and being present with them to help them figure out their own solutions. I’m not in agreement with any kind of authoritarian approach to counseling, where the counselor somehow “knows more” or tells the client what to think, feel, or do. The only good counselors are the one that help increase the power and capabilities of their clients so that they are able to follow their own paths, not a path the counselor wants them to follow.
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I don’t disagree. That’s one of the big reasons I moved out of that realm into advocacy. Even the “good ones” are embedded in a system which rewards compliance and challenges any attempt to improve services or humanize clients. At a certain point, it starts to feel like you’re “sleeping with the enemy” and supporting a system that is generally much more damaging than helpful, and not by accident. My personal ethics would not allow me to continue to collaborate with the system.
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It appears to me that you are unable to accept data from my personal experience that contradicts your philosophical premises. It should be easy enough for you to simply acknowledge that I had this experience and that my therapist, at least, did not have the intention of preventing me from becoming active in asserting my rights or was encouraging me in any way to “adjust” to my environment. Why is this so difficult for you to accept? What would be wrong with recognizing that not all therapists are the same? And that some do, in fact, encourage their clients to stand up against those who are mistreating them, whether in the past or the present or the future, even if the majority do not do this? Is maintaining your philosophical purity more important than respecting the actual data you get from people who actually use this kind of service? Maybe you would do well to stop telling everyone what to think and instead listen to people’s experiences? Maybe you could learn something from listening to survivors yourself?
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I most definitely agree with you on this point. Most therapists have been coopted by the psychiatric industry and the DSM.
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I don’t at all disagree. Most therapists are either ineffective or dangerous. There are a small minority that can be very helpful, but most people either lack access to such people or don’t realize what they are really looking for. Just signing up for a therapist is a dangerous act, because the power imbalance is so profound and so few professionals are able to recognize this problem and address it.
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They have stopped talking about “endogenous” vs. “exogenous” depression, first off because there is no way to actually tell the difference, and secondly, because if they really looked at this question, it would be clear that the vast majority of their client base has very good reasons for being depressed, which would eliminate their justification for drugging anyone they encounter with these “symptoms,” regardless of the reason they might occur.
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Not necessarily. There is no requirement that a therapist listen from a point of view of superiority or of instructing the client on what is going on or what to do. Certainly the majority of therapists these days DO operate in that way, partly because they’re now trained to look down on their clients, partly because they haven’t done their own work on their own issues.
But a truly good therapist would, in my view, listen only from the point of an outside observer of their client’s narrative of their own life and experiences. Their job is to ask questions to help the client make up their own minds about what is causing their distress and what THEY want to do about it. The therapist’s job is not to tell the client what to think, in fact, my own therapist years ago pretty much refused to EVER tell me what she thought even if I asked her to. She did share some things from her own life to help me understand that she was NOT coming from a superior point of view, but had been through similar pain and frustration herself. But she never, ever told me what to do or think. She simply helped me unwind my own story and realize some important things regarding “feeling my feelings,” which you correctly point out is so essential to moving beyond the abusive/neglectful/oppressive environments that most kids grow up in. She empowered me by listening without judging, asking pointed questions about what I said, and supporting me in feeling my feelings and acting on the logical consequences of those feelings. It was my parents who viewed my viewpoints as invalid. She never did, and in fact, strengthened my confidence that my own views were, in fact, valid, in contradiction to what I’d come to believe from listening to and being worried about my parents’ and siblings’ views of what I should/should not be or think or do.
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Because not all therapists are the same, and saying they are is inherently insulting to people who either provided or received care that conflicts with your generalized assessment.
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I always felt it important to be transparent when I was playing the role of counselor/social worker. The more real and human I was, the easier it was for the person I was helping to be open to communicating with me about how they want to change their lives.
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It is not a majority that go on psych drugs, but it is WAY more than the average for non-foster kids. Over half of teens in foster care are on psych drugs. Usually around 20% of all foster youth are on psych drugs, including even 1-2% of infants! Interestingly, though, kids placed in relative foster care have only slightly higher drug use rates than the general public, whereas non-family foster placements have 3-5 times higher rates of psych drug use.
Foster kids are most definitely at higher risk of being diagnosed and drugged than the average kid.
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Well, I still think you’re making generalizations that aren’t true for every therapy relationship. My therapist didn’t specifically suggest that I do anything or not do anything in particular, because she saw her role as helping me process those unconscious feelings you and Alice Miller talk about, and then to decide FOR MYSELF what I should do about it. It certainly did involve confronting family members about how I had been treated, and seeing roles that other family members had been thrust into and helping protect them against the (mostly unconscious) tyranny of my mom and my brothers. There was also a raising of social consciousness regarding the plight of others who had experienced similar family dynamics and were suffering. This led me eventually into social work, and then when I observed what social work systems were doing to people, into advocacy. She most definitely helped me move from being angry at myself to being angry about social injustice, not because she told me to feel that way, but because she helped me find and connect with my own sense of righteous indignation. And as I said before, without this experience, I would never have gotten to advocacy as a career and life path.
So my therapist did not fit your model of “teach you to adjust to injustice” or “accept your lot in life.” It was much more about, “If you have an issue, what are you going to DO about it?” Which certainly fits into your framework of encouraging people to take action against their oppressors.
Now this was in the 80s, and I fully acknowledge that such therapists have become more and more rare as the DSM has taken hold. But to pretend that there is some generalized agreement among therapists that their job is to prevent people from holding their oppressors accountable is to me simplistic and not supported by the fact. Therapists are not lawyers, nor are lawyers therapists, but there’s nothing to prevent a therapist from making referrals to lawyers for class action suits and the like, and I certainly have done that with many a person in my social worker days.
As a wise man once said, “Generalizations are always wrong.”
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I am saying that it depends very much on who the psychotherapist is and what they’re about. I would say that it is true that most therapists these days are fully indoctrinated into the DSM system and see people’s problems as “mental illnesses.” But as Bonnie points out, there are therapists who take a very different view of what therapy is or should be, and there are many people, including myself, who have had very positive therapy experiences themselves. I can pretty much guarantee you that I would not have become an antipsychiatry activist and advocate for stopping the mass drugging of kids in our society (and adults, of course, but kids were my specialty) without having gone through that experience myself. You have talked about Alice Miller and the need for people to get in touch with, feel, and validate their own experiences in order not to perpetuate the same offenses on the next generation. I agree totally with Alice, and I would also submit that most therapists haven’t done this work and are either useless or dangerous. But not all.
So my objection is not to making generalizations about the practice of therapy as a profession, but to generalizing that all THERAPISTS have the objective of removing someone’s honor and having them accept themselves as inferior beings. That was not at all my experience, and others report finding therapists who have helped them gain new and helpful perspectives on how to live their lives without worrying about how “the system” or “the middle class” would judge them. I think this is very valuable when it happens, even if it is rare, and I don’t want folks who have had that kind of experience or who have provided that kind of experience to be invalidated by sweeping generalizations about what “all therapists” are intending to do.
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I would agree that psychiatry is an organized system with a specific purpose and a political apparatus to support it, including mass funding through the drug companies, and it is much easier to make accurate generalizations about psychiatry. I would still maintain that saying that “all psychiatrists” are the same is inaccurate, but in the case of psychiatry, the defectors from the status quo are much fewer and much more exposed to blackballing and other punishment from the powers that be.
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Posting as moderator: It is important not to make generalizations about large groups of individuals, even based on profession. I’m not going to publish any more comments that make negative generalizations about therapists.
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That is what I have always suspected. SSRIs appear to create a sense of not caring what others think about your behavior. This might be seen as a good thing of someone is spending a lot of time worrying that others don’t think they are good enough. Being able to say, “Screw mom, I’m gonna do what I want to do,” might feel really good to some people. But what if someone is being prevented from doing something violent because s/he is concerned about the consequences, that they might be shamed or put in jail? In that case, removing empathy or concern for the views of others may be deadly!
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Well said, Bonnie!
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Denial is not “trauma informed.”
This is more proof that anyone can take any concept and turn it into a means of oppression. The attitude is what has to change, and calling one’s oppressive attitude “trauma informed” is just another way of coopting the drive to expose abuse of power for what it is and turning it into a way to protect the perpetrators.
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The problem is that the concepts being introduced don’t actually make sense, while the cultural practices do. “We don’t need pills for fear” sums it up completely.
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This is kind of sad to me. Talking about the person’s neighborhood they grew up in or other aspects of their culture should be standard practice for anyone who actually wants someone to feel safe talking to them. Sharing about one’s own background is also helps build trust. If psychiatrists understood that building trust is the beginning of doing anything remotely helpful, this would not be a necessary exercise.
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We might also add “Have a higher likelihood of being viewed as dangerous by system personnel when engaged in the exact same behavior as their paler-skinned counterparts.”
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Wow! Pot/kettle?
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I wish I had one! Big social changes take time, and also usually money. I think maybe we have to start with getting money out of politics so our representatives are representing us rather than big corporations. But that in itself is a huge task, and probably starts with political organizing at a local level and commitment for years to making changes. It is a daunting task!
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It is hard to accept. I think that’s why so many people get so upset when this kind of information is brought up. It undermines confidence in the people we’re supposed to be able to trust.
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I would submit that we don’t KNOW anything that we haven’t personally examined and found to be true based on our own standards. You don’t “know” something just because someone else told it to you. All you know is that this is what you were told. The lack of intellectual curiosity and rigor amongst people who claim to be representing scientific or technological advances is disheartening, though no longer even slightly surprising.
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Sandra,
As a psychiatrist whom I respect greatly, I’d be very pleased to hear whether you have seen psychiatrists or the APA promoting the “chemical imbalance” or “brain disorder” hypothesis. It’s hard for me to imagine you have not heard this being put out there all the time, as I ran into it frequently just in the foster care system. What’s your experience?
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Ha! You had me going there. The sad part is that it doesn’t need to be satire – it is completely believable!
— Steve
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Yup, “sit down and shut up” is the message. The real diagnosis should be given to the adults: “Impatience with Normal Childhood Behavior Disorder.”
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You are assuming they actually want to cure their patients.
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Silly woman – you’re trying to get them to use LOGIC again! You KNOW how that upsets them…
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Did they fall back on what they actually knew, or what they had been trained to believe?
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So either they are not psychiatrists, or the entire psychiatric profession in New Zealand has to be regarded as “not serious” by Pies and his ilk. Of course, there is also the possibility that they are lying for the purpose of increasing their “market share,” but no, that COULDN’T be true! Psychiatrists would NEVER be corrupted!
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Even if psychiatrists did not promote the “chemical imbalance hypothesis” (which of course we all know they did and continue to do), they certainly said and did NOTHING to correct any “misimpressions” created by the Pharmaceutical Industry or whoever else made them look like they believed in it. Failing to take action to correct false information is pretty close to promoting it, in my view.
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Too many people making too much money and getting too much professional status with the current system to allow for something more effective to elbow its way in.
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How about if they are informed of the multiple long-term studies showing that stimulants do not improve ANY long-term outcomes for “medicated” vs. “unmedicated” students, including academic test scores, high school graduation, college enrollment, grades passed, delinquency rates, teen pregnancy rates, social skills, or even self-esteem ratings? Why is this rarely if ever mentioned in critiques of stimulant drugs for “ADHD”-diagnosed children? If long-term outcomes are not improved (or in some studies, made worse), what is the purpose of drugging these kids, even if one accepts the concept that “ADHD” exists as a disease state (which I do not)?
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The dogmatic proponents of each viewpoint have intentionally created this dichotomy, so that it sounds as if there is a choice between doing what they believe in or doing nothing or something stupid. It isn’t a real dichotomy, but a lot of people have a hard time with uncertainty.
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I have also worked with foster youth, and found that the “trauma brain” trainings, rather than increasing empathy as they ought to, for some people provide yet another way to say that “his brain is broken because he’s traumatized” and use it to justify more drugging and diagnosing. What is needed for traumatized people (which is pretty much all of us!) is empathy and kindness and honesty and human vulnerability. It doesn’t matter how many trainings are done – we need to impact the ethics of the people involved such that they start thinking about how they might accidentally be harming someone rather than assuming that everything they do is magically helpful.
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Very well said, KS!
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How odd! Who would have guessed?
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And there is actually no evidence that any psychiatric drug will stop a person from being violent.
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The problem with mindfulness is that it has been abstracted from its spiritual roots in Buddhism and is now being used as a gimmick to deal with anxiety. Which it does help with, but it seems a shame (but typical) to remove the spiritual focus that provides a context for why one might meditate and what one might get out of such a practice over time. It should not be a means to escape the rigors of capitalism. It is a lot bigger than that.
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I would say more that psychiatry as a profession tends to attract more arrogant people on the average, because people who are more humble will be turned off by the apparent hubris in the authoritarian approach promoted by most all psychiatric training schools.
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That is very well said. Unless someone has an identifiable neurological disease that one can accurately test for, whatever people do is “neurotypical.” Genetic diversity is the key to species survival. We need all different kinds of people, and the sooner we learn to value what gifts everyone brings to the table, the healthier we’ll be as a society. But I’m not holding my breath on that one…
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I love this post!
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I respectfully disagree, based on personal experience. You appear to be committed dogmatically to a viewpoint that is not supported by the reported experiences of many people. I agree that the run-of-the-mill therapist is likely to be supportive of the status quo, and that there are certainly a significant number who are married to diagnoses or other client-blaming theories, and that such “help” is not very helpful. However, to say that all psychotherapy has the client yielding as the goal, or the client putting all problems in the past, is simply not true, no matter how many times that idea is repeated. It feels very disrespectful both to people who have found counseling/therapy beneficial and to those therapists (admittedly a minority these days) who work very hard at helping the client meet his/her own goals in an empowering way.
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Sadly, there are no consequences for this kind of dishonest “research”.
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Have you done a study to prove that? Can you prove that hitting a person on the head with a 2×4 decreases their cognitive functioning? We need more studies!
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Well said!
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I don’t think that everyone knows what is good for themselves, not by a long shot. What I do believe is that everyone has a right to make his/her own decisions, and the job of a helper is to assist that person in gaining sufficient perspective to see the options available and the likely consequences of whatever decision they make. Forcing someone to do something “for their own good” is so fraught with problems that it is far better to decide never to force someone to do anything at all in the name of helping. Sometimes we do need to use force to keep them from hurting someone else, but at that point, we’re helping the potential victim, not the person we’re using force on.
It is very painful to watch someone doing things you know will lead to pain, but everyone has to learn in their own way. We can provide information, show love, set boundaries, share perspectives, but in the end, each person is responsible for charting their own course in life, even if we don’t like the results.
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I would say that DIAGNOSIS is based on that principle. As I’ve said before, generalizations about psychotherapy are really not possible to make, as there are all kinds of services offered as “therapy.”
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“We do need a model to help clinicians and service users understand why their emotions and behaviors are maladaptive for them.”
I would respectfully disagree with this statement, as a former counselor/therapist. I believe any “model” needs to understand why their emotions and behaviors are, or were at one time, ADAPTIVE for them, and help them decide if that behavior is still adaptive or if different options might be more effective in accomplishing their goals. Calling clients’ behavior “maladaptive”, in my experience, leads to defensiveness or self-shaming, whereas acknowledging that “all behavior meets a need” (as the saying goes) and that people aren’t acting or feeling random things, but are making decisions based on their own perception of what makes sense in their world. And of course, no one can really understand what makes sense in their world except the client him/herself. As soon as an helping person starts deciding for the person they’re helping what is and isn’t “adaptive,” they stop helping.
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In my experience, this is very much the norm – it takes an act of Congress to get a doctor to support withdrawing from psychiatric drugs, and the desire to do so is often regarded as a “symptom of the illness” rather than a rational decision based on the pros and cons of the situation. Many docs seem to believe that being “mentally ill” eliminates the ability to think and reason and make decisions.
It is true that it is getting easier to find clinicians to help someone wean, but such professionals are still the exception rather than the rule. And even when one does find someone “willing” to help them taper safely, there is an almost constant message that it’s a bad idea and will probably go wrong soon. Plus a lot of the “supporters” don’t appear to understand how to taper safely anyway. So it’s not really a very easy process, and some people can’t find anyone willing to help at all.
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Sauce for the goose, sauce for the gander. If any person or group wants to have their identifications and views respected, they would do well to return the favor to others who respectfully disagree with them.
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It depends who uses them and how. I have no problem with a person him/herself identifying as “mad” or “neurodiverse” if that is an identity they find helpful. The problem comes in when we start studying “neurodiverse” people to find out “what is different (aka wrong) with them” based on the same brain-based reasoning that the psychiatrists use. So “neurodiverse” in particular doesn’t challenge the psychiatric paradigm to recognize that THERE IS NO NORMAL in terms of “brain function” – everyone’s brain is different, and should be! After all, genetic diversity is the key to species survival. The term also tends to imply for me that one’s brain condition is fixed – I’m “neurodiverse” because I was born that way, you’re not, because you “fit in” better to our society’s expectations. Now, I understand that some people do believe that they were born particularly different, and that may even be absolutely true in their particular case. But brains change and develop over time, and everyone has their gifts and challenges biologically. I do very much appreciate the reflection that people who get diagnosed “ADHD” or “Autistic” or whatever can find positive characteristics associated within the groups that are diagnosed that way, and I often pass on or comment similarly when someone starts talking about “brain-based disabilities” and such crap. But those labels are still based on the DSM and the “adapt or you are diseased” way of thinking, and I’d rather do away with them altogether.
So again, I’m not against a particular person identifying that way as a person, I just don’t like to use these terms myself because they reinforce the biological model for me. Others are certainly very much entitled to their own views on this, and those views may be far more informed than my own. It was just that the comments on this article brought to my attention why the term bothered me, as I would guess I’m pretty “diverse” based on what is actually expected of human beings in our society, but because I chose a quiet way to rebel and to deal with the oppression I was experiencing, I am considered to be somehow a “normal” person. I don’t think such a “normal” person exists on this earth.
I hope that makes things a bit clearer.
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Interesting spin in the title. Shouldn’t it be, “Maintaining on antipsychotics diminishes cognitive functioning?” Or better yet, “Continuing administration of antipsychotics makes people duller and less intelligent?” Why frame getting off as a benefit, rather than noting correctly that getting ON does measurable damage?
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An excellent question, and very kindly put!
I do support that kind of use of the word – I have never had any problem with people advocating for “mad pride” or seeing themselves as “neurodiverse.” I think my issue is more one of assuming, for instance, that the kids who don’t act out in school and do their homework and try to keep the teachers happy are “normal” while kids who can’t manage that intense effort are “diverse.” I was one of those kids who did what he was told and tried to play the game so that I wouldn’t get in trouble. But I hated every minute of it. It was totally traumatic on a daily basis. So I was no more “neurotypical” than the kid who was being sent to the principal’s office for acting out. I was just being harmed in a different way because I did have the capability of pretending I was OK more than other kids did. I totally support anyone identifying as “neurotypical,” because I know some people have a rougher time than I have had. I just want to make sure everyone is clear that the kids (or adults) acting “normal” may be suffering in their own way from the oppressive system that we have to deal with. Just because I can “fit in” doesn’t make me “typical.” Those who “fit in” are an extremely diverse group that have little in common beyond their ability to dance to the masters’ tune well enough not to be singled out for special discrimination.
I hope that makes my view a little clearer.
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You are so right, the “helpers” seem to believe that they are automatically being helpful and are incapable of abuse and harm, and so are blind to the damage they do. People believe that taking a kid from an abusive situation and putting them into foster care makes it all better for them, but it does not. There is automatic instability and craziness inherent to the situation, not to mention unavoidable breaking of almost every social bond the child has had to date, but kids are frequently overtly abused by the system itself beyond those unavoidable challenges. Any helping agency that can’t admit it could inadvertently do ill should not be trusted for human beings.
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I just realized what it is about using the term “neurodiverse” that’s bugged me. It seems to imply that there is some monolithic mass of people with “normal” brains from whom the “neurodiverse,” well, DIVERGE. But isn’t the real truth that ALL of us are “neurodiverse,” and that it is the practice of expecting everyone to think and act the same that is causing the distress? Shouldn’t the concepts of allowing people to think and feel as they see fit apply to ALL of us, rather than just a category of people who are already judged to be “weird” by the judgmental “mainstream” of oppressive social institutions?
I’m not saying this as a criticism, just asking what folks think about it?
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Hmmm, who was out of touch with reality there? So you have to believe that being locked up against your will is NOT incarceration in order to convince them you’re sane?
Thanks for sharing your story. I’m glad you saw it for what it really was.
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And yet studies where they simply provide food and shelter and basic necessities to people living on the streets, without any requirement to do anything else (the “Housing First” concept) appear to start getting better without any further intervention. Imagine, getting enough sleep, being able to have food and shelter and to be able to wash and use the toilet safely actually helps people feel better and stay safer. What a concept!
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Your comments reflect my experience completely. There are people who are able to be helpful in more than a run of the mill way, but they are rare and a degree or license or “school of therapy” certainly does nothing to identify such people. They are human, real, caring, and allow themselves to be affected by our stories, and even share some of their own experiences when it is helpful. They make mistakes and apologize for doing so, they are properly horrified by horrific things, they are, in short, real humans who are there to help in whatever way they can. And again, they are quite rare.
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Yes, they are supposed to be the experts, which is the main problem. I have always felt I was the most helpful when I was the most humble and least expert-like, just talking one human being to another. No one is an expert in another person’s life!
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Little irks me more than when they give someone a bunch of fat-inducing “SGAs” and then put the person on a diet because they “make bad food choices.” Saw it happen all the time in the foster kids I advocated for. Then there was the kid who spent two years working through a tendency not to want to eat anything. She was eating well and doing great, then they decided she had “ADHD” and put her on stimulants. Lo and behold, she appeared to “relapse!” I was apparently the only one who saw the obvious causal factor. They were totally ready to see it as a resurgence of her “eating disorder.”
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It will continue as long as the financial incentives pay off for labeling, drugging and dismissing.
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So if a kid decided they didn’t want to go there any more, would they have “Agora-phobia?”
Or maybe they’d just have “smart kid who doesn’t like being disrespected disorder.”
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Sorry, my bad!
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Did I say something different than that? I thought I agreed with you on that point previously. Or is this a response to someone else?
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I agree completely that confronting propaganda and sharing factual knowledge is essential for changing the system, and that is sometimes going to be uncomfortable for some people. I’ve certainly been accused of “pill shaming” or “being biased” or “not sharing both sides” many times in the past, and it does not deter me from sharing the information. I do think that “peer pressure” plays a big role in how people decide things, and knowing that there is someone who questions this paradigm and has data to back it up can be a big game changer for some people.
The only point I want to emphasize is that this kind of work has to be done with a sensitivity to the potential backlash for some people who are very committed to believing in the paradigm for whatever reason. Again, if it is a professional, I have no problem “shaming” them when they are using their power to do harm. I feel different about how to approach a person who has been a believer in this system from a “service user” point of view. I think it’s important to find out where the person is and how much they are able to process to avoid unnecessary pain and confusion. That doesn’t mean not to share the truth with such a person. It just means it’s important to do it in a way that is at least marginally digestible given their present viewpoint. It has been a path for many of us to get here, and it’s sometimes way too easy for those of us farther down the path to think that the truth is obvious, and to forget that we were once farther back along that path and that it took time and patience and multiple experiences for us to get to where we are today. And it’s also important to remember that others’ paths may look different than ours. We don’t want psychiatrists and “mental health” workers to assume we’re all the same – we ought to make sure not to do that to ourselves.
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You as a client should NEVER have to give the “benefit of a doubt” to your supposed caretakers/helpers. It is THEIR responsibility to figure out what is helpful, or to admit that they don’t know how to help. It infuriates me (though it’s not surprising) to hear the staff telling YOU that you need to understand and take care of the staff who are supposed to be there to help YOU. I find it disgusting.
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Have you looked into “Hearing Voices” groups? They are run by other people who have had similar experiences and can make suggestions of what may or may not be worth trying. If I were in your situation, I think I might start there.
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Seems like the first thing to do would be to remove the perverse incentives. But that’s a big task, as lots of schools will be upset when the idea of them losing extra funds is brought up!
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Sorry, I always was a diplomat!
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It is certain that feelings of self-deprecation are present in most of us who grew up in this highly shaming society. They are exploited by the system in order to create more compliant “patients,” and this can be very effective. It’s easy to say “not to be open” to shaming, but that has been a journey of decades for me, and I don’t think we can expect most people to be free from it. The real shaming that goes on is the labeling of someone as inadequate or insufficient in the first place, and the responsibility for that shaming lies squarely on the shoulders of the “professionals” who engage in it.
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I totally respect yours, Julie. I’m simply saying that therapy experiences are all different and that I have an issue with making gross generalizations about what therapists intend, even if in most cases it ends up being fruitless or counterproductive. Believe me, I recognize how fortunate I was to find the person I did! I also recognize that she could have taken the same approach with a different person and not gotten good results. (To her credit, she recognized and stated this to me as well.) It was a good match, for whatever reason, and worked for me.
I also recognize that therapists such as Elissa would be much harder to find nowadays, since so many people have been trained and propagandized into the DSM model of reality.
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I agree with you, Richard, except in one point: I think that Oldhead and Auntie Psychiatry are correct in saying we should not use the term “pill shaming,” as it was invented by and is continuing to be used by those in charge of the system to discredit any criticism. But the phenomenon of someone from an anti- or critical-psychiatry viewpoint acting in ways that effectively disempower those who are being victimized by the system or who are trying to sort out what to do does in fact occur and is harmful, and often gets into what seems like victim blaming. I just think we need a new name for it.
I think we do best when we recognize that people are where they are and that it’s not our job to “convert” people in low-power situations to our viewpoint, as it reinforces the idea that this person is foolish or incapable of making his/her own decisions with the right information. I do think we are responsible for educating anyone who is in any way receptive in the truth about these drugs, but it needs to be done in a way that respects their autonomy and power to make and live with the consequences of their own decisions.
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Compare that to the most optimistic genetic studies. The amount of bias in this area is astounding. And that’s not even getting into the issue of what “schizophrenia” really means, if it means anything at all.
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I agree with all you said above. I worked 20 years for the CASA program in Portland. I’m glad you have heard of and understand what CASA does.
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I am not sure you’re really getting what I’m talking about, and I find your comments here more than a bit dismissive of my reality. I ABSOLUTELY was encouraged to fully experience all the pain and confusion and loss that was the reality of my childhood, with tears and hopelessness and anxiety and angry swearing and the whole 9 yards. So your comment that therapists are always about stopping feelings or distracting oneself from reality is not accurate, at least in my case.
Moreover, though this therapist didn’t specifically suggest getting involved in political activity, she certainly inspired me to understand how widespread my experiences as a child were and how important it was to try to change the real conditions that exist which create understandable fear, anxiety, anger, apathy and other strong emotions in children and continuing into their adulthood. It is fair to say that one of the first steps on my path toward political enlightenment was my engagement with this particular therapist. And led to my eventual career advocating for abused and neglected children in the foster care system, including getting a law passed to help protect them from psychiatric drugging.
So while I agree with you on the fact that most therapy is crap these days, I don’t agree that all therapy can be categorized that way. I agree completely that feeling emotions that are repressed or intellectualized is essential to becoming a fully functioning human being, but I’d have to say that any therapy that does have that effect will help you get folks to the barriers protesting the injustice of the world.
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Not much mystery there. Psychiatric intervention appears to make things worse. The only mystery is why those facts don’t seem to make headlines, or why the media continues to make excuses and fail to ask the pointed questions this kind of data suggests.
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Wow, THAT was a “trauma informed” therapist??? I think they missed the boat by a pretty wide margin, there. It goes to show again that training and qualifications don’t mean much in this world of contradictions and power trips. Finding a person who actually cares enough to get to know you is the real winning game, and there is no guarantee or necessarily even improvement in odds that a person with a degree or training in “trauma-informed therapy” will be that kind of person for you. It absolutely disgusts me to hear this kind of story – thanks for sharing it and good for you for seeing what was really going on!
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I guess by their reasoning, speaking Korean or using forks and knives or having birthday parties must be genetic. After all, your parents did the same thing…
Good post!
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The moderators thank you!
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You know I agree with you.
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I am so sorry – this makes me feel very sad to hear!
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Thanks for sharing this – I think it is brilliant!
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And I would add that she was ANYTHING but protective of my parents. In fact, my mom said to others (naturally, I never heard about this for YEARS later and from a third party) that my therapist was “driving a wedge between us.” We spent most of the time talking about my historical relationship with my mother and her denial of any kind of emotional reality except that “everything is just fine.” And it was VERY helpful to me, and I doubt that selecting an average person off the street to share my issues with would have been remotely as helpful. She had a very useful skill, and I was happy to pay her for the excellent service she provided.
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You’ve said this stuff before, and I’ve finally realized why some of it bothers me. You claim that all therapy is about making someone “feel OK” without dealing with emotions. But I had a fine therapist back in the 80s (before the DSM III and the “chemical imbalance” theory had taken hold), and it was ALL about me learning to feel the feelings I was avoiding. That was the whole point of it. So while I agree that much if not most therapy today avoids dealing with these awkward realities (and that the DSM III and later editions were, in fact, carefully constructed to allow for this shift in emphasis), there have always been therapists who viewed their jobs as doing exactly what you are saying needs to be done. So I think you are overgeneralizing in these statements – there are a lot of different therapists doing a lot of different things, and with a lot of different competence levels, but the idea that ALL of them are aiming to help people repress their emotional experience and side with their parents against abused kids is just not true in my experience.
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I’d be the last person in the world to argue against some increased sanity in the foster care system, as I worked as an advocate for foster kids for 20 years. The Kibbutz/commune idea has a lot of merit, and I’d love to see it worked out.
However, I do think it is important to remind everyone that today’s parents were yesterday’s kids who were usually abused and/or neglected and/or misunderstood by THEIR parents (and other adults responsible for them). While there are certainly parents who overtly wish their kids ill, and I see no reason to have mercy on such parents, there are a hell of a lot more who are just passing on what was done to them. You are an Alice Miller fan, as am I, so you know what I mean. Of course, this does not excuse the parents from the damage they do – I personally find the “don’t blame the parent” meme offensive and destructive to kids (and adults) who are the victims of inadequate or abusive parenting. It’s not the kids’ fault that the parents had a rough upbringing, and the parents are responsible for not passing that on. But most do so inadvertently or unconsciously, and I therefore see no reason why sane approaches to raising kids should not be a legitimate subject of study, as long as we aren’t providing excuses for parents or other adults to continue harming their children with impunity. It is very possible to talk about improving one’s approach to child rearing without making excuses for the parent or supporting child abuse, neglect or exploitation.
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The correlation between “schizophrenia” diagnosis and childhood abuse (especially sexual abuse) is orders of magnitude hither than any genetic correlation that the most optimistic study has every come up with. Yet we still spend millions on gene studies and almost nothing on researching childhood abuse effects and how to help people resolve them. At this point, it is clear to me that those leading the field are either utterly blind to the obvious or extremely corrupt, or both.
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Absolutely! I feel the same way for most adults as well!
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It beggars belief that anyone would be so arrogant as to claim neuroleptics increase lifespan. Just based on weight gain, increase in diabetes, and increase in heart disease, it is obvious that these drugs kill people more quickly than if you left them alone. Add in the increase in smoking cigarettes as a means of dealing with “side effects” and you know the death rate will climb.
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This article reinforces my observation that what people need to “heal,” if that is the proper word for it (a bit medical for my taste), is for someone to connect with them on a real and personal level. There is no technique, training, school of therapy, medical intervention, or special approach that will create this kind of connection. It requires a person being human and being willing to experience with another person what is happening in their lives.
When therapy works, it’s because such a connection is formed. Most of the time, it appears to me, such a connection is not formed. And having a degree or a license is no guarantee of better odds that a person will be helpful.
You are blessed and fortunate to have found such people, and others are no doubt very fortunate to have found you so you can pass it on. I wish there were some way to teach people how this works, but I don’t know that such a thing is really possible. Everyone follows their own path, even therapists. I guess a person who wants such an experience needs to know what they’re looking for and spend a lot of time shopping around.
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That is such a good point! The shame is what comes from the system labeling someone and exerting power over them. Then the system comes and accuses anyone who wants to tear the veil of secrecy over their own shame and tries to project it onto those who is trying to get the facts on the table. It’s classic projection.
I also agree that “no-pill shaming” is a lot more common, and yet no one seems the least bit disturbed by “did you take your meds?” humor or the pressure that people come under to give in to the psychiatric worldview and accept their shaming label without complaint.
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Absolutely! “Adherence” is a very authoritarian kind of goal!
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I think this is a very important clarification. Thanks for sharing it.
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That is MOST educational! Thanks for that!
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Very true. In the world of mediation/negotiation, it’s long been recognized that “shared decision making” is impossible in the presence of large power disparities. It’s hard to think of a greater disparity than a person who is highly distressed talking to a person with high social standing who has the back pocket option of imprisoning them if they don’t go along with the program.
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Some parents won’t listen. There are a lot of parents who are working on doing the right thing very, very hard. And the answers aren’t always as simple as to take away the video stimulation. Parents are fed a lot of bad information, and it’s hard to sort out what makes sense, especially when so many of them have been treated less than respectfully by their own parents growing up.
Parenting is a tough job, but at the same time, parents should not be let off the hook for the damage that they may do, intentionally or inadvertently.
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OK, I was overgeneralizing a bit. There are moments when it IS the correct thing to say. But mostly not, and I’d have to gather a lot of information before deciding to go that route. A person has to be at the right point to be able to process that kind of a push.
But you’re right – there is a difference between personal communication that is unintentionally shaming and the use of this concept of “pill shaming” in a shamelessly (sorry!) political manner as has been done. Acknowledging that there are moments when people can’t process the idea that their pills may be dangerous really doesn’t connect with the idea of “pill shaming” as put forth by the leaders of the psychiatric/drugging movement.
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Not at all. I’m saying that if you really want to bring someone to a different place, you need to meet them where they are and understand why they believe what they do rather than starting off by telling them that they’re making bad decisions and should change their minds. I’m by no means tolerant for a second of the concept of “pill shaming,” as it was invented for the purposes of stifling discussion. I’m merely saying that an approach that recognizes the person being harmed as a victim of the system who needs some gentle guidance, vs. someone who needs to be rescued or fixed by again doing what someone else says they should do. What I want from these encounters is to maximize the odds that the person’s going to be able to hear what I’m saying. Anything that smacks in any way of me judging the other person’s decisions as being “bad” or “wrong” or me “correcting” their views generally leads me no where at all. I learned this by much trial and error, and believe me when I say, I have had plenty of time to discover what works, and telling people they’re wrong doesn’t do the job.
Again, very different from how I’d approach someone accusing ME of “pill shaming.” No need for gentle measures there generally, though there are those who are brainwashed and don’t really believe it themselves who still engender my compassion, even though I have to call out their judgmental behavior. But if I want to be in a position to call out judgmental behavior, I kind of have to avoid it myself, don’t I? Or I end up being way too similar to those whose behavior I am trying to stop.
Hope that makes a little more sense this time. It is a kind of subtle point, but as far as dealing with domestic abuse survivors, it’s tried and tested over hundreds and hundreds of people who have found my interventions generally very helpful, once I figured out what NOT to do. I haven’t done half bad with psych survivors, either, based on what feedback I’ve gotten. I’m not talking through my hat – I’m sharing what I’ve found to work best for those I’ve worked with.
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I think this is a very good observation. It being such a normal reaction, I think we all need to be sensitive enough to expect it and not judge people who have been understandably pulled into a system they don’t understand for displaying this predictable sign of resistance to being “wrong” about their investments.
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Well said, Richard.
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Hi, AP,
I have to say, I have seen some pretty serious insensitivity from some folks about the impact of their statements on the person in question. It seems to me that, as we care about the welfare of the folks we’re trying to educate, we need to start gently and from where the person is rather than overwhelming them with information and pressure to agree with us.
A useful analogy may be someone in a relationship we see as domestically abusive. We may be absolutely right about our observations and assumptions, but I can assure you that it’s not very helpful to say to someone, “You’re in an abusive relationship – you need to leave right away!” Now, the person who says this may have no intention of shaming the survivor, but the effect will nonetheless be one of shaming – the survivor will almost always feel inadequate and defensive, and will in fact often go into a reactive defense of the abuser as a means of avoiding the perceived judgment that s/he is too stupid to see the obvious reality that we “outsiders” are kind enough to point out.
I have found it MUCH more helpful to enter into a discussion with the person, to find out his/her own view of what is going on, what the pros and cons are, what they’ve thought about as possible solutions, or just to hear their story and listen supportively. It has become very, very clear to me over time that people are in different places in their processes and that the last thing they need is someone else telling them what they should do or that they are wrong.
Of course, we also have to consider the possibility that we are wrong, that the person is not feeling abused or mistreated, and that the situation is not the same to them as it looks to us.
This is a very, very different approach than I would take toward the PERPETRATORS of such ill treatment. I see no reason not to pull out all the stops in challenging those in the position of power to deal with the actual facts of the situation and to let them know we see and know what they are about. But they are the ones committing the heinous acts, whether intentionally or not. Those who are being victimized deserve a high level of sensitivity to how our approach may come across, including making sure that our efforts don’t have the unintended effect of making them feel LESS empowered and more shamed. We can absolutely create a shaming situation without intending to.
I would also suggest that this is very different than presenting objective DATA to a person in a difficult situation, while allowing that person to decide what it means and what to do with that information. My big objection is when people start objecting to providing objective information on the grounds that “it might discourage people from taking their meds” or “it might be perceived that you are shaming them.” I think sensitivity is still in order, but there is nothing “shaming” about sharing research data, statistics, personal experiences, cross-cultural studies, or whatever solid factual information is known with anyone who is interested in hearing about it, and even with some who aren’t.
I guess the big difference for me is whether one believes that the other person has the right to make their own decisions based on their own assessment of the data, or if one believes that anyone who doesn’t agree with one’s own interpretation is de facto wrong or deluded or deceived or victimized. I think it is a minimum level of respect to grant to any person in the low power situation the right to make up their own minds about things without having to worry about how I’m going to react or judge them if they make a different decision than I would want them to make.
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The data suggests strongly that anyone interested in increasing the long-term rate of recovery from “schizophenia,” whatever that may actually be in each case, would do best to minimize the use of neuroleptics in every possible way. It is clear that the more neuroleptics are in use, the more chronic the “condition” becomes.
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It’s actually even more ironic – smoking is often an attempt to minimize the side effects of neuroleptic drug.
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I can see the pamphlet now: “Learning to Live in Poverty: It Can Be Done With the Right Attitude!”
Neoliberalism at its finest: let’s not worry about ending poverty, let’s help people deal with how they feel when they have no escape from it.
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Sometimes the article titles are from the journal or publication that published them. But I agree with you – I’d like to see articles with titles more like, “Kids enjoy school more when they have lots of exercise” or “Active kids learn better when allowed to be active.” Or even, “Kids who are allowed to be active are less likely to end up with an “ADHD” diagnosis.” We can talk about issues without labeling kids.
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Yeah, alcohol is an AWESOME anti-anxiety agent. Of course, dosage control is a bit of an issue, and there ARE some adverse effects…
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I’ve always found that people considering suicide have good reasons for feeling that way. Trying to “stop suicide” is a very short-sighted approach that leads to bad results. Finding out what the person is finding hopeless about his/her life and helping them regain some measure of real hope is a lot more effective.
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I do think we’d agree on most points. My issue is the professionals pushing these “diagnoses” when we know they are BS. But they have permeated society, and some people do take offense or get confused when I communicate my disagreement with these concepts. I think it’s an inevitable part of the problem, and I blame the doctors and the profession for promoting ideas they know to be false for the bulk of the confusion.
The most important part of helping anyone is, as you say, recognizing that everyone has different experiences. Unfortunately, the main thrust of the DSM (in my view) is to invalidate those differences and suggest that we can lump people together based on how they feel or behave rather than taking the time to actually find out what’s going on. I am guessing we’d be of a mind that the job of any helper should be to find out from the person they’re trying to help what works or doesn’t work for them, rather than forcing one’s own view of the situation down their throat (in some cases literally). As to how the average clinician views the situation, it might be interesting to do a survey and find out for sure.
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Ooh, yeah, that one creeps me out, too! Like “cleaning out your brain.” Someone’s going up in your head with some chlorine bleach.
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I know what you’re talking about, as I trained as a chemist undergrad and have done some programming as well. The most important element of creating a functional model is feedback from the model in action. If the model doesn’t predict reality accurately, you have to start redefining your assumptions. And you’re right, the most basic assumptions affect the outcomes most significantly.
So what I see here is that the psychiatric industry, for reasons of economics and prestige/power/status, made a decision to regard the brain as the source of all mental/emotional/behavioral distress or wide variance from the norm. We are seeing now a lot of the feedback from that model in application and it is not pretty. However, rather than doing what a good scientist would do, and understand that the original assumptions were erroneous or at a minimum simplistic and go back and start altering those assumptions, they have a financial and power-based investment in maintaining the original assumptions as true regardless of any feedback they might receive from the model’s outcomes.
In other words, they have abandoned the scientific method and have decided to do what makes them the most money/power instead of what helps their clients.
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Thank you – that is a good clarification.
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I think you underestimate the importance of and the damage done by the DSM. To start with, there is no reason that we can’t say, “X has difficulty eating enough food” or “Y has a difficult relationship with food” or “Z has a very negative body image that she wants to change.” Not labeling something doesn’t mean denying the circumstances that prompted the labeling process. In fact, we can get a MUCH more accurate description of what is going on by simply asking the client to describe the circumstances they feel they are facing and having them identify their own description of the problem. So there is no need to tell someone “you have an eating disorder” to provide helpful intervention. Now if the person him/herself identifies that “I have an eating disorder,” I would certainly not invalidate that. But that’s very, very different than a professional telling you, “You have an eating disorder” and defining your reality for you. This is especially true when the doctors start telling you that you suffer from a “chemical imbalance” or that your “disorder” is hereditary or due to some kind of brain malfunction that no one has even come close to identifying as true. And if you don’t believe this happens, you need to read up on this site or talk to a lot more people who have engaged with the “MH” system.
More importantly, the DSM is taken VERY seriously by both professionals and the society at large. Not all, but lots and lots. Saying that a person “has depression” implies that there is something wrong with THAT PERSON for feeling that way, that they have a “medical problem” and that they need “treatment.” A survey in the late 2000s showed that over 80% of Americans believed that “depression” was caused by “low serotonin.” This belief did not just happen – it was the result of a large and coordinated effort to convince Americans that “mental health problems” were, in fact, biological. There is plenty of documented evidence that the thrust of the DSM III, which prompted a huge expansion of biological explanations for “mental illnesses” defined in the book, was to expand psychiatry’s market share. It was, in fact, a quite cynical effort to position psychiatry as a “real branch of medicine” and to promote its practices as “scientific” and “proven effective.” Naturally, the pharmaceutical industry was happy to team up with psychiatry in this effort, and continues to provide most of the funding for the continued propaganda campaign to that end.
It’s easy to think that those who made the DSM are just trying to understand better and refine their model, but the origins of the DSM series belie that suggestion. It is more than possible to provide good support to people who face mental and emotional suffering without the slightest reference to a “diagnosis.” Again, if an individual wants to view him/herself through that lens, they’re welcome to do so, but the profession has no right to promote the idea that these “diagnoses” represent real, biologically-distinct entities when they know absolutely that they do not and never will.
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What if the “diagnoses” are known to be manufactured and to not represent any kind of medical problem? Is it not a fraud to pretend one is practicing “medicine” beyond “symptom management” when “treating diagnoses” that are known not to be scientifically definable? What’s to stop someone from inventing “nose-picking disorder” or “excessive skipping disorder” or “unreasonable political protest disorder?” If we can just invent “disorders” out of anything we don’t like or find uncomfortable or confusing, where does it end? Hell, they’re prescribing STIMULANTS for “Binge Eating Disorder” now! As if the person is suffering from excessive appetite and suppressing the desire to eat is “treating” the problem! I’m sorry, but these utterly unscientific “disorders” are not advancing the understanding of people’s mental/emotional distress or well being, but is instead creating further confusion.
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You are absolutely right, the proof is in the pudding, and so far the psychiatric pudding is falling pretty flat. Making more people disabled, reducing people’s lifespan, reducing hope and increasing stigmatization and discrimination – nothing that could be called a success in any sense.
Real science makes things simpler and more effective over time. The psychiatric model makes things more complex and more confusing and is ultimately very ineffective.
I agree that people are programmed to categorize, but categories are only as useful as they create better understanding. And any real scientist knows that categories are always approximations and that incoming data has to be considered to improve the model of reality over time. A model is not reality, but psychiatry seems to think the model is more important than the results. Unless you count financial results for their corporate buddies.
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“Even if” was supposed to suggest that I thought it very unlikely to be true, but “even if” it were true, it still wouldn’t prove their point.
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I’m not going to try and explain myself again. You seem to have difficulty following what I’m saying for some reason. I never assumed that bad brain chemistry causes anything – to the contrary, I think the whole thing is a bunch of pseudoscientific chicanery invented to sell drugs. Anyone who has ever read anything I wrote knows this about me. All I’m saying is that sometimes having hard scientific data proving such assumptions FALSE is helpful in counteracting pseudoscientific propaganda put out by the proponents of the DSM “model” toward their potential victims. You’re free to disagree with me, but not to put words in my mouth that I not only didn’t say, but which are in direct contradiction to what I’ve clearly expressed myself to believe over and over again on this forum.
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I think you misunderstand me. The only research I’m talking about it that which debunks any idea that there is some medical issue at play. For instance, I have found it extremely valuable to read decades of reviews of the literature on “ADHD,” not because I believe in that bogus concept, but because those decades of research prove what we all intuitively know to be true: giving kids stimulants doesn’t improve their grades, their academic test scores, their social skills, their high school dropout rates, their rates of delinquency, or even their “self esteem,” however they measure that subjective concept. This is very useful to me when someone tries to explain to a parent how “untreated ADHD” leads to high school dropout and delinquency, and I can say, “What most people don’t seem to know is that 50 years of research have shown that “treating ADHD” with stimulants does not change those outcomes one iota, and in some studies it makes them worse.”
I’m certainly not in favor of wasting good money on studying these idiotic constructs. But I do value people (like Giovanni Fava or Jonathan Leo or Peter Breggin) who do or assemble research showing that the institution of psychiatry has its collective head in a very dark place. Yes, even if they use “those terms.” Because sometimes people just need to hear that psychiatry is lying to them as a place to start their journey to understanding how deeply harmful the industry really is.
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I agree absolutely. I’ve said to people that even if they DID prove that people “with ADHD” have a difference in their brains from the average person, it would not mean that there was anything wrong with them. After all, genetic diversity is the key to species survival! Or as one foster youth once wisely said to me, “Maybe different people should be allowed to have different brain chemicals.”
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I think they should be called “Antimotivators” or “Anticreators” because their real effect is to blunt the functioning of the frontal lobes, which are the seat of creativity and planning and motivation.
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Was it ever gone?
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That one gags me every time! It’s even worse than “mental health” to me. As if behavior can have “health!” It is an utter absurdity, and yet people talk about it as if it is a real thing.
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I also think research is needed to debunk claims of “chemical imbalances” or other pseudoscientific claims of physiological “causes” of these metaphorical “disorders.”
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That is my general practice, and I think it says what needs to be said. This particular use of quotation marks is meant to indicate that this term is used by others but is considered by the “quoter” to have a different value, and usually indicates a degree of disrespect or scorn for the term. Kind of like saying, “So-called schizophrenia.” I have also used “persons who have been labeled as” when talking about research. This allows us to communicate the intent of the researchers without buying into the terminology. That’s just my personal take on it, but I agree with Oldhead here that the quotation marks are the easiest way to show disagreement while still using the recognized term for those who are new to the idea of critiquing the DSM “diagnoses.” (See, it works!)
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I should add, the concept of “mental illness” would itself have to be trashed as job one, because it is most definitely NOT “trauma informed” to tell someone that their understandable reaction to being beaten, sexually abused, or otherwise oppressed is a “disorder” that needs “treatment!”
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I don’t think that it’s possible to be truly “trauma informed” as long as you are relying on the DSM-driven standard “mental health” system. The only “trauma informed” thing to do is to erase everything people claim to know about “mental illness” and start over from scratch, and rebuild from the viewpoint that the people who have been traumatized are the ones who actually know what they need.
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Fantastic post!
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Plus if you treat for lead exposure or sleep apnea or anemia, you might actually make the problem go away, and there goes another customer!
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The problem is that there is no profit in it for any big corporations, so there is no motivation to do anything different than what is being done. If Maori methods actually help “cure” people of their ostensible “disorders,” that would be a strong reason for many in the industry to try and bury the idea as deeply as possible so they don’t start losing “customers,” whether voluntary or not.
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It kinda seems like the mainstream psychiatrist doesn’t even really recognize there is a person out there to connect with. I think they really believe they are working with a body.
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Yeah, I guess “healthy” people feel OK regardless of how they are treated by others. Sounds like the old macho “get tough” crap I got from my football coaches. The “healthiest” people are apparently those who need nothing from anyone else and keep very quiet.
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True enough. Unrelieved stress most definitely affects both nutritional intake and nutritional consumption by the body.
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I am impressed at how complex and confusing they have made a very simple correlation. Burnout and depression “overlap” because they are both descriptions of how people feel and act when they are overwhelmed, stuck,hopeless, and/or disconnected or unsupported by their communities. Making it seem like they are somehow different things that “overlap” is just a sleazy way to continue to legitimize their medicalization of “depression.” I found it particularly amusing that they assert that “burnout” is a syndrome that can’t be clearly defined, as if “depression” were somehow different.
Anyway, you can tell when someone’s explanation doesn’t hold water if it continues to make the situation seem more and more complicated instead of simpler.
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Thanks for your kind words. It baffles me beyond belief that a person who knows they feel lonely and unloved would be secluded in a room and put in a straight jacket and drugged!!!! How could ANYONE think that would help you feel LESS lonely and unloved? Seems like the best way I could think of to make you feel MORE lonely and unloved?
I can only surmise that a lot of these people don’t really understand or care how other people feel. The lack of empathy is astounding to me. There is nothing wrong with a person who is feeling lonely and unloved! Maybe what they need is connection and love? Radical thought!
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And those are real disabilities, as opposed to DSM fiction. What happened to “First, do no harm?”
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They often even tell you when you DO experience these effects that they are NOT caused by the drugs, but are a sign of “relapse.” The lack of ethics in the field is shocking, or would be if I didn’t already expect it at this point.
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The problem I see with “Disability Rights” is that by even engaging them, we are allowing that being “diagnosed” with one of these pseudoscientific “disorders” means we are “disabled” in some way. I think the resistance will not be coming from that direction.
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Wow. That’s some seriously strained thinking! I can think of a hell of a lot of better “substitute behaviors” over holding a frozen orange! Why not talk to the actual client him/herself about what they would choose as a substitute? What, too empowering? Don’t want to encourage people to think for themselves?
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Sheesh! Well I guess at least the adverse effect profile is limited to frostbite. How on earth is this supposed to help?
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Wow, that last is very revealing! I have heard people smoke to deal with the adverse effects of neuropleptics, but I didn’t know there was research that objectively supports the idea.
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The system itself is organized along racist/classist/sexist lines, and unless the field suddenly and miraculously divorces itself from the DSM and all the attendant “diagnoses” and similar medicalized language toward people in distress, it will continue to function as an agent of oppression, despite the scattered patches of sanity that one finds here and there fighting for their own survival. The fact that the psychiatrist could make that incredibly racist statement without an outcry from the entire staff shows how completely accepted it is that psychiatrists get to do whatever they want and the rest of the staff either go along with the bully or get bullied themselves. How anyone could get “saner” in such an environment is a miracle that occurs in spite of rather than because of the system itself.
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I thought the original coining was Eisenhower’s warning about the “Military-Industrial Complex.”
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Way to get complex about it, researchers. The explanation is both simple and obvious: ADHD is diagnosed based on the degree to which the child creates problems for the teacher. Younger kids are more likely to create problems for the teacher, and are therefore more likely to get a referral or pressure to get diagnosed and “medicated.” The other explanations (2-4) are clearly just attempts to rationalize continuing to drug kids because they are annoying.
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They don’t even seem to read their own Holy Scriptures, do they?
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Holding a frozen orange? Really? This is part of DBT? Kind of bizarre!
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The first problem is grouping all people who fit the “PTSD” criteria into one group and trying to find one intervention that helps everyone. Some people may like “exposure therapy,” some hate it. Some people find meditation to be a very difficult experience, I personally found it very helpful. People are all different, and different approaches help different people. Why anyone would try to force a “therapy” on someone who said it didn’t feel right is beyond my comprehension.
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Except that you’re insulting real clowns. At least a clown’s purpose is to make you laugh. If the psychiatric docs and other MH workers went a little more “Patch Adams” on their patients, we’d all be better off!
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I recall doing an excellent exercise on distinguishing facts from opinions/projections. A person would be asked to look at a picture and say what they know about the person in the picture. People would say things like, “He’s sad.” The facilitator would say, “Do you KNOW he’s sad? What do you actually see that you know to be true?” “Well, he looks sad.” “Looks sad to you – that’s your opinion, too. What do you SEE?” “Well, his face looks sad.” “What about his face looks sad?” “He’s frowning.” “How do you know he’s frowning?” “Well, his lips are turning down at the edges.” “THAT is a fact. The rest of the things we think we “know” are assumptions or judgments.” It was a sobering exercise. Most of what we “observe” is not really an observation at all, it’s a judgment. I would also submit that any “observation” made would need to be checked back with the person being “observed” for accuracy, but far better for the person to make his/her own observations without any suggestions from the “helper.”
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“Sugar shaming!” LOL!
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Faith-based medicine!
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Solid advice. I’d add that there are some “patients” who have bought into the system as it is and will be difficult to engage on these points. I’d also add that the system personnel will sometimes ask if you are “antipsychiatry” or “a Scientologist” or “anti-science.” You want to be prepared not to engage with this kind of attack, and I’d suggest responding by asking, “Why are you changing the subject? I thought we were talking about whether or not psychiatry works?” But of course, anyone who attacks you in that way is probably not really worth trying to convince, as they are invested in the status quo and maybe even making money off of it.
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I actually agree with you, and efforts to be “objective” are often a big barrier to helpers connecting emotionally with the people they are trying to help. Perhaps a better description is for the helper to understand that s/he is NOT objective, and to make strong efforts to double and triple check his/her observations and ideas with the person whom they are supposed to be helping.
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What earthly good is a “risk factor” that doesn’t actually predict the likelihood of the event under examination actually happening?
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“Why is my car not running?”
“There is no way of knowing – there are too many factors involved.”
“So if you don’t know why it’s not working, why should I pay you to fix it?”
“Trust me, I have 25 years of experience working on problems that I don’t actually understand.”
Time to get a new mechanic?
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The mainstream’s reply: Must have been misdiagnosed. We all know that “schizophrenia” is incurable. Must have had something else going on.
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Nobody makes much money for inventing practical solutions.
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I think that is a very legitimate concern!
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Well, I’d say the doctors should know better and are engaging it outright deception, vs. being credulous in believing that doctors would not lie. So both are responsible, but the doctors have more power to change the narrative, and I therefore hold them more to account.
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True words!
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Exactly. Depression is never “the problem.” It’s a manifestation of being alive!
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It is possible, but it is my firm belief that only a tiny percentage of people who are suffering will have any kind of neurological difficulties at all. Because being scared, or angry, or depressed, or bored, or even having fantasies are all completely normal activities that every human being experiences at one time or another. It makes no sense at all that 20% of the population is “mentally ill” – they are in the vast majority just people having normal reactions to life. The idea that there will be some physiological cure for something like “depression” is a fantasy. It’s just as likely as curing something like “pain.” It isn’t going to happen, because pain is a part of life, and so is depression and anxiety and all of it.
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Actually, beyond direct force there is a lot of manipulation using parental fears. For instance, they tell parents that “untreated ‘ADHD’ leads to delinquency and school dropouts and etc etc.” Of course, they don’t bother to tell them that the “treatment” doesn’t do anything to improve any of those outcomes, nor that most “ADHD” diagnosed kids turn out just fine as adults. So parents are afraid if they don’t “medicate” their child, the child will suffer these awful outcomes that the “treatment” doesn’t even touch. It’s pretty evil!
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The first and most important thing anyone for who really wants to help is to start from the awareness that we don’t actually know ANYTHING about the other person except what we observe and what they tell us. Humility is the beginning of wisdom!
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Though it is true that many capitalists claim to be “libertarians” in order to justify their opposition to anything that might help the working stiff have a chance at a better quality of life. The Koch brothers are a great example – they claim to be libertarians who are in favor of minimizing regulations and supporting the “free market,” but when rooftop solar started to out-compete other energy providers in sunny places like Oklahoma, they were first in line to propose a tax on rooftop solar. So much for the free market, guys…
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He clearly states that the use of the term “illness” to refer to a state of mental or emotional suffering is not a proper use of the term. He (and I) believed that some illnesses could have impacts on thoughts and emotions, such as low thyroid or anemia or a head injury. But those are identified as real illnesses and treated by real branches of medicine. He always was clear that if there is no known physical cause, it’s not an illness. I wanted to make sure you knew I wasn’t denying that things like loss of sleep or the side effects of certain drugs or poor nutrition can cause mental/emotional problems. But to call something like “depression” an “illness” doesn’t make sense to me (or to Szaz), because it assumes that everyone who is feeling depressed has something wrong with them. Indeed, it assumes that all people who are depressed have the same problem. This is about as silly as saying that all people who feel pain have “pain disorder” without bothering to see what is actually causing the pain. Actually, it’s even more silly, because feeling depressed is a normal part of living, it’s not even an indicator of something physically wrong, as pain most often is.
So to be clear: “Major Depression” is not caused by a physical problem. It is an invented category that does not correlate to any physical abnormality. It is just a label for a phenomenon that could have many different causes. Low thyroid IS a physical problem that can cause a particular person to feel depressed. In this case, “depression” is just an indicator of the problem, no different than weight loss/gain or tingling in the hands and feet. So “depression” is never the “illness.” It is just an emotional experience people have, which in rare cases can be caused by a physiological problem of some sort, but which in most cases is simply a normal emotional response to a difficult environment where one has difficulty figuring out what to do.
I hope that makes things clearer. But Oldhead is right – Szaz did not believe that “depression” was or could be a “disease” or “mental illness.” He wasn’t opposed to treating actual illnesses that might cause a person to feel depressed, but he was very much against any kind of idea that “depression” as a whole was or could ever be the result of a biological problem.
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That is exactly what I mean. He is pretty clear about saying that if something is discovered to have a real physiological cause, it is moved into one of the actual medical categories, like neurology or nutrition or internal medicine. Psychiatric “illness” is only reserved for those manifestations that DON’T have an actual known physiological cause, which he properly identifies as a metaphorical use of the term “illness,” since there is no reason to believe there is anything physiologically wrong with the person in question. I’d say his take is, “If you know it’s an actual physical ailment, show me the test and treat it as such. If you can’t show it to be physiological, stop calling it an ‘illness,’ because it isn’t.” I’m no Szaz expert, but that’s what I most recall of his writings.
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Your point is well taken. The biggest problem with the psychiatric/DSM viewpoint is the absurd assumption that all people or even most people who behave or feel or think in a certain way have something wrong with them, or that all such people have the same thing wrong with them.
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Exactly!
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I think it means that of all the people who end up diagnosed with “schizophrenia”, only 2.28 out of every 100 had some gene that supposedly conferred vulnerability to “schizophrenia.” Or to put it another way, the idea that “schizophrenia” is caused by genetic variation is BS.
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Makes sense to me. Having a degree or license or training in “mental health care” appears to me to bear little to no relationship to actually being able to help someone who is struggling with their life.
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Not at all, and neither does Szaz. The important point is that you can’t DIAGNOSE A DISEASE STATE by looking at HOW SOMEONE ACTS OR FEELS. There is no question that certain physiological conditions can cause mental/emotional symptoms or adverse effects. The problem is claiming that a person has such a condition BECAUSE they have certain mental/emotional effects. For instance, it’s legitimate to say that a person might be depressed because he’s had insufficient sleep, but it’s not legitimate to say that you know he has insufficient sleep because he’s depressed. He MIGHT be depressed due to lack of sleep or due to having a dead end job or because he was abused as a child or because he is lonely and has no connections or because his wife just left him or he lost his job or etc., etc, etc.
An analogy might be diagnosing a person with “knee pain disorder.” It is meaningless to say that a person has “knee pain disorder” because their knee hurts. You’d have to know WHY the knee was hurting. Maybe it’s arthritis, maybe it’s a muscle cramp, maybe it’s a bruise, maybe it’s nerve damage, who knows? You’d have to analyze it further to find out what was the cause before you made a diagnosis.
Same with “depression.” Saying “he has depression” tells you nothing at all, except that he’s feeling depressed at that particular time. It may be physical, mental, emotional, social, spiritual, political, or any mix of the above. So calling “depression” a “disorder” is not only meaningless, it is destructive, because it gives people the idea that the psychiatrists have some understanding that they actually don’t have.
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You should read his books. Essentially, he says that the idea of “mental illnesses” is only metaphorical – they are not really “illnesses” but “difficulties in living” that have been labeled as such for the purposes of those in positions of power in society. That’s all I’ll say for now – you should read some of his writings. I think they would be very helpful for you to understand why some people say “mental illnesses don’t exist” – very different meaning than “people don’t suffer mentally/emotionally.”
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They say a lot, but it’s mostly speculation and nonsense. The one thing we do know is that brain chemistry is constantly changing as we encounter different stresses and needs. So to suggest someone’s brain is “chemically imbalanced” means practically nothing. We also now know that the actual physical structure of the brain is changed by experience. So it seems to me we waste a lot of time studying genetics, which can’t be changed, instead of studying which EXPERIENCES help people feel more strong and capable.
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Very true. And what’s wrong with being more active than the average person, or not liking how the world is doing right now, or having difficulty reading others’ cues in social situations? Sounds like being human to me.
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All of those elements are involved in creating or alleviating distress, for sure. For instance, loss of sleep definitely increases my feelings of hopelessness or anxiety and reduces my ability to communicate effectively. So sleeping could be said to be a “treatment” for my negative feelings, but really, all they are “symptoms” of is a lack of sleep.
So by all means, we should be addressing deficiencies in our social environment, eating better food, working on our own attitudes, working to improve the economic situation, etc. The problem is that my reacting badly to, say, a very oppressive school environment as a child (I was deeply depressed, did act out one time, had a psychological evaluation, etc.) meant that I had a “disorder” or “disease” or “condition” – it meant that the school’s rules, expectations, and processes and the complete lack of recourse that I or any of the other students had to address any kind of injustice or arbitrariness provided a horrible environment for me to grow in. The real answer wasn’t to ‘treat’ me, but to get me the heck out of there or to change the environment so I didn’t feel so hopeless about having to go there and be bored and lonely and angry and frustrated 5 days a week, 6 hours a day.
Do I have a tendency more than other people to be anxious or depressed? Yes, I do. Could some of this tendency be built into my personality? Sure, it could. But so is empathy, compassion, willingness to fight for justice, humor, and lots of other things that go along with being “sensitive.” I don’t think I needed to be “assessed” or “evaluated” or “treated,” I needed to be loved and listened to and provided more opportunities to take more control of my own life.
So I’m all for looking at all the factors that contribute to someone’s distress. I’m just opposed to the idea that being distressed in a particular way that is inconvenient for those in charge means that I have a “disorder.” I think it means I’m human, and we humans are all different and unique in our needs and goals and values and deserve to be treated that way. We don’t deserve to be slotted into categories of “wrongness” for the convenience of those who want to pretend that life is a garden of delights and that anyone who is not loving every minute of it needs to be “fixed.”
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Well said!
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Given what the “mental health” world has done with ‘mindfulness’ by abstracting it from the Buddhist philosophy that underpins it and in some cases making it a requirement in someone’s “treatment plan,” I am very skeptical that Western Psychiatry will do anything but distort and ruin any helpful practice the Maori may have developed. Maybe we should skip reforming psychiatry and instead pay the Maori what we used to pay the psychiatrists rather than expropriating their spiritual practices and turning them into yet another bastardized western product for sale?
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Cuz they knew you were right!
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I don’t think anyone should invalidate your own perception of what works for you. Certainly, lots of people report finding psych drugs helpful. But that does not make psych diagnoses legitimate. They are not discovered, but literally voted on by committee. Read “So They Say You’re Crazy” by Paula Caplan, who served on the DSM IV task force.
And yes, they do invent “disorders”. Look at the cases if Juvenile Bipolar or Social Anxiety Disorder or Binge Eating Disorder. Not that such things are not issues for some people, but there is solid documentation that pharmaceutical companies conspired with leading psychiatrists to create these “disorders” in the DSM to sell pharmaceuticals and psychiatric “services.” I know it’s hard to believe, but it is true.
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I wish I were surprised by this finding. I’m not.
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True. Most suffering by children is caused by adults’ mistreatment of them. My biggest objection to “diagnoses” is that it lets adults off the hook and blames children for having “bad reactions” to adult abuse, neglect and mistreatment.
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If Leonardo “had ADHD”, he seems to have done quite well in his “unmedicated” state. Maybe we need to let our “ADHD” kids explore their creative sides and we’ll have more Leonardos. Just a thought…
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But it is important to acknowledge that people DO suffer in various ways, and often need help dealing with their emotions and their experiences. This doesn’t make them ill, but I think it is important to distinguish that these “diagnoses” are crap, in that they are social inventions, but that suffering is real and that we need to get together as a community and look for solutions that actually help but don’t blame the sufferer for suffering too much or in the “wrong” manner.
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I do see what you’re saying. I think it involves a confusion about language. When people say, “There is no such thing as ‘Bipolar Disorder,'” I think they mostly mean that “Bipolar Disorder” is an invention that doesn’t have a scientific basis as a medical diagnosis. I don’t think people mostly believe that those behaviors defined as “bipolar disorder” don’t occur, or that they don’t cause distress, or that help is not sometimes required. I think the objection is that someone with medical authority is DEFINING these behaviors as a “medical disorder” without cause. But it is often intepreted by readers as meaning that people don’t have these feelings or behaviors, which leads to lots of confusion and, as you say, distraction from the key points. At the same time, I really do understand why people who have survived the system often are very strongly against using these terms, which is why I put them in quotation marks whenever I use them. These generalizations have been used to harm people, often intentionally, and if that had happened to me, and I later found out the “disorder” I was assigned was voted into existence by a committee, I’d never want to see that word in print again!
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I mean the goal of being “normal” as defined by the social norms promoted by our cultural system of values. It is the slavish adherence to this artificial “normalcy” and its conflict with people’s actual reality that is behind many cases of “mental illness.” This is very different from accomplishing what the client personally wants to create as their own “normal” mode of operation. What I find abhorrent is when therapists/counselors/psychiatrists define “normal” for the client and feel their job is to make them “fit in” better to society, rather than finding their own definition of “normal” that allows them to be comfortable in their own skins.
As for pissing of psychiatrists, it depends if the psychiatrist is in a position to influence your reputation or your employment potential. There are definitely situations where one’s survival as a therapist in a particular institution depends on not being too vocal about critiques of the DSM or “medication” use. I respect anyone who can operate “behind the lines” without being beaten down or giving up. You appear to have established a certain level of respect and independence that has allowed you to be a maverick with limited consequences, but that takes time and skill to develop, and for some, it appears to be beyond their capacity. Working in a psychiatric institution or one controlled by psychiatric thinking can be extremely oppressive toward the workers as well. It takes a lot of courage not to pass on that oppression to the clients.
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I never really thought about it, but you’re right, the concept of “baseline” is totally bogus. It assumes a person is a fixed entity that is only temporarily impacted by life circumstances. This is rot, of course. People are always developing, and the whole idea of “therapy” ought to be to help someone move onward to their next step in life, rather than returning to some “baseline” equilibrium defined by another person.
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The link between psychotic experiences and childhood trauma (especially sexual abuse) is dramatically higher than the most optimistic estimate of genetic contribution. Yet billions continue to be spent on genetic research and almost nothing on the connection to abuse and cultural dislocation. And they call that science?
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I think there is a big difference between a person preferring a particular framing of their situation and a doctor claiming that everyone having a particular behavioral manifestation is suffering from “X disorder.” We are all entitled to view our circumstances in a way that makes sense, but doctors are claiming to have some superior knowledge of the situation. Making unsubstantiated claims of understanding situations that are scientifically inconsistent or mysterious or invalid is something no professional should be allowed to do. I see it as extremely damaging to our society as a whole to allow these false claims to be viewed as some kind of scientific truth. At the same time, I have no problem with anyone choosing to view their own problem as a “mental disorder.” I just don’t support doctors making this kind of assertion unless there is actually evidence it is true. Medical diagnoses should not be something people choose because they prefer them. They should be objectively measurable conditions that can be reliably identified and treated. OCD certainly does not meet those criteria, nor does essentially any other “mental disorder” in the DSM.
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Hi, PD,
I have to respectfully disagree with your assertion regarding therapists not being allowed to practice if they don’t follow the priorities you mention above. I have tons of experience with therapists, both as a part of the MH system and as an advocate for foster youth for 20 years. I can assure you that therapists are all over the place in terms of practice, and any generalization you’d like to make is not going to be accurate. Some are unwilling to give any direction at all to the client, no matter how bogged down they get, others think they know everything and constantly tell the client what to do. Some believe that everyone’s issues come from poor parenting, others believe that nothing in the past has any impact on the present. Some have people go over past traumatic events in detail, others avoid them like the plague. Some believe religiously in the DSM, others consider it ridiculously simplistic and only use it for billing purposes. Some seek to be empowering, others seek to define and solve the client’s problems for them. Some feel that sharing personal details of their lives is essential to a successful relationship, others consider any sharing a violation of “professional boundaries.” The only generalization that can be made about therapists is that there is no consistency regarding expectations or results.
I do get that the CONCEPT behind therapy suggests that fixing the person to make them more “normal” is the goal, and I of course find such a goal abhorrent. But therapy for the most part can be whatever the therapist and client make it, and some people report very positive experiences with therapists that have helped them change their lives for the better. (Though I have to admit that such reports seem to have become rarer over the decades.)
Bottom line, I think comments about the therapy industry as a whole can be reliably made, but generalizations about what would happen to a particular therapist if they didn’t toe some imaginary party line do not line up with what I’ve seen. Therapists can generally do whatever the heck they want, as long as they can bill the insurance company for their work, and as long as they don’t piss off any psychiatrists they have to answer to by threatening their label-and-drug gravy train.
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The fly in that ointment is how one decides which person is qualified to be a therapist. I personally think the only measure of success is the experience of the client in meeting his/her own goals during the process. At this point, unfortunately, it appears that “Caveat Emptor” is the rule of the day.
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“Equilibrium?” It was Christian Bale, not Tom Cruise. I get them mixed up sometimes.
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This would not surprise me much. There has always been a strong undercurrent of racism amongst our ruling classes. It became unfashionable to say such things in public, but it’s amazing how many people still express this kind of feeling behind closed doors.
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Once again, I think we see how the labeling process actually does as much or more harm than the drugs themselves. What if we just said, “Here are some strategies for those who want to figure out a way to reduce unwanted compulsions” or something like that. Why not just describe the problem in terms that are meaningful for the client, and work toward the client’s goals? Why do we have to ascribe some critical label to the behavior, rather than just identifying that it’s something the client wants to change?
It is unfortunate that some good tips and ideas can be obscured by these medicalizing terms. I hope we as a community can work to tell the difference between our cultural training to use medicalized terms and the actual potential of the interventions being discussed. Some people with good ideas haven’t yet figured out the problematic nature of these terms just yet.
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I think the problem is that the FDA is loaded with industry insiders who think like Big Pharma and don’t ever question their intentions. And those who do challenge the industry have reportedly felt attacked for speaking up. It may not be direct corruption, but it’s certainly “insider trading,” or as you called it, “Cronyism.”
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Exactly. That’s why I believe in many ways the labels are far more destructive than the drugs they prescribe. The labeling alters social perceptions of the PERSON who is so labeled, and alters our attitude toward trauma – it moves from compassion to “let the victim beware!”
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Was Tom Cruise in it? I think I remember this movie.
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Wow, I didn’t know that!
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Well, I can agree with that. It seems we are pretty much agreeing with each other here.
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Not sure I agree with you, Ron. I think of survivors of domestic abuse – they are or should be proud that they have survived such horrific abuse and continue to lead semi-functional lives in the wake of it, even if they fully know and understand that they have to continue to work on overcoming the damage done to them. It’s possible to be proud that you came up with ways to get through something difficult while still recognizing that one’s life can be improved yet further by continuing efforts.
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They will always tell parents that “untreated ADHD” is associated with higher rates of delinquency, school dropout, drug use, lower test scores, lower college enrollment rates, lower self-esteem and so forth. What they DON’T ever tell them is that “treatment” in the form of stimulant drugs has never been shown to improve ANY of these outcomes! It’s a real flim-flam job, though I sometimes think the teachers themselves have mostly been flim-flammed and don’t even really realize what they are saying. It’s like a robot or computerized message, they just all say it because they’re programmed to do so.
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Posting as moderator: I would also add to Emmeline’s comments that choosing to publish a summary and link to a research article in no way implies that MIA approves of the research or supports the conclusions. It is simply a summary of research that some readers might find helpful. If you don’t, it’s fine to ignore it. I personally find MIA to be the best place to gather ammunition if I’m trying to influence a professional person to take another look at their belief system. Some people make up their minds based on research, and this kind of information is sometimes essential to counteract their narrative.
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I agree 100%, and this should be obvious. How can you send a “therapeutic current” when you don’t even know whether the brain is the causal factor, let alone what part is involved? Why is it not obvious to people that these folks are deceiving them?
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Makes me think of “Brave New World” by Aldous Huxley.
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And I think the challenge for me is that the degree confers some kind of confidence in people that this person knows what they are doing. If therapists are to be licensed, there ought to be a much more practical way to do so that is based primarily on the person’s actual impact on the client(s) s/he serves, rather than how many years of education s/he may have consumed.
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And in too many cases, that bullying is passed on down to the kids, who then pass it on to the lower status kids among the group. Bullying doesn’t start with kids, it starts with adults mistreating each other and then mistreating the kids in their charge.
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In other news, hitting people on the head with two-by-fours leads to head pain and lumps and sometimes brain damage, depending how hard you hit them.
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It is my understanding that lot of the “paraprofessionals” used by Mosher at Soteria House were people who had used hallucinogens and had experience as “trip guides.” There are many ways to learn the necessary skills to be a good helping person. And it should be very, very clear that obtaining a Masters Degree or Ph.D. is no guarantee that a person will learn these skills. It is unfortunate that the conferring of an advanced degree is assumed to indicate a minimal level of interpersonal competence when there is really no way to assure such competence by any educational approach now known.
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But “authority” is not the same as “authoritarianism.” Authority will always exist, often quite legitimately. Authoritarianism can be resisted.
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I think “trauma” can only realistically be defined by the person reporting the experience. Trying to set some kind of standard only gets us confused. Some people are sexually molested by a family member, yet are believed when they tell their parent or loved one and are protected, and some of those people reportedly have relatively little long-term impact from the experience, while others find it horribly traumatizing. Some folks are yelled at by a parent or teacher or left on their own very young and feel frightened enough that it ends up being a lifelong issue for them. I think you get to decide how traumatic an incident that you experience is for you. Anything else is just authoritarian invalidation of your experience.
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There are all kinds of fundamentalism, which is why I say that the real enemy is not the Right or the Left, but AUTHORITARIANISM in any form. A certain amount of agreed authority is needed to accomplish many tasks, but the assumption that there are authorities who are “right” and that those who want to be successful have to merely follow the instructions of the wiser “guide” or “leader” without having to think too hard is what screws us over. This happens with a lot people who are hard-line conservatives and a lot of people who are hard-line liberals/progressives/whatever and it happens to lots of folks who don’t identify with either end of the spectrum. It’s not a left-right issue, it’s an issue of whether people want to actually solve real problems or feel safe being in the middle of an ideological herd and not have to tax their intellect or their emotions too much.
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Wow, powerful post!
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Amen to that!
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A little confused by this, because I didn’t suggest that Marxism was a solution. I’m asking what it is? I agree that good must defeat evil, but what is the mechanism by which that happens on a societal scale? I don’t think there are any simple answers, but I think humans tend to be easily mesmerized by attempts to present simple answers, whether it be total government control over everything or elimination of all regulations and letting the “free market” save us all, or following some spiritual leader who seems to “have the answers.” Saying “socialism is bad” is no more sensible than saying “socialism is good.” There are clearly elements of socialism that are embedded in any Western democracy, and there are free markets operating in the most totalitarian economies. It’s not a black and white thing to me – it seems we need a balance between freedom to exercise our own ideas and objectives and the need to act together as a society to make sure that people’s rights are not violated.
Or to put it in terms of an old joke: What’s the difference between Capitalism and Communism? In Capitalism, man exploits man, while in Communism, it’s the other way around.
We can do better, but I think we have to have a practical way for “good to fight evil.” I don’t think it’s simple, and it most definitely doesn’t involve trusting all or most corporations to be on the side of “good.” Especially Big Pharma!
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I do feel compelled to add to your narrative that the current “drug first and ask questions later” approach to “mental health” is driven to a very large extent by pharmaceutical companies in the interests of maximizing profits at the expense of the “patients.” This is not Marxism in action, but the profit motive. Of course, we can go off into explaining how “big government” makes this all possible, but government corruption is also a function of too few people having too much money and using it to influence politicians to do their bidding. So as much as an actual “free market” arguably has shown some large-scale benefits, at least for a proportion of people participating, the redistribution of money to those who already have money and power is something that has to be addressed in my view. How do you see this happening? How do we reduce the vast influence of big pharmaceutical money that is driving this “epidemic” of invented “disorders?”
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What specifically do you have in mind?
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I would add that there is plenty of evidence that maternal SSRI usage is associated with increased autism rates, and that the increase in autism diagnoses corresponded to big increases in SSRI use by adults.
Of course, there is also the loosening of “criteria” for autism and the constant seeping in of the idea that “diagnosing” kids is more effective than understanding them.
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Posting as moderators:
Sorry, it seems to have been moved off. Essentially, all comments are going to be read first before they are posted. This will eliminate spam as well as rude or disrespectful comments in advance, rather than have them posted all day before I can get to reading them. It will slow down the rate of posts, but we have extra people looking over and approving comments at different times of the day, so it shouldn’t be too much different than it is now. But if it really affects your experience, Bob Whitaker is available to answer questions and take feedback.
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So what I think you’re saying is that the very act of calling something an “alternative” validates psychiatry as providing a useful service. Am I getting that right?
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Sure thing.
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Of course, this begs the very important question of why someone would have to argue about whether or not someone’s behavior is considered a “disease.”
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The “therapeutic” and toxic levels of lithium are the closest for any drug in use. That should tell us something – it sounds like we are adding enough lithium to ALMOST poison the “patient.”
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The other problem is that the FDA is often staffed with people who come directly from the pharmaceutical industry. There is a lot of pressure to approve things that are not effective and/or to minimize the adverse effects.
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Yeah, kind of like “researchers discover that planting strawberry plants frequently leads to strawberries growing.” When you set up incentives to cheat, people are more likely to cheat. No research needed.
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All comments are now being pre-moderated. There is a note about this from Bob Whitaker on the home page toward the upper right.
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Well, at least Santa Clause brings something fun or tasty for Christmas! If only psychiatrists handed out chocolates instead of drugs!
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Very well said!
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In other words, people who are abused as kid are more likely to abuse their kids than those who aren’t. The old cycle of abuse idea. Hardly groundbreaking research here. The disturbing part is that everyone in the field doesn’t already know that childhood abuse is behind much of what is called “mental illness.” Treat kids better and “mental illness” will be reduced. But oh, that’s “blaming the parents,” isn’t it? Safer to blame the kids’ brains.
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Again, you are clearly overgeneralizing. There are therapists, admittedly fewer and fewer as the DSM is more dominant, but there are therapists who support taking action to alter one’s circumstances for the better, including taking political action if one is so inclined.
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I actually think there is another factor – I think people often become worried that THEY are the “crazy ones” and are happy to find someone else to be labeled “crazy” so they can feel more “normal.” I think most people suffer confusion, anxiety, depression about our current society and the fragmented and often conflicting and competitive roles they have to play to survive, from grades in school right up through competition for jobs and wages. They seek some sort of order that they can hang onto, including looking for someone “below” them in the social order so they can feel like, “At least I’m not as messed up as THOSE people!” Psychiatry is happy to take on that role so that this kind of “othering” has the backing of the “authorities.”
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I think it is an excellent and important question. It is the kind of question that gets people tied up in knots when someone suggests eliminating psychiatry altogether. While they don’t understand that psychiatric practice appears to actually increase the suicide rate, people will want to know where they can go for help if there is no doctor/psychiatrist/hospital to go to. I’m not sure I have a great answer yet.
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Soteria House provided this kind of option back in the 80s. Naturally, it was quickly de-funded, as it threatened to undermine psychiatry’s market share just at the time they were trying to expand it.
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How do you know he was ‘born like this?’ You are assuming a lot here.
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The lack of objectivity of these “diagnoses” makes the concept of “overdiagnosis” essentially meaningless, as there is no way to ever tell what the “correct” rate of diagnosis should be.
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Yeah, obviously incompetent in data manipulation and invention. Need some further training, I guess…
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I’m not saying that at all. I’m saying that grouping people together based on their emotional state is not going to lead to any positive conclusion. Most emotional states are the result of our interaction with the environment. Anxiety is mostly caused by experiencing scary things, depression by hopeless experiences. Now anxiety can also be created by deprivation of oxygen or by taking a lot of stimulants, which are physiological causes, but the idea that there is ONE physiological cause of anxiety is just plain wrong. So what I’m objecting to is not the idea that biology can cause anxiety in some cases, but the idea that anxiety is all caused by the same thing every time, or that anxiety is even always a “disorder.” Anxiety is our body’s way of telling us that something scary is happening and we need to take action to remedy it. What it is that is scary can be very different, depending on the person and the situation. It is not a “mental illness” to be anxious. It may be an indicator of some other illness, but anxiety itself is not an illness. It’s a natural state of the body under stress.
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I concur. Guilt, like all of our emotions, has a survival role to play in our lives. Psychiatry’s first mistake is identifying emotions as being “good” or “bad,” and trying to eliminate the bad ones. Emotions aren’t good or bad, they send us messages about how we are surviving and what we can do to survive better. Learning to listen to our emotions is a part of being a rational human being.
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I have not found that to be true in all cases. I’ve certainly seen many who do, and you may not have encountered any who don’t, but psychotherapists are human beings, too, and since they don’t really have any specific guidelines, my experience is that everyone pretty much does what they think works. Whether they support political activism for their clients is a function of their personal beliefs and goals. If they are a “top-down” therapist who believes that they know best, they can be extremely invalidative. But there are therapists (admittedly in the minority in my experience) who truly do believe in empowerment of the client to be more capable of living his/her life the way s/he wants to, including taking action against oppressive agents if need be. And there are a whole lot who are in the middle, trying to be helpful at they can but not really having a good idea of what they are trying to accomplish.
As I said before, generalizations about “therapists” lead to mistaken ideas. Not all therapists are alike or believe in the same things.
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Wow, she was enmeshed AND distant at the same time? That takes some talent!
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Commenting as moderator:
A reminder that I am not sitting at my desk with a little red light that goes off when someone posts a comment that requires my attention. Making critical comments regarding moderation decisions is not appropriate in the comments section, as it leads to escalation and further difficulties, and it is for that reason a violation of the guidelines to do so.
If you have concerns about a comment, please contact me at [email protected]. I may be up to a full day before I’m able to deal with the issue, because I only work 5-10 hours a week and have other things to do besides moderating at MIA.
In the meanwhile, please don’t make things worse by attacking the commenter yourself or by criticizing the moderation process when I may not have even read the comment for moderation at the point you see it. I left some pointers on how to respond appropriately to inappropriate comments in my original blog:
https://www.madinamerica.com/2018/08/thars-new-sheriff-town/
I appreciate your understanding and patience with this process.
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Gosh, a brain scan finding claims to be legitimate, gets big press, and then is refuted shortly after. Who saw THAT one coming?
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Making gross generalizations about therapists leads to errors in judgment. There is a huge range of therapists/counselors out there with different orientations and priorities. I was fortunate to have one who was very empowering and focused on me getting better at accomplishing my own goals. She was very much “trauma informed” and the results were quite significant for me. Of course, this was back in 1981 before the DSM III and the ‘chemical imbalance’ model had totally taken over, but there are still folks out there doing good work, though I most definitely consider them to be very much in the minority these days. I’ve certainly spoken to folks who became more radicalized through therapy, not because the therapist wanted to “radicalize” them, but because as they woke up to what led to their so-called “mental illness,” they realized that radicalization was the path they needed to take. I’m one such.
In fairness, I know a lot more stories about therapists who were either ineffective or were invalidative and destructive, and more and more these days believe wholeheartedly in the DSM and in drugs for “mental illnesses.” So I’d be super careful looking for a therapist, actually, I probably would not consider it for myself these days because I know more than most of them. But there are still some competent people out there.
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Hey, I suck at selling, too! I can sell ideas, but somehow whenever money gets involved, I seem to withdraw or collapse!
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Catch-22.
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That’s the basic lie, I agree. Calling it “mental illness” means it is the client/patient’s problem instead of a natural outgrowth of living in a social system that is designed to allow a small number of people to thrive at the expense of the masses. “Diagnosing” people clearly and intentionally puts the problem on the individual and exonerates social institutions from any responsibility.
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Angry is definitely more productive than guilty, but both are understandable and totally to be expected. Unlike what the psychiatric profession wants us to believe, feelings are actually a normal part of being human!
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I found this very moving. It seems to me that you have learned that humility is the beginning of understanding and being of help to another human being in distress. Sadly, humility is sorely lacking in most of our ‘mental health’ services and professionals. The entire enterprise is based on hubris and prejudice. I wish your attitude would spread among those who errantly believe they are helping. Being willing to hear that kind of feedback is painful but really the only path to gradually unraveling the truth.
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It was a classic example of co-optation, a very effective strategy that oppressors have used as long as there have been oppressors.
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I agree. Didn’t I say that?
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It’s pretty freakin’ bizarre. I am sure if you thought I said otherwise, you misinterpreted. I have always wondered how ANYONE could look at this idea, “Gosh, I’m feeling depressed, maybe passing an electric current through my brain and inducing a seizure might help,” has got to be pretty darned confused, and anyone who would do it to someone else is either completely lacking in judgment and empathy or else enjoys making others suffer. I am totally against drugging people for “mental illnesses,” but “ECT” seems even worse.
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I agree 100% that it is an attempt to “get ahead of the story” and control the narrative. I believe it only is happening because the true information about the ineffectiveness and dangers of psychiatric drugs are coming to the surface. They have to deflect attention somewhere, so they are choosing to focus on “withdrawl effects” in order to keep their “diagnostic” and “treatment” systems as intact as possible. So as distorted as the story itself may be, it is a sign that the recent increase in pressure to get the truth out is having an impact. “Cracks in the armor” make space for a well-placed sword strike to do some real damage!
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Fearing medicine is rational. It is now the third leading cause of death in the USA. Though massages and acupuncture are not part of that picture.
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Just to be clear, “Biological psychiatry” was alive and well long before the DSM III. Insulin coma therapy, lobotomies, “hydrotherapy,” and all sorts of weird practices went back decades or even centuries before 1980. I would say, though, that 1980 and following was a shift toward a more systematic marketing and disinformation campaign to intentionally and vastly expand the scope of psychiatry’s influence, especially into the “markets” of children, the elderly, and those formerly considered “neurotic.” There was also a coordinated campaign to minimize the impact of social conditions and trauma that served the purpose of improving psychiatry’s “brand.”
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An excellent analysis from start to finish. As a former teacher and classroom aide, I agree with every word.
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I believe the reference to “materialism” refers to the idea that the human is just a body, and that nothing can exist outside the physical plane. Whether that philosophy bred psychiatry, it has certainly been seized upon by psychiatry as a means of “proving” their point that “mental illnesses” are in the brain – “because if they aren’t, where could they be?” You and I have both made the point repeatedly that the assumption that mind = brain is at the crux of psychiatry’s “brain disorder” concepts. I think that is the aspect of materialism being referred to here.
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“Biological psychiatry” goes back way before Thorazine. But I certainly don’t hear Bob calling for a return to the “good old days.” I see him identifying the DSM III as a big shift toward “diagnosing” teens and children, which was a lot less common before that time. They were identified as a new “market.”
But you make a good point that the attack on the patients’ liberation movement appears to have been coordinated with the release of the DSM III. It stands to reason that if psychiatry was interested in altering their “image” to appear “more scientific,” silencing those who would tarnish that image would have to be part of the plan.
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And more scientifically valid.
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So as I said, bloodletting is MORE EFFECTIVE than psychiatry!
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As long as there are tests that can reliably and objectively distinguish one category from another, we can have actual diagnoses. But I very much doubt that all or even most of the people currently diagnosed will fit into any of these measurable categories.
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There is actually no reason EVER to give “antidepressants” to a child, as there is no evidence that they “work” even in the short term. Of course, they don’t really “work” for anyone in the long run, but apparently the placebo effect is stronger in adults, I guess. Even psychiatry’s own researchers admit that kids don’t benefit from “antidepressants.”
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They might also consider altering the structure of schools to lessen the performance pressure and increase the sense of safety and acceptance for the kids they are trying to teach.
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I will say, though, that there appears to be a move to acknowledge withdrawal symptoms from “antidepressants” in many media stories all of a sudden. Someone else said this, but I think it is a “damage control” approach, where things are so bad they have to admit something, but want to direct the “flow” to a place where it will minimally interfere with their financial concerns. So it IS a victory of sorts that the narrative has changed, if only in this one respect, and I don’t think it would have happened without MIA and other efforts to make the truth known to the public. Keep the heat on!
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I actually think Laura’s story is very common. Many people become ensnared in the system because they trust that the “professionals” know what they are doing. Once they are in, many are scared into compliance by stories of what will happen if they go off the drugs, and if they do try, no one is there to explain about or help with the withdrawal symptoms. So they start falling apart when they go off the drugs, and it seems that the psychiatrists were right so they stay on for years or decades. It’s not a rare story.
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The obvious point that is overlooked here is that the psychiatric profession “diagnosed” these people “treatment resistant depression,” when in fact there was nothing wrong with them that some artificial hope and time passing could not change. How is it possible that these people were deemed “treatment resistant” when they were completely capable of “self-healing,” if there was even anything to heal in the first place? Rather than “regression to the mean,” is it not in fact likely that the withdrawal of psychiatric diagnosis and “treatment” and the hopelessness that it conveys was the biggest variable in these miraculous recoveries from a supposedly hopeless condition?
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It seems so odd that those in the field are comfortable with the idea that we can choose the theoretical framework we like or don’t like. Can we decide we don’t like the “theoretical framework” for cancer? If some people don’t like the idea that it’s an overgrowth of cells, and prefer to think of it more as a focus of negative energy, and others see it more as a new evolutionary pathway, do they get to pick?
Real diagnoses refer to real, observable, measurable physical phenomena. No one has to vote on whether a broken leg is broken, or how you fix it. The very fact that we’re having this kind of discussion is proof enough that the “professionals” don’t have any idea what is going on. STOP DIAGNOSING, at least until you actually figure out what small percentage of the “mentally ill” actually have an observable physical problem you can see, measure, and effectively address!
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“Transitive diagnosis” still seems to medicalize distress as being somehow abnormal. Why bother with diagnosis at all? Why not talk about ongoing learning and development of new understandings of the world or new skills for approaching problems facing the client?
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Actually, there is MORE evidence for the usefulness of bloodletting than psychiatry:
https://www.latimes.com/archives/la-xpm-2001-aug-06-he-31093-story.html
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“Radical” is always the accusation of the person benefiting from the status quo against anyone who wants to change it.
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That is what I have always found. If we assume that the person has a purpose for their behavior, and that our job is to understand it rather than just stopping anything we find inconvenient or uncomfortable, we can make real progress in creating better communication and understanding. And guess what, when we do that, a lot of the “bad behavior” goes away on its own.
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Taking a stand against the Viet Nam war in the mid 1960s, not to mention marching the streets to end racism and getting locked up over and over again, and having poor people march en masse to Washington DC to protest, certainly doesn’t seem very “middle ground” to me.
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Confirmation bias is very strong. Few people believe that they could be doing damage by their own usual practices.
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They may cost less in the short run, but a lot more in the long run.
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Posting as moderator: JeffreyC, if you email me at [email protected], I’d be happy to look into this issue.
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My favorite was, “Damn it, Jim! I’m a doctor, not a tree surgeon!”
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Sounds like you got it. Thanks!
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I’m glad you mentioned oppression. The big shortcoming of this article is that it makes it seem like there are two equal ideas competing to see which one comes out on top. This is not what is going on. One idea is being FORCED on people, both practitioners AND clients within the system, and the other is being actively suppressed, not because the dominant one is “better,” but because it is more financially rewarding for certain people and because it helps those in power relieve themselves from any responsibility for the damage they cause. I eventually concluded that I had to get out of the profession completely, because change from within seemed impossible and because I felt I was colluding just by participating in such an oppressive system, even if I could help a small number of people along the way to escape or minimize their experience of oppression within the system.
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I am not at all being facetious. You write very well and articulately, and have important things to say. I say this as a writer myself. Sometimes writing the book is in itself a very empowering exercise, regardless of who reads it. Mine has not sold a lot of copies, but I figure if even one person is helped by what I have written, it makes the entire process worth my time and energy.
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I am not sure the “middle ground” you’re talking about is what was meant in the article. Your sounds more like a Hegelian “synthesis,” or like the Buddhist concept of the “middle way,” selecting neither of the two opposites. I think what the article is talking about is something more along the lines of, “Well, ECT does do some brain damage to some people, but let’s not forget that other people say they really like it!” Or, “Let’s not be too extreme in how we talk about psychiatric drugs, because some people who take them might have their feelings hurt.” It’s a call for not speaking the whole truth because it’s uncomfortable. Very different than collaborating to find a solution that works for a wider range of people involved in a conflict.
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I totally get this. A ton of foster youth I worked with were diagnosed with “bipolar” or “emerging schizophrenia” based 90% on the fact that a parent had such a “diagnosis.” Despite the fact that not one of the “diagnoses” has ever been connected to any genetic anomaly, it’s assumed that “he got it from his mom.”
The expectation of “medication compliance” from “therapists” is also not surprising to me. Sometimes it seemed they spent more time on that than on actually trying to help the kid sort out how to deal with all the bizarre dynamics of being in an abusive family and then being in foster care. I mean, if you can’t get why a foster kid might be feeling depressed or anxious or angry, what the heck are you doing trying to provide “therapy” to them?
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How about an electrician with a degree in neurology?
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You should write it!
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Yeah, I know. He does not check in here or post responses for whatever reason. It might be very helpful to be able to get clarification from him, but I suppose he gets to decide where he wants to put his energy.
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Though I guess it could help you screen out the psychiatric “true believers!”
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Ugh, really? Refusing patients who aren’t in psychiatric care? That’s appalling!
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“A nod is as good as a wink to a blind bat, eh?”
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It has always bugged me when someone says, “Oh, they JUST need attention!” As if needing attention is some trivial thing, or that the child is being somehow selfish by needing it. Attention is survival for young kids, they will literally DIE without attention. And the need for social connection is vital to all humans. The minimization of kids’ need for attention is a sign of people who really don’t like or understand children at all. Which says a little something about the psychiatric profession.
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How about “inappropriate expectation disorder?” A lot of teachers and parents have this problem. Maybe there’s a drug to “treat” it? /s
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Nah, if their brain chemistry were right, they’d be totally OK with being poor and hungry and having to work two jobs to barely survive. I mean, what’s depressing about THAT?
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I agree, very few non-medical folks know anything much about benzo withdrawal. Many have been told that benzos don’t create dependence if used as directed, in direct contradiction to the published product information. There is a lot of misinformation out there.
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I doubt that Peter Breggin would disagree with you on that point. I took it that this was what he was talking about in the article, the lack of love and compassion coming from the “professionals,” not from their victims.
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Posting as moderator:
There is certainly a VERY large difference between arbitrary and ambiguous. Arbitrary would suggest a complete lack of any kind of standard except a person’s whim, whereas ambiguous would suggest that the standard is not black and white, which is certainly the case in any moderating scenario.
It would certainly be possible to censor people based on the content or position their comment takes, but I think a look at the wide variety of comments and views that are allowed to stand that at least in general nothing of a censorship nature is occurring. Of course, when there are subjective standards, individual bias comes into play, and if there is any preferential treatment of which I am unaware, it would be coming from this kind of place rather than an intent to suppress or promote different views. That said, I can say with absolute certainty that I leave most posts up, including ones with which I personally disagree or some of which are critical of MIA or Robert Whitaker or a particular article or author, and the only intent I have is to make sure that people are “playing nice.” There ARE standards, and they are published standards, and decisions regarding moderation must be held to those standards. That’s what moderation is about. It is not based on any intent to sponsor or suppress any particular viewpoint as long as it is expressed within those rules, which everyone can read and which everyone implicitly agrees to by choosing to post.
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Yes, sadly, wisdom can not be mandated. It can only be arrived at through experience, and there will always be fools aplenty for the unscrupulous to mess with.
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Especially powerful when your current way of thinking allows you to justify making a lot of money by doing things of questionable validity.
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Commenting as moderator:
We do not moderate for content here. People are free to express whatever views they want to express. The editorial staff also selects a wide range of articles, many of which are not written for MIA but are gleaned from various places on the web. The only moderation that occurs is for potentially offensive or hostile language that would make the comments section an unsafe place for people to express their views. You are, of course, welcome to respectfully express your opinion on the value or lack of value of such questionnaires or articles regarding them.
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Oh, sorry. I got excited for a minute there. Laura was at that one, too. Only time I met her in person.
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They don’t forget, they choose to ignore.
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I think you are perhaps not taking into account the impact of the lies and mythology spread so widely by mass marketing. I personally think it should be illegal for ads to claim things that aren’t true (actually, I think Pharmaceutical ads should be banned, as they are in every other industrialized nation except New Zealand), and I think it should be illegal for doctors to lie to their patients about what is supposedly known about “mental illnesses.” I also think it should be illegal to invent “diseases” by committees.
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In other words, the 10% recovery rate is likely not due to antipsychotics, but likely in spite of them.
In what other area of medicine would a reduction of recovery by 2/3 be considered a “success?”
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Or perhaps they did not want to offend their advertising sponsors.
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The suicide rate may also be related to the “treatment” they are receiving, i.e. “antidepressants” and benzos and sometimes stimulants. Besides, who says you have to be in combat to see or experience atrocities or trauma in the military?
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Posting as moderator: I will try to find it and fix it. Thanks for letting me know.
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I like your revised title! Much more on point.
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Horrifying, but not entirely shocking to me. People who like power and control like to find jobs where they “care” for vulnerable people so they can get their jollies.
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I had a similar thought. I believe he’s talking about the caretakers in people’s lives starting from a place of love. I say this based on past reading of his works. He’s very big about the adults being responsible for creating a safe and loving environment for their children, and doesn’t think kids should have to worry about taking care of the adults in their lives. By extension, it would make sense that he means that the “mental health professionals,” if that term applies, would have to be loving toward those in their care. I doubt very much that he means that if you meet your psychiatrist with love, that s/he will somehow magically become a good and loving person. We don’t live in fairy tales!
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Your sense of responsibility is orders of magnitude higher than that of a big corporation. Or apparently than most individuals. I wish more other people felt the same as you do about it.
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Hey, I was at the 2014 Philly APA protest! I wonder if we met without realizing it?
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Not a problem.
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“What I think best for the patient’s illness.” Yeah, that sounds DEEPLY grounded in “Science.” Sheesh!
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I don’t have a lot of time to make comments, John. I am mostly moderating others’ comments for appropriateness, so I don’t have a lot of time to make lengthy remarks. Additionally, you have summed things up so well in most cases that there isn’t much to say besides, “I agree, and I’m glad you said that!” You’re talking about a lot of things that occurred just as I was coming to adulthood. I grew up in the 60s and early 70s and related to the student protest movements big time. The election of Reagan was such a grave disappointment to me, yet the media and a lot of Americans somehow continued to portray him as some kind of hero or amazing leader when he was mostly a figurehead B-movie actor acting out his greatest role. The same scum that were really behind him were behind Bush, Bush II, and continue to have influence on Trump, though Trump is pretty hard to control. These are not nice people, and you are absolutely right that they were terrified by the youth movements and did all they could to shut them down. Limiting employment and creating economic anxiety were not accidents that happened, but in my view were part of the plan to get us so worried about our daily survival that we (especially the young) had no time or energy left for organizing. It’s been very effective, unfortunately.
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There are most definitely “secondary gains” for people who’d rather pretend that emotional distress doesn’t exist or is pathological. Makes it easier for folks to discriminate and dismiss anyone whose behavior they don’t approve of.
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Commenting as moderator:
John, I understand your feelings, and a lot of people feel that way. I’m going to post this not only for you, but for anyone who is feeling that way. It is an act of power for me or another moderator to choose to remove what someone has posted, and that can easily feel like bullying to anyone. I try to be very, very sensitive to this fact when I make moderation decisions.
I guess the question is what is meant by “censorship.” If I or anyone is removing comments because their content is considered unacceptable by the management, that would be censorship.
Definition:
“the suppression or prohibition of any parts of books, films, news, etc. that are considered obscene, politically unacceptable, or a threat to security.”
https://www.google.com/search?q=censorship+definition&rlz=1C1RLNS_enUS769US769&oq=censor&aqs=chrome.3.69i57j0l5.4226j0j7&sourceid=chrome&ie=UTF-8
What happens here is that we have certain standards of behavior that are expected and are implicitly agreed to by anyone who posts. These standards are posted and available for anyone to read. When we remove comments, it is intended ONLY to reflect concerns about whether or not it violates the guidelines that are written on the site. I always try to work with anyone whose comments are moderated and give them an opportunity to re-post an edited version that doesn’t violate the guidelines. And I have in a few cases been talked into leaving the post unchanged once I understood the intent.
So no, we don’t do censorship here, though I understand why it might feel that way. Anyone is free to post any idea or thought or story they have, as long as it fits within the posting guidelines. In fact, I sometimes get pushed to censor certain viewpoints that aren’t popular in the community, and I always refuse to do so. Everyone has a right to their viewpoint and to express it here, as long as it is done in a way that respects others’ rights to do the same.
I hope that clarifies things, and I do apologize for any hurt feelings that may have happened along the way.
—- Steve
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Yeah, science is all about voting on what’s true or not true. “Committee science” – that’s the ticket to truth!
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If lying as a professional were forbidden, that would bring an end to psychiatry in short order!
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It sounds awful, John! No one should have a parent who doesn’t care. Sadly, it happens far too often. I have worked with foster kids for over 20 years and I have seen a lot, including a teen whose mom in fact backed over her in the driveway. She said she THOUGHT it was accidental, but couldn’t be sure. It’s just wrong to have to feel that way about a parent or caretaker!
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Woah, wait a minute – are you suggesting that being depressed MIGHT be related to having depressing things happening in your life?? Nah, that’s just TOO far fetched – makes so much more sense to blame our brains. Or more profitable at least…
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Once again, your analysis is spot on. He broke the ATC union which had a chilling effect on unions nationwide, and he also promoted the idea that if you’re not doing well, it’s all your fault. “It’s Morning in America,” and if you’re not happy, you’re not trying hard enough. Very good fit with the psychiatric worldview, which not coincidentally began to expand its influence at just about the same time.
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It is, indeed.
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I agree absolutely. Americans in particular are awful about remembering even recent history, which means they don’t really understand what’s going on today. “Those who forget history are condemned to repeat it.”
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You said a mouthful! I think that is the real key to good parenting – to teach kids that it’s OK to be who they are and it’s safe to bring up stuff that is uncomfortable. Of course, kids need a lot of guidance and love, but it is so important for them to be able to “bring what’s inside to the outside.” In fact, that sounds like a great title for a book!
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Of course, you are grieving. It is hard for me to understand how people can be so callous? Is it just because they don’t want to feel the grief themselves? But in any case, it means nothing about you. You’re entitled to feel whatever you feel, and the heck with anyone who says otherwise!
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This is such a sad story, and really illustrates one of the many unintended consequences of forced “hospitalization.” It is also pretty awful that you are “used to” being looked at in a negative way. I am certain you do not deserve such treatment, yet a “diagnosis” (especially of “Borderline Personality Disorder”) seems to leave one open to any sort of denigrating comments from those claiming to be “helping.” It kind of makes me ill.
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Commenting as moderator:
I have not moderated any of the comments between Krista and Kindredspirit, but in both cases, some of the comments are getting pretty personal. I’d ask you both to back off and refocus on the content of the article, or to come up with a more respectful way to discuss the cat issue so I don’t need to intervene. Thanks!
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I really don’t think it is, if the “bashing” is coming from the victims of the system. I consider it quite natural and necessary for oppressed people to gather up their energy and get good and angry before they can fight back against the oppressors. I don’t consider it quite reasonable to expect those who are being harmed to differentiate between the “good workers” and the “bad workers.” While I think intentional meanness and cruelty should not be practiced against anyone for any reason, but I guess I see it as the job of the “good mental health workers” to listen and hear the harm done by our colleagues and to help the person in question come to terms with it and decide what they want to do about it. At the end of that, it’s up to them to decide if you or I are an exception to the rule or not, no matter what we think of ourselves. And perhaps if we do a good enough job, we can introduce the possibility that not ALL “mental health workers” are abusive or condescending.
I experienced plenty of oppression from my supervisors when I spoke up and called out things that were wrong and hurtful. But I can’t say I ever experienced the kind of uncontrolled harmful environment that was enforced on those our system claimed to be “helping.” It is different in both kind and in degree.
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I absolutely did. But I also saw it as kind of a negative turning point in our political dialogue, where leadership was being undermined by the corporate media in the interests of protecting the well off and the powerful.
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A lot of people read the comments but don’t respond. But you’re talking about a topic near to my heart, and most people aren’t old enough to remember the 70s any more.
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Too true! Whatever brings in the advertising bucks is what they play.
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I am so sad to read your story! I only wish it were the first or only one I’ve heard. I hope you can find a new direction for your life!
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I could not agree with you more.
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I think what he’s getting at is that psychiatrists pretend to offer the “quick fix” and take advantage of people who are looking for it. I think he’s said elsewhere that he’s not criticizing the patients, but the system for setting up rewards for being compliant and not asking a lot of questions but instead accepting their assigned “identity” as “mental patient.”
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It does really come down to authoritarianism.
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The way the system is constructed, and in particular, the faux “diagnoses” found in the DSM, make it easy to dehumanize “clients” and decide that treating them badly is “helping” them.
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I also remember that speech. It was prescient in many ways, but of course, the media panned it and no one listened.
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There really is more than one. They’re rare, but they do exist, in my experience. That’s why I try not to overgeneralize – I do want to support anyone who is working to stop the current label-drug-bill-and-forget plan.
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Way to think “outside the box!”
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Wow, you kick butt! I’m impressed with your history!
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This is an excellent example about how “privilege” works. Those running the show can do almost whatever they want and get away with it. Some choose not to, but they all have that privilege in the system. Those below them have to accept abuse from their superiors as they dish it out, but they have the privilege of dumping it on the person below them. They may or may not exercise it, but they do have that ability to do it and get away with it. So people can be and are oppressed and yet still have privilege over someone lower down in the hierarchy. I feel bad for those line workers, but they do have a choice not to pass it on and to challenge the oppressive environment they are working in instead of taking it out on the inmates. Someone has to make a decision to toss a monkey wrench in the works, and yes, it’s scary, but continuing to work in the oppressive system without challenging it is tacitly approving of it. That’s what eventually drove me out. I could no longer live with what I had to do, or should I say what happened to some of the people even when I did my job well.
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Well said, John!
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But perhaps taking the problem out of the realm of “medical care” would be facilitated if we stopped calling normal emotional reactions to difficult or painful circumstances “illnesses.”
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Thank you for saying this. I think your experience is pretty typical of “voluntary” patients. They have been told that this is the place they should go for help and that these people know what they’re doing. It’s quite a shock to arrive at the conclusion that they don’t.
I also very much appreciated that a PTSD “diagnosis” “allowed me to reframe how the trauma in my life had led to my mental distress.” This seems in my experience to be what most people really are looking for – a way to reframe their experience that makes sense to them. Sadly, the DSM “diagnoses” generally do the opposite – cause more confusion and minimize or invalidate completely the role of trauma in the genesis of one’s so-called “mental illness.”
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I think you may want to add one more incentive: parents or caretakers benefit from “diagnosis” by having the responsibility for figuring out what’s going on and how to help taken from their shoulders. It’s not because you need to develop more effective parenting skills – she has Bipolar Disorder! It’s not that you’re a boring teacher with poor classroom management – he has ADHD! It’s not that we’re neglecting our child – she has Depression! It makes it easy for parents, teachers and other caretakers to blame the child for their inability to care appropriately for him/her or to figure out what s/he needs.
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Looks like shuffling deck chairs on the Titanic. Same “disorders” clumped around into different groups. Same focus on “symptoms” instead of life conditions. “Meet the new boss, same as the old boss.”
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Exactly. Yoga is not just a stretching exercise!
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When the huge bulk of the research is paid for by industries who profit from it, it should not surprise us at all that any problems or concerns with the technology in question are buried as deeply as they can dig.
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If there is any hope of a scientific understanding of the human mind, Chaos Theory appears to be the only sensible way to start. But psychiatrists aren’t mathematicians for the most part, except that they do know how to calculate income as related to type of “treatment” offered, apparently the only graph of any real importance.
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Two excellent points, Lee. Morality and ethics are not scientific endeavors, and no amount of scientific experimentation can determine right from wrong – that’s an entirely human individual and social effort.
I have also argued that the “null hypothesis” for these drugs should always be that they ARE dangerous, and the burden of proof should be on the company selling the drug to prove convincingly that they are not. If they can’t prove safety, we should assume dangerousness and act accordingly. If we did, medical care wouldn’t be the third leading cause of death in the USA today.
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OK, I’ll bite: what’s an “austrolibertarian?”
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Wow! Well, at least they were direct and honest about their biases. No need to bother with THAT support group ever again! Did you ask the facilitator why this was a requirement?
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I think it goes even beyond that. There is an underlying need to believe in materialism, the idea that nothing can exist that goes beyond the physically observable and measurable universe. Any suggestion that there may be such a thing as a spiritual existence beyond the body, or even the idea that there are extra-physiological phenomena (like the mind) that might arise from the body but transcend it, seem anathema to such people. They seem to believe that materialism is the only way to be “scientific.” Ironic, as they are operating on a non-scientific assumption but are unable to recognize it because they’re so committed to making others whose beliefs are based on non-scientific assumptions wrong.
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You make a valid point. However, in terms of brain damage specifically, it seems likely that both could cause such damage in a similar way due to similar effects. They use benzos, for example, to detox someone from alcohol, so they’re almost interchangeable in terms of effects on the brain. As such, their damage profiles in the brain should be similar. It may be that the livers and hearts of the benzo users are not impacted in the same manner, though again, it may be very much dependent on dosage control, or lack of same.
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Sounds like a plan!
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Too true, John. We’d be far better off if the “professionals” started off with, “We really don’t know what they’re doing.” That way, we’d at least all be on the same page starting out.
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They mention “heterogeneity of groups of interest.” This is a very oblique way of saying that the people “diagnosed” with these “disorders” have little to nothing in common. Which can even more directly be reframed as “These diagnoses are all bullcrap!”
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Wow, who would have guessed?
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If opposing human rights abuses is labeled “antipsychiatry” (in its most pejorative sense), doesn’t that suggest that psychiatry is in favor of human rights abuses, and that to oppose such abuses is to oppose the mainstream psychiatric system?
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Indeed!
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Seems not unlikely. It’s a point I try to hammer home wherever I can. Few things irk me quite as much as the commodification of spiritually meaningful activities. Corporate capitalism can turn almost anything into crap.
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Since Benzos and alcohol both act on the same systems in the brain, if alcohol causes brain damage, it stands to reason that benzos would do the same eventually. Perhaps it depends on the person, dosage, and length of exposure, but it seems we ought to expect benzos to do such damage and be surprised if it doesn’t.
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Which goes to my statement that one group isn’t necessarily saying what the other suggests they are saying.
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Mindfulness is, in the end, a SPIRITUAL practice, which is grounded in Buddhism. Efforts to make it into a utilitarian tool for surviving the rigors of a heartless and isolating modern society I think disrespectful to the true purpose of meditation, which is to free the mind/spirit from its bindings to the cycle of life and death. There is a lot more than “brain activity” going on here!
—– Steve
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Commenting as moderator:
At this point, it appears that this thread has had plenty of time for everyone to air their views, and it feels like the comments have in some cases become excessively personal and disrespectful. My appreciation to those who have maintained equanimity throughout the discussion.
I will try to summarize what I see happening at this point. It appears that one side of the discussion is focusing on the need for survivors to take a leadership role in the antipsychiatry movement, and it appears that the other side is saying that professionals have a lot to contribute and that it should not be framed as an us-vs-them dynamic between professionals and survivors. I think both of these viewpoints have some validity and that it is very understandable that professionals and survivors are likely to have different points of view, and indeed are likely to have difficulty completely understanding where the other side is coming from. I’m also not certain that either side is actually trying to say what the other side seems to believe they are saying.
I don’t think there is a lot more to say, and it seems that further discussion, rather than leading to further clarification and understanding, is instead leading to more frustration, hurt feelings and hurtful comments. As such, it seems best that we close this discussion on this thread.
I am closing the thread for further comments. I will continue to moderate comments that have already been made, as it appears there are some which will need to be addressed, but we will now be ending further discussion on this topic thread.
—- Steve
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I would add that most people remain unaware of the frequent escalation of domestic abuse during pregnancy or after birth. A good percentage of the “postpartum depressed” are in such escalating relationships, but of course, everyone wants to blame “hormones.”
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I agree, John. There is frequently a collaboration between the parents, who want the professionals to “fix” their child, and the professionals, who want the parents’ support in keeping the child in “treatment,” with no respect for what is going on for the child. Often (not always) it is the parents or the family that needs to be “fixed.” It sounds like you needed support you didn’t get.
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And maybe we could put those “useless eater” babies to work a lot sooner, too! /s
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That is one of the less obvious problems with the DSM – it allows abusive parents and professionals to blame the children for their own inability to appropriately handle the children in their care. I read a study at some time in the past where children with abuse histories were significantly more likely to be diagnosed with “ADHD.” Some psychiatrist actually commented that this was because “ADHD” kids are more difficult and it makes it more likely that their parents will abuse them! The least powerful person always gets the blame when the DSM is involved.
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I believe it was J & J, and the drug in question was Risperdal.
Remember when their big seller was baby shampoo?
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My understanding is that esketamine is just one of the steroisomers (two different mirror image molecules) of ketamine, which contains both stereoisomers. What difference that makes is not something that is obvious. It could make a difference in some cases, but I’m guessing (as a chemist) that in most cases, the actions of stereoisomers would be very similar unless they’re engaging some system that only accepts one isomer over the other. And even if only one isomer is active, the ketamine contains both, so if there is a difference, the most likely one is that it would be a more powerful impact of the same effect.
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I merely commented that Ketamine has been used as a date rape drug.
“Ketamine
What is Ketamine?
Ketamine was developed in the 1960’s as an anesthetic for surgeries. Today it is used mostly by veterinarians. Ketamine causes unconsciousness, hallucinations, loss of body control and numbing. Overdose can be fatal. Ketamine is found in a white powder or a liquid and has a horrible, strong bitter flavor. Ketamine works very quickly, so if you tasted it in your drink you would only have a few seconds before losing consciousness.”
https://www.ramapo.edu/aod/date-rape-drugs-xtc-rohypnol-ketamine/
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I think you are more than a bit optimistic about the intentions of the psychiatric profession when you say it’s obvious that “mental health is not a medical issue.” In fact, this is the song the profession has been singing loud and clear since the DSM III came out in 1980. Millions of the so-called “mentally ill” have been told by their doctors, their psychiatrists, the Oprah Winfrey show, TV shows and movies, and of course, those wonderful DTC advertisements showing Zoloft “rebalancing” the chemicals in our cartooned synapses while failing to mention the dramatic reduction of serotonin receptors that results from this supposed “balancing.” It is thus VERY far from “obvious” that “mental illnesses” are not biological entities. A few years back, over 80% of surveyed Americans believed that “low serotonin” causes depression, despite the fact that this idea was convincingly disproven by the mid 1980s.
I’m glad you “get” that, but I don’t think you’re going to convince anyone that the psychiatric profession agrees with your assessment or shares it with their clientele in most cases.
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What if we flipped this around and said, “LACK of green space CAUSES increase in adult ‘mental health issues’ as defined by the DSM.”
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This was my strong reaction! For every case where someone was dense enough not to recognize that stimulants were causing the problem and instead the child was diagnoses with a “psychotic disorder” and prescribed another drug, there have to be at least 10 where the doctor or the parent or the child him/herself was smart enough to say, “Hey, this shit’s making him/her nuts! We need to get them off immediately!” If this is true, then suddenly we’re going from .2% to 2%, which is hardly negligible. And we’re only talking about psychotic episodes here. A Canadian Journal of Psychiatry retrospective study of 100 kids’ files showed an over 6% rate of psychotic symptoms in kids taking stimulants for “ADHD,” which means it’s happening in one kid out of every 16 kids who is taking the drug. With millions of prescriptions out there, there are at least hundreds of thousands of kids experiencing psychotic symptoms as a result of their “treatment.” Yet we’re just “discovering” this now?
“And in other news, people who are cut have a tendency to bleed…”
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Well, if embracing psychiatry is a requirement to be a religion, Scientology certainly fails that test!
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“If death should ensue, contact your doctor immediately, as this may be the sign of a rare but serious side effect.”
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I have seen many, many cases of this working with foster kids. Stimulants cause aggressive behavior, or less commonly, mania and even frank psychosis, and instead of stopping the stimulants, they add more drugs to “treat” the adverse effects, and of course that requires new “diagnoses” as well. Part of the “juvenile bipolar” explosion was due to stimulant adverse effects being diagnosed as ‘bipolar disorder.’ Ironically, they are often prescribed antipsychotics, which reduce dopamine transmission, while still being given stimulants, which INCREASE dopamine transmission. But as many times as I pointed out this contradiction, only one psychiatrist ever listened to me that I remember.
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I guess they changed their minds. More profits became available, courtesy of the “work” of Joseph Biedermann and others.
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I guess I see this more as a way to demonstrate that, once again, the psychiatric profession is lying and prescribing something else that doesn’t work.
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But if you tell someone that they might be getting a “real drug” or a placebo, the placebo response is stronger if people feel “something happening.” There is, however, a placebo response for both groups, which says a lot about the idea that these “disorders” are purely or primarily biological in nature.
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I actually believe the medical education system chases off critical thinkers from the word “go.” The hypercompetitive atmosphere, the extreme authoritarian approach, the intentional overstressing of trainess by loss of sleep and ridiculous expectations – an antiauthoritarian or non-authoritarian would run the other way screaming. I think the field also attracts authoritarians because being a doctor conveys status and financial success, which are less important to antiauthoritarian types.
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Commenting as moderator: “Report comment” means you have concerns about the civility or appropriateness of a particular comment. Lots of people push it by accident – it’s not a big problem.
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Yeah, you’d think that if SSRIs prevented suicide, there’s be a lot more NOT taking SSRIs who would end up in the hospital, eh? I guess the manufacturers and their psychiatric handmaidens have a different concept of what “works” means. Perhaps “works” means “creates profits?”
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Exactly! Glad you get what I’m talking about.
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“Narcissism” is just a description of a way of behaving, nothing more or less. A pretty obnoxious way, admittedly, but it’s just a description. Anyone who thinks that people fall into two classes, “good” and “evil,” will not be very successful in understanding human behavior.
As one wise person once said, “There is so much good in the worst of us, and so much bad in the best of us, that it ill behooves any of us to talk about the rest of us.”
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Nah, that’s not the problem. The problem is that no one can get a long-term patent on Vitamin B6 or zinc. Otherwise, they’d be all over it.
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And Conduct Disorder has been disproportionately assigned to African-American children, in my observation, and I believe statistical research backs me up on this point.
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I agree with you about antiauthoritarian vs. anarchist. It is very much a real possibility to have government that respects people’s rights to make their own decisions. Such governments are, sadly, very rare, as most people are in the end authoritarians, and are in fact heavily trained to be so by our school system and other institutions. But I have, on rare occasions, been part of a group that governed itself in a truly democratic fashion, and it is a joy to participate in.
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This has become our policy ever since our 18-year-old son was “screened” for depression by a doctor, who afterwards went into the usual tirade about how “depression is a disease, just like diabetes” and “it’s now treatable” and so on when he told them he’d been suicidal. The doctor never for ONE MOMENT asked why he had felt that way. It actually pissed him off big time, as he had been struggling with an assault and other issues and so had many good reasons to feel hopeless or discouraged at the time. Now if someone asks, we simply decline to answer those questions, or else say, “I’m just fine!”
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120,000 people annually are killed by adverse effects of properly prescribed and administered drugs in the USA. It’s a scandal, but no one wants to look at it.
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The fact that stimulants can be perceived as helpful for some people doesn’t make “ADHD” a “disorder.” It appears to me that people who “have ADHD” are simply different in that they are less tolerant of arbitrary rules and boredom, and have a more difficult time getting organized and planning things. This is no more a “disorder” that being a person who doesn’t like big groups of people or who lacks athletic skills or who finds doing artwork challenging. I’m not for a moment suggesting that these challenges are not real or difficult, or that stimulants can’t be helpful in dealing with them. I have two (of my three) boys who all fit the “ADHD” criteria, and believe me, I know what the challenges can be! But to call something a “disorder” just because people have particular personality characteristics that are difficult for them or for people dealing with them is just not scientific. People can “have ADHD” for dozens of different reasons (at least 50, by one author’s count), including sleep apnea, low iron, rigid classrooms, high intelligence relative to peers, poor parenting skills, abuse/neglect/trauma at home, nutritional deficiencies, allergies, and on and on and on. Or maybe that’s just the way they are.
If folks want to take stimulants to help them focus or pay attention to dull things they need to do, I have no problem with that. I do have a problem with a doctor telling you that you are deficient simply because your personality doesn’t fit with the expectations of modern society. “ADHD” behavior has survival value for our species, and it should not be disrespected or diminished in value.
One quick example: a recent study put groups of three kids together, elementary age. One half the groups had an “ADHD” diagnosed child in it, the other half did not. They were each given a set of problem-solving tasks to do. The groups with the “ADHD” child in them spent significantly less time working on the problems and significantly more goofing around, while the other groups stayed with the problem most of the time. But in the end, the “ADHD” groups solved all the problems, while those without the “ADHD” child didn’t solve any.
Staying “on task” is overrated, especially when the task is mindless and pointless and repetitive. Being able to look at things from different angles and try out new ideas is critical to solving problems. Of course, if we had a group with THREE “ADHD” kids, who knows if they’d ever get anything done? But the “ADHD” types were essential to the more straight-ahead reasoners, and when they worked together and valued each other, they had more fun AND they came up with better results!
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Sounds like Social Darwinism.
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It is SO reassuring to know that if the drug makes you unconscious or psychotic, it will probably go away eventually if you stop. Really makes me want to try it out! /s
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But, but, but… chemical imbalance… brain disorder… AAAAHHH!
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There is definitely incredible value in reclaiming one’s own narrative, telling one’s story in public, defining one’s own experience. It’s vital to empowerment. It’s just that it doesn’t sound like that’s the true purpose of this arrangement, as the people running the contest seem to have their own agenda as to what an acceptable narrative is. At least that’s how it sounded in Sera’s case.
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I see it as a PR thing, as well as providing protection to those who are so unfortunate to run into this kind of situation while we’re trying to unravel it. Psychiatry’s not going to end tomorrow, and even if it did, there are still plenty of other options for extrajudicial incarceration that will arise. I think they all should be viewed as what they are, namely arrests, and be treated accordingly. Otherwise, people are tricked into “confessing” their “symptoms” to someone they thought was there to help.
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Yeah, the 80s was kind of a nightmare from a dating perspective, wasn’t it? I remember avoiding discos at all costs because I didn’t want everyone judging my dancing or my clothing as “not cool enough.” Plus the music I grew up with was all about protest and revolution and fun and love, not about money, sex and drugs! OK, well, there was a lot about drugs in there, too, but you get my point.
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Just to be clear, they also attack working moms (and dads) who want to do a good job of raising their children.
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“… far from that lean and hungry supermodel all guys demanded.”
I hope it has become clearer by now that not all guys demand a lean and hungry supermodel look. I personally find such a look unattractive and sometimes a little disturbing, as it seems to represent a desire to punish women for looking like, well, like WOMEN!
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I just want to add here that government is not the only large institution exerting unwanted control over our lives and undermining our freedoms.
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I don’t think the stories themselves are what folks are objecting to. It’s the apparent use of these stories to perpetuate the status quo and the apparent enforced limitations put on the stories so as not to “upset” anyone, not to mention the choice to threaten civil commitment when someone’s story is too scary for them to hear.
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I think the Miranda Warning makes it more clear to non-involved people that this is not about helping, it’s about incarceration. Plus it increases the odds that the potential prisoner will get legal counsel, which means fewer people locked up. Naturally, it’s not anything close to a total answer, but I think it would be an important statement and provide needed protection.
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I loved Wayne Dyer!
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That was my first thought – we have more and more kids “in the system,” and particularly taking one or more psychiatric drugs, and we have more kids with worse “psychopathology.” If this shit remotely worked, wouldn’t our “new technology” be REDUCING the burden of “mental illness?” Yet this theme is essentially never, ever heard in the media or the psychiatric research world. At best, we can easily conclude that all the extra drugs are not helping. But based on the long-term research, there’s a good possibility that they are actually making things worse with their “diagnoses” and “treatments.” WAKE UP PEOPLE!
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It also occurs to me that even these “candidate genes” in the most POSITIVE light presented by biased researchers never came within orders of magnitude of the known effect of trauma and environmental stress on so-called “mental disorders.” Most likely, nutrition, exercise, sunlight exposure, change of environment, laughing, hugs, and all sorts of other things have more measurable effect than the most optimistic estimates for any gene. Yet somehow, these studies continue to get funded. It’s a total dead end, and high time the research literature stated this out loud.
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Yikes! “Tell us your stories, but not so as to make anyone feel UNCOMFORTABLE. If you do, you will be censored and possibly incarcerated.” And they charge you 10 bucks for the experience? Excuse the term, but that’s “insane!”
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The real question is why placebo so often equals or beats the drugs. I often wonder what would happen if active placebos were used to avoid accidental unblinding.
Additionally, remember that most psych drug trials are 4-8 weeks at the longest. There are lots of drugs that can temporarily make you “feel better.” Alcohol is a great example. It’s a superb “antianxiety agent” and would certainly beat the pants off of placebo in a 6-week trial for anxiety. Unfortunately, the withdrawal effects have a tendency to counterbalance the benefits, don’t they? Especially after 10 years. Of course, the exact same thing can be said for Xanax, Valium, Klonapin and the other benzodiazepines. But somehow, these are considered “medications” rather than simply a way to distract oneself temporarily from the pain of living. What’s the difference? Someone’s making a lot more money off the benzos. That’s about it.
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Absolutely true!
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Yes. Because panic attacks have never been shown to be caused by one thing only. They are caused by many different things, including physiological (like insufficient oxygen), psychological (such as reactions from childhood abuse), social (as happened to me when I retired, sold my house and bought a huge camper to live in), and spiritual (such as losing faith in God and not knowing what happens when one dies). There are as many causes as there are individuals, and the idea that genetics would cause such a temporary and conditional situation is actually so unlikely as to approach zero probability. And to date, there is absolutely not one iota of evidence, despite decades of research, to suggest a genetic cause to ANY “mental illness.”
We should look at what is going with each individual and stop trying to blame normal emotions like anxiety on “bad brains” with zero evidence that it is true.
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Agreed!
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“Little boxes on the hillside
Little boxes made of ticky-tacky
Little boxes, little boxes, little boxes, all the same
There’s a green one, and a red one, and a blue one, and a yellow one
And they’re all made out of ticky tacky
And they all look just the same.”
“And they all play on the golf course
And drink their martinis dry
And they all have pretty children
And the children go to school,
And the children go to summer camp
And then to the university
Where they are put in boxes
And they come out all the same.”
Malvina Reynolds, 1962
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It DOES exist, we’ll show you, just a few more years of research and all will become clear…
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I am pretty disgusted by the movement to silence ANY discussion of vaccine science that doesn’t totally support that every vaccine ever invented is safe and necessary. I got temporarily tossed off another site for mentioning that the flu vaccine is not generally very effective against the flu, and should probably not be a priority for anyone who isn’t in a high-risk group. I provided a link to scientific research on the point I raised. But I was accused of posting “antivax propaganda.” Pretty authoritarian, and ironic, as people accusing others of being antiscientific are denying anyone else the right to post scientific information and to discuss its implications. I complained to the moderators, to no effect. Disgusting.
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Dang, Fred, that sucks!!!! Hope you’re feeling better soon.
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Very true. The first thing a scientist should do when presented with evidence that a particular hypothesis is true is to generate any other possible explanation that might also be valid and start testing those, too, while setting up to have others try to replicate the experiment you did. Apparently, something like 50% or or more of recent accepted studies fail when replication efforts are made. We would be much better off being a lot more humble about what we “know,” especially in a “soft” science like psychology. Unless, as you say, our purpose is marketing, in which case we spin every “positive” study to make it seem better than it is, and either spin “negative” studies to sound positive, or make sure they are never published. That’s Marketing as Science, and it seems to be how business is done these days.
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Very true. The main effect and probably the main purpose of these “diagnoses” is to keep anyone from looking into what’s really going on. Calling “depression” a disease is absolute idiocy! Unless you’re trying to bilk people out of a lot of money, of course.
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Quite so, and that is my point. What is called “major depressive disorder” could be caused by childhood trauma, iron deficiency, low thyroid, chemotherapy, finding out about a serious life-changing diagnosis, having a dead-end job, being in a domestic abuse relationship, not knowing the meaning of life, having Lyme Disease, or a long, long list of other possibilities. As Kindred Spirit points out, they don’t even bother to check for well-known biological causes. All of which tells us that “mental disorders” AS DEFINED IN THE DSM are nonsensical entities that have no meaningful value, and that claiming any such “disorder” is caused in the main by a “brain disorder” is rank idiocy without a shred of scientific evidence.
If we ditch the DSM, we might actually find out what IS causing the problem, be it biological, psychological, social, or spiritual in nature.
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It is perhaps a generalization, and as I often say, “All generalizations are wrong.” However, what I’m talking about here is an extreme of strong reaction to normal feedback, for instance, a person says, “I’ve felt really weird since taking this drug, it doesn’t seem to be working and it’s keeping me from sleeping and making me itchy.” The doctor says, “This has nothing to do with the drug. You have to wait for it to work, you can’t expect instant results, besides, maybe you’re just not used to feeling good and it seems weird.” Or even worse, “I’m the doctor here, and I know what these drugs do. Just report your experiences and I’ll decide what’s working. I have medical training and experience, you can’t possibly understand these things.” This person is clearly uncomfortable with plain old FACTS as presented by the patient. To me, it’s a bad sign. Sure, it might be caused by something else, but the odds are very strong that this person is trying to establish authority over you for some reason, and very often that reason is that they don’t know how to help you and that this drug is their only tool, but they can’t admit it. To me, it would be a HUGE red flag that I want to go elsewhere for advice.
There is no reason for a professional person to feel threatened by a client reporting the results of an intervention. At a minimum, it would take a very insecure doctor to find this kind of feedback disturbing or upsetting. But I guess there are a lot more insecure doctors around than one might expect, especially in psychiatry.
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Plus they are often prescribed drugs which mess with their appetities and make them crave unhealthy foods.
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Of course, they also CAUSE thyroid or kidney or brain problems, but take no responsibility when these things happen.
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Well, THAT was an impressive list! Perhaps we’re missing each other a bit because of what is defined as “mental illnesses.” I have never had any interest in denying that there are biological causes of mental DISTRESS or CONFUSION. What I have a problem with is when the DSM creates a “disorder” like “ADHD” or “bipolar disorder” and claim that ALL people with these ill-defined and subjective “diagnoses” have the SAME biological cause! What you said toward the end is what I believe also – that each case is different and no one-size-fits-all approach will suffice for any “disorder,” especially those defined by behavioral observation rather than any kind of scientific measurement and analysis. In fact, one of psychiatry’s great crimes (and there are many) is their insistence on “diagnosing” people without even bothering to do a physical workup to see what might be causing their “symptoms.” This doesn’t even get into environmental stresses (both physiological and psychological) that contribute beyond a person’s own biological variables.
So sure, there are biological causes of mental/emotional distress, and you’ve documented a ton of them here, which is appreciated. The question I pose is, can anyone name one DSM-defined disorder that is reliably caused by any specific biological problem? I think we all know the answer to that one.
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Quite so. In the “mental health” system, it’s essential to start off playing defense until you know who you’re dealing with. The consequences of getting connected with the “wrong” kind of counselor could be devastating to your life!
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That would cover all the bases!
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I think you are right on. Any time a supposedly professional person gets defensive with someone they’re supposedly trying to help, it suggests that the person doesn’t actually know the subject matter at hand and their client/customer is hitting too close to home.
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Or low iron causing “ADHD” symptoms.
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Wow, so it sounds like they are INDUCING autism-like symptoms as a “treatment”? And they consider this helpful?
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Can you share one such example, where a “mental disorder” as identified in the DSM has a defined and measurable biological cause?
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Yes, it is, unless your goal is to “capture a maximum market share” by implying that any divergence from being mildly happy to mildly irritated is a sign of “mental illness.” It is also rooted in the assumption that “normal” people are always happy (but not TOO happy, that would be MANIC!) with things just the way they are. This kind of thinking lets our leaders off the hook for the damage their institutions, agencies and corporations are doing by blaming anyone who is unhappy for having a “bad brain” instead of seeing if maybe we have some bad institutions creating problems.
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Just to clarify, I’m not a fan of “crazy” or “bonkers” either. But I’m saying that I find “mental illness” a far more damaging term, even though professionals claim that they use it to decrease “stigma.” If you say I’m nuts, at least I know you’re not trying to help me out!
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I think “mental clarity” is a very different term than “mental health.” Clarity is a much more specific quality than “health”, especially in the “mental” sense of it. I’m also OK with “spiritual well being.” I think the problem now is that “mental health” as a term has been coopted by the industry, and brings a whole lot of negative assumptions along with it. I’m for not using it except in quotation marks. But that’s just MHO.
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The underlying problem is trying to categorize all these people who are suffering some kind of emotional/mental distress as being in a group that has anything in common with each other. Kind of like talking about Native Americans as if they were a group who are all the same, or children, or women, or gay people, or any large group. It’s bigoted at the least to view people as being the same based on one shared characteristic. The terms “mental health” or “mental illness” both seem to imply that there are some people whose brains work right and others whose brains work wrong, and that being in the second group implies some kind of pathology. It’s not a good starting point for a positive discussion of how to help people who are suffering for whatever reason.
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My understanding is that “neuroleptic” generally refers to a class of drugs that act by decreasing dopamine transmission in the brain. Thorazine, Haldol, Stelazine, were the original neuroleptics. The “second generation” antipsychotics are hybrid neuroleptic/SSRIs. There are lots of neurotoxins that are not neuroleptics, but all neuroleptics are neurotoxins.
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LOL!
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You may be an exception, or your school may be. But I don’t think this has changed. Schools are very concerned with liability and try to “counsel” students with “mental health difficulties” to go on leave, at least in the USA. The confidentiality violations alone in this story are hair raising. I think the advice to be VERY careful about college counseling centers is very much on target.
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Following up on Miranda’s comment, I find it interesting that the fact that the clients are feeling too intimidated to speak up is not considered to be the central problem in this interaction. If you want “shared decision making”, you need shared power, and the current model goes against that. “Clinical authority” is simply the asserted right of the psychiatrist to dominate the decision-making process. In other words, most psychiatrists don’t BELIEVE in shared decision making. This should be the primary focus if someone really wants to change that dynamic. I actually make it very clear to any doctor I have to see that I am, in fact, the one making decisions here, and that their advice is advice which I may accept or reject, and if they don’t like this attitude, they should let me know now so I can find another doctor. But most people are very uncomfortable taking that assertive a position.
This also belies the “blame the patient” approach to explaining away the steady increase in prescribing by doctors in every area of medicine. These things are not happening because the clients saw Drug X on TV and are demanding it. In most cases, it is the doctor who is deciding what the patient is supposed to take, and it’s clear from this discussion that most patients don’t have the skills or the wherewithal to challenge the doctor’s opinion on any recommendation.
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I think the problem with “mental health” is that it implies that people who are suffering are somehow “ill” and that “healthy” means not being upset in any way with the status quo. I’d rather go with “crazy” or “nuts” or “bonkers” than “mentally ill.” But there are better terms that can be used. I believe that controlling language is part of controlling the narrative.
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Ugh! What you’re describing should be a crime subjecting the “professional” to jail time.
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Wow, well done! There are SO many things that can be done to help a kid succeed, but we have to actually both observe and care about the child instead of trying to shut him/her up! It’s not rocket science, but it starts with understanding that kids do what they do for a reason – and it’s NOT because they have broken brains!
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My understanding of “intentional communities” is that their original purpose was, in fact, to undermine the capitalistic assumptions underlying our culture. I could be wrong, but that’s what I associate with the concept.
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For a lot of us, the function of a family is to raise capable and empowered children and to support each other in surviving the insanity that is our modern world. Admittedly, it would be a lot easier if we had much bigger units than “nuclear families,” but I see that more as a symptom of the larger problem of intentional community destruction by our “leaders.”
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I think the correct statement is that people who TOOK ANTIPSYCHOTICS showed brain shrinkage, regardless of their spurious psych “diagnosis.” But I agree that avoiding psych terminology is an important strategy in decreasing the power of the psychiatric profession to control the narrative.
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“Our” case means the case of anyone who wants to ditch the current DSM label-drug-and-shock paradigm of doing business. These folks aren’t going away without a fight. I don’t see the “brain shrinkage” argument as being about permanent brain damage (though we know that does occur – Tardive Dyskenesia and the like) so much as being about undermining the disingenuous and unsupported arguments from the psychiatric mainstream that there are good reasons to believe these “disorders” are biological in nature, and that their wonderful drugs actually repair some “imbalance.” The entire enterprise is founded on that faulty mythology, and I don’t think it’s possible to undermine people’s faith in it without some hard evidence that the psychiatrists are full of crap. Science alone won’t do it, but it is part of the picture if ending psychiatry is the goal.
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I have always viewed authoritarianism as more of an attitude as a system. An authoritarian believes that some people are above and others below, and that those above get to give orders and do as they please, while those below have to follow orders and do as they’re told. Of course, one can be below someone and above someone else, so the basic rule of authoritarianism is “fecal matter descends to the area of lowest gravitational potential.” Those higher in the structure have entitlements and different rules, but any frustration the authoritarian may feel can be dumped on those lower than them in the structure. It’s all about in-groups and out-groups and hierarchies and entitlement and force and power.
As Oldhead properly observes, any political party or structure, as well as commercial and religious groups, or really any group of people can have an authoritarian set of social expectations. It is more about how people interact with each other and how decisions are made in the group than it is about political orientation.
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I think the importance of this particular study is that it was done by a mainstream psychiatrist whose interest was to prove that “the disease” was causing loss of brain matter, and accidentally proved it was the drugs which did so. The loss of brain matter (on the average) claimed to be seen in long-term “schizophrenia”-diagnosed people was used to support the idea that “untreated schizophrenia” was dangerous and was used to promote “early intervention” for anyone with the slightest indication of what they call a “thought disorder.” This study has almost silenced that argument. I think it’s important to know about and use these studies to make our case, even as we all know that every individual case is different, and that recovering even from long-term use of these drugs is possible for many so exposed.
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Hey, I was born in Pittsburgh! St. Francis Hospital. Lived my first 4 years in Wilkinsburg.
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Commenting as moderator:
As much as I appreciate comments in defense of my efforts, I’d appreciate it if this poster and or similar could be ignored or reported and ignored. It simply encourages more of the same nonsense.
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Plus stories about psychiatric harm might offend their rich advertisers.
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The drugs create brain shrinkage on the average, according to studies. How each individual responds is, of course, different. Also, brains can heal, so some may only experience temporary damage.
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The challenge I see here is that you can’t really compare a car accident to being suicidal or hearing voices. In a car accident, you can see broken bones, bleeding, bruises, you can check pupil dilation or reflexes or a hundred other little things that tell you what’s going on. But as you say, you can’t do this with psychiatric diagnoses. In fact, one could easily invent a psychiatric diagnosis by choosing any behavior you think is “unhealthy” and calling it a “disorder.” We have stupid things like “internet addiction disorder” and “mathematics disorder” and “oppositional defiant disorder” which are obviously just observations and judgments about certain behavior. There is, as you say, no test.
The part I’d like you to think about is the question of why, when there is so much research and information on the dangers of these drugs, the psychiatric profession is not interested in investigating things like Soteria House or Open Dialog or even stuff like nutritional approaches or other forms of helping like “hearing voices” groups and other peer support? While they often give lip service to some of these ideas, they are always considered secondary or additional to the REAL treatment, which is drugs. Do you really believe the billions of dollars raked in by the drug companies don’t come into play here? There is now strong data showing that long-term use of antipsychotic drugs leads to a LOWER likelihood of ever recovering. And yet the profession continues to recommend immediate and ongoing drug “treatment” to every single person who presents as “psychotic.” Why is this?
I’m not suggesting that the individuals at the front line are all bought off and corrupt. I’m suggesting that they all participate in a system that is based on a dishonest model of reality, and that model was constructed with the idea of making money in the forefront, not the idea of helping people get better. You said you have read “Anatomy of an Epidemic?” Bob Whitaker talks about this at length in his book.
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Most of those who buy the current paradigm fully actually think the brain IS the mind, that there is nothing else to “treat” except the brain, in my observation. They get quite confused when I talk about mind being more than just brain. They think they are being “Scientific” by not believing that anything beyond “brain” could exist.
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Which is rank discrimination, plain and simple. I could easily have been diagnosed, in fact, I probably was in my 20s when I went for therapy for a year or so. I’ve been tremendously successful as a counselor and social worker, according to my clients, which is the only measure that’s worth looking at. Why would they not want me as a social worker? Some of the best social workers I’ve known have had rough lives. It helps them empathize with the clients.
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They did this in one high school, I want to say in Wisconsin, and their behavioral referrals went down, grades went up, and everyone seemed to be doing a lot better. Of course, this experiment didn’t make the news…
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An unfortunate but sadly apt comparison.
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I am so sorry! That is just awful! Your story is emblematic of exactly what is wrong with this whole idea of “broken brains.” There is no healing that way, only more and more damage. And I HATE how they minimize memory loss as no big deal, just a minor “side effect,” when it is evidence of brain damage and can ruin someone’s life. I know a survivor who can’t remember her own wedding. It is too sad for words, but it also pisses me off big time!
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Another psychiatric success story!
A very sad tale, that the doctor himself was taken in by the psychiatric/big pharma mythology, to the extent of being told he was condemned to a life of drug “treatment” and anxiety. No one apparently told him there was anything else he could do, and the “diagnosis” itself appeared to be the final straw. How very sad – no one created a safe space for him to talk about why his life wasn’t working for him, about the pressures and tensions at work and whatever else was happening, including the pressure to keep pretending everything was AOK. It is a classic example of how and why the psychiatric paradigm is not only not helpful, but significantly adds to the kind of problems it purports to know how to fix.
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And the creative thinkers just get into trouble for their efforts.
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I believe those suffering from what are metaphorically called “mental illnesses” might be much better off if “mental health” were NOT a central plank of the candidates’ platforms. Unless there are some uniquely well-informed and courageous candidates who are willing to argue for the removal of “mental health” from the field of medicine altogether, or to prevent any kind of forced “treatment” (which is an oxymoron to me), it would be better for all if “mental health” is left in the background, as it will be easier that way for those wanting to avoid the system to fly under the radar.
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I’d advocate more for any “mental health” worker to take Haldol or Abilify for a few weeks before they’re allowed to prescribe anything. Might create a little more compassion, though the compassion bar is pretty low at this point.
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Maybe some of each? A larger herd of sheep herded by some freakin’ evil shepherds?
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I agree. Calling something a “last resort” is admitting that you’re desperate and don’t know what else to do. Any “medical” person in a state of despair will no longer be providing ME service, that’s for sure! I’d much prefer if the person says, “I’m not sure what to do that would help you” than have them engaging in some desperate “treatment” that might kill me or leave me wishing that it had.
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Did you ever recover those memories? If you did not, I’d suggest that is evidence of long-term damage to your brain.
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Very well said!
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I wish I were surprised by this. Good for you for having the guts to speak up! The idea that they are somehow able to induce “different” seizures is beyond comprehension. Do the other doctors really BELIEVE this? Or are they in on the not-so-funny “joke?”
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So you are saying that “ECT” helped you because it erased most of your memories?
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Ah, but WHERE and HOW HARD do you hit the person so that just the right amount of brain damage is done in the right region of the brain? That is the fine art you have yet to study.
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Maybe we should call a psychiatric degree a PhBD – a Doctor of Brain Damage?
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I think the problem with your statement is the word “treatment.” People deserve HELP, but the term “treatment” redefines these issues as medical problems and invalidates the reality that trauma, pain, physical illness and social conditions all impact what is defined as “mental illness.” This may be very different from what you’ve been told or read about, but that’s because most people seem to have bought into this very idea that “mental illnesses” are something a psychiatrist can measure and identify and “treat.” You just stated yourself that there are no tests. To me, this means that “diagnosis” is completely subjective and could be given to anyone for any reason. Which means the “treatment,” including ECT, can be given to anyone for any reason.
I think the link you provide is moving more in the right direction – nutrition, exercise, change of environment, listening, all of these serve to return the power to the person with the problem. Drugs and electrically-induced seizures do nothing but damage the brain and do essentially nothing to help the person even figure out what’s going on, let alone what the person can do about it.
So by all means, let’s offer help and support to anyone who is suffering! But there is no need to redefine their suffering as a “disease” nor the helping as “treatment.” Let’s just call it helping each other out!
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Sigh… This is what happens when you brand “anxiety” as a problem instead of looking for its cause. Their conception of “anxiety” is a disembodied head with a weird expression on its face and the word “anxiety” written across the forehead, as if anxiety were just some “thing” associated with heads and having no relationship to the school, its staff, its students, their parents, or the community in which the anxious person lives.
Where is the curiosity? Doesn’t anyone wonder WHY the kids are feeling anxious? Is “school refusal” in a particular case due to some disembodied “anxiety,” or is it due to being worried about the bullies waiting for you at school, or the mean teacher you have to put up with all year long, or the incredibly DULL class periods where you always fall asleep and get in trouble, or the reading group where you’re forced to read out loud and are so worried about making an error and having kids laugh at you that you can’t read at all and they laugh at you anyway?
This kind of idiotic research shows how the DSM “diagnoses” prevent meaningful research from actually occurring, because everyone stops at the “diagnosis” as if this means they understand the situation.
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To be called a “menace” by psychiatry is, indeed, a high compliment!
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All I can say is, “WELL DONE!” But you are right, no one should have to fight off the people who are claiming to be helpful. It is baffling that they still get away with it.
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I have known plenty of people with physical disabilities, and very, very few ever lived lives of luxury, and none did so on the government. The amount provided by SSI is generally barely enough to survive, and many of the “mentally ill” who are so disserved by the “system” have physical disabilities, too, many induced by their “treatment.” I don’t think it’s proper to make generalizations about people with physical disabilities – they are an extremely diverse group!
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Hope you can find your way not to feel guilty about your thoughts. There is no harm to thinking thoughts, as long as you don’t act on them. There are lots and lots of people who have similar fantasies, as well as parents with thoughts about killing their children. My wife and I always share our brief homicidal impulses with each other – most of the time, we just laugh about it!
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You’d think he was talking about today’s psychiatry. Oh, but you already said that…
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When you say, “As a last resort,” how is it decided when “last resort” comes around? Who decides, and on what basis?
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I also find that a good percentage of alternative practitioners have adopted the DSM “diagnostic” terminology, which affects both how they talk to people about their difficulties and the kinds of strategies they tend to employ. I’d keep clear of anyone who is still talking about “natural remedies for bipolar disorder” and the like – they are still steeped in the medical model, just coming up with other “magic bullets” within that model.
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I agree completely. There is an entirety of Buddhist theory and beliefs that underlies the whole idea of why we meditate and what is to be gained from it. It is ironic that someone could think of scheduling a “mindfulness seminar” in the midst of an insane, “monkey-mind” world where real mindfulness would create nothing but horror as the person gained real awareness of what was going on!
Psychiatry aims at removing any idea of spiritual existence and awareness in favor of worshiping the material world under the guide of corporate capitalism. Buddhism moves away from materialism to spiritual awareness of the meaninglessness of striving to control the material world. It is in some ways the essence of anticapitalism.
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“Treatment-resistant depression” translates loosely to “I have no idea how to be helpful to you, but want to pretend that it’s your fault, or better, your DEPRESSION’S fault.”
Would we ever want to take a car to a mechanic who told us we had “repair-resistant fuel injectors?” Or a tutor who said we had an “education-resistant child?” How do they get away with this nonsense?
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Glad you posted! Sounds like you have seen “the man behind the curtain” but are still entangled with “the system.” Let us know how things go and if there’s anything we can do to help out.
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What exactly DOES mix with psychiatry?
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The Mission Statement is available on the Home Page, under the “About” pull down menu.
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Instead of calling it “sinking,” let’s call what happened to the Titanic “assuming a lower floating equilibrium.” That way, everyone will feel better as they go under.
What the heck difference does it make if it’s renamed? Do we have to “gain consensus” before we decide whether cancer is an illness? If “schizophrenia” is decided NOT to define a “disease” category, why would you rename it instead of just tossing it out?
Or maybe we can rename each person’s experience without forcing them all into a category – maybe ask the client him/herself what name seems most appropriate to them? But then where would the research money come from, and how could we justify drugging if every person’s needs are different and can’t be categorized?
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When people have grand mal seizures in any other context, doctors will do anything they can to stop them. It is known that people with seizure disorders experience brain damage if the seizures are not controlled. Why on earth would anyone expect that inducing a seizure would have a different effect?
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I would add that in Buddhism, participation is always voluntary, and no one is “the authority” who can tell you that “you are doing it wrong.” It is understood that it is a practice that will unfold differently for each person, and that the person him/herself is the judge of what it all means. VERY different than the “mental health” version.
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It is one of the underrecognized ill effects of the DSM and the “chemical imbalance” concept – it gives adults permission to not take responsibility for their condition, or more nefariously, to blame their children or others in their care for not “appreciating” their abusive behavior sufficiently. I think the problem is painting with too broad a brush. This is one of the forces at work, but even that force is created and encouraged by the psychiatric profession for power and profit. The fact that other misguided or ill-intended people are willing to buy into the fiction in no wise alleviates the responsibility for the psychiatric “profession” for creating this mess in the first place.
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I totally agree that there are individual physicians who are corrupt and evil and know absolutely what they’re doing. I don’t think most of them are – I think most are simply entitled and believe they know a lot more than they do. Some are also report being afraid to “disappoint” patients by not prescribing something. But there are definitely evil docs out there – I have met more than a couple.
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I suppose it’s an improvement over saying we’re all antiscientific whack jobs, but definitely a pretty cowardly position!
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I agree 100%. We do seem to have lost some of this “grit” over time, for many reasons, and of course, every person is responsible for their own attitude toward the current dire set of circumstances. But the psychiatric profession has led the charge to promote this idea – their concept is that “no one should have to suffer,” even though suffering is a key part of learning how to live, and even though of course they have no real solution for suffering and generally create more and more suffering in the long term. I’m all for helping create cultural change, and it starts by recognizing the economic and power incentives for those telling the tale that we can’t handle adversity. I believe most people still have this in them, but some of us need help bringing it to the surface, usually through moving from fear or hopelessness to righteous indignation. Casting blame on the victims of these evil machinations doesn’t help them get there. Educating them regarding what’s happened and why and that they are not alone is a much better path, IMHO.
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Psychiatrists are almost ALWAYS portrayed in movies and TV as caring therapist types who know how to listen and help people safely explore their conflicts and issues. If someone’s only image of psychiatrists was from the media, it’s easy to see how they might expect that they could be helpful. I don’t think it’s by chance that such portrayals so massively predominate. I think it’s part of the propaganda effort, just like it is to show “patients” who “go off their meds” and do something dangerous. They’re painting a picture, and it is hardly surprising that most people expect that picture to reflect reality.
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I am NOT trying to minimize medical errors as a cause of death! I’m trying not to allow a reframing of this issue as one of “errors” in medical care when a huge proportion of the deaths come from “standard care.”
“Estimates dating back nearly two decades put the number at 100,000 or more deaths annually, which includes a study published in the Journal of the American Medical Association in 1998 that projected 106,000 deaths. A more recent analysis estimates 128,000 Americans die each year as a result of taking medications as prescribed – or nearly five times the number of people killed by overdosing on prescription painkillers and heroin.”
https://health.usnews.com/health-news/patient-advice/articles/2016-09-27/the-danger-in-taking-prescribed-medications
While medical errors in and of themselves are a HUGE problem, looking like something over 200,000 annually, I don’t want to minimize 128,000 deaths as “errors” when the doctors were simply following the standard protocols and dosages. Even a “good doctor” could kill you!
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That’s CRAZY talk!
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And who did they say was “mentally ill?” Sounds like both doctors needed to be locked up as “a danger to self or others!”
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Let me know how it goes!
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I think Veblen’s concept holds a lot of water.
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I realize the real problem with Lawrence’s statement: that people “knowingly” turn over their lives to psychiatry. If they did this “knowingly,” it would mean that they knew and understood the likely outcomes, including the potential negative consequences, and that they knew and understood the fictional nature of the idea of “mental illness” diagnoses and related concepts. VERY few people who actually know this would be willing to turn their lives over to those in charge of such a mass deception!
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And then feel bad that they are so “disordered” as to find the current social reality doesn’t “make them happy.”
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Actually, it wasn’t “medical errors,” though it has been spun that way by the propaganda machine. It was actually MEDICAL CARE that measured out as the third leading cause of death in the USA. And the most common cause of death by medicine was not an “error,” but side effects of properly prescribed and properly administered “medication.” I think the attempt to spin this as “medical error” is an intentional PR effort to make it seem like “bad doctors” are the problem, rather than bad drugs and bad medical training.
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I would add that some people don’t “walk away” because the difficulties of withdrawing from psychiatric drugs can be an incredible barrier to escaping.
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I think you may be confusing intent to avoid responsibility with trust. We humans need to develop trust with our clan. These “doctors” are selling trust – “We’ve got you covered, don’t worry, we have the answers!” While it is true that looking for simple answers is part of the problem, I think it’s pretty unrealistic to expect the entire culture to decide not to trust doctors when they are told from birth onward that doctors can be trusted. I think there is a difference between WANTING to give up responsibility and BELIEVING that someone can be trusted when they can’t. It takes a lot of courage to challenge cultural mythology, and I personally think fear plays a much larger role than desire to avoid responsibility. That being said, I do believe that learning to assume maximum responsibility for what we control is critical to our getting out of the current capitalistic trap. But I don’t think framing it as laziness on the part of those who succumb to the propaganda machine really helps move us forward.
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Sam,
Just to clarify, there really WAS an epidemic of falsely accused people, which led to some much-needed reforms in forensic interviewing of children, which have taken hold nationwide, and maybe internationally as well. The McMartin Preschool case was most definitely an example of implanted or extracted “memories” of things that did not happen, and the therapists were in the main culpable for creating this disaster.
What I’m objecting to is jumping from the clear and fully supportable observation that false memories CAN be implanted to the conclusion that there is no possibility of suppressing a memory of something that really did happen. There are people who can’t remember anything before they’re 10 or 12. I doubt that they really can’t remember anything during that time, but I do believe it’s possible not to WANT to remember bad stuff and to wall it off from conscious recollection.
But it’s a very delicate area, and it is very easy for a person to inadvertently (or intentionally) encourage or induce “recollections” of things that did not happen. I’m not in a position to know what has happened in your family’s case, nor do I really want to weigh in on that question. I just don’t want you to come away thinking that I believe implanted or created “memories” are a fantasy. They are very real and very, very destructive to all involved.
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I don’t think it requires encouraging people to alter their beliefs about past events to validate that such events may not be entirely conscious in their memories. I have a clear example from my own past where my second grade teacher hit me in the head and tossed me and another kid out in the hallway. I shared this story with a classmate at our 30th high school reunion, and she remembered the incident, including some parts I was not aware of (like the part after she hit me in the head!) While I still did not recall this part of the event, I did remember going down to the nurse after heading to the office, and I remember her checking my head for signs of injury, which I did not recall previously. I also knew there was another kid in the hallway, but she reminded me of who it was, which helped me flesh out the memory.
Was that recollection 100% accurate? I very much doubt it. Did my teacher hit me in the head? I am absolutely certain that this is what happened. And the parts I recovered were not manufactured or imaginary, but were very much connected to the events I had recalled before. There is no reason to doubt that I was hit, that Freddy Baughman was crying (which I also recalled after telling the story) and was tossed out in the hallway with me, and that I did make a visit to the nurse. The exact details of the event will no doubt never be known, and I’m sure different people who were present would have different recollections of what occurred. That’s the nature of memory.
So I don’t think it’s anyone’s job to tell anyone else what is true or not true, and especially to tell anyone what to BELIEVE about their historical trauma. But I do think it is absolutely wrong to deny the possibility of recalling or fleshing out memories of abuse that a person comes up with themselves. In fact, telling them NOT to believe their recollection IS telling someone what to believe about their historical trauma, which we both agree is wrong. It is up to that person to determine for him/herself what is and is not true about their own past. And I agree, the relevant point is to process the emotion attached to such events, including any conclusions or decisions the person may consider they have made in regards to their interpretation of such events. But the client owns the recollection and their own sense of how certain that memory is in their reality.
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It is also important to recall that the large majority of serotonin receptors are in the gut (90%, I believe?) So screwing with the serotonin system screws with the gut, and Lord knows what this does to our “microbiome.”
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You clearly suffer from USD – “Ugly Slacks Disorder!” Is there a drug for that?
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Bummer!! Two years can feel like a VERY long time!
Where I live (West Coast USA), there is an organization that does legal advocacy for teens in difficult legal situations. Have you looked for that kind of service near you? The “age of consent” is generally regarded to be around 14-16 in most states, so you may have a legal right to decide this for yourself. I would definitely recommend you talk to an attorney in your area and find out the laws in your state. Of course, a parent can always claim that you are “a danger to self or others,” but from what you’ve said, you’re not threatening to kill yourself or anyone else, and are obviously rational and articulate enough to care for your own basic needs, by a very long margin. Who knows? Maybe you can win this one!
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Well said. “Diversity” covers it quite thoroughly. But everyone wants “brain-based” explanations these days, even if they are total BS.
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You’d be surprised how many doctors actually believe in “chemical imbalances” despite the research. They are almost as susceptible as the average Joe to Big Pharma’s lies.
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And we are often trained NOT to look at these experiences honestly, and if we don’t find a way to become aware of the feelings we repressed, we generally end up doing the same things to our own offspring accidentally. Alice Miller writes eloquently about this phenomenon.
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Not just the experts, but the news media, movies, TV shows, their family, neighbors, friends, and most people they meet in the world. It takes some serious courage to stand up to that kind of mass agreement, no matter how deceptive or ineffective the agreement may be.
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You may be right on some level, Lawrence, but it seems to me that such motivations as you discuss are largely unconscious and are fed by general social agreement and expectations. It’s true that we have the free will to challenge or refuse to comply with these expectations, but that often comes with consequences that people aren’t willing to contemplate. I’ve found plenty who are seeing psychiatrists because they literally have no idea that there is any other option. While I’m all for empowering them to realize they have other options, blaming such people for lacking the levels of awareness and responsibility to recognize psychiatry’s shenanigans and manipulations is unproductive and in some cases could be seen as downright hurtful.
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Interesting discussion – clients are certainly going to do better with such an approach than “treatment as usual” (and I use the term “treatment” very loosely).
Unfortunately, the discussion doesn’t go deep enough to get to the core of what is really going on here. The two client examples are people who were TOLD that their “moods” and “anxiety” were, indeed, things that descended upon them for no reason, and they were TOLD this by the “mental health professionals” they were seeing. The fact that the client had “never been asked” these questions before tells us enough to know that the people dealing with him either were completely incompetent or were corrupt and didn’t care about the outcome. It’s time to move beyond the question of “what to do when people ask for ‘medication,'” and start informing them of the misinformation they have been fed, and the actual hope that they can go way beyond “not feeling bad” in their lives.
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So “allowing” youth to select adults whom THEY find supportive leads to better results than forcing them to do “therapy” with a total stranger or be “diagnosed” by a disinterested “doctor?” Who would have guessed?
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Glad you mentioned this. We seem to have moved quickly from “false memories can be implanted” to “there is no such thing as repressed memories.” The latter is part of the “blame the victim” attitude psychiatric leaders have assumed towards those who are traumatized early in life.
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Forced “mindfulness” is a contradiction in terms.
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It’s not so much that people don’t want to see it. I think it’s more that advertisers don’t want it known or talked about.
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In rereading this, I agree – researching “mental illness” automatically feeds into the idea that there is such a thing. But researching the real impact of what the corrupt profession really DOES and what impact it has can be very useful, as Bob’s work has proven.
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But you CAN prove that the “treatments” provided make things worse, which Harrow and Wunderlink and many others have successfully done without setting out to do so. The studies proving that antipsychotics cause brain shrinkage, done by someone who deeply believed in the “medical model,” were particularly useful in debunking the idea that “schizophrenia causes brain shrinkage.” There is no need to embrace psychiatric terminology or “diagnoses” to debunk the bullcrap “research” that is out there. Obviously, this by itself does little, as the APA and their profiteering supporters will simply discount such research as irrelevant or biased, but it does provide a base for making deeper strikes into the PR machine.
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Very well said!
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I always get worried when someone is interested in “stabilizing” someone else. It generally is code for “get them to stop bothering everyone else with their personal needs and concerns.” Or sometimes “beat them into submission.” Please, don’t “stabilize” me!
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Hi, Sam,
Are you suggesting that the current dilapidated and destructive state of psychiatry as a profession is not strongly linked to corruption within the field, due to huge financial incentives and the desire for professional credentials and power? I can’t agree that the current state of affairs is solely the result of confusion and fear on the part of professionals and others who want to make things more comfortable. This plays a role, but what I see is the APA and the drug companies SELLING an idea that somehow they have a magical solution in the form of a pill that will obviate the need for the kind of personal work and commitment that you and I both know is really necessary to do things like healing attachments and gaining insight into the impact of traumatic experiences and learning how to love oneself enough to stand up and take action in an increasingly hostile world.
So I agree that the psychiatric model is a tool, but I don’t believe it’s designed to actually accomplish the things that you have spent much of your adult life working towards. I see the model being designed to make things more comfortable for those in control and to increase financial gain for big corporations and associated “professionals” who profit from having clients that never get better. If this were not the case, why is the APA so resistant to the evidence that these drugs are only useful, if they ever are, for short-term suppression of symptoms, and that long-term use creates the very problems that they purport to address? Why the powerful resistance within the ranks to the results of their own research, if not to protect their personal prerogatives and their funding?
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You are not encountering lack of interest. You are encountering protectionist oppression because you’re threatening too many people’s gravy trains, and you’re also pissing off abusive adults who don’t want to be called out on their bad behavior.
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Posting as moderator here:
I am feeling that this back and forth regarding who is really saying what about how antipsychiatry should move forward is unproductive and is getting kind of personal. I am not inclined to go through and moderate/edit all the negative comments and tones that are emerging, but I really think we’re all in position to hear where both parties are coming from, and I don’t see much point in trading competing accusations. I am still going to go through and remove anything egregious, but if the two of you could please take this discussion back channel, I’d appreciate it. It’s really gone quite far off the topic of the article at hand.
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Ha! That’s for sure!
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Thanks for that, Sam. Loving oneself is not sufficient to change the world, but I do see it as a prerequisite to making real change. Believing one deserves to be treated with respect means it becomes OK or even necessary to stand up for what is right. And all sorts of things become possible once we’re at that point.
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I would be of the opinion that scientific studies do provide ammunition to be used in the fight to shut down psychiatry. If nothing else, I believe science is necessary to demonstrate the level of dispassionate lying involved in their “diagnoses” and “treatments.”
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And if it’s a brain disease, why is there no evidence that depressed people’s brains have anything in common with each other?
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I don’t buy that it is ignorance. I believe it is not so simple to revise one’s beliefs without understanding the emotional reasons for adopting one’s original belief system, especially when early life trauma or attachment issues are present.
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You probably told us this already, but if so, I missed it. Are you under 18? If not, is your mom your guardian? There ought to be some way an articulate person such as yourself could be in a better position to make your own decisions!
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Absolutely! Cognitive therapy methods are, in my view, only ethical if the client identifies what thoughts (if any) they find troublesome and what kind of changes they would want to make. If the therapist has an agenda, the process is going to go south quickly, though many therapists don’t seem to notice when this happens, and mistake compliance for engagement.
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Well, you do make a good point here. We have to start somewhere, and building strong attachments always seemed to me to be the easiest place to make the biggest impact, because the kids aren’t messed up yet! But of course, the kids are raised by parents who have their own attachment issues, and have also been trained by our social system to believe certain things that aren’t necessarily very helpful to creating a connected community of human beings. So we have to somehow help the parents attach to the children despite their own fractured attachments. A monumental task. Alice Miller has a lot to say about this. I guess my wife and I decided to simply start with our own kids and build out from there. It wasn’t perfect, but they are certainly some of the least sexist, racist, whatever-ist boys I’ve ever met. Modeling is the most important part of learning, including learning that the world is a safe place to be who you are.
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Stigma is a euphemism for prejudice and discrimination and bigotry. “Stigma” suggests that the poor “mentally ill” are unable/unwilling to “get help” because they’re afraid their families or friends will be ashamed of them, or that they’ll be ashamed of themselves. It is intended to be rooted in the unreasoning fear of the potential “patient.” Whereas prejudice and discrimination clearly lie in the treatment of the potential “patient” by the very system that purports to “help” them. It’s a very important distinction, I believe. These terms are chosen strategically.
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True!
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I do agree that attachment is central, as I’ve said, however, there are plenty of outside influences, such as racism, sexism, etc., oppressive schools and churches, our mobile, disconnected society (lack of community), and other influences which can result in anxiety, depression, anger, distractedness, and anything else in the psychiatric hierarchy. I want to make sure that people who don’t perceive themselves as having been mistreated or having had poor parental attachment are not considered of less importance or have their suffering minimized.
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I think you are missing the point here. It’s not that people are arguing against being happy, it’s the EXPECTATION that everyone is happy, all the time, regardless of circumstance. The corollary to this is that if one is unhappy, it’s one’s own fool fault for not “thinking the right thoughts.” While it is helpful to maximize one’s ability to choose his/her reaction to events, we do not control all of the events around us, not even vaguely.
For instance, I was miserable in school. I was a very smart kid who was very shy. Elementary school in particular varied between weeks of massive, soul-crushing boredom and discrete oppressive events, the majority of which were perpetrated by the teachers. Now, one could say that I had a choice – I could have “made the most” of the situation, I could have left in protest, I could have learned to meditate so the boredom and anxiety I felt were reduced… sure, I had options, but realistically, I was in a very bad situation and had no way to really change it. I think depression is a very natural reaction to being trapped in a miserable situation. I think if I were cheerful about it, it would have been at the cost of utterly denying my humanity.
Was I “disordered” because I was massively depressed and anxious and “maladjusted” to the school environment?
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OK, I’ll bite – what’s the 12-Step Chant?
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I believe it is commonly used as a date rape drug.
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You hit the nail. Compassion and empathy come first. Without them, “techniques” are worse than useless – they become a new form of abuse and oppression. And with them, “techniques” become of only secondary importance, as empathy will lead us down the right path toward knowing what best to do to help.
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And worse, it often gets passed on to another generation when the scapegoat or the witnesses have children of their own. It’s literally a vicious cycle.
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I agree, attachment is fundamental, and without it, a person has no sense of safety and can’t relate to others. Naturally, any kind of therapeutic intervention (the real kind, anyway!) depends on connecting to the counselor/therapist/helper/group, and absent the ability to attach, it’s almost impossible to process traumatic experiences of any kind. It is the most overlooked and most important element in a child developing what is so euphemistically called “mental illness.” So I don’t minimize the importance at all. I only wanted to be clear that there are other people who have good attachments but experience other kinds of abuse and trauma and oppression that lead to “mental illnesses” as defined in the DSM. Of course, the psychiatric profession doesn’t want to look at any of these valid and real sources of distress, because it upsets their political and financial power base.
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I agree 100%. It’s not because people are stupid, it’s because they are brainwashed and cowed and unable to use the intelligence they have due to the oppressive conditions they face. Waking up is, indeed, job one!
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That was my philosophy – you do what works for the client, and if it doesn’t work, you stop doing it. Pretty simple, really, but it is based on the idea that the therapist actually gets to know and care about the client, and is able to empathize with the client’s suffering and understand how s/he thinks about things. In other words, human connection guides a helper toward things that work. In fact, a person in excellent communication with another can actually invent “techniques” on the spot, specific to that person. Eric Erickson said, “Therapy has to be reinvented with each client.” I believe he was right.
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I’d say that attachment is one important factor in development, but there are many others. We don’t want to go down the same path as the psychiatric profession by assigning all distress to one single cause and approaching it with one single approach. That being said, the current reality in the “mental health” field is for the most part to excuse parents’ behavior as “doing the best they can” while refusing to acknowledge the damage parents (and siblings, BTW) can do inadvertently, even with the best of intentions. So it’s good to have articles talking about attachment – it really does affect everyone, but it doesn’t explain everything.
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Perhaps I worded that carelessly. Helping people find some ACTION they can take to improve their lives provides hope, whereas telling them their brains are broken and that there is nothing to be done about their “lifetime illness” drives people into despair, unless they are smart enough to understand that they’re being scammed. I don’t believe in broken brains, or if there is brain damage, it is observable and is dealt with by neurologists based on actual evidence.
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In my experience, CBT is simply one of many potential techniques one can use depending on the person you’re working with and their needs and goals. To make it a “therapy school” has always seemed like a delusion and a deception to me. Why would someone restrict themselves to a particular technique and apply it to everyone? Different people have different needs. I’ve also seen/heard of CBT being used to blame the victim of abuse for not “thinking correct thoughts” instead of dealing with the traumatic experiences that led a person to the kind of beliefs they have.
It seems like the movement was driven by ego and money-making. Starting from the assumption that someone’s thoughts are somehow “wrong,” and that these thoughts occur in a vacuum, having no relationship whatsoever to past or current experiences, is both idiotic and guaranteed to create bad effects. I’m glad someone is writing about this, but as usual, the facts will do little to nothing to disturb the professionals from their greed and egotism.
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Marsha Linehan.
It seems that these studies neglected to take therapist variables into account, nor did it control for psych drug use.
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The DSM is actually enforced by insurance companies, not the government. If they would reimburse without a DSM code, the DSM might very well die.
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I remember very clearly that being said about the Viet Cong during the Viet Nam war when I was just a kid. I recognized it for what it was then and it made me extremely uncomfortable even as a young person. It’s an ancient trope, and should be easily recognizable, except to those who don’t want to see it.
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A worthy goal, though sometimes difficult for me to do when I see the pain and destruction around me!
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I also wonder if OrthoPsych contributes to increasing hope and a sense of agency in the recipient, beyond whatever concrete physiological health issues are being addressed. One of the worst things about the psychiatric model is that it tells people there is nothing they can do about their “broken brains.” It seems that OMP challenges that directly and says, “Yes, you can!”
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This truly accomplishes a new level of idiocy. We now want a pill so that people don’t care if they are isolated and disconnected from their community? The need to communicate, organize, and work together is as fundamental to humans as the need to breathe and eat. It seems that the drug industry and psychiatry are bent on making sure that basic humanity is drugged out of existence.
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I used to be a staff person for the Long Term Care Ombudsman program in Oregon. I was called once to a nursing home to see a guy whose daughter thought he was “overmedicated.” I could barely get him to open his eyes. He had bruises on his head because he’d walked into the doorframe instead of through the opening in the door. I interviewed the activities director and she told me that a week ago, he’d been hitting a volleyball back and forth with her in the courtyard! The difference: he was now on Risperdal.
How anyone could call this an “improvement” is beyond my comprehension. It shouldn’t take an outsider coming in to point out that they’ve now disabled a perfectly capable person for nothing but the convenience of the staff.
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Wow, that sounds like the kind of things people say to dehumanize our war “enemies.” “They don’t have the same respect for life that we do.” Amazing that she could say such a thing and not expect you to have a horrified reaction.
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The fact that many people “in treatment” continue to do (or START doing) what the “treatment” is supposed to prevent seems to be completely ignored or suppressed. You’d think that improving “symptoms” would at least be a minimum standard for effectiveness, but apparently, there are no such standards.
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Exactly.
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Ever see Invasion of the Body Snatchers? Sounds like psychiatric utopia – no one excited or upset about anything, and no purpose but to snatch more bodies.
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Quite so. Intuition is information – it’s usually a warning to look more deeply. It can’t always tell you WHAT is off, but it does tell you SOMETHING is not right, and that further investigation is warranted.
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Exactly. If they don’t have time to do that kind of work, they should not be pretending they are in a position to help. They should be honest and admit they are not qualified to help, and refer the person to someone who has the inclination and the skills to be a patient listener and an interested friend in time of need.
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“Living well is the best revenge!” Yet a desire for other forms is certainly understandable.
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Excellent questions! It seems bizarre to think that a person who has just had a stroke would be anything BUT depressed, anxious, and confused. Why does this need to be “fixed?”
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“Moreover, the study suggests that although it may seem that further questioning about suicidal ideation would elicit more information to facilitate accuracy in assessment, it is also associated with a higher false positive rate. In other words, detailed questioning increases the likelihood of inaccurately assessing people as at-risk for suicide when that is not the case.”
“Clinicians sometimes rely on suicidal ideation as a crucial test for short-term suicide risk, and it has been argued that asking about suicidal ideation could form part of a screening test for later suicide.”
I think these paragraphs highlight the real problem with this kind of questioning. The clinician is “assessing” or “screening” or “testing” for “short-term suicide risk.” They aren’t having a real conversation with the client – there is nothing here about establishing rapport, about finding out what is going on in this person’s life, about exploring why the client would feel that ending his/her life was a good or necessary idea. It is no small wonder that their clients/patients aren’t willing to share the truth with them. Would you tell someone whom you knew was “assessing” you that you were considering suicide, when that their “assessment” could get you locked up if it went the wrong way?
There is nothing wrong with asking someone if they’re thinking about suicide, IF you have a sufficiently trusting relationship and have the clear intent of listening and helping rather than “evaluating” the person you’re talking to from some elevated pseudo-“objective” viewpoint. The problem isn’t the question, it’s the intent of the person asking it that causes the difficulty.
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Amen!
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2/27 sounds like the place for me. Thanks!
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True, and it’s frequently not obvious at all to outsiders, or even to those in the family itself. Thanks for your kind words – I appreciate you as well!
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And plenty of “immoral” people got away with whatever they wanted, because they had money, status and power.
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That is the title of the last chapter of my book: “Trusting your gut!” We all have intuitive knowledge that we can’t explain regarding other peoples’ priorities and intentions. When we learn to trust that knowledge, it is much, much harder for others to get away with this kind of subtle control.
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Yeah, sorry about that. For anyone who knows what foster care is like, it’s pretty grim reading, isn’t it?
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Ah, the power issues! It’s easy to claim you’re trying to help when your social power protects you completely from the consequences of your help being so terribly harmful.
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I don’t disagree. It is a sign of the decay of our culture.
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I think perhaps you are confusing the effect on certain individuals with the character of the institutions involved. The fact that there may be some psych wards that get good reviews, or that some teachers run very democratic and engaging classrooms, or that some kids love school for whatever reason, does not change a thing about the underlying purpose and structure of the institutions involved. If the basic design of schools is to teach children compliance and snuff out creative thinking, and that is the general effect on the population as a whole, the fact that a small or even moderate number enjoy their time being brainwashed and trained to bark on command doesn’t alter that effect.
A similar argument is commonly made about DSM diagnoses – “Some people like their diagnoses.” Well, sure, they do. But does that change for one second the fact that the diagnoses themselves are complete social constructs with no actual validity in the real world, or that they are used to undermine and blame those who experience psychological and social oppression by claiming their adverse reaction to their oppression is due to malfunctioning brains, rather than a malfunctioning social and economic system?
When I worked as an advocate in nursing homes, a home was taken over and put into federal receivership because it was so awful in terms of patient care. Yet they received approval ratings in the mid to high 80% range. Most people are satisfied with the status quo, even if it isn’t something they ought to have to put up with. They simply aren’t aware that other options exist.
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True dat!
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In addition, there are misunderstandings and personality misfits between parents and children which contribute to later “mental illness” diagnoses. Moreover, there is research showing that sibling relationships can do a lot of damage, especially in families where feelings are not processed and problem-solving is done in a mostly unconscious manner. No overt abuse or trauma need necessarily be present. For instance, I was assigned a role as a “scapegoat” in my family and was picked on by an older sibling. I became seriously ill and was no longer an acceptable target, and my youngest brother was born about the same time, so my next youngest brother got the job of “scapegoat.” I suddenly became aware, though I could not have verbalized it, that I wasn’t the scapegoat because of some flaw, it was an assigned JOB.
Anyone looking at my family would have thought that all was well. There was very little in the way of overt trauma per se, but plenty of subtle undertones of hostility and unspoken emotion and unspoken rules and defined roles, all of which caused a great deal of emotional damage without any discreet “trauma” on which to hang one’s hat.
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Better to die of kidney failure than to live without their drugs.
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Lots of snow up here – 10 inches, I’d say.
Let me know what’s going on and when – I’d definitely join in such a protest! I know a couple of others here in town as well who might be interested.
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I don’t think the shame is as much a deterrent as the loss of funding!
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We should not forget that the adults are often mean to the children before the children are mean to each other. I mean parents and teachers and administrators. Kids don’t just become mean, they learn it from someone.
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I would recommend it. DV professionals seem to be the ones who really understand and speak from a position of empowerment and understanding of oppression and the pain it causes. I don’t know Seattle at all (I live in Olympia, and before that Portland), but the DV programs there might be able to help you find a good person to help. At the least, you will experience that you are very far from the only one to experience such disrespect and foolishness in the Court system.
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I don’t disagree with what you’re saying. The research in question is about children healing while still children, and the ability to have a safe dependency on a caring adult appears to be the most important aspect of their psychic healing, which apparently manifests in the brain as well. When we get to adulthood, we have to figure it out on our own if we are not fortunate enough to have had such a person, but similar considerations still come into play. What is quality therapy but a person listening to and caring about another person in a safe space? And why can’t non-professionals do the same for each other? Of course they can, and they do, as you (and I) have observed.
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Ornish was absolutely on target when he started writing this stuff back in the 70s. Naturally, he was roundly attacked and ostracized by his peers at the time. Now everyone makes Ornish’s recommendations, but I never heard any apologies or crow-eating on the part of the big medical system. It is amazing how often truth is obscured in medicine when it conflicts with habit or profits.
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Bravo, Richard! Great post!
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That IS how “ECT” “works” – it creates a traumatic brain injury. That’s all it does.
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It’s always easy to think of what to say after the fact. I seldom come up with these zingers when I’m actually talking to the person who is messing with me. Maybe I need to learn to stop and say nothing for a while instead of immediately responding, and I can come up with some better routines on the spot!
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As JRR Tolkien wisely said, “It takes but one enemy to make a war.” And we know who created THIS war. It’s not the fault of the downtrodden who rise up against the oppressors that the oppressors fight to maintain their power. They could simply acknowledge that these drugs have little positive effect and a lot of potential harms, and redo their “algorithms” accordingly. No war would be necessary if those in charge would simply admit the facts and work from them.
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I often do the same. If we’re going to use a label, I use the ones that indicate damage from trauma. Though I talked to a psychiatrist once who said “PTSD” was not caused by the trauma, because not everyone who was traumatized got “PTSD.” What? So being hit by a car doesn’t cause broken bones, because not everyone’s bones break when they get hit by a car??? The problem is apparently “vulnerability,” because I guess everyone should be able to handle being traumatized without having flashbacks or nightmares. Very weird!
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OMG, that is awful! “Are you sure?” Maybe you should have said, “You sound so disappointed. Would you feel better if I were suicidal?” Nah, probably would have gotten you locked up for “excessive snideness disorder.”
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Jesus spent 40 days alone in the desert. Doesn’t sound too extroverted to me!
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I am SO sorry to hear all this! I wish it were an isolated incident, but it is not. What amazes me is not that abusers engage in this behavior, but that the “professionals” seem so ready to fall for it. The fact that you’re teaching school all this time despite the abusive crap he’s been spewing at you should be enough to make it clear you’re a very sane person in an insane situation. Additionally, his focus on controlling how much time you spend with your child and ACCUSING you of wanting to spend more should be an obvious indication that he is abusive and controlling and doesn’t care a whit about the child.
Are you connected with any kind of domestic abuse agency or services? They can be really helpful! And keep reading your Lundy Bancroft – he is the best guide to how to deal with these suckers.
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It’s not paranoia if they’re really conspiring against you!
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Wouldn’t it be great if we can mistreat people and they wouldn’t mind? That’s the ultimate pill – to make people willing to accept whatever crappy treatment those in charge want to dole out without complaint.
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There is also great work from the “decade of the brain” which is largely ignored, showing that the BEST thing to reduce the damage from early childhood abuse or neglect is, wait for it… a positive relationship with a caring adult!
It’s not brain surgery, but they apparently want to make it into brain surgery. Sometimes literally…
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That is an amazing book for anyone who has to deal with abusive men. I’d highly recommend it, too.
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That is an excellent point! The psychiatric worldview is in actuality a religious one, and it attempts to supplant other belief systems. Perhaps enforced “treatment” can be objected to on the grounds of freedom of religion?
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I very much like your first statement – if anyone is “mentally ill,” we all must be, because there is really no way to distinguish “normal” from “abnormal” people.
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Yeah, who saw that coming?
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It is definitely a lose-lose situation!
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I would rather suggest that the new/old way of thinking is not at all compatible with the DSM or any of its definitions. If things defined as “mental illness” are to be considered common reactions to difficult circumstances, we need to dispense with the idea that a particular emotional/behavioral reaction is in any way a “disorder” or “disease.” Moreover, the idea that lumping people together based on their particular reaction to their particular history and context and saying they all are “suffering from the same disorder” is, to me, inherently invalidative of the very context it seems you and I both want to see brought to the forefront. I hope that makes sense!
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I have seen this many times in my work with foster kids and Juvenile Court. I got to the point where when I saw a crying, emotional, seemingly out of control mom and a super calm, confident, under-control dad, I thought, “OK, we know who the real problem is here, and it’s not her.” I also saw how things changed in the cases where the survivor was believed and things started turning against the abuser. All of a sudden, the calm, confident person became increasingly angry, agitated, and even bizarre as the control slipped away from him. But someone has to start by believing that the person who is upset has a reason for it, and the reason is usually sitting across the courtroom from her.
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I have to agree. The very fact of being told that your brain is broken and there is nothing you can do about it would make anyone feel hopeless. Add to that the frequent invalidation of one’s own experience and internal knowledge about what is going on, and you don’t need a drug to make someone give up. Not even getting into the horrors of “involuntary treatment.”
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https://www.merriam-webster.com/dictionary/meanwhile
meanwhile adverb
Definition of meanwhile (Entry 2 of 2)
1 : during the intervening time
meanwhile, however, new projects are being undertaken this year
— Jonathan Eberhart
2 : at the same time
You can set the table, and meanwhile I’ll start cooking dinner.
Seems like you were thinking of the first definition, while I was intending the second.
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Ah, if only you could have engineered a REAL disaster – simple extreme suffering just doesn’t get the audiences it used to…
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“Meanwhile” to me means “at the same time.” There is no sense of higher priority intended for either point.
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Too true!
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As usual, the solution devolves into doing things to the patients instead of the doctors looking at how their practices and beliefs led to the problem. Easier to blame the least powerful.
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I like “injustice evidence!” Puts the responsibility where it belongs.
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Sounds good to me!
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I don’t disagree with a word you said. Helping people “game” the system and helping them recognize the true sources of oppression in their lives is a huge effort that has its own challenges and rewards, and is very clearly distinguishable from “helping people accept their illness” and other such nonsense. Domestic abuse is a good analogy – we all want to stop domestic abuse from happening, and working at a societal level to alter perceptions and biases and privileges enjoyed by abusers is the ultimate game. But meanwhile, helping those ensnared in such a situation is most definitely needed and contributes to the larger goal, especially when part of the process is political engagement for the survivor.
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I actually like it that they call it a “Bible.” It correctly identifies psychiatry as the secular religion that it is.
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I guess the distinction here would be that one’s support of current victims of the system would need to be in a frame of helping them understand that the system is in itself a part of what they need to “recover” from. The Underground Railroad is, I think, a valid analogy.
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For one thing, many “antidepressants” don’t affect serotonin and still are considered “antidepressants.” For another, studies back in the 80s showed that lots of “normal” people have lower serotonin levels. For a third point, no one knows what a “normal” level of serotonin is – serotonin levels vary widely from moment to moment. Have you read Anatomy of an Epidemic yet?
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Gotta say, I see both viewpoints here. On the one hand, we don’t want to do anything to validate the dangerous nonsense that is the current system. On the other hand, I don’t want to simply abandon those in the clutches of the system when they are suffering. I think we need to do both – provide practical support to those in trouble while still insisting that the current system is utterly wrong from the ground up. How to do that is the tough question, but I think both/and is the essential way to go.
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Hey, good for you! You’re personal success is a thumb in the eye of the psychiatric lie factory!
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Yeah, I get what you’re saying. Spiritual harm is a very real thing to me, but it’s very different than a physical injury. Metaphorical vs. physiological.
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It is my understanding that his withdrawal of the trauma theory was made under great pressure from his colleagues and Victorian society in general. However, we can’t absolve Freud of his decision to create a confusing and dishonest counterexplanation that served to baffle and mislead the public and the profession for generations. His cowardice in the face of social pressures had enormous negative consequences for millions of people.
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I am glad you said that. I find “behavioral health” particularly disturbing. Now behavior has “health???”
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There are definitely points at which men experience bias, but on the balance, women are far more likely to get the short end of the stick, even today (though it is better than it used to be by a long way). For instance, there is this idea that women usually get custody in divorce proceedings. But this is mostly because men usually don’t contest. Many studies done in many US states in different jurisdictions have showed the same thing: men who contest win custody 60-70% of the time.
There’s a lot more I could say about this, but suffice it to say that while things are better than they were in 1965, men still receive plenty of protection just because they’re men. The Kavanaugh hearing and DT’s comments on how “hard it is for young men” now that they have to worry about being called to task if they’re too aggressive toward an unwilling “partner” should be enough to remind us that there is a LOT of work still to be done.
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Very well said!
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They still often portray psychiatrists as talk therapists or hypnotists on TV and in movies. There are some that show what the current reality is, but I’m sure it’s a PR effort by the APA to make sure psychiatrists are shown as kindly therapeutic types rather than drug front people.
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The word “pretend” bothers me here. I don’t think people are pretending they are in pain or are confused. Perhaps you could call it “spiritual injury”. Or don’t you think it damages someone to be, say, abused by one’s parents? Do you think they are pretending that it hurts them beyond the physical damage?
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It is also important to keep in mind that while women can be abusive, emotionally and sometimes even physically, men are supported and protected by social structures and gender role expectations in ways women are not.
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I like “inmates liberation.” Gets to the core of what is really going on.
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I actually think SAMSHA is a great example of why a survivor leadership is critical. It’s way too easy for any other structure to be coopted by the status quo defenders.
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Just my two cents here. I don’t hear anyone wanting to deny membership or participation to people like me or others who don’t fit the “survivor” description. And I’m not sure the most important issue is honesty or trust, either, though I don’t want to invalidate Kindred’s raising of this as a vital issue. It seems to me that the issue is one of social power. It is pretty easy for those in the one-up situation to believe they are being “fair and equitable” when they are actually exerting their unearned authority based on social biases. So making sure that the direction and priorities of an antipsychiatry movement are not only informed by, but directed by survivors seems a very important point to me. It’s not that others can’t help and be passionate and come up with new ideas. To me it’s that the ultimate test of any idea is whether those who have been through the ringer think it makes sense and would work. Survivors have to ultimately direct the effort, even if a lot of hard work is done by people from all walks of life who interact with the system in some way.
That’s MHO, for what it’s worth.
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It is so important to call out these “ad hominem attack” strategies for what they are! The reason they resort to these tactics is because using actual data and logic will be a losing proposition. Unfortunately, the tactic is often extremely effective in silencing dissent!
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That is a fantastic idea!! I would love to have that data to toss out when someone claims “the mentally ill” are causing most of the violence we see or hear about.
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Thanks for the laugh!
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Maybe we could create ways to afford an education WITHOUT going to prison. The GI Bill had pretty amazing positive effects. A similar program of service would add a lot to our economy and end up with a lot fewer criminals, I’m betting. (Except the white collar kind who already have educations and commit their crimes “legally.”)
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Wow, that doesn’t even make any kind of sense! “However, given the increased risk of suicide in untreated depression and the absence of an increased risk of suicide associated with pharmacotherapy, currently available evidence does not support the avoidance of initiation and continuation of pharmacotherapy for depression in children and adolescents.” Didn’t he just say there WAS an increased risk of suicide with SSRIs???
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Such a fantastic story of how your own “commonsense” understanding of the situation was repeatedly invalidated or ignored by the “professionals” in favor of their own worldviews and beliefs. It is wonderful that you had the courage and historical models to tell the doctors to shove off when you needed to do so. I also find it important to note that your political analysis of the society you grew up in factored into your ability to resist the inappropriate and abusive authorities. I think such political awakening is often critical to folks “recovering” from their ostensible “disorders.” In the end, our social system has abuse built right into it from the foundations, and recognizing that may be the most “therapeutic” act a person can engage in.
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I appreciate the perspective of unearned privilege that you lay out in this piece. I had not really thought of it that way, but it makes total sense. “There are some good ones out there” doesn’t do a thing to address systemic oppression, and in fact impedes the effort. I love the idea of convincing local NAMIs who “get it” to go rogue and disavow the NAMI moniker and all the nasty history (right up to the present!) that goes with it. I’d love to see that happen, but even people with respectable levels of integrity have a hard time walking away from privilege, however unearned it may be.
Thanks for another great article!
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I agree with all of this, and could go on for days talking about it. My book is in part an effort to raise consciousness, especially in women, regarding how our culture tells us men and women should act, and how acts of abuse are normalized and even romanticized (fighting over a woman, pursuing someone who says “no” as a sign of how much he “loves you,” etc.) I think this is particularly true for those victimized early in life,o or who witnessed their parent being abused, who have little or no model of what a loving relationship looks like and who are therefore less able to distinguish grooming tactics from genuine affection. Our culture does them no favors by romanticizing “bad boys” and making excuses for abusive behavior by men, and putting women in the role of “peacemakers” or “fixers” if the relationship doesn’t seem to be working as it should.
Domestic abuse is a very, very complex dynamic. It is perhaps natural for those who aren’t aware of this to ask, “Why doesn’t she just leave?” but too few are willing to look at the very real and very dark and difficult answers to that question when they make the perhaps understandable mistake of asking it.
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Very well said!
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Depression may “feel like a disease,” but that doesn’t make it a disease. I say this as a person who struggled with depression and anxiety for the first 30-40 years of my life, including times of feeling suicidal and seeing no point in life at all. I am GRATEFUL that no one ever “diagnosed” me with a “brain disease,” but instead people (including my therapist) encouraged me to believe that I could DO something about it, and helped me take small steps, one at a time, that led me to a place where I actually spent most of my day NOT feeling anxious or depressed, and where I knew what to DO if I felt that way to find my way quickly to a more effective approach to whatever was bothering me.
Some approaches that helped: recognizing being over tired or having low blood sugar, learning to meditate, learning to emotionally process difficult experiences from my past in a safe place, spending time hiking and biking, finding meaningful work, listening to clients about their own experiences and seeing what they seemed to find helpful, challenging myself to confront injustice when I was scared of the outcome, raising some wonderful but at times incredibly difficult children, learning how to grow with my wonderful but at times incredibly difficult partner…
ALL of these things and more have contributed to my learning how NOT to be depressed, and it took a couple of decades and a lot of support from a lot of people, some professionals but mostly just “regular people” who cared about me, or for whom I was responsible in some way or another. How could such a complex interaction of forces be considered a “disease?” Depression didn’t just HAPPEN to me – it was the result of many years of experiences and decisions and goals and accomplishments and failures and relationships. The body was certainly involved, and may perhaps have colored the way I reacted to things. But to reduce my feelings of depression to a random problem in my brain would be absurdly reductionistic and invalidative – it would take away the meaning of the work I’ve done and the things I’ve learned in the process.
There may be a tiny percentage of depressed people who actually have something wrong with their bodies, and they certainly deserve medical help if it is available. But the vast majority of depressed people have a history of their own, very different than mine and yet in some ways very similar. Reducing their suffering and their emotional experiences to a malfunctioning brain is not only insulting, it is ultimately disempowering in that it denies that person’s ability to look at, sort out, and address whatever range of experiences lie underneath their emotions and behavior. If the indications of depression can be in any way viewed as “symptoms,” they can only be considered “symptoms” (aka clues) of the actual problems or challenges a person has to face. And those problems and challenges are intensely personal and unique to each person, and will never be able to be categorized as a “mental illness” in the physiological sense.
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Wow, that is a great story! Good for your mom! Did that experience contribute to your eventual awakening?
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Not yet, but I intend to.
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I like option 2!
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Fantastic response, Dan!
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Not to mention, if you cure people, you lose customers!
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“I thought I just had eyes that got dry all the time. Then I realized I had a real medical problem – chronic dry eye! Then my doctor told me about Zaquejex!”
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Amazing – changing how you live your life changes how you experience your life! Who would have thought?
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Again, we know from scientific research that meditation can change the actual structure of the brain – MENTAL activity can restructure the brain! So to suggest that fixing the brain can fix the mind seems to fly in the face of evidence that it is the mind (whatever that is) that affects the brain, or that at a minimum, it’s a two-way street.
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Not sure how else I can put it. Mental/emotional suffering does exist. That is not in dispute. The dispute is the idea that “mental illness” can be defined in scientifically precise terms. “Mental illness” is an analogy, a metaphor, a squishy-soft social construct that has no scientific definition at all. Even the former head of NIMH agrees with this. But it is a common argument in favor of the concept of “mental illness” to say that, “saying mental illness isn’t real means that you’re saying that mental suffering isn’t real.” It’s a false equivalence.
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Your statements are very consistent with my experience with hundreds of domestic abuse survivors. Accusing partners of being “mentally ill” is a very common and very effective tactic used by abusers in domestic relations hearings and in juvenile court child abuse cases. There has been a lot of improvement in terms of professionals’ understanding of domestic abuse, but this strategy still works in way too many cases. And intentionally pushing a partner to retaliate is also very, very common in domestic abuse situations. The threat of involuntary commitment and/or loss of children is a very powerful tool that a “diagnosis” puts into the hands of the abuser, yet a lot of mental heath professionals seem to have no awareness of this kind of manipulation.
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Expert opinion is, in my view, not relevant to this discussion. We’re talking about science, or I thought we were. The concept of “neural connections” is very soft science at this point – there are not “connections” in the same sense that wires connect to each other. It is certain that neurology comes into play when talking about distressed states, but saying that provides no evidence regarding the causes of distressed states, which is the really relevant point here.
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I’m not arguing against studying the brain, Shaun. I’m arguing against the idea that you can assume that the brain and the mind are identical, and that studying the brain will yield an understanding of the mind. And I reiterate: the results to date suggest strongly that we are barking up the wrong tree, and in fact probably in the wrong forest. Studying the brain gives information about the brain, which may be very useful information. But so far, the study of the brain seems to have created nothing but confusion about what the mind even is, while studies like Buddhism, which look at the mind as a separate entity, seem to have let to much more satisfying results.
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And c) Science actually SUPPORTS the idea that “mental illnesses” are not physiological in nature, and in fact, don’t define homogeneous groups at all. I think Shaun is confusing the idea that no one SUFFERS from the idea that there is no scientific way to define the concept of “mental illness” in the sense of a physiological problem.
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Yes!!
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The question is not whether distressed states exist. No one disputes that. The question is whether these states can be explained and understood by studying the organ of the brain. I suggest that they can not.
Of course you can see no distinction, because it violates your basic beliefs. I do assert that the mind boils down to the decisions we make, but more importantly, WHY we decide to make the decisions we do. And I defy you to show where values and principles and priorities are stored in the brain. We don’t even have a clue how memories are stored. You can’t tell me where to find values.
Perhaps a clearer way to put it is that the brain is kind of like the computer processor. It doesn’t work without a program, which you can NEVER understand just by studying the circuits. But more importantly, the computer requires an OPERATOR. To me, the mind is the operator of the brain. We may one day find the operator within the brain’s structures, but as of now, no one can say where the operator is or how it works. A true scientist would have to admit that this is the case.
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Gotta agree with you there, Frank!
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Millions of people believe a lot of stuff that isn’t true. What is the scientific underpinning of any “mental illness” you can name? How is a person objectively determined to “have” vs. “not have” a particular “disorder?” And even if such “disorders” could be objectively identified (which they can’t), what evidence is there that all people with the same “disorder” have the same thing wrong with them or need the same kind of help?
The DSM itself proves that neither of the above conditions can be met. It admits in the introduction that there is no line between having one disorder or another or no disorder at all. It also states that there is “no assumption that people with the same disorder are alike in all important ways.” In other words, they admit that these “diagnoses” are actually heterogeneous groups of people who may have little to nothing in common with each other. What on earth is the use of a “diagnosis” that labels people arbitrarily into groups where the people don’t even share common characteristics? It makes about as much sense as saying someone whose knee hurts has “knee pain disorder” which causes his knee to hurt.
If you claim to believe in science, you ought to think carefully about how these “diagnoses” are arrived at. There is very little science involved, actually.
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So in other words, yes, you do think the mind and the brain are the same.
The fact that all information goes back to the brain to be processed proves nothing. The fact that science can’t distinguish between “mind” and “brain” simply means that science has no idea what “mind” is and is incapable of speaking intelligently on the topic.
MIND, to me, is that part of us that has intentions, valued, priorities, goals, scruples, etc. It demonstrates such qualities as courage, anticipation, regret, integrity, faith, etc. As long as none of these qualities and qualities like them aren’t definable in terms of the brain, then science can not claim the brain is the same as the mind.
For materialists (like you, I guess), there is no possibility of anything existing beyond the physical. This forces them into a position where they can have no clue what “mind” is, and yet be completely certain it must be part of the brain, “Because where else could it be?” But again, that’s a matter for philosophical discussion, not scientific.
Science is supposed to be skeptical. This means that if something is not shown by data to be true, it is simply unknown. It can’t be assumed to be true, in fact, any such hypothesis would need to be thoroughly tested and all alternative possible explanations eliminated before we could conclude this is the case. Obviously, nothing remotely close to this has ever been accomplished, or as far as I know even attempted. The fact is, the mind is a MYSTERY to science. It can’t even be defined, let alone located in the brain. (Let me know when you find where “courage” or “integrity” are located in a brain.) Just because you or others are materialists doesn’t mean materialism is “right” or “true.”
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But is the choice between lazy wastrels and wage slavery?
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I don’t disagree with you. I’m just saying the task is easier for psychiatrists. But psychiatrists are a predictable product of the medical system, almost inevitable. Psychiatry is a symptom of a much larger problem.
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For a very long time, producers of any product had the luxury of dumping their waste into the environment for free. It’s only recently that the levels of waste have gotten so high that people demand some action, yet it is still not accounted for when calculating the cost of production. There is still this sense that making corporations pay to clean up their own messes is somehow unfair or undermining of “competition.” But of course, anything that is dumped leads to a cost, and most of the time, the taxpayers end up paying that cost and the producer gets off with little or no responsibility for the effects of their production.
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The Fed also exists to make sure wages don’t start going up too fast. Or at all, maybe.
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It looks from my angle like a guild war – psychologists want in on the 15-minute med check action and psychiatrists want to protect their turf. Nothing to do with caring for their supposed clients.
Any psychologist who wanted to be able to prescribe would be immediately scratched from my list of possible helpers.
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They are operating on the radical notion that black people shouldn’t be shot at and killed for being black. Pretty crazy idea, eh?
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True enough! Or give them enough Risperdal that they’re unable to stand or walk, and suicide rates would be expected to drop. The only problem is “underdosing” such that the patient is still able to move and formulate any kind of plan of action.
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Thanks for sharing that. How can anyone imagine that such a process can be “helpful?”
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How about “you can’t trust the majority of psychiatrists?”
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There is one difference in psych research, though. They are researching “entities” that can’t be objectively defined or observed, which is perhaps the worst possible sin in science. When we start dealing with metaphorical entities, we’re dealing with philosophy, not science. Not that most doctors are concerned with science, either, mind you. It’s just harder to get away with pure BS when you have to at least demonstrate that your drug has a measurable effect theoretically considered positive by the recipient rather than the doctor and the family and the society at large.
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Ha! Good one!
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Your answer avoids my most important point. Your comments seem to reflect a belief that the mind and the brain are the same thing. Is this your belief?
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I was going to object to the “throwing darts” metaphor, but the more I think about it, the truer it is. It’s like throwing darts at the patient.
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Your points regarding brain development are well taken. However, you’re still not dealing with the question of what the mind is. We know that actions of the mind can not only “reprogram” the brain (to use an idiotically oversimplistic metaphor), they can actually cause the structure of the brain to change. It can alter the expression of DNA. So what is this “mind” that can fix up the brain itself? Is the mind more than the brain? And if so, should we not engage the mind in overcoming unfortunate developmental results of early neglect or abuse?
I’d also add that we know that 90% of serotonin receptors are in the gut region, and that there are some who theorize that some level of “thinking” is moderated by the gut. People don’t say they have a “gut feeling” about something for no reason – they really do appear to judge things with their guts!
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He felt resentment against Whites, eh? And that’s a sign of “mental illness,” per the authors? What would be the appropriate response to being treated as a second-class citizen your entire life? Cheerfulness? Or would that be too “manic?”
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Of course, having the largest percentage of armed people of any country where stats are kept hasn’t really helped the USA avoid oppression much, has it?
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Done!
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Didn’t know that. Thanks for sharing!
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Akathesia happens while taking the drugs, too. So it can’t be a withdrawal reaction, or not just a withdrawal reaction, anyway. But it’s definitely a reaction.
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Of course, there is never a study to see if drug-based “treatment” is safe.
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NAMI Santa Cruz used to have a really interesting website, very much supportive of individual empowerment and questioning the dominant paradigm. Somehow, they seem to have removed it years back. But I assume they may be one of the “rogue” local NAMI branches that actually do some good work.
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We have to alter the incentives.
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That, and the fact that their “treatments” cause diabetes and heart disease…
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Of all the idiotic things they do in psych hospitals, waking up “patients” in the nighttime or early in the AM may well be the most idiotic of all. Anyone alive knows that sleep deprivation impacts the emotions and the brain’s operation in a destructive way. Especially someone suffering from any kind of hallucinations needs, above all, SLEEP! A “normal” person deprived of sleep for a long enough time will start hallucinating. Why the f%$k would you wake up someone who was hallucinating once they fell asleep? Unless you WANTED the person to keep hallucinating…
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Still waiting to see what exactly the evidence is of these “organic” brain problems.
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Sounds like impressive “progress!” But the psychiatric profession has never been all that interested in facts, especially inconvenient ones.
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I like the sound of it! We’re living in an RV ourselves these days, which is about as “off the grid” as we’ve been able to manage for the moment. It doesn’t surprise me that our monied elite is opposed to such a concept!
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You seem to be operating on the reductionistic assumption that mental distress is “driven by” something wrong with the brain. I don’t agree. There is, at this point, no evidence to suggest that malfunctioning brains create any “mental illness.” Even if you choose not to believe in the possibility of non-material entities, the evidence to date strongly suggests that there is a process (or a SOMETHING) we call “mind” that transcends the mere interaction of cells, just as a computer program transcends the diodes and transistors and capacitors in the processing unit. It is clear from research on Buddhist monks, for instance, that directing the mind to do certain activities changes the actual STRUCTURE of the brain.
It seems you go back and forth between the idea that caring for people and creating safe spaces is paramount to hoping that studying the brain will somehow provide some answer that transcends the human needs and priorities that occupy our attention as human beings.
I don’t think you can have it both ways. The brain is certainly a participant in all human interaction, but so is the heart and the spleen and the liver. Participation is not the same as causation. In my view, the problem with the “medical model” is not the complexity of the brain, but the effort to seek a generalized solution for problems of the mind by trying to study and manipulate the body. We can see from the results to date that this approach is doomed to failure, and further study of the brain is highly unlikely to lead to anything but further confusion.
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I’d be more inclined to call it a “denied disorder.”
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It is not always the same symptoms that were “treated,” but it’s very common for the target “symptoms” to come back with a vengeance. Which is frequently considered by our “mental health professionals” to mean you’re having a “relapse.” At least that’s my understanding.
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The system is a lot more than just the government.
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That’s why I asked that question – it seems to me that once you lock the door, abuse is already happening.
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Sounds like they should keep the hospital police and get rid of the “mental health professionals!”
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Sounds like fun! Let us know where we can visit you!
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The first thing we have to learn about “mental health” is that you can’t and don’t need to “cure” an emotional reaction to circumstances. An emotional reaction doesn’t need to be cured, it needs to be understood through communication. Doctors need to realize that they can’t treat the mind as if it were an organ of the body. It is a lot more than that.
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There is one other difference. Inmates have a defined term or sentence. Psych “inpatients” can be “sentenced” for as long as they want.
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Ugh! That’s all I can think to say. Ugh!
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It is “the institution,” but every institution is composed of people, and it is people’s choices that allow the institution to continue.
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Hey, it scared me as a “mental health professional” when the big steel door locked behind me! The locked psych ward was a scary place, every one I visited.
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Sounds like a SUPER healthy environment! Especially for people who are anxious or paranoid – to actually spy on them and reinforce their sense of insecurity? Brilliant plan. But I guess “normal” people don’t mind being spied on…
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Disgusting! They are residents and should have the right to make phone calls and whatever else residents do. They aren’t supposed to be in prison, but apparently, they are.
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I think I got it all. The identities of the spammers were particularly helpful! Thanks for your civic contributions to the welfare of the community. I shall recommend you for the Despammer’s Award!
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And thanks very much for doing the digging! I have to look into why this amount of spam is getting through.
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Fobos has now been banned.
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Not to mention the folks making billions off the process who don’t want to have to remove their snouts from the trough.
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Would you consider the locked door violence in and of itself?
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From my understanding, it is not drug-based, but does use drugs in a minority of cases. Mostly, it’s about talking and listening as a group. I had a training on it and drugs were never even mentioned. I think they would use them only if their standard intervention wasn’t taking hold, and for a short period of time in most cases. Not saying that doesn’t raise concerns, but the data I have read suggests that 80% come out without any drugs at all, and that’s a pretty big improvement over 85% ON drugs in “standard treatment.”
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A saying I hope we all can learn to follow!
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We are apparently MUCH more advanced in our diagnostic capabilities! ///
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Trust me, MIA can’t afford to hire people to “study” behavior, even if we wanted to!
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I don’t disagree at all, and I believe chosen labels are more relevant for critique than those foisted on one by someone else. But I still hold that making complete assumptions or generalizations, even about psychiatrists, should not be allowed. Saying “all psychiatrists are NAZIs” neglects the fact that some psychiatrists, such as Peter Breggin or a handful of others, have been major critics and providers of helpful data to fight the status quo.
A very good point, though, and I’m glad you raised it.
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I don’t personally believe people are saying that to you, or most are not. I think they’re saying that this particular point was powerful enough to distract their attention away from the real point of your article.
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True. In a system that was truly trying to be helpful, this kind of intervention would be central rather than reported as an interesting sidelight to “standard treatment.”
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Except perhaps to the staff and administrators who are too lazy or incompetent to do so.
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Posting as moderator:
I appreciate you sharing your views on this. I want to make sure to clarify that there is no requirement that people avoid the use of “psychiatric language” and that people will never be moderated for that reason. The reason many posts on this thread were moderated was a specific violation of the guidelines against making assumptions regarding a group of people based on their psychiatric label or other chosen or assigned identity. The issue of “psychiatric language” is something that people in the community get to hash out among themselves.
That said, I do agree with you that folks would do well to consider the potential impact on a poster, including authors, when they comment. It’s important to remember that many of us were at a different place when first exposed to the kind of views one hears here, and that we may be running off potential allies by being overly harsh in our assessments and our language, because most people can and do learn if they are able to hear and process the information. But that goes well beyond the purview of the moderator.
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Commenting as moderator: Posts are moderated ONLY for violating the posting guidelines. I have explained clearly the reason why posts making generalizations about “personality disorders” or any other diagnosis will be removed, and provided a specific quotation from the guidelines that outlines this exact situation for purposes of clarity. You agreed to these guidelines before you started posting here, and you should not be surprised when violations of these guidelines lead to posts being moderated.
It is not appropriate to raise these issues on the threads, and I have explained to you each time why the post removed has violated the guidelines. Any future comments about “censorship” will be immediately moderated. I have only allowed this to stand so I can explain to any readers who may be confused the actual cause of posts being removed, which has nothing to do with any political agenda and everything to do with the posting guidelines that everyone has agreed to by choosing to post here.
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And ironically, they INDUCE seizures through “ECT” as a method of “treatment!”
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It sounds like you had VERY real reasons to be afraid! While you might have identified some “wrong targets,” your fear of your ex appears to be very well founded. Good job getting away from him, and well done to your husband for doing what the “mental health experts” were too blind to figure out. Just goes to show you don’t have to be a “counselor” to understand how to help someone in distress.
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They actually get tax writeoffs for lobbying expenses!!!!d Instead, they should be taxed or fined for lobbying!
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I agree that this is often the case. Unfortunately, due to the sketchy way these “diagnoses” are made, it’s unlikely that one cause can possibly be identified for any of these “disorders.” But we most definitely should be looking at prenatal pharmaceutical exposure. We know that street drug exposure does damage to the growing embryo/fetus – why would pharmaceuticals be any different?
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I find it understandable that you were upset by all the negative feedback. It takes a lot of courage to post a personal story. I’m glad you’re working to make it a learning experience.
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Thanks for sharing that. You’ve outlined the basics of how these “PD” diagnoses are used to invalidate and dismiss clients who have abuse histories. A minimum qualification for any counselor in my world is someone who recognizes that the DSM labels are BS and who understands that most “mental illness” is a result of being treated shabbily when one is vulnerable.
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You sound like you’re quoting from my own writings. What you’re describing is very real. I don’t think it’s always due to “low self esteem.” I think women in our culture are trained from early on to like “bad boys” and believe they can “save them.” Some men do this, too, but women are primed for it from the first time they read “Beauty and the Beast.”
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Perhaps the dehumanizing suicide protocol are the real problem, not the patients.
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When you invent “disorders” based on subjective behavior list, anyone can “have” anything.
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A fair criticism. I’d like to focus attention on the horrible conditions you were exposed to, what created them, and what kind of resolutions may be possible.
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I stand corrected!
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You are 100% correct. There is no excuse for such actions. You describe specific behavior here that is horrific, and I very much doubt that one single person here would disagree that you were inexcusably abused by these people.
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This is a sad and gripping description of the abusive environment you and the others were exposed to. Thank you for sharing it.
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Posting as moderator:
To a large extent, I have failed to moderate this thread effectively. Comments which are generalizations regarding people with a particular psychiatric label are expressly identified as violations of the posting guidelines, to wit:
“We are an oppression-free zone. Comments that are racist, sexist, transphobic or otherwise oppressive may be subject to removal. Statements that attack or assume things about a person based on a label they carry (i.e. “psychiatrist” or “schizophrenic”) are similarly not condoned.”
I take full responsibility for failing to intervene effectively, and I intend to change that starting immediately.
That being said, it is acceptable for people not to appreciate certain aspects of an author’s blog and to say so in the comments section, as long as the comments themselves are within the guidelines. I know this can be tough for authors, but it is a reality that has to be respected if we are to have any kind of meaningful conversation about these topics. It is a balance that has to be struck, and the guidelines are the best way I think we have to strike such a balance.
I will add that anyone seeing a post violating the guidelines is again welcome and encouraged to report it. It helps the community when the members of the community participate in setting standards they would like to see respected.
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You mean everyone here? Or everyone in the ward where you were held?
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Posting as moderator:
I have been very soft on my moderation of this thread, and I think that has been a mistake. That time is over and I am returning to full moderation policies as always. Comments that generalize about “the personality disordered” or any other psychiatric label will be moderated from this point forward. Please restrict your comments to the specific people you have direct experience with. “The people in the ward I was in” or “the other residents” is acceptable language. Generalized statements about “Drug addicts” or “people with personality disorders” is a violation of the posting guidelines, specifically,
“We are an oppression-free zone. Comments that are racist, sexist, transphobic or otherwise oppressive may be subject to removal. Statements that attack or assume things about a person based on a label they carry (i.e. “psychiatrist” or “schizophrenic”) are similarly not condoned.”
All commenters are to follow these guidelines, and further comments in violation will be removed. If you see a violation, PLEASE do not react with further escalation – report the comment to me via the reporting button, or by e-mailing me at “[email protected]”
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I think the point you are missing here is that nobody disbelieves your story or that you were harmed by other “patients” in the “hospital.” The problem arises when you speak of “the personality disordered” as if they are a homogeneous group who can all be assumed to believe and behave in the same way. If you were talking about “people who are violent” or “people who are emotionally abusive,” you would have no objections from this quarter.
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Of course, it makes no sense to have placed you there. My point is only that it is the STAFF who make these decisions, and the staff are the ones who are responsible for making sure that the residents are safe. They failed you, miserably, and you suffered extreme and unnecessary harm as a result.
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Thanks for that reply. Almost all of what you say, I agree with. The main purpose of the DSM is to allow billing, and if it were used just for that, I would have a lot less problem with it. And I don’t really have a problem with a CONCEPT like “narcissistic” or “antisocial” – these can be used as descriptive language to characterize someone’s behavior for purposes of discussion. But when such subjective concepts are somehow codified into purported scientific entities or medical “diagnoses” that can be assigned to someone by a person in authority, we are very quickly into deep trouble.
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I agree, any of the staff/psychs who toss about “personality disorder” toward clients ought to look in the mirror. A lot of them meet their own subjective “criteria” for Narcissistic PD. Though I prefer more colloquial descriptors myself. I won’t specify, but use your imagination.
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In my mind, what happens is that a particular client is unable to get his/her needs met by the standard system of “care.” Because they have learned a certain set of coping skills for whatever reason (usually a totally abusive childhood and and almost complete lack of love or caring in their lives), they are unwilling to sit by and just accept that their needs go unmet, so they call more often or figure out ways to try and pressure the clinicians into meeting those needs. (I have to acknowledge here that very often, the needs are more than a clinician alone can meet, but the clinicans should know that and understand the paramaters of working with this person). The person then gets labeled as “uncooperative” or “high service user” or “frequent flyer” and is then treated with even less concern and is dismissed more easily due to the group’s agreement that they ‘need boundaries to be set.’ Such a person then seeks other caregivers, who are warned ahead of time not to trust this person or put in too much time on them, so the client is more and more frustrated, escalates to more extreme behavior, thereby “proving” that “they’re borderline” and are not deserving of the clinicians’ time. Word gets around, and soon this person is treated as a pariah almost everywhere they go. That’s what I’ve seen, anyway. I think such people are to a large extent created, first by having their childhood needs go so dramatically unmet, and then by the “caregivers” putting the blame back on them instead of helping them figure out what needs they are trying to meet by their behavior.
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I think this is more to the point. The staff are responsible for protecting those in their “care” from harming each other. This responsibility is chronically ignored, and that’s the issue for me. And if we are talking about “mean people” (AKA people who engage in harmful behavior), that’s a big difference for me than focusing on what label these particular “mean people” may have been assigned.
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I think I see what you’re saying here, but I don’t think anyone’s upset about a “diagnosis” being “insulted.” I think the point is that when one is LABELED with such a “disorder” (usually against one’s will), one experiences prejudice and discrimination, even if one believes the labels are crap. I don’t personally want to continue to further the concept that people “have personality disorders” which can then be used to categorize them behaviorally as “mean.”
This is not to dispute that mean people exist and indeed suck it big time. I am only disputing that such people can be identified by seeing if they fit a list of “criteria” invented by a bunch of arrogant wealthy folks meeting in conference rooms in a hotel in San Francisco for a few days.
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$1200???? That is truly offensive! Doesn’t even qualify as a “slap on the wrist.” Disgusting!
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Where are you from?
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That’s just what I was talking about below! What business does your mom have telling you that “you have Borderline Personality Disorder?” Or any other such label? How is that helpful to anyone? And you can also see, apparently, how the label is used to distract from or disguise the abuse that happens to children, instead blaming the victim by labeling them “BPD.” The very act of labeling creates this opportunity. I sometimes wonder if that is the actual point of the DSM.
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Or don’t care enough to bother.
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I would disagree slightly with your last comment – I believe most people here believe the DSM is invalid as a guide to “medical diagnosis” and is, from a scientific point of view, completely lacking in scientific validity. This does not mean that the DESCRPTIONS in the DSM don’t describe things that actually happen, or that a certain framing of a person’s experience might not be helpful to them, even if it is framed in terms that parallel or even totally reflect the DSM. In my mind, the objection is to claiming scientific or medical meaning to these “disorders,” when a simple review of the “criteria” for such “disorders” show them to be utterly subjective and lacking in any kind of cohesion. Moreover, the DSM itself states in its introduction (apparently not read or pointedly ignored by most psychiatrists or other “diagnosers”) that the DSM “disorders” don’t assume any kind of firm boundary between those who “have” or “don’t have” a “disorder,” and even more tellingly, don’t assume that people with the same “diagnosis” “are alike in all important ways.” The last quote is particularly telling, as it essentially admits that even people who completely fit the criteria to a tee may have completely different problems or issues and may have completely different needs which can’t be met by one approach or intervention type. Well, if the people who fit the criteria don’t have important things in common, what the heck is the meaning of the “diagnosis?” I mean, everyone with cancer has tumors, everyone with thrombosis has a stuck blood clot, everyone with diabetes has problems with his/her insulin system. But these “diagnoses” apparently don’t work like that. A person who is “depressed” may be grieving, escaping from a violent relationship, stuck in a dead-end job, suffering “empty nest syndrome,” reeling from the shock of having a new baby, or living with the long-term consequences of early childhood trauma, just to name a few. What is the point of labeling all of those people as “having major depression?” Why not just deal with their actual issues?
I could go on, but I hope that helps clarify a little why I, at least, find these “diagnoses” utterly objectionable. It’s not that people don’t get depressed, and even seriously so. It’s that labeling them as “suffering from Depression” provides no extra help in understanding what is happening, and in fact, makes it easier for clinicians to ignore the causes and simply try and make the effects go away.
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Wow, I don’t think I’m familiar with a hospital that has a “psychotic ward” and a “depressed ward!” Not that I’ve seen that many, but the ones around here seem to just put all of the “patients” into the same place. There was a differentiation between the ward for people with good insurance coverage, where actual therapy was practiced (or at least attempted) and people were allowed to come and go, and the locked ward, where most of the people were involuntary and where the only apparent “therapy” was trying out different drugs until the person seemed “stable” enough to be released into the community.
The issue you raise here seems to be twofold, to me – one, that people are put together randomly and without any sense of self-control or even rational selection criteria, and that this sets up bad patient dynamics. And two, that the staff do a crappy job of providing any kind of protection from physical or emotional traumatization by other patients. I think both of these are very important issues and are pretty widespread. I’m not sure that selecting out the “less damaging” patients for one ward and putting the “mean ones” in another would solve anything, though, as the “mean ones” would then be hurting each other, even if you had been protected from them to some degree. Mean people are everywhere, and if the “hospital” is going to take on patients and put them together in a ward, I’d say they have a responsibility to create safety for all the patients, regardless of the “diagnoses” of the people on the ward of the label characterizing the ward itself. Does that make any sense?
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Yeah, maybe helping the person stop getting traumatized on an ongoing basis might be considered “good therapy!” Nah, too radical…
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I appreciate your comment very much. It is a particularly sensitive subject for a lot of folks who have been exposed to that particular label. I think I understand that you are talking about a particular behavior pattern or patterns that tend to get that diagnosis assigned. I also know that such terms are used colloquially, not by “mental health experts,” and that the concept of, for instance, someone engaging in “narcissistic” behavior, or being “a narcissist, can actually be quite helpful to some people who have been victimized and need a frame to understand it.
I agree that people who do engage in that kind of damaging behavior can be incredibly difficult to be around, and that staff often do an incredibly poor job of protecting clients/detainees or whatever word we want to use to describe them from each other. I’ve dealt with many folks who have had similar experiences, and in some cases, the staff even joined in on bullying the scapegoat. Such behavior is awful, particularly if you are forced to be there and can not escape!!! I wish I had included that proviso more clearly in my comment, and again, I very much appreciate your willingness to recognize the charged nature of that particular label in this community. I apologize for any distress my comments may have created for you.
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“Frequent Flyer” is often used as a derogatory term for clinicians to distance themselves from people they perceive to be “difficult clients.” It doesn’t surprise me that such a person ends up having their needs ignored, even to the point of death. Once those in charge stop caring (if they ever did), anyone in their care is in danger.
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Well, we agree on THAT point! Ending open-ended political contributions, especially from corporations, should be a high point on any political agenda if I’m to support it.
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I agree with you on this point. I think we have to meet people where they are at. Many people who post here today with very radical views acknowledge that they were once taken in by the system. Change starts with education. It’s not enough, but it is a start.
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It is, indeed, daunting. However, one strategy followed by those in power is to create the impression that nothing can be done about it. If we all accept that, it makes their position into the truth.
Fight back where you can! Even if you only accomplish making other clinicians aware that you feel the same way and that their perceptions are correct, that’s still something important.
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I completely agree.
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This is very true, John!! It is very much a political thing, posing as a medical one.
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The list of “symptoms” of “personality disorders” are simply a list of behaviors that most people find obnoxious or disturbing. It should not be surprising that people who are addicted to substances might more frequently engage in behavior that most people find obnoxious or disturbing. I will also note that many of the “symptoms” on your list don’t apply to all or even most “personality disorders. It looks like what you wrote mostly applies to the “symptoms” of “Antisocial” or “Narcissistic” PD diagnoses, which is a small subset of all “personality disordered” people, even if we accept that such categorizations are valid, which I do not.
It would be much preferable to me and I think many others here if you would stop talking about ‘personality disorders’ and instead talk about “people who are self-centered and disrespectful to others.” PD “diagnoses” are extremely problematic for many reasons, and it can be very hurtful to some so diagnosed to be grouped together with “people who are self-centered and disrespectful to others” and dismissed without any effort to differentiate whether or not those people fit your pre-determined assumptions about what “having a Personality Disorder” means about them.
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It also begs the question of which came first, the abuse or the “symptoms?”
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I took a stab at it below.
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Well said!
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I don’t see any difference in definition. Both are defined by subjective judgments made against a person without their agreement, and both represent generalizations which don’t appear to have any consistent basis in reality. They are both decided on in committee by consensus or vote, and there is no way to objectively determine if anyone has either type of “disorder.” All the DSM diagnoses suffer from similar limitations.
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Beautiful quote! I never heard that before, but I will remember it.
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A very good point! “Depression” doesn’t really mean much out of context.
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Hey, nothing to lose, right? Since you’re on the way out, why not see what can happen?
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Or maybe we could come up with a way to share power? Nah, too radical…
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I don’t believe that would work. Big Pharma has plenty of money to buy ads and sell their false ideas on TV without any help from the government. In fact, they could lie even more effectively with even less accountability – at least the FDA puts some limits on what they can claim is true. They have tremendous power through their billions of income, and smaller government won’t do anything to change that. Or am I missing something? Can you explain how having less government will lead to less control by big corporations over our lives?
Less CORRUPTION would definitely help. Less restrictions on pharmaceutical company crimes? Not what I would recommend.
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Indeed!
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Yes, that was FASCINATING! Physiological changes in the brain’s STRUCTURE result from meditation. Similar observations have been made about taxi drivers – the part of the brain dealing with geography is bigger and more functional. Epigentics explains all of this – our activities alter how our genes are expressed. But that doesn’t fit with the DSM philosophy, so it is quietly dismissed or not talked about, even though it has everything to do with how to help people deal with whatever distress they are experiencing.
Ah, well, psychiatry and science, nay truth, never had much to say to each other.
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You know, that would work…
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My point would be that at least in part, women are less resistant to authority because they have been “feminized.” So the war is not on men. It is on men AND women AND children, and has been going on for a long, long time against the women and children. It feels like women are being blamed for “emasculating” men when in fact it is for the most part OTHER MEN who are trying to create a more docile population so that they can continue to dominate. To suggest that there is a “war on men” denies the fact that there has been a “war on women” since at least the appearance of Cro Magnionoid culture tens of thousands of years ago.
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I think sometimes rage is necessary to get out of the less empowering emotions, like fear, grief, and apathy. I personally had to go through a rage “phase” to stop being anxious all the time, and I’ve seen many who do the same.
Rage has its uses, but it’s not a place I want to get stuck.
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Wow, that is a seriously long list! This is big corporate “mental health” at its worst. And apparently there are no substantive consequences for their general failure to do anything but suck.
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I do think there are a lot of clinicians who think the way you do. But it takes a lot of course, and willingness to accept harsh consequences, for people in the system to take a stand. Maybe you can create a subgroup of those who think differently and start supporting each other in speaking up?
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Thanks for that rational analysis.
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Actually, I think the biggest confounding factor is the fact that no one can objectively decide who “has bipolar” and who does not. So whatever groupings you create, they are likely highly heterogeneous and not really comparable to each other.
The best we get from these studies is “the drugs do something. Some people think it’s good. Other people don’t. They also do bad things. We don’t know who will get the bad things. So essentially, we’re guessing. Try it out and see if you like it or not.”
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Seems like a pretty disempowered viewpoint. Why don’t we do research on how to get people to value and take care of their environment, instead of giving up and dealing with the grief of failing to have done so?
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Obvious to you and me, perhaps. That idea would blow away anyone who believes in the “chemical imbalance” concept.
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Perhaps he’s talking about love coming from the HELPER?
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Perhaps he’s talking about love coming from the HELPER?
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One of the key observations that led me away from positivism as a philosophy.
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Well said, DS!
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Now you’re talking about dissent, and I agree with that sentiment. Why do you try to make it into a gender/sex thing? Don’t you believe women are capable of effective dissent? Or perhaps you should also be critiquing the feminization of WOMEN, who are driven into a far more disempowered role in society than the men you are complaining of. Are you not complaining of men being forced into behavior that women are expected to accept and deal with every single day? And which gender, I may ask, is the one engaging in this ostensible “war on men?” Are not the Captains of Industry and the rich elite primarily comprised of white MEN?
I think it’s time to broaden your analysis. The war is not on men. It is on anyone who is willing to stand up to the authorities, and women and children get hit far worse than what men are exposed to, often quite literally.
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They may not believe things they know are false, but they sure as heck SAY things they know are false all the time!
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You mean instead of grieving, fix the problem? Too radical!
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I think you make a good point. Love is necessary but not sufficient. Righteous indignation is an essential ingredient for change!
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I hadn’t heard that one! Though I did always like Heidegger.
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I like that last definition, except that “common sense” is sadly not all that common!
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“All that is not love, is fear.” I think that’s from the Course in Miracles.
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I don’t disagree. I was referring more to the idea of deciding that “mind=brain” in order to avoid the rather obvious fact that nobody really understand what “mind” actually is. Thinking that somehow studying the brain will lead to an understanding of how/why people act in a particular way, or even the idea that all people act in a similar way for similar reasons, is mythological.
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Posting as moderator: This is not directed at a specific person, but it seems we are diverging from a discussion of the topic at hand. It is best not to make comments that characterize other people’s actions or beliefs. I’d like to see the commentary return to the subject of the blog. I’d add that if another commenter is feeling hurt or misunderstood, it is best to attempt to find out why rather than continuing to insist we were correct in our original comment. Or simply to apologize and clarify or move on. I hope everyone reading can apply this here – I don’t want to start removing posts, but this exchange is getting too personal and hurtful to allow it to continue in the same vein.
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I agree, philosophy transcends all sciences. There is no science absent an underlying philosophy. It is a shame that many if not most modern “scientists” neglect to remember that fact.
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There is a lot more to science than the scientific method. The scientific method is a MEANS to accomplish the ends of science. Science is based on the assumption that there is an objective reality that can be studied and understood independent of the person observing it. It also assumes that humans are inaccurate observers of reality, and that special means must be employed to assure that we are objective despite the inherently subjective nature of our lives.
Other scientific values are that the primary means of proof is negation of alternative hypotheses; that given several explanations to explain a phenomenon, the simplest is most likely the best one; and that a hypothesis is true only for as long as data doesn’t contradict it. There are a great number of smaller postulates that are in operation as well, such as the idea that a hypothesis is assumed false unless it is proven true, and that replication of an observation is required to substantiate its validity, among many others.
Use of the scientific method doesn’t define science.
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Agreed!
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Commenting as moderator: Wow, thanks for doing that! I am not sure where these were residing, but I really appreciate you hunting them up. I have spammed all of the above. If they are still there for some reason, please let me know. I will look into finding out how/why these are not being blocked by the SPAM blockers.
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How chains and the concept of “treatment” appear in the same paragraph is beyond comprehension.
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“Social sciences” are only concerned with probabilities and statistics, and can never be precise and accurate in the sense that the hard sciences are. I’m not saying the “scientific method” can’t be applied, but it requires a great deal more humility and willingness to tolerate ambiguity, because the number of variables is overwhelming. Naturally, psychiatry chooses to ignore that fact and even the results of its own soft-scientific studies, in the interests of maintaining power and profits.
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Glad you enjoyed it, but of course, I was not joking!
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The idea that psychiatry is trying to implement or support socialism is lacking in any kind of empirical support. Psychiatry works closely with large, multinational pharmaceutical corporations to maximize profits. In classic socialism, such corporations aren’t even allowable. It is basic to socialism that corporate control of the means of production is the central problem to be resolved.
As an aside, are you suggesting that only MEN are being controlled by this approach? Or that “masculine” behavior, whether undertaken by men or women, is the target? And if “masculine” behavior is the target, why is so much of the DSM focused on not engaging in any kind of emotional interaction?
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There are plenty of psychiatrists and also some therapists who are told and believe that one should not talk to a client about the content of the voices they hear. They are told that engaging in such discussions strengthens the voices. Some are told that they are actually supposed to tell people that the voices are imaginary and that they have no meaning, being simply random outputs of a diseased brain.
You may not have been trained that way, but I’d be willing to bet that lots of commenters here have heard similar messages. I’d be interested in seeing how others have been treated in this regard.
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I actually think love IS antipsychiatry, or perhaps it is better to say that psychiatry is anti-love.
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I would not argue that all of the above are involved. But the arguments made by the psychiatric mainstream, while claiming to be “bio-psych-social,” in actuality deny the validity of the psycho-social-economic-political aspects of suffering and spend all their energy on “bio.” I think that’s that this article is really about.
Thanks for your kind words!
— Steve
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Further consultation has led me to reverse this decision. Direct, gratuitous criticism of MIA’s editors will in the future fall under the rubric of disrespectful/shaming comments and be moderated. It is OK to critique a particular decision, but implied disrespect for those having to make the decisions is crossing the line.
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I think that is the key point – psychiatry’s pretentions to science are false and disingenuous. They know well themselves that the data doesn’t support their contentions, but they proceed anyway, because it’s not about science, it’s about convincing people to believe you no matter what kind of BS you spew out. AKA MARKETING!
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I wouldn’t call Buddhism a science per se, but I think it can be approached in a scientific manner, and it appears that many Buddhists (and the Buddha himself) have done so. I think the variance in Buddhism is that it studies the human spirit, and the number of variables is huge. But I think it is a far more honest and humble study of it than psychology, and the conclusions it draws have much wider applicability.
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Unless your purpose is to make a lot of money, in which case, “the treatment is a total success!”
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Exactly. The answer is always “more treatment,” even when they were receiving treatment for YEARS prior to their suicide.
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I’m a total science nerd, and back in middle school or so, I was very much committed to the idea that materialism was the right viewpoint. Thankfully, I have matured a lot since then, but part of my transition away from that view has been following science itself and observing its limitations, as stated in my earlier post. I think the need to believe that science will answer all the questions there are comes from the same need that religions often fill: the need to believe that there is an explanation and the fear that if we don’t know the explanation, we will be vulnerable. For me, though, I get a lot more security from acknowledging that much is beyond our grasp, and may remain that way. Isaac Newton once remarked that everything he knew was like a handful of sand on an endless beach. One of the greatest scientific minds of history recognized that the mysterious is much, much larger than the sum total of everything we humans know, or believe we do.
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I agree – the implication is that the only acceptable response to stress ranges from mild annoyance to mild amusement. Any strong reaction, even enthusiasm, is “diagnosable” as “abnormal behavior!” Apparently, “Invasion of the Body Snatchers” or “The Stepford Wives” is the ideal human society.
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There have been social systems which do not create the kind of suffering we see in “modern” societies. Is it not possible that the very nature of our society and what it expects of its members is the primary cause of this added distress?
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It is an assumption that all mysteries will eventually yield to the methods of science. There is no scientific proof to back up this assumption. As soon as we’re operating on unverified assumptions, we’re in the area of philosophy, not science. It IS arrogant to presume that science will answer all questions and to thereby dismiss anyone who believes otherwise. Both operate on assumptions that are not provable or disprovable by science.
Having a scientific attitude begins with admitting what is not known. Science is most effective at proving hypotheses false. What is true scientifically is always subject to change given new data. Even the most scientific field of all, physics, eventually leads to unexplainable conclusions, such as matter being able to move from one space to another without occupying the space in between, or being unable to actually make 100% accurate measurements (Heisenberg’s uncertainty principle). It is extremely unscientific to assume science will answer all questions. Scientific proof of such a thing is required but will never be available.
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I appreciate the clarification.
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Sounds like a religious commitment to all things “Sciency.”
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I do think that humans enjoy engaging in productive behavior. I think the problem comes from who gets to define what is “productive.” Nobody enjoys slaving away for someone else’s benefits. Nobody likes someone else telling them that if they don’t do as indicated, they will starve to death. The concept of “work” has been co-opted by our exploitative culture into meaning “doing what someone else says you have to do.” This starts early in school, where “work” is defined as what the teachers make you do, while anything you personally enjoy is considered “play” and defined as non-productive or even wasteful. If we can overcome this kind of brainwashing, it can be true that “work” as in productive activity as defined by ourselves and those we care about is in fact extremely valuable. It is wage slavery that reduces the concept of “work” to something odious.
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Posting as moderator:
After long thought, I have left this comment up, but I find it problematic. MIA makes editorial decisions all the time about which blogs do and do not get posted, often based on the content, quality of writing, number of other blogs to be posted, and other factors. It appears you may have had some difficulty finding out why, but it seems the appropriate approach would be to communicate further with the editors, or with Robert Whitaker. The post seems to have criticizing MIA’s editorial policies as its main objective, and while there is no ban on criticizing MIA by any stretch of the imagination, it would seem to me to be more responsible to find out what the actual policy is before publicizing such a critique.
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I think you’re missing my point. First, I’m not defaulting to the idea that SOs are automatically unhelpful. I don’t know how you get that from my comment, but I suggest you re-read it. What I said is that in SOME cases, SOs can be incredibly destructive. I would think that should be kind of an obvious point. It is not fair to assume that someone’s SO or parent or other relative is going to be helpful – it’s something the client has to be able to decide. I’ll happily acknowledge that this kind of decision is a lot more complex in a situation involving multiple identities.
Second, it is certainly your right to decide what YOU think is helpful, based on your own observations. However, it is NOT your right to decide what your wife or anyone else thinks is helpful for them. Obviously, caring people try to do the best thing for the person they are trying to help, and sometimes we have to proceed on our best estimation of what is likely to be helpful. However, and this is critical, we MUST OBSERVE HONESTLY from the behavior and reactions of the person we are trying to help whether or not our plan is helpful FROM THEIR PERSPECTIVE. This is where psychiatry fails utterly as a profession and an industry. They don’t do what they hope might help and observe if it is helpful. If they did this, they’d have recognized long ago that their labels and their drugs are making people worse on the average, both from direct personal observation and from looking at the research. They’d be talking about taking individualized approaches with each client, about the high correlations between adult “mental illness” and childhood abuse and neglect, about the long-term damage to the brain done by the drugs they so happily prescribe.
It’s not about assuming all SOs are destructive or dangerous. It’s about not assuming the opposite. I’ve seen way too many situations where family members increased their power over their partners or children, with the assistance of the medical/social services system. Clients need first to be protected. SOs can be extremely helpful, but I would by no means make that assumption about any SO without looking carefully into the situation first.
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“What started out as an effort to make sure everyone had a basic understanding of the three Rs…”
I would contest that this was the original purpose of universal public schooling. Documents from the time (mid- to late-1800s) suggest that the main purpose was to create “good citizens,” which pretty much meant people who could read and write enough to participate in society but who were conditioned to behave and know their stations in life. There was big concern at the time regarding both freed slaves and immigrants from Italy, Ireland, Poland, China, etc. threatening the supremacy of the white male elite of the time. They wanted to train compliance to authority, and you can see the essential principle of compliance to authority running through all but very unusual schools. So like psychiatry, the idea that “the system is broken” doesn’t necessarily hold true if the purpose is not to help people, but instead to control them.
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Responsibility requires knowledge. We can’t be responsible for what we don’t know. This is why false advertising and DTC advertising of drugs have to be a target for our efforts, as well as challenging media characterizations of violent or dangerous people as “mentally ill.” Misinformation is a huge part of how this whole juggernaut gets away with what it does.
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Done.
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You are right, there is no report button! I will get right on those, and see if we can get a report button on those posts.
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All such decisions are now structured around psychiatry’s worldview, unless you’re lucky enough to find a dissident practitioner who actually sees you as a human being.
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I agree that both occur and are related to how the DSM views people who are suffering – it is both blameful and destructive of society’s “misfits”, however it may be that they don’t fit in. So whether poverty exposes you to the MH system, or the system makes you poor, it all pretty much adds up to “disposable people” as the central problem.
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Ah, but pathologizing and drugging IS the core, Shaun! It’s like saying that the school system is controlling children and discouraging independent thinking because they are misguided. Sorry, but that’s the purpose of the school system, and many documents from the mid- late-1800s verify this. Good teachers or administrators can make it more tolerable, and there are schools that exemplify a totally different approach. But it doesn’t change the essential purpose of the system.
The DSM III was created in order to improve psychiatry’s standing as a “medical specialty” and to increase their market share, which was being undermined by non-MD therapists. This is all clearly documented at the time of these decisions. The decision to make the DSM “atheoretical” was specifically done to make it possible to engage in creating “disorders” and coordination with the drug companies was started very early in the process. To suggest it was anything else than a power play is rewriting history.
And as such, I continue to maintain that psychiatry is rotten to its core. I won’t even go into other “core” practices such as lobotomies, ECT, insulin coma therapy, etc., nor their participation in eugenics and total support for the NAZI war atrocities. I’m not saying that people can’t help people by listening and caring and asking the right questions and being real. I’m saying that psychiatry itself is based on false premises and corrupt practices, and there is no way to “reform” it other than starting over. Psychology or counseling/therapy may be salvageable in some form, but psychiatry is not. If you take away the DSM diagnoses and their drugs, what do they have left?
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Can’t argue with that.
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Or perhaps people experiencing poverty, unemployment, homelessness and unsafe housing are more likely to be “diagnosed” as “mentally ill,” especially when they let people know they aren’t willing to accept these conditions?
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I think “antipsychiatry” folks are also pretty diverse as a group. It’s hard to make generalizations about such a group. I find it more productive to address particular concepts or ideas rather than critiquing the whole idea of “antipsychiatry.” The bottom line for me is that I don’t see psychiatry as it is practices doing anything but harm. Such “help” as they provide is, if it even works, temporary and dangerous. I’m not against the concept of “professional help,” but in the current system, it’s pretty dangerous to even engage with a “therapist” unless you’re already well educated on how the DSM is used and how to avoid it. You found your own pathway forward, but a lot of people can’t do that for a lot of reasons. So on the balance, I think we’re much better off without the psychiatric profession and its antiscientific “theories” and “treatments.” It’s not that people shouldn’t help each other. It’s that people shouldn’t be pretending that they understand and can “help” when they actually have no idea how.
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I have to point out here that sometimes, SOs are very much the cause of great distress for the “identified patient.” Every situation is different, and the client is ultimately the one who has to decide if they are helpful or not helpful. The real problem is when the psychiatrist or mental health professional thinks they can decide for the client whether or not the parent/SO or other involved person is an ally or not.
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Posting as moderator: that’s the nature of spamming, I’m afraid. Make sure you hit the “report” button on any spam you happen to see. Thanks!
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I believe the honest study of human beings and how they develop, learn and grow is extremely valuable. The issue is, it needs to be done honestly. Piaget, Eric Erickson, Carl Rogers, William Glasser, and plenty of others have presented very valuable information that has helped us learn to be better parents and better human beings. I see this as very separate from the current “mental health system” and its pseudoscientific pretensions of being able to “diagnose” someone with a “disorder” based on a set of unusual or inconvenient behaviors. Psychiatry appears to be a total wasteland today, if it ever had anything at all of value to contribute, which history suggests is an extremely long shot. Psychology has been more of a mixed bag, but to the degree that psychologists subscribe to the DSM labels and attendant pseudoscientific concepts of “chemical imbalances” or “bad circuitry” as the causal agents in “mental illness,” it needs to go as well. I’d add further that the need for “therapy” seems to suggest some deep failings in our social system that need to be addressed, rather than have to “heal” people from the resultant damage. It is possible to view therapy as an enabling concept that again puts the cause of one’s suffering in oneself and not one’s relationship to the expectations and demands of the society one is part of.
So for me, I’ve seen good ideas come from psychology and I’ve known some good therapists, and like to think I’ve provided some quality experiences to people who came to me for help. But I don’t think it matters much how good or kind or capable the individuals in the current system may be – the system itself is rotten to the core, and if that doesn’t change, no amount of honest study will help.
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It is also very possible that the extremely common social bias against “the mentally ill” was used to undermine her credibility as a parent.
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Are you saying that depression is a reaction or a circumstance to which people react? It’s a very important question.
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GLT – I love it!
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There is, of course, zero evidence that “depressed” people are more likely to be violent than non-depressed people. In fact, depression by its very nature suggests a restriction of action and a turning of hostility toward oneself rather than others. I’d guess that the rate of violence from non-“treated” depressed people would be lower than the general population.
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I find it sad that people want to come that far and spend that much time going to a place of such artificiality as a “mental health center.” While it may be better than nothing, it is a sad commentary on the deterioration of our communities. Folks ought to be able to find people who care about them and can relate to them within easy walking distance of their homes, maybe even right on their blocks. The “need” for “mental health centers” is a result of the bizarrely dysfunctional social system we’re living with, and in many ways, such outlets “enable” the current system to continue to be as screwed up as it is, because those being harmed are siphoned off into enclaves rather than gathering with their neighbors to protest or revolt. I don’t want to take away the idea that some good work happens in “mental health” centers. But there were always people who treated their slaves well and men who didn’t abuse their partners and children and teachers who didn’t use the arbitrary authority they had to harm their charges. When the system is messed up, individuals being kind within the system doesn’t really create the kind of change to the system that is needed.
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The evidence says that they don’t. If the pills were working, would we not have decreasing rather than increasing suicide rates, since so many people are now taking them.
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That is the very person. Thanks!
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I agree. Speaking of “mad people” in and of itself shows bigotry, as if all “mad” people have in common is their “madness” and as if such a grouping could even be logically made.
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Oh, those POOR psychiatrists, having to deal with people in crisis! It is SO hard, how can we expect them to… wait a minute… isn’t that what they’re being paid to do?
BUCK UP, PSYCHIATRISTS!
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I also wonder what the onslaught of one vaccination after another does to a little child’s immune system development. It was one thing when there were 3-4 vaccinations spread out between 0 and 5. Now kids are hit with a dozen or more, many happening shortly after birth. It can’t be a good thing.
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This is true for basically all the DSM diagnoses. All contain a social judgment about what is “good” and “bad” behavior, and try to explain “bad” behavior by arguments re: faulty wiring or brain chemistry. The DSM is a clever way of disguising social judgments and criticism as a neutral “medical diagnosis.” It’s quite insidious.
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Understanding what is actually going on is what helps. Diagnoses may in some cases help understand what is going on, but in most cases, my observation is that they act to obscure what is going on, or trivialize it. Saying someone has “Oppositional Defiant Disorder” tells you that the person tends to not go along with what they’re asked to do. It tells you NOTHING about why or what one might do to improve the situation.
In your wife’s case, it appears that the diagnosis helped create some understanding of what was going on so you’d know what to do. But you didn’t do what the “mental health” system would have told you to do, you figured it out yourself. So what was helpful wasn’t the diagnosis per se, but your ability to use that information to craft a good approach. The key elements of the improvement were you and her. The diagnosis would have been useless or perhaps even destructive if you’d followed the advice of the “professionals.”
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My sense is that they don’t want to know or think about possible negative effects of their drugs. What a horrible experience!
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This is very much reminiscent of my wife’s father’s experience. He really did have some dementia going on, but they put him on Risperdal and had him close to paralyzed. He was showing obvious signs of distress, trying to talk, rolling his eyes, moving his head side to side, but couldn’t make any coordinated movements of his body.
Once my wife got her mom to take him off, within three days, he was sitting up, making eye contact, talking, joking, laughing, feeding himself. Yet in his nearly frozen state, not one of the staff people or the doctor showed any concern that this previously vigorous and energetic person suddenly was unable to move or talk. The doctor, in fact, was very angry that Ginny’s mom had exercised her right to informed consent and stopped the drug!
One can only conclude that a) they don’t care, or b) the inert state achieved is considered the desirable outcome. It is amazing that 20 years of complete and utter treatment failure, in your dad’s case, led to absolutely no reassessment of the situation or any attempt to try something besides more drugs. It is sickening, yet all too common. I’m glad you were able to find your way out of the maze.
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Now THAT is thinking ahead!
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Flu vaccines are notoriously ineffective; I seem to remember one year when it was estimated to protect a paltry 10% of the population. I’ve had the flu a number of times in my life, last in 2009 or so. It’s a pain in the ass, but unless there is some reason you’re weakened, it’s most likely just a temporary discomfort. Most of the deaths are in the very old or the very young. It looks like this year’s version is 60% effective, meaning there is slightly less than a 50-50 chance you’re being immunized for zero benefit. Everyone has to make their own decisions, but the flu vaccine is definitely overhyped (sorry, bad pun!) in my view.
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“Incel” is spelled “S-C-A-R-Y!”
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Posting as moderator: does this “/” mean something? Or is this just an errant post?
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One of the big psych researchers, whose name escapes me for the moment, has pretty clearly demonstrated (kind of by accident, actually) that the gray matter loss, at least, is almost certainly due to long-term use of neuroleptic drugs.
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I guess he was a bartender, not a journalist!
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My brief research dates this back to the 1800s and a fictional journalist named Mr. Dooley, invented by a humorist named Finley Peter Dunne. The newspaper was said to “comfort the afflicted, and afflict the comfortable.” Here’s the link I found: https://www.poynter.org/reporting-editing/2014/today-in-media-history-mr-dooley-the-job-of-the-newspaper-is-to-comfort-the-afflicted-and-afflict-the-comfortable/
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I think you’re absolutely right. It’s clear that the focus is on everything a person can’t control, so they can claim there’s nothing you can do about it but submit to their “treatments” and pray. At the same time, if it’s all biological, we don’t have to change any of our institutions that are causing distress, because after all, it’s all in the brain, eh?
Not to mention the profit motive…
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I think evil is a characteristic of behavioral decisions, not people. That being said, sometimes people choose evil so very often that the temptation to simply decide they are irredeemably evil is strong. It can be a pretty good approximation to the truth.
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Have you considered finding a group of people who have had similar concerns – a support group? You have to be careful that you don’t get one of those sponsored by the drug companies or the MH system – a lot of those are spouting propaganda and will tell you to get “back on your meds.” But I think other people who have had similar experiences are the best source of good advice about how to move forward, including others who have come off “ADs” in the past. This website can be a good source, and other internet communities can help, too.
Hope that helps a bit. There are a few good counselors around, or life coaches, so that might also be worth exploring, but you definitely have to shop around very carefully, because these days, it appears that most of the “professionals” involved in the system have bought into the label-and-drug philosophy.
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It is always interesting to get specifics on what his “improved behavior” constitutes. It is usually what the child DOESN’T do (He doesn’t yell anymore, he hasn’t hit me, I don’t have to get him from school, etc.) There is no focus at all on the child’s quality of life. “He stares blankly out the window for minutes at a time.” “He is very isolated.” “He falls asleep in class.” “His hand vibrates and twitches unceasingly.” These observations are not noted. The focus is usually that the child is less annoying to the adults around him/her.
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Psychiatry is riddled with religious overtones. They don’t call the DSM “psychiatry’s Bible” by chance. It is a very apt description!
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What would happen if there were no one guarding the henhouse, though?
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That’s true – at least the people who eat my cookies have a right to spit them out, or decide not to eat another one!
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“Belief perseverance?” I think they mean arrogance and pride and need for power. Semmelweiz wasn’t chastised because they didn’t believe he was right. It was because he insulted the powerful men of society by suggesting they had “dirty hands.” The question of whether or not he was right was never even raised. “Belief perseverance” makes it sound like some benign and inherent human trait, but it is, in fact, quite a pernicious and often violent effort to protect the status quo power brokers from accountability for their actions.
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I have also noticed that the criticism of the troop withdrawal never gets into talking about how they got there in the first place and how they contributed to the current mess and the mass migration and other consequences of our own stupidity.
When has our intervention in another country to alter their government ever led to anything but disaster? And yet we never seem to learn or even talk about it.
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Doctors are scary! They literally kill you these days with impunity. #3 cause of death in the USA!
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Pain to the consumer base will be directed toward the consumers taking out their animosity on each other based on race, social class, ethnic origin, gender, religion…
hey, wait a minute…
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That is a very good description of what happens. For most psychiatrists (or physicians or police officers or teachers or whatever), their behavior is governed by how they are trained and by what their peers believe, as well as what their supervisors will reward, tolerate, or punish. Real independent thinkers are rare in any profession, and tend to be seen as threatening. And with psychiatry’s complete lack of objective statistics and decision-making tools, they are particularly vulnerable to this group-think kind of “logic.” The issue isn’t whether the individuals in the system care or don’t care (well, that IS a big issue, but not the main one), it’s what the system expects and incentivizes that determines most people’s behavior. Which gets into power dynamics and oppression, which is probably too much for a response to your well-written comment.
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The destruction of Obamacare means going back to the old system. There is no ‘new plan’ except to continue to let the insurance companies suck us dry. Obamacare, as flawed as it is (and I am NOT a fan, trust me!), was an effort to solve the problem. If we “destroy Obamacare,” what is the solution?
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Well, I don’t really disagree with you, Richard. However, I think change of power has to start somewhere, and I choose to start with making people aware that they do have some kind of power. The kind of revolution we’re talking about isn’t going to happen in the next few months. People have to wake up, and it starts by reassuming responsibility for the government we DO have. At least, that’s how I look at it. Abandoning electoral politics or the use of media to distribute information doesn’t lead toward resolving the situation. Sure, using FB does pay off the enemy, but it’s a great organizing tool. I don’t see any magical path forward, especially with the huge majority of people being convinced daily that their efforts to assert their power are doomed to failure. Help me with a better practical way to get that started beyond getting saner people elected, and I’m happy to listen.
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Anyone telling you there is “irrefutable proof” that “schizophrenia is caused by structural abnormalities of the brain” is having you on. There is increasing agreement even among mainstream researchers that “schizophrenia,” like pretty much all of the DSM ‘diagnoses,’ is not actually an entity that can be scientifically defined. I believe Japanese researchers have scrapped the term altogether and are looking at multiple causes.
We do all agree that drug company money creates corruption, but it is sometimes hard to see the full scope of that corruption. Have you read “Anatomy of an Epidemic?” It will be a great education for you if you have not. It explains how the entire DSM model is built on a desire for psychiatrists to give an impression of scientific competence to a field that has never demonstrated scientific support for its models. If you haven’t, READ IT. It is essential at this point in your education.
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LOL!! That’s a good one!
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I consider harm reduction legitimate and very important. We can’t abandon those who are currently suffering while we work on stopping psychiatry altogether. People need support, and they aren’t getting it. That’s how psychiatry continues to justify itself.
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I think you hit the nail when you talked about profiting from harming people. We, the people, theoretically own the government, and if we get the right people making decisions without their own views being polluted by corruption, we can remove the incentives for hurting people. That IS possible, even if it seems very difficult, and to my mind, humans being what we are, changing incentives is the key to changing how people act. If you pay people to hurt other people, you’ll find people willing to do it.
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Avoiding standard schools would probably be a good way to “improve children’s mental health.”
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I agree. It always seemed hokey to me. Glad to know others with more direct experience agree with me.
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But an ex-murderer would be reformed, wouldn’t s/he?
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I never thought of it that way – they are trying to teach you on the one hand to be mindful and to respect your inner voice of wisdom, but when that voice contradicts the authoritarian structure, then you’re supposed to stop listening. Very confusing!
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I never have found these simulations very realistic. Of course, I’ve never had the experience, but some of them seem to be designed by other people who are totally speculating and have no such direct experience themselves. How real are these simulations? Do people who actually KNOW what it’s like participate in making them? How many are dedicated to the purpose of compassion and understanding and how many are designed to sell drugs?
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Very weird framing here. Why go to “Increasing physical activity improves mental health?” Would it not be more correct to say, “Kids shouldn’t have to sit still all day” or “Kids need exercise?” We’re not “preventing mental health problems” or “improving mental health,” we’re actually meeting the needs of children in ways that have been known for millennia to be necessary.
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They’re afraid they’ll lose their market share. It’s about that simple.
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I like it! You should syndicate and create franchises all across the globe!
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Exactly. No one, and I mean NO ONE, tried to exercise their 5th amendment right or any other right. Some resisted physically, but you know what THAT got them.
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Oh, OK. I think someone already removed that comment. Thanks for the clarification.
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I agree 100%. We start with removing direct force, but we have to also remove false advertising, manipulation, lying, and use of authority to intimidate or pressure one into submission. What we really need is a change in the basic mythology that underpins our understanding of people’s emotional needs, starting with ditching the idea that it’s all individual and all genetic, and expanding to include the fact that much of what passes for “mental illness” is a result of our decaying communities and ruthless economic system.
But I’d be happy if we could start with removing force.
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Almost all totalitarian societies (I know of no exceptions) are run by men, who, far from being emasculated, have masses of unearned and undeserved power. Women in such societies (on the average) are generally FAR more disempowered than men, though of course, there are many men who are also lower in the power structure and have limited power. These societies are generally organized in authoritarian structures where people are considered above or below other people and where those considered “above” in the system are allowed to abuse those “below” but have to accept the abuse of those “above” them in the system. So the problem isn’t the “emasculation of men,” it is the authoritarian structure of entitlement based on power, regardless of gender. That being said, when gender IS taken into consideration, it is clear that, at least on Planet Earth, women are in almost every case held below men in the hierarchy. I’d challenge you to come up with an example of a totalitarian society where women were in charge, outside of the world of science fiction. Blaming it on “emasculation” of men appears to me to be missing the point.
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Do genes determine brain? To an extent, yes – they appear to determine development potential. But the Decade of the Brain research and more recent research into “epigenetics” has proven unequivocally that large structural and functional changes in the brain occur as a direct result of personal experience. So the idea that genes determine brain is not entirely true – genes PLUS experience determine brain.
Does brain determine mind? This is a question that transcends the realm of science. No one really knows that the “mind” is, and the assumption that the mind is a direct result of the brain is based on the philosophical school called “materialism,” that assumes there can be nothing that is not observable and measurable in the physical world. Of course, quantum physicists have already shown that this school of thinking doesn’t explain everything, including such fascinating phenomena as a particle being able to move from one place to another without occupying the space in between, or the fact that you can’t measure anything to 100% accuracy, so in fact, all scientific measurements are approximations, which is not a big deal with big objects, but gets very significant when looking at tiny things like electrons. So the idea that “Brain determines mind” is not established scientifically, but is a conclusion drawn from a particular philosophical school. There are many schools of philosophy that draw different conclusions on that question.
“Brain determines emotions” – True in a very physiological sense, though apparently gut and other organs can also influence emotions dramatically. But without knowing what MIND is, to say that “brain determines emotions” cuts out the possibility that mind affects brain which then determines emotions as a result. That’s the reality I observe.
Brain drives survival and reproduction – for sure this is true, but again, without the question of what MIND is being answered, we can’t really say that all is driven only by the brain.
I suppose I’d ask you the question: do you believe humans can exercise free will?
Depending on your answer, I might present some other questions or arguments that have a bearing on this. Suffice it to say, it is not such a simple question as you seem to want it to be, in my view. The interaction between brain and mind is the biggest mystery of human beings, and anyone who tells you this mystery has been solved scientifically is blowing smoke. The main reason that decades of genetic research has turned up close to nothing regarding genetic underpinnings of mental/emotional/behavioral phenomena is that, in most cases, such underpinnings either don’t exist or are so incredibly complex and subtle that they provide no explanation whatsoever as to why a person is acting the way they are.
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Obviously, it would be modified to the situation. The most important parts are “What you say may be used by the evaluator to hold you in the hospital against your will and force you to accept drugs which you may not wish to take” and “you have a right to an attorney, who may be present during your examination by the evaluator.” I think both statements would put both the evaluator and the potential victim in a much clearer relationship to each other. I used to do these evaluations (briefly – worst job I EVER had!) and no one ever said, “I’d rather not talk to you because it might result in my being held here against my will.” I really think most people in the situation don’t understand what is at stake until it’s too late.
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People will think what they think. And if they invite reviews, I don’t think you can get in trouble for giving them feedback. I think the Court’s view would be, “Well, if you don’t want to hear feedback, don’t accept reviews.” I do think how you write it might have an impact on whether people take it seriously. I think the best reviews are mainly factual, with a brief introduction and conclusion to add a little emotional context. Simply, “Dr. X insisted I had Y disease and recommended treatment Z. When I asked what the side effects were, he said there were none. I looked it up and found a long list of adverse effect about which he failed to inform me. I quickly decided he could not be trusted.”
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That feeling of rebellion is a good one to drive you forward. Unfortunately, the urge to rebel by itself doesn’t necessarily lead to the right path. It provides good energy but needs you to provide direction. At least that’s my experience. Keep rebelling!
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Posting as moderator: If you let me know the comment you want deleted, I’ll do so. I’ll see if I can figure it out.
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Posting as moderator: I will look into this, Jclaude. Not sure how that could happen.
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I think armchair diagnosis reminds them that there is no technical skill or know-how involved, and that, in fact, the entire process is simply a matter of judging others’ behavior that we find uncomfortable or inconvenient. They have to protect the image that only a “professional” can “diagnose” someone with a “mental disorder.” Though a 5-minute perusal of any “diagnosis” would quickly result in the conclusion that it’s about as complicated a process as making chocolate chip cookies from scratch. But the results aren’t nearly as tasty!
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That’s my view as well. The idea would be to divorce the idea of imprisonment from the idea of “treatment.” Calling out force for being force instead of pretending it is helpful.
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Yeah, it’s weird, huh? Why would we have to CONVINCE anyone that inducing a seizure by electrocution is a bad idea? Should the onus of proof not lie on the person claiming it is helpful? Or is not the very act so obviously damaging that any argument to the contrary should be dismissed out of hand?
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Remember that a lot of the algorithms also come from insurance companies. It’s not just the government.
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HIS “treatment” failed because YOU have the wrong “diagnosis?” Even for a “real” doctor with a meaningful diagnosis, this would be an idiotic statement! If he knew you “had Borderline Personality Disorder,” and that “ECT” didn’t work on “BPD” clients, why would he have offered you this “treatment?” Or was he saying he “discovered” that you “had BPD” simply BECAUSE the “ECT” didn’t “work?” Sounds like pure justification to me!
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I love this concept – “Placebo by Proxy!” I see a learned paper coming from you on the topic in the near future.
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It is quite ironic, to “diagnose” someone for being afraid of an abusive partner who actually does them physical harm. Do they ever believe it’s appropriate to have feelings?
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“Dependent” is probably the correct term. Thanks for that corrective feedback.
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OMG, what a liar! How can he say that with a straight face? Or is he really saying that he never bothered to check with his patients so he can honestly say he’s never heard of any memory loss.
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I would agree. It is incorrect to generalize that all counselors/therapists/treatment providers are dangerous or misguided. It’s not incorrect to assume that they are until proven otherwise, however. I’ve certainly known a significant number of professional people who actually care about those they are trying to help, and some who have helped me significantly, particularly my therapist in my 20s. However, such people are in the minority in my experience, so assuming that a person cares BECAUSE they are a MHP is, in fact, very dangerous. The other thing that’s VERY important is to remember that there are plenty of people who are NOT “MHPs” who care and are skilled in connecting and helping others. The key is not to seek out or avoid people with a particular title, it’s to understand that what is needed is not a professional so much as someone who cares and is willing to listen and be real and help you sort things out rather than acting to enforce his/her views in the name of “help.”
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I am a parent, and this is fantastic advice. It provides a sane way out of the ‘don’t blame the poor parents’ distraction that is used to blame kids for their own distress. Well done!
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I think it’s high time that doctors were simply forbidden to prescribe certain drugs to children. We’re talking about killing children here. Do we really think “advisories” are going to work?
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That’s for sure!
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Hmmm, I don’t think I’ve ever heard anyone take that position with me… I agree, it would be just as wrong to expect everyone to be unhappy as to expect them to be happy – people have a right to feel whatever they want to feel. It’s just that psychiatry has put such a focus on erasing any “negative” feelings, the message seems to be that everyone should be at least mildly pleased with the current state of affairs no matter what kind of indignities or stresses they might experience.
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That is exactly why this seems important to me. On the path to getting rid of enforced “treatment” to go away, the first step is a public acknowledgement that enforced “treatment” is potentially extremely damaging, and that denying a person’s right to free movement and free association and informed consent to medical “treatment” of any sort is something one has the right to resist as an offense against one’s basic rights as a citizen.
People’s opinions are amazingly weak and changeable in general. There are always hard core believers at either end of the spectrum, but many people’s opinions are formed and altered by what they hear in the media. (For instance, it was nearly impossible to find anyone who would admit to voting for GW Bush in 2008 after the Iraq mess and the economic collapse, even though obviously a lot of people voted for him not once, but twice.) So influencing public opinion is very, very important, and a legal fight to ensure the right to real legal protection against involuntary commitment would make very, very good press, IMHO.
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It’s very similar to “supersensitivity psychosis.” If you block a pain receptor, the brain compensates by creating more receptors, and when you stop blocking, the extra receptors make one extra sensitive to pain. This is very well known in the world of substance abuse, yet somehow, the exact same or very similar drugs aren’t acknowledged to create the same effect, apparently because they are prescribed by doctors which magically prevents them from doing the same things as their street drug cousins. It is amazingly idiotic, and yet that’s what people continue to believe. And now the solution is to pull them off the drugs that the doctors have gotten them addicted to, without any plans on how to deal with the induced damage to their nervous systems? It is beyond comprehension.
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And is justified with similar false claims and denial of actual data, and is pitched as either a “safety measure” to protect against urinary tract infection (even though circumcision scars get infected at something like 100 times the rate of UTIs in uncircumcised male babies), or as protection against the supposed shaming they’ll get in the middle school locker room, despite the fact that over a third of boys in the USA are no longer cut. It’s a travesty that very much mirrors the kind of idiotic “reasoning” and religious commitment to stupid procedures that one sees in the world of psychiatry.
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There is something disturbing about viewing “loneliness” as a health problem, rather than a consequence of our loss of community and our hypercompetitive social and economic system. It feels like we’re removing any chance of confronting what is really going on for people and setting the expectation that no one should feel lonely and anyone who does is “defective” in some way.
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Gotta love how they still manage to avoid the obvious conclusion. Rationalization is the core of the DSM drug-and-label ideology.
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And it would also establish in the public’s mind the almost total analogy between being arrested and being committed against one’s will.
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It would provide some protection of the rights of citizens while we work to eliminate the process altogether. It would undoubtedly prevent some people at least from being incarcerated.
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And in my experience, most people being “evaluated” do NOT know that they can remain silent, nor that what they say can be used to hold them against their will. You think it’s obvious, but most people assume a psychiatrist or mental health professional is there to help them.
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Except that the prisoner has more rights than the “mental patient.”
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I think that is an excellent strategy. Personally, I think that people ought to get their Miranda rights or the equivalent before they are allowed to question you about your mental status.
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Posting as moderator: I read what I think is the post (the BMJ references) and was myself confused as to what is yours and what is quoted from someone else. That said, I didn’t find anything in there particularly offensive – it just seemed like an outline of the kind of “thinking” one sees in medical journals, contrasted with the very important comments on the article about side effects. What I got out of it was that, rather than recognizing that the so-called “ADs” are ineffective and even destructive in what appears to be the majority of “patients,” they blame the patients or their “TRD” and continue to insist that their “treatments” are effective.
If there is another interpretation, let me know.
If you do want me to delete part of the post, please let me know which part you mean and I can do this for you.
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Writing as moderator: I will take a look and see what I can do to make it understandable.
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I think it proves unequivocally that the “diagnosis” itself is utterly subjective, and that a huge percentage of kids who are “diagnosed” are simply later in maturing and would be just fine if they were left alone and allowed to grow up.
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I don’t think that’s a psychiatric diagnosis, is it? Maybe we can call Virgos “Obsessive-Compulsive” and leave it at that. I mean, what’s the point if you can’t prescribe a drug for it?
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Very, very little. The most optimistic estimate I’ve read is that 15% of the variation in behavior/mood related to “mental disorders” is correlated to a set of over 100 genetic markers. And these markers didn’t correlate with a specific “disorder,” but with people who were diagnosed with “ADHD,” “Bipolar,” “Schizophrenia” and/or “Major depressive disorder,” I believe. So these genes, considered as a WHOLE, might represent something like sensitivity to others’ emotions, or a tendency toward getting angry more easily than the average, or a tendency to worry, or something completely unrelated.
As a contrast, any “mental illness” you consider has high correlations with abuse, neglect, and stress. 80% or more for “schizophrenia,” for instance, and the more trauma experienced (especially sexual abuse), the higher the rates of “psychotic” symptoms.
So the correlation with environmental factors is MUCH higher than even the most optimistic estimates of genetic “vulnerability.” Yet psychiatry as a profession insists on spending all its time and money on drugs and physiology and genetic research and brain scans. That’s where the disconnect is. There may be genetic contributions to mental/emotional distress, but whatever they are, they pale in comparison to the known contribution of environmental factors, and yet psychiatry pretends it’s the other way around.
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I agree. There is no way anyone should be allowed around a “helping profession” with power over vulnerable people without making certain they have their own childhood issues under control. Unfortunately, that means most of those doing those jobs would be out.
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Closed head injuries frequently result in a temporary euphoric state. This is well established. It is also a possibility that memory loss can sometimes be viewed as a “positive,” if they are negative memories. As for “psychosis,” I suppose destroying some of the dopamine system would result in less ability to creatively imagine anything, which would reduce “psychotic” symptoms. So it’s all easily explainable as brain damage, and you acknowledge there is no other known reason why it “works.” Per the concept of scientific parsimony (Occam’s Razor), the simplest explanation is the most likely. Since we know seizures damage the brain, and brain damage easily explains the “benefits” as well as the long-term damage, I’d say it would be up to psychiatry to prove that it’s NOT brain damage causing the “benefits.”
Psychiatry is also notorious for not defining its endpoints, so they can claim “benefits” based on “observer ratings” or “clinician assessment” while the client him/herself is incapacitated or feels their life is ruined.
The fact that you would eschew doing animal experimentation suggests that you yourself see it as having a high potential for pain and suffering for animals who might be subjected to the “procedure.” Why would that concern not apply to humans?
Electrocuting people to induce seizures can’t be a “treatment” and doesn’t deserve the dignity of being “studied.”
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To me it’s very similar to saying, “Well, we have to study whether or not hitting people on the head with a 2×4 is effective in a certain subset of the population.” No, sorry, I don’t care how many people feel better after a blow to the head, it’s not an experiment we’re allowed to do. It’s just plain wrong.
As I’ve pointed out before, a near-death experience is often life-changing for a person who survives. Does that make killing a person and bringing them back to life a “treatment?”
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Wow, “Social neurochemistry!” Is there such a thing?
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I find the title misleading, though. It should really say the link is between school admission age and “ADHD” diagnosis. The month appears only to be relevant when it’s the month where they draw the arbitrary line between admitting to school one year vs. the next.
Honestly, astrology would be just as legitimate a way of diagnosing people, though. Maybe better, because at least being a Virgo doesn’t imply there is something wrong with you.
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Pisces is more likely to get the “ADD without hyperactivity” kind of diagnosis, unless Taurus was rising at birth, or the moon sign is an earth sign. It’s all very specific, in a general sort of way, most of the time, anyway.
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That’s how birth should be handled – assume things are normal unless there is some indication to the contrary, rather than assuming something will go wrong and constantly messing with the process and ultimately causing something to go wrong and saying, “See, I told you birth was dangerous!” So glad you had that “corrective” experience – not many people get to see birth the way it’s supposed to happen.
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You do make an excellent point. Robin Williams, Marilyn Monroe, Stevie Nicks, Ernest Hemmingway, Judy Garland, Heath Ledger, … the list goes on of rich and famous people whose lives were damaged by “mental health treatment” in the form of prescribed psychiatric drugs. They can afford better “treatment”, but can they find it, or do they even know enough to look?
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It doesn’t say that. It says that the twin studies PROVE nothing. That means the question is not answered by twin studies. It doesn’t mean genes exert no influence on people’s mental state.
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I think you might have hurt their feelings. Just because they’re big, powerful, and sociopathic doesn’t mean they don’t have feelings, you know.
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People often confuse conscious decisions with intent. Intent is very frequently not conscious, so saying someone is “trying to do the right thing” when there are obvious and undeniable destructive results doesn’t really cut any ice with me. The real intent is reflected in one’s response to results. Does the person continue doing destructive things despite bad results? Do they stop or prevent things that seem to be working? Are they unwilling to accept any data that might undermine their own theory or beliefs regarding what is “best,” no matter how well-founded the data? Do the observations, preferences and beliefs of the person they are “helping” seem to have no impact on their calculations of “what is best?” If these things are true, they have ill intent, even if they claim and/or personally, genuinely believe they are acting in your “best interests.” Which is why “best interests” is an extremely fraught and dangerous legal standard to apply!
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Yeah, like, totally, Aries are MUCH more likely to get “ADHD” diagnoses because they’re a fire sign, you know, because fire is like, TOTALLY moving all the time…
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Another “promising gene candidate” bites the dust. But don’t worry, with another 1000-2000 years of research…
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Another errant comment in the article is that the “numbing effect” is an adverse effect. It would appear from my reading of the research and my personal discussions with users that far from being an “adverse effect,” the numbing IS the therapeutic effect, such as it is. For some people, being numbed out feels like an improvement. For others, it feels horrible. But it’s not an accidental “side effect” – it IS the therapeutic effect that is offered. People should know that.
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Yeah, I love that. It’s really a fancy way of saying, “Most of these people aren’t getting any benefit at all, but we can’t really admit that fact.”
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True enough! The main cause of “mental illness” is our sick society and its prioritization of profits and its ignoring of the real needs of the human beings that live in and sustain that society.
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I love the reference to “Madeline’s Rescue!” One of my childhood favorites!
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I am with you on this one. We’d never give birth at a hospital again, even though our first was “not too bad” by hospital standards, there was one little thing after another after another where they seemed bent on interfering with any and every aspect of the process. Two homebirths later, the difference was startling and difficult to describe to someone who hasn’t experienced it. Obstetrics is the one branch of medicine (besides psychiatry, though the brand “medicine” doesn’t really apply there) where perfectly healthy people are “treated” for entirely normal processes that are somehow regarded as being abnormal and dangerous. A hospital is a much more dangerous place to give birth than your home.
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I’ll have to take a look, but he doesn’t generally publish anything that he hasn’t documented thoroughly.
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There is actually no evidence that they are of any use, especially anyone under 12. Even under the most generous interpretation of their own data, there is absolutely no indication for the use of “ADs” for children.
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And the pharmaceutical companies make billions off of the label-and-drug model, while talking therapy leaves them broke. So it must all be about brain chemistry, because that’s what pulls in the big bucks. Plus, if you start actually CURING people, you’ll have to find new clients, and that’s SO much work…
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The difficulty starts with the fact that “depression” is not caused by one thing, but tons of different events and effects. For that reason, calling “depression” the problem is both misleading and confusing, and as long as psychiatry starts from this false premise, it will continue to come up with one wrong answer after another.
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Sadly, more people believe in childhood bipolar disorder than the Easter Bunny and Santa Clause combined. Perhaps it should say, “Deconstructing the myth of ‘childhood bipolar disorder.'” Or “delusion” might be particularly ironic.
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How many people will actually read about this study? Any way we can make it more available? This is stuff that everybody should know but that many people don’t want to believe.
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As I recall, there is a section it Anatomy of an Epidemic where he goes over some of this history. I looked around for an unbiased source on this, but it was all either totally for or totally against the article from what might be biased sources. However, the article, entitled “Scientology: a Cult of Greed,” seems to suggest a certain lack of objectivity, to say the least. I’ll see if I can get Bob to let us know what he knows.
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Would you deny that one of the primary motivations for proposing and supporting the “chemical imbalance” theory and the DSM worldview is simple greed, the drive for money and power? There are documents from the mid to late 1970s where psychiatric leaders acknowledge that this is their aim. “It is difficult to make someone understand something when their salary depends on their not understanding it.”
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I agree that in most cases, “anxiety disorders” are fairly predictable developments from mistreatment or neglect of children by their caretakers. In fairness, the caretakers themselves are often suffering from their own childhood mistreatment, but that is the cycle we need to look at if we actually want to help reduce unnecessary anxiety in our world. Problem is, no one makes money off of treating children well.
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As well you know, being viewed as something doesn’t make that viewpoint correct. Pharmaceutical companies are viewed as saving lives, despite the well-established fact that receiving medical care is the third leading cause of death in the USA, the majority of deaths coming from properly prescribed and administered drugs.
What is viewed as mainstream is determined in a lot of cases by what is most effectively publicized by the people who make money off of the practice.
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Not arguing with your example, but I do want to point out that a large percentage of women are partly or fully supportive of patriarchy. Remember Anita Bryant? Internalized oppression is very real and necessary for the elite to maintain their authority and control. I think there’s plenty of good evidence that psychiatry has been biased against women from way back, starting with Freud first believing and then recanting his belief that women were, in fact, being sexually abused in large numbers. (I’m sure it really started long before that, but “modern” psychiatry started off with the invalidation of women’s experiences by the wealthy white men who ran the show. I don’t think things have changed that much in terms of the attitude of the psychiatric professionals toward women, even if their rhetoric has gotten more subtle.
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Bob goes into this in his book, how Scientology was specifically and intentionally targeted by psychiatry to make it into a go-to criticism of anyone who opposed their activities. The attacks, including a heinous hit piece by Time magazine in the early 90s, did not intend Scientology, but antipsychiatry, as their main target. Not even just antipsychiatry, but any critique of the psychiatric drug pipeline or anything that affected it. Hence, nobody cares if someone is a Moonie, as its not useful as a tool for psychiatry to undercut their enemies. This is not a critique or defense of Scientology, simply an observation that the choice of Scientology as a whipping boy was intentional and utterly disingenuous, and it continues to be used in that way to this day, which is why I think it’s so important to call it out any time someone tries using this kind of ad hominem attack to distract from the facts on the table.
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And kids, of course.
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The last point isn’t necessarily true at all. The things that get used aren’t always the ones that work – they are often just the ones that make the most money for the practitioners.
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Exactly. Science is supposed to be both objective and skeptical. Psychiatry, under the influence of their partners in crime, Big Pharma, are, aggressively and intentionally, neither of the above.
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I think you’re onto something!
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Exactly! Calling out the tactic is essential. Because in the end, it doesn’t matter what religion someone claims to be, psychiatry still doesn’t work!
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I appreciate your feedback and support!
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If only this could be a requirement!
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That is, indeed, the question. What ARE the “good parts?”
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I certainly did not intend to imply that at all. Taking an antipsychicatry viewpoint is 100% supportable by rational arguments, which is something a pro-psychiatry viewpoint can not claim at all, especially since the current model starts off with a huge logical error of not bothering to objectively define what it is they are “treating.”
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That is such an excellent example!
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Precisely. It is obviously a very different process than, say, suing someone for demolishing your car. The removal of someone’s rights is, or should be, a very, very big deal, very much on the same plane as being imprisoned (since that is effectively what it is). So why not require a fair warning as to the consequences of one’s actions? If prisoners and murderers deserve that kind of protection, why not innocent people who just happen to run afoul of societal expectations in some way?
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Too true.
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A “hearing voices” group could also be helpful, but I would only make such a suggestion after a good, long chat about what the “patient” thinks is going on. There could be lots of other ways to go, but I’d never know until I actually connected with the person having these experiences.
As an example, a friend of mine’s husband (in his 80s) was losing his hearing and was increasingly in despair about his life. He took lots of drugs that didn’t work, then was “offered” “ECT.” I tried to discourage her from considering it, but they were desperate and she still trusted psychiatrists. So they did it and it had no discernible effect. Soon after, they spent 6 months in Palm Springs and other places in southern California. His depressed state lifted and he required no further ‘treatment.’
Every person is different, and the idea that “depression” is the problem is almost always incorrect. It’s an indicator of a problem the person feels unable to figure out, whether physical, mental, emotional or spiritual, and the key is finding out what the problem is, not making the “depression” go away.
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I agree that rigorous science is the path to sane practices. Unfortunately, there seems to be such a commitment at this time to perpetuating the model regardless of or in direct contravention to science, that doing research alone doesn’t appear to be sufficient. Consider that Wunderlink and Harrow and others have shown consistently that long-term use of antipsychotics does not generally lead to recovery, but instead increases the likelihood that recovery will never occur. This is known, proven, consistent with observation. And yet it has barely made a bump in the road for psychiatry’s continuing drive down the ‘let’s drug ’em early to head off psychosis’ roadway.
Science is wonderful when practiced well, but it appears that politics and economics have to be addressed before this mess is ever going to change.
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You are right, of course. The focus has to be the caring relationship, not the “techniques”.
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Posting as moderator:
I am actually not going to take down any of these posts, even though some might find them offensive, because I want this discussion to be read and thought about and maybe learned from. It is important to note that MIA does not promote or oppose any particular viewpoint on the “MH system” and moderation is not invoked simply because people have differences of opinion regarding what should be done. Some commenters appearing “hostile” toward a VIEWPOINT is part of a discussion board experience. When comments get hostile toward individuals or groups of PEOPLE, that’s when the moderator steps in.
That being said, it seems kind of destructive to make general criticisms of “MIA” just because the comments don’t reflect what you want said. MIA is a community, and it has its own characteristics, just like any community. Depending on one’s viewpoint, these characteristics may be considered good, bad or indifferent, but the answer if one is not connecting with the community is not to criticize the community to others within the community. It’s either to listen to the viewpoints you’re finding challenging and seeing where those others are coming from, or to choose to spend one’s time elsewhere.
Some of the comments on this thread are edging toward personal, even though they are couched in general terms. I’d like to see that stop. You can see in the case of MedLawPsych that extremely contrasting opinions are being exchanged in a mostly quite civil manner, so there is no prohibition on expressing opinions not generally agreed upon by the community. However, the community being what it is, one can expect to encounter some strong disagreements if expressing approval of processes or concepts that most people here find objectionable. That’s just human nature.
There are few places where survivors of the psychiatric system are welcome to express their experiences. While it is by no means perfect, nor is my moderation flawless, it is the priority to allow the widest expression of viewpoints and to recognize that everyone has their own experience. This includes the experience of having seen such horrors perpetrated by psychiatry that one wants to eliminate it from the face of the earth. That some people take that position, and express it passionately, should not be a surprise, nor should it deter others from respectfully expressing their own personal viewpoints, even if they are more “revisionist” positions, or support some things that most people in the community might not support. Just be prepared to defend your position!
So let’s try to get back to respecting the fact that people have differences of opinions, and try to learn from them instead of getting into attack/counterattack mode. If a comment really does appear offensive, please report it to the moderator, and we will make our best judgment about whether to remove it or ask for it to be edited. But please don’t make comments that are calculated to escalate the conflict. It is that kind of comment that makes people feel unsafe in sharing their experiences, and that’s the opposite of what we really want here.
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Rejecting the DSM certainly does not imply a lack of or a nihilistic theory of the mind. In fact, I find the DSM rather nihilistic – it seems to suggest that people’s “symptoms” have no cause or meaning and are simply random fluctuations of brain chemistry that are to be controlled by external means. There are many theories of the mind that are far richer and more consistent with actual human evolution and behavior.
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I think the problem with this argument is that the basis of eugenics is an assumption that certain human lives are worth less than others. While the specific arguments for eugenics (eliminating “bad genes” from the gene pool) have been discredited scientifically, psychiatry, besides a few mavericks, continues to perpetuate the belief that there are certain people who have genetic defects, which make them less valuable as human beings. The ongoing denial of the impact of traumatic events and stress, which began in Freud’s day or before, continues to be central to the DSM model and the label-and-drug approach used by today’s “modern” psychiatrists. It’s all about “blaming the brain.”
We have progressed from leeches based on scientific analysis of what causes physiological diseases and the substitution of rational approaches developed from increased understanding of what is really going on. Psychiatry has not made any similar progress, and in fact, seems to have deteriorated in effectiveness and respect for research data as the years have moved onward. It is not valid to compare psychiatry’s failures with primitive medicine, as in psychiatry’s case, the data is there but is denied due to conflicts of interest.
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Commenting as moderator:
There most definitely is a moderator here, namely me, and if there is a comment you feel is inappropriately hostile, please hit the “report” button at the bottom of the comment. I moderate about once a day, so there is not a flashing red light that goes off when you report it, but I will get to it within 24 hours or so.
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I’m not sure one can call it “alleged” damage. As I’ve said, we know that seizures cause neurological damage. That’s why people get treatment for seizure disorders. There is nothing else going on with “ECT” than the induction of a seizure, and we know the effect of “ECT” is to cause a closed head injury. The fact that not everyone suffers permanent damage doesn’t take away from the fact that there is damage to the brain, and that this is, in fact, the entire effect of the “treatment.”
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I think that is a legitimate argument. It is a very real dilemma, and I’ve been on both sides of it, but in the end, I had to get out of the “mental health” system because I felt I was implicitly approving of things that I could not truly support, and in fact found abhorrent.
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I think this is an important clarification and deserves emphasis. Other means of dealing with mental/emotional distress aren’t “alternatives” to psychiatry, they are means of dealing with mental/emotional distress. As soon as we call them “alternatives,” we accept the idea that psychiatry is a means of dealing with mental/emotional distress, and that, in fact, it’s the main one and the others are options for those who don’t like the main options offered. Kind of creates an equivalence, rather than observing that a “hearing voices” group is an attempt to provide information and support leading to mental/emotional/spiritual growth, while psychiatry is dedicated to keeping people’s unwanted or inconvenient emotions in check and keeping people from acting in ways inconvenient for the status quo economic/social system. They really have nothing to do with one another, but calling it an “alternative” diminishes it to a second choice in an array which includes psychiatry as the mainstream option.
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This is true. However, there is nothing preventing requiring a Miranda-type warning for specific civil cases. With the level of rights potentially being curtailed, it seems more than reasonable.
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There was a definite correlation with the specific number of “ACEs”. I don’t think they tried to estimate “severity.”
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It sounds like there was a pretty large percentage who were abused but felt it was justified. Classic internalized oppression. That’s a big part of what I think we’re up against.
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Sorry, unless you have some objective means to know what is happening and why, intentionally inducing brain damage in patients should be malpractice in every case.
BTW, there was a recent article on MIA showing that when depressed vets were given sham “treatments” of (I think) cranial magnetic stimulation, they got significantly better, even though they were classed as “treatment-resistant” (aka did badly on “antidepressants”) before the study. The real “treatment” they got was hope. Might be a much better starting point than electrocution and seizure induction.
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You seem to believe that psychiatric “diagnoses” are legitimate “other conditions” that can be properly diagnosed in some people. I would strongly disagree with that assessment. There is no objective means to distinguish any psychiatric “disorder” from other “disorders” or normalcy, as the DSM itself admits in its very own introduction. How could you possibly know if someone suffered from “psychotic depression?” If it is merely based on the person being depressed and having delusions or hallucinations, how would you know what the cause of this condition was, let alone what the best approach to intervening is?
It is possible that passing electricity through one’s head may, for some people, create some kind of subjectively “positive” change in their life. It’s also a possibility that someone having a near-death experience after being hit by a truck could have positive changes in his/her life as a result. That doesn’t suggest pushing someone in front of a truck is a good “treatment” for “depression.”
ECT causes a grand mal seizure. Know anyone who has a seizure disorder? Do their doctors recommend allowing or inducing seizures, or do they want seizures to be avoided at all costs if at all possible? Clearly, seizures do damage to brain tissue, sometimes leading to death, and are avoided for that reason. Why on God’s earth would anyone want to induce one?
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An excellent answer in my book!
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No one in power, anyway.
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I would pretty much guarantee that “commonly accepted knowledge” about Mumia Abu Jamal and the MOVE incident(s) are quite significant distortions of reality. History is written by the victors, as they say. It was a very ugly time in Philadelphia history, and I am absolutely sure that no one wanted the full story to emerge.
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I guess that says as much about NAMI as it does about Uncle Joe. If that’s the kind of guy they admire, I’d steer very clear of them!
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Neither will most of those suffering from what the DSM euphemistically calls “mental disorders.”
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A sad story. I only wish it were a rare story. It is baffling when an obvious failure of the system like this doesn’t prompt people to observe that the system has obviously failed.
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This is very true!
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I think that’s kind of the point. Psychiatric patients need to be informed that they are not simply being admitted to a hospital, they are potentially having their legal rights taken away, completely analogous to being arrested. They need to understand that they are not talking to a therapist with an interest in helping them out. They are talking to a legal agent who has a great deal of arbitrary power to take away control of their life for an indeterminate period of time.
I believe they should be informed that what they say can be used to hold them against their will, that they don’t HAVE to stay anything at all, and they should be afforded the right to speak with an attorney to go over their rights and assist them in deciding what they should or should not say. In this way, the patient/potential inmate can be maximally empowered to make their best decisions with a full understanding of the potential consequences of their decisions.
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Definitely a class action. Maybe start by seeing how Miranda was originally argued and won?
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I really get both sides of this, and I don’t think either side is “wrong.” I see the viewpoint that radical change takes a long time, and meanwhile, other people are being damaged. I also get that people (actually MOST people) DO suffer from the negative effects of our bizarre social system, and such people need and deserve all the help they can get.
On the other hand, I’ve experienced first hand that being a “good player” in a bad system doesn’t really change the system. In fact, participation eventually felt like collusion, tacit acceptance of the system’s legitimacy. I believe we need to come up with new ways to help each other that don’t convey that kind of acceptance, that remains 100% opposed to the dismissive and abusive concepts behind the psychiatric worldview.
I don’t know the answer, but I think we need both – new ways to help people, and direct resistance to the system aimed not only at dethroning psychiatry, but at addressing the social power imbalances that make psychiatry appear necessary to the general population.
A tall order, to say the least!
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Most likely people did like it, but the advertisers did not. Challenging psychiatry is pretty much challenging capitalism, and capitalists don’t like that much.
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I don’t know all the details, but I was in Philly during the MOVE events, and I assure you, the Rizzo police force/mayoral administration would be quite capable of framing someone for murder.
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You are right, of course. Unfortunately, there are a lot more ‘Wannabe psychiatrists’ out there than we might want to believe.
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If one can’t think of something better to do than inducing a seizure by electrocuting one’s patient, it is time to step out of the way and let someone with a little more creativity and compassion take a turn.
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It pretty much establishes the enforcement purpose of “hospitalization,” as well as helping folks know they can avoid trouble by not talking to the “enforcers.” Why did Tina think it a bad idea?
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I really believe this is important for the short term. It may even be realistic to accomplish with a good court case. Probably have to go to the Supreme Court, but I think it’s a very winnable proposition, and I hope some hotshot attorney who is not too worried about money will take it on.
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The “stigma” is anything that discourages people from taking more drugs.
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Well said, indeed!
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I have to disagree here. I think it is very important that research be done to disprove the lies that are being spread by psychiatry. I think it’s also important NOT to use their language to describe the research, except to the extent necessary to undermine psychiatry’s facade of “scientific” pretensions. There is always the danger of being coopted, and it’s also true that many researchers have not really “got” the reality that the DSM is a science fiction novel. But in the world of academia, research speaks loudly, and most of our society believes that people who claim to be scientists will give them accurate data. I don’t see any way to undermine people’s confidence in psychiatry without presenting solid, scientific data that show it’s a bunch of crap. That certainly isn’t enough in itself, but I don’t think we can win without it.
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I know what you’re saying. My comment was not to suggest that New Amsterdam “got it right,” but my utter surprise at the very fact they brought up the possibility that the drug might be the problem and that communicating with compassion might be the solution. It is quite a contrast to the idea that brain scans can predict “sociopathic” behavior, or that the reason people are being violent is because they are “off their meds.”
Of course, the psychiatrist is totally unrealistic – they don’t much exist in the real world. But the show DID show a psychiatrist doing evil due to laziness and making excuses based on “lack of resources” – very real representations of what happens in most situations involving psychiatry or other “mental health” systems (not to mention the school system itself).
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Here is one link: https://davidhealy.org/benefit-risk-madness-antipsychotics-and-suicide/
“Atypical antipsychotics” affect the serotonin system, just like SSRIs. It makes total sense that they would have a similar impact on suicide rates.
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Just looked it up – 20-30% of Americans don’t believe in climate change. I personally thought it would be even worse.
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Another good reason to ban DTC advertising of drugs.
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I have noticed that, too. “Chicago Med” also shows people magically coming around within seconds or minutes of an injection, and also asserts that they can determine if someone is a “sociopath” by looking at a brain scan, which is, of course, utter blather.
On the other hand, “New Amsterdam” ran a show where a kid’s difficulties were proven to be severely exacerbated by a school psychiatrist putting him on antipsychotics and completely ignoring the context of his distress. The hospital psychiatrist took on the school psych and assumed some personal risk to his job in order to prove that bullying and the loss of his dad were the real issues for this kid and start him on the path of feeling heard and cared about. I wrote the network to let them know how much I appreciated their raising this issue in such a clear manner. It gave me a little hope!
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That was the part that really got me – zero responsibility, “You know how those borderlines are, she seduced me, what was I to do about it?”
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Repulsive. My wife had one who cried when he was fired and begged her to still be his private client. She was horrified!
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I agree wholeheartedly. This is in my view the most serious damage psychiatry has done to our society. It has removed context from our suffering and made it a trivial matter, as well as making it an entirely individual problem, as if any upset or disagreement with our social system is proof of personal malfunction, and the system itself is flawless.
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A good analogy! “Your bones broke because you have ‘brittle bone syndrome,’ a genetic disorder. Most people are able to take that kind of hit without their bones breaking, so really, it’s your body that is deficient. It has nothing to do with the crowbar.”
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I don’t disagree with you. For one thing, there is no way anyone can determine which “professionals” can help you re-learn these functions and which will drive you further into the “pit of despair.” (Sorry, I’m just running the Princess Bride lines today!) So what’s the point of having a “profession” where being a “professional” provides no guidance as to what the professional is able to provide?
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It’s kind of the ultimate application of the profit motive. But it also shows that the profit motive is ultimately degrading, reducing even our own bodies to mere commodities to be bought and sold. No one should be reduced to the point that they are forced to do this. Those who genuinely choose to do this is a different issue, but let’s be honest, the vast majority of prostitutes are not in it because they think it’s a fun way to make a few extra bucks.
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I am afraid there are no “quick fixes.” A quote from “The Princess Bride” movie applies here: “Life IS pain, highness. Anyone who tells you otherwise is selling something.” Psychiatry promises a magical no-effort solution to “mental illness” where no one needs to change anything and no one needs to take responsibility for everything and we can continue to pretend that life’s a lark and anyone who doesn’t feel that way needs to be “fixed.” Have you ever read “Brave New World” by Aldous Huxley? That’s the direction the psychiatric industry is taking us. “A Gramme is better than a Damn!”
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Well said on all points.
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Good to know it’s not just me!
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I agree. There is nothing minor about a therapist (or a doctor or an attorney) taking advantage of their position to have a sexual relationship with a client. It is often extremely destructive.
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I think it took courage to write this, and that it raises a vitally important issue for professionals, one which ultimately drove me away from the field: even if an individual can do good work with individuals, does participation in the system convey tacit approval of the “status quo” ideas of chemical imbalances, subjective pseudo-medical “diagnoses,” and paternalistic force applied to “noncompliant patients?”
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Recovery rates in industrialized countries are worse than in the developing world.
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He is most definitely a survivor of both hospitalization and psychiatric drugging.
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I love both quotes!
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Well, we wouldn’t want any PASSION to slip out… that would be a sign of bipolar disorder, or maybe ADHD, or something pretty scary… no passion allowed in THIS society…
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I would add that forcing people to meditate is the MOST likely way to take a potentially great thing and turn it to destructiveness.
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I would add to that the fact that womens’ burden of abuse, poverty and discrimination is much higher on the average than men, yet psychiatry continues to refuse to take such stresses seriously as causal factors, and this attitude has spread to GPs as well. The Kaiser study showed that physiological problems like IBS and fibromyalgia, lupus, and others occur more frequently in trauma victims than the general public. But we can’t seem to get together as a society and admit that oppressive circumstances are preventable and are causal factors in many of the problems we see in adults.
Back in the 70s, feminist writers were all over this idea that women’s reactions to an oppressive society were minimized and trivialized and hidden by the psychiatric professions’ approach to diagnosis, and that real physiological issues were often also hidden through accusations of “hysteria” going back 100 years or more. But I don’t see much writing from feminists on these points lately. Am I missing something?
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I am glad you said this. Many cases of “depression” involve chronic pain or other chronic conditions that impact quality of life, and of course, the psychiatric profession tends to ignore these completely, as they don’t fit with the “brain disorder” worldview the profession is trying to promote. Dealing with daily pain is draining and has dramatic effects on one’s view of life and the world.
As I’ve said many times, the first error of psychiatry is to believe that the same “symptoms” are always caused by the same thing and always require the same “treatment.” This goes for chronic pain as well, in my view. What works for one person won’t work for another, and the person who is best situated to determine what the best approach is would be the patient. Rigidity in either direction leads to stupid and often dangerous results.
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Commenting as moderator here:
CCHR is a controversial subject, but their genesis or purposes are not particularly relevant to this discussion. I will ask that folks leave off on this aspect of the discussion, understanding that some people will find CCHR’s information and purpose worthwhile while others will find it disingenuous. Let’s leave it at that.
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Sorry, that is in fact what I was referring to – politics writ small.
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True enough.
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I don’t disagree with you at all. I just find it sad that such a shock is needed when the evidence for these facts is long-standing and robust.
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I have also found this to be true.
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Commenting as moderator: It is a tough one when we’re talking about public figures. It’s generally accepted that being a public figure, especially a politician, leaves one open to attacks regarding one’s policies and actions. However, the comment threads ought to be focused on the goal of revising/eliminating psychiatry, and political discussions can pose a serious distraction.
I appreciate you bringing this up and will give some serious thought to when a “Trump” or other political figure comment is actually contributing to the conversation or detracting from it.
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Wow, this is great information! I’m pretty well informed about “ADHD” and stimulants, and this is very new to me. Thanks for sharing!
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Glasser is amazing. He’s one of my very few heroes in life.
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Who said non-violence needs to be polite?
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Totally understandable. It’s hard to keep calm when you know the damage that is being done. But I also agree that taking a strategic approach is crucial, and sometimes that means focusing the anger/rage toward a particular approach that is most likely to work.
Doing the right thing doesn’t always feel good!
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It’s a win-win. Well, for everyone except the patients…
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I agree. There has to be proper intention, and that can’t be accomplished by forcing someone to meditate.
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I have frequently accepted a lot of other peoples’ “shit” into my life – it’s almost like opening my heart to it draws it to me like some kind of magnet. I have to be sure I’m fully ready to go where I need to go before I agree to enter into such an engagement, but I seem to have many such encounters per week, and actually on some level seem to seek them out. Some of these have been professional encounters, some have not, but I think I have a pretty good idea what is needed to be helpful in most cases. And when I don’t, I’m perfectly comfortable letting people know that. Which in itself seems to be helpful much of the time.
But I agree, I can’t always be prepared to “be there” for others, and I have moments of self-centeredness, sadly most often with the people I care about the most (and am most comfortable with, easiest to take for granted, but also most capable of draining my reserves). We all have our limitations, which is why we need more people to be available to provide love and caring to our fellow humans.
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I agree, rage and righteous indignation are the drivers of major social change. But I believe that strategic focusing of rage is the most effective strategy.
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Maybe we can start a new therapy model – we’ll call it the “Give a Shit” (GAS) model of therapy. We can study the results when therapists appear to give a shit about their clients compared to control groups whose therapists are uninvolved or actively controlling and/or hostile. We can publish papers on GAS and sell workbooks and do national seminars showing people how actually caring about the person you’re talking to seems to help them feel as if you care about them, whereas not caring about them seems to have the opposite effect.
Would it sell?
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It IS important. That’s the sad point. There is clearly some powerful denial going on if this kind of research conclusion is ground-breaking or controversial!
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Or does wetness CAUSE water? We’ll have to commit to further study on the matter…
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Ha! I’ll have to steal that one!
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Most families have a scapegoat.
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We also moved to the West Coast to escape East Coast rigidity and artificiality. Haven’t escaped it completely, but we have found the West Coast much more amenable to us feeling like a part of it.
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Unaware or don’t care.
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Kids know this instinctively. If you can get them to stop parroting the lines they’ve been given, most kids on psych drugs will tell you they take them “because I act bad” or “because I get in trouble.” That’s my experience, anyway, and I have talked to lots of kids about this issue.
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But then again, as Tim McCarver once said, “If it were that common, more people would have it!”
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That sounds good for starters.
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Yeah, whod’a thunk it?
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Here is an example of speciation that has happened in the 20th century:
https://blogs.scientificamerican.com/science-sushi/evolution-watching-speciation-occur-observations/
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They forgot the third factor: school! Being grouped together with kids the same age and “assessed” and “evaluated” and compared to “norms” is the beginning of the shaming process that eventually leads to the kind of bullying she experienced. Of course, labeling her “ADHD” and giving drugs only adds insult to injury, not to mention the emotionally destructive adverse effects that some kid experience. It is hard to imagine a less effective approach, yet we continue to do the same thing, expecting different results.
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Another no-brainer study. Time to quit focusing so much on ‘techniques,’ which anyone can learn, and focus instead on the qualities that actually distinguish a capable helper, regardless of label. Empathy is, of course, the number one quality that is required, and no matter how many years of college and grad school one attends, it is not something that can be “trained” into anyone. It’s a very personal thing.
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Why would anyone be surprised by this?
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Not weird at all. I’ve seen it happen.
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Not much good I can find in the DSM. None, really.
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Sounds like you found your own form of “mindfulness.” As someone said above, there is no guarantee that being present in the moment means you’ll be happy or relaxed. You appear to have contacted the present moment and remained in it despite the pain, and it had positive results.
No one should tell anyone else “how to meditate.” It’s an offense against the concept.
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We don’t know. Every generation of frogs will be slightly different than the last. If there isn’t any great change in the environment they have to live in, they’ll probably just become better frogs. But if there is a sudden big shift, a lot of the froggies may die off, leaving an odd lot who may have some characteristics that “normal” frogs lack.
The antibiotic example is the easiest to get. We kill off 98% of the bacteria in a person’s body with an antibiotic. Of the 2% that remain, a lot of them may have a particular genetic mutation that allows them to sometimes live through an antibiotic attack. Normally, they’d only be 2% of the population, but now they’ve suddenly become most of the population. These are the only bacteria to reproduce themselves, so that the next generation is made ONLY of survivors. If these survivors are attacked by the same antibiotics, a much larger percentage survive this time, say 20%. These are even MORE strongly selected for the resistance gene, and they’re the only ones again to reproduce. After a few rounds of this, we find that 80% of the bacteria are no longer killed by the antibiotics! New species. Can’t kill them with these antibiotics any longer, and we need to develop a new approach. Keep this up with a course of 3 or 4 different antibiotics over time, and you have “superbugs.”
It’s way quicker with bacteria because they reproduce multiple times a day. But there are classic observations with moths in England turning from black-brown to grey because of ash being deposited on trees due to coal burning in the early 20th Century. The color change took a few years to happen, but it was observable pretty easily. The light ones used to get eaten, but when the trees got ashy, suddenly the black ones got eaten and the light ones survived. That’s natural selection. Continued through hundreds or thousands or tens of thousands of years, if two parts of a species are living in different environments, it can lead to new species entirely.
That’s the theory, anyway. Makes sense to me, and it fits with all the data we know about species. There may be some things not explained by evolution, but it explains a hell of a lot.
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The analogy of brains as computers has long since been debunked, even though it is very commonly referred to: https://aeon.co/essays/your-brain-does-not-process-information-and-it-is-not-a-computer
What that article doesn’t really address is the additional problem of WHO IS RUNNING THE BRAIN? A computer can’t operate without an operator telling it what to do. So even if we accept that the brain is running itself, the computer analogy completely fails us.
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They WAKE YOU UP to make you meditate!!!!! OMG, that is idiocy in the extreme!
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You’re not the first person I’ve heard this from. Being forced to do “mindfulness” is ironic in the extreme. It’s not mindfulness if you’re feeling like someone else is making you do it. Any Buddhist monk would cringe at the thought. And two hours is also a VERY long time, especially for beginners! I’ve been advised that you have a person work UP to 20 minutes at a time. Only a person who has practiced for a good long while can do two hours without needing to alter their activity. Way to ruin a good practice, folks!
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That’s my theory on how “ECT” “works.” After receiving several “treatments,” the victims say to the psychiatrist, “You know, I feel SO much better now. THANK YOU, thank you SO much for all that wonderful ‘treatment!’ I’m sure I’ll never feel depressed again! Now, can you please unlock that door so I can get out of this place?”
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Frogs are still evolving. It just takes a really, really, REALLY long time! But it’s a lot quicker for bacteria, hence “antibiotic-resistant” strains are developing all around us.
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I would suggest that lack of love by those who have power over us is what he’s really talking about. When we are kids, we have little power to do or change anything in our world, and we’re totally dependent on those who care for us. How those people care for us teaches us a lot about what to expect of the world and how to treat ourselves.
In adult life, a lot more goes into success than giving and receiving love, as others have remarked. And adults don’t HAVE to rely on their parents for care any more. But there are still plenty of areas where “big people” have power and control and don’t use it in a very loving fashion. It is also difficult to escape those lessons we learned as kids when dealing with people we consider more powerful than us.
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I think I see a pattern developing…
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I think you said it well. Being who we are without concern for others’ opinions about it (except when consciously deciding to work with others’ opinions to get something done) is at the core of getting clear of most of what gets labeled “mental illness.” I have similarly used meditation as I have come to understand it to work for me. I would not expect the same approach to work for anyone else. The only measure of success is that feeling of authenticity and calmness that comes with rejecting the “lessons” someone else has forced down our throats, including “lessons” about how we should meditate.
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But what if psychiatry is based on things that are not really true? You’ve seen the damage that can be done – isn’t the loving thing to do to stop the damage and expose the lies so that people (including those doing the hurting) can start to heal?
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But why call it a “disorder?” Why not call it “stuckness” or “lack of self love” or “unwillingness to risk connection” or call it what it IS rather than pathologizing it? I’d say “stuckness” is pretty much a universal attribute of anyone growing up in Western social/economic networks. It’s not a “disorder,” I regard it as a way of coping with a difficult reality. If we can find yet better ways to effect change in that reality rather than merely coping, more power to us, but it doesn’t mean that our means of coping were “disordered.”
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Nah, that’s not right. Species develop into whatever fits into the niche provided for food, shelter, etc. Obviously fish can’t develop into humans because they have to live underwater to breathe. Humans are just one branch of many thousands of developing branches.
Darwin certainly hasn’t explained everything, any more than the “big bang theory” explains how the universe began. (What was it that banged? WHERE did it bang? WHY did it bang? What happened right before it banged?) I just wanted to make sure we’re clear that he would never say that all species ultimately have to evolve into humans. If they did, we’d have nothing for food but cannibalism!
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Chilling!
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Any therapist who recommends “medication” should quickly become an ex-therapist.
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I think this is very well said, and resonates with my own experience. I’d only add that there is a general hostility toward “attention seeking” by children that goes back many generations, and that this is particularly evident in the structure of the average school classroom. Even kids with loving and rational parents are exposed to massive anti-attention-seeking propaganda and punishment from their school in the majority of cases. To intentionally seek attention in an assertive way is very much discouraged in society. It is much preferred if we keep quiet and go along with the program, in my experience.
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I think healthy relationships with other human beings are the key to recovering from abuse, neglect, etc., in combination with having sufficient means to survive in the current seemingly heartless world. These relationships COULD be with someone called a “counselor” or “therapist,” but there is no guarantee (or even necessarily odds in favor) that a particular person in that role will be of any assistance, or that a person who does NOT have that label might not be just the person needed to promote healing. The idea that “counseling” can be quantified and delivered by someone who has X training is nonsense of the highest degree. The only judge of what is helpful is the person ostensibly being helped. I don’t judge anyone as disqualified because they happen to carry the moniker “counselor,” but I’d estimate that each such person must be judged on his/her own merits.
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Thanks for sharing this sad but moving story. It is a perfect example of how wrong-headed the current form of “help” really is. Well done to you and to her for figuring out what the issues were really about. What they call “symptoms” are not meaningless, but full of meaning, and the invalidation of this meaning is perhaps the most heinous thing they do to their “charges.” I hope that you will find peace and a pathway forward.
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You might consider a “moving meditation” like Tai Chi or Qi Gong. Some people have a hard time sitting in one place, especially after drug damage from your friendly psychiatric pushers.
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Exactly!
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Posting as moderator:
That is the correct spelling. I’m not sure that MIA does the redlining – I think it may be your spellchecker on your own computer, in which case, adding “akathisia” to your computer’s spellchecking dictionary (usually an option if you right-click the word) will make it go away.
I just did that on my own computer and it worked!
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Because we don’t believe there are any other choices.
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In societal terms, pretending to “treat” someone with an invented “diagnosis” in the way we do is VERY expensive!
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I mean “left-right” politics as described and played out in today’s media and public conversations in the USA. It’s a long time since the USA has an actual “left” in the old 1930s “let’s organized and take on the capitalists” sense. When Bernie Sanders is considered a radical leftist and Hillary Clinton is called a “socialist,” the term “leftist” has long since lost any rational meaning in the USA. So perhaps “Democrat/Republican” is a better description, but in truth, that’s what the vast majority of US citizens think of when someone says “left” and “right” these days, at least over here.
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Sorry, I got too excited…
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Wow, YOU caused their devices to fail! You appear to be VERY powerful!
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Sometimes family is part of the solution. Sometimes family is a big part of the problem.
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Shhhhh! Someone might hear you! You don’t want to upset the Big Capitalists – they aren’t very nice!
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Some people improve over time, but apparently some do not. I’d advise talking to other people who were victimized in this way, and see how they have learned to deal with it. Professionals are not going to be a lot of help here, unless it’s a dissident professional who is willing to admit to how TD is caused and to really work to find solutions. Alternative medicine might also be an option, though I’ve never explored that avenue specifically regarding TD.
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But of course! But calling it “treatment-resistant depression” or whatever even takes that level of agency away from the patient. They couldn’t HELP resisting! They were powerless to their “depression” which is what resisted! Imagine, a concept resisting a drug! It is beyond ludicrous, but they get away with it. Why not just say, “My treatment failed” or “I don’t know how to help you?” At least that keeps alive the idea that someone else might have a better idea.
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Come now, who can make billions of dollars off of psychosocial interventions? Bad business model!
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Don’t forget that big businesses buy influence by their campaign contributions, and actually like and want the kind of regulations that allow them to succeed and small, local businesses to fail. And TV advertising is also a huge factor in selling brands rather than useful products, which goes well beyond the purview of government control. Government can’t do it alone – they collaborate with big businesses, including Pharma, to create the environment we see before us.
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A point which seems to bypass the media at every opportunity they are given to observe it.
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Though nobody in the medical world is claiming that alcohol is a “treatment” for anxiety or depression. Force must be eliminated, but so must the veneer of respectability that pseudo-medical diagnoses give these mind-altering drugs.
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But only sometimes… nothing to worry about, really…
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“Always remember that you are unique.
Just like everyone else.”
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I think it may be a form of Stockholm Syndrome in many cases.
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“She added: “We have underestimated the power of social interactions. We see people who’ve been in the system for years, on every med there is. How is it possible that such people have recovered, through the process of talking with others? How has that occurred? That is the question we need to answer.””
Psychiatry hasn’t “underestimated the power of social interactions,” it has almost entirely dismissed it. The reason people have recovered from interaction and not from drugs is because drugging the brain is not a solution, whereas often, communicating with someone who understands you is, or is at least the beginning of a solution. This very statement should make that point obvious, and yet the psychiatrist in question appears to find the result incomprehensible. Could the simple answer be that your model is wrong?
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And of course, it’s utterly ridiculous to claim to be a “trauma-informed” agency and still use the DSM as anything other than a billing code document or an emergency toilet paper roll. Any real “trauma informed” agency would have to START by abandoning the “medical model” altogether and start over from scratch, preferably with a lot of honest interviews and focus groups with their clients.
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There is some good research showing that the CONTENT of voices heard by people is dramatically affected by the attitude of the culture they are in. If the person lives in a culture that accepts or even values voice-hearing, the voices are more positive and encouraging. If the person lives in a culture that fears voice-hearing, the voices tend to be more destructive and hostile. How that is explainable by a disease model is beyond me! Though psychiatry has long since given up on actually evaluating data – it’s more of a religious practice at this point, so contrary data can safely be ignored.
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But even within their own system, when the person gets worse, shouldn’t this indicate that they are barking up the wrong tree? I’ve pointed this out a number of times as an advocate, and always seem to get bafflement from the audience. It’s like observing that “treatment doesn’t seem to be helping” is some weird taboo! It’s not just that there is no objective way to determine success, they don’t seem to want to even THINK about whether or not their approach is successful! I find it utterly baffling!
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You are right, doctors are often threatened by intelligence and independent thinking.
I always give any doctor I have to see a preamble that I’m an intelligent person who will appreciate their ADVICE, but will consider it and do my own research and come to my own conclusions, which may be to refuse their advice completely, and if they have any problem with this, to let me know right now so I can seek another provider right away. It generally shuts them up pretty quickly.
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Oppression is not a left-right issue. The sooner we peons realize this, the sooner we can stop buying into the idea that voting in a new set of oppressors will solve the problem. Not that I’m against voting, mind you, as some oppressors are objectively worse than others, and there are still a few bright lights out there in the darkness of politics, but it should be clear now that direct and unified action is the answer, and left-right politics is a divide-and-conquer tactic that serves all the elite from whatever side of the aisle.
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Quite so. I also wonder how folks can read that the amount of “treatment” is dramatically increasing worldwide, and yet the “burden of mental illness” is also increasing lockstep with increasing “treatment.” If the “treatment” worked, shouldn’t the “burden of mental illness” be dropping? What happened to our new technological understanding and wonder drugs? At what point does the obvious question rise to the surface: “What are we doing wrong?”
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Not at all. Just making sure that we’re all on the same page. I’ve accidentally offended folks with my facetious sense of humor on many occasions. It’s always a hazard of using indirect humor.
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I know, who would have thought that poverty could actually cause people to feel depressed or anxious? I mean, wow, what incredible insight is required to make such a leap of reasoning!
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I think we are taught to fear our own poverty, which is always lurking right around the corner even for people with reasonable jobs/incomes. As a result, I think we fear the poor, which turns to anger and hatred, because we KNOW there has to be SOMETHING that separates them from us, otherwise, we could end up being poor, too, which would be awful! And when they survey actual poor people, most of them don’t think they are poor, and instead find someone yet poorer to heap their pity and hostility on.
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Oh, we all wish it were relegated to the realm of mythology over here. Unfortunately, though the “thought leaders” have had to disclaim this notion, it is still very much alive in the trenches and is regularly used by doctors to manipulate their patients into taking the drugs. I think probably the majority of doctors actually believe it themselves and are pretty impervious to even their own leadership telling them otherwise.
Sounds like things in Russia are pretty grim, though. I wish you good fortune in turning that around!
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Well said. I’d only add that suggesting that everyone who is experiencing these phenomena is experiencing a “spiritual awakening” makes a similar mistake to the DSM – assuming that all people having a similar experience are having it for the same reason. Some may be experiencing a “spiritual awakening.” Others may not have slept for a week or taken drugs that have messed with their sense or reality or be having flashbacks or, or, or… The basic fallacy of the DSM/mental health viewpoint is the idea that we can categorize people by their mental or emotional experiences, and I think we would all benefit from being vigilant that we don’t fall into the same trap.
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Brilliantly written. We all think we’ve already got it right. We don’t learn anything until we can step out of that place and note that the places we are MOST assured of our “rightness” are the ones where we are least likely to see where we might be missing something. Humility is the core of good science, and good living, at least I think so.
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Could not agree with you more. Well stated!
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So why not use the terms “visions,” “thoughts,” and “voices?” I have found that being as specific as possible about describing the actual experiences of the person in layperson language is the best antidote to the psychiatric song and dance routine.
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Posting as moderator: I am assuming the poster is being facetious here. Calling someone “a psychiatrist” would certainly be considered an insult of the highest order in this particular community!
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Giddiness, spontaneity, impulsive behavior… sounds like a manic episode to me, Eric. We only accept people who are mildly interested in society as it is, and if they get upset about anything, they keep it to themselves. Creativity and spontaneity are particularly dangerous, as people like that start THINKING for themselves, and who knows WHAT will happen if that is allowable?
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That is horrible! Especially when we can be pretty certain the psychiatrist at least observed these reactions and knew what they were. Though some psychiatrists are astoundingly ignorant about their own drugs. I am appalled, even with what I know about psychiatrists and their practices and have seen similar situations ignored. It is a criminal act.
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And the psychiatrists and teachers and family doctors/nurse practitioners that prescribe should also be required to do the same.
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You are right, I meant that the psychiatric profession considers it LESS dangerous to pass electricity through your head than using fasting or nutritional approaches. Thanks for the catch. The same kind of thing applies to childbirth – it’s more dangerous for the physician to have the laboring woman take a bath than it is to cut the baby out of her womb, because Caesarians are so very common these days that one will essentially never get sued for doing one, while baths are outside of “standard practice” and so to be assiduously avoided. Very strange set of perverse incentives.
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They pretty much all cause at least temporary damage to the brain. That’s how tolerance occurs and why there are “discontinuation effects” (AKA withdrawal) for essentially all of these drugs. With antipsychotics, we KNOW there is long-term neurological damage. It is suspected that SSRIs and especially Benzos cause cognitive impairment that lasts well beyond the use of the drugs, and may be permanent.
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Ekaterina, what about the word “hallucinations?” “Visions” would be better, but to meet your need for a word that those in the medicalized system recognize, a “hallucination” is an event, not an “illness” or “disorder.” I think the issue with “psychosis” is that it invalidates the very premise you are setting – namely, that the event is not an indication of “illness” but is a step in a process that could be embraced rather than denied and pushed away. Am I reading that correctly?
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Follow the money…
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Yeah, but think of all the security companies and government drug agents who are losing money!
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I got that when one of my foster youth clients had a horrible hand tremor that she spent all day, every day dealing with. “What’s a little hand tremor compared to all the behavioral benefits she’s getting?” Without questioning the so-called “benefits,” my inclination was to say, “That’s easy for you to say – it’s not your hand!”
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Maybe we should require all “ECT” patients to listen for an hour to a panel of survivors who have been damaged by the process before they can agree to it. Though it seems so odd – if a person has a seizure, doctors will take immediate and extreme measures to bring it to an end, because they know it’s damaging to the brain. Why would inducing a seizure be any less damaging?
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Silly me! I thought they were doing it all for the good of their poor, ignorant patients who just don’t know what’s good for them.
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That is a very sad conclusion!
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I do believe that the main purpose and effect of psychiatric drugs is to suppress emotional reactions to things. Consider that the drugs are categorized that way – anti-anxiety drugs, anti-depressant drugs, anti-psychotic drugs… they are categorized based on their purpose, to STOP emotional reactions, rather than deal with or process them. Very similar to why many people get drunk or use other drugs to numb their emotions. When you stop using, whether legal or illegal drugs, all the stuff you were working to suppress is still there, in addition to withdrawal reactions and potentially damaged processing ability. Life presents extremely painful situations for us all to deal with, and the urge to escape from that pain is understandable, but calling it “treatment” would be laughable if it didn’t do so much damage.
Is it possible you can connect with other people who have had similar experiences to process? Maybe some who experience the world similarly to how you do?
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Internalized oppression IS the definition of “insight” to those dedicated to the psychiatric worldview! “Insight” means realizing that they are right about everything they say and that your best course is to just do as you’re told and not think about it too hard.
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We’re in a bizarre place when passing electricity through someone’s head and intentionally inducing a seizure is considered more dangerous than having someone try a fasting program or vitamin B3. They probably meant it was more dangerous for THEM, as they can’t be sued for inducing convulsions, since it’s “standard practice,” whereas if something went wrong with someone who is fasting on their advice, they could get in legal trouble. Or maybe they are simply so blinded to the dangers of electrocution that it genuinely seems safer?
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It may very well do so if the label means you give them a drug that screws with their metabolism.
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Posting as moderator: I found the comment – it had somehow been labeled “spam,” most likely based on the link you included. I have restored it to the thread.
—- Steve
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It irks me particularly when they give someone Zyprexa or some other fattening drug, and when the person predictably gains a bunch of weight, they say they need to go on a diet!
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OK, I get what you’re saying. I could see Bob being against using that term, but I can’t really see him in any way opposing the complete deconstruction of the psychiatric profession or the way of thinking they currently represent, as I know he finds both odious and laden with contradictions, corruption and greed.
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I like that! Let’s get it going. “WBU local #147 annual meeting will come to order.”
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Just going for a walk or a hike or a bike ride is the best therapy I know of. 5 minutes and I already feel better. And you’re right, there is not a “right way” to do it. I never listen to fitness gurus, I just do what feels right to me, and it works.
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Or perhaps wince…
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This is my favorite post from you ever!
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Well, then, I guess what I received wouldn’t have been “psychotherapy” by your definition. But she did call herself a therapist and the experience was pretty amazingly consciousness-raising for me.
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He asked survivors for their hands up. I don’t consider myself in that category. The only “treatment” I received was some psychotherapy in my 20s, and there was no force, no drugs, and the therapist did nothing to “diagnose” or explain what was “wrong” with me. She was, in fact, very empowering to me. I later discovered how fortunate I’d been to find her, though this was in the early 80s before the DSM III and the “chemical imbalance” meme had taken hold. So I don’t feel I can claim being a “survivor,” except to the extent that I may very well have “dodged a bullet” by avoiding the “system” for the most part.
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Can you give me an example of him disparaging an antipsychiatry viewpoint? I agree that his research leads almost inevitably in the antipsychiatry direction if followed through to its natural conclusions. How can one support an industry whose entire basis is an intentional falsehood regarding the nature of mental/emotional distress? If you remove that falsehood, what is left beyond greed and a drive for power and control?
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And if there were, the “subgroup” would be the actual diagnostic category, and they’d admit there was nothing wrong with the rest of the group. Also, the “subgroup” would have to have something more in common than “reacting positively” to a drug. Lots of people “respond positively” to alcohol when anxious, but we don’t categorize them as “mentally ill.” They just like how it feels when they drink alcohol.
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I still think you are missing the point. It’s not whether antipsychiatry is good or bad or holding opinions “because of one’s socialism” is acceptable or unacceptable. They are changing the topic! Why allow the other person to take control of the communication by making it about antipsychiatry or socialism or Scientology or Catholicism or whatever else? Why not point out that they are trying to distract from the point you just made by bringing up a philosophical discussion of some external explanation of “why” rather than the very obvious factual reasons you have just brought to light? Are the long-term outcomes for ADHD any better or worse based on my philosophical or religious orientation? Are we talking about science or philosophy? I prefer to keep the topic on scientific facts, because when we do that, the forces of psychiatry lose every time. Which is why they want to talk about something else, ANYTHING else besides the actual facts! And I don’t allow them to do that, and point out their deceptive intent into the bargain.
They have also tried to change the topic into admiring me for all of my great advocacy work and how wonderful it is that I’m willing to stand up for foster kids, etc, etc. I do the same thing: “Thanks for your kind words. Now let’s get back to talking about why this kid is having hand tremors. They are listed as side effects for two of the drugs she’s taking – what are you planning to do about this?”
I hope that makes my point clear. It has nothing to do with antipsychiatry or socialism. It has to do with calling out the evasive tactics used to distract from talking about the real subject.
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Or perhaps they ought to attribute their “mental illness” to being refugees torn from their countries by violence and warfare and poverty and systemic corruption. Or is that not one of the options?
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I believe any “therapy” worth calling that name has to include a strong element of consciousness raising. If one isn’t able to become more aware of the oppression one is or has been under, it’s unlikely any radical change will happen in how one approaches that oppression.
Always liked Paolo Friere.
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I would also add that whatever you or I or anyone else thinks of the term “antipsychiatry,” it is USED by psychiatric proponents as a means of discrediting someone. I don’t think they care what YOU think about the term, they use it in a way to try and convince other people that you’re irrational. That’s the problem I’m talking about here.
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One of MIA’s missions is to provide a voice to survivors. My understanding is that it has never taken an “antipsychiatry” stance, but is more intended as a discussion forum for folks of any philosophical viewpoint, as long as it is focused on the facts at hand and not on promoting psychiatric propaganda. Actually, propagandists have always posted here, too, but they don’t really have a lot of fun in general. So it might be a good place for antipsychiatry folks to get together and communicate, but MIA and Bob Whitaker have never taken and antipsychiatry stance, and that is reflected in the diversity of topics presented and commenters.
This is just me talking, not representing MIA formally, it’s just always been my understanding of the situation.
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Perhaps a poor choice of examples. I apologize for any offense. I had no intent to compare Scientology to antipsychiatry or either to antiscience – these are simply the “accusations” commonly used by pro-psych forces to try and get off the topic of whether there is any truth to psychiatry’s claims.
My point is that any attempt to distract from the discussion should be confronted and labeled as such. I would submit that even if one got into a long discussion of why one is an antipsychiatrist and made a great argument, that person would still be off on a tangent and their antagonist would win a round. My point to that person would be that PSYCHIATRY IS BASED ON LIES AND THE DATA PROVES THAT, and you choosing to try and discredit me by labeling me in any way is simply a tactical distraction from the point at hand, whether it’s true or false, or positive or negative in my own view.
Perhaps the better analogy is if I said I see large corporate contributions are dangerous to our society, and the person said, “You only believe that because you’re a socialist.” I don’t need to “defend myself” against an “accusation” of being a socialist, nor do I have to explain that I am a socialist and explain what it means or why it’s not a bad thing. My reply would be more along the line of, “No, I believe that because it happens to be true” and present my evidence. A more snide response might be, “No, I’m a socialist because what I said is true and it needs to be changed.” Or I might ask them, “So are you saying that buying votes by making “contributions” to politicians in exchange for access and favors is a good thing?” But I’d bring it back to the point, whether the accusation was good, bad or indifferent in my view. It’s a distraction tactic and I think it plays into their hands to fall into that discussion at all.
Does that make it any clearer? Or at least less offensive?
Your candor is appreciated, as always.
—- Steve
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I think that is very well said. We don’t need an “alternative to psychiatry,” we need some alternative to being involved in the “mental health system” altogether, where folks can get the help and support they need without having their lives controlled or invalidated by so-called “professionals” who have the power to destroy their lives with impunity.
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I would submit that that the judgment involved in determining whether or not something is “not caused by an external source” and/or is “not recognized to be real” means they are ultimately not objective criteria. For purposes of philosophical or lay discussions, I think these are workable definitions, but for any kind of scientific work, they are hopelessly vague and unfalsifiable.
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I agree. The very act of diagnosing is a power trip, especially when the “diagnosis” has no basis in the physical universe whatsoever. To take a social construct and apply it to another as a means of diminishing their power is an unquestionable act of aggression.
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This is very true, but at least we can remove the idea that some “sciency” doctor with lab equipment can tell me what’s wrong with me and what I have to do to “fix it”.
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The “mental health” system is based at this point on the spurious claims of the DSM 5 to be able to identify “disorders” of the “mind” which can be “treated” by some medical modality, in which I include any form of reimbursable “therapy” of any sort. Until the DSM is completely deconstructed and the truth about the non-medical nature of most “mental illnesses” defined therein widely publicized, and the entire edifice removed from any semblance of “medical treatment,” we’re still screwed. So being anti-mental-health-system definitely involves a large degree of being antipsychiatry, as psychiatry is the progenitor and main profiteer from the DSM and its multifarious cultural offspring.
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This is truly chilling!
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I’ve said this before many times – being called a “scientologist” or an “antipsychiatrist” or an “antiscientist” is a tactic of distraction, and should be labeled as such. Such tactics are used by people who don’t have actual data to counter your arguments. I believe the proper reply is to ask why they are distracting from the question at hand. If you defend yourself in any way, you have allowed the topic to be changed to whether or not the label fits you, rather than whether or not psychiatry is a legitimate medical field, which is what we need to be talking about. That’s my humble opinion, and others can disagree if they wish, but decades as an advocate have taught me that the “ad hominem” attack generally means you have your opponent on the ropes, and you should continue your attack rather than let yourself be pulled off topic.
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It is remarkable how gender, which is BY FAR the highest correlation with violence with guns or otherwise, is completely ignored by the MSM and mainstream psychiatry/psychology, while the tiny correlation with “mental illness” as diagnosed by the subjective DSM is made into the biggest issue. It is a clear case of scapegoating the less powerful instead of looking at the facts, protecting the powerful at the expense of those who can’t defend themselves.
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Well said. Sharing differing beliefs is not the same as shaming someone for their particular belief. This same kind of thinking is behind the concept of “pill shaming,” where pointing out legitimate critiques of the facts surrounding psychiatric drug use is conflated with telling people who use them that they are wrong. If we can’t talk about differing beliefs and observations, we can’t have an honest conversation. The key is respecting the right of others to their own beliefs and observations, rather than insisting that yours must be “correct” for everyone.
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Maybe it shouldn’t be a “secular field.” Maybe it should be considered a religious/philosophical inquiry.
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A related question here: do psychiatrists have the right to represent themselves as experts and to make recommendations of destructive “treatments” just so they can make money? Truth in advertising has been a concept since at least the 1800s. I’m not sure I think it’s depriving psychiatry of its “liberty” if we require honesty in all representations about their supposed “knowledge” about people and the apparent effects of the drugs they are peddling. Where do you stand on that point?
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I had this same thought! I called it “fractional reincarnation.”
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Done! I encourage others to add to the comments. So far there are two. This is a very big deal, and I would like to see lots of people help make it even bigger. I happen to know Deborah personally, and she has fought for many years to make this happen. Time to take “ECT” down!
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Very true. Since there is no way to determine “proper indications” with the current subjective diagnostic criteria, that claim you quote is ludicrous. Additionally, there has never been any evidence to suggest that antidepressants reduce the suicide rate, and in fact, there is evidence suggesting they most likely increase the suicide rate. “Antidepressants save lives” is drug company propaganda.
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Will do.
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Actually, more are killed by properly prescribed and administered pharmaceuticals than by medical errors, by a fairly large margin. Which is not to minimize the damage due to errors, but to emphasize that NORMAL MEDICAL CARE IS DANGEROUS!
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You are correct. I believe it also matters a lot how the people around you respond to the trauma. I understand that those who are sexually abused as children but have a supportive adult believe and protect them are much more likely to come through functioning pretty well, whereas those who are not believed suffer more greatly, even if the traumatic event appears less severe.
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You are assuming that they want to help in the manner you are describing. Many can’t even imagine such a means of helping, and think they are “helping” by stopping “bad” emotions. And others are just helping themselves to a bigger payday.
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I believe this is true and well established. One piece of evidence is that the more warlike a culture, the less nurturance they provide to their little boys. Learning to “grow up tough” is important for warrior cultures. We no longer live in such a culture, but we still raise our boys that way, I believe.
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BTW, I agree 100% that the male-violence connection is incredibly strong and obvious, much stronger than any other association that exists. It is kind of amazing how little attention it receives.
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It is also true that the vast majority of traumatized males don’t become violent killers, either. Obviously, there is more at work, much more, but it is so much more convenient to blame “the mentally ill.”
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Understanding the intentional driving of people into “right” and “left” camps is rarely commented on, but central to why we are where we are today. It’s great to see you identify it with such clarity. I only wish it were possible to help those enamoured of those labels how they are being played!
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I have to disagree to some extent – I think it is fairly easy to observe that psychological damage exists. Look at a child who is constantly berated, or beaten, or sold to someone else for sexual favors, and compare to a child who is raised in a rational and loving manner, and you will consistently see the former showing evidence of having been damaged by the treatment they received, in the sense of lacking trust, being aggressive or withdrawn, having flashbacks, having difficulty relating to others, etc. Where I do agree is that such phenomena are not really amenable to study and classification in the same way that something like a broken leg or an infection would be. We are, indeed, operating on the borders of metaphysics here. However, we all need metaphysics to make sense of the world we live in, and I think it is this very process of making sense that is distorted and blunted by abusive treatment by those who have power over a person. Whether you call that “injury” or “trauma” or something else is all semantics, but I do think such damage is very clearly observable.
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Or perhaps not allowing any financial conflicts of interest for those lecturing or training medical students.
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The problem is that people are approaching the data with an agenda. A true scientist will believe what the data says, even if it contradicts expectations or future income potential. Conflicts of interest have fueled a massive breakdown in scientific integrity across all areas of science.
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I wouldn’t say that faith requires you to believe things that are CONTRARY to facts, just that no facts are required to sustain your belief. I think there are people who have faith to a point, but if consensus reality conflicts with faith, are willing to change their view. There are lots of Christians, for example, who don’t believe that God created the world 5000 years ago by blowing on a bunch of dust, because scientific evidence contradicts that version of reality. But they may still believe in God or Jesus without any need for evidence.
I’d have to agree, though, that the religion of psychiatry goes more along the “religious literalist” line of faith – even contradictory evidence doesn’t shake their faith in the DSM/Broken Brain mythology.
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Commenting as moderator here:
You are right, everyone has a right to their beliefs. Stating one’s beliefs in general is not a cause for being moderated. Telling someone else their beliefs are wrong may very well be cause for being moderated. Sometimes, we have to just allow people to state their beliefs and let them have those beliefs, even if they seem misguided or contradictory. Naturally, it’s always acceptable to ask why, and to share one’s own beliefs that conflict, but I don’t think we want to be in the business of moderating people’s belief systems, unless they intrude upon the rights of others to operate successfully (such as racism, sexism, etc.)
Just want to be clear about that distinction.
— Steve
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I guess it’s worth asking who has the right to force “treatment” on someone, even in the name of saving a life. Of course, we never know if we really DO save a life or just feel like we’ve done so. It’s also worth asking how many have lost all hope of help after being detained against their will, and how many of those killed themselves when they might not have. I ask all of this having been the person deciding whether or not to suspend someone’s civil rights for reason of “mental illness.” It was an agonizing job and one that I don’t recommend to anyone. The decision between holding someone in a psych ward, one of the most un-healing kind of places I’ve ever seen, at least where I was, and letting them go home and possibly hurt themselves – well, there are nothing but two bad options.
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Sounds pretty disgusting. Ironic, too, as capitalism drives both the denial of services AND the denial of your feelings and needs about the denial of services. But capitalism is always held harmless somehow.
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It is also a religion in the sense that it is not based on any kind of rational fact-finding process. You believe because you believe, it is not required that the things you have faith in make any kind of logical sense or fit with the evidence of the physical world, or even the spiritual world for that matter. You can collect data that support your beliefs and neglect or minimize data that doesn’t. Of course, not all religious people behave in this way, many are very rational, but a religion doesn’t REQUIRE that your faith fits the facts. Psychiatry definitely acts this way – when the data doesn’t fit the desired hypothesis, “we need more data.” When someone presents a more workable explanation, “You’re antipsychiatry” or “you’re a Scientologist.” There is no possibility of engaging in rational discussion when someone is taking that kind of a position. No matter how much actual science contradicts it, psychiatry must maintain its central belief system at all costs. That’s a religion, not a scientific discipline.
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I love the beach trip idea!
The DSM labels have coopted common human terms and turned them into “medical diagnoses.” Certainly, no one is wanting to ban words like “depression” and “anxious.” I just want the psychiatric “profession” to stop pretending that people who are depressed all have a problem, all have the SAME problem, and all need the SAME “TREATMENT.” In particular, I want to end the idiotic concept that someone is depressed because their brain doesn’t work properly, in the absence of the slightest evidence that this is the case.
As for insurance payment, surely we can come up with something more real and less stigmatizing to tell insurance companies and still get payment.
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This is very true!
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I see “provider” as simply a description of a role a person has chosen to play. I see this as very different from a high-power person assigning a label to someone who has no voice to object.
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And yet when the low-power person expresses discomfort, it’s regarded as some kind of insult to the high-power person for not being “appreciative” enough. The game is fixed!
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Post a link and I’ll be happy to join into the fray!
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As I said in another comment, in the hands of a person who doesn’t genuinely respect the person they are trying to help, any language is quickly converted to condescension and disrespect and becomes yet another power play.
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I think there is an insincerity when words or stories are coopted. I worked with foster kids for many years. They had many forums where social workers “listened” to the youth describing what worked and didn’t work for them and how the system should be altered. The listeners seemed sincerely interested and always congratulated the youth for their courage and wisdom, and yet the system changed not one iota. Language is important, but the attitude of respect for the voice of the recipients of one’s service is not contained in the language itself, but in the intent of the service provider. A person who doesn’t respect the person they are serving comes across as condescending regardless of the language they choose. Which has ruined many excellent terms and ideas.
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Very well said, Sera!
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Thanks!
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One can also recover from an injury, which is often what is happening in the cases of the “mentally ill” as identified by the DSM. Psychiatry’s insistence on denying this obvious connection is one of its most evil acts.
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I very much like that approach. Asking where they got the information doesn’t challenge their identity, just makes it clear that it has an origin, which automatically moves in the direction of “bipolar” being a way of viewing things rather than a solid reality. I have also used “What led you to that conclusion?”
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Agreed. Independent is dangerous to the status quo, but at the same time is held up as a mythological goal that we’re all to strive for. I think what our “leaders” mean by independence is not needing anything and accepting our lot, not actually thinking for oneself and making our own decisions. Real independence is easily classified as a “mental illness” in a lot of cases.
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Of course, internalized oppression is usually very well established well before any contact with the “mental health” system. It usually starts at home, and if not there, is certainly put in place for most people by the schools or their family church.
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There are times when the reason they don’t “get” what you’re saying, it’s because they have another agenda that your ideas conflict with, and they aren’t really that interested in doing the “right thing” if it means they’d lose power, money or influence that they want to have.
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Commenting as moderator: We have worked hard to minimize any such comments, with some success. If you feel there is something that is hurtful to you, please let me know via the “report comment” function, or e-mail me at [email protected].
—- Steve
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This is where I really want that “upvote” button!
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And those supporting the status quo will be uncomfortable and threatened, no matter how you phrase it. So might as well call it what it is, while maintaining a respectful demeanor, so that when they start attacking you, it will be clear who has the moral high ground.
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I dunno. I got it on the first read.
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Dependent is different from compliant. We don’t want people to be clingy and dependent – we want them to DO AS THEY ARE TOLD! People that refuse to knuckle under are the most likely to get “diagnosed,” followed by those who get upset about being abused and start to complain about it.
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Unfortunately, the entire DSM diagnostic scheme is the opposite of “trauma informed.” It’s essentially impossible to do “trauma-informed care” within the diagnostic system in place.
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This is a brilliant comment!
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I think it says a lot about the diagnostic system that so many more women than men get diagnosed. It’s not that women necessarily suffer more (though you might want to read up a bit on how much energy women vs. men spend on trying to avoid being raped or sexually assaulted every day), but that women’s emotionality is interpreted as “disordered” while men’s emotions are generally channeled into anger and competitiveness and are seen as “good” as long as they remain within these bounds. It is easy to note that the DSM disorders often center around strong emotions – depression, anxiety, intensity, hopelessness, grief. I think the message is pretty clear: strong emotions are not acceptable, especially in those who don’t have the power to control others but are expected to be controlled. Hence, the biggest groups diagnosed are women and children, schizophrenia diagnoses are more common among black people, etc. It is impossible to separate the DSM diagnostic system, which you may recall is created by committees (mostly of older white men) VOTING on what constitutes a “disorder,” from the efforts of the larger society to deny or minimize problems of oppression of the less powerful elements of society and preventing them from gathering any force to demand a change in the power structure. So sure, women may be more likely than men to seek “help,” but this is all part of a much bigger social problem involving the suppression of emotional expression in both men and women. My view is that those higher in power deal with it by beating up those lower in the hierarchy, while those with less power are judged “mentally ill” when they start to object or react to their mistreatment.
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I have always thought that should be a “diagnosis!” If being excessively oppositional and defiant is a disorder, it’s only fair that being excessively compliant and submissive should be a “disorder,” too. Just like there is no “Excessive attention hypoactivity disorder.” The fact that only one extreme is emphasized shows the moral bankruptcy of the process. We LIKE compliant kids, so they are “healthy.” We only label the ones that give us trouble!
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Sounds like a lot of similarities with what people call a “cult.”
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Indeed!
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Yeah, that’s why that BS about “Anosognosia” or whatever really steams me! The basic attitude is, “We know what you need, and even if you say it’s not helpful, it’s because you don’t understand yourself. So just do what I say and shut up.” About as arrogant and authoritarian as you can get.
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That totally sucks! I have never understood how anyone can justify inducing a seizure in another person as a way of “helping” them. It makes no sense whatsoever, and it is hardly surprising that memory loss and other cognitive impairment is a result. If someone has a seizure, we consider it an emergency situation and dangerous to the person. Inducing seizures is not “treatment!”
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There is such a thing as “natural authority” – some times a person has knowledge, skills or understanding in a particular area that makes them able to plan and direct a project or undertaking in a way that most others can’t manage to the same level of success. This is very different from “structural authority” due to position or education or money or political position or whatever. Natural authority is specific to an area of activity or a specific project, and is gone when we change to another area. It is logical and emerges naturally, as opposed to structural authority, which is maintained whether or not the person in authority is competent or ethical.
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I have always wondered about that – if exercise is so good for us, why is it that it’s so damned painful to start with! I suppose in nature we are forced by circumstances to exercise just to survive, so we don’t have a choice about it.
Good point about sex, too. It’s a particularly excellent sleep aid!
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National NAMI has taken a lot of money from the drug companies, and is often a mouthpiece for the drug industry. They have promoted the “chemical imbalance” theory and talked about “mental illnesses” being “neurological brain disorders”. They have historically minimized or avoided any implication or suggestion that poor parenting or other trauma have anything to do with “mental disorders” or emotional or behavioral difficulties. “Blaming the parents” is a HUGE no-no at NAMI – it’s always the fault of the child’s brain, and the answer is always biological.
There have been some changes over the last few years and their presentation has softened, and more time has been given to alternative approaches, but they are still very committed to the idea that “mental illnesses” as defined in the DSM require “treatment” and are not the fault of the parents.
Local NAMI chapters vary widely in what they present and what kind of discussions are allowed or encouraged, but the danger is always that NAMI is generally very supportive of the status quo and preaches “mental illnesses” as “biological brain diseases” and are generally very supportive of forced “treatment” and “Assisted Outpatient Treatment” that forces people to take drugs no matter what effect they may have on the recipient.
I hope this is a good primer. I’m sure others will chime in with more direct personal experience.
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You are right, of course. Relapse implies a specific condition from which one is recovering, and none of the “mental illnesses” can meet that criterion. Perhaps addiction, but there you at least have the measurable question of whether one has returned to the use of substances or whatever one is addicted to. “Relapse” is pretty meaningless when applied to “depression” or the like, particularly when withdrawal or other drug effects are in play. It all starts with the mistaken concept that saying someone “has depression” or whatever has any scientific meaning, which it does not.
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A very fair question, indeed. Though to me, the stigma ought to devolve upon the prescribers, not upon their victims.
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The number is most definitely higher. One study in the Canadian Journal of Psychiatry found that 6-7% of kids taking stimulants had some psychotic symptoms (hallucinations or delusional thoughts). That’s hardly a rare phenomenon.
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Hiring an attorney is what they really fear most. But you have to get an attorney to take your case.
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Seriously. One of the best antidepressants for me is to stop watching or listening to the news.
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What a fantastically simple idea! The new anti-stigma campaign – quit labeling your patients!
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Amen!
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The only “stigma” the psychiatric leaders appear to care about is anything that discourages people from taking more psychiatric drugs.
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Wow, that’s seriously obscure! I have to add it to my list!
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“The best revenge is living well!”
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Bipolar psychosis with grandiose and paranoid delusions and command hallucinations – thinks God is telling him what to do, feels persecuted by the Romans, believes he is some kind of “savior” of mankind… obviously needs acute hospitalization!
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Definitely an “antidepressant.”
“A Gramme is better than a Damn!”
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Hey, Jesus Himself would have been a mental patient today, for certain! Spiritual healing, preaching that the meek would inherit the earth, creating insurrection with his crazy ideas – a sure candidate for “AOT!”
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Not only did he not take neuroleptics following his early hospitalizations, as I recall, he describes actively avoiding contact with the authorities to avoid any engagement with the “mental health” system. Apparently, as unclear as he was about many things, he was very clear on this one point and committed himself to staying under the radar so he would not be forced back into the hospital again. His mind cleared eventually without any further intervention from the “professionals.” Not a story Big Pharma wanted to have told.
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Love it!
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The psychiatric community has even admitted this was true – those that Biedermann’s “criteria” identified as “bipolar” apparently rarely ended up diagnosed with “bipolar disorder” as an adult, and most adults so identified never had these “symptoms” as children. Which is why they invented “Disruptive Mood Dysregulation Disorder (DMDD),” so they could continue to have a DSM justification for drugging these same kids despite their admittedly being completely wrong about “Juvenile Bipolar Disorder.” So we see that, in the end, the diagnosis is of no actual consequence, as long as prescribing of drugs can be continued.
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How about “IS increasing ‘mental disorder’ diagnoses?”
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It shows just how weak their actual belief in their own theories is that they have to force someone to like in order to protect their drugs’ “image” and the validity of their profession. They really are afraid the truth will get out!
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LOL!
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This should be the #1 objective for anyone who believes democracy matters in the USA!
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Amen to that!
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Posting as moderator:
I have moderated all comments since yesterday regarding the “abortion debate.” Oldhead reminded me above that these comments are all off topic, which is regarded as a violation of the posting guidelines. I often allow off-topic conversations to continue if they are productive and focused on the objective of critiquing psychiatry and its practices, but in this case, the thread is not contributing to the mission of the site. All further abortion-related comments will therefore be moderated from this thread, regardless of the opinion of the poster, in the interests of consistency. It is a topic simply not appropriate to this site, particularly in the way in which it has been presented, as I think LavenderSage reminded me as well. Thanks to those who responded in a respectful manner despite the temptation to do otherwise.
—- Steve
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Excellent point! Some sneaky word-play here to preserve the concept of “psychosis” as an abnormal state, even though it appears to be common among “normal” people.
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Seems like Pharma paying direct damages for life is more than fair.
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It also allows those who still retain consciences to soothe them by pretending they are “helping.”
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See, now I want the “upvote” button.
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Amen!
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Thanks for that important clarification.
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Or to put it yet more simply, it relapse is more likely the longer you take these drugs.
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Right! My view is that I’m a smart person, you ought to be able to explain things so they make sense to me. If you can’t, the most likely reason isn’t that you have an advanced degree and are dealing with issues that are over my head. The most likely reason is that what you’re saying doesn’t make sense.
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Funny, and yet not really funny at all.
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Well said.
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A very important point that is often ignored when people look at “outcomes.” What a real outcome is depends a lot on one’s objectives. And of course, the objectives are almost always defined by the “treater” rather than the “treated.”
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It seems like we’re coming from a similar place. I’m only pointing out that talking about “depression” as if it were a real clinical entity implicitly supports the worldview we’re trying to break down. Joanna Moncrieff writes well about using the “drug-based model” of intervention – we’re using a drug because some people like its effects, not because we’re “treating” some medical entity. I think language is very important at this stage – we need to make folks conscious of the implicit assumptions in suggesting that someone “has depression” that “can be treated.” It’s part of the marketing scheme to use such language.
That being said, if doctors or anyone else spends 90+ minutes actually listening and asking compassionate questions, the client is much more likely to actually get something they need. I just think it’s important to convey to them that there isn’t something “wrong” with them for feeling or reacting as they do – it’s just their current condition, and if they want to work to change it, that’s their decision. It’s not up to me to “diagnose” them with some spurious “condition” and pretend that means I know something that they don’t. The client is the one who has the answers.
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There you go talking about that pesky EVIDENCE again! Just because there’s no evidence doesn’t mean my “treatment” isn’t wonderful! What ever happened to blind faith in professionals? It’s people like you that make charlatanism much harder to sustain!
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The absurdity of forcing someone through a “program” that doesn’t allow discussion of historical trauma, even when the client specifically states a need to do so herself, is beyond comprehension. Sometimes these manualized programs are almost as bad as the drugs, because they still adopt the idea that you “have something” that needs to be “treated” and that everyone who “has” the same “diagnosis” is treated in the same way. It’s beyond disrespectful!
I’m so glad you found MIA and have been able to reclaim your narrative to a large extent, by all appearances. I am not surprised that some of your “diagnoses” melted away when you got off the drugs. Many people here have shared similar experiences.
Thanks for sharing your story! The more we talk about these experiences, the sooner the truth will float to the surface of our blind and deaf society.
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The way you discuss this makes it appear that “depression” and “episodes” are the problem, rather than symptoms of other difficulties. “Depression” is not a scientific entity, it’s a lay-person’s description of a state of the mind at a particular time. “Depression” as described in the DSM can result from early childhood trauma, thyroid dysfunction, nutritional deficiencies, a dead-end job, relationship instability, lack of sleep, lack of a sense of purpose, side effects of other drugs, a range of actual physiological illnesses, and more. It is ABSURD to consider “depression” as a unitary “disorder” and try to “treat it” without bothering to discover what is actually going on. Sure, drugs can make anyone feel better, if it’s the right drug at the right time. That’s why people go out drinking after work or smoke some weed when they get home. But no one thinks drinking alcohol is “treatment” for “anxiety disorders”. It’s a drug, plain and simple. Same with SSRIs or any other “medication.” They are drugs, plain and simple. They can’t “treat” depression any more than they could “treat” boredom or excitement or pain or irresponsibility. Depression isn’t a “treatable” entity. It is usually an indication of something else going on, and “treating” it without consideration of the causes is about as smart as “treating” pain without looking for the source of it.
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What you’re talking about is analyzing what is actually happening to a person’s body, rather than just saying “all anxious people need B1” or other such generalizations. I’m right there with you. Everyone is different, and pretending that all people need therapy or B1 or meditation or ANY single intervention based on how they feel is never going to work. But for some, nutritional interventions have been very successful. It needs to be case by case.
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All this “new” information about withdrawal symptoms was documented by Peter Breggin back in 1993 or so in Toxic Psychiatry. I wonder why it is suddenly acceptable news?
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LOL!
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Beautifully put!
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The most basic error of psychiatry in the DSM era is the assumption that all people presenting certain ‘symptoms’ have essentially similar needs and causal factors in place. This, of course, could not be more wrong. So it is that some people will do wonderfully with magnesium supplementation, and some will experience no effect at all, and some might even do worse. True, it is much safer and smarter to try nutritional interventions or supplements of this sort, as the consequences of a “no result” are pretty minor compared to “antidepressants” or, Lord help us, “antipsychotics.” But the idea that a person experiencing intense anxiety automatically has a need for magnesium supplementation is just as scientifically wrong as believing that all anxious people need SSRIs. It is dehumanizing to lump people together based on some arbitrary category of emotional “disorder” defined by subjective observation and judgment regarding basic human emotional responses that could literally mean almost anything depending on the person experiencing them.
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I’m less worried what the system is called and more worried about the integrity of those running it.
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But Frank, nobody can make any money off of people spontaneously recovering! These are dangerous ideas you’re putting out!
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On the other hand, one could just go down to the bar and get a couple shots of Johnny Walker Red.
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Quite so. The biggest barrier to learning is not caring enough to want to find out. Or being afraid of finding out the truth.
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Thanks for that inside information about life in the UK. I know things are different in different countries. I’d have to say, though, that sounds like the facts on the worker level. I am guessing that someone higher up the food chain is still making a lot of money or it wouldn’t be so important to make sure workers are prescribing.
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The damage to one’s trust in humanity can be even worse than the damage to your body. It is utterly demoralizing even to just hear about it. To have been through it must be absolutely devastating, body and soul.
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My understanding of socialism is that each person contributes work based on their skills and abilities without concern for salary per se. “To each according to his needs, from each according to his abilities.” Perhaps not the most realistic approach given human nature, but certainly not a call for people loafing around doing nothing.
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Their pretensions of “science” in the face of total denial of the actual evidence is, indeed, an evil of monumental proportions. All in the name of profits and power.
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Rather an old breed, actually.
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OK, well, there are some I have eventually decided are entirely hopeless. But I try to at least give them a chance first. Perhaps I’m too generous?
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Glad I did – making people laugh is the very best ‘therapy’ I know of!
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Quite so. Power is the issue!
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Or the possibility that someone will stop making money off of their lies.
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I really appreciated this comment. It is important that we don’t allow ourselves to deteriorate into labeling and dismissing, as that is the tactic used by “the system” to keep dissenters down. We need to recognize the humanity of everyone we encounter, even if we have to decide to keep someone’s views or behavior in check due to the damage done to others. There is no telling which antagonist might at some time have “the scales fall from their eyes” and start to see things differently.
Psychiatry’s biggest crime, in my view, is undermining and defeating people’s hope. We have to continue to have hope that people are human and are never entirely hopeless.
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You speak very wisely! I still feel guilt sometimes but have learned to acknowledge it as a voice from the past and let it go in most cases. But it is still a struggle some times. It’s hard to kick those early childhood lessons.
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I’ve often said how senseless it is to focus all this energy on genetics, which is the one thing about a person you CAN’T alter, and take it off the environment, which is ultimately highly modifiable given sufficient motivation and skill (whether society’s or an individual’s motivation, it’s still modifiable.) So what if some people are more ‘susceptible’ to PTSD genetically? QUIT FREAKIN’ TRAUMATIZING PEOPLE and the ones who are more ‘vulnerable’ will be just fine!!!
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I do think it’s possible to be direct without being antagonistic, but I agree that there are times when setting good boundaries requires doing things that others might find hurtful, mostly due to your violating their sense of entitlement.
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They don’t want to believe it, so they don’t see it.
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Wow, prophylactic “antidepressants?” First time I’ve heard that one. Let’s give people drugs BEFORE they have any “symptoms” just in case, eh? Disgusting!
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I agree, calling them “antidepressants” perpetuates the lie. Perhaps “serotonin hyperactivity inducers?” Or just “chemical brain experiments?”
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That’s my understanding. Doctors can commit any manner of destructive or deadly actions as long as their colleagues agree that this is considered “standard practice.” So it is that in the realm of childbirth, it is more dangerous for a doctor to recommend a hot bath than it is to perform a Caesarian section.
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Psychiatry is certainly linked to eugenics by history – the psychiatrists were part and parcel of efforts to eliminate “bad genes” by sterilizing or killing the “mentally ill”.
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How many “reviews” does it take before the obvious truth is accepted as truth? This fact has been known for decades – why is it still being “researched?” Not criticizing the researchers here, just the fact that the psychiatric community has not yet accepted the obvious reality that so-called “antidepressants” cause dependence and withdrawal.
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I like the term “coalition.” It suggests that the people involved don’t have to agree on all their goals, but have common interests that allow working together toward an agreed upon goal that forwards both/all groups in the coalition. This kind of thinking is vitally important for a movement relating to “mental health”, because it is a form of oppression from which no one is entirely immune, and which cuts across all other identity groups to some degree or another.
I will reiterate Poison Ivy’s point, which I also think is important: the term Identity Politics has been hijacked by the extreme right and I think we need to be very careful to define what we mean when we’re talking about it. I very much appreciate the clarity of your definition.
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I guess that’s what happens when you “diagnose” with checklists!
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In fact, I don’t think I would have survived school without daydreaming. It was the only thing I could do to keep from running screaming from the building. Though maybe the latter would have been a healthier response.
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Why not? I daydreamed plenty and I turned out OK.
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Too true! A lot of psychiatry and therapy ends up being about “stopping” those uncomfortable feelings that the “helpers” have projected/externalized onto their “clients.” This is one of the most destructive things about the DSM – it allows and even encourages the ostensible “helpers” to externalize their own demons to be symbolically wiped out in the “clients” who are making them so uncomfortable. If I can drug away everyone else’s “depression,” maybe I don’t have to become aware of or deal with my own.
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Not sure I entirely agree with you. There is such a thing as social/system manipulation, whereby choices are arbitrarily limited or directed in one preferred direction by the use of shame, isolation, authority, financial incentives/punishments, etc. If you define “force” as including all those other manifestations of power, then I think I can agree.
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“Always remember that you are unique… just like everyone else!”
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Good to know there are other countries where the left is taking this up as a human rights/social justice issue. I hope it catches on!
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Wow, now homelessness is a disease, too? Is it genetic? Is it contagious?
Unbelievable!
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The usage you describe here is, indeed, the way I understand the term. I was I interested in what Richard meant when he uses the term, as I absolutely know he is far, far away from being a “white nationalist”. I find it difficult to see how the term at this point can be used in a different way, but I don’t want to make any assumptions as I am pretty well aware of Richard’s political leanings.
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I can definitely work with that!
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I can see how that could happen. Thanks for sharing that perspective. Unfortunately, for more serious situations, this effect is unlikely to have the necessary effect. It also doesn’t address structural problems in the school which set kids up for failure. But at least there is some awareness that these behaviors don’t happen in a vacuum. Most bad behavior by kids IS caused by adults failing to meet their needs, as the Rat Park experiments have shown.
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I had similar thoughts. As helpful as these methods may be in certain cases, the article ignores the fact that many children engage in aggressive behavior because they see it modeled at home (especially domestic abuse situations) or are subjected to it themselves. Additionally, many kids have outbursts because they are being expected to do things beyond their developmental capabilities, and this happens more and more in school. Bullying is also referenced, but the solution seems to be for the kid to learn not to react rather than to address the bullying. And it is important to remember that sometimes the adults are the ones doing the bullying.
It is great that kids can learn skills in not reacting to abusive behavior. But to try and address aggressive or tantruming behavior without looking at the social environment and expectations they are exposed to will in many cases lead to the student accepting that abusive behavior by adults and more aggressive children is OK and that their reaction is the problem rather than the abusive behavior or unreasonable expectations they are exposed to.
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Your comments remind me of the “Rat Park” experiment. It’s always been accepted in addiction research that rats given a choice between pushing a button for food and one for cocaine will eventually choose cocaine over food to the point of death. This is supposed to prove that the substances themselves are the problem. But when the Rat Park guy put the rats in a healthy environment with lots of stimulation and socialization opportunities, the rats were no longer very interested in the cocaine, and didn’t become “addicted.” When we see lots of addiction, we’re seeing people whose needs are not being well met in their environment. Yet we want to blame the drugs, because it lets our social leadership off the hook.
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So when you refer to “identity politics,” are you simply referring to a group identifying itself as a “survivor based” group leading such an effort? Or are you objecting to the creation of such identity-based groups, or using the ‘survivor’ identity as a means of organizing people who have been harmed by the system? Or the exclusion of “non-survivors” from such groups?
I remain genuinely somewhat confused as to what you’re objecting to, and would appreciate some clarification of what you mean in this case by “identity politics” diverting us from our goals.
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It’s funny, because I think you’re both much closer together than you think you are. Frank (if I’m getting this right) believes that removing psychiatry won’t deal with the issue of coercion, because something else will take its place. Richard (again, if I’m understanding correctly) also believes that trying to remove psychiatry in and of itself won’t handle the situation, because there is a bigger power structure behind it that would continue the oppression. So it seems that both of you agree that psychiatry is problematic, but that removing it without dealing with the underlying patterns of coercion and oppression would not accomplish the end of keeping the “mentally ill” from being mistreated, labeled, and jailed.
Something to build on, I think.
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The only thing we can say about “everybody” is that “everybody is different.” The most fundamental problem with the “mental health” system is that it tries to categorize people’s “problems” and prescribe “solutions” that are supposedly going to work for everyone. It’s a fool’s errand, except if your goal is to confuse people and make a lot of money.
Your post is right on the money!
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I think this is very well said, Bonnie. The political situation is very complicated and neither mainstream “left” nor “right” truly grasps the issues involved.
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You are threatening their gravy train, Julie! No pig wants to have its head pulled from the trough while feeding!
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The other part people don’t think about is that those who are NOT drugged and have that somewhat wild, hate-to-be bored kind of personality LEARN HOW TO COPE with people who don’t like their style or with situations where a less spontaneous approach is helpful. They learn SKILLS. But those who are on the stimulants don’t have to face those challenges, and can blame any failures on “my meds aren’t working” or “I have ADHD, I can’t help myself.” The psychological damage that can be done is quite substantial, beyond the obvious physiological damage of flooding the brain with dopamine every morning for a decade or more.
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Can you possibly figure out what they want to hear and say it to them often enough to have them let you out? Agree with them how incredibly helpful they’ve been and thank them, because you’re “symptoms are under control?” Or won’t that work? It doesn’t sound like rational argumentation is going to work. I feel so bad for you being stuck in there!
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Yes, and a knee-jerk violent reaction to anyone who questions the basic dogma. It’s very much like a religion, and a very rigid religion at that.
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But, but, but… if it’s a DIET problem, that would mean the PARENTS or the SCHOOLS would have to do something different! Isn’t that “blaming the parents?” Why should the ADULTS have to change when we can just use a handy “diagnosis” to blame the child?
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I’m with you on that point! Unfortunately, that would not stop the big con going on regarding “broken brains.” Though it WOULD help a lot.
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Clearly, in my view, only a fully vetted peer-run organization with at least a critical view to the DSM and standard psychiatric practice could possibly certify “peer workers.” And of course, the powers that be will not support that kind of approach. Hence, the problem that has been noted with co-optation of “peer workers.” Unless there is a real shift of power, the psychiatric establishment still gets to make the rules and gets to decide who is “certified” and who gets fired for being a little too honest. Same for professionals, actually. I was thoroughly discredited at a place I worked as “the guy who doesn’t like meds” and my opinion on the subject was completely discounted. That was just for voicing my opinion. If I had tried to talk to folks about actually getting OFF their “meds,” I am sure I’d have been in hot water, and probably got fired.
So it all comes down to power, which is why deconstructing our authoritarian economic and power distribution system is critical to really making any changes stick over time.
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No problem. I appreciate your gracious response.
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More than a bit! And the percentage keeps going up and up. Now they have toddlers on Ritalin. Seriously, what’s a “short attention span” for a toddler????
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It is certainly not a pathway to revolutionary change. At best, a way to make a bad system a little less dangerous for the few who can benefit. I left because I felt like continuing to work in the system was giving it tacit approval, but I think everyone has to make that ethical call themselves. Because as bad as the system is, those who happened to run into me were a hell of a lot better off than they would have been if I hadn’t been there. I quit for my own peace of mind, but I still struggled with the awful situation the clients were left in. I just knew I couldn’t change it from within.
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I think that is very true. It takes a lot of courage to work behind the lines, and it takes a toll on one’s psyche to have to make compromises to be able to keep close enough to the clients to be of service. That’s why I eventually quit and went into advocacy. But I still have great admiration for folks who are able to walk that line successfully and be there for folks, because as much as we’d like to be rid of “the system,” there are still a lot of folks enmeshed in it and they still need to know that someone cares, even if it’s “the secret resistance.”
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Very well said!
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I think that is an awesome starting point!
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Who says basic principles need to be diluted for conservative-identifying folks to come on board? You’re assuming again that all “conservatives” are the same and that none are able to work together with people who see things differently and learn from them. Yes, there are even conservatives who are pro-choice. There are a growing number of younger conservatives who are very environmentally conscious. I just read an impressive story about a super right-wing Tea Party US representative who went to jail and had his eyes radically opened to the oppression of prisoners and of black people and has done a total political 180.
I say, you create the organization on the principles you believe are necessary, and if someone identifying as “conservative” is interested, they are welcome to come. They’re not welcome to undermine the values of the organization, however.
I was privileged to work for 20 years with the Court Appointed Special Advocates program in Portland, OR. I managed volunteers who went out into the homes and lives of foster youth who were abuse/neglect victims and tried to get them back to a safe home and protect them while in care. Many of my volunteers were of a conservative bent, though on the average, they tended to be liberal. Some of the more conservative folks were EXCELLENT advocates, including helping get kids off of psychiatric drugs. And some had their own epiphanies or growth experiences in terms of understanding poverty, racism, domestic abuse, and the oppressive psychiatric system. So I know from experience this can happen.
Of course, I did have to fire a couple of folks for making unapologetically racist or sexist comments or otherwise violating our policies or our values as a group. They still had to live within the group values and expectations, and some couldn’t do it. (I fired a few “liberals,” too!) But we’d have been a poorer organization if we excluded all “conservatives” from our ranks.
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Not arguing with you there. Psychiatry is the handmaiden of neoliberalism. Problems aren’t caused by capitalism and cronyism, they’re caused by bad brains or bad characters. The blame flows to the least powerful. If this central part of the equation is ignored, as Frank often points out, we will most likely exchange psychiatry for another form of oppression.
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That’s devious thinking! And based on the Rosenhan experiment, it would probably work, because nobody even noticed the pseudo-patients taking notes.
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How about “people who have been screwed over by the system?” PWHBSOBS. It has a ring.
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Looking at that link, I can’t really agree with you. Unless you are saying that ALL observations of racist behavior are of necessity “trial by accusation?” Surely you would agree that racism still exists and is in regular practice today? Or are you really saying that racism is a thing of the past? People do use accusation to affect people’s opinion of a person, but it’s also true that some people do rape other people, and some of them are in positions of power. Are you denying the right of anyone to tell their story, because their story might damage someone’s reputation? Aren’t psychiatric survivors “accusing” psychiatrists and the field of psychiatry by telling the truth about what has happened to them?
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I think that as long as anyone admits to the possibility of “legitimate ADHD”, the problem will continue to expand. When you come up with “diagnoses” that are convenient for those in power and have no rational or objective bounds that can be established, “diagnostic creep” is inevitable. And there are a lot of “diagnostic creeps” out there happy to be making big bucks supplying the fixes!
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Ha! Love the “Princess Bride” reference!
My question is when do we ask if the problem is the student or the “social, professional, and school-related pressures” they are expected to navigate?
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I would say it depends to some degree of what those “good terms” constitute.
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Thank you! That is just the term I needed.
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I think this is an unfair generalization about peer workers. I agree that this is what the “MH” system WANTS them to be, and some, perhaps the majority even, knuckle under to those expectations, but there are certainly dissident peer workers who do their work “behind enemy lines”, as it were, and are providing such support as they can within the limits of their power. I think it is very important to distinguish the intent of the system from the actual behavior of individuals within the system. I say this as a person who was a “behind the lines” dissident counselor, and I can name any number of situations where the person I encountered was very fortunate that they got me instead of a run of the mill system drone. Eventually, I couldn’t keep it up because of my own sense of ethical conflict, but to suggest that there aren’t others in the system doing this kind of work is, I think, quite inaccurate.
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So how would you feel about engaging antipsychiatry folks who identify as “conservative” and finding out what made them decide to be “antipsychiatry” and to see where they’re at politically and to discuss your reasons for taking a “leftist” political analysis as essential to attacking psychiatry’s validity and power? Isn’t that the same thing we have to do with other left-leaning folks who are shouting out for “parity for mental health” and against “pill shaming” and other such unhelpful belief systems?
Let’s be honest, there is not a big “left-leaning” (or “right-leaning” for that matter) movement to eliminate psychiatry. Why not collect all the allies we can find who are open to looking at the bigger picture? I’ve talked to lots of conservative folks who recognize the role of corruption and the impact of Big Pharma on medical practice. Why not start from a point of agreement and work toward educating in the areas where a person may need more information?
I think it’s important not to make generalizations about “conservative” people. Sure there are some who are very rigid and who don’t really think through their positions, but there are others who are thoughtful and intelligent and open to reason. While I agree that an analysis that doesn’t include the impact of the profit motive and a harsh critique the neoliberal/neoconservative capitalistic society we’re part of will always fall short of the mark, but since most people aren’t there and need to be educated regardless of their political affiliations, why not just try to educate anyone who is compassionate about the plight of the survivors of the system, and work from where they’re at? If we don’t, we’re going to have a very small “movement,” IMHO.
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I think it depends entirely on who the “peer” in question is and what kind of support or opposition they area getting from the institution where they work. In some institutions, peer work is valued or at least tolerated, while in others, it is openly attacked any time it conflicts with the institutional objective of compliant and well-drugged “residents.” At least that’s my experience.
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Hey, that’s a great move!
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Not only the training programs, but the support or lack of it received from the institution you’re working in. It’s hard to work effectively behind enemy lines, and I admire anyone who is willing to take on such a dangerous and potentially life-changing role.
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Actually, it’s ironic that the “Decade of the Brain” research that was expected to find specific genetic or structural problems associated with “bipolar disorder” and “schizophrenia” and the like actually showed the opposite: that the human brain is incredibly flexible and capable of enormous growth and change, even in adulthood, in response to the environment. Other than the part about how early trauma causes brain changes (which fits with the “broken brain” agenda), very little of this research has seem the light of day, as it conflicts massively with the “bad genes” theory of “mental illness” and actually deeply supports the idea that positive relationships and a positive, supportive environment is the key to people avoiding or working through what has euphemistically been called “mental health symptoms.”
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I am the biggest critic of the DSM and psych “diagnoses” as you’ll find anywhere. I’m not suggesting that nutrition should be promoted as “treatment” for psych “diagnoses.” What I said was that “I don’t think that an ‘antipsychiatry’ position in any way prevents one from believing that nutritional variables affect one’s mental/emotional state.” This is in SUPPORT of people who are saying they don’t believe in psych diagnoses, not opposed to it! I’m countering the implied or stated criticism, which is pretty common, that people who identify as “antipsychiatry” are denying that nutrition or any other physical body variable affects mental/emotional state. Try not sleeping for three days and you’ll see what I mean. A person who hallucinates after three days without sleep is not “mentally ill,” they are sleep deprived, and there’s no reason why an antipsychiatry activist would deny that obvious fact.
I hope that clarifies my point. I’m the last person in the world to advocate for using “nutritional cures for ‘ADHD'” or that sort of thing. It totally supports the idea that “ADHD” is a “disorder” that needs to be “treated,” and I find that kind of marketing disingenuous at best, as well as having the unfortunate “side effect” of supporting the “broken brain” view that I so heartily detest.
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Essentially, I try out gradually more and more potentially emotional or controversial topics. I often start with humor to see what this person believes is humorous. Then I try talking about something that has some meaning to me, and see if this person reacts as I might expect to something more personal. This might happen over multiple interactions, of course, and if I get feedback that this person either a) has no interest or is uncomfortable talking about non-standard topics, or b) grabs on a little too hard and is trying to control the conversation, I back away from sharing anything personal or intimate with that person. It’s hard to exactly describe what I’m looking for, but genuineness and compassion are definitely a part of it, plus a willingness to allow themselves to be a little vunlerable and share some of their own stuff. A person who is empathetic but not compassionate is most likely willing to hear what you’re willing to share (as it might come in handy later in meeting their objectives), but will rarely share their own experiences, or will do so in an artificial and probably dishonest way.
That’s the best I can do. It’s something I started developing as a kid, long before I knew what it was I was doing, so a lot of it is pretty ingrained and hard to describe. I kinda just do it.
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Thanks for that feedback. I struggled with that a bit, as “con-people” or “con-persons” doesn’t really work. But “people who play con games” would have done the job.
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That’s not how I understand it. I participated in a training on OD a few years back led by Will Hall, and got a pretty good idea how it works.
“Open Dialog” starts without any assumption regarding what, if anything, is “wrong.” It also steps down the power of the therapists by including larger numbers of people and regarding all as having important things to say, including the client, which is a VERY big shift from most US psychiatry in my experience. The therapists further break down their “authority” by talking about the case with each other in front of the client and other participants, acknowledging when they don’t understand things and asking the other participants for their ideas of what is going on or what might be helpful. It was about the most empowering therapy modality that I’ve ever seen. And it works not on techniques, but on principles of how people should treat each other in the present moment to give the best chance of finding a solution or a path forward.
Does this mean someone might not coopt the name OD and do something else with it? Of course not. But it is not a “manualized therapy” like DBT where all of the “clients” are lumped together and assumed to need the same things. It is VERY individualized and requires therapists who are comfortable not knowing where exactly they’re going to end up or how they’ll get there, and are not afraid to show that vulnerability to the other participants in the process.
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I have wondered if this is how SSRIs really “work.” Maybe increasing serotonin induces a “who gives a crap” attitude that might seem a big relief to those who have spent a lot of time worrying about other peoples’ opinions of them. It would also explain why a small subset, like the Germanwings air pilot who flew his plane full of passengers into a mountainside, do bizarre things on SSRIs that appear out of character and totally irrational from an outside viewpoint. Perhaps they stopped caring about the consequences of their actions, so suicide or homicide suddenly became acceptable.
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It has always seemed to me that learning I can work my way through difficult emotions and even understand their origins was a much better approach than trying not to have those emotions or making them go away. If I know I can handle feeling anxious BY EXPERIENCE, then having anxiety is less worrisome to me, and my anxiety actually lessens over time. And I know that I am the one who did that, rather than someone coming in and messing with my body from the outside.
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Commenting as moderator here:
I don’t agree in this particular case. It appears he uses it in reference to to a specific comment, saying that the term “so-called racism” as used suggested that no racism currently exists and that people are making it up in order to accomplish some objective or other. You’re welcome to respond as to your actual intent in using that phrase, or dispute that the comment is racist, but it’s not an insult directed at you, it is an attempt to characterize a particular comment in terms of its implications. If we didn’t allow that, then we really would be in an “echo chamber.”
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Ah, but what happens when social control enhances profits? BF Skinner anyone?
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It is ironic that the shame so often falls upon those who are victimized instead of the ones doing the harm. Psychiatry is highly complicit in continuing and enhancing that pattern.
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It is a very common tactic for domestic abusers to label their partners as “crazy” or more subtly “Bipolar” or “borderline” as a means of either directly confusing them or convincing others intervening in the situation that the victim is the one making the problems. Psychiatry unfortunately plays right into this tactic by tossing out labels that abusers can then use to discredit or attack their partners.
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Posting as moderator here:
Calling someone a “racist” is most definitely an ad hominem attack. Saying that a comment is “racist” may or may not be, depending on the context. There are definitely comments that could be called “racist” legitimately by the definition of the term. It is true that claiming “racism” can sometimes be used to shut down discussion. It is also just as true that there are plenty of racist memes and beliefs floating around and there is nothing wrong with confronting them if the content truly puts down an entire race or promotes the superiority of one race over another or justifies racist behavior.
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I know what you’re saying, but it comes across a bit like “victim blaming.” It is not the fault of a person working to create change that the protectors of the status quo attack to keep control of their little or big fiefdoms. It is for sure to be expected, and strategies should be in place to keep such things in check to the degree possible. But the harm is not done by the person challenging the status quo. Those who engage in the “blowback” and especially those who ORGANIZE and PROMOTE such “blowback” are the ones who deserve to be chastised. I know this does no good for the victims of a “blowback” experience, but I think it’s important to make certain we’re not saying people shouldn’t try to make big changes just because there will be a reaction from those in charge of the status quo. It’s part of the price of change.
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Communists and trade unionists were among the first ones jailed by Hitler, long before he got around to concentration camps for Jews and Gypsies and the “mentally ill.”
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I think I understand what you’re talking about. I’ve only found a very small number of people able and willing to talk about “what’s happened to you,” and the majority of the “mental health” system are focused on “what’s wrong with you.” Most of the support I’ve found has been people who know little to nothing about the “MH” system but have worked on their own issues personally and can share the perspective of how to move forward. Such people are rare but do exist. I have a way of testing out people to see how far they can go down this path. I don’t think one in a hundred can even go there. It’s frustrating and disappointing, but I am afraid that is reality.
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Are you equating the antipsychiatry movement with fascism and/or “white nationalism?” I’m confused.
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I do think this is an important distinction to make. I’d add that there is another type of dangerously empathetic person, though. There are definitely con-men and -women who just get into your head to mess with you. I think there are also those who genuinely get HOW you are feeling but don’t get WHY. These folks project their own “reasons” onto you and can thereby justify their actions as “being in your best interests” from their point of view. If confronted as you suggest, they would assure you that OF COURSE, they care about you, THAT’S WHY THEY ARE FORCING YOU TO TAKE THESE DRUGS (or whatever)! Because they are GOOD for you because they’ll make you FEEL BETTER.
What they really mean by this is that if you take the drugs, it will make THEM feel better because they have done something to show they care for you so very, very much. If you deny they are helping, it hurts their feelings and a much less empathetic side will often emerge.
Such people don’t appear to be moved at all when you tell them (or when observation shows them) that their “help” isn’t really helping or is making things worse. Because their worldview depends on believing that their model of “helping” has to work. But they do recognize how you are feeling and try to pressure and manipulate you, very similarly to the con man. I suppose the real difference is that in this case, they are “conning” themselves as well.
Anyway, bottom line is that a person showing empathy for how you feel isn’t necessarily going to be able to help you get to a better place, and may in fact victimize you in the name of “helping.” Real compassion feels very different.
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An excellent analogy, Oldhead. A little arsenic goes a long way. Same with Lithium. I would guess that it messes with your sodium/potassium balance really badly (since they all three are in the same group in the Periodic Table and easily replace one another in solutions and compounds) and those kidneys have to work double overtime to get the lithium out of there and get the sodium and potassium levels back to normal.
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Commenting as moderator here:
At this point, this conversation has gotten out of hand. I apologize for not getting to it sooner, but it appears we are degenerating into making negative comments about the authors and taking up personal issues that should be handled in other places than a comment section of an article. I have removed a few comments, but I am more concerned with the general tone of this conversation. The article focuses on the question of whether the TED organization is intentionally editing who is able to present talks and what they are allowed to talk about based on keeping their financial supporters happy. The conversation needs to stay on that point, and not stray to personal opinions as to whether or not TED was right or wrong regarding the author. Some of these comments are more subtle but are still aimed at attacking the character of the author, which violates the posting guidelines.
Let’s please get back to the subject of TED and possible corruption and the marginalization of non-mainstream viewpoints in general.
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There was a very well-documented and very successful effort by allopathic doctors (MDs) to wipe out every other form of competition in the late 19th and early 20th century. They went after midwives, naturopaths, homeopaths, chiropractors, and of course, patent medicine marketers, calling them all “quacks” and other more insulting terms and assuring everyone that MDs are the only ones who can be trusted. Their success was so complete and widespread that even today, we hear remnants of these marketed beliefs, where chiropractors are all quacks or where midwives are “dangerous” even though their safety records and Caesarian rates are far, far better than MDs. It was an incredibly vicious mass marketing effort that we have yet to recover from.
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Indeed, the emphasis being on EFFECTIVE! And the person being helped has to be the one to decide what “effective” means for them!
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Too true!
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Have you read “Anatomy of an Epidemic”? Read the part about neurological up- and down-regulation and the impact it has on trying to withdraw from these drugs. The fact that people have a bad reaction to withdrawal doesn’t mean they “need these drugs.” It could mean that their brains have adapted, just as brains adapt to cocaine and meth and heroin, and that withdrawal effects occur when the drug is discontinued.
Anyway, you really should read the book. That’s what this whole website is based on.
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The obvious answer to the last question is “yes.” As to the rest, seems like we’re getting WAY off track here. But I’d bet that very, very few posters are in favor of nationalizing all industries and completely eliminating corporations and private ownership of stocks and that sort of thing. Marxism is the most extreme version of anticapitalism. Most “liberals” are in favor of stuff like Sweden and Denmark and Japan, where the government makes sure that people are able to survive the worst fallout from the profit motive, but companies are still privately owned and driven by profit. I don’t think that point is even worthy of debate – it’s simply obvious from the kinds of policies they promote. Even Bernie Sanders, avowed “Democratic Socialist,” has never even started to go down the path of nationalization of any industry or corporation. He just wants everyone to have healthcare coverage and decent wages and that sort of radical craziness.
Sorry, but Marxists are very, very rare in the US of A, including on MIA.
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You may be right. I think that’s because social causes have been so vigorously and systematically eliminated from consideration by the DSM and the APA. However, medicine in general has always given short shrift to nutrition and sleep and other variables that affect mood. I see nothing wrong with these aspects of someone’s mental/emotional wellbeing being handled by medical folks who actually KNOW about nutrition. My objection to psychiatry is the presumption and marketing of the idea that ALL “mental illnesses” are PRIMARILY caused by biological problems, and that the DSM was created without ANY consideration of the actual cause of any of the so-called “disorders,” including the complete denial of any role for nutrition, exercise, sleep or any other physiological cause or contributing factor.
I could go on, but I think it’s important for you to recognize that most people in the antipsychiatry camp would never deny that biology plays a role in how we feel. The main objection is to the field of psychiatry deciding who is and is not “mentally ill” and the lies perpetrated in the interests of selling more pharmaceuticals, including forcing some people to take them against their will.
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I said the majority. There’s also a very big difference between Marxist and liberal, as Richard I’m sure will passionately agree. And there are definitely conservative folks who post here, as well as “centrists” and anywhere else on the political spectrum. There is no requirement that people believe in any particular political worldview to post, only that they are respectful that their views are not the only ones that can be heard.
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It’s also in Western cultures that reject and/or fear voice hearing where voices appear to be the most aggressive and destructive, according to cross-cultural research. Fascinating, eh?
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I agree essentially with all you’ve said, Cassie. I’d only be cautions about using the term “mental healthcare,” because that term has largely been coopted by the forces advocating for the medicalization of all forms of distress, in service of the ideas that a) social conditions have nothing to do with why we are distressed – it’s all a malfunction in our own bodies or processes, and b) doctors and medical professionals are the ones who are knowledgeable about this area (after all, aren’t doctors in charge of “health?”) I prefer to use the terms “emotional support” or “processing” or “external perspectives.” I absolutely believe that therapy can be a wonderful experience – I had a great therapist in my 20s who helped me very much to get where I am today. But therapy is very different than medical care, in my book.
Anyway, it is a sad reality of our society that many people don’t have good support networks, and that our “always productive” model says that it’s NOT OK to break down or to need to be unproductive for a while as you process your experience. Heck, the DSM 5 now thinks we should be productive and fully functioning again TWO WEEKS after the loss of a loved one! It is no surprise that people appreciate having an anonymous person to hear their struggles when there is so much shame attached to not being able to “roll with the punches.”
And you’re totally right about insurance – it is at the very core of how this whole mess came into being.
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Never heard that one, but it wouldn’t surprise me. He is an arrogant prick, or to avoid labeling, he engages regularly in “arrogant prick-like behavior.”
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Honestly, I try to stay away from using psychiatric terms to refer to Trump and his minions. I don’t want to give more credence to DSM labels, nor ignore the fact that Trump’s agenda has been embraced by many folks who don’t like him personally but are themselves corrupt enough to see how they can profit from his fear-mongering approach to politics.
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That is extremely thoughtful and respectful of you, Steffen! I only wish all professionals were as open to feedback as you seem to be.
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Lithium IS required in the body, but only in very small amounts. The amounts given to “treat bipolar disorder” are huge and very close to the toxic dose.
http://www.jpands.org/vol20no4/marshall.pdf
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Yes, DMDD was actually invented to allow doctors to continue to prescribe drugs for what was called “Juvenile Bipolar Disorder” after Biedermann essentially created THAT disorder out of thin air in the late 1990s for the benefit of his buddies at Johnson and Johnson Pharmaceuticals. When it was discovered by research that kids labeled with “Juvenile Bipolar Disorder” did not tend to develop symptoms of “Bipolar Disorder” as adults, and that those who did end up with “Bipolar disorder” diagnoses did not engage in Biedermann’s list of behaviors as kids, they realized they were in a bad spot. So they invented “DMDD” to allow doctors a diagnostic category for the annoying kids that Biedermann had decided were “bipolar” so that they could still bill for drugging kids who were annoying to the adults around them, despite no evidence that these kids actually ever had any medical problem whatsoever. It really is a study in disease invention and shows the complete lack of credibility and ethics in the development of these DSM categories. They seriously do invent them out of whole cloth with the intention of “covering” as wide a range of behavior as possible to increase their market share.
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It’s actually the lightest metal that exists. Right near the top of the Periodic Table, atomic number of 3. But it’s still poisonous in large doses, and people receiving “treatment” with lithium often develop serious kidney problems and can die if their dosage gets just a little too far beyond “therapeutic.”
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I pretty much agree with the above. If someone’s using “mental health” terminology, I think it’s important to talk about why that can be harmful to people and why it might reinforce the current mythology about “mental illnesses” and suggest or request some changes. But I also think it’s important to look at the meaning of research findings no matter what language is used, and the idea that nutritional interventions could help some people who find themselves embroiled in the world of “mental health treatment” actually helps UNDERMINE the idea that people have broken brains and there is nothing that can be done about it.
As long as the proviso is in place that not everyone who happens to get “diagnosed” with a particular “disorder” is given some nutritional “therapy” specific to their “diagnosis” and expected to be “cured,” I think nutritional research can be a very, very important part of undermining the current psychiatric hegemony over “mental health.” I also think it’s possible to provide honest feedback regarding the use of this kind of terminology without tossing out the baby with the bathwater. I think these women have been quite courageous in challenging the status quo and deserve our support for doing so, even if there is legitimate feedback that folks want to provide regarding terminology.
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Lithium at “therapeutic doses” comes very close to poisoning people. That’s why they have to check lithium levels so carefully – the distance from “therapeutic” to “deadly” is smaller than any other drug on the market. So you are absolutely correct, calling it a nutrient would be laughable if it weren’t actually promoted by some as the truth.
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Or maybe they are getting kickbacks from the pharmaceutical suppliers.
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I don’t think either left or right is particularly supportive of stopping human rights abuses and protecting the so-called “mentally ill” from being lied to and having their lives shorted by doctors claiming to understand and help them. But such POLITICAL objections that I have heard have come mostly from the right, who assert excessive government interference when people are forced into “treatment.” I have not heard any coherent objections from the political left to this kind of “treatment.” Of course, when someone with a gun does something scary, the right are the ones quick to blame “mental illness” while the left blame lack of adequate gun control, so let’s be honest, it comes from both sides of the aisle.
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Which kinda lets us know they’re essentially a mainstream business.
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I agree. When the “left” and “right” are reconfigured into the “authoritarian” and the “anti-authoritarian” or “non-authoritarian,” we may make some progress. Some folks on both left and right agree that corporate corruption of government is a huge issue. If we can get together with such folks and come up with some agree-upon tactics, we’d be in great shape. But my experience is the majority of people asserting “left” or “right” politics are really following some authoritarian dogma, regardless of what they claim. And it’s hard to get dogmatic people to think beyond their dogma.
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There I agree with you 100%. But how to attack authoritarianism is a huge challenge!
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Posting as moderator here.
If you are honest with yourself, the vast majority of comments don’t even vaguely reflect a Marxist viewpoint, and very few truly do. I think it’s a gross overgeneralization to suggest that more than a small fraction of people who post here identify as Marxists (not that there is anything wrong with being a Marxist, mind you.) Even if they were, you have been a strong advocate for making sure that certain possibly minority or at least less empowered viewpoints get a full hearing here. I think this should hold also for any and all viewpoints, no matter whether they are popular or not, as long as they are consistent with the purpose of this site. I think we want to try and create an environment here where people don’t get to shout other people down just because their viewpoint is not popular or is threatening or because one person simply disagrees with it. After all, aren’t most of the views that are expressed here unpopular or threatening to the general public?
I’d like to make sure that we are open to and supportive of all viewpoints that are consistent with the goal of protecting people from the lies and power dynamics of the “mental health” industry as it stands today. Maybe for you, Marxism isn’t a valid answer, but it is certainly a valid topic for discussion and should be viewed as such. You’re welcome to challenge why a particular person believes Marxism will work or to provide evidence that it won’t or provide your own alternative ideas, but not to generalize negatively about people who identify as Marxists simply because you don’t like Marxism. In other words, I challenge you to critique the ideas of Marxism, rather than trying to downgrade the people who might find them convincing.
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Actually, we kinda do know. Robert Whitaker talks about it at length in Anatomy of an Epidemic. Any time we make long-term alterations artificially in the brain, the brain adapts to re-establish “homeostasis,” a condition of stability that it is programmed to see as optimal functioning. So if there’s a lot of serotonin around, the brain reduces the production of and sensitivity to serotonin. Same for dopamine or any other neurotransmitter. This fact is well known and accepted in the field of addiction, and it’s called neurological down- (or up-) regulation. Why psychiatrists would not full expect and accept that the same thing happens with their “miracle drugs” is only attributable to wishful thinking or utter corruption. So yes, tolerance happens and yes, withdrawal effects happen for very well known reasons. It’s just that the pharmaceutical industry and the psychiatric industry are committed to not knowing it, or at a minimum, to denying the obvious truth of it.
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The “rat park” experiment was VERY telling, though no one wants to really examine the meaning of the findings. If rats don’t get addicted when they live in healthy environments, what does that say about our society that appears to result in huge numbers of addicted people? We ain’t livin’ in the equivalent of the Rat Park, that’s for sure!
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I have never put doctors on a pedestal, and understand how destructive and deadly they can be. I have broadly published the fact that receiving medical care is the third leading cause of death in the USA. Not medical ERRORS – RECEIVING medical care at all! Pretty disturbing.
The reason I discourage bashing doctors rather than medicine is that doctors are individuals and some are not corrupt or evil or even misguided. From a very practical standpoint, if a person happens to have a doctor they have thoroughly screened and found workable, someone saying “All doctors are sellouts making money off of addicting you to drugs” is going to sound crazy and wrong to them. Instead, I make it clear that the MEDICAL PROFESSION is what has become corrupt, and that individual doctors, no matter how competent or well-intended, can’t stop the juggernaut of money and power that is corrupting the entire industry. It’s kind of like saying “All teachers are tyrannical control freaks.” No, they aren’t. There were lots of very nice teachers that I ran into in my elementary and secondary school experience. Unfortunately, this did not for one minute change the utterly oppressive environment of the school system they were a part of, and I still suffered miserably at the hands of that system, and kids continue to do so today. Not ALL kids, but plenty of them.
Or to put it more briefly, “Generalizations are always wrong.” There are always exceptional individuals in any system, and the system also takes potentially competent individuals and makes them incompetent and destructive, if it’s a destructive system, as both psychiatry and the school system are. I think it is more powerful to talk about the system and allow that individuals within the system may vary widely in their capabilities and their ethical integrity, but that this variation doesn’t change the fact that the system itself is an ongoing source of oppression.
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I have never put doctors on a pedestal, and understand how destructive and deadly they can be. I have broadly published the fact that receiving medical care is the third leading cause of death in the USA. Not medical ERRORS – RECEIVING medical care at all! Pretty disturbing.
The reason I discourage bashing doctors rather than medicine is that doctors are individuals and some are not corrupt or evil or even misguided. From a very practical standpoint, if a person happens to have a doctor they have thoroughly screened and found workable, someone saying “All doctors are sellouts making money off of addicting you to drugs” is going to sound crazy and wrong to them. Instead, I make it clear that the MEDICAL PROFESSION is what has become corrupt, and that individual doctors, no matter how competent or well-intended, can’t stop the juggernaut of money and power that is corrupting the entire industry. It’s kind of like saying “All teachers are tyrannical control freaks.” No, they aren’t. There were lots of very nice teachers that I ran into in my elementary and secondary school experience. Unfortunately, this did not for one minute change the utterly oppressive environment of the school system they were a part of, and I still suffered miserably at the hands of that system, and kids continue to do so today. Not ALL kids, but plenty of them.
Or to put it more briefly, “Generalizations are always wrong.” There are always exceptional individuals in any system, and the system also takes potentially competent individuals and makes them incompetent and destructive, if it’s a destructive system, as both psychiatry and the school system are. I think it is more powerful to talk about the system and allow that individuals within the system may vary widely in their capabilities and their ethical integrity, but that this variation doesn’t change the fact that the system itself is an ongoing source of oppression.
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It runs away screaming from real science of any sort.
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I don’t know that this is true. The influence that psychiatry has over the narrative of what is and isn’t normal has a huge impact on how schools are run, for instance. If there is no DSM, there is no “ADHD” and no justification for putting kids on Ritalin. Most parents do “voluntarily” put their kids on stimulants, but it’s not really voluntary when they are lied to about the “causes” and the “consequences of untreated ‘ADHD'” and the “mildness” of Ritalin, and even how supposedly kids with ‘ADHD’ react differently to stimulants than “normal” kids (which has long since been disproven). For sure, let’s get rid of overt force, but I think we also need to get rid of the redefinition of social problems as medical ones, because most of psychiatry is ostensibly “voluntary” based on misleading the patient or their representative.
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Well said. I have even used bike riding and hiking as meditation forms. There are many paths to the fountain, as someone wise once said.
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Wow, I knew about Semmelweis but I didn’t know he died in the asylum, let alone that he was essentially beaten to death! His experience is a great example of how even clearcut, scientific proof is not sufficient to override social mythology and power.
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Not noted in the conclusions: more psychiatric drugs associated with MORE criminal actions on the part of these kids. Not really helping much, are they?
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Naturally!
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So what you’re saying is that society still needs someone to control the outliers and if psychiatry didn’t do it, some other institution will be created or will step in to fill the vacuum. Is that correct?
So how do you see us proceeding in reorganizing our society so that such a function isn’t perceived as necessary any longer?
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So what, in your view, is the mind? Where does it reside? How does it arise? What is its relationship to the body?
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I have to say, though, that “science” that is coopted for the purposes of making money or projecting power over people is no longer science. Science, by definition, is dedicated to discovering the truth of a situation, no matter how anyone feels about it and no matter who does or doesn’t profit from it. So what you’re talking about is not anti-science to me, it’s anti-corruption.
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I think it’s pretty clear at this point that you and Oldhead have different views on this matter. I personally see getting rid of coercion as the #1 goal, but I don’t think we’ve really succeeded until we get rid of psychiatry’s power to define “mental illnesses” by their whackadoodle DSM manual. This manual helps decide who does and doesn’t get “treatment” and what kind of “treatment” is paid for, which has a huge influence on what is available to the general public. Many people would seek other options if they knew that they had them. So yeah, legal coercion has to go, first and foremost, but I will not be happy until other less obvious manifestations of force are also addressed and eliminated.
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There is a difference between bashing DOCTORS, who are individuals who vary widely in their intelligence, competence, and ethics levels, and bashing PSYCHIATRY, which is a set of assumptions and beliefs and processes that are organized and promoted as a way of dealing with people who are seeking some kind of help with mental/emotional issues, or who are behaving in ways that are not illegal but are judged as upsetting or “weird” by our society (or certain powerful members of that society).
There are doctors (including psychiatrists) who are ethical, hard-working, open-minded, and/or kind-hearted people. There are also doctors who are insensitive, lazy, rigid, and corrupt. And everything in between.
But the psychiatric system of thought, including LABELING people based on subjective “disorders” with no scientific validity, JUDGING people for not fitting into society or having certain kinds of difficulties, LYING to people about their supposed understanding of the causes of these invented “mental illnesses,” as well as about the serious adverse effects of their “treatments,” CREATING AND SELLING diseases or disorders, DENYING real research that contradicts their dogmatic worldview, and FORCING people to accept “treatment” that is damaging and potentially deadly. I could go on.
So it’s not DOCTORS I am criticizing. It is the intentional distortions of fact being passed of as “science” by the psychiatric leadership in collusion with the pharmaceutical industry. There is a BIG difference.
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Of course!
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I don’t think Psychiatry is either a hard or a soft science. It’s more like a religious practice.
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I would have to disagree. It is very clear that Big Pharma and private insurance are huge reasons why healthcare is much, much more expensive here than anywhere else in the world, with poorer outcomes. Any developed country with national health insurance (which is basically everyone but us!) has better outcomes for a lot, lot less money. If Medicare and Medicaid were the problem, these other countries would have much higher healthcare costs, as all of their healthcare is paid for by Medicare/Medicaid type of services. Fee for service payments do encourage inventing things to pay for, like extra testing and the like, but that happens with private pay just as much as Medicare/Medicaid. The evidence is strong that national healthcare plans save lots of money and provide better care.
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Ah, the magic of the “free market.” Worked great in the early industrial revolution, leading to sweatshops and kids working 80 hours a week and slave labor and… oh, wait, that’s still happening, isn’t it?
Anyone who believes that the “Free market” will solve everything should visit Malaysia or Indonesia and see how our running shoes are assembled. Capitalism unchecked leads to a few rich people and a lot of poor ones.
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Private insurers like psych drugs because they seem to be cheaper than paying for therapy. And of course, they scratch the backs of the pharmaceutical industry and Big Pharma scratches theirs. Removing the profit motive for healthcare would be a big move in the right direction. We also need legitimate, objective and firm regulations regarding what is and is not safe in terms of pharmaceuticals, including criminal penalties for violations. A quick start would be eliminating paid DTC advertising for any pharmaceutical product.
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Private insurers like psych drugs because they seem to be cheaper than paying for therapy. And of course, they scratch the backs of the pharmaceutical industry and Big Pharma scratches theirs. Removing the profit motive for healthcare would be a big move in the right direction. We also need legitimate, objective and firm regulations regarding what is and is not safe in terms of pharmaceuticals, including criminal penalties for violations. A quick start would be eliminating paid DTC advertising for any pharmaceutical product.
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I would say not only does psychiatry suggest biology is a COMPONENT – it seems to insist that biology is the PRIMARY or ONLY component of what they call “mental illnesses,” again, with zero proof. That doesn’t even get into the question of why a difference in biology constitutes and “illness.” For instance, I’m sure there is some biological variation in children as to how active they tend to want to be and how willing they are to sit still and listen to someone else tell them what to do. So what? Kids have a disease because they are unable or unwilling to sit around and do whatever boring crap the teachers want them to do? Ever notice there is no “hypoactivity disorder?” Gee, I wonder why?
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It appears we would agree on this point. I was actually quite shocked to hear the first time that any kind of enforcement was applied to mindfulness, but since hearing this the first time, have heard from others who verified that it happened to them as well. I think it comes from not really understanding what mindfulness meditation is all about. It is, indeed, a practice that takes a lifetime to fully develop, and I can’t claim to be much more than an amateur, despite years of practice. I’ve just never put in the length of time daily to accomplish the fuller benefits. But it is still a go-to place when I get to feeling crappy about something, about anything, really. It’s a lot more than a “coping skill” to me.
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I think that’s a good way of putting it. Unfortunately, it is a very common human attribute to consider one’s own worldview to be the “right” way. It’s encouraging that mindfulness has spread as a practice to help folks survive better in their lives, and I fully support that effort. However, I do think a great deal is lost when the practice is divorced from its roots in observations on the nature of the ‘self’ and the ephemeral nature of physical reality.
And I most definitely object to it becoming a “required curriculum” for those who have not chosen to explore it, though I suspect we are on the same page on that point.
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I don’t think anyone was saying that encouraging mindfulness was dangerous.
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I don’t think anyone’s offended by the concept of mindfulness. I think some may be offended by efforts to “monetize” mindfulness as part of a manualized program of “treatment,” rather than seeing it as a spiritual practice emerging from an Eastern philosophical view that would be very inconsistent with both the Western “mental health” system and with the profit motive.
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I don’t “charge” Shaun with being a materialist – there’s nothing inherently wrong with being a materialist, it’s a legitimate philosophical viewpoint to assume. I’m just reminding him and other readers that it’s not the only viewpoint, and checking to see if that is, in fact, where he’s coming from. I’m not a materialist myself, so it may be that disagreements he and I encounter come from diverging views on the nature of the mind. It’s not intended as a slam or criticism, just a clarification.
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I agree that this is the case. But what that means is that we are in the area of PHILOSOPHY, not science or medicine. We don’t assign medical diagnoses because people “find them helpful.” Cancer is not a way of thinking about yourself – it is an observable THING or that is growing inside you that will kill you if you don’t do something about it. If people want to think of themselves as “ill” or “neurodivergent” or whatever, that’s their choice. That doesn’t make it OK for the psychiatric profession to pretend that these phenomena are “illnesses” in the same sense as diabetes or cancer or a blood clot in your artery.
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I don’t think Out said that.
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You are correct. I absolutely distinguish between the brain, which is an observable organ of the body, and the mind, which is a conceptual phenomenon which science has only the vaguest grasp upon, of they have any grasp at all. It is psychiatry’s insistence on failing to make this distinction (in addition to baldfaced greed) that leads to their complete inability to do anything helpful for human beings beyond temporary suppression of certain thoughts and feelings through chemical/mechanical means.
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It is exactly in DBT where I have heard of “mindfulness” being required. And if you really think that DBT is always voluntary, you need to look around closer at the world of “mental health treatment.” DBT is often a requirement of courts to get kids back from child protective services, it is sometimes ordered in criminal cases, and of course, there are those who manage to escape psych “hospitalization” by agreeing to “participate in services,” and whether it is overtly stated or not, the fear of re-hospitalization can make it feel very much like “I’d better do what they tell me or I’m gonna get in trouble again.” There are also housing programs that require “participation in services,” and again, whether correctly or not, people perceive that noncompliance with “treatment” can get them tossed out onto the street.
I am not at all against offering mindfulness meditation to anyone who wants to learn it. However, I do think you’d do well to listen more carefully to those who are expressing concern with HOW it is presented to them. The power differentials in “mental health services” are VERY real, and a lot of things that seem “voluntary” to you seem anything but to those who have to deal with the consequences of “noncompliance.”
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At a minimum, it certainly seems to indicate a LACK of correlation between AD use and suicide. And scientifically speaking (though we know that most who make these claims aren’t really being scientific at all), it is the responsibility of the person CLAIMING the correlation to prove the correlation. Hence, if there is no proof that AD DO reduce the suicide rate, we have to assume that it does not, especially when evidence such as what you present is present to undermine the case.
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The analogy is quite apt, I think. But people who believe we’re just a brain seem unable to comprehend that a sense of purpose is essential to our emotional/spiritual well-being, and there is no drug that has ever conveyed a sense of purpose.
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I can see the benefits of that, for sure! I am not sure how technically challenging it would be. I’ll raise it at our next meeting.
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AMEN to that!
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Actually, bar owners CAN be held responsible for continuing to serve a drunk person. So there are actually more serious legal sanctions on bar owners than on psychiatrists.
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I think mindfulness can also be misunderstood by practitioners who don’t practice it themselves. There are a lot of different forms of meditation, for one thing. Some people have a very hard time sitting still and closing their eyes, as it may bring up flashbacks or anxious feelings. There are moving meditation forms like Tai Chi that can be employed for people who find the sitting forms difficult. There are also often arbitrary timeframes attached, rather than allowing each person to figure out how it works best for them personally. I also find it diminishes the power of mindfulness meditation when it is only recommended as a “treatment” for “symptoms of mental illness.” It can be and should be MUCH more than that. It is an opportunity to get in touch with deeper personal truths, and it can require a sensitive leader to make it safe for such truths to find the light of day. It’s not just a “skill” like deep breathing, but it is often taught that way, in my observation.
I’d love to see mindfulness presented in the full context of Buddhism and an Eastern philosophical world view. Of course, the Eastern worldview completely conflicts with and threatens the Western psychiatric theories of the primacy of the body and the brain, so it is unlikely that we will see this kind of shift any time soon.
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I was not referring to the article, but to comments I’ve heard from system users/survivors, who have been told that they “need to practice mindfulness” as a part of their program (usually DBT). I was pointing out the ironic fallacy of such an approach, not downing mindfulness in general. Mindfulness meditation is very powerful and something I have practiced over many decades. I fully encourage anyone to explore it, but only from a self-determined position. One person I know was totally turned off to the concept of mindfulness and meditation in general by being forced to do it as part of a program. I find this kind of outcome very sad, as I know the benefits when it is allowed to unfold properly instead of dealt with by force or manipulation.
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I agree. I was horrified to discover that clients were sometimes forced to practice “mindfulness!” It is such an utter contradiction, it’s hard for me to wrap my head around it. “You will be mindful or I will punish you!” Sort of like telling someone they have to have fun or else. Anyone who knows the first thing about true mindfulness meditation would realize that making someone do it is totally destructive to the actual purpose of the activity.
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I will point out that we are now making arguments regarding philosophy, not science. In science, a proposition is considered false until it is proven, not true until it is not. If a scientist proposes that such a thing as “mental health problems” exist in a physical sense, it is his/her responsibility to show evidence that supports this, as well as looking at any other compatible explanation and proving that they do NOT explain the data at hand.
Statements about the presence/absence of God are entirely philosophical/religious in nature. That you choose that particular analogy I think says a lot about the ground on which psychiatric diagnoses now stand. There is a hell of a lot of faith, and little to no science involved. The fact that such phenomena as anxiety, dissociation, hallucinations occur is not proof of “mental illness.” It’s simply a recitation of observed phenomena, such as “stars appear at night in the heavens.” The DSM diagnoses are exactly that – descriptions of observed phenomena, with no scientific analysis of why these things occur or if even more than one manifestation of these phenomena would necessarily have the same cause. The DSM itself admits as much. So were not talking science here. We’re talking beliefs.
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You are sounding like a strict materialist – you seem to imply that dissociation must be a problem of some body part. Am I understanding your view correctly?
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I assume you intend “normal” and “mentally ill” as if in quotation marks. Based on your earlier writings, you appear to find such distinctions meaningful.
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Glasser has always been a stalwart opponent of the idea of labeling people with “disorders.” He is a big advocate for working with what you have and taking responsibility for moving in the direction you want to go, no matter what the barriers. He never identified as “antipsychiatry” but he really has been.
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I think we have got it done!
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“Another psychiatric success story!” It simply amazes me how many stories like this exist where the person receives the best “mental health care” that our system has to provide, and yet spends decades of suffering before ending their own life. How is it that those providing this “help” are not held accountable, or at least forced to acknowledge that their efforts were a failure? How is it that such stories always seem to end with a call for more funding for “mental health care” despite the fact that this person had plenty of it and it still ended as badly as possible?
Is it even considered that the reason he could no longer write the way he wanted to was BECAUSE he was receiving “help” in the form of mind-altering chemicals? That the absence of such chemicals might have made him MORE able to write and hence LESS likely to end his life?
It is a strange phenomenon to watch, when a profession’s utter failure leads to calls for more of the same but harder.
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I would agree. The vast majority of psychiatrists I’ve encountered are completely disinterested or threatened by my view of the “mental health” world. There are a few odd exceptions here and there, but I’d say over 95% are not worth wasting my breath on. And that’s not a generalization, that’s a summary of my own observations. In fact, I’d say that the less advanced degree the person has, the more likely they are able to hear contrasting viewpoints without feeling threatened.
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Stephen, I sent the all the email addresses to you and Oldhead and LavenderSage, but yours bounced back. Can you send me your proper email to [email protected]?
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That is an excellent point! It is absolutely true that many “mental health patients” have their livelihoods threatened if they fail to comply with “treatment recommendations.” Sometimes it’s less overt force than implication and manipulation: “I guess you can go off if you want to, but you know what happens when you try that – you’ll probably end up being thrown out of here and living on the streets, and back in the hospital. And you know how disappointed your mom will be if that happens…” Sometimes it’s literally, “If you don’t do as I say, you’ll be out of the program.” That certainly is not a “voluntary” situation!
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Oh, OK. I’ll have a look.
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Absolutely disgusting. Will we never learn?
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Your comment assumes that there is such a thing as a correct interpretation of someone’s “manic” behavior, and that a “competent psychiatrist” is capable of such a translation. Surely you are well aware that the psychiatrists “interpretation” is almost always based on the DSM, which translates every behavior into a problem in the person who is acting a certain way, based on a highly culturally biased view of what is “acceptable” or “disordered.” And the DSM itself admits that it makes no attempt to determine cause or group “disorders” by cause. So the psychiatric translation of “manic” behavior would be only that “the person is manic” or “the person has Bipolar Disorder because they’re acting in ways described as ‘Bipolar’ in the DSM.” It hardly seems remotely similar to an accurate translation of meaning from one language to another. Now, it’s possible the psychiatrist may have a drug to offer that could possibly mute the person’s manic behavior (at least temporarily) at some potential risk to the taker, but that hardly qualifies as translating his behavior into any kind of meaningful frame, IMHO.
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I do think we have the right to be left alone to interpret our own experience, regardless of other peoples’ view of it.
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Your psychiatrist has a sense of integrity. I think your psychiatrist is a rare specimen!
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I did not, though I will say that I’ve seen a lot of people with “process work” training and it appears to me to have all the key elements of empowerment, humility, etc. that we mentioned.
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Are you saying they have revived forced sterilization laws in Western Australia? That would be truly horrifying!
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Well, I think there is a pretty big difference, in that someone in the hospital involuntarily can’t legally leave and has many rights taken away, and is often acted upon violently or abusively without recourse.
This is not to say that pressure, manipulation, lies and chicanery don’t happen in an outpatient setting. It’s just that a person can walk out the door without consequence, unless of course they say the “S” word or act “psychotic” enough to allow someone to call the cops on them. And that last part wouldn’t be possible without involuntary commitment laws.
I’d say at the least that it would be a whole lot easier to take on the psychiatric establishment if involuntary commitment was no longer an option as a tool of “enforcement” of their “treatment.”
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Not so much a “method” as an unconscious “out” when things get uncomfortable. I think that the general acceptance of such categories makes it easier for someone to say, for example, that the reason they feel uncomfortable with a certain client is because “they’re a borderline,” rather than because the clinician didn’t know what to do or had their own history triggered by something the client said or did in their session together. There may be a small cadre of particularly sick individuals who would intentionally stick a label on someone as a tactical approach to induce distance, but I’m guessing for the vast majority it’s pretty unconscious, and simply presents and easy way out of their own personal discomfort.
Of course, in my experience as a counselor, being able to tolerate my own personal discomfort and remain available to communicate with the client is probably the most important element of good counseling, so providing the DSM diagnostic scheme to counselors is one of the most destructive things one could ever do to the field. That part may, in fact, have been quite intentional on the part of the architects of the DSM III, as they were angling at that time to win their ‘market share’ back from the counseling professions. There are clear and unambiguous documents of this motivation from that time in history, in case anyone doubts me that this was the intent of the DSM III.
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I’ll just gently remind us all that we don’t diagnose heart problems or cancer based on how someone feels about the diagnosis. The fact that such criteria are even considered in such a discussion proves the point that these “mental illnesses” are not objectively observable and are, in fact, social constructs that people choose to use or not use as best fits their needs and cultural belief systems.
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Unfortunately, the need for outside funding at universities has led to the profit motive driving a lot of university research, at least in the USA. Add to that a change in law allowing university researchers to patent discoveries they make and to make profits off of their “neutral” research, and things are indeed very messy even at universities. As for government entities, the picture is perhaps better, but they are still heavily influenced by the politicians who lead them, who in turn are heavily lobbied by the pharmaceutical industry. And that’s not even getting into publication bias. It’s difficult to find an objective scientist these days!
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Right, if what we are teaching is living with uncertainty, maintaining humility, being flexible, and empowering the client, I can agree that such things are helpful. What I’m objecting to is the idea that some workbook can teach you steps to follow that will help anyone with a particular set of “symptoms,” as people are all different and have different needs and motivations and reasons for their anxiety or whatever, and thinking that there is some formulaic way to address this that works for everyone is at best misleading, and can be quite dangerous.
But I think I’m preaching to the choir at this point.
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I think there is a big difference between saying that clients often appreciate the services you provide and that the concept of “mental illness” is metaphorical and to a large degree mythological. It’s important to remember that “mental illnesses” are GROUPINGS of “symptoms” that are categorized as “illnesses” by the medical profession, and that the DSM is the current set of such definitions. If you think the DSM is bullshit, you’re agreeing that “mental illnesses” as construed by the DSM are mythological.
I think the point has been made too many times to count that saying that “mental illnesses” as medical entities that can be studied, diagnosed, or “treated” are mythological does not mean that SUFFERING is mythological, or that genuine help for such suffering is not possible. The myth we’re talking about here is the idea that a person can run someone through a checklist of “symptoms” and conclude that they “Have depression” or that someone can magically distinguish between “situational depression” and “clinical depression” or that we can conclude that “mania” is a brain problem because the brain does stuff differently when someone is elated or intense. Those are the myths. The fact that you are able to help people or at least not harm them when they come to you for help is a worthy accomplishment. But the fact that they appreciate your assistance does nothing to show that “mental illnesses” are anything more than the social constructs you see in the DSM.
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Which country do you mean? That sounds like a pretty draconian law!
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I looked but did not see the “disinfomercial” you refer to. The only thing I saw with The Lancet was a critique of their publishing an article that was not valid. Am I missing something?
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Wise words, Fred. If you have any specific feedback regarding my posts, I’d welcome it, either on the thread or through back channels. My e-mail is [email protected]. I agree 100% that humility is the beginning of wisdom, especially for anyone who likes to imagine they are helping another person find their way on the tangled pathways of life.
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Excellent points! Context is vital in any of these “studies,” yet context is almost always ignored or minimized.
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That is a truly beautiful and inspiring poem. It strikes at the heart of why the current approach to people’s emotional/spiritual struggles fails so completely and so miserably! I’m going to copy this poem for later use.
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I think it’s fair to say that the very fact that doctors are “diagnosing” instead of listening and empathizing and trying to sort out what’s going on is what makes them appear disgusted and contemptuous. To really help someone who is experiencing emotional distress, in my view, requires stepping out of the one-up power relationship afforded doctors by society, and to get ‘real’ with the patient and make it safe to talk about what’s going on. As soon as the doctor slaps a label on a person who is baring their soul, they have stepped away from connecting and understanding, and almost every patient understands that immediately, even if often unconsciously.
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I stand corrected!
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Very true!
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Excellent post, Fred!
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I appreciate the fleshing out of your views. I do believe that QUALITY counseling has a role to play for people lacking support systems or struggling with complex issues that might be difficult to impossible for a friend to really get their heads around. Unfortunately, the operative term is quality. So much of the counseling world has been coopted by the DSM worldview that it is harder than ever to find someone who is empathetic enough to really sit with a client in his/her darker emotions and not try to “fix it” by some magical intervention. The DSM provides excellent cover for any “professional” to react to a moment of discomfort by blaming the client or his/her “disorder” for the behavior that is disturbing and then send a psychiatrist or other doctor in to snuff out the inconvenient feelings or behavior. There are still quality counselors out there, but if you can’t really shop around, it can be dangerously misleading to assume that the person you are assigned will really know how to be helpful.
I do think that it is vitally important to help empower anyone who has the rising awareness that their distress is not theirs alone and that the system in which we are all expected to participate is largely responsible for the rising levels of distress and confusion that we see all around and inside us. I think it’s part of the process of fighting capitalism – if people don’t know what it is they are fighting, they won’t make very good warriors. I suspect you are not in disagreement on that point.
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I’m a big Glasser fan, too!
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I am certainly not arguing against that being a possible narrative for people reaching new heights of awareness and sensitivity. I’m in many ways an example, though my childhood was hardly unusual in its challenges. I guess your answer leaves me with another question: while you or I might find a particular kind of narrative of someone’s history to lead to better results, it’s the person we’re trying to help who is in charge of the narrative. Many of the complaints I’ve heard re: BT and CBT models are that it feels like the therapist is telling you that “things really weren’t that bad” or that “how you think about it is the problem” or “if you just think THIS way, things wouldn’t feel so bad.” This feels invalidating to a lot of folks I’ve talked to, as it feels like they SHOULD feel OK about their childhood and they are “wrong” for not finding a way to do so. I find it much more productive to acknowledge that they did NOT have a “happy childhood” from their perspective and then help them re-focus on their strength and ingenuity in having found ways to survive it.
I’m not a fan of wallowing in the past and blaming our parents for everything they did wrong. And I did discover after my own quality therapy and after having my own kids that I had in many ways misunderstood their intentions and more importantly their limitations. But that was possible only AFTER I was able to recognize the many things I HAD been upset, sad, angry, disappointed about which were not an allowable topic of conversation at home. In fact, we were encouraged to be cheerful ALL THE TIME and never talk about anything negative. Even after a huge emotional blowup with screaming and slammed doors, we would just come back to the dinner table and watch baseball and pretend nothing had ever happened. If someone had started my on a therapy focused on “looking on the bright side,” I would have either sunk further into depression or jumped across the desk and strangled the therapist on the spot.
You do seem to acknowledge varying needs for different people, and I think this is the key. Expecting the same approach to work for everyone with the same emotional challenges is the first place the psychiatric system went off the rails.
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Sounds like a fantastic group!
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Hi Ben,
I have known about “Brief Therapy” for years and agree that the concepts involved can be useful in a lot of situations. However, there ARE people (lots of them) who have been screwed up by abusive parents or other adults, and have developed belief systems based on having to cope with being mistreated as kids. Many of these folks, I’ve found (including my wife!), have reported finding the concepts of “brief therapy” kind of insulting and frustrating. Much like CBT, it seems the therapist is telling the client, directly or indirectly, that their past is not a relevant consideration and that they just need to “change their minds” or “develop new skills” without acknowledgment of where their current survival skills (which are often demonized as “symptoms” these days) developed and what purpose they have served and perhaps continue to serve in the present.
I’d be interested in your comments on this. I personally have found great value in lightly using psychodynamic concepts with some people to help them come to grips with why it was IMPORTANT for them to act in the ways that they are now being criticized for or personally seek to change. I often find that when a person is able to see (for themselves, no “analysis” from me going on here) the role their coping measures played in surviving their own historical trauma, they are often able to realize that it is a skill that has value but doesn’t have to be used ALL THE TIME, and can be reserved selectively for moments it is useful, or modified in some ways to allow it to continue to be effective with fewer adverse consequences from their social contacts or society at large.
Would love to hear your thoughts on that point.
— Steve
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Or to put it another way, the problem isn’t that people with anxiety don’t need assistance, it’s the idea that we can somehow classify ALL people who “have anxiety” as needing the SAME assistance, which I believe is observably false. And in my view, the very act of classification of people as “having anxiety” immediately takes it out of the realm of normal human experience, which as Frank points out, is also not coherent with observation of human reality.
This does raise a serious question, though, and I’m going to ask it here: if I’m understanding the abolitionist position correctly, all forms of professional psychiatric/psychological assistance are eliminated. So where do you see the support for people who are struggling to survive for psychological/emotional/spiritual reasons coming from? I am genuinely interested in hearing your thoughts on that. I actually think it’s an important question, since the most common argument from the “reformer” point of view is that people need something when they are unable to cope with the expectations of society, and if we remove everything, where do people go?
Naturally, I am not getting into the question here of why we have a society that drives so many people “around the twist,” as they say. I’d love to reform our corporate capitalist marketing-based exploitative social status quo. But supposing that would take more than a couple of months, how do we help the casualties in the meanwhile? Seriously very interested in hearing anyone’s thoughts on this matter, especially those on the full abolitionist end of the scale.
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I think it also shows the insecurity of many of those trained in and committed to (sorry, bad choice of words there!) the current system. I believe most of them KNOW on some level that they are missing something big, and if someone went to a “hearing voices” group and got better, it would point out to them the thing they are trying so desperately not to admit – they really don’t know what they are talking about, and their way of “helping” doesn’t really help the way they’ve been told it should.
It reminds me of a group of volunteers who went into schools in Oregon and read to the elementary school kids. They did nothing but read to the kids, and have the kids read to them, and give the kids two books a month if they participated. The volunteer training was something like 4 hours. And kids reading levels went up immediately to the point that a study showed that the program made the difference between meeting the reading benchmarks and not meeting them for an average child. The educators were astounded, and started asking the people who ran the program what their method was, how they did it, what was their “secret.” The leader explained that they just read to kids, nothing more. The educators could not accept this. It bothered them no end that a layperson simply taking the time to interact with a child around reading would be sufficient to teach them to read, and were sure there was some “trick” the program was holding back that would explain these (to them) unexpected results. They’d spent all this time learning all these “educational methods,” and the study showed their educational methods to be of little to no value in terms of teaching kids to read – an average untrained person could do the job with only 4 hours of very general training.
I think the same fear exists for psychiatrists/psychologists/therapists. If peer support can create positive change, it means their own years of training were misleading or maybe even worthless, and it’s even possible their actions were making things worse. It takes a courageous person of integrity to allow such an observation to really impact their view of the world.
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I’d kinda say it was more or less invented by the “mental health” industry. I’d be that if you looked at documents from say 1900, the term “mental health” would never be used. I have always considered it euphemistic at best.
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I have no problem with “damaged” or “injured.” I do have a problem with somewhat arbitrarily deciding who does or does not qualify for being “injured enough” to deserve compassion (if they even receive compassion for a PTSD diagnosis, which for many doesn’t happen, either). And saying that others may qualify for different diagnoses clearly misses my point: these people are harmed by being in a war zone and killing people and watching people be killed or maimed around them. They are all damaged in some way by this experience, or so I have to imagine. It seems very odd and counterproductive to me for vets to have to “prove” that they “have PTSD” (or some other form of “disorder” approved by the APA) before they qualify for help. (And again, I’m not commenting on the quality or effectiveness of said help, which has been copiously covered in other posts). Why doesn’t ANY vet returning from service qualify to get ANY kind of help s/he believes s/he needs WITHOUT ANY KIND OF STIGMATIZATION OR DISCRIMINATION based on being “diagnosed” with some “disorder?” Why don’t we call it “Fucked over by warfare disorder” and leave it at that? At least that label puts the blame where it belongs – on the incredible traumatic stress of war, rather than the “weak character” or “disordered brain” of the person who has to live through that particular form of nightmare.
And everything I’ve said goes times 5 for kids who were traumatized by their parents or other adults. Let’s diagnose them all with “fucked up childhood disorder” and “treat” the parents or other adults who screwed them over. Sure, they all deserve help and support, but there is no need to blame them for having a bad reaction to being treated like crap.
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Love it!
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I would add to this that the statement that “most vets don’t come back with PTSD” shows a huge part of the problem with diagnosing people. We have selected out a certain proportion of people who have the most extreme reactions to warfare and tell them that they have this “disorder,” and those who don’t “qualify” are considered to be “normal.” As if there were some LINE we could draw, and decide that some people are “overreacting” when they are across this line, and that those who DON’T cross the line are AOK. This is, of course, utter nonsense. EVERYONE who experiences warfare is damaged, EVERYONE is traumatized, except perhaps those (if such exist) who were so damaged beforehand that killing people doesn’t bother them that much. Ironically, with the current diagnostic system, the psychopathic killer is the one who is considered the MOST normal, as s/he doesn’t have any reaction to killing and watching people be killed.
Additionally, those who don’t meet the criteria for PTSD are given the message that they have “successfully handled the transition” back to civilian life, and the damage that has been done isn’t validated or brought to light, because, after all, to talk about this stuff is to admit that you are “disordered” and “need professional help.”
The problem with returning veterans who qualify for a PTSD diagnosis is not that they have reacted too severely to warfare – it’s the warfare they were exposed to! And those who don’t qualify were also traumatized by that same warfare. It reminds me of being in school, when I was quiet and did exactly what the teachers told me. They all assumed that I was AOK and that the kids who were acting out had problems. In actual point of fact, the ones who acted out were probably a lot mentally/emotionally healthier than I was, because they objected to the arbitrary, authoritarian and at times outright abusive behavior we were exposed to, while I pretended it was not a problem while seething inside. But they’d be the ones getting diagnosed with “disorders” because they didn’t force themselves to fit into the status quo.
I’m the last person in the world to suggest that returning veterans should “pull themselves up by their bootstraps.” But I don’t support making people feel wrong or “disordered” for finding the experience of orderly and intentional violence and killing disturbing to their sense of meaning and stability in life. ALL veterans deserve support, and it should start by an acknowledgement that warfare SUCKS big time and that having negative reactions to being forced to experience such systematic violence is completely normal and expected and not a manifestation of something “wrong” with the person having those experiences, even if they are pretty extreme experiences.
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Posting as moderator here:
I have allowed more to pass than I ought to in the discussion of personality disorder diagnoses, because I thought it was an important discussion. However, it has more recently deteriorated into a more personalized and hurtful place. I am calling a halt to that right now. I think we’ve established that there are people who view personality disorder labels as having positive applications and others who believe they are generally used harmfully. We’re not going to resolve this issue by further discussion – people are allowed to disagree with each other on this point, and neither side is going to “win.”
I would ask that the comments return to the topic of “ableism” in psychiatric practice and get away from making any generalizations about people who happen to be labeled with a particular diagnosis. It is find to share one’s own personal experiences, but it’s not OK in this space to talk about “borderlines” or any other diagnostic category in derogatory ways.
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SHE had fooled THEM? Sounds like they fooled themselves and blamed her!
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True words!
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I would say the vast majority find it neither particularly helpful nor particularly unhelpful. Most drug regimens are taken for only a few months and discontinued, and most therapy these days is a couple of months at most. I think there are lots and lots of people in distress, and they seek out help or they don’t, but I think the long wait list probably reflects the isolation and unmet needs of most of society that people are seeking to meet at the mental health clinic. Some people do find some help there, and I agree that most are not dramatically injured, but in talking to many, many hundreds of people over time who have sought out therapy, the average person has not experienced any breathtaking life changes as a result, one way or the other.
The part that is harder to gauge is the impact of the DSM mindset on society at large. It’s possible that one reason for the increase in demand for your agency’s services is simply that the marketing of “mental illness” has led people to believe that any time they feel anxious or depressed or angry, they need professional help. What with 20% or more of the USA “diagnosed” at any given time, it seems like there is a lot of push in the direction of “getting help”. I don’t think this is a legitimate gauge of how helpful the services really are overall.
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Shaun, I don’t buy into this idea that either you accept a diagnosis or you are somehow telling people to pull themselves up by their bootstraps. I’m guessing Frank’s answer would be to find support among your friends and associates, though of course, I could be wrong, and Frank is capable of answering for himself. That may or may not be realistic for everyone, as some people have limited support or need support that the average person can’t usually provide. However, the idea that the only two options are professional intervention and bootstraps is a meme heavily used by the psychiatric industry to promote their own agenda, and I find it kind of repugnant at this point to make it seem that critics of psychiatry are advocating that as the only other option.
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I think a lot of “peer workers” went into it for the same reasons you did. I think they also experience similar frustrations, based on my limited experience talking to people who have occupied those roles. It’s true, there are some who go into it because they want to enlighten everyone how important it is to “take your meds” and follow the program. But I think it’s more common that the system does everything it can to make sure no real “peer support” happens outside of the confines of the dominant pseudo-medical paradigm. I can see why some see this as “collaborating,” but I totally see and recognize your courage for fighting behind enemy lines, as I was there once myself, and it is no fun at all!
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Yeah, they are afraid it will work and they’ll be out of a job!
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I’ll reserve the right to go case by case on that last point. While I don’t condemn a person as nasty, some do engage in some pretty nasty behavior!
But I do appreciate your point.
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It’s on the package insert. Not new news here.
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This is why maintaining labeling is so important to them, despite the industry’s ironically deceptive “Anti-stigma” campaigns. As long as “the mentally ill” can be automatically deemed not credible, any facts about wrongdoing by “mental health professionals” can remain hidden. It is appalling.
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“Unintentionally Negatively Outcomed” – really? Is that a thing? Totally new one on me. Sounds like an awesome euphemism: he wasn’t harmed by being hospitalized, he experienced an UNO! That’s right up there with “Treatment Resistant Depression” in terms of obfuscation of the truth.
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You speak wisely. There is no “last word” on parenting – it’s always an evolving subject, and every parent has to make their own decisions as to what to do or not do.
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Apparently, in the USA at least, we’re more likely to drown in our bathtub or be shot by a toddler than be killed by a terrorist. Big Pharma is certainly a bigger threat by many orders of magnitude.
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Yup. Government by focus group. What’s true is less important than what people are willing to believe or are afraid of. If you are told your child will suffer if you don’t do as the authorities say, it takes a pretty strong parent to say, “Wait a minute – whose agenda is being served by your statements?” Most people aren’t up to it, especially when the media and their friends/family are siding with the psychiatrists.
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We call it “Play-C-Bow” and it works for EVERYTHING!
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OMG, that is such a horrific story! I thought the first one was bad until you described the second. Inexcusable!
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Me, too. The coverage definitely feeds the energy for the next attack.
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I’m actually more thinking that the lack of a clear path to economic success is the big driver for adolescent anxiety. When I went to college, I knew for certain that I’d be able to get a job that paid enough for me to raise a family. Kids going to college these days come out with often $100K or more in debt and no guarantee of a job good enough to pay off their loans, let alone raise a family. Not to mention our bizarre political situation that seems to be plunging downhill fast, global warming, and the insistent sensationalization of mass shootings and international terrorism. Overprotection may play a role as well, but I’d also point to parents having fewer children per family and therefore putting more unconscious expectations onto their kids in order to feel competent as parents, and I believe that overprotection often comes from that frame.
BTW, do you have any data on to what degree “overprotection” has increased in parents over the last couple generations? I’d be interested to hear about it.
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It sounds like a good initiative. I just wonder how this could possibly apply to psychiatry, when the diagnostic system itself doesn’t allow for figuring out what the “right care” should be, since it assumes that all “depressed” or “manic” or “hyperactive” people have the same issues and needs. Is that addressed specifically anywhere in the grant?
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I absolutely respect your right to make your own mind up about your own relationship with your father, and if thinking of him as a “narcissist” helps you maintain that connection, why would anyone criticize you for using it? I’m not talking about colloquial usage such as what you’re describing, but about the way these labels are used by professionals to judge and condemn people and to limit their options with the full power of the medical community behind them. I’m sorry if my comments came across in any other way.
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Gosh, I kind of find myself wishing that hadn’t posted those comments! These are complex issues, and I hope that people can understand that people will have different views on this kind of issue and it’s OK.
I don’t know what to say except to reiterate my position: people make judgments about other people’s personalities and behavior all the time. This is normal human behavior. And societies judge what is acceptable and not acceptable behavior. This is normal human behavior, and occurs in every functioning society that has ever existed.
The problem, in my view, comes in medicalizing someone’s distress or (socially defined) poor behavior or both as if there were some way we could categorize all people who act a certain way as automatically “diseased” or “disordered,” and therefore “treatable” in a certain way.
In a sense, you could say it is semantics, but I’d submit that words do, in fact, have great power. “Borderline” is a label that has been used to denigrate people and not offer them help or limit them to certain kinds of help. Believe me when I say that I’ve seen this many, many times and I find it awful. I’d much prefer if someone says, “This person has a hard time trusting people and sometimes uses indirect ways to get his/her needs met.” It’s more honest and also allows for more chance of change, because the behavior is identified as the problem rather than the person. And again, I’ve helped many, many people with this label with this kind of approach. I’ve never found the label to me helpful or necessary.
As for the “Narcissistic” label, I have certainly used it as a social shorthand, but it is almost entirely pejorative in intent and meaning. It’s an insult, not much different from calling someone a jackass. To suggest that being self-centered is a medical problem while at the same time condemning the behavior, and let’s be honest, the person, seems more than a bit inconsistent. And again, all such people are not alike – some have simply learned to be that way and are open to education and change, while others seem completely fixed in their need to act in self-centered and hurtful ways. I’d rather focus on the behavior and work at changing it if they are able than to lump all of “them” together into a group.
These are my personal opinions, and I understand that others may disagree with them. But in the end, I find it more important to try and understand each other rather than distancing ourselves from each other with labeling. I totally understand and agree that sometimes, the best or even only thing one can do to be safe is to put distance between oneself and a destructive person. But whether or not someone falls into that category is determined by each individual and what they are willing to put up with, rather than medicalizing such judgments into “diagnoses” which, in my view, which again others are welcome to disagree with, tend more to isolate and condemn rather than to help.
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Do you not believe a person can decide to alter their behavior without having something medically “wrong” with him/her?
I am certainly not denying the need to help people with their challenges in life. I’m saying that calling someone “borderline” doesn’t really mean much, because people who qualify for that label are all over the map in terms of what, if anything, is “wrong” with them and what actually might be helpful. I say this as a person who has helped many, many people with this diagnosis and has been particularly successful at helping such folks. And often, they needed plenty of help. I’m objecting to the idea that needing help = having a disease, and that we can judge someone’s “diagnosis” based on their behavior.
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I very much appreciate the clarification. I guess my issue with what you’re saying is that you’re talking about “personality disorders” as if they were somehow “diagnosable” and “treatable.” For certain, people can behave in ways that are harmful to others, and we can group such people into groups and put labels on them. And there could even be some value in that – after all, my book, “Jerk Radar,” groups a bunch of people with similar behaviors into the category of “Jerks.”
The problems I see are A) the people in the groups defined by psychiatry as “personality disorders” don’t actually have any specific thing wrong with them, and are actually quite divergent in both behaviors and needs (as you at least partly acknowledge above), and B) as a natural consequence of the above, there is no “treatment” that can be said to consistently improve any of the categorized “disorders.” In essence, saying someone has a “personality disorder” is not much different than saying “He’s a jerk.” It’s a social label that shows our disapproval of their behavior, but it does nothing to help the person or even identify what is wrong or IF anything is wrong with them at all, let alone what to do about it.
So should people be protected from other people who are harmful? Yes, absolutely. Is it a health issue? IMHO, I’d say it is not, because engaging in socially unacceptable behavior is not a health problem. It’s a problem of ethics and respect.
In your last comment, you talk about the “untreated personality disorder” – what is the “treatment” that you recommend?
Finally, you refer to “borderlines” as if they are a group of people who have a shared identity. There are many people on this site who have been given that label, and if I were one of them, I think I’d find it offensive to be referred to with that as my primary identity. People are not “borderlines” and to use such a term seems condescending at best and I think comes across as highly disrespectful. I think the behavior labeled as “borderline” can be confusing and frustrating, but again, I can’t condone heaping people together with such a pejorative label and referring to them as if they are “all the same.” Especially as the Mental Health system has an unfortunate habit of labeling uncooperative people as “borderlines” and using it as an insulting term meaning that these people are unworthy of attention or support and can safely be looked down on or dismissed entirely as “manipulative” and/or “untreatable” or be herded into “special programs” which become the only source of “treatment” they are eligible for, whether such programs work for them or not.
I’m all for providing help to people who want it, and I’m all for protecting the vulnerable from the dangers of self-centered behavior, but I think we’re better off focusing on the behavior itself rather than the labels/diagnoses. If for no other reason that such labeling incorrectly suggests to the partner of a “narcissistic person,” for instance, that there might be some “treatment” for their abusive behavior, rather than realizing s/he needs to protect him/herself from further damage. Avoiding these labels also prevents us from joining in with the psychiatric industry in demonizing those who object to or don’t do well with their standard brand of “treatment.”
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I actually never heard of Bernays, but his ideas certainly seem to be the dominant ones of our time. We are all being governed by the “herd mentality,” and most people aren’t even aware that it’s happening.
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Very common for those with that label. And then, you get to be called fat, ugly AND clingy, plus crazy. I never got how anyone could think that adding a new negative label to someone’s list could help them do better. The research supports us, but hey, who reads research? It’s more fun to just feel superior.
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Commenting as moderator here.
RR, I think that sometimes your dark humor is a little difficult to translate. I think I’m understanding your comment that Rachel took exception to as a sardonic illustration of how damaging that the labeling process can be, as well as how “entitled” the labeler appears to feel in using the label. Hence, you DON’T think the label would apply in reality? But I can see how that would not be obvious to all readers. Is my interpretation correct?
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No, that’s true. But I am talking about the psychiatric INDUSTRY, the LEADERS of psychiatry. They are, in fact, pretty crooked. As you can see in this article, “thought leaders” continue to conspire to “spin” the data to make it look like a reduction in adolescent AD prescriptions is behind the increasing suicide rate, when there is no evidence at all that this is true. I’d call that pretty crooked.
There are always individuals even in the most evil of empires that try to do good (Shindler’s List, for example). But that doesn’t make the empire itself less evil.
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I agree with you. Human gullibility seems to know no bounds. I could make a related political comment, but I’ll restrain myself…
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Chilling but true, and applicable to a lot more than just psychiatry.
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Were the psychiatrists impressed by this “spontaneous remission,” or did they ignore it and act as if she was still “ill” as she had been before? Or did they somehow take credit for her getting clearer without their magic pills?
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The term “overdiagnosis” is inappropriate to use when referring to psychiatric “diagnosis.” As there is no means to objectively “diagnose,” there is no meaning to the term “overdiagnosis.” It’s good that the authors mention the problem of definitions, but this is much more destructive in the psychiatric realm. The problem becomes not overdiagnosis, but the invention of diagnoses that are not objectively illnesses in the first place.
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The comments in STAT really roast the authors. I don’t think there is one that supports them. Worth the read – I found it encouraging.
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Well said.
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Yes, but that is AFTER you are already on a hold. I’m talking about when they are evaluating you, just like if the police interview someone to consider charges against them. If you’re “arrested” (aka awaiting an evaluation), you should get your rights, including the right to have an attorney present during the evaluation.
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I mean that, and also the right to have an attorney there during the process. It seems like an obvious need, but apparently those charged with crimes actually have more rights than those who act in ways deemed “mental illnesses.”
Maybe this is a real area where advocacy could lead to a change in the system as it is.
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Well, at least it would be a bit more honest…
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I agree 100%. That’s why I put “mental illness” in quotes and said “what is CALLED ‘mental illness.'” The concept of “treating” something like not wanting to do what your teacher tells you in class or feeling angry that your dad abused you is beyond ridiculous.
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That’s a great point, actually – how many of those in the study were given drugs that made any kind of exercise activity feel incredibly onerous or even dangerous?
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Because the term “mental illness” has been co-opted by the “mental health” industry and is used to refer to DSM “diagnoses” that are not valid or scientific and are employed to blame the victims of our oppressive society.
I think that’s a pretty simple answer.
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Indeed!
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Yup. Rode my bike to work for decades. It was an easy way to work in exercise without it being a chore.
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That’s our policy, too. Any questions re: psych diagnoses are answered “No” or “N/A.”
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One thing I note here is the concept of “adherence,” which is a short step from “compliance.” I’d be interested to know if there was any attempt to identify the person’s perception of internal and/or external barriers to exercise, including past bad experiences, perceived lack of time, joint or other pain that makes exercising uncomfortable, lack of understanding of how to gradually build up to higher levels of exercise, etc. I’d be willing to bet that getting to know the person and their perception of what exercising will be like for them would lead to more people choosing to participate.
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Shaun, I’d be interested in your take on “Mirandizing” anyone subjected to an involuntary detention evaluation.
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I’ve known plenty who have been essentially forced to take psych drugs for decades. First off, there are “AOT” orders that continue for a year at a time, and those who fail to take their drugs religiously are re-hospitalized without really any evaluation beyond whether or not they are complying with “treatment.” Then there are the psychiatrists (and sometimes family members) who threaten calling the police if a person is not “compliant” with “treatment.” Then there are the care facilities who only allow the client to live there as long as they are “in treatment” which means taking drugs.
It is true that the majority of “mental health” clients are able to stop taking drugs if they choose to, which is why the average length of “compliance” with these drug regimes is something like a year or so. But once enforced “treatment” comes into play, there is literally no legal limit to how long they can continue to force you to comply, except for getting the AOT order renewed annually. There is no “maximum sentence.”
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Well, that’s a whole different point. You can’t really “treat” made up “diseases” anyway. Which makes calling forced “hospitalization” a form of “treatment” all the more ridiculous.
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I was thinking of you as I wrote that, Frank!
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I by no means meant to imply that the justice system is just. All I am saying is that if you have a term of three years, and you serve three years, they have to let you go. Whereas the sentence for being labeled “schizophrenic” or “bipolar” can be a life term without possibility of parole.
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I look it up at Drugs.com or Medscape. They don’t hand it out to you at the pharmacy generally speaking, though I think they should offer it up to those who are interested. It has a LOT more data about adverse effects, as well as what the drug is supposed to be doing, what drug-drug interactions may occur, and situations for which it is “contraindicated,” AKA should never be used.
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I always look at the doctor’s handout rather than the patient handout. The patient handouts, in my experience, are often sanitized so that the patients won’t be as alarmed by the possible adverse effects.
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“You should have better self esteem” sounds like a great way to help someone hate themselves even more.
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Exactly so.
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I make no excuses for such behavior. All I am saying is that being incarcerated for presenting a danger to the community isn’t a form of treatment. It’s a form of protecting the community from danger. And yes, there are some very practical considerations that come into play. First off, a person incarcerated for presenting danger in a police setting is afforded and informed of the right to remain silent and the right to have an attorney present during questioning. Second, the incarcerated prisoner requires a higher level of evidence to convict them – “beyond a reasonable doubt” rather than “preponderance of evidence.” Third, and perhaps most important, there is no assumption that those who arrest and guard and control the prisoner are there to “help” the prisoner become a “better person,” nor is their any assumption that the prisoner has something internally “wrong” with them other than that they made decisions that were illegal and/or dangerous.
Finally, the prisoner is assigned a term of punishment according to the crime they commit. Whereas a “mental patient” can be afforded a life sentence of enforced “treatment” that could very well kill them decades before their time, and they have NO right of protest.
So I’m not talking about some pie-in-the-sky impractical reality here. I’m talking about providing protection from having one’s civil rights violated with impunity. I believe at an absolute minimum all involuntary “evaluations” should start off with Miranda rights, and that a client should be able to ask for an attorney before being questioned by authorities. I would certainly want some legal advice before being put in the hands of someone who can lock me up or force me to take “meds” for the rest of my life. And the very fact that such large legal issues as incarceration and enforced drugs are involved means this is NOT and never will be a “treatment” situation.
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You can send it to me at my MIA e-mail and I can pass it on to Oldhead privately.
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Nice!
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I can’t agree with you. This is simply expropriating medical terminology for a non-medical cause. There is nothing medical about preventing people from doing harm – it is entirely behavior-based and comes from a moral viewpoint that some behavior is ‘wrong’ or ‘bad’ or ‘unacceptable.’ You can’t “treat” a social/moral problem in the same way you treat a broken arm or high blood pressure.
The key point is that from the point of view of the person being “treated,” s/he may not see any need for “treatment” and object to the entire enterprise. In the world of real medicine, a person who protests treatment has the right to say “no.” Take that right away, and we’re talking law enforcement, not medicine. Law enforcement is needed in society, but it is not a form of medical treatment. It’s law enforcement. And the sooner we divorce law enforcement functions from “treatment,” the sooner many of the arrogant and presumptuous attitudes we’re up against in the psychiatric industry will be forced to soften or at least be held up to some level of accountability.
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I think some confusion enters in as soon as we conflate protecting people from danger with “treatment.” It is NOT and can NEVER be “treatment” if the person is forcibly engaged in the process, no matter how well-intended the person exerting the force. Treatment is an agreement reached between a physician and his/her patient. In cases of unconsciousness or inability to communicate, the patient’s interests may have to be represented by someone else, but in this case, we’re already on shaky ground as far as “informed consent” is concerned. But if there is no “informed consent,” the concept of “treatment” is out the window. We are now managing social problems, not “treating” anything. Again, a police function exists in essentially all societies, but it should never be confused with a helping agreement between client and professional.
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Well, there is nothing wrong with checking someone’s thyroid or their vitamin levels or for actual medical problems. Unfortunately, I have not know many psychiatrists who bother with anything along those lines. Mostly, they ask people to list their “symptoms” and then “diagnose” them and prescribe something.
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So what do you particularly see that is good in psychiatry?
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“Oh, no, I’m a very GOOD man. I’m just a… very bad WIZARD…”
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What is the “new neuron?” What is its significance?
Being opposed to psychiatry doesn’t mean not believing that biology plays a role in what is called “mental illness.” For instance, anyone who doesn’t sleep for 3-4 days will start hallucinating, just as if they were “schizophrenic.” It is the LYING about what they pretend they know but really don’t that is the big problem. I’m always interested in new research, just not in dishonest “interpretations.”
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I am so sorry! I don’t think anyone here is “better” than you are. Some are, perhaps, more fortunate.
I hope you can find a way to get some relief. Zyprexa is a bad, bad drug!
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This might be helpful for a person who is in a relatively strong and safe position and who CHOOSES to try out this approach on their own CHOSEN points of anxiety. To suggest that this would be a good idea for all or most people qualifying for a c-PTSD diagnosis is ridiculous. Actually, suggesting that any one approach will be helpful to everyone in this category is ridiculous. It would completely depend on the circumstances, preferences and personality of the person who is suffering these effects, as well as the relationship between them and the therapist.
The big mistake the psychiatric model makes is assuming that they can group people together by “symptoms” and somehow know what will help everyone in the group.
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Thanks for the smile – I can totally relate!
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I love the saucers on the asphalt plan! I used to volunteer to do glass recycling and would throw the glass bottles as hard as possible into the glass bin. I found the shattering most satisfying, especially a nice, thick olive oil bottle into a big wine jug. Crash!!!!
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It’s a massive conflict of interest situation. They’re not going to honestly report things that will hurt their bottom lines. So it’s more marketing than it is science, but sadly, most people don’t know or want to know this.
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Well, it SHOULD see the researchers disgraced…
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Reminds me of school. Sure there were “good teachers” and “bad teachers,” but the very essence of the system was to teach kids that they have no power and need to kowtow to their superiors. Good teachers made it more bearable, but the school was oppressive from top to bottom, and no “good teacher” could really change it.
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“Often unhelpful” may be the understatement of the month. How about “is the essence of what makes the current model completely unsalvageable?”
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I absolutely agree. He shows over and over that the profession has long since sold out concern for the patient in favor of protecting the powerful and blaming the victim. I am sure he was ostracized from his profession for doing so, but I think writing this stuff was him deciding to bail on a totally corrupt profession and telling the truth about it.
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It is almost never really bio-psycho-social. It has become bio-bio-bio for most psychiatrists, and a lot of psychologists, too, these days. And really, it should be the social-psycho-bio model if they’re serious about it, because if bio’s at the front, it will always dominate, especially when that’s where the financial rewards are.
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8Anafranil used to be used both as an AD and an anti-anxiety drug. It was more used for anxiety, but I saw it used for both, even in kids. Also used as a sleep aid at times, though the side effect profile was so bad it was abandoned. Oh, and they used to use it in the early 90s to “treat ADHD.” I had to advocate to get a kid off of it because he was having extrapyramidal symptoms, which they were calling “making funny faces” at his school. They had him on a behavioral reward system to discourage the “funny faces” which he had zero control over. I guess they used it for whatever they could pitch it for.
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Masson’s book is really important reading. It shows that the suppression of trauma as a causal factor in what are now called “mental illnesses” has a long history, and is very highly motivated toward protecting the white male aristocracy from any kind of scrutiny or accountability for their criminal actions against children. It is a shame that Freud knuckled under, but his retreat from the “trauma theory” reflects our entire culture’s “blame the victim” attitude that continues to the present day, and is now embodied in the “blame the victim’s brain” meme that is central to the current DSM/label-drug-and-dismiss approach to mental/emotional distress.
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Hey, thanks! I definitely got a few good chuckles out of your clever post. If humor is out, MIA better hire someone to moderate MY posts, too!
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Lying is a very legitimate survival tactic, especially when oppression reigns.
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Again, I get what you are saying, and from the point of view of an adult who has sufficient control of his/her own environment, this kind of thinking can in fact lead to healing. But what about you or me at the time we were IN school? Did we really have a reasonable alternative at the time? I’m not talking about holding onto resentment – I’m talking about POWER here. There are times when a person is unable to exercise much if any control of his/her environment. To me, this is a totally separate issue than how one views one’s experience in retrospect. There IS real oppression toward black people, toward women, toward the so-called “mentally ill,” and it does genuine, real damage, both spiritually and physiologically. I’m all for dealing with the spiritual damage after the fact, or even learning to deal with oppression directly when it is happening. But it definitely feels very judgmental to suggest, as you seem to, that the only variable in gaining control of one’s life is internal. There are times when one is under suppression and at such times, simply adopting a different attitude is not sufficient to maintain one’s integrity. This is not because I don’t understand what you’re saying. I simply don’t agree that it is as broadly applicable as you seem to think.
I find it unlikely you will allow this perspective, so I don’t plan to comment further on it. I simply ask that you recognize that your framing of your philosophy comes across as invalidative to those who have been injured by the oppressive conditions in the “mental health” system.
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So what is the point of “peer review” if this kind of crap is allowed to pass as legit?
Maybe we need a non-peer review by people from a different field!
—- Steve
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There are “housing first” programs developing in a few places and they have shown exactly what you say – providing logistical support reduces “symptoms” (whatever THAT means!) without any kind of “treatment” at all. Forcing people to accept drugs in order to get a home is not only morally offensive, it’s proven not to work!
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As moderator, I appreciate your final clarification!
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I appreciate you reposting this for me.
I’m not sure you got my point, though. I definitely agree that people sometimes need to be reminded that their attitude and beliefs are within their own control. Where we diverge is the idea that all forms of suffering come from attitude or belief issues. I think it comes across as insulting to people who have been in places where they don’t actually have control of their environment and they are directly and specifically harmed by that environment. It sounds like you’re saying that the ONLY reason people are suffering is because of their attitudes/beliefs, and I don’t think that is factually true. I gave a couple examples, such as me going to school as a kid for me, where a person realistically doesn’t HAVE a choice about the environment. Sure, I could choose an attitude toward school that might make it feel less onerous to me, but it was still an oppressive environment where I had to, for instance, hold in my pee or suffer consequences for going to the bathroom without permission. I don’t think there is an attitude that could make that kind of decision feel anything but oppressive. I probably would have felt LESS disempowered if I’d gone ahead to the bathroom and accepted the consequences, but seriously, why should I have had to make that kind of choice?
I think it’s quite appropriate for me to object to this kind of double bind and to feel and express righteous indignation toward such situations, and I don’t think it’s helpful at all to tell people anything that suggests “if you just change your attitude, you’ll feel OK.” It provides a great cover for abusive people to claim that they’re not really being abusive, you just have a bad attitude.
I don’t want to say that applying your kind of reasoning can’t be helpful at times, because it really can. I’m saying that it doesn’t apply to all situations, and that saying it does can really feel invalidative to people who are in bad situations that a change of attitude simply won’t be sufficient to address.
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I really don’t. But I can ask about it.
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John, I seriously only know about you exactly what you’ve shared and nothing more. I don’t doubt your perception of the situation, as you’re the only one there to tell us about it. I don’t really believe there is much we can do here except to talk about it, as we don’t know where you are or what it is you’re up against. Which is why I don’t really see what we can do to help you, other than hearing, empathizing, and providing some ideas of what you can do yourself. I wish we could do more!
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I think it’s OK for people to gather together and identify themselves by something they feel they have in common. “Voice hearers,” for instance, is a group of people who get together to talk about their experience hearing voices. No pathology is assumed, no power differential gives some more authority, no one is the “diagnoser” and no one is the “diagnosee.” I think it’s really different when a doctor or counselor diagnoses YOU with something and tells YOU what it means or what to think about it. I know some folks have grabbed onto psych diagnoses as a means of identifying themselves and others who have similar issues, and it’s great if that helps them find a community. But it’s a slippery slope when we start taking what are supposedly medical “diagnoses” and instead using them as cultural constructs and use the fact that they may be useful in the second role to justify their use in the first role. No one asks a person how they feel about their “broken leg” diagnosis – a leg is broken because an x-ray says it’s broken, and we can not only tell what we need to do about it but also continue to monitor it objectively until it heals. Until and unless psych diagnoses can be objectively determined and monitored in this way, they remain very dangerous, because they mislead folks into thinking that the doctor understands what’s going on when in fact they are simply categorizing things based on outward appearance, kind of like diagnosing someone with “pain.” I agree, we’re lacking a word for it, but it lives more in the realm of “distress” than it does in the realm “disease.”
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Thanks for clarifying. I’m not sure what you would want an internet website to do about that problem, though. We are here to communicate. What would be helpful to you?
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The damage that parents can do is enormous. One of the things I really hate about the DSM is that it lets the adults off the hook and blames the child. It is truly inexcusable.
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And I agree, defensiveness and immaturity does not lead to anything productive.
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Maybe we need a blog on the topic of how survivors and dissident professionals can communicate effectively despite varying intentions?
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I see that this kind of thinking can be really helpful for certain kinds of issues. However, there really ARE situations where people have limited control, whether economically, socially, physically or whatever. Children are a great example. A baby who isn’t being fed is genuinely in crisis and is a victim of poor parenting, regardless of how they think or what they believe. They NEED someone to feed them. They will die if they don’t.
Other examples: a person has to take antipsychotic drugs or else they’ll be arrested and tossed back into the “hospital” and forcibly injected. More control than the baby has, but a lot there the person doesn’t control, and his/her options are limited.
A black person can’t alter society and make it so that the person they’re applying to for a job or an apartment suddenly isn’t going to go against them because they have dark skin.
The “victim identity” concept has applicability, but it can also be used to allow those with social power to abdicate their responsibility for doing harm. I would have LOVED to escape from school as a child, and yet I spent 13 years there. Was that because I had a victim mentality? Or because I had no practical option to survive?
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I have been a passionate opponent of diagnoses before the DSM III even came out. There is nothing that enrages me more than the DSM. Check out my past posts and you will see where I’m coming from, and was coming from long before I was moderating.
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I would submit, at the risk of generalization, that psychiatry is almost never “right”, at least in the scientific sense, because it starts from invalid assumptions. Assumptions such as the mind=the brain, chemicals are causal agents in the brain rather than messengers influenced by the environment and the decisions of whoever or whatever it is that runs the body, that “negative” emotions are problems because they are inconvenient, that “delusions” or “hallucinations” have no meaning but are just random events… So while I would not say all PSYCHIATRISTS are always wrong, I’d say that anyone who adheres to the DSM/brain chemistry model is going to come up with wrong answers nearly 100% of the time.
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Such arrogance! They have no idea what the mind actually even is or means, and yet they are trying to find a relationship between this vague, undefined entity and the brain?
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Commenting as moderator here:
Well, I guess I should not have gone to sleep yesterday without checking the comments!
I appreciate the reporting of several comments on this thread, and it does appear to have gotten well out of hand. I have removed a number of posts, and may need to remove some more. This is the kind of disrespectful exchange I was talking about in my blog. I’m not laying the blame on anyone at all, but asking everyone who posted to take a look at their own approach here. Some did a great job of returning to the topic, or making observations of what was going on without attacking back. Some chose to throw more fuel on the fire.
I would seriously ask those in the latter category to do some self-policing here. I’m not sitting by my computer day and night, checking each comment as it comes in! It seems unfair, at the least, to be judging publicly how the rules are being applied when I haven’t even had time to look at the comments. As I said in the blog, the most helpful thing to do is to report the comment and not reply. If a reply seems called for, stating how you are feeling about it or observing what you see going on is much more helpful than attacking back. Again, my thanks to several posters for doing just that – that’s the kind of response that keeps a community like this functioning effectively.
I’d ask those who find this kind of exchange challenging to recall that each of us is here as part of his/her own larger objective(s) and that not everyone’s objectives or strategies will line up. Bob wants this site to be a place where all of those who are concerned about or resisting the system of labeling and drugging are able to communicate safely with each other. We have enough antagonists outside of this community without being antagonistic to each other. At least that’s my humble opinion.
Let’s get back on topic!
Steve
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It’s hard to pick one book. I suppose Alice Miller has been one of the strongest influences on me (The Drama of the Gifted Child), but far from the only one. I think I got most of my insights from my own therapy (back in the days when therapists still asked questions and listened to their clients) and from working with people over many decades. I was fortunate to start in the “mental health” field with almost no training, so I went with what I observed and learned from the clients I was talking to. I don’t think there is a better teacher than approaching the person needing help with humility and creating a safe space where they can honestly explore their own intentions and motivations and fears. What I found is that almost all behavior, no matter how odd it seemed to me, made sense from the point of view of the person engaging in it, once I understood their lives well enough. I’d say that’s where most of my learning originated.
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Steve as moderator: you said “in some cases,” which means you’re allowing that it’s not all cases, so I would not see that as a derogatory generalization. I’d be interested if others would see it differently.
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Steve, are you in Portland, OR? That’s my neck of the woods if you are!
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Very well said! And I would add that the less “professional” (in the sense of “distant” and objectifying) the professional is and the more human the professional comes across, the more successful the intervention. Which makes one wonder, is the real problem a lack of human connection?
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An excellent point!
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I agree 100%. Without these bogus “diagnoses,” nobody can bill for “treatment,” which stops the train in its tracks. Of course, a lot of people’s salaries depend on keeping that particular gravy train rolling, so it won’t be easy!
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Hey, I don’t disagree with you at all! I certainly don’t expect the psychiatric profession to ever admit to its own failings and venality – Venality is the basis on which it’s built, and the failings we recognize aren’t failings to them – they have succeeded beyond their wildest dreams, because they’re making money and everyone believes their bullcrap.
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Great post! You have encapsulated my own feelings about the “therapy industry” quite well. I had to leave the field eventually because I could not stand it any more. A little dose of humility would go a long way, but humility seems to be anathema to those who are invested in “the system.” It’s the only place I know where you can screw your client over and then blame them or their “treatment-resistant depression” for your own failure.
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Amazing – they somehow made the sexual side effects go away without altering the drug in the slightest! Could be a little “data management” going on here?
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But, but, but… I thought “ADHD” was a “genetic brain disorder?” And if it’s not, why are we “treating” it with drugs? How did those 10% of adolescents (and 4+% of the control group!) develop “ADHD” if they didn’t have it at “baseline?” Could it be that “ADHD” isn’t inherited at all?
NO, NO, NO, look the other way people – drugs are god, bow down and worship, never mind about those pesky facts…
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They are so tepid in their recommendations! They SHOULD be saying, “Prescription of SGAs causes almost instant disruption of metabolic function and weight gain is substantial in just 20 weeks. These drugs should NEVER be prescribed to children except in the most dire of circumstances, and if they are, children should be weaned off of them as quickly as possible. The dangers far outweigh any benefits, especially for off-label prescribing.”
Or they could go with, “These drugs are dangerous – don’t prescribe them to anyone!”
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The idea is to discredit the widely held belief that psychiatrists are able to prevent or mitigate violence with their “treatments,” and in fact most likely INCREASE violence, which is contrary to what many subconsciously see as their mission. If a commission of independent scientists concluded that many murders and suicides would not have happened in the absence of psychiatric drugging, or that psychiatric drugging increased the rate of homicide and suicide, it would be a massive blow to psychiatric credibility, as they will be shown to have failed in their unspoken role as protectors of the populace from the purported dangers of the “mentally ill.” Of course, this would have to be combined with other efforts to show that “the mentally ill” aren’t even a definable category, that their “diagnoses” are a pile of crap, and that the odds of recovering from so-called “mental illness” appear to be greater the further away from psychiatric “treatment” one is able to remain. I’m sure you can see the potential impact on AOT orders if the “danger to self and others” was recognized NOT to be mitigated by the drugs, but in fact, made more likely.
Of course, this is just one action, and it may or may not have the desire effect. But that’s the concept, as I understand it today, and I think it makes a lot of sense. There are “fatality review” committees all over the country (I used to serve on one) and it would not take a lot of effort for these committees to simply add collection and analysis of legal drugs to their reviews. I am confident that the results would show what we know to be true. I am also confident that the psychiatric profession knows this and would fight such efforts tooth and nail. But perhaps in doing so, they will reveal too much of their hidden agenda.
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Quite so. Carey has run stories critical to psychiatry before, but he’s in very sparse company. Of course, major media outlets get a lot of advertising money from Big Pharma, so this should be no surprise.
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It is difficult to balance empowerment, which depends on assigning agency to the person making decisions and reminding them they have options, and recognizing oppression, which often makes people feel or believe that they don’t have choices that they actually do have. Striking that balance is key to being able to be helpful. Responsibility (literally, the ability to respond) is not the same as blame, but the term “responsibility” is very frequently used in a blameful manner. I find the use of these terms to be very delicate! But I do get what you are saying – it can be vitally important to help folks remember their power to make decisions, as long as its done in such a way as to make sure not to blame a person for being deceived and victimized by the lies and manipulation and force of organized psychiatry.
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Or claim that it’s due to “lifestyle choices” and avoid any scrutiny of their beloved substances.
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Dang, I never heard of this! Thanks for the education – it seems to fit the circumstances remarkably well.
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I think we are all gullible to our parents’ need to protect themselves. Because we need our parents to protect us. Unfortunately, much of what is called “mental health” issues stems from this very tendency, at least in my observation. Alice Miller writes eloquently about this – we protect our parents in order to make sure we’re protected, but we also know better on some level and end up resentful and confused. The smart ones eventually come to see this is what’s happening, but seeing it isn’t the same as working through it. It totally sucks that this happened to you, and I wish you continued success in sorting out what it means to you going forward.
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I agree with this wholeheartedly. Unfortunately, I have had endless frustration in talking to most people coming from a social justice perspective about these issues. I get the impression that the “proper” social justice response has been defined for most people as avoiding “pills shaming” and supporting more funding for “mental health.” Has anyone had any kind of success in communicating past this kind of barrier?
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Steve posting as moderator here.
Don’t sweat it. Thanks for letting us know.
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At a minimum, they sure didn’t make everything AOK! It is amazing how many people who commit suicide have already been using psych drugs for years or even decades, and yet their suicides result in a call for more “mental health treatment.”
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You know I’m with you on that one!
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I think this gets at the most basic fallacy of the psychiatric system – that people’s “disorders” can be identified and categorized and that one “treatment” can be implemented for one particular category. This is observably untrue and extremely destructive. Different people travel very different pathways to get where they are, and each of them needs different things at different times. Anything that promotes healing has to humbly invite participation and be humble and open to being totally ignorant of what is really helpful to this particular person. The only person who knows what is helping is the person being helped. They may not consciously be able to tell us what they need, but if something’s not helpful, they will know it. It is arrogant for any of us to assume we know what will be helpful to another.
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I think these results come from believing that a particular “school” of therapy is more important than who is delivering it. Rigidly adhering to a “CBT” or any other particular school of therapy is likely to be damaging to a certain percentage of people even if delivered “perfectly,” because it is likely not what some people need. Additionally, therapists who haven’t dealt with their issues are likely to mess up anyone they see, regardless of what approach they take. The researchers act as if someone doing “CBT” is the same as someone else doing “CBT.” In my observation, humility and flexibility are the keys to success in helping another person. Deciding ahead of time what is going to “work” leads to blaming the client when it doesn’t, as well as other damaging interactions.
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Wow, good catch! I totally missed that point. I like you titles, too – more honest.
How about: “Making money by inducing brain damage with one drug and selling another drug to “treat” the damage.”
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Thanks!
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This is a common phenomenon, and one of the reasons I really despise the DSM. It provides cover for the adults who are not doing their jobs, or are outright abusive. If the kid protests his/her treatment, s/he is “ADHD” or “Oppositional Defiant” or “bioplar.” Saves anyone having to ask the difficult question of why the child is protesting and what is going on in his/her life?
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I have worked both with the elderly in nursing homes and with foster youth, and have seen massive use of these drugs for behavior control alone. It is disgusting!
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I agree completely. It’s always puzzling that the data supports a conclusion that is inconvenient, and then it’s explained away or buried. Obviously, we’re not talking about science here. We’re talking about marketing, and in marketing, “bad data” is hidden and the good is overblown as much as possible, if not frankly invented.
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I know of one person where this is true. Zoloft for migraines, and she started having random suicidal thoughts, which she found bizarre, because she was never suicidal. She also took months and months to get off, due to withdrawal effects of some severity. I think this is a good idea.
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I agree completely. The whole concept presented here, that “side effects” can even be measured by clinicians, seems ridiculous. Since we are not “treating” disease states, the only legitimate measure of success is whether the client feels they have accomplished what they wanted out of the therapy. I can tell you for certain that any therapy that didn’t involve “distress” or “strong feelings involving the therapist” would have been a total waste of time for me. But another client might have different goals than I did.
Why not ask the clients? Radical concept…
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My experience is that there are two kinds of helpers. One believes that helping means making people do what you think they should and using rewards, punishment and force to ensure compliance. The other kind could care less about compliance and focuses on helping the other increase personal power. These two subgroups exist in any profession and across the political spectrum. I try to hang out only with the latter whenever possible.
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Very scientific, eh?
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I think “contagion” is most likely to happen in environments which do NOT allow discussion of these difficult feelings, ironically. Too many MHPs are afraid of “negative feelings” and try to stop them instead of listening.
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This is a very important observation!
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I agree with this from my own observation. My emotions often alert me to problems that exist or conflicts I have not dealt with or things that would be rewarding and my rational side helps decide whether or how these things can best happen. We’d all be crippled in our decision-making ability without both sides.
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I will do so. I’m going to shut down the comments at this point, because we appear to have gotten very far afield from the topic of how to conduct a more welcoming community.
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I don’t disagree with you there. As I said, generalizations are a more challenging point, more of a gray area, and the relative power level of the group in question and the person speaking will definitely play into how a comment is judged. I hope you did pick up that the comments I make toward survivors suggest more protection of their voices, while those toward professionals posting encourage developing more understanding and a thicker skin.
Thanks for the feedback. I hope you’ll be kind enough to let me know if you see me going too far astray!
— Steve
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You’re welcome. I really appreciate your mentioning Alice Miller. Some of her thinking has been very central to my understanding of why clinicians so often take the side of the parents or the authorities when clients/patients/victims report abuse by their parents or by the system as a whole. I have concluded that the best qualification for a therapist/counselor is that they have taken a good look at their own historical crap and have it under a good level of understanding and control.
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I like the “Miranda Rights” idea. I used to do this when talking to kids who were in difficult situations with their parents (and sometimes with the parents, too) if it appeared they were going in a direction of reporting abuse. I wanted them to know I was a mandatory reporter and that there may be consequences that neither I nor they could fully control if they disclosed abuse to me. That way, at least they had the option of choosing not to talk about details, or presenting a hypothetical case instead of telling me what happened. It seemed the fairest way to give them the most control I could.
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Midwives in the USA experience similar dynamics. Doctors can have babies and even moms die in their care and their colleagues just shake their heads and say how sad it is that “we can’t save everyone.” But any kind of bad outcome for a midwife is proof that anyone who doesn’t give birth in a hospital with a doctor attending is a fool, and that midwives are dangerous butchers who don’t care about the lives of their patients. It’s amazing they get away with it, but I guess it’s one easy way the people in power continue to exert their control over anyone who poses a threat to their unearned authority.
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And another thought on this point: just because the person continues to feel suicidal or even plan suicide doesn’t mean we have NOT been helpful. The goal should not be to stop the person from doing something or making them do something. It should be to understand their viewpoint and priorities, and in so doing, perhaps help them understand themselves a little better.
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I agree 100%. For whatever flaws it has, MIA appears to be the only site where survivors of the system and people who think the system is nuts rather than the people it claims to help can have this big a national voice. It is also kind of unique it the attempt, however awkward, to bring dissident professionals and survivors as well as their friends/family that support them together in one place. Not an easy task!
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The point about “system failure” resonates deeply with me. Systems that can’t identify failure never grow and develop. If I can’t help a depressed person, it’s not because they have “treatment-resistant depression,” it’s because what I did was not effective. This is not a place of blame, but one of learning from experience, and if one really wants to be more helpful to those in distress, one must be humble enough to admit when one’s efforts were not helpful or made things worse.
BTW, BRILLIANT idea to ask him what he wants to do before he dies! I’m definitely going to have to remember that if the occasion arises in the future.
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I am glad the author included the sad and lonely and abused childhood that Williams experienced. While it is obvious that the environment always interacts with the person’s goals, intentions, preferences, etc., the correlation between what is called “mental illness” and childhood adversity is enormous. Those who wrote about Williams purported “mental illness” after the fact almost completely failed to provide this important context in their zeal to advocate for “treatment” for Robin’s “brain disorder.” I found it disgusting, and appreciate this more nuanced and humanizing biography.
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In other words, kids who are more likely to take risks as children are more likely to take risks as adults. Wow, enlightening results here. In other news, kids who run fast tend to run faster as adults, kids who like to paint are more likely to paint as adults, and the sun is very likely to come up in the East tomorrow morning.
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A word limit is probably a very good idea. Even if it would force me to be more concise!
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I think that is the healthiest response. Of course, then you get labeled with “Anosognosia,” but if you’re far enough away not to hear it, it doesn’t matter what they call you anymore.
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All very true. We seem to toss out any respect for all the good work on developmental expectations and the range of appropriate development as soon as they reach Kindergarten. Suddenly, everyone’s expected to be on the level the teacher wants, and if they are not, they have a “reading disorder” or “mathematics disorder” or “Oppositional defiant disorder” or “ADHD.” And I agree, school for me was AGONIZINGLY dull! It’s only because I was possessed of an extraordinary level of self control as a child that I didn’t run screaming from the room!
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You might be interested to know that a good study of employees who had been diagnosed with “ADHD” at some time in their lives. The employer ratings were compared to non-ADHD employees and were found to be essentially the same for both. The researchers posited that once the “ADHD” youth were freed from the bounds of the school system, they chose jobs that allowed them to take advantage of their strengths. So when they were able to select the environment, their “ADHD” had little to no impact on their ability to perform up to standards.
And you’re right, our kids were fortunate in many ways. What I find sad is that our school systems are so rigid that they are unable/unwilling to do what is necessary to adapt to these kids’ needs. It’s already a known fact that open classrooms are the best setting for most of these kids. Instead of drugging them, why aren’t we creating open classroom environments so they can succeed in school?
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I always found it particularly egregious when they’d put someone on Zyprexa or some other fat-inducing antipsychotic drug, and then talk to the client about “bad food choices” and “needing healthy exercise,” as if being fat were somehow the fault of poor eating habits or laziness. I often brought that point up, but it only seemed to get the staff upset with me. Almost no one (except me or my CASA volunteers) ever told the kid they were beefing up due to the drugs.
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Thank you very much!
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Posting as moderator here. If you re-read my blog, you will see very clearly that no one will be moderated for posting antipsychiatry comments (or pro-psychiatry comments, either). You can also see my lean toward protecting survivor voices even if they are perceived as expressing anger toward the psychiatric profession, and advising professionals to develop a bit thicker skin. I’m not sure how this can be characterized as protecting professional voices at the expense of survivors. It seems rather to lean a bit in the other direction. Am I missing something here?
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Maybe the profession should start off aiming to PREVENT brain damage by stopping this practice until it is proven safe, rather than continuing to potentially damage millions of brains until someone proves it is not.
What happened to “First, do no harm?”
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You bet. It’s a very sore subject for me, too. We found that alternative schooling was absolutely essential to maintaining any kind of sanity, and home schooled for years. We also helped create a few different alternative school environments where kids got more control of their own educational goals and activities, as this has been proven long since to be the best environment by far for them (educators asked to distinguish between “ADHD” and “normal” kids back in the 70s were unable to do so in an open classroom, while they were 90+% accurate in a standard classroom environment). We also found that standard disciplinary tactics were often totally ineffective, and we had to be VERY creative. We used to often “bet” each other or our son that he could not or would not do what we wanted him to do. He hated us predicting anything about him and enjoyed making us “wrong,” so this worked pretty well. The best we ever came up with was what we called “energy points.” He started every day with zero energy points. If he did something to make me feel more energetic, or saved me energy in some way, he got “plus one.” If he did something to drain or waste my energy, he got “minus one.” If he got below zero, I stopped doing ANYTHING for him – talking, making lunch, driving him anywhere, playing with him – I did nothing at all. Of course, arguing about receiving a minus meant another negative point. He then had to do something to elevate my energy in order to get back up to zero or above. This usually meant some kind of work, and doing work in and of itself often brought him out of his negative state. In fact, I used to try and start the day giving him a useful task or two in order to set the tone. The only thing I had to remember was not to go more than minus two, because then he felt like he was so deep in, there was no point in trying.
You know your child and will figure out what works. Schools don’t know your child or try to get to know them, and the DSM diagnoses simply make it easier for them to blame the child and evade any kind of professional responsibility for figuring out how to teach him what he needs to learn. I encourage you to seek alternatives. I don’t know that we would have survived if we had not.
Thanks for sharing your story, and I wish you the best of luck in finding a better path forward!
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I am quite sure that it does. In fact, if you wanted to drive someone to “mental illness,” telling them constantly what they were doing wrong or telling them what was “wrong with them” would be a very efficient method!
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I think they were hoping to prove that “ADHD” kids did better when receiving “treatment.” They were, not surprisingly, sadly disappointed. But ever hopeful, rather than admitting that they have their answer and need to give it up, they will continue to apply for and receive grants to “study” this “condition” that is only definable in the vaguest and most subjective terms, and whose “treatment” apparently does little to nothing to improve the ostensible “condition” it is supposed to “treat.”
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Of course, trying to get anything about systematic traumatization into the DSM is going to be a failure. PTSD only got in there due to war vets, not abused children and partners. It is absolutely against the guild interests of psychiatry as a profession to give any acknowledgement of the role of trauma in creating “mental health disorders.” If they did, the entire edifice of the DSM would collapse under the weight of its on corruption. They only hold their power as long as they can convince people that they can “diagnose” people with different “disorders” that are driven by “brain diseases.” As soon as it becomes clear that traumatic experiences and social stresses are at the center of most “mental health problems,” the psychiatric leaders are exposed for the charlatans that they are. Plus the drug companies lose profits, and we can’t allow THAT!
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Very well put!
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Posting as moderator here. Are you talking about in the articles, or in the comments section, that you see the “dialog degenerate into projections and defensiveness?” I’m interested because if it’s in the comments section you’re talking about, I want to be looking for this tendency, and would really appreciate it if you let me know when you see it happening in your perspective.
Thanks for that.
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And if it is sometimes “neurological,” so what? Species survival depends on genetic diversity. Everyone has challenges and strengths. My kids (two of which would definitely have qualified for “ADHD” diagnoses) always heard what they were good at and what they needed to work to improve, and THEY were a big part of deciding for themselves what those “work ons” were and what they were going to try and do to make improvements.
And there are upsides to any personality tendencies as well. The unfortunate reality for so-called “ADHD” kids is that they are forced to contend with a school system that specifically does almost everything it can to frustrate them (albeit mostly without evil intent. Mostly.) “ADHD” is pretty much synonymous with “hates a standard classroom.” Put those same kids in an open classroom with freer choice and movement, and “ADHD” is almost invisible. That’s what we did with our kids (homeschooling or alternative schools with open classrooms) and all three are doing very well as adults, with nary a milligram of stimulants. Not saying it was easy, because it wasn’t, but just because a kid is frustrating for adult does not make him/her “mentally ill.” Sometimes they are just being normal and it’s inconvenient for the grown ups. I think it’s the adults’ job to adapt.
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Thank you very much! I worked very hard on that blog, and it’s nice to have it and my prior comments appreciated. So far, it appears everyone is adhering very well to the guidelines, which is great!
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I relate very much to your comments here. In particular, it’s become clear to me that verbal connection between a counselor and client, or any person trying to help and the “helpee”, is insufficient. It is the emotional connection on a real level that matters the most – that sense that the other person really GETS where you are at on a visceral level. And I think that’s also what babies are looking for, and you’re right, their very survival depends upon making such a connection. My sense is that it is terrifying for a baby not to be able to connect with a caretaker many, many times a day, essentially whenever they need something. Once the baby gets the idea that the parent figure is going to respond every time (or almost every time), s/he learns to relax some and be able to tolerate distress without panicking. I think that life can be very difficult for those who never have this primary experience of safety and trust.
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The analogy is, unfortunately, all to apt. Including the fact that the general populace is not going to be protected by their cowardly avoidance of the gang. But as in the movie, it’s hard to convince the regular folks to stand up to evil, especially when evil has such firepower!
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Increased “civility” is the goal here, not discouragement of people’s views. I see what you mean about people feeling unsafe in sharing their stories at times. A recent acquaintance of mine wants to submit under a pseudonym for exactly that reason. I just want to make sure everyone knows I have no interest or intent in moderating away anyone’s voice, and I have a particular interest in protecting the space for survivors to feel safe in sharing their stories, since those are the voices most likely to be silenced in other arenas. I think my blog above reflects that intent.
What would you suggest could be done to make it feel more safe for survivors to post?
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I think you make a great point – not only the scales themselves, but the decisions of what to “measure” are very much culturally bound, which prevents them from ever really being “scientific” in the sense of truly objective. And I also have found, for me and for others, that thinking in terms of what I don’t like and want I want to change and what I do like (learned this one a LOT later in life) and what I want to preserve and appreciate is much more helpful that thinking of “what is wrong with me?”
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I’m sorry that my comment came across that way. I don’t believe and never have that “some people are fundamentally bad.” I agree 100% that intergenerational trauma is usually at the core of any misbehavior by children, and I’m the biggest advocate you can imagine for family work and attachment parenting and dealing with childhood trauma. I was perhaps being too flippant in my statements, as I was thinking more about the attempts to characterize “ADHD kids” as “needing treatment” to avoid bad outcomes. Two of my three met the criteria for ‘ADHD’ and we did a lot of work to avoid getting them enmeshed in the psychiatric system/paradigm, including some very creative discipline and home schooling. Lord knows what would have happened if we’d put the oldest in school – he probably WOULD have gotten at least an “ODD” diagnosis.
Anyway, my intention was not to insult kids or their parents, but to point out that if a certain behavior occurs as a child, predicting that the same kind of behavior would continue as an adult is not really an accomplishment. I most certainly should have chosen my words more carefully, and I apologize for that.
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Again, speaking with my moderator hat on.
Thanks again for sharing this. It only just occurred to me yesterday how sensitive this issue with “likes” could be for many people. You have stated it very clearly here, and I appreciate this. Again, if you ever feel that I am discouraging certain voices because of their position rather than the tone of their presentation, PLEASE tell me right away.
I will add that I intend to always communicate directly with the writer about their intent in writing anything I feel needs to be moderated, unless it’s really blatant and obvious. I want to make sure no one is feeling they are having posts removed without any opportunity for feedback. It’s kind of a big deal to me to remove someone’s post, and I know I’d want to be fully in the loop about the whys and wherefores if it happened to me. Which it has, BTW.
Again, thanks for letting us know so clearly what your concerns are. I’m sure it will be a further topic of conversation among the staff.
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Nixon made his name on the House Unamerican Activities Committee when he was a representative. He was a total McCarthyite. My understanding is that McCarthy finally buried himself when he started attacking folks in the Army, who had sufficient organization and power to defend themselves and take him out.
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Thanks for sharing that. I think it’s important to consider how powerless WE feel as professionals with degrees and positions of respect, and then consider how it must feel to be a CLIENT in such a system where the supposedly powerful people themselves are feeling oppressed! At a certain point, I just couldn’t stand it any more. I felt like I was colluding with the occupying army.
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Thanks for pointing that out. Of course, it was not a conscious intent, but we all have lots of these images in our language and there is a lot of confluence of aggressive and sexualized language, particularly toward gayness in any form. I will be more thoughtful of such phrases in the future.
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As a moderator, I absolutely see your point, and I encourage you to keep that viewpoint in the editors’ minds. We are all human here, too, and it’s sometimes difficult to anticipate the impact a particular piece might have on the readers. All I can personally assure you is that I have no intention of creating an special protections for anyone based on their role as MH providers. They are here on the same terms as the rest of us. And my experience so far is that my colleagues here are very open to feedback regarding what articles are posted, so I encourage you strongly to let one of the editors know if you feel an article that’s posted is or has been offensive to you or to the survivor community in general. It’s very easy for those who have not been there to misunderstand why some subjects or comments or attitudes might be hurtful to those already hurt by the system.
Let’s keep talking!
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Now THAT is ominous!
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Thank you, Uprising! I hope I live up to expectations, but if I don’t, feel free to let me know!
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Most “treatment providers” have no idea what “individualized treatment” actually means. I think they believe it’s about choosing the drugs they give you on an individual basis rather than giving the same drugs to everyone. I’m not surprised you have not experienced anything that looks like it.
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Hi, Kindred!
Speaking as the moderator here, I wanted you to notice that I never used the term “civility” in my blog, and that was a very purposeful decision. I don’t want us to ever convey that it’s not OK to express anger and rage toward those who are in a position to harm us. There is, in fact, no actual shift in what will and won’t be allowed – I was being very specific in stating that the main issue is PERSONALIZATION, not the position being expressed. If you will re-read my blog, you’ll see that I was very clear about stating that any position on the spectrum is welcome to be stated and supported, from “psychiatry saved my life” to “psychiatry should be abolished.” I had hoped that would provide some reassurance that there is no intent to censor or discourage any viewpoint here. I’ve seen some legitimate concern expressed that professional voices have felt more protected in the past, and I specifically addressed that too, by suggesting that we be very cautious about attacking people’s personal experiences, while counseling professional commenters to develop a thicker skin.
It is hard to see how else to conduct a discussion forum without some expectation of decent treatment of posters. Otherwise, we get de facto censorship, as people with certain views will be too intimidated to ever post. Like I said in the blog, I’m sure this happens anyway with “mainstream” folks – 5 minutes reading comments or even half the articles would drive most of such committed pro-DSM folks running from the building! But I want people to be able to post whatever content they feel is relevant, and I want a principled discussion of facts and experiences to be the way issues are resolved, rather than by ad hominem attacks or resorts to degrees or other authority or humiliation and condescension. I have faith that the truth will win out in any such discussion, and it seems to me that sinking to personal attacks actually undermines the power of the truth to break through the mythology that passes for “mental health care” these days.
What’s the other solution? “Moderating” anyone who is not sufficiently ‘antipsychiatry’ or who expresses a view that people here don’t like? It seems to me that allowing an open expression of viewpoints to compete in the “marketplace of ideas” is the best way to boil down the truth and break through the psychiatric religion’s dogma. While I don’t relish the idea that folks with pro-psychiatry views come and post here, I think enforcing the commenting policies on everyone will in the end empower those who can be most easily shouted down, namely those who have directly experienced the massive power of the psychiatric juggernaut aimed at their bodies and their persons.
I’m seriously asking, though. What do you think would be the best moderation policy? What could we put in place that is better than saying, “You get to say anything you want, but you can’t attack people in a personal way?”
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True enough! And there is lots of money in selling drugs, while there’s a lot less in investigating whether drugs really work or whether other approaches work better. There are many effective “alternative” approaches to pain management that have been known about for decades, some for centuries, but unless someone can get a patent on it, we’re probably not going to see mainstream medicine supporting it any time soon.
Thanks for your reply!
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Apparently not. Or else they are writing only to their colleagues, considering the actual patients/clients to be too far beneath them to bother talking to.
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I think doctors work in a ridiculously over-competitive and stressful environment, and at some level recognize the degree to which their profession has become subservient to the all-powerful pharmaceutical industry. Psychiatrists in particular, at least those with consciences, must feel pretty hopeless at the utter ineffectualness of their approach, and their inability to pursue another course without quitting their profession or going completely rogue. I would further guess that the profession weeds out those with high “emotional intelligence” early in the process, so those who remain will have relatively high authoritarian traits that prevent any real self-examination. Sounds like a pretty hopeless place to be.
Though I do find it interesting that articles I’ve read about physician suicide rates all talk about the stresses of the training and the job, the lack of sleep, etc. but when these same physicians see “depressed” patients, they spend all their time talking about “bad brain chemistry.” Kind of a disconnect there, eh?
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Besides which, it could cost some people BIG money!
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That is exactly how I experienced it. I held to my integrity as best I could, but it was not safe to talk about certain things, and certainly not safe to challenge the status quo. When I did so, I was most definitely marginalized. To maintain my ability to empathize with the clients and at the same time fend off the wrong-headed approach that was almost a 100% agreement among the staff was a constant stress that eventually drove me out of the field entirely.
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That makes a lot of sense to me. It appears you see both sides of the dilemma very clearly.
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I’m just writing as myself here. I’m a little confused as to where there was a desire expressed to court NAMI or “the pro-psych crowd” to become “fans” of MIA. I’ve seen what happens to anyone who comes here to post with a pro-NAMI or pro-medical model viewpoint – they are properly put in their place in short order, and I don’t see anything suggesting that will stop happening. I’m honestly asking this question – where do you see that position put forward?
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In fact, what the title REALLY should read is, “Experts show that ADHD diagnosis does not predict adult functioning.” That’s what the experiment showed.
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Posting as moderator here. I would have to say that I have no intention of making the comments section “less controversial or passionate” or even “less lively.” I think if you read through my blog, you’ll see that there is still plenty of room for controversy and passion without being insulting or attacking.
You make a good point regarding more specific details of the feedback perhaps being shared. As for the survey questions, also legitimate points worthy of careful thought for future surveys. Crafting survey questions is an art form that I certainly have not mastered by any stretch of the imagination!
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Hi, Richard!
Do you have hard data on that point of chronic pain not being specifically linked to suicide? I’d love to see a link or two if you do. The claim of such a connection is very common in claiming the need for “antidepressants” for those with chronic pain, and I’d love to have something scientific to use against such arguments if you have it.
Thanks in advance!
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Very well put!
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I am absolutely committed to the same standards for everyone, and if you see me flagging from that commitment, please let me know right away.
Personally, (meaning that I’m NOT representing MIA below), I see any advocate for AOT or “Anosognosia” or any other kind of dehumanizing crap having their views quickly and effectively dissected by this group without any help from me. That’s the beauty of an “open forum” to me – those who claim such positions need to defend them, and there is more than enough intellectual clout and knowledge of the real data, as well as brutally contradictory personal experiences, to show up any such claims as the BS that they are. The reason I think it’s important to have moderation on these comments is that such presentations come across MUCH more effectively when they are presented without personal attacks or rancor. In the field of psychiatry, the truth speaks for itself very loudly, and our job is more undermining the mythology that the truth doesn’t fit with. Unfortunately, calling names and attacking categories of people makes it easier for the myth-makers to say, “See, those guys are all crazy, don’t listen to them.” I’ve always found that a passionate but respectful recitation of the true facts, followed by some solid Socratic method towards the misguided poster, is much more effective than calling them names.
Anyway, thanks for your support!
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It seems the proper conclusion would be, “We (the professionals) really suck at predicting anything to do with ‘depression’ and should give up on our ridiculous tests and just ASK people what’s going on, since that appears to give much more accurate and useful results.” Your point about pronouns is very well taken, as well – why does “we” not include the client “we” are supposed to be helping? Perhaps this is the center of “our” difficulty in predicting “depression?” Perhaps “we” need to give up on the idea that “depression” is a thing to be measured in the first place?
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I just scratch my head when I read these things. Are they not scientists? They are SO biased, they are searching for certain results, and when they don’t get them, they are “disappointed.” This is actually a very helpful study, because it shows that “having ADHD” as a child is NOT associated with negative long-term outcomes. The conclusion should not be that “predicting the course of children with ‘ADHD’ remains a challenge.” It should be that “Our original hypothesis was disproven – an ‘ADHD’ diagnosis does not lead to worse outcomes as an adult.”
As for the proviso about children with “conduct disorders,” that’s meaningless, because it’s been determined long before that kids with ‘ADHD’ and ‘conduct disorder’ diagnoses do have later troubles in live, while those who “just have ADHD” do just as well as their peers. And when you consider that “conduct disorder” just means kids who are mean and selfish, what we have is that mean and selfish kids grow into mean and selfish adults, a trivial result that should surprise no one. It was, in fact, very smart to isolate “ADHD” in kids not diagnosed with “conduct disorder,” because now we can see that having the “ADHD” characteristics in and of themselves has NO EFFECT on whether or not a kid turns out to be a successful adult.
But I guess the authors just can’t accept the conclusion that the data tells them is true. They need to hold onto their reality despite the data, which means they’re not scientists after all.
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Right, we wouldn’t want people trying things and not always succeeding – it will torpedo their self esteem! The proper action is to discourage them from trying anything at all by telling them they are incapable of both the action they want to AND of handling the disappointment if they are unsuccessful. THAT is a SURE way to make someone feel good about themselves!
Seriously, if you wanted to make someone feel as bad about themselves as you can, it would be hard to imagine a more effective course of doing so than telling someone they can’t handle trying something they are not assured of succeeding at. It makes me wonder how “accidental” this approach could be. It’s pretty freakin’ evil!
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The government can apparently read anything we post anywhere if they’re really interested. I have personally stopped worrying about it. I’m sure they are bored to tears with most of what I write.
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I did not know that! Though I have to say, any film John Wayne felt was “unamerican” is probably worth watching in my book.
You are a treasure trove of new information!
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How about “Study leads to reduction of malpractice in nursing homes?”
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Devastatingly true analysis. Sometimes the story they want you to believe is even worse than the drugs!
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Good points, all. Access and time are huge factors in who chooses to post or is able to even consider it.
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Or are those who are making money off of selling them.
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I wonder also how a refocusing of attention away from external environmental factors and toward brain chemistry manipulation contributes to people losing hope and increasing self-blame for their “condition.” Perhaps it’s easier not to feel hopeless if you can find an external condition that you CAN change and focus your energy on regaining control in that area. I’ve found that the most helpful thing for people who are feeling depressed is acknowledging that their feelings are a normal or at least not unusual reaction to the conditions of their life, and then focusing on one aspect of their lives, no matter how small, that they can exert some control over. Suggesting that “it’s all in your brain” may create a sense of hopelessness, as what can one do about one’s own brain chemistry?
Of course, there really ARE things one can do about one’s own brain chemistry, but that’s material for a different blog.
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Thanks!
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That is an excellent point! I think that would be very helpful, but I don’t know the answer to that. I’ll research it for y’all and get back to you.
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This was pointed out by another reader. I thought I was being “funny,” but it turns out I was being insensitive. I appreciate your observation – it shows how deeply these concepts of power are embedded in our culture and how easy it is for a person in a power position (like me) to make such “jokes” without understanding the impact it might have on someone in a less powerful place in our social hierarchies.
My apologies!
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Thanks!
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And I am learning! I will very much value any helpful tips or feedback you have in mind. Thanks!
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Thanks for the clarification. I expect it to be a very interesting process! Any ideas or observations you have to assist will be appreciated.
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Hey, I’ve had a few moderated myself, John!
Thanks for your support. The purpose of moderation isn’t censorship, it’s creating a workable community. I’m glad you appreciate that distinction!
—- Steve
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I always read anything potentially controversial over three or four times before I post it. When I haven’t, I’ve sometimes regretted it deeply!
The Sheriff idea was most definitely intended as humor. I think my job will be more like a referee!
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Your last point is probably a good one. And I wouldn’t mind using the DSM as a conflict resolution tool in the way you suggest, but I would hate to send a penny to the authors. Perhaps we can use toilet paper instead – the value would be the same, but at least the toilet paper manufacturers are honest about its intended use.
I very much appreciate your support and advice. Sarcasm is probably the hardest thing to moderate. And I agree that there will be some hot items where this could get VERY interesting…
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Exactly what I’m talking about. Thanks for clarifying and extending the concept – credibility of the poster AND of our site is what is at stake! I think we are MUCH better off when we are specific and pointed in our criticism. When we drop to ad hominem attacks and sweeping generalizations, it is much easier to attack or dismiss us as unstable or uneducated. First-hand experience with specific details is what really gets past people’s defenses.
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Sometimes anarchy is, indeed, what is needed. Unfortunately, anarchy and discussion boards don’t go together very well. Perhaps the discussion board can be a place to organize some effective anarchy, eh?
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Much appreciated!
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I don’t intend to be a censor. I intend to make sure that people aren’t mean and nasty to each other. That’s all. It really won’t be that different from what’s been happening all along. I’m just trying to be clear about what I’m intending so no one is surprised. So far, I’ve moderated two posts out of the last 5 days, so I don’t think it’s going to be as much of an impact as some folks are imagining.
Thanks for your perspectives – you are clearly a person of great intelligence and learning. I’ve still GOT to read Hillman – got any suggestions on where to start?
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Thank you! That means a lot to me!
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Thanks for your comments and your willingness to give me a shot!
I can say from my viewpoint that I don’t think there is any resistance to the idea that “rethinking” may include abolition. Bob and all the top editors looked over this blog and supported it 100%. I believe I’ll be supported fully in allowing content from across the spectrum of opinion, as long as it is stated within the guidelines.
I agree (and said so in the blog) that there is a lot more “wiggle room” in the insulting a group concept. A big part of my desire to make this a priority is that I believe making generalizations about “the mentally ill” or some diagnostic category is very much accepted in our society, and not even noticed in many cases. So I’d really appreciate it if you let me know if you feel like I’m missing such instances. I think it is very good discipline for anyone to think carefully about generalizing, because generalization is the beginning of bigotry. Even if the generalization applies to 80% of a group, there is still 20% being unfairly disrespected. That’s my take on it, anyway. So I really want us to be specific about who we are talking about and to own our own experiences, whether we’re professionals or survivors or family members or just interested parties checking out the site.
You may also note that “feeling insulted” isn’t the standard for moderation. I provided 5 different options for people who feel insulted, including reporting the comment. Just because it’s reported doesn’t mean it will get moderated. The one thing I wish I had was the ability to communicate to the person reporting a comment to find out what they are upset about, because sometimes I can’t figure out what the issue was. I suppose someone could e-mail me with their concern to add clarification. Anyway, my point is that the standard is not someone FEELING insulted, it’s if a reasonable person would consider it insulting. And it is sometimes going to be a close call. This is why I included the “thick skinned” comment in the blog.
Anyway, I’m going to do my best, and I’m sure I’ll make errors, and I’ll count on you to help keep me on mission. Thanks again for your comments and your good wishes!
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What are you afraid is going to happen?
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Thanks, J!
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Thanks, Steve! We “Steves” have to stick together, eh?
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Thanks, Alex!
Do I detect a slight note of skepticism?
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And I’m not necessarily going for embracing in fellowship, but putting those swords down or at least sheathing them for the moment would be lovely!
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As I like to say, “Generalizations are always wrong!”
I appreciate your support. I think the distinction between attacking ideas vs. people is the most important part of this approach. I know that there is some concern that certain views are more likely to be edited because they are uncomfortable for professionals to hear, and I wanted to make clear that is in no way ever going to happen.
We’ll see how it goes!
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Not sure they could pay me enough to moderate that particular discussion at the moment!
Thanks!
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I agree. Most of the “data” in support of long-term antipsychotic use is based on withdrawal studies, which completely fail to take supersensitivity and withdrawal effects into accounts (primarily because they want to pretend that such effects don’t actually exist). It’s pretty warped!
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SSRIs are associated with an increase in behavior that gets labeled “autistic.” Massive increases in SSRI use by pregnant women may be a contributing factor.
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I agree absolutely. That’s why I had to quit.
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I think there is a LOT of room between “expand the mental health system” and making career patients or “peer specialists” who support the system and the suggestion that some seem to make that any form of assistance offered to people experiencing mental or emotional distress from a professional source is de facto oppression. I guess that’s my definition of “strict abolitionist position” – no professional assistance may be offered for any form of mental/emotional distress. My understanding is that you have no objection to the latter when force is eliminated. I have absolutely agreed with you that the use of force as “treatment” (which includes manipulation, threats, lying, enforcing “diagnoses” to get insurance reimbursement, and so on) is wrong and needs to be eliminated.
What about my example of altering the system to meet the needs of kids (or adults), rather than “treating” those who don’t “adjust” to the authoritarian system that we’re supposed to all love?
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And as for “playing favorites,” we’ll have to see how it plays out, but I have trust enough in the MIA community to believe that well-articulated antipsychiatry comments that are truthful and compelling in their presentation will get plenty of “likes”. They’ll definitely get some from me!
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If there is no coercion, the decision whether or not something is “wrong” would be up to the person seeking “treatment” or “help.” Of course, there are also ways of making one’s life better that don’t start off with the assumption there is something “wrong” with you to begin with. For instance, we know from research that so-called “ADHD” kids are virtually indistinguishable from “normal” kids in a less structured classroom where kids have choices about what they do and how long they do the activity. Such classrooms have been around since the 70s and before, but they fell out of political favor. Would it be too “revisionist” to create classrooms that these kids actually enjoy being in? This could “cure” most cases of “ADHD” without any diagnosis or force whatsoever. (Of course, there is also the much larger question of the use of force in the educational system, or with kids in general, but that’s a bit bigger than this moment’s discussion.)
There are all kinds of ways that people seek help, and some people find things helpful that I don’t. I think that should be up to the individual, but I also think that sharing these viewpoints and experiences is very valuable to many who read here. I think that’s the part of the discussion we lose out on if we insist on a strict “abolitionist” viewpoint. Besides which, a lot of people start out as “revisionists” and become more radical by reading stuff by folks like you. I don’t think we want to chase those people away because they are not “radical” enough yet, do you?
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Yeah, how do they get away with that? Not, “I wasn’t able to help you” or “I haven’t been able to figure out what you need” or even “We seemed to be unable to connect,” but instead, “You have ‘treatment resistant depression?'” What a freakin’ cop out!
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“Decent people following orders” is the core of why the system doesn’t collapse of its own weight. If these “decent people” followed their instincts, there would be a huge uprising against the system as it is. I am not saying it is easy to resist, as I was an “insider” for many years and found that resistance to the status quo was punished in various ways, from ridicule to ignoring to dismissing me as “one of those anti-med guys.” I had very little support from colleagues, even though behind the scenes I found that many agreed with my basic principles. It’s scary to stand up, but if you don’t, it’s tacit approval of the system. That’s why I eventually got out of the “mental health” world and into advocacy. I could no longer deal with the moral compromises I needed to make to stay in there, even though the ones who managed to see me instead of someone else were probably much better off because I was there.
It’s a tough line to draw, but I eventually concluded that participation was becoming collusion, and I had to bail.
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I have heard many people make this exact comparison, including people who have experienced both. Are you suggesting that the people in the hospital ER have no other option besides Haldol injections, or that we ought to be well informed enough to know this and therefore avoid getting taken to the ER?
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I agree with you – some medical diagnoses do have their own attached stigma. But I think psychiatric diagnoses are the only field where stigmatization occurs primarily BECAUSE of the label put on a person. “AIDS” is associated with being gay or being a needle-user and those categories are a primary the source of the discriminatory attitudes, although any communicable disease can certainly create anxiety and discrimination (remember leprosy!) My point is that in the realm of psychiatric diagnosis, this trend is avoidable by simply choosing not to toss the label at a person. A person with AIDS has AIDS, and there may be attached discrimination and prejudice, but the person gets the label because they literally have something wrong with their bodies that is observable and undeniable. But someone who feels anxious in social situations – well, they’re ANXIOUS, it’s a normal human emotion, and it’s not necessary to go out of our way to identify that person as “disordered” and bring on additional distancing and discrimination when we could to the opposite by reminding people that everyone is anxious sometimes and that it’s OK to be anxious and that we can all be sensitive to shy people and help create circumstances where they will feel more welcome.
So yes, I get it, there are stigmatizing labels associated with medical diagnoses. But I see that as different from the CREATED stigma that result from the idiotic practice of labeling people’s behavior or emotions as “disordered” instead of trying to help the person or alter the social circumstances that create such anxiety/depression/distress in the first place.
I hope that makes some sense!
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Right you are! “Antipsychiatry” has been rebranded by the psychiatric profession as “anti-science,” which ironically and subtly supports the idea that psychiatry is somehow scientific despite it’s own admission that not one of its diagnoses can be objectively distinguished from another diagnosis or from “normal” (the admission is right in the intro to the DSM!)
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I’m not sure I agree, Frank. It appears entirely possible that the “likes” would go toward those posts which do have an abolitionist slant. It’s also possible they’d go toward the ones which are most thoughtful, regardless of the position taken. I think it will be interesting to see how it pans out, but it also sounds like you don’t have to “filter” if you don’t want to. My guess is that it will bring more readers who don’t want to or have time to wade through every comment.
Of course, I agree with you that the system as it is has essentially no redeemable qualities. Forced drugs, locking people up, lying about “causes” to make money, creating permanent customers, creating “diagnoses” that have no basis in reality, blaming the resultant prejudice and discrimination that arises as “stigma” and asking for MORE money to continue to stigmatize their “customers,” ignoring trauma and social conditions… it’s hard to think of one thing “the system” does right. But I’m also very willing to listen to people who see it differently, not because I necessarily agree with them, but because their reality deserves to be heard, and also because anyone who is having problems with the current paradigm is a potential ally.
I actually align pretty well with your “free choice” concepts, which does allow for various kinds of services to be sold to people who feel they need them. Some of the “rethinkers” who post here are developing that kind of service, and I always find it interesting to see what people are finding helpful. My biggest objection of all to the system as it is would be that it assumes that we can classify people based on their behavior and emotions and somehow know that they all need the same “treatment” regardless of their individual circumstances. Anything that moves us in a direction AWAY from that concept and TOWARD an individualized and empowered approach is worth reading about in my book.
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Richard, a great outline of the social/emotional motivations that may lie behind “manic” behavior! We’d be so much better off if we started there. But who would make profits off of helping people understand their motivations better?
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So “manic” is a kind of shorthand to describe this set of behaviors. I get that. The question, I think, is whether by using this kind of technical jargon as shorthand, we induce or support the belief that the problem lies solely or primarily in the person showing the behavior. To take a less loaded example, “ADHD” can be used as shorthand for a certain set of behavior that tends to occur together. However, saying that this kid “is hyperactive” or “is ADHD” or “Shows ‘ADHD’ symptoms” immediately brings the child in as “the problem.” As I’m sure you’re aware, family systems theory talks extensively about assigning roles to different people in the family, including the role of “scapegoat” or “identified patient.” I believe the same thing happens among professionals, and of course, the likely “identified patient” is the patient, the client, the person with the least power.
So for me, I think we’d be better off saying, “Mary is staying up all night, engaging in seemingly random sexual encounters, and speaking rapidly without allowing interaction” rather than “Mary is manic” or “Mary’s having a manic episode.” I know it costs more words to say, but it requires us to be more precise and doesn’t imply any particular “wrongness” of the behavior, but simply allows it to be described in a less judgmental way. It also, I think, encourages a further discussion of causes and environmental conditions, rather than automatically situating the cause with Mary.
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From one point of view, it does make sense. I guess the question people struggle with is whether a real change in how things are done can be accomplished without challenging the “guys with power.” I think on an individual level, your approach is probably very wise. However, it seems unlikely that the people making so much money on this racket are going to give up their power without a fight. So if enough people get together, maybe it DOES make sense to take on the “big guns.” Hope that makes some sense!
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You often repeat this. I’m not sure what you mean. Why is “antipsychiatry” going to make things worse?
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We should start by listening to them. Children are the most disempowered group in the world. The odds are tremendous that their feelings of hopelessness have to do with being in a hopeless situation that they are unable to fix or escape.
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“Mania” is simply a description of a certain set of behaviors that tend to occur together. I don’t think anyone said a person who is struggling doesn’t need any help. However, I think using the term “mania” does tend to pull things into a medicalized viewpoint. It seems more legitimate to me to talk about exactly what is happening for the person, rather than creating a generalized category like “mania.” It’s similar to talking about “depression” as if it were a “thing” such that everyone who “has depression” is the same or very similar. It also suggests that “depression” (or “mania”) is the problem, rather than a manifestation of a set of much more complex circumstances that can’t be described by a single word or phrase. Calling it “mania,” I think, discourages looking for causes and environmental conditions and focuses the attention on the “wrongness” of the behavior.
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I agree, it is easy to make generalizations about therapists. There is a huge range of therapists out there with different philosophies and priorities. It is unfortunate that more and more new therapists are being trained in the DSM terminology and that insurance companies are expecting DSM diagnoses for payment. Which means that only people with enough money to afford private pay can have the range of choices that are available. But it is certainly not right to generalize about therapists as a group – they are really quite diverse, especially once you get outside of a public “mental health” agency setting.
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I had a similar reaction. The ability for the first child to act out his fantasy knowing that his family is there to back him up and help him out of things go badly has to make a huge difference in his ability to let him self go in this way safely. And there is a HUGE correlation between sexual abuse and what is generally considered “psychotic” behavior. (I won’t even get into the gender bias in the descriptions of the behavior, as I feel it’s been covered well by two other posters). While I respect the effort to contextualize “manic” behavior, the author really doesn’t provide any means to differentiate between “healthy” and “unhealthy” manic behavior. Which reinforces my own belief that behavior isn’t “healthy” or “unhealthy,” it is just how someone acts, and is meaningless without understanding their motivations and experience and the social supports and/or barriers they may be facing.
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Yeah, too bad most psychiatrists don’t seem to have gotten this memo. I have rarely seen any psychiatrist pull back on antidepressants or stimulants due to an induced manic episode.
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As baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were that common, more people would have it!”
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It is fascinating how this discussion completely avoids the subjective and speculative nature of these diagnoses as the major reason why their is a discussion of “to diagnose or not to diagnose.” Diagnoses shouldn’t be decided on based on how someone FEELS! They should be decided on by an objective observation of a specific problem that can be accurately identified and potentially intervened upon. No one talks about whether a “cancer” or a “flu” diagnosis has potentially positive or negative social consequences! When you have the flu, you have the freakin’ flu, and we all know what that means (more or less) and what your options are. It is only the subjective and frankly disrespectful and invalidative nature of these diagnoses themselves that lead to such questions. No one feels their identity enhanced or invalidated by a diagnosis of “cancer.” They might be able to connect with other cancer patients because they have something in common, but the diagnosis isn’t given for that purpose. It’s given so they’ll know what they’re up against and have some idea how to attack the problem. It is ridiculous to talk about the social benefits/costs of any real diagnosis. The fact that it is even a discussion for psych diagnosis indicates the complete lack of scientific validity behind the diagnostic process.
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Yup. Black Box warning on those for dementia, yet they are used on them all the time without any accountability.
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It was proven decades ago that stimulants don’t affect “ADHD” people any differently than “normal” people. There is no “paradoxical effect,” as seems to be implied by this article’s title. As you say, any difference that may exist is at most attributable to tolerance effects if someone has been using for a while. So if it impairs cognitive performance on “non-ADHD” students, it impairs it for “ADHD” students as well!
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The fact that professionals have to be so careful about giving out legitimate information shows just how oppressive the system has become. If we, the ones supposedly with the power, are afraid to speak up, just think what that would mean about the position of the poor clients, whose lives can be destroyed by saying the wrong thing!
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This is pitiful but not at all surprising to me. That’s how crazy it has become. The doctors are gods and no one can question them, or even provide missing parts of “informed consent.” It is an incredibly dangerous scenario, and we see the kind of damage that this set of assumptions can do.
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Wow, “Whack in!” How uncommonly honest of them. Suggests that anyone wanting to avoid being “whacked” should stay far away from them!
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I agree 100%. My first question to anyone I’d see now in a therapeutic setting would be, “What other ‘treatment’ have you received before? And how did you feel about it?” Same question re: diagnoses. It’s essential at this point, because so many have been harmed by their “treatment.”
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Wow! Powerful words and true. Thanks for sharing your story in such striking form.
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We had our own “Adam.” He was definitely a tough kid to work with, and our own issues definitely contributed to his lack of discipline. I really don’t subscribe to this “don’t blame the parent” concept. OF COURSE, it has something to do with how you’re treating the child. It is silly to imagine that a parent’s behavior has no effect on the child’s. And OF COURSE, the child also contributes by virtue of their own personality and intentions. To solve the problems in any family, it requires everyone to work together and own their own contributions to the system. It’s not a matter of blame, it’s a matter of shared responsibility. No judgment needs to be passed – it’s just a simple fact of life that a system is composed of all of its parts, and any change in one part of the system affects all the other parts. If we can stop worrying about who is “being blamed” and instead focus on what can be DONE to alter the situation in a positive way, we’ll make a lot more progress.
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Hey, some people change their lives for the better after near-death experiences from car crashes and the like. Maybe we should push people in front of cars as a form of “treatment?” Sure, a lot will die, but a few may get a new lease on life, and the rest can keep taking pharmaceuticals for decades.
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Thank you!
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Equally disgusting!
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I don’t know anybody who doesn’t think biology plays a role in how we feel and act. The objection to psychiatry is not that it involves biology. The objection I have is that 1) psychiatry claims to understand the causes of “mental illness” when it does not; 2) psychiatry pretends that those causes are primarily or exclusively biological (ignoring psychological, social and/or spiritual issues entirely, and also ignoring nutrition, btw); 3) psychiatry lies about the effectiveness/dangers of their drugs (because they are corrupted by pharmaceutical company money!) and 4) psychiatry relies on the legal system to force “treatment” on people who knowingly decline to use it, violating people’s human rights with impunity.
Biological impacts on behavior are very real, as anyone who has missed a couple nights of sleep in a row or not eaten all day can easily attest. It’s not about denying biology – it’s about resisting a false narrative that’s driven by corruption and power dynamics which doesn’t really lead to healing in most cases, and in many leads to further damage that the psychiatric profession is unwilling to take responsibility for.
— Steve
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Another amazing study result. People who are treated like crap end up feeling bad compared to those who aren’t. Glad we spent THAT research money well…
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I don’t hear any “antipsychiatry persons” complaining about this article. I think it’s awesome that people are researching how nutrition affects our mental/emotional well being. The main objection I’ve heard in the past to Julia’s commentaries is only that she uses DSM categories in her published research. I understand her reasons for this AND the reasons why people object to it, and both have good points. But that doesn’t take away from the rather obvious fact that what we eat affects how we feel. I don’t think that an “antipsychiatry” position in any way prevents one from believing that nutritional variables affect one’s mental/emotional state.
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Oldhead is doing fine. He’ll be back soon.
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I read parts of a couple of the articles and some comments on the latter link you shared. ABSOLUTELY DISGUSTING! This guy is not a “therapist,” he’s a mysogynistic creep!
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I agree. The oppressors mostly need some kind of motivation to alter their view of things, and they will usually violently resist altering that view, because their viewpoint benefits them and altering it causes them to lose their comfortable and dominant position in the hierarchy.
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Well done! I love hearing stories from people who actually know how to talk to someone without telling them what to think.
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Ha! Good one – I’ll have to make a note of that!
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Wow, that is truly horrifying and disgusting! I only wish I were surprised by it. One of the DSM’s primary purposes was to avoid looking for actual causes of any “mental disorder,” which of course means that the powerful get to blame the powerless and use their “reactions” against them. I only wish the Courts were more aware of how this works, because an incredible amount of damage is done by abusers using the court and “mental health” system to drive their victims further into the mud!
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In other words, everyone is an individual and what an individual needs or wants in order to move forward will be, well, gosh, INDIVIDUAL! This certainly supports my contention that the first rule of quality therapy, or any helping effort, is HUMILITY! What we know about groups is, at best, a probability distribution. Trying to apply the same approach to everyone based on a “diagnosis” or even a similar set of “symptoms” is both dangerous and foolish. Which kinda undermines the entire mental health system, doesn’t it?
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This is very true, and was proven back in the late 70s. And the higher the dosage, the more the impairment. Anything more than a very small dosage led to cognitive decline. The slant of the article seemed to be “if you don’t have ‘ADHD,’ you shouldn’t take these drugs,” but it appears that no one really “benefits” from them for more than a very short time of “mood enhancement” (aka getting high).
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Naturally, they neglect to mention that stimulants have the same lack of enhancement of cognitive effect and all the rest on “non-ADHD” students. Judith Rappoport et. al. proved way back in about 1978 that stimulants don’t act differently on “ADHD”-labeled students – they have the same effects on everyone.
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The replacement will only be better if those who replace it have different intentions in designing the new system. Otherwise, it will be “meet the new boss, same as the old boss.” So we have to work on being clear ourselves about our intentions and keep that clarity as we work for change. But there is no way that change happens until/unless the reality of the current system is thoroughly exposed and discredited.
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Those unethical bastards! They are giving the prescribers and the drug companies a bad name!!!
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Systems may evolve, but the basic purpose behind them generally does not. Look at the public school system. It’s initial purpose, back in the 1800s, was to create “good citizens” out of freed slaves and incoming immigrants from Ireland, China, and southern and eastern Europe. This meant teaching these kids to grow up and become good factory workers. Public education has gone through huge reforms in waves since the early 1900s, and in many ways looks very different today than it did then. And yet, the main message of school is for kids to follow the authority of the teachers, to start and stop when the bell rings, and not to create any problems. In essence, they are still training factory workers, and they don’t even remember why. The “mental health system” will be the same. Its purpose was never to heal – it was to remove problematic people from the general populace and to make a lot of money for certain people. This is not to say that individuals within this system are not sincere and even very capable in helping people figure out how to empower themselves and improve their lives. It is saying that the system will always keep such people under control or fire them if they get too far out of line, because truly empowering people challenges the power of those running the show.
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In the case of Noel Hunter, I can’t agree. She’s a warrior behind the lines.
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I agree. I believe most clinicians are fearful and unconscious of their intentions and the motivation behind their actions. There are some at the top of the food chain who are very much aware of what is happening and are involved in intentional obfuscation, but most of the rank and file are either uninformed sycophants who are trying to do what they were trained to do by “the system,” or (a smaller number) people who enjoy having power over others and like being in a position of dominance for whatever reason. There are some who actually understand how to connect with patients/clients, but they are always in the minority and are oppressed at any time they try and question how the system works, because those power people don’t want to give up their power.
So in my view, those in power don’t really understand or particularly care whether or not they are harming their clients. They are absorbed in their own needs and act that out toward their clients, mostly without even realizing what they’re doing. I’d estimate that the large majority genuinely NEED to believe they are helping, which is what makes it so damned difficult to communicate this kind of viewpoint to them.,
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Noel is amazing, and thanks, Bruce, for your on-point interview.
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Any group you name will have a percentage who commit violent crimes. It is only bigotry that LOOKS for examples to prove that a particular group is “worse” than others. I am reminded of the rhetoric about “immigrants” being “criminals” and “rapists” when the actual data shows that the illegal immigrant population has a slightly LOWER rate of crime than the general US population. But you can pick out an example where one Latino immigrant is violent and say, “See, he’s right, THEY are so violent!” There is really no difference between this and saying “mental illness causes violence.” It’s bigotry, 100%.
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Exactly so!
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Indeed it does!
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It actually goes beyond the idea of “drug treatments being the last resort.” It goes to “treating” things that aren’t unhealthy but are merely inconvenient or threatening to the adults. So it moves away from helping kids who need help into suppressing dissent or oppressing indications of stress or failure of the classroom or school system. I don’t see it as a matter of “overdiagnosing” or “overtreating” – it’s a matter of overt oppression that is built into the ‘education system.’ For reasons which I could go into in great detail, these childhood “diagnoses” are incredibly destructive toward kids who just don’t happen to fit into what the adults expect of them. And mostly, what they expect is for kids to do as they are told and not make too much noise or trouble. To use drugs to keep kids in line when there is strong evidence that there are many other, more effective and more supportive ways to accomplish these goals, is nothing short of evil.
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Very true. It’s just that people don’t view “white music” as representing the “white race” nearly as often.
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I think it’s a lot more subtle than that, Shaun. I think people’s “dissidence” is what is being drugged, not specific to a particular instance of political dissidence. It’s much more preemptive. For instance, a kid doesn’t like going to school, it’s boring, seems pointless, the teachers have arbitrary power over the kids, the other kids are suffering but say nothing, etc. This kid (a 6 year old) starts to rebel in whatever ways he can, maybe not even conscious of why, but knowing he is encountering oppression and must oppose it. He is punished for this but continues to rebel. He is then routed to the “mental health professionals” because he “can’t pay attention” and is “oppositional and defiant.” He is diagnosed with ADHD/ODD and given drugs so he will fit in better to the artificial school environment. Somehow, he is thwarted despite his efforts, and he knows it, but not exactly how or why. He’s given the message that his rebellion was a mistake, a failure of his brain, but more importantly, he gets the message that he will never be able to succeed against the power of the system. So he never grows up to be the rebel or the political organizer or the radical songwriter, because he’s learned that there is no point.
Obviously, this doesn’t happen to all rebels – some avoid drugging, some see it for what it is and push through it anyway, but it thins the ranks considerably. And it makes it easier for society as a whole to dismiss such people as “mentally ill” and pay no attention to their ideas.
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100% agreed. They are confusing effect with cause, as usual.
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Why could there not be voluntary Soteria Houses out there for people who like them?
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There should be safe places for people to go when they are feeling unsafe. No “treatment” is needed, just a place where it’s OK to be who you are and not have to “fix things” and not have to “be productive” and “manage your symptoms” and so on. Soteria House is a great example, as was the Quaker concept of taking folks out into the country and having people walk and talk with them in a calming environment. The idea that one needs a hospital because one is feeling stressed and finding the environment overwhelming is ridiculous. It puts the blame on the person having a hard time with the crazy environment rather than looking at what is going on around them in their lives. It is sad that the hospital seems to be the only option for someone feeling unsafe and seeking support.
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I also think it’s important to recognize that the urban environment itself, which has massively increased as a result of industrialization, contributes to deterioration of people’s “mental health.” Disconnection from community, absence of green spaces, high mobility, large income differential, planning dominated by commercial interests – all of this contributes to the emergence of mental/spiritual distress, as it is not a healthy environment to live in. Adolescence itself appears to be a consequence of the industrial revolution. There is something in the very fabric of how we live that makes people “crazy,” IMHO.
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It is very easy to make gross generalizations about rap. My son has exposed me to a lot of highly socially conscious rap, including rap that makes fun of commercialized rap itself. It is a very diverse medium.
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Well, we really don’t, because obviously the ER is not a safe place. You are in constant danger of being forcibly detained, restrained, drugged, or whatever if you say/do the wrong things. I’m talking about a safe place, like Soteria House, where people will listen to you and not hurt you and be there with you. It’s not an “alternative,” it’s a completely different concept. And it’s very possible, if we can all wake up enough to make it happen.
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Well, I will keep my fingers crossed for you that a miracle occurs.
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As a person who has seen a lot of court hearings, I concur with Oldhead that this is way too much information for the judge to digest. It’s also important to keep in mind that most judges are incurably biased toward believing the “mental health” narrative.
My suggestion would be to keep it short and simple. Bullet points would be best.
What the judge wants to know is:
1) Does the person in question qualify for a “mental disorder” diagnosis. This one is a tough argument to handle, because they’ll have their “experts” and there is no objective way to argue against it. If you want to argue this point, you’d probably need an expert witness on your side to show how you no longer “meet the criteria” for whatever “disorder” they’re claiming you have. Arguing that psych disorders are subjective and meaningless won’t get you anywhere, in my view.
2) Are you a danger to yourself and/or others? This is the one where you have the best odds of success. I’d focus on what has been happening in the last X period of time, and challenge them to point out any time that you have endangered yourself or anyone else in recent times.
3) The AOT argument: Will you deteriorate and BECOME a danger to yourself or someone else if you discontinue “treatment.” Expert witness would again do you very well here. I’m not sure where the burden of proof lies, but I’m guessing it’s a mere “preponderance of evidence.” You’d have to look in your state. This is where you would demonstrate that you have already been successful in behaving in safe ways when you have NOT been “in treatment”. Not sure what evidence you have, but this is a trickier one to prove, since it’s speculative.
It might be worthwhile making an argument that important civil liberties are taken away by an AOT order, and that this should be something that is not done except in the most extreme circumstances. The main argument is that you are not posing any danger to anyone and that the idea that you MIGHT pose a danger at some time in the future is speculative and is not sufficient grounds to deprive you of your civil rights and enforce drugs on you that you do not find helpful.
It might also be helpful to note very BRIEFLY and SPECIFICALLY what harm the drugs have done to you and why you want to discontinue, as well as what other “treatment” or other interventions you are engaging in to ensure emotional support and stability.
I know this is all pretty obnoxious, but I want you to WIN, which means you have to look at the law and make your arguments accordingly. Judges have to act on laws and evidence, and they are not, in most cases, going to challenge the “accepted wisdom” of the psychiatric profession.
Can you find an attorney to consult with prior to the hearing?
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I think you missed my point. The analogy isn’t between the human brain and a car. It’s between the mechanic and the psychiatrist. The mechanic, in being unable to fix your car, will tell you one of two things: I don’t know what is wrong yet, or the part involved needs to be replaced. They will not tell you that your car is “repair resistant” and yet ask you to bring it back for a “treatment” every week that doesn’t actually fix it but “reduces the symptoms.” Either they can fix it, or they can’t. They might even suggest taking it to a specialist who is more expert in the area of fuel supply, as it’s possible the injectors are working fine but some other part of the fuel system is malfunctioning. But under no circumstances would they tell you that your car is to blame but you should still pay him money to “treat” the car’s “symptoms.”
The psychiatrist, on the other hand, is dealing with a situation that is inherently uncertain. S/he does not have the same kind of objective understanding of what is going on in the mind as the mechanic does with the car, so s/he should be even MORE cautious not to make bold pronouncements of cause. To blame the patient they are unable to help for being “unhelpable” is actually far MORE egregious than the mechanic saying, “Your injectors are shot.” Because the psychiatrist has NO IDEA why this particular person didn’t respond the way they expected to this particular “treatment.” To me, the ONLY proper response to a treatment failure is to say, “This treatment did not work for you.” To blame the client by calling him/her “treatment resistant” is a complete and total cop out. This is reinforced by the recent MIA article showing that something like half of the “treatment resistant” veterans in a study improved with sham “magnetic stimulation”, in essence, improving solely because someone paid attention to them and gave them hope. The concept of “treatment resistance” should NEVER be applied to “mental illness,” because the psychiatric profession is not in any kind of position to even pretend to know what they are “treating.”
This is not to say that a brain can’t be damaged. It’s to say that they have no way of knowing this just because someone doesn’t “respond” to their “treatments” the way they want them to. Any honest clinician would start from a place of saying, “We don’t know what’s going on, and we’re going to try some things and see if they work.” There is no “resisting” of “treatment.” The “treatment” works or it doesn’t. If it doesn’t work, then treatment failed. It’s not the patient’s fault that the clinician doesn’t really know what s/he is doing.
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Perhaps the problem is looking for a total system of thought, rather than constructing our own over time and modifying it as seems best in light of new experiences?
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Subtitle: “101 reasons why brain damage can be good for you.” Sickening!
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True enough. However, the point is that when one’s approach fails, it’s not the patient/client’s (or their “disorder’s”) fault. Just because you can’t help a person doesn’t mean it’s because s/he is “unhelpable.” A more humble approach might suggest that you, perhaps, need to learn more about the person you’re trying to help instead of doing the same thing you did before harder and harder and being baffled when it continues to fail.
Did you see the recent article where “treatment resistant” veterans got better with sham “magnetic stimulation?” The fact that people paid attention to them and gave them some kind of hope suddenly changed their “treatment resistant” condition. So were they “treatment resistant,” or were their clinicians incompetent? I think we know the answer.
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Shaun,
An important question: why does the need to protect some people from other people’s behavior (a social control function) have to be connected to some sort of “treatment?” Why can’t we simply create a space where people who are dangerous can be safe until they’re no longer dangerous? The Quakers did this in England centuries ago – took people out to the country and walked with them and held their hands and communicated with them and created a safe place for them to be, and most of them seemed to “get better,” if that’s the right term. To me, enforced “treatment” isn’t treatment. It’s just plain force. Force is sometimes necessary, but it’s never “treatment.”
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I have seen plenty of socialists who are authoritarian, and plenty of conservatives who are not. Authoritarians exist in every social group that there is. They are simply people who believe that rank and status and group membership is more important than what is true or effective or good for the whole society. Authoritarians believe that they need to follow the directives and ideas of those who are perceived as “above” them in the hierarchy, and in exchange, expect obedience from those below. This can happen in any group, liberal, conservative, socialist, or fascist.
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Great Haiku!
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Wasn’t Cipriani the same one who said that we need to give out MORE antidepressants?
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Who could POSSIBLY have guessed?
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Brilliant commentary!
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“Overdiagnosis” is a problem in other areas of medicine. But the concept is VERY different in the realm of “mental illness.” Because at least when you’re talking about cancer, you can later go back and say, “Actually, this person never developed cancer but this one did.” Whereas with “mental illnesses,” there is no objective measure of what constitutes a “proper diagnosis.” So the concept of “overdiagnosis” is meaningless in a psychiatric context.
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Using “motivational interviewing” to convince someone to do something they don’t want to do is a perversion of the approach. Motivational interviewing is supposed to engage the person’s internal motivations and goals and engage them in the process of deciding what it is they need/want and how to get it. It’s supposed to be very open-ended and put the client in the position of deciding what path to take next. Not really compatible with the “accept your disease” paradigm, though the psychiatric profession can coopt and poison anything that works.
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I hate that term. It’s not “our treatment stopped working” or “our treatment doesn’t work” or “we don’t know how to help you.” Instead, you are “treatment resistant.” In other words, it’s the CLIENT’S fault that the PSYCHIATRIST failed. I wonder how long you’d take your car to a mechanic who said your car’s engine doesn’t work because it has “repair-resistant fuel injectors?” INFURIATING!
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In my view, there is no direct correlation between belief in religion and rationality. Lots of irrational people don’t believe in any religion, and lots of rational people do. I personally find lots of good, rational statements in almost any religion I’ve approached, especially Buddhism and Quakerism, and I’m about as rational a person as I think I know. Following a given “religion” (of any sort, including pseudo-rationalistic religions) blindly, or in other words, AUTHORITARIANISM, is the real enemy of rationality.
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Ugh!
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Sheesh! Did they even bother to ask him what he was depressed about? My son had just been assaulted by a roommate and was coming off of a run of several drugs over a few months, but all they wanted to do was tell him how “depression is a disease just like diabetes” and never bothered to even ask him why he’d been thinking about suicide. He was totally pissed and insulted by the insensitive approach and never wanted to see that doctor again.
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Holy crap! What an insane (forgive the choice of words) story! And the part that continues to baffle me again and again is that they don’t see that you were made WORSE by their ‘treatment!’ It should be obvious that going from feeling bad to feeling completely numb and overdosing on every drug available is moving in the wrong direction, and yet at no time do they ever stop and say, “Wow, this really isn’t working – maybe we need to consider a different plan?”
Thank you for having the courage to share your story. I hope you are able to find a different path that moves you forward. I think coming forward and telling your own story in your own words is a great start.
—- Steve
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Must have been a “misdiagnosis.” You KNOW “Schizophrenia” is incurable! [Hint: that was sarcastic!]
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I think you perhaps underestimate the ferocity with which the psychiatric industry protects its own interests. As soon as the “peer service” movement got on its feet, the big guns in psychiatry set out to undermine its credibility and at the same time co-opt such peers as had gotten hired into handmaidens of the psychiatric community. In other words, this is not about the “free market,” but about monopolization of the market by a single, very powerful industry that doesn’t allow for competition. Any ideas that threaten their control over their market, even if these ideas are 100% scientifically and economically viable, or perhaps ESPECIALLY truly viable options, must be shut down at all costs. There are HUNDREDS OF BILLIONS of dollars at stake annually, and those with their snouts in the trough are not willing to give up their free mass feeding without a fight.
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I had that thought, too. It appears that in order to succeed, the effort needs to embrace a “business model” that emulates the very conditions of life that bring about “mental illness” in the first place. I absolutely agree that peer-centered and peer-delivered services (or perhaps “escapee-delivered!”) are going to be much more likely to be helpful. But competing with the “standard services” on a capitalistic basis will ultimately fail, because the Big Behemoths will get upset when they start losing “market share” and crush the upstarts like a bug. I think we have to get at the idea that the current system is motivated by better service delivery and lowering costs (because they aren’t) before we can really set up anything else that would be helpful. It’s a big task!
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I have never agreed with the concept that “the system is broken.” The system works quite well. The problem is, we assume that the goals of the system are consistent with point #5 above, to wit: “My job is not to get people into the mental health system, my job is to get them out.” If that’s the goal of the MH system, it’s definitely broken. But if the goal is to increase the number and intensity of “permanent customers” who will never get better but depend on the system and bring in big bucks, well, I’d say the system is pretty darned effective.
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I have always considered that there is no “cause” of any particular set of “psychiatric symptoms.” I have always believed (due to decades of personal observation) that every single case is different, or as Milton Erickson put it, therapy needs to be reinvented for each different client. Some people may have biological problems (sleep, nutrition, illness, chronic pain, etc.), some may have been traumatized, some are experiencing social stress (racism, sexism, etc.), some may be in bad environments (oppressive schools, psychiatric hospitals, domestic abuse relationships, etc.), and so on. The problem is that the psychiatric profession wants to group these varied circumstances together and act as if there is one “cause” for a particular set of reactions, instead of honestly and humbly looking at each case as its own special set of needs and circumstances.
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Thanks so much! I am really looking forward to assuming this new role.
— Steve
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The analogy with domestic abuse is quite apt. This from a person who has extensively worked with and supported hundreds of domestic abuse survivors over the last 30 years. Gaslighting, blaming, threats, abandonment, manipulation, charm – it’s all there.
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It is my believe that this website exists to distribute information to anyone who wants to resist psychiatric hegemony in any way possible. It is not an “action site” in the sense of planning some specific action to combat psychiatry. I see the value in the comments section to be that people can take from it what they want.
It’s important to remember that some people who come here are just barely on the verge of awareness that psychiatry is dangerous or misguided, some are well-versed in the challenges of the DSM and the medical model but still have hope in the creation of some other means of providing support, and some are focused on the political struggle of complete deconstruction and elimination of psychiatry. ANY of these people from ANY of these groups can get together and plan some kind of action. I am part of a couple different groups, one of which educates people about the realities of the current system and helps people consider getting off of drugs, the other of which is very much focused on the destruction of psychiatry’s power base.
My hope is that MIA assists in informing people and bringing people together to take action in their own communities or nationally or around the world. MIA doesn’t appear to me to have the specific purpose of promoting a particular action agenda. As a result, I don’t expect MIA to assume a particular editorial position or to organize any particular action (though I’d be happy if it did). It seems to me that it’s my job and my community’s job to create that kind of action, and that a wide range of actions can be helpful in making our society less oppressive and more responsive to the needs of its citizens.
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Precisely. I was the scapegoat in my family for the first 8 years of my life, at which point I got seriously ill (ruptured appendix) and I had a younger brother born. The job passed on to my next younger brother, who used to be in “the baby” role until my youngest brother was born that year. By this strange twist of fate, I got to see first hand that being the scapegoat was not who I was, but a job I’d been assigned, and saw it reassigned to my little brother. This gave me a sudden and deep insight into my own family, and probably led me into social work/counseling as a profession. But only after I got my own very good counseling to get my own head straight.
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Sounds pretty depressing to me!
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This is something I believe and used to hear a lot, when Family Systems theory was taken more seriously. While I am not fond of psychological schools of thought in general, Family Systems theory has some really excellent points, including the idea that the family offloads their issues onto the kids (who have the least power) by assigning them “jobs” or “roles” that they don’t understand or even know they are playing. A lot of our adult issues come from exactly this, and that’s why it’s so important to talk to kids (or adults) about what’s happening instead of blaming the kid for acting in ways the adults find inconvenient or confusing.
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There is also an incentive to find “positive” study results, which is perhaps the most disturbing distortion of science. Real science puts MUCH higher value on NEGATIVE outcomes, because those are the only ones that can be definitively proven. Positive outcomes are only positive until a study contradicts them. Only after attempting to find any other better way to explain the data or to disprove the theory at hand fails can we call something a “scientific fact.” Focusing on positive studies and ignoring negative ones is no longer science – it is a form of marketing.
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And it might help if the adults started by recognizing that these kids are reacting to the way the ADULTS are treating them. Most of the kids’ anxiety could be relieved by removing the kind of pressures, stresses and traumatic experiences they are being expected to deal with.
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Wow, so now you’re not allowed to feel depressed about your kidneys failing and you needing dialysis for the rest of your life? What, are you supposed to be cheerful about it? And where is all this bullshit about how we’re not “treating” things that would be called “situational depression?”
How can anyone take this crap seriously? Thanks for sharing this. I continue to be amazed at the depths to which psychiatry will sink to make a few more bucks.
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Can’t really argue with you. Pills should not be a “caveat emptor” undertaking. But in a way, it’s worse when they are prescribed, because then you get the “seal of approval” from someone who is supposedly objective and concerned with your welfare. Wish I had the answer, but I KNOW that the DSM has got to go, and if it did, the dropoff in pill consumption would be massive.
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Yeah, I love that – your approach failed completely, but instead of saying, “I don’t know how to help this person” or “my method was totally ineffective,” you get to blame the client, or actually, the client’s CONDITION for “resisting” your approach. “It would have worked, except that bastard Depression didn’t want to cooperate!” Idiocy, and yet they continue to get away with it.
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I was using a prejudicial, negative term to make the point. You can’t create pejorative terms for a group of people, call them pejorative names, and then ask us all to not stigmatize the people you yourself have stigmatized. It feels like that’s what psychiatry does. They claim this kid over here who hates school “has ADHD,” they call him “brain disordered,” and then ask everyone “not to stigmatize the poor sod, after all, he’s disabled.” It’s pretty hypocritical, to say the least.
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It is because the “treatment” and “diagnostic” system allows the staff to dehumanize their “clients.” Nazi Germany is proof that people don’t have to be evil to do incredibly evil things, or to stand by while evil things are done by others. All they appear to need is an authority to tell them what to do, and a big enough group of people to agree with them that it’s OK, and all sorts of awful things can happen. Most of the clinical staff at these facilities were nice enough people, but few really empathized with the plight of the youth they were serving. They were trained to look at the kids as a set of “symptoms,” and from that point of view, drugging the kids “made sense” and anyone (like me) who questioned the practice was seen as odd or perhaps even dangerous.
I only wish we could weed out a few monsters and things would be OK. It’s the “normal person” that we have to watch out for!
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It is astounding how researchers get away with this kind of euphemistic crap! “Study Shows Poor Outcomes for the Treatment for Childhood Anxiety.” In other words, “STANDARD TREATMENT FOR CHILDHOOD ANXIETY DOES NOT WORK!” That’s what the title should be. But they talk all around the issue talking about ‘short-term outcomes’ and “extended treatment and attention paid to relapse prevention could potentially improve outcomes for children exposed to acute treatment for anxiety, but that further research is needed to explore long-term effects of various approaches to therapy over time.” Blah, blah, blah.
And this is in light of their own statements earlier in the piece that “Increased adverse childhood experiences (ACEs), increased academic expectations imposed, Common Core curriculum initiatives, and the general emphasis in schools on teaching to promote test success are some of the environmental features that breed stress among student-aged children.”
So why the F*&K don’t we stop traumatizing our kids, stop demanding developmentally inappropriate behavior from our kids in school, drop Common Core, and knock off the high-stakes testing? But no, instead of actually facing up to what they KNOW is causing the increased anxiety, they try to “treat” the children for the anxiety that the adults cause. And they are surprised when their “treatment” doesn’t work?
—- Steve
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An excellent point! Diagnoses are used all the time to further abuse of women, and particularly to get custody of kids away from a protective mom.
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Very good! Or here’s my try: “Clinical depression” is the one we can make money off of.
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I worked for 20 years with foster kids, and they were “medicated” in many cases at the first sign of any behavioral problems, and it got worse and worse over the 20 years I worked with them. They are probably the most disempowered group in the USA (at least), and it should not be surprising that they get the most drugs as a result.
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I do have a certain amount of knowledge about the CoS. A close friend was a staff person for a time. It appears to be a highly centralized and bureaucratic organization.
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I think this is a VERY important distinction. Maybe we can get a blog on the topic at some point. Ever consider submitting one?
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I think you make a good point. These drugs can cause tremendous damage, and they are not easily handled by the body. The thing is, though, there ARE people who appear to feel better when they take these drugs – just met one the other day. And I really don’t want to take that away from them. And I don’t hear too many people demanding straitjackets or ECT. We live in a drug-based culture and it’s hard for me to see a way around that. Certain drugs should absolutely be banned, and maybe some of the psych drugs fit into that category. But banning drugs won’t undermine psychiatric hegemony, whereas exposing the fallacious “science” behind the DSM and the idea of “medical treatment” of social constructs voted on in committees will. And if the mythology of these “diagnoses” can be dissipated, I doubt that most people would be interested if given a fully informed choice.
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I don’t know, but I liked it!
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Another psychiatric success story!
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You might consider starting by finding a doctor who isn’t going to lie to you and will support you in making your own decisions about what you need and what does and doesn’t work for you. Has anybody ever worked with you on non-drug approaches to anxiety issues? There are plenty of them and I use some myself all the time. But it sounds like your psychiatrist is out of touch with reality and thinks Klonapin prescriptions for the long term are AOK, even though the package insert says never to prescribe for more than two weeks continuous use, and to be cautious about prescribing to anyone with substance abuse issues. So he’s either ignorant or he doesn’t care. I’d guess the latter. I would most definitely never see him again, and I’d start off my next psychiatrist (if you still think you need to see one) by asking him his views on the long-term prescription of benzodiazepines, particularly to someone with substance abuse issues.
The short answer is, it’s time to take control of your treatment plan. The very act of taking responsibility for making your own decisions and shopping around for a doctor may in and of itself help reduce your anxiety and increase your sense of personal power.\
Good luck!
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Sexual feelings are a part of being human. I agree with Shaun that ideally this would become a part of the discussion with the therapist if it seems appropriate to the issues at hand. Behavior, on the other hand, is a choice. I would have no problem with a client letting me know they felt sexually attracted to me. I WOULD have a problem with them getting physically close, touching me in inappropriate places, using suggestive language, etc. The actions of that director do, indeed, seem very creepy and bizarre. Clearly a person who has not dealt with his own “sexual transference” and is projecting it onto his trainees like crazy. I’d hate to be his trainee, but even more to be his client.
And you’re right about therapists, too. I knew a guy who had sex with one of his marital therapy couple. Disgusting!
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Precisely!
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They changed their rhetoric after they finally had an actual service user as their ED. But they’re still heavily funded by Big Pharma and still argued in favor of the new “mental health act” that discourages “alternatives” and encourages locking up and forcing “treatment” on the unwilling.
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Very well said, Oldhead!
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Sounds like pure rumors to me. One thing you can say about the Church of Scientology, they are very, very clear about who is in charge and what the chain of command looks like. I’m sure he’s as influential as he wants to be, but this reporter sounds like he’s talking through his hat to me.
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I bet that would work! But you can’t make billions off of tinfoil. They’d have to come up with some titanium-infused superheated alloy that has to be made in outer space so they could charge bunches of money for their tin hats.
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Yeah, they’re a bit slow on the uptake, aren’t they? How can you call these people “treatment resistant” when you haven’t even tried talking to them? Does this not strongly suggest that it is not “resistance” but “incompetence” that is the reason they have not recovered?
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Shaun,
Well, they both suck, but as you point out, the DSM creates the justification for labeling and drugging. Also, the DSM doesn’t just affect “diagnosis,” it has become absorbed into our society as part of the “bad brains” mythology about the “mentally ill.” So in the interests of making more money, the psychiatric industry has intentionally warped our entire cultural thinking about the mind and emotional distress in a blameful, undermining, disempowering way that supports the status quo and marginalizes those whose behavioral or emotional reactions tell us that we’re on the wrong path as a society.
As for the drugs, there are people who like taking them, and as long as they are not forced or lied to, I see no reason why people should not be afforded this opportunity if it works for them. It’s the reframing of these drugs as “medical treatment” that creates the horrible dynamics, including the use of force to make people take them who find them worthless or harmful. So if you take away the DSM justification, it’s easier to help people see emotional damage as an attempted adaptation to their environment, and also to see value in condemned traits like “hyperactivity” or “anxiety” or “compulsiveness” which are demonized by the diagnostic process.
Anyway, that’s why I put the DSM as a more damaging entity, even though the drugs have wreaked havoc on many lives. I guess I’m focusing more on the overall social effect rather than the effect on an individual. For sure, the drugs can be far, far worse for any individual to have to cope with!
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OK, so this is important. These people were judged “treatment resistant.” Translated into “responsible adult” language, this means that anything they’ve done to date has utterly failed to have any lasting impact. Then we find that pretending to do something that is supposed to help now “remits” 39% of these people for whom STANDARD ‘TREATMENT’ did ABSOLUTELY NOTHING! And Nemeroff, the Big Pharma shill, is “puzzled” by these results, and attributes them to “engagement with the treatment team!”
Obvious conclusions:
1) “Standard treatment” doesn’t work for these people, but pretending to do something while doing nothing does work. Seems less like “treatment resistance” and more like “incompetent clinicians” to me.
2) “Engagement with the treatment team” is MORE IMPORTANT than the “treatment” that you are providing
3) Ergo, STOP PROVIDING ‘TREATMENT’ and START PROVIDING ENGAGEMENT!
Why does this seem obvious to me and yet it is “puzzling” to Dr. Nemeroff?
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EXACTLY! If they created “remission” by essentially doing nothing but telling them they might get better, and more than a third improved as a result, there’s no telling what might happen if they actually started giving clients the impression that THEY could do something about it without any “clinical intervention!” Add in specific, empowering supports and a caring support system, and the “treatment resistant” suddenly start getting better in droves!
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Not meaning to imply that YOU were saying it was a momentary decision – I’ve just heard way too many people send out the “Just think positively, have a good attitude and everything will go well” message, and it’s crap. It’s not that easy to do – it’s something I work on every single day, and it’s literally taken years to get to where I have a pretty good handle on not letting others’ attitudes and beliefs affect how I see myself.
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I absolutely agree that there is the possibility of internal freedom from stigma or anything else having an adverse effect on how we view ourselves. But this is a very great challenge, the challenge of a lifetime, really, and not something a person can just decide in a moment. It it, in fact, where real therapy should be pointing us.
That being said, there are external manifestations of prejudice and discrimination that no amount of internal insight or attitude can change. Being denied housing or having medical concerns ignored or having one’s employment options curtailed due to a “mental health diagnosis” is very real and isn’t something that attitude can change.
Perhaps the most important point, though, is that if we want to lead a movement to overcome prejudice and bigotry and to alter the unerlying myths of the “mental health” system, we really do need to model a new way of being together and supporting each other and apply that even to those who insist on promoting these prejudices. So Ghandi or whoever decided he said that was correct, in my view. We can’t be hypocrites if we’re going to create a better society. So yes, we have to start with ourselves, but then we have to expand it out into the rest of the world. And it’s a long, slow process.
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That is my view as well, and the point of my sardonic comment. They start off by stigmatizing all of their clients, claiming their brains don’t work right without any evidence that is even true, and then bemoan the fact that people discriminate against those they have themselves stigmatized? And there’s even research now showing that their own actions cause the stigma they complain of. Are they evil, or stupid, or both?
But I do think there is hope, because somewhere inside of us, we all know it’s bullshit. If we can break out of the social “niceties” and assumptions and look reality hard in the eye, most humans understand that emotions are, well, HUMAN, and not a sign of “illness.”
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I am saying that taking the drugs can do damage to one’s brain over time. I’m referring to the “neurological down- and up-regulation” that Whitaker talks about in Anatomy of an Epidemic.
As for the “weirdos” comment, I was using that as an example of someone creating a pejorative term and labeling someone with it, and then complaining that people mistreat the group they have so labeled. I would NEVER call anyone a “weirdo” or any other such label! In fact, the biggest rule for our kids and our household was NO NAME CALLING, no matter what. I was going for something so ridiculously over the top that it could not be taken seriously.
I am truly sorry if this was confusing to you. I can see looking back on it how it could be interpreted that way. I was not critiquing the group labeled “weirdos,” I was critiquing the psychiatric profession for effectively calling people derogatory names by labeling them with “mental disorders.” I was trying to point out the absurdity of giving a derogatory label to a group of people and then acting surprised that they experience “stigma.” That’s what I see the psychiatric profession doing. I have always been a strong advocate for eliminating the DSM entirely, because I find the labels to be worse than the drugs, for the reasons asserted above, and other reasons.
I have the utmost respect for those I have tried to help with mental/emotional pain over the years, because I’ve suffered such pain myself and know the struggles involved. I guarantee you that I am the biggest advocate you can imagine for viewing “mental health issues” as normal reactions to difficult circumstances. I’m sorry if I ever gave a different impression.
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The concept of “pill shaming,” no doubt generated by the psychiatric establishment, show a great deal of confusion between the choices of an individual to use/not use a particular intervention vs. the intentional deception of generations of “consumers” regarding the nature of their difficulties and the kinds of solutions that might be available. People who want to use pills can use them, and not too many people are going to argue with you. But doctors telling people they have a “chemical imbalance” when they know it’s not true, just so they can increase their “market share,” THAT is truly despicable and can’t be allowed to go by unchallenged. I’m sorry if that’s upsetting to people who find these drugs helpful. I know there are plenty who do. But it’s not the fault of the person telling the truth that the public has been deceived. The anger should be directed toward the appropriate place – the people who lied to you in the first place.
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We need a “be kind to weirdos” week.
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Or were you replying to someone else?
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I’m not sure why you think I’m not a fan of your work? I thought the video was excellent! Can you let me know what I said that gave you that impression? I’ve always thought you were one of the most thoughtful and rational posters on MIA. I think there is a misunderstanding of some sort here.
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Exactly. He was already in trouble, but jumping on the table really removed any remaining shreds of credibility he had.
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He really isn’t. I know this. Unless he’s joined the “Sea Organization” lately. As far as I know, he’s just a “public person” with no official role in the church hierarchy. Let me know if you can find any documentation to the contrary, but I just looked and found nothing of the sort. I’m sure he contributes tons of $$$, but he’s not a decision-maker that I can tell.
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As soon as we group any bunch of people together, “stigma” (aka discrimination and bigotry) will emerge. Particularly when these people are grouped by subjective traits that most people (including the labelers) view as “negative.” It’s kind of idiotic to create a group called “weirdos” and then say, “There is great stigma against weirdos. We need to treat weirdos with respect and offer them our support despite their weirdness.” Let’s face it, as soon as we called them “weirdos,” we stigmatized them! And making it more “sanitized” or “medicalized” by calling it “Bipolar disorder” or “ADHD” fools no one – everyone knows they are categorizing people by their problem behaviors, and the stigmatization is done the minute the label is applied.
Seems obvious to me.
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They actually do brain damage over time, which makes it very hard or sometimes perhaps impossible to completely get off of them. But of course, nobody warned you of that possibility, did they?
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But it is good to see someone in the scientific research field reinforcing these ideas. It’s hard to claim that the authors are being “antiscientific!”
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You had me stunned for a minute there! I can’t imagine the psychiatrists ever questioning their Holy Book of Diagnoses!
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I will watch it!
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“Maladjustment” in this case is only seen that way from the point of view of the oppressors. They want everyone to adjust and accept their lot in life, because they don’t want to have to change out of their comfortable seat of superiority and privilege.
I agree 100% that we are all weirdos. We have a refrigerator magnet from many years ago that says, “Remember, nobody is normal. Everybody is weird!” from Melissa Chen, age 11. If we all did that, we’d be on the path to a whole new society!
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He’s not really a leader, he’s just a celeb who happens to be vocal about being a Scientologist. But I agree, involving anyone who is a Scientologist as a spokesperson would open us up to attacks, no matter how articulate and on-point their presentation. And to be quite honest, I didn’t find Cruise’s presentation about antidepressants particularly effective. He seemed to simply attack psychiatry without using any research or statistics or even specific anecdotes. I wouldn’t think of him as a good spokesperson, for both reasons.
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I think they’re making the insightful observation that telling people they’re second class citizens and depriving them of basic rights is upsetting to them. Glad we have some research to back up that extremely complex point.
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Well said! I laughed with absolute recognition at your last paragraph. Krishnamurti knew what he was talking about. The sad part is, even those most ‘successful’ in the system are still subject to its pressures and abuses. Your comments that there is one or a small cadre of abusers and a whole lot of scared “hangers on” is right on target. It is my hope that places like MIA can encourage “creative maladjustment” in those who have begun to see what’s really going on. Of course, the psychiatric profession is 100% on the side of enforcing social norms at this point, so getting an understanding of that fact is crucial to people finding the pathway toward greater self-respect.
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Excellent points! Mindfulness should be applied to individual spiritual growth. It should not be a substitute for or a distraction from the myriad causal factors in our society’s increasingly anxious and depressed population. It’s always easiest to make recommendations for the victims to change, so the victimizers can blame them for not “meditating more effectively” when they continue to find the current status quo soul-crushingly depressing.
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The author states that: “It is imperative to distinguish between actual clinical depression, and “healthy depression…”
Yet there is no even marginally objective means offered to do so. Any of the “healthy depression” causal factors could eventually plunge a person into an extremely depressed state that seems unescapable. How about living in a domestic abuse relationship that you are unable to find the resources to escape? Living in a society where every day you are judged harshly because your skin is brown or you don’t speak the common language? What about realizing that you are trapped in a dead-end job that brings no satisfaction but can’t be stopped without risking homelessness and starvation for your family? I could go on…
The author also fails to note that most of the people meeting his vague “clinical depression” criteria have experienced childhood abuse and/or neglect, often in very extreme ways. I have known many childhood sex abuse victims who suffer from “ingrained pessimistic thinking; disturbances in sleep and appetite; lethargy; difficulties concentrating; pathological guilt over real and imagined transgressions; isolation; dire hopelessness; and, a despondent mood.” Does this merit a “medical diagnosis?” On what basis? Is this not just a more extreme version of a call for “the emotional impetus to revamp one’s life commitments in line with new, emerging beliefs and values?”
I absolutely appreciate the focus on normalizing depression. I just don’t think you’ve gone quite far enough. The concept of “clinical depression” is seductive, but separating “clinical depression” from “normal depression” is simply not a scientifically viable process. There MAY be some people who DO have a medical problem that causes them to feel depressed, but it is not possible to make that distinction based on how bad someone feels or whether or not they have sleep issues.
Thanks for the article – lots of great stuff in there for the medical profession to chew on!
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Well said!
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True enough! It is more a symptom of a very challenging and potentially unsatisfying social system, where connectedness is a rare and extremely valuable commodity.
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Well, it is from Psychiatric Times, so we should expect a fairly mainstream rhetoric. I think the reason this one appears is that it promotes the radical concept that doctors should actually try LISTENING to their “patients” before telling them what to do. If this really happened, if the doctors actually dropped their arrogant attitude and started really hearing those they are purporting to help, a revolution would follow soon afterwards, I think, if only because most of them would realize that they have their heads up their butts.
I am sure that MIA editors can’t pre-select only such articles as meet some “radical sufficiency” standard, or it would be a very thin read. I don’t think they intend approval of everything they publish – it’s an attempt to keep us all informed of what’s going on in the “MH” world, and in particular, any efforts to diverge from the standard paradigm of what passes for “care,” even if it’s still mostly mainstream. Makes for more interesting discussions, don’t you think?
— Steve
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I do agree, but try to tell anyone in the mainstream “MH” system that. It’s amazing how many simply panic at suicidal thoughts, despite the fact that it’s very, very common to have them.
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True enough, and I also have raised my kids to do the same. It’s about all I can personally do about it, but I don’t hold my breath for the world to catch up. Actually, I do think that very slowly, there are more and more raising their boys this way, and I’m hoping this will eventually create bigger waves. But there are also a lot of young Trump supporters around, so clearly we’ve still got a very long way to go.
How did you end up becoming an empathetic champion for the downtrodden?
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So just to clarify, I am a big supporter of GENUINE toughness. I am not a supporter of “toughness” being defined by people in power and enforced on people they see as “subordinate.” The first is a skill that is very valuable in the right situations. The second is an effort from the controlling elite to suppress empathy toward those being harmed by their dominant position.
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There is a difference between having the personal value of toughness as a voluntary identity vs. being TOLD that you HAVE TO be tough and that having or expressing emotions is a sign of weakness. This kind of pseudo-toughness is very different than REAL toughness, which often involves dealing with strong emotions effectively and without having these emotions deter you from your intentions. In fact, teaching boys that feeling or expressing emotions is “weakness” is actually a cowardly viewpoint, not a “tough” one. A truly tough and courageous person knows that emotions are part of life and expects them to happen. Moreover, allowing emotions to happen provides good information to guide one’s decisions toward accomplishing one’s goals and improving one’s life.
My son is a great example. If something upsetting happens, he gets frustrated or withdraws or cries, but he lets these emotions wash through him and soon after focuses on why these emotions happened and how he can deal with the kind of problems or activities that led to them. I’d suggest he’s a lot tougher than the fragile hyper-males who are terrified of crying in public for fear that their “tough” facade will crack and people will see just how fearful they really are.
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Klonapin is a muscle relaxant??? If THAT’S not malpractice, I don’t know what is!
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I’m not so sure it’s lack of empathy for white men, Steve. I rather suspect it’s that by buying into the “white privilege” game, white men who do so give up empathy for others AND for themselves. The game becomes about dominance and aggression and emotions are suppressed. What people who are not white males don’t recognize is the degree to which compliance with the norms required to remain a part of the dominant group leads to anxiety, self-denial and hopelessness. Ironic as it seems, those married to the power structure often feel powerless themselves, because any move toward recognizing the reality of their position means vulnerability, and vulnerability means being attacked or ostracized. I know for me that showing empathy towards the more vulnerable kids meant I got teased or laughed at, which I tried to avoid when in elementary school. By high school, I’d pretty much given up on being in the “popular” (aka privileged) crowd, but I was still pretty quiet about the obvious injustices I saw going on around me, because speaking up brought on bullying and humiliation. I have to imagine that all but the main leaders of the most privileged group felt similar anxiety, and I wonder how many of them actually saw the injustices and violence around them and yet felt unable to speak up for fear of becoming a victim of their “friends.”
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Right. It’s multiplicative. If a person is black, they’re worse off. If the person is poor, they’re worse off. If they are poor AND black, they’re a LOT worse off! Add in “drug user”, non-English speaker, having a “mental health” diagnosis, etc., and it gets more and more dangerous to be in contact with the police.
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I have no doubt that part of the reason more men commit suicide is that we are taught early on to stuff our feelings and “tough it out.”
—- Steve
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It certainly CAN act as a spy! That is its intent, to track on “compliance” so that doctors and their enforcement minions can locate “uncooperative” clients, especially those who are on conditional release agreements/AOT orders. There is no other real purpose for this system – it was designed for forced “treatment.”
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Good idea!
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Can you admit that you are powerless over your addiction to blogging? Do you need the help of a Higher Power to help you gain control of your addiction?
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Oh, you’re getting ANGRY again! We can’t have ANGRY patients around here – you’re supposed to be HAPPY because you’re getting such wonderful help. (But not TOO happy, of course – that would be manic!)
Good for you for saying it. There are plenty of rank assholes out there, and some to whom far worse terminology applies.
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Once you’ve seen “the man behind the curtain,” it’s not really possible to believe in the Wizard again.
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I never used a contract per se. I simply asked the person how long they believed they could go without going through with suicide. I’d then invite them to contact me again at that point and we could talk some more. It was more an acknowledgement of their own capabilities. I don’t know if it helped or not.|
Having been suicidal myself, I agree 100% that dealing with the strong emotions attached to that urge was the MOST important aspect of any kind of therapy or helpful assistance I ever received. Along with that, validation that it is OK for me to feel that way and in some sense a NORMAL experience given my history was also extremely helpful.
I used to work at a crisis line, and we got calls all the time from people who felt suicidal but could not tell their therapists for fear of being locked up. Same with people who cut themselves. I often thought that having therapy with someone you couldn’t talk to about how you’re feeling must be worse than useless, actually kind of re-traumatizing.
Thanks for your insightful post!
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That is what 99% of the people I’ve tried to help really needed to hear. There is HOPE and you can DO SOMETHING ABOUT IT. Whereas the bio-psych message is, you can’t do ANYTHING about it, and the ONLY hope is trying out more drugs and accepting that your life will not be what you want it to be.
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Forcing someone to engage in “mindfulness” is ironic in the extreme. The origins of mindfulness are in Buddhism and Hinduism, where the purpose is to establish individual spiritual freedom from the “wheel of life.” Forcing someone to meditate would completely contradict the intention of the whole enterprise. Anyone who tries to force someone to be “mindful” doesn’t understand the concept. Idiocy!
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re: Freud’s retraction of the “seduction theory” under pressure from the medical community:
https://www.theatlantic.com/magazine/archive/1984/02/freud-and-the-seduction-theory/376313/
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West coast, at the end of Galway Bay. Beautiful spot!
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Didn’t mean to cause dejection, but it seems an inevitable result of looking at the reality of the system as it is. And your agency appears to be one of the better ones! The arrogance and lack of humility behind the whole DSM strategy pervades everything that happens in the system. Which is why I eventually bailed out and got into advocacy. I started feeling I couldn’t live with myself.
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Now THERE’S an idea…
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Shaun, I’m starting to like you more and more!
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Can’t disagree with you there. If you’re not interested in the goals, purposes, feelings of the person you’re supposedly “helping,” they are no longer your “client.”
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This article reflects an extremely ironic contradiction in the “mental health” world – those running the system are invested in keeping expressed emotion to a minimum, while those IN the system are often suffering from being forced (historically AND in the present) by safety concerns to suppress their emotional expression! So in essence, these supposedly therapeutic people are unable to deal with someone being angry. What the f*&k kind of help can they provide if they’re not willing to deal with anger? Don’t know about the rest of you, but 90% of my own (very helpful) psychotherapy was dealing with suppressed anger at how I had been treated as a child, and I never would have gotten to where I am today if I had not learned how to feel OK about being angry and expressing my anger to those who are transcending my boundaries. Sure, I’ve learned “better” or “more effective” ways to express anger over the years, but sometimes I still “let someone have it” if they’re really being disrespectful.
It looks to me like those in charge are simply cowardly and unable to deal with their own emotions. If so, they have no business claiming to be in a “helping profession.” If you can’t handle anger (and other strong emotions), you’re not going to be much help to anyone.
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Since it’s clear that the lifespans of those diagnosed with “schizophrenia” have significantly declined since the beginning of the drug era, and since it’s clear that social outcomes do NOT improve as a result of “TAU,” why in the hell is “TAU” even considered “treatment?” Especially when you combine this with the WHO cross-cultural studies showing massively higher recovery rates in “developing” countries that use less drugs, any real scientific reading of the data says we need to reduce the use of these drugs to the absolute minimum or eliminate them altogether.
Of course, we know the answer. “Follow the money.” Sigh…
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Too true!
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Yup. Conflicts of interest abound, and any organization’s first job is to make sure it survives. There has to be a better way.
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That sounds awful!!!! I’m so sorry you have to endure this. I hope you can muster up some legitimate rage at these bastards!
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The fact that one would have to say “these people deserve to be taken seriously” shows that they are not treated as people. That’s the central problem. The point of honest engagement with one’s clients on an equal power basis isn’t just a “good idea” that people “ought to consider.” It is the key to being able to be helpful in any way at all. How could anyone think they’re being helpful to another person if they don’t take that person seriously? Wouldn’t that other person’s framing of reality be the CENTRAL point that a helping person would be trying to discover and flesh out? Even using the term “these people” is insulting in itself. As if “these people” are somehow different than “us?”
Why not just take EVERYONE seriously and treat each other with respect at all times? Why categorize people as “mentally ill” and then insist that people treat “these people” respectfully? Isn’t the very act of labeling them as “mentally ill” without even consulting “them” an immediate act of “othering” and disrespect?
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Love the “Hobbit” reference! Very well said!
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Exactly!
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Amen to that! The difficulty from my viewpoint is that the DSM diagnostic system is specifically designed to discourage clinicians from assigning any validity or importance to the clients’ viewpoint and experience. It’s a natural progression from “we get to define your ‘disease’ for you” to “we get to tell you how to think and feel” to “your comments are irrelevant.” It’s a power thing, and it’s built into the system as it is, intentionally so. Listening to the clients immediately starts undermining basic assumptions of the system, and so it can’t be allowed. Clients’ voices threaten those in power, because those in power know at some level that they are emperors without clothing. So any clients who start complaining have to be shut up before people start to realize that “the man behind the curtain” is the actual Wizard of Oz.
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“In light of his self-analysis…” What a bunch of crap! He recanted his “trauma theory” under intense pressure from the medical community, who was horrified by what he was saying and could not allow him to continue pursuing such a line of inquiry. Probably because so many of them had engaged in or knew about molestation that they didn’t want to have come out. It was a classic example of the power structure continuing to support the powerful at the expense of their victims. To leave that point out of the Wikipedia article reflects a continuing denial of the reality that power politics rather than concern for health drives a lot of what happens in the medical community, and especially in the psychiatric/”mental health” world.
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Great story! It proves that the framing you put on a problem or issue has a large impact on the results you get. Choosing to label has consequences. Choosing NOT to label has consequences, too.
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Hi, Mark,
Your explanation doesn’t really explain anything to me. Even if I accept your premise about the possibility of “real” mental illness, the fact that we could define such an “illness” doesn’t mean that we should or that it helps. It’s true that it can help people to identify with others and feel less isolated if they know they’re not the only ones experiencing a certain condition, but reframing and normalization can easily done without any illness concept being invoked. IMHO, the purpose of the DSM-III forward was to medicalize mental/emotional/behavioral experiences so that drugs can be sold for them. The APA said as much prior to the DSM-III coming out. They were losing market share and needed to promote something that they could do that other therapists could not. That means drugs. Practitioners who “operates from a solely medical-paternalistic or deterministic approach” are the majority, and justifying this approach is, in fact, the purpose of DSM diagnosis. One could very easily accomplish the same goal as you mention without any reference to diagnosis, and the possibility of such reductionistic justifications would be eliminated at no cost.
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Thanks for that. But I’d really like an answer to that question: why do YOU, Mark, think we need a concept of “mental illness” in order to help people improve their sense of freedom and responsibility? Doesn’t the very fact of saying someone “has a disorder” instantly reduce their sense of responsibility? Why not simply say, “You appear to experience a lot of feelings of anxiety, and it seems you want to find a way to make sense of and get a handle on those experiences?” This enables one to engage in both psychological counseling and lifestyle coaching without any disabling labeling process (and remember we have solid evidence that labeling in and of itself creates a sense of “otherness” and a loss of hope for resolution). Unless one is holding out for a drug or surgical intervention, what possible benefit is there to calling someone’s behavioral or emotional struggles an “illness?”
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I agree that high-quality therapy can be a life-changing experience, and I have been fortunate to have had such an experience. My concern is that the number of quality therapists has been declining steadily since the 80s and the DSM-III and managed care have taken over. As Chris states, there has been a big push toward “brief therapy,” toward manualized therapy, and toward diagnosis and drug interventions. Many therapists I have encountered in the foster care system seem more like case managers, talking only about “current events” and “symptoms” and avoiding any effort by clients to seek more significant understanding of deep emotions and historical behavior patterns. I asked one therapist what they were doing to deal with trauma issues for a kid who was literally having flashbacks in the juvenile courtroom hallway. She stated, “Oh, we’re not dealing with THAT!” “Emotional management” is the watchword of the day, and while I definitely value “skills development,” it is not what I think of as therapy in the transformational sense.
Worse yet, many therapists now take on the role of medication compliance monitors, pressuring and manipulating clients toward “accepting their diagnosis” and “cooperating with treatment.” There are definitely exceptions out there, but they are exceptions, especially in the world of involuntary clients. I’m sure it’s easier to find a quality therapist for those who have money, but no insult intended to you or your clinic, for poorer and more powerless people, therapy often varies from ineffective to downright dangerous, in my observation.
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It seems the real question is, why do we need a concept of “mental illness” in order to assist people in increasing their levels of freedom and responsibility? Why do we need artificial and heterogeneous categories of metaphorical “illness” to accomplish what are essentially the basic tasks of being a human being in society with other human beings? Don’t all humans struggle with exactly the same questions of freedom and responsibility? Without a clear indicator of physiological ill health, what purpose does it serve to call such people “ill,” other than to distance them from the rest of the so-called “normal” population?
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Fair enough. I appreciate that you appeared to hear my feedback.
The only place I’d diverge here is that the term “mental illness” has been almost completely co-opted by the psychiatric profession, to the point that if someone has a problem that affects his/her mental functioning, most people will NOT assign that condition the term “mental illness.” In fact, the DSM (prior to the 5) was specific about pointing out that symptoms caused by a medical condition were NOT indicative of “mental illness.”
I think it’s fair to say that the use of the DSM to categorize these metaphorical “illnesses” based only on external symptoms is the central problem we face in figuring out what to do. When such a mainstream luminary as Thomas Insel comes right out and says the DSM categories lack validity, we’re not talking about an extremist position here.
Thanks for hanging in there through a challenging discussion. I very much respect you for continuing to communicate even though the conflict level seemed pretty high.
—- Steve
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“…mostly filled with the typical anti-psychiatry rhetoric…” Sounds like typical anti-antipsychiatry rhetoric to me. You’re being a tad hypocritical accusing others of propagandizing when you are doing the same thing.
As for your comments on “metaphoricity,” there have been several very valid challenges to your comments which remain unaddressed. Simply referring people to your earlier comments doesn’t make them any more convincing. If you want to be credible, you’ll need to take on the legitimate points that are raised rather than simply ignoring them.
It appears that a rational person who is NOT engaging in propaganda could extract the truth from reading both your and Slaying’s comment threads and pulling out commonalities and contrasts. Your comments would be a lot more credible if you gave credit where credit is due (Slaying’s comment is full of quotes from Szaz that contradict some of your earlier comments rather thoroughly) and sought to find agreement instead of dismissing his entire, well-researched post as “antipsychiatry rhetoric.”
Your comments suggest that you may have a rather large axe to grind, IMHO. This conversation would proceed a lot better if you put it down.
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I am very glad you raised these parallels, Noel. I worked in foster care as an advocate for children for over 20 years, and I saw this happening first hand. The less power a person has in society, the easier it is to “diagnose” them and “treat” them whenever their behavior is inconvenient for the authorities. Of course, this leaves children of any color the most vulnerable group. Add other rationalizations for dehumanizing these kids, be it race, sexual orientation, country of origin, or immigration status, and the power differential soars to the point that these kids have no protection against randomly being drugged for the convenience or malice of the staff involved.
It is good that this crisis is bringing some of these issues to a head, but they are, indeed, only the tip of the iceberg, the inevitable result of policies where we are allowed to define and “treat” kids for “diseases” that only manifest when they do and say things that the powerful adults don’t want to deal with.
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Dang, that was an amazing summary of Szaz and critique of his critics. I feel greatly enlightened!
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Your comments seem confusing or confused. A metaphor specifically uses imagery that is not literally true, otherwise, it’s not a metaphor. Saying, “That bridge looks shaky!” doesn’t mean the bridge is shaking. Saying, “That murderer is SICK!” doesn’t mean he’s sick. It means his behavior is so far outside the norm that describing it as “sick” emphasizes that no “normal” person would act that way.
This, of course, has ENORMOUS implications for the use of the concept of “mental illness.” There is a good hunk of very consistent evidence that telling people they have “an illness like diabetes” leads to them losing hope and others viewing them as “abnormal,” in very much the same sense as they viewed the killer as “sick.” That’s the impact of that particular metaphor. And of course, to suggest that they are literally “ill” in the sense that it becomes literally dark when “night falls” is a massive distortion. Humans understand literal illness as something that can be identified in the body and that medical intervention can help ameliorate or cure. Psychiatrists, far from using “mental illness” as the metaphor that it is, have spent billions of dollars (along with their handmaidens in the drug industry) convincing people that “mental illnesses” are LITERALLY illnesses in the physiological sense. And yes, sorry, that IS a lie, because they know better, as the estimable Dr. Pies has himself repeatedly pointed out.
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“Biological involvement” is only “discovered” in terms of probabilities of people falling into these subjective categories that are not defined by any objective measure. I think Szaz would be very clear that any PHYSIOLOGICAL condition that can CONSISTENTLY be connected to a specific “mental state” could be considered a disease, but that disease (like Parkinson’s) would then be dealt with by diagnosing and treating the actual physiological condition. The fact that some people with physiological issues of some sort HAPPEN to fall into these heterogeneous categories like “major depressive disorder” or “bipolar disorder” doesn’t indicate that these categories are legitimate entities for study, let alone suggest “biological involvement.”
Naturally, there will be biological correlates that are connected with emotional states, but the research has shown over and over again that none of these correlates are consistently present in ANY “mental illness,” and in fact large numbers of “non-mentally ill” people have the exact same genetic markers or biological indicators as those purportedly “mentally ill.”
Furthermore, any such correlation is likely to be associated with very general characteristics, such as higher energy levels or emotional sensitivity, which have undoubted survival value for the species and are only problematic when someone is under unnatural levels of stress or is forced into an unnatural situation (like a 5 year old sitting still for hours a day) or is lacking in the basic necessities of social and logistical support that our species is adapted to expect.
There is no logical reason why we should anticipate that everyone who “fits the criteria” for “major depression” or any other “diagnosis” will have any physiological similarity to each other besides the surface similarities in behavior and/or emotion. That is why these “diagnoses” have to be given up completely before any meaningful research can be effectively done on causality. It may very well be that a certain subgroup of depressed or anxious people DOES have something physiologically wrong with them. But we will NEVER find such a subgroup if we insist on grouping people together based on external manifestations like “anxiety.” It makes about as much sense as seeking a cause for “pain” or for “courage.” There is not and likely never will be a single cause for any DSM disorder, no matter how much reductionistic “science” is thrown at those “diagnosed” by the Bible of the Psychiatric Religion.
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Hence, the quote marks.
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It’s not a question of liking or not liking names. It’s a question of pretending to know things that we don’t. For example, pretending that all people who ‘have depression’ are alike and have the same needs.
You can call yourself “unipolar” if that explains things for you, but it’s different when a whole profession pretends it can reliably identify “unipolar” people and assert that they know what is “wrong” with that person and what they can do about it.
Think about this: do you have to decide if you “like” the name of a broken leg, a syphillis infection, or a heart attack? Of course not. Because you can easily and reliably separate people with broken legs from people who don’t have them by a simple x-ray. It’s not right to tell people that they “have depression” when they may literally have NOTHING in common with another person who “has depression” except for how they feel.
You can describe your own condition in any way you like. Professionals are held to a higher standard – they need to be honest about what they know and don’t know and can’t diagnose you based on how you or how they feel about the label they put on you.
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I have to say, nothing lifts my depressed mood more quickly than deleting my sex life, disrupting my relationships, and reducing my “quality of life.”
It continues to astound me that “professionals” continue to prescribe these drugs so copiously when so many people suffer as a result. Some kind of weird disconnect is going on when professionals trying to “treat” depression feel like ruining the patient’s sex life is an acceptable “side effect.”
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This kind of research provides some good information, but it always feels like it’s making things SO complex! Fucking with parents fucks with their kids, who then grow up to be parents, and so on. The cycle of abuse – not really new news, and the disturbing part is that researchers have to actually point this out to clinicians when it should be so obvious. I think we have the “biological model” to thank for removing our attention from the obvious fact that treating children well is the key to improving our society at every level.
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And we need to remember that today’s children are tomorrow’s parents. Foster care is awful, but so is growing up with abusive parents and feeling like nobody cares. Whether they are in care or not, we need to reach out as a society and show kids that we care about them, ALL kids, and help them make it better for their own offspring. A challenging job, to say the least!
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Nobody said your clients didn’t value your services. I specifically addressed that elsewhere. If they didn’t like your services, they’d leave and you wouldn’t hear a thing, would you? Additionally, you are assuming other clinics provide similar levels of respect to clients at yours, which you have no reason to assume. Furthermore, clients have a habit of telling their providers what they want to hear, especially if they can sense that their clinicians need that reassurance. So the situation is much more complex than you describe. You make it sound as if clients being dissatisfied with the MH system are outliers. I can tell you from talking to many hundreds of clients that this is not the case. This is where you are sounding insulting to those who are not satisfied with their services. It feels like you’re dismissing their complaints by saying things like “I do find it interesting that my clients’ experiences are minimized by MIA.” A subtle but pretty barbed comment attacking the entire community here, or at least suggesting that those who post here are, as I said, outliers or extremists.
I continue to note that you avoid commenting on the very critical question of whether you think depressed people all have something/the SAME thing wrong with them, regardless of external circumstances, and that they all need “treatment” of a similar sort (therapy and/or drugs). I find it interesting that you choose to avoid that particular question despite several attempts from me to get it answered. My guess is that your answer is “yes” but you either don’t want to admit it to yourself or don’t want to admit it to the commenters on this thread.
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Exactly! How can that be an improvement? Especially when you add early death to the list of “side effects?”
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The power balance is so skewed that most clients are afraid to use any “grievance process” for fear of being further abused. This is especially true for anyone diagnosed with any kind of “psychotic disorder.” It is very easy for those in power to dismiss any complaints as “symptoms of their disorder.” I am aware of a situation where multiple sexual abuse complaints against the same person in a MH facility were dismissed out of hand because the clients “were not reliable witnesses.”
This is what I mean by disrespecting the voices of those who have been there. It’s easy for you to say, “Use the grievance system.” You are a person in power. It’s very different to ask clients who are IN your power to do this. There ARE people in the MH system who abuse their power, and they are NOT rare. Consider the implications of filing a complaint for someone who has been forcibly hospitalized and “treated” against their will on multiple occasions. Don’t you think the impact of the huge power differential and potential costs of complaining would weigh heavily against trusting “the system” to do the right thing?
Your ability to believe the best of your colleagues is remarkable, but not supported by the reports of those using the system.
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I’m talking about clients’ negative feedback about the mental health system. And my questions about the heterogeneous origins of the so-called DSM diagnostic categories.
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This helps me understand why I got confused. I asked you for the link to your post that you’d mentioned, and you gave me the link to Jaffe’s article. So, not TOTALLY my bad after all!
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Sorry, my bad on that one. Still, referring to Jaffe as representing anything close to your views puts us at very distant ends of the “respect for the experience of the recipient” spectrum. Jaffe’s review seemed confused and unfocused, and at times he clearly was promoting his own “we know better that the clients” viewpoint, as he always does. You seem to have an agenda, too, and you reflect it by choosing not to respond to certain central points I have made. It seems clear you are more interested in promoting the interests of therapists and mental health professionals and seem very uninterested in talking about very important philosophical questions like why the f*&k anyone taking a remotely scientific viewpoint would ever expect all depressed people to be suffering from the same difficulty. But that’s your decision. It just makes me feel like I wasted a lot of time talking to you, because you don’t seem to be nearly as open-minded as you think you are.
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I think it shows where he’s coming from. It seems to indicate a person who feels superior to his “clients” and is unwilling to listen to any feedback from his or any other participant that undermines his view.
He did, however, post the Jaffe review when I asked him for a link to the Huff Post review he’d written. So he at least suggested that he’s Jaffe. Not that it likely makes much difference. He’s coming from the same kind of viewpoint.
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Philosophy transcends scientific investigations, in fact, science is a tiny subset of philosophy. Philosophy doesn’t ask the question, “what’s the relationship between the microbiome and the CNS?” It asks questions like, “What is a human being? What is consciousness? Is our awareness a result of our body or are we beings who become aware of the body? Who or what makes the decisions that tell our bodies what to do? Are feelings a function of body, spirit, or the interaction of them? What IS spirit? Do we HAVE a spirit, or ARE we spirits that HAVE bodies?
Psychiatry runs on the philosophical assumption that we are bodies and that our minds are a result of brain activity, and they conclude therefore that the only solution to altering the mind is altering the brain. That’s “materialist reductionism” from a philosophical viewpoint (or some such name). What they don’t tell you is that there is no SCIENTIFIC reason to believe in reductionism any more than there is to believe in spiritual implantation at birth. The reality is that Science has NO answer as to what the human mind really is or where it comes from. These are questions for philosophy, because they transcend the questions of material reality.
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You gotta be kidding me. You’re DJ Jaffe? No wonder I feel like I’m swimming up the river. Your reputation precedes you. I understand why we are unable to communicate, but I feel like I’ve been scammed. I am no longer surprised at your lack of compassion for those harmed by the psychiatric system.
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How would I find the Huff Post link?
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I did not see your Huff Post article. I’ll see if I can find it.
I think again you miss my point. At a certain point, it doesn’t matter what “services” you offer if the context in which they are offered is not workable for the person seeking it. No doubt, you have many people who continue to use your services for extended periods of time, and no doubt, they mostly find it helpful or they would not continue. I am not telling you that CBT/DBT are THE SAME as psych drugs. I’m asking you to open your mind and LISTEN to those who are telling you why it did NOT work for them, rather than generalizing that “these things are not damaging.” Heavens to Betsy gives a great example above – she needed help with a domestic abuse situation, and was provided with CBT or DBT. NOT GONNA WORK! Again, you can claim these are all “outliers,” or you can start to realize that there are some who do NOT avail themselves of your services or anyone else’s because they don’t meet that person’s needs.
We’re going to have to part company on the idea that somehow “science” will discover “why people are depressed.” In my view, as I explained above, there is no logical reason that anyone truly dedicated to the requirements of science could possibly believe such a thing is possible. To even DO a scientific study with humans, you’d have to establish a homogeneous group to study, and as I clearly outlined, “depressed people” is not a homogeneous group. Now there may be a SUBGROUP of “depressed people” that actually have a physiological problem, but this subgroup is more likely to be divisible into half a dozen or a dozen or more subgroups ALL who have different problems, just like 10 people presenting with shortness of breath will have 10 different reasons that explain it. This is why “shortness of breath” isn’t a diagnosis – it’s not a homogeneous category. The idea that all people with “major depression” will all turn out to have the same problem is even LESS likely as that all 10 people turning up with chest pain will have the same needs and treatment.
And stretch yourself a minute, here. Isn’t it a bit disrespectful to suggest that a person who has lived a life of trauma and abuse, who learned distorted coping measures and never knew a healthy relationship in his/her life, has something physiologically WRONG with him/her if s/he has learned not to trust authority figures or not to ask directly for his/her needs to be met? Doesn’t it seem much more likely that s/he learned some crappy things from experience, some of which might be valuable to retain but some of which that person might wish to “re-learn” at his/her discretion? And would this person really be likely to respond to the same “treatment” as someone whose thyroid is out of whack and who can’t sleep well at night as a result? Or a person who just found out that s/he has cancer and has 6 months to live? How on earth do you think that those people all need the same “treatment?” Is there something “wrong” with finding the fact that you suddenly are going to die in half a year in a slow and painful manner extremely depressing, even to the point of considering suicide? Is that really the same as feeling like your life isn’t worth living because you have no friends and a dead end job? Or feeling like you’ll never recover from the flashbacks and anxiety you experience as the result of being raped by your abusive husband?
You sound like a kindly person, but I gather you are still really connected with the idea of diagnoses and treatments, and don’t see how that, for at least some people, the very ACT of being “diagnosed” for a “mental disorder” could be demeaning and insulting. I see it very differently. I find that labeling people tends to leave them feeling negated and misunderstood. I find that reaching out to them and having them tell me what’s going on and what they want to accomplish and what they think might help to be much more humane and effective.
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Interesting statement. “May never be.” Do you hold out any kind of hope that the “chemical imbalance theory” MIGHT be proven valid? To me, it is completely illogical. Why would we assume that all people who experience anxiety or depression do so for the same or similar reasons? Do people feel pain for the same reasons? Do people feel joy for the same reasons? It makes zero sense that something as biologically essential as anxiety or depression or high activity levels could ever be reduced to an “imbalance” or any universal cause, or could even be clearly identified as “excessive” by any reliable measurement that could ever be invented. It is simply a fantasy (IMHO) to think that any kind of generalization can be made about why people feel chronic depression, for instance. It may be a result of early childhood abuse, lack of sleep, feeling trapped in a boring job, low thyroid, being involved in a violent or abusive relationship, lacking essential nutrients, being lonely, feeling out of control of world events… the list could go on and on.
The fact that some people feel better (or less bad) when taking a particular drug is not an indication of anything specific wrong with them, any more than finding aspirin or tylenol a relief is an indication that someone has a broken bone vs. muscle aches vs. the flu. Johanna Moncrieff has written very effectively on this point – you should read some of her stuff.
Again, I think you’d do very well to listen to some of the people who have experienced DBT and CBT and EMDR. Some have found any of these helpful, and some have found them to have little to no effect, and some have found them damaging. It seems to me that you feel empowered as a clinician to decide that “these things are not damaging” and regard any reports of harm as outliers. It comes across as dismissive of the experiences of those who have “been there.”
I’m glad you understand some of the barriers that people diagnosed with “mental illnesses” often face. At the same time, I am not sure you come across as really understanding or WANTING to understand why so many folks here object to the entire system and don’t see things like “CBT” and “DBT” as much different than the drugs. There is still a disrespect, an air of condescension/superiority, and implied “put down” in the whole dignose-and-treat process, even if there may be some services offered that could be helpful under the right circumstances. For many people, the idea of being considered “broken” or “damaged” or “emotionally disturbed” is in itself enough to be traumatic and diminishing, and sometimes pretty insulting. It’s as if some other person gets to tell you what the “right” reaction to a traumatic event or an entire traumatic childhood should be, and you are judged inferior because you didn’t react in the “right” way. For this reason, I eschew DSM diagnoses at all turns and consider them a fundamental evil of the system. They warp how we think about people and how people think about themselves. They are ultimately dehumanizing labels, and even when I had to use them to get reimbursement, I always explained to my clients that they were just names and numbers that I had to submit so I could get them the kind of help THEY needed, and that it was THEIR job to define what (if anything) was wrong and what kind of help was actually “helpful.”
BTW, I notice that you never told me whether you read Anatomy of an Epidemic yet. Just wondering…
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I guess for me the question is more is the person attacking the comment/concept or the person making the comment. It is easy sometimes for one to drift over into the other. I’ve been moderated a few times myself, but it always made sense to me (even when I didn’t like it or might not have interpreted my comments that way). But it seems a pretty grey line to me. Tough job being a moderator. I’ve been there on a very different kind of site. Kind of like being a referee – no matter what call you make, someone’s gonna be yelling at you.
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Hmmm, that doesn’t sound right. I’ve certainly seen plenty of articles and comments criticizing therapy and advocating for a wide range of other alternatives, including the abolition of the mental health field entirely. But I trust you and I’m sure you would not make up something like that, so it’s a bit puzzling to me.
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Thanks – back at ya!
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I shall keep my eyes and my mind open.
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It is, indeed. The Stockholm Syndrome operates on similar principles.
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Parents or family members are often hurt when family members speak about things that were painful. It isn’t necessarily about blame, it’s about understanding that we all have limitations and that good intentions are not protection against hurting those we love. The “let’s not blame the family” meme has been used to powerful effect by the psychiatric mainstream to keep people from examining their history and culture as contributing agents to their distress. It is possible to be honest about what has happened without being blameful. We all fail our children to some degree or another, and making it safe for our kids to tell us what we did well and poorly is one of the best ways to help our kids mature to their greatest potential.
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A common but misleading language that supports the power of those providing “treatment” over those who are its recipients without providing explanatory power of any significance.
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I have recently learned that racism was quite intentionally introduced by early capitalists (at least in the USA) to keep indentured servants and enslaved Africans from getting together and rebelling. It is all about economics and dominance of the owner class.
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True enough, but that doesn’t excuse psychiatrists for putting out the press release, and claims that they were “misunderstood” by the press are totally bogus. The press repeated exactly what they were told.
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Oh, please! Don’t know where you’re hearing this, Frank, but there is no moderation for content, just violating the guidelines we all agreed to. Do you see anything about “discouraging therapy” in there?
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“Death therapy, Bob. It’s a sure cure!”
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Very well said, Rachel! It is the passing on of abuse and trauma that we need to address. Blaming parents’ brains or demonizing them avoids the reality that they, too, are the products of the distorted and traumatic culture in which we all participate.
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Actually, there is no evidence that SSRI users are better off in the long run, and some that suggests they may be worse off (in terms of being less likely to recover). So the analogy to street drugs isn’t really that much of a stretch – they do create dependency and withdrawal, we do develop tolerance to them, and they do apparently create some long-term damage to the brain. Just because they don’t make you euphoric doesn’t mean their effects on the brain are any different than street drugs – they just affect a different part of the brain. Neurological down-regulation is still in play, and the long-term effects of down-regulation are very similar for cocaine, stimulants, and SSRIs.
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Well, I can’t say my experience is very different than yours regarding clients “wanting” drugs. I think it is an unfortunate “side effect” of the cultural shift toward believing drugs are the answer to everything, brought to us by our lovely pharmaceutical corporations in concert with a very corrupt psychiatric profession. I simply don’t believe it’s possible that these folks would all “want” drugs without the advertising. 80% of Americans believe that depression is caused by low serotonin, even though that idea was debunked scientifically in around 1985. What does one do about that? There is a much bigger picture here that I think we have a responsibility to attack. I encourage you to have a look at Julie’s article on Lauren Slater’s new book to see how a person who ‘Needs her drugs’ is living her life.
Have you read “Anatomy of an Epidemic”, by the way?
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This story broke my heart. So many stories like it, where the drugs “work” and yet the person they are “working” on lives an increasingly limited and restricted life, beset by continuing “symptoms” and advancing physiological deterioration leading to an early death. It is the story of psychiatry, the “good news.” This is what ‘success’ looks like for many, many users of psychiatric “services,” and it is appalling.
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Oh, and by the way, I’ve historically been a treatment provider, including doing involuntary hospitalization evaluations, and nobody here has ever been particularly hostile toward me or my views on the possibility that people can be helped by quality communication and emotional connection. Some have disagreed with me on the hows and the whys of it, but no one has rejected my views out of hand or personally attacked me for having a different viewpoint. I think it’s because they feel that I understand and deeply care about their viewpoints and experiences and craft my posts accordingly. As a capable ‘mental health professional,’ it seems that applying your skills in human relations that you use in your therapy practice might help your messages be more readily received. Could be wrong there, but it might be worth considering.
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Wow, 99% voluntarily? I find that more than a tad difficult to buy into. Do you actually have figures on that, or is that just your impression?
Furthermore, how many of those “voluntary” clients have been lied to, pressured, misled, partially informed, or not informed at all about the effects, potential adverse effects, possible long-term deterioration, withdrawal effects, other treatment options, non-treatment options, etc.? How many were told or learned elsewhere that they had a “chemical imbalance” and had heard drug advertisements telling them that drugs were the main or only answer? How many were told that this was not really known to be the case, and that doctors actually have little to no idea what a “mental illness” really is? How many were children or others not in a position to provide genuine consent? Do you have any stats on those questions?
Your post sounds like an advertisement for your treatment center. I seriously doubt there is a treatment center in the USA which gives 99% of its clients full informed consent about psychiatric drugs and alternatives, or even comes close to doing so. There is plenty of solid evidence that clinicians are not very good at evaluating the value of their own services. My personal experience tells me that those who ARE good at evaluating this are generally very humble and recognize fully the possibility that they may feel great about providing services that the clients actually are not benefiting from.
I have been trying to feel sympathetic to your position, as I recognize that there is high potential value in QUALITY therapy with a gifted individual who is able to connect emotionally to his/her clients. I was fortunate to have found such a person myself in my 20s, back in the 80s when most therapists used psychodynamic approaches and a year or more was considered a normal length of therapy. But I can guarantee you that your clinic is not filled from top to bottom with such capable clinicians, because my experience tells me that they were never common and are becoming rare as hens’ teeth. And because such clinicians are to a person EXTREMELY skeptical about the current paradigm of care, and are generally quite original in their approach to each individual and are not committed to a specific “school” of therapy, it is highlyk unlikely that a community clinic would appeal to very many of them.
Your confidence in the current model of therapeutic delivery at your clinic creates great skepticism in me as to your ability to be objective about the services your clinic provides. Again, this is not because I feel hostile to you OR to the concept of therapy – it’s just that the percentages say that your view has to be grossly overinflated.
Perhaps I am wrong and your clinic is an impressive outlier. Nonetheless, your comment that you don’t see the system as keeping people helpless and dependent seems very far beyond your own ability to observe. There are many, many commenters here who have been the recipients of such services, and I take their word for their experiences as being the most valid source of information available. The number who report intentional and extensive efforts to create and maintain dependence and helplessness and total, unquestioning compliance with the authorities, is quite impressive. There are a handful who felt they got good services, and there are a larger number whose experience was mixed, but the majority report at least at some point serious pressure to limit their dreams as far as education and employment, to get onto social security/medicaid, to expect to be on psych drugs for the rest of their lives, and most report rather extreme measures, including often incarceration and enforced “treatment” with drugs, as the typical response to any attempt to empower themselves to move beyond what the system provides.
While there can be at times a perhaps excessively rigid (IMHO) hostility toward any kind of ‘treatment’ from some posters here, my sense is not that you are experiencing hostility for being a treatment provider, but for trying to defend a system that has committed egregious harms against many people who post here. If you’re unable to accept the viewpoints of those who were so harmed, it is difficult to see how you will be able to engage in any kind of productive discussion on this site. I think the #1 value that underlies Bob Whitaker and the entire MIA community is that clinicians should not empowered to define their clients’ experiences for them. It appears to me that you have not embraced that value, and hence, you garner a lot of negative comments. Read some of Sandy Steingard’s or Johanna Moncreif’s comment threads and you will see a big difference.
A little humility goes a long way, especially for folks like you and me who have not been on the receiving end of the ‘helpful services’ that “the system” provides, often without the consent of the “helpee.” I think we need to listen first and incorporate the reality of the commenters’ experiences into our own worldview. I hope you can hang around long enough to do that, but really, I don’t think it’s proper to blame the posters for responding the way they do if you’re not willing to listen to and validate their direct, personal accounts of their own experiences.
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A new and disturbing trend. This will certainly open the door for indoctrination about the DSM and “brain disorders” and “chemical imablances” foisted onto unsuspecting youth.
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I have heard more than one similar story. The amazing part to me is how the teacher suddenly starts reporting problems when they realize the kid isn’t “medicated.” Talk about confirmation bias! Are they that stupid that they can’t see and admit that they were wrong? They just TOLD you how much he’d been improving! I guess being “right” is sometimes more important than actually meeting the kids’ needs. Disgusting!
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Too true! ADHD is all about letting adults off the hook and forcing kids to adapt to adult needs. The exact opposite of what is really appropriate.
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I agree, the profit motive is at the core of the problem. People should not profit from others’ poor health. Healthcare workers certainly deserve to be well paid for good work, but no investor should be banking on making money off of healthcare. It’s one area where the “free market” appears to lead to worse and worse outcomes.
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He and his cohorts are busily pretending that people from Mexico and South American (and even Puerto Rico, apparently) are not really human. So punishing them by taking their kids away is OK, since the kids aren’t really quite human, either. This apparently goes too far even for his sycophantic Republican Congress, which kind of surprised me, actually. But it’s reassuring to know that there is SOME level of moral depravity that even the Republican leadership can’t stomach. About time they stood up to him.
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I’d say practice defensive engagement. Let the doc know up front that you are consulting them for information, that you’re an intelligent person and will take on their information but will be making your own decision as to what to do, even if they don’t agree. Tell them also that you will want ALL your options, and will take their suggestions home and research them yourself. Ask them if they have any problem with any of this, and if so, you’ll be seeking a new provider.
I never take or do ANYTHING from a doctor without doing my own research. Doctors almost killed my dad when I was 8 or 9 years old and I learned early to verify anything the medical profession claimed to know.
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OK. So you didn’t accuse me of saying this was good for suicidal youth, but I was “championing this show as a good thing for suicidal youth.” You are either unable to articulate your point or are contradicting yourself.
And saying I probably won’t be able to understand you isn’t insulting? Is your intellect so superior that even a bright person won’t be able to understand your subtle prose?
You clearly have your well-molded and impermeable viewpoint in place and are unable/unwilling to see anything different. It is not worth my time to try and explain to you how honest the portrayal of adults being unwilling or unable to meet kids where they’re at due to their own authoritarian or self-absorbed attitudes, nor the repeated references to Hannah’s missed opportunities to reach out for help, nor the honest treatment of bullying that is almost never seen in film or television, nor the direct confrontation of rape culture, nor the message to peers and adults that they ought to ask more questions and offer support to kids who are suffering has ANYTHING whatsoever to do with reducing suicide.
I’ll end by observing that your insistence that they show the “real symptoms” of “major depressive disorder seems ridiculous. The reason this was the most popular Netflix original ever is not because people want to watch someone commit suicide. People watched because it felt REAL to them. Again, I’ve worked with tons of suicidal people and have been so myself. You are one person with a few contacts with similar experiences. Your claims to superior moral authority are utterly baseless, as I believe anyone reading these posts can see. I think the proof is in the pudding – kids and young adults LOVED this show. It’s not perfect, but it has great value for kids who deal with these issues and never hear them talked about, IMHO. You’re free to disagree with me.
Suicide is a complex decision. Your generalizations are unsupported by anything but your own experience, as for the most part are mine. People are entitled to their own opinions, but assuming such a superior attitude doesn’t encourage discussion. If you opened your mind, you might find that not everyone who is suicidal or depressed is alike, or sometimes even remotely similar. It is this tendency to try and put everyone who is suicidal (or whatever) in the same “basket” that makes the “mental health” system as screwed up as you claim to believe it is. If you want it to change, you’d best start by dropping your assumption that you already know everything and can lecture people you don’t even know from your very limited personal experience.
But in any case, PLEASE quit attributing things to me that you have no reason to know or pretend to. Speak from your OWN experience and stop generalizing about people you don’t know, including suicidal people you’ve never met. Real healing starts with respect, and you will be a lot more helpful to others if you start by respecting them and listening when they tell you that you’re behaving in an insulting manner, instead of defending your own “rightness.”
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You are probably quite correct, and I did have that consideration that it’s possible I might not notice or might not have time to respond before I’d lost all touch with reality. Just for the record, I have never had any objection to people being offered genuine help in a respectful way. It’s just that most of the time, “mental health clients” receive neither the help nor the respect they deserve.
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Of course, medical problems should always be the first place to look, particularly when there are other drugs (legal or illegal) involved. I think each person deserves a full workup, including checking any possible medical causes. The problem is, this almost never happens. So my answer reflects that I’d want to know what I was looking at BEFORE I saw the medical professionals, because I don’t trust them at all. Given that receiving medical care is the third leading cause of death annually in the USA, I don’t think my concern is unwarranted!
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Well, you start your comment off with an insult and then avoid almost every comment I made, and then simply declare that you are right, and that Alex’s brutal shooting of himself is “romanticized” or “glorified?” It is very hard to take you seriously when you approach conversations in this manner. I’m not simply contradicting you. I made very specific points, such as the clear and severe consequences of Hannah’s suicide for others she loved, and the completely cold and pointless and totally UNGLORIFIED nature of Alex’s act. And of course, you utterly avoid the rest of the show and focus only on two scenes, one of which you don’t even really discuss at all but simply claim to have been “glorified” through some mysterious psychological mechanism.
Your comments about “mental illness” continue to be confusing and illogical to me. If “mental illnesses” are just “symptoms that present in a psychological manner and have no clear somatic cause,” then my statement is completely true – there is nothing to say about Hannah’s “mental illness” except that she hated her life and wanted to die. I’ve never asserted anywhere that people don’t feel depressed and have related ‘symptoms’ or don’t “meet the criteria” for these DSM “disorders.” Hannah would 100% meet the criteria for “Major Depressive Disorder.” So you can easily say she was “mentally ill” just by watching the show. What did you want from the producers? That she be “diagnosed” during the show? If being “mentally ill” is simply grouping together unexplained “symptoms,” how is that different from saying that a person, for whatever reason, is overwhelmed by the conditions of his/her life? Any fool knows that a person’s experience is a combination of their own view/perception of things and the experiences that they have in the world. So what’s it mean to say she was “mentally ill”? And why is that important?
These two questions are what is bothering me about your post. There is no logical path from “Hannah’s suicide was romanticized” or “The show had a bad impact on me and people I know” to “Hannah should have been depicted as ‘mentally ill.'” It makes no sense at all. Hannah WAS depicted as “mentally ill” by your definition. So what should the producers/directors/writers have done differently that would have made it better in your view, other than not writing a show about teenage issues from the teenage viewpoint?
Oh, and just to be clear, you also completely dodged my comment that I did NOT recommend this show for people who are suicidal. I said that it showed teenage issues from a teenage viewpoint, and that’s what makes it valuable. Apparently, you don’t find that point worth responding to, even though it was the main point of my original comment, which made me wonder what your agenda really is here. Based on that observation, it did not appear to me to be your agenda to have a reasoned discussion. I’ll see how you respond to this one and draw the appropriate conclusion.
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I would probably start by researching myself and asking when this started and what set it off. The answer might be in the realm of the physiological (it started right after I took X, which can cause “psychiatric” symptoms), or psychological (it started just after an ugly confrontation with my mother in law) or a combination (I haven’t slept well for four days due to worrying about Z). It could be something altogether different that I am unable to imagine now. But I’d look for the source before I decided what to do.
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And yet the overwhelming majority of people who are killed by someone else are killed by people who are not experiencing a “psychotic state,” and the overwhelming majority of people in a “psychotic state” never attack or harm anyone at all. People who use drugs and alcohol to excess, domestic violence perpetrators, sex offenders, gang members and wannabes, all of these categories statistically are MUCH more dangerous than “psychotic” people. Not to mention the professional business CEOs (like pharmaceutical companies) who murder millions indirectly and get off with no consequences. Raising the “dangerous psychotic” meme here doesn’t really hold a lot of water, because we know better.
I do respect, however, your statement that psych drugs and even non-psych drugs do cause violence at times, just like street drugs do. Unfortunately, the “treatment” for “psychotic states” is giving more mind-altering drugs to the people who are so diagnosed, which as I think you are intimating can actually increase the odds that they’ll do something dangerous. And when they do, lo and behold, it’s all blamed on their “psychotic state.”
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OMG – add weight to his argument! You cracked me up!
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So apparently, for him, tardive dyskinesia is not a negative long-term outcome, and the death as a side effect is not greater than the “positive effects” of antipsychotics. He sounds VERY rational…
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So you were SEEKING support for your decision from Kurt Cobain’s letters. People can seek and fund such validation if they want to find it.
I also very much doubt that anyone watching the entire series could view that Hannah’s suicide was “worth it.” It was clearly an act of despair following many attempts to find a way forward with her life. The consequences for her mother, her father, her friends, and her school were obviously devastating. How does it seem “worth it?” Just because she lit some candles before slashing her wrists? It is clearly a TRAGEDY from start to finish. I’d suggest that seeing what her mom and her dad and Clay had to go through as a result of her decision would discourage anyone from considering suicide. The idea that “they’d be better off without me” is clearly and completely dashed by the production.
You continue to suggest that someone has to be “mentally ill” before they’d consider suicide. What on earth can you mean by that? Many people (including me) have suicidal thoughts that stem from having difficult experiences that they have difficulty coping with, including rape or incest or child abuse or neglect or war or gang violence or any of a myriad of crappy things that life has to offer us sometimes. Unless you define “mentally ill” as “having a hard time coping with life”, you have no grounds to stand on here.
I am assuming that you are one of those who believe that “chemical imbalances” are behind “mental illnesses,” and conclude that Hannah or someone like her could never consider taking her own life unless such an “imbalance” was present. If that is the case, it is understandable why we disagree. However, I would love to see any actual evidence you can present to support such a hypothesis. At this time, no “mental illness” can be defined by any physiological process or measurement, including depression. As such, saying someone “has a mental illness” has as much meaning as saying someone “feels like crap because s/he has been abused and mistreated all of his/her life.” The idea that a person has to be “mentally ill” in order to commit suicide is simply an opinion with no scientific backing, if only because “mentally ill” is a vague and subjective term that doesn’t allow any kind of scientific conclusions to be drawn.
In other words, people kill themselves or feel like doing so for a million reasons. Saying they are “mentally ill” avoids looking at the individual’s experience and values and process of decision making, which is, of course, what the series is really all about.
Last comment: how is it glorifying suicide when another kid shoots himself because he can’t deal with the reality of your actions? Was Alex’s suicide romanticized? Was it?
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I find your post confusing, as you seem to accuse me of things that I didn’t say. Of course, the suicide scene is overdone, and of course, they’re trying to make money. Obviously. I never said otherwise.
You clearly have your own view of “mental illness” being the cause of Hannah’s suicide. I find that view somewhat bizarre in the face of all the crap that happened to her. Do you really think that people aren’t driven over the edge by bullying, by lack of support, by rape or sexual assault? What is the meaning of “mental illness” in this context? Are you implying that Hannah or a person like her would NOT kill herself despite all the abuse she tolerated if she were not “mentally ill?” Is there a proper, “normal” way to respond to being raped by a peer and then having to face him in school the next day?
If you have specific responses or comments you are upset with, please let me know what they are before you go off on me. It’s impossible to really understand what you’re saying. However, I want to be clear that I NEVER said that this was ‘a good show for suicidal people to watch.’ I said that it depicts the dilemmas that kids face from the kids’ point of view, and that is why I found it valuable.
I will end with the observation that I’ve talked to many, many suicidal people over decades, and not one has ever said they became suicidal because they watched a show or read a book or watched a movie. They all had difficult life circumstances they were trying to navigate, and were struggling to find a way forward. The idea that a show would put something like this in someone’s mind is, again, naive. People don’t suddenly become suicidal just because they see a show. You of all people should know this, having been there yourself. I also have been there, and the things that put me there or kept me there were real things that happened to me, or that didn’t happen, or that I imagined or feared would happen, and while a show or a song might remind me of a certain dilemma or depressing event, there is no way that any show could possibly have affected my decision to kill or not kill myself. Maybe other people are different, but that’s my reality.
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This was published in the Journal of the American Medical Association, as mainstream a journal as there is in the USA. The data is from the Institute of Medicine, one of the most trusted government organizations. Here is a link to a summary.
https://nutritionfacts.org/2016/11/10/medical-care-the-third-leading-cause-of-death/
Over 100,000 people are killed IN HOSPITALS by drug side effects. Many more are killed outside of the hospital.
It is scary!
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I agree with most of what you said, though I see your clinic as being an anomaly compared to the low-income clinics I am aware of.
Also, the woman I was talking about wasn’t too depressed to consider taking action (and honestly, I don’t buy that such a condition is anything but exceedingly rare – people CAN take action, but they have to find a REASON to take action and have HOPE that it will make a difference!) She was EXCITED to hear there was something else she could do. No one ever bothered to tell her that she had options.
Glad to hear your clinicians are up on the BS involved in DSM diagnoses. I hope it spreads!
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Unfortunately, my experience is that the majority of psychotherapists these days adhere closely to the “medical model,” including applying DSM diagnoses uncritically and referring clients for drugs when they fit certain diagnostic categories. In particular, people who don’t have great insurance (which includes probably the majority of Americans) don’t have much choice and are not informed of options that are or should be available, nor are they informed of the potential damage these drugs can do.
I recall talking to a woman on a crisis line who was frantic after a year plus of trying different antidepressants without results. She was feeling completely hopeless until I asked her, “Has anyone ever told you that there are other things you can do for depression besides drugs?” She stopped for a second, and said, “No…” When I told her that there were, she was SO relieved! Imagine, a whole year plus interacting with mental health professionals, and not one had told her there was another alternative?
The idea that therapy is better today than in 1970 doesn’t seem right to me. At least back then, they had the idea that talking and listening was part of the process. Today, it’s much more about categorizing and changing “symptoms” rather than exploring meaning and options. At least that’s my experience.
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What do you think about the euphemistic use of the term “overprescription,” Frank? Wouldn’t it be more accurate to say “unneeded prescription” or “Unjustified drugging of children?” To me “overprescription” implies that there would be a ‘right’ level of prescription, which of course is impossible to determine when your criteria for diagnosis include such objective measures as “sometimes fails to wait his turn in line” or “sometimes acts as if ‘driven by a motor.'”
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Very true. The first mistake is assuming that all “hyperactive” kids have a problem, and then assuming that they all have the SAME problem, and then assuming that the problem lies in the CHILD (or more specifically, the child’s BRAIN). None of these assumptions are supported by even a slight degree of evidence. Catering to individual needs is, indeed, the answer, but that would require the adults in charge to take responsibility, and it is SO much easier to blame the kids, especially when billions in profits are to be made into the bargain.
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And who can make massive profits off of duct tape?
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Perhaps it is a success, because the proponents had a different goal in mind than actually helping people. I agree that if we assume the purpose of psychiatry is to assist people in becoming more functional and dealing better with emotional distress, it is a disastrous failure. But if the actual purpose is making a lot of people rich by creating permanent “clients” who can be forced to accept “treatment” even if it doesn’t work or makes things far worse over time, and establishing power for the psychiatric profession to define what is “normal” in support of the current status quo hierarchy in society, I’d have to say it’s been a roaring success.
People’s biggest mistake in engaging with psychiatry (and to a lesser extent, the entire medical/pharmaceutical/insurance industry) is making the assumption that helping us obtain better health is the primary objective. Receiving medical care is the third leading cause of death in the USA annually. If patient health were really the objective, this statistic would horrify the medical world and lead to massive efforts to find and eliminate the causes of these unnecessary deaths and harms. The fact that it has not led to such an outcry and effort should be enough for us to realize that their objective is something very different, that has very little to do with maintaining their clients’ health and well being.
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I think this is a very important clarification. We have spent way too much time attacking each other for being “too extreme” or for not being “antipsychiatry enough.” Both goals are legitimate and necessary to move forward, because however much we’d like to remove psychiatry from the face of the planet, people are suffering TODAY as part of this system, and such people need help TODAY and can’t wait for capitalism to collapse and some other better system to take its place that recognizes that psychiatry as practiced today has no place in a civil society. At the same time, it is VERY important to recognize the degree to which participation in the system suggests a degree of tacit approval of some of its principles, and that those very principles are the things that need to be tossed out!
There are a lot of aspects to this whole process of moving in a new direction, and I agree that identifying one’s goals is important, but it’s equally important to recognize that others may have different goals and that as long as we’re all working toward ending the abuse of the “mentally ill”, having different final outcomes in mind should not keep us from working together.
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The title is unfortunate. These are not “mentally ill students,” they are any student whose behavior is sufficiently inconvenient or uncomfortable for the college to deal with. Better to excise the “problem students” than to examine the conditions in the university or our culture as a whole that lead students to a sense of despair.
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Like the story of the frog in the slowly-warming water. Apparently, if you heat the water up slowly enough, the frog never realizes s/he’s heating up and dies despite being able to leave the water at any time.
Of course, we might want to ask who exactly thought up this experiment…
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“Very few” doesn’t mean “nobody.” I have never argued for an elimination of the drugs, as I am well aware that a significant percentage of those labeled as “mentally ill” find them helpful in one way or another. I simply object to the psychiatric profession defining your reality for you, and especially to them forcing “treatment” onto you whether you find it helpful or not.
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I remember!
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They claim that the increase in stimulant prescriptions is “unexplained.” But it is easily explained! When you start with a “diagnosis” that has no objective criteria to “diagnose” with and which has no boundary between it and “normal,” and you add a drug which provides both a financial incentive to the prescriber AND a social incentive to the parent/teacher looking for a prescription, you have a formula for an ever-increasing rate of “diagnosis” and prescription.
One thing that would help is if we stopped saying “overprescription” or “overdiagnosis” and we started saying “unjustified drugging” and “malpractice.” These euphemisms make it seem like it’s just a little “whoopsie” instead of a massive and continuing abuse of both a “diagnosis” and a drug that are being used mainly to control unruly or active kids for the convenience of the adults involved.
It is also important to add that this trend toward increasing “diagnosis” and drugging flies in the face of decades of long-term studies showing that the kids who receive stimulant drugs do not improve in any long-term outcome area relative to other “ADHD” kids who are forced to take stimulants only in the short term or not at all. Given the clear risks that giving a kid stimulants entail, there is no excuse for this continuing malpractice.
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Great analysis! And despite these biases and limitations of the HAM-D, “antidepressants” STILL have difficulty reaching even a three-point improvement on the scale. Pseudoscience at its best!
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Hi, Rasselas.redux,
It appears I have not communicated clearly enough. I had no intention of minimizing your suffering or that of those who have similar experiences. I have worked for years with people who have difficulties that get labeled as “mental illnesses” as both a therapist and an advocate, and I have a very good idea of the kind of pain and confusion such conditions can bring about. I am also not opposed to using drugs for those who find them helpful, and never have been. Nor am I arguing against individuals such as yourself embracing a particular label or identity that you might find helpful, nor am I proposing that I have some magical understanding of “what is wrong” with people who get these labels or what you or anyone else should do about it.
What I object to, and I make no apologies for it, is a profession getting together and deciding to create these arbitrary names and categories that they give to people based solely on how they act or feel, and then act as if these names are some kind of scientific reality that they can apply with confidence to anybody that comes through the door. I object even more strenuously to the “profession” blaming people’s brains for any kind of distress or upset that they exhibit, as if their surroundings and experiences and the people and stresses they have to deal with have nothing whatsoever to do with their suffering. I object most strenuously of all to those embracing the DSM categories using them to look down on those so categorized and treat them with disrespect and prejudice and discrimination based solely on the category that the “professionals” have chosen to put them into, including locking some up and forcing “treatment” on them that may or may not be helpful and may or may not be totally destructive, without that person having a word to say about it.
As the person who is suffering, I consider that you have every right to decide what your suffering means to you and what you think may be helpful or destructive. I don’t think it’s someone else’s job to make up subjective or arbitrary categories and then tell you what is “wrong” with your brain (even when they have almost zero knowledge of your brain) and what you have to do about it, and it’s especially not their job to force you to do it if you disagree with them. There is good evidence that this approach encourages a lack of empathy and a prejudiced approach to people who receive such labels, all of which I believe makes your life a lot tougher.
So by all means, identify as you feel is appropriate and use whatever means you think will best help you deal with your reality. My comments are not about you and your choices, but about the intentional efforts of the psychiatric profession to create a false, pseudoscientific narrative to keep people like you under their control and to make billions for their profession and its big corporate allies. I will never apologize for attacking these efforts, but I want to be very clear that you and your needs are a completely different story, and I’ll fight for your right to define your own experience and needs.
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Except that the labels create the culture that supports the drugs. If there were not the belief that psychiatrists “know something about the brain,” and that their labels represented some kind of scientific truth, the whole edifice would fall on its ugly ass. It’s people’s belief in the labels that makes all of this possible. I really believe that if pseudo-scientific labeling were eliminated, very few people would want these drugs.
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I’m confused by this particular conflict. It seems to me that the Spotlight report reframes the mistreatment and abuse of the so-called “mentally ill” as the human rights issue that it really is. I don’t expect a mainstream bunch of attorneys who are pissed at their clients’ treatment and are trying to do something about it to meet some “antipsychiatry” standard. They are fighting for the rights of their clients, and GOOD FOR THEM! I think there is a lot there that is very useful for the most radical antipsychiatrist to use, and for the mainstream language and the rest of it, I consider it simply the reality that not everyone has come to the same degree of awareness of how the system works and what’s behind it. My thought is that we should engage anyone of goodwill in this discussion, and that anyone who understands and is genuinely opposed to the status quo (as opposed to having a financial interest in the outcome) is AOK by me. If we expect everyone to be in favor of eliminating psychiatry, we’ll be preaching a lot to the choir.
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It’s like turning the ship when three burly sailors are fighting to hold the wheel steady. The Captain doesn’t want the ship to turn!
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The problem I see is that those in power are factually opposed to the idea of peer specialists and/or patients having any increase in power or voice. It’s possible to create little pockets of enlightenment, and I truly value and admire those who manage to do so (having been such a person myself at one time). I just think it’s too easy to co-opt or silence those whose interest is to genuinely empower the clients. Lots of clinicians talk a good game, but when push comes to shove, they are disturbed and threatened on a very deep and usually unconscious level by anything that supports clients making their own decisions and being let out from under the full control of the clinical staff.
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Maybe they should be “measuring” the mindsets of the teachers, rather than the students!
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There really are such things as “scientific values,” but unfortunately, anything can be co-opted.
My understanding of scientific values includes: 1) Observable data is the only basis for determining what is true; 2) Human beings are inherently susceptible to confirmation bias, therefore, the primary role of science is to be skeptical and to intend to disprove potential hypotheses rigorously rather than searching for data to support them; 3) Scientific models are only as “true” as they are useful in predicting real data and events, and they are true only as long as they consistently produce this kind of result; 4) ALL data relating to any particular hypothesis must always be made available to all researchers – per #2 above, any data potentially REFUTING a hypothesis is particularly important to make available.
There are more and there are other viewpoints on what makes an inquiry scientific, but the idea that scientists have some special knowledge and ability to determine truth and that those less qualified should stand back and let the scientists do their jobs is certainly not valid. Many scientific discoveries (or invalidations) are made by people in a different field entirely. Science is about finding the truth, and no one has special access to the truth.
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It’s also important to remember that “works” is defined here only as “temporarily makes ‘symptoms’ less bad than they were.” It does not imply feeling good, nor does it imply long-term improvement in prognosis or outcomes. Whitaker has done a great job showing that even if these drugs “work” for the short term, they tend to make things worse in the long run. And for many, even the short-term results can be disastrous, even if they are judged “helpful” on the average.
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Your point is very well taken. Heisenberg proved that even the most precise measurement is an approximation. Perhaps the focus on measuring is not really relevant to helping people survive better, eh?
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No problem. I appreciate the exchange.
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Not sure why we appear to be arguing here. I have never spoken against using science to study human behavior. I am a scientist (chemist) by training and am well aware of the advantages and limitations of the scientific method. I also posted my clear understanding that general trends can be arrived at scientifically using norms and averages. What I objected to is the idea that certain therapy “brands” can be identified as “evidence based” and therefore considered reliably better or more effective than those lacking this “evidence base” in most or all cases. I and others have outlined in several posts both the limitations of such evidence when applied to individuals AND the financial and other biases that warp the “evidence base” in favor of certain kinds of interventions (drugs being the MOST supported by “evidence” because, of course, they get the most funding for research since they make the most MONEY.)
It seems to me that your arguments mostly support an evidence base for certain very specific signs/symptoms being best approached (at least initially) by certain means. I don’t have any real argument with that. The problems arise when we either overgeneralize (if phobias are most likely to improve with exposure therapy, then exposure therapy is the best therapy for ALL forms of anxiety) or fail to adapt to individual circumstances (some people WON’T improve with exposure therapy but will with something else, and some don’t have elimination of that “symptom” as their goal). So the science involved in psychology is mostly applicable to people considered as a group, but only if that group has very specific characteristics in common, which we all know that most people working in the field don’t grasp.
The greater danger of “EBP”, though, is when it is applied to entire DSM categories, or to therapy in general. I can’t tell you how many stories I’ve heard where CBT or DBT (or drugs) have been forced on someone because “that’s what works” or “it’s evidence-based practice.” I recently heard from someone that they and others were FORCED to do “mindfulness” exercises every day as part of a DBT group (they got in trouble if they refused). I’m not sure how familiar you are with mindfulness, but I think it’s fair to say that forcing someone to do mindfulness exercises is deeply ironic and defeats the very purpose of the concept, kind of like your Dad saying, “We’re going on a trip and you are going to have FUN, do you hear me? FUN, whether you like it or not!” Oddly, this person did not find “mindfulness” very helpful…
You can (perhaps rightfully claim) that this isn’t really the “EBP” that was studied, and that it’s being misapplied, but that is what clinicians tend to do when presented with this EBP concept. As a scientist, my observation over many years is that science is by far the best at showing what DOES NOT work by falsification. This is particularly true when humans are involved. It is, again, arrogant, in my view, to suggest that a particular therapy is THE BEST for any diagnosis, or that ANY particular therapy is bound to work for a particular person. I think that science itself has shown us that the DSM categories are not scientific entities and are grossly heterogeneous, such that proposing any single solution based on grouping people together by how they feel or think is bound to lead to unscientific practices.
BTW, I noticed you didn’t address my point regarding “EBPs” for a diagnostic category like “Major Depressive Disorder.” It seems to me that your example of phobias is a very focused and specific category compared to any DSM diagnosis. Do you think there can be an “evidence based practice” that applies to all people who are diagnosed with “MDD” or “Bipolar disorder” or “Borderline Personality Disorder?” Do you see a danger in prescribing a particular approach to take with ALL people in such a category? Do you see potential corruption in marketable “workbook strategies” that would encourage the marketers to claim more general success than is actually observed?
In my experience, what these “EBPs” provide are concepts that can be applied or attempted in specific situations, but the bottom line continues to be whether or not the client him/herself accomplishes his/her goals in his/her own opinion, and any clinician who considers his/her school of therapy more important than the client’s response is going to have a lot of failures, and will be very tempted to blame his/her clients for those failures instead of coming up with a different approach.
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I agree with oldhead that it is not possible to objectively measure emotions, behaviors, and beliefs with behavioral rating scales. First off, we are relying on either self-report, which depends on the reporter both being honest and sufficiently self-aware to answer accurately, or on observer report, which opens us to prejudice and value judgments that are almost impossible to sort out. Additionally, what we are measuring doesn’t really have width or weight or pressure – things like “do you sleep well at night” or “do you frequently have trouble concentrating?” don’t have yes/no or scalable answers. Normalization allows for some kind of statistical studies, which makes it possible to look at large groups and draw some very general conclusions about probabilities, but as for measuring individuals’ emotions or thoughts or anything of that sort, we’re getting into a realm so subjective that the term “measurement” can’t really be applied. And applying probabilities to individuals is part of what doesn’t work about “mental health” interventions.
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I think that sums up the situation remarkably well.
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1600 mg! Holy crap! That would put a horse in a coma. You must be one tough dude!
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I agree 100%! There is NO evidence that I’ve ever seen that assigning homework is correlated in any way to improved learning. My son had to do sometimes 3-4 hours of homework every night for days at a time. He was also on the wrestling team which had meet run until 9 PM a couple nights a week. It was ridiculous, and for what?
I’m also a great believer that free time is at least as educational, probably moreso, than any work assignment kids ever receive. We learn best from things we’re interested in, not something we’re forced to do to make someone else happy.
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I agree in principle. However, the problem right now is that “training” doctors in the area of “mental health” would mean they’d be trained in the crappy DSM/chemical imbalance/Drugs first paradigm. Before we start training doctors, we would need to figure out how they need to be trained. Moreover, just training someone doesn’t make them able to handle difficult issues with compassion and skill. I have no idea how we could assure that all doctors are capable enough to be a safe place to go with this kind of intimate issue. My personal belief is that peer support is a much safer and more reliable option.
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That’s why I find the DSM to be more problematic than the drugs themselves. It provides a rationalization to distance oneself from both the clients and one’s own personal issues. Instead of making oneself open to hear where another person is coming from and feel compassion and help them figure out what action they might take, clinicians are now allowed and expected to categorize people based on their particular “brand” of suffering, and their suffering IS the problem instead of an indication of some personal problem they may have. It also makes it easy to blame your “client” if your own approach fails, as the article points out.
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I think I have that, too…
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Now I’m really confused. Laughing gets me committed, but failing to laugh somehow means I’m denying my “illness,” and I get committed anyway? This would certainly wipe out any tendency I’d ever have toward excessive cheerfulness. I think I’m cured! (Oops! Still with the exclamation points…)
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The situation is even more dire than your comments suggest. If the suicide rate is higher amongst the “treatment group”, and the treatment group has been PRE-SCREENED for suicidality and suicidal people are removed in advance, it means ALL of the suicidality reported is caused by the drugs! So the drug doubles the suicide rate AMONG THOSE WHO ARE NOT SUICIDAL. What it would do when we include people with suicidal feelings into the cohort? Frightening to think.
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I remember those ads where “more doctors smoke Kools” or something of that nature. Disgusting!
The psych wards I have visited usually have smoke breaks maybe 2-3 times a day. Many of the inmates are pushed into nicotine withdrawal as part of their “treatment.”
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Oooh, I’m dying to put a “laughing” emoji here, but you’ll probably have me committed…
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Watch out, buddy, or I’ll start sending you smiley face emojis! You can’t intimidate me!
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Love it! Unfortunately, it’s probably in the pipeline. “Excessive cheerfulness disorder” – ECD!
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I agree with the captioned statement 100%. Unfortunately, I think many people don’t understand what that means. I think a lot of people think it means that all white people are racists, or all white people are bad people. It doesn’t. It means that we’ve all been exposed to racist images and stories and ideas, and that it take a strong, conscious effort to be aware of that and to set it aside as best we can. I think acknowledging this fact is a fantastic first step for people to realize that racists beliefs and ideas aren’t something held by some small percentage of evil people who use the “N” word and beat up black people. They are a part of our entire culture It is much bigger than some bad individuals doing bad things. It’s a part of our culture, and to change it, we have to start by being aware of it, and that good people, even the best people, still have to work to be aware of and counteract these racist images which have become embedded in our own experience.
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I agree with you 100%. Epigenetics and neuroplasticity directly undermine the “broken brain” model and are therefore conveniently ignored by the mainstream of psychiatric research. This is not new information, either – neuroplasticity was uncovered back in the late 1990s, almost 20 years back. But you can’t use neuroplasticity to sell drugs, so it seems to get very short shrift.
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For those who don’t know, I’m moderating this week while Emily is moving to her new digs in another state.
I’m speaking with my moderator hat on here. Personal attacks of any sort are not allowed, regardless of perceived provocation.
If a post seems personal or inappropriate to you, the correct handling is to report the post and let the moderator handle it. At this point, we’d like to see everyone get back to the topic of the article.
Your help is appreciated.
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Well, it sounds like we’re not too far apart here. I think just approaching the problem from different directions. My big concern about manualized therapy approaches is that they convey the idea that if you follow certain steps, you’ll get results, regardless of who you are or what the client’s full presentation is. The corollary to that quickly becomes: clients who DON’T respond to the ‘recommended technique’ are “resistant clients” or have “treatment-resistant depression (or anxiety or whatever)” and are classified as somehow “difficult” clients because they don’t cooperate with the therapist’s biases. In addition to the problems with warped data collection and some approaches failing to ever BE researched (as I discussed above, and as I THINK you agree), calling some therapies “evidence based” has been used to dismiss anything OTHER than the “evidence based” approach, so that instead of saying, “Let’s start here, as this is what is most likely to work,” the field quickly devolves into “This is the only way to do it, and anyone who denies this or tries anything else is “antiscientific.” There is simply NOT enough scientific research available to make such claims, especially (a point you have not really addressed) as the groups being so “treated” are by definition highly heterogeneous in nature.
As to your quote at the end, the discussion of “classification” and “misclassification” really does suggest a power relationship of the therapist to the client with which I strongly disagree and have found to be detrimental to any kind of help. No one needs or wants to be “classified.” They want help finding a way to survive and thrive better in their lives. It is exactly this kind of “classification” that concepts like “evidence based practices” enshrine. And of course, it is not by chance that both classification AND “evidence based practice” are most strongly supportive of the sketchiest intervention of all – giving drugs for every ailment. I sometimes wonder if that was the original purpose of the concept.
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While I hear your views and totally get where you’re coming from, I can’t agree that psychiatrists always go into the field because they want to help. Just like some police go into it because they like to be able to run stop signs and give orders, and some join the army because they like to shoot guns, and some teachers go into teaching because they want summers off, some psychiatrists (like any field) go into it for less than altruistic reasons. I’ve seen some psychiatrists with such incredible power needs and egotism that all the staff at the facility are terrified of them, not to mention their clients. I’ve seen some who appear “nice” on the surface but actually enjoy setting up double binds and manipulating both clients and staff. Sure, the majority probably believe they are helping, but the fact that they chose this particular way to help does say something about who they are. There are a few wonderful psychiatrists out there, but I am afraid to say that most I have known are neither thoughtful nor very sensitive to their own clients, and many stories support this.
I’m glad your son is able to tolerate the drugs and they have the desired effects for him. I know there are many others who feel similarly. But there are also many who feel their lives have been destroyed by psychiatrists and the mental health system, and those people don’t have advertisements and celebrity endorsements to support them. A lot of them come here to be heard.
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You are too right. Doctors are accused of “overtreating” or “overmedicating” instead of MALPRACTICE. Additionally, most of the deaths are not from medical ERRORS, but from the side effects of properly prescribed and administered drugs. So accepted medical care is killing off over 100 million people annually, no errors involved. Scary situation, but no one seems to want to do a thing about it.
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I think we’re speaking to two different issues here. Is it possible that a certain approach works better for a certain kind of problem? Yes. Is it scientific to suggest that you can train anyone to use a workbook to apply such approaches to anyone who comes to them and expect success? No. You’re talking about probabilities with an incredible number of variables. I do believe in probabilities, but the variable of who is talking to the person and how they treat the person is AT THE LEAST as important as the technique they choose to use. Moreover, suggesting that “CBT”, for instance, is a “better therapy” because a larger percentage of people with a certain kind of condition respond positively by some subjective measure is a gross oversimplification.
Let’s get off of your one example of phobias and talk about something more general. Is CBT the “best” therapy for “major depression?” You know and I know that the name “major depression” can be assigned to a huge range of conditions that vary from childhood abuse to low thyroid function to a bad job situation to domestic abuse in a current relationship to existential concerns about the meaning of one’s life to feelings of hopelessness regarding a chronic medical condition that is drastically reducing one’s quality of life. Do you think that one brand of therapy is going to address every case of this “diagnosis?” Do you think that the style, emotional health, flexibility, creativity and life experience of the therapist would not be at least as important a factor?
I have used CBT techniques plenty. I’ve also used Motivational Interviewing (though I kind of invented that myself before I realized I was using it), regressive techniques, exposure, “rejection therapy,” spiritual guidance, meditation, journaling, dreams, empowerment techniques, reflective listening, reframing, positive reinforcement, and a few inventions of my own that I won’t get into trying to explain. It all depends on who the person is and what needs they have. My experience is that a) what works for one or even most people won’t work for everyone, and 2) the PREREQUISITE for ANY of these techniques working well is the establishment of sufficient rapport and trust with the client, which is not something that ANY manual can teach – it is learned through having good therapy oneself and/or through humility and the hard work of introspection over many years. Again, I’m not saying that techniques don’t have their place, or that a particular technique might not work well for a lot of people with similar “symptoms.” I’m saying that pulling out a workbook and going through the steps of CBT or exposure therapy or any kind of manualized therapy doesn’t work without these other elements, and I’m also saying that trying to suggest that one particular therapy is “evidence based” and therefore BETTER than other techniques creates unfortunate dynamics that don’t really connect with the intangible stuff that HAS to be present, nor does it allow for the observable fact that people presenting with the same “symptoms” don’t always have the same problem or the same needs.
Not being argumentative here, just trying to be clear. I have NO problem with knowing a range of techniques AND knowing such data that informs when they may be more likely to be effective. What I have a problem with is deciding that “CBT” or whatever is the ONLY approach that can be applied and that any other approach is “less than” because it doesn’t have an “evidence base.” None of what I’ve said even gets into the sketchy research techniques used to gather such evidence, nor the effect of financial incentives to research or not research particular techniques or areas (impossible to be “evidence based” if no one is motivated to pay to research your particular approach). Bottom line, I think that knowing how to handle a wide range of techniques is important and helpful, but will never overshadow the essential elements of establishing and maintaining genuine rapport and flexibility with clients, which of course will never be a focus of any research.
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I would add that while I think techniques are handy and valuable to have around, and do not in any way diminish their potential value to a particular client, it is more than possible that the next client you have will not respond well at all to the approach that worked so well for this particular person. The idea that a therapy is “evidence based” appears to suggest that it is the better therapy for everyone with a particular problem. Since the problems that we’re talking about can’t be defined in any kind of objective way, it seems arrogant, at the minimum, to suggest that “science” has somehow come up with the “best way” to deal with problems that are heterogeneous in both origin and in meaning to the client.
So I’m not dismissing therapeutic techniques here. I’m saying that suggesting one school of therapy is superior for all based on the fact that it has been “studied” and that more people with a particular complaint on the average seem to benefit is a very big leap. It may well be that exposure therapy is more likely to be helpful for a specific phobia, and we should all know that, but that doesn’t make exposure therapy better for everything, nor does it mean that a particular client will do better with exposure therapy for their particular phobia. It also doesn’t mean that some goofball who is thoughtless and insensitive and has lots of personal issues that make him/her emotionally unavailable and difficult to relate to can take out the “exposure therapy” manual and be trained up to do “exposure therapy” on anyone successfully.
Evidence is important and should be considered, but making out that one school of therapy is the best and should be used on everyone, or that the characteristics and interpersonal skills of the therapist are irrelevant, is simply not true.
— Steve
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I like the response!
My personal approach is, “What does a person’s religion have to do with whether or not science supports the short- or long-term use of psychiatric drugs?” It generally stops people in their tracks, and if it doesn’t, it makes it obvious they are avoiding the issue.
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Ooooh, that is good news! If we can get that kind of teenage kick-ass energy on board, shit will happen.
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Reality CAN be a bit inconvenient at times. I’m not against a little healthy denial from time to time, but not when people in power use it to continue to hurt those who are already hurting, just so they can feel more comfortable and make more money.
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I agree – it appears to me that the very choice to identify “mental illness” as anything at all immediately creates “otherness” and invites prejudice and discrimination. Instead of saying, “She has depression,” why not say, “She is sad a lot of the time and struggles to find anything positive to look forward to in her life.” The latter formulation affirms the person’s individuality and implies a possibility of change and development over time. The former simply slots a person as belonging to some group of afflicted people whom we can readily decide are not like us, so we can feel pity for them while at the same time not really bother to care, since they have a “disease” and it’s now the doctors’ problem.
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The author fails to even mention the life-shortening effects of the drugs used to “treat” these metaphorical “illnesses.”
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Seems like nobody believes anything until there are brain scans these days. Anyone with an ounce of common sense (though as baseball announcer Tim McCarver once said, “If it were all that common, more people would have it!) would know that most “mental illnesses” are caused or massively exacerbated by high stress environments. Of course, no one in power really wants to tell this story, because it doesn’t sell pharmaceuticals, so this kind of report is relegated to the back pages of “Science” and no one ever reads about it, even when the conclusion is so obvious.
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You are clearly obsessed with the silly idea of being treated respectfully by the psychiatric profession. You’re also delusional because you imagined such a thing was possible. You’re only healthy when you believe all you are told and stop worrying about silly little things like being listened to and respected. After all, you’re just a brain, and how can something like respect or listening make a difference to a big mass of chemical reactions?
(Just in case anyone is unclear – the above is intended to be utter sarcasm!)
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While I am not well versed in the various arguments and data in favor of one form of therapy over another, I am agreement in the author that calling “CBT” an “evidence-based therapy” privileges it in a way that is not deserved. In fact, my observations and my limited exposure to research on particular therapeutic schools suggests that the school of therapy is a very small part of what makes therapy effective. I regard CBT as ONE tool (or maybe one TYPE of tool) in a large toolbox, and psychodymanic approaches are another set. But bottom line, what seems to matter most is 1) the relative emotional health of the therapist, and 2) the ability of that therapist to support the client in his/her own discovery process by whatever means appear to be most effective in his/her case. This requires therapists to be genuine, real, honest, non-judgmental, safe, creative, thoughtful, and sensitive regarding verbal and nonverbal feedback they receive from the client. It also requires the therapist to be aware of his/her own unresolved issues and constant vigilance to keep these from directing his/her intervention and support in any way.
None of this can be taught in a manual, and I doubt it is even measurable. Nor is a client’s progress really measurable in real terms. Most studies use “symptom reduction” as their outcome measure, but clients generally have a lot more than symptom reduction in mind when they come to see a therapist. How do you measure things like an increased sense of personal power? Hope for the future? Ability to set boundaries? Ability to connect with difficult emotions without recoiling or acting out to avoid them? These things are subtle and don’t improve on a 1-10 scale. They are things that are more FELT by the client than observed by the therapist directly, and even if they were measurable, “evidence based medicine” doesn’t have either the means or the interest in measuring them.
Evidence Based Medicine is more appropriate to actual disease states where outcomes like lowered blood pressure or failure of a tumor to return can objectively be recorded. There is no objective measure of even who HAS a particular “mental disorder.” How can we measure improvement when we have no objective measure, or even any real objective CONCEPT, of what improvement looks like? Given the circumstances, the only possible worthwhile measure of success in therapy is the client’s opinion of whether or not it was worth his/her time and energy. And of course, no one is ever going to care enough to try and measure THAT!
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I agree that power is the real issue, and that eliminating psychiatry might very well lead to some other “profession” taking their place in exercising the same kind of power and control. I will note, however, that money is absolutely power in our society, and that Big Pharma and the psychiatric “profession” have used finances to sell the “broken brain” story, and that a large degree of psychiatry’s accepted authority comes from marketing. It seems to me that even if psychiatrists are unable to force “treatment” on the unwilling (which I agree 100% is Job #1), their use of massive funds to manipulate people’s perception of reality also needs to be address.
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I like that! Or how about “People with no relevant experience?”
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Such people have no business calling themselves therapists. I am very familiar with this type and have criticized their “trade” since my earliest days in the field. Eventually, I couldn’t stand being around such “services” and went into advocacy. I was fortunate that my therapist actually cared about me and knew how to be helpful. No diagnoses, no drugs, no hospitals, just good, solid questions and good listening. A vanishing breed.
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ALL Starbucks employees? I have met many Starbucks employees who appear to be decent or even very interesting people. While I am not a black person and can’t say I’ve been able to directly test out your comment, I’d say it is important not to overgeneralize about people just because they happen to work at Starbucks. Which takes nothing away from your argument that “designer coffee” joints like Starbucks definitely promote snob appeal and elitist attitudes to sell more coffee for more money.
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I love it! You and Oldhead should work up a rap for us all. Call it the “Stop the Crap Rap” or something like that.
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Another study on the obvious. Next up: “Study proves that having terrifying things happen to you is correlated with feeling terrified.”
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I see. I will have to start keeping a watch for articles that take an antipsychiatry view. You may well have a point.
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Nope. Dogma is dogma. This doesn’t mean we don’t have values that drive our decision making. The point is whether other people are bent on defining my values for me. I get to make my own decisions regarding what is a priority for me, just as you do. I have plenty of issues with folks in groups claiming to be “social justice” oriented groups using hostile language toward people deemed to be “less than.” I also am not afraid to point out when a person is being inconsistent or irrational, whether they are “left” or “right” leaning or lean some other direction. Not saying I don’t have my own biases and “dogma,” but they are MINE and not foisted on me by some outside group demanding I comply in order to belong.
But you dodged the point a bit, didn’t you?
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I think that is an excellent clarification, and I believe I truly understand where you’re coming from now. Never really thought of it that way, but it makes total sense. Thanks for the enlightenment!
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Though there are societies where adults simply move into adult roles but continue to be cared for by the community. These societies seem to be a lot better at figuring out how to find the value in community members who don’t “fit the mold” as we in industrial societies seem to expect everyone to do.
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I think it’s very legitimate to let someone know how s/he is affecting others. I’m not sure it’s quite true to say that someone “wants to suffer.” But there are “secondary gains” that sometimes make it harder to throw off the “suffering victim” role. It can take a lot of strength to be willing to examine what you’re really doing to harm other people, especially if you have “professionals” backing you up on your inability to make any changes.
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I have lately heard from an increasing number of people that their therapist diagnosed them and sent them for drugs rather than providing real therapy. I’m afraid it’s happening more and more often, and that our up and coming therapists are spending more time learning DSM diagnoses and less learning how to connect effectively with a client’s reality.
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Have you tried submitting a blog?
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Well, I can’t really argue with that, though the same can be said for many academic disciplines. I believe all education should lead to action. What I would object to is setting up a course of study that did not allow a range of viewpoints and honest discussion of potential strategies, or even a questioning of the goal itself. I detest anything that even vaguely smells of propaganda and/or dogma, even if it’s something I tend to agree with. I don’t want to replace one set of dogma with a new one!
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This has certainly been a fascinating discussion, and I’ve mostly just watched so far. I have to say, I’m a little puzzled by the critique of MIA for hosting such a seminar. If Bonnie Burstow is endowing a “Chair for Mad Studies,” then I feel comfortable assuming that “Mad Studies” has a distinctly rebellious intent. That being said, MIA has a mission and part of that mission is to show a wide range of views and information on the topic. That this information is slanted away from supporting the status quo can not be doubted, but MIA doesn’t appear to have some “litmus test” regarding who is ideologically pure enough to post here, and I’m glad they don’t. Some of the blogs that are closer to mainstream views generate fascinating and important discussions, as do some of the clearly antipsychiatry blogs. I personally prefer to have a wide range of information and views available rather than being limited only to the “acceptable” range of opinions on the topic. My assumption would be that
“Mad Studies” would similarly look at a whole range of data and opinions and experiences and encourage students to draw their own conclusions, which I personally think is how education should work. If the administrators decide ahead of time what you’re allowed to read or hear, then it’s indoctrination, not education.
That’s my two cents’ worth!
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“Does the profession prefer to medicate others, because they are frightened of who THEY could become? ”
Short answer: YES!
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I have never disagreed with you on that point.
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Interesting that caring about the needs and context of the student’s experience doesn’t seem to make the list of important counselor qualities. Let’s be honest, the whole idea that you can “assess” a child and label them provides excellent cover for continuing ineffective classroom and schoolwide practices. Maybe we should keep it simple and just work on teaching each child in the way s/he needs and leave all the “assessment” and “evidence based practices” to those with too many degrees to play with?
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Where did I say that? I’m merely differentiating between psychological impacts (which are to some degree within the control of the one being mistreated) and the physical and social consequences, which are not controllable by the victim. It’s all well and good to say “don’t care what someone thinks about you,” but if they don’t hire you or won’t speak with you or won’t rent you an apartment or shoot you or lock you up for being “mentally ill”, your attitude doesn’t stop them. So attitude is important, but wanted to make sure to clarify that attitude is not an antidote to oppression.
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Not sure what you’re arguing about. I agreed with you regarding psychological freedom. I’m merely pointing out that not all effects of prejudice and oppression are psychological.
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Maybe they should start by admitting that their ‘services’ often aren’t all that helpful to white folks, either.
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Let’s be honest, the system’s biggest fear of “peers” is that they will talk about the possibility of not following orders, especially as regards “medication.” Their second biggest fear is that the “peers” will call them out on their lack of knowledge regarding how to help, or will show them up in some way that embarrasses them. Both very “patient centered” reasons to be worried, eh? It’s all about control, and those who fear “peers” fear losing control, usually because they have no idea how to establish any kind of helpful relationship with anyone.
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Not at all, but liberating oneself from PHYSICAL slavery or analogous conditions of abuse and oppression takes more than “not caring” what your owner thinks of you.
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Unfortunately, it IS used to interpret the nature of human experience, even though it is a billing document. It takes a special kind of idiot to use a billing guide to make determinations about human experience, but apparently, there are a lot of idiots out there pretending to provide medical advice.
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True, Julie. Looking at movie stars and TV personalities of the late 50s and early 60s, it’s obvious that a more full-figured woman was more than merely acceptable. Times have changed, and once again, the rigors of corporate capitalism and TV advertising seem to be pushing the trend.
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Yeah, I hear you. Unfortunately, if you insisted on full scientific rigor in psychiatric/psychological research, MIA wouldn’t have much left to publish, since it all starts with the disproven assumption that people who act the same way as described in the DSM have something “wrong” with them, and in fact have the SAME thing wrong with them which has to have the SAME “treatment.” Kind of like prescribing medical treatment based on someone’s astrology chart. Probably not going to get much that’s truly of scientific value!
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This is ominous, though certainly not shocking.
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I think MIA sometimes just reports on relevant research, most of which is written from the “medical model” viewpoint. It is a bit frustrating, but the report does offer up some good information that actually supports the idea that external conditions and events (in this case, physical activity) have a major impact in how people feel and behave. So I’d rather read the information and put their comments into perspective rather than filtering out anything that uses medical model language, which would mean missing a lot of interesting data.
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How about banning DTC advertising like they do in every other industrialized country except New Zealand?
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I agree with you here. “Not caring” is really more of a coping measure than a means of addressing abuse. It’s something I’ve learned to get by, but it is less and less easy to do the lower down a person is on the social hierarchy. As I said, “not caring” doesn’t stop people from ganging up on you or discriminating against you or the group you’ve been identified with. Not so easy to “not care” when you’ve been locked up in a psych ward and then put on an AOT order that threatens to lock you up if you don’t “take your medication” per their orders!
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Because the ruling powers in society need them, and because their “diagnoses” shift the blame off of those with the most power and place it onto those with the least. Because it absolves our society from having to do anything about the adverse conditions we create, because those who can’t “adjust” are found to be failing, rather than the conditions they are expected to tolerate.
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Why not just categorize people as violent based on their acts of violence? “Schizophrenia” doesn’t need to enter into it, any more than “black violent person” or “rich violent person” or “Canadian violent person” would be legit labels. People from ANY category can be violent. It’s the intentional association of violence with “mental health issues” that needs to be negated.
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I do the same. I have actually gotten to the point where I really DON’T care what a lot of people think, but still, people who I care about have an effect. I’ve worked on being honest about this effect, but it’s still a very natural source of anxiety for me and a lot of people. Not caring means being disconnected, and we all want to feel connected to someone or something, or most of us do, anyway. It’s the disconnected ones who are OK with it that scare me!
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Thanks, Julie! I am well aware that some women choose not to worry about glamour and whatnot, as my wife is one of them. Nonetheless, she and all of us have received countless messages that say “women can’t be fat.” The fact that some rise above it doesn’t make the shaming any less real, or any less differentiated by gender. I’m glad you’ve somehow managed to like yourself the way you are – I find that you are a rare person in our culture!
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In fact, they both do the opposite – undermine confidence and remove any remaining sense of agency, as the patient is required to put him/herself in the hands of the doctors, and accept that there is nothing s/he can to about his/her broken brain.
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“Death therapy, Bob. It’s a sure cure!”
From the movie ‘What About Bob?’ If you’ve never seen it, you really should. It’s a comedy that acts as a very effective antipsychiatry message.
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I am SO glad someone is finally talking about this issue. Look at those stats – 3/4 of the women diagnosed with “postpartum depression” were current domestic abuse victims!!! The authors neglect to mention that physical abuse is known frequently to begin or significantly increase before or soon after a baby is born.
It is simply inexcusable for anyone to conduct any kind of research or scientific discussion of “postpartum depression” without taking domestic abuse into account, yet this topic is almost NEVER discussed by anyone supposedly researching the area. This is one more way that psychiatric labeling is not only inaccurate and unhelpful, but actually PREVENTS genuine research into major causal factors that contribute to the distress psychiatry is claiming to want to ameliorate.
— Steve
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The thing is, I don’t think she said that; I think she said that what is healthy/unhealthy or that what is a priority or not a priority is not something that an outside person can determine for someone else. And if you read my posts carefully, you’d see that offering support and perspectives is most definitely an important part of how I see people helping each other. It’s the paternalistic part that I object to, and it’s very, very easy to slip into that mode once we decide that WE know what is “better/worse” for someone else without bothering to consult them on their priorities and reasons.
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Now THAT is a good point. Although ganging up and abuse can still happen, even if you don’t care what someone else thinks.
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I’m kind of working from Kate’s assumption here – a person identifying as female, regardless of their sex, would most likely experience similar pressures to be slim, attractive, well made-up, shaved legs, etc. I could be wrong, but that would be my assumption. Naturally, there are people of any gender who are working to challenge these assumptions, but that seems to be the pressure society places – females have to be sexy, slim and attractive, while males who are powerful can be fat, ugly and stupid and still be OK.
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Uprising: I thought I said that. It’s not about smoking or eating certain foods or whatever is good or bad for your health. It’s about judging and shaming and making assumptions about others because they are fat, smoke, or are diagnosed “mentally ill.” Unlike some who post here, I totally think it’s possible for one person to help another person in a professional or non-professional capacity. But the first prerequisite is to not judge a person’s actions, but instead to find out what’s going on. A person who drinks all the time is going to kill him/herself eventually, but I’m not going to start on a tirade on how drinking’s bad for you – I’m going to get to know that person and build some trust and perhaps find out what drinking does for that person (what need it meets) and why they think it’s important and what is underlying it and whether or not they see it as something they want to change or if perhaps there is something else that they want to change but don’t feel they can and hence the drinking as a means of coping. You get the idea. It’s not about whether smoking is healthy. It’s about assuming you know better than the other person what they should or shouldn’t be doing.
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In what way (besides smoking) do people assume smokers are failing in their lives? Isn’t smoking just smoking? It doesn’t seem to imply anything else except that the person smokes.
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Same arguments apply to the extent that telling smokers they are bad people for smoking is disrespectful and unhelpful.
However, there are pretty big differences in the situation:
1) You can’t quit eating. Everyone has to eat something, and there are a ton of cultural forces that determine what’s available, what’s portrayed as desirable, and what is “forbidden fruit.”
2) Assuming fat people eat poorly is neither respectful nor correct. Lots of skinny people eat like crap and lots of fat people eat healthy diets and exercise plenty. There is no similar association that cigarette smokers are somehow inadequate in some part of their lives that is reflected in their smoking.
3) Smoking has never been used as a means of disparaging a particular gender in the way fat-shaming has been used. Nothing even close. Worry about being fat vs. skinny vs. “normal” is driven into every woman in the USA from birth onward in a way that smoking/not smoking never has been or will be. In fact, smoking was long considered a strong sign of “coolness.” Pretty sure there is nowhere in US or Western industrial culture where being fat is considered “cool.”
I am sure that others can contribute further to this list.
— Steve
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I didn’t read that she’s saying that. What I’m reading is that it’s not OUR job to tell the other person what the best path is for them. Certainly, I don’t think anyone is unaware that drinking soda or beer is not good for your body. This is about judging PEOPLE for doing things you personally would not do. This includes giving unsolicited advice about “healthy choices.” If you have a friend who is doing things that seem destructive, I see nothing wrong with trying to communicate about that, as long as you’re not taking a position that you’re superior to them. If we get interested in their situation, other people can teach us a lot about what’s going on behind the behavior that is bothering us. This may lead us to realizing that our concern was misplaced, or that the actual issue is something very, very different than what is presented. But it’s not our decision what is or is not an issue someone wants/needs to work on or change – it’s the person’s decision, and the entire “mental health” industry invalidates that decision almost every time they encounter someone whose behavior seems “unhealthy” to the mainstream/status quo. The correlation between trying to “fix” someone who has a larger body and trying to “fix” someone who acts in ways you don’t understand is quite apt, in my observation. It all starts with the paternalistic assumption that you know better than someone else how they should behave.
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I so totally agree with you – labeling people as “privileged” seems to imply for some people permission to dismiss all that the “privileged” person has to say and to engage in all manner of generalizations about them, often subtly or not so subtly justifying putting down someone who happens to fit into a particular category.
At the same time, privilege is very real and I’m totally down with pointing out when it is being used to avoid thinking about their condition and blaming other people for NOT having their condition. So the problem isn’t being or not being privileged so much as grouping people together and dismissing them based on some apparent group association or similarities. Of course, it’s way easier for the privileged to get away with dismissing other people’s realities, but treating a person with disrespect BECAUSE they fit into some privileged category is pretty bad, too. We all have some degree of privilege, and it should never be a means of putting someone down or disregarding their feedback.
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I think you misunderstand me. I don’t regard ANYONE as being “normal.” I see “normal” as an attempt to control and direct people into behavior that others find more comfortable for them, and if there are enough people agreeing to act a certain way, they are then defined as “normal.” There is nothing more “normal” about this behavior except for the agreement that it is called that, and setting up that standard of “normal” enables those in power to label those who don’t comply as “mentally ill” or whatever other label they want to sling. So I agree 100%, people with “mental illnesses” are for the most part completely normal and either don’t fit in or are reacting to difficult circumstances. It’s the claim that other people are “normal” and the “mentally ill” are not that is the core of what I’m calling “normalism.”
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Disgusting, but not surprising.
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The NRA appears to consistently oppose any form of gun control, no matter how focused or practical it may be. Two recent examples are straw purchases and the “gun show loophole.” The NRA would be far better served if they simply looked at current gun control laws and people’s objections to them and proposed their own form of legislative fix that would protect honest peoples’ right to own firearms while preventing them from getting into the hands of people with known histories of violence. I have not seen any effort in this direction. Instead, they seem to want to create maximum alarm in the public toward any sort of gun control proposal, equating any efforts at resolving current issues with an attempt to disarm legal gun owners. Choosing Ollie North as their leader says a lot.
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Not so great for your “patients,” but fantastic for drug company bottom lines! A drug that you can’t get off and have to keep taking to keep from being miserable – sounds a lot like a street drug dealer, doesn’t it?
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True, but it doesn’t imply superiority on the part of the “normal.”
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Hey, I have no problem with the second amendment. But I do have a problem with people who have been proven violent being allowed to own firearms. Most gun owners are AOK, but just like if you drive drunk or drive on the sidewalk, you lose your car, if you’re unsafe with your firearms, you should lose them. Not sure why anyone would disagree with that concept.
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Consciousness transcending corporeal existence? You are operating on questions WAY beyond the comprehension of the psychiatric field! They are still having trouble with the idea that someone actually decides what they’re going to do rather than being determined to do everything they do by chemical reactions!
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It is important not to confuse their public image with their political power, which appears to remain quite substantial.
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At least duct tape is a more honest approach.
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I think it’s because they hit him where he lives and he knows that he can’t answer without further prevaricating, which the gentlemen writing him will quickly suss out.
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“…without having to reduce Western medicine to a caricature…”
With “disorders” like “Intermittent Explosive Disorder” and “Oppositional-Defiant Disorder” and “Disorder of Written Expression,” Western medicine appears to be reducing itself to a caricature without the help of any outside forces.
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The irony is that efforts to define what is “sane” or “healthy” drive people’s ability or willingness to communicate about any perceived “non-normal” experience underground, which is, in itself, the cause of much of what is called “insanity.”
I had a new idea about the concept of “sanism.” I don’t like that word, because it implies that there are “sane” people who look down on “insane” people because they are “insane,” and the answer is for the “sane” people to be nicer to the “insane.” I propose the word “normalism,” which represents the tendency to dismiss or denigrate or abuse anyone who veers away from the sacred “norm.” Of course, no one is entirely “normal,” so it creates the possibility of the problem not being deviation from the “norm” so much as the bizarre expectation that everyone should strive for “normal” in the first place.
Thanks for the excellent article!
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There are stats showing a recent severe decline in public opinion regarding the NRA, starting from when they made such rude and degrading comments about the teenage survivors of the Parkland shooting massacre. Their stock is most definitely down, at least for the moment. I can’t see how having Ollie North as their “face” could possibly help matters, though I know he’s a “hero” in certain very irrational circles.
http://www.businessinsider.com/nra-poll-popularity-favorability-more-americans-dislike-2018-3
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It is, indeed, the criminal Oliver North, returned from notoriety to head the NRA. The NRA is in a strange way a natural ally, in that they want to distract any attention from gun control. However, being supported by the NRA may be as helpful as an endorsement from NAMBLA (the North American Man-Boy Love Association) the way their reputation is sinking lately!
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And when they finally get the screw hammered in, it falls out again somehow, and we conclude we have a hammer-resistant “nail.”
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Of course, labeling this whole group “ADHD” would prevent us ever finding out if there are a very small number of people who actually have something wrong with them biologically, since the “ADHD” group is wildly heterogeneous. The serious problem with allowing stimulants for a theoretical small group who can’t be differentiated from the masses so diagnosed is that once you do, “diagnostic drift” takes over and you get what we have today. Until there is some way to actually determine who has this ostensible disorder in some objective way, protests to “never say never” come across as avoiding the issue.
Thanks for your reply!
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If you hit a screw with a hammer and it doesn’t go into the wood, hit it harder or with a different hammer, or maybe two hammers at once, or maybe a power hammer will work or…
Does it ever occur to them that if drugs don’t improve the situation, maybe they should try something else besides drugs? Maybe, just maybe, this situation is not resolvable by drugs?
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It is almost laughable to see these efforts to “standardize” the “diagnosis” of an abstract entity that can’t be defined in any kind of objective terms. Researchers substitute consistency (do people come up with the same answer with the same people) for validity (do these “measurements” actually represent a legitimate homogeneous grouping of people based on that which is being measured?) If you know which people have cancer by some objective means, you can run tests to see if these tests detect cancer and perhaps start identifying it earlier. But these checklists don’t identify anything, or specifically, they identify people who answer the questions in a certain way that they have decided means something they want it to mean. If you find out if a person’s depressed by asking them if they feel depressed, you’ll get a pretty high agreement amongst raters – they will diagnose “depression” if the person says “I’m depressed.” These checklists are a little more subtle than that, but it amounts to exactly the same thing. You might as well just talk to the person and ask them how they feel and not bother with the trappings of pseudo-objectivity. At least you’re being more honest that way.
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Hi, Mark,
I am glad that you recognize the chances of psychosis or “manic states” being brought on by stimulant use at accepted dosages. What I wonder is this: since you don’t seem to think that “ADHD” is really a disease state at all, it’s confusing that you talk about people who “actually have the underlying mental disorder.” Do you actually believe there are people who “have ADHD”? If so, how are they differentiated from those have “a mismatch between their attention spans and the required attention of their lives?” Or is that what “the underlying mental disorder” actually means in your observation?
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It is now illegal to do this in the USA, though I don’t doubt that it still happens, if perhaps more subtly than before.
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What made you want to become a therapist in the first place?
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“Treatment-resistant depression” is such a bizarre turn of phrase! “Depression” is resisting somehow, as if it were an animate object of some sort. And the doctor/therapist who is unable to help is off the hook, because it’s not that they are unable to help, it’s the DEPRESSION that is RESISTING their efforts!
If you took your car to a mechanic who said he couldn’t fix your car because it had “repair-resistant fuel injectors,” but you can come back next week and pay for another “treatment,” I think you’d go find another mechanic pretty quick. How do they get away with this kind of chicanery?
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Right, but only if someone is able to recognize hopelessness as a REALITY and not as a flaw of some sort!
I LOVED George Carlin…
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Mat, thanks so much for sharing your moving and heartfelt story! And VERY well done for coming up with so many approaches that worked – you actually invented for yourself stuff that people go to universities to learn!
One thing struck me about the start of your story – you said that you grew up in an “affluent, happy home and community.” If that was really the case, why were so many people so intentionally mean and hurtful to you? I have to wonder how happy those other people really were when they seemed to be unable to accept you but instead attacked you for being different. It also sounded later like when you were finally finding your way despite the “help” of the system pushing you further in the mud, your family was not only not supportive, but continued to work to undermine your recovery. It sounded to me like they were very busy blaming you for making them feel uncomfortable.
I’m very impressed by the path you’ve followed and really appreciate you sharing it with us. It saddens me that you had to figure out so much of this yourself, but it’s also a joy to hear that at least the folks at Howie the Harp center understand how to truly support someone. Hang in there and keep on moving forward – you are a tough and smart person who survived a lot of crap!
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Yeah, I wonder how “the authorities” would act if a parent said, “Well, he has trouble concentrating, so I slip him half a bennie in the morning and it really helps. Can you give him the other half at lunchtime, please?”
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Thanks for the laugh! “ITD” – inadequate teaching disorder, characterized by restless kids, boredom and yawning in class, rebellious pranks, and kids screaming with joy as they run out of the room when they are finally allowed to escape your classroom. Treatment? Go into flower arrangement or something where you can’t hurt vulnerable children!
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So we’ve done research showing that chronic pain makes you feel bad. Wow. What a startling conclusion. I never would have guessed!
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Good article! The author did miss one point I’d like to see added: 40-50 years of long-term studies have failed to show ANY improvement in ANY significant long-term outcome as a result of stimulant use. High school graduation, college admission, academic test scores, social skills, delinquency, substance abuse, even self esteem – NONE of these areas are improved by long-term use of stimulants, and in some studies, outcomes were WORSE for the stimulant users. These studies were largely done by mainstream psychiatrists, and these conclusions aren’t even controversial. But they are kept VERY quiet.
It should be obvious to anyone that there is a risk involved in giving stimulant drugs to children. When we see that there is NO benefit in quality of life in ANY domain, what could possibly justify their being prescribe to these poor kids?
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So Mischa, it sounds like you agree with the people you’re arguing with (and with Szaz) on the main issue, namely, that psychiatric diagnoses are bullshit. So what’s with the endless stream of ad hominem attacks? If it’s all semantics, why not just find the part you agree with and agree with it and move on? Your behavior has become obnoxious and rude and I have reported it to the moderators. What’s your beef? Why can’t you just have a civil conversation?
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The truth is a great place to start. But what is “the good” that you think needs to be preserved?
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I can’t speak for Slaying, but I have helped and supported hundreds, probably thousands of people as a counselor, advocate, friend, parent, teacher, listening ear, etc. I had next to zero training in psychology, absolutely zero training in psychiatry, and have never for one minute subscribed to the physiological reality of any of the “DSM” concepts. Remember they are VOTED ON in committees and are “diagnosed” by checklists! It’s like basing a diagnosis on one of those Reader’s Digest “Are you an introvert or an extrovert?” quizzes. It is BULLSHIT! And refusing to use or believe in these diagnoses has never provided the slightest impediment to me helping lots and lots of people who would fit any number of these “diagnoses.” In fact, I think it worked strongly to my advantage to avoid them. Because it allowed the person I was helping to define both the problem as they saw it and the possible solutions, and empowered them to address THEIR problem rather than the one foisted on them by well-meaning but condescending “professionals.” Suffering is not a myth. The idea that suffering can be categorized and “treated” in the same way a broken leg or a hernia can is absolutely a myth. And admitting this to be true actually opens the door to finding REAL solutions for people who are suffering.
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So did you miss my main point? I’m saying that the CATEGORIES dreamed up in committees by the psychiatric profession are not real categories that identify real “disease states” that can be “treated” by the proper “medication.” Not denying that it sucks to be depressed all the time (used to be that way myself, actually), or that there may be some depressed people who actually DO have something physiologically wrong with them. It’s just that lumping all depressed people together and saying they have “Major Depressive Disorder” based on a checklist of unwanted behaviors and feelings doesn’t make it a “disease.” Can we agree on that much?
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Perhaps darker-skinned Americans are savvy enough from experience (on the average) to recognize that the “authorities” can’t be trusted when they promise “help.”
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The confidence with which they convey this totally unsupported disinfirmation that conflicts even with itself is quite astounding to me, even now. No provisios, no “we’re still exploring this area,” no “some people have different experiences…” Such arrogance in the face of no scientific support, it’s just baffling!
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I didn’t phrase that quite correctly. I should have said that the SUFFERING that is sometimes named a “mental illness” can be very real, but the act of labeling it a “disease” or “disorder” is still mythological. I agree 100%, there are no “things” that “mental illness” labels actually identify – they are fictionl and mythological. But some people seem to think that this position means we are denying that people experience negative feelings or thoughts or have a difficult time making their way through the world, and I don’t think anyone here would pretend that such emotions and experiences don’t exist.
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I don’t think anyone here is denying that the things that are called “mental illnesses” exist and need and deserve help. I think we’re saying that the idea that these are “illnesses like diabetes” is a complete and utter lie, designed to sell drugs and “services.” I have no problem with people using drugs to assist them in dealing with whatever issues they need to deal with. I have a BIG problem with the psychiatric profession telling us that ALL depression is caused by “brain chemistry defects” when there is no evidence that this is the case.
I think it’s easy to get hung up on rhetoric. But the bottom line is, regardless of individual success stories, which exist in plenty, the psychiatric profession itself is corrupt, and the model used to “diagnose” these “disorders” is fatally flawed and does a lot of damage. Real informed consent means admitting that they don’t know what causes ANY of their “mental disorders” nor do they even know if these categories they have identified are valid entities to study, as the people grouped together as having “major depressive disorder” or “ADHD” or even “Schizophrenia” often have little to nothing in common with each other except the label.
Until the day when someone can objectively divide those who “have a disorder” from those who don’t, I will continue to hold that the DSM labels that psychiatrists so breezily hand out to all and sundry are, indeed, scientifically mythological. And the people who actually DO need help will be best served if they scratch the DSM concept and start over with trying to find the REAL reasons why these phenomena happen, and more importantly, come up with a legitimate way of approaching these problems that actually leads to large numbers of people recovering, instead of leading to an ever-increasing number of people becoming disabled and unable to lead their lives.
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Frank, I’d say we also have to outlaw false advertising about psychiatry and psychiatric drugs in all of their forms. And preferably lying about “diagnoses,” too. A lot of psychiatry’s power comes from marketing lies. However, removing coercive power is definitely the most important step, and the one where the law can most readily be modified. People have always sold snake oil, but holding one down and pouring the snake oil down your throat is taking it to a different level.
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I do agree that it’s an important distinction to make. Coming up with arbitrary labels for someone else’s problems and telling them “what is wrong with them” is harmful. Working with a person to come up with ways for that person to understand his/her own situation and strategize how to more effectively approach it FROM THEIR OWN VIEWPOINT can be incredibly transformative!
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The same critique could be applied to any DSM “diagnosis”. The DSM itself admits in the introduction that there is no way to draw a line between normal and “disordered,” and that those labeled as having a particular “disorder” may not “be alike in all important ways.” In other words, the DSM is unable to distinguish any “disorder” from normalcy, and even those identified as having the same “disorder” may have different things wrong with them or nothing wrong with them at all.
The whole thing is based on smoke and mirrors, and the DSM itself admits it. It is amazing that professionals can waste their time and energy talking about “differential diagnosis” and “misdiagnosis” when the “diagnoses” are admitted not to even represent a homogeneous grouping. It reminds me of the debate about “introverts” and “extroverts,” except no one is claiming that “extroverts” are healthy and “introverts” are sick. It’s 100% fantasy!
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This is such an important topic, but gets very little attention, even in the antipsychiatry/psych reform community. Back in the 70s, feminist writers were VERY strong about the role psychiatry plays in enforcing the norms of patriarchy, and how psychiatric diagnosis is used to pathologize the (predominantly female) victims of violence and protect the perpetrators of such violence. I am not sure how this thread has been lost, but I rarely if ever hear modern-day feminists talk about this issue, even though it appears far worse today than it ever was in 1975. What’s going on there? What can we do to re-link with current-day feminist activists and get onto the same page?
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Of course, you are right, Frank, and institutionalized “help” has been generally disastrous over time and seems to be getting worse, whether it’s asylums or “residential treatment” or schools or churches or whatever you want to pick out. However, I do believe it is very possible for individuals, and even institutions on rare occasion, to be helpful, and that’s what I’m talking about here. Some helpful people may carry the label “therapist” or “pastor” or “teacher” or “mentor,” while others may carry the label “friend” or “partner” or “parent” or “son” or “cousin” or “guy I met at the bookstore.” The label or professional credentials are not the determining factor, it is how you treat the other person that makes a difference. And a person can get better at it with practice, and can learn from reading others’ experiences in helping and being helped. I don’t think helping each other is impossible, or even tremendously difficult. Psychiatry’s problem isn’t that it’s trying to help, or even that it’s an institution, it’s that its purpose is NOT to help others. Its purpose, as well as many if not most social institutions in Western society, is self-perpetuation and amassing of power and wealth, and the willingness and ability to lie and use force to accomplish its goals makes it all the more heinous.
I think it is misguided for people to dismiss helping because the institutions of psychiatry and psychology have failed to accomplish it. I think the important shift is to dismiss the idea that there is some kind of “treatment” that will “cure” these DSM “diseases,” and instead get back to realizing that people are people and that life is tough sometimes and that we need to be there for each other in helpful ways. I see no problem with trying to study the question of what is or is not helpful to other people, as long as we define “helpful” from the point of view of the person purportedly being “helped.”
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It becomes apparent fairly quickly, at least to me, when someone isn’t really interested in help. It has to do with whether they are interested or willing to take some kind of action in the direction of accomplishing their goals or intentions. I sometimes spend a little time figuring this out, but I’d say 10-15 minutes is generally sufficient. I’m not willing to waste my time on someone who isn’t interested in real change, but I have found it much more common that people are happy to work on changes that fit with their own needs rather than the needs of their clinician. Happy to share a story or two if you’re interested.
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But I do agree with you, there is no such thing as “healthy” or “unhealthy” coping mechanisms, except by someone’s personal preference. Society wants us to believe in these ideas so they can control us into thinking the way we are ‘supposed to.’ It should go without saying that I find that particular concept obnoxious.
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I don’t try to help people who don’t want my help, not ever. And if they do want help, I try to find out what they think “help” means to them. I do find that a lot of people who supposedly “don’t want help” really do, except that they don’t want the kind of “help” that has been forced on them. Avoiding force, manipulation, invalidation, evaluation, condescension often leads to situations where people actually feel safe enough to reach out, and I’m happy to help them, formally or informally.
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It also allows others to empathize with our experience, whereas psych labels, as Rachel points out, are shown to encourage distancing ourselves from the victims of “bad brain chemistry.”
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LOL! Nice one! (Wait, you’re serious? They’re coming for me! NOOOOOOO!)
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I agree with your comments. My only proviso is that anyone I would consider a valid therapist (and they are rare, I admit) would never tell someone what to think, who they are, or what their problems really are. If that’s what “therapy” has become (and as I say, it frequently is exactly that), a walk in the woods would be safer and more effective by a long ways!
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Why not call it “unhappiness?” And what I would say to the psychiatrist is “This approach isn’t really working for me. Do you have any other suggestions besides changing medications? What can I do day to day to help manage these feelings?” But don’t be surprised if the psychiatrist, as nice as s/he may be, doesn’t really have any other ideas. Searching the internet for others with similar issues might be more helpful. Hope you find something soon!
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Having a pipe wrench, some plumbers’ tape, a snake, and a toolbox doesn’t make one a plumber. Focusing on one particular school of thought as somehow “evidence based” creates detachment from the client and inflexibility in approach. I certainly have lots of tools in my toolbox, and as I said, “techniques can be handy tools for specific situations.” Not being married to a school of thought isn’t the same as having “no theory or principles for making sense of the client’s experience.” It simply means being flexible and building one’s model of reality from direct experience, and being willing to alter and adapt that model when new experiences and data enter the scene. I would maintain that some therapists can and do accomplish this, but many, perhaps most these days, do not. I would also maintain that most untrained folks can do this, too, if they have the right perspective and attitude. It doesn’t require an advanced degree, and it doesn’t require commitment to “evidence based practices,” except to the extent that one needs to observe the evidence of one’s own efforts from the point of view of the client’s goals and intentions. It DOES require sufficient perspective on one’s own emotional needs so that one does not judge or react adversely to the client’s own description of reality. Again, some therapists can do this, but a lot of them can’t, in my experience. And plenty of people with no formal training ARE able to assume this attitude. I would maintain that, with enough practice and attention to their effects on the people they are trying to help, a completely untrained person could become a very effective helper without any kind of formal training at all. (Not that some kinds of training might not be helpful, but again, they are simply adding tools at that point, and are in a position to decide which tools appear to work and which do not.) And it is a CERTAINTY that having training as a therapist in the latest “evidence-based practices” provides no assurance that the therapist would be even marginally capable of connecting with and understanding another human being.
So I guess I see specific training in specific “schools of thought” as a minimally relevant variable in this case. And I see unflagging commitment to a single school of thought to be deadly to any chance of even marginal competence.
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“Panic attacks” are generally caused by something scary happening to you. Sometimes the scary thing happens long before the “attack.” But there is some process going on for you that you feel somehow that things are going to go badly and you need to prepare to run or to do battle.
The only thing a therapist can do to help (if they can do this, which many can not) is to help you identify what it is that you are reacting to. They can’t TELL you this, but a good therapist (or a good friend or support person or parent or brother/sister or grandma) can listen and ask questions to help YOU figure out what was going on.
It seems pretty clear from your comments that the current model of label-and-drug has not really changed things for you. Maybe time to look at it differently? Maybe there IS a reason you panicked, even if it’s not obvious to you what it was about?
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I think I get what you’re saying. Just because “professionalizing” helping others creates a lot of problems, it doesn’t mean it is simple or easy to know how to be a helpful person to someone in a difficult situation. It behooves us to study what is and isn’t helpful, but more importantly, it is most important to put our own houses in order so that we can really be there for those who need us. And that is NOT a no-brainer!
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Not sure why “depression pills can’t cure anything” leads to “people claiming to be depressed are malingering.” People DO feel depressed, sometimes severely, sometimes for a long time. No one is denying this reality. The problem is calling “depression” a “disorder” implies that it is ALWAYS caused by the same thing, is ALWAYS pathological, and is “curable” by these pills in most or all cases. You and I both know that none of these three statements is true. It is VERY easy to say, “Depression as a state of mind exists and can be extremely painful. However, efforts to “cure” depression with pills have not been effective.” These two premises do not contradict each other in any way.
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I doubt you’d find a mainstream psychiatrist anywhere who claims that antidepressants cure something. They will almost universally say that they are “treating symptoms” but that there “is no cure.”
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Sounds a lot better than rambling on about “evidence based practices” and whatnot. Being honest about what is not known and about the very subjective aspects of both “diagnosis” and whatever form of “therapy” is provided would be essential, but I’d bet my life savings that the number who actually provide this is infinitesimally small.
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Techniques can be handy tools for difficult situations, but I don’t think any set of techniques guarantees success in any situation, because people are different. My personal approach to assessment is, “gather information until some picture of what might help emerges. Try that out. If it doesn’t work, gather more information and try something else.” And “work” must be defined by the CLIENT’S perception of what they are seeking, which is where I think most therapists fall down on the job.
Just as a fer instance, I tend to use “motivational interviewing” techniques a lot when I am trying to help someone out. But I didn’t know it for over a decade! I had no training in “motivational interviewing,” but simply followed what seemed to be working and essentially “invented” a style of motivational interviewing based on the needs of my clients. As such, I am never married to using those techniques – I only use them when they appear to be workable. And when they aren’t, I do something else.
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Sounds like the best basis for any kind of helping!
CBT and any “school” of therapy is mostly just techniques that can be applied. Applying techniques can be done in a connected, caring way or a disconnected, condescending way. Absent the caring part, I don’t think it makes a bit of difference what techniques you use, you will screw someone up in the name of “helping” them. And if you really care, the techniques become secondary, because you’re seeking a real understanding of the person and that is what guides you forward. The search for the “gold standard therapeutic approach” is doomed to failure.
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The only person whose opinion matters on “what works” is the person looking for help.
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Oh, no, no! Please! I feel FINE now! I feel VERY HAPPY with the status quo. Please don’t “help” me again!!!!
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Interesting. I definitely felt torn about the PTM concept. On the one hand, it is awesome that the professionals involved are prepared to publicly challenge the DSM/ICD madness in a direct and public manner, and provide an alternative explanation for how/why people act in these ways. On the other hand, when I was reading the list of coping measures, I could see how easily they could become their own “labels” or “illnesses” and it still kind of felt like there is something WRONG with the people doing these things, even if they now have a reasonable and less blameful explanation for them.
It is certainly a vast improvement over “your brain is broken.” Vast improvement. And the recognition of societal power as a force creating these effects is something I have not ever seen in the world of psychology/therapy, other than some individual writers. So I see some hope here, but also a real possibility of the new framework being co-opted into just another way of creating or reinforcing superior/inferior divisions.
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All of this is based on the weird and incorrect idea that “mental illnesses” are uniquely identifiable and should all respond to a particular “treatment.” The truth is, all people are unique and their needs and strengths are unique, and so what is needed to help them is unique to their situation and personality. Milton Erickson opined that therapy needs to be ‘reinvented’ for each new client. I agree 100%, and would go further to say that “therapy” itself assumes that some professional needs to intervene to help someone make their way through whatever they are struggling with, and this assumption is also 100% wrong. Sometimes the best therapy is no therapy at all.
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Good article! Perhaps the problem starts with making “happiness” the goal. Why would we assume that everyone would be “happy” with the status quo?
— Steve
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Glasser was both a visionary and a very practical problem-solver. “Reality therapy” is about as fully empowering a concept as I have ever read about or seen applied. He does a fantastic job of separating responsibility for external circumstances (which we don’t control) and responsibility for attitude and decisions (which we DO control). He focuses on the intentions of the person asking for help, rather than having some “plan” for the other person that is outside of their control. His goal is higher self-determination for the client, not “compliance” with “treatment.” He is most definitely worth the read.
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And we can’t have that, can we?
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If they have been doing it for 60 years despite repeated “education,” it should be clear that “education” isn’t going to do the job. They will stop when it’s made illegal and that the doctors are fined and/or jailed and lose their medical licenses when they do it. Nothing else will work, as the facilities really don’t care about this issue – they are meeting their own needs, and their clients in many cases are an afterthought.
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He is very “sciency.” Pretty brain pictures mean he must be smart and know more than you and me. The new breed of charlatan.
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So again you use the term “overmedicating.” How can you “overmedicate” when there is no objective means to determine what “appropriate” medicating is? Isn’t giving “medication” for a non-medical condition called “malpractice” rather than “overmedicating?” What is the standard?
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First off, WOW! Amazing work, and thanks for the wonderful guide/pathway for others to create similar successes!
Second, WOW! It is amazing the lengths to which the industry and its beneficiaries will go to snuff out anything that threatens their domination of the field. Your persistence is incredible in the face of such systematic direct and indirect attempts to derail your intentions. You really have exposed the incredible fear these people have of being exposed, and now created a means of furthering their exposure. They must be terrified of you!
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Thanks! I’ve always wanted to invent a word that achieves general acceptance in the language. Maybe this is my big hit!
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Hi, Niel,
So I am a little confused by your comments. You refer to Szaz, who very clearly and articulately took the position that “mental illnesses” are social constructs, not disease states. Yet you use the term “overprescription,” as if there were a “right” level of prescription that has been exceeded. How can there be a “right” level of prescription for a social construct? Unless we had a real diagnostic system that allowed people with actual, physiological problems be sorted from those whose metaphorical “diseases” are a consequence of social and interpersonal stress, or “problems of living,” as I believe Szaz called them, how on earth could we ever arrive at an “appropriate” level of “medicating?”
Or perhaps you are in the Moncriefian camp, and view drugs as simply having effects that we find desirable/undesirable? If so, how does the profession distinguish between effects found desirable by the individual him/herself and effects found desirable by the society around him/her?
To me, this issue of “diagnosis” is central to the whole problem of “overmedication,” as drugs are being used to “medicate” people who are not objectively ill in the physiological sense.
The fact that folks other than Big Pharma-influenced psychiatrists came up with some of the diagnostic categories is neither here nor there – the categories lump together people who have little to nothing in common and presume that they ALL have the same problem and need the same solution. This is not science, it is fiction, and to the extent that it is known to be fiction, can only be regarded as a hoax, as Phil outlines.
Prominent psychiatrists have admitted out loud that the chemical imbalance concept has been known to be false for decades, and research backs them up on this. Yet they have publicly justified telling patients this is true in order to make them feel more comfortable with taking their prescribed drugs. Doesn’t that sound pretty “hoaxy” to you?
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I do see them as different. Psych labels are external and fixed. “Patterns of distress” are more of a philosophical categorization and are both flexible and applicable by either “clinicians” or the people experiencing the distress. Plus, you can’t arrest someone for a “pattern of distress.”
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The average person is easily deceived by the perception of “sciency-ness.” We have a tendency to want to believe that some smart, “scientific” person is going to figure things out and explain them to us, and if we agree, we’ll feel smart, too. I am afraid our educational system helps make us this way. “Science” in school is not about experiment and discovery, it’s about getting the “right” answer as “discovered” by some other person smarter than we are. Not sure what is necessary to change that, but science teaching most definitely has to change.
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I have to agree with Phil, here. The evidence is in that psychiatric diagnoses are almost totally subjective, that the “chemical imbalance” theory was disproven (at least for serotonin and dopamine) back in the 1980s, that psychiatric drugs are not specific to any problem with the brain, but are general agents that impact the brain and body in a wide range of ways, sometimes very unpredictably. There is evidence that psychiatric diagnoses and the chemical imbalance theory cause discrimination against those so diagnosed, there is evidence that long-term “treatment” with these drugs does NOT create better outcomes, and increasing evidence that it actually may WORSEN outcomes overall. There is a ton of evidence that the main thing those who are diagnosed as “mentally ill” have in common is a history of trauma, and that the psychiatric system ignores or minimizes traumatic experiences in favor of biological explanations. There is evidence that being a minority, being an immigrant, or living in an urban environment contribute significantly to the development of “schizophrenia.”
In the face of all of this evidence, what evidence do YOU have that Phil’s line of reasoning is wrong or is biased?
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Hi, Laura!
I just want to say how wonderful it is to see your name back on MIA again! It sounds like you have really created a sustainable way of supporting people in thinking and acting in an empowered way when dealing with the pressure to label and drug. WELL DONE!
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Wow, that explains a lot!
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Surely you would agree that psychiatrists and psychotherapists fall under the rubric of “mental health professionals?”
You still haven’t pointed out any “fact” that I mentioned that you felt was a criticism. You are certainly validating my point that there is a power differential that exists between “mental health professional” and “client.” Doesn’t that give the mental health professional a “privilege” vis-a-vis the “client?” Am I being judgmental when I point this out?
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“All stakeholders — service users, carers and practitioners — could benefit from moving towards a space where we can enter into dialogue as equals…”
Yes, but if such a space/conversation were held, it would require the “professionals” to step down from their place of power. Their chronic and continuing unwillingness to do so is the exact reason why such efforts at analysis will not create the needed changes.
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You know I agree with you, a good mamma can make all the difference. However, I do think it’s important to keep in mind that not all mammas are good ones. Pappas, too. There are some who do incredibly destructive things and then use psychiatric labels to blame their own kids for their failings. As in all things, “Generalizations are always wrong.” It comes down to whether the mamma/pappa in question is focused on the needs of their offspring, or their own need not to feel bad about their own mistakes and misunderstandings.
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Absolutely! A consultant is what is needed, someone to observe what’s happening and provide perspective and options, not someone who thinks they have the right to tell you what to do, think and feel!
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I do support the message – I just think the title is very “erudite” and confusing to the person on the street. There has GOT to be a more intuitive name for it!
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Can anyone think of another area of medicine where a discussion of how we or the clinicians FEEL about the diagnosis has an impact on what the diagnosis it self will be? Something is VERY wrong with a diagnosis process that is so subjective that people’s opinions play a primary role in arriving at the diagnosis. Shouldn’t diagnosis be based on facts and objective observations?
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As a person who worked as an advocate for kids in the child welfare system for 20 years, I absolutely agree that white, middle class parents (and even more so upper class) are held to much lower standards and are assumed to be “good parents” because of their social position, education, and ability to afford a good attorney. Not meaning to disrespect the indigent defense bar, because some of the most amazing attorneys I have ever met are indigent defense attorneys. But the ability to hire a private attorney is seen as very intimidating, and Child Welfare seldom wants to go up against a doctor or attorney or well-regarded white citizen if there is any way to avoid it. 98% of the parents in child welfare were poor, and we KNOW that the poor don’t commit 98% of the child abuse in America.
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I hate the name “Power, threat, meaning” and hereby vote to rename this viewpoint the “get off my back model.” Or perhaps the LMTFA model – “Leave me the f*&k alone!”
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Gabi, I think you hit on a VERY important point here – feminism focused on giving women more power WITHIN THE CURRENT SYSTEM THAT EXISTS. When women became more able to work in high-paying jobs, they also discovered that even those in high-paying jobs experience oppression on a very serious level – long hours, not being able to take time for family needs (I had to ARGUE to get THREE DAYS off when my first son was born in 1983!), being bullied by abusive bosses, and being at the beck and call of the corporate capitalist juggernaut that determines how everything runs. The absurdity of our “parental leave” policies in the USA is a huge contributing factor to “Postpartum depression.” As is the fact that decreasing average wages have created a situation where instead of being ABLE to get a job, women (and men) are now forced to work full time when their babies are young in order to survive economically. But I don’t blame all this on feminism – it is a result of our sick and sickening social/economic system which demands that close to everyone, male or female, has to sell his/her soul to the Company in order to survive. Feminism, in my view, never actually intended initially to deal with these power structure issues, and they remain substantially unchanged (actually worse) than they were in the 1970s.
All that being said, I don’t want to take away the effective work in balancing power and creating more safety for women and children that has resulted from the feminist movement. There are hard stats backing me up on this. Like I said, there is still a hell of a lot more work to do, and perhaps the current challenge among activists of all stripes is to start banding together to deal with the larger social power dynamics that really drive racism, sexism, classism, etc. Because even having totally equal access to opportunity in a society built on oppression will not end the core assumptions that power over someone else is the most valuable commodity available.
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How many more studies like this will it take before reality undermines the psychiatric myth of the ‘chemical cure?’ This looks like as well-controlled a naturalistic study as could possibly be arranged, and it comports with the data from every other naturalistic study on the subject already published. How many does it take before the industry is held accountable for promoting ineffective and destructive “solutions” that don’t even identify the real problem, let alone solve it?
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I would put it that a person could USE a competent therapist as a catalyst to improve his/her OWN happiness. The operative word here is “competent”. I was fortunate enough to hit upon a very competent therapist in my 20s and was much the better for the experience. However, the number of therapists who actually know how to play that “catalyst” role (who were never in the majority even back in 1980) appears to have decreased dramatically since the introduction of the DSM III and the push for biological explanations. More and more appear to have become handmaidens of the psychiatric industry, and such “therapists” are more than dangerous, as they not only harm the individual but give the idea that there is no real help out there except for drugging up your brain.
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Who said that was the basic premise of the feminist movement? The basic premise is that women are human beings deserving the same rights as men. Our society has always (and to a large degree continues) allowed men to get away with things that women are punished for, allowed men to make decisions and rules and control the lives of women and children, allowed men in power to behave abusively toward other women, children, and other men lower in the hierarchy than them. Consider domestic abuse: in 1970, there were NO shelters, NO domestic abuse laws, NO protection at all for an abused spouse – if you complained to the police, they’d ask you what you’d done wrong to deserve it. We have come an INCREDIBLY long way (though we still have a long way to go) in reducing the #1 cause of injury or death to younger and middle-aged women. That is not a “side effect” of feminism, that was one of the primary areas of intentional focus of feminism, and it’s pretty disrespectful of the women who in some cases risked their own lives to bring about these changes to suggest that it was all about saying that men and women have the same bodies and the same needs.
On the other side, feminism helped make it possible for men like me to become nurturing dads and to be there for their kids with full social support. When I stayed home with my son back in 1986, a visit to the park with my infant son (and I was the ONLY man there on almost every occasion) led to suspicious glares that seemed to indicate I was probably a child molester. Nowadays, there are men walking through the park in droves every weekend and plenty on weekdays as well. This has nothing to do with men and women having the same needs and the same bodies. This is major cultural change that would never have happened without feminism.
I can certainly entertain the idea that feminism may have had side effects (to use your term) that may not have all been positive. But your concept of what feminism is reflects a complete misunderstanding of the subject. It’s not about bodies. It’s about POWER and the abuse of power by men over those they deem below them in the power structure. To consider that a side issue is factually inaccurate and again very disrespectful to those who fought to give you the increased power you now enjoy in society. And I was there, I lived through those times, and I know what it is I’m talking about. You don’t want to go back to 1970, trust me on that point. And one major reason our society is better for you is because of those early feminists who risked their lives and reputations to make it so. Maybe you should read up on it and see if I’m making this up.
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The article seems spot on, except that I would add that other causes are also ignored, including boring classrooms, bullying by other kids OR by teachers and staff, meaningless busywork, lack of free play time, requiring kids to do things they are not developmentally ready for, and more. Psychiatry also disregards nutritional or sleep problems, ongoing or prior trauma in the home environment, and social issues such as racism, sexism, homophobia, and many other issues that lead to anxiety, depression, rage or even psychosis. The DSM-III intentionally created labels that disregard cause, and these labels have removed almost any effort to figure out why kids are acting how they are, replacing meaningful analysis with empty and meaningless labels that discourage any effort to figure out what is actually going on.
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I think it’s very easy to take for granted the many, many improvements that have happened in society as a result of the feminist movement. It is quite disingenuous to trash feminism while enjoying the benefits you deny have accrued to you. It reminds me of people getting down on unions, but try to take away their 40-hour week or their vacation or sick time and see how upset they get. Feminism, like any movement, has its downsides and its extremist members and is not perfect, but to claim that feminism has not brought a very large and dramatic change in the US and world culture is just plain unappreciative denial.
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I don’t have stats, but I absolutely believe you are right. Psychiatry’s “no-fault” view of “mental illness” has in part been in service of protecting the powerful from scrutiny, both in individual family situations, as well as society in general. If “mental illness” is all in the malfunctioning brains of the sufferers, then we don’t have to look at how our families or schools or government or corporate institutions are contributing to creating this suffering in our citizens.
Plus, the fact that it pays out billions to stockholders makes it that much easier to support.
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Thanks for your comments! It appears we are in substantial agreement across the board. I do object to the term “privilege” being tossed about as a derogatory term, because it truly is not the fault of the person with privilege, and also because privilege can be used in very positive ways. Making it an insult stops healthy conversation – in fact, the original intent in creating the word, as I understand it, was to get away from judgment and to create a neutral term that simply described the situation as it is, without casting blame on either the privileged or those whom they may be overlooking or harming (whether accidentally or intentionally) due to lack of understanding of their condition. This certainly applies to parenting – there are many parents who have every intention of doing a good job yet end up doing harm (my parents certainly qualified) based on their freedom to do as they will without consequence and their failure to realize the impact of their actions on the powerless children in their care.
You are welcome to share any perspective I have put to paper (or “to screen” in this case!), as I am completely open regarding my observations and opinions regarding these issues. Thanks so much for engaging in a civil and positive way on what I think can be a very touchy issue!
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The staff psychiatrist named in the article claims that disabling side effects are “extremely rare,” yet admits there is “no data” on this point. What arrogance! How do you know something is “extremely rare” without data?
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Deeply disturbing. Maybe we should just set up self-service kiosks on campus, where you type in your symptoms and a remote psychiatrist approves your prescription?
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Add it to the list of bad things associated with long-term psych drug use. Are we surprised?
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Whew! I apparently barely passed out of the realm of shortness humiliation at 5′ 9 1/4″.
Thanks, Noel, for your beautiful rendering of a very sad picture. I very much doubt that social prejudice and bullying will be part of the narrative, but you do a great job of bringing that reality to life.
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The removal of context from experiences labeled as “mental illness” is the central tenet that allows the DSM and psychiatry to dominate the definition and discussion of care of the human psyche. It must be identified and challenged whenever and wherever it appears!
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Right. “Headaches can cause pain in your head!” It is hard to understand why people can’t see this tautological idiocy for what it is.
And I appreciate your expansion of my list! As I said, the list can go on and on. One I did not mention is the differential attention before and after birth – suddenly while pregnant, everyone is all excited and wants to touch your belly and wants to share their baby stories, but after the birth, everyone drops off a casserole and then doesn’t talk to you again for 6 months or sometimes ever.
My wife did a brief sociological study of postpartum depression around the world. She found that there are cultures where there is essentially NO postpartum depression AT ALL. Interestingly, those cultures were the ones where the mother had the least to do besides caring for the baby and the most continuous support from other members of the community for the longest period of time. I’m sure the same would be true for pregnancy – lots of attention and genuine support would ameliorate a lot of stress and bad feelings for everyone in the family.
I also appreciate your mentioning our bizarre childbirth practices and their contribution to prenatal/postnatal feelings of depression. Obstetrical care is almost as irrational and destructive as psychiatry, with treatment decisions made through myth and tradition and attempts to intervene with actual science met with scorn and ostracism. Consider that a third of US babies are born by C-section, and no one finds this alarming. The unnecessary anxiety and disempowerment of moms by birth practices in the USA is criminal.
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As to the subject of “meritocracy,” without going into a specific critique of the idea, the concept itself depends on the assumption of equal access to resources and opportunities. Which of course is bullshit. So not really possible to have a “meritocracy” when merit is rewarded more for some than others having the same “merits.”
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Well, the fact in this case is that psychotherapists and psychiatrists have more power than their clients. That fact in itself doesn’t make psychotherapists or psychiatrists bad people or mean that they are doing harm. It just makes it easier for them to get away with doing harm if they want to, and easier for them to blame their clients if the clients don’t get better. So having more relative power doesn’t make one evil. Using that power to fuck someone up makes you evil.
It is also true that a psychotherapist may have power over his/her clients and yet be abused by his/her partner or be discriminated against because s/he isn’t white. So power is relative to the relationships and institutions involved. I’m not sure how any of those things constitute criticisms. It’s often interpreted that way, but I don’t see one thing I said that isn’t factually and objectively observable. If you do, please let me know which statements you consider critical, and who is being criticized. I think our society is very uncomfortable with any discussion of power, so saying someone “has power” seems equivalent to saying they abuse their power. But it isn’t. We all have power, and all have people with power over us. How we use our power is up to us, but we can’t control how others use their power, which is why high power often leads to abuse and oppression. But there is no rule that says it has to.
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And it’s not just psychiatry. As SE points out, receiving medical care is the #3 killer in the USA today. Most of the deaths are from properly prescribed and administered drugs. So far from slowing down the production of “new and helpful medications,” setting more restrictions will SAVE lives by making sure that new and HARMFUL drugs don’t make it to the market. Viiox, anyone?
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My observation is that “conservative Americans” overall like to pretend that differential privilege doesn’t exist at all. It makes it easier to beat up on the poor and blame them for their own poverty. This is a gross generalization, but it’s certainly a very common phenomenon for those claiming conservative values. The idea that all Americans can accomplish whatever they want if they just work hard enough is embedded in American mythology, but it isn’t really true. There is not a level playing field, and those calling themselves conservatives often choose to overlook that fairly obvious fact.
I’m not a big fan of the left-right political spectrum divisions anyway. I believe those who really have power in our society like to see “liberals” and “conservatives” fighting each other, because it keeps the attention off of the fact that big corporations increasingly own our government and our representatives. If the left and right could get together on getting big money out of politics, we could get back to the days when each side recognized that the other had value to contribute to the discussion. We seem to have come a long way from that idea.
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Having worked as an advocate for kids in the child welfare system, I can validate your observations about who does and doesn’t get the State involved in their kids lives. It is, quite literally, the ones who can’t afford an attorney to sue the state who end up involved. Over 90% of the kids in Oregon’s DHS system were very low income. The only time the State got involved with well-off familes was with sex abuse, and occasionally with very severe domestic abuse involving arrests and criminal charges. So the privilege in this case was afforded to the parents – the privilege of being able to avoid State involvement despite their abusive behavior, drug abuse, interpersonal violence, or more commonly, physical and emotional neglect of their kids.
Again, I agree that kids are disempowered in our culture, whatever level of financial privilege their parents may have, and I would encourage others commenting on this thread to make that important distinction.
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Saying someone is “privileged” is not “calling them out.” It’s just a fact of life. All societies have more and less privileged members. Some of this is earned, but some of it is not. And of course, privilege is different in different areas of examination. My kids are privileged to have caring, intelligent, emotionally healthy adults raising them. They are privileged to have had access to alternative educational opportunities rather than attending standard public schools. They are not so privileged economically (though they are compared to some in our society or around the world). There are many who have economic privilege from birth, but don’t have the privileges my kids have had in the emotional/educational realms. These are just facts of life, not criticisms. I think it’s sad that people view the term “privileged” as a put down. It isn’t. There is no need to be defensive about having earned or unearned privileges in life. But it IS important when considering other people’s ability to succeed in society. It’s easy to be judgmental of, say, inner city kids for being so often involved with crime and/or gangs. But when we look at what opportunities these kids are or are not offered, it becomes understandable, and we may be moved to help change the conditions of poverty and crime surrounding them instead of judging them as morally or genetically inferior. Just for example.
Why is “privilege” something you “call out?” Do you see the term as an insult?
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Well said!
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Childhood Bipolar Disorder has been shown to be even more delusional fiction than the adult version. “Irritability” was INVENTED as a criterion by Joseph Biedermann in service of his Big Pharma masters at J&J so they could sell more Risperdal. There was never any evidence that these kids had anything wrong with them, and longitudinal studies showed NO correlation between which kids got “bipolar” labels in childhood and those who were labeled “bipolar” as adults. “Irritability” is pretty damned common among kids (and as Frank points out, among their parents as well!) Telling doctors there is some way to “correctly assess irritability” is about as stupid as saying you can assess “emotional immaturity” or “oversensitivity” or “aggressiveness” in children. In other words, it’s meaningless, and the reason doctors are confused is because they’re being lied to!
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“…the suffering caused by the depression itself is horrible.” I object to the idea that “depression CAUSES suffering.” Depression IS suffering, and calling it “depression” is only a way of categorizing this suffering. It is highly misleading to make it seem like “depression” is some outside force that takes over your brain and MAKES you suffer. There is no evidence, nor even any kind of mechanism, to support this kind of far-fetched conceptualization, though of course lack of evidence has never been a barrier to psychiatric hubris in the past.
Moreover, there are lots of REAL REASONS that women get depressed during pregnancy. These include biological reasons, like loss of sleep, rapidly changing nutritional needs, and hormonal shifts that alter normal expectations and routines; psychological reasons, such as the fear of parenthood, childhood issues being brought up by the idea of being pregnant, changes in body image, conflicts between the desire to continue working and the desire to stay home with the baby; and social issues, including changing relationships with and expectations of others, loss of connection with single or non-parenting friends, challenging behavior from older siblings, and most often ignored but very important, the common initiation or escalation of abuse by a partner that so frequently occurs during this vulnerable time in a person’s life. That is a very abbreviated list that could easily be expanded on at great length. Being pregnant is stressful and brings up a lot of crap. Being depressed during this time is hardly surprising and often 100% normal given the context. None of this is discussed in the article.
In my view, “depression” is not a “disorder” to be “treated.” It is a (usually) temporary condition that arises when a person is in a situation s/he is not happy about but can’t immediately get away from. It is not something that needs “treatment,” it needs understanding, patience, and empowerment to seek one’s own solutions. Until we stop framing “depression” as something that “happens to” people rather than something they are experiencing and over which they have some degree of control (however difficult that control may be to exercise), we will continue to have dilemmas like whether or not we want to pass on brain-damaging chemicals to our vulnerable fetuses in huge numbers.
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You got that right! Funding defines what is provided, and who decides what is funded? Hint: it is NOT the people who are actually supposed to be helped by the services!
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Oh, and vis-a-vis social class, of course, it does belong on that list, and it is one of the easiest ones to leave off. Rich kids get abused as well as poor and middle class kids, and there are some unique difficulties for privileged people to get in touch with historical feelings of powerlessness. Thanks for reminding me to include that.
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Thanks for your thorough answer. I agree that, in essence, most of us are projecting our rage/powerlessness either on those who appear to have the most social power (left) or those who have the least (right). Dealing with our own disappointment/rage/grief regarding our own upbringing and the adults who were supposed to care with us but failed is the first job of anyone trying to be helpful to others or to society at large. Unfortunately, few people do this, and once a person has ripped open this veil, other people’s motivations seem all to obvious and yet often impossible to discuss. It is, indeed, a lonely experience. Thanks for sharing it with me!
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Which proves that the real problem is NOT the drugs themselves, it is the ATTITUDE that allows the idea of prescribing drugs for behavior problems to be accepted. The essential purpose of the DSM III and beyond was to provide cover and justification for drugging normal human beings for profit. Until we address that approach and eliminate it completely from anyone’s idea of “care,” stopping “overprescription” of one drug will simply lead to a new drug to replace it. It is the idea of labeling and drugging people whose behavior is inconvenient that has to go!
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Well done! Gave me a couple of laughs!
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Patriarchy as a concept most definitely includes children. The term “patriarchy,” as I’m sure all are aware, comes from Latin for “father,” hence, means the rule of the father literally.
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Thank you for the clarification. I agree that children in general are the least powerful and most oppressed group on the planet, and that their oppression is often ignored or minimized by all folks across the political spectrum. It’s kind of sad, because it is the one kind of oppression that most of us can deeply share and relate to, regardless of what race, religion, sexual orientation, gender, or national origin label may apply to us. I think it’s crucial that we come together on the point of the oppression of children, because that’s where all the other forms of oppression have their birth, IMHO. But sadly, children don’t vote and have no real social power at all, so it falls to us who used to be children to speak for them, and for the most part, we have failed them miserably.
I’m interested in your views on what I said above, namely, the difficulty or unwillingness of those leaning left on the political spectrum to find a way to see the oppression of the psychiatric system and work it into their “intersectionality” analysis.
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The term “meds” evolved to get away from calling them “drugs”. It’s been apparent from the first that these drugs were in a different category than normal medicine, and the fear of people creating an analogy (essentially correct) that these drugs are not dissimilar to street drugs. So we call them “meds” to make it seem like it’s somehow different.
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Wow, great blog, Chaya! I particularly liked the analogy of candy bars for emergencies vs. long term health. I also appreciated your elucidation of how mainstream views are always presented as “the other side of the story” while the mainstream speakers are never required to be balanced by other points of view. This is stuff I’ll be able to use in talking with others about the strange anti-critical bubble that seems to surround the psychiatric worldview. Thanks!
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Danke!
Personally, I find the very process of “diagnosing” people with these largely arbitrary labels like “OCD” and “mental retardation” and “schizophrenia” to be problematic in itself. I have rarely used them except as a means of getting insurance companies to pay for their client’s needs. I find them dehumanizing.
I agree about assessing each individual as an individual, but even the term “assessing” suggests that I’m somehow above them and able to tell the client “what is wrong” or “what to do.” My approach is more humble: I try to help the client clarify what s/he needs and what is happening to him/her without me trying to evaluate or direct them beyond simply helping them gain some perspective on what is happening. I figure that the only one who knows what’s really going on is the client. It seems your approach supports that idea, but still uses diagnostic labels. I wonder, is it possible to accomplish the same or better results with no labels or “assessment” whatsoever?
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I think the missing first step here is recognizing that our so-called “objective medicine” IS a culture in itself, and is a reflection of the larger culture. Pretending that it is objective in the first place is the starting point for allowing medicine to avoid dealing with the truth shown by its own research. There IS no separation of culture and medicine, so it’s impossible to “rejoin” these, since one is embedded in the other. Pretending to be objective is what gives this cultural phenomenon its unearned power.
“Zen and the Art of Motorcycle Maintenance” is a fantastic book that takes about an ECT survivor whose personality is erased by the process. It is a true story that shows his slow recovery of himself, but meanwhile completely and effectively takes down the idea that science is somehow separate from and superior to “subjective” areas of study. (Though he places fault not with the Romans, but with the Greeks, and specifically with Aristotle). It’s an amazing read!
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Yeah, some people benefit from Jack Daniels, too. Alcohol is a great anti-anxiety agent. Doesn’t mean getting drunk is “treating” a “mental illness.”
What do you think about the DSM/ICD classification of “mental illnesses” based on behavioral checklists?
Ich habe einmal in Deutschland gewohnt (Freiberg i. Br.) und verstehe die Einschrankungen des Deutschen Sinn fuer Humor! (Ungluecklicherweise habe ich kein Umlaut auf mein Computer!)
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Thanks for your reply. I was not referring to individuals who have distortions, but somewhat sardonically referring to the DSM diagnostic system and the mainstream’s religious adherence to it in contradiction to actual data. The idea that all or most “mental illness” is due to physiological malfunctions of the brain is completely unsupported by the data (the “low serotonin” theory of depression was debunked back in the 1980s, before Prozac even came to market), and yet is still held to be undeniably true by many in the field. It is a shared delusion, given more power by the agreement of powerful people, despite a complete lack of evidence that this belief has any connection to reality.
So my post was intended as dark humor, as in my view, the entire psychiatric worldview is based on a mass delusion, namely that the DSM diagnostic categories represent some as yet undefined physiological malfunction, despite years of research failing to find any such malfunction for any such diagnosis. In fact, the very idea that all people meet the criteria for a particular disorder have the same problem, or even have anything wrong with them at all, is another shared delusion. Unfortunately, those who have power can safely maintain their delusions, while persecuting those whose beliefs don’t comport with the official version of what people are supposed to believe.
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I’m not convinced that “the left” is throwing privileged children “under the bus,” nor that “they” are racist toward white or privileged people. My concern is that “the left” (whatever that means) is so worried about offending people that it fails to act on the oppression that those receiving “mental health” diagnoses experience.
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Saying something over and over again doesn’t make it true. Where is your evidence? Your Edgar Cayce link on Depression is simply a stating of opinion with no facts, and his opinion conflicts with even mainstream psychiatrists these days who have admitted several years ago that the “chemical imbalance” theory is completely unsupported by evidence and has no validity.
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“…attributional distortions (especially one-sided attributions; module 1), a jumping to conclusions bias (modules 2 and 7), a bias against disconfirmatory evidence (module 3), problems in theory of mind (modules 4 and 6), overconfidence in memory errors (module 5), and depressive cognitive patterns (module 8).”
Well, this looks like it might be an EXCELLENT therapy for the PROVIDERS of “mental health care,” especially the psychiatric community. All of these except perhaps Module 8 are regularly evidenced by mainstream practitioners. “Attributional distortions” are, of course, built into the DSM diagnostic system, including the infamous “chemical imbalance” trope. “Jumping to conclusions” is facilitated by the DSM, as fitting the checklist allows one the luxury of pretending you know what’s happening in the absence of evidence. “Bias against disconfirmatory evidence” – well, that one’s kind of obvious. “Problems in theory of the mind” – again, completely obvious. “Overconfidence in memory errors” – such as Dr. Ron Pies’ confident statement that no well-informed psychiatrist would ever put the “chemical imbalance theory” forward, despite evidence he’d done so himself in the past. As for “depressive cognitive patterns,” if you changed that to “depressing cognitive patterns,” psychiatry would be 100%!
Let’s require them to go through this before they’re allowed to talk to a client. I bet 80% would drop out of psychiatry rather than face up to the delusion on which their profession is built.
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I had a similar experience, despite telling the guy that I never took drugs for anything if I could help it, and was only there for antibiotics. I think they get kickbacks. Why else would they push so hard for us to get a prescription we’re making clear we won’t use?
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Yeah, really, it’s not rocket science. Listen empathetically, be interested, care, be real… don’t need to go to school for those, and in fact, no school can really teach them. What it requires is being in touch with your humanity and putting out your energy to be there for someone else. Apparently, that skill is in short supply, though!
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Exactly. I’d much rather have people exposing themselves to light rather than drugs, but why do they have to be “diagnosed” to do so? And what about the impact of the society that deprives its members of sufficient natural lighting?
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Lots of other sources of abuse, too. School was a huge one for me. Just for one example, I got hit in the head in 2nd grade BY THE TEACHER when I had the temerity to object when she tossed a book over our heads in a rage while spitting venomous words at the whole class. Of course, nothing happened to hear at all, while me and another kid had to go to the principal’s office. That was the worst, but stuff like this happened all the time, with kids getting intimidated, punished and humiliated just for acting like kids. Churches and businesses and many other institutions are similarly abusive. To limit trauma to family of origin stuff (though that is VERY important!) will miss a lot of the harms that our society perpetrates on those not in power positions.
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You’re not making sense, Pat. What does a critique of psychiatry have to do with “white privilege?” And why would the fact that some people scam the system mean that the system is working fine? People scam ANY system. The question is whether or not people on the average are getting better with the current model, and the answer appears to be no. Have you even READ “Anatomy of an Epidemic,” the basis for this website? Please answer this question – failure to do so will terminally undermine what credibility you currently maintain.
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Oooh, you are sneaky! Love to see how THAT conversation turned out!
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Almost every TV show or movie with psychiatrists shows them as therapists who talk and listen to patients. It is very different from reality. I recently saw an episode of Chicago Med where the psychiatrist was claiming that a man’s “scan” (of his brain) could show that he is a sociopath. So it’s weird – they support the “medical model” but still portray the psychiatrists as being interested in the patient’s experiences. Best of both worlds, I guess, but it’s pretty much all BS.
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You’re forgetting one – 7. They are receiving direct or indirect kickbacks from the drug companies for prescribing.
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“Rather, trauma exposure is posited to create an initial level of heightened vulnerability for later psychopathology, including but not limited to psychosis…”
Wow, way to make it sound as complex as possible! Why not say, “Being traumatized makes it very likely you’ll get a later DSM diagnosis.” Or better yet, “Trauma is bad for you.”
With Someone Else’s great contribution, we see that over 80% of “psychotic” adults have been traumatized. Compare this with the fact that the most optimistic genetic studies have showed less than 15% of “mentally ill” adults have any correlation with even a wide range of genetic markers (over 100, as I recall). Seems like we’re wasting a lot of time looking at genetics, when the most obvious “contributing factor” is childhood trauma.
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Not sure I like “negative” behavior pattern, because it still leaves room for others to decide what is “negative”. Struggling to come up with something better, though. Maybe it’s better not to call them anything except “what the client wants to work on.” Categorization of behavior patterns into “good” and “bad” may just inevitably feed into authoritarianism rather than empowerment.
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The flaw is that they created the categories first and then tried to make the neurology fit. The should be testing for neurological problems on a case by case basis until they see some pattern, and then group people together based on their actual, observable neurological issues (assuming they are not simply a common variant and not a real biological problem at all), and create and apply treatments ONLY to those circumstances where actual neurological problems have been identified, and ONLY if they are shown to improve the problem. Examples include Parkinson’s, epilepsy, Multiple Sclerosis, etc.
No psychiatric disorder comes close to meeting these criteria, because they are manufactured from the completely errant assumption that all people who are depressed (or anxious or highly active or whatever) ALL have something wrong with their brains, and ALL have the SAME thing wrong with their brains. There is NO evidence that these assumptions are true, and as long as psychiatry operates on these assumptions, it will never find any neurological evidence for any of its “disorders.”
— Steve
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And if there WERE some actual physiological problem in some small proportion of people with a DSM “diagnosis,” it would be completely obscured by the vast majority of people in the category being completely healthy. The DSM is a huge deterrent to any real research, and I don’t think that’s by accident.
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I think the important question is whether the RESEARCHERS had an open mind doing their research. It appears pretty clear that they WANTED to find a correlation and worked hard to find one. If they had found that 80% of people with, say, and “ADHD” diagnosis had a particular variant, vs. 20% of the general population, it might get my attention. But they had to combine 5 DIFFERENT “disorders” together to get a less than .5% correlation! It literally means nothing when the VAST majority of those with these “disorders” did NOT have the gene pattern in question and a good portion of the “control group” did have the pattern. I’m open to any real data that challenges my observations to date, but this one certainly doesn’t challenge anything except for any shred of remaining confidence that the “scientists” doing this kind of research actually care about the truth.
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VERY well said!!
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“A Gramme is better than a Damn!”
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Very well put!
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Perhaps you may need to read more over time. Many people (including myself) have written about the damage done by social institutions, including and perhaps especially the nuclear family, to people’s ability to thrive. Child abuse, neglect, and even thoughtless parenting have lasting impacts on people’s view of themselves. Kelly Brogan just put out an article today that directly addresses both REAL physiological problems (like nutritional deficiencies, lack of sleep, etc.) as well as exploring traumatic origins of habitual coping measures in one’s family of origin.
I, for one, believe that nurture makes the most sense to focus on, not only because the VAST majority of those diagnosed with “mental illnesses” have experienced family and social trauma to high degrees, but also because even if there are genetic contributors to our “mental illnesses,” it’s the one area we can’t do a damned thing about! And with the new research on brain plasticity and epigenetics, the idea that “biology is destiny” should be dead in the water. Unfortunately, financial incentives and political ambitions as well as guild interests don’t support applying this concept, which I think is why we see so much energy focused on these perverse incentives and evil intentions. The question of “what replaces it” is a much more challenging one, and in the end, perhaps is only answerable by the person needing assistance.
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Of course, I agree with you. I guess my two objections to the term being applied to people by professionals are 1) lumping all people with a certain set of behavioral characteristics together prevents any real analysis of whether it is a meaningful grouping of people with real similarities, or simply a social prejudice masquerading as a “diagnosis,” and 2) labeling a group is in and of itself a means to differentiate and “stigmatize” (aka be prejudiced against) the members of this group, which I find inherently dehumanizing. There may be, and perhaps likely is, a certain subset of such folks who actually DO have something physiologically malfunctioning, but we can never identify such situations if we lump all people together who act in similar ways without any understanding of the underlying mechanisms. So if it’s just a means of communicating about and between people who share some behavioral characteristics in common, no problem. But when applied by one person to another, I really have a problem with labels of this sort, as they make it way too easy to dehumanize them as a group instead of trying to understand.
As for “neurodiversity,” as one of my old foster kid friends put it, “Maybe people should be allowed to have different chemical balances.” Viva la difference!
— Steve
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Well, as I said in my definition, I would see “scientism” as a complete repudiation of science, the opposite, in fact, because science involves the absolute unwillingness to have faith in anything that is not supported by evidence. So clearly, believing scientific authorities without or even contrary to existing evidence is not scientific in the least. However, given the cooptation of this term to mean something different, I’m going to have to agree with you that the term is confusing and unclear (partly because most people don’t really understand what science is). I have to say, though, that none of your terms actually identifies a dogmatic belief in or blind faith in science as a specific term. It is really a lot more than reductionism – it is a religious faith based on the belief that there are some smart people called Scientists and these people are Smart and Know Things that the rest of us can’t know, and that if we simply follow them, then the world will be a good and happy place. It is a form of “blind faith,” but specifically blind faith in purported “SCIENTIFIC” AUTHORITIES rather than SCIENCE. Perhaps “authoritarian pseudoscience true believers” describes it, but really doesn’t provide a very catchy meme, does it?
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Personally, I think “causal agnosticism” is a BS cover for the true intentions of the DSM III+ series. It appears clear in hindsight that this approach was taken to specifically AVOID looking at cause so that the biological causation theories could be safely inferred. Grouping “disorders” without regard for cause, including things like high cholesterol and obesity, makes it easy to avoid bothering to look for one, which plays right into the hands of Big Pharma and professional guilds who want to create a “helping” industry and get paid for it. Because let’s be honest, if we start curing people, or providing free or low-cost home interventions, then we need to find more clients, which is a lot of work.
So in my view, the DSM is a far more nefarious enterprise than you appear to give it credit for. If there were no “ADHD,” for instance, then we’d have to look at each individual kid and figure out what was going on. We might discover that some DO have something physiologically wrong (like low iron, heavy metal poisoning, sleep apnea, or just plain lack of sleep), or psychologically challenging (very anxious, angry, hopeless), or social oppression (child abuse, racism, bullying), OR, we may eventually conclude that our schools are not meeting the needs of a lot of kids and we might have to re-think how we run our classrooms (“ADHD” labeled kids do WAY better in open classrooms than in standard classrooms!)
So in the end, creating the cause-free label undermines scientific inquiry and rewards lazy professionals for failure to look deeper into the real conditions behind the behavior they see.
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My definition of “scientism” is accepting the pronouncements of credentialed “scientists” as infallible and having a religious commitment to following their dictates, whether they make sense or not. It suggests a dogmatic approach to “science,” and an unwillingness or inability to take personal responsibility to separate truth from propaganda. It also involves so-called “scientists” claiming such authority and attacking anyone who disagrees with them as “unqualified” or “hostile to science.” Within that definition, psychiatry fits quite securely. “Pseudoscience” covers some of that, but for me it doesn’t cover the religious commitment aspect as well. Not that I completely disagree with your concerns, because I do see “scientism” used to mean believing that science is a valid way to determine truth, as opposed to having faith in a spiritual reality. But I most definitely do see people who view anything with the trappings of “science” as an article of faith, and who accuse anyone who does their own thinking about it as “anti-science.” Most mainstream psychiatrists fit into the latter category, and they train their subordinates and “patients” to think (or not think) in the same way. Perhaps there is another term you can suggest that covers this unquestioning faith in the Scientific Authorities having special knowledge that we mere mortals are unable to attain?
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I don’t really think that’s what the article says at all. I think it says that autism is not a scientific term because it’s not definable, and that we should not be prescribing “treatment” for entities that are not definable as different from “normal.” I think a lot of folks who identify as autistic would agree with this, based on my own experience. To say that autism was “discovered by science” is not really true, and that is the main point of the article. Autism was defined by agreement between professionals, but that’s not the same as being scientific, not at all.
My experience of the author is that he is, in fact, deeply committed to the principles of science, and in fact he is stressing in this article is the need to be scientific in defining “mental disorders.” Sammi has been a stalwart defender of the basic principles of science despite being castigated by his own profession for his integrity. You may or may not agree with his conclusions, but to accuse him of “hating science” is an extreme misunderstanding of his viewpoint and principles.
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We just have to write in our comments as well. I did write one on that article. It was actually the first mainstream news article I’ve ever seen that addresses the issue of adverse effects seriously. Too bad some of the commenters didn’t appear to read it!
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Well said. I’d point out that “obesity” itself is now a medical diagnostic category. The tendency to look at symptoms or outcomes as “diseases” is most definitely not confined to psychiatry. There are profits to be made and power to be established by denying social determinants of health, all across the board. It’s just easier with psychiatry, as there has never been any slight requirement that the categories have anything to do with physical reality, and as the social benefits of being able to categorize people’s behavior as “diseased” far outweigh the related but far less powerful benefits of categorizing people’s cholesterol levels or BMI as unhealthy.
— Steve
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I think you frame the issue well – it is a social/political issue rather than a scientific one. That being said, I do see the author’s legitimate critique of the term “autism” being used, as it is both a pseudo-scientific label and a means of putting down a heterogeneous group of people based on their inconvenience to the status quo. It’s a difficult conflict to resolve – I don’t want to be disrespectful to those who choose to view themselves as “autistic” nor to disrespect the fact that this group does have different experiences based on how they are viewed and treated by society. At the same time, I definitely don’t want to do anything to reinforce the idea that diversity of behavior necessarily associates with diversity of neurology, because in the vast majority of cases, it does not. I’m interested in your views on how to resolve this conflict – any thoughts?
Thanks so much for your thoughtful response!
— Steve
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I’ll just note that if only a tiny percentage of depressed people commit violent acts, then it should be obvious that being depressed doesn’t cause violence, nor is it even associated with violence, so giving drugs to prevent depressed people from committing violent acts is nonsense. A more intelligent approach would involved looking at VIOLENT people as a group and see if they have anything in common. When folks have done this, they’ve found a few commonalities: most violent people are males, most violent people are younger in age, many are taking drugs (legal or illegal) at the time of their violent acts. Many are perpetrators of domestic violence, child abuse and/or pet abuse. A certain subset are involved in or supported by violent philosophies that support their violent beliefs. Having or not having a “mental health issue” of any kind has not been correlated with violent acts, except for a very small subset of those suffering from “delusions” of some sort. We should NOT be trying to stop violent acts through “mental health treatment,” we should be working to figure out how to intervene with young men who have shown violent tendencies and who gravitate to drug/alcohol abuse, or better yet, figure out who these people are when they’re kids and find out how to intervene when they first start to show signs of violence.
I’d also add that even if there is a very small subset of people who become less violent on psych drugs, this and many other stories, not to mention the product label information, suggest that such small numbers are more than negated by the number of less violent people who become violent as a result of taking these drugs. In other words, as a violence prevention measure, the data suggest that psychiatric drugs are at best useless, and probably make violence more likely, just like intoxication with other mind-altering drugs will do.
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And I gave up on fitting into mainstream society back in my 20s. It’s a lot easier to just be me and feel OK about driving away those who don’t appreciate me. It leaves me with fewer connections, but the ones I have are real.
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So I was right in first grade when I though that reading groups were stupid and destructive! Always good when science catches up with 6 year olds.
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I thought the same thing. How about, “Malpractice through unethical prescribing is a result of our society prioritizing drug solutions and failing to invest in necessary psychosocial, educational and political priorities.”
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Plus it takes away people’s hope and sense of agency. But other than that, it’s an awesome model!
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Well, sounds like I qualify as “SMI” by these standards!
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Again, the term “overprescription” used in place of “malpractice” or “fraud.” I want to ban that word!
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I heard him speak. He acts as if these brain scans are diagnostic of something. Sounds very convincing when he talks, until you look into the data and find out he’s completely talking through his hat. Mostly suggests bio-bio-bio solutions, but to give him credit, he does outline other options for altering brain activity besides taking drugs. Charlatan about sums it up.
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This should be obvious to us all. Genetic diversity is the key to species survival. Being all the same spells death to a species, as recent disasters resulting from mono-cropping have demonstrated. Also, a “negative” trait can have unexpected positive correlations. I recently read that the “killer bees” that were released way back around 1990 or so have bred into the general honeybee population, and have conferred greater resistance to the mites that are killing off so many bees. Nobody could have been expected to know this would happen but it did.
It’s time to start appreciating that people are not supposed to all be the same, and that being different is not a disease state.
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Actually, I think even Ayn Rand would find Trump’s version of crony capitalism objectionable. She at least recognized that monopolization of markets is incompatible with a true free market economy.
I do see the pendulum swinging back. I just hope the young folks don’t get discouraged. We really need a full-scale revolt!
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Oh, “Trickle down” worked just fine. The problem is that people didn’t realize what it was designed to do. The PLAN was to redistribute wealth upward, and it was very effective in doing that. What needs to change is that regular folk need to become aware of what is going on and insist that it come to an end. We need to start with “percolate up” economics, where regular folk prosper and those at the top can reap the benefits of the general prosperity, as sort of happened in the 60s. But I’m not holding my breath…
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So 94% of negative voice content is related to adverse childhood experience. Yet “schizophrenia” is a biological phenomenon that has nothing to do with traumatic experience? How psychiatrists continue to maintain this fiction is astonishing.
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Sounds like what any sexual abuser would say about his/her victim(s). “They really wanted it.” “I did it for their benefit.” “It wasn’t a big deal.” “They’ll get over it.”
What I don’t get is how they don’t get in serious legal trouble for failing to report these crimes, especially when their own staff is involved. It’s as disturbing as the Catholic priest scandal, but no one seems to be scandalized.
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“Epistemic injustice” sounds a lot like paternalism, bigotry and prejudice to me. Why not call it what it is?
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Psychiatry has developed as one face of capitalism, especially corporate capitalism. It both provides cover for and protects the elite from the masses by dividing people into categories so that one can look down on another, and also allows those too “out there” to follow the rules like good drones to be singled out and punished, oops, I mean HELPED to “adjust” to the status quo.
And I agree, socialism is neither good nor bad, but works as well as the people running it. Which is why I say the enemy is authoritarianism, and unless we deal with that, any revolution ends up with “meet the new boss, same as the old boss.”
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Shocker. Not really. Disgusting, but not shocking. I wish it were a surprise.
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I think it is also true that therapy was constructed by well-off white men, and so it tends to pathologize things relating to poverty, sexism, and racial oppression, as a lot of well-off white men really want to believe that such things are either trivial or don’t exist. While there are exceptions, the majority of therapy is focused on adjusting to the status quo, rather than questioning the roles we’ve been assigned and/or working to change the oppressive structures that dominate our experiences. Naturally, black people are likely find this a lot less appealing, both as a profession and as a means to improve one’s life condition. Therapy’s got to get a lot more “real” if it is going to be helpful or even relevant to those who experience daily oppression in our society.
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Very well said. Economics drives oppression in almost every case, and general opposition to psychiatry necessitates general opposition to oppression which necessitates economic reform. While the comments regarding psychiatry under communism are points very well taken, it illustrates my biggest stress, namely, that the enemy is not liberals or conservatives but AUTHORITARIANISM under any name. The idea that there are people “at the top” who deserve to run things and decide what’s OK for the rest of us is the core of oppression, and both capitalism and soviet-style communism are built upon that same bedrock oppressive assumption. Real democracy/equity is not possible when the power is hoarded by a few individuals who dictate to the rest of us. But it starts with economic power needing to be more evenly distributed. Lots of folks will say, “Oh, but wealth redistribution is bad!” Unfortunately, wealth redistribution is occurring every single day, but it’s not from the rich to the poor, it’s from the working people to the rich! If we want to ditch psychiatry and the victim-blaming philosophy that goes with it, we have to attack the problem of wealth redistribution to the wealthy, too.
Thanks, Richard!
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Psychiatry is driven by the concept that all “depressed” or “psychotic” people have the same problem and need the same intervention. Real medical care is not the enemy, but psych diagnoses often have the effect of obscuring any physiological problems that actually ARE going on, by lumping everyone into a category and not looking further. So yes, I agree absolutely, real medical care is sometimes essential, and there are real physiological conditions that can cause “mental health” symptoms. But you’d have to actually LOOK in order to find them, and 99 out of 100 psychiatrists don’t even bother to ask those questions.
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I would ask you to consider this: are depressed people generally know for violent acts when they are NOT taking antidepressants? Depressed people in general are known for NOT taking action, for withdrawing and feeling like there is no point in doing anything. This does not describe a person who is contemplating violence in general (though of course, there are exceptions).
I’d also ask you to consider the poster’s story. Does this sound like a person who would be violent if not intoxicated with a psychoactive drug?
Remember that the fact that some or even many people feel better with antidepressants does NOT mean that a small or even fairly large number don’t feel awful or do awful things. The idea that all “depressed” people are the same and need the same thing is the central fallacy of the psychiatric system. Different people are different and respond differently to the same intervention. True in general medicine, why would it not be true for psychiatry?
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We could start by dropping the term “overdiagnosis” and replacing it with “malpractice.” If someone “overdiagnoses” my car with problems it doesn’t actually have, it’s called fraud. Why doesn’t this apply to medicine, or specifically to psychiatry?
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One thing my wife found worked really well for her was blackstrap molasses. It has a lot of iron and the iron is very easily absorbable. May or may not work, but it’s cheap and easy to find. Has to be BLACKSTRAP, though. Hope that helps!
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Who would have guessed that the drug companies lie to us in their advertisements?
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I should mention that the author of “Zen and the Art…”, Robert Pirsig, is an ECT survivor whose personality and historical memory was completely erased by the process, and he unravels his amazing philosophical discoveries during a motorcycle trip with his son during which he gradually rediscovers reclaims his true self that was taken from him by the psychiatrists. It’s one of the best books I’ve ever read and would be very meaningful to anyone recovering from the grasp of psychiatric abuse.
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A good observation. Science can only go so far. At a certain point, we’re really talking about philosophy. What becomes important is what we VALUE rather than what is objectively true, or rather, objective truth only becomes available in the context of what we value and prioritize. If you’ve never read “Zen and the Art of Motorcycle Maintenance,” you should. He goes right at this question of “What is Best?” and comes up with some valuable conclusions. Among them, he very effectively debunks the idea that science is or can be “value free” – what we consider a “good hypothesis” or a “true result” is determined in part by what we think is “good.” It’s a great read.
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Well, perhaps I should qualify that it is BAD for those incarcerated. It provides income and status and power for those who run the asylum. The reasons it continue include 1) people make money out of it , 2) people get to feel superior, 3) people get to take out their aggressive feelings on those less powerful and feel OK about it, 4) society gets to scapegoat the “mentally ill” and avoid having to deal with the real challenges of our society. There are probably more reasons, but they all kind of fit into that mold, I think. There is no patient-centered reason why mental hospitals should be the way they are. Even if one could justify arresting and incarcerating someone on the speculative ground of “danger to self or others,” the conditions in the average psych ward, as you describe, are anything but healing. If the people in charge really cared, these institutions would look very different.
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Well said!
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I sometimes thing “neurodiversity” cedes way too much to the psychiatric model, and in doing so makes things more complex than they need to be. If we keep it as “The human species is made up of a wide range of different people, all of whom are potential contributors to our survival,” it gets a lot simpler. I don’t think we need to give extra credence to the idea that we are how we are because of our “wiring”. Some difference is sure to be due to genetics, and some due to education/programming, but who cares? People survive as best they can with the tools they’ve been given. Why not just focus on finding the gifts that each of us brings to the table and helping each other expand on what we have to offer? No “neuro” explanations are required!
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I certainly would. And honestly, I don’t think we need scientific proof that institutionalization is bad! It is BAD! So let’s get on with fighting it and stop bickering about whether psych drugs cause “cell death” or “temporary brain damage” or “sedation leading to atrophy.” They are also BAD for your brain and your spirit! Science can assist us in the battle, but truth transcends science, and we all know the truth: labeling, drugging and incarcerating people for feeling or acting in inconvenient ways is BAD!
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Exactly. Both/and.
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Great blog, Chaya! I appreciate your weaving in of social context in all of the sections of your blog. People should have to pay when they harm others, even if they’re not intending to. Psychiatrists and Big Pharma as well as the medical profession as a whole have a lot to answer for, and it’s sad that they make billions while people like you get criticized for charging too much for cleaning up their messes!
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Your psychiatrist and I agree, it would appear. Unfortunately, it appears to me that he is a rare bird in the forest of psychiatry. The majority believe in labels and drugs, as their leadership directs them to do. You are very fortunate to have found someone with a different perspective.
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In other words, you have no scientific data to back up your “obvious” conclusion. Sorry, but “checkmate.”
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I would add the general and increasing ripoff of wage earners in order to flow maximum wealth to those already ridiculously wealthy. Since the Reagan Administration, productivity has massively increased while real wages have remained stagnant. The middle class shrinks, the super wealthy own more and more, and no one wants to do anything except admire those who manage to survive the deteriorating conditions that pass for “normal.”
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Which of course no manufacturer or psychiatrist (well, the overwhelming majority, anyway) would be willing to even consider for a second. It would appear they are not really interested in solving anything at all. I guess the status quo is working for them, even if it is killing off their clients.
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Great post, SlayingtheDragon! I think I’ve said my piece and will leave it at that. Your support is greatly appreciated!
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“Simple logic” is not science. Science is built on evidence. You present no evidence whatsoever. For instance, saying “chemically impaired brains can’t learn or remember anything.” You provide zero evidence for this assertion. Logic would suggest that what can or can’t be learned would differ depending on who is drugged, how drugged they are, what they are drugged with, how long they are on the drugs, what they are taught, etc, etc. There are far too many variables to even make such a statement, let alone evidence to support it. It’s kind of ironic that you’re criticizing my evidence as potentially circumstantial, and yet running solely on your own “logic” without any evidence whatsoever.
In summary, your assertion that cognitive decline MUST BE due to disuse and atrophy, and CANNOT BE due to the drugs, is completely unsupported speculation. It COULD be due to disuse and atrophy, but it COULD also be due to drug use, and only an experiment controlling other variables and testing this question could say for sure. As a result, your assertion that people supporting the idea that drugs COULD cause cognitive decline are somehow unwitting supporters of biological psychiatry is ridiculous. There is evidence to support the possible link between cognitive decline and long-term drug use. There is NO evidence supporting the idea that DSM diagnoses are due to brain diseases, and plenty of evidence (and logic) that they are not. There is and can be absolutely no comparison.
Here is just one example of many where evidence of a connection between long-term drug use and cognitive decline is presented:
https://www.sciencedaily.com/releases/2010/07/100713111724.htm
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Thanks for your reply. While I can’t refute your assertion that cognitive decline is directly caused by brain damage, you also can’t refute that it is caused by the drugs. Studies that have been done have specifically correlated the use of benzos and antipsychotics with cognitive decline. I am not aware of any studies that correlate cognitive decline with institutionalization. I also know of nothing that compares institutionalization to psych drug use as relates to cognitive decline.
So given the data to date, the hypothesis that cognitive decline is associated with psych drug use IS supported by evidence, if not conclusively. There is also ancillary evidence from drug abuse studies showing long-term cognitive decline with alcohol and other drugs, and alcohol is particularly similar to benzos in its effects and mechanism of aciton.
Your hypothesis is not supported by any evidence at all that I am aware of. So it seems very rational to me, and not brain-blaming in the least, to say that damage from psych drugs is or at least is likely to contribute to difficulties in recovering from psychiatric “treatment.” This is VERY different from saying that someone’s brain is damaged at birth due to some theoretical “chemical imbalance” that is unsupported by even the slightest degree of evidence, or that diagnoses like “major depressive disorder” and “ADHD” are real disorders despite no evidence that people in such subjective groupings have anything in common with each other. It’s hard to understand why the difference is not as obvious to you as it is to me. One case involves an actual, physical substance being put into the body and measurable differences in cognitive ability being associated with using that specific drug. The other case involves using subjective social constructs to create groupings of people having no known connection besides their behavior, and postulating brain damage in the complete absence of any evidence whatsoever. Do those sound the same to you, Lawrence? Is it so hard to see why it would be insulting and infuriating to be accused of the latter type of assertion, when actually working from real evidence measured from real events that happen to someone’s body in the real world?
I would be very interested to know if there is any actual data to support your hypothesis. Until I hear such data, I’d say “Occam’s Razor” applies here. The most likely explanation is the simplest one: the drugs cause the decline in cognitive ability. The drugs directly impact the brain, brain damage from other drugs has already been shown to occur (Tardive Dyskinesia is only one example of many), there is a correlation directly between these drugs and cognitive decline. Any alternative explanation needs some kind of evidence beyond that you think it’s probably true.
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So Lawrence, can you please answer the oft-placed question: is Tardive Dyskinesia a result of institutionalization? Or is it evidence of old-style brain damage? What about the demonstrated cognitive decline in long-term antipsychotic or benzo users? Or the development of Tourette’s Syndrome in a subset of stimulant users?
Your definition of brain damage is pretty narrow here. I’d suggest that brain damage should be defined as something that makes the brain unable to effectively function as it is supposed to on a long-term basis. But however you define “brain damage,” the adverse effects of long-term psychiatric drug use are well documented above and beyond the effects of institutionalization. At a minimum, you are speculating without evidence. It might be an interesting area to explore, but as a scientist, you can’t assume your hypothesis to be true, you have to test it.
Your lack of response to this question continues to concern me greatly. Are you unwilling to deal with data that don’t fit with your hypothesis?
— Steve
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Yeah, I wonder where they got the idea they might be disregarded or pathologized? Could it possibly be from being disregarded and pathologized?
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He’s having a hard enough time admitting that psychiatric drugs actually can damage the brain. I doubt the victim blaming piece will be resolvable. But we’ll see.
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And you STILL have not explained to us how Tardive Dyskinesia is not a result of brain damage. I find it disrespectful to have avoided this question several times, which I believe Stephen Gilbert also put to you.
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Sorry, but saying that suicidal feelings can result from taking or withdrawing from drugs is not a “pro-psychiatry” position. If it were so, psychiatrists would be promoting this idea instead of going into apoplexy every time it’s brought up. It is not necessary to deny that substances can change feelings. I used to get drunk as a kid to overcome my shyness. And it worked! I was a lot less shy when drunk. I felt different and acted different. This is not news. Psychiatry is not based on the idea that substances change mood and behavior, which long predates it. Psychiatry is based on the idea that people can be “diagnosed” with a “brain disease” based on how they act and behave, absent any biochemical intervention, and that such “diagnoses” are caused by unproven brain malfunctions.
Denying that substances affect mood and behavior is just plain denying reality.
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Not sure why this is a radical thesis. Maybe because it takes the blame off of the victims of poverty and puts the responsibility back on those with the power to change those conditions?
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People heal from damage all the time. People break their bones in car accidents, have heart attacks and strokes, have their appendix removed and then recover. There is absolutely no assumption that brain damage is not recoverable, as many people with TBIs can tell you. But the brain is no less damaged just because recovery is possible. Talk to someone with Tardive Dyskinesia and ask them if they think it is a result of institutionalization or drugs.
I want people to have hope, too, but it’s not helpful to give dishonest or unreliable information to people. The first step toward recovering from harm is admitting the harm has happened, and the second is understanding what that harm is and what can be done about it. I consider it frankly insulting to those who have struggled to overcome the known, direct adverse effects of these drugs to suggest that their problem is “institutionalization.” Institutionalization DOES occur and is a legitimate phenomenon to explore, but suggesting that these powerful drugs have no damaging effect on the brain, in the face of strong evidence to the contrary, is just plain dishonest. It makes about as much sense as saying a heroin addict who is chronically impaired from long-term use is suffering from being a part of the drug culture, and if he’d stop, he’d just recover his prior functioning.
Drugs do damage our bodies. 120,000 people a year die from properly prescribed and administered medications. A lot of these are psych drugs. Is it really your position that these drugs can kill your body but have no deleterious effects on your brain?
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I’d be very interested in hearing where your psychiatrist is coming from. What big changes does he foresee or recommend?
Unfortunately, most psychiatrists I have known and/or heard about are not interested in “big changes” and are unable to even accept hard scientific data from their own researchers. It is hard for me to imagine any kind of reform when the majority of practitioners appear allergic to any kind of factual analysis and are instead religiously committed to their “bio-bio-bio” views.
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Understanding personal meaning and cultural context – what a concept! Who’d have ever thought that personal meaning and cultural context would be relevant in how someone thinks and feels? Sheesh…
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How can you say this? Tardive Dyskinesia is an acknowledged outcome of long-term neuroleptic use, even among the most mainstream psychiatrists, and it is understood as damage to the dopamine system. Brain shrinkage from neuroleptic usage has been proven by psychiatry’s own minions in research labs. How can you say that there is no evidence of long-term neurological damage?
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I agree, Julie. It’s easy to attack people who don’t support psychiatry as being “anti-science” or “not believing in biological causes.” These are handy ways to discredit people, but that argument assumes that psychiatry is scientific and deals in biological causes. Nothing could be further from the truth. There is not one psychiatric diagnosis that any psychiatrist could tell you the cause of in even a small percentage of cases. And the psychiatric profession ignores the actual science that should inform its practice. There are plenty of real biological conditions that can cause hallucinations, agitation, anxiety, or depressed feelings (including, of course, reactions to the drugs they give you to “treat” such feelings), and we’d be a lot better off if we tried to actually look at real biological causes and peel off those cases of “major depression” or “psychosis” that really DID have a biological cause, and admit that the rest are not “treatable” in the medical sense. The big mistake psychiatry makes is creating a set of labels for conditions they don’t understand, and then assuming biological causation for everyone who fits their subjective criteria. Any real scientist would never put up with that kind of shabby pretense.
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I am so very, very sad to hear your tragic story! I appreciate you sharing it so the public can keep hearing that people can and do develop suicidal and homicidal feelings from taking SSRI antidepressants, sometimes even people who have zero such feelings beforehand. I can’t imagine how you would feel about this, but it is clear that the action of promoting these drugs without sharing these rare but incredibly serious side effects is criminal.
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What about the increased autism rates for kids of moms taking antidepressants? What about the brain shrinkage/expansion studies for people on antipsychotics/stimulants over time? What about the measurable cognitive decline in folks taking antipsychotics and/or benzos over time? What about the induction of Tourette’s Syndrome in kids taking stimulants? And those are just the ones that come to mind right off the top. What about those, Lawrence? Do these issues (especially brain shrinkage!) not speak to physiological harm done by these drugs?
I would also submit that admitting these things happen does not minimize or deny the impact of institutionalization as you describe. However, acknowledging these known facts is very, very different than the harebrained and totally unscientific proposals that things like “major depression” and “ADHD” are biological “diseases” resulting from “broken brains.”
It really IS possible to break someone’s brain. A crowbar to the head will do the trick, but electric shocks to the brain and mass screwing with neurochemicals will do it, too.
— Steve
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I must say, I didn’t really notice that section of the blog. I agree 100% that psychiatric practitioners take advantage of social power to deceive and manipulate people into believing they are able to help, and that blaming their “patients” is blaming the victim. I agree also with your later comments that assigning responsibility is different than assigning blame. It is true that the vast majority of those engaged with psychiatry do so “willingly” and have the agency to make another choice, but the combination of our deification of doctors as “scientists” that near godhead, as well as the intentional misinformation provided by doctors, drug companies, and the psychiatric profession as a whole makes such agency extremely difficult to exercise. Not only are trusted doctors providing bad information and pressuring their patients to “take their meds,” our entire society has embraced this “solution” and there is now mounting social pressure from friends and family and even acquaintances to get with the program. We have seen the lengths to which psychiatry and the drug companies go do attack reputable physicians and clinicians and to deny people with personal experience who critique the psychiatric model with hard data from psychiatry’s own research arm. It is difficult to get one’s head around the full pressure that is put on untrained individuals without our level of knowledge and advocacy skills to simply knuckle under and accept the doctors’ advice uncritically, or the attacks they receive if they decide not to take such advice.
So you are absolutely right, Richard, and I apologize for not supporting you fully. Clients can NEVER be responsible for the decisions of the profession to manipulate and pressure them into complying with their misguided or downright nefarious “advice.” Thanks for clarifying the issue for us all!
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I didn’t hear anyone denying this. I heard people objecting to being told they supported the “medical model” by insisting that brain damage from psych drug use is very real, above and beyond the institutionalization that Dr. K rightly identifies. He appears to be saying that damage from drug use is NOT a key factor and anyone that says it is would be supporting the “chemical imbalance theory.” This assertion is just plain wrong and needs to be challenged. It’s too bad, because the bulk of his essay makes a whole lot of sense. Breeding dependency is psychiatry’s stock in trade.
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My pleasure!
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How do you explain tardive dyskinesia if not toxicity? How do you explain the cognitive decline evidenced by people who take “antipsychotics” or benzodiazepines over extended periods of time, or the increase in autism diagnoses for children born to mothers taking antidepressants, or the neurological up- or down-regulation that has been shown for antipsychotics (up) and stimulants (down) and appears to also be happening for SSRIs? (Not to mention ECT, which clearly causes irreversible brain damage.) While we may not yet have demonstrated significant levels of cell death (but who is researching that question, I ask you?), we certainly have plenty of evidence of brain damage on a broad scale. How can you suggest that this kind of damage does not impede the recovery of even the most hard-working and dedicated citizens working their way out of psychiatry?
It is certain that dependency on the psychiatric system is encouraged at every turn and that institutionalization contributes significantly to challenges in recovery. But the question of brain damaging substances is 100% a different question. It is very possible to have both/and in this situation, and that’s what I think is happening.
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Well, that is the most basic thing. I think what people got upset about was being accused of being biological determinists simply because they believe that drugs can alter one’s mood and behavior in negative ways. Other than that, I think it’s a fine blog, but I think that sentiment has been properly taken as an insult.
That being said, I believe the #1 issue we should pursue is the elimination of the psychiatric hold. Arresting people and locking them up is not “treatment” and should not be allowed to be called that. If people need to be arrested for threatening or harming people or otherwise violating their rights, it should be called arrest and jail, not “treatment.” If we can accomplish that, antipsychiatry will be so far ahead of the game as to almost have won.
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Drugs purport to present an easy path, and any kind of quality therapeutic process requires hard work and a willingness to experience pain and discomfort. Naturally, the promise of an easy fix is appealing to a lot of people by comparison. Drug pushers know this. So do doctors and especially psychiatrists. Of course, it’s easier for the doctors, too, in the short run. Of course, only one of these approaches actually helps a person improve over time, and we know which one that is.
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Actually, penis envy is very real. It happens when a man and a woman are out hiking in 38 degree weather and they have to take a leak.
Think about it…
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The problem is, the drugs DO have adverse effects on the brain. I think it’s a combination: the adults have distanced themselves from the kids partly due to the DSM/bad brain theories, and the drugs make it easier to do that, but the drugs themselves make it easier for the kids (or others) to distance themselves from their feelings and their oppressors. They are not mutually exclusive, and there is plenty of evidence to support that certain drugs in and of themselves make violence more likely. It’s not blaming the brain to note the evidence supporting the drugs’ adverse effects.
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I agree. It is very possible that both have an effect on deterioration, given that suicides INCREASE after hospitalization. However, the evidence Whitaker presents shows a DIRECT relationship between increasing use of drugs and dramatic increases in disability. He also presents a clear mechanism by which this occurs. It is not possible to dismiss his hypothesis without refuting the data, and the author fails to do so.
I would also add that the REMOVAL of genuine supportive services over time contributes to the deterioration of clients over time, but that still does not invalidate the data showing strong correlation with the use of psychiatric drugs and the vast increase in disability.
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Words are a reflection of intent. The author wants to move the words around without changing the intent. Is the purpose of “mental health treatment” to engage with and empower the client, or to make uncomfortable people stop acting the way they do? Is it about encouraging perspective or enforcing social norms? If the intent is different, the words will follow.
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So now they’re allowed to simply invent data points by “predicting” what people would report! This has to be a new scientific low. How are they not held accountable by their peers or the journal editors for this inexcusable departure from anything vaguely resembling scientific procedure. I know, I know, corruption drives the train…
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I agree. What passes for “the left” in the USA would be center-right in most European countries. Most Americans are completely ignorant about this. Although neoliberalism is having its effect over there as well.
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It is like a religious cult. There are dogma that simply can’t be transcended without being attacked or ostracized. It baffles me why this is such a challenging issue for the new Left to handle. Feminists in particular used to be brutally critical of the psychiatric profession for targeting women’s reactions to violence and sexual abuse as “mental disorders.” What has happened?
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There is a definite disconnect on the left (as well as the right) about this issue. It is regarded as “pill shaming” by many on the left to criticize the psychiatric establishment, and those who don’t feel this way are afraid of being labeled by those who will attack them for doing so. The left’s general approach seems to be “let’s advocate for more money for the “mentally ill,” without realizing that grouping people as “the mentally ill” is a highly oppressive action. It’s a big blind spot, and I have not yet figured out how to reframe this as a civil rights/social justice issue for people coming from that viewpoint.
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“I am shocked, SHOCKED to find that GAMBLING is going on in this establishment!”
“Your winnings, sir?”
“Thank you.”
Claude Raines in “Casablanca”
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How about “Researchers don’t take any money from pharmaceutical companies?” I think that would handle the problem.
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Something being “mainstream” or having agreement in the field doesn’t make it true. There is no evidence presented here. It’s an argument from authority. Not really worth reading.
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Well, ya can’t make a buncha money curing people with food, man! You can’t expect psychiatrists to embrace such a ludicrous notion just because it WORKS, can you? How will they get clients if you start giving people the means to cure themselves?
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Or maybe, just maybe, being mistreated creates fear or anger in the victim, which is later expressed as distrust, hostility, anxiety or depression as an adult. Do these people actually believe that human beings exist and have the ability to affect their own bodies?
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Beautifully spoken! This is one of the best description of the subtle but pervasive oppression that are an integral part of our public school experience in the USA. Until this changes, we can have little hope that the pattern of angry young men will abate. Thanks, Bruce!
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Thanks for the appreciation, and the chuckle! I hope I get to meet you in person some time – I think we’d have a lot to talk about!
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Transparency doesn’t solve this problem, or any other conflict of interest problem. The only answer is to stop direct contributions to advocacy groups directly affecting their market. If they want to donate, they should donate to a fund administered by and independent board of directors who can donate to whomever seems worthy. It’s not a donation when strings are attached!
Perhaps we could start by making such contributions no longer tax deductible?
— Steve
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Agreed!
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I am sure the number is quite high. I’ve even heard rationalizations from the psychiatric community – people have a manic reaction to SSRIs because they have “uncovered an underlying bipolar disorder.” Not because their drugs are doing it, but they totally know it happens – they just blame the victim, as usual.
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I get the impression that you think an antipsychiatry position is not compatible with the possibility of biological causation. This is not accurate, in my view. I think an antipsychiatry view would say that biological causation exists, but should fall into the categories of neurology, immunology, nutrition, sleep apnea, or whatever real medical category applies. The problem is not that these phenomena called “mental illnesses” don’t exist, but that they are grouped together AS IF they all had the same cause. You acknowledge that they don’t, so what’s the point of calling someone “bipolar” if it doesn’t tell you what’s wrong or what to do about it?
If someone has hallucinations due to a brain injury, they should see a doctor who knows about brain injury. Not a psychiatrist, because they don’t know anything about brain injuries. They just know about drugs and labels, and that doesn’t help people get better.
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You are absolutely right, Frank. The Fed starts raising the interest rates whenever the unemployment rate drops below 5%. They say it’s because they’re afraid of inflation, but it’s really rising wages they hate. Recently, the rate has dropped below 5% and rates started to rise a little, but wages remain stagnant, so they’re not too worried. I think this is because most of the jobs available pay crap, but in any case, it’s definitely a conspiracy to keep wages low and profits high.
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Thank you so much, Sera! You put into words much of what I was feeling about this article. The intent seems good, but the execution is both confusing and at times disrespectful of people who are working to end the current oppression both in and out of the system. And I VERY much appreciate your deconstruction of the concept of “saneism,” which seems to suggest that there IS some differentiation and the “sane” people are beating up on us poor, unfortunate “insane” folks, and they just need to stop being so “stigmatizing” and let us be nuts in peace.
Your clarity and honesty is refreshing, as usual.
— Steve
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Agreed!
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These designations are completely arbitrary and subjective. They’re based on scores on a depression questionnaire, which relies either on patient reports on subjective questions, or caregiver reports on the same subjective questions. It’s kind of like someone saying, “I feel severely depressed,” and you saying, “That means you have severe depression.” It’s all BS.
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Not really saying there needs to be an “alternative.” I’m saying that the underlying social forces that lead people to seek out and/or accept psychiatric “treatment” need to be addressed. Otherwise, something else will emerge that is based on the same principles, namely, that reacting badly to the status quo is proof there’s something wrong with you. Schools are also run on this principle. Religions are often run on this principle as well. Oppression goes way beyond the purview of psychiatry, even if psychiatry has come up with a very efficient way of managing it.
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Not sure you’re getting what I’m saying. Psychiatry DOES fill a need for society to keep us from getting together and rebelling.
But a crisis line was originally a rebellion AGAINST psychiatry. It was regular folks volunteering to help their neighbors in the community. As I said, most have been co-opted by psychiatric institutions, but the original concept was completely independent of psychiatry, and it was conceived of as a way for people to help each other WITHOUT “professionals” sticking their noses in. Or are you suggesting that people don’t need other people to talk to or a community to support them? Our communities ARE shattered and dispersed and it is the absence of such real communities that is at the heart of the angst and despair so common in industrialized countries, IMHO. So there is a need for people to connect, and it’s very real, even if that need is preyed upon by those trying to make a quick buck off of shutting up the distressed and the disenfranchised.
Capitalism has focused a lot of energy on undermining communities so they could have a mobile work force and so they could pollute and trash the environment without people being organized enough to resist. That’s what the Luddites were saying way back a couple hundred years ago.
A little history:
https://en.wikipedia.org/wiki/Crisis_hotline
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That question is kind of like the game, “Would you rather?” Would you rather have one finger cut off or have to sleep every day in a dumpster for 20 years? Guess what, I wouldn’t want to do either!
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But of course, long-term users are more likely to develop diabetes or heart disease.
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I can’t entirely agree about crisis lines. I think they are an outgrowth of the disturbing level of disorganization and oppression in society at large. They are more a symptom than a problem. The original crisis lines were entirely community based, manned by volunteers who were there to listen and care. They have been largely co-opted by the “mental health” system at this point, but there are still a few like the one I’m currently volunteering at in Olympia, WA, which runs on the old principles, including never tracing a call or dispatching the police to anyone who isn’t specifically asking for that kind of help.
In order to really eliminate psychiatry, there are some fundamental changes to our society that will have to be made, starting with encouraging community and putting some limits on the ability of commercial interests to keep the bulk of humanity in poverty.
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#18: Refocus research and intervention on individual and social trauma and disempowerment rather than blaming the biology of those who are traumatized or socially outcast.
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How about creating a society where people who have jobs are able to afford living, like we did in the 60s?
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It is also bad science to propose new hypotheses to explain away experimental results. They are supposed to state their hypotheses BEFORE running the experiment! Their new hypotheses might form the basis for another experiment, but are IRRELEVANT to their current experiment, as they are pure speculation without further testing. One can almost always come up with multiple ways to explain an outcome, but only pre-existing hypotheses that predict the outcome before it happened can be considered legitimate scientific results.
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Well said!
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We could start by disconnecting the need to detain people who are creating problems from the idea of forcing “treatment” on unwilling detainees. What’s wrong with the idea of “keep[ing] the individual securely locked up until such time as they had recovered?” Why does holding someone who is threatening to burn down the house imply enforcing drugs or other violent
“treatment” on their unwilling bodies?
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They call psychological or behavioral testing “neurological?” Drank the Kool-aid, I guess…
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Good to see her challenge the chemical imbalance mythology. Unfortunately, there is little emphasis on changing away from the biological model or exploring trauma and social conditions as the main (and most modifiable) causes of psychiatric “disorders.” There is also no questioning of the DSM diagnostic model, which drives the biological intervention train. So maybe some sign of the pendulum starting to swing back, but still not entirely encouraging to me.
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There are limitations on our potential, but I don’t think there are limitations on our free will. It may be more difficult for some of us to do certain things (and it’s also easier for us to do certain other things!), but that doesn’t limit our ability to choose what we’re going to do. For instance, I can’t suddenly develop good small motor skills, as it’s a gift I don’t have, but I CAN develop my small motor skills to a higher level with practice and dedication. Taking action is always a choice, though the outcome isn’t ever guaranteed.
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Lots of people buy into the system. There is lots of propaganda and social pressure to do so. We who see through it should consider ourselves fortunate and help educate those who have not come so far. I don’t see it as in any way helpful to criticize those who are just now beginning to see they’ve been had. We should instead encourage them to learn more and join the fight!
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Humility is required for learning. People who already think they know everything don’t learn much, but still feel superior. It’s a baffling conundrum. The only thing I’ve extracted from my experience from such people is to stay as far away from them as I possibly can. Sounds like you learned the same lesson!
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Glasser was a freaking genius, but of course was marginalized by his peers. The adults actually taking responsibility for altering the family dynamics? That’s crazy talk!
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I agree, this myth is still firmly embedded in the public mind and continues to be propagated by many practitioners, whether out of ignorance or malfeasance or whatever. It appears on many websites across the internet. The tide does appear to be turning, but we’re a long way from having general agreement that this idea is mythological.
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Though as Tim McCarver once wisely said, “If it [common sense] were so common, more people would have it!”
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It’s like you take your car to the mechanic, they can’t fix it, and they say it’s your fault for having a “repair resistant car.” How they get away with it astounds me. So sorry you had to go through with it.
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What is “improperly medicated” when there is no standard to even determine what a proper “diagnosis is,” let alone what proper “treatment” would be?
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Besides, “mentally ill” people aren’t supposed to have sex lives, you know? They only exist to consume “meds” and to sit on their couches and watch TV. Anything else is “a danger to self and others.”
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Well, there goes 80% of psychiatrists’ business! If only they would abide by this, involuntary “treatment” would come to a swift end. Frank’s right, the problem is who gets to define “torture”. If you asked the “patients,” you’d get a very different answer than if you ask the psychiatrists.
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“In educational contexts, a student is more likely to become intrinsically motivated to learn if a specific task is inherently interesting and enjoyable, and the associated behavior is based on an internal perceived locus of causality.”
So kids are more motivated to do thinks they are interested in and enjoy? WHY DO WE NEED A STUDY TO FIGURE THIS OUT???!! I get so baffled by all the obfusticatory language being used to describe the obvious. I suppose it’s needed to make their papers sound erudite and scholarly, but really, isn’t this the most obvious thing in the world? Who is motivated to do things they find dull????
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Wallenfan, of course, there are such conditions, but why call them “mental disorders,” rather than “bad reaction to prescription drugs” or “physiological damage from street drug use” or “hallucinations secondary to stage 3 syphilis infection?” To me, it’s kind of like calling a rash a “disorder”. Well sure, there’s a rash, and you want it to go away, but the real “disorder” is what’s causing the rash – the rash is just the indication that you ate something you’re allergic to, or rubbed your hand in poison ivy, or have the measles. A rash isn’t a disease, it’s a sign. Same with depression. It’s usually a sign of something wrong, but calling it the problem is like diagnosing “pain” when your hand is on a burner. Pain isn’t the problem. It’s the hand on the burner that’s the problem.
RFS, of course, I agree 100%. The big problem with these DSM labels, beyond blaming the victim so effectively, is that they don’t differentiate cause at all, or even attempt to. They assume that all depressed people are depressed for the same reason and need the same kind of help. This is, of course, nonsense, but for some reason, it sells big time with people who are too lazy or too scared to look deeper for the real reasons. It also keeps our leaders from having to look too hard at our institutions, like schools and churches and government programs, and see how they might be causing or perpetuating anxiety and distress, because that would be too inconvenient for our elite to have to deal with, and might cost them some money, which is the ultimate sin.
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Your points are very well taken. I was merely objecting to “too much empathy” being blamed for suffering, when too much brutality is the real problem. And I agree 100%, the point of empathy is to create more cohesive communities where violence and brutality is minimized because it’s not something anyone wants to experience. So dampening empathy is not the answer, though you’re right that limiting exposure can be important to one’s sanity!
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This seems like a lot of very complex language to explain a simple phenomenon. I can’t imagine anyone trying to follow these “directions” and ending up doing anything helpful.
“… this involves the therapist’s stepping out of an interpretative role and assuming a stance of curiosity, interest, and respect toward the client’s experience.”
This seems very, very basic and is essentially ALL I have done in therapy sessions of whatever sort – be interested and respectful, seek to understand the client’s viewpoint, and try to help him/her obtain some kind of perspective on his/her own process. But it’s not complex at all. It involves being present and NOT thinking about all these theories and strategies and rules that get in between the client and the person trying to help them.
This also (properly) suggests violating the idea that a therapist/helper must remain “objective” by not getting “emotionally involved” with the client. To the contrary, emotional involvement is the only thing that makes it possible to know what to say or ask! And it enables the client to sense that you actually care about what they’re saying. Because you DO actually care! I defy anyone to truly care about another person without some level of emotional involvement. All the body language, nonverbal cues, etc. that the article talks about are readily available to someone who is paying attention and not trying to “accomplish something” with the client, but instead is just trying to understand the client’s worldview and create a safe environment to communicate together.
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I think these traits are heavily discouraged by our society. There is an article in the “In The News” section about how being too sensitive makes one more vulnerable to trauma, instead of talking about how trauma is damaging to us all but some are more sensitive and feel others’ pain.
Most definitely not a “normal” trait, at least as far as our society is concerned, but I’m guessing it would be a lot more common if it weren’t punished so consistently.
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Cool! Of course, I filled mine out. It is a fantastic idea and I’m dying to hear the results! 🙂
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Empathy doesn’t hurt. Being empathetic in a world filled with violence and cruelty is what hurts. It seems like they think the answer is protecting yourself from empathetic experiences, rather than working to eradicate violence and cruelty, which really cause the suffering.
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Wow, sounds a lot like me!
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Are we going to hear the results of the above surveys?
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Wow! I always love your blogs, but this one, you hit out of the park!
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And who exactly are they accurate FOR?
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You present no evidence that this is true. Since the USA was to a very significant extent founded on the institution of slavery (and this is factual, not deniable) and the institutions of Jim Crow and the KKK and many others continued well into the 1960s and institutional bias against black people existed (and still does) in voting rights and loans and housing (remember redlining?) and many other areas, I’d say the burden is on YOU to prove that somehow this has all magically disappeared. As I said, there is plenty of hard data supporting my viewpoint, and Uprising has been kind enough to provide a couple of links, and telling stories and using ad hominem attacks against me does nothing to address this data or the obvious and undeniable history of institutional racial bias which has been a major thread in this country’s identity since before it was a country.
Explaining away facts doesn’t make them untrue.
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Thanks for sharing these links. I was too tired to start looking up links that he could easily find himself if he bothered to look.
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Nonsense. If you lived in a very oppressive society, the USA would feel like a breath of fresh air, even if you had to put up with some crap due to your race. Also, if you were starving, it would be worth whatever you needed to suffer in order to find a place where you could earn money and live a decent life.
I your last sentence, you admit you are a bigot. You also clearly imply that darker skinned people are “racist” toward white people when saying that “liberals” are the same. It doesn’t take fantastic hearing for that dog whistle to come in loud and clear.
As for systemic racism, you will have to educate yourself on that point. I will assure you that there is hard data that black people and Native Americans are treated differently by our police, our court systems, and our child welfare systems. This is not to say that ALL or even MOST police are racists (remember, grey areas, grey areas). It simply means that black people and native people are treated differently ON THE AVERAGE than white people. It is factual and supportable if you actually believe in data. I question whether you do or not, but I am guessing you don’t really want to think about this area, you just want to attack anyone who disagrees with you as “insufferably self-righteous and dishonest,” because it’s easier to generalize about people than it is to acknowledge that people are complex and that good and evil can exist in the same person and that people can behave in what they believe to be a fair and equitable way while actually being quite unfair and biased. No, that’s too complex to allow for dogma. So I won’t bother talking further with you about this topic. Anyone who is actually in touch with the data knows which of us is talking through his hat.
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Why is it SO important to you to prove racism doesn’t exist except against white people? I suspect I know the reason, but help me understand why this argument is so important to you?
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I agree 100%. Therapy to adjust to oppression is totally out of order. Not to say that support can’t be helpful, just like supporting someone abused as a child can be helpful. But it’s not a “mental disorder” to get angry or upset or anxious when you’re kicked around by people who are more powerful than you are. It’s a normal reaction.
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That is a foolish analogy. Obviously, people come here because of a) economics, and b) relative freedom from oppression in their own country. Obviously. Do you really think it’s rational to assume that because the USA appears a better option than their home country, the USA has no problems with racism? Do you really believe there are only two options, that the USA is perfect and wonderful (except for those awful liberals and dark people, of course) or that the USA is horrible and that everyone needs to escape it?
Every country has its strengths and weaknesses. I’m happy to be an American and I believe the American Constitution and other elements of our political system (especially the court system) are admirable and worthy of emulation. At the same time, I’m realistic – no country is perfect, and it should be clear to anyone who isn’t closing their eyes that this country was partly built on slave labor, and that the consequences of slavery and the subjugation of the native population still affect us all today. To believe otherwise is simply closing one’s eyes. It’s not “politically correct” – it’s factually observable, both in statistics and in millions of anecdotes that anyone who is actually interested in the truth can easily obtain.
It’s easy to use confirmation bias to support your belief system. It’s a lot harder to look at actual data. The truth is almost always very gray. It is uncomfortable to love this country and still believe it can be improved.
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OH: Your presumption that there is a conspiracy to disarm all Americans is unsupported by any kind of facts. Anyone can speculate, but the Constitution prevents the disarmament of the general citizenry. I am far more concerned with Frank’s point, that the “mentally ill” will be targeted for disarmament, not because it’s safer but because the “mentally ill” make a good scapegoat.
As for the causes, obviously “violent people” commit violent acts, by definition, but that’s a pretty tautological argument. I certainly am not suggesting that “the mentally ill” are to blame somehow. For one thing, there are no more “mentally ill” people here per capita than anywhere else, but a hell of a lot more mass shootings. Obviously, the possession of guns doesn’t cause it either, because the overwhelming majority of gun owners don’t commit crimes. Drug use IS associated with increasing levels of violence, but I think the causes are very complex, and as to why it happens in the USA so much, even more complex.
All that aside, my point is that once someone credibly says “I’m planning to shoot up the local school tomorrow,” I think they give up their right to own or use a gun. If someone shoots his wife (or her husband) with a gun, I think it’s reasonable to restrict their access to a gun. If someone has a history of armed robbery convictions, I think it’s reasonable to restrict their access to a gun. Would you disagree?
As I said, “Gun control” doesn’t mean disarming all citizens. It is reasonable to stop certain people from having guns if they use them to hurt or threaten people. Your choice to believe that there is some secret plot to disarm everyone doesn’t make it true, and I guarantee you there are enough Americans who would protest if such a thing were attempted. And a lot of them are armed!
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I am not sure why people so often say that having some level of gun control laws means “disarming the public?” I have rarely seen anyway but the most extreme radicals advocating for disarming citizens, and it can’t be done anyone, because of the second amendment. What I’m mostly hearing is making it harder for people with known violent pasts from getting their hands on weapons, while regular citizens are free to hold as many guns as they want. It’s true that banning semiautomatic assault rifles is on the table, and I see the arguments on both sides of that, but as for “disarming the public” – who is arguing for that????
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I hope you’re right, Oldhead, but I have my doubts. Both sides of the aisle appear to be sold out to their contributors, and until that changes, the priority will be making sure the big corporations make money. The rest is mostly window dressing.
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Probably not too hard for them to imitate – it’s a type cast!
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This sounds like psychodynamic therapy, not psychoanalysis. The thing that set psychoanalysis apart, for me, is that it focused on interpreting (analyzing) the content of a person’s conversations, dreams, etc. It’s very possible to do psychodynamic therapy without resorting to any analysis or interpretation for the client, instead letting the client tell his/her story without any attempt by the therapist to tell the client what it means or what they should do about it. It is very possible to bring unconscious thought to consciousness without any evaluation whatsoever on the therapist’s part, just by being patient, listening well, and asking the right questions at the right moment.
The article also seems to ignore another important reason why psychodynamic therapy went out the window – the DSM III and the intentional marketing of the idea of mental illness as biological defect. We can’t have people getting better without drugs if these things are biological, so any kind of deeper therapy has to be eliminated in the interests of profits.
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Sorry, but whatever prejudice (and prejudice is not the same as racism, the proposed dominance of one race over another) is directed toward white people by people of color pales in comparison (sorry, bad pun there!) to what darker skinned people have to put up from their Caucasian counterparts in the USA. The fact that you refer to “leftists” as a group and talk about anyone who disagrees with “them” suggests some prejudice on your part, as you are grouping “leftists” together and assuming that you understand “them” and know how “they” act and believe that “they” are all the same. I do get what you are talking about – there are some subgroups on the left who are highly authoritarian and who are intolerant of disagreement. But this is clearly just as true for some subgroups on the right, who often target gay people, minorities, women, and anyone who doesn’t share their worldview.
Personally, I see the left/right conservative/liberal spectrum as a distraction pushed on us by those REALLY in power, so that we’ll fight with each other instead of joining forces with each other and demanding a more equitable sharing of the fruits of our incredibly productive society with the people who work so hard to keep it productive. But that’s just my opinion. You’re entitled to yours, but not to your own set of facts.
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I somewhat agree, though I believe the labeling process in itself is unnecessary and disempowering to many if not most who receive them. But I am interested to note which of the DSM disorders you see as being capable of guiding one to effective treatment? My experience is that almost all guide only to blaming the victim and ineffective and disingenuous drug “treatments,” and those that don’t (like personality disorders) lead instead to condescension and shaming. I am also unaware of ANY psychiatric “disorder” per the DSM that has a known cause. I’d truly be interested if you have any information to the contrary, but as far as my experience goes, anything that can be done with a DSM label that is actually helpful can be done just as or more effectively without the label, other than getting insurance reimbursement.
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Not everyone has had your experience. Many people have been badly damaged by the system, and want changes to happen. You appear to be a reformer yourself, so obviously some of the things that happened to you weren’t so wonderful. Is it that hard to understand why some people would be angry at a system that mistreated them so badly?
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It is also often forgotten that even with good parenting, the stresses of our bizarre society can lead to madness. The current system not only doesn’t acknowledge this fact, it actively goes out of its way to deflect attention away from social and environmental causes and back to blaming the person who is reacting badly to them.
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That’s the sad part about the whole DSM-based worldview – it encourages individuals, professionals, and society at large NOT to take responsibility for environmental and lifestyle impacts, but instead to blame the brain of the person suffering from those impacts. As a person who used to be chronically depressed/anxious and sometimes suicidal, I can honestly say that good therapeutic support plus improved living strategies have almost completely changed how I feel and interact with the world. The thing is, it takes YEARS of hard work and a willingness to become aware of some painful things we’d all like to keep under wraps. Labeling someone with “Major Depressive Disorder” or “Bipolar” or “Anxiety Disorder” makes it seem like it’s all in your brain, you just HAVE this “disorder” and there is nothing you can do about it. It also makes it easy for professionals to blame YOU when their interventions don’t actually work for you. I mean, would you take your car back to a mechanic who said your car isn’t working because it has “repair-resistant fuel injectors?” I hate the DSM, not because I don’t believe people suffer from depression or anxiety, but because it removes power and agency from the person having those experiences.
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All of this would presume that those in power actually CARE about the impact of poverty and toxic waste. They are forgetting that ADHD and similar “disorders” were invented so we don’t have to think about such things and can instead blame the victims.
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Do you really think Republicans have been better? Other than a few oddballs here and there, I don’t know any Republicans OR Democrats who have taken up this issue. In fact, Republicans seem even more willing to blame “mental illness” as a means of avoiding a discussion of any changes in gun laws. So it’s not a Democrat/Republican thing in my view. It’s a rich/powerful vs. poor/powerless issue, and of course, both sides of the aisle are buddies with psychiatry, because psychiatry is on the rich/powerful side of the scale.
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Class action is a very real possibility. But so far, no attorneys are willing to go up against Big Pharma in that kind of large scale way.
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Exactly!!!!
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I agree 100%! Violence is not associated with “mental health diagnoses,” it is associated with taking DRUGS, legal and/or illegal!
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They do, but if they’re used more than occasionally, they actually make the problem worse, just like street drugs or alcohol do. In fact, alcohol is very, very similar to benzos in actions and side effects and addictive potential. Benzos may actually be worse. One COULD prescribe drinking three times a day as a “treatment” for anxiety, and it would “work,” but I’m pretty sure most people would recognize it as, at best, a very temporary and superficial solution.
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Too true!
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I think you are right. The majority of therapists are apologists for the status quo, and would consider your resentment or criticism of your past psychiatric “treatment” as either irrelevant or misguided. There are exceptions, fortunately. I know one foster care survivor who had a therapist start off by asking, “What have professionals like me said about you in the past?” The therapist spent the entire first session helping the young lady reject all of these historical labels and get ready to start over with real, client-focused therapy. It was the first time she realized that therapy was supposed to be for HER. It had always seemed more like a punishment for behaving badly.
Thanks for sharing your story – it breaks my heart to hear, but I’m glad you are finding a new way forward!
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That is hilarious! I certainly hope it was a farce, but with the state of psychiatry these days, I can totally see this being taken seriously if presented to a bunch of psychiatrists by someone with the proper credentials.
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You are so right. Unfortunately, parents ARE sometimes responsible for at least not knowing what to do to help their kids, and sometimes really DO create these problems by abuse or neglect, and the ADHD label lets them off the hook. More significantly, though, it lets SCHOOLS off the hook for not knowing how to educate these kids. The fact that going to school a year later leads to a 30% reduction in ADHD diagnoses tells us that a lot of this is just development, expecting things from kids before they are ready. It’s also a well-kept secret that kids with “ADHD” diagnoses do immensely better in more child-centered classrooms (think Montessori) where they have more control of their time and activities, to the extent that they look quite “normal” in such circumstances. There are no doubt a small subset of kids who really DO have something physiologically wrong with them, but the ADHD label also obscures any attempt to understand about the real physical causes (such as sleep apnea, drug side effects, low iron, thyroid issues, etc.) On the whole, the main thing that ADHD does is let grownups off the hook. But I mainly hold the professionals responsible for misleading the parents into thinking this is a real thing. The behavior is real; the idea that all kids who act that way have something WRONG with them is a fantasy.
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I like “satisfaction” as the goal. Of course, the Buddhists would say that “striving” for anything is what keeps us from experiencing satisfaction or contentment. Being OK with the world as it is, even if it’s not what you would ideally want, does seem to be the best way to feel OK about myself and the world.
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And it pisses many of them off that their abusive histories and unstable present environnments are ignored. I worked with foster kids for 20 years and rarely met one who had anything but contempt for psych drugs.
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How can they quote these pseudo-statistics when there’s no way to actually know who does and doesn’t have it? Why are people so gullible??
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‘Under National Socialism [Nazism], psychiatrists showed contempt for their fellow man. They lied to and deceived the patients in their care and their families.’
Well, I guess some things never change, do they?
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I hadn’t thought of it that way. It’s supposed to be so absurd as not to be close to true. Hard to believe they’d show that movie to involuntary psychiatric inmates!
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Disgusting but hardly surprising. I have no patience for this kind of dishonesty and abuse.
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A great perspective. Goes to show that people with the exact same “diagnosis” need totally different things. What works for one won’t work for the next. Which makes me wonder what the meaning of the “diagnosis” is, if diagnosis doesn’t tell you what you should do to help. But well done to you for finding your way, Pat, because of or in spite of outside efforts to help. It is a very personal journey.
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“…identifies “connectedness and meaningful activities” as crucial components of recovery journeys.” But wait, I thought it was all about brin chemistry!
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I am kind of amazed that the media has avoided the obvious major causal factor in this mass murder: racism and hatred, promoted and supported by a white supremacist militia this young shooter belonged to. Why do we need to go to the “mental health” argument when white supremacy appears to be the clear motivation? If the guy were Latino, we’d be shouting about illegal immigration. If he were Muslim, we’d be shouting “terrorism” from the highest buildings. But he’s a white supremacist, so he must be “mentally ill?” Help me understand this!
I am also wondering if he was being “treated” with benzos or SSRIs, but we’ll have to wait for more data on that point.
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Maybe “changing their minds” isn’t really the right phrase here. Perhaps “helping them remember their purpose” or “helping them process their pain” are what really make the difference. I agree that we can’t “change people’s minds,” but I’ve intervened in the lives of hundreds of people who were considering suicide, and helped almost all of them by helping them take a good look at what problem they were trying to solve by dying, and helping them come up with other ways that might solve the problem in a less final fashion. Most of the people I encountered did not WANT to die, they wanted to stop suffering and saw death as a certain means to do that. Of course, I worked at a crisis line, so those calling were almost all ambivalent about their intentions. I know there are people who genuinely want to end their lives and have their reasons, and I agree it’s not society’s job to “stop them” or “make them change their minds.” But that doesn’t mean we can’t help people who are suffering through compassionate listening and support.
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I still don’t understand how anyone can claim “overdiagnosis” or “misdiagnosis” of something that has no objective diagnostic criteria. It’s good they recognize that “Adult ADHD” is a marketing scheme, but how is it any different than “childhood ADHD,” which they still claim to be able to diagnose accurately?
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Very well said! In my view, the power elite LOVE it when the rest of us are divided by left-right politics. We do best when we find things we agree about and pursue them regardless of political background or affiliation.
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I don’t agree that it’s oppressive to have rules and expectations for civil behavior. Oppression comes from the rule of one “in” group over another “out” group. There are many examples in Western democracies, but the most encompassing is the oppression of the poor and the working laborer by the rich and the propertied classes. This oppression is chronic in Western societies, but societies have been observed where such oppression does not exist at all.
Laws in a democracy are supposed to be made by general agreement, with all having either direct or indirect input through representation. If such is the case, problematic laws can be changed by communication, and any oppressiveness is temporary, accidental, and remediable. Looking at psychiatry, we see the opposite. “Patients” or “clients” are clearly considered less valuable than “professionals,” leading to the latter feeling justified in making decisions for the former, including forcing “treatment” on them “for their own good.” The main thing a Soteria-type model provides is freedom from this kind of oppression. If people are allowed to be themselves, yet still expected to maintain some kind of respect for other people’s rights, it is possible to create a society where oppression is not a major force. Unfortunately, psychiatry is clearly and violently opposed to any such creation, and will stamp it out wherever such creations begin to blossom, as Mosher learned to his dismay.
Oppression starts with a significant imbalance in power, and the person in power can and often does use that power to do harm. It has nothing to do with creating laws for a just and smooth-functioning society. It’s not oppressive to expect societies’ members to treat each other with respect. It IS oppressive to expect some to accept disrespectful treatment while not holding those treating them poorly accountable for their violations.
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Unless you count corporate welfare…
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US healthcare is WAY more expensive than most other countries, mostly due to the profit motive and to perverse incentives, such as paying $200/hr for 10-minute “med checks” vs. $75/hr for therapy vs. next to nothing for “peer support.” So we have plenty of money to afford this kind of system. It’s just not profitable enough for the powers that be.
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It’s also kind of ridiculous to call SSI “financial security.” Almost everyone I know on SSI of any form is living in poverty.
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Sounds like the perfect setup!
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Thanks for the excellent article. I notice at a few places that you say that the professional staff “doesn’t understand” true peer support principles. I don’t agree with this. My observation is that they don’t BELIEVE IN peer support principles, and the more they understood them, the less they’d believe in them. Peer support presents a THREAT to the status quo, including threatening many professionals’ deeply held belief that they are inherently superior to “the mentally ill” and therefore have a right to condescend to and feel superior to them. Accepting a true peer support concept would be tantamount to admitting that they (the professionals) are not substantially different from the clients they are supposed to help. While such an admission would, of course, be tremendously helpful in allowing professionals to actually understand what works and what doesn’t work, the vast majority of professionals don’t have the courage to face the uncomfortable feelings that come up when they step down from their place of power and face the truth of their own oppressive behavior and their own prior experiences of oppression.
As in any movement, cooptation is an effort to disempower a threatening group. No amount of education, training, or regulation will make peer support acceptable to the mainstream. They won’t give their power away voluntarily, with a few exceptions, and those exceptions will be hounded and driven out (as I was) by the violence and corruption of the system.
What we need is not “peers” in the current system, but a new system not based on power differentials.
— Steve
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I assumed they were talking about a football fan!
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Most of the psychiatric armamentum would qualify as “unnecessary care.” But if you pay people to prescribe drugs, they’ll prescribe drugs. If you pay people to do tests, they’ll do tests. For profit healthcare is problematic, because as soon as the need for profit drives care, then we receive what is profitable, not what is actually helpful to us. Something’s got to change!
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Agree 100%, Pat. Imagine that!
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You’re right – it should be Job #1, as the threat of involuntary “treatment” (aka torture) contaminates any system that tolerates it. Job #2 should be to eliminate psychiatric “diagnosis.” I don’t hold my breath that either of these things will be a part of ANY “Integrated Care” initiative, which is why I doubt there is any value in the concept.
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Like I said, it’s a viable strategy. It’s not a panacea, and it can be and often is used in an authoritarian manner. The enemy isn’t CBT, it’s AUTHORITARIANISM. An authoritarian thinks s/he is better than “the mentally ill” and so believes clients need to be “fixed” by having something done TO them. Quality therapy (and I admit it is rare) involves empowering the individual to take action in the service of improving the conditions of his/her own life. It should never be driven by the needs of the therapist, but it too often is, and the DSM lends tremendous credence to authoritarian views and encourages this kind of abusive, controlling behavior in the name of “therapy.” I can completely understand that even one visit with one of these charlatans would turn one off of therapy forever. I was fortunate to have run into a capable therapist early in my life, and I learned what good therapy can do, but I don’t think most people in therapy get therapy at all. They get authoritarianism and/or ineffectual sympathy, neither of which helps anyone get anywhere good.
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I agree – the truth is messy and requires a lot of tolerance for gray areas. Anyone who says they have it all figured out is suspect. Or as Westley said in “The Princess Bride,” “Life IS pain, Highness. Anyone who tells you otherwise is selling something!”
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CBT is often used in an authoritarian manner – instead of the client deciding what thoughts or beliefs s/he wants to change, if any, the therapist decides what beliefs THEY think the client should change and tries to force the client to change them. When approached that way, it can be extremely oppressive.
Also, CBT is just one strategic approach that could be used, doesn’t work for everyone. A therapist who is committed to being a “CBT therapist” will continue to force the issue even when it isn’t working or is harming the client.
A really good therapist will have a range of options available to apply, and will adjust his/her approach to the needs of the client. But I’d estimate that 80% of therapists are not fully capable of doing this kind of work, and as such, they become dangerous.
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Now someone will develop a manualized therapy program involving involuntarily hospitalizing people and forcing them to listen to Metallica until their symptoms remit. They could call it “Metal Health Treatment!”
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It should also talk about stopping involuntary “treatment,” which is both very costly and highly ineffective, not to mention a gross human rights violation into the bargain.
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That is actually a glaring omission. Thanks for pointing it out, Frank.
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A dialogue often involves asking interested questions, Pat. I am really interested in knowing how YOU personally decide if something is a disease or not. It’s actually a very interesting philosophical question, certainly worthy of intelligent dialogue, IMHO.
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The list is very thorough, though incomplete in one regard: to put an end to “ADHD” diagnoses, we need to revise the oppressive nature of our educational system and take an approach that respects the individuality and internal motivations of our students. The industrial educational model is responsible for probably 90% of “ADHD” diagnoses. Consider alone the fact that 30% of the “ADHD” cases go away if kids go to school one year later. Clearly, schools (and now even preschools!) are expecting things from kids that are not appropriate, and alternative models already exist. Time to start doing what works instead of what’s politically expedient!
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I so agree with you, Julie! There is nothing beneficial to being considered having a “disease,” especially when the psychiatric profession is involved!
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“Standard Protocol” – Jeez! This is why it is really, really dangerous to have these things viewed as “medical diseases.” They start acting like they have some scientific handle on how to “treat” it and your opinions stop meaning anything at all. This is horrific – they almost killed you! I hope you are someday in a position to sue their asses!
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Can you explain how “eating disorders” are a disease? What definition of “disease” are you using?
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I agree. Ultimately, real community is the answer. So how to go about rebuilding communities in a system that is designed to destroy them? How to dismantle that system in a way that allows communities to be reborn and to flourish? That’s the truly big question at hand. “Therapy” almost by definition assumes a society that fails to meet the needs of a large percentage of its members.
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Finally, someone who knows how to design and honestly report on a social science study! Notice that he reports on both his original hypotheses and outcome measures, and whether nor not the measures support his original hypotheses in full or in part. And he honestly reports the results when his hypotheses are not supported or only partly supported. If only psychiatric research were supported this way, psych drugs would be rarely used.
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Right you are, Brett. Arbitrary measurements lead to arbitrary results.
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Rate of prescription is not the same as rate of “depression.” If the definition of depression is arbitrary, the rate of prescriptions written will be, too. The question is, given the subjective and frankly arbitrary definition of “Major Depression” in the DSM, how can any rate calculation be anything but subjective and arbitrary? We already know that rates of concordance on diagnosis for any of the DSM “mental disorders” are mediocre to poor. So talking about “rates of depression” is just not meaningful.
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I think it’s simple to explain. “Mental illnesses” as defined in the DSM are not scientifically true. What is called “mental illness” is very real. It’s the names they put on them, or the way psychiatrists group people together that have little to nothing in common that is the trouble.
OK, it’s not simple to explain, but it isn’t that hard, and NOT explaining it means allowing the mythology of the DSM to continue unchallenged.
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I had the same thought. Industrialization forces us all to comply with many arbitrary schedules and rules, often starting as infants. This is highly stressful and screws not only with our sleep schedules but any other part of our circadian rhythms. Not to mention disruptions in nutrition, toxic chemicals in the environment, noise and light pollution, and on and on. Psychiatry is the handmaiden of industry, helping blame individuals for the costs of industrialization.
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I have to say, my Schadenfreude on hearing this one was quite extreme. Couldn’t happen to a nicer guy!
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You mean that actual medical testing led to discovering actual medical conditions that could actually be treated by objective alteration of actual measurable quantities? How frighteningly scientific!
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Sounds more like a bad mother than a therapist!
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That’s not therapy, that’s abuse!
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I think it is perhaps a mistake to say that “EDs” are caused by any one thing in particular. Every person is different, and the big error (if it is an error and not a tactic) made by psychiatry is to assume or pretend that all people who behave, feel or think in a particular way have something wrong with them, and in fact have the SAME thing wrong with them and need the SAME “treatment.” This sells drugs well, but does not serve their patients. I am certain that every case of “binge eating disorder” is different, having different causes, different needs, and different things to be done to help.
That said, your comment about reconnecting with the passions of one’s life is a good recommendation for almost any condition one may have, regardless of the cause. While medical intervention may be temporarily needed or helpful, living a full life and engaging with the world on one’s own terms is what life is always about. I know that not everyone has the means or the capacity to do that, but I think that should be a primary target, if not THE primary target, of any psychological therapy/help that is offered.
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How can you “overestimate” the prevalence of “depression” when there is no way to identify the “actual rate of depression,” since there is not an even close to reasonably accurate way to measure what “depression” really is? It’s like estimating the “accurate rate of anger” or “accurate rate of itchiness.” There is no such thing as an accurate rate of “depression.”
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What you say seems so clear and obvious to me. It’s baffling that so many “mental health professionals” don’t see it this way. If someone’s angry, you can bet they’re angry at something or someone. Why not find out who or what is involved instead of snuffing out the anger to make yourself feel more comfortable?
Thanks for sharing this – I am sure many readers will relate.
— Steve
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Well said. Too many folks WANT to conflate the actions of certain people claiming to be “Muslims” with the entire religion. Many of the same folks WANT to distance the actions of certain people claiming to be “Christians” from the entire religion. Therein lies the hypocrisy.
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Pretty good article. The writer speculates a whole lot about purported biological causes near the beginning without research basis, but toward the end, the discussion of holistic care is quite interesting and probably very useful to many who are looking beyond the narrow-minded “modern” bio-bio-bio lens. Thanks for sharing!
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A “myth” in this sense means a belief system that is not necessary ENTIRELY false, but is based on assumptions that are not factual and verifiable. It is a “story” told not for the truth of it, but for the symbolic content. In other words, for psychiatry, these “disorders” are “disorders” not because there is proof of it, but because believing that makes their job seem more meaningful or confers more power to them. A myth is a way of structuring the world through a system of beliefs which are not verifiable, but are held so strongly to be true that questioning them often feels like some sort of attack on reality.
In my personal observation, it appears you have been both exposed to and indoctrinated into these myths to a heavy degree, as many people here have been initially. It appears you have become aware that the truth varies from what you have been told, but it seems like it’s hard for you to conceive that this mythology is both intentional and known to be less than truthful. It’s very hard to emerge from this mythology, because it means accepting you’ve been deceived and that the general field of psychiatry has not had your best interests at heart.
Remember that something mythological doesn’t have to be entirely false. It can be true, for instance, that some people feel better when they take psychiatric drugs, or that biology plays a role in at least some people’s “mental illness” as identified by the DSM. The fact that there is some truth in the myth doesn’t make it any less of a myth, because the point of the myth is not truth or falsity, but control over the belief system of those who are exposed to it.
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How do you know they “do have biological roots,” Pat? Would it not be more correct to say “Some of these symptoms MAY have biological roots in some cases?”
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I think it needs to be worked together. In other words, eliminating psychiatry goes along with making other changes. I don’t think either psychiatry or capitalism is going down without a fight, and both are going to be undermined step by step. But just as we can’t eliminate capitalism without another means of people having a medium of exchange, people will have to have some way of dealing with challenges in operating in our weird society.
I was thinking about this last night: here is a short list of “needs” psychiatry fills: 1) gives people an explanation (however poor) for why some people act or think or feel in ways that are outside the “status quo.” This is a real need for people and it will have to be filled in some other way. For instance, trauma, nutrition, social stress are all potential explanations that can be substituted for psychiatry’s “chemical imbalance.” But people need a way of thinking about psychological/spiritual issues.
2) Psychiatry provides an excuse/justification for avoiding revising or examining current institutions. Naturally, avoiding these things is not healthy for a society, so in order to eliminate psychiatry, we need to create some ways to deal with institutional problems that require accountability and responsible change. Eliminating psychiatry won’t handle this need, because our social system will come up with new ways to justify the continuation of the status quo and the blaming of the victims of their shortcomings.
3) Psychiatry provides an “authoritative” view on what’s “wrong with people,” allowing rank and file proletarians like you and me to avoid having to think about the issue. Clearly, this is also not healthy, but authoritarianism is rampant in our culture and we need to start addressing this and encouraging people to think independently. This would involve revising schools, at the minimum, as well as many other authoritarian institutions.
I could go on. You see where I’m going with this? There are reasons why psychiatry has been able to be so successful in today’s society. It fulfills certain niches that our current system demands, and unless that system changes, removing psychiatry will simply open the door for some other charlatans to move into that role.
Hope that’s a little more articulate.
— Steve
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Thanks, Julia and Frank. I agree, moving beyond writing information and comments is needed, some form of political action. I really think we need to get the “left” activated around this as a human rights issue. I also agree with Julia that simply saying how bad it is doesn’t accomplish much. It has been seen over and over again that revolutions that don’t address the underlying social issues end up replacing one oppressor with a new one. “Meet the new boss – same as the old boss…”
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It may not be a “system” per se. As I said in another comment, it may simply mean rebuilding communities along collaborative lines. It may mean creating sub-communities and support networks of folks who are interested in and capable of supporting each other, much as has happened in the domestic abuse survivor movement. My point is only that being against psychiatry will not be effective if people ask, “Well, what do we do to help people with these difficulties if we don’t lock them up and drug them?” We do need an answer to that question, or panic will ensue.
Perhaps I might reframe this to say that psychiatry meets a SOCIETAL need in our modern neoliberal corporate capitalist society. Some big changes need to happen in the system or there will continue to be people rebelling against or collapsing under the pressure of this system. That has to be part of our approach. Just screaming “lock up the psychiatrists” doesn’t get us there.
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Perhaps it’s more correct to say that psychiatry proposes to meet a need that is real, but does it in a very destructive way. People are LOOKING for something, and psychiatry purports to provide it, just as drugs purport to meet a need and end up being destructive. I’m making no argument that psychiatry actually does anything helpful, but that folks are genuinely attempting to get help with real problems, and that’s what leads them to psychiatry’s doorstep. Failing to provide or create some way for those needs to be met will allow psychiatry to be “replaced” with something just as destructive or worse (if that is even possible).
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This is a great example. It’s quite possible that the professionalization of therapy has prevented other more natural means of resolving conflicts and traumatic events. Perhaps at the core it’s about the loss of community and the psychiatric profession is an attempt to redirect the sense of loss and disconnection that the loss of community entails. Perhaps the answer is creating more intimate communities where people actually care about each other. But there’s definitely something needed that our society is not providing.
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Sounds good to me!
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I am only saying that such needs will have to be addressed, in essence, that the presence of psychiatry in its current form is a consequence of the disturbed and disturbing society we inhabit, and that some means to address these needs has to be developed. It seems we agree on that point. The disagreement is whether psychiatry meets a need. I contend that it does, or no one would voluntarily get involved. Of course, drugs and alcohol, prostitution, and other heinous things meet a need as well. They do need to be addressed, but to eliminate drug abuse without addressing why people crave these drugs in the first place would not work. Same thing with psychiatry, IMHO. So yes, it needs to go, but just saying “get rid of it” I don’t think is enough. There needs to be another path, or preferably MANY other paths, for people to follow to get those needs met along with the drive to eliminate the coercive, corrupt and evil practice of “modern psychiatry.”
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I’m with Oldhead. The average street psychiatrist might not be “evil” per se, but those in charge KNOW they are using marketing and KNOW the DSM is invented and KNOW the drugs do long-term damage and don’t work very well, and that they make people die young, and intentionally hide these facts so they can make more money. That’s pretty evil in my book!
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Why would people seek out psychiatric “treatment” if they didn’t have a need to meet? Most psychiatric “patients” are voluntary, and most psych drugs are handed out by regular doctors, not psychiatrists. There is a need there, and it’s being manipulated, but if we banned all psychiatric drugs tomorrow and the DSM the day after, there would still be people saying, “I hate myself, I don’t have any friends, I have no idea what to do, why don’t I just kill myself because my life is meaningless.” Our society is abusive in many ways, and people need some pathway to figure out what to do about it. I don’t know what that pathway is, and I know it’s not taking drugs to numb out your feelings, nor is it categorizing different kinds of difficulties into “diagnoses” and blaming the victims. But there IS a need there and it will still exist even if there is no psychiatry.
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Agree on both points!
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The idea that “depression” is somehow a unique and different state than feeling sad/hopeless/despondent is a myth. There is no evidence that one can make such a distinction based on how bad someone feels or how long it lasts, as the DSM pretends we can. I suffered for a long time from chronic anxiety and depression, including suicidal thoughts and feelings. A psychiatrist would have certainly diagnosed me with a depressive disorder. I don’t feel that way any more. I like myself, I like my life, and I am very comfortable interacting with people I don’t know at all. How did that happen if my brain was not functioning properly and it was genetic and out of my control?
There are almost certainly people who are feeling depressed for biological reasons alone. If that’s the case, those reasons should be found and addressed. But to suggest that somehow we can distinguish these cases of “biological depression” from a list of “symptoms” that are created by committees is ludicrous. I would submit that MOST depressed people got that way because of how they were treated by other people. Pretending there is a biological explanation prevents us from actually looking at the psychological/spiritual causes that underlie most “depression,” hence the desire of many of us here to use a different term that reminds us that there is no special “depression” that can be “diagnosed,” but rather than sadness and despair, even the most extreme forms, are part of the human condition and require a human response.
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I believe eliminating involuntary “treatment” is the first step toward a more rational approach. The second is to eliminate the DSM, or to return it to it’s original role as an insurance billing document. The drugs will eventually sink under their own weight if the DSM/psychiatric mythology supporting their use is eliminated.
The challenge inherent in Bob’s post here, though he does spin it in a very negative (dare I say nihilistic) way, is that in order to eliminate the entire “mental health” system, we’d have to create a world where folks could get their physical, mental, emotional and spiritual needs met in a more consistent and safe and rewarding fashion.
It’s worth pointing out that mental/emotional struggles appear to be a part of human life, and that every culture in history has had both formal and informal ways of dealing with these challenges. So while abolition of coercive “treatment” and the DSM are very realistic goals, it does appear that something needs to be in place to assist people who are having difficulty figuring out how to respond to the stresses of ANY society, especially our bizarre Western post-industrial culture. I’m all for eliminating psychiatry, but there is a need to be met, and something needs to be in place to meet that need or our efforts will ultimately be fruitless.
— Steve
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Or white males in general, or even white people in general. “Intersectionality” is very real, but somehow oppression of the “mentally ill” appears not to have made the scene yet. The real enemy is authoritarianism, and that is found all over the place, including in “liberal” enclaves.
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So now “eco-anxiety” is a problem, and the solution is to pretend global warming doesn’t exist?
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I always find these articles both amusing and disturbing. How can you “overestimate” the number of people who have a “condition” that is entirely based on social assumptions and subjective lists of “symptoms” that have been agreed on by consensus but have no objective, measurable quality whatsoever? You can rate how many hours people sleep, what percentage try to kill themselves, what they eat for breakfast, whether they meditate or not, but you can’t accurately measure “depression,” any more than you can measure “courage” or “hostility” or “tiredness.” It’s idiotic!
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I have found mindfulness-based meditation very helpful. Also talking about traumatic experiences to someone who cared. I had a great therapist for a while back in the 80s who actually LISTENED to me and asked good questions and helped me sort out what had happened to me and what it meant. I have read a LOT of self-help books and tried to apply them.
I have also done work to help other people, including advocacy work to try and change the system. It required me to face my own fears, because I was working for someone else rather than just myself, and I was willing to do for them what I was afraid to do for me.
Those are just some things that worked for me. The biggest problem with psychiatry isn’t the drugs, it’s lumping everyone who feels similarly into the same group and expecting the same thing will work for all of them. Everyone is different, and different things work for different people.
— steve
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The USA has objectively become less socialist since the Carter administration or before. Even the ACA, which everyone accuses of being socialistic, is a market-based attempt to address unaffordable healthcare while assuring no interruption in insurance industry profitability. I suppose you could call it socialism for the insurance companies, but it’s nothing like what exists in Europe, Japan or other truly socialist countries.
You seem to have a knee-jerk opposition to socialism. I don’t see it as a cure-all by any means, but neither is the “free market”, at least when you get larger than a small community. Almost every Western government today mixes capitalistic and socialistic policies, for very good reason: unfettered capitalism leads to sweatshops and crime and rampant poverty, and unfettered socialism leads to the Soviet Union or something of the sort. People need incentives to work, but corporations can’t be trusted to work in the interests of anyone but themselves, as the recent developments in psychiatry should assure anyone.
Given that this is what has developed almost anywhere you can think of as a first world country, it appears to be what works. Why the emotional rejection of “socialism” when it’s part and parcel of every country’s success, including ours?
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Right, Steve. The DSM is the biggest hoax, and it allows us to dehumanize those who are suffering. It also allows our social institutions like families, doctors, schools, etc. to get off the hook for having done harmful things. I’m never against helping people figure out their path in life, but I’m VERY much against categorizing and dismissing people with arbitrary labels and using drugs to suppress their reactions to living in our crazy society!
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I am glad you are recognizing that you are getting triggered, Pat. I’d be interested in knowing what kinds of things you find triggering. I think it’s important to be aware of our triggers and take responsibility for having them, even if they are often the result of other people doing stuff to us that was harmful. That way, it’s more possible to have a rational discussion instead of going off on attack/defense mode. It sounds like you had some traumatic experiences both in the “mental health” system AND in the recovery movement, which is not uncommon for folks. I’m glad you’ve found your own path.
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Promises, promises…
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I am being sardonic, Pat. Dark humor. Of course, no one would actually SAY those words to anyone. I suggest you consider the intent of the poster before responding.
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The problem is the system will continue to abuse people as it has always done regardless of “ACE screening.” Any well-informed and sensitive person will ask questions that lead to information about “ACEs” in the course of a normal conversation intended to help. In fact, even calling them “ACEs” diminishes the power both of the experiences themselves and the survivors’ ability to create their own narrative of the meaning of such experiences.
A more honest approach would be that “crappy things that happen to you often lead to you feeling crappy and getting sick.” And to allow the person to share such experiences if they like, without giving them a “score” and labeling them as a victim of “ACEs” as if these were some disembodied entities that need to be “assessed.” Same with depression or any other “screening tool.” Sure, doctors and others should be aware of these issues and be willing to talk about them as needed, but “scoring” people on their past difficulties will only serve to dehumanize them even further.
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Thank you for saying that. We should be looking for common values and strategies, not attacking each other!
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Pat, you’ve said this many times. If this website is not for you, why do you keep reading and commenting on it?
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In my observation, the best answers come from others who have panic attacks. They DO happen, but they don’t get better (as you have no doubt observed) by being labeled and blamed and having things done TO us! I don’t suffer from long-term repeated attacks, but I have had a few, and have also helped a lot of other people get through them and eventually reduce their frequency, mostly by listening to them and understanding what was going on behind the attacks. There is also an immediate intervention path involving things like meditation, food health, breathing, exercise, supplementation, etc. that many find helpful but that you will almost NEVER find any doctor (and especially any psychiatrist) telling you about. And of course, there is also the need to look at the big-scale SOCIAL issues that create so much of the anxiety that many if not most members of Western society feel – the need for employment, lack of healthcare, corruption in government, institutionalized violence, racism, sexism, and so on.
One thing I HAVE found helpful in reducing years of chronic anxiety is to start recognizing that beneath my anxiety is ANGER and RAGE at how I have been treated. As I have learned to stop and SPEAK UP when I feel wronged or dismissed, I have had less and less experience of generalized anxiety about my life. Of course, I feel anxiety big time in the moment I take on my antagonist, but I feel SO much better when I just handle it in the moment it occurs – I feel self-respect and a sense of power, things I never felt much as a kid when I learned anxiety as a way of dealing with a world where I was small and my voice counted for little to nothing. That’s just my path, I’m sure there are many other paths, but the answer for me lay in identifying and feeling OK about my own RAGE regarding how I’d been treated as a kid, and feeling more and more OK about expressing my CURRENT rage (usually very respectfully, but not always) when I was feeling mistreated in the here and now.
Hope that provides some useful perspective!
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Hi, Sera,
SO good to read another blog from you – I was thinking recently it had been a while, and I always find your blogs energizing and affirming!
You really struck a chord with me this time. I was one of those “insider” dissidents in the “mental health” system for a decade or so, and I ran into the very same kind of dismissive attitudes once my views were known. In particular, I relied a lot on knowing the latest research on a topic as a means of balancing the power for clients, but I encountered exactly the same resentment from folks, as if I’d somehow “outfoxed” them by presenting actual DATA that they were unfamiliar or uncomfortable with. It was, indeed, VERY tiring, and I got out of the field and into advocacy as a result. Advocacy pays like crap but at least I could go home feeling OK at the end of the day. Still, most advocacy is for individuals, and system advocacy is much harder and much slower.
Bottom line, we’re working against CORRUPTION, and corruption is not changed by data or even by good working relationships. It’s changed by deleting the financial incentives toward corrupt behavior, and it’s rampant in our society today. I truly believe that’s where we have got to put more of our energy, yet the thought of taking on THAT juggernaut is even more exhausting!
Thanks for putting so much of my experience into words. Sometimes helping individuals who are brutalized by the system doesn’t feel like much, but it DOES make a huge difference for those individuals, and in the end, the country IS made up of individuals and maybe we need to help wake up a lot more before the big-scale changes we need to see become possible.
—- Steve
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It’s not just a matter of identity or ideology – it’s also a matter of power and financial remuneration. Social determinants require large-scale social ACTION, and this threatens the bottom line of big corporations (and the politicians who depend on their donations) as well as threatening the hold of dominant groups on power over those they deem below them in social value.
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Taking Risperdone PRN is about as idiotic as I can imagine. It takes weeks to get to full effect. It sounds like a formula for keeping him in a constant withdrawal state.
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If you read about and look at most people’s experiences with psychiatrists these days, you will see that many if not most propose that the MAIN cause of “mental illness” is biological. They need to do this in order to justify using drugs as their first line treatment.
Clearly, there are situations where a person is very easily injured from almost no impact. However, the psychiatric field is taking NORMAL reactions to traumatic situations and blaming the brain of the patient for their “wrong” reaction. I had this conversation with a very mainstream psychiatrist, smart guy, generally rational. He argued that people who react with flashbacks to a traumatic event are “disordered,” simply because not everyone reacts that way, so there “must be something wrong with their brains.”
As for people claiming no genetic impact, I think you have to be careful not to confuse the idea that genes may influence people’s reaction to trauma and stress, which most people would agree with, with the concept that any of the DSM “disorders” are caused by genetic defects, which is nonsense. The real problem is in the diagnoses, which are made up by committees based on things that are uncomfortable or difficult for society, rather than being based on any common biological problem causing these “diagnostic” categories. If you think about it, why would they? Why would all “depressed” people have the same thing wrong with them? Why would they all need the same kind of help? They have nothing in common except for feeling a certain way. Diagnoses should flow from biological findings, not the other way around.
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Some people make radical changes in their lives after near-death experiences, like almost being killed by a car hitting them. Should we use pushing people in front of a car as a means of “treating” “mental illnesses?”
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No one would deny that genes are INVOLVED in how people react to stress and trauma. What I object to is two ideas: one, that genes are the ONLY thing (or even the MAIN thing) that causes what is called “mental illness.” The other is the idea that what the psychiatric profession calls “mental illness” is anything but a collection of biases and social constructions that are most likely caused by a bunch of different things, and sometimes aren’t even “disorders” at all.
For the first idea, I would ask you this: not everyone who gets hit by a car breaks bones. I would guess there is some variation in genetic bone strength that makes some able to withstand a greater impact. Does it make sense to diagnose people whose bones break from impact with “weak bone syndrome?” Should we research the genetics of bone weakness so we can provide extra protection to the weak boned?
Or should we try to reduce the number of cars hitting people?
As for the diagnoses themselves, let’s take a look at “ADHD,” the one I’m most familiar with the research on. Possible causes of “ADHD” symptoms include anxiety, trauma, low iron, low or high thyroid activity, nutritional deficiencies, sensory issues, sleep apnea, poor parenting, inappropriate classroom structure, kids being admitted to school too young (a one-year wait reduces “ADHD” diagnoses by 30%), boredom, foster care placement, and many other reasons. Of course, every one of those casual factors would require a different approach. So what’s the meaning of a “diagnosis” that doesn’t tell you the cause and doesn’t tell you what you should do about it?
The final point I’ll raise is that even if we discover some genetic cause of any of these “disorders” (and 50+years of research have failed to find ONE “mental illness” that has a consistent, identifiable genetic cause), genes are the one thing in the scenario that CAN’T be altered. Why would we spend all of our money and time researching about the one thing that we can’t do anything about? If we know that both genes and environmental impacts combine to create “mental illnesses,” why wouldn’t we want to focus our energy on the environmental issues that can actually be modified?
Hope that helps answer your question.
— Steve
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A horrific story! Thanks for having the courage to share it. It continues to astound me that a person under their care can deteriorate SO horribly over SUCH a long time, and yet at no time do they ever question that their “treatment” is necessary and effective, and that any “failure” that occurs is the fault of “the disease,” never their treatment at fault.
As I like to say, “Another psychiatric success story!” So glad you’ve figured out how to escape.
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I would not refer to these as “somatic therapies.” They don’t really address the body so much as perceptions from the body. “Somatic therapies” would be things like drugs, shock therapy, magnetic stimulation, electric brain inserts, etc., and these have been almost all complete failures in bringing about long-term improvements in survival and quality of life.
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This is all politics. The Trump Administration decided that “Evidence based” is a dirty word, so they’re not allowed to do it any more. I’ve always had mixed feelings about “evidence based practices.” It’s often used as a way to promote the status quo over anything else, as status quo “treatments” are the ones that get research funded, and hence are the only ones that have any “evidence base” to draw on.
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“Unlikely” isn’t the same as “impossible.” If you said “most” or “the vast majority” instead of insisting on “every” I might be able to agree with you. As I like to say, “Generalizations are ALWAYS wrong!”
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Wow, that sounds like just like what you need! It’s really incredible, isn’t it, how they just talk about what they’re going to DO to you right in front of you, as if you don’t even exist? Stunning that they’d even admit Zoloft is screwing you up, but of course, the solution is another drug or another. Glad you’re getting away from them!
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It is hard to find a holistic doctor. Most would not call themselves “psychiatrists.” PTSD is one label that can be addressed by talking therapies along with good diet, exercise, meditation, and many other approaches that don’t involve drugs. The Zoloft and Klonapin are both potentially going to make things worse in the long run. The lack of sleep may very well be related to Zoloft.
I wish I had a great idea, but it comes down to searching and searching and interviewing people and seeing who is available and sane in your area who might be able to help. Perhaps finding peer support groups that are not psychiatrically oriented and talking to the other members can be helpful?
Wish I had more to offer. You can see how how completely incompetent and delusional these psychiatrists and their allies really are. They have NO idea what they’re doing and you’re just a “brain experiment” to them. Get as far away from them as you can! Best of luck to you!
— Steve
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“Death Therapy, Bob. It’s a sure cure!” From “What About Bob” – see it!
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A good friend of mine was prescribed Zoloft for migraines. She had never been suicidal in her life, but suddenly had these odd thoughts when struggling with a problem: “I could kill myself.” She was stunned and disturbed! It took her over a year to get off of it due to withdrawal reactions, had to cut the pills down into tiny fragments to wean off. So yes, this does happen, and it’s a horrible idea!
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Does credentialing actually provide any assurance that the practitioner is competent or ethical? Studies seem to indicate that para-professionals or untrained peer counselors do at least as well as professionals with advanced degrees. What does licensure provide, other than job protection for those so licensed?
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This is stunning, even for me. Corruption plus desperation is a bad, bad combination!
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I can easily explain that. The globe is warming, of that there is no denial. Average annual temperatures continue to climb. However, many who don’t understand climate issues complain that “Hey, it’s been super cold this winter, so that proves there is no ‘global warming.'” I think that in order to address this misunderstanding, the term “climate change” began to be used, because a warming earth doesn’t mean it’s warmer everywhere all the time, but it does mean that the expected climate for different regions becomes less predictable, including significantly more or less rainfall than average, extremes in temperature, more extreme storms, longer dry spells leading to a longer fire season (as happened in the US West this year), and rising sea levels.
The degree to which this is caused by human activity is debatable. The question of whether or not it’s actually happening is not debatable. This, I think, distinguishes global warming from psychiatry in a pretty dramatic way. Psychiatry simply makes up categories and counts them based on arbitrary checklists that don’t measure anything at all. Global warming is measurable by averaging the temperature around the globe, and can be verified to occur. Climate changes relating to warming temperatures are also predicted by mathematical models, though as we all know, climate prediction is a much more imprecise activity than measuring the average temperature. Temperatures rise, glaciers melt, sea levels rise – all completely predictable and measurable. Psychiatry has nothing remotely similar to measure or report on.
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This is an excellent point. The entire economic system we operate in is organized around oppressive principles and assumptions, and unless that’s fair game for discussion, we end up colluding with that system, no matter how helpful our individual interventions might be.
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I like this. I have also approached it from the other direction – “What were you hoping to accomplish when you did this – what was your goal?” Or “What need were you trying to meet with this behavior?” Not always an easy question to answer, but I found it digs down very quickly to the key issues that are hanging the person up. Whether or not it worked, or continues to work, I come from the point of view that all behavior is intended to meet a need, to accomplish something, and once we find the goal, we can talk about other options that might meet the same need at a lower cost.
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Oh, and I CERTAINLY didn’t discourage any impulse to strike back at the perpetrators of harm – to the contrary, I always felt that anger and intent to act against oppression was a sign of progress, as the person was moving AWAY from being a victim and toward taking ACTION, which seemed in most cases to be the best antidote to feeling bad about him/herself.
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You keep saying that, but it’s not necessarily the case. I provided therapy from the point of view that the person came in needing/wanting some change in his/her life, and that my job was to catalyze whatever change that was, as they conceived of it. Part of the job was to help them figure out what it was, but that’s not the same as me having an agenda. I agree that most therapists these days lack the skill to do that, but that doesn’t mean EVERY therapist has an agenda for the client. I had a therapist who was very helpful to me in accomplishing MY goals, and actually refused to tell me what she thought about anything I said or did, instead insisting that what I thought of it was what mattered. I can’t see that she had an agenda, other than to help me make sense of my world and decide what I wanted to do differently.
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Right, I’m agreeing with you. Any real scientist, would, of course, be 100% opposed to “scientism,” as it undermines the most basic tenets of science, namely, that we need to be humble and skeptical about our own assumptions and that any theory or assumption can be disproven by data. To use “scientism” as an ad hominem attack on real science is only possible when used on the ignorant. Unfortunately, as stated above, the ranks of the scientifically ignorant are legion.
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Pseudoscience is pretending to be scientific when you’re not. I think “Scientism” is more of a religious belief system where there are “smart” people who “know science” and we can be “smart” too if we just agree with them and do what they say, and we don’t have to think about it too hard. The second is a much more encompassing concept, but also more complex, as it involves the development of religious/philosophical dedication to a set of dogma, whereas pseudoscience is just straight up deception. I think Scientism certainly applies to psychiatry, but Richard’s point is well taken – it is too complex for people to understand fully and is too easily used by demagogues to promote an anti-intellectual agenda.
The truth is, very few Americans actually understand science and most are unable to differentiate it from pseudoscience. Most are ultimately either proponents of “scientism” or are knee-jerk opponents of “those left-wing intellectual communists” without any real comprehension of what science is about and what it can do when unadulterated by corruption and politics.
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I think you’re right, we don’t know very much. It’ OK for scientists not to know very much as long as they ADMIT they don’t know very much.
The problem Dr. Timimi is outlining here is that psychiatry as a profession PRETENDS to know things that it doesn’t know, and uses its authority to convince people that it knows what it’s talking about when really their ‘science’ is mostly just made up.
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Exceptional article! Not that I expect less, as Dr. Timimi has been a leader in fighting psychiatric “scientism” from the inside for decades. Thanks for putting it into words so succinctly and effectively!
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Kind of ironic, isn’t it? Hope that perhaps it makes some of them stop and think what it’s like for their clients to go through the same process of labeling and invalidation.
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It’s just that you’re mostly a one-trick pony, Pat. People don’t want to debate you because there’s no point, since you’re not open to new data, so once we’ve heard your presentation, there isn’t much else to be said. It might be different if you actually were willing to incorporate others’ views and data into your worldview. But I won’t hold my breath on that.
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No one slams anyone for choosing to use medication, Pat. You’re projecting your own fears out there. You should know by now that the critique is of lying and intentionally misleading people with false data. You and anyone else is welcome to use whatever medications/drugs they choose to use. You’re even welcome to find your psychiatrist useful, helpful, or wise. We’re not talking about individuals. We’re talking about a system that’s intended to create customers instead of promoting health and truth.
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Hi, Shaun,
I have to say, as a therapist myself, I see what looks like victim-blaming in your post. If I am receiving funds to provide help to a person, it’s my job to figure out a way to help. If I take my car to the mechanic, and he can’t figure out what’s going on or how to help, he doesn’t get paid. There were certainly people I was not able to reach, but I considered it my own failure, not theirs.
I also find that labels, and Borderline in particular, provide a handy excuse to infantilize the client and to avoid facing up to the real issues behind the label. I have no objection to teaching skills to someone who wants to learn them, but so much of the DBT approach seems to focus on how WRONG the client is for “lacking emotional control,” and many therapists take a very condescending attitude toward their clients, referring to them as “she’s a borderline” or saying “she’s manipulating” or making many statements indicating severe judgment against the client. This is, in my experience, the OPPOSITE of what is needed.
I’ve been very successful with so-called “borderline” clients, mostly because I approach them with a very genuine, direct, and caring relationship that builds trust with them. Trust is the big issue for most of the people who get this label, because most have been abused and/or neglected. Treating them like children or disabled people tends to lead to resentment and disrespect, while acknowledging what pain they area suffering and normalizing their coping measures as necessary to confront the situations they had to deal with works far better, IMHO.
Anyway, it sounds to me like you are operating very much within the confines of the psychiatric paradigm. Maybe that works for you, but I never found it worked for my clients, and most of the time, once I opened the door for genuine discussion of their experience, most of them described extremely frustrating experiences, even with caring therapists, mostly because they got the impression that they should “get over it” or that their emotional damage was their own fault, or they got the message that they were permanently damaged and should lower their expectations for life. It might be really helpful to increase your perspective by taking to some clients who have hated DBT or other forms of therapy, and genuinely inquire as to what they hated about them. It might be an eye opener for you.
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I knew that, but thanks for the clarification. I think she’s using a different definition of “patriarchal” than me, more focused on gender and less on privilege and oppression.
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Boy, you’re lucky! What a GREAT guy! 🙂
Thanks for the references. I’ll get reading!
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Do you have a book you’d recommend?
I’d continue to assert that women being in charge of a social service organization does not make it not patriarchal, if the women are required by the structure and their superiors to adhere to the rules made up by men or else be castigated or shunned by their peers. Many women are business leaders, for instance, but sexual harassment is still rampant in the business realm, and is chronically ignored or suppressed, including by women in charge. And guess what, it’s almost always men harassing women. Obstetrics is another great example – more women OBs than men by now, but they still do all they can to disempower the woman and do things to her and in any possible way prevent the natural birth process from going forward. Caesarian rate is over 30% nationally, and much higher elsewhere, but there is no outcry about cutting open so many women without need. Because, after all, they are women, so their rights are secondary.
It is more complicated now that absolute apartheid can’t exist, but I don’t think matriarchy can be claimed in social work in all but the most formal definition. We’re still living with male privilege. The fact that many women can work their way around to grasp some privileges at lower levels, and that a few can even make it up to higher levels, doesn’t change the fact that men are granted power advantages simply by being male, nor that the rules are created to favor men.
To give a more simple and amusing example: My wife and I split the housework 50-50. If someone hears this about me, what do they say? “Wow, what a great guy, he splits the housework 50-50!” What do they say about her? “Wow, she’s so lucky, he does half the housework!”
Same amount of work, I’m great, she’s lucky. All I have to do to be a “great guy” is not be violent or disrespectful and clean up after myself. Men have much lower standards than women to adhere to. That’s privilege!
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Well said. The point of the article is that individualizing reactions to trauma and oppression obviates the need to examine the cultural/structural reasons why they occur. Black people probably “need help” dealing with the effects of racism, but providing a diagnosis and “therapy” seems like a pretty thin cover for letting racism continue to drive social and political behavior.
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Thanks for the clarification. I hope you’ll consider whether a different term might be better, because the term “mental health” has been so critically co-opted by the industry that saying “a right to mental health” sounds immediately to me and others like “a right to mental health TREATMENT.”
How about a right to “an environment that supports healthy physical, mental and emotional development?”
Again, I appreciate the article and your work. Thanks for sharing it with us!
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Not a woman, but I did address the attack.
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Are you seriously suggesting that patriarchy doesn’t exist in the USA? Have you looked at the composition of Congress, at pictures of most of the CEOs in the USA, at how rape victims are treated in the USA? Not to mention, patriarchy goes WAY beyond “women are oppressed by men.” It seems your view of what constitutes patriarchy is very, very narrow. It really comes down to relative privileges in society, and to suggest that white males don’t have an overall advantage economically and politically is quite naive, in my view. Men and boys being abused by the system is not evidence of the absence of patriarchy, but its continued domination of our system.
It’s also naive to suggest that being democratic, female, or liberal in any way absolves someone from abusing one’s patriarchal privileges. Weinstein, Bill Clinton, Al Franken, all liberals, all Democrats, all still felt superior enough to or had enough power over women that they could take advantage of them with impunity.
I’d suggest you read up on the subject.
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In order to progress as a society, we’re going to have to transcend this liberal/conservative axis anyway. Those designations don’t mean what they once meant, and we need to reorient. The new axis, I think, is authoritarian vs. non-authoritarian, and their are authoritarians on both the left and the right. The question is whether you believe some other person smarter or more powerful than you has the right to boss you around or not. This goes to the very heart of what is wrong with psychiatry, and even to the internal struggles within the field. Those who are non-authoritarians rebel in ways they can, but the authoritarians are in control and punish any deviation from the party line, whether rational or not. That’s what we have to overcome, and it will require both the traditional left, favoring protecting the rights of the poor and downtrodden and regulation of big business/big money, and the traditional left, favoring maximum freedom from unwarranted intrusion and direction from the government or other groups pretending to “help” for those who aren’t looking for it.
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We are spending billions and billions on fighting terrorism, which has killed something like 4-5000 US citizens since the late 90s (20 years, mostly on 9-11), and yet NO effort is expended to stop over 200,000 deaths EVERY YEAR from poor quality “medical care.”
Our priorities are warped.
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Too true!
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You summarize the problem succinctly. The neolib solution to “mental illness” is to try to make the downtrodden “feel better” about their subordinate role in society through chemical means. The neocon solution is to “leave it to the free market,” aka social Darwinism. Both sides protect the business class and the wealthy. Neither gives a crap about the victims of our current social institutions.
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But the SSRIs became much more common in the early 1990s. Prozac was licensed in the USA in 1986, as I recall. Listening to Prozac came out in 1993, which had a huge effect in normalizing “AD” use.
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It is amazing how they manage to retain the fiction of “bipolar disorder” while clearly indicating that people so diagnosed don’t have all that much in common with each other, and probably have different causal factors involved.
Additionally, I noticed how they talked about genes conferring “vulnerability to bipolar disorder,” but make no mention of what percentage of variability is attributable to these ostensible genetic causes. Given the history of such reports, a 10% concordance would be amazing, and I’d guess more like 2-5% tops. It’s probably nothing to boast about or they’d tell us the numbers. Sleazy.
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Very well put, Richard. And Lawrence, too – I do get your point, but I still think it very important to note that a huge part of the purpose of psych drugging is to cover up and/or minimize the impact of oppressive adult individuals and institutions.
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This guy just makes way too much sense. Maybe he should run for APA president?
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I laughed when I read the title, because “bipolar” behavior is pretty synonymous with teenage behavior.
I like the arguments and the conclusions you draw, as far as they went. I especially like the idea of “active addressing of kids’ issues via meaningful social interaction” as a means of handling behavioral issues.
I would love to see you work in a couple more concepts, though. For one thing, the school system itself is the cause of most “ADHD” and thereby at least indirectly a lot of “bipolar” behavior in kids. We expect young people to do things that don’t make sense to them and to comply with adult authorities unquestioningly, and this exacerbates the natural rebelliousness of youth. Additionally, schools are increasingly focused on forcing academic learning on kids who don’t need it and/or can’t handle it, and vocational options are often not available, so non-academic kids have no means to feel any sense of accomplishment. These structural issues contribute greatly to ALL kids’ struggles in school, and providing alternative avenues to success would to a great deal to improve “discipline,” as it’s hard to be truly disciplined without a purpose to pursue.
Additionally, parental abuse/neglect/lack of skill is a huge contributor to the group designated “bipolar” in adolescence, and the drugs provide cover for parents and other “professionals” who are mistreating kids or neglecting their needs.
Finally, I have to take exception to the comment: “Even if hospitalized for violence, the experience may be so supportive, friendly, and cushy that teenagers find it more rewarding than punishing.” There may be a facility here or there that is “cushy,” but most psych hospitalizations are humiliating and disempowering in every possible way. The only times I saw kids wanting to go to the hospital was to avoid other institutional mistreatment (by schools, foster homes, group homes, etc.) that seemed even worse.
None of this is to invalidate your arguments regarding the disturbing underlying message of diagnosing kids just because they are struggling. Struggling is part of human experience, and should be a call for learning and development, not pity and infantilization. But I did not want our other institutions, including the institution of the family, to be let off the hook in our zeal to identify the myriad shortcomings of the psychiatric model.
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Hey, on this one, I’ve got to disagree with you, though I generally support almost anything you post. We are operating in a Western industrialized society, and in such societies, voice-hearers and the like are feared and treated like lepers. If there is an approach based on COMMUNICATION that allows 80% of such people to sort out what’s going on and figure out how to make their way in this insane world, I have to support it. It’s true that the concept of “mental illness” is a crock, but sometimes people still need help finding their way, and Western industrialized society isn’t making any big changes any time soon. If we can get people free of a life sentence of incarceration and forced drugging, I don’t think we have to be such ideological purists as to oppose the workable concept on principle.
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I don’t think we all have a “right to mental health.” What does that mean?
I’d suggest we have a right to live free of abuse and oppression, and to have those responsible for such oppression held fully accountable for their actions. If those rights are enforced, “mental health” will improve for all of us with no “treatment” whatsoever.
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Good for you! Your efforts are greatly appreciated! And yes, that nebulous concept of “reputation” for some reason seems to mean more to folks than actual DATA. Go figure!
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Sorry, are you suggesting that my comments are somehow labeling and judging with my comments? If so, I’d like to know where and how, as this is not my intent. I raised two kids who would have been labeled with “ADHD” if I let anyone near enough to “diagnose” them, and I have great compassion for how challenging it is to raise such kids. In my view, it is the system who is judging and labeling these kids instead of respecting that their behavior is indicative of efforts to meet a need. I’m all for nutritional solutions being offered, and 50% is a very good percentage and should be respected. Unfortunately, micronutrients don’t make big bucks for Big Pharma and the APA, so they will remain a marginalized intervention until the DSM is challenged, IMHO. That’s my only point here. I get that you have to work within the system to get the research published, but sometimes working within the system can inadvertently provide tacit approval for its destructive aspects. I found this to be true myself – I was a very effective alternatively focused therapist within the system, but I ended up feeling quite powerless to change the system, like a toy tugboat trying to tow the QE II. That’s why I got into advocacy instead. It was too hard to live with myself.
Thanks for hanging in on a difficult conversation!
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I agree 100%. It’s not a black and white issue. Many people report great benefits from therapy, while many others report great harm. My guess is that most are in the middle, not particularly harmed or helped. But there are some very skilled people whose time and perspective are tremendously valuable, whether paid or unpaid. Such people are worth their weight and should not be dismissed as cranks even if they accept payment for their services.
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I suppose you are right – slavery is a matter of degree. The parallels are legitimate, even if slavery as an institution was clearly more horrific than anything the psych profession has yet come up with.
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Correction: the third leading cause of death is not medical ERRORS, it is RECEIVING MEDICAL CARE IN ANY FORM! Most of the annual death rate is due to PROPERLY PRESCRIBED AND PROPERLY ADMINISTERED MEDICATION. Tens of thousands are killed by psychiatric drugs alone. And these are just the ones they ADMIT are due to medical treatment.
Such a law is crazy, as it lets the medical system off the hook for the damage they are causing every single day.
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I’m reading, and I totally agree that despite parallels between psychiatric incarceration and slavery, they are not really comparable. The point that the racism that has descended from the institution of slavery continues to be a pernicious force every day in the USA and other places is also very well taken. Privilege is a relative thing, and the fact that psychiatry is oppressive as hell doesn’t make it comparable to having one’s body and life bought and sold as if one were a head of cattle.
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That’s the point I’m making above: “ADHD” is a hodgepodge collection of behaviors that can have a mass of possible causes, from sleep apnea to iron deficiency to poor discipline to poor classroom management to childhood traumatization. To imagine that any one “treatment” could be effective against all of these myriad causes is foolish, unless your goal is to sell more stimulants.
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That makes sense to me. I appreciate the clarification.
I guess my point is mainly that I consider it important for you to establish that even if a small percentage of so-called “ADHD” sufferers improve with nutrition, those kids should NOT be labeled with “ADHD” at all, as “ADHD” assumes an unidentified neurological problem that could not possibly be remedied by nutrition. Of course, there are many other contributing factors, including high lead or heavy metal exposure, low iron, sleep apnea, and so on. Naturally, sleep apnea will not respond as well to nutritional interventions (unless they somehow help address sleep apnea).
I guess what I’m saying is that you have a golden opportunity to undermine the idea that “ADHD” is a unified “disorder” and that every remedy must address ALL “ADHD” cases or it is not considered effective. Not sure exactly how you do it, but it seems very, very important to taking down the current hierarchy of “diagnoses” that psychiatry’s success in subverting all other forms of help has relied on.
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I am very pleased to see this kind of research getting published. However, I do believe you would do better to challenge the ADHD label, for very practical reasons.
You note correctly that not all kids respond to nutrient interventions, but those who do often respond strongly. This is most likely because only SOME of those labeled as “ADHD” have nutrient deficiencies. Grouping all “ADHD” kids together therefore dilutes your results and makes it appear that what could be large effect sizes in the right target population are much smaller.
It would seem to me the best way to challenge this arbitrary grouping is to start with a group of “ADHD” labeled kids and to do nutritional testing or dietary analysis on the group. Once it’s established which kids may likely have deficiencies, split THAT group into nutrient vs. placebo. I would bet your effect sizes would be quite substantial.
The DSM labels are not just arbitrary – they were actually created to remove any analysis of causality and to make groups that can be spun as responding to drug “treatments.” Unless we break these labels down and look at subgroups who actually have something in common with each other, drugs will almost always get the “best results” because they are targeted to decrease the “symptoms” that are used to identify the “disorders.” If 20% of “ADHD” sufferers improve substantially from taking B-complex vitamins, that’s a FANTASTIC outcome – 20% of kids are now FINE just from a nutritional intervention! But if you compare all “ADHD” kids on this measure, you’ll get only 20% effectiveness, and the drug companies can claim 70%. See what I mean?
I believe it is of the utmost importance to your research being taken as seriously as it should be that you identify subgroups of those diagnosed as “ADHD” and instead of saying you’re treating “ADHD,” say that you’re treating NUTRITIONAL DEFICIENCIES that are identifiable within the group, and that those so identified DO NOT HAVE “ADHD” OR ANY OTHER DISORDER, as proven by their dramatic improvement with nutritional interventions alone.
Hope that makes sense. Thanks for your great work!
— Steve
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European-style socialism has existed for many decades without leading to totalitarian rule. I think you’re letting your imagination run a bit too freely here. The most successful modern societies combine ideas of socialism and capitalism. It’s the modern neoliberal/neoconservative movement of the last 40 years that has really led us to the crappy situation we’re in today, and blaming it on the left is very myopic.
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Sure thing. I’m at [email protected]
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Well, there is the “change through total collapse” approach. With Trump in the White House, perhaps a complete unraveling of neoliberal society is not far ahead.
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A thoughtful reply. I agree that incremental inside change is happening and is very important. I’m just very doubtful that this by itself can really bring about the necessary change. The financial and psychological/social benefits of the current system are way too large for this model to die easily. After all, the models let EVERYONE off the hook, even the clients, who never have to do any of the hard work to change their lives. But of course, the main benefit is it allows the current neoliberal system to continue unreflective about its destructive aspects. It’s a tough nut to crack!
Again, I totally believe that inside evolution is relevant and should occur. I just don’t see MDMA being successful as catalyzing some sudden and dramatic realization that the DSM should be scrapped and that clinicians should start viewing client trauma as central to their work. System change is slow, and as the quote goes, “It’s hard for someone to understand something when their livelihood depends on them not understanding it.”
Thanks for the thoughtful exchange!
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Agreed. Not only do psych diagnoses end up leading to drugging healthy people for no reason, they also obscure actual physiological problems that CAN cause “symptoms” that are labeled as “mental illnesses.” Low thyroid, iron deficiencies, drug side effects, sleep problems, chronic pain, nutritional deficiencies and many other things can result in emotional/mental “symptoms” that could actually be resolved by a real analysis of the body.
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I think it’s a bigger problem, and that the corruption at the top has to be attacked. My more conservative friends will hate me for saying this, but I don’t think it happens without specific government action to forbid a) DTC marketing, b) any kind of kickbacks, gifts, honoraria, etc. for any doctor hawking a drug for a drug company c) colleges and universities using public research dollars to parlay professors into big business opportunities d) the revolving door at the FDA (and other regulatory agencies) where industry insiders “regulate” their old bosses, and so on. This set of events will only happen when a larger movement of citizens demands that government corruption by lobbyists and big business campaign contributions come to an end. It will take a lot of people getting together and demanding change. People in power generally don’t give it up voluntarily, Nelson Mandela notwithstanding. Unless corruption is addressed, Big Pharma will continue to run the show and the APA will continue to Emcee their performances. That’s how I see it. Dissident action inside the system is important, but it’s too easy for them to be silenced or minimized by those in control. I know this from personal experience. It’s gonna take a revolt, starting with the clients themselves and their family members, friends and supporters (and whatever dissident professionals have managed to survive in the system) saying NO, we are not going to play this game. What it takes to create that is beyond my personal imagination and planning skills. Any ideas from your end?
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First off, I am SO sorry for your son’s untimely and very preventable death. It is hard to imagine a more painful kind of loss, and my heart goes out to you.
Second, I REALLY hope you can and do take legal action against the psychiatrist. While they are protected by the “standard of care” language, so that doing stupid things is not malpractice as long as your colleagues do the same stupid things that you are doing, this psychiatrist appears to have violated informed consent standards and failed to do standard tests, and I believe that should be sufficient to make him legally liable for his negligence. The courts appear to be the ONLY area of viable accountability for doctors, and finances appear to be the only motivation to get them to avoid bad behavior.
Finally, I’d add to your analysis that CORRUPTION is at the center of this problem. The reason doctors prescribe off label and the reason the psychiatric drug crisis is ignored and that things like Open Dialog are suppressed is because Big Pharma and many, many physicians are profiting massively from keeping the status quo in place. Unless this is addressed, tragedies like your family’s will continue to occur.
Thanks for sharing your story and helping push for some much needed changes in the system!
— Steve
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Again, not arguing against (and I never have) the strategic use of a short-term drug intervention (with proper informed consent) as long as it has an established positive effect that outweighs the risks involved. I’m arguing against the idea that MDMA being successful in this context would have the slightest positive impact on the demise of the medical model. At best, it will allow a few lucky souls to slip through psychiatry’s net if they manage to connect with the right provider. At worst, it will be trumpeted as proof that the victims of trauma who react poorly are at fault for their negative reactions, which is all the diagnose-and-drug model needs to continue to function. The fact that this argument holds no water is not relevant – NONE of the arguments for arbitrary diagnosis and drugging hold any water. It will provide a PR opportunity for the greedy and malfeasant industry, but even if they miss that, it won’t even make a tiny chink in their armor. And if it does, they’ll find a way to blackball anyone using it by relegating it to a permanent “experimental” status, as they have with neurofeedback and other promising interventions.
It is hard to overestimate the venality and ruthlessness of the psychiatric juggernaut. I think it is a big delusion to think that this kind of intervention will knock some kind of hole in their boat.
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And of course, I’ve made the “Weak bones” argument myself, and it makes total sense, but it doesn’t stop the psychiatric mainstream from telling those with PTSD diagnoses that their reaction is a disease because not everyone acts that way. Apparently, the only acceptable response to trauma is to shake it off and get back to work. We get a whole two weeks now to grieve the loss of a loved one, why should being sexually abused or seeing a friend blown up by a bomb require a longer recovery period?
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If there’s a way to hijack it, they will do so. And it’s very possible they CAN get a patent for a form of MDMA if it’s used for a new purpose. Drug companies do this all the time. My point is, whether or not this pans out as a helpful intervention, it doesn’t change the power dynamics of the Big Pharma/APA juggernaut as the author suggests it might, and I see a good chance, even if they can’t patent it, that it gets used to further their context-free agenda that’s worked so well for them since 1980 and the DSM III. That’s the central problem we face, and MDMA will do nothing to create sudden “enlightenment” of an industry which has made billions by denying known scientific facts such as those Whitaker so thoroughly outlines in his work. Why would they change what’s been so profitable, just because a few inconvenient facts suggest they are wrong? The general public still believes in them and their marketing, and that’s not going to change as a result of MDMA’s projected successful use.
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My reaction is not knee-jerk “all drugs are bad.” It is a rational expectation, given history, that any successful drug intervention will be taken out of context and promoted as the “new miracle pill” and promoted to make billions while undermining any chance of it being used in its proper role. Psychotherapists all over the nation will be recommending MDMA use to “cure” PTSD without any understanding of the subtleties you mention, and those who don’t improve, rather than having the therapeutic approach looked at, will be labeled “treatment resistant” and re-routed to the same old, same old list of psych drugs for further “treatment.” Meanwhile, psychiatry will be revitalized because they finally have a drug that “works on mental illness,” proving that it really WAS all in your brain all the time, and providing continued cover for the fiction that environmental impacts are of secondary or no importance in the “treatment of mental illness.”
Just as an example, a fairly recent qualitative study sent student volunteers into residential treatment facilities for youth with a list of questions. Something over 80% of the residents reported to a TOTAL STRANGER that they had significant childhood trauma that impacted their mood and behavior. Only 20% of the kids had any traumatic past documented in their charts!!! So either the staff is so unsafe that at least 60% of the kids felt more comfortable disclosing to a total stranger, or more likely, trauma is so low on their radar that they don’t ask about it, and even if it’s mentioned, it is not considered relevant enough to write down.
So it’s not that psychiatry hasn’t found a way to help trauma victims – psychiatry doesn’t WANT to help trauma victims and has a vested interest in MINIMIZING the role of trauma in creating adverse emotional/mental experiences – they don’t even consider it worth noting as a factor! They want to blame the trauma victim for their failure to “adjust” and any biological intervention, no matter how helpful it can be in the proper context, will be used to further their agenda of minimizing any discussion of psychosocial causation so that they can promote the much more profitable “chemical cure.” This situation will pertain until and unless the DSM concept of “diagnosis by committee” is dead and buried and pharmaceutical company influence over the profession is deleted.
You can’t cure corruption with science. It’s about power.
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Ron, I think there are a couple of points you are missing. This is not a critique of MDMA or the possibility that it might catalyze healing for some. I’m critiquing the idea that finding a drug-based solution will somehow lead to the dismantling of the DSM-diagnosis-based and drug-based “treatment” paradigm we’ve all come to despise. Until and unless we do away with the idea that the “patient” is “ill” based on some arbitrary criteria, a drug-based solution, however well-intended, will lead instead to an INCREASE in drug-based arguments and interventions and a further deflection away from looking at root causes for these “disorders” and a continued and redoubled effort to blame the client’s brain for his/her difficulties. There will, as there always are, be practitioners who use this information and possible intervention responsibly and in an empowering way that respects the social context of a person’s suffering. But the industry, with the help of Big Pharma, will be saying, “MDMA is the new miracle drug! Psychiatry’s big breakthrough proves that they CAN heal the brain with new and better medications!” MDMA being successful will not alter the current power dynamics. In my view, it would make them worse, no matter how effective MDMA might be if used in the right context.
— Steve
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It is wonderful to see the relationship between food and emotional experience outlined here. This relationship is very complex, as it’s well known that traumatic exposure dramatically impacts eating habits, and that food can take on a role as a comfort measure or be used as a means of controlling self or the environment (eating disorders), which would naturally lead to poorer nutritional habits for those who have been traumatized on the average. Additionally, poor diet is going to be associated with poverty and lower educational levels, which of course impact “mental health” variables assessed. A bidirectional relationship seems intuitive, but to really flesh this out requires looking at the relationship between psychosocial stressors and diet.
One perhaps seemingly picky but actually kind of important critique: The use of terms like “patterns of overdiagnosis and overmedication” give credence to the idea that there is such a thing as optimum diagnosis or optimum medication, which is not actually possible given the subjective and socially-driven criteria used for “diagnosis” in the DSM, and the damage done by such arbitrary categorization of distress.
More appropriate would be to say that we want to curb “The use of psychiatric drugs to mask the results of psychosocial stress and the likely causal link between nutrition and common expressions of psychosocial distress through mood and behavior as outlined in the article.” Or something like that…
— Steve
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Or how about, “Antipsychotic use is killing those prescribed them at high rates, and reducing their use is the most important factor in improving the health of those with “mental health” diagnoses.” I agree 100%, call a spade a freakin’ spade!
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Well said, Bonnie. The disconnect between the very relevant critique of the medical model and the absence of ANY kind critique of the view of PTSD as a “treatable disorder” is glaring. The victim is still blamed and the psychosocial origins of PTSD remain obscured behind the “diagnose and treat” model. Far from undermining psychiatry’s medical model view, any success of MDMA will be grabbed upon and trumpeted from the rooftops as proof that PTSD IS a biological problem (because after all, a drug solved it, so it MUST be biological!) Meanwhile, the root causes of PTSD, including parental abuse/neglect, dysfunctional schools and other social institutions, structural poverty and unemployment, domestic abuse, racism, sexism, and other institutional oppression, and the generally oppressive nature of our corporate capitalist social system will all be given yet another free pass.
Oh, and just for the record – psychiatry doesn’t stand “just outside” of medicine, IMHO. It’s miles away in the area of self-promotional delusion. Admittedly, some other medical specialties spend time in that area, too, but psychiatry is at this point almost completely divorced from any honest effort to comport itself according to the scientific findings of its own researchers. It’s closer to religion than it is to medicine, or even to sociology.
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A good answer. Science needs to allow for all perspectives and all data to be considered objectively, and for any theory or law to be revised based on conflicting data and observations.
The biggest barrier to understanding the mind is the materialistic assumptions of many claiming to be “scientific.”
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Sounds like some beginning awareness that something is wrong in the State of Denmark, which I guess is a good thing. I notice a couple of things – first, they’re still using “illness” language, like “symptoms,” to describe the effects of these institutions, continuing to allow and encourage victim-blaming. Second, it’s fascinating that of all the institutions listed, they fail to mention school and family, which are the institutions that most seriously affect young children and are the cause of a great deal of suffering regardless of race or gender. The other factors mentioned are, of course, very important issues that can’t be disregarded, but the specific failure to mention childrearing practices as a major contributor to what they call “mental illness” seems significant and suggests continuing energy to protect the parents and adults rearing children from accountability for their impact.
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I believe it! You always struck me as a person of great compassion. Loving our enemies may be our greatest challenge.
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I thought of you when I read that!
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Love this. Exactly!
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They do not HAVE to be that, Tireless. Most people WANT to feel better, but good therapy catalyzes their ability to feel better by reassuming control of their lives. This is the opposite of what you’re saying. I most often found that clients NEEDED to get in touch with their anger and outrage in order to move forward to a new path, and that, in fact, learning that they don’t HAVE to live up to ANY social expectations is essential to being able to find a way to move forward in the crazy world we have to live in. There is a big difference between “adjusting” to social expectations and becoming CONSCIOUS of social expectations that one may have felt compelled to follow against one’s own will or interests. If you want to fight for justice, being aware of your own emotions and expectations seems an important starting point.
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“Absence makes the heart grow fonder!” My parents and Ginny’s live on the East Coast USA, we live on the West Coast. Not by chance!
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I think that’s the warmest sentiment I’ve ever heard from you! Thanks for helping me get into the Christmas spirit.
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I think this is a wonderful analogy. The lack of empathy that is at the core of Scrooge’s rapciousness and heartlessness is very similar to the lack of empathy displayed by “the system” towards those it tries to “help.” The main difference is that Scrooge at least admits he is out for money, whereas the psychiatrists would feel very comfortable institutionalizing Tiny Tim and putting both of his parents on SSRIs to deal with their “distress in excess of what would normally be expected” from having your kid taken away.
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You make a lot of generalizations about therapists. Not all therapists are the same. Many have been taken in and are participating in the psychiatric mainstream effort to pathologize anything but being mildly happy regardless of circumstances. But some (a minority, I acknowledge) really are there to help their clients sort out the meaning of their experiences and move on to take meaningful action, as I explained in another of my posts. It just doesn’t work to label “therapists” and to say they all do the same things. It has a haunting similarity to the kind of labeling we all agree we hate when it happens to us. Therapists are people, too. Some are empowering, some are power tripping. Some haven’t dealt with their own issues, and some have dealt with them quite well and are in a good position to help others find their way.
Or as I like to say, “Generalizations are ALWAYS wrong!”
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I think that’s very accurate. The other thing is, a lot of those who provide such services have not dealt with their own issues. So instead of being there and supporting their clients, they try to “make the bad feelings go away” because THEY feel uncomfortable, not because it’s good for the client. Unfortunately, the DSM plays right into this – instead of understanding what’s going on, we can label it as “bipolar disorder” and blame it on the client. Clients also are afraid of facing their historical pain, and psychiatrists give them an “out” by saying “It has nothing to do with your past – it’s just brain chemicals.” Also makes it easier to blame kids for not behaving instead of learning new parenting/teaching techniques.
Basically, psychiatry works for those in power and less and less the lower you are on the power scale. I believe that power imbalances are really at the center of most “mental illness” symptoms, and resolving abuse of authority is the best way to stop “mental illness” for ever developing.
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I don’t think so. I think it is about control, yes, but about whether the client should be put in more control or if the professional is supposed to control the client. There are plenty of psychologists who believe in controlling the client and a few odd psychiatrists who believe in empowering clients. But the DSM system is 100% about the professional dictating to the client, usually in the absence of evidence that following their orders is even likely to be helpful in the long run.
Have you read Anatomy if an Epidemic?
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You can certainly e-mail me. [email protected]. Looking forward to hearing from you!
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An excellent question, Oldhead. One would not feel the need to deny one’s “boogerheadedness” and assure the attacker that one is categorically opposed to “boogerheadedness” to label the attack as an immature avoidance of the question at hand.
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Liberals tend to be supporters of “mental health parity” and other means of increasing funding for psychiatry and its allied forces. What support I have seen politically has come from the libertarian right. There is a small sliver of progressive activists, most of whom have had “services” from the “mental health” system, who are trying to take on psychiatry, but it’s definitely not a “progressive” thing at all. Though it really should be, if human rights and addressing oppression are their supposed goals.
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Prostitution and the sex trade often involve literal slavery.
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Being an advocate ABSOLUTELY involves holding the system accountable! What exactly do you think advocacy IS? Advocates support their clients in speaking up, in organizing together, in proposing legislation and testifying at the legislature, and all sorts of other political activities. I worked with a group called Oregon Foster Youth Connection, composed of current and former foster youth, which did speaking engagements about what it’s REALLY like to be a foster kid, and which proposed new legislation to the Oregon State Legislature every session (and they have never yet failed to get a bill they wrote passed). They very much needed and benefited from adults helping them with planning and organizing their activities, as well as helping them sort out the feelings that commonly come up when a kid used to being totally disempowered starts “speaking truth to power.” It would never have happened without the adult supporters (the first of whom was the founder, who was herself a survivor of the foster care system). Advocates also appear in court and in other meetings with their clients and make sure their rights are protected. Advocacy is all about holding the system accountable.
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Sorry, but I think you’re missing the point here. If a person is injured, we are not BLAMING them by helping them heal from the physical injury. You are interpreting the desire to help as meaning blaming the victim. I can assure you that plenty of supportive environments exist where such blaming doesn’t happen. I would present a “hearing voices” group as an example. Do you think it’s “blaming the victim” to let folks know that other people also hear voices and that you can meet with them and talk about what it’s like to live in a society where you’re treated like a pariah, and talk about different approaches to dealing with both the voices themselves and society (and especially the psych system) treating them like less than human?
Are you suggesting that the ONLY thing that will help a rape survivor or domestic abuse survivor is sponsoring political action? Would a friend listening to a person telling his/her story be victimizing the person by supporting the idea that they need compassionate listening to help them work through the traumatic event that happened to them?
I totally get that organized “mental health treatment” is by and large focused on eliminating difficult people from our midst, and that the DSM was created to shift the blame from social conditions onto the victims of them. However, I think it’s going way too far to suggest that someone who is psychologically/spiritually injured by violent or oppressive actions can’t “heal” without being blamed. The kid who got hit by the car isn’t blamed for the car hitting him. Why would it automatically imply blame to let someone know that being abused is painful and that it’s possible to feel better through reconnecting with others who understand and have worked through the kind of pain you are experiencing? Or even through just talking to someone who cares about you?
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I believe the definition part is the problem, Littleturtle. As I’ve said before, and I don’t think you’ve responded to me about this, no one denies there is suffering nor that biology is involved. What folks are fighting here is the idea that some “professional” can come a long and define “what is wrong with you” based on a book that was written in committees and that denies that the abuse and neglect and oppression experienced by most they define as “mentally ill” (including such abuse as is dished out by the system itself) is even RELEVANT to their “diagnosis.” “Mental illness” is NOT “just like any other illness” nor are drugs given to dampen out the “symptoms” in any way like “insulin for diabetes.” It’s the idea that someone with some advanced degree can label and box you up without even consulting you for your view on it that’s offensive. Plus the idea that “mental illness” is IN YOU, rather than being a consequence (as it usually is) of what has happened to you and your body in this oppressive society in which we live.
You’re absolutely entitled to view yourself as “mentally ill” if that is a workable view for you. I’d argue that no one else is in a position to define for you “what is wrong with you” unless they actually know both the CAUSE and a range of potential REMEDIES for what is ailing you. THAT is the trouble with “mental illness.” Not that the manifestations so described don’t exist – the trouble is that psychiatrists and their minions have no right to define for you “what is wrong” and “what you should do” (let alone FORCE you to do these things) when they themselves know and sometimes even admit out loud that they have no idea what a “mental illness” really is or whether their “treatments” actually address a physiological problem or are just one more substance to make you feel better (or feel less) without any connection to a physiological problem at all.
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Maybe the reason people in high-income countries anticipate discrimination more is because they encounter it more often. Maybe our Western idea of “progress” breeds such discrimination, and breeds depression as a result? Maybe our Western approach to labeling such people “mentally ill” is in itself a form of oppression and discrimination?
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Here’s a link that talks about this concept in a “mental health” context. Inequality really is a serious impediment to healthy living!
https://www.thealternative.org.uk/dailyalternative/2017/11/20/the-political-self-and-the-inner-level
BTW, I think the two of us together in a room could map out a lot of good solutions. I personally think that “liberal” and “conservative” ideas are like yin and yang – you need both in balance to create a good society. Unfortunately, we lately seem to be going in the opposite direction!
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Oh, and many unionists and supporters DID die fighting for rights we take for granted today, so if “life on the line” is the criterion, there were plenty who took that risk and some who paid the price. There are also many, many deaths that result from the current corporate capitalist culture where folks don’t even have a chance to identify their enemy, let alone fight back.
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I’m with you on term limits, except that we also have to stop corporate campaign contributions as well, as that is the largest factor creating corruption in our representatives. It shouldn’t take 10 million dollars to run a campaign, and campaign funding should not require becoming subservient to ANY special interests, whether left or right on the political spectrum. To do this will require a transcendence of the left-right split and a recognition that ALL working people have common interests in preventing the takeover our our government by rich multinational corporations.
I agree about laziness – we should not reward people for doing nothing. But I have to add that accusing people as a group of “laziness” denies certain realities that impede progress and set unfair and unnecessary barriers for certain subgroups of Americans. To use your example, the fact that slavery ended in the 1800s does not mean that all or even most barriers are gone, as any honest reading of recent history should make clear. Black folks and Native Americans, in particular, can do the same hard work and not get so far ahead for a lot of reasons. Consider just one example: many poor white men (including my dad) came home from WWII and took advantage of the GI Bill, including buying a house in the ‘burbs for $30k. They sold the house in 2008 for $750 K. No black person could possibly have bought that house, no matter how hard they worked – the owners would not have sold it to them, and the banks would not have lent them money, and if they did buy it, the property value would have gone DOWN as white people fled the neighborhood. Many such families expanded their wealth in a large way by investing in real estate. Not something black families could do at the time.
Just one of many examples. Not saying it’s valid to say, “Hey, society is screwing us over, so screw them!” but I don’t think it’s a fair analysis to suggest that everyone has anything remotely close to a “level playing field” in the USA today. And that’s not even mentioning poverty as a limiting factor that affects people of all races and genders.
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Exactly. And such people were branded “communists” and blackballed or even attacked for not kowtowing to the monied elite.
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There is one other variable they did not consider: the escalating use of “antidepressant” drugs in teens and young adults.
The other point that is completely ignored is that they may be using cell phones a lot because they’re feeling disconnected from relationships and are seeking intimacy through technological means. Remember the Rat Park experiment – rats didn’t become addicted to cocaine when they had a health environment to live in. Same applies to humans.
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Don’t confuse “liberalism” with “political correctness.” Political correctness is an illness of both sides if the aisle, as Trump’s recent orders to his agencies about what words they’re not allowed to use clearly prove. The real enemy is authoritarianism, the belief that there are some who have a right to exercise their authority over others arbitrarily and without basis in reality.
Liberalism brought us 40-hour weeks, minimum wages, healthcare benefits, vacation and sick time, and safety provisions in the work place. And Americans and others around the world fought for and DIED for these goals. Plus there are plenty of liberals who have fought in wars, including my father. So it’s not true that “liberals” sit back and loaf while “conservatives” fight for freedom. There are also plenty of “conservatives” who make millions and billions off of unnecessary war and never put themselves at risk of any kind of danger. Our current President is one such, as our many of our representatives.
Freedom takes many forms and many have fought for it in many different ways. The liberal-conservative split is an intentional fiction that has been pushed by those in power to keep citizens fighting against each other and prevent them from joining forces. Things are not going to get better until those of us who are not in power get together and stop buying into these false divisions like black/white, liberal/conservative, urban/rural and start realizing that those in positions of power want to keep us from getting together and forcing them to cough up some of their power.
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“Anticholinergic load?” Really? Why don’t they just admit they’re doing brain damage and have done with it?
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Oldhead: I’ve always been a tad on the heretical side!
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This is a critical point, Richard! There are some biological aspects that can be controlled or directed, such as food, exercise, sleep. But as for genetics, it’s the one thing we can’t change! So why are millions and millions being spent on exploring genetics and brain structure and so on, when it’s clear that the ENVIRONMENT is the big variable that we DO control? It makes no sense at all, unless you’re interested in keeping people sick and dependent, and that, littleturtle, is the part where I think we are having some difficulties communicating. Nobody here denies that biology is part of the picture. But environmental impacts are the big variable we control even regarding the “bio” part. The problem with psychiatry is not that they focus on “bio,” it’s that they don’t really focus on whether their approach WORKS or not! They focus on “symptom control” without any THOUGHT as to why a person might have these “symptoms” or whether they are really “symptoms” of anything at all.
You seem to believe that the field of psychiatry is seeking to find the best way to “treat” these “diseases” of the mind. I believe that psychiatry is seeking the best way to make a lot of money for themselves and their allies, even if individuals believe they’re being helpful. If they REALLY cared about their clients, they’d be a lot more open to hearing when new data contradicts their theories. All they have is their drugs, and they HAVE to believe that “broken brains” are the problem or their justification for prescribing is gone. So the big variable that we CAN change, our environment, is the one thing they can’t ever consider. The results speak for themselves.
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Perhaps instead of un-dismantling Freud as a person or clinician, we try to resurrect the parts of his observations that appear relevant and effective today. For instance, the idea that listening to your client is the beginning of any attempt to know what might be helpful was a breakthrough. Initially, he believed his clients’ stories of trauma – that was helpful. He identified that people are not generally completely or sometimes even vaguely aware of their motivations for doing what they do – the idea of the unconscious mind was probably his moment of greatest genius. And his initial idea of bringing the unconscious motivations to consciousness seems to be important to effective therapy, especially as regards historical trauma.
There’s a lot to toss out, too, but that’s how real science works. We take what comports with the data and toss the rest. We don’t expect one person to come up with a theory that explains everything, we continue to explore and build on and discard pieces as needed. That’s what’s important here, not whether Freud is a good guy or a bad guy. Lots of good guys come up with dumb theories, and bad guys sometimes have moments of genius. We need to focus on the ideas and models that work and not concern ourselves too much with the character of the person who thought of them.
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I think you’re missing the point.
I’m not going to make a blanket condemnation of a group based on rumors and anecdotes under any circumstances. The US government and most governments of the world have acknowledged them as a religious organization, and the Scientologists I’ve gotten to know seem no more bizarre or extreme than members of other fundamentalist religious groups – I have a harder time with fundamentalist Christians, to be honest with you.
But even if Scientology were a devil cult, I’d still take the same approach. The point is not whether or not Scientology is evil, but how to handle an attack against one’s integrity. Let’s say that someone accused you of being biased because you’re a Szaz follower. What would you do then? Maybe you’d tell them you think Szaz was the bomb, or say that you don’t agree with everything he said, or say that he was way off base – and guess what? You’re talking about Szaz and not psychiatry and you’ve been diverted. THAT is my point. Why give fuel to the idea that your personal belief system is relevant when we’re talking about the legitimacy of psychiatric diagnoses and how research contradicts their version of reality?
Actually, this conversation is a great example. We stopped talking about Freud and antipsychiatry a long time back. Though of course, I’m always more interested in off-topic discussions with someone of intelligence and perspective such as yourself, so I don’t mind. But if we allow someone attacking us to change the subject, IMHO, I believe we’ve done ourselves a great disservice. The use of ANY group association as a means of trying to degrade my status is unacceptable to me, and I make sure that any attempt to do so is dealt with firmly and directly. That’s my view. Like I said, you can take your own approach, but I don’t buy that it’s a requirement to agree to the depredations of Scientology in order to challenge someone’s use of smear tactics to distract from the point at hand.
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You are letting your personal feeling get in the way of rational discussion, Richard. I don’t know why you are so passionate about the CoS, and maybe you have good reason, but the point is, it is being USED as a distraction tactic. The more negative things you say about it in any discussion, the more ammunition you give your antagonist, and the further off topic you go. By berating the Church of Scientology, you are giving credence to the idea that Scientology’s opposition to the Church of Psychiatry is a legitimate reason to doubt any opposition. It doesn’t matter at all who it is they are using as a distraction. They are distracting from the point. Psychiatry is not good or evil based on the beliefs of the person involved. It is evil based on the FACTS, and any distraction from that point is a victory for their allies. It is simply not the appropriate forum for that discussion to happen, and my belief is that we TACTICALLY do much better if we go on the offensive by identifyinig the fact that our antagonist is using smear tactics, instead of defending ourselves against meaningless allegations. That’s my view. You don’t have to agree, but I really don’t think you’re being objective about this question here. You seem to be more looking for a forum to promote your view than the best tactics to stop a distracting attack on a rational critique of psychiatry.
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I believe that giving the Scientology smear ANY play at all simply gives it more force. It’s really clear at this point that any association with the CoS is going to be damaging as it invites this tactic. However, bringing up Scientology is a TACTICAL DISTRACTION and needs to be labeled as such. It’s similar to discounting a person’s opposition to abortion because s/he’s Catholic. It’s not relevant. I not only want to be sure this doesn’t work on me, I want to make sure that it doesn’t work on anyone, and that they think twice before ever bringing it up again. I know that most people are not as willing to be as assertive as I am, and I consider it my responsibility to make sure that everyone watching hears that the Scientology smear is BULLSHIT and will not be tolerated, by me at least.
That’s my view of it. The less energy I give it, the better, but what energy I do will be directly confronting the person using it for evading the issue.
As for the last comment, I’d say, “Well, it appears that I’m talking about data and you’re talking about religion, so if anyone’s got something to hide, it’s you hiding the fact that you have no data to counter my argument.” And I’d restate what I’d said just to make sure we’re clear what the person’s avoiding.
Again, it’s not really failed for me yet. Applicable to any situation where someone’s deflecting from the original topic. The worst that happens is that they look like assholes and I look like an intelligent person of integrity. Which works for me.
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Nope. I come right back at them with, “Since you’re continuing to deflect attention from the question at hand, I am assuming you have no actual data to counter my argument. Is that correct?” It has never failed to drive the antagonist away or get back on topic. We did this much more aggressively when protesting the APA in Philadelphia, and it worked even better because we had a half a dozen or more simply saying, “Oh, no, you’re not going there!” Your approach may work just as well – that’s just how I approach it.
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I take a different approach. I say, “I thought we were talking about science here? Why would you want to change the subject to religion? If you have scientific data to discuss, I’m happy to do so, but religious affiliations are simply not relevant to this discussion.” I find that even entertaining the subject lets them control the conversation, and I’d much rather point out their sneaky tactics so the public would be aware of them as tactics, rather than focusing on whether or not I am associated with any particular group.
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Little Turtle: I’d add to this that Big Pharma and psychiatry actually INVENT diseases to seel their products. The best example is “Social Anxiety Disorder.” Some Paxil experiment suggested that people were less shy while taking Paxil. So the APA and drug companies got together and decided that shyness could be added as a disease and Paxil would then be prescribed to “treat” it. Childhood bipolar disorder is another one. There is solid documentation that Joseph Biedermann colluded with Johnson and Johnson to create “data” that would support the idea that millions of children were “bipolar” and needed “treatment” with Johnson and Johnson’s drugs.
I am sure you would find this to be a problem. But the problem is much bigger than these two examples – the entire DSM is filled with such speculative “disorders,” and the creators of the DSM III made clear statements at the time that moving to an “atheoretical” categorization was the intent (in other words, they no longer cared about the CAUSES of these “disorders”) and the reason for this was so they could claim a larger share of the market, not because there was some scientific advantage to using the DSM categories. The DSM was invented to bill insurance companies – it’s not based on any kind of science at all. Again, it’s not that folks like you and me don’t suffer from emotional/mental problems, and it’s not that biology doesn’t play a role – loss of sleep, for instance, can cause psychosis eventually, and thyroid problems can lead to depression and lethargy. But categorizing shyness or aggressiveness or not liking to sit still in a boring classroom as “diseases” is not only not scientific, it’s intentionally misleading and destructive, as it prevents real analysis of causes and solutions, including biological ones, from happening.
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Any scientific theory needs to be open to re-interpretation when new data comes along. Evolution is open to new data, psychiatry is not. So comparing them (as the original poster did) is just plain wrong-headed. That was my original point. Even Newtonian mechanics, long considered the most obvious and stable of scientific postulates, had to be modified when scientists looked at very small objects or very high speeds and masses. While there are some who subscribe to the idea that “science is truth” in a quasi-religious kind of way, any real scientists know that all theories can be revised based on new information. This is why psychiatry is not a scientific enterprise, while evolution is.
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Probably true. But I’m guessing they were the only ones fighting that fight at the time, and he took an ally where he could find one. It is unfortunate when comments by Tom Cruise can be used to characterize opposition to psychiatry, but if it weren’t them, it would be someone else.
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Do people need to recover from being hit by a car, even if it’s not their own fault? I think you’re conflating two disrelated ideas: recovering from injury and acknowledging the political underpinnings of oppression that support those injuries and deny their effects. It is very possible, and in my view ultimately essential, for part of the recovery process to involve becoming aware of the forces of oppression behind one’s injuries. A long-term domestic abuse victim, for instance, seldom moves beyond self-hatred and self-blame without recognizing that their “loving” partner was in fact taking advantage of his situation and using threats and manipulation to keep her “in her place.” The process of moving responsibility off of her own shoulders and onto the person it belongs to is often a great relief, though it is often accompanied by a lot of grief at the lost dream of the abuser somehow “reforming” himself. In many cases, survivors become the next generation of advocates for safe relationships and become politically active as part of their “healing.”
If you perhaps redefined “healing” in a broader way, this conflict could be resolved without anyone being “wrong.”
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Perhaps part of why most people consider it to be a scary cult is because they teamed up with Szaz and posed a threat to the hierarchy? If you re-read Anatomy, you can see that the psychiatrists intentionally smeared Scientology so that they could attach any critique of psychiatry to Scientologists? Not saying Scientology doesn’t have its issues. but let’s be honest, psychiatry has done all it could to make Scientologists look like brainless drones and make anyone who criticizes them look like they are drones as well.
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They also fail to mention that these “brain scans of normal/depressed people” are AVERAGES. Many, many individual comparisons have been done and it’s been shown over and over that many depressed people DON’T have this kind of brain scan, and many non-depressed people do. Brain scans are the new phrenology – it sounds “sciency” but it’s mostly smoke and mirrors.
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I do think that’s what good therapy is all about – understanding when and why you had to submit to the irrational and unreasonable wishes of an authoritarian authority figure and how that may have altered your life, as well as coming up with plans as to how to deal with future authoritarians one might meet. Alice Miller does a great job talking about this, though she is rather pessimistic about whether we can really break the cycle and not pass on our own authoritarian reactions to the next generation.
To me, the most unfortunate thing about the DSM (though there are many unfortunate things about it) is that it makes it easy for the “helper” to assume the authoritarian role and to “help” their client become a “good authoritarian” and submit properly to higher authority. Any therapist worth his/her salt is an anti-authoritarian.
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The other element is that while authoritarians are required to be submissive to those above them in the hierarchy, the payoff is that those below them must be submissive to them or face punishment. It’s a weird tradeoff where you trade in your personal freedom for the unquestioned right to abuse those who you deem beneath you.
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“Power disparities” are most definitely behind abuse at all levels. Our entire Western culture was built on oppression, and oppression still lies at the heart of it. Any effective “therapy,” if we really wanted to call it that, needs to acknowledge this fact and apportion responsibility where it really lies. The best “therapeutic” results I’ve gotten involved the person I’m working with either getting away from or directly taking on the forces of evil in their lives. It’s about taking back control from the oppressors, in one way or another. Otherwise, we’re just putting wallpaper over giant holes in a person’s foundation. But guess what, the establishment doesn’t want people becoming assertive and politically astute, and it’s much more effective to blame the victims and tell them they’re “sick” so they can go “heal themselves” and “adjust” to the sick society they’re a part of. Unfortunately, I’d have to say the majority of counselors appear to pursue this kind of goal, and as long as the persecutors are running the show, that will continue to be the case.
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My point is only that there are some people who do have exceptional skills in helping a person look at why they do what they do and take a more conscious and active role in deciding what kind of life they want to have. I make no claim that having a professional degree delineates such folks (I actually have an undergrad in Chemistry!) – I’m only saying that I don’t find anything wrong with someone charging a reasonable fee for helping someone make changes they want to make in their life. But they need to PRODUCE THE DESIRED RESULTS. Most counselors and almost all psychiatrists fail to meet this standard. A lot more untrained folks with personal experience and skill can meet that standard, and I have no problem if they get paid for doing something that most people can’t do.
I guess I tend to agree with you that professionalization, particularly licensing and medicalizing and involving insurance payments, has almost certainly done far more harm than good in the collective.
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I have to say, Nathan, that I had quality psychotherapy (NOT psychoanalysis) for 15 months back in the 80s, and I very much doubt that any friend or family member could have provided me with the kind of support that I received. I was very fortunate to find her, and would be even more so today.
Such therapists have, indeed, become rare, but I have also provided this kind of service professionally, and I am very comfortable saying that I have been able to help people in some very unusual ways that would be unlikely to be available to the average person.
I do think there is a place for professional helpers. I don’t think there is any place for professional arrogance and hubris. Unfortunately, the vast majority of “mental health” workers are short on humility or too afraid to speak out about the destruction happening in the name of “healing.”
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Freud’s genius was in listening to what was behind his clients’ complaints, and recognizing that people are generally not fully aware of their motivations. It is, perhaps, understandable that he knuckled under to the pressure of the times, but the profession was irrevocably damaged by the choice to suppress the truth. It make psychoanalysis ineffective and even destructive, and ultimately opened the door to biological psychiatry’s takeover, based on legitimate claims that psychoanalytical theory was not valid and didn’t lead to effective growth.
So while I admire Freud’s genius, I can’t help but deeply regret his failure to stick to the truth instead of kowtowing to social pressure. We might be in a different place today if he’d stuck with believing his clients.
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Thanks!
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Comfort the afflicted, afflict the comfortable.
Freud’s real betrayal was backing away from his Trauma Theory. He initially listened to his female clients, who told him that they’d been sexually abused in their childhood in large numbers. When he published this data, he was brutally attacked by his peers, many of whom no doubt were the perpetrators of such abuse themselves. Rather than sticking with what he knew, he decided that the women were FANTASIZING these sexual contacts, and his drive theory saved his career, but of course sentenced a century and more of women to continued sexual abuse and molestation supported by the psychiatric profession. The unwillingness of the psychiatric profession to admit that such abuse is common and harmful and is responsible for much of what is called “mental illness” continues to the present day. Freud was brilliant for listening to his clients, but in the end was a coward and betrayed them all.
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It might be helpful to define what you mean when you say “I have a mental illness.”
I am with you that people can help each other, and I was very fortunate to have an excellent therapist who actually helped me sort out what was going on in my muddled head. However, it appears to me the term “mental illness” has been co-opted by the Forces of Evil and is used not to help, but to demean and blame those who don’t “adjust” to our weird Western capitalistic society. While most psychiatrists are most likely not intending to do harm, most are massively misinformed by their leaders, and many of those leaders ARE in fact quite aware of what is happening and are more concerned for their financial welfare and power than they are for your welfare or mine.
Nobody here wants to deny that people experience mental and emotional stress and difficulties. But I lack any confidence that the psychiatric profession is genuinely engaged in trying to help minimize such stress, and in fact, the profession mainly denies that such stresses have ANYTHING AT ALL to do with why people are suffering. Hence, the distrust and in some cases the desire to dismantle psychiatry and all of its manifestations. I hope you can understand the difference.
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Truth, are you suggesting that more “rightists” that “leftists” are knowledgeable about history? My experience is that, at least here in the USA, most people speak freely without any comprehension of history at all, regardless of which end of the so-called political spectrum they choose to occupy. Most people who actually DO study history agree with progressives on some issues and conservatives on some issues and don’t agree with either on other issues. It’s called being a rational person – a person of reason doesn’t simply agree with a point of view because it’s convenient or his/her friends believe it or because it feels good. Any real analysis would show that both liberal and conservative viewpoints are needed but neither is sufficient to understand history or current events.
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Actually, I’ve observed a huge gray area between people seeking these drugs and people being forced to take them. Kids, for instance, often have no choice at all about it. Same with elderly or disabled folks in many cases. And many adults “voluntarily” take these drugs because they understand that refusing will mean trouble for them. Beyond that, there are many more who “voluntarily” take these drugs because they are lied to about their “condition” and about the drugs’ effectiveness and dangers, and have been denied any access to or knowledge of any alternative options, and they are also often pressured by counselors, doctors, and/or family members to take the drugs against their own intuitive discomfort. So it’s not really very easy to distinguish between those seeking drugs, those taking them because they think they should, those taking them because they’re afraid of what would happen if they refused, and those who are overtly forced to take them. It’s an ugly scenario by all accounts.
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Oooh, I LIKE it! The parents and siblings have to undergo screening for abusive and crazy-making behavior, and THEY get locked up if they fail the screening!
Not really, of course, because they’d just lock everybody up and put the whole family on drugs, but I like the concept of the “kind, caring parents” who often contributed to the situation in significant ways putting their scapegoat in the psych ward and getting off without consequences.
To be clear, I understand that the majority of parents do care about their kids and are trying to do the right thing, and many people end up in the ER despite caring and sane parents. But there’s a huge overlap between abusive parents and emotionally upset children, and psychiatry has been working hard to eliminate any knowledge of that fact.
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Soon they will do a study showing that racism makes structural and chemical changes in our brains, and recommend giving all minority groups prophylactic antidepressants just in case.
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I can understand that, too. What I can’t understand is how someone can praise or compliment a system or approach that has failed to have any positive impact. At what point do you say, “Hey, these people don’t seem to really know what they’re doing. Maybe I need to look somewhere else for a solution.”
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Any doctor who is alienated because I want to make my own decisions is a doctor I want to avoid at all costs. And any doctor who even THINKS the word “noncompliant” when considering his patient’s decisions should not longer be a doctor. A doctor is not a jailer or schoolteacher or general – s/he is a professional adviser, and his/her client is entitled to listen or not listen to his advice. That’s what “informed consent” is about.
I would bet that James trusted his psychiatrist and paid the price. It’s kind of arrogant to suggest that he should trust them again. I don’t trust any treatment I haven’t personally researched. With doctors having been shown by the JAMA itself to be the third leading cause of death in the USA, such caution is very well warranted, and any doctor who can’t understand that is not going to have me for a patient.
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I heard a news magazine report on NPR about a guy diagnosed with autism that got this process done on an experimental basis. It did make him more sensitive to others’ emotions, in fact, dramatically so. This unfortunately was overwhelming for him and altered his relationship with his wife, who felt he was withdrawing and didn’t need her any more. It ultimately led to them getting divorced. And when the experiment was done, they left him on his own and the effects faded. He said he would do it again because it helped in his relationship with his son, but reported it created tremendous chaos in his life. Again, we humans are arrogant when we believe we can mess with someone’s emotions and not have serious adverse effects occur!
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Which goes to show that emotions are important survival entities, even “negative” ones, and generally speaking, screwing with them does not improve our survival.
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Actually, sexual harassment is incredibly common and it’s not surprising that this stuff comes out in bunches. When someone makes it safe to disclose, lots of disclosures often come out. I am sure that there are some “copycats” who want attention, but based on the stats on sexual harassment and abuse, the odds are that most of these allegations are true. This is especially the case when one person has multiple accusers who don’t know each other at all. Unless the person has some specific motivation for making something up, why would a bunch of people decide to gang up on a Roy Moore or Harvey Weinstein? Especially when we look at the character of both of these people, it would hardly be surprising if multiple people were in fact harassed and/or abused by them, and once one person makes it public, it seems not at all surprising that others now feel safe to tell their stories as well.
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The DSM and any similar “diagnostic” manual would be gone, there would be no forced “treatment,” and psychiatrists/psychologists/therapists would not be able to testify about someone’s “mental health” in court, they could only talk about observed behavior. No drug ads on TV, and lobbying of all sorts would be taxed and the funds invested in real research. Doctors are held liable for the actual results of their actions, rather than being let off the hook if they are adhering to the “community standard of care” no matter how ineffective or destructive that “care” might be.
Of course, corporate contributions to political candidates would have to have been banned long since for such events to occur, so that’s part of the picture.
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They were looking at those taking SSRIs, not depressed moms in general. Plus we know the autism rate has skyrocketed since the early 90s. We also know that the SSRI prescription rate has skyrocketed since the 90s (though there are obviously many contributing factors to this). There were plenty of depressed moms in the 60s. At this point, the evidence seems pretty strong that there is a specific connection between SSRIs and later autism diagnosis.
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That kind of crap is not therapy. It should be called “client management” or something more honest. Most “therapists” these days don’t know how to help someone and are handmaids for the system. Sorry you had to deal with this crap, and well done for escaping it!
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I don’t really see charging for quality therapy and charging for life coaching as being fundamentally different. The question is only whether you provide a quality product. I have helped tons of people (in their own opinions, not mine) over my career and don’t feel bad having been paid to do so. There are things an independent third party can provide that a friend can’t. The big problem is that most therapists have not dealt with their own issues and act them out on their clients. Can’t say I’ve never done that, but in the main, I understand the difference between what I need and what my clients need, and they can tell the difference. People who can make a difference should be able to be paid for their efforts. People who don’t help or make things worse should not.
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Did they really need a study to figure this out???
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The only possible useful application of psych drugs is for acute care in the vast majority of cases. I know there are a small minority of folks experiencing paranoia and voice-hearing, etc., who are willing to accept the horrific side effects because they can’t seem to find another path, but for most people, whatever benefits (if any) they experience diminish rapidly, or are pretty quickly outweighed by the increasing adverse effects. In my view, except for temporary sedation during a crisis, going to psych meds should only be an act of final desperation.
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Thanks! I do think the wheels are starting to come off the psychiatric cart, but it’s a big cart with lots of wheels, and the psych profession isn’t averse to dragging the cart along the ground even if the wheels are gone. As long as they’re making billions of dollars off of selling psych drugs, they’ll do whatever they can to keep the cash flowing. And you’re right, I’ve been attacked and/or undermined for speaking my mind about psych drugs. You kind of learn a way of maintaining balance between honesty and protecting your job, but it’s not really safe to speak up in these settings. That’s why I got into advocacy instead of working directly in a mental health agency – the ethical conflicts were just too intense for me to feel good at the end of the day. But researchers have more latitude, and I would really like to see more of them come out and be honest about what the data suggest.
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Please provide even one article showing solid, scientific evidence that “schizophrenia is a brain disease.” Even the psychiatric mainstream admits that this is not the case – those who are up with research have long said that “schizophrenia” is a collection of observations that may or may not even have the same or similar causes. Japan and other countries have stopped using this label altogether in favor of something more descriptive. Are the Japanese psychiatrists wrong? “Schizophrenia is a brain disease” is a propaganda piece published by Big Pharma with the support of the APA and “support groups” owned by Big Pharma like NAMI. There may be SOME people with the symptoms labeled as “schizophrenia” who DO have a brain disease of some kind, but we’ll never find it as long as we treat “schizophrenia” as if it were a disease rather than just a description of how some people behave. Heck, the DSM itself admits that people fitting the same diagnosis are not necessarily “the same in all important ways.” So they admit their categories are heterogeneous, and hence that 10 people with the same “diagnosis” can have 10 different things wrong with them (including nothing at all being wrong) and have 10 different possible solutions or pathways forward.
This website may well be biased toward finding issues with psychiatry, but in terms of understanding research, folks here are WAY ahead of mainstream psychiatry. So if you want to make bold pronouncements like “schizophrenia is a brain disease” here, you’d better be able to back it up with real data, cuz we know the true story.
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Precisely! Except that at least with a fever, you can agree on some measurement that tells you what is too high, even if you have no idea the cause. Psych diagnosis is like diagnosing a fever, but without a thermometer.
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While I’m glad you were able to find relief in this way, your example is one anecdote. Anecdotes (single stories) are data of a sort but no one can draw a any conclusions from them. I know it’s confusing, but the same drugs you found very helpful have destroyed the lives of others with the same or similar diagnoses. That’s the problem when we are deciding on “diseases” by committee, and based only on surface manifestations rather than causes. A legitimate diagnosis leads to consistent treatment results. This is most definitely NOT the case in the psychiatric world. “Treatment” is mostly by trial and error, and summaries of scientific studies seem to suggest that your experience is the exception rather than the rule. Not meaning to invalidate your personal experience in any way, but in a word, what works for you may not work for everyone, or even for most people. We can’t generalize from one example.
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Well said. Fear of losing one’s job is no excuse. That’s what the NAZIs said, too.
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This looks like very solid research. It remains disturbing that such articles are written so cautiously and in such arcane terms that the impact is minimized. “Overprescribing” of antidepressants should be referred to as “malpractice” or “harming patients through the harmful side effects of unneeded drug prescriptions.” Instead of saying “Providing medication may be counterproductive,” why not say, “Prescribing drugs appears to harm many patients by preventing their seeking of other approaches that are likely to be more effective.” And why not recommend that “antidepressants should not be prescribed before other less damaging approaches are fully explored?” It’s time to stop being so mealy-mouthed about this stuff. Scientist need to confidently state the conclusions of research to date: antidepressants don’t help most people (5 out of 6 in this study), and long-term use of antidepressants makes things worse for many users. Those two facts together should be enough to make doctors very, very reluctant to prescribe ADs as a first or even second-line treatment. But nobody in the mainstream seems willing to say that the emperor is, in fact, quite naked.
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I agree. I would also add that some analysis of WHY these 10 simple and in some cases rather obvious steps are not taken – the level of corruption underlying the assumptions of the current model can not be overemphasized!
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Well, in that case, than none of the psych diagnoses are “syndromes” at all. They’re just plain old fiction!
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I can agree, except that syndromes don’t necessarily represent a disease process or medical condition. The consistency of their appearance can suggest a medical issue, but there is no requirement that a medical issue be present, or else it would be a diagnosis, not a syndrome. An example: insomnia. You could break down insomnia into a couple of syndromes, such as failing to fall asleep, waking and being unable to get back to sleep, or waking repeatedly and reducing quality of sleep. We could map out “symptoms” that occur together with each of these sub-syndromes and outline the adverse consequences. But there is no distinction as to why a person “has insomnia.” Could be any number of medical conditions, could be psychological in nature, could be the dog wakes him/her up every night at 3 AM. Obesity and high blood pressure would be two more syndromes that may or may not be caused by a medical problem nor “treatable” by medical means. Some psych “diagnoses” qualify as syndromes (“ADHD” probably does) and some certainly do not qualify, but being a syndrome doesn’t imply medical treatability or causality, in my opinion.
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Comparing evolution to psychiatry in terms of scientific legitimacy is like comparing astronomy to astrology. While evolution doesn’t explain everything about how inheritance of traits and natural selection work, it is based on observation and experiment and is modified when new observations occur. Compare to the DSM, which is invented in committees and is based on subjective opinions of “clinicians” and is impervious to any new data and whose authority is based entirely on social position and bias instead of evidence.
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Too true!
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Link seems to go to a different article.
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There is no denying that environmental effects alter the brain, even to the epigenetic level. My objection is when people claim the brain is “hard wired” as if it were some sort of an electrical appliance. The brain is incredibly complex and mysterious, and even if the brain were fully understood, it still would most likely not fully explain human behavior, as there are questions as to the “software” of the human mind, as well as the “operator.” It is very easy to oversimplify what is probably the most complex biological situation in nature.
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I agree that plasticity is well established, but the important point in your comment is that any “mapping” is CORRELATIONAL. There is no way to actually map “circuits” – it is all related to the ACTIVITY of the brain, not specific linear connections. So while there are “maps” of areas that
associated with certain kinds of activities, no one really knows what causes what, and as to circuitry, it’s mostly a fantasy.
But I agree 100% with the rest of your comment, and the flexibility of the brain in response to experience makes the idea of “genetically wired” problems in the brain causing “mental illness” completely unsupportable.
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You are naive if you think that chemical-based treatments are not forced on people – they are forced on hundreds of thousands or more around the world every day. ECT is also forced in many other countries, even though it’s not allowed to be forced in the USA thanks to Peter Breggin and others. As for ECT, it induces a seizure in the brain. This can not be considered anything but a violent act. We know that uncontrolled seizures damage your brain, which is why there are such things as anti-seizure medications.
I’m glad it worked for you, but millions report long-term brain damage from ECT, including long- and short-term memory loss. Many people report being suicidal after ECT due to forgetting important events in their life like their weddings, births of children, important childhood events, etc. Reviews of ECT show that such benefits as do occur are usually short term, and such damage as occurs is usually long term. The fact that a few lucky people like yourself benefit without serious damage doesn’t change the fact that for most people, the risks far outweigh the benefits.
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A lot of speculation posing as science here. No one really knows what a “brain map” is or how it would change, “circuits” are almost totally speculative, and the piece ignores some important questions as to how things like purpose, intention, values, and meaning are “brain phenomena.” That being said, it’s an important counterargument to biopsychiatry to note that almost any human activity changes brain chemistry and can even change structure over time, so arguments about the “need” for drugs to change the brain are spurious. Examples include taxi drivers having more development in the geographical/spatial parts of the brain, and Buddhist monks having expanded areas associated with peacefulness and contentment.
So brains change depending how you USE them. The big mystery is, who exactly is choosing how the brain is used? The brain? The mind? If the latter, what exactly IS the mind, and how does it apparently control the brain in which most people assume it resides?
We know next to nothing about the mind, and abstract claims about “mind maps” do nothing to alter that fact. The important result to extract from this presentation is that we can change our brains by how we employ them, and that should be good news for anyone trying to escape the biological determinist worldview.
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The drug they used is called Inapsine. It is very fast acting, and as a result, you can see if it works in 20-30 minutes, and it’s out of the system in several hours. It is (or was) used mostly in ERs for acute cases, often people on meth overdoses. It could certainly be used coercively, but it seemed to be very helpful as a temporary intervention in a crisis situation. Got some people quickly to a place where informed consent became possible, at which point, any perceived coerciveness could be dispensed with completely.
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How does a drug get approved that has marginal “benefits” and clear and dramatic adverse effects? Corruption is the only answer. Abilify should NEVER have been approved for this use. Taking neuroleptics for depression is like taking speed to help you sleep.
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And some police officers ARE intentionally oppressive. Clearly, the profession would be attractive to those with big power issues. Even though most officers do try to do a good job, it is essential to have police accountability, or the minority of abusive officers end up controlling the culture and making even honest officers more likely to do bad stuff.
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Drug suppliers and sellers actually put in lots of hard work. The problem is that they get financially rewarded for their efforts. There are plenty of legal businesses (like making money off of forced “treatment”) that are just as slimy and evil as the illegal drug trade. The problem is when people are financially rewarded for doing destructive things. No amount of policing will ever stop the drug trade as long as people can make so much more money than they can doing honest work.
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Very well said!
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Wow – incredible effort! Way to speak truth to power! I am consistently astounded that these psychiatrists can claim that they NEVER have seen these reactions, NEVER, in all their years of practice! Are they simply that ignorant, or are they that venal and corrupt that they are willing to lie on the stand just to protect their own egos????
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The irony is painful – they are complaining about being told that they need to change themselves and their attitudes, rather than addressing the environment. Isn’t that what the medical profession has been doing to its patients? Isn’t that exactly what we’re complaining about? Don’t they get it?
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Very well said!
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That is an excellent question! I also wonder what percentage are actually sympathetic with a critical view but feel unable to talk about it because they will be attacked by their more avaricious colleagues. Probably a much smaller percentage, I’m guessing, but they do exist.
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Because the power structure assures that any dissident is knocked out of the running early on. Kind of like how our political parties work.
I agree that it was a complete error to every subsume the care of the human spirit into the world of medicine. That being said, I appreciate psychiatric insiders doing what they can to revise the current model of understanding (or misunderstanding) why people feel and act the way they do and what can help. Like it or not, our current culture puts extra value on the opinions of MDs, and the more MDs and former psychiatrists we can get supporting a change, the better off we will be.
Sometimes it’s necessary to understand that all of us have to figure this out somehow, and some figure it out faster than others. I appreciate insider who can figure it out and be a voice of reason in a world of irrationality and greed.
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Why would being “antipsychiatry” mean being “anti-biology?” Psychiatry’s problem isn’t that it CONSIDERS biological causality – it’s that it postulates biological causality without any evidence or understanding of what causes anything, and invents “diseases” without knowing the first thing about what causes them or whether they are “diseases” at all. Psychiatry’s other problem is that it’s totally corrupt. It denies facts and data in favor of what is profitable. There are certainly biological issues that inform how people behave, but those are the province of neurology, nutrition, pain management, endocrinology, etc. Psychiatry itself is a sham – it has become the pretense of knowing something that they don’t know so they can make money and control people’s behavior. Very, very different than working towards understanding the causes and possible interventions for mental and emotional distress.l
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I have no problem with taxpayers subsidizing actual medical care for those who can’t afford it. I have a big problem with taxpayers subsidizing the unnecessary creation of “disability” so psychiatrists and drug companies and others in the “mental health industry” can make bunches of money off the taxpayer!
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It sounded quite genuine. I just wasn’t sure how you were relating it to the topic at hand. I’d be interested in hearing more.
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It’s not even subtle. He’s aiming to destroy any regulatory authority of the government.
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Of course he’s not. Why would anyone think that he cared about this area? It appears he is no different than most of his predecessors – as long as his buddies in the healthcare/pharmaceutical industry are making good money, as long as stock prices are up, he doesn’t give a crap how much waste is occurring.
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I agree 100%. That’s why I find it best to focus on evil ACTIONS. The Rosenhahn Experiment and Nazi Germany, as well as many other examples, prove that many “regular” people can commit evil acts under the wrong circumstances. Let’s work at changing the incentives so that doing evil things doesn’t pay off!
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So we focus on the evil of the ACTIONS involved rather than trying to figure out which PERSON is evil or not evil. It feels a lot cleaner to me to say that the psychiatric paradigm was designed with evil intent than to try and sort out individual motivations, which in my view are all over the place. This protects us from the “counterattack by anecdote,” saying that we are wrong because psychiatrist A is really a nice guy and helped get me off of the stuff that was hurting me. Psychiatrist A may be a stellar human being, but if he’s labeling people based on behavior and prescribing drugs without consideration for their long-term negative effects and is not providing informed choice to his clients, he’s engaging in evil actions, regardless of his intent.
How’s that sound?
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There is a difference between those who knowingly perpetrate evil in the name of profits or power, and those who are genuinely deceived and believe they are helping. I’d agree that those at the top of the APA/psychiatric hierarchy are, indeed, evil, but many front line psychiatrists are simply confused or frightened of bucking the system. Of course, it doesn’t make that much difference for the recipients – it’s still evil, but it’s important not to let the leadership off the hook by blaming poor results on “bad prescribing practices” or “a few bad apples” or “a lack of training in the field.” The leaders are the ones intentionally perpetrating evil, though as noted, there are a lot of evil folks who go into psychiatry because it gives them power. There are also a number of dissident psychiatrists doing research or organizing projects to alter the status quo, and such people are most definitely NOT evil.
So organized psychiatry, IMHO, is organized around an evil purpose. Individual psychiatrists may or may not be evil, and need to be judged on a case-by-case basis.
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“Psychiatric diagnoses are poor indicators of treatment, and also of outcomes.”
What use is a “diagnosis” that doesn’t correlate to either effective treatment or case prognosis? Answer: no use whatsoever! Might as well call someone a “dunce” or a “spoiled brat,” as these labels have equally poor relationship to any concrete intervention or outcome. The DSM is just a rarefied way of name calling those whose behavior we don’t like and/or don’t understand. While I think it would be BETTER if we required diagnostic reports, it still would give credence to these nonsense labels, which as Lawrence points out are actually no more or less than a list of insurance billing codes. The best approach would be to call the psychiatric profession out and demand the DSM no longer be used as a diagnostic manual at all. If they want to put down little numbers for the insurance company, I guess that’s their problem, but these labels have next to nothing to do with helping clients, whether the clients like the labels or not. After all, we don’t decide someone has cancer or doesn’t based on whether they like their label or not. It’s idiocy and it needs to be abolished!!!
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This is some sick shit. Emotions are an organism’s guide to survival. What arrogance to believe that somehow another person is going to be able to improve on nature’s guidance system! Is it going to be helpful to a soldier to be “happy” during a battle? Should the domestic abuse victim be “calm” while being beaten nearly to death by her abusive partner? Should a person crossing the road be “content” despite the danger of being hit by a car on the way across?
Very dangerous idiocy! I can only hope that the trials will be so disastrous as to prevent any attempt to apply this kind of futuristic nightmare to the general run of humans!
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One thing I think you missed, Phil. Psychiatry is now claiming meditation/mindfulness as a psychiatric intervention???? Really?
I would think the answer to your product being disliked is not better advertising. It’s making a better product! One can hardly claim that psychiatry suffers from lack of awareness – in fact, those who lack awareness of psychiatry are more likely to think they’re going to get something valuable out of the experience! Almost all critiques of psychiatry come from people who are very well aware of exactly what it represents. You can con people into coming into your restaurant, but when the food sucks and sometimes kills people and the door is closed and locked behind you so you can’t escape and they force the crappy food down your throat, your restaurant is going to get some bad reviews, no matter how well you “brand” your food.
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I think this is pretty conclusive as to the integrity and real intentions of the field of psychiatry. There are hard data showing that using non-drug interventions first is better, and there are hard data showing that outcomes are no better or sometimes worse for long-term use of stimulants, yet stimulants remain the first-line intervention for “ADHD” despite even their own recommendations to the contrary. “ADHD” has become an excuse for blaming kids and adults avoiding their responsibilities to go through the struggle of finding the right way to help children become functional adults. It’s not a medical intervention, it’s an excuse for adult intellectual laziness, plain and simple.
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Hi, Littleturtle,
Have you picked up on the thread that the psychiatric leadership is not really “working on it” due to corruption? That they are dedicated to biological “explanations” regardless of what the research shows? I think there’s a lot bigger issue here than understanding the mind or behavior. The problem is that the profession has stopped honestly looking at the data. Sure, there are undoubtedly physiological issues that cause SOME of the manifestations of “mental illness” in some cases. But psychiatry is not interested in making these distinctions. They appear to be interested in selling their “services” and the drugs that go with them. That’s a very different problem than figuring out what a particular person needs to assist them with their mental/emotional distress.
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Yup. That sums it up. Anyone who thinks they can tell anyone else what they’re supposed to think or do is a dangerous person. A profession dedicated to that purpose is deadly.
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Not really very different from casting out of demons. Except at least they didn’t think the brain itself had to be removed!
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Right. It’s not a lack of transparency, it’s CORRUPTION that is the problem!
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The fact that we’re even considering using smartphones as a remedy for “mental health symptoms” is an ironically sad commentary in itself. That said, it appears they do as well as antidepressants, and with no real side effects. Which is an even sadder commentary on the state of “mental health care” in the world today.
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It is also true that those who have been traumatized are more likely to develop physiological issues like endometriosis. But it’s good that the piece recognizes that chronic pain causes people to feel emotional distress. I just wish it weren’t called “mental illness” in the piece.
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I agree. Shame in our culture is heaped upon its victims to protect the powerful from accountability. Such shame, is in my opinion, the result of repressed RAGE against the powerful using their power for evil. It’s not safe to express the rage, so it turns into shame. It is also true that there is no obvious target for the appropriate rage, so it ends up that we turn it on ourselves. Which to me makes the violations that much worse – there is not even an opportunity to fight back!
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If not government, than what? Government is SUPPOSED to be collective action by the people. It has become corrupted, and psychiatry is just one aspect of that. And the collusion between industry and government is central to that corruption. But I would suggest we need to take government BACK from the corporate elite. I don’t know any other way to control the power of the corporate giants. What do you think?
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Actually, those are not all or even mostly from medical “Mistakes”. The majority of those deaths are from properly prescribed and properly administered pharmaceuticals. Visiting a doctor is dangerous, especially a psychiatrist!
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Awful! I just wish it were surprising or unusual. I’m glad you’ve found a pathway out, though I understand you’re still working on escaping, at least you have that as a goal. Hang in there, and thanks for sharing!
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I have seen moments where acute use of psych drugs have brought a completely incoherent person into a state where communication was possible within 20 minutes. I think that’s good medicine. But it’s kind of like pain relievers. A person comes in with a broken leg, you use opioids to help bring the pain under control. THEN YOU MEND HIS LEG! You don’t prescribe opioids for life because he has “excessive leg pain disorder!”
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I honestly have no beef with Susan or her efforts. I’m simply commenting on how this kind of intervention seems to go, based on too many years of watching “promising new treatments” become marginalized by this process. It is very encouraging to see homeopathy, naturopathy, chiropractic, acupuncture, etc. reach some kind of mainstream acceptance. But the MDs and their drug company allies are still in charge and will make sure they stay that way, and that’s the real issue I think is not dealt with by this approach. I know you agree with me there, but I just wanted to clarify that point.
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OMG, that is just AWFUL! I can see no rationalization, even in the crazy rules of the psychiatric world, for restraining a person who is not violent, and this catheterization is just plain abuse. I can only imagine the rage I would feel after having this done against my will!!!! You are kind not to have beaten them to a pulp at the first opportunity. The shame you felt should be THEIRS! THEY are the ones who deserve to feel awful about the violence they perpetrated for you!
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Well, exactly! The thing I learned VERY early on in my experience was that I had to always ask the question, “Whose needs am I meeting?” If every action I took was run through this question, both before and after I took it, I rarely if ever ran into problems. Of course, this requires a brutal level of self-honesty that is not a part of training for most therapists, and that I achieved through personal work and an unrelenting observation of what got results, not any kind of “therapy training.” If something helped the client feel safer, more connected, or more in control of his/her life, it was good. If not, I trashed it. Case by case. I used to joke that my assessment procedure involved: “Try something that seems like it might work. If it works, keep doing it. If it doesn’t, do something else.” All these theories and manualized approaches simply don’t take into account the uniqueness of each human relationship. For some, self-disclosure was an essential element of moving forward. For others, it got in the way. There is no “rule” that governs when it’s helpful – it’s helpful when it is, and it’s not when it’s not. I guess it’s called “being human.” There is simply no formula for good helping behavior!
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Your wisdom shines through in this thread! Being present and allowing others to be who they are safely – that’s what we all need! And you’re so right, no matter how great a relationship is, there are conflicts that need to be worked through. How we work through them is what differentiates a successful from an unsuccessful relationship.
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Oh, and BTW, “oversharing” is my specialty. They always warned me against “self-disclosure” as a counselor, but I self-disclose in sessions all the time! I find that it’s essential to make me seem more like a real person to the one I’m trying to help. The less like a therapist I acted, the more helpful my actions seemed to be. It seems that the most helpful think we can do is to just be a caring person who is willing to be with another in experiencing their pain.
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Dang, that sounds like the OPPOSITE of what I have found helpful for me and those I’ve tried to help! What most people need is what you said at the end – to be encouraged to accept their feelings as NORMAL RESPONSES to abnormal events and an abnormal society. What gets us into trouble in the first place is being unable or unwilling to experience our strong emotions. It sounds like DBT, at least as you experienced it, is a sure way to keep someone agitated and upset! Thanks for sharing your experience, and I hope it helps others prepare to avoid that kind of experience in the future.
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I tend to agree. “Integrative mental health” gives credence both to the DSM and to the concept that psych drugs are a legitimate “medical intervention,” which they are not, at least beyond acute/emergency care. While “integrative medicine” is an improvement over the allopathic-only standard we’re all used to, it still privileges MDs, drugs and surgery as the “real” interventions, and is mostly an attempt to coopt alternatives into the Big Healthcare machinery. This is bad enough for physical heathcare, but when we go to “mental health,” it is an outright disaster. “Integrative mental health” is a way for psychiatry to maintain its dominance and avoid any real accountability for its dishonesty and the harm it continues to do.
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I was so glad to see this evil POS go down!
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I think you said the most important thing – they get sued for not following the “standard of care,” no matter how stupid or dangerous that standard may be. So who sets that standard? It is the more powerful “thought leaders” of psychiatry who have colluded with the drug companies to develop these “standards,” often white directly and shamelessly (see the TMAP in Texas as a telling example). It’s not accidental, it’s profit-driven, and the on-the-street psychiatrists, no matter how cool they are, can’t as individuals alter the standard of care. Also, those who DO follow the standard of care CAN NOT be sued, no matter how many people they kill! Antipsychiatry, to me, is opposition to this SYSTEM of harming individuals in the name of profit. There have always been psychiatrists who see through this, and I am certainly not opposed to those people trying to help. But the profession as a whole is organized to stifle ANY resistance, even from within their own ranks. That has to change, and it won’t until the financial incentives for establishing and following a destructive “standard of care” are eliminated.
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I will also add that I have worked with DV victims for many years, decades actually, and I have not seen any evidence that any drug stops or even decreases domestic abuse. However, I have seen domestic abusers use the “My meds aren’t working” and “my psychiatrist is screwing me over” and “I have bipolar, what do you expect of me?” lines to justify continued abuse of their partners. Enforced Abilify will have no impact on that area, either. IMHO.
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You did not answer my question. Do you want to live in a world where a person, without any legal authority beyond their own opinion and a rubber stamp court hearing, can force you to take Abilify, even if it makes your life miserable? I’m not talking about some theoretical violent teen, I’m talking about YOU.
And BTW, as you yourself have seen, taking Abilify or any other drug doesn’t necessarily make things better. There are plenty of people who committed violent crimes while taking these very drugs that are supposed to prevent it. Is there any real evidence that forcing people to take a particular drug has the predictable effect of stopping them from committing violent acts?
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Well, glad THAT doesn’t happen any more. Oh, wait, it does…
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I think you are missing the point here. It’s not about whether the drugs help YOU in your perception. It’s about whether you should be FORCED to take drugs, whether you think they help or not, and be tracked remotely and punished if you fail to follow the orders of your superiors! You said Abilify didn’t work for you. What if your psych insisted you take it anyway, and sent the police around any time you skipped a dose? Is that the kind of world you want to live in????
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Shhhh! That’s a SECRET! If people found that out, they might not take their DRUGS! And we can’t have THAT, can we?
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Well, this should not be a surprise to anyone. This has been known by anyone not in denial for well over a decade now. Of course, facts never have had much impact on psychiatric practice – they prefer to blame early death on the “poor life habits” of their charges.
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One thought that you could change (if you wanted to) might be the idea that you have to change who you are to be acceptable. It sounds like that message was pounded into you by your parents, your school, your peers AND your therapists. I had to learn that same lesson in my 20s, and fortunately had a quality therapist who understood what it was I needed to do. A therapist telling you how you should feel/react is the worst of all of your story – it’s unforgivable! Therapists should be on YOUR side, 100% of the time!
Thanks for sharing your story. I have to say, I’ve worked with lots of people with the BPD label and didn’t know a single one who didn’t have a story of being abused, labeled and misunderstood in their past. I also found school to be particularly traumatic, but no one wants to look at our society and how it contributed to making people “mad”, figuratively AND literally! I hope you can continue to connect with people who love and accept you for who you are.
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Well, maybe they SHOULD shut it down. Even the administrators aren’t following their own rules, and it sounds like some of the staff actually HATE the patients!
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The challenge I found working in the system wasn’t that I was forced to recommend drugs or any particular “treatment,” it was that the system was so committed (sorry, bad pun!) to that approach that I could make no impact on it. So introducing someone to that system meant introducing them to drugs in most cases, even if I personally did all I could to to keep them on another path. I couldn’t live with myself after a pretty short while! Though I have to say, when I started out doing residential care for teen moms, NO ONE was on drugs (1986). Things have changed dramatically for the worse.
Grief coach sounds good! How do you get “qualified” to do such work?
— Steve
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I tend to agree, bullying is more or less a consequence of our industrialized society where communities have been undermined by the need for mobile workers and homogeneous (if shallow) belief systems. I find it interesting that bullying programs in schools always focus on bullying of kids by other kids, but never address bullying of kids by adults, or the bullying of one adult by another. Kinda missing a big part of the picture, IMHO.
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My caveat to that is that there ARE biological events and processes which affect “mental health,” such as sleep, nutrition, physical pain, other drugs, toxic environmental exposures, thyroid problems, etc. These should be looked at as potential causes or exacerbating factors. But the concept that you’re depressed or whatever because your brain is acting badly is pitifully lacking in any scientific validity. The vast majority of psychological/emotional issues are indeed stress-induced, as any bright 10 year old already understands. The amazing thing is how marketing techniques have overridden the commonsense understanding that most people have of how and why people get depressed/anxious/angry and how deeply this biological brain disease concept has become embedded in our society!
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That’s where I’m at, too. There might be some minority percentage of depressed people who have something demonstrably wrong with their brains, but until there is evidence that this is the case, and these people can accurately be identified, medical approaches are dangerous and inappropriate except perhaps in acute and very temporary situations (like pain killers for a broken leg). Using psychiatric drugs to “treat” depression is like doing surgery with a jigsaw. You don’t even know what you’re fixing but you start throwing stuff at it and hope it goes away. We can all accomplish this at the corner bar. It’s not medicine.
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Sure, Mr. Fox, we’d LOVE to hire you as our new chicken coop security manager. You seem so PASSIONATE about chickens!
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What would stop a therapist from encouraging and supporting his/her clients’ need for justice through political action? I have been a therapist in the past, and I encouraged many domestic abuse victims to get involved in political action to protect survivors and their kids. I’ve also encouraged youth in foster care to get involved with a group of current and former foster youth that lobbies the legislature and even submits laws every two years (they’ve never failed to get one passed!), and I was an adult supporter of their efforts. And in truth, I had no “doctrine” except that “every person is different and deserves their own unique approach and relationship.” Of course, I had an advantage – I never got any actual training to be a therapist!
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How ’bout “He’s a Jerk!”
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Very well said. If we want to combat labeling, we need to be open to people having different experiences than us and help make it safe to share them.
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Yeah, if we’re going to label people, let’s go with “He’s a freakin’ asshole” rather than “He has Bipolar.” We’re both admitting to the fact that we’re making a moral judgment and also creating a context to expect him to behave otherwise, rather than making an excuse for his abusive behavior and creating feelings of pity rather than the appropriate righteous indignation.
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I had what I consider quality therapy in my 20s, and far from teaching me not to have my feelings, I learned to be more aware of the injustices I’d experienced and to feel properly angry and hurt instead of pretending that nothing happened or that it was my fault or that “they couldn’t help themselves.” There were no excuses made for my parents, brothers, the schools, church, or any other injustice I’d experienced. She just made it feel safe for me to experience what I’d repressed in the past. Sure, it didn’t make the world more just, but it put me in a position where I could avoid or fight injustice where I saw it, and where I could recognize that the injustice that occurs is not caused by the recipient nor does it mean anything about the one being attacked or mistreated. I learned a LOT of important lessons, not because she taught them to me, but because she made it safe to FEEL again. Which is kind of the opposite of what you’re suggesting therapy is about. Now I’m the first to admit, I lucked out, and would be a lot more lucky today to find such a quality therapist, what with everyone trained to diagnose and judge these days. But to suggest that all therapy is about denying injustice and suppressing your feelings is not true, at least in my case.
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We could call it the “Duration of Untreated Psychosis Experiment” (aka DUPE). Seems appropriate to the subject!
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I agree 100%!
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They don’t include them because they have an agenda. Look how hard they worked to explain away Harrow and Wunderlink and the WHO studies! You’d think they’d be interested to find out how they could accomplish 60% funtional recovery rates. But their finanical conflicts of interest drive everything they do, and anyone in the fold who tries to go another direction is shouted down or driven out. It all comes down to MONEY. Psychiatry is hopelessly corrupt, and no amount of data, no matter how convincing, will change their attitudes.
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“Draining the swamp” appears to mean letting those in industry “regulate” their rich buddies at an even more alarming rate than was already occurring previously. Probably better not to have an FDA than to have one rubber stamping for the industry!
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Great example! According to psychiatric logic, our body decides to walk and walking is caused by chemical reactions. There is no person involved.
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You know what I’ve found the best marker of distress to be? I ask the person, “How are you feeling?” If they tell me they’re depressed, or describe a depressing outlook, I conclude they are depressed. I think this whole biological marker idea is just a waste of time. People know how they feel, even if they have a hard time explaining it to you. The only real thing a therapist can do for a person is to help them become aware of their own observations, and perhaps become aware that they can view the situation from a different perspective. I think biological changes are usually effects, not causes, and as such deserve very little scrutiny. And those that ARE causal (such as thyroid problems, lack of sleep, chronic pain, etc.) should be treated in their own right and not in the context of “depression.”
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Impressive array of studies! Thanks for pulling this all together – must have taken a LOT of research. It will be very helpful to me in conveying this info to those in need of some education on the matter.
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Yeah, they had the radical concept that being with someone in a loving fashion was the best way to help. Let’s imagine what the “mental health” system would be like if it was based on that concept! It would be unrecognizable.
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Corruption, corruption, corruption. This is not a couple of “bad apples.” This is systematic deception on a grand scale.
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Which is why it’s pretty much a waste of time. We know that heart disease is heritable, but there is no gene or set of genes that “cause” heart disease, because there are SO many variables that go beyond genetics that there is no way to even identify the genes that might convey vulnerability. Stress, style of eating, exposure to toxic substances, lack of exercise, diabetes, smoking, legal drug exposure (antipsychotics are particularly horrible in this area) and on and on. If this is true for heart disease, something you can visibly see and measure, how much MORE true is it for “mental disorders,” which are defined solely on behavior and emotional experiences that are far more affected by post-birth variables than heart disease.
It’s just a losing proposition, which is why they’ve never found a genetic basis for any of these “mental illnesses” as defined by the DSM. The definitions are made up based on social concerns. Why would all people who are depressed, anxious, intense, easily bored, etc. all be that way for the same reason? Why would we assume they have anything at all in common besides their behavior?
We’d be much better off spending our time and money reducing poverty and childhood trauma, and assisting immigrants with their integration into new cultural milieus. We might also learn a lot from studying cultures where recovery rates are WAY higher than ours, like Columbia and Nigeria and India. Interestingly, one thing those countries have in common is using a lot less antipsychotic drugs!
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You’re not the first to observe this similarity. It is disturbing, but the use of power and control tactics permeates our society, and any time there is a power imbalance, those who enjoy feeling superior and humiliating others will gravitate to those positions. It also appears that our system is based on the assumption that their must be “authorities” who decide what to do and “clients/patients” who have things done TO them, so the power/control dynamics are built into the system, and even those IN the system who oppose such behavior are often powerless to stop it, as they are themselves abused if they step out of line.
We need a “new deal!”
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The disconnect between the data and mainstream practice is so profound, and it seems that logic and research make no dent in it. It seems obvious that if you could safe 20% of people, or even 10%, or 5%, from the long- and short-term consequences of antipsychotics, anyone who cared about their patients would want to know. I can only conclude that caring about patients is a secondary concern (at best) of our leading psychiatric “opinion leaders.”
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Supposing you identify a subgroup that has a certain gene. What would you suggest could be done to help these people as opposed to those who do not? This is not even considering the fact that 40 years of genetic research has failed to turn up any gene that explains more than a tiny fraction of any psychiatric disorder, or even of the vast majority of known physiological problems like high blood pressure and heart disease. But say we did discover such a gene – what would be the intervention?
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Let’s say we discover that, say, 10% of cases of “schizophrenia” (whatever that is) have a genetic contribution. What do we do with that? What benefit is there to know this? How will it help us help people who suffer in this particular way?
We already know that traumatic exposure in childhood has an 80+% correlation to psychotic problems. We have not found anything close to even 15% correlation with genetics, even when multiple genes are included as well as multiple “disorders.” And you can’t do ANYTHING about genetics anyway! Why don’t we spend our time and energy dealing with the 80% effect that we actually CAN do something about, instead of wasting billions researching something that isn’t even within our control? Does that make sense to you?
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What we do have is a lot more people on psych drugs. And a lot of very poorly educated people who have forgotten even recent history.
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Oooh, I don’t want THEM on my back. They’re armed!
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I don’t think the suffering that is called “mental illness” in our society is made up. I think that the CONCEPTS they put forward as “mental illnesses” are in fact made up. In other words, people DO have mood swings, hallucinations, anxiety, etc. But finding someone who is genuinely depressed and saying “you have depression” really is an invention, especially if we regard “depression” as a brain illness of some sort. People are depressed for all sorts of reasons, some of them physiological, some of them psychological, some of them social, some of them spiritual. Calling them all “depression” takes away their meaning and prevents us from really looking into what is going on.
It’s easier to see with something like “ADHD.” We decide that being active and disliking boredom and not liking to sit still or take orders are bad things because kids like that are harder to manage in a classroom. And instead of talking to the kid or finding out when he is bored and why or creating more interesting and engaging things to do or challenging him with more advanced work or putting him into a different classroom with a more stimulating teacher or structure, we say “He has ‘ADHD’ and that’s why he’s having trouble” and we give him stimulants. I’m not saying he isn’t highly active and intolerant of boredom and disorganized, etc, etc, but why do we assume that all kids who act like that have something wrong with them? And why do we assume that all of them have the SAME thing wrong with them, and need the same “treatment?” Especially when we now know that this “treatment” doesn’t actually lead to better long-term outcomes, it seems pretty silly to just group everyone together who acts in a similar fashion and say they have a “disease.” Why not just say, “He likes to run around a lot and doesn’t like doing boring things” and go from there.
A description of behavior can’t possibly be a disease. It’s the IDEA of these “diseases” defined by behavior and emotion that is invented.
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If “mental health problems” explain mass shootings, why does the USA have such a disproportionate number of mass shootings, when “mental illness” frequencies, by psychiatry’s own claims, are similarly common around the world?
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I hate to tell you this, but in the USA, where we don’t have “single payer,” you still can’t really get a second opinion. Or you can, but it will almost always be the same as the first opinion, because the system tells providers what they can get paid for. The only way to get a real “second opinion” is to find a rebel who bills with the DSM but otherwise ignores it and does what helps. Such people are rarer than hens’ teeth, even in our “free choice” health system. Besides which, most people don’t have a free choice – their provider is chosen by their employer, and they are stuck with what they get. Of course, if you’re rich enough, you can afford to purchase decent therapy, but for the common man, single payer is not the barrier – psychiatry and its selling of delusional “diseases” is the barrier.
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Few people would argue that the biological has nothing to do with what are called “mental illnesses.” The difficulty is one of objectivity. Even if the number’s arbitrary, you can at least say that someone has “high blood pressure” when their blood pressure exceeds a certain agreed-upon standard. There is no such standard for “mental illnesses.” In fact, just taking the biological aspect of depression, you are no doubt aware that depression can be caused or made worse by sleep loss, physical pain, vitamin deficiency, poor diet, lack of exercise, thyroid problems, low testosterone, other hormonal variations, and other physiological things? Does it make sense to say you “have depression” when your problem is low thyroid, and that someone else “has depression” when they are suffering from chronic sleep loss due to chronic leg pain? Why would these conditions be lumped together as being the same thing? They have different causes and different effective treatments. So how could you possibly develop an objective scale to measure something that is not really the same thing? It’s like diagnosing “pain” instead of looking for the cause of the pain.
That’s not even getting into the wide range of psychological/social reasons someone may be depressed. Does the person who was sexually abused as a child need the same kind of intervention as the one who is currently being beaten by her husband weekly or the one who is using methamphetamine or the one who is in a dead-end job and sees no future for him/herself? What about the one who is using heroin because she’s got chronic pain and looses sleep because her husband broke her jaw and she’s afraid to go to the hospital to get it repaired? How could these extremely variable presentations be considered the same “disease?”
Again, no one is denying that biological factors play a role. But to reduce “depression” to a disease denies the fact that people are depressed for a hundred different reasons and need a hundred different interventions. What is the point of defining a “disease” when the diagnosis doesn’t tell you what kind of help the person would need?
Hope that makes some sense to you.
— Steve
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That would be a SHOCKING revelation!
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Exactly. I worked with foster youth for 20 years. No matter how badly they were beaten, abused, abandoned, humiliated, and unstabilized, it was always the kid who got diagnosed. I like the idea of the “holy fool” – certainly can’t be anything but a step up from the “cursed victim” approach we are taking today.
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It is sad in the extreme that our system is so warped that no one even wants to hear about how traumatized you were as a kid, or even as a wife on an ongoing basis! But you are far from alone. The best I can suggest is that you figure out what to tell them so they’ll let you out, and then fade into the woodwork so they can’t find you again, and meanwhile, find a support group for domestic abuse victims or those sexually assaulted as children. Your peers will be a much more reliable source of support than these sadly mis-educated, insecure “professionals” who are too scared to feel anything at all.
I agree that Borderline PD has been used as a means of silencing or ridiculing those who have experienced abuse. In the end, it is simply a description of how some people act when they have not been protected from harm early in their childhoods. It means nothing about you, but a lot about them that they need to use this label to defend themselves against the reality of childhood abuse and molestation.
I wonder if you can redirect your anger toward a mission to simply escape their clutches and find another pathway forward for yourself that allows real healing?
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Another no brainer study. Loss of sleep almost always precedes psychotic episodes, and anyone deprived of sleep for long enough will start to hallucinate. But of course, the DSM is “cause neutral” – God forbid we should actually try to UNDERSTAND why a person is acting as they are!
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ADHD voices seems pretty slanted to me – a little genuineness mixed in with a lot of propaganda. Or am I missing something? Psych.ox, on the other hand, seems more genuinely objective and willing to critique the status quo.
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Religion CAN be a force of stability for some people. It can also be a cover for incredible destruction!
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The other aspect of psychiatry that is cult-like is the intolerance of any facts that conflict with the agreed-upon dogma. This is where psychiatry is most like a religion – they have their “scriptures” (the DSM) and any attempt to question the scriptures is punished by shaming or ostracism.
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You’re actually saying the same thing I am – science is not able to study the mind because the mind transcends the physical plane of existence. Studying the brain will never lead to understanding of the mind. Materialism is a school of philosophy, not a requirement for being “scientific.” I do believe that science can study the manifestations of the mind IN the physical universe, but there is no way science can determine that the actions of the mind ” are all automatic.”
It seems we agree on almost all points.
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Hey, I am all about mindfulness and meditation and Buddhism. But it’s still not science. It’s philosophy, which I consider VERY important, but it’s not science. My contention is that science has nothing to say about free will, determinism, or mind streams, and my objection was to the statement that “scientific research has shown that all our experiences are automatic.” My philosophical assertion is that this is impossible to prove by any scientific means. Science has no clue what the mind is, and as long as psychiatry or any other discipline insists on studying only the body, it will never have any clue. I agree that Buddhism does the best of any discipline in defining and understanding the mind. But again, Buddhism is not science.
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By the way, I understand what you’re saying about the mind stream, and it is arguable that the decisions a person makes are inevitable, since all events and input led them to that decision at that time. But that seems to be freezing time and the moment of decision, and time is not frozen. A person has a decision to make, and they make a decision. Perhaps it is true that they are inevitably going to make that decision under the exact same circumstances, but of course, that premise is completely untestable, since we can’t go back in time. For this reason, I contend that there is no way to “prove” that a decision could or could not be made another way than it is. It is pure philosophical speculation, not science.
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Sorry, I see absolutely no way that scientific research could possibly determine that all our experiences are automatic. And people do things for their own reasons, not always due to social pressures. In fact, some times people choose to go against advice, suggestion, social convention because of some value-based decision regarding higher priorities. It seems likely to me that you and the other scientists are simply assuming materialism to draw your conclusions. If you can provide me a live link, I could analyze it further, but on the face of it, I see no way that anyone could conclude anything about how decisions are made simply by studying brain scans and the like. Perhaps you could explain how this conclusion is drawn. I am not saying that the belief in independent will power is any more or less scientifically supported. I’m saying that science has nothing to say about it, as the human mind is the most complex and mysterious phenomenon in the world, and I doubt that it will ever be explained by science.
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Wow, great data!
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I do like this analogy also. The painting is more than the paint and the canvas, and you can study the components of the paint and canvas for years and years and learn exactly nothing about what makes a painting. Because there is MEANING in the painting, there is an intended communication of an idea which is in no way reducible to the medium used to communicate it. It is actually pretty insulting to any human being to suggest that their life and decisions have no meaning. It’s about the same as saying that a painting is no different than a can of paint being spilled on the floor.
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So are you suggesting that I can’t decide to teach myself to dance or to pitch a base ball or to memorize a list of spelling words? Are you saying that something “leads me” to decide to learn to pitch and that I have no choice about it? Again, determinism is a PHILOSOPHICAL viewpoint, not a scientific one. I’d suggest that it is apparent that humans do, in fact, intentionally reprogram their brains based on their personal intent. This is a free-will argument, and I don’t see you have said anything that suggests it is not true, other than that you don’t believe in that concept personally.
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I think you can at least conclude that the treatments offered don’t improve the situation. If you looked at knee pain, people with more severe knee pain might get more pain relievers on the average, but one would assume that the overall TREATMENT for knee pain would REDUCE the knee pain over time. What is the point of “treatment” if more severe sufferers don’t accomplish a bigger reduction in suffering from receiving increased treatment? The “more depressed people get more antidepressants” argument doesn’t hold water.
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Feeling exuberant seems like a “healing” experience to me!
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That’s a very good point. Unfortunately, psychiatry has defined the terms of engagement, and if one wants to make an impact within the system, one has to start from their definitions, no matter how irrational or subjective. The good news is, even using their own terms and measurements, their drugs fail miserably! Proving such may be a key part of establishing a new paradigm where recognition of the idiocy that underlies defining “diseases” by behavioral or emotional manifestations becomes the new reality.
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Well said!
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Of course. The point being that the program is independent from the “hardware,” though it may be stored in the “hardware” and/or use the “hardware” to execute.
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This site exists to distribute actual DATA from scientific studies, as well as anecdotal stories such as your own. Your story is data of a sort, but all it demonstrates is that sometimes these drugs work well for some people. The study, however, looked at many hundreds or thousands of people, and it showed that ON THE AVERAGE, antidepressants made no difference or in fact made things worse, and that most people are better off without them. This finding does NOT conflict with your story in the least. It says that your experience is not what most people will experience, that’s all.
My question to you is this: if you are so comfortable saying that this approach worked for you, why does it bother you when an honest research study is published whose results are not what you expected? Do you believe that your personal experience must translate into everyone’s personal experience? Do you think psychiatry should be based on science, or individual stories? Why is it difficult to accept that a study might find that most people are not having the same positive experience you have had?
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No one said you can’t heal yourself! Go for it!
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Of course, the REAL mystery is who the “programmer” is and where s/he resides. This is a mystery that materialism has not even vaguely approached, and has only dealt with by denial.
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It appears to me that knowledge is synthesized information that is useful for the purposes of solving a problem in survival. It does not appear to me that there is a requirement of social interaction to have knowledge – merely a sentient relationship to the environment. A hermit still has the knowledg of how to build a hut, set a trap, light a fire, etc.
As for mind-body dualism, most definitely not required in the sense of body-spirit as separate entities (though I will note that no one has presented scientific evidence that eliminates that possibility – the requirement that all things reside in the physical universe is a philosophical one, not a scientific one.) It should be very clear that the brain runs the body, but that it is clearly and obviously “programmable” by experience and education. It is easy to observe that the “program” can be massively altered without any change to the “hardware” at all. So it is that some people speak Chinese from birth because that’s what they are taught, but they can learn English or Swahili by reprogramming. I would suggest that the MIND is the analogy for the program. This theory effectively explains all actions of the mind without resorting to mind-body dualism at all.
The “mind-body dualism is wrong” argument is a bunch of hot air. Too bad so many folks confuse science with the philosophy of materialism. They are not even close to the same thing.
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If someone hits you with a car, and your leg is broken, is it invalidating to talk about your leg healing? Is it blaming the victim of the car crash to say, “Hey, if you set that bone and splint it, you will probably be able to walk normally again?” Does it make it like the bone was never broken? No. Does it mean you’re able to function better, even if you’re not back to 100%? Yes. Does it excuse the person who hit you with the car? Absolutely not. I am the last person in the world to blame children for the abusive behavior by their parents or by the system. I am simply saying that there are things that a person who is hurt can do to make their lives more livable. Part of that healing might very well involve taking political action to fight the systemic abuse of kids and others.. It often does. But healing does not, in my mind, imply even forgiveness of the abuse, and absolutely does not include blame of the person so harmed. It’s just a question of whether you have to sit on the road with your leg broken for ever, or to take action to help it mend after the trauma of the accident. Hope that makes things clearer.
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I met a guy when I was advocating for nursing home residents who was so drugged that he could barely open his eyes, and had bruises on his head from running into the doorframe, as he could not navigate through the door. I talked to the activity director, and she said they’d been hitting a volleyball back and forth in the courtyard only a week or so before. They put him on a neuroleptic for “aggressive behavior,” not for a “mental illness” diagnosis. Something tells me his sudden inability to play volleyball (or get out of his chair for that matter) was not because his “mental illness” was so severe.
— Steve
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I am with Chaya. I have worked for many years with foster youth and I can say that hitting, beating, burning, sexual abuse are by no means restricted to the poor or working classes. That being said, I do agree, Tireless, that rich and middle class folks are often able to avoid the consequences of their violence and abuse, as they can afford to hire threatening attorneys, they live further away from neighbors and mandated reporters, and their status enables them to claim “I wouldn’t do something like that” with more credibility. That’s the nature of privilege.
I would also disagree with you that no healing can occur. It’s true, like any injury, that spiritual injuries leave a scar behind, but I have known many people who have made very workable lives for themselves and who have achieved a large degree of happiness and peace of mind despite abuse they experienced. It can never be like it never happened at all, but it is possible to find a way forward for many folks. I think each has their own path to get there, but don’t give up hope – it can and has been done!
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Gosh, if you are SO concerned about the “sedentary behavior” of people with “SMI,” maybe you should stop giving them drugs that make it difficult to move and difficult to get motivated to do anything! And if you’re so concerned about heart disease, maybe you should stop giving them drugs that give people diabetes! Sheesh!
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As usual, they miss the point. The reason they lack “cross-cultural validity” is because the scales are “measuring” cultural constructs loaded with bias. Naturally, different cultures have different biases, so the “tests” look different if you run them in another cultural milieu. The real answer it to stop pretending they are “measuring” anything real, and remember that “psychopathology,” as academic as that word makes it seem, is almost completely a matter of cultural values, and is, therefore, not measurable as a “real” quantity.
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I have always thought that “boundaries” have become an excuse for avoiding genuine human interaction. And you’re right, they have also become a power exercise for staff who have big control issues. I find it pitiful, as genuine human contact appears to me to be the #1 antidote to “mental health disorders.” The whole industry is corrupt and disturbed. They are the ones who need healing!
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Seriously? People are worried about “power poses” when millions are dying decades earlier due to the dishonest and often forced prescription of antipsychotics and other drugs? Give me “power poses” any day!
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If only today’s working class and poor of all races would learn this important lesson! As they said in “The Hunger Games,” “Remember who the REAL enemy is!”
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Very well said.
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Fantastically written, very moving testimony! As always, it is love and compassion and shared humanity which heals. Perhaps the psychiatrists and the mean staff have never had this experience themselves and are in need of some hugs from the residents/inmates, who appear to understand far more about “mental health treatment” than the staff does!
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I think the underlying issue is that we live in a culture that is fundamentally based on oppression. While oppression affects people of color more severely, the fact is that ALL of us operate under some degree of oppression, whether from being female, being children, being elderly, being poor or even working class, or whatever. Even powerful white males experience oppressive conditions, because in order to keep their dominance, they have to agree to operate within certain very restrictive and dehumanizing rules, including being expected to fully support the oppression of others lower on the economic/power scale than themselves. This is easily seen when a kid in school stands up for the “weird kid” or the gay kid or the bully’s victim – even if that kid is not in a despised group, s/he quickly becomes the victim of bullying him/herself as soon as s/he steps outside of the expected behavior of the dominant culture. This will only change when folks band together and realize that the dominant culture itself is the problem, and that bullies can’t bully when the group rises together in resistance.
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It is interesting that they talk about “differing demographics impacting imaging results” or some such, but overlook the more important conclusion: BRAIN DEVELOPMENT IS MASSIVELY IMPACTED BY ENVIRONMENT! This kind of research should immediately put any speculation about “brain illnesses” explaining “mental health issues” to rest, but of course, the authors don’t even notice this very important issue and focus instead on “sampling problems.” It shows how biased and unbending the medical model worldview really is.
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Why anyone would believe that all or most cases of a “disorder” identified by behavioral or emotional characteristics would possibly yield genetic causality is beyond my comprehension. It’s like trying to find the cause of car accidents. Yes, they have the similar appearance of one car crashing into another. But they can be caused by sleepy drivers, ice, poor road signs, aggressive driving behavior, distractions, mechanical malfunctions, and on and on. To postulate that EVERY car crash is caused by something wrong with the car is idiotic. Similarly idiotic to suggest that a particular behavior pattern MUST always be caused by some kind of genetic fault in the person engaging in the behavior. Unfortunately, facts don’t seem to deter these fanatical researchers, because they just KNOW they will find a genetic cause because it HAS to be genetic because, because, well, you know, SCIENCE!
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Such arrogance is difficult to wrap one’s head around.
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Part of the larger issue of corruption and propagandizing by the power elite. If the focus is freedom to make one’s own decisions without lies and force, I think there isn’t as much room between you and the “reformers” than you might imagine. It is for the most part only the hopeful and perhaps delusional belief that these guys will listen to reason that differentiates the two groups, IMHO.
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Sounds like Alice Miller’s work. She’s amazing if you’ve never read her. Totally gets the impact of even more diffuse trauma, like constantly getting the message you’re not living up to parental expectations, or being expected to emotionally care for a parent who is not specifically abusive but needy and self-centered. Of course, she has been ignored or castigated by the mainstream.That’s usually a sign you’re onto something, when the Powers that Be get upset with you!
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Right – that’s my objection, because saying “overdiagnosis” suggests there is a correct level of “diagnosis” that is being missed somehow. But how could the correct diagnostic frequency ever be established when there’s no measurement to refer to? Even hokey medical diagnoses like “obesity” have a numerical standard, if a somewhat arbitrary one. You can measure someone’s weight and height or BMI and say where they fall on the scale. You can’t even do that with “mental illness.” You’re ill because someone decided you are ill, and the culture supported it. It’s such BS, but unfortunately most of our society is brainwashed into thinking it makes sense when it does not.
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I have also known lots of foster kids who were “diagnosed” in their younger years, but who miraculously “recovered” once they escaped the foster care system and their enforced “mental health” treatment. Certainly, many foster youth go on to the adult “MH” system or to the prison system, but I strain to think of even one “recovered” foster youth who attributed his/her success to proper diagnosis and medical “treatment” of his/her “condition.” They always describe a PERSON or RELATIONSHIP or ACTIVITY they engaged in as critical to their success.
They tend to recover when they have a sense of purpose and are able to assert some control over their own lives. Weird, isn’t it, how having more control of your life and decisions and environment helps make you “mentally healthy?”
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They are missing the most basic reason – there is no definition for “overdiagnosis” when there are no objective criteria for “diagnosis” in the first place. The main reason for “overdiagnosis” is that anyone can be diagnosed with anything based on someone else’s opinion, and there are HUGE incentives to diagnose and therefore blame kids for creating problems that are actually created by adult inflexibility, neglect, or abuse.
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This is the ultimate truth that psychiatry and the drug companies have been empowered to cover up. And it’s not just parents – our social institutions are very responsible for abuse, physical and emotional. Churches and schools promote fear of authority. In my case, this included being hit and sent out of the classroom in second grade for speaking up when the teacher tossed a book across the room in a rage, as well as being laughed at and abandoned in a hallway by a Sunday school class at the age of 4. These are only the more obvious manifestations. The maxim “It’s no one’s fault” was created to protect adults from responsibility for their hurtful behavior toward our society’s children, and also from becoming conscious of the fact that they were abused in the same way when they were kids.
Thanks for speaking the truth, Chaya, and eloquently!
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This would mean that our bought-off congresspersons will have to bit the hands that feed them. The flow of money from big corporations to our politicians will have to stop before this kind of scandal is actually taken seriously. I just read that Trump’s new appointment for Drug Czar helped right a bill to hamper the DEA investigating drug companies involved in this very problem. Corruption is at the core of these problems, and needs to be our real target!
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Yup. It’s really all about POWER. That’s the piece that apologists for the current system are missing.
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It seems a shame that the same kind of thinking (not hiring all-or-nothing thinkers) does not apply to the “professional” staff in our hospitals and mental health institutions. It seems that “placing your views on others when they don’t ask for it” is allowable only for those who have degrees and sufficient power in the system.
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This article provides an excellent analysis of how the diagnosis-focused viewpoint impedes actual investigation of real issues, and how parents can influence school behavior. It unfortunately does not directly address school staff behavior or structural issues that help create these “ADHD” problems. However, it does a great job of showing just how totally subjective this diagnosis is, and why the very concept of diagnosing creates more problems for kids AND schools than it ever can possibly solve.
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Corruption is, indeed, the key to why things keep staying the same. We have to develop incentives for people to do the right thing, and penalties for doing the wrong thing that are much larger than the profits gained by doing it. It is a very complex process to accomplish this, however. In the meanwhile, people are being hurt TODAY and I believe providing and promoting alternatives is essential to minimize the harm that’s being done, as well as providing a direction for our incentives to push people once we gain control of the wheels of power.
The real problem is that “power corrupts,” and it is always possible, maybe even likely, that if people within this movement gained control, they would perpetrate similar oppression on those without. So the ultimate goal, I think, is shared power, and that CAN be promoted both locally/immediately to those in need, as well as politically, as we work to get money sidelined in political matters. But that will not happen without a big fight, and we need to join together with other anti-oppression/human rights movements on some shared goals and strategies.
So I don’t agree 100% with the “failure” assessment – every movement has to have a base, and again, we can’t forget those who are suffering today in pursuing larger goals. But you are absolutely correct – financial incentives drive the current system, and it won’t change without changing the incentives, no matter how much data or stories we present.
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It is fascinating that this whole article regards “social isolation” entirely as a failing or deficiency on the part of the individual, rather than recognizing that our social and economic system CREATES social isolation as an inevitable “side effect.” This fits with the entire psychiatric paradigm where the individual is always responsible for any ill effects that occur as a result of our social institutions. Those in power to effect changes in these institutions are, as always, let off the hook.
— Steve
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The concept of using “CBT” to enforce “medication compliance” violates the most basic tenets of therapy. The therapist is supposed to form an alliance with the CLIENT, not to “collaborate” with the psychiatrist or the client’s parents to enforce their will! It shows just how far “therapy” has drifted from actually trying to help the clients to becoming a part of the oppressive system that creates “mental health issues” in the first place.
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Wow, who would have guessed?
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Why should that matter? Are you unable to see Mr. Renaud’s mean-spirited rhetoric for what it is?
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Well, dogs got protection from abuse before children – maybe if dog owners start getting upset about their doggie friends being screwed up by SSRIs, the idea will eventually translate into protecting children, and maybe someday even adults!
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Pat, so you admit you just like screwing with people? Essentially, admitting you’re trolling? On that basis, I’d suggest that no one should respond to you ever, as you are clearly not serious about establishing the truth of the situation. I will begin applying the policy of “ignore the troll” starting immediately.
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‘Common in the literature are statements like “While the short-term efficacy of stimulants for ADHD is well established, information about their long-term effects is sparse.” ‘
This kind of claim is rather disingenuous – it leaves out that the fact that what studies have been done (and there are several at this point) suggest that stimulants have either no effect or a deteriorating effect on the outcomes that ADHD supposedly puts at risk. Extensive reviews have been done in 1978 (Barkley), 1993 (Swanson) and 2001 (Oregon State University), all showing that there is no major long-term outcome area in which “treated” kids do better than “untreated,” including academic test scores, high school completion, college enrollment, delinquency scores, social skills, or self-esteem measures.
Moreover, the naturalistic studies which have been done, including the Quebec study, the Raine study, the MTA (mentioned above) and the USA-Finland comparison study all showed NO positive long-term effects for stimulant users as compared to short-term or non-users. The Quebec study showed higher rates of emotional issue for stimulant users, especially girls, and the Raine study showed much more likelihood of being held back for stimulant users.
So to claim that evidence is “sparse” denies reality. Such evidence as has been collected is uniform in showing no long-term effect on social or academic outcomes for stimulant use. It is high time the academic psychiatry world acknowledges what should now be an accepted fact.
— Steve
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It is unfortunate that you seem incapable of a civil conversation, Pat. Why do you insist on insulting posters just because they express a point of view you don’t agree with? Is it just possible that other people had different experiences with the MH system than you have?
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No argument from me on those points. Though it is indeed obvious to a child, I have unfortunately found many “mental health professionals” to whom this appears to be a foreign concept.
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Thank you!
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People with privilege don’t need to be denounced; we simply need to be aware of such privilege and how it arises. It is not the fault of the privileged that they are privileged, but it does create a much higher level of responsibility for critiquing and altering the system when it harms those with less privilege. Ultimately, the goal I would pursue would be to minimize privilege differences, which is actually part of the “American Dream” we’re all supposed to be allowed to pursue – essentially, everyone deserves a fair shot at success, but the game is rigged.
I’m a white male from an upper-middle-class background and so have plenty of privilege automatically sent my way by this society. I don’t need to feel bad about that or apologize for it, but I do need to use that privilege consciously and wisely to help empower and improve the lot of my fellow humans. I am sure I fail at this all the time, but that’s one of the reasons that issues of psychiatric oppression, as well as racism, domestic abuse, and the mistreatment of children, have been big focus areas in my life – the folks I mentioned don’t have social power and I do, and it’s my job to try and alter the system so that those with less power are able to get more of it and have a better chance at survival.
It is unfortunate that “privileged” is seen or is even intentionally used as an insult or put down. It should be neither. It should be a call to action to empower those lower on the privilege scale, as well as a call for compassion and understanding for those who are not so fortunate as yourself, rather than blaming those without privilege for their condition when a large part of their condition is a result of social dysfunction and is not within their control. The parallels to the “mentally ill” being drugged and institutionalized should be pretty obvious in this context.
—- Steve
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It is a possibility, but marketing is not really something I’m any good at. CatNight also outlined some of the limitations – when you work without insurance, you’re working with the rich or well to do, and those who are most in need of help can’t afford it. My adjustment has been to go into advocacy, which requires no specific license and enables me to help change the system which creates much of the distress which I would end up listening to in therapy. My bottom line is that real therapy has to involve engaging in a reassessment of the social system in which one lives, not only a re-examination of one’s own beliefs and values. And that can be done from other perspectives besides being a therapist. Of course, a lot of folks get free counseling from me on a short-term basis, just because that’s the way I am and sometimes I’m called into service. But I have never figured out a way to make a business out of it. It’s kind of not me, I guess.
Thanks for your interest, and thanks to CatNight for your in-depth response as to why it’s not as easy as hanging out a shingle.
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This seems off the topic of the blog. The question at hand is whether psychological phenomena are the consequence of brain activity, or independent phenomena that can be studied or acted upon independent of the brain. You seem to be saying you accept the former. However, I wonder if you are recognizing the fact that both positions are philosophical, not scientific, positions. As I think has been stated multiple times directly to you, there is no actual evidence that any of these “mental disorders” have a consistent biological cause or treatment. So depression may SOMETIMES be the result of a bodily system breakdown or even of “low serotonin” in specific cases, but there is no GENERAL condition that “causes depression,” because “depression” is not a thing that can be caused, it’s a natural body reaction that is caused by many different potential things. The idea that “depression” is a specific state that is always caused by the same thing and requires the same “treatment” is exactly the concept that has led psychiatry down the false path it currently follows.
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* Exercise
* Sleep
* Support groups
* Journaling
* Talk therapy with a COMPETENT trauma-focused therapist
* Meditation and other spiritual practices
* Changes in life circumstances that create unresolved stress (boring job, bad relationships, kids out of control, etc.)
* Active volunteer work
* Political activism to resolve poverty, racism, and other issues that impact lots of people’s emotional state
* Seems silly but highly underrated: stop watching/reading the news!
Love to hear others’ ideas on this! Great question!
— Steve
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Not sure where I read that communism or even socialism were antidotes to psychiatry. I don’t think capitalism is, either. It appears to me that the fundamental issue with psychiatry has to do with believing that humans can be grouped into those who “live correctly” and those who “have problems,” and that “having problems” with the status quo means you are “mentally ill.” I think it’s pretty obvious that this kind of oppression is not dependent on political beliefs, but on an unwillingness to face the true level of oppression that exists within our society and a willingness to “blame the victim” when something goes wrong. In other words, those in power, regardless of party affiliation or of political orientation, are happy to use the “mental health system” to keep their populations under control. We saw Stalin use psychiatrists to herd dissidents into internment camps. We saw Hitler use psychiatrists (or was it the other way around?) to herd Jews and other “undesirables” into concentration camps for forced labor or extermination. Psychiatry is an equal opportunity oppressor – it can be and is used by both ends of the political spectrum to keep the common person in line.
Or as Mad Magazine once cleverly put it: what’s the difference between Capitalism and Communism? In Capitalism, Man exploits Man, while in Communism, it’s the other way around.
— Steve
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I meant my last “mental health job.” I have worked in several other jobs since, but that job did me in as a participant in the “system as usual” approach.
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I haven’t been “in the biz” for decades. My last job involved evaluating people at the hospital for involuntary detention in the psych ward. Three days in, I knew I had to get out of that job, though it took months to find something else. Don’t get me wrong, those who met me were very fortunate, as I worked my ass off to keep them as far away from the hospital as possible, and had some pretty amazing results right in the ER. But I couldn’t help everyone, and it tore my heart apart when I saw what happened to them in the psych ward. That was when I knew I had to go into a different role, and have been an advocate for either the elderly or for foster kids ever since. Which is perhaps a shame, because I was the kind of therapist that people really wanted to see – I actually cared about their viewpoint and tried to help them come up with their own plans, and even shared a lot of my own experiences as needed to help create safety and common reality, and I was always interested in any current or past trauma and how these affected them, as well as checking eating and sleeping habits, work stress, etc, depending on what was called for. But I felt like I was in collusion with an evil system, especially as DSM diagnoses and drugs took over from listening and caring.
So that’s my story. I still consider myself a caring and competent therapist, but any work I do now is informal and on a volunteer basis. I can’t work with a crazy system!
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The greatest privilege of those who have it is the privilege of pretending or believing that your privilege doesn’t exist.
The concept of privilege is by no means supportive of a victim culture – to the contrary, it is a concept that deals very directly with power dynamics such as those shown by most “mental health professionals” when they are confronted with their patients’ reality. Because they have power, they can freely ignore or minimize their clients’ complaints – they have a whole system of diagnoses they can use to blame the clients for not liking their “treatment.” Rather than hearing that “your treatment made me barely able to move and I lacked the will to even complain, so I stopped,” they can claim that you have “anosognosia” and therefore “don’t understand you are ill” and therefore can be forced to receive “treatment” at their discretion. To understand psychiatry’s ability to ignore facts and feedback from their own clientele is to understand privilege. It really is that simple. They abuse you because they have the power to do so and you don’t have any recourse within the system when so abused. It’s not a victim culture, it’s very simply the reality of the power dynamics that exist within the system, and the exact same or very similar dynamics exist at all levels of our social system and are very highly responsible for much of the “mental illness” that same system later feels compelled to “diagnose.”
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As a former “mental health” professional, I can only say that you nailed it (as usual). Humility is the starting point for any attempt to help another. They are the only ones who know what is really going on and what will help. If you won’t even listen to the person you’re “helping,” don’t be surprised if your “help” ends up being resented and leading to worse problems.
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Why do they call it “overtreatment?” Isn’t that just a euphemism for “malpractice?”
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I love how “scientists” continually state that their inability to observe something means it is not there. How could you prove there is no such thing as a “true self”? We’re clearly outside of the realm of science and into philosophy, but pseudoscientists like this insist that anything outside the realm of science to explain simply isn’t there.
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Wait, you mean that inducing a seizure by electrocuting someone’s head DOESN’T make them feel better and has a high risk of doing permanent damage? Whoda thunk it???
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I am so sorry to hear that!
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I think the comparison is around attempts by adults to “heal” those being abused instead of asking why society mistreats them and working on society instead of blaming the victims.
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The graphic comparing smoking and psych drugs is a great resource! Thanks for sharing this perspective – I admire your persistence in trying to work with NAMI and other groups still invested in the medical/blame the victim model.
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This is exactly what happens when you create “diagnoses” that are based on subjective criteria. People “diagnose” what they don’t like or don’t understand. The DSM can say whatever it wants about how it “should” be used. People will use it in the same way people use most things – they will act in ways that are self-centered and that avoid discomfort. There will be exceptions, of course, but the incentive is there to blame the victim, and the DSM makes it very comfortable to do so. It needs to be banned!
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Couldn’t have said it better myself.
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Took the words right out of my mouth!
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Amazing clarity as usual, Sera. Power dynamics lie at the center of why there is an antipsychiatry movement. Embedding “peers” in the system and then taking away their ability to proceed from an empowering viewpoint is cooptation at its most pernicious. I would ask Patrick to look at some of the comments of Stephen Gilbert, a peer worker of great integrity, who is constantly barraged with complaints and threats and disrespect when he stands up for his peers in a truly peer-like way. Certification per se is not the problem – the problem is that the professional “mental health” workers don’t want to give up their power over their clients. A true peer-to-peer model means clients get to make their own decisions and have those decisions respected, even if if those decisions are now what the peer would decide for him/herself. Those currently in charge of the mental health system will never stand for it, and that’s why certification is popular amongst the professionals – it enables them to disempower the peer movement and make it the handmaiden of their own need for control.
Thanks for your courageous response!
— Steve
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Actually, my experience is that good, active listening does, in fact, provide something practical – it removes the barriers of confusion and overwhelming emotional intensity and helps the person involved get to a place of doing their own practical problem-solving process. I’ve done this with dozens and dozens of suicidal people, and had excellent success in helping them achieve some sense of greater control over their lives, and sometimes even a plan for moving to a better way of surviving and thriving in their lives. I could share a story or two. The truth is, no one can really develop a practical plan for someone else – they can only help that person develop perspectives that enable the person him/herself to come up with such a practical plan. At least, that’s my experience.
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You’re welcome, and thanks for the positive feedback!
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That is an excellent point! A lot of kids are “oppositional” to things that don’t make sense, or they are generally opposed to being bossed around arbitrarily. When given more control of their environment, they seem oddly enough to be a lot more cooperative.
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The many psych patients I worked with (mostly foster youth) were not even screened for CURRENT stress and trauma. None were EVER screened for nutritional issues nor were 98% even screened for physical conditions that might lead to their symptoms. All the psychiatrists were primarily interested in was a list of symptoms and their severity so they could decide what drug to prescribe.
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I see nothing here to provide evidence that these interventions help kids in any way. They merely provide evidence that setting up a program leads to “more treatment.” That is not what I want from a review!
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It doesn’t sound like we disagree much, except on terminology. I have never been opposed to people choosing to try drugs if they seem to work for them. I am opposed to psychiatrists lying about what they know and pretending that all cases of “mental illness” are caused by faulty brain chemistry or wiring or and that the drugs are specific “treatments” for specific “conditions” which they supposedly understand. Beyond that point, we seem to be in agreement on each person needing their own approach. “You use what helps.”
As for science, I’m afraid the inability to make a distinction between who “has” and “doesn’t have” “schizophrenia” makes any kind of scientific conclusions absolutely impossible. The first job of science is to distinguish an experimental group from a control group. If we are unable to consistently parse these two groups, any scientific conclusion is meaningless.
For instance, let’s say that 10% of cases of “ADHD” are due to low iron (a known cause of “ADHD” symptoms). If we treat 100% of “ADHD”-labeled kids with iron, only 10% get better. If you compare this treatment to stimulants, which at least temporarily reduce symptoms in 70% or so, stimulants look like the better “treatment,” even though there is no specific understanding of what is being “treated” and even though people without “ADHD” diagnoses react to the drugs in the same way.
So we conclude (erroneously) that stimulants are a better “treatment for ADHD” than iron, even though 10% of subjects would be cured by being given iron alone. The 10% should not be diagnosed with ADHD, they should be diagnosed with iron deficiency.
So you see, if you can’t properly divide your participants into objectively discernible groups, your research leads to meaningless or misleading results. If you grouped them into “hyperactive – low iron” and “hyperactive – normal iron”, you’d have gotten 100% success, but when you call it “ADHD,” 10% of your population never gets the help they really need.
Hope that makes sense!
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Well said!
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Not sure I understand what your supposition is?
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Intimidated? Seriously? I have given you plenty of coherent replies. The most relevant here is the question you were already asked: if some cases of depression/psychosis are caused by biology alone, how specifically do you distinguish which cases are or are not? Drug response is not an adequate answer, not even close – all of these drugs have similar effects of those diagnosed vs. not diagnosed. Just like alcohol relaxes most and removes inhibitions, these drugs have effects on people’s brains that are not specific to a “disorder.” Until you can sort out the conundrum of diagnosing which people have which condition, your theories remain theoretical.
You also appear to forget that while the best correlation with genes and any “mental disorder” is about 15%, the correlation with trauma is more like 85%. Which seems more likely to be the relevant causal factor?
Please knock off the insults. They diminish the credibility of your presentation.
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Who ridiculed you, Pat? As I recall, you were ridiculing others and that’s what got you into trouble. You want others to respect your choices. Why don’t you respect the choices of others, including their choice to take a position you don’t agree with?
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I completely understand your objections to certification – it is simply an invitation to co-optation and control by the system. I would also be very interested in hearing if there are some areas where the two of you agree. Maybe there isn’t anything, but it’s hard to build a movement with so much fragmentation! I guess that’s the point of co-optation, isn’t it?
Looking forward to your response!
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Wow, what an awesome summary of everything wrong with the ADHD diagnosis and “treatment!”
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The challenge here is that many of his supporters don’t recognize even his bald-faced manipulations and support for the corporate-capitalist status quo. This hard core of supporters genuinely believe he will change things for the better by chasing away dark-skinned immigrants and magically bringing back anachronistic industries like coal, as well as somehow increasing salaries while he does all he can do make sure workers are unable to organize and that employers get to set the standard for what they feel like paying. I could go on, but the point is, Trump supporters (the poor and working class type) don’t appear to understand that he is completely antithetical to their interests, even though it is “out of the closet,” as you say. It’s a conundrum!
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I would more put it that “care” in the context of schools comes from an adult viewpoint and denies the legitimacy of kids’ actual, valid complaints about the injustice that occurs so frequently and for which they have no recourse whatsoever. The huge controversy over the TV series, “13 Reasons,” proves the point. It’s OK to “care” about kids as long as you don’t talk about what’s really going on, especially when the cause of their distress is the adults running the system they are forced to comply with. The problem is a chronic power imbalance that allows adults to act with impunity while punishing kids for objecting to their mistreatment.
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Great summary. This guy has it all laid out in one article, but of course, logic is not part of psychiatric research, so the truth will have little to no impact on psychiatric practice or research.
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In other words, the goals of psychiatry, namely to assure that a person DOESN’T feel depressed or anxious, are calculated NOT to lead to happiness. Big surprise.
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This is some tortured reasoning. The fact that people with food issues latch onto the “clean food” movement doesn’t mean the movement itself has any causal relationship to eating disorders. Clear case of correlation not meaning causation. Some people use nursing a baby continuously as a means of “purging.” But nursing babies doesn’t cause bulimia. Total logical fallacy.
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Glad they are taking a stand, but I wish they’d take a similar stand regarding the serious human rights issues affecting their own clients at the hands of their fellow “mental health professionals.”
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I agree 100% that the DSM is at the core of the evil rot that is being perpetrated across the world. Unfortunately, the DSM’s claptrap is supported by a general belief, almost religious in nature, that doctors are smart and ethical and can be trusted. How do we accomplish undermining the DSM without running afoul of the worship of “medical science” as a stable point for many people’s security?
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“Freeman and Honkasilta note that the DSM-5 itself requires that a disorder not be comprised of cultural difference, or socially deviant behavior that is not harmful.”
And how exactly does that differ from any other “disorder” in the DSM? If the DSM really required that a “disorder” not be comprised of cultural difference or deviant behavior, it would be a VERY thin manual! It would, in fact, be essentially EMPTY!
—- Steve
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It invalidates the child’s voice completely. But that’s what school was all about, as far as I recall. My voice was rarely if ever of interest to anybody there. When I graduated high school, I felt like I’d been released from a POW camp. It was 13 years of torture for me. But nobody ever bothered to ask how I felt about it.
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#1: Don’t send your kid to a school that scares them!
This is a fantastic example of ignoring your child’s cues. If a preschooler cried and tantrumed and told you they were afraid to go to preschool, you wouldn’t just force them to go, would you? You’d at least look into it and find out what was bothering him/her. But somehow we’re supposed to assume that school is a great place and that any kid wanting to avoid it is malfunctioning. Maybe the kid wants to avoid school because school is a place of fear, abuse, disrespect, and humiliation. Maybe you should take a good look at what’s happening in your child’s school before you decide that his/her complaints are lacking in substance!
—- Steve
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I think you’re missing the point. I am certainly very concerned about addiction to street drugs and think it reflects major failings in our society that so many people feel they have to drug away their feelings of anxiety, rage and hopelessness. My point is that using psychiatric drugs is not at all a different approach, and implies that there is something WRONG with the people who choose drugs as a means of coping with that distress. It also implies that “medication” will somehow be a BETTER means of dealing with their “disabilities.”
I would also love to see your response to my other points. How we talk about these issues has a very significant impact on how people themselves think of their own distress and the kind of “solutions” proposed by our social system is willing to propose or support. Most importantly, it absolves our society for creating these conditions in the first place. For instance, “ADHD” is simply a critical description of a child who doesn’t fit into a standard classroom environment. By calling them “ADHD,” we prevent any research into the following questions: Are our classrooms failing to meet the needs of kids in general, or these kids in particular? What is causing this behavior for the child? Are there multiple causes? Are we expecting more from our kids than is reasonable for their age? Is it sometimes a function of variable development rates? (A third of ADHD diagnoses appear to evaporate if you wait a year before sending your kid to school!) Boring classrooms? Stress in the home environment? Poor parenting or poor classroom management? Poor diet or dietary deficiencies? Poor sleep? Calling it ADHD prevents ANY research into these potential difficulties!
And the issue of testing stands on its own: how can you propose testing for a “disorder” that is defined with completely subjective and unmeasurable criteria? And without objective criteria, how would “overmedication” ever be determined? Are not the subjective criteria the reason why “overmedication” can’t be defined, leading to ever-increasing levels of drugging for the convenience of the authorities in charge?
Thanks for your reply!
— Steve
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OK, they used an existing drug “off label” and decided it was a wonder drug, and overstated its benefits and hid the adverse effects, etc…
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With all due respect, Joel, the diabetes analogy is an anachronism, or should be for an educated person by this point. Diabetes results from the measurable lack of insulin leading to a measurable increase in blood sugar levels. Successful treatment by diet can be achieved and measured by observing blood sugar and HA1c levels, and if unsuccessful, can be augmented by providing the NATURAL SUBSTANCE (Insulin) which is known to be missing.
There is no “mental disorder” which has a comparable known missing substance, nor is there any “mental disorder” with a known means of measuring success objectively, nor is any psychiatric drug a naturally-occurring brain chemical that is being replaced in measured amounts. There is literally no point at which diabetes and “mental disorders” have the slightest similarity, other than the fact that drug companies sell drugs that are supposed to treat them.
And while I will agree with you that there are acute situations where the use of psychiatric drugs may have application, it should be clear to one as educated as you that there is not one such drug that does anything but disrupt normal brain processes (as well as similar processes elsewhere in the body) in a manner no different than using alcohol or street drugs used to achieve similar purposes. The similarities between drinking alcohol and taking benzodiazepines are MUCH greater than any purported similarity between taking psychiatric drugs and the treatment of an identifiable deficiency with insulin. If you want to be taken seriously in an educated community critiquing psychiatry, you’d do very well to leave the “insulin for diabetes” analogy in the dustbin of history where it belongs.
— Steve
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I agree with the general sentiments expressed here, namely, that a one-size-fits-all inflexible approach to life leads to higher levels of distress and sometimes to emotional collapse in youth. I’m also glad you mentioned that not everyone goes to college, or needs to.
That said, there are some distortions in the article that I need to point out. First off, a person who reacts badly to this tracking and enforced life schedule is not DISABLED or suffering from any disorder. They are reacting NORMALLY to an abnormal set of expectations, as the author’s original presentation suggests. It’s important to use that kind of language and to avoid “disability” language or we play into the medical model concept that everyone should “adjust” to whatever expectations society throws at them and that anyone who doesn’t is a failure or is “disabled” by definition.
Second, you mention “self-medication” (I HATE that term – it implies again that they are deficient or “disordered”) without mentioning the huge and increasing numbers who are legally drugged by their doctors, and the damage done by such legal drugs is not discussed, but is a very important part of the equation. The use of drugs to delete the negative emotions mentioned in my first paragraph is simply one more way to keep our young people “on track” to do the proper things at the proper times and to avoid any discussion of whether such tracking is healthy or destructive.
Third, and most important, giving counselors more power to “emotionally test” our youth is an EXTREMELY misguided concept! We have already seen that 1) there is no kind of “emotional test” that gives any kind of useful, objective data that would help modify the bizarre expectations of our modern world, and 2) people given this kind of power have been coopted by drug companies into “screening” youth for “disorders” and into routing them to psychiatrists so they can be identified with the proper labels and forced to take the proper drugs, all in the name of keeping them “on track” with the very social expectations you so properly criticize as you open your essay.
The proper thing to do is not to scan for “disabilities,” but to alter the expectation that every kid goes to college and to re-focus our efforts on providing a wide range of options for youth, and to convey an understanding of and compassion for the very real challenges of moving from youth to adulthood in our screwed-up society. There is no simple “test” that can do this – it requires compassionate, caring, supportive human interaction, starting with overtly stating and recognizing that the world they are entering is, in fact, a bizarre one that provokes anxiety in almost all of us who live in it. Honesty goes a lot further than testing in helping kids cope, though of course, the BEST solution would be to work at revising our society in ways that don’t make its participants quite so “crazy” by expecting abnormal things and pretending they are normal.
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I would also challenge the author to define “overdiagnosis” when the ADHD diagnosis is totally subjective. The reason the diagnostic boundaries can expand is because they are simply made up by a committee of psychiatrists who vote on what they should be. There can be no “overdiagnosis” without an objective standard, and lacking one, the whole concept of diagnosis becomes meaningless.
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As for the “paedogogical” effectiveness of stimulants, this is an illusion. Every review of long-term literature on stimulants confirms that there is NO academic or social benefit from long-term stimulant use, including completion of grades, academic test scores, dropout rates, and college enrollment. While I appreciate your description of the many possible causes and alternative approaches for this particular behavioral syndrome, you do your readers a grave disservice not to mention that any academic benefits that may accrue are small and fleeting, according to the Raine study, the MTA study, the Quebec ADHD study, the Oregon State University Medication Effectiveness study, and the Finnish/US comparison study, just to name a few. The very best reason NOT to consider stimulants for your kids is that in the long run, THEY SIMPLY DO NOT WORK, at least not if you care about outcomes beyond reducing adult frustration.
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Getting drunk can sometimes be helpful, especially for anxiety. That doesn’t make it a medical treatment. Sometimes people like what drugs do, sometimes they don’t. Altering the mind and emotions with substances is as old as humanity. Pretending we’re “treating” a “medical condition” is the big issue.
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There has been a frantic (dare I say “manic?”) search for “genetic or chemical predispositions” to “bipolar disorder” and any other “mental illness” you care to name. The success has, to put it mildly, been “disappointing.” The BEST correlation they’ve come up with is about a 15% correlation of people having SOME of a range of about 100 genetic markers being diagnosed with a RANGE of “mental illnesses,” including ADHD, depression, and schizophrenia.
Meanwhile, correlations with early life traumatic events such as abuse and neglect or loss of parental figures, etc., reaches well over 80%. PHYSICAL illnesses are also correlated highly with early childhood traumatic experiences. Epigenetic changes have been proven to occur when people are traumatized, especially in childhood. So 15% AT MOST correlation with genetics, 80+% correlation with environmental trauma, not even considering larger scale social stresses like bad jobs, racism, poverty, etc…. So what exactly makes you believe that “genetic or chemical predispositions” are the main cause of “bipolar disorder?”
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Sounds like she may have been having delusional adverse effects, which either stimulants or SSRIs can cause. The commercials may have provided the material (most commercials are very much anxiety based), but I doubt she’d have had this reaction without the “help” of the drugs. And as usual, the doctor completely discounts the idea that the drugs could be causing this, despite it being on the label and despite this behavior never occurring before the drugs. Wouldn’t you expect to get BETTER with the right treatment, even if you totally buy into the “medical model?” Baffling!
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Sort of ironic that they present this information in a Youtube video…
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Wow, what a surprise! Psychiatric researchers develop a new “wonder drug” but overstate its effectiveness and intentionally hide the large adverse effect profile. THAT’S never happened before…well, except for Benzedrine, Valium, Xanax, older antipsychotics, second generation antipsychotics, SSRIs…
— Steve
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Hmmm…. Could there be a connection…
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This sounds like what therapy should be about. It should be flexible, focused on developing options rather than “reducing symptoms,” and should change based on direct feedback from clients. The therapists should LEARN from the family what is happening, what works, and what doesn’t, rather than following some pre-digested set of “techniques” approved by someone else based on some statistical probabilities about outcomes that may be of no interest to the family involved.
Thanks for the inspiring article. If only this would develop into the standard of care!
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Wow, they seriously think that life conditions might affect a person’s “mental health?” Dude, what a radical concept! Next thing you know, they’ll discover that running into something causes pain in the parts of the body that are impacted! Or that hunger can be alleviated by eating food!
We’re in a bad place when this obvious fact comes as a revelation to the field. What’s sadder is that it will be ignored by the psychiatric mainstream.
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Who would have guessed? Answer: anyone who has any familiarity with the SSRI literature.
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I agree in large part with the author’s assertions. The very fact of being told you have a “chemical imbalance” that you can do nothing about is demoralizing, and it’s far worse if you’ve tried their magic pills and found no improvement, because this suggests that you are DOOMED to permanent depression!
I used to work a crisis line and handled a call where the person was absolutely frantic. She had tried a half a dozen or more drugs over a year or more and had gotten no relief. She was absolutely desperate and terrified that nothing would ever help. I asked her, “Has anyone ever told you that there are other things you can do for depression besides drugs?” She stopped, seeming kind of stunned. “No,” she said. “Well, there are.” I said. “Oh. Well, that’s good,” she said. She was 90% calmer just knowing that she might be able to take some kind of action, without even exploring what action was possible! The idea that she was limited by her “chemical imbalance” and had no power to do anything herself to stop it. The concept is more depressing than anything that might have brought on the depression in the first place!
— Steve
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Interesting fact: there are many, many more (probably hundreds of thousands or even millions) people taking “antidepressants” worldwide, and yet “depression” is worse than ever! Could there be a connection? Hmmmm…..
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I agree 100%. There is proof that our Western society makes people ill. Some group did a study over three generations on health outcomes for immigrants to the USA. At the start, their health outcomes were all over the place, but after the third generation, they had American problems like heart disease, cancer, anxiety and depression in numbers similar to those who had been here many generations. Part of psychiatry’s job is to keep the focus off of “the system” so the rich can get richer and the powerful more powerful. But I fear I am preaching to the choir now!
— Steve
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Too true. However, starving to death tends to have ill effects on one’s mental state, in my experience.
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He doesn’t have a “serious mental illness.” He’s an ASSHOLE. If we’re going to label someone, let’s get it right!
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Oh, Frank, you’re SO naive! Thinking that people having a PURPOSE and a means of supporting themselves will help with their mental/emotional state? I mean, how can ANYONE make money off of that model!
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And psychiatry plays right into this mythology, by insisting that any deviation from being mildly happy all the time is proof of a “neurochemical brain disorder” requiring “treatment.”
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This is what happens when you invent “disorders” based on arbitrary or socially constructed “symptoms.” There is no objective way to “diagnose,” so anyone can decide to move the goalposts. Add in the financial incentives to prescribe, and you have a perfect storm for corruption disguised as “medical treatment.”
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This is a powerful case study and a startling indictment not only of Prozac, but more importantly, of the damage our “label-and-drug” system does to real human beings, minimizing what is important and isolating those suffering from any possibility of real help. What would have happened if people had TALKED to these kids instead of giving them the message that their brains were messed up and that these drugs would somehow magically make everything all better? What kind of message does it send to say that being upset about your grandparents dying in succession is something “normal” people don’t get upset about, or that your problems are all in your brain so don’t bother telling us what you’re thinking because none of it means anything?
Thanks to Peter Breggin for this lucid and disturbing account of the poor impact of this approach and the incredible disconnect between what the news media reports and what is really going on.
—- Steve
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Does anyone have to forbid armchair diagnosis of heart disease or cancer or a broken leg?
This is merely reflective of the negative power of psychiatric “diagnosis” in society at large. People make “armchair diagnoses” all the time, all over TV and movies and in cafes and living rooms around the country. The very subjective and judgmental nature of these labels play into the human desire to lump people into “us” and “them” and to spread blame and hostility toward someone we want to downgrade or humiliate or feel superior to.
While I personally can’t stand Trump due to his immaturity and his deep involvement in corruption, slapping a “diagnosis” on him is simply a childish exercise of acting out against the “bad daddy.” Not only should psychiatrists and psychoanalysts be forbidden from diagnosing public figures, the whole concept of “diagnosis” based on behavior and emotional state should be scrapped, because it serves no real purpose besides stigmatizing and distancing us from those who are so labeled.
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Appalling article. They spend most of the article talking about “depression genes” and “treatment-resistant depression” and the “new breakthroughs” that are “just around the corner,” just as we’ve heard since Benzedrine came to the market back in the 60s. They toss in a few “other things you can do” at the end but they feel like an afterthought. They also comment on the STAR-D study as if there were no methodological issues with it, despite lots of criticism even from the mainstream. No comment section, either. I wonder of one of our respected professionals can write a letter to the editor to complain of the one-sided and disingenuous treatment of the subject?
—- Steve
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Nothing wrong with doing so. But there IS something wrong with calling it “medical treatment” and claiming that the condition is caused by a “chemical imbalance” just so you can make buku bucks off of insurance coverage.
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Why the focus on homeopathy, when so many approved drugs kill so many people? At least homeopathy has next to no adverse effects, while Risperdal can and does kill many people. Where’s the effort to debunk Big Pharma’s scamming? Referring to Thalidomide as the reason Big Pharma isn’t trusted is pretty disingenuous, with Viiox and many other more recent examples to refer to.
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They overlook the obvious reason for the inconsistent findings: THERE IS NO CONSISTENT FINDING TO BE MADE! IN other words, there is no correlation between depression and a particular “aberrant” brain function. This is the clear SCIENTIFIC conclusion when multiple experiments lead to no result. It is only the lack of a scientific intent that allows these experiments to continue to be funded. Any real scientist wouldn’t be blathering on about methodology and statistical issues. If 50% of experiments point to increased activity and 50% point to decreased activity, you have your answer – there is no effect to be measured. Why is that not the conclusion of the study???
— Steve
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I agree. It is only an assumption that we are all chemicals and nothing more. Lots of cultural traditions, indeed almost every cultural tradition, posits that we are more than that. The concept that we are only material is a PHILOSOPHICAL assumption, not a scientific fact. The mind is a mystery that science has not even begun to unravel in the slightest degree.
That being said, the author recognizes that “we” (the entity possessing the mind in charge of the body) can cause things to happen, and that biochemical changes are the response. That’s the most important starting point, regardless of what we believe “mind” to be or how we believe it to be generated. The latter question is one of metaphysics, and I doubt hard science will ever be able to find a concrete answer to it.
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The other problem with this kind of research is that it only establishes probability. Some people with less white matter are not depressed, and some people with more white matter are. Unless EVERY depressed person presents with reduced white matter, there is no possibility of even a high correlational link, let alone a causal one. It’s really an idiotic conclusion to draw when 80-90% of your sample overlaps with “normal.”
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Hi, Jill,
I agree it is likely that SOME depression/anxiety is caused by nutritional problems or inflammation from stress. Is that the cause of ALL depression/anxiety? And might not “treating” the resulting inflammation from stress provide an excuse for society not addressing the many causes of avoidable chronic stress in our modern society?
— Steve
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So not counting the large number of dropouts, . which would no doubt lower the response rate, still half of the users didn’t have a strong response, and 30% barely had a response at all. This also doesn’t include placebo response. This suggests that probably half of the users didn’t benefit even in the short run. Not a very impressive display of effectiveness, was it?
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Since receiving medical care is the third leading cause of death in the USA, I doubt their explanation is legitimate.
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I agree that attachment-based therapies get to the core of what’s going on much more effectively for those with long-term trauma. CBT is favored largely because it avoids such issues, as there is a huge “don’t blame the parents” meme that is central to the biological viewpoint. EMDR I think has sensible components to it, including recognizing that traumatic events are the core of the person’s suffering, and I am guessing it’s much more effective than what most people get as therapy or “case management.” I do agree that the eye-movements and tapping and other stuff seem hokey, and I’m guessing they’re probably somewhat ancillary, but telling a narrative of the events in question is no doubt therapeutic for those with specific traumatic events to process. And let’s face it, most people in “the system” have plenty of traumatic events to process. So if it’s a choice between EMDR and treatment as usual, I’d go for EMDR every time, even though I believe attachment-based therapeutic interventions will have more long-lasting results. The other difficulty with attachment-centered therapies is that the therapist has to have their attachment issues under control, and most therapists do not, and engaging in that kind of approach can do a lot of damage with an unenlightened therapist.
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So more than half are able to discontinue successfully, and are happy with their decisions to do so, despite an almost complete lack of support by professionals. If half of your cohort can discontinue and are happy with the results, why the f*&k would you not be encouraging folks to try it? Kickbacks or meeting one’s own security needs at the expense of the client seem the only reasonable explanations.
—- Steve
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A Science Court for psychiatry would have to be staffed by totally disinterested citizens. Best to select people from totally different professional backgrounds, like a sociologist or ecologist or computer scientist, and an equal number of consumers, selected by random or from consumer-based (NOT parent-based) support organizations. No psychiatrists or psychologists allowed!
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Obstetrics is an area with similar ignoring of evidence in order to maintain the status quo. The national Caesarian rate is around 30% or higher and no one bats an eyelash, while midwives have as good or better of a safety record with rates under 10%.
Another great example is Semmelweis. He introduced handwashing into labor and delivery wards and reduced the childbed fever rates from very high to almost nothing. He was fired because the doctors were insulted he thought their hands were dirty, and his successor eliminated the practice and rates soared again, sending Semmelweis to the mental ward with frustration.
Freud himself was intimidated away from his original finding that many adult women had been sexually molested, and completely changed his “trauma theory” and developed the “drive theory” in order to accommodate the community’s need not to admit what was going on. A hundred years later, it was shown that his observations were absolutely correct, but psychiatry remains committed not to look at abuse and trauma as the main cause of “mental disorders.” Not much money in trauma, I guess.
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Wow, you’re SUCH a radical!
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True dat! I also rarely see the disheartening social and political consequences of our current “system” identified as contributing factors. Interestingly, these factors also massively contribute to the food-based environmental issues to which you so rightly refer.
—- Steve
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What a novel recommendation! Sheesh…
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As long as they depend on drug companies for their campaign funds, you’re right. That’s why campaign finance reform, in the form of banning ALL corporate contributions to candidates, is the issue of our age.
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In other words, when people experience scary things, they get scared. Big surprise here. But wait, I thought it was all biological? Perhaps we’re supposed to be totally bland about terrorist attacks and not react at all?
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Thanks for telling a great story so effectively! It sounds like the last therapist you saw was the only one who got what was going on. It kind of sounds like your need to go along with what others were suggesting was a big part of your struggle, but “the system” saw that compliance as the ultimate in good patient behavior. Does that sound right? I say this as a person who worked years to overcome my need to keep everyone but me happy. I was very fortunate to strike gold on my first therapist, but this was back in the 80s before the DSM was in place. It was particularly disheartening to hear how much time they spent trying to figure out which DSM box you should be fit into and so little time actually listening to your view of things. It seems they actually did the exact OPPOSITE of what you really needed, and it predictably made things worse.
Thanks again for sharing your story. It’s very important for people in similar situations to see that there really IS a way out, but that finding the right label is not part of the path to a better life.
—- Steve
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Too true. I am familiar with some of Connors’ work and can attest that the “objective” screening tools he developed are totally based on teacher and parent ratings of children’s behavior as it affected them or their classrooms, and zero consideration was given to family stress or personal trauma history. You do the checklist, the kid gets a score, and no one ever even talks to the kid to find out why they might be acting the way they are. It’s a joke.
I’m glad he came to the conclusions he did toward the end of his life, but it’s telling that neither he nor many like Allen Frances who decry the “over-diagnosis” of this or that “disorder” appear to understand that the “diagnostic” process itself leads to this result inevitably. As soon as you have a subjective element in diagnosis, especially when it involves people in a relationship with a significant power differential, the victims of abuse and neglect will be subjected to ever-increasing criticism in the form of “diagnosis” of anything they do that is inconvenient or uncomfortable. Allowing subjective “diagnosis” based on the opinions of parents or professionals opens the door wide to blaming the powerless victims of their irresponsible behavior, and given the opportunity, I’d say the majority of adults in the power-up situation are only to happy to open that door the moment a crack of light shows a possibility of passing through.
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I agree. I can only speculate that mania may be harder for the person him/herself to notice, as it doesn’t necessarily feel bad to the person experiencing it at the time it’s occurring. I also wonder what kind of questions they asked – if they were very open ended, a person might report, say, agitation and feelings of restlessness and loss of sleep and suicidal thoughts, but not put them all together and call it “mania.” We know mania is a reasonably common reaction, and it is puzzling that it doesn’t appear in the manuscript.
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There is no drug war against the recipients of ANY of these drugs. The war (if that is the right term) is against the PURVEYORS OF LIES who pretend that these drugs aren’t addictive or that they have no adverse effects or that anxiety is “treated” by giving these drugs over the long term. Informed consent merely gives people like you the information needed to decide if you want to or don’t want to use them. There is no hostility intended toward the users of these substances.
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Great comment, Erin!!! This is the “secret” of “mental health!”
—- Steve
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These contributions should not be disclosed, they should be BANNED!
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The basic problem starts from treating “symptoms” as “disorders.” Giving up on the idea that we can “treat” an emotional condition without figuring out what’s behind it, whether mental, physical, or spiritual, would be a great first step toward a rational approach. I guess this is better in that it at least doesn’t denigrate the person with the “symptoms,” but you’d think the lack of results for “causes” would lead an intelligent person to abandon the labeling process that gave us “disorders” that don’t have unitary or even similar causes.
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Missing the #1 reason these evaluations are unreliable – they are relying on subjective “diagnoses” and sketchy “objective” tests that aren’t the least bit objective, because they’re “measuring” things like risk of violence that are not actually measurable in any real sense. Admitting this will help us realize that the courtroom is a place of moral judgment, not medical, except as far as medical expertise can objectively shed light on guilt or innocence. As such, psychological/psychiatric pseudo-experts should not be considered to provide valid testimony, and the judge should consider the case on more objective facts. For instance, instead of testimony on whether someone is “mentally ill,” why not hear testimony from people who know the person in question as to his/her volatility/violence potential in their direct observation? A person’s actions are a much better predictor of their future actions than some “expert” who barely knows the person and tosses a few Mickey-Mouse “tests” at them.
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This is not news. Already a black box warning on the label. Yet the thoughtless deaths continue to climb.
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No one is suggesting that people don’t act the way BPD and others are described in the DSM. We’re only saying that it’s a DESCRIPTION, not a DIAGNOSIS. The “diagnosis” (though I don’t think that’s the right word at all) for most BPD people should really be childhood abuse and neglect, because it’s present in almost all cases. This way, we’re looking at actual causes instead of blaming victims. Saying someone “has BPD” places the problem within the person who was abused, and lets the parents and/or cultural institutions and/or other perpetrators off the hook for their destructive behavior.
You say that people with these “disorders” come for help. So I guess there are two questions: one, is it really OK to “diagnose” a person with a “disorder” that is simply an observation of how someone acts and has no connection to any kind of objective physical cause or measurement, just because it allows them to get insurance reimbursement? And two, is “diagnosing” someone with BPD actually helpful TO THE PERSON who is diagnosed?
I think on the latter, the concerns are pretty obvious. As a person who has worked in the field, I can tell you that people with a BPD diagnosis are commonly feared and even reviled by mental health “professionals” in the system. People find their behavior frustrating, and the label BPD allows them to blame the client for his/her frustrating behavior and allows clinicians to act out their anger punitively with the support of their fellow professionals while denying any kind of real connection or empathy with the client. It also often disqualifies a person for therapeutic support, since “BPD” is considered by some to be “untreatable.” So I think the answer to the second question is a resounding NO in most cases.
As to the first, I again ask you if it makes sense to “diagnose” someone with a description? To get more concrete, would it make sense to diagnose someone with “a rash” and leave it at that? A rash is an indication that something might be wrong and that further investigation into causes is needed. If we diagnosed a rash like we do BPD, we’d give everyone topical steroids. It would work for some cases, would do nothing in others, and make it worse in yet other cases. Some cases would really be caused by poison ivy, others by measles, others by syphilis. The ones with poison ivy would resolve better with the steroids, the measles would be unaffected. The syphilis rash would go away, too, but the person would later die an excruciating death as the bacteria ate up his/her brain. We’d say that the syphilitic person was “treatment resistant,” and no one would ever suspect that the problem was with the diagnosis itself, or rather the pretension of diagnosis that prevents actual diagnosis from ever happening.
It would be a lot easier for people to be “diagnosed” with “Badly mistreated by parents and learned coping measures that are ineffective in current life” than “BPD.” They could still get help without someone blaming and denigrating them for having what is a very common reaction to very poor conditions in early life.
Hope that clears things up a bit!
—- Steve
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Disclosures are very close to meaningless. What we need is a prohibition on conflicts of interests, not disclosures of conflicts of interest. Disclosed or not, the conflict still drives the research, and that’s simply not science any more.
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Again, not suggesting that the suffering of the privileged isn’t miserable. The point is only that the privileged have more options as to how to escape or mitigate the effects. Trauma is trauma, and no one is immune, regardless of privilege.
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What a great treatise on the realities of privilege! Privileged people DO get abused and otherwise traumatized, but they have many more opportunities to have alternative outcomes, because they have funds, more connections to other privileged people, more sympathy, better educations, and so on. I have compassion for all folks who have been traumatized, but it is very important for privileged folks (like me) to recognize that trauma for those less privileged are more constant, more systematic, less avoidable, and less recoverable. Reducing poverty is probably the #1 way to reduce what is so laughably called “mental disorders” by our cold and unforgiving system.
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So in other words, these people aren’t “disordered,” they have adapted to the environmental needs of their upbringings. So why do we keep focusing on them as problems, instead of seeing the poor environmental conditions as the problem?
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True enough. And it happened under Democrats and under Republicans. When push comes to shove, they all hang together to support corporate power over human rights, and the further from US soil you get, the less we give a crap about the human rights of the citizens involved.
As to Sanders, one of the great things about him is that he IS open to being educated about things he is not fully informed of. If there is one politician who might be able to be influenced to take a stand contrary to Big Pharma, Bernie is that guy.
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Wow, that was an awesome comment! Could not have said it better myself!
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Why is it that doctors have “mental health issues” “due to the unrelenting pressure, inhumane working hours, brutal competition, and workplace bullying that is commonplace in the field of medicine,” whereas the rest of the world is suffering from chemical imbalances?
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I wish I did! We could perhaps start by supporting efforts to end corporate contributions to political campaigns, shorten those campaigns, and massively reduce the cost of running for office. Physician groups have already come out against DTC advertising – perhaps that’s a good place to start? I suppose another goal might be to make it so that lobbying expenses can’t be taken off on a corporation’s taxes, but I’m guessing we’d get ENORMOUS resistance to that kind of idea!
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This sounds kind of sketchy. How do they explain that other reviews showed different results? How did they select their participants? What did they measure? Who paid for this study?
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I like the focus on finding points of agreement, Gary, and I found the points you mentioned excellent. I believe you are, however, missing one of the most, if not THE most important one. Financial corruption! I think we can get strong agreement that pharmaceutical companies purchasing influence in various ways, including sponsoring “educational” seminars promoting their products, ghostwriting articles, and engaging in DTC advertising and promotion to doctors which massively impacts prescribing habits and research priorities, is an evil that needs to be eliminated in the service of accomplishing any of the other goals you mention. Corporate malfeasance is also an area where many who occupy different ends of the left-right political spectrum can find solid agreement.
Thanks for a timely article!
— Steve
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Fired by whom? There is obviously a story under here…
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It is truly a religious system. The doctors are the holy priests, and people go to them for magical cures. They even have holy vestments. Nurses could be considered “vestal virgins” of a sort. The Holy Scriptures, in psychiatrists’ case, are the pages of the DSM, which ironically enough is often called the “psychiatrists’ Bible.” Doctors are the priests of Scientism, the belief that Science will provide us with Ultimate Truth. Hence, doctors are believed regardless of the sense of anything they say, and those who speak ill of them are considered apostate or heathen. Real science often inconveniently undercuts many Scientist dogma, but that doesn’t seem to bother the True Believers. Hence, we have electronic fetal monitoring as a standard of care (increases Caesarian rates massively with actual reduction in outcomes), cholesterol drugs massively prescribed with little to no improvement in outcomes, and of course, the entire field of psychiatry, whose clients are sicker and die younger than those who manage to escape their notice.
It is very hard to undercut basic mythology in any society.
— Steve
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Once again, the intervention is wrong-headed – it is focused on trying to stop self-harming behaviors instead of trying to figure out why they’re happening and addressing the underlying causes. The first thing I learned as a counselor about self-harming behaviors (and I learned this from the clients, not any training I had) was that self-harming behaviors served a purpose, and understanding the purpose was the key to moving forward, regardless of whether the person continued to self-harm or not. The very concept of hospitalizing someone for self-harming (non-suicidal) behavior is stupid in the extreme. Most self-harming behavior is not intended to be lethal or anything close to it, but “professionals” end up punishing the coping measure instead of looking for what the client is coping with. When I worked a crisis line for 3 1/2 years, we had many cutters call us instead of their therapists, because they knew telling their therapists meant either shaming of them (you know you’re not supposed to do that) or being sent to the hospital. As long as we’re studying how to “stop self-harming behaviors,” we will continue to create “interventions” that do more harm than good.
—- Steve
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The DID phenomenon does happen in males.
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Well, your fear seems rational to me. I’m sorry no form of therapy has seemed helpful, either. It sounds from your story that your early life experiences lie at the core of your distress most likely. There is no drug for that.
Two things you didn’t mention that some people have found helpful: 1) support groups of people who have had similar past experiences, and 2) mindfulness/meditation. Now I know the latter has been commodified and mutated so as to remove any spiritual significance, and I know that some support groups have been coopted by the authorities and are no longer worth going. But if you find something through a YWCA or a women’s program, you can probably find a support group for survivors of childhood abuse, and there are plenty of genuine meditation practitioners out there who have no association with the so-called “mental health” system. I’ve personally used meditation practices to handle high-anxiety situations with lots of success. Of course, nothing works for everyone, and you have to find your own path, but both of those I’ve seen work for many people.
I’m so sorry you’ve gone through such horrors! It sounds like almost every authority figure you’ve ever known has betrayed you. I hope you are able to find some comfort and support from others like you, because your suffering is by no means unusual, though your particular experiences may be unique. It’s a crappy world sometimes, and we have to be careful whom we trust, but there ARE trustable people out there. Just not a lot in the places we’re told to look.
—- Steve
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I agree. However, these syndromes should be called syndromes, not “disorders.” And the explanations given for them claim that they are something a lot more than syndromes. Clients are frequently told that they “have a chemical imbalance” or “their brain doesn’t work quite right” or “I know you want to pay attention, but your brain won’t let you” or “mental illness is a neurobiological disorder of the brain.” I could riff off half a dozen more “explanations” that are simply lies, given out of ignorance or malfeasance, it doesn’t matter. I have no objection to people using shortcut terms to communicate, but syndromes are syndromes, and when they’re treated as if they are something else, you get idiocy and destruction as a result.
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Not to mention doctors doing a RIDICULOUS number of Caesarian sections in the first place – over 30% of babies in the USA are delivered by Caesarian. WHO recommendations say no more than 15%, which I think is very high. Midwifes often sport figures like 2-5%. US Obstetrics is almost as irrational as US psychiatry.
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The video is an anecdote. It’s one story about one person. We should never make decisions based solely on personal anecdotes. We should look at hard data gathered from many people over time. And the data says that people exposed to electric shocks to their brains have brain damage, lose important memories, sometimes feel despairing and hopeless, and lose whatever “benefits” they gain within days or weeks of the “treatment.” I would never use ECT even if I thought I had no other options.
What else have you tried before?
— Steve
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I have no problem with diagnosis as a means of getting insurance reimbursement. When I had to do psych diagnosis, I told the clients exactly what the diagnosis meant – essentially a description of what seemed to be happening on the outside, chosen for the purpose of getting the insurance company to pay for the needed services. I assured them that I was not in the least concerned with this label, which had to do with payment, and was very much more interested in what the client has to say about what’s going on, when it started, when it stops, what THEY thought it was related to, what has helped in the past, what has made it worse, etc.
As for psychometrics, sure, you can give someone the HAM-D and count up points and some will have higher scores than others, but what does it mean? I never, ever bothered with such silly nonsense, but instead simply asked the person the kind of questions that might be on such a questionnaire in the context of a normal conversation. As to whether they improved or not, well, they were of course the best and in many ways the only way to make that determination. I feel the same way about IQ tests (somewhat more reliable, but still, what the heck are you really measuring?) and any other psychometric tests. They are mostly very unscientific, because they measure undefined and undefinable entities. To compare a HAM-D scale score to a blood sugar measurement is absurd. One measures a physically determinable quantity. The other “measures” a concept. Measuring depression is as ridiculous as measuring courage or shyness or integrity. They are not measurable entities – they are social constructs that have meaning that varies widely based on both the reporter and the “measurer,” and can’t ever be standardized. They can be “normed,” but of course, “norming” makes the assumption that the average of scores on a questionnaire establish how things ought to be. There is no objective norm possible.
Diabetes is of course BASED on signs and symptoms, but it is not itself a SIGN or SYMPTOM – it is a concept or model that EXPLAINS why low blood sugar and other signs and symptoms are happening, and PREDICTS with some accuracy what kind of intervention will help. As I outlined very clearly above, an “ADHD” diagnosis does neither of these things – it provides no explanation as to cause, nor does it accurately predict what will help, because of course the same thing will not help all members of an utterly heterogeneous group. So what’s the point of saying someone “has ADHD” when it tells you neither the cause nor the treatment for the “disorder?”
As for psychiatrists, I defy you to name where I said they were all evil bastards. I believe there ARE some evil bastards at the higher levels of the hierarchy, and a smattering of evil bastards lower in the ranks, but most are simply grossly misinformed, and are committed (as you appear to be) to believing in these subjective and misleading categories of “disorders” which don’t serve them or their clients well.
I could go on all night, but I’ll stop here. You’re simply stating things without addressing my clearly expressed concerns with the system. You admit that psych diagnosis creates heterogeneous categories, and yet still feel the diabetes-insulin analogy is appropriate? It’s very hard to fathom how an obviously bright person as you appear to be can’t see how very different answering a questionnaire is from having one’s blood sugar measured. I’ll leave it at that.
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The difference between your diabetes example and psych diagnosis is that at least for diabetes, there is a MEASUREMENT of something that is out of range, even if the range is arbitrary, and treatment can be gauged by whether the measurement moves in the right direction. The “measurements” for psych diagnoses are completely invented based solely on social/behavioral criteria. There is no actual measurement of something “out of balance,” nor is there any way to determine if the situation has been corrected, as there is zero attempt to discover or differentiate cause. Hence, totally heterogeneous groups are lumped together. To take ADHD as an example, a kid could meet the criteria due to low iron, sleep apnea, poor parenting at home, poor classroom structure or a rigid teacher, understandable boredom, prior or ongoing trauma, or lack of sleep, to name only a few. The range of potential solutions for diabetes is pretty narrow – improve diet and exercise, or alter insulin levels in some way. The range of potential solutions for ADHD is huge and totally variable depending on the situation. If you alter the diet of a kid whose mom is being beaten up, it will have little to no impact. If you assign parenting instruction for a kid whose teacher is a poor classroom manager or who bores the kids to tears, it’s not going to help. So calling “ADHD” a diagnosis isn’t just unhelpful, it’s destructive. It is like saying that a “rash” is a diagnosis. A rash can be caused by poison ivy, measles, or syphilis. You MIGHT want to know which is which before you start treatment, eh? A rash is not a diagnosis, it’s a sign. ADHD is not a diagnosis. It’s a sign that needs to be interpreted.
— Steve
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The prevalence of ODD is estimated between 2 and 16%? Any scientist would be filled with shame at such a massive range for a prevalence estimate! It’s like saying your IQ is between 100 and 110 with 45% accuracy. An 8x variance in prevalence might as well be admitting that you don’t know what you’re talking about or are just plain making it up from whole cloth. Which pretty much describes the DSM.
— Steve
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I agree, I always think of some guy walking down the street and suddenly his head explodes and splatters guts all over the walls!
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Sorry, duplicate comment.
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While I agree that attributing all early deaths to psychiatry is factually incorrect, still, psychiatry is the profession who has chosen to group clients in this way and the comparison between the labeled and unlabeled is their comparison. We would expect those labeled with heart disease and treated to do better than those with heart problems who receive no treatment. The opposite appears to be the case. I believe THAT is the point we need to hammer away at. I don’t want to spend a lot of time talking about the “other reasons” that this cohort dies earlier, because, as I have said, it is impossible to sort out that complex of a causal structure. HOWEVER, when we compare those receiving to not receiving “treatment” who have been so grouped by psychiatrists themselves, the “treated” group dies earlier, among a host of other problems that ensue. That point is factual and undeniable, and is more important than trying to figure out what percentage of people who took “atypicals” and developed diabetes would have developed diabetes anyway without the drug. I hope that makes sense to you and others on this thread. The idea that “not all of these deaths are caused by psychiatry” is a distracting straw-man argument. Obviously, they are not ALL caused by psychiatry, but the statistics tell us clearly that psychiatrists are killing a large number of their own patients.
Perhaps you can propose some language that takes the admitted uncertainty into account, and yet doesn’t give psychiatry an “out” for their failures?
— Steve
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Right. The difference is in science, when your “opponent” wins, you acknowledge it and thank him/her for furthering your understanding of science. Science is not about BEING right, it’s about GETTING IT right. Anything else is propaganda and politics.
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If you’re offended, please stop reading and unsubscribe to any posts you’re subscribed to. Sounds like we’ll all be happier if you do. Deleting your account is not necessary.
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A computer could literally do a better job. At least it would be consistent and not influenced by drug company inducements, and could be programmed to actually tell you about the potential side effects and alternative options. Most psychiatrists seem to provide negative “added value” to the process.
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Actually, that would not be sufficient to diagnose a brain disease. It would diagnose a brain INJURY, but the “disease model” suggests that addicts are somehow different from “normal” people and that their addiction is a result of these biological differences. So in order to demonstrate a “brain disease,” they’d have to show that “normal” people can somehow be distinguished from “potential addicts” BEFORE exposure to the drugs, and that “normal” people do not develop the same brain injuries upon use. My guess is that most anyone using these drugs would accumulate the same incremental brain damage, and that addicts and non-addicts are not distinguishable before this damage occurs. I would surmise that the main difference between addicts and non-addicts is that the addicts gain something from the drug use that seems important to them, whether physiological, psychological or social, and that non-addicts are not seeking that same kind of relief or experience.
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Of course they can’t.
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So, Ron, how would we distinguish between the lives they are responsible for ending early that those they are not? I agree it’s unwise to overstate the case, but I find no reasonable way to determine what percentage of the 25 year earlier death rate is caused by psychiatrists. For instance, if someone on Risperdal dies of heart disease, would they have died on their own without Risperdal? If so, would they have died later without it? Did Risperdal contribute to the person’s decision to smoke, as smoking is often reported as being a means of reducing the side effects of antipsychotics? Is the person’s decision to smoke their decision, or is it a consequence of antipsychotics? If the person dies earlier due to smoking, is psychiatry in any way responsible?
I find it much simpler to frame it this way: receiving treatment should improve the quality of life for the person receiving the treatment. If the person’s quality of life is reduced instead, including increasing health issues which create impairments and sometimes even death, it doesn’t really matter what percentage is whose responsibility – the “treatment” is making the patients worse on the average, and killing some of them early. I suppose it is possible to acknowledge that other factors are also involved, but this, of course, provides an “out” for psychiatry – they can claim that this death was caused by smoking and that one by suicide and the other by diabetes, without ever taking the slightest responsibility.
I’d be very interested in hearing how you would approach this dilemma.
I would also submit that whatever we say, the psychiatric “thought leaders” will ALWAYS paint anyone who doesn’t 100% agree with their dogma as an irrational extremist. It is an unavoidable side effect of trying to pull the pigs’ snouts out of the trough.
Sorry, that was probably insulting to pigs…
— Steve
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I also suspect that non-white families are more likely to distrust the “standard of care” and to stop at the first sign that things aren’t working well for their kids. There is an advantage to not trusting the medical system, especially when psychiatry is involved!
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One of the fundamental core principles of science is skepticism. You’re always supposed to look for evidence to DISPROVE your hypothesis, and only when vigorous efforts to disprove it fail is it considered true. You aren’t supposed to try and skew the data to prove the hypothesis you want to be true! Something is scientifically true only if it is THE BEST hypothesis among all possible hypotheses. You don’t get to pick your favorite!
— Steve
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You don’t have to read or post, Pat. You’ve already said you’re leaving like three times. Is there something in this article that throws you over the edge? You do realize, don’t you, that there is no evidence that any of the SSRIs work with kids under 12, and the one study showing only Prozac working with teens was considered badly flawed? Does this not concern you?
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Pat, I actually agree with your post. My only complaint about you is when you create conflict for no reason. Sharing your own experiences is great, as is making suggestions as to how people can come together, which you did above. I happen to agree that a synthesis would be the best solution. The only problem is that some folks are making so much money that coming together to build consensus will most likely never happen.
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The recommendations include SSRIs for kids, when SSRIs have never been shown to be effective for kids (even by psychiatry’s weak and biased “evidence” base), and when SSRIs increase the suicide rate for kids. Brilliant.
— Steve
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WE means those of us who are committed to the truth rather than dominance of the current elite.
Another example: US outcomes for “ADHD”-diagnosed kids vs. Finland, where drugs are rarely used. No difference in outcomes. Stimulants do nothing to affect outcomes, and this study provides more proof that is the case.
The real question is how to get this actual DATA through the screen of BS that those wishing to dominate the world are able to put out there as propaganda. When you figure that one out, let me know!
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You may be mistaking political multiculturalism for attending to scientific variables. The latter has no agenda except for truth, otherwise, it’s politics, not research. The WHO study was actually very important in this whole movement we’re involved in. They were hoping it would show that those poor, underprivileged countries would benefit from our benevolent drugging paradigm, but in fact, the opposite was proven to be true. They were so incredulous they forced the WHO to repeat the experiment, which had exactly the same results. It was one of Bob Whitaker’s “aha” studies that prompted him to write “Mad in America” in the first place.
The problem isn’t honest multicultural scientific studies. The problem is when fake science becomes the mute handmaid of politics. Real science is our friend, and showing that psychiatry’s cultish practices don’t work is easier, I think, the further away from Western society we look.
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I don’t know, Cat, I think it’s totally legit to question research that doesn’t include cultural variables. What about those WHO studies showing that third-world countries had much better “schizophrenia” recovery rates than in the US/UK? I am against globalization as a manifestation of corporate dominance but in the context of science, I think it makes sense to realize that what “works” from a Western viewpoint won’t necessarily be seen as “working” by people from a different culture.
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Arrogance and stupidity are certainly dangerous partners. A stupid person who is humble enough to know he is ignorant and seeks enlightenment can get better. An arrogant person who knows his or her business and gets good results is perhaps worth tolerating. But to be both arrogant and ignorant or stupid together is unforgivable, and that’s unfortunately a good description of the average psychiatrist, in my experience.
Of course, there is also the arrogance of knowing you’re doing evil and profiting from it, and continuing because you just don’t give a crap, and that’s the worst of the three.
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Pat, there’s a difference between your psychiatrist and psychiatry as a profession. The conflicts that you keep bringing up and even creating seem to be related to this confusion. You have had your own experience and no one is entitled to invalidate that experience, and no one is trying to. However, you can’t extrapolate from your experience to all experiences, because then you are invalidating others who have had very different experiences than you. When someone has a different experience, it’s your job to listen, just like it’s my job to listen to your experience. That’s how this works. If you have a comment on the article that comes from your own experience, that’s totally your right. It’s just not your right to say that those who want to abolish psychiatry because of their own crappy experiences or their own research are not entitled to their own conclusions. Please feel free to communicate any DATA that you have that might refute the article, or please feel free to give your own personal ANALYSIS of the data that is presented, but it’s just not OK to keep accusing people of being horrible because they don’t agree with you. This is a free country. People are entitled to draw their own conclusions about psychiatry. If you want to have that freedom yourself, you need to grant it to others. Otherwise, you will get into endless arguments and accomplish nothing but annoying yourself and others.
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More arrogant than stupid. Unwilling to look at actual data or actual PEOPLE in front of them. More interested in being right than getting it right. The field breeds narcissism.
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The other thing is, even if a dietary change helps only a little, it starts the person down the path of realizing that THEY THEMSELVES CAN CHANGE THEIR CONDITION! The very worst thing about the current psychiatric model is not the drugs – it is the nihilistic message that you have no control over your own brain, mood, thoughts, and behavior. It is the exact opposite of what actually helps people. So if they find that reducing copper improves their behavior, even if it’s still not great, the psychiatric message is broken – they realize they CAN do something about it, and perhaps even realize that the psychiatrist they were trusting has no idea what s/he is talking about.
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Angry is up the scale from depressed. I had to go through a very angry period before I came out the other side and started feeling rational. I think anger means you’re getting in touch with how YOU have been mistreated, instead of blaming yourself. Because depressed people mind their own business and don’t bother anyone, but angry people DO things – they FIGHT! I’d say respect that anger and see if you can use that energy to take action, as we talked about before. And too bad for them if they don’t like the “new you.” They have contributed to that anger and it’s about time they saw the real results of their behavior. That’s my take, anyway.
— Steve
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Oh, they don’t want to annihilate them, they want to keep them weak and dependent so they can bilk insurance companies out of billions without having to look for new customers. They don’t MIND if they annihilate its victims, but only after they’ve squeezed them for a bunch of pharma dollars first.
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I’d be desperate, too! What amazes me is that someone with an obvious historical and ongoing trauma background is drugged because of “brain chemistry problems.” WTF – did they think you’re supposed to be HAPPY about all this? It’s total victim blaming to me, and I’ve seen it a LOT.
I think waiting to taper the Effexor makes a lot of sense. That’s another principle I try to apply – one thing at a time. Depression is also a reaction to being overwhelmed – kind of like “playing dead” when you can’t fight off an attack. It seems like getting clear from your parents’ influence has to be the priority. You’re like a Viet Nam vet with an apartment under the helicopter pad across from the gun range!
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OK, so it sounds like you’d like to get away from your parents, but feel you can’t afford it. Is that the basic problem? It sounds like they are the ones making you nuts or reinforcing your upsetness.
What would you like things to look like if you were moved away? See if you can visualize what it would look like if things were better.
$733 a month isn’t much to start with. Where do you live? Are there housing agencies near you? Would you qualify under some other category for extra assistance – for instance, if you’re a domestic abuse survivor, there are funds that are specifically available to help AND specific housing resources reserved for that kind of problem.
To really help, I’d need to know the resources in your area. I am sure there are many others who have suffered similar problems and found a way – I’m sure you can find something. But I know it’s really tough moving forward with all of the withdrawal effects, too! So maybe the first step is accepting that you’ll be there a while, and that your parents will be kind of jerky, and to make a plan of how you can respond that will minimally sap your energy? My wife came up with a plan to simply acknowledge the possibility that her mom was right about things – “That’s a good point.” “I can see how you might be worried about that.” “You’re right, life can certainly be dangerous at times.” Never actually agreed to DO anything her mom suggested, but it stopped the arguments when she seemed to agree. That’s just one approach. Sometimes you have to be creative, but that in itself can start to be almost fun if you take the right attitude – namely, this is a problem and I’m going to try different approaches and see what works, meanwhile not bothering to explain how I feel or try to alter their behavior one iota.
The other thought for immediate improvement is instead of hiding in your room, to get outside, preferably to a wooded or grassy area where there aren’t too many people around. I find walking to be very rehabilitating, and sometimes I walk around and touch the trees and plants and say hello to the insects and birds and just get in touch with present-time reality. The further away you are from your parents, the easier it will be to relax and think straight, at least that’s what I’m guessing from what you shared so far. My guess is that they have been a big part of how you ended up being drugged in the first place. My parents were both really nice people, but they still contributed big time to me being fucked up as an adult. In some ways, I understand they did the best they could, but it was NOT good enough and they caused a lot of pain for us. Dealing with that was the MOST important thing I did to regain my emotional balance, but I had to not be living with them to do it. You can’t move away now, but you don’t have to spend all your time in that house.
Don’t know if any of that is helpful at all – just kind of sharing what’s worked for me. Another path that can be helpful for some is to find a support group of adults dealing with childhood issues. It can help to tell your story and sometimes you can make friends or at least have colleagues who share your pain. Doesn’t work for everyone, but just thought I’d toss it out there.
Bottom line, you can’t change how other people act. The only thing you completely control is your attitude toward their behavior. Not saying it’s easy, because it isn’t, but any small step you can take away from being under their control and observation will be a step toward becoming healthier and more capable and less depressed and hopeless.
Hope that helps a little!
—- Steve
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I think job one is realizing that depression is a normal reaction of the body/mind to being in a place and time that isn’t working for you. It sounds like you recognize this yourself. What is it that you would like to be different about your life? What seems to be in the way of making that happen, internal or external? That’s pretty much how I worked with most of the clients I had, and I was very successful in helping them. Another aspect of depression is that it is generally engaged when we feel there is nothing we can do to alter the situation. It’s a self-defense mechanism so we don’t waste energy in a hopeless situation. But there are almost always things we CAN control that we often take for granted or fail to recognize as options. If you can start finding where you want to go, and find things you DO control that can lead you even slightly in the direction you’ve identified, you’ll start feeling a little better. It’s a lot harder than taking drugs and it takes longer and sometimes it’s scary because we have to do things we don’t want to do, but the solution ultimately takes us to a new place and we learn things that help us solve future problems.
I’ve suffered a lot of depression in my life, but rarely do today. It’s been a long, long road but I’ve stayed on it and it’s led to a better place.
Hang in there!
— Steve
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I think this is a very wise post. Us vs. Them is the oldest meme in human history. We have to find ways to let the person who disagrees know it’s OK to disagree, and to listen to WHY they believe what they do. It is also almost axiomatic that a person being defensive about something is ambivalent, or they wouldn’t have to be so emotional – they’d just be kind of incredulous or scoff but they don’t get upset about it if there isn’t some uncertainty there, usually a LOT of uncertainty. Helping the person locate the pro vs. con in him/herself can enable them not to project the con onto you as the “enemy.”
Thanks for your wisdom!
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And the DSM admits it’s not powered up to designate causes, but it’s used as if it is. Most of the folks I know who went to psychiatrists (and I worked 20 years with foster kids, so I have known A LOT!) say that the psychiatrist told them they have an imbalance of brain chemicals that causes their difficulties. It is not the beginning of an investigation – it is THE END.
Again, there is no point to “diagnosing” someone with something where those with multiple causes are lumped together based on external observation alone. It only adds confusion. Syphilis is a diagnosis. A rash is a sign. If ADHD is the start of investigation, it’s a sign, not a diagnosis, just like a rash.
—- Steve
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I know of at least three different studies from different locations – one in Kentucky, one in Canada, and I can’t recall the third. All found the same result. I think there were even a couple more that someone else talked about, but I didn’t read them. They looked at kids just before the age cutoff for admission and those who were just after the age cutoff, and so started almost a year later. All three reported something around 30-33% reductions in diagnosis rate.
Some related links from a one-time google:
http://www.inquisitr.com/2512234/delayed-kindergarten-enrollment-reduces-adhd-in-children/
http://www.medicalnewstoday.com/articles/307678.php
Looks like Australia is the third:
http://www.metronews.ca/life/health/2017/01/23/youngest-kids-more-likely-to-be-medicated-for-adhd-study.html
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Too true. Good experiments in the 70s showed that “ADHD” kids are indistinguishable from “normal” kids in an open classroom setting. Too bad we don’t care enough to create them. We actually helped create a charter school for our kids that allowed for lots of free movement, interage classrooms, signing up for desired classes instead of just assigning kids to teachers, democratic classroom rules, etc. Our youngest, who would TOTALLY have qualified as “ADHD” in Kindergarten (his nickname was “Wild Boy!”), had no behavioral difficulties whatsoever and graduated with honors. I’m just sorry that most kids never get that chance.
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I commented this on another thread, but I always wonder how many “assaults” on staff are actually assaults on the “patients” who then retaliated or defended themselves? Nutrition is important, but traumatization and oppression are the big drivers of violence and “mental illness.” Hell, oppression is the big driver of crappy nutrition, too!
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I’d be very interested in hearing about these anomalies. What’s your theory?
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I think the problem is that while the behaviors so labeled do exist, there is no reason at all to believe that all people so labeled have anything wrong with them at all, or have the same problem if they do have something wrong. The DSM itself admits this in its introduction, saying that, it is not assumed “that all people having the same diagnosis are alike in all important ways.” So what’s the point of labeling something based solely on external observations when the group so labeled is completely heterogeneous? It’s like saying that everyone with a skin rash has the same problem. Some of them have poison ivy, some have prickly heat, some have the measles, some have syphilis. Might be a good idea to figure out which one the person has before you start treatment, eh?
Not to mention, a lot of kids labeled “ADHD” have nothing wrong with them at all. A number of studies have replicated the finding that admitting a child to school one year later reduces the “ADHD” diagnosis rate by 30% or more! So while there may be a small number of “ADHD”-diagnosed kids and adults who actually have something biologically wrong with them, there is no way to distinguish these from those kids who are simply bored or who have a naturally active personality and don’t like to sit still or who don’t get enough sleep at night or who have low iron or whose parents are violent or whose parents are neglectful or lack parenting skills. Calling all such cases “ADHD” simply creates confusion and prevents us looking into what might really be causing these subjective “symptoms.”
— Steve
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And smokers being allowed two or three smoke breaks a day. And other inmates being strapped down to tables in locked rooms. And, and, and…
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An excellent point! I’d love to see how many “Aggressions” or “assaults” by residents follow actual hands-on aggression by staff on the “aggressive” resident/inmate.
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We don’t really disagree, except on the point that calling this an entity “ADHD” to me really just confuses things. Why not say “Hyperactive behavior” or “inability to pay attention” and study the underlying various reasons for it. Since the people grouped together as having “ADHD” may have nothing in common as to the cause, calling it a disorder is nothing but misleading. Of course, the REAL reason that ADHD was constructed was not to figure out the cause but to sell the “cure,” and many other “disorders” were constructed for the same purpose. Rational people like you and me without conflicting interests could certainly study “ADHD” as to underlying cause with little confusion, but sadly, there is a huge financial and social incentive to call these things “disorders” so that drugs and patented therapeutic interventions can be sold for a profit.
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The only way psychiatry will change is if the financial incentives that reinforce it are altered. It is very clear that psychiatry chose its current direction out of a desire to maintain control of the field and to assure that psychiatrists could make lots of money with less work. It is also supported by the “permanent disability” concept that keeps their biggest funders, the drug companies, making billions. No amount of data can overcome the greed and power drive that is behind the current psychiatric paradigm. It will only stop when it stops paying off.
— Steve
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Actually, the article is kind of disturbing. First, they blame “fear of stigma” for African-Americans not seeking out counseling, overlooking the more obvious explanation that on the balance, they are less likely to trust any institution and that the “mental health system” doesn’t feel at all helpful to them. It also avoids the rather obvious question of why more “treated” kids have more problems with anxiety and depression by claiming that “treatment has allowed more kids with mental health issues” to enroll in college. They really don’t seem to have a clue, but they’re going to keep operating on their misguided beliefs.
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Hmmm… more and more college students are taking psychiatric drugs, yet the number of students with “mental health concerns” is rapidly increasing. Ya’d think all that “treatment” would drive the numbers down instead of up. What could be going on here? Of course, no one will really ask that question.
— Steve
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I believe it was the other way around. Dianetics was wildly popular in the 50s and the psychiatric field saw it as a big threat to their hegemony. The AMA and the APA attacked Scientology viciously and consistently all through the 50s and 60s and the IRS continued to pursue them even into the 80s, until George HW Bush decided to change the tenor of the IRS and told them to accept that Scientology was a religion. I think it’s fair to say that Hubbard decided that the answer to being attacked was to attack back. I suppose you could say a vendetta developed, but from what I understand, psychiatry threw the first punches. Scientology also very strongly believes that drug use is damaging to the human spirit in severe ways, and so as psychiatry has relied more and more on drugs, the antipathy has become greater in both directions.
That’s what I know about it.
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“That’s what the commercials say!”
A brief summary of what’s wrong with Western culture, especially in the USA!
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And there are also kids who naturally hate sitting still and love exploring their environment in a physical way. Such kids have NOTHING wrong with them at all, but are inconvenient for adults to manage, and “treatment” is usually nothing more than an attempt to make them easier for the adults to deal with.
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That is very true. It’s important to keep the statistics very simple, and to have stories available as illustrations of what the stats mean for normal folks who don’t have advanced degrees. That’s why I tell the stories first before getting into the data. But for some people, data is irrelevant, at which point, I would stop using it as an argument.
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There is a lot of “secondary gain” from going along with the system. For people who have little, it can provide an identity, sympathy from others, an excuse for failure, and protection from dealing with emotional pain from the past, just to name a few items. It can also be scary to try and escape, as one faces isolation, anger from friends and family members, condescension and/or outright hostility from providers, and serious but unacknowledged side effects of withdrawal, just to name a few. It’s kind of like an abusive relationship – it requires a lot of courage to leave and it’s a lot easier to stay, despite the intermittent or even constant pain and disrespect you receive.
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As a dad who helped raise two classic “ADHD” boys, I can empathize with your statements. It sometimes feels like others expect us to “control” our children when it is very clear that these kids make their own decisions and HATE being controlled in any way that feels arbitrary to them. And I would say I also resented anyone who felt they “knew” how I should parent my kids without any actual knowledge of what it’s like to be in my shoes.
That being said, I am a scientist and a mental health professional as well as a parent. I appreciate Timimi’s work because he’s always been objective and not afraid to disagree with the establishment if the data tell him they’re wrong. If you look at the long-term DATA regarding “ADHD” interventions, it is VERY clear that long-term outcomes are NOT improved by the long-term use of stimulants. That being the case, it seems pretty shortsighted as a society for us to insist on stimulants as a primary intervention and to disregard or minimize the potential benefits of psychosocial interventions which have a greater chance of making these kids’ lives better in the long run.
Additionally, you and I may not be interested in controlling our children, but there are most definitely parents and especially teachers and other professions who have control as their main objectives. There were a number of studies done back in the 70s showing that the optimum dosage for academic attention was much, much lower than the average dosage, and that most doctors increased the dosage to the optimum for behavioral control, which dosages actually diminished the child’s ability to attend to schoolwork.
So I urge you not to throw out the baby with the bathwater. You seem an intelligent and committed parent with the best of intentions for your children and all children. I strongly suggest you re-read the article and pay attention to the actual DATA that is presented, and forget what it means about you or me or your particular situation. If we think about the welfare of all kids, the data is pretty clearly telling us that we need to look at stimulants as at best a short-term intervention, and we need to look at a whole range of other options as a means of really helping these kids become functioning adults. Some examples are: alternative schooling (child-centered classrooms), meditation, exercise, nutritional interventions (low iron is particularly common), addressing sleep apnea, teaching parenting skills specific to intense or oppositional children, teaching self-management skills, and many others. If we really care about helping these kids, we have to get past our own personal fears and ego and look objectively at what has proven to help. At least with regards to the kind of long-term outcomes that matter to most of us, like delinquency rates, college attendance, high school dropout rates, social skills, and self-esteem, stimulants fail the test.
You might want to read Corrina’s MIA post on anecdote vs. aggregate that was posted just today. It is very much applicable to this discussion.
—- Steve
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The main reason anecdotal information is preferred is because of the financial incentives. Unless those change, it’s hard to imagine the industry actually respecting the real data. There is no money in honesty.
As for those who are themselves convinced by the propaganda, it’s very important to start by acknowledging the reality of their personal experience. I think the next question would be to ask, “Do you think that everyone has the same experience as you do, or do you imagine that some people have different experiences?” If they can’t handle that possibility, I would not bother with further discussion. Some people are like that. If they can, I’d ask, “Would you like to hear some more about that?” and then share some anecdotes (after all, this person is basing their assessment only on anecdote, right?) where things didn’t work out so well. At that point, you can introduce the concept of aggregate data, maybe starting with, “So let me ask you to imagine this: imagine that some people (like you) feel like they do better taking these, some people feel like they do worse, and a lot of people don’t feel very different. Can you imagine that happening?” If they can, you’re in a place to start educating about aggregate data. But you have to get the person to allow that aggregate data is relevant or important before it will be a viable argument.
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It is also VERY important to recall that they screen out actual suicidal people before starting these trials. So ALL suicidal participants developed suicidal thinking and/or behavior AFTER they started the trials (outside of the possibility of dishonesty in an odd participant here and there). The actual suicide rate in community practice would be considerably higher.
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I also think it is very possible to be civil regardless of whether the articles are big or small. We can be honest and still be respectful. That goes double for authors who post here, as it should be clear that reactions are expected and normal, and that not all posters will necessarily communicate as diplomatically as could be wished.
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I agree 100%. There is no training for the kind of ability to be present and non-judgmental and patient yet firm that is needed to be a true helper. I started out in the field by the back door, and had only a three-hour group processing class under my belt. I think this worked hugely to my advantage, because I knew I didn’t know anything and I also knew the only source of the information I needed to figure out what to do was the clients themselves. So I asked them questions and learned from them and I developed my own “theories” based on what actually seemed to work.
I had one other advantage: I had already had some very good therapy and worked through a lot of my childhood issues, so I knew what good therapy looked like, and I also knew how to separate what was my emotional reaction from what was the client’s need. This is the real “training” for therapy, the only training that will really help – learning to understand and respect how your own life was shaped by your childhood and adult experiences and how to change your perspective on your own life. Absent that, 20 years of “clinical training” will do little besides make you feel like you should know something that you really don’t.
— Steve
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I agree with you, when we’re talking about a lay person being a caregiver. When it is a paid staff person, however, the client should be the focal point and the caregiver’s goal should be to be as helpful as they can to the client without letting their own immediate feelings drive their decisions. Not saying that having and sharing feelings in a therapeutic setting is always a bad thing (I do it a lot) but it needs to be done because it’s good for the client, not because it makes the professional feel better. And I’m speaking from very direct experience here. Happy to share an example or two if need be.
Always a pleasure to hear from you!
—- Steve
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Gotta agree with you both! Oppression is oppression, regardless of the left/right orientation.
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I am afraid I can’t agree with the idea of a genetic basis for “mental illness.” So far, the best correlation that has been found explains about 15% of cases of a range of “mental disorders” as described in the DSM, and this was a set of over a hundred genetic markers and was the most optimistic interpretation possible from the data. On the other hand, well over 80% of those diagnosed with “schizophrenia,” the most “genetically linked” of “disorders,” report histories of abuse and trauma. So it’s pretty clear that environment is MUCH more important than genetics in explaining “mental illness.”
Beyond this, there may be genetic patterns that leave one more vulnerable to stress, but such patterns might also make one more sensitive to others’ feelings or more capable of bringing people together socially. Genetic diversity is the key to species survival, and we need people with a wide range of genetic presentations in order to succeed as a society. Arbitrarily defining certain emotional or behavioral responses as “disorders” denies both the importance of genetic variety and the fact that such responses are almost always related to unresolved stress, much of which comes from the bizarre expectations put on us by this bizarre society we live in and for which we have not had time to evolutionarily adapt.
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When a helper takes on the experience of the “helpee,” they generally set up a situation where the “helpee” feels like they have to take care of the helper because of their distress. I’ve always felt the best approach is to put oneself into the helpee’s shoes long enough to get a sense of what is going on, but then backing away and looking at the situation from a more removed perspective. That way, I can ask relevant questions and suggest options without being invested in whether the person I’m helping agrees with me or not about my assessment. This is critical to the person feeling empowered, and empowerment is at the core of any kind of healing, IMHO.
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New way to prevent “anxiety disorders” in kids: STOP SCARING THE CRAP OUT OF THEM, ADULTS!!!
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Wow, those reactions, especially the movie comment, really do sound like antidepressant-induced numbness. She is being portrayed very unsympathetically by the media, but it sounds like she has been a multi-generational victim of both child and pharmaceutical abuse.
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Kinda sounds like Guantanamo, doesn’t it?
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This was known back in 1987. Prozac was banned in Germany initially for this very reason – suicide plus aggression. I think in Italy as well. The rest is all smokescreen. There is no question that SSRIs increase suicidal and homicidal thoughts in a small proportion of users.
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Well, I certainly can’t argue that all of that abuse and disrespect and injustice isn’t a big contributor to suicide rates and serious health problems! And I very much appreciate your attending to these very important issues that almost never get mentioned by any writers.
That being said, it seems very hard to deny that drugs which induce diabetes and heart disease, and as many report, create a stronger urge to smoke cigarettes as a means to minimize side effects, are not HUGELY contributing to a 25-year earlier death rate. And in truth, I regard it as the responsibility of the pharmaceutical industry or mental health industry to show that these are NOT causally related, as safety should be the primary concern with any form of “treatment.”
In any case, whether the drugs or the surrounding environment of disrespect and injustice are more important factors, it seems very clear that spending time in the hands of the “mental health” industry is currently hazardous to one’s health.
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Can you elaborate on the correlation/causation comment? It appears to me that Whitaker’s summation of the evidence pretty clearly shows more than correlation, though I think it’s fair to say that further study is needed. I agree 100% that incentives drive what care is provided, but a pretty radical rethinking of the current model (beyond mere capitation) would have to happen for psychiatry to get itself back under control. It is a highly corrupt field, as you yourself have experienced.
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Your comments don’t make sense to me. I never compared you to anyone, I simply gave examples of people who had worked through delusions and hallucinations without drugs. You also evaded the main point of my comments, namely that you are making gross generalizations about “people at MIA” without reference to specifics, and your comments are not relevant to the article above. I think you’ll be happier at another website, but blaming folks here for not approving of your hostile comments seems out of line.
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Pat, please find a forum that meets your needs better. It is not helpful to have you constantly looking for a reason to lash out. I’ve reported both of your last two comments, as they are hostile and have nothing to do with the topic at hand. I’m not sure why it’s so important for you to be right about MIA being wrong, but I would really like you to take a look at your motivations.
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It seems that anything you, Ron, are suggesting could be prescribed by a GP or family practitioner. There is nothing medical that is really helpful that is specific to psychiatry, except perhaps for the few who know how to wean people off of their wonderful psychiatric drugs. There are real physiological things that could cause “psychiatric symptoms,” but again, these could be provided by the appropriate medical specialist. There is really nothing “medical” that psychiatry brings to the table that isn’t based on their subjective and deceptive DSM diagnostic scheme. And we know exactly how scientific that scheme really is. So I guess I’d ask what psychiatry as a medical specialty can bring to the table that can’t be addressed by another doctor?
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Hi, Lauren,
It’s important to remember, I believe, that it’s not just a matter of creating dependency – psychiatric treatment can and often does make clients WORSE and psychiatrists deny this, and it also creates massive health issues that kill clients 25 years sooner (in the case of those taking antipsychotics) than the general population. Further, it creates a lack of trust in ANY helping person, which creates further isolation from potential help from any source.
I assume you have read Anatomy of an Epidemic? If so, you will realize that these “treatments” on the average make a bad situation worse in the long run, even if they may temporarily provide a respite in the short run. I believe the evidence is pretty clear that the only real utility of these drugs is for the short-term reduction of undesired feelings or difficult behavior (and I am talking from the CLIENT’S viewpoint, not difficult or undesired by others, which is the usual standard), and the long-term use of these drugs should be avoided in any way possible.
Would be interested in your take on these issues. Thanks for being so available to talk about your views and experiences!
— Steve
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Thanks!
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LOL!
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I think the difficulty in this conversation is the association of the word “psychiatry” with “anything that can be done to help a person suffering from mental/emotional distress.” If psychiatry is defined as the latter, than antipsychiatry doesn’t make sense. If psychiatry is defined as “the medical ‘treatment’ of any form of emotional distress, regardless of the cause,” I think antipsychiatry makes a whole lot of sense.
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It staggers the imagination.
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The huge problem is that there is no way to guard against “overmedication” because there is NO OBJECTIVE STANDARD for when “medication” is needed.
Hey, I just thought of a new word: “mendication.” It combines “medication” with “mendacity” (the intentional telling of lies to deceive or mislead). What do y’all think?
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It is true that Freud originally believed his patients and attributed their difficulties to having been abused as children. It was only after the Viennese aristocracy excoriated him for saying such horrible things about them that he developed his “drive theory” to explain away his observations. He chickened out, for which I can’t forgive him, but we do need to give him credit where credit is due.
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Pharmaceutical companies colluding with psychiatrists to defraud the public? Say it ain’t so! I’m SO shocked…
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One more example of the social/psychological causes of “mental illness” as defined in the DSM. It amazes me how the “profession” continues to maintain its fiction in light of the overwhelming evidence against it?
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FeelingD, that is a very good reason why I would like to see this. Being arrested is being arrested, and it’s often not pretty. Once it’s clear that people are being taken into custody and their words are being used against them, the general public might start to get an inkling that “involuntary treatment” isn’t some benign act by caring individuals – it’s often an act of the severest brutality!
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I have often thought that a Miranda warning would be very appropriate for psych hold evaluations. Maybe that’s a fight we can win?
Sorry for your HORRIBLE experience! It is hard to believe that such a thing could be considered “treatment” by anybody but a Nazi death camp commandant.
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Actually, the history of psychiatry exhibit was amazing. They had it in Portland. Definitely needed a “trigger warning,” though – especially the exhibit on the “lobotomobile!”
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My pleasure!
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Hey, maybe we can get together and write a “consensus statement” on the use of daily alcohol consumption as a “treatment for anxiety!” We can get papers published and maybe get a grand from Seagram’s or Jim Beam or Budweiser. What do you think?
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Oh, come on, no one can make a profit from recommending walks! We have to re-name it as “therapeutic perambulation treatment” and patent it, and require the person to go do a doctor to get it prescribed, but only, of course, as an ADJUNCT to their “medication.” Otherwise, you start losing customers!
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There were much more egregious things going on than Pauling. Why don’t they talk about the intentional suppression of nursing in favor of formula, the Thalidomide scandal, the denial that Benzedrine was addictive, then that Valium was addictive, then that Xanax was addictive, the denial that Tardive Dyskenisia was caused by antipsychotics, the denial of violence and suicidal behavior caused by SSRIS (known before it was ever on the market), the promotion of electronic fetal monitoring, which caused a huge increase in the Caesarian rate without any improvement in outcomes… I could go on.
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Clearly written tongue-in-cheek.
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And sadly, these two issues (corruption and appeal to authority) play very well together in our current climate. If we taught our kids to question authority, we’d be miles better off, even with the perverse incentives in place.
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You avoided my question, so I will take that as a tacit admission that you were wrong but can’t admit it.
As to your question, it’s not even coherent. “Only white peoples messing with big pharma?” What does that even mean? If you are suggesting that only white people are victimized by Big Pharma, you’re really out of touch. The disproportion of black men diagnosed with schizophrenia and drugged accordingly is admitted even within mainstream psychiatry. Of course, they blame the black men…
Sounds like you’d be better off on another forum that is more in line with your values, but it’s really not cool to come here just to make trouble.
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I guess you see what you look for. It’s a shame you are looking to find negative things. Monica is only one author, but you get stuck on her and spread it out to everyone else?
Besides, you still are avoiding my question: can you admit that you misinterpreted the author’s intent? That she never suggested that you were a “good little boy” for following your psychiatrist’s advice?
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So it sounds like you get a catharsis by intentionally annoying other people who don’t agree with you? Is that right?
I’d really appreciate some clarity about what is cynical about the article, and more importantly, that you misinterpreted both the author’s and my comments about the “good boy” comment. It is very clear in the article that the author was APPALLED that the psychiatrist would call his client a “good girl” for following orders. You seemed to think she was somehow expressing contempt for you or “your kind.” You were clearly way off base. Can I at least get an acknowledgement on that point?
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You are saying the author referred to “your kind” as being “a good boy” for “taking your medicine.” I assume you feel this characterization is disrespectful, which I agree with. That’s what I mean by “your views.” My point is, the author did not use that term at all – the psychiatrist used it to refer to the patient, and the author objected. So on that point, you two agree.
I find it challenging to communicate with you about simple stuff like this. You seem to get upset by things that aren’t even intended, and seem kind of ready for a fight even with those who don’t disagree with you. This is just one example. It’s frustrating. I have no intention of insulting you, but your comments seem sometimes very far off base to me, and in this case I am trying to simply refer you to the actual statement made by the author so we can have a common ground to discuss things.
I also fail to see how the author is being cynical by reporting her direct observations on how cases are handled. She is simply sharing case histories that she has been a part of. She has had a different experience than you, as have many posting here. I have acknowledged a number of times that you have had a different experience and have every right to your perception of the value of psychiatric treatment. It seems you have a hard time doing the same for others who have found it less than helpful for them or their clients. Why is that so difficult for you?
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There has always been a disparity between men’s a women’s “treatment” by the “mental health” system, going way back to Freud and before. Women who don’t fit in get rough treatment from our society.
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You have missed the context. It was the PSYCHIATRIST who called his patient a “good girl” for taking her medication. The author found such behavior appalling, as it reflected the psychiatrist’s authoritarian and paternalistic view of the patient as a little child, almost sub-human. I am not sure why you’d be angry at the author, as she agrees with your views on this point 100%.
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The first time I visited a psych ward, my first thought was, “Wow, if you weren’t depressed before you arrived her, you’d sure be depressed afterwards!
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Incarceration is deeply harmful, but insisting on calling it “treatment” and expecting the prisoner to appreciate your kindness is even worse! If they’d at least admit they’re imprisoning you, it would be a step in the right direction!
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Dream theories also put the locus of control back on the client, and that is very much counter to the financial interests of the psychiatric drug lords.
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How did no one notice this for 17 years? Answer: they did notice it but ignored it or thought it was OK. This should be proof enough that enforced institutional “treatment” is extremely dangerous and should never be allowed!
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That’s a great analogy! Didn’t know Jung was such a critic, though perhaps I should not find that surprising. Of course, he’s right on target. I use the analogy of trying to figure out why a computer program isn’t running by looking at the memory chips and other circuitry. The computer certainly can’t run without chips, but to reduce a computer’s function to chips and printed circuits and to try and resolve every issue by altering the electrical functions of the computer will lead to a lot of broken computers and very few that actually work. Even a rationally materialistic approach has to allow that there is a PROGRAM running to tell the computer what to do, and you can’t re-program by altering the circuitry!
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Awesome recommendations – looks like this guy gets what’s not working about the “mental illness system.” Unfortunately, he fails to address the main driver of the current distorted paradigm – finanical incentives. Until and unless these financial incentives are addressed, the “social determinants” he mentions will never be the driving force behind decisions, because profit will always be prioritized over patients in the collective. Changing incentives is the key to changing the system. Don’t pay people well to do stupid things!
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They seem to be missing one very important aspect of help-seeking behavior: whether or not the “help” sought in the past has been helpful! My guess is that educated white folks are more likely to see the current model as likely to be helpful, while lower income, darker-skinned, and immigrant folks are more likely to view “the system” with suspicion based on bad experiences in the past. This is especially true for those who have sought help and found it damaging, which I would bet my mortgage is more likely to occur the lower in income or SES the person “seeking help” is.
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So exactly how much ARE you allowed to cry as a result of bullying? Is there an “excessive crying scale” to judge when you’ve gone too far? And who gets to decide where the “cutoff” value is? You’re right, “feminine” traits like emotional self-expression and tears are most definitely pathologized at a much higher rate, and we boys learn that VERY early on. One of the worst insults as a boy is being called a “pussy,” which means not being “man enough” to handle abuse without complaining or getting emotional. The hatred of gay men is also very related to the male fear of the feminine. And yet they look to the BRAIN for causes of “mental illness?!!”
The idea that you have to “stabilize” in the therapist’s office is about as offensive and anti-therapeutic as I can imagine! If you can’t cry in your therapist’s office, where the F*&K can you cry? Clearly, therapists like this are more interested in protecting their own psyches from their own repressed childhood rage and grief than they are at helping you. Such people should not be allowed to be in any “helping profession.” They should arrange flowers or pour concrete or do something where they can’t hurt people.
I know the “MH” system is crap, but this I find astounds even me.
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“Stigma” is also code in the mental health industry for “don’t do anything that might make someone feel bad about taking any drug we prescribe them.” The “stigma” created by their own labeling and “treatment” system rarely seems to enter into their view. “Stigma” has become a loaded word in the MH community, and its most common use is not in any way empowering.
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Crying in public is now cause for involuntary hospitalization? Things are even worse than I thought! That’s RIDICULOUS! I am a sensitive person and as a male I had to learn to control my tendency to cry by about 1st grade because of all the shaming. It’s one of the worst impacts on my “mental health” that ever happened. I spent years learning how to cry again. To consider you “dangerous” because you’re crying – I just find that stunningly inane!
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It appears that many therapist/psychiatrist trainees don’t even learn about the unconscious mind, or relegate it to some quaint historical place in history when we didn’t understand that the brain is everything. It is a disturbing trend.
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And there are excellent examples of it already being done. Switzerland being perhaps the best. Insurance companies still participate in the market despite single-payer government controls and they make plenty of profits. The real problem isn’t lack of interest, it’s conflicts of interests, as in our legislators being bought off by insurance companies.
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Now they’ll probably come up with a range of “spiritual-informed therapies” and get patents on them and then sue people who use their approach without a license.
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Too true!
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Thanks, that is very educational and comports very well with my own observations. Techniques are like tools that one can use or options that one has available, but without client motivation and a good relationship, no particular technique is of the slightest use. Given that placebo effect is just as strong as technique, I think we can dispense with spending a lot of time talking about which approach is “best” and recall that all good therapy starts with good human relationships.
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While I of course disagree with the medical terminology used in the article, I am very pleased to see mainstream psychiatrists finally taking a stand and putting out some real data. The lack of scientific support for the diagnosis, the association with younger age, the multiple reasons why this kind of behavior might occur, the total lack of evidence that ANY long-term outcome is improved by stimulants, the adverse psychological impact of being labeled – short of saying that ADHD is a fraud, this article covers all the important bases (except maybe for diet/exercise and alternative medicine) and I’m just astounded that this is published in a mainstream journal. This presents a great opportunity for us to build on an excellent summary of the data from a source that psychiatry itself can’t invalidate. Though I’m sure they’ll still try…
—- Steve
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A truly competent therapist should never consider that s/he knows best what is good for others. I’ve never operated on that assumption – I figure the client is the ONLY one who knows what’s really going on, and my only job is to help them sort it out and get some kind of perspective on it so they can look over their options as consciously as possible. The arrogance in assuming that someone knows better than someone else what’s good for them is a sure path to harm and destruction.
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Very well said. The client’s objectives have to be the therapist’s objectives – otherwise, it’s not therapy, it’s social control.
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A lot of practitioners do CBT (or DBT) in a way that presumes superiority on the part of the therapist/counselor, and the professional feels OK about forcing the client to “create positive thoughts” or other such nonsense without the agreement or cooperation of the client. As has been observed many times in the past, how the therapist relates to the client completely alters how the client experiences whatever modality is uses, so in fact, the therapist’s ability to create a bond with the client and be a safe and real person to whom the client can relate is much more important than what school they subscribe to. CBT is really just a set of skills. They can be useful if approached and offered in an empowering way, or they can be experienced as oppressive if forced on the client or presented as the only possible approach to healing. When I did therapy, I used a variety of approaches, psychodynamic, CBT, motivational interviewing (though I didn’t know I’d basically invented that approach until years later), or whatever was helpful to the client in the moment. Milton Erickson said that you have to re-invent therapy for every client you meet. I agree with him 100%. There is no mechanical approach that works for everyone. What works is listening and caring and being creative and responding to the client’s needs. The rest is window dressing.
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Great post, Madmom!
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Ya think?
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Did the author say she opposed AA? I didn’t read that. Why don’t you try to focus on the article instead of picking nits? Seems like you’re looking for an argument!
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Teens and young twenties I’ve talked to about it have said that they find it kind of insulting that adults argue they can’t “deal with” this kind of material – they say they ARE dealing with it and it feels like someone’s finally TALKING about the realities they face. I would agree that a person who is already feeling suicidal, especially if they are a sexual assault victim, might need to be very careful about whether they want to watch it or not, but it is rare that teens get to hear something in a teen voice that is so real and relatable for them. That’s why it’s so popular. And you’re right, the absence of any focus on “mental illness” is one of the series’ primary strengths – it focuses on the fact that there ARE reasons for feeling suicidal and it’s NOT abnormal and that there are THINGS THAT ALL OF US CAN DO ABOUT IT! To me, that was the most exciting and positive message – that any of the 13 people could have made a difference in her mind, and perhaps if only one of them made a different choice, she’d still be alive. It was tragic on the one hand, but on the other, it ended with a message of hope, which is more than I can say for most shows addressing “mental health issues” like suicide.
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I had forgotten that point, though I have observed it – there is a great deal of shame in “failing” to kill oneself, and the hospital venue TOTALLY reinforces this, with everything from condescending pity to messages that the client’s “disease” made them do it, implying they are “wrong” for wanting to kill themselves. I wonder how much that contributes to the huge increase in suicides AFTER hospitalization. The whole thing is humiliating, especially if it’s involuntary, and no one seems to be willing to simply acknowledge that to the clients.
Thanks for sharing and reminding me of that important perspective!
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You are so right, and if the psychiatric community would deal with reality instead of their financially-fueled fantasies, they could help route a LOT more families down the right road! That’s what I’m saying – not that families can’t face these facts, but that when given an easy path that lets them off the hook, it is very seductive. To help parents really understand attachment theory, it would mean helping them face their own attachment issues, which requires sensitivity and skill and compassion, which usually means the clinician has to face THEIR own attachment issues, which is painful and hard work. I still think many COULD do that work and WOULD do that work, but they aren’t required or even encouraged to, because the DSM provides them an easy out: it’s the client’s brain that is the problem, nobody has to deal with all this hard stuff. Most people take the path of least resistance unless they are prompted to do otherwise. That’s the worst effect of the DSM – it prevents real healing by letting people avoid their pain and instead pass it on to those who were harmed by their own mistakes or bad actions.
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Attachment theory also puts responsibility on the doorstep of the caretakers, while psychiatry blames the victims. That’s why a lot of abusive or neglectful parents, educators and “mental health professionals” prefer psychiatry – it lets them off the hook!
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Well-meaning parents are often the cause of extreme distress. They often love the “mental health” system because it absolves them of responsibility to alter their own behavior, and allows them to blame “your disease” for the fact that you’re upset with how they treat you so disrespectfully.
Moving away might be the best “prescription” for your “mental health disorder.” The more you can associate with people who like you just the way you are, the less “crazy” you will feel and the more you’ll be able to live the kind of life you need to live.
— Steve
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The problem with this argument, which I essentially agree with, is that the financial conflicts of interest in the “mental illness industry” (thanks, Frank!) make a rational dialogue difficult if not impossible. Add on how the “biological brain disease” story helps parents, teachers, and other adults absolve themselves from responsibility for kids’ and adult children’s suffering and the task seems monumental. It’s difficult to imagine having a rational conversation with Lieberman or Jaffe about any of these issues, and until they are no longer funded by Big Pharma, it will be an enormous uphill battle. Perhaps the proper focus is to provide more support to parents of children/adults experiencing extreme states or other emotional distress and provide some kind of alternative to NAMI. It seems disheartening to think about.
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We also didn’t have 4-5 hours of homework nightly like my son did.
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The similarities between childbirth and psychiatry are legion. They are the two branches of “medicine” that enforce “treatment” on perfectly healthy, normal people. They both use interventions that make outcomes worse instead of better, and neither is willing to respond to actual data about their interventions, instead adhering to quasi-religious dogma that are not able to be questioned without being branded a heretic. Both insist on hospitalizing perfectly healthy people and treat them as if they are bodies rather than human beings. In both cases, they deny the impact of the mind/spirit and insist on treating the “patient” as a body and ignore social and environmental context. Both professions need to be razed to the ground and started over from scratch, because they hurt and kill people gratuitously and make money off of creating medical problems when none are there to start with.
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Well written article, Aaron. My only question is: what if you really did fit the criteria for “schizophrenia?” Would the “treatment” have been any less brutal and ineffective? I don’t think the problem is that you were “wrongly diagnosed.” I think the problem is that you were “diagnosed” at all, instead of what you suggest at the end, which is to be looked at as an individual human being with a story to tell.
Thanks for sharing – it takes great courage to put this kind of story out there, but it’s VERY helpful to others still receiving “treatment” that is ruining their lives!
— Steve
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It doesn’t follow that if drugs appear to help someone, it means there is something wrong with them. I appreciate the rest of what you said, though. I think the big, BIG problem with schizophrenia is that it’s just a description of some things that happen for reasons unknown. If they were really honest, they’d admit that psychosis was a phenomenon that could be caused by many things and would look at each case and look for subgroups of people who may have similar experiences or physiological findings. But they don’t. Because they WANT their “biological dysfunction” story to be true because it brings them money and professional power and status. That’s pretty much the definition of corruption.
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So they’re worried about kids practicing mindfulness, but putting kids on stimulants for years when there IS science saying that it does them no good is not of concern?
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I do think he’s pointing out a real phenomenon, though. It’s another big downside of this whole labeling craze. Having a label gives teachers an excuse why they can’t teach kids, gives parents an excuse why they don’t have to learn better skills, and gives kids and adults a built-in excuse for why they “can’t behave.”
My son had a friend whose little brother was allowed to annoy him on purpose for years, and every time he objected, his mom would say, “Oh, you know he has a disability, he can’t help it!” Of course, it took a very short time before the kid (who was only 6 or 7) figured out the deal and would himself tell his brother, in a teasing and sarcastic way, “You know I have a disability, I can’t help it!”
Of course, I’d ditch all the arbitrary labeling for other reasons, starting with the fact that the labels are just made up from cultural bias and the convenience of those in power and have no validity whatsoever, but I do think it’s important for us to note this as one of the bad things that starts to happen the minute you start blaming brains and absolving humans of responsibility for their actions.
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Go, Susan! Where do you teach?
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Additionally, I think the inclusion of this article on MIA is important because of the number of women who experience sexual assaults and trauma who have these experiences discounted and are told they are “mentally ill” because they are anxious, depressed and/or angry about their experiences is enormous. When I briefly did involuntary detention evaluations in Vancouver, WA, I found many women who were diagnosed with “bipolar disorder” who were sexual assault or child molestation victims. It seemed that their history of trauma was either not known or was intentionally discounted in favor of a biological explanation and a drug-based solution. So this issue is very relevant to our work here.
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I think the important point you may be missing, Cat, is that while abuse and even sexual violence can happen to men at the hands of women, our CULTURE justifies and minimizes the presence and impact of sexual violence and rape culture on women. While a man may have a specific bad experience with an abusive female, almost ALL women have to almost constantly work to assure their safety from rape and abuse. As one person said wisely, “When a man gets a woman’s number, his biggest fear is that she gave him a fake number because she doesn’t like him. When a woman gets a man’s number, her greatest fear is that he might rape or kill her.” Women have to put up with a constant onslaught of come-ons, unwanted touching, lewd remarks, “jokes” about their sexual value, and put downs about their appearance, day in and day out throughout their lives. There is simply no comparable experience in a man’s life, unless he’s part of some other disempowered group, but not just because he’s a man.
I hope that clarifies things. Men and women have very different cultural experiences, even if some men do experience abuse by women in relationships.
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Wow, what a great essay! You should have it posted as an MIA blog!
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That “unmasking” BS really irks me. Blame the victim and keep making people nuts, cuz insanity pays the bills. SICK!
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They’re kind of overlooking the most basic (incorrect) assumption: that one group of people (namely these researchers) are in any kind of position to decide for everyone what is “moral” and therefore to be “enhanced!” I think the people in most need of “moral enhancement” are the ones running the experiment!
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Even more important, 50 years of long-term studies have failed to show ANY benefit of long-term stimulant use in ANY major outcome area. This includes delinquency, test scores, teen pregnancy, college enrollment, illegal drug use, social skills or even self esteem. This should be in EVERY textbook so that doctors realize that AT BEST, stimulants provide some short-term changes in the “core symptoms” (meaning that they mostly make kids more manageable). The biggest selling point used to push stimulants is that “untreated ADHD” leads to all these bad outcomes, but as it turns out, NONE of these outcomes is improved by stimulants! What a scam!
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Oh, I bet they objected – but they weren’t afraid of stigma to the “mentally ill,” they were afraid of well-earned stigma for their own warped professional history!
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Semmelweis is a very sad story. He was apparently hospitalized after this happened because it drove him totally nuts that he had PROOF that hand washing worked and they just ignored it! So we have more proof that “mental illness” is CAUSED by the medical system!
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You are correct that there is a high suicide rate among the group, which is a contributor, but certainly does NOT explain a 25-year (nearly a THIRD of an average lifespan!) decline in average life expectancy! Consider also that the suicide rate INCREASES with increasing contact with the psychiatric profession, partly because of the drugs they sell. And there is no denying that antipsychotics cause an increase in diabetes, huge weight gain, and a very significant increase in cardiovascular disease. To think that these don’t increase the death rate very significantly is, forgive the term, delusional. Additionally, cigarette smoking is commonly used by those on antipsychotics to reduce the side effects (it increases dopamine, which is what antipsychotics decrease), and we all know the impact of cigarette smoking on lifespan. So indeed, psychiatrists kill people.
If you were reading the other comments, you’d see that many (including me and the author) that local chapters can provide valuable services, particularly those like yours who allow or encourage leadership from survivors/consumers.
Your last comment I agree with completely, and that is one of the huge problems we face. Without an objective definition, almost anyone could be identified with a “mental illness,” and it is also very possible to redefine “mental illness” in a way that allows the drug companies to create “science” that supports their drugs. They do this by seeing what the drug does and then defining a “mental illness” based on whatever “symptoms” it “treats.” “Social Anxiety Disorder” is one such fake “disease” that didn’t exist before they decided to market Paxil to “treat” it. Juvenile Bipolar Disorder is a similar scam, long since proven to be utterly bullcrap by psychiatry’s own researchers, and yet many youth are still “diagnosed” with this non-existent “disorder,” and given these life-shortening drugs to “treat” their inconvenient childhood behavior.
8 years of medical school is actually a big DISADVANTAGE if you are being trained in things that are absolutely false or are based on false assumptions. Hence, it is actually often parents who are more adept than doctors at sensing what is really going to be helpful, but in any case, the invalidation of the client’s viewpoint is ultimately the most destructive thing that can be done if we have any hope of recovery, yet such invalidation is the core of how psychiatry is practiced today.
Have you read “Anatomy of an Epidemic”? I believe you really would benefit from reading it if you have not. It would help further your understanding of where this big protest energy is coming from. It seems you are not at all far away from my views on what is helpful, though our views on whether national NAMI can provide it seem to diverge.
Thanks for the rational exchange!
— Steve
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Hi, Michael!
Well, a lot of people have a similar belief about doctors always being wise and scientific and reliable. It’s a very solid cultural belief, even when evidence speaks loudly to the contrary.
Are you aware that the august Journal of the American Medical Association published an article verifying that receiving medical care kills over 200,000 Americans every year? Which makes it the third leading cause of death in the USA, behind heart disease and cancer. And over 120,000 of these deaths were attributable to properly prescribed and administered medication. A LOT of those deaths are from psychiatric drugs. The average lifespan for those diagnosed with psychotic or bipolar disorders is 25 YEARS shorter than the average American. These doctors kill people. Can you imagine a cancer drug that killed off its patients years earlier than those who don’t receive treatment?
In steps NAMI. They promote a VIEWPOINT that “mental illnesses are just like diabetes” and have nothing whatsoever to do with how people are treated or what kind of stresses they are under, or even what they eat or whether they exercise. They are “genetic brain disorders” and no one needs to “feel guilty” about the damage done to our young people or to adults who have to experience this life-threatening “treatment.” The potentially deadly side effects, though very well documented, are minimized or denied, and the supposed benefits promoted under the tutelage of the drug company sponsors.
In addition, the people running NAMI are not “mentally ill” individuals, but parents and professionals who “know what is best” for their adult children/clients, and when the “recipients” complain, they are accused of having “anosognosia” or of acting out their “symptoms” instead of listening to their views.
Remember also that psychiatrists assured us that Benzedrine was not addictive, then assured us that Valium was not addictive, then Xanax. They also assured us that tardive dyskenesia was caused by “schizophrenia” and only later were forced to admit it was the drugs. So they have a very poor track record of reliability.
So being skeptical about a doctor’s advice is not silly or dangerous – it’s very, very smart. Trusting doctors blindly, especially psychiatrists, can get you killed. But national NAMI does not appear to care much about these problems, and is all too happy to blame them, including the 25-year earlier death rate, on the victims.
I hope that clarifies why it is that I and many here trust neither NAMI nor psychiatrists. I’d be very interested in hearing your specific response to this information. You seem like a smart guy, so perhaps a bit of hard data can help you see another viewpoint, even if you don’t agree with it.
—- Steve
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Psychiatry is founded on violence and the judgment of others as “defective” in the eyes of society. “Modern” approaches are simply another way to force the “aberrant” back into line with society’s expectation. While individual psychiatrists may or may not be specifically committed to authoritarianism and invalidation, the entire field, starting with the diagnostic system, is still based on the primitive thinking that gave rise to “insulin coma therapy” and the like. While lobotomies are “out”, the barbaric ECT is still widely practiced, and of course, the drugs used on the brain are all based on stopping the brain from engaging in its normal functions in some way or another. So violence and invalidation continue to be the linchpins of the psychiatric worldview, even if individuals in the field are able to escape that viewpoint.
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I think it’s also important to clarify that not all local NAMI branches are as bought out as national NAMI. NAMI Santa Cruz (or maybe Santa Clara) used to have an awesome website with lots of empowering articles and discussion boards. But they don’t appear to any more.
I encourage you to look on the national site and see how many times they talk about “biological brain diseases” and how infrequently traumatic experiences like child abuse are emphasized as causes. See how supportive they are of forcing “treatment” on the unwilling and how often they talk about “anosognosia” and how little they talk about hearing voices groups and peer support (except in the context of supporting peers in following their psychiatrist’s orders). They have improved somewhat since the late 90s when I first encountered them, but the national website is loaded with inaccuracies and power trips that have nothing to do with those who willingly or unwillingly engage in “mental health services.” The unquestioning support for enforced outpatient “treatment” (aka forcing drugs on people who aren’t even endangering anyone just because the psychiatrists think they MIGHT some day be dangerous) should be enough to convince any objective person that they are at best very far down the wrong track. Looking at their Big Pharma connections just explains why.
So yes, lots of people have found local NAMIs helpful, though lots have also found them awful. But national NAMI does not represent the “mentally ill,” it represents their family members and the pharmaceutical industry. Which is a VERY dangerous combination.
— Steve
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“Breaking point?” That sounds totally sick! And they said YOU were “mentally ill?” What is wrong with these people?
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“Neither expect nor demand.” That’s it, 100%!
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MePat, not sure what your issue is, but you seem to be intent on provoking conflict here. I am not in favor of making personalized attacks, but your comments appear to be personalized as well in a more subtle way. Monica made a totally legitimate post, and your comment is simply attacking due to whatever issues you are bringing to the table. I suggest you take a step back and look at your reasons for doing this.
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I think the MIA staff is creating a safe space for discussion, or trying to. The only “side” I think MIA is on is that the current way of doing things doesn’t work and needs to be “rethought.” And I agree, more “sides” means less cooperation and less success. We should be emphasizing what we agree on, and your postulates are a great starting point.
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I agree. Perhaps they will feel compelled to publish it, as it is a direct response to the article they wrote. Perhaps you can even get other dissident MHPs to sign on to the article?
Fantastic piece of analysis!
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Absolutely true. Unless you have the courage of your convictions and the skill to know how to help, the safe play is to hospitalize even if it’s totally uncalled for and totally destructive to any chance of further therapy. It’s no wonder that clients don’t tell their therapists when they are suicidal, but when they don’t, they’re then called “manipulative” and get labeled “Borderline Personality Disorder.” If you wanted to create a system to discourage healing, the current one would certainly do the job.
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A very good article! I’ve always been very suspicious of “EBT” for the very reasons mentioned in the article, namely that it is both politically and financially motivated. The one issue not addressed in the article is that in order to be an “EBT”, someone has to spend the money to research something in a systematic way. Guess who has the most money to fund such research? Drug companies, of course. Drug companies can afford to run multiple research studies (and of course can afford to buy “results”) in a way that other entities can’t. So of course, most “EBTs” are drugs. Pretty sneaky!
I also like the emphasis on humility and individualized approaches, even in the purely medical world. That thinking is 50 times more applicable to the “mental health” world, where there is no concrete way to even say who is “ill” or if anyone is “ill” at all.
Thanks for the link!
— Steve
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I did a training on suicide intervention with mental health therapists many years ago, when I worked at a volunteer crisis line. Our volunteer crisis counselors knew 10 times what the professionals knew about helping suicidal clients. Our emphasis was listening and understanding, focusing on what can be controlled vs. what could not, building relationships, and inviting further contact as frequently as needed. Most of the professional therapists didn’t seem to even have an idea what to do besides calling 911. They didn’t even have the skill to figure out who was contemplating doing something immediately vs. those who were feeling despairing but mostly needed to talk and connect. They were effectively clueless. That was in 1992. Things are far, far worse today, because at least the ones we were training knew they didn’t know, whereas now they can just diagnose them and send them to the psychiatrist or the hospital as soon as anyone even talks about the word “suicide.” Many therapists are simply scared by any suicidal statements and go with the safest approach for THEM, rather than the best approach for the client. Of course, there are many exceptions, but I’d say a majority of therapists are not really prepared to deal with a suicidal client, both in terms of training and in terms of their own emotional reactions. In fact, many therapists appeared to hospitalize people for much less serious things like self-harming in ways that are neither intended to nor capable of killing or even seriously hurting themselves. Which meant the self-harming people couldn’t even talk to their therapists about their urges without risking being hospitalized, so they called the crisis line to stay anonymous and to actually find someone who would listen.
So you’re not wrong. A lot of therapists don’t actually have any training in helping suicidal people, and as often as not, it is not really safe to tell them if you want to just talk without being hospitalized.
— Steve
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Can’t ask for more than that. Sorry your first go was a little rougher than expected! I appreciate you hanging in through a difficult conversation, and I hope we’ll be hearing more from you in the future. I think in the end it was a very important conversation about topics that are central to this project of “rethinking psychiatry,” and while I wish we all could figure a way to have these discussions with less rancor, it’s a very emotional subject, especially for those who have been “helped” in some not very helpful ways by the system.
Keep the faith!
— Steve
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Without feedback form the client, how would you ever know if you were making progress? This seems to obvious as to be trivial, but it’s clear from the data that the majority of therapists don’t practice this way. It’s a head scratcher, for sure!
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Fantastic article, Kelly! I once handled a crisis call from a woman who was frantic about her ongoing depression and anxiety. She told me a list of at least 4-5 antidepressants she’d been on and nothing had changed and she was worried that she’d ALWAYS feel this bad and it was driving her crazy! That’s kind of how she talked. So I asked her one question: did anyone ever tell you there are other things you can do for depression and anxiety besides drugs? She stopped cold for a moment. Calmly said, “No.” I said, “Well, there are.” She said, “Oh. Well that’s good!” She instantly felt better knowing there was something she could do herself, but had been seeing mental health professionals for A WHOLE YEAR and no one had told her there was more she could do.
I’ve worked for years with foster youth who are put on these drugs sometimes in elementary school, despite the data saying they don’t work, and I can’t think of one who was told that s/he might become aggressive or suicidal on these drugs, nor were their parents or even their caseworkers informed. I ended up being the one who shared these facts. It is a very disturbing reality when people are given drugs that don’t work, not told of potentially dangerous or deadly side effects, and not given any alternative that might actually help them out. Not saying some people don’t feel good about their antidepressant use, but informed consent basically doesn’t exist for these drugs!
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Wow, I just realized how appropriate the title of this article is! This really is a clash of perspectives, but not necessarily the perspectives outlined in the article. I think the real clash of perspectives is between the more powerful (professionals) and the less powerful (let’s just call them “recipients” for now) who meet in the crazy world of “mental health.” Maybe it’s easiest to understand if looked at that way – as a clash of worlds. The problem being that when worlds clash, the more powerful are able to continue to maintain that their world is the “right one.” Similar comments apply to the recent intense discussion of “reality” vs. “delusions.” Hence, my comments that power dynamics are the most important aspect of a helping relationship, and if they are not resolved, it’s hard to get beyond a fairly rudimentary level of “helping.” At least that’s my experience.
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You mean being active isn’t a disease? Might even be good for you? Go figure!
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I really do get both sides if this conversation, and I understand why it is uncomfortable for you, Kurt, and I also understand your frustration, Sera.
I don’t think Sera is trying to be hurtful but is speaking from the heart as a person who has experienced the “help” of the mental health system and found it quite harmful. It appears you have embraced the science that Bob has published, which is great. But I think. Sera’s getting at what I was talking about earlier, and it goes deeper than Big Pharma corruption.
Perhaps the clarity comes from your response to my comment when you said that “power dynamics have to be considered.” I think a different viewpoint, which I am trying to convey, is that “dealing with power dynamics between provider and client is central to ANY effort at creating healing.” I believe that people who have been harmed by the system tend to take the second view. I think it is hard for a professional person who hasn’t been in that position to really understand why, and it often comes across as hostility, and actually can BECOME hostility if enough frustration builds up. But what Sera says is absolutely true – the privilege of being “the professional” allows us (and I include myself as a fellow professional) to dismiss or minimize the impact of our power differential, and this gets in the way of or sometimes completely prevents a healing relationship from forming.
I don’t know why I have been granted the ability to bridge this gap, but somehow I really see and understand deeply the cost of resting comfortably in our “professionalness,” as well as the true power of stepping out of those shoes and meeting our clients where they are without the slightest judgment or condescension.
It is hard to describe if you haven’t been there, but it really does come across in your presentation that you don’t quite grasp this reality, although I am quite sure you do excellent work within the context of your role and that clients would be VERY fortunate to see you vs. the average mental health professional. There is just a possibility that you might be able to take one step further to seeing the reality of your clients, and I am hoping this discussion might make you aware of that step. Again, I’m not saying you’re doing something WRONG or that you are a bad actor and I’m not minimizing the work you’re doing to make the mental health world more respectful of those it serves. But Sera’s viewpoint is (I believe, not trying to put words in your mouth, Sera, so please correct if I’m off) just the viewpoint I was wanting to point out – the idea that it is the CLIENT (if that’s even the right term) who has the right to define his/her experience and whose viewpoint and needs must be the touchpoint of any intervention.
If you had been a recipient of these services yourself, I think you’d see a different perspective that comes from chronically being in that one-down power situation and having to be careful not to say the wrong thing because some “helpful professional” will decide what is “good for you” and make you have it whether you want it or not (and I don’t just mean drugs here). It’s like being a kid in school again, except the punishments for stepping out of line can actually imprison you, disable you for life or kill you.
Not sure what else I can say. I know not everyone is always a diplomatic as they might be on this site (though in fairness, I thought Sera’s first message showed a strong effort in that direction), still, a similar message has been communicated a number of times by a number of different people, and maybe there’s something there you’re not hearing. That’s all I’m saying. If I didn’t think you had it in you, I wouldn’t have put this much energy into it. If it’s not something you can get your arms around, that’s OK with me, but I don’t think the message is intended to hurt, it’s intended to inform, whatever form it has taken. I think there’s something there for you to take a look at, and I believe you’re enough of a real professional to hear that message if you can sit with it for a bit.
Hope that helps!
—- Steve
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I would have to amend that to say I’d suggest being VERY CAREFUL about whom they might trust. There are definitely a few diamonds in the rough, and clients/patients/inmates are sometimes fortunate to find them, but I would most definitely counsel them that sharing in a hospital could be dangerous and to be very selective about whom they might trust. In fact, I’d tend to apply that to any counselor/social worker/mental health professional in any role. A lot of damage can be done by trusting the wrong person with sensitive information, and sometimes the very best thing we can teach our clients is how to figure out whom they can and cannot trust.
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Thanks for sharing your story. It sounds just plain awful! It has always stunned me that they can forcibly “hospitalize” you against your will and then CHARGE you for the privilege! Stunning!
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And we have to remember that it takes only one or two bad experiences to shut down trust in service providers for the long term. Even if 80% of providers are safe, the client doesn’t know which are dangerous until they open up and potentially get hurt. A bad experience often means no one else gets a chance. I always thank clients who extend their trust because I understand the risk the are taking. All clinicians should learn to appreciate how precious and delicate that trust is for the vast majority of clients.
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Wow, what a sad and infuriating story! Good for you for standing up for yourself! Did you say your “symptoms” are decreasing but they still want to force you onto antipsychotics? Do you have a good attorney? Wish I lived in Michigan – I’d come and support you!
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Sam, your comments are incisive and effective as always – thanks!
Kurt, I would very much be interested in hearing more about that project – do you have a link? It’s easy to give lip service to “informed consent,” but how many clinicians really do that even for adults, let alone kids? In my experience, not only do foster youth not get informed, they are outright lied to about what is being “treated” and what their options are, let alone the common fear of telling them about medication side effects. It sounds like this program would directly address that issue, and I’d love to hear more about it.
Personally, I think we should do a lot more than “consider the perspective” of the youth we’re treating. Their perspective should be the main jumping off point of any planned treatment, and should constantly be consulted as our guide to whether or not we are being effective in our work.
Thanks for your response!
—- Steve
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Fair enough. The ACE study has brought an increased awareness if the impact of trauma, though my experience is that the mental health system has been very slow to respond. Perhaps you are fortunate enough to travel in more enlightened circles than those I have worked in.
However, years of advocating for foster kids has shown me that very often, we as adults really do care and BELIEVE what we are doing is right and helpful, and yet those receiving our services don’t feel that way at all. I suppose the lesson I find is that kids have a lot to say but the adults don’t often create safe spaces to listen. I just had occasion to talk to a young couple in their early 20s last night who had seen the whole series (I’m only about halfway through, and most definitely NOT looking forward to the suicide scene, it sounds AWFUL!) and both of them said that the conditions represented in the school in the series were not an exaggeration and seemed very familiar to them. I think it’s way too easy for those with power to imagine we are doing good without bothering to consult those we are purporting to help, and I hope that is the real takeaway from this provocative series.
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And in perfect timing, here’s an article published on MIA that supports exactly what I’m saying:
https://www.madinamerica.com/2017/05/school-driving-kids-literally-crazy/
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I am quite sure that YOUR students are trained in a different way, Kurt, but I’m pretty confident that many if not most in the USA are trained in DSM diagnosis and brain-disease theory, even if some rebel psychologists/therapists provide different perspectives. And just like the kids at Hannah’s high school, whatever their prior training and beliefs, they have to deal with the oppressive system that they will be operating in, and that system challenges anyone who wants to look at “mental illness” in more human terms. I say this as a mental health professional who got out of the field and into advocacy after I could no longer stand seeing what happened to my clients who were hospitalized or even “treated” by the agency I worked for. I have many more than one anecdote to share (though it was actually a study, not a single anecdote), and the comments I make apply not only to the mental health system, but to almost any institution in US society today. That’s the point I was making – that Hannah’s difficulties were not a result of a “mental health issue,” but of her and her friends/associates having to survive in an oppressive environment day to day and the absence of anybody in a position of power willing to or capable of intervening. Perhaps I have put this in better terms this time and you can comment on this aspect of suicide prevention, which I believe is the main point the series is trying to highlight, namely, that someone has to acknowledge and challenge the power dynamics in the school and the larger environment for this kind of depressing hopelessness really to be challenged.
— Steve
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You captured what I wanted to say in many fewer words. The teens’ behavior is a response to the structure provided (or not provided) by the responsible adults. Those setting up the system are responsible for making sure it works, not those who are powerless participants. Thanks for your comments!
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Thanks!
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Thanks! Back at ya!
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Perhaps you misunderstand me. I have helped run a suicide hotline and have done involuntary hospitalization evaluations. I’ve placed many people into involuntary holds, directly or indirectly, and have also intervened with many, many more suicidal people and prevented many, many hospitalization with on-site or telephone crisis interventions. I have also spoken with many folks who have been hospitalized after the fact. To suggest that traumatization by involuntary hospitalization is rare suggests a Pollyanna view of reality. Sure, clients in the hospital often express relief that they didn’t end up killing themselves, but they also learn very quickly that telling the staff you’re pissed about how the situation was handled or that you feel powerless is both pointless and dangerous. I don’t know if you watched the show in question, but you ought to, and you ought to look at how often the teens tell the staff and/or their parents and even each other that everything is “fine” and there are no problems, even though they are seething with discontent, fear and grief. You have to develop sufficient trust for people to tell you their true feelings. I am very good at doing so, and I guarantee you that feeling traumatized is far from a rare thing.
As for suicidality from antidepressants and antipsychotics, gosh, there are warnings on the labels to this extent. Not sure how you can actually argue that point. New evidence more recently has shown rather conclusively that these effects are not limited to teens and young adults. Aggression is also sometimes a consequence of messing with the serotonergic system, as is listed on the label of all of these drugs, and as a recent MIA article has documented.
Naturally, preventing immediate suicide IS important and is the priority in a crisis situation. That was not my point. My point is that IN THE CONTEXT OF THIS SHOW, talking about methods to reduce the likelihood of suicide without looking at the causes misses the entire point of the production. The point is, people had MANY opportunities to intervene and perhaps prevent this suicide LONG before the crisis situation ever began to arise. This is true in many, many situations and the main intervention is to have people care about you and have the guts to stand up to bullying, sexual assault, and harassment instead of keeping quiet until the victim can’t stand it any more.
The secondary lesson also appears to bypass you completely based on your comments. The show demonstrates how our INSTITUTIONS, parents, police, schools, and the mental health system itself, fail to create a safe place where talking about the above issues is realistic. To give you an illustration, a recent survey of kids in residential treatment centers showed that they revealed significant trauma histories to complete strangers in 80% of the cases. Oddly, only 20% of the cases had traumatic events documented in the file! So at least 60% of the kids were willing to share their abuse stories with TOTAL STRANGERS but were either never asked by staff, didn’t feel safe telling them, or worse yet, told staff who didn’t feel the information was significant enough to include in their files.
Perhaps you have to watch the series to know what I’m talking about. Perhaps you need to step down from your professional pedestal and actually meet your clients where they live. Maybe you should ask a couple to DESCRIBE what being taken into custody was like, rather than asking them if they are grateful to be in the hospital. You might be surprised how many people appreciate that someone cared enough to try and stop them, but most definitely did NOT appreciate the violence and invalidation involved in being taken into custody. I’m sure you’ll hear from many of our regular posters on this point.
Lastly, your comments on how benign the SSRIs have since been found to be are questionable to me and lack any reference. It might help if you can provide links to these statements.
Appreciate your candor in responding, but you might want to avoid questioning my experience and credentials before you know anything about me. It is that kind of approach that encourages people to say they feel fine when they really don’t.
— Steve
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While I appreciate the important emphasis on compassion for suicidal teens, I’m really not sure what to say about this article. While I agree that putting resource numbers at the end of each episode is a good idea, I’m kind of astounded at how badly the author appears to miss the point of the series. The comments about not needing to understand the “why” and simply removing “means” seem to invalidate the important issues that the series raises, namely the importance of understanding the context in which suicides occur. The whole point of the series is to show that there ARE whys and that many people COULD have done something about the situation but did not! It also emphasizes that systemic changes are needed, as administrators and the counselor don’t appear to understand that bullying is rampant in the school, and the kids are unable/unwilling to trust the adults BECAUSE THE ADULTS HAVE NOT SHOWN THEMSELVES TO BE TRUSTWORTHY! The counselor and assistant principal had Clay on the verge of talking about the whole situation, but their authoritarian and accusatory approach caused him to clam up. The similarities to the situation in the “mental health” system can’t be missed by anyone who has been on the receiving end of “services.”
The incredible challenges involved in reporting sexual assault are also highlighted, and contributed very significantly to Hannah giving up. One very good way to reduce suicides is to make it easier and less traumatic to report events like sexual assault and domestic abuse, but the author fails to even mention these points in the article.
From the article: “Part of the problem here centers on what happens after a person is hospitalized and the time immediately after discharge. As clinicians we can sometimes be lulled into a false sense of security that as long as the acute crisis is dealt with, we are out of the woods. Regrettably this is often not true.” This suggests that suicidal feelings somehow “sneak up” on clinicians because the clinicians are overconfident that “the crisis is over.” This ignores more significant reasons why suicide happens AFTER hospitalization. First, hospitalizations are TRAUMATIC for most clients, especially if they are enforced or not entirely voluntary. This trauma is denied or minimized, just as the administrators at Hannah’s school deny or minimize the enormous reality of bullying in their school. As a result, no one talks about this to clients, nor acknowledges the feelings of powerlessness that often occur in the context of a psych ward. Additionally, many clients describe being unwilling to communicate their feelings to their professional support people after being hospitalized against their will, because they are afraid to be hospitalized and traumatized yet again.
Second, the main thing that happens during psych hospitalization is that the client is tried out on a new drug regimen. It is well established at this point that antidepressants and antipsychotics, the two most common prescriptions given in psych wards, both can induce suicidal ideation or action. To ignore this important variable shows a limited commitment to scientific reality.
To talk about “suicide prevention” outside of the context of why people kill themselves seems bizarre and disconnected. In fact, it seems to reflect the same kind of disconnectedness that kept Hannah and Clay and the other students from reaching out for help. I think the author does a great disservice to both clients and professionals by suggesting that preventing the ACT of suicide is more important than preventing suicide by understanding our clients and by revising and reforming our institutions so that trauma is less common and easier to talk about with authorities and less traumatic to resolve.
— Steve
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Actually, they can’t even objectively identify who belongs to the group “addicts.” It’s downhill from there.
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I object to the labels because they are not scientific, as not a one of them defines a group that can be accurately and objectively distinguished from a group not having the “disorder” in question. That’s not a political objection, it’s a scientific one. If you can’t establish a reasonable amount of variable control, you can’t do science. You can’t do studies on heterogeneous groups and expect to learn anything. It’s about that simple.
— Steve
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Jill, this simply can’t be true. There are many, many people who experience similar disruptions in their dopamine system temporarily and yet don’t become addicted. It is claimed that this difference proves a biological underpinning, but I don’t think there is much evidence that that is true, because it should be very evident from both research and a casual survey of the addicted population that there is an ENORMOUS disproportion of people who have been severely traumatized in their childhoods or later on who then become addicts. While it is possible that there is a subset of addicts who simply “can’t stop” for biological reasons, this subgroup has never been identified, as is usual for all psychiatric “disorders,” simply because the profession is comfortable sorting people into boxes based solely on behavior and have never bothered to try and make any kind of distinction between the reasons that people become addicted. It is both more convenient and more financially remunerative to dismiss the importance of causes, but it doesn’t serve the addicted person very well at all. As a result, neuroscience can tell us a lot about what happens to a brain after it’s soaked in dopamine for long periods of time with some accuracy, but it can tell us essentially nothing at all about why some people choose to so bathe their brains while others choose not to.
— Steve
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Arguing about which drug “relieves stress” more effectively is a ludicrous proposition. Alcohol can make anyone feel less anxious in the short term. Getting drunk is not a medical treatment.
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Excellent analysis, Richard!
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Your comments make sense to me. We need to seek a balance, and stop trying so hard to be “right” at the expense of someone else being “wrong,” which to me is the very essence of authoritarianism. I’m sure we’d have some fascinating discussions in person! Thanks for sharing your thoughts so articulately.
— Steve
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Exactly. It’s about having the power to define one’s own experience. Parents “advocating” for “eliminating” what some people view as parts of their personality is more than a tad invalidating!
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I know what you mean. I think it’s hard to really understand the level of trauma and disrespect and outright shaming and humiliation many of these survivors have experienced, usually from the hands of authorities like their parents or teachers or “mental health” professionals. I find their anger quite understandable, having spent enough time in “mental health” agencies and a couple of psych wards and heard enough stories to see what really goes on. It is unfair when overgeneralizations are made, and it does make some folks anxious about posting. And some of those comments, like calling you a “NAMI Mommy,” are just insulting and inappropriate. But it is important to realize how much hurt is there and that such comments are not really directed at you personally, they are directed at all the “mommies” and “professionals” and other authorities out there who have hurt them and not even noticed or cared.
You are clearly a good person who likes to deal with facts and has done some great work confronting the system with its own failures and mean-spiritedness. I’m glad to have you hear with us, despite the challenges you have faced!
— Steve
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The video was pretty disturbing, to say the least!
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It is also important to note that a lot of parents are unable to recognize how they are harming their children or encouraging or creating the very behavior that bothers them. Giving them this “explanation” prevents any meaningful dialog with caring parents who might actually be willing to CHANGE their behavior if they understood what was going on. The whole point of the DSM labels seems to be to blame the person who is suffering and absolve those with the power to actually do something about it from any responsibility whatsoever.
— Steve
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Love it!
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Wow, you mean you’d try to distinguish between possibly disparate CAUSES of “depression” instead of treating all “depressed” people in the same way? Wow, what a concept!
Thanks for your comments – glad I can beat out the catfish for empathy, but sad that a catfish beats out the psychiatric profession!
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Good for you for beating NAMI into submission! You must be a proud ODD victim!
— Steve
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“The criticisms of small effect sizes raised by these letters imply that we should only use the term brain disorder when everyone with the disorder shows the same pattern of brain abnormalities. By that definition, no psychiatric disorder would be a brain disorder.”
Excellent point! They have accidentally drawn the correct conclusion – no psychiatric disorder can qualify as a “brain disorder.” This is like saying that not all people with cancer should show the same indications of inappropriate growths, or that not all people with high blood pressure need to have higher than average blood pressure. Such idiocy is what passes for “science” in the world of psychiatry!
—- Steve
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I’d add also that the support of the pharmaceutical companies for these supposedly “patient advocacy” groups and the pushing of pharmaceutical solutions to every problem adds to the lack of trust in these organizations. Further, the lack of any apparent interest in consumers/survivors contributing to their agenda is a barrier to trust.
I’d have look at the youtube from Autism Speaks if you had any doubts of their lack of connection to the actual needs of autistic people:
https://www.youtube.com/watch?v=9UgLnWJFGHQ
I found it pretty awful!
— Steve
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I think the anger toward Autism Speaks and toward NAMI is not a result of people denying the existence of conditions that are called “mental illness” or “autism,” but rather of the “professionals” and parents of such people deciding how to define what is “wrong” with their clients/children as well as what they HAVE to do to “fix” themselves to the satisfaction of the parents/professionals. It is a very undignified position to put someone in and folks are understandably upset/angry about having that done to them.
It is important to distinguish also between saying that no one SUFFERS from conditions that are called “mental illnesses” in the DSM, and saying that the DEFINITIONS of the “disorders” in the DSM are unscientific and damaging. No one is saying that people don’t suffer or that they usually want their “symptoms” back if they go away. What I think most people are saying is that LABELING someone with a “disorder” and prescribing “treatment” based on fraudulent notions of “chemical imbalances” while completely ignoring trauma, social conditions, nutrition, sleep and other factors that may cause or contribute to the distress. It’s kind of a shorthand to say “mental illnesses are a myth” when we mean “mental illnesses as defined in the DSM are unscientific and misleading.” Based on what you’ve said earlier, I don’t think you and I are very far apart on that question, though I’m happy to be corrected if I got that wrong.
People definitely experience all forms of distress and difficulty, and no one is saying they don’t need or deserve help. All I’m saying is that DSM labels and condescending “professionals” who are unable to see past their own biases and issues are not helpful to anyone.
— Steve
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Well, of course not, silly! How can psychiatry and the drug companies keep the money coming in if you actually CURE people of what ails them?
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I tend to agree with Richard in that it seems kind of over the top to suggest that “matriarchy” is anything close to a power in the USA. I have heard from my own son that there is a certain authoritarianism that can arise in his left-leaning college and that he finds that offensive. However, this is not a manifestation of “matriarchy” so much as of AUTHORITARIANISM. Anyone who believe the right has cornered the market on authoritarianism has something big to learn, and there are also plenty of conservatives who are open minded and not sexist or racist. So we shouldn’t be making over-generalizations as if they are the truth, because that’s another form of authoritarianism right there.
I think authoritarianism itself is the real enemy, and both Martin and Richard are recognizing it in different forms, but I find we get into trouble when we allow ourselves to be herded into the classic “liberal-conservative” discussion frame, as this seems to me to be an anachronistic frame. Richard and especially Frank hit hard on this – it is this belief that the global capitalists/corporatists have our “best interests” at heart and the unchecked power they now wield that should be our target. And I gather that all of us agree on that point. So I’d suggest we get away from blaming liberals or conservatives or those under 35 or their parents or matriarchy and direct our energy toward the hegemony of the rich and powerful, as well as all the manifestations of authoritarianism, both on the left and the right, which impede our ability to attack those targets. At the same time, civil discourse, including cross-cultural awareness and sensitivity, is going to be very important to moving forward with these goals, not because people “aren’t tough enough,” but because people are very susceptible to being misdirected into foolish discussions such as whether Democrats or Republicans are responsible for the mess we’re in (or for that matter, which party is more likely to be “mentally ill”) and it requires diplomacy to help get people over these barriers and to see what’s really going on and that their enemy isn’t black people or women or white people or liberal universities or matriarchy, but CORPORATE POWER AND AUTHORITARIANISM. It’s not a matter of rightness, it’s a matter of effectiveness.
— Steve
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Yes! They have been beating down Autism Speaks because they have organized a resistance movement. That’s what we need to do!
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And how did s/he respond? Did logic actually have any positive effect?
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So here’s the big question, Pat: how exactly does one distinguish between these two purportedly distinguishable groups? Psychiatry has no answer for this, none at all. They give lip service to the idea of “endogenous” vs. “situational” depression, but their DSM checklists don’t even attempt to make that distinction that I can discern. I’m quite serious when I ask this question – how would you tell the difference?
— Steve
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Only if you’re genetically vulnerable to car accidents.
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Perhaps they should just eat a lot more yogurt? Oh, but that can’t be PATENTED, can it?
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You are so right! The diagnostic process itself is a means of “blaming the victim” and distancing ourselves from the “mentally ill” individual, as well as avoiding any and all responsibility for doing something about the situations that may have caused the problem. ADHD is a great example. The fact that a child can’t stand sitting through your class does NOT mean there is something wrong with the kid! Maybe your class is incredibly boring, or this kid simply hates to sit around doing nothing with his body, or the kid is super smart and figured out what you’re “teaching” about two years back, or you’re talking over the kid’s head and he has no idea what you’re talking about but is embarrassed to admit it, or the kid is distracted by the fact that his dad threatened to kill his mom last night and he’s wondering if she’ll still be alive when he gets home today… you get the drift. But with “ADHD”, no one has to ask any of those uncomfortable questions, and the teacher doesn’t have to change a thing! We simply blame the kid’s brain and put him on a drug that makes him less annoying to the teacher, despite long-term evidence that this does NOTHING to improve the kid’s overall well being down the road.
It’s a cop out. The least powerful person in the room takes the blame, which is probably what got them to be labeled “mentally ill” in the first place!
—- Steve
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I agree. It is also important to recall that these studies showing increased suicidal thinking or behavior SCREEN OUT suicidal people before starting the experiment! So the results are actually reflecting not the total number of suicidal thinkers in the group, but the total number BECOMING suicidal as a result of “treatment.” Especially when we look at the long-term outcomes being so poor, “antidepressants” are not only generally ineffective, they are overall more dangerous than they are useful.
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You know, not everyone who gets hit by a car has internal injuries. Probably 90% escape with no internal injuries at all! There MUST be something wrong with that other 10%… Let’s do some genetic analysis and see if there are commonalities among those who appear vulnerable to internal injuries so we can counsel these folks to wear extra protective gear when walking around near traffic, or perhaps prescribe some organ-toughening or bleeding-suppressing drugs for them to take all the time, just in case it happens again.
What, install a traffic light? What kind of naivete is that? “Common sense” has failed these poor people who are obviously genetically vulnerable to damage from being hit by cars, so let’s dispense with it altogether! After all, 90% of those hit by cars had NO internal injuries whatsoever! What’s wrong with the rest of you wimps?
—- Steve
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I actually believe that this discussion was a very healthy one in many ways, and is full of learning opportunities if we can all put our hurt feelings aside.
There are some comments which possibly could have been moderated, but the rate of comments is so fast, I’m not sure it’s realistic for anyone to intervene quickly enough. But I still find discussions like this INCREDIBLY valuable, because we are now discussion one of the most fundamental problems/issues/conflicts with the current system, not just the mental health system but our social system as a whole: WHO GETS TO DEFINE WHAT IS TRUE/REAL/VALID? And it’s not an easy question!!!
I would exhort ALL posters to take this thread as a lesson on how important it is to be respectful and to own our own views without invalidating others who post. After all, isn’t that the very thing our most passionate posters are objecting to? The idea that “mental health professionals” are allowed to invalidate your reality? Well, let’s not do that to our allies in the mental health professions, either, or better yet, let’s all commit not do that to ANYONE who posts here!
There are many professionals who have been extremely courageous in their battle to make things better for those condemned to interact with the system for whatever reason, and Brett and James are certainly two who qualify. If they say something that we object to, let’s treat them the way we’d want to be treated, respecting their viewpoint while respectfully disagreeing and expressing our own. Let’s model how helpful human interaction SHOULD be right here on our site! Similarly, we who come from a more professional background, let’s understand that feelings will get strong in this kind of discussion, for very good reasons, and let’s not take it personally and use our best professional skills to moderate the conversations ourselves rather than escalate them with our own emotional reactions.
“Be the change you want to see in the world” – we can do this, all of us, right now. It’s really the best, maybe the only way to counter the crappy treatment that so many authorities dish out.
In the end, this was a very valuable discussion. It will be more readable and will affect more people in the way we want it to if we ALL take the time to moderate our own comments, as well as accepting it if we may have offended someone else and taking steps to make it right. Stephen is right (as usual) – if we consider that we’re dealing with very different cultures colliding here, and act accordingly, we’ll come out much stronger and more effective in the end.
— Steve
P.S. One last thought – I wonder if we might have a cadre of “on-call” moderators available for the times when a discussion like this one gets big and deep and powerful? I’d be happy to volunteer for that role. Emmeline, let me know if you’re interested!
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Brett, I really appreciate this reply – it certainly reflects that you fully read and digested my comments, and I feel fully heard. It is actually quite a conundrum to me: I’d really LIKE to have lots of mental health professionals join this site and the movement in general, and I know that angry survivor voices most likely impede that; at the same time, the main REASON I’d like to see more professionals is because we generally don’t pay attention to or block out the very voice that is being expressed here. I don’t see any real progress in the field until and unless hearing the voice of those harmed by the system, and even those not yet harmed but who are at high risk to become so, becomes the PRIMARY voice by which we operate.
I was fortunate to come into the mental health field by the “back door,” so to speak (my MS is in Education, actually), and I was in a position initially where I had very little theoretical training but a lot of compassion, and I actually developed my initial knowledge base almost entirely from talking to clients and seeing what they needed and how they reacted to my approach. Of course, I made lots of mistakes, but I did so with an open heart and an open mind and was almost always prepared to be corrected by the client’s verbal or nonverbal communications. I think this last part is what many professionals are lacking, and the DSM and the current system of dismissing trauma and blaming the victim makes it WAY too easy for professionals to dismiss their clients’ righteous indignation (at them or at their previous traumatizers) as irrelevant or “inappropriate” (I HATE that term!) That absolutely HAS to change – the client’s emotions and reactions and information HAVE to be the basis of all we do, or there is really no point in putting ourselves out there as helpers. Which is why my initial reaction to this idea of “correcting” the perceptions of others was so strong – it just plain doesn’t work, and it leads to exactly the kind of anger we’ve seen on this thread. Survivors of the MH system are not ever going to be OK with having their own realities invalidated, because it’s happened WAY too many times both before and after entering “the system.”
That being said, I really do appreciate your efforts and I also really do understand your frustrations. As I said, it is a conundrum of major proportions. All in all, I’m really glad this discussion happened, and in my view, by taking the risk of expressing your own experience here, you were a catalyst for the conversation going much deeper than it otherwise would have gone, and I really appreciate you for putting yourself out there and taking some hits to get folks to dig down deeper. I hope you can reflect back on what’s happened and see the value in the discussion, even though I know it caused you some personal pain to participate.
Thanks again for all you have done to move this project along!
—- Steve
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I would most definitely miss you and your contributions!
— Steve
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Exactly!
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Or be therapists to anyone who is actually experiencing emotions of any sort.
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It feels like entitlement – that “professionals” somehow are entitled to be protected against anger and being perhaps unfairly targeted of others’ rage. Naturally the recipients/victims of the “mental health” system are not entitled to any such protections.
An important contribution of Freud was the idea that clients who have been unable to speak their rage and helplessness will make us FEEL their rage and helplessness through their behavior. Professionals worthy of the name ought to know that well and understand that especially if they are “safe” professionals, they WILL be targets of these emotions, and they should expect it. I would go so far as to say that any professional who can’t handle this should stay far away from trying to “help” people and do something where they won’t have to deal with the discomfort of people’s real emotions.
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Thanks for your lovely comment!
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Excellent point!
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VERY well said!
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I agree, Sandy sets the ultimate example of how to handle criticism professionally. Her humility and her willingness to learn from other viewpoints makes any attempt to needle or provoke negative responses from her fall flat. That is the kind of professionalism we need from professional bloggers and from professionals in general who want to change the system. If we can’t listen to the distrust and anger our wonderful “system” has helped to create, how will we ever be able to alter things in a healing direction?
I would also add Johanna Moncrief and Lucy Johnstone to the list of professionals who are not afraid to roll up their sleeves and swim into the seas of conflict!
— Steve
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Brett, I am sorry you have felt so attacked by this discussion, and definitely can see how you might have felt that way, as some comments did seem very personal.
I generally find your comments highly enlightening and thought provoking, but I have to say, this last set of comments makes me wonder if something has triggered your own issues here. I could be wrong, but it doesn’t feel to me like you’re simply working to improve the quality of the comments or improve the likelihood of the mission being effective – you sound angry and irritated, and you’re making gross generalizations, for instance, about people in general being anti-science or positing that there is no objective reality, which characterizes a VERY small proportion of the comments I’ve read.
I agree that professionals posting here are sometimes attacked unfairly, but again, I think that is a function of the kind of audience this type of a website will inevitably attract, and I agree with Richard that it is part of our job as professionals to be able to respond to such apparent attacks without rancor or judgment. The voice of the oppressed can be harsh, especially toward the perceived authorities, but that is a function of the trauma they have experienced and their righteous rage, not necessarily any reflection on you and your contributions to the movement.
Which gets to the real point of the discussion, which I wish you had tried to hear behind the anger. The point is not whether there IS an objective reality, the point is whether PROFESSIONALS like you and James and Richard and Stephen and Ron and I are entitled by virtue of our professional titles and experiences to DICTATE what reality is to our clients? Or is it our job to negotiate, test, communicate, question, probe, and encourage our charges to look at things from different viewpoints and make their OWN evaluation of what reality is. I heard one commenter only who pitched the idea that reality is whatever we make it – the vast majority accept objective reality exists, and are objecting instead to the idea that it is James’s or my or any of our jobs to CORRECT the client’s perceived misconceptions of reality, but suggesting instead that our job is to explore with them how and why their “misconception” makes sense to them and move forward from there. Of course, there are times of danger when we may feel we have no choice but to act protectively, but the VAST majority of the time, the client’s “delusions” are no more delusional than the psychiatrists’ idea that their lives can be fixed by drugging their brains, and actually far less dangerous. It’s a question of whether reality is something that the authorities dictate to their subordinates or is something we discover together, understanding that none of us has the full scoop on what “objective reality” truly means.
I hope this clarifies at least where I and where I think a lot of other posters are coming from. It is really not personal, even if it may seem like that. And being a professional means being able to make that distinction. You are getting the suppressed rage from every time these posters had something to say to a professional but didn’t feel safe saying it or was punished for doing so. It may not be good politics, but it is a natural outgrowth of a certain part of objective reality that professionals in similar roles to you and me have historically tried very hard to deny exists. It’s gonna happen, and it’s not fair, but it’s reality. For all this talk of clients denying reality, I think we as professionals need to be honest enough to admit that the clients’ reality as conveyed, whether fair or not to us individually, is a VERY big reality to be dealt with, and the system change we want to see happen will NEVER happen until we as professionals can not only accept but embrace that reality, the reality of the very clients we are trying so hard to help.
— Steve
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Actually, I think a goodly percentage are actually that delusional. The ones at the top know what they’re doing, but a lot of the rank and file are just emotionally crippled people who have been trained to say certain things, so they say them.
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Another fox guarding the henhouse. Such corruption is unprecedented, in my opinion.
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I am with Richard. I think being a professional means taking responsibility for the effect you have on your audience/client base, whether intended or not. I always figured that people have the reaction they have, and whether they were polite about it or not, there was almost always important information to be gained from hearing and clarifying their reactions. Part of being a professional is understanding that the client is going to have reactions and that it’s your job to set the tone of respectfulness, not theirs. Not that this means a professional has to put up with abusive behavior, but the professional has a responsibility to handle it, well… professionally.
— Steve
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“I’m learning that I don’t have to agree to find things of value.” I think this sums up the big lesson of this comment thread. There may be “objective reality” but no one is the final authority on what “objective reality” is, and it looks different from different perspectives. Even when I think someone is totally “out there” in terms of what’s actually true, there is a lot to learn from finding out WHY the world looks the way it does to them. As long as no one is being hurt, I think we do best to simply realize that agreement is not required to respect someone’s viewpoint on reality.
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So wondering where your next meal comes from makes people anxious and depressed? Who would have guessed?
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I don’t think so. I think Vlado is trying honestly to provide his perspective, and I think it’s important that we respect his experience, even though I think most of us would not adopt his suggestions as a good general policy on how to engage with someone in distress. He’s found a way that works for him – good for him! And I think his argument holds elements of empowerment – that psychiatrists should enable their customers to utilize the offered drugs in ways that work best from the customers’ point of view. This would, of course, involve psychiatrists admitting that their entire approach is not scientific, but is basically the offering of substances to make people temporarily feel better subjectively while making no effort whatsoever to figure out what is really wrong, which they would never allow, but still, there is a legitimate point in there that deserves recognition.
— Steve
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“Consensus reality,” by definition, requires consensus, doesn’t it? The word itself is basically an admission that many viewpoints can constitute reality, and that common reality is defined by consensus. Hence, the only thing really “wrong” about “delusions” is that they defy what most people choose to believe is true. Your point about slavery is very well taken. There are plenty of “consensus reality” beliefs (such as the belief that psychiatry is a scientific field!) that are of pretty questionable validity.
I do believe there is a “reality” out there that we all perceive, but even physics, the most reality-based discipline there is, has run up against the problem that even perceiving reality alters that reality. So any perception of reality, no matter how precise, is always an approximation. Admittedly, some approximations comport more closely with the actual DATA of reality, but they are still approximations and subject to modifications when new data comes in.
Bottom line, reality for humans exists as a relationship between the perceived and the perceivers, and no two people perceive reality the same way. Consensus reality is always a negotiation, and I think you’ll agree that we get into big trouble when only a small subset of humans get to be involved in the negotiations and the rest of us have to live in their “reality!”
— Steve
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Here is one link:
http://www.nytimes.com/2013/05/19/health/the-health-toll-of-immigration.html
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A fascinating study looked at US immigrants’ health measures over three generations. While health indicators for first generation immigrants were all over the map, by the third generation, they had all “normalized” to USA-typical health problems, including increases in obesity, heart disease, diabetes, anxiety and depression. So much for genetic causes of “mental health problems,” or even physical health problems, for that matter! Our way of living makes people ill!
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Very well said. Thanks for the clarification!
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Sam, you’re a gem! And it sounds like your wife is, too, despite everything.
— Steve
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Well, you never seemed too interested in hearing others’ views, which is kind of the point of this forum. Since you already seem to believe you’ve got it all figured out, I encourage you to go back to toenail picking.
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The law of gravity and all other scientific laws/theories are human inventions. Gravity (as in the tendency of massive objects to move toward each other, at least in the 3-D conception of space) does appear to exist, but it can be viewed in a number of different ways, both mathematically and philosophically.
While reality does clearly exist, we know, even in physics, that perception can and does alter the very nature of reality itself. Without a consideration of viewpoint and perception, any description of reality is incomplete, hence the need to create AGREED-UPON reality between the clinician and the person they are trying to help, even if the client’s viewpoint appears to us to be distorted or “wrong.”
— Steve
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I would suggest that you add the provisions of the Harrow study, which found that patients with BETTER prognoses did worse on neuroleptics than patients with WORSE prognoses off neuroleptics. This really undercuts the idea that only the “less ill” do better off drugs. I don’t think you should concede that point at all.
Otherwise, great data, well argued. Thanks for keeping up the fight!
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Not to mention that there is no objective way to even approach determining who the “right patients” are except by giving them the drugs and seeing what happens. And the claim that they are “life-saving” flies in the face of the horrific early death rates for those taking the major tranquilizers aka “antipsychotics.” I agree 100% – it is the responsibility of the medical and psychological professions to actively discourage the long-term use of these agents and to explore other options that are more likely to lead to a real improvement in life quality.
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Your comments also remind me of the qualitative study showing that “psychotic” people in countries where voice hearing was accepted or even valued as a special gift had friendlier voices, whereas ones where “psychosis” was rejected and feared had scarier experiences. It appears the social environment not only affects the presence of voice hearing, but also the quality and content of the voices! So your thesis makes total sense – it may be that suppressing the voices may be the WORST approach we could take!
—- Steve
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These studies also generally fail to distinguish between SYMPTOM REDUCTION (usually the clinician’s goal) and QUALITY OF LIFE (usually the client’s goal). If you focus only on symptom reduction as an outcome measure, neuroleptics will be judged “beneficial,” at least in the short term. But if you look at quality of life measures, it appears that neuroleptics are at best of limited use, and more likely generally destructive. I think that’s where a lot of the conflict and confusion comes in – psychiatrists are often only concerned with making the “symptoms” go away, and frequently have little to no concern for long-term quality of life outcomes.
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“Nerve seizing.”
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“The only authority on my perceptions and my reality is me.”
VERY well said!
— Steve
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Wait for what, and see what?
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Thanks! Honestly, I really don’t know what others are perceiving or why they are perceiving what they are. And I’m genuinely interested in understanding how and why they believe what they do. Perhaps it’s because I didn’t receive any formal training before starting my work as a counselor, so I had no illusions that I understood anything except as the client explained it to me. That approach has never failed me yet!
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I agree 100%. But the way you frame that is YOU think the truth is x” vs. “You are wrong and need to listen to what I say.” There is all the difference in the world between letting the client know what you honestly think vs. telling the client that they need to think the same way you do. It is subtle but can make the difference between eating the rat poison and not eating it.
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I find your last paragraph to be the most important. We fail our clients, or the people we’re trying to help in any capacity, when we believe we know more than them and are entitled to dictate reality to them, and when we believe our knowledge is “right” and infallible. Being open to our own vulnerability and potential lack of understanding allows the client to also be open to the possibility that their viewpoint may not be the only “right” way to view the situation, either.
— Steve
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Exactly! That is what works!
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I am not sure the critique is exactly what you’re suggesting, at least in my case. You might want to see my post above. I believe, from direct observation, that it is not only quite possible to influence someone’s views while still being totally validating of their viewpoint, it is actually the key to good therapy. A woman living in a domestic abuse situation and imagining she can make it better if she tries harder is not a situation I want to see continue. However, it’s very clear from my experience that telling the person she’s wrong about her ability to make her abusive partner change either alienates me from her or makes her feel stupid and incompetent, neither of which leads to the desired reconsideration of her reality. What I have found DOES work is exploring her belief that something good is happening by staying or at least that something bad is being prevented by staying, and validating that reality, which almost always makes a lot of sense when you take the time to hear the reasons behind it. I then try to turn the discussion to one regarding what THE CLIENT wants and whether or not the current situation provides it IN THEIR VIEW, and honestly explore the pros and cons of staying vs. leaving, at NO TIME telling the client she is wrong for staying, and in fact letting her know that many if not most DV victims stay for long periods of time trying to fix up the situation, and for very understandable reasons. Of course, I am also willing to share my personal thoughts on what is happening and why if they are interested, and also how likely I believe it is or is not that this will work out, but I don’t present them as REALITY, simply as my personal views based on my own experience with this kind of situation.
So one doesn’t have to AGREE with a “delusional” (is there not implied negative judgment in even using that word?) viewpoint to validate that it looks that way from the client’s perspective. Nor does one have to invalidate that viewpoint in order to help the client see that other viewpoints also exist and may have validity as well. It’s the difference between saying, “There are no voices talking to you – you are imagining it” and “I understand you are hearing these voices, but I personally can’t hear them and don’t know what they’re saying.” The first invalidates the other person, the second merely states the reality that you’re having two different experiences, and doesn’t privilege the therapist/helper to having the “right” viewpoint.
— Steve
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Not sure how validation and confidence/independent thought are not compatible. While I have very strong personal ideas about what is right and wrong, I also understand that I don’t always see how things look from others’ viewpoints. I’m not shy about sharing my views, and strongly, but I’m also always interested in hearing where others come from, and especially WHY they come from that viewpoint. In the cases where I do think a person would benefit more from being able to see things my way (I’m a pretty smart and observant guy and I think have a lot of insights to share in many situations), it still works much, much better if I understand what the person is thinking before I intervene.
A great example: I used be a supervisor for a community suicide/crisis hotline. Once I got a call from a woman who was suicidal, and I asked, as I always did, what benefits they thought would occur from suicide, or in essence, what problem they saw suicide solving for them. She said, “Because the pain would end.” Now I don’t know why I said this, never have said it before or since, would probably be criticized roundly by most “mental health” professionals for doing so, but for some reason, it seemed the best thing to do. I said, “How do you know that?” She said, “What?” I said, “How do you know the pain would end?” She said, rather heatedly, “What are you talking about??!!” I said, “What if when you die, the pain doesn’t end, but you have no body but you still have the pain?” She said, “Oh, my God, I never thought of that!” We were then able to talk about other options she might have short of suicide to reduce her pain, keeping in the background that suicide was always an option she could return to if need be, but a rather uncertain one at best. At no time did I tell her that she shouldn’t commit suicide, nor that committing suicide would NOT end her pain, I merely pointed out the possibility that her certainty about the outcome might be misplaced.
So I validated her pain and her desire to be rid of it, but I neither validated nor invalidated her solution. I simply created grounds where we could talk honestly about the pros and cons. I showed I understood her and accepted her viewpoint and needs, but let her know that other viewpoints might be possible, as well as other solutions. I was certainly both confident, even bold, and quite independent in my approach, while still validating her reality. It can be done.
— Steve
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And all side effects of the “medication” will be attributed to “the disorder.”
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VERY well said!
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Well said. My oldest is super gifted in math – could translate negative 100 Centigrade to Fahrenheit degrees IN HIS HEAD at the age of 6, and even knew without being told that he had to add 32 degrees to adjust for the difference in the zero points of the two scales! But he was failing 6th grade math. Found out that the teacher gave them “steps” to memorize and repeat, and they got one point for each “step,” and if he skipped half the steps, he got 50%. Her most common quote was, “Math is just a mechanical process.” The next year, he did independent study and covered two year of material in 7 months and was taking math at the high school by 8th grade. But this dumbass lady was flunking him for not following her steps. Idiocy!
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Very true, Hugh. Recognizing that we’re not alone and that our reactions to abuse/trauma/oppression aren’t all that unusual is most reassuring and often the first step to healing. Unfortunately, as this study seems to indicate, that first step is often never encouraged or allowed by those purporting to “help” those with “mental health problems.”
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Sad but true. It also allows more profit-taking when you blame the victims, and it also absolves all the people who actually have the power to make a difference from responsibility, even if they are the perpetrators of the abusive or oppressive behavior. It’s a win-win, as long as you’re the one in power!
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There is a need for a consensus reality of some sort for us to operate as a society. But that reality needs to be a negotiation between different viewpoints or else it degenerates quickly into an authoritarian mess. Kids have very important information about their experiences as kids that both parents and teachers need to know about and respect. Dismissing every kids’ experiences as wrong if they conflict with the adults leads to rebellious or demoralized children.
An example: I was acting as a classroom aide in a school for kids with behavior problems, but sometimes I helped the teachers with reviewing the kids’ work. I got a true-false quiz from one really bright first grader, and I saw that he answered several questions “wrong” according to the answer key. Knowing how smart he was, I went and asked him about his answers to each question. In all cases, he had a completely rational and sensible reason why he answered as he did. Marking these “wrong” would have invalidated an unusually deep kind of thinking for a first grader, but that’s what happens all the time to kids in school.
The proper response to “the blackboard is red” is to say, “What makes you think it is red?” If you find disagreement, it’s fine to say, “Well, I have to say, to me it looks green.” But it is not necessary to “correct” him/her and insist your viewpoint is correct.
When it comes to things like classroom rules, I’ve always found that having the kids make them up with you is the best approach, and creates an excellent consensus reality to work from. But that’s an AGREEMENT between parties, not the dominance of one viewpoint just because the person has more power than you.
It seems there is always a way to let someone know when your viewpoint differs from theirs without invalidating their viewpoint.
— Steve
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Why do they even need to “study” this kind of question??? It’s the most obvious thing in the world! Why don’t we spend our time trying to stop abuse and trauma instead of “studying” whether it affects adults’ “mental health???”
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“Overtreats” is an interesting word. Don’t they mean, “recommends ‘treatments’ that are unnecessary and potentially dangerous, in violation of medical ethics?”
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Thanks!
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Great summary of the issues and the testimony! This is REALLY big news!
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So running electricity through your brain and inducing a seizure can induce cognitive impairments? Who would have guessed it? Next thing, they’ll discover that being hit in the head by a speeding car has adverse impacts on brain function!
— Steve
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“This intervention focused on treating the residents as human beings with needs, not as patients with problems.”
Treating the residents as human beings… what a concept…
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I always ask what we’d think of a car repairman who told you that you had “repair-resistant fuel injectors” but to pay them $300 and bring it back next week for another “treatment” to reduce the “symptoms.” We’d find another mechanic REAL quick! So how does psychiatry get away with blaming the people’s “depression” for “resisting” their efforts to be helpful? Wouldn’t it be a lot more honest to say, “Our approach didn’t work and we don’t know what to do to help?”
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Ah, what’s a few thousand deformed babies compared to all the WONDERFUL benefits of sedating oneself into numbness for weeks/months/years at a time?
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You are right, Richard, that true science does not eliminate the concept of the mysterious and the unknowable, but I hope you can acknowledge that many folks use the cloak of “science” (I call this “scientism”) to promote ideas of strict materialism (that which can’t be measured doesn’t exist), and that psychiatry itself is dependent on this very phenomenon. The big argument I hear many times in favor of bio-psychiatry states “the mind is the brain” or “the mind is a product of the brain” because “what else can it be?” It is a very short step from there to “treating the mind = messing with your brain.” The unwillingness of psychiatrists and other “mental health professionals” to acknowledge the unknown and their lack of understanding is pivotal to psychiatry’s continued existence. They “know” that genetic causes for “mental illnesses” exist and they just haven’t spent enough time looking. Soon they think they will have “designer psychiatry” specially created for your own personal brain. Meanwhile, receiving medical treatment is the third leading cause of death in the USA annually.
I think it is very important to deconstruct this kind of hyper-materialism as part of deconstructing psychiatry. Most people I have encountered who espouse a materialist philosophy around psychiatry don’t even understand that it IS a philosophy, they just think that it is TRUE, and even those who recognize it as such don’t have the subtle understanding of the implications of a true scientific materialist viewpoint. The recognition of the unknown and even the unknowable is a fundamental lack in psychiatry and all of its allies, and is central to its continued existence. Once their pseudoscientific “certainty” is undermined, it becomes much easier to show lay people that they are full of crap.
Not to mention that there are other possible philosophies that can’t be eliminated by science, leaving us open to a lot of possible views on the nature of reality, even while maintaining a scientific viewpoint, as uncomfortable as that may make us feel. Consider the uncertainty principle, or the quantum mechanical fact that a particle can move from one place to another without having occupied the space in between, or the nature of a quantum of light that when perceived in one location, it becomes unavailable to be perceived in all other locations. It appears that perception can and does create and/or modify physical reality, and that the goal of science to create hard and fast rules regarding material reality can’t actually ever be met. Even material reality appears to be affected by viewpoint, so relativism is a scientific reality even in physics. How psychiatry can deny the essential reality of relativism in the realm of the mind and get away with it remains baffling to me.
— Steve
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Both great comments!
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I think that’s a perfect idea! Or we could coin a new word — neoclib? Neolibervative?
Nah, let’s just stick with Neos!
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That’s because guys like Murphy aren’t conservatives. They are neoconservatives, AKA supporters of big businesses and the well-to-do. They don’t care about free markets but use that kind of rhetoric to make it seem like they are conservatives. They are really in favor of monopolization of markets by their big corporate contributors. Same is true for neo-liberals like Hillary Clinton. As a result, you are right, they don’t give two figs about their voters as long as they can fool them into voting for them next time around.
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I do think we can help ourselves by getting rid of anyone who is taking money from big business as their main source of campaign funding. We can also support an amendment/court decision/whatever to get corporate funding completely out of politics. Anything that will reduce our congresspersons’ dependence on corporate donations will help our cause immensely!
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I am afraid Trump is not a deep thinker. It seems he is more easily swayed than I would have guessed, and he travels in very rich, elite business circles. In such circles, profits matter more than whether something works or not. IMHO, anyway.
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Why would this be surprising, as they suggest in the subtitle? Only because of the HUGE propaganda to the contrary. Common sense tells anyone who possesses it that environmental influences are both very large and modifiable, while genetic are pretty much fixed and immutable. Why do we spend all these billions studying genetics, when there is little to no evidence they are the primary influence, and when they are the one thing in the equation that can’t be changed anyway?
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It would seem to me that the conservative view of this would be that the “mentally ill” are responsible for their own decisions and would experience the consequences of their decisions, and also have inalienable rights to freedom of speech and association. I believe that’s one reason that we tend to get more support for these issues from the right. However, this appointment is not about “right” vs. “left,” but it is about corporations and the elite vs. the rest of us. There appears to be little to no room for hearing the voices of the actual recipients of their “help,” but plenty of space for those in power to expand their power base. I would hope that any compassionate person would oppose this kind of oppressive behavior, regardless of political affiliation. Unfortunately, many otherwise rational people appear to have a hard time getting their heads around this issue, largely because of the massive propaganda from the drug corporations and the psychiatric hierarchy.
— Steve
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Does this really surprise anyone?
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“Rates of sexual violence are so high for college women that some researchers recommend that counselors ask any female college student who presents with “mental health distress” about experiences of interpersonal violence.”
I always asked ANY client presenting with any kind of distress about their past experiences of interpersonal violence. Especially women. This shouldn’t have to be a recommendation – what the f*%k else are they talking about?
It also seems like they are making this a lot more complex than it needs to be. “Communication accommodation theory?” Really??? How about just talking to them and listening to what they have to say? Too radical?
— Steve
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Or an even more basic question: Is “ADHD” actually an entity that can validly be studied at all? That’s my point re: genetic variation. We can pick any spectrum and choose to cut of the end of it we don’t like, and call it a “disorder.” Why would we assume that just because some kids don’t like sitting still, there is something wrong with them? I know, I’m preaching to the choir here, but I think studying “ADHD” is idiotic. If there really were a small percentage who DID have something wrong with their brains, we’d never find it by studying a group of kids who happen to have a hard time tolerating the generally very oppressive atmosphere in the average elementary school classroom.
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Feeling, you need to discover the magic of placebos! Just put some Niacin or something in one of your old pill bottles and make sure to pop one in front of your mom and you’re home free!
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There is also no distinction made between detention and “treatment.” If it is deemed that someone be held against their will for threatening others or for otherwise being dangerous, why does that automatically confer the right to “treat” the detainee with some enforced drugging regimen that can do irreparable harm and end one’s life years early? Why not be honest and admit we’re simply arresting and detaining a person to avoid speculative and ostensible harm, and stop pretending we’re “treating” or “helping” the person, thereby justifying all manner of paternalistic abuse in the name of “help?”
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And most of the rest by chronic psychological pain, for the most part as a result of traumatization or unrelenting stress. Depression is a natural reaction to feeling trapped in an untenable situation and having (or perceiving) no ability to escape. Address the pain, find another way to move from the apparent trap, and suicide no longer seems like an appealing option. Unfortunately, psychiatry does the opposite – tells you that you have no control and the only hope is to keep things “less miserable” through their drugs. They are purveyors of hopelessness for the most part.
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More insults do not heal your earlier insults.
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This has no bearing on your insulting remarks above. Accusing people of being “fakes” is the problem. I expect an apology to all the people whose suffering you have minimized or ridiculed because you don’t agree with how they handled it. Accusing people of fakery is absolutely not acceptable, a violation of ANY community’s standards for posting if they have any standards at all.
Think about THAT, Pat!
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You are welcome!
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This is not a “beat down.” You are directly insulting people who suffer from similar problems to your own and claiming they are not “really” suffering because they had different experiences than you did. That is disrespectful and hateful behavior in ANY context. I never gave you a “beat down” for your opinions and have ALWAYS respected your own experience as finding the drugs a positive for you personally, and have only argued that you can’t assume that because you personally had that experience, it meant there was scientific proof that your or anyone else’s brain was faulty. You can call that a “beat down” if you want, but I have NEVER suggested that your own experiences and suffering were not legitimate just because you didn’t agree with me! That is absolutely outrageous behavior, and I believe you owe an apology to others on this site who have suffered similar experiences to you but chosen different paths to healing/recovery or whatever word you want to call it.
There are people here who have been to hell and back several times over and you have NO IDEA the severity of their suffering, but choose to arrogantly assume that “real mentally ill” people could never have “recovered” without drugs, despite my even providing you with some very cogent public examples of people who have.
You are entitled to your beliefs, but you’re not entitled to insult people with impunity. And you’re not entitled to accuse me of “beating you down” when I step in to defend the folks you so blithely consigned to “fake suffering” status just because you want to protect your own ego.
—- Steve
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This all reminds me of the movie, “What About Bob?”, where the psychiatrist (Leo) behaves in a more and more crazy fashion while his client, Bob, gets more and more rational. In the end, he attempts to murder Bob, but calls it “Death Therapy” – “It’s a sure cure!”
What is wrong with these people??????? It would be funny if it weren’t really happening!
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“Mimic the real thing?” Now you have gone too far. How do you know what the people writing here have suffered and how do you dare insult them by suggesting their suffering isn’t real???? How would you feel if someone minimized your suffering and suggested it wasn’t bad enough to be real? Just because others find different solutions than you have doesn’t make them wrong and you right. I strongly suggest you take a big dose of humble pie before you post again! BTW, I am reporting your post as a violation of the posting rules, and I am hoping it will be removed, but in any case, your insensitivity is hurtful to others who have worked hard to get where they are, even if they traveled a different path than you chose.
— Steve
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Why seek preventable causes when “treating” the effects is so much more profitable?
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It’s not because stories about domestic abusers are boring. It’s because these stories challenge the powerful and empower the victims. Whereas blaming the “mentally ill” blame the powerless and protect those in control. Domestic abuse is symbolic of the dominance model that most of our Western institutions are organized around, including Psychiatry.
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Well said!
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I especially agree about the “don’t blame the family” meme. Sometimes, in fact often, the family is a BIG contributor to any of the “mental health diagnoses” that the psychiatric profession has manufactured in order to eliminate the hard work of figuring out what would really be helpful. The Authorities are always spared and the weakest and most vulnerable always blamed. Unless that dynamic changes, there is no “healing” going to happen.
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The music might be dull, but he can play without making ANY mistakes!
— Steve
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In other news, scientists have discovered that striking people in the head with a hammer repeatedly leads to both head pain and cognitive decline. It is unclear whether this is due to the particular kind of hammer used or a genetic vulnerability to hammer strikes, or perhaps simply the course of sore head disease causing the deterioration.
— Steve
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Seriously, the problem isn’t that some people have privilege and others don’t, it’s that the entire capitalist system is based on the powerful keeping the powerless in their place. Sure, some are lower on the hillside than others and get more shit dumped on them, but the problem is people dumping their shit on people below them. Readjusting and having some with less “privilege” get higher up the hill so they can have someone to dump on really doesn’t change the dumping system in the least.
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I don’t agree that a drug “working” is evidence of a medical problem with neurotransmitters or anything else. Alcohol is widely used as an anxiety-reducing drug, and is very effective for that purpose. Does that mean everyone who takes a drink or two to relax has a medical problem? Coffee is a stimulant that helps increase alertness, especially if sleep is somewhat lacking. Do people have to have a neurotransmitter problem for coffee to keep them awake? You can’t use reaction to a drug as evidence of a medical problem.
It should also be noted that changes in brain chemistry and PET scans happen when people talk to someone about their issues, or even when they change what image they are thinking of. Brain chemistry is very fluid and changeable. The idea that there are such things as “neurochemical deficits” is pretty much delusional.
— Steve
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Hmm…. I didn’t really find anything about Dewey supporting whole-word reading. I believe that is a much more recent development. But the entire school system has always been geared toward creating an authoritarian society, whether “Socialist” or “Fascist” in philosophy, even before Dewey. Consider the history of “black schools” and Indian schools – they were clearly designed with cultural re-education in mind. Again, a technique used by both the right and left political wings, though with different justifications. The dysfunction in the educational system most definitely predated Dewey, though I have never been a Dewey fan, as I consider him to be a manipulative authoritarian slimebag.
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Good one! It is just as absurd a premise as paralyzing their brains, though cultural mythology allows the latter premise to sound viable.
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Genetic variation is the key to species survival. It is only our weird society that requires certain variations to be eliminated for the benefit of those in control.
Besides which, there is no evidence to support a general conclusion of a “dopamine dysregulation” in all or most “ADHD”-diagnosed children. I’m open to hearing something to the contrary, but I’m very familiar with the literature on the subject and know of nothing supporting that other than a few odd studies which have never been duplicated.
And why would we expect to see that all or even most kids that act a certain way have something “wrong” with them, or the same thing “wrong” with them? It is not a logical conclusion that you can diagnose a physiological problem from behavior. Kids act hyper for tons of documented reasons – chaotic families, trauma histories, boredom,lack of sleep, malnutrition, iron deficiency, sleep apnea, certain drug reactions, the list goes on and on… It is ludicrous that you can tell that someone’s brain is malfunctioning based solely on a somewhat arbitrary collection of behavioral indicators, all of which can be summed up as behavior that makes it inconvenient to have this kid in a classroom or to parent them.
I say this as the parent of two “ADHD” type kids who turned out to be very productive adult citizens without a milligram of stimulant drugs. If you feel these things help you out, by all means, use them, but don’t make out that all kids who don’t like to pay attention to boring lectures or follow adult directions are in some way diseased or disordered. There is simply insufficient evidence to even vaguely support such a notion.
— Steve
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Your observations are quite accurate, but I would question blaming “the Left” for this state of affairs. I grew up in the 60s, when “the Right” was running the schools, and it was just as oppressive, though in different ways. Boys were expected to wear boy clothing and be aggressive and go out for football and not cry, and girls were expected to wear skirts and take Home Ec and only go to college to get a husband. But kids were humiliated and shamed and sometimes hit and had zero power.
The problem is not “the Left” or “the Right” but AUTHORITARIANISM from either end of the spectrum. The idea that we can take kids and put them through some kind of grinder and have them all come out the same is the core problem. Whether it is right-wing authoritarianism, enforced through violence, fear and shame, or left-wing authoritarianism, enforced through fake sympathy and drugs, the effort to make everyone comply with the status quo is the problem with our public schools. And that problem is part of the design – if you read back when public schooling was invented, the effort was to create “good citizens” out of freed black slaves and a large influx of immigrants from Ireland, southern Europe, and Asia, whom the powers that be were worried might decide to become rebellious and take power from the ruling elite. “Good citizen” meant someone who could read and write and who followed the rules and was prepared to be a factory drone in the new industrial America.
So it’s not about left or right. It’s about authoritarian vs. individual freedom, and putting right-wing authoritarians in who want to bring back prayer and corporal punishment will not make things better for our kids or our society.
— Steve
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I am amazed that even the initial research gets so much press and excitement! Even if the findings were true (and I am not the least surprised that they aren’t), all it shows is that a certain small percentage of sufferers may have a certain genetic pattern. The genetic pattern doesn’t occur in all depressed people, nor do all people with the pattern get depressed. So what the fuck? Who cares? And now, shockingly, we find that the link so celebrated is not even valid! Why don’t we just accept that we can’t change genetics, no matter how much or little they are involved, and focus on changing the environmental variables (food, sleep, chronic stress, trauma, etc.) that we actually have some control over?????
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Being a non- or anti-authoritarian in today’s society can be a major cause of feeling suicidal. It has certainly been my experience. Calling it a “mental illness” is society’s way of continuing to assert the dominance of the status quo.
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I have known a ton of therapists and psychiatrists who practiced for years while fully qualifying for a “mental illness” diagnosis. Anxious, depressed, delusional, emotionally unstable – all the labels they throw at their “clients.” There is ZERO accountability until something horrible happens. It seems very clear to me that these “peers” will be held to a much higher standard, based on pre-judgment and bias against their role and them as persons. I find it offensive to assume that “peers” have “mental health issues” and assume that the “real professionals” don’t!
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I think what it reflects is the bias of the investigators, who claim that “ADHD” diagnosed kids have smaller brains (however unsupportable that claim) and yet intentionally buries the data that these supposedly “smaller-brained” individuals appeared to have higher IQs. The higher IQ point is less important than the fact they chose not to comment on it when it didn’t support their thesis.
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That’s a very interesting point! I do think part of the reason for a therapist not disclosing too much is supposed to be so the client can kind of project his/her own feelings/needs/expectations onto the therapist without worrying how the therapist is actually feeling about it. That’s kind of a “Freudian” concept, but my therapist seemed to use that approach to some degree. I do find that it’s a balancing act – I don’t want the person I’m talking to to worry about my reactions, but knowing what they are worried about is important to knowing where to go with the person. I have found that honesty is very important, but don’t share details unless they seem relevant to the person I’m trying to help. Sometimes it’s really good for the client to know that I’ve struggled with suicidal thoughts because it makes him/her feel like s/he’s not alone or weird. In other cases, it seems more important to just listen to the client’s story and not tell anything at all about me. I just have to gauge it for each individual.
Class I am sure is a huge variable, one that is very far beyond the scope of my understanding. I do think a history of trauma IS helpful, but ONLY if the therapist has done his/her work and can use it as a tool of understanding rather than using therapy as a way of working out his/her own issues on the client.
So I think you’re right – it helps a lot to trust the therapist if they can share some personal information, but at the same time, it’s very important not to set up a situation where the client needs to “take care” of the therapist. The therapist does seem to need to have some “elevation” or “authority,” but I found that a big part of my job was to step down from that authority position and help the other person re-tool his/her relationship with authority figures in general. It’s a weird role and one that I don’t think you can really train someone to assume. It requires a lot of tolerance of ambiguity, both in terms of roles and in terms of emotions. That’s my experience, anyway.
Thanks for the response!
— Steve
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Getting “peer specialists” “out of the way” seems to be the point of this. If they won’t be handmaidens to the “authorities,” they have to be bumped off. And Lord help us the “peer” should have any kind of “mental health issues!” Do psychiatrists and psychologists have similar requirements to resign or go on leave when they “have issues?” Are the authors unaware that psychiatrists are at the top of the charts for professionals who commit suicide?
Unbelievable! Or I wish it were unbelievable…
— Steve
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Oh, it’s not broken. It works quite well at creating docile, unquestioning, anxious sheep. We only believe it’s broken because we have the mistaken impression that schools exist to create truly educated citizens. In truth, that’s the last thing our corporate owners want.
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I have been a therapist in the past, and without being egotistical, I have had great feedback from those I have helped. My main thrust was to a) listen very carefully to what the other person shared, trying to help them shape and frame exactly what the problem was from their perspective, b) asking questions to help get at how/why the person came to look at things from the perspective they did (for instance, a woman had never left her kids with a babysitter in 5 years; she shared that she was worried they’d be molested; not surprisingly, she had been molested by a babysitter…), and c) help them generate some other things they might try that would help them look at the problem differently. My caution was always to make sure I did nothing that was focused on making myself feel better – I had to be able to sit comfortably with their pain and NOT try to make it go away just because it was hard for me to hear – but to put all the focus on helping the other person feel safe and confident enough to gain some perspective on his/her situation, normalize and understand how/why they got there and maybe consider thinking/acting in a different way that might help them move forward. Sometimes it meant going back and hearing about some rough stuff that happened in the past, sometimes it meant working out some new things to try out in the present, sometimes it meant looking at new ways of thinking about things that have plagued the person in the past – it all depended on who the person was and what they seemed to need and how they responded to me. Everyone’s “therapy” was different and pretty much invented on the fly as I found out more about them. I never assumed I knew ANYTHING about a client that they had not told me themselves.
As for honesty, I never hesitated to share personal things with someone coming to me for help IF I thought it would help that person find a new perspective or feel more OK about their decisions in the past. I found it important to be very real and warm and present and this idea that “boundaries” meant being somehow distant or “clinical” always seemed totally wrong to me. Boundaries, for me, meant not putting my crap on the person I was working with, and not taking on their issues as my own so I “had to solve” their dilemmas. I think the most important point was simply being willing to hear their story without making any judgments and being genuinely empathetic to their situation so I could see things from their perspective.
Of course, I had one huge advantage in being a therapist – I had never had any training in therapy at all! I figured out how to help almost 100% from the clients themselves, who often talked about what other therapists had done that was or wasn’t helpful, and whose reactions and perspectives taught me everything I know about how to be helpful. I wonder if being “trained” would have ruined me?
— Steve
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I am used to skewed studies, but this one seems like a record-setter! I am stunned that The Lancet or any other journal would accept such a questionable study, especially the unwarranted conclusions. It is disturbing that such crap is passing for “science” these days. I wonder who got paid off?
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The problem is, they are getting paid big money to provide “low-value treatment.” Stop paying doctors for committing malpractice and they’ll be more likely not to commit it!
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I certainly don’t mean to minimize the incredible damage done by the drugs! What I’m trying to say is that while some experience horrible drug effects and some don’t, the labeling process harms almost everyone who comes in contact with it, and is in fact a large part of how and why they are able to convince their clients to take the drugs they offer. If they really told you, “We don’t know what is going on, but this drug may or may not make you feel temporarily better,” a lot more people would just say “NO” or would contemplate other options for the longer term. The drugs are horrible, horrible abominations, but they would be much less of a problem if the diagnosis and labeling process could be dropped. Additionally, the labeling process invalidates each person’s own knowledge and certainty of what is going on and what might help, and encourages dependence on doctors, which of course helps them to peddle their evil pharmaceutical wares more effectively.
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Exactly my thought. Why do they have such a need to find these spurious “links?” Even if they found a gene that “influenced” depression, so what? First off, these studies show probability correlations, so it’s quite possible that even with such a link, most depressed people still won’t have the gene in question. Second, what would you do if you found it was true? Splice in a new gene? Feel sorry for the person? Give them more Prozac? There is no real solution that would be rendered even if they find some small percentage of people with a gene that “makes them more vulnerable” to depression.
Last but not least, if such a gene exists, is it not possible that it is also linked to other positive characteristics like empathy or thoughtfulness toward others? The idea that a gene influences one and only one trait is ridiculous when considering emotional variables.
Instead of wasting time finding one gene that affects only a percentage of depressed people who are exposed to stress, why not spend our time and money trying to reduce the stresses that might trigger such theoretical vulnerabilities? Why not focus on something we actually have some control over, instead of spending billions trying to find some gene that we don’t really understand and couldn’t change if we wanted to?
— Steve
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This is the core problem with the psychiatric model. It’s not the drugs, it’s the MESSAGE that comes along with them – you are permanently faulty, and you personally can do NOTHING to change it. You are doomed to a life of dependency and half-living, never capable of moving beyond because your had the bad luck to be born with an inadequate brain. The message of hopelessness is far worse than any drug side effects, if the poor patient buys into it.
I would have a lot less trouble with someone saying, “You feel like crap right now. A lot of people have similar experiences, and there is nothing wrong with them. I can provide you with a drug that might blunt those feelings a big while we work on another plan.” That’s at least an honest assessment of what the “doctor” can actually offer. But to say “you have a lifelong disability and will have to take drugs for the rest of your life” – well, if you weren’t depressed before hearing this, you sure would be afterwards!
Thanks for a very direct and compassionate description of what is really needed – HOPE!
— Steve
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It is hard to imagine neuroscience fully or even mostly supporting the psychiatric worldview, primarily because the “diagnoses” they have promoted have no actual connection to any physiological reality, and as such, the “groups” they are purporting to study are almost completely heterogeneous. It is quite possible that SOME members of a particular group may have some kind of genetic or physiological problem causing their “mental” difficulties (such as porphyria) , but these would only be a small proportion of the whole and might even span a number of different “diagnoses.” Medicine can’t even find genetic causes for obviously physiological things like heart attacks – what is the likelihood that such causes would ever exist for such a nebulous and subjective category as “depression” or “anxiety disorders?”
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I agree, psychiatry as practiced is a form of spiritual abuse. It insists that you believe in a set of dogma and punishes you if you don’t. It involves a set of “scriptures” which are not something that can be questioned. It is authoritarian – the “parishioners” have no say in the rules, and even the higher authorities (the psychiatrists) have no power to question the rules set by THEIR superiors, and they are attacked or shunned if they challenge the dogma of the group. All they are missing in being a solid cult is a single charismatic leader. They also invalidate any effort of the “parishioners” to empower themselves, and in fact are able and willing to use force to gain “membership.” I think the analogy is pretty complete.
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I agree 100%! If someone (like a certain political figure) is an evil bastard, let’s call him that and not give him the “out” of a “mental illness” (especially since all of those “mental illnesses” are made up anyway!)
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I like “labeled with X” as a way of describing the reality without buying into it. “X”, of course, always in quotation marks. Sometimes I even add “so-called” in front of the quotes to make sure no one is misinterpreting.
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I usually say “emotional distress” rather than “mental,” but it is a shame that the term “mental” has been so co-opted by the current system. As soon as one says “mental,” people either think “mentally retarded” or “chemical imbalance.” Sad, but that seems to be where our culture has moved.
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SO the long and the short of it is, it is always a very bad idea to assume that ALL cases of “mental illness” or a particular “diagnosis” are caused by the same thing or require the same kind of intervention. Even the DSM admits as much: “There is also no assumption that all persons qualifying for the same disorder are alike in all important ways.” (From the intro of the DSM IV) That’s the real problem with psych diagnosis – it is based literally on NOTHING except a set of social assumptions and biases about a certain set of behaviors. The idea that we can “diagnose” a particular problem simply by looking at how a person is acting or feeling. To postulate that all “eating disorders” are caused by sexual abuse is dumb; to assume that all “eating disorders” are caused by nutritional problems is equally dumb. Everybody is different!
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Yeah, I wonder if the “savages” had any “mental health consequences” of surviving genocide? Perhaps if they were able to return to their original healthy diet, their accommodation to the dominance of the violent European culture and over a century of intentional suppression of their culture and way of life would be much simpler, eh?
— Steve
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They HAVE to say “remission,” no matter how complete the recovery. If they say “recovered,” the are admitting that their “permanent brain disease” meme is a bunch of crap.
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So you really are saying that all “mental illness” is caused by poor nutrition? Can you PLEASE answer that question with a simple YES or NO?
As for “what is the proof of that?”, I think the ACES study by itself is absolute proof that early childhood stress and trauma is a causal factor not only in “mental health” problems as defined in the DSM, but also in a wide array of physical health problems. It seems absurd to suggest that a person being abused by his/her parents systematically and then being removed and put into multiple foster homes while separating him from his siblings and other relatives would not cause anxiety/depression/anger issues, not as “disease states” or nutritional deficiencies, but as very normal reactions to very abnormal childhood circumstances. To deny that these circumstances substantially affect kids’ emotional well-being, mood, and ways of thinking seems just plain ridiculous.
I think you risk substituting nutritional dogma for psychiatric dogma. Again, I agree 100% that nutrition is massively ignored in both psychiatry and general medicine as both cause and treatment of a wide variety of conditions, and that SOME conditions will resolve with nutritional interventions (and in some cases ONLY by nutritional interventions), but it is a very, very large leap to move from there to saying that all “mental distress” is caused primarily or only by nutritional deficiencies, as if how you were raised or the social conditions that affect you are irrelevant. I think it would be insulting to the vast majority of my foster youth clients to suggest that all they need to do is eat better to overcome 15-20 years of abuse and neglect by their parents and the system.
—- Steve
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Nobody is saying you are wrong, just that there is more to the picture than ONLY nutrition. It is misleading to tell someone who was raped by his dad repeatedly for 15 years and whose mother didn’t protect her and who later got into an abusive relationship because this guy put her on a pedestal at first and she had no way to screen his behavior for abuse that if she just ate better and got some exercise, all of that past trauma would no longer concern her. I think giving her nutritional counseling is not only good, but excellent advice, but it would only be the beginning of how to reconsider the meaning of the survival strategies she learned in all those years of abuse.
I hope that is clearer. Thanks for hanging in the conversation!
—- Steve
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I’m certainly not arguing against anything you said. But there are often issues much more deep-seated than a current bad relationship. I have worked for 20 years with foster youth and even longer with domestic abuse victims and adults with childhood sexual abuse issues. I guarantee you that nutrition alone, or even spiritual practices, are not sufficient in most of these cases to create a positive outlook. These people need help sorting out why their lives went the way they did, why they hate themselves and/or others, why they can’t make friends, etc. so they can DO something about the coping measures they adopted to survive the awful situations they were in. What is your approach to such people BEYOND improving their nutrition or exercising or even practicing mindfulness? Or do you believe all such cases can be addressed by nutritional approaches alone?
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Good to see the NIMH putting some emphasis on this. However, until we lose the DSM, such efforts are doomed to failure, because we’re still “treating” depression or anxiety as if they were “the problem” instead of a manifestation causing us to be curious regarding the cause.
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So the big question I still need to hear your answer to: Do you believe that nutrition is always the best approach to what we call “mental health” issues in our culture? Do you or do you not think that traumatic experiences or chronic unresolved stress can cause “mental health” problems as defined in the DSM? If so, what would you do or suggest beyond nutrition and exercise?
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Very well said, Richard! Agree 100%.
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Excellent example of the complexity of these issues. The physical affects the emotional and the spiritual and vice versa. Any attempt to come up with one solution for every case is going to end up creating havoc!
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I agree 100%, and understand your viewpoint. My question was for the author, though. I’m not sure she’s made that point clear in her presentation.
Thanks for the reply!
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All very true. My wife has been a doula and I used to live with a homebirth midwife, plus I worked at a teen moms’ home, so I’ve seen plenty of “standard of care” obstetrics, and its brutality and disrespect and complete disconnection with both science and common sense is exceeded by only one other discipline – psychiatry! The parallels between psychiatry and obstetric care in America are legion. Both need to be started over from scratch!
— Steve
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Just to clarify, are you saying that the ONLY reason people feel mentally/emotionally unwell is because of poor nutrition? Do you discount the impact of childhood trauma, poor relationships, the incredible stress of working a mindless job in an industrial society, exposure to racism, sexism, etc. as contributory factors? Because I agree that nutrition is very important and can resolve some cases, but to suggest that ALL cases are caused by poor nutrition seems a very large leap!
— Steve
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Perhaps the real problem is assuming that “mental disorders” all have the same cause or type of cause. My belief is that SOME depression is the result of physical things like diet, sleep, other drugs, etc., but that much or maybe most is stress-related. Of course, unresolved stress also results in loss of sleep, poor nutrition, etc., so there is no way to separate the effects entirely. Bottom line, it is the idea that “depression” is a disease state that creates the impression that there should be a “treatment” that works for all situations. That impression is absolutely false.
— Steve
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Wow, whod’a thunk it? Did they REALLY get funding to study something this obvious? It says a lot about how distorted our view of “mental health” is that this conclusion isn’t a basic assumption of “mental health” practice!
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Sheesh! Talk about making things more complex than they need to be!
‘The researchers also find, “the more that a mother identifies as a mother the less likely she is to experience depressive symptomology after giving birth.”’
My wife has done research into “Postpartum Depression” (I HATE that term!) in other cultures. She found that there are cultures where there is essentially NO incidence of the “PPD” phenomenon! Not surprisingly, these are cultures where the new mother is supported by a big social network and rituals that welcome them into motherhood. The more the mother can focus on just being a mother and taking care of her baby, with the other women in the group providing cooking, cleaning, childcare, and emotional support, the less likely the women will be depressed. DUH!
Finally, the authors make a somewhat bizarre statement near the end: ‘The authors state, “given that the vast majority of mothers refuse pharmacological treatment due to concerns about side effects and breast feeding, a program that targets social (rather than individual) dysfunction may be preferable for many women.”’
So now, despite what should be the obvious conclusion that social support should ALWAYS be the provided BEFORE “PPD” develops, they are saying that the reason they should provide this “SMIC” (otherwise known as “being a supportive human being”) is because most moms refuse to take antidepressants! As if the two were somehow equivalent????
Again, SHEESH! Way to make the obvious conclusion as obscure as possible!
— Steve
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Agreed. The critiques offered don’t get to the fundamental problem with the DSM concept – namely, that adaptive strategies to cope with unrelenting chronic stress are somehow diseases or disorders or dysfuntions, as if the “normal” reaction to every situation is to be mildly happy or mildly annoyed, and any more severe reaction to the status quo, however horrible that status quo might be, is an aberration. There is no acknowledgement that what they call “mental illnesses” are 90% or more of the time normal reactions to abnormal circumstances. And since there is no way to refute one’s diagnosis, they also provide excellent cover for drugging any manifestations of stress into submission without the slightest effort to understand the origins or purpose of the person’s behavior or emotions.
— Steve
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I agree wholeheartedly, and think the harm done by diagnosis is substantial and sometimes irreversible, even more so in cases where overt abuse is involved. I worked with foster youth for 20 years, and saw so many cases of hurt, insult, confusion, and anger created by the invalidation of the youth’s difficult experiences prior to and during their stay in foster care. It is the very opposite of what is helpful, namely, NORMALIZING the youth’s experiences and reactions and helping them make sense of what happened to them and what they want in their lives. There is not much you can do worse than taking the meaning away from someone’s painful experiences.
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You took a courageous and wise approach. I wish you could teach the “clinicians” what you knew instinctively to be true!
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The answer is obviously NO. Science, for starters, needs to be self-skeptical, needs to test and re-test its own assumptions in the search for new knowledge. It also needs to have clear definitions that can be verified by external observer. Neither of these most basic assumptions of science are even vaguely attended to by psychiatry. They invent unverifiable categories based on untestable criteria, and insist on the correctness of their theoretical framework despite any and all evidence to the contrary. Those who challenge them from within are ostracized, those who challenge them from without are ridiculed and attacked. They have no interest in advancing their understanding of the people they are trying to help. They use technology and shiny lights and biochemical smoke and mirrors to obfusticate and distract from the fact that they don’t have the first idea what causes ANY of their spurious “mental illnesses” nor what anyone could do to actually “cure” their “diseases.” It is, in fact, the antithesis of science, with much more in common with a religious practice than a medical one.
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I’d say we have to discount anyone who says they are “necessary for the treatment of my disease” as being genuinely positive. Such comments don’t support a positive experience, merely an assumption that things would be worse if they stopped, which is really a fear-based rationale. Obviously, there are some good experiences that people have with antidepressants, but if that’s the main “positive experience,” it’s not very convincing, because “treating a disease” isn’t an experience, it’s a belief system, one that many are indoctrinated into believing.
As an example, my wife and I were asked in our childbirth class for our second son how the birth of our first son went. We both replied it was “pretty good,” until we were asked some more specific questions, during which we recalled not being allowed to eat, not being allowed to open a window, my wife being called out of the shower to visit the doctor who never arrived, my wife being given sleeping pills under pressure from the nurse, only to be awakened an hour later by someone taking her blood… but none of these experiences were conscious as we said the birth was “pretty good,” because we did as we were told we had to, and were not aware of any other options. Today, having experienced two homebirths, one with Ginny in a hot Jacuzzi tub, with capable midwives in attendance, I can say that our first birth pretty much sucked. Antidepressant users who don’t know of other options are likely having similar experiences and reporting similarly unmeaningful responses to the question of “do they help?”
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Weird how they try to provide such a range of provisos. But it seems pretty clear – long-term stimulant use provides no benefits, even at the symptom reduction level. It’s a waste of time. And this is from JS Swanson, a long-time mainstream researcher who has supported stimulant use his whole career. Yet despite this dismal record, there are recommendations for expanded treatment?
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This article really sums up the difference between helpful or unhelpful interventions: do they validate or invalidate the experiences of the people needing help? Do they bring hope or destroy hope? Do they move people toward feeling more capable or less capable? Too bad the world of psychiatry will never pay any attention, because empowering people doesn’t pay well enough!
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They are missing another important aspect of this finding: part of the reason antidepressants come out with positive results is BECAUSE so many people drop out. Dropouts are commonly NOT counted in figuring the final success figures, but most people drop out because of ineffectiveness or bad side effects, so discounting those people skews the results (quite intentionally) toward a positive outcome. Combine this with the nefarious “placebo washout” protocol (where they test people for placebo response and remove them from the study before starting), and it’s easy to see how and why antidepressants are reported to be a lot more effective in treatment studies than they are in the actual reality of life.
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They shouldn’t have worried. Based on his earlier appointments, it should have been clear he’s appointing 100% industry sellouts and lobbyists.
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Beautifully written – thank you, Kelly!
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More shocking news: caring for people and engaging them in activities makes them feel better! Whoda thunk it?
— Steve
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They also provide a convenient narrative that makes it easier for folks to join in the oppression or internalize it.
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Too true!
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This is an excellent point. Many more privileged people engage freely in oppression of lower-status groups in order to project their own feelings of inadequacy onto someone else. This is particularly obvious in domestic abuse situations, where the person who has all the power seems to NEED to confuse, oppress and control their partner, even when the partner is doing everything she can to accommodate. I think it’s wrong to think that the powerful have no anxiety. They just have more options on how to deal with it, including making others feel even more anxious than them.
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You didn’t answer my last question, though. Is it possible that a human being has a significant level of control over how and what fires in the brain? Is not the simple expedient of breathing slowly and deeply universally understood to alter pulse and blood pressure and to calm the body and reduce anxiety? There is also excellent evidence that long-term Buddhist monks, when their brains are studied, have built up certain regions of the brain associated with calmness and focus through their meditative practice – they can change the actual PHYSICAL STRUCTURE of the brain through meditation!
Everything human has a “biological component.” That doesn’t leave us in a situation where we are dependent on chemical or physiological interventions to alter our psyches. A smart man once drew the analogy of hardware and software – a computer is totally dependent on its electrical structure, but without a program it’s totally useless. The programs have an “electrical component,” but if you try to solve a software problem by altering the hardware, you’ll be in big trouble.
So far, there is neither proof of any specific hardware problem, nor any specific universally effective solution, for ANY of the so-called “mental illnesses.” It seems to me that psychiatry would do very well to be a hell of a lot more humble about their pronouncements, especially as they are completely and utterly unable to explain the John Nashes or Elanor Longdens of this world.
So sure, drugs may “work” for some people by creating what they consider positive effects, but that’s a long, long way from your claim that schizophrenia (and what is that, really) or any other “mental illness” is caused by misfiring neurons. I think we have a lot more to say about which neurons fire or don’t fire than you’re giving us credit for.
—- Steve
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If that’s the case, how do folks like John Nash or Elenor Longden or Will Hall recover without any drug interventions, in your view? Why do their nerves suddenly start firing differently? Could it have something to do with how they respond to their situations? Do we as human beings have the ability to alter how our nerves fire?
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It seems you are confusing your own personal experience with scientific data. You may have found these drugs to be helpful, even life saving. This doesn’t mean that others have the same experience you did. The data show the likelihood that any particular person may or may not benefit, and people can make their choices based on that data. I think it is important to acknowledge that some people do report benefits, even very strong benefits, from taking antidepressants. However, it is JUST as important to acknowledge that some people have damage, even very strong damage, from taking these very same drugs. I think it should be very clear from the postings here that doctors not only don’t share this information with their clients, they go out of their way to deny it or blame their patients for not reacting the way the doctors want them to.
The DATA say that antidepressants should not be recommended for everyone, and that each case should be treated differently. They also say that we should be very aware of the possibility of serious side effects in every case, and remove people immediately if they emerge. I’d venture to say also that the data tell us that antidepressants alone are VERY unlikely to make things better for most people, and in fact may make things worse ON THE AVERAGE over the long run. So kudos for you for finding your own path that works for you, but it feels quite disrespectful to suggest that everyone having a different experiences should shut up, especially in light of this kind of study.
As to Robin Williams, I would suggest you study up on his childhood before you attribute his long-term depression to biological causes alone. It appears he had a miserable upbringing and used comedy as a way of coping with feelings of inadequacy that went back to his earliest childhood. I don’t want to pretend that biology doesn’t play a role, because it most likely always does, but I am saying that we DO NOT KNOW the degree to which biology affects someone’s reaction to abuse and neglect, and we DO no for sure the impact of abusive behavior on a range of behaviors and emotions. EVERY “mental health” diagnosis is correlated with early childhood trauma and abuse. And since there is nothing we can do about genetics, and there is LOTS we can do about childhood abuse, it appears the conversation has been badly, badly skewed in the direction of biological causation. This site provides the rest of the story. You can call it biased, but it is vital for you and others to understand that the standard viewpoint on “mental health” is badly biased in the other direction. It is an absolutely vital counter-narrative to the constant droning on about how it’s all biological and antidepressants are the only answer.
I hope that clarifies things. You’re entitled to your viewpoint and experience, but I strongly urge you to remember that others have had dramatically different experiences and they are just as valid. And beyond that, I want you to respect that conveying scientific data is never wrong, even if it conflicts with your personal experience, as decisions depend on good data and everyone is entitled to it, even if it messes with the accepted “take your drugs forever” narrative.
— Steve
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The first problem is, how would you be able to tell who “needed them” and who didn’t. The second problem is that when they DON’T work, which (looking at the data above) appears to be very frequently, are the doctors able to notice and admit that they are making people worse? My experience, and I have lots of it over 20 years working with foster kids and ten more working as a counselor, is that they don’t.
The bloggers here appear to me for the most part to be trying to tell a story that the “mental health” industry doesn’t want told, and this article says it well – most of the time, drugs do more harm than good, and doctors are just plain incapable of being objective enough to sort out who they do and don’t work for, or to even bother to ask. The data in this study basically say that if there is a group the antidepressants work for, it is either very, very small, or thoroughly offset by an equally large group who are made worse. This is important information. I have no idea why you would not want folks to share it. Perhaps you can explain why asking these questions or sharing this data is bad?
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Despite the availability of “treatment?” Or because of?
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This is just disgusting!
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A change of venue can be an excellent “treatment,”especially when the old environment has assholes in it who are committed to making you miserable. But none of that counts in psychiatry. You’re supposed to be happy and effective regardless of whatever abuse you may be experiencing, and if you’re not, it’s your brain that needs fixing, not the bully. Idiocy, but that’s “modern” psychiatry for you.
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Two answers: one – too much money being made to allow any critique, however rational, to stand. Two: the narrative fits a lot of cultural needs, such as blaming the poor for their poverty or black people for objecting to their subjugation, or blaming children for asserting their needs when we’d rather control and abuse them. In short, the powerful elite love the idea that “mental illness” is a physiological thing, because they get to make money and resist any inkling that we might have to make changes to our system rather than blaming the victims.
— Steve
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Wow, so legalizing same-sex marriage apparently improves “neurotransmitter imbalances” all by itself! Nah, can’t be. Must be that the populations in same-sex-marriage states share some genetic commonalities that make them more sensitive to changes in political climate. Need to do a study there…
(NOTE: SARCASM ABOVE)
—- Steve
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In other news, getting shanked with an iron pipe in the knees tends to cause knee pain. Shocking results!
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“Overdiagnosis” is kind of an oxymoron when it is impossible to actually determine who merits a diagnosis by any kind of objective criteria. There is no objective standard for diagnosis, therefore, no standard for “overdiagnosis,” which is a fundamental problem with the entire idea of diagnosing “mental illness” based on social constructs that have no valid, objective indicators of their presence or absence.
— Steve
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Yes, we should simply say “The effects” instead of pretending these are accidental or unexpected somehow.
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Real science does everything it can to DISPROVE any hypothesis before accepting it as truth. Science is crappy at proving things true, but very good at proving things false. Every other reasonable hypothesis or explanation needs to be considered and eliminated before a model is accepted as “truth.” And then it’s only true until further data invalidates or modifies it.
Unfortunately, these days “scientists” are allowed to run with biased data and positive results are published and studies disproving popular theories are buried as deep as possible and those profiting from the current “truth” spend time and money discrediting known facts. Even in physical medicine, we’re getting increasingly crappy results, and as for psychiatry, it left the vaguest impression of scientific integrity in the dust decades ago.
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As I said, “PPD” is an invention like any other diagnosis. Most “PPD” is caused by high levels of stress – loss of income, deteriorated body image, interrupted sex life, changes in relationship due to change in status to “mother,” loss of friendships, increased isolation, loss of sleep, and on and on. Not to mention that a huge percentage of domestic abuse starts during pregnancy or right after birth. To suggest that “postpartum depression” is a disease state is rank ignorance or else intentional greed and manipulation. As I stated above, there are cultures where “PPD” DOES NOT HAPPEN AT ALL. If it is “biological,” why is it so much more common in modern industrial societies and so rare in tribal cultures?
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They really needed to study this? Is anyone surprised? Maybe we should commission a study to see if depressing conditions lead to more depression?
Sometimes I feel like I’m in a Franz Kafka novel…
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My wife saved her dad from a similar fate. I wrote a blog about it a while back. He was put on Risperdal and became rigid and tense and unable to sit up or talk. After she got him off, in three days he was chatting and laughing and trying to feed himself. And yet somehow, none of the staff seem to have noticed that the drugs had almost completely disabled him. Or more likely, they considered it a “successful treatment.” Honestly, it would be kinder to kill the people outright, but I guess they couldn’t collect insurance for them if they were dead.
The normal psych world is dark enough, but what they do to senior without even the pretense of something actually medically wrong with them is downright evil.
— Steve
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That’s exactly what it demonstrates!
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“Encouraged” to discuss the realities with their patients???? Why aren’t the authors calling for doctors engaging in these practices to have sanctions on their licenses? Why should there not be class action lawsuits against doctors for ignoring the most basic instructions for the use of Benzos?
And I agree with Richard – the problem is not failing to provide psychotherapy alongside benzos, it is ignoring the fact that Benzos are not recommended for us for more than two weeks due to the risk of dependency, and that they are simply not appropriate for the uses they’re being prescribed. The only potential legitimate use (and I find this questionable) is for short-term use in anxiety attacks. These doctors are engaging in MALPRACTICE and should be called to account for it.
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I agree. “Postpartum depression” is an invention to cover the fact that we set up mothers for stress and disappointment in our oppressive society. It is a fact that certain cultures have essentially ZERO cases of “postpartum depression.” mostly because they provide continuous and ongoing support for the mom and baby after birth. “Postpartum depression” is a Western industrial society disease that is a function of how we treat new moms and babies. It is NOT because of hormones – it’s because of unresolved stress in 99% of cases.
— Steve
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Evergreen State, where my son attends, includes this kind of critique in their first-year statistics course. I was very pleased to see it there, though my son, of course, is already very savvy about detecting statistical BS.
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Odd that they identify increased contact with providers as a confounding factor. Isn’t that the point? That contact with caring people reduces feelings of isolation and hopelessness?
And notice we’re talking about 6 group sessions, four before and two after the birth. There is no specific intervention based on the needs of the specific mother in question. And despite this, double the number in the control group fell into deep depression in the control group.
Given the anemic response level for antidepressants, the broad side effect profile, and the lack of any evidence of long-term advantage, even within psychiatry’s own warped viewpoint, this intervention is clearly superior. What would happen if someone actually paid some individual attention to the mothers’ specific stressors and helped them plan for their families’ futures?
— Steve
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Never heard of the HOD or the EWI. I personally never bothered with testing of any kind when I worked with people in distress. I generally found that asking them the questions instead of having a test do it for me allowed a lot more nuanced approach. The challenge is maintaining sufficient objectivity and being OK not knowing what you have to do until you get enough information. I wish there were some “objective test” but I haven’t seen one yet that even comes close. I will look into those, though.
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Do you really think that assigning a DSM diagnosis improves one’s understanding of the problem? I totally disagree. Even mainstream psychiatrists like Insel have acknowledged that the DSM categories don’t relate to any particular physical anomaly or problem, and that in fact we are clumping together heterogeneous groups and assuming they have the same causes and effective treatments. If a mainstreamer like Insel is saying this, please explain how lumping people into subjective categories like this helps us understand them better? Isn’t it more effective just to talk about what behavior they engage in that is distressing or problematic? Wouldn’t we understand more if we asked the client about his/her perspective on what the problem is in their terms, rather than trying to force them into our artificial frame of reference?
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So are you going to the “brain problem” model here? Do you think Trump is an asshole because he has a “brain problem?” Or do you think he’s learned to be an asshole because it’s gotten him power and control in the past and he continues to use what works?
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Not to mention the people who are depressed because they are trapped in a dead-end job or an unhappy or dangerous marriage or kids (like me) who are forced to attend school every day for 13 years in a soul-crushing environment and have no sense of self-efficacy. Sometimes depression is not due to bad nutrition, it’s because depression is a normal expression of distress when in distressing circumstances, regardless of someone’s nutritional state.
It is just too much work for them to figure out what’s actually going on. Much easier to blame the patient and drug them into submission!
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When you say “mentally ill,” I think you mean what I would call “irrational.” He is most definitely irrational and makes decisions based on emotions and biases. But that doesn’t really address what Sera is saying here – that using labels to identify his irrationality both validates these subjective and irrational labels AND minimizes our ability to truly analyze what is not working about Trump as President. It is his irrationality and dedication to being RIGHT at all costs that leads to many of his bad decisions and allows him to be manipulated by others who are “handling” him to their own advantage. It seems far better to me to describe what he’s doing that is dangerous or irrational than simply labeling him as “mentally ill.”
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Great article! The one thing I think is missing, though, is a recognition that OF COURSE not all instances of depression are caused by poor diet or will be remediated by improved diet, because DEPRESSION IS NOT A LEGITIMATE DIAGNOSTIC CATEGORY. But we DO see that at least a third of depressed people could be dramatically improved in their mood by eating better. What is going on with the other two-thirds should be investigated, of course, but we would expect that not all of them will improve with ANY particular intervention, because DEPRESSED PEOPLE NEED DIFFERENT THINGS.
This is vitally important, because analysis of this kind of study is dramatically hampered by the categorical clumping of depressed people into one group. This subjective grouping serves the interests of the drug companies, because they can say, “Well, nutritional counseling only helped a third of depressed patients, while antidepressants helped 45%, so antidepressants are better.” I strongly encourage you to write unequivocally on this point, as it is a very important argument to undercut any efforts by mainstream psychiatry to minimize the importance of these results.
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Maybe African-Americans are more sensitive to oppressive conditions and can more easily detect the deception behind the psychiatric facade.
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They’re not even bothering with diagnoses any more. Let’s just drug those too frail to resist!
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Why do you call Soteria a “fiasco?”
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ALL ads for drugs need to go away!
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It means that even AFTER the usual lying, hiding and spinning, they STILL couldn’t make it even look like they might work in the slightest way.
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“5-HT6 receptor functionality is much more complex than initially defined.” In other words, we have not the slightest clue what we’re doing, and once again, our guess was wrong.
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Well, that’s a bit deeper analysis. Our economic dominance is, of course, based on stealing our land from the native inhabitants and enslaving both them and Africans and profiting off of their free labor. And so on and so on. But most people are not willing to ever go there, are they?
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Sorry, Cat, but bolstering the stock market has not helped the common laborer one iota. The stock market broke 2000 sometime in the early 80s, as I recall. The gap between rich and poor was MUCH lower back then than it is now, as the stock market just broke 20,000. The stock market is a measure of how the wealthy are doing. Meanwhile, the middle class has shrunk and our long-term prospects as a country have shrunk with it. Our greatness economically was based on a large and prosperous middle class. Both parties have worked for big businesses and against small businesses and local workers since Reagan, and Trump is just doubling down on the failed policies that got us here. As Sera suggests, Trump isn’t “crazy,” he’s just entitled and will be the advocate for the other entitled folks he hangs with. The rest of us will continue to suffer.
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Great analysis!
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The fact that we are even having this discussion on a national level shows just how bankrupt the idea of DSM diagnoses are. Would there be a national argument on whether Trump had cancer? Over what his cholesterol levels were or whether his blood pressure exceeded 140/90? Could there be a pro/con discussion over whether or not he had AIDS or syphilis?
Only in the world of “mental health” can such an idiotic discussion be conducted by laypeople arguing with professionals. Any other medical profession could answer this question quickly by providing actual evidence that something was or was not wrong, or at least that some measurement indicated that he did or did not have a condition. Even something as vague as “obesity” has some kind of measurable standard. Only “mental health” disorders can be diagnosed solely by opinion, because there is no way to actually determine ANYTHING objectively in the “mental health” world of smoke and mirrors.
— Steve
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Let’s be honest, we had a choice between two rotten candidates. Saying Hillary was worse doesn’t really solve anything. The real question is, how did the system we have select the two MOST UNPOPULAR candidates as the main party nominees?
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There is great wisdom in what you say, Tina. The “sickness”, as it were, is in our disconnection from each other and the system that we have “agreed” to that keeps us separate and at each others’ throats.
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Inertia to me implies continuing to move in a direction already selected due to lack of sufficient force to divert one from this course. It’s very passive. Whereas active opposition is a force that attempts to push the profession in a certain direction in opposition to other forces. Inertia certainly comes into play, but there’s a lot more going on. And yes, it sounds like we agree on most all points, which doesn’t surprise me at all.
Thanks for the response!
— Steve
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Right, reminds me of Rudolph Semmelweiss, who cured childbed fever in the 1800s by having doctors wash their hands before before “helping” deliver babies (some apparently came straight from cadavers to the maternity ward!) He reduced the rate to almost zero and then was fired from his hospital for insulting doctors by implying that they were killing their patients with their dirty hands (which, of course, was 100% true!) He spent some time in the asylums of the time because it infuriated him so much to be proven 100% correct but to be stopped by convention, arrogance, and lack of concern for the patients’ welfare.
It’s not a new problem.
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Very well spoken, Liz! The sad part is that despite this evidence of the subjectivity and arbitrariness shown by these studies, people continue to believe that “ADHD” is something that can be discerned from just being a kid who doesn’t like to sit still and follow directions. Very sad!
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Yeah, I just love that one. The child simply provoked the poor parents into abusing them! This is also a disingenuous “explanation” for why abuse is more common in homes with kids diagnosed with “ADHD” (by a significant margin, BTW – diagnosed like 4-5 times more frequently in foster kids). The kid was so obnoxious it increased the odds of the parent abusing it because it HAD “ADHD.” Makes me sick. I’ve also heard it said that soldiers who develop PTSD must have something “different” (AKA wrong) about their brains, because not everyone who fights in a war develops PTSD! Pretty outrageous stuff, but if you need to believe something, you’ll come up with a way to justify continuing to believe it.
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I am shocked by this news! Who knew that medical personnel tried to sell interventions just so they can make a profit?
DUH!
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Humility is the key. Real scientists understand that science is intended to undermine their confirmation bias, and want to know the truth, even if it is not convenient. Wolfgang Pauli, one of the founders of the theories of quantum mechanics, said that he really WANTED his findings to be false and did everything he could to try and falsify his findings, but could not. He begrudgingly admitted his original hypothesis was wrong. That is what a real scientist does, but we don’t have a lot of real scientists at work any longer, because they have other priorities, including making money.
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Absolutely. Depression is a reasonable response to a crazy way of living. I recall reading research that immigrants to the USA develop USA levels of anxiety and depression after only two generations following immigration. We live in depressing times!
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This is good stuff. I just find it too bad we have to call it something. I’d call it “being with someone in a caring way.” But I guess it would be hard to get research money with a mundane name like that! Anyway, the point that the “help-ee” has to make the “helper” feel better is fundamental to the weird relationship that psychiatry has with its clients. The psychiatrist gets to define the problem, and the patient needs to reassure him/her that a) s/he will do as instructed, and b) the patient will at least say they feel better. It’s most extremely disempowering! And a lot of therapists are just as bad.
Learning to be with a person in their pain and NOT try to make it go away, and NOT know what you are going to say or do but helping the client look around in the swamp, that is what makes therapy or whatever you call it really work.
Thanks for sharing!
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It always amazes me the lengths to which “alternative therapies” like acupuncture have to go to prove their effectiveness, despite in many cases THOUSANDS of years of experiential data, while drugs are given a pass after two pre-screened 6-week trials show that they are slightly better than doing nothing at all. Double standard, anyone?
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I agree, This goes well beyond inertia – there is active resistance to the very idea that non-drug therapies can ever be anything more than ancillary support. This is true because the drug and psychiatric industries DON’T WANT PEOPLE TO GET BETTER OR EVEN CONSIDER OTHER OPTIONS BECAUSE THEY LOSE CUSTOMERS! The medical profession in general practices similarly, but they are at least required to show some kind of physiological indication that the body isn’t working properly, whereas psychiatry has been allowed to simply invent “disorders” and re-define the entire field and control the terms of discussion in very self-serving ways.
And there ARE absolutely nefarious bad guys. There may not be that many, but they are in positions of huge power and influence, including the ability to spread dollars around to support their model of reality, despite all evidence for better ways of understanding the truth.
Consider the “Open Dialog” model. It’s been around since the 70s! It has much better outcomes than any other approach, even if you accept psychiatry’s subjective definitions of “schizophrenia.” But efforts to promote this approach led to nothing, even in Finland where the approach was well known. This isn’t inertia – they intentionally suppressed this information and removed the effective approach from most Finnish hospitals. Same thing happened to Loren Mosher. These are not benign forces. They actively suppress any attempt to redefine “mental health” in any way that cuts into their profits and their control of the “mental health” market.
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It is interesting that you posit that the scientific method can lead to errors. However, the scientific method was devised specifically to avoid the kind of confirmation bias you and the earlier author are reporting on. Hence, the errors in psychiatry are not errors of the scientific method, but errors that arose from failing to apply it in favor of personal, institutional, and/or financial conflicts of interest.
I think it is VERY important to stress that good science had already invalidated many of bio-psychiatry’s main premises in the 1980s, and any serious application of the scientific method at this point would completely destroy the idea that giving people drugs for life for “schizophrenia” is completely invalid, not only because it doesn’t help in the collective over time, but also because the category of schizophrenia, like almost every artificial “diagnosis” in the DSM, has no scientific legitimacy whatsoever.
Thanks for your intellectual honesty and your willingness to tolerate the masses of feedback and emotion your posts sometimes stir up. It’s a sure sign that you’re on the right track when lots of people want to comment on your discussion!
— Steve
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Thanks for the laugh, Matt! If only they could understand our deviance…
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I thought it notable that the psychiatrist didn’t even notice that she was totally threatened by his approach. She was not hard to read, in my estimation. The DSM makes it SO easy to blame the client when you irritate or frighten them!
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Thanks! If we both agree on something, it MUST be right!
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Wow, way to make something simple insanely complex! What they’re really saying here is that human thought and behavior can make the brain do different things. Big news. The REAL news is that using drugs to alter the human brain is not only unnecessary but ultimately totally destructive. But I guess the authors have to kowtow to the “neurobiology” gods in order to get funding. Kind of disturbing, but I’m glad they are proving what anyone with common sense already knows.
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Sera,
Great blog, as always! I have known several multiples and have provided brief counseling to one for about 6 weeks, and I can say that your description of their reality is SO much more accurate than the stupidity this movie represents. In particular, the movie plot seems to represent that calm and rational alters can suddenly become violent, which I have never seen (alters seem VERY consistent in their presentation, and I think they have to be for the whole system to work properly), and it was also very common for such people to be diagnosed as Borderline and treated as such. (The one I did the most work with had a ‘teenager’ personality with a major attitude that she pulled out for dealing with threatening people, which she used with the psychiatrist who evaluated her. Not surprisingly, he diagnosed this alter with ‘BPD’ and that was that.)
I so appreciate the reality you are able to create for people who get these diagnoses of whatever type. You really have a gift for portraying others’ reality in a compassionate way. Thanks for being you and for sharing!
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Believe me, I feel your pain. My oldest put us through the ringer! We had to create our own plan as we went along, as no one really had a great approach that respected our values. I was fortunate to get training in intensive behavior management for my work, but most of that still didn’t work unless we adapted it to his unique needs and strengths.
Thanks for your positive words!
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Pretty disgusting. They have no right to treat their “residents” this way. They’re not kids, nor are they prisoners – is the Bill of Rights suspended because of staff inconvenience?
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This article really bugged me for a number of reasons. The most disturbing is the apparent bafflement of the psychiatric community as to why antipsychotics are being prescribed to kids with “ADHD” diagnoses. The answer is obvious to anyone who knows the biochemistry of stimulants and antipsychotics. The reason is because the kids are taking stimulants.
Stimulants’ main effect is to INCREASE the amount of available dopamine in the brain. It is well known that increasing dopamine is associated with increases in aggression and moodiness (anyone who has ever worked with meth addicts can attest to this). Sufficient dosages of stimulants can lead to frank psychosis in otherwise healthy adults or kids. Some kids who take stimulants predictably become aggressive at “therapeutic” doses.
Antipsychotics’ main effect is to DECREASE the amount of available dopamine in the brain. Note that this is the OPPOSITE effect of the stimulants. So the obvious reason for so many prescriptions for Risperdal et al is because they are making these kids aggressive with stimulants, and then “treating” the resulting aggression with antipsychotics. In chemical terms, they are upping dopamine with stimulants and then decreasing dopamine with antipsychotics. There is nothing surprising about it.
What SHOULD be disturbing is that psychiatrists are so corrupt and/or ignorant not to recognize or acknowledge that their own “treatment” is causing the secondary problem they are “treating” with the antipsychotics. If they really wanted less dopamine in the brain, why don’t they just stop increasing it by reducing or eliminating the stimulants???? But that would require logic, something noticeably lacking in most psychiatric settings.
To add insult to injury, the authors separate amphetamines from “methylphenidates,” when the mechanism of action is so similar as to be essentially identical. Ritalin is an amphetamine in both structure and action.
None of this even begins to address the infinite stupidity of using behavioral variables to diagnose a “disease” that is then “treated” in this ham-handed fashion. This article is a complete repudiation of psychiatry’s approach to kids who are active and don’t like to sit still or follow directions. They can’t even evaluate the effects of their own interventions, and are baffled by something so obvious that a college biochem student could figure it out in their spare time.
— Steve
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Your point is very well taken. I have written on this topic in the past for MIA, maybe it’s time for me to take another swing at it. There have been some articles about foster kids, but regular old kids like yours and mine who just happen to be very inconvenient and difficult for adults to manage just don’t have sufficient cache to pull in big numbers of readers.
Do you have any thoughts as to a better venue to get the attention of parents who are loving and well-intended but need some help figuring out their options?
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Shook,
You state with confience that “Antipsychotics decrease the length of psychosis.” However, you provide no evidence to support this. Studies by Harrow, Wunderlink and others show the opposite – short use or no use of antipsychotics is associated with shorter length of “schizophrenia,”even if short-term use does decrease psychotic symptoms.
You also clam that they reduce mortality. However, the mortality rate among the “chronically mentally ill” is MUCH higher than the general population, 25 or so years earlier, often due to medication-induced diabetes and heart disease. I think you’re believing what you’ve been told, but not looking at the totality of the evidence showing that long-term use of antipsychotics has very negative consequences that outweigh the benefits more and more significantly as length of use continues.
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Thanks for the good article. I’d add that your argument will be strengthened by noting that psychiatric patients are more likely to kill themselves AFTER a psych hospitalization than before. You might also want to note that the psych drugs sometimes make non-suicidal people suicidal, and a non-drug alternative is essential for people for whom the drugs either don’t work very well (a solid majority) or for whom drugs make the situation even more dire.
Of course, the real problem is that to fund these initiatives, money must be redirected from the ruling elite of psychiatrists and drug companies, and this will never be tolerated without a big fight. Sadly, the benefit of our rich elite is more important than the benefit of the patients they are supposed to be helping.
— Steve
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Actually, defunding SAMHSA is attacking the wrong target. What needs to be defunded is enforced involuntary “treatment” with drugs, as well as the constant flow of money to drug “research.” Such money should be redirected toward psychosocial interventions, especially peer-based services. SAMHSA is actually the only federal agency I am aware of who has ever supported peer-based services. The NIMH would be a better place to start.
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The problem is that there are so many variables that affect “mental health” that none of them will ever be “the cause,” but if a researcher wants to create a study to suggest a correlation, they can often find one. I am sure green space improves “mental health” variables, but so does good nutrition, sex, having parents who love you, having current positive relationships, being in chronic pain, the list goes on and on. Bottom line, it is pointless to look at the brain as the cause of any “mental health condition,” as they are all made up from social biases anyway and there is no reason to think any of them has one single cause.
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Interesting to note that HALF of the participants in the control group got better with NO intervention. Also interesting to note that the improvements here appear far superior to antidepressant drugs, which barely beat a placebo. Once again, talking to a caring human being beats the crap out of screwing with brain chemistry.
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The real question here is “What was a ‘good response’ to Risperdal? And by whose estimation?” As usual, no one bothers to ask the “patient” why they stopped taking the drugs.
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You need to read more carefully. The author clearly states that there are ASSOCIATIONS of particular brain states with particular identified psychiatric “conditions” or “disorders”, but a) there is no real evidence that such brain states are in any way abnormal, and more importantly b) there are many people showing the same brain state who do NOT qualify as “disordered,” even by the DSM’s own subjective rules, and there are many people who qualify as “disordered” who don’t have the brain condition. EVERYONE who has malaria has a malaria virus, and almost everyone who gets infected gets malaria. Saying that 15% of “schizophrenia” cases are associated with a handful or more likely an armload of genes leaves 85% of schizophrenia sufferers with no such influence. Any REAL scientist would recognize that this is a dishonest attempt to get a result when no result exists. Hence, “pseudoscience” is most definitely an applicable term.
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With or without coaching, these figures appear to kick the ass of pharmaceutical interventions!
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It is obviously not difficult to accomplish anywhere. The idea that helping people solve their problems helps them live better is basic to any culture. Sadly, the real reason that it would be difficult to accomplish in the US is because the entrenched business interests here would oppose it with every bone in their bodies. And every dollar in their wallets!
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This line struck me especially:
“That is, beyond improving the psychological health of the patient, the HAP intervention appears to actually improve the context of the patient’s life, particularly for women.”
This statement seems to suggest that the psychological health is somehow an unrelated variable to the context of the person’s life! Really? Do the authors think it’s POSSIBLE that the reason they were less depressed is BECAUSE THE CONTEXT OF THEIR LIFE IMPROVED????? What a radical concept!
Glad someone’s doing this work, but this should not have to be proven. It shows how far we’ve moved away from “common sense” that someone’s psychological well-being is not seen as directly resulting from the conditions of his/her life, or that talking to someone about how to improve those conditions, even a fairly untrained person, is the best way to improve psychological welfare.
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The saddest part of this study is that it seems to be considered a radical concept to ask the recipients of a particular drug “treatment” about their experiences. What other profession would ignore the response of the recipients of their product????
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This is scientific reductionism at its very worst. The obvious hypothesis to explore is what the prior living conditions of the people in the studies were like to find correlations that really connect physical and emotional difficulties. For instance, the ACE studies at Kaiser showed that kid who experienced abuse and neglect or other childhood trauma were more likely to have both physical AND emotional difficulties in adulthood. Additionally, physiological insults like lead poisoning and other pollution effects have also been shown to associate with both physical and emotional difficulties as life progresses. They are looking at effects instead of causes, and postulating that two effects which occur more likely together are somehow causing each other. This is particularly idiotic, since of course not all depressed people have the physiological difficulties nor do all with the physical difficulties have the correlated emotional problems. It should be clear that looking for an earlier cause for both conditions is the simplest explanation if you want to be scientific. But these folks either don’t understand that or don’t want to. Baffling, disappointing, but not really that surprising. The level of scientific integrity in the psychiatric world is remarkably low.
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Right – CBT didn’t really work much, but Prozac actually made it worse. It’s hard to understand how a comparative study overlooks the fact that neither intervention is significantly helpful more than randomly selecting a person to talk to, and of course, the Prozac was worse than doing nothing overall. We are living in a world of marketing and mythology and actual fact seem to have little to no effect on people’s views!
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The study is presented as if these were equivalent treatments, but the data said that the drugs made CBT LESS effective. Why is it so taboo to say that?
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So let me get this straight. Non-drug treatments are minimally effective overall. However, when compared to “antidepressants,” they are AS effective, or MORE effective, and have many fewer side effects. So if they are minimally effective, but MORE effective than “antidepressants,”what does that say about “antidepressants?” They are obviously barely more than useless, and expose people to a wide range of risks when the same or better benefit are available from homeopathy, individual therapy, or exercise. What a fraud!!!!
— Steve
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They increase the mortality rate for anyone. This should be old news, and only the media’s suppression of this kind of information keeps it from being common knowledge.
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I saw this in residential “treatment” homes for teens with behavior problems. The staff not only didn’t screen for side effects, they had not even been trained on what the side effects were. In one case, the therapist readily acknowledged that they never told the teens about the side effects because they were afraid the teens would then refuse to take the drugs (definition of “informed consent,” please?) One girl in this facility had a constant hand tremor, was taking FOUR drugs that cause involuntary movements (TWO “antipsychotics” and TWO “mood stabilizers), two of which specifically noted HAND TREMORS as an adverse effect. They told her that her hand shaking was because she was “nervous!” I was never quite so appalled in my sometimes quite appalling career working with kids. So no, this doesn’t surprise me one bit. Most doctors and facilities approach adverse effects with either minimization or complete denial. To actually screen for them would be most out of character for most facilities I’ve seen.
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Until a pet can be patented and hundreds of dollars charged for a “pet therapy” prescription, they will be viewed as a marginal contributor in the field, regardless of the actual data. The term “Animal Assisted Therapy” kind of turned my stomach a bit. Why don’t we just call it “Getting a pet whom you know loves you and gives you lots of affection?” Nothing fancy, really. People need to be loved.
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Wow, way to hit ’em where they live! I was particularly struck by the story of the guy who has received standard psych treatment for decades and is still a mess, which any sane person would conclude was a story of complete and utter failure of the system and the paradigm that drives it, and yet they use that same story to argue for MORE “treatment” that we know has failed him! It’s hard to understand how people can’t see through this. I guess it goes back to Joseph Campbell and people’s need to believe in their own cultural mythology no matter what. I wish I knew what to do about it, because it’s obvious that logic is not a part of the support structure for the psychiatric myth.
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In other news, being hit on the head with a frying pan can cause bruising and head injury.
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This is not new information. Known for decades, actually. The physical deterioration of the brain is NOT sufficient to bring about Alzheimers. But no one really wants to know that, do they?
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This is even more dismal than I had imagined! Even in the short term, you’re talking 70-80% treatment failure rates (dropping out of getting worse or not improving). That’s without any psychosocial interventions, either. These quacks should be embarrassed, if they were capable of shame!
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Makes me ill. A “documentary” that is a marketing piece for drug use. I WONDER who could have funded this little piece?
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I would bet my mortgage that the survey did NOT include people living out in the community who are refusing “treatment” or using it in their own more empowered way. Sleazeballs!
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To add to your critique: not only does the author not provide any data supporting that people off drugs have worse social and medical outcomes. The author does not provide any data suggesting that “treatment” leads to improved outcomes for those who receive it. This is psychiatry’s biggest dirty secret of all – people on the average don’t improve in key outcomes for any psychiatric intervention that have been studies. This should not surprise anyone – taking mind-altering drugs is known to have bad outcomes in the long term, but for some reason, folks want to believe that somehow the fact that a doctor prescribes the drug protects from the predictable long-term deterioration that messing with the brain inevitably creates.
And I have to say, I’m impressed by their utter hubris in comparing Wunderlink and Harrow to cancer treatment! How is it that folks can’t see through this kind of smoke and mirror chicanery?
— Steve
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The other question is: so what? Let’s say we discover some biomarker that is more frequent in people who have a “schizophrenia” diagnosis. How would that help? We can’t change their biology, and psychiatry has no “cure” for any “disorder” they identify. The only purpose of studying biomarkers appears to be to try and “prove” that “mental illnesses” are biological so we don’t have to face the myriad ways our society makes people crazy.
—-Steve
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NAMI is not a reliable source, nor is the NIMH necessarily, as they engage in lots of propaganda that simply is false (such as claiming that all mental illnesses are ‘brain diseases,” stated unapologetically on their website and in many of their publications and their courses. It should also be noted that a large segment of those “untreated” recover and are no longer counted as “mentally ill.”
You really should read “Anatomy of an Epidemic” if you really want to have productive conversations on this site. I know a lot of what is said goes contrary to the “conventional wisdom,” but a lot of the “conventional wisdom” is shown to be false by psychiatry’s own scientific studies.
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It remains a fact that more treatment leads to earlier death. What you say is, of course, important, but the author makes it very clear, with good research support, that dying 25 years younger on the AVERAGE can not be explained by “not understanding that they have a disease.” I would add that there are PLENTY of non-diagnosed people who deny or minimize diabetes or many other conditions and/or fail to seek or maintain treatment, so that factor would be even more reduced in overall impact with the general population.
The fact is, the drugs given for “schizophrenia” and “bipolar disorder” DO cause diabetes, heart disease, and strokes, AND also encourage smoking and other drug use to compensate for adverse effects. This is NOT an arguable premise – it is known and published on the side of every bottle of the drugs. There is a black box warning regarding antipsychotics leading to early death in the elderly. This is NOT imaginary – it is a FACT.
I will add that while your mom may not be willing to accept treatment for her medical conditions, if she is diagnosed with a “major mental illness,” I am guessing that the drugs she has been taking psych drugs for them. Am I wrong? If so, is it possible that she would not HAVE diabetes or congestive heart failure to be worried about if some other approach had been taken from day one?
It is important to look at our own potential biases as well as any potential biases the authors may have before offering a critical analysis. I think things may be much more complex than your own description of your mom’s experience may suggest.
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It remains baffling in the face of such strong evidence that the medical community in general has not been more accepting of this data. A needed–to-harm of 16 is pretty small, and means that almost every doctor with a sizable practice will see this effect dozens or potentially hundreds of times a year. And the fact that it’s seen with women with no psychiatric diagnosis or history cuts out any argument that it’s “the disease” causing the effect. The level of denial is quite astounding!
Thanks for your excellent summary of the recent data!
—- Steve
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I guess I read this article differently. I think what it says is that while there are differences between males and females, they are AVERAGE differences and can’t be generalized to all members of either gender. I think it also says that researchers are biased in their interpretation of data based on their own cultural stereotypes. I don’t think it’s possible to deny the huge impact of large amounts of testosterone on the brain and body – it is, in fact, what makes a body turn out male rather than female. But it’s also very easy to ignore the huge impact of social and cultural training on how men vs. women act in a given culture.
As is frequently the case in the nature vs. nurture argument, it’s not one or the other, but both.
— Steve
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It may be a relief, but it is misleading, and intentionally so, as you yourself indicate. Sure, it could be a relief for parents to feel like it’s “not their fault,” or for teachers to be told that the kids’ lack of progress in their class is not a result of poor teaching or lack of a stimulating environment or a child’s inappropriate or dangerous home environment, but if it is NOT TRUE, then the parent/teacher/psychologist is being let off the hook, as my son’s doctor was. And if you’re saying that only a “poor psychiatrist” would act upon a person without asking psychosocial screening questions, I would have to say that there are a lot more poor psychiatrists in practice than you seem to recognize.
As for your other examples, you’re correct that “high cholesterol” is not a verifiable illness, either, and that many medical diagnoses are subjective and lack an understanding of cause. However, one IS able to establish that a person DOES have a specific cholesterol level and that all persons can be measured and compared and a standard set above which it is considered “high.” We all know that politics enters into both where that line is set and what recommended treatments are allowable, but that does not excuse psychiatry from engaging in the same unhelpful political nonsense, which again you seem to agree is the case with the DSM. But at least we can measure blood pressure and weight and cholesterol levels. What the heck are we measuring in psychiatry? How can we create “nose-picking disorder” without any measurement of what is supposedly wrong?
And of course, your assertion that there is no such thing as science is completely specious. Science does exist, even if many people practice it in a corrupt or distorted manner. A call for psychiatry to actually respect the findings of their own scientific literature, including, for instance, the fact that “ADHD” diagnosed kids are no better off in the long term whether medicated or not, is certainly not unreasonable, nor is calling them out when they repeatedly ignore known scientific findings in favor of their pet biological theories, which is what the DSM really encourages. We’d be far better off to drop the whole thing and start over if we really care about helping people instead of getting more insurance reimbursement for less time spent with the client.
—- Steve
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I reiterate, why is it important to defend labels that you yourself admit are arbitrary and socially determined, driven mostly by insurance reimbursement and irrelevant to treatment decisions?
It sounds like you see the real point of these labels as justification for getting paid for treatment. That’s the only thing they are useful for, so we agree on that point.
As for disempowerment, you are really not trying very hard if you can’t understand this. Your “good psychiatrist” may not use the labels to define a person’s condition, but if that’s the case, most are not good psychiatrists, because it appears very, very common in the folks I talk with. Best example is from multiple foster youth I’ve spoken with, most of whom have been through hell and back and have understandably difficult emotions and behavior to deal with. These kids are almost always told that the reason they are depressed or angry or anxious is because their brain isn’t working properly, and that medication will help “balance out” their brain chemistry. Psychiatrists as a rule have almost nothing to say or ask them about why they are acting the way they are or what their history is. They medicate based on symptoms and explain away any causal factors. The kids find this confusing and/or downright insulting. And I’m talking multiple examples from a fairly specific sample of people who do NOT respond well to that kind of treatment. So disempowerment is VERY real and damaging both to the kids’ desire to continue treatment of any kind and of their chances of success, since the actual reason for their “condition” is not examined or validated or directly addressed.
Or for another example – my son went off the rails temporarily and was living a dangerous life for a couple of months, including taking drugs and ultimately being assaulted. He went to see a doctor and in a depression screening endorsed suicidality. The doctor went on a lecture about how depression is a “disease just like diabetes” and that “treatments are available” but never ONCE asked him why he might have considered killing himself! And he would certainly have told her what was going on, and it might just have been helpful, but the “MDD” label allowed the doctor to feel like she’d “diagnosed” him without bothering to even find out what was going on.
You’ll try to tell me this is rare. In my experience, it is not. It is, in fact, extremely common, and the labeling process makes that possible for doctors to get away with.
Of course, you are again being intentionally obtuse if you don’t recognize the difference between telling someone they have influenza, which is a verifiable fact that leads to a verifiable treatment that is almost uniformly effective, with diagnosing “Major Depressive Disorder,” which is nonspecific, non-verifiable, and does NOT lead to a uniformly effective treatment plan, since the wide range of people diagnosed with MDD are incredibly heterogeneous, and what works great for one person could actually ruin someone else’s life.
I am afraid you are so committed to your position that you are unable to look at any other perspective. I am not going to bother trying to convince you further that other rational viewpoints are viable and have value. You can remain rigid if you want, but I am not going to accept that you are somehow more knowledgeable about this area than I am, because it just ain’t so.
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You seem to be suggesting that the only way to help someone with a problem is to diagnose them with a disease. I have helped hundreds, probably thousands of people professionally over many years without feeling the need to diagnose a single one of them. The only purpose psychiatric diagnosis served for me is to get insurance to pay for people to get certain kinds of help, and whenever I did so, I clearly explained to the person that the diagnosis was simply a description of what is going on with the purpose of getting insurance reimbursement, but that their conception of the problem is the only thing I was really concerned with.
Psychiatric diagnosis, in my experience, tends to invalidate people’s own experience and takes away their ability to define their own problem and potential solutions, and is therefore extremely disempowering. It puts people in the position of having some “expert” tell them what’s wrong with them and what they have to do. This is particularly egregious when the “expert” has no real clue what is going on.
As for “biological correlates,” well gosh, we all inhabit bodies and there are biological correlates for everything we do. So what? Are you intending to say that anger is “caused” by “excessive adrenaline and other neurotransmitters?” Or is it caused by someone deciding that something pisses them off and the body responds to their thought by preparing to fight?
As for not diagnosing someone with “Nose-picking disorder” being somehow a barrier to helping him/her with that problem, you have now descended into the extremes of absurdity. I am thinking you are being perhaps intentionally obtuse in order to be “right” about your point. Perhaps you are suffering from “Irrational Need to Win an Argument Disorder.” It seems to be interfering with your ability to hear others’ viewpoints. Do you think there are biological correlates for your condition? Perhaps I can offer some kind of treatment?
I hope you get my gentle jest above. Not meaning to be insulting, just to point out the absurdity of taking any condition you consider undesirable and labeling it as a disease. At a certain point, it reduces to total absurdity.
— Steve
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SO you really do think that it’s OK to say someone has a “nose-picking disorder” if nose picking is getting in the way of their social success???? That’s a very weird way of defining “disease.” Seems to me like you are perhaps invested in defending the current paradigm rather than really listening to how/why people find this medicalization of normal behavior disturbing and destructive.
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Thanks!
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I would have to add, though, that different kids require different disciplinary approaches. Kids who get diagnosed with “ADHD” generally are seeking stimulation, and knowing that does help decide HOW to approach discipline with them. Of course, needing something different does not make someone diseased, especially if what is different is simply behavioral style and personality.
I’d also add that there are kids who have been abused and/or neglected by their parents, or have been injured by society at large, and they may choose stimulation-seeking as a means of coping. So we do have to be careful to posit a lack of discipline as a universal commonality – trauma also plays a role, as can easily be seen by the massively higher “ADHD” diagnosis rates for kids in foster care.
Thanks for continuing to fight this fight – this topic is near and dear to my heart!
— Steve
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I think your argument is rational, and I don’t object to defining “disease” in that way. What I object to is psychiatrists and other doctors or professionals telling people that they are depressed “because they have a chemical imbalance” rather than admitting they have no idea exactly what is happening biologically or psychologically and they are treating symptoms. It’s obviously idiocy to tell someone with a rash that they have “irritated skin disorder” that is caused by an “overactivity of the immune system” and that suppressing the immune system response is the only answer. And I would still submit that calling “anxiety” a mental disorder leaves the door open to “nose-picking disorder” or “ball scratching disorder.” Where is the line in your view? How insipid and subjective and culturally bound does a condition need to be before the definition of a disease becomes absurd?
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He is absolutely correct. There is no proof that the mind is the product of activity originating in the physical brain. It is a philosophical assumption that many “modern” people make, and there is a tendency to dismiss anyone who doesn’t automatically agree as “superstitious” or “mystical” as you have. However, I defy you to show us any specific proof of that postulate. I know you can’t, because there is no way to prove what “mind” really is. What you’re saying is that you believe there IS no possibility of non-material existence, therefore the mind must originate in material reality. But there are many, many cultures and individuals who would disagree with you, and you have nothing less mystical than their assumptions to fight them with. You believe that because you believe it – what other proof can you provide other than “It has to be because it can’t be anything else?”
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There have actually been plenty of long-term studies, starting back in the 60s. The MTA is the most referred to, but most only refer to the firts 14 months, when the medicated group did slightly better on reading scores. By three years, these advantages had evaporated and those maintained on stimulants actually did slightly worse. Same is true with the Raine study in Australia – no advantage for long-term stimulant use, with worse academic outcomes. Montreal study – no improvements in academic outcomes, worse psychosocial outcomes for girls on stimulants. Finland vs. USA comparison study – Finnish kids much less likely to be on stimulants, no difference in academic outcomes at all. Plenty of other studies have been reviewed, including Barclay’s 1978 review, Swanson’s 1993 “review of reviews,” and the Oregon State University’s Medication Effectiveness Project, which looked at every piece of research ever published on the subject that they could unearth, over 2000 articles. None showed any improvements in long-term outcomes for long-term stimulant users, whether academic, psychological, or social, except for kids taking stimulants being somewhat less likely to get into major accidents as teens (OSU study). True, those not taking stimulants still had significant struggles, but it is clear that assuming the risk of long-term stimulant use did little to nothing in the long term to help with those struggles. Scientifically speaking, long-term use of stimulants to “treat ADHD” is a complete failure and should be abandoned.
Of course, individuals may have different experiences, and I don’t want to invalidate that. But it is absolutely wrong for doctors or teachers or psychologists to say that “untreated ADHD leads to X” when the proposed treatment doesn’t alter those outcomes at all, or maybe even makes them slightly worse in some cases.
Don’t mean to be difficult – this is just an area I’ve studied intensively and I know that what people are told generally is not supported by the literature. If folks said, “Stimulants may help you pay attention in the short term, it is not likely by itself to make any differences in your long-term performance, and we should talk about other strategies to get you (or your child) to where you want to be.”
— Steve
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And just for clarity’s sake, I don’t really support stimulant use at all, as I’ve raised two “ADHD”-type boys using creative discipline and alternative schooling, and they are thriving without any “medical” intervention whatsoever. And they were not “mild cases,” either. My person opinion is that the major cause of “ADHD” is our idiotic insistence on making kids sit still and follow teachers’ directions when they’re not developmentally ready to do so, and don’t benefit from being forced to in any case.
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You neglect to mention that such long-term studies have shown little to no effect on key outcomes like high school graduation/college enrollment rates, academic test scores, delinquency rates, teen pregnancy rates, self-esteem, social skills, or any major outcome that people claim “untreated ADHD” purportedly damaged. If you’re going to quote the long-term literature, your credibility would be enhanced if you told the whole story. Not only does long-term stimulant use not appear to have much impact on substance abuse one way or the other (though you should read Nadine Lambert re: possible connection with stimulants, especially smoking), but it doesn’t appear to have much impact on ANY important outcome measure. The honest conclusion should be that long-term stimulant use makes little to no difference in the aggregate, and should not be supported by doctors. Stimulant use, at best, should be considered a short-term intervention to make kids more manageable while other psycho-social interventions are attempted.
—- Steve
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Luke, it is not the responsibility of anyone to establish that there is NOT a biological marker. As a scientist by training, I can tell you that it is the responsibility of the one claiming a connection to show that it exists. There has been plenty of research attempting to find such biological markers over many years, and it has yielded very limited results. Interestingly, the same is actually true for physiological issues like heart disease – even though there appears to be a significant level of “heritability,” there is not a specific gene or genetic combination reliably connected even with many measurable disease states that are much more objectively diagnosable than “BPD.”
We both agree that the situation is very much more complicated than “he was abused as a child and that’s why he acts this way.” What I’m asking you to agree with is the counter proposition: that the situation is very much more complicated than “He has a chemical imbalance and that’s why he acts that way.” In no way have I ever stated that I did not believe there were a range of possible causes – to the contrary, my very point is that you CAN NOT determine one cause for a set of behaviors, and that research into the range of possible causes is the way to go, rather than ASSUMING that all people exhibiting “bipolar” symptoms are suffering from the same problem or need the same kinds of interventions.
If you are really listening, you should be able to hear that many different people had a wide range of different experiences with the mental health system – some (like you) seem to have found it very helpful, while others feel it has destroyed their lives. That should be evidence enough that there is no “one size fits all” solution to these issues. It is a logical inference from that observation that different people with the same behavioral manifestations may have different problems requiring very different solutions, and that forcing the “standard solution” down someone’s throat (sometimes literally) can lead to disastrous outcomes.
You call for more open-mindedness, and I think with some fairness. I’m calling for you to do the same. There are parts of this we absolutely agree about – why don’t we build on those instead of each person taking terns invalidating those they feel have invalidated them?
— Steve
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Sorry, I have not dismissed anything you’ve said except your insistence that “bipolar” is a disease, and I’ve given solid, logical explanations why I don’t agree with using that term. I have agreed that there may be people who have a “chemical imbalance” but have asserted that it is impossible to determine that based only on a person’s behavior or emotions. I’m sorry if we are not agreeing with your philosophical views, but philosophy is not science. You can say “It IS a disease” all you want, but it does not change the fact that NO ONE has any proof that people with “bipolar” have anything specifically in common biologically, as the only definition of “bipolar” is their behavior. I am not sure how you can accuse others of not being “open minded” when you’re not able to accept that the definition of “bipolar disorder” is subjective and behavioral and does not require or establish any kind of biological problem in order to be diagnosed.
— Steve
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Which leads me to believe that rather than psychiatric disorders, they should be referred to for the most part as “psychic injuries.”
I do agree that some form of “treatment” can be proposed for things that aren’t understood (though bleeding is not a good example, as we know VERY clearly why a person is bleeding and what we can do to help), however, treating SYMPTOMS is not the same as treating a DISEASE. For instance, a person whose knee is swollen for no reason we know of might benefit from pain killers or antiinflammatories or some kind of drainage to reduce the pressure. But we would be extremely remiss to call a swollen knee a DISEASE and stop looking for a cause just because the antiinflammatory reduces the swelling. Psychiatric diagnoses are very much like saying someone has a “swollen knee.” You can describe what’s happening and try to reduce the “symptoms,” but only an idiot would assume that all swollen knees are caused by the same thing or needed the same treatment. Hence, a swollen knee is NOT a disease, even if it is amenable to symptomatic treatment.
You also have not addressed my rash analogy. Is a RASH a DISEASE? Or is it a condition that could be caused by many things, some disease states and some not? No one’s saying you shouldn’t help a person in distress, but it is presumptuous in the extreme to tell people they “have bipolar disorder” when bipolar disorder is simply a description of how they are acting. If that’s an OK way to define a disease, what is to stop us from diagnosing people with “nose-picking disorder” or “excessive digital-nasal insertion disorder” if you want something more erudite? After all, nose-picking is something that disturbs social functioning and leads to bullying and exclusion. Why not diagnose and “treat” anything that people find annoying?
Thanks for the civil exchange!
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My understanding is that the idea that depressed people consistently or even more commonly have low levels of serotonin was substantially disproven back in the 1980s, before Prozac even came to the market. Read “Anatomy of an Epidemic” and catch up with the actual research!
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I don’t think anyone is saying or implying “Get over it” because they are saying that traumatic experiences can cause “bipolar” symptoms! Trauma is a BITCH, and it is tough as hell to get over. Imagine being forced to go to school every single day, when the majority of people at the school call you “retard” or “dummy” or “fatso” or far worse things, physically abuse or threaten you, refuse to let you sit with them or play with them, threaten others who try to make friends with you… and remember that TEACHERS are sometimes the biggest bullies of all, and kids often have zero recourse if they get stuck with an abusive teacher. The point is not that you need to “get over” being abused, it’s that a person with an abusive background will be more likely to be helped by interventions intended to resolve that background, rather than being told “it’s all because of bad brain chemistry.” I’ve worked a ton with foster youth, and I can tell you, saying they have a “chemical imbalance” is every bit as insulting to them as you seem to find the idea that your symptoms result from abuse that you don’t identify as having ever occurred.
The point is, “bipolar” is just a description of a bunch of emotions and behaviors that tend to occur together – there is no proof and not really much evidence that it is uniformly or even commonly caused by faulty brain chemicals. That does not mean it CAN’T be caused by such faults, but it is unscientific and foolish to ASSUME that such behavior is always caused by this and dismissing abuse history and social context as secondary or even irrelevant, as many if not most psychiatrists tend to do.
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I do agree 100% that different learning styles should be respected, and that more discipline to force “ADHD” kids into regular classroom environments is stupid. Of course, the real purpose of “medication” is to do exactly that, to force kids who don’t fit to modify their personalities and learning styles so as to be less inconvenient for the adults involved.
I raised two of my three boys who had this range of behavior, and we used home schooling and alternative schooling with a child-centered approach, where they were allowed more room to explore and pursue their own interests at their own pace. They both did much, much better in this kind of environment, to the point that both graduated high school with honors, without a milligram of stimulants passing their lips. They DID require some unique approaches to discipline as well, but more or tougher discipline wasn’t the issue, it was more a matter of adjusting disciplinary techniques to their unique needs, most specifically, to take their need for stimulation as an opportunity to be smart and effective, rather than continuing to do what doesn’t work and expect that more of the same will somehow magically change the situation.
Thanks for your comment!
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I think he does answer that question, if indirectly, with his pneumonia example. He is saying that an identifiable disease is something where the cause is known or at least knowable, that some kind of specific test will indicate the presence of said cause, and that the cause is distinguishable from a recitation of symptoms. His critique of ADHD, and I think it is quite valid, is that the symptoms define the “disease,” hence, “He has ADHD because he’s hyperactive and impulsive and lacks focus,” when the very definition of the disorder is “he’s hyperactive and impulsive and lacks focus!” We could just as easily say that someone is picking his nose because he has nose-picking disorder, or that his knee is swollen because he has swollen-knee disorder. The diagnosis is neither explanatory, nor specific, and doesn’t distinguish for the likelihood that these same “symptoms” could be caused by a wide range of different factors.
ADHD is at best a syndrome, a set of “symptoms” that tend to occur together and are troubling, but for which no known cause has been determined (as the author of the original article clearly states himself). If the definition of a disease is “anything that is uncomfortable or difficult to deal with,” perhaps it would qualify, but the purpose of medical treatment is supposed to be to differentiate between causes rather than just treat symptoms.
My best example is a rash. Any rash could be “treated” with calomine lotion or with corticosteroids, but you’d REALLY want to know if you have poison ivy, prickly heat, or syphilis. Syphilis is a disease. A rash is a condition or syndrome that may or may not be caused by a disease state. ADHD is much more like the rash. Except that in some cases, the behavior is an entirely normal reaction to abnormal circumstances. So treating the symptoms is both cowardly and ineffective, and we really should be looking for the cause, be it poor diet, lack of discipline in the home, boredom, or an overly rigid school environment, or whatever. If there ARE odd cases of purely physically determined “ADHD”, we should be trying to distinguish them from the various other causes, rather than lumping together everyone who acts a certain way into a huge, heterogeneous group and trying to suppress the “mysterious” (again from the original article) manifestations with a drug “treatment” for a “disease” when we haven’t the vaguest comprehension of what we are “treating,” let alone what the long-term impact of “treatment” might be.
— Steve
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” This suggests that whether or not there is a genetic component to the disorder, the impact of experiences such as neglect and physical and sexual abuse cannot be ignored.”
Actually, it suggests that whether or not there is a genetic contribution, the impact of these experiences is MUCH MORE IMPORTANT than whatever genetics are involved. Because we’re seeing a factor of 2.6 times increase in BPD diagnoses, and no genetic study has ever shown anything remotely close to that kind of association. In other words, the biological determinists are barking up the wrong tree and need to shut up. But it is interesting that the authors are unable to draw this obvious conclusion, and as usual, soft-pedal the effects of trauma, abuse and mistreatment in deference to the biological paradigm that is supported by so much money and prestige. The truth is there but they don’t want to look!
— Steve
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Again, did we really need a study to find out that alcohol has short-term antidepressant and anti-anxiety effects? I think the more important aspect of this to highlight is that taking pills to reduce depression is not substantively different than drinking to reduce depression. It’s not a “treatment,” it’s a temporary way to feel better that has unpredictable long-term consequences, including a good shot at making the depressed and anxious feelings worse. Why should we pretend we’re doing anything else? Just because it makes people feel less bad about being dependent on a substance to make it through the day if a doctor prescribed it? If so, why not just prescribe controlled doses of alcohol as “treatment?”
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They suffer with and without “medication.” Hence, the “medication” is not specifically helping them with any particular “disease” but only in some cases suppressing symptoms. Do you consider the fact that some people drink after work to reduce anxiety a sign that they have “anxiety disorders” and that alcohol is “medication?” In truth, benzos have almost the same effects and side-effects as alcohol. Why isn’t alcohol prescribed as a “treatment” for anxiety?
If you really want to know why Bonnie has lost all hope in psychiatry, read some of the stories here, and read “Anatomy of an Epidemic” by Robert Whitaker, or read his more recent publication, “Psychiatry Under the Influence.” There is very good reason to doubt the efficacy and the integrity of psychiatry as a profession.
—- Steve
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Thank you for this generous gift, Bonnie! This is a great model of how we can create evolutionary change without ever buying into the idea that the profession of psychiatry will somehow miraculously come to its senses.
— Steve
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It’s my granddaughter. She is, most definitely extremely adorable!
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Wow, who would think they’d be so UNETHICAL! Shocking, just shocking…
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Matt, thanks for an incredibly passionate and well-researched article. The truth is out there, but unfortunately, too many people don’t want to hear it. I’m sure glad you figured it out, and have given others the chance to look the truth straight in the eye!
—- Steve
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The REAL horror attraction would not be the inmates being freed from the asylum, but the participants being exposed to the psychiatrists and their procedures. Set up an “ECT” exhibit if you really want to scare the shit out of your Hallowe’en guests!
— Steve
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Of course. The error is in thinking that these “conditions” share a common cause, and that the cause is necessarily biological. There are lots of things that can “cause” depression, from crappy parents to lack of sleep to chronic pain to nutritional deficiencies to existential angst about the meaning of life or one’s purpose on the earth. Why anyone would imagine for a second that all “depression,” which is clearly a NORMAL physiological signalling and survival strategy of the human organism, is a disease state that is necessarily a result of some brain malfunction is idiocy of the highest order. Unless, of course, you’re trying to make a lot of money off of duping people…
—- Steve
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I agree about the term “Misdemeanors.” These are high crimes, the equivalent of medical “treason!” They completely violate the trust of the public that pharmaceuticals are intended to be safe and helpful. They are crimes of the highest order.
— Steve
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Interesting that they felt that talking to patients about their assessments is a change in “style.” It seems like a very radical change in values to me.
— Steve
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Maybe the reason they can’t find biomarkers is because most “mental illness” is environmentally activated and has little to do with biological causation.
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Well, that CLEARLY explains why it’s been ignored. You can fix it with nutritional supplementation? How’s a guy supposed to make billions of dollars on THAT?
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Oh, the IRONY! It is painfully delicious! Their biological solution to their purported biological problem is thwarted by – THE ENVIRONMENT!!!!! I am just loving this result!
— Steve
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I pretty much agree, though it is important to note that SOME kids diagnosed with “ADHD” are suffering from trauma and poor parenting, even if that’s hard for the parents to hear. But my observation is that the majority of “ADHD” diagnoses are a result of unrealistic expectations of kids by institutions like public and private schools. And the idea that letting kids “cry it out” as babies causes decreased “ADHD” diagnosis rates is absurd in the extreme. I think the only real point is that French parents appear less likely to be willing to excuse a child’s behavior based on the idea of “bad brain chemistry.” I do think that’s a healthier viewpoint, as it empowers the child, parents and teachers to actually work on making improvements in behavior. Additionally, French kids, as I recall, don’t go to school until later, which is associated with much lower ADHD rates.
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Exactly!
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I only want to add to the healthy discussion that “ADHD” symptoms aren’t always the result of psychosocial causes or trauma. Often, they are the result of normal kids being expected to act abnormally by adults who have unreasonable expectations for the age. Most kids don’t “get ADHD” until they enter school, because “ADHD” is basically a description of a kid who doesn’t fit in well to the standard school classroom’s structure. While good discipline and structure in the home can help with this, it’s also very possible to have kids engage in an educational environment that doesn’t demand they act like they’re not kids.
Just as an interesting side note, kids in France are not expected to attend school until 7, as I understand it. This may be a huge factor in the lower diagnosis rate.
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It always bugs me when they say things like “subjective or vague criteria make it easy to misdiagnose ADHD.” What they SHOULD be saying is that vague or subjective criteria make the ADHD diagnosis invalid and useless in planning any kind of “treatment,” because it is impossible from the diagnostic criteria to even determine if anything at all is wrong with the “patient,” let alone determine what could or should be done to help. How would you even judge what a “misdiagnosis” is if you don’t have any concrete criteria for the diagnosis in the first place?
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Dave, that was perhaps the most cogent and concise letter on the subject I’ve seen in a long time. I hope you’re willing to continue to engage in political and legislative action to force some action on this point. Your calm and rational approach as well as your status as a veteran having honorably served this country make you an ideal spokesperson for these issues in the legislature, where any real change will have to originate, as the field itself is, as you so eloquently describe, corrupted beyond the point of being capable of any kind of honest self evaluation.
Thanks so much for your courage and clarity!
— Steve
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You’re so right. Very thoughtless of me. If we did that, they’d lose their jobs and become depressed and… hey, wait a minute…
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Gotta agree with you there. As soon as you say “He’s got narcissistic personality disorder,” you’ve taken away the layperson’s ability to do their own assessment, and validated the DSM in the process. I prefer to say “He’s a self-centered asshole.” Just as unscientific a pronouncement as the prior one, but much more accessible to the layperson!
—- Steve
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If the doctors were sensitive or thoughtful enough to even consider the impact they were having on the family, none of this would happen. The kind of extreme bullying behavior and rank dishonesty the author experienced is not reflective of a lack of understanding, but of a lack of empathy and a desire and need to be “right” at all costs and to punish anyone challenging her authority. He was very fortunate, indeed, to have landed with a sane psychiatrist who recognized the difference between normal teen angst and an actual medical condition. I’d estimate that 90% of psychiatrists would have backed the family doctor to the hilt.
It is most definitely a case of “caveat emptor” – “Let the Buyer Beware!”
—- Steve
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Insulting, indeed. Anything bad that happens is caused by “the disease.” Anything good is caused by the amazing effects of their miracle drugs. The profession spent 10-20 years denying that tardive dyskinesia is caused by neuroleptic drugs, even though there was no rational way to deny the connection and there was an excellent scientific mechanism in place to explain it. There is no science going on in this field – it’s a religion.
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LOL!!! It’s also true that double amputees have much slower average times in the 100 yard dash. I wonder if slow running could be a causal factor in leg amputation?
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Excellent points! The proponents of the current paradigm aren’t even looking at biological causation in any kind of thorough way. They’ve simply decided that it’s all genetic and ignore even simple stuff like sleep and anemia and thyroid dysfunction.
I have to say, though, this is another of those “duh!” moments for me. Why would you even have to study this? Do we really need a scientist to tell us that a person who lost his job and whose house is in foreclosure and who has no idea where his/her next meal is coming from is more likely to be anxious, depressed, angry, or disoriented?????
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In re-reading this, I’m inclined to think that the Western approach to viewing “mental illness” or anything else having to do with human beings from a detached, analytical perspective is what creates a lot of the problem. People aren’t “problems” or “hypotheses.” Maybe being “scientific” takes the humanity out of the equation.
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As a chemist by training, I have given this a lot of thought historically. By my understanding, a scientific model is an attempt to provide an explanatory mechanism for a phenomenon that is observed. Any good scientist knows that a model is only as good as its ability to predict the phenomenon in question and/or intervene to alter the outcome in predictable ways. Clearly, the “medical” or “disease” model has proven a total and abject failure in both ways.
The “oppression model” would be a means of explaining why people experience intense anxiety or depression or extreme states from the point of view that such experiences are likely a result of experiencing abuse or traumatizing experiences at the hands of another. We would also hope it might suggest ways of intervening to either prevent the oppressive conditions or to assist in analyzing how a person experiencing such conditions might act or be helped to act in order to alter the predicted outcome.
It doesn’t necessarily imply that the phenomenon in question is an aberration or in fact pass any judgement whatsoever about the phenomenon. It’s more like “when people are traumatized, they’re more likely to hear voices in their heads” or “people who hear voices in their heads are likely to have had a history of individual or social oppression.” The model certainly doesn’t require an acceptance of “mental illness” as a concept.
That’s my take on it, anyway. Good discussion!
—- Steve
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I also see this frequently with foster youth. I never cease to be amazed that the obvious seems so obscure to those prescribing the drugs.
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I am astounded at the euphemistic avoidance of reality in the psychiatric research world!
“Antipsychotic medications have little impact on improving cognition…”
Really? Don’t you mean, “Antipsychotic medications appear to cause deteriorating cognition over time?” Who ever thought or expected that antipsychotics would IMPROVE cognition? They make it WORSE!
“…exercise may also reduce the physical health problems associated with schizophrenia, such as obesity and diabetes, which contribute towards reduced life expectancy.”
Are obesity and diabetes REALLY associated with ‘schizophrenia?’ Don’t you mean “health problems associated with drug ‘treatment’ for ‘schizophrenia?” Or more bluntly, health problems frequently CAUSED by atypical antipsychotic drugs?
How do they get away with this tripe?
—- Steve
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It seems like you would need a separate medical expert opinion to challenge the hospital in court. I wonder if he can get a current mental health assessment or psychological evaluation along with an official “risk assessment” tool being used to get at least the impression of a quantitative measure of his current risk? I don’t think you can counter the hospital on legal grounds alone. The judges respond to experts differently, so you’ll need expert counter-testimony to get him out.
What a ridiculous situation!!!!!
—- Steve
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I’m surprised they aren’t claiming that “Singulair uncovered a latent psychotic disorder” in those who reacted poorly. We can’t actually be blaming the DRUG now, can we?
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An amazing tale, all the more amazing for its having been edited previously to delete his involvement in the psychiatric mainstream. I agree with Frank, it’s hard to fathom how many creative geniuses or even just plain creative contributors to society have been and continue to be wiped out by our “mental health” paradigm. Glad that both you and Law were able to survive it!
—- Steve
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You said it! How did these two become our major party choices????
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Great work, as always, Bob. Being sneered at by these guys is the ultimate compliment.
I’d love it if you could comment further on the “Placebo washout” approach described so clearly in the first study. It appears that they systematically removed anyone who got better when coming off antipsychotics. This always seems like a pretty sleazy maneuver to me. If you have people whose quality of life IMPROVES when they STOP the “treatment,” wouldn’t that be very important data? I’d love to compare the “washout” folks at 52 weeks to the Zyprexa users at 52 weeks.
All that being said, the most important point is that the study is meaningless, as they couldn’t even record their primary measure due to an incredibly high dropout rate. Not to mention that they only compared the QOL of the RESPONDERS! Isn’t that like saying that “people who experience pain relief when taking aspirin have less pain than those who didn’t experience pain relief?”
And of course, the other huge deal is that they selected out only these two studies as their best evidence to support their point, rather than looking at the whole of the literature. Such “cherry picking” is systematically criticized (and rightly so) when committed by those who disagree with them. Why are they allowed to get away with it?
The real message here is: “Trust us and don’t ask too many questions like that guy over there.” Or “Don’t confuse yourself with facts.”
Thanks for another excellent blog.
—- Steve
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I get sick of this “Stigma against the profession” crap. Do they really believe that some bunch of people got together and decided to stigmatize psychiatrists for some mysterious reason? The main reason there is a “stigma” against psychiatrists is because they dogmatically promote “treatments” that often don’t work and even more often are damaging even if they help in the short term.
Are people “biased” against Walmart when they refuse to shop there? Or are they correctly observing that Walmart’s policies hurt their communities and their own employees? Are we biased against a mechanic when we choose not to take our car back after he fails to diagnose or correct the problem?
Psychiatry’s poor reputation is well earned. Time they stopped blaming it on public ignorance. Maybe the public is smarter than they think!
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Or perhaps “Science is the belief in experts regardless of their ignorance.”
And I’m just SURE that these low-powered experiments that are more likely to produce a positive result are just a result of naivete on the part of our poor, under-educated scientists. It’s just IMPOSSIBLE that they conduct this kind of experiment specifically BECAUSE it is more likely to give a positive result. Or is it?
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Can’t argue with you there, although the ability to blame the victim provides a great cover for the failures in controlling (and sometimes success in CREATING) the social behaviors that are deemed undesirable. Whether it succeeds or fails in quashing the “bad behavior,” those in power are always let off the hook, because the “mental disorder” is the culprit and ALL of us are its victims!
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Sera, you’re amazing as usual!
I have a question, though. Is the system really broken? Or is it working well at doing something that you and I and most of us here don’t approve of as a goal?
I recall my brief stint as a public school teacher. I went in naively believing that the school system was there to educate students and prepare them for adulthood, and that the failures of the system were due to lack of insight or skills. What I discovered is that the school system appeared to be geared less to educate and enlighten than to cow and demoralize students into automatic compliance, either out of fear or desire for conditional reward. It is designed to create compliant citizens, not to teach people to think, and it’s not broken – it works quite well at doing exactly that. My efforts to individualize and to empower students who were struggling were not only not admired, but generally ridiculed and dismissed as a waste of time.
I think the same is most likely true of the “mental health” system. I think it serves two purposes: first, to give society the opportunity to control difficult behavior that doesn’t fall into the realm of criminality, so that people engaging in such behavior can be cleared off the streets legally. Second, it gives society, or the powerful in society, excellent cover for their domination and oppression within the currently accepted social structure, by blaming those who don’t “adjust” to the current crazy expectations and “treating” them as deficient people, rather than looking at the circumstances producing such anxious, depressed or angry people. And again, it does both of these things quite well.
I think our error is to imagine that the powers who construct and maintain this system really have any other intent. I am sure they would say they are there to “help people,” but what they mean is to help people adapt to society as it is and stop creating problems for those busy trying to run things efficiently. It means to help them either feel OK about living in the oppressive society we’re in, or to help them suppress their rage/anxiety/despair about current conditions. There are, of course, very notable exceptions, and I admire such workers greatly, as I’ve been one of them. But the system itself is not designed to create mentally healthy, highly effective adults. It’s designed to keep creative, oppositional, critical, and insightful people from messing with the machinery that the powerful need to keep in place.
—- Steve
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Excellent point regarding language. Can’t remember who said it, but someone said “language is power.” By selecting certain words, we pre-set the context for the conversation. Suffering isn’t a disease.
—- Steve
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I think what they do is make people care less about stuff than they would. I think they make people more emotionally numb. I believe some people find this beneficial – for instance, if you’re constantly worrying what your mom will think if you refuse to come to the expected Sunday dinner every week, it might feel good to take a drug that makes you not care so much. But it’s pure anesthetization. And supposing you’re being kept from killing yourself by thinking how hard it would be on your kids, or you refrain from shooting someone because you’re worried about the consequences? A “what the f*&k” attitude can be and is very dangerous!
I’ve talked to a number of people who took SSRIs, one for a migrane, and all have reported similar effects – it simply made them less engaged in or concerned about the feelings or experiences of other people. One woman even had a term for it – she called it “Zolofting.”
I suppose it might be easier to “push forward” in some circumstances if you are immune to caring how others think about you. But it’s hardly a medical treatment to make a person less empathetic and more apathetic! How is it different from getting drunk to “drown your sorrows?” Seems exactly the same to me.
—- Steve
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I have always thought there was a lot of hokiness in these fMRI studies.
—- Steve
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The early comments she makes are actually quite significant. Loss of pleasure, loss of empathy, loss of the ability to emote. Seem like things that would be associated with an increase in suicide or violence. Very important observations.
—- Steve
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Imagine. Being under intense financial stress is not good for your mind. Who’da thunk it?
Why do these things even need to be said? Isn’t this kind of like “Scientists have discovered that having one’s foot stuck in a bear trap increases emotional distress?”
—- Steve
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Research also shows no significant improvement in ANY long-term outcome area for kids using stimulants vs. none, including educational, social, and emotional variables. The only “success” that stimulants have shown is that they successfully make active kids a lot less annoying for the adults who have to manage them. I know from personal experience (two of my three kids) how annoying that behavior can be, but that’s who these kids are, and the comment about changing environment vs. changing the kid quoted in the article really describes the direction we need to go.
—- Steve
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Very well said, Steve.
—- Steve
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“…supported by significant success of pharmacologic intervention. ” Not really. I’d say that the bio model was supported by billions of marketing dollars from the pharmaceutical industry, not from significant success of pharmacologic interventions. Unless you count success in elbowing out the competition and success in making more money in less time and success in drugging a significant portion of the “mentally ill” into inertia and an early grave.
— Steve
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One quote jumped out at me: “Why is organized medicine failing to grasp the significance of this dangerous prescription pattern…”
My question is, how could they possibly NOT grasp the significance, when even many lay people are well aware that benzos + opiates can equal death? My thought is that they DO grasp the significance, but choose to deny it, because of the powerful interests who need to sell both prescription opiates and benzos for profit. They don’t want to bite the hand that feeds them.
Until we deal with the corruption in the medical field, these “significances” that should be and really are obvious will continue to be ignored. As Upton Sinclair is quoted as saying, “It’s difficult to get a man to understand something when his salary depends on his not understanding it.”
— Steve
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Language does matter, very much. Using the term “medication” most definitely is part of the effort to legitimize “medical treatment” of these “conditions”. We should use the terms “drugs” and “labels” every time we refer to these fictions!
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Right you are. Different people respond differently to alcohol or meth, too. Doesn’t mean meth is “medication” for some people and others have “side effects.” They are both drugs. They have effects. We may like or not like the effects, but the effects are not “treatment” just because we like them.
—- Steve
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You’d think that, but only if the current system was really aimed at helping people recover from their condition, whatever it is. The actual focus of the current system is making money and asserting authority over “lesser” people diagnosed as “mentally ill,” so such interventions are not welcome. If nothing else, they’d potentially undermine the base of chronic clients consuming their drugs and other “services.”
— Steve
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Well said! I realized that by wanting people to like me, I was not only letting them control how I feel, I was actually trying to control how THEY feel, too! People should get to feel however they feel, without someone imposing their needs on it, one way or the other. And it should not change that we act with compassion and responsibility toward all. But we don’t have to be friends with or feel sorry for someone just because their assholish behavior got them into difficulties!
— Steve
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Well said!
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I like what you said there!
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I think what we need to let go of is the desire for a different outcome, for our tormentor to suddenly understand their error and try to make amends. It is a form of mourning to let go of that, especially if the tormentor is someone who was supposed to love and care for us. But I agree, it doesn’t mean you accept that the other person is “OK” or that you have to forgive them. You have to simply stop imagining that there’s anything you can do to cause them to willingly reform. Their crappy behavior is their problem, not yours.
— Steve
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This study should be a caution to all those AOT/reduced civil rights advocates out there. But of course, it will be ignored, because its conclusions don’t fit the desired narrative of “lock up the dangerous crazies and drug them into submission!” Or should I say, “Provide ‘treatment’ to those poor crazies and drug them into submission!” Comes to about the same thing.
—- Steve
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More like bringing a submarine to a dairy farm for repairs. Though a dairy farm would be highly preferable to a psych ward as “treatment” for “insanity,” IMHO.
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And it continues to amaze me that despite not only not helping, but making your situation WORSE, at no time does even one of them stop and say, “Wow, it doesn’t really seem like our treatment plan is working. What else could we try instead?” It’s beyond infuriating!
Thanks for sharing your story – I hope you’ve escaped!
— Steve
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And then they blame YOU for going nuts in that crazy environment!
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I am not so sure that murderers or violent criminals experience worse, but I am sure that if they do experience worse, it does nothing to mitigate the stupidity of the system or the cruelty and injustice of enforced “treatment” on a person who has nothing wrong with them. Perhaps you missed the part where he went two years without using the drugs and had NO issues, yet once he was “outed,” their first mission was to punish him and force him to take the drugs he’d proven he did not need or benefit from? What kind of insanity is THAT?
Comparative oppression is a zero-sum game to me. Being “less oppressed” than a comparable population is no cause to put up with it or fail to document it.
—- Steve
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Exactly. Well said!
— Steve
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I think the act is strongly mitigated by the drug use, especially any drug use that is forced or engaged in without informed consent. That being said, I agree that abusing substances, or even being intoxicated on a substance involuntarily, doesn’t completely remove responsibility for the action taken.
— Steve
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I am not sure you’re getting the point of the article. This is not a rogue doctor engaging in anything unusual or outlandish. These are the STANDARD RESPONSES that people receive. Despite absolute, unremitting proof of TWO YEARS with no drugs and no psychotic reactions or episodes at all, the IMMEDIATE response is to punish the subject for FAILING TO COMPLY WITH ORDERS. So this is NOT about whether or not medications work for you or someone else. This is about a system that is IRRATIONAL – that believes that their patients need drugs EVEN WHEN THERE IS ABSOLUTE PROOF TO THE CONTRARY. I am not sure how you can argue with the label “junk science” when the supposed scientists involved are unable to see the actual results of an actual experiment right in front of their own eyes, just because it conflicts with what they want to believe is true. Any real scientist who encountered this story would immediately be very INTERESTED: when did you stop taking it, how did you do it, what if any symptoms did you have as a result of discontinuing, how long did they last, how did you get this diagnosis in the first place?
Instead, these psuedo-scientific pretenders focused on the patient’s unwillingness to follow their orders, as if the patient were a wayward young child or the doctors were military commanders whose orders must be followed without question. Please tell me, where is the science in that scenario?
—- Steve
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And I appreciate your perspective and your willingness to share and have a civil exchange of views. It’s how we all learn and do a better job. Honestly, I have never had a problem with people doing whatever they need to do to overcome feeling hopeless and depressed about life, because I’ve been there, many times. My objection to the modern medical viewpoint is the idea that depression is always the result of a failing in the individual, rather than failings in their social system or society as a whole. As you can see in my comments above, I believe we’re living in a rather sick society right now, and I kind of see depression as a pretty reasonable response to a rather dismal political and social picture out there. Maybe if I weren’t “depressed,” I wouldn’t feel upset about global warming and the current political contest or the US policy of overthrowing foreign governments we don’t agree with and so on. Maybe I’m supposed to be OK with all that. But I kinda think that’s my decision to make, not some MD psychiatrist who is more interested in making my bad feelings go away than addressing the actual issues that those bad feelings relate to.
Best of luck to you, and thanks again for the exchange!
— Steve
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Does anyone find this surprising? It is an indicator of how inane and corrupt the “mental health” system has become that such research is even necessary. This should be an obvious conclusion.
—- Steve
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Hey, no one could possibly make massive profits from this kind of cheap intervention. It has to be stopped!
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Maybe learn to meditate? Get some sleep?
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I know what you’re saying and don’t really disagree. People can’t be trusted to “care” for someone when they have authority over them. I do think it’s important, though, to distinguish that being opposed to enforced treatment does NOT mean being opposed to law enforcement being involved when someone’s doing something dangerous or illegal to someone else. I often get the argument, “What, so people should be able to run around threatening or hurting others and nothing happens to them?” I always am clear that violating social rules should result in being restrained, but that does NOT mean that I get to label you as “ill” and “treat” you against your will. It means you have to stop hurting people in order to maintain your freedom, just like anyone else who commits a criminal act against another in society. It is the automatic coupling of detention with “treatment” that makes that argument even possible, so I want to be sure and decouple them, so people know I’m not advocating for anarchy or mayhem, but I’m against labeling and forcing “treatment” on someone just because they behave in a way that violates social expectations for safety and respect of others’ property.
—– Steve
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Well done, and thanks for telling your story so articulately! It sounds like you are yet another victim of SSRI-induced “bipolar disorder,” which led to year of “treatment” that left you far worse off than the original condition they were trying to treat! I also appreciate your description of the vague and hazy state of disinhibition that was the “positive” part of your psych drug experience. I believe this kind of “who cares what anybody things?” experience is what people find helpful about the drugs, especially people like you and me who have histories of shyness and anxiety. But that very effect, I believe, is why suicide becomes a more “reasonable” option for some users, and why extreme and bizarre forms of violence suddenly seem less foreign and repugnant to a significant minority of users.
It also amazes me that after years of obvious failure, the psychiatric system at no time took a look at the results and said, “Jeez, she came in complaining of anxiety and now she’s totally psychotic! Where did we go wrong?” No, instead they blamed you or your “condition” for every failure they produced.
It is a frightening prospect being sucked into such a system. I’m very glad for you that you escaped. Thanks again for sharing your story!
—- Steve
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True enough. However, the choice to end his/her life based on excessive suffering does not lead me to the conclusion that this person or anyone else is victim of a “disease” simply based on the idea that they are suffering. My point is that, as Emerson famously quoted, “To be great is to be misunderstood.” To be misunderstood, is also, to some extent, to suffer, at least for most of us. Much suffering, including suffering to the point of committing suicide, is caused by a sense of alienation from the society in which we currently live. While not all people get to feeling suicidal, plenty experience huge distress because of “not fitting in” to their prescribed social roles. How many depressed moms in the 60s got Valium or Benzedrine instead of someone recognizing that their life as a housewife was isolating and unfulfilling? How many kids get drugged in school because they are unable or unwilling to cope with the stifiling boredom of their classroom? Would Edison have been better off if he’d been drugged into sitting still for his teachers, who clearly couldn’t begin to cope with his energy and creativity? How many domestic abuse victims get Prozac instead of someone asking them what they’re depressed or anxious about? Hell, we’re now supposed to diagnosed a person with Major Depressive Disorder two weeks after the death of a loved one if they’re still having trouble functioning!
Great people suffer. Normal people suffer. Oppressed people suffer. Suffering is part of the human condition. Cherry picking certain famous people who chose to end their lives as proof that they needed “treatment” is reductionistic nonsense.
— Steve
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Her name is Jane Elliott. Her demonstration is absolutely mind blowing – everyone should watch it. Here is a link to a youtube of one of her events:
https://www.youtube.com/watch?v=Nqv9k3jbtYU
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There’s a study that will quickly be buried in the bottom of the psychiatric dustbin! We can’t have proof out there that locking people up doesn’t help! How can we make sure we have clients if we can’t lock them in?
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Oh, and CREEP OUT about the therapist getting a hard on in front of you! At least he had the decency to realize he was unable to help, though again it sounded like you were blamed instead of him admitting he had boundary problems that kept him from being a good therapist.
—- Steve
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“BPD” is, of course, just another label for behavior that psychiatrists/psychologists decided needs to be “treated.” It is never true that you can “have” or “not have” “BPD” in the same sense that you have or don’t have an ulcer or pancreatitis or a ruptured spleen.
That being said, the vast, overwhelming majority of people I’ve known (and I’ve known a lot, as I work with a traumatized population) diagnosed as “Borderline Personality Disorder” had significant childhood trauma histories. From what I understand of DBT, it focuses a lot on developing emotional management skills, to which I have no real objection. But if people are receiving DBT for “BPD” and no one is discussing the likely traumatization that underlies this “condition,” I agree, they are doing their clients a huge disservice.
Bottom line, I regard “BPD” as a description of a common set of coping measures used by people whose parents or other caretakers were usually inconsistently abusive or neglectful when they were very young children. I find that describing and treating these “symptoms” as a rational set of coping techniques adopted by a powerless child in a very confusing and scary situation provides many potential avenues for resolution, whereas viewing it as a “mental disorder” that somehow resides in the client reinforces the idea that 1) your reaction to being traumatized was WRONG, and 2) you should get over it and to the extent you haven’t, you’re the problem.
I find the labels themselves more problematic than the proposed “treatments.” If you’re honest with people from the start in a compassionate way, almost any situation or “condition” can be improved upon, but it never helps to label and blame the victim of abuse.
—- Steve
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Sera of all people should not be accused of “throwing away” anyone. She has dedicated herself and her career to helping folks in the so-called “4%” as well as many others to find a path, particularly those who have not been served well by the mainstream psychiatric system. In fact, I’d guess that Sera and her program have done more to keep the “most ill” out of incarceration and homelessness than any mainstream psychiatrist can ever claim. Your need to believe that “AOT” is the answer for everyone is based solely on your own very limited personal experience. I don’t mean to deny that experience (there is no question that “AOT” has positive effects in many cases, at least as seen from the viewpoint of a concerned family member). But I think it is very presumptuous of you to assume that all or even most people have that positive an effect when you don’t know anything about their lives. Sera talks to these people EVERY DAY and hears their stories of trauma and disempowerment and abuse by many of the “helpers” in the current system. She isn’t just making this up – she hears the stories personally, and feels driven to make sure that their stories are told. That’s advocacy. You are coming from a very personal place, and I respect that. But don’t try to enforce your experience on others who have experienced something very different. AOT is a violation of civil rights on a grand scale, because it goes way beyond recognizing that some people need help that don’t recognize it, and moves to deciding exactly what kind of help they “need” and punishes them for refusing to accept such “help,” even if it is harming them dramatically and even if they are perfectly capable of analyzing the damage it is doing.
We have commitment laws already. The civil restrictions on commitment laws were made because those laws were being abused by system members, parents, and society at large. Moving away from that toward enforcing more “treatment” on those who are competent to refuse is a very, very dangerous step that does damage to many that it claims to help. Even if some are “saved” in the way your suggest, how many more are harmed? And who are you to say what the harm/help balance is? Isn’t that the right of each of us to determine?
—- Steve
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They also neglect to mention that the huge bulk of these famous individuals accomplished all they did with no “treatment” of any sort! Edison clearly met the criteria for “ADHD” and got tossed out of school at a young age, yet ended up being one of our greatest inventors without a milligram of Ritalin ingested. Who’s to say what greatness we may be suppressing in order to “help” our exceptional offspring “fit in” to a warped and unhealthy social system?
—- Steve
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And this is exactly the state that those currently in power do NOT want us to accomplish by ANY means! I think this is why the resistance to common-sense ideas like peer support and nutritional changes and improved listening skills is so high. The current paradigm is popular specifically because it keeps power with the powerful and blames the “mentally ill” for their own predicament. Teaching the “mentally ill” to not be worried about others’ opinions and to act in empowered ways TERRIFIES the supporters of the status quo! Hell, the entire CONCEPT of “mental illness” is based on labeling disapproved behaviors/emotions as “different.” Self-approval is the last thing in the world the psychiatric profession wants to promote!
—- Steve
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Can’t argue with you there. It’s almost laughable when doctors critique natural remedies and herbs because there is a “lack of controlled studies” supporting their use, when such things have a 10 thousand year or longer evidence base, compared to a couple of biased 6-week studies run by pharmaceutical companies or their minions. I prefer the 10,000 year data track. Arsenic may even be safer, because at least everyone knows and admits it’s poisonous!
—- Steve
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I only wish I were surprised.
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I think you are conflating two very different issues, as is very common in this kind of article. The first: do people experience distress to the degree that they are unable to care for themselves and/or present a danger to the community? The obvious answer is YES, and I don’t think there is a single person posting here who would object to a person engaging in dangerous or intentionally threatening or violent behavior being arrested and held until such time as they are safe.
The second question, which I don’t think you’re addressing here, is what is supposed to happen to such a person once they are taken into custody? Does the fact that a person is acting in a way that isn’t considered socially acceptable give the community license to do whatever they want to them? Even criminals have to be convicted based on evidence, and their sentences are limited based on the crime. But the “mentally ill,” when so labeled, are now subject to the doctors engaging in almost any “treatment” without their consent, even when such “treatment” is shown to result in early death, or is clearly not helping or making things worse.
How do you suggest we address the problem of people being taken into custody based on some subjective perception of “threat to self or others,” and then losing most of their civil rights, including the right to protest to harmful treatments? Are you following the case of the guy in Australia, who has clearly and repeatedly elucidated rational reasons for his wanting them to stop electrically shocking his brain, but has been ignored for years and years?
I am not opposed to the idea of someone being taken into custody for their own or others’ safety. I am opposed to forcing “treatment” on them, especially when they are in a rational enough place to honestly understand the pros and cons and communicate their objections.
Hope that makes sense.
—- Steve
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I agree so much – LABELS are the big problem! Drugs have always been around and people have always used drugs to alter their mental/emotional state, sometimes for the better, sometimes for the worse. The problem is not the drugs themselves, but the pretense that they are being “prescribed” for “treatment” of some “condition” that is essentially invented by those holding the strings of power in society. Without the labels, the concept of “medical treatment” dies a swift and well-deserved death, and the drugs can be viewed as what they are: mind-altering drugs that have effects on the body and brain, which effects are up to the user alone to determine whether they’re worth the cost or not.
—- Steve
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Truly, it is authoritarianism that is the real enemy. I hate someone else telling me what is supposed to work and getting upset if I don’t agree. Everyone’s got their own path to follow.
And thanks for your kind words!
— Steve
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I don’t knock it at all. In fact, if someone wanted a short-acting anti-anxiety agent, I’d definitely recommend alcohol over Benzos any day. Of course, dosage control CAN be a problem…
— Steve
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Based on my understanding of and experience with employment in “mental health” programs, I’d say that is an outstanding result.
— Steve
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An excellent point. As I said above, the counter to the Scientology attack is not to agree that Scientology is horrible and claim you have nothing to do with it. It’s to separate the ad hominem attack from the substance. “What’s religion got to do with psychiatric treatment?” is always a good line. The Scientology attack is a distraction, and should be labeled as such right away. “You’re trying to use people’s feelings about religion or Scientology to distract from the facts I’ve presented. Let’s get back to talking about science!”
— Steve
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Which goes to show that Peter Goetze is right – doctors can’t be trusted to even follow their own guidelines, let alone honestly evaluate the effectiveness of a drug or honestly inform their patients of the pros and cons and other viable alternatives.
—- Steve
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I agree about the placebo response. Most people who are depressed feel better within several months or less without ANY intervention, psycho-social or medical. But AD users understandably attribute the changes to the drug they are taking, rather than other actions or decisions or changes in environment or diet or exercise or thinking or beliefs that have contributed. And of course, withdrawal effects reinforce the idea that getting off ADs is a bad idea.
It’s also important to remember that the fact a substance makes one feel better doesn’t mean it’s an effective medical treatment. A shot of Jim Beam three times a day will definitely reduce your anxiety levels, as will smoking a small amount of marijuana in controlled doses. This doesn’t mean marijuana or alcohol are treating a medical condition. It just means you’ve found a substance that makes you feel better temporarily. Just because a drug is prescribed doesn’t make that any less true. Unless the doctor has an actual understanding of what condition they are “treating” and how the drug works, antidepressants or any other psych drugs are simply a way of temporarily altering your emotions. While that may seem appealing to some, this kind of action is no more medical than getting drunk on Saturday night to forget your troubles.
—- Steve
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I think you used them in the best way they should be used – short term, help get over a hump and get active again, then OFF. The idea of taking the long-term is increasingly being shown to have an increasing downside over time.
— Steve
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Quite so. I was channeling our old friend in the post above. He provided the best way I’ve known yet to completely nix the biological argument without getting into metaphysics. He is a man of great insight.
—- Steve
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“Associated with” doesn’t mean “caused by.” It means this gene is more likely to occur in people having these experiences, and/or that people with this gene are more likely to have such experiences. It does not mean that all people who are paranoid have this gene variation, nor that all people who have it are paranoid. It’s an association.
The idiocy of psychiatry is not in assuming that genes play a role in personality and behavior – it’s in assuming that ALL behavioral and personality variation is caused by genetics, and that ALL interventions should focus on the physical body as a result. There is PLENTY of evidence that psychosocial interventions, both formal and informal, not only can change personality and behavior, but can change the expression of such genes as you identify.
So which should we study? The genes that create greater vulnerability for certain people to certain reactions, over which we have essentially no control? Or the environmental variables that can help turn such genes on and off to the benefit of the person involved?
Or to put it another way: does it make more sense to try and figure out why some people react more severely to being dropped in a war zone than others? Or would it make more sense to figure out how to keep from having to put people into war zones in the first place?
I think you know where my vote would go.
—- Steve
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First off, that statement is as much a statement of faith as the idea that the soul is implanted in the body. You are assuming that nothing can exist outside the physical realm, and have zero proof of that. Not saying you’re wrong, just saying that you are stating a BELIEF, not a scientific fact.
Second, WHO CARES? The personality is clearly something that transcends any analysis of individual brain circuits, in the same way that a computer program like the one I’m using to communicate with you transcends the circuitry I’m using to make it run. Sure, the computer program RESIDES in the circuits of the computer – ultimately, it’s just a series of ones and zeroes. But the location and order of these ones and zeroes has MEANING that is in no way discernible from examining or fiddling with the circuits.
Psychiatry trying to fix mental/emotional problems by studying brain circuits makes exactly as much sense (or maybe even less) as trying to de-bug Windows 10 by fiddling with the printed circuit board or memory chips. It is an effort doomed to failure from the outset, because it fails to recognize that personality is about meaning and intent, which do not and never will translate into circuitry.
— Steve
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You really believe human beings are in a position to decide who is allowed or not allowed to reproduce? Are you unable to see that it is the same belief in the US eugenics program that led to Hitler’s excesses? It’s not a door that should be opened. We’re clearly unable to handle even the responsibility for those detained “for their own good,” as we drug and shock them and ruin their brains and don’t even listen to what they tell us is happening. Don’t try to pretend we as a species or as a culture are some how able to constrain ourselves to act responsibly when given power over someone else’s life. We have proven again and again that we are not.
— Steve
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“Dangerous religion pretending to be a science.” Kinda says it all!
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Love what you say about Scientology. Bringing it up is just a distraction, and should be labeled as such. Forceful denial plays into their hands. I think the proper response is, “What would someone’s religious beliefs have to do with the facts I’ve just presented? Are we talking about facts or religion here? If you have some actual facts or research to present, I’m anxious to hear it, but stop trying to distract people from the point at hand.”
Always demand that your antagonist come back to the scientific question at hand.
—- Steve
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I agree. I’m looking forward to reading your book. You write well and will be hard to discount, as you have no actual label of “insanity” that can be used to discredit you. Thanks for sharing your story with us. I continue to be appalled that such treatment is legal in Canada or any other civilized nation!
— Steve
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So was I!
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This was just posted above your post by Christopher J:
“ChristopherJ
on July 26, 2016 at 2:35 pm said:
Six years ago, against medical advice, I weaned myself off of my medications. My ” time in dungeons and on the streets” occurred while I was on medication. Since going off of my medication, I have been able to go back to school, work full time, and become a productive member of society. I am one of those who will never see a psychiatrist again.”
What do you have to say to Christopher? Is he not standing proof that your assumption that those taken off antipsychotics will deteriorate into street people is not necessarily true at all?
—- Steve
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Perhaps you didn’t read the article. The ones who DIDN’T take medications functioned BETTER in society and were MORE likely to have a job. I know this goes against what you have been told and apparently really want to believe, but this is a scientific study with controls, and they are simply reporting on their findings. The findings happen to contradict what you have been taught and/or want to believe is true.
This and other research shows that “schizophrenics” do better when the drugs are used sparingly or not at all. The point of scientific research is to minimize confirmation bias and untested assumptions. If you have a scientific worldview, this research should, as the author suggests, give you pause to wonder whether your current set of assumptions as to what helps people having psychotic experiences is actually true or perhaps needs to be modified.
— Steve
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And the results seen in the WHO intercultural schizophrenia research.
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Interesting. The “spin” on these things is always that “the less serious ones self-select to go off “medication.” Yet we’re also told ad nauseum that the mayhem in the community is being caused by people who self-select to go off their “medication.” Can’t really have it both ways, can we?
We now have four major studies (they failed to include Wunderlink) directly supporting that long-term use leads to more disability, as well as the two WHO studies confirming that people living in countries with low use patterns have better outcomes, plus a couple of well-known treatment protocols (Open Dialog, Soteria, etc.) showing that low- or no-use approaches work for the majority of people with “psychotic” experiences. Yet still no energy from the psychiatric community to question their “medicate everyone forever” protocol for “psychotic disorders.” They don’t even pay attention to their own research.
Kinda sickening…
— Steve
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Many, many of the cases where “antipsychotics” are prescribed for “ADHD” are a result of kids becoming aggressive as an adverse effect of the stimulants they’ve been prescribed. I see this regularly in my work advocating for foster youth.
The truly bizarre nature of this approach is only apparent if you know a little of the biochemistry involved. Stimulants increase levels of dopamine available in the brain, which can cause aggression, especially in those who have a trauma history. Antipsychotics DECREASE the same chemical (dopamine) that the doctor has been INCREASING with the stimulants!!! So they raise dopamine with one drug while suppressing it with another. And our tax dollars pay for this stupidity????
I don’t know why people are so willing to allow this chicanery to pass unnoticed!
—- Steve
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A good point. We could actually get a lot of mileage out of simply pointing out that they don’t even follow their own research based on their own idiotic diagnostic protocols and categories. Within their own paradigm, giving antipsychotics for ADHD would be like giving blood pressure medication for someone with back spasms. I have no idea how they get away with it, really. Mass hypnosis, I guess.
As for funding, that’s the rub, isn’t it?
—- Steve
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It proves only what it says: that people labeled with what we call “mental disorders” more often then not get better with or without any kind of formal treatment. It proves or disproves nothing about brains healing or not healing themselves. It only proves that treatment per se doesn’t make a difference on the average. It also doesn’t mean that certain individuals won’t improve more with treatment – it only suggests that if such “improvers” exist, there are an equal number of people who get worse receiving treatment vs. those receiving none, balancing out to no gain.
As a side note, the only actual proof of healing of brains came from the Decade of the Brain, and ironically, the thing that healed brains was not a drug, but relationships with healthy adults who care about you. See Dr. Bruce Perry for more data on that fact.
—– Steve
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You can’t treat a lack of love with a drug!! Trust me, I’ve talked to hundreds of foster youth, and not one has ever identified a drug as helping them cope with a lack of love. The thing they report as most healing is ALWAYS a relationship with someone whom they found they could trust, someone who cared about them despite them not always being polite or kind or rational. Lack of love can only be treated with LOVE! Drugs simply make it easier for the adults involved to avoid their responsibility to figure out a way to understand what is going on and DO something about it.
— Steve
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Wayne, I have seen a lot of therapists who, while perhaps not exactly talking their clients out of their perceptions, very invested in minimizing or ignoring the effects of these abusive experiences, or trying to talk them into “forgiving and forgetting.” It’s certainly not true that anything close to all therapists work this way, but it’s a very substantial minority, and I think their numbers are growing as the years pass. I can’t remember the last time a therapist I’ve encountered (and I encounter a lot of them) talked about subconscious motivations or the specific long-term impact of the specific child’s traumatic history. There’s a lot of lip-service to trauma history recently, but it’s more focused on how trauma damages the brain, rather than on how to PROCESS their traumatic experiences and/or deal with the currently traumatic people in their lives. There is a lot of focus on developing emotional coping skills, and very little on creating a more empowering way of looking at the world that helps put their abuse into some kind of perspective that helps them move on with their lives. I don’t take the position that most therapists collude with the abusive parties in a child’s life, but most are also not comfortable directly confronting the oppression that kids experience from parents, teachers, foster parents, caseworkers, mental health professionals and/or psychiatrists in their lives. We can do a LOT better!
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Wow, Peter, can you come work in our child welfare system in Oregon? I have worked for the CASA program locally for almost 20 years, and have seen exactly what you document here. Kid after kid is diagnosed with a “brain disorder” and their traumatic histories are ignored. Many kids get WORSE under the “treatment” of these doctors, and yet the answer isn’t changing the treatment plan, but adding yet MORE drugs and MORE diagnoses. Bringing up any kind of objection is often met with disdain or outright hostility. The system is set to meet the needs of the adults, just like it was in the kids’ abusive homes. It sounds like you and your team set up the best system possible to counter the systemic issues, and it still didn’t really get to the core of what is needed to help these kids. Thanks for all your commitment to these kids, who really need folks like you to help them see that not everyone in the system is untrustworthy or corrupt!
— Steve
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The thing is, if a “disease” is found to be heterogeneous, it no longer qualifies as a “disease.” It is, at best, a syndrome for which a small proportion can be explained by a particular disease process. The big error psychiatry makes (scientifically, I mean – from a marketing standpoint, it’s brilliant, if evil) is lumping together people who have little to nothing in common biologically into a “medical” category based on surface manifestations such as emotions and behavior. It actually PREVENTS any effort to discern those few who DO have some kind of physiological problem from the many who are simply normal people reacting to highly stressful circumstances.
—- Steve
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The implications of this for psychiatry should be obvious. Even if their specious “chemical imbalance” theories are true, does this not demonstrate pretty convincingly that the action and thought pattern of the patient himself can, in fact, alter whatever chemistry may be going on? Of course, even the neurologists don’t want to hear this. How much harder for psychiatrists, whose model is largely based on faith rather than science, to admit that they’ve been barking up the wrong tree all this time.
—- Steve
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They DO know, many of them, but they for the most part seem to dismiss any such person as a “crank” or a “menace” without actually reading what they write. That’s the insidious thing about psychiatry – since it’s really more of a religion than a science, you can just dismiss people for not following the dogma without having to actually entertain the possibility that your faith may be misplaced.
—- Steve
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And that antipsychotics somehow “fix” this ephemeral “imbalance,” despite the evidence that it would make any such “imbalance” worse over time, or create one when it never existed in the first place.
Follow the money…
— Steve
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“Resistance is futile. You will be assimilated.” The only way not to be considered “mentally ill” is to be a drone!
—- Steve
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You sound like Joanna Moncrief. You should read some of her stuff – she says pretty much the same thing. We’re altering states chemically. Some people like the altered state, some don’t, but in either case, we’re not curing or even “treating” any disease state. We’re just messing with brain chemistry and hoping it turns out OK.
—- Steve
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Wow, that is REALLY disturbing! Apparently they don’t know or choose to ignore the fact that many peoples’ “caregivers” are very invested in their remaining “ill” and under control of the system. In fact, a lot of “mentally ill” adults got the way they are because their “compassionate caregivers” treated them like crap for years or decades leading up to their deteriorating state.
Sums up again to having your civil rights removed based on some subjective assessment by a person who doesn’t know and maybe doesn’t even care about what’s really happening in your life. SCARY!
—- Steve
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They seriously just figured this out? Seems kind of obvious to me, notwithstanding the specific receptors involved. Parkinson’s results from low dopamine production, suppressing dopamine produces Parkinson’s symptoms. Should not be surprising to anyone.
—- Steve
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Sorry, Mayara, but antidepressants, like any other psychoactive drugs, don’t have specific effects on depressed people. They have the same basic effects on all people, and some people in any group have adverse reactions to them, whether they officially count as “depressed” or not. Moreover, the idea that there is some way to distinguish reliably between “depressed” and “normal” people is a delusion promoted by the psychiatric profession and the pharmaceutical industry. There is no clear line between “depressed” and “normal,” nor between “situationally depressed” and “clinically depressed.” There is no way to test for this or any other psychiatric condition – they are “diagnosed” by checklists of behavior and emotion that are completely subjective and have no necessary relationship to any “disease” state in the person being so “tested.”
And that doesn’t even address the question: if she wasn’t “depressed”, why did she get the prescription? Why wasn’t her doctor able to see that she didn’t need it? Or why, after she had the classic adverse reactions that she did, would the wise doctors not realize that they were on the wrong track and take her OFF the drug that was making her worse? Why, instead, did they give her a new set of diagnoses and drugs and send her down a pathway to disability and insanity?
It seems you are getting your information from limited sources and would really like to believe that doctors know what they are doing and are basing their decisions on scientific reasoning and fact. I’d suggest you start reading some alternative viewpoints. I think you’ll find that trusting a doctor to make good decisions on your behalf is a rather dangerous thing to do, especially when it comes to psychiatric drugs.
—- Steve
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True enough – PCPs are actually doing the lion’s share of prescribing of both “antidepressants” and stimulants for “ADHD.” (I decided it’s time to start putting quotes around “antidepressants” to indicate “so-called antidepressants,” since it’s becoming clear that they are at best active placebos for most and something much more sinister for some.)
When I did a brief and painful stint doing involuntary hospitalization evaluations in Vancouver, WA, I discovered an inordinate number of women with obvious trauma histories diagnosed as “bipolar” because they had “mood swings” that were very obviously related to their history of (or ongoing current) traumatization. It really opened my eyes completely to how easy it is to blame the victim for having the “wrong reaction” to their traumatic experiences, or worse yet, to simply ignore that such trauma exist or have an impact on someone’s “mental health.” That was part of my impetus to get out of the field and get into advocacy – I couldn’t support a system who wanted to drug a person’s trauma history out of view. It really is quite revolting, but it’s sadly very common.
— Steve
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I agree completely. However, it is important to understand that not everyone is at the same place on taking risks, and that the risk of retaliation, especially for those working on or subject to the whims of the current system, is very, very real.
— Steve
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There are plenty of alternatives offered in articles throughout this site, and in comments offered after the articles. You don’t appear to be open to hearing much of it, though. Start with the Open Dialog model in Finland if you need an alternative. Or read the WHO studies in the 90s that showed that one of the best things you can do to “treat” psychosis is to move to a developing country where they don’t use drugs as a primary intervention. Or read a bit about peer support services, which Sera actually participates in providing to the “mentally ill” in her center every single day.
Sera, in fact, is the last person in the world you should accuse of failing to provide alternatives. She is LIVING the answer to your question every day. I hope you’re able to put your need to be “right” aside and actually listen to the answers to your questions. It is not necessary to deny people’s need for support and financial assistance in order to critique the current model of service delivery.
Stop defending and LISTEN and you might just learn something.
—- Steve
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What’s wrong with working on a farm? Lots of people make a happy living doing so. It’s been the primary mode of survival for humans since the beginning of the modern age. I think you should visit the place before you make any assumptions about how miserable and enslaved the workers are. In any case, it certainly seems a big step up from prescribing a lifetime of brain-disabling, life-shortening antipsychotics, doesn’t it?
— Steve
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This is doubly idiotic! First off, they are identifying RELATIONSHIP problems and then prescribing a PHYSIOLOGICAL intervention to “help” – do they really think that taking a drug will improve your relationships? Second, they ignore the obvious fact that having a challenging relationship situation would LEAD to depressed or anxious feelings NATURALLY. This totally belies their claim that they only treat “endogenous depression” or “clinical depression” with drugs – they’ve got a hammer, so everything that comes their way is a nail.
This is not even mentioning the sexist assumptions under which these “diagnoses” and “treatment” plans are made.
The message is clear: if you have relationship problems of any sort, or even if you aren’t in a relationship, stay away from psychiatrists. Or perhaps more generally: if you’re alive and human, stay away from psychiatrists. “Quackery” doesn’t even begin to describe the venal stupidity behind this kind of “treatment.” These people are either evil or dumb, or probably both.
—- Steve
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Wow, what a sad story, though I’m glad it seems to be moving in a happier direction of late! I work with kids in foster care and I see this dynamic all the time. Not only the parents, but foster parents, the school system, caseworkers, and even mental health professionals supposedly trained to help kids who are victims of abuse have blamed foster youth for being angry, sad, anxious, or inattentive, or for having “mood swings”, all of which are clearly related to their horrible upbringings and the traumatic experience of being in foster care. Instead of normalizing their emotional reactions as an understandable reaction to a very abnormal life pathway, these kids are told that THEY have a “mental disorder”, and that faulty brain chemistry is at fault, all of which implies pretty obviously that they SHOULD be happy about their situations and that any adverse emotions or behaviors they experience are an indication of their own “disorder” rather than their crappy lives. It is most infuriating, and truly represents the exact OPPOSITE of what is actually helpful to traumatized individuals, in my experience.
I wish I had some answers, but the pathway forward seems to lie in finding individuals you can trust and develop relationships with, so you can learn, just as you say, that there are people who care and won’t abuse you, if you look around and learn how to judge who is legitimately on your side.
Well done to you for hanging in there and getting on a positive pathway!
—- Steve
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Agree 100%. There was one NAMI branch in Santa Cruz, I think, which had a website with great articles and comments from survivors – kinda reminded me of David Oaks and MFI’s website. At some point, it simply disappeared. I can only assume they lost their NAMI charter for being too “off message” for the national organization. As long as national NAMI continues to be owned by Big Pharma and promotes the protect the powerful/blame the brain model, local NAMIs with a different agenda will simply be anomalies who can only go so far before being excommunicated.
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As far as I understand, your only recourse is to complain to the medical board in your area regarding a lack of informed consent. It is difficult to convince medical boards to do a whole lot, though, as they are made up of doctors and a lot of the things you are complaining of are kind of standard practice, and the docs on the board may do them as well. I wish there were something else that could be done, short of a class action lawsuit, which would require a lot of folks like you sharing notes and hiring an attorney to work for a piece of the settlement.
It sucks, but at least you’re now enlightened and will never trust them again. Jerks!
—- Steve
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Michael, you are a heretic and are being the modern equivalent of excommunicated. Which I think you should consider a badge of honor. I did not receive the same degree of hostility when I made my views known, it was more a degree of marginalization – people knew I was one of “those people” who “didn’t believe in medication” and therefore my views could be discounted whenever the topic came up. Eventually, I “excommunicated” myself because I felt bad about participating in such an oppressive system, plus there were fewer and fewer dissident professionals to whom I could talk openly about the situation. At this point, those with integrity have mostly quit or been tossed out of “the system” and outside advocacy seems like the only path toward rethinking/reforming/rejecting the current dogma and faith-based “treatment” protocols.
Well done for standing up and calling out the fraud for what it is. When people suggest I’m a “conspiracy theorist,” I say, “I never said it was a conspiracy. It doesn’t require a conspiracy to be corrupted, only a nice, reliable conflict of interest.”
— Steve
—- Steve
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The Brits did a TV show based on this same concept. They had something like 10 contestants, 5 of whom had MH diagnoses and 5 who did not. They got to see them interact over some extended number of days, and then had to guess their diagnoses and who was and wasn’t “mentally ill”. Not only couldn’t they get the diagnosis right, they didn’t even sort out who had a label and who didn’t. They did embarrassingly poorly. Not that I’m surprised. I’ll have to look that up and post it.
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I agree 100%! The consequences of speaking up can be life-destroying, even sometimes worse than a prison sentence!
—- Steve
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That has been my experience.
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I think it’s mostly because people need to distance themselves from their own emotions and fears. I also think that people on some gut level KNOW that there is no real objective difference between them and the “mentally ill” and they really NEED to believe the “chemical imbalance” crap because it reassures them that “those people” REALLY ARE DIFFERENT and that they don’t have to worry about “becoming schizophrenic.” It’s not dissimilar to the incredible hostility in the USA towards the poor. If the poor are poor because they’re lazy or stupid, then I don’t have to worry because I’m protected and I don’t have to do anything about it. If they’re poor because our system assures a certain percentage of poor people in order to keep wages low and keep the populace at odds with each other, then they COULD be a poor person and the poor person COULD be where they are and MAYBE there is a problem they have to do something about.
That’s my take on it. It’s just beyond unfortunate that the psychiatric system has chosen to make it easier and more socially acceptable to be biased against people who are different, but I guess they’re making lots of money and have more power and prestige as a result, so they’re not really willing to take a look at how their model harms the people they’re claiming to help.
— Steve
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I agree that NAMI is bought and paid for by Big Pharma, and that its original intent was to help family members avoid blame and make it easier for them to force their adult kids into “treatment.” It’s a very toxic combination, parents looking to avoid self-examination and organized psychiatry teaming with drug companies profiting from providing them a model that does just that.
But it’s also true that a lot of people go to NAMI because they don’t know any other support network for family members of people struggling with these issues. I think it’s great that someone is going in there and providing a different point of view, and letting people know that NAMI’s framing of reality is not the only way to look at the situation.
I’d also add that there are some local NAMI chapters who do take a much more survivor-based approach than the national office, so it can be a mixed bag. But I don’t trust NAMI further than I can heave them collectively, and I think suspicion of or even contempt for their motives on a national scale is very well deserved.
—- Steve
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“Anosognosia” is the cooptation of a real phenomenon happening when a very specific kind of brain damage occurs to a pejorative word for anyone who disagrees that they are “ill” when a psychiatrist or similar MH “professional” say that they are. Since there is no hard evidence that can distinguish ANY “mental disorder” from “normal” behavior (and the DSM admits that quite frankly in its introduction), how can one claim that a person “doesn’t realize they are ill” when you can’t even prove whether they are ill or not? Denying your leg is broken when you can’t walk is one thing; denying that you “have schizophrenia” when there are mainstream voices in psychiatry who admit or even assert that “schizophrenia” isn’t a specific disease state is something completely different.
In the end, “anosognosia” is just a calculated excuse for enforcing “treatment” on the unwilling.
— Steve
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I guess I have to disagree with you on this point. There are dissident psychotherapists/counselors in any system, just like there are dissident teachers in public schools and dissident doctors at mainstream hospitals. Such folks may be hard to find, but as Chaya has so clearly laid out, it can be a goldmine if you manage to get connected with one. I say this because 1) I did luck out and find a very competent and helpful therapist when I was in my 20s, and 2) I was one of those dissidents who gave people what I think most would report was great service that was respectful and empowering. Eventually, working in the crazy system did drive me out, but while I was there, people were, in fact, very fortunate to find me, because I believed neither in diagnoses nor in drugs, and I was able to truly listen and care about the people I interacted with and focus on empowering them rather than telling them what to do or forcing them to do anything.
It doesn’t sound like you’ve ever had that experience, and I agree that the system is set up to suppress such behavior by any therapist, but some are able to resist and can maintain their integrity even in the mess of the “mental health system”, at least for a while.
—- Steve
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The other big correlation is with violence is domestic abuse.
—- Steve
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Why would psychiatric leaders want to promote full long-term recovery? It would totally mess with their bottom line! Where would they get customers if people started actually recovering?
— Steve
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Not unless they can make buku bucks prescribing these things without having to do any work. I’m with knowledgeispower – we already know a range of effective alternative approaches. Organized psychiatry’s only real objection to alternatives is that they undermine psychiatry’s lock on their market share and prevent them from profiting from the misfortunes of others. It isn’t just that they’re not interested, they have an interest in suppressing this information and continue to do so because it benefits them in terms of power, prestige and income to suppress it. They don’t want an alternative – they’re just fine with the status quo and will do almost anything to preserve it, whatever the impact on their patients.
—- Steve
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Of course, the problem is that when you have no actual objective criteria for a “diagnosis,” how would one ever tell if something is “overdiagnosed?” Just the use of that term sets my teeth on edge, because it presumes there would be a right level of diagnosis, and there is absolutely no non-arbitrary way to accomplish that. In the end, the ultimate result of any kind of diagnosis based on a spectrum is that the line of “disorder” will be pushed closer and closer to the line of the average, especially when there are folks with strong financial interests in moving the line in that direction. Same thing has happened with blood sugar levels, cholesterol levels, and various other tests (how many cases of “pre-cancerous cells” will never develop into cancer?) It works great for Big Pharma, but not so great for the recipients of this kind of “care.”
—- Steve
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Eight studies shut down. Doesn’t sound like a bad apple, here. Sounds like unethical practice is now the accepted norm. I bet she’d get the same results in most universities around the USA today.
— Steve
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Couldn’t agree with you more. The only thing I’d add is that schools are often the worst enemy of this kind of kid, because they are as dull as dull can be, but it doesn’t have to be that way. We used homeschooling and alternative schools for our very active, bright, easily-bored boys and had no complaints about “ADHD” and actually very few complaints about ANYTHING. It wasn’t easy, but who said raising kids was supposed to be easy? The dumbest thing we can do is tell kids, “Oh, well, the reason you aren’t paying attention is because you can’t because your brain won’t let you.” Instant off-the-hook excuse for the kid, his parents, and his teachers, when the reality is, paying attention, like anything else, is a skill that can be learned. They may find it harder than other kids, and they may never be great at it, but they can learn to be better than they are and at the same time learn that you can overcome any shortcoming in time if you work at it, which may be the most important lesson of all.
— Steve
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I agree, the main point is that exercise addresses the physiological side of depression in the short term, just as antidepressants are supposed to do. And it appears that exercise is both more effective and has fewer dangerous side effects. So in direct comparison to antidepressants, exercise should be by far the first choice. Naturally, one would need to address causal factors such as childhood abuse, bad relationships, boring, dead-end jobs, and so on to have a long-term impact in most cases, but if you just want to feel better today, an uphill hike in a nearby forest is probably a way better bet than a visit to your local psychiatrist.
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I think your math is right on, and I also think you’re entitled to make simplifying assumptions, since your counterparts in this argument have done exactly the same. You accepted their simplistic and inaccurate premises and still proved what we already know – the bulk of violence is committed by people who have no “mental health” diagnosis, despite the subjective nature and questionable genesis of these highly culture-bound “diagnoses.”
Nice job for a non-math-whiz!
— Steve
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Tranquilizing people is not a new concept, and I have to say, when I did mental health assessments, I was super impressed by what a shot of Inapsine would do to a previously incoherent person, allowing me now to have a conversation with them. However, this is VERY different than deciding to force a person to continue to take a drug for years that they may hate or that may not really work for them or whose side effect may ultimately kill them decades early, based on some speculative, subjective label that’s been applied to them without any actual scientific evidence that such a course is generally beneficial, and with increasing evidence that such a course is generally quite disabling and may ultimately be fatal.
For sure, we need to find better ways to help, but the current paradigm actually impedes or prevents this, because all “schizophrenics,” for instance, are assumed to be the same, assumed to have a biological reason for their distress (despite almost no evidence this is true and plenty of evidence to the contrary), and are assumed to “need medication” for the rest of their lives (again, in direct contradiction to established long-term data). The hard fact is, long-term “treatment” with these drugs does not really work, as you’d know if you would read “Anatomy of an Epidemic” and consider the scientific record described in the book. They are, at best, a short-term method of reducing symptoms while other needs are sorted out.
A look at the Soteria model or the Open Dialog model should convince a rational person that it is not only possible for so-called “schizophrenics” to recover without drugs, it’s actually easier and far more likely to happen via these methods. If such approaches are available and have been shown to be effective, why aren’t they being used? I think you know the only viable answer: the field is corrupted and is not interested in real solutions that might cost them profits and prestige and force them to look for new clients.
So it’s not as simple as you suggest. It’s not a choice between drugs and no help – it’s a choice between sticking to a failed paradigm or working hard to come up with a better way, including actually applying the knowledge we have of what DOES work to our clients.
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This, of course, would be exactly what would be expected based on years of research on illicit drug use and its effect on the brain, much of which was solidly established as early as the 1980s. Why anyone would think that a doctor prescribing a substance that impacts neurotransmitters would make any difference in its long-term effects is baffling in the extreme.
—- Steve
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An excellent question, one that I as a former provider have struggled with.
I think the first answer is to know that there is no specific answer to “treating mental illness,” because “mental illness” as it is defined doesn’t have one “answer,” since there is no requirement, assumption, or observation that says that all people with the same “diagnosis” have the same problem or require the same intervention. If you read the introduction to the DSM-IV, the authors state this very point in a very direct way.
Milton Erickson used to say that you have to reinvent therapy for each client you meet. I agree with him 100%. The biggest failure of the mental health industry is that we have not bothered to ask the client him/herself what the meaning or purpose of his/her behavior might be, or provide an opportunity for him/her to figure that out for him/herself. There is no medication/drug that can ameliorate years of abuse, for instance, nor is there one that can embolden one to quit a dead-end job, or adjust more effectively to a foreign culture (migration and urbanization are highly associated with “schizophrenia” diagnoses, for instance), or to analyze a nutritional deficiency. There is not even an effective drug to deal with sleep issues, for that matter! We’re simply barking up the wrong tree, in essence, giving someone painkillers for a bum knee without bothering to find out whether they have a bruise, arthritis, a poor exercise routine, fallen arches, or a torn ACL ligament. If we want to do a better job, step one is to recognize that each and every “diagnosis” is simply an insurance billing code that tells us essentially NOTHING about what is wrong with a person or what might help them make progress toward a happier or more effective life. And the long-term research bears this out. If you have not yet read Anatomy of an Epidemic, the book which inspired this website, read it right away. It will answer a lot of your questions as to why rejecting medication, at least over the long term, as a first line “treatment” is, in fact, an important part of the answer.
—- Steve
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I kinda liked Bustin Globs. It totally worked for me!
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Dan, I think the point you may be missing is that, OF COURSE, if you label a bunch of people who are experiencing emotional distress for whatever reason as “mentally ill,” a somewhat disproportionate number of these will be more prone to be violent, if only because you’ve pre-selected people who are experiencing some sort of emotional distress. It’s sort of like saying “Angry people are more likely to yell than non-angry pe0ple.” It’s a meaningless correlation. Despite the subjectivity of the sampling technique, we find that, even with the distorted “statistics” the Globe “collected,” 90% of violence is still committed by people who don’t qualify for ANY of these diagnoses, even with their very soft and non-specific criteria!
Just as one example, domestic abuse permeates our society. A certain percentage of domestic abuse perpetrators are designated as “mentally ill,” but the vast majority are not. Do you really think it appropriate to lump all domestic abuse perpetrators who happen to be diagnosed with a “mental illness” in with people who are scared to leave their homes and people who are too depressed to get out of bed in the morning and people who are super active and have trouble focusing on boring activities? Or would it make more sense to address DOMESTIC ABUSE as a phenomenon, and not spend unnecessary time focusing on a variable that has a very small correlation with the larger topic, and in fact has never been shown to be a causal factor in any scientific way?
Similarly with substance abuse. Some substance abusers are considered “mentally ill,” others are not. Substance abuse is known to be highly associated with violence. Should “mentally ill” substance abusers be categorized with other “mentally ill” but non-violent people, or with other substance abusers, who share a known causal behavior that correlates with violence?
In fact, it has been reported scientifically that if you eliminate substance abuse as a risk factor, the “mentally ill” are no more violent than the general population. Maybe we should be spending more time talking about the dangers of substance abuse for ALL citizens, regardless of their “mental health” status?
The idea that “mental illness” is the cause of large swathes of violence across the USA is popular because it allows us to exercise our pre-existing stereotypes and let the larger society off the hook for creating violent circumstances. If nothing else I say is convincing, tell me why that “mental illness” prevalence is claimed to be essentially the same worldwide, but the USA has massively higher violence rates than about any other industrialized nation in the world? How can “mental illness” be the cause of all this violence, when the “mentally ill” in other countries don’t behave that way?
Time to stop scapegoating and look for the real culprits in this scenario, including domestic abuse, substance abuse, and general societal oppression, all of which not only contribute to increased levels of violence, but also contribute to higher levels of “mental health problems” that the Globe is so happy to blame.
—- Steve
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Jack, you speak as if torture and abuse no longer happen in mental health facilities, which you can see by reading the comments here is just not true. Also, you say that “medications are reserved for the absolute hardest cases,” but that’s not true, either – they’re handed out like M&Ms in most facilities I’m aware of – in fact, it’s hardly possible to escape a psych ward or even a voluntary visit to a psychiatrist without a prescription in your hand. These pills are given out absolutely in lieu of any kind of psychosocial interventions, however inept they might end up being. I can share a number of stories of folks who were told they had a “chemical imbalance” or “needed medication” when just one good therapy session with me or another competent therapist was enough to put them on a much better pathway.
I am afraid you have a somewhat rose-colored view of what happens to most people who enter the mental health system. Few receive the kind of help they need, and many deteriorate under the “care” of the mental health professionals. I agree that most are not evil people, but they work for a dangerously ineffective and flawed system that ends up turning their good intentions to damaging interventions.
—- Steve
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There are other options besides, prison, homeless, and forcibly treated, Jack. There are programs in several cities now that focus on getting people places to live and food without any requirement that they participate in any treatment. Not only do they get more people interested in voluntary treatment this way, the ones who don’t get ANY treatment also improve on their “symptoms” and quality of life.
The fact that someone is homeless or suffering in some way doesn’t give us the right to force our idea of “treatment” down their throats, in this case, quite literally. Please remember that these people are being forced to take drugs that make them feel awful, often prevent them from working at any kind of meaningful employment, and create conditions that lead to early deaths. It is not a trivial thing to force a person to receive “treatment” against their will. The long-term negative consequences are pretty dramatic, and as I said above, there are other options besides neglect and force.
—- Steve
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Can we use this idea on politicians, too?
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I agree 100%. Even saying that “only 4% of violence is attributable to mental illness” is still likely a distortion. What if 4% of any health-based sample engaged in violent acts? This seems like a reasonable number, considering the frequency of violence in the USA. Would anyone ever report that “only 4% of violence is attributable to high blood pressure” or “only 4% of violence is attributable to rheumatoid arthritis?” There is an automatic assumption that any violence committed by a person with some “mental health” label is “attributable” to their “mental illness.” Wouldn’t it make more sense to suggest that violence has many causes and occurs in all cohorts, which is clearly the factual truth?
Very aggravating!
—- Steve
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As is very common, Duncan confuses the need for protection/safety of citizens in society with the “need” for enforced “treatment” of the “mentally ill.” Certainly, there needs to be a mechanism for policing society and assuring that people don’t hurt one another. How do we jump from that to pretty arbitrarily labeling certain people “mentally ill” and forcing them to take drugs or have electricity passed through their brains against their wills? It does not follow that a person being unsafe to themselves or someone else needs to be “helped” by having their brain chemistry forcibly altered in ways that are neither understood nor predictably positive. We need as a movement to STRENUOUSLY make this point over and over again: policing our society and making sure people are not hurt by other people is a legitimate government function. Forcing people to take drugs just plain isn’t.
At least when someone is arrested, no one is trying to pretend that the inevitable trauma of the experience is intended to “help.”
—- Steve
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The only way to identify a “serotonin deficiency” would be to determine a “normal” level of serotonin and then measure another person’s serotonin against that measure. Of course, this has never been done, and is actually impossible, because serotonin levels vary widely from day to day and moment to moment, depending on what is happening to you. You know someone has low iron because you know what a normal iron level is and you can measure their iron levels. We have no standard for normal serotonin levels, and no way to measure someone’s current levels meaningfully, so why the hell is anyone even talking about this any more?
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It seems more than unfortunate that folks are overlooking that the prime motivation for this act appears to be homophobia, not “Islamic terrorism.” This guy was not acting to promote some political goal – he wasn’t a member of ISIS or acting in coordination with any group. He chose a gay bar because he was uncomfortable with “gayness” as evidenced by his statements to his father the night before, when he was deeply disturbed by seeing two men kissing.
It’s amazing how ready we are to see conspiracy in anything an Islamic person does that is violent, even when there is evidence that suggests other, clearer motivations. As for dismissing what that representative of CAIR says, that’s just rank prejudice, folks. I know dozens of Islamic people who are as sweet and loving and kind and “normal” as anyone else I know. Not one of them is promoting violent overthrow of “the West,” but they all do report being treated disrespectfully or in a discriminatory manner because of their appearance or their faith.
We can do a deeper analysis than “He is Islamic and read something about ISIS online and therefore all Islam is trying to kill us all!”
—- Steve
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Yes, it makes me ill when they say stuff like “untreated ‘ADHD’ leads to…” without mentioning that stimulant treatment does NOTHING to improve the outcomes they’re spending time making you anxious about! I’d love to be there to ask her, “What review of the literature are you referring to when you suggest that treatment for ‘ADHD’ improves kids’ likelihood to reach their full potential? Because I’m pretty familiar with the literature and every review I’ve seen suggests that stimulant treatment makes no difference in these outcomes.” Would love to see her squirm!
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Hi, Michael,
I loved the article, but I do have one addition: sometimes kids “have ADHD” because they are normal kids who are being asked to do abnormal things like sit still all day doing boring, repetitive, meaningless tasks that don’t fit with their active personalities. I never acted out in school, but I still viscerally recall the agonizing, stab-a-pencil-in-my-eye, daylong, torturous boredom I suffered at the hands of the educational system. I specifically recall doing subtraction with borrowing problems for MONTHS AND MONTHS ON END in second grade, even though I’d gotten the hang of it on day one and had mastered it in probably a week or two. It was horrible and painful and miserable but I tolerated it and “acted in” with fantasy and depression. Some kids, however, simply can’t stand that, not because they’re experiencing any stress at home, but simply because the expectations were ridiculous and they lacked either the motivation or self-denying self-discipline to put up with it. Looking back on it, in many ways, those were the HEALTHIEST kids – the ones who said, “This is bullshit and I’m not putting up with it.” But they were punished and ostracized and held up as the ultimate models of “bad” behavior, and the rest of us compliant cowards were identified as “good students.”
I am sure you’ll agree with me that it’s not sick to object to a sick system!
—- Steve
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I agree with Sera 100%, and would add that self-harm is not necessarily an act of violence at all. I’ve spoken to many, many people who self harm, especially when I worked at a crisis line, and almost to a person, they explained to me that they were not suicidal or even feeling masochistic, self-harming was simply a way of coping with overwhelming pain. They often called the crisis line because they could remain anonymous, and reported that telling their treatment providers of their actions often resulted in hospitalization, even though they had no intention of doing serious harm to their bodies. I’ve always viewed MOST “mental illness” as a person’s means of coping with a difficult reality. Our judgment of these choices to cope in ways that society at large doesn’t like is actually the source of the “stigma” you are so worried about. The only path away from “stigma” (which I also agree with Sera is really a euphemistic term for oppression and discrimination) is to accept that PEOPLE DO WHAT THEY DO BECAUSE IT MAKES SENSE TO THEM IN SOME WAY. Instead of trying to STOP someone from self-harming, why not try to understand why they feel they benefit from doing so? You will become more enlightened and less stigmatizing in moments! Same for drinking and drug use, suicidal thinking and attempts, intense activity labeled as “manic”, withdrawal labeled as “major depression” – 98% of it is coping with pain and distress caused by circumstances or the society we’re in impacting an individual in a bad way. And the other 2% actually have something wrong with them that an actual doctor can detect and treat FOR REAL once the patient gets away from the psychiatrists trying to explain that it’s all about bad brain chemistry.
It seems that while you reject psychiatry’s solutions, you’re still buying into their framing of reactions to distress as “disorders” that need to be “treated.” I hope these comments help you reconsider that maybe that framing itself is the bigger problem that leads to ineffective and destructive “treatments” in the first place.
—- Steve
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Geez, this guy sounds both lazy and dangerous! Have you looked for someone more competent to help you? It almost sounds like there’s no place to go but up from this dimwit!
— Steve
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I always point out that NAMI and other anti-stigma mouthpieces are constantly saying that ‘mental illness’ (whatever THAT means) is not more common in one country than another. So if “mental illness” is the problem, why are there such a disproportionate number of these random-type shootings here in the USA? And it can’t be “untreated mental illness” either, because our “treatment” rates are among the world’s highest. (Of course, the idea that the “treatment” itself could be contributing is rarely mentioned…)
So logically, the “mental illness” explanation has no legs. But as you point out, people aren’t necessarily looking for true explanations, just convenient ones.
—- Steve
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Research has never had much impact on religious mythology. People WANT to believe that narrative, because it lets adults and people in power off the hook for their oppressive behavior. It’s not how we treat them, it’s their BRAINS that are at fault, so I don’t have to do anything about boring, authoritarian classrooms, child abuse, or racism, because if their brains worked properly, they wouldn’t MIND being mistreated!
Not to mention the profit motive… as Upton Sinclair said, “It’s difficult to get a man to understand something when his salary depends on his not understanding it.”
— Steve
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Yup. That Est. As you can see, Scientologists have a longstanding grudge against Est. They view Est as having misappropriated their stuff.
I agree, Richard, that authoritarian approaches to morality are not a good bet and can be very dangerous. But it does seem to be amazingly popular in the prison system for some reason. I’m not that familiar with it, but it’s definitely a thing.
—- Steve
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Glad they are publishing this, but it should not be news. There has never been any real data supporting effectiveness of antidepressants in youth and especially in children. The younger you are, the more useless they appear to be. Maybe it’s because the placebo effect doesn’t work as well on kids, since it looks like 80% or more of the AD’s actions are placebo effect.
— Steve
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Sounds like this MRT stuff is based on EST, not on Scientology. The EST founder was a disaffected Scientology adherent who modified/borrowed/stole a lot of stuff from Hubbard and gave it a different spin. It doesn’t surprise me there are similarities in the presentation, but if the founders were trained in EST, the history suggests that this similarity comes from the similarity of EST to Scientology. It does not appear to be “based on Scientology” except in a very indirect way through the EST movement.
Not that this means anything pro or con about it. I don’t give a crap what something’s based on, as long as it works. I just like things to be factual, and if you read the article, there is no evidence of any historical connection to Scientology, only to EST. So the headline was definitely misleading.
Interestingly, I tried searching Google for history of MRT and came up very empty. Whatever connection they may have to any other organization seems to be completely unavailable.
—- Steve
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As I said above, rape, slavery, enforced psychiatry are all forms of oppression that can be parsed in many different ways. There are most definitely similarities between them, but also differences, yet they all fall under the rubric of OPPRESSION, the use of political or personal power to dominate another person and force them to do your will despite their lack of willingness and the inevitable harm to them as a result. There is intersection between all these and other forms of oppression. Slicing and dicing the semantic differences or similarities between one and another form of oppression doesn’t really forward the discussion. We can all agree that slavery, rape, and psychiatric force have a great number of overlaps and are all oppressive efforts to subdue another to one’s will, with an attendant set of justifications based on privilege and power. We don’t all have to agree with each other about which word subsumes which other word to agree that these forms of oppression have much in common and are all worthy of battling to the last breath.
—- Steve
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We are wasting time on a sematic distinction about something we all generally agree about. I think we can all agree that enforced psychiatry (including using the force of authority and the manipulation of recipients with known misinformation) is a form of oppression that overlaps with many other forms of oppression. Whether it qualifies as “slavery” or not appears to be a contentious point that will never be resolved and distracts us from the things we do agree about. Let’s just call it OPPRESSION and have done with it. If individuals want to think of it as “slavery,” they can think that, but it’s not helping anything to keep having this discussion, which distracts from the more important point of the justification of the abuse of power by those in privileged positions to keep victims of abuse and oppression of any form in their place and quiet.
— Steve
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True enough. It is fortunate I work for an organization whose purpose is to help amplify kids’ voices and make sure they’re safe while in care. We can’t change the whole paradigm, but we can and do change the reality for a lot of individual kids, and also continue to pressure the system to change in the right direction for the kids they’re supposed to be helping. It is an uphill struggle, though. Good to know others are pushing in the same general direction.
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Wow, Sera, I always look forward to your posts and find them valuable, but this one was incredibly powerful! I’m so sorry you had to go through such trauma, and am doubly sorry that the adults/professionals who should have seen the obvious and helped protect and validate you did the opposite, hid their heads in the sand and blamed you for your own victimization. It is appalling to hear about, but sadly is not an uncommon experience in our warped culture. I really appreciate you sharing your personal experience, and especially the tie-in to how the “mental health” system ignored and exacerbated the situation with their slavish compliance to their own model of reality and their complete lack of empathy for your situation. I unfortunately see the same thing happen all the time to the foster kids I work with – they’ve been abused at home, forcibly removed and put with people they don’t know, separated from their siblings, pets, possessions, neighbors, extended family, school friends, teachers, etc., and given little to no sense of either why it happened or how long it will continue or what they can do to regain some control. And yet when they express rage, or anxiety, or hopelessness, or are distracted or unfocused on the daily trivia of school, they are told they are “mentally ill” instead of someone saying, “Gosh, you seem really angry! I sure would be, too, if I’d been through what you’re experiencing! Help me understand what you’re angry about and let’s see if there’s anything we can think of to make it a little better for you.” It is often received by the youth as insulting and condescending when they are told, as one kid put it, “Not only am I an abused foster kid, now I’m crazy, too?” Same kid once said, “They told me I had a chemical imbalance. Well, maybe different people have different chemical balances and should be allowed to have them. Why does everyone need the same “chemical balance” in their brains?”
Blaming the victim or minimizing their experience is the most destructive and harmful thing someone could do. I am so glad you have brought this to light in such a powerful way.
—- Steve
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This person is not providing therapy. The most basic aspect of good therapy is the ability and willingness to assist the recipient in finding his/her own narrative and ability to make decisions on his/her own behalf. Telling someone else what to do to prove they are “healthy” is no part of any sane or effective therapy. I think you would be wise to consider finding a therapist who respect you and doesn’t try to control you in the name of “therapy,” but rather helps you feel in better control of your own life.
— Steve
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I think the comment about “independence” was more targeted at the idea that no one should need anything from someone else or the society at large, and if they do, it suggests some failing on their part. Independence is a fine goal, but being told that TOTAL independence is the ONLY worthy goal and that ANY kind of dependence or need is a sign of pathology is quite sick. This is particularly true for children, the elderly, or disabled people in our society, who clearly can’t function without support. We do, indeed, live in a pretty cold and heartless culture when it comes to supporting those who are dependent by definition. And a lot of the childhood attachment trauma we’ve talked about results from parents who were forced to be “independent” way too early and who continue to pass on this expectation to their infants or toddlers.
I think talking about helping adults develop a sense of autonomy and agency is a very different point than what Noel is trying to get at in that sentence.
—- Steve
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Chewable speed. Definitely something particularly disturbing about this. Some mainstream psychiatrists are disturbed, which means it must be REALLY bad!
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Brilliant, as usual.
— Steve
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The biggest cause is sending them to a standard school classroom. “ADHD” is basically a description of “a child who won’t be able to tolerate a standard classroom environment.”
Look at the criteria – they have to do with blurting out answers, being unwilling to wait one’s turn, failing to persist on tedious tasks – sounds a lot like “doesn’t cooperate with the teacher’s agenda.” We homeschooled or used child-focused alternative schools (even helped to create one!) and our kids thrived without any kind of medication or even any attempt by others to convince us there was something wrong with them.
The other issue is discipline. These kid have a hard time thinking ahead, and they need to learn about the consequences of acting without thought, hopefully without getting severely injured. But punishment approaches don’t seem to work well at all with them (generally don’t work great with most kids, but they seem to be particularly damaging for these kids). So we spent a lot of time making it FUN to go along with the program and BORING to act up or break the rules (and let’s be honest, the one thing these kids have in common is that they HATE being bored!)
We did try to make sure they got enough sleep and ate well – less sugar seemed to help, but sleep helped a lot more. Of course, they also hated any kind of schedule, so we had to be creative there. Setting up rituals around bedtime and being willing to spend a couple of hours getting them to sleep seemed to be the important points.
There are also nutritional conditions, like allergies, heavy metal poisoning, low iron, that can contribute. Also issues with “sensory integration” can be part of the problem, and addressing these can make things a lot easier. And of course, trauma or family conflict can create or make worse this kind of behavioral issue, so that really needs to be looked at in any case, no matter how “normal” the family seems from the outside.
That’s just a short list. I could write a book! There are tons and tons of things that can be done, including just accepting that your kids are like that and not trying to make them be too different from their natural temperaments, while helping them learn some skills for situations where some restraint is required rather than doing the first thing that comes to mind. But it takes all kinds to make a world, and while these kids will never like sitting still and doing as they are told, they’re fun, funny, creative, often athletic, and can be incredibly committed to justice and fairness or other goals or values they consider important.
Hope that’s at least a partial answer to your question. The real bottom line is that all kids are different and have their own challenges, and it’s up to the adults to help them figure out how to succeed, even if the adults find their behavior inconvenient or annoying. It’s not the kids’ job to follow our agendas – it’s our job to help them find a way to execute theirs.
— Steve
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They are forgetting another long-term study on human behavior: that which people make more money on with less labor or discomfort involved will be repeated more frequently, regardless of the actual effectiveness of that behavior. Thinking that docs are prescribing ADHD drugs because they actually know the research data and think it’s the right choice is naive. Most do it because it’s quick, cheap, and lets the adults off the hook for doing any hard work. Add to that the fact that some insurance companies don’t pay out for “ADHD” treatment unless you have the kid on a prescription, and you’ve got a formula for ignoring what is actually needed for the kid in favor of what improves prestige, control and income for the adults involved.
— Steve
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I am afraid you may be having a somewhat rosy picture of medical training, slc8. Perhaps you were fortunate to attend a more holistic school. Or perhaps their training didn’t translate into appropriate behavior in the field, but the assertions in this piece are very much what I hear when my foster youth clients are sent to a psychiatrist. They are told they are upset because their “brain chemistry” is messed up (apparently nothing to do with being abused at home and then yanked into foster care), They are told that the drugs are safe, they are NOT told about side effects, the side effects they do have are seldom attributed to the drugs and more likely attributed to “their disorder”, they are frequently diagnosed with “bipolar disorder” which is “uncovered” when they have an aggressive reaction to stimulants or antidepressants, they are told they need to take these drugs for life because there is no cure… If these things aren’t taught in medical school, they certainly ARE taught in the culture these doctors emerge into after they graduate.
The problem with identifying injustice from within is that there is always huge agreement within a profession that the standard protocols are basically sound and that bad results are anomalies and not a result of a malfunctioning paradigm. Look at a public school classroom as an example – the standard classroom has been critiqued as not meeting kids’ needs since the early 1900s, and yet it has changed remarkably little since then. Or look at obstetrics – we’re seeing 30%+ Caesarian rates nationally, and no one appears to be alarmed or wanting to do anything about it, despite the fact that the midwifery care model has as good or better outcomes with well under 15% Caesarian rates.
The status quo isn’t always functional, and the peer-review process (which you seem to recognize is warped and corrupted by capitalism) does not guarantee that the correct data is what gets published, nor does it assure that the best results actually result in changed treatment protocols. I think the critique is quite legitimate, and you might do better to seek to understand where this critique is coming from rather than being upset by its direction.
Just as a case in point, what about the increasing evidence that long-term antipsychotic use may worsen the course of “schizophrenia?” Have you ever heard that stated in your training or clinical staffings? Try bringing up the idea some time and listen to the reaction. Then you’ll have some idea of how open the medical culture in America is to data that don’t fit in with the dominant narrative of what is supposed to be “true.”
—- Steve
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And we’re not beyond racial stereotyping either. “The Bell Curve” is not that far back in the past, and I still see people referring to it and talking about how black people supposedly have lower IQs and that’s why there is more poverty among black people. Racial/genetic “explanations” are very handy for those in power who want to explain away their acts of oppression and blame the effects on the oppressed.
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No surprises here. When you have a totally subjective set of criteria for a supposed “disease” and huge financial and professional incentives for prescribing, you’re going to get a pretty big range of variation, based on both the lack of objective standards and the bell curve of variance in peoples’ integrity/corruptibility levels.
—- Steve
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Well, it’s kinda like saying that torturing someone for months or years creates “epigenetic changes in their brain.” I would think it does! But does this suggest the torture victim’s brain is flawed, or that the torturers are evil and should be stopped? This should be a call for alleviating poverty, not for drugging its victims!
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All right, then, how about TOTALLY EVIL!!!!!
— Steve
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Too true!
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Are you freakin’ kidding me? Here they have PROOF that poverty increases the rate of depression, but instead of advocating for fighting to reduce poverty, we’re going to modify the brains of those so affected so they find poverty more amenable and tolerable in the future. THESE PEOPLE ARE TOTALLY IRRATIONAL!!!!!
—- Steve
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I think a reporter would be AWESOME. I also think that some on-line journals may be willing to publish stuff that WaPo and NYT and their ilk would not go near. Huffington Post might be an option worth exploring – probably as close to mainstream as we can get. More radical publications like Mother Jones might be willing as well.
Thanks again for all you’ve done – you have really catalyzed a movement!
—- Steve
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There is even a sleep-inducing drug whose trade name is (or was) “Soma.” I found it quite chilling!
—- Steve
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Of course, I agree. Losing connection to others is tantamount to losing our humanity. It’s never a good thing to reduce someone’s empathy for others. Leads to bad ends, like mass murder in some cases!
—- Steve
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I believe that when it comes to involuntary treatment, the shoe is on the other foot.
— Steve
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I think it’s because white folks, on the average, are more likely to grant that “s/he’s the doctor and must know what s/he is talking about” while black people are more likely to be suspicious of powerful white folk giving them drugs to make them more accepting of the status quo.
— Steve
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I appreciate your comments, and would just say that perhaps the main reason that no cause for “major depression” has been found is outlined in your summary of the situation. You state, “It is about time we start developing more refined approaches for accurately sorting out the underlying CAUSES of major depressive disorder… [emphasis added]” A true illness doesn’t have “causes”, it has one single cause and that indicates a range of treatments specifically targeted at the specific cause. If depression, as you correctly assert, can have many causes, framing it as a “disorder” simply creates confusion, as we should not be treating “depression,” but trauma, nutritional deficiencies, sleep problems, work issues, or whatever the cause or causes might be in a particular case.
So in an odd way, in disagreeing with the author, you actually are making his point for him. He’s not saying depression isn’t a problem to be addressed, he’s saying it isn’t a DISEASE STATE, even though it could in certain cases be caused by some other disease state. Just as syphyllitic psychosis is real but very different than amphetamine psychosis or spontaneously-occurring psychosis without a known cause, depression resulting from the loss of a parent is different than depression caused by a poor diet which is different than depression caused by 25 years in a dead-end job. Depression is a condition and a set of circumstances that could be caused by many different things, and is therefore NOT really a disease or illness, in my view.
—- Steve
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True words! The psychiatric worldview removes all responsibility from the power elite for social conditions and blames anyone who is unhappy or protesting by “diagnosing” them with not supporting the status quo. Remember “Brave New World” and Soma? “A gramme is better than a damn!” Prophetic.
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I think the numbing effect IS what they do. I think for some people, who are hyper-concerned with what other people think about them or whether they are measuring up to some outside standard, a small degree of numbing feels good, because they’re able to say, “Who cares what my mom thinks? I’m going to do what works for me!” But for others, numbing itself is probably very uncomfortable, and for a small but significant number, it becomes dangerous, because they no longer care about the consequences of their actions and are now willing to do things that they previously only fantasized about, like running an airplane full of passengers into a mountainside or shooting up a school or shopping mall.
Calling them “antidepressants” is, indeed, a huge fraud. Perhaps they should be called “numbing agents” so people who are taking them will know what they’re really getting into.
Or perhaps they simply shouldn’t be prescribed by doctors at all.
—- Steve
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As a man who works in the foster care system as an advocate, I have observed that there is another factor at work. Kids who have parents who care for them are much more willing to have their parents or guardians ask questions and challenge authorities who are trying to drug kids into submission. The real problem is that the treatment staff don’t really empathize with the kids in their care. They believe they are “helping” by “calming down” kids or “helping them learn emotional regulation” or “setting appropriate boundaries” when they are, in fact, behaving oppressively. Most workers in such places (and I used to be one) have almost no training and are not required to have done their own therapy, so they’re making it up as they go and/or responding to the pre-existing “structure,” which is often a culture of disrespect and aggression toward the youth. The staff are protected at every turn – they can put hands on a youth and physically redirect them, but if the youth fights back, the youth gets in trouble for “assaulting” them and can sometimes even have criminal charges filed, while the staff have an automatic protection against any lawsuit for that kind of event. In other words, the kids have zero power and any staff person who is untrained or unhealthy enough to act out against them can pretty much get away with it unless called on it by other staff.
So in the end, while I agree 100% that the pro-nuclear-family propaganda is thick in this country and is quite harmful, the kids who have a parent or committed parent figure do have a better chance of avoiding drugging. In the 2009 GAO survey of foster youth and “medication,” they found that kids in stranger foster care had 4-5 times higher rates of drugging than the general population, but kids placed with relatives had only slightly higher rates of psych drug use. The difference, I think, is that the relatives were more likely to actually see the kids as people and to advocate against drugging them until other things have been tried. I think relatives are also more likely to tolerate annoying behavior as just being part of their personalities, whereas institutions want kids to be convenient and are willing to use any means, including drugs, to make them more manageable.
—- Steve
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Privilege is a relative thing. I agree that large males are more likely to be assumed to be aggressive, but large BLACK males are most definitely considered more dangerous. Look at the number of shootings of unarmed people by race. Unarmed black men are shot at MUCH higher rates than white. I don’t think it’s because a bunch of overtly racist police officers are out there looking for a black guy to shoot. I think it’s because they’re more likely to GENUINELY believe their lives are in danger when the person is black, regardless of any other variables.
—- Steve
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We should also not overlook the finding that 73% of clients were offered drugs, while only 34% were offered psychotherapy. This belies the claim that drugs are only being used on “endogenous” conditions that are not based on external circumstances, as the figures on traumatized individuals with “mental health” diagnoses show the rate to be in the 80+% range at least. It shows that drugs have become the first-line intervention regardless of the cause of a person’s distress.
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I’d vote for both of those laws!
— Steve
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Agree 100%.
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I agree that the euphemism “discontinuation effects” should be called “WITHDRAWAL” because that’s exactly what it is. I would further suggest that the “poop-out effect” (an even more horrific euphemism) should also be called by its proper name: TOLERANCE. We need to clearly establish that there is NO essential difference in effect of these drugs to any other psychoactive drugs, including street drugs. Anyone with training in the area knows that cocaine, amphetamine, heroin, etc. all create TOLERANCE because they increase the presence of a particular neurotransmitter, and the brain/body reacts by DECREASING that same transmitter’s production and pruning off of receptors for that transmitter, a process long known as “neurological down-regulation” in the field. The drug becomes less effective because the brain adapts. Similarly, longer-term WITHDRAWAL effects are not just the result of the drug leaving the system – they are also caused by the fact that the brain’s down-regulated state doesn’t work well when there are normal neurotransmitter levels around. It takes the brain time to readjust, and it’s not clear if full readjustment happens if the person has been using a long time.
Why would we imagine that these same processes don’t happen just because a drug is prescribed????
—- Steve
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This is a VERY important article!
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Yeah, you’d think, wouldn’t you? Perhaps there is something about the training our psychiatrists and mental health professionals receive that somehow trains this compassion out of them. If you go into a field where you’re dealing with emotional distress, you ought to be the kind of person who wants to and is capable of dealing with emotional distress. It’s just common sense. Although as Tim McCarver once quoted, “They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
—- Steve
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A “mental health professional” who has no idea what to do about trauma is a danger to his/her clients. Yet that’s what clients get at the psych ward every day. It’s what actually drove me out of the mental health field in the end – when I saw the inside of a psych ward, it was clear that no one with an ounce of empathy for the patients could allow this kind of scenario to exist or imagine for a moment that there was anything therapeutic about it.
Thanks for sharing your observations from “behind the lines!”
— Steve
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When I worked at the community crisis line years ago, there was always a huge surge in suicidal behavior and thinking after the holidays. Expectations almost always fell short of reality and people were reminded by too much time with their families that they weren’t a part of the Norman Rockwell image that we’re all “supposed to” experience.
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We used to see “Conduct Disorder” diagnosed in foster youth for a lot of teens who acted out. There was a 95% chance anyone with a “Conduct Disorder” was black, and probably a 90% chance they were male. It’s fallen out of use because of it’s loadedness and an improving awareness of bias in the child welfare community, but there was a time in the not-too-distant past where someone would say, “He’s got a conduct disorder diagnosis” and I’d say, “Oh, you mean he’s black?” I don’t think I was ever wrong when I asked that.
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Does the study control for withdrawal impacts, euphemistically known as “discontinuation effects?”
Also note that you’re quoting a single study, whereas the article is referencing a review of the literature, which as I’m sure you are aware is considered a much more accurate way of assessing the overall impact of a particular intervention, as individual studies are always prone to both bias and more random fluctuations that appear to be significant, hence the emphasis on replicability in all areas of science.
But I’m sure I’m preaching to the converted on that point, nec pas?
—- Steve
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I was, of course, referring to psychosocial approaches when I suggested that it helps to have been through the process, and I’m assuming Gary was talking about that, too. No one should have to experience drugging, though of course it might make a psychiatrist think twice about prescribing Risperdal or denying someone’s reported side effects if he’d have to spend a couple of weeks trying not to drool and trying to conjure up complete sentences while on a solid dose of that crap.
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And yet licensing has clearly provided a sense of legitimacy to a set of practices that are not actually supportable and effective, and in some cases are overtly destructive. Licensing can be good if there is an understanding of what “good care” is supposed to look like. But if we don’t even know what we’re supposed to be taking care of or what a “success” actually looks like, licensing becomes less about assuring quality and more about job protectionism and creating an illusory impression of relative competence that is not supported by actual fact and experience.
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Julie, it is also very sad that in both cases, doing the actual “right thing” was not only not standard practice, but was discouraged to the point that both workers felt they were putting their jobs on the line by doing what was actually needed by their charges.
And Gary, I 100% agree with you that being human and vulnerable is often the most important aspect of being able to help – stepping away from the power relationship and just being one human talking to another about life. I was fortunate to get into the mental health field with essentially NO training (I had an MS in Education and they somehow thought this qualified me to do therapy – go figure!) and therefore never had the misconception that I knew more than the people I was helping. In fact, it was they who taught me how to do therapy, and they were awesome teachers.
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This is not new news. And the conclusion is almost comical – “Clinicians should prescribe them only for patients with a clear need.” Oh, so clinicians should only risk doubling the person’s chances of death by heart attack if there is a “clear need.” What kind of “clear need” would justify this, and how with the mental health industry’s subjective “disorders” would a “clear need” ever be established?
—- Steve
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This is very true. Freud’s genius was that he listened to his patients and believed their stories, and thereby uncovered the trauma and the scandal of widespread sexual abuse in Victorian society, a hundred years before these facts came to be generally accepted. But the reaction of his profession says all that needs to be said about psychiatry’s roots and true intentions – they did everything they could to suppress this truth, and Freud knuckled under and became the progenitor of a hundred years of further denial of the truth.
Psychiatry has never really been all that interested in the truth, at least when it has conflicted with the interests of the elite and the powerful.
—- Steve
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“But ordinarily we do not discover the wisdom of our feelings because we do not let them complete their work…”
That sums up the real problem with the psychiatric worldview in a sentence. They have defined FEELINGS as the problem, rather than an indication of a process that needs help in unfolding. Fearing emotion means suppressing it, which is generally the exact opposite of what is needed for healing and growth.
Thank you for this beautifully written piece, Kelly!
—- Steve
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“Mental illness” is a “mystery” for the simple reason that psychiatry is looking in the completely wrong places. The idea that knowing more about the brain will help cure “mental illness” is the central fallacy that keeps them from learning the first thing about it.
A recent article on this site mentioned that over 90% of people on the inpatient psych wards had trauma severe enough to cause PTSD in their past, vs. something like 3.5% of the general population. Yet psychiatry consistently overlooks or denies that trauma plays a central role in almost every case of “mental illness,” and spends billions looking fruitlessly for genes that will “explain” what is very obviously NOT a genetic phenomenon.
I have no hope that psychiatry will be able to change its path, nor even want to. They’re making lots of money even though they have no real idea what they’re doing. It’s not a lack of information, it’s a lack of compassion and intention to find out what they don’t know.
—- Steve
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Being required not to talk about the truth because it might upset someone is at the very core of what makes us mentally/emotionally unwell, in my opinion. Good for you for sticking to your path and saying what needed to be said. Those being paid to help you should not be worried about being traumatized by what you say. It’s their job to be able to absorb and process that trauma, and if they can’t do so, they’re in the wrong job.
As for professionals, I was reminded of a saying: “Always remember that the Ark was built by amateurs; the Titanic was built by professionals.”
— Steve
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It is often considered more “scientific” to be a materialist and discount the belief in higher order events or spiritual existence. But I’ve pointed out many times that materialism is a philosophy, and as such is no more “scientific” than spiritualism or the belief in life after death. There is absolutely zero evidence to support that the mind and brain are the same thing, but it is stated as if this is so obvious that anyone who doesn’t automatically agree is a superstitious fool. At a minimum, I do think there’s plenty of evidence that the mind operates at a “software” level, being more akin to programming than wiring, even assuming a materialist jumping off point. To reduce the mind to chemical interactions in the brain is at best similar to saying a computer is just a bunch of on-off switches. It is composed of those switches, but a computer without a program is useless, and the same is true of a brain without a mind, whatever this mysterious “mind” phenomenon might be.
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Maybe we should promote your oral surgeon to be in charge of the psychiatric hospital. It seems likely we’d get better results.
I have heard similar statements from others, that psych hospitalization was worse than whatever trauma they’d experienced in the past. It is hard for me to comprehend how anyone could consider that kind of intervention “therapeutic.” The pro-force movement bemoans the fact that the poor “mentally ill” are languishing in our jails instead of getting “needed treatment.” I’m kinda getting the impression they’re better off in jail, if for no other reason than they have to let you go when your sentence is over.
—- Steve
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No one who is threatened by someone figuring out how to get better should ever be allowed to “help” someone, especially in the psychological/spiritual realm!
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I think there are a lot of unfortunate parallels between obstetrics and psychiatry. Both involve “treating” people that have nothing wrong with them, both tend to rationalize and use physiological interventions on what is primarily a psycho/social/spiritual set of needs, both disciplines use interventions that have been proven useless or even harmful despite evidence to the contrary, both areas have had strong movements opposing their inappropriate practices, and both have reacted to these movements with a combination of ignoring, hostility, and co-optation. I’d love to see both disciplines disbanded and to start over from scratch.
Lots of people have given birth for millions of years with little or no intervention. While it’s true that a lot of women died in childbirth as well, and it’s certainly good to have modern surgical procedures on hand in case such becomes necessary, we are now running at a 30% + Caesarian rate in the USA, and no one in the OB field seems to bat an eyelash. It’s also worth noting that the number of deaths in childbirth radically INCREASED when hospital births were instituted on a large scale, mostly because of a complete lack of hygiene techniques. When Ignatz Semmelweiss attempted to introduce hygiene techniques, with an immediate and dramatic drop in postnatal maternal deaths, he was fired and shunned by the medical community in his time. It’s grim but educational reading and the parallels with psychiatry, again, are legion.
These are the two medical professions I know of where failure of their approach is blamed on the victims, and the bad results of “treatment” are mitigated by increasing the amount of “treatment” being used. In both cases, 90% or more of patients would be better off being cared for by someone who is less “trained” but more compassionate.
—- Steve
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If people tend to get better over time irrespective of treatment, what’s the point of treatment? We were clearly better of before we started “treating” every time someone feels bad.
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Isn’t it stunning that the nurse could not just sit down and say, “Wow, this sounds really interesting – do you mind if I join you?” Instead, they try to STOP whatever is going on.
—- Steve
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Well said. The desire for and willingness to have human connections, even if they may be painful for you, is the center of what being able to help others is all about. The rest is window dressing. If you can’t allow yourself to feel what the client is feeling, you’re at best useless, and most likely dangerous. In fact, removing the client/helper relationship and as much as possible being just two humans communicating is what quality therapy looks like in my experience.
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Exactly so. A person who has experienced traumatic events can very much be helpful to others, but ONLY if they’ve processed their own trauma and its ongoing impact on them THOROUGHLY. I had zero training in “mental health” when I started out in a teen mom’s home. The one thing I did have is a great therapy experience and a willingness to admit I didn’t know what was going on and needed the young ladies to help me understand their own behavior and inner process. So I asked questions and listened deeply, and discovered that that, and nothing else, is what was needed to assist 90% of the people there.
Self-acceptance and humility are the keys to being a good therapist. Any sense of having to defend oneself against the distress of your clients just makes you dangerous!
—- Steve
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Subjectivity is Psychiatry’s stock in trade. You’re lucky you weren’t perceived as a black male – you’d either have Antisocial Personality Disorder or Schizophrenia. To call psych diagnosis “racist” doesn’t begin to get at how divisive and destructive it really is.
Thanks for sharing your experience – I’m going to keep my eyes open regarding African-American women in a different way now. (I’ve already observed that white women who are unhappy with their roles are mostly labeled “borderline” or “bipolar” or have “major depressive disorder).
—- Steve
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Pterry was the facilitator from Icarus, I believe. Are you in Portland? I was there.
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It was commented by one of the participants, and I shared this view, that the providers who REALLY needed to be there would run a hundred miles to get away from it. I don’t think we can truly find reconciliation when the folks willing to admit to and talk about what’s really going on are marginalized and punished by the powers that be for speaking up. I think it will increase the courage of some to speak up who haven’t, but might also cause others working within the system to conclude, as I eventually did, that collaborating with the psych system is not consistent with keeping one’s on integrity intact.
I admire you for being able to continue the good fight, despite the discouraging odds. It is quite dispiriting to be “behind enemy lines” like you are, and it’s impressive you have been able to maintain your integrity despite the obvious threats to your reputation and even your employment. You are a remarkable person!
—- Steve
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This is an excellent article!
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I agree – it is clearly a religion, the DSM is the Holy Text, and the Psychiatrists are the Priests of the Order. The biggest difference is that this Church allows members to be forced to “join” against their will. Which kinda makes it worse than even the worst cults around. At least most of them allow people to choose not to come in the door.
—- Steve
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I think you missed a key requirement. Anyone allowed to provide professional assistance to others for a fee should be required to undergo their own therapeutic process to assure their own sanity and emotional availability to those coming to him/her for help. This should involve structured interaction with “service users” or “peers” who can grill them about their ability to be open-minded and safe and to avoid condescension and arrogance. They should have to be passed by a panel of mostly service users before they’re allowed to hang out a shingle.
It’s way too easy to go through the motions, or to even believe one ‘gets it’ about patient empowerment and trauma-informed care and the like. The challenge is that under stress, almost everyone reverts back to their own primitive coping measures to deal with the situation, and only those who can recognize 1) what their primitive coping measures are, 2) when they are happening, and 3) what they should be doing when such emotional reactions surface, are going to be able to be of assistance to anyone in distress.
There is no “class” for emotional health and sanity. It’s something people earn by hard work and a willingness to be brutally honest with themselves. Needless to say, the majority of “mental health professionals” today have not done this work and are therefore potentially dangerous to anyone being vulnerable around them.
—- Steve
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Have you considered writing a book yourself? You write well, and have a compelling story to tell!
—- STeve
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I am so sorry! This is an awful story! I’m glad you at least tried acupuncture. It sounds like you need to find a doctor who specializes in getting people off of psychiatric drugs. It’s been done, but it’s not easy. Maybe there is a group of people who have been “patients” and are working on this in your area?
Wish I had more to say that might help. Good luck!
— Steve
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Well said!
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The traditional “snake oil salesman.” I saw him present one time – very smooth but talks through his hat all the time.
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“Under-recognized?” Geez, talk about the understatement of the year! So we have 91% of the psychiatric hospital residents reporting traumatization vs. less than 5% of the general population, but their “mental illness” is caused by brain chemical imbalances and is unrelated to what happened to them. The relevance and primacy of trauma is ACTIVELY SUPPRESSED in the psychiatric community, in my observation. It is at best considered an “additional stress factor that contributes to their illness” and is often not even considered. I once evaluated a 17 year old developmentally delayed girl (maybe 6-years-old developmentally) hospitalized for aggression. She had been fine behaviorally but suddenly became withdrawn, and a year later disclosed to her mother that she’d been sexually abused, after which time she became aggressive. Her diagnosis: “Bipolar Disorder!” Apparently, the rape, which marked both the time of her initial withdrawal, and the time of her aggressive behavior emerging when disclosed, had nothing to do with her “mood swings” and aggression. Idiots! Is it possible they were really THAT stupid???
—- Steve
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“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”
Upton Sinclair
—- Steve
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This is important news. Though it shouldn’t be news. It’s kind of obvious, really.
—- Steve
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Well, Julie, OBVIOUSLY, you must have been misdiagnosed. The drugs don’t do those things to people who NEED them. If you’d REALLY been sick, you’d have killed someone for sure by now. Although aren’t most of those ones killing people TAKING the drugs at the time they started killing people? I guess they were misdiagnosed, too…
Way to get out and stay away from the trap. Too bad more people don’t know about “dangerous” folks like you who seem to magically improve once they stop being “helped” by their “treatment.”
— Steve
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Why, I’m just certain the Emperor is wearing clothing. Look at all those people who agree with me! While your evidence of direct observation of naked skin might be of some merit if it were verifiable, the tailors have carefully explained that this lack of visibility is due to your own personal disloyalty, not any lack of clothing on the Emperor’s part…
Thanks for hanging in there, Bob. It is a Kafkaesque world at times that we try to impact. You have done more than anyone I know to keep that boulder from rolling back down the hill.
—- Steve
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Yes, but I think the proper SCIENTIFIC conclusion is that they do not prevent suicide. Scientific hypotheses are held to be false until proven otherwise, and the burden of proof is on those claiming there is a positive effect. This shows that there is no evidence of a positive effect over many studies, and the trend suggests it is more likely that a negative effect is present, as even in the non-significant result studies, there were still more suicides and suicidal ideation in the antidepressant arms. Hence, a rational scientist must conclude that the data does not support the hypothesis that suicide rates are decreased by antidepressant use, and for all intents and purposes, we have to conclude that there is no such effect.
Unfortunately, many scientists are not rational on this particular point. Wanting something to be true or thinking that it should be true is not relevant to science, though it appears to be quite relevant to marketing!
—- Steve
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I’m saying that it’s valid within the timeframe that is being measured, as all people in that timeframe are being similarly impacted by these macro variables. I agree that comparing, say, 1958 to 1995.
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Sounds like the UK is “catching up” with us, sadly. But perhaps it’s been caught a little sooner – it certainly sounds like the question of whether this is working or not is much more “askable” in the UK than it is over here.
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My thoughts exactly. Might as well say, “People who reject being labeled and ‘othered’ by the system and insist on their own solutions have better outcomes.” 80% of stigmatization is the result of the system itself stigmatizing its clients, or making it easy for others to do so.
— Steve
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True enough, which further supports my contention that “treating” all kids who act like this in the same way is a formula for failure.
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Or perhaps a move to a school environment more suited to their strengths and needs. We put our two intense and active boys into alternative schools that allowed them more freedom and self-direction, and even home schooled the oldest for four years. Both have become productive and functional adults without a milligram of stimulants.
Perhaps its time we stopped hammering square pegs into round holes and blaming the pegs when they are damaged?
As to the “occupational system,” the only study I’m aware of on the topic showed employers to be just as satisfied with their “ADHD” employees as they were with any other employee. As you say, they no doubt made their way into professions that are compatible with their strengths and proclivities. It is unfortunate that they don’t have that option in school, because the research suggests that if they did, they’d select classrooms where they could move around and make decisions and start and stop things when they were ready to do so, and that in such classrooms, they’d be indistinguishable from “normal” kids. That is exactly what we experienced with our own boys when put into an environment that was flexible enough to meet their needs for autonomy and stimulation.
—- Steve
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Portland is my favorite city in the USA.
I’ll send you a note if I’m heading to NYC, though it’s been a long, long time. I do get Upstate sometimes, as my brother and his family live in Ithaca. And my family is in Philly, a mere 90 miles away. So who knows? Let’s stay in touch!
—- Steve
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Me, too! I’d love to meet you one day. If you’re ever in Portland, OR or nearby, please look me up!
—- Steve
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Sorry, but the idea that “ADHD” sufferers can be identified through PET/MRI scans is not validated through the scientific literature, whatever Daniel Amen may say about it.
That being said, I very much appreciate you sharing your experience with supplementation and diet, which can make a difference for many people with this behavior pattern.
The problem is, not ALL people labeled as “ADHD” have nutritional issues or can alter their situation through nutrition. Some have very unstable home lives. Some suffered early life trauma and are highly anxious and easily triggered. Some are very smart and get bored easily because they are not being challenged in school. Some are just tactile learners – they need to move to learn and they’re doing what works for them, but the teachers won’t allow it and they get in trouble. Some have sleep issues. Some have lead or other environmental poisons on board. And some are just in need of a year or two of development before they are asked to make themselves fit into a school classroom environment. There have been a few studies now showing that delaying Kindergarten a year reduces ADHD diagnosis rates by 30% or more! Such kids don’t need nutritional counseling, they need some time to grow up. Yet others are suffering from dietary issues or sensitivities and need that kind of help.
The problem is the label and the resultant lumping together of people with disparate needs into one category based solely on their behavior. People are different and need different things and do well in different environments. Instead of pathologizing kids who don’t do well in a standard classroom, we ought to be approaching each individual case and finding out what’s going on. You’ve done this for yourself, which is admirable. But most kids never get the chance to learn what you have learned, and as I said, it will only work for a minority where nutrition is the issue.
Yes, people do act in the way described as “ADHD.” There may even be some biological reasons for this. But genetic diversity is the essence of species survival. There is nothing inherently “wrong” with “ADHD” behavior, and in fact there are some substantial benefits in the right venue. It is only labeled as a “disorder” for the convenience of the adults involved, who don’t want to go to all the trouble of getting to know the child and his/her circumstances sufficiently well to actually map out a solution to their dilemma.
—- Steve
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Hi, Cynthia,
I can really get where you’re coming from, and certainly don’t want to minimize the challenges of being an “ADHD” kind of person in our current world. I think where we may be getting some confusion is that the hoax referred to, and I don’t think that’s really too strong a word for it, is NOT that having the symptoms or behaviors designated as “ADHD” is not real. There are absolutely people who, whether because of their biological makeup or their experience or a combination of both, have difficulty paying attention to dull things, like to be up and about and hate sitting still, and can get frustrated and impatient when constrained to do things that don’t have an immediate reward, and so forth. Such people ABSOLUTELY do exist, and such people ABSOLUTELY do have a different set of challenges from the “average” person in the population. I have two kids who grew up with this kind of personality, and I can say with certainty that neither suffered any kind of severe trauma, though the first did have to suffer through us learning how to parent a challenging child such as he was.
The hoax, though, is in suggesting that such people 1) have something WRONG with their brains, just because they operate in a manner that is inconvenient for adults, and moreover, that 2) ALL people exhibiting these traits ALL have the SAME thing wrong with them and need the SAME “TREATMENT,” usually meaning drugs.
Now I can see from your post that you don’t believe this yourself – you clearly state the need to view such “disorders” as having multiple possible causes and solutions. But the psychiatric profession and their allies in the education field for the most part don’t agree with you. I’ve heard countless situations where education professionals or psychiatrists or family doctors explain that “you have a chemical imbalance in your brain” and that “untreated ADHD can lead to school dropout, delinquency, teen pregnancy, etc.” The latter comment I find particularly offensive, as multiple long-term studies over 50 years or so have failed to show ANY improvements in these outcomes from long-term medication use.
So again, it’s not that people don’t have this kind of behavior pattern, it’s that the psychiatric, education, and pharmaceutical industries have intentionally labeled these kids as defective and insisted on a “treatment” that makes them big bucks without actually leading to any better outcomes for the children involved, and in some cases, doing specific long-term damage to kids’ welfare in the process.
I and many other people have had “ADHD” kids and raised them without medication with excellent results. The most important thing for us was to get them out of standard school classrooms and into homeschooling or child-centered alternative schools. We were fortunate to have the resources to do that, which I understand many people don’t possess. However, this does NOT excuse the school system for continuing to hammer these “square pegs” into the round holes that are available in standard school classrooms. The “ADHD” label allows schools to get off the hook for providing the kind of environment that so-called “ADHD” students actually thrive in (which has been scientifically been shown to be an open classroom setting where they get to move around and make decisions rather than being bossed around all day).
I hope you can see the distinction. No one here (I hope) is trying to invalidate your own challenges or even your perception that stimulants were essential to your ability to navigate your life to adulthood. What we are objecting to is the pathologizing of what is in most cases simply a normal behavioral/personality variation that makes it difficult for adults to manage these kids in a herd such as teachers in public schools are required to do. It’s very understandable why teachers in particular want to believe this description of reality, as it validates their experience that these kids are difficult and provides some sense that there is an easy solution. But the long-term outcome studies prove that there IS no easy solution, and supports that each child is different, and that labeling and treating them all the same does not lead to better results.
I hope that provides some context and reduces your sense of invalidation. This is not about individual people and their struggles. It’s about the efforts of an industry to capitalize on those struggles by pathologizing normal behavior in order to make a profit and normalize social institutions (like schools) that aren’t actually working very well for these kids, and most likely for a lot of other kids who are simply better at biting their tongues and putting up with the oppressive environment they’re expected to tolerate.
—- Steve
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This is awesome news! It sounds like a real debate, not the kind of “investigations” we get in the US congress where they only invite those who preach the party line. I find it encouraging to know that this kind of honest examination of data is going on at such a high level of government. I hope there is a plan to get this story to the media, especially if the committee recommends action to reduce long-term antidepressant prescriptions. It is a very exciting prospect!
—- Steve
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I agree with what you say. However, I think the research studied controls for that effectively, because it’s randomly selecting people from the whole population, all of whom are affected by the variables you mention. Those variable would explain a GENERAL rise in disability rates, but the one study directly compares disability rates after receiving “treatment” and finds clearly that that variable alone leads to a fairly dramatic increase. Also, the bipolar conversion rates, especially for kids, are quite dramatic, and further support that the increase we see in disability rates is likely due to adverse reactions to the drugs rather than or in addition to other social factors.
— Steve
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However, stimulant treatment over the long term has NOT been shown to help kids sustain friendships OR learn information more effectively. It suppresses these “symptoms” temporarily. And you’re right, the pill often causes adults to decide that “the problem is solved” and stop doing other interventions. There was a good study in the 70s that showed kids who got stimulants received LESS academic support after getting onto the drug, mostly because the teachers felt that they were going to be OK now that they had been “treated” and were demanding less attention, regardless of whether or not they were actually learning anything.
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The fact that you can share one anecdote that contradicts the author’s premise, without us even knowing the actual case details, has zero value in answering the question at hand. The author is collecting data, not anecdotes, and when that much data is assembled, it tells a story. It appears that there are some people who are made manic or even homicidal by these drugs, even if it doesn’t happen to most people. Let’s say it happens to one in 200, or one in 500 – does that not still merit concern? Should people not be informed about this? And why is the FDA, who is supposed to be sharing this information, trying to keep it under wraps? Doesn’t tha bother you at all?
As to the title of “Doctor,” remember that Doctors brought us insulin coma therapy, frontal lobotomies, thalidomide, a 20-year or longer suppression of nursing, 4-hour feeding schedules, the Juvenile Bipolar Disorder hoax, telling us not to pick up our crying little babies for fear of spoiling, lying about the addictive properties of Benzedrine, and later Valium – I could go on. Having an MD after one’s name does not prevent one from being corrupted by big money.
—- Steve
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I was indeed fortunate to be in Portland where there is an alternative public school that allows that freedom (a survivor from the open classroom movement of the 80s) and where we were able to create a charter school of the right nature, again with support of public funds. We were also fortunate enough to be able to work complimentary shifts so that homeschooling was a possibility for us. But I object to a system where only the lucky have such options! The research I’m referring to is decades old (from the 1970s) and we should already have been designing such classrooms in every district in the country!
I honestly have no objection to people using medication if they feel it is helpful to them individually. I do, however, have an objection to folks overgeneralizing from a set of behaviors that could have a number of causes and possible solutions (including classroom expectations inappropriate for a child’s age and development) and blaming the child’s brain when the adults have a lot to do with both what is expected and what happens when those expectations go unmet. It’s just too easy for adults to blame kids for their own failure to create an effective environment. I think the “hoax” is not that such kids don’t exist, it’s that such kids all have something wrong with them and all need the same interventions, while absolving the adults involved from any responsibility for mitigating the environmental factors that make it hard for such kids to thrive in this particular society.
I acknowledge having a lot less knowledge about how best to intervene in the non-hyperactive attentionally-challenged child, but I am sure that there would be ways to help that extend beyond medical intervention. Again, I have no trouble with individuals choosing this path, but I have a BIG problem with all individuals having such struggles being lied to about “chemical imbalances” and told that stimulants are the one and only solution, especially when the long-term outcome studies I cited above show that on the average, stimulants don’t lead to better outcomes over the long haul.
Anyway, thanks for the respectful exchange. I think we can both agree that the situation is more complex than a simple pro- or anti-argument can encompass.
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Right you are. And many of the “negative” studies never even get published. That’s NOT how science really works! In fact, negative studies are MORE important than positive ones, because only a negative study can give a definitive answer to a hypothetical question. Positive results continue to support our preconceptions, but science is supposed to be about reducing subjectivity, preconceptions, and “confirmation bias.” So in truth, ALL studies should be submitted, and only the consistent presence of a positive result despite many attempts to disprove or explain the phenomenon in a different way should be accepted as evidence that something is true or helpful.
But there aren’t as many profits that way…
—- Steve
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I relate to your comments, Prefer, but I think they may reflect less about “ADHD” diagnosed youth and more about the oppressive and inappropriate nature of our school system. I agree 100% that kids like this are often damaged by insensitive or thoughtless teachers or administrators, but I believe that is a result of how the school system and its expectations are constructed.
We have two boys, both adults now, who were poster “ADHD” children – active, busy, intense, impulsive, often going from one task to another quickly, hated being bored, seeking stimulation always, rarely willing to “go along with the program” unless it was THEIR program. After doing our own research that supported this idea, we had them go to alternative schools with a more open-classroom focus, where they had more choices and control over their environment. The oldest we even home-schooled for four years. Neither had any medication, and both are functioning well as adults, the older (32) working two jobs, including training people to create websites and managing the administration of a busy educational business, and the younger (20) maintaining a very high academic and athletic (s0ccer) reputation at Evergreen State College.
I believe the smartest move we made was to avoid the standard public school classroom, at least through the end of elementary school. It is poison for these kids, but it doesn’t have to be this way. There is good science supporting the idea that “ADHD” kids do much better in open classrooms, and if you read my response above, you’ll see that there is no evidence that their medicated counterparts learn more or do better in the long run in any significant way.
So “ADHD” exists, in the sense that yes, there are kids like that, but that doesn’t mean that medical treatment is the answer. The research suggests that such kids should be provided with a different structure that has less ordering about and more freedom of movement and decision-making, and that they will thrive in the right environment. But the standard classroom is not the right environment for active, curious, impulsive, hard-driving kids.
— Steve
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I am glad my thoughts resonated with you! I am cautious about trying to speculate about situations or experiences that I have no personal knowledge of, but this felt right to me, and I’m glad it felt right to you, too. The power of social repression and denial is incredible, and it always seems to be the most sensitive and the least powerful who have to carry the pain for the privileged and the boorish masses. Pisses me off, really. I have found that getting in touch with my own anger at social injustice helps keep me going when it all seems to be too depressing to think about.
Thanks again for a great article!
— Steve
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We have long had a quote from a Melissa Chen, aged 11, on our refrigerator. Melissa’s wisdom: “Just remember, no one is normal. Everyone is weird.” True words!
— Steve
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Hi, Alan,
While your rendition of history is, for the most part, accurate, I think you are supporting a very subjective and therefore dangerous re-categorization of a behavioral/personality tendency, which of course could be described and identified in a number of people, as a “need” for medical treatment, which should be defined by something observably malfunctioning in the person’s body. You mention the possibility that a brain chemistry anomaly might be present, and yet despite decades of research, you will have to acknowledge that no such anomaly has ever been verified in most or even a large number of “ADHD” cases.
You are also not taking culture into account here. There are a wide range of expectations that we put on our 5-year-olds which are developmentally inappropriate for their age and yet are accepted as “norms” for our youth, and when kids very understandably don’t meet those “norms,” we diagnose them instead of questioning whether our expectations are inappropriate. Supporting data include that French kids are admitted to school a year later and yet still learn more than US kids by the time they reach high school. They have VERY low medication use rates compared to the US, and yet their kids don’t appear to be adversely affected. Add this data to several studies showing that delaying a year before starting Kindergarten reduces “ADHD” diagnosis rates by about a third (!) and it becomes hard to deny that inappropriate developmental expectations play a role in “ADHD.”
Consider further that in tribal cultures, where kids are allowed the freedom to roam and experiment and explore, the behavior described as “ADHD” doesn’t really present any problem whatsoever, and in fact, such kids may be valued more highly for their creativity or their willingness to take risks or their ability to stay “hyperfocused” on a task like shooting arrows or throwing things.
Finally, I am not sure if you are aware of the increasing mass of data suggesting that medication use for kids in elementary school has no significant impact on any of the outcomes that adults care about for their kids, including high school graduation rates, academic test scores, delinquency rates, teen pregnancy rates, social skill development, or self-esteem. Studies supporting this conclusion include Barclay and Cunningham’s 1978 review, Swanson’s 1993 “Review of Reviews,” the Oregon State University Medication Effectiveness Project, the Raine study in Australia, the Quebec ADHD study, a comparison of Finnish and US “ADHD” – diagnosed students, and of course the long-term outcome studies associated with the MTA study, which showed that the nationally-touted small advantage for stimulant users at 14 months had disappeared by the three-year followup study.
So all in all, the argument for “ADHD” as a discrete “disorder” requiring “treatment” with stimulant drugs is quite weak. It seems the parents who have been skeptical about this were correct – paying attention in class in the short term is less important than learning the important lessons on how to control and direct one’s own intentions, emotions and behavior, and those skills can’t be taught with a drug. They require patience, persistence, and creativity over a long period of time. There is no shortcut to raising kids.
As a parent of two boys who clearly fit the “ADHD” diagnosis, both of whom became productive and functional adult citizens without a milligram of “medication,” I can attest to the fact that some kids are different and more difficult, but parents can and will rise to the occasion given the proper training and support. And kids can and do succeed if you alter the environment and stop expecting them to behave in ways that young kids were never designed to act.
—- Steve
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Your story reminded me a little of some of Jung’s ideas about the “shadow self” and how what we repress has power over us. I’m thinking on a more global scale – that our society represses a lot of who we are, and that folks like you and your visitor are sensitive to and able to express the repressed or “shadow” side of society and bring it to the light. But of course, most people don’t WANT to see the ‘shadow’ (that’s kind of the point, isn’t it) so YOU become the enemy instead of being able to see their own very similar internal conflict of having to repress who they are in order to “fit in” to a more and more unaccepting and restrictive social norm.
We do, indeed, live in dark times. Thanks for sharing your light with us. I am saddened (but not surprised) that you have encountered so much prejudice and resistance that you no longer want to risk sharing your reality with people you don’t know will be receptive, and I’m very glad you were willing to share it with us here.
—- Steve
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I am afraid I can’t agree with you, because this is not about better practice, it’s about POWER, and people don’t give up their power without a fight. Not just psychiatry, but the entire medical profession is very much in the control of Big Pharma, and they see only drugs and surgery as options to improve any condition. Psychiatry is just the natural extension of this “thinking” to the realm of the mind, which is unfortunately much more subjective and more easily manipulated, because at least if you’re making billions in the cancer industry, you have to show by some test that a person you’re treating actually has cancer.
Such a change will be a revolution, and will most likely start with alternative practitioners elbowing their way into the mainstream and getting some amount of insurance dollars. But just as midwifery has much better outcomes than obstetrics and yet remains an ancillary and often resented alternative in most hospitals, alternative practitioners alone won’t take over the practice by being more effective or less dangerous. It will take a POLITICAL revolt that takes the money and power away from the current promoters of the joke of the DSM and the intentionally distorted way of looking at people as bodies to be manipulated rather than beings to engage.
Institutional change is difficult and doesn’t come from talk. It comes from elbowing the powerful out of their seats of power, or from a mass uprising of the citizenry demanding something better. I don’t see incremental change being possible with the level of corruption that exists in psychiatry and in the larger medical profession. It will require some level of a revolt.
—- Steve
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Except that when you are in prison, you did something wrong (usually) and also have an idea of how long you’ll be there and what you need to do to make your sentence shorter. Not so for the mental ward – you’re there as long as they want to keep you (and as long as the insurance keeps paying), and they can still exert massive control over you even after you are out of there. There is no maximum sentence for “the mentally ill.”
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I agree with Oldhead – let’s certify Keith Richards or ZZ Top members to be our specialists – they have more direct knowledge and less of a conflict of interest, and are more likely to keep the best interests of their clients as their focus.
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New definition of “hallucination:” instead of “Seeing things that aren’t there,” it is now redefined as “Seeing things you’re not supposed to have seen and talking about it.”
Way to stand up and speak truth to power!
—- Steve
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I will take that as a compliment. Anyone in the drug industry hating me is a sign I’m on the right track!
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Well, I have to say, this was not an argument for maintaining a limited role for psychiatry, because in my experience, psychiatry generally does absolutely none of the things you mention. Because they believe that “mental illnesses” are biological and can be “diagnosed” by behavioral checklists, they never bother to look for any actual physiological causes that might exist, like lack of sleep, low iron, thyroid problems (low or high), side effects of other drugs, nutritional deficiencies, etc. Nor do they bother to ask about psychosocial causes in most cases. A recent study of kids in residential treatment centers showed that over 80% readily disclosed childhood abuse or trauma to the total strangers who interviewed them, but something like 20% actually had this identified in their files. This suggests that in at least 60% of the cases, they didn’t bother to ask the kids about their history, or if they did, didn’t consider childhood traumatization to be relevant enough to write in the chart!
The profession is corrupt from top to bottom. While there are some “good psychiatrists” out there, I don’t see how the profession will ever garner the humility to admit it has misled us and choose another path. Perhaps a new specialty, starting from scratch, might be able to work OK, but we’ll have to do a ton of damage control on the huge mass of mythological misinformation the profession and its Big Pharma allies have already unleashed upon the public.
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Sorry, but there is a huge difference between finding purpose in your life and “navel gazing!” A person who has to work a dead-end job for years on end in order to barely put food on the table and who can’t afford healthcare or any entertainment or luxuries and feels he is simply walking a treadmill every day toward the end of his meaningless life is very likely to be deeply depressed. I have certainly helped many people find reason or purpose even in negative events that have happened to them (I have worked with domestic abuse survivors, child abuse survivors, and foster kids and their parents for years), and also see that when a sense of purpose is achieved, these people feel a lot better about themselves and their lives. In fact, it is one of the ost critical aspects of good therapy, for the client to find ways to turn suffering into meaningful action. Comparing this to some sort of es0teric meditation practice (though I remind you that meditation has been shown to have positive effect not only on the psyche, but on the brain itself) feels like a distracting minimization of the potential power of human contact and relationship on depression.
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They also say he is “very passive” and goes along with the program in general. My guess is the guy is pretty darned confused.
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No, really? Overmedicating our youth?
Actually, I hate that term, “Overmedicating.” How about “We’re using drugs to make our toddlers less like toddlers.” Or “We are MEDICATING kids under %!” Overmedicating indicates there would be an appropriate amount of medication to give a toddler. Sorry, but drugging toddlers for behavioral control is just plain WRONG.
—- Steve
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I know how the FDA works, and even I find this disturbing! This is not negligence or minimization, this is overt and intentional suppression of knowledge that they already have. This should be a scandal of monumental proportions. Any way to get 20/20 or 60 minutes interested? You’ve done all the research – they have their story and just have to tell it.
Thanks for all the research. This is INCREDIBLY valuable!
—- Steve
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Exactly. The “informed consent” is much higher with alcohol.
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True enough. I read something just yesterday where they suggested that SSRIs sometimes “unmask” an underlying bipolar disorder! It’s beyond outrageous, not the least because they have no way of actually determining if someone has “an underlying bipolar disorder,” while a very simple expedient will tell them if the drug is at fault – STOP THE DRUG AND SEE IF IT GOES AWAY! I am never quite sure if it’s intellectual dishonesty or just garden variety ideological stupidity driving this kind of remark – do they REALLY not see that psychoactive drugs can have unintended psychological effects? What kind of idiots are we dealing with here?
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69 consecutive days in restraints. If that’s not torture, I don’t know what is.
And when you’ve been “treating” someone for 20 years with no improvement, it’s time to admit you don’t know what the f*&k you’re doing and graciously give way to someone with a different plan of action.
Thanks for this thorough though stomach-churning report.
—- Steve
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And the alcoholic has at least some idea that alcoholism is a possible outcome of his/her decision. Most psych drug takers have no clue what might happen to their brains as a result, and some never do figure it out.
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It’s often not medical ERROR – it is often the actual accepted TREATMENT PROTOCOL that kills people!
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That’s not what my therapy looked like, either what I received or how I handled clients myself. I was always about POWER – getting more power for the client, both internal and external. Some of it is obviously exploring options outside of what you’d normally consider, but a lot of it was helping understand how NORMAL it is to be upset about a life and a society where you’re constantly disempowered and at the mercy of others. Finding ways to be LESS at their mercy was the core of what I found helpful to anybody, regardless of what was bothering them. That’s what I think real therapy should be about!
—- Steve
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Nothing is more trouble than the patients having individual needs they have to deal with!
Kind of disgusting, really. Both making people stop cold turkey, and denying smoke breaks as a punishment for “misbehavior.”
Not sure what else to say. These staff people are the ones who have the mental problems!
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It should be noted that Abilify affects serotonin levels as well as decreasing dopamine levels. Both of these could easily lead to impulsive behavior, as increasing serotonin is associated with manic behavior, and lower levels of dopamine are associated with poorer executive functioning and hence impulsive decision making.
Or in layman’s terms, randomly messing with your neurotransmitters can have unexpected and unpleasant effects!
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How very thoughtful of them.
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Oh, they’re not blind to it. That is, indeed, the point of the whole enterprise!
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Could not agree with you more. This is NOT a liberal/conservative issue. It is a human rights issue, and crosses all political boundaries. After all, the pharmaceutical companies aren’t particularly selective where they spread their Pharma dollars, why should we be worried which side of the political fence someone is sitting on, as long as they get what is going on?
—- Steve
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If the placebo arm was associated with a 2.22 times greater risk of suicidal acts, they’d be all up at arms about how dangerous such an experiment was and how unethical it was to “withhold treatment” from those in need. Interesting how it is so differently interpreted when the shoe is on the other foot…
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It all makes too much sense to me. I don’t know why this is not obvious to anyone trying to help. In the end, empathizing with the person who was victimized is more important than any degree or professional role a person might have. I would really suggest you try out a support group, unless the idea just freaks you out too much. I think it would really help to hear that you’re not alone, that others do the same things for similar reasons and get the same treatment from “professionals” that you did.
Glad to know you’ve still got some fight in you!
— Steve
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Wow, I am used to hearing stories of incompetence and abuse from psychiatry, but I think yours hits me harder than most, because the causes of your suffering are SO obvious and right on the surface, and yet they seem to want to blame YOU for being upset about what happened to you and coping with it the best you can! It does anger me that the victim “needs treatment” while the perpetrator appears to get away with whatever they did with no particular consequence. Who is the sick one, the one who intentionally does damage or the one who us upset by the abuse they suffered? Isn’t it NORMAL to be hurt and angry and scared after being taken advantage of and disbelieved by the people who are supposed to care for you?
It sounds like you need to talk to someone who is an expert in helping people heal from the damage of abuse. Such a person would not label you and make it seem like you have a “disease” of some sort. They would validate your pain and normalize your efforts to keep your pain at bay through whatever means you have come up with. They’d let you know that many, many people who suffer from sexual abuse in childhood use food or other more extreme means to re-establish some sense of control of their lives. And I would hope they’d give you some idea of a path to making things feel a little better so you won’t be constantly fighting off the pain. Food would be a very, very small part of the conversation, and drugs would not even come up.
If you can’t find a professional to help with this, have you considered going to a support group for others who have been through this kind of painful experience? I bet you’d find a lot of folks who found the psychiatric system unhelpful or even damaging and abusive, as you have experienced it yourself. You might also find some people who have found some ways to make it a little easier to move forward and heal. It might be worth looking into.
Bottom line, you’ve been massively disserved by the people purporting to help you. I wish there were more I could do to help myself, but I appreciate you sharing your story and giving an excellent example of exactly what I was saying above – “eating disorders,” if we must call this common coping measure something, are not about food. They’re about managing emotions. And there really is no drug for that, nor will there ever be.
Thanks for having the courage to share. I hope you’re able to find someone who can help, because there really are people out there who understand your situation and how to help. You will have to look around, because these people are very much in the minority these days, but they do exist.
Hang in there!!
—- Steve
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I don’t disagree – I think the very concept of calling them “peer workers” frames them as less valuable and less important than the “Real Professionals” with degrees. And I have also become disillusioned with the idea that change from within the system is going to be successful, at least by itself. At the same time, I value the courageous contributions such people make, and have to also remind folks that sometimes “insiders” minds are actually changed by their interactions with people in the system who know what it’s like to be a patient/consumer/victim of their services. Such people may disconnect from the system and work on alternatives and join our movement, as we have done.
I see the concept of “peer workers” as being problematic in that there is disempowerment in the very structure that “allows” them to work in what feels like the “professionals’ realm.” And until and unless we do something about the essentially authoritarian structure of the mental health industry, that will not be changing any time soon. But I want to validate that individuals within the system can contribute to both the health of individuals and the growth of our movement. It is a very tough role to play, and it wears on you over time, as it did on me, and eventually, I think a lot of folks get to the place where they feel like you do, and I do now, that it becomes collusion when you can’t really say you’re impacting significant change within the system and people are getting hurt. But when and where that line comes is up to each individual to decide, and I will not judge anyone for trying their best to make a difference for people who have to tolerate the horrors of psychiatric hospitalization or enforced outpatient “treatment” – those folks have little enough support, and kudos to anyone having the balls to stand up to psychiatry and spit in their faces right on their own turf!
We are all needed in this movement, including dissident insiders. The Viet Nam war was brought to an end partly as a result of dissident soldiers and commanders in the army. It can make a difference.
—- Steve
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The only way to stop psychiatry is to cut off its food supply, aka MONEY. Which also means cutting off its main supplier of money, the pharmaceutical industry. Which is very challenging in today’s neoliberal oligarchic world!
— Steve
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That’s OK, he’s used to people pretending he’s not part of the family.
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Great article, Phil!
Two things come to mind. First, the kind of genome-wide associations they are looking for are so broad and so infrequent that even if they did find such an association, it would apply only to a tiny percentage of the people so diagnosed. Far from a key to understanding the larger cohort, such a finding would at the VERY best provide a possible explanation for a tiny subset of the whole. And even such an “explanation” is only an association – there is really no way to establish causality simply because of the presence of such an association, as you so clearly explain above.
More important, let’s suppose there IS an association of some sort that is found. SO WHAT? Does that give us the SLIGHTEST clue of what to do about the situation? Other than giving genetic counseling to parents whose children are affected by these genes (who would then be advised that their children had a less than one in a hundred chance of developing an eating disorder???), what would be DONE differently as a result of a positive finding for a tiny percentage of all anorexia sufferers?
On the other hand, sexual abuse, witnessing domestic abuse of a parent, and abuse in general are all associated with eating disorders. Something like 30-40% of eating disorder sufferers acknowledge having been sexually abused as children. Compare this percentage to the paltry results that the most positive spin possible could put on their figures for genetic correlation. Obviously, abuse as a child kicks genetics’ ass as a likely causal factor. And you can actually DO something about an abuse history!
So we spend billions on analyzing someone’s genetics, when the correlations have historically been very low even for PHYSICAL disorders like heart disease and cancer, and when there is basically NOTHING we can do to change the suspected genetic defects, yet we minimize or ignore the abuse history so often associated with anorexia, which is something we actually could help a person process and move through toward a healthier and happier life. Talking about misplaced priorities!
Of course, this doesn’t even talk about the cultural impact of our thin-focused culture. It is well established that non-Western countries have much lower rates of eating disorders, and that as Westernization moves in, eating disorder rates rise accordingly.
http://www.healthyplace.com/eating-disorders/articles/eating-disorders-culture-and-eating-disorders/
It never ceases to amaze how much money we waste studying genetics when genetics are the one thing about a person that is essentially unchangeable. Though when one reads the list of conflicts of interest, the motivation, I think, becomes clearer. They only want to find some excuse to CLAIM that eating disorders are genetic so they can market a drug to “treat” them, as well as selling expensive testing methodologies so you can find out if you “have” the dreaded Anorexia Genes. The actual needs of the clients are obviously secondary to the marketing and moneymaking festival that is anticipated by the authors, and probably by the funders as well.
—- Steve
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Yeah, I always wondered about throwing someone into nicotine withdrawal during a depressive crisis. For all their yammering about “chemical imbalances,” they don’t appear to understand the first thing about the impact of drug withdrawal. Can’t think of a worse time to force someone to quit smoking against their will!!!
Not to mention those other “minor” trauma…
—- Steve
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Don’t forget Uncle Ritalin, who is in denial that he’s actually an amphetamine relative, though he does have Cocaine relations on the paternal side…
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“Drugs are bad unless we tell you to take them, then they’re good.” Pretty simple, huh?
— Steve
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It should have been discussed, if you really want to have people providing “first aid” in this kind of situation. This would be like forgetting to mention that blood spurting from the body intermittently means an artery has been cut and immediate action must be taken. You could end up getting someone killed if you handle that situation poorly. I find it inexcusable, but not surprising.
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I think it supports people’s denial systems all too well – “I’m not a crappy parent – my kid has Oppositional Defiant Disorder!” “My classroom isn’t boring – I just have a lot of “ADHD” kids for some reason – bad luck!” “I’ve always been depressed – I’m sure it has nothing to do with the sex abuse history I’ve been trying so hard to repress!”
And as you say, it lets all the professionals off the hook as well. Blame the brain and you don’t really have to do anything. Seductive, indeed!
— Steve
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I wonder if anyone brought up the possibility under question 1 that the person threatening suicide might be a domestic abuser. Suicide threats are a common tactic used to make a departing partner feel guilty and re-engage with the abuser. Any discussion of this question that doesn’t raise that point is, in my view, extremely irresponsible, because the answer should be VERY different than in a non-coercive ex-relationship.
The whole thing sounds like a very juvenile attempt at indoctrination. I admire you for being able to sit through it without becoming physically ill.
— Steve
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I have to say, as a person who worked in the system for a number of years, you are perhaps being overly simplistic about the conflict between trying to help the people IN the system vs. trying to change the system from the outside. While I admit I did not fully understand what was going on, and when I eventually found out the truth, my personal ethics would not allow me to continue to working in the system, I would have to say that the people who encountered me were VERY fortunate, because I was one person who did not buy into the system paradigm for “helping” and was always helping them think about and develop alternative approaches to just going along with the program. I helped a lot of people stay out of the hospital or avoid self-harm because they knew I cared about them as people and was not judging them or labeling them with a “disease” just because they were upset about having horrible things happen in their lives.
One of our posters here is a “peer worker” and appears to do a LOT of great work in a hospital setting, despite the adverse conditions. Another worked in a hospital for years as a counselor, and had to deal with that same ethical conflict in the best way he could. I admire the courage of such people, and applaud them for being able to tolerate “sleeping with the enemy” and bringing hope to those “behind the lines” of the psychiatric oppression that we all abhor.
So let’s not be so judgmental of those trying to make things better from inside the system. I know there are “peer workers” who believe the medical model wholeheartedly and are basically cheerleaders for the psychiatrists’ agenda. But there are others who are courageous reformers who risk their jobs and reputations every day to help people who are not out here reading MIA, but are incarcerated by the MH industry and have little to no hope or perspective on their situations.
As I like to say, “Generalizations are ALWAYS wrong!” Let’s judge people by what their actions and intentions are, rather than what role they use to try and accomplish them.
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Psychiatry’s definition of an “Unproven Treatment:”
Any treatment from which they or their allies have not proven able to make sufficient profit.
—- Steve
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There are certainly plenty of oppressive attitudes amongst “liberals,” and some “conservatives” I have found to be quite rational. I don’t think we should make assumptions about peoples’ openness to this kind of thinking based on political affiliations or beliefs.
But I think Sera’s point is well taken – the question is not whether we should ally with such liberals as see what is going on and understand the overlap and interaction between racial, gender, and psychiatric oppression. I think she’s saying that liberals IN GENERAL should be open to making this connection (“Intersectionality” is all the rage theses days, after all) and yet a large majority appear to be unwilling to see the similarities and connections between these various forms of oppression and are all to ready to let psychiatry off the hook, and usually advocate for “more treatment” rather than looking at what the diagnostic and treatment protocols commonly practiced really DO to clients.
In the end, psychiatric oppression isn’t a liberal/conservative thing. It’s about connections and compassion for the human condition, and frankly, a small minority of Americans seem to be able to muster these for the “mentally ill” regardless of what end of the political spectrum they represent.
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I do think that during the time of involuntary commitment and control, the analogy becomes closer. But there are still ways to escape psychiatry that slaves do not and did not have. John Nash is a good example. He recognized who the enemy was and kept a low profile, didn’t tell anyone what he was thinking or doing and years later “came out of” his altered state spontaneously. He managed to escape by avoiding notice, something that a slave doesn’t have as an option.
That being said, I’ve never had either experience, so I’m probably not qualified to really say.
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I suppose this must be because people in intensive care units have a biological predisposition to anxiety and depression that makes it more likely they’ll be severely ill or injured leading to worsening depression/anxiety from their stressful experience.
It couldn’t be that depression/anxiety/PTSD is caused by exposure to highly stressful events… Nah…
—- Steve
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Yeah, I hear that too, as if there were some way to distinguish objectively between “endogenous” and “reactive” depression. The whole thing starts with the error of defining “depression” as the problem, rather than an indication of other potential problems, which could be physiological, psychological, social or spiritual in nature. And of course, you’re correct, the real driving motivation behind this is to be able to assume some medical “knowledge” whose purpose is not to cure, but to control and profit from those too naive or ill-informed to understand that they’re being played. It is sooooo obvious to me at this point that it’s hard to understand why so many people are taken in by this ruse.
Thanks for your reply!
—- Steve
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I very much appreciate your thoughtful reply. I find it rare that someone is able to reconsider their initial emotional reaction when faced with some rational counter-response, and in fact I would consider that ability the heart of a truly progressive attitude.
I also totally get that there are plenty of other methods and approaches that are put forward as panaceas for your “condition,” and some folks advocating for these approaches can be just as rigid and oppressive as their psychiatric counterparts. None of that is helpful, honestly. Empowerment is what heals best, even if there is something physical that is objectively malfunctioning in an individual. Empowered heart or cancer patients have been shown to do better than those treated by an authoritarian and dismissive doctor – would this not be even more critical when mental/emotional distress is involved? I have never understood why this is not obvious to many in the mental health industry.
There are also practitioners of every art and technology who are just abusive and use their approach to enable them to find victims more easily. Sounds to me like that might be what happened to you, and I can’t stress enough that in my view, you are NOT responsible in any way for that kind of reprehensible behavior from that criminal posing as a professional.
It is an unfortunate reality, again in my view, that psychiatry as a profession has co-opted many people’s desire to reduce suffering and turned it into a propaganda campaign against anyone questioning their authority. This doesn’t mean people don’t sometimes or even often do better with the assistance of certain substances. It means that the profession at the highest levels is engaged in manipulation of known facts in the service of an agenda that has little to do with helping the likes of you and me.
I strongly suggest you read Robert Whitaker’s book, “Anatomy of an Epidemic,” which was the inspiration for this site. It will, I think, explain a lot about why so many folks here are against the general concept of labeling and drugging everyone who is experiencing mental/emotional distress as a first line of “treatment,” when the evidence shows that such an approach in the collective appears to have some significant adverse consequences, even when in individual cases it may work out to a benefit. I am very hopeful you will find it eye-opening and educational.
Thanks for hanging in and reading our replies!
—- Steve
P.S. As you can see from my comments, I agree with you about the “slavery” analogy being inappropriate, and I can understand your reaction. However, I think those referring to forced psychiatric intervention as analogous to rape have a lot of evidence to back up their views.
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And that two-week line was, of course, chosen after years of precise scientific research into EXACTLY when “normal” people are supposed to start feeling better after the loss of a loved one, and EVERY person who doesn’t feel better at that time is PROVEN to have a “chemical imbalance” that prevents them from just freakin’ burying Mom and getting on with their lives.
Grief is SO inefficient!
—- Steve
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I most definitely still hear the “behavior vs. mental health” dichotomy. I’ve never been able to figure out what the hell they are talking about, since every “mental health disorder” is essentially defined solely by behavior! It’s like “situational” vs. “clinical” depression. We are always told that there is this big difference and that those with “situational depression” need therapy and support but that this won’t help “clinical” depression, yet there are not even any ham-handed, subjective DSM criteria requirements that attempt to make this distinction. Depression’s severity is solely evidenced by the clinician’s subjective assessment of the severity and duration of the “symptoms” that define the “disorder.” The question of “situational” vs. “clinical” doesn’t even come up, yet we continue to be fed this BS, meanwhile, the DSM 5 committees decide that being immobilized by the loss of a loved one for more than two weeks now qualifies us for being diagnosed as MDD!
And yes, the skew to the biological does appear to be worst here in the USA, where drug companies have a stranglehold on our government and can charge obscene prices for their questionable products.
—- Steve
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As a person who has worked inside the system, I can tell you that the right to benefit from treatment is never at issue. It is the right to decide that one is NOT benefiting from treatment or would benefit more from another approach that is denied to clients/patients. In my view, a Liberal person, in the way you describe it, would be in a place where s/he wanted the PATIENT/CLIENT to be able to decide what their experience was and what it means, much in the way you describe wanting to have your own experience and viewpoint without having it invalidated. I absolutely grant you that right, and I think Sera has proven over many years of hard work that she respects the right of people to do whatever they need to do to take care of themselves.
The bigger issue that comes into play is the DEFINING of people’s experience as “mental illness” based on a list of
“criteria” agreed upon by a group of mostly male, mostly white, entirely middle- or upper-class American doctors (with a few psychologists tossed in here and there) who have little to no understanding as to what is or may be “wrong” (if anything) with the people they so label.
Certainly, no one here would deny the reality of suffering, and as Sera has said many times over, she fully supports the use of these drugs by anyone who finds them to be helpful (given, of course, an honest “informed consent” discussion prior to them being given out). But finding a substance helpful for your own condition is VERY different from another person defining for you both what is “wrong” with you (based on the subjective and culturally-bound process described above) AND what you HAVE TO to for your “condition,” even if you don’t want to or have tried it and found it extremely destructive. I would think that any Liberal worthy of the name would be deeply opposed to the idea that someone else gets to both define your experience and command what experience you will have in the future based on a set of culturally-bound, subjective, and frankly deeply biased criteria invented by a committee at the APA!
If, as you say, the Liberal mindset is one in which all experiences are valid, why is it so difficult for those same folks to understand that not all people have the same experience with the “mental health” system, even if some people (like you) report very positive experiences? Would you not expect that a Liberal mindset would involve acceptance that each person receiving such services would be entitled to his/her own perception and reaction to the services provided? Would s/he not be in favor of providing maximum information, choice, and empowerment for the recipients, rather than favoring the enforced intervention of the State “for the client’s own good?”
— Steve
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I am more inclined toward the rape analogy, where someone exerts power over another for his/her own satisfaction. Slavery involves ownership of another, which is something different than exerting inappropriate CONTROL over another under the premise of it being “for his/her own good.” It certainly qualifies as abuse of power and intentional, systematic oppression, but I think of, say, trafficked youth and the total control the “pimp” has over the child’s life, including extracting financial benefit from forced labor, and it seems there is another element of slavery that is not present in the psychiatric survivor’s situation, as horribly oppressive and abusive as I see that situation being.
—- Steve
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Wow, I’m a chemist and I know a lot about drug categories and I never knew that! Thanks for the extra enlightenment for the day!
—- Steve
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I was truly disturbed when I read that “treatment resistant depression” only meant two trials of antidepressants, with NO requirement of any kind of psycho-social interventions, and NO proviso that the “depression” not be “situational” (as if there is any way to objectively determine THAT question!)
The woman was, indeed, fortunate to talk to me, but this was also back in 1992 when citizen-based crisis lines were common and had not yet been co-opted by the “mental health” profession, as many of them now have (including the one I used to work for). I am sure it is much worse now. That was a huge dilemma for me – I felt ethically compromised working within the system, and yet if I had not been there, so many people would have had a worse experience. Eventually, I could not stand it any more (after several months doing involuntary detention evaluations and finding out what REALLY happens on a psych ward!) and got into advocacy instead. But I feel so badly for anyone innocently calling in for assistance these days, because there is a 90+ chance that the first thing that will happen to them is to be labeled and sent for drugs without any further exploration of options, and ECT has become a much more “acceptable” option than it was back in the 90s.
It is a sick system!
—- Steve
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Well, now they have invented “Binge Eating Disorder” to flesh out (ha, ha) their range of potential victi- oops, I mean CLIENTS to include the overweight as well as the underweight. Fascinatingly and frighteningly, the “treatment” is taking stimulants. We’re right back to the 1960s and Benzedrine!
And “obesity” has been classified as a medical disease. Soon to be “treated” with new drugs, probably more stimulants re-branded as “anti-0besity” drugs.
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You do have a chemical imbalance… you do have a chemical imbalance… you do need to take drugs… you do need to take drugs…
Mesmerism is at least more honest about the purpose of assuming control of your beliefs!
— Steve
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I used to work on a crisis line, and talked once to a woman who had been trying different antidepressants for over a year at the behest of her various physicians/psychiatrists. She was absolutely frantic and becoming convinced that there was something desperately wrong with her that she would not respond to this ‘treatment’ despite her doctors having ‘tried everything.’
I asked her, “Has anyone told you that there are other things you can do about depression besides antidepressants?”
Suddenly calm. “No…”
“Well there are.”
“Oh. Well, that’s good…”
And of course, she was completely open to trying out a range of suggested remedies that we were able to come up with in a 5-10 minute further conversation, and felt MUCH better by the end, if only because she’d been given some sense that SHE could do something about it instead of waiting and hoping that the “experts” would come up with a magical cure.
Seriously. An entire year had gone by “trying everything,” and no one had so much as mentioned there might be something else she could do besides trying different drugs. Idiocy, but it masquerades as “treatment-resistant depression.” Sets my teeth on edge every time I hear of it! And they wonder why there is “stigma” attached to “mental illness.” They cause it themselves by blaming the patient for their own failure to help!
—- Steve
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Looking at the comments in the article, most people attribute the rise in suicidality to the constantly disappointing economy and the lack of hope for the future. The common person seems to understand that “chemical imbalances” don’t cause depression – crappy life and cultural situations are the most common culprit. That being said, this data certainly belies the old psychiatric saw that “antidepressants cause a decrease in the suicide rate.” More antidepressants than ever, more suicides than ever. Not saying ADs are necessarily the main or only cause, but it was interesting to note that female suicides have increased much more than male suicides, while female use of antidepressants has increased much more than male use of antidepressants. Sounds like a fertile area for further research, but I won’t hold my breath for Eli Lily to fund that kind of experiment any time soon.
—- Steve
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I also found them deeply disturbing!
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“Mental illness,” being a social construct, is incapable of discriminating. But mental health professionals sure can and do discriminate with impunity!
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Exactly my point! Denying the possibility of a spiritual reality does not make them “scientific,” it makes them stupid and reductionistic. I think there IS good evidence that there is such a thing as a human mind/spirit, though we have no real idea what exactly it is from a scientific viewpoint. To deny or minimize the role of the human mind/spirit in how we live is absolutely a denial of reality. Just as an example, there is a great case from Dr. Gabor Mate where a “schizophrenic” youth from the US, who had received all the usual “treatments” was taken to Africa to a shaman and came back a few months later, cured. He went to MIT and became a fully functioning member of society.
From a scientific point of view, that was an intervention that WORKED, and it should be explored whether it will work for other people. But such an idea would be ridiculed as “superstitious” or “mystical” right off the bat, because “spiritual” solutions can’t be “scientific” unless they deny the existence of the spiritual element of humanity. Totally irrational, but they’d smugly call Dr. Mate the irrational one.
If I’m going to subscribe to a mystical belief system, I at least want one that seems to work! Psychiatry’s mysticism is clothed in “scientific” language, but is indeed just as superstitious as belief in the shaman, and in at least one case, has been proven a lot less helpful.
—- Steve
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Richard, I think the key word here is “believe.” When we’re talking beliefs, we’re talking philosophy. Of course, there is no science possible without some underpinning of philosophy, but philosophy is not science and the assumptions and beliefs of our particular philosophy, while vitally important to be clear about in order to be scientific, remain beliefs. Beliefs also do have validity and can often have scientific support for them, but the belief that the mind is a byproduct of brain activity isn’t one of those beliefs. It’s an assumption, one that folks are entitled to make, but when I talk about “scientism,” I’m talking about turning assumptions into “facts” that can’t be disputed, because “scientists say it is so.” Any real scientist understands that even well-founded theories (like Newton’s laws of motion) which seem intuitively obvious can be disproven (i.e. by Einstein and quantum mechanics) by later experiment. To confuse assumptions with scientific facts is central to Psychiatry’s worldview. And one of their central assumptions-as-facts is the idea that we’re a collection of cells and that the mind is nothing more than the reactions of chemicals in our bodies. If that assumption is identified for what it is, the entire edifice of thought and justification for their reductionistic worldview comes crashing down.
So if we’re talking about recognizing that there is a material reality separate from our own thought processes, I think there’s some pretty good evidence that that is the case. (Though some Eastern thought may call into question the actual nature of that “material).) That’s a pretty different matter (ha, ha) than jumping to believing that the mind MUST BE an illusory artifact of the operation of the brain, and that anyone who believes otherwise is “not scientific.” There are other materialist models: for example, one might describe the mind as the “programming” and the brain as the “hardware,” which I find appealing personally, but again, it’s not something there is any objective proof of, or perhaps any objective way to even prove.
I agree, you, me and Oldhead at a pub would make a really fascinating evening’s entertainment and education! Either of you ever come t0 the Portland, OR area?
—- Steve
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I’m with Sera. I have worked in the mental health field, including doing involuntary detentions for a very short and very painful period of time, and I can tell you, it’s oppressive as hell, even though people believe genuinely that they are helping. Consider what kind of warped thinking is required to believe that forcibly putting electricity through someone’s head against their will and inducing a grand mal seizure is “helpful.” Consider that the introduction of Benzedrine and later Valium was intended to “help” suffering housewives “adjust” to their roles in the home. Consider “conversion therapy,” still being done in some places to “help” gay people decide to be straight, even though it’s been shown to be a very destructive process. Consider how “helpful” doctors in the 1950s convinced millions and millions of women not to breastfeed their children, because the new “scientific” baby formulas were better for them.
There is no reason to assume that a system intended to “help” is not oppressive. I remember 13 years of slow torture in public school, all done “for my own good,” including the crazy second grade teacher who hit me on the head for confronting her about tossing a book across the room. When I finally graduated from high school, I felt like I’d been freed from prison! Oppressive? I think we can call it that, don’t you?
—- Steve
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I think you nailed it!
— Steve
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I suppose the key point is that you “believe that everything is knowable.” I am not sure if I agree with you, but whether I do or not, we’re talking philosophy here, not science. In fact, I can’t think of a way to test the hypothesis that “everything is knowable.” It’s something we either believe or don’t believe based on our observations and understanding of the world. A person could be very scientific and believe that there are unknowable things in the world. Heck, look at Heisenberg’s uncertainty principle – maybe there is proof of the “unknowability” of certain things after all!
—- Steve
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Perhaps “mechanical materialism” is more what I’m talking about when I refer to these folks. But the real point I’m making is that materialism of whatever sort, just like idealism, is a philosophical viewpoint, not a scientific verity. There is no requirement that a person subscribe to materialist or reductionist views to be scientific, nor is the presence of that kind of philosophical viewpoint a guarantee or even a suggestion of a person being scientific.
It would be quite possible, for instance, to do scientific experiments into “ESP” to see whether it exists and if so under what circumstances. Many would think it unscientific to consider the possibility that “ESP” might exist, just on the face of it, because it would violate their reductionist philosophical assumptions.
Now I’m not saying that ESP exists or that there is valid evidence for its existence. I’m simply saying that it could be studied scientifically as a question, with one’s hypothesis being that it did or did not exist, and measurements or conditions defined that would be considered evidence of its existence or lack thereof. That would be scientific.
Psychiatry and its minions shy away from any real scientific thinking, because they already “know” that they are “right” about these things, and people who argue against them are “stigmatizing the mentally ill” or “parent-blaming” or what have you, and it sells partly because of the reverence that we have for doctors of any sort, who are viewed as “scientific” by virtue of their role. Most people unfortunately are unable or unwilling to dig beneath the surface and really look at what the basic assumptions of psychiatry are and whether they are borne out by actual experiment, while at the same time being willing to completely dismiss other possibilities without evidence because they conflict with the ‘scientific’ view purportedly being put forth by psychiatrists. It is indeed disturbing and for some simply not digestible that psychiatrists have simply made most of this shit up from a combination of greed and social bias, and have little to no shred of actual scientific evidence to support it. After all, they are DOCTORS, they must know what they’re talking about.
Doctors are the priests of “scientism” and to question them is heretical to many seemingly well-educated folks.
—– Steve
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There is something particularly heinous to me about “treatment-resistant depression.” First off, “depression” can’t resist anything. Second, “treatment” is very narrowly defined as drugs. Third, and I think most importantly, failure to help someone with one’s standard approach does NOT mean that the subject is “resistant.” It means your treatment DID NOT WORK! These should be regarded as “treatment failures,” but somehow the recipient, nay, not even the recipient is so empowered, the DEPRESSION resisted and refused to respond to the treatment as expected! That dastardly “disease” is responsible for our product not working – it can’t be that we are just doing the wrong thing!
What would you think of a garage mechanic who said that your engine failed to work because it had “repair-resistant fuel injectors,” but to come back once a month for a three-hundred dollar “treatment” to minimize the “symptoms?” I think you’d look for a new mechanic.
What’s wrong with just admitting that your plan didn’t work?
—- Steve
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I really agree. I think this is really about class and privilege in a way that is too painful for those having such privilege to recognize, at least until it happens to them personally. By which point, it may be too late.
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MANY of those forced into the criminal justice system are criminals, perhaps even most. But that doesn’t mean the system isn’t biased. Since the advent of DNA evidence, it has been discovered that huge percentages of death row inmates are innocent, causing the Illinois governor to declare a stop to all executions until the cases were reviewed. Look at the case of Hurricane Carter if you doubt that this can happen. Additionally, you are apparently forgetting that lots of criminals DON’T go to jail, and that a lot of that particular cohort are white and well off and get away with horrific crimes without penalty. How many fraud cases were filed in the wake of the 2008 financial disaster? If it wasn’t zero, it wasn’t far from it, despite evidence of widespread fraud that cost more money than ten thousand AM/PM holdups. This is also injustice and bias.
And as Sera has said, the “mental health” system is by no means an “equal opportunity” oppressor. Women and darker-skinned people have been shown to receive more and more serious diagnoses and often more serious and dangerous treatments, from large swathes of women getting “ECT” in nursing homes to the hugely disproportionate diagnosis of “schizophrenia” in African-American males. It’s not a “leftist platform” – there are hard data out there showing that this is the actual truth.
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I agree and was by no means suggesting that a non-materialist viewpoint was needed to counter psychiatry’s ill-founded philosophical bases. I was merely commenting that people get “scientific” and “materialist” confused all the time, and the most materialist folks are quite intolerant of any kind of ambiguity or mystery, whereas a REAL scientist knows that mystery surrounds him/her at every turn of the road, and that the best scientific “knowledge” is merely an intellectual model to predict the behavior of a complex and highly mysterious reality into which we have only the opportunity to take an occasional glimpse. Newton himself said something along the lines of that all his knowledge was like a handful of sand out of a beach that reached as far as he could see in both directions. That’s a true scientific viewpoint.
The good news is, psychiatry’s own research disproves its own theoretical underpinnings at every turn, as Bob Whitaker has so aptly pointed out. The bad news is, most people are so scientifically illiterate and so married to the infallibility of the medical profession that even good data is not sufficient to convince them that the psychiatrists have their heads up their butts. I mean, who can take a book seriously that has something called “Intermittent Explosive Disorder” or “Oppositional Defiant DIsorder” or “Disorder of Written Expression” as proposed “disease states?” It is absurd on the face of it, but folks simply assume that, as a colleague once put it, “there are years and years of solid scientific research behind” the DSM and are unwilling or unable to listen when I describe the actual conditions under which such “disorders” are invented.
Sigh… It is hard to be an actual scientist in a world where pseudoscience is hailed as the height of technological brilliance.
— Steve
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Yeah, I especially hate that “when left untreated” crap, when the literature shows that stimulant “treatment” does essentially ZERO to improve any of the major outcomes that people care most about, including educational test scores, high school graduation, college enrollment, teen pregnancy, delinquency, social skills or even self esteem. It’s just a song they’ve been taught to sing, but they’ve never actually listened to the lyrics and tried to figure out if they made sense or not.
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“We need to work hard to avoid stigmatizing those poor disabled folks whom we posit to be biologically different from us and from whom we want to make sure to distance ourselves with dismissive labels and speculative and self-serving theories of their biological deficiencies.”
The whole “anti-stigma” campaign crap is more stigmatizing than leaving things alone. It is condescending at the minimum and postulates “otherness” while claiming to preach “acceptance” of the otherness it puts forth as fact.
— Steve
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I think you may have something there. To not believe in psychiatry’s view apparently means being “superstitious” or “mystical,” which for many educated folks is almost the worst thing you could say about them. I’ve had many a discussion about the nature of the mind, and have often pointed out that it is no more mystical to insist that the mind is generated by the brain than to insist that it is an external entity occupying the body, as neither of these positions has the slightest degree of scientific evidence to support it. But I am accused of being unscientific for saying so. Apparently, accepting the philosophical doctrine of materialism seems to be a requirement for being considered “scientific” or “rational,” and the mind “must” be generated by the brain, because “where else could it come from?”
Sounds like a pretty scientific argument to me!
— Steve
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I agree 100%. And I like how you include “misunderstandings,” because a lot of harm comes from parents simply not getting where their kids are coming from, and the kids not having the words to describe what is happening, or being too worried about their parents’ reactions to tell them. That’s why MOST of us need therapy, even if our parents (like mine) were not overtly abusive the vast majority of the time. It is not “blaming” to correctly assign responsibility where it belongs, and if done respectfully, it can lead to healing for all parties involved.
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I think the right’s support is more straightforward – they tend to be suspicious of any kind of government intervention into private lives, and arresting people for being “weird” and forcing them to accept “treatment” from the “nanny state” would be abhorrent to the more libertarian folks on the right. That being said, when a mass murder occurs and gun control is threatened, the Right is very willing to throw the “mentally ill” under the bus, and the Left is all too willing to join them.
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I do understand what you’re saying. “Peer” implies a lower status – you’re not a REAL professional like the doctors or the psychologists or therapists. It’s condescending from the word “GO.”
— Steve
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I have to disagree with you, Jack. I don’t think that most people know that violence is a risk from antidepressants, because the mainstream medical profession has done all they could to dismiss or minimize this risk. I have worked with lots of people who received antidepressants as part of their treatment plan, and can honestly say I haven’t met one yet who was told, “Let me know if you start having any violent fantasies or feel agitated, because that is a side effect of the drug.” (You do hear some being warned about suicide, finally, but that was a long time coming as well, and is still not done in the majority of cases, in my experience.) And when I have brought this up in my role as an advocate for kids in the foster care system, more often than not, I’ve been met with the message that I’m being an alarmist, or that it’s “the disease” causing the violence, or that the new diagnosis explains these behaviors.
I agree with you that taking antidepressants doesn’t automatically make everyone or even most people violent. But for a small segment of those taking antidepressants, they feel disconnected from other people and seem to sometimes find violent things acceptable that would normally seem horrible, as the author so eloquently points out. There are many, many more people who experience a less severe version of the same thing, who find it hard to relax or connect with things they used to like, who report feeling agitated and “crazy” as a result of these drugs, and who become moody and rude in ways that are not congruent with their historical behavior.
The situation is complicated, but I think there is plenty of evidence that in the absence of antidepressants, many people who have engaged in violent acts would not have done so. That makes antidepressants partly responsible for what happened.
Look at the latest info on the Germanwings air crash. Recent documents from his psychiatrist indicate that the pilot specifically told the psychiatrist that the drugs were “making him crazy” and he was worried what he might do. The psychiatrist did nothing to reduce his medication or change it, or apparently even advise him not to fly an airplane until she could look into it further. There was no question in my mind from the moment I heard about that crash that antidepressants were involved, and I was proven 100% right. It is a very real pattern and should be faced up to, not palmed off with the idea that “violence has always been around” or “most people don’t have that reaction.” People are being killed that might yet live if we confronted this problem head on. But the psychiatric profession is more interested in suppressing this information so they can continue with business as usual.
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This is indeed a thorny issue. I have always found myself well to the left of most “liberals” on a lot of issues, but for some reason, this issue of psychiatric oppression seems to resonate a lot more with people on the right. I am not sure I can answer your question on why, but it most definitely seems that the mainstream left has bought into the notion that it is politically incorrect to challenge the mainstream psychiatric view of mental distress as a biological disease.
Perhaps there are too many users of psychiatric services in the liberal camp, or perhaps the idea of challenging doctors’ supremacy as Arbiters of Truth is too much of a challenge for folks who are still benefiting from the current system. Perhaps recognizing the oppression of psychiatry means looking deeper into our own complicity in the economic oppression of others around the world. Or maybe the idea that social conditions are the main causal factor for “mental illness” is just too depressing to be accepted.
I suppose the other possibility is that the mainstream media has specifically targeted this group of people, by which I mean the middle- and upper-class liberals, with their “anti-stigma” messages and it’s had a powerful effect. It might be easier for someone personally victimized by general economic oppression to “get” how psychiatry fits into the oppressive picture.
It is an odd situation, though. The people coming out to defend Justina Pelletier, for example, were almost entirely conservative columnists and activists. It’s definitely a thing. You’ve inspired me to start asking some people I know to help me understand why they don’t get this particular form of oppression and how it intersects with all the ones they appear to care about.
—- Steve
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Yeah, I agree about the website – no one should be allowed to make money by stoking people’s desire for murder and mayhem! I just thought, given the comments of that one young lady, that it might be a good place to contact folks who have been through what you have. It did occur to me that the owner of the website might not want to ‘cure’ anyone of their obsession with violent and degrading images – bad for business!
Anyway, it really does add credibility to the idea that disconnection from emotion is how SSRIs “work”. I can easily see that if someone is worried all the time about how other people feel or what others think of them might find the idea of caring less about others to be quite beneficial and positive. Unfortunately, disconnecting from emotions means disconnecting from our humanity, a point which psychiatry seems to be unable to fully grasp. So folks who already have some violent fantasies but were restrained by the fear of consequences or of what someone else would think or say if they did it may suddenly be unencumbered by such scruples and end up doing things they’d never actually do without the “help” of their antidepressants.
Thanks again for a very powerful story!
—- Steve
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I think, if I am not off base here, that the implicit question in Oldhead’s comments is whether “recovery” is construed to mean whatever the client thinks it means, and if they are supported in pursuing their goals and preferences in whatever way makes sense to them, or if “recovery” means following the treatment plan you have been given and staying “on your meds” and not causing unnecessary trouble for the authorities. “Peers” have often been coopted into the role of helping explain to clients/patients/victims of the system why the system is right and why they should follow the doctors’ orders even if they don’t want to. In other words, are the clients TRULY empowered and are the “peers” TRULY empowered to do what makes the most sense from the client’s viewpoint? Or are the “peers” simply agents of the medicalized system helping enforce social norms and ensure compliance with directions from the authorities in charge?
— Steve
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Great article. I agree 100% that the effect of antidepressants appears to often be to have a person feel LESS rather than feeling good. And I have long believed that the increase in violence and suicide by some people on SSRIs is a result of a lack of concern or awareness of consequences that the drugs themselves induce.
Thanks for writing this courageous narrative – I hope it is read by many readers who are having similar experiences. Perhaps you can post it on the Ogrish website?
—- Steve
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Lovely. Very trauma informed of them.
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Oh, but that would mean we’d have to DO something about lead poisoning, and that would require time and energy and money and might also require us to take a look at who is getting poisoned and confront the ugly economics and racial politics behind these realities. Just much more convenient to blame the kids’ brains. That way, no one gets hurt (well, no one in POWER gets hurt), people make money and the problem sometimes goes away, at least temporarily. Best of all, if the “treatment” doesn’t work, instead of admitting that you are not helping, you can say he has “treatment resistant ADHD” and avoid all responsibility while still making buku bucks. What a deal, eh?
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I call that “Scientism” vs. actual science. “Scientism” involves the belief that certain super smart people do “science” that determines “what is true” and that all the rest of us have to do is listen to these smart experts in lab coats and we can be considered smart by association. It is a very authoritarian religion that punishes blasphemy severely by excommunication and/or shunning. Real scientists are, of course, considered a great danger to “Scientism” because they threaten to expose the flimsy assumptions on which it is based. Psychiatry is all about “Scientism” and condemns any real scientist who questions their dogma as heretics.
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Actually, a lot of abuse victims don’t become abusive as adults, and are in fact dedicated to not repeat what was done to them. That being said, you are right that many abusers were abused themselves as kids. What is unfortunate is that as our society as a whole looks the other way or minimizes the impact of abuse, it makes it more likely for abuse victims to turn to abuse as a way of coping with their history of pain, because awareness and acceptance of that pain seems to be critical to healing from the damage.
But I do want it to be clear that this is not the only choice, and many abuse victims make a different choice for themselves. Some of them have been among the most caring and loving people I’ve ever met, because they KNOW what it’s like to be a kid and not be heard or respected, and do their damnedest to make sure they never put their own kids in such a situation.
— Steve
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I agree with what you say, Wayne, but I have to say that I’ve heard a lot more about how early childhood trauma damages the brain, and a lot less about research by Bruce Perry and others showing that RELATIONSHIPS WITH HEALTHY ADULTS are the best way to heal a traumatized brain. I’ve even heard the neurological damage done by early childhood trauma used as an excuse for why drugs are needed, because after all, these kids’ brains are damaged, what else can you do?
Unfortunately, almost any research can be turned on its ear to serve the needs of those making up the rules. TIC is no exception. I really do think it’s a vitally important movement, but cooptation is a danger that is always looming.
—- Steve
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Too true. Psychiatry and the “mental health” industry often colludes with abusive, neglectful or just plain unaware parents to exacerbate the damage already done. This has been talked about long ago in family therapy circles, casting blame on the “identified patient” and letting the rest of the family off the hook, but that’s exactly what the DSM and the current model does to kids who have been abused or harmed by their parents or other adults in their lives.
—- Steve
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Whom did you contact? You sound like a person with a story to tell and the ability to tell it well. MIA should be proud to have you write for us!
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I agree, a lot of the professional response to the ACEs research is “we need to do more self-care so we don’t get burned out.” It seems that most miss the point regarding stopping oppressive practices, including those oppressive practices we use to “help” our clients that end up traumatizing them yet further. As for looking “upstream” and ending oppressive practices across society, it’s not even on anyone’s radar.
As many projects, it has become another way to get grant funding, rather than an effort to transform how we do our work. Of course, to REALLY apply “trauma informed care,” the first thing you’d have to do is toss the DSM and stop “diagnosing” people who are reacting to trauma. And we all know how likely THAT is to happen any time soon.
As Upton Sinclair once said, “It is hard to get people to understand something when their salary depends on their not understanding it.”
—- Steve
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Of course, the real mistake is taking a phenomenon and labeling it “schizophrenia” and deciding that all such phenomena are caused by the same thing without any evidence to suggest that is true. I like to use the analogy of a rash. What a confusion we’d be in if we decided that all rashes have a common cause and must have a common solution! All we could do would be to try out drugs that suppress skin irritation, and in cases where it didn’t work or wore off, call it a “treatment-resistant rash.”
Rashes, like most conditions, can be caused by a lot of different things, ranging from poison ivy, which will go away on its own without any treatment at all, to syphillis, which will eventually kill you after driving you crazy by eating away your brain function bit by bit. It sure would be good to know which of these you have before starting any treatment approach!
So parents sometimes contribute to their child’s mental stress and deterioration (actually, quite frequently), but sometimes it has nothing to do with parents at all. Why we’d expect all cases of some arbitrary selection of “symptoms” voted on by a committee of biased middle-class mostly white men to all or even most have the same cause is beyond my comprehension.
—- Steve
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I agree, people who aren’t easily cowed or who are very sensitive to hypocrisy and injustice are the most likely to display “symptoms” and to be psychiatrized into submission. Those who “See the man behind the curtain” are the most dangerous to our society’s ruling elite, who are, as you say, VERY insecure about their positions of power!
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I think it is also important to note that most parents who do harm to their kids don’t actually realize they are doing harm (though there are certainly a minority who do realize it and get some perverse satisfaction out of it). Most parents err by reproducing what was done to them or by following misguided professional advice that does damage to their kids. There are also sometimes personality mis-fits between parent and child that cause conflict or stress that can’t really be called abuse, but is still very painful for the child, often in ways s/he is unable to articulate.
That being said, while parents are the most likely source of traumatization, there are still plenty of folks who can’t point to poor parenting as a causal factor. Our society at large adds a whole raft of additional stressors, such as attending school or daycare away from parents before being ready, needing to “get a job” to survive when not enough jobs are available or jobs don’t pay enough to live on, being part of an economy based on oppression of other people, and so on. It is somewhat short sighted to limit to specific individual traumatic events as a potential cause of mental/emotional distress, as there are broad social causes and cumulative impacts that can lead to the same “symptoms” via another path.
Finally, I agree that blaming parents is very different from identifying their potential contributions to a person’s mental/emotional welfare. The first is dismissive and judgmental, while the second can be quite empowering (though painful) if done effectively. And denying such effects for the comfort of the parents or other adults is simply compounding the injuries done to the child. The kindest thing that can be done for injuries of this sort is for the parent to acknowledge the possibility that they may have done harm and listen to the viewpoint of the person who is suffering. Unfortunately, that is the exact opposite of what our current system encourages adults to do.
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That’s what I’ve said many times! Why does a person’s need for protection automatically translate into giving doctors the right to do whatever they want to you in the name of “protection?” Protection is pretty simple – keep away the poisons and sharp objects and don’t let the person attack someone else. Why that leads to the assumption that you need drugs or electricity through your brain to “help” you with your “mental illness” is way beyond rational. If you feel the need to protect someone, protect them. Don’t attack them further in the name of protection!!!
—- Steve
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Indeed!
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You are right, both the authors and the NIMH have ignored that physiological input and experience massively impacts behavior. For example, low iron levels and sleep problems are both associated with “ADHD” symptoms and are rarely ever considered by a physician diagnosing “ADHD”. As the author aptly points out, the diagnosis provides an label that lets the adults off the hook for trying to find a more explanatory and resolvable hypothesis of what is going on, whether it’s in the physiological or psychological or social realm.
—- Steve
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I’m just sure it was an oversight. They would NEVER sell a drug without admitting to its shortcomings. That would be DISHONEST!
—- Steve
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That was a very moving and horrifying story! It seems completely wrong that the psychiatrist has the ability to manipulate the facts and have his/her opinion prevail without any objective discharge criteria. Whatever happened to the “danger to self or others” standard? You clearly didn’t pose a danger to anyone. Without that standard, anyone could be held for any length of time for any reason. Talk about a Kangeroo Court!
Thanks for sharing your story, and I hope you’re able to escape from their scrutiny soon.
—- Steve
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Wow, this is an amazing story! Wish I’d been able to witness it first hand. It is kind of amazing that any doctor prescribing this could claim they had NEVER seen such a reaction when we know how frequently it occurs! I immediately thought of that famous Upton Sinclair quote: “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”
Thanks for sharing this great news!
—- Steve
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This should not surprise anyone. It sounds like neurological down-regulation of dopamine receptors, which Peter Breggin was talking about back in the early 1990s, and which has been known to happen from substance abuse research long before that. It is the mechanism by which we develop tolerance and also long-term withdrawal syndromes that last beyond when the drugs leave your system. Of course, no one making money off this kind of venture wants these dots to be connected, but there is nothing new about this revelation.
—- Steve
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Could not agree with you more. I’d also add that culture appears to exert a great influence on how psychotic experiences play out. In cultures where voice hearing is accepted, the voices themselves tend to be much more positive and supportive, whereas in cultures (like ours) where voice hearing is denigrated, the voices appear to be more hostile and menacing. This certainly supports the idea that voice-hearing is a very culturally-bound phenomenon and that how it is viewed dramatically affects the experience of the person having these phenomena. Is this true of any other “disease?” Does diabetes or heart disease present differently depending on a culture’s acceptance of it?
The idea that psychotic experiences are always a direct consequence of some kind of malfunction is nonsense. While there can be physiological causes (such as lack of sleep or some of the wonderful drugs given to supposedly combat it), viewing it as a coping measure that any of us could potentially adopt is both more accurate and more helpful to anyone having such experiences than blaming their brains.
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Even if your 3x claim is true (even the most optimistic reviews I have seen only claim a doubling of the risk), that still leaves an extremely large group of people sharing the exact same or very similar genes who don’t develop the same condition. And the association with trauma is the same or higher than 3x.
“Researchers at the University of Liverpool have found that children who have experienced severe trauma are three times as likely to develop schizophrenia in later life.”
http://www.sott.net/article/244378-Childhood-Trauma-Increases-Chance-of-Schizophrenia
So a strict biological causality argument is pretty well dead in the water at this late date. Genetic vulnerability is still a viable position to take, but there is oodles of research now showing that trauma, as well as other psychosocial issues such as immigration/emigration and racism, contribute at least as much and probably a whole lot more to the development of psychosis than any genetic pattern ever studied.
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I can’t agree with you when you say schizophrenia is “strongly associated” with over 100 genes. First off, being associated with 100 genes, some of which are present in some cases and some in another, is a pretty weak way to demonstrate genetic causality. Secondly, the strongest correlation I’ve ever seen is about 15%, but that was for a range of “mental health” conditions including depression, bipolar, schizophrenia, and ADHD, and despite the large number of markers they considered and the wide range of “diseases” they included, they still got only a 15% correlation. Whereas correlations between schizophrenia and childhood trauma range in the 80%+ range, and are especially high for childhood sexual abuse.
No one is saying that genes and/or biological processes don’t play a part in any form of mental/emotional distress. What I think the author IS saying is that the idea that depression (or any other “mental disorder”) can be categorized as a biologically-caused “disease” in all or most cases is absolutely not scientifically supportable.
It is also interesting that you claim that no one seriously promotes the idea of chemical imbalances who is familiar with the literature. Well, there must be a lot of docs out there who are not, because this language is used very, very commonly all across the country. Some docs have even admitted during radio interviews that they know it’s not true, but that it provides a “useful metaphor” (as one of them put it) that helps convince people to consider taking medication. So the idea that this is some urban myth that educated professionals don’t really use is not true, in my observation.
I’d strongly encourage you to read “Anatomy of an Epidemic,” the book which inspired this website, as a means of understanding better where folks are coming from. This effort is not from ignorance of the literature – it is actually based on a thorough review of the literature from a very different point of view, namely looking at long-term outcomes vs. short-term symptom management. You may find it an eye opener.
—- Steve
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First off, yes, psychiatric diagnoses are just names for manifestations of humans struggling with some aspect of existence. It’s not that there can’t be biological causes in some cases (sleep, diet, exercise, other medical or recreational drugs, and toxins all can play a role in a person’s distress). It’s that lumping ALL cases of depression together and seeking a biological explanation and/or “cure” for ALL such cases is just raw scientific nonsense. People are depressed, anxious, angry, delusional, etc. for a wide variety of reasons, and simply slapping a label on a person and giving them drugs to “make it go away” is the most primitive approach imaginable.
As to the question of why she is suffering so much, it is my belief and always has been that the only person who knows the answer is her. There are a lot of shabby therapists out there who don’t know what they are doing, but finding a really good one can be hugely beneficial in helping sort out what is going on and why. It is also important to remember that specific trauma are not always the cause of these manifestations – there can also be accumulation of stress over time from negative environments, such as living in a rough neighborhood, being exposed to bullying or more specific oppression due to weight, skin color, sexuality, social preferences or whatever else, or such as having to go to a school that forces you to engage in spiritually deadening experiences under uncaring teachers for years (this was a big contributor to my own issues). It is also possible that you or other family members may have been inadvertently doing things that were perceived as hurtful or stress-inducing without knowing it, because kids don’t always tell you what is going on, especially the very sensitive ones who don’t want to hurt your feelings.
In other words, it is a very, very complex question why someone feels anxious or depressed, and someone outside simply can’t figure it out without some direct help from the person in question. And in the end, that person is much better off if someone helps him/her to find his/her own solutions rather than imposing our idea of “help” on an unwilling or unwitting participant.
It sounds like she is finding her voice. That is the first step toward empowerment. Encourage her to respect her inner voice and keep looking for a person or process that helps. Ones that have helped me are hiking/biking/athletics, playing piano, meditation, reading self-help books, and talking to a quality therapist, who helped me challenge myself to do things I used to be afraid to do like telling someone off for being rude or sticking up for myself when I feel I’m being taken advantage of. These things may or may not work for her – she has to find her own path and her own options. But thinking about what she can DO about it is a lot more productive than trying to blunt her emotions with drugs.
It is shocking to realize that these diagnoses are actually made up by committees and have virtually no research basis, but that is the reality we face. It’s better to recognize that “the emperor has no clothes” and that she has to find her own way than to continue to delude ourselves that these people know something we don’t. She has to become the expert on helping herself, and on finding other people or activities that she sees as helpful. No one else can do it for her.
Hope that helps explain things. Good luck!
—- Steve
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I have no problems with using drugs to function. I do have a problem with posing that kind of solution as a medical treatment. Lots of people smoke dope or head down to the bar for a few brewskis after work as a means of improving their functioning. I don’t think they are receiving medical treatment, even if their “dosage” of beer were carefully controlled.
Making ourselves feel better through substance use is as old as humanity. But it ain’t doctorin’. And pretending it is medicine is dangerous and diminishes the legitimate practice of medicine in other arenas.
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Agreed!
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I have always despised the phrase “Behavioral Health.” Behavior doesn’t have health! Individual people have health. Behavior is simply an indicator of a person’s values, priorities, fears and motivations. Defining certain behaviors as “healthy” is a purely cultural phenomenon bound to be rife with bias and power-driven value judgments. It sets my teeth on edge every time I hear it!
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I most definitely appreciate your perspective and do not want to in any way invalidate your personal experience. That being said, I think it’s important to remember that brutal trauma in the form of overt abuse is far from the only causal factor in the psycho-social arena. There are many, and I’d be one of them, who view our society itself as “diseased” and peoples’ reactions to the stress and insanity of modern society to be actually very normal and understandable given the craziness of modern life. For instance, the fact that we live in isolation from each other and are constantly moving away from our extended families and support systems and have no sense of connection to community is very unhealthy, even for those from a healthy family background. Having to work at a job away from your family, doing something relatively meaningless 8-10 hours a day in order to ‘earn’ a two-week vacation in the summer is not healthy. Expecting 5-year-old children to be separated from their parents and sit in a classroom with other 5-year-olds being “taught” things that may be of no interest and expected to behave in ways that are not appropriate to expect of a 5 year old is not healthy. These things lead to distress and ultimately to “mental illness” as defined by our current psychiatric community.
There is solid research showing that people coming to the USA from another country have a wide range of varying health issues when they arrive, but within three generations, their offspring move solidly toward “American” health outcomes, including increasing diabetes and heart disease, and yes, increasing anxiety and depression.
My big problem with the mental health system today is that such psycho-social stressors are not considered a valid topic for discussion. If a child can’t sit still in a standard Kindergarten classroom, s/he is diagnosed with “ADHD” and given stimulants to “help” him/her adapt to these abnormal circumstances, instead of altering the environment to meet the needs of the child in question. Similar comments can be made regarding “depression” as an adult. Are there kids who are genetically programmed to be more active? I’m sure there are. Are there people whose psyches are more attuned to the pain and oppression inherent in modern society? Absolutely, and I am one of them. I suffer bouts of depression, and they have been fairly severe at times in the past. I have attributed these to the poor “fit” between what society expects of me and who I really am. My solution has been to live my life in a way that gives me a maximum sense of purpose, while using meditation and other means to re-center myself when I am going down the depressive tubes. And I still suffer times of depression. Yes, I do. I don’t consider that a sign that my brain doesn’t work right, but more that I am aware of many things that others are able to more effectively pretend don’t exist, and that awareness is at times exquisitely painful.
Again, that doesn’t mean your view of depression as inherent in your brain is wrong. What it means is that the psychiatric view that depression is inherent in anyone’s brain that “has depression” is not founded in science, and denies the huge impact of large-scale social forces that have been proven scientifically to induce depression in immigrant populations, as well as denying the impact of the individual severe trauma that you mention in your post. That’s what this forum is really about. Personally, I think everyone is entitled to define their problems in the way that makes sense to them, and to seek whatever solutions seem to work, including drugs if that’s part of your worldview. But that’s the exact opposite of what the “mental health” industry is doing. That industry has a vested interest in minimizing the impact of abuse, neglect, and social oppression and blaming individuals’ brains for every kind of mental/emotional distress that occurs. They do this will little to no evidence that their story is remotely true, and in contravention of good evidence that it’s a crock of hooey. Their story is only “true” because it’s been told over and over again, by people who have a vested interest in profiting from other peoples’ misery and in maintaining the current oppressive power structure that keeps us peons in our places.
And yeah, that’s a depressing outlook. But that’s what I see as the current situation. Being cheerful about it would seem irrational to me. I see depression as a message that something needs to change, and the large number of depressed people in Western countries suggest that our society is in need of radical changes. Medicating large swathes of the population because they find modern society excessively burdensome is not a real solution, even when individual people may themselves find benefit in the drug options that are offered up.
I hope that helps understand that the issues at stake here are much larger than the question of whether you or any other particular individual find antidepressants beneficial or even essential to your survival. We’re talking about a massive social mythology designed to disguise the real causes and possible solutions to the problems that plague our modern world. It is a very important issue that transcends any of our individual needs and feelings.
—- Steve
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So owning a cat causes one to be mentally ill? Or does being mentally ill make people more likely to like cats? Very important research questions, don’t you think? Hard to believe anyone gets paid to do this kind of pointless study!
—- Steve
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I am really hoping that this inquiry will open the door to other areas where similar damage is being done. It’s hard to miss that veterans’ issues are the direct result of being exposed to warfare and death on a daily basis. If the ineffectiveness and even dangerousness of using drugs to numb or dampen these effects in veterans is observed, it’s a short path to pointing out the same thing regarding the children, the elderly, and eventually the population in general. We should keep a close eye on this project and look for openings to expand the scope!
—- Steve
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I agree 100%. I also found the absence of analysis of prior-life trauma to be conspicuously absent. It seems a likely hypothesis that transgenered females, fitting into two “othered” categories at once, would be more likely to be victimized in various ways by both their family members and the society at large. Ignoring this makes the research pretty meaningless, and leads to the expected, “Those poor women, they need mental health treatment to assist with their suffering!” rather than looking at why suffering might be greater in this particular population. I suppose that would require the uncomfortable admission that oppression, violence and abuse are actually quite common, an admission that would also tend to undermine the mental health system’s bottom line, and hence an admission that is not likely forthcoming in the near future.
—- Steve
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Well said!
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I agree wholeheartedly. Adults often don’t give kids credit for being able to make decisions about what things mean, but they do, and often very early, and we take these beliefs and assumptions forward with them into adulthood. Often we don’t remember WHY it is that we know something to be true, we just know that it is and that our survival depends on remembering this belief. We are often trying to prevent the recurrence of a dangerous situation from our early lives and are very committed t0 a particular way of acting that we think worked at the time. Of course, each person may respond differently to the same kind of stressors, so some decide that “you have to be careful around adults” while others decide that “you have to connect with a lot of different people, because you can’t count on any one person” while others may decide that “you have to attack anyone who crosses you.” But the common thread is that they have decided these things based on their early experience, and it is very difficult to change these deeply-held certainties that once might have meant life and death to us, or at least seemed to do so at the time.
The more we recognize the NORMALCY of having behavioral and emotional defense mechanisms to fend off a difficult childhood environment, the easier it is to actually be helpful to someone who is trying to sort out what of their primitive defenses are still needed and when, vs. what they can now safely let go of as an adult who can fend for him/herself.
Thanks as always for your insightful comments!
—- Steve
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Yeah, but it doesn’t even work for that purpose. A certain percentage of the “doped up” are far more dangerous than they were before starting their “treatment.” But of course, it’s always easy to blame “the disease” for their outbursts of violence, rather than looking at the fact that the best “treatment” available appeared to be unable to prevent and may have caused the violent behavior psychiatry is charged with deleting out of existence.
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I wrote a pretty scathing reply to the above blog. I hope others will join me in attacking his conflation of someone presenting a danger to society to someone “needing” treatment that they don’t want to be literally forced down their throats.
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I find the technique of blaming the disserved, abused and angry former “patients” on misdiagnosis or poor treatment protocols particularly rich. Where is his evidence of that? Or are we supposed to take his word for it? As I’m sure he is well aware, and even documents above in his own blog, the current treatment protocols are pretty primitive and are almost always followed to the letter: interview the “patient,” get a list of current symptoms, come up with a diagnosis that justifies your intended prescription, and send them away with a drug to “reduce the symptoms of his/her disorder.” These angry patients are not the results of outside the norm doctoring – they are the results of your standard of care, and blaming them for your failures or suggesting that a few crazy outlier docs doing bad work caused millions of former “patients” to be critical of your lame efforts at peacekeeping is just plain lame.
—- Steve
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Yeah, you’d think at least we’d hold them to the standard that their drug treatment would actually improve the condition, wouldn’t you? Yet the patient is ALWAYS blamed when the “symptoms” get worse. If you got something for a swollen knee and two weeks later the knee was still swollen and now your ankle and hip were also sore and your toenails were turning blue, would you say, “Oh, my knee disease is so bad, I need more medication!” or would you say, “Hey, this drug is making it worse! I need to stop and try something else?” But apparently common sense is not applicable to psychiatric “treatment.” I guess it interferes with profits too much!
—- Steve
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“Documented instances and case studies suggest possible confusion between the spiritually advanced and schizophrenia patients. Clinical practice contains no clear guidelines on how to distinguish them.”
Because there is no objective way to do so, nor will there ever be! The distinction is cultural and arbitrary, and comes from lumping people together based on what annoying behavior you want them to stop doing, rather than what might actually help them move through their current crisis.
—- Steve
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“Unfortunately, our current diagnostic schema for bipolar disorder, which is based on descriptive nomenclature rather than clearly delineated causal mechanisms, has not given rise to treatments that provide sustained, symptomatic, and functional recovery for many patients.”
Or to put it in plain English, “We have no freakin’ idea what we’re doing – stay away from us!”
— Steve
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They have surveyed doctors on this point, and the vast majority claim they are unaffected by company front-man visits. The data collected from those same docs completely proved the opposite. Many don’t even realize they are being corrupted!
One relevant article:
https://www.scu.edu/ethics/focus-areas/bioethics/resources/prescribing-under-the-influence/
—- Steve
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Weight loss AND weight gain are listed side effects of SSRI antidepressants. There is already indication of a link prior to this study.
—- Steve
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Too true. I work in foster care and have seen how kids balloon up from taking Risperdal or Seroquel or Abilify. And then they try to put the kids on a diet, as if “poor eating habits” were the problem! The sudden increase in diabetes is very close in time to the sudden increase in atypical antipsychotic prescriptions, and to not even investigate a relationship is either stupid or sleazy. I’m sure soft drinks played a role, but we had tons of soft drinks when I was a kid, and didn’t see this kind of impact. I think the drugs are a huge causal factor.
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Hi, Richard!
Thanks for taking on a difficult topic directly! I have to agree that there is a spectrum of behavior and dependency and that it is not possible to categorize folks into “addicts only” and “iatrogenic dependency”, even though there are some who would fit rather clearly into one category or another.
Perhaps the meta-message of this entire discussion is that the act of labeling, and especially labeling in a pejorative way, is at the core of the problem. It’s clear that our view of “addicts” is very judgmental and negative as a society, and that this view has been reinforced and exacerbated by the medicalization of addiction treatment and intervention by requiring those who want to get paid to adhere to the DSM criteria. It is important to remember that psychiatry coopted addiction intervention after the DSM-III came out (part of the plan), and that of course, like any other psychiatric label, the result is that the people so labeled would be stigmatized. And it seems more than understandable that someone who became dependent on benzos through following their doctors’ advice would resist being so labeled.
I think the larger problem is that “addict” is just as vague and subjective a label as most any other in the DSM, and I’d like to make a pitch for not applying such a stigmatizing label to anyone. Instead, we need to look at each case and talk about b0th what behavior is happening and what is driving it, just like we would with any other of the spurious “mental illnesses” in the psychiatric Bible.
I also appreciate the call for others to be sensitive to the needs of this unique group of folks who have been victimized by their own physicians, and would advocate for very specific kinds of support for people who identify in that way. But the identification should be left up to the individual, not appended from the outside by some well-meaning professional. It seems to me that this is the core issue that affects both “addicts” and “Iatrogenically dependent” people adversely, and should be tackled head on.
There is a physiological withdrawal process from benzos that can be deadly if not handled properly, and appears by all reports to be very tricky and require careful management. That is a medical issue. But beyond this point, addiction and addiction “treatment” are no more medical than the “treatment” of “bipolar disorder” or “major depressive disorder.” The labels are invented and voted on by DSM committees in just the same way, and are just as political and just as fraught with social biases and judgments. For some reason, we as a reform movement seem to have shied away from saying this quite so bluntly about addiction issues, and I think the lack of clarity about that adds a great deal more discomfort to this discussion than needs to be there.
Anyway, thanks for the thoughtful and thought-provoking article. I feel much more educated about the distinctions between what is called “addiction” and the unintentional dependency on benzos (or opiates) caused by following doctors’ orders, an issue that wasn’t until recently on my radar. I also appreciate the commenters who have most definitely enriched the conversation and educated me even more!
—- Steve
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Clozapine can cause a very serious blood disorder, agranulocytosis, occurring in less than 1% of patents, but possibly deadly. Other blood problems are observed in up to 10% of the population, according to Drugs.com, a very mainstream source. They identify tachycardia (racing heart) as “very common” at 25% of cases, and weight gain is also very common. More info is readily available on line. It’s generally not something that’s prescribed until you’ve tried everything else, because the side effects can be deadly.
This guy got off VERY easy for all the hundreds of lives he put in danger just so he could make more money. Still, it’s good to know someone got busted.
—- Steve
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Very well said!
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The link seems to be broken.
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This should not be news. The Raine study, the Quebec ADHD study, the comparison study between Finnish and American “ADHD” kids (American kids did no better despite massively higher medication rates), and the long-term MTA study results all lead to the exact same conclusion: stimulants are essentially irrelevant in affecting any kind of long-term outcomes for kids diagnosed with “ADHD.” Of course, the starting problem is that they are lumping kids together based on behavior alone and then assuming some kind of biological cause and therefore biological solution, which is doomed to failure from the word “go.” But this data proves that they’ve got their heads up their butts. Again. Still.
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I know, that one is one of my favorites for pointing out the absurd to people who believe in the DSM. That and “Intermittent Explosive Disorder.” We used to call them brats (ODD) and assholes (IED). How can anyone take a document seriously that uses such obviously contrived and meaningless “disease” titles? It’s about as much sense as saying that a kid who kicks his mother has “maternal kicking disorder.” Madness!
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Why is this even a topic of dispute? It has long been proven that some kids develop psychotic symptoms from stimulants at prescribed dosages. In one study in the Canadian Journal of Psychiatry, it was over 6%. This should not be a question – the answer is YES. The real question is, why aren’t people being told this fact?
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This same finding has been made in Canada and in at least one US state, and I think more than one. There should be no need for further experiments – the jury is in. Some kids get diagnosed with “ADHD” because they’re too young for school and would be totally fine if they enrolled a year later. In the Canadian study, it was over 30%. So about a third of kids “grow out” of “ADHD” with no “treatment” within a year. What would the figures be for two, three, or five years?
Perhaps this explains why we see short-term improvements in behavior with stimulants but no long-term effect? We’re essentially “treating” varied speeds of development as if it were a disease, instead of recognizing the obvious truth that kids develop at different rates, and some skills may develop earlier or later than the “sacred norm” without being in any way indicative of any kind of problem. Some kids learn to talk at 10 months, others at 20, and they still manage to develop into “normal” adults. Why wouldn’t the same apply to “attentional skills?”
— Steve
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The chemical structure of Ritalin is similar to both amphetamines and cocaine, so your description doesn’t surprise me.
The idea that “if you have ‘ADHD’ the pills don’t get you high” is ludicrous on so many levels! First off, how would you ever determine that when we have no actual way of figuring out who “has ADHD” and who doesn’t. And it’s long been proven (since the late 1970s) that kids not diagnosed with “ADHD” react just the same to stimulants as those who are. Bottom line, the whole idea is based on getting someone marginally high without getting them to be obviously impaired. The “high” of amphetamines at lower dosages is very much what the schools want kids on stimulants to display – narrowed focus, willingness to engage in what would normally be boring activities, lowered need for outside stimulation, reduced socialization. And kids taking stimulants at prescribed dosages also show the same signs of people taking high doses of amphetamines: increased agitation, increased aggression, anxiety/paranoia, and psychotic symptoms. How anyone can pretend that there is a distinction at this late date is beyond me.
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And if exposing kids to second hand smoke is bad for them, how about bathing their brains in excess dopamine through ADHD drugs for years? Think that might have some long-term adverse effects?
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It will not be “spun,” it will be ignored or suppressed, because it doesn’t fit the narrative they want to see published. If it’s brought up, it will be downplayed as a one-off situation and those citing it will be accused of cherry picking anecdotal data to make a point. The fact that this accusation would be remarkably hypocritical will be lost on most people. But unless you live in Germany or a German-speaking country, it’s unlikely you’ll even hear about this in the mainstream press.
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The link is back up. I don’t know if the article has been changed.
— Steve
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What about the third reason? Namely, that antidepressants have not been shown to be effective in children!
— Steve
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I’ve actually heard a seemingly rational psychiatrist argue with me that trauma doesn’t cause PTSD, because not everyone reacts that way, so SOMETHING must be different (implied meaning: WRONG) with a person who develops PTSD symptoms. I was pretty stunned that a seemingly rational person would try to make that argument. I pointed out that, while their reaction might be different, they wouldn’t have had any reaction if there were no trauma, hence, I saw the trauma as the major causative factor, even if different people reacted differently to the trauma. Not much progress was made.
Commitment to medical explanations is very much like a religion. Speaking against it is heresy, no matter how much sense you’re making or how little they are making.
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Here is the article:
http://bjp.rcpsych.org/content/200/2/89
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Note that I said “many” and not “all.” In my view (and I’ve been a therapist for many years), it’s not the therapist’s job to decide for the client what the meaning of his/her experience is. Forcing the client to adopt a belief that his parents are the cause of his distress is probably just as damaging as telling him that it isn’t and that it’s all in his brain. It is for the PATENT to discover the meaning of his/her symptoms and experiences, not the clinician.
That being said, it is VERY common for kids to idealize their parents and not be willing to look at the possible dysfunction that may exist in the home. This person is just one of many examples I could cite. I recall a girl I worked with (16 years old) who said she’d never thought she was abused, even though her dad beat her black and blue on a regular basis. She just thought that was how parents raised kids.
It is also common for parents to want to believe they did a great job and to not want to hear about whatever shortcomings may exist in even the best of homes. Kids learn very early that calling out mom for yelling or dad for being drunk at the dinner table is not tolerated, and they learn to keep their observations to themselves. To suggest that this kind of message does no damage is very wrong.
There are certainly adults who have “mental illness” problems as defined by the DSM who did not have troubled childhoods. We live in a difficult society, and there are many stressors and expectations that may be difficult to address, even for people who had basically supportive upbringings. However, the association of childhood trauma with adult mental health issues is FAR greater than the most optimistic estimate of the genetic contribution.
The following article provides some perspective on how biased the field has been AGAINST viewing childhood trauma having anything at all to do with adult mental/emotional distress, despite massive evidence that it does. It is that bias that I am trying to address. Going to a bias that ALL “mental illness” is caused by childhood mistreatment would be a very large leap from what I am suggesting.
Hope that clarifies things!
—- Steve
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Knowing Rachel, I don’t think I can agree that she is any more “under the sway of the medical model than most of us posting here.” That being said, the point is very well taken. “Medication” is clearly a euphemistic term adopted to avoid the obvious similarity (and in some cases, absolute identity) of psychiatric drugs to street drugs. I try to use the term “drugs” unless I am specifically talking to an audience where doing so will in some way impede my bigger message. Language does make a difference – it is a way of exerting power, and reframing the conversation away from euphamistic avoidance of the reality of these drugs is an important part of our message, I think.
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Oh, yeah, all those quacks selling vitamins are SOOOO dangerous! They are bilking people out of money for treatments that don’t work, unlike us psychiatrists, who… um… uh, oh…
==== Steve
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My comment to anyone who says that is very simple:
If they were taking all these drugs to help with their “mental illness,” why did they still go off the deep end and do these crazy things? At the very least, we have strong evidence that for at least some people, these drugs do not prevent them from being violent. If they were working, something like this would not occur.
If they can’t accept that, it’s hard to think what else could be said. Unfortunately, your daughter, like all of us, has been exposed to massive propaganda and she appears to simply be spouting what she’s heard. I know it must be hard to hear one’s own child coughing up this nonsense, but it’s hard to avoid.
The other approach is to suggest the possibility that the drugs may work for a large proportion of the population, but suggest that WHAT IF a very small proportion have a very bad reaction? It doesn’t require a “conspiracy” for this to occur – you can use Viiox as an example of a drug that helped a lot of people with pain but also killed a significant number of people. Point out there are always tradeoffs between positive and negative effects of drugs, and you’re not calling to ban them but to be honest about these rare but very serious side effects.
As I said above, I have never seen a clearer example of a case where this could have easily been prevented if the doctor would just have listened and said, “Oh, wow, that’s NOT what these drugs are supposed to do! We’re going to take you off them, but meanwhile, you are not to fly, and I’ll be happy to write you a note so your bosses will not get you in trouble.”
The psychiatrist is very much culpable in this scenario!
—- Steve
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I agree. I’d use the school system as an analogy. There were good teachers in the system as well as evil ones. I loved my fourth grade teacher (Miss Zeller) and would have happily been adopted by her! But she worked in a system that required her and the other teachers to act in ways that allowed and supported oppression, even if they as individuals did not choose to act that way. I recall being in first grade when Miss White (also an incredibly kind and warm person!) asked a poor youngster to read a book aloud. He sat there looking at the carpet, his face turning red, saying nothing for at least a half a minute, while I said to myself, “Move on, move ON!” I felt so bad for that kid, I remember it to this day. But Miss White wasn’t being intentionally cruel – she was just implementing the system as required, and having your kids read aloud is part of that system. I’m not sure she would have had the authority to say, “You know what, I find this reading aloud is traumatizing to some kids. From now on, only kids who volunteer will be reading aloud.” She’d have experienced danger to her professional career if she’d done that.
So the system sustains itself, and even those within the system appear powerless to change it for more than an instant. I did involuntary detention evaluations for 9 months, and I helped a lot of folks in the ER get some on-the-spot quality therapy and freed a lot of people who would otherwise have been detained against their wills. They were VERY lucky they got me to do their evaluations. And yet, I had to quit the job, because I knew from the first week that I was supporting an unhealthy system that forced people to do “treatment” that often didn’t help at all and sometimes made things dramatically worse. I felt I was colluding by even participating, and could not ethically continue the job, especially after I saw what happened to the few people I felt compelled to detain for their own safety when they made it to the psych ward.
Being a good person in an evil system can’t change the evil that is intended and performed on the larger scale. While you might be a breath of fresh air to someone who is otherwise starved for a real human connection, it doesn’t change the fact that the bulk of the time, these folks do not have that kind of experience and you are not in a place to make that different without a wholesale re-thinking of the system from top to bottom.
—- Steve
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I have to say, I called this one as soon as I heard the details of how it went down. This is one of the clearest cases of antidepressant-induced violence I’ve every seen. I’m glad it’s getting a lot of press in Germany, but folks over here need to read this stuff, too.
— Steve
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One fascinating aspect of this story is the revelation that this person’s “normal, healthy upbringing,” which he himself believed in, was a myth created to cover up some very ugly family dynamics. It is an excellent example of the fact that many people can have very stressful childhoods and not actually realize this was the case, as they generally accept the family narrative and consider the behavior they had to tolerate from their parents or siblings as “normal,” not knowing that any other alternatives exist.
Additionally, it demonstrates how easy the current paradigm and diagnostic system makes it to ignore such causal factors or even collude with abusive/neglectful parents in blaming the child or young adult for developing “symptoms” which are actually indicative of unhealthy family dynamics. In our large scale social enthusiasm to “not blame the parents” when kids don’t fare well, we’ve forgotten that parents are very frequently primary contributors to the eventual “mental health problems” of their offspring. By ignoring the likelihood of traumatic childhood experiences, which we have now learned are widespread and very common in our society, we place the blame on the child for not adapting to the unreasonable expectations that their family and/or society place on their shoulders at an inappropriately young age.
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It is particularly ironic for psychiatry, the ultimate in privileged, power-based authoritarianism, claiming “stigma” against their profession! They, who are such purveyors of the very stigma that causes their own patients to revolt, they, who are the most arbitrary wielders of State power and authority with the least accountability, they, members of the most privileged class of society (doctors) and reaping all the advantages thereof, they are somehow victims of prejudice! It is as bizarre as the domestic abuser stating that his partner/victim is out of line for criticizing his abusive behavior and wanting to leave as a result.
If psychiatry is an unpopular profession, the answer isn’t a slick PR campaign. In fact, psychiatry is BASED on a slick PR campaign and that’s why it is in disrepute! The answer, if there is one, would be a humble self-examination, combined with a seeking of feedback from those damaged by their supposedly helpful practices. If over half of the people protesting your services are those who received them, I think you’ve got more than a PR problem, folks!
— Steve
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Thanks for sharing your story and making some very important points. I find it arrogant for anyone who hasn’t gone through the experience to speak for those who have, and even those who have can’t assume that their experience is the same as others who had similar experiences. One huge problem with calling voice hearing a “disorder” named “schizophrenia” or whatever else it’s called is that it assumes that all people lumped into this category are the same (in addition to assuming without evidence that they are “disordered, as you point out), and that leads to all sorts of false assumptions and conclusions and in the end is harmful to the very people the labelers are ostensibly trying to help out.
If you really want to help another person, start by listening to them, because they’re the only one who really knows what’s going on!
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I participated in a model Open Dialog session. It appears to mostly involve gathering the people a client feels connected to in a room, and discussing the issues and possible solutions as a group. The most interesting part is that there are two therapists involved, and the two of them talk to each other about what they’re thinking and wondering right in front of the group! A major contrast to the obfuscating language and secret notes and meetings that characterize “treatment planning” in most mental health settings. There is a big emphasis on being comfortable with the unknown and letting each person have their own experience respected and validated. There is also an emphasis on reconnecting the support network emotionally and communicationally, and it is believed that this process if engaging in dialog with the supportive community around the person is key to reducing or even eliminating “psychosis” by creating a common, shared reality among the participants, including the idea that all participants, even the therapists, are learning as they go and are as vulnerable and as human as the identified “patient.”
I hope that helps a little. I’m no expert, but that was my experience of the process.
—- Steve
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I agree, that is the one comment that really bothered me, though I want to thank Sandy for having the courage to speak up about this issue despite no doubt receiving a lot of flak about it. It is important to characterize these diagnoses as subjective and to a large extent arbitrary collections of people who for myriad reasons have some kind of similarity of “symptoms.” I even object to the word “symptom,” as it implies some kind of medical malfunction, while many who are diagnoses literally have nothing wrong with them at all and are simply displaying the emotional effects of abuse, stress, and an unsupportive cultural environment.
Of course, this idea doesn’t sell well, and maybe Sandy’s ability to get her message across would be limited if she started using words like “fraud” and “deception.” But I do think it’s important to get that on the table – these “diagnoses” aren’t lacking refinement, they’re lacking VALIDITY, and even Dr. Insel has admitted the same.
—- Steve
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I am disappointed at the unsupportive tone of some of the comments on this thread. Language absolutely does matter, and if I’d become accidentally dependent on a drug that a doctor prescribed to me with assurance that it was safe and with no warning about addictive properties of the drug, I’d be totally pissed if people lumped me in with someone who decided that using street drugs was a good way to manage their emotions or physical pain or to have some fun or whatever. The two are certainly very different. And while I agree that the “addiction language” that has become accepted in our culture has some rather disempowering aspects that should be changed, it doesn’t alter the fact that a doctor lying to you about the drugs you’re prescribed is a very different process than knowingly engaging in taking a drug that you already know to be dangerous and/or addictive. I don’t think it should be too hard to make that distinction, and am having a hard time understanding why some posters seem to be unwilling to acknowledge that very simple error in grouping that I think would very naturally lead members of the iatrogenic group to be massively pissed off.
The real lesson of all this is to not trust your doctors’ assurance that anything is safe. I learned this early in my life when a doctor almost killed my dad. I don’t take anything I haven’t researched, and most of the time when I research it, it leads me not to take it anyway. Unless death is the alternative, I avoid drugs like the plague, as they are one of the biggest causes of death in the USA, even when taken as prescribed. It’s caveat emptor in the medical world!
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He seems to be classified as an addict, but he took this stuff as a sleep aid, and the doctors did not tell him it was addictive, according to his own words. Why is that not the focus of this story? And their use of new diagnoses and “treatments” instead of recognizing that he was fine before he started on this addictive substance is very typical and disheartening behavior from the system.
Is there some way to get someone to cover this story from the angle of a guy who was misled and effectively killed by his “medical treatment?”
— Steve
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It would not surprise me if longer durations of therapy are also harmful.
Your comments appear to skirt the question of whether you’re familiar with Wunderlink and so on and how you think that affects the decision to use drug treatment in the long run. There is a new but increasing trend toward delaying initial drug treatment in favor of psychosocial options, and then adding medication temporarily and in as low a dose as possible, based on these findings. I’m interested to hear your take on this new thinking, which I personally find is much more consistent with the literature findings than the classic, “You need to take these for the rest of your life” model.
— Steve
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Quite so. If the child’s brain is to blame, then the parents are off the hook, the teachers are off the hook, the psychiatrist is off the hook, even the child is off the hook, and only “the disease” remains to be blamed. This may be reassuring in the short run, but in essence says that no one can do anything to change the situation, which is the ultimate in disempowerment. We wring our hands and try drugs, and if they don’t work, the psychiatrists wring their hands with us and bemoan “the progress of the disease” instead of admitting they don’t know what the heck to do other than give the kid more drugs.
I’ve talked to lots of foster kids coming out of the system to adulthood about this issue, and they generally find it insulting. “You mean to tell me that despite the abuse and neglect I experienced and the involuntary placement with people I don’t know and separation from my family, friends, neighborhood, teachers, and apparently random moves to yet other foster homes over many years, that I’m supposed to be CALM and HAPPY about all this, and if I’m depressed or angry or anxious or hopeless, it’s because my BRAIN is broken?!!” It is hard to convey the contempt in which most of them hold the “mental health system” and especially attempts to medicate them into compliance or emotional neutrality.
When you see what else can be done, and how totally empowering it is when parents are able to start to face the demons of their own upbringing and/or learn some new skills that WORK, it is simply shocking that the psychiatric community continues to get away with the fraud they are perpetrating on the public.
Thanks for your writing and your reply!
—– Steve
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I think it’s also important to note that much of “bad parenting” comes from cultural influences and expectations, many of which came from the field of medicine or even directly from psychiatry itself. Remember how worried we were all supposed to be about picking up our babies for fear of “spoiling” them? Whose idea was that, I wonder? What about the widespread and systematic suppression of nursing in favor of formula feeding in the 50s and early 60s? Directly from the medical profession. Feeding schedules, advice NOT to read to your kids when they were young, advice that parents should never disagree in front of their kids but should always present a “united front” – all of these pieces of culturally accepted advice came from medicine and from psychiatry/psychology.
Parents can try their hardest and still not do what their kids need, sometimes because they have had bad information or advice, or have never had positive parenting modeled for them. Rather than blaming, the process of identifying these issues EMPOWERS parents to re-learn the wrong information and poor modeling they received and to become the kind of parents they want to be for their own kids. Denying that “good enough” parenting is an absolute requirement for adult mental health is about as smart as suggesting that eating poor quality food doesn’t affect a child’s growth and development. It’s a straw man put up by NAMI and the psychiatric profession to justify the medical model. The “don’t blame the parents” argument doesn’t serve parents OR kids well at all.
—- Steve
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I love it – “I’m here from PAW – Pills Against [your] Wills!] They could have a big puppy holding out a little white paper cup with a couple of Abilify inside.
I agree with you, I don’t see how psychiatrists as a group aren’t ashamed and embarrassed by their apparent complete lack of ability to deal with the problems they are supposed to handle. Perhaps the problem is that most of the “compassionate, knowledgeable, and curious psychiatrists” quit the profession early on and choose to engage in a more ethically clean and effective profession, leaving mostly the hyperauthoritarian, the slow-witted and the sociopathic to ultimately get their degrees.
Sorry if that’s insulting to the handful of ethical psychiatrists out there. I really appreciate you folks fighting the good fight, but you shouldn’t have to fight so hard for the obvious!
—- Steve
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A more radical view of recovery would be something like, “Learning to deal with the shit that’s been and continues to be heaped on me by this insane society I have to live in.” “Recovery” is almost always from the effects of oppression and mistreatment, not some mystical “mental health disorder.” I suppose we also have to “recover” from our own overwhelmed initial or habitual reactions to said oppression, but the mental health world’s view of “recovery” is “no one is to blame,” which is accurately translated into, “It’s your problem, not ours, you figure it out, except that you have to keep taking our drugs.”
More specifically, “recovery” in the mainstream is often defined as “having your symptoms under control so you can live a somewhat more normal life instead of being in the hospital and bugging everyone so often.” In other words, staying on your meds and staying out of trouble. To recover WITHOUT the mental health system, or DESPITE the mental health system, or FROM the mental health system itself is all inconceivable to most of the insiders.
“Recovery” has become a loaded term, and we need a new one, one that doesn’t allow cooptation by the very system of oppression that almost always contributed massively to the “mental health symptoms” arising in the first place. “Recovery” without presenting the context of systematic societal oppression is more disempowering than the system just being honest and saying, “We want to control you so you won’t waste our time and resources and annoy those of us enjoying our privileged status.” At least that’s something you can wrap your head around and fight against if need be.
—- Steve
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Well said. I’d also add that improvements in “academic performance” have not been consistently noted, even in the short run, and when they have showed up, they are very mild and transient. Long-term research has never revealed any consistent improvement in academic performance for medicated vs. non-medicated kids with “ADHD” diagnosis. So his resort to “improvements in academic performance” is either ignorant or disingenuous, or both.
If you combine the lack of long-term outcome improvements with stimulants and the data from this latest research, it becomes very clear that the BEST that stimulants can ever be is an adjunct “treatment” for the short term, and that it is psychosocial intervention that actually change the long-term outcomes for these kids. Of course, it’s somewhat questionable to even call it a “treatment,” when what it’s “treating” is not something wrong with a child, but behavior that adults find annoying or difficult to manage.
—- Steve
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Seriously. Don’t know why that argument is considered radical in any way – if something doesn’t work, why are we spending money on it?
I remember one woman who was voluntarily signing herself into the psych ward for suicidal feelings, who told me, “For the cost of this, they could probably put me up for a few weeks in a nice hotel on a beach in Hawaii. And it would probably be at least as helpful.”
— Steve
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I would suggest you start by reading Anatomy of an Epidemic, by Robert Whitaker, who does an excellent job of summarizing this research over many years.
Key research: the two WHO studies in the 1990s showing that people diagnosed with psychotic disorders in developing countries like Columbia and Nigeria have much better FUNCTIONAL outcomes (relating to employment, relationships, community involvement, etc.) than those in Western countries where medication use is much more common.
https://schizophreniabulletin.oxfordjournals.org/content/34/2/253.long
The Harrow Study, showing that even those with a better prognosis in the beginning did worse on medication over the long term than those who had a worse prognosis but did not use medication over the long term.
http://www.ncbi.nlm.nih.gov/pubmed/22340278
The Wunderlink Study, showing again that those taking less medication at lower doses for shorter periods of time did better in the long run:
http://www.ncbi.nlm.nih.gov/pubmed/23824214
Thanks for being interested. I hope those help get you started. It’s all very counterintuitive from the short-term symptom management viewpoint, but I find the research compelling and replicable at this point, and I see no credible replicated research that contradicts it.
— Steve
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I like to say, “The Hand of Providence will at times reach down and gently guide you in the direction your path leads… and if you resist… the Foot of Providence will come around and kick you hard in the behind over and over again until you relent!”
Best to let the Hand guide us. It’s a lot less painful than the Foot!
Always love your deep insights!
— Steve
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CBT’s effectiveness is very much dependent on the practitioner. I always considered it a tool rather than a therapy modality. I think the problem happens when CBT is disconnected from compassion and listening and being guided by the needs of your client. CBT can be very useful in the right context for the right person, but can be harmful if applied to all people in an emotionally disconnected way. It is most dangerous in the hands of a person who has not done his/her own internal work, because it provides a great way for the clinician to avoid his/her own personal discomfort by “making” the client change his/her thinking, and rejecting/punishing the client who won’t/can’t do as they are told.
Thanks for the link!
—- Steve
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And his reaction was of course regarded as more “symptoms,” because any sane person would simply accept the bizarre environment of locked wards, beds with leather restraints, cameras everywhere, and nurses and doctors writing notes about you that you can’t read in a private room you can’t access.
The final nail in the coffin of my inability to work within the system for reform was my first visit to a psych ward. I’d rather have spent time in jail than there – at least in jail, they’re being honest about what they’re up to. I can’t see how anything remotely related to healing could have happened in that place!
—- Steve
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Pelham was one of the lead investigators in the MTA study, and was gracious enough to acknowledge that the long-term data did not support the initial contention of stimulants providing benefits over behavioral treatment or no treatment. He was, not surprisingly, castigated by many in the mental health industry for his courage in putting science above personal benefits. It’s good to see him doing this work. I applied very similar approaches to my very active young children with excellent long-term results. To relegate “medication” to a secondary role would be a very big help to a lot of kids, second only to providing alternative open-classroom environments making the diagnosis primarily irrelevant and unnecessary.
— Steve
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Well said. It is a strange irony that being aware of what is going on, while extremely painful at times, appears also to be the only pathway to transcend them. But by definition, anyone having that awareness and acting on it is going to be on the margins, as the status quo is defined by oppression from top to bottom. So you can be “inside” and live with the security of the herd, but never really know you’re being herded, or be “outside,” and make the herders very, very nervous. I, for one, prefer the second choice. And really don’t have any choice to go back at this point, as once we have “seen behind the curtain,” it’s not really possible to believe in the Wizard of Oz any longer.
—- Steve
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I am not talking about short-term remission rates, but about long-term recovery, and I think Whitaker’s summary of the literature, followed by more supportive evidence from Wunderlink and the 20-year followups from Harrow et. al. certainly support that medication interventions have a very disappointing long-term impact on functional recovery.
As for side effects, I’m certainly the last to say that poorly-executed therapy is free of side effects, but if we are talking about antipsychotics, we are now seeing lifespans 25 years less than the average population. Of course, some of that is attributable to life choices of those so treated, including suicide, substance abuse, and very high smoking rates. On the other hand, users of antipsychotics describe the use of cigarettes as a way to minimize the side effects of the drugs, which makes logical sense, given the dopamine effects of nicotine opposing those of the antipsychotics.
But regardless of that, it is clear that not all of the lifespan reduction is due to poor lifestyle choices. We know that antipsychotics can mess badly with metabolism, inducing large weight gain and diabetes, as well as heart problems. It should be obvious that some of the lifespan reduction is due to antipsychotic drugs, as neither smoking nor substance abuse per se are associated with that kind of reduction in life span expectation. As bad as formulaic application of CBT can be, it is unlikely to kill the subject except by driving them to suicide, which is not something I have heard occurs very frequently. Correct me if you have data to the contrary.
I completely agree with you about not being ideological, and that CBT or any other therapy can be damaging. I just think you are looking only at short-term data for your evaluation of the effectiveness of drug therapy, and that misses perhaps more than half the picture, as most people are more interested in quality of life than in immediate symptom reduction per se (quality of life would be a desired RESULT of symptom reduction in most people’s minds – being miserable with fewer symptoms is not an outcome most would desire). One need only look at the much higher recovery rates in the developing world, per the two WHO studies in the 90s, to sense that we may have a lot to learn about what really facilitates recovery. Simply saying that CBT is no better than psychotropics begs that more important question.
—- Steve
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Sadly, the evidence base for antidepressants is just as weak or weaker than the evidence for CBT that you properly critique. Most people who “successfully” use antidepressants improved an average of something like 3-5 points on the BDI, leaving them “moderately sick,” as you so aptly put it.
So the real question is, what else can be done? It does not appear that either of these interventions are particularly helpful, although it seems that at least the side effect profile for CBT is less severe.
—- Steve
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Because it is not allowable to feel or especially express rage against systematic social abuse. You’re supposed to grin and bear it, and any signs of getting “uppity” are punished with further discrimination and violence. I think this is one reason many more women are labeled with “mental disorders” than men – they are not supposed to acknowledge any kind of oppression they are experiencing, and are expected to be happy with second-class citizen status. Being depressed, anxious, hopeless, or most horribly, ANGRY about it is simply too frightening to those in charge to be allowed. So instead, your anger or depression or anxiety is redefined as the problem, and our authoritarian system will “make it go away” for you, but only if you do exactly as we tell you. And if our approach doesn’t “make it go away,” well, it’s not OUR fault, it’s the DISEASE!
Quite the effective tool of oppression!
—- Steve
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Maybe “TAU” should be renamed “Torture As Usual.”
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Yeah, seriously, if you weren’t depressed before you got the “psychiatric explanation,” you should would be afterwords!
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Yeah, kind of a no-brainer, isn’t it? “Which would you prefer, to be treated as a malfunctioning ‘unit’ that needs to be tinkered with and ‘fixed’ by ‘professionals’, or to have someone provide support for things that weigh on you and cause you stress?” I wonder what percentage of people would select the first option?
— Steve
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Richard, great letter! The one thing I’d add is that not only have recovery rates for
“mental illness” not improved, as Bob Whitaker has shown, they have gotten dramatically WORSE as the age of medical intervention has taken over from our earlier focus on communication and experience as the primary interventions, including even shorter and shorter average lifespans for “patients” in the system. If this happened in the field of cancer or heart disease, there would be a huge outcry, but for some reason, worsening outcomes (including early death) among the “mentally ill” disturbs no one particularly much. I think it’s a point worth emphasizing.
—- Steve
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Interesting that you find the evidence for peer support for bipolar and schizophrenia to have no positive effects. I’m wondering if you are familiar with the emerging research demonstrating that long-term treatment with medication appears to have a detrimental effect on those outcomes you mention?
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These data don’t reflect only “greater improvement,” they reflect dramatically greater improvement, particularly in “hopelessness” (41% vs. 3%), better by a factor of 14! I’m kind of surprised (though perhaps I should not be) that their conclusions are so muted given the results. If any actual MEDICAL intervention showed a 14x greater chance of significant improvement over TAU, it would most likely be immediately proposed as the new standard of care. Yet this is published in some journal and will be forgotten within days or never read by most psychiatrists. This should be BIG NEWS!
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Fascinating, isn’t it? No matter what evidence is presented that trauma is a primary causal factor in essentially every “mental disorder” they have identified, they seem to be religiously committed to bringing it back to brain chemicals. It seems very intuitive to think that racism drives people mad, and very counterintuitive to think that only people with “bad brains” are susceptible to be driven mad by systematic racism. And yet…
Do they think they’re being more “scientific” by talking about brains? Or are they just so completely immersed in their worldview that they are incapable of stepping outside their comfortable paradigm of thought?
—- Steve
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Nice smackdown, Vivek. It continues to amaze how strong the “confirmation bias” is in those who really, really want to believe it’s all in your brain chemicals, despite the almost total lack of evidence supporting that theory. They just haven’t identified the right chemicals yet, if only we keep researching… More like a faith community than a group of scientists.
Very much appreciate your objective assessment of the literature and your willingness to call out the deceptive marketing practices of those who don’t always want to face the real truth about their practice of medicine.
—- Steve
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I never cease to be astounded how easily the medical profession (and I’m not just talking psychiatry here) completely ignores extremely significant scientific discoveries when their financial/professional interests are challenged. This study should be reason for a complete rethinking of the medication/brain disease paradigm. It offers a free and empowering alternative that can make patients independently able to address their own distress without having to report in to the psychiatrist for prescriptions. How would this not be huge news? Unless, of course, you WANT your patients to be disempowered, dependent, and to have to report in for prescriptions for the rest of their lives…
—- Steve
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Another psychiatric success story!
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Death has been proven to eliminate every single mental health problem every identified. How about “death therapy” for all. “It’s a sure cure, Bob,” for those who have seen the movie, “What About Bob?” for those who haven’t, you really, really should watch it!
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Tepid recommendations when looking at the actual conclusions of the data! What it SHOULD say is “Antidepressants should only be used as second line treatment when acupuncture, yoga, exercise, St. John’s wort, and individual therapy have been attempted without success. Antidepressants have no more effect than any of the above, and yet have a much more serious side effect profile, so the risk/benefit analysis speaks strongly against antidepressants unless other less risky efforts have proven fruitless.”
And that’s not even getting into the question of why we’d expect “depression,” which could result from a wide range of causes, to always respond to one particular approach.
—- Steve
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“Swine complain when threatened to have snoots removed from trough!”
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Joel appears to have his mind made up and seems to want to criticize anyone who disagrees with him. To say that nothing of substance has ever been posted here is ridiculous in the extreme, and of course, he is disingenuous in claiming that Whitaker or most people here are categorically opposed to the use of psych drugs in any and all circumstances.
It is interesting that he “defies” us to come up with alternative approaches for the theoretical depressed person who can’t function, when there are dozens of alternative approaches that he, as a bio-psycho-social psychiatrist, should be very familiar with. So while on the one hand claiming that people here are rigid and don’t understand flexible and supportive psychiatrists like himself, on the other, he suggests that medication is the only solution for a person disabled by depression.
As for his dismissive wave at the questionable validity of DSM diagnosis, many of his own colleagues appear to disagree with him. To not even consider the importance of the validity argument doesn’t show much in terms of openness and flexibility.
Joel provides no substantive arguments to validate his points, and is probably not worthy of responding to unless he changes his style, which I find unlikely.
—- Steve
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Noel, I have to say, that was impressive! Your grasp of both the issues and the research is obvious, and your writing style allows the lay reader to understand the research without being bogged down in technicalities. And you make SO much sense! Thanks for sharing this – I hope it can be published elsewhere as well, as it is a remarkable review of the data as well as an overdue critique of the media habit of trumpeting almost trivial results as if they were earth-shattering.
Well done!
—- Steve
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Minimization I am sure is a symptom of some mental disorder or another. I think these docs have personality disorders. They’re always willing to make apologies for the drug. Does is not concern them that 90% of the youthful antidepressant users received NO benefit from using them, while increasing their risk of suicidal thoughts and aggression? And saying, “Well, they had increases in suicidal thoughts, but no one ACTUALLY COMMITTED suicide” is hardly reassuring, but apparently makes them feel better about continuing to prescribe these essentially useless drugs to kids.
—- Steve
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That is a trend I have noticed before. I found out that Time and other newsweeklies have a European edition, in which they talk about world politics and economics and important issues of the day, and an American edition, where they’re more likely to talk about Hollywood or the President’s vacation and “lite” news items that won’t upset anyone. Whether this is marketing to the sensitivities of US readers or an attempt to keep us in the dark, I can’t really say, but it is beyond question that the USA gets sanitized news that the rest of the world would find trivial and banal.
—- Steve
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You speak wisely. Psychiatry has thrived here partly because of our unwillingness to allow that our culture is flawed and damaging to its members in many small and large ways. It’s much easier for those in power to blame the victims of an unfair or oppressive system rather than trying to listen and change it, and unfortunately, psychiatry’s need for power and funding plays right into the hands of those inclined to that kind of thinking.
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I agree. Another great example is “continuous fetal monitoring” of women in labor. It ties a person to the bed, usually means having to lie on their backs, and creates anxiety when the baby moves and suddenly the monitor flatlines and there’s no one there to intervene or interpret. This became 100% standard practice back in the ’80s, the idea being that this heart rate monitoring would lead to improved outcomes. But it was already known that these devices did not provide any better outcomes than intermittent checks with a fetoscope or stethoscope! They did, however, change one outcome – they dramatically increased the rate of Caesarian section. And yet they became standard practice, and may yet be today.
Tests are fine when there is an identified problem that needs to be further analyzed, but universal screening tests often have unintended consequences for the patient. I suppose in this case, they also have intended consequences for the industry, aka more patients, but the health and welfare of the patients themselves appear to be a secondary consideration, if they’re even a consideration at all.
—- Steve
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I love that! Screen for happiness and reinforce it! What a paradigm shift THAT would be!
We could also screen for righteous indignation over real wrongs that exist in the world. We could validate the indignation instead of finding it a “disease state.” We could make the person RIGHT for feeling angry at injustice and cruelty. How would that impact our “mental health” system?
—- Steve
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That is, indeed, a conclusion that “rethinking” could lead to. A thought like, “Why the hell are we doing this and pretending it helps?”
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Right, ’cause everyone is SUPPOSED to be thrilled and happy 24-7 about their new baby, and if you’re not, well, have we got a drug for you! It’d be more honest if they prescribed vodka tonics three times a day. But, of course, there’s no way to patent a vodka tonic, so we have to go more esoteric to make the big bucks.
—- Steve
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Impressed that Dr. Paul is actually looking at this scientifically. I have to say, if I were a parent (even not knowing what I know) seeing a 1 in 10 chance that my kid might feel better vs. a 1 in 33 chance they may turn aggressive and a 1 in 50 chance they became suicidal, I’d probably look for other options.
All in all, I’d say a person would be better off smoking three joints a day or taking controlled doses of alcohol than experimenting on their brains with SSRIs.
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Thanks, Harriet! People are people and should not be characterized by their associations – that’s part of what we’re fighting, isn’t it, classifying all people who act/feel/think a certain way as being “the same?”
As I like to say, “Generalizations are ALWAYS wrong!”
— Steve
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I was thinking of a first baby, but of course, sibling rivalry and confusion and attendant behavioral issues are very common responses to a new baby, which often leads to feeling even more overwhelmed. My mom had three of us under three, and four under 5. I’m amazed she didn’t beat one or more of us to death, or slit her wrists!
Not only does telling a mom she is “disordered” for having these reactions not helpful, it my experience, it is the exact OPPOSITE of what should be done, and does overt and lasting harm. The mom is already feeling inadequate and overwhelmed. Now you tell her that her brain isn’t working right because she should be happy and shiny about all of these wonderful changes? I think if a psychiatrist had told even me that after our first, very challenging child was born, I’d have wanted to knock his teeth in. I can only imagine how invalidative that would be to a new mom!
—- Steve
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Good reasons to be depressed postpartum:
1) Sleep deprivation
2) Complete change of daily routines and expectations to accommodate new, helpless infant
3) Breastfeeding problems
4) Shift of focus from pregnant mom to new baby
5) Difficulties with body image resulting from pregnancy/birth changes, which are often not entirely reversible
6) Loss of income
7) Loss of connections with fellow employees
8) Loss of sense of purpose provided by work environment
9) Changes in relationships with friends who don’t have a baby
10) Birth brings up own childhood issues
11) Mythological social expectations fail to meet with reality of new baby
12) Sex life essentially non-existent
13) Potential contact with abusive/disrespectful family members
14) Domestic abuse frequently starts or escalates during or after pregnancy
15) Increasing sense of dependence or “trapped” feeling
16) Challenges of dealing with unwanted pregnancy
17) Baby presents medical challenges or other difficulties that violate expectations and prevent good bonding
I could go on. Feel free to add to the list.
Note that not one of the above even mentions the mother’s physiology or hormone changes, which of course can contribute in other ways, such as malnutrition or low blood sugar due to dieting to regain pre-pregnancy weight, or low iron resulting from difficulties with appetite during pregnancy. Being a new mom in today’s society is extremely difficult and often isolating, and also leaves new moms vulnerable to abuse or mistreatment by family members, including their spouse in too many cases. To suggest that “PPD” is some kind of a biological disorder of the brain in all or even most cases is laughable in the extreme. This is especially highlighted when we look at cross-cultural studies, which show that there are some cultures where PPD essentially never occurs.
While it is always worthwhile to explore physiological factors like diet, sleep, and illness, the vast majority of depression following birth is an entirely normal response to a rather abnormal society’s lack of support for new motherhood. Normalizing feelings and helping the mom identify the reasons and some actions she can take to get more in control of her new life situation is much more effective than trying to dismiss these feelings as a “mental disorder” and drug the sufferer into numbness and increased disconnection from her emotions.
—- Steve
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Autism and birth defect rates increase for certain.
— Steve
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If only they would listen to what I tell them!
I once stated in a room full of mental health and social work professionals talking about protocols for medication oversight that “there is no indication for antidepressants in kids under 5.” Nobody said a word! I said it again. No response, as if I had not spoken. Talk about denial! If anyone had had a counterargument, they would have said it, but no one said a word. Everyone knows they don’t work in kids, and yet they are unwilling to simply say, “Don’t prescribe them to kids!” It’s sick.
But I will make note of what you said and will keep pointing to the elephant in the room, even if they continue to turn their eyes another direction.
— Steve
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Wonderful to see employment practices linked to mental and emotional suffering! It is way past time we started recognizing that our society itself is a crazy-making environment and that we need to take some action to address the constant low-level anxiety and hopelessness that pervades many of the well-integrated members of our society. Those on disability are the “canaries in the coal mine” that should warn us that we are on the wrong track!
—- Steve
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Right you are. This phenomenon is “unique to the US” because we are uniquely brutal and relentless in pushing these drugs on people whether they need/want them or not. It is typical of oppressive forced to blame someone less powerful for their failures, but an honest assessment would tell anyone who really cared that a huge negative response from your clientele is a message that YOU need to do something different!
—- Steve
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Any real scientist would not need this article. There is no such thing as a “negative result” to a real scientist. There are only results and their implications. A “negative result” implies that the researcher had a desired outcome, rather than objectively seeking the truth. Of course, we all know that such researchers are the norm today, and that most have substantial financial and professional conflicts of interest, but it’s time to stop allowing these biased technocrats dominate the language we use and get back to the real scientific method. Real science values “negative results” even MORE than “positive results,” because when a hypothesis is defeated, it gives a degree of certainty, whereas validation of a hypothesis only calls for more research to verify that the result can be replicated. The only absolute truth from science lies in “negative results,” so not publishing them is scientific suicide.
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Go, Bernie! Name one other politician who publicly takes this kind of stand (OK, Elizabeth Warren, but name another). This guy is the real deal!
—- Steve
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Exactly! Not being anxious about anxiety (or any other emotion) appears to be the most important key to overcoming intense anxiety or “attacks.” Unfortunately, the current model perpetuates the opposite framing – anxiety is a problem, is THE problem, and STOPPING anxiety (or depression or paranoia) is the goal, rather than learning to observe the mind’s machinations from a safe distance and identifying the cause and the process by which the anxiety manifests and ultimately resolves.
Psychiatry’s labeling process is not only not helpful, it appears to be the exact opposite of what actually helps people come to terms with difficult emotions!
—- Steve
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As anyone with half a brain, or perhaps half a heart, would know, stigmatization results from grouping people as “different” from the mainstream. That energy of “differentness” comes directly from the mental health industry, which is profiting from convincing everyone that they need “treatment” for the emotional experiences that come with being alive.
A real anti-stigma campaign would not say, “You shouldn’t be prejudiced against these people just because their brains are fucked up.” It should be saying, “There is nothing different about the ‘mentally ill’. These folks are just the same as you. Many of them have had tough lives and have had to fight to survive. Love and care about each other and ‘mental illnesses’ will drift away.” In fact, even identifying “them” as people with “mental illnesses” is still stigmatizing! How about, “All of us suffer from the struggles of life sometimes. Anxiety, depression, anger, and hopelessness are all a normal part of life’s many challenges. Help each other when you see someone else is struggling – tomorrow it may be you who needs their support!”
So much of the “stigma” is caused by the system itself, it just makes me gag every time they develop a new “anti-stigma” campaign that just rubs more salt in the wound. It makes as much sense as saying, “Don’t be prejudiced against Spanish-speakers, even though they aren’t really Americans.” It would be better for them to say nothing than to explain why “mental illness” is just like physical illness, and you shouldn’t be prejudiced against people just because their brains don’t work right.
—- Steve
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You have got the real ad campaign down! Let’s make some videos!
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It is now well known that SSRIs can increase suicide risk, especially for adolescents. I’m glad that Cochrane also mentions increased aggression, which I see frequently in my work with foster children. This problem is almost never mentioned by “opinion leaders” in the field, and kids who become aggressive on SSRIs are very often diagnosed with “bipolar disorder” and put on antipsychotics. This study needs to get some big publicity, as a lot of kids’ lives could be improved and stigmatizing diagnoses avoided if this “side effect” of SSRIs were noted.
Of course, the more important finding is that SSRIs don’t really improve the “depressive symptoms” for youth, and the younger you are, the less effective the SSRIs become. There is really no benefit to offset the risks, and the proper conclusion is that these drugs should never be given to children for any reason. But that message will be obscured, because it is inconvenient to those profiting from the delusion that SSRIs are helpful to kids.
—- Steve
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I agree – it still posits Abilify as something that will instantly and magically end their delusions of running for president. There is no attempt to deal with the real impact Abilify has had on so many lives.
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I used to work at a suicide hotline, and I learned to ask those very questions (or paraphrases of them) very early in any conversation with a person who stated suicidal intent or thoughts. There was almost always a very good reason for the person to feel suicidal, and I found that agreeing that the situation was depressing and felt hopeless led to lots of helpful conversations.
I also learned that almost no one in the mental health field had any training in suicide prevention beyond “ask if they have a plan and if so get them to the hospital.” Our volunteer phone counselors had more training than the average MA counselor in suicide intervention. Most counselors were completely at sea in dealing with any kind of a suicidal person.
Maybe my favorite call ever was from a woman who was depressed about her boyfriend breaking up with her. She went on at some length about how her mom had told her she’d easily find other men, and her girlfriend said he was a jerk and she’d be better off without him, but despite all this, she still felt depressed. They’d broken up four months ago after a four-year courtship. I told her, “Not only do I think it’s totally normal for you to feel depressed right now, if you weren’t at least a LITTLE depressed, I’d think there was something wrong with you.” She said, “Really?” I said, “Yeah.” She said excitedly, “Wow, thanks!” and hung up the phone!
Sometimes giving a person permission to tell their story and validate their reaction to difficult events is all that is needed. Unfortunately, psychiatry and our mental health system these days almost always provides the opposite – disinterest in the story and distress and disempowerment about the reaction.
— Steve
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Not to mention release from the hospital usually occurs right in that 1-3 week range when the most suicides from new antidepressant or antipsychotic prescriptions are most likely to occur.
— Steve
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Not only are the drugs not ameliorating the rise. They are most likely a major contributor.
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There is a distinct difference between blame and responsibility. The first says, “You made this happen because you screwed up!” This is rarely if ever helpful to anyone. But responsibility means, “You have had and continue to have an influence on this situation, and your decisions can make it better or worse. Let’s look at what you can do to make sure your influence is positive.” This presumes no ill intent or foolishness on the part of the parents, and yet acknowledges the reality that parent behavior can and does impact the presence and/or expression of psychosis, and so gives the parents credit for some power to help change the situation. Sure, this may lead to some painful self-examination and acknowledgement of errors made in the past, but if presented in the context that “parenting is hard, kids are complex, and sometimes things don’t turn out the way we expect,” it’s pretty easy to create a safe place to explore what may or may not have gone wrong, and more importantly, what to do TODAY to make the situation easier for everyone.
Avoiding blame is a natural reaction, but avoiding responsibility leads to disempowerment, and that helps exactly no one.
—- Steve
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There are efforts afoot to create alternatives to traditional mental hospitals, like Soteria models or other sanctuary models where people can go to a calm environment with low stress to get re-oriented to consensus reality safely. But such efforts require funding, and the psycho-pharmaceutical complex has a stranglehold on most of the “mental health” dollars. I personally find psych hospitals to be horrible places to heal, but I do agree that safe spaces are critical to helping people like your son to get to a better place. Unfortunately, today’s model involves giving people drugs and trying to make sure they stay on them for life, while the rest of life’s needs are considered of secondary importance, if they are considered at all. This site isn’t really about stopping medication as much as it is about finding better ways to help. I hope you’ll join us and give us your perspectives going forward, as you have clearly seen both the serious drawbacks of the current system and the lack of viable alternatives.
Welcome!
— Steve
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I also understand that smoking is often adopted by people taking neuroleptic drugs, as it appears to reduce some of the side effects. This makes total sense, since nicotine increases dopamine, which is drastically reduced by neuroleptics. So we can’t count cigarettes out as a side effect of psychiatric drug use, and we know the kind of effects smoking has on lifespan.
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I agree with Ron, it is important to be precise about our facts so that we can’t be viewed as careless or ideological to the point of being sloppy about the truth, as that prevents us from distancing ourselves from those we are critiquing.
That being said, I think the vitally important fact is that the “treatment” for “serious mental illness” is making people’s lives shorter than they would have been without it. What other specialty would allow a treatment that shortens your life, even if only by a year or two? Extended lifespan is one of the key measurable outcomes for any medical intervention, and if psychiatry wants to pretend to be a medical specialty, they need to be called out on killing people earlier. I’d love to see the specific data on relative life expectancy for this group before and after neuroleptics, or reflected as a graph over time. I am quite sure we would see that as the “chemical age” in “mental health” has proceeded, lifespans have been reduced. It is one of the clearest pieces of evidence we have that psychiatry is not really “treating” anything at all, but instead manipulating brain chemicals in somewhat random ways that have unintended outcomes of great significance, including, in many cases, an early grave.
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I did see this happen once in my role as an advocate for foster kids. Two divorced black parents of clearly educated backgrounds had their kid at a special school that recommended stimulants for “ADHD.” The parents listened, researched and then refused to agree. They were brought into court on allegations of neglect, and the child welfare agency was asking to have the child removed to foster care! Fortunately, the judge saw reason and dismissed the petition out of hand, which gave me some reassurance that here, at least, the judges are not so easily convinced that a parent loses their right to make medical decision because a school said they should do something different. But I’m not sure it’s like that everywhere in this country. The whole thing seemed completely absurd to me, but apparently not to the social services worker. Kind of scary!
—- Steve
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The one thing I appreciate about the author of the article in question is that he actually admits that the psychiatric worldview “requires no proof” IF and only if you are a reductionist philosophically. He calls it a “monism,” and thereby acknowledges (if inadvertently) that psychiatry is, in fact, based on religious or philosophical faith in a particular monism, rather than any actual scientific data. This is the hard truth that most will never admit, so I have to give the guy credit, even though he continues to write afterwards as if his monism were absolute truth.
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It probably also means they had a hard time finding anyone with this diagnosis who wasn’t already being “treated” chemically. Don’t know how it could be “unethical” not to “treat” with antidepressants after Kirsch’s work showing that they are barely better than placebo for most cases.
I find it odd that they recommend CBT for “treatment resistant depression” when it’s clear that it should be the first line treatment, and drugs only used when therapy of some sort fails. Of course, there are tons of other options outside the paradigm that says depressed people need “treatment” for a “disorder,” but operating within their own paradigm, this suggests that drug treatment should be ancillary and therapy primary in all cases, which is the opposite of what we see today.
— Steve
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I think what you are really talking about is that some people may actually have some sort of neurological problem that makes it difficult for them to control their impulsivity. I would not deny that this may be the case. However, the diagnosis of ADHD is not made based on any kind of neurological measurements or observations, and in fact, lumping all these people who have similar behavior together has the effect of OBSCURING the rare but probably extant cases where there really IS something wrong neurologically. Let’s say that your brother had some kind of, I don’t know, benign tumor in his frontal lobe. He goes to the doctor. Doctor says, “Oh, this is ADHD, seen it a hundred times. Give him some Ritalin, he’ll be fine.” He did the same thing with the kid who had sleep apnea, the one whose iron was low, the one whose father beats up his mother but he’s never told anyone, and the one who is really smart and bored to death with his dull teacher and classroom. How will he ever detect the tumor, or the low iron, or the domestic abuse, or the sleep problems if he can just lazily lump all these things together and call it “ADHD?” It gives the adults an “out” from admitting they don’t know what’s going on and actually doing some specific research on the causes of this particular person’s difficulties.
There may very well be neurological problems that cause someone to have difficulties with attention, but if they exist, they should be identified and called what they are rather than lumping them into some catch-all garbage can diagnosis like “ADHD.” Anyone can make such a diagnosis by simply listing off characteristics of an annoying type of person and calling it a disease. In fact, the DSM has done that in at least two other cases, “Oppositional Defiant Disorder (characterized by being unwilling to be bossed around by authorities) and Intermittent Explosive Disorder (characterized by having occasional outbursts or temper tantrums). There is, of course, no reason in the world to imagine that ALL people who have temper tantrums or ALL people who don’t like being told what to do have the same problem, or indeed have anything physiologically wrong with them at all. It’s just lazy diagnosis, made easy by the deceptive idea that the DSM diagnoses are somehow linked to some kind of scientific research. Once you realize they’re voted on in committee, you can see that the whole enterprise is pretty shady and not worth much.
If someone has something really wrong with their brain, we should look at their brain and find out what it is. But assuming that some annoying behavior is due to a brain malfunction is dangerous, and the epidemic of drugging you see is both the purpose and the predictable result of such delusional thinking.
—- Steve
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It seems to me you are missing the point, Joel. It seems the article is about claiming that adjusting serotonin is the ultimate treatment for depression, not that antidepressants do not have a positive effect in many cases. There are plenty of folks who have made similar arguments, and the response is almost always protective of the role of drugs/medication vs. acknowledging the lack of conceptual and scientific backing for the idea that depression is a primarily biologically caused phenomenon.
I’d be interesting hearing your comments on that point, rather than your rather generalizing put-downs regarding this particular website.
—- Steve
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I had a professor in college (chemistry) who used to set up the first test to be so tricky that most of the class failed. He then expected you to come into his office, where he sat in a chair behind a desk, and expected you to sit in a very comfortable chair that was about a foot and a half off the ground! The impression was very much of being a supplicant at the Delphic Oracle or some such power imbalance. I KNOW he enjoyed the spectacle of good students coming to him with their hats in hand and having to supplicate to him for relief. He was a total narcissist, and there was no protection or recourse.
Of course, it was worse in elementary school, where among other things, my second grade teacher, after a typical bout of yelling at the class, threw a book across the kids’ heads and destroyed a poor kid’s diorama that he’d spent hours putting together. I was the shyest kid in the room and almost never spoke, but I was so incensed on my friend’s behalf that I stood up and said, “Miss Vaughn!” She came down the aisle, hit me in the back of the head, and threw me and the kid whose work she destroyed out in the hallway without any further instructions. Talk about bullying!!! But everyone knew she did these things, it was her reputation, and nothing ever happened to her as a result. I didn’t even bother telling my parents about it, it was so unsurprising to me. What a great message for kids – “speak up to an authority abusing her power, you get hit in the head and tossed out of class.” I wish I’d gone home and never come back again, but that did not seem possible at the time.
Bullying by teachers is a poorly-kept secret, hidden only by the fact that we expect authorities to be abusive in our society. Same applies to mental health professionals, in my experience. If you have sufficient authority, bullying becomes “discipline” or “intervention” and the victim is always to blame for “forcing” you to use force on them.
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Too true, sadly!
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And I would opine that one reason some people read the book with that bias is because their own biases blind them to any possibility but the dominant paradigm being 100% right. There are many reasons for this, practical, psychological, and financial, but whenever I see someone jumping on an honest critique and claiming the person is biased, I know it’s time for them to look in the mirror, because they’re almost always projecting their own bias in the opposite direction.
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I so totally agree with you! Why is it that when a person is acting dangerously we automatically consider that we have carte blanche to “treat” them against their will? What would be wrong with holding onto someone until they calmed down and then finding a safe place for them to go? Of course, we’d have to create safe places, and it’s much easier to blame the client for making our lives difficult.
It is indeed the fear of those in extreme states and our own feelings of loss of control that make it challenging not to use force to intervene. But as I said above, most interventions are really designed to make the intervenor feel better, not specifically to help the client, who may or may not want the kind of “help” we wish to force on him/her. Far better to simply create safe places like Soteria House where people can chill out and decompress for a while without fearing for their own safety, and letting them decide what would help and what would not. Drugs could be a part of what is offered, but only offered with honest informed consent. My guess is that no one would choose that option for more than the very short term if they were not intentionally misinformed and pressured to do as the authorities told them to do. When one is already feeling out of control, taking away more control is not a good solution!
— Steve
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VERY well put! Thanks!
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I think you strike on an important issue – there is a difference between what is scary to the person and what is scary to the clinician or friend or family member watching it. And it is accepted in this particular society and culture that it’s OK for us to try and stop something another person is doing by blunt and even violent means if it is scary to us. Not saying that extreme states are not scary to individuals who experience them, because they often are, but I think we have to be honest that a large amount of psychiatric intervention with people in extreme states is PRIMARILY meant to make the practitioners, friends and family feel better, not to assist the patient, though of course it is rationalized in the latter way.
It is fascinating to me the cross-cultural studies I’ve read showing that in cultures where voice-hearing is accepted and not feared, the voices themselves are much more likely to say positive things about the hearer! This shows that culture plays a huge role in how voices are experienced and how we choose to intervene or not. And you are absolutely right, to reduce this to a chemical-mechanical problem is never going to yield any long-term results, though it may yield plenty of dollars and prestige to the companies and practitioners who promote the practice.
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Gotta agree with you. We need some regulators who have been victims of the mental health system! A fine of this magnitude is like a small tax they are more than willing to pay. How about the fine is proportionate to the estimated additional profits made from dishonest marketing? Hit them up for a billion or two and maybe you’ll get their attention.
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Of course, you are right, but it will never deter the determined biopsychiatrist from wetting his pants about the next “great breakthrough.” In the end, psychiatry is so determinedly non-scientific in practice that actual failures to produce results over time seem to have not the slightest impact on the hope for the new Holy Grail to appear.
Take ADHD and stimulants for an example: we now have 50 years of research trying to prove that giving kids stimulants over time improves their academic and social outcomes. No such evidence has ever emerged, despite some fairly biased attempts to infer it. Any real scientist would say, “Gosh, we’ve got 50 years and hundreds of studies that fail to find an effect. It sounds like there is no such effect.” But in psychiatry, all they’ll say is, “There is insufficient evidence to prove that ADHD children do better in the long term with stimulants, but we’ll keep working and we’re sure such evidence will emerge when enough studies are done.”
Intellectual dishonesty lies at the core of the DSM-based psychiatric worldview. No amount of reasoning or scientific facts will dislodge their faith in their interventions. It’s more like a religion than a medical practice.
—– Steve
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And I’m just SURE that every psychiatrist does a full workup to check for all of these possible causal factors before giving a diagnosis. Riiiight…
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Psychosis is just a name, similar to saying that you have knee pain when you tell a doctor your knee hurts. They don’t know what it is, what causes it, what to do about it, or anything. Best not to say too much about it to them.
The real question is, do YOU think you are sometimes paranoid? If you do, what do you think is behind that? Is it something you want to change? What can you do to get control of that process?
Don’t let the doctors fool you. They have no more understanding of your situation than you do, and may in fact have less, because they are most likely brainwashed into thinking that your “condition” is a result of a “chemical imbalance in your brain” and to try to do everything they can to make it go away without ever bothering to figure out what is actually going on. Kind of like pain relievers for a broken leg. Not really going to address the problem, are they?
—- Steve
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Right you are. Receiving medical care was found to be the third leading cause of death in the USA in an article published in the JAMA in around 2000 or so. The biggest cause was properly prescribed and properly administered medication (120,000 deaths a year). The idea that Good Medicine somehow magically leads to people getting better is delusional. The hard truth is, most of medicine is so corrupted by pharmaceutical and other money that you’re better off doing your own internet research and using alternative and folk medicine for most conditions, especially anything chronic.
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Wow, this is indeed discouraging! If a person of your experience and stature can be so systematically ignored, it’s pretty obvious that no one in Government wants to go up against this industry! And of course, a referral to the Medical Board would have been useless, because they’d simply claim that the doctors were engaged in “common and customary practice” and could not be sanctioned, even if people were dying at their hands. As long as a lot of other docs are killing people in similar ways, you’re off the hook.
It makes me wonder what can be done about this? Is it even possible to generate public outrage when everyone appears to be so mesmerized by the training and degrees that the psychiatrists use to protect themselves from criticism or accountability?
—- Steve
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Another stunning revelation that everyone should already know. It just goes to show how hard and consistently the psychiatric mainstream has worked to promote their “biological” theories that something like this should even have to be studied! Anyone who has experienced the powerlessness of being bullied and not knowing what to do and having the witnesses all join in or remain silence would instantly realize how demoralizing such an experience would be, especially if repeated.
I wonder if they bothered to include teachers and staff in their count of bullies. The worst bullying I ever experienced in elementary school was from the teaching staff!
—- Steve
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Well, except about the “symptom improving” part…
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Wow, I actually agree with something Jeffrey Lieberman said! Am I getting soft?
— Steve
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Can’t argue with you there, Steve. He totally sold out and the consequences were dire. My point was more that the psychiatric/medical establishment of Freud’s time was no more interested in hearing the truth about trauma and its effect on the mind than today’s psychiatric leaders. I think it’s about more than just money – the people in power positions don’t want to believe that their arbitrary use of power is or can be harmful to the rest of the populace. Blaming the victim is an old game, and it’s very unfortunate that Freud decided to go there, but he’s in very good company!
—- Steve
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School is a common trauma that many of us share from our own childhoods. The very idea of a standard school is triggering for me!
I am fortunate to live in Portland, OR, where we have some alternatives built into the public school system. Notwithstanding these less oppressive options, we still opted to homeschool our oldest for four years, helped develop a child-centered alternative school within the system, and ultimately helped create a charter school that allowed kids some power to be who they are and study what they were interested in at the level they were capable of, and even have some recourse if teachers decided to behave badly. It has been a rousing success (the school is in its 20th year of existence!) but more importantly, it allowed my youngest, who would have been considered highly distractible and disruptive in a standard classroom, to develop at his own rate and in his own unique way. He’s now in college and doing great. I have to wonder how many other “square peg” kids would thrive if they were just allowed to be in an environment which adapted to their needs instead of expecting them to adapt to the adults’ version of reality.
I hope you find your way for your son, and I wish and hope there are some alternatives you can take advantage of.
Hey, isn’t the Sudbury Valley school right in your neighborhood?
—– Steve
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I see nothing more absurd in Freud’s “id” and “ego” formulation than anything in the DSM series since Spitzer. Actually, I like Freud’s conceptualization better, because at least it’s simple and easier to apply, and doesn’t completely remove behavior from its context.
Of course, the real truth about Freud and psychoanalysis is that Freud was the first to honestly observe that women were being sexually abused in massive numbers as children, and to say that out loud. He was so severely castigated by his colleagues at the time that he reacanted and invented his “fantasy” theories including the Oedipus complex and so forth, and thereby helped set us back 100 years before the truth once again came to the surface. But compared to Spitzer, Freud appears to have been much more genuinely interested in understanding what was really going on with people. It’s unfortunate that even in his day, organized psychiatry was already suppressing any effort to contextualize suffering and severely punished anyone who did so.
— Steve
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It is important to distinguish between unconscious motivations and lack of free will. A person acting out of unconscious or subconscious motivations is still exercising free will – s/he is making a decision, but is simply not being honest with him/herself of the reasons for doing so. This is very different from not being able to become an NBA star due to lack of athletic skills, height, or other abilities. It’s also different from being able to decide to be attracted to a particular person or gender.
A great example is child sexual abuse. I’ve heard it argued that certain people are sexualized toward younger children and molest for this reason. But I would bet you a whole lot of money that there are many, many people who feel sexual attraction for younger children and choose not to act on it, because they know it is socially inappropriate. Or perhaps a less threatening example: I can readily admit to finding certain high school girls very sexually attractive. But I’d never choose to engage in a sexual relationship with someone of that age, because I know it would be harmful to them (in addition to being illegal). We always have a choice as to whether we give in to a particular impulse. It may be harder for some people to make that choice, but it’s still a decision that is being made. To say that prior circumstances force a person to act a certain way dehumanizes us all and makes efforts to change and to address personal challenges appear pointless and meaningless.
Humans make choices. It’s what we do. Conscious or not, we’re still making choices, and saying we have a “disorder” preventing us from making those choices takes away both agency and meaning from our lives.
—- Steve
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Szaz took that very position, as I recall. He believed people should be held accountable for their crimes, regardless of mental state, and that incarceration should be based on what one did, not on some theoretically perceived risk of harm to self or others based on a spuriously-defined “mental disorder.” I tend to agree with him. Unless it can be proven that the person was in a condition where they genuinely did not understand what they were doing, they should be 100% accountable for their choices. The fact that someone has some speculative “warrior gene” is neither here nor there.
It is interesting that the IED description says that the person can’t be using this for any kind of specific gain, such as power 0r control over another. This would disqualify 99% of domestic abusers even by their own definition.
“Intermittent Explosive Disorder” may be the most ridiculous “disorder” in this entire ridiculous volume. That anyone can read that name and still take this book seriously is indication of how gullible the public has really become.
—- Steve
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“…which attempted to obfuscate the findings by referencing the heterogeneity in persons who exhibit social anxiety.”
Well, if social anxiety is “heterogeneous,” then what’s the point of calling it a diagnosis and trying to “treat” it chemically? How is this any different than someone smoking a joint or taking a few shots of Johnny Walker’s Red to make themselves feel better?
If it’s not homogeneous, it can’t be “caused” by anything specific, by definition. So it’s not a medically treatable entity, it’s just a name you are giving for feeling a certain way. And any drug you’re taking isn’t a “treatment,” it’s just a way of temporarily feeling better. Why is this not obvious?
—– Steve
BTW, I could certainly have qualified for a “Social Anxiety Disorder” diagnosis as a child and a teenager. I can tell you that sufficient alcohol was a magical “treatment” for the condition – enough drinking and I stopped worrying what people thought about me and became quite the social butterfly! So why don’t we just use alcohol as a “treatment” for “SAD?” Rhetorical question…
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I agree, this should not be news to anyone, but apparently it is in the delusional world of psychiatry. A retrospective study in the Canadian Journal of Psychiatry some time around 2000 showed that between 6-7% of all children prescribed stimulants in a 100-chart survey had psychotic symptoms noted in their charts. This, of course, does not include those children for whom these symptoms were not detected, nor those who may have later developed such symptoms due to increasing dosage of continued use over time. The only thing that makes this news is years of institutional denial.
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This is a fantastic article and helps make our argument that mental illness is not a function of brain as much it is a function of society and culture. It appears that our unwillingness to let our kids make and learn from their own decisions is part of what is making them anxious, depressed and ineffective. Worth reading!
—- Steve
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Pregnancy is a huge psychological and physiological stress on a woman’s body and on a family. It is 100% NORMAL for anxiety, depression, anger, and all sorts of emotions to emerge during this time, and yet we do little to nothing to prepare new moms for this experience. We’d be FAR better off normalizing pregnancy as a natural period of adjustment and depression as an indicator that some thing or things need to be changed in the mom and family going forward.
Other stressors include the potential loss of income, loss of role at work, changes in sex life (which can lead to frustration by her partner), body image problems, expectations from partners and/or extended family members, planning for childbirth (including paying for it in some cases), loss of sleep, big changes in schedule, increasing isolation after the birth, the list goes on and on and on.
There is also a huge increase in the incidence of domestic abuse during pregnancy that is almost never discussed in the context of PPD or maternal/prenatal depression. The shift of attention from a self-centered partner to the developing baby often triggers jealousy in such partners. Additionally, pregnancy often provides a sense that the mother is now under more control of the abuser, and abuse can escalate without fear of her leaving.
Add to that the tendency for pregnancy to bring up childhood abuse/neglect issues, and it seems very understandable that depression increases during pregnancy and childbirth. How someone can view depression during pregnancy as a disease state is beyond me. I’m surprised that anyone isn’t filled with anxiety and dread at the idea of starting a family in this culture and economy! Antidepressants should be the very last choice of desperation by any doctor, as there are so many other things that can be done. And the very process of diagnosing and prescribing for this “condition” kind of automatically invalidates the long and yet non-exhaustive list of legitimate reasons to be worried or dismayed that I have provided above. It is beyond idiocy to diagnose a pregnant woman with “prepartum” or “postpartum depression” when it is such a normal part of a very stressful process and doing so I think does a lot of damage to our chances of ever really finding out how to help.
— Steve
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Terror does not harden us. Being bombarded with massively, hysterically overblown “information” that suggests terrorists are around every corner and that drastic emergency action is needed is what hardens us. In essence, we are being “hardened” on purpose by those who benefit from the population living in fear. That’s the core of how fascism gets started, and there are a lot of fascists vying for power these days.
If we were in Israel or Palestine or Syria or Iraq right now, it might be fair to look at how terrorism affects the population. The USA has no claim to have been a major victim of terrorism since 9/11. Poverty, corruption in politics, domestic abuse, substance abuse, and the killing of people by our pharmaceutical industry are all much more vital issues that are being intentionally sidelined by our obsessive focus on “Islamic terrorism” to the exclusion of all else.
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And the implications for the world of biological psychiatry are, of course, systematically ignored. If therapy can change brain chemistry, it stands to reason that brain chemistry is readily altered by environmental experiences. Logically, the idea that “mental illnesses” are uniformly caused by fixed problems in the brain is therefore completely disproven, and all those brain scans of the “ADHD brain” or the “depressed brain” can be completely dismissed as anything but evidence that different people are simply reacting to differing sets of circumstances. So why are we trying to drug brains into submission, when they appear to be responding to the survival needs of the environment? I know, I know, rhetorical question… as long as there are financial and social benefits to a certain “truth,” it will stay “true” regardless of the data.
—- Steve
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An intriguing and in my view extremely accurate and meaningful article. I have to say, though, I was surprised that you didn’t take the next step when talking about parents’ reaction to their children’s separation. It seems clear to me that parents who have their own issues with attachment have a much harder time with this, as they perceive abandonment and/or rejection by their own child/children, as well as having their identity as a parent, which for some is their primary identity, become increasingly obsolete. I experienced this to a degree with my own mom, though she appeared to show some uncharacteristic awareness of this and took some steps to make it a little easier on me. My wife experienced this phenomenon to a much more intense degree with hers. Her mom was literally in tears when she moved out, saying things like “You held the family together!” and “What will we ever do without you here?” It was quite appalling to me to hear about, partly because I was toward the end of my own course of quality therapy at the time and could see the awful bind she was putting her daughter in.
I like to think we’ve been able to avoid passing most of this on to our kids, but it is a very hard time for parents like us who haven’t had the greatest attachment experiences, and making it clear to parents that their pain is not caused by their kids leaving but by their own unresolved history seems like a very important point to keep in mind.
Thanks for sharing your insights and excellent writing skills!
—- Steve
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Indeed, I think it is the opposite of blame to honestly re-examine one’s personal behavior and ask if there is something that needs improving or healing. Blame is hurtful and aims at pulling someone down. True healing can be painful, but leads to opportunities that don’t happen if we act out of the fear of being blamed. It is not a choice between blame and blamelessness. It’s a choice between assuming and avoiding responsibility. Very, very different questions.
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And BTW, I think it is normal and healthy for a parent to search his/her soul as to what s/he might have done to contribute to a child’s eventual experiences, even if they ultimately decide it was out of their control to influence. I had that experience with my son who went off the rails on drugs for a year or so and went through exactly those machnations and doubts. It can be very painful, but can also result in some insights that can help figure out what to do. Ultimately, I think it’s not healthy to go to a place of self-blame, but neither do I consider it healthy to go to a place of self-protection. We all contribute in one way or another to our children’s mental and emotional wellbeing, and to deny that is the case is just plain childish. Normal adults work to take responsibility for what they control, and to let go of what they do not. This is a very different process from self-recrimination – it’s an effort to assume responsibility for healing whatever damage may have been done and to help the child move on from it. To deny that opportunity to both parent and child is truly unhealthy for both.
— Steve
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Discussing family dynamics as a factor in mental illness IS taboo in many circles, and in particular in any kind of event or posting I’ve ever seen from NAMI. There are many NAMI local chapters who are branching away from the national narrative, but the one thing you can count on is that “blaming parents” is 100% taboo, and all discussions of family dynamics are framed as parent-blaming. The “refrigerator mother”/autism concept is the one that is usually hauled out to make the speaker feel guilty and ignorant for raising the issue. The fact that every single “mental disorder” is highly associated with abuse history is not an allowable topic of conversation. “Trauma informed care” is starting to be allowable, but it appears that only extreme abuse is given credence as a possible contributing factor. Something as simple as a parent having unrealistic academic expectations or treating one child favorably over another can have long-term mental/emotional impacts of great significance, but this is not something we’re allowed to discuss.
There is unfortunately a conflict of interest for many parents who may not have done the best possible job raising their kids, in that it absolves them from responsibility if the “chemical imbalance” narrative were true. This is the bread and butter that NAMI was originally built around. The truth is unfortunately much more subtle and nuanced, but NAMI appears to allow only two positions: either you agree that parents play no causal role in mental/emotional challenges (unless they beat or sexually abuse their kids or something of the sort), or parents are “to blame,” i.e. 100% responsible for everything that happened. Both of these positions are absurd, of course, but that’s the propaganda that NAMI appears to put out there.
If all parties thought like you, we’d be able to have a rational discussion, but unfortunately, there are many (some on both sides of the issue) who aren’t willing to look at the actual facts of the situation and aren’t really interested in the truth.
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I always find it disingenuous, at least, when a study like this finds equivalent outcomes and then suggests that both therapy and medication are equally valid approaches. Aren’t we forgetting something important? Namely that therapy doesn’t attack your brain with foreign chemicals or create an array of side effects that vary from annoying to potentially deadly? If both have the same outcomes, and one has much, much lower risks, an honest conclusion should be that PSYCHOTHERAPY MUST BE OFFERED IN ALL CASES before antidepressants are even considered.
Of course, considering Kirsh’s work that suggests most of antidepressants’ effects are placebo effects, this isn’t exactly a ringing endorsement of psychotherapy, either. But at least it’s very unlikely to end your sex drive permanently or induce you to kill yourself or go on a mass shooting spree.
— Steve
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It looks to me as if holding the perpetrators accountable would result in the loss of a significant percentage of the military command personnel. If this kind of thing is tolerated or even promoted, it means the administrative authorities know all about it and are either looking the other way or encouraging or even perpetrating the retaliation. To have nearly two-thirds of reporters experiencing retaliation says that this isn’t the action of a few outliers – it is military policy being enforced from the highest levels. It also reflects the highly sexist atmosphere that exists in the military and our society as a whole.
This is not a matter for policy change – this is a matter for culture change, just like the prosecution of police officers abusing their power. Only when the higher-ups are held accountable for what happens under their command, as well as for creating a new culture of support for victims and intolerance of rape and the sexist harassment that goes along with it will we see any real change in these statistics.
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While you are correct that some local branches of NAMI can be quite supportive of survivor voice and choice, and while NAMI on a national level appears to be trying to emulate that effort, my direct experience with NAMI programs tells me that recovery almost always means “recovery with medication.” The classes are organized that way, the national promotional material looks that way, and the politics clearly leans that way. Look at NAMI’s support for the Murphy bill, as an example. How can they claim to be pro-survivor voice and choice and advocate eliminating SAMSHA, who has been the biggest cheerleader and funder of efforts to increase survivor participation in decision making and shifting to a recovery focus? How can they support more use of force and a lessening of the civil rights of individuals with “mental illness” and maintain that they are pro-recovery and pro-voice and choice? How can they be anti-stigma and yet allow Murphy and Torrey and their ilk to continue to peddle the disproven concept that mass shootings are caused by “untreated mental illness?”
NAMI may be mending their ways in some respects, but they’ve done a HUGE amount of damage over the years in promoting the medical model and the medication-first treatment paradigm for decades, and they have a lot to answer for. If you can’t see why folks would be appropriately suspicious of their motives, given both their behavior and their primary funding base, you perhaps need to try to extend the empathy for other points of view that you’re asking for to those who may have had a very, very different experience than you with NAMI and with psychiatric treatment.
— Steve
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I have long maintained that this phenomenon is more damaging than even the drugs themselves can be. Conceptualizing mental health issues as “brain problems” is inherently disempowering. Interestingly, in Harrow’s longitudinal study of those diagnosed with “schizophrenia,” one commonality amongst those who recovered was an internal locus of control – essentially, the idea that they could do something about it rather than waiting for a doctor to cure them. This is the opposite message of what most clients receive. What could be more demoralizing than hearing, “The reason you feel bad is that your brain doesn’t work right. It has nothing to do with your history and life experience, and there isn’t anything you can do to fix it. We’ll give you drugs for the rest of your life that might make it more tolerable, but that’s all we have to offer and it might not work. Good luck!”
If I weren’t depressed before getting that message, I sure would be afterwards!
—- Steve
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I do like “emotional distress” better. Appreciate the feedback.’
— Steve
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“Mind,” I think it is safe to say, is an intellectual construct used to identify the processes that encompass things like beliefs, values, motivation, perspective, which are not easily attributable to any known location or physiological process we know if. Who knows, some if not all of the functions of mind may someday be explainable in physiological terms, but they aren’t as of right now, that’s for sure. Steve, I read your website and some of your document, and while it’s fascinating and well-reasoned, it’s still philosophy to me. A scientific finding that “mind” is a function of “brain” would have to tell me what exactly in the brain makes “mind” occur and how we know that this is the case. There would need to be measurements and testable theories and replicability of results. I’m not seeing that. I’m not surprised, either, because I think mind is a very mysterious phenomenon, and it may never be fully understood. I don’t believe it’s unscientific to acknowledge what we don’t know. In fact, that’s one of the core values of science – we assume we don’t know until proven otherwise, and then we only know what the data tells us and when conflicting data arise, we once again don’t know. Science is inherently skeptical, and it’s much more scientific to say, “I have this data suggesting this may be true” than to say, “The mind resides in the brain” when there really isn’t the data to show that with confidence.
I love philosophy and think it is VERY important to understanding our world, but it’s different than science.
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Well said!
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And don’t forget receiving standard medical care, the third leading cause of death in the USA, behind heart disease and cancer, and an almost completely preventable one. MUCH more dangerous than terrorism!
— Steve
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Wow, seems unnecessarily complex to me! I think the concept has some validity, but a much simpler chart would be needed to make it effective and efficient. Perhaps starting with a single “cycle” and building from there would be more helpful that creating this gigantic map, which to me would feel overwhelming and demoralizing to look at.
—- Steve
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I hate to say this, Steve, but your proposition is also philosophical. You say, “I also do not believe in emotional ‘states'” and “I believe that the ‘mind’ and the brain are the same thing.” Those are most definitely philosophical positions, not known scientific facts. I think it’s fine and important to discuss all of these philosophical viewpoints, but in truth, we don’t KNOW what “mind” really is and almost have to resort to philosophy to even discuss it. I think it’s important to remember that science itself is based on certain philosophical assumptions, and was originally conceived as a branch of the more overarching subject of philosophy (which, in fact, was originally seen as overarching ALL subject, and I think properly so).
It’s OK with me for you to take a materialist viewpoint on the mind, but I don’t accept that it is automatically more “scientific” to argue from that particular viewpoint.
— Steve
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I like “trauma adaptations” better, by far. The reason I suggest “mental injury” is because I think it could be adopted more easily and doesn’t sound too “PC” for those who are not so far along in understanding the power of words to redefine thought and political decision making. It’s kind of a “middle ground” term that might catch on, or that was my thought, anyway. In our alternative worldview, “trauma adaptation” is definitely a more empowering alternative.
Always love to hear your thoughts!
— Steve
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I have often thought that rather than “mental illness,” those with a normal reaction to trauma would be better conceived as having a “mental INJURY.” This puts the blame where it belongs – on the injury and the person or events that caused it. It recognizes the suffering that results, but also is more empowering because injuries generally can be healed. It’s still a little medical for me, but I think it’s a much better frame than “mental illness” that might be more palatable to the mainstream but still get the point across that reacting with fear to a terrifying experience is hardly abnormal.
What do you think of that idea?
—- Steve
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Well said, Frank!
— Steve
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I have been clear if diplomatic about my opposition to DSM labeling and the wholesale drugging of foster kids for many years. I am fortunate to be in an advocacy job where we are expected to take contrary positions sometimes. It has affected me professionally in some ways (I believe it prevented me from getting a particular job at the State level that I would have been great for), but my agency has never wavered in their support for my taking on these issues publicly. I’m somewhat of a celebrity in the world of CASA (Court Appointed Special Advocates, my organization’s affiliation) and in the local courts, where people know me as the psych med guy. And the local foster-youth-driven advocacy agency loves me.
So it is possible to survive in a professional job while being “out” about my views, but it most definitely has costs.
—- Steve
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It would be great to have more community, but I have found that my very well researched views are not welcome in many communities where people are very invested in the “chemical imbalance” viewpoint. I think there are a lot of political reasons for this, and most of them do NOT come from fist-raising by consumers, but from job protectionism and corruption within the industry. And sorry to say, when you remove the pig from its accustomed feeding trough, the pig is going to squeal.
It really is a bullying type situation. We can tell people to “get along” all we want, but as long as the bully has everyone afraid of being beaten up if they don’t support the status quo, “getting along” quickly deteriorates into “capitulating to avoid a fight.” That does not lead to community.
So if you have a pathway where those who are invested in their either pro- or anti-medical viewpoint can find some common ground, I’d love to hear it. But in truth, it’s not the “mentally ill” who started this fight. Your comments remind me a little (just a little) of black people being told that white people can’t hear their message because they’re too strident and angry about it. Well, gosh, I think they have good reason to be strident and angry, and it’s not the job of the person experiencing oppression to take care of the oppressors to make sure they feel OK! In fact, to capitulate to that reasoning seems like collaborating in their own oppression. I think the same applies to those with mental health labels. If some people are OK with or even like their labels, that’s their choice, but why is it that people rejecting labels is so threatening to those who accept them? Or especially to the parents who are concerned about their adult children and see force as the only answer?
I know it’s not easy to navigate these waters, but remembering that the recipients of dishonest and sometimes deadly psychiatric care are not equal players on a level playing field, but are in fact the victims of forces vastly beyond their own control, it becomes a lot more understandable why ANGER is an appropriate response, rather than endless attempts at “respectful dialog” that do nothing to enhance the power position of the victims in this power play.
—- Steve
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It must be an epigenetic response tied to inherited economic crisis sensitivity genes which modify the brains of vulnerable persons to be upset about being unemployed and potentially starving to death with one’s family. The truly mentally healthy person has a brain adapted to handle this kind of stress by stoically continuing to look for unavailable jobs until one expires from starvation or physical exhaustion.
In other words, since not EVERYONE commits suicide or becomes otherwise mentally unhealthy as a result of loss of a job, it MUST be that the people who become upset are ill in some way, otherwise, they would find a less upsetting way to either scrabble out an existence selling pencils on the street corner or to quietly expire in some remote place where it won’t cause any upset to the general population.
Wow, that started out funny but got kind of grim towards the end there!
—- Steve
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When you start dispensing drugs based on subjective and spurious behavioral characteristics without any measurable way to distinguish between those who “have” and “don’t have” these “disorders,” this is the inevitable result. Anyone can go into a doc and claim to be having “difficulty concentrating” and get a prescription, because there’s no way the doctor can actually test to see if they have a problem or not! Works well for the pushers, but not so much for the addicts we’re creating. And of course, the medical veneer of acceptableness of a drug is known to cause the public to view it as safer, leading to more experimentation without concern for consequences.
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It is interesting that they did not do a comparison of side effects. I have to imagine that the side effects from light therapy are little or none, whereas we know the side effects of Prozac can be substantial. There is so much emphasis on “symptom reduction” as the ultimate measure of success that quality of life measures are almost systematically ignored. If you add in the side effect profile, this should make light therapy a first-line treatment for depression and relegate Prozac to the place it belongs – an adjunct treatment that can be tried when all else has failed – an act of desperation when we are ready to give up.
And of course, BPD is right that the whole premise of these studies is faulty when they act as if they are “treating” a “disease” called Major Depressive Disorder, rather than just experimenting to see if exposure to light makes people feel better, which is what is really happening.
— Steve
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It is obviously not guns alone, because lots of other countries have lots of guns and don’t have this problem. it’s also obviously not about “mental illness,” because we are assured by the Church of Psychiatry that mental illness prevalence doesn’t vary much from country to country. Why would the USA, the most “treated” population in the world when it comes to “mental illness,” have these ridiculously higher rates of mass murder? (Unless, of course, the “treatment” was a factor, but I’ll let that rest for now.)
There is clearly something CULTURALLY DIFFERENT about the USA that allows and encourages these events to happen. The argument against the Murphy Bill is almost absurdly easy: “They have mental illness in France, don’t they? Germany, Italy, China, Japan, Australia, right? So why don’t they have mass shootings then?”
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He is the creator of the Connors scale for assessing “ADHD” symptoms. Making plenty of money off the mainstream conception of “ADHD.” So if he thinks the diagnosis is out of control, you KNOW it’s out of control.
http://www.attentiondeficit-add-adhd.com/adhd-connors-test.htm
— Steve
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Right! It’s artificial stimulation to make up for the lack of expected natural stimulation. Why not instead make the environment more stimulating? But that would require the ADULTS to make the adaptations, and it’s much easier to put the blame on the powerless and continue with our own misconceptions unchallenged.
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I agree. In terms of scientific validity, I’d say astrology beats psychiatry hands down. At least there is some way to actually measure and agree upon terms, and the labels don’t automatically imply disease or disability. Plus it’s a lot more fun than psychiatry, by a long shot! But that’s kind of like saying it’s more fun than waterboarding…
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This is not new, but also not published. Apparently, people who are at peace with their lives are much less likely to develop the full range of Alzheimers symptoms even if their brains are falling apart. They may not remember things, but they don’t get disoriented and confused and hostile and delusional. So even Alzheimers, which clearly has a physiological component, is not entirely a “brain disease.” Experience and attitude are factors even when your brain is dying off.
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And despite that, there is no single “diagnosis” that can be even close to predicted by brain scans of any type. The pictures they show you of the “ADHD brain” are AVERAGES over many people. Not all “ADHD” people have that particular brain scan, nor do all with that kind of scan show any signs of “ADHD.” Daniel Amen, the brain scan’s biggest proponent, even admits that the so-called “ADHD” brain is also seen in people with brain injuries as well as diagnoses of schizophrenia and one other “disorder” I’ve forgotten.
Also remember that these are brain ACTIVITY scans, not structural scans. So they reflect how you USE your brain at a given moment. They are fluid and active and respond to external stimuli (the “ADHD brain” is apparently only observable when you make the subject do something they find tedious or stressful, so maybe it’s the “bored brain” or the “stressed brain?”) There was a study I recall where they had people think of something sad, and their brains went in the direction of the “depressed brain” averages. When they then thought of something happy, their brains changed back.
Brain scans should be renamed “Brain scams.” They don’t diagnose anything.
— Steve
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Except you can’t make money off them if they’re dead, so they have to create a near-death state that persists for years. Otherwise, you’re no longer billable.
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Love it!
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Truly. What if we found that treatment for heart disease or cancer REDUCED people’s life span by decades? Would such “treatment” be tolerated? I don’t think so. It’s only because of the marginalization of the so-called “mentally ill,” which the DSM so effectively operationalized for professionals and society at large, that such outcomes could be considered anything short of outrageous and criminal.
I have plenty of outrage – my question is, where do I direct it? There are some gigantic social forces at work to keep these outrages “hidden in plain sight.” How do we, such a small and easily marginalized movement, counteract such massively funded antagonists?
—- Steve
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Wow, these guys appear to have hit the nail on the head! It surprises me that this ever got published, but it’s encouraging to hear those in academia honestly reporting the lack of long-term benefits and the myriad of problems these drugs and the disingenuous promotion of their more widespread use have caused. When Keith Connors, who is the ultimate psychiatric mainstream guy, is telling you that you have a disaster on your hands, it’s time to wake up and listen!
—- Steve
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Exactly. The only legitimate measure is the impact on the client, and if it’s negative and the treatment persists, it’s abusive. I don’t really care why the perpetrator acted that way – s/he had the power and abused it to harm his/her charge. There really is no legitimate excuse.
— Steve
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I think it has to do with whether the professionals have dealt with their own abuse issues. A lot of abusive behavior is simply accepted as “normal” in our culture. Consider this: if a parent is taking his/her kid to preschool, and they’re crying every day or pretending to be sick or begging the parents not to make them go, almost any parent would investigate and if necessary pull their kid out of that daycare setting, as it’s obviously harming their child. But a kid in Kindergarten doing the same thing is told they have to go, that school is difficult but it’s part of growing up, that they have to adjust, etc, and if they can’t, they earn a trip to the psychologist or psychiatrist and are pathologized. Yet we all know that school environments can be abusive, and are often neglectful, especially in terms of setting unreasonable expectations of children based on their development. We accept this as “normal” because we all went through it and nobody believed our cries for help and it’s uncomfortable to think about trying to confront this behemoth, so instead, we do to our kids what was done to us and the cycle continues.
How much harder to face that your PARENTS may have mistreated you, intentionally or not, or that your needs went unmet when you were very young! And if this is true, and you personally haven’t faced it, how much EASIER is it to diagnose and prescribe a pill than to sit and listen to the helplessness of another person that reminds you of your own unresolved feelings of helplessness?
The inability of professionals to deal with their own pain leads to them acting out those issues on their clients. The DSM facilitates this process very effectively, as it’s simple to find a label for the distress in another and to make your objec tive to WIPE OUT THE DISTRESS that is making YOU uncomfortable, rather than facing the uncertainty of recognizing that the distress may have a very real and understandable cause that reflects your own distress that you’ve been trying so very hard to avoid experiencing.
—- Steve
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Great post! I mostly do agree, but I think there is one point that is missing from your analysis: people who haven’t done their own work on their own trauma or childhood distress are often eager to see ways to work out their issues on others on whom they can project their problems. I think a lot of psychiatrists and other MH professionals fit into this category. The absolution from guilt you so correctly observe is a big part of the appeal of this labeling system. But I can’t absolve those who grasp onto this from all responsibility – because their decision IS intentional (albeit unconscious) and they are acting out of their own interests rather than their clients’. Your description is accurate and makes their behavior more understandable, but I don’t think it makes it more excusable.
You are, of course, correct that it is hard for someone high in the IQ department to really understand what it’s like to be in the lower 50%. I try to be compassionate, but when a person has a power OVER another person, my compassion goes first to their victim, regardless of their own limitations.
But like I said, it’s hard to know who to be mad at. Somewhere at the top of the food chain, there are people who know EXACTLY what is happening and are very conscious and intentional about their actions. But I can’t believe that all psychiatrists are just dumb and misled. I am sure that some have heard data and arguments that counter how they have been trained, and if they are real professionals intending to help their clients, they are responsible to explore and examine this data. Not to do so makes them guilty of severe neglect, at the very least, and I don’t think it’s correct to let them off the hook just because they’re mistrained. After all, the clients’ responses can tell them what is and isn’t helping if they bother to listen, but that would mean exhibiting a humility that all too many seem unwilling to embrace.
Thanks as always for your great and stimulating post!
—- Steve
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I absolutely agree, these articles are VERY helpful in providing education to the miseducated masses. It just pisses me off that those in power to do something about it are so married to the status quo that we have to “discover” these obvious things and encounter resistance to “reeducation” from people who have a hard time believing their doctors would wittingly or unwittingly deceive them.
I also agree it requires great patience when dealing with folks who are steeped in the “conventional wisdom.” It makes me sad, as most are decent folks just looking for answers. It is those who know better, meaning the professionals in charge of mental health institutions and agencies, who are most at fault for allowing their charges to be mis-educated due to their own lackadaisical attitudes or venal greed.
It’s hard to know who to go after, though, because a lot of doctors are consuming the same propaganda as their patients. Where does the buck really stop?
—– Steve
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Too true. It is ironic that the drugs that “treat” ADHD also cause lower appetite (which of course leads to lower blood sugar levels) and less sleep, both of which contribute to the very symptoms it’s supposed to be treating!
Bottom line, messing with the brain is a bad idea and should be avoided if at all possible. There are so many other options, but of course, none so profitable, and profit drives policy in this sad world we live in.
—- Steve
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Again, this all seems to obvious to me as to not even need investigation. It’s sad that these folks have to work to convince the mainstream that this is true.
Depression is the physiological reaction to being in an untenable situation that you can’t fix. It’s essentially a response to being powerless, an effort for the organism to conserve energy until such time as an attack or escape becomes available. There is nothing abnormal or unhealthy about a kid being depressed when s/he is in a situation of powerlessness – it is the obvious and actually most rational approach to take.
That this has long-term consequences should also surprise no one. The real question is how and why the professionals have allowed this obvious conclusion to be “news.” It continues to astound me that so-called professionals can minimize this obvious causal factor and waste so much time and money exploring biological explanations that obviously explain very, very little.
—- Steve
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I do agree with you about recovery. Unfortunately, too many of the patients have been trained to believe the mantra that we are talking about. That might be a difficulty for some people regardless, but one thing we CAN change is to stop convincing them it is true! EMPOWERMENT is the key to recovery. Teaching people what they ARE capable of, sometimes against even their own deep inner belief, is what we should be doing, not teaching people that they are condemned to a lifetime of disability!
Change is slow, but it’s slower when people with vested financial and power interests don’t want the change to happen. Sadly, I think that’s what we’re up against here. There are too many people making big bucks off of the “lifetime disability” meme to allow a few inconvenient fact stand in the way. After all, if we start empowering everyone to recover, they’d have to start finding new clients!
— Steve
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I agree with your basic premises, but would add one thing: expectations (at least in US schools) have become higher at lower grade levels, and young kids are more commonly asked to do things (like sitting still or working on worksheets or even doing homework) in the early grades that are simply developmentally inappropriate for their age. As evidence, a few studies have now shown that waiting a year to start kids in school reduces ADHD diagnoses by 30% or more.
It is also worth noting that there is no “hypoactivity disorder:” kids with low levels of activity are never critiqued, because they’re not inconvenient for adults to manage.
—- Steve
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“admitting subclinical phenomena into a classification system is a very slippery slope. The lifetime prevalence of mental disorders could easily come to approach 100%.”
Exactly. That’s the plan, isn’t it?
—- Steve
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It is also important to remember that these brain scan studies always use averages of a large number of scans. Any individual person’s scan may vary widely from the average, and the scans you see represent at best general correlations of what is MORE LIKELY to occur in one condition than another. Of course, this is to be expected, given the heterogeneity of people who happen to get any one particular label, and it’s always important to keep in mind that any similarities are more likely to be related to treatment effects than to any similarities the participants may have had preceding “treatment”.
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You should read “Anatomy of an Epidemic” if you want to understand why most of us disagree with your assessment of optimum care for the “sickest people.” There is actually good evidence that simply providing housing for a person without any expectation of treatment participation improves their symptoms, as does giving them money to buy essential items in their life. Whereas the long-term outcomes associated with psychiatric drugs are looking more and more discouraging. It seems they may actually make it LESS likely that a person will recover from a “serious mental illness.” Don’t you think that’s something people deserve to know?
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People should not be shamed for not “recovering” the same way someone else expects them to, any more than they should be shamed for rejecting Psychiatry’s worldview that their condition is a chronic and incurable disease. We’re generally not talking about individual cases here, but about big-scale trends. And the big-scale trend in the world of “chronic mental illness” is that psychiatry, on the balance, is making things worse in terms of the probability of recovering a functional life. The biggest objection I have is not to offering the drugs, but to lying about what they are and what they are “treating.” A couple shots of Jack Daniels “treats” anxiety just as well as a hit of Xanax or Valium. They all reduce anxiety and bring certain side effects. But “treating” someone with alcohol would be considered horribly unethical, while prescribing Benzos like the above chronically over many years is totally accepted psychiatric “treatment.”
Individuals should have the right to make informed decisions. Lying by doctors (0r pharmaceutical companies) on a grand scale prevents such decisions being truly informed. “Recovery” is a personal thing, but enforcing “treatment” that can make you worse is a political one and should not be allowed.
—- Steve
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“Say no more, say no more… a nod is as good as a wink to a blind bat, eh?”
“Sir, are you implying something?”
“Oh, no…oh no, no, no, no, no, no, no … yes.”
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This is VERY good news! I had to laugh when they write that pharmaceutical companies claim that “ads help consumers learn about diseases.” Those guys are SO sociopathic, it makes me ill! At least they could admit what they were up to – why would they spend 16 billion dollars on DTC if it didn’t bring back a whole lot more in profits?
—- Steve
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It is sort of ironic that they settled on the “insulin for diabetes” meme when the main “treatment” for certain “illnesses” actually CREATES diabetes. It’s also the only area where “good treatment” leads to a shorter rather than longer life expectancy, which of course would be a disaster in any other field of medicine!
It IS a big deal!
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The link does not lead to the article!
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If he is attributing “little white lie” to Whitaker, he ought to present it in context. Whitaker was clearly using that phrase to highlight psychiatry as an institution displaying a marked tendency to minimize what is in fact a very crucial and dramatic alteration of the narrative of what a “mental disorder” actually consists of as well as how to “treat” such a disorder. Whitaker was certainly not suggesting it was a “little white lie,” he was suggesting that Pies and others of his stature are painting it that way, as a little something they did to make it easier for patients to accept their need for treatment, rather than a primary means of diverting clients from other kinds of help, or even convincing people without any substantive problems that they needed “treatment.” The corollary of benefit to the profession and the pharmaceutical industry should be a pretty obvious motivating factor for such intentional duplicity. To suggest that it’s “not a big deal” to lie to patients about the etiology and treatment for their purported condition is the very thing that Whitaker is critiquing, and that Pies is displaying in his responses.
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As stated, the critique is not of Dr. Pies, nor of Dr. Carlat, but of the issue of psychiatric key opinion leaders, which both Carlat and Pies most likely qualify as, remaining silent on the issue if the “chemical imbalance” myth. It is Hickey’s contention that responsible psychiatric thought leaders knew this idea was at best “simplistic,” and in certain cases, out and out disproven and false. And yet nothing was said or done to dissuade the public from adopting this convenient viewpoint, which specifically is noted to make people feel more comfortable taking prescribed pharmaceuticals. I think he also does an excellent job of outlining how “unrestricted grants” could wittingly or unwittingly steer even a person of high integrity subtly down the road of promoting something that was not actually proven to be the case. I’d be interested to hear your views on those points, rather than a critique of Carlat, who I’d say has made himself a relatively easy target at times, but whose candor in recent years I think has shed some significant light on how the psychiatric community views the chemical imbalance mythology.
—- Steve
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I don’t know if he reads them, but I don’t recall ever seeing a response from him.
—- Steve
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Ah, but they’ve already got the kids as long-term customers before they get there. It’s the elementary schools we need to kick them out of!
—- Steve
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You can probably get more funding for the second to last than any of the others. We don’t really want to know how social variables affect mental health, because then those in power would have to DO something about it, and that’s nothing but work, work, work… not to mention the lost profits if people start to get BETTER! We can’t have that, now can we?
—- Steve
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My thought exactly! The number of kids on antidepressants in college is something like 25%, and even more are taking stimulants, licitly or illicitly. I wonder two things: first, are we seeing the long-term impacts of messing with serotonin emerging, as a whole generation becomes more anxious due to counterproductive medical intervention in their brains? And second, as we increasingly substitute pseudo-medical interventions for genuine human-to-human problem solving, is this generation arriving at college with diminished skills because they’ve never been taught to cope with adversity?
I suppose my third question would be: what is the impact of gr0wing up in a world where even going to college does not give you a reliable key to economic success in a world that seems increasingly unforgiving of any deviation from a narrowing “norm” of behavior?
—- steve
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Not to mention, it’s objectively false. But lying is apparently OK to get people to “take their meds,” which is the main function of “mental health treatment” for the “seriously mentally ill” today.
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I’m sure it’s the bacteria. Couldn’t be that our modern lifestyle is just plain unhealthy, could it?
We all need green and natural environments. It isn’t something we need to study. All this will lead to is patented earth bacteria capsules so that people can eat dirt while continuing to live in a sterile environment doing things they hate with people they barely know and don’t care about without going completely around the twist.
—- Steve
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Wow. Thanks so much for sharing that! It is healing just to read it!
—- Steve
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You sound like the kind of therapist that was common when I started in the field. Unfortunately, your kind are becoming rarer and rarer over time. I hate to say this, but the main reason the DSM 5 diagnosis appears to indicate a fate of never recovering is not because the clients somehow infer that, but because THAT IS WHAT THEY ARE TOLD by mental health professionals. They are told they have a chemical imbalance in their brains, that it is incurable, but that if they take their medication faithfully, often for life, they may be able to function. Many with bipolar disorder of schizophrenia diagnoses are told that they should give up on their ambitions and accept that they have a disability and will be in treatment the rest of their lives. It is a most disheartening message, but it is delivered by our professionally-trained mental health workers, including psychiatrists.
And it is a self-fulfilling prophecy, especially for those for whom the medications don’t work or have adverse effects of major significance, which is actually quite a high percentage, especially when looking at those diagnosed with “bipolar” or “schizophrenia.” These people are dying years earlier than their non-drugged counterparts, mostly because of the very drugs they’re taking to supposedly improve their lives.
A fairly recent survey asked people with mental health diagnoses who gave them anti-recovery messages after hearing about their “disorder.” The #1 culprit, at something like 75% of the cases, was mental health professionals.
Folks like you may be helping, but you are a small fish in a very big ocean of distorted training and messaging. I’m glad you’re there to help counteract it, but the truth is, a large hunk of the negative stigma around being diagnosed “mentally ill” comes from the diagnosis and the people who assign it.
—- Steve
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Bottom line, Mark, is that you or whoever are setting arbitrary standards of “illness” that would never be accepted in the world of physical medicine. What is and is not considered problematic is very much a socially-mediated question. “Normal functioning” is defined differently in every culture and subculture, and pretending that interference with “normal functioning” constitutes an illness is most definitely a scientific fallacy of a high degree.
As to whether people have a choice or not, we seem to have dropped the concept of unconscious motivation out of our discussion of “bad behavior” in the last 40 years. People make choices, but they’re not always aware of why they do so. The hoarder is CLEARLY deciding to prioritize keeping unnecessary things because it meets some internal need that s/he is not aware of. The fact that this need and the attendant choice is not conscious does not make it any less of a choice. In fact, really good therapy, in my experience, is very much about making people aware of WHY they feel they have to act a certain way, which enables that person to make a more conscious and intentional choice rather than feeling s/he has to go along with the script unconsciously laid down by his/her past experience. I’d say the same applies to drugs or alcohol, although long-term use does make quitting a much more challenging decision to make. No one stops drugs without deciding to stop. It is a decision to continue, even if it doesn’t feel like it’s in the addict’s control.
—- Steve
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Exactly. People are told that it’s hopeless, and they feel more hopeless. Seems pretty logical to me.
—- Steve
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I agree on both points. And I think the same is true of true liberals. Both are endangered species!
—- Steve
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I would add that this is also part of the Gun Lobby’s effort to deflect attention away from gun control. If we can blame “the mentally ill” for these events and lock more of “them” up, they figure it takes the heat off of guns as a possible target for legislation. Of course, what they don’t realize is that they’re opening the door for more oppressive gun laws targeting the “mentally ill,” which given the DSM’s charge toward pathologizing any emotional reaction to anything, will soon include them and all of their constituents. It’s actually a great back-door way to disarm and disenfranchise Americans who object to the status quo, used effectively in the USSR and other places in the past. They really ought to be careful what they wish for, but as long as they can see “the mentally ill” as someone OTHER than them and their constituents, they will continue to support this odious legislation as a means of scapegoating someone other than their contributors for the problem.
— Steve
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This is SCARY! Why are conservatives, who are always expressing concerns about World Government, outraged by this attempt to control others’ behavior under government auspices? Why aren’t liberals, who are always expressing concerns about civil rights, outraged by this attempt to invade the privacy of anyone declared “severely mentally ill” by this ridiculously subjective set of criteria?
Where is the outrage?
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I agree, Alex, power is at the center of all of the “isms,” the desire to have power and the fear of losing it. Psychiatry is built on this desire and fear, from its very foundations, and it is only through our own humility and willingness to step out of power roles and create the space to be human that this can ever be healed.
Sera, thanks for writing this and putting it on the table for all to see and engage with. Not sure what else I can say – it’s a vitally important issue and I’m glad when folks speak out about it. I’ll make every effort to be all the more attuned to these dynamics in the groups I’m part of, including this one!
—- Steve
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Actually, I think it would be interesting to see what percentage of psychiatrists take their own prescriptions. Psychiatrists have one of the highest if not the highest suicide rate among professions. The first Fort Hood shooter was a psychiatrist. Just makes me wonder…
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I agree 100% and intended no criticism of the posting. It is the fact that it is considered NEW INFORMATION in the mental health field that is so distressing! I really appreciate your making this public so that others may recover from the misinformation they are flooded with on a daily basis.
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Brilliant idea!
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Don’t forget receiving medical care on your list of most dangerous activities! As of about 2000, receiving medical care was the third leading cause of death in the USA, after cancer and heart disease. Readers here will not be surprised to hear the #1 cause of medical death induction: side effects of properly prescribed and administered medication.
—– Steve
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The relevance of gun control to the Murphy bill is that it is that opponents of gun control are using the “mental illness causes mass shootings” meme to promote the Murphy bill as a deflection of attention away from guns. They really are completely separate issues, and should be treated as such, but we do have to be aware that in their zeal to protect gun rights, some activists are promoting discrimination against “the mentally ill” as the scapegoat for a very complex cultural problem. Perhaps some people in the survivor movement should try to link up with gun rights advocate groups and point out that this kind of law promotes exactly the kind of tyranny they are concerned about. Once we establish “mentally ill” people as dangerous, we can remove their arms, then label more people as “mentally ill” and remove their arms, too. The USSR used “mental illness” legislation to imprison thousands of political dissidents. It could happen here, too.
—- Steve
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Of course, they’re skeptical. They’re skeptical as to how this could be profitable to them and their brand. They can’t really allow competition to become mainstream – people might start getting better, and there goes the client base!
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Apparently!
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Laughable indeed. This sounds about as brilliant as saying, “We are going to eliminate all back pain by 2099 by studying the genetics of back pain.” While I have no doubt that there are genetic constellations that might make one more vulnerable to back pain, back pain is a sign to your body that something is wrong and should be addressed! Same with depression – it’s a message that something isn’t working. Why would anyone think that an emotion so central to our survival as a species should be eliminated? Or that it even could be?
These people are delusional. But apparently so are their funders.
—- Steve
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Or as the Buddhists say, “All misery is caused by expectation.”
— Steve
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Because when you actually try to help people who are depressed, you quickly discover that all of them have different needs and the same approach does not work for all of them. At least that’s what I’ve found. Take your light example. Some people who are depressed get better when exposed to more light. Most do not. All of them may qualify for “Major Depressive Disorder” diagnosis, but only a small percentage benefit from light therapy. If we study “MDD.” We may conclude that, say, only 15% improve with light therapy, therefore light therapy “doesn’t work for depression.” Whereas if we take Johanna’s approach, we say, “Let’s figure out who amongst this diverse group of “depressed” people will benefit from light therapy – that will help 15% of our population, which is awesome! Now let’s see what we can do for the next client who wasn’t helped by that. Let’s also see if there are other things that some of the light therapy clients might need to help them succeed even more!”
See the difference?
— Steve
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“When we go against nature, we are bound to become depressed.” That’s about the best description of the etiology of depression I’ve ever heard! Our society from our earliest days, even before birth, requires us to do the unnatural, from forcing babies to be born before they’re ready and snatching them away from moms to put them under lights in a box, to encouraging parents to let their babies “cry it out” in another room without responding, to sending kids as young as 6 weeks off to daycare, and later on to a school that has little respect for their developmental needs to explore and create and interact, to requiring adults to work 8 hours every day at something they find little to no meaning in in order to survive, and live under the constant threat that this job will be taken away and they will starve to death and die.
Depression is a natural reaction to unnatural circumstances. Kinda sums it up.
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This is the third no-brainer research article I’ve read on here today! Anyone ever been depressed? Does it help when people come by and connect with you? Why do we have to pay people to “discover” these obvious human facts?
—- Steve
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Another effort to study the obvious. Why is this even a question that anyone has unanswered?
— Steve
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First off, I hope no one was actually surprised by this revelation.
From the article: “For depression, the activation of a highly central symptom means that impulses will spread through the network and activate a large number of other symptoms, whereas a peripheral symptom is less relevant from a dynamic systems perspective because it has few means to influence the network.”
What an incoherent collection of blather! No actual mention of a human being or his/her experience in this paragraph or the article. We should send this to Ron Pies and ask, “Is this what you mean by psychiatry working on the bio-psycho-social model, Ron?” Looks like the bi0-bio-bio model to me!
—- Steve
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I’m afraid more “education” isn’t going to change anything, because most of these prescribers know very well what the risks are. They continue to do this because it benefits them either financially or professionally or both. What is needed is not education, but ACCOUNTABILITY. Doctors should not be able to get away with “standard and accepted practice” when that standard practice is harmful.
How about a ban on off-label prescribing for starters?
—- Steve
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I agree, there is a big difference between blaming someone and identifying the actual antecedents to a bad set of circumstances that has arisen. Blame implies judgment, but finding the contributing factors is more a matter of communication and honesty than blaming someone. I do get worried, though, when the author generalizes to “mothers” as the default cause of trauma. There are plenty of other traumatic sources besides our moms. My brother was a huge one for me! And I don’t think he was or is a bad person. He was just a kid and so was I and we were close in age and probably were not really meant to live together. I don’t blame him, but I do recognize that he was mean to me a lot and that it had an effect on how I grew up. To deny that in order to save his feelings would, in a word, be “crazy!”
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You know, there was actually an experiment at a university where students used a computer terminal to provide programmed “therapy.” The computer asked non-directive questions like, “Tell me about your childhood,” or “What was school like for you?” It was programmed to acknowledge the person’s answer appropriately (like, “Go on…”) and ask followup questions. If a person got off the track too far, it would say something like, “Let’s get back to talking about your father…” The funny thing was, the students reported feeling significantly better after interacting with the computer program! Maybe people mostly need to tell their story and not have it invalidated or questioned or be given a bunch of ill-conceived advice about it. But that’s not what they get in today’s mental health system.
—- Steve
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Maybe more like a blind man grabbing an elephant by the nuts and twisting, and being surprised when the elephant kicks him in the head and runs away.
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You speak very wisely. I am sure you’ve helped a lot of people, because you’re honest and compassionate. As you say, it’s not quantum physics. But most mental health people seem to be clueless or simply don’t care enough to try. What it mostly requires is being humble enough to know that you don’t and can’t know all there is to know about another person. So you have to care and listen and be willing to feel their pain. Not something our system seems designed to encourage.
Thanks for sharing!
—- Steve
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Had a client I saw in the hospital one time. She said, “For the cost of all this, I could take a two week vacation in Hawaii.” I said, “Yeah, and it would probably be more helpful!” She agreed and laughed. Probably the most therapeutic conversation she had had all day.
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Yup. It’s narcissism, plain and simple. I must be right, therefore, you must be wrong if you oppose anything I say or do. They go to the gallows protesting that they are the real victims.
I also had a charge placed in a facility that was obviously inadequate and dangerous. They placed this kid on two “antipsychotics” and two “mood stabilizers” at the same time. When her hands began to shake all day long, they told her it was because she was “nervous.” When I told the psychiatrists we were worried about the side effects she was experiencing, he said, “We haven’t noticed any side effects!” And they ironically had a poster of “client rights” on every hallway wall that included “the right to know what medication you’re taking, what it’s for, and what the side effects are.” When the volunteer assigned to the case asked the therapist if she’d gone over the side effects with the kid (who was 14 and quite bright), she said, “Oh, we don’t tell them about side effects!”
When they were shut down a year or so later, one of the repeated complaints was “an unwillingness to respond to feedback from the community.” They stuck to their distorted views to the bitter end.
There are some very dangerous people in this field, and the biases and structure are such that they literally can sometimes get away with murder!
—- Steve
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Well, I’m shocked. Corruption in the drug industry – who would have expected it?
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Too true! And women and children are usually left to take the blame when male-dominated institutions fail us. I think that’s a big part of what the DSM is about – shifting the blame from social institutions onto its victims, and the less powerful are the easiest to target, hence, women, children, the poor, the elderly, the darker skinned and the incarcerated are the scapegoats for any social ills that may emerge. If they’re unhappy or upset or angry about their role in society, it’s proof that their brains don’t work right, because if they were “normal,” they’d simply accept their subordinate victim roles without bitching about it and making things uncomfortable for the ruling elite.
—- Steve
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This should surprise no one, and yet nothing will be done. Doctors can basically do whatever they want, however stupid, as long as lots of other doctors are doing the same. Something needs to be done to create some accountability, in psychiatry and in medicine in general. Doctors really are handing these things out like M&Ms.
— Steve
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As to incentives, who said Socialism is averse to incentives? I think most social democrats would agree that incentives to, say, invest in green energy are good, while incentives like cleaning up oil spills without charging the company who spilled the oil are bad. I think they’d just advocate for different incentives.
Additionally, as B says somewhere below, I think socialistic structures in a capitalistic economy actually encourage innovation by allowing small entrepreneurs to make money more easily, while creating barriers to large corporate entities to dominating markets and suppressing wages and suchlike. I have no doubt that small businesses feel oppressed by regulations. But how many of those regulations are advocated for by Big Businesses themselves in order to assure their control of the markets?
The problem is not socialism, but corruption. Any government can be corrupt, but a combination socialistic/capitalistic political economy appears to minimize the incentives for corruption by assuring that beyond a certain point, trying to squeeze more money out of the workers and consumers of the country no longer really pays a big dividend, while investing in the community starts to look more appealing.
If you have doubts about this, look at how the city of Burlington, VT did under Bernie’s leadership. The business community did everything they could to keep him out at first, but in the end, they saw that their businesses thrived under his approach to government. That’s why he keeps getting re-elected – he really does know what he’s doing.
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I had the same misgivings. The biggest improvement in the “trauma theory” inherited from Freud (before he recanted and started blaming kids for “fantasizing” their traumatic sexual abuse stories) is recognizing that trauma comes from many sources, including the very social fabric we live within. Lots of folks with good mothers develop mental/emotional challenges due to bullying, abuse by teachers or other outsiders, racism/sexism/community violence, or just growing up in the unforgiving atmosphere that pervades our “modern” world. And of course, we can’t forget the trauma of receiving “treatment” from “mental health professionals” who invalidate the trauma that underlies most if not all “mental health” problems.
That being said, I’m also not inclined to let moms off the hook entirely, as NAMI so disingenuously preaches. Bad parenting practices are frequently behind anxiety, depression, aggression, or even psychosis. While they may not be the direct or only cause, the best way to minimize trauma is to have kids experience warm, loving, and safe homes. It’s also important to remember that parents are traumatized as kids, and often pass on what was done to them without being aware of it, unless they’ve taken some significant action to recover from their own traumatic upbringing. Alice Miller has written eloquently on this subject.
Blame is never actually helpful, but helping parents deal with and resolve their own issues with their own childhoods is an excellent way to help the next generation experience happier and less stressful and more productive lives. And we can hope that these healthier children will then raise yet healthier children and the world will become a better place. I think that’s really the only way the world will get better, if each of us can reach inside and accept and get OK with what’s happened to us and take concrete action NOT to pass it on.
—- Steve
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Ya think?
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Very cogent points. I also observed above that the NIH director spent a lot of time emphasizing the need for “early intervention in psychosis” and ignored the real point that more human interaction and less drugging led to better results. And of course, as Robert B points out above, no one bothered to try NO drugs as an option. I don’t think they really want to know what the result of that experiment might be.
—- Steve
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Among the staff, I mean, of course.
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Yeah, delusional thinking certainly seems to be the order of the day in the psych ward!
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Because they wanted to de-emphasize that aspect of the study, which threatens the psychiatric status quo.
—- Steve
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Nicely said!
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It is my understanding that the atypicals affect the serotonin system, and accordingly, some people do appear to have increased suicidal ideation, at least anecdotally. I think there is a warning at least on Zyprexa.
— Steve
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That was my concern as well. It’s quite a spin to take a study that shows LESS drugs and MORE social interactions and job training, etc. lead to better outcomes and say it means that untreated psychosis is the problem! Of course, the psychiatric field will never acknowledge that its interventions are less than miraculously helpful, despite evidence to the contrary, but it would have been great if the NYT authors hit that point a little harder. This is not just a new approach to treatment – it is a total indictment of the “lifetime med management” strategy that is encouraged and at times enforced on the unwitting victims of their “helpful” paradigm!
—- Steve
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Agree 100%!
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Good one! I wish all docs had to take neuroleptics for two solid weeks before they were ever allowed to prescribe them. Only the totally sociopathic ones would be unmoved by the experience.
I am sure they had to include medication in the mix as a way of placating the psychiatrists. It’s interesting that when I went to the “NIH Director’s Blog” link, the coverage stressed the importance of not waiting to start treatment and of adding therapy to the mix, and totally minimized the large reduction in drugs used. I made a comment on it, too. Doubt it will be read much, but hey, trying to do my part.
— Steve
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Those brain scans studies are ALL correlational. They take averages over time with a lot of subject and then highlight correlational trends. Not everyone with the “disorder” has the brain activity they show you, nor does everyone who shows this brain use pattern have symptoms of the “disorder” in question. There is no attempt made to determine causality (did the person’s brain become this way because s/he was feeling depressed or thinking about depressing things, or did the brain becoming like this cause the depressed thoughts or feelings.) And, as B points out, they are only usage patterns and reflect nothing at all about structure or chemistry underlying the pattern.
Other than that, they’re super reliable.
—- Steve
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I’m glad this has finally gotten some national attention. Of course, they still have not considered how many of the clients would do even better with little to no neuroleptic “treatment” at all. Still, it’s definitely a step in the right direction, and appears likely to have a bigger impact than Wunderlink or Harrow, even though both showed similar trends.
When it comes to psychiatry, less is most definitely more!
—- Steve
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And also because of the lack of adverse effects, which are very real and can be extremely damaging. It’s one thing to take a placebo like Niacin that just gives you a facial flush and some discomfort. It’s quite another to take a “placebo” that can result in agitation, violence, anorexia, or permanent loss of libido, among other fun things.
—- Steve
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Though it might be thought more ethical than an experiment giving a bunch of people antidepressants and not bothering to watch whether they become violent or not, which is what we’re doing on a massive scale worldwide today.
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Kids with developmental challenges really show where psychiatry is coming from. They claim to be scientifically “treating” medical “disorders,” but Meili and her cohorts for the most part had no indicatio of any such “disorder,” if such are even assumed to actually exist. Despite this complete lack of any even pseudo-scientific rationale, they continued to push you to put Meili on drugs. But if she doesn’t have a “mental disorder” that is “treatable” with drugs, what are they proposing the drugs for? The truth is revealed. The primary purpose of these drugs is to control inconvenient behavior and make it easier for the adults to manage their difficult charges. There is no other reason, and they’re not even pretending there is one. This should give anyone pause who is prescribed these drugs for any reason. Not only are they willing to prescribe drugs for any purpose that suits the adults’ needs, regardless of “diagnosis,” they are also apparently willing to lie about their true intentions and the drugs’ adverse effects without compunction.
Well done holding the line on the “professional” insanity!
— Steve
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What I have heard from many users, and this is verified by studies looking at side effects, is that many people using these drugs experience a degree of emotional numbing, a sort of “I don’t care” or “WTF” attitude toward things that they previously might have cared about. A friend of mine who had used SSRIs called this condition of her mind “Zolofting.”
Now for some people who were worried a lot about their mom’s approval or whether they’re socially accepted, this might be a good thing, for them to start feeling like “who cares what my mom thinks, I’m going to do what’s right for me!” And these folks would report a positive effect. But what if the thing that’s keeping someone from committing suicide is the knowledge that their mom will be devastated? The result of “who cares what my mom thinks?” could be that an actual suicide attempt is made. Or perhaps the person is repressing the urge to kill people because it’s socially frowned upon and jail might result. A change to a “WTF” attitude may mean carrying out on ideas that might have remained fantasies.
I don’t think the drugs by themselves necessarily cause violent outbursts – I would guess that other factors need to be present as well. But I absolutely believe there is evidence that they may catalyze a latent thought or fantasy into an active plan. There are just too many of these shooters taking or withdrawing from psychiatric drugs for it to be a coincidence, especially when increased hostility, agitation, or suicidal thinking are known side effects. Increased hostility plus decreased inhibition probably won’t cause murder in 99.9% of people, though it may cause a host of other problems. The mass murderers are a tiny percentage of users, but they should be seen as canaries in a very dangerous coal mine, indicating that disinhibition of negative or dangerous behaviors is a very real risk with SSRIs, which should be carefully considered both before and after any person is allowed to take these drugs.
—– Steve
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And the goal of mass extermination was not accomplished by disarming anyone. It was accomplished by creating “other” groups and demonizing them, assuring the general public that they were in danger from the “others,” not the government. Group by group, they peeled off larger and larger segments of the society, until those who would resist were so marginalized that resistance was not realistic.
It was xenophobia, nationalism, corporate domination of the government, and the acceptance of eugenics theories that made Nazi Germany possible. Arms control had about zero to do with it.
—- Steve
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My thoughts exactly! The are blaming “depression” for their inability to do anything helpful, or even making things worse. Instead of saying “he has treatment-resistant depression,” what if they said, “We don’t have any idea how to help” or “our approach clearly didn’t work.” But such honesty appears to be anathema in the world of “mental health treatment.”
What would we say if the mechanic said our car had a “repair-resistant engine?” We’d fire them and find someone who knew what he was doing!
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“Pathological overreaction to the restraints?” Really? How can a person even talk like that? I wonder what she’d say after she spent several days being unable to do so much as scratch her nose! It makes me feel panicky just thinking about it.
Thanks for sharing your story. It is astounding how few people are able and willing to hear that a “helping” place like a psych ward can be such a nightmare. Perhaps it’s related to people’s need to distance themselves from the “mentally ill,” because empathizing means realizing that they, too, could be in the same place under the right or wrong circumstances.
I’m also glad you had at least one person who supported you through it all. I think that’s the minimum we all need – one person who can validate our story and believe in our ability to overcome the oppression that we encounter. I am also glad you’ve found MIA and I hope it continues to be a place where you can get your vital message out to those many who need to hear it.
— Steve
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Nothing really radical in this piece. More funding for mental health programs. Even speaks positively about “ACT.” Not really worth watching, except for a few chuckles. Jon needs some education from us, I think!
—- Steve
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What is also real is that classroom expectations have always been developmentally inappropriate in the lower grades, and are becoming more so over time. When I went to Kindergarten, we did a lot of pre-reading and psychomotor activities, like singing songs, identifying letters and letter sounds, counting to ten, finger painting, throwing balls, building with blocks, etc. No one thought that a Kindergartner should be learning to read. Certainly, the concept of being BEHIND in school was completely foreign. Now kids are expected to learn basic reading skills by the end of Kindergarten, they’re given worksheets and even HOMEWORK in some places, their free play time has been reduced bit by bit to a tiny proportion of the day, and they are expected at times to stay focused on things that most adults would find dull, let alone a 5 year old. We need to acknowledge that part of the “ADHD” epidemic is setting unreasonable expectations for kids and blaming them when they don’t measure up.
A recent Canadian study showed that waiting a year before admission to Kindergarten reduced ADHD diagnosis rates by over 30%! So a THIRD of ADHD is just plain starting too soon, and probably even more would drop off if we waited yet another year for them. In France, they don’t start school until 7, but by high school, their kids have surpassed US kids in every academic department. And France has one of the lowest ADHD diagnosis rates in the developed world.
We need to stop “treating” kids for being young and immature. They deserve the time and respect to be allowed to develop normally rather than being pathologized for being unwilling to sit still for things they’re not developmentally ready to do.
—– Steve
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I used to work at a community-volunteer-based suicide/crisis hotline. I spoke with one woman who had been trying different antidepressants for over a year, and was absolutely desperate since none of it has worked at all and she thought maybe she was just condemned to feeling awful forever! I asked her, “Has anyone ever told you there are other things you can do besides trying antidepressants?” She was instantly silent for a moment, and then calmly said, “No…” She’d been exposed to an entire year of the message that antidepressants are the ONLY answer, despite their obvious failure to be of the slightest assistance, and no one ever even intimated there might be another solution! She was quite willing to try anything, and we quickly came up with both a short- and long-term plan for her to start moving in a totally different direction. But it astounded me that she’d been misled in this way! And this was in about 1993 or so. I am sure things are far worse today.
—- Steve
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I actually read something recently that showed how a dose beyond a certain range is not going to improve the likelihood of response, and that in fact most psychiatrists used way too HIGH of a dosage, leading to avoidable adverse effects and even reducing the likelihood of anything positive coming out of the experiment. They recommended getting a person OFF of something that did not improve matters at the recommended dosage rather than continuing to increase it. Which makes way too much sense, even if you buy into the whole psychiatric paradigm, which I absolutely do not.
— Steve
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That is great news, Bonnie! It added some inspiration to what has been a somewhat discouraging day so far. I also sense a shift in the social fabric – I do mental health trainings for our volunteer foster youth advocates, and I used to get a lot of flak for critiquing the dominant paradigm just 4-5 years back. These days, most of the class is already halfway there before I even start. “Anatomy” was a catalyst that came at just the right time. Both your book and Bob’s new one are on my short list of things I must read ASAP!’
—- Steve
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I kind of agree with both of you – I think it is dangerous that so many Americans trust their doctors (in all specialties, not just in psychiatry) to know things and give them good information, when the evidence of the whole field being sold out to Big Pharma is so substantial. At the same time, it’s not reasonable to expect the average consumer of medical care to be educated and assertive enough to deny the pronouncements of doctors, who in many ways are the holy priesthood of our society. For a lot of people, questioning doctors is akin to questioning the entire underpinnings of everything they believe about life in the USA – if doctors are on the take, what does it mean? Whom can I trust? Where do I go for advice? It feels very unsafe and insecure.
So by all means, let’s encourage everyone to educate themselves, but that does not absolve doctors from blame when they intentionally lie to their patients or don’t bother to inform themselves about key aspects of their own profession. We don’t expect everyone to know how to fix their car or install new plumbing fixtures – we expect mechanics and plumbers to be experts in their field and if they don’t know their jobs, we appropriately blame them for ripping us off. Why should doctors have any lower expectation? In fact, shouldn’t they be expected to be even MORE responsible and careful in what they say, based on the amount of trust people are putting in them?
That many docs and most psychiatrists don’t set that expectation does not mean those who listen to them are any less victimized. We should stand to fight oppression, and the first step is self-education, but those who are not educated are still being harmed, and it is 100% the doctor’s responsibility to make sure that doesn’t happen.
—- Steve
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I like it. I might add, “Ignore the messenger” when you hear anything from him/her out in the world.
They made a pact with the devil, and the devil is one day soon going to demand his due.
—- Steve
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Which is why most psychiatrists don’t do that. As BPD says below, it takes away their market advantage. Plus it warps their brains too much to think they might actually be harming their clients in some if not most cases.
BTW, I have no objection to them talking about what psych drugs might be useful for – I remember a lady who was totally incoherent due to meth use, and they gave her a shot of Inapsine (a fast-acting antipsychotic), and in 20 minutes, I could talk rationally to her. Very useful! But only for the acute situation in order to be able to have the necessary conversation about what happened and why and what her options were to deal with it. Having her take Inapsine every day to prevent her from getting high or psychotic when she took Meth (the Methadone model) would be rank stupidity.
A little honesty would go a long way, but it would mean a total repositioning of psych drugs and psychiatrists as an adjunct intervention in short-term emergency situations rather than something that 20% of the society supposedly needs based on the warped concept that their brains don’t work properly!
—- Steve
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Wow, not quite sure how best to respond here. I guess my first reaction is that a psychiatrist’s or medical doctor’s first duty is to inform their patient of the truth, even if it’s hard to hear. So if someone comes seeking a pill to make things all better, the first response should be, “I need to be totally honest – there is no pill that can fix your situation.” Handing out pills because patients demand them is just plain irresponsible. You’re the doctor – you get to decide what you prescribe.
When I was briefly involved in the horrible job of deciding whether or not someone was to be held against his/her will in a psychiatric ward, I ran into a guy who was clearly asking for antidepressants. His friend insisted that there was no reason for his depression, that it was one of those “biochemical depressions” and that he needed drugs. I told the guy the honest truth: that there was no drug that would make him feel better tonight, that he’d most likely have to try out two or three or more and that it took weeks to see if it helped or not, and that it would not address any underlying issues that might be causing the depression. He looked increasingly distressed by the information I gave him, so I decided to ask him why he was depressed. I found out he had broken up with his girlfriend a few weeks back! And he thought it was all his fault! I ended up conducting an impromptu therapy session in the ER and ran him back to a time he was hiding from his dad behind his bed, knowing that his dad was going to ask him what he did wrong and would belt him if he didn’t have an answer, even though he had no idea what his dad was upset about. The guy felt MUCH better after only 15-20 minutes of conversation and was very excited where he could get more of that kind of help. He was a perfect therapy client who really WANTED to know what was going on, but had been duped by social messages and his “helpful” friend into thinking a pill was what he needed.
Just because the person is asking for drugs doesn’t mean s/he wants drugs. It usually means s/he wants hope of improvement and has been told that drugs are the answer. And certainly, the friends or family members who are asking us to drug the patient have their own agendas and should not be considered decision-makers in any sense at all.
I appreciate Hugh’s honest description of how these events occur, and I agree 100% that the doctor is often trying to appease a patient or his/her friends and family, or even protect him/herself from social and professional consequences. But the fact that this occurs speaks volumes about the moral bankruptcy of the psychiatric profession, as well as their almost complete lack of skill in understanding and handling human beings in states of distress. As the example above shows, most people want real help, not band-aids or symptom suppression. They’d love it if there were a magic pill to make everything all better, but we do them a huge disservice by pretending such a pill exists or ever will exist. They are best served when we assist them in learning that they have within them the capacity to find a path forward, and that we are there to assist them in finding the path that works best for them.
Psychiatry provides little besides temporary symptom suppression (in some cases) and empty promises (in the vast majority of cases). If psychiatrists started with the unvarnished truth about the risks and limitations of their “magic bullets,” most people who come seeking drugs will start to realize that drugs in themselves are not the answer. It is psychiatry’s ethical duty to get them that message, whatever the patients may have heard on the Zoloft ads, but I see very few doctors honest enough to admit that they don’t have the answers or to empower the client to seek real solutions that transcend momentary numbing of the “symptoms” of life being a rough go.
—- Steve
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And given the individual nature of these “issues,” it is also ridiculous to think you can have some objective outcome measure, since each person has different objectives and values that inform both their use and their evaluation of the services offered. “Evidence-based” therapy is tainted from the beginning in that their “evidence” is based on the same assumptions as “treatment” with drugs: namely, that “symptom reduction” is the ultimate goal and that the client’s assessment of the goals and success of therapy is, at best, a secondary consideration, if it is even considered at all.
You can’t create an evidence base without an objective way to determine who belongs in a particular group and what a “successful outcome” looks like. Psychiatry and psychology have both consistently failed to provide either, and have used their “checklist method” to cover for the fact that they don’t even know if their “treatment group” is a legitimate study group with a common variable to evaluate, let alone whether those so “treated” have made any measurable progress, since we really have no agreement or means of establishing what “progress” even means.
The only appropriate measure of whether therapy “works” is whether the person receiving it says that it works, and that will never be a scientifically measurable outcome. Different approaches work for different people. There is no cookie-cutter way to do it, and efforts to provide one only create confusion. Which, no doubt, is the real purpose of “evidence based” therapy evaluations.
—- Steve
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It also serves a political purpose: medicalizing suffering allows the privileged in society to continue to believe that they are better than the masses and that any objection or upset with their “benign” rule is due to failure in the person who is upset, rather than a flaw in the system that allows them to rule and look down on those they consider to be “the rabble.” It further allows those who are directly or indirectly expressing their dismay to be numbed into quiescence so that they will never be able to join forces and undermine the control of the privileged class.
— Steve
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Yeah, hardly stunning news to anyone in the field (like me).
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I get what you’re saying. There is an assumption that psychosis just somehow “develops” and that stimulants bring it on sooner. Of course, it begs the very important question of whether stimulants themselves are causing the psychosis to occur. Given what we know about stimulants, it seems a very reasonable question to ask, but this is one of psychiatry’s “blind spots,” whether intentionally or unconsciously, I don’t know. All I know is that they generally adopt language that assumes biological causation and inevitability all the time without ever noting the “metacommunication” that is implied. I guess if that’s your view of the world and you’ve never considered another, it doesn’t sound quite so odd.
—- Steve
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This totally reflects Irving Kirsch’s work. A 10% difference between placebo and active treatment is essentially zero when you take into account unblinding by side effects. If we used active placebos, it is likely we’d see no difference whatsoever.
Taking side effects into account, it seems that active placebos would be the preferred “treatment.”
—- Steve
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I agree. I do a quarterly training of new volunteers advocates for foster youth and take on the DSM and the mass drugging of foster youth pretty directly. I used to get objections from people who thought I was biased against drugs or psychiatry, even though my presentation is pretty diplomatic in its approach. But the last two-three years, I mostly get strong agreement from most of my audience, and even those who have doubts are still open to questioning the dominant medical paradigm. We are definitely making progress in the larger social sphere, though such progress is, by the very nature of culture, hard to notice on a day to day basis.
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I think what it means is that some kids who are prescribed stimulants later develop psychosis, and that it starts earlier than for people who develop it with no stimulant use. It doesn’t exactly prove that these kids might not have been psychotic without the use of stimulants, but it certainly suggests that may be true. Personally, I’m quite certain that a small number of kids forced to take stimulants when young do develop psychotic symptoms as a result. I am not sure anyone really wants to find out if that’s true or not, as there are so many billions of dollars to be made selling stimulants to help kids cope with the standard, rigid classrooms our society accepts as “normal.”
I see why it is confusing, but I think they have to put it that way so as not to overstate what they actually learned from the experiment. The next experiment is to match kids who are taking stimulants with similar kids who aren’t, and see if there is more psychosis in the first group, but that one will never get funded, for reasons I mentioned above.
—- Steve
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That would make an interesting qualitative and quantitative study. Gather up randomly selected focus groups of people who have received “medical care” for “mental health difficulties” and among the questions, ask them what messages they were given about why they were having difficulties and why they should accept drugs as a treatment. This would pretty quickly put the lie to Pies’ assertions that it’s just a few misinformed people making these representations. In my experience, it’s the most common explanation given, even to foster kids who have been massively traumatized over many years.
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Exactly. All emotions serve a survival purpose. It would be like a pill that made us not feel pain. No one WANTS to feel pain, but if we didn’t, we’d never know when to move our hand from a hot stove or when to come in out of the sun or that we had just stepped on a nail. Emotions are just the same – they exist to help us survive. Psychiatry’s biggest crime isn’t pushing damaging drugs – it is convincing people that their emotions don’t have meaning or purpose and that the thing to do is to eliminate them rather than figuring out what they’re trying to tell us.
—- Steve
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A “conflict of interest” is not pejorative – it is just a plain fact! What is insulting about saying to, say, a psychotherapist, “Providing therapy to someone you have a sexual relationship with is unethical because you are likely to lose objectivity” or “you can’t evaluate the drug that you yourself submitted for safety because you’re likely not to see flaws in your own arguments?”
Humans are not objective about their own work, especially if there is profit or social status to be gained. That’s not pejorative, it’s just the way it is. For them to try to “newspeak” this into something else suggests that they are trying to avoid the real facts and pretend that conflicts of interest don’t affect any of THEIR people…
They discredited themselves in the first sentence. Ridiculous!
—- Steve
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I think the correct statement would be that the “mentally ill” are no more violent than the general population when controlling for substance abuse. There may be a slight trend for the “mentally ill” to be more likely to be violent, but when compared to the impact of substance abuse, the trend is negligible. Of course, when we include the misuse of psychiatric drugs that can cause violent side effects, it may well be that there really is no difference at all.
Mind-altering drugs are by far more correlated with violence than any other indicator. In addition, domestic abuse and other forms of economic and social oppression are far more significantly implicated in the widespread violence in the USA. “Mental health” experts assure us that the presence of “mental illness” is similar around the world. Why, then, is mass violence so common in the USA? Can’t be because we have more “mentally ill” people, since the rate is supposedly the same world wide. So why is “mental illness” getting the blame?
I read somewhere recently that something like 4% of all severe violence in the USA is associated with “mental illness.” Even if we drugged all the “mentally ill” into a stupor, as appears to be Murphy’s general intent, that would still leave 96% of the violence untouched.
I’m glad someone is standing up to this convenient but inaccurate narrative and laying the truth on the line. More oppression is not the answer to violence!
—- Steve
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“Caring Rulers,” eh? Well, at least they’re getting around to admitting the “ruler” part of it. Of course, the real answer to improving their image would be to put more energy into “caring” and less into “ruling.” But as far as I can tell, there isn’t as much money in caring, so ruling always takes precedence, with “caring” being the justification for the right to rule. As in “caring” enough to protect us from our poor, mentally disturbed selves by making all our decisions for us, and drugging us into a stupor if anyone has the temerity to object.
—- Steve
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What was the question he posed?
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Dang, that was DEPRESSING! No joke intended. I am always amazed at people saying “My psychiatrist is great” despite trying 30+ drugs and ECT without any improvement. I can’t even imagine being in a state where allowing the surgical insertion of such a device in my brain would even enter in as a possibility I’d ever consider.
Another psychiatric success story!
—- Steve
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But wait, I thought these were “brain disorders” were were talking about! Do you mean teaching children skills and concepts of respect actually might improve their behavior without drugs? What a radical concept!
Good for Chile. Once again, the USA is lagging behind the curve and needs to look to South American to improve its treatment of its children.
—- Steve
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Exactly. And nobody pretends it’s a “treatment” or forces it on them as a solution to their problems.
—- Steve
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This did get coverage in The Atlantic:
http://www.theatlantic.com/health/archive/2015/09/paxil-safety-bmj-depression-suicide/406105/
And the NYT:
http://www.nytimes.com/2015/09/17/health/antidepressant-paxil-is-unsafe-for-teenagers-new-analysis-says.html?ref=health&_r=0
And CBS News:
http://www.cbsnews.com/news/paxil-antidepressant-ineffective-unsafe-for-teens-study-finds/
Among many others. It seems to be getting very good press so far! Maybe the pendulum is slowing…
—- Steve
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And in other news, a new study proves that the sun will continue rising in the East for the foreseeable future…
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Noel,
Beautiful writing, as usual! Your analogy with the sports training process is so appropriate, I’m going to use that in the future when discussing this issue. I’ve used the rape analogy before, but some people really can’t process the intensity of that one. This gives a great example of drawing a moral line between helping and domination/oppression.
And it IS a moral issue, and the attempt to redefine it as a scientific one is a big part of why they get away with continuing to do this. It may be helpful and acceptable to remove the means of suicide from a person’s access temporarily, but it’s impossible to see how to morally justify locking people up and shoving pills down their throat as anything but rank oppression and abuse.
I have faced the dilemmas you describe and ultimately decided I couldn’t work for that system any more, and got into advocacy, but I still believe it is fortunate that people ran into me rather than someone else when they were in crisis and at the emergency room. I hope you can find a way to continue to live with your principles and still be there for the people inside the system who so badly need someone like you to connect with!
—- Steve
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There is a feedback form at the bottom of the page. I gave my feedback, and I encourage anyone else who has strong feelings on this to do the same. I quoted Harrow and Wunderlink, which would be great if others reinforce so they don’t think I’m just one “nutcase.”
— Steve
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The idea that messing with neurotransmitters can make you feel better is hardly new – it’s existed a long as humans have existed, as long as we as a species have been able to ingest foreign substances into our bodies. My objection is not attending to neurotransmitter function, but calling the use of drugs to alter their function a medical practice. People should be free to experiment with substances to help their mood and behavior if they so wish, but of course, we all know that this generally leads to bad ends for those using this approach in the long term. Why would we be surprised that pharmaceutical drugs that mess with the brain also lead to bad ends? Again, how is this medicine? What is the difference between taking Xanax for an anxiety attack and taking a shot of Johnny Walker Red for the same purpose?
—- Steve
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Many individual psychiatrists may well be dupes, but the profession as a whole behaves in every way as a sociopathic individual, by their own description. While they may not be AWARE of their sociopathic beliefs, the profession at the highest levels justifies harmful and criminal behavior as “in the best interests” of its clients, so lying or forcing treatment or causing long-term physiological illness or even death are justified, because it meets the needs of psychiatry to believe so. Maybe narcissitic is a more appropriate description, but by their own definition, the entire profession is “personality disordered.” And it is important to recall that just because a person isn’t aware of his/her evil motivations, does not make the motivations any less evil. It just means they have good defense mechanisms, including justification of evil as being “helpful” to the victim.
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Is there really a QUESTION that his ties will bias him? Is there really a question that those ties were fundamental to his even getting the nomination?
— Steve
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I’m sure it won’t, but I agree, this is amazing news and I am hoping perhaps the beginning of a trend toward reanalyzing questionable data or conclusions, many of which have been driving practice in the complete wrong direction for decades. It should be front page news on the NYT. Maybe The Guardian will pick it up?
—- Steve
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Sorry, Len, but that link is just a bag of propaganda to “explain” something without providing any basis. Ritalin was supposedly introduced “as scientists began to develop a better understanding…” but there is nothing about what the original “understanding” was or what was “better” about their new understanding.
Remember also that Bradley’s experiments were on encephalitis victims whom we KNOW had actual brain damage. A REAL history would note that researchers ASSUMED that kids who were inattentive had “mimimal brain damage” that reflected Bradley’s cohorts but was not visible or testable, and that despite 50 years and hundreds of millions of dollars of research, no such brain damage has ever been detected. It would also note the history of the DSM, as it changed from the DSM II to the DSM III and altered the criteria to avoid any stated theories as to the cause of ANY disorder, including “ADHD”. And that this was done in large part so that psychiatry could regain their market share by pushing the idea that these “disorders” were biological in nature and required drugs to “treat.” But none of that appears in the “history” you quote. For some REAL history of ADHD, try “The Myth of the Hyperactive Child” by Peter Shrag and Diane Dvorky.
Propaganda is not the same as history.
—- Steve
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His focus is on “the neurobiology of complex social behaviors.” The study of which has yielded almost nothing after decades. Sounds like a sadly wasted career to me. I hope his replacement has a broader view of behavior as an adaptive response to environmental factors, but I’m not holding my breath…
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hing I was going to, and said it so very well. BPD is a creation, a description of what happens to many adults who received inconsistent and/or abusive care when they were very young. It’s no more a “disorder” than having a limp is a “disorder” after having had one’s leg broken. The “symptoms” of BPD are scars from psychic injuries that were perpetrated upon a helpless infant. To blame the victim the way psychiatry does just adds insult to injury.
Additionally, many so-called “clinicians” treat “borderlines” as if they were pariahs, subject to some untreatable condition that renders them chronically annoying and intractable. I have never found that to be the case. Some of my greatest successes in the realm of helping people were with victims of childhood abuse who bore the “borderline” label. It’s really just a way of stigmatizing and dismissing clients that our so-called “clinicians” are too incompetent or too lazy to deal with.
Thanks for your tireless efforts to bring attention to this travesty of a “diagnosis.”
— Steve
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Big Brother is watching you!
— Steve
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And please, leave firearms and other weapons at home when coming in for your appointment!
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I so agree. Even if we accept psychiatry’s model (which I most strongly do NOT), the emergence of NEW symptoms after “treatment” should cause any doctor with an IQ over 85 to consider that the drug is most likely the cause of the “symptoms.” But for some reason that never occurs to them, and adding another drug is always the solution. If one drug fails, let’s try two. I’d call it stupidity, but too much money is involved. I think the proper name is “corruption.”
—- Steve
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Jill,
Great summary of the issues and attendant literature. I’m glad that you mentioned the absurdity of increasing dopamine (or serotonin) on the one hand and then blocking its activity when the increase causes problems. The one aspect I’d like to highlight is that stimulants and/or antidepressants often CAUSE the very symptoms that are then identified as “bipolar disorder” or “psychotic disorder NOS” and then “treated” with antipsychotics. Working with foster youth, I’ve seen many, many kids who were started on stimulants and then became aggressive as a result, and instead of stopping or decreasing the stimulants, they get a new diagnosis and a prescription for Abilify or Risperdal. It does not surprise me that a significant majority of the kids taking antipsychotics are on stimulants. It is very likely that absent the stimulants, the “aggression” being treated with the “antipsychotics” would not even be an issue.
It is hard to overstate my frustration with this particular brand of criminal activity on the part of the psychiatric profession.
— Steve
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Arm amputation, coma induction, and murder all have high efficacy in reducing aggression and conduct problems in youth. Murder is 100% effective in every case. “Death therapy” could be the psychiatric trend of the future, except once they’re dead, you can’t bill their insurance company any more.
Using behavior as “symptoms” and “reducing aggression” as a drug efficacy measurement is fraudulent in the first place. Behavior is behavior and can have a million different “causes.” It is this slick translation of effects to “symptoms” that underlies psychiatry’s shift of focus off of causes and toward blaming the client for any negative experience they may have.
—- Steve
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There are also plenty of free support groups in pretty much any urban or suburban area for trauma survivors, including domestic abuse victims, sexual assault victims, victims of childhood sexual abuse, adult children of alcoholics, and many others. There are also groups like “women in transition” that offer support for changes in life circumstances, such as returning to work after childrearing.
— Steve
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Your analysis sounds spot on to me. Sad that they are requiring “diagnoses” now – college campuses are one of the few places left where you could get therapy/counseling without having to prove you fit into a DSM slot.
—- Steve
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Another no-brainer research study. People do better with social support and worse when they don’t have it. Unfortunately, they missed the biggest point: the other “treatment” did nothing to maintain any gains they made from receiving social support! Drug “treatment” should, at most, be offered as an adjunct temporary aide toward the goal of social reintegration, which is the real solution. The WHO studies and the Open Dialog and Soteria experiments should have convinced anyone paying attention of this, but I guess there are a lot of people in the industry who make money off of not paying attention to the actual research.
—- Steve
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Fascinating that the number of kids taking antidepressants before admission has skyrocketed, and the number of kids experiencing anxiety and depression has skyrocketed. Wouldn’t you think that all of this “treatment” they are receiving would have REDUCED the rates of anxiety and depression? But no, it seems the more treatment is received, the more anxiety and depression is reported! I guess maybe Bob Whitaker has a point…
—- Steve
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Right you are. Certain groups get shot more often because they are more vulnerable and easy to target, but the real problem is an almost total lack of accountability. Police in England have to make a special request to sign out a firearm. They shoot almost no one – like one or two a year or less – and yet have a much lower violent crime rate than the USA. Why can’t we do that?
—- Steve
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First off, DUH! Foster kids in EVERY state are inappropriately medicated and are not provided appropriate psychosocial assistance, all with the agreement and support of the psychiatric community nationwide. They’re a great market – plentiful and powerless and with insurance.
Second, I don’t know why people don’t get the “ADHD”-antipsychotic connection. These kids end up on antipsychotics because the stimulants make them aggressive and sometimes frankly psychotic! Stimulants INCREASE dopamine, which is associated with increased aggression in a decent proportion of the population. Having made these kids aggressive through stimulant “therapy,” they then apply antipsychotics to DECREASE the dopamine levels that they have been increasing with the stimulants! It is absolute biochemical insanity, but it’s a very obvious explanation for anyone who knows the biochemistry of those two drug categories. I wish more people would speak out about this, because I see it ALL THE TIME in the foster kids I work with, and the stimulants are almost never recognized as a causal factor, even if the kid was less aggressive or not aggressive at all before starting “therapy.”
Finally, it disturbs me that 5% of the GENERAL POPULATION of kids on Medicaid are on antipsychotics! That is a scary figure, especially when considering the extreme negative long-term health impacts of these drugs.
— Steve
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I think the assertive way to answer those questions is something like this:
“I appreciate why you are asking me these questions, and it’s nice to know you care, but I prefer to keep discussions of my emotional state private at this time.”
Or: “I am choosing not to answer any questions today that aren’t directly related to the condition I’m coming in for.”
Or, of course, you can just tell them the answer most likely to get them off your backs. They have no actual right to force you to answer any of those questions. If they are written down, just write in “N/A” as in “Not Applicable.” If they ask you why, just say that you’re a private person and you object to sharing personal information unless you believe it is necessary. You can even be humorous: “Information will be shared on a need-to-know basis” or “Do I look suicidal to you?”
If you simply maintain a calm demeanor and politely let them know that this is not anything you think they need to ask about, most of them will stop pretty fast. I am actually even more pre-emptive with my care providers. I tell them right up front that I’m not interested in getting into any kind of “mental health” treatment and that I avoid drugs at all costs, so there is not really any point in asking me about that kind of stuff. They can then write “patient refused” and their job is done.
Hope that helps!
—- Steve
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How do you know what might or might not have helped her? Was anything else tried besides drugs? How does she function today? Have the drugs led to a recovery of normal social and occupational functioning?
Some people do appear to do better taking psychiatric drugs, or at least report that they do. That’s not the point of the article. The point is that there is no way to determine that something is physiologically wrong with your relative based only on how she behaves. And the fact that she responds positively to a drug does not prove this point, either. For instance, I was very, very shy as a youth. When I drank alcohol, it made me less inhibited and more likely to introduce myself to a stranger or engage in a conversation with a group of people. Was I “disordered” or “ill” because I was shy? More importantly, since alcohol made me feel less anxiety, was alcohol a “treatment” for my “illness?”
Additionally, one never knows what goes on behind closed doors in a family. Sometimes things look very “normal” on the outside but are quite tense and uncomfortable for the family members, or sometimes just for one of them. That was true of my family – both my parents were very ‘nice’ and not abusive (within the cultural context of the day – we did get hit and in a pretty terrifying way on a couple of occasions), but the environment was quite unhealthy emotionally, with everyone pretending everything was just fine until tensions built and someone blew up and we scattered. A half hour later, we’d all get back together and pretend nothing happened, never talked about it again. It was not overt abuse, but it WAS traumatic over time and unquestionably contributed to my anxiety around other people.
So was I sick or healthy? Or was my family sick? Or do we just live in a sick society that thought beating your kids was OK at that time? How would you decide? If I had cancer, you could see it. Even something as nebulous as obesity has a measurement associated with it. There is no measurement for “bipolar disorder.” It’s someone’s opinion, nothing more. Drugs may or may not be helpful to a particular person, but telling them they have a “brain disease” based only on their behavior or emotions is a plain lie that helps no one and has the potential to do great harm.
—- Steve
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This is one of those situations where the jury is in but the psychiatric field just plain doesn’t want to hear the verdict. There is no doubt that brain cell death is caused by antipsychotics, and if they were anything close to honest scientists, they’d deal with it. This fact has a lot of explanatory value for both cognitive decline and in the increasing relapse rates in long-term users. You’d think that would be of interest, but since it goes against the financial and guild power interests of the profession, they will continue to argue that “we don’t know for sure” until and unless someone forcibly stops them.
—- Steve
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That’s what they do. It would be laughable if people didn’t swallow it hook, line and sinker. Consider such luminous examples as “Oppositional Defiant Disorder,” characterized by not doing as you’re told and liking to argue with authorities, “Intermittent Explosive Disorder,” characterized by having a bad temper and acting out physically at times, and “Mathematics Disorder,” characterized by having difficulty doing academic math work. They will take anything considered “non-optimum” and turn it into a disorder, especially if there is a drug company waiting in the wings to sell a drug to “treat” the “disorder.” “Social Anxiety Disorder” was essentially invented by the makers of Paxil, once they found that their drug tested out as being able to reduce the “symptoms” of the yet-to-be-defined “disorder.” “Juvenile Bipolar Disorder” was created out of whole cloth by one Joseph Biedermann, who of course was taking payola from a drug company.
The whole DSM is constructed that way – they take a bunch of behaviors that often occur at the same time, make them into “criteria,” decide how many “criteria” you have to meet before you have the “disorder,” and bam! you’re mentally ill! They might just as easily take a nose-picker and say he has “Excessive digital-nasal insertion disorder” characterized by … It is just that scientific, aka not scientific AT ALL.
It makes me ill that they get away with this crap!
—- Steve
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Great quote by Huxley – could not agree with him more!
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Too true! And it’s especially easy when the medical profession provides “cover” for the practice.
In what other specialty would it be allowable for doctors to prescribe drugs to patients who have no diagnosis whatsoever? The use of steroids or stimulants for athletic performance comes directly to mind. This is considered ILLEGAL and can result in criminal punishment! And yet, to give an antipsychotic to a little kid without even bothering to find out why they’re acting that way – standard practice now.
This is repulsive and shows how low the psychiatric profession and medicine in general has sunk. It’s time for an avenging angel to sweep those promoting the current way of “thinking” about kids and behavior into the sea. The criminals are running the show!
—- Steve
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Thanks as always for your exceptionally solid scientific analysis, Jay.
I have to ask, if we accept that each gene contributes only a tiny amount to this mythical “heritability,” and hundreds or even thousands of genes could be involved in a single personality trait, what the hell would be the point of discovering which set of 350 genes contributed to say, “ADHD”? Especially as not everyone with the postulated “disorder” would have the same subset of those 350 genes involved? And as none of these genes would be modifiable in any case once their presence was discovered?
Wouldn’t it make a lot more sense to study things that are controllable variables that have a more direct and knowable impact on behavior, such as poverty, education, parenting styles, nutrition, and protection from toxic exposures pre- and post-natally?
What is wrong with these people? It appears all they are worried about is being “right” even if their “rightness” is of no use to anyone. Oh, well, I guess if you’ve wasted your career on a fruitless line of research, it might be hard to admit it. Though of course, if they are real scientists, proving the null hypothesis isn’t fruitless – it’s just more information – you’ve proven that specific genes don’t create specific behavioral traits, and that’s a good thing to know. Too bad their egos and their mis-education in the sciences forbids them from observing the actual data!
—– Steve
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Hi, Jeanene,
Thanks for a very powerful recounting of your experience and your movement toward creating a new narrative! I think choosing our own descriptors and reclaiming our right to tell our own stories is central to any real healing. I also love the focus on society as the ill party who needs the real healing, because that’s what I see as well.
A couple of thoughts struck me during my reading. The first: do you think that most of those “normal” people that you and I both strove to be like are really “normal?” Or are they also suffering the same kind of oppression but have better ability to deny and repress their discontent and internal sense of rage? I really don’t know the answer to that question, but I am inclined to think that there are very few among our fellow citizens who really feel free to be who they are in this oppressive society.
I also noticed that you did not mention children among oppressed and invisible groups. I would submit that the oppression of children is almost completely sanctioned by society at large and lies at the base of many of society’s other maladies. A look at a typical school classroom supports this view: children herded together in age-specific groups with no choice of either where they go or with whom they care to associate. Teacher gives orders that children are expected to follow without question, regardless of their sense or offensiveness. Children who resist or rebel in any way are punished, or increasingly, labeled and drugged until they submit. Parents who object are marginalized in similar ways, either by shaming or patronizing behavior or by fear-mongering regarding the dangers of allowing the child’s “disease” to go “untreated.” Children have almost zero recourse when abused, neglected, or otherwise mistreated, with certain very limited exceptions, and even those are often overlooked or minimized when reported. And that doesn’t even get into the much larger area of parents’ ability to emotionally and even physically abuse their own children with impunity. I’d be interested in whether you agree with this assessment, and how you see it fitting into your analysis of later life as a “mentally ill”-labeled person.
Bottom line, I see “mental illness” as an effort of the dominant forces of society to deny the built-in oppression that all of us (at times even those in the dominant groups) frequently experience. You have gotten to the point of being able to express that out loud, which of course makes you dangerous to the elite, but also creates a new path of freedom for you to follow. Thanks again for sharing your story and inspiring me to keep my “madness” alive!
—- Steve
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Because psych patients are not considered actual people, so the laws apparently don’t apply. Seems like an excellent point for a mass protest – have a hundred people come by one or two or three at a time to visit patients on the psych ward, bearing copies of the state law, make sure the media is aware of it, and watch what happens!
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I am not arguing with you. I’m saying they do it to kids who are NOT diagnosed as “autistic” or anything else, who are just labeled as “aggressive” and are difficult to manage. The answer, of course, even when there are neurological differences is to use whatever strengths are present to help the person overcome the challenges presented by their unique neurological presentation.
—- Steve
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Ya think? What other purpose would they have?
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I was just going to post that almost word for word! We DO share a brain!
— Steve
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And Pete Early is actually kind of a moderate in NAMI-world!
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I wrote a book that lightly touches on this very phenomenon. It’s called “Jerk Radar” and is about how to prevent abusive relationships by detecting the fake “nice” behavior of the abuser before s/he lets his/her true colors show. You might find it of interest given your studies in the area.
—- Steve
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It reportedly “reduces aggression,” most likely because the recipient is unable to generate sufficient intention to move his/her fist toward someone’s face. They do this with kids all the time, too. There really is no “diagnosis”, the kid is just obnoxious and they want to keep them from acting up. To call it practicing “medicine” is a total farce. It’s social control, plain and unvarnished.
—- Steve
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Oh, NO, they would NEVER do something like that!
—- Steve
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It should be very interesting to compare the classic Zoloft commercial cited above and this link to a very simple description of down-regulation in stimulant addiction:
https://www.youtube.com/watch?v=nznSbVN6Ef8
Zoloft commercial: http://www.youtube.com/watch?v=twhvtzd6gXA
They even use the same graphics. It should be obvious to anyone comparing these two videos that the use of Zoloft (or other SSRIs) would lead to the same kind of down-regulation and ultimately to drug dependency and withdrawal effects.
I even found another you-tube link suggesting that down-regulation IS the mechanism of action of antidepressants!
https://www.youtube.com/watch?v=CdRoOVsa1ag
The only thing missing from the Zoloft commercial is the ensuing damage to the brain from this sudden increase in serotonin.
They are both slick and sleazy in the extreme!
—- Steve
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And c) a naturally-occurring empathy that has been bred or indoctrinated out of the majority of our “mental health professionals” and doctors.
— Steve
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It is unfortunate that none of the commenters seemed to notice that a huge percentage of the shooters are ALREADY RECEIVING PSYCHIATRIC TREATMENT in the form of drugs! Yet the call is for MORE drugs, even when the drugs haven’t solved or may even have helped create the circumstances surrounding the mass murders. Kip Kinkel, Columbine, Red Lake, the Batman shooter, possibly Adam Lanza, both Fort Hood shooters… the list is long. If psych drugs stopped violence, why would all of these “treated” shooters have been violent? And why is that question not asked by the Times?
—- Steve
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Good to know that a 4 year old is able to understand basic science concepts. Maybe they have a few things to teach our renowned psychiatric colleagues.
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My son got the “insulin for diabetes” lecture from a doctor, despite the fact that he was withdrawing from using multiple street drugs and also recovering from an assault by his roommate, among a lot of other stressors at the time. They did a depression screening and he said he’d been suicidal in the last two weeks, and the doc was totally prepared to prescribe. Didn’t even bother to ask, “Why would you want to kill yourself?” A four year old would have done a better job – at least they’d have the sense to ask, “Why are you cwying? Why are you sad?” My son was actually quite insulted by the whole approach, trying to encapsulate his wide range of human suffering into a “brain disorder.”
Yes, it definitely still happens all the time.
—- Steve
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Well, they can’t directly measure serotonin levels, but they can measure changes in receptor density, at least in animal studies, and it’s pretty clear that increasing a neurotransmitter in any area leads to a decrease in receptor density in that same area. So increasing serotonin leads to a pruning of serotonin receptors. This is not new information – it has long been understood as the reason why addicts develop “tolerance” and require more and more of the same drug to get the same effect, and also explains longer-term withdrawal issues that continue after the drug is out of the system. You often hear it described as “your brain has ‘gotten used to’ the drug,” but what that really means is that the brain has adapted to whatever change you made by making the opposite change in receptor density.
What should be clear is that if you decrease serotonin receptor density and then go back to a more normal level of serotonin, the brain will respond as if there is a serotonin shortage, because it won’t have enough receptors to receive the serotonin that is there. It appears the brain then adapts back in the direction of more receptors to compensate, but it is not clear how complete this process is or whether long-term use leads to permanent damage to the receptor system in question.
—- Steve
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You are so right, Joe. The biggest problem with training people on TIC is that a practitioner really has to be willing to get in touch with his/her own traumatic past and be willing to feel that pain before they can really be present to do good trauma work with someone else. When it comes to “mental illness,” the diagnostic system makes it WAY to easy for practitioners to project their insecurities and pain onto the client and victimize them yet further. I don’t think any amount of training can make it less traumatic to have your emotional reactions to a difficult childhood relabeled as “bipolar disorder” and “treated” by suppressing those reactions. I believe most DSM “true believers” really NEED to believe in the DSM because it protects them from seeing that they’re not so very different from their clients. But in my experience, it is the very ability to find those similarities and to empathize with the client’s situation that leads to an understanding of how to help.
TIC is wonderful, but without a total scrapping of the DSM, I don’t think the mental health world can really incorporate it, because it is totally counter to everything the current paradigm encourages clinicians to do to their clients.
—- Steve
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As I would expect.
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Alex, unfortunately the support group and mad pride movements have been coopted by the establishment. It doesn’t surprise me that peer services you encountered were “normed” just as the rest of the psych world is “normed.” I’m thinking more of things like the domestic abuse survivor groups or groups for spouses of soldiers in Iraq or other more free-floating groups that haven’t been coopted yet. Still you’re right, the same thing doesn’t work for everyone. It just seems to me that labeling your own reactions or coping measures designed to deal with a traumatic environment as “disabilities” or “disorders” is so automatically disempowering that almost anything you could do would be less harmful. A lot of people focus (properly) on the dangers of psychiatric drugs, but I find “diagnosis” to be the more insidious evil. Convincing people that they are abnormal and damaged is never a good way to promote healing!
—- Steve
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I understand how Will chooses to tread a careful line between saying what needs to be said and maintaining his credibility with the mainstream. He’s actually done a great job of this and gets invited to places where “antipsychiatrist” – labeled people never get to come. So I respect his ability to tread that line, but felt it needed to be said.
Can’t agree with you more about the incarceration of marijuana users. It is increasingly ironic that these psych drugs are touted as the “treatment” for everything from inability/unwillingness to pay attention to boring things to the natural grief from the loss of a loved one, and yet others who devise their own “treatment” that absolutely parallels the “reasoning” behind psych drugs are put in jail!
There really is no distinction in my mind between getting high/drunk and using psych drugs, except for who profits. Dosage control is more of an issue with the self-applied approaches, as is purity of product, but in terms of what is trying to be accomplished, you’re giving a person a drugs in the hope s/he will feel/think/act “better” by some person’s definition. To call it a medical intervention is as silly as calling a shot of Jim Beam to relax after work a prescription.
— Steve
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Great article, well-researched, balanced and informative. My only objection (and I understand your reasons) is in the title. It would seem more correct to say “interest in marijuana for making people feel or function better.” It is no more a “treatment” than Zyprexa in my mind – it’s just a drug that can improve some people’s mood and functioning and could potentially damage that of others, as you describe so well. To call it a “treatment” buys into the idea that mental distress is a “disease,” which does not appear to me to have ever been shown to be the case.
That being said, I’ve often thought it would be interesting to do a head-to-head competition between marijuana and psych drugs for anxiety or depression. I bet it would match or beat any psych drug for helping with those experiences, and would certainly have vastly fewer side effects. The issue, as noted, is dosage control.
Thanks for the additional info about the different types of marijuana as well. It seems that a well-informed clinician should be able to help advise a person on some viable options that are much less dangerous than the ubiquitous psych drugs that are so readily handed out without a tenth of the concern people give to this relatively innocuous plant.
Thanks for a very educational blog!
—- Steve
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I agree, Fichara. NORMALIZATION of our feelings and experiences is primary to healing. Yet psychiatry does the opposite – it pathologizes normal reactions and makes people feel inadequate and embarrassed about their own at least semi-successful methods of coping with a less than optimum reality. Support groups are radical because the whole idea is to connect with other people who understand just how normal your reactions are. The support group movement was and is very threatening to the psychiatric establishment.
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Thanks! I attribute my youthful looks to my commitment to ongoing immaturity.
—- Steve
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And these are the ones under some level of scrutiny. What happens in the ones that AREN’T registered?
And pretty sleazy of the journals not to make this a requirement before publication. Not surprising, but definitely sleazy.
— Steve
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You’re right, of course. Parents do the best they can, and blame isn’t really appropriate when someone is doing the best with the tools they have. But allowing parents to accept responsibility for their contributions to whatever issues are going on for kids allows them to address and change their own behavior in a way that can help. Instead, we are denying them their own power and claiming there is nothing they can do about it! I don’t see it as blame at all, I see it as empowerment for both kids and parents. Unfortunately, the NAMA/APA line has been the opposite – any suggestion that parents might be able to impact the situation is seen as “parent blaming” and is shamed out of existence. It’s actually a quite insidious way to take away parents’ control and responsibility for their offspring.
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I do think it is swinging that way, and about time. I am just predicting that it’s going to take some serious force to keep it moving that way, because I think psychiatry as an institution (not talking about individual psychiatrists here) has been denying this fairly obvious truth ever since 1980, and is not likely to decide to change paths, and in fact will continue to actively oppose this kind of thinking. I sure hope this momentum continues, because I view it as a return to sanity!
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I agree – it all fit in very well with the Reagan Revolution and the “Me Generation” and the deifying of greed and rugged individualism and the de-contextualizing of poverty, racism, etc. And I also think things like support groups (non-professional people helping each other? Heresy!) were very threatening to the authorities. Psychiatry’s move was very coherent with larger society’s backlash against the rebelliousness of the 60s and early 70s. Which probably helped the selling of the “chemical imbalance” story – it’s a story the elite establishment also liked and related to, because it let them off the hook for the oppression they were creating and advocating for.
—- Steve
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Great article, Wayne. I love the vision. However, I am afraid I don’t see things going that way in the long run unless the institution of psychiatry is dethroned as the ultimate arbiter of what makes someone mentally ill or well.
When I first got into the MH field (1896), the DSM-III was new and just starting to have an impact. At that time, everyone KNEW that mental health problems were caused by childhood trauma! Although too much blame was probably put on mothers and not enough on fathers, siblings, communities and societal institutions, it was generally accepted that we learned to be the way we were as a means of coping with our childhood environments at home. Carl Rogers was in the ascendancy, everyone was recommending using “I-statements” and having family councils at home and avoiding spanking and letting your kids feed when they wanted to and picking them up when they cried. Counseling and support groups expanded explosively at this time, as did grassroots political efforts to reduce social oppression, such as domestic abuse shelters and programs and volunteer community crisis lines.
This changed primarily because of the DSM-III and psychiatry’s selling out to the pharmaceutical companies in the interests of increasing their market share. The narrative was changed because it didn’t fit with the needs of the new paradigm, namely that mental illness was in your brain and you needed drugs to fix it. The propaganda to that end was remarkable in both its volume and its effectiveness, and within a generation, it became an absolute taboo in the MH profession to attribute any responsibility to a parent for how his/her child turned out, and of course, social causes of mental illness were ridiculed into oblivion.
With this amount of investment in their “model,” however fictional they may know it is, it is difficult to imagine the profession of psychiatry allowing this new (old) narrative, which, let’s be honest, is what most of us intuitively know is really the case without having to look at the ACEs study, to get more than minimal footing, because it will cost them buku bucks. And of course, Big Pharma would be even more upset if we started talking instead of prescribing, and maybe even curing people to the point they don’t need their “helpful” drugs any longer. I really wish that the facts so clearly demonstrated in the ACEs study were sufficient to convince Psychiatry to join the movement and to join reality, but unless the profit/loss balance sheet changes significantly, I see them as likely to fight any such efforts to the death.
— Steve
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John, I think the issue is not so much about whether biology is connected to emotion and behavior, which it obviously is and which few on this website would ever deny.
It’s more that the psychiatric profession helped to promote the mythology of the “chemical imbalance” in order to promote their product, namely psychotropic drug prescriptions, as the ultimate answer to mental health problems of all types. Naturally, they had a great deal of help from the drug companies who stood to profit far more than the psychiatric profession from this viewpoint. But the issue isn’t really about the brain, it’s about institutional corruption and the intentional deception of patients to further the professional and financial interests of those who profit from this “story.”
To that extent, it IS important whether psychiatrists were simply misguided and overenthusiastic, or were blinded by their own guild interests despite believing they were doing right, or were consciously and intentionally engaging in dishonest propaganda with the full knowledge they were lying and probably hurting their clients. The answer to this question has a great impact on whether one believes psychiatry is a redeemable or reformable entity, or whether its very purpose is destructive and dishonest. A misguided psychiatry should be able to be redirected with the truth, whereas a consciously corrupt psychiatry would resist any attempts to undermine their market advantage, regardless of the truth of their position.
As I remarked above, your “Moncrefian” view of drugs as a practical aide for particular symptoms neatly avoids this pitfall, but I think you are a minority viewholder amongst the many psychiatrists I have interacted with over my career. I think most fall into the blinded category, believing what is generally believed and not wanting to rock the boat too much, even if they see some issues with the current model, but I also see evidence that there are a large number at the higher echelons of the profession who do actively suppress any data contrary to the psychiatric storyline (Jeffrey Lieberman would be a perfect example) and attack the presenters of such information rather than deal with the actual information presented. Such people are not just following the herd for career reasons – they are setting the tone for the profession, and their continued support for purely biological explanations for “mental illness” and for the factual validity of the DSM diagnoses that even the head of the NIMH admits are of questionable validity and utility shows that they most likely are corrupt rather than misguided, and are probably not amenable to change this side of criminal charges or death.
—- Steve
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This should not be surprising, as Risperdal and all the “atypical antipsychotics” cause heart issues in adults of whatever age. I’m glad Australia is finally doing something about it and hope the USA follows suit, but it should have been done long before. This is not new news.
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Agree completely. The big error is believing that what is now defined as “mental illness” represents distinct entities that require distinct treatments, rather than suggesting the need for a thorough search for what is causing these manifestations to occur. Which requires humility and respect for the client and a willingness to recognize the complexity of both the brain and of human behavior. As in general health, drugs can be very useful in acute situations, but long-term use almost always becomes problematic over time, even with the most beneficial drugs. But of course, it’s hard to make massive profits on psychosocial interventions, and as long as capitalism drives medicine, we’ll get this kind of profit-driven oversimplification rather than a more considered look at the big picture.
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Both very good comments, Alex. I agree, forgiveness is for the forgiver more than the forgiven, and it does NOT imply acceptance or tolerance of bad behavior.
Your comments regarding abusive people are also right on. I’ve worked with domestic abuse victims a lot, and the most successful strategy I’ve recommended is not reacting to the abuse. At first, it leads to some degree of escalation, but if that doesn’t work, they change tactics, and if that doesn’t work, they become puzzled and dismayed, and ultimately bored, and start looking for other victims.
Compassion for the gaslighters of the world is best accomplished at a safe distance!
—- Steve
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I like your understanding of how medication is best used – sounds like you and Joanna Moncrief would agree on a lot.
I understand your point about the loss of randomization, though of course the real world works much more like the post-study period of time and less like the experimental conditions. Still, I would not consider this definitive, but there is a lot of other data published since that supports it. The Raine study was referenced on one link in the article, and it drew similar conclusions. The Montreal ADHD study also found that kids who stayed on medication over time did the same or worse on major outcome measures. There was a recent study comparing Finnish children and US children, where the rates of ADHD dignosis were similar, but stimulant treatment was much more common in the USA, and yet treatment outcomes were no worse and maybe even a bit better for the Finns. And then there was the OSU medication effectiveness study done somewhere in the early 2000s, where they found that no major outcome measure, social, educational, or emotional, was positively impacted by stimulant use, after looking at basically every study ever done on the subject that they could dredge up. So I think the jury is in on this one – stimulants do NOT improve long-term outcomes for kids. And it is to me disturbing that despite what is now a fairly solid set of literature data showing this to be the case, no one, and I mean basically no one, in the mainstream discusses this fact, and they still tell parents willy-nilly that “untreated ADHD” leads to delinquency, school dropout, drug use, teen pregnancy, and low self-esteem, without telling them that on average, stimulant treatment improves NONE of these measures over time.
Psychiatrists have been trying to present themselves as being “scientific” by focusing on the brain and chemicals. They may appear “scientific” to the lay public, but if they were real scientists of any sort, they’d be willing to admit when their primary hypothesis is not supported by the data.
—- Steve
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Cool! I will definitely look into this. It makes total sense. But hey, if you can’t patent it and make a big profit, why would it making sense be of interest to the powers that be?
— Steve
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Your read of my comment is absolutely correct. However, I do think it’s helpful for this study to be published as support of the idea that it is schooling and other institutionalized or personalized experiences that contribute to the ultimate experience of “psychosis,” rather than just faulty wiring. The suppression of any natural and spontaneous activity on the part of children appears to be central to the modern school model, and I literally mean it that it drives us crazy.
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Alex, you speak wisely, as usual. However, I have to say that my compassion for the gaslighters is limited during the time they are doing the gaslighting. I am interested in hearing their stories, but only after I have tried to help protect their victims from further harm. Yes, they have stories, but so do most of us, and most of us choose to try and find a way not to pass it on, which is the minimum I really ask of a person who has other people in his/her charge.
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I agree 100%. Singing is also one of the things dementia patients remember the longest. There should be singing going on all day at these places, instead of giving them drugs that stop them from singing!
—- Steve
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Indeed. It should not be legal to drug someone just because you find them inconvenient, without even the poor excuse of a “psychotic disorder’ to justify it.
—- Steve
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YES!
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I agree, Alex. Bullying only occurs when it is supported by the status quo. Even the typical school targets of bullying (gay, dark-skinned, physically weak, lacking social skills, to “brainy”) are determined by social criteria and are condoned to some degree by the society at large. The only way to stop bullying is to confront oppression on the larger scale. I’ve always thought it deeply ironic that people talk about kids bullying other kids in school and say, “Kids can be SO mean!” Guess where they learn it? From the adults, many of whom run the very oppressive school system these kids are forced to attend! If I had to name 5 kids who bullied me in school, I don’t think I could come up with the names, but 5 teachers would be exceptionally easy to identify. Bullying is always a sign of living in an oppressive society.
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I was always of the opinion that school could drive me crazy. Looks like I have the science to back me up now!
— Steve
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Gutsy is right! It amazes and appalls me that no one thought to ask you about your family life growing up in all those many years. You are a very strong woman, and I am so glad you have recorded your experience. Looking forward to your book!
—– Steve
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It is laughable to compare the few farthings you pull in from speaking engagements and book sales to the hundreds of billions of dollars involved in the pharmaceutical industry corruption of psychiatry and our society as a whole. I for one appreciate the sacrifices you have made to get this message out, and I seriously believe the publicity surrounding your book has had a dramatic impact on the conversations going on nationwide regarding the “mental health” system. I hear SO much more critical thinking and so much less acceptance of medication as the panacea for “mental illness” than I did even 5 years ago, it’s quite remarkable. So thanks for putting your passions before your pocketbook. If the majority of those in the psychiatric field did the same, we’d be having a very different conversation today.
— Steve
—- Steve
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I should have mentioned – his funeral was the most hilarious event of its kind I’ve ever experienced, by a long shot! People were rolling in the aisles as 9 speakers talked for over an hour about his lively and eccentric personality and behavior. This was followed by a moving rendition of “Jesu Joy of Man’s Desiring” by Ginny on the flute, and the tears flowed freely. It was a true celebration of his life!
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Thanks! I value your opinion and encouragement highly. I do hope to write more in the future!
— Steve
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There’s been plenty of railing against psychotherapy on this site, especially the ubiquity of CBT in its increasingly reductionistic form.
I think the main reason you see more passion against psych drugs is because there is more long-lasting damage from their use, including serious physiological damage, including death. Psychotherapy just doesn’t have the scope and power to do that kind of damage. The other reason is that the chemical imbalance-chemical cure “story” has become the prominent explanation and justification for pulling more and more people into the realm of “mental illness” while spending less and less time trying to figure out what is really helpful to people in distress. Consider the millions spent on researching genetic causes vs. the paltry sum by comparison spent on the impact of trauma, when the association of early-life trauma with almost any mental disorder you could name is an order of magnitude higher than the most optimistic data on genetic associations.
The third and perhaps most important reason you hear more against drugs is because the bulk of the money corrupting the influence of psychiatry comes from the direction of selling more diseases to sell more pills. It’s just as profitable to talk to people over weeks and months when you can drug them in 15 minute segments and make more money at it. Besides which, people who get psychotherapy sometimes actually GET BETTER, and this really cuts into the bottom line and forces you to have to look for new clients. The therapy business can get pretty shady, and I’d recommend extreme caution and assertiveness to anyone looking for a therapist, but dollar for dollar, it can’t hold a candle to the drug industry’s incredible corrupting influence over psychiatric research and practice.
One thing to remember also: the patients you continue to see are the ones who continue to participate in the MH system. This creates a large bias, in that “dropouts” who are successful will almost never come to your attention. Reading this board, and looking at the WHO research and the prior research from the 50s on schizophrenia recovery rates, should convince you that there are a lot of such people around whom you would never, ever see in your practice, because they either don’t need your help or are terrified of getting enmeshed in the MH system. Look at John Nash as an example. He was still very symptomatic but intentionally flew under the radar to avoid being hospitalized again, and then he somehow came out of it again years later. Not a medication success story, but his story would normally never even be told, because no one in the system would ever hear about his recovery. They’d just say, “I wonder what happened to that guy? Must have either died or moved away.” He’d never get counted as a recovered client who recovered by escaping the system.
I appreciate your efforts to be rational. I encourage you to look a little further outside your normal field of vision. There’s a lot of healing going on in the community that you will never see in the office or the clinic. Don’t dismiss it.
—- Steve
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They are only “wonder drugs” in that it’s a wonder that psychiatry and Big Pharma have gotten away with lying about how bad they are for so long!
—- Steve
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Too true, I’m afraid. I’ve seen it way too often. I was called to see this one guy who couldn’t talk or get out of his chair, and literally kept walking into the doorframe because he was so zoned out. I couldn’t get him to wake up long enough to talk to me. I talked to the Activities Director at the home, and she said that a couple weeks before, she’d been hitting a volleyball back and forth with him in the courtyard! How can they consider that a “success,” unless the goal is to induce complete inertia? It would be more honest to just kill them outright, but I guess you can’t bill for a dead patient, so a half-dead zombie is the best they can do.
Disgusting and criminal!
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I agree, it is a very oppressive violation, and the analogy to rape is drawn by very many who experience it. And the very righteous indignation that arises when you actually start confronting what is being done to you and start objecting is considered yet another manifestation of your “mental illness!” Like my father in law grabbing Ginny’s arm too hard – it wasn’t a “mental illness symptom,” he was trying to tell them something and was frustrated that he couldn’t say it or they weren’t listening! How is expressing yourself honestly a sign of mental illness?
Anyway, thanks for your kind words. I admire your courage for standing up for yourself and deciding your own path. It takes some real chutzpah to tell these doctors where to shove their “meds.” And of course, when you do get better after rebelling, they say you’re “in remission” rather than admitting they had their heads up their butts. Glad you’re able to keep them at a good, long distance!
—- Steve
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Thanks, Richard! I also enjoy your contributions, both formal and informal – you are one who really “gets” what good therapy is about, and such peopel are rare.
My father in law passed away on January 1, 2010. Ginny’s mom moved him from that nursing home to a hospice care place pretty soon after her visit, which appeared to be more humane, though Ginny never had a chance to visit again after that. I think we were both a little relieved that he went pretty quickly once he became dependent on the nursing home for care. It was very hard on her mom and sister, who lived nearby and saw things going downhill. Alzheimer’s is tough, but the drugs don’t make it easier, unless you’re a staff person who is able to emotionally detach from the suffering of your charges and are only worried about your own workload.
Thanks for asking!
—- Steve
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Of course, there is also the little caveat that they only have to consider any two studies submitted by the company, even if there are 15 that say it doesn’t work or makes it worse.
—- Steve
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Don’t I know it! While I was highlighting the inappropriate use of these drugs for the convenience of nursing home staff, I see the same every day, as I work with the CASA program as an advocate for kids in foster care. I see kids on 3, 4 or 5 psych drugs whose behavior is massively out of control, who are getting kicked out of home after home and are in institutionalized care, but at no point does anyone (except some of our wonderful volunteer advocates!) stop and say, “Hey, I thought these things were supposed to make him better? How come he’s throwing bricks through windows? Do you think we might be missing the boat here?” No, all behavioral manifestations are the fault of the child or “the disease,” and even obvious stuff like obesity resulting from antipsychotics is dealt with by putting the kid on a diet! It is quite oppressive, and most of the foster kids coming out the other end will tell you all about it.
That’s not to mention the millions of non-foster youth on psych meds who are equally being harmed without notice or concern. There was one state where over 1% of the INFANTS in the state were on a psychiatric drug! Under one year old! Who would do that? How would they have ANY clue what the long-term impact would be?
The elderly and kids are the most vulnerable, but this basic approach of medicating “symptoms” without bothering to find out what’s wrong or even whether these drugs are helping or harming is ubiquitous in the “mental health” field. That’s a large part of why I don’t work in it any more!
—- Steve
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Have to agree with you, Mark. It seems a general lack of concern for the welfare of those we are supposedly “helping” is endemic in the mental health system. I see a ton of it at the other end, with youth, but it’s the same from preschool through the nursing home – we suppress “symptoms” inconvenient to the authorities and deny or don’t bother to ask about the experience of the client we’re supposed to be helping. The results are obvious to anyone with the ability to empathize with the less powerful in society, but apparently, there aren’t enough of these folks in mental health fields, or they are too intimidated to speak up.
Niemoeller’s quote is most appropriate to the situation, unfortunately!
— Steve
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It is the lack of empathy that I found so disturbing in re-reading these notes. I am glad they are doing more training, but there seems to be a more fundamental issue of disconnection from the consequences of these decisions that allows professionals to sit on and watch while someone deteriorates badly and blame them or their “disease” rather than saying, “Wow, that sure didn’t work!”
Additionally, you are right that taking a moment (as Ginny did when her dad was squeezing her hands too hard) to find out what is going on and to help the person calm down and refocus seems like a natural thing to do. But you’d have to be able and willing to put yourself in the place of the resident, and that seems to be something that a lot of our “mental health professionals” and nursing home staff seem unable to do.
— Steve
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Agreed!
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It is my first, and thank you for your kind words!
It is amazing how married people are to the idea that these doctors always know what they’re up to, and that we can always trust their word. It’s also disturbing how willing many doctors are to abuse that privilege and use their power to intimidate rather than to educate.
Ginny’s mom is pretty “0ld school” regarding doctors and took a lot of convincing. If her two daughters hadn’t been there, it is almost certain he would have continued on the drugs to his death. He was fortunate to have advocates in the family!
—- Steve
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Thanks – most informative blog. It is amazing that someone who knew he was obsessing about killing people was never even held accountable for failing to act. And of course, Sertraline (Zoloft) gets a free pass as always…
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And of course Klonapin’s product information sheet says that it should never be prescribed for more than two consecutive weeks due to its addictive nature. But psychiatrists and other doctors systematically ignore this and benzos are very commonly given for years. It’s a sick, sick system.
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LOL!
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Binge eating, like almost any behavior, meets a need for the person. If you help the person find out what need s/he is meeting through binge eating, and then try to find another way to meet the need, it becomes a lot easier to stop the binge eating. It doesn’t just happen randomly.
Psychiatrists would have us believe that we have no volitional control over ANYTHING, that our choices are meaningless and that we have no more self-control than a bird taking a crap as it flies overhead. If humans really just responded to genetics, we’d all be tearing our clothes off copulating in the streets and taking a dump wherever we felt like it. Human behavior has MEANING in a way that primitive creatures like ants never can. It is only by studying the meaning of the behavior that we can understand how to change it.
Psychiatry acts like the only two choices are to say to someone, “STOP DOING THAT” or to absolve them of all personal responsibility and give them a drug. I can’t think of a more stupid thing to say to a person who binge eats than to say, it’s just a matter of your genetic makeup. If I were the person you said that to, I’d be inclined to slug you in the face and say, “Well, I couldn’t help it, it’s just my genetic makeup that hit you.”
—- Steve
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We also have to remember that in almost all RTCs, actively suicidal people are removed prior to the investigation beginning. So we’re seeing 4% increases in suicidal thinking in people who WERE NOT THINKING OF SUICIDE BEFORE TAKING THE DRUGS!!! How this doesn’t merit a warning of the most serious kind is beyond my comprehension.
— Steve
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It should be 100% illegal to use these drugs just to “calm” someone who is difficult, especially the elderly and children. I’ll be sharing a blog next week about what happened to my wife’s dad on Risperdal. It’s pretty awful what these things do, and yet, as B says, there is zero accountability. The are literally getting away with murder.
—- Steve
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We should not forget that this guy was taking Klonapin and Zoloft at the time of his murder spree. Not saying that was the whole story, but these drugs may well have put him over the edge. At a minimum, they certainly did not make him safer.
Another psychiatric success story!
—- Steve
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First off, it is not the job of non-psychiatrists to prove there is NOT a brain pathology – as the ones making the claim, the burden of proof is on THEM, and as long as that proof is lacking, if we’re being scientific at all, we must assume that there is no such pathology or differentiation that explains the behavior.
Second, individuals with markedly poor care during childhood are generally NOT taught to control their temper, in fact, they have complete emotional dysregulation modeled for them and reinforced by their environment, which is one of the reasons that they continue to display that kind of behavior into adulthood.
Third, while there MAY be physiological changes resulting from abuse that may make it HARDER for individuals to regulate their emotions, we are insulting and diminishing individuals we are trying to help by implying or suggesting that they are unable to learn that skill. It absolutely IS a skill and it CAN be learned, and letting folks know that 1) their emotional regulation difficulties are a common and natural result of growing up in a chaotic environment (not a “disease state” at all, but a normal and common coping measure to deal with their world), and 2) that with proper motivation and hard work, they can learn other coping measures that may work better for them in the future, you give a person HOPE and DIRECTION, instead of encouraging pity and a sense of permanent disability.
I think we would be doing our clients a huge disservice by suggesting that something like temper control can not be taught. My main approach as a counselor is to maximize the empowerment of the individual to learn to take control of his/her life. Suggesting that they are unable to control their emotions provides a ready excuse for not trying and discourages the seed of righteous indignation that generally is found deep inside any abused person and whose presence adds strength and motivation to any attempt to make their lives what they want them to be instead of what others say they should be.
I also don’t agree with letting parents off the hook. Lax or even abusive or neglectful childrearing practices very often ARE at fault, but it’s never too late to learn, for parents or for their children. But no one learns anything until they have the courage to face the fact that THEY and no one else are responsible for deciding what they are going to do with their lives. Taking that responsibility away is one of the worst effects of the DSM process, because it tells people they can’t change themselves, and that is exactly the wrong message to send.
— Steve
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I am just waiting for them to come up with “Road Rage Disorder” in the next edition. They have “Shift Work Disorder” now, so why not “Road Rage?”
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Thanks for the laugh! My son actually had a similar experience after a few intense months trying a bunch of drugs and living with a seriously abusive roommate after running away from home. He had to call me at 3 AM to get me to retrieve him when the roommate was arrested, and a couple weeks later was still recovering from the drugs and the shame of having to come crawling back home and feeling like a failure.
He went to the doctor around this time for a skin rash condition. They did a depression screening, which asked “have you been suicidal in the last two weeks,” to which he answered “Yes.” The doctor came back with a lecture about how “depression is a disease like any other disease, and we have treatments now so you don’t have to suffer…” At no time did the doctor every say, “Wow, you said you were thinking about killing yourself recently! What’s going on that would lead you to think that way?” or “You said you had been suicidal recently – would you be willing to share a little more about what’s been going on?” My son was quite infuriated and insulted by her approach, which amounted to a sales pitch for antidepressants. Needless to say, he didn’t buy into her crap, but it shows how completely useless and downright destructive these diagnoses really are. They allow the clinician to completely avoid the uncomfortable gray area of “what is really happening and what should I do to help?” and go straight to a formulaic response that avoids any need to actually understand what is going on.
Seriously, the average four year old could have done a better job. At least they’d know enough to ask, “Why are you so sad?”
— Steve
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I think you may be missing the point. We are unable to determine the etiology of most psychological conditions because THEY DON’T HAVE ONE ETIOLOGY! As long as we keep treating “depression” as if it is the problem rather than a human reaction to some other underlying problem, which could be social, psychological, or physiological, we have no chance of figuring out ANYTHING about etiology! “IED” is not a condition, it’s a description of behavior that could be caused by a dozen different conditions, as Norman describes. So how will research on “IED” ever yield any results, if a tenth of those diagnosed have “IED” due to difficult social conditions, 30% act that way because of childhood trauma, another 10% have physical health conditions, 20% are in inappropriate educational environments, 15% suffer from poor parenting environments at home, 15% are having adverse reactions to drugs they’ve been prescribed, etc.? Diagnosing by symptom is stupid and counterproductive, as dumb as prescribing nitroglycerin to everyone who has a racing heart or doing knee surgery for everyone whose knee is swollen up. Medical problems should be organized around their CAUSES, not their EFFECTS! Otherwise, research gives you stupid answers which relate only to the suppression of the effects and allow the causes to go undetected and untreated in every case. That is what the state of psychiatry is today. We have a bunch of invented “disorders” that don’t have common origins and that don’t respond to the same kind of interventions, and because we lump all these things together and try to “treat” them as measured through symptom suppression, drugs always end up looking like the “best treatment.” And don’t think the drug companies don’t know this, either. That’s the whole game, beginning to end. Find out what your drug suppresses, get those symptoms into the DSM and defined as a “disorder,” and sell your drug to “treat” it. “IED” is only one of many similar examples. “Social Anxiety Disorder,” “Childhood Bipolar Disorder,” “Oppositional Defiant Disorder,” “Premenstrual Dysphoric Disorder,” ALL invented to sell drugs and other “treatments” aimed at making the symptoms go away without having a clue what is going on.
It’s a multibillion dollar industry. There is no impetus to create alternatives. In fact, there is an incentive to suppress them. And as for actually understanding the causes of people’s distress, that is the biggest threat to the market and the profession that there is!
You are naive if you believe that the profession of psychiatry is interested in finding and resolving the cause of any of their vaunted “disorders.” Curing people loses customers.
—- Steve
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Psychologists do diagnose “IED.” As to disputing the diagnosis, I’m not sure how anyone would really do that, except by maybe measuring the length of time between incidents or disputing whether the property damage done is “serious” or not. There are simply no concrete criteria for determining who does or does not “have” this “disorder.” It is literally anything the clinician wants it to be, as long as there is some kind of anger outbursts in there somewhere. Along with “Oppositional Defiant Disorder,” I have always “IED” the most ridiculous, nay ludicrous and absurd contribution to the DSM, and evidence in and of itself that the whole manual is a worthless bunch of biased social judgments and pseudo-scientific jargon based on absolutely nothing of substance whatsoever. The title itself is ludicrous: “Intermittent Explosive Disorder?” I always visualized someone strolling down a street past some small businesses and suddenly, KABLOOEY! They explode and splatter their brains and body parts all over the sidewalk!
It would be more helpful and intellectually honest to say, “Joe seems to have some difficulty managing his temper when he gets angry,” but you can’t really justify drugging someone for lacking a skill, can you? The range of drugs offered as “therapy” also prove the lack of integrity of the “disorder.” Anything that can be “treated” by antidepressants, benzodiazepines, OR mood stabilizers is something you’re just chucking drugs at. Why not just let the guy smoke a doobie three times a day? Or provide a dose of smack at mealtimes? It would make just as much sense as a “medical” treatment. In fact, marijuana would probably be a better choice than SSRIs, since occasionally the SSRIs actually CAUSE something very much like the very symptoms they are supposedly “treating.” But you can’t get much money out of selling marijuana compared to SSRIs, so that’s just not a solution, is it?
—- Steve
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Of course, they are also creating a lot of the symptoms themselves with medication side effects, especially of stimulants and SSRI antidepressants. I can’t tell you how many foster kids I’ve seen who started out on stimulants for “ADHD” and ended up on antipsychotics because it made them aggressive or manic. It always appalls me how incredibly irresponsible this prescribing is, and believe me, it’s NOT because non-psychiatrists are prescribing – psychiatrists do this all the time, and I almost never hear of them taking a kid off of something because the side effects are making him/her more aggressive or agitated.
It’s a monster of their own creation.
— Steve
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Actually, a lot of times they are prescribe antipsychotics because the stimulants have made them aggressive. Since stimulants increase dopamine and too much dopamine can lead to aggression or even hallucinations, it’s not rare for these to be seen in stimulant users, even at “therapeutic” doses. Of course, in their rigid and narrow-minded stupidity, instead of saying, “Wow, too much dopamine, better give them less stimulants!” the stimulants are in most cases let off the hook, and the child is diagnosed with bipolar disorder or some psychotic disorder and then put on antipsychotics, which ironically REDUCE the very dopamine that the stimulants are so effectively increasing above tolerable levels. One can imagine that the result of this push me-pull you kind of “therapy” are not very happy, but as always, the drugs are never to blame and it’s always the patient’s fault, so if the kid doesn’t get better with the two drugs, they get onto three, four or even five and usually end up in residential treatment. Even if the two drug plan “works,” the child is generally left overweight, unmotivated, and kind of hopeless. It’s a great plan, if you’re trying to drug someone into apathy.
—- Steve
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As baseball color analyst Tim McCarver once said, “They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
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“The importance of avoiding a one-size-fits-all approach?” Where is their criticism for the baseline behavior of the entire psychiatric profession?
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I would add that despite the huge positive publication bias, when long-term studies or reviews do support the null hypothesis, or even worse, show that the treatment is destructive over the long term, they are generally explained away or dismissed. Examples include Wunderlink, Harrow, the WHO studies, the long-term arm of the MTA, the Quebec ADHD study, the Raine study, and many more. Knowing that we’re already dealing with a bias toward believing Psychiatry’s story, it should be considered all the more important and relevant when data comes out that breaks through that barrier and says we have something more to think about. And yet folks like William Pelham, who honestly assessed the long-term MTA outcomes, are condemned as biased or ill-informed and business continues as usual.
This really does make me question whether any kind of research or factual data will ever bring about major reform in psychiatry. I’m afraid the field is simply based on false premises, and looking at the data will ultimately undermine its very foundations. And yet millions of people are making billions of dollars off this chicanery. So rather than reforming, I expect psychiatry as a profession to dig in and defend itself to the last inch of ground, yielding nothing to actual research. To allow the actual facts to surface will bring about the complete downfall of the current paradigm, and those with their snouts in the financial trough are not about to let that happen without a monumental battle!
—- Steve
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Cognitive Dissonance Theory sounds like a rarified way of saying “insufficient courage to face the truth.” We ALL experience cognitive dissonance. It is how we choose to address it that shows who we are. The seemingly easy path is to deny the data that conflicts with your preferred theory, because it’s either more convenient or safer or more profitable to stick with the status quo. That’s what the mental health industry is doing today. Everything that questions the current paradigm, from the long-term MTA studies to the WHO studies to Wunderlink and Harrow, is brushed under the rug with “we need more research” or “the sample is probably skewed,” or if all else fails, “The author is a Scientologist or and Antipsychiatrist and can’t be trusted.”
The path to enlightenment is to realize that cognitive dissonance is a learning opportunity. It means your operating model of the universe is not predicting reality. The adjustment needs to be made to your own model, rather than denying the incoming data that conflicts with it. This is called HUMILITY, and it is something that is strikingly missing from most of the KOLs in the psychiatric world today. It admittedly requires a lot of courage to stand up to the current power brokers in psychiatry, but the truth is not compliant to our social needs and fears.
—- Steve
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It is also important to recall that Freud originally recognized the primacy of trauma in women’s “hysteria” back in the late 1800s, but he was bullied by the medical establishment of the time into recanting this theory and attributing these recollections to “fantasy,” in essence, “false memories.” So psychiatric denial of trauma has a long and pretty intense history that has never really been dealt with. There have always been those in the mental health field who understood the central role of trauma in all forms of psychological suffering, and such people have ALWAYS come under attack from mainstream authoritarian thinkers who have tended to dominate both psychiatry and medicine as a whole.
Admitting the importance of trauma means acknowledging that authorities can not only be wrong, but can also be abusive and evilly intended. Most of those currently holding power don’t want that possibility to be considered, because in many cases, they are abusing their current power and don’t want to be called to account. It’s always easier to blame the victim and maintain your power.
—- Steve
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“False memories” were caused by therapists insisting that people (especially children) had memories they were suppressing and engaging in a search for them. This is VERY different than invalidating someone’s own recollections. Of course, the concept of “false memories” was grabbed onto with both hands by those who prefer an authoritarian world where kids do as they’re told and women know their place and pharmaceutical companies and doctors can make money without too many questions being asked, and what was a relatively brief error in therapy technique became a ringing critique of the idea that someone might ever have a vague recollection of something that actually occurred, or that repressed memories of abuse even existed.
I agree that one of psychiatry’s greatest crimes is to minimize the impact of abuse and trauma. The VAST majority of people suffering from ANY “mental illness” (except perhaps “ADHD,” which as we know isn’t an illness at all) are victims of trauma. We waste billions seeking for genetic explanations when the real explanation is before our eyes. “Mental illness” is primarily caused by oppression and trauma, which is rampant in our crazy society.
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It is a dilemma. Even when I just used the best diagnostic code I could to get the service I needed, and told the same to the clients, it felt like I was being coopted. I think a mass boycott is the real answer, but that requires a critical mass of people committed to boycotting, which is not yet forthcoming. For the moment, I think educating as many as possible about the subjective, culture-bound political nature of these so-called “diagnoses” and remind everyone that they’re just descriptions of behavior is the best we can do. I don’t think taking someone who chronically picks his nose and saying he has “excessive digital-nasal insertion disorder” does anything but confuse the issue, but that’s what most of the DSM really does. Just giving something a clinical name doesn’t mean you understand it any better. But you already know this. Preaching to the choir.
—– Steve
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Agree 100%! There is no “right” way to respond to stress and bizarre social expectations. Sensitivity is not a disease, except to those who want to be thoughtless and insensitive with impunity!
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Deck chairs on the Titanic, I’m afraid. It’s just a bad idea from the ground up, unless you are a pharmaceutical company trying to make as much money as possible by pathologizing every emotional reaction a human being can have. They really need to give it up.
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Sometimes an “unstable mood” is a normal reaction t0 an unstable world.
Love the poem!
—- Steve
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My wife did some research recently on the impact of culture on rates of postpartum depression. (She has an anthropology degree and has been active as a birth doula and La Leche League leader for years.) She found that in cultures where mothers have supportive people around them to assist with making food, washing up, and caring for the baby, postpartum depression is almost completely non-existent. Yet we are told it is all hormones…
And I’m quite sure having a mother who feels supported and having multiple available adult supports leads to less anxious adults.
Thanks for the additional data. We could learn a hell of a lot from traditional societies!
— Steve
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I am sure this is because their “disease” caused them to miscarry in some way. It could not be the drugs, because that would mean the authorities would have to actually think about what they’re doing to people’s bodies.
Or else they’ll say, “Oh, it’s very said, but the benefits outweigh the risks.”
—- Steve
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Yeah, they can’t actually be making people BETTER! What would happen to their customer base?
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I agree that social connection is something we have lost as a society (and not accidentally – there is writing back into the 1700s about the need to break up communities in order to serve the needs of industrialization) and that this causes a great deal of existential anxiety that we see around us. Relatedly, it is easy to underestimate the effect of the huge effort in the 50s and before to undermine mothers nursing their children and parents picking up their kids when they cry. The current 40+ generation was subjected to early childhood 4-hour feeding schedules and enforced “cry it out” strategies when we wanted comfort, and most were denied the physiological and emotional benefits of the nursing relationship. Additionally, most of us were removed by hospital protocol from our parents’ care immediately after birth during the imprinting period, causing yet further damage to the normal parent-child bonding process.
Some of this has changed (nursing figures have increased dramatically, for instance), but the damage is far from repaired, as our nursing rates remain unacceptably low, and there are huge swathes of society where mythology regarding sleeping arrangements, feeding schedules, and fears of “spoiling” one’s infant still reign supreme, including with some of our medical professionals. There remains, for instance, a constant message from the medical community that having a baby sleep in the same bed with you is extremely dangerous, when most of the world has used this arrangement for most of human history with little to no difficulty.
It is difficult to quantify the impact this has had on our society as a whole, but one almost certain result of babies not being picked up and cared for when they cry and not being held and fed when they’re hungry and being forced to sleep alone when they are frightened is that these babies grow up into more anxious adults.
It is not surprising that we live in a society where anxiety is so common. It’s actually a pretty scary society to live in!
—- Steve
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Too true!
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Including the trauma of being labeled and stigmatized for not responding “correctly” to the bizarre expectations of our bizarre society!
—- Steve
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Or we could say, “The kid has a challenging temperament and his parents treat him poorly, understandably resulting in a lot of acting out behavior.” Or “His needs are not being met by his parents and his behavior reflects that lack.” Why bother diagnosing at all? Just describe the problem we need to address and go from there.
—- Steve
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Typical reductionistic “research” based on untested assumptions and ignoring of inconvenient variables. Thanks for bringing it to light. Unfortunately, the mainstream will no doubt latch onto this as proof of the “biological nature” of “bipolar” without giving any thought to the extreme limitations of the study, which frankly make it almost completely meaningless.
—- Steve
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Where’s the link???
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I so agree with you! I think the DSM diagnostic process is more damaging than the drugs in the long run, because the psychiatrist/therapist becomes allied with the forces in the client’s world that have told him/her, directly or indirectly, that s/he is no good. The concept of trying to cure the bad parent/authority figure of his/her abusive ways is a powerful one that I find is essential to doing good therapy. If you haven’t read Alice Miller, you should do so – she talks about this as the central concept of therapy. We have to learn how to stop making excuses for our parents, and taking on our our own parents’ failings and trying to fix them, instead accepting that our parents have hurt us or failed us and that there is nothing we could have done or can do now to make it better, and really feel the grief of that loss. But instead, the labeling and distancing process inherent in DSM diagnosis conveys that YOU are the one with the problem, and that YOU need to be fixed, and that your feelings toward your parents or toward the psychiatrist are part of the problem, because you SHOULD be happy with what you got and the fact that you aren’t is proof that YOU are failing, not your parents.
It is a sick, sick system full of the very delusions they accuse their patients of harboring. If anyone “lacks insight,” it’s the people who take these made-up childish diagnoses the least bit seriously.
—– Steve
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I think there are two huge issues that need to be addressed but are never talked about. The first is that clinical people confuse restraint to protect people with therapy. There is nothing therapeutic about restraint, chemical or otherwise. It serves the needs of the people doing the restraining. Admittedly, sometimes those safety needs transcend the needs of the client, and that has to be recognized. But often the restraining is couched as some sort of assistance to the client to “help get him/herself under control.” This is especially true of chemical restraints, and doubly true with kids.
The other issue, which B mentions above, is that restraint is very frequently “necessary” because of abusive or thoughtless or incompetent behavior by staff people who end up provoking the client by putting them in a no-win situation. It’s so easy to always blame the client for such situations. Any time I read a report that says “Client assaulted staff” I want to read what exactly happens. More often than not, what happened is “Staff assaulted client” by putting hands on him/her or trying to take something away or force them to take medication or some such power struggle, and the client was defending him/herself, at least in his/her mind. Remembering that huge proportions of the “mentally ill” population have had multiple and serious traumatic events, often perpetrated by other staff in this or another facility, their sense of threat is naturally heightened and staff absolutely need to take responsibility for not threatening them. If staff can’t do that, they should not work at such a facility. Sadly, the staff almost always get a pass, no matter how poorly they behaved, and the client always gets the short end of the needle.
A restraint ought to be a rare event and be handled as a critical incident by the facility, with a full debriefing (including with the person so restrained, whose version of events must be fully respected) and proper discipline of staff as appropriate, including firing and/or criminal charges if they apply. It should never become so routine that 25% or more of the clients are experiencing it.
If staff people were held accountable for practicing good deescalation techniques and for avoiding power struggles, we could eliminate 99% of such situations without any physical intervention. Unfortunately, the people with the most power are the most likely to be held blameless, and the result is that restraint is common and unjustly and inappropriately applied daily at most facilities I have gotten to know.
—- Steve
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Hey, Joel, I sure don’t expect you to change the tune of the KOLs in the psychiatric profession, nor do I hold you personally responsible for their pronouncements! I do recognize that there are and always have been responsible psychiatrists (several of whom have blogged for MIA) and I appreciate that such people are swimming against the stream. It is definitely not acceptable (though it is in some ways understandable) to tar all psychiatrists with the same brush, based on the APA’s intransigence.
But the buck has to stop somewhere, and I’m not OK allowing the institution of psychiatry off the hook when they really have created the circumstances under which things have come to this pass. I really do think it comes down to the DSM (which again, I understand you have practically speaking zero influence over) providing an opportunity for the pharma companies and corrupt elements at the top of the APA to create a marketing strategy that doesn’t put patient/client best interests at the top of our considerations. Does the same thing happen in oncology, pain management, and obstetrics? (Oh, God, especially obstetrics!) Yes, yes, and yes. But I think that’s a job for another blog.
Corruption is a huge issue in medicine and in our modern society in general. It appears to me you are well aware of that, and I am guessing doing what you can in your limited circle of influence to change that. That’s all I’m trying to do here, and I think most of the posters as well. While some may express themselves more artfully than others, and some may have more direct reason for hostility toward specific psychiatrists, I think we all know this is a systems issue that starts and ends with politics. It’s an unfortunate fact that professionals don’t always make decisions based on what’s best for their clients, but instead on what benefits them personally, but again, that’s human nature. What I really think we need is a system where the incentives to medicate normal behavior and emotions are taken away, and where serious interventions are limited to acutely serious situations where they are merited. (And I could use almost exactly the same words to describe my views on childbirth and obstetrics!) I am guessing from your comments that you’d agree with me. I just wish we were in somewhat better company in forwarding that viewpoint.
—- Steve
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Joel, it is definitely true that people come to the doctors demanding benzos and other drugs, and certainly the pharmaceutical industry has much responsibility to bear for this state of affairs, as well as our government for being foolish enough to allow DTC advertising, which most enlightened Western democracies are smart enough not to allow. And you’re also correct that non-psychiatrists write the lion’s share of scripts for benzos, stimulants, and SSRIs. Where I find psychiatry as an institution to be grossly at fault is for providing a socially accepted pretext for this kind of prescribing behavior. When there are “diagnoses” available that are so speculative and subjective as “anxiety disorder,” and when the pharma companies have free rein to “educate” both doctors and the general public about these vague “disorders” (and in the meanwhile gradually distort the diagnostic boundaries so that more and more people appear to “fit” the criteria), the current scenario is an almost inevitable result, human nature being what it is.
This advertising and distortion could not occur without sanction of the APA’s DSM diagnostic criteria, and patients could not demand medication for an “anxiety disorder” if there were no such disorder to provide cover for their demand. Of course, it is 100% the doctor’s responsibility NOT to prescribe based on patient demand, but again, human nature says that the pressure to do so will mean more docs will give in and more patients will be prescribed drugs that are not needed or helpful.
I believe psychiatry’s institutional responsibility is to speak out loudly and firmly against this practice. Every benzo, as you well know, has written on the product information that it is not to be prescribed for longer than a several week period of time due to its addictive nature. Yet doctors all over the country are prescribing these for regular use over many years. I think it is incumbent on psychiatrists, who define these disorders and their treatments, to demand that this behavior stop, both within their ranks (which you yourself amount to 30% of the prescriptions or more) and within general medicine. I’d also expect a fully ethical psychiatric profession to speak out against DTC advertising, as it is obvious the impact this is having on patients and their increasing self-diagnosis and increasing demands on doctors for prescriptions, compounding this problem.
I see none of this. I see psychiatry as a profession sitting on its hands and blaming drug companies and family docs and even patients for the situation and taking no action whatsoever to remedy it. I don’t blame psychiatry for the entire problem, because psychiatry does not control the actions of patients or non-psychiatric docs or pharmaceutical companies.
But I do blame psychiatry for failing to take the responsibility to correct the massive amount of misinformation and mythology out there about benzos and psychiatric drugs in general. There is in my view a significant degree to which psychiatry promotes these very practices, but at the least, I’ve heard little to nothing from key opinion leaders concretely working to correct misimpressions about “chemical imbalances” and deteriorating long-term outcomes and the inappropriateness of long-term prescriptions of highly addictive drugs based on very soft and subjective criteria that almost any patient would be smart enough to fake. Silence in this case is appropriately interpreted as acquiescence to the status quo.
Similar arguments could be made about the use of opiates, but of course, the blame in this case would not be on psychiatrists, but on the pain management specialists for not making it clear to doctors and patients around the world that the long-term use of opiates for pain management is dangerous and generally counterproductive, and other more effective and/or less addictive options exist.
Psychiatrists are supposed to be the leaders in the field of medical treatment of mental health issues. When will the profession speak out against pharma manipulation and against the inappropriate long-term use of benzodiazepines?
—- Steve
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I agree 100%. And the insidious underbelly of this assumption is the belief that the status quo is completely healthy and functional and any adverse reactions to it must be due to failings in the individual, never the society or institution with which they are interacting.
A great example is ADHD. The entire “disorder” is predicated on the idea that all kids should be able to do well in a standard classroom. But that has never, ever been the case! And we also have proof that “ADHD” diagnosed kids do much better in classrooms that are designed with more freedom of movement and choice of activity. And yet the “ADHD” label protects schools and society at large from having to examine whether classrooms as designed are effective or need to be re-thought, or whether different kids may need different kind of classrooms or instruction, or whether the whole idea of herding kids into groups of 30 to be taught by one trained professional is just a dumb idea in the first place. No, the institution can have no flaws, so we must diagnose the child who doesn’t like or fit into the mold we’ve created.
Looking around society today, I’d say a certain level of depression and anxiety is completely to be expected. But those in charge don’t want to face the consequences of that observation, and psychiatry is only too happy to help label any dissidents as “mentally ill,” with the real standard being that we’re all right out of “Invasion of the Body Snatchers,” and anyone who is not “happy” with the current state of affairs is the one who has the problem.
—- Steve
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And my point would be that the ONLY thing science could ever prove is that “chemical imbalances” don’t exist. It can’t prove that they do. There is some possibility of proof by induction, namely that if chemical imbalances existed, certain things would be observed, and if they aren’t observed, than they are disproven. For instance, Bob refers to research in the 1980s showing that serotonin metabolites don’t differ between depressed and non-depressed subjects. That alone is enough to disprove the “serotonin theory” of depression, at least temporarily, as the expected outcome doesn’t occur if the condition were true. But as you say, human behavior is quite complex and we know next to nothing about the causes or processes involved.
I think scientifically, though, that the burden of proof for a “chemical imbalance” lies with those claiming it exists. The evidence doesn’t have to contradict this theory, it just has to not support it. So far, there is essentially no concrete support for the existence of a chemical imbalance, so from a scientific standpoint, it is wrong to suggest that this is the case. We can’t say FOR SURE that no such imbalance exists, but again, science is skeptical. Scientifically, we have to assume there is no such imbalance until evidence suggests this to be the case, while we can still retain the possibility that such imbalances might some day be discovered in some cases.
Of course, the more fundamental problem with this whole idea is that we’ve lumped “depression” case together without any real knowledge that they belong in the same group. If you study ALL depressed people, you will probably never find anything of use except for the crudest methods of suppression (as we have seen). If some depressed people actually DO have a “chemical imbalance,” you will never find that out by studying all depressed people and treating them as a homogeneous group.
Good science actually begins with a good definition of the problem, and in this case, the DSM has completely failed to provide one. Even Thomas Insel has recognized that as long as we rely on the DSM diagnostic criteria, we will never discover anything of scientific value.
—- Steve
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I am an advocate for children in the foster care system, and mostly manage volunteers who do the front-line advocacy. It’s called the Court Appointed Special Advocate (CASA) program and there are such programs all across the USA. I like it because I can help kids get better lives and I can also speak my mind and follow my conscience without having to worry about offending my bosses or colleagues. My history as a counselor/mental health worker is very beneficial in being able to talk mental health jargon with the arrogant elite in the mental health world, and in being able to see through the usual deceptions in proposed diagnosis and treatment of these poor kids, most of whom have nothing at all wrong with them except having had the bad luck to have parents who have not provided what they needed.
What about you?
—- Steve
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The psychiatrists know the answer to whether or not they can help people recover. See this link:
https://www.youtube.com/watch?v=vgKp6_QRNgk
— Steve
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And then they blame you for getting worse, don’t they? I am so sorry you have had to go through this awful experience! I’m glad you’ve at least identified the culprits, however. Thanks for sharing your testimony as to the incredible lack of integrity and dishonesty the so-called “mentally ill” are exposed to! Hope things get better for you over time.
—- Steve
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“Control interventions are not ideal because they counter a patient-centered approach to care and can damage therapeutic relationships while further stigmatizing patients.”
“Not ideal?” Seriously?
How about “control interventions are inherently and uniformly harmful to patients and must be avoided by all means possible. They often occur as a result of inappropriate or abusive behavior on the part of facility staff, and frequently provide an easy excuse for failure and incompetence by professional personnel.
“They can only be considered appropriate when violent or criminal actions are involved, and are never a method of therapy, but are an absolutely last resort means of protecting someone from physical harm when the full range of other de-escalation efforts have been honestly attempted without achieving safety. They should never be considered a part of any therapeutic intervention plan.”
—- Steve
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Wow, I never thought of that! A “midwifery” model would be the perfect counterpoint to the “medical model,” as the basic focus of midwifery is to help the mother realize that it’s her birth and that it’s normal and that she has the capacity to do it, and the midwife is only there to gently assist the way through any sticking points. I also like the idea of “giving birth” to a new spiritual awareness – definitely comports with a lot of what I hear those experiencing “spiritual crises” describing.
Great information – too bad the mainstream of the field appears to have forgotten their origins so completely.
—- Steve
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Hey, way to let him have it, you rebellious radical, you! I hope you thanked him for the compliment of calling you “radical.” He obviously finds any alternative viewpoint threatening, and doesn’t want to hear about “recovery” unless it fits his pre-established and accepted pathway.
I bet he will remember you forever. I hope you were able to establish a few cracks in his defense system!
—- Steve
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I am glad there are still folks like you in the profession. Your description of a professional attitude toward counseling completely reflects my own. Your clients are very fortunate to have found you.
Don’t be too lonely – there are others like you and me out there if you look hard enough!
—- Steve
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That’s exactly right, and is a big part of why the disability roles continue to dramatically expand in the era of “biological psychiatry.” We are biochemically creating an inability to work, and then claiming that the “disease” caused the disability. The psychiatric luminaries clearly can’t accept the proposition that working could possibly be more important than “taking your meds!”
—- Steve
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Science is actually never able to prove anything. But it is quite adept at DISPROVING certain things. Scientific truth only lasts as long as it is impervious to vigorous efforts to disprove it through logical contradictions. A lot of my issues with psychiatry relate to their unwillingness to try and shoot holes in their own theory, and their apparent need to attack anyone else who does find those holes. Additionally, psychiatric researchers appear particularly susceptible to the urge to find convenient or comfortable explanations. For instance, when people in third world nations have better schizophrenia outcomes, it must be the culture, or different diagnostic criteria, or the study was flawed in design, because it COULDN’T be that our modern approach is just plain not as helpful as what more “primitive” people do. That ain’t science!
Real science is ultimately very skeptical, and should be even moreso when dealing with the vagueries of human behavior. Putting any theory under intense and unrelenting scrutiny is the core of good science. Only when it survives a brutal onslaught of attempts to disprove or provide alternate explanations can any scientific theory even approach anything remotely resembling a “scientific truth.”
—- Steve
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Whitaker never claimed to be doing more than examining the extant research and reflecting on its implications. His great value lies in his ability to contrast the “story” commonly reflected in the media and in most doctor’s offices with the actual data that is to hand. He has not claimed to be a scientist or a physician, or a clinician, but his work has started a vital conversation that has been absent for decades in the mental health field. You have your personal experience, and I would not want to take that away from you, but you seem to be wanting to trash Whitaker’s work for some personal reason that has nothing to do with its real value. It frankly diminishes my respect for your comments when you are unable to recognize and acknowledge that Bob Whitaker has put decades of research into this topic and has radically changed his own views based on what he’s learned. You seem to claim that others are not open to hearing what you have to say, but it seems like the pot calling the kettle black to me.
Bob’s a journalist and never claimed to be anything different. A journalist deals in stories. He’s called the mental health consensus story into question and proposed an alternate reading of the facts. That’s what an investigative journalist is supposed to do, and he’s done it with tremendous success. I think your scorn is very much misplaced.
—- Steve
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What of the fact that his psychiatrists were providing him with stimulants prior to his development of manic episodes? I am sure an educated person like you is aware that stimulants can cause mania even in “normal” people? And that stimulants increase dopamine while antipsychotics decrease dopamine?
Diagnosis on a live person who can give immediate feedback is an extremely subjective and dicey operation. I find post-hoc diagnosis on the deceased to be particularly odious and disrespectful. You can believe what you want, but none of us really know what happened, and there are certainly a range of possible explanations for his behavior that prevent a blithe statement that he couldn’t play without his medication.
I would add that there are plenty of folks who will give positive testimonials about the benefits of these drugs, and there are plenty who will give equally negative testimonials for the same drugs. While both constitute data of a sort, this kind of story does little or nothing to illuminate the real issues facing psychiatry today. Let’s say for the sake of argument that Monk really did feel he couldn’t play without his medication. That is one person’s experience. I am much more interested in the collective experience, which I would have to say is very nuanced and politically charged, but is on the whole much more honestly reflected by the articles and data here than those put forward by the psychiatric community as a whole. Namely, that drugs can suppress symptoms in the short run, but IN THE COLLECTIVE, they do not appear to lead to better outcomes for those exposed to them, and in fact, can lead to significantly worse outcomes (like drug-induced mania and early death) in some of the drug categories.
It seems foolish to spend a lot of time arguing about an individual case of a person who is unable to clarify the facts for us due to his having moved on to a better world. It certainly does nothing whatsoever to answer the question as to whether depression is a physical or mental illness. Perhaps we should get back on topic.
— Steve
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Thank you, Susan! I had a sense that this was at least a distortion of what really happened, but it sounds like almost the opposite was true of what TM claimed above. It is always easy to make someone a poster child for a cause after they’re no longer alive to defend themselves. They even did it to John Nash while he was still alive.
—- Steve
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Besides which, whose quality of life are we improving? Theirs or the staff’s? I’ve advocated in nursing homes and can attest to the quality of life of some of these poor victims. Death would be kinder.
—- Steve
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How about having a trusting relationship with someone that doesn’t involve drugs at all? Too radical?
—- Steve
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Scary, indeed. And I thought marketing it for “binge eating disorder” was over the top!
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Note that it says “in some people.” The huge mistake that people studying this field make is assuming that “depression” is an entity that can be “treated,” rather than a bodily response to what could be any of a huge number of potential provocations, both physiological and psychosocial. Trying to “treat depression” is about as dumb as trying to “treat soreness.” If you could isolate causes, you would probably find that SOME depression is caused by vitamin deficiencies, SOME is caused by inflammation, SOME is a result of prenatal drug insults, SOME is caused by early childhood abuse and neglect, SOME is the result of sensitive personalities interacting with a very insensitive world, etc., etc. “Depression” does not have a single cause, and all efforts to treat “depression” are therefore doomed to failure absent concerted effort to search for the real problem that caused the person to become depressed.
—- Steve
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This kind of study really emphasizes the absolute idiocy of diagnosing kids (or adults) with a “disorder” based only on symptoms. The authors write that “substantial heterogeneity in effect sizes was seen across studies,” seemingly blind to the fact that “substantial heterogeneity” is seen across the cohort who receive this subjective and socially-derived diagnosis! It should surprise no one that different interventions implemented by different people toward different students would have a range of different results. The real lesson is that EACH CHILD IS DIFFERENT and that we should be creative in finding out WHAT WORKS FOR EACH SPECIFIC CHILD!!!! To think that ONE approach will always work for EVERY child who doesn’t like sitting still or doing boring repetitive work is the height of scientific stupidity. Unless you know WHY they aren’t sitting still, you are simply lumping together kids who are irritating to the adults, and you will never find a single solution that will help all of them, because they each need different things.
Of course, this kind of blunt and crude “diagnosis” does grant a huge advantage to the drug intervention, because it is aimed only at the symptoms and is completely unconcerned with causes or long-term effects. As long as we utilize these reductionistic and inane labels to classify kids, research will always show that drugs “work” best (at least in making the kids less annoying), because they are the crudest and most simplistic tools that attack the identified “symptoms” directly while doing absolutely nothing about the wide variety of possible causes and needs that are not being addressed, hence assuring a steady flow of customers over time.
— Steve
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It is interesting that it is generally assumed that caregivers have the best interest of the patient at heart. This is often true, but is also often false. In fact, many (but certainly far from all or even most) people suffering from severe “mental illness” symptoms have been abused or are continuing to be abused by their caretakers. It does not surprise me that half of the sample did not want the caretaker contacted, nor does it surprise me that the caretakers on the average saw less coercion and more fairness than the patients themselves.
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I think you hit the nail on the head, Norman. Not only are the drugs used to evade examination of massive social dysfunction, but the entire DSM is designed primarily for that purpose. As long as those in power can blame any adverse response or objection to the status quo as a “disease of the mind,” they don’t have to think about the actual impact of their policies and activities, and meanwhile can continue to enrich themselves at our expense.
—- Steve
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If I were the “patient” in question, do you think I’d want to spend time with John, or with Dr. X?
I hope your social work prof is listening, Sacha!
— Steve
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Ironic, indeed!
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Isn’t this kind of like saying “I know your appendix is infected, but it’s a lot easier to remove your tonsils?” Why would you focus on changing something that isn’t causing the problem????
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Bless you for sharing your heartbreaking story! I am so sorry you had to go through all of this, and it makes me very angry at all the so-called “professionals” who continue to be too arrogant to listen to anything their clients tell them. You are very brave to go public with this, and it will help others to know it’s not their “depression” and they are not alone.
Thanks for posting your story!
—- Steve
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My thoughts exactly. If psychiatric drugs are helping so many people become less disabled and more functional, why are violence rates among the “mentally ill” increasing as the use of these drugs becomes more common? Rhetorical question, of course…
—-Steve
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They need to do something similar with people who haven’t taken them before and are NOT diagnosed with “bipolar.” This makes it sound as if you avoid them if you already have a “bipolar” diagnosis, and doesn’t acknowledge that this happens to people who have never had a manic episode in their lives.
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Who needs these “regulators” messing with the “free market?” Why should a little thing like safety interfere with corporations’ rights to make profits?
Whoever voted against funding this agency needs to be voted out of office!
—- Steve
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When I was briefly doing involuntary hospital evals (and I let go almost everyone I saw!) I ran into at least a half a dozen young women diagnosed with “bipolar disorder,” all of whom had severe childhood abuse histories, none of which were documented or considered of particular importance to their psychiatrists. One was 17 and developmentally delayed, emotionally about age 6. She was raped. Was depressed for about a year, then disclosed the rape, and immediately became aggressive. I learned this in a 10-minute conversation with her mom. No note of this in the chart. “Bipolar disorder.” Not even a rule out of PTSD. I got her diagnosis changed so at least they’d have to give her some kind of talking therapy, but I was appalled. After that job, I knew I could not work in the mental health system any more. It is more insane than any of the clients it purports to serve.
Bipolar has become a catch phrase for anyone who is emotionally unstable for any reason. It’s total BS. I did see a few “classic” bipolar presentations, but they were not served well, either – drugs and “case management,” which meant making sure they stayed on their drugs. No kind of therapy or exploration of how and when this started, and very little skill development on how to cope when things started to feel out of control. It was a joke, except it was not at all funny. And don’t get me started about foster kids…
—- Steve
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VERY well said!
— Steve
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Your case is an excellent example of what Alice Miller was talking about. If you have never read her, you should check her out – you might find her viewpoint validating, if more than a tad discouraging. Our current system, intentionally or not, consciously or not, aids and abets those in authority projecting their own shortcomings and anxieties and aggression onto their clients. If Alice is right, and I believe she is, this is the thing we must absolutely avoid if we’re to actually assist anyone in healing. It can NEVER be the child’s fault that the adults have failed him/her, regardless of what the adults were struggling with themselves. And covering up the truth is often a worse crime than what actually happened to the child (0r powerless adult) in the first place.
The truth really shall set us free.
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I actually agree that it is less harmful to posit a negative outcome with unclear data, because the negative assumption is always the appropriate scientific assumption until proven otherwise (the “null hypothesis”). It is the job of the person claiming benefit to prove it occurs, and if they can’t, it should be assumed that there is not one. In the case of side effects, any indication that they may exist should be considered significant, regardless of the clarity of the data, because we have an obligation to protect against negative outcomes. It is the researchers’ job to prove safety, and in the absence of that proof, we should assume lack of safety for the protection of the patients. The research has enough to suggest that an increase in suicide rate MAY have occurred as a result of the drugs, even if it’s not clear that it was directly caused by the drugs. This should be a very big red flag, especially as it comports with other data raising the same issue. Trying to explain away such a result by data manipulation seems to me far more egregious than overstating the concern, and I do believe the data does suggest a potential significant danger, even if it does not prove the danger comes from the drugs. Unfortunately, psychiatric researchers (including those doing this study) generally take the opposite approach – their drug is assumed to be safe until proven otherwise. This is a very anti-scientific approach.
Even if the critics are taking some liberties with the data, it is very important that this kind of critique be raised. It should probably be framed more cautiously, but cautiously framed concerns don’t seem to get a lot of attention in the psychiatric world these days.
—- Steve
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I agree. The only conclusion that can be reached from this research protocol is that the researchers were biased and probably corrupt.
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Not sure what else could be done with the data after the hash the investigators made of it. I think the big news here is that the investigative team appeared to be both incompetent in terms of understanding and adhering to the study protocols as well as intentionally deceptive in their findings, and we must assume significantly biased regarding the results. It illustrates that many studies that purport to have some important finding are deeply flawed and that the researchers are often either “on the take” or bring personal or professional biases to the table. It seems like we may need researchers from other fields to take over for psychiatric researchers, because the bulk of them appear to be either incompetent or corrupt or both!
—- Steve
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Indeed. As Alice Miller points out so eloquently, the adults almost always expect the children to acquiesce to what makes the adults feel comfortable, thus passing on the pains of the last generation on to the next. This is really my biggest objection to modern-era psychiatry – not the drugs, but the overt and covert invalidation of people’s history and right to frame their own narratives. It takes away the client’s freedom to create meaning from their lives, which I believe is critical to any real healing. Psychoanalysis did this, too, in a different way, but there have always been and always will be therapists who see through this and start from understanding and validating the client’s own personal experience.
We all need to make sense of our own “stuff,” and it does a lot of damage when others presume to tell us what our own experiences are supposed to mean. It may make parents and clinicians feel better, but it is hell on the actual patients we’re supposed to be helping!
—- Steve
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Wow, another little dose of sanity from the world of psychiatry. I think that’s twice in less than a week! It is rare that anyone in the profession appears to pose the correct question, which in this case can be formulated as: “Does the fact that you are inconvenient for your teachers and other adults in your life mean there is something wrong with you?”
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Too true. Anxiety is often a function of being hyper-conscious of what others are or may be thinking, and a lack of ability to focus on one’s own needs in the moment. I say this as a lifetime anxious person who has learned other approaches. I’m as empathetic as all get out, but it doesn’t stop me from worrying about rejection and embarrassment and humiliation, which are very real possibilities when dealing with other people who really DON’T have empathy for others. It is only through refocusing in a less purely empathetic way (because I KNOW I’m only rarely going to err in the direction of being too self-centered!) that I am able to set boundaries and reasonable expectations that reduce my anxiety considerably.
—- Steve
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The important aspect of this study is that they were randomly assigned to the groups, so the drug proponents can’t claim that “only the better functioning ones went off the drugs.”
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Agreed, Norman. But I would add also that kids are expected to do things at younger ages, such as reading in Kindergarten or doing homework in first grade, that my teachers knew better than to expect. Additionally, recess and PE and art and music have been reduced and in some cases practically eliminated from the curriculum, and hours per week of classroom instructional time (generally dull times when kids have to sit still and do as they are told) have increased. Homework loads for older kids also appear to have climbed dramatically. And class sizes are at an all-time high for our recent history in the USA.
All of these are in-school variables that could be altered in order to reduce the “ADHD” diagnosis rates. Consider the Canadian study where they noted that a one-year delay in school admission led to a 30% reduction in the “ADHD” rates! Clearly, there is a disconnect between children’s development and what is now expected of them, and this is a big contributor to “ADHD” diagnosis rates. We’re also expecting too much of teachers to manage classes of 30+ Kindergarteners. Reduce class size, increase time spent on “non-academic” pursuits like art, PE, music, and plain old garden variety RECESS and FREE PLAY, and the “ADHD” epidemic would fade out rather quickly. Except, of course, that there are forces at work which don’t want such things to happen.
—- Steve
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Excellent article – I wish all practitioners could assume your sense of humility and commitment to seeing the actual facts and results of our interventions. It is way too easy to believe our own perceptions and take credit for anything positive a client does, but blame failures on our clients.
Interesting that you should bring up psychoanalysis in the context of “recovered memories.” I think a lot of people forget or never knew that psychoanalysis went off the rails early in Freud’s career. His original thesis was that “conversion reactions” or “hysteria” were caused by abuse, often sexual, by people known to his clients during their childhood. He drew his conclusion not from recovered memories, but in large part from people actually telling him what happened to them. He chose to believe them and published his early works on the “trauma theory” of mental/emotional distress. But his work was so severely criticized by his colleagues of the time, as no one wanted to believe or admit that sexual abuse was widespread in Victorian society, that he recanted this and came up with the concept that the children were somehow projecting sexual fantasies onto their parents, uncles, etc.
Of course, we now know that childhood sexual abuse is extremely common in our society, and was most likely just as common back in Freud’s day, so his initial theory was right on target. It was society’s unwillingness to acknowledge the primacy of traumatic experiences in childhood that led to 100 years traveling down the wrong path, and once again, our current paradigm continues to make it easy to minimize or dismiss damage from social and cultural reasons and to blame the individual for the suffering s/he experiences. Of course, individual responsibility is critical to any path of healing, but so is the acknowledgement that we are all to a large extent the products of our upbringing and our times. Denying this reality really does prevent psychiatry from ever getting back on the right path again.
Bottom line, everyone is different and everyone has their story. To deny a person the right to tell his/her own story from his/her own viewpoint will always be the biggest mistake we can make, whether it results from telling them that things happened to them which didn’t, or telling them that things didn’t happen to them that did, or worst of all, telling them that what happened to them isn’t even relevant to their current struggles, as so often happens to people entering the MH system today.
—- Steve
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interesting that they only let them off drugs one day and they still did better; half of them were probably having withdrawal effects!
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I think they are generally a waste of time, even if they make people feel better. A shot of Jack Daniels reduces anxiety just great. But it’s not a medical treatment. It’s just a temporary way to feel better. Using psych drugs to improve mood, even if they “work,” is a false approach, because it subverts any real attempt to figure out what’s going on. Some people report feeling better when they take them, but to me, that’s not the goal.
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Wow, this is a really important finding to use in our fight against the Murphy bill!
—- Steve
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As far as I can tell, the Murphy bill is unconstitutional on the face of it. Based on prior Supreme Court rulings, you can’t force a person into treatment without a demonstrated immediate risk. This is a constitutional issue, not something they can legislate away.
That said, I wonder how many people were bribed to bring this back after its earlier ignominious defeat?
We need new representatives in Congress!!!!
— Steve
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Looks like a BS study to me. The people aren’t even experiencing anxiety – wouldn’t it make more sense to create an anxiety-ridden situation and watch what changed? Oh, but that would suggest that the environment causes anxiety and that the serotonin increase is in response to stress. Which would be a much more reasonable hypothesis, but it doesn’t fit the desired narrative. So they get to freely “speculate” as to the supposed “relationship” they never actually tested out.
I do agree with Paula and Bonnie that more of a proviso would be helpful – perhaps the title could state “researchers CLAIM that anxiety is caused by increased serotonin, despite serious study limitations.” Something to alert readers who don’t regularly visit that this is a claim to be looked at very skeptically.
It is also worth mentioning that SSRIs have claimed to be helpful to people with anxiety for a long time, maybe with more actual supporting data than claims about depression. If they actually are reportedly helpful, how could this be if increased serotonin leads to more anxiety?
Pretty shoddy stuff.
—- Steve
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Awesome article, Jay. I have a whole new understanding of “heritability” and some new examples and explanations for folks who have an understandably hard time wading through the rhetoric.
—- Steve
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Some are totally against it, others are the worst perpetrators who have personal physicians they go to who will prescribe what the foster parent wants. It’s totally pot luck.
Interestingly, when kids are placed with family members, their psych drug rates are only slightly higher than the general population. So there is some protective effect of being placed with someone who already knows you. But foster kids are totally vulnerable and rarely have anyone looking out for them. They are possibly the most disempowered population in modern society.
—- Steve
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That last is probably the biggest lesson I’ve learned in my adult life – while everyone has been hurt and their acting out comes from hurt, there are some who choose to pass their hurt on and choose not to empathize as a protection. Such people are dangerous in that they continue to dramatize what was done to them and pass their pain on to another generation. So while I remain as compassionate as I can, there are times when I have to set boundaries to stop the damage of myself or others, and that’s OK.
Compassion can’t be taught – it has to be felt, and it comes from being willing to deal with our own pain and to feel it rather than passing it on. Only a small percentage of folks are really able to do that. Most of the rest harm mostly themselves, but there are enough of those others to do a lot of damage. And sadly, a disproportionate number of trhem seem to become psychiatrists!
— Steve
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And in both cases mentioned, there is at least some objective measure being used to determine when the level of “obesity” or “hypertensive” is reached. While these levels are somewhat arbitrary, they can at least be argued about, objectively researched, and treatment can be determined to be effective/ineffective based on these measures. No such objective measure exists with psychiatric labels. They are entirely at the discretion of the labeler, and the label-ee has no logical way to disprove or modify the label they have been assigned, other than to find another “professional” to disagree with the first one. And research becomes confused hogwash, because people are arbitrarily lumped together who have little to nothing in common besides their emotional reaction to whatever has happened to them.
All labels are definitely NOT created equal!
— Steve
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Such entitlement! They believe it is right to lie in order to convince people to go along with their plans, and are baffled and upset when people object. Sounds extremely narcissistic to me! Maybe that’s why they 86ed “Narcissistic Personality Disorder” in the DSM 5 – it fit too many of them a bit too closely!
—- Steve
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LOL!!!!
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Which is kind of what I was originally saying. The label does not cause the bias, but it builds on existing bias and allows biased people to feel OK about continuing to categorize and other-ize people who aren’t like them. Whereas real healing happens when we start to find the SIMILARITIES between us and the “other,” and can truly empathize with their experiences, which are unique for every person and defy easy categorization.
Thanks for your articulate passion. I always enjoy reading your posts!
—- Steve
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So people are unconsciously biased about their own level of bias?
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Orbit,
While not technically “uppers,” SSRIs are acknowledged by mainstream psychiatrists to have a stimulating or “activating” effect on people.
There absolutely is a documented increased risk of an early death from antipsychotic drug use, due to diabetes, other metabolic disturbances, obesity, and heart effects of the atypicals. It is perhaps somewhat hyperbolic to blame the entire 25-year shortening of the lifespan of the “seriously mentally ill” on antipsychotics, since there are other impacts, such as smoking, drug use, and suicide. On the other hand, smoking is often reported by those taking antipsychotics to help with reducing the side effects (makes sense, as smoking gives a little boost to dopamine, which is massively decreased by AAPs), and there is also some evidence that the AAPs do increase suicide rates somewhat (makes sense also, since they usually mess with serotonin as well), though not as much as the SSRIs.
So while Al may have used a little poetic license, he is essentially speaking the truth here. Antipsychotics do reduce people’s lifespans dramatically. And Paxil and Prozac are “uppers” of a sort. As for Ativan, I hope your correction was for educational purposes, not to somehow discredit the author. Not knowing how to spell the brand name for a drug hardly disqualifies someone from speaking on this important issue.
— Steve
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“Do not reduce?” It sounds like they make “relapse” more likely!
— Steve
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I shall have to check out your blog!
— Steve
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Well said, Norman! Too bad “common sense” isn’t all that common. It seems like what you said should be obvious to anyone who is truly interested in helping.
—- Steve
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Dang, these guys actually sound semi rational. Social issues require social solutions? What a radical concept! Are we sure they are really psychiatrists?
—- Steve
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But why should they need to be labeled to get necessary services? I have issues with that concept.
And I agree, the labels are often used in a way to let the real perpetrators of harm in our society off the hook.
Why do we bother spending so much time and money on genetic research, when decades of research have given us, at the very best, a probability distribution of genes that MAY be involved in at most 15% of the origin of “mental illness,” when we KNOW that 85% or more of “mental illness” is associated with trauma and childhood abuse and neglect? It only makes sense if your strong interest is to direct attention away from the very common causal factor and toward something that is more comfortable (and profitable) for those in power to attribute as a source. The fanatical dedication to finding genetic causes to these “disorders” says a huge amount about the real purposes of psychiatry as a profession.
—- Steve
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You are correct, as usual, Alex. The problem is not the labels themselves but the inherent disrespect that lies behind them. It gives people, including your own clinicians who are supposed to be helping you, total cover for dismissive and disrespectful attitudes. Those diagnosed as “mentally ill” are treated in undignified ways that no one would consider acceptable with so-called “normal” people.
Thanks for articulating that important point so clearly!
—- Steve
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I would certainly agree that SOME cases of “Oppositional Defiant Disorder” or “ADHD” occur in the absence of other stressors or explanations. The point, I believe, of the article is to suggest that the labels have some added utility that makes them worth the downside of inappropriate use. That’s where we have the disagreement. Two of my kids, especially the oldest, were certainly oppositional, hyperactive, and intense from birth. Not disputing that at all. But I dispute that this represents any kind of an illness or disability – it was just the way they were. The first, we struggled with mightily. With the younger, 11 years later on, we were a lot smarter and started doing some things early that we didn’t do till a lot later with Patrick. But we adapted to their needs, found schools that worked for them, set up positive disciplinary programs that took their oppositional natures into account, and built on their many strengths. Both got excellent grades in high school, both are now functional adult citizens. There is and was nothing “wrong” with them just because they tended toward a personality style.
I would still maintain that labeling either of them would have been harmful, both because it would provide them with a built-in excuse to feel sorry for themselves and avoid responsibility for their actions, and because those dealing with them would have a built-in excuse if they failed to figure out how to adapt to their unique personalities and needs.
I would also acknowledge that there are people who are disabled severely by their “mental health” problems and who need extended care and who will not succeed in society without ongoing support. Those people may, indeed, be appropriately considered disabled by their mental/emotional condition, but I still don’t see that lumping them together under one vague and subjective rubric does anything but confuse the issue. As with my kids, each and every one of them deserves a full and individualized analysis of what is troubling them physically and emotionally and an individualized plan of action that takes their unique needs and perspectives into account and is driven by their own goals and preferences. DSM labels, in particular, appear to me to impede any efforts to make this kind of thing happen.
I am sure we would agree on many things, but I don’t agree that the fact that people naturally deviate from norms means they should be assumed to be malfunctioning, if only because it makes it way too easy for those in power to dismiss legitimate concerns (like a rigid teacher or a boring classroom or a gifted child) as “mental health problems,” as is occurring to millions of people across the country today. Again, disagreeing with DSM labeling doesn’t mean that kids and adults don’t have different needs or that they don’t suffer from emotional pain and behavioral dislocation. It just means that it doesn’t help to lump people together that really have very little in common with each other besides a bunch of behaviors (of potentially widely diverse causes) that the powerful don’t want to have to deal with.
— Steve
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So if urbanization is such a big impact on schizophrenia rates, where do they get off continuing to maintain that it’s a “genetic brain disease?”
Rhetorical question, of course…
—- Steve
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Ron, I agree with you 100%. I think we’re seeing more intractable cases of depression mostly because we’re seeing more antidepressant-exposed clients.
Additionally, I am guessing that the further we get away from the fundamental relationship-based approach to therapy, the worse the results will become. CBT becomes something you do TO someone instead of helping them decide if it’s a tool they want to use.
One size doesn’t fit all!
—- Steve
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I agree that labels can be comforting, but that doesn’t make them valid scientifically or fully descriptive of reality. For instance, I kind of like the Myers-Briggs system. It creates labels, but they are soft labels with acknowledged fuzzy edges, and each label carries with it both important strengths and assets as well as challenges and frustrations. It is not particularly stigmatizing to be an INTJ (that’s my “label”) because INTJs are acknowledged to be important contributing members of society, and their characteristics are recognized as necessary to the functioning of a team or group. Whereas “ADHD”-labeled people are generally considered deficient, annoying, impossible to care for, and likely to grow up to be criminals without “treatment.” There is no recognition of the redeeming strengths of such a personality, which include persistence, creativity, divergent problem solving, high energy, courage, and willingness to challenge authority, all of which can have great value if properly channeled.
So it’s not the label itself, but the pejorative implications that are most disturbing to me. These labels are inherently stigma-producing in the collective, even if some individuals may find them temporarily or permanently reassuring. And there is science backing that up – people who believe in the biological model implied by the DSM system have been shown to have less empathy for and more fear of the “mentally ill” than those who understand mental illness as an understandable human response to excessive stress.
Words do have power, and choosing words that isolate and exclude people as contributing members of society can be very dangerous indeed.
—- Steve
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Sigh… I think you should re-read what I said. I was very careful to say that the removal of labels was NOT the same as saying that people were not in distress or requiring assistance. I quote: “Some people seem to believe that saying no to psychiatric labels means saying “there is nothing wrong” with people who are suffering. This is objectively not the case. ” I am the last person in the world to make such a suggestion. The point I am making is that schizophrenia, for example, is a concept that emerged from social discomfort with people who heard voices or experienced similar odd phenomena. There is no actual evidence that all people with “schizophrenia” have the same problem or need the same kind of help – the DSM itself acknowledges this in its introduction, which unfortunately no one seems to bother reading. Even more to the point, “disorders” like “ADHD” and “Oppositional Defiant Disorder” are clearly based on kids not fitting into the slots that we expect them to occupy, and there is not the slightest degree of effort required to determine why a kid is oppositional or hyperactive before such a label is affixed. To assert that all oppositional children are oppositional for the exact same reason or need the same kind of help is a reductionistic absurdity that has zero factual basis in reality. It is entirely a social construct, end of sentence.
So to re-assert my original point, something like “ADHD” exists because teachers (and many adults) don’t like having to deal with kids like that, and never have. A pre-existing bias LED TO the decision to label “ADHD” as a “disorder” rather than deciding to re-examine how we teach children and why it doesn’t work for a significant proportion of children we encounter. It allows the adults to put the blame on the child and not bother to explore the best ways to help. This is not saying that “ADHD” type “symptoms” aren’t problematic for the student – they definitely can be a big problem! But there are ways to help these kids (and I know this from both professional and personal experience, having two “ADHD” type boys) that do not require us to label them as defective or use harmful drugs to force them to fit into an environment that is not health for them.
As to creating a “situation of parts,” it seems to me that the current diagnostic system is responsible for doing exactly that. “Anxiety” is viewed in isolation from any context, and is “treated” as if anxiety itself were the problem, rather than a reflection of physiological or psychological loss of equilibrium in the person as a whole. As a result, analysis and solutions are limited to what will reduce the “symptoms” without concern for the long-term impact on the larger social context. Hence we have “miracle drugs” that reduce psychotic symptoms very quickly but kill you very slowly, and the symptom reduction is considered vitally important, while the loss of quality of life is denied or trivialized as a sad consequence of “the disease.”
So I agree with your last point of recognizing all factors that prevent an individual living up to his/her highest capacity, but I would assert that psychiatric labels do the exact opposite of this, by encouraging people to indulge in their projections about the dangers of the “mentally ill” and distancing themselves from the kind of empathy that is really needed to take a holistic healing approach.
As to other physiological conditions engendering stigma, this is certainly true and unfortunate. But this doesn’t counter my argument that these are all more objectively observable and falsifiable, protecting someone from false diagnoses, and are also not associated with the use of social force against a person.
Again, I understand that people suffering from anxiety, depression, psychosis, etc., need and deserve our compassion and assistance. I am simply noting that there is nothing about being diagnosed with “Major Depression” or “Generalized Anxiety Disorder” that helps me or anyone else know what to do to help, because the people in these groupings are heterogeneous and are grouped that way for the convenience of our own social comfort and prejudice. When we really dig into these “diagnoses,” as again I’ve had ample professional opportunity to do, we find a huge range of differences and nuances between people who are supposedly suffering from the same “disorder,” to the point that the categories themselves quickly lose any real meaning. They are generally descriptions of things that most people feel are odd or uncomfortable to deal with, and the unfortunate side effect of labeling is that it keeps most people from looking any deeper to find the rich tapestry of context in which the person exhibiting these “disorders” actually lives.
I could go on, though I’m not sure we’ll come to any agreement. But please, do not EVER suggest that because I don’t believe in these subjective and somewhat arbitrary categories it means I don’t believe that depressed, anxious or otherwise suffering individuals don’t need help. It is a very common and frankly insulting insinuation that the psychiatric community inevitably throws at those who disagree with their approach, and it is absolutely, 100% wrong.
—- Steve
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So a 1% risk increase isn’t significant, because they’re going to die soon anyway? Why don’t we just kill them outright and save ourselves the bother of caring for them? These researchers are sociopathic!
— Steve
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I understand the MTA study quite well, as well as the Quebec study and the Raine study and the comparative study of Finnish and US youth with ADHD diagnoses as well as the Oregon State University medication effectiveness study as well as Swanson’s 1993 “Review of Reviews,” all of which find that stimulants have no long-term positive impact on a child’s school performance, school completion, college enrollment, delinquency rates, teen pregnancy rates, self-esteem, or social skills.
JD is correct in warning parents about this kind of research. The fact that the psychiatrist doesn’t know it or wants to keep it quiet does not make this less true. Strategically, it might have been better for him to share his concerns with the psychiatrist ahead of time and talk over what the psychiatrist’s beliefs are about the implications of the study, but bottom line, professionals have a duty to give clients the best information they have, and professionals are allowed to have professional opinions that disagree with each other.
I have to wonder what qualifications you have to tell JD what he does or does not understand, especially based on such limited information as he discloses in a single post? Perhaps he’s a lot more educated than you think he is. Perhaps he knows something that you don’t.
Your lack of humility in approaching this controversial and subjective topic lowers your credibility significantly in my eyes.
—- Steve
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Thank you – your appreciation is most valued, as your own incisive commentary is something I always look forward to.
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Thanks, and feel free to use this any way you like.
— Steve
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Called that one as soon as I heard about the crash. One more psychiatric success story!
—- Steve
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How very reassuring! Only a 31% increase – not that important, unless you’re the one getting killed or doing the killing!
Did they at least suggest that warning patients that this is a rare but serious side effect would be necessary?
—- Steve
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Well spoken, Saul. It is always interesting that the pro-label, anti-stigma campaigns always seem to equate a lack of support for labeling with blaming the sufferer. How is this the truth? In fact, the psychiatric labeling process itself is a study in blaming the victim. You are not suffering because of poverty, or childhood tramatization, or an unknown infection, or being part of a bizarre society that expects unreasonable things from its members, or worrying about a world that is being ecologically destroyed when there is little or nothing you can do about it. Apparently, you’re not ever supposed to get upset about ANY of those things, and if you are, well, you’re “mentally ill.” I once said to a psychiatrist that PTSD is clearly caused by trauma. He said, “You can’t say that, because not everyone who is traumatized develops PTSD. There must be something about that person’s brain making them react differently.” As if there is a correct way to respond to trauma, determined, of course, by psychiatrists and their associates, and anyone who reacts in the “wrong way” has a mental disease!
That’s my main objection to labels – it subverts the process of actually understanding what is going on. And I agree 100% that the purpose of anti-stigma campaigns is mainly to normalize labeling and psychiatric drug use among the population, even though the research shows that the very process of labeling increases the very stigma they are supposedly opposing.
Follow the money…
—- Steve
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A difficult topic, indeed. I admire your courage for taking it on.
That being said, I think the essay misses the most salient point: psychiatric labeling is unique in being almost entirely BASED ON preexisting stigmatization, while at the same time PROMOTING AND EXACERBATING these stigma in society. There has always been a degree of stigmatization of those who act or think differently than the general population. This is generally based on a genuine fear of those who are different, but has also been co-opted in the past by people interested in manipulating the population, such as the Nazis in WWII and before, or Jaffe and his minions at the TAC.
Psychiatric labels differ from genuine medical labels in that they are almost entirely social constructs, but they are given the weight of medical “science” to cement them as “real” entities in people’s minds. No one is upset when someone says “she’s a cancer patient,” because it describes an objectively observable condition. And while such spurious or sketchy labels as “pre-cancerous cells” and whatnot, these do not carry the social weight of judgment that psychiatric labels do.
Furthermore, psychiatric labels can be used in ways that no other medical label can be. They can provide a pretext for removing children from a parent’s care, for influencing the outcome of a custody proceeding, for incarcerating a person in jail or letting them out of jail or for incarcerating them indefinitely in a psychiatric institution and forcing potentially deadly “treatments” on people against their wills, based merely on the clinical judgement of someone who may be as biased and even hostile toward “people like you” as any unobjective and uneducated lay person could be.
And since these social constructs have no objective basis in reality, they can’t be tested for, so the person who is said to “have” these disorders has no defense. At least if they say your cholesterol levels are too high, they have to identify a number and measure it, and you can argue about what the right number is or do things to lower your number, but at some point, there is a way you can say, “No, you’re wrong, I don’t have what you are labeling me with.” In psychiatry, there is no such recourse.
Finally, psychiatric labeling plays into the ability of the powerful to project their inadequacies and fears onto the labeled subject. I can’t tell you how many domestic abuse survivors have been labeled by the medical community with a psychiatric label, allowing the abuser to use this as an explanation for why the victim is reporting abuse. I’ve seen abusers get someone committed for exactly that purpose, and the psychiatric community almost always seems to go along with it. Moreover, clinicians who have not done their own work are absolved of any need to question their own inability to connect with a client and do useful therapy, because the client can be labeled with “borderline personality” or “bipolar disorder” and we can treat their brains instead of figuring out what is really going on with the client or with ourselves.
Some people seem to believe that saying no to psychiatric labels means saying “there is nothing wrong” with people who are suffering. This is objectively not the case. Lucy Johnstone and others have identified ways to characterize psychological struggles without attaching the stigma associated with being “mentally ill” in our society. Schools can also make provisions for children’s needs without having to label them with “ADHD” or “ASD” or anything else. While these labels can provide a common language for professionals, the cost in terms of allowing professionals to use their power to blame the child or client for the professionals’ inability or unwillingness to be genuinely helpful dramatically outweighs any benefits, in my view.
Social stigma against “mentally ill” people exists independent of the psychiatric profession. Unfortunately, rather than actually working to subvert these stigma by helping us understand that any or all of us could suffer from similar difficulties in sorting out how to live in our modern world, psychiatry has chosen instead to use and build on those prejudices and constructed a system that reinforces that the “mentally ill” are “different” from us biologically and so we can safely distance ourselves from them and leave it to the doctors to fix up their presumably screwed-up brains. There is recent research showing that believing in the biological model decreases empathy and increases the likelihood that “mentally ill” people will be feared and avoided. I am afraid that whatever small benefits may accrue are wiped out by this larger trend. Additionally, this labeling process lets society completely off the hook for creating a system where labeling and disabling language is required before someone is allowed to be helped. A truly compassionate system would not require that you prove yourself disabled before your needs can get met.
—- Steve
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Yes, but they are often willing to make exceptions when it involves using force against a hapless or helpless population. Anything that can lock up, deport or kill more poor and minority people will fly with the Neocons, regardless of the economic impact.
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This link was known before Prozac even came out. It was banned in Germany initially for exactly this reason. They are full of crap pretending that the connection is “anecdotal.” It is well established.
— Steve
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Good to know someone is writing about a behavioral perspective on ADHD, as many, many cases are simply a matter of the child finding a way to meet his/her needs when presented with a situation that is dull or frustrating or overly constraining. The author does not appear to identify one other reward of “ADHD” behavior – it makes things more interesting! The only thing most “ADHD” kids have in common is that they don’t like to be bored. Our own often seemed to create arguments just for the sake of seeing the adults getting upset or getting themselves removed from a dull environment. Pre-emptively creating interesting or exciting or stimulating activities is often an incredibly effective way to redirect “ADHD” behavior to something productive. Additionally, getting “upset” when they do what is wanted is an excellent and humorous way to reinforce the more oppositional kids when they are induced to cooperate.
It is also important to remember that this kind of behavior can actually be caused by a number of other physical and/or psychological conditions, such as low iron, sleep difficulties, and a traumatic or chaotic home environment. It’s always critical to keep in mind that “ADHD” children are for the most part very different from one another, other than the fact that their behavior is annoying to adults and especially teachers who have an interest in children who can more easily be herded efficiently into doing what they are asked.
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I think you’re actually agreeing with Sarah – I believe she was using the term “NAMI Moms” derisively.
—- steve
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Karen De Sa deserves a Pulitzer Prize for the amazing work she did on this topic. The legislation would not have been so easily passed without her amazing work. We really need to get some media allies to write this kind of article in support of our cause.
— Steve
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Sounds like the parents are smarter than they expected.
This kind of sounds like “black people are unaware of their role as an underclass in American society” or “women are unaware of their role as housekeepers and raisers of children for the more privileged male class.” Why the F(*K would I take my kid to the doctor if s/he had trouble completing his/her homework? I’d take them to the kitchen table or the desk and say, “OK, it’s time to do your homework!” And sit there with them until they got into the habit of doing it without my help and assistance. No doctors required, thanks.
—- Steve
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This reminded me of a study I read many years ago, comparing kids with the “ADHD” diagnosis AND aggressive behavior to those who were labeled “ADHD” and not aggressive. Predictably, the children in the “HA” (hyperactive-aggressive) group had more run-ins with the law and more delinquent behavior than the general public. However, those in the “H-NA” group (not aggressive) showed exactly the same levels of delinquency as those not labeled with “ADHD” at all.
So in essence, studies finding that “ADHD” leads to more delinquent behavior are actually making the profound observation that young kids who are aggressive are more likely to continue to be aggressive when they are a few years older. (And they got PAID to discover this?)
When you consider the high correlation between aggressiveness and early childhood abuse and neglect, and the very high frequency of abused kids being diagnosed with “ADHD” and having their trauma unrecognized, it’s quite possible to conclude that “ADHD” is completely unrelated to delinquency, except through the probability that many kids with abuse/neglect issues will get swept up into its subjective range.
—– Steve
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I have spoken to many hundreds of suicidal people on the phone and in person in the emergency room. I have yet to find one yet who would talk to me that I have not been able to help using communication alone. Depression is almost always related to a sense of being unable to control or master the environment you are living in. It is a biological coping mechanism for the organism not to waste energy when in a situation that doesn’t allow for an immediate solution, such as being trapped and unable to move or starving in a cave when there are still weeks before food becomes available. Depression is not in and of itself the problem in almost every case. It’s an indication of another problem. Finding out what is going on, what the person has tried, when they’ve done well in the past, what brought that about, what has changed, what do they wish were different, what do they control vs. what don’t they control, and so forth, almost always leads a person to feeling a little more in control of some aspect of their lives and a little less depressed. Does this instantly change the situation? No. Is ECT faster. Sure. But ECT does not convey hope or increase control – it conveys victimhood and a lack of control, hoping that somehow having an electrically-induced seizure will make everything OK.
The husband of one of my volunteers was becoming deaf and feeling it was impairing his functioning and made him feel useless as he approached the age of 80. He was chronically depressed and hopeless for some time, but it seemed to me the reasons were pretty damned clear. His doctor recommended a course of ECT, and they did this for many months. His wife tried to remain positive and saw short-term improvements following “treatment,” but he predictably returned to his baseline within weeks, or sometimes days, just as the research suggests most commonly happens. After a year of this, they vacated Portland and lived in southern California for a year. He was cured! A change of venue was all that was required, but he was being electrocuted three times a week for a year with no benefit, while no one bothered to even discuss why he might feel this way or what could be done to help besides inducing seizures and damaging his brain.
That’s “standard practice” ECT today. It is appalling and it is NOT effective, except in the most crude and short-term of measurements. There is ALWAYS something better you could do.
—- Steve
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But are you really having an open dialog? “No one enters psychiatry in order to practice sadism and tyranny on vulnerable patients.” How do you know this is true? Aren’t their psychopathic and sociopathic people in virtually every field? And if they aren’t entering to practice sadism and tyranny, why are patients experiencing their “treatments” in that way, and why are they as a profession so unwilling to listen to their own patients?
“…we are far more accustomed to criticism and personal attack from people essentially ignorant of the nature of our work.” Do any of the criticisms come from people who are quite well aware of the nature of your work? Why would the fact that someone is critical suggest they are ignorant? Does that statement really suggest openness to feedback and differing perspectives?
Ted is himself a survivor of a long string of shock treatments before the euphemism “ECT” had been invented. I’d hardly suggest that he is ignorant of the nature of psychiatry, as he’s experienced it on a first-hand basis. He sees himself as a victim of psychiatry because he was actually victimized by psychiatry. I doubt that you telling him anecdotes about people who got better after ECT is going to convince him that what happened to him was beneficial. If you want others to have a dialog, you have to be really open to hearing their point of view, and not relegating it to either “things used to be bad but we don’t do that any more” or “you were the victim of an unethical or incompetent practitioner but your experience doesn’t reflect the general reality.” People here have experienced horrors at the hands of your profession. They are by no means ignorant, but they have a different perspective than you based on very real personal experiences. If you can’t hear that, you have no business critiquing anyone for being unwilling to engage in dialog.
—- Steve
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Though you may be right about what the public will accept as a framing, ECT has been shown to be ineffective in more than the very shortest term temporary symptom relief. As has been documented by a number of writers, the “benefits” are very similar if not identical to the symptoms of a closed head injury. The reason I think we get confused is that psychiatry as an institution has redefined these “mental disorders” purely in terms of “symptoms” which are somewhat arbitrarily grouped into “disorders” that have no actual etiology. So saying that ECT “works” is only based on the assumption that feeling less depressed temporarily is evidence of efficacy. On this basis, drinking three shots of tequila at breakfast lunch and dinner is an effective treatment for anxiety. And really, it would be. But it’s not a medical treatment. It’s an attempt to make the person feel better temporarily without any understanding of what one is “treating.” ECT is a crude approach which has no mechanistic basis for understanding why it might “work,” not to mention that there is no mechanistic understanding of what it is “working” on. So claiming it is effective is about as silly as saying that getting buzzed all day is effective, except the side effects are far, far worse.
Sending electricity through someone’s brain as a “treatment” is a complete admission of failure. If hitting someone on the head with a 2×4 made them feel better temporarily, I’d say the same thing. It is not a treatment for anything – it is an intentional induction of a seizure causing intentional brain damage. There is nothing “effective” about it. If you can’t help someone without damaging their brain, it’s time to hand their care on to someone with some better ideas.
—- Steve
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Of course, I am a proponent of flexible planning for every case, as no two kids are alike. My biggest beef with the DSM is that it lumps together kids that aren’t very similar. I appreciate your recognition that effective trauma screening is rare (a recent survey of boys in California residential treatment centers found that over 85% had trauma histories, but I think it was less than 20% who actually had this documented in their records!), but this suggests that most kid in the community are getting substandard treatment. Unfortunately, when enough practitioners engage in substandard treatment, it becomes standard treatment, much to the detriment of the clients being served.
To be quite honest, I am not a believer that “ADHD” is a disease in any real sense of the word. It appears to be a social construct designed to describe and isolate kids who behave in certain ways that are inconvenient for the adults around them. Fitting the criteria for “ADHD” shows nothing except that you fit the criteria, as there is no solid evidence that this cohort of kids has anything much in common other than being difficult for the adults to manage. Only by doing a much more thorough analysis does one ever find an real physiological problems (like FAS/FAE or low iron or sleep apnea) or psychological underpinnings (like current or past trauma) or social causes (like poor or inappropriate school structure or limited parenting skills or developmentally inappropriate expectations). The act of diagnosing appears to absolve most clinicians from giving any further thought to possible diverse causes or creative treatment approaches. While there clearly is a phenomenon that “ADHD” describes, calling it “ADHD” seems to preclude any further thought from any but the most responsible clinicians.
—- Steve
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But it also found that both groups did make improvements in symptoms, regardless of treatment or lack thereof. Which kinda suggests that formal “treatment” may matter less than other variables, such as the school structure, parenting styles, “fit” between parents and kids personalities, and simply allowing for the child’s development over time. We know from developmental psychology that kids develop different skills at different times and are still within the normal range of development. Is it possible that the main “cause” of most “ADHD” is the unrealistic expectation that all kids will be capable of performing the same level of academic work at the same time and in the same kind of setting?
Supporting this is the fascinating finding in a Canadian study that waiting one year to admit a child to Kindergarten reduced the “ADHD” rate by over 3o%! Think of it – almost a third of all cases go away if you admit the child to school a year later. Why are those kids getting drugs?
Similar results have been found in other studies:
http://www4.ncsu.edu/~msmorril/EvansMorrill_ADHD.pdf
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There is evidence from a number of sources over the years that putting these kids in open classroom environments where they have increased control over their activities and schedule almost eliminates any disruptiveness in the classroom environment. We used this with our two ADHD boys and they had no serious difficulties and never used medication, even though both would have been in the moderate to severe category in terms of hyperactivity and oppositional behavior. The fact that such environments are not available is not an excuse for putting kids on drugs unnecessarily. I would ask and expect that you as a young and evidenced based practitioner would be interested in helping assure that kids in schools across America have this kind of environment available, rather than allowing our society to medicate healthy children because they don’t conveniently fit in to the standard classroom model.
The other confounding factor you’re not mentioning is that “severe ADHD” is often actually the result of or compounded by historical or ongoing traumatization. The DSM criteria do not attempt to distinguish the cause of the “ADHD” behavior, hence many traumatized kids are labeled “ADHD” and prescribed stimulants, which often make the situation even worse, since stimulants can exacerbate anxiety, depression, and aggressive behavior. Kids whose behavior is so provoked are often labeled with yet another “disorder” and given even more drugs, rather than removing the offending stimulants. I speak from experience on this point, as I work with foster kids, who have an ADHD diagnosis rate that is 4-5 times the general population. Clearly, if “ADHD” is purely biological, we would not expect to see this kind of differential rate of diagnosis. The obvious conclusion is that traumatized kids are frequently being diagnosed with “ADHD” and their actual needs are being obscured or neglected by their diagnosis and treatment plan.
—- Steve
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Sorry, MT, but I don’t think your accusation of “cherry picking” holds up, especially as to #3. As Jonathan points out, the study did not stop treatment at 14 months, but it allowed people to choose which treatment they wanted to use, and they compared those who continued or added stimulants to those who discontinued or never started them. The three- and 8-year followups showed the same thing: it didn’t matter whether kids used or did not use stimulants, the outcomes were the same for all groups.
The Raine study in Australia showed similar results when children’s outcomes were compared based on long-term stimulant use or avoidance. In fact, the kids taking stimulants were more likely to repeat a grade by something like a factor of 9. Additionally, there was a study in Quebec that compared outcomes after a change in medical coverage allowed the widespread use of stimulants for the first time. Kids who took stimulants did not out perform those who did not on any measure. Girls who took stimulants were more likely to experience emotional problems like depression and anxiety. Finally, a comparison of outcomes for Finland vs. the US showed that the rates of ADHD to be similar, the US rate of stimulant use to be massively higher, and the social and educational outcomes to be no different between the countries.
If that’s not enough, there is the OHSU medication effectiveness project, which reviewed over 2000 different studies, basically the entirety of the literature on ADHD that they could find, and there was no proof of any improved outcome on any measure, except a small improvement in the rate of serious accidents for stimulant users.
The data is in. Stimulants don’t improve long-term outcomes. They just don’t.
—– Steve
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Any condition that affects 13% of the population can only be considered NORMAL.
— Steve
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I thought they needed at least two studies to get a drug approved? And of course, the study design is ridiculous, as if the only options are a long-acting injection and immediate withdrawal to nothing! They should have had a maintenance group with medication as usual and a slow tapering group for comparison. They could also have compared the impact of psychosocial supports between the groups, which I bet they did nothing about. Not to mention the ones on placebo still thought they were taking the drug! What if they came into their physician and said, “Doc, this stuff doesn’t seem to be working for me any more – I’m feeling really weird. Can we make an adjustment?” Would they completely ignore this person’s needs for the interests of the experimental design?
Cruel and stupid, and it’s amazing that the FDA swallows this crap. Copy cat’s point is also well taken – if it’s not working or making things worse, how do you stop?
—- Steve
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LOL!
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Let’s say that genetics and nature have equal contributions to behavior. Which of these do we have control over? Since genetics are fixed before birth, why don’t we focus on the part we can actually change?
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Exactly what I just said!
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Exactly. The one measure that is MOST likely to respond to placebo is “do you feel better?” It’s harder to say that you’re sleeping well when you’re not, etc., but the “feelings of depression” question they choose to focus on is probably the most vague in the questionnaire.
It’s also VERY bad science to change the measurement used after the experiment is done. If they believe this, they would have to design and conduct another series of experiments and use this as their only measurement, and report on the results. It’s not OK to re-interpret results after the fact in any scientific study, as it enables you to choose the variable that you already know has changed in the direction you want it to. Which is exactly what they are doing here. It’s totally bogus and clearly just an effort to justify what they already believe.
—- Steve
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There is actually some very good evidence that sleep apnea is a causal factor for “ADHD” symptoms in many cases. I’m not sure what treatments are available or whether they work well or not, but I agree that this is an area that needs further research. It is an actual measurable phenomenon, unlike “anxiety disorder” or “Personality Disorder NOS,” so people can actually determine whether or not a particular approach works on some objective basis. That there are charlatans who will use this to peddle some useless or overly expensive intervention is beyond question, but it is definitely not in a class with the fictional psychiatric diagnoses in the DSM, IMHO.
—- Steve
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I agree wholeheartedly. Even if we want to discuss nutritional options with a person, the first thing we need to do is reach out and understand the person and their needs and values and fears. Maybe nutrition is something they relate to and it will be easy for them to integrate into their thinking. Maybe it’s way outside their realm of reality and they need to spend more time talking about their past abusive relationship with their mom. Maybe they simply want some skills around how to stay calm when they get triggered. Everyone is unique and communication should always be the first and most important part of any attempt to be helpful. After all, how do you even know if you’re helping if you aren’t connected enough to even know what the person wants help with, or if they want your help at all.
Moreover, love is healing in and of itself. Regardless of what else may be going on, including whatever nutritional deficiencies a person may have (which are alarmingly common due to our incredibly corrupt and unhealthy food production, marketing and distribution system!), a person who feels loved, accepted, and not judged for not “fitting in” to our society’s expectation is going to feel better and make better decisions for him/herself. Love is not all, but love is central to healing, and without love and empathy, there is no guide for one person trying to assist another, and much harm results.
—- Steve
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I meant “Noel!” Sorry!
— Steve
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Nicole,
I’ve had the same issues, despite an MS and many years of experience. The reason is because we’re dealing with a religious creed here, not a scientific enterprise. You say the wrong thing and you’re shunned. They come up with a “reason” that maybe sounds semi-legitimate to someone who doesn’t know much or is a “true believer,” but your real crime is not supporting the status quo. Alice Miller writes eloquently about the important message that the child must protect their parent in order to be protected, and identifies this as the source of most human emotional suffering. The same absolutely applies to most “mental health” settings – the biggest priority is making sure the staff feels OK about whatever they are doing. The clients who figure this out fastest are the ones who are declared “stabilized” and let out the door. It is a rare treat when they find someone like you or Stephen who actually cares about what they are saying and doesn’t require them to kowtow to your needs in order to be safe. It’s actually the most healing thing you can provide, in my view. But how to be there and do that in the mass of counterforce and oppression? It’s an incredible challenge. I got out of direct mental health care for that very reason, and now work as a supervisor for volunteer advocates in the foster care system.
The system definitely punishes anyone who strays too far from the party line. I guess it’s human nature in some ways, but unfortunately only the most vulnerable people are the least able to defend themselves from this kind of oppression.
— Steve
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I agree the language is ambiguous, but usually what they are doing is measuring the difference between the beginning of the trial and at a certain set point, or points. So what it suggests to me is that at 4 weeks, they were at best minimally “better” than at the start. It doesn’t necessarily imply there was an improvement followed by a dropoff. To gauge that, they’d have to do a symptom check at two weeks, and “antidepressants” are generally not expected to have any significant effect for at least that long in any case.
Does that help?
—- Steve
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I see – sort of the inverse of what I’m saying, but comes to the same thing: they don’t really expect there to be a difference. My guess is that often, the whole thing probably seems pointless to them anyway. I think in order to have a real placebo effect, you have to be investing some hope that the “real” pill will make things better, but if the kid doesn’t even have or understand the objective, it would be hard for their personal hopes and expectations to influence the outcome one way or the other.
— Steve
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It’s not that science is flawed – it’s more that people don’t understand or chose to pursue real science. Science is inherently skeptical – a new finding, rather than generating enthusiastic excitement and automatic acceptance, should instead generate a raft of efforts to disprove or qualify the finding. Rigorous science assumes that human beings are flawed observers and that only repeated, measured observations by multiple people over different times and settings can provide sufficient data to establish an actual scientific truth. And even such truths are only true until further data contradicts them.
Nowadays, “Science” is used as a marketing tool to promote products, professions, or viewpoints, and anyone who looks can find a “scientist” to support his/her pet theory or product. That is not real science. The only thing science is supposed to promote is a search for what is true and reproducibly real, regardless of whether it turns someone a profit or advances their career or not. Marrying profit to science inevitably corrupts the process, as the scientist is no longer objective when his/her livelihood depends on turning out a particular “right” answer. Even very honest people can be corrupted in this way.
The only real way out is to stop any funding of academic scientific research by industry. Industry can do their own studies, but they have to pay for them and the public knows the source is biased. Academic research should be funded only by government or non-profit sources who have no interest in the outcome. And of course, industry folks need to be completely removed from any kind of oversight role in the government. The FDA should be manned primarily by lay people who have no stake in the industry they are regulating. To do otherwise brings about exactly the situation we face today.
—- Steve
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Two of my sons were in the frightening 40% of “untreated ADHD” sufferers. The oldest has two jobs he is very successful at both, after graduating high school with honors. The youngest had a straight-A high school GPA and is now a freshman in college, and is also a college soccer player. Neither every got hooked on drugs, committed a crime, crashed a car, failed a grade, dropped out of school, or got a girl pregnant. Both have friends and active social lives. Neither appears to be suffering one iota from their “lack of treatment.”
It is now well established that long-term stimulant treatment does nothing to improve any social or academic or psychological outcome. Yet we are still intimidated with scare-tactic stories about “untreated ADHD” causing havoc. When will people catch on?
—- Steve
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Exactly! How could half of the population have a “brain disorder” and our species still survive? And why isn’t the general public or the media smart enough to see this obvious logical flaw?
—- Steve
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LOL!
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This is also not news. It is clear that the younger the child, the less effective antidepressants of any sort seem to be. My personal assumption is that this is because the main effect of antidepressants is an active placebo effect, and the younger kids are, the less likely they are to understand or buy into the “magic pill” concept. Which is interesting, since younger kids are supposedly more prone to “magical thinking” than us more mature older folks. But in this case, it seems the psychiatric providers have cornered the “magical thinking” market, and the younger kids are still enough in tune with their gut-level instincts to not buy into the deceptive worldview.
— Steve
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Or are receiving funds from the same sources?
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Not to mention that depression is also associated with higher adverse childhood event (ACE) rates, which have been shown to directly relate to physiological illness rates, including strokes. Additionally, there is no evidence presented that those “treated” for depression did any better, so the call to “identify and treat depressive symptoms before…” is really out of order.
— Steve
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http://www.webmd.com/stroke/news/20121017/some-antidepressants-stroke-risk
The potential link is not disputed even in the mainstream medical press. Not controlling for medication use is pretty inexcusable here.
—- Steve
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No, no, no, brain damage causes odd thoughts, not the other way around! And having odd thoughts proves you have brain damage, because, well, what else could cause them? They’re ODD, damn it! They can’t be caused by a “normal brain” because they’re ABNORMAL, because they BOTHER us and that is BAD, BAD, BAD. So the fact that there is no brain damage yet is only proof that we need to work harder to find the brain damage that we KNOW is there.
Oh, and it can’t be the drugs, despite the evidence, because, well, because the drugs are GOOD, because we thought of them. And all we do is good, so they must be good, so it must be the brain’s fault that it shrinks. That’s it, only BAD brains shrink when we drug them! GOOD brains get better! The bad brains are genetically malfunctioning so they aren’t able to benefit from our wonderfully helpful drugs! It’s all the brain’s fault, because by God, the psychiatrists and the system MUST be protected from any possibility of wrongness!
—- Steve
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I worked briefly doing involuntary hospitalization evaluations. My greatest service was keeping people from being committed by doing emergency therapy in the ER. Almost every person who was committed was put onto psychiatric drugs, and that’s basically all they were offered. Any therapy that happened was post-discharge. After discharge, the “clients” had case managers whose main job appeared to be to make sure people “took their meds” and stayed out of trouble. People with “bipolar” or “schizophrenia” diagnoses got no therapy whatsoever. I always tried to diagnose people with “PTSD” or “Adjustment Disorder” so they’d have to get them some kind of talking therapy.
There were also a handful who were discharged with the stipulation that they had to keep taking their drugs, and if they stopped, they could be immediately apprehended and detained in the hospital. There was never a clause saying that if they didn’t attend therapy they’d be re-detained. The focus of involuntary detention was almost 100% forced drugging. There was really no other option offered up, unless the client was educated enough to object and ask for alternatives. I am sure it is even worse today than it was in 1995. That’s how the system “works.”
—- Steve
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Mostly because the media, with the help of the TAC and other industry front groups, continues to portray anyone with a “mental illness” as a danger, and blames every shooting on “mental illness” (unless it’s committed by a person of color, in which case it is caused by “thugs” or “terrorism”). Getting the counter-narrative into the media seems like Job One.
—- Steve
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I didn’t even see an age limit. So a 5 year old can provide “informed consent” to psychiatric treatment, an action that is challenging for an educated adult in today’s very warped and Orwellian “mental health” world where “treatment” and “damage” are almost indistinguishable?
— Steve
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Reminds me of “Casablanca:”
Claude Raines: “I am shocked – SHOCKED – to find that GAMBLING has been going on in this establishment!”
Croupier (to Raines): “Your winnings, sir?”
Raines: “Oh, thank you very much.”
Ya gotta wonder how this surprises anyone whose head isn’t firmly placed up his rectum!
— Steve
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I did not know this, and I agree it is very important to continue to shift the narrative not only away from confabulated “diseases,” but also toward reintegrating CONTEXT into people’s mental/emotional suffering. When 85% of “schizophrenics” relate a significant abuse/trauma history, while the wildest data manipulations can only account for less than 10% of such cases with genetics, it is quite bizarre that we spend billions researching genetic causes and almost nothing on the wide range of known environmental insults that impact the rate of psychosis experienced by the affected people.
— Steve
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Interesting that Dr. Marder gets away with making his statements of what “he believes” about most “schizophrenics” requiring long-term neuroleptics in contradiction to all that Johanna and Hugh presented, and in contradiction to the WHO cross-cultural studies, without having to provide any evidence on his own behalf. Or did he come up with something other than his personal clinical experience? Did anyone call him out on ignoring or minimizing the hard data that had been presented?
—- Steve
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There really is no difference, except that the guy downing the whiskey at least knows he’s “drowning his sorrows” and not engaging in “medical treatment.” I’d be a lot more tolerant of the drugs if the docs were at least honest about what they are used for – a temporary means to feel better that does nothing to address the underling cause, and can have long-term adverse effects that could damage your health. Just like drinking alcohol.
—- Steve
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They also sometimes physically hold them down and sit on their back or legs and hold their arms behind their backs until they calm down. I was trained in this technique when I was doing day treatment for 6-12 year old kids. Another intervention is locking them in a padded 4×4 foot room with a tiny window for extended periods. We were not allowed to use this for more than 5 minutes and had to check on them every minute, but I know there are many places that don’t follow these protocols.
—- Steve
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Who’da thunk it?
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Wow! So despite all the claims that people are just going off their meds because they “feel better and don’t think they need them any more,” apparently as many stopped by DYING as stopped by “patient choice.” The main reasons, as I’ve always said, are lack of effectiveness and intolerable side effects. Good to have this in black and white to help counter the claims that “if these poor people would just stay on their meds, everything will be better.”
—- Steve
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Wow, you have the plot all worked out! Start writing the screenplay and someone will do it. Anyone have Hollywood connections? Or other filmmaking credentials or connections?
—- Steve
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One of the main functions of the psychiatric worldview is to deflect any suggestion that your suffering may be caused by the social conditions you are exposed to and make sure that all the blame lands on YOU, the sufferer, for not “adjusting” to the wonders of modern life. This is particularly absurd when thinking about First Peoples, as each and every one of them has good reason to be depressed, anxious, hopeless and/or righteously infuriated by the way both individuals and the group as a whole is represented and is treated by the larger society. But this view is completely inimical to what psychiatry stands for – it is all about preserving the status quo and assuring that those in power don’t have to worry about the peons of various sorts getting together and objecting to their continued running the world into the ground.
Instead of taking pills and accepting passive and dependent roles, it’s time we channel this appropriate rage and disaffection into altering the conditions that perpetuate the misery of so many people of whatever race and history. A handful of “mental health workers” will do nothing but try to shove the oppressed further into the mud!
—- Steve
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I also found that fact disturbing! Apparently most Americans are unaware that medical care is the third leading cause of death in the USA. And don’t forget the increasing evidence of a connection between antidepressant use during pregnancy and “autism spectrum disorders.” The FDA is completely sold out at this point. Disgusting, indeed.
—- Steve
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Wow, talk about manipulating the data! You have twice the prematurity rate and twice the neonatal death rate, but they are “safe” because other people exposed to different psychotropics at different times in their lives or pregnancies did just as badly? It is hard to imagine a more warped form of “logic!”
I also thought it odd that they mentioned an increase “risk” of vaginal birth. Is a vaginal birth now considered a bad outcome?
This is a marriage of the two most unscientific and corrupt disciplines in medicine: psychiatry and obstetrics. Both are expert at taking normal human processes and pathologizing them, and both chronically insist on intervening in situations in ways that predictably lead to worse outcomes. It is no surprise that they teamed up to come up with something sleazy and dishonest, but even I am shocked at the disingenuousness of this ridiculous approach!
—- Steve
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I am so glad you were there and asked that question, and it doesn’t surprise me that many people appreciated your doing so. I think the answers he gave are less important than the meta-message, which the people in the audience who were really listening are sure to have heard: 1) he has no real answer to your question; 2) he doesn’t care about the real answer, and 3) when attacked, he will resort to platitudes and ad hominem attacks rather than the actual data. Of course, there were many in the audience who are just the same and agree with his authoritarian approach, but there are many others who are open to ideas and have now heard about Harrow and Wunderlink and Whitaker and the long-term data that stimulants don’t improve outcomes. I am guessing not a few attendees got on the internet and looked up some research as a result.
Well done for planting some seeds, and for standing up in the belly of the beast and speaking truth to power!
—- Steve
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Seriously. If the “treatment” were working, why are they on three or four drugs and still having anxiety and behavior problems? And if it’s “the child’s age,” then why are they prescribing drugs for what they are saying is normal developmental behavior?
When things get better, it’s always because the drug is working, but when they don’t improve or get worse, it’s always the child or the “disorder.” There is zero accountability.
— Steve
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There was also a protest in Portland, and shock survivor Deborah Shwartzkopf was arrested in a peaceful act of non-violent resistance at the Kasier-Sunnyside hospital. There was no media coverage that I was aware of, except for KBOO Community Radio.
—- Steve
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It would be kinder to just kill them outright. I find this outrageous!
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Note the increase in antipsychotic “therapy” as the years of stimulant “treatment” go forward. This is true insanity. Stimulants increase dopamine levels in the brain. Antispsychotics decrease them. The longer kids are on stimulants, the more their brains adapt by lowering dopamine transmission, and the higher the dosage required to suppress the “symptoms.” The higher the dose, the more likely there are side effects like aggression and psychosis, and the more likely they get diagnosed with “bipolar disorder” and put on antipsychotics to decrease the dopamine cascade caused by the increased dosage of stimulants.
Stupidity. If you want less dopamine, stop increasing it with the stimulants! Instead, we have over 10% of these kids taking antipsychotics with all the attendant side effects (including dramatically decreased life expectancy) for iatrogenic reasons. And no one has the insight or the kahunas to call BS on the psychiatrists. I see it every day working with foster youth, and it really is a very disgusting situation.
—- Steve
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And I wonder what the results would be if they held drug interventions to the same standards? Oh, no, I don’t wonder – we already know that drugs are less and less effective the younger the user (can anybody say “placebo effect?”) and that in anyone younger than teens, there is no evidence that they are in any way helpful, even from the biased research of the pharmaceutical companies.
— Steve
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I don’t know if Lieberman is a chronic liar (probably is), but I think we all know that Torrey lies like a rug and is willing to swear to the truth of stuff that is known to be false. Of course, anyone who would take Torrey’s word for something is stupid. I don’t know how the guy has the slightest credibility left.
Thanks for directly taking on the liars!
—- Steve
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Well said, B, as usual. I agree with acidpop – we adapt as we need to, and there’s nothing “crazy” about coming up with creative ways to survive an oppressive environment!
—- Steve
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The researchers always appear surprised when communication works, and surprised when drugs don’t work or make things worse. A little bias in the expectations, you think?
—- Steve
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A thought-provoking essay, to say the least!
I think the area of kids is a tough one. If we all waited until we were fully healed to have kids, there wouldn’t be many kids in the world. Which might be a good thing, except the people who haven’t done any healing at all are having kids by the bushel without any such compunctions.
My feeling is that the therapist’s choice to have or not have children is not particularly important – the question to me is whether the therapist has done his/her own work of healing and is continuing to do that work as part of making sure s/he is doing a good job as a therapist. I would tend to agree that quality therapists are rare as hens’ teeth, because becoming a therapist in no way requires that the person have accomplished any degree of emotional health or sanity before offering his/her services. I am very much in the camp of Alice Miller (whom I know you value highly as well) in believing that unexamined issues from our own upbringing prevent our being really available to our clients (or our kids) and that we tend to act out those issues that we haven’t consciously faced on both our clients and our children.
I would never claim to have completed my healing process. My childhood was no worse than most and better than many, but there were traumatic experiences in abundance, and I am quite certain there will always be more to learn about that. What I think makes me viable as a therapist is that I am aware of what happens when my own issues get triggered, and I have processes in place to recognize and get assistance when that occurs. I like to believe that I am very good at keeping my own issues out of the discussion with clients, and I think the results I’ve had speak for themselves. I don’t think clients need a perfect person as a therapist. I think they need a HUMBLE person who recognizes the potential harmful impact of everything s/he says or does, and is very gentle and respectful in all interactions with the client. A good therapist is also constantly working to put the client in the seat of power and helping him/her see ways to regain control of his/her life, rather than advising or critiquing or in any way pushing the client toward the therapist’s goals. This is not easy to do unless you’ve done your own work first.
I was very fortunate to have found a good therapist on the first try back in my 20s. She helped me get started on the path of understanding my childhood and my own reactions to it, as well as helping me see that I always had choices and options. She had a young daughter she was raising and it did not prevent her from being a very helpful agent in my life. I find it very sad that others aren’t able to find a person like that, and I hope that I’ve been able to be that person for a lot of other folks who have encountered me. I’m sure I wasn’t for every one of them, but I know I have been for some, and it is something I feel very good about.
I agree that therapy is an art form, and that it takes a different form in each person I am trying to help. As to forgiveness, I think that is completely at the option of the person who has been harmed. Pushing forgiveness would be a giant red flag, because people who do that are usually not comfortable dealing with their own anger and grief towards those who have hurt them. But I also agree with Alex that a time comes when forgiveness makes sense and is healing, at least for some pe0ple and situations. I have certainly forgiven my mother for the most part for her failings early in my life, partly because of my own parenting experiences and partly because of good therapy helping me recognize the impact her limitations had on me. But I still recognize those limitations and have been able to reconsider my expectations of her as an adult so that I don’t keep hurting myself by expecting things that I know she will never be able to deliver.
Therapy is very complicated and emotionally challenging. A good therapist is very rare, and bad therapy can do a hell of a lot of damage. Perhaps the most important point in the essay is to screen one’s therapist hard and thoroughly, and to trust your gut if it feels like this one isn’t right for you. I’d say the odds are at least 9 out of 10 that the therapist you are in front of will be at best of marginal help. Do your homework and find a good one if you can. They are out there, but you can’t tell by the degree. You can tell best by how you feel when you are talking to them.
—- Steve
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This is extremely important news – it has implications for every other “mental disorder” in the DSM. Their biggest support for their “genetic inheritance” theory is these twin studies. If anxiety can be transmitted early in life, why not depression, aggression, or even paranoia or delusions?
Unfortunately, it will probably get buried somewhere and no one will really talk about the results. Between those who feel sorry for the parents and don’t want to say anything that “blames” them (even if it would actually help them do a better job!) and those who are currently profiting financially and professionally from the “genetic inheritance” assumption, most of the luminaries in the “mental health” industry will find this study terrifying.
—- Steve
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I assumed that the title was completely intended as sarcasm. To think that a serious article could start off with such a title is disturbing. I personally find the words “f0rced” and “treatment” very difficult to say in the same sentence. To give CHOICES of forced treatment is a ludicrous oxymoron.
— STeve
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In addition to the author’s very valid observations, there is another contaminating factor, and that is that the actual definition of what is “better” can differ depending on values and priorities of the party doing the evaluating. Most psych drug studies focus only on symptom reduction as the goal of treatment. Using this as a guide, we could easily and correctly design a study showing that alcohol is an excellent treatment for anxiety, probably as effective as the benzos with a somewhat better side effect profile. In fact, I’d love to see low doses of marijuana tested against SSRIs for antidepressant effects – I’d bet marijuana would come out on top with ease.
But if you measure other data points, like long term health, employment, relationship stability, community engagement, personal satisfaction with life, you get very, very different results. I think part of the mesmerization has been the act of convincing everyone that symptom reduction is the ultimate measure of effectiveness, because the drug companies can ask “what symptom can we say this drug reduces” and then find or invent a disorder that encompasses the symptom in question.
Part of the reason Whitaker’s work has been so influential is that he cuts through that assumption and asks the important question, “Does symptom reduction in the short term lead to better lives for patients in the long term?” And the answer in every circumstance appears to be NO.
—– Steve
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My wife’s dad had dementia and was in a nursing facility where she visited him. She saw that he was thrashing his head from side to side, had very rigid muscles, and appeared to be trying to say something but was unable to talk. She called me and I told her to check what he was taking – sure enough, they’d put him on Risperdal because he was gripping the staff’s arms when he was trying to tell them something and felt he wasn’t being heard. She and her sister convinced her mom to take him off of it. Within three days, he was talking, laughing, telling stories, and seemed as much his normal self as possible under the circumstances. The doctor was FURIOUS that her mom had taken him off without consulting him and tried to insist he go back on. No one at the nursing home appeared to notice his incredible distress, and the fact that it resolved within three days when the drug was stopped had no impact on the doctor’s view of its usefulness. Apparently, a person unable to move or talk is preferable to one who expresses his needs in a way that is inconvenient for the caretakers. I think it’s pretty clear why in most cases this stuff is given to seniors. It is a chemical restraint, no more.
— Steve
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Too true! The distinction between what they think of as “mentally well” and “I just don’t give a crap” is remarkably fine, if there is one at all. It seems the goal is to never be upset about anything that happens, no matter how bad. Very convenient for the promoters of the “status quo!”
—- Steve
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Cats have as good a chance as anything else at being helpful. This is another example of “scientism” – nothing without double-blind studies counts as helpful, and the same thing has to help everyone or it doesn’t count, even when the categories we’re helping are arbitrary and subjective. Why not just let the person try out having a cat. If they feel better, it worked. If they don’t, it didn’t work. Kinda how they do medication anyway, except with cats, the only side effects are fleas and having to change the litter box.
—- Steve
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I already did!
— Steve
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I think that is its main advantage overall, unless you happen to luck out and find one of the small minority of therapists who actually knows what s/he is doing.
—- Steve
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It reminds me of some good stuff from the family therapy literature: there is an “identified patient” who is the person who acts out the repressed conflicts in the family, and is scapegoated in various ways for doing so. The family asks the professionals to “fix” the identified patient and believes once s/he is “fixed,” all will be well. Of course, none of them changes their behavior and the identified patient is still subjected to the same stresses as he was before and is still scapegoated, and if in treatment, any success is undermined by the “family system” so that he continues to be “ill.” If, despite all this, the identified patient improves, someone else ends up acting out and stepping into the scapegoat role.
I think this very much reflects our society, which is in huge denial about problems caused by the status quo, from poverty to pollution to unemployment to depression to violence. We need a scapegoat to avoid dealing with this denial system, and the “mentally ill” are a perfect match for that need! These people are “weird,” they “act out,” they don’t accept the current reality and complain and want changes – they are clearly “ill” and need to be “fixed.” And the biological/medical model provides the perfect opportunity to act as if we’re trying to “help” the identified patient(s) while making sure that they don’t really address the underlying issues that are causing their distress. Hence psychiatry’s subtle but consistent hostility toward looking at any kind of trauma-based model of treatment – it means holding the entire “family” accountable instead of the identified patient(s) who happens to protest the current state of affairs.
Treatment is, indeed, designed to benefit society, but only in the limited sense of providing the appropriate scapegoat so as to avoid dealing with real issues. Helping the individual is most certainly a secondary consideration, and in fact could create some problems if too many people get better, because then we’d need to create more “patients” to take the blame for the discontent that our current social system so effectively generates.
—- Steve
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Antidepressants don’t work against suicide, either, which gives these programs a big advantage – at least they don’t have side effect like violence, and actually INCREASING the risk that a non-suicidal person will become suicidal!
—-S teve
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I love the website and the approach! Very entertaining and easy to digest. Well done!
— Steve
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CPU, I’m not arguing that such folks need and deserve all the support and care that is available (and I’ve been one of them from time to time, too). All I’m saying is that you can’t assume that just because a person fits a particular list of symptoms you somehow understand what is wrong with them and what is needed to help. I’d never argue against pain relievers if someone has a lot of knee pain, but I’d be very disappointed in any doctor who didn’t look for the cause and try to treat it. It seems to me that this is what psychiatry has become – we list off a bunch of obvious “symptoms” of a condition that often occurs, such as being depressed, and call it a “disorder.” We disclaim technically that these people necessarily have the same problem and claim to be doing research to find causes, but in actual practice, all the research focuses on the “disorder” as defined and all “treatment” focuses on reducing the listed “symptoms,” with no attempt to differentiate between the various possible reasons the person is suffering. I see this as harmful, but my view of this labeling process as being harmful doesn’t mean I don’t respect that you, for instance, have suffered very real hallucinations/delusions and that you’ve found psychiatric drugs at least somewhat helpful in suppressing these manifestations. And I’m not even denying that you or someone experiencing similar might have something physiologically wrong with you. I’m just saying you don’t KNOW what if anything is physiologically wrong just based on that DSM symptom checklist.
I think we agree about a lot of things, but the sticking point seems to be that when I say “DSM diagnoses as described aren’t discernible diseases” you hear “people with psychiatric diagnoses don’t have any real problems.” I am not saying the second, I’m saying the first.
— Steve
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I suppose there isn’t as much profit in trauma, besides which, they’d have to admit they have no tools to actually deal with it. I actually had a psychiatrist (one I even have some respect for) tell me that PTSD isn’t caused by trauma, because if it were, everyone who was traumatized would develop it, so there must be something wrong with the person who develops PTSD beyond being exposed to the trauma. Seems to presuppose that there is a “right way” to respond to being traumatized, and those who “overreact” are somehow wrong or deficient for doing so.
I also read a recent study (I think on MIA) where they discovered that over 80% of the kids in a psychiatric residential facility (or maybe it was more than one) had trauma histories, but less than 20% had any documentation of this in their files. So 60% of the residents either had reported trauma and it wasn’t considered important enough to write down, or simply weren’t asked, despite their residing in a facility for kids who have major behavioral or emotional issues that are very highly associated with trauma.
I’d suggest you listen to Van der Kolk and send the psychiatrists packing. There really is nothing they have to offer to trauma victims in the vast majority of cases, even though trauma is present in the vast majority of cases they encounter. They just don’t appear to think it’s important enough to bother with, if only because they can’t sell drugs as easily if working from that frame of reference. But it does seem like they often do the opposite of what would be helpful, doesn’t it? Makes you wonder how invested they are in people actually getting better…
—- Steve
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And what is fascinating is that the way they get depressed monkeys is by exposing them to isolation and social/emotional stress! But it’s all chemicals…
— STeve
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And unbeknownst to the therapist as well.
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This is very true. The parallels between psychiatry and obstetrics are quite common and most alarming. Unnecessary interventions that increase morbidity and mortality are promoted intensely, helpful non-intrusive interventions are demonized and discouraged, and anyone daring to critique the holy writ of the orthodoxy is subject to social ostracism and high legal risk. It’s actually more legally risky to recommend laboring in a bathtub than it is to do an unnecessary C-section. But most “consumers” are completely ignorant of all this until it happens to them personally.
— Steve
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Too true, and very well said.
— Steve
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That is exactly what I meant. Even given the horrific physiological effects of the drugs, I’d still wager that if you compare folks getting the same script based on their relationship with their psychiatrist, the ones with the more compassionate psychiatrists would win, not only because they’d actually listen more when the person said it wasn’t working or complained of intolerable “side effects,” but also because having someone listen is therapeutic in and of itself. I think this would be especially prominent in cases of “active placebos” like antidepressants.
On the other hand, it’s been shown that a friend who is a compassionate listener is about as helpful as any therapy, so maybe the better comparison would be “compassionate psychiatrist” to “any other compassionate person.” In that case, I’m sure the psychiatrists would lose, even the “good ones,” as long as drugs were the primary intervention.
— Steve
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We need more menaces like you! In fact, let’s ALL be menaces to the comfortable world of psychiatry. When the start in on the ad hominem attacks, you’ve got ’em on the ropes, Bob. Keep hitting!
—– Steve
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I’d love to see his MMPI!
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Ironic indeed.
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And the meta-message here is: It is true because Liebermann said it is so. It irks me incredibly that a journalist lets him get away with that. Easy response: “I hear what you’re saying, but Whitaker has given us several long-term studies to back up his contention – do you have any studies saying the opposite?” And continue to ask for studies if he tries to deflect, finishing with the clear statement, “So am I understanding that you don’t actually have any studies you can cite that say this?”
That being said, being cursed by Liebermann is proof that Bob is really making an impact and the psychiatrists are running scared.
“Insulin for diabetes…” What a crock!
— Steve
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I don’t hear anyone saying that mental emotional distress doesn’t exist, only that it isn’t an illness per se, as I’ve described before. You seem a bit stuck on this point. People suffer and we should help them, but emotional suffering has many, many causes. A disease should be something where you can identify a cause and recommend a treatment. A rash is a condition but not a disease. It can be caused by lots of things, and depending on the case, requires nothing or intensive treatment.
What are called “mental disorders” in the DSM are not identifiable disease states. It doesn’t mean no one gets depressed or has hallucinations or that those people don’t deserve help. The question is whether all people having those conditions require medical assistance because of a physiological condition that causes the “symptoms”. The answer is clearly no.
— Steve
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This is one of those things where I wonder why we had to pay someone to do research to figure this out. It seems inherently obvious that seeing a therapist you don’t like isn’t going to help and may make things worse. And this is not the first time that the therapeutic alliance has outweighed the school of therapy applied. Basically, people need kindness and respectful listening. It’s not rocket science.
— Steve
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Exactly. I’d like to see them do the same thing for “medication” interventions. I bet the people whose psychiatrists treat them more like human beings have better outcomes regardless of the prescription.
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BTW, I just wrote a scathing review of Liebermann’s “Shrinks” on Amazon. It’s something like 34-10 positive, so I encourage others to add your two cents worth and bring down the average. It is kind of interesting – people are either 5 starring or one-starring for the most part – they love it or they hate it. You can guess how many stars I gave it.
—- Steve
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Maybe, but pre-emptively lumping them together into categories actually obscures any chance of really finding out of there is a brain function disorder that is verifiable. For instance, “ADHD” is diagnosed for kids fitting a range of symptoms that are common for many kids but appear to a greater degree in those so diagnosed. What if 20% of these kids had a B vitamin deficiency? If we treat a whole group of 100, only 20 get better. But if we give them stimulants, 70% get better. So stimulants are “more effective” for treating “ADHD.” But 20% of these kids got better with a nutritional intervention!!! We lose sight of those 20% if they are lumped in with the rest as all having “ADHD.” There may be another 15% who suffer from sleep apnea, another 5% have low iron, another 30 % (this figure is actually validated in a Canadian study) who went to Kindergarten a year too early, and 10% more who are really smart and are so bored by the curriculum they have to do something to break up the monotony. Add in another 10% who are in abusive homes or in foster care, and we’ve taken care of 90% of the cases without a milligram of stimulants. But they each had different issues, and none of these issues will encompass more than a minority of kids so labeled.
There may be a hard core 10% or less (of those diagnosed) who really have some kind of brain damage, though that figure seems ridiculous high for kids who haven’t suffered head injuries), and maybe we can then study those 10% and see if they have anything in common that is malfunctioning or can be fixed. But we’ll never actually find THOSE kids, either, because they’re lumped in with the 90% whose brains are actually fine!
It may seem like a small thing to simply name a condition of non-optimum operation in order to talk about it, but words absolutely have power and they alter and restrict how we think about a problem. There are consequences to labeling that go well beyond simply a recognition that a particular set of behaviors or emotions objectively exists.
— Steve
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I think it is easy to get confused between saying “the mental illnesses defined in the DSM aren’t really illnesses per se” and that “the experiences that are labeled mental illnesses aren’t real.” No one’s saying depression isn’t a real thing that happens. At least I’m sure not. I’m saying that “Depression” is a state that a person is in which 1) is not a disease state in itself, as all of our emotions have survival value, and 2) there are literally hundreds of different situations, some physiological and some not, that could result in a state of “depression.” What is ridiculous is to assume that ALL states of depression result from the same cause and require the same “treatment.” What makes sense to me is to look at depression as an indicator of something ELSE that is wrong, rather than defining depression as the problem. For instance, a person can be depressed due to the loss of a loved one, a vitamin B-12 deficiency, a lack of purpose in his/her life, the side effects of a medication s/he is taking, loss of sleep, the long-term consequences of childhood abuse, a thyroid condition, or any combination of the above. Why would you assume that all of the above conditions are a result of an “imbalance in the brain?” Why would you prescribe an antidepressant for all of the above conditions?
For sure, people get depressed. They always have and they always will. It’s real. And it CAN be caused by a disease in some cases. But it is not in itself a disease state. It’s a normal state of the body that communicates something about the survival conditions in the environment. Are some people more prone to assuming that condition, perhaps even biologically? Probably so. But that doesn’t mean there is something wrong with those people, either.
If people feel bad and want to take drugs to feel better, I have no problem with that. But I do have a problem with taking a normal human emotion and defining it as a disease state without bothering to look at why it is happening or what other options you might have to get yourself to a more favorable condition.
— Steve
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And in any case, she received the full-on psychiatric standard of care and still ended up killing herself. At one point in the article, she says, “Since I’m going to hear voices anyway, I may as well stop the medication.” That sounds like the voice of a person in despair, who has been told that following this path will make everything all better and finds out that it does not remotely come close to fixing her situation.
It astounds me how bio-psychiatry’s proponents manage over and over again to take stories of psychiatric failure and turn them into advertisements for more psychiatry!
—- Steve
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Hah! So the kids are right and the teachers got it wrong, as usual. Open classrooms or homeschooling for all “ADHD”-diagnosed kids!
—- Steve
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Here’s the thing: in real science, we operate from the null hypothesis, and the person claiming the null hypothesis is wrong has the burden of proof. So if someone says antidepresssants work but has not proof of it, the assumption is they don’t work. As for dangerous effects, I think it’s the opposite: the appropriate assumption is that all drugs have side effects that could be dangerous until proven otherwise. If there is any suggestion that, for example, SSRIs cause certain people to go berserk and commit mass murder, it is not the person observing this who is responsible for proving it is so. It is the manufacturer’s obligation to demonstrate that this is not connected to the drug. Of course, there has to be at least an apparent connection – the bad behavior has to follow administration of the drug in more than one case. But the recipients should not have to submit double-blind proof that the drug is dangerous. If there is indication it is dangerous, then we should assume it is dangerous until proven otherwise. That’s the null hypothesis. It makes no sense to assume no side effects until proven otherwise, because that goes counter to huge amounts of general experience that drugs do have side effects. In fact, aggression (euphamistically called “manic behavior”) and suicidal behavior are noted as side effect possibility on all SSRIs.
The drug is not innocent until proven guilty. If there is any reasonable chance that such a drug could cause such a reaction, it should be eliminated before the drug is assumed to be safe.
—- Steve
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I had the same experience. I thought the odd expressions and movements and vocalizations were a result of “schizophrenia.” Once I learned about Tardive Dyskinesia, the scales fell from my eyes. In fact, I was in a bus station on the way back from the training and saw a person waiting who was making all these grimaces and twitches, and I thought, “Tardive Dyskinesia! There it is!” Apparently it was quite common but I had no idea what I was looking at before that training.
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I agree with B – I hope they do the study, and won’t they be surprised to find that the people receiving LESS mental health “treatment” do BETTER over the long run? This is perhaps the only benefit of states refusing to implement expanded medicaid – less clients for the mill!
— Steve
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I can’t believe I used the term “resistance!” What I mean is a client’s unwillingness to engage in what the therapist thinks will be helpful to them. The term “resistance” kind of blames this on the client, whereas I think it is a sign that the therapist may be barking up the wrong tree and needs to stop deciding what the client needs and instead listen to what it is they are saying they need themselves.
—- Steve
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Thanks, Tim, for an inspiring read. I agree with Duane’s proviso that we should be looking for and eliminating real physiological diseases before assuming psychological causes, but that being said, your analysis of the reasons for client resistance are quite on target. One of the great evils of the “medical model” is that it provides what seems like an easy way to avoid looking at what is behind our distress, which seems good in the short run but ends up preventing a more basic solution to our woes. Of course, there are also plenty of non-psychiatric ways to address immediate pain/distress reduction, the most obvious being meditation/mindfulness breathing, but to discover these options requires a much more honest and humble discussion with the client than many professionals are willing to engage in.
The other barrier you don’t mention, and I really think you ought to, is that many therapists/counselors are extremely limited in their scope of practice. Many these days are trained not to even consider the review of historical trauma as relevant, but to focus entirely on present-time “new thoughts” (CBT) to replace the old “bad thoughts” without any consideration of what service those supposedly “bad thoughts” may have provided in the past. There is also often little discussion of unconscious or subconscious motivation or the effects of present-day harm a person may be experiencing at the hands of an individual or social forces much larger than him/herself. In short, many therapists today have adopted the psychiatric view that the problem/illness lies in the client him/herself, and that the solution is to help the client “adjust” to current reality. This approach has severe limitations, especially when dealing with trauma victims or others experiencing high levels of emotional distress. Naturally, when these therapists fail to have the desired effect, they are encouraged by our system to pass these people on to psychiatrists, because their problems “must have an organic component,” to use one of the common phrases.
Bottom line, getting quality therapy is about more than just getting it funded, though that is a big barrier. It’s about knowing what quality therapy even is, what it intends to accomplish, and finding someone really capable of delivering it. I was very fortunate to find one on the first try, but that was back in 1982, when psychotherapy was in the ascendency. I think it’s a lot harder today, not only because of social mythology speaking against it, but because many therapists aren’t actually trained to get to the root of a person’s struggles effectively, and clients try it and find it doesn’t really get them what they need.
—- Steve
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Now THERE’S a thought! A little dose of humility, with a dash of empathy for flavor…
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No, that’s one of the POSITIVE effects! We don’t want “schizophrenic” people having sex – it creates ALL kinds of difficulties on the unit.
Seriously, this does not surprise me and should be expected. Antipsychotics basically shut down the dopamine system, and dopamine is definitely a big part of sexual arousal and satisfaction. If anyone bothered to think about it, it should be an obvious “side effect,” but psychiatric myopia knows no bounds. I doubt that most psychiatrists ever even ask their “psychotic” clients about their sexual lives – they most likely assume or try to pretend that they don’t have sex at all, or at a minimum, that it is of little to no relevance to their “mental health.”
—- Steve
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Cpuusage,
I appreciate your civil tone and clarity in this discussion.
I really don’t agree that there are significant numbers of people suggesting that you are lacking in moral fiber if you can’t think your way out of a mental illness. I think that particular line is used to distract from the legitimate arguments of psychiatry’s critics, because it throws down the unstated assumption that either you buy into psychiatry’s view of “mental illness” or you are automatically stigmatizing victims and blaming them for not “bucking up.” Those are not the only two viewpoints. It is possible to take the position that life is challenging and that it’s perfectly normal and acceptable, not a moral failing in any sense, to struggle emotionally and mentally with the challenges we face, especially in our crazy modern world. It is my contention, in fact, that the psychiatric labeling process does more to stigmatize sufferers than even the “buck up” message does. There is research showing that people view sufferers more negatively when given a biological explanation for their suffering. I think it is much healthier to identify the source of conflicts between what the person wants or needs to survive and what the world has provided them to date, and to help them start to figure out some new and more effective ways to get their needs met. There is absolutely no criticism in this approach – I generally frame it as what the person has been taught or learned to date has not prepared them for what the world is expecting them to do, and therefore some new learning is in order. I don’t recall anyone ever telling me that they felt I was judging them for not having it all figured out, because I spend a ton of energy normalizing their struggles as part of the challenges of life. To the contrary, most people report feeling very safe with me because they know I do NOT judge them for not “adjusting properly” to the world as it is.
Psychiatry is actually very much built on the assumption that people should automatically adjust to whatever expectation the world puts on them. For instance, it takes kids who don’t fit in to the standard educational classroom and tells them they have a mental illness and need to take drugs, when research shows that putting them in an open classroom environment, or even waiting a year before starting them in school, can reduce or eliminate the “symptoms” of their “disease.” Talk about stigmatizing! I do NOT expect the child to “buck up” and make it in the standard classroom. I expect the teacher to modify his/her approach or the school to be restructured to meet this child’s actual needs.
I hope that makes my point clear – being opposed to psychiatry as currently practiced does not equate to “blaming the victim.” I believe most antipsychiatry activists find that it is the larger society that is being let off the hook for first creating unnecessary distress and then putting all the blame on whatever person doesn’t fit into the status quo paradigm.
—- Steve
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There is a difference between denying that the current conception of “mental illnesses” as discrete categories defined by the APA in the DSM and having assumed biological underpinnings that are similar for all sufferers and denying that the phenomenon of “mental illness” exists. Szaz never denied that people suffered depression or hallucinations or such things, he merely pointed out that you can’t assume that someone has a physiological illness based only on psychological symptoms. It’s a position I can readily agree with, and yet I have worked as a “mental health professional” for many years and believe that quality psychotherapy is a godsend to those who are able to process their experiences in that fashion.
Most “mental illness” is the result of people’s reaction to stress and trauma in their lives, current and historical, and “mental illness” is itself clearly socially defined and mediated by assumptions of what is “normal” (see the DSM categories for proof of this). It makes little to no sense to me to take what is so clearly a social phenomenon and deny or minimize the social contributions to it, as psychiatry has done. Again, these things do occur, but I don’t view them as essentially medical problems, even though medical issues can contribute to them. I think that is what most “antipsychiatry” activists believe as well. So the dichotomy is not accurate to me, and I think I have answered your question of “what is it, then?”
— Steve
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LOL!
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In layman’s terms, SSRIs damage your brain. It is hidden behind a lot of jargon, but that is the bottom line.
—- Steve
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I would love to see a comparison between countries, comparing psych drug rates with death rates. It seems likely that would be possible from the data at hand. The US stats appear to be much higher, with 20-25 years being commonly quoted, and the US is the #1 psych drug consumer and purveyor in the world.
It is quite unconscionable that they did not make any attempt to factor in “treatment,” and explained away the association between intensity of treatment and earlier death by blaming it on the victims. It is amazing the degree to which this profession will go to protect its dogma in the face of contrary data.
—– Steve
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Fascinating! So not paying attention to stupid things and paying attention to things you personally care about is associated with living longer? Go figure! But don’t worry, with the one-two of stimulant “treatment” creating manic episodes, leading to a “bipolar” diagnosis and an antipsychotic, should quickly shorten up their lifespans and thereby negate this uncomfortable and inconvenient finding.
—- Steve
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Nah, Vyvance may be worse but this has been going on for years, ever since “juvenile bipolar” was invented, oh, oops, I mean DISCOVERED by the estimable Dr. Biedermann, who interestingly worked a lot with “ADHD” kids before he made his “discovery.” It happens with any amphetamine-type stimulant, though Vyvance may make it even more likely. It sounds nasty to me!
—- Steve
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Precisely. I have seen this many, many times in my work with foster children, where stimulants cause increased aggression and this is “treated” by antipsychotics instead of reducing or eliminating the symptoms. You’d think that basic scientific reasoning would speak against this practice, which is about as logical as roping a rock climber and pulling him/her both up and down at the same time. But apparently scientific logic does not apply, and we are operating either from blind religious adherence without any scientific understanding at all, or from blatant profit-making evil motivations. Either way, anyone prescribing this combo should be called on the carpet, but it is common enough that they can get away with it by calling it “regular and accepted practice,” even when it is totally irrational. Pisses me off big time!
—- Steve
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“Little evidence?” How about NO EVIDENCE? Psych drugs under ONE? LUNACY!
—- Steve
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“Epigenetics” is simply the discovery of how our body adapts to our environment. Why it was ever a question that our body adapts to our environment is what I find baffling. Human survival in so many different climates and niches happens solely because we’re the most adaptable species on the planet. It is only economics and ideological rigidity that ever made the “genetics only” argument seem viable.
It is also interesting to ask why even those still believing in the nature/nurture dichotomy would focus all of their energy on genetic inheritance, when that is the one thing we have absolutely no control over. Why not focus on the environment, which contains thousands and thousands of possible variables that we actually can change?
— Steve
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I agree with Rob – whether these things were “claimed” by “mainstream psychiatrists” or whether they merely stood by and allowed this gigantic misimpression be spread without a word of caution or contradiction is not that important. What is most relevant is that psychiatry benefitted both financially and in terms of status from this belief, and they either actively or tacitly approved of it, depending who you talk to. Bottom line is that many if not most consumers/survivors who have directly interacted with mainstream psychiatrists have been told that a “chemical imbalance” is a causal factor in their depression (or almost any other “mental illness”).
It is also interesting that Scott does not acknowledge the misdirection involved even in the “chemical imbalance” concept itself, which he seems to acknowledge is promoted by mainstream psychiatrists. It it really better to say, “We don’t understand this complex disease of the brain” while still assuming it IS, de facto, a disease of the brain when there is no convincing evidence that any particular disease state is involved, and while there is HUGE piles of confirmatory evidence that trauma is a robust predictor of almost any “mental illness” you can name?
The issue is not the specifics of a “serotonin imbalance.” It is the continued insistence that somehow, with more research, we will eventually “prove” what mainstream psychiatrists really want to believe – that depression is ultimately a primarily biological “disease” that requires drug “treatment.” This premise, in my view, has long since been proven false. The “complexity” of depression as a “brain disease” is observed largely because the researchers are not bothering to take in the myriad social and psychological and even non-brain-related physiological factors that are almost always involved.
— Steve
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“Wilfully?” Do you really mean that word? As if the users were somehow intentionally violating some social agreement or contract by seeking these services?
Clearly, you have not watched the myriad ads nor ready the many news articles letting everyone know that “depression is a disease just like diabetes” and implying that treatment is for everyone. The message that “no one has to suffer” is clearly out there for one and all to see, and we are supposed to trust doctors to know whether we need the given prescription or not. It is the DOCTORS’ lack of ethics that lead a person to be misdiagnosed and forcibly “treated” with something that is either of no use or destructive. For instance, should the doctor not have said that Benzos are addictive and that using them more than a week leads to severe withdrawal reactions? Or is it “caveat emptor,” where the poor patient is forced to look up every drug personally or suffer the consequences? Of course, I know that “caveat emptor” is totally the current reality, but do you really blame the victim for being duped by the guys who are supposed to be telling her the straight scoop?
The main reason the “worried well” are getting so much “treatment” is because psychiatry and the pharmaceutical industry have sold us on the idea that we all need drugs any time we feel badly. We are supposed to trust doctors to tell US if there is “something wrong with us.” We shouldn’t have to avoid checking in with our physician for the fear they’ll prescribe us something addictive or deadly in the name of “treatment” without even bothering to tell us what the dangers are.
— Steve
P.S. I have reported this poster. While we’ve been cautioned to avoid using the “T” word, I think it applies in this case absolutely.
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If “insight” means “agreement with the professionals,” then “insight” means accepting that your brain is broken, that you won’t ever be able to do anything about it, and that you should adjust your expectations in life to being partially to totally disabled and to be dependent on drugs to manage your emotional states for the rest of your life.
With that kind of “insight,” it is small wonder that people feel more depressed and hopeless! Other than a diagnosis of a terminal disease, it’s hard to imagine a more disheartening message than what most people are told about the nature of their “mental illness.”
—- Steve
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I clearly am not assuming that if you read my full post. My issue is that the psychiatric orthodoxy assumes the contrary. MOST of the time it is psychological, and if psychiatry claims to be scientific in its approach, it must begin by recognizing that absolute fact. If there are physiological issues contributing (such as poor folate assimilation or processing), those issues should be addressed (in this case, most likely through nutritional counseling). Many physiological things like loss of sleep, sleep apnea, low iron, thyroid imbalances, chronic pain, side effects of other drugs, etc., can contribute to depression and should be addressed. The problem is lumping ALL cases of depression together and assuming ALL of them are physiological in nature and treating ALL of them with antidepressants, regardless of the context and without any reference to any valid test of what may, in fact, BE wrong physiologically. For instance, I’ve never yet seen a psychiatric evaluation that tested for anemia or low thyroid, and they often don’t even ask about sleep patterns. I’ve almost never seen a recommendation of dietary changes or working on sleep issues as a primary intervention in a case of a depressed patients. CBT and drugs are the only things offered, and often only drugs. It is, in my view, a very distorted and unhelpful paradigm of care, as it tends to do the exact opposite of what is generally experienced as helpful by the people I’ve worked with. I don’t deny the importance of taking the physiological issues into account, but psychiatrists don’t do this, either. They basically assign a diagnosis and prescribe in 90% or more of the cases I have encountered.
And the diagnosis itself is a problem, first, because it invalidates instead of normalizing the client’s reactions to stress, and second, because it generally stops any efforts to discover a valid physiological cause, since they already “have depression” and are “under the care of a psychiatrist,” so why should we look any further for a cause?
— Steve
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There is no such evidence. The high dopamine theory was discredited in the 1980s, along with the serotonin hypothesis for depression. We’re dealing with mythology at this point, not science.
— Steve
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So if a person is known to have that particular polymorphism, then THAT is the problem and THAT is what should be treated. But we’re talking about a tiny, tiny percentage of all pe0ple who have issues with depression. The vast majority of depressed people I’ve talked to (and I’m a mental health professional who has worked a suicide hotline and done involuntary detention evals, so I’ve talked to A LOT) have very good reasons to be depressed. Most appear to be helped by hearing their story and acknowledging the absolute NORMALCY of their depressed reaction to difficult circumstances. This sets the stage for an empowering discussion of what THEY can do about the situation, rather than placing the blame on their brains and the control in the hands of their doctor, in effect totally reinforcing the idea that there really IS nothing that they can do about their situation, which is why they’re depressed in the first place!
A case in point: a young woman called me up on the crisis line, telling me she’s depressed about losing her boyfriend. She has talked to her mom and a coworker and both insist that she’s lucky to be rid of him and will soon find someone else, but she still felt depressed. I asked her how long they’d been together – 4 years. I asked how long ago they’d broken up – 4 months. My reply, “Not only do I think it’s totally normal for you to feel depressed at this point, if you weren’t a little depressed, I’d think there was something the matter with you.” She says, “Really?” I say, “Yes.” She says, “WOW! Thanks!” and hangs up the phone!
Validation and normalization work better than labeling and drugs. Not that some people don’t find the drugs helpful, and I don’t wish to ban them, but in the long run, finding someone to understand you and help you make plans is almost always the real solution. There may be the odd exception where a genetic condition really does exist, but these have been proven over time to explain only a tiny percentage of cases. Such cases should be detected and dealt with accordingly, but assuming that ALL cases of depression (or even most) are biological in origin ignores both the evidence and basic common sense.
—- Steve
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That is the logical fallacy we’re dealing with. We are told that “all behavior arises in the brain” as if there were no agent OPERATING the brain. We decide to be angry and then we get the surge of adrenaline. True, we could probably eliminate anger by excising everyone’s adrenal glands, but is anger really the problem?
ALL of our emotional states are survival mechanisms and are a result of our working to survive as an organism. Randomly selecting certain biological states as “disordered” is bad enough, but the current paradigm takes away the entire concept of personal agency and acts as if we are mere leaves in the wind of biological determinism and that our emotional states have no meaning or utility. I guess everyone is supposed to be mildly interested at all times and everything else needs to be medicated out of existence!
—- Steve
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I agree. People get upset about messing with their mythology, and that’s what this is really about – not science, but a mythological worldview where nothing upsetting is anybody’s fault and where magical medicines can make everything all better without anyone having to take any responsibility for changing anything. Your very existence challenges that mythology, and that’s probably the biggest reason your funds are first to go on the chopping block.
I guess my thinking is that when they ask you about effectiveness, you raise the question, “Are you talking about quick symptom reduction, or long-term outcomes? Because where we make a difference is in the long-term.” I guess there is no politically correct way to do it, though. Maybe passing a copy or two of Anatomy around the statehouse is a prerequisite. But I think facility visits and stories from people who use your services are probably the best argument you have.
— Steve
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There is increasing evidence that SSRI use during pregnancy increases the risk of autism. Autism rates have skyrocketed in the years since SSRIs were introduced. I’m sure it’s not the only reason, but I have to believe it’s a contributing factor.
— Steve
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It seems that psychiatry’s love affair with eugenics (including their complicity in forwarding the goals of Hitler’s Germany in the 1930s) is left out of this analysis. Does he talk about that in the book at all?
—- Steve
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Ah, Hemmingway – sounds like another psychiatric success story! I suppose once he killed himself, his symptoms abated completely – a total cure.
It is disheartening to know that people are still so mesmerized by doctors’ aura of scientific exceptionalism.
— Steve
P.S. It is important to note that many of the deaths due to medical care are NOT due to accidents or malpractice – they are due to side effects of properly prescribed and properly administered medications. Remember Viiox…
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The good retort to this is to ask, “What is the evidence that the standard approach leads to better outcomes or saves money?” The trick that the mainstream employs is to focus on “symptom reduction” rather than long-term outcomes. There is basically NO evidence that psych drugs improve outcomes (and increasing evidence that it makes them worse) and plenty that peer support does improve those outcomes. Maybe give out some copies of Anatomy for them to read.
Perhaps in addition to defending your own program’s value, it’s time to discredit “business as usual” as one of the biggest wastes of money in the State budget!
— Steve
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When you say “mental illness could very well be genetic,” are you aware that you are talking about a huge range of issues, varying from difficulty paying attention in class to hearing voices to having flashbacks of historical trauma? How can you or anyone say “mental illness could very well be genetic” when there is such a range of things that “mental illness” is now purported to cover?
One simple example: how and why is “ADHD” a mental illness? Even if there is some genetic variation in activity level and intensity, which there no doubt is, who gets to decide that kids all need to sit down at desks in a herd and do as they’re told for 6 hours a day, and that kids who can’t do that are “ill?”
Or at the other end: how can PTSD be genetic, when it is clearly a reaction to a severe environmental stressor? Are you saying there is a “right” way to react to being sexually abused or seeing your mom murdered by your dad, and those who don’t respond “correctly” are mentally ill?
It is a completely untenable proposition that “mental illness” is genetic, if only because the definitions of “mental illness” are so heterogeneous that the idea they’d all have the same or similar causes is delusional in the extreme. I really don’t understand why all this focus on genetics anyway, when that’s the one part of the equation you can’t even change? Why don’t we focus instead on changing school environments to be more responsive to kids’ needs, or stopping child abuse and domestic violence, or reducing poverty, or assuring good prenatal nutrition, or providing quality healing environments for people who have been overwhelmed by stress? Why are we always blaming the genes? Because, Logan, blaming the genes is effectively blaming the client, and lets society completely off the hook. I don’t think that is a very accurate or helpful view to take if we really want to help people avoid and/or heal from extreme mental distress.
— Steve
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Wow, that was hard to read! Your daughter is very fortunate to have you – she could very well be dead if you had not stood up for her. It is terrifying what these maniacs can get away with!!!!
—- Steve
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Good point. Lobotomies “worked” in a similar way. The person was never upset or agitated again. Of course, they could hardly find their way to the kitchen and drooled a lot, but the “symptoms” went away. With that reasoning, murder makes a very effective treatment for any mental disorder – the symptoms are permanently erased, along with the life force.
You might be interested in reading some of John Nash (“A Beautiful Mind”) writing about how he avoided getting imprisoned and ultimately recovered. The movie makes it seem that he’s rescued by a prescription of atypical antipsychotics, but in reality, he says he recognized even in his delusional state that he’d better not tell these people what he was seeing, hearing, or thinking or they’d lock him up. So he decided to just keep a low profile and lie to anyone about his “symptoms” if asked. Then one day, years later, he sort of came out of it and said, “Wow, I’ve been thinking some really weird things.” And he recovered from there. He is clear that he only felt he recovered because he avoided psychiatrists and hospitals like the plague, and he lied like a rug when needed to stay out of their custody.
—- Steve
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It also ignores the problem of the social context for what is considered “abnormal behavior.” Psychiatry would make a great leap forward if it could start acknowledging that much of the suffering of the depressed and anxious folks out there is a result of living in a very depressing and anxiety-laden environment. The impulse to take every uncomfortable behavior and emotion and designate it as a “disorder” avoids dealing with the huge impact of the social context that both helps produce these behaviors and also judges them as being “abnormal” in the first place.
—- Steve
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As I like to point out, people who experience a near-death experience, say by being hit by a car, often experience elation at having escaped death, and in some cases even make major changes to their lives to incorporate their new awareness of their mortality. But we don’t push people in front of cars as “therapy.” How any sane person can consider inducing a grand mal seizure through electrocution a form of therapy is baffling to me. It makes just as much sense as improving their mental health by hitting them repeatedly in the head with a hammer until they pass out.
My other theory is that the reason electroshock is found to “work” is that a significant percentage of people understand that they won’t be allowed to escape until they say they feel better. “Oh, yes, THANK YOU, doctor, I feel SO MUCH BETTER NOW! Can you please unlock the door and I promise I’ll never be depressed again as long as I live! (Or at least I’ll never tell YOU about it!)
Barbaric!
—- Steve
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My thoughts exactly!
— Steve
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I agree 100%, as long as they are willing to have a real dialog. Our big volume of posting is going to push us up on the search engines, and non-affiliated people are going to wander in. It’s not surprising that they get upset when their view of the world is challenged – it is called “cognitive dissonance” and is the precursor to deep learning. Some will not be able to make the shift, but I think we’re a formidable group with a lot of facts at our disposal, and we should not be upset or in any way intimidated when folks come by quoting the “common wisdom.” We can continue to challenge them to produce their references and to let them know the data we’re working from. Most will probably bounce off, but a few will find cause to question the status quo, and that’s one of the things we’re really here to do, I think.
“Love thy enemy!”
— Steve
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I am so sorry to hear of your difficult circumstances! Like I said, it’s not as simple as “pull yourself up by your bootstraps.” People who have been through the wars like you do experience chronic depression and anxiety, and I’ve never been inclined to criticize anyone in your situation for doing whatever you think works.
That being said, I am a counselor by trade and have spent a lot of time working with trauma victims, especially childhood abuse victims and domestic abuse victims. I don’t believe that there is nothing that can be done, and my biggest objection to the psychiatric paradigm is not the drugs, but the basic message that you have to accept that you’re disabled for life because your brain is broken! It appears to me you’re doing a courageous job fighting that message, but I still think it is inherent in the label-and-drug approach that ignores the impact of trauma on a person’s life.
Of course, I don’t know you and can’t presume to suggest what might or might not work. You have your own path to walk, and I admire your courage for pushing forward despite the challenges. My only thought is that you may find more help in actually getting to a better place in the long haul by hooking up with other survivors of abuse and with therapists who really understand this kind of trauma and what it does to you. Most therapists I encounter nowadays are quite shallow in their conception of what therapy should look like – they tend to be very present-focused and skill-based but don’t really take a look at the impact of historical trauma. And psychiatrists are generally far worse – their only nod to trauma is “your brain got wrecked by all those bad things that happened and that’s why you need to stay on your meds.”
I wish I had something more than my compassion to offer, but I do feel for you and hope you’re able to find a better path forward. You shouldn’t have to suffer because someone else was an asshole in your past. I wish I could take your suffering and send it to the perpetrators, who are the ones who really deserve to feel that pain.
Take care and thanks again for sharing your story!
—- Steve
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Wow, you make me seen conservative by comparison! I certainly have former clients that became friends and have attended some ceremonies, and one actually did live with us for a while and left a lot of storage at our house for years. Her abusive partner also came to the house to visit us once, which was really fun! And I certainly made mistakes, though I would have to say that anything we learn from that does no lasting harm is a learning opportunity that we’d miss if we didn’t take the risk of making “mistakes.” I found clients to be quite forgiving when I was humble enough to admit my not knowing what to do, in fact, it sometimes was quite empowering for me to say, “Wow, that sucks! I understand why you feel so awful, but I’m not sure I have any great ideas about what to do.” Often, they’d reply, “Well, it’s not THAT bad” and start telling me some things they could try.
It’s all about being human, and being human is messy. Boundaries are all fine and good when they benefit the client by keeping them from having to deal with your crap, but they are often an excuse for keeping one’s distance from the client and avoiding being vulnerable. I found that a degree of self-disclosure and vulnerability was the key to people trusting me to really be on their side.
Thanks for your kind words and for your fascinating answer! You really do go the extra mile!
—- Steve
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Depending on the label, this is absolutely the case. For that reason, I avoided using “bipolar disorder,” any “psychotic disorder,” or “borderline personality disorder,” because those are the ones that are most likely to have long-term consequences. Have to be a little careful about “Major Depressive Disorder,” too. I tended to favor giving “Adjustment Disorder,” because by definition, it was temporary and therapy was the only intervention, or sometimes PTSD, of course with a strong recommendation of trauma-based individual therapy or groups rather than any psychiatric intervention. It was, however, quite an inadequate approach and I could not sometimes avoid those diagnoses, especially when people were unsafe and I could not let them leave the hospital and still keep my job. It was a pretty awful experience, though I have to say those that encountered me were very fortunate, because I’d do anything I could think of to prevent them from an involuntary hospitalization, including some pretty impressive ER therapy sessions! But it finally convinced me that by even participating in the system, I was colluding with the forces of evil. If I ever do therapy in the future, I’ll have to do it without insurance reimbursement, because I’d have to do what I thought was right even if the insurance company disagreed.
Hence, advocacy.
—- Steve
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I agree, I think packaging and therapy are unable to coexist. Real therapy helps the client rethink power dynamics in his/her life, and requires incredible sensitivity and flexibility. Manualizing or branding therapy approaches takes us away from that flexibility and puts us back on the path of correcting the client and making him/her follow our steps instead of his/her own. Instead, therapy needs to focus on assisting the client in reclaiming the right to define both his/her own experience and his/her own power, and to determine what “success” means for him/her and what pathway leads in that direction. I don’t really see any way to create “evidence based” therapy that is replicable in the scientific sense, because the same action may help one person but make another one worse.
Quality therapy requires precisely a stepping down from that place of power and privilege the therapist is granted by society and usually by the client as well, and I think one of the main reason the OD approach has been successful is that it requires exactly that. The therapists talk right in front of the client about their inability to understand the situation given the current information, and speculate about possible explanations, and check back in with the client and his/her support system about their ideas and perceptions. This is about as far from standard psychotherapy and especially psychiatry as one could get.
I agree, Eugene, that the bottom line is the assumption that the client is not only capable but is currently making the best choices s/he is able to make, and the only measure of those choices is how they are working for the client. The less we evaluate the meaning of things for people and the more we help people learn to make and value their own meanings, the healthier people appear to become. But most professionals would find this thinking anathema, and it certainly doesn’t lend itself to double blind studies.
Those in power are seldom willing to give it up without a fight. That’s what’s really “wrong” with most “mentally ill” people – they are subject to a power structure they don’t feel capable of managing. Those in the power structure are usually more interested in oppressing than empowering such people, as they pose a danger to the status quo. Manualizing, branding, and packaging therapy techniques takes the power out of the hands of the clients and gives it right back to those who feel qualified to decide for the client what is “Acceptable therapy.” Which generally means any therapy that makes the client less of a problem for the authorities to deal with.
—- Steve
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I agree with this wholeheartedly. I am an activist for abused kids in foster care and for domestic abuse victims as well. The intersection of all of these things is the abuse of power that is justified in our society for those entitled to wield it. We need to be part of these other movements and help them become part of ours.
—- Steve
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Of course, the antipsychotic drugs that “schizophrenia” sufferers are prescribed make it hard to move around freely and increase weight and decrease cardiovascular health, all of which make exercising much more difficult. I’d love to see exercise incorporated as an option for folks in a Soteria-like setting. I know the Quakers in the old days did a lot of long walks which seemed to be very healing.
As usual, the standard of care makes actions leading toward genuine healing more difficult rather than easier to do.
—- Steve
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So in essence, what we’ve proven is that some people feel somewhat better taking Zoloft than they do when taking a sugar pill. It is also true that some people feel somewhat better when drinking alcohol or smoking marijuana or even taking heroin than similar people taking a sugar pill. Using drugs to modify consciousness is not a new idea, and “symptom reduction” in a short term study proves nothing about the causes or ultimate outcomes for people who are depressed for whatever reason. Common sense suggests that people are depressed for a wide range of reasons, some of which are interpersonal, some social, some financial, ans some physiological. Lumping them all together and giving someone a drug to make them feel better is a stupid plan in the first place.
Reality is that depression (and anxiety and anger, etc.) is an evolutionary survival mechanism that comes into play when the body feels it is necessary. It is not a disease, not ever. There are diseases that might CAUSE a person to feel depressed, and we should screen for those, but to think that ALL depressed people are depressed for the same reason and need the same kind of help is scientific reductionism of the worst sort. (And it’s even contravened by the introduction of the DSM itself!).
Pharmaceutical companies and organized psychiatry have chosen to focus all research on symptom reduction rather than longer term outcomes, mostly because that’s what drugs do and they will almost always be superior if you use that measurement. However, when we look at long-term outcomes like employment, education, intimate relationships, and community involvement, it’s clear that the label-and-drug model is not successful. If Nigeria and Brazil are beating the crap out of the US and the UK in terms of schizophrenia outcomes, it’s time we ate a slice of humble pie and started questioning our own paradigms.
Symptom reduction by drugs can be perceived as helpful, but so can going to the bar after work. The real deal is improving lives long-term, and I defy you to find a Zoloft study that shows it improves that kind of outcome.
You really should read “Anatomy of an Epidemic”. If you really believe in science, it will blow your mind.
— Steve
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Kay, that is simply a restatement of the rhetoric we’ve all been exposed to. There is no solid evidence to support this viewpoint. If you look at the DSM criteria for “Major Depressive Episode” or “Major Depressive Disorder,” there is no distinction between “clinical depression” and any other kind of depression.
As to depressive symptoms returning when someone goes off an antidepressant, you really need to read Anatomy of an Epidemic. There is a well-understood physiological mechanism from research into addiction that explains why “symptoms” that a psychoactive drug suppresses will return with a vengeance when they are discontinued, called neurological up- and down-regulation.
I do agree that stress is the culprit, but there are many, many things an individual can do to reduce his/her unresolved stress and feel more in control of his/her life. I used to work at a crisis line and talked to hundreds of depressed and suicidal people. The number that I could not help through communication to get to a better place I could count on one hand. Genuine human communication, whether through therapy or some other means, that is focused on helping a person regain a sense of personal agency and control in his/her life is healing and leads to a more permanent solution. Labeling and medication, on the other hand, seems in my observation to lead many people in the opposite direction – feeling that the depression is inherent in them, rather than related to how they are living their lives and what has happened to them, and feeling that there is nothing they can do about it (after all, it’s all in my brain) except wait around for the drugs to make them feel better. I recall speaking to one woman who had been trying different antidepressants for over a year without result and was positively frantic about her prospects for a productive future. I asked her if anyone had told her there might be other things she could do besides medication. She was silent for a moment and then said, “No,” in a much calmer voice. She was stunned at all the alternatives I was able to suggest.
“Clinical depression” is a cultural construct. It has no real definition and no actual scientific basis in reality. While many people report finding their antidepressants helpful, this does not mean that there was something wrong with their brains. It just means that the drugs make them feel better. More power to them, but using drugs to make us feel better is an action as old as humanity and does not qualify as medical care. I believe folks deserve more and better than a label and a prescription, and for the most part, they are not receiving it.
Stress is a real issue that can be addressed and changed. This is the key to recovery from depression or any other condition – resuming responsibility and control for a larger and larger portion of our lives. This is not to blame the victim – our society places a lot of barriers in the way of feeling in control of our way of living. But it is those barriers that constitute the real problem, not the individual’s brain, IMHO. And my opinion is backed by years of clinical success stories. Depression can almost always be reduced by effective and loving communication.
— Steve
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Shineone, I am afraid the evidence that SSRIs prevent suicide in the aggregate is completely lacking. It appears that they actually increase the overall risk of suicide, especially in adolescents and young adults, but really for all users, according to the scientific data.
And admitting that SSRIs do cause aggressive and manic reactions in some people is not blaming the drug – it is very simply informing people honestly about what can and does happen to some people. It is admittedly a minority of people who experience this reaction, but it is hardly rare. It is, after all, on the label of the drug. So what’s the big deal about letting people know this can happen so that clinicians and patients and family members can watch for it and take the patient off as soon as any such side effects are evident?
—- Steve
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Wow, I had no idea you had been so close to “the belly of the beast!” Your story completely comports with my experience helping foster youth recover from the devastations of an impossibly difficult and inadequate upbringing by abusive and neglectful parents followed by an often abusive and neglectful foster care system. All issues that come up are blamed on the child, including any adverse reaction to psychiatric treatment. Kids often are started on stimulants for “ADHD” and have aggressive reactions, which are then regarded as signs of “bipolar disorder” and medicated with antipsychotics, while still being prescribed stimulants. Biochemically, this makes not the least sense, as stimulants increase dopamine availability while antipsychotics decrease dopamine availability – raising dopamine with one hand while lowering it with the other! Not surprisingly, this often leads to further behavioral or emotional symptoms, similarly blamed on the patient and similarly treated with yet more drugs. Sometimes we end up with kids on 4, 5, 6 or more psychiatric drugs who are still breaking windows, throwing furniture, and assaulting people. At no time during this process do the mental health professionals ever seem to say, “Gosh, our treatment plan seems to be making this kid worse! Maybe we’re barking up the wrong tree!” No, it’s always a new diagnosis and usually a new drug to boot. It is up to our advocates or the kid’s attorney or parents or social worker or foster parent to put their foot down and demand a different approach.
SSRIs clearly have their advocates, but to suggest that they are effective for the vast majority with minimal side effects is just not true. Kirsch’s work has shown marginal effectiveness for mild to moderate depression, most likely due to an active placebo effect. And the stories of withdrawal difficulties are legion. Shineon is entitled to her opinion about her own treatment, but it seems unfortunate to invalidate the experiences of so many who come here for a little dose of sanity.
—- Steve
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One real challenge we face is our society’s deification of doctors as the ultimate arbiters of scientific truth. Even very reasonable and rational people still have this bias, and letting people know that doctors not only don’t always get it right, but are downright corrupt, is something that many folks are unable to tolerate emotionally. It undermines some folks’ basic beliefs in “progress” and the basic goodness of our modern social system. Many of our posters and bloggers (Laura Delano is a great example) describe being completely mesmerized and taken in by the idea that Modern Medical Science had an answer for their woes.
I’m interested in how folks think this can be approached. It is a big part of our conundrum, because attacking Psychiatry means attacking Medicine, which means attacking The Holy Order of Scientific and Technological Progress, which means attacking the core values of Western Civilization! If Scientists don’t have all the answers, where does that leave us? I think this unspoken question pushes many who might join us to the sidelines of this fight, even when they are sympathetic with our cause.
—- Steve
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Hi, Bob!
This is a great overview of the complex political machinations that drive decision making in healthcare. It is notable that patient outcomes are a very low priority, with saving money and “public safety” (as perceived by those in power, of course) at the top of the priority list. While the kind of changes you suggest can happen, there is and will continue to be no political will to do so until and unless the masses rise up and demand these changes. At the moment, the foxes are guarding the henhouse and enjoying their delectable easy meals and aren’t going to give up their dominance without a very big fight. And politicians don’t engage in that kind of fight unless their election to office depends on it.
So let’s get the grassroots going and make some noise! We know that these changes can happen, but we have to show that the danger of going against the pharmaceutical lobby pales in comparison to the danger of going against the citizens of the nation.
— Steve
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More proof (if more were actually needed) that Big Pharma, in collusion with our sold-out government regulators, will always put profits before health and safety.
—- Steve
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Most likely one more reason why those labeled “seriously mentally ill” are dying 25 years before their peers.
Most psychiatrists seem to practice without application of their knowledge of general medicine. And it sounds like their leaders support them in doing so, even when it’s killing off their clients.
—- Steve
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I agree with Ted – it starts with working to be the way we need others to be when we’re with each other. Love is not owned by a profession!
Sarah, I’d be very interested in hearing which rules you felt you were breaking, other than the obvious (I sense you give out a lot of hugs!) I have been a renegade therapist myself and pretty much ignored most of the rules and was guided by my conscience and my heart, but I had the good fortune of being a mental health professional without ever having been trained to be one (undergrad in Chemistry, grad in Education). So it might be fun to look back and see which rules I was breaking!
I am sure you were and are one of the most helpful people for the clients to meet, regardless of what the so-called professionals felt about it. I agree 100% – what helps people heal is first off getting real with them and stepping out of any power advantage and helping them connect with the idea that their suffering is OK and human and that you accept it and them as they are. There are lots of different tricks and techniques and approaches but none of them are worth crap without the human connection, and once you have that connection, the person seeking help is almost always able to generate a raft of his/her own “tricks” that you might never have thought of.
Thanks for an inspiring article. Glad it’s not just me!
—- Steve
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For anyone who is a real scientist, the failure to publish “negative” results is an obviously unacceptable situation. Anyone can cherry-pick positive studies and make a drug appear effective. But that’s what the FDA actually encourages – all you need are two positive studies to get a drug approved, even if there are 45 negative studies saying it doesn’t work! It should be obvious that this approach asks for bias and corruption. And the larger suppression of even publicizing the negative studies makes it impossible for anyone to really know and understand whether something is effective or not.
Which brings us all back to not being able to trust medical science. Caveat Emptor!
—- Steve
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I understand what you’re saying, but I don’t think that anyone is saying “don’t stress and worry about life situations” here. I hear that a lot, as if there are only two options, either ignoring the impact of stress, or somehow minimizing the person’s suffering by implying they should “get over it.” Those are not the only options.
I doubt there is a person here who doesn’t understand how debilitating and exhausting and hopeless it can feel to be in a deep depression, and I doubt equally that anyone believes you should just “pull yourself up by your bootstraps.” I think the author’s intent is to say that understanding and acknowledging the role that current and historical stress and trauma has on our current mood leads to a much better understanding of how to help. The author is certainly not judging a person for being depressed about really depressing things happening to him/her!
As for the diabetes analogy, I am afraid that one has been thoroughly discredited. Diabetes is something you can objectively test for and observe – the body is not making sufficient insulin. It is also something you can objectively treat and observe if the treatment works – if the medication is effective, blood sugar levels will stabilize. It it isn’t, they won’t. Whereas there is no way to measure if someone’s brain chemicals are “imbalanced” (not to mention the fact that no particular “imbalance” is consistently associated with depression – the low serotonin theory was discredited back in the 1980s). As a result, there is also no way to figure out if the chemicals are now “correctly balanced,” since we don’t know what a “correct balance” really is. In truth, the chemistry of the brain is constantly changing, depending on the environment and the needs of the moment, so the idea that there is a “correct balance” may be completely wrong.
To summarize, the author is not trying to say that depression isn’t real, that people don’t suffer, or that they should just “buck up” and get over it. He is saying that the depression is almost always a normal response to abnormal conditions, and that we’d do a lot better to focus on alleviating the stressful conditions rather than essentially “blaming the victim” by pathologizing the person who happens to feel depressed. As an example, I work with foster kids who have been abused and/or by their parents and removed forcibly from their homes. They don’t know where they are going to grow up, they have conflicting feelings of loyalty and anger at their parents, and they are totally confused about why all of this is happening to them. It seems very understandable that they’d be depressed about all this, especially when they have had to endure multiple foster placements and separation from siblings while in care. Why would we assume that they are depressed due to a brain malfunction? Wouldn’t it make more sense to try and help them make sense of what’s happened and help them achieve a greater sense of certainty and control of their future lives?
There is a lot of propaganda out there about “depression,” but John Read is cutting through it with this piece. People are almost always depressed because they’ve had depressing things happen to them. That doesn’t mean they aren’t suffering or that they should get over it. It means that we should compassionately listen to their stories and try to help them find a way to put some meaning and perspective onto their suffering. Counseling is one way to do that, but there are many others. While medication may help some people deal with the pain they’re experiencing in the moment, they will never help anyone to process and digest either the problems in their current life or their historical trauma. The analogy is not insulin for diabetes. It’s more like opiates for a broken arm. They’ll take the pain away temporarily, but you’d be foolish not so look for the actual cause of the ongoing pain and try to fix it more permanently.
—- Steve
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You did what “treatment” should d0 – you provided hope, confidence, and a pathway forward. You also provided unfiltered information regarding the truth. I’m totally impressed and ready to nominate you for sainthood! But while what you did is remarkable, I wish that it weren’t. None of these things are rocket science. They require courage, empathy, and the belief in the human spirit. You obviously possess all three in abundance.
Thanks for sharing both of your experiences. It is discouraging but not surprising that the psychiatric profession is not interested in “human interest stories,” though I suspect what they really weren’t interested in was your questioning of their basic paradigm and providing an alternative viewpoint on what does and doesn’t help a person suffering from “extreme states.”
—- Steve
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This is truly scary! It’s bad enough as it is – giving these folks license to lie is unconscionable!!!
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I only wish this were so absurd as to be unbelievable. I’m afraid the author cuts very close to the quick with this particular satire!
—- Steve
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I was forced to use it in one job (in order not to get fired, I mean – of course, I still had a choice). I simply told the clients that it was just a description of what they’d told me and had no real meaning except that I needed to put it down for our agency to be paid for providing service. I told them that I selected the label that I believed would lead the insurance company to pay for the kind of service I felt they would benefit from based on our discussion. I was always clear that their own description of the situation and the perceived causes and possible solutions was what really mattered, not the diagnostic code. I am not sure that covered me, but I felt like it did with the client at least. Perhaps I should have staged a larger protest, but it felt like spitting in the ocean at the time (1995), as there was no real organized DSM resistance movement back then that I was aware of. I definitely felt like an outlier, if not a pariah, but I also felt my reframing was doing some good subversive education and advocacy with the client base.
It is not by chance that I moved into advocacy after finishing that job.
— Steve
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I generally agree with all that is said in the article. It is kind of obvious that most people who take SSRIs never experience anything like this, and it is equally clear that the overwhelming majority of depressed people would never even consider such an act, regardless of whether or how they are being “treated” for their condition. So blaming either SSRIs or depression simplifies an obviously extremely complex situation.
However, I don’t think this absolves us of raising the possibility that SSRIs may have been a contributing factor. I believe the evidence supports that under the wrong circumstances, taking SSRI antidepressants can lead to a person doing things that they might otherwise not do. There is evidence that many people taking SSRIs experience a sense of disconnection, a “WTF” attitude toward others, which I believe may be a large part of why they seem to work for a lot of people. If you’re constantly worried about what others think of you and it consumes your day and you feel like no matter what you do, you’ll never gain approval in others’ eyes, this WTF effect could be quite a relief! To be able to say, “You know what, I really don’t CARE if my mom is upset with me, I’m not going to suffer through another dinner with her this week!” could be quite freeing and empowering.
The dark side is this: if a person is fantasizing about doing something dangerous or deadly, the “WTF” factor could take away the social inhibitions that are preventing him/her from taking this action. Obviously, the person would have to be in a place where they had such fantasies, and equally obviously, some people don’t have that kind of inhibition in the first place and don’t need any drugs or alcohol to get there. But if, say, Eric Harris was fantasizing about shooting up the school, but normally would have thought, “No, I can’t do that, there are too many innocent kids” or “I’m sure I’d get caught and spend time in jail – fun to think about, but I can’t really go through with it,” it is possible that the SSRI might make those social impediments seem less serious. Or encourage him to come up with a novel “solution” like killing himself after shooting the rest of the pe0ple, hence avoiding the jail problem.
Of course, that’s a lot of speculation, but my point is that this effect would not seem adverse for most people – only those who are holding themselves back from some kind of vengeful or rageful feelings would end up acting out as a result, and most highly anxious/depressed people would experience some sense of relief, or maybe feel no big effect, just like most people who get drunk feel more relaxed and socially uninhibited, while a percentage of those with underlying rage/violence issues are likely to act out violently when drunk.
So violence doesn’t have to be CAUSED by SSRIs – the point is, like alcohol, they can be a contributing factor, a catalyst, as it were. There is enough evidence that this should be thoroughly investigated, but it hasn’t been, and I see it as very proper, and not “stigmatizing” in any way, to demand that this rare but potentially deadly side effect be discussed and taken seriously by the medical community and the public at large.
—– Steve
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My rather tame and very professional comment was present for a couple of days, but now appears to have been removed from the Psychiatric Times by Dr. Pies or his moderator! I will have to re-submit it. My point was that resistance to labeling was not necessarily a function of how the information was presented, but had more to do with the values and priorities of the person being so labeled. Pretty radical stuff, eh? Not sure why that bugged them so much, but we’ll see what happens when I re-post it.
—- Steve
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First off, nobody does all those tests, or almost nobody. Second, the vast majority of psychiatrists don’t even screen for current or past stresses in my experience. I read an article very recently where they interviewed kids in a residential treatment home and discovered that some ridiculously high percent, 90% or more, had been traumatized in the past. This was not surprising to me or probably most people. The surprising part was that only 22% of these situations were actually noted by the staff!! How can you have a residence full of “mentally ill” children and not even bother to ask them what’s going on in their lives? Why does it take an outside researcher asking a set of questions to bring out this information?
That is what happens when people take the current system too seriously. They forget that the main reason most people are “mentally ill” is because shitty things have happened to them. DSM diagnoses let the professionals off the hook from having to ask these difficult but obvious questions.
—- Steve
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The fact that psychiatrists or their subordinates could in any way not notice or epathetically respond to the distress and fear their patients experience is the biggest indicator of what is wrong with the system. Professionals are trained and encouraged to act without empathy for their patients. If they were truly empathetic, they’d get the feedback on the spot and make the needed changes. I’ve worked with a huge range of people with all kinds of diagnoses, and can count on one hand the number who were unable to feel some kind of safe connection with me, enough that they felt calmer and more in control by the end of the conversation. This includes frankly psychotic people and some who were extremely aggressive and hostile to begin with. Sometimes the feedback is not verbalized, but the information is almost always right there in front of your eyes. The main reason professionals don’t get to hear this feedback is because they really are not listening. When you respond in a non-judgmental way to that feedback, the client feels more in control and feels like you care about them. In fact, the best way to give the client the impression you care about him/her is to actually care about him/her.
Any “treatment” that does not start and end with empathy and honest communication, including the humility to accept both verbal and non-verbal feedback from patients/clients, will be traumatizing. It’s kinda that simple.
— Steve
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Actually, if we’re actually being scientific, the lack of a test for it essentially does mean it doesn’t exist – the concept, not the condition. If your hypothesis for the explanation for depression doesn’t test out, your hypothesis is scientifically wrong. Science is predicated on the ability to predict a particular result and test for the presence/absence of that result. Anything less is “professional opinion.”
You say “it is an illness for some people, who have it chronic for the rest of their lives.” This is where the problem comes in scientifically. You are relying entirely on anecdotal evidence. There is no proof that depression needs to be chronic in general or for a specific person (even if they report that it is), mostly because there is no way to distinguish “clinical depression” from a normal reaction to adverse life events. For instance, a person may be chronically depressed because his/her mother abandoned him/her at a young age, or because s/he was bullied in school and never fit in, or because s/he is gay and has experienced and continues to experience ongoing discrimination and abuse, just to name a few examples. S/he may also be chronically depressed due to low iron, thyroid dysfunction, metabolic problems, sleep apnea, or chronic pain. And there may be things that can be done for any of those situations that will vary widely from person to person and condition to condition.
There is no effort whatsoever in the DSM to actually distinguish any cause for depression – if you fit the criteria, you’re in, regardless of why. Scientists should be working to distinguish between real situations that cause depressed feelings, and devising specific responses to those situations, some of which would be medical and some of which would not, rather than trying to “treat” the feelings as a disease and provide a one-size-fits-all solution that really doesn’t work very well for any of the above conditions.
Sure, some people are depressed chronically, and there are always some people who will view antidepressants as helpful to them. Scientifically, that is almost useless information. Lacking any systematic way to distinguish potential causes and the effect of possible treatment options on different circumstances, we are basically throwing painkillers at a broken leg. It may feel better, but the damned leg is still broken!
And just to address your example, cancer can be tested for biologically, and we can objectively observe whether or not a particular treatment works. It’s a completely non-analogous situation. A better analogy would be “chronic fatigue syndrome” – yes, it happens, but no one really knows why, and different things seem to help different people. Of course, CFS sufferers have often been routed to psychiatrists and told it’s “all in your head” and prescribed drugs for it. Which maybe some of them find helpful, but it’s not a scientific approach at all.
My last comment: a lot of people suffering job stress go down to the bar after work and heft a few brewskis to relax. It is a chronic condition (they feel this way every day), there are clear symptoms (tension, anxiety, depression), and the alcohol in the beer has a remarkable and direct positive effect on the symptoms. Does this mean that chronic disenchantment with work is a mental disorder, and that beer is an effective treatment for it?
Just because something makes you feel better doesn’t make it a medical treatment.
—- Steve
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Just to be clear, “Anxiolytics” includes benzos like Ativan, Klonapin, Valium, and Xanax. Taking these with opiates can absolutely kill a person – very similar to drinking and taking opiates. If a person drinks and takes both of these – well, I’d be pretty scared for them. That this is even allowed shows how low our medical professionals have sunk in terms of taking any kind of responsibility for their own patients’ safety.
—- Steve
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Thanks for your kind comments, Travailler-vous! I do agree with Duane that good therapy is not and never really will be science. It’s about being human together with another human. What works is what works for you, and it might not work for someone else. My biggest beef with the psych industry (and I have many) is the denial of the right of the recipient of the “help” to decide what is and is not helpful for them. A good therapist (admittedly not the norm or average) is one who can adapt what s/he is doing to help the client from the client’s own viewpoint, and will be creative in finding an approach that will get that job done. The idea that some “manualized” approach will work for everyone with a particular set of “symptoms” is nonsense.
CBT is just a way of thinking about making changes. As Duane says, one of many. Everyone’s path is different. All a good therapist can do is help the person find their path, and encourage them to walk it.
— Steve
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It is also easy to “blame the disease” when the drug was what pushed the person over the edge. It’s not the fact that he was suicidal that makes me suspect antidepressants, it’s the bizarreness of the way he went about it. Depressed people in general aren’t into hurting bunches of other people – they just want to end their own lives. This was a very dramatic and destructive way to go out, and it is consistent with other stories of people who were adversely affected by antidepressants.
Most suicidally depressed people don’t commit mass murder.
—- Steve
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I am SO on it! This is both a particularly egregious issue, and one that people are particularly willing and able to relate to. Whether you have personal lived experience, know a child who has experienced this, or have a professional relationship to foster kids, you should really put your energy into helping this campaign. It may become a model for foster care systems across the country!
—- Steve
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Just to clarify: not saying that some people don’t find these helpful. The scam is the idea you can diagnose someone with a “mental disorder” based on a checklist of inconvenient behaviors or emotions. And believe me, lots of psychiatrists prescribe promiscuously for people who don’t qualify for any diagnosis – I work with foster kids and I see it all the time. You’re right about the ignoring of trauma – it is systematic and very troubling.
These drugs have their (in my view very limited) applications, but they should be a last resort, and we should not lie to people about what we’re doing – we’re medicating away symptoms, not treating a disease. And the millions of people now taking them for normal reactions to difficult life conditions or even just unreasonable expectations (see the “ADHD” epidemic for an example), well, it’s a travesty.
— Steve
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Yeah, but it does show that they don’t really even follow their own sketchy and subjective invented standards. Which really does reinforce that the whole damn thing is a scam.
—- Steve
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I totally called this one as soon as I heard the details. This has all the earmarks of an SSRI suicide/murder case – distressed and isolated individual takes new or increased prescription, inhibitions and empathy are reduced or eliminated and he acts out a bizarre fantasy that he would normally never have actually acted on because he’d have felt restrained by not wanting to hurt so many innocent people. I am so glad to have someone actually cover the real story!
—- Steve
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Bummer about the school situation! I totally understand why lacking alternatives you do whatever you need to do to get your son through to the other side. You’re obviously a caring and well-educated mom. I’m sorry to hear that charter schools in your locale have not provided the promised range of options. Do you mind sharing where you are? I kind of like to track on the Charter School movement, even though we’re out of the school-seeking business now that all our kids are grown up.
Your last comment is also interesting. There was a good study on employer satisfaction with “ADHD” employees that found that employers are just as satisfied with them as anybody else. The author’s hypothesis is that this was due to the fact that the adults could choose a profession and work environment that works for them. It is a crying shame that school students don’t have the same options. Wish I could ship you the money to pay for him to go to the private school – it sounds like the perfect kind of setting.
Life is most definitely not fair, especially to kids!
—- Steve
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I know that this solution requires a lot of work and time and that currently kids don’t have time to wait. We were fortunate to be able to homeschool our oldest for 4 years after two years in an alternative magnet school within our regular Portland Public School system. For our youngest, we actually helped create a public charter school that did what we needed it to do for him, and he attended that school from Kindergarten through high school. He’s now a freshman at Evergreen State College after graduating with a 4.0 from the Trillium Charter School. The great thing about Trillium was that it was all individualized – there was no “keeping up” to be done. Kids who could do third grade math did third grade math, whether they were in first grade or fifth grade, and there was no shaming or weirdness about it – everyone accepts that everyone has their own program. It almost completely eliminates those artificial comparisons that are caused by the bizarre expectations that all kids learn all things at the same time and rate.
I feel badly for others who aren’t as fortunate as we have been, but I also want to stress that charter schools are a realistic option in many states now, and I encourage disgruntled and disempowered parents to band together and create this kind of alternative, as that’s what the Charter School movement is supposed to be about. Additionally, many people are worried about homeschooling, but it was really not as hard as we had originally feared, as there are many groups and even community school classes that cater to home schoolers these days.
My point is not to criticize parents for making the best decisions they can in a dysfunctional school system. What I think we need to do is pressure schools to create these alternative options that the research says works for our kids, and if they’re not willing, to go ahead and create them ourselves. The schools will not change unless we make them, but in the end, we are the taxpayers and they work for us.
Hang in there and I hope things work out well for you and your unique and special son!
— Steve
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I signed up for their newsletter, and I encourage anyone here who cares about this issue to do the same. I’m also offering my professional assistance, though I don’t know what exactly that will mean.
This is such an important issue, and as Ted always points out, it’s places like this where the psychiatric storyline most easily comes unraveled. Almost anyone can understand how and why a kid in foster care comes to have behavioral or emotional problems, and the idea of drugging them at 4-5 times the national average is almost instantly offensive to most lay people. It’s a great political platform if we can all get behind it.
—- Steve
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Hey, Duane,
Real science is about the outcome, not the theory. A hypothesis is only as good as it is useful in predicting outcomes. We can spend all the time in the world arguing about whether “ADHD” or any of these dumbass labels is a “disease” or not, but the bottom line is, their theory has zero predictive value in altering outcomes.
Even if you don’t know the mechanism, it’s hard to argue with a 5000-year-old practice that allows complete anesthesia in a waking human. That’s what I call a result! The fact that modern researchers can’t or don’t want to find an explanation is their problem. The results speak for themselves. As to the results of psychiatric “science,” but their message is quite a bit different…
— Steve
—- Steve
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We did it with ours. Let me know if you’d like some suggestions.
—- Steve
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LOL! I agree 100% – teachers need “treatment” to assure they are willing to tolerate normal childhood behavior!
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I agree 100% that people with concentration or attentional difficulties deserve help, and I also believe from direct experience with my own kids that attentional skills can be learned. I applaud you for applying CBT principles systematically to this population and wish your enthusiasm would spread. In addition to working better than medication, these techniques impact the long-term welfare of kids and adults in a positive way long after treatment has discontinued, a claim that stimulants are still unable to make after 50 years of research.
That being said, I don’t know why you need to take personal offense at this article. It posits, very simply stated, that some kids are born with different personalities and temperaments, and that having a different temperament doesn’t mean a child is ill or disordered mentally. What’s offensive about that? Sure, there will be evidence that on the average, “ADHD”-diagnosed kids’ brains may work differently. However, the evidence to date suggests that far from being a unified diagnosis with a common cause, “ADHD” brains are all over the place in terms of what is different. The bottom line is, some kids find paying attention more difficult than others, and we really don’t know the reason, or that there is one reason causing all of these cases. In fact, it’s a very fair assumption that they are NOT all caused by the same thing, as we know that issues as divergent as sleep apnea, anemia, domestic abuse, poor attachment, and fetal alcohol exposure can all cause “ADHD” symptoms.
I guess my bigger question for you is this: if we can teach kids and adults to improve their attentional capacity in the large majority of cases, and if we can mitigate what appears to be somewhat delayed development in these areas by admitting them to school later (Canadian study shows a 30% reduction in diagnosis for kids admitted a year later to Kindergarten), or by putting them in open classrooms, why are we giving drugs to so many of these kids instead of doing things that actually have a positive long-term impact? I actually don’t give a crap if you call it a disease or not – the point is, individual kids need different approaches, and using the right approach “heals” these kids’ “mental illnesses” and they are able to be productive adults. Whereas there is no consistent evidence that long-term stimulant use does anything to improve those long-term outcomes that we care about.
I suggest putting your personal feelings aside and asking yourself instead why so many people are so strenuously objecting to “treatment as usual” for “ADHD.” You yourself seem to acknowledge that the current treatment is not what is actually needed. What’s wrong with simply viewing these kids as having different needs instead of pathologizing them? What’s wrong with teaching them the skills they need in the context of an educational environment instead of making it a “mental health disorder?”
The fact that someone’s brain is different is not de facto proof of disease. Men are much more likely to commit rape or other violent crimes, to beat up their partners or their children, to use drugs, to be arrested and serve time in jail, and so forth. They clearly have a “chemical imbalance” in having a huge overproduction of testosterone in comparison to women, and the genetic linking to this behavior is simple enough for a 9th grade biology student to see on a slide. Their brain scans are different from women’s brain scans, and even the size of certain parts of the brain are different. Does that make mean diseased, just because their brains are male brains and that these brains are associated with higher violence and crime? Or did men develop differently because our species needed men to be more aggressive and impulsive and more willing to attack prey or defend their homes from other species and other humans?
Species survival depends on genetic diversity. There is no reason to assume that those who have an extra hard time coping with dull and repetitive tasks assigned by others are ill in any way. Nor does NOT finding them ill mean that they aren’t entitled to help in developing the skills that they need to survive in today’s economy. No insult is intended – it is just a different way to look at the behavior, and in my view, it’s a way that leads to much better solutions, including your skill-building approach, whose effectiveness (in my experience) is almost always passionately denied by most who are invested both emotionally and financially in the currently accepted treatment paradigm.
— Steve
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To the contrary, I think the evidence in the psychiatric field is that drugs can be useful in acute care, but are increasingly dangerous the longer you use them. I’d be interested in your comments regarding long-term damage due to therapy. If you’re talking psychoanalysis, I might agree, but I think it likely that quality therapy can have a very positive long-term outcome profile, even though it is likely to take a lot longer to take effect than the drugs.
—- Steve
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I would add that ALL trials must be submitted to the FDA or other approving agency for consideration, and approval should reflect an analysis of ALL data submitted, rather than the “best two” approach that is currently used.
Of course, your other requirements are more than reasonable.
Oh, and no “placebo washouts” are allowed, either. Placebo effects are legitimate effects, and removing them biases the research in favor of a positive finding.
— Steve
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I have recently learned that acupuncture is not based on some mystical energy fields, but on lines of connective tissue beneath the surface of the body. These connective tissues are ignored completely in Western medicine, which puts all the emphasis on organs, but they are very important in Chinese medicine, which puts more emphasis on connections and relationships.
Additionally, anyone who has been through and honestly evaluated an acupuncture session with a skilled practitioner can attest that it is most definitely scientific and mathematical in approach. We may not understand exactly why this or that point is associated with this or that organ or this or that extremity, but it is observable that they are connected and has been so observed for thousands of years. They can do SURGERY on an AWAKE SUBJECT using acupuncture – they obviously have a pretty damned good idea what they are doing!
—- Steve
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The problem with complaints against doctors is that they’re not held to the standard of being helpful or at least non-damaging – they are held to the standard of “accepted community practice.” Hence, doing what other doctors do, no matter how destructive, is a safe play that will never get you into trouble. Whereas trying to look at new approaches or to individualize care to your particular patient can get you sued if things don’t go according to plan. As a result, in obstetrics for instance, it’s safer to do major abdominal surgery and remove a baby by C-section than it is to counsel a laboring mom to labor in hot water, which often obviates the need for drugs and ultimately surgery. Of course, a C-section is MUCH more dangerous for the patent(s) than a bath, but the bath is much more dangerous for the doctor. So we have gigantic C-sec rates and tiny percentages of women offered laboring in water as an option.
Just one example. Psychiatrists are quite safe drugging you to the gills, as long as their colleagues are doing the same. It’s the ones who really try and help that are at risk of being sued.
—- Steve
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From Lovemylittleboy’s link:
“”The take-home message of this study shouldn’t be that children with ADHD are more likely to become drug users. Rather, seemingly ‘normal’ teenage behavior, such as experimenting with tobacco or alcohol use, may occur at younger ages for individuals with ADHD,” lead author Eugene Dunne, a doctoral student in clinical and health psychology, said in a university news release.”
Basically, what this says is that “ADHD” diagnosed children, who are obviously pre-screened to be more likely to take risks, are more likely to take the risk of trying drugs earlier than their more risk-averse peers. There is no indication in the article that these kids are more likely to use drugs chronically or abuse them or become addicted – they just experiment earlier.
My “ADHD” boys were definitely experimenters – risk-takers from day 1. Again, this is not indicative of a disease. It just means they are willing to take more risks. Weirdly, they were both less likely to get hurt than their much more cautious middle brother. Maybe they were so used to minor bumps and bruises that they were more confident with their bodies and hence were able to deal with dangerous situations more easily? Or maybe they were just great athletes and good at avoiding injury even when they did something foolish. I don’t know. But bottom line, it shouldn’t surprise us that kids who are screened for being impulsive are more likely to be impulsive than the general population. It is, after all, what they have in common that identifies them as part of the group.
—- Steve
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We had to be very crafty about such things as cleaning up. Mostly, I learned to make them into games. I’d ask how fast he could do it and put on a timer, or I’d race him to see who could get more in the box, or I’d bet him a quarter he couldn’t clean up in less than X minutes. We also did contracts and positive reinforcement (sticker charts, etc.) It was a lot of work, but it was worth it. Both my “ADHD” types are healthy adults with great work ethics, despite no official “treatment” by the authorities. But we had to avoid standard school classrooms, especially in elementary school, as they are quite toxic to any kid with this kind of temperament!
— Steve
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Which is why I advocate for open/informal classrooms for these kids. It has been shown many years ago that “ADHD” kids are not distinguishable from “normal” kids in an open classroom, as they have more control over their time and activities and so can more easily head off boredom that leads to behavioral problems. Since we know that stimulants DO NOT lead to increases in self-esteem in comparison to kids not using stimulants, clearly, this “square peg into round hole” approach is meeting the needs of the teachers and the system, not the needs of the kids.
—- Steve
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The difference is that in France, they recognize that this kind of behavior is not a medical problem and they work with the child’s temperament and help them grow to adulthood.
— Steve
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Ridiculous comparison. It is clear and easy to tell who has hep C and exactly what causes it, as well as whether any treatment prescribed works or not. None of this is true for “ADHD.” Impossible to objectively distinguish from a normal condition, no universal cause, and no measurable variable to tell if treatment is working. Of course, I’d be thrilled for a Hep C cure. But the most ardent ADHD proponent acknowledges that there is no “cure.” Absolutely no comparison. Not to mention that you can’t improve Hep C by moving the child to a different classroom!
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Well, sounds to me like demonization has become a two-way street!
—Steve
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Great post – you have really captured the dilemma parents find themselves in. We avoided standard public schools like the plague for exactly that reason – we KNEW our boys would not be successful in that environment, because they are NOT robots or clones and we didn’t want them to be. I’m sorry you and your son have had to go through this. I wish I could have your son enrolled in our charter school – it was a great place for Kevin!
—- Steve
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I’d appreciate it if you’d stop saying that! I already showed you proof and there is almost universal agreement in the psychiatric world that ADHD drugs DO NOT have a different effect on “ADHD” kids or adults. They are general stimulants and have a generally stimulating effect on everybody. Rapoport concluded that the only reason we saw this effect as different with “ADHD” kids is because we wanted to see it and felt relieved that it occurred. Non-ADHD kid had EXACTLY the same range of reactions as those diagnosed with ADHD. End of story.
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But it doesn’t say, “prevents the mind or body from working properly in certain settings where properly is arbitrarily defined by adults with their own agenda that may or may not be appropriate for the child’s age and development and temperament.” Context is critical in evaluating what is a “disease.” Culture most definitely comes into play.
Try this one on: stimulants are known to improve athletic performance in the short term. What if athletic excellence instead of academic performance were the standard required for adult success in society? Would we be willing to say that non-athletic kids have ‘athletic deficiency disorder’ and consider stimulants a “treatment” for it? After all, it does create social and emotional distress, creating low self-esteem and self hatred in some – ask any non-athletic kid about gym class some time! So why not give stimulants if they help kids perform more on a par with their peers, so they can stay out of trouble and feel better about themselves?
Think hard before you dismiss the analogy. It really amounts to the same thing. Certain kids don’t do well in a certain environment that we’ve decided they need to function in. They are diagnosed and given performance-enhancing drugs so they’ll be more successful. But these kids are almost always skilled and successful in other areas that aren’t valued, or are so academically talented that they aren’t really learning anything in the school environment. Why not change the expectations instead of trying to force these square pegs into round holes year after year?
—- Steve
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Which reinforces what I’m saying: the schools are 90% of the problem. We operate on distorted assumptions about kids and the economy that are not even consciously considered. They are very, very unhealthy places for children in my view.
— Steve
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Hi, Joel,
I didn’t really see anything in the article sliming honest and approprate and sincere doctors. I saw a critique of a MODEL OF THINKING, which is being promoted by Lieberman as if it were scientifically proven truth, when in actuality, increasing evidence shows it to be lacking in credibility on almost every level. This is not to say that drugs have no utility in mental/emotional distress. It is to say that LYING to clients and the public about what is known and not known, and PRETENDING that we’re making progress toward a goal that looks to be a false one in the first place (to treat all mental/emotional distress as a “disease of the brain”) is wrong and evil, and for Lieberman to go on a national radio station and proclaim this “truth” to millions is quite reprehensible. While the comments section will, of course, contain more extreme views, as in ANY comments section of a controversial issue, the article does not appear to me to do anything but juxtapose the statements of one APA-invested arrogant thought leader against the actual known facts regarding the long-term history of the APA and the DSM. It doesn’t look like demonization to me. I’d be interested to hear where you see this occurring.
Given your username, I assume we’d agree aboout a lot of things. There are a lot of people who area angry at psychiatry for very good reasons and need to vent their frustrations, but Whitaker has never been an abolotionist. I suggest you really take a good look at what you are terming “antipsychiatry” really looks like, lest you do a bit more demonizing yourself than is really appropriate. We could use your wisdom and experience if you can find a way to appreciate that people here come from a variety of viewpoints, many of which aren’t nearly as extreme as you seem to assume.
— Steve
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And why, indeed, is he denied that privilege? What evidence is there that denying a child the right to run around and have fun leads to a better education or a more satisfying life? That is the gigantic elephant in the room that the “ADHD” industry and our school systems are completely unwilling to look at.
Bored kids don’t learn much. Those suffering from “ADHD” are the canaries in the coal mines. The biggest difference between me and them is that I was too scared to let the teachers know what I really thought of the bullshit I was expected to tolerate, especially in elementary school. I would have done anything to escape that slow torture. I admire these “ADHD” kids for making it clear they aren’t willing to put up with it, and I feel very sad that the adults in our society are too narrow minded and cowardly to listen to their message.
—- Steve
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The point I was making is that the rarity of stimulant treatment in Finland does not lead to worse outcomes for the Finnish youth in comparison to the highly-medicated US population. So regardless of whether it is considered a disease or not, stimulants don’t improve long-term outcomes. Hence, my conclusion that we are wasting tons of time and money on something that doesn’t help except in the short term. I’ve presented the evidence on the huge advantage of “ADHD” kids educated in informal/open classrooms. Why not get on board in helping these classrooms become more common, rather than arguing about whether “ADHD” is a disease when we know the “treatment” doesn’t actually create the long-term improvements in the general population that have long been expected but have never materialized?
And BTW, the fact that Norwegian or Finnish psychiatrists agree that “adhd” is a real disorder doesn’t mean anything much to me. Physicians have in the recent past agreed that Benzedrine is not addictive, nor was valium, that cigarettes did not cause cancer, that midwifery care was dangerous (even though it appears to be as safe or safer than doctor care), that formula teeding was as good or better for babies than nursing, and that thalidomide and Viiox were safe and effective drugs. Professional agreement is subject to bias just like any other agreement.
— steve
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Sorry, but this is an opinion article, obviously “dumbed down” for the lay person. There is no actual reference to any study or scientific evidence for any of these claims. I’m certainly in agreement that “ADHD” kids are seeking stimulation and have little to no patience for things they aren’t inherently excited by. But we found that by making the more tedious activities into games, we could teach them to develop their attentional skills in a fun and non-coercive way, so that they learned how to persevere at less exciting activities because of the exciting rewards available at the end.
I am not and will not be convinced by some authority making pronouncements about “ADHD.” I have a very solid knowledge base, both experientially and research-wise, and I KNOW that it is possible to teach these skills. And if they are teachable, it suggests to me that the problem is not a lack of capacity to create these amorphous chemical connections in the brain, it’s more a need for a lot more practice than the average kid. And there is no drug that can provide that practice. In fact, it is possible that medicating the problem may actually defer the need to learn these skills much later than they can actually be taught. Again, the adults (especially the schools) have to learn to be a lot more flexible for this to occur, and I’m not holding my breath for that to happen. But it’s not the kids’ fault that the schools are rigid and lack creativity. We actually went to the length of helping create our own school that would work for our youngest. And it did and he is doing awesome. I think that ought to count for just as much as any anecdote of someone whose kid’s academic life was saved by stimulants, don’t you?
— Steve
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The fact that a genetic variation is “more common” in the ADHD population proves exactly nothing. First off, correlation doesn’t mean causation – just because they occur together doesn’t mean they are related in any way. Second, if it’s only “more common,” it can’t be causal, because a lot of people who don’t have “ADHD” have the variation, and a lot of people who do have “ADHD” don’t have it. If it were causal, we’d find that 90% or more of “ADHD” people have it, and only a tiny percentage of non-diagnosed people showed the variation. Third, even if it were causal, which it clearly is not, genetic variation is not automatically indicative of disease. Genetic variation is the core of species survival. Consider that some people are born with good athletic skills and some are not. Are those lacking athletic skills disordered? Or is it just a variation, because we need some fast people but not everyone has to be fast, because they have other gifts that the fast people lack? Finally, even if it is a disease state, which is by no means even vaguely proven by this research, the “treatment” still doesn’t improve the long-term outcomes for the recipient on the average.
Such research is, to my mind, almost completely worthless. What I really want researched is what actually helps these kids succeed better. We know that informal school classrooms are one element in a helpful environment for these kids. I’d suggest we spend a lot more time working on these classroom variations and other social ways of helping that don’t involve messing with their brains.
— Steve
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Assuming you are genuinely interested in examining this question, a quick look at the FDA approval procedures will cast appropriate doubt on your assumptions of thoroughness and scientific validity. Simply stated, all a drug company has to do is to present two studies showing some statistically significant benefit in order to gain approval. That benefit could be as small as a three-point gain on the BDI, which is hardly evidence of a cure. More importantly, there could be 5 or 10 or 50 legitimate studies that showed no benefit or even show a destructive trend. This leads to a dramatic overestimate of the effectiveness of drugs in general. Irving Kirsch’s work re-examined the antidepressant data including all studies instead of just the ones submitted to the FDA, and the effectiveness was reduced to barely better than a placebo. Kirsch concluded that if active placebos were used, there would be no difference – in essence, the SSRIs are very expensive active placebos.
Additionally, the longest studies submitted are generally about 8 weeks. I have recently heard of three-week studies now being accepted. So on the strength of two three-week studies, cherry picked from whatever literature actually exists to maximize the chances of acceptance, we are to conclude that a drug will be safe and effective over the course of years. Not a realistic conclusion at all, in fact, a very dangerous one. Certainly not a scientific conclusion by any stretch of the imagination.
To get the whole picture, read Anatomy of an Epidemic cover to cover, and check into some of the references, especially the WHO studies and Martin Harrow’s work. I hope you are genuinely open to learning, because we need a new breed of psychiatrists, but I worry when you use the word “antipsychiatry” as a pejorative, as it suggests you may already be indoctrinated into the worldview that your patients strongly need you to critique.
Hope that helps!
— Steve
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Wow, Jay, I always love your stuff, but this one really grabbed me. What I’m seeing behind the presentation is that the very CAUSE of much distress that exists is the commodification and branding of everything (and the power dynamics behind that process), and that any real and effective therapy has to be in the place of looking at and potentially undoing those dynamics. But the therapy industry has an interest in maintaining the status quo and hence promote branding and controlling of therapy, and specifically controlling it away from any examination of the external conditions that may be creating these “mental diseases” in the first place. Don’t know if I’m saying that clearly enough: therapy (if we want to call it that) should help resolve power and control issues, with parents, school, work, society as a whole, whereas the industry wants to keep the patients in the low power position so that the powerful can profit and the powerless won’t rebel. And CBT fits the bill perfectly – if you are distressed, it’s because you’re thinking the wrong thoughts. It has nothing to do with your history or events that you were involved with, and it has nothing to do with political or social conditions you are exposed to. If you just learn to think happy thoughts, everything will be OK!!!
I have always been of the opinion that good therapy is different for each person, and I have never been a fan of manualized therapy approaches. This blog has helped me realize what was behind this intuitive sense of distrust in this “evidence-based therapy” movement. It always seemed biased toward more “present-time” approaches and against any attempt to put a person’s narrative history into perspective, even though the latter seemed to be at least an essential part of any effective therapy I’d done or seen done.
I’ve always been eclectic in my approach, as was my own good therapist years ago. I use CBT concepts and teach them, but only as a possible skill-based option for those who seemed to find it helpful. My measure has always been, “If it works for the client, it’s good. If it doesn’t, stop it and do something else. It has always bothered me how CBT took over, and this has given me a much more thorough grasp of both the politics and the fear and greed behind the politics. So thanks again, Jay!
— Steve
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Apparently even people who are being tortured are supposed to maintain between mild amusement and mild irritation or they are also mentally ill. A well-adjusted person would never be upset about being tortured. He’d realize he was a terrorist and know that he deserved it. Or maybe he’s a terrorist BECAUASE he has a mental disorder! THat explains it!
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My thoughts exactly! To think that anyone would have been paid money to study this question shows how far we have fallen. I consider this as sensible as saying that “Chronic loss of sleep leads to symptoms that appear very similar to exhaustion.” The authors can’t even see the stupidity of their own title.
— Steve
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I am not aware of any data to support that contention. The Raine study, the Montreal ADHD study, the long-term arm of the MTA study, and a recent Finnish vs. USA study all indicate that high school dropout rates are not improved by stimulants. In fact, the Raine study found kids who took stimulants were much more likely to drop out (9 times), though that has not been replicated anywhere I know of. And the data on drug abuse has historically been equivocal – there is some indication that cigarette smoking is more common with kids who were exposed to stimulants, and kids who are still taking stimulants in HS appeared in one study to be less likely to abuse substances, but the rest of the research has shown no consistent differences.
Two of my kids “actually had” ADHD, to the extent that they fit the criteria perfectly and had no particular trauma or other explanation for their behavior (other than two young and semi-clueless parents!), plus a mom and grandpa who also would qualify. Neither of them abused substances, and both graduated from HS with honors. The one who dropped out of HS and got into drugs was the “normal” one! Which goes to show that no one is really “normal” and who does or does not drop out of HS or use drugs is a very, very complex affair, and simply medicating or not medicating a child who fits these criteria is not a very powerful variable in determining their ultimate outcomes and experience.
I’d still love to see a link to the article about dying prematurely. Accidents are the only outcome that has scientific backing for being affected by stimulants, according to the OSU Medication Effectiveness study back in 2002 or so. Saying they have twice the likelihood of dying prematurely sounds concerning, but I’d have to see what the absolute probabilities are to determine how important such a difference would be in the real world. (I.e. the difference between .001 % and .002% is pretty tiny, whereas the difference between 10% and 20% is huge, even though both are “twice as frequent.”)
— Steve
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I agree that the “not real” framing is not helpful. It is certainly very “real” that there are kids that meet the “ADHD” criteria, and that these kids are difficult to manage (I know mine were!) The problem is that these behaviors, real as they are, don’t constitute a DISEASE as they have been purported to do. The reason I say that is because there are a ton of possible REASONS why a child might behave this way. Some of them probably are medical – low iron, sleep apnea, certain allergies, sensory integration difficulties, fetal alcohol syndrome, lack of sleep, side effects of medications, head injuries, and many more medical problems can manifest these symptoms. But there are also social causes: child abuse/neglect, especially early in life, lack of boundaries in the home environment, inappropriate expectations by parents and/or teachers (look at what is expected of Kindergarteners today vs. in the 60s!), reduction in recess and outdoor time, emotional immaturity, domestic abuse at home, all have been associated with these very same symptoms. AND there are some kids who just are like that, and it’s normal for them to be that way. Kids who are bright and very active get bored easily, and the average school classroom is, let’s face it, pretty dull. Some kids (I was one) are able to just white knuckle it and do what they are asked, no matter how repugnant or painful, but some are not able to, and these kids act out. Is the fault in the child’s brain chemistry, or the classroom that fails to challenge them?
I ultimately agree with the author: kids are all different and need different approaches. We had no idea what we were doing with our oldest and made some serious mistakes that made his childhood harder on him and us. But as a result, we were prepared for our youngest and took a different approach, and he’s a much healthier and more functional young adult. Not that our oldest is dysfunctional – he’s got two jobs and works hard, never got into trouble with drugs or the law, is loved by his employers, etc. Has a little trouble with girlfriends, but otherwise he’s a totally normal and functioning grown up, despite no “treatment” for “ADHD”. There is nothing WRONG with him other than that he is a unique person who meets his needs in unique ways some times. The younger is just an amazing young man and no one would ever think he had a “mental disorder” in his life. He’s a super athlete, has lots of friends, does great in school, and is a highly responsible college freshman, no drugs or alcohol or dangerous activities or teen pregnancies or any of the horrible predictions for “untreated” ADHD. It’s because we learned that staying away from standard schools is important, and we learned that discipline looks very different for active, oppositional kids. I really do need to write a book on the subject…
Anyway, I have great compassion for those raising such a child, because they’re a HELL of a lot of work and it’s not always so rewarding in the short run. But difficult is not diseased. It’s not that “ADHD” doesn’t exist as a behavior pattern, it’s that just because you kid fits that behavior pattern does not mean that s/he is “mentally ill” and needs “treatment.” Sometimes there is a medical problem. But sometimes, s/he just needs the time and space to grow up, with some extra discipline and skill-building along the way, and some freedom from the bizarre and unreasonable demands of today’s standard school classrooms.
—- Steve
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You are too right about the educational system. My biggest problem with the labeling is that it takes our professionals off the hook for trying to actually find solutions for our kids. We actually had to help create our own charter school so our youngest could be protected from the kind of crap they get in school. If you look at the “ADHD” definition, it’s a list of traits that makes it difficult to teach you in a herd-management school classroom. Luckily, we had the means and support to make a better plan!
— Steve
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Ah, but they don’t have Voc Ed curricula in most schools now, do they? It was understood in my day that not every kid was bound for college. Still is that way in Europe, but nowadays, US schools train everyone for college, even though only 20% of our population gets a 4-year degree. If our schools were more flexible and allowed for different temperaments, a lot of these kids would do just fine. I believe 80% of the problems for these kids are caused by our school system. Alternative ed made ALL the difference for ours!
—- Steve
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Awesome post! We had very similar experiences. My saying is, “They make great adults, if you can survive their childhoods!”
— Steve
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What is interesting is that Finland’s rate of medication is much, much lower than the USA, and yet a recent study showed a very similar array of outcomes for their “ADHD” diagnosed kids. I have no problem with adults choosing stimulants for themselves if they think they are helpful, but it’s pretty clear after 50 years that despite the horrific warnings that “your child will be more likely to drop out of school and become a delinquent if you don’t get him treated,” stimulant treatment does NOTHING to alter these outcomes on the average.
I do believe that lots of kids (including two of my own) exhibit these “symptoms,” and I KNOW they are a whole lot harder to raise. They also do much worse in standard school classrooms. But I think it’s the job of the adults, especially the schools, to figure out how to help these kids learn self-management skills, because in the long run, stimulants don’t help these kids develop the skills they need in order to survive, and may even make it easier to think things are going OK until it’s kind of too late.
Another recent study showed that just waiting a year for Kindergarten admission reduced the “ADHD” diagnosis rate by THIRTY PERCENT!!! Think of this – almost a third of kids diagnosed ADHD could be saved this diagnosis if they waited a year to start school! I am sorry, but it’s a pretty sketchy diagnosis if a third of the kids who “have it” no longer “have it” a year later.
I empathize with parents who have to meet the challenge of these kids, but I can say from experience that there are other ways that work better. Alternative classrooms and creative discipline methods (which you can’t just learn from any old book or professional, because a lot of professionals don’t know these techniques) were the keys to our success. Read “Raising Your Spirited Child” for more on this.
Just because kids are hard to raise or don’t fit into standard classrooms doesn’t mean they are mentally ill!
—- Steve
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It has long been understood that stimulants do NOT act differently on the “ADHD” brain. Judith Rappoport gave stimulants to “normal” teens back in 1978 and found that they had the exact same reaction to low doses – reduced motor activity, increase focus, decreased distractibility. She suggested that the reason it appeared different in “ADHD” kids is only because people were looking for that result.
The current understanding is that “ADHD” kids are hyper and intense because they are seeking stimulation. The drug provides artificial stimulation and so they appear “calmer” to someone who was finding their activity level annoying to them.
There is absolutely no evidence that children with “ADHD” have a “chemical imbalance” in their brains. There is some emerging evidence about some small difference in dopamine receptor density, but of course, we should expect that any population will have some differences in dopamine receptor density, as they would in height, weight, eye color or muscle mass. I think the author would suggest that such differences are a natural variation and only become a “disease” when these kids are forced to do things all day that they are not genetically programmed to find very interesting or enjoyable.
—- Steve
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I don’t think the author means to demean loving parents! It is the psychiatric industry, and frankly, our school system that has done so much damage to our children and our families. I say this as the parent of two “ADHD” boys, neither of whom had any medication and both of whom can be regarded as successful adults. This might not have happened if we enrolled them in a standard school education, but we instead used alternative schools and homeschooling and avoided labeling and unnecessarily forcing them to engage in boring busywork.
There is good research over time to show that “ADHD” kids are indistinguishable from “normal” kids in an “informal” or “open” classroom (think Montessouri). I fully recognize that these kids have a very hard time functioning in a standard classroom, but I blame the standard classroom structure, which is rigid, boring, and overly concerned with compliance to adult authority. When our kids were in an environment where they were allowed some freedom of choice to pursue things they found interesting and valuable, and to stay obsessed with something if they wanted or to change to a new task if they were “done” with the one they were on, they had much fewer problems. And that environment, which was naturally motivating for them instead of de-motivating like a standard classroom would have been, also gave opportunities to teach the SKILLS involved in organizing and focusing attention, which are definitely teachable skills but are NOT taught to these kids in a standard classroom setting.
I am not a person to say that “all these kids need is a little discipline.” They were TOUGH to raise! But I agree with the author, there was nothing WRONG with them – they just had a more challenging temperament.
It might also interest you to know that 50 years of l0ng-term outcome studies have shown that kids taking medication don’t do better on the average than those who don’t. This isn’t saying that no child benefits, but it is saying that for every child that does better, there is another that does worse to the same degree. Ours used no medication and are doing just fine.
I’d like to see a link for that article, if you have one, BTW. I am always interested in new research on the topic.
— Steve
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Hear, hear!!!!
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Does this creep anyone out besides me?
—- Steve
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I also work in the foster care system, and I have to disagree that relationships don’t heal kids with RAD or even FAS. In fact, the research from the “Decade of the Brain” in the 1990s showed that relationships are the MAIN thing that heals children who have been abused and neglected in early childhood, and that brain changes can and do occur into young adulthood. It is true that certain “windows” do close for true attachment and other developmental steps early in childhood, but it appears that other parts of the brain can compensate, if the child is able to grow in a safe and supportive environment. The works of Dr. Bruce Perry might be of great interest to you in supporting your adopted children.
That being said, most people here are not criticizing folks like you who are dealing with real problems finding the best solutions available at the current moment. What I think Phil is correctly criticizing is the use of these drugs in lieu of actual efforts to figure out what the children actually need and trying to provide it. The diagnostic system in the DSM allows almost any behavior or emotion to be reframed into a “mental disorder,” regardless of how appropriate the behavior or emotion. For instance, a bright child in a boring classroom with a rigid teacher who picks on him/her might lash out and be sent to the principal’s office frequently, and be diagnosed as “oppositional defiant disorder” or even “bipolar disorder,” regardless of the provocation or circumstances surrounding the behavior. This is even worse in foster care, where kids come from backgrounds where they were mistreated badly or were never properly socialized, and engage in behaviors that they needed to in order to survive, or experience emotions that are completely to be expected given their difficult circumstances. I’ve talked to dozens of foster kids who are “aging out” about their experience, and most find medication to be at best an annoyance or distraction, and in some cases a deep insult. They tell me that they are medicated because they are upset or protest their situation, and ask very legitimately, “So you’re saying the fact that I’m depressed and anxious about the fact that my mom abandoned me and is living on the streets with a violent boyfriend and shooting up meth and I have no idea where I’m going to grow up is a sign that my BRAIN IS BROKEN? What, am I supposed to be HAPPY about all this?”
Foster kids are difficult. They’ve been hurt and trust is always a challenge for them. Some have even had physiological changes as a result of either trauma or drug exposure. But assuming that ALL foster kids who have behavior or emotional issues are “mentally ill” is patently absurd. And allowing these diagnoses prevents professionals from having to exercise their responsibility to view each child as an individual and help figure out what’s bothering them most and what will be most helpful. I always ask these foster kids what they found most helpful, and I can tell you that NO ONE has ever said that a diagnosis or a drug was key to their survival. It is ALWAYS a person and a relationship – a foster parent, an attorney, a CASA volunteer, a caseworker, a therapist, a teacher – someone who cared enough to hang in and believe in them when things were tough. Giving out diagnoses and biological “explanations” that aren’t even scientifically true does not convey believing in the child. To the contrary, it pathologizes normal behavior and gives the discouraging message that your brain is broken, rather than the much more empowering message that “your behavior and feelings are absolutely normal, and we can help you learn to cope with your difficult situation and feelings.”
— Steve
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“And in other news, foxes left to guard chicken coops have shockingly been found to actually eat some of the chickens during their shift…”
— Steve
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Yes, they are supposed to have at least two. They used to require 8 week trials, then 6. Now they are down to three? The other thing people don’t realize is they can have two positive trials and 25 negative or no results trials, and they only have to submit the positive ones. This makes no scientific sense, but I guess we’re more worried about what makes money than what makes sense.
Disgusting…
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There is no effort in the article to articulate why this is happening, and they let the psychiatrists off the hook big time. None of them really seem to give a crap.
—- Steve
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Not only didn’t advise exercise, but saw it as a symptom??? What a motherf(*&*r! Glad you got his ass fired. He and Satan are probably old pals.
—- Steve
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I totally agree! The more upset they are, the more you know that they’ve done some things they’re not proud of and are afraid on some level will come out. Not consciously, mind you, as they’ll mostly assure you that NOTHING like this EVER happens in THEIR facility. That denial is essential for them to continue to feel OK about doing their jobs, even though deep down they don’t really feel OK about it at all.
Then there are the psychopathic ones…
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Serotonin is also in many other areas of the body, especially the gut, which has more receptors than the brain. Your accurate observation certainly explains why there is such a high rate of emotional and behavioral “side effects” to SSRIs. It’s like trying to fix a fine watch with a hammer and a Phillips head screwdriver. You’ll have an effect, but it’s probably not going to make your watch work better.
Still, probably better to provide the body with building blocks it can use as it sees fit rather than forcing it to engage in an unnatural increase in serotonin levels throughout the body.
—- Steve
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It is a high compliment to be compared to the integrity of the average 4-year-old. We so-called grown ups have a lot to learn from them!
— Steve
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Yeah, odd that stakeholders does not appear to include the people they are supposedly trying to help. I guess you’d have to be considered human before you can qualify as a stakeholder.
— Steve
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I stand by my statement 100%, though I know you’re far from the only source of support. Though I have to say, the bar isn’t very high – I’d imagine talking to the average 4 year old is probably more helpful than the average psychiatrist. At least when you were crying and looking depressed, the average 4-year-old would know enough to say, “Why are you cwying?”
— Steve
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If the choice is between funding the current, admittedly less than vibrantly empowered, forms of peer support vs. funding the standard psychiatric treatment system, peer support wins out hands down. Even having it there as a token is a reminder to the system that “peers” exist as people and have voices and that recovery (or perhaps escape is the better word) is a very real possibility. Of course, it’s in some ways spit in the ocean, but if even a handful of people get more of the kind of support they need, it helps our cause.
Can you imagine the difference between meeting for 15 minutes with a conventional psychiatrist and spending 15 minutes with Sera Davidow? Orders of magnitude difference in experience!
Keep fighting, Sera!!!!!
— Steve
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Given the frequent analogy that survivors make between enforced “treatment” and rape, I am forced to ask the following: Is it helpful to a rape victim to debrief with a caring professional after the fact? What about debriefing with the rapist or his/her associate?
Wouldn’t it perhaps be better to do something to help the person that doesn’t involve a forced violation of his/her bodily integrity?
Just a silly thought…
— Steve
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We don’t want to actually halt the spread of disease. We just want people not to get too upset when their friends or their family members die unnecessarily because no one in the “modern” world gives a crap about whether West Africans live or die. Because if they start getting upset, they may start rebelling, and we KNOW how upsetting rebellion is to the status quo…
—- Steve
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Hi, Molly!
I’m also in Portland and will definitely be there! It’s great to see something like this gather it’s own momentum. Hope to meet you there on the 16th!
—- Steve
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I believe the call for humility is the most likely cause for much of the uproar. All sorts of theorizing is allowable, as long as you don’t start suggesting that the patients/clients/survivors may have some knowledge that the “professionals” may lack. Suggest that, and the gloves are off!
—- Steve
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Well said. I think this particular psychological impact can be far more damaging in the end than the drugs themselves. It is a message of disempowerment and disability, and it is almost never an accurate evaluation of the reality that faces the person in question. Telling people they can’t do anything about their issues is always a very bad idea.
— Steve
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Except it does once again undercut the idea that depression is only a result of bad genetics.
— Steve
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I would add that even the ones who have a sincere desire to help their patients don’t actually know how to do it. They’ve been given a hammer as their only tool, and so every problem is a nail. Most psychiatrist have limited to no training in psychotherapy, and have also been given rafts of bad information about “chemical imbalances” and genetic underpinnings of “mental illnesses” that are both inaccurate and helpful. Beyond this, the DSM (which was created primarily by the profession of psychiatry) is taken WAY too seriously and seen as representing real “diseases” when the document itself says that there is no clear line between normal and “disordered” and that any two people having the same disorder may have totally different causes and totally different needs. The serious application of this document causes great harm, even when the person doesn’t mean to, because it tends to focus all the attention on the client’s symptoms and conveys some mystical understanding of the situation that simply doesn’t exist.
If psychiatrists really mean to do no harm, they would need to start with a much more humble attitude, admitting to their clients that mental health problems continue to be very mysterious, that many people find many different things helpful, and that they are interested in understanding the problem from the point of view of the client. To say that this is rare is a gross understatement, in my experience. Most people experience a professional categorizing them via the DSM, telling them that their brain is broken, but that there are treatments “like insulin for diabetes” that can make the situation much better. They also tend to convey that the client him/herself can do little or nothing about the situation themselves, and invalidate or minimize the importance of environmental factors and past emotional experiences as possible causal or contributing factors to their problem. In short, regardless of their intentions, the practitioners who follow the script they are trained to follow will not only fail, they will do damage and not even realize they are doing it. Only the more antiauthoritarian types who question the dominant paradigm will find their way to being helpful, and honestly most of those people would stay very far away from psychiatry, as it appears to be one of the most rigid and authoritarian fields one could possibly study.
The road to hell is paved with good intentions.
—- Steve
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First, I want to say, Tyler, that I appreciate your acknowledgment and recognition of the damage that other people have experienced, even when your own personal experience has been different. I find it rare that folks are able to maintain that kind of “grey area” perspective when talking about these issues.
That being said, I agree with Jeffrey – I work with foster kids and they are promiscuously drugged for behavioral manifestations and emotional reactions that are completely understandable given their circumstances. These drugs are almost always credited for any good things that happen, and are almost never blamed for anything bad that happens, regardless of sometimes obvious causal and temporal connections between drug prescription changes and behavioral deterioration. I don’t want to invalidate that those positive stories exist and are real, but I don’t think you end up hearing most of the negative stories, because they tend to be buried by those who have an interest in maintaining the myth of effective chemical treatment for all.
To take “ADHD” as an example – you, Tyler, describe a positive experience over time, but the research shows that on the average, “ADHD” kids who take medication do no better than those who don’t. That suggests that for every positive story like yours, there is at least one person whose life was made as much worse as yours was made better. You sound like a compassionate person and I know you would not wish that on anyone, but I want you and others to realize that it’s not a rare phenomenon. I’ve worked with multiple kids who started out with an ADHD diagnosis, got aggressive on stimulants, were put on antipsychotics, showed signs of depression as a result, were put on antidepressants, had manic episodes as a result, and were put on mood stabilizers. These kids will be on 4-5 psychiatric drugs and still be behaving horribly, breaking windows or beating people up or even threatening to kill themselves. It is incredibly rare that the doctors ever look at this situation and say, “Gee, what we’re doing doesn’t seem to be working very well – maybe we should start over!” No, they continue to add more drugs or change dosages or change to different drugs despite the fact that the kid just gets worse and worse or at best continues to be a huge problem. And sometimes, when my advocates are able to prevail on them to try reducing or eliminating medication, we find that the child is no worse or even much better WITHOUT the drugs in his/her system.
It is a very ineffective and insensitive system. You are smart enough and independent enough to judge for yourself whether something is working or not. Most kids don’t have that ability or that luxury. Many are drugged at the behest of parents, foster parents, teachers, counselors, doctors, whose main interest is controlling the child and deflecting blame and discomfort from the adults. The 100/1 ratio you postulate is very much counter to both science and my personal and professional experience.
Thanks for writing, though. I wish all medication proponents were as rational and reasonable as you are.
— Steve
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Todd, I am so sorry about what happened to you, and I thank you so much for sharing your story. Folks really need to hear that these “symptoms of ADHD” are absolutely and commonly caused by children being abused and neglected at home and/or in school. The list of drugs you were on is appalling, and anyone thinking rationally about it would see that they were obviously barking up the wrong tree if they had to “try” all these drugs and nothing appeared to actually help. Yet they seem to feel they have to continue to try one drug after another after another until you either escape or die. They are unable to recognize when they are doing harm.
I am glad you found your voice and hope you keep speaking up and education those who really haven’t got a clue that this is happening in this country.
—- Steve
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But of course, psychiatrists mostly DON’T listen to people all day – they ask a few “symptom” questions and write a prescription. They should, indeed, be ashamed.
As to common sense, baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were that common, more people would have it!”
— Steve
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I know, it’s a far-fetched theory. I really shouldn’t be making people feel uncomfortable by pointing out the obvious. After all, charlatans have feelings, too!
— Steve
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Thank you!
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So I guess that being unemployed causes people’s brain chemicals to become unbalanced as a result of a predisposition toward depression that was exacerbated by the stress of being unable to eat or afford shelter or protect his/her family. Conclusion: people at risk of unemployment should receive prophylactic antidepressant treatment.
Or perhaps we should work at reducing unemployment…
— Steve
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It’s way too easy to do, since there is no way to refute their nonsense. Of course, everyone has “mood swings,” especially when you have been or are being traumatized, but if you speak up and complain, well then you’re “irritable” and that’s another mark against you. Then they give you drugs to “help” and create more “symptoms” which reassures them that they were right all along, even though they created the “symptoms” themselves! It is an incredible scam.
— Steve
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I agree, the Woozle analogy is awesome. Every time around the tree, they find more and more “evidence” that they are on the “right track”, when in the end, all they are doing is chasing their tails. The big difference is that Pooh and Piglet are humble enough to see their foolishness when it is pointed out to them, whereas Psychiatry will continue ’round the spinney until they wear a 10-food trench into the ground.
— Steve
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I agree, the term “behavioral health” sets my teeth on edge! Behavior doesn’t have health! People have health! It goes to show that the current paradigm is intent on reducing us to mechanical devices so that the only thing that matters or even really exists is our “behavior.” BF Skinner would be proud.
—- Steve
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Andrew, I would have predicted that you would respond that way! I wish I could send you some clients.
I think having a really good sense of boundaries requires having a good perspective on your own needs and issues, and I think that’s what differentiates people who can do this from those who can’t. It’s not “good boundaries” when you are holding back your own humanity and acting like a cold or robotic person with no heart. But I think some clinicians interpret it that way because that is what keeps them safe from the uncertainty, pain, and messiness of really connecting with someone on a personal level. It is just plain safer to avoid that discomfort and “diagnose” from a distance. It also explains why medication is so appealing to some clinicians – if they can make the client’s discomfort disappear, they don’t have to deal with their own.
I find that the ability to sit with that discomfort is what helps the people I talk to end up feeling better. It is also what helps me figure out what to say and do that might be helpful. If I kept a big emotional distance, I don’t know how I’d ever figure out what to do! The information I need is internal to the client, and I have to connect with them in order to find out what their needs are and why they might be acting or feeling the way they do. I really don’t know any other way to do therapy!
—- Steve
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Hi, Hannah!
You are seeing a psychiatrist but still appear to be suffering disabling anxiety. I assume you are taking medication, but do you feel it is really helping you the way it should be? Is it possible it may even be holding you back? Have you read “Anatomy of an Epidemic,” the book which inspired this website? Some of your comments make me wonder if you are suffering from deterioration of your condition BECAUSE of the drugs.
I used to be an incredibly shy and socially incompetent person. I do believe it is possible to learn the skills to change that. It’s a lot of work, but I am sure it can be done, as I have seen it done and done it myself. True, I don’t have Aspergers, but I still believe you are a human being with a natural capacity to learn. I hope your therapist is helping you develop these skills.
You state that you are the obstacle standing in your own way. I found that to be true of me as well. I had to figure out a way to get out of my own way and stop worrying what other people thought of me. I had to get comfortable with the idea that some people would think I’m weird and not want to be around me and that’s OK. I have gotten to the place where I can actually give presentations to big groups of people, even though when I was a kid I did anything I could not to have to talk in public.
I am glad you have had the courage to post here. I actually do know what it’s like to be afraid to put myself out there. It is good to hear your perspective as a person who doesn’t find the “neurodiversity” concept very helpful. Everyone has their own path, and I send you my very strongest wishes that you will find yours and travel it with the courage that I know you have.
—- Steve
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I think there are many people trying to figure out how to help someone who has “Aspergers Syndrome.” I think the big message here is that it’s very easy to label and dismiss someone, as it seems you are feeling happened to you. I think it’s totally OK to hate having those limitations. What do you think would be helpful? Are you hoping for some medical treatment that would make it easier? Or do you think there are ways you can adapt that would make your limitations less onerous?
In any case, I don’t think that the concept of “neurodiversity” is meant to say you should not seek or find help with these challenges. I think it is more about saying not to judge someone to be a drain on society or unworthy of help because of a particular label that society has affixed to them. Obviously, it’s only one way to think about it, but it seems to help a lot of people regain some sense of power and control over their own lives. Clearly it hasn’t done so for you. What do you think would help you feel like you’re more in control?
— Steve
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Oh, don’t go bursting my bubble! I lived in Germany for a year in 1978-79 and had a few occasions to encounter the healthcare system, and it certainly was a lot simpler and less contentious than the US system. My son also was over there in the late 2000’s and was sick and got seen immediately for free. Of course, he still got standard “medical model” care, but no one really asked him to prove he was sick or destitute in order for him to be seen. He was really stunned – he was sure they’d bill him later for being a foreigner using up their resources.
Of course, I never applied for financial assistance and can’t speak to the level of shame there, and I am sure the mental health system is just as oppressive as ours. But seriously, it would be hard to be more humiliating and degrading than what the US system does to people who need help.
Thanks for that cross-cultural perspective!
—- Steve
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I am sure you are correct. The whole idea of “depot” shots is disturbingly disempowering and lazy. I am quite sure that they are not able to determine precisely the level of release, as everyone’s body is different. Unfortunately, they have the cover of these subjective “diseases” to blame for anything that goes wrong. It’s pretty disgusting!
—- Steve
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This sounds kind of similar to the Soteria House model of Dr. Lauren Mosher.
— Steve
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I agree that these terms are commonly used pejoratively. “Low functioning” is a PC way of saying “dumb” or “incompetent” or “frustratingly inconvenient.” “High functioning” often means “faking” or “doesn’t really need help” or “low priority.” While I understand the first poster’s concern that these terms are embedded in the system and are required in order to get help, this should not be the case. It speaks to the larger issue of the US social welfare system, where people constantly have to “prove” that they are “really needy” before any help is offered. I much prefer the European system, where people seek out the help they feel they need without having to prove “low functioning” to merit assistance. That approach also allows people to continue to receive support as their “functioning” improves, rather than punishing folks who get better with loss of medical care or housing or financial support because they are now too ‘high functioning’ to deserve it.
—- Steve
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I use self-disclosure all the time as a way to create better trust and a sense of personal credibility. I do it in a way that doesn’t require the person I’m talking to to take care of me in any way, but as a means of reducing the power imbalance and letting them know that their suffering isn’t that unusual or “bad.” Unfortunately, the DSM now allows clinicians to completely distance themselves from their clients and “analyze” them and “categorize” them and “treat” them as if they were somehow a different species altogether.
Boundaries means doing what is good for the client rather than what is good for you as a clinician. It does not mean avoiding any impression of your own vulnerability and humanness. Selective self-disclosure is a powerful way to help clients understand that they are not malfunctioning, but are part of the human race’s struggle to make sense out of this confusing, horrific, and wonderful world we are a part of.
—- Steve
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The Mercury-News did an amazing series on this. If you haven’t checked it out, you all should:
http://webspecial.mercurynews.com/druggedkids/
Karen Sa deserves a Pulitzer for this amazing investigative journalism. Foster kids are the most powerless group of people in this country, and it’s not surprising the pharmaceutical industry and the psychiatric profession take profit at their expense. I see it every day, and it breaks my heart.
— Steve
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No one is suggesting that your experience is invalid. You clearly found stimulants helpful with minimal side effects – more power to you! My problem with the tenor of your posts is that you seem to assume that everyone has your experience, or that difficulties are rare and easily resolved by simply “talking to your doctor.” This is not most people’s experience who are posting here.
When you get “kicked in the teeth” is when you make unsupportable statements, like that brain scans can be used to diagnose “ADHD,” and that kids who attend “open classrooms” don’t learn anything, and that you can tell if someone has “ADHD” because they respond differently to stimulants than someone who doesn’t have that diagnosis. None of these things have scientific backing, and people have taken the time to show you the science 0r shared anecdotes refuting your claims. If you want your own anecdotal evidence respected, then you need to do the same with others’ stories, which are all just as valid as yours. When I tell you my kids had full “ADHD” characteristics as kids and were raised using alternative schooling and turned out to be functional adults, I expect you to recognize that there are at least exceptions to your way of thinking. When I give you references documenting that kids who receive stimulant treatment don’t turn out better on the average than those who don’t, I expect you to acknowledge that as factual. When I or Jonathan acknowledge that stimulants do have a short term positive effect on “ADHD” symptoms, I expect you to remember and give us credit for that rather than claiming we said something else.
You seek respect from others, but you are not respectful of others’ viewpoints. We have lots of heated debates here from people seeing things differently than each other. You can do that, too, but not when you dismiss or ignore or invalidate or intentionally misrepresent what other people are saying.
—- Steve
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I shall try to use simple words here. Yes, everyone has better concentration than they otherwise would on stimulants. Are you disputing this fact, despite scientific evidence from your friend Judith Rapoport that it is true? This is not the same as saying no one needs improvement. It means that this effect is not specific to “ADHD” sufferers, as has been claimed in the past (i.e. the “paradoxical effect.”) People point this out because you claim in another post that such an effect does occur. They are merely giving you the science to back up their claims that this effect does not happen.
No one has said that chemicals don’t alter the performance of the brain, sometimes in ways that are regarded as positive by the recipient. We are merely saying that the fact that someone likes the way a drug affects them does not mean they were ill. You may remember my illustration that alcohol reduces anxiety. Some people appreciate that about alcohol. It makes them feel relaxed. That doesn’t mean they have an “anxiety disorder” and that alcohol is a “treatment” for it. It means the drug does something they like so they choose to use it.
No one has said that disease does not cause deficiencies in the brain. What we actually said is that you can not TELL if a person has a deficiency in the brain just by checking off behavioral items on a checklist, or just by the fact that they like how they perform when taking a certain class of drugs.
Your conclusion, and in fact, your line of pseudo-reasoning, is not something anyone here would subscribe to. My personal conclusion would be more like this: Different people have different brains/bodies and different experiences in their past. As a result, they behave differently from each other and like and dislike different things and are good and bad at different things. A teacher’s job is not to identify people who don’t like how they teach and label them as defective. A teacher’s job is to modify the environment and their instructional methods to assure that all students, regardless of their personalities and preferences, are able to learn the material they need to function as an adult.
There is no doubt that people are born with differential skills. Some are good at focused attention to detail, some are not. Some have artistic gifts, others are incompetent in the area. Some understand mathematics intuitively, some struggle with it their entire lives. Some are great runners and jumpers and athletic talents. Others are clumsy and slow. That’s how people are. I would not label a person who has difficulty with or limited interest in academics defective, any more than I’d call the person who can’t play football well defective. They are different.
If we valued athletics over academics, we could come up with an “Athletic Deficiency Disorder” manifested by clumsiness, slow running, lack of coordination, and a lack of competitive attitude. We could, in fact, “treat” that disorder with stimulants, and this would allow the less athletic students to run a little faster, be a little more coordinated, and be a little more competitive. Or we could have them spend more time in the science lab, where we discover they are particularly gifted in understanding and designing scientific experiments.
Most people would consider giving kids stimulants to make them better at sports to be a borderline criminal act. We tolerate it with academics only because it is sanctioned by the Doctors who make all things OK when they say so. It is really not so different from a performance-enhancing drug for sports. Some people feel OK about it. I really don’t, especially when we know we can teach the same stuff with less stress by creating a less formal classroom setting and allowing the child more control. Unfortunately, schools in general don’t believe in giving kids control. They believe in controlling kids. So they opt for drugs instead of changing their own behavior.
Your explanation is insulting and seems kind of immature to me. I would suggest you try listening rather than automatically condemning anyone who doesn’t agree with you.
—- Steve
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I didn’t make that statement, but I can tell you that kids in foster care, clearly trauma victims one and all, are diagnosed with “ADHD” at a rate around 4 times higher than in the community. Many I have seen are first diagnosed with “ADHD,” given stimulants, react by becoming aggressive, are then diagnosed with “bipolar disorder,” are put on antipsychotics, and so forth, so that some have 5 or more psych drugs and are breaking windows and beating people up and are being removed from care and put into residential treatment facilities and so on and so on. And it is rare that ANYONE (least of all their various psychiatrists) appears to recognize that stimulants were the starting point for this deterioration and advocate their discontinuation.
Kids in foster care are generally given psych drugs at a rate 4-5 times the general population. This is clearly not because they are “genetically determined” to develop “mental disorders,” but because they are traumatized and the adults don’t know how to deal with their predictably challenging behavior.
When over half of all the teens in Massachusetts’ foster care system are on psychiatric drugs, I’d say they are being “given out like candy,” at least in this population, and continue to be given out like candy, even when they have proven ineffective or even harmful to the youth taking them.
There are, of course, people who feel these drugs have benefited them. They have discussion boards all over the web, many of them partly or totally sponsored by their friendly pharmaceutical company representatives. The kind of stories we tell here are generally unwelcome on such discussion boards. This is a place for people to explore alternatives. If you don’t want to do that, please, find one of the pro-medication boards where you will feel more at home. But don’t come here insulting our writers and posters and demanding that we give your views “equal time.” We’ve been more than patient with you, and you got a lot of very calm, rational, research-based responses to your queries, most of which you seem to have ignored completely or dismissed out of hand. If you’re expecting us to agree with your viewpoint regardless of your presentation, you’ve come to the wrong place. Please, feel free to share references to support your views, but it is less than helpful to have such an accusatory attitude toward people who are just as dedicated as your psychiatrist friend to trying to help people get better, even if you don’t personally agree with their conclusions.
— Steve
— Steve
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I agree as usual, B. There are absolutely parents who create “ADHD” symptoms with bad parenting, and such should never be let off the hook. And I have to honestly acknowledge, we made it a lot worse than it needed to be with our first, because we had no clue what we were doing and were learning on the fly. But you are so right, the biggest problem with “ADHD” and most of these “diagnoses” is that it allows the adults to pretend they “understand” a situation without having to do the hard work about figuring out what’s really going on. I just read about a kid who was almost diagnosed with Tourette’s Syndrome as the result of a bacterial infection. Good thing the mom didn’t just “trust the doctor.”
In the end, the diagnoses do far more large-scale harm than the drugs ever could.
—- Steve
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Interesting that they don’t take into account the type of care the baby receives. Many premature babies live in isolation, with lights on all day and little to no regular holding or stimulation. By contrast, “Kangaroo Care” was developed in Columbia, where the premature infant is given lots of skin to skin contact and is exclusively nursed. Kangaroo Care improves cognitive outcomes as well as a host of other improvements. Or perhaps it is more accurate to say that FAILURE to promote Kangaroo Care leads to a DECREASE in cognitive or other skills.
This is not new information. It should be universal practice, but of course it is not. Obstetrics is second only to psychiatry in its insistence on maintaining ineffective practices in the face of contrary evidence.
A brief summary of history and effects: http://en.wikipedia.org/wiki/Kangaroo_care
— Steve
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The number of rape, domestic violence, and childhood abuse victims I’ve encountered professionally who were diagnosed as “bipolar” is quite astounding. I’ve even heard psychiatrists argue that trauma didn’t really cause their suffering ‘because not everyone reacts to trauma that way, so their brains must somehow be different.’ As if there is a right way to react to being raped!
—- Steve
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And of course, the first application will be for “schizophrenics” who “don’t know they’re ill” and need to be forced to “take their meds.” Brave New World, we have arrived.
—- Steve
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Oooh, sign me up for THAT one. But what happens if your little garage doors all get stuck in the “OPEN” position? Can you say robotic overdose?
—- Steve
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Ah, so now I KNOW you are Excedrin! I have reported you for your hostile remarks.
—– Steve
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You sound remarkably similar to Excedrin, asking the same questions s/he has already had answered many times by me and others on this forum. Makes me wonder…
No one can say with absolute certainty that you do or do not have “ADHD” or any other psychiatric diagnosis, because the criteria are not objective, but are based on clinical judgment and opinion. Hence, two professionals can freely disagree in a way they could not about whether your blood sugar is too high or whether your leg is broken or whether you have congestive heart failure or cancer. Until there is some objective way to test for these “mental disorders” that allows a repeatable measurement that is not subject to personal bias or whim, the diagnosis of mental disorders will remain the collection of voodoo and sleight of hand that it is today. Which means any 5 doctors can diagnose you with any of 5 “disorders” based on exactly the same symptoms, and not a one of them will be “wrong.” Sadly, there is no examination they can do to answer your question with even a modicum of certainty.
—- Steve
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The widespread suppression of nursing in the 50s and 60s was also most likely a contributor to obesity and eating disorders, possibly due to the baby learning to self-regulate food intake early rather than having to wait for someone else to decide when and how much to feed them:
http://calwic.org/storage/documents/wellness/bf_paper1.pdf
Great article, Sandra! Love to hear your passion coming out!
—- Steve
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While I think it is great that the psychiatric inmates have gotten this right back, I think the fact that you had to fight so hard for it and that it was a “nail biter at the end” goes to show how completely unhealthy and destructive our current paradigm of care has become. Even criminal prisoners in the US have a right to daily exposure to fresh air. And anyone with half a brain knows that sunlight and fresh air are nature’s best antidotes to depression. To think that anyone would have to fight for such an obvious right and benefit for people who have done nothing wrong just shows how far we have our collective heads up our butts when it comes to providing “care” for the “mentally ill.”
—- Steve
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Excedrin is back!
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Yeah, if you live in Brazil or Nigeria. Not so much in the USA…
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I am not aware of any evidence on that. They generally don’t even do long-term studies on side effects, because no one who wants to know that badly has the money to fund it.
I think anecdotes are all we have to go on. I can imagine that messing with the dopamine system over time could have all sorts of interesting effects, including chronic insomnia.
—- Steve
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Just wait. “Obesity” was recently adopted by general medicine as a disease code. I am sure it is in prelude to prescribing “anti-obesity” drugs, and stimulants will be at the front of the line. Scary!
—- Steve
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I’ve also heard people get down on parents of “ADHD” diagnosed kids who use stimulants, saying they are “lazy” or that “basic discipline will put these kids on the right track in no time.” I can say from personal experience that this is not generally the case. The mismatch between this type of personality and the expectations of the school creates massive difficulties that are not easily addressed with even the best of parenting approaches. And there are parenting strategies that work well with this kind of child (those who seek intensity and stimulation and hate being bored or told what to do) that are not necessarily obvious or commonly known.
Again, I see this as a small minority and not even necessarily from people who are very well informed on the issue. It is not something I see on this site, for certain, but I think the group that congregates here is generally extremely well informed scientifically.
— Steve
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Just as an example, some people say, “We are making drug addicts out of our kids by giving them Ritalin!” But the science is kind of equivocal on that point. It is likely we’re making more smokers, but the jury’s out on whether stimulant abuse is any different for stimulant users. So far, there isn’t really good data to suggest that it’s more likely, though Nadine Lambert’s work suggests it is possible that they are sensitized to later stimulant abuse to some degree. Which may explain the smoking increase, though that’s also common with antipsychotics.
The biggest difference, though, is when I provide some information to someone in this movement, they are generally interested in hearing about it, or at least will modify their remarks. Unlike certain recent posters on here, who shall remain nameless, that repeat the same message over and over again despite massive evidence presented to the contrary. On the whole, I think the antipsychiatry movement is much more firmly grounded in science. Not even close, actually. Orders of magnitude more grounded.
Hope that helps clarify a bit.
—- Steve
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I am stunned that people continue to fall for this crap. Any fool knows that taking amphetamines reduces your appetite. I suppose there is some tortured logic involved in someone taking it if they are desperate to overcome these urges, but from a scientific point of view, positing it as a “treatment” is ludicrous! They aren’t even bothering to identify the problem, but as usual, calling the “symptom” the problem and selling a drug to make it go away without bothering to find out what’s going on, and of course, creating some handy addicts along the way so they’ll always have a market for their product.
Why don’t we just go back to selling Bennies as diet pills again? It is absolutely no different.
— Steve
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You are so right about that! If a loving parent is told their child will become a delinquent unless they take Ritalin, most parents will be worried and at least consider the drug as an option. If they are instead told that SOME kids with this condition are more likely to be involved in delinquent acts, but that MOST kids in this category do not, and also that the Ritalin does nothing on the average to change that probability, nor does it increase the likelihood that your child will do any better academically or in any other way, the parents will make a very different calculation. If you go so far as to tell the FULL truth, that “ADHD” is a social construct derived from these kids difficulty managing in a regular classroom, and that alternative classrooms have been shown to be a much better place for them to learn, but that Ritalin is an option that may help them “fit into” a regular classroom better at least temporarily, while exposing the child to a range of risks that could be avoided if we changed the classroom structure, I doubt that most parents would seriously consider making that leap of faith.
Truth is the enemy of toxic psychiatric interventions. I am completely OK with informed choice, at least for adults, but the key word is INFORMED!
—- Steve
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And as another scientist, I have to say that even when real scientific models (like neurological down-regulation) are utilized by Whitaker and others writing in this area, their concerns appear to be viewed as anti-science. My personal view is that “scientific anarchy” is not so much the problem as pseudo-scientific authoritarianism. And while I see this occur in the antipsychiatry movement at times, it is a much more prominent theme among mainstream psychiatrists and the institutions they inhabit and promote. Real scientists, as you point out, are always anxious to hear other points of view, or are at worse tolerant of them, knowing that science is created out of the crucible of constant skeptical review of what we know. If psychiatry wants to be viewed as an actual scientific enterprise, it needs to stop using illogical rhetorical arguments and phrases like “scientific anarchy” and show some respect for the actual DATA that they are being presented with, including the vitally important data of their patients’ own reports of their experiences.
— Steve
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Yes, and because the psychopathic “leaders” know this on some level, I think we make them VERY nervous!
—- Steve
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It’s in the product information. Insomnia is one of the most common side effects. Ritalin is also “contraindicated” for people with depression or severe anxiety, as it can make these conditions worse. I’m very close to quoting the product insert there. This is on the label, but it is systematically ignored. A good starting point might be to have your friend read the full product insert, including the contraindications.
There is also good evidence that sleep problems are highly associated with “ADHD” behavior. But they “treat” it with something that disrupts sleep. Makes sense to me…
— Steve
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I love that experiment! You should gather the data from your erstwhile classmates and publish it.
And I agree with your last – this assumption that because “ADHD” kids are miserable it’s because of their “ADHD” is tautological. We know that they are much happier being homeschooled or working in non-traditional self-paced or open classrooms. Wh aren’t we “prescribing” this kind of classroom if we’re so worried about their “happiness?” Because schools are not about happiness, for the most part, nor are they primarily about learning. They are about COMPLIANCE WITH AUTHORITY.
95% of “ADHD” goes away when the kids are no longer required to function in a traditional classroom.
— Steve
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LOL!
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Really, another shocking surprise!
— Steve
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Once again, you appear to be very out of touch with reality. Read ’em and weep:
General healthcare cost vs. effectiveness (#1 in cost, #11 out of 11 in effectiveness):
http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/
Infant mortality:
http://www.livescience.com/47980-us-infant-mortality-full-term-babies.html
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Well, since there is no evidence that antidepressants reduce suicidal ideation, except maybe in the extremely depressed, who are generally excluded from the trials, I’d say the ethical risk is pretty low. Actually, there is little to no evidence that antidepressants are even effective in children, and there is definite evidence that they INCREASE the likelihood of suicidal feelings and acts in those who didn’t have them before. The only one even approved for under 18 is Prozac, and that was based on one single study that has been roundly criticized in hindsight.
So perhaps the real ethical question is why we would give antidepressants to children at all?
—- Steve
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Shhh! Start talking like that and people will get CURED, and what will they do for clients then?
I will watch that video. But if people like you and me know these things, there is no excuse for the bigwigs not to know them. Which means they really do know them and are very intentionally lying. Which kinda pisses me off!
—- Steve
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I reiterate: alcohol works great to reduce anxiety. Many people use it, swear by it, find it helpful. It is not treating a disease, it’s just helping them relax. The condition of BEING ANXIOUS exists and alcohol eases that condition.
The condition described by the “ADHD” criteria also exists, because it’s a description. People who fit that description are more able to pay attention, stay focused, whatever you want to call it, on stimulants, just like anyone else. Similarly, people who are anxious are able to relax, be more social, worry less, etc. if they’ve had a couple of drinks. Completely analogous situations here. Calling the one condition “ADHD” is just a way of naming people who find concentration/organization, etc. challenging.
Perhaps a better analogy: stimulants make people eat less and lose weight. Some people have a “condition” of being overweight. Taking stimulants can make them less overweight. But being overweight isn’t a disease state. It’s just a description of a person who is a good bit fatter than average. Skinny people would lose weight, too, but they wouldn’t be interested in losing weight because it’s not a problem they want to solve.
I am thinking you are going to be unable to understand this because of your worldview, but just because a drug makes something “better” in the sense that the person likes the effect doesn’t mean they were “ill” or that the drug was “treating” something. Unless you think that people who go down to the bar to relax after work all must have some sort of “excessive tension disorder” and require medical treatment, saying that the drugs “improve a condition” is almost tautological. The drugs do what they do. Some people find it helpful, some don’t. That does not in itself make the condition maladaptive or medically relevant or requiring “treatment.” Remember, the same kids also find the open classroom improves their condition dramatically. Does that make an open classroom a medical treatment?
—- Steve
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Why would you not believe them? What interest would someone have in coming to that site other than informing others of their experience?
Perhaps the more important question is why would be inclined to assume they are lying, just because their experience doesn’t comport with your own? Perhaps you are not being as objective as you would like to believe?
—- Steve
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Goebbles and Torrey would have agreed on many points.
And even if it’s true, which I seriously doubt, Columbia and India and Nigeria still kick our ass by a factor of 2 with very little use of antipsychotics. If my data is correct, we’re talking 4 times better recovery rates in these “primitive” cultures who have not yet seen the wisdom of drugging people who behave differently than the scared “norm.”
— Steve
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I have covered this already. They have the same kind of impact on anyone, because they are stimulants and act like stimulants. If a person is looking to be better able to concentrate, stimulants will do that, just like drinking alcohol will reduce your anxiety levels at low dosages for most people, regardless of “diagnosis.” The fact that stimulants increase concentration levels proves nothing except that the person who wants that outcome will get it. The problem I have with this is that 1) kid get no sayso about whether they take them or not, 2) informed consent is almost non-existent, as people bandy about mythology about stimulants having positive long-term benefits that they don’t have, and 3) the stimulants have a side effect profile that can be very serious in some cases, including anxiety, depression, and psychotic symptoms (which is almost never shared with the client/patient). And we know that there are other approaches that work better, such as a less rigid classroom structure that allows more movement and decision making. So why spend so much time and money promoting a drug that has short-term effects that are viewed as beneficial, but has no long-term benefits for the group as a whole and has risks that could otherwise be avoided.
My own kids are proof that the alternatives I’m talking about can work. There are others who have done the same, and I think our testimonials should carry as much weight as those from folks like you who found stimulants to be remarkably helpful. A look at Jonathan’s site should easily convince everyone that stimulants are not always benign, and that the adverse effects in some cases are pretty dramatic. Why not look at alternatives? My experience says that attentional skills can be learned with the right approach, not easily, but they can be taught and learned. That’s where I think the emphasis needs to be placed, because a learned skill can be practiced and developed over time, whereas a drug can only be consumed with the hope of this outside agency providing relief. The skill-building approach is more empowering, and I believe much more likely to lead to the improved outcomes we’re all looking for.
—- Steve
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I was also disappointed that there was no mention of the WHO studies in the 90s showing much higher recovery rates in countries using less antipsychotic drugs. It seems he hangs his recommendations on that one study, rather than looking at the entire database on recovery.
—Steve
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Citation please? I have understood it is closer to 10-15%.
“Sustained recovery occurs in less than 14% within the first five years following a psychotic episode2 ” [http://www.nimh.nih.gov/about/director/bio/publications/rethinking-schizophrenia.shtml]
— Steve
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Jeez, I guess this guy doesn’t read my posts at all. It has been shown in every review since 1978 (the first was done by none other than Russell Barclay himself) that stimulants DO NOT REDUCE THE LIKELIHOOD OF CRIMINALITY in “ADHD” youth. There is NO DATA, NONE, to show that kids given ADHD are less likely to be delinquent or to be jailed as adults. It is a fantasy.
Additionally, most psychiatrists agree at this point that giving SSRIs to people with bipolar diagnoses is probably a bad idea, as it makes it more likely for manic episodes to happen. Manic episodes are clearly stated side effects in the product information for SSRIs.
Finally, the WHO studies both showed unequivocally that employment is much more likely ( 60% or more) for those diagnosed with schizophrenia in developing countries who are less reliant on drugs for treatment. Whitaker also cites studies showing the social recovery rate for schizophrenia in the USA in the 50s (pre-Thorazine) to be much higher than today. Whatever your beloved drugs are doing, they aren’t saving people from the disability roles.
Your “facts” appear to be fantasies that you really need to be true. You should really read the book before you bother to comment. You have a lot to learn.
—- Steve
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Too true. Alcohol is an awesome anti-anxiety drug. But I wouldn’t prescribe it as a “treatment” for “anxiety disorder.” Just because something makes you feel better temporarily doesn’t mean you’re sick or that you just received “treatment.” That substances alter our emotions and perceptions is not new information, but messing with consciousness is not a form of medicine.
— Steve
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The real political mission of psychiatry appears to be to deflect all criticism of the status quo as “mental illness” and to medicate anyone who isn’t willing or able to play ball, so the rich can get richer and the rest of us can shut up.
One guy in there does a good job of outlining the major schism between what is known about adverse social and emotional environments and “mental health” vs. the biological model. But he really doesn’t address the social-political-financial reasons this split with reality has occurred and continues to thrive. Without addressing corruption by pharmaceutical dollars and competition for “market share,” any analysis of psychiatry will fall short of addressing what is really going on.
—- Steve
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I don’t get why it is legal to prescribe a drug that has little to no positive effects for children and known severe side effects. It makes no sense whatsoever. Should be a crime. It is a crime, but it should be illegal and punishable by prison and loss of medical license.
— Steve
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Wow, great site! I think it does a great job of demonstrating the tradeoffs. So many people talked about being socially withdrawn or irritable and hostile. Interesting that one person mentioned feelings of superiority…
I’d think real informed consent would involve having someone read a site like this and consider what the possible pros and cons are. Clearly, some people felt it benefited them, but some of the other stories are quite harrowing. It seems to show a thin line between successful treatment and the development of OCD, and there are a number of people talking about feeling great initially but having the effects wear off over time, very much in line with our knowledge of stimulants as addictive substances.
This really supports Johanna Moncrief’s view of these agents: they are drugs with nonspecific effects. Some people find these effects helpful, some don’t. They are not a “treatment” for a “disease,” if only because their effects are so unreliable and variable that for each person who calls them a “miracle” there is another who says “they ruined my life.”
Thanks for sharing this link!
—- Steve
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Thank you, Donna. Your words leave me feeling both warm and humbled. It is an honor to be a part of this community.
— Steve
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“I think you have ADHD, Steve. ” Sounds like a diagnosis to me. And I don’t think this guy really understands the meaning of the word “condescension.” “Characterized by a patronizing or superior attitude toward others.” If the shoe fits…
—- Stefve
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I am currently renting rooms to a former foster youth who was on Adderall for 8 or 9 years. I just talked to her about this last night. She describes Adderall leaving her feeling like a zombie, having no emotions, and feeling trapped. She did not feel she had a choice whether to take it or not, and attributes some of her wild behavior in her mid-teens (including cutting on herself) to trying to get her emotions back from her zombified state. She said it did help her concentrate on one thing at a time, but this also had a negative side effect of having her stay focused on some of the bad experiences she had while at home and in foster care and being unable to redirect her attention to something else.
She was in an emotionally abusive foster home for most of those years, but of course, no one ever asked her about why she had a hard time concentrating or what her home life was like, because they “knew” that her difficulty concentrating was due to her “ADHD” and no other reason was ever considered.
She said she hated Adderall with a passion and would never take another psychiatric drug as long as she lived. She said she liked being able to feel things, even if they are hard feeling sometimes, and she needed to feel them to work through them and to heal. She is a hard worker and has a great sense of humor and also has gained a lot of insight into people and social situations as a result of some good therapy and her own hard work on gaining personal enlightenment. Drugs were not a part of her healing; she saw them as a barrier to her healing and learning how to let go of her past.
For every “success story,” there is another story like this one to balance it out. Stimulants are not a panacea – they are a short-term symptom relief measure that works for some people, and makes some people’s lives worse. Some people like the effects – more power to them, as long as they understand the attendant risks. But acting like they are some miracle cure for anyone who has trouble paying attention in school for whatever reason is absolute nonsense. These drugs are quite capable of doing serious emotional harm, and they also often prevent adults from looking deeper for causes and possible solutions to their children’s behavioral challenges.
—- Steve
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Well said. The biggest problem with this phenomenon is that giving the “ADHD” label provides license for the adults to blame the kids for acting in a natural way, instead of reconsidering the bizarre and developmentally inappropriate expectations we are putting on them. I remember Kindergarten being about finger painting and singing the ABC song and reading stories and PLAYING! Now they expect kids to READ by the end of Kindergarten, and some even have homework!!! I never saw homework before fourth grade. It’s ridiculous what we expect of kids. They’re supposed to run around and tease each other and jump from one activity to another when they’re bored. They aren’t supposed to sit still and all do the same thing at the same time without complaint. It’s time we stopped blaming kids and started looking at our own behavior.
—- Steve
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The writer should know that response to stimulants is not a valid way of diagnosing “ADHD”, even within the accepted DSM heirarchy. Judith Rappoport disproved this back in 1978 by giving stimulants to “normal” teens, and found the exact same response to low doses of stimulants: decreased motor activity, narrowed focus, reduced distractibility. She called the believe in the “paradoxical effect” an “artifact of observation,” because people were LOOKING for a change in those features and were happy to find it. Whereas in a “normal” child, such a change is not particularly noticeable because no one felt these kids were overactive or distractible to start with.
Bottom line, stimulants are not specific “treatment” for “ADHD” and don’t affect “ADHD” diagnosed people differently. They are general stimulants and affect everyone’s brain in pretty much the same manner. It is unfortunate for the writer to be indirectly implying this discredited myth to be true.
— Steve
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But wait, I thought that we had somehow proven that sugar doesn’t cause hyperactivity – it’s all genetic, right?
I agree, waste of money, but it’s good to have scientific validation to counter the constant onslaught of propaganda saying “ADHD is not caused by diet.”
Related question: why do they allow these drinks to be sold in schools? (Answer: the schools make moneh off of it!)
— Steve
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More condescension. Please quit referring to “my ADHD.” I don’t have any and don’t want any diagnosis, especially from you.
They are still using averages. Give me a link to the research if you have one – all I found was a summary and it seemed that Rappoport was pretty cautious about overinterpreting these results because there was no specific finding for individuals that was consistent. I respect Rappoport’s work and was not accusing her of being a hack. She was one of the ones back in the 70s studying open classrooms and found that there was a dramatic reduction in “ADHD” symptoms without medication if kids spent a year in an open classroom. She also disproved the “paradoxical effect” theory with finality. She’s one of the more honest researchers in the field, though I have to say the bar seems kind of low sometimes.
Averages aren’t diagnostic nor do they prove anything except that some people are different than others. I haven’t even launched into my “genetic differences don’t mean an illness” speech yet. Men and women have very different brains. They’re supposed to. I bet women have better dopamine transmission on the average. Doesn’t mean men have “testosterone poisoning.” Genetic diversity is the core of species survival. Read up on population genetics some time. People should be allowed to be different from each other. Difference does not equal disease, especially when you’re dealing with averages.
— Steve
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Sorry, it’s condescending to “diagnose” another person in my view. If you wanted to be complimentary, you’d simply state what you observed to be my strengths. This is one of my objections to diagnosis – it comes across as a power play, that you somehow “know” something about me that means you can categorize me in a little box. Well, I reject any boxes or categorization. I see many strengths in most of those who get put in this box, but I don’t tell them about the box, I tell them about the strengths, as well as encouraging them to address the challenges they may face.
I also find it condescending to believe you can identify the source of a person’s pain or passion. It’s more polite to just ask them.
— Steve
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And how can you measure “effectiveness” when you don’t even know what you’re trying to accomplish?
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And BTW, you know bupkis about my career and what I have achieved. I won’t bother with details, but just add that once again, you are 100% wrong, I’ve been extremely successful at almost every job I’ve ever had, and I am very proud of the many things I’ve accomplished over the years, including being a published author and getting a law passed to protect foster kids from condescending professionals who think they can “diagnose” and drug them without bothering to find out who they are or why they behave the way they do.
Please save your diagnoses for someone who is sufficiently deluded to give a rip what you think.
— Steve
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The study reports averages over the cohort. Not everyone studied had low dopamine transmission. And including 53 non-medicated adults doesn’t help unless you compare them to the stimulant users. And you’d have have medication naive people, not just current non-users, because earlier use could have disrupted the dopamine system (since that’s what stimulants DO).
Sorry, inconclusive.
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Stimulants increase dopamine flow. Anyone familiar with the basics of amphetamines knows that. The question is whether increasing the dopamine flow does anything helpful in the long run. Science says it doesn’t make a difference. And it probably makes the dopamine situation worse, if there is such a situation to begin with.
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My last response to you: Kids in free academic settings learn a ton. My oldest and youngest went to such settings, both graduated with honors from HS and the youngest is currently attending Evergreen State College and is incredibly engaged in his own education. The oldest is a website developer and trainer and makes a solid salary, and has been lauded as an employee everywhere he’s worked. Both fully met the “ADHD” criteria as kids, neither experienced a milligram of stimulants, both are very successful adults. Colleges are actually very anxious to accept kids who are homeschooled or educated in open settings, because they are much more self-motivated. From what I recall of academic testing results, these kids didn’t do as well as “standard” classroom kids at 4th grade, but were caught up by middle school and exceeded their “standardized” peers by high school. You are again operating off of bias and “conventional wisdom” without looking at the other side of the issue.
It is also scientifically extremely tacky to criticize a study based on how long ago it occurred. The periodic table of the elements was fleshed out in the 1800s. The Rutherford Gold Foil experiment showing atoms to be mostly space was performed in 1899. Atoms still are mostly space over 100 years later. And “ADHD” kids still do better in open classrooms, despite your bias against them, 40 years later. Again, you only want to say things that support your own views. I’m not playing any more, but I want to make sure people see what you’re really up to here, which appears to be to argue and discredit anyone who disagrees with you.
I’ll close with the fact that those who claim “a mountain of indisputable information” are usually ones who are trying to disguise the lack of actual foundation for their arguments. I’ve addressed your claims above, as have others. Your mountain is by no means indisputable, because I and Michael and many others have plenty of data to dispute it. That you are able to blithely dismiss anything you disagree with does not help your case. Perhaps you should open your mind and listen instead of preaching the “c0mmon wisdom” to those who know better.
—- Steve
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Your condescending attitude marks you out as a “true believer” in the psychiatric religion, and as such, I don’t expect you will every be able to hear anything that doesn’t fit with your DSM “bible” and your psychiatric priesthood.
You also don’t appear able to read very carefully. I am not talking about whether the “symptoms” continue to adulthood sometimes, which I would not argue with in the least. I’m observing that yet another large-scale, long-term study shows that kids who get stimulants don’t do any better than kids who don’t get stimulants. They are a short-term symptom-reduction strategy and nothing more.
The authors clearly state that the differences are a result of averaging and that you can’t assume any individual would have these characteristics. So we are unable to even clearly define who “has ADHD”, and the “treatment” doesn’t make any difference in the long run on the average. Again, why are we “treating” millions of kids with these stimulants on the basis of such sketchy science?
Additionally, you don’t bother to respond to the obvious “diagnostic” issue – if ADHD is purely biological and distinguishable from other “disorders,” why is it so much more common in people who have been traumatized in childhood? Are you suggesting that “ADHD” children are causing themselves to be abused by adults? Or is it just possible that being traumatized can cause “ADHD” symptoms that are indistinguishable from biological “ADHD?” In which case, what is the difference?
I do have a deep, deep source of pain in my life, but it is not because I have “undiagnosed ADHD.” It’s because I see the wasted potential for positive interventions in kids’ lives, like open classrooms and positive adult supporters and the freedom to explore what drives them, because people like you dogmatically insist on having all kids marching along dully to the same boring curriculum, day after day, week after week, year after year, leading to increasing dropout rates and disaffection with society. The pain is because I see people like YOU pathologizing kids and adults for being “bright, passionate, and big hearted” as you put it, instead of critiquing the social institutions that are designed to snuff out passion and big hearts like mine. I feel sorry that yours has apparently been completely smothered.
Your arrogance to assume the ability to “diagnose” me based on a few posts is simply beyond the pale. I don’t have words to describe how disgusting I find that behavior. I am not prepared to “diagnose” you just because you annoy the crap out of me with your dogmatic narrow-mindedness, but I am prepared to ask you to keep your presumptuous and insulting “diagnoses” to yourself in the future! I can only assume that you haven been deeply hurt yourself and I hope you are able to find a way to heal, but insulting me while saying you don’t mean to isn’t a likely path to healing.
— Steve
P.S. I was a very compliant and hard-working student in school, even though I hated it and was bored out of my mind. I was the farthest thing from “ADHD” that you can imagine. Not that I need to defend myself, but your assessment, besides being inexcusably arrogant, is 100% wrong!
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That stuff about “ADHD” kids reacting differently is complete nonsense, btw. Judith Rappoport et al disproved that back in about 1978. I am glad it worked for him. We chose to take a different path for our boys, and they are also doing quite well as adults.
So, Excedrin, when you say “We don’t drug kids to make money,” who are the “we” you are talking about? Because there are lots of docs who would not fit into that “we.”
Also, the insulin-for-diabetes analogy is a pretty weak one, since we aren’t providing controlled and carefully titrated dosages of dopamine to kids after measuring a specific shortage. We’re firing a dopamine shotgun at a speculative target and hoping it does more harm than good, IMHO.
— Steve
— Steve
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No problem identifying problem issues young and addressing them. The problem is that by calling it “ADHD” and a “mental disorder,” the tendency is to pathologize the child rather than addressing the issues at hand.
For example, it’s by now pretty clearly established that kids with the “ADHD” label do better in an open or informal classroom where they have more control of what they do when. But you NEVER hear any of the lead researchers talk about this option, even though many parents (like me) discover that this is a much better option for their kids. Such classrooms would be a welcome addition to the mix of options for kids in elementary school, but they are seldom offered or available.
I’d be the last to deny that some kids are harder to raise than others, and need more specific assistance early on in their lives, as I raised two of them. But being difficult for adults doesn’t make a kid mentally ill. And giving it the “ADHD” label (as well as providing the option of drugs) allows parents, teachers, and clinicians off the hook for trying to do something more specific to help the individual child succeed. And the child is the one who suffers when the adults are let off the hook.
—- Steve
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Joseph Biedermann would be one clear-cut example. He was sanctioned briefly by his university, but is apparently back at work full time. He promised Eli Lilly that he’d deliver a positive study result before he even did the study! He is certainly not alone in his corruption.
There are no doubt many others who aren’t explicitly working for a pharmaceutical company, but who are influenced deeply by how things are framed in these discussions and what kind of results are easily accepted vs. what kind of results will lead to controversy. This is a lot harder to track, but it’s clear from reading about the experiences of people like David Healy and Peter Breggin and even Alan Sroufe that psychiatrists who don’t follow the “party line” will frequently be attacked professionally.
—- Steve
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They also seem “surprised” to find that PTSD rates are much higher among the “ADHD” population. I am not at all surprised, since PTSD symptoms overlap extensively with ADHD symptoms. I work in foster care, and a highly disproportionate number of traumatized kids get labeled with “ADHD”. There is literally next to no way to distinguish them from each other. But since they want to believe “ADHD” is entirely biological, they are somehow “surprised” to find that trauma is highly associated with “ADHD” traits. This should, of course, call the entire diagnostic approach into question, but naturally, the facts are conveniently “explained away.”
—- Steve
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To wit, from the link in Michael’s post below:
“Researchers also found surprising results regarding the effectiveness of medicine in treating ADHD. In contrast to children in United States, youth in northern Finland are rarely treated with medicine for ADHD, yet the ‘look’ of the disorder — its prevalence, symptoms, psychiatric comorbidity and cognition — is relatively the same as in the U.S., where stimulant medication is widely used. The researchers point out that this raises important issues about the efficacy of the current treatments of ADHD in dealing with the disorder’s long-term problems.”
Those results were not surprising to me at all. That’s what the long-term literature has been saying since at least 1978.
— Steve
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First off, these statements about 3-year delay in development are not based on any clear science that I am aware of – I’d be interested to see if you have a link to a real review of the literature, rather than an opinion piece or a single study. Second, any such estimate is undoubtedly the product of averaging and norming, as there is nothing close to a definitive “test” for “ADHD.” Third, I’d be interested in seeing/hearing whether those with delayed maturation are controlled for stimulant use, as stimulants are known to cause alterations to the brain, even at low doses.
Fourth, and perhaps most importantly, it appears that the “ADHD” brains do, in fact, catch up in time, according to this three-year delay theory. Combined with the clear but generally unacknowledged fact that 50 years of research have failed to show long-term stimulant treatment to convey any advantage in terms of long-term outcomes, how can we possibly rationalize drugging millions of children annually, down to preschoolers and toddlers, when we know that the “treatment” won’t make a difference and that the kids will eventually mature out of it anyway?
—- Steve
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Andrew, you’re a beautiful writer. Well said, and I agree 100% with every word!
—- Steve
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Hi, Sera,
I, too, have suffered from “oversensitivity,” for me in the emotional realm. I was told many times as a kid that I was “too sensitive” or that I encouraged bullying by reacting emotionally to it. It appears that sensitivity is a curse in modern society, and the people who do best are the most insensitive. That doesn’t make a lot of sense to me.
Now, of course, I’m a social worker and volunteer manager, and my sensitivity is an incredible strength that makes me exceptionally good at what I do. So is it good or bad? Or is the general insistence on people judging other people’s experience as “good” or “bad” the real problem?
—- Steve
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No, hating your job isn’t a cause of depression – you hate your job BECAUSE you “have depression!” Apparently, if we healed all of these “disorders,” no one would hate their job, or feel out of control of their relationships, or wonder what the point of life really was. Everybody would always be happy no matter WHAT happens. (Well, unless someone died – then we’d be upset for no more than two weeks and be back to normal!)
Welcome, Stepford Wives!
—- Steve
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Those poor, poor psychiatrists, once again picked on by the NYT. just because they prescribe drugs for conditions they don’t understand and claim to be scientific. I thought it particularly rich that Liebermann accused the author of “equat[ing] symptoms with illness,” when that it exactly what the DSM does from page one onward. I was frustrated I could not make a scathing reply, even though I was logged in. Maybe you have to be registered as a medical professional to comment or something. The comments were pretty offensive to me. One would think the fact that there is such a thing as an ‘antipsychiatry’ movement would give one pause – have not heard of an “anticardiology” or “antiimmunology” movement recently…
—- Steve
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Richard, all I can say is “Hear, hear!” Love the passion!
—- Steve
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I love Giovanni Fava – he is a real scientist. I am so glad to hear this stuff finally making it into the mainstream literature. In maybe 15-20 years, prescribing psychiatrists might even figure out that they need to worry about this. Sorry, I’m cynical at this point…
— Steve
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Blake, buddy, I’m getting tired. You talk like you’re open minded, but you really aren’t.
I made myself clear – it is the school’s job to figure out what works. That’s what they’re paid for. If there is something medically wrong with the child, like he’s had a head trauma or can’t see or hear well or is malnourished, by all means, he should get an assessment, but if he “can’t pay attention,” it’s the teacher’s job to motivate him. If they can’t or don’t care to bother, they don’t deserve to be called teachers. Anyone can assign work to someone and grade it. Real teaching is an art and it involves addressing the needs of each learner. It’s not the child’s fault that we have developed a factory-style school system that is too impatient and authoritarian to care for his needs.
The open classroom is the ideal scene for most ADHD-diagnosed kids. But since ADHD is a fiction and doesn’t reflect an actual group with the same issues, it won’t work for every one of them. But it will work for a hell of a lot more of them than the standard classroom. So tell me, Blake: why don’t we have this kind of classroom for this kind of kid.
The citations you requested: Jacob, J.G., Oleary, and Rosenblad, “Formal and Informal Classroom Settings: Effects on Hyperactivity;” J Abnormal CHild Psychol 1978 6, P. 47-49.
I have given you enough information for you to easily conclude that open classrooms would resolve 90-95% of “ADHD” cases, and yet you persist on harping on the one or two kids out of 100 who won’t do well in this environment. Shouldn’t you be focusing on why the school system doesn’t care enough to create this kind of school classroom for kids who need one? What does it say about the intent of those schools? What does it say about the intent of the psychiatric profession that they aren’t “prescribing” this kind of classroom?
I’ve done my part. It’s your turn. I’m not going to try and convince you if you don’t want to question the “ADHD” paradigm. I’m sorry it’s hard for you to learn that this paradigm has some gaping holes in it, but I can’t make you feel better by pretending they don’t exist.
Good luck, and don’t believe everything the professionals tell you.
—- Steve
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I don’t disagree with you, Duane. My issue is not that there are no cases where physiology causes what we think of as “mental disorders,” it’s only that we can’t say with any accuracy that based on BEHAVIOR or EMOTION or THOUGHT, we somehow KNOW there is a biological problem. A person with sleep apnea should be diagnosed and treated – for sleep apnea, not for some fictitious “bipolar disorder.” Same with B vitamin deficiencies. Psychiatrists almost never check for anything other than the “symptoms” that define the “disorder,” even when their own drugs are the cause of the “imbalance” they are now ostensibly treating.
The biggest problem with the DSM is NOT the drugs – they are a consequence of the warped thinking behind it. The biggest problem (scientifically speaking) is the lumping together of people with a wide variety of conditions, some physiological and some psychological, and people with no condition at all, and claiming they all have the same “disorder,” when the only thing they have in common is a set of symptoms. It would be like treating everyone who has a rash in the same way – topical steroids for all, whether it’s poison ivy, measles, or syphilis. It prevents any actual research into the real causes such as the ones you are presenting.
Hope that clarifies things. I don’t agree that therapy is the right thing for everyone. It depends on what problem you’re trying to solve. Real diagnosis means finding CAUSES, not simply categorizing things in ways that make someone’s product more marketable.
Appreciate your comments, as always.
— Steve
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But the second question is how to get those involved in the system to pay attention to the actual science that is known.
Some examples: 1) the ‘low serotonin’ theory of depression was discredited in the early 80s, before Prozac came to market, yet millions of doctors continue to promote this discredited theory.
2) Parents by the millions are told that “untreated ADHD” leads to delinquency, drug abuse, school failure, and vocational instability, despite the long-standing and consistent research finding that stimulant treatment does nothing to improve any of the listed outcomes.
3) SSRIs were known to cause suicidal thinking and attempts as well as aggression as far back as 1987, and Prozac was temporarily not approved in Germany for that very reason, yet it took until 2002 that the “black box warning” made its way onto the label, and there are still many researchers and “thought leaders” who deny this is an issue and disingenuously blame a temporary surge in teen suicides (which started before the warning and did not appear to be correlated, yet alone causal) on reduced AD prescriptions in teens.
I could go on. This is more than a problem with science vs. pharmaceutical company marketing. There appears to be a high degree of disease and drug marketing occurring WITHIN THE PSYCHIATRIC PROFESSION AT THE HIGHEST LEVELS. And people who raise these scientific issues, even insiders like David Healy, are accused of heresy and blackballed by the profession. And the media continues to trumpet these untruths and helps organize attacks on those who have the courage to demur from the “conventional wisdom.”
I only wish the absence of the juvenile marketing agents would solve the problem. I think it’s more akin to the scientist having an abusive partner who hangs up the phone on her every time she tries to make a call to someone who would want to hear what she has to say. It’s more than just marketing – there is bullying going on here by people who stand to lose big bucks if the truth comes out!
—- Steve
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And temporary symptom reduction is not in any way synonymous to healing.
— Steve
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You don’t seem to be accounting for the problem of whackadoodle diagnosis through the DSM. According to your criteria, alcohol is a treatment for an anxiety disorder. It reduces the symptoms, and could be prescribed only to those who benefit by ethical prescribers. I’m not saying alcohol doesn’t address anxiety – it does, and better than the benzos, in my opinion. Dosage control is a bit of a problem, but it is with benzos as well. I have no problem with recommending a snort of brandy before a plane flight for your anxious flyer mentioned below, and I guess no real big problem with a benzo, either, given informed consent. But that’s basically just a substance to reduce the anxiety temporarily, not a treatment for a “disease.”
Perhaps you are taking a “Moncrieffian” view of these drugs – a drug-based rather than disease-based paradigm? Otherwise, it seems your argument sinks very quickly in the quicksand of DSM diagnostic chicanery.
— Steve
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As usual, I agree 100% with what you said, and was thinking similar thoughts before you voiced them!
—– Steve
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My point is that we should provide the kind of instruction that works for the kid involved, rather than trying to change the kid to fit our instructional style. If the coach lecturing his football player doesn’t work, he should take him aside and show him, or have another kid show him how. My youngest, Kevin, learns soccer mostly by watching videos and trying out the things he sees. Probably doesn’t get a lot from coach lectures. Oldest was even more that way, but both are absolutely amazing athletes and learn what they need to learn on the job. “Kinesthetic learners” is the term they use in education. Look it up.
For the odd child who can’t make it in an open classroom, you come up with another plan that works for him. But don’t you think it would be marvelous if you could “heal” 95% of “ADHD” by simply reorganizing the classroom to a style that works for the child? The other 5% probably have more serious issues going on at home – abuse, neglect, domestic violence, or whatever else, and may need more specialized attention. So we provide it to them.
Teachers are paid to be experts in teaching. They should know how to approach kids who learn differently. They should be able to recognize and build on strengths. They should know how to use positive behavior management to encourage success. It’s not my kid’s job to change his personality so the teacher’s job is easier. It’s the teacher’s job to find a way teach my kid.
“ADHD” is just a way of describing a kid that is annoying for adults to deal with. While there COULD be something wrong (low iron, sleep apnea, thyroid issues, etc.) that is causing or contributing, just being active and impatient with boredom and having a hard time concentrating on someone else’s agenda is not a disease. Kids are all different. They’re supposed to be. That’s the challenge of being a teacher. If someone doesn’t like that, they should choose a different profession.
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Key proviso: these are AVERAGE findings on the group as a whole. It is not true that each individual with an “ADHD” diagnosis has this pattern, hence, we can’t assume that dopamine transmission issues are causal.
Second proviso – no information on the medication status of the people being scanned. Using stimulants over the long term has long been known to reduce the density of dopamine receptors in the brain. This is observed with both amphetamine and cocaine abuse, and is called “neurological down-regulation.” It is responsible for the development of tolerance to a drug with regular use. Anyone who has used stimulants extensively over time, even at “therapeutic” dosages, would be expected to have a lower density of dopamine receptors. This is a meaningless experiment if it’s not done on drug-naive subjects.
Additional point: If low levels of dopamine receptors really is the cause of all or even some cases of ADHD, prescribing stimulants appears to be long-term counterproductive, based on what I just said above about down-regulation. This may very well explain why stimulants seem to “work” in the short term but produce no better results in the long run – kids taking stimulants are going to have their dopamine receptor density REDUCED over time, rather than increased, as would seem to be indicated by the direction this study is suggesting.
Bottom line: “Swanson SPECUTLATED that people with ADHD may even have a net deficit of dopamine.” This is speculation. It proves nothing. And honestly, even if it did, it does not suggest stimulant treatment as a long-term solution, because stimulant treatment will bring about a worsening of the supposed causal conditions.
—- Steve
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Sorry, it was in 1978, but I now left my reference at home! Thanks for the reminder, I’ll get it to you. There was also one in 1976 by Judith Rappoport, et al, that showed kids in an open classroom having dramatically reduced ADHD symptoms after a year in that kind of environment. I’ll get you that one, too.
—- Steve
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Zombie like states? Isn’t that like saying that drinking alcohol makes you drunk? I thought inducing inertia was the whole point. Being a zombie is not a side effect – it’s what they DO!
— Steve
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I suppose you make my point for me to some degree. “ADHD” is not an entity, it’s a heterogeneous collection of people so labeled because of social expectations. (Notice that there is no “hypoactivity disorder?) This particular way of being can make it harder for a kid to succeed in the pathway our culture expects him/her to travel. For some of these kids, they are motivated and can use their intelligence and drive to come up with ways to overcome their difficulties in organization and focus. In other case, they don’t care about going to college and do other things instead. Why is that wrong? My brother, Jim, was a pretty classic ADHD case. Never liked school, always dabbling on the edge of trouble, liked riding motorcycles above the speed limit – definitely a risk-taker and not an academic type. My high school still had voc ed and he learned to be a mechanic – work with hands, lots of noise and moving parts and power, practical results he can put his hands on. He now owns a garage and earns three times what I do annually. He found his niche.
Not everyone needs to go to college. It’s a cultural bias that is rampant in our schools (unless you’re black, of course, in which case, you’re not expected to do much but fail), but it is not based in reality. School as designed doesn’t work for some kids. That doesn’t make the kids “disorderd” or “disabled.” It suggests to me that the school, who is being paid to teach them, needs to take another approach.
And while there may be an odd kid who can’t function in an open classroom setting, they appear to be extremely rare in the “ADHD” diagnosed population. This setting works for most of them with zero medication. So you can eliminate probably 95% or more “cases” of ADHD just by changing the educational approach. Seems worth a try, don’t you think?
—– Steve
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That’s a good way to eliminate the objection that ADHD is not really a singular disease, by eliminating all possible alternatives and saying “If that’s the problem, it’s not ADHD.” Kind of a scientific cheap shot. The fact is, ADHD is not objectively distinguishable from a number of other conditions based on the criteria provided, nor is it particularly distinguishable from normal childlike behavior. Until there is a way to know who specifically “has ADHD” and who has something else and who has nothing but a boring classroom or incompetent or abusive parents, it really is nothing more than a description of kids who the teacher/parent finds annoying.
—– Steve
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I am about to give a talk on that subject this very evening. There are many, many things that can be done besides overcontrolling rigidity. In fact, a structured degree of flexibility seems to be a much better way to proceed, hence the effectiveness of the “open classroom” I described in another thread. Power struggles are to be avoided at all costs. Putting the child in a position where s/he has to think about consequences and about others’ feelings in order to get what s/he wants is also a very powerful approach. The key is to teach them the skill and value of planning and forethought without crushing their exuberant spirits.
All these kids who are so labeled have in common is that they are looking for extra stimulation. We can provide it artificially through drugs, or we can provide a stimulating environment where they are challenged to learn to overcome the drawbacks of their particular personality traits. All personalities have pros and cons to them. The trick is to use the strengths to overcome the challenges. It can be done, because I’ve done it with my own kids. Twice, even. But non-traditional classrooms were an essential part of the plan.
—- Steve
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A really good therapist never tells you what the problem is. That’s perhaps my biggest of many beefs with psychiatry – they are so arrogant that they think they can tell a person what is wrong with them and what will help. A good therapist is humble – they know that the client is the one with the answers, and their job is to work to help the client get those answers to the surface, rather than telling them what to think or believe about themselves. But I’d say 80-90% of counselors don’t manage that adequately. It requires being willing to sit with the client in uncertainty and discomfort and not blurt out an answer that makes you feel more comfortable at their expense.
—- Steve
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There was actually a diversity of opinions in the Comments section, as well as a few stories from survivors who got clear of the system. I added my two cents worth. I encourage others to do so as well. I thought the article did a great job of showing how dehumanizing it is to be viewed only through the lens of your “symptoms.” And the psychiatrist came right out and said, “Medication is all I have to offer.” It’s good for people to hear that is the case, as lots of folks go to psychiatrists thinking they’ll get therapy.
Definitely worth the read.
— Steve
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“It” exists, because “it” is a list of behaviors that make it inconvenient for these kids to function in a standard classroom environment. Being artistically talented exists, as does being athletically clumsy and being short or being fat. Fatness is a good example. Some people are more likely to be fat because of genetics. This can be enhanced or reduced by exercise, diet, and other environmental factors. Fatness is more common among poor people and among those who are abused as children, so there are clearly stress-related variables, but some people don’t get fat regardless of stress or diet.
Does that make “fatness” a disease? Or is the genetic variation in body weight a natural distribution of genetic traits that might be beneficial to the species? Fat people, for instance, are more likely to survive a famine, while the skinny ones die off. On the other hand, the skinny ones are probably better runners and hunters, and the fat people might die without them.
A wide range of genetic variables are important for species survival. Just because something is partly genetic doesn’t make it a disease. Read what I wrote about the open classroom. Why aren’t we creating classrooms that work for these kids, instead of forcing the “square peg” into the “round hole” of a standard classroom? It’s not the peg’s fault it’s square. It’s just a bad fit. We used just such a classroom with our youngest, who is classically ADHD (helped to create the school, actually), and he graduated with a 4.0, was all-state in soccer, and is attending college with over $20,000 in scholarships. Guess he turned out OK without “treatment,” didn’t he?
—- Steve
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You should re-read my post. Saying there is no proof that it isn’t a biological disorder is nonsense scientifically. If there’s no proof that it is and no proof that it isn’t, then scientifically, it isn’t. There may be evidence later to change that conclusion, but you can’t assume your hypothesis is true in the absence of evidence to the contrary. It’s kind of the most basic law of the scientific method.
An open classroom is a classroom where there are activities available for children to engage in, but there is not a teacher in front directing everyone to do the same thing at the same time. Generally, there are work stations of some sort, with suggested or designated activities outlined, but within those guidelines, kids are encouraged to experiment more and learn from doing rather than from hearing. Additionally, kids aren’t usually kept to a rigid schedule – they can attend one activity for a short or long time and transition to another when they feel they are ready to do so. The investigator in the study in question believed that the constant starting and stopping at the teacher’s behest is part of what frustrated the “ADHD” kids in the regular classroom and led to their inappropriate behavior.
I don’t have the reference ready to hand but will look it up tonight and hope I remember to get it to you tomorrow.
I do think ADHD is a characteristic or trait that is at least partly inherited. But I don’t thinki it’s a disease. Human beings and other species survive on genetic diversity, as it allows adaptability to varying environments. In a hunter-gatherer society, the “ADHD” person would have been in high demand as a hunter or warrior, both occupations that allow lots of flexibility and have an element of risk and adventure. I think we end up creating problems for these kids when we put them in an environment that is unavoidably dull, especially if they have to take a lot of arbitrary orders. The difference in the open classroom shows that this characteristic behavioral pattern isn’t necessarily a detriment. It depends on the environment and the expectations. We don’t expect a geeky scholar type to be an excellent athlete. Why do we expect a creative and adventurous type to be an academic?
— Steve
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It is my theory that the reason white males are the ones who go on shooting rampages is because they belong to the privileged class, but don’t feel they are able to participate in its privileges. If a poor black man is feeling oppressed, it’s easy to find a target for your rage: rich white people. Women can band together around being oppressed by men, immigrants by the majority culture, and so forth. But if a white male is a failure, it’s his own fault. He had all the advantages and STILL failed – he has no excuses, he’s just a loser. I think this may give rise to a rage that is very unfocused and random, and if the person additionally is isolated, he has little to no opportunity to be pulled back from the brink.
The one thing not addressed in the article is that such a person, when exposed to antidepressant drugs, may lose whatever inhibitions that had been restraining them from acting out their fantasies. A hugely disproportionate number of these shooters were on SSRIs, or to a lesser extent, stimulants, during or just prior to going on their rampage. Kip Kinkel, the Columbine boys, the Red Lake MN killer, the Batman killer, the V-Tech guy, at least one of the Fort Hood killers, all had recent or current exposure to antidepressants. There is some soft information suggesting that Adam Lanza may have been as well. While I don’t believe that antidepressants alone would get anyone to this state, I have observed and heard and read that they often create a “what the f*&k attitude (a former colleague of mine called it “Zolofting”) that may feel like a good thing to someone plagued with anxiety, but is definitely NOT a good thing when the fragile inhibition against doing something horrific is set aside by excess serotonin in the brain.
It is good to hear more people pointing out that mass killings are not always or primarily the work of the “mentally ill.” But we have a long way to go before any possibility that American society is the likely cause will be entertained by the general public.
— Steve
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Science operates on the principal that an experiment has to verify the hypothesis, otherwise, it’s assumed to be false until proof arrives. Additionally, one contradictory finding can be sufficient to disprove a theory.
Psychiatry operates on the principle that what it says is true until proven false by its opponents, and allows that one positive study is sufficient to negate any number of negative ones.
If we are being scientific, your first question makes no sense. The real question is whether psychiatry has any proof that any “mental disorder” IS a molecular medical disease. In the absence of such proof, we have to assume that it is not. Such proof has been sought for years, but is not forthcoming, and every “proof” that’s been offered has been discredited. There is no currently supportable theory for the cause of ANY mental health disorder. And why would there be, when these “disorders” are decided on by committees of psychiatrists, many of whom sport long lists of conflicts of interest with pharmaceutical companies?
Science is the ultimate form of skepticism. A real scientist doesn’t try to prove his theory correct, he does everything he can to prove it wrong. Only when it holds up to that kind of scrutiny is it accepted, and then only pending new data that may conflict with it. If psychiatry operated on that basis, there would be no psychiatry.
—- Steve
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Nor is there any long-term social or emotional benefit to stimulant use over time. I have no problem with individuals using stimulants if they know the risks and are willing and able to take responsibility for them. But forcing kids to take stimulants that don’t enhance their long-term benefit just because it makes them easier to deal with is just plain dumb.
By the way, I don’t know if you are aware of this, but there was a great study back in the 80s showing that “ADHD” kids were indistinguishable from “normal” kids in an open classroom environment where they had more control of their time and activities. We had all our kids (two of which are classic “ADHD” types) enrolled in this type of schooling, and none took any medication and the two “ADHD” types both graduated HS with honors, and the youngest is currently enrolled at Evergreen State College. I don’t think they needed amphetamine “glasses.” They needed to learn in an environment that respected their personalities and learning styles. They got it, and they did just fine.
Most “ADHD” is caused by schools.
—- Steve
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Carl must finally be feeling heard by someone! Good for Gov. Carlson for publicly taking a stand on this. I’ll be interested to hear how it goes forward.
—- Steve
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I agree completely. My parents modeled kindness and tolerance, but they also modeled sweeping conflict under the rug and denying the presence of emotional suffering. They are good people and tried their best, but my mom was overwhelmed by 4 kids under the age of 5 in a day before support groups and indoor parks and the like. So we were neglected, emotions were stuffed, and we had scapegoats, none of which were able to be talked about. I managed to have some more healing conversations with my dad later in life, but going back over what had happened in the past continues to be taboo to this day, including among my brothers.
I have no intent to be hostile or blameful toward parents, but it is important to recognize the damage that can be done, even from innocent behavior on the part of the parents. They were children once and were hurt as well, just as we were, but it is my belief that being able to consciously face those hurts allows us not to pass them on to our kids. It’s something we can actually do something about, rather than blaming our brains and waiting for magic pills to make it all better. It just bothers me that discussion of family dynamics, beyond overt abuse, just never seems to be allowed in many current therapeutic circles. Just like my family, come to think of it!
—- Steve
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Very true! Until you change the lens people are looking for, campaigning for “justice” may be interpreted as meaning you want more of what’s already being doled out!
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This is a very important and intense discussion, and I thank the author for provoking it!
I found myself both strongly agreeing and strongly resisting parts of this article. I do think there are many factors contributing to the increasing disability rates mentioned by Whitaker, and most are social and economic in nature. The collapse/undermining of community, the removal of other forms of economic support, the general move of dollars from the poor and middle class to the rich, all of these create a powerful push toward using disability as both an explanation for “failure” and a form of income.
I also agree to an extent that focusing EXCLUSIVELY on medication misses the larger point of how and why this is happening. However, I can’t agree that medication should be relegated to some kind of a background issue, as it has been a huge tool in helping to encourage and enforce the distorted view of “deviance” that supports the current status quo.
I believe that a critique of psychiatry needs to focus on the use of both DIAGNOSIS and “TREATMENT” as a means of blaming the victims of the very oppression you rightly identify as central to the disability trends we see. Framing any discomfort or upset with the current system as a “disease” avoids confronting the real social issues that face us. While I’m sure you agree with that last statement, what you don’t identify is that psychiatry has PROVIDED this “out” to both the victims and oppressors.
Second, I think the data absolutely shows that psychiatric drugs do, in fact, increase the likelihood that a person will not recover from his/her “disability,” whatever the social and political reasons they may have been driven down that path. Whitaker provides a strong biological explanation for how this happens, and it is completely coherent with prior research into drug addiction and withdrawal. Interestingly, the exact same thing has been recently observed about pain medication, the other arm of increasing disability – short-term use of pain medication leads to relief, but long-term use leads to the drugs becoming ineffective and pain levels actually increasing. Managing long-term discomfort with drugs is simply not a viable plan, and that is absolutely true, over and above any of the socioeconomic issues you correctly raised.
Additionally, I agree with Alex 100% – in the move to stop demonizing parents, we’ve supported the ridiculous idea that parents are never responsible for their children’s mental/emotional suffering. This is, of course, a ridiculous proposition for anyone who has worked with abused kids or adults. Parental mistreatment is a primary cause of “mental health” problems, and this is actually part and parcel of the very oppressive structures the author has described. The family is a unit of society and often has embedded the same authoritarian social structures, including power imbalances, punitive structures, and excuses for the powerful continuing to be abusive. Alice Miller has written eloquently about this phenomenon. We will never make any inroads into addressing inequality and oppression if we let parents off the hook for harming the most oppressed and least powerful social group, namely, our children.
Finally, even if the huge rise in disability is not primarily driven by the drugs, it’s clear from the rising disability rates that we are seeing that the diagnosis/drug paradigm is not successful. The whole idea was that “medical” treatment of these “diseases” is going to lead to people who were previously unable to work and participate in society becoming productive citizens. It appears the opposite has occurred. Whether or not the drugs are directly to blame, this is a failed paradigm and it needs to be scrapped. And the main reason it has NOT been scrapped, and that “antipsychiatry” has gotten a bad name, is because psychiatry supports the oppressive social structures that continue to be viewed as the status quo.
In essence, it’s only a failed paradigm from the point of view of helping “mentally ill” people get better. From the point of view of institutionalizing oppression toward anyone disturbing the status quo, I’d say it works like a charm. I think the analogy with slavery is quite apt.
—– Steve
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In some cases, they probably don’t want to see themselves as “mentally ill,” which I find a very understandable position. Normalizing rather than pathologizing seems to be a much more healing path for trauma victims (which means most of us!) Also, they may have a sense of what “treatment” they will likely receive and have decided it’s not something they want.
It would be an interesting question to ask.
—- Steve
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Another psychiatric success story. It is sad to hear how her body deteriorated over time due to the treatment that she received, and yet she continued to get worse over time. It is pitiful what passes for mental health treatment in this country today. The image of her getting a box with her stuff says so much about the lack of compassion with which these people are treated by the system that is supposed to help them. 99% of the focus is on medication, and almost none on any kind of social or emotional support. And when other programming is funded, it’s for the short term and is often stopped even when it’s successful.
I can easily see why this woman is opposed to loosening constitutional protections against enforced treatment, and I hope anyone reading can as well. This is not just a story about the ravages of “mental illness.” It is about a system that fails its patients again and again, and often ultimately results in their early death. We have to do better than this!
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LOL!
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Vielen Dank!
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Ich habe auf einmal in Deutschland gewohnt (in Frieburg i.B.) Vielleicht besuche ich Deutschland noch mals bevor ich zu alt werde!
—- Steve
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Agreed. Most Americans fully support a wide range of socialist ideas and programs, but don’t think of them as socialism because of the incredibly distorted view of socialism we’ve been fed. (Most people believe Socialism is the same as Communism, which most people also don’t really understand, but they know it is REALLY, REALLY BAD! I’ve also seen people equate socialism and fascism, which is a REALLY big confusion!)
Medicare, Social Security, and the GI Bill are three excellent examples of socialist policies that very few people would argue with. My favorite example of this ironic fact is an anti-government protester’s sign that proclaims, “Government, keep your hands off my Medicare!”
http://www.macrofugue.com/welcome-to-peak-capitalism/medicare-keep-your-hands-off-my-medicare/
— Steve
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What side effects? What we will “discover” is that many people with “binge eating disorder” actually have a latent “bipolar disorder” which will be “uncovered” by the helpful Vyvanse. What could be bad about that?
Once again, a new disorder is invented so that a new indication and a new patent can be gained by a drug company. Any dimwit knows that taking stimulants reduces your appetite. Why are people so dumb as to not see through this transparent slimy manipulation????
—- Steve
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Agree 100%. The “side effect” profile from at least decent therapy is much lower and of shorter duration if you decide to stop. The question of an evidence base for ‘switching techniques’ is a red herring, in my opinion. The time to switch techniques is when the ones you are using aren’t having a positive effect from the client’s viewpoint. If a therapist is in good communication with his/her client, and is committed to empowering the client to gain more control and agency in his/her life, it will be obvious if they are being successful or not and that it may be time to change the approach.
Bottom line, good therapy is not about techniques, but it’s about being present and emotionally available and creative and responsive to the needs of your client. There is no real training for that, except perhaps experiencing quality therapy yourself.
I also agree that the odds of finding such a therapist on the first go round are very small. Folks need to shop around for a person who works well with them and with whom they feel comfortable. I’d say three quarters of the therapists out there are mediocre to poor, so don’t give up if the first one isn’t great, but don’t put up with half-assed therapy, either. It’s definitely “caveat emptor” in the psychotherapy realm, but luckily it doesn’t usually result in permanent brain damage. (Unless they refer you to a psychiatrist, of course, at which point it’s time to run!)
— Steve
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Her respect for one client’s religious believe didn’t stop her from inducing seizures through electric shocks. I’d rather have my psychiatrist pray with me by a long, long way.
It is actually very strange how psychiatrists in particular but also many therapist are so reluctant to explore spirituality with their clients. Do we really believe that a person’s mental conditions are NOT related to their spiritual belief system in any way? Never? I suppose that’s the result of the pure biological model – those who believe this would view one’s spiritual beliefs as accidents of neurology having no relevance to your “symptoms,” or perhaps being a “symptom” in themselves.
Maybe they are asking the wrong question. Maybe it’s not what religion someone is, but whether they believe you are more than a collection of randomly interacting chemicals that needs to be asked. Of course, that last point is a religious belief as well, but is seldom recognized as such.
—- Steve
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But you can’t patent this stuff, so it will never be mainstream. Besides, if you start making people better, you have to look for new clients – very inconvenient!
—- Steve
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Once again, you are thinking my thoughts exactly! We have to meet some day!
— Steve
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Regret is always easier in retirement, when you don’t really have to do anything more about it but sigh…
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Oh, I don’t think it was due to a lack of imagination. It’s more an unwillingness to yield control. They have rigged all the outcome measure around “symptoms” so that the drug paradigm will be able to prove “success” (though even there, they often fail). If they moved to qualitative quality of life measures, the current programs would almost all be shut down. They know this very well, and so they stick with what they can control, namely, symptom management. It is not accidental – it is very much by design.
—- Steve
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Having a nursing home as guardian for a resident is a total conflict of interest. It’s downright evil! Talk about the fox minding the henhouse!
—- Steve
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Can’t argue with you. It’s beyond odd that something like Tardive Dyskenesia is barely mentioned, and that the establishment is upset when telling people their drugs might cause suicide or homicide reduces prescription rates, but we’re very upset about male breast development. Maybe it’s a distraction tactic so that it can seem like they care when we know they really don’t.
Still, anything that makes people question the validity of these “treatments” is a good thing in my book.
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Great article as usual, Kelly. I would add one caveat about which drug to start with: it may be important to start with the drug that causes the initial side effects that another drug is “treating,” regardless of half-life considerations. For instance, it is common in the foster care population I work with to see kids started on stimulants (and less frequently, antidepressants) and then becoming aggressive. At this point, they are diagnosed “bipolar” and put on antipsychotics. When someone complains that they are overmedicated, it is common to eliminate the antipsychotic first, which then exposes the aggressiveness caused by the stimulant, and the parties draw the conclusion that “he still needs” the antipsychotic. Whereas removal of the stimulant first generally leads to a better outcome, if people are willing to tolerate the brief but sometimes intense withdrawal/rebound period that almost inevitably occurs.
Thanks for your work – I hope you become a mentor for others who have seen through the chicanery that is modern psychiatry.
—- Steve
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How is more people getting treatment a measure of better health? Would we consider that more people getting bypass surgery or more people taking antibiotics an indicator of improved physical health? What warped thinking!!
It also bothers me that anyone uses the term ‘behavioral health.’ Behavior doesn’t have health. Health is a characteristic of an organism or being. Behavior is something a being chooses to do.
These people are morons.
—- Steve
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When half the population is “mentally ill,” either something is wrong with what you’re measuring, or something is drastically wrong with the society that is making that many people suffer. In this case, I think both are true.
—- Steve
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Yes, it is always easier said than done. It’s almost insulting sometimes the tone that they assume. But I have learned to read beyond that and check for the substance of what they are saying. I do believe that thinking certain thoughts leads to feeling certain feelings, but it is a big challenge to really change one’s thinking – that’s what good therapy is supposed to help us do, I suppose. But good therapy is exceedingly hard to come by. I lucked out, but that was back in the 80s. I’d say the odds of getting a savvy, flexible, empathic therapist on the first go-round these days is probably in the 1/20 range or less. Everyone wants to diagnose you, but nobody has much to offer in terms of the “how to” question you so aptly put. I guess my only answer, in referencing my own path, is that it is a lifetime journey that continues every single day. And nobody is “just happy.” Life can be very tough, as yours has, and the world we live in isn’t exactly overflowing with empathetic concern for those who are struggling. I guess we who see more clearly have to be there for each other, ’cause no one else is going to do it!
Hang in there!
—- Steve
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Unfortunately, US Government websites are often similarly inaccurate. Part of the problem is that inaccurate information is actually accepted as medically and scientifically accurate by such a large part of the medical community that dissenting voices are drowned out. Consider the “chemical imbalance” concept, discredited for depression in the early 1980s and yet alive and well in millions of websites and doctors’ offices across the country. Marketing has long since trumped science, in all of medicine, but especially in psychiatry. “Caveat Emptor” indeed!
—- Steve
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Meditation has been a life saver for me. I was fortunate to have lucked into a good therapist on my first try, and this was in the 80s before every manifestation of emotional discomfort was a reason to drug someone. (Though she did offer to connect me with a doctor who could prescribe Valium, as I recall, which I immediately and scoffingly rejected). Self-help books have also been a godsend. I particularly like Dr. Wayne Dyer’s “Your Erroneous Zones” and “Pulling Your Own Strings,” as well as “When I say ‘No” I feel guilty,” by a Dr. Emmanuel Smith (I think). Walking in the woods, riding my bike, and just sitting in the sunshine breathing in the clear air can also be highly therapeutic.
I know you feel broken, but you sound like a person with a strong spirit. Sometimes those of us with strength end up seeing things from a deeper perspective, and that can be painful. I consider myself one such person. There is a lot of ugly crap going on that can obscure how beautiful the world actually is. Sometimes just getting into the moment and appreciating the miracle of life is the best therapy of all.
Another option to consider is a hotline. There are lots of local, statewide and national hotlines for a variety of purposes. It can be super helpful if you’re feeling lonely and just need someone to talk with, or if you’re having an immediate crisis and need another perspective. Many are staffed with volunteers who have been through similar things and can empathize.
I think the hardest thing is finding people who can accept what is going on and don’t condemn or look down on your for having some difficulty dealing with what life has been like for you. The best thing of all is to have someone really listen deeply and be interested in hearing your story. Keep looking and don’t give up until you find at least one person who can do that, and then don’t feel bad about using the help they offer. You deserve and need some support that you are not getting, and I can promise you that conventional psychiatry will never be able to provide that support. There may be individuals in the system who buck the trend and really care, so look for them and latch onto them if you find one, but anyone who is trying to tell you that drugs are the answer is selling you down the river. You’ve tried that, and it clearly has not led to a better life. Time to try something else, eh?
Hope that is helpful!
— Steve
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And yet this “condition” is “treated” with stimulant drugs, which tend to disrupt sleep patterns and reduce the total amount of sleep!
— Steve
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Sounds like a new psychiatrist might be helpful, but only if s/he listens to you! You sound like a poster child for why drugs as a primary solution don’t work very well. If they were effective, they would help people become less disabled and more able to work, but it’s clear that you have not had that experience. You are absolutely right that Lorazepam should not be prescribed for the long-term, and yet the doc continues to prescribe it contrary to the manufacturers’ own recommendations. The Paxil stopped working but the doc doesn’t want to change it. Why not? Is he getting kickbacks from these companies? That’s just bad doctoring, plain and simple. If something doesn’t work, it needs to be discontinued, but that almost never happens in the world of “mental health.” Instead, you get a new diagnosis and new pills.
Based on your diagnoses, I’m going to hazard a guess that you have experienced significant levels of trauma earlier in your life, and perhaps right up to the present day. I get the impression that this doctor doesn’t give any credence to the impact of earlier experience on your current functioning, but is focused exclusively on manipulating your brain chemistry. Many years of experience as a counselor have convinced me that dealing with the impact of history is the most effective way to actually reduce anxiety, depression, and emotional instability. How to do this varies greatly from individual to individual, but I have never seen drugs do anything more than temporarily decrease symptoms, and without any other substantive intervention that deals with things like PURPOSE, SELF-CONCEPT, POWER, and RELATIONSHIPS, giving drugs does not usually lead to anything but ongoing dependence and disability.
I say this not to discourage you, but to encourage you to seek other pathways to healing. One very simple and generally free option is a support group for people who have been through similar experiences – not based on diagnosis, but on history, such as exposure to violence between parents, to child abuse, or to domestic abuse in adulthood. These groups connect you with people who understand your emotions and reactions, rather than treating you like there is something wrong with you. From there, you may be able to get some recommendations for therapists and even psychiatrists who actually deal with the consequences of life trauma, rather than treating you like a brain on legs that needs to be chemically manipulated, rather than understood and supported.
I hope this is helpful to you. I want to validate that your psychiatrist is missing the boat, and is clearly not listening or treating you with basic respect. S/he is treating you as a subordinate whose opinions or observations are of no interest. This is insulting and hurtful, and certainly does not lead to any kind of healing. There is a better way to go.
Take care of yourself, and feel free to respond – I will check and continue the conversation if you would like to do so.
—- Steve
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A class action lawsuit is very much overdue. I’m sorry you have been damaged so badly by this senseless paradigm. I hope it helps to know you are not alone.
—- Steve
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All of what you said COULD be an explanation, but it is no more supported by data than any other explanation. As a matter of fact, if you read the book, you’ll find that Whitaker’s explanation is much more consistent with the data than the possible hypotheses you put forward. There is a clear biochemical mechanism that explains why taking antidepressants in the short term can produce more chronic depression. And you also fail to take into account that if antidepressants really work as promised, a good percentage of those taking antidepressants would become well again and be able to work.
There are confounding factors, but considering that this phenomenon is occurring in multiple countries around the world, with big variations in government assistance programs and employment rates, it’s hard to argue that it’s all because of social variables.
You need to read the book. Your explanations are more comfortable for society at large, but that does not make them true.
—- Steve
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Sometimes I think we share a brain!
—- Steve
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That’s exactly my concern. We have to change the paradigm!
— Steve
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Oh, don’t assume they can’t get patents. They’ll come up with a new name and a new time-released dispersal method or claim that it’s for a new indication, and they will be able to patent it. Zyban happened when Wellbutrin’s patent ran out, and it’s exactly the same stuff, except being repurposed as a smoking cessation drug.
Again, if people find this helpful, it is up to them to decide to use it. I’m glad that for now it’s not academic psychiatry doing the research, but the concept unfortunately reinforces the “chemical cure for a chemical imbalance” theories that psychiatry is based on. I am more of a Moncriefian regarding drugs – they have effects that people may find helpful, and if so, people can use them, but they aren’t treating “mental illnesses” unless we have objective evidence of a physiological anomaly that can be tested both before and after treatment. As an example, alcohol is perhaps the best antianxiety agent available, and it’s available at a low cost at your local bar or grocery store. People who feel tense have used it for time immemorial to relax, and I have no difficulty with that. (Of course, dosage control can be a bit of an issue…) But when someone starts telling me that alcohol is a “treatment” for an “anxiety disorder,” I would draw the line. It’s just a drug that makes you feel better temporarily. The psych drugs are the same.
So if you can figure out a way to divorce it from “mental health treatment,” I’d be on board with the experiment. I just worry that it will be another opportunity to blame distressed and suicidal people for suffering in a society where suffering is the common outcome of the bizarre ways in which we’re supposed to live.
—- Steve
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Well said!
— Steve
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I think the issue here should be less whether psychedelics may have some potentially beneficial effects on certain people under certain conditions, but rather on whether psychiatry will attempt to co-opt this possibility and turn it into yet another life-threatening product promotion to make bunches of money while continuing to deny the reality of oppression and abuse that lies behind most emotional suffering, and especially behind most suicidal thinking and behavior. I totally support people being free to seek spiritual enlightenment by whatever means make sense to them, but I don’t support psychiatrists or anyone else repurposing such drugs as “medical treatment” for suicidality. I agree with commentors who see this as a potentially dangerous line of research, not because I think LSD or psychedelics are inherently bad or dangerous, but because I think the current tenets of psychiatry are dangerous and will certainly be able to generate dangerous outcomes out of any potential good that might come out of psychedelic use.
— Steve
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Noel,
Once again, you write an incredibly forceful and moving blog about such an important topic! Much of what you say gets to the roots of why the DSM-based paradigm is so destructive. It’s easy to get caught up in arguments about medication side effects and scientific bases for treatment and forget that the entire enterprise is based on one big delusion.
Of course, the real difference between a “delusion” and a dogmatically held irrational belief system is how many people you can get to agree with you. The psychiatric/DSM delusion only works because so many people believe in it. I prefer the “delusion” you are spinning here, as it’s far more likely to actually lead to people becoming more aware and more competent and in control of their own lives, which in the end is what any good therapy needs to do.
Thanks again for sharing your beautiful and scientifically grounded essay!
—- Steve
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What an awful story! I agree, usually training is not the issue, it’s a lack of empathy that allows them to justify doing these awful things.
So sorry you had to go through that, but I’m glad you are speaking out!
—- Steve
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Kind of a misleading title, considering that some of the approaches did appear to have some effect.
I’d also love to see the question of whether any pharmocological approach actually reduces this behavior (other than drugging the person to the point they are unable to act). What I know of the literature suggests the answer is “no.”
—- Steve
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Can you say, “Placebo effect?”
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I suspect a more sinister motive. I believe Big Pharma doesn’t want this research done because their antidepressants will be identified as a big causal factor.
—- Steve
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Yes, medications DO change receptor density. Unfortunately, it’s in the wrong direction. Have you read up on neurological up- and down-regulation, where the brain reacts to increasing a certain neurotransmitter by decreasing the number of receptors for that transmitter, and vice versa? This is not new science, and lies behind both tolerance of and addiction to psychoactive substances. The analogy with psychiatric drugs is complete, and Whitaker summarizes the research showing that the same thing happens (as any rational person knowing the data might expect) when we increase Serotonin or decrease Dopamine. Look up “supersensitivity psychosis” and “tardive dysphoria” if you don’t believe me.
“These patients come to us very sick, and leave not much better.” That quote from you above says it all. The drug paradigm is good at addressing short-term acute episodes but does not address long-term recovery, and may in fact impede it. This is not that different from other parts of the medical profession, where we are great at addressing a heart attack, but engage in pointless and expensive protocols like prescribing daily Lipitor to everyone with a history of heart disease, even though the drug’s track record shows little to no improvement in outcomes and a massive increase in side effects.
And you’re not going to get away with the “must have been misdiagnosed” evasion either. People are diagnosed with schizophrenia based on behavioral/observational criteria, not on some underlying physiological defect that can be tested for. Hence, anyone who meets the description, unless there is some other known cause, qualifies as “schizophrenic” for the purposes of research. If these people do better in Finland or Columbia, you can’t get away with saying “Oh, they didn’t really have it.” The phenomenon called “schizophrenia” plays out differently depending where you live and how you treat it, and treating it with drugs appears in many cases to take what might have been an acute episode and turns it into a chronic disability.
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I noticed you did not respond to my comments regarding Wunderlink and Harrow, which I think are pretty devastating to the idea that “schizophrenics need drugs for life,” as both come from very mainstream researchers. Nor did you address the 80% social recovery rate reported by the Finnish using the Open Dialog method, nor the exceptionally better outcomes for second- and third-world nations for schizophrenia compared to ours.
I haven’t really seen an intelligent rebuttal of Whitaker’s work. I’ve seen a lot of disingenuous ones. I’d like to see you take on the actual data. So far, you are talking from personal anecdote and the assurance that you’ve somehow done all this research which you have not shared with us. It is hard to take you seriously when you are not dealing with the actual data that is known.
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I meant the odds of them acting against their conscience was extremely large, not small.
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The bottom line is, whether they expressed discomfort or not, they ultimately went along with the program despite their internal sense that it was wrong. That was the real lesson of the experiment. Not that people are horribly sociopathic on the average, but that when told by an authority figure that something was acceptable or necessary, even if they found it personally repugnant to do so, few could seem to muster up the courage to refuse to participate, even in the absence of any looming punishment. If we add in additional negative consequences for failing to comply, and the odds of a human acting against his/her own conscience in the face of authority directing them to do so seems sadly to be very small.
— Steve
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Once again, we prescribe these things without the slightest idea of their safety profile, and wait until kids are harmed before even bothering to ask these questions. We should be assuming risk until safety is proven, not the other way around. Crime, indeed!
—- Steve
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I am sure we agree about most things.
I think it depends a lot on the attitude of the professional you are working with. If they are able to see the label as a shorthand description of the challenges the child faces, and providing some professional guidance for how s/he may intervene to improve the situation, that is one thing. The difficulty comes in when the professional begins to see the child in terms of the label, as “disabled” rather than “differently abled” and having strengths in other areas that could be used to help with the challenges they face. I think the analogy with ADHD is quite apt – these so-called “ADHD” kids genuinely DO have difficulty attending to something they find dull, and it does create difficulties for a standardly-structured classroom. However, they also often bring other strengths such as stubborn commitment to a goal or objective, willingness to tolerate discomfort or conflict to accomplish their mission, an ability to think creatively and find alternate ways to solve a problem, and so on. Not to mention that they may have other challenges they face that are only expressed in the classroom through their lack of interest or distractibility, but might be something that could be addressed if anyone bothered to take the time to ask them why being in class is difficult. Further, it’s been shown through research that these kids are virtually indistinguishable from “normal” kids (on the average) in an open classroom structure where they get to make more decisions and have more control of their time and activities. Yet it is rare that they have the opportunity to try out that option, because people think that the label means they are deficient and need to be “fixed” rather than considering changing the expectations they’re exposed to.
I am sure much of this is applicable to kids with the “dyslexia” label. I am always happy when people recognize that there are unmet needs, but I hate to see these kids channeled into some “program” without someone bothering to take the time to figure out what is behind their reading challenges. Calling it “dyslexia” may be a good first step toward making folks aware of what is going on and starting to think through what options may be available to help, but too often, I find it’s a last step toward lowering expectations and creating “programming” that is more designed for the convenience of the teachers than the needs of the kids.
Don’t get me wrong – there are plenty of smart, creative, hard-working special ed teachers out there who do a great job. But I do find the labeling process dangerous, because it allows people to begin to think they know something about a kid and to stop looking further for both causal factors and possible solutions.
—- Steve
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My new analogy is this: if two people were hit by a car in the leg at the same speed and angle, and one of them got a broken leg and the other one did not, we could perhaps surmise that the one whose leg was broken was somehow more genetically susceptible to broken bones. Would we spend a lot of time doing genetic research to determine what caused his potentially weak bone structure? Or would be place the blame on the actual causal agent – THE FREAKIN’ 2000 LB CAR that just whacked into your body!
I am going to start trying to change the terminology when people say “mental illness” and substitute “mental injury.” It’s a more accurate term and puts the blame where it belongs – ON THE FREAKIN’ CAR!
—- Steve
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There is actually solid evidence from more than one study showing that doctors rarely believe they are being influenced by pharma marketing reps, but that based on their prescription writing, they are in actual point of fact dramatically affected by these visits. It is hard to combat subconscious influences, especially if your pride prevents you from honestly asking yourself if you are being influenced, as appeared to be the case for most doctors. Bottom line, if it didn’t work to increase prescription writing, the pharmaceutical companies wouldn’t spend the billions they do sending these guys out.
I also recall when I worked at a large mental health program how a client may have spent weeks or months getting onto a stable medication regime they were comfortable with, only to be required to change psychiatrists, and I’d say three times out of four, the new psych would change the prescription despite the client’s hard-won stability. Why would they do that, I wondered? It eventually occurred to me that each psychiatrist had his/her “favorite” drugs, and that it was more than possible that their favorite was at least partially determined by financial relationships to the manufacturer. Later research has shown this to be true – many practicing psychiatrists get funds in a number of ways from big pharma companies, and I can’t imagine it happening without a level of demonstrated loyalty from the psych. I can’t even rule out the possibility of direct kickbacks, but it wouldn’t have to be that corrupt to have an effect.
I’ve worked in the system, too, and I’ve certainly seen people who did better while maintained on some kind of medication regime. But I’ve also seen people punished and humiliated for disagreeing with the doctor or demanding some more helpful treatment than they were receiving. And I’ve seen many people diagnosed with “bipolar disorder” or “ADHD” when they were clearly severe trauma victims, and I’ve seen many BECOME “bipolar” as a result of stimulants or SSRIs, but almost never see anyone stop the offending treatment to see if the symptoms will abate.
There have been plenty of successful weanings off of antipsychotics, and the more enlightened psychiatrists of today (though few in number) are realizing that episodic drug treatment combined with psychosocial support and therapy is a lot less damaging to their patient’s brains and makes actual recovery MORE likely.
You really should read “Anatomy of an Epidemic,” the book on which this site is based. It may slay a few of your sacred cows, but it may also open your eyes to the fact that not everyone finds these medical interventions as helpful as your somewhat biased sample reports.
—- Steve
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Plenty of “schizophrenics” return to pre-morbid functioning. And more used to, before the prominence of drug treatment, which (if you would take the time to read Anatomy of an Epidemic, which I doubt you have) is increasingly being shown to increase the likelihood of chronic mental dysfunction, rather than decreasing it as promised. Some examples: the WHO studies, done twice in the 90s, showing that people in countries that use less antipsychotics have much better recovery rates; the Wunderlink and Harrow studies, showing that long-term recovery from schizophrenia is fairly common, but is made less likely by long-term use of antipsychotics; and the Open Dialog program, which boasts an 80% social recovery rate (people fully participating in normal social functions like employment, relationships, community engagement, etc.) with only 20% of the participants continuing to take antipsychotic drugs on a regular basis.
I am afraid your faith in doctors is also quite misplaced. Look up the saga of Joseph Biedermann, who promised J&J to get a positive result for their drug, Risperdal, before he even did the experiment. Consider also the well-founded research showing that head-to-head drug studies almost always favor the drug from the company funding the study, and the continued promotion of the idea that depression is caused by a reduction in serotonin, when that theory was disproven in the 1980s. Also consider that Peter Breggin was talking about the increase in aggression and suicide in SSRI users in 1992, but it took the psychiatric industry over 10 more years and a black box warning from the FDA to admit it is an issue (and many still argue that it is not, despite solid evidence supporting the concern.) Add other medical scandals like Viiox in the non-psychiatric field, and it’s hard to understand where your faith in the medical profession is founded. Doctors cause over 200,000 deaths annually, according to a study in the JAMA, clearly a mainstream source, and more than half of the deaths were due to medication side effects. I am sorry if this disturbs your faith in the medical community, but I am afraid the actual facts say that such faith is dangerously misplaced.
—- Steve
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There was a somewhat similar study back in the 70s looking at the impact of the ADHD label on teacher behavior toward students. They found that those kids who got the ADHD label got LESS academic attention and support after they’d been labeled and medicated, because the teachers believed the medication had solved the problem and they did not need to attend to it. Identifying the specifics of a problem and the child’s strengths can really contribute to a better solution, but I don’t believe labels, including dyslexia, are really very helpful in making things better for kids. And this study confirms my own observations.
— Steve
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If I had the choice of a year in jail or a year in the psych ward, I’d choose jail for sure. At least there is some kind of regulation as to what guards are and are not allowed to do. In the psych ward, you are truly at their mercy, and a lot of them don’t have much of that.
—- Steve
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That they are very dangerous!
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Allowing people with power to justify their violence is a core principle of our society, and it runs from a parent physically abusing a child “for their own good” right up to starting wars with foreign countries because they are somehow “a danger to the world community.” As usual, you have hit the nail on the head, Sera, and we need to really get past bias toward a particular group and see the similarities in all of these varied situations. People in power need to be held accountable or they are capable of horrible things, even those who are not horrible people. Nazi Germany, Abu Ghraib and the Milgram experiment all tell us that no one has to be evil to do evil things when the system allows or encourages it. Perhaps it’s authoritarianism that is at the base of it all and that’s what needs to be attacked.
Another mind-blowingly powerful post, Sera! Thanks as always.
—- Steve
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The reasoning is quite simple, actually. Antipsychotics are, by assumption, automatically good. Antipsychotics cause brain thickening, therefore, brain thickening must be good. If they also cause brain thinning, then brain thinning must be good. As long as antipsychotic drugs caused it to happen, it must be good, because we know how tremendously helpful antipsychotics are.
Ipso facto, QED.
—- Steve
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I think the main reason people resist the term “antipsychiatry” is because it’s been used to marginalize critics and associate them with radical/irrational/religious motives and paint them as “anti-science.” All of this, of course, is predicated on believing that psychiatry has anything to do with “science.” Personally, I prefer to avoid generalizing labels of any type, and view myself instead as a person who is opposed to oppression in all of its forms, and who sees psychiatry and psychiatric diagnoses as fundamentally oppressive in nature, and therefore something to be opposed. Not as quick to say, but a lot more descriptive!
—– Steve
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I meant let go of the idea…
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Or as Don Juan would have reminded us, reality is simply a matter of perception. Agreed-upon reality exists as such because so many people agree on it. What happens when we let the idea that this consensual reality is the only way t0 perceive the world?
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I wish I knew! I think time passing allows some healing to take place, but I’m not aware of anything that can undo the damage other than the body’s own natural healing capacity. Anyone have any ideas?
—- Steve
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Glad you resigned. Everything you have said about NAMI resonates with what I’ve heard and experienced. There are some well-intended people in there, but they as a rule tend to freak out when anybody questions the dominant paradigm or starts talking about the rights of “mentally ill” people to make informed decisions. Not all branches are like that – there are a few exceptions, but the national leadership tends to be 100% behind the diagnose-and-drug strategy, and lets parents and society off the hook completely as possible agents of mental distress.
And Sera is correct, this board doesn’t turn over fast enough to expect a 4-hour response, especially on an older thread. It’s more reasonable to expect something in a couple of days, unless it’s a very new and hot thread.
Hope you’ve found someone more helpful than NAMI in your community!
—– Steve
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Maybe it’s hard to tell the difference because they are manufactured social constructs that have no actual valid distinction in real life?
—- Steve
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It all rests on the assumption that deviation from “the norm” is de facto always bad. If that assumption goes away, the whole argument is ditched.
I also think it’s fascinating (in an aftermath of a train wreck sort of way) to see how certain bell curves are only considered “abnormal” at one end. Does no one notice, for instance, that there is no “Hypoactivity disorder?” Why would that be, if deviation from the norm is bad? It’s clearly because low activity doesn’t cause problems for teachers and other adults caring for the child. I think it would be a lot more honest to call it “Adult Annoyance Disorder,” because it’s clearly based on how annoying the kid is, rather than his/her activity level per se. And that would also make it clear that it’s the adults’ needs that are at issue here, not the child’s.
Anyway, I’m happy to have such a clear elucidation of why using a bell curve to define “disease states” is both stupid and unproductive, unless you’re interested in profits and/or social domination. Not everyone is “normal,” or needs to be. Otherwise, we’d have to drug all of our creative geniuses into an inactive stupor. But wait a minute… that IS what we’re doing, isn’t it?
—- Steve
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The lack of a model for these problems is, indeed a huge issue. But perhaps more concerning is that the definitions of these “disorders” get in the way of developing such models, because it is assumed that everyone meeting the criteria for “bipolar disorder” has the same problem and requires the same solution. So not only do we not have a working model, we have a confusing, non-working model that is purported to work, and all research is filtered through these warped lenses. I only wish Psychiatry as an institution were interested in finding a logical model for understanding “mental illness” differently, but it’s clear that this is not going to happen within the field, as they are married to their warped “chemical imbalance” model, regardless of evidence to the contrary, and even a REAL iatrogenic chemical imbalance (like that caused by antidepressants resulting in a manic episode for some users) is still dismissed as irrelevant and forced to fit into the pre-existing paradigm.
—- Steve
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Totally agree. People mistake “professionalism” for not having or displaying any emotions or reactions to the client. This just makes you seem cold and unfeeling. In my experience, people need to know you’re real, need to see you step down from your power position and let them know that you’re just another person trying to figure out how to get through a complex world. I very commonly share my own emotional responses, in a rational way (not ACTING on them but describing them) in the context of helping understand what is going on. I also find those emotions I experience to be quite informative as to how the client may be feeling. Acting like you have no feelings is yet another way for the “professional” to protect him/herself from experience the client’s reality. Unfortunately, it usually prevents you from helping them as well.
—- Steve
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I am guessing that the two facts are related – few people fill them out because they know that most of the time, they will be ignored. It says a lot about our lack of respect for the so-called “mentally ill” that we can’t even respect their clearly stated wishes in writing. Most discouraging.
==== Steve
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They may not reduce aggression, but they are quite effective at reducing lifespan, apparently, leading to a black box warning against using these drugs on the elderly. But of course, they’re still used every day, all over the country, with impunity. Class action lawsuit, anyone?
—- Steve
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LOL! You are so PRIMITIVE, B! Why bother actually communicating when there is a technological way to get information without the discomfort of actual personal interaction?
—- Steve
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If your conception (or psycyhiatry’s) of psychosis is credible, how do you explain the fact that schizophrenia-diagnosed residents of developing countries (like Columbia, Brazil, India) do dramatically better in terms of long-term outcomes than those who receive all the best of Western medical technology? Or that Open Dialog, which uses antipsychotics extremely conservatively and focuses primarily on a family/community intervention, has the highest success rate of any known treatment approach, by an order of magnitude? Or that schizophrenia is more common in immigrant populations and racial minorities and in urban settings?
I do agree with one point – research is showing that providing housing and food and meaningful work are much more important than insisting someone “take their meds.” Unfortunately, that’s the exact opposite message from what most people diagnosed in America today get. They are told they have a lifetime illness, that they should give up on their aspirations and resign themselves to living on disability, that they will be unable to work or otherwise have a normal life and won’t be able to survive without constant psychiatric support. And at the same time, we consign them to lives of poverty and don’t even provide the minimum support for survival.
And as for the “bad mothering” argument, the association between psychosis and early childhood abuse and neglect is quite robust, 10 or 20 times stronger than the most optimistic genetic correlation currently percolating around. The fact that most abused children don’t develop psychosis by no means should leave parents and society off the hook. As an analogy, if two people are hit by a car in the leg at the same angle and the same speed, and one of them breaks his leg and the other one does not, we don’t blame the guy with the broken leg for having weak bones. We know the car caused the damage, but each person’s body is different and responded differently to the harm. Psychological injury is very real and can cause any of the manifestations we call “mental illness.” It’s pretty disingenuous to suggest that war is not a cause of PTSD because only a minority of soldiers develop it. It wouldn’t have happened without the war, the war was traumatic, so the war is a cause. Maybe not the only one, but you really can’t say that everyone who doesn’t respond to our social system the way our society wants them to has a disease of the brain.
—- Steve
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Thanks, Richard!
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The “Dr. Feelgood” approach, when not motivated by unfettered greed, is often motivated by a desire to make OURSELVES feel better by making the other person’s pain go away as quickly as possible. Because the truth is, their pain is making us uncomfortable, and it’s our own pain we want to alleviate. The current paradigm makes it all too easy to rationalize taking this approach under the guise of “relieving suffering.” Of course, our goals should not be to merely relieve suffering, otherwise we’ll all end up on Xanax or Oxycodone and living in a daze.
What seems to be most helpful to people who are experiencing this kind of suffering is to have someone willing to BE uncomfortable with them and to sit in and feel some echo of the pain they are experiencing. Only then does the person stop feeling like they have to make the “helper” feel better and feel able to open up and be honest with you and themselves about what is going on. At least that’s my experience. So in essence, the whole idea of diagnosing and medicating appears to be diametrically opposed to what I’ve found people in distress need the most: an open, safe listener who isn’t going to judge or direct or control them but is simply going to listen and be interested in understanding the problem, and help the suffering person start to generate some potential solutions that might make the situation a little better from their own point of view. Anything that puts the sufferer in the place of feeling like they have to make the caretaker feel better prevents any real psychological healing, in my view. So I agree with Richard, the current system appears to meet the needs of the helpers more than the people being “helped.”
Great article!
—- Steve
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That’s good information to know, Darby! So I guess it would only be radical or new if this kind of approach was adopted as standard practice. I guess it’s not surprising that this isn’t a new idea, but it seems quite contrary to everything I am seeing in day to day practice. I hope the concept catches on, but I’m not holding my breath…
—- Steve
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The biggest joke is that these “correlations” they “discover” involve dozens of genes, and yet are associated with these “diseases” no more than 15% of the time, even in their most optimistic and probably distorted estimate, even when you include a range of diagnoses instead of just schizophrenia. If something were CAUSED genetically, we should see specific associations of 90% or higher with a very specific condition, and that condition should rarely or never occur when the causal factor is absent.
It is also fascinating how completely the associations with trauma and social conditions are dismissed, even though the correlations with these environmental events is always many times higher than the most optimistic estimates they’re ever able to generate.
It is truly a ridiculous and fruitless effort, akin to the alchemists’ efforts to transmute lead into gold, or perhaps even more reminiscent of middle age religious philosophers trying to figure out how many angels fit on the head of a pin. But they can’t be faulted for lack of loyalty to their principles, even in the face of impending humiliation and utter defeat! Great characteristics for a religious leader. For a scientist, not so much…
—- Steve
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This is an amazing series! I recommend that everyone reads all four parts. I work in foster care advocacy and this series captures what is going on incredibly well. I only wish we could get the NYT or someone big to pick it up. It’s great research and great writing telling a story that really needs to be told.
—- Steve
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It is worth noting that they say that behavioral interventions are difficult to implement due to high staffing ratios. So that they’re really saying is that we’re not willing to deploy the human resources necessary to actually meet their needs, so instead we can use shock treatment to force them into a more quiescent state while still shortchanging them on attention and effective intervention. It’s particularly offensive to read this when considering that many if not most of these folks are in for-profit nursing facilities who make more money for their stockholders by minimizing personnel costs. Naturally, drugs and ECT are much more appealing to people who are more interested in the bottom line than the actual quality of life of their charges.
It is sickening that this is even spoken of in such polite terms.
—- Steve
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I find it very telling that the discussion of “convergence” (collaborative efforts between disciplines to achieve a higher-order result) discussed neurobiologists working with engineers and physicists, but did not include a collaboration between neurobiology and psychology or spiritual studies or social work or sociology, or even economics. And of course, his analysis of why studies are hard to replicate completely dismisses malfeasance and corruption as primary causes, despite strong evidence that studies tend strongly to favor the institutions funding them. It goes to show both how far on the wrong track Insel and his minions are, and how completely dedicated they are to continuing to travel down that track regardless of the gaping chasm with the bridge out that lies ahead. These guys are only interested in controlling and manipulation and treating human beings like machines to be tinkered with. They have no interest in the experience of the “machines” they believe us to be. It is such a completely bankrupt institution, yet it continues to be funded to the tune of billions a year. I hope he will manage to work himself into the anachronism status he deserves.
—- Steve
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Legitimate critique and skepticism is not “stigma.” This would be like suggesting that there is a “stigma” against child molesters, who after all just have a particular preference, which may even be genetic, they can’t help themselves, so why all the hoopla? Psychiatry as a profession has been incredibly dishonest and manipulative, not to mention dogmatic and defensive when legitimate critiques are raised. Dr. Read’s article is the one that gets to the point – when psychiatrists stop being arrogant know-it-alls who aren’t really interested in either scientific data or their own patient’s reactions to their vaunted “treatments,” then may be the well-deserved “stigma” toward psychiatry might begin to abate.
Or as one person shared as their one-line wisdom for life: “Don’t be a dick!”
—– Steve
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It is pretty astounding to see this research in a professional journal. I will definitely be referring to it in the future, because this is what I’ve observed over and over again. People stop taking the drugs either because they don’t work or because the side effects are intolerable, or both. It also affects the way people think about themselves, and many feel they are better off finding a way without the drugs because these other approaches are sustainable and self-determined, rather than relying on an external force to alter their moods. Very few don’t feel they are suffering or believe there is no issue to be addressed. The “lack of insight” explanation needs to go on the trash heap of self-serving theories that don’t bear much if any relationship to reality.
—- Steve
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I agree 100% with your analysis. I would only add that in psychiatry, there is an element of intentionality that isn’t always present in other areas (like childbirth) that are plagued by mythology and perverse incentives. History tells us that psychiatry made a conscious decision to “sell” the concept that mental illnesses are biological and treatable by drugs. This was clearly a marketing tactic not based on even a warped misconception about what the science says or on some pre-existing traditions that conflicted with current knowledge. It was a marketing decision by a trade organization that was palmed off as science, at the very same time that scientific investigations were showing that the theories underlying the “message” were false. Given the subjective nature of psychiatric diagnoses, I consider the level of irresponsibility to be much higher when a political decision led to a huge change in how people were categorized and treated, which was knowingly embarked upon despite known contradictory findings. It is similar to the intentional suppression of nursing in the 50s in order to sell infant formula (and continued to this day in third world nations by Nestle Corporation, among others) despite knowledge that nursing is the superior option.
While medicine as a whole is massively corrupted by money from Big Pharma, and some similar scams like “erectile dysfunction” have a familiar feel to those of us knowledgeable about psychiatry, the degree of systematic and intentional distortion around the entire field I think puts psychiatry on a uniquely unstable footing ethically, even in comparison to the general corruption of medical science. While I agree that there are plenty of practitioners who entered into this with an honest desire to help, the field itself is so corrupt in its very foundations that it is hard to see any way it can be salvaged, except, as I said above, by removing it from the field of medicine entirely, where it really does not belong.
—- Steve
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There is clear emerging evidence that psychotherapy does, in fact, work for psychosis, at least initially when not complicated with brain damage caused by psych drugs.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525111/
There is also plenty of evidence at this point that antipsychotics, far from helping people become more functional, end up creating increasing numbers of disabled persons over time, as you’d know if you read Whitaker or were even up on the latest research from Harrow and Wunderlink, among others.
Tusu, you’re going to have to do better than repeating platitudes to convince anyone that your views are anything more than a stance you’ve chosen to adopt. You make these claims but provide absolutely no basis for them in research. It’s kind of an “everybody knows” sort of an approach, and it is frankly a bit insulting to those of us here who’ve spent a lot of time reading the actual research. If you have studies in mind, please provide us names and links if available. Otherwise, I don’t think anyone here is going to take you seriously.
—- Steve
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It seems the centerpiece of this well-argued piece is that psychiatry as a sub-specialty of medicine is part of a much larger movement toward promoting illness when none exists. The only conclusion I can draw from this is that including psychiatry as a medical specialty is a mistake and that it should be eliminated as such, leaving psychological/emotional/spiritual healing to the lay public and to agencies whose job is to care for people rather than just bodies.
I appreciate the inclusion of childbirth as an area with a great deal in common with psychiatry, including warping of informed consent and the de facto use of force and unnecessary medical interventions on a routine basis.
Yes, there is definitely something very, very wrong with modern medicine, especially in the USA, and it has a lot to do with financial incentives and corruption. It’s hard for me to imagine psychiatry, with its inherently subjective and socially-embedded definitions and dogma, to function in a truly helping way within the confines of the medical establishment you so aptly describe.
— Steve
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I agree with you, there is no sense in completely denying that biological causes may exist or that biological processes may exacerbate psychological problems. For instance, few who have experienced the psychiatric adverse effects of prescription or non-prescription drugs will be able to deny that the brain is massively effected by these chemicals and a number of unusual mental states can be induced by them. (Only time I was really paranoid was after being slipped mescaline in a drink!) I think the biggest problem in psychiatry is the semi-arbitrary grouping of people by their “symptoms” and assuming that all “symptoms” have the same cause and require the same intervention. It seems quite bizarre to me that they are spending SO much time trying to “prove” some degree of heritability when you can’t really do anything about that anyway. Why don’t we focus on the things we DO control, like the stressful environment, and just accept that different biological substrates may be associated with different reactions to the same stressors. Seems like a lot of time wasted to prove something kind of obvious and not very useful in determining how to help.
—- Steve
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Yes, that’s the ticket! We restrict guns for all white males. Or for males altogether. I bet that reduces the gun violence rate dramatically, and without even needing a diagnosis. Or I suppose we could invent a new one: Excessive Testosterone Disorder (ETD).
—- Steve
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I agree with Stephen, and I’ve seen this and heard this reported from SSRI users – one even had a name for it – she called it “Zolofting.” It’s basically a “I don’t give a rip” kind of state where normal social strictures on behavior don’t seem important. This might be a relief to someone who is constantly worried about what other people think, but if someone is not killing him/herself because his/her mother would be devastated, or is repressing a feeling of violent rage because s/he knows that there might be legal consequences, removing these social prohibitions can be deadly. I don’t think the drugs by themselves cause any particular behavior, but much like being extremely drunk, my observation is that they help mute one’s inhibitions and make it seem feasible to do things that otherwise might seem selfish, stupid, or dangerous.
I don’t think that he is blaming the drug’s recipient for being selfish, just saying that normal social rules are often discarded in the “Zolofting” state of mind brought about by the drugs.
—- Steve
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Well, I can’t argue with your last point!
—- Steve
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Most of this research can be summed up as “People feel better when they take drug X.” Until and unless there is a mechanism to explain what is wrong and how the drug is fixing it, they’re grasping at straws here. I feel more relaxed when I drink a beer, and I’m sure there are some biological reasons beer relaxes me, but it doesn’t mean it’s fixing something wrong. I am sure from your writing you agree, but that’s my answer to how we put this research into perspective. And I agree with your thought that they need new substances and processes to patent because the old lines are tapped out and won’t sell any more, since people are catching on to the scam.
As to drugs causing pathological psychological states, this is certainly true, and I agree 100% that saying all forms of depression are psychological/spiritual is a generalization that is not always true. However, it does appear that MOST depressive episodes are amenable to being worked through by psychological counseling, coaching, changing life circumstances, rallying support, and taking time to develop new coping skills. I think it’s always good to check for signs of other problems like diabetes, low thyroid, sleep disturbances, dietary deficiencies, etc., but those are all things that can be tested for. And of course, drug side effects should always be suspected if someone is taking any medication at all, regardless of its purpose.
Basically, I would say that none of it should be labeled as depression, except as a vernacular way of talking about how we feel. The big mistake is thinking or postulating that all “depression” has the same cause and that the same approach is needed regardless of the cause. But without that assumption, psychiatry doesn’t have much left to call psychiatry.
— Steve
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Just to be clear, I don’t really see psychiatry as reformable, as its basic premises have been skewed far back in history toward viewing differences as something to be stomped out. There have always been enlightened reformers in the system who have worked to change that, but at its core, psychiatry appears to have always been about controlling and eliminating anything (and anyone) uncomfortable and challenging from human experience. It is hard to imagine that basic orientation ever changing. Of course, I never thought the Berlin Wall would come down, and I was wrong on that point, but this may be an even tougher change to make.
—– Steve
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It sounds like it may be an important trace element, but in amounts hundreds of times smaller than “therapeutic” (aka near toxic) doses prescribed by psychiatrists.
http://www.hardynutritionals.com/blog/2014/09/daily-essential-nutrients-contain-mineral-lithium/
— Steve
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“Significantly superior” is kind of a gross understatement! How about “dramatically superior,” and that’s without even the consideration of bothersome “side effects” like diabetes, heart disease, permanent neurological damage and early death.
I’m glad to hear the news is spreading, though. It seems like the availability of an MS in Diologic Practice seems to legitimize the enterprise. But it never ceases to amaze me how mainstream folks can see these dramatic differences (80% vs 20% recovery) and be skeptical, when they accept a 10% difference between placebo and a drug as legitimate support for effectiveness.
Of course, the answer lies in profitability and ego…
—- Steve
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I have to say, I didn’t read Vivek Datta’s post as an effort to absolve psychiatry of anything. It seemed a pretty biting critique to me. I don’t know enough about him or his writing to really say where he’s coming from, but the comparison with Frances seems odious. I can’t see Frances ever writing anything as powerful or honest as Vivek’s post, since he’s still spending most of his time trying to distinguish between the DSM IV and 5, while not substantially critiquing the basis of the diagnostic criteria themselves. Vivek’s post seemed to suggest that psychiatric diagnoses are entirely social constructs that can be voted in and out of existence on the whim of a bunch of entitled white guys who have a change of heart, and that they lack any real scientific validity. Which is absolutely the case.
I don’t really disagree with anything you’re saying about psychiatry’s real intent and choices (I rarely do), but I just had to say that my reading of Datta’s last post was quite different than the take you had on it. I found it powerful and very much contributory to our intent, as opposed to Frances’s whiny after-the-fact hand wringing.
—- Steve
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This is an absolutely true story. I worked at a mental health agency briefly (which drove me out of the field and into advocacy as a result!) with a psychiatrist who was actually pretty good as psychiatrists go. He went to talk to a Native American guy who was hearing voices. In as empowering a way as he knew how, he offered that he had some medication he could prescribe that might make those voices go away. The guy’s response: “You white people – you’re all the same. You hear voices and you want to make them go away. We hear voices, we go someplace quiet and see if they have anything interesting to say!”
A Native mother I spoke with described her son (who heard voices) as having a “gift” that required that she take extra care of him. He was quite unable to care for himself much of the time, but she was concerned that Western “mental health treatment” would be damaging to his spirit. She did not see him as being ill.
This is a difference in attitude toward hearing voices that I think reflects exactly what you are talking about here. There is simply no belief that hearing voices is a malady or “disorder” of any kind. It’s just something that happens to some people, an experience to be pondered and made sense of, rather than something to fear or eliminate.
—- Steve
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I agree 100%. DTC advertising has been a huge part of creating the culture of “meds” that is so prevalent today. People come into docs or ERs looking for the pill that is going to make it all better, and continue to have faith in the docs despite disastrous failures because they’ve been told over and over that their problem is a “chemical imbalance in the brain.” Of course, we’d have to handle the APA as well, but DTC advertising is a big part of the problem and should definitely be banned, not just for psych drugs but for all of them.
—- Steve
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Exactly my thought. This supports Kirsch’s assertion that response to antidepressants is primarily or entirely placebo response, and the ADs themselves do nothing of clinical significance. Of course, the authors appear to skip over that important finding…
—- Steve
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Too true in a lot of cases, I’m afraid!
— Steve
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Shouldn’t be too tough of a challenge there. They seem pretty darned separate to me!
— Steve
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And of those few who did have mental health diagnoses, the vast majority were receiving treatment at the time of the event. Forced drugs don’t stop violence; instead, they appear to frequently cause it.
—- Steve
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I was struck that the two did have quite a bit of overlap, and I actually do agree that starting on where they did agree might actually lead to some beneficial changes. But I don’t think an alliance between Whitaker and Frances is going to make things very different.
Political change is difficult and never clean, and people do what they do sometimes for not the most moral purposes. I guess my answer to your last question is that what we need to do is to make it not profitable for people to adhere to the brain-drug-coercion model of “mental health treatment.” People usually act as they do because they benefit from doing so. This whole “movement” toward using drugs is clearly driven by unimaginable profits. Take the profits away and the incentive is gone.
How to do that is indeed a challenge.
—- Steve
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Very well said! If we’re concerned for people’s safety, we should help them be safe, but how is that in any way related to forcing them to take drugs for subjective conditions when the drugs may or may not have a positive effect even in the short term, and may have devastating effects in the long term? Those two concepts need to be COMPLETELY DIVORCED! Concern for someone’s safety is NEVER a reason to forcibly drug or shock them, or even to force them into some kind of talk therapy. If safety is the issue, then that’s what we should focus on resolving, not on “treating” spurious “mental health” conditions that are voted in and out of existence by a bunch of well-off elitists with massive financial conflicts of interest.
—- Steve
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LOL!
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Ah, but do they have a word for “arrogant, imperialistic, condescending pseudo-professional asshole” yet? Perhaps we need to help them develop that term…
Honestly, this is cultural arrogance in the extreme. It sounds like they have words to describe the emotional states that they experience, but haven’t lumped them all together into a “disease” and see them as natural responses to the challenges of life.
I wish we were so fortunate as to not have a word for depression! Perhaps they have a thing or two to teach our “modern” society.
—- Steve
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Can’t get the link to work, so I’m not sure what the author is talking about, but I’m having a hard time wrapping my head around why this would be a good idea.
—- Steve
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Well said!
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I agree, this should be a no-brainer. Telling people their own life experiences don’t matter and that there is nothing they can personally do to alter their own emotional experiences can do nothing but depress a person further than they already are. And doctors’ beliefs clearly impact their decisions, so driving them in the direction of less connection and empathy for the patient seems so obviously counterproductive.
A corollary to this: doctors who choose to adopt the biological model of “mental illness” may already be prone to lacking empathy, and this explanation may provide them more justification for their pre-existing blamefulness or insensitivity toward their own patients. I wonder if psychiatry may attract more practitioners with this attitude on the average, because the philosophy may appeal to people who have their own issues with empathy which they are unwilling to face?
—- Steve
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Note that “medication compliance” is a condition of returning to the school. Of course, the possibility that “medication compliance” may lead to worsening “symptoms” or may have even created the “mental health crisis” in the first place is never considered. And of course, the self-limiting nature of depression is never considered, nor is the possibility that the very environment at Princeton may be contributing to the suicidal thoughts or behavior ever a point of discussion.
Scratch Princeton off anyone’s list of desirable universities. I hope this is not the norm nationwide!
—- Steve
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I have to agree with Bob that Alan Frances is working pretty hard to absolve the APA of responsibility for creating the DSM III et. al. in support of the pro-biological agenda. Admittedly, it is the pharmaceutical companies who have the funds to drive the point home so effectively in the public mind, but without the tacit or explicit support of the APA, their arguments would be much easier to see as the hucksterism that they are. A great example is “Social Anxiety Disorder.” This “disorder” was clearly targeted for creation and marketing by the pharmaceutical companies (most notably GlaxoSmithKline, makers of Paxil, if I recall correctly), but despite it’s non-scientific and tainted origins, it still made it into the DSM IV under Frances’s leadership. Frances makes good arguments to remove the DSM from APA control and to stop DTC drug marketing, but he’d be more credible if he would acknowledge the role the APA has had in creating this disaster.
I was actually struck by the degree of agreement that does exist between the two, and would hope that these overlaps could form the basis for some more positive conversations regarding shared goals, but I don’t think it can happen without substantial acknowledgement of the corruption that exists in the psychiatric community. Admittedly, most of the local on-the-ground doctors are as much dupes as the rest of society, but they are supposed to be the ones protecting us from this kind of danger. If the APA changed its tune and started making more rational and nuanced recommendations regarding the limitations of drug “treatment” and the variety of other approaches that have been found to be effective, and also supported the honest dissemination of literature on the down side of psychiatric drugs, instead of always standing up to defend against the “unscientific and irrational antipsychiatry element,” there might be some hope for progress. But I’m not holding my breath….
—- Steve
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I agree the absence of any kind of analysis of race, ethnicity, and experience of prejudice is a glaring absence from the report and analysis, and I really appreciate you bringing that issue forward. I don’t think it’s necessary to throw out the baby with the bathwater, however. The report makes a big emphasis on building from the personal experiential viewpoint of the person seeking help. I see no reason why racial/ethnic identity, sexual orientation/identity, immigrant status, historical group trauma, and social prejudice can’t become an integral part of the model. Perhaps rather than withdrawing this report, which is very timely in a lot of ways, an amended report can be written that incorporates these issues into what seems a very sound framework of focus on individual needs rather than the pathologization of normal reactions to adverse social and personal circumstances.
— Steve
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Maybe it would be worth asking what is going on in a society where so many people have a pressing desire to get drunk?
—- Steve
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How can we support these brave people?
—- Steve
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Gee, you seem to have a bit of an agenda of your own, Tusu. “People who live in glass houses shouldn’t throw stones.” I’d find it more helpful to read the research you shared without the snide anti-MIA comments. It’s kind of odd that you’d choose this article to pick on, however, since the article’s premise directly challenges the “agenda” you appear to be critiquing. If congenital blindness really does reduce the likelihood of a schizophrenia diagnosis, doesn’t that suggest a more physiological underpinning, which is just what you’re saying MIA is biased against?
Anyway, I’d appreciate it if you’d keep your comments to direct responses to the article and any data you have that contradicts or fleshes out the picture. You already know that the basic agenda here, such as it is, would be to critically explore the current assumptions of psychiatry and to look at alternative viewpoints and approaches. If you don’t like that agenda, feel free to read some bloggers that support your views. There are plenty out there. Your need to make constant comments on the “agenda” at MIA is nothing but unhelpful trolling behavior, and it discredits your otherwise interesting information which you shared below.
—- Steve
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Some one send copies of this to Tim Murphy and E. Fuller Torrey! Or better yet, how about the NYT and the Washington Post.
—- Steve
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Vivek, your posts are more incisive and more impactful every time. What an impressive deconstruction of the DSM and the forces behind it! This melds very well with Sera’s comments on the connection of this movement with other human rights movements, as social oppression appears to be the centerpiece of the DSM and all of its various institutional offspring. I’m glad to hear that France and Italy may have preserved some different energy in the psychiatric profession.
Thanks for sharing your knowledge and passion!
—- Steve
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This is an amazing set of articles. Make sure to read Part 2 (see tabs at the top) in particular. Prize-winning journalism, or it should be. Does an incredible job of bringing the plight of foster youth to light.
—- Steve
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I’ve been saying this for a long time. Even if there was clear evidence of some kind of correlation with genetics as a predictive factor, which there to date is not, and I doubt there will be, the impact of environment is obvious and so much larger than any genetic effect might turn out to be. The same is observed for things like heart disease and cancer, which have identified physiological markers – the association with genetics is tiny compared with the contribution of stress, lifestyle, and early-life trauma. Since we know for absolute certain that environment accounts for most of the variation in physiological disease states, how much more certain is it that environment is by far the more important variable in a “mental health” condition? Not to mention the fact that genes can’t be changed anyway, while environment can be. Corruption, fear, and egotistical hubris are the only explanations why people continue to seek these genetic explanations when it is clear they will never begin to explain the phenomena that have come to be known as “mental illness.”
—- Steve
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We at Rethinking Psychiatry in Portland put on a symposium last year that was more focused on getting alternative service providers on board than what we’d attempted in the past. It was very interesting to note that some of the same issues came up that reflected survivor experiences with the standard mental health system, though clearly with much less intensity. The issue of labels, in particular, was very challenging – if we’re not using DHS labels, then are we using alternative labels or no labels or what? And if we’re not using labels, what exactly are we “treating?” We got feedback from some (not all) of the survivors who attended that even though it was great to see alternatives offered, there was still a sense that “we are the providers” and “you are the clients” that supported the existing biases and power structure that they’d encountered elsewhere, and left them feeling like the survivor’s voice had been muted or even eliminated from the conference.
I think this is a very tricky challenge, as our language has been so totally coopted and controlled by the DSM-aligned forces that alternative providers are still warped in their thinking by this language. (Just consider the fact that I called them “alternative providers” – kinda assumes they’re some kind of extra, and will never be part of the mainstream, doesn’t it?) For instance, providing an alternative herbal remedy for “ADHD” both legitimizes the idea that “ADHD” is something to be “treated” and avoids looking at the social/structural issues around schools and our weird modern society that make this kind of behavior seem like a “disorder.” It also avoids having to parse out whether there are some people who fit this somewhat arbitrary description who actually DO have something physiologically wrong with them (iron deficiency, sleep apnea, etc.) that is causing them difficulties, as it continues to lump all people into the same category based solely on this random construct of behavioral “symptoms.”
I am generally supportive of efforts like ISEPP to look at providing a range of alternatives for people experiencing distress. However, unless this movement is deeply informed by those supposedly benefiting from these alternatives, it’s pretty easy to fall back into the same game with slightly different rules about who is allowed to be a “client” and who is allowed to be a “treatment provider” and what a “treatment provider” has the authority to do to the “client.” Rather than doing away with ISEPP, I would love to see a more direct engagement with the survivor community and a full-on discussion of social oppression and its role in creating “mental illness” from the point of view of those who end up getting diagnosed, as well as a very survivor-centered agenda when it comes to defining what is and is not helpful. A large dose of humility is an absolute necessity for anyone purporting to help others “professionally.” There are times when I’m with Frank in thinking it may not really be possible, that defining the roles of “professional” and “client” sets up such a significant power imbalance that is too easy for the so-called “professional” to take advantage of.
Not sure what the answer is, but I do know that the biggest question I get when I suggest that psychiatry is doing more harm than good is, “What is the alternative?” I really do think that question needs to be answered, and I do believe that ISEPP and its ilk are genuinely trying to solve it. I’d just think the solution, if there is one, is going to come from the grassroots rather than from academia, for the reasons stated above.
—- Steve
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Fascinating that they are talking about associations with childhood trauma and social isolation, and that in the last sentence, he seems to imply that psychotic individuals are “withdrawing from life,” indicating an intentional (if perhaps unconscious) decision-making process involved in the eventual development of “schizophrenia” (whatever that really means). Sounds like the evidence is suggesting a pretty different narrative than that given to those so diagnosed by the system, who are told their brains aren’t working right and that it’s all genetic and their family and other early life experiences have nothing to do with it (“Let’s not blame the parents!”) and that they have no control over what happens next. Doubtful that anyone at NIMH or in the field will notice the contradictions, though…
—- Steve
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Well, Jill, as much as any of these theories and practices may work very well, there’s not a one that can be patented and sold for a huge profit. Not to mention, if you start actually making people BETTER, well, there goes your client base…
—- Steve
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I read the negative comment you quoted and correctly predicted that it was made by one Gina Pera, who is a pro-psychiatry troll of the highest degree. She substitutes ad hominem attacks for reasoning and is unable to accept any point of view not 100% in accord with her own. She relies on “expert opinion” (but only of HER experts) and is willing to explain away any research finding that she finds inconvenient. An insult by Gina should be considered a compliment. When you’re able to win someone like her over to a more reasonable point of view, I’ll know we’ve won the war!
—- Steve
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Giving advice in general seems to be ineffective and counterproductive. I think the more fundamental mistake is grouping all depressed people together and assuming that one intervention is supposed to help everyone. Since there are so many reasons and contexts for people’s emotional reaction, it should be obvious that you have to approach each person as a unique individual with different needs, goals, and experiences. By even grouping such people together in a study, you defeat the whole purpose of the study.
The only fairly universal principle I’ve found is that listening to, understanding, validating and normalizing a person’s emotional response to their life circumstances tends to help most people moving in the direction of thinking about possible solutions, regardless of their “diagnosis.” But sometimes there aren’t any large-scale solutions and sometimes someone’s circumstances simply suck. Suggesting that they “count their blessings” is so counter-intuitive to me that I doubt I could ever get the words out of my mouth if forced at gunpoint.
Kinda tired of people selling viewpoints on the “right answer” to “mental health problems.” Sometimes the best you can do is to sit with a person in their pain and let them know you empathize. Trying to “fix it” for them usually leaves people feeling invalidated and pissed.
—- Steve
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Well, this certainly can’t be tolerated! They are teaching lay people to actually make things better with minimal professional intervention and cost! Will probably be relegated to back-page news in alternative journals and then forgotten about quickly. Too threatening to the Industry!
— Steve
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Thanks so much for this brutal deconstruction of the current psychiatric mythology. I appreciate the multiple references to research in multiple fields that all impact on what we call “mental illness.” I wish all psychiatrists were as well-educated and honest as you appear to be. Can we run you for APA president next year?
—- Steve
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Ditto from my side!
— Steve
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Actually, psychiatry’s not broken at all – it does exactly what it is designed to do. The problem is that what it is designed to do doesn’t actually bring about positive results for the patient!
—– Steve
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And bummer about the reaction to the drugs. Sadly, I’ve heard that all too often. It’s compounded when they try to tell you that your suicidal reaction is “a result of your disease” instead of stopping the offending drug.
— Steve
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I agree 100%. The double standard is pretty blatant and obvious to anyone not invested in the current system financially or professionally. I’d have no problem with them doing experiments with drugs if they were actually scientific about it, but they totally aren’t. If the standards described in this article were applied to the literature on psych drugs, we’d see a 95% reduction in their use immediately. The only support for any of them is for short-term symptom reduction, and even then it only works for a limited part of the population and exposes the user to huge possible side effects beyond anything the worst results from meditation could conceivably cause. But we need to be careful about overreaching regarding meditation, while we can give out these drugs like candy, in the absence of any scientific evidence to support their extensive long-term use. I think the comparison says a lot about where the psych community is regarding scientific honesty.
— Steve
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The other weird take I have gotten from mainstream psychiatrists when I bring up the point that stress and trauma are deeply involved in almost every case of “mental illness” is, “Yes, but not EVERYONE who is stress has these symptoms!” Implying that the person should NOT react to being raped by developing flashbacks or intrusive memories or high anxiety, and these manifestations are therefore proof of a “bad brain.”
Yep, it’s bio-bio-bio right down the line for most of them, and now a lot of social workers and psychologists, too. Social and psychological issues get lip service at best.
—- Steve
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In the end, blaming the brain IS blaming the person. Not only is it blaming the person, it also communicates to them that they can’t do anything about it if they wanted to. So you are the only reason you’re messed up, but you actually have no power to have prevented it. Talk about a depressing message!!!
—- Steve
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Here is my comment I made on the article, which probably no one will ever read:
Steve McCrea · Top Commenter · CASA Supervisor at Casa
It’s interesting to hear this appropriately skeptical approach taken with regard to meditation studies. It makes me wonder why the exact same provisos and cautions aren’t applied to studies involving medication use for mental illness symptoms? In particular, observations that this science is in its infancy, that the effect sizes are often small, that initial studies often favor the intervention but are not later replicated, and that not all members in the group benefit, and some may in fact deteriorate, all of these would apply 100% to any medication study you could mention. Yet we let it slide that the average change for significance with antidepressants is a mere 3 points on the HAM-D scale, and that placebos do almost as well as antidepressants, and that a small but significant subset of antidepressant users experience some rather intense and extremely uncomfortable and even dangerous side effects, such as akathesia, manic reactions, depersonalization and increased suicidal thinking. Pointing out these very reasonable concerns often gets one attacked as “pill-shaming” or “discouraging people from taking their medication.” In fact, the very appropriate “black box” warning on antidepressants has been criticized because it slowed the long-term increase in antidepressant use among teens, which is exactly what it should have done, base on the assumption that somehow these people who stopped “taking their meds” were at more danger, when they may actually have been at LESS danger due to recognizing they were responding badly to treatment.
It feels like there’s a bit of a double standard in operation here. The writing of this article correctly frames the skeptical attitude necessary for real science to operate. It is puzzling to me why this same scientific honesty does not appear to be applied to research or publications regarding psychiatric medications.
—- Steve
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I really appreciate your historical information and perspective, which I was largely unaware of. I would only add that the entire discipline of psychology as you describe it clearly has roots in Western European culture. I’d suggest that the issue of the “soul” as opposed to the “mind” and the “brain” encompasses a wide range of spiritual traditions worldwide, and that psychiatry as currently conceived is interested in wiping out the validity of any of those traditions, regardless of their cultural origins, as providing any kind of explanation or solution for “mental illnesses.” The denial of the spiritual nature of human beings has been relegated to the realm of delusion and/or superstition, with dire results, at least from the point of view of anyone who cares about human beings more than making a lot of money and maintaining control over the masses. I hope that any future conception of “psychology” as the study of the human spirit will include the incredible array of possible spiritual philosophies, as well as acknowledging that this is an area requiring great humility in the face of the mystery of life. Such humility is almost unknown in psychiatric circles, and the lack of it is the ultimate downfall of psychiatry as a profession and a field of study.
—- Steve
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Or it could reflect a tendency to view less and less significant issues as constituting “mental health disorders,” fueled by successful advertising and drug/disease marketing efforts by Pharma and the psychiatric profession.
— Steve
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Of course, abusive people have an interest in denying and ridiculing any possibility of repressed memory. It sounds like your therapist did it the right way, allowing you to lead the discussion to where it needed to go rather than telling you the kind of things you should find or recall. I have found this to be very valid and healing, both for me and for clients I’ve worked with. It obviously worked for you. Thanks for sharing your story. I’m sorry it happened to you, but it’s great that you found a path to healing!
—- Steve
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My thoughts exactly. At least the earlier narrative provides some sense of potential meaning to the “symptoms” and perhaps a context for taking some kind of action to resolve it. Even a misguided action is potentially empowering to the client, as they might start to brainstorm other possibilities. The current narrative postulates incapacity and helplessness and permanent disability, and not surprisingly, generates results that reflect those key elements of the so-called explanation. And it denies the obvious contribution of family dysfunction and enforced trauma to the situation, in a way that reinforces the very sense of unreality and powerlessness that the parents have helped to create.
—- Steve
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Or more like plan how to avoid being noticed during your next breakdown so the “mental health professionals” can’t find you until it’s over.
—- Steve
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I agree with you. I think the author of the article does not distinguish between therapy designed to uncover purportedly repressed memories, which appears to be fraught with deeply troubling ethical considerations, and the possibility that memories could be repressed, which I think there is good reason to believe happens, based on both clinical and personal experience.
As an example, I always carried around with me a vague recollection of being in second grade with my scary teacher, Ms. Vaughn. I remembered her shaking her hand while holding a book in it, and then flinging the book across the heads of the students to hit some tables in the rear of the classroom. I remembered standing up in my desk and saying something, and next thing I recalled, I was out in the hallway with another kid. I remembered going down to the office with him, talking to the secretary, having her go to talk to the principle, and being sent back to class. None of this was “recovered memory,” but I didn’t recall all of the details.
I was at my 30th high school reunion, and encountered someone who had been in the same class. I told her the story as I remembered it, and she said, “I remember that, too!” When I got to the part about standing up, she said, “She hit you!” She also recalled what I had said (“Miss Vaughn!” apparently intoned in a voice of incredulity), as well as the name of the other kid, who was a friend of mine, and that explained the other kid I remembered being thrown into the hallway with. But the moments between standing up and being in the hallway, I had no recollection of at all.
After replaying this memory to myself, I did recall that I had been sent down the hallway in the principal’s office to see the nurse (the only clear and uninfluenced “recovered memory” I experienced), who appeared to be examining my left ear, which would have been consistent with being whacked in the head by a right-handed person. So Susan’s recollection and mine fit together perfectly, except that I did not recall the part about being hit in the head or it’s immediate aftermath.
Yes, memories can be repressed. Whether they can be recovered accurately or not remains an open question. Whether it’s therapeutic to allow a person to process what they believe to be the truth about what happened, without telling them what is true or not, seems likely to be therapeutic.
I think it’s a whole different question when it’s the therapist who wants/needs the client to bring up repressed memories. That is clinical malpractice and should be treated as such. I believe the client always has the right to decide what is true and isn’t in his/her own life, and therapists who subvert that right, either by enforced diagnostic labels or suggestions or pressure of any kind to believe or recall things that aren’t coming from the client, are doing damage to their clients.
—- Steve
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I become incensed when foster kids I work with blimp up on antipsychotics, and then the doctors put them on a diet! I’m beginning to see a few being put on antidiabetic drugs, which is at least more of an acknowledgment that there is a problem, but once again, we get one drug to address the side effects of another drug given to address the side effects of a third drug, etc. Good for pharmaceutical company profits, but it doesn’t do much for the poor client!
—- Steve
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This is not surprising, but it is appalling. When we know that stimulants provide at best short term relief from the “symptoms” of “ADHD,” the lack of additional psychosocial supports (10%) is gravely disappointing, or would be if I had any belief that the doctors involved even know or care about the long-term study results. But even in the short term, they aren’t even bothering to check and see if their drug is ameliorating the so-called symptoms!!! As if making the diagnosis and dispensing the drug ends their responsibility as a doctor. They really have become more and more like pushers. Disgusting!
—- Steve
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Ron, I think that is a very insightful analysis, and fits in well with what I’ve observed.
—- Steve
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If Jeffrey Lieberman (past APA president) is criticizing you for careless use of diagnostic terms, you KNOW you’re way over the line…
— Steve
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True enough, but as I commented on the article, I wish they’d be as concerned about the drugs they use but don’t know how they work, either. It’s interesting that this is approached with such caution when experimenting with legalized psychotropic drugs is considered so casually.
—- Steve
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Noel, you always blow me away with your intelligent and honest critiques that get right to the heart of the matter. I’ve seen and experienced this exact same “let’s ignore the pink elephant in the living room” phenomenon. In the clearest example, I was at a committee meeting talking about setting some boundaries for the use of medication on foster youth statewide in Oregon. The topic was when we should trip a “red flag” mechanism for an outside review, based on age and type of prescription. Others were talking about whether the red flag age for kids on antidepressant should be any kid under 5 or under 6. I said, “There is no clinical indication for the use of antidepressants in kids under 6.” I was completely ignored, as if I had not spoken, though there was a brief pause that showed me they’d heard. I restated this louder, and was still ignored. When I later talked to the psychiatrist heading the effort (who really is a good guy and often advocates for less or no medication for kids in foster care), and he really had no justification or explanation for why that happened. It seems that there are “taboo” topics that you don’t find out about until you say something “wrong” and encounter the silence of denial.
I don’t really know why it happens, but it is amazing that a conference on trauma would not be willing to even talk about this issue. It’s not rare in my experience that “PTSD” sufferers are diagnosed with schizophrenia or “bipolar” based on “hearing voices” that are directly related to their abuse (aka FLASHBACKS). If we broaden to other forms of dissociation, the boundary between trauma reaction and “schizophrenia” seems to become pretty porous.
I wonder if they are worried about being attacked from the psychiatric profession is at the core of their unwillingness to talk about this connection? Perhaps they are dealing with their own professional traumas?
Thanks for another great article!
—- Steve
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On the other hand, his psychiatric treatment doesn’t seem to have helped very much, does it?
I’m sick and tired of hearing people blame “the disease” (secret code for blaming the “patient”) for bad outcomes. We’re paying psychiatrists to help people with these ostensible “diseases.” If their “help” leads to misery and suicide, then they need to find another way to help. It’s the only profession where you can blame the subject of your profession for not cooperating in allowing itself to be fixed. If I take my car to a mechanic, and he can’t fix it, he doesn’t blame the car and charge me to come in for weekly “treatments” for the rest of my life. He says, “I am sorry – I can’t help you with this. I don’t know how to fix it.” It’s past time for psychiatrists to learn a little humility and start admitting when they don’t know how to help someone. The antidepressants don’t have to have been the cause of death for this to represent a colossal failure of psychiatric intervention. He was receiving the best psychiatric help money could buy, was compliant with “treatment,” and yet was still so miserable he ended his life. That’s a failure by any estimation.
— Steve
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Right back at ya!
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Kupfer’s comments are appalling. A quarter of all researchers report intentionally falsifying their results. That’s more than “a few bad apples!” But of course, I expect no more from the chair of the DSM-5 task force, as he presided over a veritable carnival of intentional falsification and lies.
—- Steve
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Thanks for that incredibly informative post, Crux! I learned a lot in a very short read.
—- Steve
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And they actually seem to notice and care what is going on with you. A little eye contact and a touch on the arm can go a long way to reminding someone that someone else still cares about them. But I guess the psychiatrist would have to allow him/herself to genuinely care first, which seems to be a challenge for many.
—- Steve
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I was impressed that the kitty seemed to be capable of a more effective mental health intervention than the psychiatrist. I hope you had a therapeutic cat, too – cheaper than antidepressants, with no side effects, except for hairballs and litterboxes!
— Steve
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I don’t think he was saying that the behaviors were caused by drugs, but that the brain anomalies noticed in some kids were the result of those kids taking drugs. I had the same thought – they noted that the enlarged areas were the same ones seen in schizophrenia, and both are often treated with atypical antipsychotics.
My brother’s son has an “aspergers” diagnosis, and it’s clear there is something definitely not quite right with him that is not a result of their parenting approach (though they may have made it better or worse by their approach). I’m not opposed to the concept that there might be some physiological reason that at least some cases of what is called autism occur. I just don’t buy that anyone knows what, if anything, is wrong in a particular case, nor do they appear to know what to do to make it better. It’s quite likely that what is called “autism” could have multiple causes that all manifest similar symptoms. My objection is to the hubris of the psychiatric profession in asserting they know far more than they actually do. And I’m confident you agree with me on that point!
—- Steve
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Creepy as heck!
—- Steve
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“A question that arises out of all this is whether psychiatric diagnosis came out of the loss of the art of listening. If we are diagnosing, we aren’t listening. Is psychiatry, as it has developed, a way to bypass listening and instead give a pill?”
Yes, it most definitely is! That is brilliantly stated. It reminds me greatly of the works of Alice Miller, whose primary thesis is that we suppress our own pain as children because we have to, and if we don’t become aware of that process, we inflict the same pain on our own children. Psychiatry provides an effective mechanism to do exactly that. “My son isn’t depressed because of his environment or upbringing or the school he has to attend – it’s because his brain doesn’t work!” The adults are absolved of responsibility and the children get to carry the “bad person” label. And into adulthood, the person in power is always protected by the ability to define anyone protesting their decisions as “mentally ill” and absolve themselves of the need to use their power more responsibly.
Listening is the key – when people listen and hear where the suffering comes from, it’s a lot harder to dehumanize the victim. Which is why it is SO terribly upsetting to the elite when survivors try to have their voices heard. Somewhere deep down, they know they are missing the boat and causing more pain and will be called to account for it some day. The only way to defend against hearing that deep voice in their own psyche is to cling more tightly to their defensive “theories” that put the blame on the victim instead of empowering their client to find new ways to be heard.
Beautiful piece!
—- Steve
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My housemate is a former foster youth. I was talking to her about the correlation between psychiatric attention and suicide, and she shared with me last night that the only time she was ever suicidal was when they forced her to take Zyprexa. She reports what clearly sounded like akathesia for a few weeks at least, and says she had the knife in her hand, and only stopped because her cat bit her on the arm just before she went through with it and it brought her back to reality. She stopped taking Zyprexa, and has never been suicidal since.
I think the number of suicides in the US is huge and largely preventable, but not by the current approach, which in fact seems to make suicide more likely to occur. Without a new paradigm, it’s hard to imagine what a suicide prevention effort that actually works would look like. I’d love to hear your ideas about that, Doug.
—- Steve
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Tusu,
For the most part, we’ve only heard about what you feel or believe, and gotten some assurances from you that these articles/references do exist but no links to them. It’s hard to take you seriously when you come in with such an attacking attitude and yet provide no independent data to back up your views which any of us can read and digest.
The only real “party line” here at MIA seems to be “don’t expect us to believe you just because you said something.” In areas of controversy, it is important to name your sources so that others can verify what you are saying and potentially offer alternative analysis. This is a core value of scientists everywhere (or at least anyone who can legitimately claim to be scientific): data is the touchpoint that we all have to start from. So far, you provide a lot of rhetoric and not much data. I’m going to ignore accusations and be interested if you provide studies that we can read.
I would also add that if you have such issues with MIA, I’m puzzled why you would want to read/post here. There are plenty of websites who post articles that agree with your opinions and beliefs 100%. Perhaps you should post there instead? Is your effort because you’re so interested in giving us the right information, or simply because an alternative viewpoint makes you uncomfortable?
—- Steve
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Scott,
Another Portlander on MIA! I’d love to meet you some time.
I think the point isn’t that people so labeled don’t exist – it is that referring to such people as if they are a group with some common characteristic simply invites and reinforces prejudice and discrimination. I recall a discussion at a presentation by two Native American social workers about whether the term “Indian” was insulting and whether “Native American” should be generally adopted. They said that neither was really more insulting than the other, and both were used in Native communities, but the real identity of the people was their tribe. They felt that the entire effort to find a word to refer to them as a group was counterproductive, and that we should see different tribes as different cultures and different individuals within these tribes as unique individuals with their own lives and values and priorities. I think this applies here as well – how can anyone make generalizations about “the mentally ill” when the concept now embraces everything from talking to disembodied spirits to being uncomfortable with the sexual identity of your body to being unable to do math problems? What do all these people have in common, other than the fact that someone chose to label them? Not a whole lot, other than being human.
Maybe when we see the word “Mentally ill,” we should just substitute “Human Being.” Let’s face it, with the DSM 5, pretty much everyone is represented in there somewhere!
—- Steve
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Agree 100%! And for a ton of other stuff, too. Psych drugs should be a last resort – they’re an admission we don’t really know what’s going on. But they’ve become an excuse for not even bothering to find out anything else.
—- Steve
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I also found that phrase chilling! No toddler should EVER be diagnosed with a “psychiatric disorder!” Well, really no PERSON should, but it is especially egregious with toddlers, who haven’t even had time to solidify their basic personality. It’s bizarre!
—- Steve
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You said it, brother!
—- Steve
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It’s not paranoia. They really are out to get you.
—- Steve
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I found this quote from Frances quite illuminating:
“…conflict between professionally run mental-health programs and those based on recovery.”
So he is admitting that “professionally-run mental health programs” are not based on recovery, and in the same sentence, he is asserting that programs based on recovery aren’t run professionally. I think he lets his real beliefs leak through here – REAL professionals aren’t concerned with recovery, and those with “lived experience” don’t really have anything to contribute to the world of those “professionals.”
I think the analysis of Frances’s real vision relating to expanding psychiatry’s influence through diverting money from the prison system is quite brilliant, really. And the analogy of enforced treatment to slavery is, of course, quite apt. Thanks for an engaging and thought-provoking article.
— Steve
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Au Contraire, tusu, I hear a great deal of dialogue on the MIA boards. There is such a range of opinions here that threads sometimes degenerate into attacking one another’s conflicting views on a particular subject.
And I definitely don’t see an “anti-treatment” bias here, unless you mean to define medication as the only “treatment” and try to force it on people. There are extensive discussions of alternative forms of treatment, including for psychosis and “bipolar disorder,” as well as frequent comments reminding us all that some people find medication helpful and that we need to respect their individual experiences. The main difference is that we also respect the individual experiences of people who DON’T find medical treatment helpful, regardless of their “diagnosis,” which is a viewpoint Dr. Frances (and I gather you agree with him) does not appear to support.
Where I don’t hear dialog is on the NAMI or the CHADD sites or in most mainstream discussions about psychiatry. Everyone is supposed to sing the “mental illnesses are brain diseases” song, and anyone who is off-key is shouted down very quickly.
As to death sentences, please recall that the average life expectancy for those receiving “medical treatment” for these “severe mental illnesses” is 25 YEARS LESS than the general population. So it does not appear that not receiving this treatment is likely to lead to loss of life in the collective, though there may be individuals who may want or benefit from medical interventions and decide the risk of a shorter life is worth the reduction in symptoms they experience. And they won’t get any argument from me or the vast majority of our community members. What will get an argument is if you pretend that the shortening of lifespan is not an issue, or that everyone who doesn’t embrace this form of “treatment” is a moron or a dangerous extremist.
Aside from which, I think you totally missed Rossa’s point if you claim to agree with her. I believe she’d agree with almost everything I just said, though of course, she’s welcome to correct me if I’m wrong.
—– Steve
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How is it even legal to market this thing? The FDA can de-license it at any time. Caveat emptor, I guess…
— Steve
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B, once again, you’ve taken the words right out of my mouth. We spend far more tax dollars subsidizing rich scoundrels than the relatively small number of dishonest SSI recipients vets and welfare cheats and illegal immigrants combined, by a very long shot. In fact, it’s been effectively argued that illegal immigrants contribute far more to our economy than they take out of it. It’s the Captains of Industry who are robbing us blind! I hope the day is not far off when the average American (or whatever country you’re in, but the USA seems the most obtuse about this) starts to realize who the real enemy is.
—- Steve
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It is more likely to be the labeler who is lacking in empathy. “BPD” is usually a fancy way of saying, “I don’t like being around her very much.”
—- Steve
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Toby,
Thanks so much for this awesome summary of the evidence regarding ECT. It makes advocacy so much easier to have a comprehensive list of references to support an alternative viewpoint. That this even needs to be said is in itself disturbing, and of course, many in the field really don’t care about or don’t want to hear any actual data that contradicts their favored (and most profitable) worldview. But for those on the fence, this kind of info is critical. Thanks again!
—- Steve
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Go, Peter!!
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My thoughts exactly, on both counts!
— Steve
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I haven’t lived in Philly for a long time, and don’t have any media connections, but it just seemed to me that they’d be more likely to grab at this kind of a story. But there does seem to be weird resistance to airing this stuff publicly. Perhaps the papers don’t want to “bite the hand that feeds them” and offend the pharmaceutical industry?
—- Steve
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I think you allude to another issue in the article – it FEELS GOOD for people to believe that psychiatry’s power is being used for good. It’s the ultimate opportunity for projection – our son’s problem isn’t because we were bad parents or because his school was oppressive and abusive or that we live in a crazy society that makes people feel awful and come up with strange ways to cope with its insanities – it’s his BRAIN that is broken, and THEY CAN FIX IT! Even if they don’t really fix anything, it still fixes the problem of who is at fault, and preserves the idea that given sufficient time and technological know-how, whatever is bothering him can be erased or suppressed or removed from consciousness and we can avoid having to deal with the issues that led to his distress. It is a very comfortable belief system for those in power, and it’s kind of jarring and disturbing when people like us start asking questions about the actual validity of these supposed guardian angels who are going to use technology to make us all feel OK.
Nobody gets rewarded for saying the Emperor is naked. There are way too many people invested in this viewpoint for a few scientific facts to disturb the social trend.
I wish I knew the answer…
—- Steve
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It is likely that the increased placebo effect has resulted from increased social expectation that drugs will be effective against “mental health problems,” which is exactly what we should expect to happen. I guess it’s the downside of the impressive (if almost completely dishonest) marketing effort that’s pushed these drugs to the top of the sales charts. But I’m with AxqYi – any real scientist would see this trend as a result. And I also agree with Frank (as I usually do) – the decreasing impact of neuroleptics probably is a result of exactly what Bob is outlining in his book – more people have used them for longer periods of time, so they become less effective.
The recommendation to shorten trial times in order to eliminate placebo effects is particularly troubling to me. These people are not scientists!!!!
—- Steve
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As baseball announcer Tim McCarver once said, “I don’t know why the call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it was so common, more people would have it!”
Of course, you make perfect sense, as always, and it seems any rational person would have to agree with you. Unfortunately, I must conclude that most of the mental health system today is peopled with irrational people for whom “common sense” is not all that common. Sure, a lot of them have been conned, but you’d think that simply observing the results (or lack of results) would be enough to get folks to question these assumptions. Sadly, it often is not.
Thanks for your clear, gentle and firm writing. I only wish I could find a way for those lacking common sense to hear what you are saying!
—- Steve
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I have always said that the main cause of ADHD is SCHOOL! There was a great study back in the 70s that showed that “ADHD” kids were virtually indistinguishable from “normal” kids if they were in a classroom that allowed more spontaneous movement and decision-making by the kids. It is primarily the rigidity of the educational environment that drives most of these kids around the bend. Some kids (I was one) are able to suppress their inherent sense of boredom and injustice and put their nose to the proverbial grindstone, no matter how stupid or inane the assignment. Some are not able to do that, and these kids get diagnosed with a “disease,” rather than looking at how or why the teaching they receive is so incredibly dull and rigid that they are unable to tolerate it.
—- Steve
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Have you tried the Philadelphia media? Trenton is kind of a suburb of Philly and your story might get more play in that region.
Thanks for taking up for her. This is disgusting. I only wish it were more shocking than it was. Can you let us know if there is someone we can contact to encourage a reporter to run a story, or an attorney to take up the case?
—- Steve
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You go, Nancy!!!
—- Steve
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For Jonathan,
I just want to add that I did a brief and very painful stint as the mental health professional who made the final call in the ER as to whether someone was held against their will or not. This has deeply colored my views on this issue, because my experience is that depressed/suicidal people (an anyone else who was involuntarily detained) were ABSOLUTELY required to take antidepressants and other drugs against their wills, and were provided essentially NO other kind of service worth talking about, unless you count the basket-weaving type “activities” they forced the inmates to engage in. I suppose you could say they had the right to refuse, if they were educated enough to realize that, but of course, no one every told them that, and even if they did refuse, they would be very unlikely to get out until they changed their minds, and the pressure to comply (as well as the rate of lies told to justify this) was incredible.
This particular hospital ward stated their role was only “Stabilization,” which is essentially code for giving the clients drugs until they stopped feeling or acting bad in the view of the staff. There was not much going on that could be construed as healing, other than the attempts of the odd extra-compassionate staff member who bothered talking with the patients. Believe me, I did everything I could, including some impressive therapy in the ER, to keep anyone from having to spend a minute on that ward. And my impression is that that was standard issue at the time, and don’t see any reason to believe that it’s any different now, 20 years later on. There may be outliers, but most psych wards exist solely to convince/cajole/force their patients onto some kind of drug. I know you don’t believe that’s what should happen, but the sad reality is that it does happen and is not questioned by most of the mental health “professionals” who participate.
I am afraid you’re a major outlier, Jonathan!
—- Steve
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Thank you, Meaghan, for such a beautiful, heartfelt, and honest rendition of your experience! I am so sorry you have had to suffer as you have, and am also just plain impressed by your ability to find the good in yourself despite all of that. Yes, I can agree from experience, this is a lifelong challenge, but feelings are what life is largely made of, and feeling less isn’t the same as feeling better. I really hope this woman and many like her are able to hear your message through the rhetoric and mythology and marketing hype that’s created this antidepressant disaster.
I’m glad you’re writing for MIA and I hope you find as many ways as possible to get your message across to as many people as possible. You articulate this with the kind of credibility that the most entrenched psychiatric true believer would find hard to ignore!
—- Steve
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It is my understanding that there are a number of states that do not have civil commitment laws for “mental illness.” Does anyone know how they manage the kind of situations Jonathan is talking about?
I agree that these cases are a dilemma, because people do need to be protected from harm and violence, and the jail system is pretty brutal. But the psych system is pretty brutal as well, and I agree with Richard that there is a benefit to acknowledging the reality that being locked up isn’t likely to be perceived as “treatment” by the vast majority of those experiencing it.
I’ll say as I have before that there is no reason that detention of a person for acts or threats of violence has to be coupled with enforced treatment. Perhaps there is a place for detention of people who have violated the law in some way but have extenuating circumstances in a separate place that is not so brutal, or perhaps we need to reform our prison system so that being detained there isn’t an invitation to further abuse by the guards and other inmates. But none of that suggests that forcing “treatment” on a person based on their purported “mental illness” is a viable idea. I think it’s a very legitimate position to be opposed to enforced treatment under ANY conditions, and yet still support using force when necessary to protect others from harm.
Of course, the question of “protecting” someone who is suicidal from him/herself is a much thornier issue. But even so, the same thinking applies: even if you decide it is OK to detain a person for self protection, it should not take away their right to consent or refuse medical treatment, in particular, the drug-based pseudo-“treatments” that are usually enforced on every detained person in the psych ward.
—- Steve
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I left the following comment below the article:
“Honestly, I find this article incredibly creepy. Reminds me of efforts to “help” soldiers with PTSD symptoms to “recover” so they can be thrown back into battle to be exposed to yet further trauma.
There are good reasons why depression has become more common and more chronic over time, and it doesn’t have to do with bad brains. The way we run our businesses and our society is the biggest contributor, as we encourage people to disconnect from families and community and work long hours at meaningless positions in order not to starve to death. Meanwhile, we incentivize businesses to minimize labor costs, maximize profits, and invest in machines instead of people, and we intentionally assure that there is always a certain percentage of unemployed people in order to keep competition in the labor market sharp and keep wages and prices down. And that’s not counting the effects of pollution, global warming, warfare, and economic oppression in almost every country throughout the world. Depression seems a pretty normal and understandable response to such a bizarre way of living, especially when it seems there is little to nothing any one individual can do to stop this juggernaut from continuing to move forward on its destructive pathway.
Maybe instead of teaming with neuroscientists to try and come up with new pills to make everyone OK with the crappy conditions we live in, they could start by working on improving wages and working conditions for their employees. There are many steps that could be taken, including on-site daycare, paid parental leave, living wages for low-level employees, employee democracy and profit sharing, and universal healthcare and education for cheap or free (something on which the USA has to catch up to the rest of the industrialized world).
Depression is a natural response to bad conditions. Trying to “cure” depression with pills is like trying to banish physical pain. Sure, it hurts, but it’s warning you to get your hand off the damned stove! Numbness to bad social conditions is not a worthy goal, in my mind.”
—- Steve
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The evidence base for Benzos is only in the 6-8 week range, and the product information itself says that it is not intended for long-term use. The best analog to benzos in terms of effects on the brain and body is alcohol. Taking a shot definitely does help you sleep in the short term, but anyone using a significant dose of alcohol to sleep every night is going to be in for trouble in the long run. It is noteworthy that long-term alcohol abuse does lead to a form of dementia in many people. Why any doctor would prescribe benzos long-term is baffling, and in my mind, it is criminal behavior.
—– Steve
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So what is the effect on later attempts at “treatment” if your first experience is being hauled off by police to the ER, put in restraints, held against your will in a hospital ward with other people there against their wills, some of whom seem kind of scary, and forcibly injected with drugs that massively alter your perception of reality, often in a negative way? Think that maybe such treatment might lead to a psychological “bias” that these people’s “treatments” aren’t anything you want to try again?
—- Steve
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I thought the Hunger Games books and movie captured this idea very well. We may not be able to control much about our lives, but we don’t have to let “them” own us. The sad thing is, most of “them” are feeling just as powerless as we are. There are a very few evil folks who do most of the damage, but it’s perpetuated by people not speaking up. Which is why I think we “sensitive” folks are needed – we’re the alarm bells for the rest of the snoozing population!
—- Steve
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Thanks! It is good to know this stuff bothers others besides just me. “Ignorance is bliss” I guess…
—- Steve
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All I can say is LAWSUIT! It is so rare that these mental health hearings result in a release, you KNOW there was no grounds to hold that person. To act with such impunity is absolutely criminal, but the evidence required for criminal conviction is quite a bit higher. So I say sue their asses. Class action would be better if they could find a handful of folks who had the same thing happen to them. It’s a gross violation of civil liberties and needs to be appropriately sanctioned by the Courts.
—- Steve
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I notice that they don’t comment on the corollary: there are no drug treatments that are effective in reducing teen suicide, either, and there is a lot more evidence that drug treatments are more likely to INCREASE the suicide rate in teens.
—- Steve
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sklujan,
As a fellow counselor, I would also encourage you to speak up loudly every time you hear this hypocritical approach being promoted. There are no doubt others in your classes who are similarly detecting that something smells wrong about this, but may not be able to articulate it, or may be too afraid to speak up. Research into bullying suggests that it only thrives in an environment where bystanders laugh along or keep quiet. And that’s what this is – bullying, with a soft, social-work-y coating laid on the outside to make it seem less harsh.
Follow your heart and speak your truth. We need more therapists like you out there!
—- Steve
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Thanks for sharing your story. It really struck me hard that it felt easier to be a gay teen in Texas than to be a “mentally ill person” in the system! The word “stigma” hardly begins to describe it – this is blatant prejudice and discrimination. And it is always fascinating (when it’s not personally directed!) to see how quick those doing the discriminating are to defend their own behavior as beyond reproach and to blame the victim for not sufficiently appreciating their “helpful” interventions.
— Steve
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Because they mostly don’t give a crap. It does not surprise me that no one has done this kind of study before. They just plain don’t want to know, because the knowledge is inconvenient, and they’re all about what is convenient for them, and profitable, of course.
—- Steve
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Good for you!! They really are idiots, aren’t they?
—- Steve
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Hi, Doug,
In a similar place myself right now. I am not sure it is about chemicals cycling for me, as much as it is about my life focus changing since my youngest son has left home for college this summer. I am questioning why I am here and what I’m doing with my life. It seems appropriate to me to be going through this somehow, even though I am hating and resisting it most of the time. I think it’s time for me to make a big change in how I’m living, and that’s why I’m feeling this way. Not sure what it looks like yet, but change is coming whether I want it to or not, so I have to work myself around into embracing the idea of a new way of living my life. Meanwhile, I am pretty miserable every single day.
I think depression for me is often the result of stagnation and feeling trapped. There are so many problems of a huge scale confronting us right now, it’s difficult not to lapse into despair. I am discouraged by the venality and thoughtlessness of my fellow humans and my own inability to impact them on a large scale. Underneath the depression for me is a towering RAGE that my life doesn’t feel like it’s my own, that I’m trapped in the capitalist treadmill of going to work to earn money, and coming home to “relax” in the evening, and looking forward anxiously to the weekend but then finding little to do on that weekend that is truly rewarding, and meanwhile waiting for the populace to wake up to the impending disasters our way of life is creating, not knowing what destruction will happen in the interim. It’s not a happy way to live, even though that’s what we’re all taught to do.
Someone once said that suicide is a political comment, not on the person committing the act, but on the society in which s/he lives. I kinda feel the same way about depression. If I were unconscious enough not to understand what is going on, I might be able to feel OK about all of this through denial and ignorance. But I am not and I can’t do it. So I am going to have to change the rules of the game somehow. We’ll see what I come up with.
Hang in there, and know that you are not alone. Perhaps your depression has a meaning you have not yet fathomed?
—- Steve
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Would be interesting to correlate this with antidepressant usage during the same timeframes. It seems pretty obvious that we have tons more antidepressants being prescribed and people are more unhappy than ever. Fits in with Whitaker’s thesis perfectly.
—- Steve
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Dangerous mishaps, like Murder, perhaps? The Fort Hood Shooter was on Ambien during his rampage. But I’m sure there is no connection…
—- Steve
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Hey, Fred! Didn’t know you were an Oregonian! I used to go to Reedsport occasionally for my job. I’m in Portland. Hope we get to meet one day.
—- Steve
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The authors leave off the most salient reason for the ad hominem attacks. The clue is that they came from America even if the published results are in New Zealand. What that suggests is that there are people in the psychiatric world LOOKING for anything that might affect their bottom line, and that they have an intentional strategy of suppression via ad hominem attacks and other tried-and-true methods of discrediting of opponents in what is really an economic war. The more serious the threat to their dominance, the more vicious their response will be. It is not accidental or the result of bruised egos – this is mob warfare, where the boss has any competition in the area wiped out by whatever means are necessary.
You must be doing good work if they are threatened enough to go on the attack!
—- Steve
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Aubrey, I am just stunned by the clarity and horror of your story, even though I am well aware of psychiatric abuse and child abuse and Munchhausen’s by Proxy. You are an amazingly courageous person not to have succumbed to this absolute Kafkaesque bizarreness. I will write to the Chief of Staff as you request, and I wish you very well in your efforts to finally find some sort of justice in all of this. Thank you for sharing your story with us.
— Steve
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At last, the acknowledgement of the obvious truth: psychiatrists believe in magic! Perhaps the more appropriate title to the article would be, “The Magic of Intentionally-Induced Brain Damage!”
—- Steve
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I am with you, John. We need to find areas we agree on in order to be effective. Trying to appease or align the whole range of political opinions leads to the kind of chaos we see on this thread.
One point of agreement that seems to be repeated by both “sides” of this debate is that corporations have too much control of government apparatus, or to put it another way, that government does not serve the needs of individuals but rather of elites who have an interest in controlling the rest of us. This might be framed differently by “conservatives” vs. “progressives,” but it’s an area I’ve found agreement on across the political spectrum. I think finding issues like that which have leverage across party or political lines is a lot more important than arguing out the finer details of climate science, which is a pretty new science that undoubtedly allows many valid critiques, and which probably none or almost none of us here know enough about to really draw any definitive conclusions about. I’d rather look through the “sides” of this debate and find out where we agree, and move forward from there, rather than spending so much time hashing out the two sides of an argument that will not be resolved in this forum.
Drug companies are self-serving and greedy entities willing to lie, cheat, and bribe their way into control. They are in cahoots with the psychiatric profession, and to a large degree with big portions of our government apparatus, and have been very successful in using marketing tactics to promote the existence of metaphorical “diseases” that their drugs purport to “treat.” That’s what I think pretty much everyone here agrees to, and that’s where I think we should build from. I am of the mind that this kind of oppression is, indeed, linked to a wide range of other oppressive activities supported by our society, but it is not a requirement that others see it that way for them to oppose the Pharma-psychiatric-government effort to drug the so-called “mentally ill” into submission for a profit.
—– Steve
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I was thinking the same thing, although that clearly doesn’t explain all of it. There are so many kids who take stimulants and become aggressive, and then get “bipolar” diagnoses! I see it all the time in my work. No one ever seems to stop and ask if stimulants could be the cause, even though increased aggression and mania are noted side effects of stimulants. Even more bizarre, we know that stimulants increase dopamine levels, and antipsychotics, which are the most common drug given for “bipolar” in children, decrease dopamine levels. So we’re increasing them with one drug and decreasing them with another.
How does the public let these people get away with it????
—- Steve
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Which goes to show that most people’s decisions are not made with scientific data in mind, but on the basis of emotion. That is an important lesson for our movement.
—- Steve
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“We need to give providers good guidance on how to use brief symptom measures in evaluating patients and making treatment decisions.”
I have some good guidance – toss them in the trash can! Anything that can give that many “false positives” is worse than useless. As an alternative, I suggest a radical concept – instead of giving them a questionnaire, why not try TALKING with them and taking some time to understand their lives?
—- Steve
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Hi, Chaya,
I really agree with you that a huge part of “good treatment” (if that’s even the right term) is helping people deal with conflict situations effectively. I am very familiar with that fear of public humiliation, and agree that this is behind so much of what is called “mental illness.” Radical self-acceptance seems to be step one of any plan to become more effective in life – reasoning by fear is what gets us into these problems in the first place! Unfortunately, the privileged class can get away with their fear-based reasoning by attacking and “othering” those who challenge their dominance and ability to control the dialog. Even more unfortunately, a lot of psychiatrists, maybe most psychiatrists, seem to fit into that category of people who need to protect themselves by projecting their power over others, whether consciously or not. It’s dangerous when the person responsible for providing healing energy is so damaged that they can’t even conceive of healing energy, especially when they have the power to compel their “healing” concepts on unsuspecting victims.
— Steve
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The alternative is very clear. A really good study done in the late 70s had professionals try to identify matched sets of “ADHD” children in regular classrooms and in an “open classroom” (think Montessouri) with work stations that kids could choose between and move between when they felt they were ready to transition. The professionals were 90+% accurate in the standard classroom, but could not consistently distinguish the diagnosed kids in the open classroom setting. This is a dramatically clear result, and suggests that we should be putting these so-called “ADHD” kids into open classroom settings where they have more control over the focus and timing of their education. We did this with both of our active, oppositional boys, and both did well in this kind of setting, though they’d assuredly have been disastrous train wrecks in a standard elementary school.
Unfortunately, open classrooms were opposed and beaten into submission in the 80s as the “accountability movement” (think standardized high-stakes tests) took over in the USA. I have always believed that those behind the “accountability movement” actually hate children and believe they need to “have the devil beaten out of them” in order to make them into orderly, compliant adult consumers. There is a small resurgent effort in the “unschooling” and the liberal end of the charter school movement, but such classrooms are not readily available to the general public, at least in the US. We actually had to help invent one for our youngest, who thoroughly defied all the predictions regarding drug abuse, school failure, low self-esteem and delinquency, as he is now a freshman at Evergreen State College after finishing high school with a 4.0 average. So much for “untreated ‘ADHD’…”
Open classrooms are the alternative. We know they work, but we have to create them and make them available to our “non-standard learners.”
—– Steve
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Can we appoint you to lead the FDA into the next millennium? Your plan makes excellent scientific sense, even though it would drive the politicians and corporate fascists around the bend!
—- Steve
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Wow, Meaghan, you have shared both the worst and the best of what psychiatry can be! I wish we could clone your latest psychiatrist – I don’t know that I’ve ever met another one who exhibited that ability to be real and human with his client and yet maintain professionalism throughout. You are indeed fortunate to have found him, and to have discovered that you are, in fact, not ill at all, simply responding in the best way you could to an intolerable situation.
Despite which, you appear to be amazingly accomplished, creative, and persistent! Thanks so much for sharing your story with us, and I hope you’re able and willing to write more about your impressions of what works and doesn’t work in helping someone overcome a traumatic and difficult upbringing in a traumatic and difficult society.
—- Steve
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Superb satire – I really did laugh out loud!
—- Steve
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Any real scientist knows that negative results are far more important than positive results. Science is actually really bad a proving anything, because there are almost always multiple ways to explain a “positive” finding, as well as many ways to manipulate data to make a finding look more positive than it really is.
The real test of science is trying hard to DISPROVE a hypothesis in any conceivable way and still having it hold up. Science is very good at absolutely disproving a hypothesis when the results contradict what is predicted to occur, so any events that contradict a given hypothesis are of the utmost importance, because their presence, or the lack of them after multiple efforts to replicate or disprove an idea, are really the bottom-line determinant of scientific truth.
Null findings should systematically be published, and should be required to be submitted along with any “positive” findings before a drug is ever allowed to reach the market. If this were done, a lot of bad drugs would be stopped in the pipeline, instead of 10 years later after hundreds are killed and the patents finally expire.
—– Steve
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Thanks as always, Michael, for your passionate advocacy against one of the most heinous crimes of psychiatry – the drugging of innocent children for their normal childlike exuberance!
The only thing I’d add to this is that our schools themselves cause “ADHD” to even be an issue in a huge majority of cases. A couple of points on that: 1) there was a recent study showing that waiting a year for Kindergarten admission reduced the rate of ADHD diagnosis by 30%. 2) A great study back in the 70s showed that professionals were unable to identify “ADHD” children in an “open classroom” (think Montessouri style), while they easily identified a matched group of “ADHD” children in a standard classroom setting. So moving the kids to an open classroom essentially eliminated the vast majority of difficulties they exhibited, even though those with the ADHD diagnosis probably suffered from disproportionate levels of abuse, neglect, and trauma outside the home, as well as probably having more sleep difficulties or dietary issues or whatever else is associated with “ADHD.”
We could “cure” 90% of our “ADHD” population by simply putting them in open classrooms, and having anyone having difficulty in that setting wait a year and restarting school. Knowing this makes the drugging seem all the more horrific by comparison to what might actually be done to help the situation.
—- Steve
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I have an even more effective screening tool that “adjusts its line of questioning depending on responses to previous questions” – it’s called TALKING TO AND LISTENING TO THE FREAKIN’ KID! I know this is a radical concept in today’s highly technological world, but I am promoting the idea that a human being may be better able to connect with a young person in distress than a computer terminal. On the other hand, given what many so-called “mental health professionals” provide today, maybe their odds are better with the computer…
—- Steve
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I think she is preparing people for what may be a grim reality, as well as helping people who don’t want to face such a grim reality perhaps decide not to start using these drugs. Of course, not everyone has this level of difficulty, but for those who do, I imagine it must feel like a big relief to hear they are not alone, that this can be a very difficult process, and that despite those difficulties, Monica has continued to move forward and ultimately succeed in getting herself off of these drugs.
We each have something to contribute, and I think Monica’s contributions are extremely valuable, and I always have.
—- Steve
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Too true!! Well spoken, both of you.
—- Steve
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This is an excellent and thought-provoking comment! I really do believe and have observed that the lack of a positive social role for creative and deep thinkers and feelers in our society is part of the reason that outcomes for people experiencing “altered states” are so bad here. I think it would be a very different experience if a person heard voices and instead of others being worried about it, someone said, “Hey, you can speak with the spirit world! What are they saying? Let’s get the shaman over here – you need some training!”
—Steve
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Sandy,
As always, I appreciate both your honesty and humility. It is the lack of both that I believe contributes to the damage done in the name of “mental health treatment.” I am the last to suggest that tapering is going to work for everyone, or that CBT is going to work for everyone, or that everyone even needs to do some kind of “therapy” that can be judged to work or not work.
I have to acknowledge that I had the biggest challenges with people experiencing what would generally be termed “psychosis” when I was working with adults sent to the hospital for possible commitment. I believed and still believed it was due to a lack of understanding and skill on my part. It was very difficult to accomplish what I usually do, which is to develop a strong sense of shared reality and agreement with the client. I have been able to do this many times with people experiencing “psychotic symptoms,” but more often than not, it was difficult and I was often completely unable to accomplish it. But that doesn’t mean it couldn’t have been done by someone more skilled than myself at it.
Even Open Dialog uses medication on something like 20% of clients long-term, so I am guessing there is no one way that is going to suddenly resolve all issues of psychotic experiences. But I think Nijinsky is correct in saying that the problem may relate to “consensus reality” itself. My biggest problem with psychiatry as practiced is not that it fails to help everyone it tries to help, but that it fails to recognize the possibility that eliminating symptoms may not be the ultimate goal. Perhaps it is more important to start with respect for the fact that all individuals have their own particular perception of reality, some aspects of which could be called “delusional” by others who disagree. Trying to force one “consensus” view of what is “normal” seems to be the central problem of the DSM and the mental health industry as a whole. Being able to acknowledge, as you do, that you don’t really have all the answers, and maybe aren’t even sure of the right questions, is increasingly a rarity in the field, in my experience. Until that kind of humility and openness becomes pervasive in the field, I believe the use of medications will continue to be extremely dangerous and lead to bad outcomes, because it will not be tempered by a proper understanding that medications/drugs are just a tool, one of many, many tools, and that it is pretty much a blunt instrument whose short- and long-term effects can be devastating if used in a careless or egotistical manner, as they most often seem to be used today.
—- Steve
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Could be. But I think it more likely reflects that the real purpose of the drugs is to make kids more manageable. Their “behavior improved” means they were less annoying. Apparently for some adults, that is more important than having the child sleep well.
—- Steve
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Interesting that Stoessel claims that there is no evidence to support claims of bias and corruption. In addition to Phillips observation, which has been replicated many times, that pharma-funded research always tends in the direction of approving or preferring the product of the person doing the research, there has been significant replicated research on doctors believing they are uninfluenced by pharma reps talking to them about products, and yet clear evidence that they are dramatically influenced by such visits.
http://arthritis.about.com/od/arthritismedications/a/drugsalesreps.htm
http://www.ucdmc.ucdavis.edu/publish/news/newsroom/7690
It is not bias to recognize the facts. It is bias to pretend they are not true when they are clearly proven to be valid. It’s kind of rich for anyone deeply inbedded in the psychiatric profession to be claiming someone else is biased. People who live in glass houses…
—- Steve
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I completely agree – we would be more correct to say that “drugs mimic the effects of naturally-occurring bacteria” than that “bacteria produce drugs.” And the conclusion should not be that we can use bacteria to create new drugs or as a biological drug factory, but that we should be looking to naturally-occurring bacterial symbiosis as a possible solution to many health problems we experience.
But some people have no respect for life or nature…
—- Steve
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This is a REALLY workable idea! There are a lot more readers than editors and it shouldn’t be too hard to establish credibility with sufficient references. The interesting question will be whether there is a reaction from the establishment to try and “correct” our authenticated version of reality where it clashes from the fantasy version preferred by the psychiatric elite.
Let’s do this!!!!
—- Steve
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What a useless hotline service! I used to run a shift on a citizen volunteer based crisis line, and no one would ever have been treated that way. Unfortunately, many hotlines are now run by “professionals,” which means they are more expensive, have less people answering calls, and treat people with a distressing degree of condescension and disrespect. I’d be interested to know if this was a purportedly “professional” hotline. It certainly failed this caller in multiple ways.
—- Steve
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My thoughts exactly. If “symptoms” are the problem, then being dead is a solution because it removes all symptoms. This is the kind of “reasoning” that led to lobotomies. It really would be kinder to just kill the person outright rather than poisoning them to make them forget why they should be afraid.
—- Steve
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The authors fail to follow up with the corollary of their conclusion: If telling adolescents that their brain is flexible and can be changed decreases depressive symptoms, does it not follow that telling them their brains are INFLEXIBLE and can’t be changed (i.e. “you have a chemical imbalance,” “you have a biological brain disease, like diabetes” or “you need to take your medication for life”) would INCREASE the likelihood of depressive symptoms? Since what you tell people makes a difference, why aren’t we looking at whether telling people what we tell them now is helpful or unhelpful? I’d love to see someone do a survey of people’s symptoms vs. the message they got from their provider when they complained of feeling depressed. I’d bet my mortgage that telling someone they have a “brain disease” that is “incurable” but can be “managed” with “medication” (notwithstanding the actual effects of the “medication” itself) would make people more depressed. It’s depressing to me just to write it down!
—- Steve
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Kind of disrespectful, but still, it’s a sign of progress to be raised up to “vocal contingent” status. Definitely above “radical cult member” or “disaffected anti-scientific maniac!”
—- Steve
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I think you nailed it perfectly, Oldhead.
—- Steve
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I am blown away every time you write, Sharon! Your passion is intense and focused on the right issues. I agree 100%, what we need is a survivor-led movement, with professionals only engaged as 100% supporters of the goals of the survivors. And issues of gender, race, and other social oppression need to be a central focus. Psychiatry is the ugly face of our oppressive, authoritarian society – the ultimate in victim-blaming. Power to the disempowered is the path forward. I would love to see you as a leader in such a movement.
—- Steve
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I was hoping for something a little more substantive. I actually found it kind of disturbing…
—- Steve
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This is extremely well described in “Zen and the Art of Motorcycle Maintenance.” It is written by a scientist-turned-teacher-turned-philosopher who eventually becomes psychotic and is “treated” with electroshock that essentially deletes his entire prior personality. The author takes us back through his road to rediscovering who he was and is, and meanwhile does an amazing job of pointing out how and why we have divorced science/technology from art, why it’s destroying our culture, and what we might do to help reintegrate them. It is one of the best books I’ve ever read on any subject, but he attacks this issue head on and with tremendous impact, at least for me.
—- Steve
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I told my wife to push me off a cliff before she puts me in an Alzheimer’s unit. I used to work as an advocate in the ombudsman program. I would never want to be in one of these place.
—- Steve
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Good to see this information getting out in a left-leaning media outlet. The Left in general has abandoned the psychiatric survivor’s movement in favor of advocating for more “access to services.” Reframing this as corporate malfeasance (which is exactly what it is) may bring a lot more advocates to our side.
—- Steve
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“Normalization” of difficult or confusing experiences is a critical element of psychological healing in my experience. Psychiatry does the opposite – it takes normal experiences and makes them seem wrong, and takes difficult experiences and makes them seem terrifying. It is the opposite of what is actually helpful, without even considering the drug aspect.
—- Steve
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That was my reaction – they’re finally admitting the reality of the situation. Economic interests DO come before our citizens’ health.
—- Steve
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I agree absolutely. What I object to his characterizing him as “mentally ill” and assuming that some kind of medical intervention would magically make him not be an abusive creep. I know I’m preaching to the choir on that one. I work with foster kids and am very well aware of the impact of early life experience on everything that one thinks, says and does as an adult. I think that’s where most of the answers to “mental health problems” lie.
—- Steve
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There was actually an article posted the other day on MIA that says the opposite. The more intense psychiatric services someone receives, the more likely they are to commit suicide. I’d be interested to hear any data to the contrary, but it has not been in anything I’ve read.
—- Steve
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I agree 100%. The problem with that guy was that he was a mysogynistic abusive creep. He may or may not have had a diagnosable “mental illness,” but that could not be the cause of his obsessive and disrespectful treatment of women, which started long before that event, because there are tons of obsessive and disrespectful men who treat women that way, but are fine with everyone else, and the vast majority of people who have any diagnosed mental illness would never behave in the way he did.
Additionally, you (Vegwellian) are assuming that some kind of “treatment” with a drug would stop him from this kind of violent act. There is no evidence that any drug treatment consistently stops violence, and plenty of evidence that any number of them make violence more likely in a small but significant number of cases. Read ssristories.org for a LOT of examples. Even if not all of them show causal connections, it should be clear to even a pretty pro-drug reader after reading the 40th entry or so that taking psychiatric drugs does not appear to have any limiting effect on the likelihood of serious violence.
There are a number of studies showing that AOT doesn’t even improve compliance significantly, and that it is the provision of additional supportive services, like housing, employment, etc., that actually reduces the likelihood of serious adverse consequences. The thought of demolishing millions of people’s civil rights in order to somehow stop the one in ten million who may engage in a mass shooting, using drugs that aren’t even shown to reduce such behaviors, but in fact, may very well increase them, is nothing short of abject stupidity. It is only promoted by those who either stand to profit from the endeavor, or who feel a need to control the ‘mentally ill’ for reasons that relate to their own personal issues. A rational person looking at the real data would easily conclude that this is absolute idiocy.
—- Steve
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Do you have a link on that event?
— Steve
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It is never helpful to invalidate the perspective of the client! CBT can be used to support a client’s goals, or it can be used to impose the clinician’s perspective on their client. It sounds like you got a lot of the latter. It makes no sense to even use a CBT approach if someone is in an unsafe situation or being currently traumatized. It’s also quite an invalidation to have such experiences in your past and have someone say, “You only feel bad because of your own thoughts about the events.” While such a statement may be technically true, it makes it sound as if a) feeling bad about being abused is abnormal, and b) changing one’s thoughts about an incident of abuse is a simple matter, like repeating a positive affirmation ten times and you’re OK. And that crap about being “treatment resistant” always sends me around the bend! You don’t keep taking your car to a mechanic who says your car is “repair resistant!” “Treatment resistant” should be replaced with “I have failed to be of help to you” or “I guess we have not found the right approach yet.” “Treatment resistant” is just another way to blame the victim of the clinician’s failure to help.
To me, any formulaic approach to helping someone in distress is bound to create problems. I think I agree most with Milton Erickson, who said “you have to re-invent therapy for each client.” It’s about being human and connecting and observing honestly if you’re actually helping and changing your approach if things aren’t improving. There is no magic school of thinking that leads to good results. It requires being a good communicator and being willing to BE with a person in their pain, no matter where that person may be.
—- Steve
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LOL! But it’s not really funny – there are probably people in the profession who really think that way!
— Steve
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Sorry, not buying the “people who are more likely to develop dementia are more likely to use Benzos.” The direct dose-dependent relationship makes that much more unlikely to be true. There is a dramatic difference between those taking them intermittently or briefly and those taking them chronically over time. Any good scientist’s first hypothesis here is that the drugs are the cause. Sure. this is not definitive and more study is needed, but this should mean an immediate halt to long-term use of benzos for sleep problems until this is proven NOT to be a problem.
There are also tons of other options for sleep issues that are rarely explored. Benzos for sleep should be an absolute last resort, and then only short-term. They are very similar in effect to alcohol. Drinking a sixpack before bed will definitely put you out, and if used occasionally won’t have too much of an adverse impact, but doing it every night is probably not advisable. Now that I think of it, long-term alcohol abuse leads to dementia, so why should we be surprised if long-term benzo use did something similar?
— Steve
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I am SUCH a spoil sport sometimes!
—- Steve
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I didn’t find the debate in the original article to be particularly bitter or acrimonious. It appeared to be an attempt to put the findings in historical (Pilgrim) and scientific (Moncreif) as well as personal perspective. It is passing strange that we have something that is an associated risk factor at the 85% or so level (childhood trauma) which can actually be addressed both preventively and therapeutically, and yet we spend huge amounts of money on something that has an associated risk factor at the 3-4% level and which is completely immutable to human intervention (inherited genes). Assuming “the best intentions” does nothing to address that issue. I am sure the author really believes he’s acting in the best interests of his clients, but he is apparently blind to the wasted energy and effort he is engaged in which will likely supply absolutely nothing of consequence.
Perhaps the real starting point is for the mainstream psychiatrists to assume the best of intentions on the part of its critics, instead of labeling rational dissent and information as “bitter” and “acrimonious.”
—- Steve
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12 seconds of 150-200 volts? Yikes!!!!! It is disturbing that this even needs to be a point of discussion!
—- Steve
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I am not from Spokane, but live in Portland. I have done a few internet searches today regarding peer services or drug-free alternative services in Spokane, to no avail. You might want to connect with Mind Freedom International out of Eugene, OR, and find out from them if they have any affiliates or members in your area. What you really want to do is to connect with a mental health alternatives/psychiatric survivors group in the Spokane area, but my searches have not revealed any group in your area. Maybe you can find a renegade mental health professional who can clue you in to the “underground?” In a town of that size, there almost has to be some kind of group having the same kind of experiences. If there isn’t, maybe you should create one! But steer clear of NAMI – I read the NAMI Spokane website, and while they claim to be “peers”, they are actually mostly family members who have been indoctrinated to believe in the “biological brain disease” model of “mental illness” and work hard to indoctrinate others. They’re heavily funded by the pharmaceutical industry.
In the end, what your son and your family needs is hope. You won’t get it from the psychiatric system, but you might get it from someone who has survived it and made it out the other side. Connecting your son with such a person might be the best you can do right now to help him find another pathway.
I hope that is helpful. I’ll be thinking of you and sending good energy your way!
—- Steve
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Sounds like the only thing they showed is that Ritalin has a direct impact on these eye movements. Of course, it can’t be a foolproof method for diagnosing “ADHD,” because there is no way to identify who has “ADHD” in the first place. So how can you know that this is “right?”
Insanity…
—- Steve
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I know your dilemma. The real answer is to find an alternative placement where he can be safe and people know how to deal with him, but where the drugs aren’t the primary intervention. I don’t know where you are right now, but maybe if you can share the general area you are in, someone here might be able to make a recommendation.
The other thing that can help is to find some sort of peer-centered service where he might find other people who can understand what he’s going through and perhaps assist him in figuring out the medication picture. It can be a lot less threatening to hear this kind of information from a person who has been where you are, as it doesn’t come across as condescending or controlling.
Bottom line, it’s a very difficult spot to be in. You care about him, but he is an adult and he has to make his own decisions and live with the consequences of them. Sometimes that means he ends up in the hospital, until he becomes motivated enough to want to come up with a way to avoid that. Sometimes it means he experiments with the medications/drugs and goes on and off until he figures out that quick changes are a bad idea. Sometimes he never figures it out. You definitely have to protect yourselves, and it can happen that you have to have faith and leave it to God or the School of Hard Knocks to provide the necessary lessons. It is very, very painful to watch and not feel you can do anything. But that is the reality of an adult who is your child. They make their own decisions and we hope they learn from their mistakes. We can provide resources and suggestions, but we can’t really tell our kids how to live their lives.
My heart goes out to you. Hang in there, and let us know if there’s anything more specific we can do to help.
—- Steve
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You are so right. Alice Miller has written eloquently on this topic for years. Either we deal with what our parents did to us, or we pass it on. Unfortunately, the 80s and the DSM/biological brain disease movement completely undermined Miller and her ilk in favor of protecting those in power from criticism. It happened in the larger society as well – the rich, corporations, the powerful all became immune to criticism, whereas in the 60s, there was a hell of a lot more accountability. We need a revolution back in that direction. We need to recognize that the person with more power ALWAYS has the primary responsibility for creating safety and a sense of value, especially when children’s fragile egos are involved. Adults need to be held responsible for what they do to kids, or else the kids become adults and continue the cycle. It’s really about that simple.
—- Steve
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And what are the non-medical psych services? A lot of what passes for “counseling” these days is nothing more than checking in and making sure they keep on their “medication.” Especially in the school setting, I’m betting most of them aren’t getting anything that I’d call counseling.
—- Steve
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There are also lots of families who trusted the system initially but discovered to their loss that they’d been deceived. These people are our allies. Lots of them post here. A number of them are part of the core of the Rethinking Psychiatry group I’m a part of in Portland, OR. We should not dismiss their contributions. Not every parent is a NAMI parent!
— Steve
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I find this fascinating! Did you publish your results? It really supports my long-time contention that 90% of what kids do as “misbehavior” is intentional and goal-directed behavior that meets the child’s needs for attention, autonomy, power, or whatever. One of my biggest beefs with the DSM is that it discounts the intentionality of behavior and assumes that someone acts a certain way because s/he can’t help it. This is often extrapolated into the idea that the brain somehow causes the misbehavior, removing the concept of the child as a causal agent. This, of course, is extremely destructive, as we’re giving the child an “out” any time they misbehave. As a friend’s son diagnoses with ADHD learned to say, “I can’t help it, I have a disability.” Not a great message for kids having to learn about morality, responsibility and ethical decision-making. I find it far more effective to give the kid credit for having developed a strategy, to find out what the strategy is for, and help them develop some new strategies that might accomplish their goal without irritating the adults or getting them into trouble quite so often.
—- Steve
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Good article! I am interested to know that there are 5 states without civil commitment laws. Apparently, these states have not been overrun with rampant, crazed, homicidal maniacs who need to be forcibly medicated. I’d be very, very interested in reading some comparison data on suicide, homicide and other serious outcome measures between the states with no civil commitment laws and those that have them. I’m going to bet that there is no difference whatsoever.
— Steve
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1) Mental illness has not been determined to be a biological condition. There is no single mental illness where a definitive biological cause has ever been identified. Even the head of the NIMH, Tom Insel, acknowledges this fact. Show me any science that convincingly proves this claim and I will be very surprised. It doesn’t exist.
2) You fall victim to the assumption that the California shooter would likely not have been violent if he were taking medication. This association (between medication usage and community violence reduction) has never been established. In actual point of fact, the young man appeared to have many of the characteristics of a domestic abuser, including a sense of personal entitlement and a very downgrading view of women as sexual objects who were supposed to respond to his commands and were targets for punishment if they did not comply. While some domestic abusers have “mental illnesses,” most do not, it has been long established that there is no direct correlation between mental illness and domestic abuse – they are two separate issues that simply occur together sometimes. And there is no medical treatment for domestic abuse – it is a behavioral choice that people make, whether mentally ill or not, and whether medicated or not. The vast majority of “mentally ill” people do not make that choice.
3) You mention Laughner and Lanza as examples. Laughner may not have been taking psych drugs, but he was abusing other substances, including psychedelics, and his behavior reportedly changed after starting them. The link between mental illness and violence is very weak to nonexistent after controlling for substance abuse. Laughner is more likely to have been violent as a result of his substance abuse issues. As for Lanza, nobody knows if he was using psych drugs or not, though there are reports from relatives that he was. His medical records were apparently not released, according to Sheila Matthews of AbleChild, because officials were worried the info might encourage people not to take their prescribed psych drugs. So I think there is a likelihood he was on them when he attacked. Of course, there are many stories of those who were on psych drugs when going on killing rampages, including Kip Kinkel, the Red Lake, MN killer, and of course, Erik Harris of Columbine fame. More stories are available on SSRIstories.org.
The idea that these violent incidents occur due to lack of appropriate treatment, or that drug treatment can prevent them, is a fantasy supported by the media but not by any kind of scientific information.
4) I don’t know where you came by the narrative that people who didn’t make themselves better were lazy malingerers, but I grew up in the 60s, and started mental health work in the 80s, and I seldom if ever heard that kind of talk. The thinking of the time was that mental health issues were primarily caused by early childhood abuse or neglect, including emotional abuse and neglect, usually in the family system. While our understanding of abuse and neglect has expanded and we’ve come to recognize that other traumatic events can have an equally important role, it is only recently that the mental health world has begun to come back around to realizing that we (then proponents of the trauma model) were essentially correct all along. Even the best genetic prediction models to date (and these are pretty strained sometimes) can only find predictions in the range of 1-3% for a specific mental health issue, or maybe up to 10% for a range of issues combined. (This disappointing lack of correlation with genetics is apparent in physical illnesses as well.) Whereas trauma predicts mental health problems at something closer to an 85% rate. (And according to the ACE study, which you really must read, physical health issues are also much more highly associated with trauma than with genetics.) Don’t know about you, but I don’t think that the trauma model “rejects science-based medicine” – it seems to me that those arguing for the genetic/biological cause model are the ones rejecting science “for something that can’t really be qualified or quantified.”
Long answer, but I was really struck by the number of assumptions and mythological statements your post contained, and I wanted to present the actual data that I am aware of that refutes those claims. I am a scientist by training and am a big supporter of empirical testing of all of our hypotheses. Unfortunately, the psychiatric profession as a whole does not appear to share my passion for objectivity. You sounded like you might be more inclined to be influenced by actual facts. I hope that what I’ve shared is taken in that spirit, and not as a criticism. Many if not most mental health folks would repeat the same “facts” as you shared, and unfortunately, Goebbels was correct in saying that if you repeat a falsehood frequently enough, it becomes true. I and most of the people here are trying to undo some of those falsehoods by presenting some factual information that the psychiatric leaders choose to ignore.
—– Steve
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I am waiting to hear how the biologically-oriented are going to spin that “forgiveness” is somehow an inborn biological trait that can’t be learned.
I agree, a pretty big jump from this correlation to the conclusion. Still, at least they’re recommending teaching something instead of drugging us into “forgiveness!”
—- Steve
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Of course, I agree with you 100%. That’s why I used the term “Schizophrenia-diagnosed” rather than “schizophrenic.” I use that term only because that’s what they purport to be studying in their efforts to prove a genetic underpinning to this pseudo-disease. My point is that their efforts are a dismal failure, and that looking at what happened to people and how they are experiencing the world is the best approach, rather than “diagnosing” them with a “disease” that has no physiological reality whatsoever. In other words, your psychotherapists’ view is in accord with my own.
—- Steve
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I agree that respite beds with a non-psychiatric focus would be essential if we’re to undermine and replace the current paradigm. People do need help in crisis situations, and we already have models (Soteria, Open Dialog, and many more) that show how that can be done with para-professionals and without force. The big question to me is how to deal with the politics? Such efforts are almost always opposed by the establishment as cutting into their slice of the economic pie. Where are the forces to oppose this politically-motivated defunding/coopting effort? Do you think the psychiatric system would ever embrace such alternatives to the point of diverting funds in that direction on a permanent basis? Maybe I’m being cynical, but I can’t see that happening without a major revolt from both “consumers” and “providers.”
—- Steve
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I think the question is answered by reading the article in the “In The News” section of MIA today, showing that there is a dose-dependent relationship between increasing psychiatric care and increasing suicide rates. Sounds like the only reason to pay for more psychiatric beds is if we want more people to kill themselves!
—- Steve
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Seems pretty clear to me. Psychiatric help provides three important things that I believe would increase the suicide rate: 1) they invalidate the genuine concerns that may have caused or exacerbated a persons’ suffering, and blame the patient for having a “disorder of the brain.” This creates a loss of agency and a feeling of being out of control. 2) they communicate that the situation is life-long and can’t be fixed by either the psychiatrist of the patient. This deepens a person’s sense of despair and hopelessness, and reinforces the lesson in #1) that the patient him/herself is unable to take any step or action to reduce their own suffering. 3) They provide “treatment” in the form of drugs that are at best temporary numbing agents that lessen the overall intensity of their experience, but don’t address whatever underlying physical or psychological issues might have caused the problem, and which at worst are independently responsible for increasing the suicide rate regardless of any other variable.
This should be viewed as a total repudiation of the current paradigm. Has someone forwarded this to the NYT or other news outlets in the form of a press release? I’d love it if someone with sufficient credentials would put this forward and offer to be interviewed about it. The best interpretation that can be put on it is that sicker people seek out psychiatric care, and it doesn’t have any positive effect at all – they are just as sick as they were when they arrived. That is the only viable conclusion from the idea that this distribution is caused by ‘selection bias’ alone – sure, suicidal people are more likely to seek psychiatric help, but getting more “help” doesn’t seem to make them better. The more likely and more sinister conclusion is that psychiatric help CAUSES an increase in suicidal behavior in the aggregate. This explanation definitely fits the data better, but even those not inclined to believe that have a lot of explaining to do.
Would LOVE to see this in the national press!
—- Steve
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Wow. I started reading and could not stop. This is a mesmerizing account (excuse my accidental reference to Dr. Mesmer!) and should be mandatory reading for anyone working in a psych ward or inpatient facility of any kind.
I think the most telling part is identifying the secrets as the central thing that folks in the psych ward had in common. Sadly, it appears that getting out requires keeping those secrets and creating yet more. Rather than safety and trust, it seems the ward creates the need for barriers, emotional isolation, and dissembling, and when you become good at those, you’re declared safe to be released.
Thanks for sharing this dark and yet strangely hopeful vision with us.
—– Steve
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As baseball announcer Tim McCarver once said, “I don’t know why they call it ‘common sense.’ They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
All the more true in the mental health field than other places, apparently.
—- Steve
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Frank, you are so right about violent and assaultive behavior by “professionals!” In addition to the inherent violence you mention in being arrested and locked up, and often held down and forced to take drugs against one’s will, which is clearly a violent and intrusive violation of a person’s integrity and body, I see way too frequently that a patient “assaulted” a staff person, and then read the incident report, and it’s clear that the staff person assaulted the patient and the patient was not allowed to defend him/herself. I’ve seen kids have criminal charges filed because they fought back when a staff person put hands on them unnecessarily after an escalation of a power struggle started by the staff person. There are institutionalized excuses for staff assault that are almost universally accepted in residential settings, and clients are almost always blamed when any kind of violence occurs, even if the staff initiate it.
There are plenty of instances of violent and predatory behavior by staff. I’m not saying this is the norm, but it’s easy to get away with, and there are sociopathic types who go into this work just so they can exert that kind of arbitrary power over helpless victims. Another reason why enforced treatment has got to go!
—- Steve
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I was struck by the statement that AT BEST, the genetic markers they discovered could possibly account for 3.8% of the tens of thousands of diagnosed individuals. I read in an article just a few minutes earlier that well over 80% of schizophrenia-diagnosed individuals were traumatized in their youth. Which of these appears to be the better predictor of psychotic symptoms developing? Is it even close? Wouldn’t it make more sense to work on the area that is so well correlated, and over which we also have a much greater degree of control?
It is amazing how the delusion about genetic causality continues, despite complete and colossal failures all along the road, and despite the much more obvious and clear correlations with environmental conditions. It is very much reminiscent of the eugenics movement – the “science” is driven by the ideology, and any evidence to the contrary is simply ignored as irrelevant.
—- Steve
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Except that as I recall the findings, they had four groups: schizophrenia on drugs, schizophrenia off drugs, less serious psychotic disorder on drugs, and less serious psychotic disorder on drugs. The schizophrenia-off-drugs group did better in the long term than the less-serious-psychotic-disorder-on-drugs group. One would assume that those with the less serious psychotic disorder had a better prognosis and a greater likelihood of recovery without drugs; still, giving them drugs provided a worse outcome profile than those with schizophrenia diagnoses who avoided or weaned off of medication.
I think that pretty much kills off the “they were worse off so they needed drugs” argument. Adding to that, when the long-term outcomes differ so widely (68% to 8% at 20 years), random differences can’t rationally be the causal factor, because you have a bimodal distribution. How would it be possible that there is this HUGE gap between those who naturally recover (92% rate) and those who “need medication” (32% rate) without some kind of artificial intervention? Unless we’re somehow talking about two distinctly different conditions, which of course there was no reason to believe was the case (these people were self-selecting), the only variable that could possibly account for the discrepancy is the drug “treatment.”
—– Steve
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Another psychiatric success story…
—- Steve
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Where is the press release and NYT news article on this one?
—- Steve
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But apparently ALL of those restraint uses prior to the protocols, and ALL of the restraints used in other similar venues, were/are justified and unavoidable for safety reasons…
It’s lovely that they’ve done this, but this kind of thing is often looked on as a “nice program they’ve got going over there,” instead of drawing the proper conclusion, namely, that they and most other psych wards are using restraints unnecessarily on an almost daily basis, and harming patients in the process.
—- Steve
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Stephen, you said a lot. Anyone can be harmful if s/he has not dealt with his/her personal issues to the point where s/he can distinguish between what FEELS GOOD to do (the psychiatrist feels better because the client is now in the hospital and can’t kill himself) and what ACTUALLY HELPS THE CLIENT (the client feels worse than before because he was actually trying to solve a problem and felt hopeless, but needed to talk, but now he’s got three more problems to solve and feels brutalized and abused into the bargain.)
Good therapy or help of any kind has to start from a place of humility. One advantage of a person with “lived experience” could be that they already have the experience of being mistreated and so approach the helping relationship with more humility. But it is also possible that the person hasn’t processed the trauma and instead acts it out on the new client in order to push away his/her uncomfortable feelings. I think this happens a lot when a person who feels they were helped by medication encounters a person who doesn’t find medication helpful. And of course, the staff pressures them to adopt the “conventional wisdom” and supports them in invalidating their client’s concerns.
There is nothing magical about a “peer” providing the service. The problem is one of empowerment and oppression. As long as the “authority” has the right to tell people what is wrong with them and what they have to do to fix it, the authority will be in a position to abuse, whether s/he is a “peer” or not.
—— Steve
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Allow me to reiterate my point: there is a difference between promoting Scientology or being a Scientologist, which as you say each person must decide about, and about which of course your own experience is a very valid source of information, and accusing someone of being a cult member or “front group” because they happen to disagree with the psychiatric mainstream. I don’t hear anyone on this website promoting Scientology as a religion. But I do sometimes hear people trying to tarnish the reputation of others who have been big contributors to our movement, including Sheila Matthews, Thomas Szaz, and William Glasser, by suggesting that they are somehow associated with Scientology or CCHR. That, I find reprehensible. I make no apologies or defense of the CoS itself – that is not my job or my purpose. But I want to make sure that we don’t get caught up into pointless arguments about who is or is not influenced/members/associated/front groups, because it detracts from our efforts and energy and feeds ammunition to those who would like to discredit us.
I hope you are able to see the difference. Scientology is whatever it is. Ad hominem attacks are ad hominem attacks, regardless of the “truth” about the group(s) to which our detractors would like to associate us all. The attackers need to be called out for using that tactic, because it harms our movement, regardless of what you or anyone else thinks about those groups.
—- Steve
P.S. I think invalidation is a very useful word, regardless of whatever “buzzword” status it may have in Scientology. I don’t like to have people feeling that I am judging their perception of the world as being wrong, because we’re all entitled to our perceptions. It’s only when perception collides with proven data that we move into a different territory. One of my biggest beefs with Psychiatry is that it tells people that their own personal experiences, and even their own perception of reality, is wrong, based no nothing but the psychiatrists’ personal biases, which of course are always assumed to be correct. There is nothing I know if that is more damaging to another person than having someone tell them that what they know to be true is false. As a counselor, I avoid creating that experience like the plague. I find that “invalidation” is a good short-cut word to describe it.
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And I want to distinguish, and would like you, Ann, to distinguish, between being a Scientologist, seeing Scientology as an “ally”, seeing CCHR (which is not the same as Scientology, though they are closely linked) as an “ally,” and opposing the tactic of attacking people’s character by accusing them of being Scientologists. It is the latter that I think David (and I) are most concerned with, especially when people within the movement fall into using this tactic (as happened in the RTP debacle) to attack others who are ostensibly pursuing the same goals. To do so feeds the fires of those in the psychiatric profession or elsewhere who enjoy conflating being against psychiatry to being a Scientologist.
To me, calling someone contesting psychiatry’s preeminence a Scientologist has become the equivalent of calling an African-American the “n” word. It doesn’t even matter if the “allegation” is true or false – the word has become so emotionally loaded that it precludes any further rational communication. And it is intended as an insult, a provocation, and a distraction, and should be labeled exactly for what it is, regardless of ones’ views on the organization.
I know you have had bad experiences with Scientology, and you are certainly not alone in reporting that experience. But that’s a totally different subject than smearing our own ranks, or allowing them to be smeared, by using what has become the ultimate “swear word” of the psychiatrists working to discredit us. It needs to be confronted for the evil tactic that it is, regardless of one’s feelings about the religion in question. As soon as we even take up the discussion, psychiatry wins.
I hope I’ve made myself clear. I am not intending to invalidate your experience. I just want to clarify the difference between the qualities and policies and dogma of a religious organization, which any person may or may not agree with, and the tactic of using religious bigotry and innuendo to try and malign and discredit those speaking out against psychiatric abuse, which I believe should NEVER be tolerated for a moment.
— Steve
—- Steve
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Thanks for that, John! Sounds like the political landscape is depressingly similar…
—- Steve
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Thanks for this article – I learned a lot! I find myself being sympathetic to the Epicurian viewpoint overall, though I had no idea of the history. I now understand why “epicurian” has been diverted to mean something much smaller – the “psychiatrists” of the time needed to demonize the movement in order to snuff it out, much as modern psychiatry has had to demonize Szaz.
I have to say, though, I think you missed the main reason why Szaz’s influence waned as he got older. It’s very clear that Psychiatry (the religion) made a monumental effort to re-define “mental illness” starting in the late 70s and early 80s with the development of the DSM-III. This effort was massively funded by the pharmaceutical industry, but also fit very nicely into the Reagan-Thatcher era push toward “individual responsibility,” meaning an increasing desire to deny the impact of social forces on individuals and free reign toward blaming all individuals for their own circumstances or conditions, including poverty, unemployment, racial discrimination, and so forth.
So there was a HUGE push toward denying that mental illness could be caused by circumstances a person is confronted with, not because it was philosophically believed to be so, but because it was economically and socially beneficial to those in positions of power to forward this belief.
Sadly, Szaz was indeed correct in his assumption that too many individuals will do almost anything imaginable to avoid real responsibility and instead cast blame somewhere else. This also leads to the desire for magical cures, and psychiatry has been all too happy to provide them, for a considerable fee, of course. The DSM and pills let EVERYONE off the hook – parents aren’t responsible for their kids’ behavior problems or emotional states, teachers don’t need to think about creating better structures or learning environments (after all, it’s the CHILD that has the problem!), therapist don’t have to actually listen to or feel what their client is experiencing, social institutions don’t have to examine their role in perpetuating prejudice and oppression – nobody’s done anything wrong, and nobody has to change anything, it’s all genetics. Even the client is off the hook – you’re emotions have nothing to do with you, it’s all your brain’s fault. So kids don’t need to learn to behave better, adults don’t need to learn to manage their lives better, teachers don’t need to learn how to teach better – we put a label on and give a drug and the problem is solved! And even if it isn’t, we blame the “disease” – if my efforts don’t work, he has “treatment-resistant depression.” It’s not because I am a crappy therapist. It’s that darned “depression” that just refuses to yield!
This viewpoint, however unsupported by actual facts, had great appeal to the masses, as well as to the monied elites who create policy and control the media. So Szaz and Laing and Mosher and Breggin and Paolo Friere and anyone who had the temerity to disagree with the “new world order” were systematically and rather easily dismissed as a crank or “antiscientific” or a “Scientologist” or whatever ad hominem attacks were effective, because these people (the psychiatric big brass and their allies) were never interested in the truth or in helping people, they were interested in dominating and making money. And they have done a great job of it, much to the detriment of those they claim to want to help.
This is the reality we’re up against, but Szaz was no politician. He was just stating what he saw. I have the greatest respect for the guy, who put his reputation on the line for the truth. If we had more like him, even if I disagreed with them, we’d be in a better place. The problem isn’t that psychiatry (the Church of Psychiatry, not all the individuals who may practice it) is wrong, its that it doesn’t care if it’s right or wrong, as long as it can hold onto it’s position of domination.
— Steve
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Ever see “Little Shop of Horrors?”
“I’m a deeeen-tist…”
I am afraid sadistic drives would fit all too well with being a psychiatrist, too.
—- Steve
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You are so right! This is all about power, and creating a cover so that the consequences of the abuse of power by those in control of our society can conveniently be blamed on the victims’ brains. I’m glad that radicals in the UK can get their arms around that. We seem to have some real challenges with left-leaning folks in the US, who seem to take the “these poor people need mental health coverage” position, and don’t seem to look at what happens when people actually receive the “treatment” they’re so anxious to have paid for. I think David is right that we need to ally ourselves with other pro-social anti-corporate anti-oppression movements and create a unified human rights agenda that recognizes the role that psychiatry plays in dehumanizing and oppressing women, gays, racial minorities, disabled people, children, the elderly, the poor, and anyone else who is “deviant” enough that they can get their greedy hands on.
—- Steve
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Another psychiatric success story!
I am so sorry for you and him. Keep the faith – you’ll get it figured out, with or in spite of the doctors!
—- Steve
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Wow, David – what an epic post! As a core RTP member, I can only say thank you for so eloquently articulating the “gray-matter scare” and why it insidiously undermines our efforts to allow it any credence. I also appreciate your focus on what we CAN do to make things better, including PULLING TOGETHER, regardless of our diversity in religion, philosophy, or other matters. Psychiatry has managed to get where they are by agreeing on a message and sticking to it (regardless of the facts, in their case). We can do that, too, but we’ve got to stop picking at each other and undermining our own allies!
Thanks for everything you do and have done for our movement!
—- Steve
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I totally agree about the checklists, and about others besides family being the potential cause of trauma. Personally, elementary school was by far the most traumatic experience I ever had. Especially second grade – Ms. Vaughn was SCARY AS CRAP!!! Threw a book across the room in a rage, destroyed my friend’s art project, then whacked me on the back of the head and threw both me and him (for crying, apparently) out in the hallway when I tried to object to her behavior. Being in her class should have given me at least 3 ACE points on any checklist!
Still, it is the CONCEPT that being mistreated is a much more important factor than genetics which we have to get out there to the public, and crude as these measures are, it does communicate that very clearly. My biggest beef with psychiatry isn’t the drugs – it’s the marketing of the concept that there are “mental diseases” that they can identify from someone’s behavior alone, and that these diseases are completely centered in the person and have no relationship whatsoever to their environment or experience. There has never been a more vile “snake oil” sold more disingenuously to the public in the history of medical fraud! And the evidence to the contrary is right there, in plain sight, all the time. It speaks to our mesmerization and deification of doctors that this chicanery has been sustained for so many years! So I’m glad we are finally talking about it, and I’d rather deal with the unscientific nature of the ACE checklist than the unscientific nature of the “ADHD” checklist any day!
Always appreciate your comments, B!
—- Steve
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I am sure this is true. I have read some recent stuff demonstrating that socioeconomic factors are more important for physical health than genetics, too. I think we all know the conclusion – we just need some highly credible person to pull the findings together and do some good PR to make sure the press gets the issue in the front pages of our not-so-trusty news media.
—- Steve
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Good to know, Wayne! We need a “white paper” or something of the sort that pulls all this stuff together. It is simply ludicrous to spend all of this time and money determining the “genetic basis” of “mental illness” when we have an awesome predictive model with ACEs. Besides which, you can’t change someone’s genetic inheritance, but we’ve got a LOT more control over how many ACEs s/he might experience in early childhood!
—- Steve
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He concludes that “improvement in parental behavior accounted for 60.9%” of the improvements in the children’s behavior. So thinking that their child was taking supplements to improve behavior impelled the PARENTS to do a better job, but they attributed the benefits to the omega-3 supplements.
Pretty fascinating. I guess it suggests to me that parental attitude toward a child is the most important variable in the child’s behavior, which is something I’ve always believed to be the case. Doesn’t fit very well with the bio-centric view of “mental health problems,” though, does it?
—- Steve
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It occurs to me that it may be interesting and useful for someone with the proper credentials to compare the predictive value of genetics to the predictive value of the ACEs when it comes to “mental health problems.” The best they’ve come up with so far is that a collection of 20 or 30 or so genes occurring together create a tiny increase in the chance of developing any of a range of “mental health diagnoses.” Whereas ACEs predict drinking, drug use, depression, anxiety, probably psychosis, cancer, diabetes, and early death. It would be lovely to see a side-by-side comparison.
—- Steve
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“…the meaning attributed to [the anxiety] and the belief that one has the power to cope with it [are] the differentiating factor between clinical and nonclinical groups.”
I think this is the most significant finding from this study. It reinforces what I have always believed – the best approach to any “mental health problem” is to assist the person suffering in coming to the conclusion that their suffering is not abnormal given their situation, and that there are ways they can cope with or overcome the situation they are struggling with. Labeling someone with a “disability” and telling them their brain is broken and can’t be fixed to the exact opposite of this. It doesn’t entirely surprise me that even using CBT approaches, especially with kids, could reinforce the idea that there is something wrong with them and that they can’t handle it without “special help.” CBT, especially when done poorly, can often convey to the person that they are “causing their own distress” by thinking the wrong things, and can easily invalidate the real challenges a person may be facing.
I also agree with the criticism that we would need to know how many in each group were taking psych drugs, because that would be expected to skew the results in the direction of worse outcomes, per Bob’s well-documented thesis regarding drugs increasing the chronicity of “mental health” symptoms.
—- Steve
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This is genius, and yet very simple and obvious. With this kind of success, this should be replicated everywhere. Imagine if we start incorporating personalized aromas, artwork, color schemes, and activity plans into these people’s lives? There is so much we can do with the environment to help with emotions and behavior, and yet the “system” continues to focus on directly manipulating the physical body’s chemistry, which is the thing we have the least control over!
—- Steve
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It is disturbing that in the article, he talks about barbiturates being addictive, then immediately talks about benzodiazepines as if they are not, making it sound like this is some kind of improvement. I am quite sure that this one will turn out to be addictive and have scary side effects – some are already outlined in the article.
We live in a world of marketing – the truth is only limited by what you can convince people of. What is actually true seem to be of very little interest, especially when there are potential profits involved.
—- Steve
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Forgiveness is very difficult when the perpetrator continues to commit his/her crimes unabated. I agree that some degree of justice is extremely helpful in finding forgiveness. At the same time, I do believe I am better off if I can recognize the humanity of individual psychiatrists, while continuing to battle against the institution of psychiatry and its accepted practices. I am not sure where I come down on the psychopathic ones, who seem to have little of what I call humanity in their hearts. But the vast majority are misguided humans who thought they were trying to help, and have a hard, hard time acknowledging they might be wrong about that. It must be a horrific experience to discover that what you’ve been doing for a lifetime to “help” may be severely damaging those you thought you were helping. I do not for a minute see that as an excuse for not facing that fact, but it makes it more understandable that individuals may be defensive when confronted with the hard truth. This is doubly true when someone’s financial well-being is connected with this fraud.
I appreciate you bringing up this topic. I do think it is very important. It also applies to our ability to find and create alliances with those who don’t completely agree with our views. Systemic change is very slow and hard and there are many forces that would oppose it, often for the worst of reasons. It is way too easy to slip into rage and forget that human beings are involved, and that our best bet is to lovingly confront the bad behavior while continuing to accept the human being as a potentially valuable contributor to our long-term objectives.
Easy to say, pretty damned hard to do sometimes!
—- Steve
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You are SO right!
—- Steve
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We could start with a PR campaign publicizing the fact that “ADHD”-diagnosed kids don’t do better on any significant long-term outcome measure than unmedicated kids, including academic test scores, high school completion, college enrollment, delinquency, drug use, teen pregnancy, social skills, or self-esteem. The biggest selling point used to coerce and manipulate parents into using these drugs is the mythology that “untreated ADHD leads to school failure, dropping out, delinquency” and so forth. If we can help the world see that “medication” positively effects NONE of these areas, a lot of people will make a different choice.
Not sure what the means to accomplish that is, though. We need some kind of a funded, grassroots organization that can do PR and lobbying for this cause. Not my particular strong suit, unfortunately.
—- Steve
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So much for psychiatric drugs “emptying the institutions,” eh? This is more evidence that Whitaker’s analysis is right on. Of course, if you’re making your living selling psychiatric services or drugs, I guess this is good news, isn’t it?
—- Steve
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I have to agree with you – that was my first hit on this: perhaps slightly exaggerated but pretty much on target – you are a captive and they experiment on you until you’re allowed to leave or manage to escape.
It is interesting that those images were seen as viable selling points. Shows that maybe the public on some level recognizes the truth.
—- Steve
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Anyone with half a brain would predict this, but psychiatric practice is so fragmented and mechanical for the most part that such connections are rarely even considered. For starters, lack of sleep is a “symptom” of depression, so depression “treatments” are supposed to improve sleep. I think many psychiatric manistreamers would have a lot of cognitive dissonance at the idea that the sleep loss actually creates the depression.
The obvious is not obvious in this field!
—- Steve
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Sera,
Thanks so much for this! I have written at least a half a dozen posts in the last couple of days trying to say exactly the same things – that it’s arrogant to presume we know the reason for Robin’s decisions, that we trivialize his suffering by calling it a “disease,” and that most people who are depressed have damned good reasons for being depressed. The world is a pretty depressing place right about now, and I kind of think that anyone who isn’t at least a little worried is either incredibly enlightened or willfully ignorant.
I also appreciate your articulate description of exactly what does help. It is, indeed, that willingness to live in the grey area, to not try and “make it all better,” to neither distance ourselves nor join in the misery, but to simply be there and provide a listening ear and compassionate perspective, that truly helps. Normalizing depression as a response to a crazy world is a much more healing response than labeling the sufferer as “diseased” and stamping out his/her “symptoms” in order to make ourselves feel less uncomfortable.
Your posts are always filled with warmth, wisdom, and hard truths. I hope I have the opportunity to meet you in person one day, meanwhile, keep on keeping the “mental health” world honest!
—- steve
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Oh, it’s the American PSYCHOLOGICAL Association… much more understandable.
— Steve
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Weird that I find myself agreeing with the APA on this one… I guess it fits in with anti-stigma campaigning. But of course, it doesn’t address the drugs’ culpability in causing much of the violence that is seen from the “mentally ill.”
— Steve
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Wow, they actually got PAID to do this study? Morons! And they talk of “bereavement-related pathology,” as if someone’s supposed to just stay cheery as hell after a loss and any “negative emotions” are to be considered pathological.
MORONS! (Did I say that already?)
—- Steve
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And the more relevant question: WHO THE F*&K CARES? I recommend ignoring any attempts to downgrade our posters or commenters by this or any other tactic and reporting the offender to the moderators. I am hoping that the removal of the comment by Ken is the beginning of a new policy of removing these posts immediately. The above article is about sleeping pills as an entry path to psychiatric addiction and control. It has about as much to do with Scientology as it does with underwater farming. The reference to Scientology was brought up apropos to nothing, and is clearly a common trolling tactic, whether the poster(s) are associated with Big Pharma, the APA, or acting on their own accord. I, for one, am done responding to this idiocy, other than labeling it for what it is – trolling, and attempt to derail and distract the conversation from what we need to be talking about. The answer is to not be derailed or distracted, and hopefully to get the moderators to remove such posts ASAP.
— Steve
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I essentially agree with you on most points, Richard, but there are a couple of caveats I’d add. First off, talking therapies may not need to be held to the same standard of proof as drug interventions, because the drugs are so much more dangerous. Sure, there are a lot of incompetent boobs out there doing “therapy,” and sometimes the results can be quite disastrous, but most of the time, the worst outcome of talking therapy is someone deciding “he’s a quack” and looking for another practitioner, or maybe deciding to give up on the effort entirely. No one comes out with permanent brain damage, involuntary movements, or diabetes. True, there are situations where bad therapy has caused violence or suicide, but certainly at a tiny fraction of the rates seen with SSRIs or stimulant drugs.
Second, and perhaps more important, saying we need double blind studies implies that we know ahead of time who fits into the category of “needing therapy,” hence, a legitimate diagnosis. Since most of us here (and the DSM itself) have observed and agree that the DSM categories of “major depressive disorder” or “bipolar disorder” don’t represent homogeneous groups of patients who all have the same problem or need the same approach. So how are we to do a controlled study of these alternatives, since we can’t identify a homogeneous comparison group? Maybe something works for some depressed people and not for others because they have differing needs. It sounds like characteristics of helpful practitioners have been identified, and perhaps that’s where we should put our energy, since the particular school of therapy a person belongs to seems to have little to no impact on the outcome.
Finally, it is perhaps legitimate to question whether “therapy” as a practice isn’t more closely related to religion or philosophy than to medicine. If this is the case, perhaps the concept of “double blind studies” doesn’t really apply – maybe people should be able to seek out the kind of support they find helpful, without some veneer of scientific-ness that has been laid over the mystery of being human?
None of this is meant to deny the possibility of actual physiological diseases or injuries causing mental/emotional distress. These should be investigated using the scientific method and should be carefully distinguished from psychological states. But I am not sure there can be or will ever be a scientific approach that encompasses mental/emotional distress, because I don’t think it’s usually the result of a disease state of the body. And if I”m right, it puts us in a whole new realm where the science of the physical universe is not of much if any use.
—- Steve
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Actually, “What About Bob,” while not directly attacking psychiatry per se, certainly portrays that Bob’s mental health is not improved by “services” or “treatment,” but by genuine connections with real people, as well as making it really clear that Leo, his psychiatrist, has more than a few issues of his own!
—- Steve
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I am so sorry to hear the difficulties you are having! It sucks to have to go to an internet chat room or message board to get information you should have known before you even started taking that stuff. It infuriates me that we are lied to, including many lies of omission, and that when we do bring forward such concerns, the docs are more likely to diagnose something new than to conclude the obvious: the drugs are the cause.
Wish I had something more helpful to say, but it sounds like you’ve connected to others who have made it through, and they are most likely your best resource. Good luck, and I hope you keep posting!
—- Steve
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And if we actually held Psychiatry to these high standards of scientific validity and scrutiny, what would we have left? IMHO, we have almost nothing, because the DSM has not the slightest shred of scientific validity behind it, as even Tom Insel admits.
It seems like the real conflict here, and it is NOT a minor quibble, is that while we work on ‘reforming’ things, millions of people are being harmed and sometimes killed. I am not objecting to reform efforts, but I had a very hard time when I was doing involuntary detention evaluations, not because I had a problem with protecting a person from immediate harm, but because the only place I could send them was the psych hospital, and I saw very quickly that what went on there was anything but healing. I spent most of my energy doing brief therapy interventions in the ER to try and get a person NOT to be committed and to find other alternatives that could work, because I knew that going up to the psych ward meant being locked into a depressingly dark and dingy space, exposed to a lot of other miserable people who were not being listened to or helped, and being tried out (without any meaningful participation on your part) on various drugs until you “stabilized,” which essentially meant you had reduced your level of annoying behavior to the point that they could figure you wouldn’t be back in the ER for at least a month or two. Then they sent you to “case management,” which meant someone checking in to make sure you weren’t going off your meds or “decompensating,” which is a fancy word for “going nuts and making trouble again.” There was little to no compassion from the system, though there were individual workers who provided some light in the generally dark tunnel these people were being sent down.
I left that job in 9 months, only because it took me that long to get another job. I got into advocacy and haven’t looked back. I don’t think I could work a job in the mental health industry, unless it was a radical agency committed to undoing the damage that the system is doing to people. It feels like collaboration with the occupying forces to me. It is an ethical dilemma, because the people who ran into me in the ER were in fact very fortunate, because I was dedicated to helping them get better RIGHT NOW so they wouldn’t have to be detained. And I was pretty good at it – I had the lowest percentage detention rate in the county. But I couldn’t stop every detention, and every one felt like I was participating in hurting someone. I had to get out.
So I get it when someone is a total abolitionist, and even when someone draws analogies with NAZI Germany. People are being systematically harmed, and participating in the system feels like tacitly supporting the damage being done. At the same time, I appreciate the reformer viewpoint, because abolition seems an unlikely goal, and because people who are sucked into the system need someone like Jonathan to give them some glimmer of compassion and hope.
Perhaps we can come together better if we talk about tactics rather than the ultimate goal. I think most people can get behind taking the force out of the equation, as long as there are some provisions for people who are dangerous in the present moment. Maybe we should try to focus on finding the things we DO want to get done, and coordinate our energies toward those things. I don’t think we can ever resolve the reform/replace/eliminate debate, because it comes from a place of ethics, and I think ethics is a very personal thing. I do think we can at least agree that individualization, empowerment and choice have to be at the center if things are to improve for those labeled by the system as “mentally ill.”
—- Steve
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That is so helpful to know! It makes so much sense to me. People are trying to find meaning and purpose in their lives and in the universe. That’s the first touch point of any intervention, even if there are physiological health issues involved. I will remember this point and keep it in mind when needing to creatively engage someone whose perceptions of reality are hard for me to join with. It seems like it provides a great way to establish some common ground and start looking toward the future.
—- Steve
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CPU, that’s actually not conflicting with what I said. A syndrome is something that is not understood. There MAY be a biological injury/illness underpinning for a syndrome, or for some part of the people with the syndrome, or it may just be a normal variant of behavior that some people find difficult to deal with. I am not saying that there are no mental conditions that occur due to biological factors – side effects of medication is a perfect example of a biologically-caused mental/emotional condition where we do understand at least the rudiments of the cause and can intervene medically to resolve the situation. Parkinsons is clearly biological, and Alzheimers appears to be largely biological (though its expression is highly variable, possibly depending on psychological variables).
The problem is when we take a syndrome (like severe depression) and assume that ALL people who exhibit this syndrome have something biologically wrong with them, and therefore ALL people with the syndrome require a particular “treatment.” To go back to migraines, there is a wide variety of approaches that people have to dealing with a migraine. Some find massage incredibly helpful, others feel it makes things incalculably worse, while some find it has little to no effect. Without really understanding the cause, we can’t prescribe a treatment. Sure, we can prescribe pain relievers to deal with the symptoms, but that is not the same as treating a known disease state that reliably responds to a known remedy. At that point, people just do whatever works to make it better, but we all know we’re dealing with effects rather than causes.
It’s even worse when you get into behavioral issues like “ADHD” or “Oppositional Defiant Disorder.” Here, we are merely identifying behavior that we find objectionable or annoying or inconvenient and giving it a label. I’m absolutely sure that there are some kids who are biologically wired to be more active and less willing to sit in a seat for extended periods. So freakin’ what? Who gets to declare impatience with tedium a disease? And when 10% or more of our population is afflicted with this particular set of characteristics, it’s pretty obvious that this personality type has high survival value for our species and that far from being a disease state, it’s more likely an essential genetic variant that improves our society’s functioning if allowed appropriate expression.
I am probably preaching to the choir here, but I wanted to make myself clear. Creating psychiatric labels out of syndromes actually obscures the search for actual psychic or physical injuries or malfunctions that may be causing a small or large proportion of a particular behavioral or emotional syndrome. Neurologists understand this well. The fact that someone can’t move their right arm isn’t a disease – it’s an indication that something is going on, and you don’t get a diagnosis until you find out the cause. Saying someone has “immobile left arm disorder” and leaving it at that is not only not informative, it actually deters anyone interested in seeking the variety of possible reasons why someone’s arm may be immobilized.
Hope that makes things a bit clearer.
—– Steve
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You haven’t heard that term because I just invented it. But since we both are using it, I think it now officially counts as a word.
My best idea to reform psychiatry would be to put you in charge. But I don’t think you’ll be president of the APA any time soon!
I think we need people in all parts of the spectrum to make things change for the better, and for my part, I appreciate your energy and your efforts. You have gotten more done than a lot of people who might criticize you from both sides. Keep up the good work!
— Steve
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Finally, a real scientist who is willing to admit when his hypothesis is disproven by experiment! This is very important news for those fighting the Murphy bill – one of psychiatry’s own inside researchers admits that AOT does not improve outcomes.
Interesting that they talk about access to treatment, while conveniently forgetting that the countries with the LEAST treatment (Columbia, India, Nigeria) had the BEST outcomes in the WHO studies. But at least they admit that forcing treatment yields no benefit. That’s a big acknowledgement.
— Steve
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Trillium Charter School is alive and well, 12 years later. It’s a public school so costs no additional money, as long as you live in the Portland Public School District. I just disconnected from their e-mail list, as Kevin’s graduated and we’ve been gradually moving on, but the community is strong and I think will be functioning 12 or 20 years into the future. The thing I love about it is the shift of emphasis away from trying to achieve approval from the authorities through good grades toward achieving self-worth through accomplishing one’s own goals. Additionally, the power dynamic is so different, with the all-school meetings and the ability to request student-assisted mediation with even a teacher who you feel has treated you unfairly or disrespectfully. He has little to no tolerance for arbitrary injustice, because he hasn’t had to put up with it, and he is therefore still in touch with his outrage when outrageous things happen.
I really think school is where most of us learn to accept oppression as an unavoidable part of the system. It’s great training to be a passive consumer. Education reform should be a part of reforming the mental health system, because it really does drive some of us around the bend!
— Steve
P.S. I only applied to Oberlin, but thought about applying to Harvard as my “back-up school.” I fantasized about sending them a rejection letter: “Thanks for your interest in my attending Harvard University. There were many well qualified schools. I have selected one whose offerings more closely match my personal and academic needs…”
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No, it would mean that migraine headaches aren’t a disease, not that they don’t exist. Migraine headaches are, in actual point of fact, a syndrome – a set of symptoms that occur together but don’t have a known cause and may or may not have a variety of causes. Pretty much every psychiatric diagnosis is either a syndrome or a redefinition of normal behavior that some people find annoying or difficult to deal with. For instance, “Intermittent Explosive Disorder” is a description of people who lose their temper a lot. This really does exist – there are such people and we have all experienced them at times. But does the fact that someone has a temper mean they are medically ill? Or that they have a different personality? Or that they were poorly raised and never taught emotional self-control? Or that they were abused and traumatized and react violently to certain stimuli? Or that they were put on antidepressants recently and are having an adverse reaction? It could mean any one or more than one or none of the above things. A real disease state would have a coherent explanation and the treatment would follow rationally from the cause. We can use pain relievers to make the migraine less painful, but that doesn’t mean we understand what caused it, or what would make it so that you stopped having migraines altogether. We’re treating signs and symptoms, not diseases.
We don’t have to deny the existence of the person with temper control problems to refuse to agree that temper control is a disease state per se. It is, at best, a syndrome, something observed to occur that doesn’t necessarily have a coherent explanation. Calling it “Intermittent Explosive Disorder” makes it sound more “clinical,” but I could diagnose “Excessive digital-nasal intrusion disorder” to describe someone picking his nose and have about as much scientific validity. Yes, people pick their noses. No, it’s not a disease state, just because it makes people uncomfortable due to social rules being violated, or just because I made up a semi-scientific-sounding name and set out some “criteria” in an official guide book.
—- Steve
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A legitimate question, indeed…
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Sandy, I do agree with your basic point – medicine as a whole has been corrupted and continues to be corrupted by big money incentives and convenient lies that allow, for instance, massive sales of statins to perfectly healthy people when statins don’t actually even address the underlying issue that it is supposedly protecting against.
Unfortunately, it appears that the vast bulk of psychiatric prescribing falls into that very same category – medicating a physiologically healthy populations with drugs that don’t address whatever underlying issues they are supposed to address, and actually making people less physically healthy and less likely to “recover” into the bargain. I really do appreciate that you personally appear to recognize this and to be trying to do something about it. I’m assuming from your writing that you would adopt a more “Moncriefian” approach to drugs in mental health, using them when they seem helpful but not assuming or asserting that they are treating a disease per se, and not assuming that they would be first-line or primary interventions. But how do you see the profession as a whole moving away from this disease/drug model, when the DSM provides cover and justification for doing so, and the drug company money provides the huge incentive for continued lying to the public about the lack of a genuine understanding that lies behind the DSM and the attendant “treatments?”
Personally, I believe a move away from using DSM diagnoses is essential for any big changes to happen, and I don’t really see that happening any time soon. When so many people (not just doctors) are intellectually, emotionally, and financially invested in this cultural artifact, it seems very challenging to imagine such support flagging except by an absolute rebellion among the recipients of psychiatric care. Do you think there is another path that does not require wresting power away from those whose lack of intellectual depth and/or corruptibility prevents them from seeing or acknowledging the truth that you have come to recognize?
It’s a big problem. I’m interested to hear your thoughts on how we get to a new place.
—- Steve
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Very well said!
— Steve
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People who live in glass houses…
—- Steve
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I thought she was saying we shouldn’t get distracted. Now upon rereading, I can’t say that I 100% agree after all. I do agree that criticism of the author ought to be made based on the points in the article, not on disliking the author.
I find many of ELS’s remarks to be off-topic and often containing unprovoked hostility, and the presence of an underlying personal agenda is apparent. You can be intense, but I don’t generally find you to be mean-spirited or distracting, and your agenda is very clearly in line with mine and my perception of the purpose of this website. I just think that allowing off-topic comments to distract us is unwise. I’m trying hard to practice that myself, although it is sometimes difficult, especially if inappropriate attacking is occurring. I have asked for some people’s comments to be removed (not mentioning any names), but I have never asked for anything you said to be removed.
I don’t know if it’s reasonable to criticize Mark for not responding to posts. David Healy almost never responds to any post, and I don’t like his views on ECT at all, but he’s been a bear on the issue of SSRI side effects, and I value what he has to offer. I guess I just take what I can that’s positive and try to make productive comments, and am happy when occasionally an author responds. Mark’s got a life, too. But your comments did have some relationship to the blog, and I was not meaning to critique either them or Mark’s lack of responding in any way. I just think we should stay on the topic of reforming/replacing/ eliminating the current damaging system and not get off into other personal agendas. And again, I am not referring to you in that last sentence at all.
Hope that clarifies things. I find you to be a very valuable poster and had not the slightest intent to criticize you or your prior posts.
—- Steve
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It is important to remember that scientifically, it is not the patient’s job to prove to the psychiatrist that the drug they are administering is unsafe, it is the psychiatrist’s job to prove that it IS safe. So any evidence that brain shrinkage and cognitive decline might be caused by neuroleptics ought to be of extreme concern, and the fact that it MIGHT be a result of the disease should not mitigate that concern one iota!
Moreover, your comment about the possibility of it being “unethical” to not provide drug treatment flies in the face of emerging evidence, to the point that the APA recently published guidelines stating that trials off medication should be attempted if possible, and that if medication is used, it should be used at the lowest dosage and for the shortest period of time. Studies by Martin Harrow and Wunderlink, as well as the WHO study, have clearly shown that many, probably the majority, of those suffering from what is labeled “schizophrenia,” are able to recover in time, and that medication in fact impedes the likelihood of recovery, probably in part due to the brain shrinkage that has been documented to be a direct and dose-dependent consequence of long-term antipsychotic use. This, again, is science, and is not really in significant dispute. There are some claims around that a different kind of brain damage may happen with repeated psychotic episodes, but I am not seeing a lot of evidence to support this claim, either. In any case, there is no longer a question about brain shrinkage caused by neuroleptics – mainstream psychiatry itself has acknowledged this as a problem.
Finally, it does appear from the comments of the researchers that they did control for cognitive decline, symptom severity, and overall level of functioning, and none of these correlated directly with brain shrinkage. If schizophrenia itself were responsible, it would seem that those with the highest symptoms and the lowest functioning would be the ones showing the most damage, but that is not the case. This is additional evidence that the theory that the brain shrinkage is caused by the “disease” is not viable.
You might want to read “Anatomy of an Epidemic” and take a look at the science backing up this concern. It is not something psychiatry wants to admit, but there is a long history of evidence that shows that neuroleptics do, in fact, cause brain damage over time.
—- Steve
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Gosh, they claimed that Prozac drove some people to murder or suicide? How could they SAY such irresponsible things! Not only that, they hurt Lilly’s drug sales and brought on these totally unwarranted lawsuits (many of which Lilly settled out of court with “gag orders” so no one could see the actual evidence against them). The NERVE of these people!
Who might the real evildoers be in this scenario? The ones who are marketing a drug that they know sometimes leads to murder and suicide but are trying to cover it up with media attack articles? Or the ones who are calling BS and holding them to account?
Criminals don’t like watchdogs much, but those being burglarized like to have them around…
—- Steve
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I agree 100%. Thank you for saying that.
—- Steve
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I don’t think any of those three would post here. Not because we would be too hostile (which we might very well be), but because they know on some level that their arguments don’t hold water. Torrey, for instance, knows he has intentionally conflated violence with untreated mental illness, because that forwards his agenda of more enforced treatment, apparently because he feels a family member would have benefited from this. Biederman, of course, was chastised for intentionally manipulating research data to get the “results” he wanted. These guys would be shot down very quickly if required to restrict themselves to a data-focused argument in favor of their viewpoints. They appear more interested in marketing than in truth, and would also not want to give MIA any credibility by choosing to appear here. I could be wrong, but I think they’d find the environment extremely threatening even if we were civil as could be, because they (unlike folks like Mark) don’t really have any interest in finding a better way – they already think they know the way, and are religiously committed to their viewpoints, and the facts be damned. I am sure they see us as dangerous antiscientific zealots out to destroy the tremendous scientific progress that psychiatry has made in the 21st century. The fact that this progress hasn’t actually improved the lives of their clients does not seem to register on these folks’ radar.
If they want to post, I’d say bring ’em on. But I would not expect them to have a very pleasant experience, even if we are all as diplomatic as we can possibly be.
—- Steve
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If you didn’t know that Scientology and Big Pharma had a big blowup in the 90s, you were either too young to notice or not paying attention. Whitaker writes about it in his book. It is when the psychiatric community went whole hog into the “antipsychiatry=scientology=antiscientific
=evil” PR campaign. There was a front-page attack piece in Time around 1991 or so, which it appears likely to have been coordinated with this PR effort. It was quite intense, but of course, big pharma and the APA had the bucks and media on their side, and the outcome was the successful “Scientology Smear” campaign that you either inadvertently or intentionally seem driven to employ on our allies. CCHR would be a lot less of a pain in the ass if y’all would follow my simple advice and stop giving the tactic energy on this site.
—- Steve
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Glasser is a long-time opponent of psychiatric drugging and has always made a lot of sense to me. He’s very practical and empowering, believing that kids have the ability to overcome challenges by their own actions, and that parents can assist kids in doing so by learning and teaching new skills in a step-by-step manner. It is difficult to imagine his views being more diametrically opposed to the idea that people have “diseases of the brain” that can’t be “cured” but can be “managed” with drugs. The absurdity of attacking such an obvious ally should be clear to anyone who has actually read his work.
— Steve
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I would point out, however, that tobacco consumption is always voluntary. Until we address the social mythology supporting these “illnesses” and take away the power to force or indirectly coerce people into taking these drugs, including through criminal courts, family courts, child protective services, schools, and other means of enforcing “voluntary” compliance, it becomes a little unclear to me how shaming the victims of these practices is helpful. I see it kind of like dealing with a domestic abuse victim who is still in the throes of Stockholm Syndrome. They will defend their abuser to the death, because they are under his control and don’t see any other way out. Yes, they do have a responsibility for the impact of their actions, but the person we should be shaming is THE ABUSER, in this case, the medical/psychiatric/pharmaceutical industry.
See my earlier post on how to discredit/disengage the religiously committed “proud user” without resorting to shaming tactics. Unless they’re actually on the payroll of the pharma industry, I view the vast majority of users as victims of a major societal con. Doesn’t mean their statements shouldn’t be challenged, but I don’t see that shaming is an appropriate path, at least until it becomes socially clear and accepted (as it did with cigarettes) that these drugs are genuinely and seriously damaging to the vast majority of users.
— Steve
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Judith Rapoport studied this back in 1980, and pretty definitively showed that her “normal” test subjects responded just the same to stimulants as her “ADHD” diagnosed subjects. The apparent observed difference she called “an artifact of observation,” meaning that people saw this “improvement” in the ADHD-diagnosed kids because they were looking for it, but the same changes were not noticed in “normal” subjects because they weren’t standing out for being particularly hyper or distractible, so the changes were not as obvious.
RAPOPORT, J., BUCHSBAUM, M., WEINGARTNER, H., et al (1980) Dextroamphetamine. Its cognitive and behavioral effects in normal and hyperactive boys and normal men. Archives of General Psychiatry, 37, 933 -941.
This is cited in http://pb.rcpsych.org/content/29/8/284, which is actually a great summary of the lack of scientific data supporting the ADHD diagnosis.
So this mythology was disproven over 30 years ago. Yet people (including professionals) still spout it all the time. I hope that reference helps you kill off any discussions along these lines in the future. I find it stops such conversations dead in their tracks every time.
— Steve
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I don’t think it requires “shaming” to counter the effects of “proud users.” I think that Moncrief’s approach is pretty easily adaptable to this situation. “I hold nothing against you for finding something that helps you get through the day. We all have our coping measures, and yours is as legitimate as mine. What I object to is classifying suffering as a “disorder” and assuming that all people who are suffering in a particular way need to follow your path. Drugs do have effects, and if you like the effects, more power to you. It doesn’t mean that others will have the same experiences as you.”
If that’s experienced as “shaming,” then I am not sure what else can be said. We can give people the latitude to do whatever works for them, but when they start becoming marketing agents for the pharmaceutical industry, I think we’re within our rights to object. It’s the difference between describing my own experience and extrapolating to assume that all people share my experience.
Another approach would be this: “Suppose someone had a horrible experience with psychiatric drugs and swore they’d never take them again. Would that person be ‘shaming’ you by letting you know that your solution wouldn’t work for them? Does everyone have to agree with your viewpoint to avoid being labeled as ‘shaming?’ Might you be ‘shaming’ this other person if you told them that psychiatric drugs were good and that anyone saying otherwise was harming people who might benefit?”
I don’t think we need to stand by while others sing the praises of psych drugs. They’re entitled to their experience, but so am I, and so is anyone else. If ‘shaming’ is brought up, I think it can be deflected by stating, “I’m just sharing my experience just like you are. Do you have a problem with me sharing what I experienced, even if it may differ from what happened to you?”
We’re not shaming, we’re just sharing!
—- Steve
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I think so. It is much too easy to go along with media representations of “mentally ill” as being brain-damaged and probably dangerous, chemically “different” than “you and me,” rather than acknowledging that a sick society is at the core of much of what passes for “mental illness.” I can certainly assert with confidence that the school system exacerbated whatever anxiety and self-hatred I had already absorbed from my “scapegoat” status in my family, and my mental health would have been dramatically improved by having even one person say, “You know, you’re right. This place really sucks for kids. Let’s try and find something you like better.” Hence, I became an education reformer, and have tried to be that one person for other kids stuck in the current oppressive paradigm. It is always reassuring to hear that others are doing the same, but I think it’s always going to be an uphill battle, and most people choose the path of least resistance.
In the end, we’ll probably get alternatives only when the psychiatric system gets sued and ends up spewing out enough money to make it no longer worth the effort to con people. As my old history teacher used to say, “Man is basically greedy.” Or maybe “man is basically lazy” is a better description, but it ends up being the same result. People follow the path that gives them the most payoff for the least amount of labor, unless they have a very well-developed conscience.
— Steve
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When one considers the wide range of difficulties observed in the current “standard practice” by psychiatrists, including incomplete histories, dismissing of trauma symptoms, overlooking of family dynamics, minimization or “treatment” of iatrogneic side effects, undue influence by pharma front men and “education,” and many more, it is hard to see how psychologists prescribing will do anything but worse in controlling this already out of control train. Based on what I see and hear from clients themselves, the last thing we need is more prescribers. We need more listeners. I thought that’s what psychologists are supposed to do.
This effort is disgusting, and that the American Psychological Association promotes it with such blithe ease makes it clear that they are being bought off by the same PharmA reps that already own the other APA.
A well-written post that should not have to be written. But logic is not at issue here – money and power are, and that’s the root of the problem.
—- Steve
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You sound like an Evergreen grad! I am sure he’s a perfect fit and is going to have a great time. I only wish I could afford to enroll myself!
—- Steve
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I appreciate the reply, Mark. I am glad you acknowledge that the process of obtaining treatment does have potential adverse effects in terms of isolation and stigmatization.
The part I was referring to about diagnosis follows:
“Often they seem psychotic, probably from schizophrenia. Sometimes they seem socially impaired from childhood, even dramatically so, perhaps with some variant of autism. Occasionally PTSD seems to be part of the problem.”
I’d still be interested in your thoughts on the fact that many of the shooters were receiving or had received psychiatric treatment before engaging in their shooting rampages. At the least, I think this makes a good argument against enforcing more treatment as a means of reducing mass shootings, even if many people will balk at examining the possible role medication side effects may have played in many of the shootings.
Thanks for taking the time from your busy day to respond. I do plan to take this forward in other places to help re-focus us away from the fact that a person may have had a diagnosis (which is very common) toward the fact that the person was socially extremely isolated (which is a lot less common and more closely associated with the characteristics of most of the shooters).
—- Steve
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I have been an education reformer my whole life, and we did several years of “unschooling” with all of our kids, as well as helping develop an alternative charter school with a child-based, democratic philosophy. I don’t think it will ever “catch on,” because that kind of philosophy is too threatening to the elite, who really need smart and well-trained but confused drones to run their social machinery for them.
My wife’s brother went to Harvard, as did his father and grandfather and who knows how far back. He didn’t really have a choice about it – his “privilege” as a white male depended on his kowtowing to the party line. He is working on his third marriage and has developed abusive characteristics and struggled at times with substance abuse. His sister (my wife), by contrast, went to Oberlin (where we met) and got a real liberal arts education, and we have traveled a very different road.
My youngest is about to head off to Evergreen State in Olympia this fall – a “progressive [school] with no tests and narrative evaluations” – not a particularly selective school, but one that really promotes interdisciplinary thinking and creative application of knowledge to the real world. I’d never consider Harvard as an option for him, and neither would he.
Great blog, as always, Laura!
—- Steve
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Abuse by Scientology is a separate subject that distracts from our purpose. There are other websites for that purpose. And the main reason CCHR is a problem for the antipsychiatry movement is because the psychiatric community embarked on an intentional PR campaign to discredit critics with the “Scientology smear” tactic. (Admittedly, CCHR did make themselves an easy target.) Perhaps you think it’s helpful for us to protect ourselves by saying “We hate Scientology, too, so we’re not bad like you say we are.” I most certainly do not think so. I think it helps them continue to divert attention from the real issues.
So as AA alludes to, my recommendation is very simple. If it’s ever brought up, we say, “What does religion have to do with the effectiveness or ineffectiveness of the current psychiatric model? I thought we were talking about science here? Why are you trying to distract us from the topic by bringing up religion? Is it because you don’t have any facts that are relevant to the discussion?”
Or words to that effect. That shuts down any discussion of Scientology or any other off-topic distraction and labels the tactics for what they are. Any intelligent person watching the conversation will easily see that one person is using facts, and the other is using rhetorical tactics.
We should work to kill off the effectiveness of this tactic, not build it up by agreeing with the APA’s marketing tactics. In fact, ANY agreement with APA marketing tactics should be avoided like the plague, IMHO.
— Steve
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Emergency ECT? Who the hell came up with that one? How about “Emergency head battering with a baseball bat?” Or “Emergency pushing in front of a Mack Truck?”
There’s an emergency – a person is feeling distressed. I know! I’ll electrocute him! That’s always helpful!
—- Steve
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Good comments, Sean!
I thought it interesting that she did not consider the possibility that the voices for Americans diagnosed with schizophrenia are more negative and battling may be because of how our culture, and specifically, how psychiatric practitioners, define our relationship to these voices. If you are told by your doctor that these voices are bad, the content of their statements is meaningless, and your main goal is to get rid of them, it seems you’ve set up a state of warfare with the voices, which in some psychological schools of thought suggests a state of warfare with oneself. It makes sense to me that a culture which accepts that voice-hearing is OK or maybe even views it as a gift is more likely to have positive experiences with those voices, as they are not fighting them off but listening to what they have to say.
Would be interested to hear if this makes any kind of sense to those who have had this experience themselves?
—- Steve
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Hi, Mark,
I think you’re right about focusing on relieving isolation. It is interesting that the focus is always on the “mental illness” that the person is suffering, and not on the isolation, which appears to be a much more defining characteristic.
It was interesting how I experienced this article while reading it. I found myself already resisting your message early on as you outlined the various diagnoses these people might qualify for, and then talking about the difficulties of isolation and stigma. Do you think that the very process of calling these things “mental disorders” contributes to the stigma and isolation you want to avoid? I believe there is scientific evidence that this is, indeed, the case – placing these labels on people not only appears to create reluctance to deal with that particular labeled person, but also reinforces the isolation of those who are “different” by defining more rigidly and narrowly what is acceptable. I actually see this labeling process as a part of what creates these isolated and disconnected young people in the first place.
You also mention that “some” of these young people had received mental health treatment in the past. I’d correct “some” to “most.” Adam Lanza, Kip Kinkel, Scott Harris, Jeffry Weise (Red Lake, MN), the kid from Paducah, KY… the list goes on and on. Many of these were receiving medication at the time they committed these acts, and many others were withdrawing from medication at the time. Others (like Lanza), we don’t have the information on their treatment status at the time of the event, but there is evidence suggesting they may have been taking medication at the time. We know from simply reading the product label that SSRIs and stimulants both can cause aggression and “manic” episodes. I am interested how this fits into your analysis – you seem to have sidestepped that issue for the most part. But regardless of that point, I think it should be pretty clear from the evidence that intervention by the “mental health system” does not appear to have prevented the majority of these incidents, so we have no reason to believe that further such treatment will do so.
It is in the interests of the psychiatric profession as a whole to minimize such effects as I mention above, but as a change agent, I think it would be extremely valuable if you and folks like you inside the profession would be more direct in addressing these issues. Labeling creates and exacerbates stigma, according to psychiatry’s own researchers. Some of these drugs cause or exacerbate aggression, according to the drugs’ own labels. Receiving diagnosis or treatment does not appear to be reducing these incidents of violence, and may be contributing to it. These are not small issues. How would you respond to this information? Why isn’t there more commentary from the psychiatric community about these things when we hear a national call for more enforced treatment? Shouldn’t the needs of clients and society at large trump the commercial interests of the mental health industry?
I do appreciate your courage in writing here and standing up to your peers by encouraging some alternative thinking. I hope I am helping prod you to take it to the next level by honestly examining the data on the effects of treatment on violence and speaking truth to power about what I see as the big elephant in the room.
—– Steve
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I agree – ECT can be compared to cutting on oneself, except that it does far more fundamental damage. Self-cutting creates temporary bleeding and scars on the skin, which ultimately is able to heal itself. There can be long-term issues with skin flexibility and maybe some minor damage to nerve endings, but it is unlikely to have any more severe impacts. Whereas ECT induces a grand mal seizure, causes temporary and often permanent memory loss, damages brain cells that can’t be repaired or replaced, and can and does sometimes lead to death, either directly through brain damage, or indirectly through severe despondency that sometimes follows ECT by report, leading to suicide in some cases.
Moreover, the choice to cut is completely personal and something in the control of the cutter, whereas ECT is something someone else is doing to you over which you have no control.
Now that I think of it, I’ve changed my mind. You can’t compare them, because ECT is orders of magnitude more damaging and less in the control of the “recipient.” Given the choice between cutting on my arm and getting ECT, I’d cut for 10 years rather than accept one “session” of brain damage in the name of “treatment.”
—- Steve
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Nice one! Too bad they were too chickens*&% to publish it.
—- Steve
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Yup. This is what success looks like from the psychiatric viewpoint. Client on medication, not being jailed or hospitalized, “symptoms” less than what they were or “under control” (not necessarily relieved or resolved.) The quality of life for the patient is not something that is even measured or considered a priority.
— Steve
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I actually think you were lucky to have your on the ground experience before your training. I was in the same position, and it helped me learn to smell a rat and not be afraid of calling it what it was. A lot of training is indoctrination into exactly what they told you at your job (which is a lot of why they told it to you). I’m glad to see that Temple is having the sense to have RW and other more provocative presentations, but I’m not sure that’s the case everywhere. Most psych students I’ve talked to tell me they spend an inordinate amount of time on how to do DSM diagnosis, and very little on creating new alternatives.
Glad you’re out there pitching a new game!
— Steve
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I am so sorry – that sounds awful!
— Steve
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I wonder if you were offered any other options besides medication and ECT? I recall working on a crisis line and talking to someone who had been trying different antidepressants for over a year, with no improvement. She was on the verge of panic. I asked her if she was aware that there were other things she could do. She suddenly stopped, calmed down, and said, “No…” No one had ever told her about therapy, support groups, meditation, peer support, exercise, or any other option – as far as she knew, if the medication didn’t work, she was completely screwed.
Your story sounds very similar to many positive ECT stories. There is sometimes a benefit, but always a cost. And you are very fortunate that it worked out the way it did for you. Many others pay the cost without the benefit you’ve experienced. Try to imagine losing 22 IQ points and forgetting 5 years of your life, and feeling the same or worse than you did before.
I also wonder if you were told about the trade-offs ahead of time? Were they honest with you?
Good for you for persisting and getting the nursing degree! And thanks for honestly sharing your story – it is one of the best non-sensationalized descriptions of the long-term effects of ECT that I’ve yet seen in print.
—– Steve
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That’s just the point, E. You are presuming “infiltration” based on association. Just because Sheila doesn’t condemn Scientology as you do doesn’t suddenly make her a “front group.” It should not surprise anyone that CCHR would support others’ efforts to expose psychiatry’s destructive behavior – that is, after all, their stated mission. The fact that they approve of someone doesn’t mean they’re financially supporting or controlling that person. To suggest that is to use the same kind of innuendo and undermining tactics that psychiatry has been employing for years.
Sheila is entitled to her opinion and is not required to agree with you. There are also a number of posters on another recent thread who describe getting support from CCHR without any apparent attempt to proselytize about the CoS – are they dupes or “front groups” as well? Your implication that her positive opinion of CCHR and/or Scientologists she has known somehow means she’s a “front group” is WAY out of line.
I am glad Emmeline has chimed in here, because her opinion about what is appropriate matters more than mine. I would like you to stop attacking our allies, and if you don’t, I’m hoping Emmeline will use her authority to remove your attacking posts. You are not helping either of your purported causes.
— Steve
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Quite so. However, I still think it’s a very strange way to argue in favor of more funding. Kind of like saying, “This garage can’t really fix your car, but it can kind of keep it running, even though it will get worse over time, so we should help them service more cars.” If diabetics were appearing more and more often in ERs and getting limbs amputated and dying of heart failure in larger numbers, despite treatment, even the very credulous would probably suspect something was amiss with the treatment.
The story, as Bob Whitaker puts it, is that these miraculous chemicals have taken disabled people and enabled them to become functioning members of society again. This kind of narrative completely debunks that story, and yet people seem to be unable to see the obvious contradiction.
Or another way to put it: if these drugs were so helpful, why are you seeing more and more people coming to the ER with worse and worse problems? Shouldn’t our wonderful scientific technology be making people more functional and less severe?
I just don’t get why people can’t see that the vignette they share doesn’t merit the conclusion they always seem to draw.
—- Steve
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My point is not to attack or defend CCHR or Scientology. It is to focus on our mission. Attacking Sheila Matthews is simply an outrageous action. I don’t give a crap about Scientology or CCHR, to be frank. I believe every person has a right to make up their own mind about those groups on their own, and there is plenty of info out there about them if people care to look. If you want to critique them, please find one of the many websites that do so. I see no point in wasting our energy on this divisive crap, when there is so much to be done. And I will reiterate that any statements that conflate antipsychiatry/psychiatric reform groups with CCHR/Scientology, especially in the critical way you have done, plays into psychiatry’s hands.
If you have issues with Sheila, take them up with Sheila. If you have issues with Scientology, take them up with Scientology. If you have issues with psychiatry, that’s what we’re here to talk about. It is foolish to validate the “scientology smear” in any way on this site. It undermines our purpose and aids and assists the very people we are trying to oppose.
—- Steve
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LOL!!
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From the article”
“At one point, Peter spent two weeks as an inpatient at the Institute of Living. He saw a therapist he liked. The prescriber there worked well with the family. Peter began attending groups. His medication was changed.
But when he got discharged, all that fell away. He returned to his old psychiatrist, who didn’t have any discharge notes that would explain what happened during the hospitalization, and who put him on the old medications.
Transitions between services are particularly problematic. Peter now receives services in the family’s home.
“By the time anything gets started, we have now had a week where basically we’re on our own because he hasn’t been to the psychiatrist, his medications aren’t working, this new in-home service hasn’t started seeing him yet, and so we’re back in the ER again,” Harding-Wheeler said.
And there’s no one professional following Peter’s care. The psychiatrist only sees him for 15 minutes at a time.
Harding-Wheeler worries the system is giving up on her son.”
This sounds like someone who has been in the system and receiving “help” for years. But the “help” isn’t helping. I do agree, the family may be and often is part of the problem. But of course, given the biological paradigm, any family issues are largely ignored unless it qualifies as child abuse, and programs to help parents improve their parenting skills or develop specialized approaches to their particular child’s needs are relegated to third-rank “nice if we can do them” status.
I’ve seen it too many times in my job. I recognize it in a second. A kid who is making that many visits to the ER is almost always involved in the psychiatric system and almost always is continuing to receive ineffective treatments, or receiving treatment to deal with the ill effects of earlier treatment. But rather than talking about the ineffectiveness of the treatment being provided, we’re all supposed to cheer for more funding for a continuation of the same stupidity that the case study shows has not only not worked, but probably made the poor kid worse than he would have been. Just as Whitaker’s thesis would support.
—- Steve
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Can we cut this crap about Scientology? I’m starting to wonder if some posters are working for Big Pharma and trying to distract us from our objectives. I’ve known Sheila via e-mail for about 15 years. There is NO ONE in this country who has worked harder for ending psychiatric abuse than Sheila. She does NOT deserve to be attacked in this way! She is definitely “one of us,” and anyone who attacks her after all she’s done, I am prepared to consider an enemy of this cause.
As I’ve stated in another thread, this is not the place to talk about Scientology. There are plenty of anti-Scientology boards where this discussion is going on. It HARMS OUR CAUSE to give even a line of space to the idea that our allies are aligned with Scientology or are “front groups.”
I am very suspicious that this is an outside attack. If it is not, it is an ill-conceived personal mission of someone who is very mixed up about what we’re trying to accomplish here.
At this point, I am going to ask that the moderators remove any comment that accuses any person or group of being a “front group” or associating anyone with the putative evils of Scientology. Not only do these comments violate the posting guidelines, they devalue and insult valuable allies like Sheila, and encourage the kind of sniping and backbiting that the APA would absolutely love us to engage in.
Sheila Matthews is, in my view, and American heroine. She does NOT deserve this kind of crappy treatment!
—- Steve
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Hi, Seth!
Here is a link that includes the article:
http://exopermaculture.com/2014/01/09/malidoma-some-in-the-shamanic-view-mental-illness-signals-the-birth-of-a-healer-who-bridges-two-worlds/
The original link is having some problems, but if you scroll down the page, the whole article appears below the link, under the title, “The Shamanic View of Mental Illness.”
Love to know what you think of it.
— Steve
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Gotta agree with you on that point! One article in Canadian J Psych showed that 6-7% of kids taking stimulants at normal dosages had psychotic symptoms noted in their charts (retrospectively). That’s hardly rare – if someone medicates a hundred “ADHD” cases in a year, they’d have made 6 or 7 of them at least somewhat psychotic. But how often do you ever hear anyone talk about amphetamine psychosis as a result of stimulant “treatment?” Never! Plus the drugs they use for “ADHD” increase dopamine, and the ones they use for “psychosis” decrease dopamine. So they give the kid stimulants, crank up his dopamine, he becomes psychotic, so they give him Risperdal to DECREASE his dopamine, which they are increasing with the stimulants? How stupid is that!
— Steve
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That is an astounding figure!
Actually, JAMA has published articles on medication damage before, including the big one about medical care being the third leading cause of death in the USA, as well as (I believe) the one about “seriously mentally ill” people dying 25 years earlier than the general population. Maybe it’s because it’s not specifically a psych journal? And Hopkins is the home of Julie Zito, at the School of Pharmacy, who has done a great job using epidemiological data to show the ridiculous rise in psych prescriptions for kids (including INFANTS) on Medicaid.
Not everyone in the research world is evil, even though a lot of research is biased. The information we need has been out there a long time. I think it’s more a problem of the psychiatric aristocracy and the media choosing to publish only those things that make money for them and Big Pharma.
—- Steve
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It always amazes me that they use an example of a kid who has received psychiatric “treatment” his whole life and is doing horribly as an advertisement for why we need more mental health treatment. And people fall for it! How dumb are we? This kid is proof positive that the problem is not a lack of available treatment, it is that the treatments we use DO NOT WORK!!!! Why is that not obvious to those reading the article?
—- Steve
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That was my thought exactly.
— Steve
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Two additional points: first, even if “ADHD” is correlated with a genetic or biological “cause” still does not mean it is a dysfunction or disorder. Being tall or overweight or having blue eyes are all genetically moderated to one degree or another. Short or fat people are treated differently in society and sometimes suffer “symptoms” as result. There is nothing wrong with a short or genetically heavy person – their “symptoms” are a result of the expectations of society and the punishment meted out for not meeting those expectations.
Second, these so-called “ADHD” kids have been shown to be indistinguishable from “normal” kids in an open classroom where they aren’t being bossed around all the time. The “ADHD” labeling process frees the adults from having to examine the structure of their school institution as a potential causal factor, and also eliminates any real motivation for coming up with structural solutions, even though science has already provided one possible answer. The label serves the adults, not the kids.
OK, I lied: three points. The last is that the so-called “treatment” has never been shown to improve long-term outcomes for kids with this label. So what’s the point of “treating” them if they’re going to turn out just the same or worse?
I hope you will discuss social structures and expectations as “causal” factors for ADHD in your coming blogs.
Thanks for continuing to challenge the conventional “wisdom” on this issue.
—- Steve
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I will try to find a link and post it. It was pretty fascinating! And I agree with you – there is so much that we control about our physiology and emotions, it is stupid to assign us as being somehow created by our bodies. We appear to be the creators, not the created. That we sometimes become sort of victims of our own creations doesn’t make that less true. And healing, in my experience, almost always results from increasing our awareness of the degree to which we are creators of our universe.
Neurochemistry is largely within our control.
— Steve
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I do agree that sometimes changes in brain chemicals can cause genuine distress. But for me, until we can specifically demonstrate a causal connection (like with Parkinsons, for instance) between a certain condition and a certain chemical deficiency and attendant physiological damage, we can’t ever claim to be curing, treating or healing anything.
I’d also add that biochemistry is massively modifiable by each of us. I’m sure I’m preaching to the choir here, but hugs, fresh air, walks in the forest sex, sleep, eating, changing scenery, meditation, getting a massage, smiling, laughing, smelling something nice – all of these things modify our biochemistry all the time. In fact, there are a number of studies showing that simply thinking of something changes our “PET scan” dramatically.
Bottom line, I’m sure there is a small percentage of “depressed” people who have something actually wrong with them. The vast majority of the time, whatever it is can be addressed in myriad ways without drugs, and should be. I have no problem with prescribing something for a real physiological problem, but we all have different brain chemistries all the time throughout the day, and we are a far, far way from even a rudimentary understanding of what is going on.
Of course, there is also the possibility that we are spiritual entities occupying and influencing our bodies, which opens up a whole different realm of possible ways to intervene. But whether you believe that or not, I think the whole chemical imbalance concept is so crude and destructive that we ought to scrap it, even if there is some tiny percentage of people where it might actually reflect reality in some way.
Thanks for writing back.
—- Steve
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Which is precisely the point I am trying to make. The agenda should be to reform psychiatry. Part of that is not participating in their favorite tactic of ad hominem attacks. Having a distracting discussion of why the 1st Unitarian Church decided to stop hosting RTP and who received money from whom and why the CoS is really a bad organization does not forward our cause – it plays into psychiatry’s hands. My sense is that it is your agenda that was off topic and distracting – you seemed more interested in defending the UU Church and attacking Scientology than doing anything to advance our movement’s cause. My effort throughout has been to get us back onto the much more important topic of how to handle ad hominem attacks and the “Scientology Smear” tactic. Casting aspersions on RTP or anyone else working toward reform is at best in very bad form.
Or to put it another way: just because you think something is true doesn’t mean it is helpful to share it. Besides which, I believe it would be much more appropriate for you to put your “facts” in context of where you heard them, and not invalidate other people’s facts, especially when they are much closer to the situation than you are. For instance, I believe your “fact” that RTP is a Scientology front group has been thoroughly discredited by both MadMom’s and my counter-facts. Don’t you think you were a little out of line making such an accusation based on such limited evidence?
I think you should check your facts more thoroughly, or at least state them more tentatively with provisos on where you got them, rather than assuming that somehow you got the whole story from a brief conversation two years back and from third-hand rumors you heard through the grapevine. You can hurt people and our movement by speaking too freely about things you are not fully informed about. To paraphrase your own earlier comment, if you weren’t a part of RTP, “you can’t say anything about it without being in error.”
—- Steve
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How would we ever know if an SSRI caused a “serotonin balance” if we don’t know what a proper serotonin balance is and can’t in any way measure it? Besides which, these drugs are not fine surgical instruments, they are crude tools which disrupt many systems within the body (did you know there are a ton of serotonin receptors in the gut, for instance?) It’s like trying to fix a watch with a sledge hammer, without even bothering to see what is wrong with the watch. Regardless of what you do, you’re going to cause damage, because you don’t know what you’re doing, and you’re using the wrong tools. Aside from which, there may be nothing wrong with the watch at all.
Of course, you’re right, you can make someone mentally or emotionally unbalanced by screwing with his/her brain chemistry, but that doesn’t mean that anyone with emotional issues is in some way biochemically “off.”
— Steve
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Thanks for your kind words, Jonah. I always appreciate your posts – they are full of passion and deep logic. It means a lot to have your support.
— Steve
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And as I said, I am in agreement with Bob’s decision to keep things politically clear by choosing not to allow CCHR or a Scientologist as a blogger, and have never said otherwise. I am glad you agree with my larger point.
— Steve
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Well said!
— Steve
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I believe you misunderstood what you were told, or else he misstated the situation. As far as I know, and I am quite certain I know more than you do about it, there is no connection between the Church of Scientology and RTP. There is a member of CCHR Oregon who has been a faithful and hard-working volunteer from the beginning, but at no time have I heard any promotion of Scientology as a religion from him or anyone else. Of course, he has shared CCHR materials at times, including the film I mentioned, but so has NAMI and the Cedar Hills psychiatric hospital. Beyond the tabling fees, we have received no money from CCHR or the CoS.
You assert personal experience with Scientology, which I have no reason to doubt, but your comments are still out of order in my book. You appear to believe you know more than people who are actual members of the RTP group about our own activities, and despite MadMom letting you know she keeps the accounts and that we are getting no money from Scientology, you continue to assert that because of a comment you heard in 2012, you know more than she does.
It is my concern and belief that by continuing to try and use the “Scientology Smear” to denigrate RTP, you not only perpetuate untruth and injustice, but you support the very organization, namely organized psychiatry, that we come here to debunk and combat. You lend credence to their assertion that that being associated with the CoS even by rumor or happenstance is de facto proof that anything you say is to be discounted, no matter how well-founded in fact your position may be. I ask you to stop now. You’ve spoken your piece, but it appears to me that your personal feelings about the CoS are allowing you to do harm to people (RTP) who have done nothing to harm you, for no reason that has anything to do with the mission of this website, and inadvertently aiding and assisting those you appear to be opposed to. I ask you to refocus your energy on not allowing psychiatry to use ad hominem attacks to distract people from the real issues at stake, rather than validating psychiatry’s patented tactic by using it against people who you should see as your allies in this struggle.
—- Steve
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Good post, Seth. The issue of the potential utility of “psychosis” to a culture and the impact on the healer (vs. patient) of embracing this “gift” rather than trying to stomp out any manifestation of it is something I often talk about. I recently read an article (maybe on MIA) about a “schizophrenic” guy who was taken from the USA to an African tribal community and trained as a shaman, and he came back calm and focused and able to complete an advanced degree and put his healing wisdom to work. Culture is a HUGE part of how these manifestations are perceived, as well as the consequences of how they are handled.
I will point out, however, that there are some on MIA who embrace the Antipsychiatry identity, including Ted C., among others. After reading this, I have to say that with Burstow’s explanation, I have to agree that I am antipsychiatry according to her definition. It is unfortunate that the psychiatric “profession” has misappropriated the word and redefined it as “pretending that people don’t suffer” or “refusing help to those in need.” I am not sure what will remedy this situation, though I think it might be helpful if the media stopped portraying psychiatrists as benign therapists who spend most of their time listening to people “on the couch” and started reflecting the true reality of what psychiatry is, so that being “anti” that does not have the connotation of being against helping people who are suffering distress, but instead indicates opposing the minimization and trivialization of the traumatic events and genuine social and emotional challenges that living in today’s “modern world” encompasses, and often blaming the victims of such events for not responding “properly” to being horrendously mistreated.
It’s a pretty monumental task to reclaim a word, though it’s been done before. I’d love to hear some thoughts on how best to go about it without creating more opportunities for psychiatry and Big Pharma to marginalize the movement.
—- Steve
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I was sure this was a farcical article! I can’t believe these guys are serious! They are now trying to post-hoc diagnose Moses, Jesus, etc. with psychotic disorders! Unbelievable! But then again, maybe not. It shows how totally “delusional” the entire profession has become.
—- Steve
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Richard,
With all due respect, I believe you miss my point entirely. I have stated below that I understand the political reasoning behind MIA distancing itself from Scientology and/or CCHR as a matter of maintaining credibility. It is simply not worth the time and energy to fend off such attacks, and as this thread clearly demonstrates, it can provide a tremendous distraction from the real issues at hand.
My point is that it is neither necessary nor prudent to respond to any ad hominem attacks regarding Scientology (or anything else) with attempts to expose the ‘”real truth about Scientology” or to waste any time saying, “No, I’m not, you’r wrong!” or “See, those other guys supported Scientology and now everyone hates them!”
If we wish to be effective, we need to label these tactics for just what they are – attempt to distract the public from the real debate. It is never helpful to buy into these tactics by denying such association nor by agreeing with the attacker regarding the bad character of the attacked party. The proper response is ALWAYS to confront the attacker with the attempt to change the subject and avoid the issue at hand. It is obvious from the reactions to this thread that Jason’s presentation was divisive and distracting and has wasted a huge amount of energy talking about something that really does not matter one iota in terms of our overall goal. That’s what Psychiatry wants us to do – to splinter, to bicker, and to waste our energy on trivial issues while they continue to dominate the landscape.
It is interesting that we are very careful here to distinguish between “Psychiatry” as an institution, while at the same time making sure we state that individual psychiatrists don’t all necessarily fall under that rubric. Why would that not apply to Scientologists? Is every one of them evil? Why would we allow psychiatry or anyone else to paint a group of people as all being the same because of their belonging to a particular group? Isn’t that what psychiatry does anyway? Group people together and condemn them?
We have no responsibility here to defend or explain away concerns about Scientology or CCHR as organizations, nor do we have an obligation to join forces with them politically. But we do have an obligation to point out the vicious tactics being used to reorient the debate using slander and bigotry and ad hominem attacks, because those tactics are broadly used by Psychiatry to condemn all critics. We don’t benefit anyone by saying, “Don’t worry, we’re not like them” or “We think they’re bad, too.” We do ourselves and anyone else in the field of resisting the current biopsych paradigm a big favor by calling out these tactics for what they are, each and every time we see them, and not letting those using them get away with it for one second, no matter what group or characterization they choose to use as the distraction.
—- Steve
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Oh, and by the way – we also had a table from Cedar Hills Hospital, a nearby private psych hospital that is getting interested in looking into alternatives to their traditional diagnose-and-drug paradigm. If we were a CCHR front group, would you really imagine Cedar Hills Hospital would be allowed to run a table, or that a NAMI-sponsored film would ever be shown?
We really have no agenda other than helping anyone interested in alternatives see what they are. I think it’s pretty damned impressive that we have a group that could encompass the views from CCHR to NAMI to Cedar Hills Hospital without coming apart at the seams. We may have our failings, but we’ve done pretty damned well in the inclusiveness and open-mindedness domain. I hope that puts any “front group’ discussions utterly to rest.
—- Steve
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Well said! We need to attack the change of subject, not validate it by trying to deny our association with their chosen scapegoat. We need to bring it back around to the question; why ARE you changing the subject? Why DOES it bother you so much to talk about this? If you are so scientific, where are your data? Why are you reduced to trying to discredit the messenger with sophomoric rhetorical tricks?
It is amusing in a way that psychiatry is so upset by “competition” from a religious group that they are so anxious to denigrate as superstitious quacks. If they’re that foolish and easily misled, why are the psychs afraid of them? I agree with SomeoneElse’s comment – I think that psychiatry unconsciously KNOWS it is a religion and can’t allow there to be competing dogma, since there is no actual scientific or rational basis for their belief system. I always thought it particularly telling that the term “diagnostic Bible” somehow spontaneously emerged to describe the DSM and has been readily embraced by our culture, and that psychiatry has done nothing to combat that appellation. Maybe everyone knows it’s really a religion deep down.
On a more practical note, it’s possible that they know their drugs work largely through the placebo effect, so warding off alternative beliefs is essential to their technical “success.” In any case, I am glad so many are seeing this for the distraction that it is. We should close this down and get back to talking about psychiatry!
—- Steve
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LOL!
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This is actually a very important finding! I always hear from psychiatrists that “we all know there are situations where polypharmacy makes sense” and “we don’t know that Practitioner A isn’t working with a very difficult population…” as explanations for why certain doctors “overprescribe.” It sounds here like it’s simply a matter of their attitude – some doctors don’t really care about the impact of drugging their patients into submission, and those are the ones who use the drugs most ruthlessly, regardless of the difficulties their patients are having. It will make it easier to de-bunk these arguments when I next hear them put forth.
— Steve
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Amen!
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Ann, you are again speaking of what you don’t know. I addressed this in another post. RTP has a tiny budget that is entirely from donations from members and visitors to symposia and other events. We never took a dime from anyone. I don’t know why you insist on spreading this disinformation?
My point again is that this forum is not about what is wrong with Scientology. It is about what is wrong with what passes for “mental health treatment.” We could talk about how the Catholic Church allowed its priests to molest young children for years without consequence, or how the US government helped overthrow the democratically elected government of Iran in the 50s, or how Nestle Corporation continues to market infant formula in third world nations, leading to millions of deaths of babies from mixing the formula with polluted water and meanwhile increasing the birth rate by suppressing nursing. But none of those things are RELEVANT to this discussion, and by even entertaining this topic, I believe we harm our own cause.
Please stop acting as if you know what happened in Portland. You do not. I don’t want to have to keep responding to your distortions of fact. Let’s get back onto the topic of stopping the psychiatric juggernaut.
— Steve
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As a practical matter, I totally understand and agree with your political decision. I believe it is legitimate to make political decisions with the long-term goal of change in mind. I am certain from your writings that you understand the tactics described in my post above.
I believe Jason’s commentary goes way beyond that and buys into slandering Scientologists as a means of clearing himself and/or his organization from that artificial “taint,” in essence buying into that taint rather than simply choosing politically to avoid the conflict. He actually supports psychiatry’s tactic and uses it to slander RTP and Marcia in a public forum. That, I cannot support.
It is always great to hear your voice on these forums!
—- Steve
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I agree 100% with Cannotsay, Ted, Barrab and the general tone of these comments. The “Scientology Smear” has been a tactic of the psychiatric community from the early 1990s. It is an evil strategy that involves 1) intentionally demonizing believers in a particular faith community, and 2) associating anyone who disagrees with them with this group. It was and continues to be an intentional marketing ploy by the psych industry that Goebbels himself would be proud of. While I understand the politics of keeping distance from such a group as a means of maintaining credibility, Jason’s statement above actually aids and assists the psychiatric marketing team by reinforcing their message that Scientologists are all ignorant fools or devil’s spawn and that none of them could have independently come to the conclusion that psychiatry as practiced is a dangerous undertaking that needs to be reformed or abolished.
I will remind everyone that the film festival showed a film from NAMI as well as one from CCHR. And in truth, the CCHR film got critiqued a lot more strenuously than the NAMI film did. The representative running that film appreciated the feedback and provided it to those who produced the film. There is absolutely no way that their film, any more than any other film, was promoted as the absolute truth, nor were the doors closed to an open-ended discussion of any issue raised by any of the films in the Festival. RTP is a very open-minded group that welcomes participation from anyone who supports its mission. To exclude someone because they believed in Scientology would be as unlikely and as inappropriate as excluding someone for being Catholic or Jewish.
It is high time we all identified the elephant in the room. We can’t continue to allow the “Scientology Smear” to succeed, regardless of anyone’s personal experiences (haven’t actually heard any of those so far) or beliefs about Scientology. It is simply UNACCEPTABLE to tarnish all people of any religious faith with the same brush – it is the kind of bigotry that we all so strenuously oppose in the “mental health” system.
I reiterate from earlier posts: any attempt to blackball or discredit someone for being or being associated with Scientology should be met with a strong retort along the lines of:
“What on Earth does a person’s religious beliefs have to do with the lack of scientific support for the current system of psychiatric treatment?” Or, “I am not going to allow you to distract us from the important questions at hand by using an ‘ad hominem’ attack on some other group that has no impact whatsoever on your practice.”
We cannot afford to allow this practice of “guilt by association with someone who has guilt by association with someone else” to go forward unchallenged!
—- Steve
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The baffling part of this for me is that these youngsters were deeply embedded in the mental health system, and in the case of the first, there is a direct and observable link between her “treatment” and her death, and yet somehow, this leads to a call for “more treatment!”
Not sure I can even come up with an analogy. Why are people who read these news articles so impervious to the obvious failings of the “treatment” these young people were receiving?
—- Steve
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Psychiatry and medicine in general have often been inadvertent supporters of domestic abuse, especially when the abuser is rich and/or powerful. One of the great dangers of the “no fault” DSM diagnostic system is that it allows a victim of abuse to be identified and labeled by the abuser and to become an instantly non-credible witness. Psychiatric coercion, of course, also allows the abuser to induce the constant fear of being committed into the victim’s life. I was conned in this way once by a very smooth abuser, who had slipped his wife some meth and hauled her into the hospital, created a conflict in the parking lot where she “attacked” him, and of course, her head was spinning so badly between the drugs and being forcibly hauled into the ER that she was incoherent. I knew something was wrong but didn’t pinpoint it until later – he was not the least bit upset about her “attacking” him or being “forced” to commit her – it was all strategy. She verified this later by saying, “He did it. He said he would do it and he did it.” Unfortunately, she refused to accept my attempts to get her into a DV shelter. I’ve learned a lot since then.
It is very, very dangerous to “diagnose” someone without an identified cause, especially in the “mental health” arena. I am sorry to hear what happened to you, and I wish it were an isolated incident, but unfortunately, it is not.
—- Steve
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Ann,
As a member of RTP, I must respectfully take issue with the accuracy and tone of your post:
1) RTP did not take any money from Scientology or any other organized group. I don’t know where you got that idea, but it is absolutely false. RTP survived ONLY on the voluntary contributions of members and participants in activities, as well as in-kind donations from the Unitarian Church in the form of space and logistical support. Naturally, this kind of effort might be of interest to people of a variety of faiths, and we would not turn away a supporter based on their religious affiliations, but the group itself has and had no allegiance or financial connections to anyone but our membership.
2) I am really, really tired of having folks in our movement buy into the use of the “Scientology smear” as a means of discrediting psychiatric reform/protest/revolt. It is clearly a tactic created and imposed by the psychiatrists themselves, and every time we bite on it, we reinforce their ability to distract others with their meaningless cant and lies. While Scientology as a religion may have many flaws (and I am personally quite aware of what those are from direct experience), it is a religious persuasion, not a scientific or professional source of information. The fact that someone in this movement is or is not a Scientologist is as irrelevant to the issue of psychiatric abuse as the fact of them being a Catholic or a vegan or having a California drivers’ license.
We need to stop buying into this crap and state right out loud to anyone bringing this up: WHAT THE HELL DOES RELIGION HAVE TO DO WITH THE EFFECTIVENESS AND INTEGRITY OF THE CURRENT PSYCHIATRIC CARE MODEL???? The obvious answer is NOTHING! (Unless Psychiatry itself is willing to admit it is a religion and is threatened by the competition…) There are sound, scientific, factual reasons why psychiatric care as practiced today is often invalidative and destructive and leads to an increase in chronic disability. The professed religious persuasion of the person stating these facts has no bearing on the truth of them.
So please, let’s not blame Scientology for the Unitarian Church’s decision. As I said, I have on the ground information that suggests a very small number of individuals, for personal emotional reasons, worked hard to have this stopped, and it had nothing to do with Scientology or the aims of the Unitarian Church, though of course, it is quite possible that those excuses were dredged up and used by the individuals behind this. It was all about personal discomfort with any message that contradicted psychiatric dogma, and it would not have mattered who delivered it.
I hope that clarifies things a bit. It would really help if people didn’t make assumptions or listen to rumors about a situation that they are not personally familiar with, especially when you have more than one person available to do fact checking and rumor control.
— Steve
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Thank you for this article. It includes the science necessary to debunk the idea that enforcing “treatment” will somehow magically reduce violence in the community. It will be very useful to me and I am sure to others as we advocate for our congresspersons to oppose this dangerous bill.
And BTW, I love your author photo! You don’t look scary, just kind of intense, and that, in my world, is a good thing.
—- Steve
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Great article, Mark! You have hit in the black on exactly what does not work about the current paradigm. The WHO studies showing much better results in developing countries for schizophrenia probably reflect the long-term adverse effects of drug treatment, but I am betting they also reflect how people in those cultures react to “delusions” and “hallucinations.” In so-called “primitive” cultures, those manifestations get you some special training as a shaman. In our “modern” world, it gets you shame, isolation, and humiliation, to the point that no one is even allowed to talk to you about your personal reality. How can that be helpful?
Milton Erickson and many others did great work helping people suffering from “psychosis” by talking to them. Apparently, Erickson and his ilk would be sued for malpractice today. It is appalling. I’m glad there are a few like yourself willing to recognize that not talking to people about what is real to them is about as smart as improving your car engine’s functioning by adjusting the tuning on the radio. It is idiotic, but it is standard practice. It makes me ill to see this stupidity as the standard of care!
—– Steve
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My heart goes out to you and your daughter! I can’t refute a word that you said. What passes for help these days is outright abuse, and docility seems to be the gold standard of treatment “success.” Your daughter is lucky to have you to provide a contrast. She sounds like a perfect candidate for an “open dialog” intervention, if only we could break out of our pharma chains and develop such options here in the USA.
Thanks for sharing!
— Steve
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Thanks for sharing your story – it was very moving and sad to me, having seen similar events happen many times over my career. It is a very common thing for PTSD sufferers, including those currently still suffering abuse from parents or abusive partners, to be labeled with psychiatric “disorders” (especially “bipolar) and given drugs to suppress their symptoms. This definitely relates back to what Mark is saying in the piece above – no one really bothers to ask why you might be feeling, thinking or acting the way you are. The assumption that mental/emotional “symptoms” have no meaning is completely wrong and destructive, and you were massively disserved by the system not bothering to find out what was really prompting your symptoms. You showed great strength in persisting despite the barriers, and I have confidence you will continue to heal.
Thanks again for sharing, and I hope you continue to post. You have a lot of good and important things to say.
—- Steve
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Yeah, great time to quit smoking by force, right after an emotional crisis leading to involuntary hospitalization and possibly restraint and/or enforced drugging. I always found that policy bizarre! Wonder if they even bother with a patch or anything to help them out.
You’re so right, if you weren’t paranoid and depressed before you got in there, you would be pretty soon after the door locked behind you!
—- Steve
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Hi, Emmeline!
Thanks for your kind words. It is always great to hear from a foster care survivor who has been able to create a positive life plan for herself. It means all that much more to me to hear from someone with your lived experience in the system.
I am currently working as an advocate for foster youth with the local CASA/GAL program here in Portland, OR. I have heard only too many stories like your own, kids who have suffered endless trauma and who have little to no social support, who are somehow counseled that they ought to feel good about themselves and their lives and that their suffering is somehow the result of some biological flaw in their physiological makeup. They don’t exactly blame you for feeling bad, but that ends up being the message – if you were a really together person, you’d be OK with all this and just happily attending school and going to whatever counseling they sent you to and living with whatever random person they found willing to take you in for a price and who could kick you out at the first indication of any slight disturbance or disagreement with the management. Don’t know WHY anyone would find such an arrangement depressing, angering, or anxiety-provoking…
I have only seen a few of your posts but they’ve all been right on target. I’m interested to know more about your story, but most of all, keep on posting – your voice is very much needed!
—- Steve
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Unfortunately, this misses the point by a good margin. It is not just the experimental treatments that are dangerous to foster youth. It is the generally accepted treatments, like “treating” a 4-year-old for “bipolar disorder” with atypical antipsychotics, or “treating” a 1-year-old with stimulants for “ADHD symptoms.” Yes, these things do occur regularly, and no, they aren’t experimental. Justina’s treatment did not qualify as experimental, either, as far as I can tell. They simply decided that she wasn’t really ill and had a psychiatric disorder causing her to think she is ill. There is something particularly ironic about them forcing treatment on her because she believed she was ill when they thought she wasn’t. If she wasn’t ill, then what were they treating???
I hope they go a lot farther than the article suggests. This won’t even scratch the surface of the disservice done to foster youth by medicalizing their understandable reactions to horrific situations.
— Steve
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I have to say, Walt, I find the old “Endogenous/Exogenous” or “the blues” vs. “clinical depression” argument a bit tired. There is, as far as I am aware, still no way to make any determination as to whose depression is “endogenous” or “clinical,” other than the DSM fiction of how long it lasts or how bad it feels, which is, of course utter and complete nonsense. I am sure you have met people who were abused and/or neglected as young children, and you can clearly observe that the “exogenous” depression experienced by many of them is long-lasting and severe. Did this happen because they were “genetically vulnerable?” Does this imply that young children SHOULD be able to tolerate abuse and neglect, and that those who have long-term adverse reactions are in some way malfunctioning? Or does it suggest that we should treat our kids better so that we don’t create an unnecessary lifetime of misery for them?
I am glad you are able to see the absurdity of labeling 20% of the population genetically defective, and I am particularly happy to hear your concern about kids who have been through hell being hospitalized and drugged into lethargy for the convenience of their adult caretakers. I work as an advocate in the foster care system and see this every day. I agree 100% that these are issues that we can and should unify about.
Unfortunately, the issues I mentioned in part 1 of this post directly impact the ability of the system to execute part 2 on these unsuspecting youth. If we admitted that, in the absence of any physical indications (which I HIGHLY commend you for attending to in your practice), we really have no idea how or why kids’ behavior deteriorates, and that we have no reason to assume it is biological, and every reason to believe it is a result of their ongoing mistreatment, where is the justification for drugging them into submission?
I have some hope that you are open to hearing what I am saying or I would not bother. The justification for the massive drugging of our abused and neglected young people (and a lot of abused and neglected adults as well!) is the “chemical imbalance” theory or one of its biological cousins. The dogmatic belief that some people have “SMI/Bad Biology” is at the core of what is wrong with the mental health system today, because it allows those in power to ignore oppression, poverty, violence, racism, bullying, and professional hubris as causal factors. And as Alice Miller so eloquently writes about, those with the least power are always left holding the emotional bag, as it were.
Until we see objective methods to tell who has “bad biology” and who does not, I think we need to absolutely avoid using that construct at all. It doesn’t mean we can’t utilize drugs in some cases – Johanna Moncrief’s approach is certainly much more valid, admitting that we are using the drugs for their noted effects rather than pretending we’re “treating” something “biological.” But continuing to pretend that we can distinguish between those who are really “ill” and those who are suffering as a result of life experience is a fiction we can no longer afford to maintain.
— Steve
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But it would certainly also be premature for us to assume that they were legitimate. And given the nature of what we’re dealing with, emotional reactivity to the essence of the effort is a very likely component. It’s an old story that has happened to many before who had the courage to speak up about oppression.
As it happens, I do know a bit about the expressed concerns and who expressed them, and I am comfortable with my statement above, as it is based on knowledge, not pure speculation. It’s impossible to know what people’s motivations are, but the information I have suggests this was a political move based on emotional reaction and defensiveness from one or two people, not a principled decision based on thought and discussion among the group. Of course, you’re entitled to assume whatever you want, but I hope you would respect the fact that I have direct knowledge that you are not able to incorporate into your viewpoint, and I hope you would trust that I am communicating that information honestly to help others understand what happened.
—- Steve
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Amen!
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Greetings all,
As an almost charter member of RTP, I appreciate the outpouring of support for the difficult position we are in, and the effort to look at the reason. Francesca, I can assure you that the reason this happened was not because of a strong anti-medication or anti-psychiatry message, and frankly, I felt a bit of resentment that you would assume this is the case without knowing anything about the situation on the ground. The name “Rethinking Psychiatry” was chosen with this in mind – the group’s purpose is not to ban or destroy psychiatry, but to help re-focus the profession on the experiences of the consumer/survivor/user of services and on the range of viable options that exist beyond the scope of the brain disease/chemical imbalance viewpoint. It is expansive and inclusive in nature, and definitely pro-choice for medication (many of our regular attendees use medication regularly), to the point that we even had NAMI present a film at last year’s film festival. They were very politely received and a rich and healthy conversation ensued after the film, which I hope left everyone feeling a little more enlightened.
In truth, I believe WileyWitch is closest to the truth: it seems to be hard for people to get their heads around “mental illness” being something that could happen to almost anyone, or that oppressive surroundings, including in the family, our communities, and our society as a whole, can cause almost anyone to “lose their minds” and act in ways that are uncomfortable for us to see. In particular, it is very painful for family members to realize that they may have contributed in some unknown way to their children’s suffering, or that they might have been able to make their child’s path easier if they’d behaved differently. It seems to be “human nature” to avoid such uncomfortable realizations and project “the problem” onto a particular family member or social group who lacks the power to defend him/herself. Alice Miller writes very powerfully about this phenomenon. Of course, when the “scapegoat” starts complaining about being singled out in this way, it is in the common interest of those in power to minimize or distort his/her voice so that the social delusion of calm and order can be maintained.
It is clear that there are a certain, very small number of INDIVIDUALS within the local church structure (or perhaps attached to people who attend but not members themselves) who were disturbed by our message, and would have been uncomfortable with any message that questioned the mainstream view of psychiatry, and those individuals acted to make themselves feel more comfortable by getting rid of the “dangerous group” who was disturbing their sense of reality. And they made enough noise to make enough other people uncomfortable that the church executives felt they had to choose one or the other, and sadly, chose to support the status quo and comfort over challenging the dominant paradigm. It is pretty much that simple.
It almost makes sense to me that this would be the last form of oppression that even those battling oppression on other fronts would be able to embrace. There is so much fear of being labeled “crazy” as a means of marginalizing dissent, that those who have another agenda are probably worried that allying with the RTP movement will tarnish them in some way, much as the antipsychiatry movement has been intentionally tarnished with the “Scientology” brush (and of course, Scientology itself has been severely attacked for having the temerity to suggest an alternative to psychiatric treatment in the first place).
That being said, it is a sad moment. I very much appreciate Jonathan bringing it to national attention. I have heard great things about the Vancouver BC Unitarians and am glad they’re still on board, and other Unitarian congregations around the country continue to be supportive of this work, so please don’t overgeneralize about Unitarians based on this one incident. It is political, but it is local, and has its own backstory that has nothing to do with Francesca’s formulation that if we’d just been nicer or less strident, things would have turned out differently. We made some people uncomfortable and they acted out to make themselves feel better. It is an almost inevitable result of challenging the status quo.
I am sure we will reconstitute in some form or another. I hope that people are also considering that this kind of reaction suggest that we are, in fact, having an impact, because no one would bother trying to get rid of an organization that was easier to ignore. Let’s keep on that path and not apologize for our message making people uncomfortable. Comfortable people don’t change.
—- Steve
P.S. Thanks to Oldhead for the Phil Ochs reprise. There was a guy who didn’t mind stirring up a bit of controversy!
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Based on Fred’s comments, perhaps the correct term is that I am “ANTI-OPPRESSION!”
—- Steve
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It is only associated with Scientology because the psychiatric industry chose to use that association as a PR tactic. As I have said before, I meet any such implications with a clear statement: What on earth does religion have to do with whether or not your treatments have been shown to work?
—- Steve
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I agree, this is actually the real core of the problem. The drugs can’t be justified without this spurious DSM “diagnostic” flim-flam. That’s what I’m most opposed to!
—- Steve
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But by no means do I think we should alter our language to appease the psychiatric industry. I don’t really care what the mainstream of psychiatry thinks. I do care about helping human beings of whatever profession who are in doubt about this area decide to start looking at the rest of the evidence.
—- Steve
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Definitely important to distinguish between psychiatrists, who cover a range of beliefs and interests and openness to learn from new data, and psychiatry, an institution with a grim and horrific history of morally and criminally destructive acts, including extreme (and some would say ultimate) responsibility for generating the Holocaust in Germany in the 1930s-45. I am definitely in support of positive psychiatrists working to make changes, and am definitely against the institution as it has come down to us through the years of lying, force, and abuse.
Unfortunately, the media image that most people have of psychiatrists is as therapists who try to help their clients re-think their world views (as seen in Good Will Hunting, Ordinary People, What About Bob, and many more films and TV shows). As a result, the moniker “antipsychiatry” can cause some who are unfamiliar with the field to conjure up images of people who don’t care about mental/ emotional/spiritual distress and think that people should just “pull themselves up by their bootstraps” and “get over it.” Which is why psychiatrists use that word as a smear tactic, along with their self-serving “anti-stigma” campaigns designed to make anyone critical of their ineffective and destructive interventions seem like an insensitive heel.
I find myself in the odd position of agreeing with Richard that “Anti-biological psychiatry” or “Anti-f0rced-treatment” might be terms that the general public can more easily process, while at the same time agreeing that if you eliminate force and drugs, 98% of the current practice of psychiatry would immediately come to an end, and the remaining 2% could easily be incorporated into neurology or psychology, based on the presence or absence of an actual physical health issue. For those who would argue that the temporary use of psychotropic agents might still have some therapeutic value, there will still be medical doctors who could prescribe them, but they’d have to be viewed more along the lines of pain killers, appropriate for temporary relief of acute symptoms, but not appropriate for treatment of anything that requires actual healing.
I don’t really see that psychiatry as a profession serves any useful purpose, and its history will always weigh it down with the likelihood of evil intentions asserting themselves. But I do see a point in approaching our language strategically, for as much as it can be frustrating, most people make decisions mostly based on emotions, even when you have the facts on your side. It is this fact that psychiatry as an industry counts on, and if we are to counter it, I think we need to have a counter-message for the general public that generates the right emotional response, even if it isn’t strictly “true” in the scientific sense.
It is a very tough point to work out.
—- Steve
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It was not my intent to be in any way condescending – I am genuinely impressed with Andrew’s ability to balance his obvious passion with an understanding of the potential limitations of his audience. It is a very difficult balance to strike and requires considerable skill to accomplish. I can easily see a person who has been browbeaten by the system but is still suffering some “Stockholm Syndrome” effects being open to hearing this letter when they might balk at a more intense approach.
I was also fortunate to have found a competent therapist, back in the days when therapy was the first-line intervention, and I’ve been a therapist myself, but unfortunately, my more recent experience is that most therapist either shy away from any deep healing because it is frightening to them to go there, or they try but lack the skills to do so effectively, and leave people in a bad place.
I also very much agree with Andrew about polemics having their place, especially from the mouths of those victimized by the system, as I’ve written about elsewhere. The Yin/Yang viewpoint makes a lot of sense to me. But this “yin” message is also vital for those who are having a hard time dealing with the possibility that their educated, trusted professional advisers may not be giving them the straight story. It can be a painful jolt to come to that conclusion, and I find Andrew’s style a perfect blend of the hard truth with a truly compassionate understanding of how best to couch that truth so that it can be heard and considered by the recipient.
Hope that clarifies things.
—- Steve
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That is pretty disheartening! Disgusting, really. I suppose they choose not to recall that outcomes for these “mental illnesses” are actually better in those countries not exposed to our helpful “treatments.” I hope Africa can resist!
—- Steve
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Live, healthy babies are the most likely outcome of ANY birth! They are basically saying, “We aren’t killing them, and only causing serious problems in what we hope is a pretty small number. Or at least that’s what we think, but nobody really knows for sure.” Not very reassuring!
— Steve
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I will reiterate, I think there is an important distinction between professional voices, who I believe have a responsibility to be fact-based and fair and honest about admitting to possible counterarguments or new data, and survivors, whose rage is 100% appropriate and should not be edited in any way. It is not the survivor’s job to make the perpetrator feel more comfortable. Imagine if we said that a child abuse survivor needed to curb his rage so we could have a more rational discussion with those who believe that some child abuse is not so bad, or a rape survivor who was cautioned not to be too confrontational so that those in political positions to make changes to rape laws aren’t offended or scared off.
Survivors have every right to their feelings and to have them be heard. It is the job of those of us within the system or professionally advocating for change to choose our tactics and strategies based on political necessity. It is important to do that work, but not at the expense of silencing or muting the voices of those who have been harmed. If the psychiatric profession can’t handle hearing the direct impact of its own actions, then dialog is unlikely to be productive in any case. It is only through conveying the honest voices of those who have been damaged that we can enforce any kind of change with those who don’t want to hear the truth. It will require others outside of the mental health profession, along with the few but hopefully growing number of courageous “insiders,” to really bring about the change that we want. And those outsiders are moved to action by stories like Justina Pelletier, not by statistics or science. We need rage and honesty as the motivating energy to alter the status quo. It won’t happen by peaceful negotiations, even if dialog does eventually become a viable part of the picture.
So I say, let the rage fly! It will be up to Jonathan and me and others like us to put those feelings into more digestible portions for the weak-hearted “insiders,” many of whom know the truth but are afraid to speak up. My hope is that your stories will inspire them to greater courage.
—- Steve
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The beauty of the psychiatric model is that we can argue endlessly about whether kids are “overmedicated” or “underdiagnosed” or whatever until the cows come home, but no one can ever establish the truth of the matter, because there is no way to actually tell if someone “has” or “does not have” a particular diagnosis. Dr. Whasisname can blame whomever he wants, but it is the psychiatric profession that invents the labels and lends medical credence to this preposterous process of labeling and drugging. It is characteristic of the profession to place the blame everywhere but on themselves, but bottom line, regardless of the “pressures” the poor, suffering psychiatrist has to put up with, it is he and he alone who has the authority to write the prescription. Nobody is forcing him to put his name on it. If he’s so concerned, why isn’t he starting up a re-education campaign for these parents and “groups” so they get the data correct? Such an abdication of responsibility is amazing, and yet is the common currency of the current “mental health” system. It is they, the ones with the most power, who are the helpless victims in every scenario.
—- Steve
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It is the lack of listening, and the invalidation of people’s experiences, that is at the core of what is wrong with psychiatry. I’m with Dr. Joanna Moncrief – if we are honest about what psych drugs are and adults make an informed decision to use them, that’s up to them. The problem is lying to people that something is physiologically or even psychologically wrong with them because they ave having feelings or experiences that make us uncomfortable.
What really seems to help most is to have someone really care about you. Physical aliments even heal more quickly when the doctor has a good “bedside manner.” Respect is, indeed, the key, and any system that approaches people without that respect is dangerous and needs to be dismantled.
— Steve
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It is fascinating when I hear these analogies with prejudice against black people or gay people or disabled people being used to explain away critiques of psychiatry. The obvious failure of any such argument is that black people, gay people, and disabled people were and are groups with diminished power in society. Whereas psychiatry appears to have way TOO much power and is hurting people, who are complaining about their treatment. A young black man can’t do much if anything about others choosing to arbitrarily view him as dangerous, but the psychiatric community has plenty of control over how it treats its patients/clients. If they are so worried about being criticized, maybe they ought to figure out what they are doing to piss people off and CHANGE IT!
It is utterly narcissistic to palm off criticisms against a well-paid and socially-entrenched profession as “prejudice.” Its very much like the bully complaining when he ends up with a broken nose because someone finally decides to hit back!
—- Steve
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I appreciate the feedback, but I am pretty confident that I have stopped many instances of potential psych drugging, both directly through my work and indirectly through policy and law changes in Oregon and through many trainings I’ve done. In truth, though, I don’t see drugging as the biggest problem – I see it as a consequence of allowing DSM “diagnoses” to stand as genuine medical entities when they’re actually social constructs that in some cases are fabricated from almost no evidence whatsoever (i.e. “Intermittent Explosive Disorder” and Oppositional Defiant Disorder). When we can stop legitimizing these diagnostic manipulations, the justification for forced drugging will be gone. I think that’s the goal we really ought to pursue. But in the meanwhile, I give no credence to drug “treatment” of “mental diseases,” because I know they aren’t really diseases at all.
— Steve
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And PS – you didn’t offend me at all. I appreciate the opportunity to make that clarification, in case someone else had the same misimpression.
—- Steve
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Hey, I’m the last guy in the world to support bipolar disorder as a diagnosis or lithium as a “good drug.” Lithium is essentially a poison to the system, and its main claim to fame in my book is that the difference between the “therapeutic” dose and the lethal dose is so small that they have to constantly check your levels so they don’t accidentally kill you.
My comment was mostly meant to summarize that there is no literature support for SSRIs reducing suicide attempts or ideation, rather the opposite. I am a scientist and have to acknowledge the evidence that exists, and having done a lot of research on suicide rates and psych drugs, I have become aware that there is research showing that lithium does reduce the suicidal thinking rate. It may do so by poisoning the brain so badly that thoughts of suicide are impossible to formulate, but that’s what the research has shown. I don’t for a minute consider it a recommendation to supply lithium to suicidal people. The point was more that the idea that an increase in suicide rates is not likely to be in any way connected with the rates of SSRI prescription, except if it goes up.
I am still waiting for someone to show me any research to the contrary, but having presented this many times as a question and gotten no response, I think we are safe to assume that such evidence does not exist, even in the pharma-distorted published literature most likely to favor such “research findings.”
Hope that clarifies things. I am no apologist for lithium or bipolar disorder or really anything in the DSM, except possibly for PTSD. Except I don’t think of that as a disorder, but more a normal response to being abused. I don’t believe “mental illnesses” as defined in the DSM even exist, let alone justify medical “treatment” with drugs that are really poisons.
—- Steve
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We can and we should, and we both do. I just think it’s important to recognize that while I’ve helped make things better for foster youth, they are still in an extremely vulnerable position with little protection, and unless the current paradigm of THOUGHT is changed, there will still be atrocities committed to foster kids in the name of healthcare. Until all or most of us in social services get away from the ‘we know best’ mentality and start with a much more humble approach, clients will continue to be harmed.
As I think I’ve said before, I am not opposed to options. I’m opposed to lying, arrogance, and enforcement of “treatment” on the uninformed or powerless. We have to address the power dynamics before real informed choice is a possibility. But we do need advocates on the “inside” in the meanwhile, because people are suffering and need our support. I just don’t think it will be enough until the general public sees that the psychiatric emperor has no clothes.
—- Steve
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My own experience fighting for reform of the use of psychiatric drugs on foster youth reinforces your comments, Richard. We spent 5 years working collaboratively with a lot of people, including the news media and the state legislature, as well as various social service and mental health types, and attorneys and judges, and got a law passed that increased oversight levels. This improved the conversation, increased advocacy for kids in this area, raised public awareness, and did reduce the use of psychiatric drugs to a noticeable degree.
But foster youth are still being drugged up at 3-4 times the rate of the general population, and are still being told they have “chemical imbalances” to explain why they are depressed about the deplorable treatment they have received, both before and during their stays in foster care. They still don’t get listened to, still are blamed for getting upset about being mistreated, still get the message that they should be happy about their conditions and just get on with their lives, rather than being allowed and encouraged to express and work through their appropriate pain, grief, and anger. Why? Because they have no power. Because the DSM and the current model of treatment allow and encourage clinicians to distance themselves from their clients. Because our society at large is unwilling to acknowledge the oppression that is embedded in so many aspects of day-t0-day life.
Reform is important, but we need to get beyond taping on severed limbs with band-aids. We need to really deal with the realities of social oppression, both within and beyond psychiatric “treatment,” for real change to happen. It is not a matter of policy changes, it’s a real change in culture that needs to happen, where people no longer look to doctors for help with psychosocial problems, and where the idea of medicating away someone’s emotional experience, rather than sounding reasonable as it does to most people today, starts to sound to most people like the invalidative and intentional misdirection that it really is.
—- Steve
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Andrew,
Thanks for a beautiful letter! You did a tremendously job of compassionately understanding the need/desire for a name/solution that is so often exploited by the current system in the name of healing, while providing the contrasting path to healing without a label. Your counselor sounds like a truly capable and compassionate person who knew what s/he was doing. I only wish there were more such people in the profession who could really focus on the kind of “deep healing” you have found.
I am glad to know you are now dedicated to passing on what you’ve received in terms of healing. Thanks for such a gentle and wise perspective – it provides such an excellent contrast to the polemics that often are heard in this and other politicized debates, and refocuses the energy where it belongs – on the needs of the person who is suffering.
—- Steve
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I don’t know why I continue to be shocked by the absolute lack of compunction the “helpers” in the mental health system are capable of, but this one got to me. To think they would consider the belief in reincarnation as a psychotic symptom is beyond the pale. According to this standard, three quarters of the world’s population is probably subject to enforced psychiatric hospitalization.
Thanks so much for sharing your story. I hope it and others like it reach the right eyes and ears. And “brain rape” certainly sounds like an apt description of what you’ve gone through. Your strength in surviving it all and being willing to tell the world what happened is admirable and appreciated.
—- Steve
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As far as I am aware, there is no evidence anywhere that antidepressants have an impact on reducing the suicide rate. The only data we do know of suggests that they most likely increase it. The only drug I know of that has been shown to reduce the suicide rate scientifically is Lithium, and it wasn’t by a lot. Somebody tell me if I’m missing something here.
—– Steve
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I would argue that equating antipsychiatry with Scientology should be met with a demand to return to the issues at hand. I would observe that anyone stating this is engaging in an ad hominem attack in order to avoid dealing with the data. A simple response: “What does religion have to do with the effectiveness of antipsychotic drugs over time? I’ve presented data to show that those receiving antipsychotic drugs do worse in the long term. Why are you avoiding answering that question? What are your data to refute that? Is it possible you are resorting to this kind of attack because you don’t have a scientific response to my query?”
This will probably not convince the person trying to distract the reader with their smear tactics, but an alert reader will easily see who is talking facts and who is trying to distract.
I do agree that people have every right to give their own experience the framing they believe it deserves, and we should not have to protect psychiatrists from hearing the emotional impact of psychiatry’s “helpful” interventions. At the same time, I agree with Francesca that sometimes we do have to be careful of how we frame things with people who are “uncommitted” in the debate, so that it is difficult to view the critique of psychiatry as anything but rational and well-grounded. I suppose I hold the professionals (like myself) most responsible for getting this message out. Survivors’ views should really be considered valuable regardless of the style of presentation, because after all, they are the ones who had the experience.
Bottom line, I don’t think “playing nice” with psychiatry as a profession is worth wasting time on, but I do think there are possible allies who should be approached with a more diplomatic message. It’s important to consider the audience.
—- Steve
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Does she sound like one to you?
—- Steve
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I would love to see a study on the “placebo/nocebo effects” of telling a client/patient that they have a chemical problem in their brain that they have no control over, vs. telling them that depression is a pretty common phenomenon, happens to lots of people for very good reasons, and that most people recover pretty quickly with some help. I’d bet anything that what the doctor says is wrong with you and what your prognosis is has a direct impact on the outcome.
—- Steve
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Psychiatrists have the power of the state backing them, whereas Jews had the power of the state opposing them. Psychiatrists are a professional organization, Jews were ordinary citizens. Nazis were a political entity attacking a cultural group. Psychiarists are the political entity, and they are both defining and attacking a cultural group. There is a huge difference in power between a group of people trying to live their lives and a group of people backed by political and social power trying to tell other people how to live their lives.
I am not down with hate speech or overgeneralizations against psychiatrists or anyone else, but the analogy between people protesting psychiatric abuse and people plotting the extinction of a cultural/ethnic group based on an ideology of superiority does not hold up.
— Steve
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Joel, I do appreciate your comments and agree that clients demanding drugs is a very significant reality. However, I can’t agree that this client action happens in a vacuum, as your comments seem to suggest. Our culture has undergone significant changes in how we conceptualize what a “mental illness” is and how to treat it. This is especially true since the DSM III came out in 1980, and it did not happen because patients suddenly started deciding to demand drugs. It appears from the history I am familiar with to have been an intentional move directed from the heads of the psychiatric profession to position themselves for a greater market share and to aspire to a more “scientific” approach to mental health. Which was not entirely ill-intended, I have to say – the approach to mental health in the 60s and 70s was anything but scientific. Unfortunately, however, scientific started to mean physiological, for a lot of reasons that don’t have a lot to do with the actual health and welfare of patients. Loren Mosher’s experience with the Soteria House project is proof enough of that – Soteria patients clearly did just as well over the medium range as anyone receiving hospital/drug treatment as far as symptoms, but did better in terms of social variables, and cost less to care for, but somehow, the project was de-funded and Mosher was persona non grata. This is not science, it’s politics, and I think it is important to recognize that fact.
Another huge factor you are ignoring in your comments is the effect of DCT drug advertising, which is banned in most industrialized countries, for very good reasons. One look at the Zoloft commercial with the sad little circle guy and the dramatization of serotonin nerve transmission should quickly answer the question of why consumers sometimes come demanding drugs: they have been lied to and have believed that the “scientists” at Astro-Zeneca and so forth have their best interests at heart. This has happened in medicine in general, not just in psychiatry, and it is a very predictable result of the use of the magic brainwashing device called television to promote propaganda about the ostensible causes of mental illness. A recent survey showed over 80% of respondents believed that depression is caused by a lack of serotonin in the brain, despite that theory being pretty much discredited in the mid-80s. This is the result of effective propaganda campaign of which Goebbels himself would be proud.
That being said, is it not the physician’s responsibility in the end to correct any misimpressions that the patient may have about treatment? Isn’t it really your job to tell someone, “Drugs can lead to a temporary reduction in symptoms, but will most likely impact your health in a negative direction the longer you take them. The first line of defense against depression is to make lifestyle changes. Here is a list of effective options.”
Yes, US culture is degrading and more and more people are relying on drugs to solve their problems. Some of them show up in your office. I don’t think that absolves you or any other doctor from being honest and prescribing only those things that are likely to help. You can’t personally defeat the entire onslaught of DCT advertising personally, but if you and others like you are honest with patients, we can start moving the culture back into a more sane assessment of the real risks and benefits of drug treatment. It is not your fault the public has been duped, but it is your responsibility to un-dupe as many people as you possibly can, and not simply blame them for being gullible to forces that are way bigger than them as well as you.
—- Steve
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I absolutely agree, as we will be unable to successfully engage professionals if we’re unable to have compassion for their experience, even if we aren’t able to support their methods of dealing with it. Healing begins with compassion!
—- Steve
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James, I think you are using the term “normalize” in a very different way than I would use it in practice. There is a difference between oldhead’s previous example of saying it’s “normal” to commit atrocities because it’s been done before by lots of people, and communicating that someone’s anxiety is, for instance, a normal reaction to being raped or beaten up by parents or a spouse/partner. The latter does not assert that it’s OK to beat people up or rape them, nor does it deny the suffering of the person reporting the assault, but it puts the responsibility for the distress where it belongs: on the distressing events that generated it. I’ve heard way too many disingenuous arguments that “not everyone reacts that way” as proof that there’s something wrong with the person who experiences intense anxiety following trauma, and I frankly don’t buy it for a moment. There is no “right way” to respond and it makes no sense to pathologize someone for having a challenge in dealing with human atrocities being committed.
The biggest problem with diagnosis is that it puts the blame for the person’s emotional experience entirely on them, and, in fact, normalizes the external conditions they have to contend with. My experience as a therapist tells me that this is the exact opposite of what really promotes healing. Much of my work with trauma survivors centers around helping victims see that they did NOT cause their own victimization, that their reaction IS a reasonable reaction to a very unreasonable set of circumstances, and that it is OK for them to feel anxious, angry, or whatever they feel and it’s not OK for anyone else or society as a whole to minimize their experience or tell them not to feel as they do. Diagnosis, by contrast, creates the impression in many if not most recipients that I SHOULD NOT be feeling the way I do, that my depression/anxiety/delusional thoughts are THE PROBLEM, rather than clues to a problem of an entirely different nature. I work a lot with foster youth, and many have shared with me how tremendously insulting it is when they report being depressed about their dire situations or histories, and the system responds by telling them they have a “mental disorder” and that they need to “rebalance their brain chemistry” with psychiatric drugs. As one kid once sagely said, “Maybe it’s OK for different people to have different brain chemistries!”
Additionally, this process of diagnosing without verifiable underlying causal factors creates great problems with research. Let’s say, for the sake of argument, that 20% of kids with “ADHD” diagnoses have low iron, 15% suffer from sleep apnea, 12 % have vitamin B deficiencies, 22% are suffering from PTSD, and 26% are bored to death because they are unchallenged in school. Any research done on any of these areas will show that interventions are “ineffective” against “ADHD”, because they don’t affect a large enough percentage. If we measure iron supplementation vs. stimulant drugs, stimulants will “win” because they’ll improve symptoms on 70% of the cohort, while iron will only help 15%. But those 15% will actually be cured of a real condition!!!! The other 85% will need more work to establish a real and meaningful diagnosis, but it’s clear that the “ADHD” label will prevent this kind of genuine differential diagnosis work ever happening. And we will spend billions of dollars researching the wrong things and paying for the wrong treatments, and projecting hostility toward the people who are rightly pointing out that the Emperor has no clothes on.
It is a lot more than semantics. Choosing diagnostic labels has profound social and psychological and practical effects on both the clients and the professions trying to help them. I don’t think anyone is arguing that people suffering emotional distress should be ignored or should not be helped. What I am saying is that “diagnosing” them based solely on subjective measurements of distress, without actually identifying a real cause, is extremely destructive. It mostly serves the interests of the professionals who are having a hard time admitting that they don’t really understand what is happening. But admitting to not understanding is essential to improving one’s knowledge. Eliminating spurious “diagnoses” based on social convention and subjective assessments can only help improve the treatment of mental distress, whatever the cause.
— Steve
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There are plenty of stories and there is plenty of evidence that stimulants and SSRI antidepressants can cause “manic episodes.” It even says so on the product information for most of them. I work with kids in foster care and see this effect all the time. Kids are diagnosed with “ADHD,” put on stimulants, become aggressive as a result, and are diagnosed with “bipolar disorder” and put on antipsychotics. Ironically, the stimulants increase dopamine supplies, while antipsychotics decrease dopamine supplies. So they increase dopamine with the stimulants, then see evidence of excessive dopamine transmission, which they view as a new “disorder” and “treat” with a new drug, rather than doing the obvious and stop overstimulating the dopamine system.
It definitely does happen to kids and adults who have never had these symptoms before. Some doctors have even been so disingenuous to say that the drug treatment “unmasked an underlying bipolar disorder!” For some reason, it seems difficult for many psychiatrists to accept the possibility that their drugs do sometimes make things worse.
—- Steve
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But wait, I thought their brains were broken…
This is actually not new – a similar experiment was done in the 70s for “ADHD” diagnosed kids, and they did noticeably better with in-school exercise. Too bad the “powers that be” don’t seem to want to incorporate that information into their handling of kids in school.
—- Steve
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I seem to remember something about Torrey having a relative, maybe a sister, who was diagnosed with “schizophrenia” and had a bad time of it. I could be wrong, but I have some memory of this.
In any case, Sera, I believe you are mostly correct, though there are a few folks near the top who have no such excuse and are just in it for the profit. I think a lot of medical decision-making in all spheres is highly influenced by professional “trauma”, as it were.
The problem, however, is that when the patient is traumatized, s/he is genuinely powerless to stop the system from doing its thing, whereas when the doctor/clinician is traumatized, because of his/her privileged position, s/he has the option of taking it out on his/her client. While the reaction (such as yours) is very understandable, the core of professionalism, in my view, is the ability to differentiate between what I need as a professional and what the client needs from me. It is never appropriate or ethical for me to take action to make myself feel better that might be harmful to the client. I am responsible for taking care of my professional needs by consultation, supervision, training, and just plain gut-wrenching and brutal self-honesty. Which is what you appear to be doing at your facility, rather than reacting by backing away from your mission.
So I can feel compassion for Torrey only as long as he isn’t taking out his fears and sadness and anger regarding his lost relative out on innocent victims who have nothing to do with his personal losses. It’s fine for his experience to drive him toward creating better treatment for those suffering similar conditions, but not to try to capture and forcibly drug anyone who remotely reminds him of his own personal situation, just so that he’ll feel safe and in more control.
And of course, as Francesca points out, he is now profiting from his projection of his bad experience onto others, which raises the unethical needle up to another level. No, I can’t feel bad for him until he comes clean about his personal life affecting what were once much more compassionate views on what genuinely helps people do and feel better.
— Steve
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Sandy,
I remember reading a bit about your history, and it suggested to me that you’ve always been open minded and willing to challenge “sacred cows” from the start. Don’t remember why I thought that, but I remember thinking it. I am sure there are any number of folks like you out there who are people with whom a productive dialog is possible – I have met a few in my years as a mental health worker and children’s advocate. The problem is that even such people (myself included) appear to be in the minority, and are under tremendous pressure from the larger culture to accept these “truths” that aren’t true. I’m interested to know how that can be changed from the inside out?
I have had my successes over the years, including helping get a law passed in Oregon to increase administrative oversight of psychiatric drugs for foster youth, which has had a definite impact in the number of kids drugged or overdrugged, and made it easier for advocates to speak up when they have concerns. But the law did not change the fundamental reality – kids who have been traumatized, sometimes brutally, often repeatedly, both before and after entering foster care, continue to be treated as if their brains are malfunctioning when they object in some way to the process, or try to adapt to the insanity of their lives.
It took a lot of work to get the small changes we did get into law. What will it take to convince an entire community that abused kids acting angry or depressed is NORMAL? That it’s hard to concentrate in school when you’re wondering if your homeless mother has attempted suicide again this week? That it is normal to be highly anxious when you don’t know if the next time your carefully-repressed anger at your parents surfaces, you may lose your foster home, school, counselor, friends, and almost everyone you know?
Or to take another issue: why is it not obvious that when you give someone a drug to make them better, and they don’t get better or get worse, you should discontinue it? I make this observation all the time, as a professional, and 8 times out of 10 (0r worse), my input is ignored or denigrated. How can I have a dialog with people who don’t want to listen?
I really do hear what you’re saying, but I don’t know the answer. It is safe now for the “powers that be” to ignore anything that’s inconvenient. The normal reaction of most people to being ignored is to shout louder or make a scene. Which, of course, is regarded as more proof that they are “mentally ill” and should not be listened to.
It’s a real dilemma. I’m interested to hear what you think will work. ‘Cause I’m kinda getting burned out being the “light in the wilderness” these days.
Thanks for any thoughts you may have about this. I hope you take time to read the link I attached above, because I think it reflects that no one is really wrong in this equation – both perspectives are really needed.
—– Steve
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I just read an article that talks about this particular conflict in a historical context. Apparently, it is an inherent conflict that takes place in most social movements, the conflict between working with the system to make a change and working to create a new system parallel to the old and oppressive one. It seemed very relevant to this conversation. Link is below:
http://www.nationofchange.org/should-we-fight-system-or-be-change-1401978457
—- Steve
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It seems the obvious missing factor here is that we have more people being treated for these “disorders” and yet the rate of violence, suicide and early death have increased. If these “treatments” were effective, wouldn’t we expect to see the reverse effect? They do call for “improved treatments,” but don’t seem to acknowledge the rather obvious conclusion that the current “treatments” aren’t working very well, at least for a big proportion of the population they’re looking at. It seems like folks were better off before they got these modern “treatments.”
Important to note also that the correlation was not with frequency of hospitalization, but with length of stay in the hospital. People who are hospitalized are spending less time there, and in my view, this is largely because we’re relying almost solely on drug treatment to “stablilize” and release folks before anyone really has a chance to find out what is going on. And now no one even really bothers to ask most of the time – causes are irrelevant, life stressors are irrelevant, it’s all about messing with brain chemistry.
The further we move into the purely mechanical view of “mental illness,” the poorer our outcomes become. It is a shame, though predictable, that the authors aren’t able to make the leap to see that poorer outcomes mean that the current treatment modality is not working.
—- Steve
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I am not sure exactly where to go with this issue. There is clearly a lot of strong emotion expressed in this piece and many comments seem to relate strongly with the sentiments expressed. While I agree that dialog involves listening in a two-directional manner, I guess my first thought is that there is a lot being said here that psychiatrists as a whole profession absolutely need to hear, unedited and blunt and to the point as it is. I don’t think Daniel needs to make any apologies for laying this out.
I also agree with Bob that we want to encourage dialog with sensible and rational psychiatrists such as Sandy who are trying to make changes from within the profession. She has shown tremendous courage, both by listening to these sentiments openly and by challenging her colleagues and making real changes happen in the great state of Vermont. Her commitment to exploring Open Dialog as a viable alternative to the current paradigm is particularly admirable, as I am sure she has experienced a great deal of professional resistance and criticism for trying to replicate a psychosocial approach to psychotic experiences that relies only minimally on drug-based interventions.
I guess my bottom line is this: Psychiatrists are the ones with the power. They are the providers of the ostensible treatments and need to be open to hearing the results of their activities. I am sorry if it is hurtful to those who are working to make changes, and it is probably unfair to paint the profession with such a broad brush. But I don’t think it’s the job of the client/recipient/patient to be fair to the therapist/operator/doctor about their feedback. I think it’s the job of the professional person to be open to hearing feedback from his/her clients, even if is put in terms difficult to digest, because a true professional is interested in finding the best pathway to healing, and WANTS to know what his/her clients are experiencing.
I believe expressive pieces like Daniels only occur because the profession AS A WHOLE has been so completely impervious to more direct dialog. It feels a bit like the profession is projecting its own anxieties onto the clients and accusing them of not listening, when in fact, it has been the psychiatric profession as a whole who has been in denial and actively working NOT to hear the loud and clear feedback from its clients, or indeed from its own research and membership. Sandy is experiencing this oppression as well, and I am sorry for it, but don’t know what else to say but “We aren’t talking about you.” If the entire field of psychiatry were half as open to feedback and observation as you are, we would not have a need for the intense emotional outpouring that Daniel’s writing and the many comments express.
It is not the clients’ fault when the treatment they are prescribed doesn’t work or makes things worse. And it is understandable that the client is angry and disillusioned and may even make generalizations about the profession as a result. I am a mental health professional myself, and I hear loud and clear the damage that is being done, and I have no problem with people expressing their outrage. I guess my hope is that those psychiatrists and therapists and social workers who really care, rather than being offended or put off, will take a deep breath and say, “Wow! This is a really important message, and I need to figure out what it means.”
As an old Chinese (I think) saying goes, “instead of breaking off my finger, look at where it is pointing.” There is no “anti-cardiology” or “anti-dermatology” movement out there. There is a reason why these feelings exist. I think it is time for those of us in the mental health professions to thicken up our skins and hear what is being said without criticizing the messenger for somehow not saying it in a way that makes us comfortable.
—– Steve
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Right you are. And Barclay and Cunningham’s work was done back in 1978 or so, and nothing has changed since that time. It is the responsibility of the DOCTORS to convey this information to patients, just like they finally have started to do about antibiotics being useless against colds and most ear infections. This was known for years, but the docs kept prescribing antibiotics to keep their patients happy, which, of course, keeps the drug companies happy, too.
Instead, the doctors should be EDUCATING their clients – “This drug may temporarily make your child easier to manage in class, but there is no evidence that they will learn anything more or become a better or more successful adult as a result of being more manageable.” Instead, they are WARNED that failure to medicate them will have “dire consequences” in half a dozen or more areas that stimulants have no effect on at all! That is malpractice, in my book. I understand that patients are susceptible to the placebo effect, but doctors should know better than to lie to their patients. The doctors’ confidence in the “treatment” is a huge part of the placebo effect anyway. They are extremely reprehensible for not conveying this information that has been known since before the DSM-III was even published.
—- Steve
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From the article:
“… lists the dire consequences if “ADHD is left untreated”:
“Increased risk for school failure and dropout in both high school and college
Behavior and discipline problems
Social difficulties and family strife
Accidental injury
Alcohol and drug abuse
Depression, anxiety and other mental health disorders
Employment problems
Driving accidents
Unplanned pregnancy and sexually transmitted diseases
Delinquency, criminality, and arrest”
As always, the authors of this paper neglect to mention that NONE OF THESE OUTCOMES ARE ALTERED IN ANY WAY BY STIMULANT TREATMENT!!!! The only one that there is any suggestion is improved by stimulants is driving accidents. The rest have been shown to be completely unaffected by long-term stimulant treatment.
I think we need to be broadcasting this fact loud and clear. There were reviews of the literature in 1978, 1993, 2001, as well as two long-term studies (the MTA in the US and the Raine Study in Australia) that compared “treated” and “untreated” ADHD-diagnosed students, and there is no consistent difference in outcomes. Actually, the Raine study showed the “treated” cohort to drop out of school at a rate over 9 times that of the “untreated” group.
This is a far more relevant point than how to define “ADHD” or whether or not it is a brain disease. The “treatment” does nothing to improve the lives of the “treated,” except for short-term symptom reduction (which does more for the “treaters” than the “treated.”) To give toddlers a drug to control behavior is reprehensible. To tell people they need to give them a drug to prevent outcomes that the “treatment” has no impact on is criminal.
STIMULANT TREATMENT DOES NOT WORK LONG TERM!!!!
—- Steve
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The other problem is that they act as if there is some way to differentiate between “healthy brains” and those who “need treatment,” which, of course, is impossible to do. Additionally, the statement implies that stimulants have some kind of differential effect on those with “ADHD,” a premise which was disproven way back in the 70s and which only an extremely ignorant or intentionally deceptive doctor would put forth in 2014.
—- Steve
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Hi, WileyWitch and Donna,
I actually wrote a book myself on this topic, based on years of work with domestic abuse victims. It’s called “Jerk Radar: How to Stop a Bad Relationship Before It Starts” and is basically a manual for detecting narcissists when they’re in their charm/grooming phase.
I definitely agree, abusers are the ones who seek out people who have never had their boundaries respected or learned it’s OK to say NO and stick to it. Most of the victims are not seeking anything but someone who genuinely cares about them, and these sickos pretend to be everything the victim’s always been looking for, and then pull the rug out once they’ve got them under control. It’s pretty disturbing, but there are some ways to turn the alarms back on, and that’s what the book is about.
Just thought I’d mention it, as it seemed very relevant to your observations.
—- Steve
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Phil, this is truly a brilliant analysis that is devastating to the basic premises of the article. Essentially, the study at best suggests that we should teach social skills to kids in their school years, which, as you note, should be obvious to anyone with half a brain.
I have made similar arguments about ‘ADHD.’ It is commonly bandied about that ‘ADHD’ children are more likely to commit delinquent offenses as teens and drop out of school early. Well, we’ve pre-screened these kids for impulsivity. Most criminal activity in teens is impulsive in nature, so should it surprise us that kids who are impulsive as kindergarteners are more likely to be impulsive as teens? We’re also pre-screening for every behavioral variable that make kids less likely to be successful in school. And then we are impressed when it is announced that the kids who we know don’t fit in well in school are more likely to drop out? Of course, it adds insult to injury that the so-called ‘treatment’ for ‘ADHD’ does nothing to change either of these variables.
Also similar to this report, the vast majority of ‘ADHD’ kids don’t become delinquents and do graduate from high school, just not as big a percentage as the mean. And plenty of non-diagnosed kids drop out and commit crimes as well. Having an ‘ADHD’ diagnosis is actaully a very poor predictor of whether someone succeeds in school, even when we have pre-screened to include only those who are bound to find school more difficult to tolerate. And of course, at no time do we spend the slightest energy figuring out what environments might work better for these kids, or teaching them the skills to survive in a standard classroom environment.
You’ve done a great job of highlighting how the scam is conducted. Unfortunately, it’s subtle enough that it’s hard for the layperson to detect, and when enough letters are attached to the author’s name, sufficient complexity causes the average person to shut down and simply assume that these guys must be smarter than me and therefore must know what they’re talking about.
Thanks for the fantastic deconstruction!
—- Steve
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Wow, I am so glad to hear that guy got arrested! Can you find an article about him in the newspaper? It is so rare that one of these criminals gets punished.
Your ordeal seems surreal, but unfortunately it is all too believable. You must be an incredibly tough person to still be pushing forward to hold these people accountable! Thanks for sharing your story, and way to hang in there and not give up!
—- Steve
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Here’s my theory on why research finds that ECT “works.” After a client has had three or four sessions, they figure out the right thing to say:
“Wow, doc, I feel SO much better now! I’m totally cured! Thank you SO much for that incredibly helpful treatment… now, can you unlock the door so I can run as far away from here as I can get!!!!!”
Chalk up another psychiatric success story!
—- Steve
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Wow, that’s brilliant. Exchanging marijuana use for highly addictive sleeping pills, because we’re worried about possible substance abuse and addiction???? Definitely got some people on the wrong side of the crazy/healthy line in THAT facility!
—- Steve
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What is kind of astounding is that psychiatrists are all too ready to claim subtle and as yet undetected brain anomalies causing all sorts of psychiatric disorders, but they deny that any such damage could occur in the case of ECT, despite the obvious fact of memory loss and a lot more subtle changes in cognition that are reported. Why would the person have memory loss if their brain was not damaged? There is also a report of a “reduction in connectivity” between the frontal lobes and the rest of the brain – how would you get a “reduction in connectivity” without damaging brain tissue?
It is readily acknowledged that seizures of sufficient strength and duration can and do cause brain damage. It’s also acknowledged that ECT causes a seizure. Ergo, ECT can cause brain damage. Don’t know how anyone can deny this connection, and yet they do so again and again.
As the Nazi propagandist Goebbels said, if you repeat a lie often enough, it becomes the truth.
— Steve
—- Steve
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Another well-established but poorly-advertised fact is that domestic abuse frequently starts or increases during pregnancy or right after birth. Whether because of jealousy of the new competitor for “his” woman, or the knowledge that she is now much more dependent and unable to escapte, abuse often escalates just at the time the new mom needs more support. But this is almost never mentioned in any of the literature about “postpartum depression.” With a quarter or more of women reporting domestic abuse in the course of their lives, this cannot be a negligible variable, but it is systematically neglected nonetheless.
http://en.wikipedia.org/wiki/Domestic_violence_and_pregnancy
http://www.uua.org/documents/ncadv/dv_pregnancy.pdf
http://articles.chicagotribune.com/2012-03-29/lifestyle/sns-rt-us-postpartumbre82s16n-20120329_1_postpartum-depression-domestic-violence-reuters-health
— Steve
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I have always maintained that being depressed is a pretty normal and common occurrence after having a baby, at least in our disjointed Western society. Interestingly, I have recently learned that in “primitive” cultures, the new mother is generally surrounded by other mothers and tribal elders and various caretakers for some time after a birth, and they often have no other responsibilities than taking care of the baby for weeks afterward. In cultures where this is the case, I understand that “postpartum depression” is essentially nonexistent. In any case, there are a ton of very good reasons why a new mom might feel very depressed that have little or nothing to do with biological predispositions:
http://www.naturalchild.org/robin_grille/post_natal_depression.html
So much for “it’s all biological!”
—- Steve
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Never thought Chuck Norris would be championing this cause. I hate to think of him on an antidepressant-induced manic episode!
—- Steve
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I worked at a mental health center for a while with a pretty decent psychiatrist. He described a client who was Native American who was hearing voices. He respectfully offered that he had some medication that might make the voices go away.
The response: “You white people are all the same. You hear voices in your head, you want to make them go away. When we hear voices, we go sit down someplace quiet and see if they have anything interesting to say!”
Would that we all had that attitude!
— Steve
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It is saying that specifically removing guns from “mentally ill” individuals will not have a significant effect on the homicide rate, as the number of such crimes committed by the “mentally ill” is so tiny. It is not an argument against gun control, just against singling out the “mentally ill” as being more dangerous than the rest of the population.
—- steve
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You are fortunate they did not kill him with the stimulants – they really should not be used for kids with heart problems!
I think the much more interesting question is not what to do with kids who have a hard time paying attention to the teacher, but why does school have to be so darned BORING!!! Most classrooms would send the average adult running screaming from the room after half an hour. The only reason the kids put up with it is because they can’t escape.
We avoided all that by homeschooling or enrolling our kids in alternative schools with a child-centered approach that allowed flexibility and maximum self-direction. Two of them were classic “ADHD” kids, but no one at their alternative schools ever mentioned it to us. They just worked with them as they were, and adapted to what worked for them. That’s how schools should be.
There is no excuse for the “SCT” crap. Honestly, if I hadn’t been allowed to daydream in school, I would have slit my wrists. There was literally nothing else to do, and I was bored to tears. Thank the Lord they let me doodle on my notebook!
Learning should not be boring. If it is, it’s the school’s and the teacher’s fault. I’m tired of kids getting blamed because the schools are too inflexible and insensitive to notice when the kids are bored out of their minds. Stimulants aren’t the answer – a more stimulating educational environment is the answer.
—- Steve
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Nice work, Aubrey!!!!
— Steve
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It is very encouraging to read this kind of document in a mainstream media outlet. Admittedly, it’s the UK, but still, I’m glad that the issue is getting this kind of very direct and honest treatment somewhere in the industrialized world.
—- Steve
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Yup. But that only works if we don’t rise to the bait and try to argue on their turf. The key is to change the context of the conversation and make it about their tactics, rather than about whether or not we care about those who choose to take pills to manage their emotions.
Thanks for your reply!
— Steve
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Accusing someone of “pill shaming” is a classic “ad hominem” attack, focusing on the purported characteristics of the person making the comment rather than the substance of the argument s/he makes. This is chronically employed by the industry and their psycho-phants in their so-called “anti-stigma campaigns,” whose real focus is to undermine any opposition to the psychiatric agenda by making anyone who brings up contrary facts appear to be thoughtless and insensitive and in favor of stigmatizing the so-called “mentally ill.”
I believe such attacks need to be labeled head on as what they are. It is almost a requirement to say, “I know for some people these drugs seem to be effective” as a means of taking the wind out of the sails of those who are committed to their drug approach, but if this isn’t effective, I think the answer is to attack the approach and the person using it. THEY are in fact shaming YOU for disagreeing with them.
If you consider that Irving Kirsh’s work correctly summarizes the literature (and I do), then the bulk of those who are “helped by medication” are experiencing the placebo effect, and their improvement depends on continuing to believe that the antidepressants are working for them. Such people will always have to vociferously and irrationally defend their views, much as those who believe in a very rigid set of religious dogma can’t allow that other religious dogma might have validity, or indeed that their dogma are dogma at all. They view such dogma as the absolute and unalterable truth, and will not tolerate anyone who speaks otherwise.
So I think the proper approach is not to try and understand or moderate one’s statements to accommodate those who would accuse you of being a “pill shamer.” I think the appropriate approach is to name and attack the tactics for what they are, and to make sure that anyone else reading your response sees what is going on. It is pointless to try and convince such people to hear you. All you can really do is call them out publicly and make sure you do NOT apologize for your views. Eventually, you can turn the tables on them and make it clear to any reader that it is in fact the accuser who is really the one using shaming tactics and avoiding the facts you are presenting.
—- Steve
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There is a difference between “not understanding they are sick” and “not agreeing they are sick.” Given the sketchy and subjective nature of these “diagnoses”, it’s hard to argue with giving someone the right to disagree with their “diagnosis.” And even if they were “sick,” that does not automatically convey the right to decide what kind of treatment is helpful.
—- Steve
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That sounds like what Torrey and his minions are going for – “may deteriorate without treatment.” And of course, we know what “treatment” means…
—– Steve
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“These results suggest that care settings affect the course of cognition..” or to rephrase, “these results suggest that psychiatric institutionalization makes people worse!”
— Steve
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You are 100% right about the housing. There is a program called “Housing First” or something like that in New York that gets people into safe housing before even beginning to address issues of substance abuse or mental illness. Not so amazingly, these people do a lot better than those who are detained, medicated, and released within a week or 10 days, as almost always happened where I was working. That is one of the alternatives Leah is talking about. Seems we could agree on that point at least.
— Steve
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The problem is that the government are the only entities that can take one’s civil rights away, and that’s what is happening when someone is detained. There are a few states that don’t have involuntary commitment laws, and I am sure there are consequences of that, though I have not seen any hard data to suggest that they have worse outcomes. Remember, the WHO studies in the 90s showed that the countries with the LEAST Westernized medical systems had the BEST outcomes, so there is no guarantee that enforcing treatment on someone will make them better off in the end (though obviously there are cases where the person is appreciative or ends up with better outcomes through enforced treatment.)
The real challenge is where to draw that line, and the Supreme Court made the ruling they did because they saw evidence that psychiatrists and other doctors readily and systematically abused the civil rights of citizens when given authority to use their own judgment. This is exactly what you oppose, and I oppose it for the same reasons you do. The Supreme Court drew the best line they could – a person has to be a risk of harm to him/herself or someone else, including being unable to care for oneself safely (which sounds like it would apply to your daughter). The Murphy bill goes way beyond that, and that is why I object to it. It seeks to enforce treatment on anyone deemed “likely to deteriorate,” and that is going to allow our government, which you and I and the Supreme Court appropriately don’t trust with this kind of decision, to empower psychiatrists to set whatever standard they want for determining who is “likely to deteriorate.” It also appears to remove due process rights of those so detained, and allow access to records that it may or may not be safe for this person to reveal. These are all government intrusions into private individuals’ lives, and it seems you are against that kind of meddling. Perhaps you need to re-read the bill. It is a Pandora’s Box for the government and the psychiatric industry to determine what is “normal” for you and me, and there is nothing to keep them from deciding you are “likely to deteriorate without treatment” simply based on the fact that they don’t like how you are acting.
It’s just a bad law, plain and simple.
—– Steve
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And by what possible objective criterion would you determine that someone “needs stimulants” in order to drive? Since there is no objective way to assess this, I am not sure on what basis they’d be able to make this decision legally. I can smell the lawsuits from here…
That nonsense about the “paradoxical effect” is still around, but was thoroughly disproven back in the 70s by Judith Rappoport, who was incidentally a big supporter of medication for ADHD. Barclay and his ilk stay away from talking about it, because they know it’s not true, but they also know the myth is still around, just like the “chemical imbalance” story. I think they try to get the concept into the popular culture and then just don’t talk about it, and pretend they never said it, or that it is “outdated information” if someone brings it up. It’s a pretty slick system.
— Steve
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As I have already said, there is ALREADY LEGISLATION IN PLACE to enforce treatment on those who pose an immediate risk of harm to self or others. This standard was set by the US Supreme Court in response to lawsuits by multiple people who were detained without just cause, in violation of their constitutional rights. Your daughter clearly received involuntary services and says she benefited from them. If this already can occur, why on earth do we need Murphy’s bill to add more involuntary detentions of people who are not endangering themselves or others?
I did involuntary detentions in Vancouver, WA. Washington has one of the most restrictive statutes, and it was still not at all difficult to detain someone who was deteriorating due to psychosis. There is no need for a more lax definition as advocated in Murphy’s bill.
But at this point, it seems you are “trolling” and not really willing to have a conversation. You already know we’re all wrong, so why are you bothering if you aren’t willing to respond to legitimate criticisms of the bill such as the one I just offered?
Let me hear you explain why the current law did not allow your daughter to get the treatment she needed, even if she was unwilling. If you can’t explain that, you have no argument.
—- Steve
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I am suggesting that you specifically did not want to be treated, because perhaps the treatment you had received in the past was insensitive or abusive. You do not know that you would want to be treated. You have not put yourself in the position of those harmed by the system. Many folks say they were helped by involuntary hospitalization. Many others liken it to being raped. Is it not possible that people might rationally experience this intervention as genuinely offensive? If they are rational enough to make this choice and don’t pose a risk of harm to self or others, why should they be forced into a treatment they find horrific?
—- Steve
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One reason they may be emphasizing this is because reduced accident is the only, and I emphasize ONLY, long-term outcome area where stimulant treatment has shown any advantage. Of course, if they did a study of “normal” people on stimulants at lower dosages, they’d find improved attention and fewer errors, too, so it’s not an impressive finding. But given that school grades, academic achievement test scores, dropout rates, college enrollment, delinquency rates, teen pregnancy rates, addiction rates, social skills, and self esteem are ALL at best unaffected by long-term stimulant treatment (and the Raine study in Australia showed dropout rates to be much WORSE for stimulant users), they have to grab onto the only straw they’ve got.
The figure of 100,000 injuries and deaths presented seems absurd on the face of it, and I wonder where that figure comes from. The TOTAL deaths from MVAs in the US in 2009 was just under 36,000. It stretches credulity to think that enforcing stimulants on the <10% of drivers who might be diagnosed with ADHD would make even a tiny dent in that figure (pun accidental!)
Bottom line, more propaganda. If this is the only area of improvement they can point to, their model of treatment is pretty lame.
— Steve
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Well it is obvious, Kate, that your daughter did receive enforced psychiatric treatment. So why would we need the Murphy bill? Those who are dangerous can be detained against their will if needed, and the criteria are pretty loose. I don’t know why we’d need to expand the criteria to include anyone who is “at risk of deteriorating” when that can be quickly reduced to “not taking one’s medication” when that medication, as you’ll know if you have read the posts on this site, does not help everyone as it appears to have benefitted your daughter.
The current laws allow involuntary hospitalization when a person is a danger to self or others. Those criteria were established because the psychiatric profession proved itself willing to detain mass numbers of people who were not bothering anyone but simply were acting in ways that were unusual. There is no benefit to changing those criteria, but there is a very large danger of increasing civil rights violations How do you address those who are not dangerous but are forcibly treated against their will? How would you feel if you were in that position?
—- Steve
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Leah’s links show that IOT does not reduce re-hospitalizations, and is inordinately expensive. There are already plenty of ways to have someone involuntarily committed. I used to do involuntary commitments myself, and I can tell you that there was very little that went on in the psych ward that would lead to any kind of healing or change. If enforcing drugs were the answer, we’d long ago have solved this problem.
Additionally, you clearly can not have used all of the alternatives that you claim don’t work, because most of them are not readily available in the US. For instance, I KNOW for a fact that you’ve never had your family member in a Soteria-like placement or an Open Dialog program, unless you are very fortunate and happen to live in Alaska, Switzerland, or northern Finland. How can you say they don’t work when you haven’t tried them?
Consider also the WHO studies in the 90s which showed that the best outcomes for schizophrenia diagnosis happened in the countries that used the LEAST psych drugs, and where involuntary commitment was very infrequent, but community engagement was high. Some of the things Leah is advocating for are the kinds of things that happen in those “less developed” countries like Brazil and India and Venezuela but are not readily available in the US.
I know it seems like involuntary commitment and enforced treatment is the best answer, and I might agree with you if the treatments actually led to long-term improvement. But they clearly have been shown not to, and in fact, there is emerging evidence that long-term use of these drugs leads to an INCREASE in psychotic episodes over time. HR 3717 is based on a hopeful belief in current psychiatric technology, but unfortunately, that technology is not up to the job.
We don’t need HR 3717. It is an emotional response to the issue of violence by those diagnosed with “mental illness,” but the “solution” unfortunately has been shown to make the problem worse.
— Steve
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Shying away from processing combined with the psychiatric brain-altering approach is a very bad combination. Perhaps you can encourage her to ask if her current approach is working for her. Perhaps you can ask what makes her resistant to processing? Usually, people make progress by processing their experience in some way or another. Doesn’t have to be therapy per se, but telling one’s story and re-creating the narrative in a more self-enhancing way seems to be central to most people’s recovery. If she won’t do that, she may be condemned to the drug-and-pray approach.
Prozac does cause psychosis in a small number of cases, BTW.
—- Steve
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How do they know that an increased estimation of the likelihood of future misfortune is more accurate? Besides which, don’t we need both optimists and pessimists as a part of our social structure for the sake of species survival?
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Seems like kind of a no-brainer here (sorry, bad pun), but I am glad that neuroscience is finally being used to demonstrate the impact of social conditions on the brain. Of course, it’s probably hard to get funding for that kind of study, since it undermines the brain-disease-drug paradigm that has made billions for so many undeserving sociopaths. Does not surprise me it comes from Germany rather than the USA. I hope we see more of it.
—- Steve
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Fascinating that the male fish are more aggressive when exposed to an SSRI. I think this provides some support for the SSRI-violence connection that psychiatry is so anxious to deny exists.
—- Steve
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Eric, you have struck at the core of what is wrong with the current model. It is not merely the minimization of dangers and the overstatement of benefits of drugs; it is not merely the promotion of drugs and suppression of alternatives; it is not merely insurance companies trying to increase profits by decreasing services. It is a fundamental misapprehension of the human condition, predicated on the idea that we all should be OK with the status quo, whatever that is. If the status quo is perfect, then it follows that any distress is not caused by current social conditions, but by an inability of the distressed person to appreciate the wonderful world s/he lives in. It is a philosophy that is designed to protect the powerful from scrutiny and to punish the little child in all of us that’s willing to say, “Hey, why is the emporer riding through the town buck naked?” Naturally, those in power want to stay in power and the psychiatric worldview is perfect for suppressing dissent. But it is also necessary for those in power to deny their own personal vulnerability and distress, and this system is the perfect way for them to transfer their own discomfort with the current state of affairs onto their clients, and then “wipe out” those projected feelings with drugs.
I like your vision, and agree with Andrew that there are many who are already doing this kind of work, even if they are not supported in doing so. I wish there was a simple way to get this idea across, but the medical model is so embedded in our social fabric that it will take many years of hard work to change, even if we were not opposed by a multi-billion dollar industry filled with sociopaths.
— Steve
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And it is important to remember that in the clinical trials that found antidepressants to increase suicidal feelings and impulses, they systematically screen out anyone who is overtly suicidal before the study starts. So the actual suicidality figures in the studies should be expected to be LOWER than the general population of people diagnosed with “Major Depressive Disorder.” We certainly can’t “blame the disease” or say they were already suicidal but the drugs “gave them the energy to act on it,” because those who acknowledged they were already suicidal were not a part of the study.
— Steve
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Exactly!! We need to get over this “liberal-conservative” split that we’re being fed by the vote-buying corporate greed-mongers and corrupt politicos who are running the show. I think that genuine liberal and conservative people can come together on issues involving corporate malfeasance and influence peddling as well as violation of civil rights by the government and other groups.
I think the real divide is between those who support the power of the exploiters over the exploited vs. those who are fighting for the rights of individuals against those who would exploit them. There are “liberals” and “conservatives” in both groups – some liberals believe the government is helping by enforcing treatment, and some conservatives believe that drug companies should be able to market and sell whatever they want with no regulation by the government at all. But a good number of either political persuasion would agree that this action is a horrible travesty of injustice and institutionalized insanity.
I want us to join together with those who believe human rights come first, regardless of their political party or affiliation. Situations like Justina Pelletier should transcend any such differences and clarify the moral imperatives that can help us move forward as a country despite differences in philosophical viewpoint.
—- Steve
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I worked as an advocate in long term care homes back in 1995, and it was a problem even then. Especially in dementia patients, any sign of aggression was generally met with antipsychotics. One guy I saw was unable to walk through a doorway without running into the door jamb, he was so drugged. The activities director said she’d been hitting a volleyball back and forth with him a week before.
Basically, anyone who can’t defend him/herself is at a very high risk of being drugged for any behavior that is inconvenient for the authorities. Foster kids have the highest rates because they are the least empowered to fight back of any population in the country. But elderly, physically disabled, developmentally delayed, school children, those in residential treatment, prisoners, soldiers – these people have become our Guinea pigs, but we’re not even bothering to look at the actual results of the experiment. What’s happening to foster kids is happening everywhere. It just happens more to them because they can’t fight back.
—– Steve
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I always say it would be really strange if your car mechanic failed to fix your car, but insisted on charging you anyway and claiming that you car has “repair-resistant fuel injectors,” but you should still come back next week for another expensive “treatment.” But if you don’t get better with whatever they prescribe, you have “treatment-resistant depression” and it’s not their fault, it’s yours. Why don’t they just admit when they can’t help? It is pitiful when clinicians lack the moral courage to simply be honest with their clients. Sometimes the most healing thing I did was to acknowledge, “Wow, that’s a really tough situation. I don’t know exactly what to do right here. I think depression is a pretty understandable response.” It can help for people to hear that it is NOT them, and that their circumstances ARE inherently depressing and would be for anybody, even if no one has a solution. Just to know it is not because you’re nuts can be a big relief. Unfortunately, psychiatry provides the opposite energy. No matter what happens, you’re supposed to buck up and be at least mildly cheerful, or else there is something wrong with YOU! It is sick and bizarre.
—- Steve
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How about “EYD” – “Excessive Youth Disorder,” unequivocally caused by not being old enough to have matured yet. The market is almost endless…
Or we could also have “BWSD” – “Bored with School Disorder” – I know I would have qualified! If daydreaming had been outlawed, I probably would have slashed my wrists – it was the only thing that kept me sane through 7 years of elementary school torture.
Next thing you know, they’ll diagnose doodling as a mental disorder.
—- Steve
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I have talked to hundreds of suicidal people (used to supervise volunteers on a suicide crisis line), and have not found one who didn’t have good reasons to feel like ending his/her life. Validating their emotions and experience while helping them come up with alternative approaches was almost always a simple and effective approach. But it required a fearless willingness to allow the person to feel suicidal if s/he wanted to. It seems the current paradigm does the opposite of what I found helpful. It invalidates the very real reasons behind the suicidal feelings, blames the victim, and offers one and only one option, which is literally forced down the client’s throat if s/he resists. I think the main purpose of this, and the main reason they don’t want their clients talking about it, is because they, the providers, really don’t know what to do about it and are terrified. It brings up their own vulnerability and humanity, and many have spent their careers trying to “be professional” by distancing themselves from their feelings, and ergo, from their clients.
There is nothing helpful about the current paradigm. It exists to protect the clinician, and when it fails to help, it provides a ready justification for blaming the client instead of looking at their own behavior as the key element in the failure to help.
—- Steve
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It is idiotic to suggest that the human brain, the most complex organ in the biosphere, could evolve in a couple of generations. Idiotic. The time from the start of human history today is a blink of the eye in evolutionary time.
My guess is that there are multiple contributing factors, mostly a combination of various ways we our poisoning ourselves and our children with an increasing willingness for us as a society to label anything inconvenient or unusual in our kids as a disease or disorder.
One emerging potential cause merits attention. There is emerging evidence that antidepressant use during pregnancy may increase the odds of autism developing later on. There are, of course, people disputing this, and it is not a settled issue, but consider that the autism epidemic in the US did not start until after antidepressants became popular, and that antidepressants are more popular here than elsewhere in the world. I am not saying it is the only factor, but it is a lot more likely to be a contributing factor than “rapid evolution” as suggested in the article. See link below for more:
http://parenting.blogs.nytimes.com/2013/04/22/study-links-autism-with-antidepressant-use-during-pregnancy/
—- Steve
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I must say, it warms my heart to know that Eli Lily is so concerned with “helping satisfy unmet medical needs around the world.” They are so sweet to be so concerned about our children! But perhaps we would better phrase it “helping satisfy unmet financial needs around the world, by creating new ‘medical needs’ they can pretend to satisfy.”
This one takes the cake! But we can’t assume everyone will laugh it off. After all, people have accepted “Oppositional Defiant Disorder” and “Intermittent Explosive Disorder,” so people will believe almost anything if spoken in somber terms by a person of sufficient “authority” to convince them they should listen.
Bottom line (ha, ha) , they will continue to pull this crap as long as we (the people of the world) allow them to get away with it.
—- Steve
—- Steve
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With all due respect, Sharon, my recollection of my own education suggests that schools have ALWAYS been institutions of coercion and indoctrination – that appears to be their fundamental purpose in our society, and if education happens by the wayside, that’s just a nice little bonus. But we don’t want our kids TOO educated – they might start to notice some things and ask some uncomfortable questions and maybe create some difficult resistance to the rule of the current elite. If you never have, I’d suggest reading “The 7-Lesson Schoolteacher” by former NY Teacher of the Year John Taylor Gatto: http://www.informationliberation.com/?id=11375.
Of course, this is all quite consistent with the psychiatric worldview that everyone should adjust to the status quo and that anyone who is in any way unhappy or behaves in inconvenient ways is “ill” and should be “fixed.” There is no intent to ever look at the social structure as a causative factor in a child’s unhappiness or acting-out behavior.
Sera, another incredibly on-point and moving article. I work with kids like Kelsey all the time (I work with foster kids) and find that they are almost always labeled when they have predictable reactions to their inadequate or abusive upbrinings (including poor parenting and abuse while in foster care). And they perceive it much the way you state it: they feel they are being blamed for being upset about things that anyone would find upsetting. They crave adults who are willing to listen and feel with them so they can feel safe processing what has happened and start to see that not everyone sees them as a “problem.” This is why I am more adamant about the DSM labeling process than the drug “treatments.” It is the DSM that allows us to distance ourselves from kids like Kelsey, to view their suffering as something “other” than us, something we can feel sorry for her about but don’t really have to face up to or deal with. And in taking this position, we side with the abusers and against the child.
I am also a parent with a voice, but we used ours to help create a democratic, child-centered public charter school where kids have a voice and teachers can’t get away with treating kids like herd animals. This is one way that we can start the process toward creating a new world – create schools where kids are encouraged to be themselves and are supported in exploring their world.
And BTW, for RISN, our son’s high school history teacher used Zinn’s “People’s History…” in his class. So it can be done!
—- Steve
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The purpose of the law appears to be to broaden the already ambiguous standards for enforced treatment. This raises two issues: one, the reason for the current regulations requiring an imminent threat to self or others is because back in the 60s, doctors were locking people up left and right for no genuine reason, and there was no kind of standard. It is extremely dangerous to entrust this kind of decision to any professional without checks and balances, because, as the saying goes, “power corrupts,” and even if most of the profession uses these powers appropriately (which history suggests will not be the case), there will always be those who consciously or unconsciously use this power to oppress those who are vulnerable.
Second, it is not necessary to allow for civil rights of parents or adults to be violated in order to oppose this kind of enforced treatment. I very much doubt that anyone here would object to someone being taken into custody for threatening a person’s life. But detaining someone to protect someone else’s rights and safety does not translate into enforcing a “treatment” of questionable effectiveness for “diseases” of questionable validity.
As you yourself can testify, “treatment” does not always help as it is supposed to, and can make things significantly worse in some cases. Once we take away a person’s right to decide for him/herself what is helpful, it again puts all the power in the hands of the professionals, who usually don’t know the person well enough to understand what is going to help, and are frequently so emotionally invested in being “right” about their own “treatments” that they don’t even recognize simple, common side effects from the medications they prescribe, and continue people on cocktails of 5 or more drugs when none of them have been effective in resolving the initial problem.
Finally, mandating a person to go to outpatient treatment is not possible without the threat of being taken and locked in an inpatient ward. That is the reality of AOT – the “Assistance” is the threat of incarceration in a psych ward and enforced treatment against your will. Especially when you consider that most of the time, enforced drug treatment is not particularly effective, and even more, the increasing evidence that long-term use of psychotropic drugs can actually make it less likely that a person will recover, the idea that enforcing treatment will somehow decrease violence is a pipe dream. In fact, the vast majority of those going on these shooting sprees, most likely including Adam Lanza, have been receiving psychiatric treatment or are in withdrawal from psychiatric treatment at the time of the event. There is good evidence that SSRIs, in particular, can create or exacerbate violent tendencies in a small but significant proportion of those receiving them. Prozac was initially banned in Germany for just this reason. Not saying that all the killings were caused by psych drugs, but there are such a high number where psych drugs were involved that we can at a minimum say that forcing people to take them does NOT prevent or reduce violence in any way.
The Murphy bill is misguided and will not create the effect it supposedly intends. And it will take money away from other initiatives that are much more promising. It is an emotional overreaction to a complex issue that no one in power cares to take the time to analyze. If it is passed, it will result in more and more civil rights violations over time. It is not something you want to support.
I’m sorry you’re having a tough time with your 13 year old. It sounds VERY frustrating and downright scary. No one is suggesting that you don’t need or deserve support with helping him find a way to survive safely. It’s just that this bill won’t really help him or you, and may make it harder to get the kind of services that he might really benefit from.
—- Steve
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I am glad this is being addressed, especially the huge evidence favoring environmental explanations vs. the complete absence of any evidence of genetic causality.
Unfortunately, taking kids into foster care does not guarantee them that love that may be missing in the home. Emotional abuse is frighteningly common in foster homes, and physical and sexual abuse are far from rare. I think the most promise has been shown in programs that support a new parent as they bring their first baby into the world. A lot can be taught in those early months that has a huge impact on both the child and the parent’s relationship to the child over time. This is where I think we should be spending our money, rather than wasting it on expensive experiments into genetic research that will, as the author suggests, always come up empty.
—- Steve
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I want to clarify, Leah, that I loved your article and the following is in no way a critique of you or your approach. I always love what you write and appreciate your courage and creativity in working to end this misguided path we’re on.
But your last comment made me think about something that has always bothered me. It is interesting how the idea of trauma causing mental injury seems to be resisted because of the idea that families are being demonized somehow. I don’t see it that way. I know I have not been perfect in raising my kids, and I welcome their feedback about how I might have done a better job, even if it may be painful for me to hear it. I had to go through quite a difficult time with my middle son, who went off the rails on drugs for a while and struggled with anxiety and suicidal depression. And of course, I felt responsible – because in part, I AM responsible! And I spent quite some time making myself available to him so he could let me know the many things that had been going on in his mind that I was not aware of at the time. I know this was healing for him, as it was for me. Part of being a parent is recognizing that our choices affect our children, and being willing to help ameliorate the consequences of our errors, even if those consequences were unintended.
I am certainly not interested in going back to parent-blaming as a means of absolving society as a whole, either. I don’t want parents to feel that how their kids turn out is 100% within their control, because it clearly is not. In my case, elementary school was a daily compound trauma from day 1, and shaped a lot of how I deal with the world and who I became, and my mom and dad had no real control over that aspect of my life (homeschooling wasn’t a thing back then, and there were no alternative schools I could have attended). So it isn’t about BLAMING parents. It is about recognizing that the source of many of our bad feelings and unproductive behavior lies in how we adapted to our early life experiences. I don’t believe we should deny this just to help parents (or our school teachers or our psychologists) feel better. It’s become one of the main justifications for utilizing the medical model – it absolves parents of blame. Heck, it absolves EVERYONE of blame, including the kid! It’s not the parents’ fault, not the teachers’ fault, not our social system’s fault, not the kid’s fault – it’s your nasty brain that is not cooperating.
But that is just plain not true! Sometimes mental health problems ARE caused by insensitive or thoughtless or downright abusive parenting. Sometimes they are caused or exacerbated by poor teachers or an overly rigid educational environment. Sometimes bullies or sexually abusive uncles or mean older sisters or domestically violent parents are a big part of it. Sometimes placement in foster care causes more harm than the abuse it was meant to prevent.
I think we have to stop protecting the powerful and acknowledge that parental behavior, among many other things done by the adults in a child’s world, IS a causal factor in mental illness. That way, we can actually DO something about it, instead of pretending that we can manipulate brain chemicals and make everyone feel OK and act OK no matter how stupid, dangerous, or neglectful the environment may be.
I know, I know – now I am preaching to the choir! But I had to say that. I really have a hard time with the idea that letting parents know that their behavior impacts their kids’ mental health is somehow the same as demonizing them. It isn’t. It’s just being honest and giving them a shot at fixing those things that might be in their control to fix.
—- Steve
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And I don’t buy that “mentally ill” labeled people are hospitalized or jailed more frequently in the absence of AOT – I don’t think the stats show any difference. Look at Wunderlink or Harrow. It’s a lot of money spent to humiliate and traumatize people that doesn’t even accomplish the questionable social control goals that it is supposed to meet.
—- Steve
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Daisy, you are so right about ADHD and sleep apnea. It is also true that foster youth (with whom I work extensively) often have other sleep issues based on nightmares and other trauma-related manifestations. They are diagnosed with “ADHD” at much higher levels than the general population, and often with less justification (if there really is ever a justification for such a vague and subjective diagnostic category).
Additionally, it is common that foster youth react to stimulants with increased levels of aggression. This is a known adverse effect of stimulants, but it is almost always attributed to the child’s “disorder” and atypicals are often used to reduce aggression that is most likely being caused by the stimulants. Sometimes these kids are diagnosed with “bipolar disorder,” and those kids would not be included in Julie Zito’s stats, so the problem is actually much bigger than her estimates (though I know she eliminated them to make sure that “bipolar” wasn’t presented as an additional justification for the atypicals).
This approach is particularly bizarre if you consider the brain chemistry involved. Stimulants increase dopamine levels in the brain (as well as norepinephrine), and this is probably what leads to the increased aggression (as one often sees with meth users). But rather than decreasing or eliminating the stimulants, they add “antipsychotics,” whose main action is to DECREASE dopamine levels, which you have artificially INCREASED with the stimulants!
How this is not malpractice is beyond my comprehension. It can only be rationalized by viewing the “patient” as an object you are playing around with to see what happens. There is not even a warped and strained scientific argument that could be made for doing so. But it is happening a lot, all over the country, to millions of foster kids. It is a crime.
—- Steve
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Was the battle to end slavery in the US “contentious?” How about the women’s rights movement? Or Ghandi’s effective effort to achieve Indian independence? Just because those in power agree to do something doesn’t mean we have to collaborate or cooperate. Contention is necessary when intended or expected evil and bad outcomes are likely to result from some action taken by those in power.
You suggest that one of the “pro” arguments is that AOT results in a decrease in imprisonment or re-hospitalization. First off, I don’t have any stats or studies showing this to be the case. Second, even if this is true, this is a pure and simple social control argument that has NOTHING to do with the mental health of the “recipients” of enforced treatment. Locking everyone in a dark basement or dropping them to the bottom of the river in “cement overshoes” would reduce the incarceration and hospitalization rates, and be a much cheaper intervention. Point being, medical treatment, as this claims to be, should not be aimed at reducing social costs, but at enhancing the health of the individuals being treated. It is notable that none of the listed arguments in favor address the long-term health and well-being of the individuals being forced into “treatment” against their will.
Additionally, the controls you suggest over the system are inadequate, not to mention they are unlikely to occur. I don’t know who you intend to have on your oversight committees, but unless they are packed with a majority of mental health consumers/survivors, such committees will become just as much a rubber stamp as the Courts are now. Plus, they cost money, and since most of our money will now go to enforcement rather than to engagement, these ideas will never be funded for more than at most an initial “show” period to shut up critics.
The “immediate risk of harm to self and others” standard was developed only after years of intentional and widespread human rights violations among those identified as “mentally ill” and some very “contentious” advocacy by the consumer/survivor movement in its infancy. It represents an absolute minimum standard to even think about justifying taking away someone’s constitutional and civil rights, and even with that standard, rights violations are rampant (look at the Pelletier case). To loosen the hard-won protections (however inadequate) that do currently exist is extremely dangerous, and not just to the so-called “mentally ill,” since the ever-expanding and increasingly subjective DSM definitions will soon allow almost anyone to be forced into “treatment” for offenses like grieving too long or being “too disturbed” about even a genuine medical condition. We need to resist this concept with every fiber of our beings, and it would really help if inside people like you, Mark, would join in condemning any loosening of the current already-too-vague standards for involuntary commitment and enforced treatment, rather than providing an “out” for proponents by proposing safeguards that won’t work and probably won’t ever be enacted.
—- Steve
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As a professional advocate working in the child welfare system, I can say that in Oregon, the standard is not that the child may or may not have a particular disorder, but that his/her physical safety is directly and immediately endangered. A parent could believe that Martians are outside the home looking in the windows, and have convinced the child that this is true, but if the child is able to eat, sleep, attend school, and is otherwise safe and healthy, having a shared delusion is not grounds for CPS to intervene (though they might well attempt to). Any parent has a right to seek out medical care for his/her child, and make medical decisions based on informed consent, without any interference from the government, unless the child is in immediate danger. The question should not be “does this child have ‘Somatic Symptom Disorder’ (gags me even to write that down!), but whether she is in immediate danger from her parents. Which she obviously is not. So WTF, Massachusetts? I hope they appeal this to the Supreme Court of Mass, and if necessary, of the US. There are some fundamental liberty rights being freely trampled here, and some judge somewhere is going to call them on this crap. And then I hope they sue the pants off of MGH and the State of Massachusetts.
— Steve
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If violence begets violence, and mental health “treatment,” especially when enforced by police and incarceration, is violent, then we can expect that mental health “treatment” will beget more violence, not less. That is what we are seeing.
There were almost never mass shootings when I was a kid. Now there are many. What has changed since then? A lot more people are taking psych drugs. And yet every time one person so drugged commits a violent crime, it is blamed on the “mental illness.” If “treatment” will reduce violence, how come so many of the extremely violent people are already receiving “treatment?”
— Steve
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This one requires massive, organized resistance. If you’ve never contacted your legislator before, now is the time to start. And get all of your friends and relations to do so as well. This is very bad policy, developed by some very narrow-minded people and supported by some evilly-motivated and greedy folks who stand to make big bucks off of more enforced treatment.
One argument to put forth in speaking with legislators is that the vast majority of those who committed these acts of extreme violent had recently received or were still receiving “treatment” for “mental health issues” at the time of their attacks. in Lanza’s case in particular, the medical records are suspiciously being suppressed for the last 5 years, most likely because he was in “treatment” at the time of the event. How would it change the outcomes of these situations to enforce “treatment” that had already failed them?
Let’s get active on this one!
—- Steve
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Hi, Sheila!
Good to see you blogging for MIA! I remember communicating with you years ago on the “Ritalin Death” website – you have been a great advocate and helped a lot of people come to grips with this huge mass of corruption and propaganda.
I’ve had very similar thoughts about Adam and many of the shooters – the call is always for more “mental health care,” and yet almost all of them have had extensive mental health care prior to the event. What’s that definition of insanity: repeating the same action and expecting a different result? But our culture has been so mesmerized with this mythology of magical cures for “mental illness” (whatever THAT means!) that even the most obvious manifestations of this “treatment’s” ineffectiveness (and at times dangerousness) is instantly and instinctively suppressed. It really is more like a religion than a medical specialty.
Great article – I hope your viewpoint gets the public airing it deserves.
—- Steve
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I get the RTP newsletter, and a lot of the stuff they talk about is very good. They even talk about avoiding coercion and working with the client on making their own choices. But they seem to simply avoid the question of harm through psychiatric drugs. (A lot of the stuff from SAMSHA is similarly avoidant of the rather large elephant in the living room.) My sense is a lot of the people writing in the newsletter would like to go there, but there is political pressure not to take on that issue directly. Which makes sense considering their connections to psychiatry and NAMI. Keris is great but is operating behind the lines in a hostile environment. I admire her courage for stepping into that role, but we’re a long way from NAMI really starting to focus on the evidence base instead of protecting parents’ and their funders’ feelings with their adherence to the bio-psychiatric line.
— Steve
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How very bizarre! It sounds like you were a tremendously successful counselor, precisely because you were in touch with your emotions and didn’t judge or stigmatize those coming to talk with you. It sounds like the hypocrites could not tolerate the idea that a person could both be a recipient and provider of counseling or other mental health services. Which is a bizarre position to take, but also a common one, because so much of what passes for “mental health treatment” is about creating an “us vs. them” mentality where we are able to distance ourselves from the “mentally ill” whom we supposedly are helping but whom we secretly or not-so-secretly believe to be beneath us. Of course, you NOT doing that is what made you successful. But if that was true, then it meant they were all doing it wrong and they might be no different from their clients and their own issues might be affecting their counseling success! Egads! That can’t be allowed! So you had to carry all the pain they were denying and be judged wanting because you had the courage to be a genuine human being.
Disgusting!!! And what a waste for the profession. You’re the kind of person we NEED as a counselor. The rest of them need to get some counseling themselves.
Thanks for sharing – while our personalities are different, it appears our values are very similar!
—- Steve
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Scapegoating was indeed the proper word for it. I was the family scapegoat for years, until I got really sick and had another sibling born, at which point, my next younger brother got the job. I was less of a scapegoat in school, but I just hated being forced to be there and do everything the teacher said, as well as being forced to spend time with kids I didn’t really have much in common with. I have read that this is a very common experience for kids with higher IQs who are forced to hang around only with kids their own age. They tend to get along better with kids older or younger than themselves. This was very true for two of my three boys as well.
I think people feel uncomfortable with me or find me “odd” mostly because I am quite honest about what I’m seeing when people ask me (and sometimes when they don’t), and I don’t play a lot of games. I’ve never been very good at disguising my feelings, though I am quite diplomatic in expressing them. People who are suffering find me very agreeable to talk with, but people who want to maintain their “bubble” of ignorance or their entitlement to freely bully and humiliate others don’t enjoy my company quite as much. I used to get down on myself for being unable to “fit in” to certain social circles that were considered “cool.” I now consider such people as mostly a mixture of dull, anxious, and evil, and don’t bother with them any more. My own way of dealing with judgment, I suppose, but I guess hypocrisy was more my button. I have a hard time being in the room with hypocrisy without commenting. Which makes me very unpopular among hypocrites!
—- Steve
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Ugh! It does not sound to me like whatever treatment you are receiving has been very effective! Let me know if there is any way I can help.
There are a lot of “off the grid” approaches that can provide some relief to some people. Honestly, my biggest problem with the system is situations just like yours, where they appear to be applying the best technology and know-how that their particular world-view has to offer, and it isn’t taking care of the problem. They have literally nothing else to offer you! It makes me both sad and very angry. I wish you were in Portland and we could meet for coffee and look at options. It’s all about maximum options and getting to know each person’s story. That’s what’s missing in the current approach. It’s not the drugs, it is the lack of caring and the lack of creative flexibility that pisses me off!
— Steve
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My first question when I had a suicidal caller, once I figured out if they were on the verge of doing something drastic, was to ask what was going on in their lives that made suicide seem like an option they would consider. It always led to a very productive conversation. It is a shame they wouldn’t do what made sense to you as one human to another.
—- Steve
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I am sorry you are getting that vibe – it is understandable, as some folks express some very strong feelings about their bad experiences on medication, but I don’t think most of the folks here oppose medication as one option in the toolbox. I think it is the enforcement of the viewpoint that medication is the ONLY thing that will help, and that biology is the ONLY explanation for your suffering, that leads to the vitriol. In the end, people are objecting to being harmed by the rigidity of the system, as well as by the intellectual dishonesty and downright greed of those perpetuating these misguided fake-science dogma. And medication is often the means by which this harm is inflicted.
Try to imagine if you had become MORE suicidal after starting on some recommended medication. Then imagine how it would feel if you told someone this was the case and they didn’t believe you. Then imagine how it would feel if you decided to stop taking the offending medication, and they locked you in the hospital and forced you to take it. Or imagine if they did this to your child and s/he committed suicide as a result of the side effects, and nobody listened to you when you said something was wrong. You’d probably express some vitriol, too.
If you look at Leah’s suggestions for improvement, no where in there does she say not to take medication or to stay away from doctors. She is talking about speaking up, about listening to those who have been suicidal, about connecting up with others who have had similar experiences. I am sure if you did so, you’d find that some people swear by their medications and say they could not do without them, while others want to sue their psychiatrists and the drug companies for ruining their lives. Both positions are very real and very welcome. I think you get more medication horror stories on this site because it’s one place a person can go to speak from the heart about their experience and not feel invalidated. I don’t think it’s meant to invalidate your experience if it has been different. My personal view is very pragmatic: we should work individually with each person and find out what works for him/her. It is only when we decide that there is a “right way” to “treat” suicidal people that we get into big trouble, especially when we don’t even bother to ask the suicidal people what they think about our supposedly helpful interventions.
—- Steve
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Hi, Doug!
Thanks for sharing your story. Reading the article made me wonder: do you believe your feelings of depression are in any way related to your parents’ rigid expectations about what you should become as an adult?
I have often struggled with depression and anxiety in my life, and much of it I attribute to being expected to “fit in” to a world that I didn’t ever really feel comfortable in, both at home and especially in school. I am very smart and very emotionally sensitive, and I think saw a lot of hypocrisy around me but had no way to process it, which led me to feel very isolated and alone, and unsafe letting anyone know what I was thinking or feeling.
Healing for me has meant (much like Alex said) learning to just be me and stop worrying about what others thought of my behavior. I may be regarded as odd by some, but I live with integrity and have a lot in my life that others wish they had. And I’ve learned to speak my mind when it is needed, even if others may find what I say uncomfortable. I still find the world depressing as hell at times, but I have come to believe that my feelings are a very reasonable reaction to a very dysfunctional society. Does that resonate with you in any way?
—- Steve
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Your point is well taken. If you take away the “mental health” justification, there is really nothing to justify intervention other than wanting to stop a person from doing what they are doing. And it is absolutely true that much of “voluntary treatment” is taken on under coercion, as the person wants to avoid the inevitable detention if they refuse.
You’ve obviously given this issue some very deep thought. I am very interested in hearing what processes you and those you are working with come up with. It is often hard to tell people I don’t believe in involuntary detention without having an alternative process in mind, so the work you are doing I see as vitally important.
Thanks for the interesting conversation! I hope I get to meet you in person one day.
—- Steve
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That absolutely makes sense, and I agree with the principles you put forth. And I have been one of those people who believes in and does the work of deescalating violent or self-destructive people, and I know it can be done respectfully, effectively and intentionally without the use of force. It does require some courage and a willingness to sit with some very uncomfortable feelings, and unfortunately, a lot of people don’t have the skills or emotional wherewithal to pull it off. I think the involuntary detention statues let us off the hook for learning those important skills and make it way too easy to victimize anyone we find making us uncomfortable.
I guess my reason for raising this is that I observe that it is harder for some people to get their head around not “protecting” someone who is suicidal or hallucinating from harming him/herself. What I am advocating for is separating these discussions, aka: “We believe it is a violation of a person’s most fundamental rights to freedom of action to forcibly detain them for preventative reasons. Additionally, even in places where such detentions remain legal,we also believe it is an egregious violation of their human rights to enforce any kind of treatment on the victims of such detention, even if there is agreement they may pose a safety threat.”
To me, they are two separate rights issues: the right to be free from arbitrary detention in the absence of due process of law, and the right to be free from enforced treatment regardless of any law violations that a person may have engaged in. In most cases, it is assumed that “protective detention” automatically confers the right to enforced treatment. I want to see that assumption overtly questioned, so that even folks who support involuntary detention will be able to see the possibility of a person retaining sufficient dignity and rights to decide whether or not they want the “help” that is being forcibly “offered” to them under coercive conditions.
I hope that makes my position a little clearer. I appreciate your thoughtful response.
— Steve
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As I have said before, it is possible to have detention for people who are demonstrating dangerous behavior without allowing any forced treatment at all. I really think these two issues need to be separated, and I hope that issue can be raised with this commission.
Thanks, Tina, for your exceptional courage and hard work in championing this issue on an international level. You are heroic!
— Steve
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As a person with a scientific background (BS in Chemistry, plus lots of familiarity with social science research), it really isn’t that hard to interpret, once you sift through the BS. The main reason you are having a hard time understanding it, besides the use of intentionally technical language to make it look like they know what they’re talking about, is because most of it really doesn’t make sense.
The following lines sum it up:
“After all, common variants explain only a very small percentage of the genetic risk, and functional consequences of the discovered SNPs are inconclusive. Furthermore, the associated SNPs are not disease specific, and the majority of individuals with a “risk” allele are healthy.”
Translation: most of the people who have “bipolar disorder” don’t have these genetic markers (“very small part of the genetic risk”), even for those who do have the markers, we don’t really know if “bipolar disorder” or anything specific will result (“functional consequences of the discovered SNPs are inconclusive”), some people with other “mental health disorders” have exactly the same markers (“not disease specific”), and most people who have these “risk” markers don’t have anything wrong with them at all (“the majority of individuals with a risk allele are healthy).
Or to sum up: We’ve discovered a genetic marker that is more likely to be present in “bipolar” clients than in healthy ones. However, the vast majority of people who have a “bipolar” diagnosis don’t have the marker, lots of people who have the marker have something else wrong with them besides “bipolar,” and most of the people with the marker have nothing wrong with them at all.
It’s a pretty lame effort – “grasping at straws” doesn’t even sum it up. They are desperate to find some correlations with genes, but if this were of significance, we’d find that 1) most people with “bipolar” diagnoses have this variant; 2) most people who have the variant have a “bipolar” diagnosis, and 3) the vast majority of healthy people don’t have this variant at all. They’re 0 for 3 in my book.
— Steve
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Leah, I always get a little worried when I read an article about suicide prevention, because I used to supervise at a volunteer suicide hotline and watched the changes over time as we got farther and farther away from a trauma-based, human-interaction focused model to the dominant medical model we see today. Most of the writing, including from the AAS, are about knowing the signs and getting “treatment.” And you are right, there are almost no voices from survivors of suicide attempts, or of the ham-handed interventions that are supposed to help.
I was so impressed by what you had to say, as it completely reflects my own experience as a counselor and a person who has at times struggled with suicidal feelings. Your emphasis on being present for the person and not judging him/her for having his/her feelings, which in my experience are almost always very understandable given their experiences, is exactly what the mental health world as a whole needs to hear. I am so glad you’ve found your voice and helped others find theirs. I really do believe this is the only way the mental health world will reform – when those who have to suffer through its “helpful” interventions stand up and say NO MORE!
Thanks for a moving and inspiring article!
— Steve
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It is kind of amazing how they feel OK to make all of these claims without any literature references or footnotes whatsoever. I wish we’d have “scientific literacy” courses for teens and young adults so that people could learn to sift through this crap. I don’t know what the answer is, but this kind of posting is totally reprehensible and possibly qualifies as downright evil!
— Steve
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Exactly. Sounds like we really are on the same page! Not that I’m surprised by that…
— Steve
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I hear you, and don’t really disagree that it is impossible to pull mind and body apart as Aristotle attempted to do. But again, you are speaking out of your personal beliefs, which I am, too, but that is not science.
I suppose the next scientific question I’d have for you is this: while it is a given that mind and body are interrelated and in a sense inseparable, how is it that we control our brains? And who is it that is controlling the brain (as in my examples of neurofeedback and the placebo effect, or the known impact of meditation in actually changing the size and structure of the brain)? I suppose we could postulate that some higher part of the brain is generating these controlling impulses, but that leads to an endless chicken-and-egg dilemma: What or who controls those higher functions?
I am not saying I know the answer to that, or that it is necessarily a function outside the brain. I am saying WE DON’T KNOW. I’m saying it is a mystery, and simply saying “we think it’s all happening in the brain” is a total punt and abdication of responsibility, which allows professionals to continue to engage in ineffective practices with impunity. An honest professional acknowledges the limitations of his/her knowledge, because s/he knows others are depending on him/her and s/he does not want to mislead those who have placed their trust in him/her. That’s my view, anyway. I think we’d all be served a lot better by admitting what we don’t know, and the nature of the mind remains a pretty damned big mystery, which is not likely to be solved, IMHO, by spending all of our energy studying and manipulating the brain when we don’t actually understand or even know what is happening up there.
And just to throw another monkey wrench into the works, what about the “second brain” in the gut?
http://www.scientificamerican.com/article/gut-second-brain/
No need to abandon materialism to study that possibility, and yet the profession still maintains we’re all brain…
—- Steve
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I think the point is very well taken. “Science” (in my view) has in many ways taken over the role that religion once held in society. I still recall the visions of endless scientific/technological progress were ubiquitous in my childhood. I remember the depictions of the year 2000 involving self-driving cars and moving sidewalks outside every downtown building, and presentations on the incredible promise of clean energy presented by nuclear power.
There is a very deep-seated belief in many that technology is the answer, and that belief does result in large degree from the position of scientific materialism. I would submit, however, that the Age of Enlightenment thinkers did not as a whole dismiss the idea of a creator or of the possibility of spiritual realities that transcend the physical.
But I digress. I was not making arguments against materialism per se, but arguing that accepting a particular philosophical viewpoint as “inherently obvious” and therefore not subject to falsification does not allow the science we all want to believe in to do its job.
And I agree, psychiatry has been granted the authority it has by a society that believes psychiatry to be a scientific enterprise that is interested in coming up with a workable model that will help us understand and solve problems of the mind. Which is all the more reason many folks feel so dramatically betrayed when they discover the lack of actual scientific rigor in the theories underlying psychiatric practice. And it also speaks to the very much higher level of responsibility the profession has to be scientifically sound and thorough and not to deny inconvenient facts – if people have entrusted you with this kind of authority, integrity demands a much higher level of rigor to merit the trust the profession has been granted.
My argument is that we need to apply scientific thought rigorously, and not allow our assumptions regarding the nature of the mind, which may widely vary, interfere with our honest assessment of the facts we’re presented with, which vary a whole lot less.
—- Steve
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BTW, Sandra, thank you for your gracious reply.
— Steve
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Where, indeed? And why is it so important for them to invalidate these experiences? Is it threatening to the psychiatric hierarchy to allow that there are huge unknowns in the world of the mind? Is the whole materialistic approach simply a way of reducing anxiety in the face of the mystery of life?
—- Steve
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Where, indeed? And why is it so important for them to invalidate these experiences? Is it threatening to the psychiatric hierarchy to allow that there are huge unknowns in the world of the mind? Is the whole materialistic approach simply a way of reducing anxiety in the face of the mystery of life?
—- Steve
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I agree 100%. When I object is when so many of your colleagues assume and assert that their perspective – which to me sounds very much like I am an illusory effect of neural firing and that I have no free will or control over my own brain chemistry – is the only perspective worth having, and that anyone who disagrees is anti-scientific or superstitious. You obviously don’t take the perspective to that extreme, and appear willing to acknowledge that it is a philosophical position that others don’t need to agree with. This is absolutely not my experience with the bulk of the psychiatrists I’ve known, and increasing numbers of psychologists and counselors of various stripes are beginning to act similarly.
I think what we do agree upon is that we should focus on what actually WORKS, and that “WORKS” should be defined from the point of view of the person being acted upon by our purportedly helpful interventions. I am essentially a pragmatist at heart – if someone does a spirit dispossession, and the “client” gets better (and I know this does really happen), well, let’s find out what was done that worked and see if it works on someone else. Real science doesn’t exclude possibilities because they conflict with our basic assumptions about reality. Science is designed to cut through those philosophical assumptions and show us what is actually KNOWN.
Anyone who attacks someone else’s integrity for not being a materialist or a spiritualist or a populist or whatever “ism” they favor is not being a scientist at all. What bothers me is that the psychiatric community as a whole (present company excepted) gets away with claiming it is the “true science” while pointedly ignoring scientific data such as Harrow and Wunderlink.
Nobody needs to agree with my philosophy. They do need to show me the data to back up the idea that their philosophy leads to a workable solution. But I don’t think we disagree on that point.
—- Steve
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Great stuff, as usual, Joanna. (Though I would not necessarily agree that “People living in western societies may no longer suffer from the desperate material deprivations of the likes of John Barton” – there are fewer but such suffering continues to exist, even in industrialized nations.) I have often said exactly what you do here – there is nothing particularly new or scientific about discovering that ingesting substances can change one’s mood or thinking. I often refer to alcohol as “the poor man’s Prozac.” But the medicalization process is clearly one of blaming the victim and sparing the oppressor, much as Alice Miller so eloquently outlines in her writing (in particular, her book, “For Your Own Good,” appears particularly applicable to this strategy of emotional suppression.)
John, I have many times experienced the same thing. I once spoke with a developmentally delayed 17-year-old (mentally about 6) who had been raped. She was depressed for about a year before disclosing her abuse, and almost immediately after telling what happened, started to act out physically. The diagnosis? “Bipolar disorder.” Another psychiatrist was treating a woman for 15 years with every drug he could think of, said he’d “tried everything,” but never bothered to ask her what had happened in her life that she was depressed about. My own son went through a difficult time as a teen, involving a short stint of drug abuse and a sexual assault by a roommate, leading to some serious depression and suicidal thoughts. A doctor tried to prescribe him antidepressants without even bothering to ask him why he’d thought about killing himself. Didn’t even bother to find out he was in withdrawal from abusing substances, not to mention having to disconnect from all of his “friends” whom he realized were only interested in using drugs and who abandoned him the moment he quit.
I could go on. It amazes me how incredibly stupid this medical paradigm allows people to be. Even an untrained 6 year old who saw someone crying would at least know enough to ask them, “Why are you so sad?”
You probably are a brilliant counselor, for the simple reason that you actually are interested in the perspective and experiences of the person you’re trying to help. And yet these morons get paid hundreds of dollars an hour to invalidate and suppress people’s normal reactions to adverse circumstances. It is disgusting!
—- Steve
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Ah, but I think you have made my point for me – you guess that most psychiatrists, you included, don’t agree that there is some other agency involved. You would SAY that there is some neural process that would account for belief. But WHY would you say that? What evidence is there to support your claim? Is that claim not just as much reflecting a philosophical/religious viewpoint as the claim that the spirit is a separate entity that occupies and manages the body? Unless you can provide evidence for your belief, it amounts to nothing more than a generally-held belief within the psychiatric community, no more scientific than someone’s belief in angels or the afterlife.
I do think this point is vital – not that you agree with me about the nature of or even the existence of a transcendent agency capable of controlling the brain (for which I acknowledge there is no direct evidence, but whose presence I infer from other events), but that your belief is not somehow more important or accurate or scientific than mine because a bunch of other psychiatrists agree with you.
I absolutely respect you and your important work, or I would not bother having this conversation with you. I want to challenge you to ask on what basis you and your psychiatric colleagues hold that belief. Is there one shred of science telling you that the placebo effect is accounted for by a “neural process?” If so what is it? Is it anything other than pure speculation that such a process exists?
It is my observation that this absolute and unfettered need to believe that everything about human behavior can and must be explained by a neural process is central to psychiatry’s absolute blindness to other options besides chemical manipulation of the brain. And for me, as a scientist (a chemist by training), it has not the slightest degree of scientific validity. It is an assumption that is so accepted that anyone who questions it is automatically considered “not scientific,” but it is an untested assumption.
Biological psychiatry has on occasion been compared to a church or religious community (and interestingly, the DSM has been dubbed the psychiatric “bible” spontaneously by many in the mental health community!), and I find that the dedication to this particular belief is what gives it that churchlike quality. I am very interested to hear if you are able to consider the possibility that it is nothing more than a belief that is unsupported by known evidence, or if you in fact have evidence that I am unaware of to share.
Again, I have the utmost respect for you and your work, and really appreciate your posts. I hope you will take this in the spirit (forgive the pun!) in which it is given. I really want to hear your response.
—- Steve
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Thanks for the thoughtful article. I have to say, I think Insel’s observation of the truth regarding the DSM is quite on target, but his solution continues to be based on an unproven assumption, namely, that out mind and our brain are synonymous. (I think Rossa said something similar above). It denies the obvious impact of what for lack of a better word I will call the spiritual being on the body and specifically the brain. I am not going to indulge in speculation on the nature of this apparent being, but merely point out that whatever it is, it appears to have a profound influence on our health and well-being. Or perhaps it is more correct to say that it is the agency that DETERMINES what health or well-being even means to us.
To be more explicit, let’s take the “placebo effect.” Apparently, believing that something can help us can actually help us. So a BELIEF is healing. It should be obvious, and has been shown also, that beliefs can also be harmful or debilitating. How would any of this be “measured” in the brain? What is the target area for “trust” or “confidence” or “sense of purpose?” These things have no apparent correlates in the brain. And yet they obviously impact how we think, feel and behave, every bit as much and moreso than the profession’s sacred psychiatric pills.
Another example is neurofeedback – apparently, a person can intentionally alter his/her own brainwaves to fit a particular pattern if they get feedback about when they’re being successful in approximating that pattern. And a person can be trained to do this eventually without any further feedback. So WHO IS ALTERING THE BRAINWAVES? If the brain is all, how can the brainwaves alter themselves? Obviously, there is an agent external to the brain, or superior to it, that can tell the brain what to do.
Again, I don’t pretend to know what this agency is, but it is apparent that human beings have an agency that is able to dramatically influence brain function, both intentionally and unintentionally. If we only study the brain, we miss that boat completely before we even start. Which is why no one will every get money to study why “Disney Therapy” worked for that family. There is something at work in that example that transcends brain function. Something to do with meaning and dedication and purpose and unbending intention to solve the problem. There is no measurement of such things and no “genetic or molecular target” for them, either. They are aspects of the human spirit, whatever that is. And the human spirit, in my view, is something that measures, not something to be measured, and it will always transcend any efforts to quantify it. Until we admit that simple and obvious fact, our “research” efforts are doomed to failure.
Sometimes it has nothing to do with the box at all. It has to do with who is controlling what goes in the box.
—- Steve
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Sera, you are awesomely on target as usual. But I have to admit, this article almost made me physically ill. Especially the “game.” I am glad you were there to throw a monkey wrench in the works, but you should have been on the panel with half a dozen other survivors who genuinely know what you are talking about. I can’t believe this drivel is being passed off as “education.” It really does make me sick!
— Steve
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I like to add Thomas Edison, who was apparently thrown out of school at an early age and his mother was told he was “incorrigible” and could never be taught anything. He was homeschooled from there forward and apparently learned a thing or two that he passed along. I am sure he did not suffer from a lack of Ritalin in his experimentation and marketing genius.
All these great people managed to be great in an age before “treatment” or labels were invented. I have always failed to see how their success does anything but undermine the notion that “psychiatric disorders” are “lifetime brain disabilities” that require “lifelong ‘treatment.'” These people didn’t have lifelong “treatment,” did they? How did they manage to be great anyway? Seems like a great argument AGAINST ‘treatment.’
— Steve
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Weird that they say community based care should be emphasized in areas where other services are less available – it sounds like they should be emphasized everywhere!
— Steve
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Rossa, I am afraid that it’s not the professionals keeping the knowledge of helping distressed individuals to themselves – they genuinely don’t have that knowledge or those skills. There is no requirement that those entering psychiatry have any education in therapy or even advanced communication skills, and it is obvious that many of them don’t seem to be to worried or even notice that those skills are lacking. The most common attitude I’ve encountered (and I’ve worked in the field for years) is, “I’m the doctor, I’ve studied about brains and drugs, I know what I’m talking about, so you shouldn’t worry your pretty little head about it – just do what I tell you.” I have seen very destructive communication from professionals who should know better, and more commonly, a simple lack of skills leading to an impasse, where the client has bared his/her soul and the clinician can’t do anything more than say “I’m sorry” or “I think you need antidepressants.”
It is a very sad state of affairs. I think the biggest reason that peer-directed services work so much better is that the peers are better communicators – they empathize and listen well and have ideas on what the client might do to help him/herself. The combination of ignorance and arrogance presented by the average psychiatrist precludes them learning anything of importance from the client, or even admitting they have something to learn. So they’re not hiding their advanced skills – for the most part, they simply don’t have them. And in most cases, they wouldn’t care to learn them if they were offered.
—- Steve
PS I know Cindy personally, and she is a remarkable woman!
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A very valid question. Unfortunately, the medical treatment model is so completely dominant in the US that very few treatment alternatives exist currently. You might want to read Robert Whitaker’s book, “Anatomy of an Epidemic,” which prompted the development of this community. There are alternatives, such as the Open Dialog approach (80% recovery rates with minimal to no medication use), the Soteria House model, and various peer-directed services. There is new research supporting “Cognitive Behavioral Therapy” for psychotic symptoms. There are also reported successes with nutritional approaches, meditation/mindfulness, vitamin therapy, and others. The biggest problem with the diagnosis of “schizophrenia” is that it probably encompasses a lot of different things that might cause the same kind of symptoms or reactions. I think the most important thing is to figure out a way to help the sufferer define the situation in a way that he can embrace. This requires a lot of skills that most mental health professionals don’t have, and honestly, I have not always been successful with it. And honestly, short-term use of antipsychotics can help get there in some cases. But the research is in, and long-term maintenance on antipsychotics clearly does not lead to good outcomes in life. Whether they are used short term or not, it’s vital to look for alternatives that the person suffering the symptoms can get his/her head around.
Hope that helps a little. It is an awful situation, and I feel for you. Wish I and/or the mental health system had more to offer.
—- Steve
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It is also illegal. The family must be proven to pose a threat of imminent harm to the child. It seems pretty obvious that these parents were loving, concerned, informed parents trying to do the right thing. They were neither intentionally harmful nor neglectful of her needs. She appeared to be functioning well despite her medical issues. It seems it is more about the doctors fighting over their turf than the parents posing any danger. Even if the doctors they consulted with were wrong, the doctors should be held accountable, not the family for seeking out and following the medical advice of a licensed practitioner.
It’s just bizarre and shows how distorted our “mental health” system has become. The bigger shame is that the judge didn’t throw this out at the first hearing. There is no legal grounds for her to be held.
—- Steve
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Who gets paid to do this kind of a study????! Can I get in on this action?
—- Steve
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That is the hidden conclusion that was drawn from the Decade of the Brain – not only do bad relationships damage brain development, damaged brains can and do heal, and the most healing thing for a tramatized brain was shown to be a meaningful relationship with a healthy adult who cares about you! Psychiatry is always fond of telling half the story. They leave out the part about how whatever damage trauma may do the brain, psychiatric drugs not only don’t heal it, but the appear to make it worse and worse. That’s the biggest message from Anatomy – you can’t heal brains with chemicals. You can only damage them further.
—- Steve
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Here is a link I just found that validates the concern I mentioned above;
“High rate of antidepressant treatment in elderly people who commit suicide:”
http://www.bmj.com/content/313/7065/1118
— Steve
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I would assume from my short stint as a nursing home ombudsman that the rate of “antidepressant” drugs given to seniors has climbed steadily over time. It is important to take that into account when looking at increasing suicide rates, as the drugs themselves may be contributing.
Additionally, the drug approach that is so common and so accepted really invalidates the reasons you mention above for so much of the depression we see in the aging population – loss of community, loss of purpose, loss of housing and possessions, loss of friends and connections, loss of status, loss of control over our bodies, and in the case of nursing home residents, loss of control over most aspects of our lives. All these things make a sense of sadness or loss or even hopelessness or despair a pretty normal and common experience, but instead of being listened to, understood and supported, most elderly folks continue to get the “drug ’em and forget ’em” message that essentially says, “You should feel good, and if you don’t, it’s because your brain is messed up.” It is the opposite of the holistic approach you are recommending, and yet it is standard practice in the care of aging Americans.
— Steve
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LOL! Good point – that’s a pretty low bar to hurdle!
—- Steve
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And the data shows that you aren’t missing anything by not paying attention, because the kids who are artificially “interested” in it through stimulants apparently don’t learn any more than the kids watching the squirrels!
— Steve
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I think you make a very good point. The field of psychology doesn’t have to be a science, and really isn’t, because we’re dealing with values and priorities and motivation and emotion, things which don’t lend themselves to measurement. In fact, I think it lends confusion to what is otherwise a much easier subject to understand when we approach it more philosophically. The very fact of choosing to believe that depression or psychosis is a problem that needs solving (for instance) is a value-laden decision that belongs entirely to the field of philosophy. Which is kinda what Jonathan is saying in his article, I think.
However, I am a scientist by training (a chemist) and find my scientific way of thinking greatly enhances my ability to help people. I treat each interaction with a person as a unique experience (because they are), but I can still hypothesize what might be happening, test out my hypothesis with careful questions, and alter my theory if the facts no longer bear it out. Of course, this is all in the context of helping the person I’m helping achieve his/her goals, rather than my own.
If all psychiatrists and psychologists approached it this way, the drugs would be minimally used, if at all, because if you really look scientifically at people’s experience with the drugs, on the balance, it’s pretty dismal. I think the biggest problem is that they don’t really think scientifically at all. They have religious faith and pretend it’s science. A more scientific attitude, as well as one more humble and respectful of the person coming to them for help, would actually improve things a whole lot!
— Steve
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I wish everyone would read this article who keeps recommending medication for “ADHD.” All the lines about “untreated ADHD” leading to delinquency, school failure, etc., are clearly not relevant, as “treatment” changes none of these variables in the slightest. And their argument that community treatment is of low quality also holds no water – that’s the treatment the community is receiving, and the data says it DOES NOT HELP!
Science is pretty mainstream. I hope the word starts to spread. It is hard to comprehend the magical belief system that underlies this practice. Of course, it’s easy to understand the financial motivations of the purveyors of the concept, but this science is not new and this “treatment” should have been tossed out as useless over longer than 12 months back in the 70s.
—- Steve
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Actually, the cooptation of government by business interests, I discovered recently, is the essential definition of fascism. I am not claiming benefits of socialism here – I am merely stating that our enemy is not socialism, but FASCISM, which is not going to stop until our representatives represent us rather than the large corporate interests like the pharmaceutical companies.
As further evidence, I will remark that the more socialist countries in Europe have been more resistant to the psychiatric drug craze than our own pseudo “free-market” economy, which is not free at all but highly controlled by the fascistic forces that have been running our government, and I include the Clinton and Obama administrations in that group 100%.
I think the liberal/conservative split is being promoted so that each “side” thinks the other “side” is responsible for the horrific politics in Washington, so that the “conservatives” call for less government and the “liberals” lapse into apathy, and the corporations run the show. I think we need to stop buying into this sales job, and realize that both liberal and conservative views have been and will continue to be relevant and important, but historically never led to the kind of hostility and gridlock we see today. It’s not about liberal vs. conservative – it’s about BIG CORPORATIONS vs. THE REST OF US!
OK, that’s my soapbox moment for the weekend…
—- Steve
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Good for you! I have to say, it occurred to me that part of the picture may be that quitting gives one a sense of accomplishment, of being successful in getting out from under the “control” of this particular substance. My experience as a counselor and advocate tells me that people feel better when more in control of their lives. (Which the biggest reason I find psychiatry so abhorrent – it does the opposite!) What do you think of that possibility?
—- Steve
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It is astounding that something having such a tiny correlation relative to the sample size could possibly be considered causal, when something like .01% of the “normal” sample have this particular anomaly. From the data, it’s obvious that this anomaly is neither required nor sufficient to prevent developing “schizophrenia,” since 99.99% of the non-diagnosed population didn’t have the anomaly.
These guys are so desperate!
—- Steve
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But that’s what Loren Mosher did back in the early 70s, and they didn’t want to believe it and fired him as head of schizophrenia research and defunded the program! These people aren’t interested in science, they want to be RIGHT so they can keep making MONEY. Anything that challenges their religious worldview will be thoroughly trashed and anyone supporting these views will be personally attacked or ignored. That’s how they work. They’ll never be convinced by evidence, because they aren’t interested in evidence. Our only hope will be that new practitioners will be educated as the older “key opinion leaders” die off, while patients continue to demand more options. Psychiatry will be dragged kicking and screaming from their dogma, regardless of the facts.
—- Steve
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Sounds from your analysis like the TAU had no effect on symptoms, either. Or am I reading that wrong?
— Steve
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I think it depends completely on how it is approached. And that’s true of any kind of talking therapy. The practitioner can be authoritarian, bossing the client around and telling him/her what to think and do, or empowering, and work with the client to identify and achieve his/her own goals.
As to CBT, I don’t see it as a technology as much as a tactical option. It is one of several approaches a client can choose to take toward making some wanted changes, but it’s not the only one. I do get exercised about folks who insist that CBT is the only way to go, and especially those who insist that reviewing past events and experiences as they relate to current thoughts and feelings can’t be a part of therapy. My approach has always been to do what works for the client, and if it doesn’t work for the client, to do something else. The only one who knows the path forward is the client him/herself, and as long as a therapist is aware of and focused on that fact, s/he can’t go too far wrong. The problem comes in when the therapist starts thinking s/he knows better than the client what the client should do. So to me it’s not CBT that’s the problem, it’s arrogant therapists, regardless of what approach they use.
In fact, my biggest objection to psychiatry isn’t the drugs. Its that the psychiatrist presumes the right to define both the problem and the solution for the patient, taking away any agency or initiative the client may have. This is counterproductive always, regardless of whether you’re a psychiatrist or a volunteer helpline counselor. Nobody needs to be bossed around and told what’s wrong with them. But I think you’re off base in identifying CBT itself as the issue. I think it can be used in an empowering way, if the therapist is sensitive and focused on the needs and reactions of the client, rather than his/her own need to feel smart and superior.
—- Steve
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The question is not just, “How does the brain give rise to consciousness,” but also, “DOES the brain actually give rise to consciousness?” Or to put it another way – does the activity in the brain CREATE our thoughts and intentions, or do our thoughts and intentions create the activity in our brains?
Ultimately, the unanswered question that neuroscience will never answer is the most fundamental of all: What is life? How and why are we alive, and what does it mean to be alive?
Psychiatry’s biggest crime is to remove meaning from our experience. It all starts with the assumption that we’re just a product of our brains. If we’re instead the operators of our brains, the picture is completely changed.
— Steve
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Ah, but sometimes what is diagnosed as “ADHD” CAN be cured with love, if you add some wisdom. For one thing, the symptoms of “ADHD” can be caused by dozens of other things, like iron deficiency, sleep apnea, witnessing domestic abuse at home, lacking sufficient structure, or being forced to do developmentally inappropriate things by your school or teacher. One well designed study showed that waiting a year to enroll your child in Kindergarten reduces the likelihood of an ADHD diagnosis by almost a third. Another showed that “ADHD” kids in an open classroom setting were virtually indistinguishable from “normal” kids, even by professionals, while they stuck out like the proverbial sore thumb in a standard classroom.
We raised two “ADHD” boys without medication, and while the oldest still has some manifestations as an adult, he’s been quite successful in his employment, and the youngest is virtually “cured” in that no one who looks at him would ever identify him as “having ADHD” despite his being a classic case as a kindergartner.
Additionally, the rate of “ADHD” diagnosis for foster children is many times higher than the general population. Unless you’re claiming that “ADHD” kids are abused at 4-5 times the rate of “normal” children, it appears that a LACK of loving interaction does in fact lead to “ADHD” symptoms. Which suggests that increasing the love available in the environment might, in fact, cure them. The overlap between “ADHD” and “PTSD” and other “anxiety disorders” is large and well known.
So sure, some kids act in the way described as “ADHD.” Just like some people feel depressed. But the fact that kids act that way or adults feel that way does not, ipso facto, prove that they are “disordered” in any way. If moving a kid to a different type of classroom makes his/her “symptoms” go away, doesn’t it make sense to ask whether it is the classroom that is “disordered?”
As I think we’ve discussed before, I’m not denying there is a wide range of genetic propensities in human beings, and it’s probable that some of us are programmed to have a hard time sitting still and doing as we’re told. I think we need those people. Genetic diversity is part of species survival. Just because people are different and don’t fit in well with our social institutions doesn’t mean they have a disease. Often, it is the social institution that really needs to be changed. Calling it “ADHD” removes any responsibility from those in power to take a look at the institutions they’ve created and honestly assess whether they’re working for those they’re supposedly designed to serve. In the case of our standard school classrooms, for most kids, I think the answer is a big NO. I’d rather fix the school than punish kids (like you were) for pointing out to us that they aren’t working.
— Steve
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You are right, of course. However, this kind of research is essential to peeling off some of the folks who are married to the paradigm that “everything is caused by the brain.” If it’s shown that supportive relationships change the brain in a positive direction, this supports those arguing for relationship-based interactions as the primary healing modality. And it also validates those who have experienced these heightened states that it’s not just because their brains are messed up – it’s because of what happened to them.
Admittedly, there is a lot more that could have been said, but I am glad this has been published, because it really undermines the idea that “schizophrenia” is a “disease of the brain,” especially when those who are not so labeled appear to have undergone a similar process as those who are.
I long for the day when we start talking about the steamroller instead of the pea. But at least this acknowledges that there was a steamroller involved!
—– Steve
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This is, indeed, a very sensitive area. I think we do need to acknowledge (and I think Philip clearly does so early in this article) that lack of nurturance is not the ONLY cause of what has come to be called “mental illness.” But it is a factor that needs to be considered.
It’s clear there ARE physiological causes of psychosis and other phenomena labeled as “mental illness,” with drug intoxication being only the most obvious one. My objection is not to the idea that there could be physiological causes of psychosis (or other “mental illness” manifestations), only to the idea that the ONLY possible causal factor is physiological.
Moreover, there are many other environmental factors that impact “mental health,” including living in an urban area, certain kinds of pollution (heavy metals are particularly implicated), unemployment, poverty, racism, sexism, various traumas, etc. Siblings play a role, too, as does neighborhood violence and cultural trends and expectations. To try and reduce all of this either to “you had a bad mom” or “you have bad genes” is reductionistic in the most extreme degree.
If we were really serious about finding causal factors for what is termed “mental illness,” we would stop grouping people together based on symptoms and start looking for differential causes that might underlie similar presentations. For instance, some “ADHD” symptoms may be a result of lack of structure at home. Some may be a result of prenatal drug and alcohol exposure. Some may be a result of inappropriate classroom expectations, the child being bored, the child being asked to do things that are over his/her head, the child being too young to be in school at all, the child having low iron, the child having a sleep apnea problem, the child being exposed to domestic abuse at home, or the child suffering the side effects of some other drug s/he is taking. That’s a very incomplete list of possibilities, all of which have evidence to support their potential to cause these “symptoms.” And of course, more than one of these can be going on at the same time. If “ADHD” symptoms can be caused by all these disperate things, what is the point of calling it ADHD? Wouldn’t it make more sense to find out what is behind it?
The last thing I’ll add is that psychiatry has been materially aided by NAMI in putting out this message. NAMI is mostly a creation of parents whose kids have developed “bipolar” or “schizophrenic” symptoms (which, of course, can have just as many causes as “ADHD” symptoms), and who wanted to stop being blamed for their kids developing these problems. As such, they have been very willing to accept psychiatric mantras and money, and have fully embraced the “biological brain disease” theory because it absolves them of any blame. Unfortunately, they have become a bit part of the problem, and have intensely promoted this idea that any discussion of parental responsibility is “parent bashing” and must be immediately hushed up.
Bottom line is, parents do make mistakes, almost always with the very best of intentions, and children suffer. Parents were children once, and their parents made mistakes with them, too, which they often repeat unless there is some kind of crisis or intervention to disrupt the pattern. It is not blameful to recognize this simple fact, and attempt to deal with the harmful impact of their behavior also opens the door to them healing from their own childhood traumas, and the opportunity to establish more trusting and intimate relationships with their children as adults. As Alex rightly says, not all parents will want to engage in this process, and that’s sad, but it doesn’t really help to support them in denying that they have caused some pain to their kids, because it’s their pain, too, and they also deserve a chance to heal, even if they choose not to take advantage of it.
Responsibility is not the same as blame. Responsibility means a willingness to look at the facts and to do something to solve the problem. More responsibility leads to more healing. While there are many, many reasons why adults and children suffer emotionally, we do parents no favors by letting them off the hook. After all, who is better placed to help a child who is suffering than his/her parent?
— Steve
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That is the truth. This is why rational arguments based on science don’t have any impact. They are, as a whole, not interested in the truth, they’re interested in power and money and being “right.” And some are even into making people suffer because they feel they deserve to suffer or just because they like watching people squirm because of what they do. They like having folks under their thumbs. While there are notable exceptions, the complete lack of empathy displayed by so many in this “profession” is truly scary.
—- Steve
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I don’t think we disagree, except for my definition of “liberal” being a little different. The “conservatives” of today (who aren’t really conservative at all, because if they were, they’d be avoiding unnecssary foreign entanglements, allowing criminal banks to fail, and letting people do what they need to do to survive instead of locking them up) are really less “liberals” than they are FACISTS. They don’t believe in a minimally intrusive State, they believe in merging the interests of corporations and government. So rather than getting a “free market”, we get a very warped and manipulated market that favors those who already have power, and they conspire to use fear and military force to keep us peons in tow. Including psych hospitalization, of course. The Nazis were very big on psychiatrists. They were also very big on spying. But so is the Obama administration, apparently, so perhaps they’re all just facists pretending to be “liberals” and “conservatives” in order to provide an illusion of choice. Bottom line, most of them support the current psychiatric-big pharma hierarchy 100%, regardless of which side of the aisle they sit on. Perhaps it’s best if I avoid the terms “liberal” and “conservative” entirely, as it plays into the little game our Corporate Masters want us to play.
Thanks for the exchange. You’re clearly a man of some intelligence. If you were running for office, I’d probably vote for you in a second!
—- Steve
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And actually, that 40% figure you cite supports Bob’s viewpoint on this. If 40% are diagnosed initially with depression, and the vast majority of those are “treated” with antidepressants, does it not seem likely that a good proportion of those became “bipolar” after the administration of the antidepressants? It begs the question we’re asking her to simply assume that these people were wrongly diagnosed. I think this is actually some good proof that receiving psychiatric treatment for depression increases one’s odds of eventually being diagnosed bipiolar. The reasons are, as usual, not even examined.
—- Steve
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“The challenge lies in showing beyond reasonable doubt that these antidepressant triggered episodes were not something that would have just popped up without anti-depressants triggering them in the first place.”
Actually, from a truly scientific viewpoint, this statement is not correct. For a real scientists (and I do acknowledge that most psychiatrists don’t come anywhere close to fitting that description), the assumption would be that the drug DOES cause the reaction that occurs after its administration until proven otherwise. The concept of “Occam’s Razor” suggests that when two competing explanations could both explain the same phenomenon, the simpler explanation is the most likely one. In this case, it’s pretty obvious that a person becoming bipolar after the administration of a drug is most likely being provoked by the drug itself. The first thing a real scientist would do is to stop the drug and see if the manic symptoms subsided. If they really wanted to be thorough, they might then administer the drug again to see if they returned, though in this case, that is probably not ethical. They would then look for other cases where this has happened and look for a pattern. And then they’d do a study like the one Bob cites. If all the data support that people are becoming manic after taking the drug, it becomes the job of the people with the alternate theory to prove the more obvious and factually supported theory wrong.
Or to put it another way: the person claiming the drug is safe and does not cause these reactions has the burden of proof. The claim that these people “would have become bipolar anyway” is the questionable claim that needs to be proven. Common sense and the data provided suggest that the drug is a causal agent, and anyone wanting to refute that needs to make their own case, not simply say “You can’t prove they wouldn’t have turned bipolar anyway.” That’s an argument for a junior high recess or an internet chat room, not for a serious scientific discussion.
— Steve
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Of course, they always blame the patient for their reaction to the drug. But this is a very real problem, and it happens when healthy people are given the drugs. Mania and hypomania are side effects listed on the label of all the SSRIs. Dr. Ghaemi’s opinion is typical of those in the profession with a conflict of interest – if antidepressants caused mania, they’d have to change their practice and their understanding of reality. So instead, it’s the patient’s fault – the drug “uncovered an underlying bipolar disorder” and we’re now lucky because now we can “treat” it with even more drugs. I have worked in the field for many years, and I have seen this more times than I can count. And yet probably at least half the time these kids go off the drugs, they are just the same or better than when they were on them.
There is no question in my mind that SSRIs and to a lesser extent stimulants can cause “bipolar” symptoms. It is quite disingenuous to blame the patient when your treatment makes them worse.
I am sure Peter has some literature references he’d love to share. But if you read Anatomy of and Epidemic, you’ll find plenty of supporting evidence in there showing that it is the drugs that are to blame, not the patients.
—- Steve
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Yeah, jeez, she’s dead already, why don’t you just move on? Ugh! Such callousness is incredible! I knew a psychiatrist who had seen a depressed woman for 15 years and never even bothered to ask her what she was depressed about. Another (developmentally delayed) teen woman was hospitalized with ‘bipolar’ when she hadn’t acted out in any way until she disclosed being raped a year before. Took me 10 minutes conversation with her mom to find out what had happened. Obviously, they simply didn’t care enough to have asked. It is disgusting beyond belief. So sorry you had to learn that the hard way. For the most part, they really don’t care.
—- Steve
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Gosh, maybe we can create a computer program that uses this kind of assessment tool, and once the computer comes up with a diagnosis, we put in our VISA card and out comes a prescription!
We have sunk to a pretty low place when psychiatrists are even able to THINK about using a computer to “diagnose” a human being who is suffering. It simply underscores the complete moral bankruptcy of this profession and its approach to mental/emotional/spiritual distress. The answer does NOT lie in being more “objective” about “symptoms,” as in treating people like both you and they are machines!
Yes, I know there are far worse crimes being committed, but somehow, this just underscores how hopeless it is to try and “reform” an effort that is this corrupt and out of touch with reality. Thanks for the info, Sandra, but I came out of this feeling exceedingly disheartened.
—– Steve
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The guy uses a lot of pictures and big words to obscure a couple of very important facts. First off, the neuroimaging studies are averaged over groups of children. There is no specific pattern of activity that is shared by all “ADHD” children, or they’d use it for diagnosis. Smoke and mirrors. Also, the PET and SPECT scans measure glucose uptake, which is assumed to associate with activity levels. This only shows how the brain is being USED at a particular time, not what it is capable of or what structural defects may be present. As to the “smaller brain” arguments, these studies don’t control for stimulant use, which is known to reduce brain volume over time.
Beyond that, the author fails to demonstrate any REASON why the “ADHD” child’s activities are behind the developmental curve. We know from many years of research that kids’ normal development can look very different from person to person, and that these developmental targets are only averages with a large range of variation. For instance, it can be normal to walk anywhere from 10 months to 18 months of age. Speech can develop anywhere from 9 months to 2 years and still be normal. These are huge percentages of a young child’s life! Why do we expect all children to develop the same level of executive functioning at the same age? It’s also well documented that boys’ executive functioning develops later than girls, on the average. You’ll notice there is no way that this person offers to determine what is “normal” and “minimially functional” for any child at any age. He simply states that some kids are behind in that area of development. This is obvious and would apply to any area of development. It doesn’t make it a disease.
Finally, he completely fails to answer the vitally important question: does your intervention actually improve the long-term development in the areas you claim are deficient? As I explained above, the answer to this question is a resounding NO! Stimulant treatment doesn’t appear to improve any long-term outcome area of significance on the average when compared to non-treated ADHD-diagnosed peers.
A fancy presentation that proves exactly nothing. “Pay no attention to that man behind the curtain. The Great Oz has spoken!”
—- Steve
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As a dad of two boys who fit all the “ADHD” criteria when young, I have to agree with what you have to say. Just because these kids act differently, and even if some subset may be genetically different in some observable way, the “disease” itself is defined by an inability to function as the adults wish in a very artificial setting that has developmentally inappropriate expectations which some kids that age will simply be unable to meet. Strong evidence of this is the study where they found that waiting one year before starting Kindergarten reduced the likelihood of being diagnosed with ADHD by a third. Additionally, there was a great study in the 70s showing that “ADHD”-diagnosed kids were indistinguishable from “normal” kids in an open classroom setting. So it’s clear to me that in most cases, the inappropriate expectations are what cause the “disorder” to even exist.
I would only add that I hope your book also looks at the long-term outcome studies that have been done over the last 40-50 years. Despite plenty of research done by people who really wanted and expected to find a positive treatment effect, there is no evidence at this point that “treating” ADHD with stimulants has a positive impact on any major outcome area, including academic test scores, high school completion, college enrollment, delinquency rates, social skills, or even self-esteem measurements. This is hard for some folks to believe, because the short-term effects of the stimulants can be quite dramatic in improving immediate attention to task, but apparently, paying attention in school to things that you find inherently boring doesn’t actually lead to learning anything new. Go figure.
Add to that the risk profile, including the not infrequent psychiatric consequences, including manic episodes and psychosis, and it seems quite baffling that anyone would advocate for this treatment for any child where any other method could possibly serve. It is a dangerous and ineffective approach to what is mostly a social problem.
Looking forward to reading your book!
—- Steve
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Hi, Vikki,
I am interested to hear how you see us addressing what I see as the underlying basis for most of this chicanery and corruption: the DSM diagnostic system. You sound like a person who understands that labeling a person is the first step to dehumanizing them and their distress, and we can all see the results. But anyone who wants insurance payments for providing service has to diagnose.
What do you think of these DSM categories, and what can be done to remove this flimsy justification that underlies all of the drugging we are so uncomfortable with? I’d love to know what action we can take to change this pattern, because in my view, as long as we can label a child or adult with a “mental disorder” based on whatever subjective criteria we as a society decide constitutes such a disorder, we can continue to blame the victims and will continue to hurt those we purport to help.
If the field can be reformed, how do you think we can do it?
—- Steve
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Besides which, the drugs don’t have a scientific basis for their use, either, at least as far as long term outcomes are concerned.
Go, Acupuncture!
—- Steve
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I’m just saying that Conservatism is no better. The “conservatives” are the ones who are always in favor or reducing or eliminating any regulation that stops businesses from doing whatever they want, and supports allowing corporations and rich folks being able to buy elections. If we’re going to rein in Big Pharma, we aren’t going to do it by letting the so-called “free market” do the job. We’re seeing the results of the “free market” right now in the “mental health” world and it SUCKS!
I don’t think the split should be between Liberals and Conservatives. It should be between those who believe in empowering those who have to live with the oppressive society we’ve created, or empowering those who already have power to continue to oppress more easily. There are folks at both ends of the political spectrum supporting either of those viewpoints. Unfortunately, most, whether “liberal” or “conservative,” are better described as “sold out to our corporate masters.”
I frankly don’t have respect for almost any of them.
—- Steve
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Jonathan,
You’re in Portland?!! Me, too! We should get together some time and chat – I sense we’d have a lot to talk about.
As to this skepticism about acupuncture – in Asia, they have done operations using acupuncture as a pain relieving treatment for centuries. I think we’d know from the patient pretty quick if the pain relief was imaginary! Aside from which, even if it’s “only placebo,” apparently, that’s true for the SSRI antidepressants, too, and people sell them for billions of dollars. The placebo effect is important and not to be disregarded as “not real.” If we can get the same effect with a few needles, a lot less money, and almost zero side effects, why wouldn’t we do it?
— Steve
PS My wife is a doula and has seen acupuncture be used on more than one occasion to induce labor. Can’t tell me it has no effect!
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I know what you mean, though. Most people have a gut-level suspicion of the idea that their brains are broken and they need drugs to fix them. They can be persuaded by the authority of psychiatrists and the primacy of “science” or more properly of “scientism” (the believe that “science” is the all-powerful supreme being that should guide our lives, and that questioning the dictates of its “priesthood” is akin to blasphemy), but deep down, there is still this little voice that says, “Yeah, but my life IS depressing. I SHOULD be depressed! There is really nothing wrong with my brain.” Most of the “true believers” act more like they are hypnotized or indoctrinated and haven’t really thought about whether they believe what they’re saying or not. And of course, there are a number of the big psychiatry bosses who are well aware that they are spewing nonsense with the purpose of controlling market share. But I’d say most people’s belief in biopsychiatry, while it may be fervent, has very shallow roots.
— Steve
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This supports the fairly obvious notion that different personality traits have different social survival value and that we need a range of such personalities for a successful society and a successful species. The problem is more that creativity and “loose associations” are less accepted and more criticized in our society than any time in the history of the world. Drones aren’t allowed to be creative. So we pathologize divergent thinking and drug our most creative folks into submission. And some escape by becoming writers or comedians. Lucky for them!
—- Steve
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Pretty weak. “The AACAP says so, so it must be true.” Doesn’t really answer your question, does it?
—- Steve
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Just a reminder: NCLB was a CONSERVATIVE (or I should say “neoconservative” – no real conservative could approve of the waste of money) program championed by George W. Bush, but pushed for years by his neocon colleagues. I remember talking about it way back in 1982, when I was getting my MS in education – it was stupid back then, and it’s stupid today, but it was always a big draw for those ideologues who wanted to see “accountability” without any understanding of the vast number of variables that would affect testing outcomes, socioeconomics being the most prominent. It’s been said by competent social scientists that you could substitute socioeconomics for test scores and get almost exactly the same proportionate results.
Why are you so down on liberals and blame them for everything when most “conservatives” are just as rigid in their own views? Isn’t the problem ideological rigidity, rather than a liberal vs. conservative split?
I notice you didn’t answer my last question, either…
—- Steve
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And you SERIOUSLY don’t think that same exact statement applies to a large percentage of conservatives?
Most people, regardless of political persuasion, are too afraid to be wrong to accept genuine feedback or to acknowledge when the facts undermine their cherished belief system. Real scientists are few and far between.
— Steve
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The fact that Psychiatry’s ugliness is paralleled by general medicine does not make me feel more forgiving. Allopathic medicine was absolutely BRUTAL in the late 19th and the 20th century (and continues at a more subtle level to the present day) in framing any other practice as ‘quackery’ and assuring that midwives, chiropractors, homeopaths, naturopaths, and any other medical specialty was either subordinate to the MD or was eliminated from competition completely. The results were particularly ugly in the field of childbirth, where ineffective and dangerous methods were instituted and the death rate for women and children rose after birth was moved from home to the hospital, mostly due to uterine infections caused by physicians who did not wash their hands, even after having come directly from working on a cadaver. While maternal and infant deaths have decreased dramatically since, it appears to me mostly due to an increase in antiseptic procedures plus the introduction of antibiotics. Home birth still comes out as a safer option, and doctors still make things worse in the hospital with dozens of unnecessary and often counterproductive interventions.
And that’s just childbirth. From dropping the recommended cholesterol levels based on industry-inspired “studies” that supported more drug sales through the impressive “Vioxx scandal,” allopathic medicine has a pathetic record when it comes to recognizing the need to change its practices or recognizing the potential contributions of other healthcare professionals. Psychiatry fits very nicely under the AMA’s mantle.
—- Steve
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They don’t even tell us how predictive the ‘improved’ predictiveness of the “stress scale” is. It may be the predictive power went up from one out of 50 to one out of 35. It seems like BS to me.
—- Steve
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I agree 100%, but we should not forget that increased psychiatric treatment also means increased drug use, and some of those drugs by themselves increase suicidal feelings and actions in otherwise healthy individuals. So I think it’s a one-two-three punch of invalidating one’s personal experience (your feelings or the reason they arise is irrelevant), conveying hopelessness (you’ll never recover from this, you are now officially disabled for life), and giving drugs that exacerbate or even help create feelings of suicidal or homicidal intent. If you tried to increase the suicide rate, you’d be hard pressed to come up with a better plan.
And I think the reason they can’t follow the results of their own investigation relates to the religious nature of the psychiatric profession. Since the diagnoses themselves are only held up by general agreement, and nobody really knows or understands what’s really going on in any of these “diagnoses,” anything that questions this structure is deeply disturbing, as if you’d told a dedicated fundamentalist that his/her god or holy figure was not real. The reaction is visceral and irrational, and the easy solution is to somehow blame the victim, who has less power, for failing to respond as they should have to your “helpful” intervention. Same thing happened when the WHO study in the 90s showed dramatically better schizophrenia outcomes in developing countries – they didn’t believe it, so they re-did the research. When it showed exactly the same thing, they attributed it to cultural differences and inadequate or incorrect diagnostics in the offending countries who had dared to show up Western medicine.
The narcissist can never be wrong, and anyone who threatens him/her must be eliminated, even if it’s their own studies. The truth almost always takes a back seat to preserving the ego when psychiatry (or medicine in general) is involved. Not to mention the threat to a lot of people’s bank accounts…
—- Steve
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I think the idea of “sectioning” and the idea of forced treatment need to be completely divorced from each other. Someone can be temporarily held for his/her own safety without having to DO something to him/her! How’s about we create a safe space where they can relax, take a bath, get some food, get some sleep, and talk to someone about what is up if they want to? Add some good social service support to address issues of poverty, victimization by parents or partners or other adults, general disempowerment, and so forth, and you might be able to turn things around pretty fast for a good proportion of these folks.
I worked at a suicide hotline for years, and did involuntary detention evals for a bit after that. I hated the latter job, because I felt awful sending anyone into the hands of those monsters who ran the psych wards, but I helped many dozens avoid that trauma. I never found a depressed person who would talk to me whom I could not help feel a little better, at least temporarily. Listening and asking good questions really DOES help, especially if you really care about the answers. And empowering folks to find some way to regain a little control over their environments without ordering them around really helps as well. Unfortunately, most of the time the MH industry sees DEPRESSION as the problem, where as I see depression as an indication of another problem the person can’t find a way to solve.
Point being, setting up a safe place for suicidal people to hang out and talk to staff if they want to is a very realistic plan. Nobody is endangered, and the odds of at least partial resolution will go up dramatically. Why is being held equivalent with needing forced treatment? It should not be.
—- Steve
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I am not judging the parents in this situation at all, nor do I think Faith is judging them. It’s the police response that is disturbing. And I believe that police response reflects our ongoing belief that people with “mental illnesses” are dangerous and can’t be talked to or reasoned with. I was involved with a friend whose father called the police on him because he was being threatening. The police did an excellent job of talking to him and encouraging him to find some other place to stay for the night and did not detain him. I can tell you, he was detained before and had treatment enforced on him and he was terrified of being detained again.
And I think that’s the other issue, and the place where I take issue with where NAMI has traditionally come from – I think we need to recognize that there are VERY GOOD REASONS why people resist “treatment” with drugs, and why people fight like hell to avoid being forced into more treatment. It’s not because they don’t know they’re having problems, it’s because the “treatment” is worse than the disease! And involuntary trips to the psych ward can be incredibly traumatizing, with violence and being strapped to a table and forcibly injected with drugs that numb the mind and subdue the spirit, and being held in locked rooms and “examined” by people who don’t seem to give a crap about who you are or why you are feeling or acting as you are, and having to act a certain way to be allowed to escape. It is often a horrific experience that no one would want to have to go through. It is anything but therapeutic.
So the first thing we can do to is to raise awareness of the fact that “mental health treatment” as generally delivered doesn’t seem to work for a lot of people, and stop trying to force them to “comply” with something that they know to be destructive to their life. The second is to start supporting the development of alternative approaches that involve voluntary placement in a place where people LISTEN to you and CARE about what is happening. And the third is to stop talking about “chemical imbalances” and start talking about trauma and the confusion of roles and expectations that characterize our modern society, and drive much of what passes for “mental illness.”
A tall order, I know. I would love to see more leadership from NAMI in this direction, but there is a lot of resistance within and outside NAMI to revising the “neurobiological brain disease” view of mental/emotional struggles. This view is very convenient for those who would like to suppress dissent, but does great harm to any efforts to create improved response from police and other first responders.
How about we start with a training for police, designed and delivered by consumer/survivors and their friends and families? I think that would be a great place to get a serious conversation going that respects all sides of the issue.
—- Steve
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I also wonder how much substance abuse among the “mentally ill” is an effort to reduce side effects from the helpful “medications” they’re taking for their “mental illness.” I agree with Nijinsky (as I almost always do) that it seems obvious that traumatized people are both more likely to use drugs and more likely to have “mental health symptoms” as defined by the system. But I think Copy Cat is also right that some people do become psychotic or depressed or anxious as a result of substance abuse. Of course, the researchers also neglect to examine the number of people who become psychotic or depressed or anxious as a result of their “treatment,” but that’s another issue…
—- Steve
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Sera,
Awesome post, as always. The horse analogy immediately put me in contact with my feelings about school as a kid, feeling like I didn’t fit there, and yet knowing with a deep part of me that NOT fitting there was a good thing, that if I ever let myself “fit in” I’d lose who I was completely. I was always baffled by those who were able to be comfortably in that environment – it was pretty clear to me that, nice as some of my teachers were, the system they were participating in was intended, to a large degree, to “break” me in the same way a horse is broken.
As to people in the field, so much of what they think and do is guided by projection. Don’t know if you’ve ever read Alice Miller, but she does a great job of describing how we take what was done to us and project it onto others, putting ourselves in the role of the person who harmed us and justifying our harmful actions as “for their own good” (which is the title of one of her books). It seems to me that facing up to the fact that they either don’t know what they’re doing or that they are doing harm brings up the pain of prior experiences when the clinicians themselves were mistreated and disempowered, and unless they’ve had some seriously good therapy themselves, they can’t tolerate this bad feeling. So they project it onto their clients and try to rub it out in them so that they don’t have to feel it in themselves. It’s a theory that goes a long way to explaining why good people can do some very terrible things. The only piece I’d add is that the clinical folks themselves are expected to comply, and rebels (like me) who speak their minds are quickly marginalized or labeled as troublemakers, because they threaten the fabric of everyone else’s defense mechanisms.
It is sometimes very hard to know if I’m making any difference, but what difference I think we do make as insider rebels is very, very gradual and incremental over time. I have definitely seen the impact of empowering clients to say NO loudly and clearly, and truly believe that is the quickest and most effective way to reform the system.
Thanks again for the blog and for all you do for your clients and for all of us working in or living with “the system.”
— Steve
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AH, but we don’t work for the State. We’re a private nonprofit, and are watchdogs of the state.
They made your parenting contingent on taking psych drugs? That is just awful. I can truly say that I would not put up with that, and the judges here would not, either. Perhaps I do not appreciate how lucky I am to be in Oregon. Bad as it is, it sounds like our system is one of the best. Which is VERY scary…
— Steve
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CASA stands for “Court Appointed Special Advocates.” They are volunteers who advocate in child abuse/neglect cases where the State has assumed custody of children for their own protection (theoretically). You can bet that my CASAs are very well trained about psychiatric drugs and labels! And I’ve gotten a number of kids off psych drugs or kept them from getting on, and also helped create some scrutiny that did not exist back in the 90s when I started, including a new law and state policy. It’s a good place to do good work. Sometimes they’re called “Guardians Ad Litem.” I can see what they have in your area and get someone to call you if you’d like. We’ve also gotten kids back to moms when the State wanted to terminate their rights or keep them in foster care perpetually. I’m not guaranteeing anything, but a CASA can really help bring rationality back to a crazy situation.
Counting one’s blessings is always good, but not always easy. You clearly have some gift for determination and toughness, which is a great survival tactic! I bet your kids know you’re still out there fighting and they still love you and always will.
Hang in there!
—- Steve
—- Steve
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Julie, I am horrified and wish I were surprised by your revelations. It is always dangerous to put anyone in the total charge of another group of human beings. It is so much worse when there are no real criteria for determining who or why or what can be done to “help” someone. To invalidate someone’s traumatic experiences in that way, not to mention continuing to traumatize the person year after year, is in some ways a worse crime than the original trauma, because these people are supposed to HELP! It is a total betrayal. I’m glad you’re still fighting and I’m glad you’re on the right side, because they will one day regret what they did.
mjk, I wish you were in Oregon and I could set one of my CASAs onto your case. I don’t know if we’d win, but we’d give them something to think about. I am impressed that you’re continuing to courageously fight despite the awful things that have happened to you! Let me know if there’s any way I can help.
—- Steve
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Hard to say on both counts. Some of these attorneys are awesome and some are just cashing a paycheck. Getting her a good one could really help. She could also benefit from a CASA volunteer or Guardian ad Litem, which is what I do. They are responsible for advocating for the best interests of the child, but are lay people and in the main are pretty skeptical about psychiatry.
As for petitions, some of them seem to be very effective and some are not. I think it not only puts pressure on the authorities, it also raises awareness of the issue among people who don’t know about it. It certainly can’t hurt, and might make a difference.
—- Steve
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Big changes are happening these days through State legislatures. It might be a good place to start with this kind of legislation. If I’m not mistaken, the prior movement to protect the civil rights of the “mentally ill” started with state statutes preventing the willy-nilly detention of anyone a psychiatrist declared insane. I think that’s the way we get this going. Congress is simply too much in the pockets of the pharmaceutical industry, and won’t bite the hand that feeds them.
—- Steve
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Sorry, somehow my prior post got re-posted.
I am interested if Justina has an attorney in all this, and if so, where that attorney’s voice is. In Portland, all kids in the child welfare system get their own attorneys, and their job is to advocate for what the CHILD wants. And I’d bet my mortgage that Justina wants to go home.
This is one of the worst cases I’ve ever seen, and I have worked as an advocate for kids in the child welfare system for 17 years. Have you considered starting a “change.org” petition on this one? I’ve seen it work on outrageous situations like this one. Just a thought…
Thanks for all your advocacy, and for giving us the real data. This case is a superb advertisement for why enforced treatment is SO dangerous and should never be allowed.
—- Steve
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It is not a left-right issue. Most of our congress is sold out to the moneyed interests. It’s about corporatists vs. those who believe that human beings are more important than dollars. There are plenty on both sides of the aisle who believe anything that will get them a campaign contribution, and the pharmaceutical companies are as ruthless as they can be in spreading their dollars around to all of the Repiblicrats who bow down to them, regardless of their “liberal” or “conservative” labels.
I agree about “right bashing,” but “left bashing” is just as unproductive. I’m more liberal than most who call themselves liberal (I actually BELIEVE in helping the poor and the downtrodden!) but I’ve been fighting this issue since the 90s, when everyone thought I was out of my mind for not supporting the “new science” of “brain disorders.”
This is NOT a left-right issue!!!
—- Steve
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It is not a left-right issue. Most of our congress is sold out to the moneyed interests. It’s about corporatists vs. those who believe that human beings are more important than dollars. There are plenty on both sides of the aisle who believe anything that will get them a campaign contribution, and the pharmaceutical companies are as ruthless as they can be in spreading their dollars around to all of the Repiblicrats who bow down to them, regardless of their “liberal” or “conservative” labels.
I agree about “right bashing,” but “left bashing” is just as unproductive. I’m more liberal than most who call themselves liberal (I actually BELIEVE in helping the poor and the downtrodden!) but I’ve been fighting this issue since the 90s, when everyone thought I was out of my mind for not supporting the “new science” of “brain disorders.”
This is NOT a left-right issue!!!
—- Steve
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I am so sorry to hear of that awful story! The most amazing and disgusting thing to me about psychiatry is that they don’t even bother to ask about what happened to you. I had a developmentally delayed girl who was 17 but mentally about 6 who was hospitalized with “bipolar disorder” and “treated” with Lithium, despite the fact that she had only started acting out after she’d been raped two years before. Another psychiatrist had been seeing a client for 15 years, said she was an “intractable case of depression” in which he’d “tried everything,” and when I asked him what had caused her to be depressed, he had no idea and wondered why I’d even bother to ask such a silly question.
They take away our power by taking away our stories and treating US like the ones who did something wrong. Well done for keeping up the fight despite it all, and thanks again for having the courage to tell your story. Are you getting any help with the situation with your girls?
— Steve
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Good clarification, Wayne. Which I guess goes to reinforce the finding that the system or school of thought applied by the counselor is much less important than the practitioner’s ability to communicate effectively with the client. My belief is that ALL good communication involves choice and empowerment. I spent years using my own approach to counseling for years before reading about motivational interviewing. I then discovered that I was doing “motivational interviewing” the whole time. I’d essentially re-invented motivational interviewing by observing what did and didn’t work and focusing on empowering the client. You can call it whatever you want, but if your purpose is to enforce your views and your will on your client, you will hurt your client. It’s kinda that simple.
—- Steve
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It is fascinating for Pies to talk like this about the client “wanting to hang onto his/her symptoms” because they receive some secondary gain from them. This is right out of the world of Freud and psychotherapy/psychoanalysis! It seems like the ultimate irony that a biopsychiatrist like Pies, whose ilk have been committed since the 80s to eliminating the influence of psychotherapy or at least dramatically limiting its scope, should resort to psychodynamic explanations or techniques as a means of manipulating his clients into “taking their meds.” In a weird way, it approaches an admission that the symptoms themselves have nothing to do with biology. Though I doubt he’d ever admit that.
Weird!
— Steve
P.S. Love the new picture, Marcia! Thanks for another enlightening article!
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I don’t think it’s entirely imaginary. I do trainings for new volunteers for the CASA (Court Appointed Special Advocate) program here in Portland, OR, and of course, I go into the DSM and its subjective diagnoses and the damage that drug use has done to foster kids and others in society. 5 years ago, I used to get a good deal of discomfort from some of the trainees about questioning the “professionals” who “must know what they’re doing.” The last few years, it’s gotten easier and easier, and lately, the bulk of the people in the group are already aware of what I’m saying, have big concerns about Big Pharma, and understand that there is a lot of politics behind the “medication movement.” Culture change takes time, but it is happening. There are so many more articles in the NYT, on NPR, in the Washington Post, that are critical or at least questioning of the current paradigm than there ever used to be, and this is having a big impact.
That being said, I also agree that writing back and forth on MIA makes only tiny scratches in the surface of the issue. It actually is much broader than the use of psych meds – it has to do with our society’s belief that “the authorities” should be able to decide what is what, and those authorities being bought off by corporate interests from one end of the government to the other. It is going to require a BIG shift in our approach as a country to take this movement down. Psychiatry is just one part of it, and they’re not going to go down without a fight. I am just not sure how to rouse the public sufficiently to fight back. We need a critical mass of angry people, and I am not sure we have it yet.
—- Steve
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I meant Milton Erickson, not Erik, though Erik was quite a fascinating and competent practitioner as well and certainly focused on communication rather than enforced brain chemistry manipulation.
I am still interested in hearing your reply…
—- Steve
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I would have chosen a different metaphor as to where they have their heads. Hint: it’s very dark and doesn’t smell to good…
— Steve
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I can see it would be very uncomfortable for most psychiatrists to post here, though Mark and Sandra seem to be managing it OK. Perhaps the perspective to consider is why there is so much anger in the consumer world toward psychiatry. As you just commented, psychiatrists used to talk to patients but don’t seem to take the time any more. This, combined with the dishonesty about causes (pretending to believe in “chemical imbalnaces” when they’re not known to exist) and denying or minimizing adverse effects (can’t tell you how many kids I know from my profession who got “bipolar” diagnoses after adverse responses to Ritalin or SSRIs) leads to anger and resentment and distrust. And amazingly, the best cure for anger, resentment and mistrust is – ta daaaaa! – LISTENING TO THE CLIENT. This just seems so obvious to me that I just can’t even fathom that idiot I described above being paid $200 an hour to throw drugs at a person he does’t even bother to get to know. How can that be permitted to ever happen, Steve? But he is being empowered by the psychiatric system to continue to practice that way.
I hope that the younger psychiatrists really are interested in figuring out where the profession left the path of wisdom. But I think the most important point is for the profession or the professionals to ADMIT that the path of wisdom was, in fact, left behind many years back, for reasons that appear to be more economic and egotistical than scientific. Perhaps we will see a resurgence in young psychiatrists reading Erik Erickson and trying to construct imitative “word salad” as a means of reaching a person who is deep in a psychotic state. Or maybe they will read the literature on Soteria House or Open Dialog and start some new initiatives. But I’m not holding my breath. I believe you dramatically underrate the powerful interests behind this movement away from talk therapy and toward drugging. There is too much money being made for the paradigm to peacefully change with a new generation of psychiatrists. It’s gonna be a fight. Look what happened to Loren Mosher, an insider who dared to challenge the dominant paradigm, and was excoriated and shunned, even though he was absolutely correct in his conclusions.
I do think you’re right about one thing. What is funded is what practiced. Perhaps an emeritus psychiatrist like yourself can put some serious energy into convincing the profession to advocate for funding things that have long term benefits, rather than continuing to focus on short-term symptom reduction and short-term profits.
—- Steve
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And alcohol is a dynamite antianxiety agent! There is that problem with dosage control…
— Steve
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As one Steve to another,
I agree that there was a time when talking to clients was the primary intervention for psychiatrists. There are some amazing stories from Laing and Erickson and others about how to accomplish this. So why, in your opinion, did the psychiatric profession stop talking to their clients? How did we get to this weird place where (and this is really true) a psychiatrist I knew said he was “treating” a woman for 15 years for depression, and had “tried everything,” but had never even once in 15 years asked her what she was feeling depressed about? And I am not buying the “insurance companies just don’t pay for it” argument – good psychiatry is not a function of how much money you get paid. It doesn’t take long to ask that question, and he had 15 years to do it in. Besides which, when I asked him what she’d been depressed about, he acted as if it was an irrelevant question. How did a person’s psychological understanding of their own emotional state become irrelevant?
I’d really like to know what you think, as you appear to have been present throughout the long transition away from talking into becoming brain mechanics. How did it happen? And more importantly, do you see how the profession can ever move back in that direction again?
—- Steve
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I am sure this must be due to an increased genetic vulnerability to becoming a bully if you’re genetically predisposed to being psychotic. Except that it extends to victims of bullying, too, so somehow the genetic vulnerability for psychosis must somehow make you more vulnerable to both becoming a bully and being bullied. I realize this may seem far-fetched to some, but since the brain is everything and everything is in the brain, we have to somehow make these results fit into our brain-chemistry dogma.
I suppose there is an outside possibility that both being bullied and bullying are associated with trauma and high stress, but not EVERYONE who is bullied becomes psychotic, so it must somehow be the fault of the bully. Or the victim. Or both of their brains. Or something like that.
—- Steve
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Amen, Chaya!
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For Keith Connors to say this publicly is pretty huge. Connors was the creator of one of the more famous rating scales that teachers and parents used to rate a kid for “ADHD” and other “symptoms.” He was 100% mainstream. Nobody’s going to get away with calling him an “antipsychiatrist.” I’m pretty jazzed to hear that he made these kinds of statements to the NYT. When the insiders start calling it a disaster, it is hard for even the most hard-line psychiatric adherents to pretend that it’s all OK.
—- Steve
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Clearly, there would need to be discussion of what the conditions would be, and clearly (in my view), it would be for some action and not some postulated risk, and clearly, it would not be predicated on the assumption or assessment of some form of “mental illness.” My point is more that this discussion, of what constitutes a danger to others and how overt and immediate that danger has to be and so forth, and separate it 100% from any discussion of enforced “treatment” for an assumed “mental disorder.” At this point, it is assumed that when someone is detained for “mental health” reasons, they can then have “treatment” literally forced down their throats. I’m saying it would be easier to stop forced “treatment” than to completely eliminate the use of force to stop harmful actions, wherever one might choose to draw that line. So we might have people being held against their will because they threatened to kill their neighbor or lit someone’s toolshed on fire, but that would NOT give the authorities any right to DO anything to them – they would still retain their right to refuse treatment regardless.
Or to put it another way, we argue to stop forced “treatment” in any setting, and have a separate discussion about how to protect ourselves and each other from people choosing to hurt us.
And you’re right, it’s not simple, but it does kind of make the point that being dangerous and needing “treatment” are not synonymous, and that even though a person may be struggling emotionally, they still retain their basic human rights.
—- Steve
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What a crock! Almost every one of these shooters was receiving or had recently received “mental health treatment.” A lack of treatment was certainly NOT the problem! Treatment that doesn’t work or makes you more violent is the problem.
—- Steve
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I’d put it another way – “Mental illness” (which I don’t regard as an illness per se) is not the cause of violence, it is generally the result of violence. And yes, violence can be passed on from those who are victimized to a new generation. So what we should be working toward is ending violence and abuse.
I will point out, however, that despite the violence you’ve been subjected to, you are here protesting violence rather than carrying it on. It takes a lot of courage to do that, but people do make that decision all the time. So the second thing we need to do is help those victimized by violence to heal so they don’t continue to perpetrate it on another generation. As you well know, this is NOT accomplished by locking people up and shooting them full of Haldol!
— Steve
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I wrote this on another thread but it didn’t seem to post. It occurred to me that there is an interesting comingling of the idea of detaining someone for being violent or threatening, and forcing “treatment” on them. I wonder if there is a way to separate these two issues? For instance, if one of the TAC types points out that some people with “mental illness” labels become violent, we can agree that violent people need to be detained for the protection of others. But why does it follow that they need “treatment?” Can we not agree that force is necessary for protection but does not take away a person’s right to accept or refuse medical treatment? If we can make this distinction, we’re no longer in the place of saying, “Well, force is never justified” and sounding naive. We’re simply saying that enforcing “treatment” is never justified, even if force may be needed for protection. This also leaves more room for entertaining the question of whether “treatment” actually reduces or in fact increases violence, as you documented in your article.
I am also glad you brought up the point about assaulting “mental health workers.” I agree 100% – I am sick of reading incident reports about how a kid “assaulted staff” after the staff person laid hands on him/her. It’s not assault if someone is trying to grab or force you or physically handle you in some way. It’s self defense.
Thanks for another great article. I’d be interested to hear if anyone else sees value in separating the issues of using force to protect vs. the use of forced “treatment” in our more public discussions of this issue.
—- Steve
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Yeah, they did kind of give the doctors a pass, didn’t they? The reason we have to have prescriptions for these drugs is because the doctors are presumed to know more about them than we do and are able to filter the truth from the marketing and give us good advice. The abdication of this responsibility is central to the current scene developing. No amount of marketing can force a doctor to prescribe something. Only professional laziness or unethical acceptance of kickbacks can lead to this level of bad prescribing. The doctors as a group could change all this more easily than any other group. But they don’t, do they?
— Steve
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I actually agree that psychiatry itself will not be changed by science, because it’s not a scientific endeavor. It’s more a cross between a religion and a multinational corporate conglomerate. Where I agree with “registered…” is that those who are NOT embedded in psychiatry will need data to convince them that psychiatry’s barking up the wrong tree.
I also agree with you that most people don’t want to believe that evil motivations exist – they want to believe that psychiatry as a profession is at worst misguided, and that giving them a chance to review the data will lead them to enlightenment. It is hard for people to accept that the top dogs of psychiatry are operating on a pure business model that is interested in capturing and controlling market share and aren’t really too upset by the fact that a certain number of their clients are permanently disabled or die as a result of their “treatment.” But again, saying this to most people does result in alienation, precisely because they don’t want to believe it.
I’m not sure what the answer is, but telling everyone that psychiatry is evil is not the first step, and may never even be necessary. If WE know the ill intents of the profession, we can strategize how to defeat them without needing everyone to agree with us. I think it’s more a matter of collecting those who are not ill intended and banding us all together around the idea of making things better for those who are looking for help. Those who believe in that will rally to the cause, and those who don’t will identify themselves for who they really are.
Of course, in the end, it’s about power, and taking back power from the powerful is scary and leads to retaliation inevitably. But 7 billion people can generate a lot of power, if we’re all pulling in the same direction. How to get that coordination of effort is the real question. Whether or not the psychiatric profession, or at least its top leaders, have evil intentions is not something that anyone in the know should doubt, but announcing that publicly probably isn’t our best marketing tool.
—- Steve
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I am impressed that the comments are so supportive. I think it makes a HUGE impact for a psychiatrist to be publishing these comments in a national news outlet. I also think you have a gift for stating these things in a way that doesn’t feel attacking or humiliating to the current practitioners (at least those with enough ethics to actually care about whether they’re harming their patients or not). Thanks for having the courage to put your voice out there in public. It is a critical part of this movement to get professionals to take these concerns seriously, and both the content and the intent of this article will make it easier for other professionals to “come out” and acknowledge these very real concerns.
Thank you!
— Steve
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My thought is to talk to others who have “been there,” both those who have provided family support, and more importantly, those who have found their own pathway to a better place despite suffering from psychosis.
If you have read Robert’s book, you’ll know that it is not uncommon for these drugs to “work” at first and then stop working, due to the physiological changes that happen in the brain as a result of long-term use of these drugs. So he really is physiologically impaired at this point, even though he may not have been at the start. So just stopping the drugs cold turkey is probably a recipie for disaster. But I do think if he says he wants to stop taking the drugs, the place to start is to understand and accept that this is his goal and help him start working towards that goal.
I know that sounds impossible, and maybe it is, but there is a lot of expertise in the “survivor” community on how to do this. Will Hall’s book, “The Harm Reduction Guide to Coming Off Psychiatric Drugs (see http://www.madinamerica.com/2012/07/coming-off-medications-guide-second-edition-free-download/ for a downloadable copy) might be a good place to start. I also suggest you find a “hearing voices” group or similar support group for “voice hearers” in your community, as well as any kind of cafe or other social meeting site where folks who can relate to your son’s struggles might hang out.
The starting point to helping anyone with any situation is empathy. You seem to have a lot of it. Try to put yourself in his situation and not invalidate his observations or concerns, but see how things look from where he sits. That may lead you to some further insights on what to do. But the truth is, there is no magic bullet or golden pathway to health or sanity or “adjustment” – these are things that he will have to struggle to determine for himself – where does he want to go, what does he think is important, what kind of life does he want to live. And he may decide things you disagree with. Accept that and see if you can help him figure out what he wants and how to get there, with the help of others who have traveled the path before him. That’s my best thinking.
Good luck, and thanks for caring!
— Steve
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I just had a thought that I’d like to hear others’ feedback about. The reason always given for involuntary detention is protection of the person or others whom that person might harm. It’s difficult to argue that this should NEVER occur, no matter what, though different arguments exist as to how and why and where such a person might be held. (BTW, I am NOT a proponent of involuntary detention in a “hospital” whose job is not to help you but is more to keep you under control!) But the biggest problem I have with involuntary detention is that it de facto authorizes involuntary DRUGGING of those so detained.
What if we changed the discussion? What if our argument became, “OK, we acknowledge that there may be times when a person needs to be protected by holding him/her against his/her will in some kind of facility, be it jail or a hospital or a halfway house or whatever. But that does NOT give anyone the right to force treatment on that person under any circumstances.” If we could decouple the need for detention (which can be argued separately in a different venue) from what should be the absolute right to refuse treatment in whatever form, we’ve taken away the argument that “well, there are those dangerous people who might hurt someone out there and have to be detained for everyone’s safety” and put the focus back on the enforcement of DRUGS as “treatment” as a separate and critical conversation.
Involuntary detention should not be synonymous with involuntary drugging. Anyone think there is value in talking about them as separate issues?
—- Steve
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My objection is not that this isn’t a real phenomenon, but that it is caused by being required to do shift work, not by something wrong with the person who has to mess with his/her sleep schedule in this way. Just like all pharma/psychiatric ploys, we take a condition that is a likely result of a stressful environment, and instead of modifying the environment or acknowledging its impact, we blame the person who is suffering for not adapting properly to the environmental expectations. It’s like they’re saying, “Everything is perfect as it is, and if you don’t like it or can’t adjust to it, there is something wrong with YOU.” This idea that the status quo is holy and unchangable and that humans have to adapt to whatever is thrown at them is a very nihilistic approach to life. Humans are inherently creative and want to adapt their environment to their needs, and get depressed and disturbed and upset when they have to just put up with adverse conditions. But those who want to change the status quo are demonized and pathologized, while those benefiting from it laugh all the way to the bank. It’s an evil system, and I feel bad for the shift worker, and don’t begrudge them a sleep aid if that what they feel they need, but let’s be honest about the real cause – it’s caused by the abnormal schedule they’re required to keep, not by a “disease” or “disorder” in the person who has trouble adapting to these abnormal requirements of our society.
—- Steve
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I agree, Ted. The other issue is that most of our politicians are bought off by these same criminal corporations. So it’s hard to get any attention in the legislature, unless you’re talking about someone like foster kids or the elderly with Alzheimers, and even then, the only action is a warning label on the box, and not a real change in practice.
I really think we need to work on getting legislators out of the influence of the corporations. We need to elect people of integrity, and to do something about campaign laws to prevent corporations from owning our legislators. Psychiatrists aren’t the ultimate powers in this situation – it’s the corporations that are calling the shots, and the psychiatrists are their compliant minions.
—- Steve
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I don’t know why this surprises anyone. But as always, the authors soft soap the real implications – namely, that the concept that there are certain people who will inevitably develop “psychiatric disorder” based on biological and genetic variables is a complete and utter lie. Stress is the most important factor in any “disorder,” and reducing childhood victimization is the most effective tool there is for reducing adult “mental health problems.” But to recognize this would require the adults to take responsibility for screwing up our children, and we’d perhaps have to consider making some big changes in our approach to childhood. It’s much easier to blame the kids and their brains, plus it makes a lot more money. Reducing early childhood risk and harm is not a profitable enterprise.
—- Steve
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This sounds very much like the writings of Robert Pirsig in “Zen and the Art of Motorcycle Maintenance.” He spent a lot of time in the high country in or around Yellowstone and analogized it with the “high country of the mind” that he explored there. He did eventually have a psychotic break, and received massive electric shock treatments and one day came to consciousness with no recollection of who he had been. The book is partly a story of his recovery of himself. If folks have never read it, I’d recommend it. It’s one of the best books I’ve ever read, and has great applicability to this theme of the safe and bland vs. the wild and mysterious.
—- Steve
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Go, Jim!
— Steve
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Well, if he’s saying an approach should not be driven by ideology, he’s the pot calling the kettle black! I don’t know if I can think of a single person who is more ideologically driven than Torrey, and more unwilling to examine any data that contradicts his dearly-held beliefs.
I admire your ability to be fair-minded in your critique. I do understand that some of his early writings were quite rational, but as of today, I find the man and his “views” utterly contemptible.
I never was very patient with hypocrisy…
—- Steve
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Well, if treatability is the real criterion for “mental illness,” I’d have to say that Whitaker’s book shows that it fails the test miserably.
Of course, the author never addresses whom the treatment is supposed to benefit. Lobotomy was very effective in making patients more docile, which the doctors and a lot of the staff felt was very beneficial. I’m not sure their “patients” would have agreed with them, had they retained the ability to actually decide and communicate their agreement or disagreement after the brutal procedure.
The author also does not address the possibility that what is called “mental illness” is actually a spiritual issue relating to the meaning of the person’s experience and their purposes as a human being on planet earth. I was surprised he never addressed this, as most of the religious arguments against psychiatric labeling and treatment (including the Dalai Lama, I’ve recently learned) focus on the presence of a spiritual entity whose experiences and decisions have a fundamental impact on things like suffering, orientation to reality, and happiness/satisfaction.
In the end, it was a lot of words to reach a very mundane conclusion.
— Steve
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The article is completely devoid of any concrete scientific observations. The use of terms “connectivity” and “dysfunction” make it sound scientific, but they haven’t presented any repeatable or measurable observation that would distinguish these people from “normal” people. The best we can surmise is that somehow the brains of people who are hallucinating or are intensely fearful are doing different things that people who are calm. But that’s kind of axiomatic, like saying that sleeping people have different brain activity than people who are awake.
Another scam article trying to spin the fact that people with “bipolar” diagnoses have nothing in common with each other into the idea that “something else is going on” rather than accepting the real conclusion that “bipolar disorder” is simply an unscientific description of a state of mind that some people experience, and has zero validity as a medical diagnosis.
— Steve
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This is a very important article, because this kind of suicidal behavior clearly cannot be blamed on the “underlying mental illness,” as people who are quitting smoking are not as a group suffering from any particular set of symptoms other than being addicted to nicotine. So it’s very clear in these cases that the violence, agitation, depression, and suicidal thoughts and actions are caused by exposure to the drug itself. By extension, this proves that such causal impacts on behavior can be created by drugs that impact the brain, including “antidepressants” and “antipsychotics.”
—- Steve
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Well, THAT is certainly a sobering finding! Very similar to the WHO findings about psychosis outcomes in developing countries being much better. Sounds to me like the technological approach to mental health strikes out yet again!
— Steve
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What I find really depressing about this story is that this kid, who was on all these drugs, was obviously suffering tremendously, and acting out on a regular basis, and yet somehow it was essential to the adults that he remain on all the drugs. It is pretty obvious that they weren’t making his condition any better, and easy to infer that they were making it worse. Why on earth would they continue a treatment that doesn’t improve the condition it is intended to treat????
And yet I see this all the time – kids are given drugs to improve condition A, which brings on condition B, and another drug to “treat” that, which leads to condition C, and pretty soon they’re on 5 drugs and condition A still persists, and condition B is worse than it even was when they had only two drugs (and of course never existed before the first drug), and the kid is in residential treatment because no foster home can handle him and he breaks windows and attacks the staff and THEY STILL THINK THESE DRUGS ARE HELPING!!!!
Good for him for getting off, and thanks to him for the awesome advice. This is such an excellent description of how and why kids get whacked out on 5 drugs at a time, and how parents and treatment providers get off the hook for their failures. Disgusting and yet inspiring.
Thanks as always for your insightful and engaging post!
—- Steve
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There is a study in Canadian J Psych from the early 2000s where they retrospectively looked at records of kids who had been prescribed stimulants, and something like 6.8 % of the records showed some level of psychotic symptoms. It is not rare. It is reflected on the label of Ritalin at the least, and I think Adderall as well, so I have to think there is more evidence of this. Of course, it should be a no brainer that stimulants can cause psychosis, since that’s part of how the dopamine hypothisis got its start, based on meth or cocaine users becoming psychotic on high dosages.
I am sure I can dredge up the reference if anyone is interested in looking it over.
—- Steve
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For someone criticizing you for not referring to scientific studies, his review was glaringly free of any references of his own. If this is the best that Danish psychiatry can do, they’re probably helping market your book by putting up such an incredibly lame rhetorical defense without so much as a single footnote.
Rock on, Bob!
— Steve
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The paradox is how we can call it treatment when at best it has no long-term benefits in the aggregate, and can cause the very things it’s supposed to address for many receiving “treatment.” But perhaps that’s not really a paradox. Perhaps it’s widespread delusion followed by widespread malpractice.
— Steve
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This is SO true! I saw an article recently about doctors having a high suicide rate. They did not talk about how many had seen a psychiatrist or what percentage were compliant with their meds or were resistant to treatment. They talked about the incredible stresses of being a doctor and how to create supportive networks so that depressed and hopeless doctors could talk to each other, as well as recommending changes in how we approach medical training. No “brain disease” talk when we’re talking about the privileged members of society. It’s understandable that DOCTORS feel depressed. But the rest of us need to buck up or drug up.
—- Steve
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It is ironic that those seeking substance abuse treatment are excluded, since the data I’m aware of suggest that when we control for substance abuse, “mentally ill” people aren’t any more dangerous as a group than anyone else. But people who use substances ARE more dangerous as a group! If we were to select a group whose second amendment rights were to be rescinded (not that I’d agree with such a blanket action in any case), it seems we ought to exempt the “mentally ill” who DON’T have a substance abuse problem, and focus on the substance abusers as the most likely to cause violence.
Of course, there’s also the use, sometimes enforced, of LEGAL substances that might push a person to violent action, but we don’t want to talk about THAT, do we?
Perhaps there are too many politicians and rich folks that have reported for substance abuse treatment and they can’t allow this “stigma” (aka prejudice) about violence be applied to them.
—- Steve
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I agree 100% with your comments. No society in the history of the world that I am aware of, other than our own, has ever entertained the idea that humans are just bodies and that there is no spiritual reality or entity involved. What that entity might be is and will probably remain a mystery, but that doesn’t mean it doesn’t exist. Your hardware/software analogy is excellent, but I’d add also that there needs to be someone operating the software, someone who decides which programs to run and what data to enter and what a desirable outcome is. None of this is addressed by the “human as brain” viewpoint.
Science is in truth a sub-study of philosophy. That’s why people get a “Ph.D.” even if they’re studying science. Psychiatry is based on some hard philosophical assumptions, such as “brain=Mind,” but tries to pretend that they are “obvious” or “unavoidable conclusions,” which is one of the classic sophistries used to slip unverified assumptions into an argument. In essence, they assume a conclusion and then reason from that assumption as if it is fact. And that, specifically, is what leads to the muddled confusion described in the article. Real science clarifies things. “Science” that creates more confusion is false science that rests on an incorrect assumption that the “scientist” is unwilling to let go of. That describes psychiatry to a tee!
— Steve
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Can’t argue with you – the study is almost meaningless without drug use profiles (licit and illicit) included in the data. However, I do find it amusingly ironic that their “predictor” genes predict the opposite of what they’re supposed to predict. Love to see them explain this one!
—- Steve
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I see a different spin being put on this. The kids are poor BECAUSE THEY HAVE SMALLER BRAINS!!! They are born to poor parents, who undoubtedly also have smaller brains, which proves that poverty is a genetic condition and we don’t have to worry about fighting poverty, because it’s really their brains’ fault after all. What an awesome discovery!
(Just in case anyone misinterprets, the above is to be read with dripping sarcasm and irony. But it wouldn’t shock me if some biopsych proponent came up with that interpretation for real.)
—- Steve
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This is super creepy. What I see in the future is that it becomes a condition of being released from involuntary detention – the equivalent of the yellow stars worn by the Jews in Europe during the Nazi occupation. It shows where NAMI is coming from, too, if we needed more evidence. So much for “person-centered care” and “recovery-based services.” If you are identified by your diagnosis and medication, it sure doesn’t sound like recovery is envisioned ever in your future.
—- Steve
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Brilliant as usual. It seems to me that disclosure actually legitimizes the conflict of interest, which would explain why disclosed conflicts are associated with higher degrees of bias. Your analogies are quite powerful and hit the nail on the head. A scientist with a financial conflict of interest is no longer a scientist – s/he is a business person working to make a profit. S/he should not be allowed to define such a vague thing as “mental illness” in a way that will benefit his/her personal bottom line!
I hope some attorney can find a place/time to file criminal charges against a conflicted psychiatrist. Even if it doesn’t work, it would sure be fun to watch!
I hope you do come to the USA – we need folks like you! And BTW, in my experience, most Americans view any British-sounding accent as being a sign of sophistication and educated wisdom. So it’s all good.
—- Steve
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People feel they are being experimented on because they ARE being experimented on! I’m glad you seem to acknowledge this fact, but I think it is best to be honest about this to the clients. That’s kind of what I think Moncrief is saying – rather than “I’m treating you for X disease or condition,” it’s more, “This drug sometimes makes people feel who feel like you do feel a little better, though it can also make you feel worse in the following ways.” Of course, the same could be said about marijuana or alcohol, which makes me seriously wonder if this kind of experimenting is very different from going down to the bar after work to toss back a couple before having to go home and face your family, or taking a couple of hits in the morning before heading off to deal with your crazy boss, because you won’t react as much if you’re high.
Taking substances can sometimes make people feel better, but I don’t think that’s a new discovery. It doesn’t seem much like medical practice to me.
— Steve
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All I can say is, WOW! What great courage you, the counselor, and these kids showed to have this discussion in a public school setting. I can barely imagine this being allowed, and I have to wonder what repercussions you and/or the counselor may experience once the psychiatrist gets wind of your discussion. But it sounds like an incredibly healing discussion! For those kids to hear that you and most of the kids in the class had all suffered and considered suicide at times must be very healing – I hope they came away realizing that life is hard and that thoughts of suicide are common and, dare I say it, pretty NORMAL for teens in this crazy society we’re in. I wish discussions like this could happen all across the country. You’ve done a beautiful thing, and I really want to see and hear the video. Thanks for making my day!
—- Steve
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How do they know what the rat remembers? Sounds like a pretty mean experiment!
— Steve
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Glad to have some of this pseudoscientific nonsense debunked, though the idea that this is a recent discovery is wrong – the scientific world knew that depressed people weren’t suffering a serotonin deficiency as far back as the mid 1980s, BEFORE Prozac even hit the market.
It is interesting to note that all of the comments regarding neuroplasticity focused on finding drug-based ways to regrow neural connections, which predictably lead to other disastrous side effects like cancer. This ignores the fairly robust research that suggests human relationships and other environmental impacts can and do cause changes in the brain, even late in life, and that the best way to heal a damaged brain is a healthy relationship with a healthy adult. Bruce Perry’s work is a great place to find out more about this. But this would explain why talking to a friend, joining a support groups, or seeing a counselor is helpful – we CAN modify our brains by how we act and whom we interact with.
— Steve
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A very interesting piece of satire – at times, I wasn’t quite sure whether to laugh or lapse into hopeless apathy. Unfortunately, it is all too accurate, both in the portrayal of the DSM as a novel and in the dystopian view of humanity that it encourages. His stabs at the possible DSM disorders afflicting those who felt the need to create the tome were particularly ironic and insightful.
Worth reading!
—- Steve
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Great discussion! There is definitely a place for both “outside” and “inside” movements, and both are vital to success. We need people with credentials and insider credibility to challenge the dominant paradigm, and we need tons of active survivors telling their stories and demanding change. And we need writers like Bob and many others laying out the science and the sociology and the economics of change.
What I think is MOST needed is to create a system where getting people more capable and independent and empowered is the goal, and where the incentives encourage instead of discouraging this. That won’t happen without some “system change” work from the inside. It will be slow, it will be awkward, it will never look exactly like we want it to, but change does happen, even in giant bureaucracies, if there is enough weight to overcome the internal momentum. Meanwhile, we keep educating, one person at a time, and each of us uses our weight and expertise where it can help the most. There is no magic – we just have to keep pushing and not give up until it’s done!
—- Steve
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I can’t argue with you. He sounds sociopathic for sure. He may have gotten the Adderall prescription just for kicks. As to the DC mom, she didn’t appear to have these weird beliefs before she started treatment for “postpartum depression.” I know people can get psychotic after a birth, but it sure doesn’t sound like whatever treatment they gave her helped, does it? Sounds like it made it a lot worse, to the point that she ended up dead!
— Steve
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I agree, the drug does not absolve him of responsibility, and I absolutely agree his belief system allowed him to absolve himself of responsibility, and it’s also really easy for him to blame the drug. The only difference between this and a drug like Heroin or alcohol is that he was prescribed the drug by a physician, who should have done a better screening and probably not prescribed an addictive and aggression-inducing drug to an aggressive person with an addiction problem. I don’t buy the “insanity defense” in this case. My guess is that he knew what he was doing when he went to get the stimulants in the first place. But that still doesn’t get the doctor off the hook.
Of course, he could be lying the whole time. He’s got a sociopathic kind of presentation. It’s not ALWAYS the drug that induces the final act. But it can be and might have contributed in this case.
I’d contrast this with the woman in DC who was shot after driving her car at the White House fence. She was being “treated” for “postpartum depression” and had no history of violence, being in fact a solid, taxpaying citizen with no criminal record prior to receiving the “help” of these drugs. In that case, I’d say the drugs are highly culpable, and she may in fact have been “insane” for legal purposes not knowing ‘right from wrong’) when she drove her care into the fence.
This guy probably needs to be in jail. He sounds dangerous, on Adderall or off it.
— Steve
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As I said, I think there’s plenty to indicate he was a violent and controlling guy before taking anything. The question is, did the Adderall put him over the edge? Did it make him willing to follow through with something he was only fantasizing about? We know that people are more likely to be violent and to be more severely violent when they’ve been drinking. Not everyone gets violent when drinking – I never did. But if a person is already thinking violent thoughts, drinking may drop their inhibitions and make them more willing to follow through. I think the same thing can happen with Adderall or SSRIs. In which case, I can’t absolve the makers or prescribers of responsibility, any more than I can this guy who did it. If they know that Adderall can make people violent or more violent, and they knew this guy was potentially violent, they shouldn’t have prescribed it.
Two more points: first, there are tons of gun owners who aren’t the least bit violent. They shoot animals for sport or for food, or use them for defense against wild animals, or against violent neighbors if they live in that kind of a neighborhood.
Second, there do appear to be people who aren’t at all violent but do become so while taking psych drugs. This guy doesn’t sound like he fits that profile, but such cases have been documented.
Thanks for your comments as always!
—- Steve
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My understanding of many of these psych-drug-induced violent incidents is that the person may or may not be acting bizarrely. They usually seem to be able to think and plan and communicate normally, but do things that are completely out of character. My personal theory, based on observations and discussions with a number of people on SSRIs and stimulants, is that it’s more a distancing from the consequences or implications of their actions. Things seem reasonable that wouldn’t normally. A friend of mine was taking Zoloft as prescribed for migraine headaches. Some normal kind of problem arose, and as she went though her array of possible solutions, she thought, “I could just kill myself.” She realized this was a very abnormal thought for her to have, and was astounded it would occur to her as a solution to such a simple problem. I think a less self-aware person might readily be prompted to act on impulses s/he would normally find outlandish or dangerous.
This guy sounds pretty irresponsible and potentially dangerous in his normal mode of behavior. But I believe it is entirely possible that his ability to ACT on his violent impulses might have been enhanced by his drug-induced state. I don’t think it fully explains and definitely doesn’t excuse the behavior in a functioning adult. But I think it’s quite possible that absent the Adderall, no murder would have occurred.
—- Steve
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I loved the article, and I think I get your point: you would be foolish to enter into a therapeutic relationship with a guy like this! He can’t be trusted, he doesn’t like you or care about your goals, he wants to push you around and have you think like he does. I totally respect you for telling him to stick his head “where the sun don’t shine!”
I would absolutely agree: folks should expect results from a therapist, and trust should only grow over time when it is earned by the therapist as a human being. The NORMAL position one should take in a new relationship is one of caution. Many people are hurt over and over again because they can’t set this kind of boundary early in a relationship, and so are unable to objectively observe whether or not trust is merited in this particular person’s case.
When I am working with clients with abuse/trauma backgrounds, I often start off by saying that I don’t expect them to trust me, that I wouldn’t trust me either, and that I hope over time to EARN their trust by my behavior. It may well be that the process of effective therapy itself leads to the trust that the therapist earns, and that this trust is only earned after results are seen by the client. This seems very healthy to me, and something we should encourage. The idea that you should open up to a total stranger just because they have a degree or assigned role in your life is foolishness. Trust is something you earn over time, and clearly your psychiatrist didn’t earn a shred of it. He earned, and appropriately received, your contempt.
—- Steve
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I am always amazed at the amount of money being spent studying the one and only thing about a person that we have no capacity to change: his or her DNA! Especially when it comes to “mental health” problems, there are SO many other variables that we CAN change! Even in the physical realm, you have sleep, food, toxins, pain, physical injury to the brain, drugs, deep breathing… Then there are the stress-related variables (abuse, neglect, grinding poverty, dead-end jobs), and social/environmental variables (noise, pollution, racism, sexism, family relationships, loneliness), and there are spiritual variables, too. Apparently, the ongoing practice of meditation can change your brain structure. And biofeedback allows us to alter our brainwave patterns intentionally. All of these things are 100% within human control, and yet we waste billions of dollars and huge amounts of time studying stuff that is unavoidably fixed at birth.
And even those billions have yielded pitiful results!! When the best you can claim is that a third of “mental disorders” MAY be associated with a range of thousands of alleles, the chances that you’re going to come up with a genetic explanation for anything are obviously beyond remote.
One more thing: Just because something is shown to have genetic underpinnings doesn’t make it a disease. I am quite sure that some of those labeled “ADHD” by the system are programmed genetically to be more active and less tolerant of boredom. As Brett says, “So what?” Any trait that occurs in 6-10% of the population obviously has some survival value. I would suggest that we NEED some people who are more active and less tolerant of boredom. Those are the ones who push the stodgy and controlling members of society outside of their comfort zones to consider things that might otherwise never be considered.
Species survival depends on genetic diversity. We all have different genetic substrates, and that’s how it’s supposed to be. Time to stop wasting our energy on discovering the obvious fact that we’re all genetically different, and time to put in a lot more energy into figuring how we can value our differences and make a society where being different isn’t considered a disease.
— Steve
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Now THAT is a shocking revelation!
— Steve
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I find it encouraging that these discussions are happening at a more mainstream level. It does not surprise me that psychiatrists have to “save face” by hanging onto some threads of their old thinking. It is, of course, scientifically wrong, but we should not delude ourselves into thinking this is a scientific process. This is sociology and culture change, and it is slow and incremental. Nobody every just says, “You know, our entire approach was entirely wrong and we’re scrapping it.”
I’m glad the guy is talking about humility, about the evidence that brains are harmed by the drugs, and about the now established fact that many folks do well with minimal or no drug intervention. I also like that he calls out his own training and lets us know that a lot of it was just plain wrong. That takes some courage, and we need folks like this to help turn the discussion in a more sane direction. Not that I think this moderates the need to take psychiatry out as a medical specialty, but an acknowledgement of at least a large subset of the actual facts is refreshing to me.
—- Steve
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And of course, they neglect to mention that the “treatment” for these supposed “neurotoxic effects” of psychosis is clearly and unambiguously shown to be neurotoxic, even by psychiatric apologist Nancy Andreasen. It is hard to understand how this isn’t obvious to theses oh-so-smart researchers. But I’m glad they at least mentioned that the neurotoxic theory of psychosis is pretty sketchy even with the biased research that has been done to try and support it. Take the drugs into account, and there is no theory. It’s crap.
— Steve
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What a load of crap that article is! I tried to post a reply, but I had to register and I think I have to be a psychiatrist to do so. Probably spitting in the ocean, but it pisses me off how they get away with spouting this bullshit (“60-80% of the cause of schizophrenia is genetic” without any reference,and in the next sentence admitting that there is no known genetic correlation with schizophrenia!) and no one in the profession calls them on it.
Disgusting…
— Steve
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Stephen, you are so awesome! I admire you for standing up to those bastards. It must be very hard to work behind enemy lines, but the folks you work with are so lucky to have you!
—- Steve
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Which is why PloS One is the most reliable journal around. It just goes to show how shabby the “peer review” process is and how questionable the ethics of these journals really are. The state of medical science in these days is pretty pathetic.
— steve
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I totally called this one as soon as I read about it. It looks like a very clear case of antidepressant-induced mania, though I did not know about the head injury, which of course adds even more of a complication and should have been carefully evaluated before someone decided to give her SSRIs.
Who in the media will point out the obvious conclusion?
—- Steve
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I tend to think that “biological psychiatry” is a philosophical/religious viewpoint purporting that the ONLY cause of psychological distress is malfunctioning biology, and that social/emotional/spiritual context is more or less meaningless. Getting away from the biological psychiatry paradigm doesn’t mean eliminating biological causality as a possibility – it simply means seeing it as only ONE possible cause that should be objectively tested for and addressed appropriately when detected. This could include testing for iron deficiency in cases of hyperactive or oppositional children, checking for thyroid issues if someone is chronically depressed, and of course, considering the possibility that pharmaceuticals themselves might be causing mental/emotional/behavioral problems that might improve with a change or elimination of the offending medical treatment.
To me, it would also mean eliminating the DSM as the standard for “diagnosis,” since the DSM is admittedly “atheoretical” and essentially ignores the question of causality and makes it possible to diagnose a disease based only on symptoms without any attention to causal factors whatsoever.
There is no question that biological conditions CAN cause the kind of problems labeled as “mental health” diagnoses. It’s also possible that biology is only secondarily involved, and it’s further possible that the so-called disorder is entirely normal behavior for that particular person in that particular place. It is the elimination of these other possibilities that makes it “biological psychiatry” to me.
On the other hand, there’s not a lot of other “psychiatry” being practiced these days. I agree with Richard, we really ought to support those fomenting rebellion from within, but I sure wish there were more of them around!
— steve
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Too true, Peter. It seems that foster kids are somehow supposed to be happy that we’ve removed them from their awful parents, and any manifestations of grief, confusion, anxiety or anger at us for “helping” them in ways they did not ask for are signs of their personal dysfunction. Sadly, the DSM invites and encourages this kind of “diagnosis” without any consideration for context. And of course, it happens just the same with adults, although the kids have less power and I think need even more protection. It’s such a horrific scam, it’s hard to even know where to begin to unravel it. But I think it starts with challenging the concept that we should all be “well adjusted” regardless of what happens to us. Which in the case of foster kids is patently ridiculous, yet it happens every day.
—- Steve
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Maybe they can change it to the “I listen so I can rat you out” campaign!
— Steve
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Ted, sorry if I was confusing – I was by no means suggesting you have engaged in ad hominem attacks on psychiatry. You have been very specific, detailed, and factual in your systematic attack on their pseudo-rational framework that excuses their abuses. As far from ad hominem as I can imagine.
I was saying that we can diminish the effects of the ad hominem attacks of the pro-psych propagandists by making sure we label them for what they are, instead of getting into a discussion of what the label “anti-psychiatry” means and whether it applies to us. I don’t like to label myself anything, especially if it gives my antagonist a hand up. I am all for reclaiming terms, but I am just not sure that proclaiming myself as “antipsychiatry” doesn’t play into their hands. Makes it too easy to dismiss me when I can be made part of a group of “anti” activists. Maybe it’s too much training in pro-social communication skills, but I prefer to label their objectionable behavior rather talk about being opposed to the group per se. It just seems to get down to brass tacks, in my view. And I don’t want to pre-label myself for their convenience, either. They have to deal with my data and not dismiss me with a term.
On the other hand, retrieving discredited terms can be very powerful in combating oppression and delineating what is really going on. I don’t think we really disagree about that. I suppose it’s more a point of tactics for me. Truth is, there is nothing to salvage in psychiatry that I can think of. It really ought to be demolished, especially their ability to define “normal” and to remove people’s civil rights based on their spurious definitions. So I am anti-psychiatry, whether I’d say it to a psychiatric apologist or not. And I am proud of it, and find it something folks should be proud of. I just like to be clear that if psychiatry made the slightest bit of sense, I wouldn’t be categorically opposed to it just because it’s called psychiatry. After all, “psychiatrist” is supposed to mean “Doctor of the Spirit.” That would sound good if they didn’t start by denying that any spiritual reality exists!
Truth to tell, we are about this close to total agreement. Sorry if my comments were confusing. I hope the context I provided makes them make more sense to you.
— Steve
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I guarantee, the numbers are huge. I see it every day in the foster care population. And it’s not just antidepressants. A lot of kids start on stimulants, get aggressive, lose sleep, may even get a bit delusional, and whack! They’re bipolar and get antipsychotics. Which is really bizarre, because stimulants increase dopamine while antipsychotics reduce it. So if you think the kids’ got too much dopamine going on, why not stop increasing it with drug A instead of decreasing it with drug B? But that would be rational, wouldn’t it.
The bipolar epidemic is only partly due to Joseph Biedermann’s arbitrary retooling of the criteria for “juvenile bipolar disorder.” I believe the bulk of it is fueled by adverse reactions to “antidepressants” and stimulant drugs.
—- steve
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It sounds like we’re of one mind on this one, Ron. I don’t like being labeled, and I don’t like to label anyone else, either. I think it plays into their game. And I don’t think we should let them throw around “Scientologist” as a bad label, either. Why should a person’s religious beliefs be a relevant issue in a discussion of the scientific utility of a supposedly medical intervention?
I think the best approach to the antipsychiatry label is to point out that this is exactly the kind of thinking that we have come to expect from the psychiatric profession – trying to discredit their critics with labeling and name calling rather than dealing with the very real issues that their preferred treatments bring to the fore.
If someone tries to label me with any label at all, I’m inclined to reply that what I am is an intelligent person who has done a lot of reading and research in this area, and who finds that research does not support what is commonly done in the field. And I provide examples.
Labeling and ad hominem attacks have always been the last refuge of scoundrels and hacks over time. I think we take that away by refusing to employ that tactic, and instead point out when and why it’s being used, and return the attacker to a discussion of the real issues at hand.
Though I am comfortable with Tina’s framing – I am anti-psychiatric oppression! Of course, that is kind of an oxymoron for most psychiatrists…
— Steve
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Quote from the article: “But it’s counterintuitive to ask people to raise their hands and say, ‘I’m not going to follow the conventional thought about mental illness, and I’m going to be open to the people who need support.’ ”
How did it become the conventional thought NOT to listen? NAMI has been central in helping the psychiatric profession convince everyone that it’s all a brain chemistry problem and that listening doesn’t matter. Kind of ironic for them to start on this kind of campaign. Perhaps they should apologize for misleading people earlier. Might make their campaign a little more believable.
—- Steve
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I like to say that I’m anti-stupidity, anti-abuse, anti-lying, anti-greed and anti-coercion. It’s not my fault that psychiatry has positioned itself to be stupid, abusive, dishonest, greedy and coercive. I’m not against psychiatry for the name – I’m against what they DO! Stop hurting people, admit you don’t know what you’re talking about most of the time, acknowledge the real scientific data, and start listening to your clients and my feelings might change.
As a Buddhist teacher once said, “Don’t break off my finger, look at where it’s pointing.” But psychiatry as a profession is not interested in looking anywhere but at its own self-interest, and as long as that’s the case, I will be against them as a group.
— Steve
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Appreciate the perspective, and I’ve heard the same from many individuals. But I’m with John on this one – just because a drug helps you with a situation or condition doesn’t mean you’re ill. I raised two “ADHD” type boys and used alternative schooling and some creative discipline to help them succeed drug-free. It can definitely be done, but trying to force “square pegs into round holes” is a specialty of our school system, and is IMHO the main reason for the “ADHD” epidemic.
You might also want to note that a good percentage of those preschoolers and school-aged kids started out on stimulants before they were diagnosed with “bipolar disorder.” Stimulants make a lot of kids agitated and/or aggressive by boosting their dopamine levels up too high. Rather than realizing they’ve created a monster, most psychiatrists will respond by using “atypical antipsychotics,” which bizarrely enough LOWER the dopamine levels that they’ve provided the stimulants to increase. So we raise dopamine with one hand, lower it with the other, and blame the kid if it doesn’t work out as we’d hoped. Not a formula for success!
My personal belief is that we need to have a range of classrooms so those who can’t do it “your way” have another way that they can learn and be successful. It worked for my kids. I wish you’d had the chance to be in such an environment yourself, so your real strengths could have been valued instead of diagnosed as a “disorder.”
—- Steve
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So if I strangle my psychiatrist, does he then suffer a “patient-related psychiatric asphyxiation event?”
Language has great power and is used in psychiatry to avoid responsibility and cast blame on the clients they are supposedly trying to help.
I think my favorite is “you have treatment-resistant depression.” Now, if I took my car to the mechanic, and he couldn’t make it work properly, I wonder what I’d say if he told me I had “repair-resistant fuel injectors,” but that I still had to pay him $200 and bring it back next week for another “treatment?” We’d expect him to say, “I don’t know how to fix it” and we’d take it somewhere else or live with it or do our own research and fix it ourselves.
So how to psychiatrists get away with not knowing how to help? They blame the client. No, they blame the “DISEASE” – it is the DEPRESSION that is resisting treatment, not you personally. If only that darned depression would get it together and stop resisting, things would be peachy around here. So of course, if the depression resists, and you “have” depression, there’s nothing you can do about it except come back for another round of “treatments” and hope for the best. I hope I live to see the day when a psychiatrist says, “I really don’t know how to help with this situation. I suggest you talk to someone else who has more tools at their disposal. I’ve obviously been of no help to you.” Haven’t heard it yet, and I’m not holding my breath…
—- Steve
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I found lots of comments, the vast majority of them reflecting disappointment/disgust with the lack of objective reporting. Four pages all together, and 90% were negative. I didn’t even feel compelled to comment, because all I’d wanted to say was covered more than once by others. Well done!
—- Steve
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That is remarkably good news from the front lines! I guess I never thought the Berlin Wall was going to come down, either – maybe psychiatry is about to make a substantive change? Dare I hope?
Good for you, though – I’m glad you’re finally going to get some help in moving in a different direction!
—- Steve
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I agree, this might not be the best example where the drugs are clearly implicated. I’d rather have seen them investigate Adam Lanza’s case, or the Batman shooter in Colorado, or the V Tech shooting, among many others. Still, it’s good to see someone looking into it. Maybe a one of us with some “authority” (namely the right letters after his/her name) can suggest to the good congressman that this is not an isolated incident, and he ought to broaden his investigation.
Still, we don’t know that he wasn’t taking other stuff, nor do we know if he was taking more of the Trazadone than recommended for sleep. The tricyclics have been known to cause manic episodes, as they do mess with serotonin, just not as much as the SSRIs.
—- Steve
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Clinical detachment is a myth, and not a very helpful one at that. It’s kind of like saying, “I’m not biased against black people.” There’s no way to be real without being vulnerable and open on some level. Doesn’t mean you bring all your crap and dump it on your client, but genuinely experiencing and at times expressing your emotional responses to the client’s situation seems to me to be critical to real progress being made. Perhaps I had an advantage – I never received any real clinical training until after I became a counselor. (For some reason, people seemed to think an MS in Education qualified me to be a counselor – go figure!) But I was never deluded into thinking I could be fully objective about my “clients,” nor did I try to be. If I was baffled by their behavior, I’d let them know, in a supportive way, that I was struggling to figure out why they were acting the way they were, and could use their help figuring it out. This almost always led to some very interesting and beneficial lines of conversation. Usually, it was the things that baffled and frustrated me that led me and the client to discover what was really going on. If I had not been able to admit being confused or frustrated, and tried to fit the client’s behavior into some preconceived “rational” framework, I doubt I would have been of the slightest help, and would probably have messed them up even worse.
Thanks for this rational picture of what therapy can be, the good, the bad and the ugly. I hate to throw out the baby with the bathwater, because there are some very competent and helpful folks out there doing therapy, but I’d say most are at best marginally clueless, and some are downright dangerous. The best of them seem like secret rebels in the enemy camp. My hat’s off to them, but you have to look pretty hard to find them in the mass of mediocrity that passes for therapy these days, or maybe in any days, past, present or future.
And a lot of them aren’t officially therapists, either.
—- steve
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Are you saying that having a sense that you are a valuable and contributing member of society with some purpose to your life has an impact on your mental health, too? Wow, now THAT’S a radical concept!
😉
— Steve
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Imagine, anxiety being caused by actual life events! What a concept!
But not EVERYONE gets anxious about losing their job or being unemployed. So those who get anxious about it must have a CHEMICAL IMBALANCE that makes them unnecessarily worried about the possibility that they may become homeless or starve to death. NORMAL people don’t worry about these things. They just roll with the business cycle and starve quietly off the road somewhere where they won’t bother anyone.
—- Steve
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“…digital smiley-faces were superimposed over the windows of his psychiatric hospital, with the title “Patients’ experience vs. meta-analytical evidence: My patients believe in the efficacy of antidepressants.” … The president of the EPA, a scientist who has co-authored more than 1,000 publications, was arguing that in the matter of antidepressant efficacy, clinical judgment trumps scientific evidence.”
Actually, he was doing more: He was postulating that the placebo effect is all that matters. Or to put it another way: he was arguing that faith is the underpinning of psychiatry, regardless of fact.
As many others have observed, Psychiatry had more in common with a religious order than it does with science. It’s not by chance that the DSM is referred to as the “bible” of the psychiatric profession. What other “medical” specialty has holy scriptures? Is there a “bible” of metabolic medicine or cardiology?
You give them way too much credit in suggesting their presentation relies on clinical opinion. It relies on personal faith that speaking the right magical words and using the right magical formulas is what creates the magical result. The truth is not relevant to their undertaking. They are upset because you’re breaking the spell.
—- Steve
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You know the reason Benzos went out of favor is because the pharma companies and doctors could make more money on the SSRIs. Besides which, SSRIs favored the “chemical imbalance” theory much better, being “targeted” at a specific neurotransmitter, even though nobody had or has a clue as to why they even have an impact on depression or anxiety.
Personally, I find a glass of beer to be an excellent antianxiety agent. It’s cheap and readily available without prescription, and fast-acting like the benzos. Sure, there’s the problem of dosage control, but people get addicted to benzos as well. I’d love to see controlled dosages of alcohol go up against benzos and SSRIs. I bet alcohol would win out, both for effectiveness and lower side effects. Marijuana in low doses is probably also better than either benzos or SSRIs, and probably even better than alcohol on the side effect profile. But as long as no one can control the supply and make big enough bucks for their corporation off of them, alcohol and marijuana will remain “drugs” rather than “medications.” In the end, there isn’t much difference, except for who profits.
Do I sound cynical?
—- Steve
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Nonetheless, I am going to find this very helpful in advocating for foster kids, who seem to get antipsychotics for any kind of distress they experience. I always get the “you’re not a doctor” routine, even though I know more about the effects and outcome literature of psych drugs than a lot of the docs. But this will be hard to refute.
—- Steve
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That is such a disgusting story! Good for you for resisting their indoctrination into disability. It revolts me that a “professional” would herd a bunch of people together for the purpose of teaching them they can’t do things. What the hell do they think they are accomplishing? Saving you from “disappointment” when you “inevitably fail?” Sounds like projection of their own failure to ever understand how to help another human being.
Keep telling your story. It’s a much better story than the one they’re selling, and all the more important for actually being the truth!
— Steve
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Which reinforces my point – even the function of the genes themselves is changed by changes in the environment and our own decisions! We inherit whatever genetic material we inherit, and there’s not a damned thing we can do about it, but how those genes are EXPRESSED is something we have a massive amount of control over. Which means we also control our brain chemistry to a huge extent, and apparently can even cause new neurons to grow through meditation!
So why is all the money being spent on studying genes and brain chemistry? Why not spend the money on preventing trauma, learning good living habits, and finding techniques to assist those who have been traumatized to re-establish control over their own bodies and brains?
Rhetorical question. We know the answers, of course. There is no money in helping people become independent and highly functioning, and acknowledging the role of trauma, poverty and abuse in mental illness means those in power have to take some accountability for their own behavior. Much easier and more comfortable to blame the brain!
—- Steve
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Great post! I would add that it is fascinating that psychiatry focuses vast amounts of energy on genetics, which is the one variable we CAN’T change. Why not focus on the environment, which is a variable under our control? The 1:76 ratio of scientific studies really reinforces the intentional blindness of the “profession” to this weird bias. In underscores my view (and many others’) that psychiatry is a religion, not a scientific medical practice.
—- Steve
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I hope I live so long!
And maybe I’m being overly optimistic – I think this particular iteration of psychiatric oppression may end, if only because the profits in it are evaporating very quickly, and the hard truth of the long-term impact of psych drugs is finally getting the press it deserves. But I have no doubt that the shadow (as JRR Tolkien put it) will reform and grow in another manifestation. It’s the basic good vs. evil battle, and probably never will end. But I do think the idea that mental illness is a purely physiological issue that can be treated with drugs is on the way out. Slowly but surely, the pendulum swings back again…
—- Steve
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I am so tired of hearing that “schizophrenics can now live in the community because of our drugs.” It’s such a lie, but Andreasen continues to publish this nonsensical myth. It was a social policy change that had nothing to do with drugs, as Bob so amply demonstrates in his book.
That being said, she is pretty mainstream, and for her to admit that there really is brain shrinkage due to neuroleptic use is very helpful.
It’s also important to remember that any links between “mental illness” and brain volume are based on average measurements. There is no direct correlation where you can say that “this person has schizophrenia and therefore will have a smaller cranial capacity.”
They continue to grasp at straws to hold up their unsupportable brain-damage theories of mental illness. But the data is now becoming clearer and clearer, and sooner or later, they will lose.
— Steve
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Who could have predicted such an outcome?
Guess I’m glad there’s research to support this, but anyone with a half a brain and one eye to observe with would see that “antipsychotics” impair cognitive functioning. It would be like an experiment to see if leaving food on the floor attracts ants. The result is obvious without the experiment.
— Steve
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Laura, what a beautiful and moving essay! You really have a great gift, and your story is so characteristic of so many people I’ve seen, both those subsumed into the psych system and those committed to escaping it.
Your reminded me starkly of my days as a counselor and volunteer supervisor at a suicide hotline. For one thing, I learned that lay volunteers often made much better counselors than the professionals, because they knew they didn’t know anything much, but were there to LISTEN to the caller and help him/her figure out what to do, rather than labeling or judging or ordering them about.
Second, I remember that the main thing I advised and applied to suicidal callers was to ask what was going on in their lives that made suicide seem an appealing option to them. I assumed based on the fact that they’d called us that on some level, they really did want to live. So something pretty painful must be going on to lead them to think of killing themselves. This almost always led to very deep and meaningful conversations that were appreciated by the callers. It was what they wanted and needed – someone to care and listen.
As soon as suicide or other “symptoms” become the problem rather than an indicator of distress, we lose the ability to intervene in a helpful way. That’s what the DSM does for us – it takes the meaning away from our suffering and leaves us as a list of symptoms to be controlled or “managed.” I don’t know that I’ve ever read a more effective personal description of the vast difference between being a set of symptoms and being a human being seeking meaning in the world. I rejoice that you’ve found yours, and may you be a beacon to others who are where you once were!
—- Steve
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He sounds like a special person who was failed again and again by the psychiatric system. It is interesting in a sickening way how the system is able to spin his story to being about how he shouldn’t have tapered off his antidepressants, when clearly 1) his antidepressants were making him physically ill, 2) his antidepressants were not working to enhance his life anyway, and 3) he continued to receive psychiatric treatment right up to the day he killed himself.
As I understand it, suicide is a pretty common outcome from multiple ECT “treatments.” It is entirely possible that he suffered not only from brain damage from long-term psych drug usage, but further brain damage from the ECT that contributed to his suicidality. Not to mention the hopelessness that comes along with the message that your brain is broken, and our ‘fixes’ aren’t fixing it.
Thanks for sharing this very sad and yet beautiful story. I’m glad you can be there with your friend when he needs you. I am sure that you have done more for him than anyone in the hospital will be able to contribute. Your willingness to feel his pain is your strength – revel in it and rejoice that you have it. It is a much rarer skill than perhaps you are aware.
—- Steve
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Glasser was a genius. Sorry to see him go. He’d have been right with us in this fight.
—- Steve
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I recall talking to a psychiatrist who had been working with a seriously depressed woman for 15 years. He’d never even asked her what she was depressed about. When I asked him about it, he acted as if it was an irrelevant question. He “tried everything” in his medical repertoire, but hadn’t bothered to ask the most obvious question that your average 8 year old would have instantly known to ask: “Why are you sad?” I guess if your chemicals are imbalanced, it’s your problem, and it doesn’t matter why it happened. Very handy for the practitioner, because it doesn’t require them to think too much, but for the client, a bit of a different story.
— Steve
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This makes sense to me, based on what people have reported to me and in the literature about the numbing effects of SSRIs. It appears to make a person less sensitive to any input from the environment, positive or negative. This may seem like a relief if you’re chronically anxious (as now you no longer care what Aunt Mable thinks of your new dress), but it also may mean failing to care about the consequences of your actions (So, I’m breaking the law – big deal). I think this is where a lot of the increased suicide/violence/homicide comes in – people may have had an impulse in this direction before, but would never have considered acting on it, because the consequences were too serious. But with SSRIs, the consequences have much less significance, so killing someone else or oneself doesn’t seem so bad any more.
—- Steve
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Go, Jim!!
—- STeve
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I am never opposed to hearing research data that may contradict the research referenced in Anatomy of an Epidemic. Unfortunately, I haven’t seen much that has done that. Mostly, I hear criticisms that MiA supporters are “anti-intellectual” or “antipsychiatry,” without any evidence countering the book’s thesis.
So pick one area, and let us know what the counterevidence is. Present it without critical commentary about other posters, and see what happens.
I’m pretty well versed in the latest research, and I have yet to see any convincing evidence that long-term use of psych drugs leads to better outcomes. I’ve heard lots of anecdotes, which have some value, but when we look at the long-term research, there’s just nothing to support the GENERAL assertion that people staying on medication leads to better outcomes. I’d be happy to see any literature you can produce that supports people being better off in the collective sense though the use of brain-altering chemicals.
The other big point is the DSM diagnoses. I would have to toss the label of “Anti-intellectual” at you if you are not willing to acknowledge the obvious fact that the DSM diagnoses are descriptions of behavioral/thinking/emotional states that do not necessarily associate with ANY physiological problem. There have been decades of dedicated research looking at this question, and we have a few faded scraps of genetic association, not even with a specific “disorder,” but with a range of mental health issues that this set of genes may make someone more vulnerable to. That’s pretty weak evidence for physiological causation of mental illness.
So we have almost no evidence supporting the DSM diagnoses, and almost no evidence supporting long-term efficacy. Why all the argument with the selective use concept? How is it anti-intellectual to acknowledge the research that has been done?
—- Steve
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I think the value in writing to counter idiot posts by unredeemable true believers is not to convince the person you’re writing to, but to give those reading that person’s post an opportunity to hear the counterargument and compare. If you consider your exchange as posted above, any sensible person reading the posts can see that you are coming from a place of openness and reason, and that s/he is coming from a place of insecurity and immaturity. Don’t discount the value of that. While the poster may never be convinced, you may have helped a dozen or a hundred other readers open their mind or solidify their thoughts with some rational backing. It’s definitely not a valueless activity, even if the moron writing the initial post is driven into childish retorts.
—– Steve
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This is a very important finding! It really calls the entire DSM enterprise into question – if a diagnosis doesn’t predict need for treatment, and if receiving treatment doesn’t impact the outcome, what is the point of diagnosing someone in the first place???
—– Steve
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All I can say is, “Another psychiatric success story.” It’s amazing the percentage of these shooters who have been “helped” by the mental health system and are either on or are withdrawing from psych drugs. If the system were so helpful, how are these people acting out so badly in ways we never, ever saw when I was a kid?
It is apparent that this woman knows more about mental health treatment than those who were trying to help this young man. She talked to him, she listened to him, she cared about him, and she had the courage to do the right thing even though she was scared. She is the kind of person we need providing care for people with mental/emotional/spiritual challenges to face. Why can’t the MH profession learn from this kind of scenario?
Go, Antoinette!
—- Steve
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Peter, you summed it up so well. When I was starting out in the world of “mental health” in the 80s, we still talked about unconscious motivations and the impact of parenting and even society as a whole on development. Now it’s 100% “blame the victim.” If you can’t hack it in today’s insane world, then you’re insane, because by definition, the status quo is always wonderful to those who are in control of it.
I’m reminded of Jung’s concept of the “shadow self.” I think society as a whole has a “shadow self” that is represented by those who object to it, consciously or not. And the larger society feels compelled to snuff out any emergence of this ugly underbelly by whatever means possible, because it reminds them that all is not as well as they want to believe. And the APA and the pharmaceutical companies have all been too happy to play into that need, as they make plenty of good bucks at it. Of course, anyone who actually looks at the data is to be shot on sight.
As a friend of mine once said, “Never let the facts stand in the way of a good theory!”
— Steve
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Well, yeah! That’s what I was saying – given the very weak evidence of anything positive happening, and the strong likelihood of something negative happening, I’d say we’ve got a great argument for banning this drug for ANY indication.
I have talked to any number of SSRI users who describe almost a depersonalization experience, an emotional disconnection not only from their own emotions, but from how anyone else feels as well. I believe this is part of what lies behind the less common but sometimes severe violence that occurs with some SSRI users – they would normally be restrained from killing themselves or someone else by empathy for the impact on others, or at least fear of the consequences, but these barriers are kindly removed by the SSRI experience, and killing oneself or someone else suddenly seems like a reasonable solution.
It is amazing to me that anyone who knows that we could be causing permanent damage to someone’s brain with a very small chance of any positive impact, and when any such impact is at best temporary, would ever feel OK about prescribing such a drug.
I’d be interesting to hear Dr. Shipko’s rationale for continuing to prescribe them.
—- Steve
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Not only do we need to show that “creatively maladjusted” people can survive and thrive without having their brains modified, but we also need to show that drugging people does NOT make people well adjusted mentally and emotionally, and that talking and listening to them is much more likely to lead to that supposedly desired outcome. Which is what Bob’s work is really trying to do.
The problem is, I’m not sure the psychiatric profession as a whole really wants people to recover. Their profession’s survival depends on people “needing drugs” on a semi-permanent basis. If you take that away, what has psychiatry got left to offer? The DSM? The occasional drug to deal with an immediate crisis? They lose all their power and authority, and they’re not going to let that happen. Whether they’re willing to admit it or not, psychiatry as a profession is invested in keeping people dependent and “ill.” If their mythology is no longer accepted, they become the worthless fifth wheels that they already really are.
—- Steve
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Right you are! You reinforced my point even more dramatically. I guess it was OK for slaves to be as depressed as they wanted to, as long as they did as they were told and didn’t complain. But running away, that caused trouble! Obviously something must be wrong with them for objecting to the status quo and making things difficult for the Masters.
Sounds like a very sound analogy for today’s “mental health” industry. If you’re not completely happy with today’s industrial-corporate-capitalist-government bureaucracy, you’d better keep it to yourself. If you act out in any way that interferes with the ongoing efficiency of the money-making, soul-draining machine, you will be dealt with by disabling your brain. “Successful treatment” will return you to an appropriate state of docility such that while you may not be contributing to the machine, at least you’re not in the way.
A lot of parallels to slavery…
—- Steve
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There is “nothing better” out there. Correct. “Nothing” is better than the DSM! We’re far better off admitting our ignorance than pretending to know what we don’t, and let’s be honest, intentionally deceiving others into thinking we do.
When I had to do psych diagnosis, I chose the one that would get the client the service I thought they needed and wanted. If they asked me about it, I’d say, “I just put that down there so the insurance company will pay. It doesn’t really mean anything at all.”
That’s about the only thing the DSM is useful for – getting money from insurance companies. If clinicians were at least that honest, we might be able to get somewhere else than where we are today.
—- Steve
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Thanks for this wonderful post! I agree with you 100%, the message from the psych community is “there’s nothing to be depressed about!” The idea that we can somehow differentiate “depression” from “simple unhappiness” is a delusion that has been promoted for many years, and is stated with such fervor and passion by many, despite the complete lack of any scientific or factual basis to make such a distinction. The author’s description of the difference appears to be more in terms of how a person is reacting to his/her sadness/despair, rather than what is driving it. In other words, some people are sad, and some people are REALLY sad and driven to do things that sad people do, like sleeping a long time or thinking about suicide. But obviously, there is a continuum from being sad to being REALLY sad, and no clear or easy way to draw a line between them.
I also agree with “feelbettercounseling” that there can be a lot of factors that come into play, some of which are purely physiological. For me, losing sleep almost always leads to a more depressed outlook, and if combined with a negative incident, can throw me into a full-fledged episode of self-hatred. Fortunately, I can recognize this now and pull myself out of it by reminding myself, “You’re tired. This will look very different once you’ve gotten some rest.” Food, exercise, physical pain/health, fresh air, sunshine, hugs, all of these have an effect on mood. But I think the most important point is to understand that depression is a human reaction that is part of our biological repertoire of survival tools. To re-define it as a disease, and to distance it completely from the experience of sadness and loss, is to diminish the experience of the sufferer and to communicate that there is something wrong with them for feeling the way that they do. Simply acknowledging that a person’s emotional response is a normal reaction to whatever difficult circumstances they are experiencing seem in my experience to be the first and most important tool in helping them come to terms with how they might move in a new direction. And yet psychiatry’s message is exactly the opposite of what I know to be helpful.
It’s SO depressing to think about it…
—- Steve
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I have noticed that my belief that the world should be improved and made more just and equitable definitely associates with me feeling more depressed. However, I don’t take that as a problem with me – I view it as a sense that I am not OK with the world being the way it is! I’m sure a lot of enslaved Africans felt pretty damned depressed living on plantations and being ordered about and beaten and raped and separated from their families and their homes and their culture. Were they “mentally ill” for feeling that way?
I believe a craving for justice is fundamental to healthy human life. It is the very fact that we have lost so much control over the injustices that are happening all over our country and the world which I believe drives many to despair and other extreme emotional states. Absent this drive for justice, we end up with a lot of sociopaths and the remainder of society living a dull and apathetic existence. It is HEALTHY to be displeased about injustice, and it is UNHEALTHY to feel OK about others being mistreated. Only the twisted nature of our society leads us to feel better when we stop caring about our fellow man/woman.
—- Steve
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It seems to me hard to believe anyone could recommend these drugs knowing this information, especially in light of Kirsch’s work suggesting that the drugs are generally acting as active placebos and have little to no actual clinical effect, except in the most severe cases. I found this article extremely distressing, as Ted did – I knew it was bad, but I’d assumed and believed that time did allow this kind of brain damage to heal.
And Stuart is right to distinguish that this is NOT a withdrawal effect. This is the effect of ongoing damage to the brain, which may or may not heal. It goes right back to Peter Breggin’s and Whitaker’s description of the neurological up- and down-regulation in response to enormous, enforced changes in neurotransmitter availability in the brain. There is NO excuse for even considering doing this to a patient, especially to a person suffering from mild to moderate depression, when there are so many other options available.
Ugh!
— Steve
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You’d think they’d have “serious concern” about the legitimacy of their predictive model, and perhaps some “serious concern” that they didn’t know their butt from a hole in the ground. I have “serious concern” that anyone takes a thing they say seriously.
—- Steve
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Remember, though, that most of the deaths due to medical intervention are NOT due to “mistakes.” They are mostly due to the adverse effects of properly prescribed and properly administered medication.
— Steve
From the AHRP website:
http://www.ahrp.org/cms/content/view/871/56/
“The findings by Barbara Starfield, MD, of Johns Hopkins School of Public Health:
12,000 deaths from unnecessary surgeries;
7,000 deaths from medication errors in hospitals;
20,000 deaths from other errors in hospitals;
80,000 deaths from infections acquired in hospitals;
106,000 deaths from FDA-approved correctly prescribed medicines.
The total estimated number of deaths caused by medical treatment in the US every year is 225,000.
Thus, the US medical system is the third leading cause of death, after heart disease and cancer.”
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As I said, biopsychiatry is the philosophical descendant of eugenics. It’s part and parcel of the entire viewpoint – mentally ill people are genetically defective. And reasoned argument does not work against these people, because they are not even vaguely interested in what science has to say – they are dogmatic ideologues who only use the veneer of “science” to cover up their more nefarious undertakings.
I do agree, we do well to be very factual in our statements, as it leaves us open to attack if we’re not, but at the same time, we have to attack the power base of those who are promoting this campaign and not be too worried at the expected drama in response.
—- Steve
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Impressive. Half of the “high risk” cases aren’t even high risk at all. Who comes up with this garbage?
—- Steve
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While Big Tobacco did not invent behavioral genetics, it seems to me that they did an excellent job of using public media to shift the focus away from their product and toward the individual who used it, using behavioral genetics as a foil, a tactic which is almost universally employed in the marketing of “mental health” drugs today. For example, there is now talk that PTSD is a biological problem, because not everyone reacts that way to a traumatic event, implying that the PROPER way to respond to a traumatic event is to NOT have flashbacks and intrusive memories, etc., and that those who do react that way are personally deficient in some way. This takes the focus completely off of the traumatic event and its progenitor, letting rapists, domestic abuse perpetrators and child abusers off the hook. A page right out of Big Tobacco’s playbook.
I do agree with the author that the tobacco industry honed this tactic to a fine point during my childhood years, though they were eventually busted by the overwhelming bulk of the evidence. My hope is that this will eventually happen to the psychiatric drug industry as well. Of course, it does make a difference that nobody was ever forcibly hospitalizing people and insisting that they smoke, or injecting them with nicotine as a means of “helping”…
Jay Joseph is amazing and very research-focused, which this particular author fails at. But I still think his point is well taken.
— Steve
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Thanks for this viewpoint, Matt. It is interesting that as a person who has done therapy with many people who have been traumatized (especially domestic abuse victims), that bluntness and the willingness to drum up some righteous indignation are actually things I try to encourage people to develop! I fully believe that learning to feel and act on anger when it arises is one of the most important recovery tools for victims of abuse and violence. I also believe that being cautious about similar future events is SMART and can often be quite enlightening for those who suffered abuse, as this rational caution often helps the survivor identify how they allowed themselves to be sucked in by the abuser and how to avoid it in the future.
I even wrote a book about it – entitled Jerk Radar. I have taken stories from victims of domestic abuse and created a manual on how to detect potentially abusive partners up front, when they’re still pretending to care about you. So I am actually advising “hypervigilance!” Many of the same principles in the book would readily be applied to receiving medical care, especially from psychiatrists.
I think seeing “PTSD” or other reactions to trauma as adaptive responses to bad situations is an awesome way for those who have been hurt to regain their power, and realize that their behavior is not a “disorder,” it is simply a matter of trying to plan a way to avoid being harmed in the same way again.
Thanks again for a very worthwhile read.
—- Steve
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Biopsychiatry is a descendant of eugenics. It continues the search for proof that some of our population is genetically inferior and can therefore justifiably be treated poorly or eliminated. And with death rates so much higher for recipients of psychiatric “treatments,” the results aren’t so different from the early 20th-century eugenicists, except that it takes longer to kill off the “undesirables.” Reframing it as “medical treatment” allows the effort to become more palatable for the masses. But the underlying assumptions are the same: those in power deserve to be in power, those who don’t “fit in” to the schemes of the powerful are labeled as genetically deficient and are physically, psychologically and socially restrained or attacked, with justification provided by their “inferior” status.
Makes me ill to think about …
—- Steve
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Yes, I understand that Pharma doesn’t see psych drugs as the cash cow they were in the 90’s and the 2000’s, as they’ve played out all the “new delivery forms” and other sleazy tactics to get new patents, and are getting hit up with a lot of damaging lawsuits. Not sure what Lieberman or the APA would have to offer them that would change this viewpoint. It’s same-old, same-old at the APA!
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And BTW, when exactly did they DISENGAGE with Pharma?
—- Steve
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Hi, MJK!
I felt very sad to read this. I have also felt despairing at times and wanted to end my life. Many times. I never did do so, and I am glad I didn’t now, but it seemed hopeless at the time. I’ve also worked at a suicide hotline and talked to hundreds and hundreds of suicidal people. I can’t judge anyone for being there. Sometimes it’s good to know you have a backup plan if it gets beyond reckoning.
What is keeping you going at this point? You must be pretty damned tough, to hang in through such daily adversity. I’m interested to know what weighs on the other side?
Wish I could be there to help. I’ve seen a number of your posts and you are always compassionate and smart and insightful. I hope you can continue to hang in there and share your wisdom with us and anyone who will listen.
— Steve
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The APA appears to be a branch of organized crime at this point. It is astounding that it never seems to occur to them that the reason they are “perceived” as having a conflict of interest is because they DO have a conflict of interest. And that the reason their profession isn’t trusted is because it has proven untrustworthy over time. After all, how much can you trust someone who thinks an electric-shock-induced seizure is a “treatment” for depression?
They are criminals, plain and simple. They want your money without providing a product of value, and they know that is the case. They can justify it all they want, but that’s criminal behavior.
—- Steve
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You’re right about corporations, especially in the USA – one of the biggest problems is that they’re viewed as “people” based on past court rulings, and as such, have “free speech” rights that include bribing, oops, I mean contributing to politicians’ political campaigns in a completely unrestricted manner. This is part of how the government has been increasingly sold off to those monied interests.
Trade is the foundation of civilization, and money is supposed to represent the labor underlying the efforts at developing and trading goods, as well as the risks assumed in bringing goods from where they are plentiful to where they are scarce, etc. What is so unfortunate is that there are so many making many billions off of products (like psych drugs) which don’t actually benefit the recipients, or who “make money” while producing nothing at all, which takes money away from the honest traders.
Hey, I like that last one. Inside each cynic is a romantic utopian at heart. I’d be happy to live on the same platform with you!
—- Steve
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You might be right if businesses were answerable to the communities they serve, but they aren’t. The levels of pollution are just one excellent example – industry has traditionally polluted the environment with impunity. They have no incentive to do otherwise, except for small businesses that have to be accountable to their constituency and drink the same water as their customers. If there were no government to tell the big corporations to stop polluting, it would be up to each individual consumer to investigate and understand the nature of that company and decide to purchase the product of someone who doesn’t pollute. Not realistic, especially with the media picking and choosing the stories they cover under the influence of advertising dollars from those self-same industries they’d have to rat out.
There are no “free markets” in this world economy. My biggest objection to government these days is that they are owned by these very corporations who supposedly are so interested in making our lives better, and the governments take money from those who can least afford it and spend making laws and regulations to support and empower those who need it least.
I’m not a big fan of the welfare state, but things are so screwy at this point that the average person in the USA can’t afford healthcare without insurance coverage. (Naturally, this situation was created in the USA at the behest of the insurance industry, and they’re making lots of money while US healthcare outcomes are the worst in the industrialized world.) Whatever you may feel about the NHS, and I understand they’re a bureaucratic mess, I guarantee it is better than the multiple bureaucratic messes that comprise the US system that costs far more and delivers far less than the NHS users can probably imagine.
Simply removing government and letting the corporations have their way is not the answer. It’s actually part of how we got the mental health system we’re all so upset with – the pharmaceutical industry got control of the psychiatric profession, and now profits are more important than patients. I wish trusting the capitalist system were an answer, but I’m pretty clear that the current low-accountability high-profit business system is more the problem than the solution.
—- Steve
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I meant an unresolvable conflict!
—- Steve
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If I might venture a thought on this point, I believe we all have an inherent desire to be creative, to experiment with life, and to rebel against those who would restrict us from doing so. Unfortunately, when the entire society appears to conspire to restrict us from living and creating and making our own decisions, the conflict can be overwhelming and lead to what are now termed “mental health issues.”
I certainly experienced this in the school environment. I had my own world of thoughts and wishes and fantasies and emotions, all of which was clearly not welcome in the school environment, and I felt I would quickly be punished by both the teachers and my classmates for letting any of that out. So I was very shy and anxious and pretty depressed throughout my elementary years, leading to a brief “outburst” in 5th grade at Valentine’s day, where I put a “fuck you” message inside a classmate’s valentine and was busted for it. (Interesting that I chose Valentine’s Day as a time to give my rebellion voice, as to me it seemed to represent both a need to pretend to like people that I didn’t, and a competition for social attention at which I did not excel and didn’t really want to participate. This was before the days where kids had to make valentines for everyone, and my box was always one of the emptier ones.)
I ended up seeing a psychologist for an evaluation and getting “special attention” for what today would certainly have been diagnosed as a “mental disorder” of some kind or another, and would surely have resulted in some kind of recommendation for “treatment.” But it’s clear to me that my internalized anxiety was a result of an resolvable conflict between who I was vs. how I was expected to behave by the authorities. I was clearly in passive rebellion from the first day I arrived at school in Kindergarten, and would have done almost anything to escape from that oppressive environment, where I was expected to kowtow all day to the arbitrary demands of teachers who didn’t know me nor seem to care to know me and simply seemed to care about making me do as I was told, and where I was forced to associate with kids that I’d mostly never have even talked to if left to my own devices. But I was impotent to make any kind of change to that environment, and simply had to go, day after day, week after week, year after year, suppressing any outward expression of what was really going on internally and acting as if nothing was amiss. It is a small wonder and a credit to my internal self-discipline that I didn’t act out more violently much sooner. But of course, no one would ever have given me credit for 5 years of self-restraint. My one small act of rebellion was the focus, rather than the years of suffering that led up to it.
I think this mechanism leads to a ton of anxiety and depression that is not necessarily linked to another obvious cause. Naturally, other traumatic events that may have happened in someone’s earlier childhood contribute to how a person might choose to act in such a situation, and I had a few of those, but nothing too severe compared to what a lot of folks have tolerated. Yet the school experience welded into place a style of responding to the world by suppressing my true impulses, feelings and thoughts in ways that affect me to this day, and that transcended any personal issues I might have had prior to entering the walls of that institution. It literally made me nuts!
This fits into Bruce’s “internal rebellion” theory very nicely, and takes the explanation of “mental illness” beyond the realm of personal trauma and adds the impact of an oppressive and sometimes seriously abusive social structure as a huge contributing factor.
Bruce, I loved the article! A very timely reminder that rebellion against an oppressive society will always be attacked, but when “mental health” means submitting to an insane system, then the only sanity is to rebel!
—- Steve
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Without even addressing the subjective and speculative nature of the “ADHD diagnosis,” even if we accept uncritically that some people have this “disease,” the “treatment” has been shown at best to be helpful in suppressing symptoms for the short term. There have been hundreds of articles and at least half a dozen thorough reviews of the literature, starting with Barclay’s own review in 1978, and none of them have ever shown any long-term outcome being positively affected by long-term stimulant use.
I raised two classically “ADHD” kids without any thought of drugging either one of them, and both ended up honors students in high school, highly successful athletes, and the youngest has developed into quite the social butterfly, while the oldest has been steadily employed for over 10 years by the same agency. No drug abuse, never fired from jobs, no high-school dropout or delinquent behavior from either one. The youngest is poised to start into college next year.
ADHD is not a disease, and stimulants are not a treatment. They are a way to suppress annoying behavior that many boys exhibit when forced to sit in a chair all day and do boring things. ADHD kids who are placed in open classrooms were indistinguishable from “normal” kids, so naturally, we put our kids in open classroom settings in elementary school, and their “ADHD” magically disappeared.
It is amazing that we have such broad participation in such an amazingly unscientific sham!
—- Steve
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Sounds like you’ve got plenty of insight to me, into the total conflicts of interest that drive most of this field. The system is really more invested in you having LESS insight. Their definition of insight is “the wisdom to realize that you’re better off doing things my way because I can punish you if you don’t.” I suppose that’s insight of a sort, but doesn’t have much to do with “mental health!”
Thanks for sharing your story.
—- Steve
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Wow, this is just fascinating! Weight gain is indicative of improvement (more weight gain is better), and cognitive impairment, which is clearly caused and/or exacerbated by SGA “treatment,” is the biggest problem he wants to solve by more SGA “treatment.”
When 70-80% of your treatment recipients discontinue treatment, it’s time to reconsider if your treatment is all that helpful.
I think he has a delusional disorder, and needs a depot injection himself!
— Steve
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Bob, thanks for hanging in there and having the courage to continue speaking despite the crap you’re being unfairly given. I posted on the website to register my dismay with the characterization of affairs as somehow being “your fault.” Notably, there is no blood, but there is a lot of fear and drama. On one level, I understand the tremendous anxiety these parents feel as they are unable to control what they feel are bad decisions by their own offspring. On the other, that need to control is part of what is wrong with the system and is most likely contributing to their children’s ongoing distress. They have been heavily brainwashed and don’t really see other options, and are so invested in their views that even the idea there might BE other options creates immediate defensiveness, perhaps because of their own guilt that they really do know they and the system may be failing their adult child.
It is somewhat ironic to hear this “blood on your hands” rhetoric when the treatment these folks so fervently defend is killing off its recipients many years prematurely. It seems very reasonable that a person receiving such “treatment,” especially for such subjective and potentially spurious “disorders,” might consider dying early and being miserable in the present a pretty poor tradeoff.
Bottom line, speaking the truth has gotten lots of people in trouble throughout the millenia, especially when the truth threatens the power base of the status quo. The fact that people are attacking you means you’re having an impact. Keep up the good work – you are making a BIG difference!!!
—- Steve
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Thanks, Donna! I always enjoy your replies as well, factual with a good dose of passion and personal experience. I consider your stamp of approval to be a very high compliment, as I know you wouldn’t hesitate to tell me if I had my head in a dark and smelly place!
—- Steve
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And again, I have to point out that these people are dispassionately talking about killing people, and arguing more about the mechanism than about whether they ought to just stop doing it. How do you do a risk/benefit analysis when 1/20 of your patients will die earlier as a result of your “treatment?” It seems very unlikely that the patient is conferred any benefit, unless they are already terminal and you’re providing palliative care. But anybody that considers an atypical antipsychotic as “palliative care” is delusional.
It disgusts me that these people can be so cold about the fact that they’re ending people’s lives prematurely!
—- Steve
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Not to mention that there is a Black Box warning on the atypicals that it can cause early death in elderly dementia patients. So he’s mad at Haldol because it kills patients more quickly than the atypicals kill them? I suppose you wouldn’t get as much profit if they died sooner…
— Steve
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Which seems to be the exact opposite of what the current practices are attempting – instead, we’re being encouraged to “split off” anything uncomfortable, and if we can’t, to drug it into submission. There will be NO shadow selves in THIS society!
—- Steve
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I remember reading about a culture, I think in the Pacific islands, where the first activity at breakfast in the morning was each person relating what they’d dreamed about the night before, in a very accepting atmosphere of interest. It did not surprise me that the article went on to say that these folks were among the most peaceful cultures on the planet.
Dreams are fascinating and informative, and it’s disturbing and indicative of where we’re at as a culture that sharing of dreams has dropped out of therapeutic practice. I definitely shared dreams with my very competent therapist as a young man, and if nothing else, they gave me a clear indication of my progress in therapy. I remember one in particular, later in therapy, where I dreamed of meeting a very ugly, stupid, diseased-looking person who looked something like me. I remember seeing him and wanting to turn away, but instead, deciding to greet and embrace this “unacceptable” version of myself. It was a very powerful moment – brought Jung’s “shadow self” right to mind. I knew at that point that my therapy was drawing to a successful close.
Thanks for reminding us of the power of our dreams. It’s interesting that “dream” is also synonymous for imagining a better future for ourselves.
—- Steve
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Marijuana in larger doses did eventually start making me paranoid (though it only started after an incident where someone had slipped me another hallucinogenic drug). I have heard this from other users as well. I think it is very possible marijuana can trigger psychosis, especially if used long-term or with other drugs (including legal psych drugs).
That being said, I agree with you, the legal drugs are far more likely to cause psychosis and other problems than marijuana ever could. In fact, marijuana in low dosages is probably a more effective “antidepressant” or “anti-anxiety” drug than anything on the market, and it certainly has a much milder side effect profile! The problem, of course, is dosage control, but as we see with the incredible rise in prescription drug abuse, that problem exists with almost any psychoactive drug.
So I agree, it makes no sense to give kids amphetamines and then be worried when some of them smoke pot. I’m a lot more worried about the speed!
—- Steve
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Wow, thanks for that moving story of growth! I related on so many levels. While I did not experience much in the way of overt abuse, I was definitely the secret-keeper and confidante and caretaker in the family, and learned early to be “not very demanding” in order to feel safe and feel liked and valuable. I was the “good kid” and made my parents happy that I didn’t make a lot of trouble for them, and I bought into that role.
I agree 100% that most of what passes for “mental illness” is the result of children needing to play adult-like roles and in some way care for their own parents’ emotional well being. This goes well beyond “trauma-informed” practice – it is about the day-to-day strain of having to be a certain way in order to feel safe or accepted. Have you ever read anything by Alice Miller? She articulates this idea so very effectively, she’s definitely worth reading.
I have also seen the healing power of people speaking out about their experiences. I work a lot with foster kids, who have generally been through hair-raising experiences beyond most people’s comprehension, both before and after entering foster care. I’ve seen real transformations when these kids are put on a panel to talk to adults about what it’s like to be in foster care and how the grown ups can do a better job. Finding their voices and having people actually listen and want to hear what they have to say is tremendously powerful and healing for many of them.
My biggest complaint about the psychiatric system isn’t the drugs per se – it’s the constant message that we need to shut up about our uncomfortable feelings and experiences. Being labeled and drugged reinforces earlier experiences that say, “These are the authorities and they must be right, I must not upset or disagree with them, I must not anger them or I will be hurt.” The psychiatric industry appears to be bent on getting people to be quiet and act “nice,” whereas the real path to healing helps people get a whole lot louder and, if not less nice, more willing to let other people be upset if they so choose. It’s a long road and can be lonely but leads to a better kind of life, in my view.
So thanks for sharing, and keep walking that path. So glad you’ve found your voice and are letting it be heard!
— Steve
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I would say that a lot of good counselors don’t get funding, and a lot of really bad counselors continue to work for agencies for a long time, especially when involuntary “clients” are involved. I’ve worked with a lot of these agencies, and most don’t know a good counselor from a bad one. Also, the training for counselors these days is really limited, with way too much emphasis on diagnosis and “techniques” of “evidence-based medicine” instead of a proper focus on relationship-building, empowerment, and sensitive and intelligent exploration of current needs as well as of traumatic events that may contribute to the current situation. Good counselors also recognize multiple factors that impact mood and behavior, including basics like food, sleep, and exercise.
In short, there are good counselors out there, but there’s no guarantee they will be funded or promoted or even allowed to continue to work at a place where they may be too threatening. I’d say that mediocre to poor counselors abound and are probably much safer in their positions than the really good ones, because any really good counselor would find the current practice parameters ridiculously restrictive and often quite destructive and would try to change them, which naturally would upset his/her bosses or someone up the food chain who is invested in the status quo.
Bottom line, I believe a really effective counselor is bound to have a subversive impact on entrenched bureaucracies, because they’d be focused on the needs of the client vs. the needs of the institution. Such behavior is rarely rewarded in the system.
—- Steve
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Quote from the article:
“Psychiatrists may be unaware that abuse can precipitate a patient’s psychiatric symptoms. “We are trained to diagnose psychiatric disorders without looking at the social context that might have generated the patient’s symptoms,” said Warshaw.
Psychiatrists fail to ask about abuse because they don’t think it is prevalent among their patients, don’t have the time, and don’t know what to do if they identify it. They may also find it difficult to tolerate the pain and helplessness they feel when patients talk about their experiences of abuse or when their own traumatic experiences are evoked, said Warshaw.”
Is that not pitiful? But I find it 100% true. It’s all about the “doctor” being uncomfortable asking the question, or genuinely being so incredibly ignorant as to believe that trauma has nothing to do with a patient’s symptoms, or somehow idiotically believing that abuse is rare among their patients. Do they read ANY research? Do they not know that 1/3 of all women are sexually molested or abused at some time in their lives? The first question to ask any client in emotional distress, beyond the details of their current situation, should be about what has happened to them historically.
I’ve seen this hundreds of times, too, so I know it’s not idle speculation. When I did evaluations for involuntary detention, I found that probably 3 out of 4 women diagnosed with bipolar disorder had obvious, easily accessible trauma histories that they were happy to reveal with a couple simple questions and some good listening skills. This included childhood sexual abuse, rape, and current or very recent domestic abuse. But the psychs were much more COMFORTABLE diagnosing “bipolar disorder”, probably because they could “treat” it without having to actually get to know the patient.
It is disgusting to me that this kind of article would ever need to be written. How can someone be a psychiatrist and not know that trauma is incredibly prevalent and that it has a direct, causal relationship with “mental illness” symptoms???!!!
—- Steve
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Jennifer,
Thanks for this refreshing counterpoint to some uncomfortable discussion regarding NAMI posted recently. I love what you’re doing and think it is truly the way to move toward a new paradigm. Institutions can’t answer these questions – people need to answer them together and tell the institutions what is needed. I find myself feeling much more hopeful after reading your blog. We can do this! All of us who care can do it together.
— Steve
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Can’t argue with you. What’s that saying about making a “silk purse out of a sow’s ear?”
—- Steve
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I have certainly seen local NAMI chapters who are very supportive of real change, and others (probably most) that are very married to the current paradigm. NAMI as a national group has been quite reprehensible, and I would really want to see some evidence that they are really distancing themselves from their pro-pharma propaganda that has characterized them over the years. That being said, I’m not opposed to a rapprochement with NAMI if there is a genuine desire to explore alternatives. But it would require some acknowledgment of the damage done and some effort to make amends to those who were harmed by NAMI’s historical rhetoric. I admit, I’m skeptical that such a thing could happen, and I also agree 100% that a “forgive and forget” attitude isn’t realistic, given the real harm that NAMI has done to those it has purported to help.
Having Ms. Myrick chairing the board does help me believe that some change is possible. And I don’t want to write off the entire rank-and-file of NAMI based on its historically misguided leadership. As the stories in the article clearly indicate, there are some allies in the NAMI ranks. But the leadership has got to move off their pro-drug, pro-incarceration, E. Fuller Torey “Anosognosia” kick for any real collaboration to happen.
—- Steve
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Well said, Sandy! There are tons of ways to improve brain functioning or make it worse. Antipsychotics are a crude tool used to attack a crudely-defined problem in a very crude way. They appear to make brain functioning worse rather than better. I was just reading another blog about how the Quaker “asylums” that involved fresh air, exercise, calm companionship, and a calm environment were more effective by far than anything we see today. Were the Quakers improving people’s brain chemistry by love and support? You bet they were!
The idea that the psychological impact of the environment can somehow be extracted from a person’s life and that we can work on brain chemistry physically without regard for that psychological environment is the primary fallacy that has led us down this destructive path.
— Steve
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I don’t know that their position is all that hard. I think they put themselves in a hard position as a profession by asserting things that aren’t true. It seems to me the research is pretty clear about what it suggests, even if the reasons are unclear: the less medication is prescribed (on the average), the more likely it is that the client will be able to maintain a functional social life, and the level of “symptoms” will be relatively unaffected. This is what the Soteria House experiment demonstrated rather conclusively back in the early 1970s. The results haven’t changed since then. If you care about the client’s ability to function in society, the results are fairly clear.
If psychiatrists are honest about what the research says, it seems clear that they will need to be much more conservative about prescribing antipsychotics, even if they believe 100% in the “chemical imbalance” theory. It appears that “antipsychotics” don’t rebalance dopamine, they appear to throw the balance off. So if antipsychotics are used, they should not be first line interventions, they should be used at as low a dose as possible, and clients should be weaned off as soon as is practical to do so. Much as they do in the Open Dialog program, which has the world’s best success rate with “psychotic” clients.
Sounds fairly simple to me.
—- Steve
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Most people spend most of their time on an unconscious level, unfortunately. By the end, if something like real peer work does become a part of the system, there will be hundreds of people who will believe it was their idea in the first place or that they worked hard to make it happen, even though they vigorously opposed it in reality. I’ve learned long ago as an advocate to stop caring if those in power understand what I’m talking about, as long as they do the right thing. If they want to believe it was their idea or that they somehow made it happen, I’m happy to let them save face.
Though in this case, the concept that clients actually have experiences that may be different from what the MH “professionals” expect is one that perhaps does need to reach some level of conscious awareness. The main reason most people stop “taking their meds” isn’t resistance or “anosognosia” or “thinking they’re better and don’t need it any more” – it’s because the damned things make them feel like crap and often don’t work or make them worse! Not sure how many peer specialists it would take to make that point. It should be obvious by talking to the clients and asking them why they stop, but that would require we view clients as human beings capable of making rational decisions. Which would be a TOTALLY radical concept!
—- Steve
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I think it’s important to distinguish between blame, which I find tends to keep us stuck, and correct assignment of responsibility, which I find tends to free us. To blame someone else for how you feel tends to make it difficult to escape the fact that you can’t change what they did to you. It can become a long-term bitterness from which it is hard to escape.
However, appropriate anger at someone for acting destructively can energize us to defend ourselves or attack the correct target to assure that we or others are not abused further. In my experience, it can sometimes be critical for someone with a history of abusive relationships and interactions to learn how and when to contact and use their anger for purposes of self-protection and the promotion of justice. Often, it has not been safe to feel or act on their anger due to the dangers of the abusive environment, and they have learned to suppress anger in exchange for self-blame. Undoing this suppression can be the most important aspect of learning a new way of being in the world.
Blaming others for our anger is seldom helpful. Choosing righteous indignation at abuse or injustice that we have experienced can be incredibly powerful and effective in helping us be motivated to take action against those who are willing to abuse us for their own gain, or simply out of their own ignorance.
— steve
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Sera,
As usual, you hit the nail on the head. And no, I didn’t roll my eyes, and don’t think others will, either. Co-optation is a time-honored strategy of those in power to de-fang a protest movement, often employed when direct oppression has been unsuccessful. So perhaps attempts to co-opt should be considered a good sign, as it suggests they’ve given up on y’all going away. But giving in to co-optation is not an option. As Steven says, it’s all about POWER. What real peer support does is empowers clients to make decisions for themselves, which is exactly the concept that the MH authorities want to snuff out. So they hire “peers” and re-define the role into one of coaching their less-powerful “peers” into toeing the party line, taking their meds and “accepting their disability” like a good slave, oops, I mean patient, oops, I mean CONSUMER ought to. Kinda like the inmate prison warden who gains privileges by enforcing the prison rules on his/her “peers” in the jail. You stop being a “peer” the moment you have and are willing to exercise institutional power toward those who don’t have it.
Thanks as always for an insightful and memorable piece.
— Steve
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I have seen first hand in my work (with the CASA program) how many foster kids have “bipolar disorder” diagnosed following “treatment” of “ADHD” with stimulants, and sometimes following SSRI prescriptions. I’ve also seen many “recover” when they stopped these drugs on their own. It is a common occurrence.
I agree, it is criminal, and Biederman and others who knowingly perpetrate this nonsense for personal financial gain should be jailed.
—- Steve
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You are right, of course. I should have put “cure” in quotes. I was using her words, but should be more careful to be clear that I don’t see any “mental illness” as a disease, and hence don’t see them being “curable” any more than playing with one’s mustache or eating vanilla ice cream is curable. Thanks as always for reminding us of the power of language to shape how we think.
— Steve
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At first, I thought this was an attempt at humor regarding the “diagnosers,” suggesting that they were “dependent on diagnoses” and that such dependence had a neurological underpinning. Might yet make a great article for The Onion or some such farcical publication.
I’ve seen this phenomenon too many times to catalog. My favorite is a kid in residential treatment who was said to be “sexually acting out.” His crime? He drew pictures with large penises on them, and he engaged in “sexualized talk with his peers.” His age? He was 12 years old! Ever know a 12-year-old boy who wasn’t fascinated with penises, or didn’t have sexualized talk with his peers? But because he was in a “mental health facility,” this normal behavior was labeled as aberrant.
Glad someone is reporting on this, but it’s kind of obvious that it happens, which is why an objective measure of health/illness is critical before we “diagnose” people. Otherwise, any prejudice we entertain can become a “disorder.” Which is pretty much what the DSM is all about.
— Steve
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Well, and how about Open Dialog? Sounds like a lot of “schizophrenia” (whatever THAT really is) has been cured by human support. Soteria House is another example. In fact, simply living in Brazil seems to be helpful, as they don’t use many drugs, and may possibly be less judgmental of those who are hearing voices, etc.
And I think there’s been some data supporting that even cancer is impacted by levels of social support.
Just because our experiences have biological correlates, doesn’t mean that these correlates are casuative of our experiences. Jill is sounding like a reductionist, which she’s entitled to be, but that’s a philosophical viewpoint, not a scientific one. She would have to explain in biological terms exactly how and why talking to or listening to someone in a calm environment reduces these supposedly biological symptoms.
One last comment – I’ve talked to lots of very agitated “schizophrenics” in delusional or hallucinatory states. I have found that the vast majority were very capable of communicating me if I was willing to listen to what they had to say first. Not that it was always easy to sort out what they meant, but making the effort almost always created a calmer situation. And sometimes, they made a whole lot more sense than they were being given credit for. They mostly needed to know that I cared about trying to figure out what they were trying to communicate. Which seems pretty normal to me.
— Steve
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That’s exactly what I was saying, Cataract. The other staff who are there need to intervene whenever something inappropriate or dangerous happens. If they don’t, they’re complicit. It’s that simple. I understand why the clients/inmates don’t feel safe to intervene, especially if the other staff stand by mutely, but if the staff intervened strongly, the inmates might feel there is some chance that adding their voices to the effort to stop the abuse might have an impact.
It is very challenging to talk about these things, especially if you’ve been a victim of this kind of abuse, and I very much appreciate you taking the time and energy to reply.
— Steve
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What an amazingly narcissistic quote! Because the patients don’t want to hear that the psychiatrist has no idea how the medications work, the psychiatrist pretends that he does, even though the truth is that he doesn’t. Sounds like lying to me, and lying not for the patient’s best interest, but lying to avoid the patient discovering that the doctor is not all-knowing and wise. Lying to meet the needs of the doctor.
So many better things happen for the patient when the doctor can admit his lack of a solution! They can work together to think over some options. The patient and doctor can both do some “homework” and come back together later to discuss what they discovered. The patient can come to the realization that s/he may have more power than the doctor to address the issues. The doctor can learn some humility and maybe discover a new approach that no one has thought of before. But we avoid these possible benefits, all to preserve the doctor’s false narcissistic image of perfection and elevated knowledge. The patient takes drugs the doctor knows don’t really help and can harm, all so the patient’s faith in the doctor is preserved. But what happens to that faith when the patient discovers that the doctor is full of crap?
This is truly criminal behavior!
— Steve
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I agree that most of those who tell this story are religious “scientism” true believers who are able to explain away or ignore research that is contrary to their epistimelogical mythology. But we also should remember that there are some, mostly in the higher echelons of power, who actually are quite aware of the deception and are actively promoting it because they are profiting from it. Those are the ones who have to be found and attacked. The drug companies are, of course, where many are located, but there are those in the psychiatric hierarchy who see this as an effort to gain “market share” and have no concern whatsoever for truth or patient safety or informed consent, as long as they are gaining power, prestige and money.
—- Steve
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The bullying literature also emphasizes the importance of engaging the bystanders in taking a stand. There is no such thing as an “innocent bystander” – silence is interpreted by the bully and other bystanders as support or at least acquiescence. We really need to get those who see the brutality of this kind of behavior to speak up, including those IN the facilities who feel afraid to speak up because they will be the next ones bullied if they do. Not sure how we do that, but your comment made me think of that point.
—- Steve
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Indeed. I was such a worker for 9 very long and difficult months, and did everything I legally could to spare or release the inmates, and was actually quite successful in doing so. But it weight heavily on my conscience to commit even one person to that horrendous institution. It sometimes seemed it would be kinder to just go ahead and let them kill themselves. The psych ward is a sick place, and the analogy with a concentration camp is apt.
— Steve
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Actually, whatever else one might say about L. Ron Hubbard, he’d have agreed with everything said in this blog. He considered psychiatry to be the most barbaric practice on the planet, and viewed psychiatrists as a long-standing group of evildoers behind most of the ills on the planet. I always felt that last was rather extreme hyperbole, but there are times I wonder whether he was right after all.
Anonymous, thanks for your passion for this issue. You are right, as the saying goes, you can’t negotiate with terrorists. While there are many individuals within the profession that have a heart, the core of the profession is invalidation, power, and coercion, and it does untold damage to millions planet-wide, and is in my view irredeemable.
“Brain-blaming cult” sums it all up quite well.
—- Steve
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I agree, “meds” seems to somehow make the dangers and side effects seem benign. It’s especially obnoxious when applied to kids. Makes my skin crawl, too.
— Steve
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Quite so. Most of the movies that show psychiatrists show them doing supportive therapy work (take “Good Will Hunting” or “Ordinary People” or even “What About Bob?” as examples.) I am sure many are quite surprised to learn how they are encouraged to distance themselves from the actual people involved and to view the client through the lens of their “symptoms.” I am encouraged to know that you and others are questioning this paradigm rather than accepting that the adult authorities must know what they’re talking about.
I just hope you and your colleagues can do some “inside work” to support what others on the “outside” are doing. Glad to know also that other docs are looking for alternatives as well. It seems your challenge is to overcome your training, rather than to implement it!
— Steve
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Hi, Vivek,
Thanks for having the courage to speak about this issue. It is not surprising to learn that you get no training in withdrawal, and it reflects the reality I see in foster care: children are almost never taken off of any psych drug without vigorous advocacy, even if the drug is clearly having no positive effect or doing damage.
I was surprised at your reports of increasing skepticism in the ranks of new practitioners, as well as a resurgence of the radical concept of actually talking to clients in a supportive way about their needs and concerns. I 100% support your belief that the recovery of a sense of personal agency is critical to survival and recovery from any mental/emotional distress.
I hope you can be a “virus” in the machinery of psychiatry, and encourage your colleagues to do so as well. The idea of listening to the experiences of those victimized by psychiatry is the beginning of learning a new path. Again, I appreciate your courage and humility. Keep your ears and eyes open and your mouth shut as often as possible, and you can be a huge agent of change.
—- Steve
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Not saying he’s a “victim,” I’m just getting tired of reading about it. I usually skip most of his stuff, because a lot of it is written by someone else, and frankly, it just takes too long to read. But now I have to read more about how long his posts are, which is more I have to not read. It gets dull.
— Steve
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Can you guys please stop beating up on David? I think we get the picture. I’m getting tired of it. I think David gets that if he writes less per post, more people will be likely to read it.
I might start counting the number of posts about the number of words in David’s posts…
— Steve
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That is an awesome point! If someone using antipsychotics as an “adjunct for depression” and their brain volume also decreases, you can’t very well blame it on schizophrenia, can you?
Brilliant idea. Someone get a grant!
— Steve
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Wow, that is a major study! I’m sorry the Vatican conference didn’t provide what you expected, but politics reigns, even at the Vatican. Studies like the one you just mention are so important in countering these political/economic messages that are so self-serving to the ruling class. THANK YOU for continuing to fight the good fight. I know you get discouraged, but you continue to inspire me and others to keep going when we get discouraged ourselves.
Thanks also for this new study – I have every intention of making full use of it. I’ve been saying for many years that there is no evidence of long-term benefit for stimulants, but this is the first time I can say there is definitive evidence of long-term damage. Let’s get this study as broadly distributed as possible! Given the new DSM controversy craze, would someone from the NYT be interested in this latest research?
—- Steve
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I am not saying that nobody fits the criteria that define ADHD. I am saying that calling it a DISEASE or MENTAL DISORDER is not legitimate. I am saying that genetic diversity is the core of species survival, and that many of those who get the ADHD label are simply one variant (or probably a huge range of variants with this behavioral overlap) of the genetic options available. My kids struggled in many ways, but they were also incredibly gifted in many ways. There may be a very unusual case here or there that involves actual damage to the brain, but for my money, “unable to focus” is not necessarily a disease or disability, it’s just a fact of life some people have to deal with, like running more slowly than others or having a genetic propensity to carry more fat. We all have our challenges, but this particular one is 95% created by our classroom expectations.
There was a great study done back in the 70s where they put matched “ADHD” kids in an open classroom vs. a standard classroom, and asked professionals to identify which children had the label. In the standard classroom, they hit over 90% correctly. In the open classroom, they essentially could not tell the difference. Pretty dramatic results, eh? So ADHD appears to disappear when we change the classroom structure.
Of course, there are some kids who don’t do well in an open classroom. You’re right, there is no “one size fits all” school. But I wouldn’t take the kid who couldn’t function in the open classroom setting and call them “overstructured” and put them on a drug to make them better able to tolerate the classroom. I’d put them in a more structured classroom. It’s not their fault they don’t do well in that setting, and it’s not the “ADHD” kids’ fault he doesn’t do well in the standard classroom. It’s high time the adults realized that it’s our job to adjust the environment to meet the needs of the kids, not the other way around.
By the way, I’m really sorry you didn’t get the opportunity to learn in an environment like our youngest son has had. I know it would have made a huge difference to you. It’s very child-centered and adapts a learning plan for each kid, plus you get to sign up for what you want to or create your own projects, and you get to work in groups or even create your own classes. It’s the perfect environment for the active and intense kind of kids that usually get whacked with that label.
Anyway, I appreciate your respectful response, and absolutely accept that you have your own framing of your situation and would not want to take that away from you. What I hate is when someone foists their own view of “normal” on someone else, just because they don’t fit the other’s expectation. It’s particularly irksome when that person has power over the victim and chooses to use it to degrade and diminish rather than to understand and create. So I get passionate about it.
You sound like an awesome human being. Well done for surviving your “education!”
— Steve
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Alex,
It made me very sad to read your post! I have always valued your posts and found them very rich, direct, and real. I think you have a great deal of understanding and compassion for those who have to actually experience the system, rather than talk about it and speculate about theoretical perspectives.
If I have said or done anything that contributed to your feeling drained of energy, I apologize for doing so. I hope you’ll still hang around and drop in your comments sometimes. You will know that I appreciate them.
— Steve
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I would not argue with your general observations. Obviously not ALL “ADHD” kids are anti-authoritarian, nor are all who are labeled “mentally ill” anti-authoritarian, either. However, I would dispute the idea that because someone “cannot focus one moment to the next” they are “legitimately ADHD.” There is no legitimacy to a “disorder” that is diagnosed with a checklist invented by clinicians sitting around a table voting on how many criteria are needed to justify a “diagnosis.” There are all kinds of people in the world, some of whom are happy to and capable of focusing on whatever you ask them to, some of whom can’t or won’t focus on things that are not of intense personal interest to them. Why are the latter classified as “disordered?” For the simple reason that they are INCONVENIENT for the authorities. Which goes back to the author’s point.
I raised two kids who had a very hard time focusing when they were in early elementary school. We wisely avoided standard classrooms and used homeschooling and open classroom alternatives. Both became very successful academically and athletically, and the younger is very socially popular at his high school, while the older is a hard-working and successful employee of a community helping organization. I never believed there was anything wrong with them because they could not/would not sit in a desk at the age of 6 and fill out worksheets handed to them by harried and overworked teachers.
Interestingly, the oldest is pretty authoritarian in some ways, while the youngest is extremely anti-authoritarian. But both fit the ADHD criteria to a tee at 5 or 6, neither received any “treatment” besides some very creative parenting, and both turned out to be good and successful citizens of the realm. Doesn’t sound like there was anything wrong with either of them, except that they didn’t fit into societal expectations of what makes a “good student.” Which is pretty much the definition of “ADHD” – “Annoying in a standard classroom” and “impatient with the dull and the arbitrary.”
There is no “legitimate ADHD.”
— Steve
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I can completely relate to your comments, as an ongoing participant in “the system.” To hear the words “Positive Peer Culture” was a balm to my soul! I worked residential/day treatment in the 80s, and we also used to have the (these days) radical belief that children made decisions and that their behavior met a need and that they were responsible for their own decision making. I actually avoided any training in the MH area until AFTER I started working in the field (for some odd reason, they felt a Masters in Education qualified me for working with the “emotionally disturbed” teen moms in our residential treatment center), so I was primarily self-trained, and based most of my principles on what I observed. It was many years later before I discovered I was an Ericksonian.
Anyway, I also watched the deterioration of responsibility and the dramatic increase in the use of “meds” and the increasing chronicity of the population. I remember in the 90’s people starting to say, “We’re seeing much more serious situations than we used to” or “These kids have much bigger issues (usually more violence) that the ones we used to see.” I did not at that time understand the likely connection with the increasing use of drugs to “treat” these kids. But I think its clear looking back that these trends were intimately connected.
Today, I work as an advocate for foster kids (my last job in the MH industry was back in 1995). When I see the res units today, I see a lot of people who have no real idea what they are doing. They still have level systems everywhere, which are mostly based on compliance and punishment. There is little to no creativity. Kids that don’t respond to this structure are either put on meds, or their meds are increased, or they get put on new meds in addition to the old ones. Kids are on 4, 5, or more “medications” and are still attacking staff and peers and breaking windows and self-harming and threatening or completing suicide. No matter how bad their behavior gets, no one ever seems to observe the obvious: if these “meds” were working, they should be getting better, not worse!
How anyone could say the benzos are not addictive is baffling, but I do hear that sometimes, and I see people (mostly adults) prescribed Klonapin or Ativan or Xanax for many years, even though the product information itself says that use for more than a few weeks at a time can be dangerous. So they don’t even follow their own “medical” information!
I find it most discouraging. It is particularly ironic when these folks who deny reality in order to maintain their “system” accuse folks like you or me of “black and white thinking!”
But it’s good to talk to someone who remembers the “old days” when we still had a focus on helping kids manage their own perceptions of the world and the effectiveness of their own decisions, and where behavior still had meaning beyond the chemicals involved. Thanks for sharing your perspective and reminding me of brighter days. I know we weren’t amazingly helpful, but at least we didn’t (for the most part) make people worse or create addicts out of distressed individuals who needed love and guidance!
—- Steve
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Don’t know if the pancakes turned out to be any good, but it sure looks therapeutic! I particularly enjoyed him/her stirring with the telephone. That would SURELY get you an injectable dose of Prolixin on most psych wards!
— Steve
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OMG, a GUITAR on the ward? What is wrong with that guy, to think that something as mundane as SINGING could make people feel better… Oh, oops, it seems to be working… OK, now we need to get rid of him, he’s making us look bad!!
There ought to be orchestras in the psych ward, choruses and solo performers and art shows and story reading and baseball games. They are just grim, dead places that would depress anyone. Too bad guys like Steve are so threatening, but I guess that tells us all where most of the system is coming from.
—- Steve
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Yeah, it’s too scary for most of them, because they haven’t faced their own demons. That’s why the DSM is so destructive – it enables the labeler to distance him/herself from the labelee and decide that the client’s behavior/emotion/experience is just WRONG and needs to be stopped. Which, of course, is the primary justification for enforced and/or manipulated drug prescriptions. If the “bad behavior” can be stamped out, then the clinician feels better, regardless of the impact on the client. To me, the opposite of real therapy.
Giving someone credit for having come up with good survival techniques is very powerful and helps connect being-to-being, as you so eloquently say. But the therapist has to be able to tolerate a lot of uncertainty and discomfort and be OK not knowing what to do for a while if they want to really connect on that level. And most are not capable of it, even if they wanted to. Which is sad, because they really miss out on the beauty of seeing someone REALLY improve instead of just suppressing their “symptoms” (aka normal reactions to abnormal circumstances).
— Steve
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You had me rolling out of my chair with this one! The Nurse Abuse Line, Self-Harm Sindy! And I loved developing your own phrases for the group! Not only amusing, but it would definitely be helpful to break out of the mold like that and see some HUMOR in the situation. I remember being on the psych ward one time in the day (I did involuntary detention evaluations, and tried to let everyone go by providing them brief therapy in the ER, but I usually worked nights), and I was immediately struck by how damned SERIOUS it was! All the psychiatrists had grim looks on their faces, and the nurses seemed to be very cautious not to be loud or say anything “inappropriate”, most likely for fear of provoking an attack from one of the psychs. It was kind of scary! Can’t imagine how anyone could heal in that environment. I had to quit that job pretty quickly.
Anyway, it feels like you’re a kindred spirit, and I hope I have the pleasure of meeting you one day. I’m glad you found your voice and let your anger guide you to fighting off the real enemy, namely, anyone who tries to define who you are and how you should behave for you, regardless of their degree. I think real healing has to involve recognizing the oppressive nature of the entire social system we’re living in. A lot of “insanity” happens because people see what’s really happening and everyone around them is pretending it isn’t real. Those of us who see what’s really happening have to stick together.
As the saying goes, “You’re not paranoid if they really are out to get you!”
—- Steve
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Stepford Wives, move over!
I actually don’t view any emotions as “negative.” I think all emotions have survival value. They contain important messages regarding our safety and need to take action to protect/defend/support ourselves. Admittedly, our emotions haven’t really adapted to the realities of our bizarre modern world, so they can be pretty confusing, but they are there for a reason. Anxiety helps us avoid dangerous situations. Anger helps us win when we have to fight for our safety or to feed ourselves. Depression helps us conserve energy when trapped in a difficult situation without an immediate solution. In fact, thinking of them as “negative emotions” probably helps reinforce their inappropriate continuation after they are no longer useful.
I can’t tell you how many people I’ve had to encourage to feel ANGRY about abusive behavior that’s happened to them, so they’ll feel enough energy to do something about it! All this Pollyanna crap about feeling happy all the time (but not too happy, that would be manic!) is just plain sick to me.
I think it all goes back to the mainstream people wanting to deny that anything bad ever happens, just like they denied in Freud’s day that the sexual abuse his female clients described had really happened. Freud did believe them at first, but was so roundly attacked by his peers and the general society at the time that he backed away from his observations and decided they were fantasies. But as it turns out, they were telling the truth all along.
Those in power would always like us to be happy or at least well-adjusted to our lower power status and dependency on their largess and magnanimity. Nobody wants the masses getting ANGRY!!! So Anger is a “negative emotion” that must be purged.
I say, embrace those homicidal feelings! You don’t have to act on them, but they’re telling you something is amiss with trying to delete “negative emotions.” Fake positiveness doesn’t help anyone but those who are already on top of the economic heap!
— Steve
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Sounds like she’s attempting to salvage the old dogma that “you need to stay on your meds,” even though they’re shrinking your brain. Naturally, she avoids any reference to non-toxic, non-drug ways to avoid “relapse,” which would provide the desired protection without any long-term brain damage. Someone should send her some of the stuff from Open Dialog…
— Steve
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Wasn’t that the whole point of the enterprise?
—- Steve
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I am honored that you would find my statement about therapy worthy of re-quoting, given the crappy experiences you have had. Perhaps my strength as a therapist was that I had almost no training when I started, so I had little to go on beyond my own simple sense of what I might feel like if my therapist did this or that. Of course, I did have some very good therapy before I started. Maybe that’s more important than one’s theoretical orientation – to have done enough work to keep one’s own crap out of the equation.
—- Steve
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This is a very important discussion, as I have seen and personally experienced quality therapy and seen what it can do, and I’ve witnessed plenty of crappy therapy and seen the damage it can do, as well.
I guess what all of this made me think of is that traumatic events involve a loss of power and control. Sometimes, it is a one-time event, which, while terrifying, does not represent the entirety of a person’s life. It seems a lot easier to recover from that kind of situation. But the people I’ve encountered who are seeking help for trauma have usually experienced multiple traumas over time, reaching back to their childhoods.
I certainly don’t practice or advocate forcing a person to revisit trauma randomly, nor do I believe that a person “must” relive their traumatic events in therapy to recover properly. What I have discovered is that kids who grew up in abusive environments were forced to find ways to cope with those environments, because they generally were unable to escape or control the events in any way.
As an example, I personally regarded school as an abusive environment where I had no control over anything, and I spent a lot of energy protecting myself from the random verbal and occasional physical abuse of teachers and peers (that from teachers was far worse), including keeping a very low profile (I was very “shy” and would undoubtedly be considered to have had “social anxiety disorder” these days.) The “coping measures” I developed were necessary to survive school. Unfortunately, they made it harder for me to behave “normally” when I finally did escape. For instance, I learned never to speak up or raise my hand in a setting where I might actually get called on. I learned not to be vulnerable in any way, such as revealing my emotions or discussing an error I’d made, in front of my peers, in order to avoid bullying or humiliation. I learned to believe that my peers disliked me and that acting as if I were someone different than myself was critical to my survival. As an adult I had to “unlearn” many of those coping techniques. Of course, my quality therapist was able to help me connect those choices back to earlier trauma in my childhood (mostly neglect, with very intermittent outbursts of verbal and physical abuse) that led me to believe that keeping a low profile would help protect me. I doubt very much that I could have re-considered those coping measures without that therapy work, because they were deeply embedded in what I believed to be my personality.
So when I do therapy, what I’m looking for is something IN THE PRESENT that the person does or doesn’t do that bothers that person him/herself. I in no way evaluate for them what they should or should not believe about that behavior, but generally engage in an honest and safe exploration of what benefit they see in that behavior that makes it seem worth continuing it, despite their own assessment of the ineffectiveness or frustration the behavior creates for them. This often leads to a trip back into history to discover how and why this behavior made sense at one time in their past. In other words, this behavior that they dislike today may well have served a vital purpose for their own survival and been a perfectly rational response to a disempowered situation where they were unable to control events around them.
What seems to be most healing is for me to help the person safely explore why they themselves need or needed this behavior, from their own point of view, and to help them reassess if they still need it now. Validation, normalization, and taking an honest but supportive view of the behavior/emotion/thinking pattern is central to making this work. Telling the client that the problem is all in his/her thoughts or is caused by past abuse or is irrational or reflects diagnosis X all puts the client back in the place of no power again, which is exactly what brought them to you in the first place! Only the client knows the value and purpose of his/her behavior, and only the client can decide when and if to let go of it.
For some people, I don’t even try to find out why or explore history at all. Sometimes, they just want to try out new behaviors and see what works. So I help identify what they want to do differently and help them practice doing it, and deal with whatever emotions or thoughts that brought up. And sometimes I help people come up with ways to deal with the emotions they have in the present, without any attempt to change anything. It all depends on what they are ready to do and what they feel will be helpful.
As another example, I heard a former foster youth (age 20 or so) speaking of her time in foster care. One of the audience asked her how she’d managed to survive being in 15 or more placements after years of abuse at the hands of her parents, and suffering more abuse at the hands of the foster care system. She stated, “Well, I have this ornery streak. When something doesn’t seem right, I just fight and fight and fight and I never give up, no matter what the consequences.” Predictably, she was diagnosed with ADHD, then Oppositional Defiant Disorder, then Bipolar Disorder, and was confined to residential treatment homes and given armloads of drugs to stop her “oppositional behavior.” Why didn’t anyone ever sit down with her and say, “Gee, you’re pretty damned tough! You will tolerate a lot of consequences to stick to your point. Help me understand why it’s so important to you to fight these things. Tell me about one of those times you decided to take a stand, and help me understand what made it worth putting up with those consequences. I’m really interested in seeing how you think about these things.” She had damned good reasons for fighting, and her fighting was actually a valuable skill she learned that she viewed as central to her survival. Instead of helping her value this skill and helping HER decide when in the present and future it might or might not be helpful, the system went out of its way to define the very thing she knew she needed to do as a disease, and tried to wipe it out.
CBT can have its applications. I do believe and understand that we are ultimately the authors of our own thinking and feeling and beliefs. But telling someone that isn’t usually super helpful, especially right at the start of your helping relationship. I certainly ask them about what they’re thinking when they choose to do X, but I don’t tell them their thinking or behavior is wrong. Helping them answer the question of WHY they need a particular belief or feeling or thought seems to help a whole lot more. And anything that takes away their power to decide what is and is not helpful is, to me, harmful by definition, because it puts the person in a position where they have to protect themselves from the therapist, and re-traumatizes them yet again.
I hope that’s clear enough. Bottom line: every person is different, and I do what seems to work for that person. It requires humility, flexibility, and compassion, as well as patience and confidence that the client has all the information that you need to provide them the support that will help them move forward. Inserting your own theoretical beliefs or allowing your own needs to enter into the discussion is destructive in every case, regardless of what those beliefs may be.
—– Steve
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Ultimately, I think you are technically correct in your statement, but it seems highly simplistic, especially when the person making the verbally insulting remarks about you is a person you need to rely on for basic survival needs, including the need for love and affection. Most clients can’t simply decide, “Oh, I’m not going to choose to believe his words any more.” It is a far more complicated situation, as the person’s identity often becomes enmeshed with the abuse and the abuser.
As you say, the child doesn’t necessarily see the sexual part as frightening at the time, but the idea that they have to not tell others about it, or that it makes their relationship “special” (later leading to confusion about the goodness/badness of the sexualized relationship), or comments made about the child during the event, and many other things that can happen create confusion, anxiety, and anger.
I agree with Joanna 100%, the words and other actions surrounding sexual abuse are often much more damaging than the abuse itself. While some people take the attitude of “I’m not going to give the assaulter any more of my energy,” others are not able to do that, and I would not label them “unhealthy” for not doing so. Responses to sexual abuse are wildly varied, and I agree also that the amount of force is only one of many factors (I alluded to it only to respond to Jill’s assertion that fear is not always part of the picture.) And while the research does show that a positive parental response has a pretty dramatic effect on minimizing the trauma in general, individual cases are always different, and sometimes the events are devastating regardless of force or parental response.
Which is why I said I take each case individually. Sometimes returning to the past is necessary – the client’s behavior makes that clear to me. Sometimes it’s destructive, and the client also lets me know that by his/her response to my questioning. Sometimes some stabilizing activities in the present are necessary to help the person be prepared to confront the past. Sometimes they are the answer in and of themselves. Everybody is different. I think that’s the biggest lesson of all, and the one that makes the DSM/Psychiatric worldview so dangerous: there is NO “right way” to help someone with an emotional/ spiritual issue. It is impossible to generalize, because for each of us, an event takes on a meaning that only we as an individual understand. Psychiatry, as well as a rote/programmatic approach to therapy, strips away the meaning of the events to the client and gives the therapist/psychiatrist/doctor the power to define the meaning for them. And regardless of the spiritual trauma encountered, that is always damaging, in my view.
People can be tough, but we all heal in our own ways. Therapists should be there to help each person discover their path, not to dictate for them what that path looks like for them.
—- Steve
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That makes sense to me. The past doesn’t determine today, but it sometimes informs the context of what today’s choices are about. I tended to take visits to the past only in context of how beliefs based on past experience seemed to be affecting the present. It should always be clear in therapy that the purpose is to help the client improve decision making processes TODAY, not to try to fix that which is long since over.
Good point about the sexual abuse – it is more often the reaction of those around the client that has been traumatic, in my experience. I remember some good research that suggested if the protective adult(s) reacted calmly, believed the child, and took action to assure it did not recur, sexual abuse was not especially traumatic in most situations. It seems to feel more weird and uncomfortable than terrorizing, unless a lot of force was employed. The question of “what does it mean about me” seems to be a lot more salient for survivors.
Although another interesting way to visit the past productively is to talk about when the person HAS been successful or felt good, and help them re-create some of those same conditions today.
I suppose the place where most therapists go off the track is when they allow their theoretical perspective to blind them to the client’s actual progress or lack thereof. I tended to do things that worked and discard those that did not. I suppose I agreed more with Milton Erickson that “therapy needs to be recreated for each client.” The client him/herself was always my best source of information on what was going to work. That kind of thinking never let me far astray.
Thanks for your thoughtful reply.
—- Steve
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Perhaps I’m not understanding “catharsis” as you mean it, but I have found that in situations where a person is experiencing recurrent flashbacks and intense intrusive thoughts about an event, it is often helpful and sometimes essential to have them review the traumatic events (which they are compulsively reviewing in any case), and to help the client create a narrative of the events that are causing the anxiety. This is perhaps more akin to “flooding,” but is done differently, where the person is being asked to review the past event with the benefit of a therapist to keep their focus on the description of what happened, rather than losing themselves in the emotion of the moment. The client certainly emotes plenty during this process, but the effect in the end is very calming if the incident is reviewed several times over (sometimes many times) to the point that it no longer seems frightening to the person. The rest of your article makes total sense to me, and I appreciate the summary of the newer research, but I wanted to share that in my experience, some level of release of emotion from past traumatic experiences appears to be quite helpful and brings lasting relief, if correctly approached and used selectively. And it is certainly applicable to many terrorizing situations, such as child abuse, rape, or domestic battery, which transcend warfare. It is clear that the basis of this isn’t just re-experiencing the emotion, but re-evaluating the past experience in terms of present knowledge, rather than compulsively avoiding/re-experiencing the terror of the past. I believe EMDR utilizes some of this thinking and I’ve also seen that be very effective.
Thanks for the article – you are absolutely right, therapy can be quite damaging, and bad therapy also sets the person up to distrust the next person who offers to help, so it’s a double whammy. We need to be prepared to acknowledge when we don’t have the skills or insight to help a client and refer them on to someone/something that perhaps might, and keeping up with the latest information on what does and does not work is a big part of that.
— Steve
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And yet despite their biases, they still found that the main reasons for “non-adherence” (glad they used that term, rather than “noncompliance”) were dissatisfaction with results or intolerability of adverse effects. Not “Anosognosia” or thinking they’re better so they don’t need them any more. They are interested in QUALITY OF LIFE, and if the drugs don’t improve or reduce their overall quality of life, people are likely to discontinue. That over half of those so treated find their quality of life the same or made worse by the drugs should give the prescribers pause. Instead of trying to force them into agreeing with their treatment, maybe they ought to ask them why they stopped? Radical thought, I know…
—- Steve
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And there is something quite disturbing about the title, “The neurobiology of child abuse.” What is he saying – only kids with “neurological vulnerability” develop adverse reactions to being abused? And those kids are somehow neurologically unfit because they can’t tolerate being burned with cigarettes or locked in closets?
This is creepy…
—- Steve
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I have decided that I’m “anti-stupidity” and “anti-corruption.” It’s not my fault the field is generally both stupid and corrupt. If they can come up with an intelligent and ethical version of psychiatry, I’ll back them 100%. But I’m not holding my breath…
— Steve
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The reason I don’t use the term “antipsychiatry” is solely because that term has been corrupted by the psychiatric profession into a derogatory term that implies a knee-jerk reaction against anything any psychiatrist thinks of. It suggests irrationality and a lack of supporting data, neither of which is true from my perspective. In actual point of fact, it is mainstream psychiatry itself that is irrational and lacks supporting data. This general movement could be called pro-empowerment or anti-enforced treatment or pro-choice or pro-client or a number of things, but anti-psychiatry is now a polluted term that can too easily be used to make us into caricatures and marginalize our views. I get that individuals may want to re-claim that title, much as the word “mad” is being reclaimed, or “gay” or “queer” have been reclaimed by the gay rights movement. I have no issue with individuals taking this stand, but my point in my response was that Dr. Lieberman was using it as a pejorative term to broad-brush any opposition as being irrational and irrelevant.
I posted a response to Dr. Pies’ comment which just showed up today. I doubt he’ll have the courage or decency to reply.
— Steve
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Thanks for that additional clarification. That is even more offensive than making someone take drugs, in a way. But you make my point for me – no matter what “helpful intervention” is used, it’s not helpful when it’s forced down your throat (literally or figuratively). I’m in the US, and there are fewer and fewer alternatives to drugs available over the course of my lifetime. I personally lucked out and found an awesome therapist who really helped me start on a new path, but it would have been a way different deal if someone told me that I HAD to see her as well as telling me what I had to do/say/think/feel in order to prove I was “recovered!” I have no truck with anyone who feels they can “prescribe” a particular service and expect a particular outcome.
It sounds like “recovery” has taken a bit of a different path in the UK, but it still sounds riddled with authoritarianism and force, as well as shame and humiliation for those who don’t “go along with the program.” That helps no one but the people getting their pay at the survivor’s expense.
Again, I think it all goes back to the initial act of diagnosing someone with a disease just because they don’t think/act/feel the way we want them to. That’s the first act of bullying, defining another person’s reality for them. Once you’ve done that, the recipient/victim of your actions has been sufficiently dehumanized that these other actions become possible to contemplate, when anyone giving it a moment’s thought would realize that they as an individual would never want to be treated that way.
Thanks for your passionate advocacy, Joanna! I hope I get to meet you one day.
—- Steve
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This is an excellent point. Domestic abusers often engage in behaviors that have unconscious motivations to maintain control at all costs. Their behavior is still criminal, and their victims are still devastated. Unconscious evil motivations are still evil and people are still responsible for their decisions, regardless of how aware they may be of their intentions.
— Steve
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I agree. The message is always “Recovery is possible – IF you are a good patent and accept your diagnosis and take your drugs and don’t expect to live a normal life ever again.” The focus is still compliance and drugs. The clients are still treated like poorly-behaved children who need to be watched to make sure they don’t get in trouble.
What I think of as “recovery” means EMPOWERMENT – finding your voice and exercising your rights and telling anyone who tries to stop you to “stick it where the sun don’t shine.” This appears to be the very last thing the bulk of the system personnel ever want to see. As Sean Donovan’s piece clearly shows, they’re actually terrified and confused by anything that looks like a real recovery. It blows away their religious belief system. It makes them look and feel like incompetents. Which, unfortunately, is mostly the case.
Anyone who is really interested in recovery is interested in empowerment. And the issue of forced/manipulated psych drug use has to be addressed head on. Anything else is lip service.
— Steve
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Good questions, Sandy. What I tend to do is simply describe what I’m seeing, or better yet, have them do it from their viewpoint. Rather than saying, “You have symptoms of borderline personality disorder,” I might say, “You’ve told me you cut on yourself. Can you tell me what it is about cutting on yourself that is appealing to you? What do you think it does for you?” Most “symptoms” have a purpose, and I consider finding that purpose the key to making progress. Sometimes good therapy even makes the “symptoms” worse. I think focusing on the “symptoms” leads down the wrong path. The repeated behaviors of the client tell you something. The DSM/Medical Model approach says that the behavior has no meaning, it’s just brain chemicals. I say that the meaning is way more important than the behavior itself.
One of the first things I learned in the world of social work was the saying, “All behavior meets a need.” Help the client find the need the behavior meets, and you can start working with them on alternatives. But stopping the behavior stops the need being met and leads to more distress. Psychiatrists need to shift their focus away from the distressing behavior to the distress that is behind it.
I hope that makes sense!
— Steve
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I think the best way to become a good therapist is to experience good therapy yourself. It helps clear your own issues out of the way, and also helps you realize what it’s like to be on the “other side of the couch.” I was very fortunate to have an awesome therapist and so came to understand that good therapy really can change your life. Once I knew what real therapy can do, it was impossible to accept the ersatz kind that you outline so eloquently with this piece.
— Steve
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Great piece, Jay. As a former mental health counselor, I can totally relate to what you’re saying. I had the privilege of becoming a mental health counselor with almost no training at all (for some reason, they all thought an MS in Education qualified me as a counselor – go figure!) and learned most of what I know about therapy from my clients. The most fundamental truths I learned were that 1) me being real and genuine and vulnerable and willing to “sit” with their discomfort when they told their stories was far more important than any “technique” I ever learned, and 2) that no matter how crazy someone’s behavior seemed to me, if I listened well enough, there was some reason why that behavior made sense.
The main reason the DSM drives me around the bend is that it interferes with both of those two points I learned to be so important. Having a diagnosis allows the clinician to distance him/herself from the patient and avoid having to deal with the feelings evoked from real empathy. It also allows them to avoid working with the client to seek a context to explain the behavior or emotion, as the behavior or emotion are identified as the problem rather than the indicator of something more fundamental.
I bet you’re an awesome therapist and your clients are lucky to have you. But of course, what you do should be the actual minimum standard for therapists. We have to have our own shit together well enough that we don’t dump it on our clients. The rest becomes kind of obvious once we get rid of the need to have “clinical distance” and “evaluate our patient’s symptoms” and start dealing with them as one vulnerable, emotion-laden, spiritually seeking human being to another.
—- Steve
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I don’t agree that this kind of effort is pointless, because not everyone in “the system” is ill intended. Some are misinformed, and others are trying to help change things from within and will really appreciate the hard-hitting emotional proof that their “radical” views might actually lead to more effective outcomes. What I’m hearing is that these people were SURPRISED that the clients they served turned out to be human after all. Keeping them conscious of that fact is critical to the safety of those currently trapped in the system.
That being said, I think it took tremendous courage to take that step, and I found their deceptive approach appalling and sickening. I hope you can have a meaningful followup discussion with them regarding the impact their “intervention” had on you and what it says about their need to maintain power over those they view as either beneath them or too dangerous to deal with in a genuine manner.
I guess what I really took away from this is that these people were actually AFRAID of you and your colleagues and felt the need to use their power to protect themselves from the danger you presented. And that danger appears to simply be that you know the truth and are willing to say it. Why is that so scary to them? Get to the bottom of that and maybe you can get to some real change.
Bottom line, Ted is right – it’s about the power structure, and until the power structure changes, this kind of intervention is just a band aid on a hemorrhage. But I still think it is tremendously valuable, both to the currently incarcerated victims who need some hope, and to those brave and lonely souls who are working inside the system to foment some kind of change.
Thanks for a beautiful and moving piece, Sean. I hope they start listening to you. You have a wonderful healing energy that they all need to get in touch with!
— Steve
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Boy, what a great idea, Mary! But I think they need to spend two weeks on antipsychotics as well, including a week of being threatened to return to the hospital involuntarily if they don’t “take their meds.”
It’s not paranoia if they really are out to get you!
— Steve
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Humbly and humorously stated!
I actually believe humility is the #1 requirement for being a helping professional If you’re humble enough, wisdom will come to you through observing and learning from your clients. If you’re not, no amount of training will make you anything but dangerous. I’m glad you’re in the humble category, and I really appreciate what you bring to this discussion. Would that all psychiatrists would model after you!
—– Steve
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I was a bit less diplomatic than you, Matthew. See below:
Wow. Where do I begin to approach this amazingly shallow collection of ad hominem attacks and unscientific rhetoric? The author does not once even mention an actual scientific study or identify and counter a coherent argument put forward by those who oppose the new DSM and its arbitrary system of identifying any form of distress as a “brain disorder.”
For starters, I don’t know of anyone who identifies their own group as “antipsychiatry.” This is a term that is mostly used by psychiatrists such as the author to try and undermine the credibility of their critics. Notice that the author doesn’t identify one single group that so identifies – he just broad-brush paints that “there are these people out there who oppose mental health treatment and they are bad.” A classic ad hominem attack.
The author compares prejudice against psychiatry to racisim, sexism and homophobia, and talks about prejudice against “mental illness and its caretakers.” This is a highly offensive comparison for a couple of reasons. First off, psychiatry was part and parcel of the prejudice against gay and lesbian people – homosexuality was designated a mental illness until the 1970s by the very DSM this guy is defending! But more importantly, racism and sexism and homophobia are efforts by those in positions of POWER to undermine groups who did not have the power to defend themselves. It is especially ironic to talk about prejudice against psychiatry in this context, as psychiatrists are, in fact, the ones with the power to detain people against their will and force “treatment” on them based on the spurious diagnoses invented and voted on at the DSM conferences. And more ironically, it has been shown that the medical view of mental illness as brain disease INCREASES the negative stigma associated with mental and emotional distress. In fact, many of those opposed to the DSM and the current treatment practices of psychiatry are patients who feel victimized by the psychiatrists who treated them. To lump psychiatrists in with patients in terms of prejudice is an extremely shallow and self-serving viewpoint.
The author also states that: “… no one can argue with one simple fact; if you or a loved one suffers from a mental illness, your ability to receive effective treatment, recover and lead a productive life is better now than ever in human history.” Actually, that is EXACTLY what the argument is about! There is plenty of evidence, starting with the WHO studies in the ’90s and continuing right on through the work of Harlow that was recently published, that psychiatric drugs are NOT associated (in the aggregate) with a more productive life – rather, people maintained on psychiatric drugs appear to be MORE likely to remain disabled and have multiple hospitalizations than those who avoid drugs or have a short-term course of medical treatment. See Robert Whitaker’s “Anatomy of an Epidemic” for more details.
One doesn’t have to be opposed to psychiatry in principle to be concerned about the enormous rise in the use of psychiatric drugs, especially when the long-term outcome studies across the board suggest that unmedicated sufferers tend to do as well or better than their medicated counterparts over time. This is not to say that no one can or does benefit from psychicatric drugs. It is more to say that the current paradigm of care does not appear to meet the needs of many of those suffering mental/emotional distress. To label such concerns as “antipsychiatry” smacks of someone trying to avoid seeing the flaws in their own argument by attacking those who have the courage to point out those flaws.
There are a lot of fairly mainstream psychiatrists and mental health professionals who have had concerns for years about the DSM, and who have even more concerns about the oddities and excesses of the newest version (such as labeling a person who is depressed at the loss of a loved one as mentally ill if they haven’t recovered two WEEKS after the fact!) It’s clear the author is committed to his philosophical view, but if he really wants to convince anyone, he’d do better to address the scientific facts that are aligned against the “brain disease” theory, rather than attacking those who have read the research and have legitimate concerns about the DSM and the current treatment paradigm in psychiatry. You don’t have to believe that mental illness isn’t real to believe that the DSM is of questionable validity. Ask Thomas Insel, head of the NIMH. Is he “antipsychiatry,” too?
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I had the same experience – I can only see my own comment. Kinda weird!
—- Steve
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Actually, the Decade of the Brain did reveal some very clear answers, which I think the works of Bruce Perry capture very well. First, it showed that the brain is dramatically modified by the environment – we are NOT given a genetic substrate that determines our ultimate mental health. This in and of itself undermines many of the biological model’s underpinnings. Second, it showed that the brain can be healed even if injured early in life, and that the most healing factor is – wait for it – healthy relationships with other healthy human adults! Which is 100% contrary to the psychiatric worldview that we’re being sold, namely, that biology is destiny and that medical interventions are the only way to help someone who is biologically compromised.
It also showed that there are specific physical exercises that can address specific areas of physiological dysfunction in the brain.
Not surprisingly, this seminal research spanning 10 years has been almost entirely ignored in the psychiatric community, because it wasn’t what was desired or expected. But anyone who takes an honest look at what is and is not successful in the human services realm can see that good relationships are critical to healing, whatever else may be going on, and that the vast majority of the time, human relationships are the PRIMARY means by which mental and emotional distress are recovered from or understood or embraced by the sufferer.
I have no objection to neuroscience. But to be scientific is to be honest and to be skeptical and to be prepared to alter one’s theory based on the results of real experiments. Instead, we have rigged experiments and a slavish adherence to a set of quasi-religious dogma that actual science seems to be completely unable to make a dent in.
The public’s big confusion is to believe that psychiatry has the slightest thing to do with neuroscience. The new information on the DSM controversy may help to clarify this gross misunderstanding. I’m all about science, but organized psychiatry left science behind many years ago and is doing all it can right now to fight off what it knows to be the actual truth.
I agree, unlikely to be an organized conspiracy. It’s more like a religious faith under attack – the members know they have to defend themselves or their faith will go under.
I’m not putting you in that category at all. If all psychiatrists were like you, we’d long ago have been looking at a different paradigm. But I don’t think your colleagues, especially those at the highest levels of the APA, are as willing to hear the truth. Look at what happened to Open Dialog. Even in Finland, it came under attack, despite the best outcomes in the history of psychiatry.
Clearly, in psychiatry, politics and money trump science every time.
— Steve
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Hi, Chaya!
I absolutely and completely related to what you’re saying in this piece! I can’t say I’ve suffered a tremendous array of trauma in my life, but I have grown up feeling unwanted and “different” from others, and still feel that way a lot. I am also a person of integrity and person (at least I like to think so!) and I tend to relate a lot better in general to people who have been through tough times or who have fought to resist the “status quo” than those who accept “consensus reality” as the absolute truth that we must adhere and adapt to. In fact, those other people scare me!
I think the biggest flaw in the current system isn’t the drugs, it’s the idea that people’s suffering has no meaning. This relates back to that idea of purpose. If we have no purpose, what’s the point of all this suffering? If we’re just a bunch of cells and our feelings are “imbalances” that can be “fixed” with the right chemicals, it suggests that our struggles are for nothing and our feelings mean nothing. I can’t accept that viewpoint! It’s too damned depressing!
We have a quote on our refrigerator, from a Melissa Chen, age 10 or so: “Always remember, no one is normal. Everyone is weird.” Truer words were never spoken. It gives me comfort to think that those who are “normal” are essentially very good at acting the way they’re “supposed to.” I can’t, but I don’t think that’s a bad thing at all. We just need to hang together with others who can see “consensus reality” for the sham that it is.
Thanks for a great article!
—- Steve
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Michael,
If you do get fired, I wonder if a wrongful termination lawsuit would be possible? It sounds like you’re providing excellent treatment with very positive responses from the clients. What exactly are their grounds for firing you? Making them look bad by comparison?
Well done “coming out” on MIA! I am sure you’ll find a good use for your passions. I’ve been out of the mental health field for about 17 years now, for similar reasons – I was just sick about what passed for “mental health treatment.” And I think it’s worse today than it was in the 90s. I am an advocate for foster kids and work to get them off psych meds and away from labels and into things that really help. Maybe advocacy is a path for you, too.
Thanks for sharing and for fighting for those who can’t fight for themselves!
— Steve
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Thanks for that clarification. You were, indeed, lucky. You found an empowering clinician, which I find to be an increasingly rare commodity. And you have had other privileges that made it possible for you to move in and out of “the system” with some capacity for survival, something many psychiatric victims lack.
I’m glad to hear you talk about the abuse of power, because that’s what this comes down to and that’s where our interests overlap. Lies are not science, even when they’re put out by doctors. We need to take the power back to define our own experiences, and I’m glad you’re on board for that fight!
— Steve
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I was writing my response as you were writing yours, apparently. See below. I’ll just comment that you are operating on assumptions regarding the nature of human beings that are entirely philosophical, not scientific. You keep repeating these assumptions, namely that all experience is explainable in molecules, as if this were indisputable and obvious scientific fact.
The vast majority of humanity has believed in the presence of the human spirit, mysterious as it is, since before the beginning of recorded history. That belief is also philosophical, but can’t be refuted simply by saying it’s not true. You may choose to believe that we’re nothing but brain, but that doesn’t make it true.
In the end, I think the proof is in the pudding. We’ve been “studying the brain” for over 60 years and proposing various theories and chemical cures. The results are depressingly clear, as outlined in Anatomy of an Epidemic (Have you read it yet? You had not last time we talked. YOU MUST READ IT if you want to get where this group is coming from!) Whereas it’s equally clear that non-biological, spiritual interventions (for lack of a better word) like various schools of therapy, meditation, and the like, are able to create significant changes in both the spiritual and physiological condition of human beings. That’s not even getting into the various dietary, homeopathic, exercise-based, and other physiological interventions that have been shown to be helpful, but continue to be denied by the Big Labelers of Psychiatry.
Did you read the recent comments by Tom Insel of the NIMH about the DSM? Even he agrees the labels are crap and do damage, and he’s a psychiatric true believer!
There is a point where science can’t take us and we have to resort to philosophy. You are now at that edge. You can’t argue people into submission by restating your hypothesis over and over. Maybe it’s time you took a look at your own hypotheses and see if maybe altering them might lead you to a better understanding of the situation you’re hearing described by those who feel victimized by the DSM-based view of mental/emotional/spiritual distress?
—- Steve
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Layla,
I would have to say that I don’t think Laura is identifying a label as the cause of her distress per se – I would say it is more the use of power and deception to “sell” such a label and thus invalidate the beingness of the person being labeled in this manner which increases rather than diminishes whatever distress a person may already be feeling.
To reduce someone’s lived experience to a “chemical imbalance” is to eliminate significance and meaning from the person’s response. I would suggest that a “neuro-reductionist” view is one that suggest there is nothing beyond our neurons that defines us as human beings. The natural extension of this hypothesis (and it is only a hypothesis, not a proven law of science) is that the brain causes all behavior and therefore the only thing we can do to change behavior is change the brain.
The fact that CBT or meditation do result in changes in the brain doesn’t necessarily mean that those changes are the cause of changes in the person. The fact that choosing to meditate can actually alter the brain should be enough right there to suggest SCIENTIFICALLY that there is something more than the brain at work. After all, who decided to meditate? How did that person maintain their commitment/motivation to meditate? What were they trying to accomplish through meditating?
These are questions of what I can only call a spiritual nature, that regard the meaning and purpose of behavior. These issues of purpose are assumed by the psychiatric model to be irrelevant. You have “symptoms” because your brain is broken. The symptoms have no meaning. Hence, your decisions and reactions have no meaning. The only thing we can do is try to fix your broken brain. That’s a depressing viewpoint!!! And NOT a viewpoint that is a necessary conclusion from being “scientific.”
I sense that you don’t believe in the possibility of an extra-physical existence beyond the body. You’re certainly entitled to that belief, but it’s not one that is axiomatic. But even if you do, it’s hard to deny that the issue of intentionality and purpose is not adequately explained by any neurological model you can suggest. Perhaps it’s a matter of the whole being greater than the sum of its parts, but it seems very clear that a person’s sense of meaning and purpose dramatically effects his/her behavior and mood and thinking. And since it is the brain, in your view that is doing the thinking, feeling and behaving, SOMETHING is affecting that brain that is outside of or beyond its scope. Otherwise, the brain is opposing its own neurochemical imperative, and that makes no sense to me.
So I don’t think it’s that a label causes distress. I think it is the process of a person in a position of power using that power to invalidate the meaning and purpose in an individual’s experience and hence reducing or eliminating their sense of individual identity and power. I’ve been a counselor over many years, and I can tell you from my own direct experience that people improve generally in direct proportion that they are able to act effectively to control and direct their own lives. To have someone come and tell you that 1) you don’t really direct your own life, it’s your messed up brain that does it, 2) there isn’t anything you can do about it except take my drugs and hope it gets better, and 3) you can look forward to a life of dependency and disability and need to give up on your life goals – well, it would be extremely disheartening to the staunchest of souls.
The only real defense against such a system is to rebel and refuse to participate. It doesn’t mean science or brain study is out the window. It means that each of us gets to decide for ourselves what our lives mean and what we believe is helpful to us. And it also means that nobody can force or manipulate us into doing something that benefits them more than us in the long run. If brain study leads to something helpful, it can certainly be made available for anyone to see, think about, and use. But seeing people through a distorted lens of assumptions that convey the message that we are not the authors and evaluators of our own lives is inherently destructive and needs to end.
I hope you can see the difference.
—- Steve
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This is a pretty big move. 10,000 psychologists is a lot of people to accuse of being extremist religious zealots. I find it encouraging…
— Stev
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I agree that a huge proportion of “mental illness” is simply a result of exposure to injustice due to an imbalance of power in relationships and society. It is amazing to me that sexism, racism, classism, domestic abuse, economic injustice, and related issues are not even mentioned when it comes to “mental illness.” Sometimes trauma gets a background mention, but only because “trauma changes the brain,” not because trauma contains elements of disempowerment and spiritual distress that are a NORMAL reaction to circumstances of being out of control of one’s experience. The idea that social systems themselves could cause mental illness seems so far off the radar as to be considered absurd by many. Yet we see that in three generations, immigrants to the USA have been shown to deteriorate in their physical and mental health to levels of the ambient population.
There is no question that social and economic variables are the most ignored factors in mental/emotional distress. In my view, they are probably the most important. And the power imbalances you mention are deeply embedded in the system, from DSM diagnoses through involuntary detention. Until a shift in perspective is made and the need to address power differentials is brought to the front, our ‘mental health’ system will continue to harm those it presumes to help.
— Steve
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Considering the lame outcomes for antidepressants, even “modest” gains by single nutrient interventions should be of interest to real scientists. And let’s say 20% of “ADHD” kids improve with Nutrient A – well, that’s 20% fewer that “need meds” to function!
Of course, the other errant assumption underlying all of this magic bullet research is the idea that “ADHD” is a single entity that must be the result of a single nutritional deficiency. This is an absurd assumption that leads to absurd results. It is quite possible that this behavioral constellation could be caused by abuse, iron deficiency, lack of sleep, boring classrooms, fetal alcohol syndrome, sleep apnea, and probably dozens of other causes. Nutritional treatment, and treatment in general, needs to look at all the variables and treat each case individually. While it’s helpful to know that a certain percentage of cases can be helped by iron supplementation or EFAs, others may need totally different approaches. So of course, a “magic bullet” is impossible. I am sure it’s not by chance that this strategy is demanded, because it gives a big advantage to pharmaceuticals. A more holistic approach is called for, but will not likely occur while the pharmaceutical industry has all the researchers hog tied and bought off.
Thanks for your hard work to do sensible science!
— Steve
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I would submit that studies have not shown A basis for depression in the body, they have shown LOTS of possible correlations for depression, because, as Dr. Insel himself just said, “depression” isn’t a thing that has a cause. It’s a set of symptoms that could have dozens or hundreds of causes, some of which aren’t “illnesses” or “disorders” or pathological in the least.
To try to reduce depression, which is clearly a biologically appropriate state with important survival value to the species, to a “mental disorder,” without consideration of how, why or when this “depression” occurs is quite irrational and of course, will never lead to any meaningful results.
I’m glad Dr. Insel has made this observation publicly. Unfortunately, his new path is still based on the assumption that genetic causes are primary and will be found. Common sense should direct us to look at a much more subtle and complex interaction of genetics, experience, and environment to understand each individual’s emotional responses in a much more nuanced way.
Psychiatry is like doing surgery with a claw hammer. The instruments are so crude, they can do nothing but make the situation worse.
— Steve
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Can’t even follow their own arbitrarily adopted rules!
—- Steve
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I agree 100% that both the “left” and the “right” have been dismissive of the rights of the so-called “mentally ill” and have for the most part fully embraced the medicalized view of “mental illness” as scientific entities caused by “chemical imbalances” and “managed” by “medication.” Most of our representatives these days are deeply indebted to corporate interests, and both the APA and the drug companies give copiously to both sides of the aisle. Anyone taking a stand against forced drugging and in favor of empowerment and compassion for those who are experiencing mental and emotional challenges will quickly be branded by either political party as a quack or a kook or a fool.
Opposing the current status quo, whether in the world of “mental health treatment” or anywhere else in the medical industry, is a radical stance that has little political support. It’s only the people themselves (or should I say “ourselves”) joining together that can create the kind of political momentum to change the current dismal state of affairs. Which I think is what Jack is really getting at.
—- Steve
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Sera, Great blog, as usual! Most of the time, most people are unable to really acknowledge the power of words and the implications behind them. I agree that for many folks (both professionals and their clientele), using the word “recovery” implies a previous illness to recover from, which can insidiously undermine a more thorough critique of the process that led to “diagnosis” and “treatment” in the first place. That critique can be critical in finding a more liberating way to view what has been happening, but such an analysis is generally not in the interests of those in power. So they discourage it by using terms like “consumer” and “recovery” to make it sound like something super helpful is happening. Sometimes words like “unwitting victim” and “escape” are more accurate and more empowering.
Don’t get me wrong – I am glad professionals are now talking about “recovery” instead of “lifetime disability” – it’s definitely a shift in the right direction. But true empowerment involves taking back the right to define our own experiences from our own point of view, and a lack of this ability or of feeling the right to exercise it is very often at the core of what the system sees as “wrong” with the individual. Being empowered has a tremendous positive impact on anxiety, depression, and hostility. But since it can’t be patented or controlled, it must not be of interest to the “service providers” (aka labelers).
I have similar feelings about terms like “self-medicating” (implies that the person using drugs “needs medication” and is using drugs as a substitute) and “misdiagnosed” (implying that the reason the person “recovered” is because the doctor picked the wrong diagnosis, rather than that there was nothing wrong with them in the first place) or “overmedicated” (implying there is a “correct level” of medication that was missed, rather than accepting that the medication was doing damage at any dosage.) I think we have to be very careful of the euphamistic use of these words to avoid the real conflicts inherent in trying to force everyone into the disease model.
I get where Kevin’s coming from, and I don’t want to take away an individual’s word for describing his/her own experiences. The problem is when those in power start using those words to cover up their misdeeds and to retain their power to define the experience of those lower than them in the social pecking order.
—- Steve
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Kelly, I am so glad you brought this up! The analogy between psychiatry and childbirth is one I’ve observed a lot, being deeply involved in both areas in one way or another, but it’s not so obvious to those who haven’t seen both in action.
I think the main thing these areas have in common is that healthy people are identified as ill. In childbirth, the expectant mother is dealt with as if she has a serious disease that puts her life in danger and requires dramatic and intense medical interventions. The same thing happens to “psychiatric patients” – a person is experiencing distress regarding his/her life, and instead of getting support, they are pathologized as having a medical problem requiring emergency and intense intervention. And both areas have a set of “required” interventions that are ineffective or destructive, and yet receive uncritical and almost universal support from the medical personnel who believe in them. Both approximate religious movements, where loyalty to the faith appears to be more important than factual accuracy, and where those who criticize the status quo are labeled as fanatics or lunatics who don’t care about the welfare of their clients.
Birth is also the place where a lot of so-called “mental illness” gets its start. The parent-infant bond has been shown repeatedly to be hugely important in the development of the infant over time, as well as in the development of empathy and attachment on the part of the parent that is critical to the parent’s development of good parenting skills and practices. Denial of the infant’s need for dependency on a reliable caregiver is the core of many later emotional and developmental and even spiritual challenges. It’s connection to psychiatry can’t be overemphasized.
Thanks again!
— Steve
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Thank you, Will. I used to work at a suicide hotline in Portland, and found the exact things you state – that everyone who wanted to kill him/herself had a solid reason for doing so, and it almost always had to do with solving a problem they couldn’t find another way to solve. It was often the result of living in unrelenting pain for long periods of time and seeing no other way out. The key to helping them was to listen, acknowledge, and help them find some small thing they could do right now to regain some measure of control over the situation they found so objectionable. Anyone who would talk to me, I would almost always find a way to help them feel better in less than an hour of supportive conversation.
Suicidality is not a disease. It’s a state of mind that deserves gentle and supportive exploration. I can’t imagine how what happened to you in the hospital could have done anything but make it worse. When you do know what is really possible in helping someone in distress, watching what happens to people in need of that kind of support be abused is all that much more painful.
Thanks from a fellow Portlander for all the awesome work you’ve done, both personally and professionally, to humanize what is currently a very inhuman profession.
— Steve
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I want to be clear that I don’t consider any drug likely to be 100% to blame for acts of aggression, just as I don’t blame alcohol for domestic abuse incidents, for example. The reduction of inhibitions tends to reveal what was being inhibited, and that’s different from person to person.
But the HUGE difference in these scenarios is that in the domestic abuser’s case, the abuser knows very well that alcohol will reduce his inhibitions and that he has a tendency to violence. Some will even drink specifically so they’ll have a justification for what they’re already planning.
In contrast, in this grandmother’s case, I doubt she had the slightest idea that this drug could cause her to become so detached from her friend’s experience and emotions that she could somehow feel OK about carrying out something that under normal circumstances might have only been the most remote of fantasies in her subconscious mind.
I think it is vitally important that this information be gotten out to people, not so criminal thinkers can use it to avoid responsibility for their crimes, but so that people who are taking these drugs can be honestly informed of the true effects they might experience. If this grandmother and her doctor (most doctors don’t know or deny this possible effect) knew to watch out for this, there may well have been early signs that she was reacting badly to the drug and she could have been discontinued.
I hope you will agree with me that by the description of this woman and how she lived her life, it seems extremely unlikely that she would have committed this act without the presence of the SSRI drug in her system. Her description of her disoriented state of mind at the time fully supports this contention, and the judge’s ruling confirms that s/he saw it the same way. So whether or not Celexa can be held 100% responsible for this murder, it appears clear to me that this woman’s friend would almost certainly be alive and she would almost certainly not be in jail if she had not been taking this prescription.
I know you don’t want to let the perpetrators off the hook. But I don’t want to let the SSRIs off the hook, either. At a minimum, they are guilty of being accessories to the crime.
—- Steve
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That’s what I’ve heard from those directly experiencing. A former colleague called it “Zolofting” when she just didn’t give a crap what anyone thought about what she was doing. For a person who is chronically over-worried about others’ opinions, I can imagine this is quite a relief. But for those who are suppressing the urge to be violent because they’re worried how others would view it, creating this “Zolofting” experience could be quite dangerous!
—- Steve
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I don’t think this is the forum to decide whether global climate change is real or not. Whatever one believes on the climate change issue, humans are polluting the planet, destroying ecosystems, screwing with the soil and creating runoff problems, creating artificial species while killing off genuine genetic diversity, and otherwise creating ecological havoc. Everything that Ron has said applies to all of these other situations as well. We need to resist the idea that mega-corporate growth is synonymous with progress, and that creative resistance is synonymous with insanity. It’s a short stride from deciding that psychotic people need to be locked up to deciding that anyone who makes too much trouble for the powers that be in society needs to be locked up with them.
I love the essay and the concept. Thanks for putting it out there, Ron.
— Steve
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Amazing that they could try to blame this on “depression” rather than the drug. This sounds like very uncharacteristic behavior on the part of this woman, and her description seems to suggest she was dissociated at the time of the event. This kind of dissociation seems very common in SSRI users I have spoken with and read about in stories of similar situations. It seems clear that the drug has to be extremely suspect, rather than “her depression.” She seems VERY unlikely to have done such a thing under normal circumstances.
Another psychiatric success story…
—- Steve
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I knew who you meant. Not to worry!
— Steve
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Has anyone thought of sending this as a “press release” to the NYT? Seems they ought to be interested, given the recent amount of material they’ve published on this issue. I’d love some organization with some street cred to put this article out to a range of newspapers and TV news outlets and see what happens. Many times, newspapers only publish stuff they’re spoon fed, and the psychiatrists are better at feeding them than we are.
Just a thought…
— Steve
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Ironically, the last “decade of the brain” was promised to provide these same physiological signs and proofs of mental illness’s location and etiology in the brain. In the actual event, ten years of research proved the opposite: that the human brain is not pre-programmed genetically, that it responds dramatically to environmental stressors or enhancements, and that even later in life, injuries to the brain can be addressed and the brain can heal. Most fascinating of all, the one thing that had the most healing impact on a traumatized brain was: a caring relationship with a healthy adult individual.
In essence, this decade of intense research completely undermined any expectation that studying the brain would lead to discrete “mental disorders” that are located in certain places in the brain, and emphasized instead the important of environment and relationships in creating healthy adults. But none of this deters the biological “true believers,” because the “cult of psychiatry” is based on certain inalienable beliefs that must continue to be believed, regardless of the evidence.
Great letters from both of you, and thanks for sharing them.
—- Steve
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Don’t forget that “postpartum depression,” like all of the invented DSM “disorders,” is not a single entity – it is an effect that could have a large number of causes, not just one. Omega-3 deficits are probably involved in some cases, and completely absent in others.
Psychosocial factors also play a huge role in this phenomenon, and are almost always given short shrift. For instance, such changes as loss of income, loss of employment, need to return to employment prematurely, shifts in expectations from partner, changes in sexual activity, loss of sleep, nutritional demands of nursing, and re-emergence of childhood abuse issues are extremely common, and all can be very significant contributing factors to depression or anxiety following birth. That list could be expanded.
Additionally, it is a well-known but massively underpublicized fact that domestic abuse frequently begins or escalates during or after a pregnancy, either because the new mother is now more dependent and more vulnerable and hence safer to attack, or because having to “share” a partner’s attentions with the new baby leads to a narcissistic partner becoming jealous and hostile toward the new mother. In any case, screening for domestic abuse should be an automatic part of any assessment of “postpartum depression” before a physiological cause is assumed to be primary, because it is a VERY common phenomenon in our culture, affecting over 1/10 of all women at any given time, and up to 1/3 over the course of a lifetime.
Depression is very complex and not reducible to either simple brain chemistry or simple nutritional causes or treatments. It requires an individualized and thorough assessment of the person who is having the experience, including a wide range of both physiological and psychosocial factors.
—- Steve
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Irene, I found your post inspiring! Perhaps what we need to do is start using the “stigma” language to insist on real dialog with the oppressive elements in the monologue, by stating that not to consider the point of view of the recipient of your ‘services’ is perhaps the essence of stigma. The “clients” or “consumers” or whatever word they want to use are categorically viewed as “different” in the sense that somehow “they” are defacto assumed to be unable to provide any legitimate feedback on the “treatment” that they are receiving. If the psychiatric labeling process isn’t inherently stigmatizing, then why are the views of this group of people, who have in common only their having been labeled by the profession, considered inherently invalid?
Thanks for providing that point of view – we have to choose not to stoop to the level of assuming ill will, but instead model what we want to experience, namely being treated as individuals of value, regardless of our views and experiences. I will definitely take this viewpoint into my next discussion with those who appear to be married to the current paradigm as a means of “reducing stigma.”
— Steve
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Great piece, Matt! You hit it when you talk about the victim-blaming that always lets the “profession” and the drugs off the hook.
The initial studies on Xanax apparently resulted in dramatic INCREASES in anxiety upon withdrawal, even after 6-8 weeks, which were conveniently not included in the results when evaluating effectiveness. It’s long been known that Benzos are highly addictive, way back in the late 60s when Valium was king. For anyone to suggest they’re only addictive for those who increase dosage without medical advice is arrogant in the extreme and approaches criminal fraud in my view.
I also get tired of having to accommodate the “other side of the story.” Sometimes one side of the story is based on lies and the other on the truth. Time was, reporters and news agencies took stands on these things instead of promoting this false “objectivity” where every story has to be “balanced” by comments on “both sides” even if one side is obviously outrageously in the wrong.
Thanks for your writing and telling your story. Bit by bit, person by person, I do think we’re turning the tide.
— Steve
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Wow, totally awesome work!!
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Duh!
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This is one of the scariest articles I’ve read in a long time. I keep up with the research in general but have never heard this information. It seems likely it is being intentionally suppressed. If folks really knew the data on this, most pregnant moms or women intending to become pregnant would stop antidepressants immediately!
Which also gives another reason why alternative approaches, which as you say are known to be as effective or moreso without the damaging adverse effects, should be the first line of approach for anyone who is feeling depressed.
—-Steve
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I almost commented, but couldn’t bring myself to become a “member” of the Psychiatric Times. Of course, he resorts to the usual approach of stating his conclusions with no evidence, and engaging in ad hominem attacks on his detractors. He didn’t even address Moffic’s comment, which hardly even qualifies as critical. And his view of what the “average psychiatrist” does in his office is tremendously distorted! I am always stunned when a psychiatrist shows the slightest interest in the context of a person’s “symptoms,” and more so if they show any inclination to explore the client’s worldview, because the first is very rare, and the second almost never happens.
Arrogance and ignorance don’t mix well…
—- Steve
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Along this line, Sandy, I’d love for your comments on the dramatically increased use of neuroleptics for “aggression” in children and the elderly. These people don’t even meet the questionable and subjective criteria for a psychiatric diagnostic label, and yet they are given drugs simply for their behavior. Where does this kind of thing stop? Can we drug someone for excessive political protest, or for being too upset about the state of the economy?
I consider this behavior not only unethical, but criminal. Do we give someone antibiotics without evidence of an infection, or blood pressure medication when their blood pressure is normal?
What do you think of this trend? Should it be stopped, and if so, how? I work with foster kids and this is done all the time, without the slightest consideration for the long-term impact on the children involved. It makes me ill, but I’d love to know how you view it.
— Steve
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Donna, thanks for the awesome post! The quotes from the “encyclopedia of domestic violence” were particularly good. I had never heard of that book, despite my working in the field of social work. And it’s good to know that this stuff does get published in mainstream journals, even though I don’t see anyone in the psychiatric field paying much attention to it.
— Steve
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Exactly! In actual point of fact, severely angry people tend to be a tad delusional anyway…
Or maybe even better, we take violent non-delusional people and put them on neuroleptics, and see if they get MORE violent. Of course, that would be considered unethical, but somehow giving them to “delusional” people isn’t.
It’s hard to be scientific when blinded by dogma, fear and incompetence. Though as a wise man once said, “Never attribute to ill will that which can easily be explained by stupidity.”
—- Steve
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Can’t disagree with you. I just think it’s important not to paint all “alternative medicine” with the same brush. The more fundamental problem is, as you suggest, the dishonest marketing which pervades our culture. Lying to make a buck is fraud and should be criminal, especially if physical or psychological harm can come to someone as a result of your fraud. Informed consent is the issue of the century, or should be.
— Steve
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While some “alternative medicine” has significant side effect risks, as a rule, most are less than those of conventional medicine, which is used with so little consideration. The concern for the use of any “unproven” remedy should be proportionate to the risk. For instance, certain herbs can have significant and even deadly side effects if used in high dosages. Folic acid, however, has almost no risk, as excess B vitamins are excreted in the urine easily. As another example, homeopathy may be seen by many as hokey and unscientific, but the side effects are essentially nothing more than a very temporary discomfort at the very worst, and the costs are minimal. If someone wants to try it out, why not?
We ought not to be viewing “alternative medicine” as a monolith, but should look at each intervention with an eye to cost-benefit analysis, just as we ought to be doing with conventional medicine. Most of the time, doing that analysis honestly brings “alternative medicine” out on top, mostly because the risks, as a general rule, tend to be so much smaller, even if the benefits may be inconsistent or difficult to determine.
—- Steve
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Awesome set of replies!! Way to go, MIA!
—- Steve
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Well gosh, Fred, they can’t be making people BETTER! Then they’d have to get more clients, and that takes SO much time… Far better to create chronic, lifetime disability so they can charge $100+ a session for a 7 minute visit and get lots of extra payola from their drug company buddies!
—- Steve
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Hi, Michelle!
I think the best bet for you is to find a “peer support” network in your area. Where are you located? There are a lot of “hearing voices” support groups and such around in most major cities that I’ve lived in. These folks won’t judge and have been there and know how to help someone, and also generally don’t charge for their services, more than some nominal fees for space and snacks and such. It might be worth looking into.
I only know one therapist in Eugene and one in Portland who does therapy work with people with psychotic issues. It’s a rare specialty, and such people are often attacked by mainstream psychiatry. It is very discouraging, but don’t give up – there are a lot of others who have experienced the same and come out the other side. See if you can find them.
Good luck!
—- Steve
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And if their “treatment” is working, why are so many more being hospitalized, eh?
— Steve
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So you mean angry people are more likely to be violent than non-angry people? Who would have guessed?
Reminds me of a study done years ago where they divided “ADHD” diagnosed kids into “hyperactive-aggressive” kids and “hyperactive-not aggressive” kids and followed them through adolescent. Shockingly, the “HA” kids were more likely to commit crimes than the average child, while the “HNA” kids were no more likely to commit crimes. So basically, they discovered that aggressive kids are more likely than non-aggressive kids to grow up into aggressive adolescents. It had nothing to do with “ADHD” diagnosis, but somehow they weren’t able to see the obviousness of their conclusion.
Sheesh…
—- Steve
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Oh, and “diagnosis” doesn’t really mean just distinguishing one condition from another. It should be a means of accomplishing a plan of treatment. But in truth, psych diagnosis doesn’t even accomplish his stated goal, as people with wildly different situations are lumped together with the same “disorder”. It would be like diagnosing someone with “a rash” without determining the cause and possible treatments for the rash. Could be they have poison ivy, in which case, Calomine lotion is appropriate. Could be they have syphilis, in which case, they’d better get antibiotics.
I’m looking forward to hearing the discussion.
— Steve
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And there is research showing that psychiatric labels and the concept of “chemical imbalances” actually encourages people to indulge in their biases to a greater degree.
This is a typical “I’m a psychiatrist and I say it’s so” argument, without any scientific or evidentiary basis. I hope someone else will write in a rebuttal using the research. I would do it, but I got mine published the last time they brought up the subject, and I doubt they’d publish me again so soon.
Someone want to take this on?
—- Steve
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“Yvonne Woodley was a 42 year old woman who was having marital difficulties. She presented to her doctor with sleep problems. The doctor viewed her as being under stress, and as posing absolutely no suicide risk. She gave Yvonne citalopram. A week later the doctor noted that Yvonne was more agitated and there were fleeting thoughts of suicide – so she doubled the dose of citalopram. After a suicide attempt, she doubled it further and a short while afterwards Yvonne hung herself.”
This is the kind of brilliant medical practice that makes me want to tear my hair out. A person presents with virtually no risk of suicide. They are prescribed a drug and became more agitated and had suicidal thoughts. First thought: could the drugs be causing agitation and suicidal thoughts, since she didn’t have them before? But no, we now increase the dosage instead. Then she actually ATTEMPTS suicide, despite being not the least bit suicidal before taking the drug. Stunningly, the idiot doctor AGAIN increases the dosage, ending up in a completed suicide.
This doctor should be stripped of his/her license and never allowed to practice again! This is gross malpractice, even within the confines of believing 100% in the “chemical imbalance theory.” A person who becomes worse during treatment should discontinue the treatment, to see if the treatment is causing the problem. Doesn’t take a trip to med school to learn that one.
As long as idiots like this are practicing medicine, we’re doomed to increasingly bad outcomes.
— Steve
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Can’t really argue with you, Nathan! Each of us deserves to decide what works for us, and to be fully informed of what is and is not known about the process we’re embarking on. And the range of consequences just for being “diagnosed”, let alone receiving “treatment,” are quite vast. As I said, it’s not an easy question to answer.
I hadn’t read before what you said about the therapeutic alliance building after the person feels better, but that makes a whole lot of sense to me. Essentially, I think most of us who are suffering need a person to trust so we can sort through what we’re thinking and feeling safely. The act of establishing trust with someone may in itself be the most important part of the process. I think there are lots and lots of ways to do that, and they don’t have to be “evidence based” or professionally driven or provided by someone with a degree to be effective. The final arbiter of “effectiveness” is the judgment of the person seeking support.
I think that’s truly where we go off the rails – as soon as someone else thinks they’re smart enough to know what’s good for me and feel OK forcing me to accept it, whatever “science” is behind their opinion, we’ve left any semblance of helping behind.
— Steve
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This is a tough argument. I am totally in agreement that the DSM is the source of almost all the evil we are fighting, and that when psychotherapists have to buy into DSM diagnosis to be paid, they are making a pact with the devil and end up colluding. I say this having been such a person for a while. It is also very true that many, I’d have to say a majority, of those purporting to provide psychotherapy either don’t know what they are doing (despite or perhaps as a result of whatever training they received), or have so many emotional issues that prevent their effectiveness, that they can either waste a lot of money or screw people up pretty badly. I was fortunate to have received almost no training prior to learning how to be a therapeutic agent, and so fell back on my own sensitivity and creating a safe space for good, solid communication, in addition to considering my clients to be the primary source of information on what does and does not work. And I had some quality psychotherapy before I ever started, which was probably more important than any training I could have had.
At the same time, I see people being drugged partly because doctors and even “therapists” see no other options. There HAVE to be other ways available to help people who are in distress, or the psychiatrists and the drug companies will own the field. Self-help and peer-delivered services can fill a lot of this gap. But in truth, this world we live in is exceedingly complicated and painful to experience, and I have found that nothing truly exceeds communication with a safe terminal who is willing to ask some tough questions in a caring way in its ability to help me create lasting change. That a lot of therapy fails to meet those criteria does not mean that quality therapy should be discarded as an option.
Interestingly, I recall a study that showed the process or school of thought employed by the therapist was relatively irrelevant to whether the client got better in the end. The client’s sense of “therapeutic alliance” with the therapist, such as feeling safe an unjudged, and being supported in trying out new things, and feeling validated for efforts they had historically made, were far more important than the therapists theoretical orientation.
I would much rather send someone who is in distress to talk to someone than to get drugs. Even if the talking is overly expensive and doesn’t always work, it at least has a chance of success. Whereas the drugs are clearly a dead-end street. Sometimes literally.
Again, a very hard topic. I don’t know what the answer really is. People do need support, and therapy can be very powerful, but the critiques raised are quite valid. In particular, I have to agree, the war is not on therapists, it’s on individuals who are suffering. But one tactic in that war is to make legitimate social and emotional support unavailable to those individuals, and cutting out the option of therapy seems to forward that goal effectively.
—- Steve
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From the article and your post: ”Given that these medications have substantially improved the long-term prognosis of schizophrenia and that schizophrenia is a disease with significant morbidity, continued use of antipsychotics is clearly still necessary. However, our findings point toward the importance of prescribing the lowest doses necessary to control symptoms.”
This statement above is the one that we as a society and mental health system keep getting caught up on. When you read “Anatomy of an Epidemic,” you will see that the evidence does not support this claim, as often as you see it bandied about. The evidence suggests that, to the contrary, the “long-term prognosis” for schizophrenia is FAR BETTER in developing nations where psychotropic drugs are less available and less accepted. Whitaker also shows that the long-term prognosis for schizophrenia in this country was much better in the 1950s, BEFORE Thorazine and the ‘psychopharmacological revolution.’
He also shows that the BEST long-term prognosis for schizophrenia worldwide is in northern Finland, where they use an approach that considers psychotropic drugs as only an ancillary aid to a psychosocial intervention called “Open Dialog.” They are reporting functional social recovery rates (working, functional relationships, involved in normal community activities) of 80%! US rates are generally less than a 10th of that, with the huge majority of “schizophrenics” subsisting on SSI payments.
The statement I quoted above from the article is so generally accepted in the psychiatric community that to question it is akin to heresy. But the scientific evidence is mounting that it is not only false, but the opposite is true – long-term prognosis may actually be worsened by antipsychotics, even when they work to reduce symptoms in the short run.
READ THE BOOK!
— Steve
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Yeah, we wouldn’t want to HEAL our clients – then we have to go out and look for more clients, which is SO inconvenient…
— Steve
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Peter, thanks for mentioning the foster care horrors. I live with that every day. I can’t say I’m having no effect, but it does feel like we’re swimming upstream and nobody seems to be willing to risk their livelihood by speaking the truth. Or very few are, not enough to really stem the tide. I’ve also gotten the “silent treatment” for mentioning unethical behavior by prescribers. No one wants to admit it, even when they know it’s true.
Thanks for your comments!
— Steve
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And sometimes the pills cost more serious and more expensive problems. I was reading recently that a huge percentage of the increase in healthcare costs is for treating diabetes. It didn’t mention in the article that the medical profession is creating tens of thousands of cases of diabetes annually with their own “treatments” for “schizophrenia,” “bipolar disorder,” and increasingly, for “aggression” in youth or the elderly that they don’t even bother to label with a “diagnosis.” No, I don’t think pills are cheaper. I think they’re more profitable.
— Steve
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As baseball announcer Tim McCarver once said, “They should call it ‘uncommon sense,’ because if it were so common, more people would have it!”
— Steve
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This actually supports just what I was saying above – if a “disorder”, and what you said, too. If there are 273 biomarkers for a “disorder,” and other “disorders” have some of the same biomarkers, how can we even call anything that heterogeneous a disorder at all? Or even identify it as an entity? There may be some percentage of these cases where there’s something actually wrong, but it’s not always the same thing, and many of the “cases” will not actually be disease states at all – simply normal genetic variations.
When a scientific theory leads to more complexity, it is generally very quickly discarded. Science should make things easier and simpler to understand. Schizophrenia is simply not a scientific concept. It’s a social construct, and the more we try to force it to be a “physiological” phenomenon, the more time we will waste and the more confusion we will generate.
— Steve
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Hi, Scott!
Wow, thanks for taking the time for these thoughtful answers. It really helps me see where you’re coming from and where we agree, as well as why we might disagree.
You appear to be operating on a philosophical assumption that you believe to be obvious and unavoidable, namely, that “Everything has a physiological etiology, unless it is magic. Brain states give rise to feelings and behaviors.” I don’t buy that assumption myself. But I want you to see that it is an assumption and not a scientifically proven fact. All we know for sure is that biological changes correlate with changes in emotional state, but correlation is not causation.
Personally, I believe (and this is my assumption, not science) that thoughts and intentions give rise to brain states. I believe the brain and body give feedback to the entity running the show, and the physiological substrate of the body clearly determines a lot of what seems desirable/undesirable to the organism as a whole. But it’s pretty clear that we as beings can override even horribly negative feedback from the body if we have some overriding purpose that drives us hard enough. Many of these purposes seem to have no apparent survival value for the biological organism, but seem to have a lot of value for what I will call the spiritual being, whom I believe to be in charge, at least most of the time.
But that’s just me. There are lots of philosophies of causality out there. My objection to psychiatry is that it posits the primacy of physiological cause as an unavoidable truth, and castigates anyone who has another viable explanation, even when they don’t have any proof of their assertions as all.
Back to science. The 25 year earlier death rate is not something I made up. Read the following article for a taste of the issue, but this stuff is published in mainstream psychiatric journals as well. It’s not news: http://usatoday30.usatoday.com/news/health/2007-05-03-mental-illness_N.htm
As to “measurable differences” for those who do and don’t “have schizophrenia,” I have yet to see anything convincing on that ground. There was some big flap about loss of brain tissue, but more recent studies (Nancy Andreasen, for instance – see http://archpsyc.jamanetwork.com/article.aspx?articleid=211084) have shown that this appears to be a result of neuroleptic treatment rather than a characteristic of the “disease.” Besides which, why should we buy into the assumption, which you kind of agreed isn’t really true, that just because two people fit the subjective description of “schizophrenia,” they have the same thing “wrong” with them? If they don’t, then how is it possible or likely that “schizophrenics” will be biologically distinguishable from each other?
There are trained research psychiatrists who have opined that schizophrenia as a category should be done away with, because those who fit the criteria are too heterogeneous to study as a group. But that’s opinion again. There is no science that I know of that shows what “schizophrenics” have in common, besides hallucinations and delusions. If you have some studies, please share – I’d be interested.
Overall, I think we agree about a lot of things. I just want you to be careful not to make your assumptions into facts. What we KNOW is very limited, and to me, suggests that schizophrenia, or mental illness in general, is a pretty unhelpful concept. Between hazy and subjective definitions, and political and marketing forces, and the money to be made from choosing to believe certain things, the actual facts have long since been lost in the forest of bullshit. Whitaker really does bring us back to what is known. I think you should re-read his book. When it comes down to it, the most important result of good science is increased predicting ability and simplicity of your model. The fact that we’re killing people we’re trying to help, and making disabled people out of those who might otherwise recover, suggests that the current model is false and should be trashed. Not to say we shouldn’t ever do genetic research, or that no one should ever use psych drugs, but we need to spend our dollars on things that pay off. Pursuing a genetic cause of mental illness has not paid off, and never will. That last part’s my opinion, not a scientific fact, but the lack of effectiveness to date is pretty darned factual, as Jay has clearly demonstrated in his article.
Thanks again for your thoughtful and serious responses.
—- Steve
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I have found plenty who say just that. As to my son, of course, he was depressed. He would have qualified for “major depressive disorder” if you wanted to diagnose him with something. But he was insulted that the person “offered” him antidepressants without even asking what was wrong. I hear from many who experience exactly the same from psychiatrists, to the point that I consider it the rule rather than the exception.
As to “brain disorders,” you continue to assume that a “disorder” such as “schizophrenia” exists as a distinguishable entity that has a physiological etiology of some sort. What evidence is there to support that? Every theory that’s been put forward so far has been shot full of holes by psychiatry’s own researchers who were dedicated trying to prove the theory correct. How do you know “schizophrenia” isn’t just a reaction, like a rash, to a variety of causes, some physical, some psychological, some existential? If there’s no physical way to distinguish those who “have” and “don’t have” schizophrenia, how do we know the sufferers have anything physiological in common? So far, the research suggests that what genes they may SOMETIMES have in common are just as common in different “disorders,” while many sufferers don’t have these genes at all.
And there are plenty of people diagnosed with “severe disorders” who would take strong exception to trying to say their conditions aren’t caused or triggered by “existential suffering” or trauma or childhood neglect or simply being sensitive to the horrid social conditions in the world they live in. Take the well-known but poorly-publicized fact that “schizophrenia” is far more common in urban areas than rural ones. Explain that in your “brain chemistry” model. Oh, right, the city badly affects their brain chemistry, triggering vulnerability to psychosis. Which means we treat their psychosis medically, rather than asking why cities make people mentally ill who would otherwise be healthy.
You also need to read about the “Open Dialog” approach, and about “Soteria House.” It should help you see that social support and caring can be incredibly effective in treating the most severe “mental illnesses,” far more effective than the crappy chemical treatment that’s helping kill people off 25 years earlier than their untreated peers.
If you haven’t read Whitaker’s book, read it. If you have, read it again with your mind open. He addresses almost everything you say here.
I stand by my contention. So far, genetic research has contributed almost nothing to the understanding and treatment of so-called “mental disorders.” I doubt it ever will. There may be a small segment of people who suffer depression or psychosis for a physiological reason. These should certainly be identified if they can, though genetics is a tiny fraction of the area of physiological causes to be studying. Given the results so far, I’d say the effort doesn’t merit the costs. Meanwhile, there are plenty of “experimental” treatments that are already proven to work better than drugs, which deserve lots of further research, but remain “experimental” because of lack of funding for research, and outright bias and prejudice by a system making billions off of drug sales.
There is much more benefit in changing the external environment. Messing with someone’s brain has so far proven ineffective, dangerous and often deadly. It’s time to invest in a different strategy.
—- Steve
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Oh, you’d be surprised how many “unreasonable” psychiatrists and doctors tell their clients that their disorder is entirely genetics and that nothing else but drugs will help (see Engineer’s post below). My son had experienced a severe emotional trauma a couple weeks before a routine doctor’s visit. On finding he had been briefly suicidal, she was prepared to prescribe antidepressants without once asking him what he was depressed about! I’ve seen it happen so often, I have come to believe that it’s a rare psychiatrist who even considers environmental stress relevant – mostly, they just hear the symptoms and prescribe.
This is fascinating to me, because if you think about it, which do we have more control over, our genetics or our environment? Obviously, the latter is much more readily changed, but we seem to be spending all of our time trying to change the one thing that we have the least influence over.
The search for genetic causes of psychiatric disorders is a complete waste of time. As you state, all this shows is that a certain genetic substrate may make a person more vulnerable to life stressors, which could lead to a wide variety of conditions. This substrate isn’t even identified as faulty genetically – it may well be an important set of survival traits that are simply not as compatible with the insane modern world we have to negotiate. If that’s the best they can come up with, they should hang up their test tubes and go home. Because while they are wasting their time, there are a ton of social issues, like poverty, warfare, gang violence, child abuse, domestic violence, authoritarian and abusive school settings, and on and on, that all could be changed if we worked on them together.
Let’s do research on things we can actually change!!!!
—- Steve
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I agree with you, Ron. It’s still pretty quiet out here in Mental Health Land. Getting better, but I still feel like the guy in Bermuda shorts at the black tie dinner most of the time.
I was recently at a meeting discussing the lower age limit for an automatic review if a foster kid was prescribed certain drug categories. When they asked if 6 made sense as a lowest age for antidepressants, I said, “There is no evidence base for the use of antidepressants in a child under 6.” No response. I said it again, louder. Again, no response. They’d given me studies on earlier points when I’d raised them, but not a word here. My read is they all knew I was 100% correct, but nobody wanted to talk about it. Too uncomfortable, I guess.
But that’s what we’re up against. Denial, plain and simple. People know what’s happening isn’t right, but we’re not supposed to talk about it. Most people, having received this treatment, will never mention it again. Of course, I’m not most people…
—– Steve
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Good for Juan! Now I just hope somebody in power cares enough to read it…
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Fred, I’ve heard some horror stories before, but this one really got to me in a new way. I hope you can continue to “go public” with what happened to you. I find it particularly painful to contrast the way you were treated and their expectations for you to what actually happened when you were able to escape their clutches. Thanks for having the courage to share this story with us and the world. It reminds me again that this isn’t just a matter of “philosophical differences” – lives are systematically destroyed in the name of “helping” every day and we need to stop it!
—– Steve
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Hey, thanks, Richard! Good to know another rabble rouser is out there. I agree, there are times I can barely live with myself for not speaking up louder. But there are limits what one person can do without completely destroying his/her credibility. I work on trying to get facts out and get people to think. Not everyone sees that as a noble effort, but I guess if we don’t, we’re yielding the field to the enemy.
Keep up the good fight! If enough of us join together, they can’t fire us all!
— Steve
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I think they are in danger of losing their jobs if they speak out. Look at Loren Mosher’s experience. There is definitely a “code” amongst even fairly radical critics that must always be followed: we have to say, “We acknowledge that many people are helped by psychiatric medications…” Anyone who comes out and says, “This whole system makes no sense, and appears to be damaging clients far more often than it helps” is quickly ostracized, and if s/he has enough power to be of influence, s/he is attacked as an “antipsychiatrist” or “Scientologist” and loses any position or authority s/he had.
The rulers of the profession don’t tolerate dissent.
— Steve
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Whitaker’s work is critical here. It seems more likely that we’d be causing depression in people who wouldn’t develop it otherwise. This is INSANITY!
— Steve
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You are too right. It’s the insurance companies and the drug manufacturers who get the big bucks. I’m sorry to hear the “Adjustment Disorder” strategy doesn’t work any more. Just goes to prove my point about greed being the driving factor.
And I believe you 100% about public vs. private healthcare – the docs aren’t making much, and neither are the therapists. A licensed MS or MSW counselor in Portland, OR often makes $30,000 or less, even in a clinical supervisor position. No wonder no one sticks around. Foster kids, in particular, get the short end of the stick, with the most inexperienced and unstable counselors handling the most complicated situations. And we wonder why a quarter or more of all foster kids are on psych drugs.
And as for the patient being on disability, that’s a benefit in a way, but it also penalizes clients who want to get a job. So we’re encouraging disability financially.
Thanks for providing the doc’s perspective. It’s a grim read all around.
—– Steve
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That’s why all of my clients got an “Adjustment Disorder” if I could in any way justify it. Almost anyone has current or recent stressors they are having a hard time dealing with, and “Adjustment Disorder” implies the need for therapy rather than drugs.
But it really does emphasize how ridiculous DSM diagnosis is. The truth is, the doctor probably doesn’t have to worry about it, since no one on earth can ever prove you’re right or wrong about a psychiatric diagnosis. It’s really a beautiful scheme, if your desire is to make money without the slightest accountability.
The DSM’s a sham, and anyone not religiously committed to psychiatric precepts knows it. The shame is that we continue to go along with it, mostly for the reasons you mention. The only real answer is to scrap the whole idea of “medical” diagnoses for mental/emotional/spiritual issues. But I’m not holding my breath on that one…
—- Steve
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Hi, Gaynor!
I am a subversive professional in the mental health field, and have been pretty successful in getting people to look more critically at the use of psych drugs, especially in kids. It’s a slow process, but it is essential to have professionals in the field who voice their opposition, otherwise, the psychiatrists just have their way.
Good for you for keeping your critical thinking skills intact and maintaining your integrity despite the onslaught of psychiatric indoctrination!
—- Steve
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Hi, Jonah!
I don’t mean to paint Healy as a paragon of scientific virtue. I selected him as an example precisely because he’s right in the middle of the psychiatric heirarchy, and yet still has been castigated because he doesn’t support the party line on antidepressants. (And he truly was, he lost a job in Canada because he published something negative about antidepressants.) He’s clearly not an “antipsychiatry” figure, he’s actually quite mainstream, and yet still can’t speak to his own profession about the actual data in the field.
I am no apologist for Healy’s views on ECT. It takes a pretty warped view of a human being to think that passing electricity through his/her brain will be anything but profoundly damaging. He’s no hero – it is more an example of how the profession is willing to shun its own members if they don’t toe the party line.
— Steve
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I don’t mean to argue with you, Layla, because your description of the current reality is actually quite accurate. But you actually reinforced exactly what I said: there is no objective way to define ANY “mental illness”.
I don’t think we should abandon the study of the mind, but I do think we should abandon the idea that a psychiatrist can look at my behavior or emotional experiences and “diagnose” a “disorder” that requires “medical treatment” due to a “chemical imbalance in the brain.” Surely, you see the difference between saying, “We’re studying people who experience the phenomenon depression to see if we can figure out what is going on” and “We can tell that you have a disorder of the brain and you need to take this drug to treat it.” I have no problem with the first approach. The second is extremely dangerous, especially when you look at the outcomes.
So my opposition to psychiatry has nothing to do with being opposed to research. It has to do with being opposed to lying to people in order to make a whole lot of money. Again, I refer you to Loren Mosher. This is not a neutral scientific enterprise. The DSM-III was an intentional business decision by the psychiatric establishment in order to reclaim their share of the market. The whole idea of “chemical imbalances” was promoted intentionally, because psychiatrists can prescribe and that was their market advantage. And of course, the pharmaceutical companies were happy to fund the effort.
Again, not saying that psych drugs can’t play a part in recovery. I’m saying that the psychiatric profession is unethical at its very core, is not interested in science, and their DSM is a tool to capture market share, not a genuine effort to understand the mind or the brain. To me, supporting scientific research DEMANDS that we oppose psychiatry, because psychiatry does not want the actual scientific data getting out. Look at how Whitaker’s book has been received, or Irving Kirsh’s work, or David Healy, or even Marcia Angell, who used to be the editor in chief of the New England Journal of Medicine. Even mainstream psychiatrists who stop spouting the party line are cut off at the knees.
There is no respect for truth at the higher levels of the psychiatric profession. “Cult” may be too kind of a term to even describe them. They are engaged in an evil enterprise, and they are doing tremendous damage in the name of helping. Don’t allow yourself to confuse them with scientists. They are capitalists plying their trade, with no concern for the consequences beyond their own bottom line.
— Steve
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I can’t remember who said it, but I’m reminded of the quote, “Well-behaved women rarely make history.” I’m glad your not afraid to shake them up!
It is interesting that our biology and genetics is the one thing that we have almost no control over, and yet that’s where all the energy goes. The environment is what we DO control, and yet we act as if it has no impact. There are SO many things that can be done to help someone with feeling depressed, anxious, suicidal that have nothing to do with their bodies. And there are even physiological things we can do, like sleep, exercise, nutrition, etc. that have an impact. Drugs seem like the very last thing you would do when all else has failed. I find it hopeful that you are working effectively to change that focus to the things we actually can control!
— Steve
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I love the graphics! Makes too much sense. Have the “authorities” in the mental health system gotten upset with you yet for grouping their wonderful magic pills in there with the illegal drugs? I have to imagine there are some who would find your presentation extremely threatening.
Well done! I’m so impressed that you have the motivation and skills to accomplish so much with so little resources. Thanks for sharing your success, and I hope your organization continues to thrive.
— Steve
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Love to hear from Jay on this.
My take: first off, they found correlations, which are large-scale statistical probability findings. This is very far from saying that every case of these 5 “disorders” involves this gene alteration, and it’s even further from saying that this genetic pattern plays a causal role.
Second, they have lumped together 5 different “disorders” to get these results! This would suggest that either the “disorder” definitions are close to meaningless (which, of course, is absolutely true), or that they had to pool all this data from different disorders to get a statistically significant result (which could certainly be true), or it simply means that this genetic array is associated more commonly with certain personality types who are somehow more vulnerable to the stresses of our current, insane social system. There could be other explanations. It certainly doesn’t convince me of anything. It seems like almost meaningless research to me.
Others take on this?
— Steve
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Glad you are interested in Mosher – it’s a thread that leads to quite a big ball of yarn. Unfortunately for all of our ideals, politics reigns supreme, even in the medical fields, and perhaps especially in psychiatry. I appreciate your willingness to explore the potential ugliness, and encourage you to continue your journey.
— Steve
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I didn’t mean a “mental system” in the first paragraph. I meant “mental distress.”
— STeve
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It is easy to confuse a refusal to accept “mental illness” as a concept and the idea that suffering is not real or can’t be caused by an illness. My objection is not against the idea that illnesses can cause mental system. It’s against clumping all people with a set of behaviors, thoughts or feelings together and ASSUMING they have an “illness” based on their “symptoms,” which are mostly a list of annoying or disturbing behaviors that we don’t like.
There could be many things your son is struggling with, some psychological, some spiritual, and some physiological. There are definitely diseases (like syphillis, for instance) that cause psychotic symptoms. They can also be caused by lack of sleep, drug side effects, or exposure to traumatic events. Wouldn’t it make sense to figure out which of these things were involved before the doctors “diagnosed” you with a “disease” just based on the outward appearance? As an analogy, if you had a rash, would you want the doctor to treat the rash without looking for the cause of the rash, whether it was allergies, measles, poison ivy, or syphilis?
If your son says the drugs aren’t helping, it’s probably because they aren’t helping. Perhaps someone needs to sit with him and help him come up with his own ideas of what he is seeking and why these events are happening, and what he thinks might be helpful? I know it’s painful to watch this happen and feel helpless to change it, but whatever’s happening, he has to be the one to figure it out. You can’t do it for him, and as you can see, the drug solution doesn’t really solve the underlying problem, even if it may temporarily arrest the “symptoms.”
As for Laura, it sounds to me like she was going through some intense but fairly normal teenage stuff, and was re-routed to a very crazy pathway that did a lot of emotional damage. I see this happen all the time. Nobody seemed to sit down and ask her what was going on – instead, they tried to snuff our her feelings and experience and used labels and drugs to try to force her to be “normal” rather than helping her find her way. I see this happen all the time.
To live is to experience distress. Distress is real, but it doesn’t work to label forms of distress as “diseases.” Sure, people recover from states of distress, but that’s the process of life. Helping people find ways to make their lives meaningful and productive in ways they care about is much more effective than drugging them into submission when they don’t fit into the status quo.
Again, I feel for your challenges with your son. Don’t give up, but see if you can focus on seeing things from his point of view. You might want to look into the Open Dialog and Soteria House approaches to get a different view on what psychosis may represent and other ways to think about helping.
Good luck!
— Steve
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I have to say, it is mostly the psychiatrists themselves who have carved out the “us vs. them” terrain. Read up on what happened to Loren Mosher when he challenged the establishment to recognize that his Soteria House non-medical approach was as or more effective than drugs with none of the side effects. Believe me, he quickly became an enemy and was summarily removed from any position of power. You are deluding yourself if you think psychiatry as a profession is interested in a middle ground. That’s why I agree with Laura that “cult” describes the overall experience quite well. Not that every member is blind, but the leadership expects blind adherence to a dogmatic and inflexible doctrine and shuns anyone who challenges it. There is no “middle ground” with such an institution. It’s either fight or be oppressed. They have the power and won’t give it up, and no rational discussion or scientific discourse is going to change that. Otherwise, we’d have Soteria Houses and Open Dialog centers in every major city in the country. But we don’t, do we?
—- Steve
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So to reply to your reply: your philosophy drives your beliefs, and makes you more willing to believe in the psychiatrists’ story about what makes “mental illness” happen. I’m not criticizing you for this, merely pointing out that this discussions stopped being about science the moment you chose to put that philosophical assumption into place. We all do this, of course, to some extent. But to be fully scientific, we have to be aware of these biases and recognize they are biases and not facts. Doesn’t make them WRONG, only, as you admit, unprovable.
So we move to the world of psychiatry. The writers of the DSM operate on a similar and maybe even more reductionistic model, truly eliminating any possibility of spiritual influence on the body. So they’re left with brain chemicals, and all of their experiments and treatments have to do with brain chemicals and all of their conclusions are about brain chemicals. These people make sense to you because you have the same assumptions as them. But their beliefs (like yours) are NOT scientifically verifiable. There is no scientific basis for ANY of these so-called mental illnesses, not one. They are literally decided and voted on by COMMITTEE. There is not one test for any mental disorder – there can’t be, because they’re not defined by pathology. They’re defined by committee and then the assumed “cause” is sought after the fact. Surely, you can see that this is not a scientific process.
More significantly, the treatments used by psychiatry HAVE been shown scientifically to cause damage. These supposed scientists know all about Open Dialog and Soteria House and other non-drug interventions, none of which has any risk of physiological harm. If they are so enlightened and scientific, why do they avoid even talking about these treatments, and why do they find them so threatening? It’s because they know on some level that their philosophy and treatment approach is deeply flawed, but admitting it means admitting they are doing harm, and also giving up on a lot of income.
You were fortunate. You had rational providers who did pretty much what Bob Whitaker recommends – used drugs judiciously, on a temporary basis, while adding psychosocial interventions to obviate the need for ongoing symptom relief. Believe me, after working for 20+ years in the field, I can tell you, this is not how most people do it. In fact, it’s a rare exception.
My last comment. You say that we can rewire our brains. If we’re all chemicals, who is doing the rewiring? Someone’s WRITING the program, folks. That someone is who we really are, and it appears to be that we USE the brain to run the body. But who WE are remains a very large mystery, one that the reductionistic model used by psychiatry avoids, because they have no explanation for it.
— Steve
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You go, Laura!!! Couldn’t have said it better myself. As one person once observed, “There is no such thing as a well-adjusted slave.”
— Steve
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There is such a thing as “mental illness” because we have defined it as such. Look at the DSM. Any one of those diagnoses is rife with subjectivity and potential bias. There is no objective way to diagnose any mental disorder in the book. A person has a “mathematics disorder” because he can’t do math. Is it possible that he was taught in the wrong way? That he wasn’t exposed to sufficient concrete stimulation to form the basis of math? That he simply doesn’t give a crap about math because he’s more interested in skateboarding or the girl sitting in front of him? The exact same argument can be made for ANY mental disorder in the book. There is not one that can be verified.
Accordingly, it is, of course, ridiculous to suggest that “mental illness” has to do with “brain processing gone awry,” as we can’t even tell what a mental illness is or who has one. This leads to stories like Laura’s. Instead of getting to the bottom of her “bipolar disorder” (namely, normal teenage developmental angst, combined with an inquisitive, non-authoritarian personality and some serious drug side effects that were ignored), she spent years suffering unnecessarily and believing her life was a hopeless disaster. A competent therapist, or even a sensitive adult supporter, could easily have helped her manager her existential conflict with sufficient time and patience, and helped her re-organize her worldview to support her success. Instead, the psychiatric profession labeled her and negated the importance of her own beliefs and experience. The results were disastrous!
If nothing else, the proof of the weakness of the “brain processing” theory is that the treatments don’t consistently lead to improvement. If you believe Whitaker’s extensive research into the scientific data on long-term outcomes (do you?), it appears we’re making a lot of people worse over time, even if a few may benefit. It all starts from the subjective and biased definition of mental disorders, which is based almost entirely on social norms and biases, with no genuine scientific means of distinguishing between one biological condition and another.
But you appear to be a ‘true believer’ in the biological model, and I doubt the lack of scientific legitimacy to any of these labels is something you can accept. How about the new proposal to limit intense grieving to two weeks (in the DSM 5)? Where’s the science behind that? If they can make that kind of idiotic and arbitrary assertion, how can you believe the rest of it is any less arbitrary?
—- Steve
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You’re admitting to operating on a reductionist assumption that “everything arises from chemicals.” You have presented no evidence of that. And you haven’t countered my evidence that large percentages of so-called “schizophrenics,” including many who are posting here on MIA, have recovered without or in spite of chemical treatment. How does Open Dialog work at all if these folks are experiencing solely chemical/biological problems? The emphasis of Open Dialog is on the meaning of experiences and relationships between people in the client’s life. How can that be effective against a chemical problem? And why is it 10 times more effective than the chemical approach, which appears FROM THE DATA to impede recovery far more often than it assists?
— Steve
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You just have to look at the “Open Dialog” approach to disprove the theory that you can’t talk your way through a psychotic episode and to healing. 80% of those having psychotic experiences are able to heal through the use of communication and social interventions. The vast majority maintain without any medication, or were given medication only briefly. If this is all a brain-based phenomenon, how on earth does such a large percentage of the Finnish population recover with Open Dialog, which is primarily a “talking cure,” when US full recovery rates hover in the single digits? If nothing else, the proof lies in the almost complete ineffectiveness of the medication interventions over time. Not one medical intervention for anxiety, depression, ADHD, or psychosis, has been shown to create positive long-term outcomes for patients, whether talking about education levels, employment, relationships, or community involvement. The drugs may help people with short-term symptom management, but if you read Whitaker with an open mind, it should be clear that many of those who would spontaneously recover are sucked into a world of psychiatric insanity, just as Laura describes. The fact that some individuals can receive this kind of care and still recover doesn’t mean the care led them to recovery. The overall evidence is that we’re making people worse as a big group, even if some individuals do better or feel they do better with the drugs.
I don’t think anyone is trying to take away drugs as an option. We’re trying to look at what the institutional practice of psychiatry is doing to its own patients and to our society as a whole. The training you are receiving is just another reflection of that insidious influence. You’re already being indoctrinated to believe the “chemical imbalance” story before you’ve even had enough clinical experience to make up your own mind. Your education should be enabling you to make your own observations about what is helpful to your clients. Instead, it wants to convince you of a mythology that science has already refuted. Please, keep your mind open – Laura’s experience is far from unique.
— Steve
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I only wish that SSRI-induced manic episodes were rare. They are sadly very common. I find it particularly egregious when you had no mania ever in your life before the pill, and they somehow manage to blame you for the reaction. I’ve heard this all too often – “We’ve uncovered an underlying bipolar disorder!” Or “Only people with bipolar react this way to antidepressants.” What they should say is, “Oh, my God, this pill is driving him crazy – we need to stop!”
Well done for hanging in and sorting this out. Glad you’re joining the fight and making some meaning out of your Kafkaesque experience!
— Steve
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Great post! I agree very much with your line of thinking, that the origins of these mind states are very complex and attempts to reduce them to simple genetic or biological causes is very unlikely to be the case. And the twin studies aren’t even convincing without the methodological flaws – supposing even 50% of identical twins with “schizophrenia” (and also ignoring the impossibility of 100% accurate “diagnosis” of this rather vaguely defined malady), what happened to the other 50%? If it’s genetic, and identical twins have the same genetic material, shouldn’t we see more like 98% concordance? Clearly, genetics can’t provide the entire answer of causality, even in the most optimistic interpretation of the known data.
I’d disagree on one point, though – I don’t think there is evidence that brain and thought are an identity. It appears to me more that emotion and brain activity track together, i.e. a state of anxiety is experienced and expressed physiologically in response to a thought. For instance, a person who believes they are in danger will generally experience heightened cortisol, which is associated with anxiety and fear. But this fear may be based on a real danger (a charging bear) or a belief (my mom is probably going to yell at me) or a fantasy (the CIA is trying to track me down.)
What actually generates a thought, as well as where a thought resides and what impact it has on the body/brain, remains a very large mystery scientifically. I think we move into the area of philosophy when we start talking about thought, and as you say, it’s way too big a topic for this forum. But so much of psychiatry’s false underpinning is bad philosophy (unstated assumptions taken as proof) that I think it’s important for us to draw the line pretty firmly between what we know and what we believe or assume to be true.
Nice post!
— Steve
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Anybody who could even think of making a robot rat to bully other rats into a state of depression has got something wrong with their thinking process!
—- Steve
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Ah, but it is not necessary scientifically to prove that the cause is not disordered brain function. Otherwise, we can put out any hypothesis and say, “You haven’t proven this is wrong yet, so it is true.”
It is the responsibility of the person postulating the theory to provide the proof. If there is no proof that brain function is disordered in a psychotic person, then from a scientific perspective, we have to assume that disordered brain function is not a cause. Even if there are brain differences in a psychotic person, those putting forth the chemical imbalance theory would have to prove that these differences are the pre-existing cause of the hallucinations, rather than the result of them or something that just happens at the same time as them.
For instance, let’s assume that depression is associated with a certain chemical condition in the brain (which has not been proven, not even close). It is possible that a person’s thoughts lead to feelings of depression which are accompanied by certain changes in brain chemistry. The thought could cause the change, but the change and the depressed feelings occur together. The chemistry difference doesn’t cause the depression, they just happen to be associated.
As an example, there was a PET-scan study done where people thought of depressing things while hooked up to the device, and their brains changed to a pattern that was associated with depression. When they thought of happy things, their brains changed back to a different state. The person apparently controlled his/her brain utilization patterns based on what s/he thought.
I don’t think that anyone here would suggest that there is no such thing as mental/emotional/spiritual distress. And it’s feasible that some part of that may be the result of inherent biological characteristics, but that proposition has not been proven, despite a hell of a lot of research trying to prove it is true.
I think the objection here is to taking a set of behaviors that have been arbitrarily determined to be a “problem” based on cultural and social norms, and decide that the person with this “problem” has a medical disease. If there is an underlying pathology of some kind that made EVERYONE depressed, and we could identify that and reliably alter it in a safe fashion, then depression as an illness makes sense. But it should be clear that there are many, many reasons why a person is depressed, and many, many approaches they can take to move forward and heal or recover or whatever word we want to use, most of which have no relationship to the field of medicine.
It’s not that there is no such thing as the distressing states described in the DSM as “mental illness” – it’s that calling it “mental illness” makes one think that it’s a “disease like diabetes” that can be “treated” with “medicine.” There is at this point little to no evidence that this last statement is remotely true, and as I stated above, in the realm of science, a hypothesis is properly considered false until proven otherwise, and is then true only as long as further evidence continues to support it. “Mental illness” as a physiological disease just doesn’t meet the scientific criteria for truth.
—- Steve
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The penny doesn’t drop because there are too many gold doubloons on the other side of the scale. The trauma theory of depression may be kind of obvious to the lay person, but to the psychiatric professional, it presents an awful dilemma, because you can’t use 15 minutes and a prescription pad to make a couple hundred thousand dollars a year. And the pharmaceutical companies stand to lose billions if they admit that bullying is a much more consistent cause of depression than any genetic vulnerability.
It’s not that the bigwigs don’t know this data. It’s an “inconvenient truth” that they want to keep quiet. Denial is a lot stronger when backed by a financial conflict of interest!
—- Steve
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You are so right about the education system. If you haven’t, you should also read John Taylor Gatto’s “The Seven Lesson Schoolroom” (or something like that), where he talks about the implicit curriculum in schools. He was an award-winning elementary school teacher who eventually rebelled, as he found that the secret lessons of compliance, undermining confidence in our own observations, and seeking reassurance through approval by the authorities were dominating any real educating he was trying to accomplish.
It’s kind of amazing when you read some of those old documents from the 1800s in the USA – they were remarkably open and clear about their intentions, and they had nothing to do with making kids smarter or more able to think for themselves. They were all about creating “good citizens” through universal propaganda and compliance training, in order to keep new immigrants and freed black slaves from rebelling. It’s not even laid between the lines. They knew what they were doing and why.
Thanks for your response – it’s good to know you’ll always read and value what folks write to you.
—- Steve
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That’s what the Luddites were saying. They were not anti-technology. They were opposed to the family and community being torn apart by industrialization’s requirement to have a mobile and docile population to manipulate. And they were right.
Thanks, Alice!
— Steve
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Weird that the Kirsh work has come out and research psychiatrists are agreeing that the overall effectiveness of antidepressants is very mild at best, and yet we’re trying to correlate reduction in suicide rates with antidepressant use. A competent scientist would have to compare those taking and not taking antidepressants, and when that’s been done, suicide rates have increased in the drugged samples, hence the Black Box Warning.
I plan to see the movie so didn’t read the article, but I’m glad a mainstream movie is taking on this issue, however sensationally it is presented. I hope it can promote the conversation about the connection between violence and psych drugs, because that conversation is long overdue.
— Steve
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I don’t know why anyone capable of the slightest degree of intellectual vigor would assume a genetic cause for a “disease” that is “diagnosed” by a behavioral checklist. Normally, one finds the gene and then defines the disease based on the cause. Anyone with half a brain would realize that just because two people are depressed doesn’t mean they’re suffering for the same reason. Real science would start to break down these situations and look for possible root causes of the “syndrome”, and only when the causes are found would the “diseases” be established.
It’s like calling a rash a disease. A rash could be caused by poison ivy, measles, or syphillus. The treatments and possible outcomes would be radically different. Yet each condition causes a rash. The rash is not the disease – the thing that causes the rash is what needs to be treated. That’s just elementary scientific logic, of which the psychiatric profession is apparently incapable.
The psychiatric establishment is remarkably deluded. Thanks for giving us this kind of hard data to help spread the new concept that DSM diagnoses are not disease states. 40 years of trying to prove something and failing at every attempt is pretty darned good proof that your original hypothesis is false.
— Steve
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I’m just glad this is even being discussed in the mainstream media. Breggin can be annoying, but he does have excellent research backing up his claims. I hope this heralds other interviews with this topic in mind. Maybe they’ll interview Bob Whitaker!
—- Steve
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Thanks, but that did not quite answer my question. I asked whether it is possible that the client is making decisions based on distorted information, based on either media reports or actual discussion with his/her physician who is similarly misinformed? And if so, do you see it as your obligation as a physician to correct this information, for example, by informing him that 1) the idea of a chemical imbalance is speculative and that antidepressants fix such an imbalance simply a fantasy, and 2) that CBT gives the same benefits without the risks and side effects, and probably maintains these benefits over time in a way that drugs can’t.
Even further, do you inform them of the possibility that antidepressants, even when they work in the short term by moderating depressive symptoms, may actually alter their brain chemistry for the worse over the long run, as Whitaker outlines in his book? Or that depression often “runs its course” with no therapeutic intervention whatsoever?
This would be true informed consent. I’m a mental health counselor, and I haven’t seen anybody in the field doing it, except for client/peer counselors who have survived the system and done their own research. I’d be astounded and impressed if you did. If you don’t, maybe it’s time to start?
—- Steve
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Gosh, you think they might find this stuff is addictive? Since it’s already used as a recreational drug? Oh, wait, it’s probably only addictive for people who AREN’T depressed. For depressed people, it’s just what they need.
That they’d even consider such an idea just shows how desperate and misguided and unethical they all are. It’s a bogus profession.
— Steve
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So if he had the deportment of a person headed for medical school, why the hell did he need psychiatric treatment? And what the hell does a “drug person” look like? Does he not know that addiction rates among MDs are very high?
The guy is an idiot with a degree and a prescription pad. Unfortunately, such people appear to be par for the course in psychiatry. You’d probably get better mental health care from a cab driver or a bartender or a healthy 12 year old.
—- Steve
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To Dr. P:
And what if the patient’s decision to ACCEPT treatment is based primarily on media-delivered (or PHYSICIAN-delivered) misinformation? Isn’t that just as bad? Or worse? Shouldn’t patients be told that far from “balancing” their “chemical imbalance,” these drugs CREATE huge chemical disruptions in the brain’s equilibrium, and that the brain may respond by creating the kind of changes that may make their situation worse in the long run?
Do you ever tell your clients this kind of information? Do you even tell them what the actual side effects are, or that CBT is just as effective with a dramatically less dangerous side effect profile?
—- Steve
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Well said. Admitting to this means we can’t distance ourselves from our clients so effectively, because we also have suffered and have our own dysfunction and pain. To truly be conscious of the impact of abuse and neglect, we have to face our own demons, and that is painful. Alice Miller totally got it right. If we are unable or unwilling to face our own losses, we act out our pain on our clients as a means of distancing it from ourselves. That seems to be what psychiatry and much of psychology has descended to – a big, complex psychological defense mechanism against recognizing that “they” are no different than “us.” Which is the exact opposite of what really helps those who come to us seeking help.
— Steve
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This should be kind of a no-brainer, but it isn’t for some reason. Kids who grow up abused and neglected in any way are more likely to be diagnosed ADHD and depressed and anxious and psychotic. But the current model divorces symptoms from causes, so we try to make the symptoms go away.
In a way, this should be big news, because it belies the “ADHD is purely biological” argument. But in another way, it’s so obvious that it shouldn’t have to be news. Anyone using their brain can see it if they simply look. Unfortunately, most of the mental health community continues to have their eyes shut.
—- Steve
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Oryx,
Thanks for this timely and well-written essay. I agree with your three points, 100%, especially regarding the dramatic negative impact of labeling kids and adults as a means of isolating ourselves from discomfort.
The only thing I’d add in the area of bullying is that one reason kids bully other kids is that adults bully kids all the time, especially in school. If we want kids to treat each other with respect, adults have to start holding themselves to the same standards they want to see from kids. They need to listen when kids have complaints or concerns, notice when their behavior is hurtful and apologize, and be willing to negotiate and mediate as needed to resolve issues.
The labeling of kids is just one manifestation of adults taking advantage of their privilege and power and dumping their emotional issues on those least able to defend themselves. As you rightly say, it’s a very sophisticated form of name-calling, and we need to stop doing it!
— Steve
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It’s on the product label, for one thing. There was something in the Canadian Journal of Psychiatry in the early 2000’s where a guy went back and checked records of kids who’d been given stimulants, 100 records, and found that, as I recall, over 6% of the kids reported psychotic symptoms. I’ve heard research estimates of anything from 2-8%. I think it depends what they define as psychotic symptoms. Anyway, I found that one just by typing “stimulants cause psychosis research studies” or some such thing into my browser. There were multiple hits, but that was the best one. Totally legitimate, mainstream journal. I don’t think there’s any doubt that it can cause psychosis.
— Steve
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What a horrible tale! I admire your gumption in trying to turn your own trauma into a benefit for others who are similarly at the mercy of these “professionals” who often lack mercy and empathy altogether, at least toward their “patients.” Thanks for sharing your story. I’m glad you’re still fighting – we’re with you!
—- Steve
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My comments were included, if somewhat reduced in detail. I think mine was the only one to connect the shootings to actually RECEIVING psychiatric care. The original author chose not to comment on that particular point.
— Steve
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And if this “cocktail” is so helpful, why isn’t she better?
— Steve
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I also wrote a letter to the editor, referencing the many shooters who had received psychiatric “help” BEFORE going on their shooting sprees. I encourage anyone with experiences to share or data to impart to write a letter. I’d love to see them bombarded with rational letters supporting the author’s viewpoint.
—- Steve
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I think you are missing the point. Jackie was “clearly schizophrenic” (as you put it) because her clinician chose to VIEW her that way, and the data he reported reflect his assumptions about the situation. It is quite possible and maybe even likely that if the second clinician had talked to Jackie, s/he would have discovered a similarly compelling story. But #1 never bothered to ask her about the reason for or meaning of her voices, while #2 was interested in Jill’s story rather than telling her his view of what was wrong.
It’s also almost certain that if Jill had gone to clinician #1, she would have been diagnosed with schizophrenia and “treated” accordingly, without #1 finding out anything about her history or the possible reasons/meanings behind her symptoms. #1 would never have asked about her story.
The point is, the conclusion that is reached is dramatically impacted by the questions that are asked, and those questions are a function of the professional biases of the clinician – they don’t necessarily have anything at all to do with the client.
Case in point: I was called to the hospital to do an involuntary treatment evaluation on a 17 year old, developmentally delayed girl. She was intellectually about 6 years old. She was diagnosed with bipolar disorder, based on mood swings and aggression, which she clearly did demonstrate. However, a 20-minute phone call with her mom revealed that she has been relatively well behaved and happy until a couple years ago, at which point she was raped. She reported that the girl became withdrawn and depressed for about a year, at which point, she disclosed the rape. It was only after this disclosure that she began to be aggressive and “moody.”
She did fit the criteria for “bipolar disorder.” But I had her diagnosis changed to “PTSD,” since the “bipolar” symptoms clearly only arose in the context of a severe traumatic event. Was the first clinician wrong, or was I? There’s no way to say. The first clinician used a very narrow set of questions focused on symptoms, and told the story that this girl’s brain was malfunctioning, because that’s what s/he was looking for. I asked broader questions based on the idea that her behavior had a cause and a meaning, because that’s what I believe is important. You could say I was as biased as the first clinician, but my bias was to support more of a sense of agency for the client, because that’s what I observe to be the most helpful way to intervene.
To me, diagnoses are not right or wrong. They are either helpful or unhelpful. Mostly, I think they are unhelpful, because they take power away from the client. I used them because I had to, and I tried to use the ones I felt were the most helpful in getting them the support they needed, and if not that, the ones that did the least harm. I think you and your clients might benefit from thinking about diagnoses in that way. The client’s story is much more important and relevant than the label we choose put on them ever can be.
—- Steve
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I would add my name and credentials (MS) to the letter.
—- Steve
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Had the same experience.
— Steve
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Gotta say, I LOVE the idea of you playing professional ice hockey! You definitely exhibit a mean verbal hip check!
—- Steve
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It’s hard to credit a diagnosis that is so vague in its criteria. Autism is probably one of the few semi-legitimate DSM diagnoses, but it’s still impossible to say who “has it” vs. who does not, let alone predict the long-term outcome. It is one more example of shoddy science leading to dire, self-serving predictions of lifetime disability that aren’t necessarily true at all.
—- Steve
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You totally cracked me up, Najinsky! A classic reply!
—- Steve
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This is simply AWESOME! Thanks so much to Sandra and her team for putting their beliefs into action. I am hopeful for the first time that something new may be going on in psychiatry, at least in one state!
—- Steve
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I doubt that was the only reason. My bet is one of their advertisers read the piece and threatened to pull their support if they didn’t retract. Or maybe more than one. Pharma companies pay a huge amount in advertising, and money is definitely power. Or perhaps they simply threatened to put a contract out on the CEO…
—- Steve
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Wow, what an excellent piece! It reminds me of the discussions of what word to use for the people descended from the people who lived here in the Americas before Europeans arrived to steal their land and livelihoods. Members of the dominant culture make themselves feel better by saying “Native Americans,” but when you talk to those people they are referring to, most would prefer to be identified by their tribe or locality or family name. Lumping them all together and giving them one name is, in itself, a part of the oppression. Might as well stick with “Indians.”
The need for “providers” to distance themselves from “consumers” of “mental health services” is deeply embedded in our culture. Ironically, I have found that the ability to erase or transcend that distance, to create a sense of commonality and mutual experience with those I am trying to help, is the core of what actually leads to a reduction in the person’s suffering, regardless of their “symptoms.”
The one thing the people you are referencing have in common is, perhaps, their experiences in the mental health system. Sometimes I have referred to the group as “those people who have been labeled by the mental health system as having a ‘mental disorder.'” A bit wordy, but a lot more specific. A slightly different group might be “those who are currently experiencing significant mental or emotional distress.” But that pretty much covers everyone at one time or another, doesn’t it? Maybe we should just refer to people as human beings, and recognize that distress and emotional pain is simply part of the human experience.
Thanks for the excellent blog – I am really looking forward to Part 2.
—- Steve
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I definitely can support the idea of “formulation,” IF it is a formulation that is created by the CLIENT in collaboration with a supportive professional, who is not invested in their own explanation of their client’s reality. I would stay away from clinical language altogether, and put it in the client’s words (i.e. “The client says he hears people talking to him that others don’t appear to be able to hear, one of whom is rather rude and scary, and he would like this voice to be quiet or at least be nicer. He says the voice reminds him of his mother’s and he wonders if it may be related to how he used to treat her as a child.”), and I would require that the clinician check back at every juncture with the client to make sure their version of reality continued to reflect the client’s formulation of the problem.
Unfortunately, it would be way too easy to take “formulation” and make it into a disguise for “diagnosis” if the clinician decides to substitute his/her voice for the client’s, whom the clinician may easily decide “lacks the insight” to be able to do his/her own formulation. The element of the clinician’s humility is the critical factor, regardless of what you call the final product.
I really appreciate your efforts to create an alternative view. I do agree also with the concerns raised regarding reimbursement – it’s hard to see how insurance companies will pay for something without their little diagnostic codes to make them feel secure. Perhaps the idea of subsuming mental/spiritual/emotional well being under the rubric of medical care/insurance has to change before we see real progress.
—- Steve
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Sounds like a lot of blaming going on. Maybe the reason is a lack of skill in understanding youth’s behavior, or even a lack of genuine empathy for the youth in their care. A careful reading of just this abstract should tell any parent to stay far away from psychiatrists in seeking help for their kids – they seem very willing to ignore scientific evidence in favor of “clinical and cultural norms” that are useless or harmful to their own clients.
—- Steve
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I have also read that the therapist’s relationship with the client may have as much or more to do with success than the particular modality of therapy used. As I recall, it appeared that creating a safe space for sharing experiences in a non-judgmental and empowering way was the core of what made any therapy more effective. If the clients felt safe and respected, they tended to get better, whatever you called the therapy.
Bottom line, I agree with Milton Erickson’s sentiment that good therapy has to be re-invented for every client. I think we do what helps the client move forward toward the kind of life they are seeking, whatever that is. I don’t think there will ever be a “modality” that can account for all the wonderful variations and nuances in human behavior and experience.
And I agree, we should not attack anyone who is genuinely trying to help, even if our own experiences differ. I’m not in a position to say if Belinda is or is not attacking you (I haven’t read her posts, to be honest), but I value anyone who is really trying to make a difference and believe there are many paths to that particular goal.
—- Steve
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We homeschooled, too, and I felt it was the best decision. Kids will eventually have to deal with the “real world,” but there is plenty of opportunity for that as they get older. When they have a strong base and believe in their own judgments, as tempered by facts and observations, it’s much easier for them to deal with the charlatans of the “real world” and maintain their integrity. But I agree, the parents have to have the right temperament, and it doesn’t work for all kids.
I did fine in school, in fact, I was a “good kid” and got good grades, never got in trouble, but I was depressed and anxious my whole school career. I absolutely remember being left in Kindergarten at age 5 and feeling abandoned to strangers. It seems a very bizarre thing for us to do, and I believe contributes to our community burden of mental/emotional/spiritual distress.
Thanks for the great post!
—- Steve
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I am glad you are out there, doing good recovery work. But I am afraid you are more in the minority than you may believe. I have been a mental health practitioner and advocate in the field for over 25 years. It did not surprise me one bit to read that three quarters of the time, a mental health professional is responsible for telling their client that recovery is unlikely or impossible. That may be changing a bit today, but if it is, that movement is in its infancy and it remains to be seen if it becomes “mainstream.” I just know that when I talk real recovery talk in mental health planning meetings, the room often becomes quiet and the subject is quickly changed in most settings. Client empowerment makes most clinicians very uncomfortable.
I have also heard the message repeatedly that “recovery is possible IF you follow your medication regime.” I do not consider that a recovery message at all. It is an implied message of hopelessness – you can only recover if you accept that your brain is broken and that your distress is a meaningless expression of genetic inadequacy.
Recovery, in my view, has to be defined by the client. Medication may or may not play a part in it, at the client’s discretion. Defining the issue as a “mental illness” or a normal response to life’s difficult circumstances should also be at the client’s discretion.
Most mental health clinicians I have known do not subscribe to these principles, even when they talk about “recovery” and sincerely mean it. The majority seem to believe the client’s brain is broken, and they convey that to the client, directly or through their behavior.
I believe the statistics are an accurate reflection of most people’s experience with the mental health system. It is not an overly negative spin – it is the truth.
—- Steve
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I used to work on a suicide hotline, staffed almost entirely by volunteers, and it was amazing how helpful it was for the suicidal person just to have someone listen to what they were struggling with that made life not seem worth continuing. Validating that life can be awful and that many of us (including me) may contemplate suicide as a potential solution to the dismal appearance of our lives seemed to be the thing that helped the most.
I do think suicidal feelings are a very normal reaction to the stresses of modern society. That the folks on a psych ward would try to stop patients from discussing their suicidal feelings with each other just shows how very far psychiatry has come from even understanding the problem they think they are working on.
I totally agree, any discussion of suicidal behavior and feelings needs to start with the person experiencing those feelings. That’s how I always approached it and it worked very well for me and the callers.
Looking forward to reading your research.
— Steve
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Lucy,
Thanks so much for this piece! I have been speaking these same words to my fellow professionals and even fellow critics in the US for years, but have often felt like the lone voice in the wilderness.
Many people protest the treatments of psychiatry without recognizing that the diagnostic system is the greater evil, the evil that makes is possible to continue to justify ineffective and destructive and even deadly interventions. Having a label allows us to blame the patient for their own distress and deny any form of social causation, allows us to invalidate their reality with impunity, and also allows us to excuse ourselves when our interventions don’t work or make things worse (you have “treatment resistant depression”). Not to mention allowing a lot of “professionals” and corporations to make obscene amounts of cash off a set of permanent “clients” who are unable to defend themselves or seek an alternative pathway.
Remove the DSM diagnosis, and the entire edifice of thought comes tumbling down. I’m so looking forward to your next post!
—- Steve
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I am so glad to hear you comment on the irrational, evidence-avoidant standard of care in the obstetrical care community, which mirrors the area of psychiatry in many ways. In both arenas, we enforce interventions on entirely healthy people who are experiencing distress around big events in their lives. We can’t leave well enough alone, can’t seem to validate the difficulty of life experiences without trying to make it go away, and arrogantly assume that “doctor knows best” and that true informed consent would only cause the ignorant and naive patient to make bad decisions, because they are too stupid to understand that our disempowering interventions are really incredibly helpful, despite their personal experiences of pain and disability that result.
I am glad you are out there informing people of what is and is not known about these interventions in an honest way, and looking at empowering patients through presenting viable alternatives, which is a much-overlooked aspect to informed consent. I wish your approach were not so unusual – it is what all doctors should be trained to do as a matter of course, but in practice, I find your attitude vanishingly rare.
—- Steve
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I hope I may have the pleasure of meeting you one day. I’m sure we’d have a lot to talk about!
—- Steve
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And remember that relapse after discontinuation does not mean the drug was working. It may well mean that the brain has adapted to the drug’s presence by becoming dysregulated in the opposite direction, and that withdrawing medication simply brings that dysregulation to the fore. It might prove that the drugs themselves are causing harm to the patients’ brains, as Whitaker so eloquently argues in his book.
It seems the real comparison group is those who never took the neuroleptics in the first place or who discontinued relatively quickly. If those people are doing no worse than those who took the drugs, we can conclude that the drugs are probably ineffective. I know there is a potential selection bias of the less affected being more likely to refuse or discontinue medical treatment, but I don’t know that that point has ever been effectively established. But regardless, treatment ought to have a significant positive effect. If we’re reduced to arguing about whether the untreated group might not have been as bad as the treated group, we’re already talking about treatment effects that are probably pretty negligible, otherwise, the difference would still be observable.
—- Steve
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It sounds like we need a change in the law that makes such prosecutions viable. It’s related to the “corporations as persons” concept that we saw in the Citizens United ruling allowing unrestricted funding of political campaigns. We need a constitutional amendment clarifying that corporations do not enjoy the same constitutional free speech protections as individuals. A Corporation is NOT a person!
This is VERY scary!
—- Steve
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Alice, your post is moving and informative as always. I totally agree with the parallels between the psych world and regular doctors – all have moved away from history and causation into a focus on immediate symptom reduction through prescriptions, and it serves us poorly. It was noted in the JAMA in the last several years that receiving medical care was the third leading cause of death in the USA, mostly from prescription side effects.
But I do think there is something more heinous about psychiatric diagnosis. Because of its subjectivity, there’s no way to dispute someone’s “professional opinion” by seeing the x-ray or test results. Additionally, the “treatment” is in most cases the very opposite of what might actually be helpful. I am actually less concerned about the drug effects (which are VERY concerning!) than I am about the message that people get when we dispense the label.
First, it tells them that their emotional response to the world is WRONG. They SHOULD apparently be feeling happy and contented with things as they are, even if they’re in foster care or in a domestic abuse relationship or have recently lost their mom or can’t make enough money to pay the bills. (But don’t get TOO happy – then you’re MANIC!)
The second message is that YOU CAN’T DO ANYTHING ABOUT IT. If you know you are feeling depressed because your relationship with your husband is destructive, that gives you options. But if you’re depressed because your brain is broken, you are powerless. In my experience, depression is often a result of a loss of a sense of agency or control over life’s experiences – feeling trapped or hopelessly committed to a destructive course of action. Telling a person they have no power to change their emotional state by changing their views or their relationships or their world in some way reinforces the depressing thoughts they already have.
Finally, the medical model holds out hope that their magical pills will make everything all better. As all of us know, this is at best misleading and can be deadly in the long run, or sometimes even the short run. People will wait months and years for their doctor to come up with the right combination of drugs to make everything OK, and meanwhile, their lives pass them by and they feel more and more hopeless about their existence.
Healing (in my experience) has generally come from three things: VALIDATION of the depressing/confusing/scary/infuriating contditons; EMPOWERMENT of the suffering person to do something about it; and SUPPORT for creative approaches that the person decides to try, whether those are physiological (improved sleep, exercise, thyroid treatment, energy medicine), psychological (therapy, self-help, support groups, role-playing, etc.), social (new activities, friendships, ending destructive relationships, renewing past successful endeavors), or spiritual (meditation, religious practices, exploration of the meaning of “hallucinations,” protest movements, writing, art, and many more).
All of these things help the person feel more in control of their lives. Psychiatry as generally practiced helps people feel less in control. It also denies the social realities that cause emotional distress, including poverty, racisim, sexism, warfare, global corporate domination, and the general commercial stupidity of our current way of living. The labels place all the cause of distress on the person’s malfunctioning brain. It’s not just destructive – it is absolutely the WORST thing you could do to a person who is suffering mental or emotional distress!
But I guess it makes money for people, so we should just be OK with it. I’m getting depressed and angry just writing this…
Thanks again, Alice – you’re awesome!
—- Steve
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REAL science takes into account all of the variables involved. Psychiatry has long since divorced itself from science by arbitrarily limiting their research to neurology, not even honestly looking at that area, and denying that other variables exist. The idea that psychiatry would “disavow science” by taking these social, emotional, and spiritual variables into account highlights the incredible biases that have prevented psychiatry from even looking at the real data in the neurological areas they claim to be scientifically interested in.
Anyone who is interested in a truly scientific viewpoint would be horrified by the dismal outcome data for psychiatric interventions, much of which has been available for decades but is only now coming to light, due to the intentional SUPPRESSION of this data by the psychiatric establishment.
To suggest that psychiatry has in any way been seriously involved in a scientific endeavor in the last 30 years is laughable. At least since the DSM-III, psychiatry has insisted that science take a back seat to marketing. Take the serotonin theory of depression, for instance: disproven convincingly in the mid ’80s, propagated for marketing purposes to the present day. That ain’t science, folks!
The sooner we stop pretending that psychiatry has been focused on neuroscience, or on any science at all, the sooner we can get back to genuinely scientific endeavors that objectively look at all the variables, and that value real patient outcomes over profit margins.
—- steve
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This disgusts but does not surprise me. I used to work at a suicide hotline, and the AFSP was a legitimate grass-roots organization. It apparently has been thoroughly co-opted by drug company interests at this point.
Similar things are happening in the area of “postpartum depression.” There have been historical grassroots efforts to provide real support to moms who are struggling emotionally after the birth of a child, and the many reasons for such struggles were identified and acknowledged. Now those groups have also been co-opted and the talk is all of “treatment” for the “disease” of “postpartum depression” rather than the frequent natural reaction of depression and anxiety that often accompanies the transition to motherhood, especially in a society that does such a poor job of supporting new parents.
Good for her for speaking up about it at the meeting. I’m sad to see good, solid, grassroots support networks being targeted by these evil corporate slimeballs. There are no limits to how low these scumbags will go to get a buck into their coffers.
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My immediate thought was, maybe her symptoms reduced when she was in the hospital because she was able to escape from whatever abuse or oppression she was experiencing at home. Why this thought does not seem to occur to the mainstream psychiatrist is puzzling at best.
I once talked to a psychiatrist to get some history about his patient. He told me she was an intractable case of depression, been seeing her 15 years, tried everything (listed a bunch of drugs they’d used), nothing seemed to work. I asked him what had brought her to his attention initially. He said, “Huh?” I asked, “What was she originally depressed about that brought her to your care?” His rely, “Gosh, I don’t know!” Stated in a mildly incredulous tone that suggested, “Why would THAT be relevant?” He’d tried everything except asking her why she felt bad. She would have been better off talking to an average 8-year-old, who would at least have had the sense to ask her, “Why are you crying?”
Part of seeing what they want to see is seeing things from the perspective only of what benefits them, and yet being able to rationalize it as for the patient’s own good. We’re all susceptible to this, but a true professional knows s/he has this vulnerability and is constantly checking him/herself for losing focus on the client. Humility is, indeed, the word. Medical decisions shouldn’t be made for personal profit or ego enhancement; moreover, decisions about people’s emotional/spiritual life shouldn’t be considered medical decisions in the first place.
Sandy, it sounds like you have been a bit of a radical all along, although it’s disturbing that the idea of taking the time to understand your patient is actually a radical one in psychiatry today. I don’t know that I could have tolerated working in those circles as long as you have, but I admire your courage AND your humility and am glad you’re there to help open they eyes of those that are willing to see beyond what makes them personally comfortable.
—- Steve
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I agree it’s a very positive sign that the psychiatric establishment is saying such things – it brings me some level of hope. But the glass is definitely only half full, or maybe only an eighth, as long as they are avoiding the hard facts about the adverse effects of their supposedly helpful medications. Both the long-term impact on mental health (increased chronicity due to messing with the dopamine system) and the long-term impact on physical health (acknowledging that these drugs ACTUALLY KILL PEOPLE who would otherwise live, which partly explains the early deaths) need to be overtly acknowledged before we make real progress.
Still, it’s an acknowledgement that the current paradigm sucks big time, and for that we have to be appreciative. Gives us something to build on. Thanks for sharing it, and good for jolly old England!
—- Steve
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Sounds like manslaughter to me. Criminal charges?
—- Steve
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I think a better question is “how do you benefit from this behavior?” or “What do you get out of doing that?” I agree that asking a child “why” ends up being an inadvertent reinforcement, as well as pretty fruitless, because many times, the child’s motivation isn’t something they are aware of. But in doing therapy with adults, I have found that discovering the purpose of a “negative behavior” enables the client to figure out what need s/he is meeting with the behavior, which makes it easier to find a different behavior to meet the same need. Many times, I am undoing some of that childhood reinforcement of negativity that Howard is talking about.
That being said, the biggest unused technique in therapy is asking the person when the problem DIDN’T happen. I often asked clients who were, say, depressed, “When was the last time you didn’t feel depressed?” If you follow up on what was going on at the times s/he felt good, you can discover some things s/he may already know that work to alleviate his/her suffering.
It seems to me that, when working with adults, a combination of “solution focused” therapy (what works rather than what doesn’t) and a very change-oriented examination of reinforcements for the client’s undesired (by them) behavior (which often leads to an examination of “reasons” from the past) is a very fruitful approach.
—- Steve
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Howard, you’re awesome, but you forgot one important point: the “medications” aka drugs given for these childhood behavioral problems have never been shown to improve long term outcomes in any meaningful category, including self-concept, academic achievement, high school graduation rates, delinquency rates, or rates of employment as an adult. If parents understood that these drugs did NOTHING to improve their child’s life in the long run, while exposing them to serious risks in the short and long term, I have to believe that the vast majority would look for other options. The main reason people continue to participate in this fraud is that they are assured that “untreated ADHD” leads to all of these awful outcomes, but are never told that the “treatment” doesn’t affect the mentioned outcomes in the slightest, except possibly to make some of them even worse.
Glad you’re still out there pitching after all these years – you’ve always been an inspiration to me. Thanks for your post!
—- Steve
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Jack, you’re doing something awesome here, and I’m so glad that you’ve gotten some people in the hierarchy of the MSW world to listen. I have found myself in that same dilemma described by the social workers, and resolved it by putting the necessary code on the paper, and explaining to the person I was helping that I was required to do so in order to be paid, but that I considered the “diagnosis” merely an oversimplified description of the external situation that meant absolutely nothing about what was really going on with them or how I would try to assist. Still, I found this an inadequate response, as the label still hung around them even when I told them it had no real significance, as I knew that others would later “treat” them based on the diagnosis I’d given. So I always tried to diagnose everyone with either and “Adjustment Disorder” or with “PTSD,” since those were the two that most closely conformed with my actual view of the causes of “mental illness” as currently defined (i.e. trauma and social circumstances), and were the ones most likely to end the client up with therapy rather than drugs. I assiduously avoided “bipolar disorder” or “schizophrenia” for anyone not already so diagnosed, and got a number of trauma victims de-labeled (an inordinate percentage of trauma victims were labeled “bipolar” in the clients that I ended up seeing in the ER).
I particularly liked you raising the question of PTSD as an injury rather than a “disorder,” and the connection of this question to the one of transferring blame for their condition from the war we sent them to back to something wrong with their internal functioning. Of course, the same applies to ADHD and the schools, and applies in spades to the new effort to reduce the time that the “Bereavement exception” applies in the DSM-5 to a matter of two weeks! The DSM 5 takes reductionism to a new level of absurdity, and I love the idea of a boycott!
Thanks for your great work, and let me know if you’re ever out in Portland, OR – I’d love to help get folks in Oregon interested in the kind of paradigm you’re promoting.
—- Steve
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I would love to see a brain scan trial on people who are indoors and then outdoors in different environments. I guarantee the brain scans would differ significantly depending on the environment. Anybody with an ounce of common sense (although we have to question how “common” it is, at least in psychiatry!) knows that a person who is feeling grim, depressed, frustrated, or out of sorts is likely to gain some relief from going for a walk out of doors. Why would we take depressed people (or anybody else) and put them in an environment with limited light and fresh air and lock the doors and not let them out? The environment itself would depress almost anybody! Especially when there are lovely locked rooms with beds that have leather straps to hold you down and a herd of grim-looking psychiatrists making notes and writing prescriptions but not bothering to talk to anyone on the ward. The whole setup in the average psych ward is frightening and depressing (I’ve visited more a few). The least we can do is let the poor inmates go for a walk. Even prisoners in the criminal justice system are afforded that right!
—- Steve
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Wow, that is pitiful! I meant it when I said, “Depending on what kind of training they get.” I was assuming they were thinking of something along the lines of “trauma informed care,” i.e. how to approach a person who may have been historically traumatized (often by other police officers) and may automatically view a police officer as a threat. But of course, you’re right – this same thinking should be applied to pretty much anyone who is in distress, even if it’s just the fear of being caught for a crime they just committed. Training in “brain disease” thinking may make it MORE likely that they’ll taze somebody, because they will find it easier to distance themselves from the victim. EMPATHY is the key element in any effective training along these lines. If that’s absent, it’s worse than a waste of resources.
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Smokin’ post, Bob!
—- Steve
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Anonymous, you’ve said (correctly) many times that nobody can know for sure whether drugs caused or added to a situation where someone commits a violent act or criminal act. I don’t think there’s a lot of disagreement there. You also say correctly that a drunk person is still responsible for their behavior when drunk. Also a given, which I don’t think anyone’s going to argue with.
I think there are a couple key points that go beyond what you’re saying, though. This is not just about people trying to evade criminal responsibility through drug blaming (though of course, there will be folks who will jump on that bandwagon if they think it will get them off – remember the “Twinkie Defense?). It’s about establishing some honesty about the true side effect profile of these drugs so that people can truly make informed decisions BEFORE taking these drugs.
Take your alcohol example: most people are well aware that alcohol reduces inhibitions, that people sometimes do really stupid things when drunk, and that alcohol does not do anything to heal your brain or address any physical or mental illness (except to the extent that a small amount seems to have a positive impact on circulatory health). They aren’t given a prescription and told they need to drink every day to maintain their mental stability. So the person who drinks is making an informed decision to poison his/her body with something s/he knows could cause trouble.
The difference with the antidepressants is that people are lied to. They are told that these are helpful drugs that are needed to heal their brains from chemical deficiencies. They are told that the side effects are “generally mild and usually go away after two or three weeks.” They are told that the drugs DON’T decrease the recipient’s inhibitions and that the stories about suicide/homicide/violence resulting from antidepressant use are either made up or are “a consequence of the condition,” as you yourself show in the article you quote.
I don’t think people here are trying to say that antidepressants can be definitively shown to make a particular person kill who otherwise would not have, or that there is any way to even make that determination. I think what folks want to say, and the reason these articles appear, is that antidepressants ARE associated with increased violence and aggression and suicidal acts, that they DO, in fact, decrease SOME people’s inhibitions, and that it is LIKELY that SOME PEOPLE commit crimes that they otherwise would not have if not on the antidepressants, just like SOME BAR FIGHTS would not have occurred if the participants were sober.
The people who were drinking at the bar knew the dangers when they started drinking. They knew they were poisoning their brains and continued to do so of their own free will. The same cannot be said for the vast majority of people who take antidepressants. They are intentionally deceived, and often don’t find out the truth until after someone is already dead. I think it is very legitimate to show examples of where antidepressants MIGHT have been a contributing factor as a means of establishing some social agreement and awareness that these drugs are not benign “chemical balancers,” but can in fact create extreme reactions in some people that can result in tragedy.
I have to believe that you’d agree with that general message.
—- Steve
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As a Portland resident, I can tell you that the main reason they’re doing this is because there have been a number of incidents where people having mental/emotional crises have been shot and sometimes killed, not to mention tazed, maced, or otherwise traumatized. I think it’s probably a good idea to have a unit that is better trained to deal with traumatized or emotionally upset individuals, depending on what kind of training they get. I’m assuming the goal will be to communicate before shooting, which I have to imagine will be a step in the right direction.
—- Steve
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It did mention that some people do fine without antipsychotics, but it was rather tepid support. The general thrust is that we should get people on antipsychotics if we can, though they do support low dosages. Trauma goes almost unmentioned. The part on CBT is probably the best, but isn’t really coherently connected to the rest – if hearing voices is a common phenomenon, and people we diagnose as “schizophrenic” are just at the far end of that spectrum, why are we treating people who hear voices as diseased individuals instead of having the primary goal be to help them make sense of their experience? Shouldn’t drugs be an ADJUNCT to these efforts, rather than the primary form of care? These guidelines don’t appear to challenge the medical paradigm, though they do expand on it significantly. I’d say it’s an improvement, but a very minor one.
—- Steve
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Wow, what an awesome and courageous experience! Will, you have absolutely embodied what we all need to be doing in our discussions with psychiatrists, NAMI, and the rest of the “mainstream” world. I am so happy to hear of the support you received from within the rank and file of the APA – it’s encouraging to know that such people are there and willing to speak up.
I would encourage us to take a different approach re: the “Scientologist” accusation. It is the APA who has worked hard to discredit Scientology and to associate anyone who disagrees with them with that religion. In doing so, it is PSYCHIATRY, not Scientology, that is intentionally discrediting genuine efforts at mental health reform, using the “Scientology attack” as their foil.
My response to such attacks is simple: “What does religion have to do with whether or not the current psychiatric paradigm’s effectiveness is supported by scientific evidence?” Or “Why are you talking about religion? I thought we were talking about science here?” We don’t have to defend ourselves or defend Scientology – we can simply label the ad hominem attack for what it is – an intentional distraction from the issues at hand.
I think we really need to take that bludgeon out of their hands – the fact that the Catholic Church opposes abortion is neither here nor there in arguing the pro-life/pro-choice issue, and the fact that Scientology is opposed to psychiatry has no bearing whatsoever on whether psychiatry is scientifically supportable in its current form. This kind of blunt turning of the tables also exposes the attacker’s strategy and makes it less likely that others will try the same tactic in the future.
That aside, I am totally impressed by your efforts and delighted at the response you got. Maybe you can get them to start a “psychiatrists for reforming psychiatry” support group, starting with the attendee list for your lecture! It was also fascinating to hear your account of the insider politics at NAMI. I think it’s a great reminder that almost any organization can be amenable to reform – there are always rational people in ANY organization whose better sense can be appealed to. Sometimes it’s not even necessary to convince the leaders to change direction – sometimes, the rank and file changes direction and the leadership has to change or will be changed by its constituents.
I will share another bit of hope. I did a “mental health” training recently for CASA volunteers, none of whom are trained in mental health care – they are volunteers off the street. When I asked them about their belief in “chemical imbalances,” one of the audience commented, “Isn’t that kind of a discredited theory these days?” The word IS getting out and public perception IS changing, if slower than we’d like.
Thanks for this wonderful message of hope, and for the awesome work you do in Portland and around the country!
—- Steve
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Not to mention teachers, school bullies, sleazy uncles, babysitters, coaches, Sunday School (I had some great Sunday School trauma!), and anyone the child has to depend on for their care or is forced to interact with despite their own judgment.
There are a lot of stressful situations out there, and abusive fathers (including those who abuse the parent and don’t directly abuse the child) are high on the list of mind-screwing experiences that would mess with anyone’s life. Oh, and let’s not forget stepfathers and unrelated boyfriends, who are the most likely people to abuse or kill children they happen to live with, beyond the child’s bio parents (who obviously are the most likely, if only due to average exposure times and numbers).
I also don’t get why it’s “blaming” the parent if you simply observe that they hit the child or sexually abused them and it had a bad effect on the child’s emotional condition. That’s not blame, it’s just observing the facts. Those who are reactive to possible “blame” are often guilty of things they feel bad about and that makes them more sensitive, in my view. It’s hard to acknowledge when you’ve let your kids down in some way, but we all do as parents, and if we have the courage to admit it, then our kids can start healing from it as needed. But pretending we had nothing to do with their adult behavior and emotional condition prevents even discussing the issues that might lead them to a healthier future.
Parents shouldn’t worry about being “blamed.” They are the parents. They are responsible for creating the best environment they can, and for helping their kids adapt to life. No one does it perfectly, but by being humble, we do a much better job than if we’re worried about being “at fault” when our kids don’t turn out to be perfect.
—- Steve
Sounds like the pendulum is swinging back…
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Maybe the drug companies have realized that there will be no new breakthroughs because their basic approach was deceptive and morally bankrupt to begin with, and people are finally catching on. If I were a drug company CEO and read Whitaker’s book, I’d certainly be thinking about alternate areas for research! I wonder if they’re just leaving town before they’re tarred and feathered and run out of town on a rail.
—- Steve
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I’d be interested in comparing rehospitalization rates for people who continued on their prior dosage. This certainly supports Whitaker’s conclusion that “relapse” is often the result of withdrawal reactions to the medication.
I’d also be interested in hearing how your colleagues responded to your presentation.
Thanks for this important information.
—– Steve
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I agree with Sandy – in order to get real change happening, we have to start using at least some of the language that is used by the people we’re talking to, or we’ll have no common basis for discussion. At the same time, Mary Boyles’ essay shows us how we can use those terms to explain what we’re talking about while still making it clear we don’t buy into the concept being implied by the label. In this way, we can start to get behind the label and look at the labeling process itself, which I and others have pointed out is what really provides the cover/impetus/ rationalization for all the rest of the dangerous nonsense about brain diseases.
I often resort to using things like quotation marks around diagnostic labels or saying, “people who have been labeled with the schizophrenia diagnosis” or “people who have been viewed by the current system as qualifying for an ADHD diagnosis.” This is usually digestible by people who need to believe in the labels, but allows a broader discussion to occur about whether those labels really have any legitimacy at all.
I do think this kind of work is essential, even though it feels a bit like an unacceptable compromise to even ask questions in the form they are asked. People are going to do research on “schizophrenia” whether we like it or not. I think it’s awesome that some funding will go to asking the question of whether treatments for so-called “schizophrenia” might be worse than the purported “disease,” even when I don’t agree that the “disease” is really a disease at all.
—- Steve
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Just to clarify, I know your work well enough by now to know that you were not saying they were safe and effective, just quoting Friedman’s statements. You’ve been one of the courageous pioneers in stating the truth about these drugs when it was politically unsafe to do so, and I’ve followed your quality scientific work for many years as the world has slowly caught up to what you already knew 10+ years ago. You’re one of my heroes, and I have tremendous respect for your work, as you have always done a great job of letting the research to the talking and keeping the rhetoric to a minimum. Thanks for this and all of your excellent work!
— Steve
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Wow! Laura, you are amazing. Thanks for sharing that inspiring speech – I may just print it out and post it on my refrigerator!
—-Steve
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Psychosis IS a well-established side effect of stimulants, even at prescribed dosages. A retrospective study published in the Canadian Journal of Psychiatry (about as mainstream a journal as there is) stated that over 6% of stimulant-treated kids he looked at retrospectively had evidence of psychotic symptoms in their file. I would hardly call 6% rare. This does not include the larger number who have aggressive incidents related to stimulant use, which is also covered in the story, though blamed on adolescence rather than the stimulant drugs. What REALLY dismays me, though it hardly surprises me any more, is that the doctor, KNOWING that psychosis is a potential side effect of stimulant treatment, switches to Risperdal, rather than just discontinuing the stimulant and seeing if the symptoms go away. And the poor kid is now left spouting psychiatric dogma: If I didn’t take Risperdal, I’d be too bad of a kid for my parents and teacher to handle.
It disgusts me no end that we know the school environment itself is causing the biggest proportion of these “disorders”, but the kids continue to take the blame and have their brains screwed with because they don’t fit into the environment. And I find this doctor highly reprehensible for going along with it. If he is so certain that the school itself is the major cause of these kids’ suffering, why isn’t he speaking out and meeting with the school principals and superintendents and PTSAs and letting them know what’s going on? Doctors have a natural authority that would make people take notice if they started sending this message. Why isn’t he refusing to medicate and offering these parents alternatives, like seeking an alternative school environment or home schooling or getting their kids on IEPs or encouraging them to take political action?
“I’m their doctor, not the doctor for society” is a total cop-out. Time to speak up, Doc!
—- Steve
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I absolutely agree with Jeffrey. I see this happening all the time in my work with foster children, and yet it is rare that anyone in the mental health field connects the dots. It’s usually up to my volunteer advocates to sound the alarm, and they are then usually subjected to a level of condescension that is often quite discouraging. The only answer seems to be to get a second opinion from another psychiatrist that contradicts the first, but most psychs aren’t willing to criticize their peers. Meanwhile, these kids are being diagnosed “bipolar” in huge numbers and given antipsychotics, when the problem originated in an adverse reaction to an SSRI.
“There’s the likelihood,” said a lead researcher, “that by virtue of the fact that our clinical diagnosis is not based in neurobiology, but rather in symptomology, that we may be giving kids a serotonin drug inappropriately.”
This quote gets my vote for understatement of the year.
—- Steve
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“Antipsychiatry” is an ad hominem attack on a person whom the psychiatric authority (or authorities) don’t want to respond to. It’s a perfectly legitimate observation to state that the DSM diagnostic criteria are observably, objectively, undeniably subjective. They are clearly based on social criteria, such as “interferes with normal functioning,” or “creates clinically significant distress.” They are also based on the assumption that “clinically significant distress” is in itself the problem, rather than being a possibly appropriate response to a stressful environment.
It’s one of those things like being “pro-life” vs. “pro-choice.” It’s really an ethical/philosophical issue, not a scientific one. We’re all operating here on the idea that psychiatric diagnostic labels should be objectively distinguishable and should suggest interventions that lead to positive outcomes. The “true believers” in the Church of Psychiatry don’t subscribe to those same values. So when confronted with the scientific reality of their failed treatments, they sink to ad hominem attacks, having no rational arguments to fall back on.
As to this movement, I agree that a civil rights framework is the most encompassing and most difficult to argue with. People have the right to good information and have the right to decide for themselves what is and is not helpful. This is held to be true in every other area of medicine – the right to refuse treatment or a particular treatment is so fundamental, it’s been argued in front of the Supreme Court. Why should the same not apply to “mental health treatments,” which are based on a much more subjective and often outright spurious basis in comparison with objectively observable disease?
We also need a comeback for the accusation that everyone opposed to psychiatry is a “Scientologist” that doesn’t buy into the idea that being a Scientologist would make someone’s argument automatically weaker. Mine would be, “What on earth does a person’s religion have to do with the lack of a scientific basis for your claims? Either they have a scientific basis or they don’t. I don’t care if your detractors are Catholic or Muslim or Zoroastrians or followers of the Reverend Sun Myung Moon – I want to hear what the scientific basis of these DSM diagnoses are, or proof of your proposed ‘chemical imbalances.’ If you don’t have it, admit it and stop trying to distract us from the hard facts of the situation by bringing in irrelevant factors.” That ought to stop them in their tracks.
—- Steve
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“Effective and safe?” Effective for what? The only thing they’ve been found effective for is psychosis. And they are NOT safe – they cause diabetes, obesity, and other metabolic problems, extrapyramidal symptoms, akathesia and Tardive Dyskinesia, and have a black-box warning for early death in the elderly. The atypicals and their earlier cousins are largely responsible for the 25-year-shorter average lifespan of a person diagnosed with a “serious mental illness.” What would they have to do to be “unsafe?”
—- Steve
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We do need to fight, but we also need something to fight FOR and people who will fight along side of us. Most of what has been said here is true in one way or another. It seems what we need to do is to work to create and fund alternatives and demonstrate their effectiveness, as Mosher did, but then be prepared to take on the inevitable backlash of the swine who will object to having their snouts removed from the trough. In doing this, we need every person who is committed to the rights of those receiving “care” in any form to decide what is right/wrong with them, what they need and want, and what is actually helpful in getting them closer to meeting those needs. Some will be in the system, some outside. Some will be part of the government, churches, the military, even inside psychiatry itself. We need all of them.
The other thing I know is that changing systems takes time, because we’re actually changing culture. The Church of Psychiatry has spread its gospel message far and wide in our society, and many special interests are bound up with it in one way or another. As Ted correctly states, those with power will not give it up voluntarily. But part of that power comes from the beliefs of the large group of “true believers” who are not aware of the actual truth. Prying away as many of these people as possible with effective public relations campaigns will also be essential to this plan working. And remember that many of the believers who can be “turned” work within the Church of Psychiatry itself. I’m an insider rebel and know many others who would join up if a movement emerged, but they don’t feel they can for fear of their careers. We can say that’s gutless, but that’s realty. We need to create a NEW reality where it’s OK to question the psychiatric paradigm and where the priests are disrobed and shown for the charlatans they are.
It’s hard to believe in the Wizard of Oz once you’ve seen the man behind the curtain!
So let’s create, let’s inform, let’s find allies, and let’s take the power back, and let them know we won’t stop!
—— Steve
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Duane, you are absolutely right! We have to find common ground with people who may not agree with everything we say and do. I’d add to your list: GOVERNMENT. While lots of government workers are frustrating and bureaucratic, and government leaders are often in bed with Pharma and the psychiatrists, there ARE people in government who are genuinely trying to do a good job and are as frustrated as we are with “the system.” And in the end, our government (which is, after all, put in place by US) will have to participate in bringing and end to the madness that is psychiatry.
Thanks for telling it like it is.
—- Steve
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I still think we miss the biggest problem: not all people are depressed/anxious, etc, for the same reason. I agree that lots of people (including me) experience anxiety and depression as a result of untenable conflicts between unreasonable or unethical social expectations and the dictates of their own consciences or personal integrity. But there are plenty of authoritarian folks who are depressed (usually for some good reason, like being abused or neglected or bullied, etc.) who simply accept the doctor’s recommendation of “medication” based on “chemical imbalance” as entirely plausible based on the assumption that the doctor knows more about these things than they do.
I agree that “antiauthoritarians” are more likely to be diagnosed, and more likely to be diagnosed with more severe “illnesses”, and are probably more likely to be coereced into treatment, because they don’t “go along with the program.” And I totally agree that the profession of “psychologist” has completely sold out to the current power elite, to the point that psychologists in many states are now demanding prescribing rights (Yikes!)
But plenty of authoritarian-oriented people are victimized as well, and the results are still disastrous. I have frequently met such people at survivor meetings, and their whole worlds have often been shattered by being forced to come to the realization that the “authorities” lied to them and did not have their best interests at heart. And some of the most vehement opponents of change in the psychiatric world are authoritarian-oriented people who are religiously committed to the idea that “these drugs saved my life.”
It’s a complicated world, but I think the first mistake is to try and classify people who are behaving, thinking, or feeling a certain way as all being the same. Even calling some people “authoritarian” and “antiauthoritarian” risks us going down the same path. I think the more salient point is that allowing the current power elite to define the status quo as “normal” and to label anyone not satisfied with that “normal” as “diseased” is the core of what needs to change. And we’ll need all the people we can, no matter where they fit on the “authoritarian” scale, to support us in challenging that enforced reality.
—- Steve
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Bummer for you, but well done on taking a stand. Sounds like you’ve been moving in this direction for a good long while. Thanks for your support for the victims of this horrible power play.
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I agree with you, but part of the problem of uneducated or mis-educated consumers is that the pharma companies are allowed to do direct to consumer advertising, as well as being allowed to market illegally to doctors, who also seem to believe their lies. Additionally, the APA, NAMI, and other groups who support pharmaceutical interventions need to be restricted in their ability to lie for Big Pharma. Lawsuits don’t seem to be enough – I think criminal penalties for illegal marketing would be a great place to start. Additionally, I agree that written informed consent should be required, including written statements to the effect that this drug is being administered in the absence of clear evidence that there is anything physiologically wrong with you, and that the long-term effects of this drug are not fully known but appear to increase in riskiness the longer you take the drug.
Which brings me back to my earlier point: we need politicians who aren’t bought off by corporations, which means we need to arrange it so corporations are not able to contribute any money to political campaigns. It’s a long road, but I hope places like MiA can help educate people in the meanwhile and build some momentum.
Sandy, would love to hear you getting involved with some advocacy at the APA!
—- Steve
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Long-term outcome studies are critical, but I agree, there are many already extant that simply need broader publication (or maybe not so simply, as the media bias toward supporting drug company propaganda is clear).
For instance, we have been studying stimulants in “ADHD” kids for over 50 years now. All of the summary reviews have shown the same thing: kids exposed to stimulants long-term do no better than those who have no such treatment or take stimulants only briefly. These include the MTA study and the Oregon State University Medication Effectiveness Study, the latter of which reviewed every piece of extant literature on stimulant research, and found no evidence for any improvement in any long-term outcome, except for a slight reduction in the likelihood of a motor vehicle accident. Delinquency, school completion, test scores, college admission rates, self-esteem, social skills, and eventual employer satisfaction with their ADHD employees were all unaffected by stimulant treatment.
This kind of research already exists for “depression” and “schizophrenia” as well, as Bob documents in the book. I think the big question is how we get this information to be published broadly enough to undermine the Joseph Goebbels strategy (the Nazi propragandist who famously stated that “if you repeat a lie often enough, it becomes the truth) pursued by the pharmaceutical companies and their allies in the psychiatric profession.
—- Steve
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Glad to hear a mainstream psychiatrist finally say this out loud. I’ve been saying it since 1990 when I first researched the long-term outcomes. Kids taking stimulants don’t do better than kids who don’t on any long-term outcome that we generally care about. It just doesn’t work.
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Yeah, I remember those breasts developing in my teen years… I hope we see another record-setting fine. But really, these guys need to go to jail. They are criminals, as well as being really bad liars.
—- Steve
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This speaks to the larger social issue of our current form of government-by-marketing. As long as political campaigns can be funded and supported by corporate marketing interests, market benefits will be the primary value our government promotes. The “free market” (and I use quotes, because it’s clearly no such thing) will never promote something like Open Dialog – it will have to be the general community, in the form of government representation by people who actually give a crap about THE CITIZENS rather than their corporate masters, who promotes this healthy and money-saving alternative to a lifetime of dangerous and ineffective drugging.
Sandy, you’re sounding more radical by the day!
—- Steve
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It seemed like this was about more than just his program. I had no big problem with it.
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Who said they are “effective and safe?” He obviously hasn’t read AOE.
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Sorry if I was a bit obtuse, there – reading it again, it does sound rather tongue-in-cheek. But my post can be considered a preemptive effort to respond to the anticipated reply of said poster, not to mention to the usual arguments of the psychiatric community, who would blame the “underlying condition” rather than the drug.
Glad I was able to re-read your post with the appropriate level of humor!
—- Steve
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I can’t agree with you, Jeffrey. While I don’t know how a drug might or might not cause intent to harm, it is obvious that many drugs reduce inhibitions and increase a willingness to take risks or transcend social norms. (Why are drunk people more likely to get into fistfights?) It is also well known that multi-day loss of sleep does cause psychosis eventually, and drugs can certainly cause insomnia (know any meth users?) that can lead to psychotic episodes. I don’t know that this absolves the person committing the crime of their criminal act in all cases, but there is another crime being committed if the doctor involved knows or should know of these added risks and does not discuss them with their client.
Prozac was initially banned in Germany because of a noted increase in suicides and violent aggression. There is no question that this information should be shared and believed. It’s not a conspiracy to blame drugs – they really do have this kind of effect, and people are dying as a result. We don’t have to let the perpetrator off the hook in order to demand that unsafe drugs are kept off the market, or at least that the safety issues are honestly discussed with patients and monitored for, instead of leaving a guy like the one in the picture to assure our safety.
—- Steve
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Don’t forget Marijuana – definitely has antidepressant effects at lower dosages, and certainly has a much better side effect profile than SSRIs. I’d rather have the munchies and feel lethargic than want to kill myself or my family!
—- Steve
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You are right about the “underlying condition,” which in a way seems even worse than blaming the patient. At least if s/he was at fault, s/he could try to fix it. The “patient” (who is disempowered by even being called that) is the victim of the “underlying condition” and has no power to do anything about it. The doctor and the drug are working on the “underlying condition” which may “resist” their treatment or may yield. It’s as if the patient/recipient is a passive observer of the whole thing. No one ever seems interested in hearing what s/he experiences, and if s/he does speak up, his/her suffering is attributed to the “underlying condition” (see “nervousness” in my post above) and the drug and the doctor are absolved. The patient/recipient/victim has no control over anything, and can’t object to or even describe his/her reaction to treatment in any effective way.
Delusion that they are being poisoned? Maybe it’s not such a delusion after all…
Thanks for your reply, Sandy.
—- Steve
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Hi, Sandy and Vanessa,
I have to say, this study did not surprise me in the slightest, because it’s completely consistent with my own experience in the field.
Sandy, I appreciate your giving the doctors the benefit of a doubt, but I think it’s important not to overlook another important reason doctors don’t get the full picture: many of them don’t want to see that picture if it conflicts with their own biases and training. I knew a 14-year-old whose hand shook 24-7 and who spent hours every day trying to reduce the tremor, and who was taking four drugs that caused involuntary movements, two of which specifically mentioned hand tremors as a side effect. I spoke to the doctor and said we had concerns about the side effects she was experiencing. His response: “We haven’t noticed any side effects.” They told her that her hand was shaking because she was nervous!
They didn’t notice any side effects only because they didn’t want to see what was right in front of their faces. There was no protocol for side effect screening, and the staff at the facility seemed to have no idea what she was taking or what side effects to look for. Not only did they not ask the right questions, they specifically went out of their way NOT to ask any questions or make any observations that would lead to noticing side effects.
And I don’t regard this as an outlier. It is almost impossible to get most psychiatrists to acknowledge that any adverse effect is happening, and even if they do, they tend minimize the effect or say it will go away. It seems to be a part of the culture of the psychiatric world: anything good that happens is attributed to the drug, anything bad that happens is attributed to the patient. Which is how we got 15+ years of denial that SSRIs cause suicidal thinking, despite Prozac being banned initially in Germany for suicidal thinking being evoked, just to give one example of many.
I’d be interested in whether you see this overt denial that I’m talking about and if you have any sense of how to deal with this on a large-scale level. I think this is job one in changing the paradigm – being honest about what is really happening.
—- Steve
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And the journals and newspapers and TV stations are owned by corporate magnates that have shared interests with the pharmaceutical companies. For instance, if Big Pharma can make more money with advertising blockbuster drugs, it stands to reason that TV stations, magazines and newspapers can make more money selling those advertisements. Why would they want to kill their own cash cow? The commercialization of the media over time plays right into PharmA’s slimy hands.
—- Steve
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Legal action is needed, but the fines aren’t enough to discourage their evil marketing actions – they still make way more money than any fines they’re assessed, and probably see lawsuits as a cost of doing business. I think we need some criminal prosecutions of CEOs and medical advisors who are lying to the public to create more profits for their firms.
It might also help to have an FDA that isn’t laced with people that have pharmaceutical company backgrounds. How about a citizen board to review these drugs, with “distribution requirements” that say you need to have people from a range of backgrounds and interests on the panel, including (of course) a minimum number of psychiatric abuse survivors, oh, whoops, I mean “peer advisers” to give real feedback about what happens and who will take such feedback seriously from others.
Other possibilities include changing the FDA rules so that all studies must be submitted for a drug’s consideration, and that the studies as a whole have to prove the drug’s efficacy rather than just having two “positive” studies, or changing the standards of what qualifies as “efficacious” to be more specific and more demanding than a 10% improvement over placebo. And how about setting a standard of maximum morbidity allowable before a drug is pulled from the market, graded based on the seriousness of the disease involved (if you’re going to die of cancer, you might be willing to take a few risks, but if your kid’s not completing his homework, a risk of psychosis or death might be a lot to be willing to assume).
We could also hold doctors accountable for failure to provide real informed consent, including failure to inform of alternatives. We could engage in media campaigns, if we could get the funding. There are a lot of things that could be done, but most require money and/or legislative or judicial support. I think the problem is that so many people have their snoots in this particular trough, the challenges in funding and political support are severe.
Maybe we start by campaigning to eliminate corporate personhood status for our legislators so that the Pharma folks can’t buy them off in the first place…
—- Steve
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Wow, what a powerful testimony to the promise and betrayal of these drugs, both for you personally and for our society as a whole! I did not know the coda to Wurtzel’s story, which of course, received no press while her original thesis was broadcast around the world. This should serve to remind us all that these are aggressive, vested interests in operation and being “nice” and “understanding” and sharing data aren’t going to change the dynamic we’re seeing. Your personal struggle is so touching, and so reflective of the many others I’ve seen, especially the drug-induced move from depressed to “bipolar” without any attention to the real issues at hand, such as historical trauma, identity, and purpose in life.
I hope your painful experience has helped you to find a new direction. I am sure that your writing will do that for some who really need it. Maybe it’s time for you to do a book!
Thanks for sharing your story.
—- Steve
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I generally try to get interested in how they came to their conclusions, and tailor my response appropriately. I’ve long ago learned that most people are not swayed by science per se. A lot of people tend to be swayed by “authorities” whom they believe to be “scientific” and would like to rely on those people for information without having to figure it out themselves. So I have to address the question of “could the authorities be telling you incorrect information?” before getting to any meaningful discussion of psych drugs. Of course, this discussion is positively TERRIFYING for some people, and there are many who simply can’t process the possibility, even when I share with them that receiving medical care is the third leading cause of death in the USA, primarily due to death from properly prescribed and administered prescription drugs.
Then there are those with a vested interest in believing in the “disease model” hypotheses, such as people in the field who have built their practice on this assumption, or parents who need to feel protected from guilt feelings for having possibly failed their children in some way. This is a very different discussion, and also often leads to barriers that can’t be overcome.
Bottom line, people believe what they believe for a whole lot of reasons that have nothing to do with science. Finding out how they make the decision what to believe is an essential first step in either understanding how best to approach them, or realizing that they will simply not be receptive for reasons we can’t control.
—- Steve
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Hey, Batsey!
You provocative dog, you! Just so you know, I am a “credentialed intellectual” (Masters in Education, BA in Chemistry, history as a counselor/therapist, MH professional, including 9 horrible months doing evaluations for “involuntary detention”), and love the ‘real’ conversations. But I do agree, there are actually a lot more professionals out there who are sympathetic to these ideas but are afraid to speak up for fear of being attacked. I was never one, but I have been attacked or ostracized or simply marginalized for my views. The oppression does not only exist for the recipients of “mental health treatment.” There is plenty of oppression for any provider who strays from the prescribed path!
— Steve
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Well said, Malene.
I will add that the dopamine hypothesis has been fairly well discredited (if you haven’t read Anatomy of an Epidemic yet, you need to – the studies are there), and even some mainstream psychiatrists have recently come out in the national media and acknowledged that “things just aren’t that simple.”
As to the increase in dopamine receptors with antipsychotic use, yes, that is also a theory, but a theory with a lot more science to back it up. Starting with animal models, the observed response is well documented. It is also very well studied in the field of addiction medicine, where changes in receptor densities have been found to correlate with the development of tolerance as well as with extended withdrawal processes that last many weeks or months longer than the actual removal of the drug from the person’s body. It’s been particularly clear in studies of withdrawal from benzodiazepines that anxiety attacks became MUCH WORSE than baseline during the withdrawal process on the average.
Given this, I don’t see why it’s far fetched to say that withdrawal from antipsychotics can cause a temporary increase in psychotic symptoms, even if you do believe the dopamine theory. It seems just as well supported as the idea that going off medication brings back the original symptoms, which is also, in your own words, just a theory.
As a fellow scientist by training, I am sure you would agree with me that a theory is only as good as it is able to predict future events and allow us to predictably influence them. The litmus test of the “dopamine theory” does not really rest on whether or not dopamine imbalance is involved in psychosis, or whether there is an increase in dopamine receptors with long term use. The test is whether or not intervening with antipsychotics produces the expected results. In the short term, there is no denying that it can reduce psychotic symptoms dramatically. But long-term outcomes, from Soteria House to the Harrow study to Open Dialog, appear to suggest that this short-term benefit can be deceptive, and that other non-medical or limited-use approaches result in much better long-term outcomes. That should be enough to convince anyone that the idea of using lifetime antipsychotic prescriptions as the preferred “treatment” for “schizophrenia” is not scientifically supported.
Add in the radical concept that it may, in fact, be the patients themselves that are being “demonized” and that their resistance to medication may be, in many or even most cases, very well-founded and rational, and the idea of forcibly medicating someone beyond anything but the most severe immediate crisis situation (and even then, only after everything else has been attempted) seems pretty oppressive.
—- Steve
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“Radical humility” is it! It appears you are on the way there, Sandra, and I so appreciate your courage and willingness to take that humble approach. And you are right that the labeling process itself prevents the necessary attitude – as soon as that process is started, we’ve already lost the humble perspective.
I think Erik Erickson said something to the effect that therapy needs to be reinvented for every person. It sounds like that’s what the Open Dialog folks are all about. I’m very interested to hear both of your experiences and of the reception these ideas receive in your professional community.
Thanks for being willing to “keep your mouth shut and your mind open,” as the saying goes, and sharing your experiences with us. I wish there were more psychiatrists like you – it might give me some hope for the profession yet!
— Steve
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Laura, you are awesome as always!
“…the biggest change I believe I can create in my work as a peer specialist (a title I take numerous ethical issues with, and that my heart really struggles with having, although that’s a conversation for another time…) is to help a person connect to a sense of inner-agency and hope that he/she has forgotten exists inside of him/her.”
It is sad to me to read this comment, because I have been a counselor/therapist in the community in the past and this is exactly what I always have done. Of course, I didn’t actually receive any training in counseling before I became one (undergrad degree in Chemistry, grad degree in Education, but somehow the MS convinced people I was a counselor!), and maybe that was a huge advantage. But I recall a lot of folks back in the 80s who thought similarly, and we got some really great results. Empowerment was the watchword – helping the “client” (whether self-identified or forcibly labeled as such) realize that it was the “client” who defined both whatever problem we were working on and what the solution was.
We have come so far from that paradigm that it is apparently almost unrecognizable as “mental health treatment,” and only “peers” (as in survivors of the system’s abuse!) seem able to recognize that this is what really helps people thrive. That paradigm came from the place of believing that everyone had a REASON or PURPOSE for their behavior, and that critical to helping was to assist the person in identifying what they were trying to accomplish and then have HIM/HER decide if their behavior met his/her own goals or if change was in order.
I concur 100% that it is the definition of “mental disorders” as medical entities needing “treatment” that is at the core of why the current system is so destructive. And despite Stevie’s protests, it is the APA that publishes and supports these definitions, and adds the social validation required to obfuscate the obvious lack of scientific validity or even scientific approach involved in developing them.
I am looking forward to the new forum. I’ve been involved in working to change the system “from the inside” for years, including helping pass a law in Oregon that has reduced the rate of psych meds in foster care from 24% to 14% in 5 years. I can tell you that it only happened when we were able to join together a group of people who had some social clout (judges, advocates, attorneys, foster youth, government officials, the news media, and the legislature), and it took a long time to make what still amounts to a significant but not sufficient impact on the system. System change takes time, and it does require an alliance of “insiders” in addition to critics from outside the system. Political power is very real, and in this country, as corrupt as the process has become, the power can and ultimately does belong to us, if only we will step up and take it back from the people who have bought it, including (sorry, Stevie) the profession of psychiatry.
Thanks again for your inspirational blogs. Let’s shake psychiatry to its foundations. The good ones (Sandra Steingard and her ilk) will come along for the ride, where as the rotten ones will fight like cornered badgers, but in the end, have nothing but their status and their illicit financial motivations to protect themselves. If we all band together, including those IN the system who want to change it, we can bring this edifice to its knees!
—- Steve
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I do appreciate your courage and commitment in coming here and posting, despite some very hostile responses at times. I am sure you are on the “right intentions” side of the ledger in the psychiatric community, and I do appreciate as well your willingness to take some heat in that community by standing up for alternative viewpoints.
What I’d really like to see from some of the groups you mention is some concrete positions on important issues of the day. Maybe they have done so, but I’m not aware of it. For instance, it would be awesome to have a group of psychiatrists go public with the position that Joseph Biederman’s alternate view of “childhood bipolar disorder” was not scientifically based, and turned out to be dead wrong and has hurt lots of kids. An extra bonus kicker would be a statement of concern that Dr. Biederman’s position and advocacy for this new definition appeared to be motivated by a conflict of interest, due to his Big Pharma connections, but that would just be icing on the cake.
An article on criticism and change movements within the psychiatric community would be most welcome. I think the psychiatric community can no longer pretend to be unaware of the lack of scientific support for many of the positions the APA has taken or supported over the years, and they could be very helpful in spearheading some real change, just as a few selected heroes have done. But so far, those heroes get attacked by the psychiatric community in general, and they need some “insiders” to speak up and support them. This would be a great role for people like you to play in supporting this movement of change.
You’re right about revolutions, but corruption is everywhere. While I don’t want to trade an old corruption for a new one, I would love it if some people currently in power were willing to point out the current level of corruption in some concrete and public ways, as the example above outlines.
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Honestly, I found your response kind of insulting. I know more than a bit about Scientology and about what are termed “cults,” and it’s very clear to me that the line between religion and “cult” is often a very vague and hazy one, much like the line between being “mentally ill” and normal. There are plenty of “cult” behaviors (such as isolation from non-members, subservience to an unassailable human authority, being expected to make unreasonable contributions of time and energy to the group, and punishment by exclusion, to name a few) that are VERY common in a wide variety of “accepted” religious sects, as I am sure you are aware.
My point, however, is that a discussion of religion, or cults if you prefer, is out of place here, in that it actually adds fuel to the fire of those who subscribe to the psychiatric cult itself. (And if we’re going to use the word cult, psychiatry may be the ultimate example of one!)
I think the point of this blog is to enhance our understanding of the real science that applies to the arena of mental distress, and the philosophical conflicts around defining what is “mental illness,” if such a thing even exists, and what might distinguish such a condition from what is called “normal.” Badmouthing a religion or religiously-affiliated group like CCHR simply reinforces the psychiatric accusation that we’re “all Scientologists” and can therefore be dismissed as cranks. So let’s focus on the FACTS, and let CCHR and the COS do what they do without wasting our energy criticising them here.
Hope that’s a bit clearer.
—- Steve
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I am tired of Scientology being the whipping boy of the psychiatric profession. Its shortcomings are very similar to the average evangelical church of whatever persuasion. The “true believers” believe they are right and want everyone else to agree and join them. Sound familiar? To say they are as vicious and dangerous as the gigantic psycho/pharmaceutical junta is a ridiculous comparison, and in my view diminishes the legitimacy of what we’re trying to do.
CCHR has not always been factually accurate (though they’re getting much better in recent years), and their rhetoric often gets in the way of their message, but they were fighting the psychiatric takeover back when everyone thought Prozac was Manna from Heaven and anyone who disagreed about the biological nature of depression and psychosis was considered nuts themselves.
Psychiatry has used the “Scientology attack” as a means of deflecting legitimate criticism for as long as they have had the opportunity. Let’s not feed them more energy by dissing Scientology or any other religious practice on these blogs. There are plenty of other blogs focused on that subject. This is NOT about someone’s religion – it’s about the domination, corruption, and greed in the psychiatric profession that contaminates everything they say and do.
If someone “accuses” you of being a Scientologist based on your views on psychiatry, I’d suggest you reply, “What on earth does a person’s religion have to do with whether psychiatric practice helps or harms its patients?” It just isn’t a related topic, except to the extent that the use of the “accusation” as an ad hominem attack on opponents needs to be stopped cold, and the accusers need to get back to talking about the hard, scientific facts of the situation.
Scientology only affects those who choose to get involved. It does not scare me. Psychiatry involves people against their will and uses its financial and professional domination to spread lies and sell drugs that disable and kill people, and then blames the victims for their own demise. It scares me a whole lot!
—- Steve
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The PET scans measure ACTIVITY rather than structure. The cause of an increase or decrease in activity is never known or even sought out. Of course, the testing is also based on our set of “known diagnoses” out of the DSM, and those with these “diagnoses” *(by the DSM’s own admission) may have little or nothing in common with each other, physiologically or otherwise. Additionally, a lot of the “results” for a particular diagnosis are obtained from averages of many scans. Any individual with an “ADHD” diagnosis may or may not have a scan remotely similar to the average scans.
On the whole, phrenology is an excellent analogy. We’re probably better off with horoscopes.
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They seriously told you that he could not get NMS on Zyprexa? Are you suing them for malpractice? That is a ridiculous assertion!!!
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Not to mention that the risks of drugs are far greater than the risks of therapy.
But the real implication of the study, in my mind, is that people who are depressed need someone to care. It may be a giant placebo effect for any treatment – the thing that makes the difference may well be only that someone recognizes and acknowledges that you are struggling and gives you some hope. And if that’s the case, giving hope without damaging someone’s brain is certainly the preferable option!
Too bad they don’t include peer support groups in their study – I am sure they’d be at least as effective, probably more so, and are certainly the cheapest and probably the safest option to boot.
—- Steve
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Well, as reprehensible as he is, at least Amen is TRYING to find some test – these guys who are criticizing him are using paper-and-pencil CHECKLISTS to diagnose people! They have a lot of nerve criticizing ANYONE for a lack of scientific rigor!
—- Steve
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As long as everyone plays along, no one gets in trouble. Oh, except the “patient.” But since the ‘patient’ is “mentally ill,” it’s easy to blame any negative results on “the disease” instead of the doctors’ own insensitivity and stupidity and corruption. Anyone who commits suicide on an antidepressant: “Well, depression is a serious disease, and sometimes people take their lives despite our best efforts. Sigh…” Of course, the fact that the victim was never suicidal until they took your drug does not get mentioned.
Until both patients and our government representatives (go, Chuck Grassley!) call them on this and make them PAY in both monetary and criminal penalties, these criminals will continue to bilk us all and maim and kill their own patients with impunity.
— Steve
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Quote from Littrell:
“What was shocking to me, however, was when this psychiatrist off-handedly stated that child psychiatrists don’t medicate diseases, they medicate symptoms. I asked whether this means that if a child is obstreperous, then the doctor puts the child in a chemical straight-jacket. The psychiatrist did not respond.”
This is the ugly secret of psychiatry: they don’t even bother with diagnoses anymore, at least when kids are concerned. They KNOW they aren’t medicating a disease – they KNOW they are drugging “symptoms” without ever asking why those symptoms might exist or whether they are even an indication of anything wrong at all. Kid is “too active,” kid gets drugs, kid is less active. That’s the whole process. They are trying to make bad thoughts/behaviors/feelings go away, and “bad” is defined by them or whomever is in charge of the “patient.” The idea that diseases are involved is only window dressing. Not even the psychiatrists themselves really believe that.
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You said it, John. If a mechanic ruined my car, he’d have to pay to have it replaced. If he knowingly did something to ruin my car, he’d be committing a crime and susceptible to criminal penalties. How much more should a person be accountable for ruining a life? Why do these guys get off without even a bad news story? The best way to end biological psychiatry is to make sure that this particular crime no longer pays. Fines in excess of profits made, and jail time for knowing perpetrators, those are the tools to drive the drug dealers out of business.
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Criminal is right. There was also a great ABC 20/20 show on the use of these drugs in foster kids (which is the world I work in) – it is definitely worth watching, because it not only shows the awful condition two of these kids were in while taking the drugs, it also shows how well they recovered when they stopped taking the drugs, got some quality therapy, and were adopted by loving families.
It is shocking that these practices are legal. Perhaps we need to do something to change that.
—- Steve
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Duh!
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If I recall correctly, the affected person is the one to identify whom s/he wants to involve in the dialogue. It definitely occurred to me that having the wrong person there could be hugely detrimental, but Will Hall did an excellent demonstration (I got to be his “co-facilitator!) which put my concerns mostly to rest.
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I encourage you all to send these comments to the authors if you haven’t already done so. They said they wanted to hear feedback – let them have their wish!
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I agree that the drugs by themselves are not likely to cause a person to plot such detailed violence. What I believe these drugs do, based on reading research and also on many personal anecdotes that others who did not kill people have shared with me, is to reduce social inhibition against doing things like killing oneself or others. We all have impulses to do destructive things from time to time, which we almost always are able to redirect, because we have an internal sense of ethics, or we’re afraid of being embarrassed, or we fear social consequences like arrest and jail time. What I believe these things do, based on observation and research, is create a situation where the person is no longer concerned about these consequences and is willing to act on what they’re thinking about.
There are many stories of these drugs also inducing destructive impulses in those who didn’t experience them before, but again, most people are able to say, “OK, suicide is not the answer” or “I didn’t start feeling this hostile until I took the drugs – maybe I should stop.” But a person who is already kind of unstable appears to be able to do things that they might previously only have thought of – to “Cross the line,” as you put it.
It sounds like you have an axe to grind with Healy, which I do, too, based on his historical support for ECT, which I consider barbaric and incredibly destructive. However, this issue goes far beyond Healy’s opinions. There is good evidence in many places that this phenomenon is very real, and that people die as a result of this information being suppressed.
I hope you can get by the specifics of this particular case, where this SSRI phenomenon may or may not be involved, and look at the bigger picture.
—- Steve
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I agree with your comment, but I still think it’s awesome to see a psych journal editorial with this thrust. Change is in the air…
Point well taken regarding bipolar, however. We have to watch out for the change being simply changing targets!
—- Steve
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Just so you know, I’m a different Steve, not the author, but I wrote the quote about males being more genetically prone to “ADHD” symptoms.
I have no doubt that socialization plays a huge role in how boys and girls act. My point was only to say that just because someone acts differently, even if it is for sure based on genetic propensities, doesn’t mean they are “diseased.” I thought males and “ADHD” was the best example, because we have a huge disparity in behavior that is very likely rooted, at least to some degree, in the 7X higher testosterone levels experienced by males. So assuming that at least a part of the “hyperactivity” of boys is due to being male, how is that a disease? What if males are SUPPOSED to be more active and less tolerant of boredom? And what if a selection of females are also genetically programmed to be that way? So what? Does that make them DISEASED or DISORDERED, just because their behavior (assumed for the sake of argument to be genetically influenced) is inconvenient for teachers?
An interesting study was done in the 70s that illustrated this point very well. Demographically matched groups of “ADHD” diagnosed kids were put into two separate classrooms, one a standard classroom, and the other an open classroom setting where the kids had control over which station they went to and how long they stayed. They had professionals try to tell which kids had the diagnosis. In the regular classroom, the pros had an easy time picking out the ‘disorderd’ kids, but in the open classroom, they could not distinguish those diagnosed from their ‘normal’ peers.
You’d think that would have caused a revolution in how we treat “ADHD” kids, but of course, it did not. Few people are even aware of that study, but it really goes to show that a kid’s inherent “negative” propensities can be neutral or beneficial in a different environment. How can “ADHD” be a disease if you only see it in certain environments? Wouldn’t it make more sense to create an environment where those deficits become assets? But that only happens when we stop viewing “difference” as “disorder.”
Kids are all different. It’s OK for them to be different. It’s our job as adults to work with these differences to bring out kids’ strengths and help them work on areas where they need help. Drugs do none of those things, but they are convenient for those too lazy to want to spend the energy to work out what will actually work for the kids they have to deal with.
Hope that clarifies things!
—- Steve
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This is not an issue of whether or not Holmes’ actions were caused or accelerated by antidepressants. (He says in the article that he doesn’t know if it was a factor or not.) It’s about whether or not antidepressants can cause violence, and whether an investigation of violent acts should include this possibility as a factor. People are sometimes violent, whether on antidepressants or not. But there is plenty of evidence supporting the idea that people can become violent or more violent when taking antidepressants, and also plenty of evidence that these facts are being suppressed. That is true no matter whether the Holmes shooting was antidepressant-involved or not.
And I will point out that it is POSSIBLE that Holmes may have been taking antidepressants the whole time he was plotting. The point is, the question needs to be asked.
—- Steve
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I noticed that the problem he is addressing is the lack of investment in new pharmaceuticals for psychiatric conditions. I didn’t notice any concern whatsoever about the millions and millions of “patients” who have been labeled, railroaded, drugged and forgotten by the helpful psychiatrists who have been so married to their misconceptions. I’m glad he’s identified the DSM system as being problematic, in that it is based primarily on fantasy and social bias, and I’m glad he wants to look for the causes rather than just the symptoms. However, he’s still laboring under the unscientific assumption that whatever is “wrong” with us can be defined by neurological findings, without any reference to the cultural subtext of these decisions on what “normal” looks like. It seems like an effort doomed to failure. It’s amazing the level of commitment that exists for an effort that he admits to have been almost completely fruitless 50 years down the line.
—- Steve
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I agree with you, Jeffrey, but in essence, you’ve captured the basic philosophical flaw in these “scientists'” arguments. They are ASSUMING that mind=brain and discount any possibility that the mind is something more. I think there’s plenty of good evidence to suggest that the mind transcends the brain and body altogether, and some to suggest that the brain is simply the “control center” whereby the mind runs the body. But many people who are devoted to “scientism” (as a religion) as opposed to true science (as the pursuit of knowledge, being open to information that may negate your initial assumptions) are unwilling to admit that the mind is much more mysterious a thing than the brain can really explain.
Of course, even if the brain is all there is, they also are expecting us to subscribe to the idea that any deviation from “normal” is a de facto disease. Let’s take ADHD as a great example. I have no doubt that some kids are genetically programmed to be more active and less tolerant of boredom and repetition than others. (We know for sure that males are genetically more that way than females, based on the prevalence data on ADHD). But why is that a “disorder”? Why can’t it be viewed as simply a normal genetic variation, part of the survival needs of the species? These “ADHD” kids, if they grew up in a tribal society, would be extremely valuable in the aggregate – they tend to be very active, athletic, creative, willing to take risks – they are ideal hunters and would help assure the tribe has food for the winter. Just because we don’t allow them to hunt and expect them to sit for hours in a chair doing boring things, and find they rebel, does not mean there’s something wrong with them. I think it suggests something wrong with our expectations.
So I think we have to challenge the “scientism” adherents to defend their assumptions and we have to identify them as assumptions. Sure, they won’t like it, but if they are REAL scientists, they’ll be willing to put their theories to the test. Anyone dismissing objections out of hand is not a scientist at all.
—- Steve
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I guess for me, the idea of using psychotropics for an eating disorder doesn’t really seem to get to the basic issue. Is the person’s body image or set of beliefs about food really a simple matter of brain chemistry? Is the solution to create a situation where the client feels a strong sense of hunger, even if they still feel that their body is overweight?
It seems to me that anorexia/bulimia (and I do have some direct clinical experience working with these issues) are more a matter of using food to meet other needs, and most commonly, a need to feel in control. There is a really high overlap with childhood abuse and neglect, especially sexual abuse. And of course, it’s MUCH more common in women, who are taught by our media and other social messages that being fat is the same as being bad and worthless.
To try and handle this with chemical means seems to me even more misguided than for depression, anxiety or psychosis.
Jean, I’d be very interested in hearing your perspective on these observations – have you had the opportunity to work though the issues that contribute to the eating disorder behavior? Or do you view it as a medical problem that therapy can’t help with?
—- Steve
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The idea that mental problems are biochemical in nature robs us of any sense of personal agency, the idea that we have some level of control over how we feel, what we think, and what we do in the world. It is very interesting that in the 2008 study on schizophrenia that Bob quotes, the author finds that one of the key factors in common with people who recovered from schizophrenia in his study was, in fact, a sense of agency, of control over his/her world and in the possibility of self-generated improvement in his/her condition.
This is the one inadmissible point in the bio-psychiatric paradigm of care, and is interestingly the one most likely to lead to recovery. My experience in providing crisis counseling and brief therapy is completely consistent with this. The thing that helped most was 1) identifying what was troubling the person, 2) NORMALIZING the emotional reaction (letting them know that it was COMPLETELY UNDERSTANDABLE that they’d experience fear, anxiety, depression, anger, or whatever as a result of their experience), and 3) helping them find at least one small thing they could do that could make the situation even slightly better.
The biological paradigm does the opposite: 1) ignore any potential outside causes and focus only on the symptoms, 2) make sure the patient knows that the “symptoms” are both inexplicable and abnormal, and 3) inform the patient that there is not the least thing they could do to improve their situation, that they will be condemned for life to a broken brain, and only the magic pills of psychiatry can give them any hope of relief.
This is not just “another good point” – this is the CENTRAL PROBLEM with the biological paradigm. It’s not just that it’s subjective or untrue or leads to unnecessary drugging and danger (all of which are true); it’s because the biological explanation does EXACTLY THE OPPOSITE of what would be helpful. It undermines any thought or belief in the patients’ ability to regain control of their lives, which is the core of recovery.
Ron, you hit the nail on the head with this one.
—- Steve
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Not only are they not different from the Nazis, psychiatrists were central to the Nazi regime. They were 100% behind experiments on the mentally ill and the eugenics concepts that drove Hitler’s regime. In a sense, Hitler was a front man for a movement that psychiatry not only embraced, but actively forwarded and championed at the time.
Psychiatrists and Nazis have an awful lot in common, including some very disturbing common history.
—- Steve
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I love that idea – “Treatment resistant depression.” In what other profession can you completely fail to help, actually make things worse, and blame the condition you’re supposed to be helping for your failure? What a great deal! What would we say to the mechanic who charged us $500 for not fixing our fuel injection system, and when we asked why the car didn’t work any better, were told that we had “repair resistant fuel injectors?”
What a racket it is! Belinda, I am so sorry you didn’t have the support you needed to recover, and I admire you for the incredible strength and courage you have shown in getting away despite the lack of support. That they would BAN you from receiving any kind of support just because you didn’t do what they wanted is quite beyond the pale. I am so happy for you that you’ve found a different way forward. Remember that there are lots of us out here who believe in you and you can find us if you look. It’s so tough to get over childhood abuse – I work with abuse victims every day and I know from experience! But it can be done, and you sound like a very tough survivor and I am sure you will make it.
Thanks for sharing your story!
— Steve
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It has always astounded me that a person could be receiving “treatment” for so long, be clearly deteriorating, and yet have the “professionals” continue to be somehow fully convinced that the “treatment” was helpful in some mysterious way. I’ve heard someone say, “She’s like this on the meds – think of what she’d look like OFF them!” But I’ve seen dozens of situations, maybe in the hundreds, where the person was no worse off and often far better off when they stopped.
If we went to a doctor with a sore knee, and a month or two later, despite treatment, the knee still hurt, was now swollen, back pain had developed, we’re now using crutches, have severe headaches, and are seriously depressed, even the most credulous among us would quickly conclude that THIS TREATMENT IS NOT WORKING! And yet somehow, psychiatric treatment is allowed to fail without blame. Anything good that happens is because of the drug. Anything bad that happens is because of the “disease.”
Laura, it was such a pleasure to meet you in Philadelphia and hear you speak, and I so appreciate you sharing your story. I totally agree with you and Emily’s Indian holy man – “There is nothing wrong with you.” There’s a lot wrong with a system that identifies any distress as being a disease. But even within the confines of its own warped belief system, shouldn’t psychiatry be able to acknowledge when a treatment isn’t helping? Apparently, such a thing never happens.
Thanks to you for sharing and to Bob’s book for helping make that possible!
—- Steve
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If physical abuse doubles the probability of these “disorders” arising, what does that say about the supposedly “biological” nature of ADHD or Bipolar disorder. All the NAMI/CHADD/NIMH literature repeats over and over that “bad parenting does not cause ADHD.” Well, apparently it can, and “Bipolar” as well. Could it perhaps be because “ADHD” and “Bipolar” and all of these labels are simply descriptions of sets of behavioral symptoms that could be caused by just about anything?
I agree, children aren’t bipolar. I don’t think adults are, either. These labels are absolute nonsense!
—- Steve
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I totally agree! Real science not only allows but insists on alternative viewpoints and explanations – it’s part of the process of sifting out the truth. And even greedy and ill-intended people change their behavior when the incentives are changed, because after all, they’re out for their own benefit. So make sure they don’t benefit from doing wrong, and we’ll see a lot less people doing the wrong things.
—- Steve
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Most people don’t do bad things knowingly, but unfortunately, a small minority of people knowingly do bad things on purpose, usually because they can make money or gain power by doing so, sometimes just because they seem to get satisfaction from being deceptive. I would term these people criminals, but many of them never go to jail, because their crimes are actually legal.
We should not assume that Gibbon or anybody else has good intentions. He may, in fact, know all the facts and be strategically working to keep them a secret. There are written memos from drug company personnel that have been released, clearly stating that their objective is to “manage the drug’s image” by minimizing the dangers or presenting alternative explanations they know to be untrue. This is very different from believing in a false theory because of insufficient or incorrect information being provided. This comes down to intentionally providing false or misleading information in order to promote a believe known to be false and potentially very dangerous.
Evil intentions do exist, and they exist, in my opinion, in much larger than average numbers in the psychiatric profession, as well as in the pharmaceutical corporations who supply them with their products. One reason the psycho-pharmaceutical industry has been able to succeed so thoroughly is because no one wants to believe doctors will knowingly act in ways that will hurt their own patients. While in most cases this is true, and the doctors are acting on what they’ve been told by someone they consider a “higher authority,” a goodly percentage of those “higher authorities” know very well that they are advocating for harmful interventions in order to maintain control of their market share. Unless we understand and accept this reality, and make it well known, I believe it’s going to be very difficult to move forward with real alternative thinking.
Some people ARE evilly motivated.
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Perhaps it’s the triumph of marketing OVER science. We’re way beyond “misunderstandings” and into the realm of overt corruption.
No one can really claim they don’t know any better today. He does know better and is trying to refute what he knows to be true, just as tobacco companies knew cigarettes caused cancer but did all they could to prevent this truth from becoming commonly accepted.
This guy is clearly out to promote a viewpoint, and the truth is simply not relevant as long as he gets paid.
— Steve
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I do find this kind of startling – I am hoping a sign of a change of attitude as the hard facts about DSM diagnosis and poor long-term outcomes for those exposed to drugs even makes the mainstream media. Could this be a sign that psychiatry’s stranglehold on the mental health world is beginning to loosen?
—- Steve
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Maybe the fact that African-Americans are “undertreated” for depression is exactly the reason that they have lower levels of depression overall! Less treatment = less drugs = less chronic depression.
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It is a confusing term as they use it, but when I read the article, they seem to be talking about criticism and intense reactions to negative behavior, not verbal or non-verbal expression of emotion. “Emotional reactivity” might be a better term to describe it. Basically, it sounds like they are saying that hostility and criticism lead to more emotional problems, which should surprise nobody. Maybe they’ll argue that being criticized “imbalances your brain chemistry” to get around this one.
Pretty obvious stuff, but I guess I’m glad someone is saying it.
—- Steve
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I agree – the most fundamental problem is the standard. If you’re looking for a reduction in symptoms according to some checklist created by clinicians with no input from the recipients of the “treatment” about what is important to them, you can delude yourself into thinking you’re being successful, because the person is temporarily “less depressed” or “less psychotic” than they were. The fact that the person is physiologically, psychologically or spiritually suffering, has a shaking hand, can’t sit still, wants to vomit, still hears aggressive voices but just less loudly than before, can’t hold down a job, is unable to engage in meaningful relationships – not one of those factors I mentioned is even vaguely considered important by the “symptom management” approach.
We need to start by resetting the goal – it can’t be about “symptoms”, it must be about improving life outcomes as defined BY THE PERSON SEEKING TREATMENT! And that includes accepting that the person may not seek treatment and be OK having his/her symptoms and working out a plan on his/her own to manage. Until we look at the person’s own intentions and values as the ultimate goal for intervention, arguing about whether a 5- or 10-point reduction on Dr. X’s scale of anxiety/depression/ psychosis will continue to waste everyone’s time.
Thanks to Dr. Steingard for acknowledging the realities of the situation. As for the intuition question, I agree that intuition is part of any problem-solving approach, and leaving it out is part of the problem. However, it’s also very easy to mistake bias for intuition. The way to counteract that is to check out each and every intuition ruthlessly against both an internal bias checklist and by external measures and values that are effective in questioning your basic assumptions. A real scientist is always skeptical, and the more skeptical the more certain they feel they are right. Intuition only becomes effective when you’re brutally honest with yourself about your own biases, something psychiatry has not even begun to entertain as a profession.
My intuition says, don’t trust anyone who says they can fix your mental problems with a pill. I think most people’s intuition would agree, including a lot of doctors, but we’ve been systematically instructed to ignore that basic knowledge. If that intuition is allowed to surface, most of the field of psychiatry would quickly dissolve out of existence, because it is based on fundamentally flawed logic that the average elementary age child finds offensive. (If you doubt me, you should ask a few non-brainwashed 8-year-olds about it.) I am not hopeful that psychiatry will ever be able to examine itself in that way.
—- Steve
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I heard they settled today.
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I think she’s also commenting on the negative message that the “chemical imbalance” talk has on kids: it says “your emotions are meaningless. You’re a bunch of chemical reactions, and nothing you say or do can impact those reactions. You don’t control your emotions and they are unrelated to your life.” I suppose the other message is that emotions are annoyances that prevent us from doing what we’re supposed to do. In reality, emotions are survival mechanisms that we all need in order to navigate our world. In many ways, emotions are what drive us to survive and thrive in the world. Trying to delete those that are inconvenient sends kids a very odd message, indeed.
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Another psychiatric success story!
— Steve
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Your daughter’s story sounds horrible! I work with foster kids all the time and see things like this every day, unfortunately. Does your daughter have a CASA/GAL volunteer? They are not always in alignment with what we’re talking about here, but they can be amazingly effective in amplifying the child’s voice. She should also have an attorney who is fighting for what SHE says she wants, and if she doesn’t want drugs, she can tell her attorney that and the attorney should fight for her. If the attorney doesn’t, she should fire them and get a new one who does his/her job.
It is too true – when we don’t value kids, we don’t value people, and our society goes down the tubes quickly.
—- Steve
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I work with foster kids and see this all the time. SSRIs and/or stimulants evoke aggressive incidents, which are interpreted as “bipolar disorder” and lead to atypical antipsychotic “treatment” of their own drugs’ side effects. Which are never acknowledged as such, of course.
I’m so sorry you had to go through that – well done for hanging in there and helping fight for sanity for others in a similar situation. Sometimes being really, really pissed is a NORMAL reaction to a very abnormal situation. And sometimes it’s a reaction to the drugs they give you to try and shut you up.
—- Steve
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This has to be the silliest and most unsupportable diagnosis in the DSM. This, I must say, is a very high bar to overtake, as it’s filled with silly and unsupportable diagnoses (like Oppositional Defiant Disorder, diagnosed when a child is, surprisingly, oppositional and defiant. Pretty creative, eh?) But IED certainly tops all. The whole basis of this disorder is that the person sometimes gets really pissed off, hence, they “explode.” There are, of course, listings of manifestations of adult temper tantrums to make it all look “scientific,” but basically, they’re diagnosing anger outbursts and calling it a “disorder.” No attempt to understand context, of course. Nothing to distinguish one’s righteous indignation from another’s selfish and intimidating rant. No attempt to ferret out what other issues may be contributing to the “explosions.” If you get pissed off a lot, you have it.
We used to have a different name for people who get hostile and intimidating for no reason. We called them “assholes.” I personally prefer the traditional term, as I find it far more descriptive.
— Steve
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Whatever you think of his personal choices (which were pretty disgusting to me), Spitzer and his office did lead the charge and set the stage not only for a lot of states questioning and suing big drug companies for their lies, but also for the news media finally providing coverage that counters the propaganda about the “Brave New World” of psych meds. It’s possible a person can do good things and also do evil things in another context.
I’m also glad the attorney who sparked the efforts got appropriate credit for her inspiration and hard work.
—- Steve
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The MYMOP was new to me and sounds of interest, as it could be used for clients to determine what outcomes they’re interested in and track on them. Otherwise, the screening tools you mention seem to continue the effort to label and categorize people according to “symptoms” rather than engaging the client in the process of self-discovery that leads to real healing. Your comments on Bipolar Disorder I found particularly disturbing, in that, in my direct clinical experience, huge percentages of people so diagnosed are either 1) suffering from trauma that results in “mood swings” and “psychotic symptoms” based on triggers, nightmares, and flashbacks they may be having throughout the day, or 2) suffering from the side effects of such “helpful” drugs as SSRI/SNRI antidepressants or stimulants. That’s not counting the ones who get the diagnosis secondary to recreational drug use.
Of course, the whole concept of “Bipolar Disorder” is an invention with no scientific grounding and incredibly vague descriptions and boundaries, such that many very normal people could be described that way if one believed in looking for this “disorder.” Not to say that some people don’t meet the description rather well – it’s that the description itself is scientifically meaningless, as are pretty much all the DSM categories.
You seem to be promoting an alternative “treatment” for the same “disorders” that psychiatry has already defined for us. While herbal approaches are generally less harmful than drugs, I think you’re doing a disservice to your clients and to the profession by buying into the deceptive and greed-motivated DSM diagnostic process. I strongly suggest you work toward creating a more client-friendly and empowering paradigm that is more consistent with the general holistic philosophy that I understand to underlie naturopathic medicine.
— Steve
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Yes, it would be very interesting to run a comparison of drug-exposed vs. drug-naive schizophrenia-diagnosed people for cognitive impairment. I thought it amusingly ironic that they found that none of the drugs have been FDA approved for this “indication,” where there’s good reason to suspect that the drugs themselves cause the impairment.
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I work in the child welfare field, and I find doctors, including psychiatrists, recommending and prescribing antidepressants for common, situational depression all the time. I’ve seen them prescribed for normal grief and loss, for women in ongoing domestic abuse situations, for the aftermath of a rape of a 17-year-old developmentally delayed girl (she was diagnosed “bipolar” because of her “mood swings” following disclosing the incident), and many, many times for foster kids who have every reason to be depressed, anxious and angry about the way their lives have treated them.
I do agree that medical doctors are a huge part of the problem, but psychiatry has led the way by proposing and insisting on inane and subjective definitions of new “disorders,” by providing convenient “explanations” like “chemical imbalances” when they know these things not to be true, and by ignoring strong evidence of other effective approaches to assisting people with the moral, situational and spiritual crises that they encounter in the course of a normal or not-so-normal life.
That being said, I agree with your basic premise: modern life is inherently stressful, and a depressed reaction to it is very understandable. When we reach a point where over half of the members of a group manifest a certain response, it’s time to stop defining it as abnormal and to start looking at the structures that they are reacting to.
Take school as an example: it is axiomatic that the large majority of kids find the academic part of school dull, irrelevant, frightening, or depressing. If you doubt me, ask a hundred kids how they enjoy school. I’d bet 90 would say they’d avoid it if they possibly could (other than their enjoyment of their friends, and possibly a specific subject, usually PE, art or music classes). So are all of those kids mentally deranged? Or do we need to look at how we educate kids and stop forcing them to do things that are dull, irrelevant, frightening or depressing?
War, global warming, rampant consumerism, racism, sexism, dead-end jobs, poverty, domestic abuse – these are huge social issues that are overwhelming and depressing for most of us to confront. I don’t think there’s anything abnormal about feeling depressed or anxious or angry looking at the world we live in. Thanks for reminding us that “mental illness” as defined by the DSM can just as easily reside in the culture we’re a part of as in the individual responding to that culture.
—- Steve
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It’s not just that they’re looking for sensational articles to publish. They also choose to emphasize “negative” findings for non-drug interventions, and “positive” findings for drug interventions. Why didn’t it make big news when the outcomes on the MTA study on ADHD and medications showed that stimulants don’t work or may make things worse after two-three years? It sure did make news when the drugs beat the alternatives at 14 months! Somehow, it’s big news that one study says that exercise supposedly doesn’t help depression, but not big news that drugs don’t help ADHD in the long term. Talk about publication bias!
—- Steve
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I would add that failure to comply with medical advice should NEVER be a cause for forced admission, and this threat needs to be 100% removed. Even if there is a “harm to self or others” clause, it should have to be invoked each and every time a person is considered for an involuntary hold. Failing to comply with a “release agreement” to take drugs is often used as a pretext for re-hospitalization or is held over patients’ heads as a threat for noncompliance. No enforced treatment is best, but this is essential if we can’t get to the ideal.
The other aspect of informed consent is an honest reporting of alternatives. This should include a wide range of medical and non-medical services, including a Soteria-like option, talk therapy, Open Dialog, homeopathy, naturopathy, nutritional advice, meditation, spiritual counseling – anything that has been shown to be potentially helpful. These options also need to be made available to sufferers through realistic funding mechanisms, because simply mentioning options the client can’t use isn’t very helpful, either. But at this point, no other options besides medication and “case management” (a big part of which is policing medication compliance) is ever even mentioned in most acute care settings.
We have a LONG way to go to meet this UN standard!
—- Steve
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Oh, but they are good for EVERYTHING! Maybe they should just be called “feel good pills.” Although from what I’ve heard, “Feel less pills” is nearer to the mark. As Robin Williams once quipped, a great “antidepressant” name would be “Fuckitall!”
It does not even slightly surprise me that this was observed, as I’ve seen it often myself (and I think it’s even in the warnings on the package inserts). What amazes me is that the clinicians still try to attribute it to other causes (like “subtle bipolar disorder”) rather than just admitting that the pills can make people worse.
—- Steve
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This is awesome!
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Really? They had to do a study to figure this out?
—- Steve
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It does sound suspicious, in that he had not engaged in this kind of behavior previously, and in that his behavior was quite blatant and erratic, as if he had no concerns about being observed or caught. There is no question that Zoloft can interfere with someone’s ability to empathize with others, and in some situations, can create frank manic episodes. Combine this with drinking, and it seems very conceivable that this could happen. I do have to say, though, that he is culpable for drinking while using Zoloft, as it does tell you not to do that on the label, as far as I understand.
—– Steve
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I am all about considering ADHD as a developmental phenomenon. A recent study showed that kids who entered Kindergarten early were something like 30% more likely to be diagnosed with ADHD. That’s not even getting into developmental trauma. But there are also many other potential reasons for the described list of behaviors.
Which is why I doubt anybody will ever come up with evidence that the “ADHD” brain is somehow defective. It is going to be different for each child. We all know that both genetics and environment affect brain chemistry and behavior, but we also know there are many reasons why a kid may act in the manner described as “ADHD,” including the simple concept that it’s a genetic variation that is important to species survival.
So it would make no sense that “ADHD” kids would respond differently to stimulants than “normal” kids, because “ADHD” kids aren’t a homogeneous group. Some have been traumatized, some have low iron, some have sleep apnea, some were entered into Kindergarten too young, some are “active learners” in an inactive environment, some are smart and bored to death with their insipid “education,” and some just don’t like sitting still and being told what to do. ADHD is not a disease phenomenon. “ADHD” kids are simply kids seeking more stimulation. If we really want to help them, we need to either figure out why they need this, or arrange an environment that provides it. The latter worked great for my two “ADHD”-type boys. They turned out fine, drug free, but we sure didn’t put them into a regular education classroom in Kindergarten!
It’s all about development – helping kids build on the strengths they have to overcome the challenges they face. No drug has yet been shown to help with that process.
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David (Bates), I am pretty familiar with the literature on ADHD and see nothing that suggests these agents act any differently on ADHD vs. non-ADHD kids. Why would they?
— Steve
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Judith Rappoport et al thoroughly discredited the “paradoxical effect” theory way back in 1978. She gave stimulants to “normal” kids and saw the same effects as we see in “ADHD” kids: narrowing of focus, increased willingness to continue with activities normally found dull, reduced motor activity, etc. She called the idea that they worked differently an “artifact of observation” – in essence, we are LOOKING for these effects in those diagnosed “ADHD” and so we notice them when they happen.
Of course, the idea that “ADHD” kids don’t experience side effects is ludicrous on the face of it. There is no question that they suffer in great numbers from loss of appetite, sleep disruption, and reduction in growth. Less common side effects include increased anxiety or depression, agitation, aggression, “manic” episodes, psychotic symptoms (as high as 6+% in one study in the Canadian Journal of Psychiatry), increased heart rate and blood pressure, and many more. In that last case, actual harm to the heart muscle has been noted, and in rare cases, death has occurred that has been medically determined to be caused by long-term stimulant use.
Combine that with the clear data that there is no long-term positive impact on any important outcomes, despite 50 years of research, and it really is time to question why we promote this questionable practice. Oh, I forgot – we do know why. It keeps kids quiet and makes money for doctors and pharmaceutical companies. There is no other reason.
—- Steve
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This is TREMENDOUSLY common in trauma victims! I can’t tell you how many PTSD sufferers (mostly female) I’ve seen diagnosed with Bipolar. It’s a huge issue!
— Steve
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It sounds to me like the brain is able to recognize a neurotoxin when it sees one, and tries to remove it from the synapse as much as possible until it can’t do so anymore. It’s a great argument for not using antipsychotics, because the brain is clearly smart enough to know they are not good for it.
—- Steve
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